14 THE QUEENS COURIER • QUEENS BUSINESS • NOVEMBER 9, 2017 FOR BREAKING NEWS VISIT WWW.QNS.COM
queens business
The Elder Law Minute TM
Navigating the Medicaid Home Care System
BY RONALD A. FATOULLAH, ESQ.
AND STACEY MESHNICK, ESQ.
Recently, it has become increasingly
diffi cult for those in need to obtain
24-hour home care, especially split shift
care (two 12-hour shift s). It is unclear
how New York State will be able to sustain
the Medicaid home care program
with the move in recent years to managed
long term care (MLTC), which is
essentially an HMO model (Medicaid
pays the agencies the same monthly
amount per recipient whether they provide
four hours per day or 24 hours
per day) and with the current challenges
to wage and hour laws for home care
workers.
If an individual is already receiving
care and the hours are reduced, he or she
must be provided with written notice as
to the reduction and the reason for such
reduction. Th ere are methods to appeal
this decision. Th e individual can initiate
an internal appeal and request a reevaluation.
However, it is important to simultaneously
ELDER LAW
request a Medicaid fair hearing
with “Aid Continuing” within ten days
of the decision. If the Commissioner
of the Department of Health grants the
request for Aid Continuing, Medicaid
must continue to provide services to the
individual at the same level at which he
or she was previously awarded until such
time as a “Decision Aft er Fair Hearing”
is issued.
In order to receive the necessary care,
it is important to know what needs to
be demonstrated to the agency evaluating
the number of hours that will be
provided. A common misconception
is that services are based on the diagnoses
of the Medicaid recipient. In fact,
hours are awarded based on the extent
to which the Medicaid recipient requires
assistance with his or her Activities of
Daily Living (ADLs). Th erefore, during
an evaluation, it is important to educate
the evaluating nurse on which ADLs the
Medicaid recipient requires assistance
with and the frequency of such need.
Th e ADLs that typically result in a higher
award of hours tend to be ambulation/
transfers and toileting.
It is important for a Medicaid recipient
to off er concrete evidence of his
or her needs. In addition to specifying
the activity, the frequency of the need
must be addressed, such as the recipient
requiring assistance with going to the
bathroom several times during the night.
If an individual must attend a fair hearing,
he or she should bring any documents
supporting the need for increased
care. Such documents include doctors’
recommendations and an Affi rmation
from a doctor, medical records, evaluations
performed by disinterested parties,
and a witness, such as an aide.
Personal care services must be authorized
in amounts that are medically necessary.
While there are specifi c standards
for determining the need for
24-hour care, the regulations are not as
specifi c for people who require less than
24-hour care. Local Medicaid programs
as well as managed care and MLTC plans
that authorize personal care aides are
permitted to use assessment tools that
may not result in receiving the number
of hours actually needed.
Ronald A. Fatoullah, Esq. is the principal
of Ronald Fatoullah & Associates,
a law fi rm that concentrates in elder
law, estate planning, Medicaid planning,
guardianships, estate administration,
trusts, wills, and real estate. Stacey
Meshnick, Esq. is a senior staff attorney
at the fi rm who has chaired the fi rm’s
Medicaid department for over 15 years.
Th e law fi rm can be reached at 718-
261-1700, 516-466-4422, or toll free at
1-877-ELDER-LAW or 1-877-ESTATES.
Mr. Fatoullah is also a partner with
Advice Period, a wealth management
fi rm, and he can be reached at 424-256-
7273.
RONALD FATOULLAH
ESQ, CELA*
editorial
5 Ways to Reduce Your Email Anxiety
Dear Mindy: I want to be
responsive to requests for
information, but I feel overwhelmed
with all the emails
I receive. Every time I hear
the sound of email entering
my inbox, I lose focus
on what I am working on. Is
there a way to get my email
under control, while still
being responsive? Emailed
Out
Dear Emailed Out: Do
you really need to be notifi
ed every time an email pops into your
inbox? Th ink about what happens to
your mind when you hear the familiar
ping of an email entering your inbox.
Do you fi nd yourself getting distracted
from what you are doing at the moment
and give into your curiosity to see who
is sending you something? Do you get
anxious if you don’t check it out immediately?
You are not alone!
Every day, more than 205
billion emails are sent and
received and that number
is expected to increase by
about 3% every year.
Getting constant interruptions
at work, while attempting
to be productive, can
take a toll on you in the form
of more stress, higher frustration
and increased time pressure.
However, there are ways
to manage your inbox so that
you can focus on whatever you are currently
working on. Here are fi ve tips to
help you manage your inbox and reduce
your email anxiety.
• Turn off email notifi cations - Your
email can wait. Turn off notifi cations
and set specifi c times during the day to
check it. Perhaps once in the morning,
right aft er lunch and once before you
leave for the day. Save time and energy
by not immediately focusing on each
email that arrives.
• Unsubscribe: Do you need to read all
of the daily or weekly notifi cations that
you may or may not have signed up
for? Make it a habit to unsubscribe or
fi lter mass emails that are not of value
to you. Th e less emails in your inbox,
the lower the stress level for you.
• Sort by Sender: Not all emails have
equal importance to you. If you create
a rule to sort the emails by sender, you
will easily be able to fi nd the emails
that your boss sent to you. Th ere are
several apps that can help you to organize
your emails.
• Archive: Use the archive feature to
separate the emails you need to read,
versus the emails you don’t need to
act on, but may want to save to read
later. Your archived email will still
be searchable, but your inbox will be
clear and unnecessary emails will not
be constantly staring you in the face.
• Make a phone call: Many people use
email as a convenient way to interact
with others. However, email is not
always the best method of communication,
especially if you need to have a
diffi cult conversation or are trying to
build a relationship with an employee
or colleague. Don’t hide behind
emails. Pick up the phone, or better
yet, meet face to face to build or reinforce
relationships.
Mindy Stern, SPHR, SHRM-SCP,
ACC is a trusted HR advisor, career
coach, author, speaker and president of
AIM Resource Group Inc. Visit the website
at www.aimresourcegroup.com to
get RESULTS! Do you want your questions
answered in this column? Send
requests to: mstern@aimresourcegroup.
com.
EMPLOYMENT
MATTERS
MINDY STERN
SPHR, SHRM-SCP,