Legislation
SECTION 366-I
Long-term care financing demonstration program
Social Services (SOS) CHAPTER 55, ARTICLE 5, TITLE 11
§ 366-i. Long-term care financing demonstration program. 1.
Notwithstanding any inconsistent provision of sections three hundred
sixty-six or three hundred sixty-six-c of this title, or any other
provision of law, the commissioner of health is authorized to develop
the long-term care financing demonstration program, an alternative
program for the establishment of eligibility under the medical
assistance program for up to five thousand persons.
2. The provisions of this section shall not take effect unless all
necessary approvals under federal law and regulation have been obtained
to receive federal financial participation in the costs of health care
services provided to persons determined to be eligible for medical
assistance pursuant to this section.
3. Defined private contribution. Upon being determined eligible for
the demonstration, a person shall disclose his or her household's
resources and income to the local social services district, or an entity
acting on behalf of such district pursuant to subdivision five of this
section, and shall enter into an agreement with such district or entity.
The agreement shall require the person to apply a defined private
contribution toward the cost of institutional or non-institutional
long-term care, as defined by the commissioner in regulations. Such
regulations shall provide for two levels of contribution: (a) a level
that would permit a full medical assistance resource exemption pursuant
to paragraph (a) of subdivision four of this section; and (b) a level or
levels that would permit a medical assistance resource exemption that is
equivalent to the value of the contribution pursuant to paragraph (b) of
subdivision four of this section.
4. Medical assistance eligibility. Upon completion of the defined
private contribution required by such agreement, the person may apply
for medical assistance under this title and, if otherwise eligible,
shall be eligible for such assistance either: (a) in the case of an
individual who opts for a contribution level under paragraph (a) of
subdivision three of this section, without regard to otherwise
applicable resource requirements of this title; or (b) in the case of an
individual who opts for a contribution level under paragraph (b) of
subdivision three of this section, without regard to an amount of
resources that is equivalent to the value of the contribution. In either
case, eligibility for medical assistance under this title shall, with
respect to the amount of resources that are exempt from consideration
under this subdivision, be without regard to the lien and estate
recovery provisions of section three hundred sixty-nine of this title;
provided, however, that nothing herein shall prevent the imposition of a
lien or recovery against property of an individual on account of medical
assistance incorrectly paid.
5. The commissioner is authorized to enter into a contract with a
private entity to assist in the administration of the demonstration
program established by this section. Such a contract may include,
without limitation, assistance in the development of the criteria for
the defined private contribution, drafting of the defined contribution
agreement, accepting and processing applications for demonstration
participation under this section, and accepting and processing
applications for medical assistance for demonstration participants.
Notwithstanding any inconsistent provision of sections one hundred
twelve and one hundred sixty-three of the state finance law, or section
one hundred forty-two of the economic development law, or any other law,
the commissioner is authorized to enter into a contract under this
subdivision without a competitive bid or request for proposal process.
6. If the commissioner exercises his or her authority to implement a
demonstration program under this section he or she shall submit a report
to the governor, president pro tem of the senate and speaker of the
assembly by the first day of November, two thousand fifteen, on the
implementation of this section. Such report shall include a statement as
to the extent to which individuals have opted to participate in the
demonstration, an analysis of the impact of the demonstration on medical
assistance program long-term care costs, any recommendations for
legislative action, and such other matters as may be pertinent.
Notwithstanding any inconsistent provision of sections three hundred
sixty-six or three hundred sixty-six-c of this title, or any other
provision of law, the commissioner of health is authorized to develop
the long-term care financing demonstration program, an alternative
program for the establishment of eligibility under the medical
assistance program for up to five thousand persons.
2. The provisions of this section shall not take effect unless all
necessary approvals under federal law and regulation have been obtained
to receive federal financial participation in the costs of health care
services provided to persons determined to be eligible for medical
assistance pursuant to this section.
3. Defined private contribution. Upon being determined eligible for
the demonstration, a person shall disclose his or her household's
resources and income to the local social services district, or an entity
acting on behalf of such district pursuant to subdivision five of this
section, and shall enter into an agreement with such district or entity.
The agreement shall require the person to apply a defined private
contribution toward the cost of institutional or non-institutional
long-term care, as defined by the commissioner in regulations. Such
regulations shall provide for two levels of contribution: (a) a level
that would permit a full medical assistance resource exemption pursuant
to paragraph (a) of subdivision four of this section; and (b) a level or
levels that would permit a medical assistance resource exemption that is
equivalent to the value of the contribution pursuant to paragraph (b) of
subdivision four of this section.
4. Medical assistance eligibility. Upon completion of the defined
private contribution required by such agreement, the person may apply
for medical assistance under this title and, if otherwise eligible,
shall be eligible for such assistance either: (a) in the case of an
individual who opts for a contribution level under paragraph (a) of
subdivision three of this section, without regard to otherwise
applicable resource requirements of this title; or (b) in the case of an
individual who opts for a contribution level under paragraph (b) of
subdivision three of this section, without regard to an amount of
resources that is equivalent to the value of the contribution. In either
case, eligibility for medical assistance under this title shall, with
respect to the amount of resources that are exempt from consideration
under this subdivision, be without regard to the lien and estate
recovery provisions of section three hundred sixty-nine of this title;
provided, however, that nothing herein shall prevent the imposition of a
lien or recovery against property of an individual on account of medical
assistance incorrectly paid.
5. The commissioner is authorized to enter into a contract with a
private entity to assist in the administration of the demonstration
program established by this section. Such a contract may include,
without limitation, assistance in the development of the criteria for
the defined private contribution, drafting of the defined contribution
agreement, accepting and processing applications for demonstration
participation under this section, and accepting and processing
applications for medical assistance for demonstration participants.
Notwithstanding any inconsistent provision of sections one hundred
twelve and one hundred sixty-three of the state finance law, or section
one hundred forty-two of the economic development law, or any other law,
the commissioner is authorized to enter into a contract under this
subdivision without a competitive bid or request for proposal process.
6. If the commissioner exercises his or her authority to implement a
demonstration program under this section he or she shall submit a report
to the governor, president pro tem of the senate and speaker of the
assembly by the first day of November, two thousand fifteen, on the
implementation of this section. Such report shall include a statement as
to the extent to which individuals have opted to participate in the
demonstration, an analysis of the impact of the demonstration on medical
assistance program long-term care costs, any recommendations for
legislative action, and such other matters as may be pertinent.