OMH-46-14-00005-A Vital Access Program and Providers
1/28/15 N.Y. St. Reg. OMH-46-14-00005-A
NEW YORK STATE REGISTER
VOLUME XXXVII, ISSUE 4
January 28, 2015
RULE MAKING ACTIVITIES
OFFICE OF MENTAL HEALTH
NOTICE OF ADOPTION
I.D No. OMH-46-14-00005-A
Filing No. 23
Filing Date. Jan. 09, 2015
Effective Date. Jan. 28, 2015
Vital Access Program and Providers
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:
Action taken:
Addition of Part 530 to Title 14 NYCRR.
Statutory authority:
Mental Hygiene Law, sections 7.09, 31.02 and 43.02; L. 2014, ch. 53
Subject:
Vital Access Program and Providers.
Purpose:
To establish a process by which providers may be designated as Vital Access Providers to receive supplemental funding.
Text of final rule:
A new Part 530 is added to 14 NYCRR to read as follows:
PART 530
VITAL ACCESS PROGRAM and PROVIDERS
(Statutory authority: Mental Hygiene Law §§ 7.09, 31.02, 43.02, Chapter 53 of the Laws of 2014)
530.1 Background and Intent.
The purpose of this Part is to provide a means to support the stability and geographic distribution of mental health clinic services throughout all geographic and economic regions of the State. A designation of Vital Access Provider denotes the Commissioner’s determination to ensure patient access to a provider’s essential services otherwise jeopardized by the provider’s payer mix or geographic isolation.
530.2 Legal Base.
(a) Section 7.09 of the Mental Hygiene Law authorizes the Commissioner to adopt regulations that are necessary and proper to implement matters under his or her jurisdiction.
(b) Section 31.02 of the Mental Hygiene Law authorizes the Commissioner to issue operating certificates for the provision of inpatient and outpatient mental health services.
(c) Section 43.02 of the Mental Hygiene Law authorizes the Office to establish rates or methods of payment for services at facilities subject to licensure or certification by the Office.
(d) Chapter 53 of the Laws of 2014 authorizes the Commissioner to provide special funding to certain designated providers.
530.3 Definitions.
(a) Vital Access Program (“VAP”) means a program of supplemental funding and/or temporary rate or fee adjustments available to providers of mental health services that are determined by the Commissioner to be essential to the availability of mental health services in a geographic or economic region of the State but in financial jeopardy due to their payer mix or geographic isolation.
(b) Vital Access Provider means a provider of mental health clinic services that is licensed under Article 31 of the Mental Hygiene Law and that is designated by the Commissioner as eligible for participation in the Vital Access Program. It does not include a provider that is licensed under Article 28 of the Public Health Law.
530.4 Vital Access Program.
(a) The Commissioner may accept applications from licensed providers of mental health clinic services requesting designation as a Vital Access Provider eligible to receive supplemental funding or a temporary rate adjustment. The Commissioner may give priority to providers serving regions or populations in the State that he or she shall determine are in special need of services. Such applications must sufficiently demonstrate that:
(1) The provider is essential to maintaining access to the mental health services it is authorized to provide to individuals with mental illness who reside in the geographic or economic region of the State served by the provider;
(2) The provider is in financial jeopardy due to payer mix or geographic isolation;
(3) The additional resources provided by supplemental funding or a rate or fee adjustment will achieve one or more of the following:
(i) protect or enhance access to care;
(ii) protect or enhance quality of care;
(iii) improve the cost effectiveness of the delivery of health care services; or
(iv) otherwise protect or enhance the health care delivery system, as determined by the Commissioner.
(b) Application.
(1) The written application required pursuant to subdivision (a) of this Section shall be submitted to the Commissioner at least sixty (60) days prior to the requested effective date of the designation as a Vital Access Provider and shall include a proposed budget to achieve the goals identified in the application.
(2) The Commissioner may require that applications submitted pursuant to this Section be submitted in response to, and in accordance with, a Request For Applications or a Request For Proposals issued by the Office.
(c) Reimbursement.
A provider that is designated as a Vital Access Provider shall be eligible to receive supplemental funding or a temporary rate or fee adjustment.
(d) Conditions on Approval.
(1) Any temporary rate adjustment issued pursuant to this section shall be in effect for a specified period of time of no more than three years, as determined by the Commissioner, based upon review and approval of a specific plan of action to achieve one or more of the goals set forth in subdivision (a) of this section. At the end of the specified timeframe, the provider shall be reimbursed in accordance with the otherwise applicable rate-setting methodology or fee schedule pertaining to such provider.
(2) The Commissioner may establish, as a condition of designation as a Vital Access Provider, benchmarks, goals and standards to be achieved, and may require such periodic reports as he or she shall determine to be necessary to ensure their achievement. A determination by the Commissioner of a failure to demonstrate satisfactory progress in achieving such benchmarks, goals and standards shall be a basis for revoking the provider’s designation as a Vital Access Provider, and terminating the supplemental funding or temporary rate or fee adjustment prior to the end of the specified timeframe.
(3) No portion of the funds received pursuant to this Part shall be used for the payment of any prior debt or obligation incurred by the designated provider, or for any purpose not related to the purposes set forth in this Part.
Final rule as compared with last published rule:
Nonsubstantive changes were made in section 530.4(d)(1) and (2).
Text of rule and any required statements and analyses may be obtained from:
Sue Watson, NYS Office of Mental Health, 44 Holland Avenue, Albany, NY 12229, (518) 474-1331, email: Sue.Watson@omh.ny.gov
Revised Regulatory Impact Statement
The changes made to the published rule do not necessitate revision to the previously published Regulatory Impact Statement (“RIS”) for the regulatory filing to create a new 14 NYCRR Part 503 – Vital Access Program and Providers. The revisions to the rule merely clarify the text by correcting technical errors (i.e., citation and grammar), which require no change to the RIS.
Revised Regulatory Flexibility Analysis
The changes made to the published rule do not necessitate revision to the previously published Regulatory Flexibility Analysis for Small Business and Local Governments (“RFASBLG”) for the regulatory filing to create a new 14 NYCRR Part 530 – Vital Access Program and Providers. The revisions to the rule merely clarify the text by correcting technical errors (i.e., citation and grammar), which require no change to the RFASBLG.
Revised Rural Area Flexibility Analysis
The changes made to the published rule do not necessitate revision to the previously published Rural Area Flexibility Analysis (“RAFA”) for the regulatory filing to create a new 14 NYCRR Part 530 – Vital Access Program and Providers. The revisions to the rule merely clarify the text by correcting technical errors (i.e., citation and grammar), which require no change to the RAFA.
Revised Job Impact Statement
The changes made to the published rule do not necessitate revision to the previously published Job Impact Statement (“JIS”) for the regulatory filing to create a new 14 NYCRR Part 530 – Vital Access Program and Providers. The revisions to the rule merely clarify the text by correcting technical errors (i.e., citation and grammar), which require no change to the JIS.
Initial Review of Rule
As a rule that does not require a RFA, RAFA or JIS, this rule will be initially reviewed in the calendar year 2020, which is no later than the 5th year after the year in which this rule is being adopted.
