Home care paths for Manhattan residents (New York County)

Manhattan is New York County. When the NYIA scheduler, the HRA form, or the HIICAP recording asks for your county, "Manhattan" is not the answer; "New York" is. Otherwise the Manhattan route to Medicaid home care follows the statewide design: Medicaid through HRA, an independent assessment, then either services authorized by a Medicaid managed care plan or enrollment in a Managed Long Term Care plan selected through New York Medicaid Choice. The borough's particular features are its concentration of academic hospitals, whose discharge offices generate a large share of the city's first-time home care requests, and the fact that NYC Aging's own headquarters and HIICAP unit sit in lower Manhattan.

Families in Washington Heights, Harlem, the Lower East Side, and Chinatown helping an older relative who already has Medicaid and now needs help at home. People leaving a Manhattan hospital who were told to "call for an assessment" without being told who assesses what. And residents 60 and older on the Upper West Side or Upper East Side who are not on Medicaid, have a modest income, and would benefit from the city's in-home services program but assume it is only for people on public assistance.

Medicaid: HRA, citywide. The Human Resources Administration runs Medicaid for the five boroughs. Manhattan residents use the same Medicaid Helpline as everyone else, 1-888-692-6116. Adults 65 and older, people with disabilities, and people on Medicare apply through HRA rather than the marketplace. HRA's office locations are on nyc.gov/hra.

The assessment: NYIA, statewide. The New York Independent Assessor Program, at 1-855-222-8350, schedules a nurse's community health assessment and a clinician's appointment once Medicaid is confirmed. Its FAQ says appointments can be in person or by video, that a caregiver may attend, and that interpreters are provided on request. The program's site says you can name an authorized representative, and it accepts a copy of a power of attorney or guardianship order in place of its own form.

Plan choice: New York Medicaid Choice. If the outcome notice says you meet the requirements for Managed Long Term Care, plan selection goes through the state's enrollment program. The long term care line is 1-888-401-6582. Nobody else, including a hospital, an agency, or this site, can enroll you.

Non-Medicaid in-home help: NYC Aging. For residents 60 and older who are not on Medicaid, NYC Aging funds in-home services through neighborhood case management agencies. Its page says the agency does a phone intake and a home visit and that fees or suggested contributions depend on income. Start with Aging Connect at 212-244-6469 or NY Connects.

NY Connects in the city is NYC Aging. NYC Aging's NY Connects page describes free, objective information about long-term services and supports for people of all ages and income levels. The statewide number reaches it.

From the program's FAQ: an identification card, a list of the medicines you take, and medical records from recent hospital stays or doctor visits. Manhattan households typically add:

• Medicaid number and confirmation the case is active with HRA.
• County: New York.
• The names and numbers of your doctors, including specialists, since the clinician may contact them.
• A medication list with doses, not just the bottles on the counter.
• ADL notes. The nurse asks about moving around the home, dressing, and bathing, and about equipment. Describe a normal day and a hard day.
• Who helps now, including any building staff or paid help you already have.
• Representative paperwork if a relative will handle calls: the designation form from New York Medicaid Choice (1-800-505-5678) or a copy of an existing legal document.

Orientation only, not recommendations: NYC Health + Hospitals / Bellevue, NYC Health + Hospitals / Harlem, NYC Health + Hospitals / Metropolitan in East Harlem, NYC Health + Hospitals / Gouverneur on the Lower East Side, NewYork-Presbyterian / Columbia in Washington Heights, NewYork-Presbyterian Allen Hospital in Inwood, Mount Sinai Morningside, Mount Sinai Hospital, Lenox Hill Hospital, and NewYork-Presbyterian / Weill Cornell. Their discharge planners use the words "independent assessment" and "MLTC" daily; the sections above translate them.