Individuals receiving home care services through a Managed Long Term Care (MLTC) company may find that the agency did not award their family member or loved one with a sufficient amount of hours of home care services after they’ve conducted an evaluation.
The evaluation process by an MLTC can be complex. A person approved for Medicaid Home Care services will eventually have to enroll with an MLTC. The MLTC provider will send an evaluator to assess the recipient’s condition in order to create a care plan that will suit the individual’s daily needs. The evaluator will determine the number of hours per day that the recipient is entitled to receive to assist with their personal care needs. Continue reading “Ensuring Maximum Hours with MLTC Evaluations”
According to the most recent data from the U.S. Census Bureau, there were 2,797,589 people in New York who were aged 65 and over in 2016 which is 14.6% of the state’s population. Compare that number to 2015, when 2,724,135 seniors lived in New York State (14.3% of the population), and 2014 (2,655,913 people ages 65 and over, 14.0% of the population). Continue reading “Expect to Pay More for Home Health and Assisted Living Costs”
The Budget makes significant changes to New York’s home care program by limiting level 1 personal care services to 8 hours per week and authorizing the Commissioner to set standards for “high-intensity” high-hour personal care services users, pursuant to emergency regulation. Changes in the definition of estate will increase liens and Medicaid recovery actions.
The Budget also mandates enrollment in Managed Long Term Care (or program models that “may” include long term home health care programs) for anyone over age 21 who needs home and community based services ( “as specified by the Commissioner) for more than 120 days. This is likely to be everyone receiving personal care (home attendant), certified home health agency (CHHA) services, and Consumer-Directed Personal Assistance Program services. Before it becomes mandatory, a federal waiver must be applied for and approved – which is unlikely before the end of 2011 at least.
Persons subject to mandatory enrollment will be assigned to a plan if don’t select one within 30 days of the date on which they are given the choice of plans. Plans are to contract directly with the State Department of Health and perform assessments for their members’ care needs every six months. The role of local districts in assessing and providing long term care is thus significantly reduced.
Reprinted from “NY Health Access”
On April 8th and 15th, 2011, the State Commissioner of Health sent all CHHA administrators two directives reminding them that state law does not allow CHHAs to reduce home health aide services that were previously authorized, without doctor’s orders and notice and hearing rights. Similarly, if a CHHA client is hospitalized, or in temporary short-term rehabilitation, these changes do not allow the CHHA to abandon them — the CHHA must reinstate the same home health services after the hospital or rehab stay is over, if the client continues to need the services as prescribed by his/her treating physician.