HCBS Manual: Essential Insights for Children's Services

11 Jan 2022
Demystify the HCBS manual and its impact on children's services with our comprehensive guide, ensuring you understand its applications.

Understanding HCBS Manual

Navigating the complexities of children's services can be a challenging task. The Home and Community-Based Services (HCBS) manual serves as a guide to streamline this process and ensure the well-being of children in need of such services.

Introduction to HCBS Manual

The HCBS manual is a comprehensive document that outlines the policies, procedures, and guidelines related to Home and Community-Based Services. It serves as the authoritative source of information for anyone involved in the provision, management, or receipt of these services.

The manual covers a wide range of topics, from eligibility criteria and covered services to provider requirements and the implementation process. It is designed to assist service providers, care coordinators, and families in understanding and navigating the HCBS system effectively.

Purpose of HCBS Manual

The primary purpose of the HCBS manual is to provide clear guidelines for the delivery of home and community-based services. It aims to ensure that these services are provided in a manner that upholds the highest standards of quality, safety, and integrity.

Furthermore, the HCBS manual is designed to promote transparency and accountability in the HCBS system. It sets out the responsibilities of all parties involved and provides a framework for monitoring and evaluating the quality and effectiveness of services.

Another important purpose of the HCBS manual is to enhance accessibility. By providing clear and comprehensive information about the HCBS system, the manual makes it easier for families to access the services they need and for providers to deliver these services effectively.

In conclusion, the HCBS manual is an essential resource for anyone involved in the provision, management, or receipt of home and community-based services. By adhering to the guidelines set out in the manual, we can ensure that these services continue to meet the needs of children and families, promote quality of life, and uphold the principles of dignity, choice, and independence.

Key Components

The HCBS Manual comprises several essential components to guide individuals and families through the process of accessing home and community-based services. Let's examine the key elements, including eligibility criteria, covered services, and provider requirements.

Eligibility Criteria

The HCBS Manual outlines specific eligibility criteria that individuals must meet to receive services. These criteria may vary based on the specific service or program but typically include age, residency, and health condition requirements. For instance, some services might be available only to children under a certain age or individuals with specific health conditions. It's important to thoroughly review the eligibility criteria for each service to ensure the child qualifies.

Services Covered

The HCBS Manual provides comprehensive details about the services covered under different HCBS programs. These services aim to support children and their families in a home or community setting rather than an institutional one. The services covered might include personal care services, respite care, habilitation services, and various therapies (physical, occupational, speech, etc.). Some programs may also cover supportive services such as meal delivery or transportation to medical appointments. It's crucial to understand what services are covered to make the most out of the HCBS programs.

Provider Requirements

The HCBS Manual also delineates the requirements that service providers must meet to offer HCBS services. These requirements ensure that all service providers are qualified to deliver the necessary care and meet the highest standards of service quality. The provider requirements might include certain licensing or certification criteria, staff training requirements, and compliance with state and federal regulations. Understanding these requirements can help families choose the right service providers for their children's needs.

Overall, understanding these key components of the HCBS Manual can empower individuals and families to navigate the HCBS system effectively. By familiarizing oneself with the eligibility criteria, covered services, and provider requirements, they can access the appropriate services to meet their children's unique needs.

Implementation Process

The implementation process of the HCBS manual is a crucial phase that determines the effectiveness of the services delivered. This process involves three key stages: the enrollment process, service delivery, and monitoring and evaluation.

Enrollment Process

The first step in implementing the HCBS manual is the enrollment process. For a child to be eligible for home and community-based services (HCBS), they must meet the specific eligibility criteria set out in the manual. This often includes factors like the age of the child, their medical condition, and their level of need for support.

Once eligibility is determined, the enrollment process begins. This involves the submission of necessary documentation and paperwork. The enrollment process must be completed accurately and thoroughly to ensure that the child receives the appropriate services they need.

Service Delivery

After successful enrollment, service delivery commences. The services delivered will depend on the specific needs of each child. According to the HCBS manual, these services may range from personal care and assistance with daily living activities to specialized medical services.

The aim of these services is to support the child in their home and community environment, promoting independence and enhancing their quality of life. The service providers must meet certain requirements as outlined in the HCBS manual, ensuring the delivery of quality and effective services.

Monitoring and Evaluation

The final stage in the implementation process is monitoring and evaluation. This step is crucial to ensure that the services provided are meeting the needs of the child and their family. It involves regular assessments and reviews of the child's progress and the effectiveness of the services delivered.

The monitoring and evaluation process also includes feedback from the child and their family. This feedback is invaluable in making any necessary adjustments to the services and planning for future care.

Overall, the implementation process of the HCBS manual is a comprehensive and structured approach that ensures the effective delivery of home and community-based services to eligible children. It is a testament to the commitment of the HCBS program to provide quality, person-centered services to children in need.

Benefits of HCBS

The HCBS (Home and Community-Based Services) manual provides a comprehensive guide for implementing and managing services for children. As an essential resource for service providers and decision-makers, the HCBS manual also offers notable benefits, particularly in terms of improving access to care and enhancing the quality of life for children receiving services.

Improved Access to Care

One of the primary benefits of the HCBS manual is its role in improving access to care. By outlining the eligibility criteria and the range of services covered under HCBS programs, the manual ensures service providers have clear guidelines to follow.

This framework helps streamline the enrollment process, allowing eligible children to receive the necessary services more quickly. It also promotes consistency in service delivery, ensuring that all children, regardless of their circumstances, have equal opportunities to access the care they need.

Moreover, the HCBS manual serves as a valuable tool for addressing disparities in service provision. By standardizing the processes and requirements, it helps to eliminate potential barriers to access, making it easier for children from diverse backgrounds to receive the same level of care.

Enhanced Quality of Life

Beyond improving access to care, the HCBS manual also contributes to enhancing the quality of life for children receiving services. By specifying the provider requirements and service delivery protocols, the manual ensures that children receive high-quality, personalized care that meets their unique needs.

Furthermore, through its emphasis on monitoring and evaluation, the HCBS manual encourages continuous improvement in service delivery. This focus on quality assurance not only helps to ensure that children receive the best possible care but also contributes to their overall well-being and satisfaction.

In conclusion, the HCBS manual presents a range of benefits for children's services. By facilitating improved access to care and promoting a higher quality of life, it serves as an invaluable resource for those involved in the delivery of home and community-based services. As such, understanding and navigating the HCBS manual is crucial for maximizing its potential benefits and enhancing the effectiveness of children's services.

Challenges and Considerations

While the HCBS manual offers several benefits and is seen as a significant step forward in providing essential services, there are a few challenges and considerations that need to be addressed.

Funding Issues

One of the main challenges associated with the implementation of the HCBS manual is funding. The provision of high-quality home and community-based services requires significant financial resources. This includes funds for hiring trained professionals, procuring necessary equipment and supplies, and maintaining a robust monitoring and evaluation system.

With limited funding, there may be constraints on the number of individuals who can be served, the types of services that can be provided, and the quality of those services. It's crucial to establish sustainable funding mechanisms that can support the continued delivery and improvement of these services.

Potential solutions could include increasing state and federal funding for HCBS, exploring public-private partnerships, or leveraging technology to reduce costs. However, these solutions require careful planning and coordination among various stakeholders.

Service Disparities

Another challenge pertains to service disparities. Even with the HCBS manual in place, disparities in service provision may exist due to factors like geographic location, socioeconomic status, and cultural barriers. For instance, individuals living in rural areas may have less access to services compared to those in urban regions. Similarly, low-income families may face challenges in accessing services due to cost barriers or lack of awareness about available resources.

Addressing these disparities requires a multi-pronged approach. This could include increasing outreach efforts in underserved areas, providing cultural competency training for providers, and implementing sliding fee scales to make services more affordable for low-income families.

However, it's important to recognize that these solutions require ongoing commitment and resources. As such, addressing service disparities should be a key consideration in the planning and implementation of HCBS.

In conclusion, while the HCBS manual offers a framework for providing home and community-based services, there are significant challenges that need to be addressed. By acknowledging and addressing these issues, stakeholders can work towards improving the accessibility and quality of services for all individuals who need them.

Future of HCBS

The Home and Community-Based Services (HCBS) manual has undergone several revisions since its inception, and it continues to evolve to better cater to the needs of children and their families. Looking ahead, the future of the HCBS manual is likely to be shaped by ongoing policy changes and their subsequent impact on children.

Policy Changes

As the healthcare sector continues to evolve, corresponding changes in policies and regulations are to be expected. These changes are influenced by a variety of factors, including emerging healthcare trends, shifts in the political landscape, and feedback from service providers and recipients.

While it is challenging to predict specific policy changes, it is reasonable to anticipate ongoing modifications aimed at enhancing the accessibility, efficiency, and quality of care provided under HCBS. These changes may involve updates to eligibility criteria, service coverage, provider requirements, and the implementation process.

An increased focus on transparency, accountability, and person-centered planning is also likely. This can lead to more detailed and explicit expectations for service delivery, monitoring, and evaluation, thereby ensuring that the needs of children and their families are met.

Impact on Children

Policy changes in the HCBS manual can have a profound impact on children, particularly those requiring specialized care and services. For instance, changes in eligibility criteria can either expand or restrict access to essential services, depending on the nature of the revisions.

Similarly, modifications to service coverage can impact the range and quality of services available to children. This can have a direct effect on their health outcomes, quality of life, and overall development.

On a positive note, policy changes aimed at improving the efficiency and effectiveness of HCBS can lead to enhanced care for children. This includes timely access to needed services, improved coordination of care, and better support for families.

However, it's important to note that the impact of policy changes can vary widely depending on individual circumstances, including the child's specific needs, family resources, and geographic location.

In conclusion, while the future of the HCBS manual is bound to be shaped by ongoing policy changes, the ultimate goal remains the same - to ensure that children have access to the care and services they need to live meaningful and fulfilling lives. As such, it's crucial for providers, families, and stakeholders to stay informed about potential changes and their potential impact on children's services.

References

[1] https://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/docs/hcbs_manual.pdf

[2] https://health.mo.gov/seniors/hcbs/hcbsmanual/index.php

[3] https://www.cms.gov/files/document/hcbs-gen-overview-factsheet-102815pdf

Recent Articles

Navigating Pediatric Cardiac Care at Home

July 18, 2024

Empower your pediatric cardiac care at home with our guide. Navigate emergencies and equipment with ease.

Top Pediatric Diabetes Management Programs

July 18, 2024

Discover top pediatric diabetes management programs for comprehensive child care and smoother transitions to adulthood.

Cardiovascular Emergencies in Pediatric Patients

July 18, 2024

Master managing cardiovascular emergencies in pediatric patients with expert home cardiac care tips.

Home-Based Heart Health Programs for Children

July 18, 2024

Discover the transformative power of home-based heart health programs for children. Better care at home!

Essential Home Care for Children with Diabetes

July 18, 2024

Gain confidence in home care for children with diabetes with our empowering guide for parents.

Effective Techniques for Managing Diabetes in Children

July 18, 2024

Empower your child's future with effective techniques for managing diabetes in children.

Community Support for Children with Diabetes

July 18, 2024

Explore community support for diabetic children, the role of health clubs, and access to care essentials.

Effective Home Treatments for Childhood Diabetes

July 18, 2024

Discover effective home treatments for childhood diabetes, from nutritional support to emotional care.

The Pediatric Out-of-Hospital Chain of Survival Steps

July 18, 2024

Master pediatric out-of-hospital chain of survival steps and empower your child's cardiac care at home.

Pediatric Asthma Care Programs That Make a Difference

July 18, 2024

Discover effective pediatric asthma care programs, from diagnosis to treatment, for your child's success.

Community Support for Kids Battling Asthma

July 18, 2024

Discover community support for kids with asthma in NY—enhancing care, school programs, and resources.

Best Practices for Children's Asthma Management at Home

July 18, 2024

Master children's asthma management at home with strategies on triggers, school challenges, and emergencies.

Effective Home Treatments for Childhood Asthma

July 18, 2024

Explore effective home treatments for childhood asthma, from natural therapies to allergy control.

Expert Advice for Managing Children's Asthma With Home Care

July 18, 2024

Gain expert insights on managing asthma in children with home care. Empower your family today!

Essential Steps in Heart Condition Rehabilitation for Kids

July 18, 2024

Empower your child's heart health journey with our guide on heart condition rehabilitation for kids.

Finding Autism and Mental Health Support for Kids in New York

July 18, 2024

Empower your parenting with our guide on autism and mental health support for kids in New York.

Specialized Therapy for Autism with Health Conditions

July 18, 2024

Discover specialized therapy for autism with health conditions, transforming lives for New York families.

Home-Based Support for Fragile Children with Autism

July 18, 2024

Exploring home-based support for fragile children with autism. Empower your child's journey with tailored guidance.

Integrated Autism and Mental Health Services

July 18, 2024

Explore integrated autism and mental health services, breaking barriers for quality care access.

Comprehensive Care for Medically Fragile Children with Autism

July 18, 2024

Explore comprehensive care for medically fragile children with autism and learn to support their unique needs.

Empowering Kids with Bullying Support

July 18, 2024

Empower your kids with bullying support strategies, understand the signs, and prevent long-term effects.

Community Prevention Programs Against Bullying:

July 18, 2024

Explore effective community bullying prevention programs, their strategies, and success in combating bullying.

Supporting Recovery from Bullying at Home

July 18, 2024

Discover strategies for recovering from bullying at home, empowering victims, and creating a safe haven.

Bullying Victims At-Home Therapy Strategies

July 18, 2024

Empower bullying victims with at-home therapy strategies. Transform trauma into strength and resilience.

Managing Bullying Effects at Home

July 18, 2024

Explore strategies for managing bullying effects at home and resources for creating a safe haven.

Overcoming School Refusal in Children at Home

July 18, 2024

Explore strategies for overcoming school refusal in children at home, from therapy to morning routines.

School RefusalCommunity Resources for Support

July 18, 2024

Explore community school refusal support programs and effective strategies to help your child thrive.

How to Help a Child Overcome School Refusal

July 18, 2024

Discover how to help a child overcome school refusal with effective treatments and supportive strategies.

Overcoming School Refusal with Effective Management

July 18, 2024

Unlock strategies for managing school refusal - from home interventions to anxiety relief techniques.

School Anxiety and Refusal: Symptoms & Interventions

July 18, 2024

Discover insights on school anxiety and refusal, learn to recognize symptoms, and explore effective interventions.

Pediatric Cardiology Resources For Families in New York

July 15, 2024

Discover pediatric cardiology resources for families in New York, empowering you with knowledge and support.

How to Support Children with Heart Conditions

July 15, 2024

Navigate strategies for supporting children with heart conditions, from diagnosis to lifelong care.

Community Cardiology Services for Kids in New York

July 15, 2024

Explore community cardiology services for kids in NY, helping build strong hearts with early detection and care.

What is a Pediatric Cardiology?

July 15, 2024

Uncover what is a pediatric cardiology? Learn about child heart conditions and expert care in New York.

Insights into Pediatric Heart Conditions

July 15, 2024

Navigate through pediatric heart conditions with expert insights - from diagnosis to long-term care.

Respite Care for Children with Special Needs

July 8, 2024

Explore respite care for children with special needs, from access to benefits, offering a lifeline for caregivers.

Is There a Cure for Sickle Cell Anemia?

July 8, 2024

Explore advancements towards curing sickle cell anemia, from gene therapy to FDA-approved treatments.

Infant Chronic Lung Disease: Breaking Down the Risks

July 8, 2024

Discover the complications of infant chronic lung disease, its risk factors, and strategies for management.

Impulse Control Disorders in Children

July 8, 2024

Conquer impulse control disorders in children with effective strategies and professional help. Get the support your child needs now!

Impulse Control Disorders and Substance Abuse: Exploring the Relationship

July 8, 2024

Unveiling the link between impulse control disorders and substance abuse. Discover the hidden dangers and find support for parents.

How to Treat High Blood Pressure in Teenager

July 8, 2024

Learn effective strategies to manage high blood pressure in teenagers, promoting healthier lifestyles and better long-term health.

How to Treat High Blood Pressure in Children?

July 8, 2024

Master strategies to treat high blood pressure in children through balanced diet, regular exercise, and medical interventions.

How to Teach a Child with Intellectual Disability to Read

July 8, 2024

Explore strategies on how to teach a child with intellectual disability to read. Empower minds today!

How To Support Teens During Major Life Transitions

July 8, 2024

Learn how to support teens during major life transitions with effective tools and strategies, promoting resilience and positive growth.

How To Support A Teen With Social Anxiety

July 8, 2024

Learn how to support a teen with social anxiety, from treatment options to creating supportive environments.

How To Support A Teen With Learning Disabilities

July 8, 2024

Discover how to support a teen with learning disabilities: from early intervention to empowering tools.

How to Support a Teen with ADHD: A Guide

July 8, 2024

Learn how to support a teen with ADHD through academic strategies, fostering independence, and promoting a healthy lifestyle.

How to Obtain Respite Care For Your Child's Wellbeing

July 8, 2024

Learn how to get respite care for your child, ensuring their wellbeing and giving you peace of mind through reliable care services.

How To Help Teens Manage Academic Pressure

July 8, 2024

Empower teens to manage academic pressure with effective strategies for stress reduction and self-care.

How To Help Teens Develop Healthy Relationships

July 8, 2024

Learn how to help teens develop healthy relationships, from nurturing friendships to handling digital influences.

How To Help Teens Develop Healthy Coping Mechanisms

July 8, 2024

Empower teens with healthy coping mechanisms. Harness their inner strength and conquer stress wisely with effective strategies and support.

How To Help Teens Develop A Healthy Self-esteem

July 8, 2024

Learn how to help teens build a healthy self-esteem. Nurture strength and resilience for lifelong confidence.

How To Handle Substance Abuse In Teens

July 8, 2024

Learn how to handle substance abuse in teens: from recognizing signs to exploring effective interventions.

How to Get Respite Care for My Child?

July 8, 2024

Learn how to get respite care for your child, explore financial aid options, and locate trusted services to support your family.

How to Get Health Insurance for Your Child with Autism?

July 8, 2024

Navigate steps to secure health insurance for your child with autism, ensuring comprehensive coverage and effective care plans.

How To Foster Positive Body Image In Adolescents

July 8, 2024

Explore how to foster positive body image in adolescents, from mental well-being to social influences.

How to Create a Safe Space for Teens to Express Their Emotions

July 8, 2024

Learn how to create a safe space for teens to express emotions, using trust, dialogue, and technology.

How to Become a Respite Caregiver for ASD

July 8, 2024

Discover how to become a respite caregiver for ASD, join a rewarding field and make a real difference.

How to Become a HCBS Provider in NY

July 8, 2024

Learn how to become an HCBS provider in NY, from Medicaid enrollment to maintaining compliance and providing high-quality care.

How to Apply for Child Care in the United States

July 8, 2024

Navigate how to apply for child care in the US, from financial aid to state programs, with our guide.

How To Address Self-harm Behaviors In Teens

July 8, 2024

Learn how to address self-harm behaviors in teens - from recognizing signs to effective intervention strategies.

How To Address Obsessive-Compulsive Disorder (OCD) In Teens?

July 8, 2024

Navigate 'how to address OCD in teens' - understanding symptoms, treatments, and the power of empathy.

How To Address Anger Issues In Adolescents

July 8, 2024

Learn how to address anger issues in adolescents with effective techniques and professional interventions.

How Sickle Cell Anemia is Inherited in Families?

July 8, 2024

Decode how sickle cell anemia is inherited and learn about risk assessment, testing, and counseling.

How Respite Can Help You and Your Child: Your Lifeline in Parenting

July 8, 2024

Discover how respite can help you and your child with disabilities – a lifeline for parents in New York.

How Rare is Childhood Dementia?

July 8, 2024

Unveiling the truth: Is childhood dementia rare? Explore the prevalence, impact, & advances in research for families facing this challenge.

How Much Time Should Parents Spend with Their Child?

July 8, 2024

Navigate the question of how much time parents should spend with their child, with a focus on autism.

How Much Is Child Support In NYC?

July 8, 2024

Get insights on 'how much is child support in NYC?' Explore factors, additional costs, and legal repercussions.

How Much Is Child Support For Two Kids In NY?

July 8, 2024

Discover how much is child support for 2 kids in NY? Unravel the factors, court's role, and services.

How Much Is Child Support For Four Kids In NYS?

July 8, 2024

Unveil the truth about how much child support is required for four kids in NYS. Explore the factors, laws, and guidelines involved.

How Much Does Health Insurance for a Child with Autism Cost?

July 8, 2024

Navigate 'how much is health insurance for a child' with autism. Uncover costs, subsidies, and more.

How Much Do Physical Therapists Actually Make?

July 8, 2024

Unravel "how much do physical therapists make" with our comprehensive guide on salaries and factors.

How Much Do Daycare Workers Get Paid in New York?

July 8, 2024

Discover how much daycare workers get paid in New York, and uncover the factors influencing their wages and overall compensation.

How Much Child Support Do I Need For One Child In NY?

July 8, 2024

Demystify how much child support is needed for one child in NY with our comprehensive guide, providing clarity and essential information.

How Many Weeks of Free Respite Care Are You Allowed?

July 8, 2024

Unravel how many weeks of free respite care are you allowed. Learn about options, costs, and coverage.

How Many Long Term Care Facilities are in the US?

July 8, 2024

Get the lowdown on how many long-term care facilities in the US, their impact, and trends shaping them.

How Many Home Health Aides Are There in New York - A Closer Look

July 8, 2024

Discover the number of home health aides in New York and how they support families with disabled children.

How Many Home Care Agencies Operate in New York State?

July 8, 2024

Discover how many home care agencies operate in New York State. Find the support your autistic child deserves.

How Long Does Group Therapy Last

July 8, 2024

Dive into the ins and outs of group therapy and discover how long group therapy typically lasts, ensuring informed participation.

How Long Can A Child Have Diabetes Without Knowing

July 8, 2024

Unmask the silent threat by learning about diagnosing diabetes in children, understanding symptoms, and effective management strategies.

How Home and Community Based Services Enhance Lives

July 8, 2024

Explore how home and community based services are transforming care, enhancing quality of life, and shaping the future.

How DSS in NYS Supports Children with Disabilities

July 8, 2024

Explore 'what is DSS in NYS?' and how it supports children with disabilities through transformative services.

How Does Cardiovascular Disease Affects Childhood?

July 8, 2024

Discover how cardiovascular disease impacts childhood, affecting physical health, emotional wellbeing, and social interactions.

How Do You Deal With Intellectual Disability? The Power of Advocacy

July 8, 2024

Discover the power of advocacy for intellectual disability and how it creates opportunities and promotes equality.

How Do You Deal With a Mentally Unstable Child

July 8, 2024

Gain insights on dealing with a mentally unstable child, from recognizing signs to seeking professional help and effective support strategies.

How Do I Know if My Child Has Intellectual Disability

July 8, 2024

Discover how to recognize if your child has an intellectual disability and the support options available.

How Crisis Affects Middle Childhood Development

July 8, 2024

Uncover how crisis affects middle childhood development and learn strategies to provide robust support.

How Conflict and Crisis Impact Childhood Development

July 8, 2024

Explore how conflict and crisis affect childhood, their impacts, and multilevel support for healing.

How Common is Pediatric Hypertension?

July 8, 2024

Discover how common pediatric hypertension is and gain insights on its risk factors, symptoms, and management.

How Child Care Vouchers Help in NY

July 8, 2024

Navigate child care vouchers in NY - from eligibility to application, we've got your childcare costs covered.

How CFASS Can Help Your Child's Journey

July 8, 2024

Discover how CFASS empowers children with disabilities. Support, guidance, and resources for your child's journey!

Home-Based Waiver Programs for Kids

July 8, 2024

Discover home-based waiver programs for kids, simplifying care and assistance for your special needs child.

Home-based Therapy for Intermittent Explosive Disorder

July 8, 2024

Discover effective home-based therapy for intermittent explosive disorder, enhancing peace and quality of life.

Home-Based Strategies for Explosive Disorder Treatment

July 8, 2024

Explore effective home-based explosive disorder treatment strategies to transform your child's life.

Home-Based Strategies for ADHD Treatment

July 8, 2024

Discover effective home-based ADHD treatment strategies to empower parents and improve children's lives.

Home-Based Respite Services for Kids

July 8, 2024

Explore home-based respite services for kids in NY: a beacon of hope for caregivers of special needs children.

Home-based Mental Health Support For Kids

July 8, 2024

Explore home-based mental health support for kids in NY: resources, professional help, and self-care tips.

Home-based Anxiety Management For Kids

July 8, 2024

Create a calming home environment with strategies for managing anxiety in kids, from structured routines to relaxation techniques.

Home Health Care Services

July 8, 2024

Explore home health care services and their benefits, financing options, and their future, all in one guide.

Home Health Aide Hourly Earnings in NY

July 8, 2024

Discover how much home health aides make an hour in NY, their responsibilities, and the advanced tasks they handle to provide comprehensive care.