(A) ADULT DAY SERVICES, INCLUDING SOCIAL ADULT DAY SERVICES, ENRICHED
SOCIAL ADULT DAY SERVICES, AND ADULT DAY HEALTH CARE;
(B) CARE TRANSITION COORDINATION;
(C) ADAPTIVE EQUIPMENT AND TECHNOLOGY;
(D) ENVIRONMENTAL MODIFICATION;
(E) PERSONAL EMERGENCY RESPONSE SYSTEM;
(F) HOME SAFETY EVALUATION;
(G) RESPITE SERVICES PROVIDING TEMPORARY SUBSTITUTE CARE TO RELIEVE
UNPAID RELATIVE OR NON-RELATIVE CAREGIVERS;
(H) HOME DELIVERED MEALS;
(I) TRANSPORTATION;
(J) SERVICES OR SUPPORTS FOR PERSONS WITH DEMENTIA, ALZHEIMER'S DIAG-
NOSIS, OR OTHER COGNITIVE IMPAIRMENTS;
(K) EDUCATION AND CONSULTATION FOR CURRENT OR PROSPECTIVE CAREGIVERS;
(L) CARE BY A QUALIFIED FAMILY MEMBER;
(M) PROFESSIONAL SERVICES, INCLUDING BUT NOT LIMITED TO SERVICES
PROVIDED BY A PHYSICIAN, PHYSICIAN'S ASSISTANT, REGISTERED NURSE,
LICENSED PRACTICAL NURSE, OR OCCUPATIONAL, PHYSICAL, OR SPEECH THERAPIST
OR ANY OTHER HEALTH CARE PROFESSIONAL LICENSED UNDER TITLE EIGHT OF THE
EDUCATION LAW ACTING WITHIN THEIR SCOPE OF PRACTICE;
(N) SERVICES THAT ASSIST PAID AND UNPAID RELATIVE OR NON-RELATIVE
CAREGIVERS CARING FOR ELIGIBLE INDIVIDUALS, INCLUDING TRAINING FOR
INFORMAL CAREGIVERS AND OTHER INDIVIDUALS PROVIDING CARE WHO ARE NOT
OTHERWISE EMPLOYED AS LONG TERM CARE WORKERS UNDER SECTION THIRTY-SIX
HUNDRED FOURTEEN OF THIS CHAPTER;
(O) HOME CARE SERVICES AS DEFINED IN SECTION THIRTY-SIX HUNDRED TWO OF
THIS CHAPTER;
(P) ASSISTED LIVING SERVICES, INCLUDING ENHANCED ASSISTED LIVING OR
SPECIAL NEEDS ASSISTED LIVING SERVICES;
(Q) ADULT CARE FACILITY SERVICES;
(R) NURSING HOME SERVICES; AND
(S) ANY OTHER LONG TERM CARE SERVICES AS DEFINED IN PARAGRAPH (B) OF
SUBDIVISION ONE OF SECTION THREE HUNDRED SIXTY-SEVEN-F OF THE SOCIAL
SERVICES LAW OR OTHERWISE DESIGNATED AS SUCH IN LAW OR REGULATIONS BY
THE DEPARTMENT.
3. "BENEFIT UNIT" MEANS THE MAXIMUM DAILY BENEFIT THE DEPARTMENT IS
AUTHORIZED TO PAY A LONG TERM CARE SERVICES AND SUPPORTS PROVIDER AS
REIMBURSEMENT FOR PROVIDING AN APPROVED SERVICE OR SERVICES TO AN ELIGI-
BLE BENEFICIARY, WHICH AMOUNT SHALL INITIALLY BE TWO HUNDRED DOLLARS,
AND WHICH SHALL BE ADJUSTED ANNUALLY BY THE ADVISORY PANEL IN ACCORDANCE
WITH THE PROVISIONS OF SECTION THIRTY-SIX HUNDRED SEVENTY-THREE OF THIS
ARTICLE.
4. "COMMISSION" MEANS THE LONG TERM CARE TRUST COMMISSION ESTABLISHED
PURSUANT TO SECTION THIRTY-SIX HUNDRED SEVENTY-TWO OF THIS ARTICLE.
5. "ADVISORY PANEL" OR "PANEL" MEANS THE LONG TERM CARE TRUST ADVISORY
PANEL ESTABLISHED PURSUANT TO SECTION THIRTY-SIX HUNDRED SEVENTY-THREE
OF THIS ARTICLE.
6. "ELIGIBLE BENEFICIARY" MEANS A QUALIFIED INDIVIDUAL AS DEFINED IN
SUBDIVISION SIXTEEN OF THIS SECTION WHO:
(A) WAS NOT DISABLED BEFORE THE AGE OF EIGHTEEN;
(B) HAS BEEN ASSESSED BY THE DEPARTMENT AS NEEDING THE MINIMUM LEVEL
OF ASSISTANCE WITH ACTIVITIES OF DAILY LIVING NECESSARY TO RECEIVE BENE-
FITS PURSUANT TO SECTION THIRTY-SIX HUNDRED SEVENTY-FIVE OF THIS ARTI-
CLE;
(C) HAS NOT EXHAUSTED THE LIFETIME BENEFIT LIMIT AS DEFINED IN SUBDI-
VISION ELEVEN OF THIS SECTION; AND
A. 1499 3
(D) DOES NOT HAVE IN EFFECT AN EXEMPTION GRANTED PURSUANT TO SUBDIVI-
SION SIX OF SECTION THIRTY-SIX HUNDRED SEVENTY-SEVEN OF THIS ARTICLE.
7. "EMPLOYEE" MEANS ANY PERSON ENGAGED IN EMPLOYMENT AS SUCH TERM IS
DEFINED IN SECTION FIVE HUNDRED ELEVEN OF THE LABOR LAW.
8. "EMPLOYER" SHALL HAVE THE SAME MEANING AS DEFINED IN SECTION FIVE
HUNDRED TWELVE OF THE LABOR LAW.
9. "EMPLOYMENT" SHALL HAVE THE SAME MEANING AS DEFINED IN SECTION FIVE
HUNDRED ELEVEN OF THE LABOR LAW.
10. "LONG TERM CARE SERVICES AND SUPPORTS PROVIDER" OR "LONG TERM CARE
PROVIDER" MEANS AN INDIVIDUAL OR ENTITY AUTHORIZED TO PROVIDE LONG TERM
CARE SERVICES AS DEFINED IN PARAGRAPH (B) OF SUBDIVISION ONE OF SECTION
THREE HUNDRED SIXTY-SEVEN-F OF THE SOCIAL SERVICES LAW, INCLUDING BUT
NOT LIMITED TO A NURSING FACILITY LICENSED UNDER ARTICLE TWENTY-EIGHT OF
THIS CHAPTER; A HOME CARE SERVICES AGENCY, CERTIFIED HOME HEALTH AGENCY
OR LONG TERM HOME HEALTH CARE PROGRAM, AS DEFINED IN SECTION THIRTY-SIX
HUNDRED TWO OF THIS CHAPTER; AN ADULT DAY HEALTH CARE PROGRAM IN ACCORD-
ANCE WITH REGULATIONS OF THE DEPARTMENT; A HOME CARE SERVICES WORKER AS
DEFINED IN SECTION THIRTY-SIX HUNDRED THIRTEEN OF THIS CHAPTER; A
PERSONAL CARE PROVIDER LICENSED OR QUALIFIED TO PROVIDE SERVICES IN THIS
STATE OR IN ANY OTHER STATE OR LOCAL AGENCY; A QUALIFIED FAMILY MEMBER
AS DEFINED IN SUBDIVISION FIFTEEN OF THIS SECTION, AND SUCH OTHER INDI-
VIDUALS OR ENTITIES THAT ARE AUTHORIZED BY LAW OR REGULATIONS OF THIS
STATE OR ANY OTHER STATE OR LOCAL AGENCY TO PROVIDE SUCH SERVICES.
11. "LIFETIME BENEFIT LIMIT", OR "LIFETIME LIMIT" MEANS THE DOLLAR
EQUIVALENT OF THREE HUNDRED SIXTY-FIVE BENEFIT UNITS PAID BY THE DEPART-
MENT ON BEHALF OF AN ELIGIBLE BENEFICIARY OVER THE COURSE OF SUCH ELIGI-
BLE INDIVIDUAL'S LIFETIME.
12. "PREMIUM CONTRIBUTIONS" OR "PREMIUMS" MEANS THE PAYMENTS AN
EMPLOYEE OR SELF-EMPLOYED INDIVIDUAL IS REQUIRED TO CONTRIBUTE TO THE
PROGRAM PURSUANT TO SECTION THIRTY-SIX HUNDRED SEVENTY-SEVEN OF THIS
ARTICLE.
13. "PRIVATE LONG TERM CARE INSURANCE COVERAGE" MEANS A CONTRACT FOR
INSURANCE WHICH MEETS THE REQUIREMENTS OF SECTION ONE THOUSAND ONE
HUNDRED SEVENTEEN OF THE INSURANCE LAW.
14. "PROGRAM" MEANS THE NEW YORK LONG TERM CARE TRUST PROGRAM ESTAB-
LISHED PURSUANT TO SECTION THIRTY-SIX HUNDRED SEVENTY-ONE OF THIS ARTI-
CLE.
15. "QUALIFIED FAMILY MEMBER" MEANS A RELATIVE OF AN ELIGIBLE BENEFI-
CIARY WHO MEETS THE EDUCATIONAL OR TRAINING REQUIREMENTS ESTABLISHED BY
THE DEPARTMENT OR THE DEPARTMENT OF EDUCATION FOR PROVIDING LONG TERM
CARE SERVICES AND SUPPORTS AND IS AUTHORIZED BY LAW OR REGULATION TO
RECEIVE PAYMENTS FROM THE STATE.
16. (A) "QUALIFIED INDIVIDUAL" MEANS AN INDIVIDUAL WHO:
(I) IS AGE EIGHTEEN OR OLDER; AND
(II) HAS PAID PREMIUM CONTRIBUTIONS PURSUANT TO SECTION THIRTY-SIX
HUNDRED SEVENTY-SEVEN OF THIS ARTICLE FOR A PERIOD EQUIVALENT TO EITHER:
(1) A TOTAL OF TEN YEARS DURING THE COURSE OF SUCH INDIVIDUAL'S LIFE-
TIME;
(2) A TOTAL OF THREE YEARS WITHIN THE SIX YEARS IMMEDIATELY PRECEDING
SUCH INDIVIDUAL'S APPLICATION FOR BENEFITS UNDER SECTION THIRTY-SIX
HUNDRED SEVENTY-FIVE OF THIS ARTICLE; OR
(3) FOR AN INDIVIDUAL WHO HAS NOT MET THE TEN-YEAR REQUIREMENT UNDER
CLAUSE ONE OF THIS SUBPARAGRAPH, WHO SHALL HAVE REACHED THE AGE OF
FIFTY-FIVE BEFORE JANUARY FIRST OF THE YEAR IN WHICH PREMIUM COLLECTIONS
BEGIN, AT LEAST ONE YEAR. SUCH INDIVIDUAL MAY RECEIVE ONE-TENTH OF THE
MAXIMUM NUMBER OF BENEFIT UNITS AVAILABLE UNDER SECTION THIRTY-SIX
A. 1499 4
HUNDRED SEVENTY-FIVE OF THIS ARTICLE FOR EACH YEAR OF PREMIUM PAYMENTS.
NOTHING IN THIS CLAUSE SHALL PROHIBIT SUCH AN INDIVIDUAL, WHO MEETS THE
CONDITIONS OF CLAUSE TWO OF THIS SUBPARAGRAPH, FROM RECEIVING THE MAXI-
MUM NUMBER OF BENEFIT UNITS AVAILABLE UNDER SECTION THIRTY-SIX HUNDRED
SEVENTY-FIVE OF THIS ARTICLE.
(B) FOR THE PURPOSES OF PARAGRAPH (A) OF THIS SUBDIVISION, A "YEAR"
SHALL EQUAL NO LESS THAN FIVE HUNDRED HOURS OF PAID WORK.
17. "WAGES" MEANS ALL REMUNERATION PAID BY AN EMPLOYER TO AN EMPLOYEE
WITH RESPECT TO EMPLOYMENT DURING ANY CALENDAR YEAR. "WAGES" DOES NOT
INCLUDE BENEFITS PAID FOR BY THE EMPLOYER SUCH AS HEALTH INSURANCE OR
DISABILITY INSURANCE.
§ 3671. PROGRAM ESTABLISHED. 1. THERE IS HEREBY ESTABLISHED THE "NEW
YORK LONG TERM CARE TRUST PROGRAM" TO PROVIDE LONG TERM CARE SERVICES
AND SUPPORTS BENEFITS FOR ELIGIBLE BENEFICIARIES REGARDLESS OF INCOME OR
RESOURCES IN ACCORDANCE WITH THE PROVISIONS OF THIS ARTICLE. THE
DEPARTMENT SHALL IMPLEMENT AND ADMINISTER SUCH PROGRAM IN COORDINATION
WITH THE OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE, THE OFFICE OF
MENTAL HEALTH, THE STATE OFFICE FOR THE AGING, THE DEPARTMENT OF TAXA-
TION AND FINANCE AND THE DEPARTMENT OF LABOR AS SET FORTH IN THIS
SECTION.
2. THE DEPARTMENT SHALL:
(A) RECEIVE APPLICATIONS FOR BENEFITS AND PERFORM INITIAL AND CONTINU-
ING ELIGIBILITY DETERMINATIONS FOR LONG TERM CARE SERVICES AND SUPPORTS
BENEFITS IN ACCORDANCE WITH SECTION THIRTY-SIX HUNDRED SEVENTY-FIVE OF
THIS ARTICLE;
(B) MONITOR THE USE OF BENEFIT UNITS BY EACH ELIGIBLE BENEFICIARY TO
VERIFY THAT SUCH INDIVIDUAL'S LIFETIME BENEFIT LIMIT HAS NOT BEEN
EXHAUSTED;
(C) ESTABLISH AND MAINTAIN STANDARDS FOR ALL LONG TERM CARE SERVICES
AND SUPPORTS PROVIDED PURSUANT TO THIS ARTICLE;
(D) ESTABLISH REQUIREMENTS FOR A UNIFORM SYSTEM OF AUDITS AND REPORTS
TO REVIEW THE QUALITY AND AVAILABILITY OF LONG TERM CARE SERVICES AND
SUPPORTS FURNISHED PURSUANT TO THIS ARTICLE TO ENSURE THAT THE PROGRAM
IS ADMINISTERED IN THE BEST INTERESTS OF PROGRAM BENEFICIARIES;
(E) ESTABLISH SCHEDULES OF RATES, PAYMENTS, REIMBURSEMENTS AND OTHER
CHARGES AND STANDARDS AND PROCEDURES RELATING TO PAYMENTS OF BENEFITS TO
REGISTERED LONG TERM CARE SERVICES AND SUPPORTS PROVIDERS PURSUANT TO
SECTION THIRTY-SIX HUNDRED SEVENTY-SIX OF THIS ARTICLE; INCLUDING PROCE-
DURES FOR AUDITING PAYMENTS AND RECOUPMENT OF IMPROPER PAYMENTS;
(F) ESTABLISH PLANS FOR THE COORDINATION OF LONG TERM CARE SERVICES
AND SUPPORTS BENEFITS UNDER THIS ARTICLE FOR ELIGIBLE BENEFICIARIES WHO
ARE FUNDED THROUGH MEDICAID OR RECEIVING OTHER LONG TERM CARE SERVICES
AND SUPPORTS, INCLUDING THROUGH MEDICARE, PRIVATE LONG TERM CARE INSUR-
ANCE COVERAGE, OR OTHER PROGRAMS;
(G) ESTABLISH STANDARDS AND PROCEDURES RELATING TO CONTRACTUAL
ARRANGEMENTS BETWEEN LONG TERM CARE PROVIDERS AND THE DEPARTMENT;
(H) DEVELOP AND MAINTAIN A REGISTRY OF LONG TERM CARE SERVICES AND
SUPPORTS PROVIDERS THAT MEET THE MINIMUM QUALIFICATIONS ESTABLISHED BY
THE COMMISSION PURSUANT TO SECTION THIRTY-SIX HUNDRED SEVENTY-TWO OF
THIS ARTICLE, IN ACCORDANCE WITH SUBDIVISION THREE OF SECTION THIRTY-SIX
HUNDRED SEVENTY-SIX OF THIS ARTICLE; AND
(I) PROVIDE CONSULTATIVE SERVICES TO LONG TERM CARE PROVIDERS IN ORDER
TO ASSIST THEM: TO QUALIFY FOR PAYMENTS UNDER THE PROVISIONS OF THIS
ARTICLE; IN PROVIDING INFORMATION NEEDED TO DETERMINE SUCH PAYMENTS; AND
IN ESTABLISHING AND MAINTAINING SUCH FISCAL RECORDS AS MAY BE NECESSARY
A. 1499 5
FOR THE PROPER AND EFFICIENT ADMINISTRATION OF LONG TERM CARE SERVICES
AND SUPPORTS.
3. PRIOR TO OR ON THE FIRST OF JANUARY NEXT SUCCEEDING TWO YEARS AFTER
THE EFFECTIVE DATE OF THIS ARTICLE, THE DEPARTMENT SHALL, IN CONSULTA-
TION WITH THE DEPARTMENT OF LABOR, THE DEPARTMENT OF TAXATION AND
FINANCE, THE STATE OFFICE FOR THE AGING, THE OFFICE OF TEMPORARY AND
DISABILITY ASSISTANCE, AND ANY OTHER DEPARTMENT OR AGENCY IT DEEMS RELE-
VANT, DEVELOP AND MAINTAIN SUCH PROGRAMS AND PROCESSES AS SHALL BE
NECESSARY TO DETERMINE AND KEEP RECORDS REGARDING THE APPLICABILITY OF
PREMIUM CONTRIBUTION REQUIREMENTS OF SECTION THIRTY-SIX HUNDRED SEVEN-
TY-SEVEN OF THIS ARTICLE TO EMPLOYEES AND SELF-EMPLOYED INDIVIDUALS.
THE DEPARTMENT SHALL THEREAFTER MONITOR INDIVIDUAL PREMIUM CONTRIBUTIONS
AND MAKE ELIGIBILITY DETERMINATIONS PURSUANT TO SECTIONS THIRTY-SIX
HUNDRED SEVENTY-FOUR AND THIRTY-SIX HUNDRED SEVENTY-FIVE OF THIS ARTI-
CLE.
§ 3672. LONG TERM CARE TRUST COMMISSION. 1. THE LONG TERM CARE TRUST
COMMISSION IS HEREBY ESTABLISHED TO MAKE RECOMMENDATIONS TO ALL RELEVANT
DEPARTMENTS AND AGENCIES TO ENSURE THE ADEQUACY OF BENEFITS PROVIDED
UNDER THE PROGRAM AND TO MAINTAIN THE SOLVENCY AND SUSTAINABILITY OF THE
FUND.
2. THE COMMISSION SHALL CONSIST OF A TOTAL OF FIFTEEN VOTING MEMBERS
AND TEN NONVOTING MEMBERS AS FOLLOWS:
(A) SIX VOTING MEMBERS REPRESENTING THE LEGISLATURE, TO BE APPOINTED
AS FOLLOWS:
(I) TWO MEMBERS APPOINTED BY THE SPEAKER OF THE ASSEMBLY;
(II) TWO MEMBERS APPOINTED BY THE TEMPORARY PRESIDENT OF THE SENATE;
(III) ONE MEMBER APPOINTED BY THE MINORITY LEADER OF THE ASSEMBLY;
(IV) ONE MEMBER APPOINTED BY THE MINORITY LEADER OF THE SENATE; AND
(B) NINE MEMBERS TO BE APPOINTED BY THE GOVERNOR, ALL OF WHOM SHALL BE
VOTING MEMBERS, WHICH SHALL INCLUDE:
(I) THE COMMISSIONER, OR SUCH COMMISSIONER'S DESIGNEE;
(II) THE DIRECTOR OF THE STATE OFFICE FOR THE AGING, OR SUCH DIREC-
TOR'S DESIGNEE;
(III) THE COMMISSIONER OF TAXATION AND FINANCE, OR SUCH COMMISSIONER'S
DESIGNEE;
(IV) THE COMMISSIONER OF THE DEPARTMENT OF LABOR, OR SUCH COMMISSION-
ER'S DESIGNEE;
(V) THE SUPERINTENDENT OF FINANCIAL SERVICES, OR SUCH SUPERINTEN-
DENT'S DESIGNEE;
(VI) THE STATE LONG TERM CARE OMBUDSMAN, OR SUCH OMBUDSMAN'S DESIGNEE;
(VII) AND THREE ADDITIONAL MEMBERS WITH RELEVANT EXPERTISE IN THE
FIELD OF LONG TERM CARE; AND
(C) TEN NONVOTING MEMBERS:
(I) ONE OF WHOM SHALL BE A REPRESENTATIVE OF LOCAL PROGRAMS FOR THE
AGING, TO BE APPOINTED BY THE DIRECTOR OF THE STATE OFFICE FOR THE
AGING;
(II) ONE OF WHOM SHALL BE A REPRESENTATIVE OF A HOME CARE ASSOCIATION
THAT REPRESENTS CAREGIVERS THAT PROVIDE SERVICES TO PRIVATE PAY AND
MEDICAID CLIENTS, TO BE APPOINTED BY THE COMMISSIONER;
(III) ONE OF WHOM SHALL BE A REPRESENTATIVE OF A UNION REPRESENTING
LONG TERM CARE WORKERS, TO BE APPOINTED BY THE COMMISSIONER OF THE
DEPARTMENT OF LABOR;
(IV) ONE OF WHOM SHALL BE A REPRESENTATIVE OF AN ORGANIZATION REPRES-
ENTING RETIRED PERSONS, TO BE APPOINTED BY THE DIRECTOR OF THE STATE
OFFICE FOR THE AGING;
A. 1499 6
(V) ONE OF WHOM SHALL BE A REPRESENTATIVE OF AN ASSOCIATION REPRESENT-
ING SKILLED NURSING FACILITIES AND ASSISTED LIVING PROVIDERS, TO BE
APPOINTED BY THE COMMISSIONER;
(VI) ONE OF WHOM SHALL BE A REPRESENTATIVE OF AN ASSOCIATION REPRES-
ENTING ADULT FAMILY HOME PROVIDERS, TO BE APPOINTED BY THE COMMISSIONER;
(VII) TWO OF WHOM SHALL BE INDIVIDUALS RECEIVING LONG TERM CARE
SERVICES AND SUPPORTS, OR THEIR DESIGNEES, OR REPRESENTATIVES OF CONSUM-
ERS RECEIVING LONG TERM CARE SERVICES AND SUPPORTS UNDER THE PROGRAM,
ONE OF WHOM SHALL HAVE BEEN SELF-EMPLOYED, TO BE APPOINTED BY THE STATE
LONG TERM CARE OMBUDSMAN;
(VIII) ONE OF WHOM SHALL BE AN INDIVIDUAL WHO IS PAYING THE PREMIUM
ESTABLISHED UNDER SECTION THIRTY-SIX HUNDRED SEVENTY-SEVEN OF THIS ARTI-
CLE, OR, PRIOR TO SUCH SECTION BECOMING EFFECTIVE, WILL PAY SUCH PREMI-
UM, AND WHO IS NOT EMPLOYED BY A LONG TERM CARE SERVICES AND SUPPORTS
PROVIDER, TO BE APPOINTED BY THE COMMISSIONER OF THE DEPARTMENT OF
FINANCIAL SERVICES; AND
(IX) ONE OF WHOM SHALL BE A REPRESENTATIVE OF AN ORGANIZATION OF
EMPLOYERS WHOSE MEMBERS ARE REQUIRED TO COLLECT THE PREMIUM ESTABLISHED
UNDER SECTION THIRTY-SIX HUNDRED SEVENTY-SEVEN OF THIS ARTICLE, OR PRIOR
TO SUCH SECTION BECOMING EFFECTIVE, WILL BE REQUIRED TO COLLECT SUCH
PREMIUM, TO BE APPOINTED BY THE COMMISSIONER OF THE DEPARTMENT OF LABOR.
3. EACH APPOINTED MEMBER SHALL SERVE FOR A TERM OF TWO YEARS,
PROVIDED, HOWEVER THAT THE INITIAL MEMBERS APPOINTED PURSUANT TO PARA-
GRAPH (C) OF SUBDIVISION TWO OF THIS SECTION SHALL BE APPOINTED TO STAG-
GERED TERMS NOT TO EXCEED FOUR YEARS. INITIAL APPOINTMENTS TO THE
COMMISSION SHALL BE MADE NO LATER THAN SIXTY DAYS AFTER THE EFFECTIVE
DATE OF THIS SECTION.
4. THE COMMISSIONER, OR SUCH COMMISSIONER'S DESIGNEE, SHALL SERVE AS
CHAIR OF THE COMMISSION. MEETINGS OF THE COMMISSION SHALL BE AT THE CALL
OF THE CHAIR, PROVIDED, HOWEVER, THAT THE INITIAL MEETING OF THE COMMIS-
SION SHALL BE HELD NO LATER THAN THIRTY DAYS AFTER INITIAL APPOINTMENTS
ARE MADE PURSUANT TO SUBDIVISION TWO OF THIS SECTION. A MAJORITY OF THE
VOTING MEMBERS SHALL CONSTITUTE A QUORUM OF THE COMMISSION, AND THE
AFFIRMATIVE VOTE OF SIXTY PERCENT OF THE MEMBERS VOTING SHALL BE NECES-
SARY FOR ANY ACTION TO BE TAKEN BY THE COMMISSION. NOTWITHSTANDING ANY
CONTRARY PROVISION OF THIS SECTION, A MAJORITY OF THE MEMBERS IDENTIFIED
IN PARAGRAPHS (A) AND (B) OF SUBDIVISION TWO OF THIS SECTION SHALL
CONSTITUTE A QUORUM FOR THE PURPOSES OF APPROVING THE ANNUAL REPORT
REQUIRED UNDER SUBDIVISION EIGHT OF THIS SECTION.
5. MEMBERS OF THE COMMISSION SHALL SERVE WITHOUT COMPENSATION BUT
SHALL BE REIMBURSED FOR REASONABLE AND NECESSARY EXPENSES INCURRED IN
THE PERFORMANCE OF THEIR DUTIES. THE COMMISSION MAY EMPLOY STAFF AS
NEEDED, PRESCRIBE THEIR DUTIES, AND FIX THEIR COMPENSATION WITHIN
AMOUNTS APPROPRIATED FOR THE COMMISSION.
6. THE COMMISSION SHALL HOLD ITS FIRST MEETING NO LATER THAN THIRTY
DAYS AFTER INITIAL APPOINTMENTS HAVE BEEN MADE PURSUANT TO SUBDIVISION
THREE OF THIS SECTION AND SHALL IMMEDIATELY BEGIN DEVELOPMENT OF
PROPOSALS FOR THE IMPLEMENTATION AND EVENTUAL OPERATION OF THE PROGRAM.
THE COMMISSION SHALL EXAMINE THE LAWS AND REGULATIONS OF THE STATE AND
CONSULT WITH HEALTH CARE PROVIDERS, CONSUMERS, AND OTHER STAKEHOLDERS
AND MAKE SUCH RECOMMENDATIONS AS ARE NECESSARY TO CONFORM THE LAWS AND
REGULATIONS OF THE STATE WITH THE PURPOSES OF THIS ARTICLE, INCLUDING,
BUT NOT LIMITED TO:
(A) THE ESTABLISHMENT OF PROCEDURES TO BE USED BY THE DEPARTMENT IN
DETERMINING IF AN INDIVIDUAL IS:
A. 1499 7
(I) A QUALIFIED INDIVIDUAL UNDER SECTION THIRTY-SIX HUNDRED SEVENTY-
FOUR OF THIS ARTICLE; AND
(II) AN ELIGIBLE BENEFICIARY UNDER SECTION THIRTY-SIX HUNDRED SEVEN-
TY-FIVE OF THIS ARTICLE;
(B) THE ESTABLISHMENT OF MINIMUM QUALIFICATIONS FOR THE REGISTRATION
OF LONG TERM CARE SERVICES AND SUPPORTS PROVIDERS WITH THE DEPARTMENT
PURSUANT TO SECTION THIRTY-SIX HUNDRED SEVENTY-ONE OF THIS ARTICLE;
(C) THE ESTABLISHMENT OF MAXIMUM ALLOWABLE PAYMENTS FOR APPROVED
SERVICES, IN CONSULTATION WITH AFFECTED STAKEHOLDERS, WHICH (I) SHALL
NOT BE LOWER THAN MEDICAID PAYMENTS FOR COMPARABLE SERVICES, INCLUDING
LIMITATIONS BASED ON DOLLAR AMOUNT, DURATION, OR NUMBER OF VISITS AND
(II) SHALL BE SUFFICIENT TO ENSURE THAT LONG TERM CARE PROVIDERS WHO ARE
INDIVIDUALS RECEIVE AT LEAST THE GREATER OF (1) ONE HUNDRED FIFTY
PERCENT OF THE MINIMUM WAGE REQUIRED UNDER SECTION SIX HUNDRED FIFTY-TWO
OF THE LABOR LAW OR ANY OTHERWISE APPLICABLE WAGE RULE OR ORDER UNDER
ARTICLE NINETEEN OF THE LABOR LAW WHICH IS OTHERWISE APPLICABLE FOR HOME
CARE AIDES AS DEFINED IN SECTION THIRTY-SIX HUNDRED FOURTEEN-C OF THIS
CHAPTER, OR (2) THE WAGE OTHERWISE REQUIRED BY LAW TO BE PAID TO HOME
CARE AIDES AS DEFINED IN SECTION THIRTY-SIX HUNDRED FOURTEEN-C OF THIS
CHAPTER;
(D) RECOMMENDATIONS TO THE ADVISORY PANEL FOR THE ANNUAL ADJUSTMENT OF
THE BENEFIT UNIT IN ACCORDANCE WITH SECTIONS THIRTY-SIX HUNDRED SEVENTY
AND THIRTY-SIX HUNDRED SEVENTY-THREE OF THIS ARTICLE; AND
(E) RECOMMENDATIONS AS TO THE ADOPTION, AMENDMENT OR REPEAL OF ANY
RULES, REGULATIONS OR POLICIES THE COMMISSION DEEMS NECESSARY TO IMPROVE
THE OPERATION OF THE PROGRAM AND MAINTAIN SOLVENCY.
7. THE COMMISSION SHALL MONITOR PROGRAM ADMINISTRATIVE EXPENSES OVER
TIME, AND SUCH EXPENSES SHALL NOT EXCEED SEVEN AND ONE-HALF PERCENT OF
EXPENDITURES.
(A) BEGINNING ON THE FIFTEENTH OF NOVEMBER OCCURRING ONE YEAR AFTER
THE EFFECTIVE DATE OF THIS ARTICLE, AND ANNUALLY THEREAFTER, THE COMMIS-
SION SHALL SUBMIT AN ACTUARIAL REPORT TO THE GOVERNOR AND TO THE CHAIRS
OF THE SENATE FINANCE COMMITTEE AND THE ASSEMBLY WAYS AND MEANS COMMIT-
TEE. SUCH REPORT SHALL INCLUDE AN ACTUARIAL REPORT OF THE PROJECTED
SOLVENCY AND FINANCIAL STATUS OF THE PROGRAM, ANTICIPATED AGENCY SPEND-
ING AND ANTICIPATED ADMINISTRATIVE EXPENSES IN THE IMPLEMENTATION AND
INITIAL OPERATION OF THE PROGRAM.
(B) FOR THE ANNUAL REPORT DUE ON NOVEMBER FIFTEENTH OF THE YEAR OCCUR-
RING FIVE YEARS AFTER THE EFFECTIVE DATE OF THIS ARTICLE, THE COMMISSION
SHALL INCLUDE ITS RECOMMENDATIONS FOR A METHOD OF CALCULATING FUTURE
AGENCY ADMINISTRATIVE EXPENSES TO LIMIT SUCH EXPENSES WHILE PROVIDING
SUFFICIENT FUNDS TO ADEQUATELY OPERATE THE PROGRAM.
8. BEGINNING ON THE THIRTY-FIRST OF DECEMBER OCCURRING FIVE YEARS
AFTER THE EFFECTIVE DATE OF THIS ARTICLE, AND ANNUALLY THEREAFTER, THE
COMMISSION SHALL SUBMIT A REPORT TO THE LEGISLATURE ON THE PROGRAM,
WHICH SHALL INCLUDE BUT NOT BE LIMITED TO THE FOLLOWING:
(A) PROJECTED AND ACTUAL PROGRAM PARTICIPATION;
(B) ADEQUACY OF PREMIUM RATES;
(C) FUND BALANCES;
(D) BENEFITS PAID;
(E) DEMOGRAPHIC INFORMATION ON PROGRAM PARTICIPANTS, INCLUDING, BUT
NOT LIMITED TO, AGE, GENDER, RACE, ETHNICITY, GEOGRAPHIC DISTRIBUTION BY
COUNTY, LEGISLATIVE DISTRICT, AND EMPLOYMENT SECTOR; AND
(F) THE EXTENT TO WHICH THE OPERATION OF THE PROGRAM HAS RESULTED IN
SAVINGS TO THE MEDICAID PROGRAM BY AVOIDING COSTS THAT WOULD HAVE OTHER-
WISE BEEN THE RESPONSIBILITY OF THE STATE.
A. 1499 8
§ 3673. LONG TERM CARE TRUST ADVISORY PANEL. 1. THE LONG TERM CARE
TRUST ADVISORY PANEL IS HEREBY ESTABLISHED. THE ADVISORY PANEL SHALL
CONSIST OF EACH OF THE MEMBERS OF THE COMMISSION IDENTIFIED IN PARA-
GRAPHS (B) AND (C) OF SUBDIVISION TWO OF SECTION THIRTY-SIX HUNDRED
SEVENTY-TWO OF THIS ARTICLE, ALL OF WHOM SHALL BE VOTING MEMBERS.
2. IT SHALL BE THE DUTY OF THE ADVISORY PANEL TO:
(A) DETERMINE ANNUAL ADJUSTMENTS TO THE BENEFIT UNIT AS DEFINED IN
SUBDIVISION THREE OF SECTION THIRTY-SIX HUNDRED SEVENTY OF THIS ARTICLE;
(B) REVIEW THE ADEQUACY OF BENEFITS PROVIDED UNDER THIS ARTICLE; AND
(C) MAKE RECOMMENDATIONS TO THE COMMISSION TO ENSURE THE SOLVENCY OF
THE TRUST FUND.
3. THE COMMISSIONER AND THE COMMISSIONER OF THE DEPARTMENT OF TAXATION
AND FINANCE SHALL SERVE AS CO-CHAIRS OF THE ADVISORY PANEL. THE ADVISORY
PANEL SHALL MEET AT LEAST ONCE ANNUALLY TO DETERMINE ADJUSTMENTS TO THE
BENEFIT UNIT. ADDITIONAL MEETINGS OF THE ADVISORY PANEL SHALL BE AT THE
CALL OF THE CHAIR. A MAJORITY OF THE VOTING MEMBERS OF THE ADVISORY
PANEL SHALL CONSTITUTE A QUORUM OF THE PANEL, AND THE AFFIRMATIVE VOTE
OF SIXTY PERCENT OF THE PANEL MEMBERS VOTING SHALL BE NECESSARY FOR ANY
ACTION TO BE TAKEN BY THE ADVISORY PANEL. THE ADVISORY PANEL MAY ADOPT
RULES FOR THE CONDUCT OF MEETINGS, INCLUDING PROVISIONS FOR MEETINGS AND
VOTING TO BE CONDUCTED BY TELEPHONIC, VIDEO, OR OTHER CONFERENCING PROC-
ESS IN ACCORDANCE WITH ALL RELEVANT PROVISIONS OF ARTICLE SEVEN OF THE
PUBLIC OFFICERS LAW.
4. (A) IN DETERMINING ADJUSTMENTS TO THE BENEFIT UNIT, THE ADVISORY
PANEL SHALL REVIEW THE COMMISSION'S ACTUARIAL AUDIT AND VALUATION OF THE
TRUST ACCOUNT, ANY RECOMMENDATIONS BY THE COMMISSION, AND DATA PERTAIN-
ING TO ECONOMIC INDICATORS, PROGRAM COSTS, AND SUSTAINABILITY. SUCH
DATA SHALL INCLUDE, BUT NOT BE LIMITED TO, DATA REGARDING INFLATION,
REGIONAL DIFFERENCES IN COSTS OF LIVING AND COSTS OF LONG TERM CARE
SERVICES AND SUPPORTS, AND WAGES OF INDIVIDUALS WHO ARE LONG TERM CARE
SERVICES AND SUPPORTS PROVIDERS.
(B) THE ADVISORY PANEL MAY, TO THE EXTENT THE PANEL DEEMS APPROPRIATE,
DETERMINE THAT ADJUSTMENTS TO THE BENEFIT UNIT SHALL VARY BY REGION IN
THE EVENT THAT SUCH A DETERMINATION IS NECESSARY TO ACCOMPLISH THE
PURPOSES OF THIS ARTICLE.
(C) IN THE ABSENCE OF THE REQUIRED VOTE NECESSARY TO TAKE ACTION TO
ADJUST THE BENEFIT UNIT PRIOR TO NOVEMBER FIFTEENTH, THE ADVISORY PANEL
SHALL ADJUST SUCH BENEFIT UNIT FOR THE SUCCEEDING YEAR AS OF JANUARY
FIRST OF SUCH YEAR AS NECESSARY TO REFLECT ANY CHANGE IN THE "CURRENT
COST OF LIVING INDEX FIGURE" BASED UPON THE CONSUMER PRICE INDEX AS
ISSUED BY THE BUREAU OF LABOR STATISTICS OF THE UNITED STATES DEPART-
MENT OF LABOR SINCE NOVEMBER FIFTEENTH OF THE PRIOR YEAR.
5. THE MEMBERS OF THE ADVISORY PANEL SHALL RECEIVE NO COMPENSATION BUT
SHALL BE REIMBURSED FOR TRAVEL AND OTHER EXPENSES ACTUALLY AND NECESSAR-
ILY INCURRED IN THE PERFORMANCE OF THEIR DUTIES.
§ 3674. QUALIFIED INDIVIDUALS; DETERMINATION. 1. THE DEPARTMENT SHALL,
IN COORDINATION WITH THE DEPARTMENT OF LABOR, AND THE DEPARTMENT OF
TAXATION AND FINANCE, DEVELOP AND MAINTAIN A RECORD OF ALL INDIVIDUALS
SUBJECT TO THE PREMIUM REQUIREMENTS PURSUANT TO SECTION THIRTY-SIX
HUNDRED SEVENTY-SEVEN OF THIS ARTICLE.
2. NO LATER THAN THE FIRST OF JANUARY OCCURRING TWO YEARS AFTER THE
EFFECTIVE DATE OF THIS ARTICLE, THE DEPARTMENT SHALL, IN ACCORDANCE WITH
SUBDIVISION ONE OF THIS SECTION AND THE COOPERATIVE AGREEMENT ENTERED
INTO PURSUANT TO SUBDIVISION SIX-C OF SECTION ONE HUNDRED SEVENTY-ONE-A
OF THE TAX LAW, AS ADDED BY CHAPTER FIVE HUNDRED FORTY-FIVE OF THE LAWS
OF NINETEEN HUNDRED SEVENTY-FIVE DEVELOP AND MAINTAIN A RECORD OF:
A. 1499 9
(A) ALL INDIVIDUALS SUBJECT TO THE PREMIUM REQUIREMENTS OF SECTION
THIRTY-SIX HUNDRED SEVENTY-SEVEN OF THIS ARTICLE; AND
(B) EVERY EMPLOYER REQUIRED TO COLLECT AND REMIT PREMIUMS FROM EMPLOY-
EE WAGES PURSUANT TO SUBDIVISION TWO OF SECTION THIRTY-SIX HUNDRED
SEVENTY-SEVEN OF THIS ARTICLE.
3. THE DEPARTMENT SHALL MONITOR INDIVIDUAL PREMIUM CONTRIBUTIONS PAID
AND INDIVIDUAL HOURS WORKED FOR THE PURPOSES OF DETERMINING AND VERIFY-
ING WHETHER AN INDIVIDUAL IS A QUALIFIED INDIVIDUAL AS DEFINED IN SUBDI-
VISION SIXTEEN OF SECTION THIRTY-SIX HUNDRED SEVENTY OF THIS ARTICLE.
4. THE DEPARTMENT SHALL, IN COOPERATION WITH THE DEPARTMENT OF LABOR,
AND THE DEPARTMENT OF TAXATION AND FINANCE, MONITOR COMPLIANCE BY
EMPLOYERS SUBJECT TO THE COLLECTION AND REPORTING REQUIREMENTS SET FORTH
IN SECTION THIRTY-SIX HUNDRED SEVENTY-SEVEN OF THIS ARTICLE, ARTICLE
EIGHTEEN OF THE LABOR LAW, AND ARTICLES EIGHT AND TWENTY-TWO OF THE TAX
LAW; AND COLLECT, MONITOR, MAINTAIN, AND DISPOSE OF ANY OTHER INFORMA-
TION THAT THE DEPARTMENT, IN CONSULTATION WITH THE DEPARTMENT OF LABOR,
THE COMMISSIONER OF TAXATION AND FINANCE, AND THE COMMISSION, SHALL DEEM
RELEVANT AND NECESSARY TO COMPLY WITH THE REPORTING, MONITORING, ADMIN-
ISTERING, OR EVALUATION RESPONSIBILITIES REQUIRED PURSUANT TO THIS ARTI-
CLE OR OTHERWISE NECESSARY TO ACCOMPLISH THE PURPOSES OF THIS ARTICLE.
5. THE DEPARTMENT, IN CONSULTATION WITH THE DEPARTMENT OF LABOR, AND
THE COMMISSIONER OF TAXATION AND FINANCE, SHALL ESTABLISH PROCEDURES TO
MONITOR INDIVIDUAL PREMIUM CONTRIBUTIONS AND VERIFY BENEFIT ELIGIBILITY
PURSUANT TO SECTION THIRTY-SIX HUNDRED SEVENTY-FIVE OF THIS ARTICLE.
6. THE DEPARTMENT, IN CONSULTATION WITH THE DEPARTMENT OF LABOR AND
THE COMMISSIONER OF TAXATION AND FINANCE, SHALL PUBLISH AND DISTRIBUTE
EDUCATIONAL MATERIALS ABOUT THE PROGRAM TO INFORM EMPLOYEES, EMPLOYERS
AND MEMBERS OF THE PUBLIC OF THEIR RIGHTS AND OBLIGATIONS UNDER THIS
ARTICLE AND THE BENEFITS AVAILABLE UNDER THE PROGRAM.
§ 3675. ELIGIBLE BENEFICIARIES; DETERMINATION. 1. BEGINNING ON JANUARY
FIRST OF THE YEAR OCCURRING FIVE YEARS AFTER THE EFFECTIVE DATE OF THIS
ARTICLE, AND THEREAFTER, APPROVED LONG TERM CARE SERVICES AND SUPPORTS
BENEFITS SHALL BE AVAILABLE, WITHOUT REGARD TO INCOME OR RESOURCES, FOR
ELIGIBLE BENEFICIARIES WHO ARE ASSESSED BY THE DEPARTMENT AS NEEDING
ASSISTANCE WITH AT LEAST TWO ACTIVITIES OF DAILY LIVING, OR FOR INDIVID-
UALS WITH A DEMENTIA OR ALZHEIMER'S DIAGNOSIS, ASSESSED AS NEEDING AT
LEAST SUPERVISION WITH MORE THAN ONE ACTIVITY OF DAILY LIVING IN ACCORD-
ANCE WITH THE PROVISIONS OF THIS SECTION.
2. ANY QUALIFIED INDIVIDUAL, OR ANY PERSON AUTHORIZED BY LAW TO ACT ON
BEHALF OF A QUALIFIED INDIVIDUAL, MAY APPLY FOR LONG TERM CARE BENEFITS
PROVIDED UNDER THIS ARTICLE BY FILING AN APPLICATION THEREFOR WITH THE
DEPARTMENT IN WRITING, BY TELEPHONE, ONLINE, OR BY ANY OTHER MANNER
APPROVED BY THE COMMISSIONER FOR SUCH PURPOSE.
3. (A) UPON RECEIPT OF SUCH APPLICATION, THE DEPARTMENT OR ITS AGENT
SHALL VERIFY THAT THE APPLICANT IS A QUALIFIED INDIVIDUAL AS DEFINED IN
SUBDIVISION SIXTEEN OF SECTION THIRTY-SIX HUNDRED SEVENTY OF THIS ARTI-
CLE, AND UPON SUCH VERIFICATION, SHALL PERFORM AN ELIGIBILITY DETERMI-
NATION, WHICH SHALL INCLUDE AN ASSESSMENT OF WHETHER THE APPLICANT NEEDS
ASSISTANCE WITH AT LEAST TWO ACTIVITIES OF DAILY LIVING, OR FOR INDIVID-
UALS WITH A DEMENTIA OR ALZHEIMER'S DIAGNOSIS, AT LEAST SUPERVISION WITH
MORE THAN ONE ACTIVITY OF DAILY LIVING, DEFINED AND DETERMINED BY USING
AN EVIDENCE BASED VALIDATED ASSESSMENT INSTRUMENT APPROVED BY THE
COMMISSIONER AND IN ACCORDANCE WITH REGULATIONS OF THE DEPARTMENT AND
ANY APPLICABLE STATE AND FEDERAL LAWS BY AN INDEPENDENT ASSESSOR, OF
WHICH SUCH INDEPENDENT ASSESSOR MAY BE, SUBJECT TO APPROVAL BY THE
COMMISSIONER, A LICENSED HEALTH CARE PROVIDER SELECTED BY THE APPLICANT.
A. 1499 10
(B) THE DEPARTMENT SHALL COMPLETE THE ELIGIBILITY DETERMINATION
REQUIRED PURSUANT TO PARAGRAPH (A) OF THIS SUBDIVISION OR ANY SUBSEQUENT
REDETERMINATION OF ELIGIBILITY UNDER THIS ARTICLE AND DECIDE WHETHER THE
APPLICANT IS ELIGIBLE FOR BENEFITS WITHIN FORTY-FIVE DAYS OF THE DATE OF
A COMPLETED APPLICATION FOR BENEFITS.
(C) NOTWITHSTANDING ANY CONTRARY PROVISION OF THIS SUBDIVISION, THE
DEPARTMENT SHALL DEVELOP EXPEDITED PROCEDURES FOR DETERMINING ELIGIBIL-
ITY FOR AN APPLICANT WITH AN IMMEDIATE NEED FOR LONG TERM CARE SERVICES
AND SUPPORTS WHEREBY A FINAL ELIGIBILITY DETERMINATION SHALL BE MADE
WITHIN SEVEN DAYS OF THE DATE OF A COMPLETED APPLICATION FOR BENEFITS.
4. THE DEPARTMENT SHALL NOTIFY THE APPLICANT OF THE RESULTS OF THE
DEPARTMENT'S ELIGIBILITY DETERMINATION, AND, WHERE SUCH APPLICANT IS
FOUND TO BE AN ELIGIBLE BENEFICIARY, THE AMOUNT OF BENEFIT UNITS AVAIL-
ABLE AND THE DATE ON WHICH SUCH BENEFIT UNITS SHALL BECOME PAYABLE FOR
APPROVED SERVICES ON BEHALF OF THE ELIGIBLE BENEFICIARY, WHICH SHALL BE
THE DATE OF THE APPLICATION, OR SUBJECT TO APPLICABLE DEPARTMENT REGU-
LATIONS, SUCH EARLIER DATE AS MAY BE DEEMED REASONABLE BASED ON THE
NEEDS OF THE BENEFICIARY. WHERE SUCH APPLICANT IS FOUND INELIGIBLE, THE
DEPARTMENT SHALL NOTIFY THE APPLICANT OF THE REASONS THEREFOR AND SHALL
ADVISE SUCH APPLICANT OF THE APPLICANT'S RIGHT TO APPEAL SUCH DETERMI-
NATION PURSUANT TO SECTION THIRTY-SIX HUNDRED SEVENTY-NINE OF THIS ARTI-
CLE.
5. (A) ALL CONTINUING BENEFITS UNDER THIS ARTICLE SHALL BE SUBJECT TO
RECONSIDERATION AND REDETERMINATION AS FREQUENTLY AS THE DEPARTMENT
DEEMS NECESSARY TO ENSURE THAT EACH PERSON RECEIVING BENEFITS UNDER THIS
ARTICLE CONTINUES TO BE IN NEED OF LONG TERM CARE SERVICES AND SUPPORTS
AND HAS NOT EXHAUSTED THE LIFETIME BENEFIT LIMIT. THE DEPARTMENT MAY
CONDUCT ANY INVESTIGATION IT MAY DEEM NECESSARY OR REQUIRED TO EFFECTU-
ATE THE PURPOSES OF THIS SUBDIVISION.
(B) THE DEPARTMENT SHALL DEVELOP A SIMPLIFIED STATEWIDE RECERTIF-
ICATION FORM FOR USE IN REDETERMINING ELIGIBILITY UNDER THIS ARTICLE.
6. (A) AN ELIGIBLE BENEFICIARY SHALL RECEIVE BENEFITS THROUGH THE
PROGRAM IN THE FORM OF A BENEFIT UNIT PAYABLE BY THE DEPARTMENT TO A
REGISTERED LONG TERM CARE PROVIDER FOR APPROVED SERVICES AND SUPPORTS IN
AN AMOUNT DETERMINED BY THE ADVISORY PANEL PURSUANT TO SECTION THIRTY-
SIX HUNDRED SEVENTY-THREE OF THIS ARTICLE. IF THE VALUE OF SERVICES
PROVIDED TO AN ELIGIBLE BENEFICIARY ON A SINGLE DATE IS LESS THAN THE
BENEFIT UNIT, ONLY THE PORTION OF THE BENEFIT UNIT THAT IS ACTUALLY PAID
ON SUCH BENEFICIARY'S BEHALF SHALL BE TAKEN INTO CONSIDERATION WHEN
CALCULATING THE BALANCE OF SUCH PERSON'S LIFETIME BENEFIT LIMIT. THE
BALANCE OF THE BENEFIT UNIT NOT EXPENDED ON SUCH DATE SHALL REMAIN
AVAILABLE TO THE ELIGIBLE BENEFICIARY FOR USE IN ACCORDANCE WITH PARA-
GRAPH (B) OF THIS SUBDIVISION OR UNTIL OTHERWISE EXHAUSTED PURSUANT TO
THIS ARTICLE.
(B) NOTWITHSTANDING ANY CONTRARY PROVISION OF THIS ARTICLE, AN ELIGI-
BLE BENEFICIARY MAY RECEIVE BENEFITS IN EXCESS OF THE BENEFIT UNIT AS
DEFINED IN SUBDIVISION THREE OF SECTION THIRTY-SIX HUNDRED SEVENTY OF
THIS ARTICLE, FOR SERVICES PROVIDED ON A SINGLE DATE, PROVIDED THAT SUCH
ELIGIBLE BENEFICIARY HAS NOT EXHAUSTED THE LIFETIME BENEFIT LIMIT. IN NO
EVENT SHALL A PERSON RECEIVE BENEFITS UNDER THIS ARTICLE AFTER SUCH
PERSON'S LIFETIME BENEFIT LIMIT HAS BEEN EXHAUSTED.
7. THE DEPARTMENT SHALL DEVELOP PROCEDURES TO MONITOR EACH ELIGIBLE
BENEFICIARY'S USE OF BENEFIT UNITS AND SHALL NOTIFY ELIGIBLE BENEFICI-
ARIES OF THE BALANCE OF BENEFIT UNITS REMAINING WITHIN A REASONABLE TIME
AFTER APPROVED SERVICES ARE RENDERED.
A. 1499 11
8. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, BENEFITS PAID ON
BEHALF OF AN INDIVIDUAL PURSUANT TO THIS ARTICLE SHALL NOT BE CONSIDERED
INCOME OR RESOURCES FOR THE PURPOSES OF ANY DETERMINATIONS OF ELIGIBIL-
ITY FOR ANY OTHER STATE PROGRAM OR BENEFIT, INCLUDING BUT NOT LIMITED TO
MEDICAL ASSISTANCE, ANY STATE OR FEDERAL PROGRAM, MEDICAID, OR ANY OTHER
MEANS-TESTED PROGRAM OR BENEFIT.
9. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, NOTHING IN THIS
ARTICLE SHALL BE CONSTRUED TO CREATE AN ENTITLEMENT FOR ANY INDIVIDUAL
TO RECEIVE, OR REQUIRE THE STATE OR ANY DEPARTMENT OR AGENCY THEREOF TO
PROVIDE, CASE MANAGEMENT SERVICES, INCLUDING, BUT NOT LIMITED TO, CASE
MANAGEMENT SERVICES UNDER TITLE ELEVEN OF ARTICLE FIVE OF THE SOCIAL
SERVICES LAW.
§ 3676. REIMBURSEMENT FOR SERVICES AND SUPPORTS. 1. BEGINNING ON
JANUARY FIRST OF THE YEAR OCCURRING FIVE YEARS AFTER THE EFFECTIVE DATE
OF THIS ARTICLE, THE DEPARTMENT SHALL REIMBURSE REGISTERED LONG TERM
CARE PROVIDERS FOR APPROVED SERVICES RENDERED TO ELIGIBLE BENEFICIARIES
IN ACCORDANCE WITH THIS ARTICLE. REIMBURSEMENT FOR SERVICES PROVIDED
PURSUANT TO THIS SECTION SHALL BE PAID TO REGISTERED LONG TERM CARE
PROVIDERS AT SUCH TIMES AND IN SUCH MANNER AS THE DEPARTMENT MAY
PRESCRIBE, PROVIDED HOWEVER, SUCH PAYMENTS SHALL BE MADE NO LESS THAN
QUARTERLY.
2. THE DEPARTMENT MAY REIMBURSE QUALIFIED FAMILY MEMBERS FOR PROVIDING
APPROVED PERSONAL CARE SERVICES IN THE SAME MANNER AS REIMBURSEMENTS ARE
PAID TO AN INDIVIDUAL PROVIDER, WHETHER DIRECTLY, THROUGH A LICENSED
HOME CARE AGENCY, OR THROUGH A THIRD OPTION IF RECOMMENDED BY THE
COMMISSION AND ADOPTED BY THE DEPARTMENT.
3. (A) THE DEPARTMENT SHALL DEVELOP AND MAINTAIN A REGISTRY OF LONG
TERM CARE PROVIDERS IN ACCORDANCE WITH SUBDIVISION TWO OF SECTION THIR-
TY-SIX HUNDRED SEVENTY-ONE OF THIS ARTICLE, AND IN CONSULTATION WITH THE
COMMISSION, SHALL ESTABLISH STANDARDS AND PROCEDURES FOR:
(I) REGISTRATION WITH THE DEPARTMENT PURSUANT TO THIS SECTION; AND
(II) THE SUSPENSION, REVOCATION, OR TERMINATION OF A PROVIDER'S REGIS-
TRATION OR OTHER LIMITATION ON THE PROVIDER'S AUTHORIZATION TO PROVIDE
SERVICES UNDER THE PROGRAM WHERE IT IS DETERMINED THAT:
(A) THE PROVIDER IS INCOMPETENT;
(B) THE PROVIDER HAS EXHIBITED A COURSE OF CONDUCT WHICH IS INCONSIST-
ENT WITH PROGRAM STANDARDS AND REGULATIONS;
(C) THE PROVIDER HAS WILLFULLY FAILED TO COMPLY WITH PROGRAM STANDARDS
AND REGULATIONS; OR
(D) THE PROVIDER HAS BEEN THE SUBJECT OF MORE THAN THREE COMPLAINTS TO
THE LONG TERM CARE OMBUDSMAN PROGRAM AND/OR TO THE DEPARTMENT, THE
NATURE OF WHICH MAY HAVE RESULTED IN SERIOUS HARM TO THE BENEFICIARY,
AND WHICH HAVE BEEN INVESTIGATED AND DETERMINED TO BE FOUNDED.
(B) PRIOR TO OR ON THE FIRST OF JANUARY NEXT SUCCEEDING FIVE YEARS
AFTER THE EFFECTIVE DATE OF THIS ARTICLE AND THEREAFTER, ALL INFORMATION
IN THE REGISTRY DEVELOPED AND MAINTAINED PURSUANT TO THIS SUBDIVISION,
INCLUDING ANY AND ALL RECORDS RELATING TO ACTIONS TAKEN PURSUANT TO
SUBPARAGRAPH (II) OF PARAGRAPH (A) OF THIS SUBDIVISION SHALL BE READILY
ACCESSIBLE ON THE DEPARTMENT'S WEBSITE BY THE PUBLIC.
4. A LONG TERM CARE SERVICES AND SUPPORTS PROVIDER WHICH EMPLOYS OR
CONTRACTS WITH ONE OR MORE INDIVIDUALS PERFORMING APPROVED SERVICES
SHALL PAY SUCH INDIVIDUALS NO LESS THAN THE GREATER OF (A) ONE HUNDRED
FIFTY PERCENT OF THE MINIMUM WAGE REQUIRED UNDER SECTION SIX HUNDRED
FIFTY-TWO OF THE LABOR LAW OR ANY OTHERWISE APPLICABLE WAGE RULE OR
ORDER UNDER ARTICLE NINETEEN OF THE LABOR LAW WHICH IS OTHERWISE APPLI-
CABLE FOR HOME CARE AIDES AS DEFINED IN SECTION THIRTY-SIX HUNDRED FOUR-
A. 1499 12
TEEN-C OF THIS CHAPTER, OR (B) THE WAGE OTHERWISE REQUIRED BY LAW TO BE
PAID TO HOME CARE AIDES AS DEFINED IN SECTION THIRTY-SIX HUNDRED FOUR-
TEEN-C OF THIS CHAPTER.
§ 3677. INDIVIDUAL PREMIUM CONTRIBUTIONS. 1. BEGINNING JANUARY FIRST,
OF THE YEAR OCCURRING TWO YEARS AFTER THE EFFECTIVE DATE OF THIS ARTI-
CLE, EVERY EMPLOYEE, AND EVERY SELF-EMPLOYED INDIVIDUAL, UNLESS OTHER-
WISE EXEMPT, SHALL CONTRIBUTE TO THE COST OF PROVIDING LONG TERM CARE
BENEFITS UNDER THIS ARTICLE BY PAYMENT OF THE PREMIUM ASSESSED PURSUANT
TO THIS SECTION. THE INITIAL PREMIUM CONTRIBUTION RATE AND ANY ADJUST-
MENTS TO SUCH RATE SHALL BE SET BY THE COMMISSION, AT THE LOWEST AMOUNT
NECESSARY TO MAINTAIN THE ACTUARIAL SOLVENCY OF THE LONG TERM CARE
SERVICES AND SUPPORTS TRUST FUND, IN ACCORDANCE WITH RECOGNIZED INSUR-
ANCE PRINCIPLES AND IN A MANNER DESIGNED TO LIMIT FLUCTUATIONS IN SUCH
RATE.
(A) THE INITIAL PREMIUM CONTRIBUTION RATE SHALL BE SET NO LATER THAN
SEPTEMBER THIRTIETH OF THE YEAR OCCURRING ONE YEAR AFTER THE EFFECTIVE
DATE OF THIS ARTICLE AND SHALL BECOME APPLICABLE TO EACH EMPLOYEE'S
WAGES PAID OR SELF-EMPLOYED INDIVIDUAL'S INCOME EARNED ON AND AFTER
JANUARY FIRST OF THE YEAR BEGINNING TWO YEARS AFTER THE EFFECTIVE DATE
OF THIS ARTICLE.
(B) BEGINNING JANUARY FIRST OF THE YEAR OCCURRING FOUR YEARS AFTER THE
EFFECTIVE DATE OF THIS ARTICLE, AND BIENNIALLY THEREAFTER, THE COMMIS-
SION SHALL MAKE SUCH ADJUSTMENTS TO THE PREMIUM CONTRIBUTION RATE, IF
NECESSARY, TO ENSURE THAT SUCH RATE CONTINUES TO BE SET AT THE LOWEST
AMOUNT NECESSARY TO MAINTAIN THE ACTUARIAL SOLVENCY OF THE LONG TERM
CARE SERVICES AND SUPPORTS TRUST FUND, IN ACCORDANCE WITH RECOGNIZED
INSURANCE PRINCIPLES AND IN A MANNER DESIGNED TO LIMIT FLUCTUATIONS IN
THE PREMIUM RATE.
2. (A) NOTWITHSTANDING ANY OTHER PROVISION OF LAW, EVERY EMPLOYER IS
AUTHORIZED TO COLLECT FROM ITS EMPLOYEES, THE PREMIUM ASSESSED UNDER
SUBDIVISION ONE OF THIS SECTION, THROUGH PAYROLL DEDUCTIONS AND REMIT
THE AMOUNTS SO COLLECTED TO THE DEPARTMENT OF TAXATION AND FINANCE IN
ACCORDANCE WITH THE PROVISIONS OF SECTION FOUR HUNDRED SEVENTY-FOUR OF
THE TAX LAW.
(B) WHEN COLLECTING EMPLOYEE PREMIUMS THROUGH PAYROLL DEDUCTIONS, THE
EMPLOYER SHALL ACT AS THE AGENT OF ITS EMPLOYEES AND SHALL REMIT ALL
SUCH AMOUNTS TO THE DEPARTMENT OF TAXATION AND FINANCE AS REQUIRED BY
SUBPARAGRAPH (D) OF PARAGRAPH FOUR OF SUBSECTION (A) OF SECTION SIX
HUNDRED SEVENTY-FOUR OF THE TAX LAW.
3. PREMIUMS SHALL BE COLLECTED AT THE SAME TIME AND IN THE SAME OR
SUBSTANTIALLY SIMILAR MANNER AS THE ASSESSMENT, COLLECTION, AND REPORT-
ING PROCEDURES USED FOR THE WITHHOLDING OF TAX PURSUANT TO TITLE FIVE OF
ARTICLE TWENTY-TWO OF THE TAX LAW OR, IN THE CASE OF AN INDIVIDUAL WHO
IS SELF-EMPLOYED, INCLUDING A SOLE PROPRIETOR, INDEPENDENT CONTRACTOR,
MEMBER OF A LIMITED LIABILITY COMPANY OR LIMITED LIABILITY PARTNERSHIP,
OR OTHER SELF-EMPLOYED PERSON, AT THE SAME TIME AND IN THE SAME OR
SUBSTANTIALLY SIMILAR MANNER AS THE ASSESSMENT, COLLECTION, AND REPORT-
ING PROCEDURES USED FOR THE PAYMENT OF TAX PURSUANT TO PART FOUR OF
ARTICLE TWENTY-TWO OF THE TAX LAW.
4. THE DEPARTMENT, IN COORDINATION WITH THE DEPARTMENT OF LABOR AND
THE DEPARTMENT OF TAXATION AND FINANCE SHALL PROMULGATE RULES FOR DETER-
MINING THE HOURS WORKED AND THE WAGES OF SELF-EMPLOYED INDIVIDUALS.
5. THE DEPARTMENT OF TAXATION AND FINANCE SHALL DEPOSIT ALL PREMIUMS
COLLECTED UNDER THIS SECTION IN THE LONG TERM CARE TRUST FUND ESTAB-
LISHED PURSUANT TO SECTION NINETY-NINE-SS OF THE STATE FINANCE LAW.
A. 1499 13
6. IF THE PREMIUMS ESTABLISHED IN THIS SECTION ARE CHANGED, THE
COMMISSION SHALL NOTIFY EACH INDIVIDUAL SUBJECT TO THIS SECTION BY MAIL
THAT SUCH PERSON'S PREMIUMS HAVE CHANGED.
7. (A)(I) NOTWITHSTANDING ANY CONTRARY PROVISION OF THIS SECTION, THE
FOLLOWING INDIVIDUALS MAY APPLY FOR AN EXEMPTION FROM THE PREMIUM
CONTRIBUTIONS REQUIRED UNDER SUBDIVISION ONE OF THIS SECTION, AS
PROVIDED IN THIS SUBDIVISION:
(1) AN INDIVIDUAL WHO HAS MAINTAINED PRIVATE LONG TERM CARE INSURANCE
COVERAGE ON AN UNINTERRUPTED BASIS BEGINNING NO LATER THAN JANUARY FIRST
OF THE YEAR IN WHICH THIS ARTICLE TAKES EFFECT;
(2) A VETERAN OF THE UNITED STATES MILITARY WHO HAS BEEN RATED BY THE
UNITED STATES DEPARTMENT OF VETERANS' AFFAIRS AS HAVING A SERVICE-CON-
NECTED DISABILITY OF SEVENTY PERCENT OR GREATER;
(3) A SPOUSE OR REGISTERED DOMESTIC PARTNER OF AN ACTIVE DUTY SERVICE
MEMBER IN THE UNITED STATES ARMED FORCES WHETHER OR NOT DEPLOYED OR
STATIONED WITHIN OR OUTSIDE OF THE STATE OF NEW YORK;
(4) AN EMPLOYEE WHO HOLDS A NONIMMIGRANT VISA FOR TEMPORARY WORKERS,
AS RECOGNIZED BY FEDERAL LAW, AND IS EMPLOYED BY AN EMPLOYER IN THE
STATE OF NEW YORK; OR
(5) AN INDIVIDUAL WHO MAINTAINS A PERMANENT ADDRESS OUTSIDE OF THE
STATE OF NEW YORK AS THE INDIVIDUAL'S PRIMARY LOCATION OF RESIDENCE.
(II) SUCH REQUEST FOR AN EXEMPTION SHALL BE MADE IN SUCH FORM AND IN
SUCH MANNER AS THE DEPARTMENT SHALL PRESCRIBE FOR SUCH PURPOSE NO LATER
THAN ONE YEAR AFTER THE EFFECTIVE DATE OF THIS ARTICLE.
(III) THE DEPARTMENT SHALL REVIEW EACH REQUEST FOR AN EXEMPTION
SUBMITTED PURSUANT TO SUBPARAGRAPH (I) OF THIS PARAGRAPH, AND UPON A
DETERMINATION THAT THE INDIVIDUAL SATISFIES THE REQUIREMENTS IN ACCORD-
ANCE WITH THIS PARAGRAPH, THE DEPARTMENT SHALL ISSUE NOTICE TO SUCH
INDIVIDUAL OF SUCH INDIVIDUAL'S EXEMPTION FROM PAYING PREMIUM CONTRIB-
UTIONS BEGINNING THIRTY DAYS AFTER THE ISSUANCE OF SUCH NOTICE OF
EXEMPTION.
(IV) AN EXEMPTION ISSUED TO AN INDIVIDUAL PURSUANT TO THIS SUBDIVISION
SHALL RELIEVE SUCH INDIVIDUAL'S EMPLOYER, IF ANY, OF THE DUTY TO COLLECT
PREMIUMS PURSUANT TO SUBDIVISIONS TWO AND THREE OF THIS SECTION,
PROVIDED, HOWEVER, THAT THE INDIVIDUAL SHALL HAVE FIRST GIVEN PROPER
NOTICE OF SUCH EXEMPTION TO THE EMPLOYER, INCLUDING A COPY OF SUCH
EXEMPTION, TOGETHER WITH ANY ADDITIONAL MATERIALS THE DEPARTMENT MAY
REQUIRE. NO SUCH EMPLOYER SHALL BE LIABLE TO AN INDIVIDUAL FOR CONTINU-
ING TO COLLECT PREMIUM CONTRIBUTIONS IN THE EVENT THAT THE INDIVIDUAL
FAILS TO PROVIDE THE NOTICE OF EXEMPTION TO SUCH EMPLOYER IN ACCORDANCE
WITH THIS SUBPARAGRAPH.
(B) (I) IF AN INDIVIDUAL WHO HAS BEEN ISSUED AN EXEMPTION FROM PAYING
PREMIUM CONTRIBUTIONS PURSUANT TO PARAGRAPH (A) OF THIS SUBDIVISION DUE
TO HAVING MAINTAINED PRIVATE LONG TERM CARE INSURANCE COVERAGE ON AN
UNINTERRUPTED BASIS CEASES TO HOLD PRIVATE LONG TERM CARE INSURANCE
COVERAGE, SUCH INDIVIDUAL SHALL NOTIFY THE DEPARTMENT AND SUCH INDIVID-
UAL'S EMPLOYER, IF ANY, OF THE TERMINATION OF SUCH PRIVATE LONG TERM
CARE INSURANCE COVERAGE WITHIN THIRTY DAYS OF SUCH TERMINATION. SUCH
NOTICE SHALL BE IN WRITING AND SUBMITTED IN SUCH FORM AND IN SUCH MANNER
AS THE DEPARTMENT SHALL PRESCRIBE FOR SUCH PURPOSE, AND SHALL STATE
WHETHER THE INDIVIDUAL INTENDS TO OBTAIN PRIVATE LONG TERM CARE INSUR-
ANCE COVERAGE WITHIN NINETY DAYS FOLLOWING THE CESSATION OF COVERAGE. IF
THE INDIVIDUAL SUBSEQUENTLY OBTAINS LONG TERM CARE INSURANCE COVERAGE
WITHIN SUCH NINETY-DAY PERIOD, THE INDIVIDUAL SHALL SO NOTIFY THE
DEPARTMENT AND THE INDIVIDUAL'S EMPLOYER, IF ANY.
A. 1499 14
(II) IN THE EVENT THAT AN INDIVIDUAL DESCRIBED IN SUBPARAGRAPH (I) OF
THIS PARAGRAPH CEASES TO HOLD PRIVATE LONG TERM CARE INSURANCE COVERAGE
FOR A PERIOD OF MORE THAN NINETY DAYS, THE EXEMPTION FROM PAYING PREMIUM
CONTRIBUTIONS ISSUED PURSUANT TO THIS SUBDIVISION SHALL BE AUTOMATICALLY
AND PERMANENTLY REVOKED AND SUCH INDIVIDUAL SHALL THEREAFTER BE RESPON-
SIBLE FOR THE PAYMENT OF ALL PREMIUM CONTRIBUTIONS REQUIRED PURSUANT TO
SUBDIVISION ONE OF THIS SECTION AND SHALL NO LONGER BE ELIGIBLE FOR ANY
NEW EXEMPTION UNDER THIS SUBDIVISION. THE INDIVIDUAL SHALL BE RESPONSI-
BLE FOR NOTIFYING THE DEPARTMENT AND THEIR EMPLOYER, IF ANY, IN THE
EVENT OF SUCH CESSATION OF COVERAGE FOR MORE THAN NINETY DAYS. ANY
PREMIUM CONTRIBUTIONS NOT PAID AFTER SUCH DATE SHALL BE SUBJECT TO SUCH
REASONABLE MONETARY PENALTIES AND INTEREST AS SHALL BE DETERMINED BY THE
DEPARTMENT AND MAY LEVY AN ADDITIONAL PREMIUM FOR THE REMAINDER OF THE
PERIOD OF COVERAGE.
(C) AN INDIVIDUAL RECEIVING AN EXEMPTION PURSUANT TO PARAGRAPH (A) OF
THIS SUBDIVISION, SHALL FORFEIT ANY AND ALL RIGHTS TO RECEIVE BENEFITS
UNDER THIS ARTICLE AND SHALL IN NO EVENT BE AN ELIGIBLE BENEFICIARY
UNDER THIS ARTICLE WHILE SUCH EXEMPTION IS IN EFFECT.
(D) AN EMPLOYER OF AN INDIVIDUAL WHOSE EXEMPTION IS REVOKED IN ACCORD-
ANCE WITH THIS SUBDIVISION SHALL NOT BE HELD LIABLE FOR A FAILURE TO
COLLECT PREMIUM CONTRIBUTIONS TO THE EXTENT SUCH EMPLOYER WAS NOT AWARE
OF SUCH CESSATION OF COVERAGE AND DID NOT HAVE REASON TO BE AWARE OF
SUCH CESSATION OF COVERAGE, PROVIDED THAT SUCH EXEMPTION FROM LIABILITY
SHALL TERMINATE WHEN SUCH EMPLOYER BECOMES SO AWARE.
(E) IF AN INDIVIDUAL WHO HAS BEEN ISSUED A NOTICE OF EXEMPTION FROM
PAYING PREMIUM CONTRIBUTIONS ON THE BASIS OF A STATUS LISTED IN CLAUSES
TWO THROUGH FIVE OF SUBPARAGRAPH (I) OF PARAGRAPH (A) OF THIS SUBDIVI-
SION, HAS A CHANGE OF STATUS WHICH WOULD RENDER THEM OTHERWISE SUBJECT
TO THE REQUIREMENTS OF SUBDIVISION ONE OF THIS SECTION, SUCH INDIVIDUAL
SHALL BE OBLIGATED TO SO INFORM THE DEPARTMENT AND THEIR EMPLOYER, IF
ANY, WITHIN THIRTY DAYS. THE EXEMPTION FROM PAYING PREMIUM CONTRIBUTIONS
ISSUED PURSUANT TO THIS SUBDIVISION SHALL BE DISCONTINUED AND SUCH INDI-
VIDUAL SHALL THEREAFTER BE RESPONSIBLE FOR THE PAYMENT OF ALL PREMIUM
CONTRIBUTIONS.
8. (A) BEGINNING ON JANUARY FIRST OF THE YEAR OCCURRING FIVE YEARS
AFTER THE EFFECTIVE DATE OF THIS ARTICLE, AN EMPLOYEE OR SELF-EMPLOYED
INDIVIDUAL WHO RELOCATES OUTSIDE OF THE STATE MAY ELECT TO CONTINUE
PARTICIPATION IN THE PROGRAM BY CONTINUING TO CONTRIBUTE PREMIUMS TO THE
LONG-TERM CARE SERVICES AND SUPPORTS TRUST FUND IF:
(I) THE EMPLOYEE OR SELF-EMPLOYED INDIVIDUAL HAS BEEN ASSESSED PREMI-
UMS FOR AT LEAST THREE YEARS IN WHICH THE EMPLOYEE OR SELF-EMPLOYED
INDIVIDUAL HAS WORKED AT LEAST FIVE HUNDRED HOURS IN EACH OF THOSE YEARS
IN THE STATE; AND
(II) THE EMPLOYEE OR SELF-EMPLOYED INDIVIDUAL NOTIFIES THE DEPARTMENT
AND THE DEPARTMENT OF TAXATION AND FINANCE WITHIN ONE YEAR OF ESTABLISH-
ING A PRIMARY RESIDENCE OUTSIDE OF THE STATE THAT THE EMPLOYEE OR SELF-
EMPLOYED INDIVIDUAL IS NO LONGER A RESIDENT OF THE STATE AND ELECTS TO
CONTINUE PARTICIPATION IN THE PROGRAM.
(B) OUT-OF-STATE PARTICIPANTS MUST REPORT THEIR WAGES OR SELF-EMPLOY-
MENT EARNINGS TO THE DEPARTMENT OF TAXATION AND FINANCE ACCORDING TO
PROCEDURES AS ESTABLISHED BY REGULATIONS OF THE DEPARTMENT OF TAXATION
AND FINANCE. AN OUT-OF-STATE PARTICIPANT MUST SUBMIT DOCUMENTATION TO
THE DEPARTMENT OF TAXATION AND FINANCE WHETHER OR NOT THE OUT-OF-STATE
PARTICIPANT EARNED WAGES OR SELF-EMPLOYMENT EARNINGS, AS APPLICABLE,
DURING THE APPLICABLE REPORTING PERIOD. WHEN AN OUT-OF-STATE PARTICIPANT
REACHES THE AGE OF SIXTY-SEVEN, THE PARTICIPANT IS NO LONGER REQUIRED TO
A. 1499 15
PROVIDE THE DOCUMENTATION OF THEIR WAGES OR SELF-EMPLOYMENT EARNINGS,
BUT IF THE PARTICIPANT EARNS WAGES OR SELF-EMPLOYMENT EARNINGS, THE
PARTICIPANT MUST SUBMIT REPORTS OF THOSE WAGES OR SELF-EMPLOYMENT EARN-
INGS AND REMIT THE REQUIRED PREMIUMS TO THE DEPARTMENT OF TAXATION AND
FINANCE.
(C) OUT-OF-STATE PARTICIPANTS MUST PROVIDE DOCUMENTATION OF WAGES AND
SELF-EMPLOYMENT EARNINGS EARNED AT THE TIME THAT THEY REPORT THEIR WAGES
OR SELF-EMPLOYMENT EARNINGS TO THE DEPARTMENT OF TAXATION AND FINANCE
WHICH SHALL TRANSMIT SUCH INFORMATION TO THE DEPARTMENT OF HEALTH FOR
PURPOSES OF DETERMINING ONGOING COVERAGE OF OUT-OF-STATE PARTICIPANTS
UNDER THE PROGRAM.
(D) THE DEPARTMENT OF HEALTH MAY CANCEL ELECTIVE COVERAGE IF THE OUT-
OF-STATE PARTICIPANT FAILS TO MAKE REQUIRED PAYMENTS OR SUBMIT REPORTS.
THE DEPARTMENT OF TAXATION AND FINANCE MAY COLLECT DUE AND UNPAID PREMI-
UMS AND MAY LEVY AN ADDITIONAL PREMIUM FOR THE REMAINDER OF THE PERIOD
OF COVERAGE. THE CANCELLATION MUST BE EFFECTIVE NO LATER THAN THIRTY
DAYS FROM THE DATE OF THE NOTICE IN WRITING ADVISING THE OUT-OF-STATE
PARTICIPANT OF THE CANCELLATION.
(E) THE DEPARTMENT OF TAXATION AND FINANCE SHALL:
(I) ADOPT STANDARDS BY RULE FOR THE MANNER AND TIMING OF REPORTING AND
DOCUMENTATION SUBMISSION FOR OUT-OF-STATE PARTICIPANTS. THE DEPARTMENT
MUST CONSIDER USER EXPERIENCE WITH THE WAGE AND SELF-EMPLOYMENT EARNINGS
REPORTING PROCESS AND THE DOCUMENT SUBMISSION PROCESS AND REGULARLY
UPDATE THE STANDARDS TO MINIMIZE THE PROCEDURAL BURDEN ON OUT-OF-STATE
PARTICIPANTS AND SUPPORT THE ACCURATE REPORTING OF WAGES AND SELF-EM-
PLOYMENT EARNINGS AT THE TIME OF THE PAYMENT OF PREMIUMS;
(II) COLLECT PREMIUMS FROM OUT-OF-STATE PARTICIPANTS WHO ELECT TO
CONTINUE PARTICIPATION IN THE PROGRAM; AND
(III) VERIFY THE WAGES OR SELF-EMPLOYMENT EARNINGS AS REPORTED BY AN
OUT-OF-STATE PARTICIPANT.
(F) FOR THE PURPOSES OF THIS SECTION, "WAGES" INCLUDES REMUNERATION
FOR SERVICES PERFORMED WITHIN OR WITHOUT OR BOTH WITHIN AND WITHOUT THIS
STATE.
(G) ENTITIES PROVIDING SERVICES TO AN ELIGIBLE BENEFICIARY OUTSIDE THE
STATE MAY NOT DISCRIMINATE BASED UPON RACE, GENDER, AGE, OR PREEXISTING
CONDITION.
(H) AN EMPLOYEE WHO RELOCATES OUT OF STATE MAY ELECT TO OPT OUT OF
COVERAGE BY NO LONGER REPORTING WAGES TO THE DEPARTMENT OF TAXATION AND
FINANCE RATHER THAN BECOME AN OUT-OF-STATE PARTICIPANT IN THE PROGRAM.
§ 3678. APPEALS AND APPEAL HEARINGS. 1. ANY APPLICANT OR RECIPIENT, OR
ANY INDIVIDUAL AUTHORIZED TO ACT ON BEHALF OF ANY SUCH APPLICANT OR
RECIPIENT, AND ANY LONG TERM CARE PROVIDER MAY APPEAL TO THE DEPARTMENT
FROM DETERMINATIONS OF DEPARTMENT OFFICIALS OR FAILURES TO MAKE DETERMI-
NATIONS UPON GROUNDS SPECIFIED IN SUBDIVISION FOUR OF THIS SECTION. THE
DEPARTMENT SHALL REVIEW THE APPEAL DE NOVO AND GIVE SUCH PERSON OR ENTI-
TY AN OPPORTUNITY FOR AN APPEAL HEARING. THE DEPARTMENT MAY ALSO, ON ITS
OWN MOTION, REVIEW ANY DECISION MADE OR ANY CASE IN WHICH A DECISION HAS
NOT BEEN MADE BY THE DEPARTMENT OFFICIAL WITHIN THE TIME SPECIFIED BY
LAW OR REGULATIONS OF THE DEPARTMENT. THE DEPARTMENT MAY MAKE SUCH ADDI-
TIONAL INVESTIGATION AS IT MAY DEEM NECESSARY, AND THE COMMISSIONER
SHALL MAKE SUCH DETERMINATION AS IS JUSTIFIED AND IN ACCORDANCE WITH
APPLICABLE LAW.
2. REGARDING ANY APPEAL PURSUANT TO THIS SECTION, WITH OR WITHOUT AN
APPEAL HEARING, THE COMMISSIONER MAY DESIGNATE AND AUTHORIZE ONE OR MORE
APPROPRIATE MEMBERS OF SUCH COMMISSIONER'S STAFF TO CONSIDER AND DECIDE
SUCH APPEALS. ANY STAFF MEMBER SO DESIGNATED SHALL BE AUTHORIZED TO
A. 1499 16
DECIDE SUCH APPEALS ON BEHALF OF THE COMMISSIONER WITH THE SAME FORCE
AND EFFECT AS IF THE COMMISSIONER HAD MADE SUCH DECISIONS. APPEAL HEAR-
INGS SHALL BE HELD ON BEHALF OF THE COMMISSIONER BY MEMBERS OF THEIR
STAFF WHO ARE EMPLOYED FOR SUCH PURPOSES OR WHO HAVE BEEN DESIGNATED AND
AUTHORIZED BY THE COMMISSIONER.
3. PERSONS ENTITLED TO APPEAL TO THE DEPARTMENT PURSUANT TO THIS
SECTION MUST INCLUDE:
(A) APPLICANTS FOR OR RECIPIENTS OF LONG TERM CARE BENEFITS UNDER THE
PROGRAM;
(B) LONG TERM CARE SERVICES AND SUPPORTS PROVIDERS; AND
(C) SUCH OTHER PERSONS AS THE COMMISSIONER MAY DEEM TO BE ENTITLED TO
AN OPPORTUNITY FOR AN APPEAL HEARING.
4. AN APPLICANT, BENEFICIARY, LONG TERM CARE PROVIDER, OR INDIVIDUAL
DENIED AN EXEMPTION, SHALL HAVE THE RIGHT TO APPEAL AT LEAST THE FOLLOW-
ING ISSUES:
(A) AN ELIGIBILITY DETERMINATION MADE IN ACCORDANCE WITH SECTION THIR-
TY-SIX HUNDRED SEVENTY-FIVE OF THIS ARTICLE, INCLUDING:
(I) AN INITIAL DETERMINATION AS TO WHETHER THE APPLICANT IS A QUALI-
FIED INDIVIDUAL;
(II) AN INITIAL DETERMINATION AS TO WHETHER THE APPLICANT IS AN ELIGI-
BLE BENEFICIARY, INCLUDING WHETHER:
(A) THE APPLICANT NEEDS ASSISTANCE WITH AT LEAST TWO ACTIVITIES OF
DAILY LIVING, OR FOR INDIVIDUALS WITH A DEMENTIA OR ALZHEIMER'S DIAGNO-
SIS, NEEDS AT LEAST SUPERVISION WITH MORE THAN ONE ACTIVITY OF DAILY
LIVING; AND/OR
(B) THE APPLICANT HAS EXHAUSTED THE LIFETIME BENEFIT LIMIT;
(III) A CONTINUING ELIGIBILITY DETERMINATION OR REDETERMINATION WITH
RESPECT TO A BENEFICIARY PURSUANT TO SUBDIVISION FIVE OF SECTION THIR-
TY-SIX HUNDRED SEVENTY-FIVE OF THIS ARTICLE;
(B) A FAILURE BY THE DEPARTMENT TO PROVIDE TIMELY WRITTEN NOTICE OF
ANY ELIGIBILITY DETERMINATION MADE IN ACCORDANCE WITH THIS ARTICLE, THIS
CHAPTER, OR ANY OTHER APPLICABLE LAW; AND
(C) A DETERMINATION WITH RESPECT TO A LONG TERM CARE PROVIDER, INCLUD-
ING:
(I) SUSPENSION, REVOCATION, LIMITATION OR ANNULMENT OF QUALIFICATION
FOR PARTICIPATION AS A PROVIDER UNDER THE PROGRAM;
(II) DISPUTES RELATING TO PAYMENTS AND REIMBURSEMENTS FOR APPROVED
SERVICES; AND
(III) ANY OTHER DETERMINATION THE COMMISSIONER DEEMS SUBJECT TO
APPEAL.
(D) A DETERMINATION TO DENY AN EXEMPTION FROM CONTRIBUTING TO THE
FUND.
5. THE DEPARTMENT MAY, SUBJECT TO THE DISCRETION OF THE COMMISSIONER,
PROMULGATE SUCH REGULATIONS, CONSISTENT WITH FEDERAL OR STATE LAW, AS
MAY BE NECESSARY TO IMPLEMENT THE PROVISIONS OF THIS SECTION.
6. REGARDING EVERY DECISION OF AN APPEAL PURSUANT TO THIS SECTION, THE
DEPARTMENT SHALL INFORM EVERY PARTY, AND THEIR REPRESENTATIVE, IF ANY,
OF THE AVAILABILITY OF JUDICIAL REVIEW AND THE TIME LIMITATION TO PURSUE
FUTURE REVIEW.
7. THE DEPARTMENT SHALL INCLUDE NOTICE OF THE RIGHT TO APPEAL AS
PROVIDED BY SUBDIVISION FOUR OF THIS SECTION AND INSTRUCTIONS REGARDING
HOW TO FILE AN APPEAL IN ANY ELIGIBILITY DETERMINATION ISSUED TO THE
APPLICANT OR ENROLLEE IN ACCORDANCE WITH APPLICABLE LAW. SUCH NOTICE
SHALL INCLUDE:
(A) AN EXPLANATION OF THE APPLICANT OR ENROLLEE'S APPEAL RIGHTS;
A. 1499 17
(B) A DESCRIPTION OF THE PROCEDURES BY WHICH THE APPLICANT OR ENROLLEE
MAY REQUEST AN APPEAL;
(C) INFORMATION ON THE APPLICANT OR ENROLLEE'S RIGHT TO REPRESENT
THEMSELF, OR TO BE REPRESENTED BY LEGAL COUNSEL OR ANOTHER REPRESEN-
TATIVE; AND
(D) AN EXPLANATION OF THE CIRCUMSTANCES UNDER WHICH THE APPELLANT'S
ELIGIBILITY MAY BE MAINTAINED OR REINSTATED PENDING AN APPEAL DECISION.
§ 3679. WAIVERS. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, THE
COMMISSIONER SHALL, TO THE EXTENT NECESSARY, DEVELOP AND SUBMIT ANY
APPROPRIATE WAIVERS, INCLUDING, BUT NOT LIMITED TO, THOSE AUTHORIZED
PURSUANT TO SECTIONS ELEVEN HUNDRED FIFTEEN AND NINETEEN HUNDRED FIFTEEN
OF THE FEDERAL SOCIAL SECURITY ACT, OR SUCCESSOR PROVISIONS, AND ANY
OTHER WAIVERS NECESSARY TO ACHIEVE THE PURPOSES OF HIGH QUALITY, INTE-
GRATED, AND COST EFFECTIVE CARE AND INTEGRATED FINANCIAL ELIGIBILITY
POLICIES UNDER THE MEDICAL ASSISTANCE PROGRAM OR PURSUANT TO TITLE XVIII
OF THE FEDERAL SOCIAL SECURITY ACT. COPIES OF SUCH ORIGINAL WAIVER
APPLICATIONS SHALL BE PROVIDED TO THE CHAIR OF THE SENATE FINANCE
COMMITTEE AND THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE SIMUL-
TANEOUSLY WITH THEIR SUBMISSION TO THE FEDERAL GOVERNMENT.
§ 3. The state finance law is amended by adding a new section 99-ss to
read as follows:
§ 99-SS. LONG TERM CARE TRUST FUND. 1. THERE IS HEREBY ESTABLISHED IN
THE JOINT CUSTODY OF THE COMPTROLLER AND THE COMMISSIONER OF TAXATION
AND FINANCE A SPECIAL FUND TO BE KNOWN AS THE "LONG TERM CARE TRUST
FUND".
2. SUCH FUND SHALL CONSIST OF ALL MONEYS COLLECTED BY THE DEPARTMENT
OF TAXATION AND FINANCE PURSUANT TO SECTION THIRTY-SIX HUNDRED SEVENTY-
SEVEN OF THE PUBLIC HEALTH LAW. ANY INTEREST EARNED BY THE INVESTMENT OF
MONEYS IN SUCH FUND SHALL BE ADDED TO SUCH FUND, BECOME A PART OF SUCH
FUND, AND BE USED FOR THE PURPOSE OF SUCH FUND.
3. MONEYS OF SUCH FUND SHALL ONLY BE USED FOR THE PURPOSES ESTABLISHED
UNDER ARTICLE THIRTY-SIX-B OF THE PUBLIC HEALTH LAW AND EXPENSES OF THE
STATE IN ADMINISTERING THE LONG TERM CARE TRUST PROGRAM AS DEFINED THER-
EIN. IN NO EVENT MAY EXPENDITURES BE USED TO SUPPLANT EXISTING STATE OR
LOCAL PROGRAMS WHICH FUND THE PROVISION OF APPROVED SERVICES.
4. THE MONEYS OF THE FUND SHALL BE PAID OUT ON THE AUDIT AND WARRANT
OF THE COMPTROLLER ON VOUCHERS CERTIFIED AND APPROVED BY THE COMMISSION-
ER OF THE DEPARTMENT OF HEALTH.
§ 4. The state finance law is amended by adding a new section 8-d to
read as follows:
§ 8-D. ADDITIONAL DUTIES OF THE COMPTROLLER; LONG TERM CARE TRUST
PROGRAM. 1. BEGINNING ON AND AFTER THE EFFECTIVE DATE OF THIS SECTION,
THE COMPTROLLER SHALL PROVIDE ALL NECESSARY ASSISTANCE, INCLUDING AUDIT-
ING AND ACTUARIAL SERVICES TO THE LONG TERM CARE TRUST COMMISSION ESTAB-
LISHED PURSUANT TO SECTION THIRTY-SIX HUNDRED SEVENTY-TWO OF THE PUBLIC
HEALTH LAW AND IN ACCORDANCE WITH ALL RELEVANT PROVISIONS OF ARTICLE
THIRTY-SIX-B OF THE PUBLIC HEALTH LAW, THE TAX LAW, THE LABOR LAW, AND
THIS CHAPTER.
2. BEGINNING ON NOVEMBER FIFTEENTH OF THE YEAR OCCURRING FOUR YEARS
AFTER THE EFFECTIVE DATE OF THIS SECTION, AND BIENNIALLY THEREAFTER, THE
COMPTROLLER SHALL PERFORM AN ACTUARIAL AUDIT AND VALUATION OF THE LONG
TERM CARE TRUST FUND ESTABLISHED PURSUANT TO SECTION NINETY-NINE-SS OF
THIS CHAPTER. SUCH BIENNIAL AUDIT AND VALUATION SHALL BE PREPARED AND
PUBLISHED IN CONJUNCTION WITH THE ANNUAL REPORT PREPARED BY THE LONG
TERM CARE TRUST COMMISSION PURSUANT TO SUBDIVISION SEVEN OF SECTION
THIRTY-SIX HUNDRED SEVENTY-TWO OF THE PUBLIC HEALTH LAW, AND SHALL BE
A. 1499 18
SUBMITTED TO THE LONG TERM CARE TRUST ADVISORY PANEL AND THE LEGISLA-
TURE. SUCH AUDIT AND VALUATION SHALL INCLUDE, BUT NOT BE LIMITED TO
RECOMMENDATIONS REGARDING ACTIONS NECESSARY TO MAINTAIN THE SOLVENCY OF
THE FUND; OPTIONS FOR ADJUSTMENTS TO THE BENEFIT UNIT, APPROVED
SERVICES, OR BOTH, TO THE EXTENT NECESSARY TO ELIMINATE UNFUNDED ACTUAR-
IALLY ACCRUED LIABILITY AND MAINTAIN SOLVENCY.
3. THE COMPTROLLER SHALL PERFORM SUCH ADDITIONAL OR MORE FREQUENT
ACTUARIAL AUDITS AND VALUATIONS OF THE LONG TERM CARE TRUST FUND UPON
REQUEST OF THE ADVISORY PANEL PURSUANT TO SECTION THIRTY-SIX HUNDRED
SEVENTY-THREE OF THE PUBLIC HEALTH LAW.
4. THE COMPTROLLER SHALL, NOT LATER THAN NOVEMBER FIFTEENTH OF THE
YEAR OCCURRING TEN YEARS AFTER THE EFFECTIVE DATE OF THIS SECTION,
CONDUCT A COMPREHENSIVE EVALUATION OF THE LONG TERM CARE TRUST PROGRAM
AND SHALL SUBMIT A REPORT, INCLUDING A CONCLUSION AND RECOMMENDATIONS
FOR IMPROVEMENT TO THE LEGISLATURE REGARDING:
(A) PROGRAM OPERATIONS, INCLUDING THE PERFORMANCE OF THE LONG TERM
CARE TRUST COMMISSION ESTABLISHED IN SECTION THIRTY-SIX HUNDRED SEVEN-
TY-TWO OF THE PUBLIC HEALTH LAW;
(B) THE FINANCIAL STATUS OF THE PROGRAM, INCLUDING SOLVENCY, THE VALUE
OF THE BENEFIT PROVIDED, AND THE FINANCIAL BALANCE OF PROGRAM BENEFITS
TO COSTS; AND
(C) THE OVERALL EFFICACY OF THE PROGRAM, BASED ON THE ESTABLISHED
GOALS UNDER ARTICLE THIRTY-SIX-B OF THE PUBLIC HEALTH LAW INCLUDING, BUT
NOT LIMITED TO:
(I) DELAYING MIDDLE CLASS FAMILIES' NEED TO SPEND TO POVERTY TO
RECEIVE MEDICAID FUNDED LONG TERM CARE;
(II) STRENGTHENING THE STATE ECONOMY THROUGH IMPROVING WORKFORCE
PARTICIPATION;
(III) REDUCING THE CASELOAD AND EXPENDITURES OF THE STATE MEDICAID
PROGRAM ON LONG TERM CARE; AND
(IV) OBTAINING SHARED SAVINGS THROUGH A MEDICAID DEMONSTRATION WAIVER,
OR THE IMPACT OF ANY WAIVER ENTERED INTO PURSUANT TO SECTION THIRTY-SIX
HUNDRED SEVENTY-NINE OF THE PUBLIC HEALTH LAW.
§ 5. Section 171-a of the tax law, as added by chapter 545 of the laws
of 1978, is amended by adding a new subdivision 6-c to read as follows:
(6-C) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY AND NOT
LATER THAN JANUARY FIRST OF THE YEAR BEGINNING ONE YEAR AFTER THE EFFEC-
TIVE DATE OF THIS SUBDIVISION, THE COMMISSIONER SHALL ENTER INTO A COOP-
ERATIVE AGREEMENT WITH THE DEPARTMENT OF HEALTH, AND THE DEPARTMENT OF
LABOR TO ALLOW THE INFORMATION OBTAINED BY THE DEPARTMENT PURSUANT TO
SUBDIVISION ONE OF THIS SECTION AND SECTION ONE HUNDRED SEVENTY-ONE-H OF
THIS ARTICLE TO BE MADE AVAILABLE TO SUCH DEPARTMENTS, OR OTHER INDIVID-
UALS DESIGNATED BY THE COMMISSIONERS OF SUCH DEPARTMENTS, FOR THE
PURPOSES OF DETERMINING AND VERIFYING WHETHER A PERSON IS A "QUALIFIED
INDIVIDUAL" FOR THE PURPOSES OF SECTION THIRTY-SIX HUNDRED SEVENTY-SEVEN
OF THE PUBLIC HEALTH LAW, OR FOR OTHER PURPOSES DEEMED APPROPRIATE BY
THE COMMISSIONERS OF HEALTH AND LABOR, CONSISTENT WITH THE PROVISIONS OF
ARTICLE THIRTY-SIX-B OF THE PUBLIC HEALTH LAW, THE STATE FINANCE LAW,
AND THE LABOR LAW, WITH RESPECT TO WHICH SUCH DEPARTMENTS HAVE REPORT-
ING, MONITORING, ADMINISTERING, OR EVALUATING RESPONSIBILITIES.
§ 6. Paragraph (e), subparagraph (iv) of paragraph (f) and paragraph
(g) of subdivision 4 of section 171-h of the tax law, paragraph (e) and
subparagraph (iv) of paragraph (f) as amended by chapter 214 of the laws
of 1998, paragraph (g) as amended by chapter 398 of the laws of 1997,
are amended and a new paragraph (h) is added to read as follows:
A. 1499 19
(e) conduct matches with the office of temporary and disability
assistance, the department of health, and the department of labor to
verify individuals' eligibility for the various programs specified under
section one thousand one hundred thirty-seven (b) of the social security
act and for other public assistance programs authorized by state law,
and for the purposes of administering state employment security
programs, AND FOR THE PURPOSES OF ADMINISTERING THE LONG TERM CARE TRUST
PROGRAM, and with the workers' compensation board for the purpose of
administering workers' compensation programs;
(iv) include such other matters as the parties to such agreement shall
deem necessary to carry out the provisions of this section; [and]
(g) furnish to the national directory of new hires, on a quarterly
basis, extracts of the reports required under paragraph six of
subsection (a) of section three hundred three of the federal social
security act to be made to the secretary of labor concerning wages and
unemployment compensation paid to individuals, by such dates, and in
such manner as the secretary of health and human services shall specify
by regulations. The [state] department of labor shall, consistent with
the authority contained in paragraph e of subdivision three of section
five hundred thirty-seven of the labor law, disclose to the state direc-
tory of new hires, such wage and unemployment compensation information
as may be necessary to allow such state directory to comply with the
provisions of this paragraph[.]; AND
(H) ON OR BEFORE JANUARY FIRST OF THE YEAR BEGINNING TWO YEARS AFTER
THE EFFECTIVE DATE OF THIS PARAGRAPH, ENTER INTO WRITTEN AGREEMENTS WITH
THE COMMISSIONERS OF HEALTH AND LABOR ON BEHALF OF THE DEPARTMENTS OF
HEALTH AND LABOR RESPECTIVELY, WHICH SHALL:
(I) PROVIDE FOR THE DISCLOSURE OF INFORMATION OBTAINED FROM THE
REPORTS REQUIRED TO BE SUBMITTED PURSUANT TO THIS SECTION TO SUCH
DEPARTMENTS AND BOARD FOR THE PURPOSES SET FORTH IN THIS SECTION;
(II) SPECIFY THE FREQUENCY WITH WHICH THE DEPARTMENT SHALL FURNISH
INFORMATION OBTAINED FROM SUCH REPORTS TO SUCH OFFICE, DEPARTMENTS, AND
BOARD, WHICH SHALL BE WITHIN ONE BUSINESS DAY AFTER THE DATE THE INFOR-
MATION IS ENTERED INTO THE STATE DIRECTORY OF NEW HIRES;
(III) SET FORTH THE PROCEDURE FOR REIMBURSEMENT OF THE DEPARTMENT BY
SUCH OFFICE, DEPARTMENTS, AND BOARD SUBJECT TO THE APPROVAL OF THE
DIRECTOR OF THE BUDGET FOR THE ADDITIONAL COSTS OF CARRYING OUT THE
PROVISIONS OF THIS SECTION; AND
(IV) INCLUDE SUCH OTHER MATTERS AS THE PARTIES TO SUCH AGREEMENT SHALL
DEEM NECESSARY TO CARRY OUT THE PROVISIONS OF THIS SECTION.
§ 7. Paragraph 4 of subsection (a) of section 674 of the tax law is
amended by adding a new subparagraph (D) to read as follows:
(D) THE PROVISIONS OF ARTICLE THIRTY-SIX-B OF THE PUBLIC HEALTH LAW
RELATING TO ADMINISTRATION OF THE STATE'S LONG TERM CARE TRUST PROGRAM
SHALL APPLY TO THE DEPARTMENT'S DUTIES UNDER THIS CHAPTER RELATING TO
EMPLOYEE PREMIUM INFORMATION, CONTRIBUTIONS AND PAYMENTS.
§ 8. Severability. If any provision or application of this act shall
be held to be invalid, or to violate or be inconsistent with any appli-
cable federal law or regulation, that shall not affect other provisions
or applications of this act which can be given effect without that
provision or application; and to that end, the provisions and applica-
tions of this act are severable.
§ 9. This act shall take effect immediately.