Memory Care in Florida

Because of the specialized staff training and resources required to provide high-quality memory care, memory care typically costs more than other types of residential care. On average, memory care will cost 20-30% more than assisted living.

In Florida, the average monthly cost of assisted living is $3,500, which is $551 below the national average of $4,051. Given that memory care usually costs 25% more than assisted living, monthly fees for residential memory care services in Florida will tend to be about $4,375.

Monthly assisted living costs in Florida range from $2,836 in Sebring up to $5,375 in The Villages. In Jacksonville, assisted living averages $4,263 per month, and in Miami, rates average $3,250 per month. In general, you can expect memory care services to cost upwards of $1,000 or more in addition to the average assisted living rates in any given county or city.

Florida Medicaid Programs for Memory Care

Statewide Managed Medicaid Care, Long-Term Care Program

As of 2014, Florida consolidated all the state Home and Community-Based Medicaid Waivers under the Statewide Medicaid Managed Care, Long-Term Care Program. This program provides a broad range of client-centered services and supports to those who meet financial and medical eligibility requirements.

SSMC LTC services are delivered based on medical necessity, with a strong focus on services that delay or prevent placement in a nursing facility. These services may include:

• Adult day health programming
• Attendant and/or personal care
• Homemaker services
• Skilled and intermittent nursing
• Medication management and administration
• Occupational, physical, speech and/or respiratory therapy
• Behavior management and caregiver training
• Transportation to Medicaid-funded appointments and services
• Respite care
• A monitored medical alert system
• Medical supplies and mobility devices
• Case management
  • Who is Eligible: To qualify for services through the SMMC-LTC program applicants must be 65 or older and eligible for Medicaid, or at least 18 years old and eligible for Medicaid due to disability. Applicants must also be assessed as having care needs at the nursing home level of care through the Comprehensive Assessment and Review for Long-Term Care Services program.

In Florida, Medicaid applicants can earn no more than $2,313 per month, per individual, while couples applying together can earn up to $4,626 per month.

• • How to Apply: Seniors 65 and older, and adults 18 and older with a qualifying disability can apply for Medicaid and the SMMC-LTC through their local Aging and Disability Resource Center.

Non-Medicaid Financial Assistance Programs for Memory Care in Florida

The Florida Department of Elder Affairs offers a number of non-Medicaid programs designed to assist people living with Alzheimer’s disease and dementia.

Community Care for the Elderly

Florida’s Community Care for the Elderly program provides in-home, non-medical support services to frail seniors aged 60 and older who are at risk of nursing home placement.

Services provided through the CCE program are based on individual needs, and may include:

• Case management and needs assessment
• Personal and respite care
• Homemaker services
• A personal emergency response system
• Adult day health services
• Funding for durable and consumable medical goods
  • Who is Eligible: Adults over age 60 who are determined to be functionally impaired qualify for this program. Those who are in the care of Adult Protective Services due to neglect or abuse are given priority admission to CCE.
  • How to Apply: Applications are handled by local Aging Resource Centers. Seniors can also contact the Elder Helpline at 1-800-96-ELDER (1-800-963-5337) for an alternate application resource.

Home Care for the Elderly

Home Care for the Elderly helps eligible seniors aged 60 and older avoid institutionalization by subsidizing care costs in a private home. All program participants receive an average basic monthly subsidy of $106 for use towards medications and medical supplies, mobility devices, personal care, and nutritional supplements. Case management is provided on an as-needed basis.

• Who is Eligible: To qualify for the Home Care for the Elderly subsidy seniors must be at least 60 years old, live with an approved adult caregiver, be at risk of institutionalization and have monthly earnings below the Institutional Care Program income limit. The ICP income is calculated by multiplying the federal Supplemental Service Income limit by three, and this amount is adjusted annually.
• How to Apply: As with other programs listed here, your local Aging Resource Center or the Elder Helpline (1-800-963-5337) is the resource for this program.

Florida Memory Disorder Clinics

Florida’s Department of Elder Affairs operates 17 Memory Disorder Clinics in 13 service areas as part of the statewide Alzheimer’s Disease Initiative. While these clinics do not provide financial assistance per se, they do provide free and scaled-to-income comprehensive diagnostic services to Floridians of any age who are experiencing symptoms which may be caused by Alzheimer’s disease or another form of dementia.

Many of these memory disorder clinics are operated by not-for-profit agencies, and the clinics also develop caregiver resources, provide educational opportunities, and conduct service-related research.

• Who is Eligible: Florida residents of any age who show symptoms of Alzheimer’s or other types of dementia are eligible.
• How to Apply: Visit your local memory disorder clinic. Click here to see a map.

Alzheimer’s Disease Initiative

ADI provides services for individuals living with Alzheimer’s disease or related memory disorders and includes services for families, such as access to caregiver training and counseling, case management, and specialized medical supplies and devices.

• Who is Eligible: Florida residents diagnosed with probable Alzheimer’s disease or other types of memory loss that interferes with their activities of daily living may qualify for in-home and adult day care, emergency care and up to 30 days of extended respite care.
• How to Apply: ADI services are delivered through Florida’s 11 Area Agencies on Aging. Click on the link to contact your Area Agency on Aging or call the Elder Helpline at 1-800-96-Elder (1-800-963-5337).

More Ways to Pay for Memory Care

In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:

• Long-Term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It’s best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.
• Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This can be a good way to fund memory care in the short-term, but the loans will need to be paid back after the sale of the home. The most commonly used type of reverse mortgages for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.
• Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs such as memory care. More information about these programs can be found on the VA website.
• Life Insurance: Some life insurance policies allow policyholders to cash out their policy before a qualifying death. There may be some downsides to accessing a life insurance benefit early, so be sure to read more about the process.

Memory Care Regulation

In Florida, assisted living facilities of all sizes and types are licensed through the Bureau of Health Facility Regulation.

Assisted living facilities, or ALFs, include private homes, homes for the aged, boarding homes and other buildings which directly or indirectly provide accommodation, meals, and assistance with one or home activities of daily living for more than 24 hours to one or more adults not related to the owner or operator.

Facility Scope of Care

Florida provides a number of specialty licenses for ALFs that meet the requirements for a standard license. These specialty licenses are designed to deliver enhanced services above and beyond the usual supports provided in an assisted living facility in order to allow residents to age in place in the most appropriate, least-restrictive placement.

ALFs licensed to provide limited nursing services (LNS) can perform specific procedures and treatments such as ear and eye irrigation, intermittent catheterization, conducting range of motion exercises and conducting nursing assessments performed by a registered nurse.

ALFs licensed as an Extended Congregate Care facility can provide all of the services available under the standard and LNS license regulations in addition to any nursing services which are within the scope of practice for a registered nurse. Facilities that are covered by an ECC license can provide a higher level of care than what is offered in standard ALFs, and this care may include supports and treatments for those with Alzheimer’s and other dementias.

Admissions Requirements

In accordance with Florida state law, each ALF must assess the appropriateness of each prospective resident in relation to the services and supports offered at the ALF. This chart provides an overview of the requirements:

Applicants who may not be Residents in ECC-licensed ALFs must be moved to a hospital or nursing facility if they are bedridden for two weeks or more.

Care Plan Requirements

Newly-placed ALF residents must be examined by an advanced RN practitioner or licensed physician no more than 60 days prior to, or 30 days following admission, and a medical report must be provided to the ALF administrator. This report is used to develop a personalized care plan that must be reviewed on a monthly basis by a licensed nurse employed by, or contracted to, the facility.

Residents must also receive a resident agreement which outlines the specific supplies, supports, and accommodations along with the daily, weekly and monthly care cost and information. This agreement must cover resident rights, refund policies, bed hold policies and disclosure of any religious affiliations of the facility.

Medication Management Requirements

Unlicensed staff are allowed to assist with the self-administration of medications, while licensed nursing staff are allowed to administer prescription and over-the-counter medications.

Assistance with self-administration of medications can include reading the label to the resident, opening the medication container and removing the prescribed dose, and applying topical medications.

Facility Requirements

While standard and LNS-licensed ALFs are not required to provide private accommodations, ECC facilities must provide either a private or semi-private room or apartment. A maximum of four residents can share a single bathroom.

Staffing Requirements

ALFs that offer dementia care must have 24-hour staffing and mechanisms in place to monitor residents, and that staff must remain awake if the facility has 17 or more residents.

Facilities with a secure area for residents with dementia must be staffed by workers who have completed at least four hours of specialized training in memory care before being assigned to the secure unit. Direct care staff must continue to complete at least four hours of dementia-specific training for the duration of their employment at the facility.

Medicaid Policy

ALF room and board rates for Florida Medicaid participants are negotiated between the facility operator and the Medicaid State Plan.

Reporting Abuse

Concerns or complaints regarding any licensed health care facility that is regulated by Florida’s Agency for Health Care Administration can be filed by calling the Complaint Administration Unit, Agency for Health Care Administration, at (888) 419-3456. Complaints against unlicensed health care facilities can be reported by calling (888) 419-3456.