TESTIMONY
Lorraine Cortes-Vasquez, Commissioner of the NYC Department for the Aging, on Fiscal Year 2025 Budget, Service Improvements, and Advocacy Against Ageism
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19 min
Lorraine Cortes-Vasquez discusses the NYC Department for the Aging's budget, achievements, and challenges in addressing the needs of older New Yorkers.
- Cortes-Vasquez highlights the department's $485 million budget for fiscal 2025, including funds for home delivered meals and home care for non-Medicaid eligible seniors.
- She emphasizes initiatives to combat ageism and to support older New Yorkers through various programs such as the talent competition 'Talent is Timeless.'
- Cortes-Vasquez advocates for equitable funding for home care workers and seeks partners to challenge ageism.
- She updates on successful collaborations with city agencies for public safety, public service campaigns on elder abuse, and the implementation of transportation services for older adults.
- The testimony underscores ongoing challenges such as insufficient state and federal funding, and the need for guidance on meal provision for Medicaid-eligible clients.
Lorraine Cortes-Vasquez
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Good morning.
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Good morning, chair Hudson.
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Oh, is it on night?
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Yeah.
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Good morning, chair Hudson.
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Chair of Brendan of the Finance Committee, Members of the Aging And Finance Committee.
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As you know, I'm Lorraine Corte Vasquez.
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I am the Commission of New York city department for the aging known as NYC Aging.
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I'm joined this morning as we've just been swear sworn in, Jose Mercado, our Chief Financial Officer.
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I thank you for this opportunity to discuss aging's preliminary budget for fiscal year 2025.
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FY 25.
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I'm also pleased to be speaking to you today because March 8th, which is the International Woman's Day.
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I have the honor of presenting this testimony before a historic number of women in leadership in New York.
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Particularly in the city council, which for the first time has the majority of women serving in this chamber.
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And the administration with the majority of women in leadership and also representing the agency, which serves a client base that the majority of women over the age of 60.
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So congratulations to all of us on International Women's Day.
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Good morning, speaker, Adams.
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In addition to working to eliminate ageism and ensuring the dignity and quality of life of older New Yorkers, Providing high quality services and resources among our top priorities at NYCAG.
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To support this important work, our FY preliminary budget, as the council chair has stated, is 485,000,000 of which 347,000,000 is city funds, including allocations for 223,000,000 to support older adult clubs commonly known as OACs and 59,600,000 for home delivered meals all called HDMs, $44,400,000 for case management and $39,500,000 to support home care for homebound older adults, which are not Medicaid eligible.
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14,700,000 for no programs, 8 $200,000 for caregiver services and $5,200,000 for transportation services.
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The past fiscal year has been challenging for the city financially.
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And New York Aging has worked to ensure we are pre prioritizing the needs of older adults and our core services while limiting the impacts of these challenges, like the various programs to eliminate the gap, the pegs.
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We are pleased to see that under this executive budget, there are no mandatory savings exercise and the previous pegs were implemented without negatively a acting services to older adults.
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Nonetheless, we are keenly aware of the need for aging services, particularly in core services that are aligned, with our community care approach, especially as the number of older adults in New York continues to grow.
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Because of that, we are working to ensure our state and federal partners share this financial responsibility to aging services in New York City.
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Despite these challenges, these past challenges, including as I said early insufficient state and federal funding, We are proud of the work that has been done along with the network of nonprofit partners in addressing some notable recent successes.
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One of those is that in September 23, we celebrated the 1st year anniversary of the NYC Cabinet for Olden, New Yorkers.
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This effort continues to grow through a project with 24 city agencies and the continued support of the mayor's commitment to an age inclusive city and interagency collaboration, which addressed the needs of Aldrin, New Yorkers.
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In the past year, for example, NYPD has enrolled rolled out the assignment of older adult liaisons in every preset.
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And every police service area to better enhance public safety for older adults.
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Additionally, cabinet agencies work to create a public service campaign and training for city agencies on elder abuse and ways to recognize when an older adult is being mistreated.
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These initiatives break down communication silos between older adults, agencies, and also other agencies that serve older New Yorkers.
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And this is a budget neutral process that happens through collaboration and the meaning of mutual goals.
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Another such initiative has been that in August 23, we worked with the mayor to host a series of older adult town halls.
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At select older adult clubs throughout the city.
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To ensure that older adults got the same access to city services when voicing their concerns, about their community.
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Thus far, we've held 9 town halls covering every borough with the input from city agencies such as dyct, DOT, HPD, PEU, NYPT, Department of Health And Mental Health, and the Department of Finance, well as the Department of Education, just to name a few.
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We're excited to continue this kind of community engagement and are planning additional town halls throughout the city.
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I hope you can join us at some of these.
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Last summer and into the fall, New York City hosted our first ever talent is timeless.
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Competition for older adults where we welcome more than a 1000 older New Yorkers to showcase their artistic musical and performance skills.
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Every OAC had the opportunity to put forth talented older adults who competed at local regional and Burrow Wide competitions.
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The citywide competition was hosted at the iconic United Palace Theater in Washington Heights.
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Home of the 2023 Tony Awards.
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That gave Alden New Yorkers a brand stage to shine.
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It was a display of talent and joy, but it also showcased that ability is ageless.
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Additionally, Our ongoing efforts to combat agism is a constant uphill battle.
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I was happy to write an armpit, which ran in a New York Times ledger I mean, I'm sorry.
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The Queenstown's ledger, we wish it was in New York Times.
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The Queen's Curia in Northeast, New York City regarding the pervasive ages and seen in the current presidential election.
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We look to the council for assistance in standing up against agism.
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Which is the last critical social justice is social justice, discrimination with a level of acceptability.
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We need as many partners as possible to join us as we raise awareness to combat an injustice that affects an individual's self worth as well as marginalized an entire population.
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I implore each of you to raise your voice and write up ads on this critical social injustice.
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Discrimination.
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We're also incredibly grateful, and I said this over and over again, for the ongoing support of the city council.
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Which in FY 24 awarded New York City aging over 41,300,000 in discretionary funding.
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Allowing us to make even greater investments in often underserved or unserved communities.
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I'm gonna talk a little bit about one of our signature programs called Home delivered meals.
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The program is a vital component of New York City's network of services.
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Home delivered meal programs not only provides meals, to homebound older adults.
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The interaction with a delivery person for many clients may be the only direct human interaction for a day.
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Support our ongoing efforts to combat social isolation.
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Again, a critical aspect of our community care approach.
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This program continues to follow the strict guidelines set by the state and is open to those who meet those criteria.
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Because financial security remains amongst the critical the most critical needs of older adults, and it is highly correlated to food and security.
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NYC Aging is continuously evaluating our efforts and exploring areas for improvement.
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This includes enhancing meal options for recipients.
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Embracing the diversity of our city by increasing the availability of culturally aligned meals.
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Promoting uniform high quality nutrition meals.
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The current HDM RFP now includes a requirement for halal meals.
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Which is indicative of our goals to further expand NYC Aging's commitment to cultural competency and religious preference.
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If at in FY 23, our network of 14 HDM home delivered meals providers delivered 4,000,000 over 4,000,000 meals to 27,500,000 clients.
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That same year we were thrilled to have announced a continued increase in the reimbursement rate for home delivered meals, something that you fought along with us to get.
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HDM reimbursement rates spread from 11 78 in fiscal year 20.
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23 to $12.78 in fiscal year 2024.
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Additionally, we are grateful for the partnership the council to support an important program by funding $3,100,000 to replace 44 specially designated vehicles used to deliver these important meals.
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These are called hotshot vehicles because they have the ability to keep food warm and hot.
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We are pleased to report that all 44 hotshot vans have been delivered and are likely, as I am speaking, right now, delivering meals to homebound older adults across to 5 boroughs.
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We welcome your critical partnership as we explore new options similar to this again this year.
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I'd like to also raise an ongoing issue which we have spoken about in previous hearings.
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Last year, we were informed by the New York State New York State Office on Aging that managed long term care clients, MLTC, clients would receipt, would should receive meals only through their MLTC providers.
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This was surprising as New York City Aging had been providing home delivered meals to Medicaid eligible clients for the past 12 plus years.
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As Medicaid is a means tested programs, MLTC clients should be receiving meals through those providers rather than HMDM.
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Since we've learned of that issue, we had identified MLTC clients, which were enrolled in the program, 7th totaling 7000.
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We were very clear with NICE Sofer that we were not to remove 7000 HDM client services.
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Rather, they would have to be grandfathered in.
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And then we ask them for guidance moving forward for new MLTC clients.
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We still wait for SOPH to deliver formal guidelines for these older adults.
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Which New York City believes should still be in the HCM program if they qualify.
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Currently, NYCAG has identified 2 point I mean, 2097 older adults in the MIT's MLTC programs who have been deemed ineligible to receive home delivered meals.
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Again, we are still waiting for guidance from the state office on aging on how to proceed with these cases.
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I employ you.
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We employ you.
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To partner with us as we seek guidance and clarity for this from the state on this issue.
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Your voice will amplify the needs of older adults, in all of these items and food pro provision for these vulnerable older adults.
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So I really am looking forward to that partnership.
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Transportation.
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During FY 23 New York City Agency, New York City Agency completed the transportation RFP process and awarded contracts.
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To provide individual and group rides to older adults.
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That is for older adults, particularly those in transit desert or mobility issues.
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Can call a transportation provider and be scheduled for a ride to a medical appointment, a bank, a grocery store, pharmacy or other essential destination.
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The transportation program is meeting, is filling a gap, and the lives of older adults who have difficulty navigating public transportation in New York City or who have special mobility needs, which require accessible vehicles.
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In FY 24, the transportation program was funded at $5,200,000 across 10 programs.
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I would like to note that the transportation program is separate from community based transportation provided by our network of older dog clubs.
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Many of whom opted to prioritize the transportation needs of their sensor membership in their RFP submissions and ultimately in this contract.
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This is meant to be for OAC clients to get to and from their home to the center or hard rides as a group to the center for certain eye openings or an event.
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Each OAC had the opportunity to include transportation dollars as part of their response to the I'm sorry, to the response to the RFP and ultimately to be included in their contracts.
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108 chose to include community transportation services.
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One of our most critical areas is what I'm going to speak about now.
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As the number of older adult in New York City continues to grow, it is imperative that we continue to grow the community care support systems.
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Which allowed Olden New Yorkers to remain in the communities that they built and to truly age and place.
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We do this through home care and caregiving services, which greatly serve those who are home bound or in need of additional support.
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Home care services are provided through Medicaid reimbursement for those who do not qualify for Medicaid.
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Through the expanded in home services or ISEP program, which Kate's management hours are then reimbursed to programs.
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Currently, we are advocating to New York State for the inclusion of 55ยข per hour to match ISAP home care workers which bring them into parity with the Medicare home care workers who have already received these raises.
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This leaves Isep clients at a disadvantage when Medicaid home care workers are incentivized to take on clients because their pay is higher.
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There is no distinction between the IEP or the Medicaid home care worker.
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They are primarily women of color.
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This paid disparity exacerbates in inequity because of the source of funding.
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Currently, the home care program on NY CAGG is funded at the tune of $38,700,000 for FY 25.
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This does not include the wage increases to match Medicaid workers.
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That this occurred in previous years, and this was resolved last year in part with the help of the advocates, of the council, and our aging network, and all of us who were vigorous about making sure that the state had parity in funding for these women of color and that they should not be left out of critical aging services.
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We prevailed last year.
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I don't know why it happened again this year.
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As we know, the pandemic was challenging for everyone, and the strain on unpaid care givers has been significant.
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New York City agents caregivers support program office support counseling, training, outreach informations to unpaid caregivers.
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Many older adults are caretakers for their aging parents.
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Many are caregivers who also have full time past well, I mean, full time jobs.
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The caregiver program offers support options for respite care through home care in participation.
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With other services.
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In 1927, we estimated that there are 1,300,000 New Yorkers who function as caregivers.
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Without the support of care for daily living activities, respite care.
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Many of these caregivers do not have the financial means or ability to leave the caregiver as somebody else's care, while they take a needed break from their care responsibility.
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We know that the cost of keeping an older adult in institutional care is far higher when compared to the cost of community care options.
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Such as supporting caregivers.
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The cost on an average is $160,980 to house an older adult in institutionalized care.
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Whereas the average cost of community care is roughly between $32,000 per person per year.
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In FY 'twenty five, funding for the caregiver program is projected to be $8,200,000.
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Caregiver support positively impacts the health and well-being, not only of the older adult, while being also aligned with their cultural ground of the individual.
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This is why community care is so important to the future of Olden New Yorkers.
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This integrated service for home assistance which is care for daily needs such as bathing, cleaning, food prep, shopping, transportation, and meals provision.
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Can keep all older adults in the community longer, which is their desire and is a shared goal between this administration and this council.
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As many of you know, I have personal experience with this.
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I have a ninety four year old mother who wants to remain in her home, who wants to go to the church that she's familiar to the community in which she lives, to hang out with her friends and her family, and surrounding the community that she is.
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She should have that opportunity.
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Every older adult should have that opportunity.
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Many of you on this counsel committee also know that experience personally.
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In conclusion, I want I wanna say over and over again that I'm proud of the work that NYC Aging is doing.
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But this work is not our work.
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This is the work of a vital network in the community who with our resources provide for the greatest need of older adults.
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This past year we have shown where New York City aging as a whole can look to efficiencies and improvement for our program.
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That truly met the needs of older in New York.
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The peg and the peg exercise was an eye opener.
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This mindset has allowed us to weather cost savings exercises, which every agency had had to complete, while the financial outlook, even though it's improving, we are continuing to be good steward of public dollars.
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While the needs of older adults often outpaced resources for aging services, I look forward to continuing to explore ways to match our programs.
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To those increased demands.
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As always, I'm grateful to you, to you chair Hudson for your partnership and also for your ongoing advocacy.
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I thank you very much, and I'm gonna ask you, we all have to combat agism.