S T A T E O F N E W Y O R K
________________________________________________________________________
6007
2015-2016 Regular Sessions
I N A S S E M B L Y
March 9, 2015
___________
Introduced by COMMITTEE ON RULES -- read once and referred to the
Committee on Ways and Means
AN ACT to amend section 4 of part X2 of chapter 62 of the laws of 2003,
amending the public health law relating to allowing for the use of
funds of the office of professional medical conduct for activities of
the patient health information and quality improvement act of 2000, in
relation to extending the provisions thereof; and to amend the social
services law, in relation to enhancing the quality of adult living
program for adult care facilities (Part A); to amend the social
services law, in relation to statewide supplemental rebates; to amend
part H of chapter 59 of the laws of 2011, amending the public health
law and other laws relating to known and projected department of
health state fund medical expenditures, in relation to extending the
provisions thereof; to amend the public health law, in relation to the
clinical drug review program; to amend the public health law, in
relation to the prescriber prevails provision; to amend parts A and B
of chapter 1 of the laws of 2002, relating to the health care reform
act of 2000, in relation to upper payment limits; to amend the public
health law, in relation to covered lives assessments in the Rochester
region; to amend the public health law, in relation to noticing of
hospitals; to amend the public health law, in relation to community
service plans and performing provider systems community advisory
boards; to amend the social services law, in relation to health homes;
to amend part B of chapter 59 of the laws of 2011, amending the public
health law relating to rates of payment and medical assistance, in
relation to managed care supplemental payments; to amend part H of
chapter 59 of the laws of 2011, amending the public health law relat-
ing to general hospital inpatient reimbursement for annual rates, in
relation to supplemental Medicaid managed care payments; to amend the
social services law, in relation to spousal support; to amend the
social services law, in relation to school-based health centers; to
amend the social services law, in relation to payments for Medicare
beneficiaries; to authorize a mobility management contractor; to amend
the public health law, in relation to energy efficiency; to amend the
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD20005-01-5
A. 6007 2
public health law, in relation to payment rates for managed long term
care enrollees and long term care health programs; to amend the social
services law, in relation to working disabled eligibility; to amend
the social services law, in relation to family planning benefits; to
amend the social services law, in relation to foster care; to amend
the public health law, in relation to certified home health agencies;
to amend the public health law, in relation to value based payments;
to amend the social services law, in relation to the basic health plan
program; to amend the social services law, in relation to establishing
a health technology assessment committee within the medical assistance
program; to repeal subdivision 25-a of section 364-j of the social
services law, relating to managed care provided coverage for certain
drugs; to repeal subdivision 7 of section 364-i of the social services
law, relating to presumptive eligibility for medical assistance; and
providing for the repeal of certain provisions upon expiration thereof
(Part B); to amend part A of chapter 56 of the laws of 2013 amending
chapter 59 of the laws of 2011 amending the public health law and
other laws relating to general hospital reimbursement for annual rates
relating to the cap on local Medicaid expenditures, in relation to
rates of payment paid to certain providers by the Child Health Plus
Program; and to amend chapter 111 of the laws of 2010 relating to
increasing Medicaid payments to providers through managed care organ-
izations and providing equivalent fees through an ambulatory patient
group methodology, in relation to rates of payment paid to certain
providers by the Child Health Plus Program (Part C); to amend chapter
884 of the laws of 1990, amending the public health law relating to
authorizing bad debt and charity care allowances for certified home
health agencies, in relation to the effectiveness thereof; to amend
chapter 81 of the laws of 1995, amending the public health law and
other laws relating to medical reimbursement and welfare reform, in
relation to the effectiveness thereof; to amend the public health law,
in relation to hospital assessments; to amend chapter 659 of the laws
of 1997, constituting the long term care integration and finance act
of 1997, in relation to the effectiveness thereof; to amend chapter
474 of the laws of 1996, amending the education law and other laws
relating to rates for residential health care facilities, in relation
to the effectiveness thereof; to amend part C of chapter 58 of the
laws of 2007, amending the social services law and other laws relating
to enacting the major components of legislation necessary to implement
the health and mental hygiene budget for the 2007-2008 state fiscal
year, in relation to delay of certain administrative costs; to amend
chapter 81 of the laws of 1995, amending the public health law and
other laws relating to medical reimbursement and welfare reform, in
relation to reimbursements and the effectiveness thereof; to amend
chapter 474 of the laws of 1996, amending the education law and other
laws relating to rates for residential healthcare facilities, in
relation to reimbursements; to amend chapter 451 of the laws of 2007,
amending the public health law, the social services law and the insur-
ance law, relating to providing enhanced consumer and provider
protections, in relation to the effectiveness thereof; to amend the
public health law, in relation to rates of payment for long term home
health care programs and making such provisions permanent; to amend
chapter 303 of the laws of 1999, amending the New York state medical
care facilities finance agency act relating to financing health facil-
ities, in relation to the effectiveness thereof; to amend chapter 165
of the laws of 1991, amending the public health law and other laws
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relating to establishing payments for medical assistance, in relation
to the effectiveness thereof; to amend the public authorities law, in
relation to the transfer of certain funds; to amend part H of chapter
59 of the laws of 2011, relating to enacting into law major components
of legislation necessary to implement the health and mental hygiene
budget for the 2011-2012 state fiscal plan, in relation to the effec-
tiveness of program oversight and administration of managed long term
care plans; to amend chapter 659 of the laws of 1997, amending the
public health law and other laws relating to creation of continuing
care retirement communities, in relation to the effectiveness thereof;
to amend the public health law, in relation to residential health care
facility, and certified home health agency services payments; to amend
part B of chapter 109 of the laws of 2010, amending the social
services law relating to transportation costs, in relation to the
effectiveness thereof; to amend chapter 21 of the laws of 2011 amend-
ing the education law relating to authorizing pharmacists to perform
collaborative drug therapy management with physicians in certain
settings, in relation to extending the provisions of such chapter; to
amend chapter 505 of the laws of 1995, amending the public health law
relating to the operation of department of health facilities, in
relation to making such provisions permanent; to amend part H of chap-
ter 59 of the laws of 2011, amending the public health law relating to
the statewide health information network of New York and the statewide
planning and research cooperative system and general powers and
duties, in relation to the effectiveness of certain provisions; to
amend part A of chapter 56 of the laws of 2013, amending chapter 59 of
the laws of 2011 amending the public health law and other laws relat-
ing to general hospital reimbursement for annual rates, relating to
the cap on local Medicaid expenditures, in relation to extending the
provisions thereof; and to repeal section 2 of chapter 459 of the laws
of 1996 amending the public health law relating to recertification of
persons providing emergency medical care (Part D); to amend the public
health law, in relation to the payment of certain funds for uncompen-
sated care (Part E); intentionally omitted (Part F); to amend the
financial services law, in relation to the financial assessment that
offsets the operational costs of the health insurance exchange; and to
amend the public health law, in relation to health care reform act
pool administration (Part G); to amend the public health law, in
relation to standardizing urgent care centers and enhanced oversight
of office-based surgery; and to repeal subdivision 4 of section 2951
and section 2956 of such law relating to the statutory authority of
upgraded diagnostic and treatment centers (Part H); to amend the civil
practice law and rules, the criminal procedure law and the executive
law, in relation to the use in evidence of the fact of possession of a
condom; to amend the penal law, in relation to criminal possession of
a controlled substance in the seventh degree; to amend the general
business law, in relation to drug-related paraphernalia; to amend the
public health law, in relation to the sale and possession of hypoderm-
ic syringes and needles; to repeal subdivision 2-a of section 2781 of
the public health law relating to certain consent for HIV related
testing; and to repeal section 220.45 of the penal law relating to
criminally possessing a hypodermic instrument (Part I); to amend the
education law and the public health law, in relation to authorizing
certain advanced home health aides to perform certain advanced tasks;
and providing for the repeal of such provisions upon expiration there-
of (Part J); to amend the public health law, in relation to streamlin-
A. 6007 4
ing the certificate of need process for hospitals and diagnostic and
treatment clinics providing primary care; and to amend the public
health law, in relation to public health and health planning council
reviews, and in relation to hospital sponsored off-campus emergency
departments (Part K); to amend the public health law, in relation to
the enhanced oversight of office-based surgery (Part L); to amend the
public health law, in relation to requiring notice and submission of a
plan prior to discontinuing fluoridation of a public water supply
(Part M); relating to conducting a study to develop a report address-
ing the feasibility of creating an office of community living for
older adults and individuals of all ages with disabilities (Part N);
to amend chapter 111 of the laws of 2010 relating to the recovery of
exempt income by the office of mental health for community residences
and family-based treatment programs, in relation to the effectiveness
thereof (Part O); to amend the education law, in relation to authoriz-
ing contracts for the provision of special education and related
services for certain patients hospitalized in hospitals operated by
the office of mental health; to require the commissioner of mental
health to report on children hospitalized in hospitals operated by the
office of mental health and to amend part M of chapter 56 of the laws
of 2012 amending the education law, relating to authorizing contracts
for the provision of special education and related services for
certain patients hospitalized in hospitals operated by the office of
mental health, in relation to the effectiveness thereof (Part P);
intentionally omitted (Part Q); to amend part A of chapter 111 of the
laws of 2010 amending the mental hygiene law relating to the receipt
of federal and state benefits received by individuals receiving care
in facilities operated by an office of the department of mental
hygiene, in relation to the effectiveness thereof (Part R); to amend
the social services law, the education law, the executive law and the
mental hygiene law, in relation to providing professional services to
individuals with developmental disabilities in non-certified settings;
in relation to the exemption of the nurse practice act for direct care
staff in non-certified settings funded, authorized or approved by the
office for people with developmental disabilities; and to repeal
certain provisions of the mental hygiene law relating thereto (Part
S); intentionally omitted (Part T); intentionally omitted (Part U); to
amend the mental hygiene law, in relation to commissioning a statewide
evaluation regarding the extent of legal and illegal gambling by New
York residents (Part V); to amend the mental hygiene law and the
racing, pari-mutuel wagering and breeding law, in relation to compul-
sive gambling assistance (Part W); to amend chapter 495 of the laws of
2004 amending the insurance law and the public health law relating to
the New York state health insurance continuation assistance demon-
stration project, in relation to the effectiveness thereof (Part X);
to amend the insurance law, in relation to an exemption to certain
provisions of law relating to risk-based capital for property/casualty
insurance companies (Part Y); to amend chapter 266 of the laws of 1986
amending the civil practice law and rules and other laws relating to
malpractice and professional medical conduct; and to amend part J of
chapter 63 of the laws of 2001 amending chapter 266 of the laws of
1986, amending the civil practice law and rules and other laws relat-
ing to malpractice and professional medical conduct, in relation to
extending certain provisions concerning the hospital excess liability
pool and requiring a tax clearance for doctors and dentists to be
eligible for such excess coverage (Part Z); to amend the insurance
A. 6007 5
law, in relation to the New York state health insurance modernization
and quality care commission (Part AA); to amend the elder law, in
relation to enriched social adult day services; and to amend chapter
58 of the laws of 2008, amending the elder law and other laws relating
to reimbursement to particular provider pharmacies and prescription
drug coverage, in relation to the effectiveness thereof (Part BB); to
amend the mental hygiene law, in relation to providing state operated
opportunities for people with developmental disabilities (Part CC); to
amend the social services law, in relation to establishing presumptive
eligibility for Medicaid for inmates (Part DD); to amend the mental
hygiene law, in relation to establishing a crisis intervention team
program (Part EE); to amend the mental hygiene law, in relation to
requiring the commissioner of developmental disabilities to conduct a
geographic analysis of supports and services in community settings for
individuals with developmental disabilities (Part FF); and to amend
the metal hygiene law, in relation to transformation workgroups (Part
GG)
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. This act enacts into law major components of legislation
2 which are necessary to implement the state fiscal plan for the 2015-2016
3 state fiscal year. Each component is wholly contained within a Part
4 identified as Parts A through GG. The effective date for each particular
5 provision contained within such Part is set forth in the last section of
6 such Part. Any provision in any section contained within a Part, includ-
7 ing the effective date of the Part, which makes a reference to a section
8 "of this act", when used in connection with that particular component,
9 shall be deemed to mean and refer to the corresponding section of the
10 Part in which it is found. Section three of this act sets forth the
11 general effective date of this act.
12 PART A
13 Section 1. Intentionally omitted.
14 S 1-a. Section 4 of part X2 of chapter 62 of the laws of 2003, amend-
15 ing the public health law relating to allowing for the use of funds of
16 the office of professional medical conduct for activities of the patient
17 health information and quality improvement act of 2000, as amended by
18 section 25 of part B of chapter 56 of the laws of 2013, is amended to
19 read as follows:
20 S 4. This act shall take effect immediately; provided that the
21 provisions of section one of this act shall be deemed to have been in
22 full force and effect on and after April 1, 2003, and shall expire March
23 31, [2015] 2017 when upon such date the provisions of such section shall
24 be deemed repealed.
25 S 2. Intentionally omitted.
26 S 3. Intentionally omitted.
27 S 4. Intentionally omitted.
28 S 5. Intentionally omitted.
29 S 6. Section 461-s of the social services law, as added by section 21
30 of part D of chapter 56 of the laws of 2012, is amended to read as
31 follows:
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1 S 461-s. Enhancing the quality of adult living program for adult care
2 facilities. 1. The commissioner of health shall establish the enhanced
3 quality of adult living program (referred to in this section as the
4 "EQUAL program" or the "program") for adult care facilities. The program
5 shall be targeted at improving the quality of life for adult care facil-
6 ity residents by means of grants to facilities for specified purposes.
7 The department of health, subject to the approval of the director of the
8 budget, shall develop an allocation methodology taking into account the
9 financial status and size of the facility as well as resident needs.
10 2. (A) No payment shall be made under the program to a facility that,
11 IN THE PRECEDING YEAR:
12 (I) has received official written notice from the department of a
13 proposed revocation, suspension, limitation or denial of the operator's
14 operating certificate[.];
15 (II) HAS RECEIVED ISSUANCE OF A DEPARTMENT ORDER UNDER SUBDIVISION TWO
16 OF SECTION FOUR HUNDRED SIXTY-D OF THIS ARTICLE; A PROPOSED ASSESSMENT
17 OF CIVIL PENALTIES FOR A VIOLATION OF SUBPARAGRAPH TWO OF PARAGRAPH (B)
18 OF SUBDIVISION SEVEN OF SECTION FOUR HUNDRED SIXTY-D OF THIS ARTICLE;
19 THE GRANTING OF EQUITABLE RELIEF UNDER SUBDIVISION FIVE OF SECTION FOUR
20 HUNDRED SIXTY-D OF THIS ARTICLE; OR THE ISSUANCE OF A COMMISSIONER'S
21 ORDER UNDER SUBDIVISION EIGHT OF SECTION FOUR HUNDRED SIXTY-D OF THIS
22 ARTICLE;
23 (III) IS SUBJECT TO AN ORDER BY A COURT OF COMPETENT JURISDICTION OR
24 AN APPROVED SETTLEMENT AGREEMENT WHICH AFFIRMS THAT THE RIGHTS AFFORDED
25 TO RESIDENTS OF ADULT CARE FACILITIES AS PROVIDED FOR BY SECTION FOUR
26 HUNDRED SIXTY-ONE-D OF THIS ARTICLE HAVE BEEN VIOLATED; OR
27 (IV) HAS FAILED TO COMPLY WITH SUBDIVISION FIVE OF THIS SECTION.
28 (B) WHEN PAYMENT IS DENIED UNDER THIS SUBDIVISION, THE DEPARTMENT
29 SHALL DETERMINE THE MEANS WHEREBY PAYMENT SHALL BE MADE TO THE RESIDENTS
30 LIVING IN THE FACILITY IN ENFORCEMENT, PROVIDED THAT THE FUNDS WILL
31 SUPPORT EXPENSES THAT DIRECTLY BENEFIT THE RESIDENTS.
32 3. Prior to applying for EQUAL program funds, a facility shall receive
33 approval of its expenditure plan from the residents' council for the
34 facility. THE RESIDENTS' COUNCIL SHALL IDENTIFY THE PRIORITIES OF THE
35 MAJORITY OF RESIDENTS FOR THE USE OF THE PROGRAM FUNDS AND DOCUMENT
36 RESIDENTS' TOP PREFERENCES BY MEANS OF A VOTE OR SURVEY. THE PLAN SHALL
37 DETAIL HOW PROGRAM FUNDS WILL BE USED TO IMPROVE THE PHYSICAL ENVIRON-
38 MENT OF THE FACILITY OR THE QUALITY OF CARE AND SERVICES RENDERED TO
39 RESIDENTS AND MAY INCLUDE, BUT NOT BE LIMITED TO, STAFF TRAINING, AIR
40 CONDITIONING IN RESIDENTS' AREAS, CLOTHING, IMPROVEMENTS IN FOOD QUALI-
41 TY, FURNISHINGS, EQUIPMENT, SECURITY, AND MAINTENANCE OR REPAIRS TO THE
42 FACILITY. THE DEPARTMENT SHALL INVESTIGATE REPORTS OF RESIDENT ABUSE AND
43 RETALIATION RELATED TO PROGRAM APPLICATIONS AND EXPENDITURES.
44 4. EQUAL PROGRAM FUNDS SHALL NOT BE EXPENDED FOR A FACILITY'S DAILY
45 OPERATING EXPENSES, INCLUDING EMPLOYEE SALARIES OR BENEFITS, FOR
46 EXPENSES INCURRED RETROSPECTIVELY, OR FOR EXPENDITURES RELATED TO
47 CORRECTIVE ACTION AS REQUIRED BY AN INSPECTION REPORT OR AUDIT UNDER
48 SUBDIVISION FIVE OF THIS SECTION.
49 5. THE DEPARTMENT OF HEALTH SHALL CONDUCT AN ANNUAL AUDIT OF EACH
50 FACILITY THAT HAS RECEIVED PAYMENT UNDER THIS SECTION TO ENSURE THAT
51 PROGRAM FUNDS WERE SPENT AS INDICATED IN THE EXPENDITURE PLAN UPON WHICH
52 THE RESPECTIVE PAYMENT WAS MADE. AT THE COMPLETION OF THE AUDIT, THE
53 FACILITY SHALL PREPARE A CORRECTIVE ACTION PLAN TO ADDRESS OR DISPUTE
54 EACH NEGATIVE AUDIT FINDING INCLUDED IN THE CURRENT YEAR AUDITOR'S
55 REPORTS. THE CORRECTIVE ACTION PLAN SHALL PROVIDE THE NAMES OF THE
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1 CONTACT PERSONS RESPONSIBLE FOR CORRECTIVE ACTION, THE CORRECTIVE ACTION
2 PLANNED, AND THE ANTICIPATED COMPLETION DATE.
3 6. THE DEPARTMENT SHALL PROMULGATE REGULATIONS TO IMPLEMENT THIS
4 SECTION.
5 S 7. This act shall take effect immediately.
6 PART B
7 Section 1. Subdivision 7 of section 367-a of the social services law
8 is amended by adding a new paragraph (e) to read as follows:
9 (E) THE COMMISSIONER MAY NEGOTIATE DIRECTLY WITH A PHARMACEUTICAL
10 MANUFACTURER FOR THE PROVISION OF SUPPLEMENTAL REBATES, INCLUDING
11 SUPPLEMENTAL REBATES RELATING TO PHARMACEUTICAL UTILIZATION BY ENROLLEES
12 OF MANAGED CARE PROVIDERS PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J
13 OF THIS TITLE, RELATING TO ANY OF THE DRUGS IT MANUFACTURES FOR THE
14 PURPOSE OF FUNDING MEDICAL ASSISTANCE PROGRAM BENEFITS; PROVIDED, HOWEV-
15 ER, THAT THIS PARAGRAPH SHALL APPLY ONLY TO ANTIRETRO-VIRALS AND HEPATI-
16 TIS C AGENTS FOR WHICH THE MANUFACTURER HAS IN EFFECT A REBATE AGREEMENT
17 WITH THE FEDERAL SECRETARY OF HEALTH AND HUMAN SERVICES PURSUANT TO 42
18 U.S.C. S1396R-8.
19 S 2. Intentionally omitted.
20 S 3. Intentionally omitted.
21 S 4. Intentionally omitted.
22 S 5. Intentionally omitted.
23 S 6. Intentionally omitted.
24 S 6-a. Subdivision 25 of section 364-j of the social services law, as
25 added by section 55 of part D of chapter 56 of the laws of 2012, is
26 amended to read as follows:
27 25. [Effective January first, two thousand thirteen, notwithstanding
28 any provision of law to the contrary, managed care providers shall cover
29 medically necessary prescription drugs in the atypical antipsychotic
30 therapeutic class, including non-formulary drugs, upon demonstration by
31 the prescriber, after consulting with the managed care provider, that
32 such drugs, in the prescriber's reasonable professional judgment, are
33 medically necessary and warranted.] NOTWITHSTANDING ANY PROVISION OF LAW
34 TO THE CONTRARY, MANAGED CARE PROVIDERS SHALL COVER MEDICALLY NECESSARY
35 PRESCRIPTION DRUGS IN ALL DRUG CLASSES, INCLUDING NON-FORMULARY DRUGS,
36 UPON DEMONSTRATION BY THE PRESCRIBER, AFTER CONSULTING WITH THE MANAGED
37 CARE PROVIDER, THAT SUCH DRUGS, IN THE PRESCRIBER'S REASONABLE PROFES-
38 SIONAL JUDGMENT, ARE MEDICALLY NECESSARY AND WARRANTED.
39 S 6-b. Subdivision 25-a of section 364-j of the social services law is
40 REPEALED.
41 S 7. Intentionally omitted.
42 S 8. Subdivision 1 of section 92 of part H of chapter 59 of the laws
43 of 2011, amending the public health law and other laws relating to known
44 and projected department of health state fund medicaid expenditures, as
45 amended by section 33 of part C of chapter 60 of the laws of 2014, is
46 amended to read as follows:
47 1. For state fiscal years 2011-12 through [2015-16] 2016-17, the
48 director of the budget, in consultation with the commissioner of health
49 referenced as "commissioner" for purposes of this section, shall assess
50 on a monthly basis, as reflected in monthly reports pursuant to subdivi-
51 sion five of this section known and projected department of health state
52 funds medicaid expenditures by category of service and by geographic
53 regions, as defined by the commissioner, and if the director of the
54 budget determines that such expenditures are expected to cause medicaid
A. 6007 8
1 disbursements for such period to exceed the projected department of
2 health medicaid state funds disbursements in the enacted budget finan-
3 cial plan pursuant to subdivision 3 of section 23 of the state finance
4 law, the commissioner of health, in consultation with the director of
5 the budget, shall develop a medicaid savings allocation plan to limit
6 such spending to the aggregate limit level specified in the enacted
7 budget financial plan, provided, however, such projections may be
8 adjusted by the director of the budget to account for any changes in the
9 New York state federal medical assistance percentage amount established
10 pursuant to the federal social security act, changes in provider reven-
11 ues, reductions to local social services district medical assistance
12 administration, and beginning April 1, 2012 the operational costs of the
13 New York state medical indemnity fund. Such projections may be adjusted
14 by the director of the budget to account for increased or expedited
15 department of health state funds medicaid expenditures as a result of a
16 natural or other type of disaster, including a governmental declaration
17 of emergency.
18 S 9. Intentionally omitted.
19 S 10. Intentionally omitted.
20 S 11. Section 2807 of the public health law is amended by adding a new
21 subdivision 14 to read as follows:
22 14. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, AND SUBJECT
23 TO FEDERAL FINANCIAL PARTICIPATION, THE COMMISSIONER IS AUTHORIZED TO
24 ESTABLISH, PURSUANT TO REGULATIONS, A GENERAL HOSPITAL QUALITY POOL FOR
25 THE PURPOSE OF INCENTIVIZING AND FACILITATING QUALITY IMPROVEMENTS IN
26 GENERAL HOSPITALS. AWARDS FROM SUCH POOL SHALL BE SUBJECT TO APPROVAL BY
27 THE DIRECTOR OF BUDGET. IF FEDERAL FINANCIAL PARTICIPATION IS UNAVAIL-
28 ABLE, THEN THE NON-FEDERAL SHARE OF AWARDS MADE PURSUANT TO THIS SUBDI-
29 VISION MAY BE MADE AS STATE GRANTS.
30 (A) THIRTY DAYS PRIOR TO ADOPTING OR APPLYING A METHODOLOGY OR PROCE-
31 DURE FOR MAKING AN ALLOCATION OR MODIFICATION TO AN ALLOCATION MADE
32 PURSUANT TO THIS SUBDIVISION, THE COMMISSIONER SHALL PROVIDE WRITTEN
33 NOTICE TO THE CHAIRS OF THE SENATE FINANCE COMMITTEE, THE ASSEMBLY WAYS
34 AND MEANS COMMITTEE, AND THE SENATE AND ASSEMBLY HEALTH COMMITTEES WITH
35 REGARD TO THE INTENT TO ADOPT OR APPLY THE METHODOLOGY OR PROCEDURE,
36 INCLUDING A DETAILED EXPLANATION OF THE METHODOLOGY OR PROCEDURE.
37 (B) THIRTY DAYS PRIOR TO EXECUTING AN ALLOCATION OR MODIFICATION TO AN
38 ALLOCATION MADE PURSUANT TO THIS SUBDIVISION, THE COMMISSIONER SHALL
39 PROVIDE WRITTEN NOTICE TO THE CHAIRS OF THE SENATE FINANCE COMMITTEE,
40 THE ASSEMBLY WAYS AND MEANS COMMITTEE, AND THE SENATE AND ASSEMBLY
41 HEALTH COMMITTEES WITH REGARD TO THE INTENT TO DISTRIBUTE SUCH FUNDS.
42 SUCH NOTICE SHALL INCLUDE, BUT NOT BE LIMITED TO, INFORMATION ON THE
43 METHODOLOGY USED TO DISTRIBUTE THE FUNDS, THE FACILITY SPECIFIC ALLO-
44 CATIONS OF THE FUNDS, ANY FACILITY SPECIFIC PROJECT DESCRIPTIONS OR
45 REQUIREMENTS FOR RECEIVING SUCH FUNDS, THE MULTI-YEAR IMPACTS OF THESE
46 ALLOCATIONS, AND THE AVAILABILITY OF FEDERAL MATCHING FUNDS. THE COMMIS-
47 SIONER SHALL PROVIDE QUARTERLY REPORTS TO THE CHAIR OF THE SENATE
48 FINANCE COMMITTEE AND THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE
49 ON THE DISTRIBUTION AND DISBURSEMENT OF SUCH FUNDS.
50 S 12. Section 2807 of the public health law is amended by adding a new
51 subdivision 22 to read as follows:
52 22. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, AND SUBJECT
53 TO FEDERAL FINANCIAL PARTICIPATION, GENERAL HOSPITALS DESIGNATED AS SOLE
54 COMMUNITY HOSPITALS IN ACCORDANCE WITH TITLE XVIII OF THE FEDERAL SOCIAL
55 SECURITY ACT SHALL BE ELIGIBLE FOR ENHANCED PAYMENTS OR REIMBURSEMENT
56 FOR INPATIENT AND/OR OUTPATIENT SERVICES OF UP TO TWELVE MILLION DOLLARS
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1 UNDER A SUPPLEMENTAL OR REVISED RATE METHODOLOGY, ESTABLISHED BY THE
2 COMMISSIONER IN REGULATION, FOR THE PURPOSE OF PROMOTING ACCESS AND
3 IMPROVING THE QUALITY OF CARE. IF FEDERAL FINANCIAL PARTICIPATION IS
4 UNAVAILABLE, THEN THE NON-FEDERAL SHARE OF SUCH PAYMENTS PURSUANT TO
5 THIS SUBDIVISION MAY BE MADE AS STATE GRANTS.
6 (A) THIRTY DAYS PRIOR TO ADOPTING OR APPLYING A METHODOLOGY OR PROCE-
7 DURE FOR MAKING AN ALLOCATION OR MODIFICATION TO AN ALLOCATION MADE
8 PURSUANT TO THIS SUBDIVISION, THE COMMISSIONER SHALL PROVIDE WRITTEN
9 NOTICE TO THE CHAIRS OF THE SENATE FINANCE COMMITTEE, THE ASSEMBLY WAYS
10 AND MEANS COMMITTEE, AND THE SENATE AND ASSEMBLY HEALTH COMMITTEES WITH
11 REGARD TO THE INTENT TO ADOPT OR APPLY THE METHODOLOGY OR PROCEDURE,
12 INCLUDING A DETAILED EXPLANATION OF THE METHODOLOGY OR PROCEDURE.
13 (B) THIRTY DAYS PRIOR TO EXECUTING AN ALLOCATION OR MODIFICATION TO AN
14 ALLOCATION MADE PURSUANT TO THIS SUBDIVISION, THE COMMISSIONER SHALL
15 PROVIDE WRITTEN NOTICE TO THE CHAIRS OF THE SENATE FINANCE COMMITTEE,
16 THE ASSEMBLY WAYS AND MEANS COMMITTEE, AND THE SENATE AND ASSEMBLY
17 HEALTH COMMITTEES WITH REGARD TO THE INTENT TO DISTRIBUTE SUCH FUNDS.
18 SUCH NOTICE SHALL INCLUDE, BUT NOT BE LIMITED TO, INFORMATION ON THE
19 METHODOLOGY USED TO DISTRIBUTE THE FUNDS, THE FACILITY SPECIFIC ALLO-
20 CATIONS OF THE FUNDS, ANY FACILITY SPECIFIC PROJECT DESCRIPTIONS OR
21 REQUIREMENTS FOR RECEIVING SUCH FUNDS, THE MULTI-YEAR IMPACTS OF THESE
22 ALLOCATIONS, AND THE AVAILABILITY OF FEDERAL MATCHING FUNDS. THE COMMIS-
23 SIONER SHALL PROVIDE QUARTERLY REPORTS TO THE CHAIR OF THE SENATE
24 FINANCE COMMITTEE AND THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE
25 ON THE DISTRIBUTION AND DISBURSEMENT OF SUCH FUNDS.
26 S 13. Subdivision (e) of section 2826 of the public health law, as
27 added by section 27 of part C of chapter 60 of the laws of 2014, is
28 amended and a new subdivision (e-1) is added to read as follows:
29 (e) Notwithstanding any law to the contrary, general hospitals defined
30 as critical access hospitals pursuant to title XVIII of the federal
31 social security act shall be allocated no less than [five] SEVEN million
32 FIVE HUNDRED THOUSAND dollars annually pursuant to this section. The
33 department of health shall provide a report to the governor and legisla-
34 ture no later than [December] JUNE first, two thousand [fourteen]
35 FIFTEEN providing recommendations on how to ensure the financial stabil-
36 ity of, and preserve patient access to, critical access hospitals,
37 INCLUDING AN EXAMINATION OF PERMANENT MEDICAID RATE METHODOLOGY CHANGES.
38 (E-1) THIRTY DAYS PRIOR TO EXECUTING AN ALLOCATION OR MODIFICATION TO
39 AN ALLOCATION MADE PURSUANT TO THIS SECTION, THE COMMISSIONER SHALL
40 PROVIDE WRITTEN NOTICE TO THE CHAIR OF THE SENATE FINANCE COMMITTEE AND
41 THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE WITH REGARDS TO THE
42 INTENT TO DISTRIBUTE SUCH FUNDS. SUCH NOTICE SHALL INCLUDE, BUT NOT BE
43 LIMITED TO, INFORMATION ON THE METHODOLOGY USED TO DISTRIBUTE THE FUNDS,
44 THE FACILITY SPECIFIC ALLOCATIONS OF THE FUNDS, ANY FACILITY SPECIFIC
45 PROJECT DESCRIPTIONS OR REQUIREMENTS FOR RECEIVING SUCH FUNDS, THE
46 MULTI-YEAR IMPACTS OF THESE ALLOCATIONS, AND THE AVAILABILITY OF FEDERAL
47 MATCHING FUNDS. THE COMMISSIONER SHALL PROVIDE QUARTERLY REPORTS TO THE
48 CHAIR OF THE SENATE FINANCE COMMITTEE AND THE CHAIR OF THE ASSEMBLY WAYS
49 AND MEANS COMMITTEE ON THE DISTRIBUTION AND DISBURSEMENT OF SUCH FUNDS.
50 WITHIN SIXTY DAYS OF THE EFFECTIVENESS OF THIS SUBDIVISION, THE COMMIS-
51 SIONER SHALL PROVIDE A WRITTEN REPORT TO THE CHAIR OF THE SENATE FINANCE
52 COMMITTEE AND THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE ON ALL
53 AWARDS MADE PURSUANT TO THIS SECTION PRIOR TO THE EFFECTIVENESS OF THIS
54 SUBDIVISION, INCLUDING ALL INFORMATION THAT IS REQUIRED TO BE INCLUDED
55 IN THE NOTICE REQUIREMENTS OF THIS SUBDIVISION.
A. 6007 10
1 S 14. Section 2826 of the public health law is amended by adding a new
2 subdivision (f) to read as follows:
3 (F) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, AND SUBJECT
4 TO FEDERAL FINANCIAL PARTICIPATION, NO LESS THAN TEN MILLION DOLLARS
5 SHALL BE ALLOCATED TO PROVIDERS DESCRIBED IN THIS SUBDIVISION; PROVIDED,
6 HOWEVER THAT IF FEDERAL FINANCIAL PARTICIPATION IS UNAVAILABLE FOR ANY
7 ELIGIBLE PROVIDER, OR FOR ANY POTENTIAL INVESTMENT UNDER THIS SUBDIVI-
8 SION THEN THE NON-FEDERAL SHARE OF PAYMENTS PURSUANT TO THIS SUBDIVISION
9 MAY BE MADE AS STATE GRANTS.
10 (I) PROVIDERS SERVING RURAL AREAS AS SUCH TERM IS DEFINED IN SECTION
11 TWO THOUSAND NINE HUNDRED FIFTY-ONE OF THIS CHAPTER, INCLUDING BUT NOT
12 LIMITED TO HOSPITALS, RESIDENTIAL HEALTH CARE FACILITIES, DIAGNOSTIC AND
13 TREATMENT CENTERS, AMBULATORY SURGERY CENTERS AND CLINICS SHALL BE
14 ELIGIBLE FOR ENHANCED PAYMENTS OR REIMBURSEMENT UNDER A SUPPLEMENTAL
15 RATE METHODOLOGY FOR THE PURPOSE OF PROMOTING ACCESS AND IMPROVING THE
16 QUALITY OF CARE.
17 (II) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, AND SUBJECT
18 TO FEDERAL FINANCIAL PARTICIPATION, ESSENTIAL COMMUNITY PROVIDERS,
19 WHICH, FOR THE PURPOSES OF THIS SECTION, SHALL MEAN A PROVIDER THAT
20 OFFERS HEALTH SERVICES WITHIN A DEFINED AND ISOLATED GEOGRAPHIC REGION
21 WHERE SUCH SERVICES WOULD OTHERWISE BE UNAVAILABLE TO THE POPULATION OF
22 SUCH REGION, SHALL BE ELIGIBLE FOR ENHANCED PAYMENTS OR REIMBURSEMENT
23 UNDER A SUPPLEMENTAL RATE METHODOLOGY FOR THE PURPOSE OF PROMOTING
24 ACCESS AND IMPROVING QUALITY OF CARE. ELIGIBLE PROVIDERS UNDER THIS
25 PARAGRAPH MAY INCLUDE, BUT ARE NOT LIMITED TO, HOSPITALS, RESIDENTIAL
26 HEALTH CARE FACILITIES, DIAGNOSTIC AND TREATMENT CENTERS, AMBULATORY
27 SURGERY CENTERS AND CLINICS.
28 (III) IN MAKING SUCH PAYMENTS THE COMMISSIONER MAY CONTEMPLATE THE
29 EXTENT TO WHICH ANY SUCH PROVIDER RECEIVES ASSISTANCE UNDER SUBDIVISION
30 (A) OF THIS SECTION AND MAY REQUIRE SUCH PROVIDER TO SUBMIT A WRITTEN
31 PROPOSAL DEMONSTRATING THAT THE NEED FOR MONIES UNDER THIS SUBDIVISION
32 EXCEEDS MONIES OTHERWISE DISTRIBUTED PURSUANT TO THIS SECTION.
33 (IV) PAYMENTS UNDER THIS SUBDIVISION MAY INCLUDE, BUT NOT BE LIMITED
34 TO, TEMPORARY RATE ADJUSTMENTS, LUMP SUM MEDICAID PAYMENTS, SUPPLEMENTAL
35 RATE METHODOLOGIES AND ANY OTHER PAYMENTS AS DETERMINED BY THE COMMIS-
36 SIONER.
37 (V) PAYMENTS UNDER THIS SUBDIVISION SHALL BE SUBJECT TO APPROVAL BY
38 THE DIRECTOR OF THE BUDGET.
39 (VI) THE COMMISSIONER MAY PROMULGATE REGULATIONS TO EFFECTUATE THE
40 PROVISIONS OF THIS SUBDIVISION.
41 (VII) THIRTY DAYS PRIOR TO ADOPTING OR APPLYING A METHODOLOGY OR
42 PROCEDURE FOR MAKING AN ALLOCATION OR MODIFICATION TO AN ALLOCATION MADE
43 PURSUANT TO THIS SUBDIVISION, THE COMMISSIONER SHALL PROVIDE WRITTEN
44 NOTICE TO THE CHAIRS OF THE SENATE FINANCE COMMITTEE, THE ASSEMBLY WAYS
45 AND MEANS COMMITTEE, AND THE SENATE AND ASSEMBLY HEALTH COMMITTEES WITH
46 REGARD TO THE INTENT TO ADOPT OR APPLY THE METHODOLOGY OR PROCEDURE,
47 INCLUDING A DETAILED EXPLANATION OF THE METHODOLOGY OR PROCEDURE.
48 (VIII) THIRTY DAYS PRIOR TO EXECUTING AN ALLOCATION OR MODIFICATION TO
49 AN ALLOCATION MADE PURSUANT TO THIS SUBDIVISION, THE COMMISSIONER SHALL
50 PROVIDE WRITTEN NOTICE TO THE CHAIRS OF THE SENATE FINANCE COMMITTEE,
51 THE ASSEMBLY WAYS AND MEANS COMMITTEE, AND THE SENATE AND ASSEMBLY
52 HEALTH COMMITTEES WITH REGARD TO THE INTENT TO DISTRIBUTE SUCH FUNDS.
53 SUCH NOTICE SHALL INCLUDE, BUT NOT BE LIMITED TO, INFORMATION ON THE
54 METHODOLOGY USED TO DISTRIBUTE THE FUNDS, THE FACILITY SPECIFIC ALLO-
55 CATIONS OF THE FUNDS, ANY FACILITY SPECIFIC PROJECT DESCRIPTIONS OR
56 REQUIREMENTS FOR RECEIVING SUCH FUNDS, THE MULTI-YEAR IMPACTS OF THESE
A. 6007 11
1 ALLOCATIONS, AND THE AVAILABILITY OF FEDERAL MATCHING FUNDS. THE COMMIS-
2 SIONER SHALL PROVIDE QUARTERLY REPORTS TO THE CHAIR OF THE SENATE
3 FINANCE COMMITTEE AND THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE
4 ON THE DISTRIBUTION AND DISBURSEMENT OF SUCH FUNDS.
5 S 15. Intentionally omitted.
6 S 16. Section 12 of part A of chapter 1 of the laws of 2002, relating
7 to the health care reform act of 2000, is amended to read as follows:
8 S 12. Notwithstanding any inconsistent provision of law or regulation
9 to the contrary, and subject to the availability of federal financial
10 participation pursuant to title XIX of the federal social security act,
11 effective for the period September 1, 2001 through March 31, 2002, and
12 state fiscal years thereafter, UNTIL MARCH 31, 2012, the department of
13 health is authorized to pay a specialty hospital adjustment to public
14 general hospitals, as defined in subdivision 10 of section 2801 of the
15 public health law, other than those operated by the state of New York or
16 the state university of New York, receiving reimbursement for all inpa-
17 tient services under title XIX of the federal social security act pursu-
18 ant to paragraph (e) of subdivision 4 of section 2807-c of the public
19 health law, and located in a city with a population of over 1 million,
20 of up to four hundred sixty-three million dollars for the period Septem-
21 ber 1, 2001 through March 31, 2002 and up to seven hundred ninety-four
22 million dollars annually for state fiscal years thereafter as medical
23 assistance payments for inpatient services pursuant to title 11 of arti-
24 cle 5 of the social services law for patients eligible for federal
25 financial participation under title XIX of the federal social security
26 act based on each such hospital's proportionate share of the sum of all
27 inpatient discharges for all facilities eligible for an adjustment
28 pursuant to this section for the base year two years prior to the rate
29 year. Such proportionate share payment may be added to rates of payment
30 or made as aggregate payments to eligible public general hospitals.
31 S 17. Section 13 of part B of chapter 1 of the laws of 2002, relating
32 to the health care reform act of 2000, is amended to read as follows:
33 S 13. Notwithstanding any inconsistent provision of law or regulation
34 to the contrary, and subject to the availability of federal financial
35 participation pursuant to title XIX of the federal social security act,
36 effective for the period April 1, 2002 through March 31, 2003, and state
37 fiscal years thereafter UNTIL MARCH 31, 2012, the department of health
38 is authorized to pay a specialty hospital adjustment to public general
39 hospitals, as defined in subdivision 10 of section 2801 of the public
40 health law, other than those operated by the state of New York or the
41 state university of New York, receiving reimbursement for all inpatient
42 services under title XIX of the federal social security act pursuant to
43 paragraph (e) of subdivision 4 of section 2807-c of the public health
44 law, and located in a city with a population of over one million, of up
45 to two hundred eighty-six million dollars as medical assistance payments
46 for inpatient services pursuant to title 11 of article 5 of the social
47 services law for patients eligible for federal financial participation
48 under title XIX of the federal social security act based on each such
49 hospital's proportionate share of the sum of all inpatient discharges
50 for all facilities eligible for an adjustment pursuant to this section
51 for the base year two years prior to the rate year. Such proportionate
52 share payment may be added to rates of payment or made as aggregate
53 payments to eligible hospitals.
54 S 18. Notwithstanding any inconsistent provision of law or regulation
55 to the contrary, and subject to the availability of federal financial
56 participation pursuant to title XIX of the federal social security act,
A. 6007 12
1 effective for the period April 1, 2012, through March 31, 2013, and
2 state fiscal years thereafter, the department of health is authorized to
3 pay a public hospital adjustment to public general hospitals, as defined
4 in subdivision 10 of section 2801 of the public health law, other than
5 those operated by the state of New York or the state university of New
6 York, and located in a city with a population of over 1 million, of up
7 to one billion eighty million dollars annually as medical assistance
8 payments for inpatient services pursuant to title 11 of article 5 of the
9 social services law for patients eligible for federal financial partic-
10 ipation under title XIX of the federal social security act based on such
11 criteria and methodologies as the commissioner may from time to time set
12 through a memorandum of understanding with the New York city health and
13 hospitals corporation, and such adjustments shall be paid by means of
14 one or more estimated payments, with such estimated payments to be
15 reconciled to the commissioner of health's final adjustment determi-
16 nations after the disproportionate share hospital payment adjustment
17 caps have been calculated for such period under sections 1923(f) and (g)
18 of the federal social security act. Such adjustment payment may be added
19 to rates of payment or made as aggregate payments to eligible public
20 general hospitals.
21 S 19. Section 14 of part A of chapter 1 of the laws of 2002, relating
22 to the health care reform act of 2000, is amended to read as follows:
23 S 14. Notwithstanding any inconsistent provision of law, rule or regu-
24 lation to the contrary, and subject to the availability of federal
25 financial participation pursuant to title XIX of the federal social
26 security act, effective for the period January 1, 2002 through March 31,
27 2002, and state fiscal years thereafter UNTIL MARCH 31, 2011, the
28 department of health is authorized to increase the operating cost compo-
29 nent of rates of payment for general hospital outpatient services and
30 general hospital emergency room services issued pursuant to paragraph
31 (g) of subdivision 2 of section 2807 of the public health law for public
32 general hospitals, as defined in subdivision 10 of section 2801 of the
33 public health law, other than those operated by the state of New York or
34 the state university of New York, and located in a city with a popu-
35 lation of over one million, which experienced free patient visits in
36 excess of twenty percent of their total self-pay and free patient visits
37 based on data reported on exhibit 33 of their 1999 institutional cost
38 report and which experienced uninsured outpatient losses in excess of
39 seventy-five percent of their total inpatient and outpatient uninsured
40 losses based on data reported on exhibit 47 of their 1999 institutional
41 cost report, of up to thirty-four million dollars for the period January
42 1, 2002 through March 31, 2002 and up to one hundred thirty-six million
43 dollars annually for state fiscal years thereafter as medical assistance
44 payments for outpatient services pursuant to title 11 of article 5 of
45 the social services law for patients eligible for federal financial
46 participation under title XIX of the federal social security act based
47 on each such hospital's proportionate share of the sum of all outpatient
48 visits for all facilities eligible for an adjustment pursuant to this
49 section for the base year two years prior to the rate year. Such propor-
50 tionate share payment may be added to rates of payment or made as aggre-
51 gate payments to eligible public general hospitals.
52 S 20. Section 14 of part B of chapter 1 of the laws of 2002, relating
53 to the health care reform act of 2000, is amended to read as follows:
54 S 14. Notwithstanding any inconsistent provision of law or regulation
55 to the contrary, and subject to the availability of federal financial
56 participation pursuant to title XIX of the federal social security act,
A. 6007 13
1 effective for the period January 1, 2002 through March 31, 2002, and
2 state fiscal years thereafter UNTIL MARCH 31, 2011, the department of
3 health is authorized to increase the operating cost component of rates
4 of payment for general hospital outpatient services and general hospital
5 emergency room services issued pursuant to paragraph (g) of subdivision
6 2 of section 2807 of the public health law for public general hospitals,
7 as defined in subdivision 10 of section 2801 of the public health law,
8 other than those operated by the state of New York or the state univer-
9 sity of New York, and located in a city with a population of over one
10 million, which experienced free patient visits in excess of twenty
11 percent of their total self-pay and free patient visits based on data
12 reported on exhibit 33 of their 1999 institutional cost report and which
13 experienced uninsured outpatient losses in excess of seventy-five
14 percent of their total inpatient and outpatient uninsured losses based
15 on data reported on exhibit 47 of their 1999 institutional cost report,
16 of up to thirty-seven million dollars for the period January 1, 2002
17 through March 31, 2002 and one hundred fifty-one million dollars annual-
18 ly for state fiscal years thereafter as medical assistance payments for
19 outpatient services pursuant to title 11 of article 5 of the social
20 services law for patients eligible for federal financial participation
21 under title XIX of the federal social security act based on each such
22 hospital's proportionate share of the sum of all outpatient visits for
23 all facilities eligible for an adjustment pursuant to this section for
24 the base year two years prior to the rate year. Such proportionate share
25 payment may be added to rates of payment or made as aggregate payments
26 to eligible public general hospitals.
27 S 21. Notwithstanding any inconsistent provision of law, rule or regu-
28 lation to the contrary, and subject to the availability of federal
29 financial participation pursuant to title XIX of the federal social
30 security act, effective for the period April 1, 2011 through March 31,
31 2012, and state fiscal years thereafter, the department of health is
32 authorized to increase the operating cost component of rates of payment
33 for general hospital outpatient services and general hospital emergency
34 room services issued pursuant to paragraph (g) of subdivision 2 of
35 section 2807 of the public health law for public general hospitals, as
36 defined in subdivision 10 of section 2801 of the public health law,
37 other than those operated by the state of New York or the state univer-
38 sity of New York, and located in a city with a population over one
39 million, up to two hundred eighty-seven million dollars annually as
40 medical assistance payments for outpatient services pursuant to title 11
41 of article 5 of the social services law for patients eligible for feder-
42 al financial participation under title XIX of the federal social securi-
43 ty act based on such criteria and methodologies as the commissioner may
44 from time to time set through a memorandum of understanding with the New
45 York city health and hospitals corporation, and such adjustments shall
46 be paid by means of one or more estimated payments, with such estimated
47 payments to be reconciled to the commissioner of health's final adjust-
48 ment determinations after the disproportionate share hospital payment
49 adjustment caps have been calculated for such period under sections
50 1923(f) and (g) of the federal social security act. Such adjustment
51 payment may be added to rates of payment or made as aggregate payments
52 to eligible public general hospitals.
53 S 22. Section 16 of part A of chapter 1 of the laws of 2002, relating
54 to the health care reform act of 2000, is amended to read as follows:
55 S 16. Any amounts provided pursuant to sections eleven, twelve, thir-
56 teen and fourteen of this act shall be effective for purposes of deter-
A. 6007 14
1 mining payments for public general hospitals contingent on receipt of
2 all approvals required by federal law or regulations for federal finan-
3 cial participation in payments made pursuant to title XIX of the federal
4 social security act. If federal approvals are not granted for payments
5 based on such amounts or components thereof, payments to public general
6 hospitals shall be determined without consideration of such amounts or
7 such components. Public general hospitals shall refund to the state, or
8 the state may recoup from prospective payments, any overpayment
9 received, including those based on a retroactive reduction in the
10 payments. Any reduction in federal financial participation pursuant to
11 title XIX of the federal social security act related to federal upper
12 payment limits APPLICABLE TO PUBLIC GENERAL HOSPITALS OTHER THAN THOSE
13 OPERATED BY THE STATE OF NEW YORK OR THE STATE UNIVERSITY OF NEW YORK
14 shall be deemed to apply first to amounts provided pursuant to sections
15 eleven, twelve, thirteen and fourteen of this act AND SECTIONS EIGHTEEN
16 AND TWENTY-ONE OF A CHAPTER OF THE LAWS OF TWO THOUSAND FIFTEEN.
17 S 23. Section 20 of part B of chapter 1 of the laws of 2002, relating
18 to the health care reform act of 2000, is amended to read as follows:
19 S 20. Any amounts provided pursuant to sections thirteen and fourteen
20 of this act shall be effective for purposes of determining payments for
21 public general hospitals contingent on receipt of all approvals required
22 by federal law or regulations for federal financial participation in
23 payments made pursuant to title XIX of the federal social security act.
24 If federal approvals are not granted for payments based on such amounts
25 or components thereof, payments to public general hospitals shall be
26 determined without consideration of such amounts or such components.
27 Public general hospitals shall refund to the state, or the state may
28 recoup from prospective payments, any overpayment received, including
29 those based on a retroactive reduction in the payments. Any reduction in
30 federal financial participation pursuant to title XIX of the federal
31 social security act related to federal upper payment limits APPLICABLE
32 TO PUBLIC GENERAL HOSPITALS OTHER THAN THOSE OPERATED BY THE STATE OF
33 NEW YORK OR THE STATE UNIVERSITY OF NEW YORK shall be deemed to apply
34 first to amounts provided pursuant to sections thirteen and fourteen of
35 this act AND SECTIONS EIGHTEEN AND TWENTY-ONE OF A CHAPTER OF THE LAWS
36 OF TWO THOUSAND FIFTEEN.
37 S 23-a. Subdivision 6 of section 2807-s of the public health law is
38 amended by adding a new paragraph (g) to read as follows:
39 (G) A FURTHER GROSS ANNUAL AMOUNT ALLOCATED TO THE ROCHESTER REGION
40 BEGINNING JANUARY FIRST, TWO THOUSAND SIXTEEN SHALL BE ONE HUNDRED TEN
41 MILLION DOLLARS. SUCH AMOUNT SHALL BE EXCLUDED FROM ALL COMPUTATIONS AND
42 ADJUSTMENTS MADE PURSUANT TO PARAGRAPH (B) OF SUBDIVISION SIX OF SECTION
43 TWO THOUSAND EIGHT HUNDRED SEVEN-T OF THIS ARTICLE.
44 S 23-b. Subdivision 7 of section 2807-s of the public health law is
45 amended by adding a new paragraph (d) to read as follows:
46 (D)(I) FIVE MILLION DOLLARS OF THE FUNDS ALLOCATED PURSUANT TO PARA-
47 GRAPH (G) OF SUBDIVISION SIX OF THIS SECTION SHALL BE DISTRIBUTED TO A
48 REGIONAL HEALTH PLANNING ORGANIZATION FOR USE IN FUNDING REGIONAL HEALTH
49 CARE IMPROVEMENT PROJECTS. THE REGIONAL HEALTH PLANNING ORGANIZATION
50 SHALL DISBURSE THOSE FUNDS IN ACCORDANCE WITH THIS PARAGRAPH, OR PURSU-
51 ANT TO GRANTS MADE BY THE ORGANIZATION IN ACCORDANCE WITH THIS PARA-
52 GRAPH. DISTRIBUTION OF ANY GRANT FUNDS ADMINISTERED BY THE REGIONAL
53 HEALTH PLANNING ORGANIZATION SHALL BE PURSUANT TO A MULTI-STAKEHOLDER
54 PROCESS. THE REGIONAL HEALTH CARE IMPROVEMENT GRANT FUND PROJECTS SHALL
55 INCLUDE THREE MILLION DOLLARS PER YEAR FOR A SHARED COMMUNITY HEALTH
56 INFRASTRUCTURE DESIGNED ON THE BASIS OF COLLABORATIVE COMMUNITY EFFORTS,
A. 6007 15
1 INCLUDING COMMUNITY-WIDE PATIENT SAFETY AND QUALITY IMPROVEMENT
2 PROGRAMS, ELIMINATION OF HEALTH DISPARITIES, HEALTH INFORMATION TECHNOL-
3 OGY, AND TWO MILLION DOLLARS TO FUND THE REGIONAL HEALTH PLANNING ORGAN-
4 IZATION. THE HEALTH PLANNING ORGANIZATION SHALL USE REASONABLE EFFORTS
5 TO GENERATE MATCHING FUND CONTRIBUTIONS IN THE FORM OF GRANTS, DONATIONS
6 AND OTHER CONTRIBUTIONS.
7 (II) ONE HUNDRED FIVE MILLION DOLLARS OF THE FUNDS ALLOCATED PURSUANT
8 TO PARAGRAPH (G) OF SUBDIVISION SIX OF THIS SECTION SHALL BE ALLOCATED
9 TO A NOT-FOR-PROFIT ORGANIZATION OR ASSOCIATION THAT HAS BEEN DESIGNATED
10 THROUGH A MULTI-STAKEHOLDER PROCESS, WHICH SHALL DISTRIBUTE THOSE FUNDS
11 TO ALL OF THE HOSPITALS IN THE REGION ENGAGED IN GRADUATE MEDICAL EDUCA-
12 TION IN ORDER TO FUND GRADUATE MEDICAL EDUCATION. ONE HUNDRED MILLION
13 DOLLARS OF SUCH FUNDING SHALL BE DISTRIBUTED PROPORTIONALLY TO EACH OF
14 THE HOSPITALS IN AMOUNTS WHICH REFLECT EACH HOSPITAL'S CURRENT COSTS FOR
15 GRADUATE MEDICAL EDUCATION, AND FIVE MILLION DOLLARS OF UNREIMBURSED
16 ADMINISTRATIVE AND OTHER GRADUATE MEDICAL EDUCATION RELATED COSTS SHALL
17 BE ALLOCATED IN THE SAME PROPORTIONS. ONE HUNDRED MILLION DOLLARS OF THE
18 DISTRIBUTED FUNDS SHALL BE IN LIEU OF CURRENT FUNDING OF SUCH COSTS AS
19 CURRENTLY INCLUDED IN CLAIMS PAYMENTS BY SPECIFIED THIRD PARTY PAYORS IN
20 THE REGION RESULTING IN A REDUCTION IN THE AMOUNT PAID BY SUCH THIRD
21 PARTY PAYORS IN AN AMOUNT EQUAL TO THE ONE HUNDRED MILLION DOLLARS.
22 PRIOR TO THE ALLOCATION OF FUNDS PURSUANT TO THIS SUBDIVISION, THE
23 PARTICIPATING HOSPITALS AND SUCH THIRD PARTY PAYORS SHALL DEVELOP A
24 PROCESS FOR THE DISTRIBUTION OF SUCH FUNDS AND A MECHANISM TO ENSURE
25 THAT THE REQUIRED REDUCTION OF PAYMENTS BY SUCH THIRD PARTY PAYORS TO
26 THE HOSPITALS OCCURS. THE AFFECTED HOSPITALS AND THE THIRD PARTY PAYORS
27 IN THE REGION SHALL SELECT AN INDEPENDENT THIRD PARTY TO DETERMINE THE
28 REDUCTIONS WHICH SHALL OCCUR FROM PREVIOUSLY NEGOTIATED RATES FOR CLAIMS
29 PAYMENTS TO SUCH HOSPITALS BY SPECIFIED THIRD PARTY PAYORS IN ORDER TO
30 AVOID DUPLICATE FUNDING PURSUANT TO THIS PARAGRAPH. PRIOR TO THE IMPLE-
31 MENTATION OF THESE PROVISIONS, A REPORT SHALL BE PREPARED BY SUCH INDE-
32 PENDENT THIRD PARTY TO ANALYZE THE ANTICIPATED IMPACT OF THESE
33 PROVISIONS ON GRADUATE MEDICAL EDUCATION AND THE PROMOTION OF COMMUNITY
34 HEALTH IN THE ROCHESTER REGION. THE REPORT WILL CONSIDER: THE IMPACT OF
35 THE PROPOSAL ON THE DEVELOPMENT AND RETENTION OF THE PHYSICIAN WORKFORCE
36 IN ROCHESTER AND THE SURROUNDING REGION AS A RESULT OF ITS EFFECTS ON
37 THE SUPPORT OF GRADUATE MEDICAL EDUCATION; THE IMPACT OF THE PROPOSAL ON
38 THE HEALTHCARE COMMUNITY (INCLUDING HOSPITALS AND OTHER HEALTHCARE
39 PROVIDERS), THIRD PARTY PAYORS, THE BUSINESS COMMUNITY AND CONSUMERS;
40 AND THE OVERALL IMPACT OF THE PROPOSAL ON THE HEALTHCARE DELIVERY SYSTEM
41 IN THE ROCHESTER REGION, INCLUDING ITS SUPPORT FOR COMMUNITY HEALTH
42 INITIATIVES AND HEALTHCARE PLANNING. THE REPORT WILL BE SUBMITTED TO THE
43 SPEAKER OF THE ASSEMBLY, THE TEMPORARY PRESIDENT OF THE SENATE AND TO
44 THE COMMISSIONER OF HEALTH NO LATER THAN OCTOBER 1, 2015.
45 S 24. Subdivisions 7, 7-a and 7-b of section 2807 of the public
46 health law, subdivision 7 as amended by section 195 of part A of chapter
47 389 of the laws of 1997, subdivision 7-a as amended by chapter 938 of
48 the laws of 1990, subdivision 7-b as added by chapter 731 of the laws of
49 1993, paragraph (b) of subdivision 7-b as amended by chapter 175 of the
50 laws of 1997, are amended to read as follows:
51 7. Reimbursement rate promulgation. The commissioner shall notify each
52 [hospital] RESIDENTIAL HEALTH CARE FACILITY and health-related service
53 of its approved rates of payment which shall be used in reimbursing for
54 services provided to persons eligible for payments made by state govern-
55 mental agencies at least sixty days prior to the beginning of an estab-
56 lished rate period for which the rate is to become effective. Notifica-
A. 6007 16
1 tion shall be made only after approval of rate schedules by the state
2 director of the budget. The [sixty and thirty day] notice provisions,
3 herein, shall not apply to rates issued following judicial annulment or
4 invalidation of any previously issued rates, or rates issued pursuant to
5 changes in the methodology used to compute rates which changes are
6 promulgated following the judicial annulment or invalidation of previ-
7 ously issued rates. Notwithstanding any provision of law to the contra-
8 ry, nothing in this subdivision shall prohibit the recalculation and
9 payment of rates, including both positive and negative adjustments,
10 based on a reconciliation of amounts paid by residential health care
11 facilities beginning April first, nineteen hundred ninety-seven for
12 additional assessments or further additional assessments pursuant to
13 section twenty-eight hundred seven-d of this article with the amounts
14 originally recognized for reimbursement purposes.
15 [7-a. Notwithstanding any inconsistent provision of law, with regard
16 to a general hospital the provisions of subdivisions four and seven of
17 this section and the provisions of section eighteen of chapter two of
18 the laws of nineteen hundred eighty-eight relating to the requirement of
19 prior notice and the time frames for notice, approval or certification
20 of rates of payment, maximum rates of payment or maximum charges where
21 not otherwise waived pursuant to law shall be applicable only to such
22 rates of payment or maximum charges prospectively established for an
23 annual rate period and such provisions shall not be applicable to a
24 general hospital with regard to prospective adjustments or retrospective
25 adjustments of established rates of payment or maximum charges for or
26 during an annual rate period based on correction of errors or omissions
27 of data or in computation, rate appeals, audits or other rate adjust-
28 ments authorized by law or regulations adopted pursuant to section twen-
29 ty-eight hundred three of this article.
30 7-b. Notification of diagnostic and treatment center approved rates.
31 (a) For rate periods or portions of rate periods beginning on or after
32 October first, nineteen hundred ninety-four, the commissioner shall
33 notify each diagnostic and treatment center of its approved rates of
34 payment, which shall be used in the reimbursement for services provided
35 to persons eligible for payments made by state governmental agencies at
36 least thirty days prior to the beginning of the period for which such
37 rates are to become effective.
38 (b)] (A) Notwithstanding any contrary provision of law, all diagnostic
39 and treatment centers certified on or before September second, nineteen
40 hundred ninety-seven shall, not later than September second, nineteen
41 hundred ninety-seven, notify the commissioner whether they intend to
42 maintain all books and records utilized by the diagnostic and treatment
43 center for cost reporting and reimbursement purposes on a calendar year
44 basis or, commencing on July first, nineteen hundred ninety-six, on a
45 July first through June thirtieth basis, and shall thereafter maintain
46 all books and records on such basis. All diagnostic and treatment
47 centers certified after September second, nineteen hundred ninety-seven
48 shall notify the commissioner at the time of certification whether they
49 intend to maintain all books and records on a calendar year basis or on
50 [or] a July first through June thirtieth basis, and shall thereafter
51 maintain all books and records on such a basis.
52 [(c)] (B) The books and records maintained pursuant to paragraph [(b)]
53 (A) of this subdivision shall be utilized and made available to the
54 commissioner in promulgating rates of payment for annual rate periods
55 beginning on or after October first, nineteen hundred ninety-seven.
A. 6007 17
1 [(d)] (C) Notwithstanding any provision of the law to the contrary,
2 rates of payment established in accordance with paragraph [(b)] (A) as
3 amended, and paragraph (f) of subdivision two of this section for the
4 rate period beginning April first, nineteen hundred ninety-three shall
5 continue in effect through September thirtieth, nineteen hundred nine-
6 ty-four, and applicable trend factors shall be applied to that portion
7 of such rates of payment for the rate period which begins April first,
8 nineteen hundred ninety-four.
9 S 24-a. Section 2803-l of the public health law, as amended by chapter
10 639 of the laws of 1996, is amended to read as follows:
11 S 2803-l. Community service plans. 1. The governing body of a volun-
12 tary non-profit general hospital OR THE SPONSORING ENTITY OF A PERFORM-
13 ING PROVIDER SYSTEM ("PPS") PARTICIPATING IN THE MEDICAID DELIVERY
14 SYSTEM REFORM INCENTIVE PAYMENT ("DSRIP") PROGRAM must issue an organ-
15 izational mission statement identifying at a minimum the populations and
16 communities served by the hospital OR THE PPS and the hospital's OR
17 PPS'S commitment to meeting the health care needs of the community.
18 2. The governing body OR PPS SPONSORING ENTITY must at least every
19 three years IN THE CASE OF A HOSPITAL AND EVERY TWO YEARS IN THE CASE OF
20 A PPS:
21 (i) review and amend as necessary the [hospital] mission statement;
22 (ii) solicit the views of the communities served by the hospital OR
23 PPS on such issues as [the hospital's] performance and service priori-
24 ties;
25 (iii) demonstrate the hospital's OR PPS'S operational and financial
26 commitment to meeting community health care needs, to provide charity
27 care services and to improve access to health care services by the
28 underserved; and
29 (iv) prepare and make available to the public a statement showing on a
30 combined basis a summary of the financial resources of the hospital OR
31 PPS and related corporations and the allocation of available resources
32 to hospital OR PPS purposes including the provision of free or reduced
33 charge services.
34 3. The governing body OR SPONSORING ENTITY OF A PPS must at least
35 annually prepare and make available to the public an implementation
36 report regarding the hospital's OR PPS'S performance in meeting the
37 health care needs of the community, providing charity care services, and
38 improving access to health care services by the underserved.
39 4. The governing body OR SPONSORING ENTITY OF A PPS shall file with
40 the commissioner its mission statement, its annual implementation
41 report, and at least every three years a report detailing amendments to
42 the statement and reflecting changes in the hospital's OR PPS'S opera-
43 tional and financial commitment to meeting the health care needs of the
44 community, providing charity care services, and improving access to
45 health care services by the underserved.
46 S 24-b. Paragraphs (c), (d) and (e) of subdivision 20 of section 2807
47 of the public health law, as added by section 8-a of part A of chapter
48 60 of the laws of 2014, are relettered paragraphs (d), (e) and (f) and
49 amended and a new paragraph (c) is added to read as follows:
50 (C) (I) PERFORMING PROVIDER SYSTEMS COMMUNITY ADVISORY BOARDS. 1. THE
51 SPONSORING ENTITY OF EACH PERFORMING PROVIDER SYSTEM ("PPS") PARTICIPAT-
52 ING IN THE MEDICAID DELIVERY SYSTEM REFORM INCENTIVE PAYMENT ("DSRIP")
53 SHALL ESTABLISH A COMMUNITY ADVISORY BOARD, OR BOARDS BASED ON GEOGRAPH-
54 IC SERVICE AREAS. THE COMMUNITY ADVISORY BOARD OR BOARDS SHALL CONSIDER
55 AND ADVISE THE PPS UPON THE PPS'S MISSION STATEMENT AND ANNUAL IMPLEMEN-
56 TATION REPORT UNDER SECTION TWENTY-EIGHT HUNDRED THREE-L OF THIS ARTI-
A. 6007 18
1 CLE, MATTERS CONCERNING OPERATIONAL ASPECTS OF THE PPS, SERVICE DELIVERY
2 ISSUES, ELIMINATION OF HEALTH CARE DISPARITIES, MEASUREMENT OF PROJECT
3 OUTCOMES, THE DEGREE TO WHICH PROJECT GOALS ARE BEING REACHED AND THE
4 DEVELOPMENT OF ANY PLANS OR PROGRAMS. THE PPS MAY ESTABLISH RULES WITH
5 RESPECT TO ITS COMMUNITY ADVISORY BOARD OR BOARDS.
6 (II) THE MEMBERS OF THE COMMUNITY ADVISORY BOARD OR BOARDS SHALL BE
7 REPRESENTATIVES OF THE COMMUNITY, OR GEOGRAPHIC SERVICE AREAS, SERVED BY
8 THE PPS, INCLUDING MEDICAID CONSUMERS ATTRIBUTED TO THAT PPS. THE PPS
9 SHALL FILE WITH THE COMMISSIONER, AND FROM TIME TO TIME UPDATE, AN
10 UP-TO-DATE LIST OF THE MEMBERS OF THE PPS'S COMMUNITY ADVISORY BOARD OR
11 BOARDS, WHICH SHALL BE MADE AVAILABLE TO THE PUBLIC BY THE PPS ON ITS
12 WEBSITE AND SHALL BE MADE AVAILABLE TO THE PUBLIC BY THE DEPARTMENT ON
13 ITS WEBSITE.
14 (III) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, NO OFFICER OR
15 EMPLOYEE OF THE STATE OR OF ANY CIVIL DIVISION THEREOF, SHALL BE DEEMED
16 TO HAVE FORFEITED OR SHALL FORFEIT HIS OR HER OFFICE OR EMPLOYMENT BY
17 REASON OF HIS OR HER ACCEPTANCE OF MEMBERSHIP ON A COMMUNITY ADVISORY
18 BOARD OR BOARDS. NO MEMBER OF A COMMUNITY ADVISORY BOARD SHALL RECEIVE
19 COMPENSATION OR ALLOWANCE FOR SERVICES RENDERED ON THE COMMUNITY ADVI-
20 SORY BOARD, EXCEPT, HOWEVER, THAT MEMBERS OF A COMMUNITY ADVISORY BOARD
21 MAY BE REIMBURSED BY THE PPS FOR NECESSARY EXPENSES INCURRED IN RELATION
22 TO SERVICE ON A COMMUNITY ADVISORY BOARD.
23 (d) For periods on and after April first, two thousand fourteen, the
24 commissioner shall provide a report on a quarterly basis to the chairs
25 of the senate finance, assembly ways and means, senate health and assem-
26 bly health committees with regard to the status of the DSRIP program.
27 Such reports shall be submitted no later than sixty days after the close
28 of the quarter, and shall include the most current information submitted
29 by providers to the state and the federal CMS. The reports shall
30 include:
31 (i) analysis of progress made toward DSRIP goals;
32 (ii) the impact on the state's health care delivery system;
33 (iii) information on the number and types of providers who partic-
34 ipate;
35 (iv) plans and progress for monitoring provider compliance with
36 requirements;
37 (v) a status update on project milestone progress;
38 (vi) information on project spending and budget;
39 (vii) analysis of impact on Medicaid beneficiaries served;
40 (viii) a summary of public engagement and public comments received;
41 (ix) a description of DSRIP funding applications that were denied;
42 (x) a description of all regulation waivers issued pursuant to para-
43 graph [(e)] (F) of this subdivision; and
44 (xi) a summary of the statewide geographic distribution of funds.
45 (e) For periods on and after April first, two thousand fourteen the
46 commissioner shall promptly make all DSRIP governing documents, includ-
47 ing 1115 waiver standard terms and conditions, supporting attachments
48 and detailed project descriptions, and all materials made available to
49 the legislature pursuant to paragraph [(c)] (D) of this subdivision,
50 available on the department's website. The commissioner shall also
51 provide a detailed overview on the department's website of the opportu-
52 nities for public comment on the DSRIP program.
53 (f) Notwithstanding any provision of law to the contrary, the commis-
54 sioners of the department of health, the office of mental health, the
55 office for people with developmental disabilities, and the office of
56 alcoholism and substance abuse services are authorized to waive any
A. 6007 19
1 regulatory requirements as are necessary, consistent with applicable
2 law, to allow applicants under this subdivision and paragraph (a) of
3 subdivision two of section twenty-eight hundred twenty-five of this
4 article to avoid duplication of requirements and to allow the efficient
5 implementation of the proposed project; provided, however, that regu-
6 lations pertaining to patient safety may not be waived, nor shall any
7 regulations be waived if such waiver would risk patient safety. Such
8 waiver shall not exceed the life of the project or such shorter time
9 periods as the authorizing commissioner may determine. Any regulatory
10 relief granted pursuant to this subdivision shall be described, includ-
11 ing each regulations waived and the project it relates to, in the report
12 provided pursuant to paragraph [(c)] (D) of this subdivision.
13 S 25. Section 365-l of the social services law is amended by adding a
14 new subdivision 2-b to read as follows:
15 2-B. THE COMMISSIONER IS AUTHORIZED TO MAKE GRANTS UP TO A GROSS
16 AMOUNT OF FIVE MILLION DOLLARS, TO ESTABLISH COORDINATION BETWEEN HEALTH
17 HOMES AND THE CRIMINAL JUSTICE SYSTEM AND FOR THE INTEGRATION OF INFOR-
18 MATION OF HEALTH HOMES WITH STATE AND LOCAL CORRECTIONAL FACILITIES, TO
19 THE EXTENT PERMITTED BY LAW. HEALTH HOMES RECEIVING SUCH FUNDS SHALL BE
20 REQUIRED TO DOCUMENT AND DEMONSTRATE THE EFFECTIVE USE OF FUNDS DISTRIB-
21 UTED HEREIN.
22 S 26. Intentionally omitted.
23 S 27. Intentionally omitted.
24 S 28. Subdivisions 6 and 7 of section 369-gg of the social services
25 law are renumbered subdivisions 7 and 8 and a new subdivision 6 is added
26 to read as follows:
27 6. RATES OF PAYMENT. (A) THE COMMISSIONER SHALL SELECT AND CONTRACT
28 WITH AN INDEPENDENT ACTUARY TO STUDY AND RECOMMEND APPROPRIATE
29 REIMBURSEMENT METHODOLOGIES FOR THE COST OF HEALTH CARE SERVICE COVERAGE
30 PURSUANT TO THIS TITLE. SUCH INDEPENDENT ACTUARY SHALL REVIEW AND MAKE
31 RECOMMENDATIONS CONCERNING APPROPRIATE ACTUARIAL ASSUMPTIONS RELEVANT TO
32 THE ESTABLISHMENT OF REIMBURSEMENT METHODOLOGIES, INCLUDING BUT NOT
33 LIMITED TO: THE ADEQUACY OF RATES OF PAYMENT IN RELATION TO THE POPU-
34 LATION TO BE SERVED ADJUSTED FOR CASE MIX, THE SCOPE OF HEALTH CARE
35 SERVICES APPROVED ORGANIZATIONS MUST PROVIDE, THE UTILIZATION OF SUCH
36 SERVICES AND THE NETWORK OF PROVIDERS REQUIRED TO MEET STATE STANDARDS.
37 (B) UPON CONSULTATION WITH THE INDEPENDENT ACTUARY AND ENTITIES
38 REPRESENTING APPROVED ORGANIZATIONS, THE COMMISSIONER SHALL DEVELOP
39 REIMBURSEMENT METHODOLOGIES AND FEE SCHEDULES FOR DETERMINING RATES OF
40 PAYMENT, WHICH RATES SHALL BE APPROVED BY THE DIRECTOR OF THE DIVISION
41 OF THE BUDGET, TO BE MADE BY THE DEPARTMENT TO APPROVED ORGANIZATIONS
42 FOR THE COST OF HEALTH CARE SERVICES COVERAGE PURSUANT TO THIS TITLE.
43 SUCH REIMBURSEMENT METHODOLOGIES AND FEE SCHEDULES MAY INCLUDE
44 PROVISIONS FOR CAPITATION ARRANGEMENTS.
45 (C) THE COMMISSIONER SHALL HAVE THE AUTHORITY TO PROMULGATE REGU-
46 LATIONS, INCLUDING EMERGENCY REGULATIONS, NECESSARY TO EFFECTUATE THE
47 PROVISIONS OF THIS SUBDIVISION.
48 S 29. Section 1 of part B of chapter 59 of the laws of 2011, amending
49 the public health law relating to rates of payment and medical assist-
50 ance, is amended to read as follows:
51 Section 1. (a) Notwithstanding any inconsistent provision of law,
52 rule or regulation to the contrary, and subject to the availability of
53 federal financial participation, effective for the period April 1, 2011
54 through March 31, 2012, and each state fiscal year thereafter, the
55 department of health is authorized to make supplemental Medicaid
56 payments OR SUPPLEMENTAL MEDICAID MANAGED CARE PAYMENTS for professional
A. 6007 20
1 services provided by physicians, nurse practitioners and physician
2 assistants who are participating in a plan for the management of clin-
3 ical practice at the State University of New York, in accordance with
4 title 11 of article 5 of the social services law for patients eligible
5 for federal financial participation under title XIX of the federal
6 social security act, in amounts that will increase fees for such profes-
7 sional services to an amount equal to the average commercial or Medicare
8 rate that would otherwise be received for such services rendered by such
9 physicians, nurse practitioners and physician assistants. The calcu-
10 lation of such supplemental fee payments shall be made in accordance
11 with applicable federal law and regulation and subject to the approval
12 of the division of the budget. Such supplemental Medicaid fee payments
13 may be added to the professional fees paid under the fee schedule [or],
14 made as aggregate lump sum payments to eligible clinical practice plans
15 authorized to receive professional fees OR MADE AS SUPPLEMENTAL PAYMENTS
16 MADE FOR SUCH PURPOSE AS DESCRIBED HEREIN TO MEDICAID MANAGED CARE
17 ORGANIZATIONS. SUPPLEMENTAL MEDICAID MANAGED CARE PAYMENTS UNDER THIS
18 SECTION SHALL BE DISTRIBUTED TO PROVIDERS AS DETERMINED BY THE MANAGED
19 CARE MODEL CONTRACT AND MAY UTILIZE MANAGED CARE ORGANIZATION REPORTED
20 ENCOUNTER DATA AND OTHER SUCH METRICS AS DETERMINED BY THE DEPARTMENT OF
21 HEALTH IN ORDER TO ENSURE RATES OF PAYMENT EQUIVALENT TO THE AVERAGE
22 COMMERCIAL OR MEDICARE RATE THAT WOULD OTHERWISE BE RECEIVED FOR SUCH
23 SERVICES RENDERED BY SUCH PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN
24 ASSISTANTS.
25 (b) The affiliated State University of New York health science centers
26 shall be responsible for payment of one hundred percent of the non-fed-
27 eral share of such supplemental Medicaid payments OR SUPPLEMENTAL MEDI-
28 CAID MANAGED CARE PAYMENTS for all services provided by physicians,
29 nurse practitioners and physician assistants who are participating in a
30 plan for the management of clinical practice, in accordance with section
31 365-a of the social services law, regardless of whether another social
32 services district or the department of health may otherwise be responsi-
33 ble for furnishing medical assistance to the eligible persons receiving
34 such services.
35 S 30. Section 93 of part H of chapter 59 of the laws of 2011, amending
36 the public health law relating to general hospital inpatient reimburse-
37 ment for annual rates, is amended to read as follows:
38 S 93. 1. Notwithstanding any inconsistent provision of law, rule or
39 regulation to the contrary, and subject to the availability of federal
40 financial participation, effective for the period April 1, 2011 through
41 March 31, 2012, and each state fiscal year thereafter, the department of
42 health is authorized to make supplemental Medicaid payments OR SUPPLE-
43 MENTAL MEDICAID MANAGED CARE PAYMENTS for professional services provided
44 by physicians, nurse practitioners and physician assistants who are
45 employed by a public benefit corporation or a non-state operated public
46 general hospital operated by a public benefit corporation or who are
47 providing professional services at a facility of such public benefit
48 corporation as either a member of a practice plan or an employee of a
49 professional corporation or limited liability corporation under contract
50 to provide services to patients of such a public benefit corporation, in
51 accordance with title 11 of article 5 of the social services law for
52 patients eligible for federal financial participation under title XIX of
53 the federal social security act, in amounts that will increase fees for
54 such professional services to an amount equal to either the Medicare
55 rate or the average commercial rate that would otherwise be received for
56 such services rendered by such physicians, nurse practitioners and
A. 6007 21
1 physician assistants, provided, however, that such supplemental fee
2 payments shall not be available with regard to services provided at
3 facilities participating in the Medicare Teaching Election Amendment.
4 The calculation of such supplemental fee payments shall be made in
5 accordance with applicable federal law and regulation and subject to the
6 approval of the division of the budget. Such supplemental Medicaid fee
7 payments may be added to the professional fees paid under the fee sched-
8 ule [or], made as aggregate lump sum payments to entities authorized to
9 receive professional fees OR MADE AS SUPPLEMENTAL PAYMENTS MADE FOR SUCH
10 PURPOSE AS DESCRIBED HEREIN TO MEDICAID MANAGED CARE ORGANIZATIONS.
11 SUPPLEMENTAL MEDICAID MANAGED CARE PAYMENTS UNDER THIS SECTION SHALL BE
12 DISTRIBUTED TO PROVIDERS AS DETERMINED BY THE MANAGED CARE MODEL
13 CONTRACT AND MAY UTILIZE MANAGED CARE ORGANIZATION REPORTED ENCOUNTER
14 DATA AND OTHER SUCH METRICS AS DETERMINED BY THE DEPARTMENT OF HEALTH IN
15 ORDER TO ENSURE RATES OF PAYMENT EQUIVALENT TO THE AVERAGE COMMERCIAL OR
16 MEDICARE RATE THAT WOULD OTHERWISE BE RECEIVED FOR SUCH SERVICES
17 RENDERED BY SUCH PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSIST-
18 ANTS.
19 2. The supplemental Medicaid payments OR SUPPLEMENTAL MEDICAID MANAGED
20 CARE PAYMENTS for professional services authorized by subdivision one of
21 this section may be made only at the election of the public benefit
22 corporation or the local social services district in which the non-state
23 operated public general hospital is located. The electing public benefit
24 corporation or local social services district shall, notwithstanding the
25 social services district Medicaid cap provisions of Part C of chapter 58
26 of the laws of 2005, be responsible for payment of one hundred percent
27 of the non-federal share of such supplemental Medicaid payments, in
28 accordance with section 365-a of the social services law, regardless of
29 whether another social services district or the department of health may
30 otherwise be responsible for furnishing medical assistance to the eligi-
31 ble persons receiving such services. Social services district or public
32 benefit corporation funding of the non-federal share of any such
33 payments shall be deemed to be voluntary for purposes of the increased
34 federal medical assistance percentage provisions of the American Recov-
35 ery and Reinvestment Act of 2009, provided, however, that in the event
36 the federal Centers for Medicare and Medicaid Services determines that
37 such non-federal share payments are not voluntary payments for purposes
38 of such act, the provisions of this section shall be null and void.
39 S 30-a. Subdivision 1 of section 364-j of the social services law is
40 amended by adding a new paragraph (w) to read as follows:
41 (W) "SCHOOL-BASED HEALTH CENTER." A CLINIC LICENSED OR SPONSORED BY A
42 FACILITY LICENSED UNDER ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW,
43 WHICH PROVIDES PRIMARY HEALTH CARE SERVICES WHICH MAY INCLUDE URGENT
44 CARE, WELL CHILD CARE, REPRODUCTIVE HEALTH CARE, DENTAL CARE, BEHAVIORAL
45 HEALTH SERVICES, VISION CARE, AND MANAGEMENT OF CHRONIC DISEASES TO
46 CHILDREN AND ADOLESCENTS WITHIN AN ELEMENTARY, SECONDARY OR PREKINDER-
47 GARTEN PUBLIC SCHOOL SETTING.
48 S 30-b. Subdivision 2 of section 364-j of the social services law is
49 amended by adding a new paragraph (d) to read as follows:
50 (D)(I) THE COMMISSIONER OF HEALTH IS AUTHORIZED TO INCLUDE THE
51 SERVICES OF SCHOOL-BASED HEALTH CENTERS DESIGNATED BY THE COMMISSIONER
52 OF HEALTH, IN THE MANAGED CARE PROGRAM PURSUANT TO THIS SECTION ON AND
53 AFTER JULY FIRST, TWO THOUSAND FIFTEEN, COMMENCING WITH NO FEWER THAN
54 THREE SCHOOL-BASED HEALTH CENTERS, THAT VOLUNTEER TO BE PART OF A PILOT
55 PROJECT FOR A PERIOD OF TWO YEARS. THE COMMISSIONER OF HEALTH SHALL
56 PROVIDE AN INTERIM REPORT ON THE IMPLEMENTATION OF THE PILOT PROJECT TO
A. 6007 22
1 THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON
2 OR BEFORE JULY FIRST, TWO THOUSAND SIXTEEN. THE COMMISSIONER OF HEALTH
3 SHALL PROVIDE A FINAL REPORT ON THE IMPLEMENTATION OF THE PILOT PROJECT
4 TO THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY
5 ON OR BEFORE JANUARY FIRST, TWO THOUSAND SEVENTEEN. SUCH INTERIM AND
6 FINAL REPORTS SHALL INCLUDE BUT NOT BE LIMITED TO INFORMATION CONCERNING
7 ACCESS BY CHILDREN AND ADOLESCENTS TO PRIMARY HEALTH CARE SERVICES,
8 URGENT CARE SERVICES, SERVICES FOR THE MANAGEMENT OF CHRONIC DISEASE,
9 WELL CHILD CARE, AND DENTAL CARE, AND THE TIMELINESS AND ADEQUACY OF
10 PAYMENT TO SCHOOL-BASED HEALTH CENTERS BY MANAGED CARE PROVIDERS.
11 (II) ON AND AFTER JULY FIRST, TWO THOUSAND SEVENTEEN, THE COMMISSIONER
12 OF HEALTH IS AUTHORIZED TO INCLUDE THE SERVICES OF SCHOOL-BASED HEALTH
13 CENTERS IN THE MANAGED CARE PROGRAM ON A PHASED-IN SCHEDULE BASED ON
14 GEOGRAPHY AND THE CAPABILITY OF THE SCHOOL-BASED HEALTH CENTER AND THE
15 MANAGED CARE PROVIDER TO PARTICIPATE IN THE PROGRAM. SUCH ASSESSMENT OF
16 CAPABILITY TO PARTICIPATE IN THE PROGRAM SHALL BE MADE BY THE COMMIS-
17 SIONER OF HEALTH AFTER CONSULTATION WITH THE INVOLVED SCHOOL-BASED
18 HEALTH CENTER, THE ORGANIZATION SPONSORING THE SCHOOL-BASED HEALTH
19 CENTER, IF ANY, AND THE MANAGED CARE PROVIDER. THE COMMISSIONER OF
20 HEALTH SHALL TAKE INTO CONSIDERATION ANY RELEVANT FINDINGS OF THE FINAL
21 AND INTERIM REPORTS.
22 (III) THIS PARAGRAPH SHALL NOT APPLY TO BEHAVIORAL HEALTH AND REPRO-
23 DUCTIVE HEALTH CARE SERVICES PROVIDED BY SCHOOL-BASED HEALTH CENTERS.
24 S 30-c. Subdivision 3 of section 364-j of the social services law is
25 amended by adding a new paragraph (d-2) to read as follows:
26 (D-2)(I) HEALTH CARE SERVICES PROVIDED BY SCHOOL-BASED HEALTH CENTERS
27 SHALL NOT BE PROVIDED TO MEDICAL ASSISTANCE RECIPIENTS THROUGH MANAGED
28 CARE PROGRAMS ESTABLISHED UNDER THIS SECTION, EXCEPT AS AUTHORIZED UNDER
29 PARAGRAPH (D) OF SUBDIVISION TWO OF THIS SECTION.
30 (II) BEHAVIORAL HEALTH AND REPRODUCTIVE HEALTH CARE SERVICES PROVIDED
31 BY SCHOOL-BASED HEALTH CENTERS SHALL NOT BE PROVIDED TO MEDICAL ASSIST-
32 ANCE RECIPIENTS THROUGH MANAGED CARE PROGRAMS ESTABLISHED UNDER THIS
33 SECTION.
34 (III) WHERE HEALTH CARE SERVICES ARE PROVIDED BY SCHOOL-BASED HEALTH
35 CENTERS TO MEDICAL ASSISTANCE OTHER THAN THROUGH THE MANAGED CARE
36 PROGRAM, THE SERVICES SHALL BE PAID FOR IN ACCORDANCE WITH APPLICABLE
37 REIMBURSEMENT METHODOLOGIES. APPLICABLE REIMBURSEMENT METHODOLOGIES
38 SHALL MEAN:
39 (A) FOR SCHOOL-BASED HEALTH CENTERS SPONSORED BY A FEDERALLY QUALIFIED
40 HEALTH CENTER, RATES OF REIMBURSEMENT AND REQUIREMENTS IN ACCORDANCE
41 WITH THOSE MANDATED BY 42 U.S.C. SECS. 1396A(BB), 1396(M)(2)(A)(IX) AND
42 1936(A)(13)(C); AND
43 (B) FOR SCHOOL-BASED HEALTH CENTERS SPONSORED BY AN ENTITY LICENSED
44 PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW THAT IS NOT A
45 FEDERALLY QUALIFIED HEALTH CENTER, RATES OF REIMBURSEMENT AT THE OTHER-
46 WISE-APPLICABLE AMBULATORY PATIENT GROUP RATE FOR THE SERVICE.
47 (C) FOR THE PURPOSES OF THIS PARAGRAPH, THE TERM "BEHAVIORAL HEALTH
48 SERVICES" SHALL MEAN BEHAVIORAL HEALTH SERVICES INCLUDING: PRIMARY
49 PREVENTION, INDIVIDUAL MENTAL HEALTH ASSESSMENT, TREATMENT AND FOLLOW-
50 UP, CRISIS INTERVENTION, GROUP AND FAMILY COUNSELING, AND SHORT AND
51 LONG-TERM COUNSELING; BEHAVIORAL HEALTH SERVICES ARE HEALTH CARE
52 SERVICES.
53 S 30-d. The social services law is amended by adding a new section
54 364-j-3 to read as follows:
55 S 364-J-3. INDEPENDENT CONSUMER ADVOCACY NETWORK. 1. THERE IS HEREBY
56 ESTABLISHED IN THE DEPARTMENT OF HEALTH AN INDEPENDENT OMBUDSMAN PROGRAM
A. 6007 23
1 KNOWN AS THE INDEPENDENT CONSUMER ADVOCACY NETWORK (REFERRED TO IN THIS
2 SECTION AS "ICAN") TO PROVIDE COMMUNITY CONTACT AND INVOLVEMENT WITH
3 ENROLLEES IN MEDICAID MANAGED CARE PROGRAMS UNDER THIS ARTICLE AND ARTI-
4 CLE FORTY-FOUR OF THE PUBLIC HEALTH LAW, AND ANY OTHER MEDICAID COORDI-
5 NATED CARE PROGRAM; APPLICANTS AND RECIPIENTS WHO MAY BE ELIGIBLE FOR
6 ENROLLMENT IN ANY OF THOSE MEDICAID PROGRAMS; AND REPRESENTATIVES, ADVO-
7 CATES, CAREGIVERS, AND FAMILY MEMBERS OF THOSE ENROLLEES, APPLICANTS,
8 AND RECIPIENTS. THE COMMISSIONER OF HEALTH SHALL DESIGNATE (WHICH MAY BE
9 DONE THROUGH A REQUEST FOR PROPOSALS PROCESS BEING UNDERTAKEN (UPON THE
10 EFFECTIVE DATE OF THIS SECTION) AND CONTRACT WITH AN ENTITY TO FUNCTION
11 AS THE ICAN. THE ENTITY SHALL BE A NOT-FOR-PROFIT CORPORATION WITH EXPE-
12 RIENCE ADMINISTERING A STATEWIDE PROGRAM OF ASSISTING AND ADVOCATING FOR
13 CONSUMERS IN MATTERS RELATING TO HEALTH COVERAGE AND A DEMONSTRATED
14 ABILITY TO ASSEMBLE AND MANAGE A STATEWIDE NETWORK OF PARTICIPATING
15 ORGANIZATIONS IN THAT PROGRAM. UNLESS THE CONTEXT CLEARLY REQUIRES
16 OTHERWISE, AS USED IN THIS SECTION, "ICAN ENTITY" SHALL MEAN THE ENTITY
17 DESIGNATED UNDER THIS SUBDIVISION AND ANY PARTICIPATING ORGANIZATION OF
18 THE ENTITY. THE ICAN ENTITY SHALL BE AUTHORIZED TO CONDUCT ACTIVITIES
19 INCLUDING, BUT NOT LIMITED TO:
20 (A) EDUCATING AND CONSULTING WITH ENROLLEES, APPLICANTS, RECIPIENTS,
21 REPRESENTATIVES, ADVOCATES, FAMILY MEMBERS, CAREGIVERS, RESIDENT COUN-
22 CILS OF FACILITIES HOUSING A SUBSTANTIAL NUMBER OF MEDICAID APPLICANTS
23 OR RECIPIENTS, AND COMMUNITY GROUPS IN RELATION TO ENROLLEE, APPLICANT
24 AND INDIVIDUAL RIGHTS, MEDICAL ASSISTANCE PROGRAM OPTIONS, BENEFITS,
25 ASSESSMENT, APPEALS, AND ADVERSE EVENTS;
26 (B) INVESTIGATING AND RESOLVING COMPLAINTS MADE BY OR ON BEHALF OF
27 ENROLLEES, APPLICANTS, AND RECIPIENTS RELATING TO MATTERS THAT MAY
28 AFFECT THE HEALTH, SAFETY, WELFARE, AND RIGHTS OF THESE INDIVIDUALS;
29 (C) REPRESENTING ENROLLEES, APPLICANTS, AND RECIPIENTS OR THEIR DESIG-
30 NATED REPRESENTATIVES IN GRIEVANCES, APPEALS, AND OTHER LEGAL
31 PROCEEDINGS; AND
32 (D) UNDERTAKING PUBLIC ADVOCACY.
33 2. THE ICAN ENTITY, IN CONDUCTING THE PROGRAM, SHALL:
34 (A) FUNCTION WITH INDEPENDENCE FROM STATE AND LOCAL GOVERNMENTS,
35 HEALTH PLANS, AND OTHER INDUSTRY STAKEHOLDERS;
36 (B) BE CULTURALLY COMPETENT FOR THE POPULATION SERVED;
37 (C) COLLECT DATA ON THE CASES HANDLED;
38 (D) COORDINATE AS NEEDED WITH THE EXISTING LONG TERM CARE OMBUDSMAN ON
39 MATTERS RELATING TO THE LONG TERM CARE OMBUDSMAN'S WORK; AND
40 (E) REPORT ANNUALLY OR AT THE REQUEST OF THE COMMISSIONER OF HEALTH ON
41 ALL PROGRAM ACTIVITIES.
42 3. THE COMMISSIONER OF HEALTH SHALL:
43 (A) ENSURE THE ICAN ENTITY IS SUFFICIENTLY FUNDED TO CARRY OUT ITS
44 FUNCTIONS UNDER THIS SECTION;
45 (B) IMPLEMENT A SYSTEM OF INFORMATION SHARING AND COORDINATION AMONG
46 THE DEPARTMENT OF HEALTH, THE ICAN ENTITY, AND THE LONG TERM CARE
47 OMBUDSMAN PROGRAM;
48 (C) REQUIRE HEALTH PLANS IN THE MEDICAL ASSISTANCE PROGRAM TO:
49 (I) COOPERATE WITH THE ICAN ENTITY; AND
50 (II) APPOINT AN INTERNAL OMBUDSMAN TO HELP ENROLLEES, APPLICANTS,
51 RECIPIENTS, REPRESENTATIVES, CAREGIVERS AND FAMILY MEMBERS WITH INTERNAL
52 PLAN ADVOCACY AND TO WORK WITH THE ICAN ENTITY AND OTHER CONSUMER ADVO-
53 CACY PROGRAMS.
54 (D) REPORT, AT LEAST ONCE EVERY TWO YEARS, TO THE GOVERNOR AND THE
55 LEGISLATURE ON THE WORK OF THE ICAN ENTITY, AND MAKE THE REPORT AVAIL-
56 ABLE ON THE DEPARTMENT OF HEALTH'S WEBSITE.
A. 6007 24
1 S 31. Subparagraph (iii) of paragraph (d) of subdivision 1 of section
2 367-a of the social services law, as amended by section 65 of part H of
3 chapter 59 of the laws of 2011, is amended to read as follows:
4 (iii) [When payment under part B of title XVIII of the federal social
5 security act for] WITH RESPECT TO items and services provided to eligi-
6 ble persons who are also beneficiaries under part B of title XVIII of
7 the federal social security act and [for] items and services provided to
8 qualified medicare beneficiaries under part B of title XVIII of the
9 federal social security act [would exceed the amount that otherwise
10 would be made under this title if provided to an eligible person other
11 than a person who is also a beneficiary under part B or is a qualified
12 medicare beneficiary, the amount payable for services covered under this
13 title shall be twenty percent of], THE AMOUNT PAYABLE FOR SERVICES
14 COVERED UNDER THIS TITLE SHALL BE the amount of any co-insurance liabil-
15 ity of such eligible persons pursuant to federal law were they not
16 eligible for medical assistance or were they not qualified medicare
17 beneficiaries with respect to such benefits under such part B, BUT SHALL
18 NOT EXCEED THE MIDWAY POINT BETWEEN THE AMOUNT THAT OTHERWISE WOULD BE
19 MADE UNDER THIS TITLE IF PROVIDED TO AN ELIGIBLE PERSON OTHER THAN A
20 PERSON WHO IS ALSO A BENEFICIARY UNDER PART B OR IS A QUALIFIED MEDICARE
21 BENEFICIARY MINUS THE AMOUNT PAYABLE UNDER PART B AND THE AMOUNT THAT
22 WOULD OTHERWISE BE PAID BY PART B OF TITLE XVIII OF THE FEDERAL SOCIAL
23 SECURITY ACT; provided, however, amounts payable under this title for
24 items and services provided to eligible persons who are also benefici-
25 aries under part B or to qualified medicare beneficiaries by an ambu-
26 lance service under the authority of an operating certificate issued
27 pursuant to article thirty of the public health law, a psychologist
28 licensed under article one hundred fifty-three of the education law, or
29 a facility under the authority of an operating certificate issued pursu-
30 ant to article sixteen, thirty-one or thirty-two of the mental hygiene
31 law and with respect to outpatient hospital and clinic items and
32 services provided by a facility under the authority of an operating
33 certificate issued pursuant to article twenty-eight of the public health
34 law, shall not be less than the amount of any co-insurance liability of
35 such eligible persons or such qualified medicare beneficiaries, or for
36 which such eligible persons or such qualified medicare beneficiaries
37 would be liable under federal law were they not eligible for medical
38 assistance or were they not qualified medicare beneficiaries with
39 respect to such benefits under part B.
40 S 32. Paragraph (d) of subdivision 1 of section 367-a of the social
41 services law is amended by adding a new subparagraph (iv) to read as
42 follows:
43 (IV) IF A HEALTH PLAN PARTICIPATING IN PART C OF TITLE XVIII OF THE
44 FEDERAL SOCIAL SECURITY ACT PAYS FOR ITEMS AND SERVICES PROVIDED TO
45 ELIGIBLE PERSONS WHO ARE ALSO BENEFICIARIES UNDER PART B OF TITLE XVIII
46 OF THE FEDERAL SOCIAL SECURITY ACT OR TO QUALIFIED MEDICARE BENEFICI-
47 ARIES, THE AMOUNT PAYABLE FOR SERVICES UNDER THIS TITLE SHALL BE THE
48 AMOUNT OF ANY CO-INSURANCE LIABILITY OF SUCH ELIGIBLE PERSONS PURSUANT
49 TO FEDERAL LAW IF THEY WERE NOT ELIGIBLE FOR MEDICAL ASSISTANCE OR WERE
50 NOT QUALIFIED MEDICARE BENEFICIARIES WITH RESPECT TO SUCH BENEFITS UNDER
51 PART B, BUT SHALL NOT EXCEED THE AMOUNT REPRESENTING THE MIDWAY POINT
52 BETWEEN THE AMOUNT THAT WOULD OTHERWISE BE MADE UNDER THIS TITLE IF
53 PROVIDED TO AN ELIGIBLE PERSON WHO IS NOT A BENEFICIARY UNDER PART B OR
54 A QUALIFIED MEDICARE BENEFICIARY AND THE AMOUNT THAT WOULD OTHERWISE BE
55 PAID BY PART C OF TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT, LESS
56 THE AMOUNT PAYABLE BY THE PART C HEALTH PLAN.
A. 6007 25
1 S 33. Intentionally omitted.
2 S 34. The commissioner of health is authorized to conduct an assess-
3 ment of the mobility and transportation needs of persons with disabili-
4 ties and other special needs populations. The assessment shall include
5 identification of any legal, statutory or regulatory, and funding barri-
6 ers. After consultation with the department of transportation, office
7 for people with developmental disabilities, office for the aging, office
8 of mental health, and office of alcoholism and substance abuse services,
9 the contractor shall make recommendations for the development of a pilot
10 demonstration project to coordinate medical and non-medical transporta-
11 tion services, maximize funding sources, enhance community integration
12 and any other related tasks.
13 S 35. Section 133 of the social services law, as amended by chapter
14 455 of the laws of 2010, is amended to read as follows:
15 S 133. Temporary preinvestigation emergency needs assistance or care.
16 Upon application for public assistance or care under this chapter, the
17 local social services district shall notify the applicant in writing of
18 the availability of a monetary grant adequate to meet emergency needs
19 assistance or care and shall, at such time, determine whether such
20 person is in immediate need. If it shall appear that a person is in
21 immediate need, emergency needs assistance or care shall be granted
22 pending completion of an investigation INCLUDING MEDICAL ASSISTANCE. The
23 written notification required by this section shall inform such person
24 of a right to an expedited hearing when emergency needs assistance or
25 care is denied. A public assistance applicant who has been denied emer-
26 gency needs assistance or care must be given reason for such denial in a
27 written determination which sets forth the basis for such denial.
28 S 36. Section 364-i of the social services law is amended by adding a
29 new subdivision 1-a to read as follows:
30 1-A. (A) AN INDIVIDUAL, UPON APPLICATION FOR MEDICAL ASSISTANCE, SHALL
31 BE PRESUMPTIVELY ELIGIBLE FOR IMMEDIATE TEMPORARY PERSONAL CARE OR
32 CONSUMER DIRECTED PERSONAL ASSISTANCE SERVICES PURSUANT TO PARAGRAPH (E)
33 OF SUBDIVISION TWO OF SECTION THREE HUNDRED SIXTY-FIVE-A OF THIS TITLE
34 OR SECTION THREE HUNDRED SIXTY-FIVE-F OF THIS TITLE, RESPECTIVELY, FROM
35 THE DATE OF APPLICATION, PROVIDED THAT:
36 (I) SUCH INDIVIDUAL SUBMITS: (A) AN APPLICATION FOR MEDICAL ASSIST-
37 ANCE, AND (B) A PHYSICIAN'S ORDER THAT (I) RECOMMENDS THE NUMBER OF
38 HOURS OF PERSONAL CARE OR CONSUMER DIRECTED PERSONAL ASSISTANCE SERVICES
39 TO BE AUTHORIZED AS IMMEDIATE TEMPORARY PERSONAL CARE SERVICES; (II)
40 DOCUMENTS THAT SUCH INDIVIDUAL NEEDS ASSISTANCE IN THE HOME WITH ONE OR
41 MORE OF TOILETING, TRANSFERRING FROM BED TO CHAIR OR WHEELCHAIR, TURNING
42 OR POSITIONING IN BED, WALKING, OR FEEDING; AND (III) DOCUMENTS THAT IT
43 IS REASONABLY EXPECTED THAT THE INDIVIDUAL'S HEALTH AND SAFETY CAN BE
44 MAINTAINED IN THE HOME; AND
45 (II) IT REASONABLY APPEARS THAT THE APPLICANT IS OTHERWISE ELIGIBLE TO
46 RECEIVE MEDICAL ASSISTANCE.
47 (B) MEDICAL ASSISTANCE UNDER THIS SUBDIVISION SHALL BE AVAILABLE TO
48 MEET THE IMMEDIATE NEEDS OF THE INDIVIDUAL PRIOR TO AND AFTER A DETERMI-
49 NATION THAT SUCH INDIVIDUAL MEETS THE ELIGIBILITY REQUIREMENTS OF THIS
50 TITLE AND UNTIL SUCH INDIVIDUAL EITHER (I) HAS BEEN DETERMINED TO BE
51 FINANCIALLY OR OTHERWISE INELIGIBLE FOR MEDICAL ASSISTANCE OR FOR
52 MEDICAL SERVICES OR SUPPLIES, OR (II) COMMENCES RECEIVING APPROPRIATE
53 COMMUNITY BASED LONG-TERM CARE SERVICES UNDER THE MEDICAL ASSISTANCE
54 PROGRAM.
55 S 36-a. Subdivision 7 of section 364-i of the social services law is
56 REPEALED.
A. 6007 26
1 S 37. Notwithstanding any provision of law to the contrary, monies
2 equal to the amount of enhanced federal medical assistance percentage
3 monies available as a result of the state's participation in the commu-
4 nity first choice state plan option under section 1915 of title XIX of
5 the federal social security act, in each state fiscal year shall be made
6 available as additional funds to be used to implement the state's
7 comprehensive plan for serving New Yorkers with disabilities in the most
8 integrated setting, also know as the state's Olmstead plan. Such monies
9 shall be expended for the purposes consistent with the Olmstead plan,
10 including, additional funding for supportive housing, wage supports for
11 home and personal care workers, transportation supports, and the transi-
12 tion of behavioral health services to managed care. The department of
13 health shall, after consultation with stakeholders, relevant state agen-
14 cies, the division of budget and the Olmstead cabinet, submit a report
15 to the temporary president of the senate, and the speaker of the assem-
16 bly, the chair of the senate finance committee, the chair of the assem-
17 bly ways and means committee, and the chairs of the senate and assembly
18 health committees, setting forth the plan to allocate such investments,
19 and no expenditures may be made from these funds until the plan has been
20 approved by the temporary president of the senate and the speaker of the
21 assembly. The commissioner of health shall report annually to the chairs
22 of the assembly and senate committees on health, aging, and mental
23 health, the chair of the senate committee on finance, the chair of the
24 assembly ways and means committee, and the chair of the assembly task
25 force on people with disabilities on the amount of funding received and
26 disbursed pursuant to this section, the projects or proposals supported
27 by these funds, and compliance with this section.
28 S 38. Section 2808 of the public health law is amended by adding a new
29 subdivision 27 to read as follows:
30 27. FOR PERIODS ON OR AFTER APRIL FIRST, TWO THOUSAND FIFTEEN, THE
31 COMMISSIONER SHALL AUTHORIZE AN ENERGY EFFICIENCY AND/OR DISASTER
32 PREPAREDNESS STUDY FOR RESIDENTIAL HEALTH CARE FACILITIES.
33 S 39. Intentionally omitted.
34 S 40. Intentionally omitted.
35 S 40-a. Subdivision 8 of section 4403-f of the public health law, as
36 amended by section 21 of part C of chapter 58 of the laws of 2007, is
37 amended to read as follows:
38 8. Payment rates for managed long term care plan enrollees eligible
39 for medical assistance. The commissioner shall establish payment rates
40 for services provided to enrollees eligible under title XIX of the
41 federal social security act. Such payment rates shall be subject to
42 approval by the director of the division of the budget and shall reflect
43 savings to both state and local governments when compared to costs which
44 would be incurred by such program if enrollees were to receive compara-
45 ble health and long term care services on a fee-for-service basis in the
46 geographic region in which such services are proposed to be provided.
47 Payment rates shall be risk-adjusted to take into account the character-
48 istics of enrollees, or proposed enrollees, including, but not limited
49 to: frailty, disability level, health and functional status, age,
50 gender, the nature of services provided to such enrollees, and other
51 factors as determined by the commissioner. The risk adjusted premiums
52 may also be combined with disincentives or requirements designed to
53 mitigate any incentives to obtain higher payment categories. IN SETTING
54 SUCH PAYMENT RATES, THE COMMISSIONER SHALL CONSIDER COSTS BORNE BY THE
55 MANAGED CARE PROGRAM UNDER SUBDIVISION NINE OF SECTION FORTY-FOUR
56 HUNDRED SIX-C OF THIS ARTICLE.
A. 6007 27
1 S 40-b. Section 4406-c of the public health law is amended by adding a
2 new subdivision 9 to read as follows:
3 9. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, ANY CONTRAC-
4 TOR ADMINISTRATIVE SERVICE AGREEMENT BY A HEALTH CARE PLAN WITH CERTI-
5 FIED HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS, LICENSED
6 HOME CARE SERVICES AGENCIES, OR FISCAL INTERMEDIARIES IN THE CONSUMER
7 DIRECTED PERSONAL ASSISTANCE PROGRAM SHALL ENSURE THAT RESOURCES MADE
8 AVAILABLE BY A HEALTH CARE PLAN UNDER SUCH CONTRACTS OR AGREEMENTS WILL
9 SUPPORT THE RETENTION OF A QUALIFIED WORKFORCE CAPABLE OF PROVIDING
10 QUALITY CARE.
11 (B) SUCH CONTRACTS SHALL REQUIRE THAT RATES SHALL: (I) IN THE CASE OF
12 CERTIFIED HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS,
13 LICENSED HOME CARE SERVICES AGENCIES LICENSED OR CERTIFIED UNDER ARTICLE
14 THIRTY-SIX OF THIS CHAPTER, SUFFICIENTLY SUPPORT HOME CARE WORKER WAGE
15 PARITY COMPENSATION AS REQUIRED UNDER SECTION THIRTY-SIX HUNDRED FOUR-
16 TEEN-C OF THIS CHAPTER; RECRUITMENT, TRAINING AND RETENTION OF DIRECT
17 CARE PERSONNEL, INCLUDING WAGE, SALARY AND A SUPPLEMENTAL-BENEFIT RATE,
18 WHICH MAY BE PROVIDED IN ANY COMBINATION OF CASH OR BENEFITS, IN BOTH
19 WAGE PARITY AND NON-WAGE PARITY REGIONS, THE COSTS FOR WHICH SHALL BE
20 DEMONSTRATED BY SUCH AGENCIES, AND THE PROVISION OF PAYMENTS TO SUCH
21 AGENCIES AND PROGRAMS UNDER PARAGRAPH (BB) OF SUBDIVISION ONE OF SECTION
22 TWENTY-EIGHT HUNDRED SEVEN-V OF THIS CHAPTER, SUBDIVISIONS EIGHT, NINE
23 AND TEN OF SECTION THIRTY-SIX HUNDRED FOURTEEN OF THIS CHAPTER AND
24 SECTION THREE HUNDRED SIXTY-SEVEN-Q OF THE SOCIAL SERVICES LAW; ALL AS
25 APPLICABLE; AND
26 (II) IN THE CASE OF THE CONSUMER DIRECTED PERSONAL ASSISTANCE PROGRAM,
27 SUPPORT FISCAL INTERMEDIARIES TO COMPENSATE CONSUMER DIRECTED PERSONAL
28 ASSISTANTS UNDER THE PROGRAM INCLUDING WAGE, SALARY AND A SUPPLEMENTAL
29 BENEFIT RATE, WHICH MAY BE PROVIDED IN ANY COMBINATION OF CASH OR BENE-
30 FITS. NOTHING CONTAINED IN THIS SUBDIVISION SHALL SUPERSEDE OR DIMINISH
31 THE TERMS OF A COLLECTIVE BARGAINING AGREEMENT.
32 (C) WHERE A HEALTH CARE PLAN IS NOT IN COMPLIANCE WITH THIS SUBDIVI-
33 SION, THE HEALTH CARE PLAN MAY BE SUBJECT TO ANY SANCTIONS OR PENALTIES
34 PERMITTED BY FEDERAL OR STATE LAWS AND REGULATIONS, INCLUDING REVOCATION
35 OF THE HEALTH CARE PLAN'S AGREEMENT TO PARTICIPATE IN THE MEDICAL
36 ASSISTANCE PROGRAM. FOR THOSE PATIENTS AFFECTED BY A HEALTH CARE PLAN'S
37 NONCOMPLIANCE WITH THIS SUBDIVISION, THE COMMISSIONER SHALL ENSURE THAT
38 SUCH PATIENTS WILL BE IMMEDIATELY COVERED BY ANOTHER MANAGED HEALTH CARE
39 PLAN OR FEE FOR SERVICE. THIS PARAGRAPH SHALL NOT PRECLUDE ANY OTHER
40 RIGHT OR REMEDY AVAILABLE TO ANY OTHER PARTY.
41 (D) A HEALTH CARE PLAN THAT CONTRACTS WITH CERTIFIED HOME HEALTH AGEN-
42 CIES, LONG TERM HOME HEALTH CARE PROGRAMS, LICENSED HOME CARE SERVICES
43 AGENCIES, OR FISCAL INTERMEDIARIES IN THE CONSUMER DIRECTED PERSONAL
44 ASSISTANCE PROGRAM SHALL ANNUALLY SUBMIT WRITTEN CERTIFICATION TO THE
45 DEPARTMENT THAT IT IS IN COMPLIANCE WITH THIS SUBDIVISION AND THAT EACH
46 SUCH HOME CARE PROVIDER OR FISCAL INTERMEDIARY WITH WHICH IT CONTRACTS
47 IS IN COMPLIANCE WITH THIS SUBDIVISION. THE HEALTH CARE PLAN SHALL ANNU-
48 ALLY OBTAIN AND SUBMIT TO THE DEPARTMENT WRITTEN CERTIFICATION FROM SUCH
49 HOME CARE PROVIDER OR FISCAL INTERMEDIARY AND ANY OF ITS LABOR SUBCON-
50 TRACTORS WHICH ATTESTS THAT THE ENTITY AND THE SUBCONTRACTOR IS IN
51 COMPLIANCE WITH THIS SUBDIVISION. ALL SUCH WRITTEN CERTIFICATIONS SHALL
52 BE ON FORMS PREPARED BY THE DEPARTMENT. THE HEALTH CARE PLAN SHALL
53 OBTAIN INFORMATION FROM THE HOME CARE PROVIDER OR FISCAL INTERMEDIARY
54 AND THEIR LABOR SUBCONTRACTORS NECESSARY TO VERIFY COMPLIANCE WITH THIS
55 SUBDIVISION. SUCH INFORMATION SHALL BE RETAINED BY THE HEALTH CARE PLAN
A. 6007 28
1 FOR NOT LESS THAN THREE YEARS, AND MADE AVAILABLE TO THE DEPARTMENT UPON
2 REQUEST.
3 (E) A FAILURE BY A HOME CARE PROVIDER OR FISCAL INTERMEDIARY TO COMPLY
4 WITH THIS SUBDIVISION OR WITH REGULATIONS THEREUNDER, WHERE THE HEALTH
5 PLAN CONTRACT IS DETERMINED TO BE IN COMPLIANCE WITH THIS SUBDIVISION,
6 SHALL SUBJECT THE NON-COMPLIANT EMPLOYER OR CONTRACTOR TO THE SANCTIONS
7 AND ENFORCEMENT PROCESSES SET FORTH IN THE LABOR LAW OR PENALTIES AVAIL-
8 ABLE UNDER THIS ARTICLE OR SECTION THREE HUNDRED SIXTY-THREE-D OF THE
9 SOCIAL SERVICES LAW.
10 S 40-c. Subdivision 18 of section 364-j of the social services law is
11 amended by adding a new paragraph (c) to read as follows:
12 (C) IN SETTING SUCH REIMBURSEMENT METHODOLOGIES, THE DEPARTMENT SHALL
13 CONSIDER COSTS BORNE BY THE MANAGED CARE PROGRAM UNDER SUBDIVISION NINE
14 OF SECTION FORTY-FOUR HUNDRED SIX-C OF THE PUBLIC HEALTH LAW.
15 S 41. Intentionally omitted.
16 S 42. Subdivision 12 of section 367-a of the social services law, as
17 amended by section 63-a of part C of chapter 58 of the laws of 2007, is
18 amended to read as follows:
19 12. Prior to receiving medical assistance under subparagraphs [twelve]
20 FIVE and [thirteen] SIX of paragraph [(a)] (C) of subdivision one of
21 section three hundred sixty-six of this title, a person whose net avail-
22 able income is at least one hundred fifty percent of the applicable
23 federal income official poverty line, as defined and updated by the
24 United States department of health and human services, must pay a month-
25 ly premium, in accordance with a procedure to be established by the
26 commissioner. The amount of such premium shall be twenty-five dollars
27 for an individual who is otherwise eligible for medical assistance under
28 such subparagraphs, and fifty dollars for a couple, both of whom are
29 otherwise eligible for medical assistance under such subparagraphs. No
30 premium shall be required from a person whose net available income is
31 less than one hundred fifty percent of the applicable federal income
32 official poverty line, as defined and updated by the United States
33 department of health and human services.
34 S 43. Intentionally omitted.
35 S 44. Subdivision 1 of section 398-b of the social services law, as
36 added by section 44 of part C of chapter 60 of the laws of 2014, is
37 amended to read as follows:
38 1. Notwithstanding any inconsistent provision of law to the contrary
39 and subject to the availability of federal financial participation, the
40 commissioner is authorized to make grants [from] UP TO a gross amount of
41 five million dollars FOR STATE FISCAL YEAR TWO THOUSAND FOURTEEN--FIF-
42 TEEN AND UP TO A GROSS AMOUNT OF FIFTEEN MILLION DOLLARS FOR STATE
43 FISCAL YEAR TWO THOUSAND FIFTEEN--SIXTEEN to facilitate the transition
44 of foster care children placed with voluntary foster care agencies to
45 managed care. The use of such funds may include providing training and
46 consulting services to voluntary agencies to [access] ASSESS readiness
47 and make necessary infrastructure and organizational modifications,
48 collecting service utilization and other data from voluntary agencies
49 and other entities, and making investments in health information tech-
50 nology, including the infrastructure necessary to establish and maintain
51 electronic health records. Such funds shall be distributed pursuant to a
52 formula to be developed by the commissioner of health, in consultation
53 with the commissioner of the office of CHILDREN AND family [and child]
54 services. In developing such formula the commissioners may take into
55 account size and scope of provider operations as a factor relevant to
56 eligibility for such funds. Each recipient of such funds shall be
A. 6007 29
1 required to document and demonstrate the effective use of funds distrib-
2 uted herein. IF FEDERAL FINANCIAL PARTICIPATION IS UNAVAILABLE, THEN
3 THE NONFEDERAL SHARE OF PAYMENTS PURSUANT TO THIS SUBDIVISION MAY BE
4 MADE AS STATE GRANTS.
5 S 45. Paragraph (g) of subdivision 1 of section 366 of the social
6 services law, as added by section 50 of part C of chapter 60 of the laws
7 of 2014, is amended to read as follows:
8 (g) Coverage of certain noncitizens. (1) Applicants and recipients who
9 are lawfully admitted for permanent residence, or who are permanently
10 residing in the United States under color of law, OR WHO ARE NON-CITIZ-
11 ENS IN A VALID NONIMMIGRANT STATUS, AS DEFINED IN 8 U.S.C. 1101(A)(15);
12 who are MAGI eligible pursuant to paragraph (b) of this subdivision; and
13 who would be ineligible for medical assistance coverage under subdivi-
14 sions one and two of section three hundred sixty-five-a of this title
15 solely due to their immigration status if the provisions of section one
16 hundred twenty-two of this chapter were applied, shall only be eligible
17 for assistance under this title if enrolled in a standard health plan
18 offered by a basic health program established pursuant to section three
19 hundred sixty-nine-gg of this article if such program is established and
20 operating.
21 (2) With respect to a person described in subparagraph one of this
22 paragraph who is enrolled in a standard health plan, medical assistance
23 coverage shall mean:
24 (i) payment of required premiums and other cost-sharing obligations
25 under the standard health plan that exceed the person's co-payment obli-
26 gation under subdivision six of section three hundred sixty-seven-a of
27 this title; and
28 (ii) payment for services and supplies described in subdivision one or
29 two of section three hundred sixty-five-a of this title, as applicable,
30 but only to the extent that such services and supplies are not covered
31 by the standard health plan.
32 (3) Nothing in this subdivision shall prevent a person described in
33 subparagraph one of this paragraph from qualifying for or receiving
34 medical assistance while his or her enrollment in a standard health plan
35 is pending, in accordance with applicable provisions of this title.
36 S 46. Subdivision 8 of section 369-gg of the social services law, as
37 added by section 51 of part C of chapter 60 of the laws of 2014 and as
38 renumbered by section twenty-eight of this act, is amended to read as
39 follows:
40 8. An individual who is lawfully admitted for permanent residence
41 [or], permanently residing in the United States under color of law, OR
42 WHO IS A NON-CITIZEN IN A VALID NONIMMIGRANT STATUS, AS DEFINED IN 8
43 U.S.C. 1101(A)(15), and who would be ineligible for medical assistance
44 under title eleven of this article due to his or her immigration status
45 if the provisions of section one hundred twenty-two of this chapter were
46 applied, shall be considered to be ineligible for medical assistance for
47 purposes of paragraphs (b) and (c) of subdivision three of this section.
48 S 46-a. Section 365-d of the social services law is REPEALED and a new
49 section 365-d is added to read as follows:
50 S 365-D. HEALTH TECHNOLOGY ASSESSMENT COMMITTEE. 1. THE DEPARTMENT OF
51 HEALTH SHALL CONVENE A HEALTH TECHNOLOGY ASSESSMENT COMMITTEE. THE
52 COMMITTEE SHALL, AT THE REQUEST OF THE COMMISSIONER OF HEALTH, PROVIDE
53 ADVICE AND MAKE RECOMMENDATIONS REGARDING COVERAGE OF HEALTH TECHNOLOGY
54 FOR PURPOSES OF THE MEDICAL ASSISTANCE PROGRAM. THE COMMISSIONER OF
55 HEALTH SHALL CONSULT SUCH COMMITTEE PRIOR TO ANY DETERMINATION TO
56 EXCLUDE FROM COVERAGE ANY HEALTH TECHNOLOGY FROM THE MEDICAL ASSISTANCE
A. 6007 30
1 PROGRAM. FOR PURPOSES OF THIS SECTION, "HEALTH TECHNOLOGY" MEANS MEDICAL
2 DEVICES AND SURGICAL PROCEDURES USED IN THE PREVENTION, DIAGNOSIS AND
3 TREATMENT OF DISEASE AND OTHER MEDICAL CONDITIONS. THIS SECTION DOES
4 NOT GRANT THE COMMISSIONER OF HEALTH ANY AUTHORITY TO EXCLUDE ANY
5 MEDICAL TECHNOLOGY FROM THE MEDICAL ASSISTANCE PROGRAM OTHER THAN
6 AUTHORITY THE COMMISSIONER OF HEALTH MIGHT HAVE UNDER OTHER LAW.
7 2. (A) THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE SHALL CONSIST OF
8 THIRTEEN MEMBERS, WHO SHALL BE APPOINTED BY THE COMMISSIONER OF HEALTH
9 AND WHO SHALL SERVE THREE YEAR TERMS; EXCEPT THAT FOR THE INITIAL
10 APPOINTMENTS TO THE COMMITTEE, FIVE MEMBERS SHALL SERVE ONE YEAR TERMS,
11 FIVE MEMBERS SHALL SERVE TWO YEAR TERMS, AND THREE MEMBERS SHALL SERVE
12 THREE YEAR TERMS. COMMITTEE MEMBERS MAY BE REAPPOINTED UPON THE
13 COMPLETION OF THEIR TERMS. WITH THE EXCEPTION OF THE CHAIRPERSON, NO
14 MEMBER OF THE COMMITTEE SHALL BE AN EMPLOYEE OF THE STATE OR ANY POLI-
15 TICAL SUBDIVISION OF THE STATE, OTHER THAN FOR HIS OR HER MEMBERSHIP ON
16 THE COMMITTEE, EXCEPT FOR EMPLOYEES OF HEALTH CARE FACILITIES OR UNIVER-
17 SITIES OPERATED BY THE STATE, A PUBLIC BENEFIT CORPORATION, THE STATE
18 UNIVERSITY OF NEW YORK OR MUNICIPALITIES.
19 (B) THE MEMBERSHIP OF SUCH COMMITTEE SHALL BE AS FOLLOWS:
20 (I) SIX PERSONS LICENSED AND ACTIVELY ENGAGED IN THE PRACTICE OF MEDI-
21 CINE IN THIS STATE;
22 (II) ONE PERSON LICENSED AND ACTIVELY ENGAGED IN THE PRACTICE OF NURS-
23 ING AS A NURSE PRACTITIONER, OR IN THE PRACTICE OF MIDWIFERY IN THIS
24 STATE;
25 (III) ONE PERSON WHO IS A REPRESENTATIVE OF A HEALTH TECHNOLOGY OR
26 MEDICAL DEVICE ORGANIZATION WITH A REGIONAL, STATEWIDE OR NATIONAL
27 CONSTITUENCY AND WHO IS A HEALTH CARE PROFESSIONAL LICENSED UNDER TITLE
28 EIGHT OF THE EDUCATION LAW;
29 (IV) ONE PERSON WITH EXPERTISE IN HEALTH TECHNOLOGY ASSESSMENT WHO IS
30 A HEALTH CARE PROFESSIONAL LICENSED UNDER TITLE EIGHT OF THE EDUCATION
31 LAW;
32 (V) THREE PERSONS WHO SHALL BE CONSUMERS OR REPRESENTATIVES OF ORGAN-
33 IZATIONS WITH A REGIONAL OR STATEWIDE CONSTITUENCY AND WHO HAVE BEEN
34 INVOLVED IN ACTIVITIES RELATED TO HEALTH CARE CONSUMER ADVOCACY; AND
35 (VI) A MEMBER OF THE DEPARTMENT OF HEALTH WHO SHALL ACT AS CHAIRPERSON
36 AS DESIGNATED BY THE COMMISSIONER OF HEALTH.
37 3. THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE SHALL BE A PUBLIC BODY
38 UNDER ARTICLE SEVEN OF THE PUBLIC OFFICERS LAW AND SUBJECT TO ARTICLE
39 SIX OF THE PUBLIC OFFICERS LAW. THE DEPARTMENT OF HEALTH SHALL PROVIDE
40 INTERNET ACCESS TO ALL MEETINGS OF SUCH COMMITTEE THROUGH THE DEPARTMENT
41 OF HEALTH'S WEBSITE.
42 4. THE MEMBERS OF THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE SHALL
43 RECEIVE NO COMPENSATION FOR THEIR SERVICES BUT SHALL BE REIMBURSED FOR
44 EXPENSES ACTUALLY AND NECESSARILY INCURRED IN THE PERFORMANCE OF THEIR
45 DUTIES. COMMITTEE MEMBERS SHALL BE DEEMED TO BE EMPLOYEES OF THE DEPART-
46 MENT OF HEALTH FOR PURPOSES OF SECTION SEVENTEEN OF THE PUBLIC OFFICERS
47 LAW, AND SHALL NOT PARTICIPATE IN ANY MATTER FOR WHICH A CONFLICT OF
48 INTEREST EXISTS.
49 5. THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE SHALL, AT THE REQUEST OF
50 THE COMMISSIONER OF HEALTH, CONSIDER ANY MATTER RELATING TO HEALTH TECH-
51 NOLOGY ASSESSMENT. THE COMMISSIONER OF HEALTH SHALL PROVIDE THIRTY DAYS
52 PUBLIC NOTICE ON THE DEPARTMENT OF HEALTH'S WEBSITE PRIOR TO ANY MEETING
53 OF THE COMMITTEE TO DEVELOP RECOMMENDATIONS CONCERNING HEALTH TECHNOLOGY
54 COVERAGE DETERMINATIONS. SUCH NOTICE SHALL INCLUDE A DESCRIPTION OF THE
55 PROPOSED HEALTH TECHNOLOGY TO BE REVIEWED, THE CONDITIONS OR DISEASES
56 IMPACTED BY THE HEALTH TECHNOLOGY, AND THE PROPOSALS TO BE CONSIDERED BY
A. 6007 31
1 THE COMMITTEE. THE COMMITTEE SHALL ALLOW INTERESTED PARTIES A REASON-
2 ABLE OPPORTUNITY TO MAKE AN ORAL PRESENTATION TO THE COMMITTEE RELATED
3 TO THE HEALTH TECHNOLOGY TO BE REVIEWED AND TO SUBMIT WRITTEN INFORMA-
4 TION. THE COMMITTEE SHALL CONSIDER ANY INFORMATION PROVIDED BY ANY
5 INTERESTED PARTY, INCLUDING, BUT NOT LIMITED TO, HEALTH CARE PROVIDERS,
6 HEALTH CARE FACILITIES, PATIENTS, CONSUMERS AND MANUFACTURERS.
7 6. THE COMMISSIONER OF HEALTH SHALL PROVIDE NOTICE OF ANY COVERAGE
8 RECOMMENDATIONS DEVELOPED BY THE COMMITTEE BY MAKING SUCH INFORMATION
9 AVAILABLE ON THE DEPARTMENT OF HEALTH'S WEBSITE. SUCH PUBLIC NOTICE
10 SHALL INCLUDE: A SUMMARY OF THE DELIBERATIONS OF THE COMMITTEE; A SUMMA-
11 RY OF THE POSITIONS OF THOSE MAKING PUBLIC COMMENTS AT MEETINGS OF THE
12 COMMITTEE; THE RESPONSE OF THE COMMITTEE TO THOSE COMMENTS, IF ANY; THE
13 CLINICAL EVIDENCE UPON WHICH THE COMMITTEE BASES ITS RECOMMENDATION; AND
14 THE FINDINGS AND RECOMMENDATIONS OF THE COMMITTEE.
15 7. THE COMMISSIONER OF HEALTH SHALL PROVIDE PUBLIC NOTICE ON THE
16 DEPARTMENT OF HEALTH'S WEBSITE OF HIS OR HER FINAL DETERMINATION,
17 INCLUDING: THE NATURE OF THE DETERMINATION; AN ANALYSIS OF THE IMPACT OF
18 THE COMMISSIONER OF HEALTH'S DETERMINATION ON STATE PUBLIC HEALTH PLAN
19 POPULATIONS AND PROVIDERS; AND THE PROJECTED FISCAL IMPACT TO THE STATE
20 PUBLIC HEALTH PLAN PROGRAMS OF THE COMMISSIONER OF HEALTH'S DETERMI-
21 NATION. THE COMMISSIONER OF HEALTH'S FINAL DETERMINATION SHALL NOT OCCUR
22 PRIOR TO THE THIRTIETH DAY FROM THE POSTING OF THE COMMITTEE'S RECOMMEN-
23 DATIONS AND FINDINGS ON THE DEPARTMENT OF HEALTH'S WEBSITE.
24 8. THE RECOMMENDATIONS OF THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE,
25 MADE PURSUANT TO THIS SECTION, SHALL BE BASED ON CLINICAL EFFECTIVENESS
26 AND SAFETY. THE COMMITTEE SHALL TRIENNIALLY REVIEW PREVIOUS RECOMMENDA-
27 TIONS OF THE COMMITTEE AND PERMIT ORAL PRESENTATIONS AND THE SUBMISSION
28 OF NEW EVIDENCE AT SUCH TRIENNIAL REVIEW. SUCH REVIEW SHALL OCCUR PURSU-
29 ANT TO THE PROCEDURE ESTABLISHED IN SUBDIVISIONS FIVE AND SIX OF THIS
30 SECTION. THE COMMISSIONER OF HEALTH MAY ALTER OR REVOKE HIS OR HER FINAL
31 DETERMINATION AFTER SUCH TRIENNIAL REVIEW PURSUANT TO THE PROCEDURE
32 ESTABLISHED IN SUBDIVISION SEVEN OF THIS SECTION.
33 9. THE DEPARTMENT OF HEALTH SHALL PROVIDE ADMINISTRATIVE SUPPORT TO
34 THE COMMITTEE.
35 S 47. Notwithstanding any inconsistent provision of law, rule or regu-
36 lation to the contrary, for purposes of implementing the provisions of
37 the public health law and the social services law, references to titles
38 XIX and XXI of the federal social security act in the public health law
39 and the social services law shall be deemed to include and also to mean
40 any successor titles thereto under the federal social security act.
41 S 48. Notwithstanding any inconsistent provision of law, rule or regu-
42 lation, the effectiveness of the provisions of sections 2807 and 3614 of
43 the public health law, section 18 of chapter 2 of the laws of 1988, and
44 18 NYCRR 505.14(h), as they relate to time frames for notice, approval
45 or certification of rates of payment, are hereby suspended and without
46 force or effect for purposes of implementing the provisions of this act.
47 S 49. Severability clause. If any clause, sentence, paragraph, subdi-
48 vision, section or part of this act shall be adjudged by any court of
49 competent jurisdiction to be invalid, such judgment shall not affect,
50 impair or invalidate the remainder thereof, but shall be confined in its
51 operation to the clause, sentence, paragraph, subdivision, section or
52 part thereof directly involved in the controversy in which such judgment
53 shall have been rendered. It is hereby declared to be the intent of the
54 legislature that this act would have been enacted even if such invalid
55 provisions had not been included herein.
A. 6007 32
1 S 50. This act shall take effect immediately and shall be deemed to
2 have been in full force and effect on and after April 1, 2015, and
3 section thirty-eight of this act shall expire and be deemed repealed
4 March 31, 2018 provided that:
5 1. section thirteen of this act shall take effect June 1, 2015;
6 2. sections thirty-one and thirty-two of this act shall take effect
7 July 1, 2015;
8 3. the amendments made to section 2807-s of the public health law made
9 by sections twenty-three-a and twenty-three-b of this act shall not
10 affect the expiration of such section and shall be deemed to expire
11 therewith.
12 4. sections twenty-eight and forty-six of this act shall take effect
13 on the same date and in the same manner as section 51 of part C of chap-
14 ter 60 of the laws of 2014 takes effect;
15 5. section forty-five of this act shall take effect on the same date
16 and in the same manner as section 50 of part C of chapter 60 of the laws
17 of 2014 takes effect;
18 6. the amendments to section 364-j of the social services law made by
19 sections six-a, thirty-a, thirty-b, thirty-c and forty-c of this act
20 shall not affect the repeal of such section and shall be deemed to be
21 repealed therewith;
22 6-a. the amendments to subdivision eight of section forty-four hundred
23 three-f of the public health law made by section forty-a of this act
24 shall not affect the repeal of such section and shall be deemed repealed
25 therewith;
26 7. any rules or regulations necessary to implement the provisions of
27 this act may be promulgated and any procedures, forms, or instructions
28 necessary for such implementation may be adopted and issued on or after
29 the date this act shall have become a law;
30 8. this act shall not be construed to alter, change, affect, impair or
31 defeat any rights, obligations, duties or interests accrued, incurred or
32 conferred prior to the effective date of this act;
33 9. the commissioner of health and the superintendent of the department
34 of financial services and any appropriate council may take steps neces-
35 sary to implement this act prior to its effective date;
36 10. notwithstanding any inconsistent provision of the state adminis-
37 trative procedure act or any other provision of law, rule or regulation,
38 the commissioner of health and the superintendent of the department of
39 financial services and any appropriate council is authorized to adopt or
40 amend or promulgate on an emergency basis any regulation he or she or
41 such council determines necessary to implement any provision of this act
42 on its effective date; and
43 11. the provisions of this act shall become effective notwithstanding
44 the failure of the commissioner of health or the superintendent of the
45 department of financial services or any council to adopt or amend or
46 promulgate regulations implementing this act.
47 PART C
48 Section 1. Section 48-a of part A of chapter 56 of the laws of 2013
49 amending chapter 59 of the laws of 2011 amending the public health law
50 and other laws relating to general hospital reimbursement for annual
51 rates relating to the cap on local Medicaid expenditures, as amended by
52 section 13 of part C of chapter 60 of the laws of 2014, is amended to
53 read as follows:
A. 6007 33
1 S 48-a. 1. Notwithstanding any contrary provision of law, the commis-
2 sioners of the office of alcoholism and substance abuse services and the
3 office of mental health are authorized, subject to the approval of the
4 director of the budget, to transfer to the commissioner of health state
5 funds to be utilized as the state share for the purpose of increasing
6 payments under the medicaid program to managed care organizations
7 licensed under article 44 of the public health law or under article 43
8 of the insurance law. Such managed care organizations shall utilize such
9 funds for the purpose of reimbursing providers licensed pursuant to
10 article 28 of the public health law or article 31 or 32 of the mental
11 hygiene law for ambulatory behavioral health services, as determined by
12 the commissioner of health, in consultation with the commissioner of
13 alcoholism and substance abuse services and the commissioner of the
14 office of mental health, provided to medicaid eligible outpatients. Such
15 reimbursement shall be in the form of fees for such services which are
16 equivalent to the payments established for such services under the ambu-
17 latory patient group (APG) rate-setting methodology as utilized by the
18 department of health, the office of alcoholism and substance abuse
19 services, or the office of mental health for rate-setting purposes;
20 provided, however, that the increase to such fees that shall result from
21 the provisions of this section shall not, in the aggregate and as deter-
22 mined by the commissioner of health, in consultation with the commis-
23 sioner of alcoholism and substance abuse services and the commissioner
24 of the office of mental health, be greater than the increased funds made
25 available pursuant to this section. The increase of such ambulatory
26 behavioral health fees to providers available under this section shall
27 be for all rate periods on and after the effective date of [the] SECTION
28 13 OF PART C OF chapter 60 of the laws of 2014 [which amended this
29 section] through December 31, 2016 for patients in the city of New York,
30 for all rate periods on and after the effective date of [the] SECTION 13
31 OF PART C OF chapter 60 of the laws of 2014 [which amended this section]
32 through June 30, 2017 for patients outside the city of New York, and for
33 all rate periods on and after the effective date of such chapter [of the
34 laws of 2014 which amended this section] through December 31, 2017 for
35 all services provided to persons under the age of twenty-one; provided,
36 however, that managed care organizations and providers may negotiate
37 different rates and methods of payment during such periods described
38 above, subject to the approval of the department of health. The depart-
39 ment of health shall consult with the office of alcoholism and substance
40 abuse services and the office of mental health in determining whether
41 such alternative rates shall be approved. The commissioner of health
42 may, in consultation with the commissioner of alcoholism and substance
43 abuse services and the commissioner of the office of mental health,
44 promulgate regulations, including emergency regulations promulgated
45 prior to October 1, 2015 to establish rates for ambulatory behavioral
46 health services, as are necessary to implement the provisions of this
47 section. Rates promulgated under this section shall be included in the
48 report required under section 45-c of part A of this chapter.
49 2. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, THE FEES PAID BY
50 MANAGED CARE ORGANIZATIONS LICENSED UNDER ARTICLE 44 OF THE PUBLIC
51 HEALTH LAW OR UNDER ARTICLE 43 OF THE INSURANCE LAW, TO PROVIDERS
52 LICENSED PURSUANT TO ARTICLE 28 OF THE PUBLIC HEALTH LAW OR ARTICLE 31
53 OR 32 OF THE MENTAL HYGIENE LAW, FOR AMBULATORY BEHAVIORAL HEALTH
54 SERVICES PROVIDED TO PATIENTS ENROLLED IN THE CHILD HEALTH INSURANCE
55 PROGRAM PURSUANT TO TITLE ONE-A OF ARTICLE 25 OF THE PUBLIC HEALTH LAW,
56 SHALL BE IN THE FORM OF FEES FOR SUCH SERVICES WHICH ARE EQUIVALENT TO
A. 6007 34
1 THE PAYMENTS ESTABLISHED FOR SUCH SERVICES UNDER THE AMBULATORY PATIENT
2 GROUP (APG) RATE-SETTING METHODOLOGY. THE COMMISSIONER OF HEALTH SHALL
3 CONSULT WITH THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
4 AND THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH ESTABLISHING SUCH
5 FEES. SUCH AMBULATORY BEHAVIORAL HEALTH FEES TO PROVIDERS AVAILABLE
6 UNDER THIS SECTION SHALL BE FOR ALL RATE PERIODS ON AND AFTER THE EFFEC-
7 TIVE DATE OF THIS CHAPTER THROUGH DECEMBER 31, 2017, PROVIDED, HOWEVER,
8 THAT MANAGED CARE ORGANIZATIONS AND PROVIDERS MAY NEGOTIATE DIFFERENT
9 RATES AND METHODS OF PAYMENT DURING SUCH PERIODS DESCRIBED ABOVE,
10 SUBJECT TO THE APPROVAL OF THE DEPARTMENT OF HEALTH. THE DEPARTMENT OF
11 HEALTH SHALL CONSULT WITH THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE
12 SERVICES AND THE OFFICE OF MENTAL HEALTH IN DETERMINING WHETHER SUCH
13 ALTERNATIVE RATES SHALL BE APPROVED. THE REPORT REQUIRED UNDER SECTION
14 16-A OF PART C OF CHAPTER 60 OF THE LAWS OF 2014 SHALL ALSO INCLUDE THE
15 POPULATION OF PATIENTS ENROLLED IN THE CHILD HEALTH INSURANCE PROGRAM
16 PURSUANT TO TITLE ONE-A OF ARTICLE 25 OF THE PUBLIC HEALTH LAW IN ITS
17 EXAMINATION ON THE TRANSITION OF BEHAVIORAL HEALTH SERVICES INTO MANAGED
18 CARE.
19 S 2. Section 1 of part H of chapter 111 of the laws of 2010 relating
20 to increasing Medicaid payments to providers through managed care organ-
21 izations and providing equivalent fees through an ambulatory patient
22 group methodology, as amended by section 15 of part C of chapter 60 of
23 the laws of 2014, is amended to read as follows:
24 Section 1. A. Notwithstanding any contrary provision of law, the
25 commissioners of mental health and alcoholism and substance abuse
26 services are authorized, subject to the approval of the director of the
27 budget, to transfer to the commissioner of health state funds to be
28 utilized as the state share for the purpose of increasing payments under
29 the medicaid program to managed care organizations licensed under arti-
30 cle 44 of the public health law or under article 43 of the insurance
31 law. Such managed care organizations shall utilize such funds for the
32 purpose of reimbursing providers licensed pursuant to article 28 of the
33 public health law, or pursuant to article 31 or article 32 of the mental
34 hygiene law for ambulatory behavioral health services, as determined by
35 the commissioner of health in consultation with the commissioner of
36 mental health and commissioner of alcoholism and substance abuse
37 services, provided to medicaid eligible outpatients. Such reimbursement
38 shall be in the form of fees for such services which are equivalent to
39 the payments established for such services under the ambulatory patient
40 group (APG) rate-setting methodology as utilized by the department of
41 health or by the office of mental health or office of alcoholism and
42 substance abuse services for rate-setting purposes; provided, however,
43 that the increase to such fees that shall result from the provisions of
44 this section shall not, in the aggregate and as determined by the
45 commissioner of health in consultation with the commissioners of mental
46 health and alcoholism and substance abuse services, be greater than the
47 increased funds made available pursuant to this section. The increase of
48 such behavioral health fees to providers available under this section
49 shall be for all rate periods on and after the effective date of [the]
50 SECTION 15 OF PART C OF chapter 60 of the laws of 2014 [which amended
51 this section] through December 31, 2016 for patients in the city of New
52 York, for all rate periods on and after the effective date of [the]
53 SECTION 15 OF PART C OF chapter 60 of the laws of 2014 [which amended
54 this section] through June 30, 2017 for patients outside the city of New
55 York, and for all rate periods on and after the effective date of [the]
56 SECTION 15 OF PART C OF chapter 60 of the laws of 2014 [which amended
A. 6007 35
1 this section] through December 31, 2017 for all services provided to
2 persons under the age of twenty-one; provided, however, that managed
3 care organizations and providers may negotiate different rates and meth-
4 ods of payment during such periods described, subject to the approval of
5 the department of health. The department of health shall consult with
6 the office of alcoholism and substance abuse services and the office of
7 mental health in determining whether such alternative rates shall be
8 approved. The commissioner of health may, in consultation with the
9 commissioners of mental health and alcoholism and substance abuse
10 services, promulgate regulations, including emergency regulations
11 promulgated prior to October 1, 2013 that establish rates for behavioral
12 health services, as are necessary to implement the provisions of this
13 section. Rates promulgated under this section shall be included in the
14 report required under section 45-c of part A of chapter 56 of the laws
15 of 2013.
16 B. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, THE FEES PAID BY
17 MANAGED CARE ORGANIZATIONS LICENSED UNDER ARTICLE 44 OF THE PUBLIC
18 HEALTH LAW OR UNDER ARTICLE 43 OF THE INSURANCE LAW, TO PROVIDERS
19 LICENSED PURSUANT TO ARTICLE 28 OF THE PUBLIC HEALTH LAW OR ARTICLE 31
20 OR 32 OF THE MENTAL HYGIENE LAW, FOR AMBULATORY BEHAVIORAL HEALTH
21 SERVICES PROVIDED TO PATIENTS ENROLLED IN THE CHILD HEALTH INSURANCE
22 PROGRAM PURSUANT TO TITLE ONE-A OF ARTICLE 25 OF THE PUBLIC HEALTH LAW,
23 SHALL BE IN THE FORM OF FEES FOR SUCH SERVICES WHICH ARE EQUIVALENT TO
24 THE PAYMENTS ESTABLISHED FOR SUCH SERVICES UNDER THE AMBULATORY PATIENT
25 GROUP (APG) RATE-SETTING METHODOLOGY. THE COMMISSIONER OF HEALTH SHALL
26 CONSULT WITH THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
27 AND THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH ESTABLISHING SUCH
28 FEES. SUCH AMBULATORY BEHAVIORAL HEALTH FEES TO PROVIDERS AVAILABLE
29 UNDER THIS SECTION SHALL BE FOR ALL RATE PERIODS ON AND AFTER THE EFFEC-
30 TIVE DATE OF THIS CHAPTER THROUGH DECEMBER 31, 2017, PROVIDED, HOWEVER,
31 THAT MANAGED CARE ORGANIZATIONS AND PROVIDERS MAY NEGOTIATE DIFFERENT
32 RATES AND METHODS OF PAYMENT DURING SUCH PERIODS DESCRIBED ABOVE,
33 SUBJECT TO THE APPROVAL OF THE DEPARTMENT OF HEALTH. THE DEPARTMENT OF
34 HEALTH SHALL CONSULT WITH THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE
35 SERVICES AND THE OFFICE OF MENTAL HEALTH IN DETERMINING WHETHER SUCH
36 ALTERNATIVE RATES SHALL BE APPROVED. THE REPORT REQUIRED UNDER SECTION
37 16-A OF PART C OF CHAPTER 60 OF THE LAWS OF 2014 SHALL ALSO INCLUDE THE
38 POPULATION OF PATIENTS ENROLLED IN THE CHILD HEALTH INSURANCE PROGRAM
39 PURSUANT TO TITLE ONE-A OF ARTICLE 25 OF THE PUBLIC HEALTH LAW IN ITS
40 EXAMINATION ON THE TRANSITION OF BEHAVIORAL HEALTH SERVICES INTO MANAGED
41 CARE.
42 S 3. Notwithstanding any inconsistent provision of law, rule or regu-
43 lation, for purposes of implementing the provisions of the public health
44 law and the social services law, references to titles XIX and XXI of the
45 federal social security act in the public health law and the social
46 services law shall be deemed to include and also to mean any successor
47 titles thereto under the federal social security act.
48 S 4. Notwithstanding any inconsistent provision of law, rule or regu-
49 lation, the effectiveness of the provisions of sections 2807 and 3614 of
50 the public health law, section 18 of chapter 2 of the laws of 1988, and
51 18 NYCRR 505.14(h), as they relate to time frames for notice, approval
52 or certification of rates of payment, are hereby suspended and without
53 force or effect for purposes of implementing the provisions of this act.
54 S 5. Severability clause. If any clause, sentence, paragraph, subdivi-
55 sion, section or part of this act shall be adjudged by any court of
56 competent jurisdiction to be invalid, such judgment shall not affect,
A. 6007 36
1 impair or invalidate the remainder thereof, but shall be confined in its
2 operation to the clause, sentence, paragraph, subdivision, section or
3 part thereof directly involved in the controversy in which such judgment
4 shall have been rendered. It is hereby declared to be the intent of the
5 legislature that this act would have been enacted even if such invalid
6 provisions had not been included herein.
7 S 6. This act shall take effect immediately and shall be deemed to
8 have been in full force and effect on and after April 1, 2015. Provided,
9 however that:
10 1. any rules or regulations necessary to implement the provisions of
11 this act may be promulgated and any procedures, forms, or instructions
12 necessary for such implementation may be adopted and issued on or after
13 the date this act shall have become a law;
14 2. this act shall not be construed to alter, change, affect, impair or
15 defeat any rights, obligations, duties or interests accrued, incurred or
16 conferred prior to the effective date of this act;
17 3. the commissioner of health and the superintendent of the department
18 of financial services and any appropriate council may take any steps
19 necessary to implement this act prior to its effective date;
20 4. notwithstanding any inconsistent provision of the state administra-
21 tive procedure act or any other provision of law, rule or regulation,
22 the commissioner of health and the superintendent of the department of
23 financial services and any appropriate council is authorized to adopt or
24 amend or promulgate on an emergency basis any regulation he or she or
25 such council determines necessary to implement any provision of this act
26 on its effective date;
27 5. the provisions of this act shall become effective notwithstanding
28 the failure of the commissioner of health or the superintendent of the
29 department of financial services or any council to adopt or amend or
30 promulgate regulations implementing this act; and
31 6. the amendments to section 48-a of part A of chapter 56 of the laws
32 of 2013 made by section one of this act shall not affect the repeal of
33 such section and shall be deemed repealed therewith and the amendments
34 to section 1 of part H of chapter 111 of the laws of 2010 made by
35 section two of this act shall not affect the expiration of such section
36 and shall be deemed to expire therewith.
37 PART D
38 Section 1. Section 11 of chapter 884 of the laws of 1990, amending the
39 public health law relating to authorizing bad debt and charity care
40 allowances for certified home health agencies, as amended by section 3
41 of part B of chapter 56 of the laws of 2013, is amended to read as
42 follows:
43 S 11. This act shall take effect immediately and:
44 (a) sections one and three shall expire on December 31, 1996,
45 (b) [sections four through ten shall expire on June 30, 2015, and
46 (c)] provided that the amendment to section 2807-b of the public
47 health law by section two of this act shall not affect the expiration of
48 such section 2807-b as otherwise provided by law and shall be deemed to
49 expire therewith.
50 S 2. Subdivision 2 of section 246 of chapter 81 of the laws of 1995,
51 amending the public health law and other laws relating to medical
52 reimbursement and welfare reform, as amended by section 4 of part B of
53 chapter 56 of the laws of 2013, is amended to read as follows:
A. 6007 37
1 2. Sections five, seven through nine, twelve through fourteen, and
2 eighteen of this act shall be deemed to have been in full force and
3 effect on and after April 1, 1995 through March 31, 1999 and on and
4 after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
5 through March 31, 2003 and on and after April 1, 2003 through March 31,
6 2006 and on and after April 1, 2006 through March 31, 2007 and on and
7 after April 1, 2007 through March 31, 2009 and on and after April 1,
8 2009 through March 31, 2011 and sections twelve, thirteen and fourteen
9 of this act shall be deemed to be in full force and effect on and after
10 April 1, 2011 through March 31, [2015] 2017;
11 S 3. Subparagraph (vi) of paragraph (b) of subdivision 2 of section
12 2807-d of the public health law, as amended by section 5 of part B of
13 chapter 56 of the laws of 2013, is amended to read as follows:
14 (vi) Notwithstanding any contrary provision of this paragraph or any
15 other provision of law or regulation to the contrary, for residential
16 health care facilities the assessment shall be six percent of each resi-
17 dential health care facility's gross receipts received from all patient
18 care services and other operating income on a cash basis for the period
19 April first, two thousand two through March thirty-first, two thousand
20 three for hospital or health-related services, including adult day
21 services; provided, however, that residential health care facilities'
22 gross receipts attributable to payments received pursuant to title XVIII
23 of the federal social security act (medicare) shall be excluded from the
24 assessment; provided, however, that for all such gross receipts received
25 on or after April first, two thousand three through March thirty-first,
26 two thousand five, such assessment shall be five percent, and further
27 provided that for all such gross receipts received on or after April
28 first, two thousand five through March thirty-first, two thousand nine,
29 and on or after April first, two thousand nine through March thirty-
30 first, two thousand eleven such assessment shall be six percent, and
31 further provided that for all such gross receipts received on or after
32 April first, two thousand eleven through March thirty-first, two thou-
33 sand thirteen such assessment shall be six percent, and further provided
34 that for all such gross receipts received on or after April first, two
35 thousand thirteen through March thirty-first, two thousand fifteen such
36 assessment shall be six percent, AND FURTHER PROVIDED THAT FOR ALL SUCH
37 GROSS RECEIPTS RECEIVED ON OR AFTER APRIL FIRST, TWO THOUSAND FIFTEEN
38 THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN SUCH ASSESSMENT SHALL
39 BE SIX PERCENT.
40 S 4. Section 88 of chapter 659 of the laws of 1997, constituting the
41 long term care integration and finance act of 1997, as amended by
42 section 6 of part B of chapter 56 of the laws of 2013, is amended to
43 read as follows:
44 S 88. Notwithstanding any provision of law to the contrary, all oper-
45 ating demonstrations, as such term is defined in paragraph (c) of subdi-
46 vision 1 of section 4403-f of the public health law as added by section
47 eighty-two of this act, due to expire prior to January 1, 2001 shall be
48 deemed to [expire on December 31, 2015] REMAIN IN FULL FORCE AND EFFECT
49 SUBSEQUENT TO SUCH DATE.
50 S 5. Subdivision 1 of section 194 of chapter 474 of the laws of 1996,
51 amending the education law and other laws relating to rates for residen-
52 tial health care facilities, as amended by section 9 of part B of chap-
53 ter 56 of the laws of 2013, is amended to read as follows:
54 1. Notwithstanding any inconsistent provision of law or regulation,
55 the trend factors used to project reimbursable operating costs to the
56 rate period for purposes of determining rates of payment pursuant to
A. 6007 38
1 article 28 of the public health law for residential health care facili-
2 ties for reimbursement of inpatient services provided to patients eligi-
3 ble for payments made by state governmental agencies on and after April
4 1, 1996 through March 31, 1999 and for payments made on and after July
5 1, 1999 through March 31, 2000 and on and after April 1, 2000 through
6 March 31, 2003 and on and after April 1, 2003 through March 31, 2007 and
7 on and after April 1, 2007 through March 31, 2009 and on and after April
8 1, 2009 through March 31, 2011 and on and after April 1, 2011 through
9 March 31, 2013 and on and after April 1, 2013 through March 31, 2015 ,
10 AND ON AND AFTER APRIL 1, 2015 THROUGH MARCH 31, 2017 shall reflect no
11 trend factor projections or adjustments for the period April 1, 1996,
12 through March 31, 1997.
13 S 6. Subdivision 1 of section 89-a of part C of chapter 58 of the laws
14 of 2007, amending the social services law and other laws relating to
15 enacting the major components of legislation necessary to implement the
16 health and mental hygiene budget for the 2007-2008 state fiscal year, as
17 amended by section 10 of part B of chapter 56 of the laws of 2013, is
18 amended to read as follows:
19 1. Notwithstanding paragraph (c) of subdivision 10 of section 2807-c
20 of the public health law and section 21 of chapter 1 of the laws of
21 1999, as amended, and any other inconsistent provision of law or regu-
22 lation to the contrary, in determining rates of payments by state
23 governmental agencies effective for services provided beginning April 1,
24 2006, through March 31, 2009, and on and after April 1, 2009 through
25 March 31, 2011, and on and after April 1, 2011 through March 31, 2013,
26 and on and after April 1, 2013 through March 31, 2015, AND ON AND AFTER
27 APRIL 1, 2015 THROUGH MARCH 31, 2017 for inpatient and outpatient
28 services provided by general hospitals and for inpatient services and
29 outpatient adult day health care services provided by residential health
30 care facilities pursuant to article 28 of the public health law, the
31 commissioner of health shall apply a trend factor projection of two and
32 twenty-five hundredths percent attributable to the period January 1,
33 2006 through December 31, 2006, and on and after January 1, 2007,
34 provided, however, that on reconciliation of such trend factor for the
35 period January 1, 2006 through December 31, 2006 pursuant to paragraph
36 (c) of subdivision 10 of section 2807-c of the public health law, such
37 trend factor shall be the final US Consumer Price Index (CPI) for all
38 urban consumers, as published by the US Department of Labor, Bureau of
39 Labor Statistics less twenty-five hundredths of a percentage point.
40 S 7. Paragraph (f) of subdivision 1 of section 64 of chapter 81 of the
41 laws of 1995, amending the public health law and other laws relating to
42 medical reimbursement and welfare reform, as amended by section 11 of
43 part B of chapter 56 of the laws of 2013, is amended to read as follows:
44 (f) Prior to February 1, 2001, February 1, 2002, February 1, 2003,
45 February 1, 2004, February 1, 2005, February 1, 2006, February 1, 2007,
46 February 1, 2008, February 1, 2009, February 1, 2010, February 1, 2011,
47 February 1, 2012, February 1, 2013 [and], February 1, 2014 [and], Febru-
48 ary 1, 2015 , FEBRUARY 1, 2016 AND FEBRUARY 1, 2017 the commissioner of
49 health shall calculate the result of the statewide total of residential
50 health care facility days of care provided to beneficiaries of title
51 XVIII of the federal social security act (medicare), divided by the sum
52 of such days of care plus days of care provided to residents eligible
53 for payments pursuant to title 11 of article 5 of the social services
54 law minus the number of days provided to residents receiving hospice
55 care, expressed as a percentage, for the period commencing January 1,
56 through November 30, of the prior year respectively, based on such data
A. 6007 39
1 for such period. This value shall be called the 2000, 2001, 2002, 2003,
2 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and],
3 2015, 2016 AND 2017 statewide target percentage respectively.
4 S 8. Subparagraph (ii) of paragraph (b) of subdivision 3 of section 64
5 of chapter 81 of the laws of 1995, amending the public health law and
6 other laws relating to medical reimbursement and welfare reform, as
7 amended by section 12 of part B of chapter 56 of the laws of 2013, is
8 amended to read as follows:
9 (ii) If the 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
10 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND
11 2017 statewide target percentages are not for each year at least three
12 percentage points higher than the statewide base percentage, the commis-
13 sioner of health shall determine the percentage by which the statewide
14 target percentage for each year is not at least three percentage points
15 higher than the statewide base percentage. The percentage calculated
16 pursuant to this paragraph shall be called the 1997, 1998, 2000, 2001,
17 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013,
18 2014 [and], 2015, 2016 AND 2017 statewide reduction percentage respec-
19 tively. If the 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
20 2007, 2008, 2009, 2010, 2011, 2012, 2013[;], 2014 [and], 2015, 2016 AND
21 2017 statewide target percentage for the respective year is at least
22 three percentage points higher than the statewide base percentage, the
23 statewide reduction percentage for the respective year shall be zero.
24 S 9. Subparagraph (iii) of paragraph (b) of subdivision 4 of section
25 64 of chapter 81 of the laws of 1995, amending the public health law and
26 other laws relating to medical reimbursement and welfare reform, as
27 amended by section 13 of part B of chapter 56 of the laws of 2013, is
28 amended to read as follows:
29 (iii) The 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008,
30 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 statewide
31 reduction percentage shall be multiplied by one hundred two million
32 dollars respectively to determine the 1998, 2000, 2001, 2002, 2003,
33 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and],
34 2015, 2016 AND 2017 statewide aggregate reduction amount. If the 1998
35 and the 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009,
36 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 statewide
37 reduction percentage shall be zero respectively, there shall be no 1998,
38 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011,
39 2012, 2013, 2014 [and], 2015, 2016 AND 2017 reduction amount.
40 S 10. Section 228 of chapter 474 of the laws of 1996, amending the
41 education law and other laws relating to rates for residential health
42 care facilities, as amended by section 14-a of part B of chapter 56 of
43 the laws of 2013, is amended to read as follows:
44 S 228. 1. Definitions. (a) Regions, for purposes of this section,
45 shall mean a downstate region to consist of Kings, New York, Richmond,
46 Queens, Bronx, Nassau and Suffolk counties and an upstate region to
47 consist of all other New York state counties. A certified home health
48 agency or long term home health care program shall be located in the
49 same county utilized by the commissioner of health for the establishment
50 of rates pursuant to article 36 of the public health law.
51 (b) Certified home health agency (CHHA) shall mean such term as
52 defined in section 3602 of the public health law.
53 (c) Long term home health care program (LTHHCP) shall mean such term
54 as defined in subdivision 8 of section 3602 of the public health law.
55 (d) Regional group shall mean all those CHHAs and LTHHCPs, respective-
56 ly, located within a region.
A. 6007 40
1 (e) Medicaid revenue percentage, for purposes of this section, shall
2 mean CHHA and LTHHCP revenues attributable to services provided to
3 persons eligible for payments pursuant to title 11 of article 5 of the
4 social services law divided by such revenues plus CHHA and LTHHCP reven-
5 ues attributable to services provided to beneficiaries of Title XVIII of
6 the federal social security act (medicare).
7 (f) Base period, for purposes of this section, shall mean calendar
8 year 1995.
9 (g) Target period. For purposes of this section, the 1996 target peri-
10 od shall mean August 1, 1996 through March 31, 1997, the 1997 target
11 period shall mean January 1, 1997 through November 30, 1997, the 1998
12 target period shall mean January 1, 1998 through November 30, 1998, the
13 1999 target period shall mean January 1, 1999 through November 30, 1999,
14 the 2000 target period shall mean January 1, 2000 through November 30,
15 2000, the 2001 target period shall mean January 1, 2001 through November
16 30, 2001, the 2002 target period shall mean January 1, 2002 through
17 November 30, 2002, the 2003 target period shall mean January 1, 2003
18 through November 30, 2003, the 2004 target period shall mean January 1,
19 2004 through November 30, 2004, and the 2005 target period shall mean
20 January 1, 2005 through November 30, 2005, the 2006 target period shall
21 mean January 1, 2006 through November 30, 2006, and the 2007 target
22 period shall mean January 1, 2007 through November 30, 2007 and the 2008
23 target period shall mean January 1, 2008 through November 30, 2008, and
24 the 2009 target period shall mean January 1, 2009 through November 30,
25 2009 and the 2010 target period shall mean January 1, 2010 through
26 November 30, 2010 and the 2011 target period shall mean January 1, 2011
27 through November 30, 2011 and the 2012 target period shall mean January
28 1, 2012 through November 30, 2012 and the 2013 target period shall mean
29 January 1, 2013 through November 30, 2013, and the 2014 target period
30 shall mean January 1, 2014 through November 30, 2014 and the 2015 target
31 period shall mean January 1, 2015 through November 30, 2015 AND THE 2016
32 TARGET PERIOD SHALL MEAN JANUARY 1, 2016 THROUGH NOVEMBER 30, 2016, AND
33 THE 2017 TARGET PERIOD SHALL MEAN JANUARY 1, 2017 THROUGH NOVEMBER 30,
34 2017.
35 2. (a) Prior to February 1, 1997, for each regional group the commis-
36 sioner of health shall calculate the 1996 medicaid revenue percentages
37 for the period commencing August 1, 1996 to the last date for which such
38 data is available and reasonably accurate.
39 (b) Prior to February 1, 1998, prior to February 1, 1999, prior to
40 February 1, 2000, prior to February 1, 2001, prior to February 1, 2002,
41 prior to February 1, 2003, prior to February 1, 2004, prior to February
42 1, 2005, prior to February 1, 2006, prior to February 1, 2007, prior to
43 February 1, 2008, prior to February 1, 2009, prior to February 1, 2010,
44 prior to February 1, 2011, prior to February 1, 2012, prior to February
45 1, 2013, prior to February 1, 2014, [and] prior to February 1, 2015,
46 PRIOR TO FEBRUARY 1, 2016 AND PRIOR TO FEBRUARY 1, 2017 for each
47 regional group the commissioner of health shall calculate the prior
48 year's medicaid revenue percentages for the period commencing January 1
49 through November 30 of such prior year.
50 3. By September 15, 1996, for each regional group the commissioner of
51 health shall calculate the base period medicaid revenue percentage.
52 4. (a) For each regional group, the 1996 target medicaid revenue
53 percentage shall be calculated by subtracting the 1996 medicaid revenue
54 reduction percentages from the base period medicaid revenue percentages.
55 The 1996 medicaid revenue reduction percentage, taking into account
A. 6007 41
1 regional and program differences in utilization of medicaid and medicare
2 services, for the following regional groups shall be equal to:
3 (i) one and one-tenth percentage points for CHHAs located within the
4 downstate region;
5 (ii) six-tenths of one percentage point for CHHAs located within the
6 upstate region;
7 (iii) one and eight-tenths percentage points for LTHHCPs located with-
8 in the downstate region; and
9 (iv) one and seven-tenths percentage points for LTHHCPs located within
10 the upstate region.
11 (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,
12 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 for
13 each regional group, the target medicaid revenue percentage for the
14 respective year shall be calculated by subtracting the respective year's
15 medicaid revenue reduction percentage from the base period medicaid
16 revenue percentage. The medicaid revenue reduction percentages for 1997,
17 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010,
18 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 taking into account
19 regional and program differences in utilization of medicaid and medicare
20 services, for the following regional groups shall be equal to for each
21 such year:
22 (i) one and one-tenth percentage points for CHHAs located within the
23 downstate region;
24 (ii) six-tenths of one percentage point for CHHAs located within the
25 upstate region;
26 (iii) one and eight-tenths percentage points for LTHHCPs located with-
27 in the downstate region; and
28 (iv) one and seven-tenths percentage points for LTHHCPs located within
29 the upstate region.
30 (c) For each regional group, the 1999 target medicaid revenue percent-
31 age shall be calculated by subtracting the 1999 medicaid revenue
32 reduction percentage from the base period medicaid revenue percentage.
33 The 1999 medicaid revenue reduction percentages, taking into account
34 regional and program differences in utilization of medicaid and medicare
35 services, for the following regional groups shall be equal to:
36 (i) eight hundred twenty-five thousandths (.825) of one percentage
37 point for CHHAs located within the downstate region;
38 (ii) forty-five hundredths (.45) of one percentage point for CHHAs
39 located within the upstate region;
40 (iii) one and thirty-five hundredths percentage points (1.35) for
41 LTHHCPs located within the downstate region; and
42 (iv) one and two hundred seventy-five thousandths percentage points
43 (1.275) for LTHHCPs located within the upstate region.
44 5. (a) For each regional group, if the 1996 medicaid revenue percent-
45 age is not equal to or less than the 1996 target medicaid revenue
46 percentage, the commissioner of health shall compare the 1996 medicaid
47 revenue percentage to the 1996 target medicaid revenue percentage to
48 determine the amount of the shortfall which, when divided by the 1996
49 medicaid revenue reduction percentage, shall be called the 1996
50 reduction factor. These amounts, expressed as a percentage, shall not
51 exceed one hundred percent. If the 1996 medicaid revenue percentage is
52 equal to or less than the 1996 target medicaid revenue percentage, the
53 1996 reduction factor shall be zero.
54 (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
55 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND
56 2017 for each regional group, if the medicaid revenue percentage for the
A. 6007 42
1 respective year is not equal to or less than the target medicaid revenue
2 percentage for such respective year, the commissioner of health shall
3 compare such respective year's medicaid revenue percentage to such
4 respective year's target medicaid revenue percentage to determine the
5 amount of the shortfall which, when divided by the respective year's
6 medicaid revenue reduction percentage, shall be called the reduction
7 factor for such respective year. These amounts, expressed as a percent-
8 age, shall not exceed one hundred percent. If the medicaid revenue
9 percentage for a particular year is equal to or less than the target
10 medicaid revenue percentage for that year, the reduction factor for that
11 year shall be zero.
12 6. (a) For each regional group, the 1996 reduction factor shall be
13 multiplied by the following amounts to determine each regional group's
14 applicable 1996 state share reduction amount:
15 (i) two million three hundred ninety thousand dollars ($2,390,000) for
16 CHHAs located within the downstate region;
17 (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
18 within the upstate region;
19 (iii) one million two hundred seventy thousand dollars ($1,270,000)
20 for LTHHCPs located within the downstate region; and
21 (iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
22 located within the upstate region.
23 For each regional group reduction, if the 1996 reduction factor shall
24 be zero, there shall be no 1996 state share reduction amount.
25 (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,
26 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 for
27 each regional group, the reduction factor for the respective year shall
28 be multiplied by the following amounts to determine each regional
29 group's applicable state share reduction amount for such respective
30 year:
31 (i) two million three hundred ninety thousand dollars ($2,390,000) for
32 CHHAs located within the downstate region;
33 (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
34 within the upstate region;
35 (iii) one million two hundred seventy thousand dollars ($1,270,000)
36 for LTHHCPs located within the downstate region; and
37 (iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
38 located within the upstate region.
39 For each regional group reduction, if the reduction factor for a
40 particular year shall be zero, there shall be no state share reduction
41 amount for such year.
42 (c) For each regional group, the 1999 reduction factor shall be multi-
43 plied by the following amounts to determine each regional group's appli-
44 cable 1999 state share reduction amount:
45 (i) one million seven hundred ninety-two thousand five hundred dollars
46 ($1,792,500) for CHHAs located within the downstate region;
47 (ii) five hundred sixty-two thousand five hundred dollars ($562,500)
48 for CHHAs located within the upstate region;
49 (iii) nine hundred fifty-two thousand five hundred dollars ($952,500)
50 for LTHHCPs located within the downstate region; and
51 (iv) four hundred forty-two thousand five hundred dollars ($442,500)
52 for LTHHCPs located within the upstate region.
53 For each regional group reduction, if the 1999 reduction factor shall
54 be zero, there shall be no 1999 state share reduction amount.
55 7. (a) For each regional group, the 1996 state share reduction amount
56 shall be allocated by the commissioner of health among CHHAs and LTHHCPs
A. 6007 43
1 on the basis of the extent of each CHHA's and LTHHCP's failure to
2 achieve the 1996 target medicaid revenue percentage, calculated on a
3 provider specific basis utilizing revenues for this purpose, expressed
4 as a proportion of the total of each CHHA's and LTHHCP's failure to
5 achieve the 1996 target medicaid revenue percentage within the applica-
6 ble regional group. This proportion shall be multiplied by the applica-
7 ble 1996 state share reduction amount calculation pursuant to paragraph
8 (a) of subdivision 6 of this section. This amount shall be called the
9 1996 provider specific state share reduction amount.
10 (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
11 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND
12 2017 for each regional group, the state share reduction amount for the
13 respective year shall be allocated by the commissioner of health among
14 CHHAs and LTHHCPs on the basis of the extent of each CHHA's and LTHHCP's
15 failure to achieve the target medicaid revenue percentage for the appli-
16 cable year, calculated on a provider specific basis utilizing revenues
17 for this purpose, expressed as a proportion of the total of each CHHA's
18 and LTHHCP's failure to achieve the target medicaid revenue percentage
19 for the applicable year within the applicable regional group. This
20 proportion shall be multiplied by the applicable year's state share
21 reduction amount calculation pursuant to paragraph (b) or (c) of subdi-
22 vision 6 of this section. This amount shall be called the provider
23 specific state share reduction amount for the applicable year.
24 8. (a) The 1996 provider specific state share reduction amount shall
25 be due to the state from each CHHA and LTHHCP and may be recouped by the
26 state by March 31, 1997 in a lump sum amount or amounts from payments
27 due to the CHHA and LTHHCP pursuant to title 11 of article 5 of the
28 social services law.
29 (b) The provider specific state share reduction amount for 1997, 1998,
30 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010,
31 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 respectively, shall be
32 due to the state from each CHHA and LTHHCP and each year the amount due
33 for such year may be recouped by the state by March 31 of the following
34 year in a lump sum amount or amounts from payments due to the CHHA and
35 LTHHCP pursuant to title 11 of article 5 of the social services law.
36 9. CHHAs and LTHHCPs shall submit such data and information at such
37 times as the commissioner of health may require for purposes of this
38 section. The commissioner of health may use data available from third-
39 party payors.
40 10. On or about June 1, 1997, for each regional group the commissioner
41 of health shall calculate for the period August 1, 1996 through March
42 31, 1997 a medicaid revenue percentage, a reduction factor, a state
43 share reduction amount, and a provider specific state share reduction
44 amount in accordance with the methodology provided in paragraph (a) of
45 subdivision 2, paragraph (a) of subdivision 5, paragraph (a) of subdivi-
46 sion 6 and paragraph (a) of subdivision 7 of this section. The provider
47 specific state share reduction amount calculated in accordance with this
48 subdivision shall be compared to the 1996 provider specific state share
49 reduction amount calculated in accordance with paragraph (a) of subdivi-
50 sion 7 of this section. Any amount in excess of the amount determined in
51 accordance with paragraph (a) of subdivision 7 of this section shall be
52 due to the state from each CHHA and LTHHCP and may be recouped in
53 accordance with paragraph (a) of subdivision 8 of this section. If the
54 amount is less than the amount determined in accordance with paragraph
55 (a) of subdivision 7 of this section, the difference shall be refunded
56 to the CHHA and LTHHCP by the state no later than July 15, 1997. CHHAs
A. 6007 44
1 and LTHHCPs shall submit data for the period August 1, 1996 through
2 March 31, 1997 to the commissioner of health by April 15, 1997.
3 11. If a CHHA or LTHHCP fails to submit data and information as
4 required for purposes of this section:
5 (a) such CHHA or LTHHCP shall be presumed to have no decrease in medi-
6 caid revenue percentage between the applicable base period and the
7 applicable target period for purposes of the calculations pursuant to
8 this section; and
9 (b) the commissioner of health shall reduce the current rate paid to
10 such CHHA and such LTHHCP by state governmental agencies pursuant to
11 article 36 of the public health law by one percent for a period begin-
12 ning on the first day of the calendar month following the applicable due
13 date as established by the commissioner of health and continuing until
14 the last day of the calendar month in which the required data and infor-
15 mation are submitted.
16 12. The commissioner of health shall inform in writing the director of
17 the budget and the chair of the senate finance committee and the chair
18 of the assembly ways and means committee of the results of the calcu-
19 lations pursuant to this section.
20 S 11. Subdivision 5-a of section 246 of chapter 81 of the laws of
21 1995, amending the public health law and other laws relating to medical
22 reimbursement and welfare reform, as amended by section 15 of part B of
23 chapter 56 of the laws of 2013, is amended to read as follows:
24 5-a. Section sixty-four-a of this act shall be deemed to have been in
25 full force and effect on and after April 1, 1995 through March 31, 1999
26 and on and after July 1, 1999 through March 31, 2000 and on and after
27 April 1, 2000 through March 31, 2003 and on and after April 1, 2003
28 through March 31, 2007, and on and after April 1, 2007 through March 31,
29 2009, and on and after April 1, 2009 through March 31, 2011, and on and
30 after April 1, 2011 through March 31, 2013, and on and after April 1,
31 2013 through March 31, 2015, AND ON AND AFTER APRIL 1, 2015 THROUGH
32 MARCH 31, 2017;
33 S 12. Section 64-b of chapter 81 of the laws of 1995, amending the
34 public health law and other laws relating to medical reimbursement and
35 welfare reform, as amended by section 16 of part B of chapter 56 of the
36 laws of 2013, is amended to read as follows:
37 S 64-b. Notwithstanding any inconsistent provision of law, the
38 provisions of subdivision 7 of section 3614 of the public health law, as
39 amended, shall remain and be in full force and effect on April 1, 1995
40 through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
41 and after April 1, 2000 through March 31, 2003 and on and after April 1,
42 2003 through March 31, 2007, and on and after April 1, 2007 through
43 March 31, 2009, and on and after April 1, 2009 through March 31, 2011,
44 and on and after April 1, 2011 through March 31, 2013, and on and after
45 April 1, 2013 through March 31, 2015, AND ON AND AFTER APRIL 1, 2015
46 THROUGH MARCH 31, 2017.
47 S 13. Subdivision 1 of section 20 of chapter 451 of the laws of 2007,
48 amending the public health law, the social services law and the insur-
49 ance law, relating to providing enhanced consumer and provider
50 protections, as amended by section 17 of part B of chapter 56 of the
51 laws of 2013, is amended to read as follows:
52 1. sections four, eleven and thirteen of this act shall take effect
53 immediately [and shall expire and be deemed repealed June 30, 2015];
54 S 14. The opening paragraph of subdivision 7-a of section 3614 of the
55 public health law, as amended by section 18 of part B of chapter 56 of
56 the laws of 2013, is amended to read as follows:
A. 6007 45
1 Notwithstanding any inconsistent provision of law or regulation, for
2 the purposes of establishing rates of payment by governmental agencies
3 for long term home health care programs for the period April first, two
4 thousand five, through December thirty-first, two thousand five, and for
5 the period January first, two thousand six through March thirty-first,
6 two thousand seven, and on and after April first, two thousand seven
7 through March thirty-first, two thousand nine, and on and after April
8 first, two thousand nine through March thirty-first, two thousand elev-
9 en, and on and after April first, two thousand eleven through March
10 thirty-first, two thousand thirteen and on and after April first, two
11 thousand thirteen through March thirty-first, two thousand fifteen, AND
12 ON AND AFTER APRIL 1, 2015 THROUGH MARCH 31, 2017 the reimbursable base
13 year administrative and general costs of a provider of services shall
14 not exceed the statewide average of total reimbursable base year admin-
15 istrative and general costs of such providers of services.
16 S 15. Subdivision 12 of section 246 of chapter 81 of the laws of 1995,
17 amending the public health law and other laws relating to medical
18 reimbursement and welfare reform, as amended by section 21 of part B of
19 chapter 56 of the laws of 2013, is amended to read as follows:
20 12. Sections one hundred five-b through one hundred five-f of this act
21 shall expire March 31, [2015] 2017.
22 S 16. Section 3 of chapter 303 of the laws of 1999, amending the New
23 York state medical care facilities finance agency act relating to
24 financing health facilities, as amended by section 30 of part A of chap-
25 ter 59 of the laws of 2011, is amended to read as follows:
26 S 3. This act shall take effect immediately[, provided, however, that
27 subdivision 15-a of section 5 of section 1 of chapter 392 of the laws of
28 1973, as added by section one of this act, shall expire and be deemed
29 repealed June 30, 2015; and provided further, however, that the expira-
30 tion and repeal of such subdivision 15-a shall not affect or impair in
31 any manner any health facilities bonds issued, or any lease or purchase
32 of a health facility executed, pursuant to such subdivision 15-a prior
33 to its expiration and repeal and that, with respect to any such bonds
34 issued and outstanding as of June 30, 2015, the provisions of such
35 subdivision 15-a as they existed immediately prior to such expiration
36 and repeal shall continue to apply through the latest maturity date of
37 any such bonds, or their earlier retirement or redemption, for the sole
38 purpose of authorizing the issuance of refunding bonds to refund bonds
39 previously issued pursuant thereto].
40 S 17. Subdivision (c) of section 62 of chapter 165 of the laws of
41 1991, amending the public health law and other laws relating to estab-
42 lishing payments for medical assistance, as amended by section 26 of
43 part D of chapter 59 of the laws of 2011, is amended to read as follows:
44 (c) section 364-j of the social services law, as amended by section
45 eight of this act and subdivision 6 of section 367-a of the social
46 services law as added by section twelve of this act shall expire and be
47 deemed repealed on March 31, [2015] 2017 and provided further, that the
48 amendments to the provisions of section 364-j of the social services law
49 made by section eight of this act shall only apply to managed care
50 programs approved on or after the effective date of this act;
51 S 18. Subdivision 3 of section 1680-j of the public authorities law,
52 as amended by section 9 of part C of chapter 59 of the laws of 2011, is
53 amended to read as follows:
54 3. Notwithstanding any law to the contrary, and in accordance with
55 section four of the state finance law, the comptroller is hereby author-
56 ized and directed to transfer from the health care reform act (HCRA)
A. 6007 46
1 resources fund (061) to the general fund, upon the request of the direc-
2 tor of the budget, up to $6,500,000 on or before March 31, 2006, and the
3 comptroller is further hereby authorized and directed to transfer from
4 the healthcare reform act (HCRA); Resources fund (061) to the Capital
5 Projects Fund, upon the request of the director of budget, up to
6 $139,000,000 for the period April 1, 2006 through March 31, 2007, up to
7 $171,100,000 for the period April 1, 2007 through March 31, 2008, up to
8 $208,100,000 for the period April 1, 2008 through March 31, 2009, up to
9 $151,600,000 for the period April 1, 2009 through March 31, 2010, up to
10 $215,743,000 for the period April 1, 2010 through March 31, 2011, up to
11 $433,366,000 for the period April 1, 2011 through March 31, 2012, up to
12 $150,806,000 for the period April 1, 2012 through March 31, 2013, up to
13 $78,071,000 for the period April 1, 2013 through March 31, 2014, and up
14 to $86,005,000 for the period April 1, 2014 through March 31, 2015, AND
15 UP TO $86,005,000 FOR THE PERIOD APRIL 1, 2015 THROUGH DECEMBER 31,
16 2017.
17 S 19. Subdivision (i) of section 111 of part H of chapter 59 of the
18 laws of 2011, relating to enacting into law major components of legis-
19 lation necessary to implement the health and mental hygiene budget for
20 the 2011-2012 state fiscal plan, is amended to read as follows:
21 (i) the amendments to paragraph (b) and subparagraph (i) of paragraph
22 (g) of subdivision 7 of section 4403-f of the public health law made by
23 section forty-one-b of this act shall expire and be repealed April 1,
24 [2015] 2020;
25 S 20. Section 97 of chapter 659 of the laws of 1997, amending the
26 public health law and other laws relating to creation of continuing care
27 retirement communities, as amended by section 65-b of part A of chapter
28 57 of the laws of 2006, is amended to read as follows:
29 S 97. This act shall take effect immediately, provided, however, that
30 the amendments to subdivision 4 of section 854 of the general municipal
31 law made by section seventy of this act shall not affect the expiration
32 of such subdivision and shall be deemed to expire therewith and provided
33 further that sections sixty-seven and sixty-eight of this act shall
34 apply to taxable years beginning on or after January 1, 1998 and
35 provided further that sections eighty-one through eighty-seven of this
36 act shall expire and be deemed repealed on December 31, [2015] 2020 and
37 provided further, however, that the amendments to section ninety of this
38 act shall take effect January 1, 1998 and shall apply to all policies,
39 contracts, certificates, riders or other evidences of coverage of long
40 term care insurance issued, renewed, altered or modified pursuant to
41 section 3229 of the insurance law on or after such date.
42 S 21. Paragraph (b) of subdivision 17 of section 2808 of the public
43 health law, as amended by section 98 of part H of chapter 59 of the laws
44 of 2011, is amended to read as follows:
45 (b) Notwithstanding any inconsistent provision of law or regulation to
46 the contrary, for the state fiscal [year] YEARS beginning April first,
47 two thousand ten and ending March thirty-first, two thousand [fifteen]
48 NINETEEN, the commissioner shall not be required to revise certified
49 rates of payment established pursuant to this article for rate periods
50 prior to April first, two thousand [fifteen] NINETEEN, based on consid-
51 eration of rate appeals filed by residential health care facilities or
52 based upon adjustments to capital cost reimbursement as a result of
53 approval by the commissioner of an application for construction under
54 section twenty-eight hundred two of this article, in excess of an aggre-
55 gate annual amount of eighty million dollars for each such state fiscal
56 year provided, however, that for the period April first, two thousand
A. 6007 47
1 eleven through March thirty-first, two thousand twelve such aggregate
2 annual amount shall be fifty million dollars. In revising such rates
3 within such fiscal limit, the commissioner shall, in prioritizing such
4 rate appeals, include consideration of which facilities the commissioner
5 determines are facing significant financial hardship as well as such
6 other considerations as the commissioner deems appropriate and, further,
7 the commissioner is authorized to enter into agreements with such facil-
8 ities or any other facility to resolve multiple pending rate appeals
9 based upon a negotiated aggregate amount and may offset such negotiated
10 aggregate amounts against any amounts owed by the facility to the
11 department, including, but not limited to, amounts owed pursuant to
12 section twenty-eight hundred seven-d of this article; provided, however,
13 that the commissioner's authority to negotiate such agreements resolving
14 multiple pending rate appeals as hereinbefore described shall continue
15 on and after April first, two thousand [fifteen] NINETEEN. Rate adjust-
16 ments made pursuant to this paragraph remain fully subject to approval
17 by the director of the budget in accordance with the provisions of
18 subdivision two of section twenty-eight hundred seven of this article.
19 S 22. Paragraph (a) of subdivision 13 of section 3614 of the public
20 health law, as added by section 4 of part H of chapter 59 of the laws of
21 2011, is amended to read as follows:
22 (a) Notwithstanding any inconsistent provision of law or regulation
23 and subject to the availability of federal financial participation,
24 effective April first, two thousand twelve through March thirty-first,
25 two thousand [fifteen] SEVENTEEN, payments by government agencies for
26 services provided by certified home health agencies, except for such
27 services provided to children under eighteen years of age and other
28 discreet groups as may be determined by the commissioner pursuant to
29 regulations, shall be based on episodic payments. In establishing such
30 payments, a statewide base price shall be established for each sixty day
31 episode of care and adjusted by a regional wage index factor and an
32 individual patient case mix index. Such episodic payments may be further
33 adjusted for low utilization cases and to reflect a percentage limita-
34 tion of the cost for high-utilization cases that exceed outlier thresh-
35 olds of such payments.
36 S 23. Subdivision (a) of section 40 of part B of chapter 109 of the
37 laws of 2010, amending the social services law relating to transporta-
38 tion costs, is amended to read as follows:
39 (a) sections two, three, three-a, three-b, three-c, three-d, three-e
40 and twenty-one of this act shall take effect July 1, 2010; sections
41 fifteen, sixteen, seventeen, eighteen and nineteen of this act shall
42 take effect January 1, 2011; and provided further that section twenty of
43 this act shall be deemed repealed [four] FIVE years after the date the
44 contract entered into pursuant to section 365-h of the social services
45 law, as amended by section twenty of this act, is executed; provided
46 that the commissioner of health shall notify the legislative bill draft-
47 ing commission upon the execution of the contract entered into pursuant
48 to section 367-h of the social services law in order that the commission
49 may maintain an accurate and timely effective data base of the official
50 text of the laws of the state of New York in furtherance of effectuating
51 the provisions of section 44 of the legislative law and section 70-b of
52 the public officers law;
53 S 24. Intentionally omitted.
54 S 25. Section 5 of chapter 21 of the laws of 2011, amending the educa-
55 tion law relating to authorizing pharmacists to perform collaborative
A. 6007 48
1 drug therapy management with physicians in certain settings, as amended
2 by chapter 125 of the laws of 2014, is amended to read as follows:
3 S 5. This act shall take effect on the one hundred twentieth day after
4 it shall have become a law and shall expire [4] 7 years after such
5 effective date when upon such date the provisions of this act shall be
6 deemed repealed; provided, however, that the amendments to subdivision 1
7 of section 6801 of the education law made by section one of this act
8 shall be subject to the expiration and reversion of such subdivision
9 pursuant to section 8 of chapter 563 of the laws of 2008, when upon such
10 date the provisions of section one-a of this act shall take effect;
11 provided, further, that effective immediately, the addition, amendment
12 and/or repeal of any rule or regulation necessary for the implementation
13 of this act on its effective date is authorized and directed to be made
14 and completed on or before such effective date.
15 S 26. Section 2 of chapter 459 of the laws of 1996, amending the
16 public health law relating to recertification of persons providing emer-
17 gency medical care, as amended by chapter 106 of the laws of 2011, is
18 REPEALED.
19 S 27. Section 4 of chapter 505 of the laws of 1995, amending the
20 public health law relating to the operation of department of health
21 facilities, as amended by section 29 of part A of chapter 59 of the laws
22 of 2011, is amended to read as follows:
23 S 4. This act shall take effect immediately; provided, however, that
24 the provisions of paragraph (b) of subdivision 4 of section 409-c of the
25 public health law, as added by section three of this act, shall take
26 effect January 1, 1996 and shall expire and be deemed repealed [twenty]
27 TWENTY-FIVE years from the effective date thereof.
28 S 28. Subdivision (o) of section 111 of part H of chapter 59 of the
29 laws of 2011, amending the public health law relating to the statewide
30 health information network of New York and the statewide planning and
31 research cooperative system and general powers and duties, is amended to
32 read as follows:
33 (o) sections thirty-eight and thirty-eight-a of this act shall expire
34 and be deemed repealed March 31, [2015] 2020;
35 S 29. Section 4-a of part A of chapter 56 of the laws of 2013, amend-
36 ing chapter 59 of the laws of 2011 amending the public health law and
37 other laws relating to general hospital reimbursement for annual rates,
38 relating to the cap on local Medicaid expenditures, is amended to read
39 as follows:
40 S 4-a. Notwithstanding paragraph (c) of subdivision 10 of section
41 2807-c of the public health law, section 21 of chapter 1 of the laws of
42 1999, or any other contrary provision of law, in determining rates of
43 payments by state governmental agencies effective for services provided
44 on and after January 1, [2015] 2016 through March 31, [2015] 2016, for
45 inpatient and outpatient services provided by general hospitals, for
46 inpatient services and adult day health care outpatient services
47 provided by residential health care facilities pursuant to article 28 of
48 the public health law, except for residential health care facilities or
49 units of such facilities providing services primarily to children under
50 twenty-one years of age, for home health care services provided pursuant
51 to article 36 of the public health law by certified home health agen-
52 cies, long term home health care programs and AIDS home care programs,
53 and for personal care services provided pursuant to section 365-a of the
54 social services law, the commissioner of health shall apply no greater
55 than zero trend factors attributable to the [2015] 2016 calendar year in
56 accordance with paragraph (c) of subdivision 10 of section 2807-c of the
A. 6007 49
1 public health law, provided, however, that such no greater than zero
2 trend factors attributable to such [2015] 2016 calendar year shall also
3 be applied to rates of payment provided on and after January 1, [2015]
4 2016 through March 31, [2015] 2016 for personal care services provided
5 in those local social services districts, including New York city, whose
6 rates of payment for such services are established by such local social
7 services districts pursuant to a rate-setting exemption issued by the
8 commissioner of health to such local social services districts in
9 accordance with applicable regulations, and provided further, however,
10 that for rates of payment for assisted living program services provided
11 on and after January 1, [2015] 2016 through March 31, [2015] 2016, such
12 trend factors attributable to the [2015] 2016 calendar year shall be
13 established at no greater than zero percent.
14 S 30. Notwithstanding any inconsistent provision of law, rule or regu-
15 lation, for purposes of implementing the provisions of the public health
16 law and the social services law, references to titles XIX and XXI of the
17 federal social security act in the public health law and the social
18 services law shall be deemed to include and also to mean any successor
19 titles thereto under the federal social security act.
20 S 31. Notwithstanding any inconsistent provision of law, rule or regu-
21 lation, the effectiveness of the provisions of sections 2807 and 3614 of
22 the public health law, section 18 of chapter 2 of the laws of 1988, and
23 18 NYCRR 505.14(h), as they relate to time frames for notice, approval
24 or certification of rates of payment, are hereby suspended and without
25 force or effect for purposes of implementing the provisions of this act.
26 S 32. Severability clause. If any clause, sentence, paragraph, subdi-
27 vision, section or part of this act shall be adjudged by any court of
28 competent jurisdiction to be invalid, such judgment shall not affect,
29 impair or invalidate the remainder thereof, but shall be confined in its
30 operation to the clause, sentence, paragraph, subdivision, section or
31 part thereof directly involved in the controversy in which such judgment
32 shall have been rendered. It is hereby declared to be the intent of the
33 legislature that this act would have been enacted even if such invalid
34 provisions had not been included herein.
35 S 33. This act shall take effect immediately and shall be deemed to
36 have been in full force and effect on and after April 1, 2015 provided,
37 that:
38 1. the amendments to the opening paragraph of subdivision 7 of section
39 3614 of the public health law made by section fourteen of this act shall
40 not affect the expiration of such paragraph and shall be deemed to
41 expire therewith;
42 1-a. section eighteen of this act shall take effect on the same date
43 as the reversion of subdivision 3 of section 1680-j of the public
44 authorities law as provided in subdivision (a) of section 70 of part HH
45 of chapter 57 of the laws of 2013, as amended;
46 2. any rules or regulations necessary to implement the provisions of
47 this act may be promulgated and any procedures, forms, or instructions
48 necessary for such implementation may be adopted and issued on or after
49 the date this act shall have become a law;
50 3. this act shall not be construed to alter, change, affect, impair or
51 defeat any rights, obligations, duties or interests accrued, incurred or
52 conferred prior to the effective date of this act;
53 4. the commissioner of health and the superintendent of the department
54 of financial services and any appropriate council may take any steps
55 necessary to implement this act prior to its effective date;
A. 6007 50
1 5. notwithstanding any inconsistent provision of the state administra-
2 tive procedure act or any other provision of law, rule or regulation,
3 the commissioner of health and the superintendent of the department of
4 financial services and any appropriate council is authorized to adopt or
5 amend or promulgate on an emergency basis any regulation he or she or
6 such council determines necessary to implement any provision of this act
7 on its effective date; and
8 6. the provisions of this act shall become effective notwithstanding
9 the failure of the commissioner of health or the superintendent of the
10 department of financial services or any council to adopt or amend or
11 promulgate regulations implementing this act.
12 PART E
13 Section 1. Subdivision 5-d of section 2807-k of the public health
14 law, as added by section 1 of part C of chapter 56 of the laws of 2013,
15 is amended to read as follows:
16 5-d. (a) Notwithstanding any inconsistent provision of this section,
17 section twenty-eight hundred seven-w of this article or any other
18 contrary provision of law, and subject to the availability of federal
19 financial participation, for periods on and after January first, two
20 thousand thirteen, through December thirty-first, two thousand [fifteen]
21 EIGHTEEN, all funds available for distribution pursuant to this section,
22 except for funds distributed pursuant to subparagraph (v) of paragraph
23 (b) of subdivision five-b of this section, and all funds available for
24 distribution pursuant to section twenty-eight hundred seven-w of this
25 article, shall be reserved and set aside and distributed in accordance
26 with the provisions of this subdivision.
27 (b) The commissioner shall promulgate regulations, and may promulgate
28 emergency regulations, establishing methodologies for the distribution
29 of funds as described in paragraph (a) of this subdivision and such
30 regulations shall include, but not be limited to, the following:
31 (i) Such regulations shall establish methodologies for determining
32 each facility's relative uncompensated care need amount based on unin-
33 sured inpatient and outpatient units of service from the cost reporting
34 year two years prior to the distribution year, multiplied by the appli-
35 cable medicaid rates in effect January first of the distribution year,
36 as summed and adjusted by a statewide cost adjustment factor and reduced
37 by the sum of all payment amounts collected from such uninsured
38 patients, and as further adjusted by application of a nominal need
39 computation that shall take into account each facility's medicaid inpa-
40 tient share.
41 (ii) Annual distributions pursuant to such regulations for the two
42 thousand thirteen through two thousand [fifteen] EIGHTEEN calendar years
43 shall be in accord with the following:
44 (A) one hundred thirty-nine million four hundred thousand dollars
45 shall be distributed as Medicaid Disproportionate Share Hospital ("DSH")
46 payments to major public general hospitals; and
47 (B) nine hundred ninety-four million nine hundred thousand dollars as
48 Medicaid DSH payments to eligible general hospitals, other than major
49 public general hospitals.
50 (iii)(A) Such regulations shall establish transition adjustments to
51 the distributions made pursuant to clauses (A) and (B) of subparagraph
52 (ii) of this paragraph such that no facility experiences a reduction in
53 indigent care pool payments pursuant to this subdivision that is greater
54 than the percentages, as specified in clause (C) of this subparagraph as
A. 6007 51
1 compared to the average distribution that each such facility received
2 for the three calendar years prior to two thousand thirteen pursuant to
3 this section and section twenty-eight hundred seven-w of this article.
4 (B) Such regulations shall also establish adjustments limiting the
5 increases in indigent care pool payments experienced by facilities
6 pursuant to this subdivision by an amount that will be, as determined by
7 the commissioner and in conjunction with such other funding as may be
8 available for this purpose, sufficient to ensure full funding for the
9 transition adjustment payments authorized by clause (A) of this subpara-
10 graph.
11 (C) No facility shall experience a reduction in indigent care pool
12 payments pursuant to this subdivision that: for the calendar year begin-
13 ning January first, two thousand thirteen, is greater than two and one-
14 half percent; for the calendar year beginning January first, two thou-
15 sand fourteen, is greater than five percent; and, for the calendar year
16 beginning on January first, two thousand fifteen, is greater than seven
17 and one-half percent, AND FOR THE CALENDAR YEAR BEGINNING ON JANUARY
18 FIRST, TWO THOUSAND SIXTEEN, IS GREATER THAN TEN PERCENT; AND FOR THE
19 CALENDAR YEAR BEGINNING ON JANUARY FIRST, TWO THOUSAND SEVENTEEN, IS
20 GREATER THAN TWELVE AND ONE-HALF PERCENT; AND FOR THE CALENDAR YEAR
21 BEGINNING ON JANUARY FIRST, TWO THOUSAND EIGHTEEN, IS GREATER THAN
22 FIFTEEN PERCENT.
23 (D) NO LATER THAN THE FIRST OF JULY, TWO THOUSAND FIFTEEN, THE COMMIS-
24 SIONER SHALL RECONVENE THE MEDICAL REDESIGN TEAM TECHNICAL ASSISTANCE
25 TEAM ON INDIGENT CARE REFORM FORMED AS A RESULT OF RECOMMENDATION THREE
26 OF THE MEDICAID REDESIGN TEAM PAYMENT REFORM AND QUALITY MEASUREMENT
27 WORK GROUP, IN ORDER TO DEVELOP RECOMMENDATIONS TO, IN THE EVENT OF
28 AGGREGATE REDUCTIONS IN FEDERAL MEDICAID DSH FUNDING, ADJUST, THE AGGRE-
29 GATE LEVEL OF PAYMENTS MADE PURSUANT TO CLAUSES (A) AND (B) OF SUBPARA-
30 GRAPH (II) OF PARAGRAPH (B) OF THIS SUBDIVISION, THE PERCENTAGE OF
31 REDUCTIONS IN PAYMENTS REQUIRED BY CLAUSE (C) OF THIS SUBPARAGRAPH, AND
32 THE METHODOLOGY BY WHICH SUCH DSH PAYMENTS ARE DISTRIBUTED IN THE CALEN-
33 DAR YEAR FOLLOWING THE YEAR IN WHICH SUCH REDUCTIONS IN MEDICAID DSH
34 TAKE EFFECT. SUCH RECOMMENDATIONS SHALL SEEK TO TARGET, TO THE EXTENT
35 PRACTICABLE, THE REMAINING FEDERAL MEDICAID DSH FUNDS TO SUPPORT FACILI-
36 TIES THAT PROVIDE A DISPROPORTIONATE SHARE OF UNCOMPENSATED CARE TO THE
37 UNINSURED, UNDERINSURED AND MEDICAID POPULATIONS. NO LATER THAN THE
38 FIRST OF DECEMBER, TWO THOUSAND FIFTEEN, THE TECHNICAL ASSISTANCE TEAM
39 SHALL PROVIDE ITS RECOMMENDATIONS TO THE GOVERNOR, THE TEMPORARY PRESI-
40 DENT OF THE SENATE, AND THE SPEAKER OF THE ASSEMBLY, THE CHAIR OF THE
41 SENATE FINANCE COMMITTEE, THE CHAIR OF THE ASSEMBLY WAYS AND MEANS
42 COMMITTEE, AND THE CHAIRS OF THE SENATE AND ASSEMBLY HEALTH COMMITTEES,
43 INCLUDING ANY ANALYSIS OF FACILITY IMPACTS BY REGION AND SPONSORSHIP AS
44 WELL AS ANY ADDITIONAL INFORMATION IT DEEMS APPROPRIATE.
45 (iv) Such regulations shall reserve one percent of the funds available
46 for distribution in the two thousand fourteen and two thousand fifteen
47 calendar years, AND FOR CALENDAR YEARS THEREAFTER, pursuant to this
48 subdivision, subdivision fourteen-f of section twenty-eight hundred
49 seven-c of this article, and sections two hundred eleven and two hundred
50 twelve of chapter four hundred seventy-four of the laws of nineteen
51 hundred ninety-six, in a "financial assistance compliance pool" and
52 shall establish methodologies for the distribution of such pool funds to
53 facilities based on their level of compliance, as determined by the
54 commissioner, with the provisions of subdivision nine-a of this section.
A. 6007 52
1 (c) The commissioner shall annually report to the governor and the
2 legislature on the distribution of funds under this subdivision includ-
3 ing, but not limited to:
4 (i) the impact on safety net providers, including community providers,
5 rural general hospitals and major public general hospitals;
6 (ii) the provision of indigent care by units of services and funds
7 distributed by general hospitals; and
8 (iii) the extent to which access to care has been enhanced.
9 S 2. Subdivision 17 of section 2807-k of the public health law, as
10 added by section 3-b of part B of chapter 109 of the laws of 2010, is
11 amended to read as follows:
12 17. Indigent care reductions. (A) For each hospital receiving payments
13 pursuant to paragraph (i) of subdivision thirty-five of section twenty-
14 eight hundred seven-c of this article, the commissioner shall reduce the
15 sum of any amounts paid pursuant to this section and pursuant to section
16 twenty-eight hundred seven-w of this article, as computed based on
17 projected facility specific disproportionate share hospital ceilings, by
18 an amount equal to the lower of such sum or each such hospital's
19 payments pursuant to paragraph (i) of subdivision thirty-five of section
20 twenty-eight hundred seven-c of this article, provided, however, that
21 any additional aggregate reductions enacted in a chapter of the laws of
22 two thousand ten to the aggregate amounts payable pursuant to this
23 section and pursuant to section twenty-eight hundred seven-w of this
24 article shall be applied subsequent to the adjustments otherwise
25 provided for in this subdivision.
26 (B) FOR ANY REDUCTIONS IN PAYMENTS UNDER PARAGRAPH (I) OF SUBDIVISION
27 THIRTY-FIVE OF SECTION TWENTY-EIGHT HUNDRED SEVEN-C OF THIS ARTICLE
28 RESULTING FROM AGGREGATE UPPER PAYMENT LIMIT CALCULATIONS, THE COMMIS-
29 SIONER MAY REDUCE OR REDISTRIBUTE PAYMENTS UNDER THIS SECTION OR SECTION
30 TWENTY-EIGHT HUNDRED SEVEN-W OF THIS ARTICLE IN A MANNER THAT SHALL
31 ALLOCATE A GREATER PROPORTION OF THE PAYMENTS TO THOSE HOSPITALS PROVID-
32 ING A DISPROPORTIONATE SHARE OF UNCOMPENSATED CARE TO THE UNINSURED,
33 UNDERINSURED AND MEDICAID POPULATIONS.
34 S 3. Notwithstanding any inconsistent provision of law, rule or regu-
35 lation, for purposes of implementing the provisions of the public health
36 law and the social services law, references to titles XIX and XXI of the
37 federal social security act in the public health law and the social
38 services law shall be deemed to include and also to mean any successor
39 titles thereto under the federal social security act.
40 S 4. Notwithstanding any inconsistent provision of law, rule or regu-
41 lation, the effectiveness of the provisions of sections 2807 and 3614 of
42 the public health law, section 18 of chapter 2 of the laws of 1988, and
43 18 NYCRR 505.14(h), as they relate to time frames for notice, approval
44 or certification of rates of payment, are hereby suspended and without
45 force or effect for purposes of implementing the provisions of this act.
46 S 5. Severability clause. If any clause, sentence, paragraph, subdivi-
47 sion, section or part of this act shall be adjudged by any court of
48 competent jurisdiction to be invalid, such judgment shall not affect,
49 impair or invalidate the remainder thereof, but shall be confined in its
50 operation to the clause, sentence, paragraph, subdivision, section or
51 part thereof directly involved in the controversy in which such judgment
52 shall have been rendered. It is hereby declared to be the intent of the
53 legislature that this act would have been enacted even if such invalid
54 provisions had not been included herein.
A. 6007 53
1 S 6. This act shall take effect immediately and shall be deemed to
2 have been in full force and effect on and after April 1, 2015; provided,
3 that:
4 a. any rules or regulations necessary to implement the provisions of
5 this act may be promulgated and any procedures, forms, or instructions
6 necessary for such implementation may be adopted and issued on or after
7 the date this act shall have become a law;
8 b. this act shall not be construed to alter, change, affect, impair or
9 defeat any rights, obligations, duties or interests accrued, incurred or
10 conferred prior to the effective date of this act;
11 c. the commissioner of health and the superintendent of financial
12 services and any appropriate council may take any steps necessary to
13 implement this act prior to its effective date;
14 d. notwithstanding any inconsistent provision of the state administra-
15 tive procedure act or any other provision of law, rule or regulation,
16 the commissioner of health and the superintendent of financial services
17 and any appropriate council is authorized to adopt or amend or promul-
18 gate on an emergency basis any regulation he or she or such council
19 determines necessary to implement any provision of this act on its
20 effective date; and
21 e. the provisions of this act shall become effective notwithstanding
22 the failure of the commissioner of health or the superintendent of
23 financial services or any council to adopt or amend or promulgate regu-
24 lations implementing this act.
25 PART F
26 Intentionally Omitted
27 PART G
28 Section 1. The financial services law is amended by adding a new
29 section 208 to read as follows:
30 S 208. ASSESSMENT FOR THE OPERATING EXPENSES OF THE NEW YORK HEALTH
31 BENEFIT EXCHANGE. (A) FOR EACH FISCAL YEAR COMMENCING ON OR AFTER APRIL
32 FIRST, TWO THOUSAND FIFTEEN, ASSESSMENTS FOR THE OPERATING EXPENSES
33 ATTRIBUTABLE TO QUALIFIED HEALTH PLAN COVERAGE OF THE NEW YORK HEALTH
34 BENEFIT EXCHANGE, ESTABLISHED WITHIN THE DEPARTMENT OF HEALTH BY EXECU-
35 TIVE ORDER 42 SIGNED BY GOVERNOR ANDREW M. CUOMO ON APRIL 12, 2012 IN
36 CONFORMITY WITH THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, PUBLIC
37 LAW 111-14 AND THE HEALTH CARE AND EDUCATION RECONCILIATION ACT, PUBLIC
38 LAW 111-152, AND DOING BUSINESS AS THE NY STATE OF HEALTH, THE OFFICIAL
39 HEALTH PLAN MARKETPLACE (NY STATE OF HEALTH) SHALL BE ASSESSED BY THE
40 SUPERINTENDENT IN ACCORDANCE WITH THIS SECTION. A DOMESTIC ACCIDENT AND
41 HEALTH INSURER SHALL BE ASSESSED BY THE SUPERINTENDENT PURSUANT TO THIS
42 SECTION FOR THE OPERATING EXPENSES OF THE NY STATE OF HEALTH ATTRIBUT-
43 ABLE TO QUALIFIED HEALTH PLANS' COVERAGE, WHICH SHALL INCLUDE DIRECT AND
44 INDIRECT EXPENSES RELATED TO THE OPERATION OF THE NEW YORK STATE OF
45 HEALTH ATTRIBUTABLE TO SUCH QUALIFIED HEALTH PLAN COVERAGE WITH THE
46 ASSESSMENTS ALLOCATED PRO RATA UPON ALL DOMESTIC ACCIDENT AND HEALTH
47 INSURERS IN THE INDIVIDUAL, SMALL GROUP AND LARGE GROUP MARKETS, IN
48 PROPORTION TO THE GROSS DIRECT PREMIUMS, EXCLUSIVE OF FEDERAL TAX CRED-
49 ITS AND OTHER CONSIDERATIONS, WRITTEN OR RECEIVED BY THEM IN THIS STATE
50 DURING THE CALENDAR YEAR ENDING DECEMBER THIRTY-FIRST IMMEDIATELY
51 PRECEDING THE END OF THE FISCAL YEAR FOR WHICH THE ASSESSMENT IS MADE
A. 6007 54
1 (LESS RETURN PREMIUMS AND CONSIDERATIONS THEREON) FOR INSURANCE POLICIES
2 OR CONTRACTS OF MAJOR MEDICAL OR SIMILAR COMPREHENSIVE TYPE MEDICAL
3 COVERAGE OR DENTAL COVERAGE DELIVERED OR ISSUED FOR DELIVERY IN THIS
4 STATE; BUT EXCLUDING INSURANCE POLICIES OR CONTRACTS FOR MAJOR MEDICAL
5 OR SIMILAR COMPREHENSIVE TYPE MEDICAL OR DENTAL COVERAGE DELIVERED OR
6 ISSUED FOR DELIVERY IN THIS STATE UNDER TITLE XVIII OF THE SOCIAL SECU-
7 RITY ACT (MEDICARE), MEDICAL ASSISTANCE UNDER TITLE ELEVEN OF ARTICLE
8 FIVE OF THE SOCIAL SERVICES LAW, CHILD HEALTH PLUS INSURANCE PLAN UNDER
9 SECTION TWENTY-FIVE HUNDRED OF THE PUBLIC HEALTH LAW AND/OR THE BASIC
10 HEALTH INSURANCE PLAN PURSUANT TO PARAGRAPH (E) OF SUBDIVISION ONE OF
11 SECTION THREE HUNDRED SIXTY-NINE-GG OF THE SOCIAL SERVICES LAW.
12 (B) THE ASSESSMENT UPON DOMESTIC ACCIDENT AND HEALTH INSURERS
13 DESCRIBED IN SUBSECTION (A) OF THIS SECTION SHALL BE MADE BY THE SUPER-
14 INTENDENT COMMENCING APRIL FIRST, TWO THOUSAND FIFTEEN, IN A SUM AS
15 PRESCRIBED BY THE SUPERINTENDENT FOR SUCH INSURERS' PRO RATA SHARE OF
16 THE ANNUAL EXPENSES OF THE NY STATE OF HEALTH ATTRIBUTABLE TO QUALIFIED
17 HEALTH PLAN COVERAGE FOR THE TWO THOUSAND FIFTEEN-TWO THOUSAND SIXTEEN
18 FISCAL YEAR, AS ESTIMATED BY THE SUPERINTENDENT. SUCH PAYMENT SHALL BE
19 MADE ON OR BEFORE FEBRUARY FIFTEENTH, TWO THOUSAND SIXTEEN, OR ON OR
20 BEFORE SUCH OTHER DATES AS THE SUPERINTENDENT MAY PRESCRIBE. FOLLOWING
21 THE DETERMINATION OF THE AMOUNT COLLECTED BASED ON THE ACTUAL ENROLLMENT
22 IN QUALIFIED HEALTH PLAN COVERAGE THROUGH THE NY STATE OF HEALTH AND
23 FULLY INSURED INDIVIDUAL, SMALL GROUP, AND LARGE GROUP COVERAGE OUTSIDE
24 THE NY STATE OF HEALTH FOR THE TWO THOUSAND FIFTEEN-TWO THOUSAND SIXTEEN
25 FISCAL YEAR, ANY OVERPAYMENT OF SUCH ASSESSMENT SHALL BE APPLIED AGAINST
26 THE NEXT ESTIMATED QUARTERLY ASSESSMENT FOR SUCH EXPENSES AS SET FORTH
27 IN THIS SECTION, IF LESS THAN OR EQUAL TO SUCH AMOUNT, UNTIL FULLY
28 RECONCILED. HOWEVER, IF THE ASSESSMENT COLLECTED IS LESS THAN THE
29 EXPENSES OF THE NY STATE OF HEALTH ATTRIBUTABLE TO QUALIFIED HEALTH PLAN
30 COVERAGE FOR THE TWO THOUSAND FIFTEEN-TWO THOUSAND SIXTEEN FISCAL YEAR,
31 THE SUPERINTENDENT MAY REQUIRE FULL PAYMENT TO BE MADE ON SUCH DATE OF
32 THE FISCAL YEAR AS THE SUPERINTENDENT MAY DETERMINE.
33 (C) FOR EACH FISCAL YEAR COMMENCING ON OR AFTER APRIL FIRST, TWO THOU-
34 SAND SIXTEEN, A PARTIAL PAYMENT SHALL BE MADE BY A DOMESTIC ACCIDENT AND
35 HEALTH INSURER IN A SUM EQUAL TO TWENTY-FIVE PER CENTUM, OR SUCH OTHER
36 PER CENTUM OR PER CENTUMS AS THE SUPERINTENDENT MAY PRESCRIBE, OF ITS
37 PRO RATA SHARE OF THE ANNUAL EXPENSES OF THE NY STATE OF HEALTH ATTRIB-
38 UTABLE TO QUALIFIED HEALTH PLAN COVERAGE ASSESSED UPON IT FOR THE FISCAL
39 YEAR AS ESTIMATED BY THE SUPERINTENDENT. SUCH PAYMENT SHALL BE MADE ON
40 MARCH FIFTEENTH OF THE PRECEDING FISCAL YEAR AND ON JUNE FIFTEENTH,
41 SEPTEMBER FIFTEENTH AND DECEMBER FIFTEENTH OF EACH YEAR, OR AT SUCH
42 OTHER DATES AS THE SUPERINTENDENT MAY PRESCRIBE. THE SUPERINTENDENT
43 SHALL ANNUALLY RECONCILE THE ASSESSMENT PERCENTAGE BASED UPON ACTUAL
44 PREMIUM DATA SUBMITTED TO THE SUPERINTENDENT OR COMMISSIONER OF HEALTH,
45 AS APPLICABLE. THE BALANCE OF ASSESSMENTS FOR THE FISCAL YEAR SHALL BE
46 PAID UPON DETERMINATION OF THE AMOUNT COLLECTED FOR POLICIES OR
47 CONTRACTS OF MAJOR MEDICAL OR SIMILAR COMPREHENSIVE TYPE MEDICAL COVER-
48 AGE OR DENTAL COVERAGE DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE AS
49 SET FORTH IN SUBSECTION (A) OF THIS SECTION. ANY OVERPAYMENT OF ANNUAL
50 ASSESSMENT RESULTING FROM COMPLYING WITH THE REQUIREMENTS OF THIS
51 SECTION SHALL BE APPLIED AGAINST THE NEXT ESTIMATED QUARTERLY ASSESS-
52 MENT, IF LESS THAN OR EQUAL TO SUCH AMOUNT, UNTIL FULLY RECONCILED.
53 (D)(1) PAYMENTS AND REPORTS SUBMITTED OR REQUIRED TO BE SUBMITTED TO
54 THE COMMISSIONER OF HEALTH PURSUANT TO THIS SECTION BY A DOMESTIC ACCI-
55 DENT AND HEALTH INSURER SHALL BE SUBJECT TO AUDIT BY THE COMMISSIONER OF
56 HEALTH FOR A PERIOD OF SIX YEARS FOLLOWING THE CLOSE OF THE CALENDAR
A. 6007 55
1 YEAR IN WHICH SUCH PAYMENTS AND REPORTS ARE DUE, AFTER WHICH SUCH
2 PAYMENTS SHALL BE DEEMED FINAL AND NOT SUBJECT TO FURTHER ADJUSTMENT OR
3 RECONCILIATION, INCLUDING THROUGH OFFSET ADJUSTMENTS OR RECONCILIATIONS
4 MADE BY THE DOMESTIC ACCIDENT AND HEALTH INSURER WITH REGARD TO SUBSE-
5 QUENT PAYMENTS, PROVIDED, HOWEVER, THAT NOTHING HEREIN SHALL BE
6 CONSTRUED AS PRECLUDING THE COMMISSIONER OF HEALTH FROM PURSUING
7 COLLECTION OF ANY SUCH PAYMENTS WHICH ARE IDENTIFIED AS DELINQUENT WITH-
8 IN SUCH SIX YEAR PERIOD, OR WHICH ARE IDENTIFIED AS DELINQUENT AS A
9 RESULT OF AN AUDIT COMMENCED WITHIN SUCH SIX YEAR PERIOD, OR FROM
10 CONDUCTING AN AUDIT OF ANY ADJUSTMENTS AND RECONCILIATION WITHIN SUCH
11 SIX YEAR PERIOD, OR FROM CONDUCTING AN AUDIT OF PAYMENTS MADE PRIOR TO
12 SUCH SIX YEAR PERIOD WHICH ARE FOUND TO BE COMMINGLED WITH PAYMENTS
13 WHICH ARE OTHERWISE SUBJECT TO TIMELY AUDIT PURSUANT TO THIS SECTION.
14 (2) THE SUPERINTENDENT MAY ASSESS A DOMESTIC ACCIDENT AND HEALTH
15 INSURER WHICH, IN THE COURSE OF AN AUDIT PURSUANT TO THIS SECTION, FAILS
16 TO PRODUCE DATA OR DOCUMENTATION REQUESTED IN FURTHERANCE OF SUCH AN
17 AUDIT, WITHIN THIRTY DAYS OF SUCH REQUEST, A CIVIL PENALTY OF UP TO TEN
18 THOUSAND DOLLARS FOR EACH SUCH FAILURE, PROVIDED, HOWEVER, THAT SUCH
19 CIVIL PENALTY SHALL NOT BE IMPOSED IF THE DOMESTIC ACCIDENT AND HEALTH
20 INSURER DEMONSTRATES GOOD CAUSE FOR SUCH FAILURE.
21 (3) RECORDS REQUIRED TO BE RETAINED FOR AUDIT VERIFICATION PURPOSES BY
22 A DOMESTIC ACCIDENT AND HEALTH INSURER IN ACCORDANCE WITH THIS SECTION
23 SHALL INCLUDE, ON A MONTHLY BASIS, THE SOURCE RECORDS GENERATED BY
24 SUPPORTING INFORMATION SYSTEMS, FINANCIAL ACCOUNTING RECORDS, AND SUCH
25 OTHER RECORDS AS MAY BE REQUIRED TO PROVE COMPLIANCE WITH, AND TO
26 SUPPORT REPORTS SUBMITTED IN ACCORDANCE WITH, THIS SECTION.
27 (4) IF A DOMESTIC ACCIDENT AND HEALTH INSURER FAILS TO PRODUCE DATA OR
28 DOCUMENTATION REQUESTED IN FURTHERANCE OF AN AUDIT PURSUANT TO THIS
29 SECTION FOR A QUARTER TO WHICH THE ASSESSMENT APPLIES, THE SUPERINTEN-
30 DENT MAY ESTIMATE, BASED ON AVAILABLE FINANCIAL AND STATISTICAL DATA AS
31 DETERMINED BY THE SUPERINTENDENT, THE AMOUNT DUE FOR SUCH QUARTER.
32 INTEREST AND PENALTIES SHALL BE APPLIED TO SUCH AMOUNTS DUE IN ACCORD-
33 ANCE WITH THE PROVISIONS OF SUBSECTION (B) OF SECTION NINE THOUSAND ONE
34 HUNDRED NINE OF THE INSURANCE LAW.
35 (5) THE SUPERINTENDENT MAY, AS PART OF A FINAL RESOLUTION OF AN AUDIT
36 CONDUCTED BY THE COMMISSIONER OF HEALTH PURSUANT TO THIS SUBSECTION,
37 WAIVE PAYMENT OF INTEREST AND PENALTIES OTHERWISE APPLICABLE PURSUANT TO
38 SUBSECTION (B) OF SECTION NINE THOUSAND ONE HUNDRED NINE OF THE INSUR-
39 ANCE LAW, WHEN AMOUNTS DUE AS A RESULT OF SUCH AUDIT, OTHER THAN SUCH
40 WAIVED PENALTIES AND INTEREST, ARE PAID IN FULL TO THE COMMISSIONER OF
41 HEALTH WITHIN SIXTY DAYS OF THE ISSUANCE OF A FINAL AUDIT REPORT THAT IS
42 MUTUALLY AGREED TO BY THE COMMISSIONER OF HEALTH AND DOMESTIC ACCIDENT
43 AND HEALTH INSURER, PROVIDED, HOWEVER, THAT IF SUCH FINAL AUDIT REPORT
44 IS NOT SO MUTUALLY AGREED UPON, THEN THE SUPERINTENDENT SHALL HAVE NO
45 OBLIGATIONS PURSUANT TO THIS PARAGRAPH.
46 (6) THE COMMISSIONER OF HEALTH MAY ENTER INTO AN AGREEMENT WITH A
47 DOMESTIC ACCIDENT AND HEALTH INSURER IN REGARD TO WHICH AUDIT FINDINGS
48 OR PRIOR SETTLEMENTS HAVE BEEN MADE PURSUANT TO THIS SECTION, EXTENDING
49 AND APPLYING SUCH AUDIT FINDINGS OR PRIOR SETTLEMENTS, OR A PORTION
50 THEREOF, IN SETTLEMENT AND SATISFACTION OF POTENTIAL AUDIT LIABILITIES
51 FOR SUBSEQUENT UNAUDITED PERIODS. THE SUPERINTENDENT MAY REDUCE OR WAIVE
52 PAYMENT OF INTEREST AND PENALTIES OTHERWISE APPLICABLE TO SUCH SUBSE-
53 QUENT UNAUDITED PERIODS WHEN SUCH AMOUNTS DUE AS A RESULT OF SUCH AGREE-
54 MENT, OTHER THAN REDUCED OR WAIVED INTEREST AND PENALTIES, ARE PAID IN
55 FULL TO THE COMMISSIONER OF HEALTH WITHIN SIXTY DAYS OF EXECUTION OF
56 SUCH AGREEMENT BY ALL PARTIES TO THE AGREEMENT. ANY PAYMENTS MADE PURSU-
A. 6007 56
1 ANT TO AN AGREEMENT ENTERED INTO IN ACCORDANCE WITH THIS PARAGRAPH SHALL
2 BE DEEMED TO BE IN FULL SATISFACTION OF ANY LIABILITY ARISING UNDER THIS
3 SECTION, AS REFERENCED IN SUCH AGREEMENT AND FOR THE TIME PERIODS
4 COVERED BY SUCH AGREEMENT, PROVIDED, HOWEVER, THAT THE COMMISSIONER OF
5 HEALTH MAY AUDIT FUTURE RETROACTIVE ADJUSTMENTS TO PAYMENTS MADE FOR
6 SUCH PERIODS BASED ON REPORTS FILED BY A DOMESTIC ACCIDENT AND HEALTH
7 INSURER SUBSEQUENT TO SUCH AGREEMENT.
8 (E) THE COMMISSIONER OF HEALTH SHALL HAVE THE AUTHORITY UNDER SECTION
9 TWENTY-EIGHT HUNDRED SEVEN-Y OF THE PUBLIC HEALTH LAW TO CONTRACT WITH
10 THE ARTICLE FORTY-THREE INSURANCE LAW PLANS, OR SUCH OTHER CONTRACTORS
11 AS THE COMMISSIONER OF HEALTH SHALL DESIGNATE, TO ISSUE INVOICES,
12 RECEIVE PAYMENT, AND DISTRIBUTE FUNDS FROM THE ASSESSMENT AUTHORIZED BY
13 THIS SECTION AND TO DEPOSIT IT INTO THE SPECIAL REVENUE FUNDS-OTHER,
14 HCRA RESOURCES FUND.
15 (F) FOR THE PURPOSE OF THIS SECTION, "ACCIDENT AND HEALTH INSURER"
16 SHALL MEAN AN INSURER AUTHORIZED UNDER THE INSURANCE LAW TO WRITE ACCI-
17 DENT AND HEALTH INSURANCE IN THIS STATE, A CORPORATION ORGANIZED PURSU-
18 ANT TO ARTICLE FORTY-THREE OF THE INSURANCE LAW, OR A HEALTH MAINTENANCE
19 ORGANIZATION HOLDING OR REQUIRED TO HOLD A CERTIFICATE OF AUTHORITY
20 PURSUANT TO ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW, THAT WRITES
21 MAJOR MEDICAL OR SIMILAR COMPREHENSIVE TYPE MEDICAL COVERAGE OR WRITES
22 DENTAL COVERAGE.
23 (G) FOR THE PURPOSE OF THIS SECTION, "DOMESTIC ACCIDENT AND HEALTH
24 INSURER" SHALL MEAN AN ACCIDENT AND HEALTH INSURER INCORPORATED OR
25 ORGANIZED UNDER ANY LAW OF THIS STATE.
26 (H) NO HEALTH INSURER WRITING POLICIES IN THE INDIVIDUAL, GROUP, AND
27 LARGE GROUP MARKETS, AS LIMITED BY SUBDIVISION (A) OF THIS SECTION,
28 SHALL ISSUE A POLICY FOR A POLICYHOLDER REQUIRING THE PAYMENT OF THE
29 ASSESSMENT FOR THE OPERATING EXPENSES OF THE NEW YORK HEALTH BENEFIT
30 EXCHANGE BY ANY POLICYHOLDER OR MEMBER IN ADDITION TO THE REGULAR PREMI-
31 UM OR CONSIDERATION CHARGED THEREFORE; NOR SHALL ANY SUCH COMPANY HAVE
32 POWER TO LEVY OR COLLECT FUNDS FOR THE NEW YORK HEALTH BENEFIT EXCHANGE
33 ASSESSMENT FROM SUCH POLICYHOLDERS OR MEMBERS. THE NEW YORK HEALTH BENE-
34 FIT EXCHANGE ASSESSMENT SHALL BE CONSIDERED A COST OF OPERATION FOR SUCH
35 HEALTH INSURERS AND THE HEALTH INSURER SHALL NOT CHARGE ANY ADDITIONAL
36 FEE NOR INCREASE THE PREMIUM OF A POLICYHOLDER OR MEMBER AS A RESULT OF
37 THE NEW YORK HEALTH BENEFIT EXCHANGE ASSESSMENT. WHEN APPROVING HEALTH
38 INSURANCE PREMIUM INCREASES PROPOSED BY SUCH ACCIDENT AND HEALTH INSUR-
39 ERS THE SUPERINTENDENT SHALL ENSURE THAT NO PORTION OF SUCH PROPOSED
40 PREMIUM INCREASE IS BASED UPON THE COST TO THE INSURER OF PAYING THE NEW
41 YORK HEALTH BENEFIT EXCHANGE ASSESSMENT ESTABLISHED BY THIS SECTION.
42 S 2. Paragraphs (g) and (h) of subdivision 1 of section 2807-y of the
43 public health law, as added by section 67 of part B of chapter 58 of the
44 laws of 2005, are amended and a new paragraph (i) is added to read as
45 follows:
46 (g) section thirty-six hundred fourteen-a of this chapter; [and]
47 (h) section three hundred sixty-seven-i of the social services law[.];
48 AND
49 (I) SECTION TWO HUNDRED EIGHT OF THE FINANCIAL SERVICES LAW.
50 S 3. Subdivision 3 of section 2807-y of the public health law, as
51 added by section 67 of part B of chapter 58 of the laws of 2005, is
52 amended to read as follows:
53 3. The reasonable costs and expenses of an administrator as approved
54 by the commissioner, not to exceed for personnel services on an annual
55 basis [four] SIX million [five hundred] fifty thousand dollars,
56 increased annually by the lower of the consumer price index or five
A. 6007 57
1 percent, for collection and distribution of allowances and assessments
2 set forth in subdivision one of this section, shall be paid from the
3 allowance and assessment funds.
4 S 4. Notwithstanding any inconsistent provision of law, rule or regu-
5 lation, for purposes of implementing the provisions of the public health
6 law and the social services law, references to titles XIX and XXI of the
7 federal social security act in the public health law and the social
8 services law shall be deemed to include and also to mean any successor
9 titles thereto under the federal social security act.
10 S 5. Severability clause. If any clause, sentence, paragraph, subdivi-
11 sion, section or part of this act shall be adjudged by any court of
12 competent jurisdiction to be invalid, such judgment shall not affect,
13 impair or invalidate the remainder thereof, but shall be confined in its
14 operation to the clause, sentence, paragraph, subdivision, section or
15 part thereof directly involved in the controversy in which such judgment
16 shall have been rendered. It is hereby declared to be the intent of the
17 legislature that this act would have been enacted even if such invalid
18 provisions had not been included herein.
19 S 6. This act shall take effect immediately and shall be deemed to
20 have been in full force and effect on and after April 1, 2015; provided
21 that:
22 1. any rules or regulations necessary to implement the provisions of
23 this act may be promulgated and any procedures, forms, or instructions
24 necessary for such implementation may be adopted and issued on or after
25 the date this act shall have become a law;
26 2. this act shall not be construed to alter, change, affect, impair or
27 defeat any rights, obligations, duties or interests accrued, incurred or
28 conferred prior to the effective date of this act;
29 3. the commissioner of health and the superintendent of financial
30 services may take any steps necessary to implement this act prior to its
31 effective date;
32 4. notwithstanding any inconsistent provision of the state administra-
33 tive procedure act or any other provision of law, rule or regulation,
34 the commissioner of health and the superintendent of financial services
35 are authorized to adopt or amend or promulgate on an emergency basis any
36 regulation they determine necessary to implement any provision of this
37 act on its effective date; and
38 5. the provisions of this act shall become effective notwithstanding
39 the failure of the commissioner of health or the superintendent of
40 financial services to adopt or amend or promulgate regulations imple-
41 menting this act.
42 PART H
43 Section 1. Intentionally omitted.
44 S 2. The public health law is amended by adding a new section 230-e to
45 read as follows:
46 S 230-E. URGENT CARE. 1. DEFINITIONS. AS USED IN THIS SECTION:
47 (A) "ACCREDITED STATUS" SHALL MEAN THE FULL ACCREDITATION BY SUCH
48 NATIONALLY-RECOGNIZED ACCREDITING AGENCIES AS DETERMINED BY THE COMMIS-
49 SIONER.
50 (B) "EMERGENCY MEDICAL CARE" SHALL MEAN THE PROVISION OF TREATMENT FOR
51 LIFE-THREATENING OR POTENTIALLY DISABLING TRAUMA, BURNS, RESPIRATORY,
52 CIRCULATORY OR OBSTETRICAL CONDITIONS.
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1 (C) "LICENSEE" SHALL MEAN AN INDIVIDUAL LICENSED OR OTHERWISE AUTHOR-
2 IZED UNDER ARTICLE ONE HUNDRED THIRTY-ONE OR ONE HUNDRED THIRTY-ONE-B OF
3 THE EDUCATION LAW.
4 (D) "URGENT CARE" SHALL MEAN THE PROVISION OF TREATMENT ON AN UNSCHED-
5 ULED BASIS TO PATIENTS FOR ACUTE EPISODIC ILLNESS, MINOR TRAUMAS THAT
6 ARE NOT LIFE-THREATENING, OR POTENTIALLY DISABLING, OR FOR MONITORING OR
7 TREATMENT OVER PROLONGED PERIODS.
8 (E) "URGENT CARE PROVIDER" SHALL MEAN A LICENSEE PRACTICE THAT ADVER-
9 TISES OR HOLDS ITSELF OUT AS A PROVIDER OF URGENT CARE.
10 2. NO LICENSEE PRACTICE SHALL, WITHIN THIS STATE, DISPLAY SIGNAGE,
11 ADVERTISE OR HOLD ITSELF OUT AS A PROVIDER OF URGENT CARE THROUGH THE
12 USE OF THE TERM URGENT CARE, OR THROUGH ANY OTHER TERM OR SYMBOL THAT
13 IMPLIES THAT IT IS A PROVIDER OF URGENT CARE, UNLESS IT OBTAINS AND
14 MAINTAINS ACCREDITED STATUS, OBTAINS THE APPROVAL OF THE DEPARTMENT AND
15 OTHERWISE COMPLIES WITH THE PROVISIONS OF THIS SECTION AND REGULATIONS
16 PROMULGATED HEREUNDER. ANY PROVIDER THAT LOSES ITS ACCREDITED STATUS
17 SHALL PROMPTLY NOTIFY THE DEPARTMENT THEREOF.
18 3. NO LICENSEE PRACTICE SHALL, WITHIN THIS STATE, DISPLAY SIGNAGE,
19 ADVERTISE OR HOLD ITSELF OUT AS A PROVIDER OF EMERGENCY MEDICAL CARE
20 THROUGH THE USE OF THE TERM EMERGENCY, OR THROUGH ANY OTHER TERM OR
21 SYMBOL THAT IMPLIES THAT IT IS A PROVIDER OF EMERGENCY MEDICAL CARE,
22 REGARDLESS OF WHETHER IT IS AN URGENT CARE PROVIDER ACCREDITED UNDER
23 THIS SECTION.
24 4. NOTHING IN THIS SECTION SHALL BE CONSTRUED TO PROHIBIT A HOSPITAL
25 ESTABLISHED UNDER ARTICLE TWENTY-EIGHT OF THIS CHAPTER FROM PROVIDING
26 URGENT CARE OR EMERGENCY MEDICAL CARE, OR FROM DISPLAYING SIGNAGE,
27 ADVERTISING OR HOLDING ITSELF OUT AS A PROVIDER OF URGENT OR EMERGENCY
28 CARE PURSUANT TO REGULATIONS PROMULGATED UNDER THAT ARTICLE.
29 5. THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL, BY A MAJORITY VOTE
30 OF ITS MEMBERS, SHALL ADOPT AND AMEND RULES AND REGULATIONS, SUBJECT TO
31 THE APPROVAL OF THE COMMISSIONER, TO EFFECTUATE THE PURPOSES AND
32 PROVISIONS OF THIS SECTION, INCLUDING, BUT NOT LIMITED TO DEFINING THE
33 SCOPE OF SERVICES THAT MAY BE PROVIDED BY URGENT CARE PROVIDERS AND THE
34 MINIMUM SERVICES THAT SHALL BE PROVIDED; REQUIRING URGENT CARE PROVIDERS
35 TO DISCLOSE TO PATIENTS THE SCOPE OF SERVICES PROVIDED; AND ESTABLISHING
36 STANDARDS FOR APPROPRIATE REFERRAL AND CONTINUITY OF CARE, STAFFING,
37 EQUIPMENT, AND MAINTENANCE AND TRANSMISSION OF PATIENT RECORDS. SUCH
38 REGULATIONS SHALL ALSO PROMOTE AND STRENGTHEN PRIMARY CARE THROUGH: (I)
39 THE INTEGRATION OF SERVICES PROVIDED BY URGENT CARE PROVIDERS WITH THE
40 SERVICES PROVIDED BY THE PATIENT'S OTHER HEALTH CARE PROVIDERS; AND (II)
41 THE REFERRAL OF PATIENTS TO APPROPRIATE HEALTH CARE PROVIDERS, INCLUDING
42 APPROPRIATE TRANSMISSION OF PATIENT HEALTH RECORDS.
43 S 3. Subdivision 4 of section 2951 of the public health law is
44 REPEALED.
45 S 4. Section 2956 of the public health law is REPEALED.
46 S 5. Section 225 of the public health law is amended by adding a new
47 subdivision 13 to read as follows:
48 13. THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL SHALL REVIEW THE
49 TYPE OF PROCEDURES PERFORMED IN OUTPATIENT SETTINGS, INCLUDING PRACTICES
50 REQUIRED TO REPORT ADVERSE EVENTS UNDER SECTION TWO HUNDRED THIRTY-D OF
51 THIS ARTICLE AND HEALTH CARE FACILITIES LICENSED UNDER ARTICLE
52 TWENTY-EIGHT OF THIS CHAPTER THAT PROVIDE AMBULATORY SURGERY SERVICES,
53 FOR PURPOSES OF:
54 (A) IDENTIFYING THE TYPES OF PROCEDURES PERFORMED AND TYPES OF
55 ANESTHESIA/SEDATION ADMINISTERED IN SUCH SETTINGS;
A. 6007 59
1 (B) CONSIDERING WHETHER IT IS APPROPRIATE FOR SUCH PROCEDURES OR
2 ANESTHESIA/SEDATION TO BE PERFORMED IN SUCH SETTINGS;
3 (C) CONSIDERING WHETHER SETTINGS PERFORMING SUCH PROCEDURES OR ADMIN-
4 ISTERING SUCH ANESTHESIA/SEDATION ARE SUBJECT TO SUFFICIENT OVERSIGHT;
5 (D) CONSIDERING WHETHER SETTINGS PERFORMING SUCH PROCEDURES OR ADMIN-
6 ISTERING SUCH ANESTHESIA/SEDATION ARE SUBJECT TO AN EQUIVALENT LEVEL OF
7 OVERSIGHT REGARDLESS OF SETTING; AND
8 (E) MAKING RECOMMENDATIONS TO THE DEPARTMENT REGARDING THE FOREGOING.
9 S 6. This act shall take effect immediately, provided, however, that
10 subdivision 2 of section 230-e of the public health law, as added by
11 section two of this act, shall take effect January 1, 2017; subdivision
12 3 of section 230-e of the public health law, as added by section two of
13 this act, shall take effect January 1, 2016; and regulations shall be
14 adopted or amended pursuant to subdivision 5 of section 230-e of the
15 public health law, as added by section two of this act, on or before
16 January 1, 2016, and shall not take effect until January 1, 2017.
17 PART I
18 Section 1. Subdivision 2-a of section 2781 of the public health law is
19 REPEALED.
20 S 2. The civil practice law and rules is amended by adding a new
21 section 4519-a to read as follows:
22 S 4519-A. POSSESSION OF CONDOMS; RECEIPT INTO EVIDENCE. POSSESSION OF
23 A CONDOM MAY NOT BE RECEIVED IN EVIDENCE IN ANY TRIAL, HEARING OR
24 PROCEEDING PURSUANT TO SUBDIVISION ONE OF SECTION TWELVE AND ARTICLE TEN
25 OF THE MULTIPLE DWELLING LAW, SECTIONS TWELVE-A AND TWENTY-THREE HUNDRED
26 TWENTY OF THE PUBLIC HEALTH LAW, SECTION TWO HUNDRED THIRTY-ONE OF THE
27 REAL PROPERTY LAW OR SUBDIVISION FIVE OF SECTION SEVEN HUNDRED ELEVEN
28 AND SECTION SEVEN HUNDRED FIFTEEN OF THE REAL PROPERTY ACTIONS AND
29 PROCEEDINGS LAW AS EVIDENCE OF PROSTITUTION, PATRONIZING A PROSTITUTE,
30 PROMOTING PROSTITUTION, PERMITTING PROSTITUTION, MAINTAINING A PREMISES
31 FOR PROSTITUTION, LEWDNESS OR ASSIGNATION, OR MAINTAINING A BAWDY HOUSE.
32 S 2-a. The criminal procedure law is amended by adding a new section
33 60.47 to read as follows:
34 S 60.47 POSSESSION OF CONDOMS; RECEIPT INTO EVIDENCE.
35 EVIDENCE THAT A PERSON WAS IN POSSESSION OF ONE OR MORE CONDOMS MAY
36 NOT BE ADMITTED AT ANY TRIAL, HEARING OR OTHER PROCEEDING IN A PROSE-
37 CUTION FOR ANY OFFENSE, OR AN ATTEMPT TO COMMIT ANY OFFENSE, DEFINED IN
38 ARTICLE TWO HUNDRED THIRTY OR SECTION 240.37 OF THE PENAL LAW FOR THE
39 PURPOSE OF ESTABLISHING PROBABLE CAUSE FOR AN ARREST OR PROVING ANY
40 PERSON'S COMMISSION OR ATTEMPTED COMMISSION OF SUCH OFFENSE.
41 S 2-b. Section 841 of the executive law is amended by adding a new
42 subdivision 7-b to read as follows:
43 7-B. TAKE SUCH STEPS AS MAY BE NECESSARY TO ENSURE THAT ALL POLICE
44 OFFICERS AND PEACE OFFICERS CERTIFIED PURSUANT TO SUBDIVISION THREE OF
45 THIS SECTION RECEIVE APPROPRIATE INSTRUCTION REGARDING THE EVIDENTIARY
46 PROHIBITION SET FORTH IN SECTION 60.47 OF THE CRIMINAL PROCEDURE LAW
47 RELATING TO THE INTRODUCTION OF CONDOMS INTO EVIDENCE IN CERTAIN CRIMI-
48 NAL PROSECUTIONS;
49 S 3. The opening paragraph of section 220.03 of the penal law, as
50 amended by chapter 154 of the laws of 2011, is amended to read as
51 follows:
52 A person is guilty of criminal possession of a controlled substance in
53 the seventh degree when he or she knowingly and unlawfully possesses a
54 controlled substance; provided, however, that it shall not be a
A. 6007 60
1 violation of this section when a person possesses a residual amount of a
2 controlled substance and that residual amount is in or on a hypodermic
3 syringe or hypodermic needle [obtained and possessed pursuant to section
4 thirty-three hundred eighty-one of the public health law]; nor shall it
5 be a violation of this section when a person's unlawful possession of a
6 controlled substance is discovered as a result of seeking immediate
7 health care as defined in paragraph (b) of subdivision three of section
8 220.78 of [the penal law] THIS ARTICLE, for either another person or him
9 or herself because such person is experiencing a drug or alcohol over-
10 dose or other life threatening medical emergency as defined in paragraph
11 (a) of subdivision three of section 220.78 of [the penal law] THIS ARTI-
12 CLE.
13 S 4. Section 220.45 of the penal law is REPEALED.
14 S 5. Subdivision 2 of section 850 of the general business law, as
15 amended by chapter 812 of the laws of 1980, is amended to read as
16 follows:
17 2. (A) "Drug-related paraphernalia" consists of the following objects
18 used for the following purposes:
19 [(a)] (I) Kits, used or designed for the purpose of planting, propa-
20 gating, cultivating, growing or harvesting of any species of plant which
21 is a controlled substance or from which a controlled substance can be
22 derived;
23 [(b)] (II) Kits, used or designed for the purpose of manufacturing,
24 compounding, converting, producing, or preparing controlled substances;
25 [(c)] (III) Isomerization devices, used or designed for the purpose of
26 increasing the potency of any species of plant which is a controlled
27 substance;
28 [(d)] (IV) Scales and balances, used or designed for the purpose of
29 weighing or measuring controlled substances;
30 [(e)] (V) Diluents and adulterants, including but not limited to
31 quinine hydrochloride, mannitol, mannite, dextrose and lactose, used or
32 designed for the purpose of cutting controlled substances;
33 [(f)] (VI) Separation gins, used or designed for the purpose of remov-
34 ing twigs and seeds in order to clean or refine marihuana;
35 [(g) Hypodermic syringes, needles and other objects, used or designed
36 for the purpose of parenterally injecting controlled substances into the
37 human body;
38 (h)] AND
39 (VII) Objects, used or designed for the purpose of ingesting, inhal-
40 ing, or otherwise introducing marihuana, cocaine, hashish, or hashish
41 oil into the human body.
42 (B) "DRUG-RELATED PARAPHERNALIA" SHALL NOT INCLUDE HYPODERMIC NEEDLES,
43 HYPODERMIC SYRINGES AND OTHER OBJECTS USED FOR THE PURPOSE OF PARENTER-
44 ALLY INJECTING CONTROLLED SUBSTANCES INTO THE HUMAN BODY.
45 S 6. Section 3381 of the public health law, as amended by section 9-a
46 of part B of chapter 58 of the laws of 2007, subdivisions 1, 2 and 3 as
47 amended by chapter 178 of the laws of 2010, is amended to read as
48 follows:
49 S 3381. Sale and possession of hypodermic syringes and hypodermic
50 needles. 1. It shall be unlawful for any person to sell or furnish to
51 another person or persons, a hypodermic syringe or hypodermic needle
52 except:
53 (a) pursuant to a prescription of a practitioner, which for the
54 purposes of this section shall include a patient specific prescription
55 form as provided for in the education law; or
A. 6007 61
1 (b) to persons who have been authorized by the commissioner to obtain
2 and possess such instruments; or
3 (c) by a pharmacy licensed under article one hundred thirty-seven of
4 the education law, health care facility licensed under article twenty-
5 eight of this chapter or a health care practitioner who is otherwise
6 authorized to prescribe the use of hypodermic needles or syringes within
7 his or her scope of practice; provided, however, that such sale or
8 furnishing: (i) shall only be to a person eighteen years of age or
9 older; AND (ii) [shall be limited to a quantity of ten or less hypoderm-
10 ic needles or syringes; and (iii)] shall be in accordance with subdivi-
11 sion [five] FOUR of this section[.] ; OR
12 (D) UNDER SUBDIVISION THREE OF THIS SECTION.
13 2. [It shall be unlawful for any person to obtain or possess a hypo-
14 dermic syringe or hypodermic needle unless such possession has been
15 authorized by the commissioner or is pursuant to a prescription, or is
16 pursuant to subdivision five of this section.
17 3.] Any person selling or furnishing a hypodermic syringe or hypoderm-
18 ic needle pursuant to a prescription shall record upon the prescription,
19 his or her signature or electronic signature, and the date of the sale
20 or furnishing of the hypodermic syringe or hypodermic needle. Such
21 prescription shall be retained on file for a period of five years and be
22 readily accessible for inspection by any public officer or employee
23 engaged in the enforcement of this section. Such prescription may be
24 refilled not more than the number of times specifically authorized by
25 the prescriber upon the prescription, provided however no such authori-
26 zation shall be effective for a period greater than two years from the
27 date the prescription is signed.
28 [4] 3. The commissioner shall, subject to subdivision [five] FOUR of
29 this section, designate persons, or by regulation, classes of persons
30 who may obtain hypodermic syringes and hypodermic needles without
31 prescription and the manner in which such transactions may take place
32 and the records thereof which shall be maintained.
33 [5] 4. (a) A person eighteen years of age or older may obtain and
34 possess a hypodermic syringe or hypodermic needle pursuant to paragraph
35 (c) of subdivision one of this section.
36 (b) Subject to regulations of the commissioner, a pharmacy licensed
37 under article one hundred thirty-seven of the education law, a health
38 care facility licensed under article twenty-eight of this chapter or a
39 health care practitioner who is otherwise authorized to prescribe the
40 use of hypodermic needles or syringes within his or her scope of prac-
41 tice, may obtain and possess hypodermic needles or syringes for the
42 purpose of selling or furnishing them pursuant to paragraph (c) of
43 subdivision one of this section or for the purpose of disposing of
44 them[, provided that such pharmacy, health care facility or health care
45 practitioner has registered with the department].
46 (c) Sale or furnishing of hypodermic syringes or hypodermic needles to
47 direct consumers pursuant to this subdivision by a pharmacy, health care
48 facility, or health care practitioner shall be accompanied by a safety
49 insert. Such safety insert shall be developed or approved by the commis-
50 sioner and shall include, but not be limited to, (i) information on the
51 proper use of hypodermic syringes and hypodermic needles; (ii) the risk
52 of blood borne diseases that may result from the use of hypodermic
53 syringes and hypodermic needles; (iii) methods for preventing the trans-
54 mission or contraction of blood borne diseases; (iv) proper hypodermic
55 syringe and hypodermic needle disposal practices; (v) information on the
56 dangers of injection drug use, and how to access drug treatment; (vi) a
A. 6007 62
1 toll-free phone number for information on the human immunodeficiency
2 virus; and (vii) information on the safe disposal of hypodermic syringes
3 and hypodermic needles including the relevant provisions of the environ-
4 mental conservation law relating to the unlawful release of regulated
5 medical waste. The safety insert shall be attached to or included in the
6 hypodermic syringe and hypodermic needle packaging, or shall be given to
7 the purchaser at the point of sale or furnishing in brochure form.
8 (d) In addition to the requirements of paragraph (c) of subdivision
9 one of this section, a pharmacy licensed under article one hundred thir-
10 ty-seven of the education law may sell or furnish hypodermic needles or
11 syringes only if such pharmacy[: (i) does not advertise to the public
12 the availability for retail sale or furnishing of hypodermic needles or
13 syringes without a prescription; and (ii) at any location where hypo-
14 dermic needles or syringes are kept for retail sale or furnishing,]
15 stores such needles and syringes in a manner that makes them available
16 only to authorized personnel and not openly available to customers.
17 (e) The commissioner shall promulgate rules and regulations necessary
18 to implement the provisions of this subdivision which shall include: (I)
19 STANDARDS FOR ADVERTISING TO THE PUBLIC THE AVAILABILITY FOR RETAIL SALE
20 OR FURNISHING OF HYPODERMIC SYRINGES OR NEEDLES; AND (II) a requirement
21 that such pharmacies, health care facilities and health care practition-
22 ers cooperate in a safe disposal of used hypodermic needles or syringes.
23 (f) The commissioner may, upon the finding of a violation of this
24 section, suspend for a determinate period of time the sale or furnishing
25 of syringes by a specific entity.
26 [6] 5. The provisions of this section shall not apply to farmers
27 engaged in livestock production or to those persons supplying farmers
28 engaged in livestock production, provided that:
29 (a) Hypodermic syringes and needles shall be stored in a secure,
30 locked storage container.
31 (b) At any time the department may request a document outlining:
32 (i) the number of hypodermic needles and syringes purchased over the
33 past calendar year;
34 (ii) a record of all hypodermic needles used over the past calendar
35 year; and
36 (iii) a record of all hypodermic needles and syringes destroyed over
37 the past calendar year.
38 (c) Hypodermic needles and syringes shall be destroyed in a manner
39 consistent with the provisions set forth in section thirty-three hundred
40 eighty-one-a of this article.
41 S 7. Intentionally omitted.
42 S 8. This act shall take effect immediately.
43 PART J
44 Section 1. Subparagraph (v) of paragraph a of subdivision 1 of section
45 6908 of the education law is renumbered subparagraph (vi) and a new
46 subparagraph (v) is added to read as follows:
47 (V) ADVANCED TASKS PROVIDED BY AN ADVANCED HOME HEALTH AIDE IN ACCORD-
48 ANCE WITH REGULATIONS DEVELOPED BY THE COMMISSIONER, IN CONSULTATION
49 WITH THE COMMISSIONER OF HEALTH WHICH, AT A MINIMUM, SHALL: (1) SPECIFY
50 THE ADVANCED TASKS THAT MAY BE PERFORMED BY ADVANCED HOME HEALTH AIDES
51 PURSUANT TO THIS SUBPARAGRAPH, WHICH SHALL INCLUDE THE ADMINISTRATION OF
52 MEDICATIONS WHICH ARE ROUTINE AND PREFILLED OR OTHERWISE PACKAGED IN A
53 MANNER THAT PROMOTES RELATIVE EASE OF ADMINISTRATION, PROVIDED THAT
54 ADMINISTRATION OF MEDICATIONS BY INJECTION OTHER THAN INSULIN FOR
A. 6007 63
1 DIABETES CARE, STERILE PROCEDURES, AND CENTRAL LINE MAINTENANCE SHALL BE
2 PROHIBITED, AND PROVIDED FURTHER THAT A SYSTEM SHALL BE ESTABLISHED THAT
3 ADDRESSES DRUG DIVERSION; (2) SPECIFY THAT PARTICIPATION IN THIS PROGRAM
4 SHALL BE VOLUNTARY AND SUCH ADVANCED TASKS PROVIDED BY AN ADVANCED HOME
5 HEALTH AIDE SHALL BE AT THE OPTION OF THE INDIVIDUAL; (3) PROVIDE THAT
6 ADVANCED TASKS PERFORMED BY ADVANCED HOME HEALTH AIDES MAY BE PERFORMED
7 ONLY UNDER THE DIRECT SUPERVISION OF A REGISTERED PROFESSIONAL NURSE
8 LICENSED IN NEW YORK STATE AND EMPLOYED BY A HOME CARE SERVICES AGENCY
9 LICENSED OR CERTIFIED PURSUANT TO ARTICLE THIRTY-SIX OR HOSPICE PROGRAM
10 CERTIFIED PURSUANT TO ARTICLE FORTY OF THE PUBLIC HEALTH LAW, WHERE SUCH
11 NURSING SUPERVISION (A) INCLUDES TRAINING AND PERIODIC ASSESSMENT OF THE
12 PERFORMANCE OF ADVANCED TASKS, (B) SHALL BE DETERMINED BY THE REGISTERED
13 PROFESSIONAL NURSE RESPONSIBLE FOR SUPERVISING SUCH ADVANCED TASKS BASED
14 UPON THE COMPLEXITY OF SUCH ADVANCED TASKS, THE SKILL AND EXPERIENCE OF
15 THE ADVANCED HOME HEALTH AIDE, AND THE HEALTH STATUS OF THE INDIVIDUAL
16 FOR WHOM SUCH ADVANCED TASKS ARE BEING PERFORMED, AND (C) INCLUDES A
17 COMPREHENSIVE INITIAL AND THEREAFTER REGULAR AND ONGOING ASSESSMENT OF
18 THE INDIVIDUAL'S NEEDS; PROVIDED THAT THE REGISTERED PROFESSIONAL NURSE
19 RESPONSIBLE FOR SUPERVISING SUCH ADVANCED TASKS SHALL VISIT INDIVIDUALS
20 RECEIVING ACUTE SERVICES NO LESS THAN ONCE PER MONTH AND INDIVIDUALS
21 RECEIVING MAINTENANCE CARE NO LESS THAN ONCE EVERY SIX MONTHS AND
22 PROVIDED FURTHER THAT A REGISTERED PROFESSIONAL NURSE SHALL BE AVAILABLE
23 BY TELEPHONE TO THE ADVANCED HOME HEALTH AIDE TWENTY-FOUR HOURS A DAY,
24 SEVEN DAYS A WEEK; THE COMMISSIONER OF HEALTH SHALL, IN CONSULTATION
25 WITH THE COMMISSIONER, DETERMINE APPROPRIATE STAFFING RATIOS TO ENSURE
26 ADEQUATE NURSING SUPERVISION THAT SHALL NOT EXCEED ONE FULL TIME EQUIV-
27 ALENT OF A REGISTERED PROFESSIONAL NURSE TO FIFTY INDIVIDUALS RECEIVING
28 SERVICES; (4) ESTABLISH A PROCESS BY WHICH A REGISTERED PROFESSIONAL
29 NURSE MAY DELEGATE ADVANCED TASKS TO AN ADVANCED HOME HEALTH AIDE
30 PROVIDED THAT SUCH PROCESS SHALL INCLUDE, BUT NOT BE LIMITED TO (A)
31 ALLOWING DELEGATION OF ADVANCED TASKS TO AN ADVANCED HOME HEALTH AIDE
32 ONLY WHERE SUCH ADVANCED HOME HEALTH AIDE HAS DEMONSTRATED TO THE SATIS-
33 FACTION OF THE SUPERVISING REGISTERED PROFESSIONAL NURSE COMPETENCY IN
34 EVERY ADVANCED TASK THAT SUCH ADVANCED HOME HEALTH AIDE IS AUTHORIZED TO
35 PERFORM, (B) AUTHORIZING THE SUPERVISING REGISTERED PROFESSIONAL NURSE
36 TO REVOKE ANY DELEGATED ADVANCED TASK FROM AN ADVANCED HOME HEALTH AIDE
37 FOR ANY REASON, AND (C) AUTHORIZING MULTIPLE REGISTERED PROFESSIONAL
38 NURSES TO JOINTLY AGREE TO DELEGATE ADVANCED TASKS TO AN ADVANCED HOME
39 HEALTH AIDE, PROVIDED FURTHER THAT ONLY ONE REGISTERED PROFESSIONAL
40 NURSE SHALL BE REQUIRED TO DETERMINE THE ADVANCED HOME HEALTH AIDE HAS
41 DEMONSTRATED COMPETENCY IN THE ADVANCED TASK TO BE PERFORMED; (5)
42 PROVIDE THAT ADVANCED TASKS MAY BE PERFORMED ONLY IN ACCORDANCE WITH AND
43 PURSUANT TO AN AUTHORIZED PRACTITIONER'S ORDERED CARE; (6) PROVIDE THAT
44 ONLY A HOME HEALTH AIDE WHO HAS AT LEAST ONE YEAR OF EXPERIENCE AS A
45 CERTIFIED HOME HEALTH AIDE, HAS COMPLETED THE REQUISITE TRAINING AND
46 DEMONSTRATED COMPETENCIES OF AN ADVANCED HOME HEALTH AIDE AS DETERMINED
47 BY THE COMMISSIONER OF HEALTH, HAS SUCCESSFULLY COMPLETED COMPETENCY
48 EXAMINATIONS SATISFACTORY TO AND DEVELOPED OR APPROVED BY THE COMMIS-
49 SIONER OF HEALTH AND MEETS OTHER APPROPRIATE QUALIFICATIONS AS DETER-
50 MINED BY THE COMMISSIONER OF HEALTH MAY PERFORM ADVANCED TASKS AS AN
51 ADVANCED HOME HEALTH AIDE; (7) PROVIDE THAT ONLY AN INDIVIDUAL WHO IS
52 LISTED IN THE HOME CARE SERVICES REGISTRY MAINTAINED BY THE DEPARTMENT
53 OF HEALTH PURSUANT TO SUBDIVISION NINE OF SECTION THIRTY-SIX HUNDRED
54 THIRTEEN OF THE PUBLIC HEALTH LAW AS HAVING SATISFIED ALL APPLICABLE
55 TRAINING REQUIREMENTS AND HAVING PASSED THE APPLICABLE COMPETENCY EXAM-
56 INATIONS AND WHO MEETS OTHER REQUIREMENTS AS SET FORTH IN REGULATIONS
A. 6007 64
1 ISSUED BY THE COMMISSIONER OF HEALTH PURSUANT TO SUBDIVISION SEVENTEEN
2 OF SECTION THIRTY-SIX HUNDRED TWO OF THE PUBLIC HEALTH LAW MAY PERFORM
3 ADVANCED TASKS PURSUANT TO THIS SUBPARAGRAPH AND MAY HOLD HIMSELF OR
4 HERSELF OUT AS AN ADVANCED HOME HEALTH AIDE; (8) ESTABLISH MINIMUM STAN-
5 DARDS OF TRAINING FOR THE PERFORMANCE OF ADVANCED TASKS BY ADVANCED HOME
6 HEALTH AIDES, INCLUDING (A) DIDACTIC TRAINING, (B) CLINICAL TRAINING,
7 AND (C) A SUPERVISED CLINICAL PRACTICUM WITH STANDARDS SET FORTH BY THE
8 COMMISSIONER OF HEALTH; (9) PROVIDE THAT ADVANCED HOME HEALTH AIDES
9 SHALL RECEIVE CASE-SPECIFIC TRAINING ON THE ADVANCED TASKS TO BE
10 ASSIGNED BY THE SUPERVISING NURSE, PROVIDED THAT ADDITIONAL TRAINING
11 SHALL TAKE PLACE WHENEVER ADDITIONAL ADVANCED TASKS ARE ASSIGNED; (10)
12 PROHIBIT AN ADVANCED HOME HEALTH AIDE FROM HOLDING HIMSELF OR HERSELF
13 OUT, OR ACCEPTING EMPLOYMENT AS, A PERSON LICENSED TO PRACTICE NURSING
14 UNDER THE PROVISIONS OF THIS ARTICLE; (11) PROVIDE THAT AN ADVANCED HOME
15 HEALTH AIDE IS NOT REQUIRED NOR PERMITTED TO ASSESS THE MEDICATION OR
16 MEDICAL NEEDS OF AN INDIVIDUAL; (12) PROVIDE THAT AN ADVANCED HOME
17 HEALTH AIDE SHALL NOT BE AUTHORIZED TO PERFORM ANY ADVANCED TASKS OR
18 ACTIVITIES PURSUANT TO THIS SUBPARAGRAPH THAT ARE OUTSIDE THE SCOPE OF
19 PRACTICE OF A LICENSED PRACTICAL NURSE OR ANY ADVANCED TASKS THAT HAVE
20 NOT BEEN APPROPRIATELY DELEGATED BY THE SUPERVISING REGISTERED PROFES-
21 SIONAL NURSE; (13) PROVIDE THAT AN ADVANCED HOME HEALTH AIDE SHALL DOCU-
22 MENT MEDICATION ADMINISTRATION TO EACH INDIVIDUAL THROUGH THE USE OF A
23 MEDICATION ADMINISTRATION RECORD; (14) PROVIDE THAT THE SUPERVISING
24 REGISTERED PROFESSIONAL NURSE SHALL RETAIN THE DISCRETION TO DECIDE
25 WHETHER TO ASSIGN ADVANCED TASKS TO ADVANCED HOME HEALTH AIDES UNDER
26 THIS PROGRAM AND THE ADVANCED HOME HEALTH AIDE SHALL RETAIN THE
27 DISCRETION TO REFUSE A DELEGATED ADVANCED TASK AND SHALL NOT BE SUBJECT
28 TO COERCION OR THE THREAT OF RETALIATION; (15) NOTWITHSTANDING ANY
29 PROVISIONS OF SECTIONS SEVEN HUNDRED FORTY AND SEVEN HUNDRED FORTY-ONE
30 OF THE LABOR LAW TO THE CONTRARY, THE PROTECTIONS PROVIDED IN SUCH
31 SECTIONS SHALL APPLY TO INDIVIDUALS PROVIDING SUPERVISION OR ADVANCED
32 TASKS PURSUANT TO THIS SUBPARAGRAPH; AND (16) PROVIDE THAT NO ADVANCED
33 TASKS, OTHER THAN ADMINISTRATION OF MEDICATION, MAY BE PERFORMED PRIOR
34 TO JANUARY FIRST, TWO THOUSAND SEVENTEEN; PROVIDED THAT IN DEVELOPING
35 SUCH REGULATIONS, THE COMMISSIONER SHALL TAKE INTO ACCOUNT THE RECOMMEN-
36 DATIONS OF A WORKGROUP OF STAKEHOLDERS CONVENED BY THE COMMISSIONER OF
37 HEALTH IN CONSULTATION WITH THE COMMISSIONER FOR THE PURPOSE OF PROVID-
38 ING GUIDANCE ON THE FOREGOING; OR
39 S 2. Section 206 of the public health law is amended by adding a new
40 subdivision 29 to read as follows:
41 29. THE COMMISSIONER SHALL NOTIFY THE COMMISSIONER OF EDUCATION IN
42 ANY INSTANCE IN WHICH A REGISTERED PROFESSIONAL NURSE ENGAGES IN IMPROP-
43 ER BEHAVIOR WHILE SUPERVISING AN ADVANCED HOME HEALTH AIDE PURSUANT TO
44 SUBPARAGRAPH (V) OF PARAGRAPH A OF SUBDIVISION ONE OF SECTION SIXTY-NINE
45 HUNDRED EIGHT OF THE EDUCATION LAW.
46 S 3. Section 3602 of the public health law is amended by adding a new
47 subdivision 17 to read as follows:
48 17. "ADVANCED HOME HEALTH AIDES" MEANS HOME HEALTH AIDES WHO ARE
49 AUTHORIZED TO PERFORM ADVANCED TASKS AS DELINEATED IN SUBPARAGRAPH (V)
50 OF PARAGRAPH A OF SUBDIVISION ONE OF SECTION SIXTY-NINE HUNDRED EIGHT OF
51 THE EDUCATION LAW AND REGULATIONS ISSUED BY THE COMMISSIONER OF EDUCA-
52 TION RELATING THERETO. THE COMMISSIONER SHALL PROMULGATE REGULATIONS
53 REGARDING SUCH AIDES, WHICH SHALL INCLUDE TRAINING, DEMONSTRATED COMPE-
54 TENCIES, COMPETENCY EXAMINATIONS, AND OTHER APPROPRIATE QUALIFICATIONS,
55 AS WELL AS A PROCESS FOR THE LIMITATION OR REVOCATION OF THE ADVANCED
A. 6007 65
1 HOME HEALTH AIDE'S AUTHORIZATION TO PERFORM ADVANCED TASKS IN APPROPRI-
2 ATE CASES.
3 S 4. Subdivision 9 of section 3613 of the public health law is renum-
4 bered subdivision 10 and a new subdivision 9 is added to read as
5 follows:
6 9. THE DEPARTMENT SHALL INDICATE WITHIN THE HOME CARE SERVICES WORKER
7 REGISTRY WHEN A HOME HEALTH AIDE HAS SATISFIED ALL APPLICABLE TRAINING
8 AND RECERTIFICATION REQUIREMENTS AND HAS PASSED THE APPLICABLE COMPETEN-
9 CY EXAMINATIONS NECESSARY TO PERFORM ADVANCED TASKS PURSUANT TO SUBPARA-
10 GRAPH (V) OF PARAGRAPH A OF SUBDIVISION ONE OF SECTION SIXTY-NINE
11 HUNDRED EIGHT OF THE EDUCATION LAW AND REGULATIONS ISSUED THERETO. ANY
12 LIMITATION OR REVOCATION OF THE ADVANCED HOME HEALTH AIDE'S AUTHORI-
13 ZATION ALSO SHALL BE INDICATED ON THE REGISTRY.
14 S 5. In developing regulations required under subparagraph (v) of
15 paragraph a of subdivision 1 of section 6908 of the education law, as
16 added by section one of this act, the commissioner of education shall
17 take into consideration the recommendations of the workgroup of stake-
18 holders convened by the commissioner of health to provide guidance on
19 the tasks which may be performed by advanced home health aides pursuant
20 to such section including, but not limited to, recommendations encom-
21 passing the following matters:
22 (a) the advanced tasks that appropriately could be performed by
23 advanced home health aides with appropriate training and supervision;
24 (b) the types of medications that advanced home health aides should be
25 authorized to administer, including whether controlled substances should
26 be authorized;
27 (c) qualifications that must be satisfied by advanced home health
28 aides to perform such advanced tasks, including those related to experi-
29 ence, training, moral character, and examination requirements;
30 (d) minimum training and education standards; and
31 (e) adequate levels of supervision to be provided by nurses, including
32 adherence to existing requirements for comprehensive assessment and any
33 additional assessment that should be required, including when the indi-
34 vidual receiving advanced tasks performed by an advanced home health
35 aide experiences a significant change in condition.
36 On or before July 1, 2015, the commissioner of health shall, in
37 consultation with the commissioner of education, issue a report to the
38 governor and the chairs of the senate and assembly health and higher
39 education committees setting forth the recommendations of the workgroup.
40 S 6. On or before January 1, 2019, the commissioner of health shall,
41 in consultation with the commissioner of education, issue a report on
42 the implementation of advanced home health aides in the state. Such
43 report shall include the number of advanced home health aides authorized
44 pursuant to this act; the types of advanced tasks that advanced home
45 health aides are performing; the number of individuals who were moved
46 out of institutionalized settings as a direct result of this act; the
47 extent to which advanced home health aides contributed to the improve-
48 ment of quality care of these individuals; the number of adverse
49 outcomes, including medication errors, that were reported to the depart-
50 ment of health; any reports of or issues with drug diversion; and the
51 number of advanced home health aides who had their authorization limited
52 or revoked. Such report shall provide recommendations to the governor
53 and the chairs of the senate and assembly health and higher education
54 committees regarding the extension and/or alteration of these provisions
55 and make any other recommendations related to the implementation of
56 advanced home health aides pursuant to this act.
A. 6007 66
1 S 7. This act shall take effect immediately; provided that:
2 a. section one of this act shall take effect January 1, 2016. Effec-
3 tive immediately, the commissioner of education is authorized to adopt
4 or amend regulations necessary to implement the provisions of section
5 one of this act on or before such effective date; provided, further,
6 that no advanced tasks shall be performed pursuant to the provisions of
7 subparagraph (v) of paragraph a of subdivision 1 of section 6908 of the
8 education law, as added by section one of this act, until such regu-
9 lations are adopted and except in conformance with such regulations; and
10 b. this act shall expire and be deemed repealed June 30, 2019.
11 PART K
12 Section 1. Subdivisions 1, 2 and 3 of section 2802 of the public
13 health law, subdivisions 1 and 2 as amended by section 58 of part A of
14 chapter 58 of the laws of 2010, subdivision 3 as amended by chapter 609
15 of the laws of 1982 and paragraph (e) of subdivision 3 as amended by
16 chapter 731 of the laws of 1993, are amended to read as follows:
17 1. An application for such construction shall be filed with the
18 department, together with such other forms and information as shall be
19 prescribed by, or acceptable to, the department. Thereafter the depart-
20 ment shall forward a copy of the application and accompanying documents
21 to the public health and health planning council, and the health systems
22 agency, if any, having geographical jurisdiction of the area where the
23 hospital is located.
24 2. The commissioner shall not act upon an application for construction
25 of a hospital until the public health and health planning council and
26 the health systems agency have had a reasonable time to submit their
27 recommendations, and unless (a) the applicant has obtained all approvals
28 and consents required by law for its incorporation or establishment
29 (including the approval of the public health and health planning council
30 pursuant to the provisions of this article) provided, however, that the
31 commissioner may act upon an application for construction by an appli-
32 cant possessing a valid operating certificate when the application qual-
33 ifies for review without the recommendation of the council pursuant to
34 regulations adopted by the council and approved by the commissioner; and
35 (b) the commissioner is satisfied as to the public need for the
36 construction, at the time and place and under the circumstances
37 proposed, provided however that[,] in the case of an application by a
38 hospital established or operated by an organization defined in subdivi-
39 sion one of section four hundred eighty-two-b of the social services
40 law, the needs of the members of the religious denomination concerned,
41 for care or treatment in accordance with their religious or ethical
42 convictions, shall be deemed to be public need[.]; AND FURTHER PROVIDED
43 THAT: (I) AN APPLICATION BY A GENERAL HOSPITAL OR DIAGNOSTIC AND TREAT-
44 MENT CENTER, ESTABLISHED UNDER THIS ARTICLE, TO CONSTRUCT A FACILITY TO
45 PROVIDE PRIMARY CARE SERVICES, AS DEFINED IN REGULATION, MAY BE APPROVED
46 WITHOUT REGARD FOR PUBLIC NEED; OR (II) AN APPLICATION BY A GENERAL
47 HOSPITAL OR A DIAGNOSTIC AND TREATMENT CENTER, ESTABLISHED UNDER THIS
48 ARTICLE, TO UNDERTAKE CONSTRUCTION THAT DOES NOT INVOLVE A CHANGE IN
49 CAPACITY, THE TYPES OF SERVICES PROVIDED, MAJOR MEDICAL EQUIPMENT,
50 FACILITY REPLACEMENT, OR THE GEOGRAPHIC LOCATION OF SERVICES, MAY BE
51 APPROVED WITHOUT REGARD FOR PUBLIC NEED.
52 3. Subject to the provisions of paragraph (b) of subdivision two OF
53 THIS SECTION, the commissioner in approving the construction of a hospi-
54 tal shall take into consideration and be empowered to request informa-
A. 6007 67
1 tion and advice as to (a) the availability of facilities or services
2 such as preadmission, ambulatory or home care services which may serve
3 as alternatives or substitutes for the whole or any part of the proposed
4 hospital construction;
5 (b) the need for special equipment in view of existing utilization of
6 comparable equipment at the time and place and under the circumstances
7 proposed;
8 (c) the possible economies and improvements in service to be antic-
9 ipated from the operation of joint central services including, but not
10 limited to laboratory, research, radiology, pharmacy, laundry and
11 purchasing;
12 (d) the adequacy of financial resources and sources of future revenue,
13 PROVIDED THAT THE COMMISSIONER MAY, BUT IS NOT REQUIRED TO, CONSIDER THE
14 ADEQUACY OF FINANCIAL RESOURCES AND SOURCES OF FUTURE REVENUE IN
15 RELATION TO APPLICATIONS UNDER SUBPARAGRAPHS (I) AND (II) OF PARAGRAPH
16 (B) OF SUBDIVISION TWO OF THIS SECTION; and
17 (e) whether the facility is currently in substantial compliance with
18 all applicable codes, rules and regulations, provided, however, that the
19 commissioner shall not disapprove an application solely on the basis
20 that the facility is not currently in substantial compliance, if the
21 application is specifically:
22 (i) to correct life safety code or patient care deficiencies;
23 (ii) to correct deficiencies which are necessary to protect the life,
24 health, safety and welfare of facility patients, residents or staff;
25 (iii) for replacement of equipment that no longer meets the generally
26 accepted operational standards existing for such equipment at the time
27 it was acquired; and
28 (iv) for decertification of beds and services.
29 S 2. Subdivisions 1, 2 and 3 of section 2807-z of the public health
30 law, as amended by chapter 400 of the laws of 2012, are amended to read
31 as follows:
32 1. Notwithstanding any provision of this chapter or regulations or any
33 other state law or regulation, for any eligible capital project as
34 defined in subdivision six of this section, the department shall have
35 thirty days [of] AFTER receipt of the certificate of need OR
36 CONSTRUCTION application, PURSUANT TO SECTION TWENTY-EIGHT HUNDRED TWO
37 OF THIS ARTICLE, for a limited or administrative review to deem such
38 application complete. If the department determines the application is
39 incomplete or that more information is required, the department shall
40 notify the applicant in writing within thirty days of the date of the
41 application's submission, and the applicant shall have twenty business
42 days to provide additional information or otherwise correct the defi-
43 ciency in the application.
44 2. For an eligible capital project requiring a limited or administra-
45 tive review, within ninety days of the department deeming the applica-
46 tion complete, the department shall make a decision to approve or disap-
47 prove the certificate of need OR CONSTRUCTION application for such
48 project. If the department determines to disapprove the project, the
49 basis for such disapproval shall be provided in writing; however, disap-
50 proval shall not be based on the incompleteness of the application. If
51 the department fails to take action to approve or disapprove the appli-
52 cation within ninety days of the certificate of need application being
53 deemed complete, the application will be deemed approved.
54 3. For an eligible capital project requiring full review by the coun-
55 cil, the certificate of need OR CONSTRUCTION application shall be placed
A. 6007 68
1 on the next council agenda following the department deeming the applica-
2 tion complete.
3 S 3. Section 2801-a of the public health law is amended by adding a
4 new subdivision 3-b to read as follows:
5 3-B. NOTWITHSTANDING ANY OTHER PROVISIONS OF THIS CHAPTER TO THE
6 CONTRARY, THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL MAY APPROVE THE
7 ESTABLISHMENT OF DIAGNOSTIC OR TREATMENT CENTERS TO BE ISSUED OPERATING
8 CERTIFICATES FOR THE PURPOSE OF PROVIDING PRIMARY CARE, AS DEFINED BY
9 THE COMMISSIONER IN REGULATIONS, WITHOUT REGARD TO THE REQUIREMENTS OF
10 PUBLIC NEED AND FINANCIAL RESOURCES AS SET FORTH IN SUBDIVISION THREE OF
11 THIS SECTION.
12 S 4. Subdivision 3 of section 2801-a of the public health law, as
13 amended by section 57 of part A of chapter 58 of the laws of 2010, is
14 amended to read as follows:
15 3. The public health and health planning council shall not approve a
16 certificate of incorporation, articles of organization or application
17 for establishment unless it is satisfied, insofar as applicable, as to
18 (a) the public need for the existence of the institution at the time and
19 place and under the circumstances proposed, provided, however, that in
20 the case of an institution proposed to be established or operated by an
21 organization defined in subdivision one of section one hundred seventy-
22 two-a of the executive law, the needs of the members of the religious
23 denomination concerned, for care or treatment in accordance with their
24 religious or ethical convictions, shall be deemed to be public need; (b)
25 the character, competence, and standing in the community, of the
26 proposed incorporators, directors, sponsors, MEMBERS, PRINCIPAL MEMBERS,
27 stockholders, [members] PRINCIPAL STOCKHOLDERS or operators; with
28 respect to any proposed incorporator, director, sponsor, MEMBER, PRINCI-
29 PAL MEMBER, stockholder, [member] PRINCIPAL STOCKHOLDER or operator who
30 is already or within the past [ten] SEVEN years has been an incorpora-
31 tor, director, sponsor, member, principal stockholder, principal member,
32 or operator of any hospital, private proprietary home for adults, resi-
33 dence for adults, or non-profit home for the aged or blind which has
34 been issued an operating certificate by the state department of social
35 services, or a halfway house, hostel or other residential facility or
36 institution for the care, custody or treatment of the mentally disabled
37 which is subject to approval by the department of mental hygiene, no
38 approval shall be granted unless the public health and health planning
39 council, having afforded an adequate opportunity to members of health
40 systems agencies, if any, having geographical jurisdiction of the area
41 where the institution is to be located to be heard, shall affirmatively
42 find by substantial evidence as to each such incorporator, director,
43 sponsor, MEMBER, PRINCIPAL MEMBER, principal stockholder or operator
44 that a substantially consistent high level of care is being or was being
45 rendered in each such hospital, home, residence, halfway house, hostel,
46 or other residential facility or institution with which such person is
47 or was affiliated; for the purposes of this paragraph, the public health
48 and health planning council shall adopt rules and regulations, subject
49 to the approval of the commissioner, to establish the criteria to be
50 used to determine whether a substantially consistent high level of care
51 has been rendered, provided, however, that there shall not be a finding
52 that a substantially consistent high level of care has been rendered
53 where there have been violations of the state hospital code, or other
54 applicable rules and regulations, that (i) threatened to directly affect
55 the health, safety or welfare of any patient or resident, and (ii) were
56 recurrent or were not promptly corrected, UNLESS THE PROPOSED INCORPORA-
A. 6007 69
1 TOR, DIRECTOR, SPONSOR, MEMBER, PRINCIPAL MEMBER, STOCKHOLDER, PRINCIPAL
2 STOCKHOLDER, OR OPERATOR DEMONSTRATES, AND THE PUBLIC HEALTH AND HEALTH
3 PLANNING COUNCIL FINDS, THAT THE VIOLATIONS CANNOT BE ATTRIBUTED TO THE
4 ACTION OR INACTION OF SUCH PROPOSED INCORPORATOR, DIRECTOR, SPONSOR,
5 MEMBER, PRINCIPAL MEMBER, STOCKHOLDER, PRINCIPAL STOCKHOLDER, OR OPERA-
6 TOR DUE TO THE TIMING, EXTENT OR MANNER OF THE AFFILIATION; (c) the
7 financial resources of the proposed institution and its sources of
8 future revenues; and (d) such other matters as it shall deem pertinent.
9 S 5. Paragraphs (b) and (c) of subdivision 4 of section 2801-a of the
10 public health law, as amended by section 57 of part A of chapter 58 of
11 the laws of 2010, are amended to read as follows:
12 (b) [(i)] Any transfer, assignment or other disposition of ten percent
13 or more of [an] DIRECT OR INDIRECT interest or voting rights in [a part-
14 nership or limited liability company, which is the] AN operator of a
15 hospital to a new STOCKHOLDER, partner or member, OR ANY TRANSFER,
16 ASSIGNMENT OR OTHER DISPOSITION OF A DIRECT OR INDIRECT INTEREST OR
17 VOTING RIGHTS OF SUCH AN OPERATOR WHICH RESULTS IN THE OWNERSHIP OR
18 CONTROL OF MORE THAN TEN PERCENT OF THE INTEREST OR VOTING RIGHTS OF
19 SUCH OPERATOR BY ANY PERSON NOT PREVIOUSLY APPROVED BY THE PUBLIC HEALTH
20 AND HEALTH PLANNING COUNCIL, OR ITS PREDECESSOR, FOR THAT OPERATOR shall
21 be approved by the public health and health planning council, in accord-
22 ance with the provisions of subdivisions two and three of this section,
23 except that: (A) any such change shall be subject to the approval by the
24 public health and health planning council in accordance with paragraph
25 (b) of subdivision three of this section only with respect to the new
26 STOCKHOLDER, partner or member, and any remaining STOCKHOLDERS, partners
27 or members who have not been previously approved for that facility in
28 accordance with such paragraph, and (B) such change shall not be subject
29 to paragraph (a) of subdivision three of this section. IN THE ABSENCE OF
30 SUCH APPROVAL, THE OPERATING CERTIFICATE OF SUCH HOSPITAL SHALL BE
31 SUBJECT TO REVOCATION OR SUSPENSION.
32 [(ii)] (C) (I) With respect to a transfer, assignment or disposition
33 involving less than ten percent of [an] A DIRECT OR INDIRECT interest or
34 voting rights in [such partnership or limited liability company] AN
35 OPERATOR OF A HOSPITAL to a new STOCKHOLDER, partner or member, no prior
36 approval of the public health and health planning council shall be
37 required EXCEPT WHERE REQUIRED BY PARAGRAPH (B) OF THIS SUBDIVISION.
38 However, no such transaction shall be effective unless at least ninety
39 days prior to the intended effective date thereof, the [partnership or
40 limited liability company] OPERATOR fully completes and files with the
41 public health and health planning council notice on a form, to be devel-
42 oped by the public health and health planning council, which shall
43 disclose such information as may reasonably be necessary for the public
44 health and health planning council to determine whether it should bar
45 the transaction for any of the reasons set forth in item (A), (B), (C)
46 or (D) below. Within ninety days from the date of receipt of such
47 notice, the public health and health planning council may bar any trans-
48 action under this subparagraph: (A) if the equity position of the [part-
49 nership or limited liability company,] OPERATOR, determined in accord-
50 ance with generally accepted accounting principles, would be reduced as
51 a result of the transfer, assignment or disposition; (B) if the trans-
52 action would result in the ownership of a [partnership or membership]
53 DIRECT OR INDIRECT interest OR VOTING RIGHTS by any persons who have
54 been convicted of a felony described in subdivision five of section
55 twenty-eight hundred six of this article; (C) if there are reasonable
56 grounds to believe that the proposed transaction does not satisfy the
A. 6007 70
1 character and competence criteria set forth in subdivision three of this
2 section; or (D) UPON THE RECOMMENDATION OF THE DEPARTMENT, if the trans-
3 action, together with all transactions under this subparagraph for the
4 [partnership] OPERATOR, or successor, during any five year period would,
5 in the aggregate, involve twenty-five percent or more of the interest in
6 the [partnership] OPERATOR. The public health and health planning coun-
7 cil shall state specific reasons for barring any transaction under this
8 subparagraph and shall so notify each party to the proposed transaction.
9 [(iii) With respect to a transfer, assignment or disposition of an
10 interest or voting rights in such partnership or limited liability
11 company to any remaining partner or member, which transaction involves
12 the withdrawal of the transferor from the partnership or limited liabil-
13 ity company, no prior approval of the public health and health planning
14 council shall be required. However, no such transaction shall be effec-
15 tive unless at least ninety days prior to the intended effective date
16 thereof, the partnership or limited liability company fully completes
17 and files with the public health and health planning council notice on a
18 form, to be developed by the public health and health planning council,
19 which shall disclose such information as may reasonably be necessary for
20 the public health and health planning council to determine whether it
21 should bar the transaction for the reason set forth below. Within ninety
22 days from the date of receipt of such notice, the public health and
23 health planning council may bar any transaction under this subparagraph
24 if the equity position of the partnership or limited liability company,
25 determined in accordance with generally accepted accounting principles,
26 would be reduced as a result of the transfer, assignment or disposition.
27 The public health and health planning council shall state specific
28 reasons for barring any transaction under this subparagraph and shall so
29 notify each party to the proposed transaction.
30 (c) Any transfer, assignment or other disposition of ten percent or
31 more of the stock or voting rights thereunder of a corporation which is
32 the operator of a hospital or which is a member of a limited liability
33 company which is the operator of a hospital to a new stockholder, or any
34 transfer, assignment or other disposition of the stock or voting rights
35 thereunder of such a corporation which results in the ownership or
36 control of more than ten percent of the stock or voting rights there-
37 under of such corporation by any person not previously approved by the
38 public health and health planning council, or its predecessor, for that
39 corporation shall be subject to approval by the public health and health
40 planning council, in accordance with the provisions of subdivisions two
41 and three of this section and rules and regulations pursuant thereto;
42 except that: any such transaction shall be subject to the approval by
43 the public health and health planning council in accordance with para-
44 graph (b) of subdivision three of this section only with respect to a
45 new stockholder or a new principal stockholder; and shall not be subject
46 to paragraph (a) of subdivision three of this section. In the absence of
47 such approval, the operating certificate of such hospital shall be
48 subject to revocation or suspension.]
49 (II) No prior approval of the public health and health planning coun-
50 cil shall be required with respect to a transfer, assignment or disposi-
51 tion of ten percent or more of [the stock] A DIRECT OR INDIRECT INTEREST
52 or voting rights [thereunder of a corporation which is the] IN AN opera-
53 tor of a hospital [or which is a member of a limited liability company
54 which is the owner of a hospital] to any person previously approved by
55 the public health and health planning council, or its predecessor, for
56 that [corporation] OPERATOR. However, no such transaction shall be
A. 6007 71
1 effective unless at least ninety days prior to the intended effective
2 date thereof, the [stockholder] OPERATOR FULLY completes and files with
3 the public health and health planning council notice on forms to be
4 developed by the public health and health planning council, which shall
5 disclose such information as may reasonably be necessary for the public
6 health and health planning council to determine whether it should bar
7 the transaction. Such transaction will be final as of the intended
8 effective date unless, prior thereto, the public health and health plan-
9 ning council shall state specific reasons for barring such transactions
10 under this paragraph and shall notify each party to the proposed trans-
11 action. Nothing in this paragraph shall be construed as permitting a
12 person not previously approved by the public health and health planning
13 council for that [corporation] OPERATOR to become the owner of ten
14 percent or more of the [stock of a corporation which is] INTEREST OR
15 VOTING RIGHTS, DIRECTLY OR INDIRECTLY, IN the operator of a hospital [or
16 which is a member of a limited liability company which is the owner of a
17 hospital] without first obtaining the approval of the public health and
18 health planning council.
19 S 6. Subdivision 1 of section 3611-a of the public health law, as
20 amended by section 67 of part A of chapter 58 of the laws of 2010, is
21 amended to read as follows:
22 1. Any change in the person who, or any transfer, assignment, or other
23 disposition of an interest or voting rights of ten percent or more, or
24 any transfer, assignment or other disposition which results in the
25 ownership or control of an interest or voting rights of ten percent or
26 more, in a limited liability company or a partnership which is the oper-
27 ator of a licensed home care services agency or a certified home health
28 agency shall be approved by the public health and health planning coun-
29 cil, in accordance with the provisions of subdivision four of section
30 thirty-six hundred five of this article relative to licensure or subdi-
31 vision two of section thirty-six hundred six of this article relative to
32 certificate of approval, except that:
33 (a) Public health and health planning council approval shall be
34 required only with respect to the person, or the member or partner that
35 is acquiring the interest or voting rights; and
36 (b) With respect to certified home health agencies, such change shall
37 not be subject to the public need assessment described in paragraph (a)
38 of subdivision two of section thirty-six hundred six of this article.
39 (c) IN THE ABSENCE OF SUCH APPROVAL, THE LICENSE OR CERTIFICATE OF
40 APPROVAL SHALL BE SUBJECT TO REVOCATION OR SUSPENSION.
41 (D) (I) No prior approval of the public health and health planning
42 council shall be required with respect to a transfer, assignment or
43 disposition of:
44 [(i)] (A) an interest or voting rights to any person previously
45 approved by the public health and health planning council, or its prede-
46 cessor, for that operator; or
47 [(ii)] (B) an interest or voting rights of less than ten percent in
48 the operator. [However, no]
49 (II) NO such transaction UNDER SUBPARAGRAPH (I) OF THIS PARAGRAPH
50 shall be effective unless at least ninety days prior to the intended
51 effective date thereof, the [partner or member] OPERATOR completes and
52 files with the public health and health planning council notice on forms
53 to be developed by the public health council, which shall disclose such
54 information as may reasonably be necessary for the public health and
55 health planning council to determine whether it should bar the trans-
56 action. Such transaction will be final as of the intended effective date
A. 6007 72
1 unless, prior thereto, the public health and health planning council
2 shall state specific reasons for barring such transactions under this
3 paragraph and shall notify each party to the proposed transaction.
4 S 6-a. The public health law is amended by adding a new section 2827
5 to read as follows:
6 S 2827. REDUCTION OF HOURS OR CLOSURE OF A HOSPITAL-SPONSORED OFF-CAM-
7 PUS EMERGENCY DEPARTMENT. A FULL CERTIFICATE OF NEED (CON) REVIEW IS
8 REQUIRED FOR HOSPITAL-SPONSORED OFF-CAMPUS EMERGENCY DEPARTMENT
9 REDUCTION OF HOURS OR CLOSURE. 1. NO LATER THAN SIX MONTHS FROM RECEIV-
10 ING A PROPOSAL FROM A GENERAL HOSPITAL FOR THE REDUCTION OF HOURS OR
11 CLOSURE OF AN EMERGENCY DEPARTMENT OF SUCH GENERAL HOSPITAL, THE COMMIS-
12 SIONER SHALL INITIATE A FULL CON REVIEW FOR THE PURPOSE OF UNDERSTANDING
13 THE IMPACT OF THE REDUCTION OF HOURS OR GENERAL HOSPITAL'S EMERGENCY
14 DEPARTMENT CLOSURE ON ACCESS TO HEALTH CARE SERVICES OF MEMBERS OF THE
15 SURROUNDING COMMUNITY, INCLUDING BUT NOT LIMITED TO, RECIPIENTS OF
16 MEDICAL ASSISTANCE FOR NEEDY PERSONS, THE UNINSURED, AND UNDERSERVED
17 POPULATIONS.
18 2. ANY HOSPITAL-SPONSORED OFF-CAMPUS EMERGENCY DEPARTMENT REDUCTION OF
19 HOURS OR CLOSURE PENDING BEFORE THE DEPARTMENT OF HEALTH SHALL BE
20 DELAYED AND SUBJECT TO THE PROVISIONS OF SUBDIVISION ONE OF THIS
21 SECTION.
22 3. THIS SECTION SHALL ONLY APPLY TO HOSPITAL-SPONSORED OFF-CAMPUS
23 EMERGENCY DEPARTMENTS LOCATED IN TOWNS WITH A POPULATION GREATER THAN
24 TWELVE THOUSAND SIX HUNDRED AND LESS THAN TWELVE THOUSAND SEVEN HUNDRED
25 ACCORDING TO THE 2010 U.S. DECENNIAL CENSUS.
26 S 7. This act shall take effect immediately.
27 PART L
28 Section 1. Section 230-d of the public health law, as added by chapter
29 365 of the laws of 2007, paragraph (i) of subdivision 1 as amended by
30 chapter 438 of the laws of 2012, and subdivision 4 as amended by chapter
31 477 of the laws of 2008, is amended to read as follows:
32 S 230-d. Office-based surgery AND OFFICE-BASED ANESTHESIA. 1. The
33 following words or phrases, as used in this section shall have the
34 following meanings:
35 (a) "Accredited status" means the full accreditation by nationally-re-
36 cognized accrediting agency(ies) determined by the commissioner.
37 (b) "Adverse event" means (i) patient death within thirty days; (ii)
38 unplanned transfer to a hospital OR EMERGENCY DEPARTMENT VISIT WITHIN
39 SEVENTY-TWO HOURS OF OFFICE-BASED SURGERY OR OFFICE-BASED ANESTHESIA;
40 (iii) unscheduled hospital admission OR ASSIGNMENT TO OBSERVATION
41 SERVICES, within seventy-two hours of the office-based surgery OR
42 OFFICE-BASED ANESTHESIA, for longer than twenty-four hours; or (iv) any
43 other serious or life-threatening event.
44 (c) "Deep sedation" means a drug-induced depression of consciousness
45 during which (i) the patient cannot be easily aroused but responds
46 purposefully following repeated painful stimulation; (ii) the patient's
47 ability to maintain independent ventilatory function may be impaired;
48 (iii) the patient may require assistance in maintaining a patent airway
49 and spontaneous ventilation may be inadequate; and (iv) the patient's
50 cardiovascular function is usually maintained without assistance.
51 (d) "General anesthesia" means a drug-induced depression of conscious-
52 ness during which (i) the patient is not arousable, even by painful
53 stimulation; (ii) the patient's ability to maintain independent ventila-
54 tory function is often impaired; (iii) the patient, in many cases, often
A. 6007 73
1 requires assistance in maintaining a patent airway and positive pressure
2 ventilation may be required because of depressed spontaneous ventilation
3 or drug-induced depression of neuromuscular function; and (iv) the
4 patient's cardiovascular function may be impaired.
5 (e) "Moderate sedation" means a drug-induced depression of conscious-
6 ness during which (i) the patient responds purposefully to verbal
7 commands, either alone or accompanied by light tactile stimulation; (ii)
8 no interventions are required to maintain a patent airway; (iii) sponta-
9 neous ventilation is adequate; and (iv) the patient's cardiovascular
10 function is usually maintained without assistance.
11 (f) "Minimal sedation" means a drug-induced state during which (i)
12 patients respond normally to verbal commands; (ii) cognitive function
13 and coordination may be impaired; and (iii) ventilatory and cardiovascu-
14 lar functions are unaffected.
15 (g) "Minor procedures" means (i) procedures that can be performed
16 safely with a minimum of discomfort where the likelihood of compli-
17 cations requiring hospitalization is minimal; (ii) procedures performed
18 with local or topical anesthesia; or (iii) liposuction with removal of
19 less than 500 cc of fat under unsupplemented local anesthesia.
20 (h) "Office-based surgery" means any surgical or other invasive proce-
21 dure, requiring general anesthesia, NEURAXIAL ANESTHESIA, MAJOR UPPER OR
22 LOWER EXTREMITY REGIONAL NERVE BLOCKS, moderate sedation, or deep
23 sedation, and any liposuction procedure, where such surgical or other
24 invasive procedure or liposuction is performed by a licensee in a
25 location other than a hospital, as such term is defined in article twen-
26 ty-eight of this chapter, excluding minor procedures and procedures
27 requiring minimal sedation.
28 (i) "Licensee" shall mean an individual licensed or otherwise author-
29 ized under article one hundred thirty-one, one hundred thirty-one-B,
30 [individuals who have obtained an issuance of a privilege to perform
31 podiatric standard or advanced ankle surgery pursuant to subdivisions
32 one and two of section seven thousand nine] ONE HUNDRED THIRTY-TWO, OR
33 ONE HUNDRED FORTY-ONE of the education law.
34 (J) "MAJOR UPPER OR LOWER EXTREMITY REGIONAL NERVE BLOCKS" MEANS TYPES
35 OF REGIONAL ANESTHESIA IN WHICH PAIN SENSATION IS MODIFIED OR BLOCKED TO
36 A LARGE AREA OF THE EXTREMITY BY ADMINISTRATION OF MEDICATION AROUND THE
37 NERVES SUPPLYING THAT REGION OF THE EXTREMITY.
38 (K) "NEURAXIAL ANESTHESIA" MEANS A FORM OF REGIONAL ANESTHESIA IN
39 WHICH PAIN SENSATION IS MODIFIED OR BLOCKED BY ADMINISTRATION OF MEDICA-
40 TION INTO THE EPIDURAL SPACE OR SPINAL CANAL.
41 (L) "OFFICE-BASED ANESTHESIA" MEANS GENERAL ANESTHESIA, NEURAXIAL
42 ANESTHESIA, MAJOR UPPER OR LOWER EXTREMITY REGIONAL NERVE BLOCKS, MODER-
43 ATE SEDATION OR DEEP SEDATION WHERE SUCH ANESTHESIA IS ADMINISTERED BY A
44 HEALTH CARE PROFESSIONAL ACTING WITHIN THE SCOPE OF PRACTICE OF HIS OR
45 HER LICENSE OR CERTIFICATION UNDER TITLE EIGHT OF THE EDUCATION LAW IN A
46 LOCATION OTHER THAN A HOSPITAL, AS SUCH TERM IS DEFINED IN ARTICLE TWEN-
47 TY-EIGHT OF THIS CHAPTER.
48 2. Licensee practices in which office-based surgery OR OFFICE-BASED
49 ANESTHESIA is performed shall obtain and maintain full accredited status
50 AND REGISTER WITH THE DEPARTMENT.
51 3. A licensee may only perform office-based surgery OR OFFICE-BASED
52 ANESTHESIA in a setting that has obtained and maintains full accredited
53 status AND IS REGISTERED WITH THE DEPARTMENT.
54 4. (A) Licensees shall report adverse events to the department's
55 patient safety center within [one] THREE business [day] DAYS of the
56 occurrence of such adverse event. Licensees shall also report any
A. 6007 74
1 suspected health care disease transmission originating in their prac-
2 tices to the patient safety center within [one] THREE business [day]
3 DAYS of becoming aware of such suspected transmission. For purposes of
4 this section, health care disease transmission shall mean the trans-
5 mission of a reportable communicable disease that is blood borne from a
6 health care professional to a patient or between patients as a result of
7 improper infection control practices by the health care professional.
8 (B) THE DEPARTMENT MAY ALSO REQUIRE LICENSEES TO REPORT ADDITIONAL
9 DATA SUCH AS PROCEDURAL INFORMATION AS NEEDED FOR THE INTERPRETATION OF
10 ADVERSE EVENTS AND EVALUATION OF PATIENT CARE AND QUALITY IMPROVEMENT
11 AND ASSURANCE ACTIVITIES.
12 (C) The DATA reported [data] UNDER THIS SUBDIVISION shall be subject
13 to all confidentiality provisions provided by section twenty-nine
14 hundred ninety-eight-e of this chapter.
15 4-A. OFFICE-BASED SURGERY OR OFFICE-BASED ANESTHESIA SHALL BE LIMITED
16 TO OPERATIONS AND PROCEDURES WITH AN EXPECTED DURATION OF NO MORE THAN
17 SIX HOURS AND EXPECTED APPROPRIATE AND SAFE DISCHARGE WITHIN THE SUBSE-
18 QUENT SIX HOURS.
19 5. The commissioner shall make, adopt, promulgate and enforce such
20 rules and regulations, as he or she may deem appropriate, to effectuate
21 the purposes of this section. Where any rule or regulation under this
22 section would affect the scope of practice of a health care practitioner
23 licensed, registered or certified under title eight of the education law
24 other than those licensed under articles one hundred thirty-one or one
25 hundred thirty-one-B of the education law, the rule or regulation shall
26 be made with the concurrence of the commissioner of education.
27 S 2. The section heading and subdivisions 1 and 2 of section 2998-e of
28 the public health law, as added by chapter 365 of the laws of 2007, are
29 amended to read as follows:
30 Reporting [of adverse events] in office based surgery AND ANESTHESIA.
31 1. The commissioner shall enter into agreements with accrediting agen-
32 cies pursuant to which the accrediting agencies shall REQUIRE ALL
33 OFFICE-BASED SURGICAL AND OFFICE-BASED ANESTHESIA PRACTICES TO CONDUCT
34 QUALITY IMPROVEMENT AND QUALITY ASSURANCE ACTIVITIES AND UTILIZE CERTIF-
35 ICATION BY AN APPROPRIATE CERTIFYING ORGANIZATION, HOSPITAL PRIVILEGING
36 OR OTHER EQUIVALENT METHODS TO DETERMINE COMPETENCY OF PRACTITIONERS TO
37 PERFORM OFFICE-BASED SURGERY AND OFFICE-BASED ANESTHESIA, CARRY OUT
38 SURVEYS OR COMPLAINT/INCIDENT INVESTIGATIONS UPON DEPARTMENT REQUEST AND
39 SHALL report, at a minimum, [aggregate data on adverse events] FINDINGS
40 OF SURVEYS AND COMPLAINT/INCIDENT INVESTIGATIONS, AND DATA for all
41 office-based surgical AND OFFICE-BASED ANESTHESIA practices accredited
42 by the accrediting agencies to the department. The department may
43 disclose reports of aggregate data to the public.
44 2. The information required to be collected, maintained and reported
45 directly to the department AND MAINTAINED BY OFFICE-BASED SURGERY AND
46 OFFICE-BASED ANESTHESIA PRACTICES UNDER QUALITY IMPROVEMENT AND QUALITY
47 ASSURANCE ACTIVITIES pursuant to section two hundred thirty-d of this
48 chapter shall be kept confidential and shall not be released, except to
49 the department and except as required or permitted under subdivision
50 nine-a and subparagraph (v) of paragraph (a) of subdivision ten of
51 section two hundred thirty of this chapter. Notwithstanding any other
52 provision of law, none of such information shall be subject to disclo-
53 sure under article six of the public officers law or article thirty-one
54 of the civil practice law and rules.
55 S 3. This act shall take effect one year after it shall have become a
56 law.
A. 6007 75
1 PART M
2 Section 1. Subdivisions 1 and 2 of section 1100-a of the public health
3 law, as added by chapter 258 of the laws of 1996, are amended and two
4 new subdivisions 3 and 4 are added to read as follows:
5 1. Notwithstanding any contrary provision of law, rule, regulation or
6 code, any county, city, town or village that owns both its public water
7 system and the water supply for such system may by local law provide
8 whether a fluoride compound shall [or shall not] be added to such public
9 water supply.
10 2. Any county, wherein a public authority owns both its public water
11 system and the water supply for such system, may by local law provide
12 whether a fluoride compound shall [or shall not] be added to such public
13 water supply.
14 3. NO COUNTY, CITY, TOWN OR VILLAGE, INCLUDING A COUNTY WHEREIN A
15 PUBLIC AUTHORITY OWNS BOTH ITS PUBLIC WATER SYSTEM AND THE WATER SUPPLY
16 FOR SUCH SYSTEM, THAT FLUORIDATES A PUBLIC WATER SUPPLY OR CAUSES A
17 PUBLIC WATER SUPPLY TO BE FLUORIDATED, SHALL DISCONTINUE THE ADDITION OF
18 A FLUORIDE COMPOUND TO SUCH PUBLIC WATER SUPPLY UNLESS IT HAS FIRST
19 COMPLIED WITH THE FOLLOWING REQUIREMENTS:
20 (A) ISSUE A NOTICE TO THE PUBLIC OF THE PRELIMINARY DETERMINATION TO
21 DISCONTINUE FLUORIDATION FOR COMMENT, WHICH SHALL INCLUDE THE JUSTIFICA-
22 TION FOR THE PROPOSED DISCONTINUANCE, ALTERNATIVES TO FLUORIDATION
23 AVAILABLE, AND A SUMMARY OF CONSULTATIONS WITH HEALTH PROFESSIONALS AND
24 THE DEPARTMENT CONCERNING THE PROPOSED DISCONTINUANCE. SUCH NOTICE MAY,
25 BUT IS NOT REQUIRED TO, INCLUDE PUBLICATION IN LOCAL NEWSPAPERS.
26 "CONSULTATIONS WITH HEALTH PROFESSIONALS" MAY INCLUDE FORMAL STUDIES BY
27 HIRED PROFESSIONALS, INFORMAL CONSULTATIONS WITH LOCAL PUBLIC HEALTH
28 OFFICIALS OR OTHER HEALTH PROFESSIONALS, OR OTHER CONSULTATIONS,
29 PROVIDED THAT THE NATURE OF SUCH CONSULTATIONS AND THE IDENTITY OF SUCH
30 PROFESSIONALS SHALL BE IDENTIFIED IN THE PUBLIC NOTICE. "ALTERNATIVES TO
31 FLUORIDATION" MAY INCLUDE FORMAL ALTERNATIVES PROVIDED BY OR AT THE
32 EXPENSE OF THE COUNTY, CITY, TOWN OR VILLAGE, OR OTHER ALTERNATIVES
33 AVAILABLE TO THE PUBLIC. ANY PUBLIC COMMENTS RECEIVED IN RESPONSE TO
34 SUCH NOTICE SHALL BE ADDRESSED BY THE COUNTY, CITY, TOWN OR VILLAGE IN
35 THE ORDINARY COURSE OF BUSINESS; AND
36 (B) PROVIDE THE DEPARTMENT AT LEAST NINETY DAYS PRIOR WRITTEN NOTICE
37 OF THE INTENT TO DISCONTINUE AND SUBMIT A PLAN FOR DISCONTINUANCE THAT
38 INCLUDES BUT IS NOT LIMITED TO THE NOTICE THAT WILL BE PROVIDED TO THE
39 PUBLIC, CONSISTENT WITH PARAGRAPH (A) OF THIS SUBDIVISION, OF THE DETER-
40 MINATION TO DISCONTINUE FLUORIDATION OF THE WATER SUPPLY, INCLUDING THE
41 DATE OF SUCH DISCONTINUANCE AND ALTERNATIVES TO FLUORIDATION, IF ANY,
42 THAT WILL BE MADE AVAILABLE IN THE COMMUNITY, AND THAT INCLUDES INFORMA-
43 TION AS MAY BE REQUIRED UNDER THE SANITARY CODE.
44 4. THE COMMISSIONER IS HEREBY AUTHORIZED, WITHIN AMOUNTS APPROPRIATED
45 THEREFOR, TO MAKE GRANTS TO COUNTIES, CITIES, TOWNS OR VILLAGES THAT OWN
46 THEIR PUBLIC WATER SYSTEM AND THE WATER SUPPLY FOR SUCH SYSTEM, INCLUD-
47 ING A COUNTY WHEREIN A PUBLIC AUTHORITY OWNS BOTH ITS PUBLIC WATER
48 SYSTEM AND THE WATER SUPPLY FOR SUCH SYSTEM, FOR THE PURPOSE OF PROVID-
49 ING ASSISTANCE TOWARDS THE COSTS OF INSTALLATION, INCLUDING BUT NOT
50 LIMITED TO TECHNICAL AND ADMINISTRATIVE COSTS ASSOCIATED WITH PLANNING,
51 DESIGN AND CONSTRUCTION, AND START-UP OF FLUORIDATION SYSTEMS, AND
52 REPLACING, REPAIRING OR UPGRADING OF FLUORIDATION EQUIPMENT FOR SUCH
53 PUBLIC WATER SYSTEMS. GRANT FUNDING SHALL NOT BE AVAILABLE FOR ASSIST-
54 ANCE TOWARDS THE COSTS AND EXPENSES OF OPERATION OF THE FLUORIDATION
55 SYSTEM, AS DETERMINED BY THE DEPARTMENT. THE GRANT APPLICATIONS SHALL
A. 6007 76
1 INCLUDE SUCH INFORMATION AS REQUIRED BY THE COMMISSIONER. IN MAKING THE
2 GRANT AWARDS, THE COMMISSIONER SHALL CONSIDER THE DEMONSTRATED NEED FOR
3 INSTALLATION OF NEW FLUORIDATION EQUIPMENT OR REPLACING, REPAIRING OR
4 UPGRADING OF EXISTING FLUORIDATION EQUIPMENT, AND SUCH OTHER CRITERIA AS
5 DETERMINED BY THE COMMISSIONER. GRANT AWARDS SHALL BE MADE ON A COMPET-
6 ITIVE BASIS AND BE SUBJECT TO SUCH CONDITIONS AS MAY BE DETERMINED BY
7 THE COMMISSIONER.
8 S 2. This act shall take effect immediately.
9 PART N
10 Section 1. Purpose. The purpose of this act is to seek public input
11 about the creation of an office of community living with the goal of
12 providing improvements in service delivery and improved program outcomes
13 that would result from the expansion of community living integration
14 services for older adults and persons of all ages with disabilities.
15 S 2. Office of community living feasibility study. (a) There is hereby
16 created an advisory committee to conduct an office of community living
17 feasibility study. Such committee shall consist of: the director of the
18 state office for the aging, who will also chair the committee; the
19 commissioner of the department of health; the director of the office for
20 people with developmental disabilities; the commissioner of the depart-
21 ment of housing and community renewal; the commissioner of the office of
22 temporary and disability assistance; the commissioner of the department
23 of transportation; the commissioner of the office of mental health; the
24 commissioner of the office of alcoholism and substance abuse services;
25 the director of the division of veterans' affairs; one representative
26 who is an advocate for older adults; one representative who is an advo-
27 cate for persons with mental illness; one representative who is an advo-
28 cate for persons with a substance use disorder; and one representative
29 who is an advocate for persons with disabilities. The director of the
30 office for the aging may also consult with any other agency that the
31 director determines should be consulted.
32 (b) The office of community living feasibility study shall focus on
33 several areas including, but not limited to: furthering the goals of the
34 governor's Olmstead plan; strengthening the No Wrong Door approach to
35 accessing information and services; reinforcing initiatives of the
36 Balancing Incentive Program; creating opportunities to better leverage
37 resources; reviewing the available services across all agencies to iden-
38 tify the adequacy of existing services to seniors, persons with disabil-
39 ities, and persons with behavioral health disorders; investigating over-
40 lap between agencies and gaps in available services; determining the
41 efficacy of current programs and service delivery methods; evaluating
42 methods for service delivery improvements; analyzing the fiscal impact
43 of creating such an office on services, individuals, and providers; and
44 exploring what impacts such an office might have on supporting older
45 adults, persons with disabilities, and persons with behavioral health
46 disorders currently living in the community, or who could be living in
47 the community. The advisory committee shall also examine recent federal
48 initiatives to create an administration on community living, and examine
49 other states' efforts to expand services supporting community living
50 integration and local and/or regional coordination efforts within New
51 York.
52 (c) In order to ensure meaningful public input and comment for the
53 office of community living feasibility study, there shall be a series of
54 public meetings held across the state, organized to ensure that stake-
A. 6007 77
1 holders in all regions of the state are afforded an opportunity to
2 comment.
3 S 3. Office of community living feasibility study report. The advisory
4 committee shall submit to the governor, and to the temporary president
5 of the senate and the speaker of the assembly a preliminary report by
6 September 30, 2015. This preliminary report shall explain data
7 collection efforts, illustrate public comment received and state any
8 preliminary findings. The advisory committee shall submit a final report
9 to the governor, the temporary president of the senate, and the speaker
10 of the assembly by December 31, 2015 that outlines the results and find-
11 ings associated with the aforementioned collection of data and solicita-
12 tion of feedback.
13 S 4. This act shall take effect immediately.
14 PART O
15 Section 1. Section 1 of part D of chapter 111 of the laws of 2010
16 relating to the recovery of exempt income by the office of mental health
17 for community residences and family-based treatment programs as amended
18 by section 1 of part C of chapter 58 of the laws of 2014, is amended to
19 read as follows:
20 Section 1. The office of mental health is authorized to recover fund-
21 ing from community residences and family-based treatment providers
22 licensed by the office of mental health, consistent with contractual
23 obligations of such providers, and notwithstanding any other inconsist-
24 ent provision of law to the contrary, in an amount equal to 50 percent
25 of the income received by such providers which exceeds the fixed amount
26 of annual Medicaid revenue limitations, as established by the commis-
27 sioner of mental health. Recovery of such excess income shall be for the
28 following fiscal periods: for programs in counties located outside of
29 the city of New York, the applicable fiscal periods shall be January 1,
30 2003 through December 31, 2009 and January 1, 2011 through December 31,
31 [2015] 2016; and for programs located within the city of New York, the
32 applicable fiscal periods shall be July 1, 2003 through June 30, 2010
33 and July 1, 2011 through June 30, [2015] 2016.
34 S 2. This act shall take effect immediately.
35 PART P
36 Section 1. Subparagraph 9 of paragraph h of subdivision 4 of section
37 1950 of the education law, as added by section 1 of part M of chapter 56
38 of the laws of 2012, is amended to read as follows:
39 (9) To enter into contracts with the commissioner of the office of
40 mental health, to provide special education and related services, in
41 accordance with subdivision six-b of section thirty-two hundred two of
42 this chapter to patients hospitalized in hospitals operated by the
43 office of mental health who are between the ages of five and twenty-one
44 who have not received a high school diploma. Any such proposed contract
45 shall be subject to the review by the commissioner and his [and] OR her
46 determination that it is an approved cooperative educational service.
47 Services provided pursuant to such contracts shall be provided at cost
48 and approved by the commissioner of the office of mental health and the
49 director of the division of the budget, and the board of cooperative
50 educational services shall not be authorized to charge any costs
51 incurred in providing such services to its component school districts.
A. 6007 78
1 S 2. The commissioner of mental health, in consultation with the
2 commissioner of education, shall submit to the governor, and to the
3 temporary president of the senate and the speaker of the assembly, a
4 report and recommendations by December 15, 2015 and annually thereafter,
5 on the number of children hospitalized in hospitals operated by the
6 officer of mental health who received educational services from school
7 districts and boards of cooperative educational services pursuant to the
8 provisions of this act in the most recent school year and the projected
9 number to be served in the subsequent school year, the services provided
10 to these children, and the actual or projected cost of such services.
11 Such report shall also provide detailed proposals regarding whether
12 additional actions should be taken to ensure that children hospitalized
13 in hospitals operated by the office of mental health continue to receive
14 education programming and services as required by state and federal law.
15 S 3. Section 4 of part M of chapter 56 of the laws of 2012 amending
16 the education law, relating to authorizing contracts for the provision
17 of special education and related services for certain patients hospital-
18 ized in hospitals operated by the office of mental health, is amended to
19 read as follows:
20 S 4. This act shall take effect July 1, 2012 and shall expire June 30,
21 [2015] 2018, when upon such date the provisions of this act shall be
22 deemed repealed.
23 S 4. This act shall take effect immediately and shall be deemed to
24 have been in full force and effect on and after April 1, 2015, provided,
25 however, that the amendments to subparagraph 9 of paragraph h of subdi-
26 vision 4 of section 1950 of the education law made by section one of
27 this act shall not affect the repeal of such subparagraph and shall be
28 deemed repealed therewith.
29 PART Q
30 Intentionally Omitted
31 PART R
32 Section 1. Section 3 of part A of chapter 111 of the laws of 2010
33 amending the mental hygiene law relating to the receipt of federal and
34 state benefits received by individuals receiving care in facilities
35 operated by an office of the department of mental hygiene, as amended by
36 section 1 of part B of chapter 58 of the laws of 2014, is amended to
37 read as follows:
38 S 3. This act shall take effect immediately; and shall expire and be
39 deemed repealed June 30, [2015] 2018.
40 S 2. This act shall take effect immediately.
41 PART S
42 Section 1. Section 366 of the social services law is amended by adding
43 a new subdivision 7-a to read as follows:
44 7-A. A. THE COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMIS-
45 SIONER OF DEVELOPMENTAL DISABILITIES SHALL APPLY FOR A HOME AND COMMUNI-
46 TY-BASED WAIVER, PURSUANT TO SUBDIVISION (C) OF SECTION NINETEEN HUNDRED
47 FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT, IN ORDER TO PROVIDE HOME AND
48 COMMUNITY-BASED SERVICES FOR A POPULATION OF PERSONS WITH DEVELOPMENTAL
A. 6007 79
1 DISABILITIES, AS SUCH TERM IS DEFINED IN SECTION 1.03 OF THE MENTAL
2 HYGIENE LAW.
3 B. PERSONS ELIGIBLE FOR PARTICIPATION IN THE WAIVER PROGRAM SHALL:
4 (I) HAVE A DEVELOPMENTAL DISABILITY AS SUCH TERM IS DEFINED IN SUBDI-
5 VISION TWENTY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW;
6 (II) MEET THE LEVEL OF CARE CRITERIA PROVIDED BY AN INTERMEDIATE CARE
7 FACILITY FOR THE DEVELOPMENTALLY DISABLED;
8 (III) BE ELIGIBLE FOR MEDICAID;
9 (IV) LIVE AT HOME OR IN AN INDIVIDUALIZED RESIDENTIAL ALTERNATIVE,
10 COMMUNITY RESIDENCE OR FAMILY CARE HOME, CERTIFIED OR APPROVED BY THE
11 OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES;
12 (V) BE CAPABLE OF BEING CARED FOR IN THE COMMUNITY IF PROVIDED WITH
13 SUCH SERVICES AS RESPITE, HOME ADAPTATION, OR OTHER HOME AND COMMUNITY-
14 BASED SERVICES, OTHER THAN ROOM AND BOARD, AS MAY BE APPROVED BY THE
15 SECRETARY OF THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES, IN
16 ADDITION TO OTHER SERVICES PROVIDED UNDER THIS TITLE, AS DETERMINED BY
17 THE ASSESSMENT REQUIRED BY PARAGRAPH C OF THIS SUBDIVISION;
18 (VI) HAVE A DEMONSTRATED NEED FOR HOME AND COMMUNITY BASED WAIVER
19 SERVICES; AND
20 (VII) MEET SUCH OTHER CRITERIA AS MAY BE ESTABLISHED BY THE COMMIS-
21 SIONER OF HEALTH AND THE COMMISSIONER OF DEVELOPMENTAL DISABILITIES, AS
22 MAY BE NECESSARY TO ADMINISTER THE PROVISIONS OF THIS SUBDIVISION.
23 C. THE COMMISSIONER OF DEVELOPMENTAL DISABILITIES SHALL ASSESS THE
24 ELIGIBILITY OF PERSONS ENROLLED, OR SEEKING TO ENROLL, IN THE WAIVER
25 PROGRAM. THE ASSESSMENT SHALL INCLUDE, BUT NEED NOT BE LIMITED TO, AN
26 EVALUATION OF THE HEALTH, PSYCHO-SOCIAL, DEVELOPMENTAL, HABILITATION AND
27 ENVIRONMENTAL NEEDS OF THE PERSON AND SHALL SERVE AS THE BASIS FOR THE
28 DEVELOPMENT AND PROVISION OF AN APPROPRIATE PERSON CENTERED PLAN OF CARE
29 FOR SUCH PERSON.
30 D. THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES SHALL UNDER-
31 TAKE OR ARRANGE FOR THE DEVELOPMENT OF A WRITTEN PERSON CENTERED PLAN OF
32 CARE FOR EACH PERSON ENROLLED IN THE WAIVER. SUCH PERSON CENTERED PLAN
33 OF CARE SHALL DESCRIBE THE PROVISION OF HOME AND COMMUNITY BASED WAIVER
34 SERVICES CONSISTENT WITH THE ASSESSMENT FOR EACH PERSON.
35 E. THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES SHALL REVIEW
36 THE PLAN OF CARE AND AUTHORIZE THOSE HOME AND COMMUNITY BASED SERVICES
37 TO BE INCLUDED IN THE PLAN OF CARE, TAKING INTO ACCOUNT THE PERSON'S
38 ASSESSED NEEDS, VALUED OUTCOMES AND AVAILABLE RESOURCES.
39 F. THE COMMISSIONERS OF DEVELOPMENTAL DISABILITIES AND HEALTH SHALL
40 DETERMINE QUALITY STANDARDS FOR ORGANIZATIONS PROVIDING SERVICES UNDER
41 SUCH WAIVER AND SHALL AUTHORIZE ORGANIZATIONS THAT MEET SUCH STANDARDS
42 TO PROVIDE SUCH SERVICES.
43 G. THE COMMISSIONER OF DEVELOPMENTAL DISABILITIES OR HEALTH MAY
44 PROMULGATE RULES AND REGULATIONS AS NECESSARY TO EFFECTUATE THE
45 PROVISIONS OF THIS SECTION.
46 H. THIS SUBDIVISION SHALL BE EFFECTIVE ONLY IF, AND AS LONG AS, FEDER-
47 AL FINANCIAL PARTICIPATION IS AVAILABLE FOR EXPENDITURES INCURRED UNDER
48 THIS SUBDIVISION.
49 S 1-a. Subparagraph (v) of paragraph a of subdivision 1 of section
50 6908 of the education law, as amended by section 1 of part A of chapter
51 58 of the laws of 2014, is amended to read as follows:
52 (v) tasks provided by a direct support staff in programs certified or
53 approved by the office for people with developmental disabilities AND
54 HOLDING AN OPERATING CERTIFICATE PURSUANT TO PARAGRAPH 4 OF SUBDIVISION
55 (A) OF SECTION 16.03 OF THE MENTAL HYGIENE LAW, when performed under the
56 supervision of a registered professional nurse and pursuant to a memo-
A. 6007 80
1 randum of understanding between the office for people with developmental
2 disabilities and the department, in accordance with and pursuant to an
3 authorized practitioner's ordered care, provided that: (1) a registered
4 professional nurse determines, in his or her professional judgment,
5 which tasks are to be performed based upon the complexity of the tasks,
6 the skill and experience of the direct support staff, and the health
7 status of the individual being cared for; (2) only a direct support
8 staff who has completed training as required by the commissioner of the
9 office for people with developmental disabilities may perform tasks
10 pursuant to this subparagraph; (3) appropriate protocols shall be estab-
11 lished to ensure safe administration of medications; (4) a direct
12 support staff shall not assess the medication needs of an individual;
13 (5) adequate nursing supervision is provided, including training and
14 periodic inspection of performance of the tasks. The amount and type of
15 nursing supervision shall be determined by the registered professional
16 nurse responsible for supervising such task based upon the complexity of
17 the tasks, the skill and experience of the direct support staff, and the
18 health status of the individual being cared for; (6) a direct support
19 staff shall not be authorized to perform any tasks or activities pursu-
20 ant to this subparagraph that are outside the scope of practice of a
21 licensed practical nurse; (7) a direct support staff shall not represent
22 himself or herself, or accept employment, as a person licensed to prac-
23 tice nursing under the provisions of this article; (8) direct support
24 staff providing medication administration, tube feeding, or diabetic
25 care shall be separately certified, and shall be recertified on an annu-
26 al basis; (9) the registered professional nurse shall ensure that there
27 is a consumer specific medication sheet for each medication that is
28 administered; and (10) appropriate staffing ratios shall be determined
29 by the office for people with developmental disabilities and the depart-
30 ment to ensure adequate nursing supervision. No direct support staff
31 shall perform tasks under this subparagraph until the office for people
32 with developmental disabilities and the department have entered into a
33 memorandum of understanding to effectuate the provisions of this subpar-
34 agraph. The office for people with developmental disabilities shall
35 complete a criminal background check pursuant to section 16.33 of the
36 mental hygiene law and an agency background check pursuant to section
37 16.34 of the mental hygiene law on the direct support staff prior to the
38 commencement of any provision of service provided under this subpara-
39 graph if such direct support staff is a new hire. Individuals providing
40 supervision or direct support tasks pursuant to this subparagraph shall
41 have protection pursuant to sections seven hundred forty and seven
42 hundred forty-one of the labor law, where applicable;
43 S 2. Paragraph (a) of subdivision 4 of section 488 of the social
44 services law, as added by section 1 of part B of chapter 501 of the laws
45 of 2012, is amended to read as follows:
46 (a) a facility or program in which services are provided and which is
47 operated, licensed or certified by the office of mental health, the
48 office for people with developmental disabilities or the office of alco-
49 holism and substance abuse services, including but not limited to
50 psychiatric centers, inpatient psychiatric units of a general hospital,
51 developmental centers, intermediate care facilities, community resi-
52 dences, group homes and family care homes, provided, however, that such
53 term shall not include a secure treatment facility as defined in section
54 10.03 of the mental hygiene law, SERVICES DEFINED IN SUBPARAGRAPH FOUR
55 OF SUBDIVISION (A) OF SECTION 16.03 OF THE MENTAL HYGIENE LAW, or
56 services provided in programs or facilities that are operated by the
A. 6007 81
1 office of mental health and located in state correctional facilities
2 under the jurisdiction of the department of corrections and community
3 supervision;
4 S 3. Subdivision 2 of section 550 of the executive law, as added by
5 section 3 of part A of chapter 501 of the laws of 2012, is amended to
6 read as follows:
7 2. "Mental hygiene facility" shall mean a facility as defined in
8 subdivision six of section 1.03 of the mental hygiene law and facilities
9 for the operation of which an operating certificate is required pursuant
10 to article sixteen or thirty-one of the mental hygiene law and including
11 family care homes. "Mental hygiene facility" also means a secure treat-
12 ment facility as defined by article ten of the mental hygiene law. THIS
13 TERM SHALL NOT INCLUDE SERVICES DEFINED IN PARAGRAPH FOUR OF SUBDIVISION
14 (A) OF SECTION 16.03 OF THE MENTAL HYGIENE LAW.
15 S 4. Subdivisions 3, 4, 5 and 22 of section 1.03 of the mental hygiene
16 law, subdivision 3 as amended by chapter 223 of the laws of 1992, subdi-
17 vision 4 as added by chapter 978 of the laws of 1977, subdivision 5 as
18 amended by chapter 75 of the laws of 2006, and subdivision 22 as amended
19 by chapter 255 of the laws of 2002, are amended to read as follows:
20 3. "Mental disability" means mental illness, [mental retardation]
21 INTELLECTUAL DISABILITY, developmental disability, alcoholism, substance
22 dependence, or chemical dependence. [A mentally disabled person is one
23 who has a mental disability.]
24 4. "Services for [the mentally disabled] PERSONS WITH A MENTAL DISA-
25 BILITY" means examination, diagnosis, care, treatment, rehabilitation,
26 SUPPORTS, HABILITATION or training of the mentally disabled.
27 5. "Provider of services" means an individual, association, corpo-
28 ration, partnership, limited liability company, or public or private
29 agency, other than an agency or department of the state, which provides
30 services for [the mentally disabled] PERSONS WITH A MENTAL DISABILITY.
31 It shall not include any part of a hospital as defined in article twen-
32 ty-eight of the public health law which is not being operated for the
33 purpose of providing services for the mentally disabled. No provider of
34 services shall be subject to the regulation or control of the department
35 or one of its offices except as such regulation or control is provided
36 for by other provisions of this chapter.
37 22. "Developmental disability" means a disability of a person which:
38 (a) (1) is attributable to [mental retardation] INTELLECTUAL DISABILI-
39 TY, cerebral palsy, epilepsy, neurological impairment, familial dysauto-
40 nomia or autism;
41 (2) is attributable to any other condition of a person found to be
42 closely related to [mental retardation] INTELLECTUAL DISABILITY because
43 such condition results in similar impairment of general intellectual
44 functioning or adaptive behavior to that of [mentally retarded] INTEL-
45 LECTUALLY DISABLED persons or requires treatment and services similar to
46 those required for such person; or
47 (3) is attributable to dyslexia resulting from a disability described
48 in subparagraph [(1)] ONE or [(2)] TWO of this paragraph;
49 (b) originates before such person attains age twenty-two;
50 (c) has continued or can be expected to continue indefinitely; and
51 (d) constitutes a substantial handicap to such person's ability to
52 function normally in society.
53 S 5. Intentionally omitted.
54 S 6. Subdivision (a) of section 16.03 of the mental hygiene law is
55 amended by adding a new paragraph 4 to read as follows:
A. 6007 82
1 (4) THE PROVISION OF HOME AND COMMUNITY BASED SERVICES APPROVED UNDER
2 A WAIVER PROGRAM AUTHORIZED PURSUANT TO SUBDIVISION (C) OF SECTION NINE-
3 TEEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT AND SUBDIVISIONS
4 SEVEN AND SEVEN-A OF SECTION THREE HUNDRED SIXTY-SIX OF THE SOCIAL
5 SERVICES LAW.
6 S 7. Section 16.03 of the mental hygiene law is amended by adding a
7 new subdivision (f) to read as follows:
8 (F) ANY PROVIDER OF SERVICES THAT HOLDS AN OPERATING CERTIFICATE
9 PURSUANT TO PARAGRAPH FOUR OF SUBDIVISION (A) OF SECTION 16.03 OF THE
10 MENTAL HYGIENE LAW, SHALL BE AUTHORIZED TO EMPLOY PERSONS LICENSED TO
11 PRACTICE NURSING PURSUANT TO ARTICLE ONE HUNDRED THIRTY-NINE OF THE
12 EDUCATION LAW AND EXEMPT INDIVIDUALS AUTHORIZED TO PERFORM TASKS PURSU-
13 ANT TO SUBPARAGRAPH (V) OF PARAGRAPH A OF SUBDIVISION ONE OF SECTION
14 SIXTY-NINE HUNDRED EIGHT OF THE EDUCATION LAW.
15 S 8. Subdivision (a), paragraphs 2, 3, and 6 of subdivision (c), para-
16 graphs 1 and 4 of subdivision (d), subdivision (e), and subdivision (i)
17 of section 16.05 of the mental hygiene law, subdivision (a), paragraphs
18 2, 3, and 6 of subdivision (c), paragraphs 1 and 4 of subdivision (d)
19 and subdivision (e) as added by chapter 786 of the laws of 1983, para-
20 graph 6 of subdivision (c) and paragraph 4 of subdivision (d) as renum-
21 bered by chapter 618 of the laws of 1990, and subdivision (i) as amended
22 by chapter 37 of the laws of 2011, are amended to read as follows:
23 (a)(1) Application for an operating certificate shall be made upon
24 forms prescribed by the commissioner.
25 (2) Application shall be made by the person or entity responsible for
26 operation of the facility OR PROVIDER OF SERVICES AS DESCRIBED IN PARA-
27 GRAPH FOUR OF SUBDIVISION A OF SECTION 16.03 OF THIS ARTICLE. Applica-
28 tions shall be in writing, shall be verified and shall contain such
29 information as required by the commissioner.
30 (2) The character, competence and standing in the community of the
31 person or entity responsible for operating the facility OR PROVIDING
32 SERVICES;
33 (3) The financial resources of the proposed facility OR PROVIDER OF
34 SERVICES and its sources of future revenues;
35 (6) In the case of residential facilities, that arrangements have been
36 made with other providers of services for the provision of health,
37 habilitation, day treatment, education, sheltered workshop, transporta-
38 tion or other services as may be necessary to meet the needs of
39 [clients] INDIVIDUALS who will reside in the facility; and
40 (1) the financial resources of the proposed facility OR PROVIDER OF
41 SERVICES and its sources of future revenues;
42 (4) in the case of residential facilities, that arrangements have been
43 made with other providers of services for the provision of health,
44 habilitation, day treatment, education, sheltered workshop, transporta-
45 tion or other services as may be necessary to meet the needs of
46 [clients] INDIVIDUALS who will reside in the facility; and
47 (e) The commissioner may disapprove an application for an operating
48 certificate, may authorize fewer services than applied for, and may
49 place limitations or conditions on the operating certificate including,
50 but not limited to compliance with a time limited plan of correction of
51 any deficiency which does not threaten the health or well-being of any
52 [client] INDIVIDUALS. In such cases the applicant shall be given an
53 opportunity to be heard, at a public hearing if requested by the appli-
54 cant.
55 (i) In the event that the holder of an operating certificate for a
56 residential facility issued by the commissioner pursuant to this article
A. 6007 83
1 wishes to cease the operation or conduct of any of the activities, as
2 defined in paragraph one OR FOUR of subdivision (a) of section 16.03 of
3 this article, for which such certificate has been issued or to cease
4 operation of any one or more of facilities for which such certificate
5 has been issued; wishes to transfer ownership, possession or operation
6 of the premises and facilities upon which such activities are being
7 conducted or to transfer ownership, possession or operation of any one
8 or more of the premises or facilities for which such certificate has
9 been issued; or elects not to apply to the commissioner for re-certifi-
10 cation upon the expiration of any current period of certification, it
11 shall be the duty of such certificate holder to give to the commissioner
12 written notice of such intention not less than sixty days prior to the
13 intended effective date of such transaction. Such notice shall set forth
14 a detailed plan which makes provision for the safe and orderly transfer
15 of each person with a developmental disability served by such certif-
16 icate holder pursuant to such certificate into a program of services
17 appropriate to such person's on-going needs and/or for the continuous
18 provision of a lawfully operated program of such activities and services
19 at the premises and facilities to be conveyed by the certificate holder.
20 Such certificate holder shall not cease to provide any such services to
21 any such person with a developmental disability under any of the circum-
22 stances described in this section until the notice and plan required
23 hereby are received, reviewed and approved by the commissioner. For the
24 purposes of this paragraph, the requirement of prior notice and contin-
25 uous provision of programs and services by the certificate holder shall
26 not apply to those situations and changes in circumstances directly
27 affecting the certificate holder that are not reasonably foreseeable at
28 the time of occurrence, including, but not limited to, death or other
29 sudden incapacitating disability or infirmity. Written notice shall be
30 given to the commissioner as soon as reasonably possible thereafter in
31 the manner set forth within this subdivision.
32 S 8-a. Subdivision (c) of section 16.05 of the mental hygiene law is
33 amended by adding a new paragraph 6-a to read as follows:
34 (6-A) IN THE CASE OF A PROVIDER OF SERVICES SEEKING TO PROVIDE NURSING
35 TASKS BY NON-LICENSED PERSONS AUTHORIZED TO PROVIDE SUCH TASKS PURSUANT
36 TO SUBPARAGRAPH (V) OF PARAGRAPH A OF SUBDIVISION ONE OF SECTION SIXTY-
37 NINE HUNDRED EIGHT OF THE EDUCATION LAW, SUCH PROVIDER SHALL AFFIRM THAT
38 IT WILL PROVIDE SERVICES AND TASKS IN A SAFE AND COMPETENT MANNER AND
39 WILL FULLY COMPLY WITH THE REQUIREMENTS OF SUCH SUBPARAGRAPH AND ANY
40 MEMORANDUM OF UNDERSTANDING BETWEEN THE OFFICE FOR PEOPLE WITH DEVELOP-
41 MENTAL DISABILITIES AND THE STATE EDUCATION DEPARTMENT PURSUANT TO SUCH
42 SUBPARAGRAPH. NO OPERATING CERTIFICATE SUBJECT TO THIS PARAGRAPH SHALL
43 BE GRANTED WITHOUT SUCH AFFIRMATION.
44 S 9. Paragraph 1 of subdivision (a) of section 16.09 of the mental
45 hygiene law, as added by chapter 786 of the laws of 1983, is amended to
46 read as follows:
47 (1) "Facility" is limited to a facility in which services are offered
48 for which an operating certificate is required by this article. For the
49 purposes of this section facility shall include family care homes BUT
50 SHALL NOT INCLUDE THE PROVISION OF SERVICES, AS DEFINED IN PARAGRAPH
51 FOUR OF SUBDIVISION (A) OF SECTION 16.03 OF THIS ARTICLE, OUTSIDE OF A
52 FACILITY.
53 S 10. The section heading and subdivision (a) of section 16.11 of the
54 mental hygiene law are REPEALED and a new section heading and subdivi-
55 sion (a) are added to read as follows:
A. 6007 84
1 OVERSIGHT OF FACILITIES AND SERVICES. (A) THE COMMISSIONER SHALL
2 PROVIDE FOR THE OVERSIGHT OF FACILITIES AND PROVIDERS OF SERVICES HOLD-
3 ING OPERATING CERTIFICATES PURSUANT TO SECTION 16.03 OF THIS ARTICLE AND
4 SHALL PROVIDE FOR THE REVIEW OF SUCH FACILITIES AND PROVIDERS IN IMPLE-
5 MENTING THE REQUIREMENTS OF THE OFFICE AND IN PROVIDING QUALITY CARE AND
6 PERSON CENTERED AND COMMUNITY BASED SERVICES.
7 (1) THE REVIEW OF FACILITIES ISSUED AN OPERATING CERTIFICATE PURSUANT
8 TO THIS ARTICLE SHALL INCLUDE PERIODIC VISITATION AND REVIEW OF EACH
9 FACILITY. REVIEWS SHALL BE MADE AS FREQUENTLY AS THE COMMISSIONER MAY
10 DEEM NECESSARY BUT IN ANY EVENT SUCH INSPECTIONS SHALL BE MADE ON AT
11 LEAST TWO OCCASIONS DURING EACH CALENDAR YEAR WHICH SHALL BE WITHOUT
12 PRIOR NOTICE, PROVIDED, HOWEVER, THAT WHERE, IN THE DISCRETION OF THE
13 COMMISSIONER, AN OPERATING CERTIFICATE HAS BEEN ISSUED TO A PROGRAM WITH
14 A HISTORY OF COMPLIANCE AND A RECORD OF PROVIDING A HIGH QUALITY OF
15 CARE, THE PERIODIC INSPECTION AND VISITATION REQUIRED BY THIS SUBDIVI-
16 SION SHALL BE MADE AT LEAST ONCE DURING EACH CALENDAR YEAR PROVIDED SUCH
17 VISIT SHALL BE WITHOUT PRIOR NOTICE. AREAS OF REVIEW SHALL INCLUDE, BUT
18 NOT BE LIMITED TO, A REVIEW OF A FACILITY'S: PHYSICAL PLANT, FIRE SAFETY
19 PROCEDURES, HEALTH CARE, PROTECTIVE OVERSIGHT, ABUSE AND NEGLECT
20 PREVENTION, AND REPORTING PROCEDURES.
21 (2) THE REVIEW OF PROVIDERS OF SERVICES, AS DEFINED IN PARAGRAPH FOUR
22 OF SUBDIVISION (A) OF SECTION 16.03 OF THIS ARTICLE, SHALL ENSURE THAT
23 THE PROVIDER OF SERVICES COMPLIES WITH ALL THE REQUIREMENTS OF THE
24 APPLICABLE FEDERAL HOME AND COMMUNITY BASED SERVICES WAIVER PROGRAM AND
25 APPLICABLE FEDERAL REGULATION, SUBDIVISIONS SEVEN AND SEVEN-A OF SECTION
26 THREE HUNDRED SIXTY-SIX OF THE SOCIAL SERVICES LAW AND RULES AND REGU-
27 LATIONS ADOPTED BY THE COMMISSIONER. PERIODIC REVIEW OF SUCH PROVIDERS
28 OF SERVICES SHALL BE MADE AS FREQUENTLY AS THE COMMISSIONER MAY DEEM
29 NECESSARY BUT IN ANY EVENT SUCH REVIEWS SHALL BE MADE ON AT LEAST TWO
30 OCCASIONS DURING EACH CALENDAR YEAR, PROVIDED, HOWEVER, THAT WHERE, IN
31 THE DISCRETION OF THE COMMISSIONER, AN OPERATING CERTIFICATE HAS BEEN
32 ISSUED TO A PROVIDER OF SERVICE WITH A HISTORY OF COMPLIANCE AND A
33 RECORD OF PROVIDING A HIGH QUALITY OF CARE, THE PERIODIC REVIEW REQUIRED
34 BY THIS SUBDIVISION SHALL BE MADE AT LEAST ONCE DURING EACH CALENDAR
35 YEAR.
36 S 11. Subdivisions (b), (c), (d), and (e) of section 16.11 of the
37 mental hygiene law, subdivision (b) as amended by chapter 37 of the laws
38 of 2011, and subdivisions (c), (d) and (e) as added by chapter 786 of
39 the laws of 1983, are amended to read as follows:
40 (b) The commissioner shall have the power to conduct investigations
41 into the operations of any PROVIDER OF SERVICES, person or entity which
42 holds an operating certificate issued by the office, into the operation
43 of any facility, SERVICES or program issued an operating certificate by
44 the office and into the operations, related to the provision of services
45 regulated by this chapter, of any person or entity providing a residence
46 for one or more unrelated persons with developmental disabilities.
47 (c) In conducting [an inspection] A REVIEW or investigation, the
48 commissioner or his OR HER authorized representative shall have the
49 power to [inspect] REVIEW facilities, conduct interviews of clients,
50 interview personnel, examine and copy all records, including financial
51 and medical records of the facility OR PROVIDER OF SERVICES, and obtain
52 such other information as may be required in order to carry out his OR
53 HER responsibilities under this chapter.
54 (d) In conducting any [inspection] REVIEW or investigation under this
55 chapter, the commissioner or his OR HER authorized representative is
56 empowered to subpoena witnesses, compel their attendance, administer
A. 6007 85
1 oaths to witnesses, examine witnesses under oath, and require the
2 production of any books or papers deemed relevant to the investigation,
3 [inspection] REVIEW, or hearing. A subpoena issued under this section
4 shall be regulated by the civil practice law and rules.
5 (e) The supreme court may enjoin persons or entities subject to
6 [inspection] REVIEW or investigation pursuant to this article to cooper-
7 ate with the commissioner and to allow the commissioner access to
8 PROVIDERS OF SERVICES, facilities, records, clients and personnel as
9 necessary to enable the commissioner to conduct the [inspection] REVIEW
10 or investigation.
11 S 12. Section 16.17 of the mental hygiene law, as added by chapter 786
12 of the laws of 1983, subdivision (a), subparagraph b of paragraph 1 and
13 paragraph 2 of subdivision (b) as amended and subparagraph d of para-
14 graph 1 of subdivision (b) as relettered by chapter 169 of the laws of
15 1992, subdivision (b) as amended by chapter 856 of the laws of 1985, the
16 opening paragraph and subparagraph c of paragraph 1 of subdivision (b)
17 as amended by chapter 37 of the laws of 2011, subparagraph d of para-
18 graph 1 of subdivision (b) as added by chapter 618 of the laws of 1990,
19 paragraph 4 of subdivision (b) as amended by chapter 168 of the laws of
20 2010, paragraph 1 of subdivision (f) as amended by chapter 601 of the
21 laws of 2007, subdivision (g) as amended by chapter 24 of the laws of
22 2007, and subdivision (h) as amended by chapter 306 of the laws of 1995,
23 is amended to read as follows:
24 S 16.17 Suspension, revocation, or limitation of an operating certif-
25 icate.
26 (a) The commissioner may revoke, suspend, or limit an operating
27 certificate or impose the penalties described in subparagraph a, b, c or
28 d of paragraph one of subdivision (b) or in subdivision (g) of this
29 section upon a determination that the holder of the certificate has
30 failed to comply with the terms of its operating certificate or with the
31 provisions of any applicable statute, rule or regulation. The holder of
32 the certificate shall be given notice and an opportunity to be heard
33 prior to any such determination except that no such notice and opportu-
34 nity to be heard shall be necessary prior to an emergency suspension or
35 limitation of the facility's OR PROVIDER OF SERVICES' operating certif-
36 icate imposed pursuant to paragraph one of subdivision (b) of this
37 section, nor shall such notice and opportunity to be heard be necessary
38 should the commissioner, in his OR HER discretion, decide to issue sepa-
39 rate operating certificates to each facility OR PROVIDER OF SERVICES
40 formerly included under the services authorized by one operating certif-
41 icate to the provider of services.
42 (b) (1) An operating certificate may be temporarily suspended or
43 limited without a prior hearing for a period not in excess of sixty days
44 upon written notice to the facility OR PROVIDER OF SERVICES following a
45 finding by the office for people with developmental disabilities that a
46 [client's] INDIVIDUAL'S health or safety is in imminent danger. Upon
47 such finding and notice, the power of the commissioner temporarily to
48 suspend or limit an operating certificate shall include, but shall not
49 be limited to, the power to:
50 a. Prohibit or limit the placement of new [clients] INDIVIDUALS in the
51 facility OR SERVICES;
52 b. Remove or cause to be removed some or all of the [clients] INDIVID-
53 UALS in the facility OR SERVICES;
54 c. Suspend or limit or cause to be suspended or limited the payment of
55 any governmental funds to the facility OR PROVIDER OF SERVICES provided
56 that such action shall not in any way jeopardize the health, safety and
A. 6007 86
1 welfare of any person with a developmental disability in such program or
2 facility OR SERVICES;
3 d. Prohibit or limit the placement of new [clients] INDIVIDUALS,
4 remove or cause to be removed some or all [clients] INDIVIDUALS, or
5 suspend or limit or cause to be suspended or limited the payment of any
6 governmental funds, in or to any one or more of the facilities OR
7 PROVIDER OF SERVICES authorized pursuant to an operating certificate
8 [issued to a provider of services].
9 (2) At any time subsequent to the suspension or limitation of any
10 operating certificate pursuant to paragraph one of this subdivision
11 where said suspension or limitation is the result of correctable phys-
12 ical plant, staffing or program deficiencies, the facility OR PROVIDER
13 OF SERVICES may request the office to [reinspect] REVIEW the facility OR
14 PROVIDER OF SERVICES to redetermine whether a physical plant, staffing
15 or program deficiency continues to exist. After the receipt of such a
16 request, the office shall [reinspect] REVIEW the facility OR PROVIDER OF
17 SERVICES within ten days and in the event that the previously found
18 physical plant, staffing or program deficiency has been corrected, the
19 suspension or limitation shall be withdrawn. If the physical plant,
20 staffing or program deficiency has not been corrected, the commissioner
21 shall not thereafter be required to [reinspect] REVIEW the facility OR
22 PROVIDER OF SERVICES during the emergency period of suspension or limi-
23 tation.
24 (3) During the sixty day suspension or limitation period provided for
25 in paragraph one of this subdivision the commissioner shall determine
26 whether to reinstate or remove the limitations on the facility's OR
27 PROVIDER OF SERVICES' operating certificate or to revoke, suspend or
28 limit the operating certificate pursuant to subdivision (a) of this
29 section. Should the commissioner choose to revoke, suspend or limit the
30 operating certificate, then the emergency suspension or limitation
31 provided for in this subdivision shall remain in effect pending the
32 outcome of an administrative hearing on the revocation, suspension or
33 limitation.
34 (4) The facility operator OR PROVIDER OF SERVICES, within ten days of
35 the date when the emergency suspension or limitation pursuant to para-
36 graph one of this subdivision is first imposed, may request an evidenti-
37 ary hearing to contest the validity of the emergency suspension or limi-
38 tation. Such an evidentiary hearing shall commence within ten days of
39 the facility operator's OR PROVIDER'S request and no request for an
40 adjournment shall be granted without the concurrence of the facility
41 operator OR PROVIDER OF SERVICES, office for people with developmental
42 disabilities, and the hearing officer. The evidentiary hearing shall be
43 limited to those violations of federal and state law and regulations
44 that existed at the time of the emergency suspension or limitation and
45 which gave rise to the emergency suspension or limitation. The emergency
46 suspension or limitation shall be upheld upon a determination that the
47 office for people with developmental disabilities had reasonable cause
48 to believe that a [client's] INDIVIDUAL'S health or safety was in immi-
49 nent danger. A record of such hearing shall be made available to the
50 facility operator OR PROVIDER OF SERVICES upon request. Should the
51 commissioner determine to revoke, suspend or limit [the facility's] AN
52 operating certificate pursuant to subdivision (a) of this section, no
53 administrative hearing on that action shall commence prior to the
54 conclusion of the evidentiary hearing. The commissioner shall issue a
55 ruling within ten days after the receipt of the hearing officer's
56 report.
A. 6007 87
1 (c) When the holder of an operating certificate shall request an
2 opportunity to be heard, the commissioner shall fix a time and place for
3 the hearing. A copy of the charges, together with the notice of the time
4 and place of the hearing, shall be served in person or mailed by regis-
5 tered or certified mail to the facility OR PROVIDER OF SERVICES at least
6 ten days before the date fixed for the hearing. The facility OR PROVIDER
7 OF SERVICES shall file with the office, not less than three days prior
8 to the hearing, a written answer to the charges.
9 (d) (1) When a hearing must be afforded pursuant to this section or
10 other provisions of this article, the commissioner, acting as hearing
11 officer, or any person designated by him OR HER as hearing officer,
12 shall have power to:
13 a. administer oaths and affirmations;
14 b. issue subpoenas, which shall be regulated by the civil practice law
15 and rules;
16 c. take testimony; or
17 d. control the conduct of the hearing.
18 (2) The rules of evidence observed by courts need not be observed
19 except that the rules of privilege recognized by law shall be respected.
20 Irrelevant or unduly repetitious evidence may be excluded.
21 (3) All parties shall have the right of counsel and be afforded an
22 opportunity to present evidence and cross-examine witnesses.
23 (4) If evidence at the hearing relates to the identity, condition, or
24 clinical record of [a client] AN INDIVIDUAL, the hearing officer may
25 exclude all persons from the room except parties to the proceeding,
26 their counsel and the witness. The record of such proceeding shall not
27 be available to anyone outside the office, other than a party to the
28 proceeding or his counsel, except by order of a court of record.
29 (5) The commissioner may establish regulations to govern the hearing
30 procedure and the process of determination of the proceeding.
31 (6) The commissioner shall issue a ruling within ten days after the
32 termination of the hearing or, if a hearing officer has been designated,
33 within ten days from the hearing officer's report.
34 (e) All orders or determinations hereunder shall be subject to review
35 as provided in article seventy-eight of the civil practice law and
36 rules.
37 (f) (1) Except as provided in paragraph two of this subdivision,
38 anything contained in this section to the contrary notwithstanding, an
39 operating certificate of a facility OR PROVIDER OF SERVICES shall be
40 revoked upon a finding by the office that any individual, member of a
41 partnership or shareholder of a corporation to whom or to which an oper-
42 ating certificate has been issued, has been convicted of a class A, B or
43 C felony or a felony related in any way to any activity or program
44 subject to the regulations, supervision, or administration of the office
45 or of the office of temporary and disability assistance, the department
46 of health, or another office of the department of mental hygiene, or in
47 violation of the public officers law in a court of competent jurisdic-
48 tion of the state, or in a court in another jurisdiction for an act
49 which would have been a class A, B or C felony in this state or a felony
50 in any way related to any activity or program which would be subject to
51 the regulations, supervision, or administration of the office or of the
52 office of temporary and disability assistance, the department of health,
53 or another office of the department of mental hygiene, or for an act
54 which would be in violation of the public officers law. The commissioner
55 shall not revoke or limit the operating certificate of any facility OR
56 PROVIDER OF SERVICES, solely because of the conviction, whether in the
A. 6007 88
1 courts of this state or in the courts of another jurisdiction, more than
2 ten years prior to the effective date of such revocation or limitation,
3 of any person of a felony, or what would amount to a felony if committed
4 within the state, unless the commissioner makes a determination that
5 such conviction was related to an activity or program subject to the
6 regulations, supervision, and administration of the office or of the
7 office of temporary and disability assistance, the department of health,
8 or another office of the department of mental hygiene, or in violation
9 of the public officers law.
10 (2) In the event one or more members of a partnership or shareholders
11 of a corporation shall have been convicted of a felony as described in
12 paragraph one of this subdivision, the commissioner shall, in addition
13 to his OR HER other powers, limit the existing operating certificate of
14 such partnership or corporation so that it shall apply only to the
15 remaining partner or shareholders, as the case may be, provided that
16 every such convicted person immediately and completely ceases and with-
17 draws from participation in the management and operation of the facility
18 OR PROVIDER OF SERVICES and further provided that a change of ownership
19 or transfer of stock is completed without delay, and provided that such
20 partnership or corporation shall immediately reapply for a certificate
21 of operation pursuant to subdivision (a) of section 16.05 of this arti-
22 cle.
23 (g) The commissioner may impose a fine upon a finding that the holder
24 of the certificate has failed to comply with the terms of the operating
25 certificate or with the provisions of any applicable statute, rule or
26 regulation. The maximum amount of such fine shall be one thousand
27 dollars per day or fifteen thousand dollars per violation.
28 Such penalty may be recovered by an action brought by the commissioner
29 in any court of competent jurisdiction.
30 Such penalty may be released or compromised by the commissioner before
31 the matter has been referred to the attorney general. Any such penalty
32 may be released or compromised and any action commenced to recover the
33 same may be settled or discontinued by the attorney general with the
34 consent of the commissioner.
35 (h) Where a proceeding has been brought pursuant to section 16.27 of
36 this article, and a receiver appointed pursuant thereto, the commission-
37 er may assume operation of the facility subject to such receivership,
38 upon termination of such receivership, and upon showing to the court
39 having jurisdiction over such receivership that no voluntary associ-
40 ation, not-for-profit corporation or other appropriate provider is will-
41 ing to assume operation of the facility subject to receivership and is
42 capable of meeting the requirements of this article; provided that the
43 commissioner notifies the chairman of the assembly ways and means
44 committee, the chairman of the senate finance committee and the director
45 of the budget of his intention to assume operation of such facility upon
46 service of the order to show cause upon the owner or operator of the
47 facility, pursuant to subdivision (b) of section 16.27 of this article.
48 S 13. Paragraph 5 of subdivision (a) of section 16.29 of the mental
49 hygiene law, as amended by section 9 of part C of chapter 501 of the
50 laws of 2012, is amended to read as follows:
51 (5) removing a service recipient when it is determined that there is a
52 risk to such person if he or she continues to remain in a facility OR
53 SERVICE PROGRAM; and
54 S 14. Paragraph (ii) of subdivision (c) of section 16.29 of the mental
55 hygiene law, as amended by section 9 of part C of chapter 501 of the
56 laws of 2012, is amended to read as follows:
A. 6007 89
1 (ii) development and implementation of a plan of prevention and reme-
2 diation, in the event an investigation of a report of an alleged report-
3 able incident exists and such reportable incident may be attributed in
4 whole or in part to noncompliance by the facility OR PROVIDER OF
5 SERVICES with the provisions of this chapter or regulations of the
6 office applicable to the operation of such facility OR PROVIDER OF
7 SERVICES. Any plan of prevention and remediation required to be devel-
8 oped pursuant to this subdivision by a facility supervised by the office
9 shall be submitted to and approved by such office in accordance with
10 time limits established by regulations of such office. Implementation of
11 the plan shall be monitored by such office. In reviewing the continued
12 qualifications of a residential facility OR PROVIDER OF SERVICES or
13 program for an operating certificate, the office shall evaluate such
14 facility's OR PROVIDER OF SERVICE'S compliance with plans of prevention
15 and remediation developed and implemented pursuant to this subdivision.
16 S 14-a. Section 366 of the social services law is amended by adding a
17 new subdivision 7-b to read as follows:
18 7-B. SERVICES AND NEEDS ASSESSMENT. ON OR BEFORE JANUARY FIRST, TWO
19 THOUSAND SIXTEEN, THE ASSESSMENT COMPLETED PURSUANT TO SUBDIVISION
20 SEVEN-A OF THIS SECTION SHALL BE COMPLETED BY A SCIENTIFICALLY VALID AND
21 RELIABLE ASSESSMENT TOOL. SUCH TOOL MUST MEET INTER-RATER RELIABILITY
22 STANDARDS ESTABLISHED BY THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISA-
23 BILITIES IN CONJUNCTION WITH STAKEHOLDER INPUT. THE ASSESSMENT SHALL
24 ALSO INCLUDE AN EVALUATION OF THE INDIVIDUAL'S HOME ENVIRONMENT, INCLUD-
25 ING BUT NOT LIMITED TO, THE ABILITY OF FAMILY AND/OR CAREGIVERS TO
26 PROVIDE SUPPORTS OUTSIDE OF THOSE WITHIN THE WAIVER, INCLUDING BUT NOT
27 LIMITED TO, ACTIVITIES OF DAILY LIVING.
28 S 15. This act shall take effect immediately.
29 PART T
30 Intentionally Omitted
31 PART U
32 Intentionally Omitted
33 PART V
34 Section 1. Section 19.09 of the mental hygiene law is amended by
35 adding a new subdivision (j) to read as follows:
36 (J) THE COMMISSIONER, IN CONSULTATION WITH THE NEW YORK STATE GAMING
37 COMMISSION, IS AUTHORIZED AND DIRECTED TO COMMISSION A STATEWIDE EVALU-
38 ATION REGARDING THE EXTENT OF LEGAL AND ILLEGAL GAMBLING BY NEW YORK
39 STATE RESIDENTS, INCLUDING, BUT NOT LIMITED TO THE LOTTERY, HORSE
40 RACING, NATIVE AMERICAN CASINOS, INTERNET GAMBLING, SPORTS BETTING, AND
41 POKER. SUCH EVALUATION SHALL BE DELIVERED TO THE GOVERNOR AND LEGISLA-
42 TURE NO LATER THAN DECEMBER FIRST, TWO THOUSAND SEVENTEEN. THE EVALU-
43 ATION SHALL BE PREPARED IN CONSULTATION WITH PERTINENT STAKEHOLDERS,
44 INCLUDING BUT NOT LIMITED TO, VOLUNTARY AGENCIES, LOCAL GOVERNMENTAL
45 UNITS, INDIVIDUALS WITH PROFESSIONAL RESEARCH EXPERIENCE AND EXPERTISE
46 IN THE APPROPRIATE FIELDS, AND ANY OTHER PERTINENT STAKEHOLDERS DEEMED
47 NECESSARY BY THE COMMISSIONER AND NEW YORK STATE GAMING COMMISSION TO
48 EFFECTUATE THE PURPOSE OF THIS SUBDIVISION.
A. 6007 90
1 (1) SUCH EVALUATION SHALL INCLUDE:
2 (A) THE PERCENTAGE OF NEW YORK RESIDENTS PARTICIPATING IN EACH GAMBL-
3 ING ACTIVITY BY:
4 (I) AGE;
5 (II) RACE;
6 (III) INCOME;
7 (IV) EDUCATION;
8 (V) SEX; AND
9 (VI) ANY OTHER DEMOGRAPHIC THAT WOULD BE RELEVANT TO THE EVALUATION;
10 AND
11 (B) AN ESTIMATE OF THE AMOUNT OF MONEY BEING WAGERED AND LOST BY NEW
12 YORK RESIDENTS IN EACH GAMBLING ACTIVITY.
13 (2) SUCH EVALUATION SHALL PROVIDE A CRITICAL ANALYSIS OF THE RELATION-
14 SHIPS BETWEEN PROBLEM GAMBLING AND BANKRUPTCY, DOMESTIC VIOLENCE,
15 SUICIDE, CRIME, AND ANY OTHER SOCIAL PROBLEM THAT IS RELEVANT TO THE
16 EVALUATION.
17 S 2. This act shall take effect immediately.
18 PART W
19 Section 1. Section 19.09 of the mental hygiene law is amended by
20 adding two new subdivisions (j) and (k) to read as follows:
21 (J) THE COMMISSIONER SHALL CREATE EDUCATIONAL MATERIALS REGARDING
22 COMPULSIVE GAMBLING FOR THE PURPOSE OF EDUCATING INDIVIDUALS THAT VOLUN-
23 TARILY PLACE THEMSELVES ON A SELF EXCLUSION LIST OF AN ASSOCIATION OR
24 CORPORATION LICENSED OR ENFRANCHISED BY THE NEW YORK STATE GAMING
25 COMMISSION PURSUANT TO SECTION ONE HUNDRED ELEVEN OF THE RACING,
26 PARI-MUTUEL WAGERING AND BREEDING LAW IMMEDIATELY UPON PLACEMENT ON SUCH
27 LIST. THE EDUCATIONAL MATERIALS SHALL BE MADE AVAILABLE ON THE WEBSITE
28 OF THE OFFICE AND SHALL INCLUDE BUT NOT BE LIMITED TO RESOURCES TO
29 TREATMENT.
30 (K) THE COMMISSIONER, IN CONSULTATION WITH THE NEW YORK STATE GAMING
31 COMMISSION SHALL ESTABLISH A PROBLEM GAMBLING EDUCATION PROGRAM TO BE
32 COMPLETED BY ALL INDIVIDUALS THAT HAVE PLACED THEMSELVES ON A SELF
33 EXCLUSION LIST PURSUANT TO SECTION ONE HUNDRED ELEVEN OF THE RACING,
34 PARI-MUTUEL WAGERING AND BREEDING LAW, WHOM SUBSEQUENTLY REQUEST REMOVAL
35 FROM SUCH EXCLUSION LIST. THIS EDUCATION PROGRAM SHALL BE MADE AVAILABLE
36 ON THE WEBSITES OF BOTH THE OFFICE AND THE NEW YORK STATE GAMING COMMIS-
37 SION AND SHALL INCLUDE BUT NOT BE LIMITED TO RESOURCES TO TREATMENT.
38 S 2. Paragraphs (a) and (c) of subdivision 2 of section 111 of the
39 racing, pari-mutuel wagering and breeding law, as added by section 1 of
40 part A of chapter 60 of the laws of 2012, are amended to read as
41 follows:
42 (a) The commission shall promulgate rules and regulations pursuant to
43 which people may: voluntarily exclude themselves from entering the prem-
44 ises of an association or corporation licensed or enfranchised by the
45 commission pursuant to this chapter; RECEIVE THE REQUIRED EDUCATIONAL
46 MATERIALS PURSUANT TO SUBDIVISION (J) OF SECTION 19.09 OF THE MENTAL
47 HYGIENE LAW; AND, UPON REQUEST TO BE REMOVED FROM THE SELF EXCLUSION
48 LIST, COMPLETE THE PROBLEM GAMBLING EDUCATION PROGRAM PURSUANT TO SUBDI-
49 VISION (K) OF SECTION 19.09 OF THE MENTAL HYGIENE LAW.
50 (c) No voluntary order or request to exclude persons from entering the
51 premises of any such association, corporation, or facility may be
52 rescinded, canceled, or declared null and void until [seven days after a
53 request] SUCH INDIVIDUAL WHO IS SELF EXCLUDED COMPLETES IN PAPER OR
54 ELECTRONIC FORMAT, AN EDUCATIONAL PROGRAM APPROVED BY THE OFFICE PURSU-
A. 6007 91
1 ANT TO THE PROVISIONS OF SUBDIVISION (K) OF SECTION 19.09 OF THE MENTAL
2 HYGIENE LAW AND PROOF OF COMPLETION has been received by such associ-
3 ation, corporation, or facility to cancel such order or request.
4 S 3. This act shall take effect on the sixtieth day after it shall
5 have become a law.
6 PART X
7 Section 1. Section 4 of chapter 495 of the laws of 2004, amending the
8 insurance law and the public health law relating to the New York state
9 health insurance continuation assistance demonstration project, as
10 amended by section 1 of part GG of chapter 57 of the laws of 2014, is
11 amended to read as follows:
12 S 4. This act shall take effect on the sixtieth day after it shall
13 have become a law; provided, however, that this act shall remain in
14 effect until July 1, [2015] 2016 when upon such date the provisions of
15 this act shall expire and be deemed repealed; provided, further, that a
16 displaced worker shall be eligible for continuation assistance retroac-
17 tive to July 1, 2004.
18 S 2. This act shall take effect immediately.
19 PART Y
20 Section 1. Section 1325 of the insurance law, as added by chapter 489
21 of the laws of 2012, is amended to read as follows:
22 S 1325. Exemption. For the purposes of exempting certain insurance
23 companies from the provisions of section one thousand three hundred
24 twenty-four of this article, the superintendent shall exempt, through
25 December thirty-first, two thousand [sixteen] NINETEEN, those stock and
26 non-stock insurance companies to which subparagraph (B) of paragraph two
27 of subsection (b) of such section applies.
28 S 2. Subsection (c) of section 2343 of the insurance law, as amended
29 by chapter 489 of the laws of 2012, is amended to read as follows:
30 (c) Notwithstanding any other provision of this chapter, no applica-
31 tion for an order of rehabilitation or liquidation of a domestic insurer
32 whose primary liability arises from the business of medical malpractice
33 insurance, as that term is defined in subsection (b) of section five
34 thousand five hundred one of this chapter, shall be made on the grounds
35 specified in subsection (a) or (c) of section seven thousand four
36 hundred two of this chapter at any time prior to December thirty-first,
37 two thousand [sixteen] NINETEEN.
38 S 3. This act shall take effect immediately.
39 PART Z
40 Section 1. Paragraph (a) of subdivision 1 of section 18 of chapter 266
41 of the laws of 1986, amending the civil practice law and rules and other
42 laws relating to malpractice and professional medical conduct, as
43 amended by section 18 of part B of chapter 60 of the laws of 2014, is
44 amended to read as follows:
45 (a) The superintendent of [insurance] FINANCIAL SERVICES and the
46 commissioner of health or their designee shall, from funds available in
47 the hospital excess liability pool created pursuant to subdivision 5 of
48 this section, purchase a policy or policies for excess insurance cover-
49 age, as authorized by paragraph 1 of subsection (e) of section 5502 of
50 the insurance law; or from an insurer, other than an insurer described
A. 6007 92
1 in section 5502 of the insurance law, duly authorized to write such
2 coverage and actually writing medical malpractice insurance in this
3 state; or shall purchase equivalent excess coverage in a form previously
4 approved by the superintendent of [insurance] FINANCIAL SERVICES for
5 purposes of providing equivalent excess coverage in accordance with
6 section 19 of chapter 294 of the laws of 1985, for medical or dental
7 malpractice occurrences between July 1, 1986 and June 30, 1987, between
8 July 1, 1987 and June 30, 1988, between July 1, 1988 and June 30, 1989,
9 between July 1, 1989 and June 30, 1990, between July 1, 1990 and June
10 30, 1991, between July 1, 1991 and June 30, 1992, between July 1, 1992
11 and June 30, 1993, between July 1, 1993 and June 30, 1994, between July
12 1, 1994 and June 30, 1995, between July 1, 1995 and June 30, 1996,
13 between July 1, 1996 and June 30, 1997, between July 1, 1997 and June
14 30, 1998, between July 1, 1998 and June 30, 1999, between July 1, 1999
15 and June 30, 2000, between July 1, 2000 and June 30, 2001, between July
16 1, 2001 and June 30, 2002, between July 1, 2002 and June 30, 2003,
17 between July 1, 2003 and June 30, 2004, between July 1, 2004 and June
18 30, 2005, between July 1, 2005 and June 30, 2006, between July 1, 2006
19 and June 30, 2007, between July 1, 2007 and June 30, 2008, between July
20 1, 2008 and June 30, 2009, between July 1, 2009 and June 30, 2010,
21 between July 1, 2010 and June 30, 2011, between July 1, 2011 and June
22 30, 2012, between July 1, 2012 and June 30, 2013, between July 1, 2013
23 and June 30, 2014, [and] between July 1, 2014 and June 30, 2015, AND
24 BETWEEN JULY 1, 2015 AND JUNE 30, 2016 or reimburse the hospital where
25 the hospital purchases equivalent excess coverage as defined in subpara-
26 graph (i) of paragraph (a) of subdivision 1-a of this section for
27 medical or dental malpractice occurrences between July 1, 1987 and June
28 30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989
29 and June 30, 1990, between July 1, 1990 and June 30, 1991, between July
30 1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,
31 between July 1, 1993 and June 30, 1994, between July 1, 1994 and June
32 30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996
33 and June 30, 1997, between July 1, 1997 and June 30, 1998, between July
34 1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000,
35 between July 1, 2000 and June 30, 2001, between July 1, 2001 and June
36 30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003
37 and June 30, 2004, between July 1, 2004 and June 30, 2005, between July
38 1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007,
39 between July 1, 2007 and June 30, 2008, between July 1, 2008 and June
40 30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010
41 and June 30, 2011, between July 1, 2011 and June 30, 2012, between July
42 1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014, [and]
43 between July 1, 2014 and June 30, 2015, AND BETWEEN JULY 1, 2015 AND
44 JUNE 30, 2016 for physicians or dentists certified as eligible for each
45 such period or periods pursuant to subdivision 2 of this section by a
46 general hospital licensed pursuant to article 28 of the public health
47 law; provided that no single insurer shall write more than fifty percent
48 of the total excess premium for a given policy year; and provided,
49 however, that such eligible physicians or dentists must have in force an
50 individual policy, from an insurer licensed in this state of primary
51 malpractice insurance coverage in amounts of no less than one million
52 three hundred thousand dollars for each claimant and three million nine
53 hundred thousand dollars for all claimants under that policy during the
54 period of such excess coverage for such occurrences or be endorsed as
55 additional insureds under a hospital professional liability policy which
56 is offered through a voluntary attending physician ("channeling")
A. 6007 93
1 program previously permitted by the superintendent of [insurance] FINAN-
2 CIAL SERVICES during the period of such excess coverage for such occur-
3 rences. During such period, such policy for excess coverage or such
4 equivalent excess coverage shall, when combined with the physician's or
5 dentist's primary malpractice insurance coverage or coverage provided
6 through a voluntary attending physician ("channeling") program, total an
7 aggregate level of two million three hundred thousand dollars for each
8 claimant and six million nine hundred thousand dollars for all claimants
9 from all such policies with respect to occurrences in each of such years
10 provided, however, if the cost of primary malpractice insurance coverage
11 in excess of one million dollars, but below the excess medical malprac-
12 tice insurance coverage provided pursuant to this act, exceeds the rate
13 of nine percent per annum, then the required level of primary malprac-
14 tice insurance coverage in excess of one million dollars for each claim-
15 ant shall be in an amount of not less than the dollar amount of such
16 coverage available at nine percent per annum; the required level of such
17 coverage for all claimants under that policy shall be in an amount not
18 less than three times the dollar amount of coverage for each claimant;
19 and excess coverage, when combined with such primary malpractice insur-
20 ance coverage, shall increase the aggregate level for each claimant by
21 one million dollars and three million dollars for all claimants; and
22 provided further, that, with respect to policies of primary medical
23 malpractice coverage that include occurrences between April 1, 2002 and
24 June 30, 2002, such requirement that coverage be in amounts no less than
25 one million three hundred thousand dollars for each claimant and three
26 million nine hundred thousand dollars for all claimants for such occur-
27 rences shall be effective April 1, 2002.
28 S 2. Subdivision 3 of section 18 of chapter 266 of the laws of 1986,
29 amending the civil practice law and rules and other laws relating to
30 malpractice and professional medical conduct, as amended by section 19
31 of part B of chapter 60 of the laws of 2014, is amended to read as
32 follows:
33 (3)(a) The superintendent of [insurance] FINANCIAL SERVICES shall
34 determine and certify to each general hospital and to the commissioner
35 of health the cost of excess malpractice insurance for medical or dental
36 malpractice occurrences between July 1, 1986 and June 30, 1987, between
37 July 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990,
38 between July 1, 1990 and June 30, 1991, between July 1, 1991 and June
39 30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993
40 and June 30, 1994, between July 1, 1994 and June 30, 1995, between July
41 1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997,
42 between July 1, 1997 and June 30, 1998, between July 1, 1998 and June
43 30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000
44 and June 30, 2001, between July 1, 2001 and June 30, 2002, between July
45 1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004,
46 between July 1, 2004 and June 30, 2005, between July 1, 2005 and June
47 30, 2006, between July 1, 2006 and June 30, 2007, between July 1, 2007
48 and June 30, 2008, between July 1, 2008 and June 30, 2009, between July
49 1, 2009 and June 30, 2010, between July 1, 2010 and June 30, 2011,
50 between July 1, 2011 and June 30, 2012, between July 1, 2012 and June
51 30, 2013, and between July 1, 2013 and June 30, 2014, [and] between July
52 1, 2014 and June 30, 2015, AND BETWEEN JULY 1, 2015 AND JUNE 30, 2016
53 allocable to each general hospital for physicians or dentists certified
54 as eligible for purchase of a policy for excess insurance coverage by
55 such general hospital in accordance with subdivision 2 of this section,
56 and may amend such determination and certification as necessary.
A. 6007 94
1 (b) The superintendent of [insurance] FINANCIAL SERVICES shall deter-
2 mine and certify to each general hospital and to the commissioner of
3 health the cost of excess malpractice insurance or equivalent excess
4 coverage for medical or dental malpractice occurrences between July 1,
5 1987 and June 30, 1988, between July 1, 1988 and June 30, 1989, between
6 July 1, 1989 and June 30, 1990, between July 1, 1990 and June 30, 1991,
7 between July 1, 1991 and June 30, 1992, between July 1, 1992 and June
8 30, 1993, between July 1, 1993 and June 30, 1994, between July 1, 1994
9 and June 30, 1995, between July 1, 1995 and June 30, 1996, between July
10 1, 1996 and June 30, 1997, between July 1, 1997 and June 30, 1998,
11 between July 1, 1998 and June 30, 1999, between July 1, 1999 and June
12 30, 2000, between July 1, 2000 and June 30, 2001, between July 1, 2001
13 and June 30, 2002, between July 1, 2002 and June 30, 2003, between July
14 1, 2003 and June 30, 2004, between July 1, 2004 and June 30, 2005,
15 between July 1, 2005 and June 30, 2006, between July 1, 2006 and June
16 30, 2007, between July 1, 2007 and June 30, 2008, between July 1, 2008
17 and June 30, 2009, between July 1, 2009 and June 30, 2010, between July
18 1, 2010 and June 30, 2011, between July 1, 2011 and June 30, 2012,
19 between July 1, 2012 and June 30, 2013, between July 1, 2013 and June
20 30, 2014, [and] between July 1, 2014 and June 30, 2015, AND BETWEEN JULY
21 1, 2015 AND JUNE 30, 2016 allocable to each general hospital for physi-
22 cians or dentists certified as eligible for purchase of a policy for
23 excess insurance coverage or equivalent excess coverage by such general
24 hospital in accordance with subdivision 2 of this section, and may amend
25 such determination and certification as necessary. The superintendent of
26 [insurance] FINANCIAL SERVICES shall determine and certify to each
27 general hospital and to the commissioner of health the ratable share of
28 such cost allocable to the period July 1, 1987 to December 31, 1987, to
29 the period January 1, 1988 to June 30, 1988, to the period July 1, 1988
30 to December 31, 1988, to the period January 1, 1989 to June 30, 1989, to
31 the period July 1, 1989 to December 31, 1989, to the period January 1,
32 1990 to June 30, 1990, to the period July 1, 1990 to December 31, 1990,
33 to the period January 1, 1991 to June 30, 1991, to the period July 1,
34 1991 to December 31, 1991, to the period January 1, 1992 to June 30,
35 1992, to the period July 1, 1992 to December 31, 1992, to the period
36 January 1, 1993 to June 30, 1993, to the period July 1, 1993 to December
37 31, 1993, to the period January 1, 1994 to June 30, 1994, to the period
38 July 1, 1994 to December 31, 1994, to the period January 1, 1995 to June
39 30, 1995, to the period July 1, 1995 to December 31, 1995, to the period
40 January 1, 1996 to June 30, 1996, to the period July 1, 1996 to December
41 31, 1996, to the period January 1, 1997 to June 30, 1997, to the period
42 July 1, 1997 to December 31, 1997, to the period January 1, 1998 to June
43 30, 1998, to the period July 1, 1998 to December 31, 1998, to the period
44 January 1, 1999 to June 30, 1999, to the period July 1, 1999 to December
45 31, 1999, to the period January 1, 2000 to June 30, 2000, to the period
46 July 1, 2000 to December 31, 2000, to the period January 1, 2001 to June
47 30, 2001, to the period July 1, 2001 to June 30, 2002, to the period
48 July 1, 2002 to June 30, 2003, to the period July 1, 2003 to June 30,
49 2004, to the period July 1, 2004 to June 30, 2005, to the period July 1,
50 2005 and June 30, 2006, to the period July 1, 2006 and June 30, 2007, to
51 the period July 1, 2007 and June 30, 2008, to the period July 1, 2008
52 and June 30, 2009, to the period July 1, 2009 and June 30, 2010, to the
53 period July 1, 2010 and June 30, 2011, to the period July 1, 2011 and
54 June 30, 2012, to the period July 1, 2012 and June 30, 2013, to the
55 period July 1, 2013 and June 30, 2014, [and] to the period July 1, 2014
56 and June 30, 2015, AND TO THE PERIOD JULY 1, 2015 AND JUNE 30, 2016.
A. 6007 95
1 S 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
2 18 of chapter 266 of the laws of 1986, amending the civil practice law
3 and rules and other laws relating to malpractice and professional
4 medical conduct, as amended by section 20 of part B of chapter 60 of the
5 laws of 2014, are amended to read as follows:
6 (a) To the extent funds available to the hospital excess liability
7 pool pursuant to subdivision 5 of this section as amended, and pursuant
8 to section 6 of part J of chapter 63 of the laws of 2001, as may from
9 time to time be amended, which amended this subdivision, are insuffi-
10 cient to meet the costs of excess insurance coverage or equivalent
11 excess coverage for coverage periods during the period July 1, 1992 to
12 June 30, 1993, during the period July 1, 1993 to June 30, 1994, during
13 the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
14 to June 30, 1996, during the period July 1, 1996 to June 30, 1997,
15 during the period July 1, 1997 to June 30, 1998, during the period July
16 1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30,
17 2000, during the period July 1, 2000 to June 30, 2001, during the period
18 July 1, 2001 to October 29, 2001, during the period April 1, 2002 to
19 June 30, 2002, during the period July 1, 2002 to June 30, 2003, during
20 the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
21 to June 30, 2005, during the period July 1, 2005 to June 30, 2006,
22 during the period July 1, 2006 to June 30, 2007, during the period July
23 1, 2007 to June 30, 2008, during the period July 1, 2008 to June 30,
24 2009, during the period July 1, 2009 to June 30, 2010, during the period
25 July 1, 2010 to June 30, 2011, during the period July 1, 2011 to June
26 30, 2012, during the period July 1, 2012 to June 30, 2013, during the
27 period July 1, 2013 to June 30, 2014, [and] during the period July 1,
28 2014 to June 30, 2015, AND DURING THE PERIOD JULY 1, 2015 AND JUNE 30,
29 2016 allocated or reallocated in accordance with paragraph (a) of subdi-
30 vision 4-a of this section to rates of payment applicable to state
31 governmental agencies, each physician or dentist for whom a policy for
32 excess insurance coverage or equivalent excess coverage is purchased for
33 such period shall be responsible for payment to the provider of excess
34 insurance coverage or equivalent excess coverage of an allocable share
35 of such insufficiency, based on the ratio of the total cost of such
36 coverage for such physician to the sum of the total cost of such cover-
37 age for all physicians applied to such insufficiency.
38 (b) Each provider of excess insurance coverage or equivalent excess
39 coverage covering the period July 1, 1992 to June 30, 1993, or covering
40 the period July 1, 1993 to June 30, 1994, or covering the period July 1,
41 1994 to June 30, 1995, or covering the period July 1, 1995 to June 30,
42 1996, or covering the period July 1, 1996 to June 30, 1997, or covering
43 the period July 1, 1997 to June 30, 1998, or covering the period July 1,
44 1998 to June 30, 1999, or covering the period July 1, 1999 to June 30,
45 2000, or covering the period July 1, 2000 to June 30, 2001, or covering
46 the period July 1, 2001 to October 29, 2001, or covering the period
47 April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to
48 June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
49 covering the period July 1, 2004 to June 30, 2005, or covering the peri-
50 od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
51 June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or
52 covering the period July 1, 2008 to June 30, 2009, or covering the peri-
53 od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
54 June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
55 covering the period July 1, 2012 to June 30, 2013, or covering the peri-
56 od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
A. 6007 96
1 June 30, 2015, OR COVERING THE PERIOD JULY 1, 2015 TO JUNE 30, 2016
2 shall notify a covered physician or dentist by mail, mailed to the
3 address shown on the last application for excess insurance coverage or
4 equivalent excess coverage, of the amount due to such provider from such
5 physician or dentist for such coverage period determined in accordance
6 with paragraph (a) of this subdivision. Such amount shall be due from
7 such physician or dentist to such provider of excess insurance coverage
8 or equivalent excess coverage in a time and manner determined by the
9 superintendent of [insurance] FINANCIAL SERVICES.
10 (c) If a physician or dentist liable for payment of a portion of the
11 costs of excess insurance coverage or equivalent excess coverage cover-
12 ing the period July 1, 1992 to June 30, 1993, or covering the period
13 July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to
14 June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
15 covering the period July 1, 1996 to June 30, 1997, or covering the peri-
16 od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
17 June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or
18 covering the period July 1, 2000 to June 30, 2001, or covering the peri-
19 od July 1, 2001 to October 29, 2001, or covering the period April 1,
20 2002 to June 30, 2002, or covering the period July 1, 2002 to June 30,
21 2003, or covering the period July 1, 2003 to June 30, 2004, or covering
22 the period July 1, 2004 to June 30, 2005, or covering the period July 1,
23 2005 to June 30, 2006, or covering the period July 1, 2006 to June 30,
24 2007, or covering the period July 1, 2007 to June 30, 2008, or covering
25 the period July 1, 2008 to June 30, 2009, or covering the period July 1,
26 2009 to June 30, 2010, or covering the period July 1, 2010 to June 30,
27 2011, or covering the period July 1, 2011 to June 30, 2012, or covering
28 the period July 1, 2012 to June 30, 2013, or covering the period July 1,
29 2013 to June 30, 2014, or covering the period July 1, 2014 to June 30,
30 2015, OR COVERING THE PERIOD JULY 1, 2015 TO JUNE 30, 2016 determined in
31 accordance with paragraph (a) of this subdivision fails, refuses or
32 neglects to make payment to the provider of excess insurance coverage or
33 equivalent excess coverage in such time and manner as determined by the
34 superintendent of [insurance] FINANCIAL SERVICES pursuant to paragraph
35 (b) of this subdivision, excess insurance coverage or equivalent excess
36 coverage purchased for such physician or dentist in accordance with this
37 section for such coverage period shall be cancelled and shall be null
38 and void as of the first day on or after the commencement of a policy
39 period where the liability for payment pursuant to this subdivision has
40 not been met.
41 (d) Each provider of excess insurance coverage or equivalent excess
42 coverage shall notify the superintendent of [insurance] FINANCIAL
43 SERVICES and the commissioner of health or their designee of each physi-
44 cian and dentist eligible for purchase of a policy for excess insurance
45 coverage or equivalent excess coverage covering the period July 1, 1992
46 to June 30, 1993, or covering the period July 1, 1993 to June 30, 1994,
47 or covering the period July 1, 1994 to June 30, 1995, or covering the
48 period July 1, 1995 to June 30, 1996, or covering the period July 1,
49 1996 to June 30, 1997, or covering the period July 1, 1997 to June 30,
50 1998, or covering the period July 1, 1998 to June 30, 1999, or covering
51 the period July 1, 1999 to June 30, 2000, or covering the period July 1,
52 2000 to June 30, 2001, or covering the period July 1, 2001 to October
53 29, 2001, or covering the period April 1, 2002 to June 30, 2002, or
54 covering the period July 1, 2002 to June 30, 2003, or covering the peri-
55 od July 1, 2003 to June 30, 2004, or covering the period July 1, 2004 to
56 June 30, 2005, or covering the period July 1, 2005 to June 30, 2006, or
A. 6007 97
1 covering the period July 1, 2006 to June 30, 2007, or covering the peri-
2 od July 1, 2007 to June 30, 2008, or covering the period July 1, 2008 to
3 June 30, 2009, or covering the period July 1, 2009 to June 30, 2010, or
4 covering the period July 1, 2010 to June 30, 2011, or covering the peri-
5 od July 1, 2011 to June 30, 2012, or covering the period July 1, 2012 to
6 June 30, 2013, or covering the period July 1, 2013 to June 30, 2014, or
7 covering the period July 1, 2014 to June 30, 2015, OR COVERING THE PERI-
8 OD JULY 1, 2015 TO JUNE 30, 2016 that has made payment to such provider
9 of excess insurance coverage or equivalent excess coverage in accordance
10 with paragraph (b) of this subdivision and of each physician and dentist
11 who has failed, refused or neglected to make such payment.
12 (e) A provider of excess insurance coverage or equivalent excess
13 coverage shall refund to the hospital excess liability pool any amount
14 allocable to the period July 1, 1992 to June 30, 1993, and to the period
15 July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June
16 30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the
17 period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to
18 June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to
19 the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
20 to June 30, 2001, and to the period July 1, 2001 to October 29, 2001,
21 and to the period April 1, 2002 to June 30, 2002, and to the period July
22 1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30,
23 2004, and to the period July 1, 2004 to June 30, 2005, and to the period
24 July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June
25 30, 2007, and to the period July 1, 2007 to June 30, 2008, and to the
26 period July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to
27 June 30, 2010, and to the period July 1, 2010 to June 30, 2011, and to
28 the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
29 to June 30, 2013, and to the period July 1, 2013 to June 30, 2014, and
30 to the period July 1, 2014 to June 30, 2015, AND TO THE PERIOD JULY 1,
31 2015 TO JUNE 30, 2016 received from the hospital excess liability pool
32 for purchase of excess insurance coverage or equivalent excess coverage
33 covering the period July 1, 1992 to June 30, 1993, and covering the
34 period July 1, 1993 to June 30, 1994, and covering the period July 1,
35 1994 to June 30, 1995, and covering the period July 1, 1995 to June 30,
36 1996, and covering the period July 1, 1996 to June 30, 1997, and cover-
37 ing the period July 1, 1997 to June 30, 1998, and covering the period
38 July 1, 1998 to June 30, 1999, and covering the period July 1, 1999 to
39 June 30, 2000, and covering the period July 1, 2000 to June 30, 2001,
40 and covering the period July 1, 2001 to October 29, 2001, and covering
41 the period April 1, 2002 to June 30, 2002, and covering the period July
42 1, 2002 to June 30, 2003, and covering the period July 1, 2003 to June
43 30, 2004, and covering the period July 1, 2004 to June 30, 2005, and
44 covering the period July 1, 2005 to June 30, 2006, and covering the
45 period July 1, 2006 to June 30, 2007, and covering the period July 1,
46 2007 to June 30, 2008, and covering the period July 1, 2008 to June 30,
47 2009, and covering the period July 1, 2009 to June 30, 2010, and cover-
48 ing the period July 1, 2010 to June 30, 2011, and covering the period
49 July 1, 2011 to June 30, 2012, and covering the period July 1, 2012 to
50 June 30, 2013, and covering the period July 1, 2013 to June 30, 2014,
51 and covering the period July 1, 2014 to June 30, 2015, AND COVERING THE
52 PERIOD JULY 1, 2015 TO JUNE 30, 2016 for a physician or dentist where
53 such excess insurance coverage or equivalent excess coverage is
54 cancelled in accordance with paragraph (c) of this subdivision.
55 S 4. Section 40 of chapter 266 of the laws of 1986, amending the civil
56 practice law and rules and other laws relating to malpractice and
A. 6007 98
1 professional medical conduct, as amended by section 21 of part B of
2 chapter 60 of the laws of 2014, is amended to read as follows:
3 S 40. The superintendent of [insurance] FINANCIAL SERVICES shall
4 establish rates for policies providing coverage for physicians and
5 surgeons medical malpractice for the periods commencing July 1, 1985 and
6 ending June 30, [2015] 2016; provided, however, that notwithstanding any
7 other provision of law, the superintendent shall not establish or
8 approve any increase in rates for the period commencing July 1, 2009 and
9 ending June 30, 2010. The superintendent shall direct insurers to estab-
10 lish segregated accounts for premiums, payments, reserves and investment
11 income attributable to such premium periods and shall require periodic
12 reports by the insurers regarding claims and expenses attributable to
13 such periods to monitor whether such accounts will be sufficient to meet
14 incurred claims and expenses. On or after July 1, 1989, the superinten-
15 dent shall impose a surcharge on premiums to satisfy a projected defi-
16 ciency that is attributable to the premium levels established pursuant
17 to this section for such periods; provided, however, that such annual
18 surcharge shall not exceed eight percent of the established rate until
19 July 1, [2015] 2016, at which time and thereafter such surcharge shall
20 not exceed twenty-five percent of the approved adequate rate, and that
21 such annual surcharges shall continue for such period of time as shall
22 be sufficient to satisfy such deficiency. The superintendent shall not
23 impose such surcharge during the period commencing July 1, 2009 and
24 ending June 30, 2010. On and after July 1, 1989, the surcharge
25 prescribed by this section shall be retained by insurers to the extent
26 that they insured physicians and surgeons during the July 1, 1985
27 through June 30, [2015] 2016 policy periods; in the event and to the
28 extent physicians and surgeons were insured by another insurer during
29 such periods, all or a pro rata share of the surcharge, as the case may
30 be, shall be remitted to such other insurer in accordance with rules and
31 regulations to be promulgated by the superintendent. Surcharges
32 collected from physicians and surgeons who were not insured during such
33 policy periods shall be apportioned among all insurers in proportion to
34 the premium written by each insurer during such policy periods; if a
35 physician or surgeon was insured by an insurer subject to rates estab-
36 lished by the superintendent during such policy periods, and at any time
37 thereafter a hospital, health maintenance organization, employer or
38 institution is responsible for responding in damages for liability aris-
39 ing out of such physician's or surgeon's practice of medicine, such
40 responsible entity shall also remit to such prior insurer the equivalent
41 amount that would then be collected as a surcharge if the physician or
42 surgeon had continued to remain insured by such prior insurer. In the
43 event any insurer that provided coverage during such policy periods is
44 in liquidation, the property/casualty insurance security fund shall
45 receive the portion of surcharges to which the insurer in liquidation
46 would have been entitled. The surcharges authorized herein shall be
47 deemed to be income earned for the purposes of section 2303 of the
48 insurance law. The superintendent, in establishing adequate rates and
49 in determining any projected deficiency pursuant to the requirements of
50 this section and the insurance law, shall give substantial weight,
51 determined in his discretion and judgment, to the prospective antic-
52 ipated effect of any regulations promulgated and laws enacted and the
53 public benefit of stabilizing malpractice rates and minimizing rate
54 level fluctuation during the period of time necessary for the develop-
55 ment of more reliable statistical experience as to the efficacy of such
56 laws and regulations affecting medical, dental or podiatric malpractice
A. 6007 99
1 enacted or promulgated in 1985, 1986, by this act and at any other time.
2 Notwithstanding any provision of the insurance law, rates already estab-
3 lished and to be established by the superintendent pursuant to this
4 section are deemed adequate if such rates would be adequate when taken
5 together with the maximum authorized annual surcharges to be imposed for
6 a reasonable period of time whether or not any such annual surcharge has
7 been actually imposed as of the establishment of such rates.
8 S 5. Section 5 and subdivisions (a) and (e) of section 6 of part J of
9 chapter 63 of the laws of 2001, amending chapter 266 of the laws of
10 1986, amending the civil practice law and rules and other laws relating
11 to malpractice and professional medical conduct, as amended by section
12 22 of part B of chapter 60 of the laws of 2014, are amended to read as
13 follows:
14 S 5. The superintendent of [insurance] FINANCIAL SERVICES and the
15 commissioner of health shall determine, no later than June 15, 2002,
16 June 15, 2003, June 15, 2004, June 15, 2005, June 15, 2006, June 15,
17 2007, June 15, 2008, June 15, 2009, June 15, 2010, June 15, 2011, June
18 15, 2012, June 15, 2013, June 15, 2014, [and] June 15, 2015, AND JUNE
19 15, 2016 the amount of funds available in the hospital excess liability
20 pool, created pursuant to section 18 of chapter 266 of the laws of 1986,
21 and whether such funds are sufficient for purposes of purchasing excess
22 insurance coverage for eligible participating physicians and dentists
23 during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June
24 30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
25 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
26 2007, or July 1, 2007 to June 30, 2008, or July 1, 2008 to June 30,
27 2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to June 30,
28 2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June 30,
29 2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30,
30 2015, OR JULY 1, 2015 TO JUNE 30, 2016, as applicable.
31 (a) This section shall be effective only upon a determination, pursu-
32 ant to section five of this act, by the superintendent of [insurance]
33 FINANCIAL SERVICES and the commissioner of health, and a certification
34 of such determination to the state director of the budget, the chair of
35 the senate committee on finance and the chair of the assembly committee
36 on ways and means, that the amount of funds in the hospital excess
37 liability pool, created pursuant to section 18 of chapter 266 of the
38 laws of 1986, is insufficient for purposes of purchasing excess insur-
39 ance coverage for eligible participating physicians and dentists during
40 the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
41 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
42 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
43 2007, or July 1, 2007 to June 30, 2008, or July 1, 2008 to June 30,
44 2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to June 30,
45 2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June 30,
46 2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30,
47 2015, OR JULY 1, 2015 TO JUNE 30, 2016, as applicable.
48 (e) The commissioner of health shall transfer for deposit to the
49 hospital excess liability pool created pursuant to section 18 of chapter
50 266 of the laws of 1986 such amounts as directed by the superintendent
51 of [insurance] FINANCIAL SERVICES for the purchase of excess liability
52 insurance coverage for eligible participating physicians and dentists
53 for the policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to
54 June 30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June
55 30, 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
56 2007, as applicable, and the cost of administering the hospital excess
A. 6007 100
1 liability pool for such applicable policy year, pursuant to the program
2 established in chapter 266 of the laws of 1986, as amended, no later
3 than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June
4 15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
5 June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, [and] June
6 15, 2015, AND JUNE 15, 2016, as applicable.
7 S 6. Notwithstanding any law, rule or regulation to the contrary, only
8 physicians or dentists who were eligible, and for whom the superinten-
9 dent of financial services and the commissioner of health, or their
10 designee, purchased, with funds available in the hospital excess liabil-
11 ity pool, a full or partial policy for excess coverage or equivalent
12 excess coverage for the coverage period ending the thirtieth of June,
13 two thousand fifteen, shall be eligible to apply for such coverage for
14 the coverage period beginning the first of July, two thousand fifteen;
15 provided, however, if the total number of physicians or dentists for
16 whom such excess coverage or equivalent excess coverage was purchased
17 for the policy year ending the thirtieth of June, two thousand fifteen
18 exceeds the total number of physicians or dentists certified as eligible
19 for the coverage period beginning the first of July, two thousand
20 fifteen, then the general hospitals may certify additional eligible
21 physicians or dentists in a number equal to such general hospital's
22 proportional share of the total number of physicians or dentists for
23 whom excess coverage or equivalent excess coverage was purchased with
24 funds available in the hospital excess liability pool as of the thirti-
25 eth of June, two thousand fifteen, as applied to the difference between
26 the number of eligible physicians or dentists for whom a policy for
27 excess coverage or equivalent excess coverage was purchased for the
28 coverage period ending the thirtieth of June, two thousand fifteen and
29 the number of such eligible physicians or dentists who have applied for
30 excess coverage or equivalent excess for the coverage period beginning
31 the first of July, two thousand fifteen.
32 S 7. This act shall take effect immediately.
33 PART AA
34 Section 1. Section 213 of the insurance law, as added by section 1 of
35 part L of chapter 57 of the laws of 2007, is amended to read as follows:
36 S 213. New York state health [care quality and cost containment]
37 INSURANCE MODERNIZATION AND QUALITY CARE commission. (a) There is hereby
38 established within the department a commission, to be known as the "New
39 York state health [care quality and cost containment] INSURANCE MODERN-
40 IZATION AND QUALITY CARE commission". The commission shall consist of
41 thirteen members appointed by the governor, one of whom shall be the
42 superintendent OR THEIR REPRESENTATIVE, one of whom shall be the commis-
43 sioner of health OR THEIR REPRESENTATIVE, ONE OF WHOM SHALL BE THE EXEC-
44 UTIVE DIRECTOR OF THE NEW YORK STATE HEALTH INSURANCE EXCHANGE OR THEIR
45 REPRESENTATIVE and six of whom shall be appointed on the recommendation
46 of the legislative leaders, two on the recommendation of the temporary
47 president of the senate, two on the recommendation of the speaker of the
48 assembly, one on the recommendation of the minority leader of the
49 senate, and one on the recommendation of the minority leader of the
50 assembly. All members shall serve at the pleasure of the governor, and
51 vacancies shall be appointed in the same manner as original appoint-
52 ments. Members of the commission shall serve without compensation, but
53 shall be reimbursed for reasonable travel expenses. [In making appoint-
54 ments to the commission, the governor shall ensure that the interests of
A. 6007 101
1 health care consumers, small businesses, the medical community and
2 health plans are represented on the commission.] THE GOVERNOR AND
3 APPOINTING MEMBERS OF THE LEGISLATURE SHALL ENSURE THAT THE COMMISSION
4 SHALL INCLUDE ONE REPRESENTATIVE AFFILIATED WITH EACH OF THE FOLLOWING
5 GROUPS: (I) THE MEDICAL SOCIETY OF THE STATE OF NEW YORK; (II) THE AFL-
6 CIO; (III) HEALTH CARE FOR ALL NEW YORK; (IV) THE NEW YORK HEALTH PLAN
7 ASSOCIATION; (V) THE CONSUMER'S UNION; AND (VI) THE AMERICAN ASSOCIATION
8 OF RETIRED PERSONS.
9 (b)(1) The purpose of the commission shall be to [analyze the impact
10 on health insurance costs and quality of proposed legislation which
11 would mandate that health benefits be offered or made available in indi-
12 vidual and group health insurance policies, contracts and comprehensive
13 health service plans, including legislation that affects the delivery of
14 health benefits or services or the reimbursement of health care provid-
15 ers] ESTABLISH THE PROCESS FOR EVALUATING PROPOSED HEALTH INSURANCE
16 MANDATES IN ORDER TO ENSURE THAT THE CITIZENS OF NEW YORK RECEIVE THE
17 MOST MODERN HEALTH CARE TECHNOLOGIES AND PRACTICES AVAILABLE ON AN ONGO-
18 ING BASIS.
19 (2) BY SEPTEMBER FIRST OF THE YEAR TWO THOUSAND FIFTEEN, THE COMMIS-
20 SION SHALL PRODUCE AN INITIAL REPORT TO THE GOVERNOR, THE TEMPORARY
21 PRESIDENT OF THE SENATE, AND TO THE SPEAKER OF THE ASSEMBLY TO DESCRIBE
22 THE PROCESS BY WHICH, IF AUTHORIZED IN STATUTE, NEW HEALTH INSURANCE
23 MANDATES WOULD BE FUNDED AND IMPLEMENTED AND TO ESTABLISH A PROCESS FOR
24 DETERMINING THE NET IMPACT OF ANY BENEFIT MANDATES ON PREMIUMS. AT A
25 MINIMUM, THE REPORT SHALL DESCRIBE THE METHOD BY WHICH, CONSISTENT WITH
26 THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT, INSURERS OR
27 POLICYHOLDERS ARE REIMBURSED FOR ANY PREMIUM INCREASES TRIGGERED BY SUCH
28 NEW HEALTH INSURANCE MANDATES, AND THE MEANS BY WHICH NEW YORK STATE MAY
29 FUND THESE NEW HEALTH INSURANCE MANDATES.
30 [(2)] (3) The governor, the chair of the senate insurance committee
31 [and] OR the chair of the assembly insurance committee may request in
32 writing that the commission evaluate THE COST AND MEANS OF IMPLEMENTING
33 a PARTICULAR proposed mandated benefit. Upon receiving such a request,
34 the commission [may, by a majority vote of its members,] SHALL undertake
35 an evaluation of such proposed mandated benefit.
36 [(3)] (4) In evaluating a proposed mandated benefit, the commission
37 shall:
38 (A) investigate the current practices of health plans with regard to
39 the proposed mandated benefit[, and, to the extent possible, self-funded
40 health benefit plans];
41 (B) investigate the potential premium impact of the proposed mandated
42 [benefits] BENEFIT on all segments of the insurance market[, as well as
43 the potential for avoided costs through early detection and treatment of
44 conditions, or more cost-effective delivery of medical services] AND
45 WHETHER THE MANDATE WOULD TRIGGER AN ASSUMPTION OF COSTS BY THE STATE AS
46 DESCRIBED IN SECTION 10104 (E) (1) OF THE FEDERAL AFFORDABLE CARE ACT;
47 (C) STATE WHETHER SUCH BENEFIT MAY BE IMPLEMENTED ACCORDING TO THE
48 PROCESS DEVELOPED PURSUANT TO PARAGRAPH (2) OF SUBDIVISION (B) OF THIS
49 SECTION; and
50 [(C)] (D) analyze the most current medical literature regarding the
51 proposed mandated benefit to determine its impact on health care quali-
52 ty.
53 [(4)] (5) In evaluating a proposed mandated benefit, the commission
54 may hold one or more public hearings, and shall strive to obtain inde-
55 pendent and verifiable information from diverse sources within the
A. 6007 102
1 healthcare industry, medical community and among health care consumers
2 with regard to the proposed mandated benefit.
3 (c) [To assist the commission in its duties, and upon the direction of
4 the commission, the superintendent is authorized to enter into one or
5 more contracts with independent entities and organizations with demon-
6 strable expertise in health care quality, finance, utilization and actu-
7 arial services. For the purposes of this section, the superintendent
8 shall not enter into contracts with health plans, entities or organiza-
9 tions owned or controlled by health plans, or with significant business
10 relationships with health plans.
11 (d) Upon completion of its] WITHIN SIXTY DAYS OF A REQUEST FOR AN
12 evaluation of a proposed mandated benefit pursuant to this section, the
13 commission shall deliver a written [report of its findings] IMPLEMENTA-
14 TION PLAN to the chair of the assembly insurance committee and the chair
15 of the senate insurance committee.
16 S 2. This act shall take effect immediately.
17 PART BB
18 Section 1. Section 215-b of the elder law, as added by section 27 of
19 part A of chapter 58 of the laws of 2008, is amended to read as follows:
20 S 215-b. Enriched social adult day services [demonstration project].
21 1. Legislative intent. Social adult day services programs are resources
22 that can help communities maintain the independence of [elderly resi-
23 dents] FUNCTIONALLY IMPAIRED ADULTS. The level of services needed by
24 some [elderly persons] FUNCTIONALLY IMPAIRED ADULTS exceeds the level of
25 assistance currently available through social model adult day services
26 programs but is not at the level of support provided in an adult day
27 health care program. Social adult day services programs cannot enroll
28 new participants whose needs exceed the services that can be provided in
29 the current social adult day services programs. Additionally, these
30 programs must discharge current participants when their needs cannot be
31 met. Therefore, an enriched social adult day services project shall be
32 established as a demonstration project for the purposes of maintaining
33 [elderly persons] FUNCTIONALLY IMPAIRED ADULTS in the community by
34 deterring or delaying institutionalization.
35 2. Definitions. For purposes of this section, the following terms
36 shall have the following meanings:
37 (a) ["Elderly" or "elderly persons" shall mean persons who are sixty
38 years of age or older.
39 (b)] "Eligible participant" shall mean [elderly or elderly persons as
40 defined in this section,] INDIVIDUALS who are functionally impaired, as
41 defined in section two hundred fifteen of this title, and in need of
42 services that exceed the level of assistance currently available through
43 social adult day services programs but not at the level of support
44 provided by adult day health care programs.
45 [(c)] (B) "Eligible entity" shall mean any not-for-profit or govern-
46 ment entity, including the governing body or council of an Indian tribal
47 reservation, who has demonstrated to the office and the department of
48 health, based on criteria developed by the director and the commissioner
49 of health, that it can safely provide either directly or through a
50 contract with a licensed health care practitioner or licensed home care
51 provider as defined in section thirty-six hundred five of the public
52 health law, social adult day care services as defined in section two
53 hundred fifteen of this title, as well as additional allowable medical
A. 6007 103
1 services as developed by the director and the commissioner of health,
2 and optional services as defined in this section.
3 [(d) "Enriched social adult day services demonstration project" or
4 "project" shall mean programs eligible under this section that provide
5 all of the services currently required for social adult day services
6 programs under section two hundred fifteen of this title in addition to
7 enriched services, and may include optional services.
8 (e)] (C) "Enriched services" shall include the [provision of total
9 assistance with toileting, mobility, transferring and eating;] dispens-
10 ing of medications by a registered nurse; health education; counseling;
11 case management; restorative therapies lasting less than six months and
12 maintenance therapies. [Total assistance with toileting, mobility,
13 transferring and eating shall be provided under the supervision of a
14 licensed health care provider.] Restorative and maintenance therapies
15 shall be provided by an appropriately licensed health care provider.
16 [(f)] (D) "Optional services" shall mean other non-medical services
17 approved by the director designed to improve the quality of life of
18 eligible participants by extending their independence, avoiding unneces-
19 sary hospital and nursing home stays, and sustaining their informal
20 supports.
21 3. [Demonstration project. The director, in conjunction with the
22 commissioner of health, is authorized and directed to establish an
23 enriched social adult day services demonstration project for the
24 purposes of testing innovative ways that social adult day services
25 programs can successfully enable eligible participants to remain inde-
26 pendent in their communities by deterring or delaying institutionaliza-
27 tion through the use of enriched services.
28 4.] Duties of the director. (a) The director, in conjunction with the
29 commissioner of health, [may make up to twenty grants available on a
30 competitive basis to eligible entities under this section. Such grants
31 may be available for up to two hundred thousand dollars for each
32 enriched social adult day services demonstration project and shall be
33 for up to one hundred percent of allowable expenditures for approved
34 services and expenses under this section] SHALL DEVELOP AN APPLICATION
35 PROCESS WHEREBY ELIGIBLE ENTITIES MAY APPLY FOR APPROVAL TO OFFER
36 ENRICHED SERVICES, OPTIONAL SERVICES, OR BOTH. SUCH APPLICATION SHALL
37 INCLUDE, BUT NOT BE LIMITED TO:
38 (1) AN ESTIMATE OF THE NUMBER OF ELIGIBLE PARTICIPANTS TO WHOM THE
39 ELIGIBLE ENTITY COULD EFFECTIVELY PROVIDE THE SERVICES FOR WHICH THEY
40 ARE APPLYING TO OFFER PURSUANT TO THIS SECTION; AND
41 (2) A PLAN UNDER WHICH THE ELIGIBLE ENTITY WOULD OFFER THE SERVICES
42 FOR WHICH THEY ARE APPLYING PURSUANT TO THIS SECTION.
43 (b) In [making grants] CONSIDERING APPLICATIONS MADE PURSUANT TO PARA-
44 GRAPH (A) OF THIS SUBDIVISION, the director, in conjunction with the
45 commissioner of health, may consider:
46 (1) [projects] ELIGIBLE ENTITIES that can effectively serve eligible
47 participants residing in rural, urban, or suburban settings;
48 (2) [projects] ELIGIBLE ENTITIES that effectively serve culturally
49 diverse populations;
50 (3) [projects] ELIGIBLE ENTITIES that demonstrate innovative use of
51 technology, coordination, partnerships, transportation or other services
52 to enable eligible participants to be effectively served; AND
53 (4) [the capacity of the eligible entity to identify eligible partic-
54 ipants for enriched adult day services demonstration projects; and
55 (5)] any other criteria determined to be appropriate.
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1 [5.] 4. Evaluation. On or before January thirtieth, two thousand
2 [eleven] SIXTEEN, the director shall provide the governor, the speaker
3 of the assembly, the temporary president of the senate, and the chair-
4 persons of the assembly and senate aging and health committees with a
5 written evaluation of the program. The evaluation shall examine the
6 effectiveness of the project in forestalling institutional placement,
7 the costs of providing enriched services in a day care setting, partic-
8 ipant satisfaction and program quality, and identification of the
9 program design elements necessary for successful replication.
10 [6. Funds.] 5. GRANTS. (A) THE DIRECTOR, IN CONJUNCTION WITH THE
11 COMMISSIONER OF HEALTH, MAY, WITHIN AMOUNTS APPROPRIATED THEREFOR, MAKE
12 UP TO TWENTY GRANTS AVAILABLE ON A COMPETITIVE BASIS TO ELIGIBLE ENTI-
13 TIES UNDER THIS SECTION. SUCH GRANTS MAY BE AVAILABLE FOR UP TO TWO
14 HUNDRED THOUSAND DOLLARS FOR EACH ELIGIBLE ENTITY AND SHALL BE FOR ONE
15 HUNDRED PERCENT OF ALLOWABLE EXPENDITURES FOR APPROVED SERVICES AND
16 EXPENSES UNDER THIS SECTION.
17 (B) IN MAKING GRANTS, THE DIRECTOR, IN CONJUNCTION WITH THE COMMIS-
18 SIONER OF HEALTH, MAY CONSIDER THE CRITERIA ESTABLISHED UNDER SUBDIVI-
19 SION THREE OF THIS SECTION.
20 (C) Funds made available under this [section] SUBDIVISION shall
21 supplement and not supplant any federal, state, or local funds expended
22 by any entity, including a unit of general purpose local government or
23 not-for-profit, to provide services under this section. Funds under this
24 [section] SUBDIVISION cannot pay for individuals who are eligible under
25 title nineteen of the federal social security act.
26 S 2. Section 32 of part A of chapter 58 of the laws of 2008, amending
27 the elder law and other laws relating to reimbursement to particular
28 provider pharmacies and prescription drug coverage, as amended by
29 section 37 of part A of chapter 60 of the laws of 2014, is amended to
30 read as follows:
31 S 32. This act shall take effect immediately and shall be deemed to
32 have been in full force and effect on and after April 1, 2008; provided
33 however, that sections one, six-a, nineteen, twenty, twenty-four, and
34 twenty-five of this act shall take effect July 1, 2008; provided however
35 that sections sixteen, seventeen and eighteen of this act shall expire
36 April 1, 2017; provided, however, that the amendments made by section
37 twenty-eight of this act shall take effect on the same date as section 1
38 of chapter 281 of the laws of 2007 takes effect; provided further, that
39 sections twenty-nine, thirty, and thirty-one of this act shall take
40 effect October 1, 2008; provided further, that section twenty-seven of
41 this act shall take effect January 1, 2009; [and provided further, that
42 section twenty-seven of this act shall expire and be deemed repealed
43 March 31, 2015;] and provided, further, however, that the amendments to
44 subdivision 1 of section 241 of the education law made by section twen-
45 ty-nine of this act shall not affect the expiration of such subdivision
46 and shall be deemed to expire therewith and provided that the amendments
47 to section 272 of the public health law made by section thirty of this
48 act shall not affect the repeal of such section and shall be deemed
49 repealed therewith.
50 S 3. This act shall take effect immediately.
51 PART CC
52 Section 1. Section 13.17 of the mental hygiene law is amended by
53 adding a new subdivision (d) to read as follows:
A. 6007 105
1 (D) 1. THE COMMISSIONER SHALL ENSURE FOR CONTINUITY OF CARE FOR INDI-
2 VIDUALS WITH A DEVELOPMENTAL DISABILITY TRANSITIONING TO LESS RESTRIC-
3 TIVE SETTINGS PURSUANT TO ANY CLOSURE, CONSOLIDATION, MERGER OR ANY
4 OTHER ACTION THAT DIMINISHES CURRENT STATE OPERATED SERVICES. THE
5 COMMISSIONER SHALL ENSURE THAT INDIVIDUALS WITH A DEVELOPMENTAL DISABIL-
6 ITY SO AFFECTED ARE GIVEN THE OPTION OF TRANSITIONING TO STATE OPERATED
7 SERVICES WITHIN THE DEVELOPMENTALLY DISABLED SERVICE OFFICES REGION
8 WHERE THEY ARE CURRENTLY RECEIVING SERVICES. IF NO SUCH STATE SERVICE AS
9 REQUESTED BY THE INDIVIDUALS WITH A DEVELOPMENTAL DISABILITY OR THEIR
10 PARENT, GUARDIAN OR ADVOCATE ARE AVAILABLE THEN SUCH INDIVIDUAL SHALL
11 REMAIN IN THE FACILITY OR RESIDENCE UNTIL SAID SERVICES ARE AVAILABLE.
12 THE COMMISSIONER SHALL DOCUMENT EACH OFFER OF STATE OPERATED OPPORTU-
13 NITIES AND SHALL RETAIN A RECORD OF THE SERVICES OFFERED.
14 2. IN THE EVENT NO SERVICES DESIRED BY THE INDIVIDUALS THAT ARE DEVEL-
15 OPMENTALLY DISABLED ARE EITHER AVAILABLE OR EXIST WITHIN CURRENT STATE
16 OPERATED SERVICES, THE OFFICE SHALL RECORD THE NAME, PARENT, GUARDIAN OR
17 ADVOCATE AND SERVICES THEY ARE SEEKING. THE COMMISSIONER SHALL DEVELOP A
18 RECORD OF SERVICES FOR STATE OPERATED SUPPORTIVE PLACEMENT OPTIONS THAT
19 ARE NOT AVAILABLE WITH A PLAN TO ADDRESS THE UNMET NEEDS FOR THE FOLLOW-
20 ING FISCAL YEAR. SUCH COMMISSIONER SHALL SUBMIT THE PLAN TO THE TEMPO-
21 RARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY NO LATER
22 THAN DECEMBER THIRTY-FIRST OF EACH YEAR.
23 S 2. This act shall take effect immediately.
24 PART DD
25 Section 1. Subdivision 1 of section 364-i of the social services law,
26 as amended by chapter 693 of the laws of 1996, is amended to read as
27 follows:
28 1. (A) An individual, upon application for medical assistance, shall
29 be presumed eligible for such assistance for a period of sixty days from
30 the date of transfer from a general hospital, as defined in section
31 twenty-eight hundred one of the public health law to a certified home
32 health agency or long term home health care program, as defined in
33 section thirty-six hundred two of the public health law, or to a hospice
34 as defined in section four thousand two of the public health law, or to
35 a residential health care facility as defined in section twenty-eight
36 hundred one of the public health law, if the local department of social
37 services determines that the applicant meets each of the following
38 criteria: [(a)] (I) the applicant is receiving acute care in such hospi-
39 tal; [(b)] (II) a physician certifies that such applicant no longer
40 requires acute hospital care, but still requires medical care which can
41 be provided by a certified home health agency, long term home health
42 care program, hospice or residential health care facility; [(c)] (III)
43 the applicant or his representative states that the applicant does not
44 have insurance coverage for the required medical care and that such care
45 cannot be afforded; [(d)] (IV) it reasonably appears that the applicant
46 is otherwise eligible to receive medical assistance; [(e)] (V) it
47 reasonably appears that the amount expended by the state and the local
48 social services district for medical assistance in a certified home
49 health agency, long term home health care program, hospice or residen-
50 tial health care facility, during the period of presumed eligibility,
51 would be less than the amount the state and the local social services
52 district would expend for continued acute hospital care for such person;
53 and [(f)] (VI) such other determinative criteria as the commissioner OF
54 HEALTH shall provide by rule or regulation. If a person has been deter-
A. 6007 106
1 mined to be presumptively eligible for medical assistance, pursuant to
2 this subdivision, and is subsequently determined to be ineligible for
3 such assistance, the commissioner OF HEALTH, on behalf of the state and
4 the local social services district shall have the authority to recoup
5 from the individual the sums expended for such assistance during the
6 period of presumed eligibility.
7 (B) AN INDIVIDUAL, UPON APPLICATION FOR MEDICAL ASSISTANCE, SHALL BE
8 PRESUMED ELIGIBLE FOR SUCH ASSISTANCE FOR A PERIOD OF SIXTY DAYS FROM
9 THE DATE OF RELEASE FROM A STATE CORRECTIONAL FACILITY AS DEFINED IN
10 PARAGRAPH (A) OF SUBDIVISION FOUR OF SECTION TWO OF THE CORRECTION LAW
11 OR A LOCAL CORRECTIONAL FACILITY AS DEFINED IN PARAGRAPH (A) OF SUBDIVI-
12 SION SIXTEEN OF SECTION TWO OF THE CORRECTION LAW. IF A PERSON HAS BEEN
13 DETERMINED TO BE PRESUMPTIVELY ELIGIBLE FOR MEDICAL ASSISTANCE, PURSUANT
14 TO THIS SUBDIVISION, AND IS SUBSEQUENTLY DETERMINED TO BE INELIGIBLE FOR
15 SUCH ASSISTANCE, THE COMMISSIONER OF HEALTH, ON BEHALF OF THE STATE AND
16 THE LOCAL SOCIAL SERVICES DISTRICT SHALL HAVE THE AUTHORITY TO RECOUP
17 FROM THE INDIVIDUAL THE SUMS EXPENDED FOR SUCH ASSISTANCE DURING THE
18 PERIOD OF PRESUMED ELIGIBILITY.
19 S 2. Subdivision 1 of section 368-a of the social services law is
20 amended by adding a new paragraph (aa) to read as follows:
21 (AA) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, REIMBURSEMENT
22 BY THE STATE FOR PAYMENTS MADE, WHETHER BY THE DEPARTMENT OF HEALTH ON
23 BEHALF OF A LOCAL SOCIAL SERVICES DISTRICT PURSUANT TO SECTION THREE
24 HUNDRED SIXTY-SEVEN-B OF THIS TITLE OR BY A LOCAL SOCIAL SERVICES
25 DISTRICT DIRECTLY, FOR MEDICAL ASSISTANCE FURNISHED TO AN INDIVIDUAL
26 PRESUMED ELIGIBLE FOR MEDICAL ASSISTANCE UNDER PARAGRAPH (B) OF SUBDIVI-
27 SION ONE OF SECTION THREE HUNDRED SIXTY-FOUR-I OF THIS TITLE, DURING THE
28 PRESUMPTIVE ELIGIBILITY PERIOD, SHALL BE MADE FOR THE FULL AMOUNT
29 EXPENDED FOR SUCH ASSISTANCE, AFTER FIRST DEDUCTING THEREFROM ANY FEDER-
30 AL FUNDS PROPERLY RECEIVED OR TO BE RECEIVED ON ACCOUNT OF SUCH EXPENDI-
31 TURE.
32 S 3. This act shall take effect immediately.
33 PART EE
34 Section 1. The mental hygiene law is amended by adding a new section
35 7.46 to read as follows:
36 S 7.46 MENTAL HEALTH CRISIS INTERVENTION DEMONSTRATION PROGRAM.
37 (A) PROGRAM. (1) THE COMMISSIONER SHALL ESTABLISH A MENTAL HEALTH
38 CRISIS INTERVENTION DEMONSTRATION PROGRAM FOR THE PURPOSE OF ASSISTING
39 LAW ENFORCEMENT OFFICERS IN RESPONDING TO CRISIS SITUATIONS INVOLVING
40 PERSONS WITH MENTAL ILLNESS.
41 (2) THE COMMISSIONER SHALL ESTABLISH WITHIN THE OFFICE THE POSITION OF
42 MENTAL HEALTH CRISIS INTERVENTION TEAM TRAINING PROGRAM COORDINATOR WHO
43 WILL SERVE AT THE PLEASURE OF THE COMMISSIONER AND WHO SHALL WORK WITH
44 ANY LAW ENFORCEMENT AGENCY IN THE STATE THAT IS A PARTICIPANT IN THE
45 DEMONSTRATION PROGRAM ESTABLISHED PURSUANT TO THIS SECTION OR REQUESTS
46 ASSISTANCE TO COORDINATE THE PROVISION OF CRISIS INTERVENTION TEAM
47 TRAINING TO ITS FIRST RESPONDERS AS PART OF SPECIALIZED RESPONSE TEAM OR
48 AS PART OF THE TRAINING FOR FIRST RESPONDERS.
49 (3) THE CRISIS INTERVENTION TEAM TRAINING PROGRAM COORDINATOR SHALL:
50 (I) WORK WITH COMMUNITIES TO DEVELOP PARTNERSHIPS, COORDINATE ACTIV-
51 ITIES AND PROMOTE COOPERATION AND COLLABORATION BETWEEN THE OFFICE, LAW
52 ENFORCEMENT AGENCIES, COMMUNITY BASED MENTAL HEALTH TREATMENT PROVIDERS,
53 AND PEOPLE WITH PSYCHIATRIC OR OTHER DISABILITIES AND THEIR FAMILIES TO
54 PROVIDE CRISIS INTERVENTION TEAM TRAINING;
A. 6007 107
1 (II) PROVIDE SUPPORT, TRAINING AND COMMUNITY COORDINATION TO FACILI-
2 TATE RELATIONSHIPS AND COLLABORATIVE EFFORTS BETWEEN MENTAL HEALTH
3 SERVICE PROVIDERS IN THE COMMUNITY AND LAW ENFORCEMENT AGENCIES;
4 (III) PROVIDE ASSISTANCE AS DEEMED APPROPRIATE BY THE COMMISSIONER IN
5 ESTABLISHING AND IMPLEMENTING THE CRISIS INTERVENTION TEAMS UNDER THIS
6 PROGRAM; AND
7 (IV) SUBMIT A REPORT TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF THE
8 SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR BEFORE NOVEMBER FIFTEENTH
9 OF EACH YEAR THAT CONTAINS THE FOLLOWING:
10 (A) A REVIEW OF ALL LAW ENFORCEMENT AGENCIES THAT HAVE PROVIDED CRISIS
11 INTERVENTION TEAM TRAINING TO THEIR OFFICERS AND THE NUMBER OF OFFICERS
12 THAT HAVE COMPLETED THE TRAINING;
13 (B) A LIST OF COMMUNITIES IN THIS STATE THAT HAVE IMPLEMENTED THE
14 CRISIS INTERVENTION TEAM TRAINING PROGRAM THROUGH TRAINING AND COORDI-
15 NATION, INCLUDING THE LENGTH OF IMPLEMENTATION AND CURRENT STATUS OF THE
16 PROGRAM;
17 (C) THE NUMBER OF RESPONSES MADE BY EACH CRISIS INTERVENTION TEAM
18 INVOLVING AN INDIVIDUAL SUSPECTED OF EXPERIENCING A CRISIS RELATED TO A
19 MENTAL HEALTH DIAGNOSIS AND THE OUTCOME OF SUCH INTERACTION;
20 (D) AN ANALYSIS OF THE GOALS DESCRIBED UNDER PARAGRAPH TWO OF SUBDIVI-
21 SION (B) OF THIS SECTION AND ANY RECOMMENDATIONS ON HOW OUTCOMES MAY BE
22 IMPROVED;
23 (E) RECOMMENDATIONS FOR IMPROVEMENT IN THE COMMUNITY BASED PARTNER-
24 SHIPS THAT SUPPORT CRISIS INTERVENTION TEAM RESPONSES; AND
25 (F) RECOMMENDATIONS FOR IMPROVEMENT IN THE LAW ENFORCEMENT AND PUBLIC
26 SAFETY AGENCIES THAT PROVIDE CRISIS INTERVENTION TEAM RESPONSES.
27 (B) CRISIS INTERVENTION TEAMS. (1) THE COMMISSIONER IN CONSULTATION
28 WITH THE NEW YORK STATE DIVISION OF CRIMINAL JUSTICE SERVICES, SHALL:
29 (I) ESTABLISH CRITERIA FOR THE DEVELOPMENT OF CRISIS INTERVENTION
30 TEAMS; AND
31 (II) ESTABLISH, AND IMPLEMENT ON AN ONGOING BASIS, A TRAINING PROGRAM
32 FOR ALL CURRENT AND NEW EMPLOYEES REGARDING THE POLICIES AND PROCEDURES
33 ESTABLISHED PURSUANT TO THIS SECTION.
34 (2) THE GOALS OF THE CRISIS INTERVENTION TEAM PROGRAM SHALL INCLUDE
35 BUT NOT BE LIMITED TO:
36 (I) PROVIDING IMMEDIATE RESPONSE BY SPECIFICALLY TRAINED LAW ENFORCE-
37 MENT OFFICERS;
38 (II) REDUCE THE LIKELIHOOD OF PHYSICAL CONFRONTATION;
39 (III) IDENTIFY UNDERSERVED POPULATIONS WITH MENTAL ILLNESS AND REFER
40 THEM TO APPROPRIATE CARE;
41 (IV) DECREASE THE USE OF ARREST AND DETENTION OF PERSONS EXPERIENCING
42 MENTAL HEALTH CRISES BY PROVIDING BETTER ACCESS TO TIMELY TREATMENT;
43 (V) PROVIDE THERAPEUTIC LOCATIONS OR PROTOCOL FOR OFFICERS TO BRING
44 INDIVIDUALS IN CRISIS FOR ASSESSMENT THAT IS NOT AN INPATIENT HOSPITAL
45 SETTING, LAW ENFORCEMENT OR JAIL FACILITY; AND
46 (VI) DECREASE INJURIES TO LAW ENFORCEMENT OFFICERS DURING CRISIS
47 EVENTS.
48 (3) OTHER STATE AGENCIES SHALL PROVIDE COOPERATION AND ASSISTANCE TO
49 THE PROGRAM TO ASSIST IN THE EFFECTIVE PERFORMANCE OF ITS DUTIES.
50 S 2. The mental hygiene law is amended by adding a new section 7.47 to
51 read as follows:
52 S 7.47 INPATIENT DIVERSION PROGRAM.
53 (A) A LOCAL GOVERNMENTAL UNIT MAY APPLY TO ESTABLISH OR SEEK APPROVAL
54 OF AN EXISTING INPATIENT DIVERSION PROGRAM, IN ACCORDANCE WITH THE
55 PROVISIONS OF THIS SECTION.
A. 6007 108
1 (B) THE COMMISSIONER MAY APPROVE AN INPATIENT DIVERSION PROGRAM IF HE
2 OR SHE DETERMINES THAT:
3 (I) SUCH PROGRAM IS LOCATED IN A FACILITY CERTIFIED UNDER ARTICLE
4 THIRTY-ONE OF THIS CHAPTER, OR CO-LOCATED IN A HOSPITAL CERTIFIED UNDER
5 ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW;
6 (II) THE PRIMARY GOAL OF THE PROGRAM IS TO DIVERT INDIVIDUALS IN
7 MENTAL HEALTH CRISIS FROM INPATIENT HOSPITALIZATION;
8 (III) THE PROGRAM HAS A MULTIDISCIPLINARY TEAM EQUIPPED TO PROVIDE
9 APPROPRIATE SERVICES TO INDIVIDUALS IN MENTAL HEALTH CRISIS; AND
10 (IV) THE PROGRAM MEETS ANY OTHER REQUIREMENTS THE COMMISSIONER DEEMS
11 NECESSARY TO ENSURE THE DELIVERY OF APPROPRIATE SERVICES TO INDIVIDUALS
12 IN MENTAL HEALTH CRISIS.
13 (C) APPROVAL OF A PROGRAM UNDER THIS SECTION SHALL CONTINUE FOR A
14 PERIOD OF TWO YEARS, UNLESS THE COMMISSIONER SEEKS TO DISCONTINUE THE
15 APPROVAL OF A PROGRAM FOR GOOD CAUSE. THE LOCAL GOVERNMENTAL UNIT SHALL
16 HAVE NOTICE AND AN OPPORTUNITY TO BE HEARD ON SUCH DISCONTINUANCE. GOOD
17 CAUSE SHALL INCLUDE, BUT NOT BE LIMITED TO, THE INABILITY OF THE PROGRAM
18 TO CONTINUE TO CARE FOR PEOPLE IN MENTAL HEALTH CRISIS AS EVIDENCED BY
19 THE FAILURE TO MEET THE REQUIREMENTS IN SUBDIVISION (B) OF THIS SECTION.
20 (D) THE LOCAL GOVERNMENTAL UNIT SHALL REAPPLY FOR APPROVAL OF AN INPA-
21 TIENT DIVERSION PROGRAM EVERY TWO YEARS. SUCH APPLICATION SHALL CONTAIN
22 THE FOLLOWING INFORMATION:
23 (I) THE NUMBER OF INDIVIDUALS TREATED;
24 (II) THE NUMBER OF INDIVIDUALS DIVERTED FROM INPATIENT HOSPITALIZA-
25 TION;
26 (III) THE NUMBER OF INDIVIDUALS HOSPITALIZED;
27 (IV) THE NUMBER OF INDIVIDUALS LINKED TO SERVICES; AND
28 (V) ANY OTHER INFORMATION THE COMMISSIONER DEEMS NECESSARY TO EVALUATE
29 THE EFFECTIVENESS OF THE PROGRAM.
30 (E) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF ANY GENERAL, SPECIAL
31 OR LOCAL LAW, AN AMBULANCE SERVICE AS DEFINED BY SUBDIVISION TWO OF
32 SECTION THREE THOUSAND ONE OF THE PUBLIC HEALTH LAW AND ANY MEMBER THER-
33 EOF WHO IS AN EMERGENCY MEDICAL TECHNICIAN OR AN ADVANCED EMERGENCY
34 MEDICAL TECHNICIAN TRANSPORTING A PERSON TO A HOSPITAL AS AUTHORIZED BY
35 THIS SECTION, ANY PEACE OFFICERS, WHEN ACTING PURSUANT TO THEIR SPECIAL
36 DUTIES, ANY POLICE OFFICERS, WHO ARE MEMBERS OF AN AUTHORIZED POLICE
37 DEPARTMENT OR FORCE OR OF A SHERIFF'S DEPARTMENT, AND ANY MEMBERS OF
38 MOBILE CRISIS OUTREACH TEAMS APPROVED BY THE COMMISSIONER PURSUANT TO
39 SECTION 9.58 OF THIS CHAPTER, WHO ARE TAKING INTO CUSTODY AND TRANSPORT-
40 ING A PERSON TO AN INPATIENT DIVERSION PROGRAM APPROVED UNDER THIS
41 SECTION, AND ANY EMPLOYEE OF A LICENSED COMPREHENSIVE PSYCHIATRIC EMER-
42 GENCY PROGRAM, SPECIALLY TRAINED IN ACCORDANCE WITH STANDARDS DEVELOPED
43 BY THE COMMISSIONER, WHO TRANSPORTS A PERSON TO A HOSPITAL, SHALL NOT BE
44 LIABLE FOR DAMAGES FOR INJURIES ALLEGED TO HAVE BEEN SUSTAINED BY SUCH
45 PERSON OR FOR THE DEATH OF SUCH PERSON ALLEGED TO HAVE OCCURRED BY
46 REASON OF AN ACT OR OMISSION PROVIDED THAT SUCH EMERGENCY MEDICAL TECH-
47 NICIAN, ADVANCED EMERGENCY MEDICAL TECHNICIAN, PEACE OFFICER, POLICE
48 OFFICER, MOBILE CRISIS OUTREACH TEAM MEMBER, OR SPECIALLY TRAINED
49 EMPLOYEE OF A LICENSED COMPREHENSIVE PSYCHIATRIC EMERGENCY PROGRAM ACTED
50 REASONABLY AND IN GOOD FAITH. NOTHING IN THIS SECTION SHALL BE DEEMED TO
51 RELIEVE OR ALTER THE LIABILITY OF ANY SUCH AMBULANCE SERVICE OR MEMBERS
52 THEREOF, PEACE OFFICERS, POLICE OFFICERS OR SPECIALLY TRAINED EMPLOYEES
53 OF A LICENSED COMPREHENSIVE PSYCHIATRIC EMERGENCY PROGRAM FOR DAMAGES OR
54 INJURIES OR DEATH ARISING OUT OF THE OPERATION OF MOTOR VEHICLES.
55 S 3. This act shall take effect immediately.
A. 6007 109
1 PART FF
2 Section 1. Section 13.15 of the mental hygiene law is amended by
3 adding a new subdivision (c) to read as follows:
4 (C) SUBJECT TO AVAILABLE APPROPRIATIONS THEREFOR, THE COMMISSIONER
5 SHALL CONDUCT A GEOGRAPHIC ANALYSIS OF SUPPORTS AND SERVICES IN COMMUNI-
6 TY SETTINGS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES. THIS ANALY-
7 SIS SHALL ALSO IDENTIFY GAPS BETWEEN REQUIRED SUPPORTS AND SERVICES BY
8 REGION OF THE STATE.
9 (1) IN ORDER TO PERFORM THE GEOGRAPHIC ANALYSIS OR TO GATHER DATA FOR
10 PURPOSES OF PERFORMING THE GEOGRAPHIC ANALYSIS, THE COMMISSIONER MAY
11 WORK IN COOPERATION AND AGREEMENT WITH OTHER OFFICES, DEPARTMENTS OR
12 AGENCIES OF THE STATE, LOCAL OR FEDERAL GOVERNMENT, OR OTHER ORGANIZA-
13 TIONS AND INDIVIDUALS, WHICH MAY INCLUDE PROVIDERS OF SERVICES FOR
14 PERSONS WITH DEVELOPMENTAL DISABILITIES, REPRESENTATIVES FROM EMPLOYEE
15 ORGANIZATIONS REPRESENTING DIRECT CARE WORKERS, CONSUMER REPRESENTATIVES
16 INCLUDING PERSONS WITH DEVELOPMENTAL DISABILITIES, OR THEIR PARENTS OR
17 GUARDIANS.
18 (2) SUCH ANALYSIS SHOULD INCLUDE BUT NOT BE LIMITED TO THE STATEWIDE
19 NUMBER OF INDIVIDUALS SEEKING SERVICES, INCLUDING THOSE AWAITING PLACE-
20 MENT AND SHALL BE ORGANIZED BY THE TOTAL NUMBER OF INDIVIDUALS WITHIN
21 EACH REGIONAL OFFICE'S SERVICE GEOGRAPHIC AREA WHO ARE AWAITING RESIDEN-
22 TIAL PLACEMENT, DAY SERVICE SUPPORT, HOME AND COMMUNITY-BASED WAIVER
23 SUPPORT, EMPLOYMENT SUPPORT, BEHAVIORAL HEALTH SERVICES AND SUPPORTS, OR
24 OTHER COMMUNITY-BASED SUPPORT. SUCH ANALYSIS INFORMATION SHOULD ALSO BE
25 CATEGORIZED BY THE AGE OF THE INDIVIDUAL AWAITING COMMUNITY SERVICES AND
26 SUPPORTS AND THE AGE OF THEIR CAREGIVER, IF ANY, AND INCLUDE WAITLIST
27 AND PLACEMENT INFORMATION SUCH AS:
28 (I) THE TYPE OF SUPPORTS AND SERVICES SUCH INDIVIDUALS ARE EXPECTED TO
29 REQUIRE DIVIDED INTO CERTIFIED OUT-OF-HOME, SUPERVISED, SUPPORTIVE
30 PLACEMENT NEEDS AND OTHER NON-PLACEMENT NEEDS AND THE NUMBER OF SUCH
31 PERSONS WHO ARE MEDICALLY FRAIL REQUIRING INTENSIVE MEDICAL CARE;
32 (II) NON-CERTIFIED RESIDENTIAL PLACEMENTS OUTSIDE THE PARENT'S OR
33 PARENTS' OR OTHER CAREGIVER'S HOME;
34 (III) THE NUMBER OF INDIVIDUALS EXPECTED TO REQUIRE HOME AND COMMUNITY
35 SERVICES WAIVER-FUNDED HABILITATION SERVICES AT HOME;
36 (IV) THE TOTAL NUMBER OF INDIVIDUALS, WHO HAVE BEEN IDENTIFIED AS IN
37 NEED OF SUPPORTS AND SERVICES WHO HAVE RECEIVED THESE SUPPORTS AND
38 SERVICES AND ANY GAP BETWEEN REQUIRED SUPPORTS AND SERVICES AND THE
39 SUPPORTS AND SERVICES PROVIDED;
40 (V) THE NUMBER OF EMERGENCY NEED RESIDENTIAL PLACEMENTS FOR THE PAST
41 YEAR AND OTHER SUPPORTS AND SERVICES PROVIDED ON AN EMERGENCY BASIS;
42 (VI) THE NUMBER OF INDIVIDUALS WHO ARE CURRENTLY RECEIVING SUPPORTS
43 AND SERVICES, INCLUDING RESIDENTIAL SERVICES, WHOSE CURRENT LIVING SITU-
44 ATION IS NOT ADEQUATE TO MEET THEIR NEEDS AND WHO ARE AWAITING AN ALTER-
45 NATIVE PLACEMENT OR ALTERNATIVE SUPPORT AND SERVICE DELIVERY OPTIONS;
46 (VII) PROJECTED FUNDING REQUIREMENTS FOR INDIVIDUALS IDENTIFIED AS IN
47 NEED OF SERVICES PURSUANT TO SUBPARAGRAPH (IV) OF THIS PARAGRAPH;
48 (VIII) AN UPDATED FIVE YEAR PROJECTION OF INDIVIDUALS WHO WILL REQUIRE
49 ADDITIONAL IN-HOME SUPPORTS AND SERVICES AND/OR OUT-OF-HOME RESIDENTIAL
50 PLACEMENTS; AND
51 (IX) ANY OTHER INFORMATION DEEMED NECESSARY BY THE COMMISSIONER.
52 (3) THE COMMISSIONER SHALL PREPARE ANNUALLY FOR THE GOVERNOR AND THE
53 LEGISLATURE A WRITTEN EVALUATION REPORT CONCERNING THE DELIVERY OF
54 SUPPORTS AND SERVICES IN THE COMMUNITY, INCLUDING THE AGGREGATE DATA
55 COLLECTED PURSUANT TO THIS SECTION. ON OR BEFORE DECEMBER FIRST EACH
A. 6007 110
1 YEAR, THE COMMISSIONER SHALL SUBMIT A COPY OF SUCH REPORT, AND SUCH
2 RECOMMENDATION AS HE OR SHE DEEMS APPROPRIATE, TO THE GOVERNOR, THE
3 TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE ASSEMBLY, AND THE
4 RESPECTIVE MINORITY LEADERS OF EACH SUCH HOUSE. THE FIRST SUCH REPORT
5 SHALL BE DUE BY NO LATER THAN MARCH FIRST, TWO THOUSAND SIXTEEN. THE
6 REPORT SHALL ALSO BE MADE AVAILABLE TO THE PUBLIC AND SHALL BE PUBLISHED
7 ON THE OFFICE'S WEBSITE IN AN APPROPRIATE LOCATION AT THE SAME TIME AS
8 ITS SUBMISSION TO STATE OFFICIALS.
9 S 2. This act shall take effect immediately.
10 PART GG
11 Section 1. The mental hygiene law is amended by adding a new section
12 13.42 to read as follows:
13 S 13.42 TRANSFORMATION WORKGROUP.
14 1. THE COMMISSIONER OF THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISA-
15 BILITIES SHALL ESTABLISH A TRANSFORMATION WORKGROUP FOR THE PURPOSE OF
16 DEVELOPING A TRANSFORMATION PLAN WHICH WILL INCLUDE RECOMMENDATIONS AND
17 STRATEGIES FOR MAINTAINING THE FISCAL VIABILITY OF SERVICE AND SUPPORT
18 DELIVERY SYSTEM FOR PERSONS WITH DISABILITIES AND INCLUDE STRATEGIES
19 THAT WILL ENABLE THE OFFICE TO COMPLY WITH FEDERAL AND STATE SERVICE
20 DELIVERY REQUIREMENTS AND PROVIDE APPROPRIATE LEVELS OF CARE.
21 2. THE WORKGROUP SHALL BE COMPRISED OF THE COMMISSIONER OR HIS OR HER
22 DESIGNEE; ORGANIZATIONS OR ASSOCIATIONS WHICH REPRESENT THE INTERESTS OF
23 PERSONS WITH DISABILITIES, WHICH MAY INCLUDE PROVIDERS OF SERVICES,
24 CONSUMER REPRESENTATIVES, ADVOCACY GROUPS, PERSONS WITH DEVELOPMENTAL
25 DISABILITIES OR THEIR PARENTS OR GUARDIANS; AND AT THE DISCRETION OF THE
26 COMMISSIONER ANY OTHER INDIVIDUAL, ENTITY, OR STATE AGENCY ABLE TO
27 SUPPORT THE WORKGROUP IN COMPLETING ITS TASKS DESCRIBED UNDER THIS
28 SECTION.
29 3. WORKGROUP MEMBERS SHALL RECEIVE NO COMPENSATION FOR THEIR SERVICES
30 AS MEMBERS OF THE WORKGROUP, BUT MAY BE REIMBURSED FOR ACTUAL AND NECES-
31 SARY EXPENSES INCURRED IN THE PERFORMANCE OF THEIR DUTIES.
32 4. TRANSFORMATION PLAN. THE WORKGROUP SHALL DEVELOP A TRANSFORMATION
33 PLAN AS WELL AS MAKE RECOMMENDATIONS FOR THE EXECUTION OF SUCH PLAN. THE
34 PLAN WILL INCLUDE BUT NOT BE LIMITED TO AN ANALYSIS OF THE FOLLOWING:
35 (A) IDENTIFYING THE NEED FOR HOUSING AND RESIDENTIAL OPPORTUNITIES FOR
36 PEOPLES WITH DISABILITIES, AND AN IDENTIFICATION OF ANY SHORTFALLS IN
37 SERVICES, SUPPORTS, OR OPPORTUNITIES;
38 (B) PROVIDING A TIMELINE FOR TRANSITIONING SHELTERED WORKSHOPS TO A
39 MORE INTEGRATED SETTING AND TRANSITIONING INDIVIDUALS, TO THE EXTENT
40 CONSISTENT WITH THEIR SERVICE PLAN, INTO INTEGRATED EMPLOYMENT;
41 (C) INCREASING INTEGRATED EMPLOYMENT OPPORTUNITIES AND ALTERNATIVES TO
42 INTEGRATED EMPLOYMENT FOR INDIVIDUALS WITH DISABILITIES WHO MAY NOT
43 BENEFIT FROM SUCH WORK ENVIRONMENT;
44 (D) IDENTIFYING A TIMELINE FOR IMPLEMENTING AN EVIDENCE BASED AND
45 EMPIRICALLY VALIDATED ASSESSMENT TOOL; AND
46 (E) FISCAL VIABILITY AND CLINICAL APPROPRIATENESS OF TRANSITIONING
47 OPWDD SERVICES AND SUPPORTS INTO A MANAGED CARE PAYMENT MODEL.
48 5. THE WORKGROUP SHALL PUBLISH AND SUBMIT A SEMI-ANNUAL REPORT TO THE
49 GOVERNOR, THE TEMPORARY PRESIDENT OF THE SENATE, AND THE SPEAKER OF THE
50 ASSEMBLY BY DECEMBER FIRST, TWO THOUSAND FIFTEEN AND EVERY SIX MONTHS
51 THEREAFTER. THE OFFICE SHALL POST SUCH REPORT ON ITS OFFICIAL WEBSITE.
52 THE REPORT SHALL INCLUDE ALL RECOMMENDATIONS AND STRATEGIES DEVELOPED BY
53 THE WORKGROUP INCLUDING ANY POLICY, RULE, OR REGULATION CHANGE AND ESTI-
54 MATED DATES AND TIMEFRAME TO IMPLEMENT ANY RECOMMENDATION OR STRATEGY.
A. 6007 111
1 S 2. This act shall take effect immediately.
2 S 2. Severability clause. If any clause, sentence, paragraph, subdivi-
3 sion, section or part of this act shall be adjudged by any court of
4 competent jurisdiction to be invalid, such judgment shall not affect,
5 impair, or invalidate the remainder thereof, but shall be confined in
6 its operation to the clause, sentence, paragraph, subdivision, section
7 or part thereof directly involved in the controversy in which such judg-
8 ment shall have been rendered. It is hereby declared to be the intent of
9 the legislature that this act would have been enacted even if such
10 invalid provisions had not been included herein.
11 S 3. This act shall take effect immediately provided, however, that
12 the applicable effective date of Parts A through GG of this act shall be
13 as specifically set forth in the last section of such Parts.