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S09082 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          9082
 
                    IN SENATE
 
                                       May 9, 2022
                                       ___________
 
        Introduced by Sens. MAYER, MAY, KRUEGER -- read twice and ordered print-
          ed, and when printed to be committed to the Committee on Health
 
        AN ACT to amend the public health law, the state finance law and the tax
          law,  in  relation to enacting the "New York long term care trust act"
          and establishing the New York long term care trust program

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  Short  title. This act shall be known and may be cited as
     2  the "New York long term care trust act".
     3    § 2. The public health law is amended by adding a new article 36-B  to
     4  read as follows:
     5                                ARTICLE 36-B
     6                    NEW YORK LONG TERM CARE TRUST PROGRAM
     7  Section 3670. Definitions.
     8          3671. Program established.
     9          3672. Long term care trust commission.
    10          3673. Long term care trust advisory panel.
    11          3674. Qualified individuals; determination.
    12          3675. Eligible beneficiaries; determination.
    13          3676. Reimbursement for services and supports.
    14          3677. Employee premium contributions.
    15          3678. Election for self-employed individuals.
    16          3679. Appeals and appeal hearings.
    17          3680. Waivers.
    18    §  3670.  Definitions.  As  used  in this article, the following terms
    19  shall have the following meanings, unless the context  clearly  requires
    20  otherwise:
    21    1.  "Fund" means the long term care trust fund established pursuant to
    22  section ninety-nine-pp of the state finance law.
    23    2. "Approved service" means  long  term  care  services  and  supports
    24  including, but not limited to:
    25    (a) adult day services;
    26    (b) care transition coordination;
    27    (c) memory care;
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13149-09-2

        S. 9082                             2
 
     1    (d) adaptive equipment and technology;
     2    (e) environmental modification;
     3    (f) personal emergency response system;
     4    (g) home safety evaluation;
     5    (h) respite for family caregivers;
     6    (i) home delivered meals;
     7    (j) transportation;
     8    (k) dementia supports;
     9    (l) education and consultation;
    10    (m) eligible relative care;
    11    (n) professional services;
    12    (o)  services  that  assist  paid and unpaid family members caring for
    13  eligible individuals, including training  for  informal  caregivers  and
    14  other  individuals providing care who are not otherwise employed as long
    15  term care workers under section  thirty-six  hundred  fourteen  of  this
    16  chapter;
    17    (p) home care services as defined in section thirty-six hundred two of
    18  this chapter;
    19    (q) assisted living services;
    20    (r) adult family home services;
    21    (s) nursing home services; and
    22    (t)  any  other long term care services as defined in paragraph (b) of
    23  subdivision one of section three hundred  sixty-seven-f  of  the  social
    24  services  law  or  otherwise designated as such in law or regulations by
    25  the department.
    26    3. "Benefit unit" means the maximum daily benefit  the  department  is
    27  authorized  to  pay  a  long term care services and supports provider as
    28  reimbursement for providing an approved service or services to an eligi-
    29  ble beneficiary, which amount shall initially be  one  hundred  dollars,
    30  and which shall be adjusted annually by the advisory panel in accordance
    31  with  the provisions of section thirty-six hundred seventy-three of this
    32  article.
    33    4. "Commission" means the long term care trust commission  established
    34  pursuant to section thirty-six hundred seventy-two of this article.
    35    5. "Advisory panel" or "panel" means the long term care trust advisory
    36  panel  established  pursuant to section thirty-six hundred seventy-three
    37  of this article.
    38    6. "Eligible beneficiary" means a qualified individual as  defined  in
    39  subdivision sixteen of this section who:
    40    (a) was not disabled before the age of eighteen;
    41    (b)  has  been assessed by the department as needing the minimum level
    42  of assistance with activities of daily living necessary to receive bene-
    43  fits pursuant to section thirty-six hundred seventy-five of  this  arti-
    44  cle;
    45    (c)  has not exhausted the lifetime benefit limit as defined in subdi-
    46  vision eleven of this section; and
    47    (d) does not have in effect an exemption granted pursuant to  subdivi-
    48  sion six of section thirty-six hundred seventy-seven of this article.
    49    7.  "Employee"  means any person engaged in employment as such term is
    50  defined in section five hundred eleven of the labor law.
    51    8. "Employer" shall have the same meaning as defined in  section  five
    52  hundred twelve of the labor law.
    53    9. "Employment" shall have the same meaning as defined in section five
    54  hundred eleven of the labor law.
    55    10. "Long term care services and supports provider" or "long term care
    56  provider"  means an individual or entity authorized to provide long term

        S. 9082                             3
 
     1  care services as defined in paragraph (b) of subdivision one of  section
     2  three  hundred  sixty-seven-f  of the social services law, including but
     3  not limited to a nursing facility licensed under article twenty-eight of
     4  this  chapter; a home care services agency, certified home health agency
     5  or long term home health care program, as defined in section  thirty-six
     6  hundred two of this chapter; an adult day health care program in accord-
     7  ance  with regulations of the department; a home care services worker as
     8  defined in section  thirty-six  hundred  thirteen  of  this  chapter;  a
     9  personal care provider licensed or qualified to provide services in this
    10  state  or  in any other state or local agency; a qualified family member
    11  as defined in subdivision fifteen of this section, and such other  indi-
    12  viduals  or  entities  that are authorized by law or regulations of this
    13  state or any other state or local agency to provide such services.
    14    11. "Lifetime benefit limit", or "lifetime  limit"  means  the  dollar
    15  equivalent of three hundred sixty-five benefit units paid by the depart-
    16  ment on behalf of an eligible beneficiary over the course of such eligi-
    17  ble individual's lifetime.
    18    12.  "Premium  contributions"  or  "premiums"  means  the  payments an
    19  employee is required  to  contribute  to  the  program  through  payroll
    20  deductions  collected  by  the  employer  pursuant to section thirty-six
    21  hundred seventy-seven of this article or voluntarily pursuant to section
    22  thirty-six hundred seventy-eight of this article.
    23    13. "Private long term care insurance coverage" means a  contract  for
    24  insurance  which  meets  the  requirements  of  section one thousand one
    25  hundred seventeen of the insurance law.
    26    14. "Program" means the New York long term care trust  program  estab-
    27  lished  pursuant to section thirty-six hundred seventy-one of this arti-
    28  cle.
    29    15. "Qualified family member" means a relative of an eligible  benefi-
    30  ciary  who meets the educational or training requirements established by
    31  the department or the education department for providing long term  care
    32  services  and supports and is authorized by law or regulation to receive
    33  payments from the state.
    34    16. (a) "Qualified individual" means an individual who:
    35    (i) is age eighteen or older; and
    36    (ii) has paid premium contributions  pursuant  to  section  thirty-six
    37  hundred  seventy-seven or thirty-six hundred seventy-eight of this arti-
    38  cle for a period equivalent to either:
    39    (1) a total of ten years during the course of such individual's  life-
    40  time without an interruption of five or more consecutive years; or
    41    (2)  a total of three years within the six years immediately preceding
    42  such individual's application  for  benefits  under  section  thirty-six
    43  hundred seventy-five of this article.
    44    (b)  For  the  purposes of paragraph (a) of this subdivision, a "year"
    45  shall equal no less than five hundred hours of paid work.
    46    17. "Wages" means all remuneration paid by an employer to an  employee
    47  with respect to employment during any calendar year.
    48    §  3671.  Program established. 1. There is hereby established the "New
    49  York long term care trust program" to provide long  term  care  services
    50  and supports benefits for eligible beneficiaries regardless of income or
    51  resources  in  accordance  with  the  provisions  of this article.   The
    52  department shall implement and administer such program  in  coordination
    53  with  the  department  of  social  services,  the  department  of mental
    54  hygiene, the state office for the aging, the comptroller, the department
    55  of taxation and finance and the department of labor as set forth in this
    56  section.

        S. 9082                             4
 
     1    2. The department shall:
     2    (a) Receive applications for benefits and perform initial and continu-
     3  ing  eligibility determinations for long term care services and supports
     4  benefits in accordance with section thirty-six hundred  seventy-five  of
     5  this article;
     6    (b)  Monitor  the use of benefit units by each eligible beneficiary to
     7  verify that such  individual's  lifetime  benefit  limit  has  not  been
     8  exhausted;
     9    (c)  Establish  and maintain standards for all long term care services
    10  and supports provided pursuant to this article;
    11    (d) Establish requirements for a uniform system of audits and  reports
    12  to  review  the  quality and availability of long term care services and
    13  supports furnished pursuant to this article to ensure that  the  program
    14  is administered in the best interests of program beneficiaries;
    15    (e)  Establish  schedules of rates, payments, reimbursements and other
    16  charges and standards and procedures relating to payments of benefits to
    17  registered long term care services and supports  providers  pursuant  to
    18  section thirty-six hundred seventy-six of this article; including proce-
    19  dures for auditing payments and recoupment of improper payments;
    20    (f)  Establish  plans  for the coordination of long term care services
    21  and supports benefits under this article for eligible beneficiaries  who
    22  are  funded  through Medicaid or receiving other long term care services
    23  and supports, including through Medicare, private long term care  insur-
    24  ance coverage, or other programs;
    25    (g)   Establish  standards  and  procedures  relating  to  contractual
    26  arrangements between long term care providers and the department;
    27    (h) Develop and maintain a registry of long  term  care  services  and
    28  supports  providers  that meet the minimum qualifications established by
    29  the commission pursuant to section  thirty-six  hundred  seventy-two  of
    30  this article, in accordance with subdivision three of section thirty-six
    31  hundred seventy-six of this article; and
    32    (i) Provide consultative services to long term care providers in order
    33  to  assist  them:  to  qualify for payments under the provisions of this
    34  article; in providing information needed to determine such payments; and
    35  in establishing and maintaining such fiscal records as may be  necessary
    36  for  the  proper and efficient administration of long term care services
    37  and supports.
    38    3. On or before January first, two thousand twenty-four,  the  depart-
    39  ment  shall,  in  consultation  with  the department of labor, the comp-
    40  troller, the department of taxation and finance, the  state  office  for
    41  the  aging,  the department of social services, and any other department
    42  or agency it deems relevant, develop  and  maintain  such  programs  and
    43  processes  as shall be necessary to determine and keep records regarding
    44  the applicability of premium contribution requirements of section  thir-
    45  ty-six  hundred  seventy-seven of this article to employees and individ-
    46  uals who elect coverage pursuant to section thirty-six hundred  seventy-
    47  eight   of   this  article.  The  department  shall  thereafter  monitor
    48  individual premium contributions  and  make  eligibility  determinations
    49  pursuant  to  sections  thirty-six  hundred  seventy-four and thirty-six
    50  hundred seventy-five of this article.
    51    § 3672. Long term care trust commission. 1. The long term  care  trust
    52  commission is hereby established to make recommendations to all relevant
    53  departments  and  agencies  to  ensure the adequacy of benefits provided
    54  under the program and to maintain the solvency and sustainability of the
    55  fund.

        S. 9082                             5
 
     1    2. The commission shall consist of a total of twenty-seven members  as
     2  follows:
     3    (a) twelve voting members representing the legislature and the follow-
     4  ing departments, agencies or offices:
     5    (i) two members appointed by the speaker of the assembly;
     6    (ii) two members appointed by the temporary president of the senate;
     7    (iii) one member appointed by the minority leader of the assembly;
     8    (iv) one member appointed by the minority leader of the senate;
     9    (v)  the commissioner of the department of health, or such commission-
    10  er's designee;
    11    (vi) the state commissioner of social services, or such commissioner's
    12  designee;
    13    (vii) the director of the state office for the aging, or  such  direc-
    14  tor's designee;
    15    (viii)  the  commissioner of taxation and finance, or such commission-
    16  er's designee;
    17    (ix) the commissioner of mental health, or such commissioner's  desig-
    18  nee;
    19    (x) the commissioner of the office for people with developmental disa-
    20  bilities, or such commissioner's designee;
    21    (b)  five  nonvoting  members  representing the following departments,
    22  agencies or offices:
    23    (i) the commissioner of  addiction  services  and  supports,  or  such
    24  commissioner's designee;
    25    (ii) the state long term care ombudsman, or such ombudsman designee;
    26    (iii) the commissioner of the department of labor, or such commission-
    27  er's designee;
    28    (iv)  the  superintendent  of  financial services, or such superinten-
    29  dent's designee;
    30    (v) the comptroller or the comptroller's designee; and
    31    (c) ten members to be appointed by the governor, all of whom shall  be
    32  voting members:
    33    (i) one of whom shall be a representative of local programs for aging;
    34    (ii)  one of whom shall be a representative of a home care association
    35  that represents caregivers that provide  services  to  private  pay  and
    36  Medicaid clients;
    37    (iii)  one  of  whom shall be a representative of a union representing
    38  long term care workers;
    39    (iv) one of whom shall be a representative of an organization  repres-
    40  enting retired persons;
    41    (v) one of whom shall be a representative of an association represent-
    42  ing skilled nursing facilities and assisted living providers;
    43    (vi)  one  of whom shall be a representative of an association repres-
    44  enting adult family home providers;
    45    (vii) two of whom  shall  be  individuals  receiving  long  term  care
    46  services and supports, or their designees, or representatives of consum-
    47  ers receiving long term care services and supports under the program;
    48    (viii)  one  of  whom shall be an individual who is paying the premium
    49  established under section thirty-six hundred seventy-seven of this arti-
    50  cle, or, prior to such section becoming effective, will pay such  premi-
    51  um,  and  who  is not employed by a long term care services and supports
    52  provider; and
    53    (ix) one of whom shall be  a  representative  of  an  organization  of
    54  employers  whose members are required to collect the premium established
    55  under section thirty-six hundred seventy-seven of this article, or prior

        S. 9082                             6
 
     1  to such section becoming effective, will be  required  to  collect  such
     2  premium.
     3    3.  Each  appointed  member  shall  serve  for  a  term  of two years,
     4  provided, however that the initial members appointed pursuant  to  para-
     5  graph (c) of subdivision two of this section shall be appointed to stag-
     6  gered  terms  not  to  exceed  four  years.  Initial appointments to the
     7  commission shall be made no later than sixty days  after  the  effective
     8  date of this section.
     9    4.  The  commissioner, or such commissioner's designee, shall serve as
    10  chair of the commission. Meetings of the commission shall be at the call
    11  of the chair, provided, however, that the initial meeting of the commis-
    12  sion shall be held no later than thirty days after initial  appointments
    13  are  made pursuant to subdivision two of this section. A majority of the
    14  voting members shall constitute a quorum  of  the  commission,  and  the
    15  affirmative  vote of sixty percent of the members voting shall be neces-
    16  sary for any action to be taken by the commission.  Notwithstanding  any
    17  contrary provision of this section, a majority of the members identified
    18  in  paragraph  (c) of subdivision two of this section shall constitute a
    19  quorum for the purposes of approving the annual  report  required  under
    20  subdivision eight of this section.
    21    5.  The commission shall establish an investment strategy subcommittee
    22  which shall consist of:
    23    (a) the members identified in paragraphs (a) and  (b)  of  subdivision
    24  two of this section, who shall serve as voting members of the subcommit-
    25  tee; and
    26    (b)  four  nonvoting  advisors to be appointed by the governor, all of
    27  whom shall be chosen for their  experience  and  qualifications  in  the
    28  field of investment and who are not members of the commission.
    29    (c)  the  subcommittee  shall provide guidance and advice to the comp-
    30  troller on investment strategies for the fund, including seeking counsel
    31  and advice on the types of investments that are constitutionally permit-
    32  ted.
    33    6. Members of the  commission  and  the  subcommittee  established  in
    34  subdivision  five  of  this section shall serve without compensation but
    35  shall be reimbursed for reasonable and necessary  expenses  incurred  in
    36  the  performance  of  their  duties.  The commission may employ staff as
    37  needed, prescribe  their  duties,  and  fix  their  compensation  within
    38  amounts appropriated for the commission.
    39    7.  The  commission  shall hold its first meeting no later than thirty
    40  days after initial appointments have been made pursuant  to  subdivision
    41  three  of  this  section  and  shall  immediately  begin  development of
    42  proposals for the implementation and eventual operation of the  program.
    43  The  commission  shall examine the laws and regulations of the state and
    44  consult with health care providers, consumers,  and  other  stakeholders
    45  and  make  such recommendations as are necessary to conform the laws and
    46  regulations of the state with the purposes of this  article,  including,
    47  but not limited to:
    48    (a)  the  establishment  of procedures to be used by the department in
    49  determining if an individual is:
    50    (i) a qualified individual under section thirty-six  hundred  seventy-
    51  four of this article; and
    52    (ii)  an  eligible beneficiary under section thirty-six hundred seven-
    53  ty-five of this article;
    54    (b) the establishment of minimum qualifications for  the  registration
    55  of  long  term  care services and supports providers with the department
    56  pursuant to section thirty-six hundred seventy-one of this article;

        S. 9082                             7
 
     1    (c) the establishment  of  maximum  allowable  payments  for  approved
     2  services,  in  consultation  with affected stakeholders, which (i) shall
     3  not be lower than Medicaid payments for comparable  services,  including
     4  limitations  based  on  dollar amount, duration, or number of visits and
     5  (ii) shall be sufficient to ensure that long term care providers who are
     6  individuals  receive  at  least  the  greater  of  (1) one hundred fifty
     7  percent of the minimum wage required under section six hundred fifty-two
     8  of the labor law or any otherwise applicable wage rule  or  order  under
     9  article nineteen of the labor law which is otherwise applicable for home
    10  care  aides  as defined in section thirty-six hundred fourteen-c of this
    11  chapter, or (2) the wage otherwise required by law to be  paid  to  home
    12  care  aides  as defined in section thirty-six hundred fourteen-c of this
    13  chapter;
    14    (d) recommendations to the advisory panel for the annual adjustment of
    15  the benefit unit in accordance with sections thirty-six hundred  seventy
    16  and thirty-six hundred seventy-three of this article; and
    17    (e)  recommendations  as  to  the adoption, amendment or repeal of any
    18  rules, regulations or policies the commission deems necessary to improve
    19  the operation of the program and maintain solvency.
    20    8. The commission shall monitor agency  administrative  expenses  over
    21  time.
    22    (a)  Beginning  on  November fifteenth, two thousand twenty-three, and
    23  annually thereafter, the commission  shall,  in  consultation  with  the
    24  comptroller,  submit  an  actuarial  report  to  the governor and to the
    25  chairs of the senate finance committee and the assembly ways  and  means
    26  committee.    Such  report  shall  include  an  actuarial  report of the
    27  projected solvency and financial  status  of  the  program,  anticipated
    28  agency spending and anticipated administrative expenses in the implemen-
    29  tation and initial operation of the program.
    30    (b) For the annual report due on November fifteenth of the year begin-
    31  ning five years after the effective date of this article, the commission
    32  shall  include  its  recommendations  for a method of calculating future
    33  agency administrative expenses to limit such  expenses  while  providing
    34  sufficient funds to adequately operate the program.
    35    9.  Beginning on December thirty-first, two thousand twenty-eight, and
    36  annually thereafter, the commission shall submit a report to the  legis-
    37  lature  on  the  program,  which shall include but not be limited to the
    38  following:
    39    (a) projected and actual program participation;
    40    (b) adequacy of premium rates;
    41    (c) fund balances;
    42    (d) benefits paid;
    43    (e) demographic information on program  participants,  including  age,
    44  gender,  race, ethnicity, geographic distribution by county, legislative
    45  district, and employment sector; and
    46    (f) the extent to which the operation of the program has  resulted  in
    47  savings to the Medicaid program by avoiding costs that would have other-
    48  wise been the responsibility of the state.
    49    §  3673.  Long  term  care trust advisory panel. 1. The long term care
    50  trust advisory panel is hereby established.  The  advisory  panel  shall
    51  consist  of  each  of  the members of the commission identified in para-
    52  graphs (a) and (b) of subdivision  two  of  section  thirty-six  hundred
    53  seventy-two of this article, all of whom shall be voting members.
    54    2. It shall be the duty of the advisory panel to:
    55    (a)  determine  annual  adjustments  to the benefit unit as defined in
    56  subdivision three of section thirty-six hundred seventy of this article;

        S. 9082                             8
 
     1    (b) review the adequacy of benefits provided under this article; and
     2    (c)  make  recommendations to the commission to ensure the solvency of
     3  the trust fund.
     4    3. The comptroller, or the  comptroller's  designee,  shall  serve  as
     5  chair of the advisory panel. The advisory panel shall meet at least once
     6  annually  to determine adjustments to the benefit unit. Additional meet-
     7  ings of the advisory panel shall be at the call of the chair. A majority
     8  of the voting members of the advisory panel shall constitute a quorum of
     9  the panel, and the affirmative  vote  of  sixty  percent  of  the  panel
    10  members  voting  shall  be  necessary  for any action to be taken by the
    11  advisory panel. The advisory panel may adopt rules for  the  conduct  of
    12  meetings,  including  provisions for meetings and voting to be conducted
    13  by telephonic, video, or other conferencing process in  accordance  with
    14  all relevant provisions of article seven of the public officers law.
    15    4.  (a)  In  determining adjustments to the benefit unit, the advisory
    16  panel shall review the commission's actuarial audit and valuation of the
    17  trust account, any recommendations by the commission, and data  pertain-
    18  ing  to  economic  indicators,  program costs, and sustainability.  Such
    19  data  shall  include,  without  limitation,  data  regarding  inflation,
    20  regional  differences  in  costs  of  living and costs of long term care
    21  services and supports, and wages of individuals who are long  term  care
    22  services and supports providers.
    23    (b) The advisory panel may, to the extent the panel deems appropriate,
    24  determine  that  adjustments to the benefit unit shall vary by region in
    25  the event that such a  determination  is  necessary  to  accomplish  the
    26  purposes of this article.
    27    (c)  In  the  absence of the required vote necessary to take action to
    28  adjust the benefit unit prior to November fifteenth, the advisory  panel
    29  shall  adjust  such  benefit  unit for the succeeding year as of January
    30  first of such year as necessary to reflect any change  in  the  "current
    31  cost  of  living  index  figure"  based upon the Consumer Price Index as
    32  issued by the bureau of labor statistics of the  United  States  depart-
    33  ment of labor since November fifteenth of the prior year.
    34    5. The members of the advisory panel shall receive no compensation but
    35  shall be reimbursed for travel and other expenses actually and necessar-
    36  ily incurred in the performance of their duties.
    37    § 3674. Qualified individuals; determination. 1. The department shall,
    38  in  coordination  with the department of labor, the comptroller, and the
    39  department of taxation and finance, develop and maintain a  registry  of
    40  every  employee  subject to the premium requirements pursuant to section
    41  thirty-six hundred seventy-seven of this article  and  every  individual
    42  who elects coverage pursuant to section thirty-six hundred seventy-eight
    43  of this article.
    44    2.  No later than January first, two thousand twenty-four, the depart-
    45  ment shall, in accordance with subdivision one of this section  and  the
    46  cooperative  agreement  entered  into  pursuant  to subdivision six-c of
    47  section one hundred seventy-one-a of the tax law, as  added  by  chapter
    48  five hundred forty-five of the laws of nineteen seventy-five develop and
    49  maintain a registry of:
    50    (a)  every  employee  subject  to  the premium requirements of section
    51  thirty-six hundred seventy-seven of this article;
    52    (b) every employer required to collect and remit premiums from employ-
    53  ee wages pursuant to  subdivision  two  of  section  thirty-six  hundred
    54  seventy-seven of this article; and
    55    (c)  every  individual who elects coverage pursuant to section thirty-
    56  six hundred seventy-eight of this article.

        S. 9082                             9
 
     1    3. The department shall monitor individual employee  premium  contrib-
     2  utions  paid and individual hours worked for the purposes of determining
     3  and verifying whether an employee is a qualified individual  as  defined
     4  in  subdivision  sixteen  of  section thirty-six hundred seventy of this
     5  article.
     6    4.  The department shall, in cooperation with the department of labor,
     7  the department of taxation and finance,  and  the  comptroller,  monitor
     8  compliance by employers subject to the collection and reporting require-
     9  ments  set  forth  in  section  thirty-six hundred seventy-seven of this
    10  article, article eighteen of the labor law, and articles eight and twen-
    11  ty-two of the tax law; and collect, monitor, maintain,  and  dispose  of
    12  any  other  information  that  the  department, in consultation with the
    13  department of labor, the comptroller, the commissioner of  taxation  and
    14  finance, and the commission, shall deem relevant and necessary to comply
    15  with  the  reporting, monitoring, administering, or evaluation responsi-
    16  bilities required pursuant to this article  or  otherwise  necessary  to
    17  accomplish the purposes of this article.
    18    5.  The  department, in consultation with the department of labor, the
    19  comptroller, and the commissioner of taxation and finance, shall  estab-
    20  lish procedures to monitor individual employee premium contributions and
    21  verify benefit eligibility pursuant to section thirty-six hundred seven-
    22  ty-five of this article.
    23    6.  The  department, in consultation with the department of labor, the
    24  comptroller, and the commissioner of taxation and finance, shall publish
    25  and distribute educational materials about the program to inform employ-
    26  ees, employers and members of the public of their rights and obligations
    27  under this article and the benefits available under the program.
    28    § 3675. Eligible beneficiaries; determination. 1. Beginning on January
    29  first of the year beginning five years after the effective date of  this
    30  article,  and  thereafter, approved long term care services and supports
    31  benefits shall be available, without regard to income or resources,  for
    32  eligible  beneficiaries  who  are assessed as needing assistance with at
    33  least three activities of daily living by the department  in  accordance
    34  with the provisions of this section.
    35    2. Any qualified individual, or any person authorized by law to act on
    36  behalf  of a qualified individual, may apply for long term care benefits
    37  provided under this article by filing an application therefor  with  the
    38  department  in  writing,  by  telephone,  online, or by any other manner
    39  approved by the commissioner for such purpose.
    40    3. (a) Upon receipt of such application, the department or  its  agent
    41  shall  verify that the applicant is a qualified individual as defined in
    42  subdivision sixteen of section thirty-six hundred seventy of this  arti-
    43  cle,  and  upon such verification, shall perform an eligibility determi-
    44  nation, which shall include an assessment of whether the applicant needs
    45  assistance with at least three activities of daily living,  defined  and
    46  determined  by  using  an evidence based validated assessment instrument
    47  approved by the commissioner and in accordance with regulations  of  the
    48  department  and  any applicable state and federal laws by an independent
    49  assessor, of which such independent assessor may be, subject to approval
    50  by the commissioner, a licensed health care  provider  selected  by  the
    51  applicant.
    52    (b)  The  department  shall  complete  the  eligibility  determination
    53  required pursuant to paragraph (a) of this subdivision or any subsequent
    54  redetermination of eligibility under this article and decide whether the
    55  applicant is eligible for benefits within forty-five days of the date of
    56  a completed application for benefits.

        S. 9082                            10
 
     1    (c) Notwithstanding any contrary provision of  this  subdivision,  the
     2  department  shall develop expedited procedures for determining eligibil-
     3  ity for an applicant with an immediate need for long term care  services
     4  and  supports  whereby  a  final eligibility determination shall be made
     5  within seven days of the date of a completed application for benefits.
     6    4.  The  department  shall  notify the applicant of the results of the
     7  department's eligibility determination, and,  where  such  applicant  is
     8  found  to be an eligible beneficiary, the amount of benefit units avail-
     9  able and the date on which such benefit units shall become  payable  for
    10  approved  services on behalf of the eligible beneficiary, which shall be
    11  the date of the application, or subject to applicable  department  regu-
    12  lations,  such  earlier  date  as  may be deemed reasonable based on the
    13  needs of the beneficiary. Where such applicant is found ineligible,  the
    14  department  shall notify the applicant of the reasons therefor and shall
    15  advise such applicant of the applicant's right to appeal  such  determi-
    16  nation pursuant to section thirty-six hundred seventy-nine of this arti-
    17  cle.
    18    5.  (a) All continuing benefits under this article shall be subject to
    19  reconsideration and redetermination  as  frequently  as  the  department
    20  deems necessary to ensure that each person receiving benefits under this
    21  article  continues to be in need of long term care services and supports
    22  and has not exhausted the lifetime benefit  limit.  The  department  may
    23  conduct  any investigation it may deem necessary or required to effectu-
    24  ate the purposes of this subdivision.
    25    (b) The department shall  develop  a  simplified  statewide  recertif-
    26  ication form for use in redetermining eligibility under this article.
    27    6.  (a)  An  eligible  beneficiary  shall receive benefits through the
    28  program in the form of a benefit unit payable by  the  department  to  a
    29  registered long term care provider for approved services and supports in
    30  an  amount  determined by the advisory panel pursuant to section thirty-
    31  six hundred seventy-three of this article.  If  the  value  of  services
    32  provided  to  an  eligible beneficiary on a single date is less than the
    33  benefit unit, only the portion of the benefit unit that is actually paid
    34  on such beneficiary's behalf shall  be  taken  into  consideration  when
    35  calculating  the  balance  of  such person's lifetime benefit limit. The
    36  balance of the benefit unit not  expended  on  such  date  shall  remain
    37  available  to  the eligible beneficiary for use in accordance with para-
    38  graph (b) of this subdivision or until otherwise exhausted  pursuant  to
    39  this article.
    40    (b)  Notwithstanding any contrary provision of this article, an eligi-
    41  ble beneficiary may receive benefits in excess of the  benefit  unit  as
    42  defined  in  subdivision  three of section thirty-six hundred seventy of
    43  this article, for services provided on a single date, provided that such
    44  eligible beneficiary has not exhausted the lifetime benefit limit. In no
    45  event shall a person receive benefits  under  this  article  after  such
    46  person's lifetime benefit limit has been exhausted.
    47    7.  The  department  shall develop procedures to monitor each eligible
    48  beneficiary's use of benefit units and shall notify  eligible  benefici-
    49  aries of the balance of benefit units remaining within a reasonable time
    50  after approved services are rendered.
    51    8.  Notwithstanding  any  contrary  provision of law, benefits paid on
    52  behalf of an individual pursuant to this article shall not be considered
    53  income or resources for the purposes of any determinations of  eligibil-
    54  ity for any other state program or benefit, including but not limited to
    55  medical assistance, any state or federal program, Medicaid, or any other
    56  means-tested program or benefit.

        S. 9082                            11
 
     1    9.  Notwithstanding  any  contrary  provision  of law, nothing in this
     2  article shall be construed to create an entitlement for  any  individual
     3  to  receive, or require the state or any department or agency thereof to
     4  provide, case management services, including, but not limited  to,  case
     5  management  services  under  title  eleven of article five of the social
     6  services law.
     7    § 3676. Reimbursement for services and  supports.  1.    Beginning  on
     8  January  first of the year beginning five years after the effective date
     9  of this article, the department shall  reimburse  registered  long  term
    10  care  providers for approved services rendered to eligible beneficiaries
    11  in accordance with this article.  Reimbursement  for  services  provided
    12  pursuant  to  this  section  shall  be paid to registered long term care
    13  providers at such times  and  in  such  manner  as  the  department  may
    14  prescribe,  provided  however,  such payments shall be made no less than
    15  quarterly.
    16    2. The department may reimburse qualified family members for providing
    17  approved personal care services in the same manner as reimbursements are
    18  paid to an individual provider, whether  directly,  through  a  licensed
    19  home  care  agency,  or  through  a  third  option if recommended by the
    20  commission and adopted by the department.
    21    3. (a) The department shall develop and maintain a  registry  of  long
    22  term  care providers in accordance with subdivision two of section thir-
    23  ty-six hundred seventy-one of this article, and in consultation with the
    24  commission, shall establish standards and procedures for:
    25    (i) registration with the department pursuant to this section; and
    26    (ii) the suspension, revocation, or termination of a provider's regis-
    27  tration or other limitation on the provider's authorization  to  provide
    28  services under the program where it is determined that:
    29    (A) the provider is incompetent;
    30    (B) the provider has exhibited a course of conduct which is inconsist-
    31  ent with program standards and regulations; or
    32    (C) the provider has willfully failed to comply with program standards
    33  and regulations.
    34    (b)  Beginning  on  and after January first of the year beginning five
    35  years after the effective date  of  this  article  and  thereafter,  all
    36  information  in  the  registry developed and maintained pursuant to this
    37  subdivision, including any and all records  relating  to  actions  taken
    38  pursuant to subparagraph (ii) of paragraph (a) of this subdivision shall
    39  be readily accessible on the department's website by the public.
    40    4.  A  long  term care services and supports provider which employs or
    41  contracts with one or  more  individuals  performing  approved  services
    42  shall  pay  such individuals no less than the greater of (a) one hundred
    43  fifty percent of the minimum wage required  under  section  six  hundred
    44  fifty-two  of  the  labor  law  or any otherwise applicable wage rule or
    45  order under article nineteen of the labor law which is otherwise  appli-
    46  cable for home care aides as defined in section thirty-six hundred four-
    47  teen-c  of this chapter, or (b) the wage otherwise required by law to be
    48  paid to home care aides as defined in section thirty-six  hundred  four-
    49  teen-c of this chapter.
    50    § 3677. Employee premium contributions. 1. Beginning January first, of
    51  the  year  beginning two years after the effective date of this article,
    52  every employee in the employment of an employer shall contribute to  the
    53  cost  of providing long term care benefits under this article by payment
    54  of the premium assessed pursuant to this section.   The initial  premium
    55  contribution  rate  and any adjustments to such rate shall be set by the
    56  comptroller, after consultation  with  the  commission,  at  the  lowest

        S. 9082                            12
 
     1  amount  necessary  to  maintain  the actuarial solvency of the long term
     2  care services and supports trust fund,  in  accordance  with  recognized
     3  insurance  principles  and in a manner designed to limit fluctuations in
     4  such rate.
     5    (a)  The  initial premium contribution rate shall be set no later than
     6  September thirtieth of the year beginning one year after  the  effective
     7  date  of  this  article  and  shall become applicable to each employee's
     8  wages paid on and after January first of the year  beginning  two  years
     9  after the effective date of this article.
    10    (b) Beginning January first of the year beginning four years after the
    11  effective  date  of  this  article, and biennially thereafter, the comp-
    12  troller shall make such adjustments to the premium contribution rate, if
    13  necessary, and after consultation with the commission,  to  ensure  that
    14  such rate continues to be set at the lowest amount necessary to maintain
    15  the actuarial solvency of the long term care services and supports trust
    16  fund, in accordance with recognized insurance principles and in a manner
    17  designed to limit fluctuations in the premium rate.
    18    2.  (a)  Notwithstanding any other provision of law, every employer is
    19  authorized to collect from its employees,  the  premium  assessed  under
    20  subdivision  one  of  this section, through payroll deductions and remit
    21  the amounts so collected to the department of taxation  and  finance  in
    22  accordance  with  the provisions of section four hundred seventy-four of
    23  the tax law.
    24    (b) When collecting employee premiums through payroll deductions,  the
    25  employer  shall  act  as  the agent of its employees and shall remit all
    26  such amounts to the department of taxation and finance  as  required  by
    27  subparagraph  (D)  of  paragraph  four  of subsection (a) of section six
    28  hundred seventy-four of the tax law.
    29    3. Premiums shall be collected at the same time and  in  the  same  or
    30  substantially  similar manner as the assessment, collection, and report-
    31  ing procedures used for the withholding of tax pursuant to title five of
    32  article twenty-two of the tax law.
    33    4. The department of taxation and finance shall deposit  all  premiums
    34  collected under this section in the long term care services and supports
    35  trust  fund  established pursuant to section ninety-nine-pp of the state
    36  finance law.
    37    5. If the premiums established in this section are changed, the  comp-
    38  troller  shall notify each employee subject to this section by mail that
    39  such person's premiums have changed.
    40    6. (a)(i) Notwithstanding any contrary provision of this  section,  an
    41  employee who has maintained private long term care insurance coverage on
    42  an uninterrupted basis beginning no later than January first of the year
    43  in  which  this article takes effect may apply for an exemption from the
    44  premium contributions required under subdivision one of this section, as
    45  provided in this subdivision. Such request for  an  exemption  shall  be
    46  made  in  such form and in such manner as the department shall prescribe
    47  for such purpose no later than one year after the effective date of this
    48  article.
    49    (ii) The department shall review each request for an exemption submit-
    50  ted pursuant to subparagraph (i) of this paragraph, and upon a  determi-
    51  nation  that the employee satisfies the private long term care insurance
    52  coverage requirements in accordance with this paragraph, the  department
    53  shall  issue  notice  to such employee of such employee's exemption from
    54  paying premium contributions beginning thirty days after the issuance of
    55  such notice of exemption.

        S. 9082                            13
 
     1    (iii) An exemption issued to an employee pursuant to this  subdivision
     2  shall  relieve  such employee's employer of the duty to collect premiums
     3  pursuant to subdivisions two and three of this section, provided, howev-
     4  er, that the employee shall have  first  given  proper  notice  of  such
     5  exemption  to the employer, including a copy of such exemption, together
     6  with any additional materials the  department  may  require.    No  such
     7  employer shall be liable to an employee for continuing to collect premi-
     8  um  contributions  in  the  event that the employee fails to provide the
     9  notice of exemption to such employer in accordance  with  this  subpara-
    10  graph.
    11    (b)  (i)  If  an employee who has been issued an exemption from paying
    12  premium contributions pursuant to  paragraph  (a)  of  this  subdivision
    13  ceases  to hold private long term care insurance coverage, such employee
    14  shall notify the department and such employee's employer of  the  termi-
    15  nation  of  such private long term care insurance coverage within thirty
    16  days of such termination. Such notice shall be in writing and  submitted
    17  in  such  form  and in such manner as the department shall prescribe for
    18  such purpose, and shall state whether the  employee  intends  to  obtain
    19  private  long  term care insurance coverage within ninety days following
    20  the cessation of coverage. If the  employee  subsequently  obtains  long
    21  term care insurance coverage within such ninety-day period, the employee
    22  shall so notify the department and the employee's employer.
    23    (ii)  In  the  event that an employee described in subparagraph (i) of
    24  this paragraph ceases to hold private long term care insurance  coverage
    25  for a period of more than ninety days, the exemption from paying premium
    26  contributions issued pursuant to this subdivision shall be automatically
    27  and  permanently revoked and such employee shall thereafter be responsi-
    28  ble for the payment of all premium contributions  required  pursuant  to
    29  subdivision  one of this section and shall no longer be eligible for any
    30  new exemption under this subdivision.  The employee shall be responsible
    31  for notifying the department and their employer in  the  event  of  such
    32  cessation  of  coverage for more than ninety days.  Any premium contrib-
    33  utions not paid after such date shall  be  subject  to  such  reasonable
    34  monetary penalties and interest as shall be determined by the department
    35  and  may  levy  an additional premium for the remainder of the period of
    36  coverage.
    37    (c) An employee receiving an exemption pursuant to  paragraph  (b)  of
    38  this  subdivision, shall forfeit any and all rights to receive  benefits
    39  under this article and shall in no  event  be  an  eligible  beneficiary
    40  under this article while such exemption is in effect.
    41    (d)  An  employer of an employee whose exemption is revoked in accord-
    42  ance with this subdivision shall not be held liable  for  a  failure  to
    43  collect  premium contributions to the extent such employer was not aware
    44  of such cessation of coverage and did not have reason  to  be  aware  of
    45  such  cessation of coverage, provided that such exemption from liability
    46  shall terminate when such employer becomes so aware.
    47    § 3678. Election for self-employed individuals. 1.  Beginning  January
    48  first  of  the year beginning two years after the effective date of this
    49  article, any person not subject to premium  payment  requirements  under
    50  section  thirty-six  hundred  seventy-seven of this article, including a
    51  sole proprietor, independent contractor, member of a  limited  liability
    52  company or limited liability partnership, or other self-employed person,
    53  may  elect  coverage  under  this section. Those electing coverage under
    54  this section shall be responsible for payment of one hundred percent  of
    55  all  premiums  assessed  to an employee under section thirty-six hundred
    56  seventy-seven of this article. Such self-employed person  shall  file  a

        S. 9082                            14
 
     1  notice of election in writing with the department of labor in the manner
     2  prescribed by the department for such purpose. Such self-employed person
     3  shall  be eligible for benefits after paying the long term care services
     4  and  supports  premium  for  the  time required under section thirty-six
     5  hundred seventy-four of this article, unless such  self-employed  person
     6  elects  to  withdraw  from  coverage pursuant to subdivision two of this
     7  section.
     8    2. A self-employed person who has elected coverage may  withdraw  from
     9  coverage,  at  such  times  as  the department, in coordination with the
    10  department of labor and the department of taxation  and  finance,  shall
    11  adopt by rule or regulation, by filing a notice of withdrawal in writing
    12  with  the department, provided that no such withdrawal shall take effect
    13  earlier than thirty days after the filing of the notice with the depart-
    14  ment.
    15    3. The department shall cancel elective coverage upon the failure of a
    16  self-employed person to make required premium payments or  to  file  any
    17  required  reports  in  accordance  with such rules as the department may
    18  prescribe, including a  reasonable  grace  period  and  any  appropriate
    19  exceptions.    The  department shall collect any due and unpaid premiums
    20  from such person and may levy an additional premium for the remainder of
    21  the period of coverage. Such cancellation shall be  effective  no  later
    22  than  thirty  days  from  the date of the notice in writing advising the
    23  self-employed person of the cancellation.
    24    4. A person who withdraws from coverage pursuant to subdivision two of
    25  this section or is subject to a  cancellation  pursuant  to  subdivision
    26  three  of this section may subsequently elect coverage by satisfying all
    27  of the requirements of subdivision one of this section, and disregarding
    28  for such purposes, premium payments made for  any  previous  periods  of
    29  coverage elected pursuant to subdivision one of this section.
    30    5. For the purposes of this article, an individual who elects coverage
    31  under  this section shall be considered both an employee and an employer
    32  whenever the context so dictates.
    33    6. The department, in coordination with the department of  labor,  the
    34  department of taxation and finance, and the comptroller shall promulgate
    35  rules  for determining the hours worked and the wages of individuals who
    36  elect coverage under this section and  rules  for  enforcement  of  this
    37  section,  including a reasonable cure period with respect to a cancella-
    38  tion made pursuant to subdivision three of this section.
    39    § 3679. Appeals and appeal hearings. 1. Any applicant or recipient, or
    40  any individual authorized to act on behalf  of  any  such  applicant  or
    41  recipient,  and any long term care provider may appeal to the department
    42  from determinations of department officials or failures to make determi-
    43  nations upon grounds specified in subdivision four of this section.  The
    44  department shall review the appeal de novo and give such person or enti-
    45  ty an opportunity for an appeal hearing. The department may also, on its
    46  own motion, review any decision made or any case in which a decision has
    47  not  been  made  by the department official within the time specified by
    48  law or regulations of the department. The department may make such addi-
    49  tional investigation as it may  deem  necessary,  and  the  commissioner
    50  shall  make  such  determination  as is justified and in accordance with
    51  applicable law.
    52    2. Regarding any appeal pursuant to this section, with or  without  an
    53  appeal hearing, the commissioner may designate and authorize one or more
    54  appropriate  members  of  his  or  her staff to consider and decide such
    55  appeals. Any staff member so designated shall be  authorized  to  decide
    56  such  appeals  on  behalf  of  the  commissioner with the same force and

        S. 9082                            15
 
     1  effect as if the commissioner had made such decisions.  Appeal  hearings
     2  shall  be  held  on  behalf of the commissioner by members of his or her
     3  staff who are employed for such purposes or who have been designated and
     4  authorized by the commissioner.
     5    3.  Persons  entitled  to  appeal  to  the department pursuant to this
     6  section must include:
     7    (a) applicants for or recipients of long term care benefits under  the
     8  program;
     9    (b) long term care services and supports providers; and
    10    (c)  such other persons as the commissioner may deem to be entitled to
    11  an opportunity for an appeal hearing.
    12    4. An applicant, beneficiary, or long term care  provider  shall  have
    13  the right to appeal at least the following issues:
    14    (a) an eligibility determination made in accordance with section thir-
    15  ty-six hundred seventy-five of this article, including:
    16    (i)  an  initial determination as to whether the applicant is a quali-
    17  fied individual;
    18    (ii) an initial determination as to whether the applicant is an eligi-
    19  ble beneficiary, including whether:
    20    (A) the applicant needs assistance with at least three  activities  of
    21  daily living; and/or
    22    (B) the applicant has exhausted the lifetime benefit limit;
    23    (iii)  a  continuing eligibility determination or redetermination with
    24  respect to a beneficiary pursuant to subdivision five of  section  thir-
    25  ty-six hundred seventy-five of this article;
    26    (b)  a  failure  by the department to provide timely written notice of
    27  any eligibility determination made in accordance with this article, this
    28  chapter, or any other applicable law; and
    29    (c) a determination with respect to a long term care provider, includ-
    30  ing:
    31    (i) suspension, revocation, limitation or annulment  of  qualification
    32  for participation as a provider under the program;
    33    (ii)  disputes  relating  to  payments and reimbursements for approved
    34  services; and
    35    (iii) any  other  determination  the  commissioner  deems  subject  to
    36  appeal.
    37    5.  The department may, subject to the discretion of the commissioner,
    38  promulgate such regulations, consistent with federal or  state  law,  as
    39  may be necessary to implement the provisions of this section.
    40    6. Regarding every decision of an appeal pursuant to this section, the
    41  department  shall  inform every party, and his or her representative, if
    42  any, of the availability of judicial review and the time  limitation  to
    43  pursue future review.
    44    7.  The  department  shall  include  notice  of the right to appeal as
    45  provided by subdivision four of this section and instructions  regarding
    46  how  to  file  an  appeal in any eligibility determination issued to the
    47  applicant or enrollee in accordance with applicable law.    Such  notice
    48  shall include:
    49    (a) an explanation of the applicant or enrollee's appeal rights;
    50    (b) a description of the procedures by which the applicant or enrollee
    51  may request an appeal;
    52    (c)  information  on  the  applicant  or enrollee's right to represent
    53  himself or herself, or to be represented by  legal  counsel  or  another
    54  representative; and
    55    (d)  an  explanation  of the circumstances under which the appellant's
    56  eligibility may be maintained or reinstated pending an appeal decision.

        S. 9082                            16
 
     1    § 3680. Waivers. Notwithstanding any contrary provision  of  law,  the
     2  commissioner  shall,  to  the  extent  necessary, develop and submit any
     3  appropriate waivers, including, but not  limited  to,  those  authorized
     4  pursuant to sections eleven hundred fifteen and nineteen hundred fifteen
     5  of  the  federal  social  security act, or successor provisions, and any
     6  other waivers necessary to achieve the purposes of high  quality,  inte-
     7  grated,  and  cost  effective  care and integrated financial eligibility
     8  policies under the medical assistance program or pursuant to title XVIII
     9  of the federal social security  act.  Copies  of  such  original  waiver
    10  applications  shall  be  provided  to  the  chair  of the senate finance
    11  committee and the chair of the assembly ways and means committee  simul-
    12  taneously with their submission to the federal government.
    13    § 3. The state finance law is amended by adding a new section 99-pp to
    14  read as follows:
    15    §  99-pp. Long term care trust fund. 1. There is hereby established in
    16  the joint custody of the comptroller, the commissioner of  taxation  and
    17  finance and the commissioner of health a special fund to be known as the
    18  "long term care trust fund".
    19    2.  Such  fund shall consist of all moneys collected by the department
    20  of taxation and finance pursuant to section thirty-six hundred  seventy-
    21  seven of the public health law. Any interest earned by the investment of
    22  moneys  in  such fund shall be added to such fund, become a part of such
    23  fund, and be used for the purpose of such fund.
    24    3. Moneys of such fund shall only be used for the purposes established
    25  under article thirty-six-B of the public health law and expenses of  the
    26  state in administering the long term care trust program as defined ther-
    27  ein.  In no event may expenditures be used to supplant existing state or
    28  local programs which fund the provision of approved services.
    29    4. The moneys of the fund shall be paid out on the audit  and  warrant
    30  of the comptroller on vouchers certified and approved by the commission-
    31  er of the department of health.
    32    §  4.  The state finance law is amended by adding a new section 8-d to
    33  read as follows:
    34    § 8-d. Additional duties of the  comptroller;  long  term  care  trust
    35  program.  1.  Beginning on and after the effective date of this section,
    36  the comptroller shall provide all necessary assistance, including audit-
    37  ing and actuarial services to the long term care trust commission estab-
    38  lished pursuant to section thirty-six hundred seventy-two of the  public
    39  health  law  and  in  accordance with all relevant provisions of article
    40  thirty-six hundred-B of the public health law, the tax  law,  the  labor
    41  law, and this chapter.
    42    2.  Beginning  on  November fifteenth of the year beginning four years
    43  after the effective date of this section, and biennially thereafter, the
    44  comptroller shall perform an actuarial audit and valuation of  the  long
    45  term  care  trust fund established pursuant to section ninety-nine-pp of
    46  this chapter. Such biennial audit and valuation shall  be  prepared  and
    47  published  in  conjunction  with  the annual report prepared by the long
    48  term care trust commission pursuant  to  subdivision  seven  of  section
    49  thirty-six  hundred  seventy-two  of the public health law, and shall be
    50  submitted to the long term care trust advisory panel  and  the  legisla-
    51  ture.  Such  audit  and  valuation  shall include, but not be limited to
    52  recommendations regarding actions necessary to maintain the solvency  of
    53  the  fund;  options  for  adjustments  to  the  benefit  unit,  approved
    54  services, or both, to the extent necessary to eliminate unfunded actuar-
    55  ially accrued liability and maintain solvency.

        S. 9082                            17
 
     1    3. The comptroller shall perform  such  additional  or  more  frequent
     2  actuarial  audits  and  valuations of the long term care trust fund upon
     3  request of the advisory panel pursuant  to  section  thirty-six  hundred
     4  seventy-three of the public health law.
     5    4. The comptroller shall, not later than November fifteenth, two thou-
     6  sand  thirty-four,  conduct  a comprehensive evaluation of the long term
     7  care trust program and shall submit a report, including a conclusion and
     8  recommendations for improvement to the legislature regarding:
     9    (a) program operations, including the performance  of  the  long  term
    10  care  trust  commission established in section thirty-six hundred seven-
    11  ty-two of the public health law;
    12    (b) the financial status of the program, including solvency, the value
    13  of the benefit provided, and the financial balance of  program  benefits
    14  to costs; and
    15    (c)  the  overall  efficacy  of  the program, based on the established
    16  goals under this act including, but not limited to:
    17    (i) delaying middle class  families'  need  to  spend  to  poverty  to
    18  receive Medicaid funded long term care;
    19    (ii)  strengthening  the  state  economy  through  improving workforce
    20  participation;
    21    (iii) reducing the caseload and expenditures  of  the  state  Medicaid
    22  program on long term care; and
    23    (iv) obtaining shared savings through a Medicaid demonstration waiver,
    24  or  the impact of any waiver entered into pursuant to section thirty-six
    25  hundred eighty of the public health law.
    26    § 5. Section 171-a of the tax law, as added by chapter 545 of the laws
    27  of 1978, is amended by adding a new subdivision 6-c to read as follows:
    28    (6-c) Notwithstanding any provision of law to  the  contrary  and  not
    29  later than January first of the year beginning one year after the effec-
    30  tive date of this subdivision, the commissioner shall enter into a coop-
    31  erative  agreement  with  the  department  of  health, the department of
    32  labor, and the comptroller to allow  the  information  obtained  by  the
    33  department  pursuant  to subdivision one of this section and section one
    34  hundred seventy-one-h of this article  to  be  made  available  to  such
    35  departments,  or  other  individuals  designated by the commissioners of
    36  such departments, for the purposes of determining and verifying  whether
    37  a  person  is a "qualified individual" for the purposes of section thir-
    38  ty-six hundred seventy-seven of the public  health  law,  or  for  other
    39  purposes deemed appropriate by the commissioners of health and labor and
    40  the  comptroller, consistent with the provisions of article thirty-six-B
    41  of the public health law, the state finance law, and the labor law, with
    42  respect to which such departments have reporting,  monitoring,  adminis-
    43  tering, or evaluating responsibilities.
    44    §  6.  Paragraph (e), subparagraph (iv) of paragraph (f) and paragraph
    45  (g) of subdivision 4 of section 171-h of the tax law, paragraph (e)  and
    46  subparagraph (iv) of paragraph (f) as amended by chapter 214 of the laws
    47  of  1998,  paragraph  (g) as amended by chapter 398 of the laws of 1997,
    48  are amended and a new paragraph (h) is added to read as follows:
    49    (e) conduct matches  with  the  office  of  temporary  and  disability
    50  assistance,  the  department  of  health, and the department of labor to
    51  verify individuals' eligibility for the various programs specified under
    52  section one thousand one hundred thirty-seven (b) of the social security
    53  act and for other public assistance programs authorized  by  state  law,
    54  and   for  the  purposes  of  administering  state  employment  security
    55  programs, and for the purposes of administering the long term care trust

        S. 9082                            18
 
     1  program, and with the workers' compensation board  for  the  purpose  of
     2  administering workers' compensation programs;
     3    (iv) include such other matters as the parties to such agreement shall
     4  deem necessary to carry out the provisions of this section; [and]
     5    (g)  furnish  to  the  national directory of new hires, on a quarterly
     6  basis,  extracts  of  the  reports  required  under  paragraph  six   of
     7  subsection  (a)  of  section  three  hundred three of the federal social
     8  security act to be made to the secretary of labor concerning  wages  and
     9  unemployment  compensation  paid  to  individuals, by such dates, and in
    10  such manner as the secretary of health and human services shall  specify
    11  by regulations. The state department of labor shall, consistent with the
    12  authority  contained in paragraph e of subdivision three of section five
    13  hundred thirty-seven of the labor law, disclose to the  state  directory
    14  of new hires, such wage and unemployment compensation information as may
    15  be necessary to allow such state directory to comply with the provisions
    16  of this paragraph[.]; and
    17    (h)  on  or before January first of the year beginning two years after
    18  the effective date of this paragraph, enter into written agreements with
    19  the commissioners of health and labor on behalf of  the  departments  of
    20  health and labor respectively, which shall:
    21    (i)  provide  for  the  disclosure  of  information  obtained from the
    22  reports required to be  submitted  pursuant  to  this  section  to  such
    23  departments and board for the purposes set forth in this section;
    24    (ii)  specify  the  frequency  with which the department shall furnish
    25  information obtained from such reports to such office, departments,  and
    26  board,  which shall be within one business day after the date the infor-
    27  mation is entered into the state directory of new hires;
    28    (iii) set forth the procedure for reimbursement of the  department  by
    29  such  office,  departments,  and  board  subject  to the approval of the
    30  director of the budget for the additional  costs  of  carrying  out  the
    31  provisions of this section; and
    32    (iv) include such other matters as the parties to such agreement shall
    33  deem necessary to carry out the provisions of this section.
    34    §  7.  Paragraph  4 of subsection (a) of section 674 of the tax law is
    35  amended by adding a new subparagraph (D) to read as follows:
    36    (D) The provisions of article thirty-six-B of the  public  health  law
    37  relating  to  administration of the state's long term care trust program
    38  shall apply to the department's duties under this  chapter  relating  to
    39  employee premium information, contributions and payments.
    40    §  8.  Severability. If any provision or application of this act shall
    41  be held to be invalid, or to violate or be inconsistent with any  appli-
    42  cable  federal law or regulation, that shall not affect other provisions
    43  or applications of this act which  can  be  given  effect  without  that
    44  provision  or  application; and to that end, the provisions and applica-
    45  tions of this act are severable.
    46    § 9. This act shall take effect immediately.
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