Community Services for the Elderly Program (CSE)
In the late 1970's, the New York State Office for the Aging (NYSOFA) became increasingly aware of older New Yorkers experiencing unnecessary placement in institutional care. Considerable research had proven institutional settings to be counter-productive to the sustained viability of persons who had the desire and the capability, with some support services, to thrive at home, in their communities. It was evident that the absence of effective community support services, as well as a nursing home bias, often resulted in unnecessary institutional care.
In May, 1979, New York State enacted the Community Services for the Elderly Act as section 541 of Article 19-J of the Executive Law of New York State (now, New York State Elder Law, Article II, Title 1) based upon NYSOFA's assessment of these unmet needs. The Act established the Community Services for the Elderly (CSE) Program to:
- Improve the ability of communities to assist elderly people who need help in order to remain in their homes and to participate in family and community life.
- Improve cooperation and coordination among the many providers of community services, which can help frail elderly people who are at-risk of premature institutionalization.
- Eliminate the confusion and frustration often experienced by older persons, their friends, relatives, caregivers, and persons acting on their behalf when seeking services to meet the essential, and often chronic-care, needs of the elderly.
- Reduce the heavy reliance on institutions as a way to care for the older adult, prevent excessive restrictions on the freedom of needy older persons, and reduce the unnecessary public expense of caring for the needs of frail, at-risk older New Yorkers.
CSE has effectively been a State aging services block grant that enables localities to determine specific unmet needs and to shape the way the delivery system is organized to respond. Localities have considerable flexibility within the general parameters of the program's intent and goals. Through the initial and ongoing annual planning and coordination process, a wide range of service needs and gaps have been identified including case management, personal care, home delivered meals, information and assistance, referral, social adult day care, transportation, respite, telephone reassurance and friendly visiting, health promotion and wellness activities, senior centers and other congregate programs, personal emergency response systems, minor residential repairs, escort, and other important services.
The most recent data for the program is based on SFY 2012-13 and indicates that approximately 64,000 older New Yorkers benefited from CSE funded services. An unduplicated count of CSE customers indicates that 23,155 are low-income, 34,323 are frail and disabled, 39,608 are over the age of 75 and 34,246 live alone.
In SFY 2012-13, CSE was appropriated $15,312,000 with additional funding of $4,984,000 provided through a Human Services COLA for a total program funding of $20,296,000. During that period, the program supported over 121,000 personal care hours, 196,000 social adult day hours, 87,000 case management hours, 334,000 rides, 23,000 assisted transportation rides, 109,000 units of in-home contact and support, 30,000 personal emergency response units, 104,000 home delivered meals, 891,000 congregate meals, 56,000 senior center education/recreation group activities, 45,000 health promotion units, 12,863 caregiver services, and 5,048 nutrition education units.
In SFY 2013-14 the funding level for this program was unchanged from 2012-13. In SFY 2014-15 an appropriation of $20,296,000 was contained in the budget. In addition, an additional appropriation of $5,000,000 was added and a Direct Care worker COLA of $316,000 was provided for this program making the total appropriation for SFY 2014-15, $25,612,000.