Estate planners in New  York do a lot of things that aren't common in the rest of the country, although the desire to go on welfare seems to be national.  Medicaid doesn't sell anyone's home, they just have a lien on the proceeds if they have paid out benefits, and sometimes the lien is for more than their actual payments.  

Your client advised his attorney that he wanted the state to pay his final expenses so his children could enjoy his wealth.  Irrevocable trusts are used for that  instead, in many states.  There are tax consequences to those, also, although gift tax is not really an issue for 99% of people. It's like laws prohibiting cannabis or cohabitation, no one is going to enforce them.