ABSTRACT
New York's Nursing Home Without Walls is one widely discussed community care model aimed at controlling Medicaid outlays for long term care; increasing the availability of home care as an alternative to nursing home care; and removing barriers to the use of non-institutional services. The Nursing Home Without Walls program, proposed by Senator Tarky Lombardi, Jr., Chairman of the Senate Health Committee, was signed into law in August 1977 and became effective April 1, 1978. This statewide program became the prototype for the Medicaid Community Care Act, advanced by Representatives Henry Waxman and Claude Pepper, and ultimately enacted as Section 2176 of the Omnibus Reconciliation Act of 1981. The Nursing Home Without Walls law is intended to create a new permanent, statewide initiative in in-home care, rather than a time-limited demonstration. The Nursing Home Without Walls program provides for the establishment of individually-certified Long Term Home Health Care Programs (LTHHCPs) in communities throughout the state.
