Services Offered

Long Term Home Health Care Program (LTHHCP)

Commonly referred to as the “Nursing Home Without Walls”

The need for home care will continue to grow as our population ages, and more people with disabilities and chronic conditions choose to live at home. Home care is both cost-effective and intricately tied to the public health and public security infrastructures.

About 70% of home health users are age 75 or older. More than half of all users are women and more than half have family incomes of $15,000 a year or less. About 43% of home health users have limitations in one or more activity of daily living. One publication reported that the home care industry is expected to nearly double in the next eight years because of the aging population, continued availability of services at home and patient’s preference to recover from illness or injury in their own home.

The Governor’s own study, Project 2015, describes the impact of aging in New York. By 2015 2.6 million New Yorkers will be over the age of 65, and by 2010, those over 85 will have increased by 50%. New Yorker’s dependency ratio (the number of youth and elderly for every 100 people of working age) is expected to reach 78.4 in 2025. Cutting home care now will accelerate the exodus of workers from home care and bring on a crisis when community care is no longer available.

LTHHCP in Niagara County

The Long Term Home Health Care Program (LTHHCP) is a coordinated, comprehensive and statewide initiative. The Niagara County Health Department is the largest provider of this program in Niagara County, with the capacity to service 215 clients.

Additionally, the health department’s LTHHCP is the sole provider approved to serve patients with HIV and AIDS related illnesses through the Aids Home Care Program in Niagara County.

What are the advantages of the LTHHCP? LTHCP

Flexibility. The LTHHCP was conceived as a more flexible way to deliver long term care to nursing home eligible individuals. Services are reimbursable by Medicaid with the approval of the NCDSS. Limited service may be reimbursed by Medicare or other insurance plans. Private pay is also accepted. Program services are provided in response to patients’ medical needs, based on a skilled nursing assessment.
Collaboration. Patients, patients’ physicians and families, county Departments of Social Services and LTHHCP professionals’ design and put into place a comprehensive plan for care. This high degree of collaboration is a particularly strong model for assuring appropriateness, cost-effectiveness, medical necessity and “goodness of fit” of the program’s services.
Cost-effectiveness. The program must deliver services at or below 75% of the cost of the nursing home services. Most patients’ programs are well below the 75% cap.
Innovation. The program encourages innovative solutions to the kind of practical problems people encounter trying to live at home with chronic conditions. The program has provided for thousands of small, inexpensive but far reaching interventions that have prevented unwanted and costly institutionalization for LTHHCP patients.
Efficacy. Excellent, ongoing case management assures that chronic medical conditions with the potential for rapid change are monitored to prevent decline and hospitalization.
Efficiency. Case management is also the key to eliminating many of the most challenging problems for patients with chronic disease processes: fragmentation among uncoordinated medical and social services systems; unnecessary and costly duplication of services; frustrating and potentially dangerous discontinuity of care, and timely assessment and intervention when patients’ conditions change.
Dignity. The LTHHCP promotes patient independence and function, supports the critical role of family caregivers without supplanting that function, and responds to the patients’ desire to continue living at home.

LTHHCP: Coordinated, Comprehensive and Statewide

It is the coordination of all the aspects of care for individuals with such diverse, complex and chronic health conditions that makes the long term home health care program unique; not only in New York, but in the nation. The LTHHCP is available in every county in New York, and its patients are extraordinarily diverse. Though most LTHHCP patients are elderly, people of all ages, infants through senior adults may participate. LTHHCP patients include people with severe physical disabilities, such as advanced multiple sclerosis and severe cerebral palsy, people with multiple chronic diseases such as diabetes, progressive conditions such as heart, kidney and respiratory failure, and physically frail elders.

The LTHHCP’s services are comprehensive enough to permit this population to live safely and independently at home. LTHHCP’s and local departments of social services jointly assess patients’ medical conditions, and determine their eligibility for the program. After a home evaluation, a public health nurse develops the patient’s plan for care based on his/her needs and with the help of their family. Through skillful management of patients’ care, involvement of families and other informal caregivers, and emphasis on patient’s independence and autonomy, patient care costs under this program have consistently been about half the cost of comparable levels of institutional care.

To make a referral for a loved one to benefit from the services of the Long Term Home Health Care Program in Niagara County, call (716) 439-7470 for Lockport and the Eastern Niagara County and North Tonawanda areas or (716) 278-1900 for Niagara Falls and the Western Niagara County area. A nursing supervisor will assist you.

For more information on the Long Term Home Health Care Program in New York State go to
http://www.health.state.ny.us/nysdoh/medicaid/longterm/guide.htm