Staten Island (Richmond County) home care: NYIA, MLTC, and NYC Aging

Staten Island is Richmond County, and it is the borough where people most often assume the rules are different because everything else feels different. They are not. Medicaid is HRA, citywide. The assessment for Medicaid home care is the statewide New York Independent Assessor Program, which comes to your home or meets you by video. Managed Long Term Care plan selection is New York Medicaid Choice. Non-Medicaid in-home services for residents 60 and older are NYC Aging. What is genuinely different is geography: a single in-person HIICAP site on the North Shore, long bus rides from the South Shore to anything, and a car-dependent population that finds the video appointment option more useful than most.

Families across the island, from St. George to Tottenville, caring for a parent who has Medicaid and now needs help with bathing, dressing, or moving around the house. People discharged from one of the island's hospitals with a note that says "needs home care" and a number to call. And homeowners in Mid-Island and the South Shore who are past 60, not on Medicaid, and would accept a few hours of help a week if they knew NYC Aging funded it on a contribution basis.

Medicaid is citywide HRA. No Richmond County Department of Social Services exists. The Human Resources Administration's Medicaid Helpline is 1-888-692-6116, and adults 65 and older, people with disabilities, and people on Medicare apply through HRA. HRA's long-term care page routes home care questions to the DSS OneNumber at 718-557-1399 and to a borough CASA office; check nyc.gov/hra for the current location.

The assessment is NYIA and can be by video. Once Medicaid is confirmed, the New York Independent Assessor Program (1-855-222-8350) schedules a nurse's community health assessment and a clinician's appointment. Its FAQ says both can be in person at your home or by video, and that for a video visit you need a smartphone, tablet, or laptop with a camera and Wi-Fi, or a friend or relative present who has one. For a household on the South Shore, that option can shorten the wait for a visit.

Plan selection is New York Medicaid Choice. If the outcome notice says you meet the requirements for Managed Long Term Care, choosing a plan runs through the state's enrollment program. The long term care line is 1-888-401-6582. Not every plan serves every county, so ask which plans list Richmond County.

Non-Medicaid help is NYC Aging. For residents 60 and older who are not on Medicaid, NYC Aging funds in-home services through a contracted case management agency that does a phone intake and a home visit. Fees or suggested contributions depend on income. Aging Connect is 212-244-6469.

NY Connects in the city is run by NYC Aging and, per its page, serves people of all ages and income levels. The statewide number reaches it, and NYC Aging lists a Staten Island office among its borough NY Connects offices; call rather than walk in.

The assessor's FAQ lists an identification card, a list of medications, and recent medical records. Staten Island households typically also set up:

• Medicaid number and case status with HRA.
• County: Richmond.
• A device and Wi-Fi if you want a video appointment, or a relative who can bring one.
• Doctors' names and numbers, since the clinician may call your doctor.
• A medication list with doses.
• ADL notes. Stairs are the Staten Island question: many homes have the bedroom upstairs and the bathroom on a different floor. Describe exactly where help is needed.
• Who helps today.
• Representative paperwork if a relative will speak for you: the designation form from New York Medicaid Choice, or a power of attorney or guardianship order.

Orientation only: Staten Island University Hospital North in Ocean Breeze and South in Prince's Bay, Richmond University Medical Center in West Brighton, and the Staten Island Ferry terminal and Borough Hall in St. George. Discharge planners at the hospitals will say "MLTC" and "independent assessment"; the steps above are what those mean.