N.Y. Comp. Codes R. & Regs. tit. 18 § 405.1

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

Section 405.1 - Policies governing purchase of services

(a) With the exception of foster care maintenance services and child care services, a social services district may purchase services for eligible individuals from local public agencies, private nonprofit agencies or organizations and private proprietary agencies. Foster care maintenance services may be purchased only from authorized agencies as defined in section 371 (10) of the Social Services Law. Foster care maintenance services for children placed outside of this State may be purchased from public agencies, private nonprofit agencies or organizations and private proprietary agencies operating outside of this State only when the placements comply with the interstate compact on the placement of children as set forth in section 374-a of the Social Services Law. Services for children with handicapping conditions provided in accordance with article 89 of the Education Law may be purchased from private proprietary agencies or organizations, and private nonprofit agencies or organizations. Specific child care services may be purchased only from those providers designated in Part 415 of this Title as eligible to provide that specific type of child care services. All such purchases are subject to the following conditions:

(1) The social services district may purchase only those services defined, included and authorized for purchase in the social services district's component of the Consolidated Services Plan or the Integrated County Plan; child care services in accordance with Part 415 of this Title; and foster care maintenance services in accordance with Part 427 of this Title.

(2) Purchase of services and foster care maintenance must be made pursuant to a written contract in accordance with the requirements of section 405.3 of this Part unless otherwise excepted therein, or unless otherwise authorized in accordance with Part 415 of this Title.

(3) A provider may not subcontract provision of services and foster care maintenance unless expressly permitted to do so by the social services district and the provider shall at all times be responsible for the performance of any subcontractor.

(4) Services and foster care maintenance may be purchased only if and to the extent that such services and care are not available without cost.

(5) Providers of services and foster care maintenance shall be licensed as required by law and shall comply with all applicable mandatory State and Federal standards.

(6) The quantity and cost of services and foster care maintenance actually provided pursuant to contract or letter of understanding shall be documented.

(7) The social services district shall determine the eligibility of individuals for services and foster care maintenance and shall authorize the type and duration of services and foster care to be provided.

(8) The social services district shall, except when rates of payment have been established by the department, negotiate rates of payment for purchased services and foster care maintenance which do not exceed amounts reasonable and necessary to assure quality of services and care and, in the case of services or care purchased from other public agencies, are in accordance with the cost reasonably assignable to such services and care. In no event shall the commissioner of the social services district negotiate a rate which is in excess of the rate charged to private consumers.

(9) The social services district shall document the methods used in establishing and maintaining rates negotiated in accordance with paragraph (8) of this subdivision and maintain information to support such rates of payment in a form accessible for audit purposes by State and Federal officers.

(10) Payment for services and foster care maintenance purchased in accordance with this Part shall be made by the social services district directly to the provider, except:

(i) When payment is permitted to be made to the recipient for payment to the vendor, the social services district shall:

(a) specify to the recipient the type, cost, quantity and vendor of such services; and

(b) establish procedures to insure proper delivery of the services to, and payment by, the recipient.

(ii) When reimbursement to the recipient is specifically authorized by the department, in which case, the following requirements must be satisfied:

(a) The recipient shall present a receipt or bill to the social services district which evidences payment made by or payment due from the recipient of a specified amount to a provider for a specified service or care specifically identified in the individual services plan.

(b) The service or care received shall have been approved by the social services district prior to purchase by the recipient.

(c) The service or care shall have been secured by the recipient within a period of time and at a cost authorized by the social services district.

(11) Overall planning for purchase of services and foster care maintenance and monitoring and evaluation of such services and care shall be performed by staff of the social services district.

(b) In the case of services provided by purchase under emergency assistance to needy families with children (EAF), the conditions of paragraphs (a)(2), (5), (8) and (9) of this section need not be met, but only to the extent and for the period necessary to deal with the emergency situation.

(c) Services and foster care maintenance provided by purchase shall be subject to all other applicable requirements of this Subchapter.

N.Y. Comp. Codes R. & Regs. Tit. 18 § 405.1

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