Alaska Pioneer Homes is a system of assisted living residences established in 1913 by the state legislature. The concept of state-owned and operated assisted living residences is unique among the 50 U.S. states and is beneficial to state residents, including those with Alzheimer’s Disease, in several ways. First, the cost of room, board, and care provided in these residences is less expensive than privately owned assisted living communities in the same geographic areas of Alaska. Second, financial assistance is available for those who cannot afford the already below-market monthly fees. Third, the care philosophy and amenities provided at these residences usually exceeds the level provided at privately owned residences. In fact, many Pioneer Homes adhere to highly respected Eden Alternative philosophy.
Currently there are six Alaska Pioneer Homes located throughout the state in Fairbanks, Palmer, Anchorage, Sitka, Juneau, and Ketchikan. These homes are under the administration of the Alaska Department of Health and Social Services, Division of Alaska Pioneer Homes.
Pioneer Homes are open to any Alaska resident who is 65 years of age or older and has physically resided within the state for a minimum of twelve consecutive months prior to applying. (Beginning in July 2020, the age requirement will change to 60+ years old). Functionally, applicants must be unable to maintain their own home without regular assistance for meal preparation, shopping, dressing, or personal hygiene due to a physical or medical impairment, disability, or infirmity. Additionally, applicants must have, or have applied for, Medicare Parts A, B, and D and agree to pay the established monthly fees.
Eligibility for financial assistance is more complicated. In addition to the above requirements, candidates must provide documentation proving their (and their spouse’s) monthly income and countable assets, such as bank accounts, stocks, and bonds. Their financial situation is assessed and they are permitted to maintain a certain level of income and assets. (As of 2020, program participants are able to retain up to $10,000 in assets if they are single or their spouse lives in a care facility. If an applicant has a spouse living at home, the couple is allowed to keep up to $98,000 in assets. However, this is complicated and some resources are considered exempt. Note that applicants who have $5,000 or less in assets are able to retain $200 / month in income as a personal needs allowance. However, this amount will increase to $300 / month in July 2020) Everything in excess of those levels must go towards paying for health insurance premiums, medication expenses, and the Pioneer Home’s monthly fees. To be clear, there is no income limit or minimum income requirement to be eligible.
Applicants seeking financial assistance from Pioneer Homes must apply for Medicaid and if found eligible for Medicaid, may receive medical assistance from Medicaid. A payment assistance application can be found here. One can find additional information about the payment assistance program here.
Pioneer Homes offer a variety of services to residents, including meal preparation, assistance with the Activities of Daily Living (bathing, eating, dressing, personal hygiene, etc.) medication administration, health assessments, social work services, recreational activities, and supervision for those with Alzheimer’s or related dementias. Services and activities may also include laundry, housecleaning, emergency call systems, and church services. As these homes are assisted living facilities, they do not provide skilled nursing services.
Within Pioneer Homes, there are five distinct levels of care, which determine the resident’s monthly fees. An assessment is done for eligible applicants to determine which level of care is needed. “Level I” services include meals, housing, emergency assistance, activities, events, and recreation. “Level II” services include Level I services in addition to medication administration, health related services, and assistance with activities of daily living, as well as supervision. Make note, with “Level II” services, nighttime assistance is not provided. “Level III” services include all of the services under Levels I and II, in addition to around the clock assistance and behavior management or nursing services. Level IV services include all of the services included under the first three levels of care, plus extensive hands-on staff assistance. Level V encompasses all of the services available in the lower levels of service plus more extensive care as needed.
As of September 2019, Level I services cost $3,626 per month, Level II services cost $6,569 per month, and Level III services cost $11,185 per month, Level IV services cost $13,333 per month, and Level V services cost $15,000 per month. (The fees above include the cost of room and board). That said, the rates for services, plus room and board, will decrease in July of 2020. At this time, Level 1 will cost $2,976 per month, Level II will cost $5,396 per month, Level III will cost $7,814 per month, and Level IV will be $9,333 per month. At the time of this writing, the new rate for services for Level V services was undetermined.
As mentioned previously, significant financial assistance is available to state residents with limited income and assets. Each resident’s financial situation is re-assessed annually.
Despite the fact that the six Pioneer Homes can accommodate 498 individuals, at the time of this writing, waiting lists for all six homes do exist. However, applicants are not limited to just one of the home’s wait list. Those persons who are interested, but do not wish to be considered for immediate entry, should apply for the inactive wait list. (To be put on the inactive wait list, one does not have to functionally require care assistance.) Those prepared to enter the program within thirty days should apply for the active wait list. Applicants are free to change their application from inactive to active, but those that decline admission, choosing to move from the active to inactive wait list, are required to remain on the inactive list for 180 days before transferring back to the active wait list.
An application can be downloaded from the Alaska Department of Health and Social Services website or is available at each of the Pioneer Homes. One can also call 907-465-4416 to obtain an application. Completed applications may be turned in at any of the six Pioneer Homes or returned to the Division of Pioneer Homes Central Office in Juneau. For additional information about Alaska Pioneer Homes, click here.