Evo Terra (Host): Welcome to the Health Headlines podcast series from Capital Health. I'm Evo Terra, and joining me today is Lynn Osborne, Director of the Capital Health Assisted Living Program. We'll be discussing the Capital Health Assisted Living Program, a vital service designed to support seniors residing in publicly subsidized housing in Mercer County. Welcome to the program, Lynn.

Lynn Osborne: Thank you for welcoming me.

Host: So, let's talk about some of the challenges that our seniors face, especially those in assisted living, because that's different than other sorts of challenges they may think. So, what do you see most often as the challenges for seniors in assisted living programs?

Lynn Osborne: Well, an assisted living program, it's a different type of model than traditional assisted living. We specifically focus on low-to-moderate income senior residing in publicly subsidized housing. It's the people that wouldn't be able to afford to move into the fancy assisted living. They don't have much to spend down, but they still come up against obstacles in getting qualified for Medicaid. They can have as little as $2,000 and not qualify, so that would mean that they wouldn't be able to have our service.

Host: Yeah. Yeah. So, that's a massive challenge. And let's focus on the health aspect there. So, if they don't qualify, how do they stay on top of their health needs?

Lynn Osborne: Well, fortunately, because our program is under the umbrella of Capital Health, which is a not-for-profit, we have some leeway. We have, I would say, discounted rates or sliding scale rates for people. So, they may not be able to afford the discounted daily rate for people who would pay privately of $50 a day. So, the hospital allows me some flexibility. We try to do all their services on one day, where they don't need medication administration daily, but they need help with showering or cleaning their apartment or doing their laundry. So, we would do all those things on one day, and then they would have to pay $50 for the week.

So, that's how me personally and the hospital supports me doing that. I try to make sure that, if somebody needs supervision, but they can't afford it and they don't qualify for Medicaid or the PACE program, that there's still someone coming in to assist them at least weekly. In assisted living model, we have agreements with housing providers. And in our case, which is unique, we have agreements with three housing providers that have six apartment buildings for the seniors.

Host: Got it. So, you are going out to those six different apartment buildings and working directly with the seniors that live there, yes?

Lynn Osborne: So, we have two main wellness offices, where our staff is based out of. And then, from those office locations, we provide services for the tenants of those buildings. And then, we go out to the locations where we don't have offices.

Host: So, let's talk about the staff for a moment, because I'm imagining you doing all of this. But now, that I understand there are lots of other offices, you are not the only one doing this. So, who makes this program run other than yourself and what kind of training do they need to be a part of your staff?

Lynn Osborne: We have two RNs. One is a nurse practitioner and then we have an evening supervisor who's also an RN. There's a total of 12 of us that provide services, but there's home health aides certified, certified medication aids, RNs and myself. I also happen to be an LPN, but I'm a certified assisted living administrator too.

Host: You talked earlier about the discounted rates that they get. Someone's got to pay for that. So, how is this program funded?

Lynn Osborne: We're funded through Medicaid and through the PACE program, which become essentially their Medicaid, Medicaid provider through the federal funding that they get. They can pay privately, like I mentioned. But I've also applied for grants to help seniors that don't qualify for funding from the government.

Host: You've talked about qualification, and I think you may have answered this, but I want to be specific and make sure I get it for the listener. So, how do seniors qualify specifically for your assisted living program?

Lynn Osborne: So once they are deemed eligible for Medicaid, we accept Medicaid-- Medicare does not fund our services at all. Once they're qualified for Medicaid, Medicaid has a managed long-term services and support component. And that is what pays for Medicaid recipients to receive our services in their home. The seniors need to be in need of nursing home-like services long-term care. So once they go through that component and they have been accepted into Medicaid with the MLTSS waiver, then we do an assessment to deem whether or not we can meet their needs because there are people that would exceed what we can do for them in the home levels of care. So if they need a two-person transfer from their bed to get out of bed, if they have wounds that can't be managed at home successfully. If they are just resistant to being compliant with their medications and we've done all that we can do, those are people that we would have to recommend seek other assistance and possibly long-term care.

We've had successes on the other end of the spectrum where people have been in long-term care for 11 years or were unhoused. And because the housing provider had our services in place in their building, these people could get an apartment, and then we could provide services to them. So, we've had success with that. We had one gentleman that had been in a nursing home for 11 years, because he didn't have a home and he was able to get an apartment and have us take care of him at home. Another gentleman was in a nursing home for quite some time and he came. And we just received a letter from his family member thanking us because he had five years at home that he wouldn't have been able to have. We have an unhoused gentleman that the county contacted us about and was able to get him into one of the buildings where we provide service and he's still living on his own with our support.

Host: That has to be one of the best feelings in the world.

Lynn Osborne: That's why we all do this. I tell my staff all the time, we may not be millionaires financially, but the work that we're doing is making a vast difference in many people's lives. And we're like the secret weapon. Nobody really knows about us, because we're a small department and we're out in the community. And although New Jersey is the state that started the assisted living program, the state often forgets about us too. Because there's only 16 total assisted living programs in the state right now. There should be many, many more.

Host: Yeah. There should be. Well, and why I'm very glad you're doing the work that you are doing. Thanks very much for being with me here today, Lynn.

Lynn Osborne: Thank you.

Host: And thank you for listening to this episode of the Health Headlines podcast series from Capital Health. I have been your host, Evo Terra. If you or someone you know would like more information about the Capital Health Assisted Living Program, visit the website at capitalhealth.org/assistedliving-- all one word-- or call 609-599-5161.

If you enjoyed this episode, please share it on your social channels, and I encourage you to check out the entire collection of our episodes to find topics of interest to you. Thanks for listening.