S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                        3662--A
                              2015-2016 Regular Sessions
                                   I N  S E N A T E
                                   February 13, 2015
                                      ___________
       Introduced  by  Sen.  ORTT  --  read twice and ordered printed, and when
         printed to be committed  to  the  Committee  on  Health  --  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:
    1    Section  1. The social services law is amended by adding a new section
    2  364-n to read as follows:
    3    S 364-N.  BEHAVIORAL HEALTH WRAPAROUND DEMONSTRATION PROJECTS. 1.  THE
    4  LEGISLATURE  FINDS  THAT  DEMONSTRATION PROJECTS THAT INTEGRATE SERVICES
    5  PROVIDED BY THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL  DISABILITIES,  THE
    6  OFFICE  OF  MENTAL  HEALTH, THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE
    7  SERVICES, THE DEPARTMENT OF HEALTH AND OTHER FUNDING STREAMS FOR  THERA-
    8  PEUTIC  CARE  AT  THE  FAMILY  LEVEL  CAN  MOVE CHILDREN AND ADOLESCENTS
    9  THROUGH THE SYSTEM EFFICIENTLY TO  OPTIMAL  TREATMENTS,  AND  WILL  MOVE
   10  CHILDREN  AND  FAMILIES FROM CRISIS OR HIGH RISK OF CRISIS TO NORMALIZA-
   11  TION BY PROVIDING THE RIGHT SERVICE AT THE RIGHT TIME AND IN  THE  RIGHT
   12  AMOUNT.  THE  LEGISLATURE  FURTHER  FINDS  THAT  THROUGH TARGETED INTER-
   13  VENTIONS THE CARE OF THESE INDIVIDUALS CAN BE IMPROVED AND THE COSTS  OF
   14  THAT CARE REDUCED.
   15    2.  TO  THE EXTENT OF FUNDS APPROPRIATED FOR THIS PURPOSE, THE COMMIS-
   16  SIONER OF HEALTH IS  AUTHORIZED  TO  FUND  DEMONSTRATION  PROJECTS  THAT
   17  DEVELOP  AND  EVALUATE  INTERVENTIONS TARGETED AT MEDICAID BENEFICIARIES
   18  UNDER THE AGE OF TWENTY-ONE WHO HAVE ONE OR  MORE  CRISIS  INTERVENTIONS
   19  DURING  THE  PREVIOUS  TWELVE MONTHS RELATED TO BEHAVIORAL ISSUES.  SUCH
   20  INTERVENTIONS MAY BE VIEWED AS AN OPPORTUNITY TO  INCREASE  THE  COORDI-
   21  NATION  OF  CARE,  ENSURE THAT CARE IS DELIVERED IN THE MOST APPROPRIATE
   22  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.
                                                                  LBD09010-02-5
       S. 3662--A                          2
    1  USED  IN  THIS  SECTION,  A  "CRISIS  INTERVENTION"  MEANS CIRCUMSTANCES
    2  INVOLVING:
    3    A. THE UTILIZATION OF EMERGENCY DEPARTMENT SERVICES;
    4    B. CRIMINAL JUSTICE INTERVENTION RELATED TO BEHAVIORAL ISSUES;
    5    C. PRIORITY LEVEL ONE CLASSIFICATION BY THE DEVELOPMENTAL DISABILITIES
    6  SERVICE OFFICE (DDSO);
    7    D. COMMUNITY CRISIS RESPONSE; OR
    8    E. WHERE THE INDIVIDUAL IS OTHERWISE IDENTIFIED AS HIGH RISK BY HIS OR
    9  HER  MEDICAID SERVICE COORDINATOR, HEALTH HOME SERVICE PROVIDER, MANAGED
   10  CARE PROVIDER OR COUNTY SINGLE POINT OF ACCESS (SPOA).
   11    3. DEMONSTRATION PROJECTS ESTABLISHED PURSUANT  TO  THIS  SECTION  MAY
   12  TEST  MODELS  OF  CARE  AND  MODELS  OF  REIMBURSEMENT, INCLUDING SHARED
   13  SAVINGS, THAT ARE INTENDED TO ADVANCE THE GOALS DESCRIBED IN SUBDIVISION
   14  TWO OF THIS SECTION.
   15    4. SERVICE PROVIDERS ELIGIBLE TO  APPLY  FOR  ROLES  AS  DEMONSTRATION
   16  SERVICE   COORDINATORS  INCLUDE:  HOSPITALS,  DIAGNOSTIC  AND  TREATMENT
   17  CENTERS, MANAGED CARE PLANS, MEDICAL SCHOOLS AND PROVIDERS  LICENSED  BY
   18  OR  FUNDED  BY THE OFFICE OF MENTAL HEALTH OR THE OFFICE FOR PEOPLE WITH
   19  DEVELOPMENTAL DISABILITIES AND THE DEPARTMENT OF HEALTH. THE COMMISSION-
   20  ER OF HEALTH SHALL APPROVE DEMONSTRATION PROGRAMS  WHICH  ARE  GEOGRAPH-
   21  ICALLY  DIVERSE. A PARTICIPATING SERVICE PROVIDER MUST ESTABLISH, TO THE
   22  SATISFACTION OF THE COMMISSIONER OF HEALTH, ITS CAPACITY TO  ENROLL  AND
   23  SERVE SUFFICIENT NUMBERS OF ENROLLEES TO DEMONSTRATE THE COST-EFFECTIVE-
   24  NESS OF THE DEMONSTRATION PROGRAM.
   25    5.  NOTHING  IN THIS SECTION SHALL BE CONSTRUED AS REQUIRING ANY MEDI-
   26  CAID BENEFICIARY TO PARTICIPATE IN A DEMONSTRATION  PROJECT  ESTABLISHED
   27  PURSUANT  TO  THIS  SECTION;  PARTICIPATION SHALL BE VOLUNTARY.  PARTIC-
   28  IPATION IN A DEMONSTRATION PROJECT PURSUANT TO THIS  SECTION  SHALL  NOT
   29  DIMINISH  OR  IMPAIR  THE  SERVICES  TO WHICH A PARTICIPANT IS OTHERWISE
   30  ENTITLED UNDER THIS CHAPTER.
   31    6. PRIOR TO ESTABLISHING ANY DEMONSTRATION PROJECT AUTHORIZED BY  THIS
   32  SECTION, THE COMMISSIONER OF HEALTH SHALL CONSULT WITH THE COMMISSIONERS
   33  OF  THE  OFFICE OF MENTAL HEALTH AND THE OFFICE FOR PEOPLE WITH DEVELOP-
   34  MENTAL DISABILITIES.
   35    7. THIS SECTION SHALL NOT APPLY UNLESS ALL NECESSARY  APPROVALS  UNDER
   36  FEDERAL  LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL FINAN-
   37  CIAL PARTICIPATION IN THE COSTS OF HEALTH CARE SERVICES PROVIDED  PURSU-
   38  ANT  TO THIS SECTION. THE COMMISSIONER OF HEALTH IS AUTHORIZED TO SUBMIT
   39  ONE  OR MORE APPLICATIONS FOR WAIVERS OF THE FEDERAL SOCIAL SECURITY ACT
   40  AS MAY BE NECESSARY TO OBTAIN SUCH FEDERAL FINANCIAL PARTICIPATION.
   41    8. THE COMMISSIONER OF HEALTH SHALL PROVIDE A REPORT TO  THE  GOVERNOR
   42  AND  THE LEGISLATURE NO LATER THAN JANUARY FIRST, TWO THOUSAND EIGHTEEN.
   43  THE REPORT SHALL INCLUDE FINDINGS  AS  TO  THE  DEMONSTRATION  PROJECTS'
   44  EFFECTIVENESS  IN  MANAGING  THE  CARE NEEDS AND IMPROVING THE HEALTH OF
   45  PROGRAM PARTICIPANTS, AN EVALUATION AS TO THE PROGRAMS'  COST-EFFECTIVE-
   46  NESS,  INCLUDING  BUT  NOT  LIMITED  TO EVALUATION OF SCHOOL MANAGEMENT,
   47  INTERACTION WITH CRIMINAL JUSTICE ENTITIES, SAFE HOUSING  AND  RELATION-
   48  SHIP WITH AFTERSCHOOL PROGRAMS, AS MEASURED AGAINST TRADITIONAL MEDICAID
   49  CARE  MODELS,  AND  RECOMMENDATIONS AS TO WHETHER THE PROGRAMS SHOULD BE
   50  EXTENDED, MODIFIED, ELIMINATED, OR MADE PERMANENT.
   51    S 2. This act shall take effect immediately.