Bullet: The New York
Long-Term Care Compact Proposal
Wednesday, July 18, 2007
LTC Comment: New
York is considering a proposal that would revolutionize long-term care
financing. Our analysis,
draft report, and a late-breaking update after the ***news.***
TODAY'S LTC BULLET is sponsored by Gerald Dock, CEO of Greenhaven
Marketing Corporation in Anoka, MN.
We thank Jerry for supporting our coverage of the forthcoming LTC
Partnership Summit and for his creative idea that "frequent flyer
miles could be a method to increase members' support of the Center in a
fashion less costly to us and beneficial to the Center."
If you have frequent flyer miles from any airline that you'd like
to contribute to support the Center for Long-Term Care Reform's LTC
policy work, please contact Damon at 206-283-7036 or email@example.com.
Make a supplemental donation or use miles in lieu of your annual
membership dues. ***
*** SPEAKING OF THE LTC PARTNERSHIP SUMMIT:
Mark Meiners, Professor and Director of the Center for Health
Policy, Research & Ethics at George Mason University, has announced
the revival of the LTC Education Foundation (which previously put on the
original 17-year-running "Private LTC Insurance Conference")
for the purpose of sponsoring "The First Annual Partnership Summit:
Charting the Future of Long-Term Care Insurance" to be held August
1-2, 2007 in Arlington, VA. The
meeting begins with a "pre-conference" on July 31. For all the details and to register, go to http://www.gmu.edu/departments/chpre/ltcedfoundation/
and scroll right. ***
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Thank you. ***
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LTC BULLET: THE
NEW YORK LONG-TERM CARE COMPACT PROPOSAL
LTC Comment: A
description of the New York long-term care compact proposal excerpted
from our draft report on the subject follows below.
We invite Center for Long-Term Care Reform members to read the
full report in draft at http://www.centerltc.com/members/NY-LTC-CompactStudy-Draft.pdf.
You will need your user name and password to access this
material. Comments and
suggestions are welcome. Please
email them to email@example.com.
The draft was distributed to all study participants on May 31,
2007. We currently have
their feedback under review. We
will publish the final report near the end of July.
[Not yet a member of the Center, but you'd like to
see this report, the "Almanac of Long-Term Care" and the many
other content-rich features in The Zone?
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He'll zone you in immediately, give you a user name and password,
and start our popular e-letters coming to your email in-box daily.
Individual memberships are $150 per year or $12.50 per month.
Corporate memberships are negotiable.
Support the Center today.]
I would like to take this opportunity once again to
Campbell Jackson, MPH, CEBS, a private philanthropist from New York, NY,
for making our LTC Compact study possible.
Mr. Jackson has no economic ties to the long-term care insurance
or provider industries. He
responded immediately to our April 19, 2007 request
for support for this research: "LTC
Bullet: LTC Compact Study
Description of the New York LTC Compact Proposal:
(Following this excerpt from our report, you will
find a brief update on the current status of the LTC Compact
The LTC Compact proposes
to offer New Yorkers a new option to pay for long-term care. Under the Compact, a person who is chronically ill and needs
long-term care could become a Compact participant by pledging to spend
for qualified LTC services an amount equal to half his or her
non-housing assets (not counting the first $20,000 for someone with less
than $40,000 in total) or the cost of three years in a nursing home (circa
$300,000 depending on region of residence), whichever is less.
Upon spending the pledged amount for approved LTC services as
satisfactorily documented and verified, the Compact participant would
become a Compact beneficiary, eligible for a Compact subsidy. The Compact subsidy is an amount of payment for future LTC
services equal to the Medicaid rate for the same or a similar service.
A Compact beneficiary would be entitled to receive lifetime LTC
services funded by the Compact program at the Compact subsidy rate, in
accordance with an assessment of need and a plan of care, by paying out
of pocket an additional 10% of the Compact subsidy rate plus an annual
participation fee not to exceed 25% of personal income.
The benefits of
participation in the LTC Compact would be substantial as compared to
circumstances imposed by Medicaid eligibility.
Compact beneficiaries would preserve remaining resources after
the Compact pledge amount is satisfied.
They would endure no additional resource or income limitations
and no lien or estate recovery requirements as are imposed on Medicaid
recipients. They would have the right to purchase qualified services from
any willing provider at the Compact rate (i.e. the Compact subsidy plus
the beneficiary's 10% co-payment).
Compact participants could satisfy their required pledge amounts
and/or their service co-pays and annual participation fees by means of
private insurance policies, if they had the foresight to buy them while
they were still insurable. Such
policies would likely cost considerably less than coverage of their full
lifetime LTC liability in the absence of the Compact program.
Individuals who were refused long-term care insurance at least
twice could contribute, or have contributed on their behalf, up to
$10,000 per year into a tax-favored "qualified long term care
savings account" for purposes of planning ahead to fund their
pledge amount. Special
conditions and protections would apply for married Compact
The foregoing description
of the LTC Compact proposal is based on provisions in Senate Bill 00116
as "prefiled" January 3, 2007.
That bill specifies that operation of the Compact program would
be entirely conditional upon approval and receipt of federal financial
participation (i.e. Medicaid money) to help fund it. It authorizes a "program management entity" to
administer the Compact and specifies that such entity shall not be a
state agency. According to
the bill, an advisory committee would be appointed consisting of two
elder law attorneys, two senior advocates, two LTC providers, and two
LTC insurers. It also
provides for an education and outreach campaign in support of
the Compact. The
current bill contains restrictions on asset transfers done within three
years of applying for the Compact, except for participants who pledge
and satisfy the "maximum" pledge amount.
It contains no cap on protected home equity.
Therefore, it does not reflect changes made by the Deficit
Reduction Act of 2005 regarding asset transfers (e.g. five year look
back) and exempted home equity (capped at no more than $750,000) under
LTC Comment: Center
Members: If you would like
to see our analysis and critique of the LTC Compact, proceed now to the
draft report in The Zone at http://www.centerltc.com/members/NY-LTC-CompactStudy-Draft.pdf.
Following is a status report on the New York LTC
compact legislation as obtained and edited from information provided by
an expert on the scene in Albany, NY.
We requested permission to publish this information with
attribution but did not receive a reply.
The LTC Compact legislation (Senate116-A, Golden) was reported from committee to the Senate calendar, but did not pass the Senate. It was recommitted to the Senate Rules Committee on the last day of the Regular Legislative Session on June 21, 2007. (Senator Golden [R-Brooklyn] still Chairs the Senate Aging Committee.)
The Assembly companion bill, Assembly 8643-A (Englebright), was never reported from the Assembly Aging Committee. (Please note that Assembly member Steve Englebright (D-Suffolk), who was a major supporter of the LTC compact proposal, is no longer Chair of the Assembly Aging Committee, but is now Chair of the Assembly Tourism, Arts & Sports Development Committee. The new Chair of the Assembly Aging Committee is Assemblymember Jeffrey Dinowitz [D-Bronx]).
While the Legislature has technically adjourned for the summer, it will be coming back for several Special Sessions during the remainder of the year. The first such Special Session is supposed to be on Monday, July 16, 2007. It's doubtful that this bill will move in a Special Session, unless it becomes a negotiated "leaders item" which is unlikely.