STATE OF NEW YORK ________________________________________________________________________ 4881--A 2023-2024 Regular Sessions IN SENATE February 16, 2023 ___________ Introduced by Sen. CLEARE -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the social services law, in relation to increasing the amount of the savings exemption for eligibility for Medicaid and elim- inating the asset test for certain individuals; and to repeal certain provisions of such law relating thereto The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subparagraph 4 of paragraph (a) of subdivision 2 of section 2 366 of the social services law, as amended by section 43 of part C of 3 chapter 58 of the laws of 2008, is amended to read as follows: 4 (4) savings in amounts equal to [one hundred fifty percent of the 5 income amount permitted under subparagraph seven of this paragraph, 6 provided, however, that the amounts for one and two person households 7 shall not be less than the amounts permitted to be retained by house- 8 holds of the same size in order to qualify for benefits under the feder- 9 al supplemental security income program] three hundred thousand dollars; 10 § 1-a. Subparagraph 4 of paragraph (a) of subdivision 2 of section 366 11 of the social services law, as amended by section 3 of part AAA of chap- 12 ter 56 of the laws of 2022, is amended to read as follows: 13 (4) savings in amounts equal to [one hundred fifty percent of the 14 income amount permitted under subparagraph seven of this paragraph, 15 provided, however, that the amounts for one and two person households 16 shall not be less than the amounts permitted to be retained by house- 17 holds of the same size in order to qualify for benefits under the feder- 18 al supplemental security income program] three hundred thousand dollars; 19 § 2. Subparagraph 5 of paragraph (c) of subdivision 1 of section 366 20 of the social services law, as amended by chapter 583 of the laws of 21 2023, is amended to read as follows: EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD09634-02-3
S. 4881--A 2 1 (5) A disabled individual at least sixteen years of age, but under the 2 age of sixty-five, who: would be eligible for benefits under the supple- 3 mental security income program but for earnings in excess of the allow- 4 able limit; has net available income that does not exceed two hundred 5 fifty percent of the applicable federal income official poverty line, as 6 defined and updated by the United States department of health and human 7 services, for a one-person or two-person household, as defined by the 8 commissioner in regulation; has household resources, as defined in para- 9 graph (e) of subdivision two of section three hundred sixty-six-c of 10 this title, other than retirement accounts, that do not exceed [one 11 hundred fifty percent of the income amount permitted under subparagraph 12 seven of paragraph (a) of subdivision two of this section, for a one- 13 person or two-person household] three hundred thousand dollars, as 14 defined by the commissioner in regulation; and contributes to the cost 15 of medical assistance provided pursuant to this subparagraph in accord- 16 ance with subdivision twelve of section three hundred sixty-seven-a of 17 this title; for purposes of this subparagraph, disabled means having a 18 medically determinable impairment of sufficient severity and duration to 19 qualify for benefits under section 1902(a)(10)(A)(ii)(xv) of the social 20 security act. 21 § 3. Subparagraphs 2, 3 and 4 of paragraph (a) of subdivision 2 of 22 section 366 of the social services law are REPEALED. 23 § 4. Subparagraphs 5, 6, 7, 9, 10 and 11 of paragraph (a) of subdivi- 24 sion 2 of section 366 of the social services law, subparagraph 5 as 25 amended by chapter 576 of the laws of 2007, subparagraph 6 as amended by 26 chapter 938 of the laws of 1990, subparagraph 7 as amended by section 47 27 of part C of chapter 58 of the laws of 2008, subparagraph 9 as amended 28 by chapter 110 of the laws of 1971, subparagraph 10 as added by chapter 29 705 of the laws of 1988, clauses (i) and (ii) of subparagraph 10 as 30 amended by chapter 672 of the laws of 2019, clause (iii) of subparagraph 31 10 as amended by chapter 170 of the laws of 1994 and subparagraph 11 as 32 added by chapter 576 of the laws of 2015, are renumbered subparagraphs 33 2, 3, 4, 5, 6 and 7 and clause (iii) of subparagraph 4 is amended to 34 read as follows: 35 (iii) No other income [or resources], including federal old-age, 36 survivors and disability insurance, state disability insurance or other 37 payroll deductions, whether mandatory or optional, shall be exempt and 38 all other income [and resources] shall be taken into consideration and 39 required to be applied toward the payment or partial payment of the cost 40 of medical care and services available under this title, to the extent 41 permitted by federal law. 42 § 4-a. Subparagraphs 5, 6, 7, 8, 9, 10 and 11 of paragraph (a) of 43 subdivision 2 of section 366 of the social services law, as amended by 44 section 3 of part AAA of chapter 56 of the laws of 2022, are renumbered 45 subparagraphs 2, 3, 4, 5, 6, 7 and 8 and subparagraph 5 is amended to 46 read as follows: 47 (5) No other income [or resources], including federal old-age, survi- 48 vors and disability insurance, state disability insurance or other 49 payroll deductions, whether mandatory or optional, shall be exempt and 50 all other income [and resources] shall be taken into consideration and 51 required to be applied toward the payment or partial payment of the cost 52 of medical care and services available under this title, to the extent 53 permitted by federal law. 54 § 5. Subparagraphs 2, 5 and 10 of paragraph (c) of subdivision 1 of 55 section 366 of the social services law, subparagraphs 2 and 10 as added 56 by section 1 of part D of chapter 56 of the laws of 2013 and subpara-
S. 4881--A 3 1 graph 5 as amended by section two of this act, are amended to read as 2 follows: 3 (2) An individual who, although not receiving public assistance or 4 care for his or her maintenance under other provisions of this chapter, 5 has income [and resources], including available support from responsible 6 relatives, that does not exceed the amounts set forth in paragraph (a) 7 of subdivision two of this section, and is (i) sixty-five years of age 8 or older, or certified blind or certified disabled or (ii) for reasons 9 other than income [or resources], is eligible for federal supplemental 10 security income benefits and/or additional state payments. 11 (5) A disabled individual at least sixteen years of age, but under the 12 age of sixty-five, who: would be eligible for benefits under the supple- 13 mental security income program but for earnings in excess of the allow- 14 able limit; has net available income that does not exceed two hundred 15 fifty percent of the applicable federal income official poverty line, as 16 defined and updated by the United States department of health and human 17 services, for a one-person or two-person household, as defined by the 18 commissioner in regulation; [has household resources, as defined in 19 paragraph (e) of subdivision two of section three hundred sixty-six-c of 20 this title, other than retirement accounts, that do not exceed three 21 hundred thousand dollars, as defined by the commissioner in regulation; 22 and contributes to the cost of medical assistance provided pursuant to 23 this subparagraph in accordance with subdivision twelve of section three 24 hundred sixty-seven-a of this title;] for purposes of this subparagraph, 25 disabled means having a medically determinable impairment of sufficient 26 severity and duration to qualify for benefits under section 27 1902(a)(10)(A)(ii)(xv) of the social security act. 28 (10) A resident of a home for adults operated by a social services 29 district, or a residential care center for adults or community residence 30 operated or certified by the office of mental health, and has not, 31 according to criteria promulgated by the department consistent with this 32 title, sufficient income, or in the case of a person sixty-five years of 33 age or older, certified blind, or certified disabled, sufficient income 34 [and resources], including available support from responsible relatives, 35 to meet all the costs of required medical care and services available 36 under this title. 37 § 6. Subparagraphs 1 and 2 of paragraph (b) of subdivision 2 of 38 section 366 of the social services law, subparagraph 1 as amended by 39 chapter 638 of the laws of 1993, subparagraph 1 as designated and 40 subparagraph 2 as added by chapter 170 of the laws of 1994, clause (iii) 41 of subparagraph 2 as amended by chapter 187 of the laws of 2017, clause 42 (iv) of subdivision 2 as amended by chapter 656 of the laws of 1997 and 43 as further amended by section 104 of part A of chapter 62 of the laws of 44 2011, clause (vi) of subparagraph 2 as added by chapter 435 of the laws 45 of 2018, are amended to read as follows: 46 (1) In establishing standards for determining eligibility for and 47 amount of such assistance, the department shall take into account only 48 such income [and resources], in accordance with federal requirements, as 49 [are] is available to the applicant or recipient and as would not be 50 required to be disregarded or set aside for future needs, and there 51 shall be a reasonable evaluation of any such income [or resources]. The 52 department shall not consider the availability of an option for an 53 accelerated payment of death benefits or special surrender value pursu- 54 ant to paragraph one of subsection (a) of section one thousand one 55 hundred thirteen of the insurance law, or an option to enter into a 56 viatical settlement pursuant to the provisions of article seventy-eight
S. 4881--A 4 1 of the insurance law, as an available resource in determining eligibil- 2 ity for an amount of such assistance, provided, however, that the 3 payment of such benefits shall be considered in determining eligibility 4 for and amount of such assistance. There shall not be taken into consid- 5 eration the financial responsibility of any individual for any applicant 6 or recipient of assistance under this title unless such applicant or 7 recipient is such individual's spouse or such individual's child who is 8 under twenty-one years of age. In determining the eligibility of a child 9 who is categorically eligible as blind or disabled, as determined under 10 regulations prescribed by the social security act for medical assist- 11 ance, the income [and resources] of parents or spouses of parents are 12 not considered available to that child if she/he does not regularly 13 share the common household even if the child returns to the common 14 household for periodic visits. In the application of standards of eligi- 15 bility with respect to income, costs incurred for medical care, whether 16 in the form of insurance premiums or otherwise, shall be taken into 17 account. Any person who is eligible for, or reasonably appears to meet 18 the criteria of eligibility for, benefits under title XVIII of the 19 federal social security act shall be required to apply for and fully 20 utilize such benefits in accordance with this chapter. 21 (2) In evaluating the income [and resources] available to an applicant 22 for or recipient of medical assistance, for purposes of determining 23 eligibility for and the amount of such assistance, the department must 24 consider assets [held in or] paid from trusts created by such applicant 25 or recipient, as determined pursuant to the regulations of the depart- 26 ment, in accordance with the provisions of this subparagraph. 27 (i) In the case of a revocable trust created by an applicant or recip- 28 ient, as determined pursuant to regulations of the department: [the 29 trust corpus must be considered to be an available resource;] payments 30 made from the trust to or for the benefit of such applicant or recipient 31 must be considered to be available income; and any other payments from 32 the trust must be considered to be assets disposed of by such applicant 33 or recipient for purposes of paragraph (d) of subdivision five of this 34 section. 35 (ii) In the case of an irrevocable trust created by an applicant or 36 recipient, as determined pursuant to regulations of the department: any 37 portion of the trust corpus, and of the income generated by the trust 38 corpus, from which no payment can under any circumstances be made to 39 such applicant or recipient must be considered, as of the date of estab- 40 lishment of the trust, or, if later, the date on which payment to the 41 applicant or recipient is foreclosed, to be assets disposed of by such 42 applicant or recipient for purposes of paragraph (d) of subdivision five 43 of this section; [any portion of the trust corpus, and of the income 44 generated by the trust corpus, from which payment could be made to or 45 for the benefit of such applicant or recipient must be considered to be 46 an available resource;] payments made from the trust to or for the bene- 47 fit of such applicant or recipient must be considered to be available 48 income; and any other payments from the trust must be considered to be 49 assets disposed of by such applicant or recipient for purposes of para- 50 graph (d) of subdivision five of this section. 51 (iii) Notwithstanding the provisions of clauses (i) and (ii) of this 52 subparagraph, in the case of an applicant or recipient who is disabled, 53 as such term is defined in section 1614(a)(3) of the federal social 54 security act, the department must not consider as available income [or 55 resources] the [corpus or] income of the following trusts which comply 56 with the provisions of the regulations authorized by clause (iv) of this
S. 4881--A 5 1 subparagraph: (A) a trust containing the assets of such a disabled indi- 2 vidual which was established for the benefit of the disabled individual 3 while such individual was under sixty-five years of age by the individ- 4 ual, a parent, grandparent, legal guardian, or court of competent juris- 5 diction, if upon the death of such individual the state will receive all 6 amounts remaining in the trust up to the total value of all medical 7 assistance paid on behalf of such individual; (B) and a trust containing 8 the assets of such a disabled individual established and managed by a 9 non-profit association which maintains separate accounts for the benefit 10 of disabled individuals, but, for purposes of investment and management 11 of trust funds, pools the accounts, provided that accounts in the trust 12 fund are established solely for the benefit of individuals who are disa- 13 bled as such term is defined in section 1614(a)(3) of the federal social 14 security act by such disabled individual, a parent, grandparent, legal 15 guardian, or court of competent jurisdiction, and to the extent that 16 amounts remaining in the individual's account are not retained by the 17 trust upon the death of the individual, the state will receive all such 18 remaining amounts up to the total value of all medical assistance paid 19 on behalf of such individual. Notwithstanding any law to the contrary, 20 a not-for-profit corporation may, in furtherance of and as an adjunct to 21 its corporate purposes, act as trustee of a trust for persons with disa- 22 bilities established pursuant to this subclause, provided that a trust 23 company, as defined in subdivision seven of section one hundred-c of the 24 banking law, acts as co-trustee. 25 (iv) The department shall promulgate such regulations as may be neces- 26 sary to carry out the provisions of this subparagraph. Such regulations 27 shall include provisions for: assuring the fulfillment of fiduciary 28 obligations of the trustee with respect to the remainder interest of the 29 department or state; monitoring pooled trusts; applying this subdivision 30 to legal instruments and other devices similar to trusts, in accordance 31 with applicable federal rules and regulations; and establishing proce- 32 dures under which the application of this subdivision will be waived 33 with respect to an applicant or recipient who demonstrates that such 34 application would work an undue hardship on him or her, in accordance 35 with standards specified by the secretary of the federal department of 36 health and human services. Such regulations may require: notification of 37 the department of the creation or funding of such a trust for the bene- 38 fit of an applicant for or recipient of medical assistance; notification 39 of the department of the death of a beneficiary of such a trust who is a 40 current or former recipient of medical assistance; in the case of a 41 trust, the corpus of which exceeds one hundred thousand dollars, notifi- 42 cation of the department of transactions tending to substantially 43 deplete the trust corpus; notification of the department of any trans- 44 actions involving transfers from the trust corpus for less than fair 45 market value; the bonding of the trustee when the assets of such a trust 46 equal or exceed one million dollars, unless a court of competent juris- 47 diction waives such requirement; and the bonding of the trustee when the 48 assets of such a trust are less than one million dollars, upon order of 49 a court of competent jurisdiction. The department, together with the 50 department of financial services, shall promulgate regulations governing 51 the establishment, management and monitoring of trusts established 52 pursuant to subclause (B) of clause (iii) of this subparagraph in which 53 a not-for-profit corporation and a trust company serve as co-trustees. 54 (v) Notwithstanding any acts, omissions or failures to act of a trus- 55 tee of a trust which the department or a local social services official 56 has determined complies with the provisions of clause (iii) and the
S. 4881--A 6 1 regulations authorized by clause (iv) of this subparagraph, the depart- 2 ment must not consider the [corpus or] income of any such trust as 3 available income [or resources] of the applicant or recipient who is 4 disabled, as such term is defined in section 1614(a)(3) of the federal 5 social security act. The department's remedy for redress of any acts, 6 omissions or failures to act by such a trustee which acts, omissions or 7 failures are considered by the department to be inconsistent with the 8 terms of the trust, contrary to applicable laws and regulations of the 9 department, or contrary to the fiduciary obligations of the trustee 10 shall be the commencement of an action or proceeding under subdivision 11 one of section sixty-three of the executive law to safeguard or enforce 12 the state's remainder interest in the trust, or such other action or 13 proceeding as may be lawful and appropriate as to assure compliance by 14 the trustee or to safeguard and enforce the state's remainder interest 15 in the trust. 16 (vi) The department shall provide written notice to an applicant for 17 or recipient of medical assistance who is or reasonably appears to be 18 eligible for medical assistance except for having income exceeding 19 applicable income levels. The notice shall inform the applicant or 20 recipient, in plain language, that in certain circumstances the medical 21 assistance program does not count the income of disabled applicants and 22 recipients if it is placed in a trust described in clause (iii) of this 23 subparagraph. The notice shall be included with the eligibility notice 24 provided to such applicants and recipients and shall reference where 25 additional information may be found on the department's website. This 26 clause shall not be construed to change any criterion for eligibility 27 for medical assistance. 28 § 7. Paragraph (a) of subdivision 3 of section 366 of the social 29 services law, as amended by chapter 110 of the laws of 1971, is amended 30 to read as follows: 31 (a) Medical assistance shall be furnished to applicants in cases 32 where, although such applicant has a responsible relative with suffi- 33 cient income [and resources] to provide medical assistance as determined 34 by the regulations of the department, the income [and resources] of the 35 responsible relative are not available to such applicant because of the 36 absence of such relative or the refusal or failure of such relative to 37 provide the necessary care and assistance. In such cases, however, the 38 furnishing of such assistance shall create an implied contract with such 39 relative, and the cost thereof may be recovered from such relative in 40 accordance with title six of article three of this chapter and other 41 applicable provisions of law. 42 § 8. Paragraph h of subdivision 6 of section 366 of the social 43 services law, as amended by section 69-b of part C of chapter 58 of the 44 laws of 2008, is amended to read as follows: 45 h. Notwithstanding any other provision of this chapter or any other 46 law to the contrary, for purposes of determining medical assistance 47 eligibility for persons specified in paragraph b of this subdivision, 48 the income [and resources] of responsible relatives shall not be deemed 49 available for as long as the person meets the criteria specified in this 50 subdivision. 51 § 9. Subparagraph (vii) of paragraph b of subdivision 7 of section 366 52 of the social services law, as amended by chapter 324 of the laws of 53 2004, is amended to read as follows: 54 (vii) be ineligible for medical assistance because the income [and 55 resources] of responsible relatives are deemed available to him or her,
S. 4881--A 7 1 causing him or her to exceed the income [or resource] eligibility level 2 for such assistance; 3 § 10. Paragraph j of subdivision 7 of section 366 of the social 4 services law, as amended by chapter 324 of the laws of 2004, is amended 5 to read as follows: 6 j. Notwithstanding any other provision of this chapter other than 7 subdivision six of this section or any other law to the contrary, for 8 purposes of determining medical assistance eligibility for persons spec- 9 ified in paragraph b of this subdivision, the income [and resources] of 10 a responsible relative shall not be deemed available for as long as the 11 person meets the criteria specified in this subdivision. 12 § 11. Subdivision 8 of section 366 of the social services law, as 13 added by chapter 41 of the laws of 1992, is amended to read as follows: 14 8. Notwithstanding any inconsistent provision of this chapter or any 15 other law to the contrary, income [and resources] which [are] is other- 16 wise exempt from consideration in determining a person's eligibility for 17 medical care, services and supplies available under this title, shall be 18 considered available for the payment or part payment of the costs of 19 such medical care, services and supplies as required by federal law and 20 regulations. 21 § 12. Subparagraph (vi) of paragraph b of subdivision 9 of section 366 22 of the social services law, as added by chapter 170 of the laws of 1994, 23 is amended to read as follows: 24 (vi) be eligible or, if discharged, would be eligible for medical 25 assistance, or are ineligible for medical assistance because the income 26 [and resources] of responsible relatives are or, if discharged, would be 27 deemed available to such persons causing them to exceed the income [or 28 resource] eligibility level for such assistance; 29 § 13. Paragraph k of subdivision 9 of section 366 of the social 30 services law, as added by chapter 170 of the laws of 1994, is amended to 31 read as follows: 32 k. Notwithstanding any provision of this chapter other than subdivi- 33 sion six or seven of this section, or any other law to the contrary, for 34 purposes of determining medical assistance eligibility for persons spec- 35 ified in paragraphs b and c of this subdivision, the income [and 36 resources] of a responsible relative shall not be deemed available for 37 as long as the person meets the criteria specified in this subdivision. 38 § 14. Paragraph (d) of subdivision 12 of section 366 of the social 39 services law, as added by section 1 of part E of chapter 58 of the laws 40 of 2006, is amended to read as follows: 41 (d) Notwithstanding any provision of this chapter or any other law to 42 the contrary, for purposes of determining medical assistance eligibility 43 for persons specified in paragraph (b) of this subdivision, the income 44 [and resources] of a legally responsible relative shall not be deemed 45 available for as long as the person meets the criteria specified in this 46 subdivision; provided, however, that such income shall continue to be 47 deemed unavailable should responsibility for the care and placement of 48 the person be returned to his or her parent or other legally responsible 49 person. 50 § 15. Paragraph (b) of subdivision 16 of section 366 of the social 51 services law, as added by section 1 of part N of chapter 57 of the laws 52 of 2023, is amended to read as follows: 53 (b) Individuals eligible for participation in such waiver shall: 54 (i) be a disabled individual, defined as having a medically determina- 55 ble impairment of sufficient severity and duration to qualify for bene- 56 fits under Titles II or XVI of the social security act;
S. 4881--A 8 1 (ii) be at least sixteen years of age; 2 (iii) be otherwise eligible for medical assistance benefits, but for 3 earnings [and/or resources] in excess of the allowable limit; 4 (iv) have net available income, determined in accordance with subdivi- 5 sion two of this section, that does not exceed two thousand two hundred 6 fifty percent of the applicable federal poverty line, as defined and 7 updated by the United States department of health and human services; 8 (v) [have resources, as defined in paragraph (e) of subdivision two of 9 section three hundred sixty-six-c of this title, other than retirement 10 accounts, that do not exceed three hundred thousand dollars; 11 (vi)] contribute to the cost of medical assistance provided pursuant 12 to this paragraph in accordance with paragraph (d) of this subdivision; 13 and 14 [(vii)] (vi) meet such other criteria as may be established by the 15 commissioner as may be necessary to administer the provisions of this 16 subdivision in an equitable manner. 17 § 16. Paragraph (b) of subdivision 2 of section 366-a of the social 18 services law is REPEALED and paragraphs (c) and (d) of subdivision 2, 19 paragraph (d) as added by section 29 of part B of chapter 58 of the laws 20 of 2010, are relettered paragraphs (b) and (c) and paragraph (c) is 21 amended to read as follows: 22 (c) Notwithstanding the provisions of paragraph (a) of this subdivi- 23 sion, an applicant or recipient [whose eligibility under this title is 24 determined without regard to the amount of his or her accumulated 25 resources] may attest to the amount of interest income generated by such 26 resources if the amount of such interest income is expected to be imma- 27 terial to medical assistance eligibility, as determined by the commis- 28 sioner of health. In the event there is an inconsistency between the 29 information reported by the applicant or recipient and any information 30 obtained by the commissioner of health from other sources and such 31 inconsistency is material to medical assistance eligibility, the commis- 32 sioner of health shall request that the applicant or recipient provide 33 adequate documentation to verify his or her interest income. 34 § 17. Paragraph (a) of subdivision 8 of section 366-a of the social 35 services law, as amended by section 7 of part B of chapter 58 of the 36 laws of 2010, is amended to read as follows: 37 (a) Notwithstanding subdivisions two and five of this section, infor- 38 mation concerning income [and resources] of applicants for and recipi- 39 ents of medical assistance may be verified by matching client informa- 40 tion with information contained in the wage reporting system established 41 by section one hundred seventy-one-a of the tax law and in similar 42 systems operating in other geographically contiguous states, by means of 43 an income verification performed pursuant to a memorandum of understand- 44 ing with the department of taxation and finance pursuant to subdivision 45 four of section one hundred seventy-one-b of the tax law, and, to the 46 extent required by federal law, with information contained in the non- 47 wage income file maintained by the United States internal revenue 48 service, in the beneficiary data exchange maintained by the United 49 States department of health and human services, and in the unemployment 50 insurance benefits file. Such matching shall provide for procedures 51 which document significant inconsistent results of matching activities. 52 Nothing in this section shall be construed to prohibit activities the 53 department reasonably believes necessary to conform with federal 54 requirements under section one thousand one hundred thirty-seven of the 55 social security act.
S. 4881--A 9 1 § 18. Subdivision 1 of section 366-c of the social services law, as 2 added by chapter 558 of the laws of 1989, is amended to read as follows: 3 1. Notwithstanding any other provision of law to the contrary, in 4 determining the eligibility for medical assistance of a person defined 5 as an institutionalized spouse, the income [and resources] of such 6 person and the person's community spouse shall be treated as provided in 7 this section. 8 § 19. Paragraphs (c), (d) and (e) of subdivision 2 of section 366-c of 9 the social services law are REPEALED and paragraphs (f), (g), (h), (i), 10 (j) and (k) of subdivision 2 are relettered paragraphs (c), (d), (e), 11 (f), (g) and (h). 12 § 20. Subdivisions 5 and 6 of section 366-c of the social services law 13 are REPEALED and subdivisions 7 and 8, as added by chapter 558 of the 14 laws of 1989, are renumbered subdivisions 5 and 6 and amended to read as 15 follows: 16 5. (a) At the beginning or after the commencement of a continuous 17 period of institutionalization, either spouse may request [an assessment 18 of the total value of their resources or] a determination of the commu- 19 nity spouse monthly income allowance, the amount of the family allow- 20 ance, or the method of computing the amount of the family allowance, or 21 the method of computing the amount of the community spouse income allow- 22 ance. 23 (b) [(i) Upon receipt of a request pursuant to paragraph (a) of this 24 subdivision together with all relevant documentation of the resources of 25 both spouses, the social services district shall assess and document the 26 total value of the spouses' resources and provide each spouse with a 27 copy of the assessment and the documentation upon which it was based. If 28 the request is not part of an application for medical assistance bene- 29 fits, the social services district may charge a fee for the assessment 30 which is related to the cost of preparing and copying the assessment and 31 documentation which fee may not exceed twenty-five dollars. 32 (ii)] The social services district shall [also] notify each requesting 33 spouse of the community spouse monthly income allowance, of the amount, 34 if any, of the family allowances, and of the method of computing the 35 amount of the community spouse monthly income allowance. 36 (c) The social services district shall also provide to the spouse a 37 notice of the right to a fair hearing at the time of provision of the 38 information requested under paragraph (a) of this subdivision or after a 39 determination of eligibility for medical assistance. Such notice shall 40 be in the form prescribed or approved by the commissioner and include a 41 statement advising the spouse of the right to a fair hearing under this 42 section. 43 6. (a) If, after a determination on an application for medical assist- 44 ance has been made, either spouse is dissatisfied with the determination 45 of the community spouse monthly allowance[,] or the amount of monthly 46 income otherwise available to the community spouse[, the computation of 47 the spousal share of resources, the attribution of resources or the 48 determination of the community spouse's resource allocation], the spouse 49 may request a fair hearing to dispute such determination. Such hearing 50 shall be held within thirty days of the request therefor. 51 (b) If either spouse establishes that the community spouse needs 52 income above the level established by the social services district as 53 the minimum monthly maintenance needs allowance, based upon exceptional 54 circumstances which result in significant financial distress (as defined 55 by the commissioner in regulations), the department shall substitute an
S. 4881--A 10 1 amount adequate to provide additional necessary income from the income 2 otherwise available to the institutionalized spouse. 3 [(c) If either spouse establishes that income generated by the commu- 4 nity spouse resource allowance, established by the social services 5 district, is inadequate to raise the community spouse's income to the 6 minimum monthly maintenance needs allowance, the department shall estab- 7 lish a resource allowance for the spousal share of the institutionalized 8 spouse adequate to provide such minimum monthly maintenance needs allow- 9 ance.] 10 § 21. The commissioner of health shall, expeditiously and as neces- 11 sary, submit any state plan amendment or waiver requests necessary to 12 maintain federal financial participation under this act. 13 § 22. This act shall take effect immediately; provided however, that 14 sections one and two of this act shall take effect January 1, 2025; 15 provided, further, however, that sections three, four, five, six, seven, 16 eight, nine, ten, eleven, twelve, thirteen, fourteen, fifteen, sixteen, 17 seventeen, eighteen, nineteen and twenty of this act shall take effect 18 January 1, 2026; provided, further, however, that if section 3 of part 19 AAA of chapter 56 of the laws of 2022 shall not have taken effect on or 20 before such dates then sections one-a and four-a of this act shall take 21 effect on the same date and in the same manner as such section of such 22 part of such chapter of the laws of 2022, takes effect; provided, 23 further, however, that the amendments to subdivision 6 of section 366 of 24 the social services law made by section eight of this act shall not 25 affect the repeal of such subdivision and shall be deemed repealed ther- 26 ewith; provided, further, however, that if section 1 of part N of chap- 27 ter 57 of the laws of 2023 shall not have taken effect on or before such 28 date then section fifteen of this act shall take effect on the same date 29 and in the same manner as such section of such part of such chapter of 30 the laws of 2023, takes effect; provided, further, however, that the 31 effectiveness of sections one through twenty of this act shall be 32 subject to federal financial participation; provided, further, however, 33 that the commissioner of health shall notify the legislative bill draft- 34 ing commission upon the occurrence of federal financial participation in 35 order that the commission may maintain an accurate and timely effective 36 data base of the official text of the laws of the state of New York in 37 furtherance of effectuating the provisions of section 44 of the legisla- 38 tive law and section 70-b of the public officers law. Effective imme- 39 diately, the addition, amendment and/or repeal of any rule or regulation 40 necessary for the implementation of this act on its effective date are 41 authorized to be made and completed on or before such effective date.