Housing and Long-Term Services and Supports

"From Savvy Caregivers classes to support groups for people with Alzheimer's like my mom and caregivers like me, Alzheimer's Resource of Alaska is my lifeline. The staff genuinely cares about me and my mother and they do everything they can to support us and to prepare us for what's to come."


The Trust's Housing and Long-Term Services & Supports focus area concentrates on ensuring beneficiaries have access to a continuum of services and supports that maximize independence in their home and community.

Housing is a critical component to the continuum. Housing First, an evidence-based practice, identifies that a person must have the safety and security of a place to live before they can commit to consistent treatment of health and behavioral health conditions, reducing or eliminating substance use, obtaining employment or education or meeting other goals.

  • The National Alliance to End Homelessness identified that 41 percent of people who are homeless in the U.S. also experience a disability.
  • 100 percent of chronically homeless individuals have one or more chronic conditions or disabilities (U.S. Department of Housing and Urban Development definition).
  • Supportive housing services are for people who are homeless who have one or more chronic conditions or disabilities and need a range of support services to remain housed. People who are served through supportive housing have a history of institutionalization or are at risk of institutionalization. 

Equally important, is having long-term services and supports (LTSS) that are person directed to achieve maximum independence, autonomy and dignity. Long-term services and supports assist a person with their activities of daily living (e.g., eating, bathing, toileting) and instrumental activities of daily living (e.g., making phone calls, paying bills, managing medication) or support the person to become more independent and engaged in their community. 

  • LTSS are delivered in home- and community-based settings as well as institutions. 
  • LTSS are used by people with disabilities or disabling chronic conditions of all ages.
  • Person-directed services means that the person decides where and with whom they live, the services and service providers used - to include family and friends, where to work, and how they want to participate in the community.
  • Assistive technology, devices, equipment, smart home technology, physical alterations to a home including ramps, and technology based interactive medical devices are examples of supports that can be put in place to support a person.
  • Services examples include case management, care coordination, personal care services, supervision and cuing, transportation, supported employment, chore, respite, and assisted living home care. Services typically involve a combination of family caregivers and direct service workers.

Goals + Strategies

Goals of this focus area are to:

  1. Reduce number of beneficiaries who experience homelessness
  2. Increase access to affordable housing
  3. Ensure overall system of care is person directed
  4. Build a robust continuum of care that supports autonomy, independence and inclusion

Funding is allocated by the following strategies:

  • Policy coordination
  • Beneficiary access to appropriate community based services
  • Beneficiaries live in safe, affordable housing through a balanced continuum of housing
  • Home- and community-based services

The Trust is an active partner with the Department of Health and Social Services (DHSS) in implementing Medicaid reform efforts. The Trust is funding approximately $10 million in these reform efforts outlined in Senate Bill 74 (signed into law in 2016 for comprehensive reform of Alaska’s Medicaid program). DHSS is implementing the reform efforts through a series of 16 different initiatives. Some of these initiatives are aligned with strategies in the Housing and Long-term Services & Supports focus area, including: home & community-based services and community first choices. To learn more about these specific reform efforts, click here. 


Kelda Barstad, Program Officer