Community Services for the Elderly Program
In the late 1970â€™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, the New York State Legislature 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). 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, 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 programâ€™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.
During SFY 2010-11, approximately 61,000 older New Yorkers benefited from CSE funded services. An unduplicated count of CSE customers indicates that 17,916 are low-income, 29,456 are frail and disabled, 37,901 are over the age of 75 and 30,919 live alone.
CSE was funded by the state at $15,312,00. These funds supported about 368,000 personal care hours, 260,000 social adult day hours, 125,000 case management hours, 296,000 rides, 10,000 rides of assisted transportation, 102,000 in home contact and support, 26,000 personal emergency response units, 166,000 home delivered meals, 25,000 congregate meals, 21,000 senior centers education/recreation group activities, 7,000 health promotion sessions, 2,600 caregiver sessions, 65 nutrition education sessions.
Title III-B Supportive Services
The cornerstone of aging services can be found within Title III-B of the Older Americanâ€™s Act (OAA). The programs supported by these funds are key to providing older New Yorkers with a high quality of life and maintaining older adults in their preferred living environment.
Presently, Title III-B funds are used by New Yorkâ€™s network of 59 Area Agencies on Aging (AAA) to provide supportive services, including senior centers, in-home services, transportation, adult day care, legal assistance, and a range of additional services. Currently in New York State, Title III-B funds are used to provide a continuum of services designed to assist elders and support their caregivers and families.
Title III-B is authorized in Section 306 of the 1965 Older Americanâ€™s Act, as amended. Funding is provided to New York State on a formula basis; the New York State Office for the Aging (NYSOFA) distributes these funds on a per capita basis and awards smaller-populated counties with a minimum base of funding. Funds are available on a 90 per cent federal share, 10 per cent local match. The OAA provides for assurances that an adequate proportion of funds will be expended on certain priorities associated with: access to services (transportation, outreach, information and assistance, and case management services); in-home services, including supportive services for families of older individuals who are victims of Alzheimerâ€™s disease and related disorders with neurological and organic brain dysfunction; and legal services. New York State has directed that Title III-B funds will be specifically set aside to meet these priority services, with 20 per cent of the funds directed toward the access services, 2.5 per cent directed toward in-home services, and 7 per cent directed toward legal services.
At the community level, AAAs designate focal points for the comprehensive delivery of service in each community, including designating multi-purpose senior centers.
Services provided under Title III-B are targeted to those older individuals with greatest economic need, those with greatest social need, those residing in rural areas, and low-income minority older individuals. Services include:
- Personal Care Level I
- Personal Care Level II
- Adult Day Services
- Case Management
- Assisted Transportation/Escort
- Legal Assistance
- Information and Assistance
- In-Home Contact and Support
- Senior Center/Recreation and Education
- Health Promotion
- Personal Emergency Response
- Caregiver Services
Title III-B service expenditures of $24,616,187 provided approximately 19,200 hours of personal care, 19,400 case management hours, 54,000 hours of social adult day, 106,000 hours of legal assistance, 635,000 rides, 4,700 rides of assisted transportation, 77,000 senior centers recreation/education sessions, 18,000 health promotion sessions, 12,700 caregiver group sessions, 6,000 personal emergency response units, 2,500 outreach contacts, 128,000 in-home contact and support, and more than 1 million I&A contacts.