Reform of "Disjointed and Uncoordinated" Long-Term Care System in New York

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Reform of “Disjointed and Uncoordinated” Long-Term Care System 

in New York Will Likely Mean Even Greater Control by State, New Review Asserts
New York’s long-term care system is disjointed and uncoordinated, and is characterized by uneven quality, according to the authors of a newly released a examination of ongoing efforts to reform the system.

Village Care of New York has released Long-Term Care Reform in New York State: A Background Paper examining the intricacies of care and politics that are making long-term care a major policy issue.

The background paper asserts that for consumers needed long-term care is difficult to access, navigate and manage, especially as individual needs change.

And while New York State makes a heavy investment in nursing homes as well as home- and community-based care and has taken the lead in developing new and innovative long-term care delivery models, most policymakers believe that only comprehensive reform can effectively address the many complex challenges.

The paper examines the efforts undertaken by the state in the 21st Century to address long-term care needs, from Governor Pataki’s Health Care Reform Working Group to the Federal-State Health Reform Partnership (F-SHRP) that will bring a federal investment of $1.5 billion toward a series of agreed-to reform initiatives.

In looking at the various undertakings, the paper concludes that it is unclear whether the reform and restructuring efforts of the state will achieve the desired long-term-care system outcomes, particularly with respect to the dimensions of consumer access, choice and quality. The paper points out that the state lacks an evaluation framework to measure success and failure. Nonetheless, the long-term care landscape will change dramatically over the next five years or so, with the state likely exercising even greater control over the system and over Medicaid purse strings than it does now.

The background paper is the first in a series of presentations in Village Care’s New Horizon’s Policy Forum, which will look at issues from the perspective of practitioners of care. Village Care envisions the forum as a place for discussion of significant issues impacting older adults. The forum also will offer a dialog on making sense of public polices and translating them into practice.

Long-Term Care Reform in New York State was written by Arthur Y. Webb, president and CEO of Village Care; Dennis L. Kodner, professor of urban public health at Hunter College of the City University of New York (CUNY), and Herbert H. Fillmore is executive vice president, SeniorChoices at Village Care.

Copies of the background paper may be downloaded by going to or by calling (212) 337-5668.

Village Care of New York is a major provider of care and services in New York City for older adults and persons living with HIV/AIDS.