2006 New York Code - Community Support Services Program.

 
  § 41.47 Community support services program.
    (a) As used in this section:
    (1) "Approved reimbursable rate" means the maximum rate of payment per
  unit  of  service  established  by  the  commissioner  of  mental health
  pursuant to subdivision (e) of this section, or the actual unit cost  of
  providing community support services, whichever is less, minus revenue.
    (2) "Core  services"  means  the  daily managing and monitoring of the
  implementation of  the  community  support  services  program  within  a
  defined geographical area.
    (3) "Designated  adult  home"  means  an  adult care facility which is
  licensed by the commissioner of  social  services  pursuant  to  article
  seven  of  the social services law, and which has been designated by the
  commissioner of mental health as  containing  a  significant  number  of
  mentally ill persons who are in need of community support services.
    (4) "Designated  shelter  for  the  homeless"  means a shelter for the
  homeless which is  licensed  by  the  commissioner  of  social  services
  pursuant to article seven of the social services law, and which has been
  designated  by  the  commissioner  of  mental  health  as  containing  a
  significant number of mentally ill persons who are in need of  community
  support services.
    (5) "Designated  single  room occupancy residence" means a single room
  occupancy, as such term is defined  in  the  multiple  dwelling  law  or
  multiple   residence  law,  whichever  is  applicable,  which  has  been
  designated  by  the  commissioner  of  mental  health  as  containing  a
  significant  number of mentally ill persons who are in need of community
  support services.
    (6) "Functionally disabled as a result  of  mental  illness"  means  a
  person who has a severe, chronic disability which:
    (i)  is  caused by a medically determined mental illness, as evidenced
  by a primary psychiatric diagnosis;
    (ii) is likely to continue for a prolonged period; and
    (iii) results in substantial functional limitations in three  or  more
  of  the  following  areas:  (A)  self-care,  (B) social functioning, (C)
  activities  of  daily  living,  (D)   economic   self-sufficiency,   (E)
  self-direction, and (F) ability to concentrate.
    (7) "Provider   of   services"  means  the  local  governmental  unit,
  voluntary agency, proprietary agency, association, or corporation  which
  provides the community support services.
    (8) "Qualified  residence"  means  a  community residence, residential
  care center for adults,  family  care  home,  or  residential  treatment
  facility  for  children  and  youth which is licensed or operated by the
  office of mental health.
    (9) "Revenue" shall include:
    (i) reimbursement for operating costs for community  support  services
  received  from  other  local  governmental  units or from state agencies
  other than the office of mental health, provided that revenue shall  not
  include money received from any source, in the form of grants, awards or
  contracts, for purposes other than the support of such operating costs;
    (ii) federal aid received for such operating costs;
    (iii) fees received from patients, or on their behalf, from public and
  private health insurance and medical aid programs;
    (iv) other income received from the operation of the community support
  services program; and
    (v)  interest  and  dividends accruing from funds received pursuant to
  this section.
    (b) The community support services program shall include services  and
  programs  such  as:  case management services, advocacy services, clinic
  services, day treatment, day training, continuing  treatment,  homemaker
  services,   housekeeping   services,  on-site  rehabilitation  services,
  sheltered workshop and other vocational  programs,  psychosocial  clubs,
  neighborhood  drop-in  centers, transportation services, non-residential
  crisis  services,  outreach services, and other services approved by the
  commissioner.
    (c) (1)  The  commissioner  may,  upon  the  application  of  a  local
  governmental  unit,  and  within  the limits of appropriation therefore,
  grant state aid to such local governmental unit for one hundred  percent
  of  the  approved  costs  of  providing  community  support  services to
  eligible persons, which shall not exceed the approved reimbursable rate,
  and the approved costs of providing core  services.  Local  governmental
  units  which receive state aid pursuant to this subdivision either shall
  directly  provide  community  support  services  or  shall  enter   into
  contracts with providers of services for the provision of such services.
  Such local governmental units may also provide core services or contract
  with voluntary agencies for the provision of such core services.
    (2)  Persons who are otherwise ineligible to receive community support
  services  pursuant  to  subdivision  (d)  of  this  section,  shall   be
  considered  to  be  eligible  to  receive  such services for purposes of
  paragraph one of this subdivision, if they  are  certified  pursuant  to
  subdivision (d) of this section to be eighteen years of age or older, to
  be  functionally  disabled  as a result of mental illness and to have an
  ability to remain in the community which would be seriously  jeopardized
  without the provision of community support services, but who do not meet
  the eligibility criteria of paragraph two or three of subdivision (d) of
  this section, provided however, that the provider of services shall make
  a reasonable effort to determine such persons' eligibility and, provided
  further,  that no more than ten percent of the persons served by a local
  governmental unit or a provider of  services  which  directly  contracts
  with the office of mental health shall be otherwise ineligible persons.
    (d)  (1)  Persons who shall be eligible for community support services
  shall include individuals who are eighteen years of age and  older,  who
  are  functionally  disabled as a result of mental illness, whose ability
  to remain in the community would be seriously  jeopardized  without  the
  provision of community support services, and who satisfy the criteria in
  either  paragraph  two  or  three  of this subdivision. Such eligibility
  shall be certified by  a  licensed  psychiatrist,  nurse,  psychologist,
  licensed clinical social worker or a licensed master social worker under
  the supervision of a physician, psychologist or licensed clinical social
  worker  who  is  approved  by  a local governmental unit, a core service
  agency, or the commissioner to certify individuals as being eligible for
  community support services.
    (2) Persons who may be certified as permanently  eligible  to  receive
  community support services pursuant to paragraph one of this subdivision
  shall  include individuals who are determined to be eligible pursuant to
  regulations promulgated by the commissioner of mental health  and  shall
  include  but  not be limited to: (i) persons who have received inpatient
  psychiatric services in a hospital, or who have resided in  a  qualified
  residence  or a designated adult home for a period or periods of time as
  established in such regulations of the commissioner;  (ii)  persons  who
  are  in  receipt  of  supplemental  security  income  benefits or social
  security disability insurance benefits pursuant to  the  federal  social
  security   act,   provided  that  individuals  who  are  in  receipt  of
  supplemental security income benefits must have been  determined  to  be
  eligible  for  such  benefits prior to reaching sixty-five years of age;
  (iii) persons who  are  receiving  community  support  services  on  the
  effective   date  of  this  act  pursuant  to  the  regulations  of  the
  commissioner in effect on such date, who were determined to be  eligible
  for   such   services   based   upon   a   prior  history  of  inpatient
  hospitalization; and (iv) other  persons  who  have  received  specified
  psychiatric  services, as established pursuant to the regulations of the
  commissioner.
    (3)  Persons  who  may  be  certified as eligible to receive community
  support services pursuant to paragraph one  of  this  subdivision  shall
  include  individuals  who  are  residing  in  a designated adult home, a
  designated shelter for the homeless, a designated single room  occupancy
  residence,  a  qualified  residence,  or  who  are homeless mentally ill
  persons. Such persons shall be considered eligible for community support
  services for the duration  of  their  participation  in  such  community
  support services, and such persons who need such services shall continue
  to  be  eligible to receive such services for a period of one year after
  receiving any such services.
    (4)  Notwithstanding  the  provisions  of  paragraph  three  of   this
  subdivision,  persons  who  are residing in designated adult homes or in
  designated shelters for the homeless, or who are homeless  persons,  may
  receive  on-site  rehabilitation  services or outreach services provided
  under this section without a determination of eligibility  as  otherwise
  required under this subdivision.
    (e)  (1)  The  commissioner  shall  annually  establish  a schedule of
  maximum rates of payment per unit of service for reimbursable  community
  support services. In establishing such maximum rates of payment per unit
  of  service  the  commissioner  may consider geographical variations and
  other relevant  considerations.  Such  rates  shall  equal  the  medical
  assistance  rates established pursuant to section 43.02 of this chapter,
  when applicable. Upon the application of the local governmental unit  or
  a  provider  of  services  which  directly  contracts with the office of
  mental health to provide community support  services,  the  commissioner
  may  authorize  additional  reimbursement  for  a  period of three local
  fiscal years after the effective date of this act,  upon  a  showing  of
  extraordinarily  high  costs of providing community support services and
  extraordinarily high revenue receipts, which have been  demonstrated  to
  be appropriate.
    (2)  The  commissioner  shall  establish  revenue  goals for services,
  provided,  however,  the  commissioner  may  approve  local  or  unified
  services  plans  or  may  enter  into direct contracts with providers of
  services which  substitute  alternative  revenue  goals  for  individual
  providers   of   services   based  upon  appropriate  documentation  and
  justification, as required by the commissioner.
    (f) Prior to entering into contracts for the  provision  of  community
  support  services,  the  office  of mental health and local governmental
  units shall consider the following:
    (1) the service needs of mentally ill persons in the geographical area
  in which the community support services program operates;
    (2) the capacity of the program to meet identified service needs;
    (3) the current availability of services for mentally ill  persons  in
  the   area,  including  the  special  needs  of  ethnic  minorities  and
  non-English speaking mentally ill persons;
    (4) the extent to which community support services authorized  by  the
  contract will be integrated with other available services in the area to
  more effectively maintain mentally ill persons in the community;
    (5) the availability of resources for such services;
    (6)  the  extent to which the community support services authorized by
  the contract are consistent and integrated with the applicable local  or
  unified services plan of the area to be served; and
    (7)  the  extent  to  which  such  contracts  conform with the minimum
  contractual requirements as established by the commissioner.
    (g) The  commissioner  may  enter  into  a  direct  contract  for  the
  provision   of   community   support   services  when  the  commissioner
  determines, after the approval of the local or unified services plan and
  the allocation of state aid therefore,  that  such  direct  contract  is
  necessary  to  assure  that  additional  community  support services are
  available to persons who are functionally disabled as a result of mental
  illness and are eligible for community support services. Before entering
  into a direct contract with a provider  located  within  the  geographic
  area of a local governmental unit which receives state aid for community
  support services pursuant to this section, the commissioner shall notify
  the  local  governmental  unit  and  give  the  director  of  the  local
  governmental unit an opportunity to appeal  the  need  for  such  direct
  contract.  Such  appeals  shall  be  informal in nature and the rules of
  evidence shall not apply.
    (h) In order to qualify for one hundred percent state aid pursuant  to
  this  section  in  any  local fiscal year local governmental units shall
  assure that the local tax levy share of expenditures for  net  operating
  costs  pursuant to an approved local services plan for services provided
  to mentally ill persons pursuant to section 41.18 of this article,  when
  applicable,  shall  be equal to or greater than the local tax levy share
  of such expenditures under an approved local services plan in  the  last
  complete local fiscal year preceding the effective date of this section,
  and  when  applicable,  such local tax levy share of net operating costs
  for local governmental units submitting unified services plans  pursuant
  to  section 41.23 of this article, as adjusted to reflect changes in the
  rate of state reimbursement for approved expenditures, shall be equal to
  or greater than the local tax levy share of the net operating costs  for
  expenditures  under  the  approved  unified  services  plan  in the last
  complete local fiscal year preceding the effective date of this section,
  provided, however, any such required maintenance of  expenditures  under
  this  subdivision for local governmental units may be reduced to reflect
  the local governmental share of revenue applicable to increased payments
  made by governmental agencies pursuant to title eleven of  article  five
  of the social services law, which are a result of increased efficiencies
  in  the  collection  of  such  revenue  and which represent an increased
  proportion of the total local or unified services operating  costs  from
  the  prior  local  fiscal  year. The commissioner shall be authorized to
  reduce payments made  to  local  governmental  units  pursuant  to  this
  article,  in  the  following  local fiscal year, for failure to maintain
  expenditures in accordance with this subdivision.
    (i) The provisions of subdivision (h) of this section shall not  apply
  to a local governmental unit in any local fiscal year in which the total
  amount  of  state  aid  granted  to  the local governmental unit for net
  operating costs under section 41.18 or section 41.23 of the  article  is
  less  than  such  amount  of  state aid granted in the local fiscal year
  preceding the effective date of this section, or  in  any  local  fiscal
  year  in  which  the  total  amount  of  state  aid granted to the local
  governmental unit under this section, plus the total  amount  of  direct
  contracts  entered  into  between  the  commissioner  and  providers  of
  services for the provision of community  support  services  to  eligible
  residents  of such local governmental unit, shall be less than the total
  amount of such aid and direct contracts in the first local  fiscal  year
  following the effective date of this section.
    (j)  The  commissioner is authorized and empowered to make inspections
  and examine records of a local governmental  unit  receiving  state  aid
  under  this  section  or a provider of services which directly contracts
  with the office of mental health for the provision of community  support
  services.    Such  examination  shall  include  all  medical service and
  financial records, receipts, disbursements,  contracts,  loans  and  any
  other  moneys  relating  to  the  financial  operation  of the community
  support services program.
    (k)  A local governmental unit in receipt of a grant for the provision
  of community support  services  pursuant  to  subdivision  (c)  of  this
  section, which is a unit of a local government with a population of less
  than  one  hundred  thousand or which has total program expenditures for
  mentally ill persons under this article equal to five  hundred  thousand
  dollars  or less in a local fiscal year, shall be permitted to commingle
  such funds and the clients receiving  community  support  services  with
  other  local  mental  health  program  funds or clients, including local
  mental health program funds and  clients  of  other  local  governmental
  units.  Such  local governmental unit shall be required to submit a plan
  to the commissioner which shall describe how the goals and objectives of
  the community support services program shall be maintained under such an
  arrangement, and such plan must be approved by the commissioner prior to
  its implementation.
    (l) No provision of this section shall be  interpreted  to  create  an
  entitlement for any individual to receive community support services.
    (m)  The  commissioner  is  authorized  to  promulgate  regulations to
  implement the provisions of this section.