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PEREZ v. LAVINE

UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF NEW YORK


September 16, 1976;

Maria PEREZ et al., Individually and on behalf of all others similarly situated, Plaintiffs,
v.
Abe LAVINE, as Commissioner of the New York State Department of Social Services, and James R. Dumpson, as Commissioner of the New York City Department of Social Services, Defendants

Tenney, District Judge.

The opinion of the court was delivered by: TENNEY

ORDER

TENNEY, District Judge.

 Defendants having been directed in an opinion handed down by this Court dated March 29, 1976 to submit a proposed order outlining plans for revision of their procedures in conformity with such decision, and the Court having considered the submission of both parties with respect to such direction, it is hereby

 ORDERED (1) that, subject to paragraph (2) hereof, any person wishing to apply for public assistance within the City of New York shall be provided an application form on the date of such person's first or second visit to an Income Maintenance Center for the purpose of applying for assistance; and it is further

 ORDERED (2) that

 (a) application forms be provided at alternative locations throughout the community to all interested organizations which request a supply of the forms. A comprehensive list of organizations which have requested and been provided application forms is attached hereto as Appendix A;

 (b) the availability of application forms from such organizations be adequately publicized by defendant [J. Henry Smith], as Commissioner of the New York City Department of Social Services, so that persons wishing to apply for aid are, to the maximum extent feasible, made aware of the availability of application forms from such organizations;

 (c) notwithstanding the alternative provided by this paragraph, any individual wishing to obtain an application form and application kit (described in NYC Procedure No. 75-13, Oct. 6, 1975, p. 9, and subsequent revisions thereto which must include like materials) from an Income Maintenance Center must be permitted to do so, and must be provided such form and kit on request; and it is further

 ORDERED (3) that at the time such person is provided an application form he or she shall simultaneously be provided the application kit which shall include a comprehensive, intelligible set of instructions, written in large, easily read print in English and/or in Spanish as applicable, designed to ensure that an applicant can complete the application form without requiring the assistance of Income Maintenance Center personnel. A draft copy of these instructions is attached hereto as Appendix B; and it is further

 ORDERED (4) that signs be posted prominently in all Income Maintenance Centers in the City of New York notifying applicants that they are entitled to an application form and informing them to request an application from the receptionist if they want one. The sign, which will be in both English and Spanish and in letters of at least one inch in height, will read as follows:

 

" NOTICE TO APPLICANTS

 

IF YOU WANT TO APPLY FOR PUBLIC ASSISTANCE, YOU HAVE A RIGHT TO GET AN APPLICATION FORM AND WRITTEN INSTRUCTIONS THAT EXPLAIN HOW TO FILL OUT THE APPLICATION. YOU ALSO HAVE THE RIGHT TO FILE THE APPLICATION FORM AND GET A WRITTEN DECISION TELLING YOU WHETHER OR NOT YOU ARE ELIGIBLE. YOU CAN FILE AN APPLICATION AND GET A WRITTEN DECISION EVEN IF THE RECEPTIONIST TELLS YOU THAT YOU DO NOT SEEM ELIGIBLE."

 It is further

 ORDERED (5) that

 (a) after an applicant receives an application, an appointment shall be scheduled for the applicant to return for an initial application interview within five working days;

 (b) all application staff will be notified that they cannot schedule initial application appointments beyond five working days without express approval from the Center Director;

 (c) the Center Director, upon being notified by his application supervisor that the initial application interview cannot be scheduled within five working days, will provide for the transfer of staff from other sections to meet the five-working-day requirement or call the Deputy Administrator for Income Maintenance Programs, or his designee, who will take immediate steps to ensure that such appointments are scheduled within five working days;

 (d) if an appointment cannot be scheduled within five working days, the applicant's completed application shall nevertheless be accepted for filing at the time submitted by the applicant;

 (e) if the applicant returns to the Center on the date of his or her scheduled application interview, the application interview shall be held on that day and the completed application form shall be accepted as filed on or before that day; and it is further

 ORDERED (6) that all application section personnel and administrative staff within the Income Maintenance Centers be notified that applicants have a right to obtain an application form even if they are in the wrong Center or the pre-screening interview indicates that they are presumptively not eligible. Training sessions will be held to ensure that Center staff, including receptionists, "A" receptionists, application interviewers, application supervisors, and all administrative staff are aware of this requirement; and it is further

 ORDERED (7) that defendant [Philip Toia], as Commissioner of the New York State Department of Social Services, take such steps as may be necessary to assist defendant [J. Henry Smith], as Commissioner of the New York City Department of Social Services, to comply with this Order and to ensure periodic review by the State Department of Social Services so that appropriate corrective action may be taken by such State agency in the event that noncompliance is ascertained.

 APPENDIX A

 Community Offices BROOKLYN

 Brighton Beach Coordinating Committee for Russian Immigrants,

 293 Neptune Avenue,

 Brooklyn, N. Y. 11235

 Jewish Family Services,

 4917 12th Avenue,

 Brooklyn, N. Y. 11219

 Sunset Park Family Health Center,

 514 49th Street,

 Brooklyn, N. Y. 11220

 Jewish Family Services,

 186 Montague Street,

 Brooklyn, N. Y. 11201

 John the Baptist Community Center,

 807 Willoughby Avenue,

 Brooklyn, N. Y. 11206

 Bedford Stuyvesant Alcoholism Treatment Clinic,

 1121 Bedford Avenue,

 Brooklyn, N. Y. 11216

 Bedford Stuyvesant Restoration Corp.,

 172 Tompkins Avenue,

 Brooklyn, N. Y. 11206

 Bedford Stuyvesant Youth in Action,

 882 DeKalb Avenue,

 Brooklyn, N. Y. 11221

 Lyndon B. Johnson Health Center,

 507 DeKalb Avenue,

 Brooklyn, N. Y. 11205

 Bedford Stuyvesant Youth in Action,

 930 Bedford Avenue,

 Brooklyn, N. Y. 11205

 Bedford Stuyvesant Youth in Action,

 496 Franklin Avenue,

 Brooklyn, N. Y. 11238

 Club Heraldo Hispano,

 727 Fulton Street,

 Brooklyn, N. Y. 11217

 Fort Greene Community Corp.,

 205 Ashland Place,

 Brooklyn, N. Y. 11205

 Coney Island Hospital,

 Social Service Department,

 2601 Ocean Parkway,

 Brooklyn, N. Y. 11235

 Our Lady of Mercy Church,

 680 Stone Avenue,

 Brooklyn, N. Y. 11212

 Salvation Army,

 280 Riverdale Avenue,

 Brooklyn, N. Y. 11212

 Kings County Hospital,

 Alcoholism Treatment Clinic,

 600 Albany Avenue,

 Brooklyn, N. Y. 11203

 Kings County Hospital,

 Social Service Department,

 451 Clarkson Avenue,

 Brooklyn, N. Y. 11203

 Catholic Charities,

 Human Service Center,

 730 Classon Avenue,

 Brooklyn, N. Y. 11238

 Catholic Charities,

 Human Service Center,

 1101 Carroll Street,

 Brooklyn, N. Y. 11225

 Catholic Charities,

 Williamsburg Human Service Center,

 142 Montrose Avenue,

 Brooklyn, N. Y. 11206

  Northside Community Development Council,

  575 Driggs Avenue,

  Brooklyn, N. Y. 11211

  Williamsburg Community Corp.,

  815 Broadway,

  Brooklyn, N. Y. 11206

  School Settlement Association,

  120 Jackson Street,

  Brooklyn, N. Y. 11211

  St. Nicholas Neighborhood Preservation and Housing Rehabilitation Corp.,

  260 Powers Street,

  Brooklyn, N. Y. 11211

  Education Action Centers,

  577 Lorimer Street,

  Brooklyn, N. Y. 11211

  Opportunity Development Association,

  41 Heyward Street,

  Brooklyn, N. Y. 11211

  United Jewish Organizations,

  545 Bedford Avenue,

  Brooklyn, N. Y. 11211

  Italian American Civil Rights League,

  390 Graham Avenue,

  Brooklyn, N. Y. 11211

  Williamsburg Legal Services,

  260 Broadway,

  Brooklyn, N. Y. 11206

  Lutheran Community Service Center,

  366 Union Avenue,

  Brooklyn, N. Y. 11211

  Williamsburg Prenatal Clinic,

  151 Maujer Street,

  Brooklyn, N. Y. 11206

  Welfare Recipients Action Group of Red Hook,

  396 Van Brunt Street,

  Brooklyn, N. Y. 11231

  La Casa Neighborhood Service Center,

  152 Columbia Street,

  Brooklyn, N. Y. 11231

  Chama Brooklyn Child Development Center,

  1835 Sterling Place,

  Brooklyn, N. Y. 11233

  Catholic Migration Office,

  354 Court Street,

  Brooklyn, N. Y. 11231

  Catholic Migration Office,

  12 Bedford Avenue,

  Brooklyn, N. Y. 11223

  Catholic Migration Office,

  74-10 20th Avenue,

  Brooklyn, N. Y. 11204

  Catholic Migration Office,

  1449 Myrtle Avenue,

  Brooklyn, N. Y.

  Fort Greene Community Corp.,

  958 Fulton Street,

  Brooklyn, N. Y. 11238

  Community Offices BRONX

  Cypress Community Center,

  541 E. 138 Street,

  Bronx, N. Y. 10454

  Catholic Charities,

  541 E. 138 Street,

  Bronx, N. Y. 10454

  Bronx Lebanon Hospital,

  Concourse Division,

  Social Services Department,

  1650 Grand Concourse,

  Bronx, N. Y. 10456

  Bronx Developmental Services,

  State Department of Mental Hygiene,

  726 Kelly Street,

  Bronx, N. Y. 10455

  Bronx Developmental Services,

  1366 Inwood Avenue,

  Bronx, N. Y. 10452

  Puerto Rican Family Institute,

  2051 Grand Avenue,

  Bronx, N. Y. 10453

  Morris Avenue Engage,

  284 E. 150 Street,

  Bronx, N. Y. 10451

  West Bronx Jewish Federation Service Center,

  1130 Grand Concourse,

  Bronx, N. Y. 10456

  The Jewish Family Services,

  140-26 Carver Loop,

  Coop City, Bronx, N. Y. 10475

  Bronx Psychiatric Center,

  1500 Waters Place,

  Bronx, N. Y. 10461

  Bronx State Hospital,

  Highbridge Out-Patient Clinic,

  260 East 161 Street 10th floor,

  Bronx, N. Y. 10451

  Riverdale Neighborhood House,

  5521 Mosholu Avenue,

  Riverdale, N. Y. 10471

  J.A.S.A.,

  2488 Grand Concourse,

  Bronx, N. Y. 10458

  Bronx Community College,

  Loew Hall 4th floor,

  181 Street and University Avenue,

  Bronx, N. Y. 10453

  Northwest Community Coalition,

  Youth Development Program,

  2721 Webster Avenue,

  Bronx, N. Y.

  Martin Luther King, Jr. Health Center,

  3674 Third Avenue,

  Bronx, N. Y. 10456

  Martin Luther King, Jr. Health Center,

  1633 Bathgate Avenue,

  Bronx, N. Y. 10457

  South Bronx Community Corp.,

  363 E. 148 Street,

  Bronx, N. Y. 10455

  United Bronx Parents,

  810 E. 152 Street,

  Bronx, N. Y. 10455

  United Bronx Parents,

  337 E. 149 Street,

  Bronx, N. Y. 10451

  Bronx Developmental Services,

  2692 Third Avenue,

  Bronx, N. Y. 10454

  Morrisania Prenatal Clinic,

  1316 Fulton Avenue,

  Bronx, N. Y. 10456

  G L I E Community Youth Program,

  1382 Grand Concourse,

  Bronx, N. Y. 10457

  Community Offices MANHATTAN

  Little Italy Restoration Association, Inc.,

  384 Broome Street,

  New York, N. Y. 10013

  We Care Walk in Referral Center,

  28 Edgecombe Avenue,

  New York, N. Y.

  East Harlem Family Problem Clinic,

  2050 Second Avenue,

  New York, N. Y. 10029

  Project Access,

  1441 Park Avenue,

  New York, N. Y. 10029

  Afro-American East Service Center,

  1765 Madison Avenue,

  New York, N. Y. 10029

  East Harlem Nutrition Education Program,

  1692 Lexington Avenue,

  New York, N. Y. 10029

  Community Affairs Office,

  New York Medical College,

  217 E. 106 Street,

  New York, N. Y. 10029

  Community Development, Inc.,

  169 W. 89 Street,

  New York, N. Y. 10024

  Central Harlem Community Corp.,

  NAB # 4,

  2230 Eighth Avenue,

  New York, N. Y. 10027

  Central Harlem Community Corp.,

  NAB # 5,

  238 W. 116 Street,

  New York, N. Y. 10026

  Harlem Assertion of Rights,

  35 W. 125 Street,

  New York, N. Y. 10027

  United Welfare League,

  929 Columbus Avenue,

  New York, N. Y. 10025

  Better Community Association,

  1722 Amsterdam Avenue,

  New York, N. Y.

  Club Civico Ponceno,

  1230 St. Nicholas Avenue,

  New York, N. Y. 10033

  Community Action Mobilization for Prog.,

  2089 Amsterdam Avenue,

  New York, N. Y. 10032

  Community League of W. 159 Street,

  508 W. 159 Street,

  New York, N. Y. 10032

  Family Planning North,

  1984 Amsterdam Avenue,

  New York, N. Y. 10032

  Grant Youth Council,

  501 West 125 Street,

  New York, N. Y. 10027

  Neighborhood Manpower Service Center,

  760 St. Nicholas Avenue,

  New York, N. Y. 10031

  St. Mary's Involvement Program,

  514 W. 126 Street,

  New York, N. Y. 10027

  Strive, Train, Organization for Prog.,

  2121 Amsterdam Avenue,

  New York, N. Y. 10032

  Uptown Community Service League,

  3671 Broadway,

  New York, N. Y. 10031

  Action for Progress,

  189 Allen Street,

  New York, N. Y. 10002

  Action for Progress,

  175 Chrystie Street,

  New York, N. Y. 10002

  Lower East Side Community Corp.,

  42 Avenue C,

  New York, N. Y. 10009

  It's Time,

  139 Henry Street,

  New York, N. Y. 10002

  Lower East Side Community Corp.,

  195 Stanton Street,

  New York, N. Y. 10002

  Lower East Side Community Corp.,

  42 Avenue C,

  New York, N. Y. 10009

  Negro Action Group,

  217 E. Third Street,

  New York, N. Y. 10009

  Association of Community Service Centers,

  152 Avenue D,

  New York, N. Y. 10009

  Search and Care,

  341 E. 87 Street,

  New York, N. Y.

  Catholic Migration Office,

  30-58 Steinway Street,

  Astoria, Queens, N.Y. 11103

  Catholic Migration Office,

  98-21 101st Avenue,

  Ozone Park, Queens, N.Y. 11416

  Federation Jewish Community Council Service Center of the Rockaways,

  20-38 Mott Avenue,

  Far Rockaway, N.Y. 11691

  Human Service Center,

  172-07 Jamaica Avenue,

  Queens, N.Y. 11432

  Flushing Human Service Center,

  41-06 163rd Street,

  Flushing, Queens, N.Y.

  "Birth Right of Queens",

  79-24 Parsons Boulevard,

  Queens, N.Y.

  Rockaway Community Corp.,

  260 Beach 84 Street,

  Queens, N.Y.

  Jewish Community Service,

  86-92 Palo Alto Street,

  Holliswood, Queens, N.Y. 11423

  "All the Queens Women",

  163-23 Depot Road,

  Queens, N.Y. 11358

  Queensbridge Health Services,

  38-53 12th Street,

  Long Island City, N.Y. 11101

  Rockaway Human Services Center,

  253 Beach 116 Street,

  Rockaway, Queens, N.Y.

  APPENDIX B

  DRAFT

  Instructions For Filling out the DSS 1994 -- Application of Need For Public Assistance

  These instructions are designed to help you fill out the application for public assistance. Please print your answers clearly and complete all items. You will be required, at your interview, to supply proof of your statements in this application, especially proof of identity, age, place of residence, rent, relationship of children, all income and resources. A Redi-Reference Guide is supplied to aid you in determining what documentation you may have that will establish your statements.

  PART I. -- FAMILY & RELATIVE DATA

  The items under this heading are self-explanatory.

  Instructions for Section A

  Please print the name, social security number, relationship, sex, birthdate, place of birth, marital status, date came to N.Y. State for all persons applying together for public assistance. Start by giving this information for yourself, then for your spouse, and then for your children or other persons living with you and applying for assistance.

  Instructions for Section B

  If there are other persons living in your home who are not applying for assistance, you must fill out this section. If no one else lives in your home check the box marked no.

  Instructions for Section C

  We need to know the change in your situation that has caused you to apply for public assistance. Tell us. As examples: If you lost your job, tell us when. If your husband left you, explain why and when. If you have exhausted your bank account or other savings, explain how and when. There are boxes to be checked that will help you tell us what has happened but we would also like you to tell us in your own words how you got along before the change.

  Instructions for Section D

  We would like to know whether you have ever received public assistance, whether you now receive or have ever received food stamps and medicaid.

  Instructions for Section E

  Children over 16, if not attending school, must register for work programs. Please show the names of your children 16 and over and show what schools they attend.

  Instructions for Section F

  Persons who have begun the fourth month of pregnancy are entitled to an additional allowance when the bring a doctor's statement. Persons who are addicted to drugs and or alcohol must be in treatment for these addictions as a condition of receiving assistance.

  Instructions for Section G

  Self-explanatory.

  Instructions for Section H

  If anyone who is listed in Section A as applying for assistance served in the armed forces of the U.S. during a time of war, or is related to the veteran, they may be eligible for veteran assistance.

  Instructions for Section I

  We are interested in knowing whether you or your wife have children under 21 who live outside of your home.

  Instructions for Section J

  Where a husband or wife is living outside the home, we need to know where he/she is so we can ask whether he/she can give you assistance as he/she is legally responsible for your support.

  Instructions for Section K

  Where the parents of minor children for whom you are applying for assistance live outside the home we need to know where they live so we can ask whether they can provide assistance for their children as they are legally responsible for their children's support. If there is more than one parent living outside the home give information for each parent.

  Instructions for Section L

  If the parents of minor children for whom you are applying for assistance are dead, the children may be eligible for benefits from Social Security or elsewhere.

  Instructions for Section M

  If you are under 21 years of age, your parents are legally responsible for your support. Please fill out information so we may contact your parents.

  PART II -- LIVING ARRANGEMENTS

  Instructions for Section N

  We will try to help you return to your last address or help you find another place to live if you do not have a home. If you do have a home, we need to know whether you and your family live alone, share an apartment or home, or own your own home. We need to know how much it costs you for rent or payment of your carrying charges. This information will help us to decide how much money you need for public assistance.

  Instructions for Section O

  Needs no further explanation. You have to tell us whether you want food stamps in addition to public assistance. To get food stamps, you will have to pay some money from your public assistance, but you will receive a higher cash value through the food stamps than you pay in money to buy the stamps. Not everybody is eligible for food stamps, so be sure to fill out all parts of this section.

  Instructions for Section P

  If you owe rent or a gas and electric bill, we may be able to help you pay. Let us know in this section what debts you owe.

  PART III -- EMPLOYMENT

  Instructions for Section Q

  You may be eligible for assistance even if you or persons in your family are employed. Let us know how much each person who works earns and what is deducted from her salary. Give us the names of the employer. Your costs to care for your children while you work are taken into account when figuring out how much you need from public assistance.

  Instructions for Section R

  Needs no explanation. There may be benefits coming to you from past work of yourself or others in your family.

  Instructions for Section S

  Needs no explanation. There may be benefits coming to you; unions to which you or members of your family belong.

  Instructions for Section T

  We need to know whether you are now receiving or expect to receive any of the benefits or income listed. This income will be considered in figuring out how much you can get in public assistance.

  PART V -- RESOURCES

  Instructions for Section U

  We need to know, for any person applying for assistance, if he has any of the resources listed. These resources must be applied against the needs for public assistance.

  PART VI -- OTHER APPLICANT INFORMATION

  Instructions for Section V

  This question is asked so that the government can have statistics for research. If you do not want to answer this question, it will make no difference in considering your application for assistance.

  Instructions for Section W

  This question need not be answered for persons living in New York City.

  Instructions for Section X

  The law prohibits us from giving assistance to illegal aliens for more than 30 days. Please answer this questions in this section so we can determine if you are a citizen or an alien legally residing in this country.

  Instructions for Section Y

  Use this space to write in any information in your application that you want us to know more about.

  PART VII -- CERTIFICATION

  Please read the statement in this part carefully. It is important that you understand what you are writing in this application and understand what may happen if you make false statements. Your signature is required. If you can't sign yourself, a representative may sign for you. If you sign with an X, your mark must be witnessed.

  REQUEST FOR SERVICES

  If you wish to obtain a social service, read and fill in page 11. A representative of our Department will be in touch with you to discuss your need for services. You may be eligible for service even if you are not eligible for public assistance. If you don't want a social service, it will not affect your eligibility for public assistance.

  Part 1 -- Self-Explanatory

  A. In this section, list all members of your family living in the household who need Public Assistance. Give the asked for information for each person listed.

  B. List any additional members of your household who do not need Public Assistance. If there are other people living in your house who do not need Public Assistance, you must fill out this section.

  C. Self-explanatory.

  D. Indicate whether you previously applied for or received Public Assistance, Medicaid or Food Stamps.

  E. Self-explanatory. Please explain how you were getting along on the money you had and tell what changed so that you now need Public Assistance.

  F. Name any pregnant, sick or disabled member of your family and his treatment program, if any.

  G. Self-explanatory.

  H. A Veteran is a person who served in the Armed Forces of the United States. Please fill out this section if anyone applying for assistance is a Veteran.

  I. List the name and address of any child of you or your spouse who is under 21 years of age, not living with you.

  J. Indicate the name and address or last known address or your legal husband or wife.

  K. If one or both of the parents of the children for whom you are applying for assistance, listed in Section A, is not living in your home, indicate his name, address and support received.

  L. Self-explanatory.

  M. Self-explanatory.

  N. If you have no place to live, fill in your last complete address, and the reason you can no longer stay there.

  

If you pay rent, check off () the type of living arrangements and the requested information about the landlord, etc.

  

If you live with somebody else, fill in the requested information in area 3.

  

If you own your own home, fill in the requested information in area 4.

  O. Self-explanatory.

  P. Indicate the amount of any debt listed and the period incurred.

  Q. Fill in the requested information about each employed person listed in Section A, including all items deducted or withheld from his pay. In Section 3, list additional employment expenses, and in Section 4, any child care expenses caused by the employment of the listed persons.

  R. Give the requested information about the employment of any person in your family who worked during the last year.

  S. Self-explanatory.

  T. Individuals or families applying for Public Assistance are expected to take advantage of all available resources, to defray their need for Public Assistance. Is anyone in your family listed in section A expecting to receive any of the benefits listed in this section?

  U. Self-explanatory.

  V. Self-explanatory.

  W. If your name is not listed on the building registry or mailbox, or if there is no building number of your apartment, please give identifying information.

  X. Please fill in all the requested information for any citizen who is not born in the United States or any alien member of your family group.

  Y. Self-explanatory.

  Z. If you received help from an individual or agency in filling out this application, please give his name and address. If you sign the application with an "X", a witness should also sign and fill in his address.

19760916

© 1992-2004 VersusLaw Inc.



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