NY Unveils Master Plan for Aging Final Report
(July 1, 2025) On June 30, 2025, NYS released its highly anticipated Master Plan for Aging (MPA) final report, a comprehensive document intended to lay the groundwork for addressing the needs of older adults and individuals with disabilities. Developed under the leadership of the Department of Health (DOH) and the NYS Office for the Aging (NYSOFA), the MPA seeks to ensure that older New Yorkers and New Yorkers with disabilities "can live fulfilling lives, in good health, with freedom, dignity and independence to age in place for as long as possible." The plan is the result of extensive collaboration among state agencies, stakeholders, and community members, incorporating input from over 430 experts, including many LeadingAge NY members and staff, and feedback from town halls and surveys.
LeadingAge NY CEO Sebrina Barrett stated in the Governor's press release:
“As the only statewide organization dedicated to the entire continuum of care for older New Yorkers, LeadingAge NY supports the MPA’s comprehensive approach to addressing the needs of older adults. With a growing population of older adults and a shrinking number of working-age caregivers, we need to act swiftly and decisively to ensure access to appropriate services and the necessary workforce to provide them. We welcome the report’s attention to innovative solutions, such as housing with services, and its proposals to address provider regulations and payment rules that limit access and fragment care. We are excited to continue the productive inter-agency and multi-stakeholder collaboration that has arisen from the MPA process, as we work to promote a high-quality continuum of care for older New Yorkers today and in the future.”
The MPA report outlines proposals across nine thematic pillars, focusing on equity, dignity, and independence for older New Yorkers:
- Informal Caregiver and Workforce Support and Modernization of
- Community-Based Aging Network Service
- Modernization and Financial Sustainability of Health care, Residential Facilities and Community-Based Aging Network Service Providers
- Prevention, Wellness Promotion and Access
- Housing Access and Community Development
- Affordability of Basic Necessities
- Social Engagement of Older Adults
- Technology Access and Development
The MPA report includes a broad array of proposals developed by work groups and presented to the MPA Council to address critical challenges, such as workforce shortages, housing affordability and accessibility, facility modernization, Medicaid rate reform, access to technology, social isolation, and elder abuse. Proposals are classified as: near-term changes could impact New Yorkers within the next 1 to 2 years if pursued; long-term opportunities would take 3 or more years if pursued; and infrastructure initiatives that could lay the foundation for future further initiatives. The report cautions that these proposals an "represent a starting point for discussion." Further, "any proposal with a fiscal impact would need to be addressed as part of the annual budget process."
The following are just a few of the key proposals of interest to LeadingAge NY members. We will be digesting the report over the coming days to provide a more complete summary.
Among the workforce proposals are regulatory reforms to expand the ability of individuals to become nursing home administrators and feeding assistants; exploration of the use of medication aides in nursing homes; the creation of state-funded regional training centers to increase the number of personal care aides, home health aides, and certified nurse aides; and expansion of the SkillSpring program to prepare young adults to serve in caregiving professions. These proposals are classified as long-term.
The report includes several proposals related to affordable housing and supportive services offered through affordable housing. In particular, the report includes proposals to create a 5-year Resident Assistant demonstration project, expand the Neighborhood/Naturally Occurring Retirement Community (N/NORC) program and senior housing with services model, expand housing models that benefit people with mental health and substance use disorders and reduce social isolation, and allow for operators of family-type homes for adults to apply for special licenses to perform specific duties. These proposals are classified as long-term.
The report also includes a number of proposals related to the modernization and financial sustainability of residential facilities and community-based providers. Among these proposals is additional funding for Area Agencies on Aging to reduce waiting lists, expand personal care services and respite services, expand transportation support, and combat social isolation. This proposal is characterized as near-term and was partially funded through $45 million included in the SFY 25-26 State Budget.
The report recognizes the financial distress experienced by many providers that are reliant on Medicaid reimbursement and that current rate methodologies "may be" outdated and insufficient to cover costs. The report includes several proposals aimed at implementing Medicaid and SSI/State Supplement reimbursement systems, "including for skilled nursing facilities and assisted living programs, which cover actual provider costs adjusted for inflation and include targeted adjustments aimed at addressing the higher costs of serving individuals with specialized needs." It also includes proposals to establish a transparent stakeholder process to determine licensed home care services agency costs and establish regional hourly benchmark reimbursement rates for Medicaid Managed Care and to update certified home health agency (CHHA) Episodic Payment System rates to ensure sustainability. These are characterized as long-term and subject to the availability of resources.
The report also includes several proposals to support capital improvements in nursing homes. These include: creating more home-like nursing homes through the development of the Green House model or other small house-type facilities; providing a more flexible approach to capital projects through updates to regulatory requirements and metrics, modifying and reactivating the Voluntary Residential Health Care Facility Rightsizing Demonstration Program to incentivize nursing homes to voluntarily give up unneeded beds expand alternate levels of service. The capital proposals incorporate a near-term element to update the nursing home need methodology.
In addition, the report includes a proposal, characterized as long-term, to reallocate funding from the Vital Access Provider Assurance Pool to offset changes to nursing home quality incentive pool. Under this proposal, metrics would be added to the pool related to staff training, consistency in assignment and decreased turnover, and other measures, rewarding investments in workforce training.
The report includes more than a dozen proposals under the rubric of "diversifying long-term care facility services" that incorporate an expansion of Adult Care Facilities (ACF)/Assisted Living (AL) and Adult Day Care access and improved access to clinical expertise in residential or facility-based settings. These include exploring options to expand access to nursing services for residents of adult care/assisted living facilities. They also include expanding access to geriatric behavioral health services in long-term care settings.
Restructuring the licensure, regulation, and expansion of assisted living facilities is the focus of several proposals in the report. These include creating a "uniform assisted living model for the future," in contrast to the old "hospitality model;" and a single uniform licensure category with a uniform need methodology; public subsidies to increase access for low- and middle-income residents; allowing adult care facilities (ACFs) to add Medicaid assisted living program (ALP) beds; and increasing the support for transitioning nursing homes to facilities that offer lower levels of care. In addition, the report includes a proposal to require all assisted living residents (ALRs) to begin the process of seeking accreditation from either the Joint Commission, CARF International or the Accreditation Commission for Health Care by 2028. This section of the report includes a number of proposals to expand the medical, social work, and nursing staff working in ALRs. With the exception of allowing ACFs to add ALP beds, these are characterized as long-term proposals.
A new voucher program, modeled on the Special Needs Assisted Living Residence Voucher Program, is proposed as a near term initiative. It would be aimed at preventing or delaying the need for more costly, higher-level care and would provide a sliding-scale subsidy for ACF residents who are at risk of nursing home care due to depleted resources and to "individuals not eligible for Medicaid or SSI but in need of Adult Day Care (sic) services."
The report includes two alternative sets of proposals to encourage the growth of Continuing Care Retirement Communities (CCRCs). The first would consolidate oversight under the Department of Health and shift the CCRC Council to an advisory role. It would also authorize the Department to update the priority reservation fee deposit limit and reallocate state resources to the Department of Health to support expanded oversight. The alternative set of proposals is similar, but also includes bringing New York CCRCs in line with national CCRC investment strategies, eliminated bifurcated surveillance function and supporting the development of a clinical practice model across all levels of care, and eliminating duplicative cost reports. These proposals are characterized as long-term.
The expansion of PACE enrollment is supported through several proposals aimed at reducing administrative barriers and expanding access to Statewide Transformation grants.
The important roles of adult day health care programs and social adult day programs is recognized in several proposals. These are aimed at incentivizing adult day programs through regulatory reforms that address reimbursement and financing, expanded staffing, and innovative partnerships with other service providers (e.g., transportation providers).
The report also includes proposals to support the quality and availability of hospice and palliative care, including the reestablishment of the Hospice and Palliative Care Education and Training Council, development of a Regulatory and Certificate of Need Task Force for hospice, and offering an interdisciplinary palliative care benefit for qualifying Medicaid beneficiaries, and recognizing Physician Assistants as Hospice Attending Practitioners.
LeadingAge NY encourages members to review the full report and Appendix G to understand how these proposals may impact their organizations and communities. For more information, visit the Master Plan for Aging Final Report on the website.
Contact: Karen Lipson, klipson@leadingageny.org