The Long-Term Home Health Care Program, also known as the Lombardi Program or the Nursing Home WIthout Walls. It is a Medicaid waiver program which was designed to maintain individuals with chronic illness in the community. By providing panoply of home health care services to Medicaid beneficiaries who would otherwise qualify for nursing home placement, the program has been able to extend the amount of time these individuals remain in the community.
VNAB LTHHCP serves residents of Brooklyn and Queens. It currently has 700 slots in Brooklyn and 50 slots in Queens. Empire LTHHCP has 200 slots in New York County. Both programs have designations as AIDS LTHHCPs and can admit individuals diagnosed with HIV or AIDS. These individuals are not counted within the Department of Health approved slots.
Reimbursement for LTHHCP
The primary payer for the LTHHCP is Medicaid. Medicaid reimbursement is based on data from the DMS-1, which is completed by a nurse or therapist upon initial contact with the patient. This form provides information on the patient's physical and psychological condition, living situation, and ability to perform tasks at home. A socre of above 60 qualifies a patient for LTHHCP services. Every 120 days, a new DMS-1 is completed.
LTHHCP Programs are reimbursed at seventy-five percent of the average regional cost for nursing home care. One hundred percent reimbursement can be requested in cases where care has become very expensive.