N.Y. Comp. Codes R. & Regs. tit. 18 § 355.3

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

Section 355.3 - Notification of local department decisions- all programs except SSI and MA

(a) Notification to applicants. Each applicant for ADC, ADC-U, ADC-FC, EAF, EAA, HR or VA shall be notified in writing of the local department decision on his application. Each applicant for institutional care for adults shall be notified either in writing or in an interview of the local department decision on his application.

(1) Notification of acceptance.

(i) When an application is accepted for ADC, ADC-U, ADC-FC, EAF, EAA, HR or VA and a grant is to be made to the applicant, the letter of notification shall state the amount of the grant and the date the check may be expected; contain information on the program and on the right of appeal; and include an explanation of the budget on which the grant was based.

(ii) When an application is accepted for care in a congregate care facility, the applicant shall be notified by letter or interview that the care has been approved and the controlling conditions including any plans for partial payment or repayment under which such care is approved.

(2) Notification of denial.

(i) When an application for ADC, ADC-U, ADC-FC, EAF, EAA, HR or VA is denied, the letter of notification shall state adequately and clearly the reasons for denial. The letter shall include a statement informing the applicant of his right of appeal to and a hearing before the State department.

(ii) When an application for care in a congregate care facility is denied, the notification, whether by letter or interview, shall state adequately and clearly the reasons for the denial. A notice, where appropriate, shall also be sent to the facility giving care and to a person requesting assistance or care in behalf of the applicant.

(iii) When an application for HR is denied under the provisions of section 139-a of the Social Services Law, the letter of notification shall state clearly the reasons for denial and shall include a statement informing the applicant of his right of appeal to and a hearing before the State department.

(iv) When an applicant is found to be in need but not to meet the special eligibility requirements of a Federal category he shall be informed of this fact in order that he may apply for the form of assistance for which eligible. Similarly when an applicant for a noncategorical program of assistance is found to meet the special eligibility requirements of a Federal category he shall be informed of this fact in order that he may apply for the special form of assistance.

(3) Withdrawal of application. When an application is withdrawn, the reasons therefor shall be recorded in the case record. The applicant may be notified of the termination of his application in order to confirm the local department's understanding of his decision to withdraw his application.

(b) Notification to recipients. Each recipient of ADC, ADC-U, ADC-FC, EAF, EAA, HR or VA shall be notified in writing of any change in the grant or care, or of the discontinuance of the grant or care. Each recipient of care in a congregate care facility shall be notified either in writing or in an interview of any change in the grant or care, including the form or manner of payment, or the discontinuance of the grant or care.

(1) Notification of change in grant or care.

(i) When a change in the grant or the care approved is made for a recipient of ADC, ADC-U, ADC-FC, EAF, EAA, HR or VA, the letter of notification shall state the nature of the change including the amount of the new cash grant where appropriate, the effective date, the reason for the change and give assurance of an opportunity to discuss the change. The recipient shall be notified of his right of appeal and fair hearing and given a pamphlet or appropriate information.

(ii) When any changes occur which effect the conditions under which continued care is approved for recipients of care in a congregate care facility a notice of such change shall be given to both the recipient and the facility providing care.

(2) Notification of discontinuance of grant or care.

(i) When discontinuance of a grant or care occurs, the recipient of ADC, ADC-U, ADC-FC, EAF, EAA, HR or VA shall receive a written notification which states the effective date, the reason therefor, the appropriate information or pamphlet and the opportunity to discuss the discontinuance. He shall be informed of his right of appeal and fair hearing and given a pamphlet or appropriate information.

(ii) Each recipient of care in a congregate care facility shall be notified of the discontinuance of care at public expense and the reasons therefor. A facility giving care shall be notified of the discontinuance and the effective date thereof.

N.Y. Comp. Codes R. & Regs. Tit. 18 § 355.3