Ensuring Maximum Hours with MLTC Evaluations

Individuals receiving home care services through a Managed Long Term Care (MLTC) company may find that the agency did not award their family member or loved one with a sufficient amount of hours of home care services after they’ve conducted an evaluation.

The evaluation process by an MLTC can be complex. A person approved for Medicaid Home Care services will eventually have to enroll with an MLTC. The MLTC provider will send an evaluator to assess the recipient’s condition in order to create a care plan that will suit the individual’s daily needs. The evaluator will determine the number of hours per day that the recipient is entitled to receive to assist with their personal care needs.

Is the recipient able to perform activities of daily living, such as bathing and toileting without assistance?

The answer to this question will result in points that ultimately determine the number of home health aide hours that the Medicaid recipient will be entitled to receive. The number of hours that a recipient receives could be a few hours per day to a 24-hour live-in aide to two 12-hour aides, depending on the severity of the individual’s needs. After the determination of the number of hours to be provided in the care plan, the individual will enroll with the MLTC or can request an evaluation from another MLTC if they are not satisfied.

While Medicaid Home Care provides the aging population with the ability to remain in the home, an adequate number of home health aide hours must be provided to ensure an individual’s safety and to properly assist with activities of daily living. For this reason, it is beneficial to consult with an attorney about the evaluation process to assist with getting the maximum number of Home Care hours that the recipient is entitled to receive.

If you or a loved one is having trouble receiving an adequate number of home health aide hours, it is important to contact an experienced elder law attorney. The lawyers at Hobson-Williams, P.C. are skilled in all aspects of Elder Law and Medicaid Planning and are dedicated to representing its clients with diligence and compassion. Contact the experienced New York attorneys at Hobson-Williams, P.C. for a consultation by calling (718) 210-4744 or by filling out our contact form.

Author: Tanya Hobson Williams

Appointed to the bench by the Board of Trustees in 2008, and elected in 2009, Tanya Hobson-Williams was the first African-American Female Justice in the Incorporated Village of Hempstead. Tanya Hobson–Williams obtained her B.A. in Government and Politics from St. John’s University and her law degree from Benjamin N. Cardozo School of Law. Tanya Hobson-Williams has an active elder law practice assisting senior citizens in obtaining Medicaid for Home Care and Nursing Home Care. She routinely lectures at senior citizen centers, assisted living facilities, law schools and counsels families on a variety of topics of concerns to families caring for the elderly. View all posts by Tanya Hobson Williams