Karen McPhail, RN, MSN
What are Auxiliary Grants?
Obtaining an Auxillary Grant (AG) bed for assisted living can be like winning the lottery for many families and individuals in need! However, the process is often unclear and many people do not even realize that this is available, who can qualify for this, or which care communities accept Auxillary Grant payments.
An AG is an income supplement for individuals who receive Supplemental Security Income (SSI) and for those with blindness, certain other age related care needs and disabilities who reside in a licensed assisted living facility (ALF), an approved adult foster care (AFC) home, or an approved supportive housing setting.
The Auxiliary Grant provides monthly assistance directly to the individual for the specific purpose of paying for their assisted living or adult foster care fees. It is important to understand that this is different from Medicaid! AG assistance should be distinguished from Medicaid assistance. Medicaid cannot be used by law to pay for room and board in assisted living, only for care services.
The following services are offered for assisted living and adult foster care:
A Furnished room
Meals and snacks - including specialize diets
Laundry services and housekeeping
Assistance with activities of daily living - bathing, dressing, grooming, toileting.
Medication administration, reminders, oversight
Some personal toiletries - soap and toilet paper
Assistance with arranging medical appointments
Purchase of personal items
Social engagement and recreational activities
Local Telephone service
It is important to note that not all Assisted living communities accept AG payments.
An AG payment is issued to an individual monthly, and is used with a designated amount of their monthly income to pay the maximum monthly AG rate. The AG rate is adjusted periodically and is determined by the Virginia General Assembly. The AG Program is funded 80 percent by the state and 20 percent locally. So who is eligible for AG?
To determine eligibility for an AG or to obtain the current AG maximum rate, one needs to contact the local department of social services in the city or county in which the individual lives. See link for assistance: https://www.dss.virginia.gov/localagency/index.cgi
Prior to admission to an Assisted Living community, an individual must be assessed by by a qualified assessor. Qualified assessors are employees of local departments of social services, local health departments, area agencies on aging, centers for independent living, and community services boards who have received specific training on conducting these types of assessments. The individual applying for an AG, or the individual’s designated representative, should contact an assessor to request the assessment.
AG applicants must complete an Application for Benefits and submit it to an eligibility worker at the local department of social services in the city or county where the individual lives or lived prior to entering an institution such as an assisted living, skilled nursing home or hospital.
The eligibility worker will evaluate the individual’s financial eligibility for AG. The worker has 45 days to process the application. See link for application: https://www.dss.virginia.gov/files/division/dfs/as/auxillary_grants/intro_page/forms/032-03-0824-33-eng.pdf
AG recipients receive a personal needs allowance (PNA) for a valet of times. These items may include - essentials such as clothing, medical co-payments, snacks, drinks, over-the-counter medications, dental care, eyeglasses, and activities or items an Assisted Living (ALF) or Adult Family Care (AFC) provider is not required to provide.
Helpful Tips When Applying for AG
To successfully comply with application procedures there are several tips that should be considered when making an application with the local department of social services.
1. If you are aged, blind or disabled and low income, please apply for Social Security Income (SSI) with the Social Security Administration. This process can take up to three months or more for approval. This will be a requirement if you have never filed. If you were receiving SSI and was in a detention center or in a nursing home, your payments may have stopped or have been reduced. Notify Social Security update on your status immediately. Inform them that your circumstances have changed and that you plan to enter into an Assisted Living Facility.
2. Prior to application make sure that the individual applying has had a Uniform Assessment Instrument (UAI) scheduled. This process can take anywhere from 30 days to two months because of the demand of the screenings. If you had a screening done, make sure it is not 90 days old.
3. Make sure you submit the application in the right locality. The locality would be where the individual last lived prior to going into an Assisted Living Facility or Adult Foster Care Home.
4. Make sure you have the right application. An Auxiliary Grant application is called an “Application for Benefits”. This is not a Medicaid application.
5. Submit the application to the eligibility unit of the local department of social services.
6. be organized and efficient. Ensure that you have all documentation gathered as required for submission to the local department of social services. They will need proof of income, bank accounts, personal assets, including cars, property, land, along with proof of identity, citizenship and social security number. A checklist will be provided during the application process.
7. Understand that initially when one is entering into a facility they are considered to be 100 percent private pay until your Auxiliary Grant application is approved. The local department has 45 days to process your application and can be sooner if you have provided the information listed above.
8. While waiting on the application approval begin looking for facilities that take Auxiliary Grant payments. There is a limited number of beds so you may have to be flexible in terms of facilities.
9. An Auxiliary Grant facility list is posted monthly in the link provided on the Auxiliary Grant page: https://www.dss.virginia.gov/files/division/licensing/alf/intro_page/current_providers/resources/agfacilities.pdf
10. Complete the steps in timely manner as again openings are limited and can fill quickly.
Reachout to a care manager today if you need guidance on this process or help in finding a care community that potential y has an opening for auxiliary grant!