* § 36.05 Certified community behavioral health clinics indigent care
program. (a) (1) For periods on and after July first, two thousand
twenty-three, the commissioners are authorized to make payment to
eligible certified community behavioral health clinics, to the extent of
funds appropriated therefor to assist in meeting losses resulting from
uncompensated care. In the event federal financial participation is not
available for such payments to eligible certified community behavioral
health clinics, payments shall be made solely on the basis of available
state general fund appropriations for this purpose in amounts to be
determined by the director of the division of the budget.
(2) For purposes of this section, "eligible certified community
behavioral health clinics" shall mean voluntary non-profit certified
community behavioral health clinics participating in the federal
certified community behavioral health clinic demonstration awarded to
the state by the United States department of health and human services
substance abuse and mental health services administration and other
certified community behavioral health clinics certified pursuant to
section 36.04 of this article, which demonstrate that a minimum of three
percent of total visits reported during the applicable base year period,
as determined by the commissioners, were to uninsured individuals.
(3) For purposes of this section, "losses resulting from uncompensated
care" shall mean losses from reported self-pay and free visits
multiplied by the clinic's medical assistance payment rate for the
applicable distribution year, offset by payments received from such
patients during the reporting period.
(b) A certified community behavioral health clinic qualifying for a
distribution pursuant to this section shall provide assurances
satisfactory to the commissioners that it shall undertake reasonable
efforts to maintain financial support from community and public funding
sources and reasonable efforts to collect payments for services from
third-party insurance payors, governmental payors and self-paying
patients.
(c) (1) Funding pursuant to this section shall be allocated to
eligible certified community behavioral health clinics based on actual,
reported losses resulting from uncompensated care in a given base year
period and shall not exceed one hundred percent of an eligible clinic's
losses in the same period.
(2) If the sum of actual, reported losses resulting from uncompensated
care for all certified community behavioral health clinics exceeds the
amount appropriated therefor in a given base year period, allocations of
funds for each eligible certified community behavioral health clinic
shall be assessed proportionately based upon the percentage of the total
number of uncompensated care visits for all clinics that each clinic
provided during the base year and shall not exceed amounts appropriated
in the aggregate.
(d) Except as provided in subdivision (e) of this section, for periods
on and after July first, two thousand twenty-three through June
thirtieth, two thousand twenty-six, funds shall be made available for
payments pursuant to this section for eligible certified community
behavioral health clinics for the following periods in the following
aggregate amounts:
(1) For the period of July first, two thousand twenty-three through
June thirtieth, two thousand twenty-four, up to twenty-two million five
hundred thousand dollars;
(2) For the period of July first, two thousand twenty-four through
June thirtieth, two thousand twenty-five, up to forty-one million two
hundred fifty thousand dollars; and
(3) For the period of July first, two thousand twenty-five through
June thirtieth, two thousand twenty-six, up to forty-five million
dollars.
(e) In the event that federal financial participation is not available
for rate adjustments pursuant to this section, funds available for
payments pursuant to this section for each eligible certified community
behavioral health clinic shall be limited to the non-federal share
equivalent of the amounts specified in subdivision (d) of this section.
(f) Eligible certified community behavioral health clinics receiving
funding under this section shall not be eligible for comprehensive
diagnostic and treatment centers indigent care program funding pursuant
to section two thousand eight hundred seven-p of the public health law.
(g) The commissioners may require facilities receiving distributions
pursuant to this section as a condition of participating in such
distributions, to provide reports and data to the office of mental
health and the office of addiction services and supports as the
commissioners deem necessary to adequately implement the provisions of
this section.
* NB Effective November 3, 2023
