County officials cite shortage of home aides and limited programs for older residents; GoGo Grandparent fills some gaps

Cayuga County aging and adult-services staff told the Health & Human Services Committee that demand for home aides far outstrips supply and that program eligibility and payer rules limit public coverage.

Presenters said Medicare generally covers short-term, skilled home-health services but not ongoing personal-care aide time, and Medicaid is the primary payer for long-term aide services after eligibility determination. County staff said only two certified home-health agencies in the county routinely provide respite or skilled visits and that aide availability is sparse even for private-pay families. The county contracts with a small number of agencies and can serve fewer than 100 people annually with local funding for limited aide hours, staff said.

Staff also described increasing safety concerns when clients and family members become frustrated over service limitations; they said county offices recently received active-attack and safety-awareness training from sheriff's deputies to address staff safety. The aging office suggested members visit its space to see access and security trade-offs.

To address transportation gaps, the county's GoGo Grandparent program reported roughly 300 rides provided since its local start, averaging about 30 calls per month. The program assists residents who do not qualify for Medicaid transportation and cannot use mainstream ride apps; staff said it has improved access to medical appointments in and around Auburn and Ithaca but is limited in rural areas where Uber and Lyft drivers are sparse.

The county's senior resource fair and other outreach activities were highlighted as efforts to connect residents with available services. Staff urged patience and noted the broader workforce shortage in the home-care sector.