NY Elder L § 214 (2021)
2021 New York Laws ELD - Elder Article 2 - Programs for the Elderly Title 1 - State Office for the Aging 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.