N.Y. Comp. Codes R. & Regs. tit. 18 § 423.5

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

Section 423.5 - Fiscal requirements

(a) General requirements. A social services district will be reimbursed for 65 percent of the costs of mandated, non-mandated, and community optional preventive services provided pursuant to section 409-a of the Social Services Law when the following conditions are met:

(1) children and their families receiving such preventive services meet the client eligibility criteria as defined in sections 423.3 and 430.9 of this Title or a community optional preventive services program approved by the Office of Children and Family Services ("OCFS") under subdivision (3) of section 409-a of the Social Services Law;

(2) the social services district receives approval of its county's child and family services plan pursuant to section 34-a of the Social Services Law;

(3) the social services district certifies that it will not be using these funds to supplant other State and local funds and that it will not submit claims for reimbursement for the same type and level of services that the district previously provided and claimed under any contract in existence on October 1, 2002 as other than child protective, preventive, independent living, or after care services or adoption administration and services, other than adoption subsidies provided pursuant to title 9 of article 6 of the Social Services Law and implementing regulations;

(4) for a district to receive an increase in funding for child protective, preventive, independent living, or after care services, or adoption administration and services over the amount the district received for such services that were reimbursable in State fiscal year 2004-05:

(i) the amount of funds that the district expends on such services from its flexible fund for family services allocation and any flexible fund for family services funds transferred at the district's request to the title XX social services block grant must, to the extent that families are eligible therefore, be equal to or greater than the amount the district spent for such services that were reimbursed during State fiscal year 2004-05 with temporary assistance to needy families block grant funds for families eligible for emergency assistance to families and with temporary assistance to needy families block grant funds transferred to the title XX social services block grant; or

(ii) the district must increase the gross amount of such funds above the amount claimed for State fiscal year 2004-05, in which case, the increase in funding will only be available for 65 percent of the claims that exceed the gross amount claimed in State fiscal year 2004-05;

(5) beginning January 1, 2008, such preventive services, whether purchased or provided directly by the district, include performance or outcome-based provisions.

(i) For purposes of complying with this requirement, performance means quantifiable and verifiable interim changes in, or maintenance of, the conditions or behaviors of the target population resulting from the provision of services that indicate progress towards an outcome, and outcome means the anticipated change in, or maintenance of, conditions or behaviors of a targeted population as a result of the provision of services.

(ii) In the absence of the required performance or outcome-based provisions, OCFS may limit up to 100 percent of a district's State reimbursement for preventive services expenditures related to any increases in the amount of the district's gross claims for such expenditures that are otherwise reimbursable during State fiscal year 2007-08 and thereafter that exceed the amount of its gross claims for the period October 1, 2005 through September 30, 2006 that were claimed through March 31, 2007. However, OCFS may determine, in its discretion, not to reduce a district's reimbursement in this manner if the district is able to demonstrate, in a form and manner determined by OCFS, that the absence of the required performance or outcome-based provisions is due to extenuating circumstances beyond the district's control including, but not limited to, the inability to amend a contract for the purchase of preventive services that was in effect on April 9, 2007 that extends past January 1, 2008.

(b) In-kind or indirect services and donated funds. Claims for preventive services and independent living services submitted by a social services district for reimbursement may be comprised of in-kind, indirect services, and non-tax levy funds, including but not limited to privately donated funds, up to the same amount as the social services district's claims for such services during Federal fiscal year 1998-99 were comprised of in-kind, indirect services and non- tax levy funds; provided, however, that up to 171/2 percent of a social services district's claims for preventive services and independent living services may be comprised of privately donated funds if the percentage of its claims comprised of privately donated funds was less than 171/2 percent during Federal fiscal year 1998-99. Federal reimbursement of such claims shall be available only to the extent permitted by Federal law or regulations.

(c) Reimbursement by OCFS for foster care services, including casework contact requirements pursuant to section 441.21 of this Title and diligence of efforts requirements pursuant to section 430.12 of this Title may not be claimed as preventive services.

(d) Reimbursement by OCFS for child protective services, including activities of receiving and investigating reports and monitoring shall not be claimed as preventive services.

(e) Reimbursement by OCFS to local social services districts for preventive services expenditures shall be claimed on such forms as designated by OCFS.

(f) Notwithstanding any provision of this section, reimbursement by OCFS to local social services districts for preventive services expenditures shall not be made unless the local social services districts explore and use other available funding sources including title XIX of the Social Security Act where applicable.

(g) Notwithstanding any provision of this section, reimbursement by OCFS to local social services districts for preventive services expenditures shall not be made if OCFS determines that such local districts are over-utilizing particular forms or types of preventive services or are not providing balanced preventive services programs based on the identified needs of children and families residing in such local districts.

(h) Social services districts shall prepare and submit to OCFS information about compliance with this section in a form and manner and at the times specified by OCFS.

N.Y. Comp. Codes R. & Regs. Tit. 18 § 423.5