Albany, NY — New York’s Medicaid program spends roughly $12 billion per year on in-home “personal care” for the elderly and disabled — nearly as much as the other 49 states combined — according to a new report from the Empire Center.

In fact, during the decade ending in 2019 New York accounted for 85 percent of the nationwide increase in personal care spending. Per-capita spending is now eight times higher in New York than the national average.

“Personal care” consists of non-medical services provided to the elderly and disabled in their homes, and takes a large — and growing — share of the state’s Medicaid budget. According to the new report, “Long Term Crisis: The Case for Reforming Medicaid ‘Personal Care’ in New York,” New York’s huge and expensive version of the program shows increasing signs of dysfunction and waste.

The report identifies signs of trouble in New Yorks home care program, including high spending, rapid growth, a continued reliance on nursing homes over personal care and an unusually large workforce of home health aides. Despite complaints that the industry is facing a shortage of available workers, employment in the home care industry has nearly doubled in 10 years, a signal of the program’s rapid and unsustainable expansion.

“The overarching goal should be to downsize the personal care program to a scale more proportionate to the state’s demonstrated need. This would not only control costs, but also ease the demand for workers and thereby alleviate labor shortages,” said Bill Hammond, senior fellow for health policy at the Empire Center and author of the paper. “Better, more efficient management of New York’s personal care program has the potential not only to save money, but also to reduce dependence on nursing homes and improve working conditions for care aides.”

The paper includes several recommendations to rein in the program, starting with an independent review of why New York’s program is so much more expensive than every other state.

The full paper can be read here.

The Empire Center, based in Albany, is an independent, not-for-profit, non-partisan think tank dedicated to promoting policies that can make New York a better place to live, work and raise a family.

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