Testimony on Home-Based Long-Term Care Services

New York State

Committee on Aging

Chair, Assembly Member Ron Kim 

December 12, 2022 

My name is Brianna Paden-Williams and I am the Communications and Policy Associate at LiveOn NY. Thank you to Chairperson Assembly Member Ron Kim and the Assembly Committee on Aging for the opportunity to testify today.

LiveOn NY represents the diverse network of nonprofit organizations that help older New Yorkers to thrive in our communities. Through advocacy, mobilization and coalition building, we advance systemic change to ensure that New York is an equitable and inclusive place to age regardless of wealth, racial disparities and other barriers.

With a base of more than 100 community-based organizations, LiveOn NY’s members provide core services throughout New York, including senior centers, congregate and home-delivered meals, affordable senior housing, elder abuse prevention services, caregiver supports, transportation, NORCs, case management, and home care.

Background

It is evident that the pandemic itself exposed the limitations to our existing long-term care system that must be addressed to better support older adults into the future. Among other challenges, the ability to remain fed, access to community-based supports, and an insufficient technology infrastructure were some of the primary issues facing older adults during the pandemic. Further, efforts to mitigate risk of exposure to COVID-19 had the unintended consequence of exacerbating issues of isolation across our state.

Conversely, the pandemic highlighted the importance of the very community-based services that had long been ignored across our State. As programs such as Older Adult Centers, Social Adult Day programs, and NORCs were mandated to temporarily shutter in-person operations, dramatic increases in isolation and mental health concerns made clear the meaningful difference each makes in our communities when operating at full capacity.

Nonetheless, we also recognize the work still needed to be done to better support older New Yorkers. While the older adult population continues to be the fastest growing demographic, making up nearly 16% of the State’s population, the programs that support older New Yorkers remain chronically underfunded. Representative of this underfunding, last year the overall state budget grew by 3.1% in the Executive Budget, while the NYSOFA budget lagged behind overall growth, at 1.8%, despite the population it serves making up a larger and larger share of the overall population.

To begin to address the inequities impacting older adults and providers, LiveOn NY recommends the following: 

Provide Critical and Needed Funding for Home-Delivered Meals System under NYSOFA

The COVID-19 pandemic has demonstrated significant increases to the demand for home-delivered meals (HDM), with providers now serving more older adults than ever, with thousands of new clients being added to the service. The HDM program offers older adults across the State with a daily nutritious meal, however, COVID-19 has put a strain on HDM providers including difficulty hiring drivers and delivery staff due to low wages, rising costs of raw food, a significant growth in the state's 65+ population, difficulty recruiting and retaining volunteers, and high rates of food insecurity.  

Establish an Affordable Independent Senior Housing Assistance Program 

Deepening investments in affordable senior housing with services is critical in future years, not only to improve the quality of life of older New Yorkers and address rising senior homelessness, but as a cost-savings measure against increased Medicaid and Medicare spending. A resident advisor program in affordable senior housing residences has proven to reduce health care costs, including reducing Medicaid expenditures. 

The state should appropriate $10 million over five years for the Affordable Independent Senior Housing Assistance Program, to establish new programs in existing and new affordable senior housing. Resident assistance provided under this program would include an array of services that promote healthy living by extending independence and improving quality of life. This $10 million could be used by both existing and newly-created developments such as those created under HCR’s new “Senior Housing Program,” which was designed to facilitate the disbursal of the $125 million in new funding for senior housing. Pairing this service funding with affordable senior housing would create a cost-effective model for seniors to age in place in either new housing constructed for them or the preexisting housing where they reside. This would result in a savings to the Medicaid program by keeping low-income seniors out of more costly levels of care such as assisted living or nursing homes.

Through the creation of a new resident advisor program to ensure older adults can age safely with access to light touch, non-medical services. This investment will inevitably save Medicaid dollars, with one such study, by our member, Selfhelp Community Services, finding the hospitalization rate of those living in a building with service coordination was 43% percent lower than for those living in the surrounding zip code.

Fully Fund Fair Pay for Home Care

Fair Pay for Home Care, S5374 (May) / A6329 (Gottfried) seeks to “establish a base wage for home care workers at 150% of the regional minimum wage” to create jobs for New Yorkers, support older adults, people with disabilities and caregivers, and rebuild our economy by paying home care workers a just wage. Without a mandate and funding from the government, the wage compression will continue to be exacerbated, straining the existing home care system. 

This legislation would move New York forward in creating a caring economy, ensuring that older New Yorkers and individuals with disabilities have access to critical services to safely age in community as well as pay workers the fair and equitable wage they deserve. 

End Waiting Lists for Community Based Aging Services through NYSOFA

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 COVID-19 has placed on the older adult population, the prospect of adding further stress to the lives of older New Yorkers by forcing them to wait for critical services is untenable 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. 

Prioritize Community Based Care and Services within the State’s Master Plan on Aging 

LiveOn NY applauds the recent executive order signed by Governor Kathy Hochul to create New York's first-ever Master Plan for Aging to ensure older New Yorkers can live healthy, fulfilling lives while aging with dignity and independence. LiveOn NY also appreciates the cross agency work between the New York State Department of Health, State Office for the Aging and the Department of State and across all agencies in development of the MPA in order to ensure non-medical government community- based services are equally prioritized in creating the plan. We look forward to the continued collaborative efforts through the Master Plan on Aging as we work together to make New York a better place to age.

Support LiveOn NY’s Rights and Information for Senior Empowerment (RISE) Program

Through Rights and Information for Senior Empowerment (RISE), LiveOn NY trains older adult service professionals, as well as works with elected officials and their respective staff to reach and provide critical information and resources to older adults. Over the last year, we provided outreach to over 226,000 to help connect people with critical and need services; partnered with State Legislative offices to provide constituent assistance, information for local newsletters and assist with benefits and entitlement screening for older adults; and trained over 2,100 professionals, including technical support for Immigrant Senior Centers, a three-day Conference on Aging and monthly “Boots on the Ground Workgroup” meetings to equip and engage the aging services workforce, so they are prepared to support the growing diverse needs of older New Yorkers. 

LiveOn NY thanks our champions in the legislature for their previous years of support for this program, and requests continued support to allow our team to continue supporting professionals and older New Yorkers through RISE into the future.

In Conclusion 

As we look ahead, LiveOn NY is ready to work with the State to continue to move the human services sector forward to ensure all New Yorkers can thrive in community with access to equitable community-based aging services.  

Thank you for the opportunity to testify.