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Social Services

 Eligibility
Benefits
Forms and Applications
Homeless Services
Seniors 
Child Support Enforcement 
Law and Legal Services 
 

Eligibility

ACCESS NYC - Benefit Information
ACCESS NYC is an online public screening tool that city residents can use to determine the City, State and Federal health and human service benefit programs for which they are potentially eligible to enroll.
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How and Where to Apply for Public Health Insurance
Provides information on how and where to apply for Public Health Insurance.
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Immigrant Eligibility for Public Health Insurance
Useful information for immigrants about eligibility and how to establish your immigration status when you apply for public health insurance.
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Struggling to get by without coverage? Now there are healthier options for you and your family.
Information on free and low cost health insurance programs, with updates on eligibility to help families with health care costs.
Learn more (in PDF)

Your Guide to Public Health Insurance and Eligibility
A summary of public health insurance options including Medicaid, Child Health Plus, Family Health Plus, and others, and what they cover.
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Benefits

Burial Allowance Information and Application
Financial assistance is provided when an indigent resident of New York City dies without leaving funds to cover burial expenses.
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Cash Assistance Additional Allowance 
This is a list of all the different allowances an active cash assistance client can request.
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Child/Teen Health Plan 
This fact sheet provides eligibility criteria and medical benefits provided by the Child/Teen Health Program.
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Clinics and Hospitals Participating in the Child/Teen Health Program
This document lists clinics and hospitals that offer medical services to participants of the Child/Teen Health Program.
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Electronic Benefits Transfer (EBT) Cardholder Account Overview Guide
This document provides information about the EBT card.
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Family Planning Benefit Program
This brochure provides a summary of family planning services provided through the Family Planning Benefit Program.
Learn more (in PDF)

Home Care Services Program Community Alternative System Agency (CASA) - List of Borough Offices
List of CASA Borough Offices and their Addresses
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HIPAA Privacy Notice
Legal requirements of how patient medical information may be used, accessed or disclosed.
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Premium Assistance Program 
This summary includes eligibility criteria and medical benefits offered by the Premium Assistance Program.
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Reimbursement of Medical and Dental Bills
This fact sheet describes how to get your medical and dental bills reimbursed.
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Request for Health Insurance Information
A form to request copies of some of your protected health insurance documents held on file by this Agency. This form must be completed by you or your legal representative.
Learn more (in PDF)

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Forms and Applications

Application for Temporary, Medicaid and Child Care Assistance; Food Stamps; and Foster Care 
This page includes the applications forms necessary to request assistance.
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Consumer Request to Change Information on File 
A request form for consumers who want changes made to their Case Records.
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Food Stamps Application
This page includes the application form necessary to request assistance.
Learn more (in PDF)

Recertification Form for Temporary and Medical Assistance; Medicare Savings Program; and Food Stamps Benefits
This page includes the recertification forms necessary to request assistance.
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Request for Emergency Assistance or Additional Allowance (For Participants Only)
Cash Assistance clients can use this form to apply for a one-time extra cash grant to help with a special situation (like moving), or for a recurring cash grant added to your regular benefits for help with an ongoing situation (like a pregnancy allowance). This form can also be used to report changes which may affect your grant (like someone new moving into your household). The list of available allowances is noted on form W-137C.
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Homeless Services

Services for Families
This document provides a description of shelter services for families with children under 21 years old, pregnant families, and adult families with no children under 21.
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Services for Single Adults
This document describes shelter services for single adults. Specifically, it provides information about how to access City shelter and related programs/services and what clients should expect once they arrive at City Drop In Centers and Intake Centers.
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Seniors

Advanced Planning Health Bulletin
This bulletin provides information about completing advanced directives, such as a health care proxy, living will, and Do Not Resuscitate (DNR) orders.
Learn more (in PDF)

Senior Citizen Rent Increase Exemption (SCRIE) Program
This document includes information for tenants about the SCRIE program that gives senior citizens an exemption from rent increases.
Learn more (in PDF)

Senior Citizen Rent Increase Exemption (SCRIE) Application
This application offers eligible senior citizens an exemption from rent increases.
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Child Support Enforcement

How to Submit Your Payment Agreement Package for Driver's License Renewal
This letter responds to a payment agreement package for a driver license renewal from a noncustodial parent. It tells the parent where to go, and what to bring with them.
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What May Happen If You Don't Pay Child Support
This document notifies a noncustodial parent that they owe money in a chid support case.
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'What to Do after Your Driver's License Has Been Suspended and You Have Sent in a Challenge
This letter is in response to a noncustodial parent challenging a driver license suspension. It explains the steps being taken by HRA, and what the client can do next.
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What to Do If You Feel You Have Been Mistakenly Identified as the Father of a Child
Information on what to do if you think you have been mistakenly identified as the father of a child.
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What to Do if Your Bank Account Has Been Frozen
This letter is in response to a noncustodial parent asking for their bank account to be unfrozen.
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What to Do if Your Passport Application Has Been Denied
This brochure informs a noncustodial parents on what to do if their passport application was denied.
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When Your Federal Tax Refund Has Been Seized for Child Support and Then Refunded to You in the Wrong Amount
Informs the noncustodial parent how to respond if they have received a federal tax refund in the wrong amount.
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When Your Mistake of Fact Claim (for a Lien) Has Been Sent in Too Late
Information on what to do if your mistake of fact claim for a lien has been sent in too late.
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When Your State Tax Refund Has Been Seized for Child Support and Then Refunded to You in the Wrong Amount
Informs the noncustodial parent how to respond if they have received a state tax refund in the wrong amount.
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Why We Can't Process Your Challenge to Your Driver's License Suspension
This letter responds to a noncustodial parent challenging a driver license suspension. Explains how to correct the form so it can be processed.
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Law and Legal Services

What You Should Know About the Cash Bail Refund Process 
This brochure details the process and procedures you need to follow after you pay bail and are due a bail refund. It also includes contact information.
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Bail Assignment Application
This application gives instructions on transferring a bail refund to a business or another person.
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Cash Bail Refund Change of Address Notice
This notice allows those receiving a cash bail refund who have changed their address to have the refund sent to the new address.
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Lost Bail Receipt Affidavit
This affidavit instructs individuals who have paid bail about what to do if you lost your bail receipt.
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Stop Payment Affidavit 
This affidavit allows those receiving a bail refund to stop payment on a refund check that was lost or never received.
Learn more (in PDF)

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