Medicaid Home Care in New York - What You Need to Know

As many people know by now, the eligibility rules for Medicaid changed drastically in February, 2006, when the legislature enacted the Deficit Reduction Act of 2005 (DRA). It is much more difficult to help clients needing nursing home care become Medicaid eligible.

What many people may not be aware of, however, is that in New York, there is no lookback period and no penalty period for Medicaid Home Care. Elder law attorneys are still able to do a lot to help seniors who need a home health aide in the home but are afraid of depleting their assets and becoming penniless.

It has been my experience as an elder law attorney that most people prefer to remain in their homes as long as possible. With a proper care plan in place, seniors are very often able to stay in their homes longer. As you might imagine, a senior's health may stay in tact much longer if he or she is getting proper meals and hydration, routine medical care and receiving supervision with walking and getting around, thus avoiding falls. This basic kind of care can keep a senior healthy and functional for years longer than may otherwise be possible.

There may come a time when a senior needs a nursing home level of care. However, it is just as possible that having care in the home may prevent the need to ever put that person in a nursing home.

Medicaid and New York Application Process

The process of getting someone eligible for home care and applying for home care in New York takes at least 3 months, if not longer. In New York, there are a few different ways of applying for home care. You may submit an application through one of the Medicaid field offices (called "CASAs"). You may apply through one of the Certified Home Health Agencies ("CHHAs"). You may also apply through the Consumer Directed Personal Assistance Program ("CDPAP"). Your elder law attorney will help you decide which avenue to go down depending on your particular situation. In New York City, for instance, I often apply through a CHHA, because once the CHHA is satisfied that all the application requirements have been met, it may put the care in place before the Medicaid agency even approves the application.

If a client already has an aide in place and wants to keep that person, assuming that aide is able to be certified, I would go through the CDPAP program, which allows consumers to hire their own aides, within certain parameters.

The home care application process is time-consuming and confusing. Once you foresee there may be a need in the future, you should start investigating your options as soon as possible, because, as with most governmental programs, there is a lot of paperwork involved.