In order to address the growth in the senior population and the soaring costs of health care in the Medicare and Medicaid programs, Leading Age (formerly AAHSA) advocates for policies and practices that link affordable unlicensed senior housing properties such as Section 202, the low-income housing tax credit (LIHTC), or public housing communities with health and supportive services as a cost-effective answer for meeting the long-term care needs of lower-income seniors. However, this approach poses challenges in rural areas. The demographics, availability of services, and housing trends, such as fewer multifamily housing settings in rural areas, may not lend themselves to the “traditional” affordable housing with services models that may be available in metropolitan areas even though the senior populations present similar characteristics.