Home care’s roots are in public health. Dating back to the 19th century, care and support were brought from institutions into the community and homes to provide prevention, primary and critical healthcare and assistance.
Home Care was conceptualized when nurses came together to meet patient care needs outside of hospitals; fill gaps; and bring services and therapeutic skills, with compassionate hearts and unparalleled level of creativity.
Medicare and Medicaid’s enactment in 1965 brought public coverage for home health, and hospice was added in 1983. Personal care (distinct from home health care) was later included as an option under Medicaid, which NYS eventually opted to offer.
Current HCANYS President Al Cardillo (center) receiving HCA's highest honor, the Ruth F. Wilson Award, in May 1990; accompanied by Senator Tarky Lombardi, Jr. and Harriet Morse
NY Insurance Law was amended by State Senator Tarky Lombardi, Jr. to include home health coverage in 1972. The law today stands largely as Senator Lombardi developed it roughly 50 years ago.
Home care in NYS was sanctioned under NY’s hospital and clinic law (Article 28 of the Public Health Law); Article 36 governing home care did not exist until 1977.
In mid-1970’s, recognition of long term care costs, capital-dependent models, Medicaid, and demographic, public health and social/familial trend forecasts created staggering alarm of policy makers, planners and others about how to best address. This led to NYS Senate Health Committee Chairman Senator Lombardi develop a landmark home care law in NYS in 1977. This established Article 36 and the Long Term Home Health Care Program (LTHHCP), frequently referred to as the “nursing home without walls” program, and established as a state policy and priority the statewide availability and accessibility of home care services.
Over the next decade, coverage and services expanded. The Home Care License Law and Expanded NYS Regulation required licensure of any entity providing or arranging nursing, home health aide, personal care, in the home and permitted for-profit entities to be certified, all with an intent to bring all “in-home care” under uniform regulation and standards.
In 1997, following several years of cuts at the state and federal level, the “Long Term Care Financing and Integration Act” was adopted in NYS providing for the structure and expansion of Managed Long Term Care (MLTC) Plans.
In 2011, managed care and Medicaid Redesign Team (MRT) statutes instituted new reimbursement structures and mandatory enrollment of most Medicaid patients into managed care, and long term care patients into managed long term care which still exists today.
