§ 214 — Community services for the elderly

New York § 214

• Jurisdiction: New York
• Law ELD: Elder
• Title 1: State Office For the Aging
• Art. 2: Programs For the Elderly

Text

§ 214. Community services for the elderly. 1. Definitions. As used in\nthis section, the following words shall have the following meanings:\n (a) "Designated agency" shall mean an agency which is designated by\nthe chief executive officer of the county if there be one, or otherwise\nthe governing board of such county, or the chief executive officer of\nthe city of New York, or the governing board of an Indian tribal\ncouncil; which is either a unit of county government or the city of New\nYork or an Indian tribal organization or a private non-profit agency,\nand which is the area agency on aging created pursuant to the federal\nolder Americans act of 1965.\n (b) "Elderly person" shall mean a person sixty years of age or older.\n (c) "County" shall mean a county, as defined in section three of the\ncounty law, except that the city of New York shall be considered one\ncounty.\n (d) "Base year expenditures" and "base year services" shall mean the\nlevel of expenditures and services in the year prior to the first year\nfor which a county plan is submitted or in such county's two thousand\nfive fiscal year, whichever is greater.\n (e) "Community services" shall mean services for elderly persons which\nare provided by a public or governmental agency or non-profit agency,\nand which are provided in the home of an elderly person or in community\nsettings such as senior citizens centers, housing projects, or agency\noffices. Such services shall not include any services provided pursuant\nto the public health law other than home care services.\n (f) "Community service projects" shall mean community services\nfinanced pursuant to paragraph (b) of subdivision four of this section.\n (g) "County plan" shall mean a plan for community services prepared by\na county pursuant to this section.\n (h) "Non-profit agency" shall mean a corporation organized or existing\npursuant to the not-for-profit corporation law.\n (i) "Program year" shall mean the period from April first through\nMarch thirty-first of the following calendar year.\n (j) "First program year" for a county shall mean the initial year for\nwhich the county has received approval for its county plan.\n 2. County plans for improving the availability of community services\nto the elderly. (a) Counties with a designated agency are required to\nsubmit a county plan for a two-, three-, or four-year period determined\nby the director, with an annual update containing a budget request for\nthe forthcoming program year and such other information as shall be\nrequired by the director, for improving the delivery of community\nservices for elderly persons in the format prescribed by the director.\nThe plan for the city of New York shall specifically address the needs\nof each county within such city. Such plan shall be a comprehensive\ndescription of the manner in which the county intends to address the\nneeds of elderly persons living in the county through improved\ncoordination of existing community services and by the development of\nany new or expanded community service projects which will improve the\ndelivery of services to the elderly. Such plan shall contain:\n (1) a statement of goals and objectives for addressing the needs of\nelderly persons in the county, an assessment of the needs of elderly\npersons residing in the county, a description of public and private\nresources that currently provide community services to elderly persons\nwithin the county, a description of intended actions to consolidate and\ncoordinate existing community services administered by county\ngovernment, a description of the intended actions to coordinate\ncongregate services programs for the elderly operated within the county\npursuant to section two hundred seventeen of this title with other\ncommunity services for the elderly, a description of the means to\ncoordinate other community services for elderly persons in the county\nwith those administered by county government, and a statement of the\npriorities for the provision of community services during the program\nperiod covered by such plan;\n (2) an identification of community service projects to be developed to\nimprove the delivery of services, a budget request for approval for the\nforthcoming year which individually identifies each community service\nproject to be funded pursuant to paragraph (b) of subdivision four of\nthis section, letters of comment from the appropriate local agencies on\nthe relationship and expected impact of the proposed community service\nprojects, assurances that community service projects will provide\nservices to those most in need, an indication of fee schedules by which\nelderly persons participating in community service projects may\ncontribute to the costs of such projects, and an indication of how the\neffectiveness of such community service projects will be evaluated;\n (3) an identification of planning, coordination, and administrative\nactivities necessary to achieve the goals and objectives of the plan,\ntogether with a budget request for such activities for approval for the\nforthcoming year to be funded pursuant to paragraph (a) of subdivision\nfour of this section, and assurances by the county that it will comply\nwith the requirements of state and federal law; and\n (4) such other components as may be required pursuant to regulations\npromulgated by the director.\n (b) Such county plan for community services or annual update shall be\nprepared by the designated agency and approved by the chief executive\nofficer of the county, if there be one, or otherwise the governing board\nof the county, or the chief executive of the city of New York and\nsubmitted to the director no later than ninety days prior to the\nbeginning of the program period covered by such plan or annual update.\nPrior to a submission of a county plan or annual update to the director\nfor approval, the designated agency shall conduct such public hearings\nas may be required by regulations of the director, provided that there\nshall be at least one such hearing, and one in each county contained\nwithin the city of New York.\n (c) The director shall review such county plan and may approve or\ndisapprove such plan, or any part, program, or project within such plan,\nand shall propose such modifications and conditions as are deemed\nappropriate and necessary. Compliance with paragraphs (a) and (b) of\nthis subdivision shall be the basis for approval of a county plan. The\ndirector shall establish by regulation the dates for notifying the\ndesignated agency of approval or disapproval of a county plan. In the\nevent the director shall disapprove the proposed county plan, the county\nsubmitting such application shall be afforded an opportunity for an\nadjudicatory hearing, as prescribed by article three of the state\nadministrative procedure act.\n (d) Notwithstanding any provision of this section, nothing contained\nin this section shall give the director or a designated agency any\nadministrative, fiscal, supervisory, or other authority whatsoever over\nany plans, programs or expenditures authorized pursuant to titles\neighteen, nineteen and twenty of the federal social security act, or\nover any unit of state or local government.\n (e) Counties with a designated agency may submit to the director a\nletter of intent, in the form and by the date prescribed by the director\nwith the approval of the director of the budget, evidencing the\ncommitment of the county to develop a county home care plan for\nfunctionally impaired elderly.\n (f) Within the amounts appropriated therefor, counties submitting an\napproved letter of intent pursuant to paragraph (e) of this subdivision\nshall be eligible for reimbursement of one hundred percent of the\napproved expenditures for preparing a county home care plan for\nfunctionally impaired elderly. Such a grant-in-aid shall be available to\na county only once and shall be limited to one-half the amount available\nto such county pursuant to subparagraph one of paragraph (a) of\nsubdivision four of this section; provided however that in either of the\ntwo years immediately following its first submission of a home care plan\nfor functionally impaired elderly, a county which does not receive state\naid during such year for expanded non-medical in-home services,\nnon-institutional respite services, case management services, and\nancillary services pursuant to paragraph (j) of subdivision four of this\nsection, may apply for reimbursement of one hundred percent of the\napproved expenditures for revising such home care plan, limited to\none-quarter the amount available to such county pursuant to subparagraph\none of paragraph (a) of subdivision four of this section.\n (g) County home care plans for functionally impaired elderly prepared\npursuant to this subdivision shall include a comprehensive description\nof all aspects of home care, non-institutional respite, case management,\nand ancillary services available to elderly persons in the county; a\ndescription of intended actions to coordinate such home care,\nnon-institutional respite, case management, and ancillary services to\nfunctionally impaired elderly persons in their county provided under\nthis section with other services to elderly persons; a proposal for\nexpanded non-medical in-home services, non-institutional respite\nservices, case management services, and ancillary services for\nfunctionally impaired elderly persons with unmet needs to support such\npersons' continued residence in their homes; and such other components\nas may be required pursuant to regulations promulgated by the director,\nincluding how the proposed expanded non-medical in-home services,\nnon-institutional respite services, case management services, and\nancillary services will be delivered to unserved or underserved\npopulations.\n (h) Such county home care plan for functionally impaired elderly shall\nbe prepared by the designated agency after consultation with the social\nservices district and the local public health agency, and shall be\napproved by the chief executive officer of the county, if there be one,\nor otherwise the governing board of the county, or the chief executive\nof the city of New York, and submitted to the director for approval by\nsuch date as may be specified by regulation. The director shall not\napprove such county home care plan for functionally impaired elderly\nunless it complies with the standards and regulations issued pursuant to\nthis section.\n 3. Community service projects. (a) The director may authorize a county\nwhich has an approved county plan pursuant to this section to provide\none or more community service projects included in such approved plan\nwhich are designed to make community services and entitlement programs\nmore available and accessible to older persons through the improved\ncoordination and delivery of services for the elderly. As necessary to\nmeet project goals and objectives, such projects may provide new\nservices not previously provided within the county, expand services\nprovided during the base year, and establish new mechanisms to\ncoordinate all existing and new services.\n (b) Counties having an approved plan which includes one or more\ncommunity service projects shall be eligible for state aid, as provided\nin subdivision four of this section, for the provision of such projects\nidentified in such plan.\n (c) Each community service project included in a county plan shall\nclearly specify the intended goals and objectives of such project, shall\ndescribe the elderly population the project intends to serve, shall\nspecify a timetable not to exceed three years to achieve and evaluate\nsuch goals and objectives, and shall specify proposed methods to\nevaluate the effectiveness of such project.\n (d) The director, with the advice of the advisory committee for the\naging, shall promulgate regulations and issue guidelines for evaluating\nthe effectiveness and achievements of such community service projects,\nshall require periodic evaluations of each project, and shall make\navailable such evaluations to appropriate agencies, the governor and the\nlegislature.\n (e) No project funded pursuant to this section shall continue beyond\nthree years, unless approved by the director after the director is\nsatisfied that the project effectively improves the delivery of services\nto the elderly based upon periodic evaluations of the project.\n 4. State aid. (a) County plans for improving the availability of\ncommunity services to the elderly:\n (1) within the amounts appropriated therefor, counties with an\napproved county plan shall be eligible for reimbursement of one hundred\npercent of the annual approved expenditures for the preparation and\nrevision of such county plan, evaluation of projects contained within\nsuch county plan, execution of interagency agreements necessary to carry\nout the plan, actions to consolidate, combine or collocate services\nwithin the county, and such other costs of the designated agency\nnecessary to implement such county plan, provided that the total annual\namount payable to a county pursuant to this subparagraph shall not\nexceed the sum of one dollar for each elderly person residing in the\ncounty, or seventy-five thousand dollars, whichever is less, and further\nprovided that for the city of New York such amount shall not exceed one\ndollar for each elderly person residing in the city or three hundred\nseventy-five thousand dollars, whichever is less. Notwithstanding the\nforegoing limitations, counties with a population of less than twenty\nthousand elderly persons shall be eligible for reimbursement of one\nhundred percent of such annual approved expenditures provided that the\ntotal annual amount of such reimbursement per county shall not exceed\ntwenty thousand dollars.\n (2) within the amounts appropriated therefor, a county may receive a\ngrant-in-aid of up to twenty-five per centum of the total annual amount\nthat such county is eligible to receive pursuant to subparagraph one of\nthis paragraph for the cost of preparing an initial county plan in\naccordance with this section. Such a grant-in-aid shall be available to\na county only once and shall be in addition to the reimbursement\nreceived by the county pursuant to subparagraph one of this paragraph\nfor the first program year. A request for such a grant-in-aid shall be\naccompanied by a letter of intent in the form prescribed by the director\nevidencing the commitment of the county to develop a county plan for\ncommunity services and shall be submitted to the director at least six\nmonths prior to the beginning of the first program year.\n (b) Community service projects:\n (1) within the amounts appropriated therefor, counties having an\napproved county plan shall be eligible for reimbursement by the state\nfor expenditures for approved community service projects pursuant to\nthis section. Such state reimbursement shall not exceed thirty-three\nthousand six hundred dollars or four dollars twenty cents for each\nelderly person residing in the county, whichever is greater. The annual\nstate reimbursement eligibility shall be at a rate of seventy-five\npercent of the total annual expenditures for such approved programs.\n (2) the director shall provide by regulation that certain non-county\nmoneys and in-kind equivalents may be used to comprise the county share\nof such total annual approved expenditures, provided that such county\nshare shall not include cost-sharing received from elderly persons\nreceiving expanded non-medical in-home services, non-institutional\nrespite services, case management services, and ancillary services\npursuant to paragraph (k) of this subdivision or moneys received from\nthe federal government for services for the elderly allocated to the\nstates or local governments according to population or other such\nnon-competitive basis.\n (3) the director shall provide by regulation the requirements for any\nparticipant contributions and fee schedules used for community service\nprojects and the manner for the accounting and use of any such revenue.\n (c) Reimbursement pursuant to this section shall not be available for\nexpenditures for base year services otherwise provided without cost, or\nto replace base year expenditures made by the county or any other\nservice provider irrespective of the source of funds for such services.\n (d) Reimbursement shall not be available to community services\nprojects funded pursuant to paragraph (b) of this subdivision or to\nexpanded non-medical in-home services, non-institutional respite\nservices, case management services, and ancillary services funded\npursuant to paragraph (j) of this subdivision for services provided to\nelderly persons who are eligible for or are receiving services to meet\ntheir needs pursuant to titles eighteen, nineteen or twenty of the\nfederal social security act or any other governmental programs or for\nservices provided to residents in adult residential care facilities\nwhich had previously been provided by the facility or which are required\nby law to be provided by such facility.\n (e) For the purpose of determining the amount of state reimbursement\nfor which a county is eligible pursuant to this section, the last\npreceding federal census or other census data approved by the\ncomptroller shall be used. Funds appropriated by the state for the\npurpose of reimbursement for community services pursuant to this section\nshall be apportioned among the counties pursuant to the formula set\nforth in paragraph (b) of this subdivision by the director. Funds\nappropriated by the state for the purpose of reimbursement for expanded\nnon-medical in-home services, non-institutional respite services, case\nmanagement services, and ancillary services pursuant to this section\nshall be apportioned among the counties by the director pursuant to the\nformula set forth in paragraph (j) of this subdivision.\n (f) The comptroller may withhold the payment of state aid to any\ncounty in the event that such county alters or discontinues the\noperations approved by the director pursuant to this section or\notherwise fails to comply with the regulations or requirements of the\ndirector.\n (g) Counties shall submit claims for reimbursement after the end of\neach month or each quarter as required by and in accordance with\nprocedures prescribed by the director. Reimbursement shall be available\nfor approved expenditures incurred in accordance with an approved county\nplan for community services.\n (h) Reimbursement pursuant to subparagraph one of paragraph (b) or\nparagraph (j) of this subdivision shall not be available for\nexpenditures for community or expanded non-medical in-home services,\nnon-institutional respite services, case management services, and\nancillary services to elderly persons in the city of New York unless\nexpenditures for such services are apportioned for services in each of\nthe counties contained within such city in a manner which the director\nhas determined by regulation substantially reflects the proportion that\nthe number of elderly persons in that county bears to the total number\nof elderly persons in the city as a whole. In determining whether\nreimbursement shall be available under paragraph (g) of this\nsubdivision, the director shall ensure that expenditures were\napportioned in accordance with the provisions of this paragraph.\n (i) The director, within the amounts appropriated therefor and with\nthe approval of the director of the budget, may authorize a county which\nhas an approved home care plan for functionally impaired elderly to\nprovide expanded non-medical in-home services, non-institutional respite\nservices, case management services, and ancillary services pursuant to\nsuch plan. Such services shall be limited to those services necessary to\nmeet otherwise unmet needs and which support such elderly persons'\ncontinued residence in their homes. Needs will be determined pursuant to\na standardized evaluation of functional impairment, available resources\nand such other relevant factors specified pursuant to regulations\npromulgated by the director. No expanded non-medical in-home services,\nnon-institutional respite services, or ancillary services shall be\nprovided to any individual pursuant to this section unless such expanded\nnon-medical in-home services, non-institutional respite services, or\nancillary services are accompanied by ongoing case management services\nin accordance with regulations promulgated by the director.\n (j) Within the amounts appropriated therefor, counties authorized to\nprovide expanded non-medical in-home services, non-institutional respite\nservices, case management services, and ancillary services pursuant to\nparagraph (i) of this subdivision shall be eligible for reimbursement by\nthe state of up to seventy-five percent of allowable expenditures for\napproved services pursuant to this section up to the level authorized by\nthe director. The director shall not authorize a level of state\nreimbursement pursuant to this paragraph which exceeds the sum of\nninety-one thousand two hundred fifty dollars or seven dollars thirty\ncents for each elderly person residing in the county, whichever is\ngreater, and shall proportionately reduce such sum for each county in\nany years for which appropriations are not sufficient to fully fund\napproved expanded non-medical in-home services, non-institutional\nrespite services, case management services, and ancillary services for\nfunctionally impaired elderly in all counties with approved home care\nplans; provided however that in state fiscal years beginning on or after\nthe first day of April, two thousand five, the director, with the\napproval of the director of the budget, may authorize state\nreimbursement in excess of these levels to the extent appropriations are\navailable therefor.\n (k) The director, with the approval of the director of the budget,\nshall provide by regulation the extent of cost-sharing to be required of\nelderly persons receiving expanded non-medical in-home services,\nnon-institutional respite services, case management services, and\nancillary services pursuant to this section, which shall reflect such\nrecipients' means to pay for such services and which will not affect\ntheir ability to remain in their homes; provided however that the\ndirector shall not authorize or direct the withholding of state aid\npursuant to paragraph (f) of this subdivision prior to the first day of\nApril, two thousand five, based on any county's failure or inability to\ncomply with regulations promulgated pursuant to this paragraph. The full\namount of cost-sharing actually received by any county from elderly\npersons receiving expanded non-medical in-home services,\nnon-institutional respite services, case management services, and\nancillary services shall be used by such county to expand either such\ncounty's program of community services or such county's program of\nexpanded non-medical in-home services, non-institutional respite\nservices, case management services, and ancillary services pursuant to\nthis section.\n (l) Reimbursement pursuant to paragraph (j) of this subdivision shall\nnot be available for expenditures for base year services otherwise\nprovided without cost, or to replace base year expenditures made by the\ncounty or any other service provider irrespective of the source of\nfunds, or to replace community services expenditures pursuant to\nparagraph (b) of this subdivision.\n (m) Counties shall submit claims for reimbursement for expanded\nin-home services, non-institutional respite services, case management\nservices, and ancillary services to functionally impaired elderly as\nrequired by and in accordance with procedures prescribed by the\ndirector. Reimbursement shall be available for approved expenditures\nincurred in accordance with an approved county home care plan for\nfunctionally impaired elderly to the extent the director has authorized\nstate aid for such services pursuant to paragraph (i) of this\nsubdivision.\n (n) The director shall provide by regulation that certain non-county\nmoneys and in-kind equivalents may be used in part to compose the county\nshare of total allowable expenditures pursuant to paragraph (j) of this\nsubdivision, provided that such county share shall not include\ncost-sharing received from elderly persons receiving expanded\nnon-medical in-home services, non-institutional respite services, case\nmanagement services, and ancillary services pursuant to paragraph (k) of\nthis subdivision or moneys received from the federal government for\nservices for the elderly allocated to the states or local governments\naccording to population or other such non-competitive basis.\n 5. Contracts for services. (a) For the purposes of this section,\ncounties are authorized to contract with public agencies,\nmunicipalities, non-profit agencies, or such other entities as the\ndirector may authorize. Contracts for nursing services, home health aide\nservices, nutritional services (other than the delivery of meals),\nphysical, speech, and occupational therapy, and medical social services\nprovided pursuant to this section shall only be with certified home\nhealth agencies as defined in article thirty-six of the public health\nlaw.\n (b) Community services provided pursuant to this section shall not be\nprovided directly by the designated agency unless approval is granted by\nthe director. Such approval may not be given by the director unless the\ndesignated agency directly provided the service prior to approval of the\nannual county plan by the director, or unless it can be shown that the\ndirect provision of a community service by the designated agency is\nnecessary due to the absence of an existing suitable provider to assure\nan adequate supply of such service, or to ensure the quality of the\nservice provided.\n (c) Pursuant to an agreement, two or more counties may join together\nfor the purposes of this section. Such agreements shall make provision\nfor the proportionate cost to be borne by each county, the employment of\npersonnel, the receipt and disbursement of funds, and any other matters\ndeemed necessary by the director. Claims for reimbursement pursuant to\nsubdivision four of this section shall be paid to each county and shall\nbe limited to the amount to which each county would be entitled pursuant\nto such subdivision.\n 6. Implementation of home care plans. Within the amounts appropriated\ntherefor, counties authorized to provide expanded non-medical in-home\nservices, non-institutional respite services, case management services,\nand ancillary services pursuant to paragraph (i) of subdivision four of\nthis section shall be eligible for reimbursement by the state of one\nhundred percent of allowable expenditures for implementing the approved\ncounty home care plan for functionally impaired elderly, limited to a\nsum equivalent to the amount available to such county pursuant to\nsubparagraph one of paragraph (a) of subdivision four of this section.\n 7. For the purposes of obtaining state aid within the amounts\nappropriated therefor under this section, a designated agency of an\nIndian tribal organization shall qualify as though it were a designated\nagency for a county.\n