EISEP: non-Medicaid in-home help for New Yorkers 60 and older

The State Office for the Aging describes EISEP as "coordinated, nonmedical services for older adults who are not eligible for Medicaid." Its page lists four parts:

• Case management. The State calls it "the heart of EISEP." Every client gets "a trained case manager who assesses their needs, coordinates services, monitors their care, and helps maximize community resources."
• In-home services. Help with personal care such as bathing and dressing, and with household tasks such as cleaning, laundry, shopping, and meals.
• Respite. Non-institutional relief so a family caregiver can take a break.
• Ancillary services. One-time items such as a grab bar, a ramp, a medical alert device, or a small home repair that keeps someone safe at home.

It is a services program, not an insurance program. The county or city contracts with local agencies to deliver the hours, and the case manager decides with you what goes in the plan.

The State's page lists four conditions. A person must:

1. "Be at least 60 years old"
2. "Need assistance with at least one activity of daily living or two instrumental activities of daily living"
3. "Be able to be maintained safely at home"
4. "Not be eligible for the same services under Medicaid"

The regulation spells out the two lists. Activities of daily living are "bathing, dressing, toileting, being continent of urine and/or feces, transferring, walking and eating." Instrumental activities are "housekeeping, shopping, preparing meals, managing money, laundry, using transportation, telephoning and taking medication." Needing help with two chores from the second list is enough to be considered, which is a lower bar than the Medicaid home care test.

The fourth condition has a catch that families miss. The regulation says a person must "apply for Medicaid if it appears that" they "may be eligible for Medicaid without any spend-down." In other words, if the intake worker sees income and savings under the Medicaid lines, the program will ask you to apply for Medicaid, and the county cannot provide in-home services until that application is made. New York City's case management standards soften the timing: a person can receive NYC Aging-funded home care "until Medicaid service begins."

There is one local office in every county. The State's page says: "There is a local office for the aging in every county in New York State (New York City has one office that covers all 5 boroughs)." Two ways to find yours:

• NY Connects, 1-800-342-9871 (Relay 7-1-1). Say "in-home services for someone 60 or older who is not on Medicaid" and your county.
• The State's local office directory at aging.ny.gov, linked in the sources below.

In New York City, the door is Aging Connect at 212-244-6469 (212-AGING-NYC). NYC Aging's page describes what follows: "A local case management agency that is contracted to serve the older adult's neighborhood will perform a phone intake for requested services and a case manager will conduct an in-home visit to determine eligibility and coordinate services." This site does not name those agencies.

What to have ready for the intake call: the person's date of birth, address, a short description of what they cannot do alone, who helps now, and a rough picture of monthly income and savings. The regulation says the assessment should happen within ten working days of the request "unless EISEP services are not then available," which is the polite way of saying a waiting list may come first.

Case management is free. The hands-on services carry a sliding fee, and as of April 1, 2026 the State set the numbers in Program Instruction 26-PI-06. Its client agreement puts it plainly: the fee "does not include the cost of case management, which is free."

Here is how the math works, in plain terms:

1. The office looks at monthly net income. If you live with a spouse, the spouse's income counts. Income of other people in the home, such as adult children, does not.
2. It subtracts a housing allowance for rent or mortgage costs above a floor, up to $798 a month for one person or $1,082 for a couple.
3. It subtracts the program's income threshold: $1,995 a month for one person, $2,705 for a couple.
4. What is left is "adjusted income." The fee is a percentage of the cost of services, and the percentage rises with adjusted income in $70 steps for an individual (about $95 steps for a couple).

The full schedule, with the couple columns, is in the instruction linked below. Three protections are written into it: your monthly fee can never be more than your adjusted income, you "will not be charged for any services" you "do not actually receive," and you have "the right to dispute the amount" of the cost-share. Two warnings are also written in: someone "who will provide no financial information" pays 100%, and "a willful failure to pay" can end services until the balance is paid, after written notice and a chance to be heard.

These figures are educational. The office's determination is the only one that counts, and the numbers change each April.

The State does not publish county waiting lists. The State Comptroller's August 2025 report on aging services estimated that "approximately 16,000 older New Yorkers cannot be served annually" because of funding and workforce limits, and noted that "State and county waitlist data is not readily available on NYSOFA's website." The Comptroller's March 2026 review of New York City counted 356 people on the city's home care waiting list in fiscal 2025. NYC Aging's standards require a monitoring call every two months while someone waits.

The enacted 2026-27 State budget continued $68 million "for older New Yorkers who are waiting for aging network services." If you are placed on a list, ask how long it is in your county, whether case management or ancillary items can start sooner, and whether anything about the person's situation has changed that the office should know about.

Both programs put help in the home, and that is where the similarity ends. Medicaid home care needs an active Medicaid case, an assessment by the New York Independent Assessor Program, and usually a plan that authorizes hours. EISEP needs an Office for the Aging intake, a case manager's home visit, and, for most people, a fee. Medicaid has no cap on hours other than the plan's care plan; EISEP hours depend on county funding. Our side-by-side post, Medicaid MLTC vs EISEP, goes through the fork in detail.

One practical point: if the intake worker tells you to apply for Medicaid, do it, and ask whether EISEP can carry the person until the Medicaid case opens. That bridge is written into New York City's standards and is worth asking about elsewhere.

• Assuming Medicare covers it. Medicare pays for short-term skilled care at home after an illness, not ongoing help with bathing and chores. EISEP is one of the few programs that does, for people without Medicaid.
• Refusing to share income. No financial information means a 100% fee. Sharing it is how the sliding scale works in your favor.
• Waiting silently. If you are on a list, call every month or two. The office's own standards expect contact.
• Skipping the Medicaid application when asked. The program cannot start hands-on services until it is filed.
• Expecting an aide to appear the week you call. Intake, a home visit, and a plan come first, and a list may come before those.

Is there a fee for EISEP?

Case management is free. In-home services, respite, and ancillary items carry a sliding fee based on adjusted monthly income under the State's 2026 instruction. People at or below the income threshold after the housing allowance pay nothing for services; people well above it pay the full cost.

Can someone on Medicare but not Medicaid get EISEP?

Yes. Medicare does not cover ongoing personal care at home, so having Medicare does not disqualify anyone. The program looks at whether the person could get the same services under Medicaid, not Medicare.

What if my parent could get Medicaid but has not applied?

The regulation requires an application when it appears the person could get Medicaid without a spend-down. The office will tell you at intake. In New York City, services can continue "until Medicaid service begins."

How many hours will we get?

No one can say before the case manager's visit, and hours depend on the county's funding. Ask the office directly and ask about the waiting list.

Who do I call first?

NY Connects at 1-800-342-9871 anywhere in the state, or Aging Connect at 212-244-6469 in New York City.