New York City and Medicaid Subsidized Home Health Care
Under New York Medicaid rules recipients have to surrender excess Social Security payments over a set maximum of their subsidized payments from Medicaid for a home-health care worker. Betsy J. Segal, an administrative law judge with the State's Department of Health ruled that money in excess of the maximum can be left in a separate trust for the recipient as long as the trust was used specifically to pay the individual's rent, food and other daily living expenses.
In New York City, the Human Resources Administration oversees the Medicaid program. In the case in question, an elderly New Yorker who was identified only as M.O. was ordered to pay the difference between his Social Security check and the maximum that the agency deemed allowable before any excess had to go to the cost of his home-health care worker. In his case he received a Social Security check for $1,078.70 which was well above the $642 maximum for subsidized visits for the worker.
According to M.O.'s lawyer, Aytan Y. Bellin, the rent on his apartment was $2,160.51. Even though his former wife was helping out with some of his expenses, the man would not be able to live at home on just $642 a month. In effect the $358.01 that could be spent towards his rent and food would help towards keeping him at home instead of having to go to a nursing home. By keeping him out of a nursing home, Mr Belin stated that the city was in effect saving a lot of money since on average, according to Mr. Bellin in speaking about Medicaid: "But they'll allow you to move into a nursing home where they'll be paying, on average in New York, $8,695 per month."
M.O. suffered from dementia and needs 12 hours of home health aid a day. The excess of $358.01 was placed in a trust administered by Nysarc, a nonprofit group that provides services for the disabled in New York. Mr. Bellin argued that federal law allows Medicaid recipients to shelter some income in a trust as long as it goes towards basics such as rent, food, electrical and gas bills and telephone services.
In 2000 there were 630,557 people 65 or older in New York y with reported incomes of $18,000 or less, according to an analysis of Census Bureau figures by the Queens College Department of Sociology. It is uncertain as to whether or not the ruling applies to the rest of New York state.
FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN SELECTING A NURSING HOME SEE OUR ARTICLE "How to Select a Nursing Home"
By Allan Rubin
posted June 11, 2004
http://www.therubins.com
e-mail: hrubin12@nyc.rr.com rubin@brainlink.com