Case Management for the Care At Home Program

We offer comprehensive case management and service coordination for the Care At Home Program. The case manager will assist and enable a child and family to access the full range of eligible services and resources needed to maintain the child at home. The case manager will serve as the pivotal person encouraging and supporting the cooperative effort required to meet the child’s needs. The case manager and family will engage in a collaborative effort in seeking the best interest and meeting the needs of the child. The multiplicity of needs and problems faced by children and their families in the Care At Home Program cannot be addressed by any single agency or resource. Services and coverage frequently must be requested from a number of different providers and programs. The success of the home care plan is dependent upon building that understanding and on the effective coordination and delivery of services. The case manager is the key to these activities and the impetus to the cooperative provision of services to each child.

What is the Care At Home Program?

The Care at Home Program is a Medicaid Model Waiver Program designed to assist families caring for a child at home who may have a severe disability or medical condition. The program affords the availability of supportive services that helps make home care a viable option and improves the quality of life for the children and their families.  New York State administers two very similar Care At Home Programs through the New York State Department of Health (DOH) and the Office for People With Developmental Disabilities (OPWDD). An important aspect of this program is that parental income and resources may not considered when determining the child’s eligibility for Medicaid.

Back to Top

General Eligibility Criteria for the DOH Care at Home Program

DOH Program Requirements:

Children who require hospital or skilled nursing home level of care

  • Be under 18 years of age
  • Requires the level of care provided by a skilled nursing facility or hospital 
  • Must be able to be cared for at home safely
  • Must be eligible for Medicaid based on his/her parent’s income and , if applicable, resources;                                       – OR – 
  • Must be ineligible for Medicaid due to parent’s excess income and/or resources, but be eligible for Medicaid when parents’ income and/or resources are not counted
  • The cost of care of children participating in Care at Home Program can not exceed that if cared for in a skilled nursing facility or hospital.

General Eligibility Criteria for the OPWDD Care at Home Program

OMRDD Program Requirements

Children with a developmental disability and complex medical condition

  • Be under 18 years of age
  • Have a developmental disability as defined by New York States’s Mental Hygiene Law
  • Demonstrate complex health care needs that are expected to continue for at least 12 months
  • Be eligible for the level of care provided by an intermediate care facility (ICF) for persons with developmental disabilities
  • Must live at home (not be in hospital, skilled nursing facility, ICF/DD facility or other institution
  • Have a Nursing assessment indicating that the child is able to be cared for at home if the proper services are provided
  • Be ineligible for Medicaid because of parental income and resources
  • Be able to be cared for less cost in the family home than in an ICF/DD facility

Back to Top

What Services are Available?

The Care at Home Program pays for all of the standard New York State plan Medicaid services. A list of some of the essential services include:

  • Private duty nursing
  • Home health / personal care services
  • Consumer Directed Personal Assistance Program (CDPAP)
  • Medicaid supplies and equipment
  • Prescription drugs
  • Physical, occupational and speech therapy
  • Hospital inpatient and outpatient services
  • Physicians care
  • Laboratory and X-ray services

In addition, the Care at Home Program waiver pays for some services not ordinarily covered through Medicaid including:

  • Case Management
  • Respite care (OPWDD only)
  • Medical social services
  • Nutrition counseling
  • Respiratory therapy
  • Home adaptation 
  • Vehicle modification
  • Palliative care (DOH only)

Back to Top

How to Apply

If you feel your child may qualify for the Care At Home Program, please call our intake coordinator to assist with the application process.

(631) 761 – 0128

Back to Top