There are currently two Medicaid Waiver programs that do not have age limits, and therefore, a child can be enrolled from birth onward without the need to transition out at a designated age. The adolescent would still need to be certified as an adult for SSI at the age of 18.
- Long Term Home Health Care Program (also known as the Lombardi Program)
- Office For People With Developmental Disabilities (OPWDD) Home and Community-Based Services
Long Term Home Health Care Program (also know as LTHHCP, Lombardi, or Nursing Home Without Walls): The Long Term Home Health Care Program provides services that would normally be offered only in a skilled nursing home to children and adults who are living at home or in community settings. These services include a coordinated plan of medical, nursing, and rehabilitative care, offering patients who are disabled an alternative to institutional care.
LTHHCP coordinates a wide range of services for enrollees. Some children with medically fragile conditions who age out of other programs such as Care at Home may apply to transition to LTHHCP at age 18.
The following home health services may be provided under the LTHHCP: Nursing, Physical, Occupational and Speech Therapies, Home Health Aide, Personal Care Aide, Homemaking
Additional waiver services may also be available: Assistive Technology (e.g. Personal Emergency Response Services), Community Transitional Services, Congregate and Home Delivered Meals, Environmental Modifications, Home and Community Support Services, Home Maintenance Services, Medical Social Services, Moving Assistance, Nutritional Counseling/Education Services, Respiratory Therapy, Social Day Care, and Transportation to Social Day Care.
The Long Term Home Health Care Program currently requires that the total cost of services delivered at home or in a community setting is less than 75% the cost of similar care provided in a regional nursing home.
LTHHCP is administered by local social service districts and services are provided by a certified Long Term Home Health Care Program Provider. Call your local Department of Social Services (LDSS) for more information. To obtain the phone number of your local DSS, go to the New York State Department of Health LDSS web page
Office For People With Developmental Disabilities (OPWDD) Home and Community-Based Services Waiver: Operated by the OPWDD, this HCBS program offers supports and services that enable adults and children with developmental disabilities to live in the community as an alternative to Intermediate Care Facilities (ICFs). These services can include Nursing, Physical Therapy, Occupational Therapy, Speech Therapy, Audiology, Medical Supplies and Equipment, Homemaker ,Housekeeper, Home Health Aide/Personal Care Aide (31).
Other HCBS Waiver Services
The LTHHCP provider must also provide some services not normally covered for homecare under Medicaid, including these services: Medical Social Services, Nutritional Counseling/Education, Respiratory Therapy.
The LTHHCP provider may also provide these other waiver services, some of which require pre-authorization: Home Maintenance, Home Improvement, Social Day Care and Social Transport, Respite Care, Home-Delivered and Congregate Meals.