Section 210-RICR-50-00-6.10 - Asset Transfer Involving Personal Service/Caregiver ContractsA. A personal service or caregiver contract is a formal written agreement between an applicant or beneficiary and an individual service/care provider. Under the terms of the contract, the service/care provider agrees to provide personal and/or managerial services in exchange for compensation paid by applicant or beneficiary who receives the services over a set period of time. Typically, the caregiver is, but is not required to be, an adult family member or friend of the applicant and the services covered range from home chores (such as housecleaning, grocery shopping, laundry, shoveling and like) to assisting with personal care needs (transportation to medical appointments, aiding in dressing and grooming, and so forth).B. Personal service/caregiver contracts are not a countable resource for Medicaid LTSS purposes. The purchase price - the amount to be paid over the life of the contract - is a treated as a transfer of assets under the DRA. Accordingly, the State is required to determine whether a personal service/caregiver contract is a transaction made for less than FMV that constitutes a disqualifying transfer. The State makes this determination as follows: 1. Disqualifying transfer - A personal service/care contract is a disqualifying transfer if the payments are for services performed before the date of the transaction. A lump sum payment for services provided in the past is, therefore, a transfer for less than FMV. A contract for requires payment at the time the services/care are rendered is a disqualifying transfer if the services/care are covered by Medicaid or another third (3rd) party payer, or for a person other than a non-LTSS spouse, dependent child, or dependent with disabilities that has no alternative form of coverage. In addition, a contract that requires payment upfront at the time of the transaction for service/care to be provided at some point in the future is treated as a disqualifying transfer unless proof is provided that the services/care will not be covered by Medicaid or another third (3rd) party at the time they are rendered. All contracts based on the promise of services performed in the future are treated as disqualifying transfers if FMV cannot be discerned in accordance with §6.6.1(H) of this Part.2. Allowed transfer - A personal service/caregiver contract is an allowed transfer if the agreement is in writing, the payment is for services/care provided prospectively (after the contract is executed) and at the time they are performed, and the compensation for services/care provided is reasonable -- commensurate with the wage scale or customary fees that would be paid typically to a third (3rd) party performing for the same services/care in the State. Also, the services/care to paid for under the contract must not be covered by Medicaid or another third (3rd) party payer. To ensure there is no overlapping coverage, the contract must specify the types of services/care to be provided, the location, and how often, as well as a start and end date, the form and frequency of compensation, the terms for altering the contract and the signatures of the parties involved. An agreement that include these elements may be treated as a disqualifying transfer if the State determines the payments are being used for purposes other than those specified in the contract or made to persons or entities other than the persons or entities identified as the service/care provider(s) under the contract.210 R.I. Code R. 210-RICR-50-00-6.10
Adopted effective 1/20/2019
Amended effective 7/21/2021