Senate Bill S6200

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

                                  6200

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             October 2, 2009
                               ___________

Introduced  by  Sen.  STACHOWSKI  -- read twice and ordered printed, and
  when printed to be committed to the Committee on Rules

AN ACT to amend the social services law, in relation  to  providing  for
  behavioral health wraparound demonstration projects

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

  Section 1. The social services law is amended by adding a new  section
364-n to read as follows:
  S  364-N.  BEHAVIORAL HEALTH WRAPAROUND DEMONSTRATION PROJECTS. 1. THE
LEGISLATURE FINDS THAT DEMONSTRATION PROJECTS  THAT  INTEGRATE  SERVICES
PROVIDED BY THE OFFICE OF MENTAL RETARDATION AND DEVELOPMENTAL DISABILI-
TIES,  THE  OFFICE  OF MENTAL HEALTH, THE DEPARTMENT OF HEALTH AND OTHER
FUNDING STREAMS FOR THERAPEUTIC CARE AT THE FAMILY LEVEL CAN MOVE  CHIL-
DREN  AND  ADOLESCENTS  THROUGH THE SYSTEM EFFICIENTLY TO OPTIMAL TREAT-
MENTS, AND WILL MOVE CHILDREN AND FAMILIES FROM CRISIS OR HIGH  RISK  OF
CRISIS TO NORMALIZATION BY PROVIDING THE RIGHT SERVICE AT THE RIGHT TIME
AND  IN  THE  RIGHT  AMOUNT.  THE LEGISLATURE FURTHER FINDS THAT THROUGH
TARGETED INTERVENTIONS THE CARE OF THESE INDIVIDUALS CAN BE IMPROVED AND
THE COSTS OF THAT CARE REDUCED.
  2. TO THE EXTENT OF FUNDS APPROPRIATED FOR THIS PURPOSE,  THE  COMMIS-
SIONER  OF  HEALTH  IS  AUTHORIZED  TO  FUND DEMONSTRATION PROJECTS THAT
DEVELOP AND EVALUATE INTERVENTIONS TARGETED  AT  MEDICAID  BENEFICIARIES
UNDER  THE  AGE  OF TWENTY-ONE WHO HAVE ONE OR MORE CRISIS INTERVENTIONS
DURING THE PREVIOUS TWELVE MONTHS RELATED TO BEHAVIORAL  ISSUES.    SUCH
INTERVENTIONS  MAY  BE  VIEWED AS AN OPPORTUNITY TO INCREASE THE COORDI-
NATION OF CARE, ENSURE THAT CARE IS DELIVERED IN  THE  MOST  APPROPRIATE
SETTING,  IMPROVE  HEALTH OUTCOMES AND REDUCE THE COST OF THAT CARE.  AS
USED IN  THIS  SECTION,  A  "CRISIS  INTERVENTION"  MEANS  CIRCUMSTANCES
INVOLVING:
  A. THE UTILIZATION OF EMERGENCY DEPARTMENT SERVICES;
  B. CRIMINAL JUSTICE INTERVENTION RELATED TO BEHAVIORAL ISSUES;

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11939-01-9
              

S. 6200                             2

  C. PRIORITY LEVEL ONE CLASSIFICATION BY THE DEVELOPMENTAL DISABILITIES
SERVICE OFFICE (DDSO);
  D. COMMUNITY CRISIS RESPONSE; OR
  E. WHERE THE INDIVIDUAL IS OTHERWISE IDENTIFIED AS HIGH RISK BY HIS OR
HER MEDICAID SERVICE COORDINATOR, MANAGED CARE PROVIDER OR COUNTY SINGLE
POINT OF ACCESS (SPOA).
  3.  DEMONSTRATION  PROJECTS  ESTABLISHED  PURSUANT TO THIS SECTION MAY
TEST MODELS OF  CARE  AND  MODELS  OF  REIMBURSEMENT,  INCLUDING  SHARED
SAVINGS, THAT ARE INTENDED TO ADVANCE THE GOALS DESCRIBED IN SUBDIVISION
TWO OF THIS SECTION.
  4.  SERVICE  PROVIDERS  ELIGIBLE  TO  APPLY FOR ROLES AS DEMONSTRATION
SERVICE  COORDINATORS  INCLUDE:  HOSPITALS,  DIAGNOSTIC  AND   TREATMENT
CENTERS,  MANAGED  CARE PLANS, MEDICAL SCHOOLS AND PROVIDERS LICENSED BY
OR FUNDED BY THE OFFICE OF MENTAL HEALTH OR THE OFFICE OF MENTAL  RETAR-
DATION  AND DEVELOPMENTAL DISABILITIES AND THE DEPARTMENT OF HEALTH. THE
COMMISSIONER OF HEALTH SHALL APPROVE DEMONSTRATION  PROGRAMS  WHICH  ARE
GEOGRAPHICALLY DIVERSE. A PARTICIPATING SERVICE PROVIDER MUST ESTABLISH,
TO  THE  SATISFACTION  OF  THE  COMMISSIONER  OF HEALTH, ITS CAPACITY TO
ENROLL AND SERVE SUFFICIENT NUMBERS  OF  ENROLLEES  TO  DEMONSTRATE  THE
COST-EFFECTIVENESS OF THE DEMONSTRATION PROGRAM.
  5.  NOTHING  IN THIS SECTION SHALL BE CONSTRUED AS REQUIRING ANY MEDI-
CAID BENEFICIARY TO PARTICIPATE IN A DEMONSTRATION  PROJECT  ESTABLISHED
PURSUANT  TO  THIS  SECTION;  PARTICIPATION SHALL BE VOLUNTARY.  PARTIC-
IPATION IN A DEMONSTRATION PROJECT PURSUANT TO THIS  SECTION  SHALL  NOT
DIMINISH  OR  IMPAIR  THE  SERVICES  TO WHICH A PARTICIPANT IS OTHERWISE
ENTITLED UNDER THIS CHAPTER.
  6. PRIOR TO ESTABLISHING ANY DEMONSTRATION PROJECT AUTHORIZED BY  THIS
SECTION, THE COMMISSIONER OF HEALTH SHALL CONSULT WITH THE COMMISSIONERS
OF  THE OFFICE OF MENTAL HEALTH AND THE OFFICE OF MENTAL RETARDATION AND
DEVELOPMENTAL DISABILITIES.
  7. THIS SECTION SHALL NOT APPLY UNLESS ALL NECESSARY  APPROVALS  UNDER
FEDERAL  LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL FINAN-
CIAL PARTICIPATION IN THE COSTS OF HEALTH CARE SERVICES PROVIDED  PURSU-
ANT  TO THIS SECTION. THE COMMISSIONER OF HEALTH IS AUTHORIZED TO SUBMIT
ONE  OR MORE APPLICATIONS FOR WAIVERS OF THE FEDERAL SOCIAL SECURITY ACT
AS MAY BE NECESSARY TO OBTAIN SUCH FEDERAL FINANCIAL PARTICIPATION.
  8. THE COMMISSIONER OF HEALTH SHALL PROVIDE A REPORT TO  THE  GOVERNOR
AND  THE  LEGISLATURE  NO LATER THAN JANUARY FIRST, TWO THOUSAND TWELVE.
THE REPORT SHALL INCLUDE FINDINGS  AS  TO  THE  DEMONSTRATION  PROJECTS'
EFFECTIVENESS  IN  MANAGING  THE  CARE NEEDS AND IMPROVING THE HEALTH OF
PROGRAM PARTICIPANTS, AN EVALUATION AS TO THE PROGRAMS'  COST-EFFECTIVE-
NESS AS MEASURED AGAINST TRADITIONAL MEDICAID CARE MODELS, AND RECOMMEN-
DATIONS  AS TO WHETHER THE PROGRAMS SHOULD BE EXTENDED, MODIFIED, ELIMI-
NATED, OR MADE PERMANENT.
  S 2. This act shall take effect immediately.