Report Release – Supporting Aging in Place in New Jersey: A SWOT Analysis of Assisted Living Programs
by Ayse Akincigil, Uri Amir Koren, Jasmine Akman, Dima Bischoff-Hashem, Karen Zurlo
New Jersey has an innovative Assisted Living Program (ALP) designed exclusively for seniors living in subsidized public housing. ALPs help older adults remain in their communities when they experience cognitive and physical decline over time, by providing hands-on assistance with personal care, medications, nursing, and social services, with the objective of preventing or delaying placement in a nursing home. This report describes how ALPs function and details how state policies shape operational processes. Unlike conventional Assisted Living Facilities (ALFs), this model decouples the housing from the services. Given the unique structure of this program, a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis was conducted providing a structured evaluation of the model’s effectiveness, scalability, and sustainability within the broader landscape of aging policy and practice in New Jersey.
The foundations of ALP care are patient centered. With emphasis on aging at home, the model focuses on a holistic, family, and community centered approach to maintain clients’ individuality and independence. ALPs operate with customized care plans for each patient, without requiring uniform care packages, prioritizing client autonomy, fostering the patient’s self-worth, and customizing services based on individual needs.
ALPs function by building relationships with subsidized housing administrators, operating in a dedicated “on-site” ALP office within the housing property. The on-site support can be anywhere from 12 to 24 hours per day, depending on the needs of the client census, with access to a nurse 24 hours a day. The services provided by ALPs enable the clients to remain in their communities as long as their needs can be met in a supported community setting, rather than being transferred to a nursing home. In return, ALPs are reimbursed per person per day (PPPD) through NJ Medicaid’s Managed Long Term Services and Supports program.
Our key findings indicate that the model faces significant regulatory, labor market, and financial challenges. These challenges prevented the ALPs from growing in the past decade, resulting in many older low-income New Jerseyans remaining underserved. There are currently less than 25 properties with income and age restrictions served by ALPs. Based on the opportunities we identified, over 300 additional properties in New Jersey could be served by a financially sustainable ALP. Despite all the challenges, ALPs have many strengths that make them a worthwhile investment.