Fund Aging Services

Proposal Presented for the Master Plan for Aging (#50)

Disclaimer

Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.

 

Summary

Increase funding for the network of community-based aging services provided through Area Agencies on Aging (AAA). Such funding could include expanding access to capital programs (such as Statewide funding opportunities) and other ongoing State resources for community-based services, seeking support from Medicaid or other insurers, and exploring innovative financing programs (i.e., social impact bonds) to ensure that all New Yorkers can age in their community of choice.

 

Justification

New York State's community services are underfunded, hindering their ability to meet the existing and emerging needs of older adults, individuals who are fragile, individuals in need of nursing home care, and those needing primary prevention. The State could reduce costs by expanding home care services and reducing utilization of more costly nursing home care The approximately 98,000 people in Nursing Homes in New York present a particular opportunity to evaluate their needs and preferences, and follow Olmstead principles to examine whether a shift to community-based settings is appropriate.

 

Full Proposal

Fund the network of community-based services to ensure that all New Yorkers can age in their community of choice with the necessary community supports.  This could be accomplished through advocating for more state dollars and federal funding, designating a focus on community long-term care providers for future “transformations” (VI and up) of the Statewide Health Care Facility Transformation Program, increasing resources for community-based services reforms to enable community-based service providers to obtain funding from Medicaid, Medicare, and private insurers, as well as exploration of Social Impact Bonds, Tax Credit Financing and public long-term care insurance. This could be accomplished over multiple phases starting upon adoption and spanning 5-10 years.

Funding could specifically be deployed to AAAs for the following purposes:

  • $35 million allocated to:
    • Reduce waiting lists.
    • Enhance the home care rate for personal care I and II.
    • Expand personal care and case management.
    • Provide additional transportation support.
    • Combat social isolation.
    • Increase access to social model adult day services so caregivers are able to have meaningful employment.
    • Expand health and wellness services, evidenced-based interventions.
    • Other locally determined needs.
  • Invest in sustainable nutrition support - $43 million.
  • Invest in Aging Services network workforce - $20 million.
  • Expanding eligibility to younger onset Alzheimer’s and to age 50 for caregiver and respite support – $26 million
  • Provide annual appropriation for technology access - $5 million.
  • Provide annual appropriation for New York’s Lifespan Respite Care Programs - $1 million
  • Provide annual appropriation for elder abuse education and outreach - $3 million.
  • Provide increased funding for the New York State Health Insurance Program (SHIP), known in New York as the Health Insurance Information, Counseling, and Assistance Program (HIICAP) - $5.5 million
  • Provide an increase in funding for state legal assistance programs - $3 million.
  • Provide an increase in funding for the long-term care ombudsman program - $10 million.
  • Provide an annual appropriation for Aging and Disability Resource Centers - $20 million.
  • Provide reskilling and training for older individuals who wish to return to employment - $2 million. 

 

 

MPA Council Commentary

This proposal is categorized as near-term. Components of this proposal are being implemented, including $45 million invested in Governor Hochul’s FY26 Enacted Budget to reduce the number of older adults waiting for non-medical in-home services provided through the State Office for the Aging (similar to Component 1). The Department of Health and the State Office for the Aging have discussed licensing options for the network of community-based service providers as well as innovative financing programs for aging and long-term care services and supports. Funding components of the proposal would be subject to the annual budget process and the availability of resources.