Long Term Home Health Care Programs (LTHHCP)

Mrs. Greene is receiving ongoing case management and care coordination for her COPD and Osteoporosis. Respiratory therapy, visits from a medical social work and Registered Nurse as well as the addition of a doorway ramp have enabled her to continue living at home.

Overview: Also known as the “nursing home without walls” or “Lombardi” program, operates under the 1915(c) federal Medicaid waiver to provide comprehensive home- and community-based services to eligible older adults and individuals with disabilities with the goal of preventing or delaying nursing home placement. LTHHCPs offer:

Care management
Required NYS Medicaid plan services (nursing, personal care, physical, occupational, and speech therapies, medical supplies and equipment, audiology)
Specified waiver services, normally not covered under Medicaid (medical social services, nutritional counseling and education, Respiratory therapy)
A range of optional waiver services that vary by county (home maintenance, environmental modifications, moving assistance, assistive technology, non-medical transportation, social adult day services, congregate and home delivered meals, respite)

*Some Certified Home Health Agencies (see CHAAs) are authorized to offer these long term home care services as well through contract with a LTHHCP.

Eligibility: Frail, disabled and chronically ill persons who:

are assessed using NYS Department of Health's approved form and found to be medically eligible for placement in a nursing home
verify a desire to live at home and participate in the LTHHCP
are deemed safe to participate and live at home by LTHHCP, social services department and physician
require case management services and at least one waiver service per month
have care needs that can be met through a LTHHCP at a lower cost to Medicaid than they could be provided at a nursing home located in their county (exceptions are those needing respiratory therapy, tube feeding, treatment of pressure ulcers/sores or insulin therapy that cannot be provided by a personal care aide or those with AIDS, dementia, or a mental disability)

Payment Sources:

Medicaid (To help meet cost eligibility requirement, LTHHCP agencies try to maximize family help, third-party insurance, and use of informal community supports)
Medicare (to enhance continuity of care and help ensure recipients are also informed of and assessed for Medicare services as well as bill for Medicaid/Medicare dual eligibles);
Private insurance, private pay

LTHHCP in NYS:

To view LeadingAge New York LTHHCPs Listed by Region, please click here.

Local Departments of Social Services web links: http://www.health.ny.gov/health_care/medicaid/ldss.htm

Questions, concerns, complaints: Home Health Hotline (800-628-5972)

NYS Department of Health's Home Health and Hospice Profile map searchable by county: http://homecare.nyhealth.gov/