EISEP New York: Non-Medicaid Home Care for Seniors Over 60

What EISEP Actually Covers

The Expanded In-Home Services for the Elderly Program is New York's primary home care option for seniors who earn too much for Medicaid but can't afford to hire private aides out of pocket. It fills a gap that trips up thousands of families every year: your parent clearly needs help with bathing, dressing, or cooking — but their Social Security and pension push them over Medicaid's $1,836 monthly income limit.

EISEP serves New Yorkers aged 60 and older who have functional impairments in at least one Activity of Daily Living or two Instrumental ADLs (managing medications, handling finances, preparing meals). The program provides non-medical personal care, case management, social adult day services, and ancillary supports like home-delivered meals and personal emergency response systems.

The critical distinction: EISEP is specifically designed for people who are not eligible for Medicaid. If your parent qualifies for Medicaid, they should apply for Medicaid home care through Managed Long Term Care instead. EISEP exists for the in-between population — functionally impaired but financially above the Medicaid threshold.

How the Sliding-Scale Cost Share Works

Unlike Medicaid, EISEP is not free. The program uses a sliding-scale cost-sharing model that begins at 150% of the Federal Poverty Level. Your parent pays a percentage of the service cost based on their monthly income and expenses.

A parent receiving $2,400 per month in Social Security and a small pension would fall above Medicaid's income limit but may still be assessed for EISEP. The county AAA calculates the cost share from income and expenses rather than using a single statewide hourly amount. Case management is part of the EISEP service package; ask the AAA which services carry a cost share.

The exact cost share varies by county because each Area Agency on Aging administers the program locally. Your parent's county AAA will calculate the share during intake.

How to Apply and What to Expect

EISEP is administered through New York's 59 county-level Area Agencies on Aging and managed statewide by the New York State Office for the Aging (NYSOFA). The fastest route in is through NY Connects, the state's "no wrong door" information and referral portal, which can screen your parent for EISEP alongside other programs in a single call.

Here's what the process looks like:

1. Contact your local AAA or call NY Connects (1-800-342-9871). Request an EISEP intake assessment.
2. A case manager visits your parent's home to evaluate their functional limitations and calculate the cost share based on income and expenses.
3. If approved, the case manager develops a care plan specifying the type and frequency of services — typically personal care aide visits several times per week, possibly supplemented with adult day care or delivered meals.
4. Services begin after approval, subject to local availability, funding, and any county waitlist.

One thing families don't anticipate: EISEP is subject to county-level funding caps. Unlike Medicaid home care (which is a legal entitlement with no waitlists), EISEP funding comes from a mix of federal Older Americans Act dollars and state appropriations. In high-demand counties — particularly in the New York City boroughs and suburban Long Island — waitlists are common. If your parent is waitlisted, ask the case manager about interim options: congregate meal programs, volunteer transportation, and telephone reassurance services are often available immediately while the personal care slot opens up.

When EISEP Isn't Enough

EISEP has real limitations. It covers non-medical personal care and support services, but it won't pay for skilled nursing, physical therapy, or the kind of intensive daily care that someone with advanced dementia or severe mobility loss needs. The hours tend to be modest — enough to help with morning routines, meal preparation, and light housekeeping, but not 24-hour coverage.

If your parent's needs escalate beyond what EISEP can provide, the two main options are:

• Apply for Medicaid using a Pooled Income Trust to redirect excess income below the $1,836 threshold. This converts the excess income into allowable bill payments through a non-profit trustee and can establish financial eligibility for Medicaid home care through MLTC; clinical eligibility still applies.
• Explore CDPAP through Medicaid, which allows a family member to be paid as the caregiver — potentially solving both the care gap and the financial strain of unpaid caregiving.

Both routes are covered step by step in the Aging in Place in New York guide, including the Pooled Trust application sequence and the forms you'll need to submit to your local DSS or NYC HRA.

The Bottom Line

EISEP is the right starting point when your parent needs help at home but doesn't qualify for Medicaid. It provides real services — personal care aides, case management, adult day care — at a fraction of private-duty costs. The sliding-scale fee structure means your parent won't be paying full market rate, and the case management component helps coordinate other county-level supports.

The catch is availability. County funding caps and local waitlists mean you should apply early — ideally before the care need becomes urgent. Contact your local Area Agency on Aging or call NY Connects to start the intake process, and have your parent's recent income documentation ready for the cost-share calculation.

If your parent's situation involves Medicaid planning, legal documents, or navigating the CDPAP enrollment process, the complete New York home care guide walks through every step from financial eligibility to care authorization.

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