Chapter 894 of the Laws of 1986 established the Expanded In-home Services for the Elderly Program (EISEP). This program is administered by NYSOFA using uniform statewide program regulations and standards, and implemented and managed locally by the 59 AAAs. Only non-medical in-home services, case management, non-institutional respite and ancillary services are provided under EISEP.
The overall goal of the program is to improve access to, and the availability of, appropriate and cost-effective non-medical support services for non-Medicaid dependent elderly. At the same time, use of EISEP’s non-medical and informal caregivers approach enables older people to stretch their private resources to the point of delaying premature spend down to Medicaid eligibility.
EISEP assists elders who need help with Activities of Daily Living (ADLs: e.g., dressing, bathing, personal care) and Instrumental Activities of Daily Living (IADLs: e.g., shopping, cooking) who want to remain at home and are not eligible for Medicaid.
An essential part of the EISEP program is case management. The program’s case managers help elders and their families decide what assistance is needed and arrange for services that may include non-medical in-home services, non-institutional respite, ancillary services and other services available in the community. EISEP supplements and sustains care provided by families and friends. Case Managers not only assist the client, but also their families. Even under the best circumstances, caregiving is a physically and emotionally demanding task. When it becomes the primary responsibility of one family member, it can be overwhelming. Case Managers help both client and family members cope with these responsibilities and how they impact on family life, leisure time, work life, personal finances and in many cases physical and mental health.
Virtually all EISEP customers meet the programmatic eligibility requirements for Medicaid personal care services - and most are very close to being financially eligible. In SFY 2010-11, EISEP provided in-home services to almost 13,500 customers and case management services to more than 44,000 customers. Of those seniors who benefited from EISEP services: all were frail or disabled, almost 48 percent met federal poverty guidelines and were considered low-income, and almost 28 percent were minorities.
EISEP is not an entitlement program and, thus, does not serve all older individuals in need. This program operates under a fixed, capped budget and uses a sliding fee scale based on income to determine customer cost sharing requirements. Although EISEP is targeted to low income elderly, clients who are financially able may receive needed services, provided they pay for the services. The amount a client pays depends on his or her income. For individuals who are unable to pay for the full cost of their care, EISEP funds cover part or all of the costs of needed services. Eleven percent of EISEP clients were required to cost share during SFY 2009-10 and provided almost $2 million to expand the program. In addition, other non-cost share clients voluntarily contributed over almost $385,000 to increase service delivery.
