A rising waitlist and a workforce crisis are leaving vulnerable seniors without the help they need
Seniors Waiting, Services Strained
A City Council hearing in March 2026 brought into sharp relief a crisis that advocates for New York City’s elderly population have been warning about for years: the city’s home care system is struggling to keep pace with demand, and the waitlist for services administered through the Department for the Aging is growing. The hearing, at which DFTA Commissioner Lisa Scott-McKenzie testified, focused on the agency’s budget situation and the structural pressures on a system that provides essential services — personal care assistance, health monitoring, and household support — to elderly and disabled New Yorkers who need help to remain safely in their own homes.
The Human Stakes
Every person on the home care waitlist is an older New Yorker waiting for help with the basic activities of daily life: bathing, cooking, managing medications, getting to medical appointments. When home care is delayed or unavailable, the consequences can include falls, medication errors, malnutrition, social isolation, and preventable hospitalizations. In the most serious cases, the absence of home care forces elderly residents into nursing facilities far earlier than their health requires — a more expensive option that most people would prefer to avoid. The AARP Caregiving resource center has documented the value of home-based care and the consequences of its absence for elderly Americans and their families.
Why the Waitlist Is Growing
The growth in the home care waitlist reflects multiple intersecting pressures. New York City’s population is aging, increasing demand for services. Budget constraints have limited the city’s ability to expand program capacity at the rate needed to meet that demand. And the home care workforce — the personal care aides and home health aides who actually deliver these services — faces chronic shortages driven by low wages, difficult working conditions, and high turnover.
The Workforce Crisis Behind the Crisis
Home care workers in New York City are among the most essential and the least compensated workers in the healthcare sector. They perform physically and emotionally demanding work, often for wages that make it difficult to afford housing in the city where they work. The result is persistent worker shortages that constrain service delivery even when funding is available. 1199SEIU United Healthcare Workers East, which represents many home care workers in New York, has long advocated for wages and benefits that reflect the value and difficulty of this work. Without meaningful improvements in compensation, the pipeline of workers willing to take these jobs will remain inadequate to meet the city’s growing need.
What the Mamdani Administration Must Address
The Mamdani administration has not yet released a comprehensive plan for addressing the home care waitlist or the underlying workforce crisis. The City Council hearing represented an important moment of accountability, but the policy response will ultimately be determined by budget negotiations and administrative decisions that are still unfolding. Advocates are calling for the administration to prioritize DFTA funding in the upcoming budget cycle and to work with state and federal partners to expand home care workforce development programs. The National Association of Area Agencies on Aging provides policy frameworks and data that are relevant to New York City’s challenges. For Mayor Mamdani, addressing the home care crisis is consistent with his broader commitment to protecting the most vulnerable New Yorkers. But it requires resources, and resources require budget choices that will be tested against competing demands for funding across housing, transit, education, and public safety.
