N.Y. Comp. Codes R. & Regs. tit. 9 § 6652.4

Current through Register Vol. 46, No. 50, December 11, 2024

Section 6652.4 - Area agency procedures

(a) An area agency shall have and follow written procedures to carry out its functions. These procedures shall describe the process by which the area plan approved under this Chapter is developed, the composition and role of the advisory council, methods for determining which elderly people will receive each service under the plan, and procedures for resolution of complaints from elderly people or service providers dissatisfied with area agency actions or decisions.

(b) An area agency shall develop and publish its methods for establishing priorities among services, particularly for access, in-home, and legal assistance services.

(c) An area agency shall establish procedures governing outreach, training and coordination activities of service providers under the area plan.

(d) An area agency shall develop procedures to maximize services funded from other sources. No OAA, CSE, or EISEP funds may be used to provide services to any elderly person eligible to receive the same or substantially similar services available to that person under title XVIII, XIX, or XX of the Federal Social Security Act, or to residents of adult residential care facilities who are receiving or are entitled by law to receive the same or substantially similar services from that facility.

(e) An area agency shall ensure that all its procedures enhance the targeting of services (including coordination of services provided by other agencies) to elderly who are low-income (with incomes below the poverty line), minority, frail, or vulnerable.

(f) If it appears that an applicant for OAA, CSE or EISEP services or funding may be eligible to receive the same or similar services under title XVIII, XIX or XX of the Federal Social Security Act, or is a resident of adult residential care facilities who is receiving or may be entitled by law to receive the same or substantially similar services from that facility, the area agency must assist such applicant in obtaining such services from such other source, except that the area agency may provide or arrange for the provision of services to such individual if the area agency has in effect an agreement providing for reimbursement from the appropriate funding source for services so provided to individuals eligible for assistance from such other source. Nothing herein shall be construed to require that OAA, CSE or EISEP services be denied to an otherwise eligible elderly person while a determination of eligibility for the above-mentioned services is under review by the proper agencies; provided that the area agency shall ensure that arrangements have been made to secure reimbursement from the appropriate funding source once such determination has been made.

(g) The OAA shall ensure equal access for participation, services, activities and informational sessions without regard to partisan affiliation; refrain from using funds to advance any partisan candidate or effort (yet permit equal access and opportunities for all candidates/encumbents when providing information on the political process to the elderly); prevent the use of official authority, influence, or coercion to interfere with or affect elections or nominations for office; and ensure no coercion is used nor advice given to other people to contribute anything of value to a party, committee, organization, agency, or person for political purposes, nor engage in sectarian or partisan activities.

(h) Under EISEP, an area agency shall provide to any service recipient or applicant who contests a determination by the area agency concerning functional eligibility (which includes the existence of unmet needs in order to determine program eligibility) or extent of cost sharing, an opportunity for a hearing (provided, however, that despite functional eligibility, an area agency may deny services to applicants based on lack of program resources, and further provided that no entitlement to services is created under this Chapter). A service recipient or applicant may request such a hearing from the area agency verbally (in which case it must be documented by the area agency) or in writing within 30 days following receipt of notice of the contested action (except that the area agency may waive such deadline upon good cause). The hearing shall include the right to be assisted in contesting such denials of assistance or levels of required cost-sharing. The area agency shall complete the hearing and issue a hearing decision within 60 days of the date the request for hearing was received by the area agency. The area agency must send a copy of the decision to the office within five business days of its issuance. The area agency may terminate formal hearing procedures at any point if the disputed issues are resolved by negotiated agreement approved by the office.

N.Y. Comp. Codes R. & Regs. Tit. 9 § 6652.4