Proposal Presented for the Master Plan for Aging (#114)
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
Expand access to in-home personal care services by providing funding to NYS counties to allow Area Agencies on Aging (AAA) to hire home health and/or personal care aides to reduce and limit existing waiting lists for personal care services and focus resources prior to the enrollment in Medicaid.
The demand for personal care aides is expected to rise exponentially (440,000 in 2018 to 700,000 by 2028). Barriers to entry into the profession affect turnover and over a ten-year period 2018-2028, nearly a million job positions must be filled to meet the demand. Implementation of this proposal would enhance workforce development and reaffirm New York’s commitment to aging in place.
Full Proposal
The New York State Office for the Aging’s (NYSOFA) in-home program successfully operates coordinated non-medical care for older adults who are not Medicaid eligible, preventing Medicaid spend-down and unnecessary service utilization and fostering aging in place. NYSOFA’s ability to provide fewer Medicaid care hours at a more competitive economic cost than LHCSAs has created wait lists for personal care aide services. The need for home health aide and personal care aide jobs is projected to rise as the demand for care continues to increase. High turnover rates, staffing shortages and barriers to entering the home care profession exacerbates this issue. Support the existing and increasing population of older adults served by NYSOFA, strengthen the home care workforce, and enhance annual Medicaid savings by:
- Providing funding to NYS counties to hire up to 6 aides per AAA to reduce/limit existing waiting lists and focus resources prior to reliance on Medicaid.
This proposal is categorized as long-term. In-home care and other essential services are critical to allowing older adults to age in place, yet New York State is experiencing a direct-care workforce shortage. The State is already taking significant steps to address the need for in-home services. NYSOFA currently works to promote aging in place by allowing AAAs to supplement informal care with in-home personal care, case management, noninstitutional respite, and ancillary services by directly contracting with direct care workers to provide Personal Care Level I, Personal Care Level II, or both. In the FY26 Enacted Budget, Governor Hochul invested $45 million in additional funds for in-home and community-based services offered by NYSOFA and the AAAs. These additional funds will make it possible for AAAs to reduce the number of older adults waiting for critical in-home and community-based services. Any additional investments in community-based aging services would be subject to the annual budget process and the availability of resources.