PDD-02-15-00008-EP Updates to SSI Offset and SNAP Benefit Offset
1/14/15 N.Y. St. Reg. PDD-02-15-00008-EP
NEW YORK STATE REGISTER
VOLUME XXXVII, ISSUE 02
January 14, 2015
RULE MAKING ACTIVITIES
OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES
EMERGENCY/PROPOSED RULE MAKING
HEARING(S) SCHEDULED
I.D No. PDD-02-15-00008-EP
Filing No. 1103
Filing Date. Dec. 30, 2014
Effective Date. Jan. 01, 2015
Updates to SSI Offset and SNAP Benefit Offset
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:
Proposed Action:
Amendment of Subpart 641-1, sections 671.7 and 686.17 of Title 14 NYCRR.
Statutory authority:
Mental Hygiene Law, sections 13.09(b), 41.24, 41.36(c) and 43.02
Finding of necessity for emergency rule:
Preservation of public health, public safety and general welfare.
Specific reasons underlying the finding of necessity:
The emergency adoption of these amendments, which update the rent allowance offset for Individualized Residential Alternatives (IRAs) and Community Residences (CRs) and the Supplemental Nutrition Assistance Program (SNAP) benefit offset for supervised IRAs and supervised CRs, is necessary to protect the health, safety, and welfare of individuals receiving services in the OPWDD system.
The figures found in the emergency amendments were not available to OPWDD within a timeframe that would have allowed OPWDD to propose the amendments through the regular rulemaking process. Without the emergency amendments, reimbursement established by OPWDD for rent and food costs would not have been properly offset by the actual amount of rent or reimbursement for food costs received by providers.
The State would have overpaid providers by amounts equivalent to the increase in the SSI and SNAP benefits. The amount overpaid by the State would likely have been recovered by imposing a reduction in reimbursement to providers for the delivery of services to individuals with developmental disabilities. This reduction in reimbursement would have adversely affected the health, safety, and/or welfare of the individuals receiving those services. In addition, the amendments change the rent allowance offset from a daily amount to a monthly amount, in conformance with methodology changes made as part of rate reform effective July 1, 2014.
The emergency adoption of these amendments is necessary in order to avoid an overall reduction in reimbursement to providers and to preserve the health, safety, and welfare of individuals receiving services in the OPWDD system.
Subject:
Updates to SSI offset and SNAP benefit offset.
Purpose:
To adjust reimbursement to affected providers for rent and food costs.
Public hearing(s) will be held at:
11:00 a.m., March 2, 2015 at Office for People with Developmental Disabilities, Counsel's Office Conference Rm., 44 Holland Ave., Albany, NY; and 11:00 a.m., March 3, 2015 at Office for People with Developmental Disabilities, Counsel's Office Conference Rm., Holland Ave., Albany, NY.
Interpreter Service:
Interpreter services will be made available to hearing impaired persons, at no charge, upon written request submitted within reasonable time prior to the scheduled public hearing. The written request must be addressed to the agency representative designated in the paragraph below.
Accessibility:
All public hearings have been scheduled at places reasonably accessible to persons with a mobility impairment.
Text of emergency/proposed rule:
• Subparagraphs 641-1.3(c)(6)(ii) and (iii) are amended as follows:
(ii) Supplemental security income, as determined by section 671.7(b)(9)[(xxi)] (xxii) of this Title, annualized and multiplied by a provider’s initial period rate sheet capacity.
(iii) Supplemental nutrition assistance, as determined by section 671.7(b)(10)(i)[(c)] (e) of this Title, and multiplied by twelve, such product to be multiplied by a provider’s initial period rate sheet capacity.
Note: rest of paragraph (6) remains unchanged.
• Subparagraph 641-1.3(d)(6) (ii) is amended as follows:
(ii) Supplemental security income, as determined by section 671.7(b)(9)[(xxi)] (xxii) of this Title, annualized and multiplied by a provider’s initial period rate sheet capacity.
Note: rest of paragraph (6) remains unchanged.
• Section 671.7(b)(9) is amended by the addition of a new subparagraph (xxii) as follows:
(xxii) Effective January 1, 2015:
NYC, Nassau, Rockland, Suffolk, and Westchester Counties $1005.00 per month
Rest of State $975.00 per month
Note: Rest of paragraph (9) remains unchanged.
• Subparagraph 671.7(b)(10)(i) is amended by the addition of clause (e) as follows:
(e) Effective January 1, 2015, the offset shall be $194 per month.
• Subparagraph 686.17(b)(1)(iii) is amended by the addition of a new clause (d) as follows:
(d) Effective January 1, 2015, the individual shall pay the provider $194 per month.
• Subparagraph 686.17(b)(2)(iii) is amended by the addition of a new clause (d) as follows:
(d) Effective January 1, 2015, the individual shall pay the provider $194 per month.
• Clause 686.17(d)(2)(iii)(b) is amended by the addition of a new subclause (4) as follows:
(4) Effective January 1, 2015, the individual shall pay the provider $194 per month.
This notice is intended:
to serve as both a notice of emergency adoption and a notice of proposed rule making. The emergency rule will expire March 29, 2015.
Text of rule and any required statements and analyses may be obtained from:
Regulatory Affairs Unit, OPWDD, 44 Holland Ave., Albany, NY 12229, (518) 474-1830, email: RAU.Unit@opwdd.ny.gov
Data, views or arguments may be submitted to:
Same as above.
Public comment will be received until:
Five days after the last scheduled public hearing.
Additional matter required by statute:
Pursuant to the requirements of the State Environmental Quality Review Act, OPWDD, as lead agency, has determined that the action described will have no effect on the environment, and an E.I.S. is not needed.
Regulatory Impact Statement
1. Statutory Authority:
a. OPWDD has the authority to adopt rules and regulations necessary and proper to implement any matter under its jurisdiction as stated in the New York State Mental Hygiene Law Section 13.09(b).
b. Section 41.25 of the Mental Hygiene Law allows providers of services to establish fee schedules for services and requires that fees charged or payments requested take into account costs and ability to pay, considering resources available from private and public assistance programs.
c. Section 41.36(c) of the Mental Hygiene Law requires OPWDD to establish fees or rates for community residences.
d. OPWDD has the responsibility, as stated in section 43.02 of the Mental Hygiene Law, for setting Medicaid rates for services in facilities licensed by OPWDD.
2. Legislative Objectives: These emergency/proposed amendments further the legislative objectives embodied in sections 13.09(b), 41.25, 41.36 and 43.02 of the Mental Hygiene Law. The emergency/proposed amendments update the rent allowance offset for Individualized Residential Alternatives (IRAs) and Community Residences (CRs) and the Supplemental Nutrition Assistance Program (SNAP) benefit offset for supervised CRs and supervised IRAs.
3. Needs and Benefits: Section (a) below describes the needs and benefits of the update to the rent allowance offset, and section (b) does the same for the update to the SNAP benefit offset.
a. An essential element of OPWDD’s price setting and reimbursement methodologies for IRAs and CRs is an offset for rent which is based on the Supplemental Security Income (SSI) per diem allowances consistent with levels determined by the Federal Social Security Administration for Congregate Care level II. SSI levels for 2015 were increased. Without these amendments, the prices established by OPWDD for these facilities would not have been properly offset by the amount of rent received by the provider from other sources (primarily SSI). In addition, the amendments change the rent allowance offset from a daily amount to a monthly amount, to reflect the methodology changes made as part of rate reform effective July 1, 2014.
b. Effective October 1, 2014, SNAP benefits are increasing to a maximum of $194 per month. The emergency/proposed amendments change the amount that individuals pay their respective supervised CR or supervised IRA providers effective January 1, 2015 to reflect this increased amount, and state that reimbursement to these affected providers be offset by the increased amount. OPWDD considers that these amendments are necessary to prevent individuals from using other resources (which may be scarce or limited) to pay for food and to prevent an overall reduction in reimbursement for food to operators of supervised CRs and supervised IRAs.
4. Costs:
a. Costs to the Agency and to the State and its local governments.
Regarding the rent allowance offset, the modest increase in the rent and board offset in the methodology for setting prices for community residences and IRAs will reduce overall State expenditures for these programs by $1,660,000.
There will be no impact to local governments as a result of any of these amendments.
b. Costs to private regulated parties: There are no initial capital investment costs or initial non-capital expenses for either of these amendments.
The adjustments to reimbursement to providers found in these amendments result in an overall fiscal impact on providers that is cost neutral. The adjustments to reimbursement compensate providers for changes to revenue received from outside sources (i.e., SSI and SNAP benefits received from the federal government).
5. Local Government Mandates: There are no new requirements imposed by the rule on any county, city, town, village; or school, fire, or other special district.
6. Paperwork: The amendments do not require any paperwork of providers.
7. Duplication: Although the emergency/proposed amendments are derived from figures found in existing State and/or federal requirements, the amendments do not duplicate any existing requirements that are applicable to IRAs and CRs or other services for persons with developmental disabilities.
8. Alternatives: OPWDD did not consider any alternatives to the emergency/proposed amendments because not adjusting reimbursement for providers, and, in the case of the SNAP benefit offset, not adjusting the payment for food required of individuals, would have resulted in paying incorrect amounts to IRA and CR providers.
Additionally, there is no alternative to the emergency adoption of these amendments as the figures found in the amendments were not available to OPWDD within a timeframe that would have allowed for OPWDD to propose the amendments through the regular rulemaking process.
9. Federal Standards: The emergency/proposed amendments do not exceed any minimum standards of the federal government for the same or similar subject areas.
10. Compliance Schedule: The emergency rule is effective January 1, 2015. OPWDD has concurrently filed the rule as a Notice of Proposed Rule Making, and it intends to finalize the rule as soon as possible within the time frames mandated by the State Administrative Procedure Act. These amendments do not impose any new requirements with which regulated parties are expected to comply.
Regulatory Flexibility Analysis
A regulatory flexibility analysis for small businesses and local governments is not submitted because these amendments do not impose any adverse economic impact or reporting, record keeping, or other compliance requirements on small businesses. There are no professional services, capital, or other compliance costs imposed on small businesses as a result of these amendments.
The emergency/proposed amendments are concerned with updating the rent allowance offset for Individualized Residential Alternatives (IRAs) and Community Residences (CRs) and the Supplemental Nutrition Assistance Program (SNAP) benefit offset for supervised IRAs and supervised CRs. The amendments result in an overall fiscal impact that is cost neutral for the affected facilities and services, and further, the amendments do not result in any new compliance requirements. Due to an overall cost neutral fiscal impact and no new compliance requirements, the emergency/proposed amendments do not have any adverse effects on regulated parties.
These amendments do not impose any requirements on local governments.
These amendments will consequently have no adverse impacts on small businesses or local governments.
Rural Area Flexibility Analysis
A Rural Area Flexibility Analysis for these amendments is not submitted because the amendments do not impose any adverse impact or significant reporting, record keeping or other compliance requirements on public or private entities in rural areas. There are no professional services, capital, or other compliance costs imposed on public or private entities in rural areas as a result of the amendments.
The emergency/proposed amendments are concerned with updating the rent allowance offset for Individualized Residential Alternatives (IRAs) & Community Residences (CRs) and the Supplemental Nutrition Assistance Program (SNAP) benefit offset for supervised IRAs and supervised CRs. The amendments result in an overall fiscal impact that is cost neutral for the affected facilities and services, and further, the amendments do not result in any new compliance requirements. Due to an overall cost neutral fiscal impact and no new compliance requirements, the emergency/proposed amendments do not have any adverse effects on regulated parties.
The amendments will consequently have no adverse impacts on public or private entities in rural areas.
Job Impact Statement
A Job Impact Statement for the emergency/proposed amendments is not being submitted because it is apparent from the nature and purposes of the amendments that they do not have a substantial adverse impact on jobs and/or employment opportunities.
The emergency/proposed amendments are concerned with updating the rent allowance offset for Individualized Residential Alternatives (IRAs) and Community Residences (CRs), and updating the Supplemental Nutrition Assistance Program (SNAP) benefit offset for supervised CRs and supervised IRAs. The amendments result in an overall fiscal impact that is cost neutral for the affected facilities and services. Due to an overall cost neutral fiscal impact and no new compliance requirements, the emergency/proposed amendments do not have a substantial adverse impact on jobs or employment opportunities in New York State.
