S T A T E   O F   N E W   Y O R K
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                                 4109--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             March 18, 2011
                               ___________

Introduced  by Sens. McDONALD, GRISANTI -- read twice and ordered print-
  ed, and when printed to be committed to the  Committee  on  Health  --
  recommitted  to the Committee on Health in accordance with Senate Rule
  6, sec. 8 -- committee discharged, bill amended, ordered reprinted  as
  amended and recommitted to said committee

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.
                                                           LBD06854-02-2

              

S. 4109--A                          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  FIFTEEN.
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.