Public Assistance Programs

The Central Assessment unit determines the need for services of clients for any program it offers, or refers to NY Medicaid Choice if appropriate. The Data Entry Unit oversees the system and equipment, produces reports and troubleshoots system problems for the Welfare Management System (WMS). WMS is a statewide automated network that supports the administration of human services programs that provide cash, medical, SNAP, energy assistance, services for adults, children and child support.

Forms/OTDA

Medical Assistance

The Medical Assistance Program (MA) commonly referred to as Medicaid was instituted in New York State in 1966 to provide services to the medically needy enabling the state to make payments directly to participating providers of medical care, such as, hospitals, doctors, druggists, etc. Our agency utilizes the following Managed Care providers:

• CDPHP – Capital District Physicians Health Plan
• FI – Fidelis
• UHC – United Health Care
• MVP – Mohawk Valley Plan

To qualify, applicants must meet prescribed income and resource requirements.

1. General Medical Assistance – This area includes many different budgets and eligibility criteria and is the bulk of the program. Income and resources along with household size is the major bases for determining eligibility.
2. Spend-down Program (Excess Income) – Some applicants who are over income but have large monthly medical bills may participate in this program. Recipients pay to the agency on a monthly basis set amount of money, or, show proof of monthly bills they have paid, then Medicaid coverage results.
3. Chronic Care (Nursing Home Clients ) – Medicaid coverage for eligible low income clients who have need of a 24 hour nursing home facility.
4. Persons In Receipt of SSI – A person receiving SSI is automatically eligible to receive Medicaid coverage but must submit a completed application.

Agency Supporting Programs

1. Medicaid Transportation – Clients receiving Medicaid/Managed Care are entitled to transportation to and from doctor or health related visits and appointments. Arrangements are made by phoning (855)360-3545
2. Prenatal Care Assistance Program (PCAP) – This program is designed for pregnant women to get the care they need by having PCAP participating doctors make a temporary determination of eligibility which can allow clients to receive prenatal care for up to 45 days. Coverage will not continue beyond 45 days unless the applicant completes the application process at Social Services. There is no limit on resources an applicant may have.
3. Child/Teen Health Plan (C/THP) – This provides a preventive health program for Medicaid eligible children under the age of 21 and in need of medical and dental care. The program pays for initial and periodic examinations coordinating all necessary health care for eligible children. All managed care participants are included in this program.
4. Aid to Disabled (AD) and Disabled Client Assistance Program (DCA) – DCA gives special assistance to disabled clients for the purpose of applying for Supplemental Security Income or other types of disability. AD can provide program benefits to disabled clients who have met criteria through documentation, examination, medical test and consultation. The cost will be covered by the agency. Referrals come from eligibility workers in Temporary Assistance and Medicaid.
5. Third Party Health Insurance (TPHI) – This program utilizes all private health insurance a client may have, therefore, reducing the amount of Medicaid participation. When cost effective the agency may decide to pay for the client’s private insurance premiums or Medicare. Private insurance as well as Medicare are utilized before Medicaid benefits are used.

Protective Services for Adults

Protective Services for Adults (PSA) is for persons 18 years of age or older who are unable to protect their own interests, harmed or threatened with harm through action or inaction by another individual or themselves. Persons who are physically and/or mentally impaired who have no one who can help them and have unmet essential needs will be provided with this service regardless of income.

Such services include the investigation and assessment of the individual’s needs, casework counseling arranging alternative living conditions, Preventive Services, Social Services, Medical Services, functioning as a conservator, guardianship, providing homemaker services, representative payee or protective payee, providing advocacy, and assistance in arranging for legal services.

Supplemental Nutrition Assist Program (SNAP)

The SNAP Program was established under the Food Stamp Act of 1964 and 1977. The program is administered by the United States Department of Agriculture (USDA) under federal law. In New York State the program is administered by the New York State Office of Temporary and Disability Assistance under Section 95 and 29 of the Social Services Law.

The purpose of the SNAP Program is to reduce hunger and malnutrition among the members of low income households. Examples of low income households who may be eligible for SNAP are: the unemployed; persons working for low wages or part-time; the elderly or disabled on fixed incomes, and persons on Temporary Assistance or other assistance programs. It may take up to 30 days to receive your SNAP benefits.

SNAP can only be used to buy food items, plants and seeds to grow food. They cannot be used to purchase pet food, alcoholic beverages, tobacco products, paper products soap, ready to eat hot foods or vitamins.

The SNAP Program is a 100% federally funded program.

Expedited SNAP can be issued within five calendar days to cover specific emergency situations. A client does not need to be out of food to qualify.

Temporary Assistance

Temporary Assistance (TA) formerly called Public Assistance (PA) provides help to needy people in the form of cash grants to eligible clients. The cash grants will help clients to pay for:

• Food and Clothing
• Rent and mortgage
• Fuel and utilities
• Special needs at pregnancy
• Emergency – repairs/evictions

In New York State there are two major cash assistance programs.

1. Family Assistance (FA) – Provides cash assistance to eligible needy families that include a minor child living with a parent/parents or a caretaker relative. It is operated under federal Temporary Assistance for Needy Families (TANF) guidelines. Eligible adults are limited to receiving benefits for a total of 60 months in their lifetime. The months are accumulative not just consecutive. Count down began December 1996.
2. Safety Net Assistance (SNA) – This is the state assistance program for some applicants who are not eligible for Family Assistance Program. SNA is for single adults, childless couples, families of persons abusing drugs/alcohol, persons who have exceeded the 60 month limit on assistance and qualified aliens. SNA in cash is for a maximum of two years in a lifetime. After that, if you are eligible SNA will be provided in non-cash form, such as a two party check or a voucher.

The cash assistance consists of a basic allowance, energy allowance, supplemental, rent and fuel allowance if fuel is not included in the rent. All recipients must apply separately for SNAP and Medicaid although most would be eligible.

Important Information For Both Programs:

• Applicants must be financially eligible and not exceed the resource level.
• Clients who are employed must report all income.
• Clients must recertify during an interview scheduled on a periodic basis.
• All employment requirements must be met or sanctions can be imposed.
• Screening for alcohol/substance abuse, domestic violence, and child support information will be held initially and periodically thereafter.
• If the temporary assistance case closes due to employment a client may still be eligible for transitional Day Care, SNAP, Medicaid services for up to 6 months.

Other Public Assistance Programs

Day Care Services – Day Care is a service for children whose parents need help in providing care and supervision while they are ill, employed, enrolled in a job training or rehabilitation program, actively seeking employment or attending school. The service is provided to children from six weeks old through their thirteenth birthday.

Day Care may be provided to families who meet the income guidelines in one of three categories:

1. Temporary Assistance – receiving or eligible to receive temporary assistance.
2. Transitional Child Care – families who have received Temporary Assistance for three months of the past six months. A sliding scale co-payment is required.
3. Low income – families who do not fall into the first two categories but whose income is sufficiently low enough to meet an established income guidelines. Co-payment is based on income and family size.

Day Care may also be provided as part of a plan of service to provide preventive or protective services for a child without regard to income.

All Day Care facilities are licensed by New York State Office of Children and Family Services. Any person who cares for more than two children in their own home is required by law to be certified. Informal Day Care homes are not licensed but are limited to no more than two children plus the providers own children. Payment is up to established market rates.

Emergency Assistance to Families (EAF) – this program is intended to meet temporary emergency situations. It may cover persons already receiving ongoing assistance under certain conditions as well as non-recipients. To be eligible for EAF, the same criteria must be met as for Temporary Assistance and all other resources must be explored. EAF may only be authorized for one thirty day period in any twelve consecutive months. EAF may not be used to supplement a temporary assistance grant.

Emergency Aid to Adults (EAA) – intended to assist aged, blind and disabled SSI recipients. EAA can cover the following emergencies: catastrophic loss of clothing, furniture, food, shelter or fuel, stolen/lost checks, mismanaged cash, moving expenses, maintenance of a home while a person is temporarily hospitalized to prevent an eviction or a utility shutoff.

Another area of emergency aid is the payment arrangement payback. Where an able bodied single adult or childless couple not eligible for an EAF but in need of emergency assistance could, if eligible, sign a payment arrangement agreeing to pay back the agency’s money given to cover the emergency.

Home Energy Assistance Program (HEAP) – intended to assist with cost for heat and energy related expenses (including repairs and maintenance of heating equipment). Eligibility is based on income received by the household during the month in which they apply. Household size and energy type define the specific amount of the grant. HEAP regulations provide for regular and emergency benefits. Provisions vary each year.