N.Y. Social Services Law Section 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 § 369 (Application of other provisions)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 Economic Development Law § 142 (Procurement opportunities newsletter)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.

Source: Section 366-I — Long-term care financing demonstration program, https://www.­nysenate.­gov/legislation/laws/SOS/366-I (updated Sep. 22, 2014; accessed May 4, 2024).

363
Declaration of objects
363‑A
Federal aid
363‑B
Agreements for federal determination of eligibility of aged, blind and disabled persons for medical assistance
363‑C
Medicaid management
363‑D
Provider compliance program
363‑E
Medicaid plan, applications for waivers and plan amendments
363‑F
Electronic visit verification for personal care and home health providers
364
Responsibility for standards
364‑A
Cooperation of state departments
364‑B
Residential and medical care placement demonstration projects
364‑C
National long term care channeling demonstration project
364‑D
Medical assistance research and demonstration projects
364‑E
Aid to families with dependent children homemaker/home health aide demonstration projects
364‑F
Primary care case management programs
364‑G
Medical assistance capitation rate demonstration project
364‑H
Foster family care demonstration programs for elderly or disabled persons
364‑I
Medical assistance presumptive eligibility program
364‑J
Managed care programs
364‑J‑2
Transitional supplemental payments
364‑JJ
Special advisory review panel on Medicaid managed care
364‑KK
Condition of Participation
364‑M
Statewide patient centered medical home program
364‑N
Diabetes and chronic disease self-management pilot program
365
Responsibility for assistance
365‑A
Character and adequacy of assistance
365‑B
Local medical plans: professional directors
365‑C
Medical advisory committee
365‑D
Medicaid evidence based benefit review advisory committee
365‑E
Optional or continued membership in entities offering comprehensive health services plans
365‑F
Consumer directed personal assistance program
365‑G
Utilization review for certain care, services and supplies
365‑H
Provision and reimbursement of transportation costs
365‑J
Advisory opinions
365‑K
Provision of prenatal care services
365‑L
Health homes
365‑M
Administration and management of behavioral health services
365‑N
Department of health assumption of program administration
365‑O
Provision and coverage of services for living organ donors
365‑P
Doulas for Medicaid
366
Eligibility
366‑A
Applications for assistance
366‑B
Penalties for fraudulent practices
366‑C
Treatment of income and resources of institutionalized persons
366‑D
Medical assistance provider
366‑E
Certified home health agency medicare billing
366‑F
Persons acting in concert with a medical assistance provider
366‑G
Newborn enrollment for medical assistance
366‑H
Automated system
366‑I
Long-term care financing demonstration program
367
Authorization for hospital care
367‑A
Payments
367‑B
Medical assistance information and payment system
367‑C
Payment for long term home health care programs
367‑D
Personal care need determination
367‑E
Payment for AIDS home care programs
367‑F
Partnership for long term care program
367‑G
Authorization and provision of personal emergency response services
367‑H
Payment for assisted living programs
367‑I
Personal care services provider assessments
367‑O
Health insurance demonstration programs
367‑P
Responsibilities of local districts for personal care services, home care services and private duty nursing
367‑P*2
Payment for limited home care services agencies
367‑Q
Personal care services worker recruitment and retention program
367‑R
Private duty nursing services worker recruitment and retention program
367‑S
Long term care demonstration program
367‑S*2
Emergency medical transportation services
367‑T
Payment for emergency physician services
367‑U
Payment for home telehealth services
367‑V
County long-term care financing demonstration program
367‑W
Health care and mental hygiene worker bonuses
367‑X
Payment for violence prevention programs
368
Quarterly estimates
368‑A
State reimbursement
368‑B
State reimbursement to local health districts
368‑C
Audit of state rates of payment to providers of health care services
368‑D
Reimbursement to public school districts and state operated/state supported schools which operate pursuant to article eighty-five, eighty...
368‑E
Reimbursement to counties for pre-school children with handicapping conditions
368‑F
Reimbursement of costs under the early intervention program
369
Application of other provisions

Accessed:
May 4, 2024

Last modified:
Sep. 22, 2014

§ 366-I’s source at nysenate​.gov

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