New York City Council
Committee on Aging, Chair, Council Member Chin
October 18, 2021
Oversight - Community Care Plan

Thank you for the opportunity to testify.

LiveOn NY’s members include more than 100 community-based nonprofits that provide core services which allow all New Yorkers to thrive in our communities as we age, including senior centers, home‐delivered meals, affordable senior housing, elder abuse prevention, caregiver support, NORCs, and case management. With our members, we work to make New York a better place to age.

As the City works to build back a better future for New Yorkers as we all age, the stakes have rarely been higher to ensure older adults have the support they need to safely age in their communities. The Community Care Plan works to recognize these stakes, investing in funding and articulating the incredible increase in demand for services that is likely to be experienced in the coming years. However, implementing a five-year vision amidst a global pandemic in which providers are struggling to stay afloat and which the uncertainties of the new normal loom large has quickly made plain the work still to be done.

Providers have begun receiving award letters for the Older Adult Center (OAC) and Naturally Occurring Retirement Community (NORC) Request for Proposal (RFP) and are starting the negotiation process prior to contracts going into place. Unfortunately, initial reports on this process have raised significant concerns on if the investments made in the Care Plan are sufficient to fully fund the number of contracts it seeks to execute. Representative of this, we are hearing of the City urging providers to enter into contracts upwards of a million dollars less than was proposed within the provider’s application. The goal of this is clear, the City continues to ask its most trusted non-profits to do more with less support, even if that means risking forcing non-profits to offer low wages to employees living in the very communities we aim to help.

In response to these challenges and others that we have heard throughout the Community Care Plan’s RFP process, LiveOn NY recommends:

The Department for the Aging (DFTA) must extend the timeframe given to RFP award winners to review and enter into a contract. Currently, DFTA is giving providers just and five business days to submit budget documents and scopes of work. This is in response to budgets and units that are vastly different from what was originally proposed. Given that these are documents that will begin to set the terms for the work for years to come, it is in the best interest of both the City and providers that adequate time be given to allow for thorough fiscal, board and programmatic review so that meaningful negotiations and due diligence can occur.
The City must retract its position that providers enter a 10% de minimis Indirect Cost Rate (ICR) when finalizing contractual budgets, and instead commit to entering into contracts with each provider’s ICR. The City went through a time intensive process with human services providers to create, and for the first-time fund, a standardized ICR across contracts. The contracting process is the most critical time to fulfill the commitment to this funding, and no provider should face the uncertainty of not having these critical resources built into their program contract.
Given the diverging bottom-line budgets between award and proposal, the Department for the Aging must provide further context and justification when responding to award recipients in a way that significantly alters the proposed budgets or units. Throughout the RFP process, providers worked diligently to develop proposals with the appropriate budgets to adequately provide programming to older adults. The budgets offered by the City do not reflect the true cost to sustainably support the model of services proposed by the applicant, with some varying by hundreds and thousands of dollars. Providing clear information regarding the ways in which DFTA found the proposal to be out of line with their budgetary expectations will allow for greater transparency and opportunity for negotiation to ensure that each contract is finalized with realistic unit expectations and corresponding funding.
In the November Plan, the de Blasio Administration must fully allocate outyear budget needs to sustain these contracts, for which funds are not currently in place due to an overreliance on stimulus funds. It is bad fiscal policy, particularly on the cusp of a change in administrations, for the City to enter into contracts that will require funding into the outyears, for which the City has not included in its budget projections. Without proper outyear projections, the contracts will face a fiscal cliff in FY23, without funding in place to meet the need. This is particularly concerning given that COLAs and increases in Consumer Price Index are already unaccounted for in the contracts, meaning the funding required to sustain each contract will likely be much greater than currently accounted for.

Beyond the Older Adult Center and NORC RFP, the Community Care Plan articulates growing demand for numerous other services critical to older New Yorkers living in community, including, “case management, home delivered meals, home care, caregiver support,

connectivity needs, transportation and more.”

To truly address these increases in demand, LiveOn NY recommends the following:

Invest $16.6 million to serve existing clients within the traditional home-delivered meal program. This investment will allow the Department for the Aging to increase the reimbursement rate to reflect the rising cost of raw food, changes in the labor market, and heightened costs of insurance, gas, and packaging. Despite the lifeline that this program represents, it has been chronically underfunded for years, with funding lagging far behind the national average, putting the program and the non-profits that administer it, financially at-risk year after year. Currently, the reimbursement rate for home-delivered meals is capped at $9.58 cents, an arbitrary rate irreflective of the empirically verified average reimbursement rate for urban areas of $11.78 — as found by Mathematica in 2015.
In addition, the Administration must invest the required funding to the GetFood clients transitioning to the home-delivered meal contracts, at the higher rate. Both this funding and the requested $16.6 million in funding for existing HDM clients should be allocated not only through June 30th of FY22, but in the outyears as well, as it is reality that an individual who is hungry on June 30th, will be hungry on July 1st as well.
Expand investments in case management to ensure all clients can be screened for case management eligibility and receive this critical service should they be eligible. Further, exacerbated by the long-term health impacts of isolation and other stressors experienced over the past year and a half, it is likely that some if not many of the Recovery Meal recipients may require some level of case management to remain independent and safe in their communities. This demand comes on top of consistent increases in demand for case management that have historically led to waiting lists for case managers, requiring additional funding, each year.

Additionally, LiveOn NY strongly supports the following bill that would provide assistance to older adults with bed bugs in their homes:

Intro 1219, introduced by Council Member Dromm, is an act to amend the administrative code of the city of New York, in relation to providing assistance to seniors with bed bugs in their homes. Everyone should be able to safely age in place in their homes without fear of bed bugs infesting their homes. This act will provide older adults living in low-income housing with the necessary support and services to eradicate bed bug infestations from their homes. In addition, it’s critical that eligible older adults have the resources and information necessary on how to prevent bed bugs in their homes as well as the early warning signs of a potential infestation. While this bill would require the Department for Social Services (DSS) to work in coordination with the Department of Health and Mental Hygiene and the Department for the Aging, we urge the City to also work with community-based organizations as an additional trusted resource for older New Yorkers.

Thank you for the opportunity to testify.