LiveOn NY Testifies at NYC Council Oversight Elder Fraud Hearing

New York City Council

Committee on Aging & Public Safety

Chair Hudson & Salaam

October 30th, 2024

Oversight Elder Fraud 

My name is Kevin Kiprovski and I am the Director of Public Policy at LiveOn NY. Thank you for the opportunity to testify.

LiveOn NY’s members include more than 110 community-based nonprofits that provide core services under the NYCAging portfolio and many other home and community based services in our city. 

Background

Aging is a complicated and unique process that we all experience in our own way. Some of us will experience conditions that leave us unable to handle our affairs and our current system leaves many of us that are in that situation without adequate support. While there are some public programs available through nonprofits that take on these challenges admirably and with care, many are left with inadequate, questionable, or without any support at all despite state law requiring it. 

Additionally many scams are designed to target older adults and lead to a higher rate of fraud among older Americans than their younger counterparts. We must recognize these scams and provide resources to older New Yorkers to protect themselves from predatory actors. Additionally, engaging with the police is often necessary to file official complaints against the perpetrators of the fraud and for many that may be difficult for a variety of reasons. The bills proposed today would provide much needed resources to both help prevent these types of scams and assist victims in pursuing justice.

As with many issues facing older New Yorkers we find that supports that help a person either avoid scams entirely, or help them adequately prepare for situations that would otherwise require guardianship are highly preferable to dealing with the issues after they occur. We support a wide range of early interventions and light touch supports across all areas of aging, from housing to nutrition to community supports and we are excited to work with the council to continue exploring these types of investments that would both continue to allow older New Yorkers to contribute to and engage in our communities and save our safety nets both money and time to support the folks who truly need it. 

Recommendations

Explore programs that would assist New Yorkers in planning for end of life issues - Programs that would help New Yorkers learn about their legal options and support them in designating s power of attorney before they may experience severe decline can help unburden

our court systems and create healthier and safer contingencies then a court ordered guardianship for those that may have alternative available to them

• Pass Reso 0561. Call on the Governor to create a statewide public guardianship system to address current inequities and deficits and safeguard vulnerable New Yorkers in need of protective arrangements.

• Pass Intros 1101 and 1092 The resources provided through these bills would help keep existing support programs up to date with the latest information on scams and resources to help prevent them. Additionally information and assistance with a police report is key in helping victims move through the process of trying to remedy the fraud they experienced. 

We are grateful to support your work with our members and partners here today. Thank you for the opportunity to testify and thank you for your attention to these important issues. 

_____________________________________________________________________________

For questions, please email Kevin Kiprovski, Director of Public Policy at LiveOn NY, kkiprovski@liveon-ny.org

LiveOn NY’s members provide the core, community-based services that allow older adults to thrive in their communities. With a base of more than 100 community-based organizations serving at least 300,000 older New Yorkers annually. Our members provide services ranging from senior centers, congregate and home-delivered meals, affordable senior housing with services, elder abuse prevention services, caregiver supports, case management, transportation, and NORCs. LiveOn NY advocates for increased funding for these vital services to improve both the solvency of the system and the overall capacity of community-based service providers.

LiveOn NY also administers a citywide outreach program and staffs a hotline that educates, screens and helps with benefit enrollment including SNAP, SCRIE and others, and also administers the Rights and Information for Senior Empowerment (RISE) program to bring critical information directly to seniors on important topics to help them age well in their communities.

LiveOn NY Testifies at NYS Assembly Expanded In-Home Services for the Elderly Program Hearing

New York State Assembly

Assembly Standing Committee on Aging

October 17, 2024

Expanded In-Home Services for the Elderly Program

LiveOn NY thanks Assembly Member Ron Kim, Chair of the Assembly Standing Committee on Aging, for his leadership, and the full Committee for holding this hearing. My name is Kevin Kiprovski and I am the public policy director for LiveOn NY.

LiveOn NY’s members include more than 100 community-based organizations that provide more than 1,000 programs serving over 300,000 older New Yorkers annually. These core services allow older adults to thrive in their communities and include senior centers, home‐delivered meals, affordable senior housing with services, elder abuse prevention services, caregiver supports, transportation, NORCs, case management and homecare. Through policy efforts, LiveOn NY advocates to increase funding and capacity for our members to meet the needs of older adults in their communities.

At LiveOn NY, we believe aging creates momentum. Older New Yorkers all across the state use their momentum to power up the economy, the political system, and their communities. They are the anchors of their neighborhoods and provide invaluable volunteerism, caregiving, and economic input to their communities. 

Aging also creates challenges. A lack of investment in New York’s State Office for the Aging (NYSOFA) services puts the entire system and the 1.6 million older New Yorkers at risk. Seniors fall through the cracks as local aging services struggle to meet demand due to inadequate funding, difficulty retaining quality staff, and outdated capital.

The good news is, our state has an amazing tool to fight these challenges. The Expanded In-home Services for the Elderly Program (EISEP) is a New York State program that helps older adults stay in their homes by providing non-medical services and support without requiring that they impoverish themselves by spending down their assets to get Medicaid long-term care. This program helps older people maintain independence, prevents nursing home placement, and supports informal caregivers. EISEP offers case management, has a consumer-directed option, and provides a wide range of services including estimates and planning for home modifications. It is inexpensive compared to institutional care, and, most importantly, people love it.

We also know that EISEP saves the state money. The typical Area Agency on Aging client across the state is a person who qualifies for nursing home placement which costs about $100,000/year, but the AAA is able to serve their needs through EISEP costing less than $10,000/year.

We must also think more broadly about homecare than just EISEP. The state and municipalities provide funding for programs that can meet the needs of older New Yorkers in community settings or through investments in family caregiving through programs like CDPAP. There is also opportunity in pilot programs run by our members, such as Selfhelp’s SHSAM housing with services program and India Home’s Co-living program that can provide lower touch services that divert people from needing more intensive home care. Alternative MLTC programs like PACE also help alleviate these burdens through comprehensive care models that both simplify the medical delivery and adhering to care plans with a congregate social model. 

Given what we know about EISEP- a decrease in institutionalization, and a direct causal relationship to reduced Medicaid costs- continuing to defund or ignore this program only hurts our state. It hurts our budget, our people, and our future. 

Today, LiveOn recommends significant investments in the EISEP program by way of the Unmet Need Fund and Community Services for the Elderly. To ensure older New Yorkers can receive adequate home care and can age in place with dignity, the state must:

• Expand the number of service hours available to individuals, addressing current artificial limits imposed by counties due to financial constraints.

• Eliminate waiting lists and improve services for those currently underserved, with an estimated cost of $40 million.

• Increase worker compensation, enabling Area Agencies on Aging to continue recruiting and retaining home care workers, especially after the recent rise in minimum wage.

• Support counties in adopting innovative models for administering home care, such as consumer-directed programs and direct hiring approaches.

comprehensive care models that both simplify the medical delivery and adhering to care plans with a congregate social model. 

Given what we know about EISEP- a decrease in institutionalization, and a direct causal relationship to reduced Medicaid costs- continuing to defund or ignore this program only hurts our state. It hurts our budget, our people, and our future. 

Today, LiveOn recommends significant investments in the EISEP program by way of the Unmet Need Fund and Community Services for the Elderly. To ensure older New Yorkers can receive adequate home care and can age in place with dignity, the state must:

• Expand the number of service hours available to individuals, addressing current artificial limits imposed by counties due to financial constraints.

• Eliminate waiting lists and improve services for those currently underserved, with an estimated cost of $40 million.

• Increase worker compensation, enabling Area Agencies on Aging to continue recruiting and retaining home care workers, especially after the recent rise in minimum wage.

• Support counties in adopting innovative models for administering home care, such as consumer-directed programs and direct hiring approaches.

Waiting lists for NYSOFA services remain a chronic issue as New York’s counties and non-profit providers continue to experience waiting lists for services due to insufficient funding to meet the demand. Given the exorbitant strain the aftermath of the COVID-19 pandemic placed on older adults, adding further stress for older New Yorkers by forcing them to wait for critical services is unacceptable and must be addressed through significant and immediate investments. In addition, increased investments in addressing the waiting list for NYSOFA services will inevitably help balance the State’s budget by reducing Medicaid expenditures. 

While we strongly support increased funding to eliminate home care waiting lists, as they represent an immediate critical need, we caution that these lists don't fully capture the scope of the problem. In some cases, political reasons may lead to inaccurate data collection, and agencies may stop tracking once the lists grow too long. Additionally, many older adults and families, discouraged by long waits or limited resources, either give up or never apply in the first place. We believe addressing the waiting lists is essential, and we also believe a broader investment in community-based services is needed to meet the full growing demand.

NYSOFA’s overall budget continues to lag behind what the system truly needs. Today, the state spends less than one tenth of one percent of general funds on the programs offered through the State Office for the Aging, limiting capacity to serve a population of older adults that will soon outnumber school aged children. The impact of this represents not only an injustice to the needs of older New Yorkers, but a missed opportunity to improve the health and wellness of older adults through low-cost interventions.

LiveOn NY thanks the committee for the opportunity to testify today and make clear the urgency of the need to fund EISEP. We are available for questions and further discussion via our State Policy Director, Dora Fisher, who can be reached at dfisher@liveon-ny.org. 

_____________________________________________________________________________

LiveOn NY’s members provide the core, community-based services that allow older adults to thrive in their communities. With a base of more than 100 community-based organizations serving at least 300,000 older New Yorkers annually. Our members provide services ranging from senior centers, congregate and home-delivered meals, affordable senior housing with services, elder abuse prevention services, caregiver supports, case management, transportation, and NORCs. LiveOn NY advocates for increased funding for these vital services to improve both the solvency of the system and the overall capacity of community-based service providers.

LiveOn NY also administers a citywide outreach program and staffs a hotline that educates, screens and helps with benefit enrollment including SNAP, SCRIE and others, and also administers the Rights and Information for Senior Empowerment (RISE) program to bring critical information directly to seniors on important topics to help them age well in their communities.

LiveOn NY Testifies at NYC Council Community Care Plan Hearing

New York City Council

Committee on Aging

Chair Hudson

September 19th 2024

Oversight Community Care Plan

My name is Kevin Kiprovski and I am the Director of Public Policy at LiveOn NY. Thank you for the opportunity to testify.

LiveOn NY’s members include more than 110 community-based nonprofits that provide core services under the NYCAging portfolio and many other home and community based services in our city. 

Background

The Community Care Plan rightfully recognized that the demographics of NYC were changing and that bold new investments would be needed to increase capacity of the OAC network, bolster case management, serve more food, and build a system that would meet the needs of our population as we age. The reality of investments from the administration have not met the needs outlined in the document, or the greater needs that exist in our city today. We need bold new investment NOW to ensure that we can meet the needs of both the existing population of older New Yorkers and to keep up with the growth in our aging population in the coming decade. If we do not make those investments, especially in light of documents like the Community Care Plan that clearly outline the unmet needs of our communities, we are deciding that it is okay to exclude New Yorkers from our communities as we age. We cannot allow ageism to justify the current plan to divest from aging services and ignore the needs that have already been acknowledged by our city’s leadership. 

Recommendations

• Don’t cut the already low budgets for any service program.  Many programs are already on their last strings, further cuts jeopardize the fiscal solvency of the service network and undermine the goals of the contracts that the city already pays for. 

• Create a dedicated city pot of capital funds to keep centers in good repair. Most centers don’t have the resources to launch campaigns to get local elected capital money and the city has refused to consider their needs in the budget for over a decade. 

• Reform capital funding rules to match the reality of the spaces that services are being provided in. Many can’t access funds due to a lack of “site control” which leaves them without any resources from the city. Other arcane requirements can leave centers with no real options to repair necessary infrastructure and they are left to crumble. 

• Study the real needs of case management clients. Case managers in the field are seeing a stark increase in need among their clients and higher levels of physical and mental illness and the most recent RFP cut resources from programs. Caseloads must be reduced overall from 1:72 or more and a new program should be developed to deal with the highest need clients that allows for lower caseloads closer to 1:20. Funding must also be restored for administrative support positions to allow case managers to focus on their work. 

• Reform nutritional programs to match the reality of those using them.  Homebound New Yorkers only get 5 meals a week from city funds and often are unable to get additional nutrition. Many centers also see that there is a need for more than just one meal a day in their congregate meals programs. 

• Work with HPD to understand the housing crisis among older New Yorkers. Older adult homelessness is at an all time high and growing at a rate three times faster than younger demographics. Any community care plan must recognize this reality and explore further investment and new housing programs to meet this moment. 

 Thank you for the opportunity to testify.

_____________________________________________________________________________

For questions, please email Kevin Kiprovski, Director of Public Policy at LiveOn NY, kkiprovski@liveon-ny.org

LiveOn NY’s members provide the core, community-based services that allow older adults to thrive in their communities. With a base of more than 100 community-based organizations serving at least 300,000 older New Yorkers annually. Our members provide services ranging from senior centers, congregate and home-delivered meals, affordable senior housing with services, elder abuse prevention services, caregiver supports, case management, transportation, and NORCs. LiveOn NY advocates for increased funding for these vital services to improve both the solvency of the system and the overall capacity of community-based service providers.

LiveOn NY also administers a citywide outreach program and staffs a hotline that educates, screens and helps with benefit enrollment including SNAP, SCRIE and others, and also administers the Rights and Information for Senior Empowerment (RISE) program to bring critical information directly to seniors on important topics to help them age well in their communities.