OPINION: Managed Long-Term Care plans punish New York’s disadvantaged seniors

The New York City Coalition of Social Adult Day Cares provides teleservices to older adults. Photo courtesy of AiM/ OASIS Adult Day Care Services” (located at 1930 Bedford Ave., Brooklyn, NY). 

By Irina Golub

Long before the onset of COVID-19, older New Yorkers were faced with social isolation, an issue that can lead to anxiety, depression and decline in cognitive function in senior citizens.

Social adult day care programs were introduced to combat social isolation, prevent hospitalizations, and delay nursing home admissions. This is a win-win for seniors as well as the insurance companies. 

Healthy seniors residing in their homes cost the system significantly less than those in nursing homes.  Seniors that attend these programs engage with others who are in a similar stage in their lives. One of the most important activities is engaging in meaningful conversation with staff as well as other seniors leading to a happier, more fulfilled self. Social adult day programs offer age-appropriate activities, provide nutritious meals, local outings, birthday celebrations and group support. 

With over 47,000 coronavirus cases in New York City, and at least 1,941 people dead, the pandemic has become one of the most devastating in recent history — particularly for senior citizens, as social adult day cares have been forced to serve seniors remotely by providing daily wellness check-ins, a variety of teleservices, delivering meals and medications onsite at the seniors’ homes, and being available around-the-clock to help members with everyday needs and problems during a global public health crisis.

As seniors were asked to stay home to protect themselves from COVID-19, social isolation became a serious concern.  This concern is real and is highlighted daily in Governor Cuomo’s briefings. Social isolation will lead to depression.  Seniors with dementia or Alzheimer's are very accustomed to their routine.   

When they are taken out of that routine and away from their peers, depression from social isolation will set in. With the closure of social adult day cares for in-person attendance, it is imperative to provide modified teleservices and to give members continuity of care required.

 They need to hear familiar voices. They need to see familiar faces. They are petrified and alone.  Social adult day care provides these daily services to their members to ensure their safety, health and well-being for some of New York’s most vulnerable.

Yet social adult day programs were notified by the Managed Long-Term Care Plans, or MLTCs — insurance plans that work under New York’s Medicaid program to cease all services.  This is a huge and very dangerous mistake.  

Without social adult day care teleservices, seniors — many of whom are frail, disabled or cognitively impaired — are at greater risk of hospitalizations.

 Whether it’s due to malnutrition, panic or simply feeling isolated, a trip to the ER puts them at greater risk of contracting coronavirus and even death. Social adult day cares have continued serving their members, providing a range of vital teleservices in a pandemic, to prevent this unspeakable outcome.

While the federal, state and local governments are promoting telemedicine and telecare, the MLTCs are turning away their members’ desperate pleas for continuation of teleservices and are cutting lifesaving services at the time they are needed most.  As an essential services provider, social adult day programs are empathetic and cannot turn a blind eye on their members.  

Why are MLTCs refusing to pay for social adult day care telecare programs, which have been providing vital services to seniors throughout this pandemic without support? 

Representing 56 centers servicing over 10,700 members, The Coalition of New York City Social Adult Day Cares needs the immediate support of New York City, New York State, and especially MLTCs in order to continue providing vital services to New York’s most vulnerable.

Irina Golub is a member of the Coalition of New York City Social Adult Day Cares.