Enacts the "communities of excellence mental health reinvestment act".
TITLE OF BILL: An act to amend the mental hygiene law, in relation to enacting the "communities of excellence mental health reinvestment act"; and to repeal section 41.55 of the mental hygiene law relating to the community mental health support and workforce reinvestment program
PURPOSE: This bill replaces MHL . 41.55, the "community mental health support and workforce reinvestment program" with the "communities of excellence mental health reinvestment act."
SUMMARY OF PROVISIONS:
Section 1 of the bill names the act the "communities of excellence mental health reinvestment act."
Section 2 of the bill adds subdivisions 59 and 60 to section 1.03 of the mental hygiene law. Subdivision 59 clarifies the definition of "new yolk state psychiatric hospital in-patient facilities to include all state operated facilities serving adults, adolescents, and children, with serious mental illnesses, including all of the beds, wards, units, buildings and real property.
Subdivision 60 defines the services to be provided under the communities of excellence mental health reinvestment services.
Section 3 of the bill amends subdivision (a) of section 7.15 of the mental hygiene law, requiring the commissioner of mental health to include in the planning and implementation processes of the state office of mental health the "communities of excellence mental health reinvestment services" pursuant to section 4n.55 of the mental hygiene law.
Section 4 of the bill amends paragraph 2 of subdivision a) of section 41.13 of the mental hygiene law to incorporate responsibility for providing communities of excellence mental health reinvestment services, as appropriate, in areas where such services are not. already provided by the local government unit.
Section 5 of the bill repeals the existing section 41.55 of the mental hygiene law, and replaces it with a new section 41.55, which establishes the "communities of excellence mental health reinvestment services."
Section 6 of the bill adds a new paragraph 6 to section 5.07 of the mental hygiene law, which-requires the creation of an inventory and valuation of all in-patient facilities and services, and requires, in conjunction with the planning for the state's mental health regional centers of excellence, the preparation of a report to the legislature regarding the facilities, services and staffing levels to be part of the state's transition to the regional centers of excellence. This section also incorporates such planning into the states mental health section 5.07 five-year planning process into the future.
JUSTIFICATION: In the 2013-2014 state fiscal year budget, the state Office of Mental health has undertaken an initiative to thoroughly
revamp the state's existing psychiatric hospital system into a system of regional facilities, known as the regional centers of excellence. Although. a final number of facilities has not been determined, it is clear that the vast majority of the state's existing inpatient mental health hospitals will be consolidated and/or closed.
2013 is the 20th anniversary of the adoption of the initial, and landmark, Community Mental health Reinvestment Act. The intent of that law, which is restated and updated in this legislation, was to ensure that the funds saved by the down-sizing of the in-patient psychiatric hospital system were reinvested into community-based mental health services.
In the twenty years since the adoption of the original community mental health reinvestment act, hundreds of millions of dollars have followed individuals back into the community, as the hospitals have been closed and patient census reduced. however, hundreds of millions more have been lost to the system, through "notwithstanding" budget language, and the lack of specific definitions to capture all facets of the funding to be saved during the transition of the state's mental health system.
This legislation will require the state office of mental health to do an inventory and valuation of the existing state facilities and services, establish a plan for the transition to the mental health regional centers of excellence, and determine short-term and long term savings from the reduction of beds, wards, units, buildings and real property that are currently cart of the inpatient psychiatric hospital system for adults, adolescents and children. From those savings, 50% will be allocated to the state office of mental health for the structural and staffing needs of the new mental health regional centers of excellence; the other 50% will be directed to Local Government Units for the purpose of contracting with not-for-profit and other licensed and approved providers of community-based mental health services.
The funding will be available for a wide range of services (but not for capital expenses} focusing on the needs of children, adults and adolescents in non-governmental community-based settings and programs. Included are individuals with mental illnesses whose recovery could be impeded by co-occurring substance abuse disorders, homelessness, and/or physical disabilities.
Finally, the legislation requires that the plan for Regional Centers of Excellence and the Communities of Excellence Reinvestment Services be incorporated into the state office of mental health's section 5.07 five year planning process.
LEGISLATIVE HISTORY: 2013: New bill.
FISCAL IMPLICATIONS: For 2013-14, there will be minimal cost due to the inventory and valuation, and the report to the legislature that is required. For 2014-15 and beyond, the cost of the bill will be incorporated into the budget planning process.
EFFECTIVE DATE: This act shall take effect immediately.
STATE OF NEW YORK ________________________________________________________________________ 5631--B 2013-2014 Regular Sessions IN SENATE May 30, 2013 ___________Introduced by Sens. TKACZYK, BRESLIN, KRUEGER, PARKER, STAVISKY -- 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 AN ACT to amend the mental hygiene law, in relation to enacting the "communities of excellence mental health reinvestment act"; and to repeal section 41.55 of the mental hygiene law relating to the commu- nity mental health support and workforce reinvestment program THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. This act shall be known and may be cited as the "communi- ties of excellence mental health reinvestment act." S 2. Section 1.03 of the mental hygiene law is amended by adding two new subdivisions 59 and 60 to read as follows: 59. "NEW YORK STATE PSYCHIATRIC HOSPITAL IN-PATIENT FACILITIES" SHALL MEAN THOSE STATE OPERATED FACILITIES SERVING ALL ADULTS, ADOLESCENTS AND CHILDREN, INCLUDING ALL OF THE BEDS, WARDS, UNITS, BUILDINGS AND REAL PROPERTY APPURTENANT THERETO. 60. "COMMUNITIES OF EXCELLENCE MENTAL HEALTH REINVESTMENT SERVICES" SHALL MEAN THE FOLLOWING SERVICES FOR PERSONS WITH SERIOUS MENTAL ILLNESS, INCLUDING CHILDREN, ADOLESCENTS AND ADULTS WITH SERIOUS EMOTIONAL DISTURBANCES AND CO-OCCURRING DISORDERS, AS DEFINED ELSEWHERE IN THIS CHAPTER: (A) EMERGENCY AND CRISIS SERVICES PROVIDED IN A PROGRAM LICENSED OR APPROVED BY THE COMMISSIONER; (B) CASE MANAGEMENT AND INTENSIVE CASE MANAGEMENT SERVICES; (C) OUTPATIENT SERVICES WHICH PROVIDE AN ADEQUATE LEVEL OF TREATMENT AND REHABILITATION TO PERSONS LIVING WITH MENTAL ILLNESS, AS APPROVED BY THE COMMISSIONER;EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD11287-04-3 S. 5631--B 2
(D) RESIDENTIAL SERVICES, OTHER THAN INPATIENT SERVICES, PROVIDED IN PROGRAMS LICENSED OR APPROVED BY THE COMMISSIONER, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY RESIDENCES, RESIDENTIAL CARE CENTERS FOR ADULTS, FAMILY CARE HOMES, CRISIS RESIDENCE OR SUPPORTED HOUSING; (E) COMMUNITY SUPPORT SERVICES AS DEFINED IN SUBDIVISION THIRTEEN OF SECTION 41.03 OF THIS CHAPTER; (F) OTHER SUPPORT SERVICES, INCLUDING, BUT NOT LIMITED TO, PSYCHIATRIC REHABILITATION, CLIENT ADVOCACY, SUPPORTED EMPLOYMENT, CONSUMER SELF-HELP, FAMILY SUPPORT, AND VOCATIONAL TRAINING AS APPROVED BY THE COMMISSIONER; (G) ANY OTHER SERVICES THAT MEET THE NEEDS OF CHILDREN, ADULTS AND ADOLESCENTS IN NON-GOVERNMENTAL COMMUNITY-BASED SETTINGS THAT ARE LICENSED OR APPROVED BY THE COMMISSIONER; AND (H) SERVICES FOR SPECIAL POPULATIONS INCLUDING THOSE LIVING WITH MENTAL ILLNESSES AND HOMELESSNESS, CO-OCCURRING SUBSTANCE ABUSE DISOR- DERS, AND/OR PHYSICAL DISABILITIES THAT MAY IMPEDE RECOVERY FROM MENTAL ILLNESS, AS APPROVED BY THE COMMISSIONER. S 3. Subdivision (a) of section 7.15 of the mental hygiene law, as amended by section 3 of part I of chapter 58 of the laws of 2005, is amended to read as follows: (a) The commissioner shall plan, promote, establish, develop, coordi- nate, evaluate, and conduct programs and services of prevention, diagno- sis, examination, care, treatment, rehabilitation, training, and research for the benefit of the mentally ill. Such programs shall include but not be limited to in-patient, out-patient, partial hospital- ization, day care, emergency, rehabilitative, COMMUNITIES OF EXCELLENCE MENTAL HEALTH REINVESTMENT SERVICES PURSUANT TO SECTION 41.55 OF THIS CHAPTER, and other appropriate treatments and services. He or she shall take all actions that are necessary, desirable, or proper to implement the purposes of this chapter and to carry out the purposes and objec- tives of the department within the amounts made available therefor by appropriation, grant, gift, devise, bequest, or allocation from the mental health services fund established under section ninety-seven-f of the state finance law. S 4. Paragraph 2 of subdivision (a) of section 41.13 of the mental hygiene law, as amended by chapter 746 of the laws of 1986, is amended to read as follows: 2. develop the program of local services for the area which it serves, establish long range goals of the local government in its programs for the mentally disabled, and develop intermediate range plans and fore- casts, listing priorities and estimated costs. The office of mental health shall be responsible for such program development relating to community support services in areas where the responsible local govern- mental unit elects, pursuant to subdivision (c) of section 41.47 of this article, not to receive state aid for community support services. Local governmental units which elect not to receive such state aid for commu- nity support services shall integrate information relating to community support services into the comprehensive plan for services, as otherwise required by this article. THE OFFICE OF MENTAL HEALTH SHALL ALSO BE RESPONSIBLE FOR SUCH PROGRAM DEVELOPMENT RELATING TO COMMUNITIES OF EXCELLENCE MENTAL HEALTH REINVESTMENT SERVICES IN AREAS WHERE THE RESPONSIBLE LOCAL GOVERNMENT UNIT DOES NOT RECEIVE A GRANT OF STATE AID SPECIFICALLY FOR THE PURPOSE OF FUNDING PROGRAMMING UNDER THE COMMUNI- TIES OF EXCELLENCE MENTAL HEALTH REINVESTMENT ACT. S 5. Section 41.55 of the mental hygiene law is REPEALED and a new section 41.55 is added to read as follows:S. 5631--B 3
S 41.55 COMMUNITIES OF EXCELLENCE MENTAL HEALTH REINVESTMENT SERVICES. (A) SUMS OF MONEY CALCULATED ANNUALLY, BASED UPON THE PROJECTED REDUCTIONS AND CLOSURES FOR THE UPCOMING FISCAL YEAR, OF REDUCTIONS AND CLOSURES IN THE NEW YORK STATE PSYCHIATRIC HOSPITAL INPATIENT HOSPITAL FACILITIES, SHALL BE ALLOCATED ANNUALLY BY THE COMMISSIONER, BASED UPON THE FOLLOWING CRITERIA: (1) FUNDS APPROPRIATED BY THE LEGISLATURE FOR THE DEVELOPMENT, EXPAN- SION AND OPERATION OF NEW AND EXPANDED COMMUNITIES OF EXCELLENCE MENTAL HEALTH REINVESTMENT SERVICES SHALL BE MADE AVAILABLE TO THE OFFICE OF MENTAL HEALTH TO PROVIDE GRANTS OF STATE AID TO THE LOCAL GOVERNMENT UNITS, WHICH MAY INCLUDE ONE OR MORE CONTIGUOUS COUNTIES UPON THE AGREE- MENT OF THE RESPECTIVE DIRECTORS OF COMMUNITY SERVICES AND THE APPROVAL OF THE COMMISSIONER OF MENTAL HEALTH. AMOUNTS SHALL BE MADE AVAILABLE, AND THE COMMISSIONER SHALL ALLOCATE FIFTY PERCENT OF THE SAVINGS AS DEFINED IN SUBDIVISION (B) OF THIS SECTION, FOR APPROPRIATION UPON DETERMINATIONS MADE BY THE COMMISSIONER OF MENTAL HEALTH PURSUANT TO THIS SECTION AND AT A RATE UP TO ONE HUNDRED PERCENT OF THE APPROVED NET OPERATING COSTS OF THE PROGRAM OR SERVICE. THE LOCAL GOVERNMENT UNIT SHALL CONTRACT WITH THE PROVIDERS OF SUCH SERVICES, OR MAY JOINTLY OPER- ATE SAID SERVICES. (2) THE COMMISSIONER SHALL ALLOCATE FIFTY PERCENT OF SUCH FUNDS FROM SAVINGS, ON A PRO RATA BASIS, TO THE DEVELOPMENT OF THE NEW YORK STATE CENTERS OF EXCELLENCE, FOR PURPOSES OF FACILITY DEVELOPMENT, CONSTRUCTION AND IMPROVEMENT, AND FOR WORKFORCE RETENTION, RETRAINING AND WORKFORCE DEVELOPMENT. (B) FOR THE PURPOSES OF THIS SECTION "SAVINGS" SHALL MEAN THE SUMS OF MONEY TO BE SAVED FROM THE REDUCTION OF ANY AND ALL REDUCTIONS AND CLOSURES IN THE NEW YORK STATE PSYCHIATRIC HOSPITAL INPATIENT FACILI- TIES, INCLUDING ALL OF THE BEDS, WARDS, UNITS, BUILDINGS AND REAL PROP- ERTY APPURTENANT THERETO, TO BE CALCULATED ANNUALLY, BASED UPON THE PROJECTED CLOSURES FOR THE UPCOMING FISCAL YEAR, AND ADJUSTED ANNUALLY AT THE END OF THE FISCAL YEAR, AS PART OF THE STATE BUDGET PROCESS. (C) CONTRACTS FOR SERVICES UNDER THE PROVISIONS OF THIS SECTION MAY BE ENTERED INTO FOR A PERIOD NOT TO EXCEED FIVE YEARS, AND MAY BE RENEWED AS APPROPRIATE. ALL FUNDS ALLOCATED HEREIN ARE SUBJECT TO ALL REPORTING REQUIREMENTS AND AGENCY REVIEW AND AUDIT PROVISIONS REQUIRED AND ESTAB- LISHED ELSEWHERE IN LAW, THAT ARE APPLICABLE TO PROGRAMS AND SERVICES PROVIDED THROUGH THE OFFICE OF MENTAL HEALTH. (D) STATE AID GRANTS AND OTHER FUNDING PROVIDED PURSUANT TO THIS SECTION SHALL ONLY BE USED TO FUND COMMUNITIES OF EXCELLENCE MENTAL HEALTH REINVESTMENT SERVICES, INCLUDING APPROVED ADMINISTRATIVE EXPENSES. SUCH GRANTS AND OTHER FUNDS SHALL NOT BE USED FOR CAPITAL COSTS ASSOCIATED WITH THE DEVELOPMENT OF COMMUNITIES OF EXCELLENCE MENTAL HEALTH REINVESTMENT SERVICES; PROVIDED, HOWEVER, THAT SUCH FUNDS MAY BE USED FOR PROGRAM DEVELOPMENT COSTS FOR SUCH SERVICES. S 6. Subdivision (c) of section 5.07 of the mental hygiene law is amended by adding a new paragraph 6 to read as follows: (6) (A) THE OFFICE OF MENTAL HEALTH SHALL CREATE, WITHIN THIRTY DAYS OF THE EFFECTIVE DATE OF THIS PARAGRAPH, AN INVENTORY OF ALL EXISTING IN-PATIENT FACILITIES AS DESCRIBED IN SECTION 41.55 OF THIS CHAPTER. THE OFFICE OF MENTAL HEALTH SHALL ALSO BE REQUIRED AS PART OF THE INVENTORY TO EVALUATE AND ASSIGN AN ACTUAL DOLLAR AMOUNT TO THE COST OF EACH OF THE ITEMS SET FORTH IN SUCH DESCRIPTION. (B) IN CONJUNCTION WITH THE PLANNING FOR THE NEW YORK STATE OFFICE OF MENTAL HEALTH REGIONAL CENTERS OF EXCELLENCE, THE COMMISSIONER IS DIRECTED TO PREPARE A REPORT, TO BE DELIVERED TO THE LEGISLATURE, NOS. 5631--B 4
LATER THAN FEBRUARY TWENTY-EIGHTH, TWO THOUSAND FOURTEEN, OUTLINING THE PLAN FOR DOWNSIZING THE INPATIENT PSYCHIATRIC HOSPITAL, INCLUSIVE OF: (I) THE NAME, LOCATION AND CATCHMENT AREAS OF EACH OF THE REGIONAL CENTERS OF EXCELLENCE; (II) THE SERVICES TO BE PROVIDED AT EACH REGIONAL CENTER OF EXCEL- LENCE, INCLUSIVE OF INPATIENT, OUTPATIENT, TRANSITIONAL AND STATE OPER- ATED COMMUNITY-BASED PROGRAMS; (III) THE ANTICIPATED STAFFING LEVELS WHICH WILL BE IN PLACE AT EACH FACILITY FOR TWO THOUSAND FOURTEEN -- TWO THOUSAND FIFTEEN STATE FISCAL YEAR; (IV) THE ANTICIPATED NUMBER OF BEDS AT EACH FACILITY; AND (V) THE FACILITIES, WARDS, UNITS AND BEDS TO BE ELIMINATED AT EACH OF THE FACILITIES INCLUDED IN CLAUSES (I), (II), (III) AND (IV) OF THIS SUBPARAGRAPH. (C) UPON COMPLETION OF THIS REPORT REQUIRED BY SUBPARAGRAPH (B) OF THIS PARAGRAPH, AND BEGINNING WITH THE TWO THOUSAND FOURTEEN -- TWO THOUSAND FIFTEEN STATE FISCAL YEAR, CLAUSES (I), (II), (III), (IV) AND (V) OF SUBPARAGRAPH (B) OF THIS PARAGRAPH SHALL BE INCORPORATED INTO THE PLAN REQUIRED BY THIS SUBDIVISION. S 7. This act shall take effect immediately; provided that section six of this act shall take effect on the same date and in the same manner as section 3 of part N of chapter 56 of the laws of 2012, as amended.