4) Which of my patients can get homecare services?

Bellevue Hospital

• The amount of home care is dependent on insurance coverage or ability to privately pay. Different insurance providers have different entitlements. It is best to contact the Social Worker assigned to your unit or call the Social Work office at 562-4166.

Tisch Hospital

• Patients with Medicare and Medicaid are eligible for homecare if they have the need for at least one of the following: intermittent skilled nursing care, or physical therapy or speech-language therapy or continue to need occupational therapy; they must be homebound; and their primary physician must be willing to sign homecare orders. If the patient has commercial insurance their homecare benefits will depend on their policy but most policies cover basic homecare benefits. If the patient has no insurance and is in need of homecare we can usually arrange for some type of charity care for the patient. The best thing to do is to get in touch with the patient's Social Worker as soon as possible to begin discussing discharge plans for the patient.



• For patients who may need to continue with prolonged intravenous infusion, home is also an option. These patients must be able to learn to perform the infusion themselves or to have someone at home who is willing to do the infusion for them. The nurse from the infusion agency will only come in to teach the patient/family how to do the infusion. Home infusion is costly and although most commercial insurance covers the cost at home, Medicare does not. The patient also needs a PICC line in order to be discharged home on infusion. Again, the best thing to do is to contact the patient's Social Worker to discuss home infusion as a possible discharge plan.
  

VA Medical Center

• Skilled home care-VA social workers and nurses will arrange for skilled services at home (e.g. RN and PT visits) utilizing benefits such as Medicare and Medicaid. If there is no other payment source, the VA can pay contracted agencies to provide this care.



• Non-skilled home care (personal care and home health aides)-if there are no payment alternatives, the VA can pay contracted agencies to provide this care. On average, the VA will pay up to 12 hours per week of home care. More care may be authorized in unusual patient care situations. VA physicians may be asked by VA social workers to complete an application for VA monetary benefits that, if granted, can provide funds for a veteran to privately purchase home attendant services.



• Home Based Primary Care (HBPC)-some veterans, due to a homebound status or other conditions, cannot realistically receive outpatient treatment at VA clinics. The HBPC team, an interdisciplinary group usually composed of a doctor, nurse, social worker and PT/OT staff, can provide primary care in the veteran's home, if the patient meets HBPC criteria. Usually this involves assuring that a veteran's needs can be safely managed by HBPC and that there is an available caregiver.
  
  

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