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New York State's Medicaid program covers personal care services, also known as home attendant services. This is a type of unskilled, custodial care provided in the home to people with physical or mental impairments that interfere with their ability to independently perform activities of daily living. To apply for Medicaid personal care services, you must submit a form signed by the applicant's doctor. Each county administers the Medicaid program separately, so the exact procedure for requesting personal care services varies from county to county. For information on applying for personal care in NYC, see this article. We have been able to scan the medical request forms for personal care services for threecounties outside of NYC:
In September, 2009, State DOH issued a revised Form DSS-4359, which is a standardized Physician’s Order for Personal Care Services for use in the Personal Care Services Program (PCSP) and the Consumer Directed Personal Assistance Program (CDPAP). See NYS DOH GIS 10LTC006 - Physician's Order for use in the Personal Care Services Program and the Consumer Directed Personal Assistance Program with its attached DSS-4359. The directive makes the new form optional for counties, which may instead revise their own forms to "...contain all of the elements reflected in this revised form." Helping a doctor to complete the medical request form can be tricky, because many forms use terms that are not universally understood by doctors. In addition, there are some details that are very important to assessing the need for home care, but which are not solicited on the form. To help you understand how to complete a successful medical request form, we have written a memo called Q-Tips. The Q-Tips memo is also available in Spanish. This memo is written specifically with regard to the NYC medical request form, the M-11q, but most of the information should be applicable statewide. Keep in mind that this form is a medical document - non-doctors can assist in its completion, but in the end, a doctor must certify that the contents are true. In order to obtain home attendant services, the applicant must be approved for Community Medicaid. If the applicant does not yet have Medicaid, they can apply at the same time as submitting the medical request form. For more information on Medicaid eligibility and applying for home care, read this memo. This site provides general information only. This is not legal advice. You can only obtain legal advice from a lawyer. In addition, your use of this site does not create an attorney-client relationship. To contact a lawyer, visit http://lawhelp.org/ny. We make every effort to keep these materials and links up-to-date and in accordance with New York City, New York state and federal law. However, we do not guarantee the accuracy of this information.
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