Caring for someone in your family with a disability, chronic condition or an illness that gets worse over time, like Parkinson’s or Alzheimer’s, requires a lot of time and energy. Whether these long-term care services happen at home or in a nursing home or assisted living facility, they’re also very expensive. Unsurprisingly, the median cost of care at both nursing homes and at-home care in New York state is much higher than in the rest of the country, and even higher in New York City. Also no surprise, it got worse during the pandemic.
Beyond that, where does New York fare in the nationwide long-term care crisis? AARP — a national organization that focuses on issues affecting older adults — released its Long-Term Services and Supports (LTSS) Scorecard on Thursday. The report, which is published every three years, compares states’ performance on long-term care based on factors like affordability and access, safety and quality, support for family caregivers, how they integrate communities and how much choice people have in the kind of setting and provider they get. For a snapshot of how New York did, here’s our state’s most recent rankings.
Epicenter-NYC scoured the scorecard and jumped on a call with the experts behind this report on Thursday to find out how New York state is doing on an issue that affects so many of us.
Here are a few highlights:
Susan Reinhard, the senior vice president of the AARP Public Policy Institute, congratulated New York for steadily improving its long-term care performance overall. “They are way up there now in the first tier,” she told Epicenter.
What’s good …
- New York is one of only seven states to have statewide laws protecting caregivers from discrimination in the workplace.
The law ensures that they’re not treated unfairly because they have caregiving duties outside of work. In New York City, under its Human Rights Law, a company can’t decide not to hire or promote you because of it. (They aren’t, though, required to offer flexible scheduling to employees with caregiving responsibilities if they’re not already offering it to others.)
- New York was ranked third in the country for making Medicaid-Buy-in programs available in the most expansive ways.
This means New York state policy allows more working people with disabilities to get and keep their Medicaid benefits. Eligible people can earn more income without the risk of losing essential health care coverage. New York basically does this by making Medicaid-Buy-In programs as affordable as possible and enrolling a lot of people.
- New York was one of four states to get major kudos for statewide innovation. It was recognized for “taking groundbreaking steps to improve their systems” that the general public, leaders and policymakers understand pretty well. One of those steps was including a multi-sector plan for aging.
In New York, it refers to the State Master Plan for Aging (MPA) Governor Kathy Hochul approved in Nov. 2022. This plan embeds “age-friendly” principles focused on equity and accountability into state policies and operations. This includes, for instance, a commitment to regular updates on progress and challenges in supporting older adults. You can learn more about it here.
What’s not good …
- Since the 2020 scorecard, there’s been a 15% improvement across the board in assisted living supply — basically, the ratio of beds available for adults aged 75 and over (who are more likely to require assisted living). While states like Hawaii improved drastically and states like Minnesota had the largest supply ratio, New York has the smallest: 20 beds per 1,000 adults 75 years and older.
“I can’t answer your question about why they are not investing more in assisted living,” Reinhard told Epicenter. “States invest some Medicaid dollars in paying for people who choose, under their waivers, their home and community based waivers, but in general assisted living supply is a private sector matter.”
- While all states have a competitive wage problem in nursing home care, New York is among the five states offering these workers the least competitive wages based on comparable occupations. In New York, the hourly wage for direct care workers at these facilities is $4.12 less than for other entry-level jobs.
“New York does have a big problem in a way: a huge wage gap between being a homecare worker, nurse or other direct care worker, or another job they could get in another industry in that state,” Reinhard told Epicenter.
This is part of a series of articles exploring health inequities in New York funded by a grant from the Commonwealth Fund.
