PHI has supported such alternatives by developing training for staff who were moving from traditional nursing home environments to Green Houses®. THE GREEN HOUSE Project was initially developed by Dr. William Thomas, a professor at the University of Maryland’s Erickson School and leader in the elder culture change movement, who writes a blog called Changing Aging.org. The first Green Houses® opened in Tupelo, Miss., in 2003, to provide seniors of all incomes with more dignity, autonomy, and choice in long-term care. The name stems from the focus on encouraging personal growth among residents. The idea is that Green Houses® cost no more to run than traditional homes because they produce less waste and require less infrastructure.

from Wall Street Journal:

As Budget Shortfalls Force Reductions in Home Care, Low-Income People May Face Nursing Homes, Advocates Say

Faced with widening budget shortfalls, several states are rolling
back support services for the elderly and disabled. The move is making
it tougher for them to continue living on their own, advocates say.

At least 15 states, including Alabama, Virginia and Massachusetts,
are targeting such funding, mostly for programs that allow low-income
shut-ins to receive personal care -- like cooking, cleaning and basic
health services -- in their own homes, according to the Center on
Budget and Policy Priorities, a liberal-leaning Washington, D.C. think
tank that studies state budgets.

The cutbacks are exacerbating the already long waiting lists for
home-care support services in many states. That leaves the low-income
elderly and disabled to dip into their meager incomes to hire their own
help, reach out to family or charity, or seek more restrictive and
expensive care in a nursing home, advocates say.

"We are beginning to see serious cuts and we are expecting those
cuts to get worse," says JoAnn Lamphere, director of state government
relations at AARP, an advocacy group for the elderly.

As the economy falters, declining revenues and tax receipts have led
state agencies to cut spending, with 41 states facing current or
looming deficits, according to the Center on Budget and Policy
Priorities.