PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following proposed rule:
Proposed Action:
Amendment of Part 512 of Title 14 NYCRR.
Statutory authority:
Mental Hygiene Law, sections 7.09, 31.04 and 43.02; and Social Services Law, section 365-m
Subject:
Personalized Recovery Oriented Services (PROS).
Purpose:
To add provisions regarding Behavioral Health Organization (BHO) implementation.
Text of proposed rule:
1. 14 NYCRR Part 512 is amended as follows:
PART 512
PERSONALIZED RECOVERY ORIENTED SERVICES
(Statutory Authority: Mental Hygiene Law, §§ 7.09(b), 31.04, 41.05, 43.01, 43.02; and Social Services Law, §§ 364(3), 364-a(1), 365-m)
2. A new subdivision (g) is added to Section 512.2 of Title 14 NYCRR to read as follows:
(g) Section 365-m of the Social Services Law authorizes the Commissioner of the Office of Mental Health and the Commissioner of the Office of Alcoholism and Substance Abuse Services, in consultation with the Department of Health, to contract with regional behavioral health organizations to provide administrative and management services for the provision of behavioral health services.
3. New subdivisions (d) and (l) are added to Section 512.4 of Title 14 NYCRR to read as follows. The remaining subdivisions are re-lettered accordingly.
(d) Behavioral Health Organization or BHO means an entity selected by the Commissioner of the Office of Mental Health and the Commissioner of the Office of Alcoholism and Substance Abuse Services pursuant to Section 365-m of the New York State Social Services Law to provide administrative and management services for the purposes of conducting concurrent review of Behavioral Health admissions to inpatient treatment settings, assisting in the coordination of Behavioral Health Services, and facilitating the integration of such services with physical health care.
(l) Concurrent Review shall mean the review of the clinical necessity for continued inpatient Behavioral Health Services, resulting in a non-binding recommendation regarding the need for such continued inpatient services.
4. A new Section 512.19 is added to Title 14 NYCRR Part 512 to read as follows:
512.19 Behavioral health organizations.
Providers shall cooperate with the designated regional behavioral health organizations and shall be authorized pursuant to Section 33.13(d) of the Mental Hygiene Law to exchange clinical information concerning clients with such organizations. Information so exchanged shall be limited to the minimum necessary in light of the reason for the disclosure. Such information shall be kept confidential and any limitations on the release of such information imposed on the party giving such information shall apply to the party receiving such information.
Text of proposed rule and any required statements and analyses may be obtained from:
Joyce Donohue, NYS Office of Mental Health, 44 Holland Avenue, Albany, NY 12229, (518) 474-1331, email: Joyce.Donohue@omh.ny.gov
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: Sections 7.09 and 31.04 of the Mental Hygiene Law grant the Commissioner of the Office of Mental Health the power and responsibility to plan, establish and evaluate programs and services for the benefit of individuals with mental illness and to adopt regulations that are necessary and proper to implement matters under his or her jurisdiction.
Section 43.02 of the Mental Hygiene Law gives the Commissioner the authority to request from operators of facilities licensed by the Office of Mental Health such financial, statistical and program information as the Commissioner may determine to be necessary.
Section 365-m of the Social Services Law authorizes the Commissioner of the Office of Mental Health and the Commissioner of the Office of Alcoholism and Substance Abuse Services, in consultation with the Department of Health, to contract with regional behavioral health organizations to provide administrative and management services for the provision of behavioral health services.
2. Legislative objectives: Chapter 59 of the Laws of 2011 authorizes the Office of Mental Health and the Office of Alcoholism and Substance Abuse Services to contract with regional behavioral health organizations to provide administrative and management services for the provision of behavioral health services. The intent of this legislation is to facilitate the coordination of mental health and substance use services and physical health care services for individuals with significant behavioral health needs.
3. Needs and benefits: A key element of the New York State Medicaid agenda is to increase the quality and efficiency of the Medicaid program and reduce Medicaid costs. To accomplish these objectives, Governor Cuomo issued Executive Order No. 5 to convene a Medicaid Redesign Team (MRT), consisting of representatives from the legislature, health care industry, patient advocacy groups, and State executive staff including the Commissioners of the Office of Mental Health and the Office of Alcoholism and Substance Abuse Services and the New York State Medicaid Director. One of the MRT recommendations that was adopted into New York State Law authorizes the Commissioners of the Office of Mental Health and the Office of Alcoholism and Substance Abuse Services to jointly select and contract for the services of one or more regional Behavioral Health Organizations (BHO). The BHOs shall provide administrative and management services for the purposes of conducting concurrent review of inpatient behavioral health services and coordinating the provision of behavioral health services and other services available under the Medicaid Program. After a successful procurement, five regional BHOs were selected. The amendments to 14 NYCRR Part 512 necessary to inform providers of Personalized Recovery Oriented Services (PROS) of the requirements and expectations of the Office of Mental Health with respect to the BHO implementation.
4. Costs:
a) Costs to state government: These regulatory amendments will not result in any additional costs to State government.
b) Costs to local government: These regulatory amendments will not result in any additional costs to local government.
c) Costs to regulated parties: There will be no fiscal impact, nor will there be any change in reimbursement or rates of payments to regulated parties as a result of these regulatory amendments.
5. Local government mandates: These regulatory amendments will not result in any additional imposition of duties or responsibilities upon county, city, town, village, school or fire districts.
6. Paperwork: This rule should not have a significant increase in the paperwork requirements of providers.
7. Duplication: These regulatory amendments do not duplicate existing State or federal requirements.
8. Alternatives: The only alternative to the regulatory amendment would be inaction. BHO implementation is consistent with statute. PROS providers must be aware of their responsibilities and the requirements associated with the BHO implementation; this rule making clarifies those responsibilities and makes clear the Office's expectations with respect to BHO implementation. Therefore, that alternative was not considered.
9. Federal standards: The regulatory amendments do not exceed any minimum standards of the federal government for the same or similar subject areas.
10. Compliance schedule: These regulatory amendments are effective immediately upon adoption.
Regulatory Flexibility Analysis
A Regulatory Flexibility Analysis for Small Businesses and Local Governments is not being submitted with this notice because the amended rule will not have an adverse economic impact upon small businesses or local governments. The rule making merely serves to clarify the expectations of the Office of Mental Health regarding Behavioral Health Organization (BHO) implementation and notify Personalized Recovery Oriented Services (PROS) providers of their responsibilities as a result of the BHO implementation.
Rural Area Flexibility Analysis
The amendments to Part 512 of Title 14 NYCRR serve to clarify the expectations of the Office of Mental Health regarding Behavioral Health Organization (BHO) implementation and notify Personalized Recovery Oriented Services (PROS) providers of their responsibilities as a result of the BHO implementation. The amendments will not impose any adverse economic impact on rural areas; therefore, a Rural Area Flexibility Analysis is not submitted with this notice.
Job Impact Statement
A Job Impact Statement is not submitted with this notice because the purpose of this rule making is merely to clarify the expectations of the Office of Mental Health regarding Behavioral Health Organization (BHO) implementation and notify Personalized Recovery Oriented Services (PROS) providers of their responsibilities as a result of the BHO implementation. There will be no adverse impact on jobs and employment opportunities as a result of this rulemaking.
