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as local aging services struggle to meet demand due to inadequate funding, difficulty retaining quality staff, and outdated capital.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.
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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.
