New York Independent Assessor Program (NYIAP)


Roles and Responsibilities of the Local Department of Social Services (LDSS) and the Medicaid Managed Care Organization (MMCO)

The NYIAP conducts the assessment for CBLTSS, including personal care and/or CDPAS. Before developing a plan of care, or authorizing services, the LDSS/MMCO must:

  • review the NYIAP Community Health Assessment and Practitioner´s Order; and
  • determine:
    • that PCS/CDPAS can be provided according to the Plan of Care;
    • that these services are medically necessary; and
    • that such services can reasonably maintain the individual´s health and safety in their home.

Prior to authorizing CBLTSS including personal care and/or CDPAS, LDSS/MMCOs are responsible for:

  • reviewing other available services and supports to determine cost effectiveness;
  • determining frequency of nursing supervision;
  • determining the individual´s preferences and social and cultural considerations for the receipt of care;
  • heightened documentation requirements for 24-hour cases; and
  • the development of the plan of care, including the amount, duration and frequency of services.

In evaluating the cost effectiveness of services, the LDSS/MMCOs must consider:

  • the availability of informal supports voluntarily offered to and received by the individual;
  • the availability of other services and programs, equipment or adaptive or assistive technologies that may meet the individual´s needs; and
  • individual preference.