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The Expanded In-home Services for the Elderly Program (EISEP)

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. In SFY 2013-2014 a base appropriation of $46,035,000 (with a COLA of $3,977,000) was made available for this program (total appropriation of $50,012,000).

The overall goal of the program is to improve access to, and the availability of, appropriate and cost-effective non-medical support services for older adults who are not eligible for services through Medicaid. EISEP assists older adults who need assistance with Activities of Daily Living (ADLs) such as dressing, bathing, personal care, and Instrumental Activities of Daily Living (IADLs) such as shopping, cooking, who want to remain at home. The coordination of EISEP's non-medical services and informal caregiver support enables older individuals to stretch their private resources to the point of delaying premature spend down to Medicaid eligibility.

An essential part of the EISEP program is case management. The program's case managers utilize standardized screening elements identify needs and wishes of eligible individuals and their families and provide options on services and supports that are available to address their identified needs and wishes. Linkages to services may include non-medical in-home services, non-institutional respite, ancillary services and other services.

Even under the best circumstances, caregiving is a physically and emotionally demanding task and can be overwhelming. EISEP supplements and sustains care provided by families and friends. Case Managers not only assist the client, but also their families. Case managers help both client and family members cope with these responsibilities and how they impact family life, leisure time, work life, personal finances and in many cases physical and mental health.

In 2011, the EISEP regulations were amended to provide opportunities for increased consumer control over in-home services by providing for Consumer Directed In home Services (CDIS). CDIS under EISEP is a person centered planning approach that empowers the older adult by enabling him/her (or his/her representative) to hire, train and oversee their in-home support workers.

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 older adults, consumers who are financially able may receive needed services, provided they pay for the services. The amount a consumer 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. Eighteen percent of EISEP consumers were required to cost share during SFY 2011-2012 and provided almost $1.5 million to expand the program. In addition, other non-cost share consumers voluntarily contributed over $332,000 to increase service delivery.

The most recent available data for this program is from SFY 2011. In SFY2011-2012, EISEP provided in-home services to almost 11,650 customers and case management services to almost 42,000 consumers. Of those individuals who benefited from EISEP services: all were frail or disabled, almost 44 percent were at 150 percent of federal poverty guidelines and were considered low-income, and almost 28 percent were minorities.