S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9523
 
                             I N  S E N A T E
 
                               May 16, 2024
                                ___________
 
 Introduced by Sen. FERNANDEZ -- read twice and ordered printed, and when
   printed to be committed to the Committee on Finance
 
 AN  ACT  to  amend the mental hygiene law, in relation to establishing a
   co-occurring disorders patient bill of rights; and making an appropri-
   ation therefor
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  The mental hygiene law is amended by adding a new section
 19.47 to read as follows:
 § 19.47 CO-OCCURRING DISORDERS PATIENT BILL OF RIGHTS.
   THE OFFICE SHALL, IN CONJUNCTION WITH STATE  AGENCIES  WHICH  INTERACT
 WITH  PERSONS WITH CO-OCCURRING DISORDERS INCLUDING, BUT NOT LIMITED TO,
 THE OFFICE OF MENTAL HEALTH, DEPARTMENT OF SOCIAL  SERVICES,  OFFICE  OF
 CHILDREN  AND  FAMILY SERVICES, DEPARTMENT OF CORRECTIONS, DEPARTMENT OF
 HEALTH, DEPARTMENT OF FINANCIAL SERVICES, AND THE DEPARTMENT  OF  EDUCA-
 TION:
   1. ADOPT A CO-OCCURRING DISORDERS PATIENT BILL OF RIGHTS AND IMPLEMENT
 SUCH  BILL  OF  RIGHTS AS POLICY. SUCH BILL OF RIGHTS SHALL INCLUDE, BUT
 NOT BE LIMITED TO:
   A. THE RIGHT TO BE WELCOMED/NONDISCRIMINATION: INDIVIDUALS  AND  FAMI-
 LIES  SEEKING  AND  RECEIVING TREATMENT FOR CO-OCCURRING DISORDERS SHALL
 RECEIVE SERVICES WITHOUT REGARD TO AGE, RACE, COLOR, SEXUAL ORIENTATION,
 RELIGION, MARITAL STATUS, SEX,  DISABILITY,  GENDER  IDENTITY,  NATIONAL
 ORIGIN, PAYMENT SOURCE OR ANY OTHER PROTECTED BASIS.
   B.  THE  RIGHT  TO HAVE CO-OCCURRING DISORDERS NEEDS ACCURATELY RECOG-
 NIZED:   INDIVIDUALS WITH CO-OCCURRING DISORDERS,  AND  THEIR  FAMILIES,
 SHALL  RECEIVE  APPROPRIATE  SCREENING  FOR THE PRESENCE OF CO-OCCURRING
 DISORDERS, ACCURATE DOCUMENTATION OF  THE  RESULTS  OF  THAT  SCREENING,
 COMPLETE  ACCESS  TO THEIR HEALTH RECORDS AND COST ESTIMATES, AND TIMELY
 ACCESS TO COMPETENT RE-ASSESSMENTS WHEN NEEDED.
   C. THE RIGHT TO RECEIVE CO-OCCURRING  DISORDERS  SERVICES  MATCHED  TO
 NEEDS:    INDIVIDUALS  SHALL  RECEIVE INTEGRATED, CO-OCCURRING DISORDERS
 CAPABLE SERVICES FOR THEIR CO-OCCURRING MENTAL HEALTH AND SUBSTANCE  USE
 DISORDER  CONDITIONS  THAT  ARE APPROPRIATELY MATCHED TO THEIR NEEDS AND
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD15517-01-4
 S. 9523                             2
 
 PREFERENCES, INCLUDING, BUT NOT LIMITED TO ACUITY, SEVERITY,  AND  STAGE
 OF  CHANGE  FOR  EACH CONDITION. THIS RIGHT SHALL APPLY TO MENTAL HEALTH
 AND/OR SUBSTANCE USE DISORDER ADDICTION PROGRAMS FOR ADULTS AND/OR CHIL-
 DREN  AND YOUTH IN HOSPITAL-BASED, RESIDENTIAL, COMMUNITY-BASED SETTINGS
 AND AT SCHOOL-BASED MENTAL HEALTH SATELLITES.
   D. THE RIGHT TO RECEIVE THE HIGHEST QUALITY OF CO-OCCURRING  DISORDERS
 TREATMENT:  IN  EVERY  SETTING,  INDIVIDUALS  AND FAMILIES SHALL RECEIVE
 HIGH-QUALITY EVIDENCE-BASED CO-OCCURRING DISORDERS SERVICES, INCLUDING A
 FULL ARRAY OF BEST AND PROMISING PRACTICES FOR MEDICATION AND  NON-MEDI-
 CATION  INTERVENTIONS  FOR BOTH MENTAL HEALTH AND SUBSTANCE USE DISORDER
 NEEDS.
   E. THE RIGHT TO CONTINUITY  OF  CARE:  INDIVIDUALS  WITH  CO-OCCURRING
 DISORDERS,  AND THEIR FAMILIES, SHALL RECEIVE APPROPRIATELY MATCHED HELP
 FOR BOTH CONDITIONS FOR AS LONG AS THEY NEED THAT HELP. THE  EXPECTATION
 THAT  INDIVIDUALS  CAN  RELY ON SELF-HELP AFTER ONLY A SINGLE EPISODE OF
 CARE IN A PROGRAM WITH LIMITED LENGTH OF STAY SHALL BE  DEEMED  INAPPRO-
 PRIATE  FOR  PEOPLE  WHO  ARE LIKELY TO HAVE NOT ONE, BUT TWO PERSISTENT
 CONDITIONS THAT MAY REQUIRE HELP FOR AN EXTENDED TIME-PERIOD.
   F. THE RIGHT TO HELP AND HOPE FOR  FAMILY  AND  LOVED  ONES:  FAMILIES
 SHALL  BE  INVOLVED IN CONTRIBUTING TO THE CARE OF THEIR LOVED ONES, AND
 RECEIVING QUALITY EDUCATION, SUPPORT, AND TREATMENT TO HELP THEM HEAL.
   G. THE RIGHT FOR PEOPLE AT RISK TO HAVE ACCESS  TO  PREVENTION:  YOUNG
 PEOPLE WITH EITHER MENTAL HEALTH OR SUBSTANCE USE DISORDER ARE AT HIGHER
 RISK OF DEVELOPING CO-OCCURRING DISORDERS, AND THEIR FAMILIES, AND SHALL
 RECEIVE  EDUCATIONAL AND PREVENTIVE INTERVENTIONS AS SOON AS POSSIBLE IN
 BOTH NORMATIVE SETTINGS, INCLUDING BUT NOT LIMITED TO  SCHOOLS,  AND  IN
 TREATMENT  SETTINGS,  INCLUDING  BUT  NOT  LIMITED  TO BEHAVIORAL HEALTH
 PROGRAMS TREATING CHILDREN AND YOUTH.
   H. THE RIGHT TO ACCOUNTABILITY AND REDRESS:  CONSUMERS  SHALL  RECEIVE
 SERVICES  WITHIN  A FULLY TRANSPARENT SYSTEM WHERE PAYORS, PROVIDERS AND
 GOVERNMENT WORK IN PARTNERSHIP, GUIDED BY INPUT FROM PEOPLE AND FAMILIES
 WITH LIVED EXPERIENCE.
   I. THE RIGHT TO A PEER ADVOCATE: PEOPLE  WITH  CO-OCCURRING  DISORDERS
 SHALL  RECEIVE  PEER  SUPPORT  SERVICES  PROVIDING  HOPE,  ADVOCACY, AND
 SYSTEMS NAVIGATION. TO ADEQUATELY SERVE PEOPLE WITH CO-OCCURRING  DISOR-
 DERS, SUCH PEER SUPPORT SERVICES SHALL INCLUDE, BUT NOT BE LIMITED TO, A
 ROBUST  AND  COLLABORATIVE  PEER  WORKFORCE WITH DIVERSE AND SPECIALIZED
 LIVED EXPERTISE  AS  WELL  AS  CROSS-TRAINING,  ENSURING  PERSON-DRIVEN,
 RECOVERY-ORIENTED, TRAUMA-INFORMED, CULTURALLY FLUENT SERVICES.
   J.  THE RIGHT TO RECEIVE SERVICES FROM ADEQUATELY RESOURCED PROVIDERS:
 PEOPLE WITH CO-OCCURRING DISORDERS NEEDS  SHALL  RECEIVE  SERVICES  FROM
 PROVIDERS  OF  ALL  TYPES WHO ARE PAID APPROPRIATELY TO SERVE THOSE WITH
 THE GREATEST NEED.
   K. THE RIGHT TO SAFE HOUSING: PEOPLE WITH CO-OCCURRING  DISORDERS  AND
 WITHOUT  ACCESS  TO  A PERMANENT RESIDENCE SHALL RECEIVE SAFE SUPPORTIVE
 HOUSING THAT IS RECOVERY-ORIENTED, AND ENCOURAGES INDEPENDENCE.
   2. SUBMIT A REPORT TO THE LEGISLATURE AND THE GOVERNOR ON  THE  STATUS
 OF  INTEGRATED  SERVICES DELIVERY IN NEW YORK, INCLUDING STATE OPERATED,
 CONTRACTED, AND REGULATED SERVICES IN EACH REGION  OF  THE  STATE.  THIS
 REPORT SHALL INCLUDE, BUT NOT BE LIMITED TO:
   A.  THE  BEST  AVAILABLE DATA ON THE PREVALENCE OF CO-OCCURRING DISOR-
 DERS, WHETHER DIAGNOSED OR  NOT,  IN  THE  CURRENT  SERVICE  POPULATION,
 INCLUDING  THE  POPULATION  OF CHILDREN RECEIVING MENTAL HEALTH SERVICES
 WHOSE PARENTS OR CAREGIVERS HAVE SUBSTANCE USE CHALLENGES.
   B. INDICATIONS AS TO WHETHER THE  AVAILABLE  PREVALENCE  DATA  MATCHES
 EXPECTED  PREVALENCE  BASED ON NATIONAL BENCHMARKS, OR WHETHER THE POPU-
 S. 9523                             3
 
 LATION IS CURRENTLY UNDERRECOGNIZED,  AND  IF  THE  LATTER,  A  PLAN  TO
 IMPROVE THE ACCURACY OF DATA OVER TIME.
   C.  BEST  AVAILABLE CURRENT INFORMATION ON THE DEGREE TO WHICH CURRENT
 MENTAL HEALTH AND SUBSTANCE USE DISORDERS ARE  CO-OCCURRING  USE  DISOR-
 DERS,  USING ACCEPTED MEASURES OF "CO-OCCURRING DISORDERS CAPABILITY" OR
 "INTEGRATED TREATMENT" AS APPROPRIATE FOR THE PROGRAMS  BEING  MEASURED,
 AS WELL AS THE DEGREE OF INTEGRATION OF BOTH MENTAL HEALTH AND SUBSTANCE
 USE  DISORDERS  INTO PRIMARY CARE. SUBSTANCE USE DISORDER PROGRAMS SHALL
 BE EVALUATED ACCORDING TO THE CODE OF CONDUCT AND CODE OF ETHICS  STAND-
 ARDS IN THE AMERICAN SOCIETY OF ADDICTION MEDICINE'S PCC 4TH EDITION.
   3.  DEVELOP  A FIVE-YEAR PLAN FOR IMPLEMENTING THE CO-OCCURRING DISOR-
 DERS BILL OF RIGHTS AS WELL AS AN ANNUAL REPORT OF PROGRESS  AFTER  EACH
 YEAR,  AND THEN A FIVE-YEAR REPORT SUMMARIZING THE ENTIRE FIVE-YEAR PLAN
 WITH THE NEXT FIVE-YEAR PLAN. SUCH FIVE-YEAR PLAN SHALL:
   A. ILLUSTRATE A STEP-BY-STEP IMPLEMENTATION SCIENCE APPROACH TO MAKING
 SIGNIFICANT PROGRESS TOWARD  UNIVERSAL  CO-OCCURRING  DISORDERS  SERVICE
 DELIVERY,  BUILD  ON  THE  CURRENT  BASELINE, AND USE SYSTEM IMPROVEMENT
 STRATEGIES THAT WORK PRIMARILY  THROUGH  LEVERAGING  EXISTING  RESOURCES
 MORE EFFECTIVELY TO SUPPORT INTEGRATED SERVICE DELIVERY.
   B. INCLUDE STEPS THAT ADDRESS CHANGES IN REGULATORY LANGUAGE, CONTRACT
 LANGUAGE, FUNDING INSTRUCTIONS, PROGRAM DESIGN AND IMPROVEMENT, CLINICAL
 PRACTICE AND COMPETENCY DEVELOPMENT, AND INTER-PROGRAM COLLABORATION AND
 PARTNERSHIP WITHIN EACH COMMUNITY OR REGION.
   C.  INCLUDE  CLEAR  EXPLANATIONS  FOR  HOW  EXISTING  FUNDING STREAMS,
 INCLUDING, BUT NOT LIMITED TO,  FEDERAL  BLOCK  GRANT,  MEDICAID,  STATE
 FUNDING,  OPIOID  SETTLEMENT  FUNDS,  INSURANCE  PLANS, AND CORRECTIONAL
 FUNDS SHALL EACH BE DESIGNED OVER TIME TO SUPPORT CO-OCCURRING DISORDERS
 SERVICE DELIVERY.
   D. BE DESIGNED SO THAT CONTINUOUS IMPROVEMENT IS BUILT  INTO  EXISTING
 INFRASTRUCTURE TO ENSURE SUSTAINABILITY OVER TIME.
   E.  INCLUDE  DELINEATION  OF ANTICIPATED ADDITIONAL RESOURCE NEEDS FOR
 DEVELOPING SUPPORTIVE ELEMENTS INTO THE SYSTEM OF  CARE  INCLUDING,  BUT
 NOT  LIMITED  TO, STATE CO-OCCURRING DISORDERS CENTER OF EXCELLENCE WITH
 SEVEN REGIONAL  CO-OCCURRING  DISORDERS  CENTERS.  THESE  CENTERS  SHALL
 PROVIDE  TRAINING,  CONSULTATION,  AND  TECHNICAL  ASSISTANCE TO SUPPORT
 DEVELOPMENT OF UNIVERSAL  CO-OCCURRING  DISORDERS  CAPABILITY  IN  THEIR
 REGIONS.  THESE  CENTERS  SHALL  ALSO EVALUATE AND QUANTIFY THE NEED FOR
 ADDITIONAL RESOURCES WITHIN THEIR REGIONS FOR SPECIALIZED,  CO-OCCURRING
 DISORDERS  ENHANCED,  EVALUATION  CENTERS,  AND SPECIALIZED CO-OCCURRING
 DISORDERS ENHANCED RESIDENTIAL AND COMMUNITY BASED  TREATMENT  PROGRAMS,
 INCLUDING,  BUT NOT LIMITED TO, HOUSING SUPPORTS AND PEER SUPPORTS, THAT
 ARE DESIGNED TO RESPOND TO THE SUBSET OF INDIVIDUALS  WITH  CO-OCCURRING
 DISORDERS  WHO HAVE THE MOST COMPLEX CHALLENGES AND SEVERE DISABILITIES,
 AS WELL AS THOSE WHO ARE NON-ENGLISH SPEAKING.
   F. INCLUDE SYSTEM EFFORTS TO SCALE TO  IMPROVE  PREVENTION  AND  EARLY
 INTERVENTION  FOR  CO-OCCURRING DISORDERS, WITH A PARTICULAR FOCUS ON AT
 RISK YOUTH, BY INTEGRATING CURRENT PREVENTION EFFORTS  TO  ADDRESS  BOTH
 MENTAL HEALTH AND SUBSTANCE USE DISORDER ISSUES TOGETHER ON A MORE REGU-
 LAR  BASIS AND BY PROVIDING BROAD EDUCATION ON CO-OCCURRING DISORDERS TO
 YOUTH, FAMILIES, SCHOOLS, AND OTHER YOUTH SERVICE PROVIDERS.
   4. IDENTIFY THE NEED FOR ADDITIONAL  RESOURCES.  ALTHOUGH  SUBSTANTIAL
 IMPROVEMENT  CAN  OCCUR  IN  INTEGRATED  SERVICE DELIVERY THROUGH BETTER
 LEVERAGE OF EXISTING RESOURCES, THERE WILL BE ADDITIONAL RESOURCES NEED-
 ED TO SUPPORT IMPLEMENTATION OF THE  PLAN,  AS  WELL  AS  RESOURCES  FOR
 DEVELOPING SPECIALIZED OR CO-OCCURRING DISORDERS ENHANCED SERVICES WHERE
 THERE  ARE  SIGNIFICANT GAPS THAT MAY REMAIN EVEN WHEN EXISTING SERVICES
 S. 9523                             4
 
 ARE IMPROVED, PARTICULARLY FOR THE MOST SERIOUSLY AFFECTED  POPULATIONS.
 THE OFFICE SHALL, ON OR BEFORE JANUARY FIRST OF EACH YEAR, SUBMIT TO THE
 LEGISLATURE  AND  THE  GOVERNOR  THE  ADDITIONAL  RESOURCES  REQUIRED TO
 SUPPORT  THE  IMPLEMENTATION  OF  THE PROVISIONS OF THIS SECTION FOR THE
 UPCOMING FISCAL YEAR WHICH SHALL  BE  APPROPRIATED  FOR  SUCH  PURPOSES;
 PROVIDED HOWEVER, SUCH FUNDS SHALL ONLY BE APPROPRIATED IF THE FIVE-YEAR
 PLAN  FOR  IMPLEMENTING  THE CO-OCCURRING DISORDERS BILL OF RIGHTS UNDER
 SUBDIVISION THREE OF THIS SECTION INCLUDES SPECIFIC RECOMMENDATIONS  FOR
 WHAT  FUNDING  WILL  BE  NEEDED FOR EACH YEAR OF IMPLEMENTATION, AND HOW
 SUCH FUNDING WILL HELP LEVERAGE ALL CURRENT  FUNDING  TO  IMPROVE  INTE-
 GRATED SERVICE DELIVERY SO AS TO IMPROVE OUTCOMES FOR THE POPULATION.
   §  2.  The sum of two million dollars ($2,000,000), or so much thereof
 as may be necessary, is hereby appropriated to the office  of  addiction
 services  and  supports  out  of any moneys in the state treasury in the
 general fund to the credit of the state purposes account  not  otherwise
 appropriated,  for its expenses, including personal service, maintenance
 and operation in carrying out the provisions of this  act.  Such  moneys
 shall be payable on the audit and warrant of the comptroller on vouchers
 certified  or  approved  by  the commissioner of the office of addiction
 services and supports or such commissioner's  designee,  in  the  manner
 prescribed by law.
   §  3.  This  act shall take effect on the ninetieth day after it shall
 have become a law. Effective immediately, the addition, amendment and/or
 repeal of any rule or regulation necessary  for  the  implementation  of
 this  act  on its effective date are authorized to be made and completed
 on or before such effective date.