Changes That Affect Medicaid Programs Providing Community-Based Long-Term Services And Supports During The COVID-19 Emergency

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The NYS Department of Health (DOH) issued guidance in response to the COVID-19 health emergency that impacts people enrolled or trying to enroll in Medicaid Managed Care plans and other types of programs that provide community-based long-term services and supports.  If you receive this type of care, or wish to enroll, some of the requirements have been suspended or changed until further notice.

 

I need a doctor’s order so I can receive personal care services. Do I need to go to my doctor’s office?

No.  The Department of Health encourages physicians to complete initial authorizations for personal care services via telephone or telehealth.

I need to schedule an initial community health assessment. Will someone assess me in person?

Your initial community health assessment can be conducted by telephone or using telehealth. A family member, designated representative, or someone else who is physically with you during the assessment can help provide information. If the program needs information that it cannot get through telephone or telehealth, you may be assessed in person when possible.  Otherwise, your local department of social services can develop a plan of care and authorize services until your assessment can be completed. If you already had a community health assessment for one program and you now want to transfer between plans or to a different type of program, your old assessment can be used to develop your new plan of care.

I receive personal care services, but I have a reassessment or home visit scheduled. Will that still take place?

No.  All periodic re-assessments of community health assessments through Medicaid managed care plans and fee-for-service Medicaid are suspended.  The six-month in-person care management home visit is also suspended.

I am enrolled in an Adult Day Health Care program. Are my services suspended?

While you cannot attend adult day health care in person, you may receive services over the phone or using telehealth.

I am enrolled in a Social Adult Daycare program. Are my services suspended?

While you cannot attend social adult daycare in person, you may receive services over the phone or using telehealth. If you cannot use the phone or internet, your social adult daycare program may arrange for contact-free delivery of audiobooks and players, music players, arts and crafts, supplies, and games. They may also arrange phone singalongs or remote group games. If you have trouble getting food, medication, or supplies, your social adult daycare program may arrange to have them delivered to you.

I need durable medical equipment, prosthetics, orthotics, or supplies. Do I have to sign for the delivery?

No. Members do not have to sign for the delivery of their medical supplies until further notice.

I am an aide through the consumer directed personal assistance program. Do I need to renew my health assessment, immunizations, or tuberculosis test?

No. The annual renewal of the health assessment, immunizations, and tuberculosis test required for aides providing consumer directed personal assistance is suspended if you are already providing consumer directed services. This does not apply to new aides.