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Funding for New York State Mental Health Laws

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					2009-10 NEW YORK STATE EXECUTIVE BUDGET
      HEALTH AND MENTAL HYGIENE
         ARTICLE VII LEGISLATION
       MEMORANDUM IN SUPPORT
               MEMORANDUM IN SUPPORT

        A BUDGET BILL submitted by the Governor in
        Accordance with Article VII of the Constitution

                               AN ACT to amend the public health law,
                               the state finance law, the education law
                               and the insurance law, in relation to the
                               early intervention program for infants
                               and toddlers with disabilities and their
                               families; to repeal certain provisions of
                               the public health law, the education law,
                               the insurance law and the elder law
                               relating thereto (Part A); to amend the
                               public health law and the social services
                               law, in relation to long term home health
                               care programs; to amend the public
                               health law, in relation to the office of the
                               Medicaid inspector general; to amend
                               part C of chapter 58 of the laws of 2007
                               amending the social services law and
                               other laws relating to enacting major
                               components of legislation necessary to
                               implement the health and mental
                               hygiene budget for the 2007-2008 state
                               fiscal year, in relation to the
                               effectiveness of certain provisions of
                               such chapter; to amend the public health
                               law, in relation to payments under the
                               medical assistance program; to amend
                               the public health law and chapter 474 of
                               the laws of 1996, amending the
                               education law and other laws relating to
                               rates for residential health care facilities,
                               in relation to reimbursements; to amend
chapter 884 of the laws of 1990,
amending the public health law relating
to authorizing bad debt and charity care
allowances for certified home health
agencies, in relation to the effectiveness
thereof; to amend chapter 81 of the laws
of 1995, amending the public health law
and other laws relating to medical
reimbursement and welfare reform, in
relation to reimbursements and the
effectiveness thereof; to amend chapter
639 of the laws of 1996, amending the
public health law and other laws relating
to welfare reform, in relation to
reimbursements; to amend the public
health law and chapter 58 of the laws of
2007 amending the social services law
and other laws relating to enacting the
major components of legislation
necessary to implement the health and
mental hygiene budget for the 2007-
2008 state fiscal year, in relation to rates
of payment by state governmental
agencies; to amend chapter 629 of the
laws of 1986, amending the social
services law relating to establishing a
demonstration program for the delivery
of long term home health care services
to certain persons, in relation to
extending the provisions thereof; to
amend chapter 451 of the laws of 2007
amending the public health law, the
social services law and the insurance
law, relating to providing enhanced
consumer and provider protections, in
relation to extending the effectiveness of
certain provisions thereof; to amend
chapter 55 of the laws of 1992,
amending the tax law and other laws
relating to taxes, surcharges, fees and
funding, in relation to the effectiveness
thereof; to amend chapter 942 of the
laws of 1983 and chapter 541 of the
laws of 1984, relating to foster family
care demonstration programs, and to
amend chapter 256 of the laws of 1985,
amending the social services law and
other laws relating to foster family care
demonstration programs, in relation to
extending the expirations thereof; to
amend chapter 693 of the laws of 1996,
amending the social services law
relating to authorizing patient discharge
to hospices and residential health care
facilities, under the medical assistance
presumptive eligibility program, in
relation to extending the provisions of
such chapter; to amend chapter 631 of
the laws of 1997, amending the social
services law relating to authorizing
medical assistance payments to certain
clinics or diagnostic and treatment
centers, in relation to extending the
effectiveness thereof; to amend chapter
119 of the laws of 1997 relating to
authorizing the department of health to
establish certain payments to general
hospitals, in relation to making such
authorization permanent; and to repeal
section 74 of the executive law relating
to the office of the welfare inspector
general (Part B); to amend the public
health law, in relation to payment by
governmental agencies for general
hospital inpatient services, inpatient
medical assistance rates for non-public
general hospitals, grants to public
general hospitals, tobacco control and
insurance initiatives pool distributions,
health care initiatives pool distributions
and payments made on behalf of
persons enrolled in Medicaid managed
care or family health plus; to direct the
commissioners of health and mental
health to enhance funding of the
ambulatory patient group methodology
and expand certain programs; to direct
the commissioners of health, and mental
retardation and develop-mental
disabilities to enhance funding of the
ambulatory patient group methodology;
to amend the social services law, in
relation to establishing the statewide
health care home program; to amend the
public health law, in relation to
establishing the Adirondack health care
home multipayor demonstration
program; to amend the social services
law, in relation to medicaid coverage of
smoking cessation, cardiac rehabilitation
services and substance abuse
interve ntion; to amend the social
services law, in relation to the provision
and reimbursement of transportation
costs and the primary care case
management program; to amend the
public authorities law, in relation to the
authorization of the dormitory authority
to issue bonds for health care; to amend
the social services law, in relation to
directing the commissioner of health to
negotiate pharmaceutical rebates,
retrospective and prospective drug
utilization review, and the duration of
drug therapy, the development of clinical
prescribing guidelines, drug coverage for
persons who are beneficiaries under
Part D; to amend the public health law
and the social services law, in relation to
the clinical drug review program; to
amend the social services law, in
relation to electronic transmission of
prescriptions; to amend the public health
law and the education law, in relation to
prohibiting certain payments to
prescribers and requiring the disclosure
of other payments, prohibiting the
presentation of information at continuing
professional education programs that is
false or misleading and requiring
disclosure of certain potential conflicts of
interest in connection with such
programs, providing for transparency in
the business relationships between
pharmacy benefit managers and health
plans, and requiring pharmacy benefit
managers to provide certain information
to health plan participants and their
prescribers; to amend the social services
law, in relation to eligibility for medical
assistance and the family health plus
program; to amend the welfare reform
act of 1997, in relation to applicants for
public assistance; to amend the public
health law, in relation to child insurance
plans; to amend the social services law,
in relation to monthly premiums for
medical assistance and liens for public
assistance care; to amend the public
health law, in relation to fees for the
establishment of hospitals, approval of
the construction of hospitals, licensure of
home care services agencies, the
establishment of certified home health
agencies, changes in the ownership of a
home health agency hospice
construction, distribution of the
professional education pools, the
general hospital indigent care pool and
the comprehensive diagnostic and
treatment centers indigent care program;
to amend the elder law, in relation to the
program for elderly pharmaceutical
insurance coverage; to amend the public
health law, in relation to patient services
payments; to amend the insurance law,
in relation to examinations and
appraisals of authorized insurers and
employee welfare funds, independent
adjusters, establishing a fee on
insurance claims processed by
independent adjusters; to amend the tax
law and the state finance law, in relation
to the sales of cigarettes and tobacco
products and the health care reform act
(HCRA) resources fund; to repeal certain
provisions of the public health law
relating to the preferred drug program
and the telemedicine demonstration
program; to repeal certain provisions of
chapter 62 of the laws of 2003,
amending the social services law and
the public health law relating to
expanding Medicaid coverage and rates
of payment for residential health care
facilities, relating thereto; to repeal
certain provisions of the social services
law relating to specialized HIV
pharmacies, the family health plus
program, eligibility for medical
assistance; to repeal certain provisions
of the elder law relating to the program
for elderly pharmaceutical insurance
coverage; and providing for the repeal of
certain provisions upon the expiration
thereof (Part C); to amend the public
health law, in relation to reimbursement
to residential health care facilities, to
community service plans, to payments
for certified home health agency
services, to establishing the long -term
care nursing initiative demonstration
project; to amend the social services
law, in relation to assisted living
programs, to payment for AIDS home
care programs, to regional long-term
care assessment centers, to establishing
the cash and counseling demonstration
program, to Medicaid extended cover-
age for the partnership for long-term
care program; to amend chapter 1 of the
laws of 1999, amending the public health
law and other laws, relating to enacting
the New York Health Care Reform Act of
2000, in relation to adult day health care
services; to amend the education law
and the public health law, in relation to
establishing long -term care nursing
initiative demonstration projects; and
providing for the repeal of certain
provisions upon expiration thereof (Part
D); to amend part E of chapter 58 of the
laws of 1998, relating to the
determination of state aid for the long -
term sheltered employment program, in
relation to availability of funding as
certified by the director of the budget
(Part E); in relation to the establishment
of the a uthority of the office of mental
health to close wards in hospitals
operated by such office and to develop
transitional placement programs for
persons discharged from such hospitals,
notwithstanding certain provisions of the
mental hygiene law (Part F); to amend
chapter 420 of the laws of 2002
amending the education law relating to
the profession of social work, and
chapter 676 of the laws of 2002
amending the education law relating to
defining the practice of psychology, in
relation to the professions of social work
and mental health practitioners (Part G);
to amend the mental hygiene law, in
relation to civil commitment of sex
offenders (Part H); to amend the mental
hygiene law, in relation to the receipt of
federal and state benefits received by
patients receiving care in facilities
operated by an office of the department
of mental hygiene (Part I); to amend the
mental hygiene law in relation to the
consolidation of certain developmental
disabilities services offices (Part J); to
amend the mental hygiene law, in
relation to the closure of the Manhattan
Addiction Treatment Center (Part K); to
amend chapter 57 of the laws of 2006,
establishing a cost of living adjustment
for designated human services
programs, in relation to foregoing such
adjustment during the 2009--2010 state
fiscal year (Part L); to amend the mental
hygiene law, in relation to the
requirement for the commissioner of
mental health to annually report on child
and adult non-geriatric inpatient bed
closures; to amend chapter 119 of the
laws of 2007 relating to directing the
commissioner of mental health to study,
                                      evaluate and report on the unmet mental
                                      health service needs of traditionally
                                      underserved populations, in relation to
                                      such study; to repeal subdivisions (h)
                                      and (l) of section 41.55 of the mental
                                      hygiene law relating to reports on the
                                      community mental health support and
                                      workforce rein-vestment program; to
                                      repeal section 20 of chapter 723 of the
                                      laws of 1989 amending the mental
                                      hygiene law and other laws relating to
                                      the establishment of comprehensive
                                      psychiatric emergency programs,
                                      relating to reports thereon; and to repeal
                                      subdivision (c) of section 7.15 of the
                                      mental hygiene law relating to reports on
                                      the delivery of care and services in
                                      family care homes and other community
                                      residences (Part M); to amend chapter
                                      119 of the laws of 1997 authorizing the
                                      department of health to establish certain
                                      payments to general hospitals, in
                                      relation to extending the authorization for
                                      the department of health to continue
                                      certain payments to general hospitals
                                      (Part N); to amend the administrative
                                      code of the city of New York, in relation
                                      to extending the authorization of the city
                                      of New York to lease to the state of New
                                      York certain real property on Ward's
                                      Island (Part O); and to amend the mental
                                      hygiene law and the vehicle and traffic
                                      law, in relation to transfer of the alcohol
                                      and drug rehabilitation program from the
                                      department of motor vehicles to the
                                      office of alcoholism and substance
                                      abuse services (Part P)

PURPOSE: This bill contains provisions needed to implement the Health and
Mental Hygiene portions of the 2009-10 Executive Budget.

This memorandum describes Parts A through P of the bill which are described
wholly within the parts listed below.
Part A - Improve public health services and achieve savings by modifying
the Early Intervention (EI) and General Public Health Work (GPHW)
programs, increase revenue collections in selected programs and eliminate
non-essential spending within the Department of Health (DOH) and the
State Office for the Aging (SOFA)

Purpose:

This bill contains provisions needed to implement the 2009-10 Executive Budget
by implementing cost savings measures, increasing revenues and eliminating
non-essential spending initiatives in DOH and SOFA.

Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:

This bill generates State Financial Plan savings by modifying the Early
Intervention (EI) Program, including the institution of cost sharing requirements
for parents and providers, restructuring the General Public Health Work (GPHW)
Program and eliminating non-essential programs. This bill also updates fees
used to finance the Office of Professional Medical Conduct (OPMC) and the
oversight of clinical labs. Specifically:

   •   Sections 1 through 4 amend Public Health Law (PHL) §§2541, 2544, 2549
       and 2550 to modify EI eligibility for children with speech-only delays to be
       evidence-based, require the use of an evaluation tool from a list of
       preferred tools, and consolidate the responsibility for the monitoring and
       approval of providers within DOH to eliminate duplication with the State
       Education Department (SED).

   •   Sections 5 and 6 add PHL §§2550-a and 2550-b regarding the EI provider
       approval and re-approval process, add provider approval criteria, establish
       provider application fees and authorize DOH to deny approval if sufficient
       provider capacity exists in a municipality.

   •   Sections 7 through 9 amend PHL §§2551, 2552 and 2553 to make
       conforming changes to modify standards for the EI Program and require
       parents to submit income documentation for the implementation of
       parental fees.

   •   Sections 10 and 10-a amend PHL §2557 to clarify EI billing requirements
       for Medicaid and other forms of third party health insurance and set
       guidelines for State reimbursement of local governments as part of a
       proposal to shift health insurance costs of the EI Program to the Insurance
       Department assessment.
•   Section 11 adds PHL §2557-a to establish graduated EI parental fees
    based upon income, similar to those for Child Health Plus.

•   Section 12 amends PHL §2559 to eliminate the requirement that
    municipalities claim for reimbursement of EI costs under private insurance
    coverage, except for children who are dually enrolled in Medicaid and
    private insurance plans. Further, the responsibility for claiming under
    Medicaid and private insurance for dually enrolled children is shifted to
    providers effective April 1, 2010.

•   Section 13 is intentionally omitted.

•   Section 14 amends PHL §2559-b to make a conforming change to the
    Commissioner of Health’s authority to establish EI regulations.

•   Section 15 adds State Finance Law §99-q to establish the EI Program
    Account to collect revenue resulting from the new EI parental and provider
    fees.

•   Sections 16 and 17 amend Education Law §§4410 and 4403 to eliminate
    duplicative SED approval of EI providers.

•   Sections 17-a and 18 amend Insurance Law §3235-a to specify that health
    insurance policies that cover EI services cannot apply such payments
    against maximum annual or lifetime monetary limits.

•   Sections 19 through 22 amend PHL §§602, 605, 609 and 616 to
    restructure the General Public Health Work (GPHW) Program to expand
    reimbursement for basic services to include dental services to children
    (less than 21 years of age), EI Program administration and service
    coordination (when performed directly by local government), inpatient
    tuberculosis treatment, radiation inspections, radiation producing
    equipment, housing hygiene and occupancy, individual water supplies,
    sewage systems, county-operated home care services and certain
    laboratory services. In addition, reimbursement for certain optional
    services is eliminated, including: emergency medical services, non-
    specified laboratory services, medical examiners, long term home health
    care, hospice services, and the admi nistration of the pre-school special
    education program.

•   Section 23 amends PHL §576 to restructure the clinical laboratory fee
    collection from a current flat fee based on DOH's costs to administer the
    clinical laboratory program to a one percent assessment on each
    laboratory's clinical gross revenue.

•   Section 24 adds PHL §4364(6) to impose an annual assessment of one
    percent on the gross receipts of tissue banks and storage facilities.
   •   Section 25 amends Education Law §6524 to increase the physician
       registration fee from $570 to $970 to support the operations of Office of
       Professional Medical Conduct (OPMC).

   •   Sections 26 through 28 amend PHL §§225, 1352 and 201 to eliminate the
       following non-essential programs: Water System Backflow Tester
       Certification, Food Worker Trainer Certification and Temporary Residence
       Inspections.

   •   Sections 29 through 32 amend PHL §§1370-a, 1370-b, 1370-e and 2168
       to strengthen lead prevention and remediation efforts, including linking the
       immunization and lead registries, requiring reporting of lead test results to
       the immunization registry, and permanently extending the Childhood Lead
       Poisoning Primary Prevention Program.

   •   Sections 33 through 37 repeal Elder Law §§215-b and 223, PHL §§206
       and 2807-v(1)(qq), and Insurance Law §210-a to eliminate the following
       non-essential programs, currently administered by SOFA: Enriched Social
       Adult Day Services, Long Term Care Insurance Outreach and Education
       and Economically Sustainable Transportation.

   •   Section 38 sets forth the effective dates.

Budget Implications:

Enactment of this bill is necessary to implement the 2009-10 Executive Budget,
which recommends State Financial Plan savings of $52.5 million in 2009-10 and
$102.6 million in 2010-11 as follows:

   •   $23.4 million savings in 2009-10 ($56.1 million in 2010-11) to implement
       changes in the EI Program;

   •   $16 million savings in 2009-10 ($32.8 million in 2010-11) associated with
       restructuring the GPHW Program;

   •   $3.7 million savings in 2009-10 and 2010-11 associated with the
       elimination of certain non-essential programs within SOFA; and

   •   $9.4 million additional revenues in 2009-10 ($10 million in 2010-11)
       associated with modifying fees for the oversight of physicians and clinical
       laboratories.

Effective Date:

This bill is effective March 1, 2009, with the exception of sections 19 through 22,
relating to GPHW reimbursement, that take effect on January 1, 2009.
Part B - Implement additional Medicaid cost savings measures, establish
an assessment on home care providers, merge the Office of the Welfare
Inspector General (OWIG) with the Office of the Medicaid Inspector General
(OMIG), extend expiring laws and make other technical changes

Purpose:

This bill contains provisions to implement the 2009-10 Executive Budget by
reinstituting the home care assessment, merging the Office of the Welfare
Inspector General (OWIG) with the Office of the Medicaid Inspector General
(OMIG), preserving savings associated with prior year cost containment
measures and extending various expiring laws.

Summary of Provisions, Existing Law, Prior Legislative History, and Statement in
Support:

Specifically, this bill includes the following components:

   •   Sections 1 through 4 amend Public Health Law (PHL) §§3614-a and 3614-
       b and Social Services Law (SSL) §367-i to establish a 0.7 percent
       assessment on providers of home health care and personal care services;

   •   Section 5 allows payments to be modified in the event that the application
       of Federal regulations on case management, provider taxes, Graduate
       Medical Education and Medicaid rehabilitation services result in the loss of
       Federal funding;

   •   Sections 6 through 9 repeal Executive Law §74, amend PHL §§30-a and
       32 and add a new PHL §32-a to merge the OWIG with the OMIG and
       eliminate OWIG’s prosecutorial authority;

   •   Sections 10 through 14 extend various expiring laws including: extending
       the Chronic Care Demonstration Program to meet contractual obligations,
       continuing public hospital Disproportionate Share payments, continuing
       Upper Payment Limit (UPL) payments, continuing nursing home UPL
       payments to public facilities and continuing Bad Debt and Charity Care
       payments for Certified Home Health Agencies (CHHAs);

   •   Sections 14 through 37 continue prior year cost containment provisions for
       hospitals, nursing homes, ambulatory care, clinics, CHHAs and home care
       and extend other necessary measures;

   •   Sections 38 through 46 extend various programmatic provisions related to
       Medicaid managed care, Medicaid applications for those on medical
       parole, the foster care demonstration program for persons who are elderly
       or disabled, presumptive eligibility for transfers to hospice or residential
       care facilities, diagnostic and treatment center reimbursements, tobacco
       regulation and the Long Term Home Health Care Service Demonstration
       program; and

   •   Section 47 sets forth the effective dates.

Budget Implications:

Enactment of this bill is necessary to implement the 2009-10 Executive Budget
because it ensures State Financial Plan savings totaling $288 million in 2009-10
and $291 million in 2010-11 as follows:

   •   $19 million savings in 2009-10 ($22 million in 2010-11) to implement
       various cost containment measures including establishment of the 0.7
       percent assessment for home health care and personal care; and

   •   $269 million savings in 2009-10 ($269 million in 2010-11) to implement
       various prior year cost containment measures.

Effective Date:

This bill takes effect immediately.

Part C - Reform Medicaid reimbursement structures, improve access to
affordable health insurance coverage and authorize cost containment
initiatives

Purpose:

The Health Care Improvement Act continues reform of New York’s health care
system to ensure that the State is getting the highest quality for the resources it
invests. It continues to lay the building blocks for a high-performing health care
system by: reforming hospital inpatient reimbursement reform and redirecting
resources to outpatient and primary care; promoting effective and efficient
management of pharmaceutical benefits and maximizing rebate and Federal
revenues; streamlining access to affordable health insurance coverage and
identifying additional revenues to support HCRA-financed health care programs.

Summary of Provisions, Existing Law, Prior Legislative History, and Statement in
Support:

This bill reforms reimbursement methodologies for hospital inpatient and
substance abuse and inpatient psychiatric services; advances pharmacy
measures that achieve savings through effective management of pharmaceutical
benefits; limits the influence of pharmaceutical manufacturers over prescribing
decisions; improves public health insurance coverage for the State’s most
vulnerable populations by streamlining access and rationalizing cost sharing;
modernizes the Elderly Pharmaceutical Insurance Coverage (EPIC) program to
maximize Federal Medicare Part D funds; ensures equal treatment of in-state
and out-of-state insurers in the application of insurance assessments; and
provides additional revenues to support the Health Care Reform Act (HCRA).
The bill redirects a portion of savings attributable to hospital reform to hospital
outpatient, primary care and preventive services. The bill also provides
investments in the Health Care Efficiency and Affordability Law for New Yorkers
(HEAL- NY) for continued capital investments in the State’s health care delivery
system and to encourage improvements and efficiency in operations.

Sections 1 and 1 -a set forth the legislative intent and short title known as the
“Health Care Improvement Act.”

Sections 2 and 3 add Public Health Law (PHL) §2807-c (35) to modernize the
reimbursement methodology for hospital acute and exempt services, including
updating costs from the current 1981 base year to actual 2005 costs and
implementing a new All Patient Refined (APR) Diagnostic Related Group (DRG)
rate system allowing for more precise inpatient Medicaid payments.

Sections 4 through 10 amend PHL §§2807-c, 2807-v and 2807-l to eliminate
hospital rate add-ons consistent with hospital inpatient rebasing reforms.

Section 11 amends PHL §2807-c to accelerate implementation of rates of
payment to certain hospitals for services provided to patients diagnosed with
substance abuse.

Section 12 adds PHL §2807-c(e-1) to implement new psychiatric inpatient per
diem rates.

Section 13 adds PHL §2807-c(e-2) to provide a new Medicaid reimbursement
methodology for inpatient exempt unit rates.

Sections 14 through 30 amend the PHL and the Social Services Law (SSL)
(§§24, 31 and 32 are intentionally omitted) to: invest in hospital outpatient,
diagnostic, substance abuse and mental health clinic Ambulatory Patient Group
(APG) methodology reimbursement; provide incentives to primary care practices,
primary care hospital outpatient departments and other programs to meet
specific care standards; create the Statewide Health Care Home Program to
improve patient care continuity and coordination of health services; establish the
Adirondack Medical Home pilot program; enhance programs related to smoking
cessation, cardiac rehabilitation, and the Screening, Brief Intervention and
Referral to Treatment (SBIRT) for persons at risk of substance abuse in trauma
centers/ERs; provide contingency language for hospital investments; manage
transportation services throughout the State to ensure the safe and efficient
transportation of Medicaid recipients; and expand primary care case
management programs to ensure that Medicaid recipients have a medical home.

Section 33 provides language to authorize HEAL-NY to be used for the purpose
of providing hospitals with increased, and cost effective, access to capital
markets to improve the operation and efficiency of the State’s health care
delivery system.

Section 34 amends Public Authorities Law §1680-j to provide funding for HEAL-
NY.

Sections 35 through 37 add SSL §367-a(7)(e), repeal PHL §272(4) and amend
unconsolidated law to revamp the supplemental drug program to authorize direct
negotiations with drug manufacturers for the purpose of realizing additional drug
rebate revenues.

Sections 38 through 41 amend SSL §§369-aa, 369-cc, 365-a and 369-bb to
require drug step therapy to encourage the use of less expensive drugs and to
limit the quantity, frequency and duration of drug therapy through an integrated,
prior authorization process.

Section 42 amends SSL §365-a to eliminate Medicare Part D wraparound
coverage.

Sections 43 and 44 amend SSL §367-a to eliminate the HIV Specialty Pharmacy
designation and the associated higher drug reimbursement rates.

Section 45 amends PHL §274 to allow the Commissioner of Health to deny
Clinical Drug Review Program (CDRP) prior authorization requests when clinical
criteria is not met and the prescriber fails to demonstrate medical necessity.

Sections 46 through 48 amend SSL §§365-a and 367-a to require the use of
certain brand drugs when the net cost after rebates is less than the generic
equivalent.

Section 49 adds SSL §367-a(9)(i) to provide incentives for e-prescribing to
reduce medication errors.

Sections 50 through 56 relate to pharmacy reform by prohibiting certain
pharmaceutical and medical device manufacturers’ payments to prescribers and
requiring the disclosure of other payments as follows:

   •   Section 50 adds new PHL §279 to prohibit certain payments from drug
       manufacturers to physicians and other prescribers;
•   Sections 51 and 52 add Education Law §§6509(15) and 6530(50) to
    provide that a prescriber’s failure to comply with requirements constitutes
    professional misconduct under the Education Law;

•   Section 53 adds new PHL §§2999-g, 2999-h and 2999-i to require
    presenters at continuing medical education (CME) programs to make
    certain disclosures of financial relationships;

•   Sections 54 and 55 add new Education Law §§6509(16) and 6530(51) to
    provide that a presenter’s failure to disclose a financial relationship with a
    manufacturer or distributor constitutes professional misconduct; and

•   Section 56 adds a new Article 44-A, consisting of PHL §§4450 through
    4456, to require disclosure of information by pharmacy benefit managers
    (PBMs).

•   Section 57 is intentionally omitted.

•   Sections 58 through 112 (§§69 through 72 and 82 through 85 are
    intentionally omitted) amend the SSL, PHL, and the Elder Law to improve
    public health insurance coverage by streamlining access, eliminating
    barriers to coverage, rationalizing cost sharing and payments, covering
    indigent care costs and modernizing the EPIC program.

•   Sections 113 through 125 achieve savings related to HCRA as follows:

•   Section 113 adds PHL §2807-j(13) to establish a fee on select physician
    office-based procedures;

•   Section 114 amends PHL §2807-s to extend certain HCRA assessments
    to out-of-state insurers;

•   Section 115 amends PHL §2807-v to shift anti-tobacco funding to the
    State Insurance Department;

•   Sections 116 and 117 amend SSL §367-a to mandate health insurers or
    other parties that are legally responsible for payment of a Medicaid claim
    to provide the State with information as required by the Federal Deficit
    Reduction Act;

•   Sections 118 and 119 amend Insurance Law §§316 and 332 to extend
    assessments to out-of-state insurers;

•   Sections 120 and 121 amend PHL §2807-v and repeal PHL §3621 to
    eliminate funding for the telemedicine demonstration program;

•   Sections 122 and 123 amend Insurance Law §2101 and add a new §9112
    to impose a fee on registered claims adjusters;
   •   Sections 123-a, 123-b and 124 amend PHL §§2807-y, 2807-j and 2807-v
       to provide changes related to HCRA administration and a technical
       change relating to the Medical Assistance Program; and

   •   Sections 125 through 125-c amend Tax Law §§480-a and 482 and State
       Finance Law §92 to increase the application fees and related civil
       penalties for cigarette and tobacco product retail dealers and vending
       machine owners and operators.

   •   Sections 126 through 129 advance the time frames for notice, emergency
       rule promulgation, severability, and effective dates.

New York State taxpayers support a $45 billion Medicaid program that provides
an array of services to nearly four million New Yorkers. This bill builds on
achievements begun in 2007-08 to rationalize reimbursement, expand access
and coverage to public health insurance programs and contain escalating health
care costs. Specifically, the Health Care Improvement Act:

   •   Continues health system reform for hospitals, building upon
       reimbursement reform initiatives enacted in 2008-09;

   •   Manages pharmaceutical benefits effectively and efficiently;

   •   Ensures access to affordable health coverage; and

   •   Advances forward with insurance and HCRA reimbursement reform.

Absent these measures, total Medicaid program spending -- Federal, State and
local government combined -- would reach $48.2 billion in 2009-10.

This bill also advances reforms and investments to promote access to health
insurance coverage by:

   •   Streamlining access by eliminating unnecessary and duplicative
       processes under Medicaid and Family Health Plus (FHP); making
       Medicaid consistent with other public health insurance programs; and
       removing barriers to FHP coverage for public employees and 19 and 20
       year olds.

   •   Authorizing the State to submit a waiver request to the Federal
       government that would allow the expansion of FHP to 200 percent of the
       Federal Poverty Level which would be financed with Federal funds, the
       reallocation of Disproportionate Share and Upper Payment Limit payments
       that currently go to public hospitals and other savings identified pursuant
       to the waiver.
Budget Implications:

Enactment of this bill is necessary to implement the 2009-10 Executive Budget
because it ensures State Financial Plan savings totaling $767 million in 2009-10
and $1,099 million in 2010-11 as follows:

   •   $336 million savings in 2009-10 ($420 million in 2010-11) to implement
       various cost containment measures including: instituting hospital inpatient
       rate reform actions; reallocating Graduate Medical Education funds,
       reforming prescription drug utilization and coverage; modernizing EPIC;
       reflecting offsetting investments in hospital outpatient services, primary
       care improvement standards, and enhancements to certain clinic fees and
       rates; and

   •   $189 million savings in 2009-10 ($435 million in 2010-11) related to
       insurance and HCRA initiatives, including expanding certain assessments
       to out-of-State insurers; establishing a fee on registered claims adjusters,
       and establishing a fee on physician office-based procedures.

This bill requires targeted State investments of $31 million for HEAL-NY in 2009-
10 ($118 million in 2010-11), $5 million in 2009-10 ($5 million in 2010-11) to
streamline access to the Medicaid and FHP programs, and $10 million in 2009-
10 ($13 million in 2010-11) to effectuate cost-sharing provisions in EPIC.

Effective Date:

This bill takes effect March 1, 2009 with the following exceptions:

Updating and reforming the hospital inpatient methodology (§§2-10);
implementing new psychiatric inpatient per diems (§12); implementi ng inpatient
exempt unit rates (§13); investing in hospital outpatient services and D&TC clinic
rates (§§14-16); investing in substance abuse and mental health clinic rates, and
medically supervised substance abuse withdrawal services (§§17- 23-a); creating
the Statewide Health Care Home program (§25); creating the Adirondack
Medical Home pilot program (§26); expanding smoking cessation, cardiac
rehabilitation and certain substance abuse preventive services (§27); eliminating
the finger imaging requirement for Medicaid recipients (§62); and modernizing
EPIC (§§104-112) will become effective July 1, 2009.

Managing transportation services (§29); requiring drug step therapy (§§38-39);
limiting the quantity, frequency and duration of drug therapy (§§40-41);
eliminating the Part D wrap (§42); requiring the use of certain brand drugs when
the cost is less than generics (§§46-48); changing the cost sharing under the
Medicaid Buy-In for Working People with Disabilities (§75); and increasing
application fees and related civil penalties for cigarette and tobacco product retail
dealers and vending machine owners and operators (§125) will become effective
September 1, 2009.

Eliminating the HIV Specialty Pharmacy designation (§§43-44); enhancing
recoveries from pooled trusts (§74); capping health plan marketing costs for the
Child Health Plus (CHPlus) program (§78); and shifting CHPlus rate setting to
DOH (§§79-81) will become effective April 1, 2009.

Permitting the denial of CDRP drugs (§45); and increasing the family contribution
under the CHPlus program (§73) will become effective June 1, 2009.

Limiting the influence of pharmaceutical manufacturers (§§50-56); eliminating the
asset test for the Medicaid and FHP programs (§§58-59); lifting the prohibition of
public employees enrolling in FHP (§68); and imposing a fee on registered claims
adjusters (§§122-123) will become effective October 1, 2009.

Eliminating the face-to-face interview process for Medicaid recipients (§§60-61);
adopting the Medicaid gross income standard and streamlining access under
FHP (§§63-67-b); and extending the insurance assessment to out-of-state
insurers (§§118-119) will become effective April 1, 2010.

Part D – Reform Long Term Care (LTC) reimbursement by implementing
program efficiencies and cost savings measures, revising reimbursement
methodologies for nursing homes and home care, promoting alternatives
to residential care and providing targeted investments to support quality
and cost effective care

Purpose:

This bill contains provisions needed to implement the 2009-10 Executive Budget
by revising nursing home and home care reimbursement methodologies and
making targeted investments to promote quality and cost effective care.

Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:

This bill generates State Financial Plan savings by replacing current cost-based
nursing home and home care reimbursement methods with pricing models that
provide appropriate payments for services, developing alternatives to costly
institutional beds and making targeted investments to promote quality and
effective care. Specifically:

   •   Sections 1 and 1a establish a short title -- “The Long-Term Care Reform
       Act” -- and articulate Legislative intent.
•   Section 2 amends Public Health Law (PHL) §2808(2-b) to eliminate the
    planned rebasing of nursing home payments.

•   Sections 3 through 6 amend PHL §2808 to implement a new regional
    pricing system for nursing homes to replace the existing provider-specific
    cost-based system. Specifically:

       o   Section 3 adds PHL §2808(2-c) to require the operating component
           of the nursing home reimbursement rate to be calculated using
           2005 costs, adjusted for case-mix on a regional basis, and
           authorize additional transitional rate adjustments;

       o   Section 4 amends PHL §2808(11) to limit the administrative rate
           appeal process to: corrections of computational errors by the
           Department of Health; capital cost reimbursement adjustments; and
           other reasons the Commissioner of Health may deem appropriate;

       o   Section 5 amends PHL §2808(12)(d) to incentivize the rehabilitation
           and renovation of facilities eligible for residual capital
           reimbursement; and

       o   Section 6 allows the Commissioner to distribute transition funding
           proportionally based on relative Medicaid days if Federal financial
           participation is not available.

•   Section 7 amends PHL §2808(12) to increase funding for financially
    distressed nursing homes and modify the distribution of this funding.

•   Sections 8 and 9 amend PHL §2808(18) to discontinue nursing home
    worker recruitment and retention funding, which is no longer required as
    the costs are reflected in new the regional pricing system.

•   Section 9-a adds PHL §2808(5)(c) to prohibit nursing homes from
    withdrawing or transferring assets in an amount that is more than three
    percent of a facility’s Medicaid revenues.

•   Section 10 eliminates the outdated occupancy adjustment for AIDS
    specialty nursing home beds.

•   Sections 11 through 14 amend Social Services Law (SSL) §461-l to
    provide for a five -year phase-out of 6,000 nursing home beds and a
    corresponding phase-in of 6,000 Assisted Living Program (ALP) beds.

•   Section 15 amends unconsolidated law to allow AIDS Adult Day Health
    Care providers to receive inflationary trend adjustments.

•   Section 16 is intentionally omitted.
•   Section 17 adds PHL §3614(13) to replace the current Certified Home
    Health Care Agency (CHHA) reimbursement methodology with a pricing
    methodology based on patient conditions and episodes of care.

•   Sections 18 and 19 amend PHL §3614(5) to modify the CHHA bad debt
    and charity care (BDCC) program to require community service plans and
    annual performance reviews to improve access to underserved.

•   Section 20 amends SSL §367-e (3) to modify the Long Term Home Health
    Care Program (LTHHCP) expenditure caps to authorize monthly
    expenditures of up to 100 percent of nursing home services in the district
    for AIDS home care program participants.

•   Section 21 amends SSL §365-a to include personal care services in the
    managed care benefit package to improve care coordination and
    continuity for members.

•   Section 22 through 22-c amend PHL §4403-f to clarify the role of the State
    Insurance Department in the oversight of Managed Long Term Care
    plans.

•   Section 23 adds SSL §367-w to establish a Long Term Care Assessment
    Center for the purpose of assessing recipients accessing home care
    services.

•   Section 23-a adds PHL §3614(14) to reduce payments to CHHAs by 3.5
    percent, LTHHC providers by 1.5 percent and Personal Care by 1.5
    percent.

•   Section 24 adds PHL §2808(26) to establish a nursing home quality
    incentive pool to reward facilities for quality and efficiency improvements.

•   Section 25 adds PHL §3614(13-a) to establish a home care quality
    incentive pool to reward providers for quality and efficiency improvements.

•   Sections 26 and 27 add PHL Article 28-C-1 and Education Law §679-f to
    establish the Long Term Care Nursing Initiative Demonstration Project to
    provide educational incentives in the form of scholarships and loan
    forgiveness programs to address the geriatric nursing shortage.

•   Section 28 adds SSL §367-v to establish the Cash and Counseling
    Demonstration Program to provide flexible monthly allowances to
    Medicaid eligible recipients to hire, train and direct their own personal care
    and other community-based services.

•   Section 29 adds PHL §3614(1-a) to provide for CHHA Accountability
    Initiatives to ensure that home health care services are provided directly
    by CHHA, LTHHCP or AIDS home care providers and not sub-contracted.
   •   Section 30 amends SSL §367-f(1)(a) to authorize eligibility for Medicaid
       extended coverage under the Partnership for Long Term Care Program
       based on income standard rather than requiring those who exhaust their
       coverage under the Partnership Program to spend down their income.

   •   Sections 31 through 33 advance the time frames for notice, emergency
       rule promulgation and severability.

   •   Section 34 provides for the effective dates of this bill and language to
       ensure that all investments in the nursing home and home care reform
       proposals are contingent upon the enactment of the cost containment
       measures.

Budget Implications:

Enactment of this bill is necessary to implement the 2009-10 Executive Budget,
which recommends State Financial Plan net savings of $165.8 million in 2009-10
and $167.8 million in 2010-11 as follows:

   •   $345.7 million in savings in 2009-10 ($390.2 million in 2010-11)
       associated with the elimination of nursing home rebasing, the five year
       phase-out of nursing home beds and the elimination of an obsolete AIDS
       nursing home rate add-on.

   •   $212.9 million in investments in 2009-10 ($269.5 million in 2010-11) to
       implement value-based reimbursement including a quality incentive pool,
       the phase-in of ALP beds and a long term care nursing initiative
       demonstration.

   •   $36.5 million in savings in 2009-10 ($57.6 million in 2010-11) associated
       with the home care restructuring initiative and establishing a Long Term
       Care Assessment Center.

   •   $3.5 million in investments in 2009-10 ($10.5 million in 2010-11) to
       implement a home care quality incentive pool and the Cash and
       Counseling Demonstration Program.

Effective Date:

This bill is effective March 1, 2009 with the following exceptions:

   •   Section 21 shall take effect on October 1, 2009; and

   •   Sections 26 to 27 will be deemed repealed on and after April 1, 2012.

Part E - Eliminate exempt income in Long-Term Sheltered Employment
(LTSE) programs
Purpose:

This bill recognizes all revenues received by the Long-Term Sheltered
Employment (LTSE) programs in calculating net deficit funding amounts.

Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:

This bill provides the State with flexibility to recognize all income for LTSE
programs, which currently can exempt as much as $1,000 of the revenues they
receive from 100 percent State funded net deficit calculations. This proposal will
enable the State – in tough fiscal times – to require that all revenues received by
LTSE programs be recognized in the program’s net deficit calculation, thereby
reducing State costs for these services.

Budget Implications:

Eliminating the LTSE exempt income provision will generate recurring savings of
$5 million annually.

Effective Date:

This bill takes effect March 1, 2009.

Part F - Reduce and convert inpatient wards operated by the Office of
Mental Health (OMH)

Purpose:

This bill ensures that the Office of Mental Health (OMH) adult inpatient ward
closures in psychiatric centers designed to provide for the efficient operation of
hospitals by OMH will not be subject to the one year notification and
reinvestment provisions of the Mental Hygiene Law.

Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:

The Executive Budget recommends the closure or restructuring of eighteen
wards in selected Adult facilities. Implementation of these ward efficiencies would
reduce staffing needs and allow OMH to redirect a portion of these staff
resources into State -operated community-based programs.

Implementation of this proposal is consistent with overall agency goals
associated with transforming the locus of care from inpatient settings to the most
integrated setting for services in the community. It is also responsive to concerns
resulting from the 1999 United States Supreme Court decision, Olmstead v. L.C.
(527 U.S. 581), and is consistent with efforts of the Most Integrated Setting
Coordinating Council (MISCC).

Budget Implications:

Enactment of this bill is necessary to implement the 2009-10 Executive Budget
and generate $6 million of net savings in 2009-10, growing to $12 million in 2010-
11. Roughly $50 million of full annual gross savings will result from the
restructure/closure of the wards, of which $38 million will be redirected into
community and other care, including the creation of the transitional program.

Effective Date:

This bill takes effect March 1, 2009.

Part G - Extend current social worker and mental health professional
licensing exemptions for the agencies of the Department of Mental Hygiene
(DMH), the Office of Children and Family Services (OCFS), and local
government programs

Purpose:

This bill provides for an extension, until January 1, 2014, of the current
exemption for employees of the Department of Mental Hygiene, the Office of
Children and Family Services, and local government operated, regulated, funded
or approved programs from certain social work and mental health professional
licensure requirements.

Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:

This bill amends Chapter 420 of the Laws of 2002, as amended by Chapter 433
of the Laws of 2003, and Chapter 676 of the Laws of 2002, relating to the
licensure of social workers and other mental health professionals. Both laws
include provisions that exempt DMH, OCFS and local government programs and
providers from meeting licensure requirements until January 1, 2010. This bill
extends the exemption repeal dates from January 1, 2010, to January 1, 2014.

Chapter 420 of the Laws of 2002 made significant changes to the manner in
which social work practice is evaluated and regulated by creating two licensed
titles for social workers, Licensed Master Social Worker (LMSW) and Licensed
Clinical Social Worker (LCSW) and defines the scope of practice for each title.
This law also required that all individuals practicing within the scope of the LMSW
and LCSW titles be licensed by the State of New York by September 1, 2004,
except for individuals working for DMH, OCFS, and local government operated,
regulated, funded or approved programs, who have until January 1, 2010, to
meet the requirements of this law. Chapter 676 of the Laws of 2002 added
similar requirements for other mental health professionals, including mental
health counselors, marriage and family therapists, creative arts therapists and
psychoanalysts and provides a similar time-limited exemption. Chapter 433 of the
Laws of 2003 adds individuals employed by programs or services operated,
regulated, funded or approved by OCFS to the time-limited exemption for social
worker licensing.

The purpose of the time-limited exemptions is to allow for greater State and local
government flexibility in the delivery of mental health services while the full
impact of the laws is evaluated and affected organi zations move toward
compliance. The licensing requirements contain strict standards for education
and experience that must be met to qualify for an LMSW or LCSW. Many
individuals may be performing tasks that fall within the scope of the LMSW and
LCSW and have not met the education and experience required for licensure.
Since many State operated and local mental health programs and services rely
on social workers and other mental health professionals to perform counseling,
psychotherapy, and case management services, failure to extend the exemption
would have a significant negative impact on the delivery of mental health
services and may require the State and local governments to lay off social
workers and other mental health professionals who do not meet current licensing
standards and replace them with licensed individuals. Additionally, the bill would
require State and local governments to hire a large number of LCSWs, clinical
psychologists and psychiatrists in order to provide clinical supervision to LMSWs
and other mental health professionals. Given that the State faces a clinical
staffing shortage, this could also negatively impact services.

Budget Implications:

Enactment of this bill will allow the State to avoid costs preliminarily projected at
over $10 million annually. State agencies and the State Department of Education
are still working to clarify the State titles impacted by the current laws and those
provider organizations that will be impacted, and thus this projection will be fine-
tuned as that analysis is completed.

Effective Date:

This bill takes effect on March 1, 2009.

Part H - Allow alternative facility options and courtroom procedures for Sex
Offender Management and Treatment Act (SOMTA) respondents

Purpose:
This bill reduces the cost of the program for the civil commitment of dangerous
sex offenders by retaining certain respondents in Department of Correctional
Services (DOCS) facilities or on parole after their probable cause hearing but
before their trial and by authorizing video teleconferencing for certain court
proceedings.

Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:

Under the Sexual Offender Management Treatment Act statute, after a court
determines that there is probable cause to believe that an offender is a sex
offender requiring civil management, the offender must be placed in a secure
treatment program operated by the Office of Mental Health (OMH) upon the
expiration of his or her criminal sentence. This bill authorizes respondents who
have passed their maximum sentence expiration date to stay in DOCS custody
or on parole until their trial. In addition, this bill authorizes the use of video
teleconferencing capabilities for psychiatric examiners, respondents, or witness
testimony at certain court proceedings.

Budget Implications:

Enactment of this bill would generate net savings of $2.0 million in 2009-10. This
results because roughly 25 offenders are anticipated to remain in DOCS custody
or on parole, rather than shift to more expensive OMH custody, and because
certain travel, security, and staffing costs will be reduced as video-
teleconferencing is used for certain court proceedings.

Effective Date:

The bill takes effect March 1, 2009.




Part I - Clarify the role of facility directors as representative payees and the
use of federal entitlement benefits in accordance with federal laws and
regulations

Purpose:

This bill would amend the Mental Hygiene Law regarding the authority of facility
directors to receive Federal benefits as representative payees and provide that
such facility directors must use funds received as representative payees in
accordance with federal laws and regulations.
Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:

This proposal would clarify the authority of facility directors of State -operated
facilities to continue to act as representative payees to pay for the cost of care
and treatment for persons who have assets, consistent with all applicable federal
laws and regulations. The proposal would also clarify that funds received by such
directors acting as representative payees are not subject to the $5000 statutory
limit on funds or property that may be held by facility directors and that such
funds shall be used in accordance with applicable federal laws and regulations.

Budget Implications:

Enactment of this bill is necessary to implement the 2009-10 Executive Budget in
order to ensure that the Office of Mental Health and the Office of Mental
Retardation and Developmental Disabilities (OMRDD) will not lose significant
revenue (in excess of $30M) both retroactively and prospectively.

Effective Date:

This bill takes effect immediately, and deemed effective January 1, 2002.

Part J - Consolidate administrative functions of the Office of Mental
Retardation and Developmental Disabilities’ (OMRDD) Broome
Developmental Disabilities Services Office (DDSO) and the Valley Ridge
Center for Intensive Treatment

Purpose:

Streamline operations by consolidating administrative functions at Valley Ridge
Center for Intensive Treatment with those at the Broome Developmental
Disabilities Services Office (DDSO).



Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:

The consolidation of the Broome DDSO and the Valley Ridge Center for
Intensive Treatment, which are located in the same geographic catchment area,
will result in the elimination of duplicative administrative staff. However, OMRDD
will continue to operate and serve individuals at the former Valley Ridge Center
for Intensive Treatment facility as part of the Broome DDSO.

Budget Implications:
Enactment of this bill is necessary to implement the 2009-10 Executive Budget
because it will result in the reduction of five high-level administrative positions,
generating savings of $0.2 million in 2009-10, annualizing to $0.7 million in 2010-
11.

Effective Date:

This bill takes effect March 1, 2009.

Part K - Close the Manhattan Addiction Treatment Center (ATC)

Purpose:

To close the Manhattan Addiction Treatment Center (ATC).

Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:

Closing the Manhattan ATC is necessary to reduce operating costs by $4.6
million annually and to avoid $14 million in capital costs without negatively
impacting client access to chemical dependence treatment services. This bill
removes references to the Manhattan ATC as a facility that the Office of
Alcoholism and Substance Abuse Services is required to operate. The services
currently provided at Manhattan are intended to be distributed to one of four
other ATC’s in the City or to not-for-profit providers.

Budget Implications:

Closing the Manhattan ATC will generate recurring savings of $4.6 million
annually and a void $14 million in capital costs.

Effective Date:

This bill takes effect March 1, 2009.

Part L - Establish a one year deferral of the human services cost-of-living
adjustment (COLA)

Purpose:

This bill eliminates the Human Services cost-of-living (COLA) for 2009-10 and
extends the adjustment for an additional year, through March 31, 2013.

Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:
This bill eliminates the 2009-10 COLA for designated Human Services programs
under the auspices of several State agencies including the Office of Mental
Retardation and Developmental Disabilities, Office of Mental Health, Office of
Alcoholism and Substance Abuse Services, the Department of Health, the State
Office for the Aging and the Office of Children and Family Services.

This action is necessary to promote consistency among programs relative to the
lack of trends or other reimbursement to address inflationary costs in the 2009-10
Executive Budget. Additionally, this bill seeks to honor the State’s original
commitment to extend the COLA for a full three years by continuing the
adjustment for one additional year, through SFY 2012-13.

Budget Implications:

Eliminating the 2009-10 Human Services COLA will generate recurring savings
of $171 million annually.

Effective Date:

This bill takes effect on April 1, 2009.

Part M - Modify and/or eliminate a variety of duplicative or redundant
reporting requirements related largely to the provision of community
mental health services

Purpose:

This bill removes the requirement that the Office of Mental Health (OMH) submit
a discrete report for a variety of program areas.

Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:

OMH currently completes a thorough annual report as required under Mental
Hygiene Law § 5.07, as well as many discrete additional reports. This bill
reduces the number of discrete additional reports that largely duplicate the
information within Section 5.07 report. The reports eliminated or modified include:

   •   Child and Adult Non-Geriatric Inpatient Bed Closures;

   •   Unmet Mental Health Service Needs;

   •   Community Mental Health Support and Workforce Reinvestment Program;

   •   Comprehensive Psychiatric Emergency Program; and
   •   Delivery of Care and Services in Family Care Homes and Other
       Community Residences.

Budget Implications:

Enactment of this bill is necessary to implement the 2009-10 Executive Budget
because the elimination or consolidation of these reports reduces unnecessary
preparation and production costs, representing a savings of about $750,000 to
the 2009-10 Financial Plan and modest annual savings thereafter. Additionally, to
a large extent these reports represent a duplication of information and effort, and
are therefore unnecessary.

Effective Date:

This bill takes effect March 1, 2009.

Part N - Extend the authority for Article 28 hospitals to replace state aid
grant funds provided by the Office of Mental Health (OMH) and the Office of
Alcoholism and Substance Abuse Services (OASAS) with federal
Disproportionate Share (DSH) funds

Purpose:

This bill extends Chapter 119 of the Laws of 1997, as amended by Section 1 of
Part H of Chapter 57 of the Laws of 2006, through March 31, 2012 to allow
voluntary Article 28 hospitals to continue replacing, through DSH payments,
reductions in State Aid grant funds provided by OMH and OASAS.

Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:

This bill extends the authorization of annual Federal DSH payments to support
the provision of mental health and substance abuse services by Article 28
hospitals, by amending Section 3 of Chapter 119 of the Laws of 1997. The
authorization for annual DSH payments has previously been extended at three-
year intervals, and this bill would extend the authorization through March 31,
2012.

In the absence of DSH funding, Article 28 hospitals would have to significantly
curtail services they provide to persons with mental illness and/or substance
abuse. Alternatively, to maintain current service levels, the State would need to
replace DSH revenues with additional General Fund support. Therefore,
extending the current DSH statute, as provided for in the legislation, is crucial to
the maintenance of service delivery, the financial well being of the hospitals, and
to the State’s current Financial Plan.
Budget Implications:

Enactment of this bill is necessary to implement the 2009-10 Executive Budget
because it provides an annual net State savings totaling approximately $27.8
million. The two State agencies impacted are OMH ($16.4M) and OASAS
($11.4M).

Effective Date:

This bill takes effect April 1, 2009.

Part O - Extend the Manhattan Psychiatric Center and Kirby Forensic
Psychiatric Center lease

Purpose:

To permit the continued operation of Manhattan Psychiatric Center and Kirby
Forensic Psychiatric Center by authorizing the Office of Mental Health (OMH)
and New York City to extend the term of the lease of the property on which the
hospitals operate for an additional fifty years.

Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:

This new bill amends Chapter 2 of the Laws of 1896 which authorized the
transfer of the mental hospital located on Ward’s Island from the City of New
York to the State of New York and authorized the lease of the hospital property to
the State. The current lease expires in 2012 and this proposal permits the
extension of the lease for another fifty year term. The bill also amends the
Administrative Code of the City of New York to authorize the extension of the
lease term and updates the names of the facilities operated on the leasehold.

Approval of this bill would permit the continued operation of Manhattan
Psychiatric Center and Kirby Forensic Psychiatric Center on property leased from
the City of New York on Ward’s Island. Manhattan Psychiatric Center provides
essential in-patient and out-patient mental health care to the citizens of New York
City and Kirby Forensic Psychiatric Center provides vital psychiatric services for
patients from the metropolitan area involved in the criminal justice system.

Budget Implications:

The current lease provides for the use of the hospital property at no rent and the
extension will continue to do so. Failure to extend the lease term would
potentially require the acquisition of new premises for the operation of Manhattan
Psychiatric Center and Kirby Forensic Psychiatric Center, and such planning
would need to commence in 2009-10.

Effective Date:

This bill takes effect March 1, 2009.

Part P - Transfer the Alcohol and Drug Rehabilitation Program from the
Department of Motor Vehicles (DMV) to OASAS

Purpose:

To transfer the alcohol and drug rehabilitation program from DMV to OASAS.

Statement in Support, Summary of Provisions, Existing Law, and Prior
Legislative History:

OASAS oversight of the Alcohol and Drug Rehabilitation Program (known as the
Drinking Driver Program or DDP) will ensure that persons involved in offenses
related to operating a motor vehicle while under the influence of alcohol or drugs
pursuant to sections 1192 and 1192-a of the Vehicle and Traffic Law are properly
screened, assessed and, where appropriate, referred to chemical dependence
treatment programs. This will ultimately improve the effectiveness of the DDP, as
recidivism rates of offenders will decline.

Budget Implications:

OASAS will seek to use a portion ($435,000) of the Federal Governor’s Traffic
Safety Board Grant, which is currently administered by the Department of Motor
Vehicles, to administer this program.

Effective Date:

This bill takes effect on March 1, 2009.

The provisions of this act shall take effect immediately, provided, however, that
the applicable effective date of each part of this act shall be as specifically set
forth in the last section of such part.

				
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