If you already have New York Medicaid you may be eligible for managed long term care or in home care by a licensed Managed Long Term Care Agency (often simply referred to as MLTC). The animating thought is to ensure that older adults can remain in their home and community rather than in a nursing home. The menu of options available to eligible New York state residents is actually quite extensive. In fact, there is even the option of hiring and training your own personal assistant, know as Consumer Directed Personal Assistance Program.

Traditionally, they could not live with you and you cannot hire your own spouse, parent, son-in-law, son, daughter-in-law or daughter, although they can be grandchildren, neices or nephews or any other relative for that matter. That requirement is changing in April, 2016. There is an exception that allows your personal assistant to live in your home if the amount of care required by the patient makes it necessary. That means that parents (usually of a disabled child), children, grandchildren or sons and daughters in law may reside in the home and care for the patient and get paid for it. You are also required to hire and train an alternate for when the primary care assistant is unable to come to your home because of vacation or need for sick time.


For others who need a higher level of care but wish to remain in their home, there is the option to obtain managed long term care, such as adult day care or in home care. This form of service is better geared towards those who are chronically ill or disabled and who need help with medical appointments or even just keeping on top of their medication as well as assistance with housekeeping or simple weekly chores. Many people often choose to go into a nursing home for these services; for others there is the option to remain in their home. In addition to training your own personal assistant, you may simply choose to utilize a certified home health aide, who are often better trained in medical and nutritional matters. These are simply a slice of the many programs that New York authorizes for various eligible citizens.


All of the different programs require that any service obtained must be medically necessary. While that may seem obvious not all services are necessary for all 24 hours of the day. As such, if you desire personal assistants for 24 hour coverage, your physician must prescribe it. Other times your primary care doctor may only write a prescription for task based matters, such as something as narrowly tailored as driving or being out in public (for shopping or the like). Other times, the task may be much more broad, such as in cooking and eating or even such vague terms such as safety monitoring.

As with any decision dealing with the many and often confusing selection of options available or with obtaining either Medicaid or Medicare, it is always best to speak with an experienced elder law attorney to discuss your options.

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