Hudson Valley Senior AdvisorWhat is the difference between a CHHA and an LHCSA?
A certified home health agency provides Medicare- and Medicaid-certified skilled visits under a doctor's plan; a licensed home care services agency supplies aides and nurses paid privately or through Medicaid plans.
The state roster shows 4 certified home health agencies, 33 licensed home care services agencies and 2 hospice licenses with office addresses in Dutchess or Orange; most travel well beyond their office town, so ask each one whether it covers your parent's address.
How much does a home health aide cost?
CareScout's 2025 New York median is $35 an hour for a non-medical caregiver, about $6,673 a month at 44 hours a week.
| Paid help per week (hours) | Monthly cost at $35 an hour | Versus the $7,110 assisted living median |
|---|---|---|
| 10 | $1,517 | less |
| 20 | $3,033 | less |
| 30 | $4,550 | less |
| 40 | $6,067 | less |
| 47 | $7,128 | more |
| 56 | $8,493 | more |
| 70 | $10,617 | more |
| 112 | $16,987 | more |
| 168 | $25,480 | more |
Can Medicaid pay a family member to provide care?
Yes, through CDPAP: a Medicaid recipient can hire a relative other than a spouse or designated representative, paid through Public Partnerships LLC, the statewide fiscal intermediary.
Hours are set by the Medicaid plan after an assessment.
What is EISEP?
The Expanded In-home Services for the Elderly Program, run through the county Offices for the Aging, gives case management and non-medical home care to people 60 and older who are not on Medicaid, with a cost share based on income.
Dutchess: (845) 486-2555. Orange: (845) 615-3700.
Who checks on home care agencies?
The Department of Health licenses and inspects home care agencies and takes complaints at 1-800-628-5972.
Ask an agency for its license type and how it supervises aides in the home.
How many hours of home care will Medicaid authorize?
There is no fixed number: a Managed Long Term Care plan sets hours after the independent assessment and its own review, based on the tasks your parent needs help with and when, and families can ask for more and appeal a denial.
Keep a simple log of what help is needed hour by hour for a week before the assessment; it makes the case for the right number of hours far more concrete than a general description.
At a glance
| Home care in New York | Home care in New York is not | |
|---|---|---|
| Licenses | CHHA and LHCSA | Unregulated personal care |
| Medicare | Skilled home health only | Hourly aides |
| Medicaid | MLTC plans and CDPAP | Available without assessment |
Each answer rests on New York law or regulation, a Department of Health publication, CMS, the VA, a county Office for the Aging or CareScout's 2025 survey. When a figure changes we update the answer and the reference page it links to, and where no published number exists we say so instead of estimating.
