CSCS: Council of Senior Centers and Services of NYC, Inc.

Testimony

NYC DEPARTMENT FOR THE AGING
FY2010-2011 ANNUAL PLAN
OCTOBER 27, 2009

Council of Senior Centers and Services (CSCS) is comprised of 200 member agencies providing community-based services for 300,000 older New Yorkers. Services include multi-service senior centers, congregate and home-delivered meals, case management, home care, transportation, caregiver support services, health and wellness programs, NORCs, elder abuse, adult day services, ESL and other immigrant services, housing, mental health, intergenerational and other services intended to allow older adults to age in place at home in their community with dignity.

The interesting thing about the aging services field has always been that this is one part of life we all share and aspire to for us and our loved ones – growing old. The aging services network steps in to ensure quality of life and meet the daily needs of aging in place once medicine has done its job to keep us alive. No small task. No small responsibility.

New York City has the largest diverse community-based network of aging services in the nation. Each day, thousands of older New Yorkers turn to this community-based network to: stave off isolation, receive nutritious meals, connect with a community of peers and professionals committed to their well being, improve their physical and mental health through exercise, arts, falls prevention and other chronic care management classes, programs for those with Alzheimer’s, other forms of dementia and physical disabilities, have fun in life through recreational programs, continue lifelong learning through educational and cultural opportunities, remain engaged in their community through voluntarism, retain independence by utilizing accessible, affordable transportation, acculturate into their new home through ESL, citizenship classes and other supports, address depression and other mental health needs through counseling and referrals to mental health professionals, receive professional supports to remain at home if they are frail and homebound, provide a place for family caregivers stretched and in need of support to turn to, live in safe, affordable housing and generally have a place to turn to for support, services, and caring.

This is all done in many languages to serve older adults from a variety of cultures and ethnic groups from across the world. The aging services network is New York City at its best. We are in the middle of the largest age revolution in the history of the city, state and nation which will only intensify. CSCS’ 2008 policy paper, “No Time to Wait: The Case for Long Term Care Reform”, provides a blueprint for affordable, consumer friendly, community-based care.
How are we doing?

As portrayed above, in some important ways, we are doing well. Thousands of elderly people receive needed services each day. The city has often stepped in to add funding as federal funds erode and state funds fail to keep up with demand. In some ways, we have already fallen behind and are getting pushed back further as demand grows and funds diminish. CSCS is committed to working with all levels of government to strengthen the frayed safety net older adults have to depend upon if they are not eligible for Medicaid. Although the aging services network does not receive Medicaid funding, it does serve thousands of poor, near poor, and moderate income seniors. Since none of DFTA’s funding is an entitlement, is all discretionary, each dollar added comes with exhaustive advocacy campaigns, and with each downturn in the economy, services are cut. Yet, the aging revolution continues – the numbers grow, longevity grows, diversity grows, poverty grows, and the complexity of growing old in NYC grows. The only thing that doesn’t grow is the financial supports.

Some highlights of lost funding in recent years:

• 2009 Mayor’s Management Report – DFTA funded home care is down by 12%, Mow is down by 8%. While the report states that DFTA expects to bring MOW back to prior performance levels and home care to meet projected targets, it is clear that need heavily outweighs the aging services network to provide services.
• City Council restored an astonishing $32 million in the FY10 budget to DFTA for which we are deeply appreciative. However, $6 million was still lost. Each year, City Council restores cuts proposed by the administration. While this money is, of course, welcomed, it means that a growing percentage of DFTA’s direct services budget has to be won back each year, with little hope of any increases, and the possibility of decreases. This is not an appropriate way to fund and manage community-based aging services to some of the most vulnerable New Yorkers – elderly, frail, poor, victims of elder abuse, those with Alzheimer’s and so on.
• State cuts have eaten away at EISEP case management and home care, adult day care, SNAP MOW, CSE, transportation, and a variety of other community-based services. More cuts are being proposed at this time which would impact these same services.
• Federal stimulus funds have bypassed the aging services network. Only $3 million over two years for congregate and home-delivered meals has made its way into DFTA’s budget. This is a piddling amount compared to budget gaps, cuts, waiting lists, and growing need.

This is what this system of services often looks like to elderly people and their family caregivers – waiting lists. Waiting lists for: case management, gridlock in turning on MOW which has been in gridlock for over six months (and when there isn’t gridlock, there’s waiting lists for MOW), home care, transportation, and respite care for caregivers. CSCS recommends that DFTA track waiting lists for these services so we can understand the challenges and the depth of the need not being met.

Erosion of staff and services occurs at senior centers as budget cuts come and costs increase. In today’s dollars, the average $350,000 DFTA grant to senior centers, should be well over $500,000 – just to meet inflation. CSCS’ 2006 report, “More With Less is Impossible”, documented that even after laying off staff, ending programs and services, and putting off needed improvements in a senior center, the center still doesn’t have enough funds to manage their program. Staff salaries, with a low base salary to begin with, receive only small increases, not even keeping pace with inflation.

It is widely acknowledged that the numerous senior centers need serious renovations. As reported in CSCS’ 2007 renovation study, “It’s Broken, Fix It”, based on responses from 160 senior centers outlines the needs. City capital dollar spending rules often make it impossible for senior centers to benefit from use of capital funds: setting a minimum of $500,000 and demanding a 10 year lease be in place when contracts aren’t for that long. CSCS strongly urges the administration to establish a small capital grants program to allow capital funds from the Mayor, City Councilmembers, and Borough Presidents to be applied towards the tremendous renovation needs of senior centers. Seniors deserve a safe, accessible and attractive environment to be in every day.

Is all this just complaining? We are, after all, in terrible fiscal times. However, in the aging services network, we go from moments of winning some new funds to then having to fight hard to hold on to them – it’s like dancing in quicksand. Again, from the viewpoint of the elderly and the workforce on the frontlines every day, it’s not complaining, it’s just stating the facts – we have fallen behind in providing a community-based infrastructure older New Yorkers can come to depend upon – one that would help make NYC the age-friendly city we all strive for.

CSCS appreciates the efforts of Commissioner Lilliam Barrios Paoli and her staff to correcting some of the problems caused by the restructuring of case management and MOW. Re-allocating funds between case management agencies that have high caseloads and waiting lists and those with lower caseloads and no waiting lists may be a way to maximize the utilization of limited dollars. It does produce winners and losers – some agencies gain needed funds to hire more case managers while others lose funds and have to lay off case managers. Over time, it is likely their caseloads and waiting lists will grow. At the end of the day, there is simply not enough money in the EISEP case management and home care program and in MOW. CSCS recommends that OMB implement a trend factor in case management and home care to see the cost of doing business annually and allocating funds appropriately to meet the need as is done with other service areas.

CSCS is working with the state legislature, advocates and providers around the state on legislation to prevent waiting lists for MOW. We are seeking legislation that would require the state to provide funding for the cost of food and delivery once a senior is assessed as eligible for MOW. We believe this will bring financial relief to localities for the future demand for MOW while spreading cost across the state. We would seek “maintenance of effort” language that would hold local dollars intact, while letting local government know that future costs would be picked up by the state. It is not an unfunded mandate for local government, but rather the opposite – placing the responsibility for fully funding MOW on the state. The NY State Office for the Aging estimates this would cost $4 million – not a huge amount statewide. This legislation is one of the recommendations that came out of our 2007 study funded by City Council, “Hunger Hurts: A Study of Hunger Among New York City’s Elderly”.

In January, 2009, CSCS established a Senior Center Planning Committee. It is out of this committee that we have embarked on what has become the nation’s largest senior center study ever done by a non-governmental agency. We are proud of this study, done in collaboration with Manoj Pardasani, Fordham University, a nationally recognized researcher and expert on senior centers. The intention of this study is to go to the grass roots – seniors, senior center directors and administrators, and other aging professionals, to find out what they want to see in senior centers. To date, over half of all senior center directors and 3600 seniors have responded. The senior survey was done in English, Spanish, Chinese and Survey Monkey. We hope the results will help inform policy and planning around senior centers. The study’s results will be released in December, 2009.

CSCS is grateful that Mayor Michael Bloomberg, Deputy Mayor Linda Gibbs, and Commissioner Lilliam Barrios Paoli, have all embraced CSCS’s proposal for charter senior centers. Mayor Bloomberg has committed $25 million towards this initiative - $18 million of city tax levy dollars and $7 million of private foundation funds. No senior center will be closed or cut to fund this initiative. To make this new initiative successful, the funding base of senior centers needs to be left intact. We believe that this effort has already begun to change the conversation about senior centers towards building on the strengths and value they now provide and the potential waiting to be more fully realized. We look forward to working with the city to bring this initiative to fruition.

We’d also like to return to the proposal to allow senior centers to serve congregate meals off-site, creating a “senior center without walls” and expanding the congregate meal program across a community.

CSCS believes that DFTA and the NY State Office for the Aging should not be cut any further. These are very small city and state agencies and every dollar cut is a dollar of direct service to seniors and their caregivers. It pushes the city back further from developing the community-based infrastructure for growing old that New Yorkers want and need.

We look forward to working with Commissioner Barrios Paoli and her staff to ensuring that New Yorkers can grow old and age in place with dignity and the supportive services they require.

All studies referred to can be found at the CSCS website – www.cscs-ny.org – advocacy archives.