ASA-49-08-00004-P Problem Gambling Treatment and Recovery Services

12/3/08 N.Y. St. Reg. ASA-49-08-00004-P

NEW YORK STATE REGISTER

VOLUME XXX, ISSUE 49

December 03, 2008

RULE MAKING ACTIVITIES

OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES

PROPOSED RULE MAKING

NO HEARING(S) SCHEDULED

 

I.D No. ASA-49-08-00004-P

Problem Gambling Treatment and Recovery Services

PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following proposed rule:

Proposed Action:

Addition of Part 857 to Title 14 NYCRR.

Statutory authority:

Mental Hygiene Law, sections 19.07, 32.01, 32.02 and 32.07(a)

Subject:

Problem gambling treatment and recovery services.

Purpose:

Part 857 establishes criteria for problem gambling services.

Substance of proposed rule (Full text is posted at the following State website: www.oasas.state.ny.us):

Problem Gambling Services, Part 857 creates a standardized set of requirements within the field of problem gambling addiction recovery services, so that each of the service providers is delivering the same or similar services to persons suffering from problem gambling throughout the State.

The regulation defines the admission procedure, recordkeeping, quality improvement and utilization review procedure, staff patterns and qualifications, as well as treatment planning and program requirements.

The delivery of problem gambling services and its treatment modality is different from the delivery of chemical dependency services, therefore this regulation establishes the first protocol for gambling services through OASAS which will enable providers to give the best possible care to those suffering from problem gambling and their families.

Text of proposed rule and any required statements and analyses may be obtained from:

Patricia Flaherty, Associate Counsel, OASAS, 1450 Western Avenue, Albany New York 12203, [phone], email: [e-mail]

Data, views or arguments may be submitted to:

Same as above.

Public comment will be received until:

45 days after publication of this notice.

Regulatory Impact Statement

1. Statutory Authority: Section 19.09(b) of the Mental Hygiene Law authorizes the Commissioner to adopt regulations necessary and proper to implement any matter under his or her jurisdiction. In addition, the regulations were sent to the existing members of the Advisory Council on Alcoholism and Substance Abuse Services who were given an opportunity to comment.

Section 32.01 of the Mental Hygiene Law authorizes the Commissioner to adopt any regulation reasonably necessary to implement and effectively exercise the powers and perform the duties conferred by Article 32.

Section 32.02 of the Mental Hygiene Law states the Commissioner of the Office of Alcoholism and Substance Abuse Services may adopt regulations necessary to ensure quality services to those suffering from problem gambling.

Section 32.07(a) of the Mental Hygiene Law gives the Commissioner the power to adopt regulations to effectuate the provisions and purposes of Article 32.

The relevant sections of the Mental Hygiene Law cited above, allow the Commissioner to regulate the administration of problem gambling services. Problem gambling will be treated and persons seeking treatment for their addictions will be provided the opportunity to also deal with their gambling problem. Additionally, those persons suffering with a diagnosis of problem gambling without a chemical dependency can also get treatment. This objective is in line with the legislative intent of Sections 19 and 32 of the Mental Hygiene Law, allowing the Commissioner to certify, inspect, license and establish treatment standards for all facilities that treat gambling and chemical dependency. This Part establishes a treatment standard for all service providers that is in the best interest of the client by providing better health care and a stronger basis of recovery from problem gambling.

2. Legislative Objectives: Section 32.02 of the Mental Health Law allows the promulgation of rules and regulations to regulate and assure the consistent high quality of services provided within the state to persons suffering from compulsive gambling. The proposed Part 857 will assure that patients, and their families receive the best care and treatment. Treating problem gambling along with chemical dependency is within the Commissioner's jurisdiction and responsibilities under 32.02 and 19.07(e) of the Mental Hygiene Law.

3. Needs and Benefits: This rule is necessary to fulfill the purpose of section 32.02, and Article 32 in its entirety which provisions are applicable to gambling services as stated in 32.02 (b). There are currently no regulations for problem gambling services, therefore a regulation which sets out the objectives, standards, policy and expectations of gambling services providers is necessary to comply with the above referenced statute. This regulation will aid providers in understanding the requirements of the statute, and provides guidelines for the effective treatment of problem gambling. Persons suffering from problem gambling will benefit greatly from having providers adhere to a common set of expectations.

4. Costs: There will be no additional cost to the State or existing operating entities to implement this new regulation as programs are currently operating under the standards included in this regulation.

5. Local Government Mandates: There are no new mandates or administrative requirements placed on local governments.

6. Paperwork: Part 857 will require some paperwork for certified and or funded providers in order to ensure that utilization review requirements are met. However, since utilization control is presently required and providers are already familiar with utilization control record keeping, it is not expected that new record keeping requirements will be excessive. In addition some providers who are approaching the excessive services threshold will have to justify, based upon good clinical practice and specific patient needs, that the amount of services they are providing to patients is appropriate.

7. Duplication: There is no duplication of other state or federal requirements.

8. Alternatives: The alternative is to allow this area of treatment to be unregulated or to continue to provide these services through contracts. This vehicle for ensuring compliance with consistent standards of care is less viable than a regulation. The provider community commented positively in that this regulation will assist in moving forward with the viability of treatment services including possible Medicaid reimbursement.

9. Federal Standards: There are no minimum federal standards.

10. Compliance Schedule: Upon adoption.

Regulatory Flexibility Analysis

Effect of the Rule: The proposed Part 857 will impact problem gambling service providers that are currently being funded by OASAS and have contracts with the agency to provide this service. There are approximately seventeen providers currently operating in the State. It is expected that the development of the Problem Gambling Services regulation may require providers to incorporate additional standards into their current practice. However, all of the existing programs have been regulated by OASAS through contracts that specify these same standards. Therefore, the existing funded programs operations will not change significantly. These standards will not only result in better patient treatment, but more efficient and effective programs.

Local governments and districts will not be affected by this regulation.

Compliance Requirements: It is not expected that there will be significant changes in compliance requirements. Since providers are already required to adhere to many of the standards proposed in this regulation by way of their contracts with OASAS it is not expected that this regulation, which provides additional guidance on good utilization review practices, will have additional costs.

Professional Services: It is not expected that programs will need to utilize additional professional services.

Compliance Costs: Some programs may need additional staff to meet the proposed requirements; however, existing fees reimburse a sufficient staffing ratio to meet these requirements. Current problem gambling programs are bound by contract with OASAS now, and the conditions of the contract are substantially the same as the proposed regulation.

Economic and Technological Feasibility: Compliance with the recordkeeping and reporting requirements of the proposed Part 857 is not expected to have an economic impact or require any changes to technology for small businesses and government.

Minimizing Adverse Impact: Part 857 has been carefully reviewed to ensure minimum adverse impact to providers. Alcoholism and Substance Abuse Providers of NYS, Inc., the Council of Local Mental Hygiene Directors and the Advisory Council on Alcoholism and Substance Abuse Services, OASAS funded Problem Gambling Prevention and Treatment Providers and the OASAS Problem Gambling Policy Committee were briefed on this proposal.

Small Business and Local Government Participation: These amendments were shared with New York's treatment provider and the Advisory Council on Alcoholism and Substance Abuse Services were briefed on this proposal.

Rural Area Flexibility Analysis

A rural flexibility analysis is not provided since these proposed regulations would have no adverse impact on public or private entities in rural areas. The regulation makes the provision of problem gambling services voluntary, and therefore does not mandate the service in any area. The compliance, recordkeeping and paperwork requirements are the minimum needed to insure compliance with state and federal requirements and quality patient care.

Job Impact Statement

The implementation of Part 857 will potentially create new jobs in that it creates a new service that can be performed either in a stand alone clinic or within a chemical dependency service. This regulation will not adversely impact jobs outside of the agency. Part 857 will not result in the loss of any jobs within New York State.