Multi-Unit Assisted Housing with Services (MAHS) is a new housing model in North Carolina. It can serve the totally independent individual as well as the person who, at any age and for any number of reasons, may need assistance with activities of daily living. MAHS offers residents the option of at least one meal daily, housekeeping services, and the services of a licensed home care agency.

The MAHS apartment features a kitchen or kitchenette, living/dining room, bedroom(s) and private bath(s). Common areas for group dining, recreation, and activities afford opportunities to supplement and enhance independent lifestyles.

Independent housing with services is not a new concept in North Carolina. In the past, however, residents who needed even minimal personal care, such as assistance with bathing or dressing, were often faced with locating, securing and screening such services on their own. MAHS makes it possible for housing managers to offer personal care services through a licensed home care agency. The home care agency develops a care plan based on the individual resident's needs.

Resident Profile

Residents may be low, moderate, or upper income older adults or adults of any age who have disabilities. Many MAHS residents prepare their own meals, drive cars, and live as any independent apartment-dweller. Some residents may require no services, but choose MAHS for the reassurance of knowing that services can be arranged if needed.

MAHS residents must be capable of entering into a contract and must not be in need of 24-hour supervision or unscheduled assistance and care. Specific conditions and restrictions for MAHS residency are outlined in the State Statutes.

Services Provided

The rental lease entitles each resident to full use of an apartment unit and common areas, emergency call system, and facility maintenance and management.

Supportive services enable many residents to remain in their apartments longer, thus reducing turnover and enhancing their quality of life. MAHS must make available at a minimum at least one meal daily, housekeeping assistance, and personal care services through a licensed home care agency.

Management must have a written agreement with one or more home care agencies to provide personal care services. Such agreements may be brief and do not have to include or be based on any exchange of money between the two parties.

Prior to moving in, residents will be given a listing of licensed home care agencies available in the area, including any home care agency having a formal agreement with management to provide services.

Additional supportive services may be offered, including transportation to medical appointments, shopping and other destinations; wellness screenings; educational programs and other options that enhance independent living.

Service Coordination

Service coordinators are increasingly being employed by management to help link residents to existing supportive services. Service coordinators also work closely with the community to develop new programs and resources for residents.

HUD-supported properties may be able to acquire HUD funding to hire or contract with a service coordinator. A service plan including a service coordinator position is required by the NC Housing Finance Agency for the Low Income Housing Tax Credit program and NC Housing Trust Fund applications.

Pricing Arrangements

The resident signs a lease agreement with the property management. Rental fees may be private pay or public pay, or a public/private mix. Subsidized housing rental fees may vary with the resident's income.

Service fees vary according to the number, type, and funding source. Personal care services must be billed and paid for separately from rent payments. Economies of scale may make the services of the agency selected by management more affordable and therefore more attractive to residents. Residents may elect to contract with this selected agency, or they are free to choose any other home care agency from outside.

Services may be privately paid or publicly funded through existing community resources. Some publicly funded services may be available to qualified residents at no cost or a reduced cost through local human service agencies.

Management Arrangements

For purposes of illustration, here are two possible arrangements for combining housing and services in a Multi-Unit Assisted Housing with Services property.

Profile I:

The owner/managing entity provides staffing for property management and maintenance services. It negotiates a brief written agreement with a licensed home care agency with which it has no affiliation, financially or otherwise, to be the selected provider.

Profile II:

The owner/managing entity provides staffing for property management and maintenance services. It also owns, under a separate corporation, the home care agency with which it contracts to be the "provider of choice" for the apartment community. Residents may elect to use these in-house services or may choose another licensed agency.

Types of Developments

Properties may include subsidized apartments, public housing, Low Income Housing Tax Credit developments, and other publicly or privately financed housing. Existing properties for elderly and/or disabled adults may become Multi-Unit Assisted Housing with Services by adding the necessary services and following state registration and disclosure requirements.

The model can be a component of a planned unit development, a neo-traditional village or a stand-alone building in a residential neighborhood.

Quality Assurance

Housing providers must register with the NC Division of Facility Services and turn in a disclosure statement specifying lease arrangements, services available, and details about services. This disclosure statement is given to anyone who applies for an apartment. See "Whom to Contact About" for MAHS registration information.

Building requirements are the same as for any independent apartment complex. As with any apartment community, the physical structure is to be in compliance with the Fire and Building Safety Codes as outlined by the NC Department of Insurance and the Southern Building Code.Personal care services provided must adhere to the State's home care agency licensure requirements.

MAHS Requirements

The requirements are outlined in NC General Statute 131D-2(1d) under the legal title of Multi-unit Assisted Housing with Services (MAHS). The legislation was passed in Senate Bill 502 (1995).

Whom To Contact About:

Developing a housing service plan:

NC Housing Finance Agency
Supportive Services Coordinator
Box 28066
Raleigh, NC 27611-6066
(919) 781-6115

MAHS registration; identifying existing MAHS; home care agency licensure; identifying existing home care agencies:

NC Division of Facility Services
Group Care Licensure Section
Box 29530
Raleigh, NC 27626-0530
(919) 733-6650

Developing financial plans for a project:

NC Housing Finance Agency
Rental Programs
Box 28066
Raleigh, NC 27611-8066
(919) 781-6115

This information on MAHS came from the NC Independent Housing with Services Advisory Committee, which is no longer in operation.