9 NYCRR Part 6654 - Executive Department

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Source versions current through Mar 31, 2022 - Dec 27, 2023 across sections

Sections in this Part carry different compiled dates; each section shows its own.

9 NYCRR 6654.1 - Licensure and safety requirements

Source version current through Mar 31, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022

All services under this Chapter must meet all applicable Federal, State and local licensure and safety requirements.

9 NYCRR 6654.2 - Outreach, training and coordination requirements

Source version current through Mar 31, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022

Service providers must comply with any outreach, training and coordination requirements established by the area agency. All workers delivering services must be appropriately qualified, selected, trained and supervised as specified in this Part.

9 NYCRR 6654.3 - Concentration of services on target population

Source version current through Apr 15, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Apr 15, 2022

(a)Area agencies shall engage in system, program and client-level targeting to concentrate services and assistance on the target groups of minority, low-income frail and vulnerable elderly. Area agency targeting efforts shall include:

(1)developing linkages to programs and services operated by other agencies;

(2)planning with appropriate individuals or groups;

(3)assessing the need for services;

(4)informing or educating relevant public or service needs;

(5)advocating with relevant public decisionmakers;

(6)facilitating or brokering the establishment of needed services;

(7)coordinating the development of needed services;

(8)leveraging other services;

(9)securing additional resources for service development;

(10)providing services through subcontract or directly where approved;

(11)evaluating services provided;

(12)recognizing and making public their mandated responsibilities on targeting;

(13)conducting a variety of activities at county and community levels to enhance participating of target populations in service programs sponsored by the area agency and by other service systems;

(14)identifying specific unmet needs of the target populations;

(15)stimulating the development of resources and services to meet the identified needs of target populations;

(16)reexamining the allocation of aging network funds and develop strategies to make resources available to the target population;

(17)ensuring target population representation on area agency and service provider advisory committees and boards of directors and ensuring their participation in the development of targeting strategies;

(18)ensuring through monitoring (reporting), evaluating, technical assistance, assessment and training, that subcontractors identify and serve the target population;

(19)ensuring that any directly provided services by the area agency are targeted appropriately;

(20)providing for and encouraging the participating of target group members in the identification of needs and the planning, implementation and evaluation of programs;

(21)ensuring appropriate target group representation on agency staff and among volunteers; and

(22)planning and conducting a variety of activities to ensure target group representation among consumers of service at a level that exceeds their percentage representation in the aging population within the service area, utilizing such means as innovative outreach, location and services, use of appropriate community-based organizations and groups as well as informal networks to assist in needs identification, and information and referral.

(b)Area agencies on aging shall consider the proportion of target elderly in the population of the service area when asking allocation or reallocation decisions for resources. Special targeting efforts should be undertaken with any allowable sources or new or one-time funds. OAA carryover, especially that in excess of 10 percent, should be viewed as a potential resource for such targeting efforts. In granting office approval for retention of carryover, the proposed use of such funds for targeting activities will be a major factor considered.

(c)Service providers must follow methods established by the area agency for giving preference:

(1)for OAA services, to elderly with greatest economic or social need, with particular attention to low-income minority individuals;

(2)for CSE services, to elderly people most at risk of institutionalization, particularly those who are frail, disabled, of low income, members of minority groups, or isolated from their families and the community; and

(3)for EISEP services, to functionally impaired elderly with unmet needs who require assistance to remain in their homes.

(d)Service providers must follow methods established by the area agency for maximizing services funded from other sources, and must assure that no OAA, CSE, or EISEP funds are used to provide services to elderly people eligible to receive the same or substantially similar services available to them under title XVIII, XIX or XX of the Federal Social Security Act or any other governmental program, or to residents of adult residential care facilities who previously received or are entitled by law to receive the same or substantially similar services from such facilities.

9 NYCRR 6654.4 - Means-testing

Source version current through Mar 31, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022

(a)A services provider:

(1)under OAA (whether using Federal or matching funds or contributions) or, except as provided in subdivision (b) of this section, under CSE (whether using State or matching funds or contributions):

(i)may not deny or restrict services to an elderly person because of the level of that person's income or resources;

(ii)may not require an elderly person to disclose information about income or resources as a condition of receiving services;

(2)under EISEP (whether using State or matching funds or, except as provided in subdivision [c] of this section, proceeds from required cost-sharing or, to the extent provided in subdivision [b] of this section under CSE), may not deny or restrict services to an elderly person because of the level of that person's income or resources, if such person provides required cost-sharing pursuant to this Chapter;

(3)must attempt to determine whether a elderly person is eligible for the same or a substantially similar service available from another government program in the area to elderly people with specified levels of income or resources, and shall assist such person in obtaining such service from such source or, pursuant to arrangements to obtain reimbursement from such source for services to eligible individuals, supply or arrange for the provision of service to such individual;

(4)may inquire about income and resources for the purpose of identifying other resources and benefits for which the individual may be eligible, for reporting to the office, and, under EISEP, to determine the appropriate level of cost-sharing;

(5)must coordinate services with other similar providers in the area to avoid duplication of available services; and

(6)shall, when it appears that an elderly person seeking assistance may be eligible for services from another source, advise the elderly person of the other service source and offer to assist the individual in obtaining services from the other source.

(b)In any years for which an area agency receives EISEP services funds under its area plan, any CSE projects under that area plan providing similar nonmedical in-home, noninstitutional respite, or case management services shall, with respect to all new clients not previously participating under such CSE project, be covered by paragraph (a)(2) of this section.

(c)The proceeds of required cost-sharing from EISEP participants may, at the option of the area agency, be used to expand CSE services or to expand EISEP services.

9 NYCRR 6654.5 - Contributions

Source version current through Mar 31, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022

(a)Under OAA and, except as provided in subdivision (e) of this section, CSE service providers must:

(1)provide each elderly person a free and voluntary opportunity to contribute to the cost of the service;

(2)protect the privacy of each elderly person about any contribution;

(3)establish and observe procedures to safeguard and account for all contributions as specified by the office; and

(4)use all contributions to expand services of the provider. OAA nutrition providers must use all contributions to expand the number of meals served by the project, to facilitate access to such meals, and to provide other supportive services (transportation, escort, shopping assistance, information and referral, and recreation) directly related to nutrition services.

(b)Under OAA and, except as provided in subdivision (e) of this section, CSE service providers may develop voluntary, suggested fee schedules for approval by the area agency and the office. In developing such schedules, service providers shall consider the income ranges of elderly people in the community and the provider's other sources of income.

(c)Except as provided in section 6654.6 of this Part, no provider may deny services to or discriminate against any elderly person in the delivery of service because the person did not contribute.

(d)Contributions are program income.

(e)In any years for which an area agency receives EISEP services funds under its area plan, any CSE projects under that area plan providing similar nonmedical in-home, noninstitutional respite, or case management services shall, with respect to all new clients not previously participating under such CSE project, be covered by section 6654.6 of this Part.

(f)The proceeds of required cost-sharing from EISEP participants which, at the option of the area agency, are used to expand CSE services shall be considered CSE funds for the purposes of these regulations.

(g)Persons requested to cost-share under subdivision (e) of this section or under section 6654.6 of this Part shall not be asked to make a contribution to the cost of the EISEP-funded services.

9 NYCRR 6654.6 - EISEP cost-sharing

Source version current through Apr 15, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Apr 15, 2022

(a)EISEP clients shall pay cost-sharing for in-home, ancillary, and noninstitutional respite services received under the client's care plan according to a sliding scale, subject to adjustments pursuant to this section, reflecting the cost of such services and client income so that:

(1)no cost-sharing will be charged clients whose income is at or below 150 percent of poverty levels specified by the office (unless they are eligible for Medicaid);

(2)the full cost of services will be charged clients whose income is at or above 250 percent of poverty levels specified by the office and clients who are eligible for Medicaid;

(3)partial cost-sharing will be charged clients whose income is between 150 percent and 250 percent of poverty levels specified by the office; and

(4)no cost-sharing will be charged clients for durable items provided on a loan basis as an ancillary service.

(b)Adjusted monthly income:

(1)includes, to the extent available, income of the client's spouse if the client is living with his or her spouse; and

(2)equals monthly income minus the threshold and the housing adjustment;

(i)monthly income is the clients's income during the month in which the client's care plan is prepared, including a proportionate share of annual income received less frequently than monthly:

(a)consisting of money regularly received, after the payment of Federal, State, and local personal income taxes, from:

(1)wages or salary;

(2)net income (gross income minus expenses incurred in generating the income up to the amount of gross income) from:

(i)farm and nonfarm self-employment;

(ii)buying and selling real or personal property on a regular basis;

(iii)roomers or boarders and rental of property;

(3)social security old-age, survivors, and disability insurance benefits;

(4)pensions and annuities; and

(5)interest and dividends;

(b)excluding:

(1)income from participation in the Senior Community Services Employment Program under title V of the Older Americans Act, Job Training Partnership Act, Foster Grandparent Program, or other programs established to foster employment of lower income elderly or to support volunteer efforts by the elderly;

(2)unearned income from one-time lump sum payments such as insurance benefits, irregular gifts or contributions, the Real Property Tax Credit, and the Low-Income Home Energy Assistance Program;

(3)sums which the client is obligated to repay, such as proceeds from reverse mortgages and other home equity conversion plans; and

(4)goods, services, or benefits received in kind, such as food stamp coupon allotments;

(ii)the threshold is the amount of monthly income to be exempt from cost-sharing for all clients as specified by the office. (At the time these regulations were originally promulgated, the threshold was $905 for clients living with spouses whose income is available to meet their needs and $670 for all other clients.) Thresholds are adjusted regularly by the office to reflect changes in the consumer price index for all items, between the third quarters of the preceding two calendar years;

(iii)the housing adjustment is the amount by which the client's average monthly housing expenses exceed 40 percent of the threshold, except that the housing adjustment shall not exceed 40 percent of the threshold;

(a)housing expenses are costs incurred against the client's income for renting or owning the housing unit in which the client lives, including rent, property taxes, mortgage payments, heating, telephone installation and local service, and other utilities;

(b)average monthly housing expenses are housing expenses payable from the client's income during the month in which the client's care plan is prepared, including a proportionate share of annual heating and other costs which occur less frequently than monthly or are subject to seasonal variation.

(c)Cost-sharing charged a client equals the adjusted cost of in-home, ancillary, and noninstitutional respite services received by the client under the care plan, multiplied by the percentage of cost to be charged given the client's adjusted monthly income as specified in the current cost-share schedule specified by the office, except that total cost sharing charged a client living with a spouse who is also a client receiving in-home, ancillary, or noninstitutional respite services under a care plan shall not exceed one half the adjusted monthly income, and total cost-sharing charged any other client shall not exceed the client's adjusted monthly income.

(1)The adjusted cost of an in-home, ancillary, or noninstitutional respite service equals the number of units received by the client under the care plan multiplied by the unit cost for the service under the county's approved county home care plan for functionally impaired elderly (or, if no such cost is stated in the plan, the actual cost incurred in providing or purchasing the service for the client) or, for clients required to pay less than the full cost of the service, by the lesser of the unit cost specified in such approved plan (or, if none, the actual cost incurred) or the statewide average unit cost of the service, if any, as specified by the office.

(2)The percentage of cost to be charged a client shall be determined according to the client's adjusted monthly income in accordance with the current cost-share schedule specified by the office. The cost-share schedule is adjusted regularly by the office to reflect changes in the consumer price index for all items, between the third quarters of the preceding two calendar years. At the time these regulations were originally promulgated, the cost-share schedule for clients living with spouses whose income was available to meet their needs (designated as couples) and for all other clients (designated as individuals) was as follows:

COST-SHARE SCHEDULE

Couples		Individuals
Adjusted monthly income	Cost-sharing rate	Adjusted monthly income	Cost-shaing rate
$0	0%	$0	0%
$1 to $32	5	$1 to $24	5
33 to 63	10	25 to 47	10
64 to 95	15	48 to 71	15
96 to 127	20	72 to 94	20
128 to 159	25	95 to 118	25
160 to 190	30	119 to 141	30
191 to 222	35	142 to 165	35
223 to 254	40	166 to 188	40
255 to 286	45	189 to 212	45
287 to 317	50	213 to 235	50
318 to 349	55	236 to 259	55
350 to 381	60	260 to 282	60
382 to 413	65	283 to 306	65
414 to 444	70	307 to 329	70
445 to 476	75	330 to 353	75
477 to 508	80	354 to 376	80
509 to 540	85	377 to 400	85
541 to 571	90	401 to 423	90
572 to 603	95	424 to 447	95
More than 603*	100	More than 447*	100

* or eligible for Medicaid.

(d)A copy of all documents used in determining the extent of cost sharing required from a client, including forms specified by the office, shall be maintained in the client's case record.

(e)Unless the applicant voluntarily agrees to pay the full cost of EISEP in-home, noninstitutional respite and ancillary services received under the care plan, each applicant or his or her authorized representative shall:

(1)declare sources and amounts of income of the client and, for clients living with their spouse, of the spouse of which the client is aware or which are available to meet the needs of the client;

(2)provide information necessary for assessing potential Medicaid eligibility;

(3)sign a statement prescribed by the office attesting to the truthfulness of declarations and agreeing to provide supporting documentation upon request;

(4)sign a cost sharing agreement promising to pay the required cost sharing and to notify the case manager or designated case management staff of any changes in income or expenses that would affect the amount of cost sharing required of the client; and

(5)to receive a housing adjustment, declare the kind, amount, and recipient of housing expenses.

(f)The case manager:

(1)shall ensure that clients or their authorized representatives receive assistance as requested by clients or representatives in reviewing financial documents;

(2)shall sign the cost-sharing agreement attesting that the information contained therein is consistent with information provided by the client or his or her authorized representative and with any other available information;

(3)may require the client or his or her authorized representative to provide documentation to verify the accuracy of declarations;

(4)shall ensure the computation of cost sharing and the execution of a cost sharing agreement in accordance with this section and section 6654.16 of this Part;

(5)shall ensure that no cost sharing is required for services not received by a client or received prior to the cost sharing determination pursuant to this section; and

(6)shall ensure that the client's cost-sharing obligations are redetermined and a new cost-sharing agreement is developed if requested by the client or his or her authorized representative or if there is a change in in-home, ancillary, or noninstitutional respite services to be provided the client under the care plan; the client's adjusted monthly income; or the status of the client in a way that may affect the terms of the cost-sharing agreement, including new medical expenses that could make the client eligible for Medicaid. A redetermination shall not be required solely by reason of changes in the schedule of unit costs, cost share schedule, thresholds, of the client's monthly income resulting from cost of living adjustments in social security old-age, survivors, and disability insurance benefits or other income subject to periodic adjustments based on the cost of living, consumer price index, or similar measures.

(g)Cost-sharing agreements shall:

(1)clearly present the responsibilities of the client for payment of cost sharing, including payment schedules, billing practices and payment procedures;

(2)describe the client's liability for the payment of cost sharing, including:

(i)the maximum amount of cost sharing the client could be required to pay per month, regardless of the extent of services received under the care plan, based on the client's adjusted monthly income;

(ii)the cost-sharing rate for the client;

(iii)the time period covered by the agreement, which shall not exceed the period covered by the client's care plan;

(iv)the projected number of units of each in-home, noninstitutional respite, and ancillary service covered by the agreement, which shall be the same as in the client's care plan during the period covered by the agreement; and

(v)the estimated dollar amount of cost sharing the client will be required to pay if the units of service covered by the agreement are received by the client as planned;

(3)be modified or replaced when a redetermination of cost sharing is conducted; and

(4)not be presented to the client or his or her authorized representative for signature until such person has been informed in writing of policies and procedures governing payment, redetermination and nonpayment of cost sharing, including the right to a redetermination or a hearing regarding the extent of cost sharing required of the client.

(h)The area agency shall ensure the use of procedures for collection of cost sharing consistent with this section and with standards specified by the office:

(1)

(i)which may include the opportunity to pay equal amounts over the period covered by the cost-sharing agreement; and

(ii)which shall provide that no client shall be requested to pay a cost share for services for an amount in excess of the client's maximum monthly cost sharing as set forth in the cost-sharing agreement;

(2)designating authorized staff or agents to receive such cost sharing on behalf of the area agency;

(3)including the submission to the office for prior approval policies and procedures or actions for collecting cost sharing due but not paid by clients under cost-sharing agreements and for discharging clients due to nonpayment of cost sharing, providing that:

(i)clients who willfully fail to make payments shall be terminated from the program and shall be ineligible for any services under EISEP until payment of past cost sharing is received; and

(ii)clients will not be terminated from the program for reason of nonpayment without receiving:

(a)written notification of failure to make required cost sharing;

(b)an opportunity to be heard on whether such cost sharing was paid or why not;

(c)prior written notification of the proposed termination of services and the procedure for discharge from the program; and

(d)benefit of the procedures for discharge from the program.

9 NYCRR 6654.7 - OAA providers' maintenance of effort

Source version current through Mar 31, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022

Each OAA provider must:

(a)ensure that OAA funds are not used to replace funds from nonfederal sources; and

(b)agree to continue or initiate efforts to obtain support from private and other public sources for services funded through OAA.

9 NYCRR 6654.8 - Views of participants

Source version current through Mar 31, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022

Each service provider must develop and implement procedures to obtain the views of program participants about the services they receive. Copies of records of such views shall be maintained for at least five program years and shall be available to the area agency for inspection upon request.

9 NYCRR 6654.9 - Multipurpose senior centers

Source version current through Mar 31, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022

(a)Area agencies may award OAA funds to public or private not-for-profit agencies to:

(1)acquire, alter, lease or renovate a facility, including a mobile facility, for use as a multipurpose senior center;

(2)construct a facility, including a mobile facility, for use as a multipurpose senior center, if the office approves such construction after finding that no suitable facility exists or may be leased to be a focal point for service delivery; or

(3)provide professional and technical personnel to staff the multipurpose senior center.

(b)In making such awards, the area agency shall give preference to facilities in communities with the greatest incidence of elderly people with greatest economic or social need, with particular attention to low-income minority individuals.

(c)Recipients of such awards must comply with all applicable State and local health, fire, safety, building, zoning and sanitation laws, ordinances and codes, including those related to the structural soundness of load-bearing members.

(d)Plans and specifications for acquiring, altering, renovating or constructing a multipurpose senior center facility under OAA must comply with regulations relating to minimum construction and labor standards, particularly the Federal Architectural Barriers Act of 1968 and the Davis- Bacon Act.

(e)A multipurpose senior center facility must:

(1)if acquired for such use with funds under an area plan, be used for such purpose for at least 10 years after its acquisition; or

(2)if constructed for such use with funds under an area plan, be used for such purpose for at least 20 years after completion of construction.

(f)If use of a facility does not comply with subdivision (e) of this section, then the office or, if OAA funds were used, the Federal government, may recapture the proportion of the current value of the facility which is equal to the proportion of funds contributed to the original cost, as determined by agreement with the facility owner or by a judicial action in a court of competent jurisdiction.

(g)A facility altered, renovated or constructed with funds under an area plan may not be used and may not be intended to be used for sectarian instruction or as a place for religious worship.

(h)An area agency may award OAA funds under this section only if sufficient funds are available from other sources to meet the nonfederal share, and to effectively use the facility as a multipurpose senior center.

(i)If the facility is shared with other age groups, funds under this section may support only:

(1)that part of the facility used by elderly people; or

(2)a proportionate share of the costs, based on the extent of use of the facility by elderly people.

9 NYCRR 6654.10 - Earlier source heading: OAA, WIN, CSI and CSE-funded nutrition services

Related State Register notice: Adopted rule AGE-02-23-00020-A. Published Dec 27, 2023. Notice effective date: Dec 27, 2023.

Source version current through Dec 27, 2023

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Dec 27, 2023
Related Register notice: AGE-02-23-00020-A · Adopted rule
Related notice published: Dec 27, 2023
Related notice effective date: Dec 27, 2023

Current section text is not available here.

9 NYCRR 6654.11 - Earlier source heading: [Repealed]

Related State Register notice: Adopted rule AGE-44-18-00005-A. Published Oct 9, 2019. Notice effective date: Oct 9, 2019.

Source version current through Mar 31, 2022

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022
Related Register notice: AGE-44-18-00005-A · Adopted rule
Related notice published: Oct 9, 2019
Related notice effective date: Oct 9, 2019

Current section text is not available here.

9 NYCRR 6654.12 - OAA legal assistance

Source version current through Mar 31, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022

(a)Each area agency shall use an adequate portion of its OAA-supportive services funding for a program of legal assistance including advice and representation to elderly people with economic or social need. Legal assistance means legal advice and judicial or administrative representation by an attorney including, to the extent feasible, counseling or other appropriate assistance by a paralegal or law student under the direct supervision of an attorney. Legal assistance also includes counseling or representation by a nonlawyer where permitted by law, to elderly people with economic or social need. OAA legal assistance must be in addition to any other legal services already being provided to elderly people in the area.

(b)Each area agency shall develop and assure the coordination of a system of access to legal assistance for elderly in the area which encourages the participation of all segments of the legal provider community. If the area agency does not contract with a legal services corporation grantee, it will coordinate its services with existing legal services corporation projects in the area agency, in order to assure that the elderly receive a proportional share of representation from the legal services corporation grantee, to avoid under this Title on individuals with the greatest social and economic need.

(c)Each legal assistance provider shall make efforts, in coordination with the area agency, to involve the private bar in legal assistance for the elderly, including the establishment of groups within the private bar which will furnish legal assistance to elderly people on a pro bono or reduced-fee basis. The legal assistance provider and the area agency will develop a system of assisted referrals of cases to the private bar, including appropriate follow-up to assure that services have been provided.

(d)Each area agency must award funds to the legal assistance provider or providers that most fully meet the standards of this subdivision. The legal assistance provider or providers must:

(1)have staff with expertise in specific areas of law affecting elderly people in economic or social need (for example, public benefits, institutionalization, and alternatives to institutionalization);

(2)demonstrate the capacity to provide effective administration and judicial representation in the areas of law affecting elderly people with economic or social need;

(3)demonstrate the capacity to provide support to other advocacy efforts (for example, the long-term care ombudsman program);

(4)demonstrate the capacity to deliver legal services to institutionalized, isolated and homebound elderly individuals effectively; and

(5)demonstrate the capacity to provide legal assistance in the principal language spoken by clients in areas where a significant number of clients do not speak English as their principle language.

(e)Each legal assistance provider, in consultation with the area agency, may set priorities for service delivery which allocate program resources in areas which will concentrate service on the elderly least able to obtain legal assistance elsewhere. In setting case priorities, the area agency and service provider:

(1)may take into account the availability of staff resources in determining the extent of legal advice and representation to provide individual elderly people; but

(2)may not consider the priorities as eligibility criteria, but shall evaluate whether representation is appropriate in a particular case because of the benefits to the elderly individual or elderly in general, and the availability of adequate representation from other sources.

(f)In setting case priorities, criminal cases may not be defended, and representation in fee-generating cases except where private bar representation is otherwise unavailable is also prohibited. Filing conservatorships is prohibited except where an elderly person requests the filing of a voluntary petition or in the case of an involuntary petition against a close relative such as a spouse; and where no other agency can be persuaded to bring the petition and where bringing such a petition is not inconsistent with the interest of the elderly conservatee.

(1)Case priorities must be determined so as not to duplicate services available from other sources, i.e., the private bar and legal services corporation grantee, and to fill existing gaps in the availability of services to the elderly with the greatest need.

(g)Other provider responsibilities.

(1)The legal assistance provider shall assist the area agency with other advocacy efforts, and shall assist the long-term care ombudsman program.

(2)The legal assistance provider may not serve as house counsel to the area agency.

(3)The legal assistance provider shall provide training to area agency staff and, where appropriate, to community groups and members of the private bar. Training is reimbursable as training costs when provided by legal assistance providers. Outreach activities by the area agency and the legal assistance providers are reimbursable, and the legal assistance providers may be reimbursed for recruiting members of the private bar to conduct training, make group presentations and accept referrals.

(h)An OAA legal assistance provider may not require an elderly person to disclose information about income or resources as a condition for providing legal assistance. An OAA legal assistance provider may ask about an elderly person's financial circumstances as a part of the process of providing legal advice, counseling and representation, or for the purpose of identifying additional resources and benefits for which an elderly person may be eligible.

(i)Nothing in this section is intended to prohibit an attorney or staff attorney from providing any form of legal assistance to an eligible client, or to interfere with the fulfillment of any attorney's professional responsibilities to a client. When providing OAA legal assistance:

(1)Each legal assistance provider and its attorneys and employees must comply with the following regulations when engaged in the outside practice of law:

(i)no attorney shall engage in any outside practice of law if the director of the provider has determined that such practice is inconsistent with the attorney's full-time responsibilities;

(ii)if the requirement of subparagraph (i) of this paragraph is met, a provider may permit an attorney to engage in compensated outside practice of law when the attorney is newly employed and has a professional responsibility to close cases from a previous law practice, and does so as expeditiously as possible;

(iii)if the requirement of subparagraph (i) of this paragraph is met, a provider may permit an attorney to engage in compensated outside practice of law when the attorney is acting pursuant to an appointment made under a court rule or practice of equal applicability to all attorneys in the jurisdiction, and remits to the provider all compensation received; or

(iv)if the requirement of subparagraph (i) of this paragraph is met, a provider may permit an attorney to engage in uncompensated outside practice of law when the attorney is acting pursuant to an appointment made under a court rule or practice of equal applicability to all attorneys in the jurisdiction or on behalf of a close friend, family member, religious community, or charitable group.

(2)A provider, employee of the provider, or staff attorney shall not engage in the following prohibited political activities:

(i)A provider shall not contribute or make available OAA funds, or any personnel or equipment to any political party or association to the campaign of any candidate for public or party office; or for use in advocating or opposing any ballot measure, initiative, or referendum.

(ii)No employee shall intentionally identify the OAA program or provider with any partisan or nonpartisan political activity, or with the campaign of any candidate for public or party office.

(iii)No employee shall use any OAA funds for activities prohibited to attorneys under subparagraph (1)(i) of this subdivision; nor shall an employee intentionally identify or encourage others to identify the provider with such activities.

(iv)While engaged in any activity carried out during an employee's working hours which uses OAA resources and, in fact, provides legal assistance to an eligible client, no employee and no staff attorney shall, at any time:

(a)use official authority or influence for the purpose of interfering with or affecting the result of an election or nomination for office, whether partisan or nonpartisan;

(b)directly or indirectly coerce, attempt to coerce, command or advise an employee under OAA to pay, lend or contribute anything of value to a political party, committee, organization, agency or person for political purposes; or

(c)be a candidate for partisan elective public office.

(v)While engaged in any activity carried out during an employee's working hours which uses OAA resources and, in fact, provides legal assistance to an eligible client, no attorney shall engage in:

(a)any political activity;

(b)any activity to provide voters with transportation to the polls, or to provide similar assistance in connection with an election; or

(c)any voter registration activity;

(3)No provider shall use OAA funds to provide legal assistance in a fee-generating case unless other adequate representation is unavailable. All providers shall establish procedures for the referral of fee-generating cases.

(i)Fee-generating case means any case or matter which, if undertaken by an attorney in private practice, may reasonably be expected to result in a fee for legal services from an award to a client, from public funds, or from the opposite party.

(ii)Other adequate representation is deemed to be unavailable when the provider has determined that fee referral is not possible because of any of the following:

(a)the case has been rejected by the local lawyer referral service, or by two attorneys;

(b)neither the referral service nor any lawyer will consider the case without payment of a consultation fee; or

(c)emergency circumstances compel immediate action before referral can be made, but the client is advised that, if appropriate, and consistent with professional responsibility, referral will be attempted at a later time.

(iii)Other adequate representation is deemed to be unavailable when:

(a)recovery of damages is not the principal object of the case and a request for damages is merely ancillary to an action for equitable or other nonpecuniary relief; or inclusion of a counterclaim requesting damages is necessary for effective defense or because of applicable rules governing joinder of counterclaims; or

(b)a court appoints a provider or an employee of a provider pursuant to a statute or a court rule or practice of equal applicability to all attorneys in the jurisdiction; or

(c)an eligible client is seeking benefits under title II of the Social Security Act, Federal Old Age, Survivors, and Disability Insurance Benefits; or title XVI of the Social Security Act, Supplemental Security Income for Aged, Blind and Disabled.

(iv)A provider may seek and accept a fee awarded by a court or administrative body, or included in a settlement, if funds received are not used for prohibited purposes.

(v)When a case or matter subject to this section results in a recovery of damages, other than statutory benefits, a provider may accept reimbursement from the client for out-of-pocket costs and expenses incurred in connection with the case or matter, if the client has agreed in writing to reimburse the provider for such costs and expenses.

(4)While engaged in any activity carried out during an employee's working hours which uses OAA resources and, in fact, provides legal assistance to an eligible client, no employee shall:

(i)knowingly participate in any public demonstration, picketing, boycott or strike, except as permitted by law in connection with the employee's own employment situation; or

(ii)intentionally exhort, direct or coerce others to engage in such activities, or otherwise usurp or invade the rightful authority of a client to determine what course of action to follow.

(5)While employed under OAA, no employee shall, at any time:

(i)knowingly engage in any rioting or civil disturbance, activity in violation of an outstanding injunction of any court of competent jurisdiction, or any other illegal activity that is inconsistent with an employee's responsibilities under OAA, or the code of professional responsibility; or

(ii)intentionally exhort, direct or coerce others to engage in such activities, or otherwise usurp or invade the rightful authority of a client to determine what course of action to follow.

(6)Nothing in this subdivision shall prohibit an attorney from:

(i)informing and advising a client about legal alternatives to litigation or the lawful conduct thereof; or

(ii)fulfilling the professional responsibilities of an attorney to a client.

(j)No OAA funds made available to a provider shall be used, at any time, directly or indirectly, to support activities intended to influence the issuance, amendment or revocation of any executive or administrative order of a Federal, State or local agency, or to undertake to influence the passage or defeat of any legislation by the Congress of the United States or by any state or local legislative body or State proposals by initiative petition, except that:

(1)an employee may respond to a request from a governmental agency or a legislative body, committee or member, made to the employee or to a recipient to testify, draft or review measures or to make representation to such agency, body, committee or member on a specific matter; or

(2)an employee may engage in such activities at the request of an eligible client of a provider, to the extent such activities are necessary to the provision of legal advice and representation to a client who has sought such legal advice and representation with respect to particular legal rights and responsibilities which would be affected by particular legislation or administrative measures, but no employee shall solicit a client in violation of professional responsibilities for the purpose of making such representation possible.

(k)Providers shall adopt procedures and forms to document that the legislative and administrative activities in which they engage fall within the activities permitted by subdivision (f) of this section. Such documentation shall include:

(1)With respect to activities permitted under paragraph (f)(1) of this section, a written request, signed by an official of the governmental agency or a member of the legislative body or committee making the request, which states the type of representation or assistance requested and identifies the executive or administrative order or regulation, or legislation to be addressed.

(2)With respect to activities permitted under paragraph (f)(2) of this section, a retainer agreement, signed by the client or clients represented, or by an official of the client group in the case of a group client, which agreement shall specify the legislative or administrative measure on which representation is sought (appearance at a hearing, legislative drafting, etc.), and which shall include a statement of the client's direct interest in the particular legislative or administrative measure to be addressed.

(3)Providers shall obtain the documentation required by this subdivision prior to undertaking any of the activities permitted by paragraph (f)(1) or (2) of this section, except that providers may respond to an oral request made pursuant to such paragraph in the absence of a written request, provided that the fact, nature and circumstances of the request are subsequently documented in writing and signed by the requesting authority.

(l)No OAA funds may be used to:

(1)maintain separate offices for the sole purpose of engaging in legislative activity;

(2)pay dues to any organization (other than a bar association), a substantial purpose or function of which is to take positions on matters pending before legislative or administrative bodies;

(3)pay for transportation to legislative or administrative proceedings of persons other than employees engaged in activities under this section or witnesses entering appearances in such proceedings on behalf of clients of the providers, except that such funds may be used to transport the client where necessary and appropriate. This subdivision does not authorize payment of transportation expenses for employees not actually engaged in permitted representation activities;

(4)pay, in whole or in part, for the conduct of or transportation to an event if a primary purpose of the expenditure is to facilitate lobbying or any other activity which would be prohibited if conducted with OAA funds;

(5)pay for administrative or related costs associated with any activity prohibited by this section; or

(6)assist others, through legislative liaison activities, to influence legislation in a manner that would be prohibited if undertaken with OAA funds. Legislative liaison activities include, but are not limited to, attending legislative sessions or committee hearings, gathering information regarding pending legislation, and analyzing the effect of pending legislation.

(m)Notwithstanding the provisions of paragraph (f)(1) of this section, providers shall not use OAA funds for publicity or propaganda purposes designed to support or defeat proposed legislation or legislation pending before Congress or any state legislature. For purposes of this Chapter, publicity or propaganda means any oral communication or any advertisement, telegram, letter, article, newsletter or other printed or written matter or device which contains a direct suggestion or, when taken as a whole, an indirect suggestion to the public at large or to selected individuals to contact elected representatives in support of or in opposition to pending or proposed legislation.

(n)No OAA funds of a provider shall be used to support the preparation, production and dissemination of any article, newsletter or other publication or written matter for general distribution which contains any reference to proposed or pending legislation, unless:

(1)the publication does not contain any publicity or propaganda prohibited by subdivision (i) of this section;

(2)the provider has adopted a policy requiring the provider's executive director, or his or her designee, to review each publication produced by the provider prior to its dissemination for conformity to this section;

(3)the provider provides a copy of any such material to the area agency within 30 days after publication; and

(4)such funds are used only for costs incident to the preparation, production and dissemination of such publications to providers, providers' staff and board members, private attorneys representing eligible clients, and the area agency, as opposed to the public at large.

(o)Notwithstanding the provisions of subdivision (f) of this section, no OAA funds of a provider shall be used directly or indirectly to pay for any personal service, advertisement, telegram, telephone communication, letter, printed or written matter, or other device, intended or designed to influence any decision by a Federal, State or local agency, except where legal assistance is provided by an employee of a provider to an eligible client on a particular application, claim or case, which directly involves the client's legal rights and responsibilities, or to influence any member of Congress or any other Federal, State or local elected officials to favor or oppose any acts, bills, resolutions or similar legislation, or any referendum, initiative, constitutional amendment, or any similar procedure of the Congress, any state legislature, any local council, or any similar governing body, except that this subdivision shall not preclude such funds from being used in connection with communications made in response to any Federal, State or local official upon a specific matter. The exception for communications to officials does not authorize communication with anyone other than the requesting party. No employee of the provider shall, directly or indirectly, solicit a request from any official to testify or otherwise advocate the support or defeat of legislative measures.

(p)Nothing in this section is intended to prohibit an employee from:

(1)communicating with a governmental agency for the purpose of obtaining information, clarification or interpretation of the agency's rules, regulations or policies;

(2)informing a client about a new or proposed statute, executive order or administrative regulation consistent with the requirements of subdivisions (i) and (j) of this section;

(3)responding to an individual client's request for advice only with respect to the client's own communications to officials, unless otherwise prohibited by OAA statute or regulations or other applicable law. This paragraph does not authorize publication or training of clients on lobbying techniques or the composition of a communication for the client's use; or

(4)making direct contact with the area agency for any purpose.

9 NYCRR 6654.13 - Information and referral and outreach

Source version current through Mar 31, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022

(a)The area agency shall assure that elderly people have reasonably convenient access to a system of information and referral services to link them to appropriate resources.

(b)Any area agency serving an area where a substantial number of elderly people speak a language other than English as their principal language shall:

(1)assure that outreach services are delivered by workers who are fluent in the language spoken by a predominant number of such elderly people; and (2) designate an individual employed by the area agency on aging, or available to such area agency on a full-time basis, whose responsibilities will include:

(i)taking such action as may be appropriate to assure that counseling assistance is made available to elderly individuals who are of limited English-speaking ability in order to assist such elderly individuals in participating in OAA, CSE or EISEP programs; and

(ii)providing guidance to individuals engaged in the delivery of supportive services under the area plan to enable such individuals to be aware of cultural sensitivities and to take into account effectively linguistic and cultural differences.

(c)The information and referral service provider shall:

(1)maintain current information about opportunities and services available to elderly people;

(2)develop current lists of elderly people in need of services and opportunities; and

(3)employ a specially trained staff to inform and assist elderly people to take advantage of the available services and opportunities.

(d)The information and referral service provider may disclose information by name about an elderly person only with the informed consent of that elderly person or his or her authorized representative.

9 NYCRR 6654.14 - Transportation agreements

Source version current through Mar 31, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022

Under the Older Americans Act, the area agency may enter into agreements with agencies which administer programs under the Rehabilitation Act of 1973 and titles XIX and XX of the Federal Social Security Act to meet the common need for transportation of service participants under the separate programs. Such agreements may delegate the area agency's authority to award or administer funds if such delegation is approved by the office.

9 NYCRR 6654.15 - EISEP eligibility and definitions

Source version current through Apr 15, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Apr 15, 2022

(a)To be eligible for EISEP services, an individual must:

(1)be at least 60 years of age or older;

(2)be functionally impaired, as shown by a need for the assistance of another person, in at least one activity of daily living (bathing, dressing, toileting, being continent of urine and/or feces, transferring, walking and eating) or two instrumental activities of daily living (housekeeping, shopping, preparing meals, managing money, laundry, using transportation, telephoning and taking medication);

(3)have unmet needs for such assistance;

(4)not be eligible to receive the same or similar services under title XVIII, XIX or XX of the Federal Social Security Act or any other governmental program or services provided to residents in adult residential care facilities which had previously been provided by the facility or which by law are required to be provided by such facility;

(5)apply for Medicaid if it appears that:

(i)due to income and assets, he or she may be eligible for Medicaid without any spend- down; or

(ii)due to income, assets and qualifying expenses, he or she may be eligible for Medicaid, provided that no such application shall be required if such individual does not have available income to pay such qualifying expenses in the amount by which such individual's income exceeds the Medicaid eligibility level;

(6)be able to be maintained safely in his or her home environment; and

(7)for noninstitutional respite, have one or more informal caregivers who provide continuing care.

(b)To be eligible for consumer directed in-home services, an individual must meet the requirements included in subdivision (a) of this section and:

(1)be capable of making choices regarding their activities of daily living and instrumental activities of daily living and the type, quality and management of his or her in-home services worker; understand the impact of these choices; and assume responsibility for the results of these choices; or

(2)be capable of delegating authority to another who is capable of carrying out the activities listed in paragraph (1) of this subdivision on behalf of the consumer and meets the requirements of paragraph (d)(3) of this section; or

(3)if not capable of delegating authority to another, have someone who meets the qualifications of paragraph (d)(3) of this section.

(c)Determinations of eligibility are made using the standardized screening instrument and assessment process prescribed by the office.

(d)Definitions.

(1)Consumer means an individual who is receiving consumer directed in-home services and who is responsible for specific tasks as noted in section 6654.17 of this Part, as well as recruiting, interviewing, hiring, training, supervising and if necessary, dismissing their in-home services worker.

(2)Consumer directed in-home services means assistance with those tasks that are the same or similar to those listed as Personal Care Level I and Personal Care Level II in section 6654.17(f) and (g) of this Part and for which the consumer is assuming the responsibilities as noted in section 6654.17 of this Part.

(3)Consumer representative means any individual who is at least 18 years or older who on behalf of the consumer, is willing and able to perform the functions related to consumer directed in-home services as noted in paragraphs (b)(1) and (d)(1) of this section and section 6654.17 of this Part and has been delegated to do so by the consumer, provided however that when the consumer is not able to delegate a representative, the consumer representative shall:

(i)be the legally appointed guardian or conservator; or

(ii)have been previously designated as a representative by the consumer to be responsible for coordinating his/her care and the individual is currently performing and is willing to continue to perform the role; or

(iii)be currently involved in the consumer’s life and have a strong personal commitment to the consumer and demonstrates knowledge of the consumer’s preferences.

(4)Fiscal intermediary means an entity that carries out administrative functions as specified in the agreement with the area agency and shall include functions such as processing the consumer directed in-home services worker’s payroll with respect to Federal, State and local income tax and other payroll withholding requirements including FICA, workers’ compensation, unemployment insurance and other employee benefits.

(5)In-home services means services that provide assistance with those tasks listed as Personal Care Level I and Personal Care Level II in section 6654.17(f) and (g) of this Part.

(6)In-home services agency means an agency that provides Personal Care Level I and/or Personal Care Level II as defined in section 6654.17(f) and (g) of this Part.

(7)In-home services worker under consumer directed in-home services means an individual who performs the tasks listed in section 6654.17(f) and (g) of this Part and meets the following requirements:

(i)is at least 18 years of age;

(ii)is a citizen of the United States or has legal authority to work in the United States;

(iii)is not the consumer representative; and

(iv)has not been convicted of Medicaid or other benefits fraud or any form of abuse, neglect or exploitation.

9 NYCRR 6654.16 - EISEP case management

Related State Register notice: Adopted rule AGE-43-22-00001-A. Published Feb 8, 2023. Notice effective date: Feb 8, 2023.

Source version current through Mar 31, 2022

Top

Dates and status

NYCRR title agency: Executive Department
Section status: Register check
Source version current through: Mar 31, 2022
Related Register notice: AGE-43-22-00001-A · Adopted rule
Related notice published: Feb 8, 2023
Related notice effective date: Feb 8, 2023

Current section text is not available here.

9 NYCRR 6654.17 - EISEP in-home services

Related State Register notice: Adopted rule AGE-43-22-00001-A. Published Feb 8, 2023. Notice effective date: Feb 8, 2023.

Source version current through Mar 31, 2022

Top

Dates and status

NYCRR title agency: Executive Department
Section status: Register check
Source version current through: Mar 31, 2022
Related Register notice: AGE-43-22-00001-A · Adopted rule
Related notice published: Feb 8, 2023
Related notice effective date: Feb 8, 2023

Current section text is not available here.

9 NYCRR 6654.18 - EISEP noninstitutional respite services

Source version current through Mar 31, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022

(a)EISEP noninstitutional respite services may only be provided to clients receiving ongoing care from informal caregivers pursuant to a service plan based on the overall care plan developed under section 6654.16 of this Part which documents a need for such respite to support or enhance such informal care.

(b)[Reserved]

(c)Respite consisting of housekeeping/chore or homemaking/personal care services shall comply with section 6654.17 of this Part.

(d)Respite consisting of paid supervision shall:

(1)utilize only workers who have been screened for any history of client abuse and any history of conviction for a related felony;

(2)not permit paid supervision workers to deliver any in-home services as defined in section 6654.17 of this Part; and

(3)include 24-hour respite only if provided in the client's home or the home of the primary informal care giver.

(e)Respite consisting of adult day care may not be used to cover the cost of medically oriented services such as medical care, skilled nursing care, skilled therapies, dental care, audiology, podiatry or ophthalmology.

(f)Noninstitutional respite may not be provided in adult homes until the New York State Department of Social Services promulgates regulations for adult day care programs in such adult homes and must, unless otherwise specified by the office, comply with such regulations once promulgated.

(g)Noninstitutional respite may consist of any of the following: homemaker/personal services, housekeeper/chore services, paid supervision, and nonmedical adult day care.

(h)EISEP payments to providers of respite in congregate settings must only be for services provided to individual clients enrolled in EISEP and pursuant to EISEP care plans and cannot be used to subsidize, in whole or in part, services provided to persons not enrolled in EISEP.

9 NYCRR 6654.19 - EISEP ancillary services

Source version current through Mar 31, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022

(a)Ancillary services include non-medical services, items and other supports which together with other assistance are intended to provide an individual in need of long term care with the ability to remain safely in the community with an acceptable quality of life.

(b)Ancillary services shall be provided only to an EISEP client pursuant to a care plan on a per client basis.

(c)A client will be re-evaluated in accordance with the reassessment process found in section 6654.16 of this Part to insure that all ancillary services provided under this section are appropriate and necessary and continue to be in accordance with the client's care plan.

(d)Expenditures for ancillary services may only be made if no other payment source is available.

(e)Allowable services, items/goods and other supports which may be provided under ancillary services are as follows:

(1)those that maintain or promote the individual's independence such as:

(i)purchasing/renting of equipment or assistive devices;

(ii)purchasing/renting, maintaining and repair of appliances;

(iii)personal and household items;

(iv)social adult day services; and

(v)transportation to needed medical appointments, community services and activities;

(2)those that maintain, repair or modify the individual's home so that it is a safe and adequate living environment, such as:

(i)home maintenance and chores;

(ii)heavy house cleaning; and

(iii)removal of physical barriers;

(3)those that address everyday tasks, such as:

(i)house cleaning;

(ii)laundry;

(iii)grocery shopping, shopping for other needed items and other essential errands;

(iv)bill paying and other essential activities;

(v)providing meals; and

(vi)escort to appointments and other community activities.

(f)The following items or services may not be provided as an ancillary service:

(1)food, except for meals provided under the nutrition program administered by an area agency or other meals that the area agency has determined meet the nutritional requirements of such program;

(2)housing expenses which include, but are not limited to, expenditures for rent, mortgage, property taxes, heating fuel, gas, electricity, water, sewage, garbage collection, cable television and telephone services; and

(3)items or services that can be obtained only with a prescription or doctor's order.

(g)The area agency must have and follow written policies and procedures for ensuring justification and documentation for each ancillary service provided.

(h)Documentation verifying the receipt of the ancillary service must be maintained in the client case record.

(i)For any item or alteration to be left in the client's home for an extended period or permanently, the area agency must have a signed agreement with the client that includes statements regarding ownership of the item or alteration and the responsibilities of the client and agency regarding the item or alteration. Movable durable items remain the property of the area agency until the area agency determines that the item has no appreciable value.

9 NYCRR 6654.20 - Social adult day care programs

Source version current through Mar 31, 2022

Later State Register activity may affect this section.

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Dates and status

NYCRR title agency: Executive Department
Section status: Section source receipt
Source version current through: Mar 31, 2022

(a)Purpose.

The purpose of this section is to establish minimum requirements for the administration and operation of social adult day care programs as described in this section and for the oversight and other responsibilities of area agencies on aging.

(b)Definitions.

For the purposes of this section:

(1)Social adult day care program or program means a structured, comprehensive program which provides functionally impaired individuals with socialization; supervision and monitoring; personal care; and nutrition in a protective setting during any part of the day, but for less than a 24-hour period. Additional services may include and are not limited to maintenance and enhancement of daily living skills, transportation, caregiver assistance, and case coordination and assistance.

(2)Participant means an adult individual who is eligible for and is receiving social adult day services in accordance with this section.

(3)Functionally impaired means needing the assistance of another person in at least one of the following activities of daily living: toileting, mobility, transferring, or eating; or needing supervision due to cognitive and/or psycho-social impairment.

(c)Area agency on aging responsibilities.

(1)In carrying out oversight and other responsibilities related to social adult day care programs, including the purchase of services, the area agency on aging will comply with Chapter II of this Subtitle, except as otherwise provided in this Part.

(2)Consistent with this section, an area agency on aging may establish additional requirements for social adult day care programs operating under this section.

(3)The area agency on aging shall ensure that providers carry out this section in accordance with the applicable provisions of the Federal Americans with Disabilities Act.

(4)An area agency on aging shall apply these requirements to social adult day care programs, as described in this section, that are provided under contracts entered into or renewed on or after six months from the effective date of these amendments establishing minimum standards for social adult day care programs.

(d)Program standards.

All social adult day care program providers which receive funding from an area agency on aging and all area agencies on aging which directly operate a social adult day care program shall meet the following services and administration standards.

(1)Services standards.

(i)Participant eligibility. A social adult day care program shall serve only individuals who are functionally impaired and will benefit from participation in the program.

(ii)Admission and discharge.

(a)The program shall serve only individuals whose social adult day care needs can be met and managed by the program.

(b)The program shall admit an individual only after an assessment of the individual's functional capacities and impairments has been completed.

(c)The program shall discharge and, if appropriate, assist in making other arrangements for a participant who can no longer be safely or adequately served by the program.

(iii)Service plan.

(a)Each participant shall receive services only in accordance with an individualized written service plan which has been developed by the program staff in conjunction with the participant and, if applicable, the participant's authorized representative. To the extent possible, if applicable, the plan shall be developed in consultation with the participant's informal caregiver(s).

(b)A service plan shall be developed no later than 30 days after a participant's admission to the program and reviewed as necessary or at least once annually.

(c)The service plan shall be based on the assessment and shall be consistent with the needs of the participant.

(d)To the maximum extent possible, each service plan:

(1)shall seek to attain and maintain the highest practicable physical, mental, and psychosocial well being of the participant, including an optimal capacity for independence and self care; and

(2)shall encourage the participant to use his/her existing capacities, develop new capacities and interests and compensate for existing or developing impairments in capacity.

(e)The service plan shall specify the individual participant outcomes expected from the provision of social adult day care services.

(iv)Services.

(a)Required services. Consistent with the needs of the participant, all programs shall provide the following services:

(1)Socialization which:

(i)means planned and structured activities which utilize the participant's skills to the extent possible; respond to the participant's interests, capabilities, and needs; and minimize any impairments in capacity to engage in those activities;

(ii)includes social, intellectual, cultural, educational, and physical group activities; and

(iii)encourages and stimulates the participant to interact with others and seeks to establish, maintain, or improve the participant's sense of usefulness to self and others, the desire to use his or her physical and mental capabilities to the fullest extent, and his or her sense of self-respect.

(2)Supervision and monitoring which:

(i)means observation and awareness of the participant's whereabouts, activities, and current needs during attendance at the program; and

(ii)protects the safety and welfare of the participant and provides ongoing encouragement and assistance to the participant.

(3)Personal care which:

(i)shall include some assistance for the participant with toileting, mobility, transfer, and eating;

(ii)may include total assistance to the participant with toileting, mobility, transfer, and eating; and

(iii)may include some assistance or total assistance to the participant with:

(A)dressing;

(B)bathing;

(C)grooming;

(D)self administration of medication, including prompting the participant as to time, identifying the medication, bringing the medication and any necessary supplies or equipment to the participant, opening the container, positioning the participant for medication and administration, and disposing of used supplies and materials;

(E)routine skin care;

(F)changing simple dressings; or

(G)using supplies and adaptive and assistive equipment.

(4)Nutrition.

(i)Nutrition means providing nutritious meals for participants who are attending the program at normal meal times and includes offering snacks and liquids for all participants at appropriate times.

(ii)Meals shall be consistent with standards set forth in this Part for a nutrition program for the elderly site and as established by the office, unless:

(A)participant meals are brought by the participant; or

(B)the program participates in the USDA Child and Adult Care Food Program.

(iii)If meals are prepared by participants and/or staff as part of a planned activity of the program, such meals to the extent possible shall be consistent with standards set forth in this Part for a nutrition program for the elderly site and as established by the office.

(b)Optional services. Consistent with the needs of the participant, programs may provide the following services:

(1)Maintenance and enhancement of daily living skills which shall include, where appropriate, activities which supplement, maintain, and/or enhance the participant's own daily living skills; and/or training which assists the participant to learn or relearn self-care skills, if possible. Participant skills which may be addressed include:

(i)instrumental activities of daily living including use of transportation, doing laundry, shopping, cooking, using a telephone, and handling personal business and finance;

(ii)self-care skills such as grooming, washing, and dental hygiene;

(iii)use of supplies and adaptive and assistive equipment; or

(iv)other appropriate related skills.

(2)Transportation between the home and the program.

(3)Caregiver assistance which shall include:

(i)facilitating informal caregiver support of the participant;

(ii)fostering understanding of the condition of the participant, the contents of the service plan, and how to maximize at home the use of skills learned or relearned in the program;

(iii)identifying sources of assistance to the informal caregiver and facilitating access to that assistance, including participation in support groups;

(iv)facilitating respite; and

(v)other related assistance.

(4)Case coordination and assistance, which:

(i)shall include establishing and maintaining effective linkages, coordinating with, and, as appropriate, making referrals to and accepting participants from other services providers; and

(ii)may include advising and assisting participants and their caregivers, if any, in relation to benefits, entitlements, and other information and assistance.

(2)Administration standards.

(i)Policies and procedures. Each social adult day care program shall establish, follow, and have on file for review by the area agency on aging or the office written policies and procedures consistent with this section regarding the operation of the program including but not limited to:

(a)participant eligibility;

(b)admission and discharge;

(c)service plan;

(d)staffing plan, including paid and volunteer staff;

(e)participants' rights;

(f)services delivery;

(g)program self evaluation;

(h)records; and

(i)emergency preparedness.

(ii)Program self evaluation. The program shall:

(a)conduct a self evaluation of its administrative, fiscal, and program operations, including feedback from participants and caregivers, at least annually; and

(b)maintain a copy of the self evaluation on file for review by the area agency on aging or the office.

(iii)Records. The program shall:

(a)maintain the following information on file:

(1)administrative and financial records;

(2)participant personal records, including identifying, emergency, and medical information including physician name, diagnosis, and medications; and

(3)services records, including the individual assessment, the service plan, and documentation of the delivery of services; and

(b)treat all information as confidential and shall not disclose or release information except as authorized by Federal or State laws and regulations, or pursuant to court order.

(iv)Staffing.

(a)General requirements.

(1)The program shall have an adequate number of qualified staff, which may include volunteers, to perform all of the functions prescribed in this Part and to ensure the health, safety, and welfare of participants.

(2)The program shall have at least two staff, one of whom shall be a paid staff person, with the participants during the program day.

(3)Health status. The program shall ensure that:

(i)the health status of each staff person who may or will have contact with participants, including the program director, is assessed and documented annually and that the health status of each new staff person is assessed and documented prior to the beginning of contact with the participant to ensure that he or she is free from any health impairment that is of potential risk to others or that may interfere with the performance of his or her duties; and

(ii)each staff person who may or will have contact with participants has a ppd (Mantoux) skin test for tuberculosis prior to employment and no less than every two years thereafter for negative findings or more frequently as determined by the Director of the State Office for the Aging.

(b)Personnel.

(1)Director. Each social adult day care program shall have a paid director.

(i)Qualifications. The director shall be a qualified individual with appropriate educational qualifications and work experience to ensure that activities and services are provided appropriately and in accordance with participants' needs.

(ii)Duties. The director shall:

(A)have the authority and responsibility necessary to manage and implement the program;

(B)ensure compliance and conformity with all applicable local, State, and Federal laws and regulations;

(C)submit program reports, as necessary; and

(D)be responsible for policies and procedures as required by this Part.

(2)Services staff. Services staff shall:

(i)be responsible for carrying out the individualized service plan for participants; and

(ii)complete training as required by this section.

(3)Volunteers.

(i)As determined by the program director, the program shall provide training for volunteers which is appropriate for the tasks to which they are assigned. In making this determination, the program director shall consider whether such volunteer may on occasion be asked or required to perform tasks related to the health, safety, or welfare of participants.

(ii)All volunteers who may or will have contact with participants are subject to the requirements of this section, including the assessment of health status required in this paragraph.

(c)Training requirements for all staff.

(1)Except as otherwise provided in this section, the program shall provide all staff with:

(i)an orientation to the program provider, the community, and the program itself;

(ii)training on working with the elderly, participants' rights, safety, and accident prevention;

(iii)at least six hours of in-service training annually to develop, review, or expand skills or knowledge; and

(iv)training at least annually in the use of fire extinguishers, written procedures concerning evacuation and emergency situations, and emergency telephone numbers.

(2)The program shall provide staff with training appropriate to the tasks to which they are assigned.

(3)The program shall maintain appropriate documentation for all training provided to staff.

(d)Training requirements for service staff.

(1)Prior to delivering any social adult day care services, all service staff including volunteer service staff must complete basic training, or have equivalent knowledge and skills as established in this section, as follows:

(i)orientation to personal care skills;

(ii)body mechanics; and

(iii)behavior management.

(2)Within three months of being assigned to provide social adult day care services, all service staff including volunteer service staff must complete additional training, or have equivalent knowledge and skills as established in this section, which:

(i)is directed by a registered professional nurse, social worker, home economist, and/or other appropriate professional with at least a bachelor's degree or four years professional experience in an area related to delivery of human services or education;

(ii)totals at least 20 hours of group, individual, and/or on-the-job training;

(iii)covers the following topics:

(A)socialization skills and activities;

(B)supervision and monitoring;

(C)personal care skills, taught by a registered nurse;

(D)the family and family relationships;

(E)mental illness and mental health; and

(F)cardiopulmonary resusitation (CPR); and

(iv)includes evaluation of each person's competency in the required content.

(3)Equivalent knowledge and skills.

(i)Persons who have completed personal care training which is approved by the State Department of Social Services or home health aide training or nurse aide training which is approved by the State Department of Health shall be considered by the program to have met the training requirements of this clause.

(ii)Persons who have completed adult day care worker training which is approved by the State Office of Mental Retardation and Developmental Disabilities may be considered by the program to have met those portions of the training requirements which in the judgment of the program are equivalent to the training requirements of this clause.

(iii)Any person who has been employed for at least three months prior to the effective date of this Part by a social adult day care program which has been funded or directly operated by an area agency on aging and who has been delivering social adult day care services may be considered by the program to have met the training requirements of this clause.

(iv)The program shall maintain appropriate documentation for services staff who have equivalent knowledge and skills.

(4)The program shall provide all service staff with periodic on-the-job training, as considered necessary by the program director or an individual who supervises service staff according to criteria for evaluating job performance and the ability to function competently and safely.

(v)Consultants. Programs may arrange for qualified consultants to assist with education, staff training, and other appropriate tasks.

(vi)Physical environment and safety. The program shall:

(a)Use a facility which has sufficient space to accommodate program activities and services.

(b)Maintain and operate buildings and equipment so as to prevent fire and other hazards to personal safety.

(c)Notify in writing the local fire jurisdiction in which the program exists of its presence and hours of operation.

(vii)Emergency preparedness. The program shall:

(a)have current, written procedures for handling emergencies (such as a flood or fire or when a participant is choking or has fainted);

(b)have an easily located file on each participant, listing identifiable information, including physician's name and telephone number and family member's name and telephone numbers, needed in emergencies; and

(c)conduct fire drills at least twice a year and document those drills.

(viii)Insurance. The social adult day care program shall have in effect sufficient insurance coverage, including but not limited to personal and professional liability.

(e)Participants' rights.

(1)The program shall protect and promote the following rights of participants:

(i)Participants shall be treated with dignity and respect.

(ii)Participants shall not be subject to verbal, sexual, mental, physical, or financial abuse, corporal punishment, or involuntary work or service by the program.

(iii)Participants shall not be subject to chemical or physical restraint by the program.

(iv)Participants shall not be subject to coercion, discrimination, or reprisal by the program.

(v)Participants shall be free to make personal choices about accepting or refusing the services and activities offered.

(vi)Personal information about participants shall be kept confidential.

(2)The program shall give a copy of and shall explain the rights to participants and caregivers at the time of admission.

(3)The program shall post these rights, along with the addresses and telephone numbers of the area agency on aging and the office, in a public place which is clearly visible to participants, their families, and program staff.

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