S T A T E O F N E W Y O R K
________________________________________________________________________
7027--A
2009-2010 Regular Sessions
I N A S S E M B L Y
March 18, 2009
___________
Introduced by M. of A. P. RIVERA, LUPARDO, SCHROEDER, DINOWITZ, WEISEN-
BERG, JAFFEE -- Multi-Sponsored by -- M. of A. HOOPER -- read once and
referred to the Committee on Mental Health, Mental Retardation and
Developmental Disabilities -- recommitted to the Committee on Mental
Health in accordance with Assembly Rule 3, sec. 2 -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee
AN ACT to amend the geriatric mental health act, in relation to enacting
the "behavioral health, chemical dependency and long-term care act"
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 "behavioral health, chemical dependency and long-term care act".
S 2. Legislative findings. The legislature hereby finds that a large
proportion of older adults receiving or in need of long-term care in the
state have diagnosable behavioral disorders, such as depression, anxiety
disorders, psychotic conditions or substance abuse problems. These
conditions may or may not co-occur with dementia, most commonly
Alzheimer's disease. The long-term care services that they receive
include: home health services, in-home case management, social adult or
adult medical day programs and/or residential care in senior housing,
assisted living, life care communities, or nursing homes. Often they
need residential services because their family caregivers or other
in-home caregivers do not have the skills and do not get the support
that they need to deal with mental illness, with misuse of substances
such as alcohol and prescription medication, or with troublesome behav-
iors. In addition, family caregivers are at high risk for depression,
anxiety and/or physical disorders, which lead to an inability to contin-
ue to tolerate the stress of caregiving. Family caregivers of minority
populations are especially vulnerable because the strong sense of duty
to care for family members that is common in these cultures leads them
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD09159-07-0
A. 7027--A 2
to neglect their own needs, which are exacerbated by the long-term
stress of caregiving. Family support that includes the provision of
mental health services and education to navigate the geriatric and
behavioral health care needs of their family members can help family
caregivers to continue to provide long-term care.
The state of New York has adopted a long-term care reform agenda that
focuses heavily on reducing the use of nursing homes by providing commu-
nity-based alternatives to institutions. However, the state's long-term
care reform initiatives have not adequately addressed the fact that
behavioral disorders in older adults and in their family members are not
effectively dealt with by community services. As a result, the state is
missing opportunities to help people to avoid institutional placements
and to live in the community, where they and their families usually
would prefer for them to live.
The legislature, therefore, finds that it is critical to address the
behavioral health needs of people who are receiving, who meet the crite-
ria for receiving or who are at-risk of needing long-term care and to
address the behavioral health needs of their family caregivers.
S 3. Section 3 of chapter 568 of the laws of 2005, constituting the
geriatric mental health act, is amended by adding two new subdivisions
(d) and (e) to read as follows:
(D) FOR THE PURPOSES OF THIS SECTION, "LONG-TERM CARE" SHALL INCLUDE
MEDICAL AND NON-MEDICAL SUPPORT SERVICES FUNDED AND/OR REGULATED BY THE
DEPARTMENT OF HEALTH OR THE STATE OFFICE FOR THE AGING. SUCH TERM SHALL
NOT INCLUDE LONG-TERM SERVICES PROVIDED, FUNDED OR REGULATED BY ANY OF
THE OFFICES OF THE DEPARTMENT OF MENTAL HYGIENE.
(E)(I) THE COUNCIL SHALL ESTABLISH A TASK FORCE ON LONG-TERM CARE. IN
ADDITION TO MEMBERS OF THE COUNCIL, THE TASK FORCE SHALL INCLUDE PUBLIC
OFFICIALS AND OTHER INDIVIDUALS WITH EXPERTISE IN BEHAVIORAL HEALTH
AND/OR LONG-TERM CARE WHO ARE NOT MEMBERS OF THE COUNCIL. THE TASK FORCE
SHALL INCLUDE REPRESENTATIVES FROM THE ENTIRE SPECTRUM OF LONG-TERM
CARE, INCLUDING HOME AND COMMUNITY-BASED CARE PROVIDERS. SUCH TASK
FORCE SHALL IDENTIFY ALL PLANNING AND ADVISORY GROUPS WHICH ARE INVOLVED
WITH GERIATRIC LONG-TERM CARE, AND DETERMINE WHICH SUCH GROUPS DO NOT
HAVE MEMBERS WITH EXPERTISE IN GERIATRIC MENTAL HEALTH AND CHEMICAL
DEPENDENCY. FOR EACH SUCH GROUP WHICH LACKS SUCH EXPERTISE AMONG ITS
MEMBERSHIP, THE TASK FORCE SHALL PROVIDE NOTICE THEREOF TO THE APPOINT-
ING AUTHORITY OF EACH GROUP. THEREAFTER, EVERY PLANNING AND ADVISORY
GROUP INVOLVED WITH GERIATRIC LONG-TERM CARE SHALL HAVE AT LEAST ONE
MEMBER WITH EXPERTISE IN GERIATRIC MENTAL HEALTH AND CHEMICAL DEPENDEN-
CY.
(II) THE TASK FORCE SHALL IDENTIFY ALL PROGRAMS, AND PROPOSALS FOR NEW
OR MODIFIED PROGRAMS THAT ARE DESIGNED TO RESTRUCTURE LONG-TERM CARE,
DETERMINE WHETHER SUCH PROGRAMS OR PROPOSALS INCLUDE APPROPRIATE
PROVISIONS TO ADDRESS MENTAL HEALTH AND/OR CHEMICAL DEPENDENCY PROBLEMS,
AND RECOMMEND ANY CHANGES NEEDED SO THAT THE PROGRAM OR PROPOSAL WILL
ADDRESS GERIATRIC BEHAVIORAL HEALTH ISSUES APPROPRIATELY.
(III) THE TASK FORCE SHALL:
A. IDENTIFY MENTAL HEALTH AND/OR SUBSTANCE ABUSE SERVICES AND SUPPORTS
THAT WOULD HELP PEOPLE IN NEED OF LONG-TERM CARE TO LIVE IN THE COMMUNI-
TY, INCLUDING SUPPORTS FOR FAMILY CAREGIVERS, WHO OFTEN MAKE IT POSSIBLE
FOR PEOPLE WITH LONG-TERM MENTAL AND/OR PHYSICAL DISABILITIES TO LIVE IN
THE COMMUNITY;
B. IDENTIFY CURRENT ACTIVITIES TO MEET THE BEHAVIORAL HEALTH NEEDS OF
INDIVIDUALS IN OR AT RISK OF NEEDING LONG-TERM CARE;
C. IDENTIFY GAPS IN SERVICES; AND
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D. REVIEW PROPOSALS FOR LONG-TERM CARE RATE SETTING TO DETERMINE
WHETHER THEY INCLUDE APPROPRIATE PROVISIONS TO DEAL WITH MENTAL HEALTH,
CHEMICAL DEPENDENCY AND BEHAVIOR PROBLEMS; AND SHALL RECOMMEND RATE
SETTING METHODOLOGIES THAT ADDRESS BEHAVIORAL HEALTH NEEDS.
(IV) THE COUNCIL SHALL ADOPT AN INTERAGENCY PLAN BASED UPON THE RECOM-
MENDATIONS OF THE TASK FORCE SUBMITTED PURSUANT TO PARAGRAPH (III) OF
THIS SUBDIVISION. ANNUALLY, ON OR BEFORE JANUARY, THE COUNCIL SHALL
SUBMIT A REPORT TO THE GOVERNOR, THE LEGISLATURE AND THE HEAD OF EACH
AGENCY REPRESENTED IN THE MEMBERSHIP OF THE COUNCIL. SUCH REPORT SHALL
INCLUDE THE COUNCIL'S FINDINGS RELATING TO THE INTERAGENCY PLAN, THE
PLANS ADOPTED AND THE MILESTONES ACHIEVED IN THE IMPLEMENTATION OF THE
PLANS.
S 4. Chapter 568 of the laws of 2005, constituting the geriatric
mental health act, is amended by adding a new section 3-a to read as
follows:
S 3-A. THERE ARE NUMEROUS FOUNDATIONS AND OTHER PRIVATE ORGANIZATIONS
IN THE STATE THAT SUPPORT HEALTH, MENTAL HYGIENE AND AGING SERVICES,
EDUCATION, TRAINING, TECHNICAL ASSISTANCE, AND ADVOCACY. THEIR ACTIV-
ITIES ARE INDEPENDENT AND DIFFERENT FROM THE ACTIVITIES OF GOVERNMENT.
HOWEVER, THERE ARE OPPORTUNITIES FOR THE PRIVATE AND THE PUBLIC SECTORS
TO WORK TOGETHER IN COMPLEMENTARY WAYS INCLUDING RESEARCH, DEMONSTRATION
PROGRAMS, COLLABORATIVE PLANNING, AND POLICY ANALYSIS. THEREFORE, THE
INTERAGENCY GERIATRIC MENTAL HEALTH AND CHEMICAL DEPENDENCY PLANNING
COUNCIL SHALL HOLD AN ANNUAL MEETING OF SELECTED LEADERS FROM THE PUBLIC
AND PRIVATE SECTORS ON GERIATRIC BEHAVIORAL HEALTH AND LONG-TERM CARE TO
ADDRESS SUCH ISSUES. WITHIN 60 DAYS FOLLOWING EACH SUCH CONFERENCE, THE
COUNCIL SHALL SUBMIT A REPORT TO THE GOVERNOR AND THE LEGISLATURE ON THE
OPPORTUNITIES FOR POOLED GOVERNMENTAL AND NON-GOVERNMENTAL FUNDING FOR:
(A) RESEARCH;
(B) DEMONSTRATION PROGRAMS; AND
(C) THE DISSEMINATION OF INFORMATION REGARDING STATE-OF-THE-ART
SERVICES, PROGRAM MODELS, FUNDING MODELS, AND HEALTH, MENTAL HYGIENE AND
AGING POLICIES.
S 5. The department of health shall revise the nursing home transition
and diversion waiver program to add 200 slots or set aside 10 percent of
the slots existing on the effective date of this section for individuals
with mental illness and co-morbid chronic physical conditions.
S 6. (a) Those counties with a New York connects project shall have
the capacity to provide information and assistance to meet the behav-
ioral health needs of people in need of long-term care and their fami-
lies.
(b) Localities, such as the city of New York, that provide or are
planning to provide, information and assistance regarding long-term
care, other than with a New York connects project, shall have the capac-
ity to respond to the behavioral health needs of those in need of long-
term care and their families.
(c) All localities shall include experts in behavioral health on their
local long-term care councils.
(d) The office for the aging, in consultation with the offices of the
department of mental hygiene, shall establish a statewide information
clearinghouse which shall gather, maintain, disseminate and provide
access to information needed for behavioral health and long-term care
policy and program development.
S 7. The department of health and the state office for the aging shall
jointly and in consultation with the offices of the department of mental
hygiene:
A. 7027--A 4
(a) review their existing training initiatives to assess whether such
initiatives include adequate material regarding geriatric behavioral
health and developmental disabilities, and add appropriate materials
into their training requirements for long-term providers;
(b) provide technical assistance to community-based long-term care
providers regarding geriatric behavioral health best practices, cultural
competence, effective program models and viable funding models; and
(c) work with professional schools to enhance curricula related to
older adults with behavioral health problems who may be in need of long-
term care and their family caregivers.
S 8. This act shall take effect on the first of July next succeeding
the date on which it shall have become a law.