Testimony on Food Insecurity And Older Adult Centers

New York City Council

Subcommittee on Senior Centers and Food Insecurity

Chair, Council Member Mealy

Committee on Aging

Chair, Council Member Hudson

December 14, 2022

Oversight - Food Insecurity And Older Adult Centers

Thank you for the opportunity to testify.

LiveOn NY’s members include more than 100 community-based nonprofits that provide core services which allow all New Yorkers to thrive in our communities as we age, including older adult centers, home-delivered meals, affordable senior housing, elder abuse prevention, caregiver support, NORCs, and case management. With our members, we work to make New York a better place to age. 

Background

For many older New Yorkers, food insecurity remains a harsh reality of daily life. During COVID-19, food insecurity was deeply exacerbated by issues not only economic, but related to access as well, as seniors were advised to “stay home” to mitigate risk of contracting the virus. During this time, Older Adult Centers found new ways to provide critical services from setting up zoom classes to enrolling clients in emergency food systems, all in the face of unprecedented demand and a public health crisis. 

Prior to the pandemic, many older adults relied on meals from the Older Adult Center for more than half of their daily nutritional intake. An estimated 21% of older adults living in New York City are facing poverty and too often older adults have to choose between paying their rent and buying food. For a growing diverse aging population, Older Adults Centers were a lifeline during the pandemic, particularly in response to the increased risk of food insecurity and rise in social isolation that plagued many older adults. 

As we work to get older New Yorkers back out into the community, it’s clear Older Adult Centers are hubs for socialization, diverse programming, and other critical services. The City has the opportunity to create long term solutions and make meaningful investments to ensure all New Yorkers have access to equitable community-based services in their community. In response LiveOn NY recommends the following: 

Recommendations

Firstly, we invite the City to utilize our aging policy agenda, Aging is Everyone’s Business, released by LiveOn NY in partnership with Hunter College Brookdale Center for Healthy Aging, which is a bold policy agenda that provides actionable policy solutions, including food insecurity, to make New York a better, more equitable place to age. 

Second, in order to address these challenges and created long-term solutions focused on New York City’ congregate and home delivered meals program, LiveOn NY recommends the City should: 

Assess and allocate funding for the significant inflationary impacts on raw food, gas prices, and other infrastructure needs for contracts

Many of LiveOn NY’s members have raised their concern of the impact inflation cost for raw food, gas prices and other infrastructure items. For example, one of our members saw a 40% increase in raw food cost due to inflation this year. The unavoidable financial strain has created challenges for providers to continue to meet the growing capacity for home-delivered meals, in addition, providing congregate meals at Older Adult Centers. 

Continue to support new models of service including grab-and-go meals. During the COVID-19 pandemic, food insecurity among older adults was deeply exacerbated by issues not only economic, but related to access as older adults were required to “stay at home” to reduce the chances of contracting COVID-19. New models of service such as grab-and-go were critical and successful in ensuring, who may not be comfortable congregating due to COVID risks, or for personal reasons are less willing to meet their nutritional needs by eating at an Older Adult Center, have the option to take their meal home, a decision that ensures one’s nutritional needs can be met in the environment of one's choosing. 

Work with Older Adult Centers to assess the utilization of congregate meals at Older Adult Centers as providers continue to adapt to the new normal. 

It’s evident Older Adult Centers have returned to a new normal that has posed new challenges for in-person services and programming including congregate meals. Coupled with the growing concerns voiced by older adult participants such as public safety concerns, new mobility and cognitive challenges that may have arisen during the pandemic, lack of reliable transportation and other factors, illustrates a new reality for OACs and older adults. Nonetheless, LiveOn NY recognizes the importance of congregate meals to keep older adults fed as well as combat isolation through socialization at OACs and other services. In response to this DFTA must work with OACs to ensure we are addressing the new challenges for both older adults and providers.  

Assess the demand for case management to ensure all clients can be screened for case management eligibility and receive this critical service should they be eligible.

Further, exacerbated by the long-term health impacts of isolation and other stressors experienced over the past year and a half, many meal recipients of home-delivered meals may require some level of case management to remain independent and safe in their communities. These waiting lists have required advocacy for additional funding each year, and indicate a need for early and significant upfront investments to avoid the continued cycle of recurring waiting lists. 

Assess the demand for culturally competent meals for congregate and home-delivered meals

Almost 60% of New Yorkers 65 years or older, identify as a minority of an ethnic group, reflecting a significant need for meals that are culturally appropriate. The diversity of religious and health requirements - such as Kosher, Halaal, gluten free, vegetarian, vegan, or other consumer demands- also impacts the variety and associated cost of the meals providers must serve. The City must work to ensure older New Yorkers of all backgrounds and communities have access to culturally appropriate meals. 

Additional recommendations outside of the congregate and home delivered meals portfolio to address food insecurity for older adults include: 

Access to SNAP benefits for older adults 

The under-enrollment rate of SNAP benefits is a major problem among older adults as well as other public benefits. Older adults face many barriers to utilize SNAP benefits including stigma, misconceptions about SNAP benefits, language barriers, and other obstacles. SNAP benefits help keep food on the table for New Yorkers including older adults. To respond to this, LiveOn NY recommends the City continues its strong outreach effort to ensure older adults know about and enroll in SNAP. 

Develop and launch a centralized NYCFood Page to ensure all older adults can access food in their own neighborhoods.

We encourage the City to create a single, centralized, user-friendly NYCFood page that clearly lists all of the free or low cost-food options available to any individual. These options should range from older adult centers to pantry locations, to ensure all New Yorkers know how to access food in their neighborhoods at all times. Users should be able to filter by zip code, special status (like ‘senior’), hours of operation, and income limitations.

Pilot a Food Voucher Program for older adults 

Pilot a food voucher program where older New Yorkers can sign up through older adult centers to get vouchers towards meals at participating restaurants. For example, Erie County, NY, has a similar program called “Go & Dine.” In addition, Visions, an NYC-based older adult center, also has a diner voucher program.

Increase public funding support for local food pantries

In addition to OACs, there are over 500 food pantries in New York City. Older adults heavily rely on food pantries as an additional resource to receive food and groceries in their neighborhoods, making up an estimated 27% of the New Yorkers who visit the City’s food banks. . To respond to this, LiveOn NY recommends the City to increase public funding support for food pantries so that they can keep up with the high demand for food and groceries. 

 Thank you for the opportunity to testify.

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.

Testimony on Increasing Affordable Housing for Older New Yorkers and Improving Accessibility in the City’s Housing Stock

New York City Council

Committee on Aging

Chair, Council Member Hudson

Committee on Housing and Buildings

Chair, Council Member Sanchez

October 3, 2022

Oversight - Increasing Affordable Housing for Older New Yorkers and Improving Accessibility in the City’s Housing Stock.

Thank you for the opportunity to testify.

LiveOn NY’s members include more than 100 community-based nonprofits that provide core services which allow all New Yorkers to thrive in our communities as we age, including older adult centers, home-delivered meals, affordable senior housing, elder abuse prevention, caregiver support, NORCs, and case management. With our members, we work to make New York a better place to age. 

Background

Even prior to the pandemic, New York was in the grip of a housing crisis that made it difficult for tens of thousands of New Yorkers to find stable housing and make ends meet. Today, more than half of older renters are rent-burdened, as are a third of older homeowners. Further, roughly 2,000 older New Yorkers are living in homeless shelters, a number that is expected to triple by 2030 without significant intervention. LiveOn NY’s own research has found that there are more than 200,000 older adults languishing on waiting lists for affordable housing through the HUD 202 program, each waiting for 7-10 years on average for a unit to become available. This challenge is mirrored by the thousands of applications that come flooding in each and every time a new affordable senior housing lottery opens on Housing Connect. 

This crisis is particularly acute for older adults as many rely on fixed incomes, making it difficult to afford the rent while other costs rise. Further, much of the City’s housing infrastructure is inadequate to accommodate an older adult’s health and mobility needs, with 70% of the City’s housing stock only navigable by at least one set of stairs. In addition, NYCHA is a well-known provider of affordable housing for low income older adults, and yet in many situations for many older tenants living in NYCHA, their living experience is plagued by poor ventilation systems, broken elevators, leaking roofs, and recurring mold.

It is critical we address this crisis, as New York is aging rapidly and research shows that the majority of older adults would prefer the opportunity age in their community, surrounded by the networks of support built over a lifetime. Moreover, we’re all aging, and we all have a stake in ensuring there are affordable options to call home throughout the lifecourse.

Recommendations

Firstly, we invite the City to utilize our aging policy agenda, Aging is Everyone’s Business, released by LiveOn NY in partnership with Hunter College Brookdale Center for Healthy Aging, which is a bold policy agenda that provides actionable policy solutions, including housing, to make New York a better, more equitable place to age. 

LiveOn NY calls for a minimum target of 1,000 new units of affordable senior housing with services per year, as part of a total target to construct no fewer than 8,000 new units of housing dedicated to serving extremely low income and homeless households annually. As waitlists and limited housing stock pose an acute challenge for older New Yorkers, a considerable investment and consistent unit targets per year will be critical to paving a pathway out of this crisis. 

Further, this investment would build upon the clear success of the City’s Senior Affordable Rental Assistance (SARA) program, which has created incredible community assets in every borough, including examples such as West Side Federation for Senior and Supportive Housing’s (WSFSSH’s) Tres Puentes in the Bronx and HANAC’s Corona Senior Residences in Queens. These two building are clear examples of what is possible through housing, with Tres Puentes not only offering 175 new units of affordable senior housing, but providing space for a new Older Adult Center, health center and pharmacy on site, and the Corona Residences offering 67 affordable senior units that  were built to the environmentally friendly Passive Housing standards, in addition to offering a new Pre-K on the ground floor.

LiveOn NY also recommends the City increase the per unit reimbursement rate for SARA services from $5,000 per unit, to $7,500 per unit, allowing for increased staff to more adequately address social isolation and significant case assistance needs. This increased reimbursement rate would make services better available to support an aging and formerly homeless tenant population, in turn enabling more older New Yorkers to age in place and avoid institutionalization.

Increasing capital funding for public housing to support upgrades throughout NYCHA buildings and improve infrastructure to accommodate older adults. NYCHA is also one of the largest sources of affordable housing for older adults, with 38% of households headed by an adult age 62 or older. However, NYCHA faces its own set of challenges. For one, the current condition of the housing poses a safety risk for older occupants. Poor ventilation systems, broken elevators, leaking roofs, lead paint on the walls, broken locks on the doors, and unattended water damage are just some of the challenges that older tenants continue to face. Further, community-based providers operating Senior Centers in NYCHA are not immune to these challenges, particularly when receiving fines for infrastructure related violations that are wholly out of the provider’s control.

Notably, the City must also invest in the workforce of the Department of Housing Preservation and Development (HPD), by hiring new staff required to ensure that affordable housing goals can be met. While the pace of development has only quickened in recent years, hiring freezes and now PEGS have resulted in understaffing at HPD that puts the entirety of our City’s affordable housing goals at risk.

LiveOn NY encourages that attention also be paid to improving work order processes initiated by community-based organizations offering services within NYCHA facilities. Community-based organizations operating within NYCHA buildings, such as older adult centers, are critical resources for NYCHA residents and the community at-large. These spaces must also be considered when updating work order processes or should be funded directly to address maintenance concerns considered outside the purview of the authority.

Additionally, it is critical that the City prioritize public and institutional land (e.g., hospitals, libraries, etc.) for affordable senior housing. By prioritizing institutional land such as hospitals in particular, the City will reflect an understanding of the connections between health and housing, and a commitment to treating housing as the social-determinant of health that it is.

Improve the Senior Citizen Rent Increase Exemption “SCRIE.” The ability for seniors and individuals with disabilities living in certain housing types to freeze rents helps to ensure thousands of older New Yorkers will not be priced out of their housing as rents otherwise continue to rise. Despite the strength of this program, it remains underutilized and does not ensure affordability as it caps rents at the period of application, which may already be a place of severe-rent burden for the tenant. To respond to this, LiveOn NY recommends the City continues its strong outreach effort to ensure older adults know about and enroll in SCRIE. 

Proposed Legislation

Intro. 676

LiveOn NY supports the intent of Intro. 676, which would require the Department of Housing Preservation and Development (HPD) to develop a list of universal design principles and require a percentage of dwelling units receiving city financial assistance to be universal design units. Much of the City’s housing infrastructure is inadequate to accommodate an older adult’s health and mobility needs, with 70% of the City’s housing stock only navigable by at least one set of stairs. This bill is an opportunity to incorporate universal design into dwelling units to ensure housing is accessible for everyone, regardless of age, physical ability or stature. However, LiveOn NY recommends the City gather input from nonprofit community housing providers and ensure adequate funding is allocated to support community-based housing providers with the ability to comply with universal design requirements. 

LiveOn NY supports the intent of  Intro. 584, which would require the Department of Housing Preservation and Development (HPD) to provide tenants with disabilities with information about legal services when such tenants are facing eviction. While this bill is a step forward to address the housing crisis among people living with a disability, we urge the City to work in coordination with community-based organizations with existing housing programs and legal services (ex. The Assigned Counsel Project) that are an additional trusted resource for older New Yorkers and people living with disabilities. 

LiveOn NY supports the intent of Intro. 322, which would require the installation in multiple dwellings of certain protective devices for older adults and persons with disability in multiple dwellings. 35.5% of the City's older adult people 65 and older have reported having some form of disability. This is significantly higher than among the population at large, and is a reality that makes certain housing accommodations, such as protective devices including grab bars in the shower, crucial to support the independence of individuals living  in the City. Nonetheless, the city should ensure that nonprofit housing providers receive the funding needed for these requirements.

Furthermore, LiveOn NY supports Council Member Caban’s Resolution 236 calling upon the New York State Legislature to pass, and the Governor to sign, S.5102/A.1475, which would allow municipalities and localities that have a senior citizen rent increase exemption program to establish an automatic enrollment program for eligible seniors to be automatically enrolled or automatically re-enrolled in the program. Currently, LiveOn NY offers a Benefits Outreach Program, which supports hundreds of older New Yorkers in applying for benefits each year. Through this work we recognize the opportunity to address under-utilization of benefits such as SCRIE by removing barriers in the application processes.

Thank you for the opportunity to testify.

Testimony on Intro 175 of 2022

New York City Council

Committee on Civil Service and Labor: Chair, Council Member De La Rosa

September 6, 2022

 Oversight - Intro 175 of 2022

Thank you Chair De La Rosa and members of the Civil Service and Labor Committee for the opportunity to present testimony about Introduction 175 of 2022.

LiveOn NY’s members include more than 110 community-based nonprofits that provide core services which allow all New Yorkers to thrive in our communities as we age, such as older adult centers, home-delivered meals, affordable senior housing, NORCs, and home care. LiveOn NY is also home to the Reframing Aging NYC Initiative, part of the national Reframing Aging Initiative aimed to counteract ageism and improve the way policymakers, stakeholders, and the public think about aging and older people. With our members, we work to make New York a better place to age. 

As long-standing champions of the rights of human services and home care workers throughout New York, LiveOn NY initially sought to support the intent of Intro 175 of 2022 to cap home care worker shift hours at 12 hours per day in most cases. However, the lack of amendments to redress the serious jurisdictional mismatch between this legislation and existing State policies makes it impossible for LiveOn NY to continue to offer our support. Given this, LiveOn NY opposes Intro 175 of 2022, sponsored by Council Member Marte. 

After careful consideration, and despite similar goals to address the problematic 13-hour rule, LiveOn NY can no longer support legislation that would effectively shutter countless home care agencies as a result of their inability to comply with conflicting State and City regulations simultaneously. To be clear, home care agencies complying with the legal mandate to serve clients under the existing framework of regulations provided by the New York State Department of Labor (NYSDOL), would then receive heavy fines levied as a result of the City’s conflicting policies. The consequence will be forced closure of nonprofit home care agencies throughout New York City, resulting in the loss of jobs for workers and the loss of care for older adults and people with disabilities.

Instead of having State and City policies at odds, leaving home care agencies and consumers of home care hanging in the balance, LiveOn NY respectfully asks the sponsor, and all of New York City Council, to join us with in addressing this issue by supporting existing State legislation, S.359A (Persaud) / A.3145A (Epstein), which mirrors Intro 175.

Background 

NYSDOL has established that residential home care employees who have 24-hour shifts must only be paid for 13 of those hours in most cases, despite work that often stretches throughout the night and rarely affords real meal or sleep breaks. This “13-hour rule” sets Medicaid reimbursement rates, so providers who want to pay workers fairly for the full 24 hours must find 11 hours of pay in their own budgets. For many home care providers, especially those that are nonprofit organizations, this is impossible. The result is a systematically underpaid workforce[1] comprised largely of women of color and immigrants.

Workers filed several lawsuits against their employers over the 13-hour rule in 2017, but the State Court of Appeals ruled against the workers in March 2019 and the status quo was maintained. The home care sector currently employs 330,000 people in New York—less than 10% of whom regularly have 24-hour shifts—and by 2025 the sector is expected to see a 33% growth in demand with a workforce shortage of a net 23,000 workers.[2] Now that the lawsuits are settled, New York State must take action to stabilize a sector in crisis and fairly compensate its workforce.

State Legislation and Fiscal Impact

Intro 175 is based on State legislation, S.359A (Persaud) / A.3145A (Epstein), which LiveOn NY deeply supports, and mirrors much of its language. Both bills seek to rectify the unfair pay structures that result from the NYSDOL’s 13-hour rule by capping the number of hours an employer can require a home care worker to work at 12 hours, with a cumulative limit of 50 hours of work per week. It would massively reduce if not eliminate the number of 24-hour shifts, offering a creative workaround to existing State policy. Notably, the State bill additionally includes limited exceptions to go over the weekly cap, with clear worker protections added for these cases including an anti-retaliation clause; and includes a legislative intent that this bill shall not be intended to reduce the hours of authorized care for patients. While both bills are similar in nature, only the State legislation can be passed with adequate authority to ensure funding for such a shift in the home care staffing pattern.

There is a significant fiscal impact of Intro 175, with industry estimates citing an additional $1-1.2 billion in funding needed to cover existing 24-hour cases as split shifts across the state, a portion of which would be applicable to New York City, even prior to accounting for recent wage increases included in the last State budget. This makes Intro 175 an unfunded mandate and further engrains the necessity of passing S.359A / A.3145A and providing such funding in the State budget. Without this investment the bill could have dramatic unintended consequences. The City would have to conduct a fiscal analysis and include hundreds of millions of dollars per year to Medicaid to contribute to this legislation’s success. Further, while Medicaid 

[1] Mean annual wage of home health aide in New York, 2020: $28,750. https://dol.ny.gov/labor-data#31-0000.

[2] www.mercer.us/our-thinking/career/us-healthcare-labor-market-interactive-map.html

is the predominant funding source for home care in New York City, Medicare and private pay are two additional funding sources. The bill fails to clarify how Medicare and private pay patients will be able to afford split shifts.

Additional Concerns

 We have several specific concerns with Introduction 175, laid out below:

Staffing: The bill requires more workers to fill the split 12-hour shifts which are currently filled by one 24-hour worker, yet there is nothing in the bill to encourage the creation or retention of these jobs. New York is already at a point of a pending workforce shortage, and without attention this bill could exacerbate the problem. By mandating split shifts during a worker shortage, the bill could lead to 24-hour patients becoming institutionalized as opposed to staying in their homes. It is also important to note that the State recently granted a minimum wage increase for home care workers or $3 per hour spread over two years. While this is absolutely needed, and was advocated for under the Fair Pay for Home Care campaign, which our organizations support, given nationwide inflation and labor concerns this increase does not on its own sufficiently address the workforce shortage.

Jurisdiction: It is unclear whether New York City is legally able to implement this bill for City-based home care workers, given the State’s strong role in regulating the industry. For example, it is unclear whether the City has jurisdiction to legislate Managed Care Organizations (MCOs). While MCOs and the NYC Human Resources Administration (HRA) currently assign 24-hour shifts and determine whether to approve 12-hour split shifts, these entities are not mentioned in the bill language. If legally allowable, the bill should mandate that MCOs and HRA split all 24-hour shifts, and that they modify their contracts with home care agencies to ensure split shifts are the rule for people who need 24-hours of care. The bill would also have to consider the role of unions, as much of the home care workforce is unionized and adheres to contractual labor agreements.

Violations: While both the State and City bills include a right to civil action for law violations, the City bill goes further by laying out a penalty schedule for violations. Though it is not clearly stated in the bill, those penalties would likely fall on the providers and not on the MCOs and HRA that serve as fiscal intermediaries and administrators, regardless of which entity was responsible for the violation. While penalties are important to ensure compliance with a given law, without addressing HRA and MCOs’ role in authorizing service hours and split shifts this bill is missing a key component of the home care system and placing undue burden on providers.

For these reasons, LiveOn NY opposes Intro 175, and implores City Council to address this issue by supporting state bill S.359A (Persaud) / A.3145A (Epstein).

Thank you for the opportunity to testify. 

Testimony on Improving Older New Yorkers’ Access to City Services

New York City Council

Committee on Aging: Chair, Council Member Hudson

September 7, 2022

 Oversight - Improving Older New Yorkers’ Access to City Services

Thank you for the opportunity to testify. 

LiveOn NY’s members include more than 110 community-based nonprofits that provide core services which allow all New Yorkers to thrive in our communities as we age, such as older adult centers, home-delivered meals, affordable senior housing, NORCs, and home care. LiveOn NY is also home to the Reframing Aging NYC Initiative, part of the national Reframing Aging Initiative aimed to counteract ageism and improve the way policymakers, stakeholders, and the public think about aging and older people. With our members, we work to make New York a better place to age. 

LiveOn NY acknowledges the work of the Mayor Eric Adams Administration, the City Department for the Aging (DFTA) led by Commissioner Lorraine Cortés-Vázquez, the New York City Council led Speaker Adrienne Adams and the Committee on Aging led by Aging Chair, Council Member Crystal Hudson. 

Background

LiveOn NY is appreciative of the City’s investment for older adults and the aging sector in the FY23 Adopted Budget by including an additional $3.2 million to expand DFTA's Geriatric Mental Health Program (DGMH), $60 million to provide a cost-of-living adjustment for human services workers, $14.9 million for the home-delivered meals program, $3 million to improve IT education for older adults, among other key investments.  This budget moves the aging services sector in the right direction, from a significant human services workforce investment to additional funding for home-delivered meals to keep older adults fed. 

​​Nonetheless, we also recognize there is more work to be done to better support older New Yorkers. While the aging population continues to be the fastest growing demographic, with 1 in 5 New Yorkers expected to be 60 and older by 2040, the City must go further to ensure all older New Yorkers regardless of their background have access to equitable aging services to safely age in community. 

Therefore, we invite the City to utilize our aging policy agenda, Aging is Everyone’s Business, released by LiveOn NY in partnership with Hunter College Brookdale Center for Healthy Aging, which is a bold policy agenda that provides actionable policy solutions to make New York a better, more equitable place to age.

Further, LiveOn NY recommends the following to improve access to aging services for older adults and community-based organizations. 

Recommendations 

Combat Hunger

DFTA should assess and allocate funding for the significant inflationary impacts on raw food, gas prices, and other infrastructure needs for contracts

Many of LiveOn NY’s members have raised their concern of the impact inflation cost for raw food, gas prices and other infrastructure items. For example, one of our members saw a 40% increase in raw food cost due to inflation this year. The unavoidable financial strain has created challenges for providers to continue to meet the growing capacity for home-delivered meals, in addition, providing congregate meals at Older Adult Centers. 

Nonetheless, LiveOn NY is appreciative of the City Council's recent announcement of $3 million in funding for the repair and replacement of an estimated 44 hotshot vans for the City’s home delivered meals program. This critical investment in the infrastructure will literally and figuratively keep the wheels in motion for providers to expand capacity and continue to meet the growing need for home-delivered meals throughout New York.  

The City should continue to support new models of service including grab-and-go meals. During the COVID-19 pandemic, food insecurity among older adults was deeply exacerbated by issues not only economic, but related to access as older adults were required to “stay at home” to reduce the chances of contracting COVID-19. New models of service such as grab-and-go were critical and successful in ensuring, who may not be comfortable congregating due to COVID risks, or for personal reasons are less willing to meet their nutritional needs by eating at an Older Adult Center, have the option to take their meal home, a decision that ensures one’s nutritional needs can be met in the environment of one's choosing. 

Affordable Senior Housing 

LiveOn NY recommends the City allocates funding to develop 1,000 units of affordable senior housing with services per year. While the Adopted Budget included investments to support affordable housing programs, the City needs to go further to fully address the need for affordable senior housing. The investment of a minimum target of 1,000 new units of affordable senior housing with services per year, is part of a total target to construct no fewer than 8,000 new units of housing dedicated to serving extremely low income and homeless households annually, as called for by the United for Housing coalition. As waitlists and limited housing stock pose an acute challenge for older New Yorkers, a considerable investment and consistent unit targets per year will be critical to paving a pathway out of this crisis. 

LiveOn NY also recommends the City increases increase the per unit reimbursement rate for the City’s Senior Affordable Rental Assistance (SARA) services from $5,000 per unit, to $7,500 per unit, to fund two housing staff positions at each building to provide support for the residents to more adequately address social isolation and significant case assistance needs. 

Proposed Legislation

LiveOn applauds Aging Chair Hudson for introducing a legislative package aimed at promoting critical services and supports for us all to age in our communities in New York City, and thanks Council Member Hudson and cosponsors. 

LiveOn NY offers the following feedback on the proposed legislation:

Intro.1696

LiveOn NY supports the intent of Intro. 1696, which would require the Department for the Aging to require older adult centers to expand their programming to include linguistic and cultural programs relevant to the local communities in which they reside. This bill would allow the City to work to ensure all older adults have access to equitable culturally and linguistically component services to safely age in community. This is specifically important for our growing diverse aging population in the City. Nonetheless, LiveOn offers two specific recommendations for this bill: 

1. To utilize the Mayor’s Office of Nonprofit Services to push for technical assistance and training directly for immigrant-focused and/or smaller, culturally diverse nonprofits. As DFTA looks to grow its service portfolio to increase linguistically diverse programs, there must be a pipeline and support system - coupled with new and additional dollars - to support expansion. 

2. In addition, funding will be required to support resources and staffing capacity including the hiring of multilingual staff at Older Adult Centers. The network of Older Adults Centers already provides extensive language and culturally appropriate services throughout the City. However, given the growth of new needs, funding must be increased to ensure that new needs can be met.

Intro. 1538

LiveOn NY supports Intro. 1538, which would require a know your rights pamphlet for older adults. Throughout the City, a variety of aging services are available for older adults yet too often older New Yorkers and caregivers are unaware of the breadth of aging services available within their community. This bill will provide a culturally and linguistically appropriate know your rights pamphlets to older adults, caregivers and others, through outreach, educating them on the range of services and support available including age discrimination, elder abuse, food insecurity, housing support and more.

Intro. 1650

LiveOn NY supports the intent of Intro. 1650 which aims to provide housing stability for older adults by entitling any person who is 60 years of age or older to full legal representation in eviction or termination of tenancy proceedings in housing court. Across the City, older adults face difficulties with finding affordable housing with rising rent prices and over half of older New Yorkers are rent-burdened, spending more than 30% of their income on rent. While this bill is a step forward to address the housing crisis among older adults, we urge the City to incorporate a social services/legal services model which would provide both the legal and social services support that older adults will need to remain in their homes. We also urge the City to work in coordination with community-based organizations with existing housing programs and legal services (ex. The Assigned Counsel Project) that are an additional trusted resource for older New Yorkers.  Further, while legal and social service supports to address housing insecurity are critical, LiveOn also urges the City to strengthen existing programs, such as the Senior Citizen Rent Increase Exemption (SCRIE) program and affordable senior housing programs, as noted above.

Thank you for the opportunity to testify.