S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         3662
                              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
       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 DEPARTMENT  OF  HEALTH  AND  OTHER  FUNDING
    7  STREAMS  FOR  THERAPEUTIC CARE AT THE FAMILY LEVEL CAN MOVE CHILDREN AND
    8  ADOLESCENTS THROUGH THE SYSTEM EFFICIENTLY TO  OPTIMAL  TREATMENTS,  AND
    9  WILL  MOVE  CHILDREN  AND FAMILIES FROM CRISIS OR HIGH RISK OF CRISIS TO
   10  NORMALIZATION BY PROVIDING THE RIGHT SERVICE AT THE RIGHT  TIME  AND  IN
   11  THE  RIGHT  AMOUNT.  THE LEGISLATURE FURTHER FINDS THAT THROUGH TARGETED
   12  INTERVENTIONS THE CARE OF THESE INDIVIDUALS  CAN  BE  IMPROVED  AND  THE
   13  COSTS OF THAT CARE REDUCED.
   14    2.  TO  THE EXTENT OF FUNDS APPROPRIATED FOR THIS PURPOSE, THE COMMIS-
   15  SIONER OF HEALTH IS  AUTHORIZED  TO  FUND  DEMONSTRATION  PROJECTS  THAT
   16  DEVELOP  AND  EVALUATE  INTERVENTIONS TARGETED AT MEDICAID BENEFICIARIES
   17  UNDER THE AGE OF TWENTY-ONE WHO HAVE ONE OR  MORE  CRISIS  INTERVENTIONS
   18  DURING  THE  PREVIOUS  TWELVE MONTHS RELATED TO BEHAVIORAL ISSUES.  SUCH
   19  INTERVENTIONS MAY BE VIEWED AS AN OPPORTUNITY TO  INCREASE  THE  COORDI-
   20  NATION  OF  CARE,  ENSURE THAT CARE IS DELIVERED IN THE MOST APPROPRIATE
   21  SETTING, IMPROVE HEALTH OUTCOMES AND REDUCE THE COST OF THAT CARE.    AS
   22  USED  IN  THIS  SECTION,  A  "CRISIS  INTERVENTION"  MEANS CIRCUMSTANCES
   23  INVOLVING:
   24    A. THE UTILIZATION OF EMERGENCY DEPARTMENT SERVICES;
   25    B. CRIMINAL JUSTICE INTERVENTION RELATED TO BEHAVIORAL ISSUES;
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD09010-01-5
       S. 3662                             2
    1    C. PRIORITY LEVEL ONE CLASSIFICATION BY THE DEVELOPMENTAL DISABILITIES
    2  SERVICE OFFICE (DDSO);
    3    D. COMMUNITY CRISIS RESPONSE; OR
    4    E. WHERE THE INDIVIDUAL IS OTHERWISE IDENTIFIED AS HIGH RISK BY HIS OR
    5  HER MEDICAID SERVICE COORDINATOR, MANAGED CARE PROVIDER OR COUNTY SINGLE
    6  POINT OF ACCESS (SPOA).
    7    3.  DEMONSTRATION  PROJECTS  ESTABLISHED  PURSUANT TO THIS SECTION MAY
    8  TEST MODELS OF  CARE  AND  MODELS  OF  REIMBURSEMENT,  INCLUDING  SHARED
    9  SAVINGS, THAT ARE INTENDED TO ADVANCE THE GOALS DESCRIBED IN SUBDIVISION
   10  TWO OF THIS SECTION.
   11    4.  SERVICE  PROVIDERS  ELIGIBLE  TO  APPLY FOR ROLES AS DEMONSTRATION
   12  SERVICE  COORDINATORS  INCLUDE:  HOSPITALS,  DIAGNOSTIC  AND   TREATMENT
   13  CENTERS,  MANAGED  CARE PLANS, MEDICAL SCHOOLS AND PROVIDERS LICENSED BY
   14  OR FUNDED BY THE OFFICE OF MENTAL HEALTH OR THE OFFICE FOR  PEOPLE  WITH
   15  DEVELOPMENTAL DISABILITIES AND THE DEPARTMENT OF HEALTH. THE COMMISSION-
   16  ER  OF  HEALTH  SHALL APPROVE DEMONSTRATION PROGRAMS WHICH ARE GEOGRAPH-
   17  ICALLY DIVERSE. A PARTICIPATING SERVICE PROVIDER MUST ESTABLISH, TO  THE
   18  SATISFACTION  OF  THE COMMISSIONER OF HEALTH, ITS CAPACITY TO ENROLL AND
   19  SERVE SUFFICIENT NUMBERS OF ENROLLEES TO DEMONSTRATE THE COST-EFFECTIVE-
   20  NESS OF THE DEMONSTRATION PROGRAM.
   21    5. NOTHING IN THIS SECTION SHALL BE CONSTRUED AS REQUIRING  ANY  MEDI-
   22  CAID  BENEFICIARY  TO PARTICIPATE IN A DEMONSTRATION PROJECT ESTABLISHED
   23  PURSUANT TO THIS SECTION; PARTICIPATION SHALL  BE  VOLUNTARY.    PARTIC-
   24  IPATION  IN  A  DEMONSTRATION PROJECT PURSUANT TO THIS SECTION SHALL NOT
   25  DIMINISH OR IMPAIR THE SERVICES TO  WHICH  A  PARTICIPANT  IS  OTHERWISE
   26  ENTITLED UNDER THIS CHAPTER.
   27    6.  PRIOR TO ESTABLISHING ANY DEMONSTRATION PROJECT AUTHORIZED BY THIS
   28  SECTION, THE COMMISSIONER OF HEALTH SHALL CONSULT WITH THE COMMISSIONERS
   29  OF THE OFFICE OF MENTAL HEALTH AND THE OFFICE FOR PEOPLE  WITH  DEVELOP-
   30  MENTAL DISABILITIES.
   31    7.  THIS  SECTION SHALL NOT APPLY UNLESS ALL NECESSARY APPROVALS UNDER
   32  FEDERAL LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL  FINAN-
   33  CIAL  PARTICIPATION IN THE COSTS OF HEALTH CARE SERVICES PROVIDED PURSU-
   34  ANT  TO THIS SECTION. THE COMMISSIONER OF HEALTH IS AUTHORIZED TO SUBMIT
   35  ONE OR MORE APPLICATIONS FOR WAIVERS OF THE FEDERAL SOCIAL SECURITY  ACT
   36  AS MAY BE NECESSARY TO OBTAIN SUCH FEDERAL FINANCIAL PARTICIPATION.
   37    8.  THE  COMMISSIONER OF HEALTH SHALL PROVIDE A REPORT TO THE GOVERNOR
   38  AND THE LEGISLATURE NO LATER THAN JANUARY FIRST, TWO THOUSAND  EIGHTEEN.
   39  THE  REPORT  SHALL  INCLUDE  FINDINGS  AS TO THE DEMONSTRATION PROJECTS'
   40  EFFECTIVENESS IN MANAGING THE CARE NEEDS AND  IMPROVING  THE  HEALTH  OF
   41  PROGRAM  PARTICIPANTS, AN EVALUATION AS TO THE PROGRAMS' COST-EFFECTIVE-
   42  NESS AS MEASURED AGAINST TRADITIONAL MEDICAID CARE MODELS, AND RECOMMEN-
   43  DATIONS AS TO WHETHER THE PROGRAMS SHOULD BE EXTENDED, MODIFIED,  ELIMI-
   44  NATED, OR MADE PERMANENT.
   45    S 2. This act shall take effect immediately.