Establishing a Universal Direct Care Workforce Model Outcomes for Long-Term Care Clients

Direct care workers—personal care aides, home health aides, and nursing assistants—provide in-home care and personal assistance to older adults and those living with disabilities or other chronic conditions. There are more than 650,000 direct care workers in New York State, nearly 90% of whom are women and/or people of color, and 60% of whom are immigrants. The State is estimated to need close to 200,000 more of these workers over the next 10 years. Demand is largely driven by New York’s increasing older adult population, with the number of New Yorkers ages 65 and older projected to grow from 3.2 million in 2020 to 5.3 million by 2030.  In 2025, NYHealth awarded the Paraprofessional Healthcare Institute, Inc. (PHI) a grant to improve the health of New York’s long-term care clients, boost retention and recruitment rates among workers, control health care costs, and advance equity. 

Under this grant, PHI will implement and evaluate a direct care worker demonstration program. PHI has secured partnerships with three major New York City-based licensed home care services agencies as demonstration sites: the Jewish Association Serving the Aging, Selfhelp Community Services, and Sunnyside Community Services. With these partners and significant co-funding, PHI will test the model. PHI and home care agency staff will develop work protocols and new competencies to train staff. It will implement the universal worker model at all partnered home care agencies and facilitate trainings with agency managers. PHI document data and develop a report and policy recommendations to scale the model across the State. 

New York State Department of Health AIDS Institute (fiscal sponsor: Health Research, Inc.)

The opioid epidemic continues to ravage the nation and New York. The drug-related death rate in New York State has escalated over the past two decades. More than 6,300 New Yorkers are estimated to have died of overdoses in 2022, with a disproportionate impact in communities of color and rural counties. Public health and law enforcement agencies are challenged to stay one step ahead; historically, the State has relied on toxicology reports produced after a death. While this is important data, it is collected too late to save lives. One element of harm reduction is drug checking, which tests drugs for contaminants and allows users to avoid them altogether or make informed decisions to reduce potential harm. In 2025, NYHealth awarded the New York State Department of Health AIDS Institute a grant to support community-based sites to test drug samples for toxic additives and provide harm reduction interventions to hard-to-reach people who use drugs. 

Under this grant, ODUH will work with harm reduction programs, and train messengers and peer navigators to integrate on-site drug testing and implement off-site testing. It will increase harm reduction services to marginalized communities by strengthening ties to local service providers and positioning peer navigators. ODUH will conduct real-time surveillance of the local drug supply, analyze anonymized drug samples sent to the State’s surveillance site, and disseminate findings. ODUH will also create a public-facing dashboard to inform the public about drug alerts.  

Birth Control Advocates of New York, dba New York Birth Control Access Project

Comprehensive reproductive health care includes readily available birth control options for individuals who want and need it. But more than 1.2 million New Yorkers live in areas without sufficient capacity to meet the needs of people eligible for publicly funded contraception. There are 4,800 pharmacies in New York, and almost 90% of New Yorkers live within 5 miles of one. In 2023, New York signed the Birth Control Access Act into law, enabling pharmacies to serve as one-stop shops for patients who need to renew oral contraceptives. However, a policy is only as good as its implementation, and uptake has been slow in New York, too; fewer than 100 pharmacists in New York have enrolled in the State-sponsored training required to participate. In 2025, NYHealth awarded the New York Birth Control Access Project (NYBCAP) a grant to offer technical assistance and support to pharmacists to dispense oral contraception and improve reproductive health access in high-need areas of the State. 

Under this grant, NYBCAP will launch the first phase of its “Pharmacy Access to Contraception: Technical Assistance (TA) Program”. It will partner with the Pharmacist Society of the State of New York and the American Pharmacists Association to reach pharmacies. It will also partner with pharmacy advisors and the New York State Department of Health to develop a toolkit and provide TA to pharmacists and independent pharmacies. It will conduct outreach to enroll pharmacists in the TA program; provide technical support; collect self-assessment surveys and use findings to evaluate the progress for potential replication.  

American Farmland Trust

Farm-to-school programs bring locally grown, fresh, healthy food into cafeterias, benefiting children, farmers, educators, and health care providers. Starting in 2018, NYHealth has partnered with American Farmland Trust (AFT) to advance the farm-to-school movement in New York State. In 2024, NYHealth awarded American Farmland Trust a grant to strengthen and unify the farm-to-school movement in New York State through improved policy coordination and the provision of expert guidance on policy analysis. 

Under this grant, AFT offered expertise to policymakers, school districts, farmers, and other coalition members about the changes needed to address potential conflicts in existing and new policies. AFT conducted policy research and analysis; coordinated diverse stakeholders; and advocated for policy changes and modifications.  

StrivEquity Consulting, LLC (fiscal sponsor: Emerging Equity, LLC)

Unequal access to healthy, affordable food is a major contributor to the disproportionately high rates of food insecurity and diet-related disease in communities of color. To address these disparities, NYHealth used a request for proposals (RFP) to identify projects led by organizations rooted in the communities most affected by food insecurity that (1) support healthier, culturally responsive food in public institutions and (2) promote Food Is Medicine interventions. After awarding 10 grants to support projects throughout the State, NYHealth prioritized supporting grantees with customized technical assistance (TA). In 2024, NYHealth awarded StrivEquity Consulting, LLC (through fiscal sponsor Emerging Equity, LLC) a grant to provide technical assistance (TA) and increase the collective impact of a cohort of grantees working to advance a more racially equitable, healthier food system.

Under this grant, the consultants will assess each organization’s TA needs and goals during the first phase of the engagement and develop customized support for each grantee. The consultants will provide a range of TA services, including engaging community members meaningfully; structuring and executing partnerships and agreements with government agencies and health care providers; communicating effectively and tailoring strategic messaging to different decisionmakers; measuring and describing program impact; and securing sustainable funding sources. The consultants will also identify opportunities for shared learning, joint problem-solving, or collective advocacy, as well as create linkages and opportunities for collaboration.

Luminas, LLC

Older adults are a rapidly growing population with complex health and nutritional needs. Between 2011 and 2021, New York’s older adult population increased by 31%, from 2.6 to 3.4 million, and the number of older adults from racial and ethnic minorities—groups with rates of higher food insecurity—has grown faster than the number of white older adults. Research shows that between 8% and 14% of older adults in New York are food insecure and that at least 200,000 are eligible for SNAP benefits but not enrolled. Little information is available about how older adults experience hunger and about their needs and preferences. Experts have expressed a need for better data on food-insecure older adults, especially for those not participating in food access programs (e.g., SNAP, home-delivered and congregate meals). In 2024, NYHealth awarded Luminas, LLC a grant to conduct statewide qualitative research on the needs and experiences of food-insecure older adults. 

Under this grant, Luminas will design and execute a statewide qualitative research project to understand the needs and experiences of food-insecure older adults. NYHealth will partner with Luminas to publish a report that distills findings and recommends practical program and policy actions. 

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