N.Y. Public Health Law § 3616: Provision of certified home health agency services, long term home health care programs and AIDS home care programs

§ 3616. Provision of certified home health agency services, long term

home health care programs and AIDS home care programs. 1. A long term

home health care program shall be provided only to those patients who

are medically eligible for placement in a hospital or residential health

care facility. An AIDS home care program shall be provided only to

persons who are medically eligible for placement in a hospital or

residential health care facility and who (a) are diagnosed by a

physician as having acquired immune deficiency syndrome, or (b) are

deemed by a physician, within his judgment, to be infected with the

etiologic agent of acquired immune deficiency syndrome, and whose

illness, infirmity or disability can be reasonably ascertained to be

associated with such infection. Provision of certified home health

agency services, a long term home health care program or an AIDS home

care program paid for by government funds shall be based upon, but not

limited to, a comprehensive assessment that shall include, but not be

limited to, an evaluation of the medical, social and environmental needs

of each applicant for such services or program. This assessment shall

also serve as the basis for the development and provision of an

appropriate plan of care for the applicant. In cases in which the

applicant is a patient in a hospital or residential health care

facility, the assessment shall be completed by persons designated by the

commissioner, including, but not limited to, the applicant's physician,

the discharge coordinator of the hospital or residential health care

facility referring the applicant, a representative of the local

department of social services, and a representative of the provider of a

long term home health care program, AIDS home care program, or the

certified home health agency that will provide services for the patient.

In cases in which the applicant is not a patient in a hospital or

residential health care facility, the assessment shall be completed by

persons designated by the commissioner including, but not limited to,

the applicant's physician, a representative of the local department of

social services and a representative of the provider of a long term home

health care program, AIDS home care program or the certified home health

agency that will provide services for the patient. The assessment shall

be completed prior to or within thirty days after the provision of

services begins. Payment for services provided prior to the completion

of the assessment shall be made only if it is determined, based upon

such assessment, that the recipient qualifies for such services. The

commissioner shall prescribe the forms on which the assessment will be

made.

2. Continued provision of a long term home health care program, AIDS

home care program or certified home health agency services paid for by

government funds shall be based upon a comprehensive assessment of the

medical, social and environmental needs of the recipient of the

services. Such assessment shall be performed at least every one hundred

eighty days by the provider of a long term home health care program,

AIDS home care program or the certified home health agency providing

services for the patient and the local department of social services,

and shall be reviewed by a physician charged with the responsibility by

the commissioner. The commissioner shall prescribe the forms on which

the assessment will be made.

3. Prior to the initial provision of services, and upon the continued

provision of services pursuant to each complete reassessment, the agency

shall present the recipient or the recipient's representative with a

standardized written statement prepared by the department, in

consultation with providers of home care services and consumer

representatives, which informs the recipient or representative that the

services to be provided are subject to change in accordance with a

change in the recipient's needs, a change in information about the

recipient's needs and/or about the formal and informal services

available to meet such needs. The statement shall further inform the

recipient or representative that such notification and acknowledgement

is for purposes of consumer information and education, and to establish

and maintain proper understanding and expectations about the possible

course of care to be provided by the agency.