STATE OF NEW YORK
________________________________________________________________________
5084--C
2021-2022 Regular Sessions
IN SENATE
February 23, 2021
___________
Introduced by Sens. HARCKHAM, ADDABBO, BROUK, GOUNARDES -- read twice
and ordered printed, and when printed to be committed to the Committee
on Alcoholism and Substance Abuse -- committee discharged, bill
amended, ordered reprinted as amended and recommitted to said commit-
tee -- committee discharged, bill amended, ordered reprinted as
amended and recommitted to said committee -- recommitted to the
Committee on Alcoholism and Substance Abuse in accordance with Senate
Rule 6, sec. 8 -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee
AN ACT to amend the mental hygiene law, in relation to creating the
office of addiction and mental health services
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivisions 2 and 2-a of section 1.03 of the mental
2 hygiene law, subdivision 2 as amended and subdivision 2-a as added by
3 chapter 281 of the laws of 2019, are amended to read as follows:
4 2. ["Commissioner" means the commissioner of mental health,] "Commis-
5 sioner" means the commissioner of addiction and mental health services
6 and the commissioner of developmental disabilities [and the commissioner
7 of addiction services and supports] as used in this chapter. Any power
8 or duty heretofore assigned to the commissioner of mental hygiene or to
9 the department of mental hygiene pursuant to this chapter shall hereaft-
10 er be assigned to the commissioner of [mental health] addiction and
11 mental health services in the case of facilities, programs, or services
12 for individuals with [mental illness] a mental health diagnosis, to the
13 commissioner of developmental disabilities in the case of facilities,
14 programs, or services for individuals with developmental disabilities,
15 to the commissioner of addiction [services] and [supports] mental health
16 services in the case of facilities, programs, or addiction disorder
17 services in accordance with the provisions of titles D and E of this
18 chapter.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD09785-07-1
S. 5084--C 2
1 2-a. Notwithstanding any other section of law or regulation, on and
2 after the effective date of this subdivision, any and all references to
3 the office of alcoholism and substance abuse services and the predeces-
4 sor agencies to the office of alcoholism and substance abuse services
5 including the division of alcoholism and alcohol abuse and the division
6 of substance abuse services and all references to the office of mental
7 health, shall be known as the "office of addiction [services] and
8 [supports] mental health services." Nothing in this subdivision shall
9 be construed as requiring or prohibiting the further amendment of stat-
10 utes or regulations to conform to the provisions of this subdivision.
11 § 2. Section 5.01 of the mental hygiene law, as amended by chapter 281
12 of the laws of 2019, is amended and two new sections 5.01-a and 5.01-b
13 are added to read as follows:
14 § 5.01 Department of mental hygiene.
15 There shall continue to be in the state government a department of
16 mental hygiene. Within the department there shall be the following
17 autonomous offices:
18 (1) office of addiction and mental health services; and
19 (2) office for people with developmental disabilities[;
20 (3) office of addiction services and supports].
21 § 5.01-a Office of addiction and mental health services.
22 (a) The office of addiction and mental health services shall be a new
23 office within the department formed by the integration of the offices
24 and services of mental health and addiction services and supports which
25 shall focus on the integration of care and issues related to both mental
26 illness and addiction in the state and carry out the intent of the
27 legislature in establishing the offices pursuant to articles seven and
28 nineteen of this chapter. The office of addiction and mental health
29 services is charged with ensuring the development of comprehensive plans
30 for the integration of programs and services in the area of research,
31 prevention, care and treatment, co-occuring disorders, rehabilitation,
32 education and training, and shall be staffed to perform the responsibil-
33 ities attributed to the office pursuant to sections 7.07 and 19.07 of
34 this chapter and provide integrated services and programs to promote
35 recovery for individuals with a mental health diagnosis, substance use
36 disorder, or a mental health diagnosis and substance use disorder.
37 (b) The commissioner of the office of addiction and mental health
38 services shall be vested with the powers, duties, and obligations of the
39 office of mental health and the office of addiction services and
40 supports. Additionally, two deputy commissioners shall be appointed,
41 one deputy commissioner to represent addiction services and supports,
42 which shall be prominently represented to ensure the needs of substance
43 use disorder communities are met, and one deputy commissioner to repre-
44 sent mental health services. In conjunction with one another, the
45 commissioners shall develop a plan for integrating services which shall
46 be made available for public comment.
47 (c) The office of addiction and mental health services may license
48 providers to provide integrated services for individuals with a mental
49 health diagnosis, substance use disorder, or a mental health diagnosis
50 and substance use disorder, in accordance with regulations issued by the
51 commissioner. Such direct licensing mechanism allows for resources to
52 get to community-based organizations in an expedited manner.
53 (d) The office of addiction and mental health services shall establish
54 a standing advisory committee on addiction and mental health services.
55 The standing advisory committee shall consist of seven members appointed
56 by the governor as follows: (i) two members appointed on the recommenda-
S. 5084--C 3
1 tion of the temporary president of the senate; (ii) two members
2 appointed on the recommendation of the speaker of the assembly; (iii)
3 one member appointed on the recommendation of the minority leader of the
4 senate; (iv) one member appointed on the recommendation of the minority
5 leader of the assembly; and (v) one member appointed on the recommenda-
6 tion of the department of health AIDS institute, the office of mental
7 health and the office of addiction services and supports to ensure the
8 intent of the legislature is fulfilled in establishing the integration
9 of services by such office. Such standing advisory committee shall
10 consist of providers, peers, family members, individuals who have
11 utilized addiction services and supports and/or mental health services,
12 the local government unit as defined in article forty-one of this chap-
13 ter, public and private sector unions and representatives of other agen-
14 cies or offices as the designated standing advisory committee may deem
15 necessary. Such standing advisory committee shall meet regularly in
16 furtherance of its functions and at any other time at the request of the
17 designated standing advisory committee leader.
18 § 5.01-b Office of addiction and mental health services.
19 Until January first, two thousand twenty-three, the office of
20 addiction and mental health services shall consist of the office of
21 mental health and the office of addiction services and supports.
22 § 3. Section 5.03 of the mental hygiene law, as amended by chapter 281
23 of the laws of 2019, is amended to read as follows:
24 § 5.03 Commissioners.
25 The head of the office of addiction and mental health services shall
26 be the commissioner of [mental health] addiction and mental health
27 services; and the head of the office for people with developmental disa-
28 bilities shall be the commissioner of developmental disabilities[; and
29 the head of the office of addiction services and supports shall be the
30 commissioner of addiction services and supports]. Each commissioner
31 shall be appointed by the governor, by and with the advice and consent
32 of the senate, to serve at the pleasure of the governor. Until the
33 commissioner of addiction and mental health services is appointed by the
34 governor and confirmed by the senate, the commissioner of mental health
35 and the commissioner of addiction services and supports shall continue
36 to oversee mental health and addiction services respectively, and work
37 collaboratively to integrate care for individuals with both mental
38 health and substance use disorders.
39 § 4. Section 5.05 of the mental hygiene law, as added by chapter 978
40 of the laws of 1977, subdivision (a) as amended by chapter 168 of the
41 laws of 2010, subdivision (b) as amended by chapter 294 of the laws of
42 2007, paragraph 1 of subdivision (b) as amended by section 14 of part J
43 of chapter 56 of the laws of 2012, subdivision (d) as added by chapter
44 58 of the laws of 1988 and subdivision (e) as added by chapter 588 of
45 the laws of 2011, is amended to read as follows:
46 § 5.05 Powers and duties of the head of the department.
47 (a) The commissioners of the office of addiction and mental health
48 services and the office for people with developmental disabilities, as
49 the heads of the department, shall jointly visit and inspect, or cause
50 to be visited and inspected, all facilities either public or private
51 used for the care, treatment [and], rehabilitation, and recovery of
52 individuals with a mental [illness] health diagnosis, substance use
53 disorder and developmental disabilities in accordance with the require-
54 ments of section four of article seventeen of the New York state consti-
55 tution.
S. 5084--C 4
1 (b) (1) The commissioners of the office of addiction and mental
2 health[,] services and the office for people with developmental disabil-
3 ities [and the office of alcoholism and substance abuse services] shall
4 constitute an inter-office coordinating council which, consistent with
5 the autonomy of each office for matters within its jurisdiction, shall
6 ensure that the state policy for the prevention, care, treatment [and],
7 rehabilitation, and recovery of individuals with a mental [illness]
8 health diagnosis, substance use disorders and developmental disabili-
9 ties[, alcoholism, alcohol abuse, substance abuse, substance dependence,
10 and chemical dependence] is planned, developed and implemented compre-
11 hensively; that gaps in services to individuals with multiple disabili-
12 ties are eliminated and that no person is denied treatment and services
13 because he or she has more than one disability; that procedures for the
14 regulation of programs which offer care and treatment for more than one
15 class of persons with mental disabilities be coordinated between the
16 offices having jurisdiction over such programs; and that research
17 projects of the institutes, as identified in section 7.17 [or], 13.17,
18 or 19.17 of this chapter or as operated by the office for people with
19 developmental disabilities, are coordinated to maximize the success and
20 cost effectiveness of such projects and to eliminate wasteful dupli-
21 cation.
22 (2) The inter-office coordinating council shall annually issue a
23 report on its activities to the legislature on or before December thir-
24 ty-first. Such annual report shall include, but not be limited to, the
25 following information: proper treatment models and programs for persons
26 with multiple disabilities and suggested improvements to such models and
27 programs; research projects of the institutes and their coordination
28 with each other; collaborations and joint initiatives undertaken by the
29 offices of the department; consolidation of regulations of each of the
30 offices of the department to reduce regulatory inconsistencies between
31 the offices; inter-office or office activities related to workforce
32 training and development; data on the prevalence, availability of
33 resources and service utilization by persons with multiple disabilities;
34 eligibility standards of each office of the department affecting clients
35 suffering from multiple disabilities, and eligibility standards under
36 which a client is determined to be an office's primary responsibility;
37 agreements or arrangements on statewide, regional and local government
38 levels addressing how determinations over client responsibility are made
39 and client responsibility disputes are resolved; information on any
40 specific cohort of clients with multiple disabilities for which substan-
41 tial barriers in accessing or receiving appropriate care has been
42 reported or is known to the inter-office coordinating council or the
43 offices of the department; and coordination of planning, standards or
44 services for persons with multiple disabilities between the inter-office
45 coordinating council, the offices of the department and local govern-
46 ments in accordance with the local planning requirements set forth in
47 article forty-one of this chapter.
48 (c) The commissioners shall meet from time to time with the New York
49 state conference of local mental hygiene directors to assure consistent
50 procedures in fulfilling the responsibilities required by this section
51 and by article forty-one of this chapter.
52 (d) [1.] (1) The commissioner of addiction and mental health services
53 shall evaluate the type and level of care required by patients in the
54 adult psychiatric centers authorized by section 7.17 of this chapter and
55 develop appropriate comprehensive requirements for the staffing of inpa-
56 tient wards. These requirements should reflect measurable need for
S. 5084--C 5
1 administrative and direct care staff including physicians, nurses and
2 other clinical staff, direct and related support and other support
3 staff, established on the basis of sound clinical judgment. The staffing
4 requirements shall include but not be limited to the following: (i) the
5 level of care based on patient needs, including on ward activities, (ii)
6 the number of admissions, (iii) the geographic location of each facili-
7 ty, (iv) the physical layout of the campus, and (v) the physical design
8 of patient care wards.
9 [2.] (2) Such commissioner, in developing the requirements, shall
10 provide for adequate ward coverage on all shifts taking into account the
11 number of individuals expected to be off the ward due to sick leave,
12 workers' compensation, mandated training and all other off ward leaves.
13 [3.] (3) The staffing requirements shall be designed to reflect the
14 legitimate needs of facilities so as to ensure full accreditation and
15 certification by appropriate regulatory bodies. The requirements shall
16 reflect appropriate industry standards. The staffing requirements shall
17 be fully measurable.
18 [4.] (4) The commissioner of addiction and mental health services
19 shall submit an interim report to the governor and the legislature on
20 the development of the staffing requirements on October first, [nineteen
21 hundred eighty-eight] two thousand twenty-two and again on April first,
22 [nineteen hundred eighty-nine] two thousand twenty-three. The commis-
23 sioner shall submit a final report to the governor and the legislature
24 no later than October first, [nineteen hundred eighty-nine] two thousand
25 twenty-three and shall include in his report a plan to achieve the
26 staffing requirements and the length of time necessary to meet these
27 requirements.
28 (e) The commissioners of the office of addiction and mental health[,]
29 services and the office for people with developmental disabilities[, and
30 the office of alcoholism and substance abuse services] shall cause to
31 have all new contracts with agencies and providers licensed by the
32 offices to have a clause requiring notice be provided to all current and
33 new employees of such agencies and providers stating that all instances
34 of abuse shall be investigated pursuant to this chapter, and, if an
35 employee leaves employment prior to the conclusion of a pending abuse
36 investigation, the investigation shall continue. Nothing in this section
37 shall be deemed to diminish the rights, privileges, or remedies of any
38 employee under any other law or regulation or under any collective
39 bargaining agreement or employment contract.
40 § 5. Section 7.01 of the mental hygiene law, as added by chapter 978
41 of the laws of 1977, is amended to read as follows:
42 § 7.01 Declaration of policy.
43 The state of New York and its local governments have a responsibility
44 for the prevention and early detection of mental [illness] health disor-
45 ders and for the comprehensively planned care, treatment [and], rehabil-
46 itation and recovery of [their mentally ill citizens] individuals with a
47 mental health diagnosis.
48 Therefore, it shall be the policy of the state to conduct research and
49 to develop programs which further prevention and early detection of
50 mental [illness] health disorders; to develop a comprehensive, inte-
51 grated system of treatment [and], rehabilitative and recovery services
52 for [the mentally ill] individuals with a mental health diagnosis. Such
53 a system should include, whenever possible, the provision of necessary
54 treatment services to people in their home communities; it should assure
55 the adequacy and appropriateness of residential arrangements for people
56 in need of service; and it should rely upon improved programs of insti-
S. 5084--C 6
1 tutional care only when necessary and appropriate. Further, such a
2 system should recognize the important therapeutic roles of all disci-
3 plines which may contribute to the care or treatment of [the mentally
4 ill] individuals with a mental health diagnosis, such as psychology,
5 social work, psychiatric nursing, special education and other disci-
6 plines in the field of mental illness, as well as psychiatry and should
7 establish accountability for implementation of the policies of the state
8 with regard to the care [and], rehabilitation and recovery of [the
9 mentally ill] individuals with a mental health diagnosis.
10 To facilitate the implementation of these policies and to further
11 advance the interests of [the mentally ill] individuals with a mental
12 health diagnosis and their families, a new autonomous agency to be known
13 as the office of addiction and mental health services has been estab-
14 lished by this article. The office and its commissioner shall plan and
15 work with local governments, voluntary agencies and all providers and
16 consumers of mental health services in order to develop an effective,
17 integrated, comprehensive system for the delivery of all services to
18 [the mentally ill] individuals with a mental health diagnosis and to
19 create financing procedures and mechanisms to support such a system of
20 services to ensure that [mentally ill] persons in need of services
21 receive appropriate care, treatment and rehabilitation close to their
22 families and communities. In carrying out these responsibilities, the
23 office and its commissioner shall make full use of existing services in
24 the community including those provided by voluntary organizations.
25 § 6. Section 19.01 of the mental hygiene law, as added by chapter 223
26 of the laws of 1992, is amended to read as follows:
27 § 19.01 Declaration of policy.
28 The legislature declares the following:
29 [Alcoholism] Unhealthy alcohol use, substance [abuse] use disorder and
30 chemical dependence pose major health and social problems for individ-
31 uals and their families when left untreated, including family devas-
32 tation, homelessness, [and] unemployment, and death. It has been proven
33 that successful prevention [and], integrated treatment, and sustained
34 recovery can dramatically reduce costs to the health care, criminal
35 justice and social welfare systems.
36 The tragic, cumulative and often fatal consequences of [alcoholism]
37 unhealthy alcohol use and substance [abuse] use disorder are, however,
38 preventable and treatable disabilities that require a coordinated and
39 multi-faceted network of services.
40 The legislature recognizes locally planned and implemented prevention
41 as a primary means to avert the onset of [alcoholism] unhealthy alcohol
42 use and substance [abuse] use disorder. It is the policy of the state to
43 promote comprehensive, age appropriate education for children and youth
44 and stimulate public awareness of the risks associated with [alcoholism]
45 unhealthy alcohol use and substance [abuse] use disorder. Further, the
46 legislature acknowledges the need for a coordinated state policy for the
47 establishment of prevention [and], treatment, and recovery programs
48 designed to address the problems of chemical dependency among youth,
49 including prevention and intervention efforts in school and community-
50 based programs designed to identify and refer high risk youth in need of
51 chemical dependency services.
52 Substantial benefits can be gained through [alcoholism] unhealthy
53 alcohol use and substance [abuse] use disorder treatment for both
54 addicted individuals and their families. Positive treatment outcomes
55 that may be generated through a complete continuum of care offer a cost
56 effective and comprehensive approach to [rehabilitating] treating such
S. 5084--C 7
1 individuals. The primary goals of the [rehabilitation] treatment and
2 recovery process are to [restore] rebuild social, family, lifestyle,
3 vocational and economic supports by stabilizing an individual's physical
4 and psychological functioning. The legislature recognizes the impor-
5 tance of varying treatment approaches and levels of care designed to
6 meet each [client's] individual's needs. [Relapse] Reoccurrence
7 prevention and aftercare are two primary components of treatment that
8 serve to promote and maintain recovery.
9 The legislature recognizes that the distinct treatment needs of
10 special populations, including women and women with children, persons
11 with HIV infection, persons [diagnosed] with a mental [illness] health
12 diagnosis, persons who [abuse] misuse chemicals, the homeless and veter-
13 ans with posttraumatic stress disorder, merit particular attention. It
14 is the intent of the legislature to promote effective interventions for
15 such populations in need of particular attention. The legislature also
16 recognizes the importance of family support for individuals in alcohol
17 or substance [abuse] use disorder treatment and recovery. Such family
18 participation can provide lasting support to the recovering individual
19 to [prevent relapse and maintain] support sustained recovery. The inter-
20 generational cycle of chemical dependency within families can be inter-
21 cepted through appropriate interventions.
22 The state of New York and its local governments have a responsibility
23 in coordinating the delivery of [alcoholism] unhealthy alcohol use and
24 substance [abuse] use disorder services, through the entire network of
25 service providers. To accomplish these objectives, the legislature
26 declares that the establishment of a single, unified office of [alcohol-
27 ism and substance abuse] addiction and mental health services will
28 provide an integrated framework to plan, oversee and regulate the
29 state's prevention and treatment network. In recognition of the growing
30 trends and incidence of chemical dependency, this consolidation allows
31 the state to respond to the changing profile of chemical dependency.
32 The legislature recognizes that some distinctions exist between the
33 [alcoholism] unhealthy alcohol use and substance [abuse] use disorder
34 field and the mental health field and where appropriate, those
35 distinctions may be preserved. Accordingly, it is the intent of the
36 state to establish one office of [alcoholism and substance abuse]
37 addiction and mental health services in furtherance of a comprehensive
38 service delivery system.
39 § 7. Upon or prior to January 1, 2023, the governor may nominate an
40 individual to serve as commissioner of the office of addiction and
41 mental health services. If such individual is confirmed by the senate
42 prior to January 1, 2023, they shall become the commissioner of the
43 office of addiction and mental health services. The governor may desig-
44 nate a person to exercise the powers of the commissioner of the office
45 of addiction and mental health services on an acting basis, until
46 confirmation of a nominee by the senate, who is hereby authorized to
47 take such actions as are necessary and proper to implement the orderly
48 transition of the functions, powers as duties as herein provided,
49 including the preparation for a budget request for the office as estab-
50 lished by this act.
51 § 8. Upon the transfer pursuant to this act of the functions and
52 powers possessed by and all of the obligations and duties of the office
53 of mental health and the office of addiction services and supports as
54 established pursuant to the mental hygiene law and other laws, to the
55 office of addiction and mental health services as prescribed by this
56 act, provision shall be made for the transfer of all employees from the
S. 5084--C 8
1 office of mental health and the office of addiction services and
2 supports into the office of addiction and mental health services.
3 Employees so transferred shall be transferred without further examina-
4 tion or qualification to the same or similar titles and shall remain in
5 the same collective bargaining units and shall retain their respective
6 civil service classifications, status, and rights pursuant to their
7 collective bargaining units and collective bargaining agreements.
8 § 9. Notwithstanding any contrary provision of law, on or before Octo-
9 ber 1, 2022 and annually thereafter, the office of addiction and mental
10 health services, in consultation with the department of health, shall
11 issue a report, and post such report on their public website, detailing
12 the office's expenditures for addiction and mental health services,
13 including total Medicaid spending directly by the state to licensed or
14 designated providers and payments to managed care providers pursuant to
15 section 364-j of the social services law. The office of addiction and
16 mental health services shall examine reports produced pursuant to this
17 section and may make recommendations to the governor and the legislature
18 regarding appropriations for addiction and mental health services or
19 other provisions of law which may be necessary to effectively implement
20 the creation and continued operation of the office.
21 § 10. Any financial saving realized from the creation of the office of
22 addiction and mental health services shall be reinvested in the services
23 and supports funded by such office.
24 § 11. Severability. If any clause, sentence, paragraph, section or
25 part of this act shall be adjudged by any court of competent jurisdic-
26 tion to be invalid, such judgment shall not affect, impair or invalidate
27 the remainder thereof, but shall be confined in its operation to the
28 clause, sentence, paragraph, section or part thereof directly involved
29 in the controversy in which such judgment shall have been rendered.
30 § 12. This act shall take effect immediately. Effective immediately,
31 the office of mental health and the office of addiction services and
32 supports are authorized to promulgate the addition, amendment and/or
33 repeal of any rule or regulation or engage in any work necessary for the
34 implementation of this act on its effective date authorized to be made
35 and completed on or before such effective date.