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Home Care
 
document Special Income Standard for Housing Expenses: If Discharged from Nursing Homes or Adult Homes and Enroll in MLTC Plan
A huge barrier to people returning to the community from nursing homes is the high cost of housing. One way New York State is trying to address that barrier is with the Special Housing Disregard that allows certain members of Managed Long Term Care or FIDA plans to keep more of their income to pay...
document The Various Types of Medicaid Home Care in New York State
New York State has a range of Medicaid home care service programs, each oriented toward slightly different needs and sometimes to different populations. These programs are listed below, with links to detailed information posted on this site. Beginning in September 2012, for ADULTS age 21+ who...
document Medicaid Personal Care or Home Attendant Services
The Medicaid program in New York State covers a type of home care services called Personal Care services (aka PCS or "home attendant"). LAW AND REGULATIONS: Social Services Law sec. 365-a, subd. 2(e), 18 NYCRR 505.14. This regulation was amended effective Dec. 23, 2015. See notice...
document Applying for Medicaid Personal Care or CDPAP Services in New York City - 2016 Changes
Where and how to apply for Medicaid personal care services and Consumer Directed Personal Assistance program (CDPAP) services has drastically changed with the implementation of mandatory Managed Long Term Care in New York State under a federal waiver that was approved September 4, 2012. The...
document Managed Long Term Care
Managed Long Term Care (MLTC) plans are insurance plans that are paid a monthly premium ("capitation") by the New York Medicaid program to approve and provide Medicaid home care and other long-term care services (listed below) to people who need long-term care because of a long-lasting health...
document CASA Contact List - NYC
The NYC Medicaid Home Care Services Program, which is part of the NYC Human Resources Administration Medical Insurance Community Services Administration (MICSA), also known as the Medicaid program, formerly was responsible for administration in NYC for three types of Medicaid "personal care"...
document Tools for Choosing a Medicaid Managed Long Term Care Plan
As described in this article, most adults in NYC, Westchester, Nassau and Suffolk counties who have Medicaid and Medicare, who are receiving Medicaid home attendant or housekeeping ("personal care") services through their local Medicaid "CASA" office, or long-term CHHA or adult day care services,...
document KNOW YOUR RIGHTS: Managed Long Term Care and FIDA - Fact Sheets, Live and Recorded Webinars
Fact Sheets on Managed Long Term Care and FIDA. FACT SHEET 1: Basics on Managed Long Term Care FACT SHEET 2: Grievance and Appeal Rights in Managed Long Term Care (under revision from July 1, 2015 changes - see this article) FACT SHEET 3: FIDA: New Program for Dual Eligibles...
document "FIDA (Fully-Integrated Dual Advantage)" - Managed Care Expansion for Dual Eligibles in NYC Metro Area - Delayed Until Jan. 2015
Fully Integrated Dual Advantage demonstration program has started: NYC and Nassau (Region I), with the first "voluntary" opt-i enrollment effective January 2015, and "passive enrollment" scheduled for those who do not OPT OUT on April 1, 2015. 2-27-2015 NEWS: Westchester & Suffolk...
document Medicaid Certified Home Health Agency (CHHA) Services
A Certified Home Health Agency (CHHA) provides what is commonly known as “visiting nurse” services, as well as physical or occupational or speech therapy (PT/OT) in the home, "home health aide" (HHA) services, and medical supplies. The nursing visits are "part-time or intermittent " and NOT...
document Medicaid Reimbursement of Home Care and other Medical Expenses
Reimbursement in General Because Medicaid coverage can be retroactive up to three months, it is possible for a Medicaid applicant or his or her family member who paid the applicant's medical expenses to get reimbursed for some of the home care costs and other medical bills they incurred and paid...
document Applying for Medicaid Personal Care Services and CDPAP Outside NYC - 2016 Changes
New York State's Medicaid program covers personal care services and consumer-directed personal assistance services. The model for delivery of those services has, in the years since 2011, gradually transitioned from the local departments of social services, through their Medicaid programs, to...
document Medicaid Consumer Directed Personal Assistance Program (CDPAP) in New York State
WHO MAY BE HIRED AS THE PERSONAL ASSISTANT? Changes effective APRIL 1, 2016 An adult who is not "legally responsible" for a Medicaid consumer's care and support may be a CDPAP assistant for that consumer. In particular, this means that a parent of...
document SDOH Transitional Care Policy
Updated transitional care policy for new managed care enrollees issued May 2009.  Clarifies the responsibilities of Medicaid and Family Health Plus managed care plans for providing continuity of care, including certified home health agency care,  for new enrollees who are receiving an...
document Where to Apply for Medicaid and Medicaid Home Care in New York City
. Changes in how people apply for and receive Medicaid personal care services occurred in September 2012, followed by major changes for how all people under age 65 applied for Medicaid in 2014, when the NY State of Health Exchange was launched to accept Medicaid applications under the Affordable...
document Appeals & Grievances in Managed Long Term Care - Consumer Rights
Procedures to appeal decisions by Managed Long Term Care plans are different than those they are used to from the longtime system of requesting hearings to appeal decisions by the CASA/Medicaid offices. In March 2015 State Dept. of Health issued new Notice Templates to the MLTC plans, described...
document Grievance and Appeal Contacts for Managed Long Term Care Plans
Selfhelp has assembled this list of appeal and grievance contacts and policies to aid consumers and advocates in exercising their rights. The list was created using documents received in January 2013 from a FOIL request submitted to the NYS Department of Health and a review of managed long term...
document Medicaid Home-and-Community-Based Waiver Programs in New York State
Medicaid home and community-based services [HCBS] are available through waiver programs to groups of individuals who would be eligible for Medicaid if institutionalized and, but for the services, would be institutionalized in a hospital or nursing facility. Under section 1915(c) of the Social...
document KNOW YOUR RIGHTS: Fact Sheet Explaining Basic Rules on NYS Financial Medicaid Eligibility for People who are Disabled, Aged 65+, or Blind
This Fact Sheet (updated Jan.. 2017) is intended for people who are age 65+ or who have disabilities, or their family members and caregivers. It explains the basic financial rules on eligibility for Medicaid in the community for this category of people. Community Medicaid includes all hospital and...
document New Law Requires 7-Day Medicaid Application Approval if "Immediate Need" for Personal Care or CDPAP - Addresses Delays in Enrolling in MLTC Plans.
People who apply for Medicaid in order to obtain home care services face long delays in getting Medicaid approved and then accessing home care services from a managed long term care plan. Click here to learn about the reasons for these delays. A New York law passed in 2015 that is being...

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