What is Home Care--Types of Home Care Agencies

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New York State licenses or certifies a variety of home care program types. Home care agencies and programs differ in the services they provide and the State agency that oversees their operation. The New York State Department of Health (DOH) sets standards for and regulates all home care agencies that provide health or medically related services to people in their homes. DOH and the Federal Centers Medicare & Medicaid Services (CMS) jointly regulate agencies participating in the Medicare program. DOH regulations and standards require that home care providers meet the same standards relating to agency establishment, paraprofessional training, quality of care and consumer protection standards including service delivery and personnel requirements. The following types of home care agencies require either a license or certification issued by DOH:

• Licensed Home Care Services Agencies (LHCSAs) offer home care services including all levels of nursing care, various therapies, home health aides and personal care aides to clients who pay privately, have private insurance coverage or are covered through a variety of government payers. Many LHCSAs also deliver services under contract with local departments of social services or other service-authorizing agents. In particular, services through the Medicaid Personal Care and Private Duty Nursing Programs are delivered in this way. Licensed agencies also sub-contract with other home care providers to deliver services to beneficiaries throughout New York State. LHCSAs may offer a full range of services from skilled to paraprofessional or may choose to focus on the delivery of one service or population, such as high-tech pediatrics or aides to seniors.

• Certified Home Health Agencies (CHHAs) provide care and support services to individuals who, for the most part, have home health care needs for a limited duration. These agencies provide nursing and home health aide services, and provide or arrange for other professional services, including physical and occupational therapy, speech pathology, medical social work and nutrition services. They are generally reimbursed through Medicare and/or Medicaid.

• Long Term Home Health Care Programs (LTHHCPs), also known as "Nursing Homes Without Walls" are CHHAs operating under a specific Federal Medicaid waiver. They offer health care and support services to the disabled and chronically ill who are medically eligible for admission to a nursing home, but who choose to be maintained at home. These programs provide a full range of professional and aide level health care services to those in need over a long period of time, at a budgeted amount of 75% of the cost of nursing home care.

• Hospices offer home and inpatient care and counseling for the terminally ill and their families. Hospices offer palliative care rather than treating disease. Under the hospice program, dying persons and their families receive physical, psychological, social and spiritual support and care.

All together, there are approximately 900 home care agencies in New York State, employing over 250,000 workers. In addition to professional nurses, therapists, and assistants, home care agencies hire and train workers as home health aides and personal care aides, and offer these paraprofessionals additional opportunities for career growth.

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What is Home Care? Types of Home Care Agencies Home Care Paraprofessionals Home Care Programs and Services

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