Assembly Bill A4999

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

                                  4999

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            February 10, 2011
                               ___________

Introduced  by M. of A. SCHROEDER, JAFFEE, PERRY, CLARK, MAISEL, ARROYO,
  COOK, ROBINSON, SPANO, CASTRO  --  Multi-Sponsored  by  --  M.  of  A.
  BOYLAND, BURLING, CALHOUN, CONTE, DUPREY, FINCH, JACOBS, MARKEY, McDO-
  NOUGH,  McENENY,  McKEVITT,  MOLINARO,  PHEFFER, RABBITT, SCHIMMINGER,
  TOBACCO -- read once and referred to the Committee on Health

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 FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, THE
OFFICE OF MENTAL HEALTH, THE DEPARTMENT  OF  HEALTH  AND  OTHER  FUNDING
STREAMS  FOR  THERAPEUTIC CARE AT THE FAMILY LEVEL CAN MOVE CHILDREN AND
ADOLESCENTS THROUGH THE SYSTEM EFFICIENTLY TO  OPTIMAL  TREATMENTS,  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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06854-01-1

              

A. 4999                             2

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;
  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 FOR  PEOPLE  WITH
DEVELOPMENTAL DISABILITIES AND THE DEPARTMENT OF HEALTH. THE COMMISSION-
ER  OF  HEALTH  SHALL APPROVE DEMONSTRATION PROGRAMS WHICH ARE GEOGRAPH-
ICALLY 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-EFFECTIVE-
NESS 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 FOR PEOPLE  WITH  DEVELOP-
MENTAL 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  FOURTEEN.
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.