The state of New York will implement a plan in April designed to control rising Medicaid expenses, but it could wind up drastically impacting the long-term care planning for thousands of elderly residents of New York City.

Under the plan, Medicaid recipients in New York City who currently receive assistance with home care must instead sign up for a managed-care program through a private insurer. Experts working in public health say that will cause a decrease in services for the elderly and could force some of them into leaving their homes and moving to a nursing home.

The plan has not yet been extended to elderly Medicaid recipients on Long Island.

Opponents of the state policy shift have taken their protests to the U.S. Department of Health and Human Services, trying to encourage the federal agency to ban the managed-care law as currently written. Advocates for the elderly and disabled instead want the department to ensure safeguards are put in place that will allow for community care and will not force people into institutions.

More than 85,000 people are estimated to be affected by the change.

A spokesman for the governor's office said the reason for the shift is to control overutilization of services and to rein in costs. He added that managed plans strive to keep people out of nursing homes because it is financially prudent for them to do so.

Still, advocates said that comparatively few people receive a high level of care. Those who don't need it still need some in-home care, and those who don't get it will wind up hospitalized or living in a nursing home.

For Long Island residents worried about long-term care, they should begin planning now before they are forced into a program they don't want to be in.

Source: New York Daily News, "Governor Cuomo's plan to reduce New York's rising Medicaid costs may send some of the state's poor and elderly to nursing homes," Juan Gonzalez, Jan. 13, 2012