Long-Term Care Services refers to the wide range of in-home, community-based, and institutional services and programs that are designed to help the elderly and individuals with disabilities of all ages. These services can be medical and non-medical and can help people with activities of daily living (ADLs) such as dressing, bathing, and using the bathroom, and instrumental activities of daily living (IADLs) such as shopping, cleaning, laundry, and preparing meals. Learn more about long-term care from the Long–Term Care Options.
The Home Care Services Program (HCSP) provides access to, or authorizes services for a variety of Medicaid-funded long-term care programs designed to help eligible elderly or disabled individuals remain safely at home, rather than in a nursing home or other institution. In some cases, the Home Care Services Program will assess medical needs and determine the appropriate care required. Eligibility for Medicaid-funded home care programs varies among programs but all programs require that the applicant be Medicaid eligible.
Long-Term Care Options:
- Personal Care (Medicaid –Funded Home Care)- Home Attendant and Housekeeping services for individuals having difficulty with at least one or more activities of daily life, such as walking, cooking, cleaning, bathing and using the bathroom. Individuals who are Medicaid eligible and otherwise exempt from Managed Long Term Care or Managed Care should apply for service through your local CASA office.
- Managed Long-Term Care Program – case management, nursing, home health aides, home attendant services, physical therapists, for people who are Medicaid eligible, or eligible for both Medicaid and Medicare, and are medically eligible for long term care services.
- Assisted Living Program – long term residential care, supervision, and home health care services.
- Care-at-Home Program – medical and support services for severely disabled children who would otherwise be required to remain institutionalized.
- Long-Term Home Health Care Program – New York State mandates that all Long Term Home Health Care consumers enroll into mainstream managed care or Managed Long Term Care. Therefore, effective Monday June 17th, 2013 no new referrals for
enrollments into this program will be accepted.
The State Department of Health has changed the way Long Term Care services are delivered.
Dual Eligible (Medicare and Medicaid) Consumers
Dual eligible consumers, age 21 and over, who seek community-based long term care services for over 120 days are required to enroll into a Managed Long Term Care plan to receive those services. Consumers who seek community based long term care assistance can be directed to New York Medicaid Choice (NYMC) for information and assistance in choosing a plan. NYMC’s MLTC phone number is: 888-401-MLTC (6582) | (TTY: 888-239-1541)
The following populations remain exempt from mandatory MLTC enrollment:
- Native Americans
- Dual eligible consumers under the age of 21
- Consumers receiving Hospice services at time of application;
- Traumatic Brain Injury Waiver participants
- Nursing Home Transition and Diversion Waiver participants
- Individuals who have a developmental disability and are receiving services through a waiver program (OMPDD Waivered Services)
- Medicaid fee for service non-dual surplus eligible
- Individuals enrolled in a Managed Long term Care plan are not subject to a lock-in period. An enrollee can request a transfer from one MLTC plan to another at any time.
Non-Dual eligible (Medicaid Only) Consumers
Non-dual eligible (Medicaid only consumers) not otherwise exempt or excluded from managed care are required to enroll in a managed care plan and receive any needed community-based services through the plan.
Individuals enrolled in a mainstream managed care plan are subject to a twelve (12) month lock-in period following the 90 day grace period. An enrollee with HIV or AIDS may request transfer from a managed care plan to an HIV SNP, or from an HIV SNP to another HIV SNP at any time.
Continuity of Care
For transitioning Personal Care and LTHHCP consumers, the existing Personal Care or LTHHCP service plan will continue for at least 90 days after the effective date of managed care or MLTC enrollment or until the Plan’s assessment whichever is later. Service providers will remain unchanged throughout the transition period. Plan enrollees have appeal and fair hearing rights as member of the plans.
Access to Additional Services
100 Gold Street
New York, NY 10038
Community-Based LTC Services
Below is the community-based service for which HRA either provides access or authorizes services.
Institutional-Based LTC Services
Below is the institutional-based service for which HRA either provides access or authorizes services.
– long term care facilities that serve patients who have a chronic illness or disability.
For more information, visit 311 Online or contact HRA's Infoline at 718-557-1399.