For the elderly who can no longer care for themselves at home, finding an affordable long-term-care alternative is a challenge. Considering that the elderly population in New York is expected to grow by nearly half a million people by 2015, clearly this is an important public-health-policy issue that must be addressed.

At roughly a third of the cost of nursing homes, New York's 500 assisted-living residences and adult-care facilities provide all of the services needed by seniors who are at a point in their life where it is too difficult or not safe to live alone. These services include help with everyday activities such as bathing or dressing, housekeeping and assistance with taking medication.

Currently, New York has three types of licensed residences -- adult homes, enriched housing programs and assisted-living residences. While resident accommodations vary among facilities, they all offer a home-like atmosphere and are dedicated to preserving the dignity and independence of residents.

Some assisted-living residences are licensed to provide "aging in place" programs allowing seniors to remain in their current assisted-living residence even as they begin to require more specialized care.

Additionally, through an exclusive certification known as the Assisted Living Program, ALP, a select few residences provide "aging in place" programs that not only allow residents to remain in the place they have come to call home, it permits them to utilize Medicaid for assisted-living expenses. This program has proven to be a successful, cost-effective alternative to nursing-home care for seniors that do not need 24-hour skilled nursing care and who are living on fixed incomes.

Today, nursing home costs in New York state -- which are covered by Medicaid -- can be nearly triple the price of assisted living. However, with the exception of ALP, Medicaid does not pay for assisted living. So, while the state will pay for nursing-home care at an average of $112,000 per year, the elderly and their families are responsible for the $36,000 average cost of assisted living. This has driven thousands of seniors into nursing homes simply because it is the only way they can receive needed assistance from Medicaid.

In 2005, $6.3 billion in Medicaid spending went to nursing homes. If the state were to allow more Medicaid dollars to flow into assisted-living programs, we would see a significant decrease in Medicaid costs for the state by avoiding unnecessary nursing home admissions.

At a time of shrinking tax dollars and growing demand for senior housing, the time to plan for access to affordable assisted living is now. Consumers, take action and contact your local legislator -- this is an issue that affects all of us.