New York Codes, Rules and Regulations
Title 18 - DEPARTMENT OF SOCIAL SERVICES
Chapter II - Regulations of the Department of Social Services
Subchapter D - Adult-Care Facilities
Part 485 - General Provisions
Section 485.12 - Personal allowances for Supplemental Security Income or Home Relief recipients
Universal Citation: 18 NY Comp Codes Rules and Regs ยง 485.12
Current through Register Vol. 46, No. 39, September 25, 2024
(a) Each resident of an adult care facility who is receiving Supplemental Security Income or Home Relief benefits and who is entitled to a monthly personal allowance by Social Services Law, section 131-o, or section 352.8(c) of this Title, shall be afforded the following protections:
(1) Each resident must receive a personal
allowance equal to the amount stipulated in subdivision (b) of this section or
section
352.8(c)
of this Title.
(2) Any waiver of
the right of an SSI or HR recipient to a personal allowance shall be
void.
(3) The personal allowance
may be used at the discretion of the resident for personal needs not provided
by the operator pursuant to the law and regulations.
(4) The operator shall not demand, require or
contract for payment of any part of the personal allowance or any income
disregarded by the Social Security Administration in determining eligibility
for Supplemental Security Income, in satisfaction of the basic facility rate
for supplies and services or for any services or supplies, unless the resident
elects to purchase such services or supplies and the department has determined
that such services or supplies are not otherwise required to be provided by the
operator pursuant to law, regulation or agreement, and the charges for such
services or supplies are reasonable.
(5) Any individual who has not received or
been able to control his/her personal allowance to the extent and in the manner
required by section
131-o of the Social Services Law may
maintain an action in his own behalf for recovery of any such funds and, upon a
showing that the funds were intentionally withheld or misappropriated to other
than the intended use, for recovery of additional punitive damages in an amount
equal to twice the amount misappropriated or withheld.
(6) The department shall investigate any
suspected misappropriation or withholding of personal allowance funds, and may
maintain an action on behalf of any individual or group of individuals to
recover any funds so misappropriated or withheld, including any punitive
damages.
(7) In any case where the
operator is suspected of misappropriating a resident' personal allowance, the
department or its designee shall investigate and, where appropriate, take the
steps necessary to insure recovery of resident funds, including referral for
prosecution. Funds recovered in this manner shall be given to the respective
resident or credited to his/her personal allowance account at the earliest
possible date.
(8) Any person who
intentionally withholds, commingles, borrows or pledges the personal allowance
of an SSI recipient, or who demands, beneficially receives or contracts for
payment of all or any part of the personal allowance in satisfaction of the
facility rate for supplies and services, shall be guilty of a class A
misdemeanor.
(b) Effective January 1, 1987, each resident receiving Supplemental Security Income benefits in an adult care facility as defined in Social Services Law, section 209, or Home Relief benefits as set forth in section 352.8(c) of this Title, is entitled to a monthly personal allowance out of such benefits in the following minimum amounts:
(1) In
adult care facilities certified for level II Supplemental Security Income
payments:
(i) Residents receiving total
Supplemental Security Income benefits of $90 per month or less must have
personal allowances consisting of their total Supplemental Security Income
benefit amount in addition to any income disregarded by the Social Security
Administration in determining the recipient' eligibility for Supplemental
Security Income, except third-party payments from non-public sources treated as
in-kind income.
(ii) Residents
receiving Supplemental Security Income benefits greater than $90 per month, and
having no other income, must have personal allowances of at least $90 per
month.
(iii) Residents receiving
Supplemental Security Income benefits greater than $90 per month, with other
sources of income, must have personal allowances of at least $90 per month in
addition to any income disregarded by the Social Security Administration,
except third-party payments from non-public sources treated as in-kind
income.
(iv) Residents receiving
Supplemental Security Income who were "grandparented" from the Aid to the Aged,
Blind and Disabled program (AABD), whose benefit amounts are above the standard
Supplemental Security Income benefit levels, must have personal allowances of
at least $90 per month in addition to any income disregarded by the Social
Security Administration as described in subparagraph (i) of this
paragraph.
(2) In adult
care facilities certified for level I Supplemental Security Income payments:
(i) Residents receiving total Supplemental
Security Income benefits less than $80 per month must have personal allowances
consisting of their total Supplemental Security Income benefit amount in
addition to any income disregarded by the Social Security Administration as
described in subparagraph (1)(i) of this subdivision.
(ii) Residents receiving Supplemental
Security Income benefits greater than $80 per month, and having no other
income, must have personal allowances of at least $80 per month.
(iii) Residents receiving Supplemental
Security Income benefits greater than $80 per month, with other sources of
income, must have personal allowances of at least $80 per month in addition to
any income disregarded by the Social Security Administration as described in
subparagraph (1)(i) of this subdivision.
(iv) Residents who are "grandparented" from
the Aid to the Aged, Blind and Disabled program (AABD), whose benefit amounts
are above the standard Supplemental Security Income benefit levels, must have
personal allowances of at least $80 per month in addition to any income
disregarded by the Social Security Administration as described in subparagraph
(1)(i) of this subdivision.
(3) In any month in which a resident receives
a prorated SSI or HR benefit, the resident shall also be entitled to an
identically prorated personal allowance.
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