N.Y. Comp. Codes R. & Regs. tit. 18 § 404.5

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

Section 404.5 - Financial eligibility

(a)Income maintenance status.

(1) For purposes of financial eligibility for services, the following persons have income maintenance status:

(i) Recipients of ADC-an ADC recipient is any individual who is certified eligible for cash assistance under the ADC program and receives such payments during the period upon which eligibility for social services is based.

(ii) Individuals whose needs are taken into account in computing the grant for eligible persons under the ADC program-these include children and other relatives in the home not eligible for ADC in their own right but whose presence is significant to ADC recipients as "essential persons."

(iii) Recipients of SSI benefits including recipients of State supplementary payments-an SSI recipient is any individual who is certified eligible for cash assistance under the SSI program and receives such payments including State supplementary payments during the period upon which eligibility for social services is based.

(iv) Recipients of foster care or adoption assistance (FCAA)-an FCAA recipient is any child or minor certified eligible for foster care maintenance or adoption assistance who received such benefits during the period upon which eligibility for social services was based.

(v) Recipients of HR-an HR recipient is any individual who is certified eligible for cash assistance under the HR program and who received such payments during the period upon which eligibility for services is based.

(vi) Recipients of MA-an MA recipient is any individual who is certified eligible to receive a medical payment during the period upon which eligibility for services is based.

(2) Persons with income maintenance status shall be financially eligible for services in accordance with the provisions of the then effective comprehensive annual social services program plan.

(3) When financial eligibility for services is based on the income maintenance status of the applicant, such status shall be verified as of the date of application.

(b)Income eligible status.

(1) Individuals, other than those described in subdivision (a) of this section, must be financially eligible for services on the basis of income eligibility status if the monthly gross income of the family is equal to or less than:

(i) the appropriate income eligibility level contained in the then effective consolidated services plan or integrated county plan;

(ii) for New York State Child Care Block Grant child care services, the financial eligibility requirements for such services established by the Office of Children and Family Services in accordance with section 415.2(a) of this Title.

(2) The determination of family monthly gross income shall be based on the average monthly income for a period of not less than one month nor in excess of three months prior to application, adjusted for any changes in income known or expected to occur during the period of authorization.

(3) If income fluctuates significantly, the average monthly amount shall be computed based on income received during a period of not less than three nor more than six months.

(4) Computation of monthly gross income shall be based on a factor of 4&" of the weekly income.

(5)Monthly gross income means the monthly sum of income received from the following sources:

(i) Monthly wages or salary, i.e., total money earnings received for work performed as an employee, including wages, salary, Armed Forces pay, commissions, tips, piece-rate payments, and cash bonuses earned before deductions are made for taxes, bonds, pensions, union dues and similar purposes.

(ii) Net income for non-farm self-employment, i.e., gross receipts minus expenses from one's own business, professional enterprise, or partnership. Gross receipts include the value of all goods sold and services rendered. Expenses include costs of goods purchased, rent, heat, light, power, wages and salaries paid, business taxes (not personal income taxes) and similar costs. Depreciation, personal business and entertainment expenses, personal transportation, purchase of capital equipment, and payments on the principal of loans for capital assets or durable goods are not counted as expenses for the purpose of determining net income for self-employment for child care assistance. The value of salable merchandise consumed by the proprietors of retail stores is not included as part of net income.

(iii) Net income for farm self-employment, i.e., gross receipts minus operating expenses from the operation of a farm by a person on his own account, as owner, renter or sharecropper. Gross receipts include the value of all products sold, government crop loans, money received from the rental of farm equipment to others, the incidental receipts from the sale of wood, sand, gravel, and similar items. Operating expenses include cost of feed, fertilizer, seed and other farming supplies, cash wages paid to farm hands, cash rent, interest on farm building repairs, farm taxes (not State and Federal income taxes) and similar expenses. Depreciation, personal business and entertainment expenses, personal transportation, purchase of capital equipment, and payments on the principal of loans for capital assets or durable goods are not counted as operating expenses for the purpose of determining net income for self-employment for child care assistance. The value of fuel, food or other farm products used for family living is not included as part of net income.

(iv) Social security benefits include social security pensions and survivor benefits, and permanent disability insurance payments made by the Social Security Administration prior to deductions for medical insurance and railroad retirement checks from the U.S. government.

(v) Dividends, interest (on savings or bonds) income from estates or trusts, net rental income or royalties, including dividends from stockholding or membership in associations, interest on savings or bonds, periodic receipts from estates or trust funds, net income from rental of a house, store or other property to others, receipts from boarders or lodgers and net royalties.

(vi) Public assistance or welfare payments include public assistance payments such as ADC, SSI (including State supplemental payments), and home relief.

(vii) Pensions and annuities include pensions or retirement benefits paid to a retired person or his survivors by a former employer or by a union, either directly or through an insurance company, and periodic receipts from annuities or insurance.

(viii)Unemployment compensation means compensation received from government unemployment insurance agencies or private companies during periods of unemployment and any strike benefits received from union funds.

(ix)Workers' compensation means compensation received periodically from private or public insurance companies for injuries incurred at work. The cost of this insurance must have been paid by the employer and not by the individual.

(x) Alimony.

(xi) Child support.

(xii)Veterans' pensions means money paid periodically by the Veterans' Administration to disabled members of the Armed Forces or to survivors of deceased veterans, subsistence allowances paid to veterans for education and on-the-job training, as well as so- called "refunds" paid to ex-servicemen as GI insurance premiums.

(6) Exclusions from monthly gross income. Excluded from computation of monthly gross income are the following:

(i) per capita payments to or funds held in trust for any individual in satisfaction of a judgment of the Indian Claims Commission or the Court of Claims;

(ii) money received from sale of property, such as stocks, bonds, a house, or a car (unless the person was engaged in the business of selling such property in which case the net proceeds would be counted as income from self-employment);

(iii) withdrawals of bank deposits;

(iv) money borrowed;

(v) tax refunds;

(vi) gifts;

(vii) lump sum inheritances or insurance payments;

(viii) capital gains;

(ix) the value of coupon allotments under the Food Stamp Act of 1964, as amended, in excess of the amount paid for the coupons;

(x) the value of USDA donated foods;

(xi) the value of supplemental food assistance under the Child Nutrition Act of 1966 and the special food service program for children under the National School Lunch Act;

(xii) any payment received under the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970;

(xiii) earnings of a dependent child under 18 years of age who is not legally responsible for the child or children for which child care assistance is sought (no inquiry shall be made);

(xiv) loans and grants such as scholarships obtained and used under conditions that preclude their use for current living costs;

(xv) any grant or loan to any undergraduate student for educational purposes made or insured under the Higher Education Act;

(xvi) home produce utilized for household consumption;

(xvii) payments made for child care services, or the value of child care services provided to a recipient of child care services provided under the New York State Child Care Block Grant Program and under title XX of the Social Security Act who is applying for or receiving any other services funded under any Federal or federally assisted program that bases eligibility for such services upon need or the amount of benefits upon need;

(xviii) veterans' assistance payments made to or on behalf of certain Vietnam veterans' natural adult or minor children for any disability resulting from spina bifida suffered by such children;

(xix) veterans' assistance payments made for covered birth defects to or on behalf of the adult or minor children of women Vietnam veterans in service in the Republic of Vietnam during the period beginning on February 28, 1961 and ending on May 7, 1975. Covered birth defects means any birth defect identified by the Veterans' Administration as a birth defect that is associated with the service of women Vietnam veterans in the Republic of Vietnam during the period on February 28, 1961 and ending on May 7, 1975, and that has resulted or may result in permanent physical or mental disability; and

(xx) disaster relief payments other than unemployment compensation.

(c)Eligibility without regard to financial circumstances.

Notwithstanding subdivisions (a) and (b) of this section, individuals and families who are programmatically eligible for the following services will be determined to be eligible for such services without regard to financial eligibility criteria:

(1) information and referral services;

(2) protective services for adults;

(3) protective services for children;

(4) preventive services for children; and

(5) residential services for victims of domestic violence.

(d)Resources.

Financial eligibility for services contained in the district component of the Child and Family Services Plan shall be based only on the monthly gross income of the family as defined in this section.

(1) No exploration of resources shall be made in the determination of eligibility for services, except for child care assistance funded under the New York State Child Care Block Grant Program for which resources are considered in accordance with Part 415 of this Title.

(2) No lien or incumbrance of any kind shall be required from or be imposed against the property of any individual in connection with services rendered or to be rendered.

(3) No adjustment or recovery of the cost of services rendered shall be made, except for child care assistance in accordance with section 415.4 of this Title.

N.Y. Comp. Codes R. & Regs. Tit. 18 § 404.5

Amended, New York State Register December 3, 2014/Volume XXXVI, Issue 48, eff. 12/3/2014

Amended New York State Register June 3, 2020/Volume XLII, Issue 22, eff. 6/3/2020

Amended New York State Register January 10, 2024/Volume XLVI, Issue 2, eff. 12/26/2023, exp. 2/23/2024 (Emergency)

Amended New York State Register February 28, 2024/Volume XLVI, Issue 9, eff. 2/13/2024, exp. 4/12/2024 (Emergency)

Amended New York State Register May 1, 2024/Volume XLVI, Issue 18, eff. 4/11/2024, exp. 6/9/2024 (Emergency)