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Types of Agencies

Types of Agencies

Licensed Home Care Services Agencies (LHCSAs)

Licensed home care services agencies (LHCSAs) offer home care services through personal care assistants, home health aides, nurses, and therapists, to patients who are covered by Medicaid or through private insurance. Services provided include homemaking, bathing, dressing, grooming, toileting, transferring from beds to chairs or wheelchairs, preparing meals, feeding, and routine skin care, among other services. LHCSAs may also subcontract with other home care providers to deliver services, particularly when delivering skilled care services through Managed Long Term Care. 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 providing aides for seniors.

Fiscal Intermediaries (FIs)

Fiscal Intermediaries (FIs) are agencies that help consumers facilitate their role as employers in the Consumer Directed Personal Assistance Program (CDPAP). Unlike traditional home care models, CDPAP empowers consumers to directly employ aides, known as personal assistants (PAs). The program gives consumers a significant degree of control over their care.

FIs assist consumers by monitoring the consumer’s ability to fulfill their responsibilities in the program, processing wages and benefits; maintaining personnel records; ensuring the health status of PAs before service delivery; and maintaining records of service authorizations or reauthorizations.

Certified Home Health Agencies (CHHAs)

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.


Hospices offer home and inpatient care and counseling for the terminally ill and their families. Hospices offer palliative care rather than curative care to treat disease. Under the hospice program, patients at the end of life and their families receive physical, psychological, social and spiritual support and care.


Altogether, there are more than 1,300 home care agencies in New York State, employing hundreds of thousands of paraprofessional, skilled, and administrative staff. 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.

Home Care in New York State

New York’s Medicaid home care programs provide a wide range of services to hundreds of thousands of homebound sick and elderly patients throughout the State. At the same time, nearly 180,000 New Yorkers receive home care funded by the Federal Medicare Program. Thousands of New Yorkers purchase home care services privately and through private insurance coverage in both indemnity and managed care benefit plans.

The average home care visit costs significantly less than a day of nursing home or inpatient hospital care. Home care helps decrease rising health care costs, offering opportunities for achieving real cost savings for a broad variety of patients. New York must continue to look to home care as the primary source of long-term care services to keep patients in their homes and communities.

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