GIS 11 MA/026:Informational Booklets: LDSS-4148A, LDSS-4148B and LDSS-4148C

The purpose of this General Information System (GIS) message is to inform local departments of social services (LDSS) of a procedural change regarding the distribution of informational booklets LDSS-4148A, LDSS-4148B and LDSS-4148C (also referred to as Books 1, 2 and 3) for Medicaid-only applicants.Currently, these informational booklets are distributed to Medicaid applicants either at the time an application is requested or when an application is received by the LDSS.

With the elimination of the face-to-face interview, the implementation of a centralized call center and the general public's growing use of the internet, the State Department of Health is granting LDSS flexibility in the way these informational booklets are distributed. Application packages mailed out by LDSS may refer individuals to the following website to obtain the informational booklets: http://www.otda.ny.gov/programs/applications/.

However, districts must also give applicants the choice to request the booklets be mailed to them. Districts can provide applicants with the phone number for New York Health Options, 1-800-541-2831, to request the booklets.

Districts electing to refer applicants to the website and call center for copies of Books 1, 2 and 3 must include the attached informational notice with the application package.

Information on your rights and responsibilities, and the services and programs available to you

The Access NY Health Care application (DOH‐4220) includes information about your rights and responsibilities. More materials are available to assist you in understanding programs available to you.

Below is a list of three booklets with a summary of their contents. They are available on the Internet at http://www.otda.ny.gov/programs/applications/ under "Application booklets". They are offered in several languages, and you may either read them online or print them out.

(1) What You Should Know About Your Rights and Responsibilities (LDSS‐4148A

This booklet tells you about your rights and responsibilities when applying for and receiving benefits.

(2) What You Should Know About Social Services Programs (LDSS‐ 4148B)

This booklet gives information about different programs – such as Temporary Assistance and Food Stamps, as well as Medical Assistance (which includes Medicaid, Family Health Plus, and Family Planning Benefit Program). It also provides information on other services including child care, foster care, child welfare, adoptions and other programs.

(3) What You Should Know If You Have an Emergency (LDSS‐4148C)

This booklet tells you what to do in case of an emergency – such as a need for food, help with housing expenses and/or a need for medical attention.

If you do not have access to the internet and would like any of these booklets mailed to you, please call New York Health Options at 1‐800‐541‐2831.

Información sobre sus Derechos y Deberes y los Servicios y Programas que se Ofrecen

Adjuntamos la solicitud de Acces NY Health que usted solicitó. Dicha solicitud contiene información sobre sus derechos y deberes. Disponemos de material informativo adicional si necesita más información sobre los programas que se ofrecen al público.

A continuación detallamos los tres folletos junto con el sumario de lo que tratan. Esos folletos los puede obtener del sitio web http://www.otda.ny.gov/programs/applications/ "Aplication Booklets" (Folletos de Solicitud). Están disponibles en varios idiomas, y tiene la opción de leerlos en línea o imprimirlos.

(1) Lo que usted debe saber acerca de sus derechos y responsabilidades (LDSS‐4148A SP)

Ese folleto le informa sobre sus derecho y deberes cuando solicita o recibe prestaciones.

(2) Lo que usted debe saber sobre los programas de servicios sociales (LDSS‐4148B SP) Ese

Ese folleto le informa sobre los diferentes programas – tales como Asistencia Temporal y Cupones para Alimentos, como también sobre asistencia médica (entre ellos: Medicaid, Family Health Plus y Planificación Familiar). También suministra información sobre otros servicios entre los cuales citamos el programa de cuidado de niños, cuidado de crianza (foster care), programa de bienestar para niños, adopciones y otros programas.

(3) Lo que usted debe saber en caso de una emergencia (LDSS 4148C SP)

Ese folleto le informa lo que debe hacer en caso de una emergencia de comida, de ayuda con los gastos de vivienda y/o necesidad de atención médica.

Si usted no tiene acceso al internet y le gustaría ordenar uno de estos folletos por correo, llame al New York Health Options al 1‐800‐541‐2831. 5138.