2023 New York Laws › PBH - Public Health › Article 25 - Maternal and Child Health › Title 2-A - Early Intervention Program for Infants and Toddlers With Disabilities and Their Families › 2557 - Financial Responsibility and Reimbursement.

§  2557.  Financial  responsibility and reimbursement. 1. The approved
costs for an  eligible  child  who  receives  an  evaluation  and  early
intervention  services pursuant to this title shall be a charge upon the
municipality wherein the eligible child resides or, where  the  services
are  covered by the medical assistance program, upon the social services
district  of  fiscal  responsibility  with  respect  to  those  eligible
children  who  are  also  eligible  for medical assistance. All approved
costs shall be paid in the first instance and at least quarterly by  the
appropriate  governing body or officer of the municipality upon vouchers
presented and audited in the same manner as the  case  of  other  claims
against   the   municipality.   Notwithstanding  the  insurance  law  or
regulations thereunder relating to the permissible exclusion of payments
for services under governmental programs, no such exclusion shall  apply
with  respect  to  payments made pursuant to this title. Notwithstanding
the insurance law or  any  other  law  or  agreement  to  the  contrary,
benefits  under  this title shall be considered secondary to the medical
assistance program under which an eligible child may have coverage.
2. The department  shall  reimburse  the  approved  costs  paid  by  a
municipality   for   the  purposes  of  this  title,  other  than  those
reimbursable by the medical assistance program, in an  amount  of  fifty
percent  of  the  amount  expended  in  accordance  with  the  rules and
regulations  of  the  commissioner;  provided,  however,  that  in   the
discretion  of  the  department and with the approval of the director of
the division of the budget, the department may reimburse  municipalities
in  an  amount  greater  than fifty percent of the amount expended. Such
state reimbursement to the municipality shall not be paid prior to April
first of  the  year  in  which  the  approved  costs  are  paid  by  the
municipality,  provided,  however  that,  subject to the approval of the
director  of  the  budget,  the  department  may  pay  such  state   aid
reimbursement to the municipality prior to such date.
3.   The  department  may  perform  audits,  which  may  include  site
visitation, to all or any  of  the  following:  municipalities;  service
coordinators;  evaluators  or  providers of early intervention services.
The department shall provide the  municipalities  with  a  copy  of  the
findings   of   such   audits.  Early  intervention  program  state  aid
reimbursement or portion thereof may be withheld if, on  post-audit  and
review, the commissioner finds that the early intervention services were
not  provided or those provided were not in substantial conformance with
the rules and regulations established by the commissioner  or  that  the
recipient  of  such  services  was  not  an eligible child as defined in
section twenty-five hundred forty-one of this title. In the  event  that
the  commissioner  determines  that  there may be a withholding of state
reimbursement to any municipality under this section,  he  shall  inform
the state early intervention coordinating council and the relevant local
early  intervention  coordinating council and shall consider alternative
courses of action recommended within sixty days by either body prior  to
withholding state reimbursement.
3-a.  Each  municipality  may perform an audit, which may include site
visitation, of evaluators and providers  of  such  services  within  its
municipality   in   accordance   with   standards   established  by  the
commissioner. The municipality shall submit  the  results  of  any  such
audit  to  the commissioner for review and, if warranted, adjustments in
state aid reimbursement pursuant to subdivision three of  this  section,
as  well  as  for  recovery  by  the  municipality  of  its share of any
disallowances identified in such audit.
5. (a) The commissioner, in his or her discretion,  is  authorized  to
contract  with  one  or more entities to act as the fiscal agent for the
department and municipalities with  respect  to  fiscal  management  and

payment   of  early  intervention  claims.  Municipalities  shall  grant
sufficient authority to  the  fiscal  agent  to  act  on  their  behalf.
Municipalities,  and  individual  and agency providers as defined by the
commissioner  in  regulation shall utilize such fiscal agent for payment
of early intervention claims as determined by the department  and  shall
provide such information and documentation as required by the department
and necessary for the fiscal agent to carry out its duties.
(b)  Notwithstanding any inconsistent provision of section one hundred
twelve or one hundred sixty-three of the state finance law, sections one
hundred  forty-two  and  one  hundred  forty-three   of   the   economic
development   law,   or   any  other  contrary  provision  of  law,  the
commissioner is authorized to enter into a contract or  contracts  under
paragraph  (a)  of this subdivision without a competitive bid or request
for proposal process, provided, however, that:
(i) The department shall post on its website, for a period of no  less
than thirty days:
(1)  A description of the proposed services to be provided pursuant to
the contract or contracts;
(2) The criteria for selection of a contractor or contractors;
(3) The period of time during which a prospective contractor may  seek
selection,   which  shall  be  no  less  than  thirty  days  after  such
information is first posted on the website; and
(4) The manner  by  which  a  prospective  contractor  may  seek  such
selection, which may include submission by electronic means;
(ii)  All reasonable and responsive submissions that are received from
prospective contractors in a timely fashion shall  be  reviewed  by  the
commissioner; and
(iii)  The  commissioner  shall  select such contractor or contractors
that, in his or her discretion, are best suited to serve the purposes of
this section.
(c) Paragraph (b) of this subdivision shall apply only to the  initial
contract or contracts necessary to obtain the services of a fiscal agent
for  early  intervention  program fiscal management and payment of early
intervention claims and shall not apply to subsequent  contracts  needed
to  maintain  such services, as determined by the commissioner in his or
her discretion.