§ 41.47 — Community support services program

New York § 41.47

• Jurisdiction: New York
• Law MHY: Mental Hygiene
• Title E: General Provisions
• Art. 41: Local Services

Text

§ 41.47 Community support services program.\n (a) As used in this section:\n (1) "Approved reimbursable rate" means the maximum rate of payment per\nunit of service established by the commissioner of mental health\npursuant to subdivision (e) of this section, or the actual unit cost of\nproviding community support services, whichever is less, minus revenue.\n (2) "Core services" means the daily managing and monitoring of the\nimplementation of the community support services program within a\ndefined geographical area.\n (3) "Designated adult home" means an adult care facility which is\nlicensed by the commissioner of social services pursuant to article\nseven of the social services law, and which has been designated by the\ncommissioner of mental health as containing a significant number of\nmentally ill persons who are in need of community support services.\n (4) "Designated shelter for the homeless" means a shelter for the\nhomeless which is licensed by the commissioner of social services\npursuant to article seven of the social services law, and which has been\ndesignated by the commissioner of mental health as containing a\nsignificant number of mentally ill persons who are in need of community\nsupport services.\n (5) "Designated single room occupancy residence" means a single room\noccupancy, as such term is defined in the multiple dwelling law or\nmultiple residence law, whichever is applicable, which has been\ndesignated by the commissioner of mental health as containing a\nsignificant number of mentally ill persons who are in need of community\nsupport services.\n (6) "Functionally disabled as a result of mental illness" means a\nperson who has a severe, chronic disability which:\n (i) is caused by a medically determined mental illness, as evidenced\nby a primary psychiatric diagnosis;\n (ii) is likely to continue for a prolonged period; and\n (iii) results in substantial functional limitations in three or more\nof the following areas: (A) self-care, (B) social functioning, (C)\nactivities of daily living, (D) economic self-sufficiency, (E)\nself-direction, and (F) ability to concentrate.\n (7) "Provider of services" means the local governmental unit,\nvoluntary agency, proprietary agency, association, or corporation which\nprovides the community support services.\n (8) "Qualified residence" means a community residence, residential\ncare center for adults, family care home, or residential treatment\nfacility for children and youth which is licensed or operated by the\noffice of mental health.\n (9) "Revenue" shall include:\n (i) reimbursement for operating costs for community support services\nreceived from other local governmental units or from state agencies\nother than the office of mental health, provided that revenue shall not\ninclude money received from any source, in the form of grants, awards or\ncontracts, for purposes other than the support of such operating costs;\n (ii) federal aid received for such operating costs;\n (iii) fees received from patients, or on their behalf, from public and\nprivate health insurance and medical aid programs;\n (iv) other income received from the operation of the community support\nservices program; and\n (v) interest and dividends accruing from funds received pursuant to\nthis section.\n (b) The community support services program shall include services and\nprograms such as: case management services, advocacy services, clinic\nservices, day treatment, day training, continuing treatment, homemaker\nservices, housekeeping services, on-site rehabilitation services,\nsheltered workshop and other vocational programs, psychosocial clubs,\nneighborhood drop-in centers, transportation services, non-residential\ncrisis services, outreach services, and other services approved by the\ncommissioner.\n (c) (1) The commissioner may, upon the application of a local\ngovernmental unit, and within the limits of appropriation therefore,\ngrant state aid to such local governmental unit for one hundred percent\nof the approved costs of providing community support services to\neligible persons, which shall not exceed the approved reimbursable rate,\nand the approved costs of providing core services. Local governmental\nunits which receive state aid pursuant to this subdivision either shall\ndirectly provide community support services or shall enter into\ncontracts with providers of services for the provision of such services.\nSuch local governmental units may also provide core services or contract\nwith voluntary agencies for the provision of such core services.\n (2) Persons who are otherwise ineligible to receive community support\nservices pursuant to subdivision (d) of this section, shall be\nconsidered to be eligible to receive such services for purposes of\nparagraph one of this subdivision, if they are certified pursuant to\nsubdivision (d) of this section to be eighteen years of age or older, to\nbe functionally disabled as a result of mental illness and to have an\nability to remain in the community which would be seriously jeopardized\nwithout the provision of community support services, but who do not meet\nthe eligibility criteria of paragraph two or three of subdivision (d) of\nthis section, provided however, that the provider of services shall make\na reasonable effort to determine such persons' eligibility and, provided\nfurther, that no more than ten percent of the persons served by a local\ngovernmental unit or a provider of services which directly contracts\nwith the office of mental health shall be otherwise ineligible persons.\n (d) (1) Persons who shall be eligible for community support services\nshall include individuals who are eighteen years of age and older, who\nare functionally disabled as a result of mental illness, whose ability\nto remain in the community would be seriously jeopardized without the\nprovision of community support services, and who satisfy the criteria in\neither paragraph two or three of this subdivision. Such eligibility\nshall be certified by a licensed psychiatrist, nurse, psychologist,\nlicensed clinical social worker or a licensed master social worker under\nthe supervision of a physician, psychologist or licensed clinical social\nworker who is approved by a local governmental unit, a core service\nagency, or the commissioner to certify individuals as being eligible for\ncommunity support services.\n (2) Persons who may be certified as permanently eligible to receive\ncommunity support services pursuant to paragraph one of this subdivision\nshall include individuals who are determined to be eligible pursuant to\nregulations promulgated by the commissioner of mental health and shall\ninclude but not be limited to: (i) persons who have received inpatient\npsychiatric services in a hospital, or who have resided in a qualified\nresidence or a designated adult home for a period or periods of time as\nestablished in such regulations of the commissioner; (ii) persons who\nare in receipt of supplemental security income benefits or social\nsecurity disability insurance benefits pursuant to the federal social\nsecurity act, provided that individuals who are in receipt of\nsupplemental security income benefits must have been determined to be\neligible for such benefits prior to reaching sixty-five years of age;\n(iii) persons who are receiving community support services on the\neffective date of this act pursuant to the regulations of the\ncommissioner in effect on such date, who were determined to be eligible\nfor such services based upon a prior history of inpatient\nhospitalization; and (iv) other persons who have received specified\npsychiatric services, as established pursuant to the regulations of the\ncommissioner.\n (3) Persons who may be certified as eligible to receive community\nsupport services pursuant to paragraph one of this subdivision shall\ninclude individuals who are residing in a designated adult home, a\ndesignated shelter for the homeless, a designated single room occupancy\nresidence, a qualified residence, or who are homeless mentally ill\npersons. Such persons shall be considered eligible for community support\nservices for the duration of their participation in such community\nsupport services, and such persons who need such services shall continue\nto be eligible to receive such services for a period of one year after\nreceiving any such services.\n (4) Notwithstanding the provisions of paragraph three of this\nsubdivision, persons who are residing in designated adult homes or in\ndesignated shelters for the homeless, or who are homeless persons, may\nreceive on-site rehabilitation services or outreach services provided\nunder this section without a determination of eligibility as otherwise\nrequired under this subdivision.\n (e) (1) The commissioner shall annually establish a schedule of\nmaximum rates of payment per unit of service for reimbursable community\nsupport services. In establishing such maximum rates of payment per unit\nof service the commissioner may consider geographical variations and\nother relevant considerations. Such rates shall equal the medical\nassistance rates established pursuant to section 43.02 of this chapter,\nwhen applicable. Upon the application of the local governmental unit or\na provider of services which directly contracts with the office of\nmental health to provide community support services, the commissioner\nmay authorize additional reimbursement for a period of three local\nfiscal years after the effective date of this act, upon a showing of\nextraordinarily high costs of providing community support services and\nextraordinarily high revenue receipts, which have been demonstrated to\nbe appropriate.\n (2) The commissioner shall establish revenue goals for services,\nprovided, however, the commissioner may approve local services plans or\nmay enter into direct contracts with providers of services which\nsubstitute alternative revenue goals for individual providers of\nservices based upon appropriate documentation and justification, as\nrequired by the commissioner.\n (f) Prior to entering into contracts for the provision of community\nsupport services, the office of mental health and local governmental\nunits shall consider the following:\n (1) the service needs of mentally ill persons in the geographical area\nin which the community support services program operates;\n (2) the capacity of the program to meet identified service needs;\n (3) the current availability of services for mentally ill persons in\nthe area, including the special needs of ethnic minorities and\nnon-English speaking mentally ill persons;\n (4) the extent to which community support services authorized by the\ncontract will be integrated with other available services in the area to\nmore effectively maintain mentally ill persons in the community;\n (5) the availability of resources for such services;\n (6) the extent to which the community support services authorized by\nthe contract are consistent and integrated with the applicable local\nservices plan of the area to be served; and\n (7) the extent to which such contracts conform with the minimum\ncontractual requirements as established by the commissioner.\n (g) The commissioner may enter into a direct contract for the\nprovision of community support services when the commissioner\ndetermines, after the approval of the local services plan and the\nallocation of state aid therefore, that such direct contract is\nnecessary to assure that additional community support services are\navailable to persons who are functionally disabled as a result of mental\nillness and are eligible for community support services. Before entering\ninto a direct contract with a provider located within the geographic\narea of a local governmental unit which receives state aid for community\nsupport services pursuant to this section, the commissioner shall notify\nthe local governmental unit and give the director of the local\ngovernmental unit an opportunity to appeal the need for such direct\ncontract. Such appeals shall be informal in nature and the rules of\nevidence shall not apply.\n (h) In order to qualify for one hundred percent state aid pursuant to\nthis section in any local fiscal year local governmental units shall\nassure that the local tax levy share of expenditures for net operating\ncosts pursuant to an approved local services plan for services provided\nto mentally ill persons pursuant to section 41.18 of this article shall\nbe equal to or greater than the local tax levy share of such\nexpenditures under an approved local services plan in the last complete\nlocal fiscal year preceding the effective date of this section,\nprovided, however, any such required maintenance of expenditures under\nthis subdivision for local governmental units may be reduced to reflect\nthe local governmental share of revenue applicable to increased payments\nmade by governmental agencies pursuant to title eleven of article five\nof the social services law, which are a result of increased efficiencies\nin the collection of such revenue and which represent an increased\nproportion of the total local services operating costs from the prior\nlocal fiscal year. The commissioner shall be authorized to reduce\npayments made to local governmental units pursuant to this article, in\nthe following local fiscal year, for failure to maintain expenditures in\naccordance with this subdivision.\n (i) The provisions of subdivision (h) of this section shall not apply\nto a local governmental unit in any local fiscal year in which the total\namount of state aid granted to the local governmental unit for net\noperating costs under section 41.18 of the article is less than such\namount of state aid granted in the local fiscal year preceding the\neffective date of this section, or in any local fiscal year in which the\ntotal amount of state aid granted to the local governmental unit under\nthis section, plus the total amount of direct contracts entered into\nbetween the commissioner and providers of services for the provision of\ncommunity support services to eligible residents of such local\ngovernmental unit, shall be less than the total amount of such aid and\ndirect contracts in the first local fiscal year following the effective\ndate of this section.\n (j) The commissioner is authorized and empowered to make inspections\nand examine records of a local governmental unit receiving state aid\nunder this section or a provider of services which directly contracts\nwith the office of mental health for the provision of community support\nservices. Such examination shall include all medical service and\nfinancial records, receipts, disbursements, contracts, loans and any\nother moneys relating to the financial operation of the community\nsupport services program.\n (k) A local governmental unit in receipt of a grant for the provision\nof community support services pursuant to subdivision (c) of this\nsection, which is a unit of a local government with a population of less\nthan one hundred thousand or which has total program expenditures for\nmentally ill persons under this article equal to five hundred thousand\ndollars or less in a local fiscal year, shall be permitted to commingle\nsuch funds and the clients receiving community support services with\nother local mental health program funds or clients, including local\nmental health program funds and clients of other local governmental\nunits. Such local governmental unit shall be required to submit a plan\nto the commissioner which shall describe how the goals and objectives of\nthe community support services program shall be maintained under such an\narrangement, and such plan must be approved by the commissioner prior to\nits implementation.\n (l) No provision of this section shall be interpreted to create an\nentitlement for any individual to receive community support services.\n (m) The commissioner is authorized to promulgate regulations to\nimplement the provisions of this section.\n