§ 41.47 Community support services program.

(a) As used in this section:

(1) "Approved reimbursable rate" means the maximum rate of payment per
unit of service established by the commissioner of mental health
pursuant to subdivision (e) of this section, or the actual unit cost of
providing community support services, whichever is less, minus revenue.

(2) "Core services" means the daily managing and monitoring of the
implementation of the community support services program within a
defined geographical area.

(3) "Designated adult home" means an adult care facility which is
licensed by the commissioner of social services pursuant to article
seven of the social services law, and which has been designated by the
commissioner of mental health as containing a significant number of
mentally ill persons who are in need of community support services.

(4) "Designated shelter for the homeless" means a shelter for the
homeless which is licensed by the commissioner of social services
pursuant to article seven of the social services law, and which has been
designated by the commissioner of mental health as containing a
significant number of mentally ill persons who are in need of community
support services.

(5) "Designated single room occupancy residence" means a single room
occupancy, as such term is defined in the multiple dwelling law or
multiple residence law, whichever is applicable, which has been
designated by the commissioner of mental health as containing a
significant number of mentally ill persons who are in need of community
support services.

(6) "Functionally disabled as a result of mental illness" means a
person who has a severe, chronic disability which:

(i) is caused by a medically determined mental illness, as evidenced
by a primary psychiatric diagnosis;

(ii) is likely to continue for a prolonged period; and

(iii) results in substantial functional limitations in three or more
of the following areas: (A) self-care, (B) social functioning, (C)
activities of daily living, (D) economic self-sufficiency, (E)
self-direction, and (F) ability to concentrate.

(7) "Provider of services" means the local governmental unit,
voluntary agency, proprietary agency, association, or corporation which
provides the community support services.

(8) "Qualified residence" means a community residence, residential
care center for adults, family care home, or residential treatment
facility for children and youth which is licensed or operated by the
office of mental health.

(9) "Revenue" shall include:

(i) reimbursement for operating costs for community support services
received from other local governmental units or from state agencies
other than the office of mental health, provided that revenue shall not
include money received from any source, in the form of grants, awards or
contracts, for purposes other than the support of such operating costs;

(ii) federal aid received for such operating costs;

(iii) fees received from patients, or on their behalf, from public and
private health insurance and medical aid programs;

(iv) other income received from the operation of the community support
services program; and

(v) interest and dividends accruing from funds received pursuant to
this section.

(b) The community support services program shall include services and
programs such as: case management services, advocacy services, clinic
services, day treatment, day training, continuing treatment, homemaker
services, housekeeping services, on-site rehabilitation services,
sheltered workshop and other vocational programs, psychosocial clubs,
neighborhood drop-in centers, transportation services, non-residential
crisis services, outreach services, and other services approved by the
commissioner.

(c) (1) The commissioner may, upon the application of a local
governmental unit, and within the limits of appropriation therefore,
grant state aid to such local governmental unit for one hundred percent
of the approved costs of providing community support services to
eligible persons, which shall not exceed the approved reimbursable rate,
and the approved costs of providing core services. Local governmental
units which receive state aid pursuant to this subdivision either shall
directly provide community support services or shall enter into
contracts with providers of services for the provision of such services.
Such local governmental units may also provide core services or contract
with voluntary agencies for the provision of such core services.

(2) Persons who are otherwise ineligible to receive community support
services pursuant to subdivision (d) of this section, shall be
considered to be eligible to receive such services for purposes of
paragraph one of this subdivision, if they are certified pursuant to
subdivision (d) of this section to be eighteen years of age or older, to
be functionally disabled as a result of mental illness and to have an
ability to remain in the community which would be seriously jeopardized
without the provision of community support services, but who do not meet
the eligibility criteria of paragraph two or three of subdivision (d) of
this section, provided however, that the provider of services shall make
a reasonable effort to determine such persons' eligibility and, provided
further, that no more than ten percent of the persons served by a local
governmental unit or a provider of services which directly contracts
with the office of mental health shall be otherwise ineligible persons.

(d) (1) Persons who shall be eligible for community support services
shall include individuals who are eighteen years of age and older, who
are functionally disabled as a result of mental illness, whose ability
to remain in the community would be seriously jeopardized without the
provision of community support services, and who satisfy the criteria in
either paragraph two or three of this subdivision. Such eligibility
shall be certified by a licensed psychiatrist, nurse, psychologist,
licensed clinical social worker or a licensed master social worker under
the supervision of a physician, psychologist or licensed clinical social
worker who is approved by a local governmental unit, a core service
agency, or the commissioner to certify individuals as being eligible for
community support services.

(2) Persons who may be certified as permanently eligible to receive
community support services pursuant to paragraph one of this subdivision
shall include individuals who are determined to be eligible pursuant to
regulations promulgated by the commissioner of mental health and shall
include but not be limited to: (i) persons who have received inpatient
psychiatric services in a hospital, or who have resided in a qualified
residence or a designated adult home for a period or periods of time as
established in such regulations of the commissioner; (ii) persons who
are in receipt of supplemental security income benefits or social
security disability insurance benefits pursuant to the federal social
security act, provided that individuals who are in receipt of
supplemental security income benefits must have been determined to be
eligible for such benefits prior to reaching sixty-five years of age;
(iii) persons who are receiving community support services on the
effective date of this act pursuant to the regulations of the
commissioner in effect on such date, who were determined to be eligible
for such services based upon a prior history of inpatient
hospitalization; and (iv) other persons who have received specified
psychiatric services, as established pursuant to the regulations of the
commissioner.

(3) Persons who may be certified as eligible to receive community
support services pursuant to paragraph one of this subdivision shall
include individuals who are residing in a designated adult home, a
designated shelter for the homeless, a designated single room occupancy
residence, a qualified residence, or who are homeless mentally ill
persons. Such persons shall be considered eligible for community support
services for the duration of their participation in such community
support services, and such persons who need such services shall continue
to be eligible to receive such services for a period of one year after
receiving any such services.

(4) Notwithstanding the provisions of paragraph three of this
subdivision, persons who are residing in designated adult homes or in
designated shelters for the homeless, or who are homeless persons, may
receive on-site rehabilitation services or outreach services provided
under this section without a determination of eligibility as otherwise
required under this subdivision.

(e) (1) The commissioner shall annually establish a schedule of
maximum rates of payment per unit of service for reimbursable community
support services. In establishing such maximum rates of payment per unit
of service the commissioner may consider geographical variations and
other relevant considerations. Such rates shall equal the medical
assistance rates established pursuant to section 43.02 of this chapter,
when applicable. Upon the application of the local governmental unit or
a provider of services which directly contracts with the office of
mental health to provide community support services, the commissioner
may authorize additional reimbursement for a period of three local
fiscal years after the effective date of this act, upon a showing of
extraordinarily high costs of providing community support services and
extraordinarily high revenue receipts, which have been demonstrated to
be appropriate.

(2) The commissioner shall establish revenue goals for services,
provided, however, the commissioner may approve local services plans or
may enter into direct contracts with providers of services which
substitute alternative revenue goals for individual providers of
services based upon appropriate documentation and justification, as
required by the commissioner.

(f) Prior to entering into contracts for the provision of community
support services, the office of mental health and local governmental
units shall consider the following:

(1) the service needs of mentally ill persons in the geographical area
in which the community support services program operates;

(2) the capacity of the program to meet identified service needs;

(3) the current availability of services for mentally ill persons in
the area, including the special needs of ethnic minorities and
non-English speaking mentally ill persons;

(4) the extent to which community support services authorized by the
contract will be integrated with other available services in the area to
more effectively maintain mentally ill persons in the community;

(5) the availability of resources for such services;

(6) the extent to which the community support services authorized by
the contract are consistent and integrated with the applicable local
services plan of the area to be served; and

(7) the extent to which such contracts conform with the minimum
contractual requirements as established by the commissioner.

(g) The commissioner may enter into a direct contract for the
provision of community support services when the commissioner
determines, after the approval of the local services plan and the
allocation of state aid therefore, that such direct contract is
necessary to assure that additional community support services are
available to persons who are functionally disabled as a result of mental
illness and are eligible for community support services. Before entering
into a direct contract with a provider located within the geographic
area of a local governmental unit which receives state aid for community
support services pursuant to this section, the commissioner shall notify
the local governmental unit and give the director of the local
governmental unit an opportunity to appeal the need for such direct
contract. Such appeals shall be informal in nature and the rules of
evidence shall not apply.

(h) In order to qualify for one hundred percent state aid pursuant to
this section in any local fiscal year local governmental units shall
assure that the local tax levy share of expenditures for net operating
costs pursuant to an approved local services plan for services provided
to mentally ill persons pursuant to section 41.18 of this article shall
be equal to or greater than the local tax levy share of such
expenditures under an approved local services plan in the last complete
local fiscal year preceding the effective date of this section,
provided, however, any such required maintenance of expenditures under
this subdivision for local governmental units may be reduced to reflect
the local governmental share of revenue applicable to increased payments
made by governmental agencies pursuant to title eleven of article five
of the social services law, which are a result of increased efficiencies
in the collection of such revenue and which represent an increased
proportion of the total local services operating costs from the prior
local fiscal year. The commissioner shall be authorized to reduce
payments made to local governmental units pursuant to this article, in
the following local fiscal year, for failure to maintain expenditures in
accordance with this subdivision.

(i) The provisions of subdivision (h) of this section shall not apply
to a local governmental unit in any local fiscal year in which the total
amount of state aid granted to the local governmental unit for net
operating costs under section 41.18 of the article is less than such
amount of state aid granted in the local fiscal year preceding the
effective date of this section, or in any local fiscal year in which the
total amount of state aid granted to the local governmental unit under
this section, plus the total amount of direct contracts entered into
between the commissioner and providers of services for the provision of
community support services to eligible residents of such local
governmental unit, shall be less than the total amount of such aid and
direct contracts in the first local fiscal year following the effective
date of this section.

(j) The commissioner is authorized and empowered to make inspections
and examine records of a local governmental unit receiving state aid
under this section or a provider of services which directly contracts
with the office of mental health for the provision of community support
services. Such examination shall include all medical service and
financial records, receipts, disbursements, contracts, loans and any
other moneys relating to the financial operation of the community
support services program.

(k) A local governmental unit in receipt of a grant for the provision
of community support services pursuant to subdivision (c) of this
section, which is a unit of a local government with a population of less
than one hundred thousand or which has total program expenditures for
mentally ill persons under this article equal to five hundred thousand
dollars or less in a local fiscal year, shall be permitted to commingle
such funds and the clients receiving community support services with
other local mental health program funds or clients, including local
mental health program funds and clients of other local governmental
units. Such local governmental unit shall be required to submit a plan
to the commissioner which shall describe how the goals and objectives of
the community support services program shall be maintained under such an
arrangement, and such plan must be approved by the commissioner prior to
its implementation.

(l) No provision of this section shall be interpreted to create an
entitlement for any individual to receive community support services.

(m) The commissioner is authorized to promulgate regulations to
implement the provisions of this section.