SI NY02003.114 Interim Assistance Reimbursement to the Office of Mental Health (RTS 371 - 06/2003)
The New York State Office of Mental Health (OMH) has entered into an IAR Agreement with the Social Security Administration. The agreement with OMH is similar to the agreement in effect with New York State. A subsequent Agreement extending IAR to post-eligibility cases has been in effect with OMH since January 3, 1989. OMH provides financial assistance (usually in the form of voucher payments) to individuals placed in Family Care homes who would not otherwise have the funds to pay for their support and maintenance while awaiting anticipated income (usually SSI). Under the IAR Agreement, OMH may be reimbursed for financial assistance provided during the pendency of the individual's SSI claim.
When it is determined that an individual entering a Family Care home is in need of financial assistance, the OMH Patient Resource Agent will assist the individual in completing an SSI claim as well as an IAR authorization form BPR-912. Both the SSI claim and the BPR-912 will then be submitted to the FO servicing the local Patient Resource office. The state/county code 33990 is the GR code designated for OMH. The 33990 code should be used for all OMH cases regardless of the individual's address or the location of the Family Care facility, as this will ensure that the retroactive SSI check is directed to OMH's Bureau of Patient Resources in Albany. NOTE: IAR payments to OMH have NOT been automated; therefore, it is a manual process.
When a BPR-912 is received for an individual whose SSI application is pending a reconsideration decision, a decision by an ALJ or the Appeals Council, the FO should immediately input the IAR data via the SSA-450S/PR9 procedure. No attempt should be made to forward a BPR-912 to the DDS, ALJ or Appeals Council. When the claims folder is returned to the FO for filing, the BRP-912 should be associated with the folder.
Upon receipt of the retroactive SSI check, the Bureau of Patient Resources in Albany will deduct an amount equal to the amount of OMH voucher payments made during the pendency of the SSI claim. The Bureau of Patient Resources will issue a check for the balance (if any) to the recipient together with a notice, the BPR-913, describing the apportionment of the SSI funds. (See SI NY02003.080 for large retroactive checks due after 12/01/96.) Should an individual dispute the distribution of the SSI check, he/she should contact the local Patient Resources Agent for an explanation. If the individual is still dissatisfied, he/she has the right to file an appeal with the Office of Mental Health's Office of Counsel, 44 Holland Avenue, Albany, New York, NY 12229.