Managed Long-Term Care Plans Are Denying Seniors Care. Why are MLTCPs putting profits before people?

OpEd By Victoria Milo, Coalition of New York City Social Adult Day Cares

Almost a year into the coronavirus pandemic, and New York City’s social adult day care centers are still working overtime to ensure the well-being of our city’s most vulnerable populations—with zero support from New York State, and often on their own dime.

Managed Long-Term Care Plans—insurance providers also known as MLTCPs—are refusing to properly reimburse the centers taking care of New York’s at-risk populations. By refusing to cover the care, and paying just 20-50% of the agreed-upon, contractual rate for daily services, MLTCPs are proving they don’t care about New York’s neediest, while still collecting thousands a month from Medicaid for each participant.

If Medicaid funds are not going to care for these older adults, who are often needy and survive on public assistance, where are the funds going? MLTCPs owe New York City’s social adult day care participants, adult day care centers and the general public an explanation.

Furthermore, according to members of the Coalition of New York City Social Adult Day Cares, the MLTCPs have never been more disorganized— asking in some cases to resubmit documentation six or seven times for minor issues. The centers cannot survive with insufficient payments.

The Coalition of New York City Social Adult Day Cares comprises 56 adult day care center owners that serve and care for New York’s older adult population including over 11,000 mentally, physically and functionally-impaired seniors and older adults across every language, ethnicity and cultural background.

Telecare plays an incredibly important role during these unprecedented times— from meal delivery, wellness check-ins, medication drop-off and oversight, creative activities, and most importantly, socialization—to people who are often isolated and alone.

With the coronavirus pandemic raging on, and with public spaces closed by state order, adult day care centers are still providing critical daily services to their members via telecare. This means participants receive daily contact with people they know, in some cases for years.

While all are welcome, many seniors and older adults have found a true “home” at their social adult day care center, as each center caters to New York’s diverse communities—from activities and food to programs and languages spoken—and often report their centers feel like home.  For some older adults, this daily connection to their home center can mean the difference between surviving, or not.

Social adult day care center founders are often hardworking independent business owners who opened their center with a vision to help the needy in their communities—and working with slim profit margins.  Currently operating on their own dime, center owners will be forced to shut down their centers if proper reimbursements are not delivered immediately.  It is anyone’s guess what will happen to the thousands of at-risk, older individuals who rely on centers as a lifeline.

Reduced and rejected insurance reimbursements are preventing NYC’s social adult day cares from continuing care—and are at risk of closing. Whether it’s greed, corruption, or simply incompetence, MLTCPs have had zero oversight or consequences for their actions from New York’s governing bodies, including Department For the Aging and Department of Health.  New York State needs to take immediate action to ensure that MLTCPs are reimbursing Centers fully and fairly—who are caring for those in need during this critical time.

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