The management and use of personal allowance is governed by Social Services Law section 131-o and OPWDD Regulation 14 NYCRR 633.15. These regulations state that personal allowance spending should:
- Reflect the preferences, choices and needs of the person
- Involve the person
- Be planned to meet the person’s wants and needs throughout the year
Personal allowance should be used to help people enhance the quality of their leisure time and the quality of their lives. As much as possible, people should be involved in planning and spending activities. By involving each person in the decision-making process, their purchases will better reflect their preferences. Their personal allowance should be available when it is requested or when it is needed. Personal allowance may not be withheld from a person for any reason.
Family care providers and sponsoring agencies that handle personal allowance funds must follow both Social Security and OPWDD regulations. Typically, family care providers manage personal allowance funds on behalf of the people they serve, unless the person can handle their own funds. The sponsoring agency must ensure that family care providers comply with regulations and must provide appropriate oversight.
Because personal allowance usually comes from government benefits, it is very important that individuals’ benefits are maintained and protected to make sure personal funds are available for their spending. The representative payee, usually the residential agency, should track the person’s income and resources. They must make sure the person remains qualified for the benefits they receive and report excess income or resources to the benefit-paying agencies. The residential agency must also respond to requests from the Social Security Administration (SSA) in a timely manner, as Social Security benefits and Supplemental Security Income (SSI) are the main sources of personal allowance funds for most individuals. Representative payees have a big role in the management of personal allowance. The SSA website contains information about the rights and responsibilities of representative payees: www.ssa.gov/payee/index.htm.
Social Security also has several booklets available online, or you can request them by phone or mail from your local Social Security office.
For general questions or information about Social Security or SSI benefits, the Office of Public Inquiries can be reached at:
Social Security Administration
Office of Public Inquiries
Windsor Park Building
6401 Security Blvd.
Baltimore, MD 21235
Appropriate Use of Personal Allowance
People spend money on many different things and for a variety of reasons. While it may be used for things they need, people also spend money on items they like or want. They may pay for admission to a concert, movie tickets, eating out, hobby-related expenses, or personalizing their bedroom. People also set aside their money to save for a trip or other bigger ticket items. In every instance, people are making choices about how to spend money. When people choose who will cut their hair, what to read, or whether to buy jeans or dress pants, their purchases reveal their preferences and personalities.
People served by OPWDD DDSOO and voluntary agencies must have opportunities to make choices and express who they are. New York State rules and regulations require personal allowance to be used for the benefit of people with developmental disabilities. These rules and regulations also give people the right to use their personal allowance as they choose. Their purchases should help to involve them in the local community or be for items and services that improve their quality of life.
People must be able to use their personal allowance in meaningful ways. This includes making choices about personal spending, learning to budget and saving for a specific item. Does the person have a special hobby? Do they like a particular type of music? Do they want to go camping or on a special vacation? Personal allowance can be used for these purposes and more.
Prohibited Use Of Personal Allowance
We will discuss many opportunities to appropriately use personal allowance to enhance a person’s life and pursue their interests. You also need to know when personal allowance cannot be used.
Personal allowance must NOT be used for:
- Expenses that the residential, day program or other service providers must pay; refer to the Agency Responsibilities section
- Items or services that are paid for by Medicaid, Medicare and/or third-party health insurance
- Necessary medical, dental and clinical services and/or supplies
- Transportation to or from required services
- Any activity that is part of the Individualized Service Plan (ISP)/ Life Plan for which the provider will be reimbursed
- Voluntary agency staff expenses and services (unless certain criteria are met)
- Any expenses for State employees
- Purchases when the individual has no choice
Ensuring Choice In Expenditure Planning
Personal allowance funds belong to the individual. Their money must be available for personal spending on items or services of their choosing. Purchases made with personal allowance must personally benefit the individual. When an agency manages personal allowance, the agency staff must involve the person as much as possible in deciding how their money will be used. All spending throughout the year should be consistent with the person’s preferences, choices and interests.
Agency staff must assume that all people with developmental disabilities have some capacity for self-advocacy and can help determine the ways in which their personal allowance is spent. Even though some people may not use words to communicate, staff can pay attention to their body language, their eyes and other nonverbal communication. Eye contact or facial expressions can convey a lot about what a person may be feeling. Staff should watch peoples’ faces, follow their gazes and look for smiles. They can also look for other nonverbal cues such as open arms and widened eyes. People may express their preferences for spending with their behavior. Staff should observe any common or recurring behavioral expressions of happiness or other emotions to determine preferred items and services when planning personal expenditures. They can see what the person enjoys the most and looks forward to doing. Based on the things the person enjoys, staff can help the person identify the stores and vendors where they can become a valued, regular customer.
If a person uses an augmentative communication device, it should be programmed with the individual’s personal allowance choices. While planning, staff should talk to those who know the person well, such as a family member, advocate or special direct support professional. These people should continue to have input throughout the year as the individual’s preferences may change.
Example - Ensuring Choice
Grant is 40 years old and does not have family who are in touch with him. He uses a wheelchair and does not use words to express himself. When he moved into his current home, residential staff had a hard time figuring out what Grant liked. For these reasons, it was difficult to involve him in planning for the use of his personal allowance.
Residential staff paid attention and noticed what interested Grant. Every time he saw an animal, he would stop what he was doing to watch. He seemed to enjoy the squirrels that played in front of his home. He often watched the birds that had nested in the oak tree in the front yard.
After meeting with Grant’s care manager and staff at his day program, the residential staff created a plan to use his personal allowance based on what they felt would interest him. Since Grant showed an interest in animals and enjoyed watching birds, the residential staff used his personal allowance to buy a small bird feeder that they set up outside his bedroom window. He now enjoys watching the birds and squirrels that it attracts. Grant also spends time at the park and a nearby zoo. These activities benefit him personally and enhance the quality of his life because they interest him and involve him with other people in the community.
Residential staff also used Grant’s personal allowance to buy a camera and photo albums for him. They help him write the names of the animals next to the photos he takes at the park, zoo and from his room. On rainy days, staff helps Grant work on his scrapbook of animals.
Grant’s care manager found a volunteer with a van, and now he goes bird watching with another member of the community.
Determining a Person’s Preferences
When looking for input on choice for personal spending, the following questions should be asked:
- Where are the person’s favorite places?
- Who are the most important people in the person’s life?
- What are the person’s unique abilities, gifts, preferences and interests?
- What are the things that make the person happiest?
- What is the person’s activity level? Are they a morning person or a night person? Are they high energy or sedentary?
- What sensory situations does the person enjoy? Consider their reactions to bright lights, touch, sounds, smells and tastes.
- What does the person prefer when dining out - fast food or fine dining, table or booth? Does the person have a special diet or like special items from the menu?
Answers to these questions will help in planning and to determine:
- Where the person can become a valued customer
- Which community activities bring the person together with those who share similar interests
- Ways in which the person can meet new people and deepen friendships and relationships with others
- Whether the person can take part in clubs, service organizations, civic events, ethnic or cultural organizations, sports, health and fitness groups and community and personal support groups
Personal Expenditure Planning
When a certified residential agency manages personal allowance for a person, annual personal expenditure planning for that person is required. Planning must involve the person and their team. The team should include the person, their care manager, involved family members, advocates, staff from the individual's residence, staff from a non-residential program, their family care provider and anyone who will handle personal allowance for the individual. Documentation of this expenditure planning must be incorporated into a Personal Expenditure Plan (PEP).
OPWDD regulations require an annual written Personal Expenditure Plan (PEP) that includes a Money Management Assessment (MMA).
Copies of the PEP and MMA must be included in the person’s record at the residence
The PEP should be in accordance with the habilitation/treatment plan and plan for protective oversight
The person, their residential agency, their advocate and the care manager must have a copy of the PEP (information from the PEP may also be shared with other involved parties if necessary, but only after asking the person and their advocate)
Money Management Assessment (MMA)
Personal expenditure planning is a process. It starts with a Money Management Assessment (MMA) and creation of a PEP. Personal allowance regulations require that an MMA be completed by each person’s team. This applies to everyone receiving personal allowance managed by the DDSOO or voluntary agency.
The assessment is completed annually with the PEP and must show:
- The person’s ability to manage funds independently
- The amount of funds the person can manage independently
- The frequency with which the funds can be provided (e.g., $10 per week)
Some items to consider when developing the MMA are:
- The person’s understanding of the concept of money
- Their demonstrated interest in independently buying items or services
- Their interest or ability to hold money and make purchases
- Whether they recognize the difference between the value of coins and paper money
- Their awareness that they should receive change and the amount
Personal Expenditure Plan (PEP)
The PEP is a guide for the use of the person’s monthly personal allowance and resources over the next 12 months for items the person currently wants or may want in the future. The plan should let the person have as many choices as possible, and might include personal shopping or luxury items, entertainment, vacation, home and family visits, or other expenses. The PEP must include a description of the person’s anticipated resources, personal allowance and projected spending on an annual and/or monthly basis. If an individual has a credit card or loan that they are paying, the payments should be reflected in the PEP. The amount allocated in the PEP for the person to handle independently must be consistent with the MMA.
The PEP is an easily recognizable document that meets the legal requirements of annual financial planning and considers:
- The daily and long-term needs of a person
- Special items such as vacations, large purchases, or a burial account
- Wages, other income and resources as sources of personal funds
The DDSOO or voluntary agency assigns responsibility for monitoring the PEP to staff or family care providers who make personal allowance expenditures with the person. Their job is to make sure that personal allowance expenditures are in line with the PEP. Requests for funds that do not follow the PEP should be discussed with the person and team so that adjustments can be made to the PEP if necessary. By following the plan, the DDSOO or voluntary agency will ensure that a person’s choices for spending will be carried out. Following the PEP also lessens the necessity for last-minute spending to keep the person under the resource limits for Medicaid or SSI.
Although the care manager should be a member of the team creating the PEP and the MMA, these requirements are not Medicaid services. The care manager cannot be assigned the responsibility of writing, monitoring, or auditing the PEP or MMA.
Since the person’s interests may change, the plan can and should be changed at any time, but it must be updated at least once every 12 months. A change in health or family supports also may be a reason to review the plan. It is the team’s job to note these changes and arrange for changes to the plan. The DDSOO or voluntary agency managing the personal allowance establishes how a personal expenditure plan can be modified and who can modify it. The plan does not replace the ledger in terms of documentation of the actual spending; it is a guide to those helping the person make financial choices. It must not be used to limit the person’s opportunities for personal spending. Using the plan can help people to budget their income so that favorite activities or vacation are not impacted by frequent impulsive purchases, but it should be flexible enough to allow them to change their mind.
OPWDD’s Division of Quality Improvement will check for a PEP and evidence that expenditure planning is updated at least annually to reflect the flexibility and current priorities for each person.
Personal allowance must never be withheld from an individual for any reason.