NY State Senate Bill 2009-S7828

Senate Bill S7828

2009-2010 Legislative Session

Relates to adverse event reporting and notification by hospitals and diagnostic treatment centers

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Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 14, 2010	referred to health

2009-S7828 (ACTIVE) - Details

See Assembly Version of this Bill:: A11180
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§2805-l & 2805-m, Pub Health L; amd §6527, Ed L; amd Part X2 §4, Chap 62 of 2003

2009-S7828 (ACTIVE) - Summary

Relates to adverse event reporting and notification by hospitals and diagnostic treatment centers.

2009-S7828 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S7828

 TITLE OF BILL :  An act to amend the public health law and the
education law, in relation to adverse event reporting and notification
by hospitals and diagnostic and treatment centers; and to amend 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
omitting sunset provisions for enhanced penalties

 PURPOSE :  This bill would improve patient safety and quality in New
York's general hospitals and diagnostic and treatment centers (D&TCs)
by strengthening the State's adverse event reporting system - the New
York Patient Occurrence and Tracking System (NYPORTS), maintained by
the Department of Health (DOH) - and requiring such facilities to take
certain administrative steps to promote a culture of safety within
their institutions.

 SUMMARY OF PROVISIONS :

Section 1 of the bill would amend Public Health Law (PHL) § 2805-1 to:

* replace references to "incident" with the term "adverse event;"

* require adverse event reporting by D&TCs;

* expand the list of adverse events that must be reported by general
hospitals and D&TCs to include serious crimes and other serious
events;

* require reporting of an adverse event within 24 hours of the
hospital or DT&C becoming aware of such event;

* identify the categories of adverse events that automatically trigger
the requirement for a hospital or DT&C to conduct an investigation and
provide DOH with an investigation report;

* identify the categories of adverse events that require investigation
and an investigation report upon the direction of DOH;

* provide that a hospital or DT&C may request an extension of time if
it cannot complete an investigation and investigation report within 30
days, which may be granted in the discretion of the Commissioner of
Health;

* require DOH to analyze adverse event reports and use the analyses in
the development, dissemination and tracking of patient safety goals
and best practices;

* authorize DOH to release to hospitals and DT&Cs and the public
analyses and findings derived from the adverse event data;

* require DOH to consult with a variety of experts on matters related
to improving the adverse event reporting system and patient safety;
require general hospitals and D&TCs that provide ambulatory surgery,
diagnostic or therapeutic radiation or end-stage renal disease
services to establish a Patient Safety Committee that will analyze and
apply evidence-based patient safety practices, analyze adverse and
near-miss events, and develop protocols to prevent their recurrence;
and

* authorize enhanced civil penalties to be imposed upon hospitals and
DT&Cs that fail to report and investigate adverse events as required.


Sections 2 and 3 of the bill would make conforming provisions to PHL §
2805-m and Education Law § 6527(3) respectively to substitute the term
"adverse event" for "incident." In addition, the bill clarifies that
the confidentiality provisions of PHL § 2805-m apply to the actions
and records of a patient safety committee required by PHL § 2805-1.

Section 4 of the bill would amend Chapter 62 of the Laws of 2003, Part
X2, § 4, as amended by Chapter 21 of the Laws of 2010, § 1, to remove
the March 31, 2011 expiration of DOH's authority to utilize funds of
the Office of Professional Medical Conduct (OPMC) for patient safety
and quality activities,

Section 5 of the bill would make the bill effective 180 days after it
is enacted.

 EXISTING LAW :  PHL § 12 provides that a violation of the PHL is
punishable by a maximum penalty of $2,000, or more in the case of
repeated or egregious violations, unless a penalty is specified by a
specific provision of law.

PHL § 2805-l requires general hospitals to report to DOH "incidents"
that fall within seven categories: submit "incident" reports to DOH
related to seven types of events: (1) the death of a patient or the
impairment of a patient's bodily functions, except when such death or
impairment is related to the natural course of illness, disease or
proper treatment in accordance with generally accepted medical
standards; (2) a fire in the hospital that disrupts patient care or
harms patients or staff; (3) an equipment malfunction during diagnosis
or treatment that could have or did harm patients or staff; (4) a
poisoning within the hospital; (5) a strike by hospital staff; (6) a
disaster or other emergency situations external to the hospital
environment which affect hospital operations; and (7) termination of
any services vital to the continued safe operation of the hospital or
to the health and safety of its patients and personnel, such as
anticipated or actual termination of utility services.

PHL § 2805-l further requires general hospitals to conduct
investigations of incidents that fall within the first four categories
outlined above within 30 days of obtaining knowledge of any
information which reasonably appears to show that such incident
occurred. However, if the hospital reasonably expects that the
investigation will not be completed within 30 days, it must advise DOH
of the expected completion date. In addition, the hospital must submit
an investigation report within 24 hours of completing the
investigation.

PHL § 2805-m provides that information collected by hospitals and
D&TCs for purpose of complying with various quality assurance
requirements, including the reporting of incidents by general
hospitals under PHL § 2805-1 or by D&TCs as otherwise required shall
be kept confidential, and no person or entity shall be subject to
monetary liability for complying with such requirements.

PHL § 2995 requires DOH to undertake an initiative for the purposes of
increasing the information available to patients about health care
providers and health care plans, and improving the quality of health
care in this state, by creating a statewide health information system,
collecting health information for dissemination by means of such
system, and studying additional uses of such information.  Language
stating that funds may not be diverted for use under the section from
the existing uses of the Office of Professional Medical Conduct was
deleted by Chapter 62 of the Laws of 2003, Part X2, § I, which,
pursuant to Chapter 62 of the Laws of 2003, Part X2, § 4, as amended
by Chapter 21 of the Laws of 2010, § 1, expires March 31, 2011.


PHL § 2998 established the Patient Safety Center, the purpose of which
is to maximize patient safety, reduce medical errors, and improve the
quality of health care by improving systems of data reporting,
collection, analysis and dissemination, and to improve public access
to health care information not otherwise restricted.

Education Law § 6527(3) protects from liability for damages
individuals who engage in certain hospital quality assurance
activities or who participate in the preparation of incident reports
pursuant to PHL § 2805-l.

10 NYCRR § 751.10 requires D&TCs to report to DOH five types of
events: (1) patient deaths or transfers to a hospital; (2) fires in
the center or other occurrences which disrupt the provision of patient
care services or cause harm to patients or staff; (3) equipment
malfunction during treatment or diagnosis of a patient which adversely
affects a patient or staff; (4) termination of any services vital to
the continued safe operation of the center or the health and safety of
its patients and staff, such as utility services; and (5) strikes by
staff.

 LEGISLATIVE HISTORY :  This is a new bill.

 STATEMENT IN SUPPORT :  In 1998, DOH established NYPORTS in 1998 to
collect information about "incidents" that general hospitals must
report pursuant to PHU§ 2805-1 and 10 NYCRR § 403.8. NYPORTS is
Internet-based and permits hospitals both to report incidents
electronically and to query the system for information that permits
them to compare their experience with that of other hospitals on a
statewide, regional or peer basis.

One year later, the Institute of Medicine (TOM) of the National
Academy of Sciences released a report, "To Err is Human," which
suggested that between 44,000 and 98,000 people die each year in the
United States as a result of medical errors. The report emphasized
that most medical errors are not the result of bad actors - i.e.,
reckless or incompetent health care practitioners - but rather are
caused by flawed systems or processes that make it difficult for
practitioners and institutions to provide the right care. The IOM
identified mandatory adverse event reporting systems as an important
tool for improving patient safety. Adverse event reporting systems
help to identify error-prone health care activities and provide
information on what leads to adverse events so that systems and
processes can be developed to prevent human errors from adversely
affecting patient outcomes. In addition, such systems provide a
mechanism for oversight bodies to promote hospital implementation of
safety systems that reduce the likelihood that adverse events will be
repeated. Such systems also permit dissemination of information
learned from events to other facilities so that they too can avert
future errors.

Over the last decade, much has been done by hospitals, professional
societies, and accrediting organizations to promote patient safety,
identify risks, and develop new safety strategies. Yet in many aspects
of patient care, measurable improvements in patient safety have
remained elusive. This bill strengthens NYPORTS as a tool for
promoting patient safety and enhances hospital and D&TC safety
efforts.

To further promote the culture of safety advanced by the IOM, this
bill requires general hospitals, ambulatory surgery centers, clinics
that use radiation for diagnostic or therapeutic purposes and dialysis
facilities to create high-level Patient Safety Committees, chaired by
an executive who reports directly to the facility's chief executive
officer or administrator. These committees will spearhead patient

safety efforts at the facility and analyze and respond to adverse
events.

This bill facilitates a movement towards a culture of patient safety,
not only for health care facilities, but also for DOH. Under this
bill, DOH will analyze the experiences of providers from across the
State, and acting in partnership with the health care industry, will
share findings that can influence change and improve patient safety
within the health care system and its own organization.

Finally, the bill improves the completeness of NYPORTS data by
increasing penalties for failure to report and investigate adverse
events in a timely manner. Although the effectiveness of the NYPORTS
system as a patient safety tool depends in part on compliance with
reporting requirements, there remains wide variation among hospitals
in the rate of reporting. This Variation cannot be explained away by
differences in patient safety efforts. The bill seeks to induce more
consistent compliance with NYPORTS requirements by creating stronger
incentive to report and investigate adverse events.

 BUDGET IMPLICATIONS :  This bill is not expected to have a fiscal
impact to the State or localities.

 EFFECTIVE DATE :  This bill will take effect 180 days after it is
enacted.

2009-S7828 (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  7828

                            I N  S E N A T E

                              May 14, 2010
                               ___________

Introduced  by Sen. DUANE -- (at request of the Department of Health) --
  read twice and ordered printed, and when printed to  be  committed  to
  the Committee on Health

AN ACT to amend the public health law and the education law, in relation
  to  adverse event reporting and notification by hospitals and diagnos-
  tic and treatment centers; and to amend 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 omitting sunset  provisions  for  enhanced
  penalties

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Section 2805-l of the public health law, as added by  chap-
ter  266 of the laws of 1986, subdivision 3 as amended by chapter 542 of
the laws of 2000, subdivision 4 as added and subdivision 5 as renumbered
by chapter 632 of the laws of 2006, is amended to read as follows:
  S 2805-l. [Incident] ADVERSE EVENT reporting. 1. (A) FOR  PURPOSES  OF
THIS  SECTION,  "HOSPITAL"  MEANS ANY GENERAL HOSPITAL OR DIAGNOSTIC AND
TREATMENT CENTER.
  (B) All hospitals[, as defined in subdivision ten of  section  twenty-
eight  hundred  one of this article,] shall be required to report [inci-
dents] ADVERSE EVENTS described by subdivision two of  this  section  to
the  department  WITHIN  TWENTY-FOUR HOURS OF OBTAINING KNOWLEDGE OF ANY
INFORMATION WHICH REASONABLY APPEARS TO SHOW THAT SUCH AN ADVERSE  EVENT
HAS  OCCURRED.  SUCH  REPORT  SHALL BE MADE in a manner [and within time
periods] as may be specified by regulation of the department.
  2. The following [incidents] ADVERSE EVENTS shall be reported  to  the
department:
  (a)  patients'  deaths  or  impairments of bodily functions in circum-
stances other than those related  to  the  natural  course  of  illness,
disease  or  proper  treatment  in  accordance  with  generally accepted
medical standards;
  (b) fires in the hospital which disrupt the provision of patient  care
services or cause harm to patients or staff;

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

                      [ ] is old law to be omitted.
                                                           LBD15998-05-0

S. 7828                             2

  (c)  equipment  malfunction during treatment or diagnosis of a patient
which did or could have adversely affected a patient or hospital person-
nel;
  (d) poisoning occurring within the hospital;
  (e) strikes by hospital staff;
  (f)  disasters  or other emergency situations external to the hospital
environment which affect hospital operations; [and]
  (g) termination of any services vital to the continued safe  operation
of  the hospital or to the health and safety of its patients and person-
nel, including but not limited to the anticipated or actual  termination
of telephone, electric, gas, fuel, water, heat, air conditioning, rodent
or pest control, laundry services, food or contract services[.];
  (H)  SERIOUS  CRIMES  OCCURRING  ON  HOSPITAL  PREMISES OR GROUNDS, AS
DEFINED BY THE COMMISSIONER; AND
  (I) OTHER SERIOUS ADVERSE EVENTS AS  DETERMINED  BY  THE  COMMISSIONER
AFTER  CONSIDERATION  OF  NATIONAL  STANDARDS AND EXPERT ADVICE PROVIDED
PURSUANT TO SUBDIVISION SIX OF THIS SECTION.
  3. (A)(I) The hospital shall conduct an investigation  of  [incidents]
ADVERSE  EVENTS  described  in  paragraphs  (a) [through (d)] AND (C) of
subdivision two of this section. THE HOSPITAL SHALL COMPLETE SUCH INVES-
TIGATION AND PROVIDE TO THE DEPARTMENT A WRITTEN REPORT  THEREOF  within
thirty  days  of obtaining knowledge of any information which reasonably
appears to show that such an [incident]  ADVERSE  EVENT  has  occurred[,
provided  that, if the hospital reasonably expects such investigation to
extend beyond such thirty day period,  the  hospital  shall  notify  the
department of such expectation and the reason therefor, and shall inform
the department of the expected completion date of the investigation. The
hospital  shall  provide  to  the department a copy of the investigation
report within twenty-four hours  of  completion.  Nothing  herein  shall
limit  the  authority  of  the department to conduct an investigation of
incidents occurring in general hospitals].
  (II) IF DIRECTED TO DO  SO  BY  THE  DEPARTMENT,  THE  HOSPITAL  SHALL
CONDUCT  AN  INVESTIGATION OF ADVERSE EVENTS DESCRIBED IN PARAGRAPHS (B)
AND (D) THROUGH (I)  OF  SUBDIVISION  TWO  OF  THIS  SECTION  AND  SHALL
COMPLETE  SUCH  INVESTIGATION  AND  PROVIDE  TO THE DEPARTMENT A WRITTEN
REPORT THEREOF WITHIN THIRTY DAYS OF RECEIVING SUCH DIRECTION  FROM  THE
DEPARTMENT.
  (B) A HOSPITAL MAY SUBMIT TO THE COMMISSIONER A WRITTEN REQUEST FOR AN
EXTENSION  OF  TIME  TO COMPLETE AN INVESTIGATION AND SUBMIT AN INVESTI-
GATION REPORT PURSUANT  TO  PARAGRAPH  (A)  OF  THIS  SUBDIVISION.  SUCH
REQUEST  SHALL  STATE  THE  LENGTH  OF THE EXTENSION REQUESTED, WHY SUCH
EXTENSION IS NECESSARY, AND WHAT STEPS HAVE BEEN OR WILL BE TAKEN BY THE
HOSPITAL TO ENSURE THAT PATIENT  SAFETY  WOULD  NOT  BE  COMPROMISED  BY
APPROVAL   OF SUCH EXTENSION. THE COMMISSIONER MAY GRANT AN EXTENSION IF
HE OR SHE FINDS IT TO BE REASONABLE AFTER CONSIDERATION OF THE  INFORMA-
TION  SUBMITTED BY THE HOSPITAL AND FACTORS INCLUDING BUT NOT LIMITED TO
THE SERIOUSNESS OF THE EVENT, THE MAGNITUDE AND URGENCY OF THE  RISK  IT
PRESENTS,  THE  LIKELIHOOD OF REPETITION AND THE IMPACT AN EXTENSION MAY
HAVE  UPON  PATIENT  SAFETY.  THE  COMMISSIONER  MAY,  IN  HIS  OR   HER
DISCRETION,  GRANT  AN  EXTENSION  OF TIME WHICH IS OF LONGER OR SHORTER
DURATION THAN THAT REQUESTED BY THE HOSPITAL AND  MAY,  IN  HIS  OR  HER
DISCRETION,  GRANT  ADDITIONAL EXTENSIONS UNDER THE SAME CRITERIA LISTED
HEREIN.
  4. NOTHING HEREIN SHALL LIMIT  THE  AUTHORITY  OF  THE  DEPARTMENT  TO
CONDUCT  INVESTIGATIONS OF ADVERSE EVENTS OCCURRING IN HOSPITALS, NOR TO
ENFORCE THE PROVISIONS OF THIS CHAPTER BASED ON SUCH EVENTS.

S. 7828                             3

  5. THE DEPARTMENT SHALL ANALYZE REPORTS OF INVESTIGATIONS  OF  ADVERSE
EVENTS  AND  USE  SUCH  ANALYSES  IN  THE DEVELOPMENT, DISSEMINATION AND
TRACKING OF PATIENT SAFETY GOALS AND BEST PRACTICES IN  PATIENT  SAFETY.
THE  DEPARTMENT  MAY  ALSO RELEASE TO HOSPITALS OR TO THE PUBLIC OR BOTH
ANALYSES  AND  FINDINGS  DERIVED FROM THE ADVERSE EVENT DATA IN A FORMAT
THAT DOES NOT IDENTIFY SPECIFIC PATIENTS.
  6. THE DEPARTMENT SHALL  CONSULT,  AS  APPROPRIATE,  WITH  CLINICIANS,
HOSPITAL ADMINISTRATORS, RESEARCHERS AND CONSUMERS WITH EXPERTISE IN THE
AREA OF PATIENT SAFETY AND QUALITY IMPROVEMENT CONCERNING:
  (A)  IMPROVEMENTS TO THE ADVERSE EVENT REPORTING SYSTEM, INCLUDING BUT
NOT LIMITED TO, CHANGES IN THE TYPES OF ADVERSE EVENTS AND  OTHER  RELE-
VANT PATIENT DATA THAT SHOULD BE REPORTED;
  (B)  INTEGRATION  OF  ADVERSE  EVENT  DATA  WITH  OTHER DATA REPORTING
SYSTEMS FOR PURPOSES OF IMPROVING PATIENT SAFETY;
  (C) COLLABORATIVE STRATEGIES  TO  IMPROVE  PATIENT  SAFETY  WHICH  MAY
INCLUDE, BUT ARE NOT LIMITED TO, CONSULTATION WITH HOSPITALS TO IDENTIFY
EFFECTIVE  STRATEGIES DEPLOYED TO PROMOTE PATIENT SAFETY AND DEVELOPMENT
OF EDUCATION PROGRAMS TO TARGET AREAS IN NEED OF  IMPROVEMENT  BASED  ON
FINDINGS OF THE ADVERSE EVENT REPORTING SYSTEM;
  (D)  THE  TYPES  OF ADVERSE EVENT DATA THAT SHOULD BE DISCLOSED TO THE
PUBLIC; AND
  (E) STRATEGIES TO ENCOURAGE REPORTING UNDER THIS SECTION.
  7. (A) EACH GENERAL HOSPITAL, AND EACH DIAGNOSTIC AND TREATMENT CENTER
THAT PROVIDES AMBULATORY SURGERY, DIAGNOSTIC OR THERAPEUTIC RADIATION OR
END STAGE RENAL DISEASE  SERVICES,  SHALL  ESTABLISH  A  PATIENT  SAFETY
COMMITTEE WHICH SHALL BE CHARGED WITH:
  (I)  CONDUCTING  ONGOING  ANALYSIS  AND  APPLICATION OF EVIDENCE-BASED
PATIENT SAFETY PRACTICES IN ORDER TO REDUCE THE PROBABILITY  OF  ADVERSE
EVENTS;
  (II)  CONDUCTING  ANALYSES OF ADVERSE EVENTS AND NEAR-MISS EVENTS THAT
OCCUR WITHIN THE FACILITY; AND
  (III) DEVELOPING AND PROMOTING THE IMPLEMENTATION  OF  RISK  REDUCTION
STRATEGIES TO PREVENT THE OCCURRENCE OF ADVERSE OR NEAR-MISS EVENTS.
  (B)  THE  RESPONSIBILITIES  OF  THE  PATIENT  SAFETY  COMMITTEE MAY BE
ASSUMED BY AN EXISTING COMMITTEE OF THE  HOSPITAL,  PROVIDED  THAT  SUCH
COMMITTEE  SATISFIES  THE  REQUIREMENTS SET FORTH IN THIS SECTION AND IN
REGULATIONS PROMULGATED BY THE COMMISSIONER.
  (C) THE PATIENT SAFETY COMMITTEE SHALL BE CHAIRED BY A PATIENT  SAFETY
OFFICER  WHO  SHALL  REPORT  DIRECTLY  TO THE CHIEF EXECUTIVE OFFICER OR
ADMINISTRATOR, AS APPLICABLE, AND SHALL PRESENT ON AT LEAST A  QUARTERLY
BASIS  TO THE GOVERNING BODY OF THE HOSPITAL A REPORT ON THE COMMITTEE'S
ACTIVITIES, FINDINGS AND RECOMMENDATIONS AND THE STATUS  OF  EFFORTS  TO
IMPLEMENT  THOSE  RECOMMENDATIONS  PREVIOUSLY  MADE BY THE COMMITTEE AND
ADOPTED.
  (D) FOR PURPOSES OF THIS SUBDIVISION, "NEAR-MISS EVENT" MEANS AN EVENT
OR SITUATION THAT COULD HAVE RESULTED IN AN ADVERSE EVENT BUT  DID  NOT,
EITHER BY CHANCE OR THROUGH TIMELY INTERVENTION.
  [4.]  8.  The  commissioner  shall  establish  protocols  for hospital
personnel where a patient under the age of eighteen  years  dies  during
transportation  to  the hospital or while at the hospital, under circum-
stances other than those related  to  the  natural  course  of  illness,
disease  or  proper  treatment  in  accordance  with  generally accepted
medical standards. Such protocols shall address matters  including,  but
not limited to, the following:
  (a) medical and social history, and examination of the patient;
  (b) preservation of evidence and chain of custody;

S. 7828                             4

  (c)  questioning  of  the  patient's  family,  guardian  or  person in
parental authority;
  (d) circumstances surrounding the injury resulting in death;
  (e) determination of the cause of death;
  (f) notification of law enforcement personnel; and
  (g)  reporting  requirements  under  title  six  of article six of the
social services law.
  In developing such protocols, the commissioner shall consult with  the
office  of  children  and  family  services, local departments of social
services, coordinators of child fatality review teams established pursu-
ant to section four hundred twenty-two-b of the social services law, law
enforcement agencies, pediatricians preferably  with  expertise  in  the
area  of  child  abuse and maltreatment or forensic pediatrics, and such
other persons as the commissioner deems necessary.
  [5.] 9. The commissioner shall make,  adopt,  promulgate  and  enforce
such  rules and regulations as he may deem appropriate to effectuate the
purposes of this section.
  10. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF  SECTION  TWELVE
OF  THIS  CHAPTER  OR ANY OTHER LAW, THE COMMISSIONER MAY IMPOSE A CIVIL
PENALTY NOT TO EXCEED FIVE THOUSAND DOLLARS FOR EACH  VIOLATION  OF  THE
REQUIREMENTS  OF  THIS  SECTION OR THE RULES AND REGULATIONS PROMULGATED
PURSUANT TO SUCH SECTION PERTAINING TO THE TIMELY REPORTING AND INVESTI-
GATION OF ADVERSE EVENTS AND THE  SUBMISSION  OF  INVESTIGATION  REPORTS
CONCERNING SUCH EVENTS.
  (B)  THE PENALTY PROVIDED FOR IN PARAGRAPH (A) OF THIS SUBDIVISION MAY
BE INCREASED TO AN AMOUNT NOT TO  EXCEED  SEVEN  THOUSAND  FIVE  HUNDRED
DOLLARS  FOR  A  SUBSEQUENT  VIOLATION  IF THE PERSON COMMITTED THE SAME
VIOLATION, WITH RESPECT TO THE SAME OR  ANY  OTHER  PERSON  OR  PERSONS,
WITHIN  TWELVE  MONTHS  OF THE INITIAL VIOLATION FOR WHICH A PENALTY WAS
ASSESSED PURSUANT TO PARAGRAPH (A) OF THIS SUBDIVISION.
  (C) THE PENALTY PROVIDED FOR IN PARAGRAPH (A) OF THIS SUBDIVISION  MAY
BE  INCREASED  TO  AN AMOUNT NOT TO EXCEED TEN THOUSAND DOLLARS FOR EACH
VIOLATION IF THE ADVERSE EVENT DIRECTLY  RESULTED  IN  SERIOUS  PHYSICAL
HARM TO A PATIENT OR PATIENTS.
  (D) IN ADDITION TO THE PENALTIES AVAILABLE UNDER SUBDIVISIONS (A), (B)
AND (C) OF THIS SUBDIVISION, THE COMMISSIONER MAY IMPOSE A CIVIL PENALTY
OF  FIVE HUNDRED DOLLARS FOR EACH DAY THAT A HOSPITAL FAILS TO SUBMIT AN
INVESTIGATION REPORT AS REQUIRED PURSUANT TO PARAGRAPH (A)  OF  SUBDIVI-
SION  THREE  OF  THIS SECTION, IF THE COMMISSIONER HAS NOT AUTHORIZED AN
EXTENSION OF TIME PURSUANT TO PARAGRAPH (B) OF SUBDIVISION THREE OF THIS
SECTION.
  (E) THE COMPTROLLER IS  HEREBY  AUTHORIZED  AND  DIRECTED  TO  DEPOSIT
AMOUNTS  COLLECTED  UNDER  THIS SUBDIVISION TO THE PATIENT SAFETY CENTER
ACCOUNT TO BE USED FOR PURPOSES OF THE PATIENT SAFETY CENTER CREATED  BY
TITLE TWO OF ARTICLE TWENTY-NINE-D OF THIS CHAPTER.
  (F)  ANY  CIVIL  PENALTIES  AVAILABLE  UNDER THIS SUBDIVISION SHALL BE
ASSESSED SUBJECT TO THE APPLICABLE PROVISIONS  OF  SECTIONS  TWELVE  AND
TWELVE-A OF THIS CHAPTER.
  S  2.  Section  2805-m of the public health law, as amended by chapter
808 of the laws of 1987, is amended to read as follows:
  S  2805-m.  Confidentiality.    1.  The  information  required  to  be
collected  and  maintained  pursuant  to  sections  twenty-eight hundred
five-j and twenty-eight  hundred  five-k  of  this  article[,]  AND  THE
reports  required  to  be  submitted  pursuant  to  section twenty-eight
hundred five-l of this article [and any incident reporting  requirements
imposed upon diagnostic and treatment centers pursuant to the provisions

S. 7828                             5

of  this  chapter]  shall be kept confidential and shall not be released
except to the department or pursuant  to  subdivision  four  of  section
twenty-eight hundred five-k of this article.
  2.  Notwithstanding  any other provisions of law, none of the records,
documentation or committee  actions  or  records  required  pursuant  to
sections  twenty-eight hundred five-j [and], twenty-eight hundred five-k
OR TWENTY-EIGHT HUNDRED  FIVE-L  of  this  article[,]  NOR  the  reports
required pursuant to section twenty-eight hundred five-l of this article
[nor  any  incident  reporting  requirements imposed upon diagnostic and
treatment centers pursuant to the provisions of this chapter]  shall  be
subject  to  disclosure  under article six of the public officers law or
article thirty-one of the civil practice law and rules, except as  here-
inafter provided or as provided by any other provision of law. No person
in  attendance  at  a meeting of any such committee shall be required to
testify as to what  transpired  thereat.  The  prohibition  relating  to
discovery  of  testimony  shall  not apply to the statements made by any
person in attendance at such a meeting who is a party to  an  action  or
proceeding the subject matter of which was reviewed at such meeting.
  3.  There  shall be no monetary liability on the part of, and no cause
of action for damages shall  arise  against,  any  person,  partnership,
corporation,  firm,  society, or other entity on account of the communi-
cation of information in the possession of such person or entity, or  on
account  of  any  recommendation or evaluation, regarding the qualifica-
tions, fitness, or professional conduct or practices of a physician,  to
any  governmental agency, medical or specialists society, or hospital as
required by sections twenty-eight hundred five-j,  twenty-eight  hundred
five-k  and twenty-eight hundred five-l of this article [or any incident
reporting requirements imposed upon  diagnostic  and  treatment  centers
pursuant  to  the  provisions  of this chapter]. The foregoing shall not
apply to information which is untrue  and  communicated  with  malicious
intent.
  S 3. Subdivision 3 of section 6527 of the education law, as amended by
chapter 257 of the laws of 1987, is amended to read as follows:
  3. No individual who serves as a member of (a) a committee established
to  administer  a  utilization  review  plan  of a hospital, including a
hospital as defined in article twenty-eight of the public health law  or
a  hospital  as defined in subdivision ten of section 1.03 of the mental
hygiene law, or (b) a committee having the responsibility of the  inves-
tigation of an incident reported pursuant to section 29.29 of the mental
hygiene  law  or  the  evaluation and improvement of the quality of care
rendered in a hospital as defined in article twenty-eight of the  public
health  law  or a hospital as defined in subdivision ten of section 1.03
of the mental hygiene law,  or  (c)  any  medical  review  committee  or
subcommittee thereof of a local, county or state medical, dental, podia-
try  or  optometrical  society,  any such society itself, a professional
standards review organization or  an  individual  when  such  committee,
subcommittee,  society,  organization  or  individual  is performing any
medical or quality assurance review function including the investigation
of an incident reported pursuant to section 29.29 of the mental  hygiene
law,  either  described  in  clauses  (a)  and  (b) of this subdivision,
required by law, or involving any controversy or dispute between  (i)  a
physician,  dentist, podiatrist or optometrist or hospital administrator
and a patient concerning  the  diagnosis,  treatment  or  care  of  such
patient  or  the  fees or charges therefor or (ii) a physician, dentist,
podiatrist or optometrist or hospital administrator and  a  provider  of
medical,  dental,  podiatric  or  optometrical  services  concerning any

S. 7828                             6

medical or health charges or fees of such physician, dentist, podiatrist
or optometrist, or (d) a committee appointed pursuant to  section  twen-
ty-eight  hundred  five-j of the public health law to participate in the
medical and dental malpractice prevention program, or (e) any individual
who  participated in the preparation of [incident] ADVERSE EVENT reports
required by the department of health pursuant  to  section  twenty-eight
hundred  five-l of the public health law, or (f) a committee established
to administer a utilization review  plan,  or  a  committee  having  the
responsibility  of  evaluation  and  improvement  of the quality of care
rendered, in a health maintenance organization organized  under  article
forty-four of the public health law or article forty-three of the insur-
ance law, including a committee of an individual practice association or
medical  group  acting pursuant to a contract with such a health mainte-
nance organization, shall be liable in damages to  any  person  for  any
action  taken  or  recommendations  made, by him within the scope of his
function in such capacity provided that (a) such  individual  has  taken
action  or  made  recommendations  within  the scope of his function and
without malice, and (b) in the reasonable belief after reasonable inves-
tigation that the act or recommendation was warranted,  based  upon  the
facts disclosed.
  Neither  the  proceedings nor the records relating to performance of a
medical or a quality assurance review function  or  participation  in  a
medical  and  dental  malpractice  prevention  program  nor  any  report
required by the department of health pursuant  to  section  twenty-eight
hundred  five-l of the public health law described herein, including the
investigation of an incident reported pursuant to section 29.29  of  the
mental  hygiene  law, shall be subject to disclosure under article thir-
ty-one of the  civil  practice  law  and  rules  except  as  hereinafter
provided  or  as  provided  by  any other provision of law. No person in
attendance at a meeting when a medical or a quality assurance review  or
a  medical  and  dental  malpractice  prevention  program or an incident
reporting function described herein was performed, including the  inves-
tigation of an incident reported pursuant to section 29.29 of the mental
hygiene law, shall be required to testify as to what transpired thereat.
The  prohibition  relating  to discovery of testimony shall not apply to
the statements made by any person in attendance at such a meeting who is
a party to an action or proceeding  the  subject  matter  of  which  was
reviewed at such meeting.
  S  4. 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,  as  amended  by
chapter 21 of the laws of 2010, is amended to read as follows:
  S  4.  This  act  shall  take  effect  immediately;  provided that the
provisions of section one of this act shall be deemed to  have  been  in
full  force  and  effect  on  and after April 1, 2003[, and shall expire
March 31, 2011 when upon such date the provisions of such section  shall
be deemed repealed].
  S 5. This act shall take effect on the one hundred eightieth day after
it shall have become law; provided, however, that effective immediately,
the  addition,  amendment and repeal of any rule or regulation necessary
for the implementation of this act on its effective date  is  authorized
and directed to be made and completed on or before such effective date.

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