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Demand for home care in New York City is growing as Baby Boomers reach their 60s and as life expectancy rises. Two-thirds of people over the age of 65 will need some form of long-term care at some point in their lives, and over 90 percent of aging New Yorkers would prefer to receive home-based care, instead of institutional care. With the New York City senior population projected to reach 1.4 million by 2030, close to one million New York City seniors could soon need home care.


Unfortunately, too many New Yorkers are unable to access the home care they need. While some low-income seniors are able to access home care through Medicaid, many low- and moderate-income seniors who do not qualify for Medicaid still cannot afford to pay for the care they need out-of-pocket and cannot access unpaid care from family members. A survey of over 1,200 New Yorkers conducted by the New York Caring Across Generations campaign revealed serious care affordability concerns: inability to afford home care was the most frequently-cited reason for seniors having unmet care needs. We estimate that there are over 77,000 low-income seniors with care needs in New York City.

Small City Program Offers Seniors Hope

The Expanded In-Home Services for the Elderly Program (EISEP) was designed to provide part-time home care services to non-Medicaid-eligible low-income seniors 60 years and older—including those who are undocumented. Client income and expenses are used to determine the level of subsidy for services. A Department for the Aging (DFTA) case manager determines need for EISEP services.

Limited EISEP Reach, Cuts in City Funding

Unfortunately, the current reach of the EISEP home care program is very limited. EISEP serves fewer than 3,000 seniors with care needs; that is less than 4% of the 77,000 low-income seniors with care needs in the city. And recently, funding for the program has been cut, even as the need for home care has been on the rise.

EISEP Home Care Need versus Reach around NYC

As the table below illustrates, low-income seniors are underserved by EISEP.

EISEP Contract Area Near-Poverty Seniors with Care Needs Current EISEP Reach
BX 1-6 8,500 149
BX 7-12 8,500 352
BK 1-4, 6 5,000 234
BK 5, 8, 9, 16, 17 5,500 185
BK 7, 10, 11, 12 7,000 164
BK 13, 14, 15, 18 9,000 319
MN 1-5 4,000 216
MN 6, 7, 8 2,500 237
MN 9, 10, 11, 12 8,500 225
QN 1-6 8,000 308
QN 7, 8, 11 4,500 162
QN 9, 10, 12-14 5,000 267
SI 1-3 2,500 93


The Expanded In-Home Services for the Elderly Program (EISEP) has been underfunded in the City’s Fiscal Year 2015 Executive Budget. The program helps non-Medicaid-eligible low-income seniors, including those who are undocumented, 60 years and older pay for part-time home care services. It also creates living wage jobs for home care workers and provides much-needed respite to family caregivers.

FY 2015 Budget Goal:

Additional $1.8 Million City Funding for Home Care

According to DFTA, there are currently 240 seniors on the home care waiting list. DFTA estimates that an additional $1.8 million City investment in EISEP home care, above the current fiscal year 2015 allocation, would clear the 240-person waiting list for home care.

4-Year Goals:

Increase City and State Funding for Home Care and Case Management

City and State funding for home care and case management should increase to meet the needs of New York’s senior population. Case management determination of need is required to access EISEP services, so an expansion of EISEP requires the same of DFTA’s Case Management program.

Comprehensive DFTA Study of Unmet Home Care Needs

A commitment by the Department for the Aging to comprehensively assess unmet care needs by geography, race, language, and income, will enable targeted service provision to populations in greatest need.


New York Caring Across Generations is a coalition of over 40 organizations representing over 200,000 New Yorkers, working to ensure dignity, respect, and a good quality of life both for caregivers and individuals receiving care. Join us! To get involved, contact Maya Pinto at Learn about Caring Across Generations at and about New York Caring Across Generations at