N.Y. Comp. Codes R. & Regs. tit. 18 § 371.3

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

Section 371.3 - Determination of initial eligibility

In general, the scope of the social investigation shall conform to the policies set forth in sections 351.1 through 351.4, 351.20 through 351.24, 354.1, 354.2 and 354.4 of this Title, but these processes shall be modified to the extent indicated by the nature of institutional care and the needs of persons requiring such care.

(a) Appropriate form of care.

(1) Primary emphasis shall be placed upon the form of care which will best meet the needs of the individual concerned. This shall include consideration of his previous living arrangements; his current physical and mental condition; his ability to live outside the protected environment of an institutional setting; the availability and suitability of care in a private home for the aged or a private home for adults for which an applicant may be eligible because of membership in a fraternal organization or other association or in a government home or institution for which an applicant may be eligible because of veteran status; his personal wishes and those of his family.

(2) Residents of public homes, which are supported by county and State funds, are ineligible for supplemental security income payments.

(3) Residents of public homes who have medical problems should be considered for possible placement in skilled nursing or intermediate care facilities.

(b) Financial need.

(1) A person for whom care in his own home is not appropriate shall be eligible as public charge for public home care when his own resources and available support from relatives are insufficient to provide appropriate care elsewhere.

(2) When care in a public home is determined to be the most suitable form of care, the application shall be accepted. Any available income shall be applied as a refund against current operation and maintenance costs of the institution.

(3) Resources shall be explored and utilized and recoveries reported in accordance with department regulations. An agency may modify these policies when:

(i) the individual may reasonably be presumed to require only short-term care (not in excess of 90 days) and the established local policy provides for modification of liquidation, adjustment and/or assignment requirements in such cases;

(ii) the individual has a dependent spouse who is aged or has short life expectancy and with whom he has lived prior to his admission; in such cases, a $250 burial reserve may be permitted for the spouse, in addition to a reserve for the applicant himself.

N.Y. Comp. Codes R. & Regs. Tit. 18 § 371.3