*Originally published in the Boulder Daily Camera as an Op-Ed and subsequently published in the Denver Post.
Photo credit: Boulder Daily Camera
On January 4, 2023, Boulder’s Golden West informed residents and their families that the Mezzanine, the facility’s assisted living program which has provided residential services to seniors and people with disabilities since its opening in 1988, will be closing in early March.
This move will leave Golden West’s 33 assisted living residents scrambling to find a new place to live, and many will no doubt be forced to leave a community they have called home. The Mezzanine was the last remaining assisted living program in the city of Boulder that accepts Medicaid, and 29 of the 33 affected residents are Medicaid participants.
Displacing vulnerable adults from their home community has impacts that go far beyond where a person lays their head at night. These residents will be moved far from their families and other support networks and may be isolated from the specialized medical care they require.
Assisted living provides a vital service for members of our community who are independent, but need help with some daily living tasks. If they are unable to find another suitable and affordable assisted living placement, they may be forced to enter a nursing home, giving up substantial amounts of independence.
Aside from the tremendous individual impact of this closure, it signals a growing and troubling trend of assisted living facility closures over the past several years. In Boulder County alone, three assisted living centers closed in 2022 in addition to the 2023 closure of the program at Golden West.
This massive decline in the availability of assisted living care comes at the same time as demand for services for vulnerable adults is increasing. According to the Colorado State Demography Office, the state is forecast to be home to nearly 1.2 million adults over age 65 by 2030, an increase of more than 300,000 from 2020.
Policy changes must be made not only to directly assist the individuals impacted by these assisted living center closures, but also to help ensure that the Boulder County community has the capacity it will need to meet the needs of its changing population.
One important change that could both prevent the closures of assisted living centers and encourage the growth and opening of new ones would be an increase to the Medicaid reimbursement rate for assisted living care.
At present, assisted living centers face a stark economic reality — private-pay residents represent substantially more revenue than Medicaid-participating residents. Under current reimbursement rates, the gap between the funding provided by a private-pay resident and a Medicaid-participating resident can be more than $2,000 per month. Because of this difference, assisted living centers that accept Medicaid participants are unable to pay their staff at the same levels as their private pay counterparts and struggle with staffing issues.
The Colorado Department of Health Care Policy and Finance has requested $3.6 million in additional funds for assisted living services in this year’s legislative budget, and Colorado lawmakers must use this session to ensure that assisted living centers are able to accept residents who participate in Medicaid. As staffing shortages in the care profession persist, lawmakers must also continue to promote policies that would attract skilled professionals to Colorado, so that the assisted living model is able to survive into the state’s future.
Assisted living provides a vital service for those members of our community who need help with daily care but desire more independence than a nursing home can accommodate. The closure of the Mezzanine at Golden West means that as a new generation of people require those services, they may be forced into a choice between preserving that dignity and remaining in the community they call home. We must act now to preserve assisted living so that the Boulder community can be an enduring home for all of its members.
Submitted by Ailsa Wonnacott, ACL Executive Director & Nick Butler, ACL Advocacy Coordinator