senate Bill S1109C

Amended

Enacts the "people first act of 2014"

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 09 / Jan / 2013
    • REFERRED TO MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
  • 11 / Jan / 2013
    • AMEND AND RECOMMIT TO MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
  • 11 / Jan / 2013
    • PRINT NUMBER 1109A
  • 02 / May / 2013
    • AMEND AND RECOMMIT TO MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
  • 02 / May / 2013
    • PRINT NUMBER 1109B
  • 05 / Jun / 2013
    • REPORTED AND COMMITTED TO FINANCE
  • 07 / Jun / 2013
    • AMEND AND RECOMMIT TO FINANCE
  • 07 / Jun / 2013
    • PRINT NUMBER 1109C
  • 08 / Jan / 2014
    • REFERRED TO MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
  • 09 / Jan / 2014
    • AMEND (T) AND RECOMMIT TO MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
  • 09 / Jan / 2014
    • PRINT NUMBER 1109D
  • 04 / Feb / 2014
    • REPORTED AND COMMITTED TO FINANCE
  • 16 / Jun / 2014
    • COMMITTEE DISCHARGED AND COMMITTED TO RULES
  • 16 / Jun / 2014
    • ORDERED TO THIRD READING CAL.1372
  • 16 / Jun / 2014
    • SUBSTITUTED BY A8452

Summary

Enacts the "people first act of 2014"; defines terms; ensures that individuals with developmental disabilities who utilize long-term care services under the medical assistance program administered by the state have meaningful access to a reasonable array of community-based and institutional program options to ensure the well-being of such individuals.

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Bill Details

See Assembly Version of this Bill:
A4069B
Versions:
S1109
S1109A
S1109B
S1109C
S1109D
Legislative Cycle:
2013-2014
Law Section:
Mental Hygiene Law
Laws Affected:
Amd ยงยง13.15 & 16.01, Ment Hyg L
Versions Introduced in 2011-2012 Legislative Cycle:
S6420

Sponsor Memo

BILL NUMBER:S1109C

TITLE OF BILL: An act to amend the mental hygiene law, in relation to
enacting the "people first act of 2013"

SUMMARY OF PROVISIONS:

Section one provides for the short title of the bill to be the "People
First Act of 2013."

Section two of the bill contains legislative findings.

Section three of the bill amends section 13.15 of the Mental Hygiene
Law, in order to require the Commissioner of OPWDD to conduct a
geographic analysis of the supports and services in community settings
available for individuals ,with developmental disabilities and to
identify gaps between required supports and services by region of the
state. In addition, the Commissioner is directed to develop a
web-based database which will permit the prioritization of the urgency
of needs (P.D.N.S.) for supports and services for those facing
emergency or immediate need, those facing critical need, defined as
additional services and supports with one year and planning need, for
those who will require additional services and supports within five
years or where the Individual's caregiver is over sixty years old.
Annual reporting requirements will allow the Executive and the
Legislature make informed policy choices in the delivery of supports
and services to people with developmental disabilities.

Section four, of the bill makes technical, amendments. Section five is
the effective date of the bill.

JUSTIFICATION: The New York State Department of Health (DOH) in
partnership with the Office of People with Developmental Disabilities
(OPWDD) proposed a new model for the financing of services for
individuals with developmental disabilities to the federal government.
The federal government no longer supports NY's current model for
financing services and supports for people with developmental
disabilities, The current model is based, in significant part, upon
allowed costs for institutional placement, which are substantially in
excess of actual costs of institutional placement, as institutional
capacity has been reduced over the past 30 years, The state and the
federal government had previously agreed that as institutional
capacity was reduced, the funds otherwise used for institutional
placement could follow the individual into the community. The use of
these funds allowed NYS to create the current community-based service
structure.

The state was authorized in the 2011-12 Enacted. Budget to submit a
Medicaid waiver application, which OPWDD has called the "People First
Waiver", in order to transition the current Medicaid "fee for service"
longterm care services for individuals with developmental disabilities
to a case management model.

The state is seeking authority to transition individuals served by the
current service delivery system into mandatory enrollment in managed
long-term care services. The core concept behind the "People First
Waiver" application is an individual budget allocation built on a


standardized assessment of individual support needs. Recognizing that
people with developmental disabilities want to live their lives in the
community, just like everyone else, OPWDD is racing to embrace the
concept of a "self-directed person-cantered system, where individuals
and their circle of support have considerable authority over what
supports they receive, how they are received and from whom.

At the center of any system promoting self-direction is a personal
budget allocation that the individual and his circle of support may
apply within the bounds of an approved service plan to secure needed
supports. The Center for Medicare and Medicaid Services (CMS) requires
any "individual budget amount" to be "a prospectively determined
amount of funds that the state makes available for the provision of
federally funded services to an (individual)". Implicit in this
definition are two key concepts: the state determines the budget
amount for each individual, and the individual and/or his or her
circle of support is provided this information before developing a
service plan.

LEGISLATIVE HISTORY: S.6420/A.9402 of 2011-12; Reported and Committed
to Finance

FISCAL IMPACT: To be determined.

EFFECTIVE DATE: Immediately.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 1109--C

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 9, 2013
                               ___________

Introduced  by  Sens. MAZIARZ, GALLIVAN, GRISANTI, KENNEDY -- read twice
  and ordered printed, and when printed to be committed to the Committee
  on  Mental  Health  and  Developmental   Disabilities   --   committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to  said  committee  --  committee  discharged,  bill amended, ordered
  reprinted as amended and recommitted to  said  committee  --  reported
  favorably  from  said  committee  and  committed  to  the Committee on
  Finance -- committee discharged, bill amended,  ordered  reprinted  as
  amended and recommitted to said committee

AN  ACT  to  amend  the  mental hygiene law, in relation to enacting the
  "people first act of 2013"

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  Short  title. This act shall be known and may be cited as
the "people first act of 2013".
  S 2. Legislative findings. It is the  intent  of  the  legislature  to
ensure  that  individuals  with  developmental  disabilities who utilize
long-term care services under the medical assistance program  and  other
long-term  care  related benefit programs administered by the state have
meaningful access to a reasonable array of community-based and  institu-
tional  program options and to ensure the well-being of individuals with
developmental disabilities,  taking  into  account  their  informed  and
expressed  choices. Furthermore, the legislature declares that it is the
policy of the state to  ensure  that  the  clinical,  habilitative,  and
social  needs  of individuals with developmental disabilities who choose
to reside in integrated community-based settings can  have  those  needs
met  in  integrated  community-based  settings. In order to meaningfully
comply with this policy, the state must have  an  understanding  of  the
existing  capacity  in  integrated-community  based  settings, including
direct support professionals and licensed professionals, such as  physi-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02298-08-3

S. 1109--C                          2

cians, dentists, nurse practitioners, nurses, and psychiatrists, as well
as residential capacity to provide for these needs.
  It  is  further the intent of the legislature to support the satisfac-
tion and success of consumers through the delivery of  quality  services
and supports. Evaluation of the services that consumers receive is a key
aspect  to  the service system. Utilizing the information that consumers
and their families provide about such services in a reliable  and  mean-
ingful  way is also critical to enable the commissioner of developmental
disabilities to assess the  performance  of  the  state's  developmental
services  system and to improve services for consumers in the future. To
that end, the commissioner of developmental disabilities shall conduct a
geographic analysis of supports and services in community  settings  and
implement  an improved, unified quality assessment system, in accordance
with this act.
  S 3. Section 13.15 of the mental hygiene law is amended  by  adding  a
new subdivision (d) to read as follows:
  (D)  (1)  FOR  PURPOSES OF THIS SUBDIVISION, THE FOLLOWING TERMS SHALL
HAVE THE FOLLOWING MEANINGS:
  (I) "DIRECT  SUPPORT  PROFESSIONALS"  MEANS  DIRECT  SUPPORT  WORKERS,
DIRECT CARE WORKERS, PERSONAL ASSISTANTS, PERSONAL ATTENDANTS, AND PARA-
PROFESSIONALS  THAT PROVIDE ASSISTANCE TO INDIVIDUALS WITH DEVELOPMENTAL
DISABILITIES IN THE FORM OF DAILY LIVING, AND PROVIDE THE  HABILITATION,
REHABILITATION, AND TRAINING NEEDS OF THESE INDIVIDUALS.
  (II)  "LICENSED  PROFESSIONALS"  MEANS,  BUT IS NOT LIMITED TO, PHYSI-
CIANS, DENTISTS, DENTAL HYGIENISTS, DENTAL ASSISTANTS, NURSE PRACTITION-
ERS,  LICENSED  PRACTICAL  NURSES,  REGISTERED  NURSES,   PSYCHIATRISTS,
PSYCHOLOGISTS,  LICENSED  MASTER  SOCIAL  WORKERS,  OR LICENSED CLINICAL
SOCIAL WORKERS, LICENSED TO PRACTICE PURSUANT TO THE EDUCATION  LAW  AND
OTHER QUALIFIED MENTAL HEALTH PROFESSIONALS.
  (III)  "SUPPORTS  AND  SERVICES"  MEANS  DIRECT SUPPORT PROFESSIONALS,
LICENSED PROFESSIONALS, AND RESIDENTIAL  SERVICES,  INCLUDING,  BUT  NOT
LIMITED  TO,  PRIVATE  RESIDENCES,  COMMUNITY-INTEGRATED LIVING ARRANGE-
MENTS, SUPPORTED RESIDENTIAL PROGRAMS, SUPERVISED RESIDENTIAL  PROGRAMS,
OR SUPPORTIVE HOUSING PROGRAMS.
  (2)  SUBJECT  TO  AVAILABLE  APPROPRIATIONS THEREFOR, THE COMMISSIONER
SHALL CONDUCT A GEOGRAPHIC ANALYSIS OF SUPPORTS AND SERVICES IN COMMUNI-
TY SETTINGS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES. THIS ANALY-
SIS SHALL ALSO IDENTIFY GAPS BETWEEN REQUIRED SUPPORTS AND  SERVICES  BY
REGION OF THE STATE.
  (3)  IN ORDER TO PERFORM THE GEOGRAPHIC ANALYSIS OR TO GATHER DATA FOR
PURPOSES OF PERFORMING THE GEOGRAPHIC  ANALYSIS,  THE  COMMISSIONER  MAY
WORK  IN  COOPERATION  AND  AGREEMENT WITH OTHER OFFICES, DEPARTMENTS OR
AGENCIES OF THE STATE, LOCAL OR FEDERAL GOVERNMENT, OR  OTHER  ORGANIZA-
TIONS  AND  INDIVIDUALS,  WHICH  MAY  INCLUDE  PROVIDERS OF SERVICES FOR
PERSONS WITH DEVELOPMENTAL DISABILITIES, REPRESENTATIVES  FROM  EMPLOYEE
ORGANIZATIONS REPRESENTING DIRECT CARE WORKERS, CONSUMER REPRESENTATIVES
INCLUDING  PERSONS  WITH DEVELOPMENTAL DISABILITIES, OR THEIR PARENTS OR
GUARDIANS.
  (4) IN CONDUCTING THIS ACTIVITY, THE COMMISSIONER, SUBJECT  TO  AVAIL-
ABLE  APPROPRIATIONS  THEREFOR,  SHALL  DEVELOP  AND UTILIZE A WEB-BASED
DATA-BASE WHICH  PRIORITIZES  THE  URGENCY  OF  NEED  FOR  SUPPORTS  AND
SERVICES.  THE  INFORMATION  COLLECTED  SHOULD ALLOW THE COMMISSIONER TO
CATEGORIZE NEEDS FOR DEVELOPMENTAL DISABILITY SERVICES WITHIN  A  FRAME-
WORK  THAT  ENCOMPASSES THREE LEVELS OF URGENCY OF NEEDS. THESE LEVEL OF
SUPPORT NEEDS SHOULD INCLUDE: EMERGENCY NEED,  FOR  THOSE  PERSONS  WITH
DEVELOPMENTAL  DISABILITIES  IN  NEED  OF  IMMEDIATE  SUPPORT EITHER DAY

S. 1109--C                          3

SUPPORT OR IN-HOME OR OUT-OF-HOME PLACEMENT;  CRITICAL  NEED  FOR  THOSE
INDIVIDUALS  WHO  WILL  HAVE  A NEED FOR SUPPORTS OR SERVICES WITHIN ONE
YEAR; AND PLANNING FOR NEED, FOR THOSE INDIVIDUALS WHOSE  SUPPORT  NEEDS
ARE  ONE  TO  FIVE  YEARS  AWAY,  OR WHERE THE CAREGIVER IS AGE SIXTY OR
OLDER.
  (5) SUCH AN ANALYSIS SHOULD INCLUDE THE STATEWIDE NUMBER  OF  INDIVID-
UALS SEEKING SERVICES, INCLUDING AWAITING PLACEMENT BROKEN DOWN INTO THE
TOTAL  NUMBER OF INDIVIDUALS FROM WITHIN EACH REGIONAL SERVICES OFFICE'S
GEOGRAPHIC AREA WHO AWAIT RESIDENTIAL PLACEMENT,  DAY  SERVICE  SUPPORT,
HOME  AND COMMUNITY-BASED WAIVER SUPPORT, EMPLOYMENT SUPPORT, BEHAVIORAL
HEALTH SERVICES AND SUPPORTS, OR  OTHER  COMMUNITY-BASED  SUPPORT.  SUCH
INFORMATION  SHOULD  BE  GROUPED  BY  THE AGE OF THE INDIVIDUAL AWAITING
COMMUNITY SERVICES AND SUPPORTS AND THE AGE OF THEIR CAREGIVER, IF  ANY.
SUCH  INFORMATION SHOULD ALSO INCLUDE WAITLIST AND PLACEMENT INFORMATION
SUCH AS:
  (I) THE TYPE OF SUPPORTS AND SERVICES SUCH INDIVIDUALS ARE EXPECTED TO
REQUIRE  DIVIDED  INTO  CERTIFIED  OUT-OF-HOME,  SUPERVISED,  SUPPORTIVE
PLACEMENT  NEEDS  AND  OTHER  NON-PLACEMENT NEEDS AND THE NUMBER OF SUCH
PERSONS WHO ARE MEDICALLY FRAIL REQUIRING INTENSIVE MEDICAL CARE;
  (II) NON-CERTIFIED RESIDENTIAL  PLACEMENTS  OUTSIDE  THE  PARENT'S  OR
PARENTS' OR OTHER CAREGIVER'S HOME;
  (III) THE NUMBER OF INDIVIDUALS EXPECTED TO REQUIRE HOME AND COMMUNITY
SERVICES WAIVER-FUNDED HABILITATION SERVICES AT HOME;
  (IV)  THE  TOTAL NUMBER OF INDIVIDUALS, WHO HAVE BEEN IDENTIFIED AS IN
NEED OF SUPPORTS AND SERVICES  WHO  HAVE  RECEIVED  THESE  SUPPORTS  AND
SERVICES  AND  ANY  GAP  BETWEEN  REQUIRED SUPPORTS AND SERVICES AND THE
SUPPORTS AND SERVICES PROVIDED;
  (V) THE NUMBER OF EMERGENCY NEED RESIDENTIAL PLACEMENTS FOR  THE  PAST
YEAR AND OTHER SUPPORTS AND SERVICES PROVIDED ON AN EMERGENCY BASIS;
  (VI)  THE  NUMBER  OF INDIVIDUALS WHO ARE CURRENTLY RECEIVING SUPPORTS
AND SERVICES, INCLUDING RESIDENTIAL SERVICES, WHOSE CURRENT LIVING SITU-
ATION IS NOT ADEQUATE TO MEET THEIR NEEDS AND WHO ARE AWAITING AN ALTER-
NATIVE PLACEMENT OR ALTERNATIVE SUPPORT AND SERVICE DELIVERY OPTIONS;
  (VII) PROJECTED FUNDING REQUIREMENTS FOR INDIVIDUALS IDENTIFIED AS  IN
NEED OF SERVICES PURSUANT TO PARAGRAPH FOUR OF THIS SUBDIVISION;
  (VIII) AN UPDATED FIVE YEAR PROJECTION OF INDIVIDUALS WHO WILL REQUIRE
EITHER ADDITIONAL IN-HOME SUPPORTS AND SERVICES AND/OR OUT-OF-HOME RESI-
DENTIAL PLACEMENTS; AND
  (IX) ANY OTHER INFORMATION DEEMED NECESSARY BY THE COMMISSIONER.
  (6)  THE  COMMISSIONER  SHALL  PREPARE  ANNUALLY FOR THE GOVERNOR, THE
LEGISLATURE AND THE JUSTICE CENTER FOR THE  PROTECTION  OF  PEOPLE  WITH
SPECIAL  NEEDS  A  WRITTEN  EVALUATION REPORT CONCERNING THE DELIVERY OF
SUPPORTS AND SERVICES IN THE COMMUNITY. ON OR  BEFORE  MARCH  FIRST,  IN
EACH YEAR, THE COMMISSIONER SHALL SUBMIT A COPY OF SUCH REPORT, AND SUCH
RECOMMENDATION  AS  HE  OR  SHE  DEEMS APPROPRIATE, TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE, THE  SPEAKER  OF  THE  ASSEMBLY,  THE
RESPECTIVE  MINORITY  LEADERS  OF  EACH SUCH HOUSE, AND THE CHAIR OF THE
STATE COMMISSION ON QUALITY OF CARE FOR THE MENTALLY DISABLED. THE FIRST
SUCH REPORT SHALL BE DUE BY NO LATER  THAN  MARCH  FIRST,  TWO  THOUSAND
FIFTEEN. THE REPORT SHALL ALSO BE MADE AVAILABLE TO THE PUBLIC AND SHALL
BE  PUBLISHED  ON THE OFFICE'S WEBSITE IN AN APPROPRIATE LOCATION AT THE
SAME TIME AS ITS SUBMISSION TO STATE OFFICIALS.
  S 4. Subdivision (c) of section 16.01 of the mental  hygiene  law,  as
added  by  chapter  234  of  the laws of 1998, paragraph 1 as amended by
chapter 37 of the laws of 2011, is amended to read as follows:

S. 1109--C                          4

  (c) (1) Notwithstanding any other provision of law, the  commissioner,
or  his OR HER designee, may require from any hospital, as defined under
article twenty-eight of the public health law, any information,  report,
or  record  necessary  for  the  purpose  of carrying out the functions,
powers  and  duties  of the commissioner related to the investigation of
deaths and complaints of  abuse,  mistreatment,  or  neglect  concerning
persons  with  developmental  disabilities  who receive services, or had
prior to death received services, in a facility as  defined  in  section
1.03 of this chapter, or are receiving medicaid waiver services from the
office  for  people  with  developmental disabilities in a non-certified
setting, and have been treated at such hospitals.
  (2) Any information, report, or record requested by  the  commissioner
or  his OR HER designee pursuant to this subdivision shall be limited to
that information that the  commissioner  determines  necessary  for  the
completion of this investigation.
  (3)  The information, report or record received by the commissioner or
his OR HER designee pursuant to this subdivision  shall  be  subject  to
section two thousand eight hundred five-m, section eighteen, as added by
chapter four hundred ninety-seven of the laws of nineteen hundred eight-
y-six,  and  article  twenty-seven-F  of  the public health law, section
33.13 of this chapter, and any applicable federal statute or regulation.
  S 5. This act shall take effect immediately.

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