N.Y. Elder Law § 214: Community services for the elderly

§ 214. Community services for the elderly. 1. Definitions. As used in

this section, the following words shall have the following meanings:

(a) "Designated agency" shall mean an agency which is designated by

the chief executive officer of the county if there be one, or otherwise

the governing board of such county, or the chief executive officer of

the city of New York, or the governing board of an Indian tribal

council; which is either a unit of county government or the city of New

York or an Indian tribal organization or a private non-profit agency,

and which is the area agency on aging created pursuant to the federal

older Americans act of 1965.

(b) "Elderly person" shall mean a person sixty years of age or older.

(c) "County" shall mean a county, as defined in section three of the

county law, except that the city of New York shall be considered one

county.

(d) "Base year expenditures" and "base year services" shall mean the

level of expenditures and services in the year prior to the first year

for which a county plan is submitted or in such county's two thousand

five fiscal year, whichever is greater.

(e) "Community services" shall mean services for elderly persons which

are provided by a public or governmental agency or non-profit agency,

and which are provided in the home of an elderly person or in community

settings such as senior citizens centers, housing projects, or agency

offices. Such services shall not include any services provided pursuant

to the public health law other than home care services.

(f) "Community service projects" shall mean community services

financed pursuant to paragraph (b) of subdivision four of this section.

(g) "County plan" shall mean a plan for community services prepared by

a county pursuant to this section.

(h) "Non-profit agency" shall mean a corporation organized or existing

pursuant to the not-for-profit corporation law.

(i) "Program year" shall mean the period from April first through

March thirty-first of the following calendar year.

(j) "First program year" for a county shall mean the initial year for

which the county has received approval for its county plan.

2. County plans for improving the availability of community services

to the elderly. (a) Counties with a designated agency are required to

submit a county plan for a two-, three-, or four-year period determined

by the director, with an annual update containing a budget request for

the forthcoming program year and such other information as shall be

required by the director, for improving the delivery of community

services for elderly persons in the format prescribed by the director.

The plan for the city of New York shall specifically address the needs

of each county within such city. Such plan shall be a comprehensive

description of the manner in which the county intends to address the

needs of elderly persons living in the county through improved

coordination of existing community services and by the development of

any new or expanded community service projects which will improve the

delivery of services to the elderly. Such plan shall contain:

(1) a statement of goals and objectives for addressing the needs of

elderly persons in the county, an assessment of the needs of elderly

persons residing in the county, a description of public and private

resources that currently provide community services to elderly persons

within the county, a description of intended actions to consolidate and

coordinate existing community services administered by county

government, a description of the intended actions to coordinate

congregate services programs for the elderly operated within the county

pursuant to section two hundred seventeen of this title with other

community services for the elderly, a description of the means to

coordinate other community services for elderly persons in the county

with those administered by county government, and a statement of the

priorities for the provision of community services during the program

period covered by such plan;

(2) an identification of community service projects to be developed to

improve the delivery of services, a budget request for approval for the

forthcoming year which individually identifies each community service

project to be funded pursuant to paragraph (b) of subdivision four of

this section, letters of comment from the appropriate local agencies on

the relationship and expected impact of the proposed community service

projects, assurances that community service projects will provide

services to those most in need, an indication of fee schedules by which

elderly persons participating in community service projects may

contribute to the costs of such projects, and an indication of how the

effectiveness of such community service projects will be evaluated;

(3) an identification of planning, coordination, and administrative

activities necessary to achieve the goals and objectives of the plan,

together with a budget request for such activities for approval for the

forthcoming year to be funded pursuant to paragraph (a) of subdivision

four of this section, and assurances by the county that it will comply

with the requirements of state and federal law; and

(4) such other components as may be required pursuant to regulations

promulgated by the director.

(b) Such county plan for community services or annual update shall be

prepared by the designated agency and approved by the chief executive

officer of the county, if there be one, or otherwise the governing board

of the county, or the chief executive of the city of New York and

submitted to the director no later than ninety days prior to the

beginning of the program period covered by such plan or annual update.

Prior to a submission of a county plan or annual update to the director

for approval, the designated agency shall conduct such public hearings

as may be required by regulations of the director, provided that there

shall be at least one such hearing, and one in each county contained

within the city of New York.

(c) The director shall review such county plan and may approve or

disapprove such plan, or any part, program, or project within such plan,

and shall propose such modifications and conditions as are deemed

appropriate and necessary. Compliance with paragraphs (a) and (b) of

this subdivision shall be the basis for approval of a county plan. The

director shall establish by regulation the dates for notifying the

designated agency of approval or disapproval of a county plan. In the

event the director shall disapprove the proposed county plan, the county

submitting such application shall be afforded an opportunity for an

adjudicatory hearing, as prescribed by article three of the state

administrative procedure act.

(d) Notwithstanding any provision of this section, nothing contained

in this section shall give the director or a designated agency any

administrative, fiscal, supervisory, or other authority whatsoever over

any plans, programs or expenditures authorized pursuant to titles

eighteen, nineteen and twenty of the federal social security act, or

over any unit of state or local government.

(e) Counties with a designated agency may submit to the director a

letter of intent, in the form and by the date prescribed by the director

with the approval of the director of the budget, evidencing the

commitment of the county to develop a county home care plan for

functionally impaired elderly.

(f) Within the amounts appropriated therefor, counties submitting an

approved letter of intent pursuant to paragraph (e) of this subdivision

shall be eligible for reimbursement of one hundred percent of the

approved expenditures for preparing a county home care plan for

functionally impaired elderly. Such a grant-in-aid shall be available to

a county only once and shall be limited to one-half the amount available

to such county pursuant to subparagraph one of paragraph (a) of

subdivision four of this section; provided however that in either of the

two years immediately following its first submission of a home care plan

for functionally impaired elderly, a county which does not receive state

aid during such year for expanded non-medical in-home services,

non-institutional respite services, case management services, and

ancillary services pursuant to paragraph (j) of subdivision four of this

section, may apply for reimbursement of one hundred percent of the

approved expenditures for revising such home care plan, limited to

one-quarter the amount available to such county pursuant to subparagraph

one of paragraph (a) of subdivision four of this section.

(g) County home care plans for functionally impaired elderly prepared

pursuant to this subdivision shall include a comprehensive description

of all aspects of home care, non-institutional respite, case management,

and ancillary services available to elderly persons in the county; a

description of intended actions to coordinate such home care,

non-institutional respite, case management, and ancillary services to

functionally impaired elderly persons in their county provided under

this section with other services to elderly persons; a proposal for

expanded non-medical in-home services, non-institutional respite

services, case management services, and ancillary services for

functionally impaired elderly persons with unmet needs to support such

persons' continued residence in their homes; and such other components

as may be required pursuant to regulations promulgated by the director,

including how the proposed expanded non-medical in-home services,

non-institutional respite services, case management services, and

ancillary services will be delivered to unserved or underserved

populations.

(h) Such county home care plan for functionally impaired elderly shall

be prepared by the designated agency after consultation with the social

services district and the local public health agency, and shall be

approved by the chief executive officer of the county, if there be one,

or otherwise the governing board of the county, or the chief executive

of the city of New York, and submitted to the director for approval by

such date as may be specified by regulation. The director shall not

approve such county home care plan for functionally impaired elderly

unless it complies with the standards and regulations issued pursuant to

this section.

3. Community service projects. (a) The director may authorize a county

which has an approved county plan pursuant to this section to provide

one or more community service projects included in such approved plan

which are designed to make community services and entitlement programs

more available and accessible to older persons through the improved

coordination and delivery of services for the elderly. As necessary to

meet project goals and objectives, such projects may provide new

services not previously provided within the county, expand services

provided during the base year, and establish new mechanisms to

coordinate all existing and new services.

(b) Counties having an approved plan which includes one or more

community service projects shall be eligible for state aid, as provided

in subdivision four of this section, for the provision of such projects

identified in such plan.

(c) Each community service project included in a county plan shall

clearly specify the intended goals and objectives of such project, shall

describe the elderly population the project intends to serve, shall

specify a timetable not to exceed three years to achieve and evaluate

such goals and objectives, and shall specify proposed methods to

evaluate the effectiveness of such project.

(d) The director, with the advice of the advisory committee for the

aging, shall promulgate regulations and issue guidelines for evaluating

the effectiveness and achievements of such community service projects,

shall require periodic evaluations of each project, and shall make

available such evaluations to appropriate agencies, the governor and the

legislature.

(e) No project funded pursuant to this section shall continue beyond

three years, unless approved by the director after the director is

satisfied that the project effectively improves the delivery of services

to the elderly based upon periodic evaluations of the project.

4. State aid. (a) County plans for improving the availability of

community services to the elderly:

(1) within the amounts appropriated therefor, counties with an

approved county plan shall be eligible for reimbursement of one hundred

percent of the annual approved expenditures for the preparation and

revision of such county plan, evaluation of projects contained within

such county plan, execution of interagency agreements necessary to carry

out the plan, actions to consolidate, combine or collocate services

within the county, and such other costs of the designated agency

necessary to implement such county plan, provided that the total annual

amount payable to a county pursuant to this subparagraph shall not

exceed the sum of one dollar for each elderly person residing in the

county, or seventy-five thousand dollars, whichever is less, and further

provided that for the city of New York such amount shall not exceed one

dollar for each elderly person residing in the city or three hundred

seventy-five thousand dollars, whichever is less. Notwithstanding the

foregoing limitations, counties with a population of less than twenty

thousand elderly persons shall be eligible for reimbursement of one

hundred percent of such annual approved expenditures provided that the

total annual amount of such reimbursement per county shall not exceed

twenty thousand dollars.

(2) within the amounts appropriated therefor, a county may receive a

grant-in-aid of up to twenty-five per centum of the total annual amount

that such county is eligible to receive pursuant to subparagraph one of

this paragraph for the cost of preparing an initial county plan in

accordance with this section. Such a grant-in-aid shall be available to

a county only once and shall be in addition to the reimbursement

received by the county pursuant to subparagraph one of this paragraph

for the first program year. A request for such a grant-in-aid shall be

accompanied by a letter of intent in the form prescribed by the director

evidencing the commitment of the county to develop a county plan for

community services and shall be submitted to the director at least six

months prior to the beginning of the first program year.

(b) Community service projects:

(1) within the amounts appropriated therefor, counties having an

approved county plan shall be eligible for reimbursement by the state

for expenditures for approved community service projects pursuant to

this section. Such state reimbursement shall not exceed thirty-three

thousand six hundred dollars or four dollars twenty cents for each

elderly person residing in the county, whichever is greater. The annual

state reimbursement eligibility shall be at a rate of seventy-five

percent of the total annual expenditures for such approved programs.

(2) the director shall provide by regulation that certain non-county

moneys and in-kind equivalents may be used to comprise the county share

of such total annual approved expenditures, provided that such county

share shall not include cost-sharing received from elderly persons

receiving expanded non-medical in-home services, non-institutional

respite services, case management services, and ancillary services

pursuant to paragraph (k) of this subdivision or moneys received from

the federal government for services for the elderly allocated to the

states or local governments according to population or other such

non-competitive basis.

(3) the director shall provide by regulation the requirements for any

participant contributions and fee schedules used for community service

projects and the manner for the accounting and use of any such revenue.

(c) Reimbursement pursuant to this section shall not be available for

expenditures for base year services otherwise provided without cost, or

to replace base year expenditures made by the county or any other

service provider irrespective of the source of funds for such services.

(d) Reimbursement shall not be available to community services

projects funded pursuant to paragraph (b) of this subdivision or to

expanded non-medical in-home services, non-institutional respite

services, case management services, and ancillary services funded

pursuant to paragraph (j) of this subdivision for services provided to

elderly persons who are eligible for or are receiving services to meet

their needs pursuant to titles eighteen, nineteen or twenty of the

federal social security act or any other governmental programs or for

services provided to residents in adult residential care facilities

which had previously been provided by the facility or which are required

by law to be provided by such facility.

(e) For the purpose of determining the amount of state reimbursement

for which a county is eligible pursuant to this section, the last

preceding federal census or other census data approved by the

comptroller shall be used. Funds appropriated by the state for the

purpose of reimbursement for community services pursuant to this section

shall be apportioned among the counties pursuant to the formula set

forth in paragraph (b) of this subdivision by the director. Funds

appropriated by the state for the purpose of reimbursement for expanded

non-medical in-home services, non-institutional respite services, case

management services, and ancillary services pursuant to this section

shall be apportioned among the counties by the director pursuant to the

formula set forth in paragraph (j) of this subdivision.

(f) The comptroller may withhold the payment of state aid to any

county in the event that such county alters or discontinues the

operations approved by the director pursuant to this section or

otherwise fails to comply with the regulations or requirements of the

director.

(g) Counties shall submit claims for reimbursement after the end of

each month or each quarter as required by and in accordance with

procedures prescribed by the director. Reimbursement shall be available

for approved expenditures incurred in accordance with an approved county

plan for community services.

(h) Reimbursement pursuant to subparagraph one of paragraph (b) or

paragraph (j) of this subdivision shall not be available for

expenditures for community or expanded non-medical in-home services,

non-institutional respite services, case management services, and

ancillary services to elderly persons in the city of New York unless

expenditures for such services are apportioned for services in each of

the counties contained within such city in a manner which the director

has determined by regulation substantially reflects the proportion that

the number of elderly persons in that county bears to the total number

of elderly persons in the city as a whole. In determining whether

reimbursement shall be available under paragraph (g) of this

subdivision, the director shall ensure that expenditures were

apportioned in accordance with the provisions of this paragraph.

(i) The director, within the amounts appropriated therefor and with

the approval of the director of the budget, may authorize a county which

has an approved home care plan for functionally impaired elderly to

provide expanded non-medical in-home services, non-institutional respite

services, case management services, and ancillary services pursuant to

such plan. Such services shall be limited to those services necessary to

meet otherwise unmet needs and which support such elderly persons'

continued residence in their homes. Needs will be determined pursuant to

a standardized evaluation of functional impairment, available resources

and such other relevant factors specified pursuant to regulations

promulgated by the director. No expanded non-medical in-home services,

non-institutional respite services, or ancillary services shall be

provided to any individual pursuant to this section unless such expanded

non-medical in-home services, non-institutional respite services, or

ancillary services are accompanied by ongoing case management services

in accordance with regulations promulgated by the director.

(j) Within the amounts appropriated therefor, counties authorized to

provide expanded non-medical in-home services, non-institutional respite

services, case management services, and ancillary services pursuant to

paragraph (i) of this subdivision shall be eligible for reimbursement by

the state of up to seventy-five percent of allowable expenditures for

approved services pursuant to this section up to the level authorized by

the director. The director shall not authorize a level of state

reimbursement pursuant to this paragraph which exceeds the sum of

ninety-one thousand two hundred fifty dollars or seven dollars thirty

cents for each elderly person residing in the county, whichever is

greater, and shall proportionately reduce such sum for each county in

any years for which appropriations are not sufficient to fully fund

approved expanded non-medical in-home services, non-institutional

respite services, case management services, and ancillary services for

functionally impaired elderly in all counties with approved home care

plans; provided however that in state fiscal years beginning on or after

the first day of April, two thousand five, the director, with the

approval of the director of the budget, may authorize state

reimbursement in excess of these levels to the extent appropriations are

available therefor.

(k) The director, with the approval of the director of the budget,

shall provide by regulation the extent of cost-sharing to be required of

elderly persons receiving expanded non-medical in-home services,

non-institutional respite services, case management services, and

ancillary services pursuant to this section, which shall reflect such

recipients' means to pay for such services and which will not affect

their ability to remain in their homes; provided however that the

director shall not authorize or direct the withholding of state aid

pursuant to paragraph (f) of this subdivision prior to the first day of

April, two thousand five, based on any county's failure or inability to

comply with regulations promulgated pursuant to this paragraph. The full

amount of cost-sharing actually received by any county from elderly

persons receiving expanded non-medical in-home services,

non-institutional respite services, case management services, and

ancillary services shall be used by such county to expand either such

county's program of community services or such county's program of

expanded non-medical in-home services, non-institutional respite

services, case management services, and ancillary services pursuant to

this section.

(l) Reimbursement pursuant to paragraph (j) of this subdivision shall

not be available for expenditures for base year services otherwise

provided without cost, or to replace base year expenditures made by the

county or any other service provider irrespective of the source of

funds, or to replace community services expenditures pursuant to

paragraph (b) of this subdivision.

(m) Counties shall submit claims for reimbursement for expanded

in-home services, non-institutional respite services, case management

services, and ancillary services to functionally impaired elderly as

required by and in accordance with procedures prescribed by the

director. Reimbursement shall be available for approved expenditures

incurred in accordance with an approved county home care plan for

functionally impaired elderly to the extent the director has authorized

state aid for such services pursuant to paragraph (i) of this

subdivision.

(n) The director shall provide by regulation that certain non-county

moneys and in-kind equivalents may be used in part to compose the county

share of total allowable expenditures pursuant to paragraph (j) of this

subdivision, provided that such county share shall not include

cost-sharing received from elderly persons receiving expanded

non-medical in-home services, non-institutional respite services, case

management services, and ancillary services pursuant to paragraph (k) of

this subdivision or moneys received from the federal government for

services for the elderly allocated to the states or local governments

according to population or other such non-competitive basis.

5. Contracts for services. (a) For the purposes of this section,

counties are authorized to contract with public agencies,

municipalities, non-profit agencies, or such other entities as the

director may authorize. Contracts for nursing services, home health aide

services, nutritional services (other than the delivery of meals),

physical, speech, and occupational therapy, and medical social services

provided pursuant to this section shall only be with certified home

health agencies as defined in article thirty-six of the public health

law.

(b) Community services provided pursuant to this section shall not be

provided directly by the designated agency unless approval is granted by

the director. Such approval may not be given by the director unless the

designated agency directly provided the service prior to approval of the

annual county plan by the director, or unless it can be shown that the

direct provision of a community service by the designated agency is

necessary due to the absence of an existing suitable provider to assure

an adequate supply of such service, or to ensure the quality of the

service provided.

(c) Pursuant to an agreement, two or more counties may join together

for the purposes of this section. Such agreements shall make provision

for the proportionate cost to be borne by each county, the employment of

personnel, the receipt and disbursement of funds, and any other matters

deemed necessary by the director. Claims for reimbursement pursuant to

subdivision four of this section shall be paid to each county and shall

be limited to the amount to which each county would be entitled pursuant

to such subdivision.

6. Implementation of home care plans. Within the amounts appropriated

therefor, counties authorized to provide expanded non-medical in-home

services, non-institutional respite services, case management services,

and ancillary services pursuant to paragraph (i) of subdivision four of

this section shall be eligible for reimbursement by the state of one

hundred percent of allowable expenditures for implementing the approved

county home care plan for functionally impaired elderly, limited to a

sum equivalent to the amount available to such county pursuant to

subparagraph one of paragraph (a) of subdivision four of this section.

7. For the purposes of obtaining state aid within the amounts

appropriated therefor under this section, a designated agency of an

Indian tribal organization shall qualify as though it were a designated

agency for a county.