NYAPRS Note: The need for effective home care services for aging New Yorkers will only grow in the coming years. While the state is aware of the need for a more comprehensive system to address the needs of our aging population, exemplified by the Department of Health led Master Plan on Aging project, many people are at risk of losing one service which drastically improves lives and satisfaction for those who desire to age in place. Home care services offer direct assistance to people who need support with activities of daily living. These supports, such as help with grocery shopping and personal hygiene, may seem small, but they help people remain in their communities of choice and are far cheaper than the alternative institutional settings like nursing homes and hospitals. Home care services can prevent unnecessary institutionalize, are cheaper than care in nursing homes and hospitals, and help older adults keep more autonomy and age in their current homes as the vast majority want. We must protect these services and prevent the state from restricting eligibility as it is currently set to do in April 2024. Paying for these services now will prevent us from spending even more money for the unnecessary institutionalization of older New Yorkers that will follow. See below for more information about the pending rule change and how it could affect those who rely on home care services in New York.
Commentary: Rule Change Will Make It Harder for New Yorkers to Age in Place
If New York restricts eligibility for home care, more older or disabled New Yorkers will end up in institutions.
By Blaise Bryant | Times Union | August 3, 2023
It’s about to get much harder for people to become eligible for home care in New York. We cannot let that happen.
In 2020, Gov. Andrew Cuomo, looking to trim Medicaid costs, included a measure in the 2021 state budget that significantly limits eligibility for “personal care assistance,” a type of help people can receive in their homes that gives them the support they need to remain independent.
During the pandemic there was a moratorium on Medicaid cuts, but the state’s new rules took effect in May, when the federal pandemic emergency ended. And that means people who get insurance through Medicaid will need to meet stricter criteria to qualify for personal care assistance at home beginning on April 1, 2024.
Under the new rules, a person will need assistance with three or more activities of daily living, unless they have a dementia diagnosis. These activities of daily living are the hands-on essentials, activities like getting dressed or going to the bathroom. Currently there is no set minimum number of activities to qualify a person for home care. Needing help with things like cooking, cleaning or shopping won’t qualify a person for home care at all.
The type of physical assistance a person needs to qualify for home care is restricted even more. For instance, a person needing help transferring in and out of a tub or shower, or needing help washing their back and hair, would not qualify. In short, a lot of people who live independently in the community because they get just the right amount of assistance would no longer be able to receive home care services through Medicaid.
These rule changes would have broad implications. They would impact older New Yorkers who want to age in place. They would impact anyone who needs to seek home care services after a long hospital stay. And they would impact disabled people who rely on personal care assistance to live their daily lives. What’s more, without restoring home care access, a greater burden of care will fall on unpaid caregivers who already contribute billions of dollars in unpaid services.
Restricted home care access would cost the state more money in the long run: A study from the Association on Aging in New York found home care saves money, especially for those receiving fewer than 40 hours of care per week. With less care at home, more people will end up hospitalized or in emergency rooms due to issues that would have been preventable with more home assistance. Providing a less-intensive level of care now prevents or postpones the need for more intensive care later. With these new rules, more people will end up institutionalized.
When you consider that most people will either need personal care assistance in the future and/or will provide it to someone else, it becomes clear that access to home care benefits everyone. The vast majority of people say they would prefer to age at home and avoid being placed in a nursing home, where they are less likely to live their lives the way they want. As our population ages, we must expand access to home care services, not reduce it.
We urge lawmakers to reverse the new rules before they take effect next April 1. Restoring home care eligibility standards would help solidify New York as an age- and disability-friendly state, and would ensure vulnerable people can maintain the dignity and independence that we all deserve.
Blaise Bryant is a communications specialist with the New York Association on Independent Living.
Rule change will make it harder for New Yorkers to age in place (timesunion.com)