N.Y. Comp. Codes R. & Regs. tit. 14, § 635-11.9 – CCO enrollment and reviews for persons not residing in a residential facility or a family care home.

(a) If a person has the ability to choose a CCO on his or her own, or with the assistance of supported decision making, the person may:
1. (1) enroll himself or herself in a CCO;
2. (2) act in the CCO review process;
3. (3) disenroll himself or herself from a CCO;
4. (4) appoint another party to take actions on his or her behalf; or
5. (5) seek assistance with the above decisions and actions.
(b) If a person lacks the ability to choose a CCO, but has a guardian lawfully empowered to enroll him or her in a CCO, the guardian may take any of the actions enumerated in subdivision (a) of this section.
(c) If a person lacks the ability to choose a CCO and does not have a guardian lawfully empowered to enroll him or her in a CCO, then any of the following parties, in the order stated, may take any of the actions enumerated in subdivision (a) of this section:
1. (1) an actively involved (see section 633.99[ax] of this Title) spouse;
2. (2) an actively involved parent;
3. (3) an actively involved adult child;
4. (4) an actively involved adult sibling;
5. (5) an actively involved adult family member;
6. (6) the Consumer Advisory Board for the Willowbrook Class members, but only for the members of the Willowbrook Class.
(d) If the first surrogate on the list in subdivision (c) of this section is not reasonably available and willing to make enrollment decisions and enroll the individual in a CCO or act in the CCO review process, and is not expected to become reasonably available and willing to make an enrollment decision and enroll the individual in a CCO or act in the CCO review process, the surrogate who has the highest priority on the list and who is willing and available shall have the authority to make enrollment decisions and enroll the individual in a CCO or act in the CCO review process.
(e) If more than one party exists within a category in subdivision (c) of this section utilizing the standard of active involvement, consent shall be sought first from the party with a higher level of active involvement or, when the parties within a category are equally actively involved, consent shall be sought from any of such parties.
(f) If a person lacks the ability to choose a CCO: does not have a guardian lawfully empowered to enroll him or her in a CCO; and there are no parties identified in subdivision (c) of this section, the DDRO director for the region encompassing the person’s residence, or his or her designee may take any of the actions enumerated in subdivision (a) of this section. If the DDRO director or designee enrolls the person in the CCO, acts in the CCO review process, or disenrolls the individual from a CCO, he or she shall give written notice of such enrollment, disenrollment and/or action to the person’s correspondent or advocate, if one is available.
(g) If the DDRO director or designee enrolls the person in the CCO, acts in the CCO review process, or disenrolls the individual from a CCO, he or she shall give written notice of such enrollment, disenrollment and/or action to the person’s correspondent or advocate, if one is available.
(h) If a party specified in subdivisions (a) through (e) of this section, in the order so specified, makes a decision to enroll in a CCO; not to enroll in a CCO; or to disenroll from a CCO; that decision shall be considered the final decision of the affected individual and any party in a subordinate position, as specified in subdivisions (a) through (e) of this section, may not change that enrollment decision. The party that enrolls the individual shall also be the party authorized to act in the CCO review process.
(i) For each individual eligible to enroll in a CCO, the individual’s care management provider for OPWDD-certified services shall identify a decision-maker who has the authority to make enrollment decisions for the individual pursuant to this section. If there is no care management provider assigned to the individual at the time of the eligibility, the DDRO director for the region encompassing the person’s current residence, or his or her designee, shall identify a decision-maker pursuant to this section.
(j) The care management provider or DDRO director shall notify the following parties of the decision-maker identified to make enrollment decisions:
1. (1) the identified decision-maker; and
2. (2) OPWDD, if necessary.
(k) The care management provider or DDRO director shall maintain documentation of the current decision-maker identified pursuant to this subsection, including documentation of attempts to reach unavailable individuals, and shall confirm the identification of the current decision maker as necessary, but at least annually.