Enacts the "people first act of 2012"; defines terms; ensures that individuals with developmental disabilities who utilize long-term care services under the medical assistance program administered by the state have meaningful access to a reasonable array of community-based and institutional program options to ensure the well-being of such individuals.
BILL NUMBER:S6420 REVISED 06/04/12
TITLE OF BILL:
An act to amend the mental hygiene law, in relation to enacting the "people first act of 2012"
SUMMARY OF PROVISIONS:
Section one provides for the short title of the bill to be the "People First Act of 2012."
Section two of the bill contains legislative findings.
Section three of the bill amends section 13.15 of the Mental Hygiene Law, in order to require the Commissioner of OPWDD to conduct a geographic analysis of the supports and services in community settings available for individuals with developmental disabilities and to identify gaps between required supports and services by region of the state. In addition, the Commissioner is directed to develop a web-based data-base which will permit the prioritization of the urgency of needs (P.D.N.S.) for supports and services for those facing emergency or immediate need, those facing critical need, defined as additional services and supports with one year and planning need, for those who will require additional services and supports within five years or where the individual's caregiver is over sixty years old. Annual reporting requirements will allow the Executive and the Legislature make informed policy choices in the delivery of supports and services to people with developmental disabilities.
Section four of the bill makes technical amendments.
Section five of the bill amends section 16.01 of the Mental Hygiene Law in order to permit the Commissioner, in consultation with stakeholders, to identify and implement a valid and reliable quality assurance instrument that includes assessment of consumer and family satisfaction, provision of service and personal outcomes. The tool must be nationally validated, benchmarked, consistent and reliable. It must include outcome-based measures to track health, safety, well-being, relationships, interactions with people who do not have a disability, employment, quality of life, integration, choice, service and consumer satisfaction.
Section six is the effective date of the bill.
The New York State Department of Health (DOH) in partnership with the Office of People With Developmental Disabilities (OPWDD) proposed a
new model for the financing of services for individuals with developmental disabilities to the federal government. The federal government no longer supports NY's current model for financing services and supports for people with developmental disabilities. The current model is based, in significant part, upon allowed costs for institutional placement, which are substantially in excess of actual costs of institutional placement, as institutional capacity has been reduced over the past 30 years. The state and the federal government had previously agreed that as institutional capacity was reduced, the funds otherwise used for institutional placement could follow the individual into the community. The use of these funds allowed NYS to create the current community-based service structure.
The state was authorized in the 2011-12 Enacted Budget to submit a Medicaid waiver application, which OMPDD has called the "People First Waiver", in order to transition the current Medicaid "fee for service" long-term care services for individuals with developmental disabilities to a care management model.
The state is seeking authority to transition individuals served by the current service delivery system into mandatory enrollment in managed long-term care services.
The core concept behind the "People First Waiver" application is an individual budget allocation built on a standardized assessment of individual support needs. Recognizing that people with developmental disabilities want to live their lives in the community, just like everyone else, OPWOD is racing to embrace the concept of a "self-directed" person-centered system, where individuals and their circle of support have considerable authority over what supports they receive, how they are received and from whom.
At the center of any system promoting self-direction is a personal budget allocation that the individual and his circle of support may apply within the bounds of an approved service plan to secure needed supports. The Center for Medicare and Medicaid Services (CMS) requires any "individual budget amount" to be "a prospectively determined amount of funds that the state makes available for the provision of (federally funded) services to an (individual)". Implicit in this definition are two key concepts: the state determines the budget amount for each individual, and the individual and/or his or her circle of support is provided this information before developing a service plan.
Essential to reforming the resource allocation system is choosing an assessment tool that will provide sufficient information to accurately and appropriately differentiate among service participants with respect to their support needs. The state is considering testing the InterRAI-DD assessment tool for this critical function. However, in order to be successful, information must be collected on the amount of money that is expended annually for each person's support.
The support needs of individuals must be systemically analyzed in relation to cost. At the same time, the state must have reliable and accurate information pertaining to the number of people who have requested services and need them presently and others who would likely seek services in the near future. Doing so requires diligent data collection over several years to examine how demand trends behave over time.
This bill encourages the type of data-gathering initiative that has proven successful in Pennsylvania and Illinois and will insure the accuracy of waitlist numbers. Combined with the expected implementation of the InterRAI-DD assessment tool, the state can begin to make meaningful projections regarding the budget allocations individuals will require if they were immediately enrolled in the system and began receiving the services their support needs justify. This information will provide the Executive and the Legislature with more reliable estimates of the costs associated with reducing wait lists over time, and enable OPWDD to more purposefully plan for building system capacity.
A second critically important component of the "People First Waiver" is to improve the quality of services delivered. Adopting an assessment-based resource allocation approach and building individual budget allocations are integral parts of a strong quality improvement process. This approach should improve access to services because an adequate and equitable budget allocation will be established for each person. A person-centered planning process builds based upon knowledge of the support needs of individuals and is made more effective because each person served will have his or her own budget allocation. The increased efficiency and equity in resource allocation conceptualized in the People First Waiver application should enhance provider capacity as service rates are appropriately established based upon actual cost to provide the necessary supports and services to a properly assessed individual. Health and safety requirements, instead of being mandated by state regulators operating in a "one size fits all" model can be appropriately established and fashioned in direct response to the nature of an individual's support needs.
The quality of services in this new "People First Waiver" can be improved by analyzing the impact of resource allocations on service outcomes. While state policy makers and providers are concerned about the health and well being of people with developmental disabilities, there is a critical need to assess systematically the relationships between individual budget allocations, the services delivered as a result of this allocation, and the achievement of desired outcomes. It is critically important in this new system redesign that we measure the outcomes as perceived by the people receiving the supports and services. Quality needs to be tied to individual outcomes, to their safety, to their ability to gain employment, to have friendships and to live with friends in settings they feel good about.
This bill provides for the type of person-centered, empirical data collection aimed at identifying in a comprehensive, consistent and reliable manner the quality of services using assessments of consumer and family satisfaction, their perspective on the provision of service and how the new service delivery model impacts on the personal outcomes of their lives.
To be determined.
LOCAL FISCAL IMPACT:
To be determined.
STATE OF NEW YORK ________________________________________________________________________ 6420 IN SENATE February 7, 2012 ___________Introduced by Sen. MAZIARZ -- read twice and ordered printed, and when printed to be committed to the Committee on Mental Health and Develop- mental Disabilities AN ACT to amend the mental hygiene law, in relation to enacting the "people first act of 2012" 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 "people first act of 2012". S 2. Legislative findings. It is the intent of the legislature to ensure that individuals with developmental disabilities who utilize long-term care services under the medical assistance program and other long-term care related benefit programs administered by the state have meaningful access to a reasonable array of community-based and institu- tional program options and to ensure the well-being of individuals with developmental disabilities, taking into account their informed and expressed choices. Furthermore, the legislature declares that it is the policy of the state to ensure that the clinical, habilitative, and social needs of individuals with developmental disabilities who choose to reside in integrated community-based settings can have those needs met in integrated community-based settings. In order to meaningfully comply with this policy, the state must have an understanding of the existing capacity in integrated-community based settings, including direct support professionals and licensed professionals, such as physi- cians, dentists, nurse practitioners, nurses, and psychiatrists, as well as residential capacity to provide for these needs. It is further the intent of the legislature to support the satisfac- tion and success of consumers through the delivery of quality services and supports. Evaluation of the services that consumers receive is a key aspect to the service system. Utilizing the information that consumers and their families provide about such services in a reliable and mean- ingful way is also critical to enable the commissioner of developmental disabilities to assess the performance of the state's developmental services system and to improve services for consumers in the future. ToEXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD14109-01-2 S. 6420 2
that end, the commissioner of developmental disabilities shall conduct a geographic analysis of supports and services in community settings and implement an improved, unified quality assessment system, in accordance with this act. S 3. Section 13.15 of the mental hygiene law is amended by adding a new subdivision (d) to read as follows: (D) (1) FOR PURPOSES OF THIS SUBDIVISION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS: (I) "DIRECT SUPPORT PROFESSIONALS" MEANS DIRECT SUPPORT WORKERS, DIRECT CARE WORKERS, PERSONAL ASSISTANTS, PERSONAL ATTENDANTS, AND PARA- PROFESSIONALS THAT PROVIDE ASSISTANCE TO INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES IN THE FORM OF DAILY LIVING, AND PROVIDE THE HABILITATION, REHABILITATION, AND TRAINING NEEDS OF THESE INDIVIDUALS. (II) "LICENSED PROFESSIONALS" MEANS, BUT IS NOT LIMITED TO, PHYSI- CIANS, DENTISTS, DENTAL HYGIENISTS, DENTAL ASSISTANTS, NURSE PRACTITION- ERS, LICENSED PRACTICAL NURSES, REGISTERED NURSES, PSYCHIATRISTS, PSYCHOLOGISTS, LICENSED MASTER SOCIAL WORKERS, OR LICENSED CLINICAL SOCIAL WORKERS, LICENSED TO PRACTICE PURSUANT TO THE EDUCATION LAW AND OTHER QUALIFIED MENTAL HEALTH PROFESSIONALS. (III) "SUPPORTS AND SERVICES" MEANS DIRECT SUPPORT PROFESSIONALS, LICENSED PROFESSIONALS, AND RESIDENTIAL SERVICES, INCLUDING, BUT NOT LIMITED TO, PRIVATE RESIDENCES, COMMUNITY-INTEGRATED LIVING ARRANGE- MENTS, SUPPORTED RESIDENTIAL PROGRAMS, SUPERVISED RESIDENTIAL PROGRAMS, OR SUPPORTIVE HOUSING PROGRAMS. (2) SUBJECT TO AVAILABLE APPROPRIATIONS THEREFOR, THE COMMISSIONER SHALL CONDUCT A GEOGRAPHIC ANALYSIS OF SUPPORTS AND SERVICES IN COMMUNI- TY SETTINGS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES. THIS ANALY- SIS SHALL ALSO IDENTIFY GAPS BETWEEN REQUIRED SUPPORTS AND SERVICES BY REGION OF THE STATE. (3) IN ORDER TO PERFORM THE GEOGRAPHIC ANALYSIS OR TO GATHER DATA FOR PURPOSES OF PERFORMING THE GEOGRAPHIC ANALYSIS, THE COMMISSIONER MAY WORK IN COOPERATION AND AGREEMENT WITH OTHER OFFICES, DEPARTMENTS OR AGENCIES OF THE STATE, LOCAL OR FEDERAL GOVERNMENT, OR OTHER ORGANIZA- TIONS AND INDIVIDUALS. (4) IN CONDUCTING THIS ACTIVITY, THE COMMISSIONER, SUBJECT TO AVAIL- ABLE APPROPRIATIONS THEREFOR, SHALL DEVELOP AND UTILIZE A WEB-BASED DATA-BASE WHICH PRIORITIZES THE URGENCY OF NEED FOR SUPPORTS AND SERVICES. THE INFORMATION COLLECTED SHOULD ALLOW THE COMMISSIONER TO CATEGORIZE NEEDS FOR DEVELOPMENTAL DISABILITY SERVICES WITHIN A FRAME- WORK THAT ENCOMPASSES THREE LEVELS OF URGENCY OF NEEDS. THESE LEVEL OF SUPPORT NEEDS SHOULD INCLUDE: EMERGENCY NEED, FOR THOSE PERSONS WITH DEVELOPMENTAL DISABILITIES IN NEED OF IMMEDIATE SUPPORT EITHER DAY SUPPORT OR IN-HOME OR OUT-OF-HOME PLACEMENT; CRITICAL NEED FOR THOSE INDIVIDUALS WHO WILL HAVE A NEED FOR SUPPORTS OR SERVICES WITHIN ONE YEAR AND PLANNING FOR NEED, FOR THOSE INDIVIDUALS WHOSE SUPPORT NEEDS ARE ONE TO FIVE YEARS AWAY, OR WHERE THE CAREGIVER IS AGE SIXTY OR OLDER. (5) SUCH AN ANALYSIS SHOULD INCLUDE THE STATEWIDE NUMBER OF INDIVID- UALS SEEKING SERVICES, INCLUDING AWAITING PLACEMENT BROKEN DOWN INTO THE TOTAL NUMBER OF INDIVIDUALS FROM WITHIN EACH DEVELOPMENTAL DISABILITY SERVICES OFFICE'S GEOGRAPHIC AREA WHO AWAIT RESIDENTIAL PLACEMENT, DAY SERVICE SUPPORT, HOME AND COMMUNITY-BASED WAIVER SUPPORT, EMPLOYMENT SUPPORT, BEHAVIORAL HEALTH SERVICES AND SUPPORTS, OR OTHER COMMUNITY-BASED SUPPORT. SUCH INFORMATION SHOULD BE GROUPED BY THE AGE OF THE INDIVIDUAL AWAITING COMMUNITY SERVICES AND SUPPORTS AND THE AGES. 6420 3
OF THEIR CAREGIVER, IF ANY. SUCH INFORMATION SHOULD ALSO INCLUDE WAIT- LIST AND PLACEMENT INFORMATION SUCH AS: (I) THE TYPE OF SUPPORTS AND SERVICES SUCH INDIVIDUALS ARE EXPECTED TO REQUIRE DIVIDED INTO CERTIFIED OUT-OF-HOME, SUPERVISED, SUPPORTIVE PLACEMENT NEEDS AND OTHER NON-PLACEMENT NEEDS AND THE NUMBER OF SUCH PERSONS WHO ARE MEDICALLY FRAIL REQUIRING INTENSIVE MEDICAL CARE; (II) NON-CERTIFIED RESIDENTIAL PLACEMENTS OUTSIDE THE PARENT'S OR PARENTS' OR OTHER CAREGIVER'S HOME; (III) THE NUMBER OF INDIVIDUALS EXPECTED TO REQUIRE HOME AND COMMUNITY SERVICES WAIVER-FUNDED HABILITATION SERVICES AT HOME; (IV) THE TOTAL NUMBER OF INDIVIDUALS, WHO HAVE BEEN IDENTIFIED AS IN NEED OF SUPPORTS AND SERVICES WHO HAVE RECEIVED THESE SUPPORTS AND SERVICES AND ANY GAP BETWEEN REQUIRED SUPPORTS AND SERVICES AND THE SUPPORTS AND SERVICES PROVIDED; (V) THE NUMBER OF EMERGENCY NEED RESIDENTIAL PLACEMENTS FOR THE PAST YEAR AND OTHER SUPPORTS AND SERVICES PROVIDED ON AN EMERGENCY BASIS; (VI) THE NUMBER OF INDIVIDUALS WHO ARE CURRENTLY RECEIVING SUPPORTS AND SERVICES, INCLUDING RESIDENTIAL SERVICES, WHOSE CURRENT LIVING SITU- ATION IS NOT ADEQUATE TO MEET THEIR NEEDS AND WHO ARE AWAITING AN ALTER- NATIVE PLACEMENT OR ALTERNATIVE SUPPORT AND SERVICE DELIVERY OPTIONS; (VII) PROJECTED FUNDING REQUIREMENTS FOR INDIVIDUALS IDENTIFIED AS IN NEED OF SERVICES PURSUANT TO PARAGRAPH FOUR OF THIS SUBDIVISION; (VIII) AN UPDATED FIVE YEAR PROJECTION OF INDIVIDUALS WHO WILL REQUIRE EITHER ADDITIONAL IN-HOME SUPPORTS AND SERVICES AND/OR OUT-OF-HOME RESI- DENTIAL PLACEMENTS; AND (IX) ANY OTHER INFORMATION DEEMED NECESSARY BY THE COMMISSIONER. (6) THE COMMISSIONER SHALL PREPARE ANNUALLY FOR THE GOVERNOR, THE LEGISLATURE AND THE STATE COMMISSION ON QUALITY OF CARE FOR THE MENTALLY DISABLED A WRITTEN EVALUATION REPORT CONCERNING THE DELIVERY OF SUPPORTS AND SERVICES IN THE COMMUNITY. ON OR BEFORE MARCH FIRST, IN EACH YEAR, THE COMMISSIONER SHALL SUBMIT A COPY OF SUCH REPORT, AND SUCH RECOMMEN- DATION AS HE OR SHE DEEMS APPROPRIATE, TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE ASSEMBLY, THE RESPECTIVE MINORITY LEADERS OF EACH SUCH HOUSE, AND THE CHAIR OF THE STATE COMMIS- SION ON QUALITY OF CARE FOR THE MENTALLY DISABLED. THE FIRST SUCH REPORT SHALL BE DUE BY NO LATER THAN MARCH FIRST, TWO THOUSAND FOURTEEN. THE REPORT SHALL ALSO BE MADE AVAILABLE TO THE PUBLIC AND SHALL BE PUBLISHED ON THE OFFICE'S WEBSITE IN AN APPROPRIATE LOCATION AT THE SAME TIME AS ITS SUBMISSION TO STATE OFFICIALS. S 4. Subdivision (c) of section 16.01 of the mental hygiene law, as added by chapter 234 of the laws of 1998, paragraph 1 as amended by chapter 37 of the laws of 2011, is amended to read as follows:
[(c)](J) (1) Notwithstanding any other provision of law, the commis- sioner, or his OR HER designee, may require from any hospital, as defined under article twenty-eight of the public health law, any infor- mation, report, or record necessary for the purpose of carrying out the functions, powers and duties of the commissioner related to the investi- gation of deaths and complaints of abuse, mistreatment, or neglect concerning persons with developmental disabilities who receive services, or had prior to death received services, in a facility as defined in section 1.03 of this chapter, or are receiving medicaid waiver services from the office for people with developmental disabilities in a non-cer- tified setting, and have been treated at such hospitals. (2) Any information, report, or record requested by the commissioner or his OR HER designee pursuant to this subdivision shall be limited toS. 6420 4
that information that the commissioner determines necessary for the completion of this investigation. (3) The information, report or record received by the commissioner or his OR HER designee pursuant to this subdivision shall be subject to section two thousand eight hundred five-m, section eighteen, as added by chapter four hundred ninety-seven of the laws of nineteen hundred eight- y-six, and article twenty-seven-F of the public health law, section 33.13 of this chapter, and any applicable federal statute or regulation. S 5. Section 16.01 of the mental hygiene law is amended by adding seven new subdivisions (c), (d), (e), (f), (g), (h) and (i) to read as follows: (C) THE COMMISSIONER, IN CONSULTATION WITH STAKEHOLDERS, INCLUDING BUT NOT LIMITED TO PROVIDERS OF SERVICES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES, CONSUMER REPRESENTATIVES INCLUDING PERSONS WITH DEVELOP- MENTAL DISABILITIES, OR THEIR PARENTS OR GUARDIANS, CORRESPONDENTS AND OTHER INTERESTED PERSONS, SHALL IDENTIFY A VALID AND RELIABLE QUALITY ASSURANCE INSTRUMENT THAT INCLUDES ASSESSMENTS OF CONSUMER AND FAMILY SATISFACTION, PROVISION OF SERVICES, AND PERSONAL OUTCOMES. THE INSTRU- MENT SHALL DO ALL OF THE FOLLOWING: (1) PROVIDE NATIONALLY VALIDATED, BENCHMARKED, CONSISTENT, RELIABLE AND MEASURABLE DATA FOR THE OFFICE'S QUALITY MANAGEMENT SYSTEM. (2) ENABLE THE COMMISSIONER AND ENTITIES CONTRACTED BY THE COMMISSION- ER TO COORDINATE AND/OR DELIVER SUPPORTS AND SERVICES TO PERSONS WITH DEVELOPMENTAL DISABILITIES, INCLUDING BUT NOT LIMITED TO HEALTH HOMES ESTABLISHED PURSUANT TO SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW OR OTHER MANAGED CARE ENTITIES AS APPROVED PURSUANT TO SECTION FOUR THOUSAND FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW TO COMPARE THE PERFORMANCE OF NEW YORK'S DEVELOPMENTAL SERVICES SYSTEM AGAINST OTHER STATES' DEVELOPMENTAL SERVICES SYSTEMS AND TO ASSESS QUAL- ITY AND PERFORMANCE AMONG ALL OF THE MANAGED CARE AND SERVICE AND SUPPORT ENTITIES STATEWIDE. (3) INCLUDE OUTCOME-BASED MEASURES SUCH AS HEALTH, SAFETY, WELL-BEING, RELATIONSHIPS, INTERACTIONS WITH PEOPLE WHO DO NOT HAVE A DISABILITY, EMPLOYMENT, QUALITY OF LIFE, INTEGRATION, CHOICE, SERVICE, AND CONSUMER SATISFACTION. (D) TO THE EXTENT THAT FUNDING IS AVAILABLE, THE INSTRUMENT IDENTIFIED IN SUBDIVISION (C) OF THIS SECTION MAY BE EXPANDED TO COLLECT ADDITIONAL DATA REQUESTED BY OTHER OFFICES, DEPARTMENTS OR AGENCIES OF THE STATE, LOCAL OR FEDERAL GOVERNMENT. (E) THE COMMISSIONER SHALL CONTRACT WITH AN INDEPENDENT AGENCY OR ORGANIZATION TO IMPLEMENT BY JANUARY FIRST, TWO THOUSAND THIRTEEN, THE QUALITY ASSURANCE INSTRUMENT DESCRIBED IN SUBDIVISION (C) OF THIS SECTION. THE CONTRACTOR SHALL BE EXPERIENCED IN ALL OF THE FOLLOWING: (1) DESIGNING VALID QUALITY ASSURANCE INSTRUMENTS FOR DEVELOPMENTAL SERVICE SYSTEMS. (2) TRACKING OUTCOME-BASED MEASURES SUCH AS HEALTH, SAFETY, WELL-BE- ING, RELATIONSHIPS, INTERACTIONS WITH PEOPLE WHO DO NOT HAVE A DISABILI- TY, EMPLOYMENT, QUALITY OF LIFE, INTEGRATION, CHOICE, SERVICE, AND CONSUMER SATISFACTION. (3) DEVELOPING DATA SYSTEMS. (4) DATA ANALYSIS AND REPORT PREPARATION. (5) ASSESSMENTS OF THE SERVICES RECEIVED BY CONSUMERS WHO ARE MOVED FROM DEVELOPMENTAL CENTERS TO THE COMMUNITY, GIVEN THE LEGISLATURE'S HISTORIC RECOGNITION OF A SPECIAL OBLIGATION TO ENSURE THE WELL-BEING OF THESE PERSONS.S. 6420 5
(F) THE COMMISSIONER, IN CONSULTATION WITH THE CONTRACTOR DESCRIBED IN SUBDIVISION (E) OF THIS SECTION, SHALL ESTABLISH THE METHODOLOGY BY WHICH THE QUALITY ASSURANCE INSTRUMENT SHALL BE ADMINISTERED, INCLUDING, BUT NOT LIMITED TO, HOW OFTEN AND TO WHOM THE QUALITY ASSURANCE WILL BE ADMINISTERED, AND THE DESIGN OF A STRATIFIED, RANDOM SAMPLE AMONG THE ENTIRE POPULATION OF CONSUMERS SERVED BY SERVICE PROVIDERS, INCLUDING ANY NEWLY APPROVED MANAGED CARE ENTITIES. THE CONTRACTOR SHALL PROVIDE AGGREGATE INFORMATION FOR ALL SERVICE PROVIDERS AND THE STATE AS A WHOLE. AT THE REQUEST OF A CONSUMER OR THE FAMILY MEMBER OF A CONSUMER, THE SURVEY SHALL BE CONDUCTED IN THE PRIMARY LANGUAGE OF THE CONSUMER OR FAMILY MEMBER SURVEYED. (G) THE COMMISSIONER SHALL COLLECT DATA FOR THE QUALITY ASSURANCE INSTRUMENT DESCRIBED IN SUBDIVISION (C) OF THIS SECTION. IF, DURING THE DATA COLLECTION PROCESS, THE COMMISSIONER IDENTIFIES ANY SUSPECTED VIOLATION OF THE LEGAL, CIVIL, OR SERVICE RIGHTS OF A CONSUMER, OR IF IT DETERMINES THAT THE HEALTH AND WELFARE OF A CONSUMER IS AT RISK, THAT INFORMATION SHALL BE PROVIDED IMMEDIATELY TO THE CHAIR OF THE COMMISSION ON QUALITY OF CARE FOR THE MENTALLY DISABLED AND ANY REGIONAL ENTITY PROVIDING CASE MANAGEMENT SERVICES TO THE CONSUMER. AT THE REQUEST OF THE CONSUMER, OR FAMILY, WHEN APPROPRIATE, A COPY OF THE COMPLETED SURVEY SHALL BE PROVIDED TO THE COMMISSION ON QUALITY OF CARE FOR THE MENTALLY DISABLED AND ANY REGIONAL ENTITY PROVIDING CASE MANAGEMENT SERVICES TO IMPROVE THE CONSUMER'S QUALITY OF SERVICES THROUGH THE INDI- VIDUAL PLANNING PROCESS. (H) THE COMMISSIONER, IN CONSULTATION WITH STAKEHOLDERS, SHALL ANNUAL- LY REVIEW THE DATA COLLECTED FROM AND THE FINDINGS OF THE QUALITY ASSUR- ANCE INSTRUMENT DESCRIBED IN SUBDIVISION (C) OF THIS SECTION AND ACCEPT RECOMMENDATIONS REGARDING ADDITIONAL OR DIFFERENT CRITERIA FOR THE QUAL- ITY ASSURANCE INSTRUMENT IN ORDER TO ASSESS THE PERFORMANCE OF THE STATE'S DEVELOPMENTAL SERVICES SYSTEM AND IMPROVE SERVICES FOR CONSUM- ERS. (I) ALL REPORTS GENERATED PURSUANT TO THIS SECTION SHALL BE MADE PUBLICLY AVAILABLE, BUT SHALL NOT CONTAIN ANY PERSONAL IDENTIFYING INFORMATION ABOUT ANY PERSON ASSESSED. S 6. This act shall take effect immediately.