HARP BH HCBS Transition to Behavioral Health Adult Rehabilitation Services (BH ARS)

In July 1997, New York State received approval from the Centers for Medicare and Medicaid Services (“CMS”) for its “Partnership Plan” Medicaid Section 1115 Demonstration (the “1115 Demonstration”). In implementing the 1115 Demonstration, the State sought to achieve the following goals:

• Improve access to health care for the Medicaid population;

• Improve the quality of health services delivered; and

• Expand coverage to additional low-income New Yorkers with resources generated through managed care efficiencies.

In furtherance of these goals, the primary objective of the 1115 Demonstration was to enroll most of the State’s Medicaid population into managed care, and to use a managed care delivery system to deliver benefits to Medicaid recipients, create efficiencies in the Medicaid program, and enable the extension of coverage to certain individuals who would otherwise be without health insurance.

In 2015, as part of the 1115 Demonstration, NYS created Health and Recovery Plans (HARPs). HARPs are comprehensive Medicaid special needs plans serving people age 21 and older with serious mental illness and or substance use conditions. They offer an enhanced benefit package, including a suite of rehabilitation and recovery services called Behavioral Health Home and Community Based Services (BH HCBS) and are required to employ specialized staff with behavioral health expertise to ensure integration of care. BH HCBS are also available to people enrolled in HIV Special Needs Plans (HIV SNPs) who meet HARP eligibility criteria.

The Department is seeking to improve access to BH HCBS for people with serious mental illness and/or substance use disorders by removing administrative requirements associated with services authorized pursuant to Section 1915(c) of the Social Security Act, which have resulted in lower than expected service utilization. The Department has found HARP enrollees require rapid engagement and immediate connection to a service in order to successfully engage and establish trusting relationships with providers. To increase access to these important and cost-effective services, New York will transition BH HCBS to a new service array called Behavioral Health Adult Rehabilitation Services (BH ARS).

This proposal will have minimal beneficiary impact and will improve service access. Approximately 140,000 people are enrolled in a HARP. Between five and six thousand HARP members annually access adult BH HCBS. Despite numerous attempts to improve access to adult BH HCBS, fewer than 4% of HARP members have received any of these services. These proposed changes streamline access to care by eliminating the need for an independent assessment of BH HCBS eligibility, remove settings restrictions on service access, and make Adult BH ARS available to all HARP members and HARP-eligible HIV SNP members based on a recommendation from a licensed practitioner of the healing arts. Of the existing HCBS array, only two underutilized services are being eliminated. The following table shows how services will transition from BH HCBS to BH ARS.

Funding for Adult BH HCBS is already included in the HARP premium (monthly HARP premiums range from $1,233 to $2,656 depending on region). This proposal does not grant any additional benefits to the HARP population. It primarily changes the way some benefits are accessed. Given these factors, the State does not anticipate any impact on the annual average demonstration cost of $40 billion and, therefore, the State does not anticipate any impact on Budget Neutrality of the demonstration resulting from the adoption of this amendment.

Written comments will be accepted at: [email protected] or by mail at Department of Health, Office of Health Insurance Programs, Waiver Management Unit, 99 Washington Ave., 7th floor, Suite 720, Suite 1208, Albany, NY 12210

All comments must be postmarked or emailed by 30 days from the date of this notice.

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 to revise provisions of the Ambulatory Patient Group (APG) reimbursement methodology. The following changes are proposed:

Non-Institutional Services

Effective on or after July 1, 2020, the Ambulatory Patient Group (APG) reimbursement methodology is revised to include recalculated weight and component updates to reflect the APG policy updates.

The estimated annual net aggregate decrease in gross Medicaid expenditures attributable to this initiative is ($284,000).

The public is invited to review and comment on this proposed State Plan Amendment, a copy of which will be available for public review on the Department’s website at http://www.health.ny.gov/regulations/state_plans/status. Individuals without Internet access may view the State Plan Amendments at any local (county) social services district.

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

For further information and to review and comment, please contact: Department of Health, Division of Finance and Rate Setting, 99 Washington Ave., One Commerce Plaza, Suite 1432, Albany, NY 12210, [email protected]

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.

In F-2020-0104, Jay Morrow is proposing to repair a wooden breakwall and installing rip rap backfill with wooden breakwall area. The stated purpose is to repair structures damaged by high water, utilizing rip rap rock to help prevent erosion and damage with the wooden breakwall structure.

The proposal is for 1752 Lake Road in the Town of Webster along Lake Ontario.

The applicant’s consistency certification and supporting information are available for review at: http://www.dos.ny.gov/opd/programs/pdfs/Consistency/F-2020-0104ForPN.pdf

Original copies of public information and data submitted by the applicant 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.

Any interested parties and/or agencies desiring to express their views concerning any of the above proposed activities 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, July 17, 2020.

Comments should be addressed to: Consistency Review Unit, Department of State, Office of Planning, Development & Community Infrastructure, One Commerce Plaza, 99 Washington Ave., Albany, NY 12231, (518) 474-6000, Fax (518) 473-2464. Electronic submissions can be made by email at: [email protected]

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 (CZMA) of 1972, as amended.

The applicant has certified that the proposed activities comply with and will be conducted in a manner consistent with the federally approved New York State Coastal Management Program (NYSCMP). 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-2020-0238, General Motors LLC (GE) is proposing the installation of wedge-wire screens at their existing GE Tonawanda Engine facility water intake structure located on the eastern shore of the Niagara River in Tonawanda, New York. The purpose of the proposed wedge-wire screens is to meet New York State Department of Environmental Conservation impingement and entrainment requirements for the issuance of a water withdrawal permit.

The applicant’s consistency certification and supporting information are available for review at: http://www.dos.ny.gov/opd/programs/pdfs/Consistency/F-2020-0238GeneralMotors.pdf

Any interested parties and/or agencies desiring to express their views concerning any of 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 July 17, 2020.

Comments should be addressed to: Department of State, Office of Planning and Development and Community Infrastructure, Consistency Review Unit, One Commerce Plaza, Suite 1010, 99 Washington Ave., Albany, NY 12231, (518) 474-6000. Electronic submissions can be made by email at: [email protected]

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 (CZMA) of 1972, as amended.

The applicant has certified that the proposed activities comply with and will be conducted in a manner consistent with the federally approved New York State Coastal Management Program (NYSCMP). 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-2020-0362, the Consolidated Edison Company of New York, Inc. is proposing to maintenance dredge an area to 21.0 feet below MLW plus an allowable over dredge of 2 feet. After dredging, the sediment is proposed to be transported to a designated area at the Historic Area Remediation Site (HARS) located approximately 6 miles off the coast of Sandy Hook, New Jersey. The project is at 9th Street - Pier 98, Block 1109, Lots 20 and 25, Manhattan, New York County, Hudson River.

The applicant’s consistency certification and supporting information are available for review at: http://www.dos.ny.gov/opd/programs/pdfs/Consistency/F-2020-0362_ConEd_App.pdf

The proposed activity would be located within or has the potential to affect the following Special Management or Regulated Area(s):

• New York City Local Waterfront Revitalization Program: https://www.dos.ny.gov/opd/programs/WFRevitalization/LWRP_ status.html;

Any interested parties and/or agencies desiring to express their views concerning any of 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 July 17, 2020.

Comments should be addressed to: Department of State, Office of Planning and Development and Community Infrastructure, Consistency Review Unit, One Commerce Plaza, Suite 1010, 99 Washington Ave., Albany, NY 12231, (518) 474-6000. Electronic submissions can be made by email at: [email protected]

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 (CZMA) of 1972, as amended.

The applicant has certified that the proposed activities comply with and will be conducted in a manner consistent with the federally approved New York State Coastal Management Program (NYSCMP). 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-2020-0389, 4 Fair Oaks Drive, LLC proposes to remove the existing dock and piles, and construct a new fixed catwalk and seasonal floating dock. The fixed catwalk (4' x 58') to be constructed from open-grate decking, and elevated 26" above MHW and 4' above vegetated wetlands. The catwalk will be connected to a seasonal ramp (3' x 15') and float (6' x 20'), constructed perpendicular to shoreline. Located at 4 Fair Oaks Drive, Quogue, NY 11942, Suffolk County on Stone Creek.

The applicant’s consistency certification and supporting information are available for review at: http://www.dos.ny.gov/opd/programs/pdfs/Consistency/F-2020-0389FairOaksDrive.pdf

Any interested parties and/or agencies desiring to express their views concerning any of 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 July 17, 2020.

Comments should be addressed to: Department of State, Office of Planning and Development and Community Infrastructure, Consistency Review Unit, One Commerce Plaza, Suite 1010, 99 Washington Ave., Albany, NY 12231, (518) 474-6000. Electronic submissions can be made by email at: [email protected]

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 (CZMA) of 1972, as amended.

The applicant has certified that the proposed activities comply with and will be conducted in a manner consistent with the federally approved New York State Coastal Management Program (NYSCMP). 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-2020-0391 the applicant, Astoria Generating Company, LP, is proposing maintenance dredging within the existing footprint of two gas turbine barges to 15ft below MLLW. This project will remove approximately 5,900 cubic yards of sediment within an area of 48,600 square feet. The sediment is proposed for amendment and re-use upland at a permitted facility within New Jersey. This project is located at the Narrows Generating Station, 4 Whale Square, New York City, Kings County, Bay Ridge Channel in Upper New York Bay.

The applicant’s consistency certification and supporting information are available for review at: http://www.dos.ny.gov/opd/programs/pdfs/Consistency/F-2020-0391.pdf

The proposed activity would be located within or has the potential to affect the following Special Management or Regulated Area(s):

• New York City Local Waterfront Revitalization Program: https://www.dos.ny.gov/opd/programs/WFRevitalization/LWRP_status.html

Any interested parties and/or agencies desiring to express their views concerning any of the above proposed activities 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 July 2, 2020.

Comments should be addressed to: Department of State, Office of Planning and Development and Community Infrastructure, Consistency Review Unit, One Commerce Plaza, Suite 1010, 99 Washington Ave., Albany, NY 12231, (518) 474-6000. Electronic submissions can be made by email at: [email protected]

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.

In F-2020-0424, The Village of Sodus Point is proposing to place rip rap shoreline protection along ~120 linear feet of currently unprotected Sodus Bay shoreline. The project is along Wickham Boulevard in the vicinity of the intersection of Wickham Boulevard and 4th Street, within the Village of Sodus Point, Wayne County.

The stated purpose of the proposed project is to Protect Village infrastructure from flooding and collapsing and/or discharging into Sodus Bay. Also, to protect a public walking trail along the shoreline.

The applicant’s consistency certification and supporting information are available for review at: http://www.dos.ny.gov/opd/programs/pdfs/Consistency/F-2020-0424ForPN.pdf

Original copies of public information and data submitted by the applicant 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.

Any interested parties and/or agencies desiring to express their views concerning any of the above proposed activities 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, July 2, 2020.

Comments should be addressed to: Consistency Review Unit, Department of State, Office of Planning, Development & Community Infrastructure, One Commerce Plaza, 99 Washington Ave., Albany, NY 12231, (518) 474-6000, Fax (518) 473-2464. Electronic submissions can be made by email at: [email protected]

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

Pursuant to 19 NYCRR Part 1205, the variance and appeal petitions below have been received by the Department of State. Unless otherwise indicated, they involve requests for relief from provisions of the New York State Uniform Fire Prevention and Building Code. Persons wishing to review any petitions, provide comments, or receive actual notices of any subsequent proceeding may contact Brian Tollisen or Neil Collier, Building Standards and Codes, Department of State, One Commerce Plaza, 99 Washington Ave., Albany, NY 12231, (518) 474-4073 to make appropriate arrangements.

2020-0258 In the matter of Labella Associates, DPC, Mark Kukuvka, 300 South State Street, Rochester, NY 14614, for Herkimer County concerning building code and fire safety requirements including to omit sprinkler protection below open stairs and landing platforms inside the daycare areas in the inmate housing units.

Involved is the construction of a correction facility, known as “Herkimer County Correction Facility”, located at 711 Middleville Road/Rte. 28, Village of Herkimer, County of Herkimer, New York.

Pursuant to 19 NYCRR Part 1205, the variance and appeal petitions below have been received by the Department of State. Unless otherwise indicated, they involve requests for relief from provisions of the New York State Uniform Fire Prevention and Building Code. Persons wishing to review any petitions, provide comments, or receive actual notices of any subsequent proceeding may contact Brian Tollisen or Neil Collier, Building Standards and Codes, Department of State, One Commerce Plaza, 99 Washington Ave., Albany, NY 12231, (518) 474-4073 to make appropriate arrangements.

2020-0259 In the matter of Andrew Schreck, 148 Coddington Road, Ithaca, NY 14850, concerning safety requirements including a variance for reduction in required height of existing interior stair handrail.

Involved is the certificate of compliance inspection of an existing residential occupancy, two stories in height, located at 524 North Albany Street, City of Ithaca, County of Tompkins, New York.

In accordance with the New York State Waterfront Revitalization of Coastal Areas and Inland Waterways Act and the New York State Coastal Management Program, the Town of Bethlehem, located within Albany County and the Capital District region, has prepared a Draft Local Waterfront Revitalization Program (LWRP). The LWRP is a comprehensive management program for the Town’s waterfront resources along the Normans, Volman, and Binnen Kills, and Hudson River.

To approve the Town of Bethlehem LWRP pursuant to Article 42 of the NYS Executive Law, it is required that potentially affected State, federal, regional and local agencies be consulted to assure that the program does not conflict with existing policies and programs. For this purpose, the Draft LWRP is accessible online at: http://www.dos.ny.gov/opd/programs/WFRevitalization/LWRP_draft.html

The Town of Bethlehem Draft LWRP was accepted by the New York State Department of State (DOS) as complete and is now available for review by potentially affected State, federal, regional and local agencies, and the public. Comments on the Draft LWRP are due by August 17, 2020. At the close of this required review period, DOS will coordinate with the Town the responses to comments and any necessary revisions to the LWRP. Following adoption of the LWRP by the Town, and its subsequent approval by the Secretary of State, pursuant to 15 CFR Part 923, Subpart H, DOS will request incorporation of the LWRP into the State’s Coastal Management Program by the federal Office for Coastal Management (OCM), as a Program Change.

Comments on the Town of Bethlehem Draft LWRP should be submitted by August 17, 2020, to: Valeria Ivan of the Office of Planning and Development & Community Infrastructure within the New York State Department of State, at [email protected]

In accordance with the New York State Waterfront Revitalization of Coastal Areas and Inland Waterways Act and the New York State Coastal Management Program, the Village of Nyack, located within Rockland County and the Hudson Valley region, has prepared a Draft Local Waterfront Revitalization Program (LWRP) Amendment. The LWRP is a comprehensive management program for the Village’s waterfront resources along the Hudson River.

To approve the Village of Nyack LWRP Amendment, pursuant to Article 42 of the NYS Executive Law, it is required that potentially affected State, federal, and local agencies be consulted to assure that the program does not conflict with existing policies and programs. For this purpose, the Draft LWRP Amendment is available online at: http://www.dos.ny.gov/opd/programs/WFRevitalization/LWRP_draft.html

The Draft LWRP Amendment was accepted by the New York State Department of State (DOS) as complete and is now available for review by potentially affected State, federal and local agencies, and the public. Comments on the Draft LWRP Amendment are due by August 17, 2020. At the close of this required review period, DOS will coordinate responses to comments received with the Village, and modifications to the LWRP will be made as necessary to address all comments. Following adoption of the LWRP by the Village, and its subsequent approval by the Secretary of State, pursuant to 15 CFR Part 923, Subpart H, DOS will request incorporation of the LWRP into the State’s Coastal Management Program by the federal Office for Coastal Management (OCM), as a Program Change.

Comments on the Village of Nyack Draft LWRP Amendment should be submitted by August 17, 2020, to: Lisa Vasilakos, NYS Department of State, Office of Planning and Development & Community Infrastructure via email at [email protected]