What's happening
This bill requires reimbursement for certain disability programs or services even if approval is granted after the service starts.
Why it matters
Ensures financial stability for service providers. By guaranteeing reimbursement even if official approval for a program or service comes after it has already started (as long as approval is ultimately granted), local providers can offer essential services without risking non-payment due to administrative delays.
Reduces service gaps for people with disabilities. The bill allows individuals to begin receiving needed programs or services immediately, rather than waiting for bureaucratic approval, which can be a significant barrier to timely support.
Imposes accountability if approval is denied. If a program or service is ultimately not approved, any reimbursement already given must be returned within 60 days, preventing misuse of funds and incentivizing providers to ensure proper documentation and compliance.
Addresses administrative bottlenecks. The legislation recognizes that approval processes can be slow or unpredictable and seeks to protect both individuals seeking support and the providers serving them during these gaps.
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Who cares
Headline styles
Fund Local Disability Services
Plain English, a few words. Used as the page title.
Sponsors
Senator · Senate District 38
No co-sponsors yet.
History
- Reported and committed to finance
- Referred to mental health and developmental disabilities
- Reported and committed to finance
- Referred to mental health and developmental disabilities
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Reimburse Disability Service Providers
In Assembly Committee · Ways And Means · Sponsor Aileen Gunther
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
4013
2019-2020 Regular Sessions
IN SENATE
February 25, 2019
Introduced by Sen. CARLUCCI -- read twice and ordered printed, and when printed to be committed to the Committee on Mental Health and Developmental Disabilities
AN ACT to amend the mental hygiene law, in relation to reimbursement of certain programs and services for persons with a disability
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. The mental hygiene law is amended by adding a new section 43.13 to read as follows: § 43.13 Reimbursement of certain programs and services for persons with
a disability.
If a person who qualifies for and has entered into a program and/or received a service furnished by a local service provider pursuant to subdivision (a) of section 13.15 of this chapter subsequently enters into a different program and/or receives a different service not yet approved by the commissioner, provided such approval is ultimately granted, the local service provider shall be reimbursed, after such services have been rendered and approved, the cost of such program and/or service as if it had been approved prior to such person's admission into such program or receipt of such service. If a service is ultimately not approved and reimbursement has already occurred, such reimbursement shall be returned to the office for people with developmental disabilities within sixty days of notice of such denial.
§ 2. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01693-01-9
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the mental hygiene law, in relation to reimbursement of certain programs and services for persons with a disability
Purpose
To ensure local service providers are reimbursed from the Office for People with Developmental Disabilities, for the rendering of approved services, while such approval is pending.
Summary of provisions
Section 1 amends article 43 of the mental hygiene law related to fees for service by adding a new section 43.13 to provide for the reimburse- ment of a service furnished by a local service provider while the commissioner approves the service, provided that such approval is ulti- mately granted. This section also provides that if a service is ulti- mately not approved and reimbursement has already occurred, such reimbursement shall be returned to the Office for People with Develop- mental Disabilities within sixty days of notice of such denial.
Read the full memo (948 words)
Section 2 provides the effective date.
Existing law
Pursuant to § 13.13 of the Mental Hygiene Law, local services for persons with developmental disabilities shall be planned, financed, and implemented in accordance with the provisions of this chapter.
Pursuant to § 13.13 of the Mental Hygiene Law, the Commissioner of the Office for People with Developmental Disabilities shall plan, promote, establish, develop, coordinate, evaluate, and conduct programs and services of prevention, diagnosis, examination, care, treatment, reha- bilitation, training, and research for the benefit of individuals with developmental disabilities. Such programs shall include, but are not limited to, inpatient, outpatient, partial hospitalization, day care, emergency, rehabilitative, and other appropriate treatments and services. The commissioner shall take all actions necessary, desirable, or proper to implement the purposes of this chapter, and to carry out the purposes and objectives of the Office within the amounts made avail- able therefore by appropriation, grant, gift, devise, bequest, or allo- cation from the Mental Health Service Fund established under § 97-f of the Finance Law. The activities described here may be undertaken in cooperation and agreement with other offices, departments, or agencies of the state, local or federal government, or with other organizations and individuals.
Pursuant to § 13.17(c) of the Mental Hygiene Law, the Commissioner of the Office for People with Developmental Disabilities may authorize other offices of the Department and any public or private non-profit organization or political subdivision of the state to deliver supports and services to individuals with development disabilities, not incon- sistent with the programs and objectives of the Office in any facility under the commissioner's jurisdiction. The commissioner may permit any facility under the commissioner's jurisdiction to operate programs for persons with mental disabilities, not inconsistent with programs and objectives of the Department, under contracts or agreements with other offices within the Department.
Justification
Services rendered to persons with developmental disabilities by local service providers and agencies must be approved the Office for Persons with Developmental Disabilities (OPWDD). Generally, an individual, or a family member on the behalf of an individual, will approach a local service provider seeking disability services. That individual is then referred to OPWDD for an evaluative process during which OPWDD will determine the services that are available to the person and which centers provide the approved services. A family may choose only from the services and centers approved through OPWDD's assessment.
A local provider is proscribed from providing any service to a person with a developmental disability until such service is approved by OPWDD. Often, an initial placement in a particular program or the rendering of specific services is inappropriate for the individual requiring the service. This may result in extraordinary hardships for both the indi- vidual and that person's caregivers, especially when the inappropriate placement results in physical or emotional harm to the individual, or when abridgement in service results in a lapse of day care thus forcing the caregiver to modify his or her own employment obligations. Further- more, local service providers cannot help facilitate the evaluation and approval process and are prevented from advocating on behalf of their clients and families.
In an effort to offer the necessary services and treatments to all of their clients in a streamlined and consistent manner,'local service providers often provide uncompensated care. But uncompensated care does not mean that the services provided were not approved by OPWDD. Rather, the uncompensated care may have been administered while the individual was still being approved, or during an interim period when OPWDD had not yet approved a more appropriate placement or treatment for that person's particular needs.
This bill requires that if a person with developmental disabilities qualifying for such a program and has entered into a program or received a service furnished by a local service provider, and subsequently enters into a different program or receives a different service not yet approved by OPWDD, the local service provider must be reimbursed the cost of that program or service as if it had been approved prior to such person's admission to the program, provided, that such approval is ulti- mately granted by the Department.
While only those services that are ultimately approved by OPWDD quality for reimbursement during the interim period, this bill will promote the consistent delivery of necessary services to persons with developmental disabilities and ensure local service providers are appropriately compensated for the rendering of such approved services. This legis- lation will foster the relationship between all of these parties, including individuals with developmental disabilities and their fami- lies, local service providers, and OPWDD. As such it is imperative that this bill is enacted.
Legislative history
2017-18: A7868 referred to Ways & Means S1916 referred to Finance 2015-16: S.5544-A Reported and Committed to Finance.
Fiscal implications
Minimal.
Effective date
This act shall take effect immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.