Pursuant to 42 CFR 447.205, the NYS Office of Mental Retardation and Developmental Disabilities and NYS Department of Health hereby give notice of the following:

Effective January 1, 2010 OMRDD will be changing its methods and standards for setting Medicaid payment rates for individualized residential alternatives (IRAs) and community residences to implement two new initiatives: a) food stamp benefits for residents of these facilities, and b) restructuring of the reimbursement methodology for community residences.

a) The first change will establish an offset to the fees and prices for OMRDD certified IRAs and community residences. The offset is $156/month per individual (excluding temporary use beds) for supervised sites, and $126/month per individual (excluding temporary use beds) for supportive sites. There is also a one-time offset of $1,404 for supervised community residences and $1,134 for supportive community residences. These one-time offsets are prorated for facilities which opened after April, 2009.

OMRDD estimates that this change will decrease State expenditures by approximately $23 million per year.

These changes ensure the prudent use of scarce State resources. The IRA and community residence payment rates include an amount for food. The overwhelming majority of individuals in IRAs and community residences are eligible for food stamp benefits. Prior to October 1, 2008 the monthly amount an individual received was capped at $44. Since that date maximum amounts have increased to $176 effective October 1, 2008 and to $200 effective April 1, 2009.

There are other changes that would accompany these changes in payment rate methods and standards. Regulations would require the IRA or community residence, or the individuals living in them, to apply for food stamp benefits and to maintain eligibility for these benefits. If an individual capable of applying for food stamp benefits refuses to do so, he or she must pay the provider. Regulations would also protect individuals by regulating providers’ charges for food; allowing capable individuals to use their food stamp benefits to purchase and prepare their own meals; guaranteeing an individual’s funding for food regardless of whether he or she receives food stamp benefits or whether the amount of the benefit fluctuates; confirming a provider’s obligation to provide for the nutritional needs of the individual, and guaranteeing residential services whether or not an individual receives food stamp benefits or contributes toward the cost of food.

OMRDD published proposed regulations with these changes as a Notice of Proposed Rule Making (MRD-41-09-00017-P) which appeared in the State Register of October 14, 2009 and is accessible on the NYS Department of State website. The proposed regulations are also available on OMRDD’s website at www.omr.state.ny.us. Look under “Regulations.”

b) The second change would conform the reimbursement methodology for community residences to the methodology used for IRAs. OMRDD currently has two separate reimbursement methodologies for community residences and IRAs. The change will consolidate aggregate costs of community residences with the aggregate costs of IRAs to determine a single agency-specific price for both supervised IRA and supervised community residence facilities and a single agency-specific price for both supportive IRA and supportive community residence facilities.

There will be no additional costs to the state and federal governments as a result of this change.

The reason for this change is to achieve administrative efficiencies for both the providers and OMRDD.

OMRDD has previously published regulations containing this change as a Notice of Proposed Rule Making (MRD-41-09-00016-P) which appeared in the State Register of October 14, 2009 and a summary of the changes is accessible on the NYS Department of State website. The full text of the proposed regulations is available on OMRDD’s website at www.omr.state.ny.us. Look under “Regulations.”

Public hearings on both of these proposed changes will be held as follows:

Monday, Nov. 30, 2009 - 11:00 a.m. Bernard Fineson DDSO, Videoconference Room 2 New Administrative Building 80-45 Winchester Blvd. Queens Village, NY

Tuesday, Dec. 1, 2009 - 2:00 p.m. Capital District DDSO, Bldg. 3, 3rd Fl., Rm. 2 Balltown & Consaul Roads Schenectady, NY

Copies of both of the proposed changes are also on file in each local (county) social services district and are available for public review. For the New York City district, copies are available at the following locations:

New York County 250 Church Street New York, NY 10018

Queens County, Queens Center 3220 Northern Boulevard Long Island City, NY 11101

Kings County, Fulton Center 114 Willoughby Street Brooklyn, NY 11201

Bronx County, Tremont Center 1916 Monterey Avenue Bronx, NY 10457

Richmond County, Richmond Center 95 Central Avenue, St. George Staten Island, NY 10301

Any written comments and inquiries for further information may be addressed to: Barbara Brundage, Regulatory Affairs Unit, Office of Counsel, Office of Mental Retardation and Developmental Disabilities, 44 Holland Ave., Albany, NY 12229, (518) 474-1830, e-mail: [email protected]

Pursuant to Public Officer Law Section 104, the Division of Criminal Justice Services gives notice of a meeting of the New York State Juvenile Justice Advisory Group:

For further information contact: Carolyn C. DeLuise, Secretary to Jacquelyn Greene, Esq., Office of Program Development and Funding, Juvenile Justice Policy and Program Unit, Division of Criminal Justice Services, Four Tower Place, 3rd Fl., Albany, NY 12203, (518) 485-9609, Fax: (518) 485-0909

Pursuant to 42 CFR Section 447.205, the Department of Health hereby gives public notice of the following:

The Department of Health proposes to amend the Title XIX (Medicaid) State Plan for non-institutional services as it relates to the Ambulatory Patient Groups (APG) methodology, as follows:

Non-Institutional Services

• The definition of what constitutes an APG “visit” for general hospital outpatient and emergency department services, and diagnostic and treatment center clinic services is refined and supplemented by a definition of APG “episode”. Visit shall mean a unit of service consisting of all the APG services performed for a patient that are coded on the same claim and share a common date of service. Episode shall mean a unit of service consisting of all services on a claim, regardless of the coded dates of service. An episode shall consist of all medical visits and/or procedures that are provided by a clinic to a patient on a single date of service plus any associated non-carved-out ancillaries, regardless of the date of service of those ancillaries. For emergency departments, the significant procedures and/or medical visits comprising the non-carved-out ancillary services portion of an episode need not be on a single date of services and may instead be on consecutive dates of service. Multiple episodes shall not be coded on the same claim. The calculation of the APG payment by the APG software may be either visit based or episode-based depending on the rate code used to access the APG software logic. References to “visits” in this subpart shall be deemed to refer also to “episodes” for rate-setting purposes.

• The definition of "discounting" as it relates to the APG methodology shall mean the reduction in APG payment that results when additional procedures do not consolidate. Additional occurrences of the same or ancillary APGs within a single visit or episode will also discount.

• The definition of "packaging" as it relates to the APG methodology shall mean those circumstances in which payment for routine ancillary services or drugs shall be deemed as included in the applicable APG payment for a related significant procedure or medical visit. Medical visits also package with significant procedures, unless specifically excepted in regulation.

• The January 1, 2010 initial reweighting of APG relative weights for diagnostic and treatment center clinic services, freestanding ambulatory surgery services, and general hospital outpatient services, emergency department services and ambulatory surgery services shall be based on Medicaid claims data for the period December 1, 2008 through September 30, 2009. Subsequent reweightings will be based on Medicaid claims data for the most recent twelve month period.

• Revisions to general hospital base rates, case-mix indices, and/or coding improvement factors for periods prior to January 1, 2010, will be based on Medicaid claims data for the December 1, 2008 through April 30, 2009 period. Such revisions attributable to the period commencing January 2010, will be based on Medicaid claims data for the period December 1, 2008 through September 30, 2009. Subsequent revisions will be based on the most recent twelve month period.

• Revisions to diagnostic and treatment center base rates, case-mix indices, and/or coding improvement factors for periods prior to January 1, 2010, shall be based on 2007 Medicaid claims data. Such revisions for the period commencing January 1, 2010, will be based on Medicaid claims data for the period January 1, 2009 through November 15, 2009. Subsequent revisions will be based on the most recent twelve month period.

• The March 31, 2010 end date for APG general hospital services shall be rescinded.

• The statutorily established schedule for existing providers to transition to APGs (“the blend”) will apply in the same manner to services of new general hospital outpatient departments, new diagnostic and treatment center clinics and new freestanding ambulatory surgery centers.

• Rates for services provided in outpatient facilities located outside New York state shall be as follows:

- APG rates in effect for similar services for providers located in the downstate region of New York state shall apply with regard to services provided by out-of-state providers located in the New Jersey counties of Sussex, Passaic, Bergin, Hudson, Essex, Union, Middlessex and Monmouth, in the Pennsylvania county of Pike, and in the Connecticut counties of Fairfield and Litchfield; and rates in effect for similar services for providers located in the upstate region of New York state shall apply with regard to all other out-of-state providers.

- In the event the Department determines that an out-of-state provider is providing services which are not available within New York State, the Department may negotiate payment rates and conditions with such a provider. Prior approval by the Department shall be required with regard to services provided by such providers.

- For the purposes of this section the downstate region of New York State shall consist of the New York counties of Bronx, New York, Kings, Queens, Richmond, Nassau, Suffolk, Westchester, Rockland, Orange, Putnam and Dutchess, and the upstate region of New York State shall consist of all other New York counties.

The estimated aggregate increase in gross Medicaid expenditures attributable to these proposed initiatives for state fiscal year 2010/2011 is $270 million.

Copies of the proposed state plan amendments will be on file in each local (county) social services district and available for public review.

For the New York City district, copies will be available at the following places:

New York County 250 Church Street New York, New York 10018

Queens County, Queens Center 3220 Northern Boulevard Long Island City, New York 11101

Kings County, Fulton Center 114 Willoughby Street Brooklyn, New York 11201

Bronx County, Tremont Center 1916 Monterey Avenue Bronx, New York 10457

Richmond County, Richmond Center 95 Central Avenue, St. George Staten Island, New York 10301

The public is invited to review and comment on this proposed state plan amendment.

For further information and to review and comment, please contact:Philip N. Mossman, Department of Health, Bureau of HCRA Operations & Financial Analysis, Corning Tower Building, Rm. 984, Empire State Plaza, Albany, NY 12237, (518) 474-1673, (518) 473-8825 (FAX), e-mail: [email protected]

The New York State Real Estate Board will hold a public hearing on general real estate issues on Thursday, December 3, 2009 at 10:30 a.m. at Department of State, Division of Licensing Services, Alfred E. Smith State Office Building, 80 South Swan Street, 10th Floor Conference Room, Albany, NY and 123 William Street, 19th Floor Conference Room, New York, NY. The Board will hold an open board meeting immediately following the public hearing at the same locations (via video-conference).

Should you wish to participate in the public hearing or attend the board meeting, please contact Debra Ryan-Campana at [email protected] or 518-473-6155. If you plan to attend in Albany, please consult our web site (http://www.dos.state.ny.us/lcns/contact.htm) for instructions on pre-registering in order to gain access to the building. Please always consult the Department of State website (www.dos.state.ny.us/about/calendar.htm) on the day before the meeting to be sure the meeting has not been rescheduled.

A meeting of the New York State Board of Real Estate Appraisal will be held on Thursday December 10, 2009 at 10:30 a.m. at the Department of State, Alfred E. Smith State Office Bldg., 80 South Swan Street, 10th Floor Conference Room, Albany, NY, and 123 William Street, 19th Floor Conference Room, NYC, NY.

Should you wish to attend or require further information, please contact Debra Campana, Board Coordinator, at [email protected] or 518-473-6155. Please always consult the Department of State website (www.dos.state.ny.us/about/calendar.htm) on the day before the meeting to make sure the meeting has not been rescheduled.

The New York State Department of State (DOS) is required by Federal regulations to provide timely public notice for the activities described below, which are subject to the consistency provisions of the Federal Coastal Zone Management Act of 1972, as amended.

The applicant has certified that the proposed activity complies with and will be conducted in a manner consistent with the approved New York State Coastal Management Program. The applicant's consistency certification and accompanying public information and data are available for inspection at the New York State Department of State offices located at 99 Washington Avenue, One Commerce Plaza in Albany, New York.

In F-2009-0094, Joan Hatfield Matthews is proposing to modify the submitted consistency certification for the installation of a 4′ x 131′ fixed elevated catwalk, a 3′ x 14′ hinged ramp, a 6′ x 20′ float secured by (2) 8″ diameter piles in a “T” formation and (4) 8″ diameter mooring piles set 10' off each corner float. The proposed structure would be constructed at a point beginning at the existing shed and extend seaward into North Sea Harbor on and adjacent to her property at 233 Shore Road, in the Town of Southampton, Suffolk County, New York. This proposal was modified from the original and was issued a General Concurrence - Modified to be Consistent (GCM) on April 10, 2009.

The applicant has submitted a request to further modify the submitted consistency certification, which includes the following modifications: •move the location of the dock to the east along the shoreline closer to the center of the property; •increase the catwalk length from 131′ to 164′. The proposed modifications would allow the dock to extend 148′ into North Sea Harbor measured from the line of Mean High Water (MHW).

Any interested parties and/or agencies desiring to express their views concerning the above proposed activity may do so by filing their comments, in writing, no later than 4:30 p.m., 15 days from the date of publication of this notice, or, December 10, 2009.

Comments should be addressed to the Division of Coastal Resources and Waterfront Revitalization, New York State Department of State, One Commerce Plaza, 99 Washington Avenue, Albany, New York 12231. Telephone (518) 474-6000; Fax (518) 473-2464.

This notice is promulgated in accordance with Title 15, Code of Federal Regulations, Part 930.

The New York State Department of State (DOS) is required by Federal regulations to provide timely public notice for the activities described below, which are subject to the consistency provisions of the Federal Coastal Zone Management Act of 1972, as amended.

The applicant has certified that the proposed activity complies with and will be conducted in a manner consistent with the approved New York State Coastal Management Program. The applicant's consistency certification and accompanying public information and data are available for inspection at the New York State Department of State offices located at 99 Washington Avenue, One Commerce Plaza in Albany, New York.

In F-2009-00400, Mark Teitelbaum is proposing the construction of a new, private, recreational dock consisting of a 4-foot wide by 6-foot long set of stairs leading up to a 4-foot wide by 175-foot long fixed catwalk, elevated at 4-foot above grade, leading to a 4-foot wide by 6-foot long set of stairs leading down to a 4-foot wide by 13-foot long fixed “lower” catwalk with a fixed ladder to the water. The proposed structure would be constructed along the shoreline of Conscience Bay on and adjacent to his property at 3 North Road, in the Town of Brookhaven, Suffolk County, New York. Conscience Bay is a part of the State-designated Conscience Bay, Little Bay, and Setauket Harbor Significant Coastal Fish and Wildlife Habitat.

Any interested parties and/or agencies desiring to express their views concerning the above proposed activity may do so by filing their comments, in writing, no later than 4:30 p.m., 10 days from the date of publication of this notice, or, December 5, 2009.

Comments should be addressed to the Division of Coastal Resources and Waterfront Revitalization, New York State Department of State, One Commerce Plaza, 99 Washington Avenue, Albany, New York 12231. Telephone (518) 474-6000; Fax (518) 473-2464.

This notice is promulgated in accordance with Title 15, Code of Federal Regulations, Part 930.

The New York State Department of State (DOS) is required by Federal regulations to provide timely public notice for the activities described below, which are subject to the consistency provisions of the Federal Coastal Zone Management Act of 1972, as amended.

The applicant has certified that the proposed activity complies with and will be conducted in a manner consistent with the approved New York State Coastal Management Program. The applicant's consistency certification and accompanying public information and data are available for inspection at the New York State Department of State offices located at One Commerce Plaza, 99 Washington Avenue in Albany, New York.

In F-2009-0706, John R. Happick has applied for authorization from the Buffalo District of the United States Army Corps of Engineers to install a 100 foot long sea wall made of pressure treated 4″ x 4″ lumber, at 8 foot spacing, and vinyl sheet pile; the wall is proposed to extend 3 feet above current grade. The sea wall is proposed to be located at the water’s edge of North Sandy Pond at Mr. Happick’s property, located at 296 West Shore Drive, Sandy Creek, NY and would utilize excavation equipment and a water jet to facilitate installation. The stated purpose of the project is to “prevent further shoreline erosion and property damage.” The project is proposed to be conducted adjacent to a feature designated as a “natural protective feature” pursuant to 6 NYCRR Part 505.

Any interested parties and/or agencies desiring to express their views concerning the above proposed activities may do so by filing their comments, in writing, no later than 4:30 p.m., 30 days from the date of publication of this notice, or, December 25, 2009.

Comments should be addressed to the New York State Department of State, Office of Coastal, Local Government and Community Sustainability, One Commerce Plaza, 99 Washington Avenue, Suite, 1010, Albany, New York 12231. Telephone (518) 474-6000; Fax (518) 473-2464.

This notice is promulgated in accordance with Title 15, Code of Federal Regulations, Part 930.

Pursuant to Section 9-0505 of the Environmental Conservation Law, the Department of Environmental Conservation hereby gives Public Notice for the following:

Sealed bids for 1,422 tons more or less of red pine, 270 MBF more or less of Norway spruce, 76.5 MBF more or less of Japanese larch, 1.6 MBF more or less of black cherry, 1.0 MBF more or less of red maple, 0.1 MBF more or less of hard maple, 0.1 MBF more or less of white ash, and 19 cords more or less of firewood located on Chenango Reforestation Area No. 19, Stands C-50, 51, 52, & 53 and Chenango Reforestation Area No. 32, Stands A-75 & 84, will be accepted at the Department of Environmental Conservation, Contract Unit, 625 Broadway, 10th Fl., Albany, NY 12233-5027 until 11:00 a.m. on Thursday, Dec. 10, 2009.

For further information, contact: Robert Slavicek, Supervising Forester, Department of Environmental Conservation, Division of Lands and Forests, Region 7, 2715 State Hwy. 80, Sherburne, NY 13460-4507, Telephone: (607) 674-4036

Pursuant to Section 9-0505 of the Environmental Conservation Law, the NYS Department of Environmental Conservation hereby gives Public Notice of the following:

Sealed bids for 36.7 MBF more or less of hard maple, 13.1 MBF more or less of white ash, 19.0 MBF more or less of black cherry, 0.8 MBF more or less of basswood, 0.1 MBF more or less of yellow birch, 62 cords more or less of miscellaneous hardwoods, located on Madison Reforestation Area No. 1; Stand(s) A-46 & 47, will be accepted at the Department of Environmental Conservation, Contract Unit, 625 Broadway, 10th Fl., Albany, NY 12233-5027 until 11:00 a.m., Thursday, Dec. 10, 2009.

For further information, contact: Robert Slavicek, Supervising Forester, Department of Environmental Conservation, Division of Lands and Forests, Region 7, 2715 State Hwy. 80, Sherburne, NY 13460-4507, Telephone: (607) 674-4036