New York State Office for the Aging
HEALTH INSURANCE INFORMATION, COUNSELING, and ASSISTANCE PROGRAM
VOUCHERING PROCEDURE
The Health Insurance Information, Counseling, and Assistance Program (HIICAP) Vouchering Procedure has the following major characteristics:
1. Upon receipt of an approved "Notification of Grant Award" the Area Agency is eligible to request an advance. Area Agencies with awards of $5,000 or less may request an advance of up to 50% of the Federal Award. Area Agencies with awards greater then $5,000 may request an advance of 25% of their award or $2,500, whichever is greater.
2. After the initial advance, vouchers are submitted on a reimbursement basis. Expenditure data reported on the vouchers must reflect costs incurred and paid.
3. Generally, a voucher is to be submitted no less than quarterly. All vouchers, except for the final voucher, must be submitted within 30 days after the end of the quarter.
4. Copies of receipts and proofs of payment do not have to be submitted. However, the original documentation must be maintained by the Area Agency.
5. The final claim must be submitted within 60 days following the close of the program period.
6. At the end of the grant period any unexpended advance balance must be repaid to the State Office for the Aging.
REQUIRED FORMS
The following forms must be utilized under the Health Insurance Information, Counseling, and Assistance vouchering procedure:
State of New York – Claim For Payment (AC3253-S) - This is the standard claim form used for requesting either advance payment or reimbursement for expenditures.
INSERT the following when completing the "Description of Materials/Service" section on the front of the claim form:
o Program - Insert "HIICAP " in the space provided.
o Program Period - Insert the dates from your approved Notification of Grant Award.
o Report Period - Insert the dates for the reporting period of this claim.
o Type of Voucher - Indicate Advance, Reimbursement or Final.
o Amount Requested - Indicate the amount shown on the "Federal Share" line on the Fiscal Reporting Form for reimbursement claims.
Fiscal Reporting Form - This form is used to report cash expenditures by line item category and track the status of any advance received.
Fiscal Reporting Form Supporting Schedule - This form provides more detail regarding expenditures in the Equipment, Other Expenses and Non-Federal Cash line items.
Equipment Inventory & Disposition Form (OFA No. 29) - This form is used for reporting the purchase of equipment -- that is, items having a unit cost of $1,000 or more and a useful life of more than one year. It also contains a section to be completed when equipment is disposed of.
All of these forms have instructions to aid in their completion. It is essential that you read these instructions prior to completing a voucher.
Copies of all contracts (including a copy of the budget) and consultant agreements must be submitted to the State Office for the Aging prior to reimbursement for contract/consultant expenditures. If the required documents are not submitted, payment will be reduced accordingly.
NOTE: ALL EXPENDITURE DATA IS REPORTED based on ACTUAL payments made for expenditures incurred during the program period.
RECAP
A properly completed Claim For Payment must:
1. Be submitted in Original bearing an original signature in ink.
2. Be accompanied by:
a. Original copy of the Fiscal Reporting Form.
b. Original of Fiscal Reporting Form Supporting Schedule.
c. Original of the Equipment Inventory & Disposition Form, when applicable.
(OFA No. 29)
d. Copies of any applicable contracts (with budgets) and consultant agreements.
All forms requiring signature must be submitted bearing original signatures in ink.
NOTE: All Area Agency receipts and documentation for payments to contractors must be retained by the Area Agency for audit review. To ensure payment of reimbursement claims it is essential that the aforementioned vouchering deadline is adhered to.
Mail completed vouchers to:
New York State Office for the Aging
Attention: Bureau of Fiscal Operations
Agency Bldg. 2 - Empire State Plaza
Albany, New York 12223-1251
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