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.