Guarantee HIV Benefit Access

Section 1. The social services law is amended by adding a new section 138 to read as follows:

§ 138. Access to HIV services. 1. The office of temporary and disability assistance shall direct each local department of social services (LDSS) to establish and maintain access to benefits and services as defined in subdivision three of this section to every person with HIV infection who requests assistance, and shall ensure the provision of benefits and services to each eligible person infected with HIV.

2. The commissioner of the office of temporary and disability assistance shall direct each LDSS to provide to persons with HIV infection who satisfy the eligibility requirements for Medicaid as set forth in U.S.C. 1396 et seq.:

(a) intensive case management with an average ratio which shall not exceed one caseworker or supervisor to twenty-five family cases, and with an overall average ratio for all cases which shall not exceed one caseworker or supervisor to thirty-four cases; and

(b) transportation and nutrition allowances in an amount not less than one hundred ninety-three dollars per month.

3. (a) Whenever used in this subdivision, the following terms shall have the following meanings:

(1) "Access to benefits and services" shall mean the provision of assistance by staff of the LDSS to a person with HIV infection at a single location in order to apply for publicly subsidized benefits and services, to establish any and all elements of eligibility including,

EXPLANATION--Matter in italics (underscored) is new; matter in brackets

[ ] is old law to be omitted.

LBD02626-01-7

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but not limited to, assistance provided at a field office of the LDSS, at the home of the applicant or recipient, at a hospital where such applicant or recipient is a patient or at another location in assembling such documentation as may be necessary to establish any and all elements of eligibility and to maintain such eligibility;

(2) "Eligible person" shall mean a person who satisfies the eligibility requirements established pursuant to applicable local, state or federal statute, law, rule or regulation for the benefits and services set forth in paragraph (b) of this subdivision or for any other benefits and services deemed appropriate by the commissioner;

(3) "Medically appropriate transitional and permanent housing" shall mean housing which is suitable for persons with HIV infection, and if necessary, accessible to persons with disabilities. Such housing shall include, but not be limited to, individual refrigerated food and medicine storage and adequate bathroom facilities which shall, at a minimum, provide an effective locking mechanism and any other such measures as are necessary to ensure privacy;

(4) "Person with HIV infection" shall mean a person who has received a medical determination that he or she is infected with HIV; and

(5) "Commissioner" shall mean the commissioner of the office of temporary and disability assistance.

(b) The office of temporary and disability assistance shall provide, or the commissioner shall direct LDSSs to provide access to benefits and services to every eligible person with HIV infection who requests assistance, and shall ensure the provision of benefits and services to eligible persons with HIV infection. Any eligible person shall receive only those benefits and services for which such person qualifies in accordance with the applicable eligibility standards established pursuant to local, state or federal statute, law, rule or regulation. Such benefits and services shall include, but not be limited to: medically appropriate transitional and permanent housing; Medicaid, as set forth in 42 U.S.C. 1396 et seq. and other health-related services; long term care services provided by a certified home health agency, long term home health care program or AIDS home care program authorized pursuant to article thirty-six of the public health law; personal care services pursuant to this article; homemaker services as defined in subdivision six of section thirty-six hundred two of the public health law; supplemental nutrition assistance program benefits in accordance with section ninety-five of this chapter; transportation and nutrition allowances as required by subdivision two of this section; preventative services, including rent subsidies, in accordance with section four hundred nine-a of this chapter; financial benefits; and intensive case management as required by subdivision two of this section. The commissioner shall have the authority to direct each LDSS to provide access to additional benefits and services and ensure the provision of such additional benefits and services whenever deemed appropriate. The requirements with respect to such access to and eligibility for benefits and services shall not be more restrictive than those requirements mandated by state or federal statute, law, rule or regulation. Within thirty days of the effective date of this section, the commissioner shall establish criteria pursuant to which an applicant shall be entitled to a home or hospital visit for the purpose of establishing eligibility and applying for benefits and services.

(c)(1) Upon written or oral application or submission of documents required to establish eligibility for benefits and services by a person with HIV infection, such person shall immediately be provided with a

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receipt which shall include, but not be limited to, the date, a description of the information received, and a statement as to whether any application for such benefits and services is complete or incomplete, and if incomplete, such receipt shall identify any information or documents needed in order for the application to be deemed complete.

(2) Where no statute, law, rule or regulation provides a time period within which a benefit or service shall be provided to an eligible person who requests such a benefit or service, such benefit or service shall be provided no later than twenty business days following submission of all information or documentation required to determine eligibility.

(d) Where a person with HIV infection who applies for benefits and services, or access to benefits and services, indicates that one or more minor children reside with him or her or are in his or her care or custody, such person shall be given information and program referrals on child care options and custody planning, including the availability of standby guardianship pursuant to section seventeen hundred twenty-six of the surrogate's court procedure act and referral to legal assistance programs.

(e) Recertification of eligibility, as required by any state or federal law, statute, rule or regulation shall be conducted no more frequently than mandated by such statute, law, rule or regulation.

(f) Eligibility for benefits and services for persons with HIV infection may not be terminated except where the recipient is determined to no longer satisfy eligibility requirements, is deceased, or upon certification by the LDSS that the recipient cannot be located to verify his or her continued eligibility for benefits and services. In the latter circumstance, the LDSS shall conduct a reasonable good faith search for at least a ninety day period to locate the recipient, including sending written notice by certified mail, return receipt requested, to the last known address of such recipient, requiring the recipient to contact the LDSS within ten days.

(g) Not later than sixty days from the effective date of this section, the commissioner shall direct each LDSS to prepare a draft policy and procedures manual for LDSS staff. Such policy and procedures manual shall include, but not be limited to, strict guidelines on maintaining the confidentiality of the identity of and information relating to all applicants and recipients, instructional materials relating to the medical and psychological needs of persons with HIV infection, application procedures, eligibility standards, mandated time periods for the provision of each benefit and service available to applicants and recipients and advocacy resources available to persons with HIV infection. Such lists of advocacy resources shall be updated semi-annually. Within thirty days following the preparation of such draft policy and procedures manual and prior to the preparation of a final policy and procedures manual, the LDSS shall distribute such draft policy and procedures manual to all social services agencies and organizations that contract with the LDSS to provide HIV-related services and to all others whom the LDSS deems appropriate, and hold no fewer than one noticed public hearing at a site accessible to the disabled, at which advocates, services providers, persons with HIV infection, and any other member of the public shall be given an opportunity to comment on such draft policy and procedures manual. Each LDSS shall prepare a final policy and procedures manual within thirty days after the conclusion of such hearing and shall thereafter review and where appropriate, revise such policy and procedures manual on an annual basis. Each LDSS shall provide for semi-annual

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training, using such policy and procedures manual, for all division staff.

(h) Not later than sixty days from the effective date of this section, each LDSS shall publish a proposed rule establishing a bill of rights for persons with HIV infection. Such draft bill of rights shall include, but not be limited to, an explanation of the benefits and services for which persons with HIV infection may be eligible; timetables within which such benefits and services shall be provided to eligible persons; an explanation of an applicant's and recipient's right to examine his or her file and the procedure for disputing any information contained therein; an explanation of an applicant's and recipient's right to a home or hospital visit for the purpose of applying for or maintaining benefits or services; an explanation of the process for requesting an LDSS conference or fair hearing in accordance with section twenty-two of this chapter; and a summary of the rights and remedies for the redress of discrimination. Within sixty days following the publication of such proposed rule, and prior to the publication of a final rule, each LDSS shall hold no fewer than one noticed public hearing at a site accessible to the disabled at which advocates, service providers, persons with HIV infection, and any other member of the public shall be given an opportunity to comment on such draft bill of rights. Each LDSS shall publish a final rule within thirty days after the conclusion of such hearing and shall thereafter review, and where appropriate, revise such bill of rights on an annual basis. Such bill of rights shall be conspicuously posted in all LDSS offices that are open to the public and shall be available for distribution to the public in English, Spanish and any other languages that the commissioner deems appropriate.

(i) Not later than ninety days from the effective date of this section, the commissioner shall establish a policy or procedure for overseeing and monitoring the delivery of services required pursuant to this section to persons with HIV infections which shall include, but not be limited to, quality assurance measurements. The commissioner shall submit such policies or procedures to the governor, speaker of the assembly and the temporary president of the senate in writing within ten days from the date such policies or procedures are established.

(j) Beginning on September first, two thousand seventeen, and on the first day of each calendar quarter thereafter, the commissioner shall submit a written report to the governor, speaker of the assembly, minority leader of the assembly, the temporary president of the senate, and the minority leader of the senate, providing the following information disaggregated on both a quarterly and annualized basis: the number of persons with HIV infection who requested the benefits and services set forth in paragraph (b) of this subdivision and any other benefits provided by LDSS, disaggregated by LDSS and by the type of benefit or service requested, and the average length of time required to process such requests, disaggregated by LDSS, and the type of benefit or service requested; the number of persons with HIV infection who requested benefits and serviced and were determined to be ineligible for such benefits and services, disaggregated by LDSS, by the type of benefit or service requested, and by the reason for such determinations; the number of LDSS staff, by job title, whose duties include providing benefits and services or access to benefits and services pursuant to this section, the number of recipients, the number of cases and the number of requests for assistance, disaggregated by LDSS; the average length of time from the initial request for benefits and services to submission of a complete application for such benefits and services, the average length

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