Amd §§19.03 & 19.17, Ment Hyg L; amd §365-a, Soc Serv L
Requires the office of alcoholism and substance abuse services to provide contingency management services, including non-cash rewards, for persons with addiction disorders who abstain from substance abuse and comply with treatment objectives.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A6674A
SPONSOR: Carroll TITLE OF BILL:
An act to amend the mental hygiene law and the social services law, in
relation to establishing contingency management services for certain
persons with substance use disorders
PURPOSE OR GENERAL IDEA OF BILL:
To establish contingency management services for certain persons with
substance use disorders to incentivize abstaining from opioids, stimu-
lants and other substances.
SUMMARY OF PROVISIONS:
Section 1 amends the mental hygiene law to define "contingency manage-
ment services" as addiction disorder services, including digital thera-
peutics prescribed by a healthcare professional, for persons with a
substance use disorder that provide individuals with "non-cash rewards"
to abstain from substance use. 'Non-cash rewards" are defined as finan-
cial incentives that are not in the form of US currency such as vouchers
or pre-loaded debit cards that cannot be converted to cash.
Section 2 amends the mental hygiene law by instructing the office of
alcoholism and substance abuse services ("the office") to establish a
program to provide contingency services for persons eligible for medical
assistance, as well as those suffering or recovering.
The bill stipulates that financial incentives pursuant to the new
provisions are not income nor resources for the purpose of any determi-
nation of eligibility for other government benefits. The office shall
develop a plan to monitor the program for fraud and misuse of the
rewards and establish a delivery mechanism for the rewards with measures
designed to prevent program participants from converting the rewards
into U.S. currency (cash), redeeming the rewards for drugs or alcohol,
or using or spending the rewards at casinos, gambling/betting services,
gun shops, or escort services.
In addition, the commissioner of the office shall develop and submit any
appropriate waivers authorized and any other waivers necessary to
achieve the purposes of high quality, integrated and cost reflective
care and integrated financial eligibility policies under the medical
assistance program.
Section 3 amends Subdivision 2 of section 365-a of the social services
law by adding a new paragraph to include contingency management services
among services defined as medically necessary.
Section 4 sets the effective date.
JUSTIFICATION:
Substance abuse is a long-term problem in New York State and across the
nation, continuing to worsen over time, especially since the onset of
the COVID-19 pandemic. In 2021, the number of deaths from drug overdoses
surged to nearly 107,000 nationally and more than 5,800 in New York
State. Numbers from New York City's Department of Health indicate a
twelve percent increase in overdose deaths in New York City from 2021 to
2022.
Contingency management (CM) is a strategy used in substance use disorder
treatment that provides an incentive structure that rewards participants
for specified behaviors. Studies have demonstrated that CM is an effec-
tive tool for increasing treatment retention and abstinence from drug
use. One such study determined that the percentage of those who
sustained abstinence from drug use throughout the full 12-week study was
nearly four times greater for the contingency management group than the
traditional treatment group.
This legislation would mean that successful innovations in the use of CM
could be built to scale at a statewide level.
PRIOR LEGISLATIVE HISTORY:
A.8356A / S7485A of 2022
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
To be determined
EFFECTIVE DATE:
This act shall take effect on the one hundred eightieth 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.
STATE OF NEW YORK
________________________________________________________________________
6674--A
2023-2024 Regular Sessions
IN ASSEMBLY
April 28, 2023
___________
Introduced by M. of A. CARROLL, SEAWRIGHT, SIMON -- read once and
referred to the Committee on Alcoholism and Drug Abuse -- recommitted
to the Committee on Alcoholism and Drug Abuse in accordance with
Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee
AN ACT to amend the mental hygiene law and the social services law, in
relation to establishing contingency management services for certain
persons with substance use disorders
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 19.03 of the mental hygiene law is amended by
2 adding two new subdivisions 3 and 4 to read as follows:
3 3. "Contingency management services" means addiction disorder
4 services, including prescription and non-prescription digital therapeu-
5 tics overseen by a healthcare professional, for persons with a substance
6 use disorder that provides individuals with non-cash rewards to abstain
7 from substance use, by incentivizing specified behaviors, including, but
8 not limited to continued evidence of negative substance test results,
9 engagement in treatment, and other behavior which adheres to treatment
10 goals.
11 4. "Non-cash rewards" means financial incentives for healthy behavior
12 given to a contingency management services program participant that are
13 not in the form of United States currency, including but not limited to
14 gift cards, reloadable debit cards, vouchers, and other similar elec-
15 tronic or physical mediums that cannot be converted into cash.
16 § 2. Section 19.17 of the mental hygiene law is amended by adding a
17 new subdivision (h) to read as follows:
18 (h) (1) The office shall, in coordination with the department of
19 health and the New York state conference of local mental hygiene direc-
20 tors, establish a program to provide contingency management services, as
21 defined in subdivision three of section 19.03 of this article for
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD08374-04-4
A. 6674--A 2
1 persons eligible for medical assistance under title eleven of article
2 five of the social services law for individuals in recovery for
3 substance use disorder.
4 (2) Notwithstanding any contrary provision of law, non-cash rewards
5 for contingency management services received by an individual pursuant
6 to this subdivision shall not be considered income or resources of an
7 individual for the purposes of any determinations of eligibility for any
8 other state program or benefit, including but not limited to the medical
9 assistance program, any state or federal program, or any other means-
10 tested program or benefit.
11 (3) In developing the program under paragraph one of this subdivision,
12 the office shall:
13 (A) develop a plan to monitor the program for fraud and misuse of
14 contingency management rewards; and
15 (B) establish a delivery mechanism for non-cash rewards with measures
16 designed to prevent program participants from:
17 (I) converting the rewards into U.S. currency (cash);
18 (II) redeeming the rewards for drugs or alcohol; or
19 (III) using or spending the rewards at casinos, gambling/betting
20 services, gun shops, or escort services.
21 (4) In developing the program under paragraph one of this subdivision,
22 the office may:
23 (A) issue guidance on the use of contingency management services for
24 beneficiaries who access substance use disorder services under the
25 medical assistance program; and
26 (B) establish limits on the number, and value, of non-cash rewards
27 available to beneficiaries who receive services pursuant to contingency
28 management services.
29 (5) Notwithstanding any contrary provision of law, the commissioner,
30 in collaboration with the commissioner of health, shall, to the extent
31 necessary, develop and submit any appropriate waivers for implementation
32 of this program, including, but not limited to, those authorized pursu-
33 ant to sections eleven hundred fifteen and nineteen hundred fifteen of
34 the federal social security act, or successor provisions, and any other
35 waivers necessary to achieve the purposes of high quality, integrated,
36 and cost effective care and integrated financial eligibility policies
37 under the medical assistance program or pursuant to title XVIII of the
38 federal social security act. Copies of such original waiver applications
39 shall be provided to the chair of the senate finance committee and the
40 chair of the assembly ways and means committee simultaneously with their
41 submission to the federal government.
42 § 3. Subdivision 2 of section 365-a of the social services law is
43 amended by adding a new paragraph (nn) to read as follows:
44 (nn) contingency management services and supports provided pursuant to
45 article nineteen of the mental hygiene law.
46 § 4. This act shall take effect on the one hundred eightieth day after
47 it shall have become a law. Effective immediately, the addition, amend-
48 ment and/or repeal of any rule or regulation necessary for the implemen-
49 tation of this act on its effective date are authorized to be made and
50 completed on or before such effective date.
