§ 214. Community services for the elderly. 1. Definitions. As used in
this section, the following words shall have the following meanings:

(a) "Designated agency" shall mean an agency which is designated by
the chief executive officer of the county if there be one, or otherwise
the governing board of such county, or the chief executive officer of
the city of New York, or the governing board of an Indian tribal
council; which is either a unit of county government or the city of New
York or an Indian tribal organization or a private non-profit agency,
and which is the area agency on aging created pursuant to the federal
older Americans act of 1965.

(b) "Elderly person" shall mean a person sixty years of age or older.

(c) "County" shall mean a county, as defined in section three of the
county law, except that the city of New York shall be considered one
county.

(d) "Base year expenditures" and "base year services" shall mean the
level of expenditures and services in the year prior to the first year
for which a county plan is submitted or in such county's two thousand
five fiscal year, whichever is greater.

(e) "Community services" shall mean services for elderly persons which
are provided by a public or governmental agency or non-profit agency,
and which are provided in the home of an elderly person or in community
settings such as senior citizens centers, housing projects, or agency
offices. Such services shall not include any services provided pursuant
to the public health law other than home care services.

(f) "Community service projects" shall mean community services
financed pursuant to paragraph (b) of subdivision four of this section.

(g) "County plan" shall mean a plan for community services prepared by
a county pursuant to this section.

(h) "Non-profit agency" shall mean a corporation organized or existing
pursuant to the not-for-profit corporation law.

(i) "Program year" shall mean the period from April first through
March thirty-first of the following calendar year.

(j) "First program year" for a county shall mean the initial year for
which the county has received approval for its county plan.

2. County plans for improving the availability of community services
to the elderly. (a) Counties with a designated agency are required to
submit a county plan for a two-, three-, or four-year period determined
by the director, with an annual update containing a budget request for
the forthcoming program year and such other information as shall be
required by the director, for improving the delivery of community
services for elderly persons in the format prescribed by the director.
The plan for the city of New York shall specifically address the needs
of each county within such city. Such plan shall be a comprehensive
description of the manner in which the county intends to address the
needs of elderly persons living in the county through improved
coordination of existing community services and by the development of
any new or expanded community service projects which will improve the
delivery of services to the elderly. Such plan shall contain:

(1) a statement of goals and objectives for addressing the needs of
elderly persons in the county, an assessment of the needs of elderly
persons residing in the county, a description of public and private
resources that currently provide community services to elderly persons
within the county, a description of intended actions to consolidate and
coordinate existing community services administered by county
government, a description of the intended actions to coordinate
congregate services programs for the elderly operated within the county
pursuant to section two hundred seventeen of this title with other
community services for the elderly, a description of the means to
coordinate other community services for elderly persons in the county
with those administered by county government, and a statement of the
priorities for the provision of community services during the program
period covered by such plan;

(2) an identification of community service projects to be developed to
improve the delivery of services, a budget request for approval for the
forthcoming year which individually identifies each community service
project to be funded pursuant to paragraph (b) of subdivision four of
this section, letters of comment from the appropriate local agencies on
the relationship and expected impact of the proposed community service
projects, assurances that community service projects will provide
services to those most in need, an indication of fee schedules by which
elderly persons participating in community service projects may
contribute to the costs of such projects, and an indication of how the
effectiveness of such community service projects will be evaluated;

(3) an identification of planning, coordination, and administrative
activities necessary to achieve the goals and objectives of the plan,
together with a budget request for such activities for approval for the
forthcoming year to be funded pursuant to paragraph (a) of subdivision
four of this section, and assurances by the county that it will comply
with the requirements of state and federal law; and

(4) such other components as may be required pursuant to regulations
promulgated by the director.

(b) Such county plan for community services or annual update shall be
prepared by the designated agency and approved by the chief executive
officer of the county, if there be one, or otherwise the governing board
of the county, or the chief executive of the city of New York and
submitted to the director no later than ninety days prior to the
beginning of the program period covered by such plan or annual update.
Prior to a submission of a county plan or annual update to the director
for approval, the designated agency shall conduct such public hearings
as may be required by regulations of the director, provided that there
shall be at least one such hearing, and one in each county contained
within the city of New York.

(c) The director shall review such county plan and may approve or
disapprove such plan, or any part, program, or project within such plan,
and shall propose such modifications and conditions as are deemed
appropriate and necessary. Compliance with paragraphs (a) and (b) of
this subdivision shall be the basis for approval of a county plan. The
director shall establish by regulation the dates for notifying the
designated agency of approval or disapproval of a county plan. In the
event the director shall disapprove the proposed county plan, the county
submitting such application shall be afforded an opportunity for an
adjudicatory hearing, as prescribed by article three of the state
administrative procedure act.

(d) Notwithstanding any provision of this section, nothing contained
in this section shall give the director or a designated agency any
administrative, fiscal, supervisory, or other authority whatsoever over
any plans, programs or expenditures authorized pursuant to titles
eighteen, nineteen and twenty of the federal social security act, or
over any unit of state or local government.

(e) Counties with a designated agency may submit to the director a
letter of intent, in the form and by the date prescribed by the director
with the approval of the director of the budget, evidencing the
commitment of the county to develop a county home care plan for
functionally impaired elderly.

(f) Within the amounts appropriated therefor, counties submitting an
approved letter of intent pursuant to paragraph (e) of this subdivision
shall be eligible for reimbursement of one hundred percent of the
approved expenditures for preparing a county home care plan for
functionally impaired elderly. Such a grant-in-aid shall be available to
a county only once and shall be limited to one-half the amount available
to such county pursuant to subparagraph one of paragraph (a) of
subdivision four of this section; provided however that in either of the
two years immediately following its first submission of a home care plan
for functionally impaired elderly, a county which does not receive state
aid during such year for expanded non-medical in-home services,
non-institutional respite services, case management services, and
ancillary services pursuant to paragraph (j) of subdivision four of this
section, may apply for reimbursement of one hundred percent of the
approved expenditures for revising such home care plan, limited to
one-quarter the amount available to such county pursuant to subparagraph
one of paragraph (a) of subdivision four of this section.

(g) County home care plans for functionally impaired elderly prepared
pursuant to this subdivision shall include a comprehensive description
of all aspects of home care, non-institutional respite, case management,
and ancillary services available to elderly persons in the county; a
description of intended actions to coordinate such home care,
non-institutional respite, case management, and ancillary services to
functionally impaired elderly persons in their county provided under
this section with other services to elderly persons; a proposal for
expanded non-medical in-home services, non-institutional respite
services, case management services, and ancillary services for
functionally impaired elderly persons with unmet needs to support such
persons' continued residence in their homes; and such other components
as may be required pursuant to regulations promulgated by the director,
including how the proposed expanded non-medical in-home services,
non-institutional respite services, case management services, and
ancillary services will be delivered to unserved or underserved
populations.

(h) Such county home care plan for functionally impaired elderly shall
be prepared by the designated agency after consultation with the social
services district and the local public health agency, and shall be
approved by the chief executive officer of the county, if there be one,
or otherwise the governing board of the county, or the chief executive
of the city of New York, and submitted to the director for approval by
such date as may be specified by regulation. The director shall not
approve such county home care plan for functionally impaired elderly
unless it complies with the standards and regulations issued pursuant to
this section.

3. Community service projects. (a) The director may authorize a county
which has an approved county plan pursuant to this section to provide
one or more community service projects included in such approved plan
which are designed to make community services and entitlement programs
more available and accessible to older persons through the improved
coordination and delivery of services for the elderly. As necessary to
meet project goals and objectives, such projects may provide new
services not previously provided within the county, expand services
provided during the base year, and establish new mechanisms to
coordinate all existing and new services.

(b) Counties having an approved plan which includes one or more
community service projects shall be eligible for state aid, as provided
in subdivision four of this section, for the provision of such projects
identified in such plan.

(c) Each community service project included in a county plan shall
clearly specify the intended goals and objectives of such project, shall
describe the elderly population the project intends to serve, shall
specify a timetable not to exceed three years to achieve and evaluate
such goals and objectives, and shall specify proposed methods to
evaluate the effectiveness of such project.

(d) The director, with the advice of the advisory committee for the
aging, shall promulgate regulations and issue guidelines for evaluating
the effectiveness and achievements of such community service projects,
shall require periodic evaluations of each project, and shall make
available such evaluations to appropriate agencies, the governor and the
legislature.

(e) No project funded pursuant to this section shall continue beyond
three years, unless approved by the director after the director is
satisfied that the project effectively improves the delivery of services
to the elderly based upon periodic evaluations of the project.

4. State aid. (a) County plans for improving the availability of
community services to the elderly:

(1) within the amounts appropriated therefor, counties with an
approved county plan shall be eligible for reimbursement of one hundred
percent of the annual approved expenditures for the preparation and
revision of such county plan, evaluation of projects contained within
such county plan, execution of interagency agreements necessary to carry
out the plan, actions to consolidate, combine or collocate services
within the county, and such other costs of the designated agency
necessary to implement such county plan, provided that the total annual
amount payable to a county pursuant to this subparagraph shall not
exceed the sum of one dollar for each elderly person residing in the
county, or seventy-five thousand dollars, whichever is less, and further
provided that for the city of New York such amount shall not exceed one
dollar for each elderly person residing in the city or three hundred
seventy-five thousand dollars, whichever is less. Notwithstanding the
foregoing limitations, counties with a population of less than twenty
thousand elderly persons shall be eligible for reimbursement of one
hundred percent of such annual approved expenditures provided that the
total annual amount of such reimbursement per county shall not exceed
twenty thousand dollars.

(2) within the amounts appropriated therefor, a county may receive a
grant-in-aid of up to twenty-five per centum of the total annual amount
that such county is eligible to receive pursuant to subparagraph one of
this paragraph for the cost of preparing an initial county plan in
accordance with this section. Such a grant-in-aid shall be available to
a county only once and shall be in addition to the reimbursement
received by the county pursuant to subparagraph one of this paragraph
for the first program year. A request for such a grant-in-aid shall be
accompanied by a letter of intent in the form prescribed by the director
evidencing the commitment of the county to develop a county plan for
community services and shall be submitted to the director at least six
months prior to the beginning of the first program year.

(b) Community service projects:

(1) within the amounts appropriated therefor, counties having an
approved county plan shall be eligible for reimbursement by the state
for expenditures for approved community service projects pursuant to
this section. Such state reimbursement shall not exceed thirty-three
thousand six hundred dollars or four dollars twenty cents for each
elderly person residing in the county, whichever is greater. The annual
state reimbursement eligibility shall be at a rate of seventy-five
percent of the total annual expenditures for such approved programs.

(2) the director shall provide by regulation that certain non-county
moneys and in-kind equivalents may be used to comprise the county share
of such total annual approved expenditures, provided that such county
share shall not include cost-sharing received from elderly persons
receiving expanded non-medical in-home services, non-institutional
respite services, case management services, and ancillary services
pursuant to paragraph (k) of this subdivision or moneys received from
the federal government for services for the elderly allocated to the
states or local governments according to population or other such
non-competitive basis.

(3) the director shall provide by regulation the requirements for any
participant contributions and fee schedules used for community service
projects and the manner for the accounting and use of any such revenue.

(c) Reimbursement pursuant to this section shall not be available for
expenditures for base year services otherwise provided without cost, or
to replace base year expenditures made by the county or any other
service provider irrespective of the source of funds for such services.

(d) Reimbursement shall not be available to community services
projects funded pursuant to paragraph (b) of this subdivision or to
expanded non-medical in-home services, non-institutional respite
services, case management services, and ancillary services funded
pursuant to paragraph (j) of this subdivision for services provided to
elderly persons who are eligible for or are receiving services to meet
their needs pursuant to titles eighteen, nineteen or twenty of the
federal social security act or any other governmental programs or for
services provided to residents in adult residential care facilities
which had previously been provided by the facility or which are required
by law to be provided by such facility.

(e) For the purpose of determining the amount of state reimbursement
for which a county is eligible pursuant to this section, the last
preceding federal census or other census data approved by the
comptroller shall be used. Funds appropriated by the state for the
purpose of reimbursement for community services pursuant to this section
shall be apportioned among the counties pursuant to the formula set
forth in paragraph (b) of this subdivision by the director. Funds
appropriated by the state for the purpose of reimbursement for expanded
non-medical in-home services, non-institutional respite services, case
management services, and ancillary services pursuant to this section
shall be apportioned among the counties by the director pursuant to the
formula set forth in paragraph (j) of this subdivision.

(f) The comptroller may withhold the payment of state aid to any
county in the event that such county alters or discontinues the
operations approved by the director pursuant to this section or
otherwise fails to comply with the regulations or requirements of the
director.

(g) Counties shall submit claims for reimbursement after the end of
each month or each quarter as required by and in accordance with
procedures prescribed by the director. Reimbursement shall be available
for approved expenditures incurred in accordance with an approved county
plan for community services.

(h) Reimbursement pursuant to subparagraph one of paragraph (b) or
paragraph (j) of this subdivision shall not be available for
expenditures for community or expanded non-medical in-home services,
non-institutional respite services, case management services, and
ancillary services to elderly persons in the city of New York unless
expenditures for such services are apportioned for services in each of
the counties contained within such city in a manner which the director
has determined by regulation substantially reflects the proportion that
the number of elderly persons in that county bears to the total number
of elderly persons in the city as a whole. In determining whether
reimbursement shall be available under paragraph (g) of this
subdivision, the director shall ensure that expenditures were
apportioned in accordance with the provisions of this paragraph.

(i) The director, within the amounts appropriated therefor and with
the approval of the director of the budget, may authorize a county which
has an approved home care plan for functionally impaired elderly to
provide expanded non-medical in-home services, non-institutional respite
services, case management services, and ancillary services pursuant to
such plan. Such services shall be limited to those services necessary to
meet otherwise unmet needs and which support such elderly persons'
continued residence in their homes. Needs will be determined pursuant to
a standardized evaluation of functional impairment, available resources
and such other relevant factors specified pursuant to regulations
promulgated by the director. No expanded non-medical in-home services,
non-institutional respite services, or ancillary services shall be
provided to any individual pursuant to this section unless such expanded
non-medical in-home services, non-institutional respite services, or
ancillary services are accompanied by ongoing case management services
in accordance with regulations promulgated by the director.

(j) Within the amounts appropriated therefor, counties authorized to
provide expanded non-medical in-home services, non-institutional respite
services, case management services, and ancillary services pursuant to
paragraph (i) of this subdivision shall be eligible for reimbursement by
the state of up to seventy-five percent of allowable expenditures for
approved services pursuant to this section up to the level authorized by
the director. The director shall not authorize a level of state
reimbursement pursuant to this paragraph which exceeds the sum of
ninety-one thousand two hundred fifty dollars or seven dollars thirty
cents for each elderly person residing in the county, whichever is
greater, and shall proportionately reduce such sum for each county in
any years for which appropriations are not sufficient to fully fund
approved expanded non-medical in-home services, non-institutional
respite services, case management services, and ancillary services for
functionally impaired elderly in all counties with approved home care
plans; provided however that in state fiscal years beginning on or after
the first day of April, two thousand five, the director, with the
approval of the director of the budget, may authorize state
reimbursement in excess of these levels to the extent appropriations are
available therefor.

(k) The director, with the approval of the director of the budget,
shall provide by regulation the extent of cost-sharing to be required of
elderly persons receiving expanded non-medical in-home services,
non-institutional respite services, case management services, and
ancillary services pursuant to this section, which shall reflect such
recipients' means to pay for such services and which will not affect
their ability to remain in their homes; provided however that the
director shall not authorize or direct the withholding of state aid
pursuant to paragraph (f) of this subdivision prior to the first day of
April, two thousand five, based on any county's failure or inability to
comply with regulations promulgated pursuant to this paragraph. The full
amount of cost-sharing actually received by any county from elderly
persons receiving expanded non-medical in-home services,
non-institutional respite services, case management services, and
ancillary services shall be used by such county to expand either such
county's program of community services or such county's program of
expanded non-medical in-home services, non-institutional respite
services, case management services, and ancillary services pursuant to
this section.

(l) Reimbursement pursuant to paragraph (j) of this subdivision shall
not be available for expenditures for base year services otherwise
provided without cost, or to replace base year expenditures made by the
county or any other service provider irrespective of the source of
funds, or to replace community services expenditures pursuant to
paragraph (b) of this subdivision.

(m) Counties shall submit claims for reimbursement for expanded
in-home services, non-institutional respite services, case management
services, and ancillary services to functionally impaired elderly as
required by and in accordance with procedures prescribed by the
director. Reimbursement shall be available for approved expenditures
incurred in accordance with an approved county home care plan for
functionally impaired elderly to the extent the director has authorized
state aid for such services pursuant to paragraph (i) of this
subdivision.

(n) The director shall provide by regulation that certain non-county
moneys and in-kind equivalents may be used in part to compose the county
share of total allowable expenditures pursuant to paragraph (j) of this
subdivision, provided that such county share shall not include
cost-sharing received from elderly persons receiving expanded
non-medical in-home services, non-institutional respite services, case
management services, and ancillary services pursuant to paragraph (k) of
this subdivision or moneys received from the federal government for
services for the elderly allocated to the states or local governments
according to population or other such non-competitive basis.

5. Contracts for services. (a) For the purposes of this section,
counties are authorized to contract with public agencies,
municipalities, non-profit agencies, or such other entities as the
director may authorize. Contracts for nursing services, home health aide
services, nutritional services (other than the delivery of meals),
physical, speech, and occupational therapy, and medical social services
provided pursuant to this section shall only be with certified home
health agencies as defined in article thirty-six of the public health
law.

(b) Community services provided pursuant to this section shall not be
provided directly by the designated agency unless approval is granted by
the director. Such approval may not be given by the director unless the
designated agency directly provided the service prior to approval of the
annual county plan by the director, or unless it can be shown that the
direct provision of a community service by the designated agency is
necessary due to the absence of an existing suitable provider to assure
an adequate supply of such service, or to ensure the quality of the
service provided.

(c) Pursuant to an agreement, two or more counties may join together
for the purposes of this section. Such agreements shall make provision
for the proportionate cost to be borne by each county, the employment of
personnel, the receipt and disbursement of funds, and any other matters
deemed necessary by the director. Claims for reimbursement pursuant to
subdivision four of this section shall be paid to each county and shall
be limited to the amount to which each county would be entitled pursuant
to such subdivision.

6. Implementation of home care plans. Within the amounts appropriated
therefor, counties authorized to provide expanded non-medical in-home
services, non-institutional respite services, case management services,
and ancillary services pursuant to paragraph (i) of subdivision four of
this section shall be eligible for reimbursement by the state of one
hundred percent of allowable expenditures for implementing the approved
county home care plan for functionally impaired elderly, limited to a
sum equivalent to the amount available to such county pursuant to
subparagraph one of paragraph (a) of subdivision four of this section.

7. For the purposes of obtaining state aid within the amounts
appropriated therefor under this section, a designated agency of an
Indian tribal organization shall qualify as though it were a designated
agency for a county.