Dignity in Dollars
Why New York Must Raise the Personal Needs Allowance for Nursing Home Residents
In New York’s nursing homes, thousands of residents live on a fixed income that barely covers the essentials. For those relying on Medicaid, the monthly Personal Needs Allowance (PNA) is a stipend meant to cover non-medical expenses like toiletries, clothing, snacks, and phone service—is just $50. That’s less than $2 a day. In a state that prides itself on compassionate care, this figure is not just outdated…it’s unjust, and hasn’t changed in over 40 years.
What Is the Personal Needs Allowance?
The PNA is a portion of a Medicaid recipient’s income that is exempt from being used to pay for nursing home care. It’s intended to preserve autonomy and dignity, allowing residents to purchase personal items and maintain independence. With inflation and rising costs, $50 doesn’t go far. A haircut, a birthday card, a pair of socks… these small comforts quickly become luxuries.
The Consequences of an Inadequate Allowance
• Loss of Independence: Without enough funds, residents must rely on others for basic items. If there is no one else, they go without.
• Social Isolation: Many can't afford phone service or transportation, cutting them off from loved ones and community life.
• Emotional Toll: The inability to buy small treats or gifts can lead to feelings of helplessness and depression.
A Call for Reform
Advocates across New York, including ombudsmen, disability rights organizations, and elder care professionals are calling for the state to raise the PNA to at least $200 per month. This increase would:
• Reflect the true cost of living in 2025
• Align New York with other states that have already raised their allowances
• Reinforce the state’s commitment to person-centered care
Voices from the Field
Amy Gehrig, Ombudsman Coordinator at North Country Center for Independence (NCCI) , sees the impact firsthand:
“If a resident wants a haircut, or a perm, that alone will eat the $50 they currently get, leaving them very little for other expenses”. “Most facilities charge for a phone and cable in order to watch a show. They cannot afford both, so a choice must be made. What did you spend on your coffee this morning? I bet it was more than the $2.00 that residents receive each day.
Legislative Momentum
Bills to increase the PNA have been introduced in previous legislative sessions have stalled. The cost of inaction is far greater. Raising the PNA would require a relatively small investment from the state but yield immeasurable returns in resident well-being and mental health
How You Can Help
· Contact your local Ombudsman Coordinator, Amy Gehrig at NCCI at 518-562-1732 to learn more how to advocate.Sign the petition at: https://forms.office.com/g/urMXCZJy42
• Contact your state legislators and urge them to support an increase in the PNA.
• Share stories from nursing home residents to humanize the issue.
• Join advocacy groups pushing for elder rights and long-term care reform.
Final Thought
The Personal Needs Allowance isn’t just about money, it’s about respect. It’s about recognizing that even in institutional care, people deserve the freedom to make choices, express themselves, and live with dignity. New York has the opportunity to lead by example.
