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Chapter 81 of the Laws of 1995 established the limited licensed home care services agency (LLHCSA) provider type as a home care service delivery option that would be available to meet health care needs of adult home and enriched housing program residents. This law originally contained a sunset clause and has been extended several times. The most recent legislation, Chapter 31 of the Laws of 2003, extended the provider type to March 31, 2005. Each extension has also extended the submission date for the Department’s evaluation. The current law requires that this report be submitted to the Governor and Legislature by February 15, 2005.

In 1995, legislation was enacted relating to Welfare and Medicaid reform that included the establishment of the Limited Licensed Home Care Services Agency pursuant to 3602 and 3605 of the Public Health Law and 367-p of the Social Services Law (this legislation is included as Appendix C). The intent of the legislation was to provide services in a residential congregate setting.

The legislation enables licensed adult home and enriched housing program operators under contract to local departments of social services (LDSS) to be reimbursed by the New York State Medical Assistance (MA) program for providing specified home care services to eligible persons under Title XIX of the Social Security Act. The services that may be provided for which the operator may be reimbursed by MA are personal care services, the administration of medications, and the application of sterile dressings by a registered nurse.

The home care services provided by a LLHCSA are authorized by each social service district in accordance with the assessment and authorization procedures specified in a previously issued Administrative Directive, 98 OCC/ADM-1, Limited Licensed Home Care Services Agencies (LLHCSAs) (included as Appendix D). Before a resident may receive the services of a LLHCSA, an initial assessment of the resident must be conducted by a registered nurse employed by a certified home health agency (CHHA) or a licensed home care services agency under contract to the local social services distract (LDSS), or a registered nurse employed directly by the LDSS. Reassessments are completed every six months unless the LDSS has state approval for annual assessments.

Services provided by a LLHCSA must be prior authorized by the LDSS in which the Adult Care Facility (ACF) is located and must not duplicate those that the ACF operator is required to provide. Adult Care Facility Directive No. 1-92 specifies that personal care services in adult home facilities may be provided and funded by Medicaid only if a resident requires total assistance with one or more of the following tasks: bathing, grooming, dressing, toileting, walking, transferring, feeding, using medical supplies


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