Gov. Hochul’s aging services problem

Older New Yorkers desire and deserve to remain in the homes and communities where they have lived and raised families. And yet we are failing to meet this reasonable need for thousands of people who are not eligible for Medicaid. Why? In part, it’s a problem with the New York State budget, which Gov. Hochul largely controls.

The issue, as we testified at a state Assembly hearing on Oct. 17, is inadequate funding for the Expanded In-Home Services for the Elderly Program (EISEP). Despite the popularity and cost-saving nature of this program, budget shortfalls leave thousands of people waiting months or even longer for the delivered meals, personal assistance, transportation, housekeeping and other essential services they need to stay in their homes.

EISEP supports older people who are not on Medicaid but cannot afford private help. However, the New York State Office for the Aging (SOFA), which runs the program, has said that more than 11,000 service requests are unfilled at any time. The advocates and program administrators we talk to believe that number is closer to 18,000.

With a booming aging population — the number of older adults age 65 and up in the state has increased 31% in the past decade — we can only expect more people to need services.

AARP New York, LiveOn New York, and other organizations have asked the governor to add $42 million to EISEP to support our fast-growing aging population.

With that allocation, counties could meet demand for more meals, personal care and housekeeping. Sadly, though, the 2024-2025 budget added just $700,000, making barely a dent in the waiting list.

Older people who do not get regular, basic help tend to have more falls, accidents, have to move into nursing homes, or even die. A line from a 2023 SOFA report captures the essence of the problem:

“Many individuals experienced ER visits and hospitalizations, had injuries due to falls, or died while awaiting service.”

It’s a scenario the public agencies and non-profit organizations coordinating county-level aging services see all too often in far too many places from Long Island to Buffalo.

“When someone is released from a hospital, and we tell them they might have to wait four or five months for home-delivered meals, we are not surprised a few weeks later when they wind up back in the hospital,” said David Jordan, board president of the Association on Aging in New York. “When we’ve said we had wait lists, we’ve had older adults in tears say, ‘You’re letting me die at home.’ That’s literally the way it feels.”

Short-changing EISEP is also economically short-sighted. No older New Yorker should be forced to impoverish themselves. Without access to EISEP, older New Yorkers of modest means have no choice but to impoverish themselves to get on Medicaid to access home care or nursing home care. This hurts the older adult, it hurts their community where they would otherwise contribute to the local economy, and hurts the already strained state budget and taxpayers.

According to SOFA, home services cost about $10,000 per person annually. The math is simple, when you compare this to the average $400 a day, or more than $150,000 a year, for a nursing home. SOFA has said that $15 million invested in addressing the waiting list will save $50 million in Medicaid, which taxpayers also fund.

By investing an additional $42 million in housekeeping, delivered meals, and other services, the state would save $237 million on Medicaid. Not making the investment only makes the costlier options more likely.

The governor’s unwillingness to adequately fund EISEP also adds stress, and has huge economic impacts for family caregivers, who often reduce work hours or leave jobs entirely to see that a parent is fed and their personal hygiene needs are met.

During the 2025 legislative session starting next month, our organizations will prioritize getting EISEP the funding it needs to address the waiting lists. We know that basic help profoundly impacts older adults, their family caregivers and taxpayers.

The governor has many choices when she puts together a budget exceeding $200 billion. Recent budget initiatives have shown that the money flows when she is committed to an issue and makes it a priority. We hope that as the governor works on her budget proposal, she will prioritize helping thousands of families struggling to keep their aging loved ones at home.

Nickerson is the executive director of LiveOn NY. Finkel is the state director of AARP New York.