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

CONTENTS

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 intervention; 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 authority 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 administration 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); implementing 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:
  • 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;
  • 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;
  • Section 5 amends PHL §2808(12)(d) to incentivize the rehabilitation and renovation of facilities eligible for residual capital reimbursement; and
  • 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 organizations 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 avoid $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.