CDPAP (NY)

Hi hope it’s ok to ask. Helping a medicare client (I am a social worker) sort out her Medicaid spend down to get set up with an MLTC to be able to obtain HHA services done by live in family paid for through CDPAP. She is not ambulatory and requires care for toileting and other activities. I cannot imagine that they would qualify for less than 40 hours minimum but am scared that she won’t qualify for enough hours to justify the work. The family member needs 40hrs to discontinue their other job. The patient definitely needs those hours in my opinion.

I would love information from others who have been there to make sure I support and advocate for that minimum of 40hrs. Anything that really clinched it for your CDPAP agency? Anyone get more than 40 approved? What was needed to make that happen? I assume the issue is getting Maximus to see the demonstrated need, right? How does one do that? Thanks in advance.

Sorry I haven’t been in the HHA industry myself for years.