2023 New York Laws › MHY - Mental Hygiene › Title E - General Provisions › Article 41 - Local Services › 41.47 - Community Support Services Program.

§ 41.47 Community support services program.
(a) As used in this section:
(1) "Approved reimbursable rate" means the maximum rate of payment per
unit  of  service  established  by  the  commissioner  of  mental health
pursuant to subdivision (e) of this section, or the actual unit cost  of
providing community support services, whichever is less, minus revenue.
(2) "Core  services"  means  the  daily managing and monitoring of the
implementation of  the  community  support  services  program  within  a
defined geographical area.
(3) "Designated  adult  home"  means  an  adult care facility which is
licensed by the commissioner of  social  services  pursuant  to  article
seven  of  the social services law, and which has been designated by the
commissioner of mental health as  containing  a  significant  number  of
mentally ill persons who are in need of community support services.
(4) "Designated  shelter  for  the  homeless"  means a shelter for the
homeless which is  licensed  by  the  commissioner  of  social  services
pursuant to article seven of the social services law, and which has been
designated  by  the  commissioner  of  mental  health  as  containing  a
significant number of mentally ill persons who are in need of  community
support services.
(5) "Designated  single  room occupancy residence" means a single room
occupancy, as such term is defined  in  the  multiple  dwelling  law  or
multiple   residence  law,  whichever  is  applicable,  which  has  been
designated  by  the  commissioner  of  mental  health  as  containing  a
significant  number of mentally ill persons who are in need of community
support services.
(6) "Functionally disabled as a result  of  mental  illness"  means  a
person who has a severe, chronic disability which:
(i)  is  caused by a medically determined mental illness, as evidenced
by a primary psychiatric diagnosis;
(ii) is likely to continue for a prolonged period; and
(iii) results in substantial functional limitations in three  or  more
of  the  following  areas:  (A)  self-care,  (B) social functioning, (C)
activities  of  daily  living,  (D)   economic   self-sufficiency,   (E)
self-direction, and (F) ability to concentrate.
(7) "Provider   of   services"  means  the  local  governmental  unit,
voluntary agency, proprietary agency, association, or corporation  which
provides the community support services.
(8) "Qualified  residence"  means  a  community residence, residential
care center for adults,  family  care  home,  or  residential  treatment
facility  for  children  and  youth which is licensed or operated by the
office of mental health.
(9) "Revenue" shall include:
(i) reimbursement for operating costs for community  support  services
received  from  other  local  governmental  units or from state agencies
other than the office of mental health, provided that revenue shall  not
include money received from any source, in the form of grants, awards or
contracts, for purposes other than the support of such operating costs;
(ii) federal aid received for such operating costs;
(iii) fees received from patients, or on their behalf, from public and
private health insurance and medical aid programs;
(iv) other income received from the operation of the community support
services program; and
(v)  interest  and  dividends accruing from funds received pursuant to
this section.
(b) The community support services program shall include services  and
programs  such  as:  case management services, advocacy services, clinic
services, day treatment, day training, continuing  treatment,  homemaker

services,   housekeeping   services,  on-site  rehabilitation  services,
sheltered workshop and other vocational  programs,  psychosocial  clubs,
neighborhood  drop-in  centers, transportation services, non-residential
crisis  services,  outreach services, and other services approved by the
commissioner.
(c) (1)  The  commissioner  may,  upon  the  application  of  a  local
governmental  unit,  and  within  the limits of appropriation therefore,
grant state aid to such local governmental unit for one hundred  percent
of  the  approved  costs  of  providing  community  support  services to
eligible persons, which shall not exceed the approved reimbursable rate,
and the approved costs of providing core  services.  Local  governmental
units  which receive state aid pursuant to this subdivision either shall
directly  provide  community  support  services  or  shall  enter   into
contracts with providers of services for the provision of such services.
Such local governmental units may also provide core services or contract
with voluntary agencies for the provision of such core services.
(2)  Persons who are otherwise ineligible to receive community support
services  pursuant  to  subdivision  (d)  of  this  section,  shall   be
considered  to  be  eligible  to  receive  such services for purposes of
paragraph one of this subdivision, if they  are  certified  pursuant  to
subdivision (d) of this section to be eighteen years of age or older, to
be  functionally  disabled  as a result of mental illness and to have an
ability to remain in the community which would be seriously  jeopardized
without the provision of community support services, but who do not meet
the eligibility criteria of paragraph two or three of subdivision (d) of
this section, provided however, that the provider of services shall make
a reasonable effort to determine such persons' eligibility and, provided
further,  that no more than ten percent of the persons served by a local
governmental unit or a provider of  services  which  directly  contracts
with the office of mental health shall be otherwise ineligible persons.
(d)  (1)  Persons who shall be eligible for community support services
shall include individuals who are eighteen years of age and  older,  who
are  functionally  disabled as a result of mental illness, whose ability
to remain in the community would be seriously  jeopardized  without  the
provision of community support services, and who satisfy the criteria in
either  paragraph  two  or  three  of this subdivision. Such eligibility
shall be certified by  a  licensed  psychiatrist,  nurse,  psychologist,
licensed clinical social worker or a licensed master social worker under
the supervision of a physician, psychologist or licensed clinical social
worker  who  is  approved  by  a local governmental unit, a core service
agency, or the commissioner to certify individuals as being eligible for
community support services.
(2) Persons who may be certified as permanently  eligible  to  receive
community support services pursuant to paragraph one of this subdivision
shall  include individuals who are determined to be eligible pursuant to
regulations promulgated by the commissioner of mental health  and  shall
include  but  not be limited to: (i) persons who have received inpatient
psychiatric services in a hospital, or who have resided in  a  qualified
residence  or a designated adult home for a period or periods of time as
established in such regulations of the commissioner;  (ii)  persons  who
are  in  receipt  of  supplemental  security  income  benefits or social
security disability insurance benefits pursuant to  the  federal  social
security   act,   provided  that  individuals  who  are  in  receipt  of
supplemental security income benefits must have been  determined  to  be
eligible  for  such  benefits prior to reaching sixty-five years of age;
(iii) persons who  are  receiving  community  support  services  on  the
effective   date  of  this  act  pursuant  to  the  regulations  of  the
commissioner in effect on such date, who were determined to be  eligible

for   such   services   based   upon   a   prior  history  of  inpatient
hospitalization; and (iv) other  persons  who  have  received  specified
psychiatric  services, as established pursuant to the regulations of the
commissioner.
(3)  Persons  who  may  be  certified as eligible to receive community
support services pursuant to paragraph one  of  this  subdivision  shall
include  individuals  who  are  residing  in  a designated adult home, a
designated shelter for the homeless, a designated single room  occupancy
residence,  a  qualified  residence,  or  who  are homeless mentally ill
persons. Such persons shall be considered eligible for community support
services for the duration  of  their  participation  in  such  community
support services, and such persons who need such services shall continue
to  be  eligible to receive such services for a period of one year after
receiving any such services.
(4)  Notwithstanding  the  provisions  of  paragraph  three  of   this
subdivision,  persons  who  are residing in designated adult homes or in
designated shelters for the homeless, or who are homeless  persons,  may
receive  on-site  rehabilitation  services or outreach services provided
under this section without a determination of eligibility  as  otherwise
required under this subdivision.
(e)  (1)  The  commissioner  shall  annually  establish  a schedule of
maximum rates of payment per unit of service for reimbursable  community
support services. In establishing such maximum rates of payment per unit
of  service  the  commissioner  may consider geographical variations and
other relevant  considerations.  Such  rates  shall  equal  the  medical
assistance  rates established pursuant to section 43.02 of this chapter,
when applicable. Upon the application of the local governmental unit  or
a  provider  of  services  which  directly  contracts with the office of
mental health to provide community support  services,  the  commissioner
may  authorize  additional  reimbursement  for  a  period of three local
fiscal years after the effective date of this act,  upon  a  showing  of
extraordinarily  high  costs of providing community support services and
extraordinarily high revenue receipts, which have been  demonstrated  to
be appropriate.
(2)  The  commissioner  shall  establish  revenue  goals for services,
provided, however, the commissioner may approve local services plans  or
may  enter  into  direct  contracts  with  providers  of  services which
substitute  alternative  revenue  goals  for  individual  providers   of
services  based  upon  appropriate  documentation  and justification, as
required by the commissioner.
(f) Prior to entering into contracts for the  provision  of  community
support  services,  the  office  of mental health and local governmental
units shall consider the following:
(1) the service needs of mentally ill persons in the geographical area
in which the community support services program operates;
(2) the capacity of the program to meet identified service needs;
(3) the current availability of services for mentally ill  persons  in
the   area,  including  the  special  needs  of  ethnic  minorities  and
non-English speaking mentally ill persons;
(4) the extent to which community support services authorized  by  the
contract will be integrated with other available services in the area to
more effectively maintain mentally ill persons in the community;
(5) the availability of resources for such services;
(6)  the  extent to which the community support services authorized by
the contract are consistent and integrated  with  the  applicable  local
services plan of the area to be served; and
(7)  the  extent  to  which  such  contracts  conform with the minimum
contractual requirements as established by the commissioner.
(g) The  commissioner  may  enter  into  a  direct  contract  for  the
provision   of   community   support   services  when  the  commissioner
determines, after the approval  of  the  local  services  plan  and  the
allocation  of  state  aid  therefore,  that  such  direct  contract  is
necessary  to  assure  that  additional  community  support services are
available to persons who are functionally disabled as a result of mental
illness and are eligible for community support services. Before entering
into a direct contract with a provider  located  within  the  geographic
area of a local governmental unit which receives state aid for community
support services pursuant to this section, the commissioner shall notify
the  local  governmental  unit  and  give  the  director  of  the  local
governmental unit an opportunity to appeal  the  need  for  such  direct
contract.  Such  appeals  shall  be  informal in nature and the rules of
evidence shall not apply.
(h) In order to qualify for one hundred percent state aid pursuant  to
this  section  in  any  local fiscal year local governmental units shall
assure that the local tax levy share of expenditures for  net  operating
costs  pursuant to an approved local services plan for services provided
to mentally ill persons pursuant to section 41.18 of this article  shall
be  equal  to  or  greater  than  the  local  tax  levy  share  of  such
expenditures under an approved local services plan in the last  complete
local  fiscal  year  preceding  the  effective  date  of  this  section,
provided, however, any such required maintenance of  expenditures  under
this  subdivision for local governmental units may be reduced to reflect
the local governmental share of revenue applicable to increased payments
made by governmental agencies pursuant to title eleven of  article  five
of the social services law, which are a result of increased efficiencies
in  the  collection  of  such  revenue  and which represent an increased
proportion of the total local services operating costs  from  the  prior
local  fiscal  year.  The  commissioner  shall  be  authorized to reduce
payments made to local governmental units pursuant to this  article,  in
the following local fiscal year, for failure to maintain expenditures in
accordance with this subdivision.
(i)  The provisions of subdivision (h) of this section shall not apply
to a local governmental unit in any local fiscal year in which the total
amount of state aid granted to  the  local  governmental  unit  for  net
operating  costs  under  section  41.18 of the article is less than such
amount of state aid granted in  the  local  fiscal  year  preceding  the
effective date of this section, or in any local fiscal year in which the
total  amount  of state aid granted to the local governmental unit under
this section, plus the total amount of  direct  contracts  entered  into
between  the commissioner and providers of services for the provision of
community  support  services  to  eligible  residents  of   such   local
governmental  unit,  shall be less than the total amount of such aid and
direct contracts in the first local fiscal year following the  effective
date of this section.
(j)  The  commissioner is authorized and empowered to make inspections
and examine records of a local governmental  unit  receiving  state  aid
under  this  section  or a provider of services which directly contracts
with the office of mental health for the provision of community  support
services.    Such  examination  shall  include  all  medical service and
financial records, receipts, disbursements,  contracts,  loans  and  any
other  moneys  relating  to  the  financial  operation  of the community
support services program.
(k) A local governmental unit in receipt of a grant for the  provision
of  community  support  services  pursuant  to  subdivision  (c) of this
section, which is a unit of a local government with a population of less
than one hundred thousand or which has total  program  expenditures  for

mentally  ill  persons under this article equal to five hundred thousand
dollars or less in a local fiscal year, shall be permitted to  commingle
such  funds  and  the  clients receiving community support services with
other  local  mental  health  program  funds or clients, including local
mental health program funds and  clients  of  other  local  governmental
units.  Such  local governmental unit shall be required to submit a plan
to the commissioner which shall describe how the goals and objectives of
the community support services program shall be maintained under such an
arrangement, and such plan must be approved by the commissioner prior to
its implementation.
(l) No provision of this section shall be  interpreted  to  create  an
entitlement for any individual to receive community support services.
(m)  The  commissioner  is  authorized  to  promulgate  regulations to
implement the provisions of this section.