“Thousands of middle-income older adults are caught in between—too poor to pay privately [for home care], too ‘wealthy’ to qualify for help. Now, New York has a chance to fix part of that gap.”

A senior center in Brooklyn. (Adi Talwar/City Limits)

Every day at Encore Community Services in Midtown Manhattan, I meet older New Yorkers who worked their whole lives and now face an impossible choice. They can drain their savings to pay for home care, or try to live without the help they need to stay safe at home.

Medicaid, the public insurance program for people with very low incomes, will pay for long-term home care. But Medicare, which nearly all older adults rely on after 65, will not. In New York, thousands of middle-income older adults are caught in between—too poor to pay privately, too “wealthy” to qualify for help.

Now, New York has a chance to fix part of that gap. New York State Senate Bill S7077, which passed the Legislature this year and awaits Gov. Kathy Hochul’s signature, would remove the client fees for the state’s Expanded In-Home Services for the Elderly Program, or EISEP.

The program provides home care for people who don’t qualify for Medicaid. If signed, the bill would make those services free for thousands of older adults who currently pay out of pocket. This would only cover 20 hours of home care per week. But for many of my clients, that difference would decide whether they can stay home or not. 

Last month, I visited an elderly former nursing home worker for an assessment. She lives alone and suffers from several chronic illnesses that make it nearly impossible to manage basic daily tasks like cleaning, laundry, or shopping. Some days, the pain is so severe she can’t get out of bed.

She earns just above the Medicaid income limit, so she doesn’t qualify for assistance, and the cost of private home care is far beyond reach. When we calculated her fee for New York’s EISEP home-care program, it came to more than $1,200 a month—a full third of her income. Her response was immediate: “I can’t afford that.” 

Other clients try what’s called a Medicaid Spend Down. It requires them to pay down their “extra” income each month just to qualify for services—a constant financial drain. Some turn to Pooled Income Trusts, legal arrangements that let them deposit excess income to meet Medicaid rules while using the money for certain expenses. But these trusts are complicated, often require a lawyer, and make it harder for people to access their own funds. With no truly affordable option, too many older adults keep struggling to care for themselves in pain and isolation.

Ending monthly EISEP fees won’t solve everything, but it will finally give these New Yorkers a little breathing room. It says clearly that home care isn’t a luxury; it’s basic support for living with dignity. When people can afford consistent help, they avoid falls, stay healthier, and often delay or prevent nursing-home placement by keeping them in their community. That saves families stress—and it saves taxpayers money.

Recent reporting in The New York Times showed how Medicaid can even come after a person’s home after they die to recover care costs—a policy that’s stripped tens of thousands of families of modest inheritances. It’s another way the current system punishes aging and perpetuates inequality, especially for families who have little wealth to begin with.

But the deeper problem is national. Medicare, the program that covers nearly every older American in need of this support, still excludes long-term home care. Unless someone has just left the hospital and needs short-term skilled nursing, Medicare won’t pay for an aide to help with bathing, cooking, or taking medication. Those are the very supports that keep people stable and independent in their own homes.

Because of that gap, families scramble to fill the void. Adult children cut work hours or quit jobs to care for aging parents. Hospitals see more preventable readmissions. Nursing homes fill with people who could have remained at home if a few hours of weekly help were covered. The policy is outdated, and it’s costing us all more in the long run.

We’ve modernized Medicare before—adding prescription coverage, preventive screenings, even telehealth during the pandemic. Expanding it to include home care is the next logical step. It would cost money, yes, but we already spend billions cleaning up the consequences of not doing so. A modest home-care benefit would be both compassionate and cost-effective.

At Encore, I see the difference every day when care works. A client regains strength after a fall. A widow cooks her own meal again. A man stays in the apartment he’s called home for 40 years. These small victories are what dignity looks like.

Gov. Hochul should sign S7077 and make New York a model for the nation. Then, Congress should follow that lead and bring Medicare into the modern age. Aging in place shouldn’t depend on your income or your ZIP code. It should be a right we guarantee to every older adult. 

Matthew Welch is a financial caseworker at Encore Community Services, a non-profit organization in New York City that provides services for older adults. His work empowers older adults to live financially independent and healthy lives. 

The post Opinion: Aging in Place Shouldn’t Cost Everything You’ve Worked For appeared first on City Limits.

By ANDREW DeMILLO, Associated Press

Normally on Veterans Day, volunteers gather at the Riverside National Cemetery in California to place flags alongside more than 300,000 gravesites. But not this year.

The longest federal government shutdown on record is curtailing and outright canceling parades, ceremonies and other events across the U.S. that are normally held to mark Veterans Day. It’s another fallout of the shutdown that has disrupted flights and food assistance, and was already being squarely felt by military families who are worried about their paychecks.

In California, organizers of “A Flag for Every Hero” said they couldn’t move forward with the event on Tuesday without access to restrooms, traffic control and other needs for the thousands of participants. Elsewhere, a lack of federal employees and access to military facilities has scrubbed other Veterans Day events.

“We have a responsibility to provide them the resources they need, and unfortunately with the shutdown we’re unable to do that,” Laura Herzog, founder and CEO of Honoring Our Fallen, which organizes the Riverside National Cemetery event.

Many communities will still hold Veterans Day gatherings, including some of the nation’s largest and well-known events such as the annual observance at Arlington National Cemetery in Virginia and the New York Veterans Day Parade.

The disruption to a federal holiday that is intended to honor those who have served in the armed forces comes as military families face uncertainty week to week about their pay. The Trump administration has found ways to pay troops twice since the shutdown began Oct. 1.

The Texas National Cemetery Foundation canceled an annual Veterans Day event at the cemetery in Dallas-Fort Worth, saying organizers wouldn’t have time to stage the ceremony even if the shutdown ended soon. In Virginia, city leaders in Hampton cited concerns about a lack of servicemembers to participate in its annual parade because of the shutdown.

“Our veterans deserve to be recognized with great pomp and circumstance,” Hampton City Manager Mary Bunting said in a news release. “Without the presence of our active-duty military, we are concerned that the parade would appear sparse and that the recognition might fall short of the honor our veterans so richly deserve.”

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Organizers of Detroit’s annual Veterans Day parade say they’re moving forward with the Sunday event, but it won’t include an appearance by a U.S. Army band or a helicopter flyover. Others are relying on even more help from volunteers than usual to make up for the lack of federal resources.

Despite the upheaval, some communities are still trying to find ways to honor veterans even as events are canceled.

In Mississippi, the Gulf Coast Veterans Association canceled its annual parade in Pass Christian. But the group said it would use funds for the event to instead provide Thanksgiving dinners for veterans and active-duty members.

“While we share in the disappointment, we are choosing to turn this setback into a blessing,” the group said in a Facebook post.

When U.S. Rep. Tony Gonzales learned that the Veterans Day ceremony at Fort Sam Houston Cemetery in San Antonio wouldn’t take place, the Republican congressman’s office took up organizing the annual event.

Gonzales, a Navy veteran whose grandfather is buried at the cemetery, said that meant working with nonprofits to find someone to sing the national anthem and to provide chairs for attendees.

“We honor our veterans no matter what, and that’s exactly what we did,” Gonzales said.

New York State’s Department of Environmental Conservation approved permits Friday for a gas pipeline from Pennsylvania to the Rockaways. The Trump administration has been cheerleading the plan—which critics say flies in the face of local climate goals.

A rally against the proposal on Aug. 9, 2025. (Adi Talwar/City Limits)

New York’s Department of Environmental Conservation approved permits Friday for a gas pipeline from Pennsylvania to the Rockaways—a project, pushed by the Trump administration, that the state previously rejected on environmental grounds.

The so-called “zombie pipeline”—or as it’s known officially, the Northeast Supply Enhancement (NESE) project—would pump gas to National Grid customers in New York City, with a 17-mile stretch beneath the ocean’s floor.

Environmental groups have protested it for years, saying it puts local waterways at risk and defies the state’s 2019 Climate Law, which mandates New York phase out the use of polluting fossil fuels.

Gov. Kathy Hochul defended the decision Friday, saying the plan was “reviewed impartially” by the DEC for compliance with state and federal law, and that her “top priority is making sure the lights and heat stay on for all New Yorkers.”

“We need to govern in reality,” the governor said. “We are facing war against clean energy from Washington Republicans, including our New York delegation, which is why we have adopted an all-of-the-above approach that includes a continued commitment to renewables and nuclear power to ensure grid reliability and affordability.”

In the same statement, Hochul said the DEC is rejecting another Trump-backed natural gas project, dubbed the Constitution Pipeline, which would run from Pennsylvania to Upstate New York. That plan “did not meet the bar for completeness to advance,” she said.

But environmental groups slammed the NESE decision as New York bowing to pressure from President Donald Trump, who just days before criticized Hochul on social media for failing to move the pipelines forward. Since taking office, the Trump administration has championed oil and gas and slashed funding and incentives for clean energy.

“In granting the certification for this pipeline, Governor Hochul has not only sided with Trump, she’s fast-tracked his agenda,” Laura Shindell, New York State director with Food & Water Watch, said in a statement Friday.

Critics note that the DEC has already rejected water quality permits for the project, three previous times. In those past cases, the agency wrote it had “determined that the construction of the [NESE] project would have adverse water quality impacts in New York State,” and “cause numerous other significant adverse environmental impacts.”

Constructing the pipeline will require a process called “trenching”—digging a tunnel underwater—that critics say would disturb wildlife habitats and stir up contaminants buried under the sea floor.

“The certificate application hasn’t changed since being previously rejected by the DEC,” said Liz Moran, New York policy advocate with the group Earthjustice, in a statement. “Water quality standards haven’t changed—only the political context has changed and that’s not a basis to completely reverse course.”

In a letter approving the project’s water quality certificate, the DEC said its agreement with the pipeline operator, Transco, “requires mitigation for all unavoidable water quality impacts,” including “mandatory construction work windows to avoid and minimize impacts to aquatic species.”

Chad Zamarin, president and CEO of the Williams Company, which owns Transco, said the project will bring “clean, reliable and affordable natural gas” to New York. “Expanding natural gas infrastructure is vital to lowering costs and increasing economic opportunity,” he said.

But local advocates say the continued buildout of gas infrastructure is the real culprit behind New Yorkers’ rising energy bills, as construction costs get passed onto utility customers in the form of rate hikes.

Members of more than a dozen environmental organizations said they planned to protest outside Hochul’s office Friday afternoon (though the governor herself is currently in Puerto Rico).

“In the same month that Time Magazine named the Governor one of the world’s 100 most influential climate leaders, and state representatives are gathering in Brazil to advance international climate action, the Governor’s actions are speaking louder than her words,” Katherine Nadeau, deputy director at Environmental Advocates NY, said in a statement Friday. 

“Today’s decision seems to be more responsive to demands from President Trump than the concerns of New Yorkers.”

To reach the editor, contact Jeanmarie@citylimits.org. Want to republish this story? Find City Limits’ reprint policy here.

The post ‘Sided With Trump’: Climate Groups Slam NY Approval of Gas Pipeline Off Queens’ Coast appeared first on City Limits.

By Tim Henderson, Stateline.org

Illicit drug overdoses and the deaths they cause are trending down this year, despite spikes in a handful of states, according to a Stateline analysis of data from the federal Centers for Disease Control and Prevention.

A handful of places with rising overdoses are responding to the problem with cooperation, they say, by sharing information about overdose surges and distributing emergency medication.

“The national conversation is just about warships in the Caribbean and drones and borders,” said Nabarun Dasgupta, who studies overdose trends at the University of North Carolina. “It discounts this huge groundswell of Americans taking care of Americans. There’s a huge amount of caregiving and tending to the needs of local communities that is being done in a non-flashy way because this is hard, slow work.”

Overdose deaths have been dropping steadily since 2023. As of April, the latest date available, deaths were at 76,500 for the previous 12 months — their lowest level since March 2020. A pandemic spike in overdose deaths drove the number as high as almost 113,000 in the summer of 2023, according to federal statistics.

President Donald Trump has ordered more than a dozen military strikes against boats in the open waters of the Caribbean and the Pacific Ocean since Sept. 2, claiming without publicized evidence that their occupants were drug runners bringing narcotics to the United States. Nearly 60 people have been killed.

The bulk of deadly fentanyl is smuggled over the border with Mexico in passenger cars, according to a September report by the federal Government Accountability Office. Chemicals and equipment, mostly from China, are smuggled in via cargo trucks, commercial ships, airplanes and the mail, according to the report.

A more timely indicator of overdoses — nonfatal suspected overdose patients in hospital emergency departments — was down 7% this year through August compared with 2024, according to Stateline’s analysis of CDC statistics.

The nonfatal overdoses were up for the year in only a few states and the District of Columbia. The largest spikes were 17% in the district, 16% in Rhode Island, 15% in Delaware, 11% in Connecticut and 10% in New Mexico, with smaller increases in Colorado, Pennsylvania, Wyoming, South Dakota, Utah, New Jersey and Minnesota.

Other states saw drops in nonfatal overdoses: Maryland had the largest decrease through August, about 17%.

But Baltimore had an attention-grabbing cluster of 42 overdoses between July and October, all within the same neighborhood. No fatalities were reported. The cluster led the city to set aside$2 million in October for more mobile services, harm reduction and social supports to fight overdoses.

New Mexico is seeing more overdoses and more deaths than the previous year in three counties on the Colorado border. In response, New Mexico is distributing both warnings and naloxone, an opioid-overdose antidote.

Officials are giving naloxone to storekeepers near overdose sites and alerting those seeking services about the deadly threat in the local supply.

“We started planning naloxone saturation and different types of outreaches so we can hopefully stem this from getting even worse,” said David Daniels, harm reduction section manager in the New Mexico health department.

“Putting messaging directly into clients’ hands is extremely valuable. That might be, ‘If you’re choosing to use, don’t use the regular amount. Maybe you should use a quarter of it. Test it out first,’” Daniels said.

The three counties in New Mexico — which include the capital city Santa Fe, ski resort Taos and Española, the setting of the 2023 TV black comedy series “The Curse” — saw about 438 more deaths from July through September than they did during the third quarter of 2024, according to Stateline calculations. That’s more than double the 383 overdose deaths for the area during the same time period last year.

Roger Montoya, a former Democratic state representative who runs an arts nonprofit in Rio Arriba County, said most of the deaths there have been among homeless substance users.

A local hospital has responded with programs to get treatment for more people, and his own Moving Arts Española group concentrates on helping children and young people break a cycle of economic despair that often leads to addiction and homelessness, he said.

“We try to redirect and strengthen the resiliency of young people who largely are being raised by grandparents and kin because mom and dad are either dead, on the street or incarcerated,” Montoya said.

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But most states with overdose increases are still showing fewer deaths, mostly because the drug supply in the eastern United States is more likely to be cut with sedatives that don’t have the same deadly effect as fentanyl, though they can cause overdose.

The drugs linked to Baltimore’s mass overdoses were cut with an unusual, powerful sedative, according to federal testing. The sedative can cause people to lose consciousness but can’t itself be treated with reversal medication such as naloxone.

By contrast New Mexico’s tests on this year’s clusters generally found more deadly fentanyl than usual in the local supply, said Phillip Fiuty, a technical adviser on adulterant testing in the state health department.

“We’re not seeing the type of adulteration they’re experiencing on the East Coast. Once something is in New Mexico, there’s little to no adulteration,” Fiuty said.

Some East Coast states are seeing more overdoses but fewer deaths. Rhode Island warned of spikes in nonfatal overdose in August and September, but deaths through September were still lower than during the same period last year, according to state figures.

That’s not always the case. Connecticut reported a surge of both fatal and nonfatal overdoses near interstate highways in May and June.

“One of the factors is change in the illicit drug supply or bad batches. I think that’s what’s playing out now. The drug supply is increasingly unpredictable,” said Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials.

The association has a suggested framework for community response to spikes, but cities and counties may be hampered by a new aggressiveness on enforcement and more hostility to local efforts to stop deaths, she said.

The current Trump administration has shown some reluctance to support community harm reduction techniques, she said. That includes the temporary suspension of $140 million in funds for a program called Overdose Data to Action, known as OD2A, that the first Trump administration started to sound the alarm when spikes happen.

“Given recent cuts to health care and substance use and overdose prevention services that we’re seeing, that is impacting some of the work on the ground,” Freeman said. “It’s pushing people away from being able to make the changes they need to make to change their lives. It has the potential to create more of an overdose problem.”

Stateline reporter Tim Henderson can be reached at thenderson@stateline.org.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.