NY must improve access to quality assisted living services NOW!
New York State faces an urgent challenge: how to care for its rapidly growing population of seniors while ensuring accessibility to high-quality, cost-effective services in the least restrictive setting. The Medicaid-funded Assisted Living Program (ALP) is a proven solution, offering 24-hour care and supervision in a home-like setting to frail, low-income seniors who can no longer live alone safely. ALP services are offered at a fraction of the cost of institutional care. However, chronic underfunding and outdated reimbursement rates are driving this vital program toward collapse.
Immediate Action Needed:
1. Reform the ALP Reimbursement Structure:
The ALP’s reimbursement rates are still based on 1992 costs, despite decades of inflation and skyrocketing operational expenses. To ensure the program’s sustainability and prevent further closures, New York State must:
– Update the base year for reimbursement to 2024.
– Implement an additional 20% rate increase to support these essential communities until rebasing takes effect.
2. Expand the Special Needs Assisted Living Residence (SNALR) Voucher Program:
This program, which subsidizes up to 75% of the monthly cost for seniors who have dementia and are living in memory care units, is a lifeline for individuals who have exhausted their financial resources. Doubling its current funding of $7.75 million will help more seniors remain in their assisted living communities, avoiding costly transitions to institutional Medicaid-funded nursing homes.
Why It Matters
Assisted living communities offer seniors independence, choice, and privacy alongside personalized care in an independent congregate residential setting. Services include meals, housekeeping, personal care, medication management, and social activities, all delivered in a cost-effective, home-like environment. Yet, years of chronic underfunding have forced many providers to close. Over the past decade, New York has lost more than 4,200 Adult Care Facility beds primarily serving low-income seniors.
If New York fails to act now, frail seniors who cannot afford private-pay options will have nowhere to turn, and the state will face soaring Medicaid costs as these individuals transition to institutional nursing home care.
A Looming Crisis
Currently, 1 in every 5 New Yorkers is over age 65. Within the next five years, that number will grow by 1.7 million. This demographic shift demands urgent action to prepare for the increasing need for accessible, high-quality care that is both fiscally responsible and sustainable. Assisted living is a critical piece of this puzzle, providing the most cost-effective solution to meet the needs of seniors requiring 24-hour care and supervision.
A Call to Leadership
New York must rise to its leadership role by prioritizing investments in accessible assisted living services. The ALP has saved the state billions of Medicaid dollars since its inception, yet its outdated reimbursement structure undermines its continued success. Similarly, the SNALR Voucher Program is a practical solution to support seniors in need of dementia care while easing the strain on the Medicaid system.
The Time to Act is Now
New York cannot afford to delay. Reforming the ALP reimbursement rates and increasing funding for the SNALR Voucher Program are common-sense solutions that will safeguard essential services for future generations, build a more equitable system, and honor our collective responsibility to care for those in need.
By taking these steps, New York can set an example for the nation, proving that we can care for our frail elderly while ensuring fiscal responsibility. Let us work together to save, sustain, and grow assisted living and guarantee access to these critical services for all New Yorkers.
Lisa Newcomb is Executive Director of Empire State Association of Assisted Living (ESAAL).
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