N.Y. Comp. Codes R. & Regs. tit. 14 § 522.7

Current through Register Vol. 46, No. 45, November 2, 2024

Section 522.7 - Required policies and procedures

(a) Any facility director who serves or may serve as representative payee for beneficiaries receiving services from such facility shall establish policies and procedures which address the management and use of funds paid to the director as representative payee, consistent with the fiduciary responsibilities of a representative payee pursuant to the governing requirements of Social Security or other federal law and the comparable duty under State law. At a minimum, such policies and procedures shall include provisions for:

(1) establishment and maintenance of beneficiary accounts (in interest bearing accounts where practicable) with individual patient accounting to segregate balances and permit the application of interest earned, if any, on a pro-rated basis;

(2) internal controls that keep the beneficiary accounts and funds secure, prevent identity theft, provide specific authorization for check signatories, and document receipts and disbursements;

(3) the use of petty cash, including requirements for documenting expenditures by receipts and the reconciliation of cash provided;

(4) the opportunity for beneficiaries, or someone authorized to act on their behalf, to review deposits to and disbursements from their accounts at least quarterly; and

(5) designation of an appropriate staff member to act as a liaison between the facility director and the beneficiary.

(b) For facilities operated by the Office, such policies and procedures shall also include provisions requiring the facility to consider:

(1) the establishment of an appropriate Discharge Account if funds are available from accumulated Social Security or other federal benefits and/or other resources or income of the beneficiary; provided, however, that such Discharge Account, in addition to other resources held by the beneficiary, shall not exceed the monetary limits necessary to maintain his or her eligibility for government benefits in the community; and

(2) the use of a Medicaid exception trust or similar device where legally mandated or deemed necessary and appropriate by the Office of Mental Health. To determine whether and/or what type of Medicaid exception trust or similar device may be necessary and appropriate, the following factors shall be considered along with any other factors relevant to the particular beneficiary's circumstances:

(i) the beneficiary's current and future needs, including a burial fund;

(ii) the amount of the resources to be placed in trust;

(iii) the beneficiary's age, current diagnosis and functional capacity (including capacity to manage his or her funds);

(iv) the beneficiary's prognosis for discharge into the community;

(v) the beneficiary's need for government benefit eligibility in the community;

(vi) the availability and willingness of a family member, friend, guardian or other appropriate individual to serve as trustee of such a trust or as a liaison to such a trust;

(vii) the impact of anticipated costs to establish and maintain the trust and guardianship, if any, on the amount of trust resources that will be available to the beneficiary;

(viii) the eligibility of the beneficiary to establish a trust; and

(ix) the availability of a pooled community trust in which beneficiary is eligible to participate.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 522.7

Adopted by New York State Register June 1, 2016/Volume XXXVIII, Issue 22, eff.6/1/2016