So, why are some home care clients (Medicaid-NYC) blocked when requesting to switch agencies?

I was just going to comment about giving the previous agency a notice so that they know you won't be needing their services. I also like how you said that you should get things lined up and ready to move to the new health aides before you cancel the services. That will ensure that your loved one doesn't have any time where they are to fend for themselves.

Unfortunately, when working with medicaid, one's options are much more limited. Here in Connecticut there is an Area Agency on Aging program, Homecare for Elders, which helps pay for care and then serves to manage care when a person is on Title 19. I can only get aids from agencies who have a contract with the Area Agency on Aging. These tend not to be the best agencies.