§ 366-I — Long-term care financing demonstration program

New York § 366-I

• Jurisdiction: New York
• Law SOS: Social Services
• Title 11: Medical Assistance For Needy Persons
• Art. 5: Assistance and Care

Text

§ 366-i. Long-term care financing demonstration program. 1.\nNotwithstanding any inconsistent provision of sections three hundred\nsixty-six or three hundred sixty-six-c of this title, or any other\nprovision of law, the commissioner of health is authorized to develop\nthe long-term care financing demonstration program, an alternative\nprogram for the establishment of eligibility under the medical\nassistance program for up to five thousand persons.\n 2. The provisions of this section shall not take effect unless all\nnecessary approvals under federal law and regulation have been obtained\nto receive federal financial participation in the costs of health care\nservices provided to persons determined to be eligible for medical\nassistance pursuant to this section.\n 3. Defined private contribution. Upon being determined eligible for\nthe demonstration, a person shall disclose his or her household's\nresources and income to the local social services district, or an entity\nacting on behalf of such district pursuant to subdivision five of this\nsection, and shall enter into an agreement with such district or entity.\nThe agreement shall require the person to apply a defined private\ncontribution toward the cost of institutional or non-institutional\nlong-term care, as defined by the commissioner in regulations. Such\nregulations shall provide for two levels of contribution: (a) a level\nthat would permit a full medical assistance resource exemption pursuant\nto paragraph (a) of subdivision four of this section; and (b) a level or\nlevels that would permit a medical assistance resource exemption that is\nequivalent to the value of the contribution pursuant to paragraph (b) of\nsubdivision four of this section.\n 4. Medical assistance eligibility. Upon completion of the defined\nprivate contribution required by such agreement, the person may apply\nfor medical assistance under this title and, if otherwise eligible,\nshall be eligible for such assistance either: (a) in the case of an\nindividual who opts for a contribution level under paragraph (a) of\nsubdivision three of this section, without regard to otherwise\napplicable resource requirements of this title; or (b) in the case of an\nindividual who opts for a contribution level under paragraph (b) of\nsubdivision three of this section, without regard to an amount of\nresources that is equivalent to the value of the contribution. In either\ncase, eligibility for medical assistance under this title shall, with\nrespect to the amount of resources that are exempt from consideration\nunder this subdivision, be without regard to the lien and estate\nrecovery provisions of section three hundred sixty-nine of this title;\nprovided, however, that nothing herein shall prevent the imposition of a\nlien or recovery against property of an individual on account of medical\nassistance incorrectly paid.\n 5. The commissioner is authorized to enter into a contract with a\nprivate entity to assist in the administration of the demonstration\nprogram established by this section. Such a contract may include,\nwithout limitation, assistance in the development of the criteria for\nthe defined private contribution, drafting of the defined contribution\nagreement, accepting and processing applications for demonstration\nparticipation under this section, and accepting and processing\napplications for medical assistance for demonstration participants.\nNotwithstanding any inconsistent provision of sections one hundred\ntwelve and one hundred sixty-three of the state finance law, or section\none hundred forty-two of the economic development law, or any other law,\nthe commissioner is authorized to enter into a contract under this\nsubdivision without a competitive bid or request for proposal process.\n 6. If the commissioner exercises his or her authority to implement a\ndemonstration program under this section he or she shall submit a report\nto the governor, president pro tem of the senate and speaker of the\nassembly by the first day of November, two thousand fifteen, on the\nimplementation of this section. Such report shall include a statement as\nto the extent to which individuals have opted to participate in the\ndemonstration, an analysis of the impact of the demonstration on medical\nassistance program long-term care costs, any recommendations for\nlegislative action, and such other matters as may be pertinent.\n