New Rules for Community Medicaid Coming!

Provisions of the recently passed New York State Budget will make it far more difficult for many to become eligible for services under the Community Medicaid program. The new rules will impose a look back period.

This will be a major change to the current regulations, which allow access to home care Medicaid benefits without the imposition of any penalty period for transfers made any time prior to the application.

Here are some of the most notable changes to Medicaid eligibility criteria:
There will be a 30-month look back period imposed on community Medicaid applications. Applications completed now will be evaluated under the current regulations, which impose no penalty period for transfers made prior to an application for Community Medicaid. Under the new rule, any non-exempt transfer made during the look back period will result in the imposition of a penalty period; individuals will be responsible for privately paying for care during the length of the penalty period;

Under the new rules, in order to be eligible for long-term care services in the community (home care) using the Consumer Directed Program (CDPAP) or personal care services (PCS), an individual must require assistance with 3 activities of daily living (ADLs). Thankfully under this new rule, those individuals with Alzheimer’s or Dementia will only need to demonstrate a need for assistance with one ADL; and For PCS and CDPAP services, a “qualified independent physician selected or approved by the Department of Health” (not the treating physician) must determine the plan of care for the individual.

These new regulations will have a tremendous impact on Medicaid planning in New York State. One piece of good news, however, is that transfers to a non-applying spouse continue to be an exempt transfer, and spousal refusal can still be employed to access benefits. Transfers of a residence to certain individuals without the imposition of a penalty are still a possibility under the new rules.

Practice Social Distancing Even if you feel well, stay at home as much as possible. In public, keep at least 6 feet distance from others. Avoid unnecessary appointments.

Protect Yourself and Others Wash Your Hands. Cover Your Cough. Cover your cough and sneezes. Use your elbow or a tissue. Avoid touching your eyes, nose and mouth.

Take Caution with New Yorkers At-Risk                                                              Take special caution to avoid exposing the elderly and people with underlying health conditions. Avoid visiting those most at risk, call instead.  Offer help with groceries and other goods.

Benefits, Prevention Tips, Symptoms: It’s important for all of us to stay hydrated. It’s especially crucial for our seniors. Dehydration is very common. Here are some ways staying hydrated is beneficial, tips to help prevent dehydration, and symptoms to look out for.

Our bodies need to be hydrated to support a complex system that balances electrolytes and fluids. Maintaining that balance helps in so many ways including:

1. Regulates body temperature
2. Keeps joints lubricated
3. Delivers both nutrients and medications to cells
4. Helps keep organs functioning properly
5. Flushes urinary tract and preventing UTIs

Everyone has different preferences so it’s good to get creative when offering foods and drinks that can help keep our seniors hydrated. If you are thinking of different ideas, it’s good to check with their physician to be sure it is the best fit for them. Below are some tips to help seniors stay hydrated, especially during the hot summer days.

1. Keep water nearby at all times
Having the fluids easily accessible can encourage and remind someone to continuously drink. Make it more convenient for them by keeping a light water pitcher and cup near where they enjoy sitting.

2. Try liquids in different forms and at different temperature
Some people enjoy hot drinks over cold, or vice versa. Test out different temperatures to see what they like best. You can try giving someone hot soup broth instead of a regular drink, or even a homemade popsicle of fruit juice and water.

3. Offer milkshakes, smoothies, sports drinks, or even ensure
If the person continues to resist drinking liquids, try offering them something more enticing. We know they aren’t the healthiest choices, however they might be more amenable to drinking if they enjoy the taste and texture.

The effects of dehydration may start off seemingly harmless however they can become detrimental quickly. Here are some things to look out for:

  • Thirst is typically the first sign of dehydration, followed by flushed skin, headaches, fatigue, and dry mouth.
  • Body temperature, breathing, and heart rate can all increase which can turn into dizziness, increased weakness, and even confusion. 
  • As body water continues to decrease symptoms begin delirium, poor circulation and failing kidney function can occur.

We want everyone to stay safe especially during the summer, so please be sure to check on those you love and provide care for and keep them hydrated!

We hope you and your families well and safe. We want to inform you of recent changes to the New York State budget which may significantly impact your need for home care services paid for by Medicaid (also known as Community Medicaid).

New York State has passed the 2020 State budget Bill which includes radical changes to the statewide community Medicaid program covering home and community-based services:

  • Starting October 1, 2020, all new applications for Medicaid community-based (home care) benefits will be subject to a 30-month (two-and-half-year) lookback period when analyzing an applicant’s resources and income. This requirement is a drastic change from the prior one-month lookback period.
  • If transfers are found within 30-months (two-and-half-years) prior to the date of submission, a transfer penalty or waiting period will be applied before services can be granted to that individual.

The anticipated effective date of this new rule is October 1, 2020; therefore, all Medicaid home care applications filed after October 1 will have to provide 30-months of financial statements for all resources.

If you are considering applying for home care services in the near future, we strongly recommend that you contact us as soon as possible to discuss preparation of your Medicaid home care application so that it can be filed before October 1, 2020, and avoid the new lookback requirements and possible penalty period.

This change will likely cause the application process to take longer, and we do not want you to be delayed in your receiving much-needed benefits as past transfers will now affect your eligibility. Please note that the lookback period for Medicaid nursing home benefits remains unchanged at a full 60 months (5 years).

Wishing you and your family

Good Health,

Peace and Happiness on Passover and Easter and always.

Fraudulent emails and phone calls from scammers trying to get your personal information is nothing new, but there has been a dramatic increase in scams since the onset of the COVID-19 pandemic.

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We hope you and your loved ones are safe and healthy during this medical crisis. We are deeply concerned for the safety and well-being of our clients and their families, and will continue to provide our services during this crisis. These are stressful days for everyone and probably will continue to be so in the weeks to come.

We are all concerned about our own well-being and the health of those we love. Please know we are remotely available to assist you with any of your current needs. Any urgent wound care cases will be assessed and addressed by a home visit if necessary. 

Securing a Health Proxy is very important at this time. Should you need assistance with this, please feel free to contact my office. For those of you who have a Health Proxy, please have it available should you need to seek medical attention.

Wash your hands, maintain social distancing, and stay safe!

Heat & The Elderly

Excessive heat is the leading cause of preventable, weather-related deaths each year, particularly among the elderly.

  • Elderly persons and small children are mostly affected
  • Persons with weight or alcohol problems
  • Persons on certain medications or drugs
Read more