N.Y. Comp. Codes R. & Regs. tit. 18 § 429.5

Current through Register Vol. 46, No. 51, December 18, 2024

Section 429.5 - Criteria and process for approval of plan

(a) The department shall review the plan within 45 days of submission, and a letter will be transmitted to the local commissioners within this period which will indicate approval or nonapproval for the whole or parts of the plan and state the reasons for such determination. The department shall utilize the following criteria for such decision:

(1) that the plan complies with the requirements set forth in this Part and in section 409-d of the Social Services Law;

(2) that the plan is consistent with other applicable provisions of the Social Services Law and with the regulations of the department;

(3) that the plan demonstrates that services included therein are appropriate to meet the assessed needs of the children and families for whom the district is or may be responsible; and

(4) that the plan is consistent with the prior year plan in that it addresses achievement or failure to achieve objectives in the prior year's plan, recommends alternative activities to achieve restated prior year objectives, when appropriate.

(b) Within 45 days of receipt of notice of initial nonapproval of the whole or part of the plan, the local district must submit a revised plan or parts thereof. The district must submit final revisions within 30 days of receipt of notice of nonapproval of a revised plan or parts thereof. The department shall approve/disapprove the initial revision of the disapproved plan by October first, or within 10 days of submission of such initial revision, whichever is later.

(1) No portion of the plan shall be finally disapproved until the district has at least one opportunity for resubmittal.

(2) A final disapproval of the plan, pursuant to this Part, shall be reviewable pursuant to article 78 of the Civil Practice Law and Rules.

(c) Reimbursement for services.

(1) Reimbursement for services to be provided pursuant to the plan shall not be available to a local district until the local plan is approved by the State Department of Social Services.

(i) If the plan is approved as submitted, State reimbursement for all proposed services shall be available to the local district.

(ii) If the entire plan is disapproved, reimbursement for all the services covered by the plan shall not be available to the local district. In cases of partial approval, reimbursement will be available for the services covered by the approved parts.

(2) Reimbursement shall be available to the district from the beginning of the plan year for only that part of the plan approved as in subparagraph (1)(i) of this subdivision. For all or part of the plan, approved after the beginning of the plan year, the effective date of reimbursement will be determined by the department.

(3) Reimbursement for each individual service shall be available pursuant to the maximum rate established by the department. Where no rate schedules have been established by the department for an identified service, rates will be subject to approval/nonapproval by the department. The rate of reimbursement of any service shall in no event exceed the rate of reimbursement approved by the department or by any other department or agency for such services subject to reimbursement by the State.

(4) Reimbursement shall not be paid for services for which State aid or reimbursement is available through any other State department or agency.

(5) Reimbursement for preventive services provided to children in foster care shall be available pursuant to regulations promulgated pursuant to sections 398-a and 410-i of the Social Services Law.

N.Y. Comp. Codes R. & Regs. Tit. 18 § 429.5