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

    S. 6256--A                                            A. 9056--A

                      S E N A T E - A S S E M B L Y

                            January 17, 2012
                               ___________

IN  SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti-
  cle seven of the Constitution -- read twice and ordered  printed,  and
  when  printed to be committed to the Committee on Finance -- committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

IN ASSEMBLY -- A BUDGET BILL, submitted  by  the  Governor  pursuant  to
  article  seven  of  the  Constitution -- read once and referred to the
  Committee on Ways and Means --  committee  discharged,  bill  amended,
  ordered reprinted as amended and recommitted to said committee

AN  ACT to amend the public health law, in relation to requiring the use
  of network providers for  evaluations  or  services  under  the  early
  intervention  program,  state  aid reimbursement to municipalities for
  respite services, and service coordination; to repeal subdivision 7 of
  section 2551 and subdivision 4 of section 2557 of  the  public  health
  law,  relating  to administering early intervention services; to amend
  the public health law, in relation to requiring that each municipality
  be responsible for providing early intervention services; to amend the
  public health law, in relation to removing the  authorization  of  the
  commissioner  of  health to collect data from counties on early inter-
  vention programs for the purpose of improving efficiency, cost  effec-
  tiveness  and  quality; to amend the public health law, in relation to
  requiring health maintenance organizations  to  include  coverage  for
  otherwise  covered  services  that  are  part of an early intervention
  program; to amend the insurance law, in relation to payment for  early
  intervention  services;  to  amend  the  education law, in relation to
  special education services and programs for  preschool  children  with
  handicapping  conditions; and to repeal subdivision 18 of section 4403
  of the education law, relating to the power of the  education  depart-
  ment to approve the provision of early intervention services (Part A);
  to  amend the public authorities law, in relation to funding and oper-
  ations of the Roswell Park Cancer Institute (Part  B);  to  amend  the
  public health law, in relation to establishment of an electronic death
  registration  system  (Part  C);  to  amend  the public health law, in
  relation to establishing the supportive housing development  reinvest-
  ment  program; to amend the social services law, in relation to appli-
  cability of the assisted living program; to amend the social  services

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

                      [ ] is old law to be omitted.
                                                           LBD12671-02-2

S. 6256--A                          2                         A. 9056--A

  law, in relation to including podiatry services and lactation services
  under  the term medical assistance; to amend the public health law and
  education law,  in  relation  to  medical  prescriptions  for  limited
  English  proficient  individuals; to amend the social services law, in
  relation to education, outreach services  and  facilitated  enrollment
  activities  for certain aged, blind and disabled persons; to amend the
  public health law, in relation to including certain  violations  by  a
  pharmacy as professional misconduct; expanding prenatal care programs,
  establishing  the  primary care service corps practitioner loan repay-
  ment program, requiring changes in directors of not-for-profit  corpo-
  rations  that  operate  hospitals  to  be  approved by the department,
  authorizing the commissioner of health to temporarily suspend or limit
  hospital  operating  certificates,  revoking  of  hospital   operating
  certificates,  appointment  and  duties  of  temporary  operators of a
  general hospital  or  diagnostic  and  treatment  center,  authorizing
  moneys  in the medical indemnity fund to be invested in obligations of
  the United States or the state or obligations where the principal  and
  interest  are  guaranteed by the United States or the state and moneys
  distributed  as  non-Medicaid  grants  to  non-major  public  academic
  medical  centers;  to  amend  the  social services law, in relation to
  prescriptions of opioid analgesics and brand  name  drugs  covered  by
  medical  assistance;  to  amend  the public health law, in relation to
  notice requirement for preferred drug program, payment to the  commis-
  sioner  of  health  by  third-party  payors,  audit of payments to the
  commissioner of health, electronic submission of reports by hospitals,
  and changing the definition of eligible applicant; to amend the social
  services law, in relation to  medical  assistance  where  relative  is
  absent  or  refuses  or fails to provide necessary care;  to amend the
  public health law, in relation to third-party payor's election to make
  payments; to amend the elder law, in relation to the  elderly  pharma-
  ceutical  insurance  coverage program; to amend the public health law,
  in relation to reserved bed days; to amend the social services law, in
  relation  to  the  personal  care  services  worker  recruitment   and
  retention  program; to amend the public health law, in relation to the
  tobacco control and insurance initiatives pool distributions; to amend
  the  social  services  law,  in  relation  to  certain  public  school
  districts  and  state  operated/state  supported schools; to amend the
  public health law, in relation to the licensure of home care  services
  agencies;  to  amend  the  social services law, in relation to managed
  care programs; to amend the public health  law,  in  relation  to  the
  distribution of the professional education pools; to amend chapter 584
  of  the laws of 2011, amending the public authorities law, relating to
  the powers and duties of the dormitory authority of the state  of  New
  York  relative  to  the  establishment  of  subsidiaries  for  certain
  purposes, in relation to the effectiveness thereof; to  amend  chapter
  119  of  the  laws  of  1997 relating to authorizing the department of
  health to establish certain payments to general hospitals, in relation
  to costs incurred in  excess  of  revenues  by  general  hospitals  in
  providing  services  in  eligible  programs  to uninsured patients and
  patients eligible for Medicaid assistance; to amend subdivision  1  of
  section  92  of  part H of chapter 59 of the laws of 2011, relating to
  known and projected department of health state funds Medicaid expendi-
  tures, in relation to the effectiveness thereof; to amend  section  90
  of  part  H  of  chapter  59 of the laws of 2011, relating to types of
  appropriations exempt from certain reductions, in relation to  certain
  payments  with regard to local governments; to amend section 1 of part

S. 6256--A                          3                         A. 9056--A

  C of  chapter  58  of  the  laws  of  2005,  relating  to  authorizing
  reimbursements  for  expenditures  made  by  or  on  behalf  of social
  services districts for medical assistance for needy  persons  and  the
  administration  thereof, in relation to Medicaid reimbursement; and to
  repeal certain  provisions  of  the  public  health  law,  the  social
  services law and the elder law relating thereto (Part D); to amend the
  public authorities law and the public officers law, in relation to the
  establishment  of  the  New  York Health Benefit Exchange (Part E); to
  amend chapter 58 of the laws of 2005  authorizing  reimbursements  for
  expenditures  made  by  or  on behalf of social services districts for
  medical assistance for needy persons and the  administration  thereof,
  in relation to an administrative cap on such program; to amend chapter
  59  of the laws of 2011, amending the public health law and other laws
  relating to  general  hospital  reimbursement  for  annual  rates,  in
  relation  to  the cap on local Medicaid expenditures; and to amend the
  social services law, in  relation  to  the  department  assumption  of
  program  administration  for medical assistance (Part F); to amend the
  public health law, in relation to regulations for  computing  hospital
  inpatient  rates  and to amend chapter 58 of the laws of 2005 relating
  to the preferred drug program, in relation to the effectiveness there-
  of (Part G); to amend chapter 57 of the  laws  of  2006,  relating  to
  establishing a cost of living adjustment for designated human services
  programs,   in  relation  to  foregoing  such  adjustment  during  the
  2012-2013 state fiscal year; and in relation to  directing  limits  on
  state  reimbursement  for  executive  compensation  and administrative
  costs (Part H); in relation to contracts by the office for people with
  developmental disabilities made under  section  1115  of  the  federal
  social  security  act  (Part  I); to amend the mental hygiene law, the
  public health law, the general municipal law, the education  law,  the
  social  services  law,  and  the  surrogate's  court procedure act, in
  relation to the office for people with developmental disabilities  and
  the  creation of developmental disabilities regional offices and state
  operations offices (Part J); to amend chapter 723 of the laws of  1989
  amending  the mental hygiene law and other laws relating to comprehen-
  sive psychiatric emergency programs,  in  relation  to  extending  the
  repeal  of  certain provisions thereof (Part K); to permit the commis-
  sioners of the department of health, the office of mental health,  the
  office  of  alcoholism and substance abuse services and the office for
  people with developmental disabilities the regulatory  flexibility  to
  more  efficiently  and  effectively  integrate  health  and behavioral
  health services (Part L); to permit the office of  mental  health  and
  the state education department to enter into an agreement for purposes
  of  providing education programming for patients residing in hospitals
  operated by the office of mental health who are between  the  ages  of
  five  and  twenty-one; and providing for the repeal of such provisions
  upon expiration thereof (Part M); to amend the mental hygiene law  and
  the  public  health  law,  in  relation to the statewide comprehensive
  services plan for people with mental disabilities and in  relation  to
  the  local  planning  process; and to repeal certain provisions of the
  mental hygiene law relating thereto (Part  N);  to  amend  the  mental
  hygiene  law,  in relation to the closure and the reduction in size of
  certain facilities serving persons with mental illness  (Part  O);  to
  amend the mental hygiene law, in relation to amending procedures under
  the  sex offender management and treatment act, and to amend the penal
  law,  in  relation  to  providing  criminal  penalties   for   certain
  violations  of  orders  of  commitment and strict and intensive super-

S. 6256--A                          4                         A. 9056--A

  vision and treatment (Part P); to amend the criminal procedure law, in
  relation to providing for outpatient capacity  restoration  of  felony
  defendants, or restoration at psychiatric units of jails or article 28
  hospitals  (Part  Q);  and  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 R)

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

  Section  1.  This  act enacts into law major components of legislation
which are necessary to implement the state fiscal plan for the 2012-2013
state fiscal year. Each component is  wholly  contained  within  a  Part
identified  as Parts A through R. The effective date for each particular
provision contained within such Part is set forth in the last section of
such Part. Any provision in any section contained within a Part, includ-
ing the effective date of the Part, which makes a reference to a section
"of this act", when used in connection with that  particular  component,
shall  be  deemed  to mean and refer to the corresponding section of the
Part in which it is found. Section three of  this  act  sets  forth  the
general effective date of this act.

                                 PART A

  Section  1.    Paragraph  (a)  of subdivision 2 of section 2544 of the
public health law, as added by chapter 428  of  the  laws  of  1992,  is
amended and a new paragraph (c) is added to read as follows:
  (a)  [The]  SUBJECT  TO  THE PROVISIONS OF SECTION TWENTY-FIVE HUNDRED
FORTY-FIVE-A OF THIS TITLE, THE parent may select an evaluator from  the
list  of approved evaluators as described in section twenty-five hundred
forty-two of this title to conduct the evaluation. The parent or  evalu-
ator  shall  immediately  notify the early intervention official of such
selection.  The evaluator may begin the evaluation no sooner  than  four
working  days  after such notification, unless otherwise approved by the
initial service coordinator.
  (C) IF, IN CONSULTATION WITH THE EVALUATOR,  THE  SERVICE  COORDINATOR
IDENTIFIES A CHILD THAT IS POTENTIALLY ELIGIBLE FOR PROGRAMS OR SERVICES
OFFERED  BY OR UNDER THE AUSPICES OF THE OFFICE FOR PEOPLE WITH DEVELOP-
MENTAL DISABILITIES, THE SERVICE COORDINATOR SHALL, WITH PARENT CONSENT,
NOTIFY THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL  DISABILITIES'  REGIONAL
DEVELOPMENTAL  DISABILITIES SERVICES OFFICE OF THE POTENTIAL ELIGIBILITY
OF SUCH CHILD FOR SAID PROGRAMS OR SERVICES.
  S 2. Subdivision 1, the opening paragraph of subdivision 2 and  subdi-
vision  7  of section 2545 of the public health law, as added by chapter
428 of the laws of 1992, are amended to read as follows:
  1. If the evaluator determines that the infant or toddler is an eligi-
ble child, the early intervention official shall convene a meeting, at a
time and place convenient to the parent, consisting of the parent,  such
official,  the  evaluator,  A REPRESENTATIVE FROM THE CHILD'S INSURER OR
HEALTH MAINTENANCE ORGANIZATION, WHICH SHALL INCLUDE THE MEDICAL ASSIST-
ANCE PROGRAM OR THE CHILD HEALTH INSURANCE PROGRAM ESTABLISHED IN  TITLE
ONE-A  OF  THIS ARTICLE, OR ANY OTHER GOVERNMENTAL THIRD PARTY PAYOR, IF
THE CHILD HAS COVERAGE THROUGH AN INSURER OR HEALTH  MAINTENANCE  ORGAN-
IZATION AND THE REPRESENTATIVE IS AVAILABLE TO ATTEND THE MEETING ON THE

S. 6256--A                          5                         A. 9056--A

DATE  AND  TIME  CHOSEN  BY THE EARLY INTERVENTION OFFICIAL, the initial
service coordinator and any other persons who the parent or the  initial
service  coordinator,  with  the parent's consent, invite, provided that
such  meeting  shall be held no later than forty-five days from the date
that the early intervention official was first contacted  regarding  the
child,  except under exceptional circumstances prescribed by the commis-
sioner. The early intervention official, at or  prior  to  the  time  of
scheduling  the  meeting, shall inform the parent of the right to invite
any person to the meeting.   IF  THE  REPRESENTATIVE  FROM  THE  CHILD'S
INSURER  OR  HEALTH  MAINTENANCE ORGANIZATION IS NOT AVAILABLE TO ATTEND
THE MEETING IN PERSON ON THE DATE AND TIME CHOSEN BY  THE  EARLY  INTER-
VENTION  OFFICIAL,  ARRANGEMENTS  MAY  BE  MADE FOR THE REPRESENTATIVE'S
INVOLVEMENT IN THE MEETING BY PARTICIPATION IN  A  TELEPHONE  CONFERENCE
CALL OR BY OTHER MEANS.
  The  early  intervention  official,  A REPRESENTATIVE FROM THE CHILD'S
INSURER OR HEALTH MAINTENANCE  ORGANIZATION,  WHICH  SHALL  INCLUDE  THE
MEDICAL  ASSISTANCE PROGRAM OR THE CHILD HEALTH INSURANCE PROGRAM ESTAB-
LISHED IN TITLE ONE-A OF THIS ARTICLE, OR ANY OTHER  GOVERNMENTAL  THIRD
PARTY  PAYOR,  IF  THE  CHILD  HAS COVERAGE THROUGH AN INSURER OR HEALTH
MAINTENANCE ORGANIZATION AND THE REPRESENTATIVE IS AVAILABLE  TO  ATTEND
THE  MEETING ON THE DATE AND TIME CHOSEN BY THE EARLY INTERVENTION OFFI-
CIAL, initial service coordinator, parent and evaluator shall develop an
IFSP for an eligible child whose  parents  request  services.  The  IFSP
shall be in writing and shall include, but not be limited to:
  7.  The  IFSP  shall  be  reviewed at six month intervals and shall be
evaluated annually by the early intervention official, A  REPRESENTATIVE
FROM THE CHILD'S INSURER OR HEALTH MAINTENANCE ORGANIZATION, WHICH SHALL
INCLUDE  THE  MEDICAL  ASSISTANCE  PROGRAM OR THE CHILD HEALTH INSURANCE
PROGRAM ESTABLISHED IN TITLE ONE-A OF THIS ARTICLE, OR ANY OTHER GOVERN-
MENTAL THIRD PARTY PAYOR, IF THE CHILD HAS COVERAGE THROUGH  AN  INSURER
OR  HEALTH  MAINTENANCE ORGANIZATION AND THE REPRESENTATIVE IS AVAILABLE
TO PARTICIPATE IN THE REVIEW OR ATTEND ON THE DATE AND  TIME  CHOSEN  BY
THE EARLY INTERVENTION OFFICIAL, THE service coordinator, the parent and
providers  of services to the eligible child.  Upon request of a parent,
the plan may be reviewed by such persons at more frequent intervals.  IF
THE REPRESENTATIVE FROM THE CHILD'S INSURER OR HEALTH MAINTENANCE ORGAN-
IZATION IS NOT AVAILABLE TO PARTICIPATE  IN  THE  REVIEW  OR  ATTEND  IN
PERSON  ON  THE DATE AND TIME CHOSEN BY THE EARLY INTERVENTION OFFICIAL,
ARRANGEMENTS MAY BE MADE FOR THE REPRESENTATIVE'S INVOLVEMENT BY PARTIC-
IPATION IN A TELEPHONE CONFERENCE CALL OR BY OTHER MEANS.
  S 2-a. Section 2545 of the public health law is amended  by  adding  a
new subdivision 10 to read as follows:
  10.  THE SERVICE COORDINATOR SHALL ENSURE THAT THE IFSP, INCLUDING ANY
AMENDMENTS THERETO, IS IMPLEMENTED IN A TIMELY MANNER BUT NOT LATER THAN
THIRTY DAYS AFTER THE PROJECTED DATES FOR INITIATION OF THE SERVICES  AS
SET FORTH IN THE PLAN.
  S  3.  The public health law is amended by adding a new section 2545-a
to read as follows:
  S 2545-A. USE OF NETWORK PROVIDERS.   FOR  CHILDREN  REFERRED  TO  THE
EARLY INTERVENTION PROGRAM ON OR AFTER JANUARY FIRST, TWO THOUSAND THIR-
TEEN,  IF  A  CHILD  HAS  COVERAGE  UNDER  AN  INSURANCE POLICY, PLAN OR
CONTRACT, INCLUDING COVERAGE  AVAILABLE  UNDER  THE  MEDICAL  ASSISTANCE
PROGRAM OR THE CHILD HEALTH INSURANCE PROGRAM ESTABLISHED IN TITLE ONE-A
OF  THIS  ARTICLE OR UNDER ANY OTHER GOVERNMENTAL THIRD PARTY PAYOR, AND
THE INSURANCE POLICY, PLAN OR CONTRACT PROVIDES COVERAGE FOR EVALUATIONS
OR SERVICES THAT MAY BE RENDERED TO THE CHILD  UNDER  THE  EARLY  INTER-

S. 6256--A                          6                         A. 9056--A

VENTION PROGRAM, THE SERVICE COORDINATOR, OR, IN ACCORDANCE WITH SECTION
TWENTY-FIVE  HUNDRED  FORTY-FOUR OF THIS TITLE, THE PARENT, WITH RESPECT
TO EVALUATIONS, SHALL SELECT A PROVIDER APPROVED BY THE  DEPARTMENT  AND
WITHIN  THE  INSURER'S  OR HEALTH MAINTENANCE ORGANIZATION'S NETWORK, IF
APPLICABLE, FOR THE PROVISION OF SUCH EVALUATION OR  SERVICES,  PROVIDED
HOWEVER THAT THIS SUBDIVISION SHALL NOT APPLY UNDER THE FOLLOWING CONDI-
TIONS:
  1.  THERE IS NO PROVIDER IN THE INSURER'S OR HEALTH MAINTENANCE ORGAN-
IZATION'S NETWORK THAT IS AVAILABLE OR APPROPRIATE TO RECEIVE THE REFER-
RAL AND TO CONDUCT THE EVALUATION OR TO BEGIN PROVIDING  SERVICES  IN  A
TIMELY MANNER IN ACCORDANCE WITH THE CHILD'S IFSP;
  2. INSURANCE OR HEALTH PLAN BENEFITS HAVE BEEN EXHAUSTED; OR
  3.  THE CHILD HAS A DEMONSTRATED NEED, AS DETERMINED BY THE INSURER OR
HEALTH MAINTENANCE ORGANIZATION, IF APPLICABLE,  FOR  AN  EVALUATION  OR
SERVICE  RENDERED  BY A PROVIDER WHO DOES NOT HOLD AN AGREEMENT WITH THE
CHILD'S INSURER OR HEALTH MAINTENANCE ORGANIZATION FOR THE PROVISION  OF
SUCH EVALUATION OR SERVICE.
  S  4.  Subdivision  2  of  section  2547  of the public health law, as
amended by chapter 231 of the laws  of  1993,  is  amended  to  read  as
follows:
  2.  In  addition  to respite services provided pursuant to subdivision
one of this section and subject to the  amounts  appropriated  therefor,
the  state  shall  reimburse  the  municipality  IN  ACCORDANCE WITH THE
PERCENTAGE OF STATE AID REIMBURSEMENT FOR APPROVED COSTS AS SET FORTH IN
SUBDIVISION TWO OF  SECTION  TWENTY-FIVE  HUNDRED  FIFTY-SEVEN  OF  THIS
TITLE,  for [fifty percent of] the costs of respite services provided to
eligible children and their families with  the  approval  of  the  early
intervention official.
  S  5.  Section 2548 of the public health law, as amended by section 20
of part H of chapter 686 of the laws of 2003,  is  amended  to  read  as
follows:
  S 2548. Transition plan. To the extent that a toddler with a disabili-
ty is thought to be eligible for services pursuant to section forty-four
hundred  ten  of  the  education  law, the [early intervention official]
SERVICE COORDINATOR shall notify in writing the committee  on  preschool
special  education  of  the  local  school district in which an eligible
child resides of the  potential  transition  of  such  child  and,  with
parental  consent,  arrange for a conference among the service coordina-
tor, the parent and  the  chairperson  of  the  preschool  committee  on
special  education  or  his  or her designee at least ninety days before
such child would be  eligible  for  services  under  section  forty-four
hundred  ten  of the education law to review the child's program options
and to establish a transition plan, if appropriate. If a parent does not
consent to a conference with the service coordinator and the chairperson
of the preschool committee on special education or his or  her  designee
to  determine  whether  the  child should be referred for services under
section forty-four hundred ten of the education law, and  the  child  is
not  determined  to  be  eligible  by the committee on preschool special
education for such services prior to the  child's  third  birthday,  the
child's eligibility for early intervention program services shall end at
the child's third birthday.
  S  6.  Subdivision  2  of  section  2550  of the public health law, as
amended by section 5 of part B3 of chapter 62 of the laws  of  2003,  is
amended to read as follows:

S. 6256--A                          7                         A. 9056--A

  2. In meeting the requirements of subdivision one of this section, the
lead  agency  shall  adopt  and  use proper methods of administering the
early intervention program, including:
  (a)  establishing  standards  for evaluators, service coordinators and
providers of early intervention services;
  (b) approving, and periodically re-approving evaluators, service coor-
dinators and providers of early intervention services who  meet  depart-
ment  standards;  PROVIDED  HOWEVER THAT THE DEPARTMENT MAY REQUIRE THAT
APPROVED EVALUATORS, SERVICE COORDINATORS AND PROVIDERS OF EARLY  INTER-
VENTION  SERVICES  ENTER INTO AGREEMENTS WITH THE DEPARTMENT IN ORDER TO
CONDUCT EVALUATIONS OR RENDER SERVICE COORDINATION OR EARLY INTERVENTION
SERVICES IN THE EARLY INTERVENTION PROGRAM. SUCH  AGREEMENTS  SHALL  SET
FORTH  THE  TERMS AND CONDITIONS OF PARTICIPATION IN THE PROGRAM. IF THE
DEPARTMENT REQUIRES THAT SUCH PROVIDERS ENTER INTO AGREEMENTS  WITH  THE
DEPARTMENT FOR PARTICIPATION IN THE PROGRAM, "APPROVAL" OR "APPROVED" AS
USED  IN THIS TITLE SHALL MEAN A PROVIDER WHO IS APPROVED BY THE DEPART-
MENT IN ACCORDANCE WITH DEPARTMENT REGULATIONS AND HAS ENTERED  INTO  AN
AGREEMENT  WITH THE DEPARTMENT FOR THE PROVISION OF EVALUATIONS, SERVICE
COORDINATION OR EARLY INTERVENTION SERVICES.
  A LESS-THAN-ARMS-LENGTH  RELATIONSHIP  SHALL  NOT  EXIST  BETWEEN  THE
SERVICE  COORDINATOR,  EVALUATOR  AND THE PROVIDER AUTHORIZED TO DELIVER
EARLY INTERVENTION SERVICES TO THE CHILD, UNLESS APPROVAL  OF  THE  LEAD
AGENCY,  IN  CONSULTATION  WITH  THE  EARLY  INTERVENTION  OFFICIAL,  IS
OBTAINED. PROVIDED FURTHER THAT, UNLESS AUTHORIZED BY THE  LEAD  AGENCY,
IN  CONSULTATION  WITH  THE  EARLY INTERVENTION OFFICIAL, UPON A FINDING
THAT IT HAS BEEN DEMONSTRATED THAT AN  APPROVED  PROVIDER  IS  THE  ONLY
APPROPRIATE  PROVIDER  AVAILABLE  TO RENDER THE SERVICES RECOMMENDED FOR
SUCH CHILD, THE SERVICE  COORDINATOR,  THE  EVALUATOR  SELECTED  BY  THE
PARENT  AND  THE PROVIDER RECOMMENDED TO DELIVER SERVICES TO SUCH CHILD,
AND ANY AGENCY  UNDER  WHICH  SUCH  SERVICE  COORDINATOR,  EVALUATOR  OR
PROVIDER  IS  EMPLOYED  BY OR UNDER CONTRACT WITH, SHALL NOT BE THE SAME
ENTITY.
  ALL APPROVED EVALUATORS AND PROVIDERS OF EARLY INTERVENTION  SERVICES,
HEREINAFTER  COLLECTIVELY  REFERRED  TO AS "PROVIDER" OR "PROVIDERS" FOR
PURPOSES OF THIS SUBPARAGRAPH, SHALL ESTABLISH AND MAINTAIN CONTRACTS OR
AGREEMENTS WITH A SUFFICIENT NUMBER OF INSURERS  OR  HEALTH  MAINTENANCE
ORGANIZATIONS,  INCLUDING  THE  MEDICAL  ASSISTANCE PROGRAM OR THE CHILD
HEALTH INSURANCE PROGRAM ESTABLISHED UNDER TITLE ONE-A OF THIS  ARTICLE,
AS  DETERMINED  NECESSARY  BY THE COMMISSIONER TO MEET INSURER OR HEALTH
MAINTENANCE ORGANIZATION NETWORK ADEQUACY; PROVIDED, HOWEVER,  THAT  THE
DEPARTMENT  MAY, IN ITS DISCRETION, APPROVE A PROVIDER WHO DOES NOT HAVE
A CONTRACT OR AGREEMENT WITH ONE OR MORE INSURERS OR HEALTH  MAINTENANCE
ORGANIZATIONS IF THE PROVIDER RENDERS A SERVICE THAT MEETS A UNIQUE NEED
FOR SUCH SERVICE UNDER THE EARLY INTERVENTION PROGRAM.  APPROVED PROVID-
ERS SHALL SUBMIT TO THE DEPARTMENT, INFORMATION AND DOCUMENTATION OF THE
INSURERS  AND  HEALTH MAINTENANCE ORGANIZATIONS, WITH WHICH THE PROVIDER
HOLDS AN AGREEMENT OR CONTRACT. A PROVIDER'S APPROVAL WITH  THE  DEPART-
MENT  TO DELIVER EVALUATIONS OR EARLY INTERVENTION SERVICES SHALL TERMI-
NATE IF THE PROVIDER FAILS TO PROVIDE SUCH INFORMATION OR  DOCUMENTATION
ACCEPTABLE  TO THE DEPARTMENT OF ITS CONTRACTS OR AGREEMENTS WITH INSUR-
ERS OR HEALTH MAINTENANCE ORGANIZATIONS AS REQUESTED BY THE DEPARTMENT;
  (c) [compiling  and  disseminating  to  the  municipalities  lists  of
approved  evaluators, service coordinators and providers of early inter-
vention services;
  (d)] monitoring of agencies, institutions and organizations under this
title and  agencies,  institutions  and  organizations  providing  early

S. 6256--A                          8                         A. 9056--A

intervention  services which are under the jurisdiction of a state early
intervention service agency;
  [(e)]  (D)  enforcing  any obligations imposed on those agencies under
this title or Part H of the federal individuals with disabilities educa-
tion act and its regulations;
  [(f)] (E) providing training and technical assistance to  those  agen-
cies,  institutions  and  organizations,  including  initial and ongoing
training and technical assistance to municipalities to help enable  them
to  identify,  locate  and  evaluate  eligible  children, develop IFSPs,
ensure the provision of appropriate early intervention services, promote
the development of new services, where there is a demonstrated need  for
such  services  and afford procedural safeguards to infants and toddlers
and their families;
  [(g)] (F) correcting deficiencies that are identified through monitor-
ing; and
  [(h)] (G) in monitoring early intervention services, the  commissioner
shall  provide  municipalities  with  the results of any review of early
intervention services undertaken and shall  provide  the  municipalities
with the opportunity to comment thereon.
  S  7.  Subdivision  7  of  section  2551  of  the public health law is
REPEALED, and subdivisions 8, 9 and 10 are renumbered subdivisions 7,  8
and 9.
  S  8.   Section 2552 of the public health law, as added by chapter 428
of the laws of 1992, subdivisions 2 and 3 as amended by chapter  231  of
the  laws of 1993, and subdivision 4 as added by section 6 of part B3 of
chapter 62 of the laws of 2003, is amended to read as follows:
  S 2552. Responsibility of municipality.  1. Each municipality shall be
responsible for ensuring that the early intervention services  contained
in  an  IFSP  are  provided  to eligible children and their families who
reside in such municipality [and may contract with approved providers of
early intervention services for such purpose].  THE SERVICE  COORDINATOR
SHALL  REPORT, IN A MANNER AND FORMAT AS DETERMINED BY THE MUNICIPALITY,
ON THE DELIVERY OF SERVICES TO AN ELIGIBLE CHILD IN ACCORDANCE WITH  THE
ELIGIBLE CHILD'S IFSP. A MUNICIPALITY MAY REQUEST THAT THE PARENT SELECT
A NEW SERVICE COORDINATOR OR REQUIRE THAT THE SERVICE COORDINATOR SELECT
A  NEW  PROVIDER  OF SERVICES IF THE MUNICIPALITY FINDS THAT THE SERVICE
COORDINATOR HAS NOT BEEN  PERFORMING  HIS  OR  HER  RESPONSIBILITIES  AS
REQUIRED  BY  THIS  TITLE  OR  THAT  SERVICES  HAVE NOT BEEN PROVIDED IN
ACCORDANCE WITH THE ELIGIBLE CHILD'S IFSP.
  2. [After consultation with early intervention officials, the  commis-
sioner  shall develop procedures to permit a municipality to contract or
otherwise make arrangements with other municipalities  for  an  eligible
child and the child's family to receive services from such other munici-
palities.
  3.  The  municipality  shall  monitor claims for service reimbursement
authorized by this title and shall verify such claims prior to  payment.
The municipality shall inform the commissioner of discrepancies in bill-
ing and when payment is to be denied or withheld by the municipality.
  4.]  The early intervention official shall require an eligible child's
parent to furnish the parents'  and  eligible  child's  social  security
numbers  for the purpose of the department's and municipality's adminis-
tration of the program.
  S 9. Subdivision 1 of section  2557  of  the  public  health  law,  as
amended  by  section  4  of  part C of chapter 1 of the laws of 2002, is
amended to read as follows:

S. 6256--A                          9                         A. 9056--A

  1. The approved costs, OTHER THAN  THOSE  REIMBURSABLE  IN  ACCORDANCE
WITH  SECTION  TWENTY-FIVE  HUNDRED  FIFTY-NINE  OF  THIS TITLE, for [an
eligible] A child who receives  an  evaluation  and  early  intervention
services  pursuant to this title shall be a charge upon the municipality
wherein the eligible child resides or, where the services are covered by
the  medical  assistance  program,  upon the social services district of
fiscal responsibility with respect to those eligible  children  who  are
also  eligible  for medical assistance. All approved costs shall be paid
in the first instance and at least quarterly by the appropriate  govern-
ing  body  or  officer  of  the municipality upon vouchers presented and
audited in the same manner as the case of other claims against the muni-
cipality. Notwithstanding the insurance law  or  regulations  thereunder
relating  to  the  permissible  exclusion of payments for services under
governmental programs, no such exclusion shall  apply  with  respect  to
payments  made pursuant to this title. Notwithstanding the insurance law
or any other law or agreement to the contrary, benefits under this title
shall be considered secondary to any [plan of insurance or state govern-
ment benefit program] INSURANCE POLICY, PLAN OR CONTRACT under which  an
eligible child may have coverage, INCLUDING COVERAGE AVAILABLE UNDER THE
MEDICAL  ASSISTANCE PROGRAM OR THE CHILD HEALTH INSURANCE PROGRAM ESTAB-
LISHED IN TITLE ONE-A OF THIS ARTICLE, OR UNDER ANY  OTHER  GOVERNMENTAL
THIRD  PARTY  PAYOR.   Nothing in this section shall increase or enhance
coverages provided for within  an  insurance  contract  subject  to  the
provisions of this title.
  S  9-a.  Subdivision  4  of  section  2557 of the public health law is
REPEALED and subdivisions 2 and 5, subdivision 2 as added by chapter 428
of the laws of 1992 and subdivision 5 as added by section 7 of  part  B3
of chapter 62 of the laws of 2003, are amended to read as follows:
  2. The department shall reimburse the approved costs paid by a munici-
pality  for the purposes of this title, other than those reimbursable by
AN INSURER OR HEALTH MAINTENANCE  ORGANIZATION,  OR  GOVERNMENTAL  THIRD
PARTY  PAYOR INCLUDING the medical assistance program or [by third party
payors] THE CHILD HEALTH INSURANCE PROGRAM ESTABLISHED IN TITLE ONE-A OF
THIS ARTICLE, in an amount of fifty percent of the  amount  expended  in
accordance with the rules and regulations of the commissioner; PROVIDED,
HOWEVER,  THAT IN THE DISCRETION OF THE DEPARTMENT AND WITH THE APPROVAL
OF THE DIRECTOR OF THE DIVISION OF THE BUDGET, THE DEPARTMENT MAY  REIM-
BURSE  MUNICIPALITIES  IN  AN  AMOUNT  GREATER THAN FIFTY PERCENT OF THE
AMOUNT EXPENDED.  Such state reimbursement to the municipality shall not
be paid prior to April first of the year in which the approved costs are
paid by  the  municipality,  PROVIDED,  HOWEVER  THAT,  SUBJECT  TO  THE
APPROVAL  OF  THE  DIRECTOR  OF  THE BUDGET, THE DEPARTMENT MAY PAY SUCH
STATE AID REIMBURSEMENT TO THE MUNICIPALITY PRIOR TO SUCH DATE.
  5. [The  department  shall]  (A)  THE  COMMISSIONER,  IN  HIS  OR  HER
DISCRETION, IS AUTHORIZED TO contract with [an independent organization]
ONE  OR  MORE ENTITIES to act as the fiscal agent for the department AND
MUNICIPALITIES WITH RESPECT TO FISCAL MANAGEMENT AND  PAYMENT  OF  EARLY
INTERVENTION  CLAIMS. MUNICIPALITIES SHALL GRANT SUFFICIENT AUTHORITY TO
THE FISCAL AGENT TO ACT ON THEIR BEHALF. MUNICIPALITIES, AND  INDIVIDUAL
AND  AGENCY PROVIDERS AS DEFINED BY THE COMMISSIONER IN REGULATION SHALL
UTILIZE SUCH FISCAL AGENT FOR PAYMENT OF EARLY  INTERVENTION  CLAIMS  AS
DETERMINED  BY  THE  DEPARTMENT  AND  SHALL PROVIDE SUCH INFORMATION AND
DOCUMENTATION AS REQUIRED BY THE DEPARTMENT AND NECESSARY FOR THE FISCAL
AGENT TO CARRY OUT ITS DUTIES.
  (B) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTION ONE  HUNDRED
TWELVE OR ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE

S. 6256--A                         10                         A. 9056--A

HUNDRED  FORTY-TWO  AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOP-
MENT LAW, OR ANY OTHER CONTRARY PROVISION OF LAW,  THE  COMMISSIONER  IS
AUTHORIZED  TO ENTER INTO A CONTRACT OR CONTRACTS UNDER PARAGRAPH (A) OF
THIS SUBDIVISION WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROC-
ESS, PROVIDED, HOWEVER, THAT:
  (I)  THE DEPARTMENT SHALL POST ON ITS WEBSITE, FOR A PERIOD OF NO LESS
THAN THIRTY DAYS:
  (1) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACT OR CONTRACTS;
  (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (3)  THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY SEEK
SELECTION, WHICH SHALL BE NO LESS THAN THIRTY DAYS AFTER  SUCH  INFORMA-
TION IS FIRST POSTED ON THE WEBSITE; AND
  (4)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (II) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  A  TIMELY FASHION SHALL BE REVIEWED BY THE
COMMISSIONER; AND
  (III) THE COMMISSIONER SHALL SELECT  SUCH  CONTRACTOR  OR  CONTRACTORS
THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE PURPOSES OF
THIS SECTION.
  (C)  PARAGRAPH (B) OF THIS SUBDIVISION SHALL APPLY ONLY TO THE INITIAL
CONTRACT OR CONTRACTS NECESSARY TO OBTAIN THE SERVICES OF A FISCAL AGENT
FOR EARLY INTERVENTION PROGRAM FISCAL MANAGEMENT AND  PAYMENT  OF  EARLY
INTERVENTION  CLAIMS  AND SHALL NOT APPLY TO SUBSEQUENT CONTRACTS NEEDED
TO MAINTAIN SUCH SERVICES, AS DETERMINED BY THE COMMISSIONER IN  HIS  OR
HER  DISCRETION.    [A municipality may elect to utilize the services of
such organization for early intervention program fiscal  management  and
claiming  as determined by the commissioner or may select an independent
agent to act as the fiscal agent for such municipality or may act as its
own fiscal agent.]
  S 10. Subdivision 4 of section 2558 of the public health law, as added
by chapter 428 of the laws of 1992, is amended to read as follows:
  4. Local contribution. The municipality of residence shall  be  finan-
cially  responsible  for  the  local contribution in the amount of fifty
percent of the [approved costs] AMOUNT EXPENDED PROVIDED, HOWEVER,  THAT
IN  THE DISCRETION OF THE DEPARTMENT AND WITH THE APPROVAL OF THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, IN ACCORDANCE WITH SUBDIVISION TWO OF
SECTION TWENTY-FIVE HUNDRED FIFTY-SEVEN OF THIS  TITLE,  THE  DEPARTMENT
MAY  REQUIRE  THAT MUNICIPALITIES BE FINANCIALLY RESPONSIBLE FOR A LOCAL
CONTRIBUTION IN  AN  AMOUNT  LESS  THAN  FIFTY  PERCENT  OF  THE  AMOUNT
EXPENDED.   The commissioner shall certify to the comptroller the amount
of the local contribution owed by each municipality to  the  state.  The
comptroller  shall  deduct  the  amount of such local contribution first
from any moneys due the municipality  pursuant  to  section  twenty-five
hundred fifty-six of this title and then from any other moneys due or to
become due to the municipality.
  S  11. Paragraphs (a), (c) and (d) of subdivision 3 of section 2559 of
the public health law, paragraph (a) as amended  and  paragraph  (d)  as
added  by chapter 231 of the laws of 1993, subparagraphs (i) and (ii) of
paragraph (a) as added by chapter 406 of the laws of 2011, and paragraph
(c) as added by chapter 428 of the laws of 1992 are amended to  read  as
follows:
  (a)  Providers  of  EVALUATIONS AND early intervention services [and],
INCLUDING transportation services, HEREINAFTER COLLECTIVELY REFERRED  TO
IN  THIS  SUBDIVISION  AS  "PROVIDER" OR "PROVIDERS", shall in the first

S. 6256--A                         11                         A. 9056--A

instance and where applicable, seek payment from all [third party payors
including governmental agencies] INSURERS AND HEALTH MAINTENANCE  ORGAN-
IZATIONS,  INCLUDING THE MEDICAL ASSISTANCE PROGRAM AND THE CHILD HEALTH
INSURANCE  PROGRAM  ESTABLISHED  IN  TITLE ONE-A OF THIS ARTICLE AND ANY
OTHER GOVERNMENTAL THIRD PARTY PAYORS prior to claiming payment  from  a
given  municipality  for EVALUATIONS CONDUCTED UNDER THE PROGRAM AND FOR
services rendered to eligible children, provided that, [for the  purpose
of  seeking  payment  from  the medical assistance program or from other
third party payors, the municipality shall be  deemed  the  provider  of
such  early  intervention  services  to the extent that the provider has
promptly furnished to the municipality adequate and complete information
necessary to support the  municipality  billing,  and  provided  further
that]  the  obligation to seek payment shall not apply to a payment from
[a third party payor] AN INSURER who is  not  prohibited  from  applying
such  payment,  and  will  apply  such payment, to an annual or lifetime
limit specified in the insured's policy.
  (i) Parents shall provide [and] the municipality  [shall  obtain]  AND
SERVICE  COORDINATOR  information  on  any [plan of insurance] INSURANCE
POLICY, PLAN OR CONTRACT under which an eligible child has coverage.
  (ii) Parents shall provide the municipality AND THE SERVICE  COORDINA-
TOR  with  a written referral from a primary care provider as documenta-
tion, for eligible children, of the medical necessity  of  early  inter-
vention services.
  (III)  PROVIDERS  SHALL UTILIZE THE DEPARTMENT'S FISCAL AGENT AND DATA
SYSTEM FOR CLAIMING PAYMENT FROM INSURERS OR HEALTH  MAINTENANCE  ORGAN-
IZATIONS  FOR  EVALUATIONS  AND SERVICES RENDERED UNDER THE EARLY INTER-
VENTION PROGRAM.
  (IV) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, RULE OR  REGU-
LATION,  PAYMENTS MADE BY ANY INSURER OR HEALTH MAINTENANCE ORGANIZATION
FOR EVALUATIONS AND  SERVICES  PROVIDED  UNDER  THE  EARLY  INTERVENTION
PROGRAM  SHALL  BE  AT  RATES  ESTABLISHED UNDER AN AGREEMENT NEGOTIATED
BETWEEN THE INSURER OR HEALTH MAINTENANCE ORGANIZATION,  IF  APPLICABLE,
PROVIDED,  HOWEVER,  THAT IF THE INSURER OR HEALTH MAINTENANCE ORGANIZA-
TION MAINTAINS A NETWORK OF PROVIDERS AND A  CHILD  HAS  A  DEMONSTRATED
NEED,  AS  DETERMINED BY THE INSURER OR HEALTH MAINTENANCE ORGANIZATION,
IF APPLICABLE, FOR AN EVALUATION OR SERVICE RENDERED BY A  PROVIDER  WHO
IS  NOT WITHIN THE INSURER OR HEALTH MAINTENANCE ORGANIZATION'S NETWORK,
PAYMENT TO SUCH OUT OF NETWORK PROVIDER SHALL BE MADE  AT  RATES  ESTAB-
LISHED BY THE COMMISSIONER IN ACCORDANCE WITH REGULATION.
  (V)  PAYMENTS  MADE BY ANY INSURER OR HEALTH MAINTENANCE PROGRAM SHALL
BE CONSIDERED PAYMENTS IN FULL FOR SUCH SERVICES AND THE PROVIDER  SHALL
NOT  SEEK ADDITIONAL PAYMENT FROM THE MUNICIPALITY, CHILD, OR HIS OR HER
PARENTS FOR ANY PORTION OF THE COSTS OF SAID  SERVICES.  NOTHING  HEREIN
SHALL PROHIBIT AN INSURER OR HEALTH MAINTENANCE ORGANIZATION FROM APPLY-
ING A COPAYMENT, COINSURANCE OR DEDUCTIBLE AS SET FORTH IN THE POLICY OR
PLAN.  PAYMENTS FOR COPAYMENTS, COINSURANCE OR DEDUCTIBLES SHALL BE MADE
IN ACCORDANCE WITH PARAGRAPH (B) OF THIS SUBDIVISION.
  (VI)  WHEN  PAYMENT UNDER AN INSURANCE POLICY, PLAN OR CONTRACT IS NOT
AVAILABLE OR HAS  BEEN  EXHAUSTED,  PROVIDERS  SHALL  SEEK  PAYMENT  FOR
SERVICES  IN  ACCORDANCE WITH SECTION TWENTY-FIVE HUNDRED FIFTY-SEVEN OF
THIS TITLE; PROVIDED, HOWEVER, THAT IF THE SERVICE PROVIDED IS A COVERED
BENEFIT UNDER THE POLICY, PLAN OR CONTRACT AND PAYMENT HAS  BEEN  DENIED
ON  GROUNDS  OTHER  THAN THAT BENEFITS HAVE BEEN EXHAUSTED, THE PROVIDER
SHALL EXHAUST ALL APPEALS OF SAID DENIAL PRIOR TO  CLAIMING  PAYMENT  TO
THE  MUNICIPALITY FOR THE SERVICE IN ACCORDANCE WITH SECTION TWENTY-FIVE
HUNDRED FIFTY-SEVEN OF THIS TITLE. PROVIDERS SHALL  NOT  DISCONTINUE  OR

S. 6256--A                         12                         A. 9056--A

DELAY  SERVICES  TO  ELIGIBLE  CHILDREN  PENDING PAYMENT OF THE CLAIM OR
DETERMINATIONS OF ANY APPEAL DENIALS.
  (c)  Payments  made for early intervention services under an insurance
policy or health benefit plan, INCLUDING PAYMENTS MADE  BY  THE  MEDICAL
ASSISTANCE  PROGRAM  OR  THE  CHILD HEALTH INSURANCE PROGRAM ESTABLISHED
UNDER TITLE ONE-A OF THIS ARTICLE  OR  OTHER  GOVERNMENTAL  THIRD  PARTY
PAYOR,  which  are provided as part of an IFSP pursuant to section twen-
ty-five hundred forty-five of this title shall not  be  applied  by  the
insurer  or  plan  administrator  against any maximum lifetime or annual
limits specified in the policy or  health  benefits  plan,  pursuant  to
section eleven of the chapter of the laws of nineteen hundred ninety-two
which added this title.
  [(d)  A  municipality,  or  its  designee, shall be subrogated, to the
extent of the expenditures by such municipality for  early  intervention
services furnished to persons eligible for benefits under this title, to
any  rights  such  person  may  have  or be entitled to from third party
reimbursement. The right of subrogation does not attach to benefits paid
or provided under any health insurance policy or  health  benefits  plan
prior to receipt of written notice of the exercise of subrogation rights
by the insurer or plan administrator providing such benefits.]
  S  12.  Subdivision  7  of  section  2510 of the public health law, as
amended by section 21 of part B of chapter 109 of the laws of  2010,  is
amended to read as follows:
  7.  "Covered  health care services" means: the services of physicians,
optometrists, nurses, nurse practitioners, midwives  and  other  related
professional  personnel  which  are  provided  on  an  outpatient basis,
including routine well-child visits; diagnosis and treatment of  illness
and injury; inpatient health care services; laboratory tests; diagnostic
x-rays;  prescription  and  non-prescription  drugs  and durable medical
equipment; radiation therapy; chemotherapy; hemodialysis; emergency room
services; hospice services; emergency,  preventive  and  routine  dental
care,  including  medically necessary orthodontia but excluding cosmetic
surgery;  emergency,  preventive  and  routine  vision  care,  including
eyeglasses;  speech  and hearing services; and, inpatient and outpatient
mental health, alcohol and substance abuse services as  defined  by  the
commissioner  in  consultation with the superintendent.  "COVERED HEALTH
CARE SERVICES" SHALL ALSO INCLUDE EARLY INTERVENTION  SERVICES  PROVIDED
PURSUANT  TO  TITLE  TWO-A  OF THIS ARTICLE UP TO THE SCOPE AND LEVEL OF
COVERAGE FOR THE SAME SERVICES PROVIDED PURSUANT TO THIS SUBDIVISION, AS
DEFINED BY THE COMMISSIONER. "Covered health care  services"  shall  not
include  drugs,  procedures  and  supplies for the treatment of erectile
dysfunction when provided to, or prescribed for use by, a person who  is
required  to register as a sex offender pursuant to article six-C of the
correction law, provided that any denial  of  coverage  of  such  drugs,
procedures  or  supplies  shall  provide  the  patient with the means of
obtaining additional information concerning  both  the  denial  and  the
means of challenging such denial.
  S 13. Intentionally omitted.
  S  14.  Paragraph  (b)  of subdivision 5 of section 4403 of the public
health law is relettered paragraph (c), paragraph (c), as added by chap-
ter 705 of the laws of 1996, is amended and a new paragraph (b) is added
to read as follows:
  (B) UPON THE EFFECTIVE DATE OF THIS PARAGRAPH AND AT THE TIME OF EVERY
THREE YEAR REVIEW BY THE COMMISSIONER AS SET FORTH IN PARAGRAPH  (A)  OF
THIS  SUBDIVISION,  AND  UPON APPLICATION FOR EXPANSION OF SERVICE AREA,
THE HEALTH MAINTENANCE ORGANIZATION SHALL DEMONSTRATE THAT IT  MAINTAINS

S. 6256--A                         13                         A. 9056--A

AN ADEQUATE NETWORK OF PROVIDERS WHO ARE APPROVED TO DELIVER EVALUATIONS
AND EARLY INTERVENTION PROGRAM SERVICES IN ACCORDANCE WITH TITLE II-A OF
ARTICLE  TWENTY-FIVE  OF THIS CHAPTER, BY SHOWING TO THE SATISFACTION OF
THE  COMMISSIONER  THAT  (I)  THERE ARE A SUFFICIENT NUMBER OF GEOGRAPH-
ICALLY ACCESSIBLE PARTICIPATING PROVIDERS; AND (II) THERE ARE SUFFICIENT
PROVIDERS IN EACH AREA OF SPECIALTY OF PRACTICE TO MEET THE NEEDS OF THE
ENROLLMENT POPULATION.
  [(c)] (D) Each organization shall report on an annual basis the number
of enrollees and the number of participating providers in each organiza-
tion.  EACH HEALTH MAINTENANCE ORGANIZATION SHALL MAKE  PUBLICLY  AVAIL-
ABLE AND UPDATE ON A QUARTERLY BASIS, THE NAMES OF PARTICIPATING PROVID-
ERS IN THE HEALTH MAINTENANCE ORGANIZATION'S NETWORK WHO ARE APPROVED TO
DELIVER  EVALUATIONS  AND EARLY INTERVENTION PROGRAM SERVICES IN ACCORD-
ANCE WITH TITLE II-A OF ARTICLE TWENTY-FIVE OF THIS CHAPTER.
  S 15. Section 4406 of the public health law is amended by adding a new
subdivision 6 to read as follows:
  6. (A) NO SUBSCRIBER CONTRACT OR BENEFIT PACKAGE SHALL EXCLUDE  COVER-
AGE FOR OTHERWISE COVERED SERVICES SOLELY ON THE BASIS THAT THE SERVICES
CONSTITUTE EARLY INTERVENTION PROGRAM SERVICES UNDER TITLE II-A OF ARTI-
CLE TWENTY-FIVE OF THIS CHAPTER.
  (B)  WHERE  A SUBSCRIBER CONTRACT OR BENEFIT PACKAGE PROVIDES COVERAGE
FOR A SERVICE THAT IS PROVIDED UNDER THE EARLY INTERVENTION PROGRAM  AND
IS  OTHERWISE  COVERED UNDER THE SUBSCRIBER CONTRACT OR BENEFIT PACKAGE,
SUCH COVERAGE SHALL NOT BE APPLIED AGAINST ANY MAXIMUM ANNUAL  OR  LIFE-
TIME  MONETARY  LIMITS  SET FORTH IN SUCH SUBSCRIBER CONTRACT OR BENEFIT
PACKAGE. VISIT  LIMITATIONS  AND  OTHER  TERMS  AND  CONDITIONS  OF  THE
SUBSCRIBER  CONTRACT  OR BENEFIT PACKAGE WILL CONTINUE TO APPLY TO EARLY
INTERVENTION SERVICES. HOWEVER, ANY VISITS USED FOR  EARLY  INTERVENTION
PROGRAM  SERVICES SHALL NOT REDUCE THE NUMBER OF VISITS OTHERWISE AVAIL-
ABLE UNDER THE SUBSCRIBER CONTRACT OR BENEFIT PACKAGE FOR SUCH  SERVICES
THAT ARE NOT PROVIDED UNDER THE EARLY INTERVENTION PROGRAM.
  (C) THE HEALTH MAINTENANCE ORGANIZATION SHALL PROVIDE THE MUNICIPALITY
AND  SERVICE  COORDINATOR  WITH  INFORMATION  ON  THE EXTENT OF BENEFITS
AVAILABLE TO AN ENROLLEE UNDER SUCH SUBSCRIBER CONTRACT OR BENEFIT PACK-
AGE WITHIN FIFTEEN DAYS OF THE HEALTH MAINTENANCE ORGANIZATION'S RECEIPT
OF WRITTEN REQUEST AND NOTICE AUTHORIZING SUCH RELEASE.
  (D) NO  HEALTH  MAINTENANCE  ORGANIZATION  SHALL  REFUSE  TO  ISSUE  A
SUBSCRIBER  CONTRACT  OR BENEFIT PACKAGE OR REFUSE TO RENEW A SUBSCRIBER
CONTRACT OR BENEFIT PACKAGE SOLELY BECAUSE THE APPLICANT OR ENROLLEE  IS
RECEIVING SERVICES UNDER THE EARLY INTERVENTION PROGRAM.
  (E) HEALTH MAINTENANCE ORGANIZATIONS SHALL ACCEPT CLAIMS SUBMITTED FOR
PAYMENT  UNDER  THE  CONTRACT  FROM  A PROVIDER THROUGH THE DEPARTMENT'S
FISCAL AGENT AND DATA  SYSTEM  FOR  SUCH  CLAIMING.  HEALTH  MAINTENANCE
ORGANIZATIONS  SHALL,  IN A MANNER AND FORMAT AS REQUIRED BY THE DEPART-
MENT, PROVIDE THE DEPARTMENT WITH INFORMATION ON  CLAIMS  SUBMITTED  FOR
EVALUATIONS  AND  EARLY INTERVENTION SERVICES PROVIDED TO CHILDREN UNDER
THE EARLY INTERVENTION PROGRAM AND DISPOSITION OF SUCH CLAIMS.
  (F) WHERE A SUBSCRIBER CONTRACT OR BENEFIT PACKAGE  PROVIDES  COVERAGE
FOR  AN  EVALUATION  OR  SERVICE  PROVIDED  UNDER THE EARLY INTERVENTION
PROGRAM, REIMBURSEMENT FOR SUCH EVALUATION OR SERVICE SHALL BE AT  RATES
NEGOTIATED BY THE HEALTH MAINTENANCE ORGANIZATION AND PROVIDER PROVIDED,
HOWEVER,  THAT  IF A CHILD HAS A DEMONSTRATED NEED, AS DETERMINED BY THE
HEALTH MAINTENANCE ORGANIZATION, FOR AN EVALUATION OR  SERVICE  RENDERED
BY  A  PROVIDER  WHO  DOES NOT HOLD AN AGREEMENT WITH THE CHILD'S HEALTH
MAINTENANCE ORGANIZATION  FOR  THE  PROVISION  OF  SERVICES  TO  COVERED

S. 6256--A                         14                         A. 9056--A

PERSONS,  PAYMENT TO SUCH OUT OF NETWORK PROVIDER SHALL BE MADE AT RATES
ESTABLISHED BY THE COMMISSIONER IN ACCORDANCE WITH REGULATION.
  (G)  HEALTH  MAINTENANCE ORGANIZATIONS SHALL ENSURE THAT THE TERMS AND
CONDITIONS CONTAINED IN SUBSCRIBER CONTRACTS OR BENEFIT PACKAGES  RELAT-
ING  TO  PROVISION  OF SERVICES TO CHILDREN UNDER THE EARLY INTERVENTION
PROGRAM COMPLIES WITH TITLE II-A OF ARTICLE TWENTY-FIVE OF THIS  CHAPTER
AND WITH STANDARDS SET FORTH IN PART C OF THE INDIVIDUALS WITH DISABILI-
TIES  EDUCATION  ACT,  AS  AMENDED  BY THE INDIVIDUALS WITH DISABILITIES
EDUCATION IMPROVEMENT ACT OF 2004.
  S 16.  Intentionally omitted.
  S 17. Subsections (c) and (e) of section 3235-a of the insurance  law,
subsection  (c) as amended and subsection (e) as added by chapter 406 of
the laws of 2011, are amended, and a new subsection (f) is added to read
as follows:
  (c) [Any right of subrogation to  benefits  which  a  municipality  is
entitled  in  accordance  with  paragraph  (d)  of  subdivision three of
section twenty-five hundred fifty-nine of the public health law shall be
valid and enforceable to the extent benefits  are  available  under  any
accident  and health insurance policy. The right of subrogation does not
attach to insurance benefits paid or provided  under  any  accident  and
health  insurance  policy  prior  to  receipt  by the insurer of written
notice from the municipality. Upon  the  insurer's  receipt  of  written
request  and notice from the municipality that such right of subrogation
has been granted to such municipality and that the insured  has  author-
ized  the  release  of information to the municipality, the] THE insurer
shall provide the municipality AND SERVICE COORDINATOR with  information
on  the  extent  of  benefits available to the covered person under such
policy WITHIN FIFTEEN DAYS OF THE INSURER'S RECEIPT OF  WRITTEN  REQUEST
AND NOTICE AUTHORIZING SUCH RELEASE.
  (e)  [Written  claim  for early intervention program services shall be
submitted by the  municipality  as  the  approved  provider  within  one
hundred fifty days from the date of service.] WHERE A POLICY OF ACCIDENT
AND  HEALTH  INSURANCE,  INCLUDING A CONTRACT ISSUED PURSUANT TO ARTICLE
FORTY-THREE OF THIS CHAPTER, UTILIZES A NETWORK OF PROVIDERS, THE INSUR-
ER SHALL DEMONSTRATE TO THE SUPERINTENDENT THAT IT MAINTAINS AN ADEQUATE
NETWORK OF PROVIDERS WHO ARE APPROVED TO DELIVER EVALUATIONS  AND  EARLY
INTERVENTION  PROGRAM  SERVICES IN ACCORDANCE WITH TITLE II-A OF ARTICLE
TWENTY-FIVE OF THE PUBLIC HEALTH LAW BY DOCUMENTING THAT (I) THERE ARE A
SUFFICIENT NUMBER OF GEOGRAPHICALLY ACCESSIBLE PARTICIPATING  PROVIDERS;
AND  (II)  THERE  ARE  SUFFICIENT PROVIDERS IN EACH AREA OF SPECIALTY OF
PRACTICE TO MEET THE NEEDS OF THE ENROLLMENT POPULATION.  WHERE A POLICY
OF ACCIDENT AND HEALTH INSURANCE, INCLUDING A CONTRACT  ISSUED  PURSUANT
TO  ARTICLE FORTY-THREE OF THIS CHAPTER, PROVIDES COVERAGE FOR AN EVALU-
ATION  OR  SERVICE  PROVIDED  UNDER  THE  EARLY  INTERVENTION   PROGRAM,
REIMBURSEMENT  FOR  SUCH EVALUATION OR SERVICE SHALL BE AT RATES NEGOTI-
ATED BY THE INSURER AND PROVIDER, IF APPLICABLE, PROVIDED, HOWEVER, THAT
IF A CHILD HAS A DEMONSTRATED NEED FOR AN EVALUATION OR SERVICE RENDERED
BY A PROVIDER WHO DOES NOT HOLD AN AGREEMENT WITH  THE  CHILD'S  INSURER
FOR  THE  PROVISION  OF  SERVICES  TO  COVERED  PERSONS, PAYMENT TO SUCH
PROVIDER SHALL BE MADE AT  RATES  ESTABLISHED  BY  THE  COMMISSIONER  OF
HEALTH IN ACCORDANCE WITH REGULATION.
  (F)  NOTHING  IN THIS SECTION SHALL BE DEEMED TO LIMIT THE SUPERINTEN-
DENT'S AUTHORITY TO IMPOSE NETWORK ADEQUACY REQUIREMENTS ON INSURERS  IN
GENERAL.
  S 18. Subdivision 18 of section 4403 of the education law is REPEALED.

S. 6256--A                         15                         A. 9056--A

  S  19. Paragraph f of subdivision 3 and the opening paragraph of para-
graph a of subdivision 9 of  section  4410  of  the  education  law,  as
amended  by  chapter  82  of  the  laws  of 1995, are amended to read as
follows:
  f.  After  notification  by [an early intervention official] A SERVICE
COORDINATOR, as defined in section twenty-five hundred forty-one of  the
public  health  law,  that  a child receiving services pursuant to title
II-A of article twenty-five of the public health  law  potentially  will
transition  to  receiving services under this section and that a confer-
ence is to be convened to review the child's program options and  estab-
lish a transition plan, which conference must occur at least ninety days
before such child would be eligible for services under this section, the
chairperson of the committee on preschool special education of the local
school district or his or her designee in which such child resides shall
participate in the conference.
  Providers  of  special services or programs shall apply to the commis-
sioner for program approval on a form prescribed  by  the  commissioner;
such  application shall include, but not be limited to, a listing of the
services to be provided, the population to be served, a plan for provid-
ing services in the least restrictive environment and a  description  of
its  evaluation  component,  if  any.  [Providers  of early intervention
services seeking approval pursuant to subdivision seven of section twen-
ty-five hundred fifty-one of the public health law shall  apply  to  the
commissioner  for  such approval on a form prescribed by the commission-
er.] The commissioner shall approve programs in  accordance  with  regu-
lations  adopted  for  such  purpose  and shall periodically review such
programs at which time the commissioner shall provide  the  municipality
in  which  the  program  is  located or for which the municipality bears
fiscal responsibility an opportunity for comment within thirty  days  of
the  review. In collaboration with municipalities and representatives of
approved  programs,  the  commissioner  shall  develop  procedures   for
conducting  such reviews. Municipalities shall be allowed to participate
in such departmental review process. Such review shall be  conducted  by
individuals with appropriate experience as determined by the commission-
er and shall be conducted not more than once every three years.
  S 20. Intentionally omitted.
  S 21. Intentionally omitted.
  S 22. Intentionally omitted.
  S  23.  This act shall take effect January 1, 2013; provided, however,
that:
  1. the amendments to subdivision 7  of  section  2510  of  the  public
health law made by section twelve of this act shall not affect the expi-
ration of such subdivision and shall be deemed to expire therewith;
  2. the requirements contained in subparagraph (iv) of paragraph (a) of
subdivision  3  of  section  2559  of the public health law, as added by
section eleven of this act, paragraph (f) of subdivision  6  of  section
4406  of the public health law, as added by section fifteen of this act,
and subsection (e) of section 3235-a of the insurance law, as amended by
section seventeen of this act, as such  sections  pertain  to  requiring
that  an  insurer  or  health maintenance organization make payment to a
provider who is not within the insurer or health  maintenance  organiza-
tion's  network  at  rates  established by the commissioner of health in
accordance with regulation, if a  child  has  a  demonstrated  need,  as
determined  by the insurer or health maintenance organization, if appli-
cable, for an evaluation or service rendered by a provider  who  is  not
within  the  insurer or health maintenance organization's network, shall

S. 6256--A                         16                         A. 9056--A

apply only to policies, benefit packages and contracts issued,  renewed,
modified,  altered  or  amended  on  or after the effective date of such
sections of this act; and
  3. sections two-a, four, five, seven, eight, nine-a, ten, eighteen and
nineteen of this act shall take effect April 1, 2013.

                                 PART B

  Section  1.  Subdivisions  9,  10 and 11 of section 3555 of the public
authorities law, as added by chapter 5 of the laws of 1997, are  amended
to read as follows:
  9. to determine the conditions under which a physician may be extended
the privilege of practicing within a health facility under the jurisdic-
tion of the corporation, to promulgate internal policies for the conduct
of  all  persons, physicians and allied health practitioners within such
facility, and to appoint and grant privileges to qualified and competent
clinical practitioners; [and]
  10. except as provided in this subdivision or as expressly limited  by
any  applicable  state  law  or regulation, and in support of the powers
granted by subdivisions five and six of this section,  to  form  and  to
participate  in  the formation of one or more corporations, and to exer-
cise and perform such purposes, powers, duties, functions or  activities
through  one  or more subsidiary corporations or other entities owned or
controlled wholly or in part by the corporation, which shall  be  formed
pursuant  to the business corporation law, the limited liability company
law, the not-for-profit corporation law, or  the  partnership  law;  any
such subsidiary may be authorized to act as a general or limited partner
in  a  partnership  or  as  a member of a limited liability company, and
enter into an arrangement calling for an initial and subsequent  payment
or  payments or contributions to capital by such subsidiary in consider-
ation of an interest in revenues or other contractual rights.  An entity
shall be deemed a subsidiary corporation whenever and  so  long  as  (a)
more than half of any voting shares or other membership interest of such
subsidiary are owned or held by the corporation or (b) a majority of the
directors,  trustees  or members of such subsidiary are designees of the
corporation[.];
  11. TO ACCEPT FUNDING FROM THE STATE  PURSUANT  TO  PARAGRAPH  (O)  OF
SUBDIVISION  ONE  OF  SECTION TWENTY-EIGHT HUNDRED SEVEN-V OF THE PUBLIC
HEALTH LAW OR PURSUANT TO SECTION TWENTY-EIGHT HUNDRED EIGHTEEN  OF  THE
PUBLIC HEALTH LAW, PROVIDED, HOWEVER, THAT AS A CONDITION FOR RECEIPT OF
SUCH  FUNDS THE CORPORATION IS REQUIRED TO TAKE ALL NECESSARY AND APPRO-
PRIATE STEPS AND ARRANGEMENTS, INCLUDING BUT NOT  LIMITED  TO,  ENTERING
INTO  AN  ARRANGEMENT  FOR  MERGER OR OTHER AFFILIATION WITH ONE OR MORE
HEALTH CARE,  ACADEMIC  OR  OTHER  ENTITIES,  LOCATED  WITHIN  THE  SAME
GEOGRAPHICAL REGION AS THE CORPORATION, FOR THE PURPOSE OF PROMOTING THE
CONTINUED FINANCIAL VIABILITY OF THE CORPORATION, PROTECTING AND PROMOT-
ING  THE  HEALTH OF THE PATIENTS SERVED BY ITS HEALTH FACILITIES AND, TO
THE EXTENT POSSIBLE, CONTRIBUTING TO THE ECONOMIC REVITALIZATION OF  THE
REGION BY BECOMING OPERATIONALLY AND FISCALLY INDEPENDENT OF THE DEPART-
MENT  OF  HEALTH BY NO LATER THAN MARCH THIRTY-FIRST, TWO THOUSAND FOUR-
TEEN, AND PROVIDED FURTHER, HOWEVER, THAT  THE  COMMISSIONER  OF  HEALTH
SHALL  MONITOR  SUCH  STEPS AND ARRANGEMENTS, ESTABLISH GOALS AND BENCH-
MARKS FOR THE ACHIEVEMENT OF  SUCH  INDEPENDENCE,  INTERCEDE  AS  DEEMED
NECESSARY  AND  APPROPRIATE  AND  DELAY  OR  PRECLUDE  THE CORPORATION'S
RECEIPT OF SUCH FUNDS IN THE EVENT THE COMMISSIONER OF HEALTH DETERMINES
THAT SUCH GOALS AND BENCHMARKS HAVE NOT BEEN MET.

S. 6256--A                         17                         A. 9056--A

  12. No subsidiary of the corporation shall  own,  operate,  manage  or
control  the existing research, education, acute inpatient or outpatient
facilities and services now operated by the Roswell Park  Cancer  Insti-
tute.
  S 2. This act shall take effect April 1, 2012.

                                 PART C

  Section  1.  The  public health law is amended by adding a new section
4148 to read as follows:
  S 4148. ELECTRONIC DEATH REGISTRATION SYSTEM. 1. LEGISLATIVE FINDINGS.
THE LEGISLATURE FINDS THAT IT IS NECESSARY TO UPDATE AND  MODERNIZE  THE
STATE'S  SYSTEM  OF  FILING  AND  MAINTAINING  INFORMATION AND DOCUMENTS
RELATED TO THE REGISTRATION OF DEATH. AN ELECTRONIC  DEATH  REGISTRATION
SYSTEM WILL PROMOTE ACCURACY AND PROVIDE FOR MORE TIMELY TRANSMISSION OF
DOCUMENTATION, PROMOTING EFFICIENCY IN THE OPERATIONS OF THE DEPARTMENT,
WHICH  OVERSEES THE DEATH REGISTRATION FILING PROCESS; LOCAL REGISTRARS,
WHICH ACCEPT AND FILE CERTIFICATES OF DEATH AND ISSUE BURIAL AND REMOVAL
PERMITS;  HEALTH  CARE  INSTITUTIONS  AND  PRACTITIONERS,  CORONERS  AND
MEDICAL  EXAMINERS,  WHICH  PREPARE  CERTIFICATES OF DEATH; AND LICENSED
FUNERAL DIRECTORS AND UNDERTAKERS, WHO REQUIRE PROMPT ACCESS TO  CERTIF-
ICATES  OF  DEATH  TO  CONDUCT BURIALS AND FUNERALS IN A TIMELY FASHION.
LICENSED FUNERAL DIRECTORS AND UNDERTAKERS HAVE EXPRESSED THEIR INTEREST
IN PARTNERING WITH THE DEPARTMENT TO SUPPORT THE ESTABLISHMENT AND MAIN-
TENANCE OF SUCH SYSTEM THROUGH A CONTRIBUTION, TENDERED FOR EACH  BURIAL
AND  REMOVAL PERMIT ISSUED TO A LICENSED FUNERAL DIRECTOR OR UNDERTAKER,
IN THE AMOUNT OF TWENTY DOLLARS.
  2. THE DEPARTMENT IS HEREBY AUTHORIZED AND DIRECTED TO DESIGN,  IMPLE-
MENT  AND  MAINTAIN AN ELECTRONIC DEATH REGISTRATION SYSTEM FOR COLLECT-
ING, STORING, RECORDING, TRANSMITTING, AMENDING, CORRECTING AND  AUTHEN-
TICATING  INFORMATION,  AS NECESSARY AND APPROPRIATE TO COMPLETE A DEATH
REGISTRATION, AND TO  GENERATE  SUCH  DOCUMENTS  AS  DETERMINED  BY  THE
DEPARTMENT  IN RELATION TO A DEATH OCCURRING IN THIS STATE. THE CONTRIB-
UTION REFERENCED IN SUBDIVISION ONE OF THIS SECTION SHALL  BE  COLLECTED
FOR  EACH BURIAL OR REMOVAL PERMIT ISSUED ON OR AFTER THE EFFECTIVE DATE
OF THIS SECTION FROM THE LICENSED FUNERAL DIRECTOR OR UNDERTAKER TO WHOM
SUCH PERMIT IS ISSUED, IN THE MANNER SPECIFIED  BY  THE  DEPARTMENT  AND
SHALL  BE USED SOLELY FOR THE PURPOSE SET FORTH IN SUBDIVISION 1 OF THIS
SECTION.
  3. COMMENCING ON JANUARY FIRST, TWO  THOUSAND  FOURTEEN,  OR  AS  SOON
THEREAFTER  AS  THE  COMMISSIONER  REASONABLY  DETERMINES IS FEASIBLE IN
LIGHT OF THE INTENT OF THIS SECTION, THE DEPARTMENT SHALL  REQUIRE  THAT
DEATHS  OCCURRING  WITHIN  THIS STATE MUST BE REGISTERED USING THE ELEC-
TRONIC DEATH REGISTRATION SYSTEM ESTABLISHED IN THIS SECTION. ELECTRONIC
DEATH REGISTRATION MAY BE PHASED IN, AS DETERMINED BY THE  COMMISSIONER,
FOR  DEATHS  OCCURRING IN THE STATE UNTIL THE ELECTRONIC DEATH REGISTRA-
TION SYSTEM IS FULLY IMPLEMENTED IN THE STATE.
  4. COMMENCING ON JANUARY FIRST, TWO THOUSAND FOURTEEN, OR ON SUCH DATE
DETERMINED BY  THE  COMMISSIONER  PURSUANT  TO  SUBDIVISION  3  OF  THIS
SECTION,  ALL PERSONS REQUIRED TO REGISTER A DEATH OR FILE A CERTIFICATE
OF DEATH UNDER THIS ARTICLE, AND SUCH OTHERS AS MAY BE AUTHORIZED BY THE
COMMISSIONER, SHALL HAVE ACCESS TO  THE  ELECTRONIC  DEATH  REGISTRATION
SYSTEM  FOR  THE  PURPOSE  OF  ENTERING INFORMATION REQUIRED TO EXECUTE,
COMPLETE AND FILE A CERTIFICATE OF DEATH OR TO RETRIEVE SUCH INFORMATION
OR GENERATE DOCUMENTATION FROM THE ELECTRONIC DEATH REGISTRATION SYSTEM.

S. 6256--A                         18                         A. 9056--A

THE CONFIDENTIALITY PROVISIONS IN SECTION FORTY-ONE HUNDRED  FORTY-SEVEN
OF THIS TITLE SHALL APPLY TO INFORMATION MAINTAINED IN THIS SYSTEM.
  5. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, COMMENCING ON
OR  AFTER  JANUARY  FIRST, TWO THOUSAND FOURTEEN, OR ON SUCH DATE DETER-
MINED BY THE COMMISSIONER PURSUANT TO SUBDIVISION 3 OF THIS SECTION, ANY
REQUIREMENT OF THIS TITLE FOR A SIGNATURE OF ANY PERSON SHALL BE  DEEMED
SATISFIED  BY  THE USE BY SUCH PERSON OF DIGITAL SIGNATURE PROVIDED SUCH
PERSON IS AUTHORIZED IN ACCORDANCE WITH THIS SECTION TO  USE  THE  ELEC-
TRONIC DEATH REGISTRATION SYSTEM.
  S  2.  Subdivision  1  of  section 4100-a of the public health law, as
amended by chapter 644 of the laws of 1988, is amended and a new  subdi-
vision 5 is added to read as follows:
  1.  The term "certified copy" means a photographic reproduction in the
form of a photocopy or a microfilm print of the original certificate  OR
ELECTRONICALLY PRODUCED PRINT OF THE ORIGINAL CERTIFICATE, COMMENCING ON
OR  AFTER  JANUARY  FIRST,  TWO  THOUSAND FOURTEEN, and certified by the
commissioner, his designated representative, a local registrar  [or  his
deputy], DEPUTY REGISTRAR OR SUB-REGISTRAR as a true copy thereof.
  5.  THE  TERM  "ELECTRONIC  DEATH  REGISTRATION SYSTEM" MEANS THE DATA
SYSTEM CREATED AND MAINTAINED BY THE DEPARTMENT FOR COLLECTING, STORING,
RECORDING, TRANSMITTING, AMENDING, CORRECTING AND AUTHENTICATING  INFOR-
MATION,  AS  NECESSARY AND APPROPRIATE TO COMPLETE A DEATH REGISTRATION,
AND TO GENERATE SUCH DOCUMENTS AS DETERMINED BY THE DEPARTMENT,  INCLUD-
ING  PERMITS  OR  CERTIFICATES,  RELATING  TO  A DEATH OCCURRING IN THIS
STATE.
  S 3. Subdivision 1 of section 4140 of the public health law is amended
to read as follows:
  1. The death of each person who has died in this state shall be regis-
tered immediately and not later than seventy-two hours  after  death  or
the  finding  of  a dead human body, by filing with the registrar of the
district in which the death occurred or the body was found a certificate
of such death, [which certificate shall be upon the form]  IN  A  MANNER
AND  FORMAT  AS  prescribed  by  the  commissioner,  WHICH SHALL INCLUDE
THROUGH ELECTRONIC MEANS IN ACCORDANCE WITH  SECTION  FORTY-ONE  HUNDRED
FORTY-EIGHT OF THIS TITLE.
  S  4.  Section  4141-a of the public health law, as amended by chapter
153 of the laws of 2011, is amended to read as follows:
  S 4141-a. Death certificate; duties of hospital administrator. When  a
death occurs in a hospital, except in those cases where certificates are
issued  by  coroners  or medical examiners, the person in charge of such
hospital or his or her designated representative shall promptly  present
the certificate to the physician or nurse practitioner in attendance, or
a physician or nurse practitioner acting in his or her behalf, who shall
promptly  certify to the facts of death, provide the medical information
required by the certificate, sign the medical certificate of death,  and
thereupon  return  such certificate to such person, so that the seventy-
two hour registration time limit prescribed in section four thousand one
hundred forty of this title can be met; PROVIDED, HOWEVER THAT  COMMENC-
ING  ON  OR  AFTER JANUARY FIRST, TWO THOUSAND FOURTEEN, OR ON SUCH DATE
DETERMINED BY THE COMMISSIONER PURSUANT TO SUBDIVISION 3 OF SECTION 4148
OF THIS TITLE, INFORMATION AND SIGNATURES REQUIRED BY THIS SECTION SHALL
BE OBTAINED AND  MADE  IN  ACCORDANCE  WITH  SECTION  FORTY-ONE  HUNDRED
FORTY-EIGHT OF THIS TITLE.
  S  5. Section 4142 of the public health law is amended by adding a new
subdivision (e) to read as follows:

S. 6256--A                         19                         A. 9056--A

  (E) NOTWITHSTANDING ANY CONTRARY PROVISIONS OF LAW AS MAY BE SET FORTH
IN THIS SECTION, COMMENCING ON OR  AFTER  JANUARY  FIRST,  TWO  THOUSAND
FOURTEEN,  OR  ON  SUCH  DATE DETERMINED BY THE COMMISSIONER PURSUANT TO
SUBDIVISION 3 OF SECTION 4148 OF THIS TITLE, INFORMATION AND  SIGNATURES
REQUIRED  BY  THIS  SUBDIVISION SHALL BE OBTAINED AND MADE IN ACCORDANCE
WITH SECTION FORTY-ONE HUNDRED FORTY-EIGHT OF THIS TITLE.
  S 6. Paragraph (b) of subdivision  2  and  subdivisions  3  and  5  of
section 4144 of the public health law, paragraph (b) of subdivision 2 as
amended  by  chapter  153  of  the  laws of 2011, are amended to read as
follows:
  (b) Verbal permission to remove a body of a deceased person  from  the
county  in  which death occurred or the body was found to a non-adjacent
county within the state of New York, as provided in subdivision  one  of
this section, shall be issued by the said registrar of vital statistics,
upon  request  by telephone of a licensed funeral director or undertaker
who holds a certificate of death signed by the  attending  physician  or
nurse  practitioner,  OR FOR DEATHS OCCURRING ON OR AFTER JANUARY FIRST,
TWO THOUSAND FOURTEEN, OR ON SUCH DATE DETERMINED  BY  THE  COMMISSIONER
PURSUANT  TO  SUBDIVISION  3 OF SECTION 4148 OF THIS TITLE, SUCH CERTIF-
ICATE OF DEATH SIGNED BY THE ATTENDING PHYSICIAN OR  NURSE  PRACTITIONER
IS AVAILABLE ELECTRONICALLY IN ACCORDANCE WITH SECTION FORTY-ONE HUNDRED
FORTY-EIGHT  OF THIS TITLE, showing that the death resulted from natural
causes and was not a result of accidental, suicidal, homicidal or  other
external causes.
  3.  No  registrar  of  vital  statistics shall receive any fee for the
issuance of burial or removal  permits  under  this  chapter  EXCEPT  AS
REFERENCED  BY  SECTION  FORTY-ONE HUNDRED FORTY-EIGHT OF THIS TITLE AND
other than the compensation provided in this article.
  5. If the interment, or other disposition of the body  of  a  deceased
person  is  to  be  made  within the state, the wording of the burial or
removal permit may be limited to a statement by the registrar, and  over
his  signature,  that  a  satisfactory certificate of death, having been
filed with him, as required by law,  permission  is  granted  to  inter,
remove  or  otherwise  dispose  of the body, stating the name, age, sex,
cause of death, and other necessary details [upon the form prescribed by
the commissioner] IN A MANNER AND FORMAT  AS  MAY  BE  REQUIRED  BY  THE
COMMISSIONER.
  S  7.  Subdivisions  1 and 4 of section 4161 of the public health law,
subdivision 1 as amended by chapter 589 of the laws of 1991 and subdivi-
sion 4 as amended by chapter 153 of the laws of  2011,  are  amended  to
read as follows:
  1.  The certificate of fetal death and the report of fetal death shall
contain such information and be in such form  as  the  commissioner  may
prescribe;  PROVIDED  HOWEVER THAT COMMENCING ON OR AFTER JANUARY FIRST,
TWO THOUSAND FOURTEEN, OR ON SUCH DATE DETERMINED  BY  THE  COMMISSIONER
PURSUANT  TO  SUBDIVISION  3 OF THIS SECTION, INFORMATION AND SIGNATURES
REQUIRED BY THIS SUBDIVISION SHALL BE OBTAINED AND  MADE  IN  ACCORDANCE
WITH  SECTION FORTY-ONE HUNDRED FORTY-EIGHT OF THIS ARTICLE, except that
unless requested by the woman neither the certificate nor the report  of
fetal  death  shall  contain  the name of the woman, her social security
number or any other information which would permit her to be  identified
except  as  provided  in this subdivision. The report shall state that a
certificate of fetal death was filed with the commissioner and the  date
of  such  filing.  The commissioner shall develop a unique, confidential
identifier to be used on the certificate of fetal death to  be  used  in
connection  with the exercise of the commissioner's authority to monitor

S. 6256--A                         20                         A. 9056--A

the quality of care provided by any individual  or  entity  licensed  to
perform  an  abortion  in  this state and to permit coordination of data
concerning the medical history of the woman for purposes  of  conducting
surveillance  scientific studies and research pursuant to the provisions
of paragraph (j) of subdivision one of section two hundred six  of  this
chapter.
  4.  When  a  fetal  death  occurs in a hospital, except in those cases
where certificates are issued by  coroners  or  medical  examiners,  the
person  in  charge  of  such hospital or his or her designated represen-
tative shall promptly present the certificate to the physician or  nurse
practitioner  in attendance, or a physician or nurse practitioner acting
in his or her behalf, who shall promptly certify to the facts  of  birth
and  of  fetal  death,  provide  the medical information required by the
certificate, sign the medical certificate of birth and death, and there-
upon return such certificate to such person,  so  that  the  seventy-two
hour  registration  time  limit  prescribed in section four thousand one
hundred sixty of this title can be met; PROVIDED, HOWEVER THAT  COMMENC-
ING  ON  OR  AFTER JANUARY FIRST, TWO THOUSAND FOURTEEN, OR ON SUCH DATE
DETERMINED BY THE COMMISSIONER PURSUANT TO SUBDIVISION 3 OF SECTION 4148
OF THIS ARTICLE, INFORMATION AND SIGNATURES REQUIRED BY THIS SUBDIVISION
SHALL BE OBTAINED AND MADE IN ACCORDANCE WITH SECTION FORTY-ONE  HUNDRED
FORTY-EIGHT OF THIS ARTICLE.
  S 8. Subdivision 3 of section 4171 of the public health law is amended
to read as follows:
  3.  All certificates, either of birth or death, shall be written legi-
bly, in durable black ink, [and no] PROVIDED HOWEVER, THAT COMMENCING ON
OR AFTER JANUARY FIRST, TWO THOUSAND FOURTEEN, OR ON  SUCH  DATE  DETER-
MINED  BY  THE COMMISSIONER PURSUANT TO SUBDIVISION 3 OF SECTION 4148 OF
THIS ARTICLE, DEATH CERTIFICATES SHALL BE COMPLETED IN  ACCORDANCE  WITH
SECTION  FORTY-ONE  HUNDRED FORTY-EIGHT OF THIS ARTICLE. NO certificate,
WHETHER FILED IN PAPER FORM OR DEATH CERTIFICATE FILED ELECTRONICALLY IN
ACCORDANCE WITH SECTION FORTY-ONE HUNDRED FORTY-EIGHT OF  THIS  ARTICLE,
shall be held to be complete and correct that does not supply all of the
items  of  information called for therein, or satisfactorily account for
their omission.
  S 9. This act shall take effect immediately; provided,  however,  that
if  chapter  153  of the laws of 2011 is not in effect on such date then
the amendments made to section 4141-a of the public  health  law,  para-
graph  (b) of subdivision 2 of section 4144 of the public health law and
subdivision 4 of section 4161 of the public health law by sections four,
six and seven of this act shall take effect on the same  date  and  same
manner  as  chapter  153  of  the  laws  of 2011, takes effect; provided
further that the commissioner of  health  is  authorized  to  promulgate
regulations as necessary to implement the provisions of this act.

                                 PART D

  Section  1.  The  public health law is amended by adding a new section
2823 to read as follows:
  S 2823. SUPPORTIVE  HOUSING  DEVELOPMENT  REINVESTMENT  PROGRAM.    1.
NOTWITHSTANDING  SECTIONS ONE HUNDRED TWELVE AND ONE HUNDRED SIXTY-THREE
OF THE STATE FINANCE LAW OR  SECTIONS  ONE  HUNDRED  FORTY-TWO  AND  ONE
HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW OR ANY OTHER CONTRA-
RY  PROVISION  OF  LAW,  REINVESTMENT  FUNDS  FOR SUPPORTIVE HOUSING FOR
VULNERABLE POPULATIONS SHALL BE ALLOCATED ANNUALLY BY  THE  COMMISSIONER
BASED UPON THE FOLLOWING CRITERIA:

S. 6256--A                         21                         A. 9056--A

  (A)  THE  EFFICIENCY  AND  EFFECTIVENESS OF THE USE OF FUNDING FOR THE
DEVELOPMENT OF ADEQUATE AND ACCESSIBLE  HOUSING  TO  SUPPORT  VULNERABLE
PERSONS  IN  THE COMMUNITY AND TO ENSURE ACCESS TO SUPPORTS NECESSARY TO
MAXIMIZE EXPECTED OUTCOMES; AND
  (B)  OTHER  RELEVANT  FACTORS  RELATING TO THE MAINTENANCE OF EXISTING
SUPPORTIVE HOUSING AND THE DEVELOPMENT OF  NEW  SUPPORTIVE  HOUSING  AND
ASSOCIATED SERVICES.
  2.  AMOUNTS  PROVIDED  PURSUANT  TO THIS SECTION SHALL BE USED ONLY TO
FUND HOUSING  DEVELOPMENT  ACTIVITIES  AND  OTHER  GENERAL  PROGRAMMATIC
ACTIVITIES  TO  HELP  ENSURE  A  STABLE SYSTEM OF SUPPORTIVE HOUSING FOR
VULNERABLE PERSONS IN THE COMMUNITY.
  3. THE COMMISSIONER IS AUTHORIZED AND EMPOWERED  TO  MAKE  INSPECTIONS
AND  EXAMINE RECORDS OF ANY ENTITY FUNDED PURSUANT TO SUBDIVISION TWO OF
THIS SECTION. SUCH EXAMINATION SHALL INCLUDE ALL  MEDICAL,  SERVICE  AND
FINANCIAL  RECORDS,  RECEIPTS, DISBURSEMENTS, CONTRACTS, LOANS AND OTHER
MONEYS RELATING TO THE FINANCIAL OPERATION OF THE PROVIDER.
  4. THE AMOUNT OF SUPPORTIVE HOUSING DEVELOPMENT REINVESTMENT FUNDS FOR
THE DEPARTMENT SHALL BE ITEMIZED IN  THE  ANNUAL  BUDGET  IN  AN  AMOUNT
DETERMINED  BY THE COMMISSIONER, SUBJECT TO THE APPROVAL OF THE DIRECTOR
OF THE BUDGET.  THIS AMOUNT SHALL INCLUDE THE  AMOUNT  OF  GENERAL  FUND
SAVINGS  DIRECTLY  RELATED  TO  INPATIENT  HOSPITAL AND NURSING HOME BED
DECERTIFICATION AND/OR FACILITY CLOSURE.    THE  METHODOLOGIES  USED  TO
CALCULATE  THE  SAVINGS  SHALL  BE DEVELOPED BY THE COMMISSIONER AND THE
DIRECTOR OF THE BUDGET. IN NO EVENT  SHALL  THE  FULL  ANNUAL  VALUE  OF
SUPPORTIVE  HOUSING  DEVELOPMENT  REINVESTMENT  PROGRAMS ATTRIBUTABLE TO
INPATIENT HOSPITAL AND NURSING HOME BED DECERTIFICATION AND/OR  FACILITY
CLOSURE EXCEED THE TWELVE MONTH VALUE OF THE DEPARTMENT OF HEALTH GENER-
AL  FUND  REDUCTIONS RESULTING FROM SUCH DECERTIFICATION AND/OR FACILITY
CLOSURE.
  5. THE ANNUAL SUPPORTIVE HOUSING  DEVELOPMENT  REINVESTMENT  APPROPRI-
ATION  SHALL  REFLECT A PROPORTION OF THE AMOUNT OF GENERAL FUND SAVINGS
RESULTING FROM SUBDIVISION FOUR OF THIS SECTION. WITHIN ANY FISCAL  YEAR
WHERE APPROPRIATION INCREASES ARE RECOMMENDED FOR THE SUPPORTIVE HOUSING
DEVELOPMENT  REINVESTMENT  PROGRAM,  INSOFAR  AS PROJECTED BED DECERTIF-
ICATION AND/OR FACILITY CLOSURES DO NOT OCCUR AS ESTIMATED, AND  GENERAL
FUND  SAVINGS DO NOT RESULT, THEN THE REINVESTMENT APPROPRIATIONS MAY BE
REDUCED IN THE NEXT YEAR'S ANNUAL BUDGET ITEMIZATION.
  6. AMOUNTS MADE AVAILABLE TO THE SUPPORTIVE HOUSING DEVELOPMENT  REIN-
VESTMENT  PROGRAM OF THE DEPARTMENT SHALL BE SUBJECT TO ANNUAL APPROPRI-
ATIONS THEREFOR.
  7. NO PROVISION IN THIS SECTION SHALL CREATE OR BE  DEEMED  TO  CREATE
ANY RIGHT, INTEREST OR ENTITLEMENT TO SERVICES OR FUNDS THAT ARE SUBJECT
TO  THIS SECTION, OR TO ANY OTHER SERVICES OR FUNDS, WHETHER TO INDIVID-
UALS, LOCALITIES, PROVIDERS OR OTHERS, INDIVIDUALLY OR COLLECTIVELY.
  8. ALL APPROPRIATIONS FOR  SUPPORTIVE  HOUSING  DEVELOPMENT  SHALL  BE
ADJUSTED  IN  THE  FOLLOWING FISCAL YEAR TO REFLECT THE VARIANCE BETWEEN
THE INITIAL AND REVISED ESTIMATES OF BED DECERTIFICATION AND/OR FACILITY
CLOSURE.
  9. THE COMMISSIONER SHALL PROMULGATE REGULATIONS, AND  MAY  PROMULGATE
EMERGENCY REGULATIONS, TO EFFECTUATE THE PROVISIONS OF THIS SECTION.
  S  2.  Paragraph  (e)  of subdivision 1 of section 461-l of the social
services law, as added by chapter 165 of the laws of 1991, is amended to
read as follows:
  (e) "Services" shall mean all services for which full  payment  to  an
assisted  living  program  is included in the capitated rate of payment,
which shall include personal care services, home care services and  such

S. 6256--A                         22                         A. 9056--A

other  services as the commissioner in conjunction with the commissioner
of health determine by regulation must be included in the capitated rate
of payment, and which the assisted  living  program  shall  provide,  or
arrange  for  the provision of, through contracts with a social services
district, [a] long term home health care [program or a] PROGRAMS, certi-
fied home health [agency, and] AGENCIES, AND/OR other qualified  provid-
ers.
  S  3.  Paragraphs (b) and (d) of subdivision 2 of section 461-l of the
social services law, as added by chapter 165 of the  laws  of  1991  and
subparagraph  (iii)  of  paragraph  (d) as amended by chapter 569 of the
laws of 2000, are amended to read as follows:
  (b) If an assisted living program  itself  is  not  a  certified  home
health agency or long term home health care program, the assisted living
program shall contract with [a] ONE OR MORE certified home health [agen-
cy or] AGENCIES AND/OR long term home health care [program] PROGRAMS for
the  provision  of services pursuant to article thirty-six of the public
health law. [An assisted living program shall contract with no more than
one certified home health agency or long term home health care  program,
provided,  however, that the commissioner and the commissioner of health
may approve additional contracts for good cause.]
  (d) Patient services and care. (i) An assisted living program[, or  if
the  assisted  living  program  itself does not include a long term home
health care program or certified home health agency an  assisted  living
program  and  a  long  term  home  health care program or certified home
health agency,] shall conduct an initial assessment to determine whether
a person would otherwise require placement in a residential health  care
facility  if not for the availability of the assisted living program and
is appropriate for admission to an assisted living program. The assisted
living program shall forward such assessment  of  a  medical  assistance
applicant or recipient to the appropriate social services district.
  (ii)  No  person  shall  be determined eligible for and admitted to an
assisted living program unless the assisted living program [and the long
term home health care program or the certified home health  care  agency
agree, based on the initial assessment,] FINDS that the person meets the
criteria  provided  in  paragraph (d) of subdivision one of this section
and unless the appropriate social  services  district  prior  authorizes
payment for services.
  (iii)  Appropriate  services  shall  be provided to an eligible person
only in accordance with a plan of care which is based  upon  an  initial
assessment  and  periodic  reassessments conducted by an assisted living
program[, or if the assisted living program itself does  not  include  a
long  term  home  health care program or certified home health agency an
assisted living program and a long term  home  health  care  program  or
certified  home  health  agency].  A  reassessment shall be conducted as
frequently as is required to respond to changes in the resident's condi-
tion and ensure immediate access to necessary and  appropriate  services
by  the  resident,  but  in no event less frequently than once every six
months. No person shall be admitted to or retained in an assisted living
program unless [the assisted living program, and long term  home  health
care  program or certified home health agency are in agreement that] the
person can be safely and adequately cared  for  with  the  provision  of
services determined by such assessment or reassessment.
  S  4.  Paragraph  (i)  of subdivision 3 of section 461-l of the social
services law is REPEALED.
  S 5.  Notwithstanding any contrary provision of law, inpatient  hospi-
tals licensed pursuant to the Mental Hygiene Law by the Office of Mental

S. 6256--A                         23                         A. 9056--A

Health shall be subject to audit fees as set forth in regulations issued
by  the  Department  of  Health  pursuant to S2807-c(35)(b)(xiii) of the
Public Health Law, with regard to cost reports submitted to the  Depart-
ment of Health on and after April 1, 2012.
  S  6.  Subdivision  2  of  section 365-a of the social services law is
amended by adding four new paragraphs (w), (x), (y) and (z) to  read  as
follows:
  (W)  PODIATRY  SERVICES  FOR  INDIVIDUALS WITH A DIAGNOSIS OF DIABETES
MELLITUS; PROVIDED, HOWEVER, THAT THE PROVISIONS OF THIS PARAGRAPH SHALL
NOT TAKE EFFECT UNLESS ALL NECESSARY APPROVALS  UNDER  FEDERAL  LAW  AND
REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL FINANCIAL PARTICIPATION
IN  THE  COSTS  OF  HEALTH CARE SERVICES PROVIDED PURSUANT TO THIS PARA-
GRAPH.
  (X) LACTATION COUNSELING SERVICES FOR PREGNANT  AND  POSTPARTUM  WOMEN
WHEN  SUCH  SERVICES  ARE  ORDERED  BY A PHYSICIAN, REGISTERED PHYSICIAN
ASSISTANT,  REGISTERED  NURSE  PRACTITIONER,  OR  LICENSED  MIDWIFE  AND
PROVIDED  BY  A  CERTIFIED  LACTATION  CONSULTANT,  AS DETERMINED BY THE
COMMISSIONER OF HEALTH; PROVIDED, HOWEVER, THAT THE PROVISIONS  OF  THIS
PARAGRAPH  SHALL  NOT  TAKE  EFFECT UNLESS ALL NECESSARY APPROVALS UNDER
FEDERAL LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL  FINAN-
CIAL  PARTICIPATION IN THE COSTS OF HEALTH CARE SERVICES PROVIDED PURSU-
ANT TO THIS PARAGRAPH. NOTHING IN THIS PARAGRAPH SHALL BE  CONSTRUED  TO
MODIFY ANY LICENSURE, CERTIFICATION OR SCOPE OF PRACTICE PROVISION UNDER
TITLE EIGHT OF THE EDUCATION LAW.
  (Y)  HARM  REDUCTION COUNSELING AND SERVICES TO REDUCE OR MINIMIZE THE
ADVERSE HEALTH CONSEQUENCES ASSOCIATED WITH  DRUG  USE,  PROVIDED  BY  A
QUALIFIED  DRUG  TREATMENT  PROGRAM  OR COMMUNITY-BASED ORGANIZATION, AS
DETERMINED BY THE COMMISSIONER OF HEALTH; PROVIDED,  HOWEVER,  THAT  THE
PROVISIONS  OF THIS PARAGRAPH SHALL NOT TAKE EFFECT UNLESS ALL NECESSARY
APPROVALS UNDER FEDERAL LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE
FEDERAL FINANCIAL PARTICIPATION IN THE COSTS  OF  HEALTH  CARE  SERVICES
PROVIDED  PURSUANT TO THIS PARAGRAPH. NOTHING IN THIS PARAGRAPH SHALL BE
CONSTRUED TO MODIFY ANY LICENSURE, CERTIFICATION OR  SCOPE  OF  PRACTICE
PROVISION UNDER TITLE EIGHT OF THE EDUCATION LAW.
  (Z)  HEPATITIS C WRAP-AROUND SERVICES TO PROMOTE CARE COORDINATION AND
INTEGRATION WHEN ORDERED BY A PHYSICIAN, REGISTERED PHYSICIAN ASSISTANT,
REGISTERED NURSE PRACTITIONER, OR LICENSED MIDWIFE, AND  PROVIDED  BY  A
QUALIFIED  PROFESSIONAL,  AS  DETERMINED  BY THE COMMISSIONER OF HEALTH.
SUCH SERVICES MAY INCLUDE CLIENT OUTREACH, IDENTIFICATION  AND  RECRUIT-
MENT,  HEPATITIS  C  EDUCATION  AND COUNSELING, COORDINATION OF CARE AND
ADHERENCE TO TREATMENT, ASSISTANCE IN OBTAINING APPROPRIATE  ENTITLEMENT
SERVICES, PEER SUPPORT AND OTHER SUPPORTIVE SERVICES; PROVIDED, HOWEVER,
THAT  THE  PROVISIONS OF THIS PARAGRAPH SHALL NOT TAKE EFFECT UNLESS ALL
NECESSARY APPROVALS UNDER FEDERAL LAW AND REGULATION HAVE BEEN  OBTAINED
TO  RECEIVE  FEDERAL FINANCIAL PARTICIPATION IN THE COSTS OF HEALTH CARE
SERVICES PROVIDED PURSUANT TO THIS PARAGRAPH.  NOTHING IN THIS PARAGRAPH
SHALL BE CONSTRUED TO MODIFY ANY LICENSURE, CERTIFICATION  OR  SCOPE  OF
PRACTICE PROVISION UNDER TITLE EIGHT OF THE EDUCATION LAW.
  S  7.  Paragraph  (g)  of subdivision 2 of section 365-a of the social
services law, as amended by section 23 of part H of chapter  59  of  the
laws of 2011, is amended to read as follows:
  (g)  sickroom  supplies,  eyeglasses, prosthetic appliances and dental
prosthetic appliances furnished in accordance with  the  regulations  of
the department; provided further that: (i) the commissioner of health is
authorized  to implement a preferred diabetic supply program wherein the
department of  health  will  receive  enhanced  rebates  from  preferred

S. 6256--A                         24                         A. 9056--A

manufacturers  of  glucometers and test strips, and may subject non-pre-
ferred manufacturers' glucometers and test strips to prior authorization
under section two hundred seventy-three of the public health  law;  (ii)
enteral  formula  therapy  and  nutritional  supplements  are limited to
coverage only for nasogastric, jejunostomy, or gastrostomy tube  feeding
or  for  treatment of an inborn metabolic disorder, or to address growth
and development problems in children, OR, SUBJECT  TO  STANDARDS  ESTAB-
LISHED  BY  THE  COMMISSIONER,  FOR  PERSONS  WITH  A  DIAGNOSIS  OF HIV
INFECTION, AIDS OR HIV-RELATED ILLNESS; (iii) prescription footwear  and
inserts  are limited to coverage only when used as an integral part of a
lower limb orthotic appliance, as part of a diabetic treatment plan,  or
to  address  growth  and  development  problems  in  children;  and (iv)
compression and support stockings are limited to coverage only for preg-
nancy or treatment of venous stasis ulcers;
  S 8. Subdivision 9 of section 4403-c  of  the  public  health  law  is
amended to read as follows:
  9.  Notwithstanding  any  other  provision of law, a comprehensive HIV
special needs plan  certified  pursuant  to  this  section  shall  limit
enrollment  to HIV positive persons, [but may enroll related children up
to the age of nineteen] EXCEPT FOR THE  FOLLOWING  PERSONS  WHO  MAY  BE
ENROLLED regardless of their HIV status[.]:
  (A) RELATED CHILDREN UP TO THE AGE OF TWENTY-ONE; AND
  (B)  HIGH  NEED POPULATIONS THAT WOULD BENEFIT FROM RECEIVING SERVICES
THROUGH A PLAN CERTIFIED PURSUANT TO THIS SECTION, AS DETERMINED BY  THE
COMMISSIONER.
  S  9.    Paragraph (f) of subdivision 1 of section 367-a of the social
services law as added by section 1 of Part E of chapter 58 of  the  laws
of 2008, is amended to read as follows:
  (f)  Amounts  payable  under  this title for medical assistance in the
form of outpatient mental health services under  article  thirty-one  OR
OUTPATIENT  CHEMICAL  DEPENDENCE  SERVICES  INCLUDING  OPIOID  TREATMENT
SERVICES UNDER ARTICLE THIRTY-TWO of the mental hygiene law provided  to
eligible  persons who are also beneficiaries under part B of title XVIII
of the federal social security act shall not be less than  the  approved
medical assistance payment level less the amount payable under part B.
  S  10.  Paragraph  (d)  of subdivision 2 of section 3332 of the public
health law, as amended by chapter 178 of the laws of  2010,  is  amended
and a new paragraph (e) is added to read as follows:
  (d)  the  date upon which such prescription was actually signed by the
prescribing practitioner[.]; AND
  (E) IF THE PATIENT IS A  LIMITED  ENGLISH  PROFICIENT  INDIVIDUAL,  AS
DEFINED  IN  SECTION THREE THOUSAND THREE HUNDRED NINETY-EIGHT-A OF THIS
CHAPTER, INDICATION OF SUCH  STATUS  AND  INDICATION  OF  THE  PATIENT'S
PRIMARY LANGUAGE.
  S  11.    Section 3333 of the public health law is amended by adding a
new subdivision 6 to read as follows:
  6. IF THE PHARMACIST KNOWS OR HAS REASON TO KNOW THAT THE PATIENT IS A
LIMITED ENGLISH PROFICIENT INDIVIDUAL, AS DEFINED IN SECTION THREE THOU-
SAND THREE HUNDRED NINETY-EIGHT-A OF THIS CHAPTER, THE PHARMACIST  SHALL
PROVIDE  FOR  TRANSLATION  OR  OTHER  LANGUAGE  SERVICES  AS REQUIRED IN
SECTION THREE THOUSAND THREE HUNDRED  NINETY-EIGHT-A  OF  THIS  CHAPTER,
UNLESS DOING SO WOULD COMPROMISE THE CARE OF THE PATIENT.
  S  12.  Paragraphs (b) and (c) of subdivision 1 of section 3334 of the
public health law, as amended by chapter 178 of the laws  of  2010,  are
amended and a new paragraph (d) is added to read as follows:

S. 6256--A                         25                         A. 9056--A

  (b)  dispense  the  substance in conformity with the labeling require-
ments applicable to the type of prescription which would be required but
for the emergency; [and]
  (c) make a good faith effort to verify the practitioner's identity, if
the practitioner is unknown to the pharmacist[.]; AND
  (D)  IF THE PHARMACIST KNOWS OR HAS REASON TO KNOW THAT THE PATIENT IS
A LIMITED ENGLISH PROFICIENT INDIVIDUAL, AS  DEFINED  IN  SECTION  THREE
THOUSAND  THREE  HUNDRED  NINETY-EIGHT-A OF THIS CHAPTER, THE PHARMACIST
SHALL PROVIDE FOR TRANSLATION OR OTHER LANGUAGE SERVICES AS REQUIRED  IN
SECTION  THREE  THOUSAND  THREE  HUNDRED NINETY-EIGHT-A OF THIS CHAPTER,
UNLESS DOING SO WOULD COMPROMISE THE CARE OF THE PATIENT.
  S 13. Subdivision 1 of section  3337  of  the  public  health  law  is
amended by adding a new paragraph (d) to read as follows:
  (D)  IF THE PHARMACIST KNOWS OR HAS REASON TO KNOW THAT THE PATIENT IS
A LIMITED ENGLISH PROFICIENT INDIVIDUAL, AS  DEFINED  IN  SECTION  THREE
THOUSAND  THREE  HUNDRED  NINETY-EIGHT-A OF THIS CHAPTER, THE PHARMACIST
SHALL PROVIDE FOR TRANSLATION OR OTHER LANGUAGE SERVICES AS REQUIRED  IN
SECTION  THREE  THOUSAND  THREE  HUNDRED NINETY-EIGHT-A OF THIS CHAPTER,
UNLESS DOING SO WOULD COMPROMISE THE CARE OF THE PATIENT.
  S 14.  Subdivision 1 of section 3338 of  the  public  health  law,  as
amended  by  section  12 of part A of chapter 58 of the laws of 2004, is
amended to read as follows:
  1. Official New York state prescription forms shall  be  prepared  and
issued by the department in the FORMAT, manner and detail as the commis-
sioner  in consultation with the commissioner of education may, by regu-
lation, require, and, each form shall be serialized. Such forms shall be
furnished to practitioners authorized to write such prescriptions and to
institutional dispensers. Such prescription blanks shall not  be  trans-
ferable.
  S  15. Subdivision b of section 6804 of the education law, as added by
chapter 987 of the laws of 1971, is amended to read as follows:
  b. To regulate and control the sale, distribution, character and stan-
dard of drugs, poisons, cosmetics, devices and new drugs, INCLUDING, BUT
NOT LIMITED TO, IN CONJUNCTION WITH  THE  COMMISSIONER  OF  HEALTH,  THE
DEVELOPMENT  OF  REQUIREMENTS  RELATED  TO  THE  SALE, DISTRIBUTION, AND
DISPENSING OF DRUGS AND NEW  DRUGS  TO  ADDRESS  THE  SPECIAL  NEEDS  OF
PERSONS  WHO ARE ELDERLY, OF LIMITED VISION OR OF LIMITED ENGLISH PROFI-
CIENCY,
  S 16. Section 6810 of the education law is amended by adding three new
subdivisions 10, 11 and 12 to read as follows:
  10. COVERED PHARMACIES, AS DEFINED IN  SECTION  THREE  THOUSAND  THREE
HUNDRED  NINETY-EIGHT-A  OF  THE  PUBLIC HEALTH LAW, MUST PROVIDE TRANS-
LATION AND INTERPRETATION SERVICES FOR PATIENTS  HAVING  LIMITED  PROFI-
CIENCY  IN  ENGLISH,  SUBJECT TO REGULATIONS OF THE COMMISSIONER AND THE
PROVISIONS OF SECTION THREE THOUSAND THREE HUNDRED NINETY-EIGHT-A OF THE
PUBLIC HEALTH LAW.
  11. IF THE PATIENT  IS  LIMITED  ENGLISH  PROFICIENT,  AS  DEFINED  IN
SECTION THREE THOUSAND THREE HUNDRED NINETY-EIGHT-A OF THE PUBLIC HEALTH
LAW,  INDICATION  OF SUCH STATUS AND INDICATION OF THE PATIENT'S PRIMARY
LANGUAGE.
  12. IF THE PHARMACIST KNOWS OR HAS REASON TO KNOW THAT THE PATIENT  IS
OF  LIMITED  ENGLISH  PROFICIENCY,  AS DEFINED IN SECTION THREE THOUSAND
THREE HUNDRED NINETY-EIGHT-A OF THE PUBLIC HEALTH  LAW,  THE  PHARMACIST
SHALL  PROVIDE FOR TRANSLATION OR OTHER LANGUAGE SERVICES AS REQUIRED IN
SUCH SECTION, UNLESS DOING SO WOULD COMPROMISE THE CARE OF THE PATIENT.

S. 6256--A                         26                         A. 9056--A

  S 17. The public health law is amended by adding a new article 33-B to
read as follows:
                              ARTICLE 33-B
                 STANDARDS FOR PRESCRIPTION MEDICATIONS
SECTION 3398.   APPLICATION.
        3398-A. INTERPRETATION REQUIREMENTS FOR PRESCRIPTION DRUGS.
  S 3398. APPLICATION. THIS ARTICLE APPLIES TO MEDICATIONS PRESCRIBED BY
PRACTITIONERS  AUTHORIZED  TO  PRESCRIBE  MEDICATIONS, INCLUDING BUT NOT
LIMITED TO CONTROLLED SUBSTANCES, PURSUANT TO TITLE EIGHT OF THE  EDUCA-
TION  LAW;  PROVIDED,  HOWEVER, THAT TO THE EXTENT THERE IS ANY CONFLICT
BETWEEN THE PROVISIONS OF THIS ARTICLE AND  THE  PROVISIONS  OF  ARTICLE
THIRTY-THREE  OF THIS TITLE WITH RESPECT TO PRESCRIPTIONS FOR CONTROLLED
SUBSTANCES, THE PROVISIONS OF ARTICLE THIRTY-THREE OF THIS  TITLE  SHALL
CONTROL.
  S  3398-A. INTERPRETATION REQUIREMENTS FOR PRESCRIPTION DRUGS.  1. FOR
THE PURPOSES OF THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOW-
ING MEANINGS:
  (A) "COVERED PHARMACY" MEANS ANY PHARMACY THAT IS PART OF A  GROUP  OF
FIVE  OR MORE PHARMACIES OWNED BY THE SAME CORPORATE ENTITY, OR WHICH IS
A MAIL ORDER PHARMACY.  FOR PURPOSES OF THIS SECTION, "CORPORATE ENTITY"
SHALL INCLUDE RELATED SUBSIDIARIES, AFFILIATES, SUCCESSORS, OR ASSIGNEES
DOING BUSINESS AS OR OPERATING UNDER A COMMON NAME OR TRADING SYMBOL;
  (B) "LIMITED ENGLISH PROFICIENT INDIVIDUAL" OR "LEP INDIVIDUAL"  MEANS
AN INDIVIDUAL WHO IDENTIFIES AS BEING, OR IS EVIDENTLY, UNABLE TO SPEAK,
READ  OR WRITE ENGLISH AT A LEVEL THAT PERMITS SUCH INDIVIDUAL TO UNDER-
STAND HEALTH RELATED  AND  PHARMACEUTICAL  INFORMATION  COMMUNICATED  IN
ENGLISH;
  (C)"TRANSLATE"  SHALL  MEAN  THE CONVERSION OF A WRITTEN TEXT FROM ONE
LANGUAGE INTO AN EQUIVALENT WRITTEN TEXT IN ANOTHER LANGUAGE BY AN INDI-
VIDUAL COMPETENT TO DO SO AND UTILIZING ALL NECESSARY PHARMACEUTICAL AND
HEALTH-RELATED TERMINOLOGY;
  (D) "COMPETENT ORAL INTERPRETATION" MEANS ORAL COMMUNICATION IN  WHICH
A  PERSON  ACTING  AS  AN  INTERPRETER  COMPREHENDS A SPOKEN MESSAGE AND
RE-EXPRESSES THAT MESSAGE ACCURATELY IN ANOTHER LANGUAGE, UTILIZING  ALL
NECESSARY PHARMACEUTICAL AND HEALTH-RELATED TERMINOLOGY, SO AS TO ENABLE
AN  LEP INDIVIDUAL TO RECEIVE ALL NECESSARY INFORMATION IN THE LEP INDI-
VIDUAL'S PRIMARY LANGUAGE;
  (E) "PHARMACY PRIMARY LANGUAGES" SHALL MEAN THE  TOP  SEVEN  LANGUAGES
SPOKEN  BY LEP INDIVIDUALS IN THIS STATE AS DETERMINED BIENNIALLY BY THE
STATE BOARD OF PHARMACY BASED ON DATA  FROM  THE  MOST  RECENT  AMERICAN
COMMUNITY SURVEY FROM THE UNITED STATES CENSUS BUREAU AND OTHER RELEVANT
DATA SOURCES;
  (F) "MAIL ORDER PHARMACY" SHALL MEAN A PHARMACY THAT DISPENSES MOST OF
ITS  PRESCRIPTIONS  THROUGH  THE  UNITED  STATES POSTAL SERVICE OR OTHER
DELIVERY SERVICES.
  2. (A) EVERY COVERED PHARMACY SHALL PROVIDE FREE, COMPETENT  ORAL  AND
WRITTEN  INTERPRETATION  SERVICES,  TO  EACH  LEP  INDIVIDUAL  FILLING A
PRESCRIPTION AT OR THROUGH SUCH COVERED PHARMACY, IN  THE  LEP  INDIVID-
UAL'S  PRIMARY  LANGUAGE  FOR  THE PURPOSE OF COUNSELING SUCH INDIVIDUAL
ABOUT HIS OR HER PRESCRIPTION MEDICATIONS AND INTERPRETING LABEL  INFOR-
MATION,  OR  WHEN SOLICITING INFORMATION NECESSARY TO MAINTAIN A PATIENT
MEDICATION PROFILE, UNLESS THE LEP INDIVIDUAL  IS  OFFERED  AND  REFUSES
SUCH SERVICES;
  (B)  EVERY  COVERED PHARMACY SHALL PROVIDE FREE, COMPETENT ORAL INTER-
PRETATION OF PRESCRIPTION MEDICATION LABELS, WARNING  LABELS  AND  OTHER
WRITTEN  MATERIAL  TO  EACH  LEP INDIVIDUAL FILLING A PRESCRIPTION AT OR

S. 6256--A                         27                         A. 9056--A

THROUGH SUCH COVERED PHARMACY UNLESS THE LEP INDIVIDUAL IS  OFFERED  AND
REFUSES  SUCH SERVICES, OR THE MEDICATION LABEL WARNING LABELS AND OTHER
WRITTEN MATERIALS HAVE ALREADY BEEN TRANSLATED INTO THE LANGUAGE  SPOKEN
BY THE LEP INDIVIDUAL;
  (C)  THE  SERVICES REQUIRED BY THIS SECTION MAY BE PROVIDED BY A STAFF
MEMBER OF  THE  COVERED  PHARMACY  OR  A  THIRD-PARTY  CONTRACTOR.  SUCH
SERVICES MUST BE PROVIDED ON AN IMMEDIATE BASIS BUT NEED NOT BE PROVIDED
IN-PERSON OR FACE-TO-FACE.
  3.  EVERY COVERED PHARMACY SHALL CONSPICUOUSLY POST, AT OR ADJACENT TO
EACH COUNTER OVER WHICH PRESCRIPTION DRUGS  ARE  SOLD,  AND  EVERY  MAIL
ORDER PHARMACY, SHALL INCLUDE IN THE PACKAGE IN WHICH PRESCRIPTION DRUGS
ARE  DELIVERED,  A NOTIFICATION OF THE RIGHT TO FREE LANGUAGE ASSISTANCE
SERVICES FOR LEP INDIVIDUALS AS PROVIDED FOR IN SUBDIVISION TWO OF  THIS
SECTION.  SUCH  NOTIFICATIONS  SHALL BE PROVIDED IN THE PHARMACY PRIMARY
LANGUAGES. THE SIZE, STYLE AND PLACEMENT OF SUCH NOTICE SHALL BE  DETER-
MINED IN ACCORDANCE WITH RULES PROMULGATED BY THE COMMISSIONER.
  4.  ANY  PERSON AGGRIEVED BY A FAILURE TO RECEIVE SERVICES REQUIRED BY
THIS SECTION SHALL HAVE A CAUSE OF ACTION ONLY AGAINST THE COVERED PHAR-
MACY IN ANY COURT OF COMPETENT JURISDICTION FOR DAMAGES, INCLUDING PUNI-
TIVE DAMAGES, AND FOR INJUNCTIVE RELIEF AND SUCH OTHER REMEDIES  AS  MAY
BE APPROPRIATE.
  5.  THIS  SECTION  SHALL  PREEMPT ANY CONTRARY LOCAL LAW OR ORDINANCE,
EXCEPT THAT THIS SECTION SHALL NOT PREEMPT OR SUPERSEDE  LOCAL  LAWS  OR
ORDINANCES  IMPOSING  ADDITIONAL  OR  STRICTER  REQUIREMENTS RELATING TO
INTERPRETATION OR TRANSLATION SERVICES IN PHARMACIES.
  S 18. Section 6509 of the education law is amended  by  adding  a  new
subdivision 15 to read as follows:
  (15)  A  VIOLATION OF SUBDIVISION TWO OR THREE OF SECTION THIRTY-THREE
HUNDRED NINETY-EIGHT-A OF THE PUBLIC HEALTH LAW, BUT ONLY AS TO A  PHAR-
MACY AND NOT AS TO AN INDIVIDUAL LICENSED PHARMACIST.
  S  19.   Subdivisions (f) and (g) of section 2522 of the public health
law, as amended by chapter 484 of the laws of 2009, are  amended  and  a
new subdivision (h) is added to read as follows:
  (f)  follow-up  of  patient  participation  in prenatal care services;
[and]
  (g) identification of regional perinatal health care  system  barriers
and  limitations that lead to poor perinatal outcomes and development of
strategies to address such barriers and limitations[.]; AND
  (H) COORDINATION OF SERVICE DELIVERY BY COMMUNITY-BASED  ORGANIZATIONS
AMONG  HEALTH  CARE  PROVIDERS AND HEALTH PLANS USING HEALTH INFORMATION
TECHNOLOGY AND UNIFORM SCREENING CRITERIA FOR PERINATAL RISK.
  S 20. Intentionally Omitted.
  S 21. Intentionally Omitted.
  S 22. Section 366 of the social services law is amended  by  adding  a
new subdivision 15 to read as follows:
  15.  (A)  THE  COMMISSIONER  MAY CONTRACT WITH ONE OR MORE ENTITIES TO
ENGAGE IN  EDUCATION,  OUTREACH  SERVICES,  AND  FACILITATED  ENROLLMENT
ACTIVITIES FOR AGED, BLIND, AND DISABLED PERSONS WHO MAY BE ELIGIBLE FOR
COVERAGE UNDER THIS TITLE.
  (B) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTIONS
ONE HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVEL-
OPMENT  LAW, OR ANY OTHER CONTRARY PROVISION OF LAW, THE COMMISSIONER IS
AUTHORIZED TO ENTER INTO A CONTRACT OR CONTRACTS UNDER THIS  SUBDIVISION
WITHOUT  A  COMPETITIVE  BID  OR REQUEST FOR PROPOSAL PROCESS, PROVIDED,
HOWEVER, THAT:

S. 6256--A                         28                         A. 9056--A

  (I) THE DEPARTMENT SHALL POST ON ITS WEBSITE, FOR A PERIOD OF NO  LESS
THAN THIRTY DAYS:
  (1)  A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT TO
THE CONTRACT OR CONTRACTS;
  (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (3) THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY  SEEK
SELECTION,  WHICH  SHALL BE NO LESS THAN THIRTY DAYS AFTER SUCH INFORMA-
TION IS FIRST POSTED ON THE WEBSITE; AND
  (4) THE MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY  SEEK  SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (II)  ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED FROM
PROSPECTIVE CONTRACTORS IN TIMELY  FASHION  SHALL  BE  REVIEWED  BY  THE
COMMISSIONER; AND
  (III)  THE  COMMISSIONER  SHALL  SELECT SUCH CONTRACTOR OR CONTRACTORS
THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE PURPOSES OF
THIS SUBDIVISION.
  S 23. The public health law is amended by adding a new article 9-B  to
read as follows:
                                ARTICLE 9-B
         PRIMARY CARE SERVICE CORPS PRACTITIONER LOAN REPAYMENT
                                 PROGRAM
SECTION 923. DEFINITIONS.
        924.  PRIMARY  CARE  SERVICE  CORPS  PRACTITIONER LOAN REPAYMENT
        PROGRAM.
  S 923. DEFINITIONS.  THE FOLLOWING WORDS OR PHRASES AS  USED  IN  THIS
SECTION SHALL HAVE THE FOLLOWING MEANINGS:
  1.  "UNDERSERVED  AREA"  MEANS  AN AREA OR MEDICALLY UNDERSERVED POPU-
LATION DESIGNATED BY THE COMMISSIONER AS HAVING A  SHORTAGE  OF  PRIMARY
CARE  PHYSICIANS, OTHER PRIMARY CARE PRACTITIONERS, DENTAL PRACTITIONERS
OR MENTAL HEALTH PRACTITIONERS.
  2. "PRIMARY CARE SERVICE CORPS PRACTITIONER" MEANS A PHYSICIAN ASSIST-
ANT, NURSE PRACTITIONER, NURSE MIDWIFE, GENERAL OR  PEDODONTIC  DENTIST,
DENTAL  HYGIENIST, CLINICAL PSYCHOLOGIST, LICENSED CLINICAL SOCIAL WORK-
ER, PSYCHIATRIC NURSE PRACTITIONER, LICENSED MARRIAGE AND FAMILY  THERA-
PIST,  OR  A  LICENSED  MENTAL HEALTH COUNSELOR, WHO IS LICENSED, REGIS-
TERED, OR CERTIFIED TO PRACTICE IN  NEW  YORK  STATE  AND  WHO  PROVIDES
COORDINATED  PRIMARY  CARE SERVICES, INCLUDING, BUT NOT LIMITED TO, ORAL
HEALTH AND MENTAL HEALTH SERVICES.
  3. "PHYSICIAN ASSISTANT" MEANS A PERSON WHO  HAS  BEEN  REGISTERED  AS
SUCH PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE-B OF THE EDUCATION LAW.
  4.  "NURSE PRACTITIONER" MEANS A PERSON WHO HAS BEEN CERTIFIED AS SUCH
PURSUANT TO SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW.
  5. "NURSE MIDWIFE" MEANS A PERSON WHO HAS BEEN LICENSED AS SUCH PURSU-
ANT TO SECTION SIXTY-NINE HUNDRED FIFTY-FIVE OF THE EDUCATION LAW.
  6. "PSYCHOLOGIST" MEANS A PERSON WHO HAS BEEN LICENSED AS SUCH  PURSU-
ANT TO SECTION SEVENTY-SIX HUNDRED THREE OF THE EDUCATION LAW.
  7.  "LICENSED  CLINICAL  SOCIAL  WORKER"  MEANS  A PERSON WHO HAS BEEN
LICENSED AS SUCH PURSUANT TO SECTION SEVENTY-SEVEN HUNDRED  TWO  OF  THE
EDUCATION LAW.
  8. "PSYCHIATRIC NURSE PRACTITIONER" MEANS A NURSE PRACTITIONER WHO, BY
REASON OF TRAINING AND EXPERIENCE, PROVIDES A FULL SPECTRUM OF PSYCHIAT-
RIC  CARE, ASSESSING, DIAGNOSING, AND MANAGING THE PREVENTION AND TREAT-
MENT OF PSYCHIATRIC DISORDERS AND MENTAL HEALTH PROBLEMS.
  9. "LICENSED MARRIAGE AND FAMILY THERAPIST" MEANS  A  PERSON  WHO  HAS
BEEN  LICENSED  AS SUCH PURSUANT TO SECTION EIGHTY-FOUR HUNDRED THREE OF
THE EDUCATION LAW.

S. 6256--A                         29                         A. 9056--A

  10. "LICENSED MENTAL HEALTH COUNSELOR" MEANS A  PERSON  WHO  HAS  BEEN
LICENSED  AS  SUCH  PURSUANT  TO  SECTION EIGHTY-FOUR HUNDRED TWO OF THE
EDUCATION LAW.
  11.  "GENERAL  OR  PEDODONTIC  DENTIST"  MEANS  A  PERSON WHO HAS BEEN
LICENSED OR OTHERWISE AUTHORIZED TO PRACTICE DENTISTRY PURSUANT TO ARTI-
CLE ONE HUNDRED THIRTY-THREE OF THE EDUCATION  LAW  EXCLUDING  ORTHODON-
TISTS, ENDODONTISTS AND PERIODONTISTS.
  12.  "DENTAL  HYGIENIST"  MEANS  A  PERSON WHO IS LICENSED TO PRACTICE
DENTAL HYGIENE PURSUANT TO SECTION SIXTY-SIX HUNDRED NINE OF THE  EDUCA-
TION LAW.
  S 924. PRIMARY CARE SERVICE CORPS PRACTITIONER LOAN REPAYMENT PROGRAM.
1. THE COMMISSIONER IS AUTHORIZED, WITHIN AMOUNTS AVAILABLE THEREFOR, TO
MAKE  LOAN REPAYMENT AWARDS TO ELIGIBLE PRIMARY CARE SERVICE CORPS PRAC-
TITIONERS WHO AGREE TO PRACTICE FULL-TIME IN AN UNDERSERVED AREA IN  NEW
YORK  STATE, IN AMOUNTS TO BE DETERMINED BY THE COMMISSIONER, BUT NOT TO
EXCEED THIRTY-TWO THOUSAND DOLLARS PER YEAR FOR ANY YEAR IN  WHICH  SUCH
PRACTITIONERS PROVIDE FULL-TIME ELIGIBLE OBLIGATED SERVICE.
  2.  LOAN REPAYMENT AWARDS MADE TO A PRIMARY CARE SERVICE CORPS PRACTI-
TIONER PURSUANT TO SUBDIVISION ONE OF THIS SECTION SHALL NOT EXCEED  THE
TOTAL QUALIFYING OUTSTANDING DEBT OF THE PRACTITIONER FROM STUDENT LOANS
TO  COVER  TUITION  AND  OTHER  RELATED EDUCATIONAL EXPENSES, MADE BY OR
GUARANTEED BY THE FEDERAL OR STATE GOVERNMENT, OR MADE BY A  LENDING  OR
EDUCATIONAL  INSTITUTION  APPROVED  UNDER TITLE IV OF THE FEDERAL HIGHER
EDUCATION ACT. LOAN REPAYMENT AWARDS SHALL BE USED SOLELY TO REPAY  SUCH
OUTSTANDING DEBT.
  3.  IN  THE EVENT THAT ANY COMMITMENT PURSUANT TO THE AGREEMENT REFER-
ENCED IN SUBDIVISION ONE OF THIS SECTION IS NOT FULFILLED, THE RECIPIENT
SHALL BE RESPONSIBLE FOR REPAYMENT IN AMOUNTS WHICH SHALL BE  CALCULATED
IN  ACCORDANCE  WITH THE FORMULA SET FORTH IN SUBDIVISION (B) OF SECTION
TWO HUNDRED FIFTY-FOUR-O OF TITLE FORTY-TWO OF THE UNITED  STATES  CODE,
AS AMENDED.
  4.  THE  COMMISSIONER  IS  AUTHORIZED TO APPLY ANY FUNDS AVAILABLE FOR
PURPOSES OF SUBDIVISION ONE OF THIS SECTION FOR USE  AS  MATCHING  FUNDS
FOR  ANY AVAILABLE FEDERAL GRANTS FOR THE PURPOSE OF ASSISTING STATES IN
OPERATING LOAN REPAYMENT PROGRAMS.
  5. THE COMMISSIONER MAY POSTPONE, CHANGE OR WAIVE  THE  SERVICE  OBLI-
GATION AND REPAYMENTS AMOUNTS SET FORTH IN SUBDIVISIONS ONE AND THREE OF
THIS  SECTION,  RESPECTIVELY, IN INDIVIDUAL CIRCUMSTANCES WHERE THERE IS
COMPELLING NEED OR HARDSHIP.
  6. IN ORDER TO BE ELIGIBLE TO RECEIVE A  LOAN  REPAYMENT  AWARD  UNDER
THIS  SECTION,  A PRIMARY CARE SERVICE CORPS PRACTITIONER MUST MEET SITE
AND SERVICE ELIGIBILITY CRITERIA AS DETERMINED BY THE COMMISSIONER.
  7. THE COMMISSIONER SHALL PROMULGATE REGULATIONS NECESSARY TO EFFECTU-
ATE THE PROVISIONS AND PURPOSES OF THIS ARTICLE.
  S 24.  Paragraph (a) of subdivision 4 of section 2801-a of the  public
health law, as amended by section 57 of part A of chapter 58 of the laws
of 2010, is amended to read as follows:
  (a)  Any  change in the person who is the operator of a hospital shall
be approved by the public health and health planning council in  accord-
ance  with the provisions of subdivisions two and three of this section.
NO CHANGE IN THE DIRECTORS OF A NOT-FOR-PROFIT CORPORATION THAT  IS  THE
OPERATOR  OF  A HOSPITAL SHALL BE EFFECTIVE UNLESS, AT LEAST ONE HUNDRED
TWENTY DAYS PRIOR TO THE INTENDED EFFECTIVE  DATE  THEREOF,  THE  CORPO-
RATION  FULLY  COMPLETES AND FILES WITH THE DEPARTMENT NOTICE ON A FORM,
TO BE DEVELOPED BY THE DEPARTMENT, WHICH SHALL DISCLOSE SUCH INFORMATION
AS MAY REASONABLY BE NECESSARY FOR THE DEPARTMENT TO  DETERMINE  WHETHER

S. 6256--A                         30                         A. 9056--A

IT  SHOULD BAR THE CHANGE IN DIRECTORS. Notwithstanding any inconsistent
provision of this paragraph, any change by a natural person who  is  the
operator  of  a hospital seeking to transfer part of his or her interest
in such hospital to another person or persons so as to create a partner-
ship  shall  be  approved in accordance with the provisions of paragraph
(b) of this subdivision.
  S 25. Section 2806 of the public health law is amended by adding a new
subdivision 2-a to read as follows:
  2-A. (A) THE COMMISSIONER MAY TEMPORARILY SUSPEND OR LIMIT AN  OPERAT-
ING  CERTIFICATE OF A NOT-FOR-PROFIT CORPORATION WITHOUT A HEARING UPON:
(I) THE COMMENCEMENT BY THE DEPARTMENT OF AN ACTION TO REVOKE,  SUSPEND,
LIMIT  OR  ANNUL  THE OPERATING CERTIFICATE PURSUANT TO PARAGRAPH (A) OF
SUBDIVISION ONE OF THIS SECTION DUE TO REPEATED VIOLATIONS OF THIS ARTI-
CLE OR RULES AND REGULATIONS PROMULGATED THEREUNDER; (II) THE INDICTMENT
ON FELONY CHARGES OF ANY MEMBER OF THE CORPORATION'S BOARD OF  DIRECTORS
OR  (III)  NOTICE  FROM  THE ATTORNEY GENERAL OF AN ACTION TO REMOVE ANY
MEMBER OF THE CORPORATION'S BOARD OF DIRECTORS PURSUANT TO PARAGRAPH (D)
OF SECTION SEVEN HUNDRED SIX OF THE NOT-FOR-PROFIT CORPORATION LAW. SUCH
SUSPENSION OR LIMITATION  OF  THE  OPERATING  CERTIFICATE  SHALL  REMAIN
EFFECTIVE  UNTIL  THE  RESOLUTION  OF  THE  CRIMINAL  ACTION THAT IS THE
SUBJECT OF THE INDICTMENT OR UNTIL THE RESOLUTION OF THE ACTION  OF  THE
ATTORNEY GENERAL, AS APPLICABLE.
  (B)  IN  THE  EVENT  ONE  OR MORE MEMBERS OF A BOARD OF DIRECTORS OF A
NOT-FOR-PROFIT CORPORATION ARE THE SUBJECT OF  AN  ACTION  TO  LIMIT  AN
OPERATING  CERTIFICATE  PURSUANT  TO PARAGRAPH (A) OF SUBDIVISION ONE OF
THIS SECTION, HAVE BEEN INDICTED ON FELONY CHARGES, OR ARE  THE  SUBJECT
OF  AN  ACTION FOR REMOVAL BY THE ATTORNEY GENERAL AS DESCRIBED IN PARA-
GRAPH (A) OF THIS SUBDIVISION, THE COMMISSIONER MAY, IN ADDITION TO  HIS
OR  HER  OTHER  POWERS, LIMIT THE EXISTING OPERATING CERTIFICATE OF SUCH
CORPORATION SO THAT IT SHALL APPLY ONLY TO THE REMAINING MEMBERS OF  THE
BOARD  OF  DIRECTORS  PROVIDED THAT: (I) EVERY SUCH PERSON SUBJECT TO AN
ACTION TO LIMIT THE OPERATING CERTIFICATE PURSUANT TO PARAGRAPH  (A)  OF
SUBDIVISION  ONE  OF  THIS SECTION, EVERY SUCH INDICTED PERSON, OR EVERY
SUCH PERSON SUBJECT TO AN  ACTION  FOR  REMOVAL  SHALL  IMMEDIATELY  AND
COMPLETELY  CEASE  AND  WITHDRAW FROM PARTICIPATION, IN ANY CAPACITY, IN
THE MANAGEMENT, GOVERNANCE OR OPERATION OF THE HOSPITAL;  AND  (II)  THE
COMMISSIONER HAS FOUND THAT THE REMAINING MEMBERS OF THE BOARD OF DIREC-
TORS ARE OF SUCH CHARACTER, EXPERIENCE, COMPETENCE AND STANDING SO AS TO
GIVE REASONABLE ASSURANCE OF THEIR ABILITY TO CONDUCT THE AFFAIRS OF THE
CORPORATION  IN  ITS  BEST  INTERESTS AND IN THE PUBLIC INTEREST. IF THE
CONDITIONS SET FORTH IN SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH ARE
NOT MET, OR IF THE LIMITATION OF THE OPERATING  CERTIFICATE  UNDER  THIS
PARAGRAPH  RESULTS  IN  A BOARD OF DIRECTORS OF LESS THAN THREE MEMBERS,
THE COMMISSIONER SHALL TEMPORARILY  SUSPEND  THE  OPERATING  CERTIFICATE
PURSUANT TO PARAGRAPH (A) OF THIS SUBDIVISION.
  (C)  NOTWITHSTANDING PARAGRAPHS (A) AND (B) OF THIS SUBDIVISION, WHERE
THE COMMISSIONER HAS FOUND THAT THE SUSPENSION OF A  HOSPITAL  OPERATING
CERTIFICATE  PURSUANT  TO  THIS  SECTION  WOULD  JEOPARDIZE  EXISTING OR
CONTINUED ACCESS TO NECESSARY SERVICES WITHIN THE COMMUNITY, THE COMMIS-
SIONER MAY APPOINT TEMPORARY MEMBERS OF THE BOARD OF DIRECTORS TO  OPER-
ATE  AND  MANAGE  THE HOSPITAL UNDER THE EXISTING OPERATING CERTIFICATE,
UNTIL THE RESOLUTION OF THE CRIMINAL ACTION, ATTORNEY GENERAL ACTION  OR
ACTION BY THE DEPARTMENT DESCRIBED IN PARAGRAPH (A) OF THIS SUBDIVISION,
AS APPLICABLE.
  S  26.  Paragraphs (a) and (b) of subdivision 5 of section 2806 of the
public health law, paragraph (a) as amended by section 20 of part LL  of

S. 6256--A                         31                         A. 9056--A

chapter  56  of the laws of 2010 and paragraph (b) as amended by chapter
607 of the laws of 1981, are amended to read as follows:
  (a)  Except as provided in paragraphs (b) and (d) of this subdivision,
anything contained in this section or in a certificate  of  relief  from
disabilities or a certificate of good conduct issued pursuant to article
twenty-three  of  the  correction law to the contrary notwithstanding, a
hospital operating certificate of a hospital under control of a control-
ling person as defined in paragraph (a) of subdivision twelve of section
twenty-eight hundred one-a of this article,  or  under  control  of  any
other  entity,  shall  be  revoked upon a finding by the department that
such controlling person or any  individual,  member  of  a  partnership,
MEMBER  OF  A LIMITED LIABILITY COMPANY, MEMBER OF A BOARD OF DIRECTORS,
or shareholder of a corporation to whom or to which an operating certif-
icate has been issued, has been convicted of a class A, B or  C  felony,
or a felony related in any way to any activity or program subject to the
regulations,  supervision, or administration of the department or of the
office of temporary and disability assistance or  in  violation  of  the
public  officers  law in a court of competent jurisdiction in the state,
or of a crime outside the state which, if committed  within  the  state,
would  have been a class A, B or C felony or a felony related in any way
to any activity or program subject to the regulations,  supervision,  or
administration of the department or of the office of temporary and disa-
bility assistance or in violation of the public officers law.
  (b)  In  the  event  one or more members of a partnership, MEMBER OF A
LIMITED LIABILITY COMPANY, MEMBER OF A BOARD OF DIRECTORS, or sharehold-
ers of a corporation shall have been convicted of a felony as  described
in  paragraph  (a) of this subdivision, the commissioner shall, in addi-
tion to his other powers, limit the existing  operating  certificate  of
such  partnership  or  corporation  so  that  it shall apply only to the
remaining partner, MEMBER OF A LIMITED LIABILITY COMPANY,  MEMBER  OF  A
BOARD  OF  DIRECTORS, or shareholders, as the case may be, provided that
every such convicted person immediately and completely ceases and  with-
draws  from participation, IN ANY CAPACITY, in the management and opera-
tion of the hospital, and  further  provided  that  an  application  for
approval of change of ownership, CHANGE OF BOARD MEMBERSHIP, or transfer
of  stock  is  filed  without  delay  in  accordance  with the pertinent
provisions of section twenty-eight hundred one-a of this [chapter] ARTI-
CLE.
  S 27. The public health law is amended by adding a new section  2806-a
to read as follows:
  S  2806-A.  TEMPORARY  OPERATOR.  1. FOR THE PURPOSES OF THIS SECTION:
(A) THE TERM "ADULT CARE FACILITY" SHALL MEAN AN ADULT HOME OR  ENRICHED
HOUSING  PROGRAM  LICENSED  PURSUANT  TO  ARTICLE  SEVEN  OF  THE SOCIAL
SERVICES LAW OR AN ASSISTED LIVING RESIDENCE LICENSED PURSUANT TO  ARTI-
CLE  FORTY-SIX-B  OF  THIS  CHAPTER; (B) THE TERM "ESTABLISHED OPERATOR"
SHALL MEAN THE OPERATOR OF AN ADULT CARE FACILITY, A GENERAL HOSPITAL OR
A DIAGNOSTIC AND TREATMENT CENTER THAT HAS BEEN ESTABLISHED  AND  ISSUED
AN  OPERATING CERTIFICATE AS SUCH PURSUANT TO THIS ARTICLE; (C) THE TERM
"FACILITY" SHALL MEAN (I) A GENERAL HOSPITAL OR A DIAGNOSTIC AND  TREAT-
MENT CENTER THAT HAS BEEN ISSUED AN OPERATING CERTIFICATE AS SUCH PURSU-
ANT  TO  THIS  ARTICLE; OR (II) AN ADULT CARE FACILITY; AND (D) THE TERM
"TEMPORARY OPERATOR" SHALL MEAN ANY PERSON OR ENTITY THAT:
  (I) AGREES TO OPERATE A FACILITY ON A  TEMPORARY  BASIS  IN  THE  BEST
INTERESTS  OF  ITS RESIDENTS OR PATIENTS AND THE COMMUNITY SERVED BY THE
FACILITY; AND

S. 6256--A                         32                         A. 9056--A

  (II) HAS DEMONSTRATED THAT HE OR SHE HAS THE CHARACTER, COMPETENCE AND
FINANCIAL ABILITY TO OPERATE THE FACILITY IN COMPLIANCE WITH  APPLICABLE
STANDARDS.
  2. (A) WHEN A STATEMENT OF DEFICIENCIES HAS BEEN ISSUED BY THE DEPART-
MENT  AND  UPON  A  DETERMINATION  BY  THE COMMISSIONER THAT THERE EXIST
SIGNIFICANT MANAGEMENT FAILURES, INCLUDING BUT NOT LIMITED  TO  ADMINIS-
TRATIVE,  OPERATIONAL OR CLINICAL DEFICIENCIES OR FINANCIAL INSTABILITY,
IN A FACILITY THAT (I) SERIOUSLY ENDANGER THE LIFE, HEALTH OR SAFETY  OF
RESIDENTS OR PATIENTS OR (II) JEOPARDIZE EXISTING OR CONTINUED ACCESS TO
NECESSARY  SERVICES  WITHIN  THE  COMMUNITY,  HE  OR SHE SHALL APPOINT A
TEMPORARY OPERATOR TO ASSUME SOLE CONTROL OVER AND  SOLE  RESPONSIBILITY
FOR  THE  OPERATIONS  OF THAT FACILITY.   THE APPOINTMENT OF A TEMPORARY
OPERATOR SHALL BE IN ADDITION TO ANY OTHER REMEDIES PROVIDED BY LAW.
  (B) THE ESTABLISHED OPERATOR OF A FACILITY MAY AT ANY TIME REQUEST THE
COMMISSIONER TO APPOINT A TEMPORARY  OPERATOR.  UPON  RECEIVING  SUCH  A
REQUEST,  THE  COMMISSIONER  MAY,  IF  HE OR SHE DETERMINES THAT SUCH AN
ACTION IS NECESSARY TO RESTORE OR MAINTAIN THE PROVISION OF QUALITY CARE
TO THE RESIDENTS OR PATIENTS, ENTER INTO AN AGREEMENT  WITH  THE  ESTAB-
LISHED  OPERATOR  FOR  THE APPOINTMENT OF A TEMPORARY OPERATOR TO ASSUME
SOLE CONTROL OVER AND SOLE RESPONSIBILITY FOR  THE  OPERATIONS  OF  THAT
FACILITY.
  3.  A  TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION SHALL USE
HIS OR HER BEST  EFFORTS  TO  CORRECT  OR  ELIMINATE  ANY  DEFICIENCIES,
MANAGEMENT  FAILURES  OR  FINANCIAL  INSTABILITY  IN THE FACILITY AND TO
PROMOTE THE QUALITY AND ACCESSIBILITY OF HEALTH  CARE  SERVICES  IN  THE
COMMUNITY  SERVED  BY  THE  FACILITY.  SUCH CORRECTION OR ELIMINATION OF
DEFICIENCIES, MANAGEMENT FAILURES OR  FINANCIAL  INSTABILITY  SHALL  NOT
INCLUDE  MAJOR  ALTERATIONS  OF  THE PHYSICAL STRUCTURE OF THE FACILITY.
DURING THE TERM OF HIS OR HER APPOINTMENT, THE TEMPORARY OPERATOR  SHALL
HAVE  THE  AUTHORITY  TO  DIRECT  THE  MANAGEMENT OF THE FACILITY IN ALL
ASPECTS OF OPERATION AND SHALL BE AFFORDED FULL ACCESS TO  THE  ACCOUNTS
AND  RECORDS  OF THE FACILITY. THE TEMPORARY OPERATOR SHALL, DURING THIS
PERIOD, OPERATE THE FACILITY IN SUCH A MANNER AS TO PROMOTE  SAFETY  AND
TO  PROMOTE  THE  QUALITY  AND  ACCESSIBILITY OF HEALTH CARE SERVICES OR
RESIDENTIAL CARE IN THE COMMUNITY SERVED BY THE FACILITY. THE  TEMPORARY
OPERATOR  SHALL  HAVE  THE  POWER  TO  LET  CONTRACTS  THEREFOR OR INCUR
EXPENSES ON BEHALF OF THE FACILITY, PROVIDED THAT WHERE INDIVIDUAL ITEMS
OF REPAIRS, IMPROVEMENTS OR SUPPLIES EXCEED TEN  THOUSAND  DOLLARS,  THE
TEMPORARY  OPERATOR  SHALL  OBTAIN  PRICE QUOTATIONS FROM AT LEAST THREE
REPUTABLE SOURCES. THE TEMPORARY OPERATOR SHALL NOT BE REQUIRED TO  FILE
ANY BOND. NO SECURITY INTEREST IN ANY REAL OR PERSONAL PROPERTY COMPRIS-
ING  THE FACILITY OR CONTAINED WITHIN THE FACILITY, OR IN ANY FIXTURE OF
THE FACILITY, SHALL BE IMPAIRED OR DIMINISHED IN PRIORITY BY THE  TEMPO-
RARY  OPERATOR.  NEITHER THE TEMPORARY OPERATOR NOR THE DEPARTMENT SHALL
ENGAGE IN ANY ACTIVITY THAT CONSTITUTES A CONFISCATION OF PROPERTY WITH-
OUT THE PAYMENT OF FAIR COMPENSATION.
  4. THE TEMPORARY OPERATOR SHALL BE ENTITLED TO A  REASONABLE  FEE,  AS
DETERMINED  BY  THE COMMISSIONER, AND NECESSARY EXPENSES INCURRED DURING
HIS OR HER PERFORMANCE AS TEMPORARY OPERATOR, TO BE PAID FROM THE REVEN-
UE OF THE FACILITY.   THE  TEMPORARY  OPERATOR  SHALL  COLLECT  INCOMING
PAYMENTS FROM ALL SOURCES AND APPLY THEM FIRST TO THE REASONABLE FEE AND
TO  COSTS  INCURRED IN THE PERFORMANCE OF HIS OR HER FUNCTIONS AS TEMPO-
RARY OPERATOR. THE TEMPORARY OPERATOR SHALL BE LIABLE ONLY IN HIS OR HER
CAPACITY AS TEMPORARY OPERATOR FOR INJURY  TO  PERSON  AND  PROPERTY  BY
REASON  OF  CONDITIONS  OF  THE  FACILITY IN A CASE WHERE AN ESTABLISHED
OPERATOR WOULD HAVE BEEN LIABLE; HE OR SHE SHALL NOT HAVE ANY  LIABILITY

S. 6256--A                         33                         A. 9056--A

IN  HIS OR HER PERSONAL CAPACITY, EXCEPT FOR GROSS NEGLIGENCE AND INTEN-
TIONAL ACTS.
  5.  (A)  THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR
SHALL NOT EXCEED ONE HUNDRED EIGHTY DAYS. AFTER ONE HUNDRED EIGHTY DAYS,
IF THE COMMISSIONER DETERMINES THAT TERMINATION OF THE TEMPORARY  OPERA-
TOR  WOULD  CAUSE SIGNIFICANT DETERIORATION OF THE QUALITY OF, OR ACCESS
TO, HEALTH CARE OR RESIDENTIAL CARE IN THE COMMUNITY OR THAT  REAPPOINT-
MENT  IS  NECESSARY  TO  CORRECT THE DEFICIENCIES, MANAGEMENT FAILURE OR
FINANCIAL INSTABILITY THAT REQUIRED THE  APPOINTMENT  OF  THE  TEMPORARY
OPERATOR, THE COMMISSIONER MAY AUTHORIZE UP TO TWO ADDITIONAL NINETY DAY
TERMS.    WITHIN  FOURTEEN DAYS PRIOR TO THE TERMINATION OF EACH TERM OF
THE APPOINTMENT OF THE TEMPORARY OPERATOR, THE TEMPORARY OPERATOR  SHALL
SUBMIT  TO  THE  COMMISSIONER  AND  TO THE ESTABLISHED OPERATOR A REPORT
DESCRIBING THE ACTIONS TAKEN DURING  THE  APPOINTMENT  TO  ADDRESS  SUCH
DEFICIENCIES,  MANAGEMENT  FAILURES  AND/OR  FINANCIAL  INSTABILITY. THE
REPORT SHALL REFLECT  BEST  EFFORTS  TO  PRODUCE  A  FULL  AND  COMPLETE
ACCOUNTING.
  (B)  UPON  THE  COMPLETION  OF  THE TWO NINETY DAY TERMS REFERENCED IN
PARAGRAPH (A) OF THIS SUBDIVISION, IF THE COMMISSIONER  DETERMINES  THAT
TERMINATION  OF  THE  TEMPORARY OPERATOR WOULD CAUSE SIGNIFICANT DETERI-
ORATION OF THE QUALITY OF, OR ACCESS TO, HEALTH CARE OR RESIDENTIAL CARE
IN THE COMMUNITY OR THAT REAPPOINTMENT  IS  NECESSARY  TO  CONTINUE  THE
CORRECTION  OF  THE DEFICIENCIES, MANAGEMENT FAILURE OR FINANCIAL INSTA-
BILITY THAT REQUIRED THE APPOINTMENT  OF  THE  TEMPORARY  OPERATOR,  THE
COMMISSIONER  MAY REAPPOINT THE TEMPORARY OPERATOR FOR ADDITIONAL NINETY
DAY TERMS, PROVIDED THAT THE COMMISSIONER SHALL PROVIDE FOR  NOTICE  AND
THE  OPPORTUNITY  FOR  A HEARING AS SET FORTH IN SUBDIVISION SIX OF THIS
SECTION.
  (C) THE TERM OF THE INITIAL APPOINTMENT AND OF  ANY  SUBSEQUENT  REAP-
POINTMENT  MAY  BE  TERMINATED PRIOR TO THE EXPIRATION OF THE DESIGNATED
TERM, IF THE ESTABLISHED OPERATOR AND THE COMMISSIONER AGREE ON  A  PLAN
OF CORRECTION AND THE IMPLEMENTATION OF SUCH PLAN.
  6.  THE  COMMISSIONER  SHALL, UPON MAKING A DETERMINATION TO APPOINT A
TEMPORARY OPERATOR PURSUANT TO PARAGRAPH (A) OF SUBDIVISION TWO OF  THIS
SECTION OR REAPPOINT A TEMPORARY OPERATOR FOR THE FIRST ADDITIONAL NINE-
TY  DAY  TERM  PURSUANT  TO  PARAGRAPH  (A)  OF SUBDIVISION FIVE OF THIS
SECTION, CAUSE THE ESTABLISHED OPERATOR OF THE FACILITY TO  BE  NOTIFIED
OF  THE  DETERMINATION  BY REGISTERED OR CERTIFIED MAIL ADDRESSED TO THE
PRINCIPAL OFFICE OF THE ESTABLISHED OPERATOR. IF THE COMMISSIONER DETER-
MINES THAT ADDITIONAL REAPPOINTMENTS PURSUANT TO PARAGRAPH (B) OF SUBDI-
VISION FIVE OF THIS SECTION ARE REQUIRED, THE COMMISSIONER  SHALL  AGAIN
CAUSE  THE  ESTABLISHED  OPERATOR OF THE FACILITY TO BE NOTIFIED OF SUCH
DETERMINATION BY REGISTERED OR CERTIFIED MAIL ADDRESSED TO THE PRINCIPAL
OFFICE OF THE ESTABLISHED OPERATOR AT THE COMMENCEMENT OF THE  FIRST  OF
EVERY  TWO  ADDITIONAL TERMS.   UPON RECEIPT OF SUCH NOTIFICATION AT THE
PRINCIPAL OFFICE OF THE ESTABLISHED OPERATOR AND BEFORE  THE  EXPIRATION
OF TEN DAYS THEREAFTER, THE ESTABLISHED OPERATOR MAY REQUEST AN ADMINIS-
TRATIVE  HEARING  ON THE DETERMINATION TO BEGIN NO LATER THAN SIXTY DAYS
FROM THE DATE OF THE APPOINTMENT OR REAPPOINTMENT OF THE TEMPORARY OPER-
ATOR. ANY SUCH HEARING SHALL BE STRICTLY LIMITED TO THE ISSUE OF WHETHER
THE DETERMINATION OF THE COMMISSIONER WHICH RESULTED IN THE  APPOINTMENT
OR REAPPOINTMENT IS SUPPORTED BY SUBSTANTIAL EVIDENCE.
  7.  NO  PROVISION CONTAINED IN THIS SECTION SHALL BE DEEMED TO RELIEVE
THE ESTABLISHED OPERATOR OR ANY OTHER PERSON OF ANY  CIVIL  OR  CRIMINAL
LIABILITY  INCURRED,  OR  ANY  DUTY IMPOSED BY LAW, BY REASON OF ACTS OR
OMISSIONS OF THE ESTABLISHED OPERATOR OR ANY OTHER PERSON PRIOR  TO  THE

S. 6256--A                         34                         A. 9056--A

APPOINTMENT  OF  ANY  TEMPORARY  OPERATOR  HEREUNDER; NOR SHALL ANYTHING
CONTAINED IN THIS SECTION BE CONSTRUED TO SUSPEND DURING THE TERM OF THE
APPOINTMENT OF THE TEMPORARY OPERATOR ANY OBLIGATION OF THE  ESTABLISHED
OPERATOR OR ANY OTHER PERSON FOR THE PAYMENT OF TAXES OR OTHER OPERATING
AND MAINTENANCE EXPENSES OF THE FACILITY NOR OF THE ESTABLISHED OPERATOR
OR ANY OTHER PERSON FOR THE PAYMENT OF MORTGAGES OR LIENS.
  S  28.  Section  2  of  chapter  584 of the laws of 2011, amending the
public authorities law, relating to the powers and duties of the  dormi-
tory authority of the state of New York relative to the establishment of
subsidiaries for certain purposes, is amended to read as follows:
  S  2.  This  act shall take effect immediately and shall expire and be
deemed repealed ON July 1, [2012] 2015; provided however, that the expi-
ration of this act shall not impair  or  otherwise  affect  any  of  the
powers,  duties,  responsibilities,  functions, rights or liabilities of
any subsidiary duly  created  pursuant  to  subdivision  twenty-five  of
section 1678 of the public authorities law prior to such expiration.
  S  29.    Subdivision 1 of section 2999-i of the public health law, as
added by section 52 of part H of chapter 59 of  the  laws  of  2011,  is
amended to read as follows:
  1. (A) The commissioner of taxation and finance shall be the custodian
of  the  fund  and  the  special account established pursuant to section
ninety-nine-t of the state finance law. All payments from the fund shall
be made by the commissioner of taxation and  finance  upon  certificates
signed by the superintendent of financial services, or his or her desig-
nee,  as hereinafter provided. The fund shall be separate and apart from
any other fund and from all other state monies; PROVIDED, HOWEVER,  THAT
MONIES OF THE FUND MAY BE INVESTED AS SET FORTH IN PARAGRAPH (B) OF THIS
SUBDIVISION.   No monies from the fund shall be transferred to any other
fund, nor shall any such monies be applied to the making of any  payment
for any purpose other than the purpose set forth in this title.
  (B)  ANY MONIES OF THE FUND NOT REQUIRED FOR IMMEDIATE USE MAY, AT THE
DISCRETION OF THE COMMISSIONER OF  FINANCIAL  SERVICES  IN  CONSULTATION
WITH  THE  COMMISSIONER  OF  HEALTH  AND  THE DIRECTOR OF THE BUDGET, BE
INVESTED BY THE COMMISSIONER OF TAXATION AND FINANCE IN  OBLIGATIONS  OF
THE UNITED STATES OR THE STATE OR OBLIGATIONS THE PRINCIPAL AND INTEREST
OF  WHICH ARE GUARANTEED BY THE UNITED STATES OR THE STATE. THE PROCEEDS
OF ANY SUCH INVESTMENT SHALL BE RETAINED BY THE FUND  AS  ASSETS  TO  BE
USED FOR THE PURPOSES OF THE FUND.
  S  30.  Subdivision  9  of  section  2803  of the public health law is
REPEALED.
  S 31. Paragraph (b) of subdivision 1-a of section 2802 of  the  public
health law, as amended by chapter 174 of the laws of 2011, is amended to
read as follows:
  (b)  repair  or  maintenance,  regardless  of  cost, including routine
purchases and the acquisition  of  minor  equipment  undertaken  in  the
course  of  a  hospital's inventory control functions; PROVIDED THAT FOR
PROJECTS UNDER THIS PARAGRAPH WITH A TOTAL COST OF  UP  TO  SIX  MILLION
DOLLARS, NO WRITTEN NOTICE SHALL BE REQUIRED;
  S  32.   Subdivision 1 of section 1 of chapter 119 of the laws of 1997
relating to authorizing the department of health  to  establish  certain
payments  to  general  hospitals,  as amended by section 1 of part S2 of
chapter 62 of the laws of 2003, is amended to read as follows:
  1. Notwithstanding any inconsistent provision of  law  or  regulation,
effective for the period [April 1, 1997 through March 31, 1998] APRIL 1,
2012  THROUGH DECEMBER 31, 2012 and for annual periods beginning [April]
JANUARY 1 thereafter, the [department] DEPARTMENT of [health] HEALTH  is

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authorized  to  pay voluntary non-profit general hospitals as defined in
subdivision 10 of section 2801  of  the  public  health  law  additional
payments  for inpatient hospital services as medical assistance payments
pursuant to title 11 of article 5 of the social services law and federal
law  and regulations governing disproportionate share payments, based on
the [amount of state aid for which such general hospitals  are  eligible
pursuant  to  articles  25,  26  and 41 of the mental hygiene law and as
identified in subdivision 2 of this section] COSTS INCURRED IN EXCESS OF
REVENUES BY GENERAL HOSPITALS IN PROVIDING SERVICES IN ELIGIBLE PROGRAMS
TO UNINSURED PATIENTS AND  PATIENTS  ELIGIBLE  FOR  MEDICAL  ASSISTANCE.
Payment made pursuant to this section shall not exceed each such general
hospital's cost of providing services to uninsured patients and patients
eligible for medical assistance pursuant to title 11 of article 5 of the
social  services  law  after taking into consideration all other medical
assistance received, including disproportionate share payments  made  to
such  general hospital, and payments from or on behalf of such uninsured
patients, and shall also not exceed the total amount of state aid, iden-
tified by subdivision 2 of  this  section,  available  to  such  general
hospital  by  law.  Payments  made to such general hospitals pursuant to
this section shall be made in lieu of any state aid  payments  available
to such general hospital by law.
  S  33.  Subdivision  1  of section 241 of the elder law, as amended by
section 29 of part A of chapter 58 of the laws of 2008,  is  amended  to
read as follows:
  1.  "Covered  drug"  shall  mean a drug dispensed subject to a legally
authorized prescription pursuant to section sixty-eight hundred  ten  of
the  education  law,  and  insulin,  an  insulin  syringe, or an insulin
needle. Such term shall not include: (a)  any  drug  determined  by  the
commissioner  of the federal food and drug administration to be ineffec-
tive or unsafe; (b) any drug dispensed in a package, or form  of  dosage
or administration, as to which the commissioner of health finally deter-
mines in accordance with the provisions of section two hundred fifty-two
of this title that a less expensive package, or form of dosage or admin-
istration,  is  available that is pharmaceutically equivalent and equiv-
alent in its therapeutic effect for the general  health  characteristics
of  the  eligible program participant population; (c) any device for the
aid or correction of vision; (d) any drug, including vitamins, which  is
generally  available  without  a physician's prescription; and (e) drugs
for the treatment of sexual or erectile dysfunction, unless  such  drugs
are  used  to  treat a condition, other than sexual or erectile dysfunc-
tion, for which the drugs have been approved by  the  federal  food  and
drug  administration; and (f) a brand name drug for which a multi-source
therapeutically and generically equivalent drug, as  determined  by  the
federal  food  and  drug administration, is available, unless previously
authorized by the elderly  pharmaceutical  insurance  coverage  program,
provided,  however,  that the [elderly pharmaceutical insurance coverage
panel] COMMISSIONER is authorized to exempt, for good cause  shown,  any
brand  name  drug  from such restriction, and provided further that such
restriction shall not  apply  to  any  drug  that  is  included  on  the
preferred  drug list under section two hundred seventy-two of the public
health law or is in the clinical drug review program under  section  two
hundred  seventy-four  of  the  public health law to the extent that the
preferred drug program and the clinical drug review program are  applied
to  the  elderly  pharmaceutical  insurance coverage program pursuant to
section two hundred seventy-five of the public health  law,  or  to  any
drug  covered  under  a  program  participant's Medicare part D or other

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primary insurance plan. Any of the drugs  enumerated  in  the  preceding
sentence  shall  be considered a covered drug or a prescription drug for
purposes of this article if it is added to the preferred drug list under
article  two-A of the public health law.  For the purpose of this title,
except as otherwise provided in this section, a covered  drug  shall  be
dispensed  in  quantities  no  greater  than  a thirty day supply or one
hundred units, whichever is greater. In the case of a drug dispensed  in
a  form  of  administration  other than a tablet or capsule, the maximum
allowed quantity shall be a thirty day supply; the [panel]  COMMISSIONER
is  authorized  to  approve  exceptions  to  these  limits  for specific
products following consideration of recommendations from  pharmaceutical
or medical experts regarding commonly packaged quantities, unusual forms
of  administration,  length  of  treatment or cost effectiveness. In the
case of a drug prescribed pursuant to section thirty-three hundred thir-
ty-two of the public health law to treat one of the conditions that have
been enumerated by the commissioner of health pursuant to regulation  as
warranting  the  prescribing  of  greater than a thirty day supply, such
drug shall be dispensed in  quantities  not  to  exceed  a  three  month
supply.
  S  33-a.  Subdivision 1 of section 241 of the elder law, as amended by
section 12 of part B of chapter 57 of the laws of 2006,  is  amended  to
read as follows:
  1.  "Covered  drug"  shall  mean a drug dispensed subject to a legally
authorized prescription pursuant to section sixty-eight hundred  ten  of
the  education  law,  and  insulin,  an  insulin  syringe, or an insulin
needle. Such term shall not include: (a)  any  drug  determined  by  the
commissioner  of the federal food and drug administration to be ineffec-
tive or unsafe; (b) any drug dispensed in a package, or form  of  dosage
or administration, as to which the commissioner of health finally deter-
mines in accordance with the provisions of section two hundred fifty-two
of this title that a less expensive package, or form of dosage or admin-
istration,  is  available that is pharmaceutically equivalent and equiv-
alent in its therapeutic effect for the general  health  characteristics
of  the  eligible program participant population; (c) any device for the
aid or correction of vision, or any drug, including vitamins,  which  is
generally  available  without  a physician's prescription; and (d) drugs
for the treatment of sexual or erectile dysfunction, unless  such  drugs
are  used  to  treat a condition, other than sexual or erectile dysfunc-
tion, for which the drugs have been approved by  the  federal  food  and
drug  administration. For the purpose of this title, except as otherwise
provided in this section, a covered drug shall be dispensed  in  quanti-
ties no greater than a thirty day supply or one hundred units, whichever
is  greater. In the case of a drug dispensed in a form of administration
other than a tablet or capsule, the maximum allowed quantity shall be  a
thirty  day  supply;  the  [panel] COMMISSIONER is authorized to approve
exceptions to these limits for specific products following consideration
of recommendations from  pharmaceutical  or  medical  experts  regarding
commonly packaged quantities, unusual forms of administration, length of
treatment or cost effectiveness. In the case of a drug prescribed pursu-
ant  to section thirty-three hundred thirty-two of the public health law
to treat one of the conditions that have been enumerated by the  commis-
sioner of health pursuant to regulation as warranting the prescribing of
greater  than a thirty day supply, such drug shall be dispensed in quan-
tities not to exceed a three month supply.

S. 6256--A                         37                         A. 9056--A

  S 33-b. Paragraph (f) of subdivision 3 of section  242  of  the  elder
law,  as  amended  by section 3-d of part A of chapter 59 of the laws of
2011, is amended to read as follows:
  (f)  As  a  condition  of eligibility for benefits under this title, a
program participant is required to be enrolled in Medicare part D and to
maintain such enrollment.   FOR UNMARRIED PARTICIPANTS  WITH  INDIVIDUAL
ANNUAL  INCOME  LESS  THAN OR EQUAL TO TWENTY-THREE THOUSAND DOLLARS AND
MARRIED PARTICIPANTS WITH JOINT ANNUAL INCOME  LESS  THAN  OR  EQUAL  TO
TWENTY-NINE  THOUSAND  DOLLARS,  THE  ELDERLY  PHARMACEUTICAL  INSURANCE
COVERAGE PROGRAM SHALL PAY FOR THE PORTION OF THE PART D MONTHLY PREMIUM
THAT IS THE RESPONSIBILITY OF THE PARTICIPANT.  SUCH  PAYMENT  SHALL  BE
LIMITED  TO  THE  LOW-INCOME BENCHMARK PREMIUM AMOUNT ESTABLISHED BY THE
FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES AND ANY OTHER  AMOUNT
WHICH  SUCH  AGENCY  ESTABLISHES  UNDER  ITS  DE MINIMUS PREMIUM POLICY,
EXCEPT THAT SUCH PAYMENTS MADE ON BEHALF OF PARTICIPANTS ENROLLED  IN  A
MEDICARE  ADVANTAGE  PLAN  MAY  EXCEED  THE LOW-INCOME BENCHMARK PREMIUM
AMOUNT IF DETERMINED TO BE COST EFFECTIVE TO THE PROGRAM.
  S 33-c. Paragraph (b) of subdivision 2 of section  243  of  the  elder
law,  as  amended  by section 3-g of part A of chapter 59 of the laws of
2011, is amended to read as follows:
  (b) notifying [each eligible program participant in writing  upon  the
commencement  of  the annual coverage period of such participant's cost-
sharing responsibilities pursuant to section two hundred forty-seven  of
this  title.  The  contractor  shall  also notify] each eligible program
participant of any adjustment of the co-payment schedule by mail no less
than thirty days prior to the effective date  of  such  adjustments  and
shall inform such eligible program participants of the date such adjust-
ments shall take effect;
  S 33-d. Section 245 of the elder law is REPEALED.
  S  33-e.  Subdivision  1  of section 247 of the elder law, as added by
section 3-j of part A of chapter 59 of the laws of 2011, is  amended  to
read as follows:
  1.  As  a  condition  of  eligibility  for  benefits under this title,
participants must [maintain Medicare part D  coverage  and  pay  monthly
premiums  to  their  Medicare  part D drug plan] BE ENROLLED IN MEDICARE
PART D AND MAINTAIN SUCH ENROLLMENT.
  S 33-f. Subdivision 1 of section 249 of the elder law, as  amended  by
section  111  of part C of chapter 58 of the laws of 2009, is amended to
read as follows:
  1. The state shall offer an opportunity to participate in this program
to all provider pharmacies as defined in section two  hundred  forty-one
of  this  title, provided, however, that the participation of pharmacies
registered in the state pursuant to section sixty-eight hundred  eight-b
of the education law shall be limited to state assistance provided under
this  title  for  prescription  drugs covered by a program participant's
medicare [or other] drug plan.
  S 33-g. Subdivisions 1 and 2 of section  253  of  the  elder  law  are
amended to read as follows:
  1.  In  counties  having a population of seventy-five thousand or less
that are in proximity to the state boundary and which are determined  by
the  [executive  director]  COMMISSIONER  OF HEALTH to be not adequately
served by provider pharmacies registered in New  York,  and  in  Fishers
Island in the town of Southold, Suffolk county, the [executive director]
COMMISSIONER  may  approve as provider pharmacies, pharmacies located in
New Jersey, Connecticut, Vermont, Pennsylvania  or  Massachusetts.  Such
approvals  shall  be made after (a) consideration of the convenience and

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necessity of New York residents in the rural areas served by such  phar-
macies,  (b)  consideration of the quality of service of such pharmacies
and the standing of such pharmacies with the governmental board or agen-
cy  of  the  state in which such pharmacy is located, (c) the [executive
director] COMMISSIONER shall give all  licensed  pharmacies  within  the
county  notice  of  his  or  her  intention to approve such out-of-state
provider pharmacies, and (d) the [executive director]  COMMISSIONER  has
held  a  public hearing at which he or she has determined factually that
the licensed pharmacies within such county are not adequately serving as
provider pharmacies.
  2. The [executive director] COMMISSIONER OF HEALTH  shall  investigate
and  determine whether certification shall be granted within ninety days
of the filing of an application for certification by the governing  body
of  any city, town or village, within a county determined by the [execu-
tive director] COMMISSIONER to be  not  adequately  served  by  provider
pharmacies  registered  in  New York pursuant to subdivision one of this
section, claiming to be lacking adequate pharmaceutical service.
  S 34.  Subdivision 25 of section 2808 of the  public  health  law,  as
added  by  section  31  of  part  B  of chapter 109 of the laws of 2010,
subparagraph (iii) of paragraph (b) as amended and subparagraph (iv)  of
paragraph (b) as added by section 69 of part H of chapter 59 of the laws
of 2011, is amended to read as follows:
  25.  Reserved  bed  days.  (a)  For  purposes  of  this subdivision, a
"reserved bed day" is a day for which a governmental agency pays a resi-
dential health care facility to reserve a bed for a person eligible  for
medical  assistance  pursuant  to  title  eleven  of article five of the
social services law while he or she is temporarily  hospitalized  or  on
leave of absence from the facility.
  (b)  Notwithstanding any other provisions of this section or any other
law or regulation to the contrary, for reserved  bed  days  provided  on
behalf of persons twenty-one years of age or older:
  (i)  payments  for  reserved  bed  days  shall  be made at ninety-five
percent of the Medicaid rate  otherwise  payable  to  the  facility  for
services provided on behalf of such person;
  (ii) payment to a facility for reserved bed days provided on behalf of
such  person for temporary hospitalizations may not exceed fourteen days
in any twelve month period;
  (iii) payment to a facility for reserved bed days provided  on  behalf
of  such person for non-hospitalization leaves of absence may not exceed
ten days in any twelve month period[; and
  (iv) payments for reserved bed  days  for  temporary  hospitalizations
shall  only  be  made  to a residential health care facility if at least
fifty percent of the facility's residents eligible to participate  in  a
Medicare managed care plan are enrolled in such a plan].
  (C)(I)  NOTWITHSTANDING  ANY CONTRARY PROVISION OF THIS SUBDIVISION OR
ANY OTHER LAW AND SUBJECT  TO  THE  AVAILABILITY  OF  FEDERAL  FINANCIAL
PARTICIPATION,  FOR  RATE PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND
TWELVE, WITH REGARD TO SERVICES  PROVIDED  TO  RESIDENTIAL  HEALTH  CARE
FACILITY  RESIDENTS  TWENTY-ONE YEARS OF AGE AND OLDER, THE COMMISSIONER
SHALL PROMULGATE REGULATIONS, AND MAY PROMULGATE EMERGENCY  REGULATIONS,
EFFECTIVE  FOR  PERIODS  ON  AND AFTER APRIL FIRST, TWO THOUSAND TWELVE,
ESTABLISHING REIMBURSEMENT RATES FOR RESERVED BED DAYS, PROVIDED, HOWEV-
ER,  THAT  SUCH  REGULATIONS  SHALL  ACHIEVE  AN  AGGREGATE   ANNUALIZED
REDUCTION  IN  REIMBURSEMENT  FOR SUCH RESERVED BED DAYS OF NO LESS THAN
FORTY MILLION DOLLARS, AS DETERMINED BY THE COMMISSIONER.

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  (II) IN THE EVENT THE COMMISSIONER DETERMINES THAT  FEDERAL  FINANCIAL
PARTICIPATION  WILL  NOT BE AVAILABLE FOR RATE ADJUSTMENTS MADE PURSUANT
TO SUBPARAGRAPH (I) OF THIS PARAGRAPH OR REGULATIONS PROMULGATED  THERE-
UNDER,  THEN,  FOR  RATE  PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND
TWELVE,  MEDICAID  RATES  FOR  INPATIENT  SERVICES SHALL NOT INCLUDE ANY
FACTOR OR PAYMENT AMOUNT FOR SUCH RESERVED BED DAYS WITH REGARD TO RESI-
DENTS TWENTY-ONE YEARS OF AGE AND OLDER.
  (III) IN THE EVENT THE PROVISIONS OF SUBPARAGRAPH (II) OF  THIS  PARA-
GRAPH  ARE INVOKED AND IMPLEMENTED BY THE COMMISSIONER, THEN THE COMMIS-
SIONER SHALL PROMULGATE REGULATIONS, AND MAY PROMULGATE EMERGENCY  REGU-
LATIONS,  EFFECTIVE  FOR  RATE  PERIODS  ON  OR  AFTER  APRIL FIRST, TWO
THOUSAND TWELVE, PROVIDING UPWARD REVISIONS  TO  MEDICAID  RATES  ISSUED
PURSUANT  TO  SUBDIVISION TWO-C OF THIS SECTION, PROVIDED, HOWEVER, THAT
SUCH UPWARD REVISIONS SHALL NOT  IN  AGGREGATE,  AS  DETERMINED  BY  THE
COMMISSIONER,  EXCEED,  ON  AN  ANNUAL BASIS, AN AMOUNT EQUAL TO CURRENT
ANNUAL MEDICAID PAYMENTS FOR  RESERVED  BED  DAYS,  LESS  FORTY  MILLION
DOLLARS.
  S  35. Paragraphs (l) and (m) of subdivision 1 of section 367-q of the
social services law, as added by section 22 of part C of chapter  59  of
the laws of 2011, are amended to read as follows:
  (l)  for  the  period  April  first, two thousand twelve through March
thirty-first, two thousand thirteen, UP  TO  twenty-eight  million  five
hundred thousand dollars; and
  (m)  for  the  period April first, two thousand thirteen through March
thirty-first, two thousand fourteen, UP  TO  twenty-eight  million  five
hundred thousand dollars.
  S  35-a.  Clause (K) of subparagraph (i) of paragraph (bb) of subdivi-
sion 1 of section 2807-v of the public health law, as amended by section
8 of part C of chapter 59 of the laws of 2011, is  amended  to  read  as
follows:
  (K)  UP  TO  one  hundred thirty-six million dollars each state fiscal
year for the period April first, two thousand eleven through March thir-
ty-first, two thousand fourteen.
  S 35-b. Subparagraph (xi)  of  paragraph  (cc)  of  subdivision  1  of
section 2807-v of the public health law, as amended by section 8 of part
C of chapter 59 of the laws of 2011, is amended to read as follows:
  (xi)  UP  TO  eleven  million  two hundred thousand dollars each state
fiscal year for the period April  first,  two  thousand  eleven  through
March thirty-first, two thousand fourteen.
  S  35-c.  Subparagraph  (vii)  of  paragraph (ccc) of subdivision 1 of
section 2807-v of the public health law, as amended by section 8 of part
C of chapter 59 of the laws of 2011, is amended to read as follows:
  (vii) UP TO fifty million dollars each state fiscal year for the peri-
od April first, two thousand  eleven  through  March  thirty-first,  two
thousand fourteen.
  S 36.  Paragraph (g-1) of subdivision 2 of section 365-a of the social
services  law,  as  amended by section 23 of part H of chapter 59 of the
laws of 2011, is amended to read as follows:
  (g-1) drugs provided on an in-patient basis, those drugs contained  on
the  list established by regulation of the commissioner of health pursu-
ant to subdivision four of this section, and those drugs which  may  not
be  dispensed  without a prescription as required by section sixty-eight
hundred ten of the education law and which the  commissioner  of  health
shall determine to be reimbursable based upon such factors as the avail-
ability  of  such  drugs  or  alternatives at low cost if purchased by a
medicaid recipient, or the essential nature of such drugs  as  described

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by such commissioner in regulations, provided, however, that such drugs,
exclusive  of long-term maintenance drugs, shall be dispensed in quanti-
ties no greater than a thirty day supply or one hundred doses, whichever
is  greater; provided further that the commissioner of health is author-
ized to require prior authorization for any  refill  of  a  prescription
when  less  than seventy-five percent of the previously dispensed amount
per fill should have been used were the product used as  normally  indi-
cated; provided further that the commissioner of health is authorized to
require  prior  authorization  of  prescriptions of opioid analgesics in
excess of four prescriptions in a thirty-day period in  accordance  with
section  two hundred seventy-three of the public health law, EXCEPT THAT
PRIOR AUTHORIZATION MAY BE DENIED IF THE DEPARTMENT,  AFTER  GIVING  THE
PRESCRIBER  A  REASONABLE OPPORTUNITY TO PRESENT A JUSTIFICATION, DETER-
MINES THAT THE  ADDITIONAL  PRESCRIPTION  IS  NOT  MEDICALLY  NECESSARY;
medical  assistance shall not include any drug provided on other than an
in-patient basis for which a recipient is charged or a claim is made  in
the  case  of a prescription drug, in excess of the maximum reimbursable
amounts to be established by department regulations in  accordance  with
standards  established  by the secretary of the United States department
of health and human services, or, in the case of a drug not requiring  a
prescription,  in  excess of the maximum reimbursable amount established
by the commissioner of health pursuant to paragraph (a)  of  subdivision
four of this section;
  S  37.  Subdivision  6 of section 368-d of the social services law, as
added by section 6 of part H of chapter 59  of  the  laws  of  2011,  is
amended to read as follows:
  6.  The commissioner shall evaluate the results of the study conducted
pursuant to subdivision four of this section to determine,  after  iden-
tification of actual direct and indirect costs incurred by public school
districts  and  state  operated[/] AND state supported schools FOR BLIND
AND DEAF STUDENTS, whether it is advisable to claim  federal  reimburse-
ment  for  expenditures  under this section as certified public expendi-
tures. In the event such claims are submitted, if federal  reimbursement
received  for certified public expenditures on behalf of medical assist-
ance recipients whose assistance and care are the  responsibility  of  a
social  services  district  [in  a  city  with  a population of over two
million,] results in a decrease in the state share  of  annual  expendi-
tures  pursuant  to this section for such recipients, then to the extent
that the amount of any such decrease when combined with any decrease  in
the  state share of annual expenditures described in subdivision five of
section three hundred sixty-eight-e of this title exceeds fifty  million
dollars  IN  STATE  FISCAL  YEAR 2011-12, OR EXCEEDS ONE HUNDRED MILLION
DOLLARS IN STATE FISCAL YEAR 2012-13 OR ANY FISCAL YEAR THEREAFTER,  the
excess  amount  shall  be  transferred  to  such  [city]  PUBLIC  SCHOOL
DISTRICTS AND STATE OPERATED AND STATE SUPPORTED SCHOOLS FOR  BLIND  AND
DEAF  STUDENTS  IN AMOUNTS PROPORTIONAL TO THEIR PERCENTAGE CONTRIBUTION
TO THE STATEWIDE SAVINGS.  Any such excess amount transferred shall  not
be  considered  a  revenue  received by such social services district in
determining the district's actual medical  assistance  expenditures  for
purposes  of  paragraph  (b)  of section one of part C of chapter fifty-
eight of the laws of two thousand five.
  S 38. Subdivision 5 of section 368-e of the social  services  law,  as
added  by  section  7  of  part  H of chapter 59 of the laws of 2011, is
amended to read as follows:
  5. The commissioner shall evaluate the results of the study  conducted
pursuant  to subdivision three of this section to determine, after iden-

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tification of actual direct and indirect costs incurred by counties  for
medical  care,  services,  and supplies furnished to pre-school children
with handicapping conditions, whether it is advisable to  claim  federal
reimbursement  for  expenditures  under this section as certified public
expenditures. In  the  event  such  claims  are  submitted,  if  federal
reimbursement  received  for  certified public expenditures on behalf of
medical assistance recipients whose assistance and care are the  respon-
sibility  of  a social services district [in a city with a population of
over two million], results in a decrease in the state  share  of  annual
expenditures  pursuant  to this section for such recipients, then to the
extent that the amount of any  such  decrease  when  combined  with  any
decrease in the state share of annual expenditures described in subdivi-
sion  six  of  section three hundred sixty-eight-d of this title exceeds
fifty million dollars IN STATE  FISCAL  YEAR  2011-12,  OR  EXCEEDS  ONE
HUNDRED  MILLION DOLLARS IN STATE FISCAL YEAR 2012-13 OR ANY FISCAL YEAR
THEREAFTER, the excess amount shall be transferred to such [city]  COUN-
TIES  IN  AMOUNTS  PROPORTIONAL  TO THEIR PERCENTAGE CONTRIBUTION TO THE
STATEWIDE SAVINGS.   Any such excess amount  transferred  shall  not  be
considered a revenue received by such social services district in deter-
mining   the  district's  actual  medical  assistance  expenditures  for
purposes of paragraph (b) of section one of part  C  of  chapter  fifty-
eight of the laws of two thousand five.
  S  39. Subparagraph (i) of paragraph (a-1) of subdivision 4 of section
365-a of the social services law, as amended by section 46 of part C  of
chapter 58 of the laws of 2009, is amended to read as follows:
  (i)  a  brand  name  drug for which a multi-source therapeutically and
generically equivalent drug, as determined by the federal food and  drug
administration,  is  available,  unless  previously  authorized  by  the
department of health.  The  commissioner  of  health  is  authorized  to
exempt,  for good cause shown, any brand name drug from the restrictions
imposed by this subparagraph[. This subparagraph shall not apply to  any
drug  that is in a therapeutic class included on the preferred drug list
under section two hundred seventy-two of the public health law or is  in
the  clinical drug review program under section two hundred seventy-four
of the public health law];
  S 40.   Subdivision 8 of section 272 of  the  public  health  law,  as
amended  by  section  5 of part B of chapter 109 of the laws of 2010, is
amended to read as follows:
  8. The commissioner shall provide notice of any recommendations devel-
oped by the committee regarding the preferred  drug  program,  at  least
five  days before any final determination by the commissioner, by making
such information available on the  department's  website.  [Such  public
notice shall include: a summary of the deliberations of the committee; a
summary  of the positions of those making public comments at meetings of
the committee; the response of the committee to those comments, if  any;
and the findings and recommendations of the committee.]
  S 41. Paragraphs (e), (f) and (g) of subdivision 1 of section 367-a of
the  social  services  law, paragraph (e) as added by chapter 433 of the
laws of 1997, paragraph (f) as added by section 1 of part E  of  chapter
58 of the laws of 2008, paragraph (g) as added by section 65-a of part H
of chapter 59 of the laws of 2011, are amended to read as follows:
  (e)  Amounts  payable  under  this title for medical assistance in the
form of clinic services pursuant to article twenty-eight of  the  public
health  law  and  article  sixteen of the mental hygiene law provided to
eligible persons DIAGNOSED WITH A DEVELOPMENTAL DISABILITY who are  also
beneficiaries  under  part  [b]  B of title [xviii] XVIII of the federal

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social security act [and who are also], OR PROVIDED TO PERSONS diagnosed
with a DEVELOPMENTAL disability WHO ARE QUALIFIED MEDICARE BENEFICIARIES
UNDER PART B OF TITLE XVIII OF SUCH ACT  shall  not  be  less  than  the
approved  medical assistance payment level less the amount payable under
part [b] B.
  (f) Amounts payable under this title for  medical  assistance  in  the
form  of  outpatient  mental health services under article thirty-one of
the mental hygiene law provided to eligible persons who are also benefi-
ciaries under part B of title XVIII of the federal social  security  act
OR  PROVIDED  TO  QUALIFIED MEDICARE BENEFICIARIES UNDER PART B OF TITLE
XVIII OF SUCH ACT shall not be less than the approved medical assistance
payment level less the amount payable under part B.
  (g) Notwithstanding any provision of this  section  to  the  contrary,
amounts  payable  under this title for medical assistance in the form of
hospital outpatient services or diagnostic and treatment center services
pursuant to article twenty-eight of the public health  law  provided  to
eligible  persons who are also beneficiaries under part B of title XVIII
of the federal social security act OR  PROVIDED  TO  QUALIFIED  MEDICARE
BENEFICIARIES  UNDER  PART B OF TITLE XVIII OF SUCH ACT shall not exceed
the approved medical assistance payment level less  the  amount  payable
under part B.
  S 42. Subdivision 6 of section 2818 of the public health law, as added
by  section 25-a of part A of chapter 59 of the laws of 2011, is amended
to read as follows:
  6. Notwithstanding any contrary provision of  this  section,  sections
one hundred twelve and one hundred sixty-three of the state finance law,
or  any  other contrary provision of law, subject to available appropri-
ations, funds available for expenditure pursuant to this section may  be
distributed by the commissioner without a competitive bid or request for
proposal  process for grants to general hospitals, DIAGNOSTIC AND TREAT-
MENT CENTERS, and residential health care facilities for the purpose  of
facilitating  closures,  mergers and restructuring of such facilities in
order to strengthen and protect continued  access  to  essential  health
care resources. Prior to an [awarded] AWARD being granted to an eligible
applicant without a competitive bid or request for proposal process, the
commissioner shall notify the chair of the senate finance committee, the
chair  of  the assembly ways and means committee and the director of the
division of budget of the intent to grant such  an  award.  Such  notice
shall  include  information  regarding  how the eligible applicant meets
criteria established pursuant to this section.
  S 43. Paragraph (a) of subdivision 8-a of section 2807-j of the public
health law, as amended by section 16 of part D of chapter 57 of the laws
of 2006, is amended to read as follows:
  (a) Payments and reports submitted or required to be submitted to  the
commissioner  or to the commissioner's designee pursuant to this section
and section twenty-eight hundred seven-s of this article  by  designated
providers  of  services  and by third-party payors which have elected to
make payments directly to the  commissioner  or  to  the  commissioner's
designee in accordance with subdivision five-a of this section, shall be
subject to audit by the commissioner for a period of six years following
the  close  of  the calendar year in which such payments and reports are
due, after which such payments shall be deemed final and not subject  to
further  adjustment  or reconciliation, INCLUDING THROUGH OFFSET ADJUST-
MENTS OR RECONCILIATIONS MADE BY DESIGNATED PROVIDERS OF SERVICES OR  BY
THIRD-PARTY  PAYORS WITH REGARD TO SUBSEQUENT PAYMENTS, provided, howev-
er, that nothing herein shall be construed as precluding the commission-

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er from pursuing collection of any such payments which are identified as
delinquent within such six year  period,  or  which  are  identified  as
delinquent  as a result of an audit commenced within such six year peri-
od, or from conducting an audit of any adjustment or reconciliation made
by a designated provider of services or by a third party payor which has
elected  to  make  such  payments  directly  to  the commissioner or the
commissioner's designee, OR FROM CONDUCTING AN AUDIT  OF  PAYMENTS  MADE
PRIOR  TO  SUCH  SIX  YEAR  PERIOD WHICH ARE FOUND TO BE COMMINGLED WITH
PAYMENTS WHICH ARE OTHERWISE SUBJECT TO TIMELY AUDIT  PURSUANT  TO  THIS
SECTION.
  S 44.  Paragraph (a) of subdivision 10 of section 2807-t of the public
health law, as amended by section 17 of part D of chapter 57 of the laws
of 2006, is amended to read as follows:
  (a)  Payments and reports submitted or required to be submitted to the
commissioner or to the commissioner's designee pursuant to this  section
by specified third-party payors shall be subject to audit by the commis-
sioner  for  a  period  of six years following the close of the calendar
year in which such payments  and  reports  are  due,  after  which  such
payments  shall be deemed final and not subject to further adjustment or
reconciliation, INCLUDING THROUGH OFFSET ADJUSTMENTS OR  RECONCILIATIONS
MADE  BY  SUCH  SPECIFIED  THIRD-PARTY  PAYORS WITH REGARD TO SUBSEQUENT
PAYMENTS, provided, however, that nothing herein shall be  construed  as
precluding  the  commissioner  from  pursuing  collection  of  any  such
payments which are identified as delinquent within such six year period,
or which are identified as delinquent as a result of an audit  commenced
within  such six year period, or from conducting an audit of any adjust-
ments and reconciliation made by a specified third  party  payor  within
such six year period, OR FROM CONDUCTING AN AUDIT OF PAYMENTS MADE PRIOR
TO  SUCH  SIX YEAR PERIOD WHICH ARE FOUND TO BE COMMINGLED WITH PAYMENTS
WHICH ARE OTHERWISE SUBJECT TO TIMELY AUDIT PURSUANT TO THIS SECTION.
  S 45. Subdivision 7 of section 2807-d of  the  public  health  law  is
amended by adding a new paragraph (f) to read as follows:
  (F)  PAYMENTS AND REPORTS SUBMITTED OR REQUIRED TO BE SUBMITTED TO THE
COMMISSIONER OR TO THE COMMISSIONER'S DESIGNEE PURSUANT TO THIS  SECTION
SHALL  BE SUBJECT TO AUDIT BY THE COMMISSIONER FOR A PERIOD OF SIX YEARS
FOLLOWING THE CLOSE OF THE CALENDAR YEAR  IN  WHICH  SUCH  PAYMENTS  AND
REPORTS ARE DUE, AFTER WHICH SUCH PAYMENTS SHALL BE DEEMED FINAL AND NOT
SUBJECT  TO  FURTHER  ADJUSTMENT  OR  RECONCILIATION,  INCLUDING THROUGH
OFFSET ADJUSTMENTS OR RECONCILIATIONS MADE TO SUBSEQUENT  PAYMENTS  MADE
PURSUANT  TO  THIS SECTION, PROVIDED, HOWEVER, THAT NOTHING HEREIN SHALL
BE CONSTRUED AS PRECLUDING THE COMMISSIONER FROM PURSUING COLLECTION  OF
ANY  SUCH  PAYMENTS  WHICH  ARE IDENTIFIED AS DELINQUENT WITHIN SUCH SIX
YEAR PERIOD, OR WHICH ARE IDENTIFIED AS DELINQUENT AS  A  RESULT  OF  AN
AUDIT COMMENCED WITHIN SUCH SIX YEAR PERIOD, OR FROM CONDUCTING AN AUDIT
OF ANY ADJUSTMENT OR RECONCILIATION MADE BY A HOSPITAL.
  S 46.  Paragraph (f) of subdivision 18 of section 2807-c of the public
health law, as amended by section 15 of part D of chapter 57 of the laws
of 2006, is amended to read as follows:
  (f) Payments of assessments and allowances required to be submitted by
general hospitals pursuant to this subdivision and subdivisions fourteen
and  fourteen-b  of this section and paragraph (a) of subdivision two of
section twenty-eight hundred seven-d of this article shall be subject to
audit by the commissioner for a period of six years following the  close
of  the  calendar  year in which such payments are due, after which such
payments shall be deemed final and not subject to further adjustment  or
reconciliation,  INCLUDING THROUGH OFFSET ADJUSTMENTS OR RECONCILIATIONS

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MADE BY GENERAL HOSPITALS WITH REGARD TO SUBSEQUENT PAYMENTS,  provided,
however,  that  nothing  herein  shall  be  construed  as precluding the
commissioner from pursuing collection of any such assessments and allow-
ances which are identified as delinquent within such six year period, or
which  are  identified  as  delinquent as a result of an audit commenced
within such six year audit period, or from conducting an  audit  of  any
adjustment  or reconciliation made by a general hospital within such six
year period, OR FROM CONDUCTING AN AUDIT OF PAYMENTS MADE PRIOR TO  SUCH
SIX YEAR PERIOD WHICH ARE FOUND TO BE COMMINGLED WITH PAYMENTS WHICH ARE
OTHERWISE  SUBJECT  TO  TIMELY  AUDIT  PURSUANT TO THIS SECTION. General
hospitals which, in the course of such an audit, fail to produce data or
documentation requested in furtherance of such an audit,  within  thirty
days  of such request may be assessed a civil penalty of up to ten thou-
sand dollars for each such failure, provided, however, that  such  civil
penalty shall not be imposed if the hospital demonstrates good cause for
such  failure.   The imposition of such civil penalties shall be subject
to the provisions of section twelve-a of this chapter.
  S 47.  Paragraph (e) of subdivision 2-a of section 2807 of the  public
health  law  is  amended  by  adding a new subparagraph (iii) to read as
follows:
  (III) REGULATIONS ISSUED PURSUANT TO THIS  PARAGRAPH  MAY  INCORPORATE
QUALITY  RELATED MEASURES LIMITING OR EXCLUDING REIMBURSEMENT RELATED TO
POTENTIALLY PREVENTABLE CONDITIONS AND COMPLICATIONS.
  S 48.  Paragraph (c) of subdivision 7 of section 2807-d of the  public
health  law,  as added by chapter 938 of the laws of 1990, is amended to
read as follows:
  (c) The reports shall be in such form as  may  be  prescribed  by  the
commissioner  to  accurately  disclose information required to implement
this section, PROVIDED, HOWEVER, THAT FOR  PERIODS  ON  AND  AFTER  JULY
FIRST,  TWO  THOUSAND  TWELVE,  SUCH  REPORTS AND ANY ASSOCIATED CERTIF-
ICATIONS SHALL BE SUBMITTED ELECTRONICALLY IN A FORM AS MAY BE  REQUIRED
BY THE COMMISSIONER.
  S  48-a. Subparagraph (i) of paragraph (a) of subdivision 7 of section
2807-j of the public health law, as amended by section 36 of part  B  of
chapter 58 of the laws of 2008, is amended to read as follows;
  (i)  Every designated provider of services shall submit reports of net
patient service revenues received for or on account of patient  services
for  each  month which shall be in such form as may be prescribed by the
commissioner to accurately disclose information  required  to  implement
this section. For periods on and after January first, two thousand five,
reports by designated providers of services shall be submitted electron-
ically  in  a  form  as  may  be required by the commissioner; provided,
however, any designated provider of  services  is  not  prohibited  from
submitting  reports  electronically  on  a voluntary basis prior to such
date,  AND  PROVIDED  FURTHER,  HOWEVER,  THAT   ALL   SUCH   ELECTRONIC
SUBMISSIONS SUBMITTED ON AND AFTER JULY FIRST, TWO THOUSAND TWELVE SHALL
BE  VERIFIED  WITH  AN ELECTRONIC SIGNATURE AS PRESCRIBED BY THE COMMIS-
SIONER.
  S 48-b. Subparagraph (ii) of paragraph (b) of subdivision 7 of section
2807-j of the public health law, as amended by section 25 of part A3  of
chapter 62 of the laws of 2003, is amended to read as follows:
  (ii)  For  periods on and after July first, two thousand four, reports
submitted on a monthly basis by third-party payors  in  accordance  with
subparagraph (i) of this paragraph and reports submitted on a monthly or
annual  basis by payors acting in an administrative services capacity on
behalf of electing third-party payors in  accordance  with  subparagraph

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(i)  of  this paragraph shall be made electronically in a form as may be
required by the commissioner; provided, however, any third-party  payor,
except payors acting in an administrative services capacity on behalf of
electing third-party payors, which, on or after January first, two thou-
sand  four,  elects to make payments directly to the commissioner or the
commissioner's designee pursuant to subdivision five  of  this  section,
shall  be  subject to this subparagraph only after one full year of pool
payment experience which results in reports being submitted on a monthly
basis,  AND  PROVIDED  FURTHER,  HOWEVER,  THAT  ALL   SUCH   ELECTRONIC
SUBMISSIONS SUBMITTED ON AND AFTER JULY FIRST, TWO THOUSAND TWELVE SHALL
BE  VERIFIED  WITH  AN ELECTRONIC SIGNATURE AS PRESCRIBED BY THE COMMIS-
SIONER.   This subparagraph shall not be  interpreted  to  prohibit  any
third-party  payor from submitting reports electronically on a voluntary
basis.
  S 48-c. Subparagraph (ii)  of  paragraph  (b)  of  subdivision  20  of
section  2807-c of the public health law, as added by section 26 of part
A3 of chapter 62 of the laws of 2003, is amended to read as follows:
  (ii) For periods on  and  after  January  first,  two  thousand  five,
reports  submitted  by general hospitals to implement the assessment set
forth in subdivision eighteen of this section shall be  submitted  elec-
tronically  in  a form as may be required by the commissioner; provided,
however, general hospitals are not prohibited  from  submitting  reports
electronically  on  a  voluntary  basis prior to such date, AND PROVIDED
FURTHER, HOWEVER, THAT ALL SUCH ELECTRONIC SUBMISSIONS SUBMITTED ON  AND
AFTER  JULY  FIRST,  TWO THOUSAND TWELVE SHALL BE VERIFIED WITH AN ELEC-
TRONIC SIGNATURE AS PRESCRIBED BY THE COMMISSIONER.
  S 49.  Subdivision 8 of section 3605 of  the  public  health  law,  as
added by chapter 959 of the laws of 1984, is amended to read as follows:
  8. Agencies licensed pursuant to this section but not certified pursu-
ant  to  section three thousand six hundred eight of this article, shall
not be qualified to participate  as  a  home  health  agency  under  the
provisions  of  title  XVIII  or  XIX of the federal Social Security Act
provided, however, an agency which has a contract with a state agency or
its locally designated office OR, AS SPECIFIED BY THE COMMISSIONER, WITH
A MANAGED CARE ORGANIZATION PARTICIPATING IN THE  MANAGED  CARE  PROGRAM
ESTABLISHED PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL
SERVICES  LAW OR WITH A MANAGED LONG TERM CARE PLAN ESTABLISHED PURSUANT
TO SECTION FORTY-FOUR HUNDRED  THREE-F  OF  THIS  CHAPTER,  may  receive
reimbursement under title XIX of the federal Social Security Act.
  S  50.  Subdivision  6  of section 365-f of the social services law is
renumbered subdivision 7 and a new subdivision 6 is  added  to  read  as
follows:
  6.  NOTWITHSTANDING  ANY INCONSISTENT PROVISION OF THIS SECTION OR ANY
OTHER CONTRARY PROVISION  OF  LAW,  MANAGED  CARE  PROGRAMS  ESTABLISHED
PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE AND MANAGED
LONG  TERM  CARE  PLANS  AND  OTHER CARE COORDINATION MODELS ESTABLISHED
PURSUANT TO SECTION FOUR THOUSAND FOUR HUNDRED  THREE-F  OF  THE  PUBLIC
HEALTH LAW SHALL OFFER CONSUMER DIRECTED PERSONAL ASSISTANCE PROGRAMS TO
ENROLLEES.
  S  51.  Subparagraph (ii) of paragraph (e) of subdivision 4 of section
364-j of the social services law, as amended by section 14 of part C  of
chapter 58 of the laws of 2004, is amended to read as follows:
  (ii) In any social services district which has implemented a mandatory
managed  care program pursuant to this section, the requirements of this
subparagraph shall apply to the extent consistent with federal  law  and
regulations.  The  department  of  health, may contract with one or more

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independent organizations to provide enrollment counseling  and  enroll-
ment  services,  for  participants  required  to  enroll in managed care
programs, for each social services district [requesting the services  of
an  enrollment  broker]  WHICH  HAS IMPLEMENTED A MANDATORY MANAGED CARE
PROGRAM. To select such organizations, the department  of  health  shall
issue  a request for proposals (RFP), shall evaluate proposals submitted
in response to such RFP  and,  pursuant  to  such  RFP,  shall  award  a
contract  to  one  or  more qualified and responsive organizations. Such
organizations shall not be owned, operated, or controlled by any govern-
mental agency, managed care provider, comprehensive  HIV  special  needs
plan, mental health special needs plan, or medical services provider.
  S  52.  Paragraph (b) of subdivision 1 of section 4403-f of the public
health law is REPEALED and paragraphs (c)  and  (d),  paragraph  (c)  as
relettered by section 7 of part C of chapter 58 of the laws of 2007, are
relettered paragraphs (b) and (c).
  S 53.  The opening paragraph of subdivision 2 of section 4403-f of the
public  health  law,  as amended by section 8 of part C of chapter 58 of
the laws of 2007, is amended to read as follows:
  An [eligible] applicant shall submit an application for a  certificate
of  authority  to  operate  a  managed  long  term  care plan upon forms
prescribed by the commissioner. Such [eligible] applicant  shall  submit
information  and  documentation to the commissioner which shall include,
but not be limited to:
  S 54.  Paragraph (b) of subdivision 4 of section 4403-f of the  public
health law, as added by section 5 of part C of chapter 58 of the laws of
2010, is amended to read as follows:
  (b)  Standards  established  pursuant  to  this  subdivision  shall be
adequate to protect the interests of enrollees in managed long term care
plans.  The commissioner shall be satisfied that the  [eligible]  appli-
cant  is  financially sound, and has made adequate provisions to pay for
services.
  S 55.  Paragraph (c) of subdivision 6 of section 4403-f of the  public
health  law,  as  amended by section 41-b of part H of chapter 59 of the
laws of 2011, is amended to read as follows:
  (c) For the period beginning April  first,  two  thousand  twelve  and
ending  March thirty-first, two thousand fifteen, the majority leader of
the senate and the speaker of the assembly may  each  recommend  to  the
commissioner, in writing, up to four [eligible] applicants to convert to
be  approved  managed  long  term care plans. An applicant shall only be
approved and issued a  certificate  of  authority  if  the  commissioner
determines  that  the  applicant  meets  the requirements of subdivision
three of this section. The majority leader of the senate or the  speaker
of  the  assembly  may  assign  their authority to recommend one or more
applicants under this section to the commissioner.
  S 56.  Paragraph (a) of subdivision 3 of section  366  of  the  social
services  law, as amended by chapter 110 of the laws of 1971, is amended
to read as follows:
  (a) Medical assistance shall  be  furnished  to  applicants  in  cases
where,  although  such  applicant has a responsible relative with suffi-
cient income and resources to provide medical assistance  as  determined
by  the  regulations  of the department, the income and resources of the
responsible relative are not available to such applicant because of  the
absence  of such relative [or] AND the refusal or failure of such ABSENT
relative to provide the necessary care and assistance.   In such  cases,
however,  the  furnishing  of  such  assistance  shall create an implied
contract with such relative, and the cost thereof may be recovered  from

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such  relative  in  accordance  with  title six of article three OF THIS
CHAPTER and other applicable provisions of law.
  S  57. Subdivision 1 of section 92 of 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 funds Medicaid expenditures, is
amended to read as follows:
  1. For state fiscal years 2011-12 [and 2012-13] THROUGH  2013-14,  the
director  of the budget, in consultation with the commissioner of health
referenced as "commissioner" for purposes of this section, shall  assess
on a monthly basis, as reflected in monthly reports pursuant to subdivi-
sion five of this section known and projected department of health state
funds  medicaid  expenditures  by  category of service and by geographic
regions, as defined by the commissioner, and  if  the  director  of  the
budget  determines that such expenditures are expected to cause medicaid
disbursements for such period to  exceed  the  projected  department  of
health  medicaid  state funds disbursements in the enacted budget finan-
cial plan pursuant to subdivision 3 of section 23 of the  state  finance
law,  the  commissioner  of health, in consultation with the director of
the budget, shall develop a medicaid savings allocation  plan  to  limit
such  spending  to  the  aggregate  limit level specified in the enacted
budget financial  plan,  provided,  however,  such  projections  may  be
adjusted by the director of the budget to account for any changes in the
New  York state federal medical assistance percentage amount established
pursuant to the federal social security act, changes in provider  reven-
ues,  REDUCTIONS  TO  LOCAL  SOCIAL SERVICES DISTRICT MEDICAL ASSISTANCE
ADMINISTRATION, and beginning April 1, 2012 the operational costs of the
New York state medical indemnity fund.
  S 58.  Paragraph (b) of section 90 of part H of chapter 59 of the laws
of 2011, amending the public health law and other laws relating to types
of appropriations exempt from certain reductions, is amended to read  as
follows:
  (b)  The  following  types  of  appropriations  shall  be  exempt from
reductions pursuant to this section:
  (i) any reductions that would violate federal law including,  but  not
limited to, payments required pursuant to the federal Medicare program;
  (ii)  any reductions related to payments pursuant to article 32, arti-
cle 31 and article 16 of the mental hygiene law;
  (iii) payments the state is obligated to make pursuant to court orders
or judgments;
  (iv) payments for which the non-federal share  does  not  reflect  any
state funding; [and]
  (v)  at  the discretion of the commissioner of health and the director
of the budget, payments with regard to which it  is  determined  by  the
commissioner  of  health and the director of the budget that application
of reductions pursuant to this section would  result,  by  operation  of
federal law, in a lower federal medical assistance percentage applicable
to such payments; AND
  (VI)  PAYMENTS  MADE  WITH  REGARD  TO  THE EARLY INTERVENTION PROGRAM
PURSUANT TO SECTION 2540 OF THE PUBLIC HEALTH LAW.
  S 59. Subparagraph (ii) of paragraph (a) of subdivision 5  of  section
2807-j of the public health law, as amended by section 23 of part A-3 of
chapter 62 of the laws of 2003, is amended to read as follows:
  (ii) An election shall remain in effect unless revoked in writing by a
specified  third-party payor, which revocation shall be effective on the
first day of the next [calendar year quarter] MONTH, provided that  such

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payor  has provided notice of its intention to so revoke at least [thir-
ty] TWENTY days prior to the beginning of such [calendar quarter] MONTH.
  S 60. Paragraph (b) of subdivision 5-a of section 2807-m of the public
health law is amended by adding a new clause (H) to read as follows:
  (H)  NOTWITHSTANDING  ANY  INCONSISTENT PROVISION OF THIS SUBDIVISION,
FOR PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND THIRTEEN, ECRIP GRANT
AWARDS SHALL BE MADE IN ACCORDANCE WITH RULES AND REGULATIONS PROMULGAT-
ED BY THE COMMISSIONER.
  S 61. Section 1 of part C of chapter 58 of the laws of 2005,  relating
to  authorizing  reimbursements for expenditures made by or on behalf of
social services districts for medical assistance for needy  persons  and
the  administration  thereof, is amended by adding a new subdivision (h)
to read as follows:
  (H) NOTWITHSTANDING THE PROVISIONS OF  SECTION  368-A  OF  THE  SOCIAL
SERVICES  LAW  OR  ANY OTHER CONTRARY PROVISION OF LAW, NO REIMBURSEMENT
SHALL BE MADE FOR SOCIAL SERVICES DISTRICTS'  CLAIMS  SUBMITTED  ON  AND
AFTER  THE  EFFECTIVE  DATE OF THIS PARAGRAPH, FOR DISTRICT EXPENDITURES
INCURRED PRIOR TO JANUARY  1,  2006,  INCLUDING,  BUT  NOT  LIMITED  TO,
EXPENDITURES  FOR SERVICES PROVIDED TO INDIVIDUALS WHO WERE ELIGIBLE FOR
MEDICAL ASSISTANCE PURSUANT TO SECTION THREE HUNDRED  SIXTY-SIX  OF  THE
SOCIAL  SERVICES  LAW  AS  A  RESULT  OF  A  MENTAL DISABILITY, FORMERLY
REFERRED TO AS HUMAN SERVICES OVERBURDEN AID TO COUNTIES.
  S 62.   Notwithstanding any inconsistent provision  of  law,  rule  or
regulation,  for  purposes  of implementing the provisions of the public
health law and the social services law, references to titles XIX and XXI
of the federal social security act in the  public  health  law  and  the
social  services  law  shall  be  deemed to include and also to mean any
successor titles thereto under the federal social security act.
  S 63. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988,  and
18  NYCRR  505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended  and  without
force or effect for purposes of implementing the provisions of this act.
  S 64.  Severability clause. If any clause, sentence, paragraph, subdi-
vision,  section  or  part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation  to  the  clause, sentence, paragraph, subdivision, section or
part thereof directly involved in the controversy in which such judgment
shall have been rendered. It is hereby declared to be the intent of  the
legislature  that  this act would have been enacted even if such invalid
provisions had not been included herein.
  S 65. This act shall take effect immediately, and shall be  deemed  to
have been in full force and effect on and after April 1, 2012, provided,
however, that:
  (a)  the  commissioner  of health may promulgate emergency regulations
necessary to effectuate the provisions of sections two, three  and  four
of this act; and
  (a-1)  provided,  further, that the amendments to section 1 of chapter
119 of the laws of 1997 made by section thirty-two of this act, relating
to authorizing the department of health to establish certain payments to
general hospitals, shall be subject to the expiration  of  such  chapter
and shall be deemed expired therewith;
  (a-2)  provided,  further,  that  the  amendments  to subdivision 1 of
section 241 of the elder law made by section thirty-three  of  this  act

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shall  be  subject  to  the expiration and reversion of such subdivision
pursuant to section 79 of part C of chapter 58 of the laws of  2005,  as
amended, when upon such date the provisions of section thirty-three-a of
this act shall take effect;
  (b)  the  amendments  to  paragraph  (a-1) of subdivision 4 of section
365-a of the social services law made by section thirty-nine of this act
shall not affect the expiration and  reversion  of  such  paragraph  and
shall be deemed to expire therewith;
  (c)  provided,  further,  that  the  amendments  to section 272 of the
public health law made by section forty of this act shall not affect the
repeal of such section and shall be deemed repealed therewith;
  (d) provided, further, that the amendments to section  2807-j  of  the
public  health  law  made by sections forty-three, forty-eight-a, forty-
eight-b and fifty-nine of this act shall not affect  the  expiration  of
such section and shall be deemed to expire therewith;
  (e)  provided,  further,  that the amendments to section 2807-t of the
public health law made by section  forty-four  of  this  act  shall  not
affect  the  expiration  of  such  section and shall be deemed to expire
therewith;
  (f) provided, further, that the amendments to section  4403-f  of  the
public  health  law, made by sections fifty-two, fifty-three, fifty-four
and fifty-five of this act shall not affect the repeal of  such  section
and shall be deemed to repeal therewith;
  (g)  provided,  further,  that  the amendments to subparagraph (ii) of
paragraph (e) of subdivision 4 of section 364-j of the  social  services
law made by section fifty-one of this act shall not affect the repeal of
such section and shall be deemed repealed therewith;
  (h)  provided,  further,  that sections ten, eleven, twelve, thirteen,
fourteen, fifteen, sixteen, seventeen and eighteen  of  this  act  shall
take effect April 1, 2013;
  (i)  provided,  further,  that  any  rules or regulations necessary to
implement the provisions of this act may be promulgated and  any  proce-
dures,  forms,  or instructions necessary for such implementation may be
adopted and issued on or after the date this act  shall  have  become  a
law;
  (j)  provided, further, that this act shall not be construed to alter,
change, affect, impair or defeat  any  rights,  obligations,  duties  or
interests  accrued, incurred or conferred prior to the effective date of
this act;
  (k) provided, further, that the commissioner of health and the  super-
intendent of financial services and any appropriate council may take any
steps necessary to implement this act prior to its effective date;
  (k-1)  provided,  further,  that the amendments to section 2802 of the
public health law made by section thirty-one  of  this  act  shall  take
effect  on  the same date and in the same manner as section 1 of chapter
174 of the laws of 2011 takes effect, whichever is later;
  (l) provided, further, that notwithstanding any inconsistent provision
of the state administrative procedure act or any other provision of law,
rule or regulation, the commissioner of health and the superintendent of
financial services and any appropriate council is authorized to adopt or
amend or promulgate on an emergency basis any regulation he  or  she  or
such council determines necessary to implement any provision of this act
on its effective date; and
  (m)  provided,  further,  that the provisions of this act shall become
effective notwithstanding the failure of the commissioner of  health  or

S. 6256--A                         50                         A. 9056--A

the  superintendent  of  financial  services  or any council to adopt or
amend or promulgate regulations implementing this act.

                                 PART E

  Section  1.  This act shall be known and may be cited as the "New York
Health Benefit Exchange Act".
  S 2. The public authorities law is amended by  adding  a  new  article
10-E to read as follows:
                               ARTICLE 10-E
                    NEW YORK HEALTH BENEFIT EXCHANGE
SECTION 3980. STATEMENT OF POLICY AND PURPOSES.
        3981. DEFINITIONS.
        3982. ESTABLISHMENT OF THE NEW YORK HEALTH BENEFIT EXCHANGE.
        3983. GENERAL POWERS OF THE EXCHANGE.
        3984. FUNCTIONS OF THE EXCHANGE.
        3985. SPECIAL  FUNCTIONS  OF THE EXCHANGE RELATED TO HEALTH PLAN
                 CERTIFICATION AND QUALIFIED HEALTH PLAN OVERSIGHT.
        3986. REGIONAL ADVISORY COMMITTEES.
        3987. FUNDING OF THE EXCHANGE.
        3988. STUDIES AND RECOMMENDATIONS.
        3989. TAX EXEMPTION AND TAX CONTRACT BY THE STATE.
        3990. OFFICERS AND EMPLOYEES.
        3991. LIMITATION OF LIABILITY; INDEMNIFICATION.
        3992. CONTINGENCY FOR FEDERAL FUNDING.
        3993. CONSTRUCTION.
  S 3980. STATEMENT OF POLICY AND PURPOSES. THE PURPOSE OF THIS  ARTICLE
IS  TO  ESTABLISH  AN  AMERICAN  HEALTH BENEFIT EXCHANGE IN NEW YORK, IN
CONFORMANCE WITH THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT,
PUBLIC LAW 111-148, AS AMENDED BY THE HEALTH CARE AND  EDUCATION  RECON-
CILIATION  ACT  OF 2010, PUBLIC LAW 111-152.  THE EXCHANGE SHALL FACILI-
TATE ENROLLMENT IN HEALTH COVERAGE, THE PURCHASE AND SALE  OF  QUALIFIED
HEALTH PLANS IN THE INDIVIDUAL MARKET IN THIS STATE, AND ENROLL INDIVID-
UALS  IN  HEALTH COVERAGE FOR WHICH THEY ARE ELIGIBLE IN ACCORDANCE WITH
FEDERAL LAW. THE EXCHANGE ALSO SHALL INCORPORATE A SMALL BUSINESS HEALTH
OPTIONS PROGRAM ("SHOP") TO ASSIST QUALIFIED EMPLOYERS  IN  FACILITATING
THE  ENROLLMENT  OF THEIR EMPLOYEES IN QUALIFIED HEALTH PLANS OFFERED IN
THE GROUP MARKET.   IT IS THE INTENT OF  THE  LEGISLATURE,  THROUGH  THE
ESTABLISHMENT  OF THE EXCHANGE, TO PROMOTE QUALITY AND AFFORDABLE HEALTH
COVERAGE AND CARE, REDUCE THE NUMBER OF  UNINSURED  PERSONS,  PROVIDE  A
TRANSPARENT  MARKETPLACE,  EDUCATE CONSUMERS AND ASSIST INDIVIDUALS WITH
ACCESS TO COVERAGE, PREMIUM  ASSISTANCE  TAX  CREDITS  AND  COST-SHARING
REDUCTIONS.
  S 3981. DEFINITIONS. FOR PURPOSES OF THIS ARTICLE, THE FOLLOWING DEFI-
NITIONS SHALL APPLY:
  1. "BOARD" OR "BOARD OF DIRECTORS" MEANS THE BOARD OF DIRECTORS OF THE
EXCHANGE.
  2.  "REGIONAL  ADVISORY  COMMITTEES" MEANS THE NEW YORK HEALTH BENEFIT
EXCHANGE REGIONAL ADVISORY COMMITTEES ESTABLISHED PURSUANT TO THIS ARTI-
CLE.
  3. "COMMISSIONER" MEANS THE COMMISSIONER OF HEALTH.
  4. "EXCHANGE" MEANS THE NEW YORK HEALTH BENEFIT  EXCHANGE  ESTABLISHED
PURSUANT TO THIS ARTICLE.
  5. "FEDERAL ACT" MEANS THE PATIENT PROTECTION AND AFFORDABLE CARE ACT,
PUBLIC  LAW  111-148, AS AMENDED BY THE HEALTH CARE AND EDUCATION RECON-

S. 6256--A                         51                         A. 9056--A

CILIATION ACT OF 2010, PUBLIC LAW 111-152, AND ANY REGULATIONS OR  GUID-
ANCE ISSUED THEREUNDER.
  6.  "HEALTH  PLAN" MEANS A POLICY, CONTRACT OR CERTIFICATE, OFFERED OR
ISSUED BY AN INSURER TO PROVIDE, DELIVER, ARRANGE FOR, PAY FOR OR  REIM-
BURSE  ANY  OF  THE COSTS OF HEALTH CARE SERVICES. HEALTH PLAN SHALL NOT
INCLUDE THE FOLLOWING:
  (A) ACCIDENT INSURANCE OR DISABILITY INCOME INSURANCE, OR ANY COMBINA-
TION THEREOF;
  (B) COVERAGE ISSUED AS A SUPPLEMENT TO LIABILITY INSURANCE;
  (C) LIABILITY INSURANCE, INCLUDING  GENERAL  LIABILITY  INSURANCE  AND
AUTOMOBILE LIABILITY INSURANCE;
  (D) WORKERS' COMPENSATION OR SIMILAR INSURANCE;
  (E) AUTOMOBILE NO-FAULT INSURANCE;
  (F) CREDIT INSURANCE;
  (G)  OTHER  SIMILAR  INSURANCE COVERAGE, AS SPECIFIED IN FEDERAL REGU-
LATIONS, UNDER WHICH BENEFITS FOR MEDICAL CARE ARE  SECONDARY  OR  INCI-
DENTAL TO OTHER INSURANCE BENEFITS;
  (H)  LIMITED  SCOPE  DENTAL OR VISION BENEFITS, BENEFITS FOR LONG-TERM
CARE INSURANCE, NURSING HOME INSURANCE,  HOME  CARE  INSURANCE,  OR  ANY
COMBINATION  THEREOF,  OR  SUCH  OTHER  SIMILAR, LIMITED BENEFITS HEALTH
INSURANCE AS SPECIFIED IN  FEDERAL  REGULATIONS,  IF  THE  BENEFITS  ARE
PROVIDED  UNDER  A SEPARATE POLICY, CERTIFICATE OR CONTRACT OF INSURANCE
OR ARE OTHERWISE NOT AN INTEGRAL PART OF THE PLAN;
  (I) COVERAGE ONLY FOR A SPECIFIED DISEASE OR ILLNESS, HOSPITAL  INDEM-
NITY, OR OTHER FIXED INDEMNITY COVERAGE;
  (J)  MEDICARE  SUPPLEMENTAL INSURANCE AS DEFINED IN SECTION 1882(G)(1)
OF THE FEDERAL SOCIAL SECURITY ACT, COVERAGE SUPPLEMENTAL TO THE  COVER-
AGE  PROVIDED UNDER CHAPTER 55 OF TITLE 10 OF THE UNITED STATES CODE, OR
SIMILAR SUPPLEMENTAL COVERAGE PROVIDED UNDER A GROUP HEALTH PLAN  IF  IT
IS  OFFERED  AS A SEPARATE POLICY, CERTIFICATE OR CONTRACT OF INSURANCE;
OR
  (K) THE MEDICAL INDEMNITY FUND ESTABLISHED PURSUANT TO TITLE  FOUR  OF
ARTICLE TWENTY-NINE-D OF THE PUBLIC HEALTH LAW.
  7.  "INSURER" MEANS AN INSURANCE COMPANY SUBJECT TO ARTICLE THIRTY-TWO
OR FORTY-THREE OF THE INSURANCE LAW, OR A HEALTH  MAINTENANCE  ORGANIZA-
TION  CERTIFIED  PURSUANT TO ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW
THAT CONTRACTS OR OFFERS TO CONTRACT TO PROVIDE, DELIVER,  ARRANGE,  PAY
OR REIMBURSE ANY OF THE COSTS OF HEALTH CARE SERVICES.
  8.  "QUALIFIED  DENTAL PLAN" MEANS A LIMITED SCOPE DENTAL PLAN THAT IS
ISSUED  BY  AN  INSURER  AND  CERTIFIED  IN  ACCORDANCE   WITH   SECTION
THIRTY-NINE HUNDRED EIGHTY-FIVE OF THIS ARTICLE.
  9. "QUALIFIED EMPLOYER" MEANS A SMALL EMPLOYER THAT ELECTS TO MAKE ITS
FULL-TIME  EMPLOYEES  ELIGIBLE  FOR  ONE  OR MORE QUALIFIED HEALTH PLANS
THROUGH THE EXCHANGE.
  10. "QUALIFIED HEALTH PLAN" MEANS A HEALTH PLAN THAT IS ISSUED  BY  AN
INSURER  AND  CERTIFIED  IN  ACCORDANCE WITH SECTION THIRTY-NINE HUNDRED
EIGHTY-FIVE OF THIS ARTICLE.
  11. "QUALIFIED INDIVIDUAL" MEANS AN  INDIVIDUAL,  INCLUDING  A  MINOR,
WHO:
  (A)  IS  SEEKING TO ENROLL IN A QUALIFIED HEALTH PLAN OFFERED TO INDI-
VIDUALS THROUGH THE EXCHANGE;
  (B) RESIDES IN THIS STATE;
  (C) AT THE TIME OF ENROLLMENT, IS NOT INCARCERATED, OTHER THAN  INCAR-
CERATION PENDING THE DISPOSITION OF CHARGES; AND

S. 6256--A                         52                         A. 9056--A

  (D)  IS,  AND  IS REASONABLY EXPECTED TO BE, FOR THE ENTIRE PERIOD FOR
WHICH ENROLLMENT IS SOUGHT, A CITIZEN OR NATIONAL OF THE  UNITED  STATES
OR AN ALIEN LAWFULLY PRESENT IN THE UNITED STATES.
  12. "SECRETARY" MEANS THE SECRETARY OF THE UNITED STATES DEPARTMENT OF
HEALTH AND HUMAN SERVICES.
  13. "SHOP" MEANS THE SMALL BUSINESS HEALTH OPTIONS PROGRAM DESIGNED TO
ASSIST  QUALIFIED EMPLOYERS IN THIS STATE IN FACILITATING THE ENROLLMENT
OF THEIR EMPLOYEES IN QUALIFIED HEALTH PLANS OFFERED IN THE GROUP MARKET
IN THIS STATE.
  14. "SMALL EMPLOYER" MEANS, FOR PLAN YEARS PRIOR TO JANUARY FIRST, TWO
THOUSAND SIXTEEN, AN EMPLOYER THAT EMPLOYED AN AVERAGE OF AT  LEAST  ONE
BUT  NOT MORE THAN FIFTY EMPLOYEES ON BUSINESS DAYS DURING THE PRECEDING
CALENDAR YEAR. FOR PLAN YEARS BEGINNING ON AND AFTER JANUARY FIRST,  TWO
THOUSAND  SIXTEEN,  SMALL  EMPLOYER  MEANS  AN EMPLOYER THAT EMPLOYED AN
AVERAGE OF AT LEAST ONE BUT NOT MORE THAN ONE HUNDRED EMPLOYEES ON BUSI-
NESS DAYS DURING THE PRECEDING CALENDAR YEAR. FOR PURPOSES OF THE  DEFI-
NITION OF SMALL EMPLOYER:
  (A)  ALL  PERSONS  TREATED  AS A SINGLE EMPLOYER UNDER SUBSECTION (B),
(C), (M) OR (O) OF SECTION 414 OF THE  INTERNAL  REVENUE  CODE  OF  1986
SHALL BE TREATED AS A SINGLE EMPLOYER;
  (B)  AN  EMPLOYER  AND  ANY PREDECESSOR EMPLOYER SHALL BE TREATED AS A
SINGLE EMPLOYER;
  (C) ALL EMPLOYEES SHALL BE COUNTED, INCLUDING PART-TIME EMPLOYEES  AND
EMPLOYEES WHO ARE NOT ELIGIBLE FOR COVERAGE THROUGH THE EMPLOYER;
  (D)  IF  AN  EMPLOYER  WAS  NOT  IN EXISTENCE THROUGHOUT THE PRECEDING
CALENDAR YEAR, THEN THE DETERMINATION OF  WHETHER  THAT  EMPLOYER  IS  A
SMALL  EMPLOYER SHALL BE BASED UPON THE AVERAGE NUMBER OF EMPLOYEES THAT
THE EMPLOYER REASONABLY EXPECTS  TO  EMPLOY  ON  BUSINESS  DAYS  IN  THE
CURRENT CALENDAR YEAR;
  (E)  IF A QUALIFIED EMPLOYER THAT MAKES ENROLLMENT IN QUALIFIED HEALTH
PLANS AVAILABLE TO ITS EMPLOYEES THROUGH THE EXCHANGE  CEASES  TO  BE  A
SMALL  EMPLOYER BY REASON OF AN INCREASE IN THE NUMBER OF ITS EMPLOYEES,
THEN THE EMPLOYER SHALL CONTINUE TO BE TREATED AS A  QUALIFIED  EMPLOYER
FOR  PURPOSES OF THIS ARTICLE FOR THE PERIOD BEGINNING WITH THE INCREASE
AND ENDING WITH THE FIRST DAY ON WHICH THE EMPLOYER DOES NOT  MAKE  SUCH
ENROLLMENT AVAILABLE TO ITS EMPLOYEES; AND
  (F) NOTWITHSTANDING PARAGRAPHS (A) THROUGH (E) OF THIS SUBDIVISION, AN
EMPLOYER  ALSO  SHALL  BE CONSIDERED A SMALL EMPLOYER IF THE COVERAGE IT
OFFERS WOULD BE CONSIDERED SMALL GROUP COVERAGE UNDER THE INSURANCE  LAW
AND REGULATIONS PROMULGATED THEREUNDER PROVIDED THAT IT IS NOT OTHERWISE
PROHIBITED UNDER THE FEDERAL ACT.
  15. "SMALL GROUP MARKET" MEANS THE HEALTH INSURANCE MARKET UNDER WHICH
INDIVIDUALS  RECEIVE  HEALTH  INSURANCE COVERAGE ON BEHALF OF THEMSELVES
AND THEIR DEPENDENTS THROUGH A GROUP HEALTH PLAN MAINTAINED BY  A  SMALL
EMPLOYER.
  16. "SUPERINTENDENT" MEANS THE SUPERINTENDENT OF FINANCIAL SERVICES.
  S  3982.  ESTABLISHMENT  OF  THE NEW YORK HEALTH BENEFIT EXCHANGE.  1.
THERE IS HEREBY CREATED A PUBLIC BENEFIT CORPORATION TO BE KNOWN AS  THE
NEW  YORK  HEALTH  BENEFIT  EXCHANGE.  SUCH  CORPORATION SHALL BE A BODY
CORPORATE AND POLITIC.
  2. THE PURPOSE OF THE EXCHANGE IS TO FACILITATE THE PURCHASE AND  SALE
OF  QUALIFIED  HEALTH  PLANS, ASSIST QUALIFIED EMPLOYERS IN FACILITATING
THE ENROLLMENT OF THEIR EMPLOYEES IN QUALIFIED HEALTH PLANS THROUGH  THE
SMALL  BUSINESS  HEALTH  OPTIONS  PROGRAM,  ENROLL INDIVIDUALS IN HEALTH
COVERAGE FOR WHICH THEY ARE ELIGIBLE IN ACCORDANCE WITH FEDERAL LAW  AND
CARRY OUT OTHER FUNCTIONS SET FORTH IN THIS ARTICLE.

S. 6256--A                         53                         A. 9056--A

  3. (A) THE EXCHANGE SHALL BE GOVERNED BY A BOARD OF DIRECTORS CONSIST-
ING  OF NINE VOTING DIRECTORS, INCLUDING THE COMMISSIONER AND THE SUPER-
INTENDENT, WHO SHALL SERVE AS EX OFFICIO DIRECTORS.
  (B)  SEVEN  DIRECTORS  SHALL BE APPOINTED BY THE GOVERNOR, TWO OF WHOM
SHALL BE APPOINTED UPON THE RECOMMENDATION OF THE TEMPORARY PRESIDENT OF
THE SENATE AND TWO OF WHOM SHALL BE APPOINTED UPON THE RECOMMENDATION OF
THE SPEAKER OF THE ASSEMBLY.  EACH PERSON APPOINTED AS A DIRECTOR PURSU-
ANT TO THIS PARAGRAPH SHALL HAVE EXPERTISE IN ONE OR MORE OF THE FOLLOW-
ING AREAS:
  (I) INDIVIDUAL HEALTH CARE COVERAGE;
  (II) SMALL EMPLOYER HEALTH CARE COVERAGE;
  (III) HEALTH BENEFITS ADMINISTRATION;
  (IV) HEALTH CARE FINANCE;
  (V) PUBLIC OR PRIVATE HEALTH CARE DELIVERY SYSTEMS; AND
  (VI) PURCHASING HEALTH PLAN COVERAGE.
  (C) RECOMMENDATIONS AND APPOINTMENTS SHALL TAKE INTO CONSIDERATION THE
EXPERTISE OF OTHER DIRECTORS RECOMMENDED AND APPOINTED PURSUANT TO  THIS
SUBDIVISION, SO THAT THE BOARD COMPOSITION REFLECTS A DIVERSITY OF EXPE-
RIENCE  AND COMPLIES WITH ANY REGULATIONS ISSUED BY THE SECRETARY PURSU-
ANT TO THE FEDERAL ACT.
  (D) RECOMMENDATIONS BY THE TEMPORARY PRESIDENT OF THE SENATE  AND  THE
SPEAKER  OF  THE ASSEMBLY SHALL BE MADE WITHIN THIRTY DAYS OF THE EFFEC-
TIVE DATE OF THIS ARTICLE, WITHIN SIXTY DAYS  OF  THE  OCCURRENCE  OF  A
VACANCY OR WITHIN SIXTY DAYS PRIOR TO THE EXPIRATION OF A TERM.
  4.  THE  GOVERNOR  SHALL  APPOINT  A CHAIR OF THE BOARD FROM AMONG THE
DIRECTORS WHO SHALL BE SUBJECT TO THE ADVICE AND CONSENT OF THE  SENATE.
ANY  DIRECTOR  APPOINTED BY THE GOVERNOR AS CHAIR OF THE BOARD MAY SERVE
AS ACTING CHAIR UNTIL SUCH TIME AS A VOTE FOR CONFIRMATION IS  TAKEN  BY
THE  SENATE.  NO  DIRECTOR  APPOINTED  AS CHAIR SHALL SERVE AS CHAIR, OR
CONTINUE TO SERVE AS ACTING CHAIR,  IF  THE  SENATE  HAS  VOTED  NOT  TO
CONFIRM SUCH DIRECTOR AS CHAIR.
  5.  (A)  THE  TERMS OF THE DIRECTORS, OTHER THAN THE EX OFFICIO DIREC-
TORS, SHALL BE THREE YEARS, PROVIDED, HOWEVER, THAT THE INITIAL TERMS OF
ONE OF THE DIRECTORS APPOINTED  UPON  RECOMMENDATION  OF  THE  TEMPORARY
PRESIDENT OF THE SENATE, ONE OF THE DIRECTORS APPOINTED UPON RECOMMENDA-
TION  OF THE SPEAKER OF THE ASSEMBLY, AND ONE OF THE DIRECTORS APPOINTED
BY THE GOVERNOR WITHOUT RECOMMENDATION SHALL BE FOR TWO YEARS.
  (B) VACANCIES OCCURRING OTHERWISE THAN BY EXPIRATION OF TERM OF OFFICE
SHALL BE FILLED FOR THE  UNEXPIRED  TERM  IN  THE  MANNER  PROVIDED  FOR
ORIGINAL APPOINTMENT.
  6. THE DIRECTORS SHALL NOT RECEIVE ANY COMPENSATION FOR THEIR SERVICES
AS DIRECTORS.
  7.  (A)  EACH  DIRECTOR SHALL HAVE THE RESPONSIBILITY AND DUTY TO MEET
THE REQUIREMENTS OF THIS ARTICLE, THE FEDERAL ACT,  AND  ALL  APPLICABLE
STATE  AND  FEDERAL LAWS AND REGULATIONS TO SERVE THE PUBLIC INTEREST OF
THE INDIVIDUALS  AND  SMALL  BUSINESSES  SEEKING  HEALTH  CARE  COVERAGE
THROUGH THE EXCHANGE, CONSISTENT WITH SECTION TWENTY-EIGHT HUNDRED TWEN-
TY-FOUR OF THIS CHAPTER.
  (B)  EACH  DIRECTOR  SHALL  BE  A  STATE  OFFICER  OR EMPLOYEE FOR THE
PURPOSES OF SECTIONS SEVENTY-THREE AND SEVENTY-FOUR OF THE PUBLIC  OFFI-
CERS LAW.
  (C) NO DIRECTOR MAY BE EMPLOYED OR OTHERWISE RETAINED BY THE EXCHANGE.
  8.  (A) THE BOARD MAY CREATE SUCH COMMITTEES AS THE BOARD DEEMS NECES-
SARY. THE FIRST MEETING OF THE BOARD SHALL BE HELD WITHIN FOURTEEN  DAYS
AFTER  ALL  DIRECTORS  ARE INITIALLY APPOINTED.  AT THE FIRST MEETING OF
THE BOARD, AND AT THE FIRST MEETING IN EACH SUBSEQUENT YEAR,  THE  BOARD

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SHALL  ELECT  FROM  AMONG  ITS  MEMBERS A SECRETARY AND A TREASURER. THE
BOARD ALSO SHALL ELECT SUCH OTHER OFFICERS AS IT SHALL  DEEM  NECESSARY.
THE  OFFICERS  SO  ELECTED  SHALL  HAVE  SUCH  POWERS  AND DUTIES AS ARE
ASSIGNED BY THE BY-LAWS AND THIS CHAPTER.
  (B)  THE  BOARD, AND ANY COMMITTEE THEREOF, MAY HOLD MEETINGS BY ELEC-
TRONIC MEANS CONSISTENT WITH ARTICLE SEVEN OF THE PUBLIC OFFICERS LAW.
  S 3983. GENERAL POWERS OF THE EXCHANGE. THE EXCHANGE  SHALL  HAVE  THE
FOLLOWING POWERS TO BE USED IN FURTHERANCE OF ITS CORPORATE PURPOSES:
  1.  TO  SUE AND BE SUED AND TO PARTICIPATE IN ACTIONS AND PROCEEDINGS,
WHETHER JUDICIAL, ADMINISTRATIVE, ARBITRATIVE OR OTHERWISE;
  2. TO HAVE A CORPORATE SEAL, AND TO ALTER SUCH SEAL AT  PLEASURE,  AND
TO  USE  IT  BY  CAUSING IT OR A FACSIMILE TO BE AFFIXED OR IMPRESSED OR
REPRODUCED IN ANY OTHER MANNER;
  3. TO PURCHASE, RECEIVE, TAKE  BY  GRANT,  GIFT,  DEVISE,  BEQUEST  OR
OTHERWISE,  LEASE, OR OTHERWISE ACQUIRE, OWN, HOLD, IMPROVE, EMPLOY, USE
AND OTHERWISE DEAL IN AND WITH, REAL OR PERSONAL PROPERTY, OR ANY INTER-
EST THEREIN, WHEREVER SITUATED;
  4. TO SELL, CONVEY, LEASE, EXCHANGE, TRANSFER OR OTHERWISE DISPOSE OF,
OR MORTGAGE OR PLEDGE, OR CREATE A SECURITY INTEREST IN, ALL OR  ANY  OF
ITS PROPERTY, OR ANY INTEREST THEREIN, WHEREVER SITUATED;
  5.  TO  MAKE  CONTRACTS,  GIVE  GUARANTEES  AND INCUR LIABILITIES, AND
BORROW MONEY; PROVIDED, HOWEVER,  THAT  THE  EXCHANGE  SHALL  NOT  ISSUE
BONDS;
  6.  TO  INVEST  AND  REINVEST  ITS  FUNDS,  AND TAKE AND HOLD REAL AND
PERSONAL PROPERTY AS SECURITY FOR THE PAYMENT  OF  FUNDS  SO  LOANED  OR
INVESTED;
  7. TO MAKE AND ALTER BY-LAWS FOR ITS ORGANIZATION AND MANAGEMENT;
  8.  TO  MAKE AND ALTER RULES AND REGULATIONS AS NECESSARY TO IMPLEMENT
THE PROVISIONS OF THIS ARTICLE, SUBJECT TO THE PROVISIONS OF  THE  STATE
ADMINISTRATIVE PROCEDURE ACT;
  9.  TO  HIRE  EMPLOYEES,  CONSISTENT  WITH SECTION THIRTY-NINE HUNDRED
NINETY OF THIS ARTICLE;
  10. TO DESIGNATE THE DEPOSITORIES OF ITS MONEY;
  11. TO ESTABLISH ITS FISCAL YEAR;
  12. TO INSURE OR OTHERWISE PROVIDE FOR THE INSURANCE OF THE EXCHANGE'S
PROPERTY OR OPERATIONS AND AGAINST SUCH OTHER RISKS AS THE EXCHANGE  MAY
DEEM ADVISABLE;
  13.  TO  RECEIVE  AND SPEND MONEY FOR ANY OF ITS CORPORATE PURPOSES IN
ACCORDANCE WITH THIS ARTICLE; AND
  14. TO APPLY FOR, ACCEPT THE AWARD OF, AND SPEND ANY  AVAILABLE  GRANT
MONEY.
  S 3984. FUNCTIONS OF THE EXCHANGE.  THE EXCHANGE SHALL:
  1.  (A) MAKE AVAILABLE QUALIFIED HEALTH PLANS TO QUALIFIED INDIVIDUALS
AND QUALIFIED EMPLOYERS BEGINNING ON OR BEFORE JANUARY FIRST, TWO  THOU-
SAND  FOURTEEN,  PROVIDED THAT COVERAGE UNDER SUCH QUALIFIED PLANS SHALL
NOT BECOME EFFECTIVE PRIOR TO SUCH DATE AND SHALL NOT MAKE AVAILABLE ANY
HEALTH PLAN THAT IS NOT A QUALIFIED HEALTH PLAN;
  (B) MAKE AVAILABLE QUALIFIED DENTAL PLANS TO QUALIFIED INDIVIDUALS AND
QUALIFIED EMPLOYERS BEGINNING ON OR BEFORE JANUARY FIRST,  TWO  THOUSAND
FOURTEEN, PROVIDED THAT COVERAGE UNDER SUCH QUALIFIED DENTAL PLANS SHALL
NOT  BECOME  EFFECTIVE  PRIOR  TO  SUCH  DATE,  EITHER  SEPARATELY OR IN
CONJUNCTION WITH A QUALIFIED HEALTH PLAN, IF SUCH PLAN  PROVIDES  PEDIA-
TRIC  DENTAL  BENEFITS MEETING THE REQUIREMENTS OF SECTION 1302(B)(1)(J)
OF THE FEDERAL ACT;
  2. ASSIGN A RATING TO EACH QUALIFIED HEALTH PLAN OFFERED  THROUGH  THE
EXCHANGE  IN  ACCORDANCE  WITH  THE  CRITERIA DEVELOPED BY THE SECRETARY

S. 6256--A                         55                         A. 9056--A

PURSUANT TO SECTION 1311(C)(3) OF THE FEDERAL ACT,  AND  DETERMINE  EACH
QUALIFIED HEALTH PLAN'S LEVEL OF COVERAGE IN ACCORDANCE WITH REGULATIONS
ISSUED BY THE SECRETARY PURSUANT TO SECTION 1302(D)(2)(A) OF THE FEDERAL
ACT;
  3. UTILIZE A STANDARDIZED FORMAT FOR PRESENTING HEALTH BENEFIT OPTIONS
IN  THE  EXCHANGE,  INCLUDING THE USE OF THE UNIFORM OUTLINE OF COVERAGE
ESTABLISHED UNDER SECTION 2715 OF THE FEDERAL PUBLIC HEALTH SERVICE ACT;
  4. PROVIDE FOR ENROLLMENT PERIODS PURSUANT TO THE FEDERAL ACT  OR  THE
INSURANCE  LAW,  WHICHEVER IS IN THE BEST INTEREST OF QUALIFIED INDIVID-
UALS AND QUALIFIED EMPLOYERS, AFTER THE INITIAL  ENROLLMENT  PERIOD  HAS
BEEN ESTABLISHED AS REQUIRED IN THE FEDERAL ACT; PROVIDED, HOWEVER, THAT
IF  ENROLLMENT PERIODS PURSUANT TO THE INSURANCE LAW CONFLICT WITH RULES
ADOPTED BY THE SECRETARY, THEN ENROLLMENT PERIODS PURSUANT TO THE FEDER-
AL ACT SHALL APPLY;
  5. IMPLEMENT PROCEDURES FOR  THE  CERTIFICATION,  RECERTIFICATION  AND
DECERTIFICATION  OF  HEALTH  PLANS AS QUALIFIED HEALTH PLANS, CONSISTENT
WITH GUIDELINES DEVELOPED BY THE SECRETARY PURSUANT TO  SECTION  1311(C)
OF  THE  FEDERAL ACT AND SECTION THIRTY-NINE HUNDRED EIGHTY-FIVE OF THIS
ARTICLE;
  6. REQUIRE QUALIFIED HEALTH PLANS TO OFFER THOSE  BENEFITS  DETERMINED
BY  THE  SECRETARY  TO  BE ESSENTIAL HEALTH BENEFITS PURSUANT TO SECTION
1302(B) OF THE FEDERAL ACT (EXCEPT  AS  PROVIDED  IN  PARAGRAPH  (B)  OF
SUBDIVISION  ONE  OF  SECTION THREE THOUSAND NINE HUNDRED EIGHTY-FIVE OF
THIS ARTICLE) AND SUCH ADDITIONAL BENEFITS AS MAY BE  REQUIRED  PURSUANT
TO  THE  INSURANCE  LAW, PROVIDED THAT THE STATE HAS ASSUMED THE COST OF
SUCH ADDITIONAL BENEFITS AS REQUIRED UNDER SECTION 1311(D)(3)(B) OF  THE
FEDERAL ACT;
  7.  ENSURE THAT INSURERS OFFERING HEALTH PLANS THROUGH THE EXCHANGE DO
NOT CHARGE AN INDIVIDUAL A FEE OR PENALTY FOR TERMINATION OF COVERAGE;
  8. PROVIDE FOR THE OPERATION  OF  A  TOLL-FREE  TELEPHONE  HOTLINE  TO
RESPOND TO REQUESTS FOR ASSISTANCE;
  9.  MAINTAIN  AN INTERNET WEBSITE THROUGH WHICH ENROLLEES AND PROSPEC-
TIVE ENROLLEES OF QUALIFIED HEALTH PLANS MAY OBTAIN STANDARDIZED COMPAR-
ATIVE INFORMATION ON SUCH PLANS AND PUBLIC HEALTH PROGRAMS;
  10. ESTABLISH AND MAKE AVAILABLE BY ELECTRONIC MEANS A  CALCULATOR  TO
DETERMINE  THE  ACTUAL  COST  OF  COVERAGE  AFTER THE APPLICATION OF ANY
PREMIUM TAX CREDIT UNDER SECTION 36B OF THE  INTERNAL  REVENUE  CODE  OF
1986  AND  ANY  COST-SHARING REDUCTION UNDER SECTION 1402 OF THE FEDERAL
ACT;
  11. ESTABLISH A PROGRAM UNDER WHICH  THE  EXCHANGE  AWARDS  GRANTS  TO
ENTITIES  TO  SERVE AS NAVIGATORS, IN ACCORDANCE WITH SECTION 1311(I) OF
THE FEDERAL ACT AND REGULATIONS ADOPTED THEREUNDER;
  12. IN ACCORDANCE WITH SECTION 1413 OF THE FEDERAL ACT,  INFORM  INDI-
VIDUALS OF ELIGIBILITY REQUIREMENTS FOR THE MEDICAID PROGRAM UNDER TITLE
XIX  OF THE SOCIAL SECURITY ACT, THE CHILDREN'S HEALTH INSURANCE PROGRAM
(CHIP) UNDER TITLE XXI OF THE SOCIAL  SECURITY  ACT  OR  ANY  APPLICABLE
STATE OR LOCAL PUBLIC HEALTH INSURANCE PROGRAM AND IF, THROUGH SCREENING
OF  THE  APPLICATION  BY THE EXCHANGE, THE EXCHANGE DETERMINES THAT SUCH
INDIVIDUALS ARE ELIGIBLE FOR ANY SUCH PROGRAM, ENROLL  SUCH  INDIVIDUALS
IN SUCH PROGRAM;
  13. PURSUANT TO SECTION 1411 OF THE FEDERAL ACT, GRANT A CERTIFICATION
ATTESTING  THAT,  FOR  PURPOSES OF THE INDIVIDUAL RESPONSIBILITY PENALTY
UNDER SECTION 5000A OF THE INTERNAL REVENUE CODE OF 1986, AN  INDIVIDUAL
IS  EXEMPT  FROM  THE  INDIVIDUAL RESPONSIBILITY REQUIREMENT OR FROM THE
PENALTY IMPOSED BY THAT SECTION BECAUSE:

S. 6256--A                         56                         A. 9056--A

  (A) THERE IS NO AFFORDABLE QUALIFIED HEALTH PLAN AVAILABLE THROUGH THE
EXCHANGE OR THE INDIVIDUAL'S EMPLOYER, COVERING THE INDIVIDUAL; OR
  (B) THE INDIVIDUAL MEETS THE REQUIREMENTS FOR ANY OTHER SUCH EXEMPTION
FROM THE INDIVIDUAL RESPONSIBILITY REQUIREMENT OR PENALTY;
  14.  TRANSMIT  TO THE SECRETARY OF THE UNITED STATES DEPARTMENT OF THE
TREASURY:
  (A) A LIST OF THE INDIVIDUALS TO WHOM THE EXCHANGE GRANTED  A  CERTIF-
ICATION  UNDER  SUBDIVISION THIRTEEN OF THIS SECTION, INCLUDING THE NAME
AND TAXPAYER IDENTIFICATION NUMBER OF EACH INDIVIDUAL;
  (B) THE NAME AND TAXPAYER IDENTIFICATION NUMBER OF EACH INDIVIDUAL WHO
WAS AN EMPLOYEE OF AN EMPLOYER WHO WAS DETERMINED TO BE ELIGIBLE FOR THE
PREMIUM TAX CREDIT UNDER SECTION 36B OF THE  INTERNAL  REVENUE  CODE  OF
1986 BECAUSE:
  (I)  THE EMPLOYER DID NOT PROVIDE MINIMUM ESSENTIAL COVERAGE AS DETER-
MINED BY THE SECRETARY PURSUANT TO SECTION 1311(D) OF THE  FEDERAL  ACT;
OR
  (II)  THE  EMPLOYER  PROVIDED THE MINIMUM ESSENTIAL COVERAGE AS DETER-
MINED BY THE SECRETARY PURSUANT TO SECTION 1311(D) OF THE  FEDERAL  ACT,
BUT IT WAS DETERMINED UNDER SECTION 36B(C)(2)(C) OF THE INTERNAL REVENUE
CODE OF 1986 TO EITHER BE UNAFFORDABLE TO THE EMPLOYEE OR TO NOT PROVIDE
THE REQUIRED MINIMUM ACTUARIAL VALUE; AND
  (C) THE NAME AND TAXPAYER IDENTIFICATION NUMBER OF:
  (I)  EACH  INDIVIDUAL  WHO  NOTIFIES  THE EXCHANGE PURSUANT TO SECTION
1411(B)(4) OF THE FEDERAL ACT THAT HE OR SHE HAS CHANGED EMPLOYERS; AND
  (II) EACH INDIVIDUAL WHO CEASES COVERAGE UNDER A QUALIFIED HEALTH PLAN
DURING A PLAN YEAR AND THE EFFECTIVE DATE OF THAT CESSATION;
  15. PROVIDE TO EACH EMPLOYER THE NAME OF EACH EMPLOYEE OF THE EMPLOYER
DESCRIBED IN PARAGRAPH (B) OF SUBDIVISION FOURTEEN OF THIS  SECTION  WHO
CEASES COVERAGE UNDER A QUALIFIED HEALTH PLAN DURING A PLAN YEAR AND THE
EFFECTIVE DATE OF THE CESSATION;
  16.  OPERATE A SMALL BUSINESS HEALTH OPTIONS PROGRAM ("SHOP") PURSUANT
TO SECTION 1311 OF THE FEDERAL ACT  THROUGH  WHICH  QUALIFIED  EMPLOYERS
ACCESS COVERAGE FOR THEIR EMPLOYEES, AND MAY:
  (A) PERMIT QUALIFIED EMPLOYERS TO SPECIFY A LEVEL OF COVERAGE SO THEIR
EMPLOYEES  MAY  ENROLL  IN ANY QUALIFIED HEALTH PLAN OFFERED THROUGH THE
SHOP AT THE SPECIFIED LEVEL OF COVERAGE OR,  UNLESS  PROHIBITED  BY  THE
FEDERAL  ACT,  PROVIDE  A SPECIFIC AMOUNT OR OTHER PAYMENT FORMULATED IN
ACCORDANCE WITH THE FEDERAL ACT TO BE USED AS PART OF AN EMPLOYEE CHOICE
PLAN; AND
  (B) PROVIDE PREMIUM AGGREGATION AND OTHER RELATED SERVICES TO MINIMIZE
ADMINISTRATIVE BURDENS FOR QUALIFIED EMPLOYERS;
  17. ENTER INTO AGREEMENTS AS NECESSARY WITH:  (A)  FEDERAL  AND  STATE
AGENCIES  AND  OTHER  STATE  EXCHANGES TO CARRY OUT ITS RESPONSIBILITIES
UNDER  THIS  ARTICLE,  PROVIDED   SUCH   AGREEMENTS   INCLUDE   ADEQUATE
PROTECTIONS WITH RESPECT TO THE CONFIDENTIALITY OF ANY INFORMATION TO BE
SHARED AND COMPLY WITH ALL STATE AND FEDERAL LAWS AND REGULATIONS; AND
  (B)  LOCAL  DEPARTMENTS OF SOCIAL SERVICES TO COORDINATE ENROLLMENT IN
OTHER SOCIAL SERVICES PROGRAMS, AS APPROPRIATE, PROVIDED SUCH AGREEMENTS
INCLUDE ADEQUATE PROTECTIONS WITH RESPECT TO THE CONFIDENTIALITY OF  ANY
INFORMATION  TO BE SHARED AND COMPLY WITH ALL STATE AND FEDERAL LAWS AND
REGULATIONS;
  18. PERFORM DUTIES REQUIRED BY THE SECRETARY OR THE SECRETARY  OF  THE
UNITED  STATES  DEPARTMENT OF THE TREASURY RELATED TO DETERMINING ELIGI-
BILITY FOR PREMIUM TAX  CREDITS,  REDUCED  COST-SHARING,  OR  INDIVIDUAL
RESPONSIBILITY REQUIREMENT EXEMPTIONS;

S. 6256--A                         57                         A. 9056--A

  19.  MEET  FINANCIAL  INTEGRITY REQUIREMENTS UNDER SECTION 1313 OF THE
FEDERAL ACT AND THIS CHAPTER, INCLUDING:
  (A)  KEEPING  AN  ACCURATE ACCOUNTING OF ALL ACTIVITIES, RECEIPTS, AND
EXPENDITURES AND ANNUALLY SUBMITTING TO THE SECRETARY A REPORT  CONCERN-
ING  SUCH ACCOUNTINGS, WITH A COPY OF SUCH REPORT PROVIDED TO THE GOVER-
NOR, THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEM-
BLY; AND
  (B) FULLY COOPERATING WITH ANY INVESTIGATION CONDUCTED BY  THE  SECRE-
TARY  PURSUANT  TO  THE  SECRETARY'S AUTHORITY UNDER SECTION 1313 OF THE
FEDERAL ACT AND ALLOWING THE SECRETARY, IN COORDINATION WITH THE INSPEC-
TOR GENERAL  OF  THE  UNITED  STATES  DEPARTMENT  OF  HEALTH  AND  HUMAN
SERVICES, TO:
  (I) INVESTIGATE THE AFFAIRS OF THE EXCHANGE;
  (II) EXAMINE THE PROPERTIES AND RECORDS OF THE EXCHANGE; AND
  (III) REQUIRE PERIODIC REPORTS IN RELATION TO THE ACTIVITIES UNDERTAK-
EN BY THE EXCHANGE;
  20.  (A)  CONSULT  WITH  THE  REGIONAL ADVISORY COMMITTEES ESTABLISHED
PURSUANT TO SECTION THIRTY-NINE HUNDRED EIGHTY-SIX OF THIS ARTICLE; AND
  (B) CONSULT WITH STAKEHOLDERS RELEVANT TO CARRYING OUT THE  ACTIVITIES
REQUIRED UNDER THIS ARTICLE, INCLUDING BUT NOT LIMITED TO:
  (I) HEALTH CARE CONSUMERS WHO ARE ENROLLEES IN HEALTH PLANS;
  (II)  INDIVIDUALS AND ENTITIES WITH EXPERIENCE IN FACILITATING ENROLL-
MENT IN HEALTH PLANS;
  (III) REPRESENTATIVES OF SMALL BUSINESSES AND  SELF-EMPLOYED  INDIVID-
UALS;
  (IV)  STATE  MEDICAID  OFFICES,  INCLUDING LOCAL DEPARTMENTS OF SOCIAL
SERVICES;
  (V) ADVOCATES FOR ENROLLING HARD TO REACH POPULATIONS;
  (VI) HEALTH CARE PROVIDERS; AND
  (VII) INSURERS;
  21. SUBMIT INFORMATION PROVIDED BY EXCHANGE APPLICANTS  FOR  VERIFICA-
TION AS REQUIRED BY SECTION 1411(C) OF THE FEDERAL ACT;
  22.  ESTABLISH RULES AND REGULATIONS, PURSUANT TO SUBDIVISION EIGHT OF
SECTION THIRTY-NINE HUNDRED EIGHTY-THREE OF THIS ARTICLE,  THAT  DO  NOT
CONFLICT  WITH  OR PREVENT THE APPLICATION OF REGULATIONS PROMULGATED BY
THE SECRETARY; AND
  23. DETERMINE ELIGIBILITY, PROVIDE NOTICES, AND PROVIDE  OPPORTUNITIES
FOR  APPEAL  AND  REDETERMINATION IN ACCORDANCE WITH THE REQUIREMENTS OF
SECTIONS 1411 AND 1413 OF THE FEDERAL ACT.
  S 3985. SPECIAL FUNCTIONS OF  THE  EXCHANGE  RELATED  TO  HEALTH  PLAN
CERTIFICATION  AND  QUALIFIED  HEALTH  PLAN OVERSIGHT.   1. HEALTH PLANS
CERTIFIED BY THE EXCHANGE SHALL MEET THE FOLLOWING REQUIREMENTS:
  (A) THE INSURER OFFERING THE HEALTH PLAN:
  (I) IS LICENSED OR CERTIFIED BY THE SUPERINTENDENT OR COMMISSIONER AND
MEETS THE REQUIREMENTS OF SECTION 1301(A)(1)(C)(I) OF  THE  FEDERAL  ACT
AND ANY GUIDANCE ISSUED THEREUNDER;
  (II)  OFFERS  AT LEAST ONE QUALIFIED HEALTH PLAN IN EACH OF THE SILVER
AND GOLD LEVELS;
  (III) HAS FILED WITH AND RECEIVED APPROVAL FROM THE SUPERINTENDENT  OF
ITS PREMIUM RATES AND POLICY OR CONTRACT FORMS PURSUANT TO THE INSURANCE
LAW AND THE PUBLIC HEALTH LAW;
  (IV)  DOES  NOT CHARGE ANY CANCELLATION FEES OR PENALTIES IN VIOLATION
OF SUBDIVISION SEVEN OF SECTION THIRTY-NINE HUNDRED EIGHTY-FOUR OF  THIS
ARTICLE; AND

S. 6256--A                         58                         A. 9056--A

  (V)  COMPLIES  WITH  THE  REGULATIONS DEVELOPED BY THE SECRETARY UNDER
SECTION 1311(C) OF THE FEDERAL ACT AND SUCH OTHER  REQUIREMENTS  AS  THE
EXCHANGE MAY ESTABLISH;
  (B)  THE HEALTH PLAN: (I) PROVIDES THE ESSENTIAL HEALTH BENEFITS PACK-
AGE DESCRIBED IN SECTION 1302(A) OF THE FEDERAL ACT  AND  INCLUDES  SUCH
ADDITIONAL  BENEFITS  AS  MAY BE REQUIRED PURSUANT TO THE INSURANCE LAW,
PROVIDED THAT THE STATE HAS ASSUMED THE COST OF SUCH ADDITIONAL BENEFITS
AS REQUIRED UNDER SECTION 1311(D)(3)(B) OF THE FEDERAL ACT, EXCEPT  THAT
THE HEALTH PLAN SHALL NOT BE REQUIRED TO PROVIDE ESSENTIAL BENEFITS THAT
DUPLICATE THE MINIMUM BENEFITS OF QUALIFIED DENTAL PLANS IF:
  (A)  THE  EXCHANGE  HAS  DETERMINED THAT AT LEAST ONE QUALIFIED DENTAL
PLAN IS AVAILABLE TO SUPPLEMENT THE HEALTH PLAN'S COVERAGE; AND
  (B) THE INSURER MAKES PROMINENT DISCLOSURE AT THE TIME IT  OFFERS  THE
HEALTH  PLAN, IN A FORM APPROVED BY THE EXCHANGE, THAT THE PLAN DOES NOT
PROVIDE THE FULL RANGE OF ESSENTIAL PEDIATRIC BENEFITS, AND THAT  QUALI-
FIED DENTAL PLANS PROVIDING THOSE BENEFITS AND OTHER DENTAL BENEFITS NOT
COVERED BY THE PLAN ARE OFFERED THROUGH THE EXCHANGE;
  (II)  PROVIDES  AT  LEAST  A  BRONZE  LEVEL  OF COVERAGE AS DEFINED IN
SECTION 1302(D) OF THE FEDERAL ACT, UNLESS THE PLAN IS  CERTIFIED  AS  A
QUALIFIED CATASTROPHIC PLAN, AS DEFINED IN SECTION 1302(E) OF THE FEDER-
AL   ACT,  AND  SHALL  ONLY  BE  OFFERED  TO  INDIVIDUALS  ELIGIBLE  FOR
CATASTROPHIC COVERAGE;
  (III) HAS COST-SHARING REQUIREMENTS, INCLUDING DEDUCTIBLES,  WHICH  DO
NOT  EXCEED  THE LIMITS ESTABLISHED UNDER SECTION 1302(C) OF THE FEDERAL
ACT AND ANY REQUIREMENTS OF THE EXCHANGE;
  (IV) COMPLIES WITH REGULATIONS PROMULGATED BY THE  SECRETARY  PURSUANT
TO  SECTION  1311(C) OF THE FEDERAL ACT, WHICH INCLUDE MINIMUM STANDARDS
IN THE AREAS OF MARKETING PRACTICES, NETWORK ADEQUACY, ESSENTIAL  COMMU-
NITY PROVIDERS IN UNDERSERVED AREAS, ACCREDITATION, QUALITY IMPROVEMENT,
UNIFORM ENROLLMENT FORMS AND DESCRIPTIONS OF COVERAGE AND INFORMATION ON
QUALITY MEASURES FOR HEALTH BENEFIT PLAN PERFORMANCE;
  (V) COMPLIES WITH THE INSURANCE LAW AND THE PUBLIC HEALTH LAW REQUIRE-
MENTS  APPLICABLE TO HEALTH INSURANCE ISSUED IN THIS STATE AND ANY REGU-
LATIONS PROMULGATED PURSUANT  THERETO  THAT  DO  NOT  CONFLICT  WITH  OR
PREVENT THE APPLICATION OF FEDERAL REQUIREMENTS; AND
  (C)  THE  EXCHANGE  DETERMINES  THAT  MAKING THE HEALTH PLAN AVAILABLE
THROUGH THE EXCHANGE IS IN THE INTEREST  OF  QUALIFIED  INDIVIDUALS  AND
QUALIFIED EMPLOYERS IN THIS STATE.
  2. THE EXCHANGE SHALL NOT EXCLUDE A HEALTH PLAN:
  (A) ON THE BASIS THAT THE HEALTH PLAN IS A FEE-FOR-SERVICE PLAN;
  (B)  THROUGH THE IMPOSITION OF PREMIUM PRICE CONTROLS BY THE EXCHANGE;
OR
  (C) ON THE BASIS THAT THE HEALTH PLAN PROVIDES TREATMENTS NECESSARY TO
PREVENT PATIENTS' DEATHS IN CIRCUMSTANCES THE  EXCHANGE  DETERMINES  ARE
INAPPROPRIATE OR TOO COSTLY.
  3.  THE  EXCHANGE  SHALL  REQUIRE  EACH  INSURER  CERTIFIED OR SEEKING
CERTIFICATION OF A HEALTH PLAN AS A QUALIFIED HEALTH PLAN TO:
  (A) SUBMIT A JUSTIFICATION FOR ANY PREMIUM INCREASE  TO  THE  EXCHANGE
PRIOR TO IMPLEMENTATION OF SUCH INCREASE.  THE INSURER SHALL PROMINENTLY
POST THE INFORMATION ON ITS INTERNET WEBSITE; PROVIDED, HOWEVER, THAT IF
INFORMATION  SUBMITTED  TO  THE  SUPERINTENDENT AS A JUSTIFICATION FOR A
PREMIUM RATE ADJUSTMENT PURSUANT TO THE INSURANCE  LAW,  OR  INFORMATION
POSTED  TO  AN  INSURER'S  INTERNET  WEBSITE,  OTHERWISE  MEETS  FEDERAL
REQUIREMENTS, THEN SUBMISSION OF A COPY OF THE SAME JUSTIFICATION TO THE
EXCHANGE OR USE OF THE SAME POSTING SHALL BE DEEMED SUFFICIENT  TO  MEET
THE REQUIREMENTS OF THIS SECTION.  THE EXCHANGE SHALL TAKE THIS INFORMA-

S. 6256--A                         59                         A. 9056--A

TION,  AND  THE  INFORMATION  AND  THE  RECOMMENDATIONS  PROVIDED TO THE
EXCHANGE BY THE SUPERINTENDENT UNDER SECTION 1003  OF  THE  FEDERAL  ACT
(RELATING  TO  PATTERNS OR PRACTICES OF EXCESSIVE OR UNJUSTIFIED PREMIUM
INCREASES),  INTO  CONSIDERATION  WHEN  DETERMINING WHETHER TO ALLOW THE
INSURER TO MAKE HEALTH PLANS AVAILABLE THROUGH THE EXCHANGE.  SUCH  RATE
INCREASES  SHALL  BE SUBJECT TO THE PRIOR APPROVAL OF THE SUPERINTENDENT
PURSUANT TO THE INSURANCE LAW;
  (B)(I) MAKE AVAILABLE TO THE PUBLIC AND SUBMIT TO  THE  EXCHANGE,  THE
SECRETARY AND THE SUPERINTENDENT, ACCURATE AND TIMELY DISCLOSURE OF:
  (A) CLAIMS PAYMENT POLICIES AND PRACTICES;
  (B) PERIODIC FINANCIAL DISCLOSURES;
  (C) DATA ON ENROLLMENT AND DISENROLLMENT;
  (D) DATA ON THE NUMBER OF CLAIMS THAT ARE DENIED;
  (E) DATA ON RATING PRACTICES;
  (F)  INFORMATION ON COST-SHARING AND PAYMENTS WITH RESPECT TO ANY OUT-
OF-NETWORK COVERAGE;
  (G) INFORMATION ON ENROLLEE AND PARTICIPANT RIGHTS UNDER  TITLE  I  OF
THE FEDERAL ACT; AND
  (H) OTHER INFORMATION AS DETERMINED APPROPRIATE BY THE SECRETARY;
  (II) THE INFORMATION SHALL BE PROVIDED IN PLAIN LANGUAGE, AS THAT TERM
IS  DEFINED IN SECTION 1311(E)(3)(B) OF THE FEDERAL ACT, AND IN GUIDANCE
JOINTLY ISSUED THEREUNDER BY THE SECRETARY AND THE FEDERAL SECRETARY  OF
LABOR; AND
  (C) PROVIDE TO INDIVIDUALS, IN A TIMELY MANNER UPON THE REQUEST OF THE
INDIVIDUAL,  THE  AMOUNT  OF COST-SHARING, INCLUDING DEDUCTIBLES, COPAY-
MENTS, AND COINSURANCE, UNDER THE INDIVIDUAL'S HEALTH PLAN  OR  COVERAGE
THAT  THE INDIVIDUAL WOULD BE RESPONSIBLE FOR PAYING WITH RESPECT TO THE
FURNISHING OF A SPECIFIC ITEM OR SERVICE BY A PARTICIPATING PROVIDER. AT
A MINIMUM, THIS INFORMATION SHALL BE MADE AVAILABLE  TO  THE  INDIVIDUAL
THROUGH  AN  INTERNET  WEBSITE  AND  THROUGH OTHER MEANS FOR INDIVIDUALS
WITHOUT ACCESS TO THE INTERNET; PROVIDED, HOWEVER, THAT  TO  THE  EXTENT
THAT  REQUIREMENTS UNDER THE INSURANCE LAW OR THE PUBLIC HEALTH LAW MEET
THE STANDARDS OF THE FEDERAL ACT,  AN  INSURER'S  COMPLIANCE  WITH  SUCH
STATE  REQUIREMENTS SHALL BE SUFFICIENT TO MEET THE REQUIREMENTS OF THIS
SECTION.
  4. (A) THE PROVISIONS OF THIS ARTICLE THAT APPLY TO  QUALIFIED  HEALTH
PLANS  ALSO SHALL APPLY TO THE EXTENT RELEVANT TO QUALIFIED DENTAL PLANS
EXCEPT AS MODIFIED IN ACCORDANCE WITH THE PROVISIONS OF  PARAGRAPHS  (B)
AND (C) OF THIS SUBDIVISION OR OTHERWISE REQUIRED BY THE EXCHANGE.
  (B)  THE  QUALIFIED  DENTAL  PLAN  SHALL BE LIMITED TO DENTAL AND ORAL
HEALTH BENEFITS, WITHOUT SUBSTANTIALLY DUPLICATING THE BENEFITS TYPICAL-
LY OFFERED BY HEALTH BENEFIT PLANS WITHOUT DENTAL  COVERAGE,  AND  SHALL
INCLUDE,   AT   A  MINIMUM,  THE  ESSENTIAL  PEDIATRIC  DENTAL  BENEFITS
PRESCRIBED BY THE SECRETARY PURSUANT TO  SECTION  1302(B)(1)(J)  OF  THE
FEDERAL ACT, AND SUCH OTHER DENTAL BENEFITS AS THE EXCHANGE OR SECRETARY
MAY SPECIFY IN REGULATIONS.
  (C)  INSURERS  MAY  JOINTLY  OFFER  A  COMPREHENSIVE  PLAN THROUGH THE
EXCHANGE IN WHICH AN INSURER PROVIDES  THE  DENTAL  BENEFITS  THROUGH  A
QUALIFIED DENTAL PLAN AND AN INSURER PROVIDES THE OTHER BENEFITS THROUGH
A  QUALIFIED  HEALTH PLAN, PROVIDED THAT THE PLANS ARE PRICED SEPARATELY
AND ALSO ARE MADE AVAILABLE FOR PURCHASE SEPARATELY AT THE SAME PRICE.
  S 3986. REGIONAL ADVISORY COMMITTEES. 1. THERE ARE HEREBY CREATED  THE
NEW YORK HEALTH BENEFIT EXCHANGE REGIONAL ADVISORY COMMITTEES ("ADVISORY
COMMITTEES"). ONE REGIONAL ADVISORY COMMITTEE SHALL BE ESTABLISHED WITH-
IN  EACH  OF  FIVE  REGIONS,  TO BE KNOWN AS THE "NEW YORK CITY REGION,"
"METROPOLITAN SUBURBAN REGION," "NORTHERN REGION," "CENTRAL REGION"  AND

S. 6256--A                         60                         A. 9056--A

"WESTERN  REGION."  THE  BOARD SHALL DETERMINE THE COUNTIES THAT MAKE UP
SUCH REGIONS.
  2. EACH REGIONAL ADVISORY COMMITTEE SHALL BE COMPRISED OF FIVE MEMBERS
APPOINTED  BY  THE  GOVERNOR,  ONE  OF  WHOM SHALL BE APPOINTED UPON THE
RECOMMENDATION OF THE TEMPORARY PRESIDENT OF THE SENATE AND ONE OF  WHOM
SHALL  BE APPOINTED UPON THE RECOMMENDATION OF THE SPEAKER OF THE ASSEM-
BLY.
  3. TERMS SHALL BE THREE  YEARS.    MEMBERS  SHALL  SERVE  UNTIL  THEIR
SUCCESSORS ARE APPOINTED. MEMBERS MAY SERVE UP TO TWO CONSECUTIVE TERMS.
  4.  VACANCIES  SHALL BE FILLED IN THE SAME MANNER AS ORIGINAL APPOINT-
MENTS, AND SUCCESSORS SHALL SERVE FOR THE  REMAINDER  OF  THE  UNEXPIRED
TERM TO WHICH THEY ARE APPOINTED.
  5.  RECOMMENDATIONS  BY  THE TEMPORARY PRESIDENT OF THE SENATE AND THE
SPEAKER OF THE ASSEMBLY SHALL BE MADE WITHIN SIXTY DAYS OF THE EFFECTIVE
DATE OF THIS ARTICLE OR THE OCCURRENCE OF A  VACANCY,  OR  WITHIN  SIXTY
DAYS PRIOR TO THE EXPIRATION OF A TERM.
  6. THE MEMBERS OF EACH REGIONAL ADVISORY COMMITTEE SHALL INCLUDE:
  (A)  REPRESENTATIVES  FROM THE FOLLOWING CATEGORIES, BUT NOT MORE THAN
TWO FROM ANY SINGLE CATEGORY:
  (I) HEALTH PLAN CONSUMER ADVOCATES;
  (II) SMALL BUSINESS CONSUMER REPRESENTATIVES;
  (III) HEALTH CARE PROVIDER REPRESENTATIVES;
  (IV) REPRESENTATIVES OF THE HEALTH INSURANCE INDUSTRY;
  (B) REPRESENTATIVES FROM THE FOLLOWING CATEGORIES, BUT NOT  MORE  THAN
ONE FROM EITHER CATEGORY:
  (I) LICENSED INSURANCE PRODUCERS; AND
  (II) REPRESENTATIVES OF LABOR ORGANIZATIONS.
  7.  THE BOARD SHALL SELECT THE CHAIR OF EACH REGIONAL ADVISORY COMMIT-
TEE FROM AMONG THE MEMBERS OF SUCH  COMMITTEE.  THE  BOARD  SHALL  ADOPT
RULES  FOR  THE  GOVERNANCE OF THE REGIONAL ADVISORY COMMITTEES AND EACH
REGIONAL ADVISORY COMMITTEE SHALL MEET AT LEAST ONCE EACH QUARTER AND AT
SUCH OTHER TIMES AS DETERMINED BY THE BOARD TO BE NECESSARY.
  8. MEMBERS OF THE REGIONAL ADVISORY  COMMITTEES  SHALL  SERVE  WITHOUT
COMPENSATION.
  9.  THE REGIONAL ADVISORY COMMITTEES SHALL MAKE FINDINGS AND RECOMMEN-
DATIONS REGARDING REGIONAL VARIATIONS IN THE OPERATION OF THE  EXCHANGE,
WHICH  SHALL  BE  SUBMITTED  TO  THE  BOARD  OF DIRECTORS, POSTED ON THE
WEBSITE OF THE EXCHANGE, AND CONSIDERED BY THE  BOARD  IN  A  REASONABLY
TIMELY  FASHION.  SUCH  FINDINGS AND RECOMMENDATIONS SHALL BE MADE ON AN
ANNUAL BASIS, ON A DATE DETERMINED BY THE BOARD, AND AT SUCH OTHER TIMES
AS THE BOARD OR ANY REGIONAL ADVISORY COMMITTEE DEEMS APPROPRIATE.
  S 3987. FUNDING OF THE EXCHANGE.  1. THE EXCHANGE SHALL BE FINANCIALLY
SELF-SUFFICIENT BY JANUARY FIRST, TWO THOUSAND FIFTEEN.
  2. THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF, AND
SHALL REPORT ITS RECOMMENDATIONS UPON, THE OPTIONS TO  GENERATE  FUNDING
FOR  THE  ONGOING OPERATION OF THE EXCHANGE, AS PROVIDED FOR IN SUBDIVI-
SION EIGHT OF SECTION THIRTY-NINE HUNDRED EIGHTY-EIGHT OF  THIS  ARTICLE
AND  SUBJECT  TO  THE PROVISIONS OF SUBDIVISIONS FOURTEEN AND FIFTEEN OF
SUCH SECTION.
  3.  THE EXCHANGE SHALL PUBLISH ON ITS INTERNET WEBSITE  THE  FEES  AND
ANY  OTHER  PAYMENTS  REQUIRED  BY  THE EXCHANGE, AND THE ADMINISTRATIVE
COSTS OF THE EXCHANGE, TO EDUCATE CONSUMERS ON SUCH COSTS AND THE AMOUNT
OF MONIES LOST TO WASTE, FRAUD AND ABUSE.
  4. THE EXCHANGE SHALL NOT UTILIZE ANY FUNDS INTENDED FOR THE  ADMINIS-
TRATIVE  AND  OPERATIONAL  EXPENSES  OF THE EXCHANGE FOR STAFF RETREATS,
PROMOTIONAL GIVEAWAYS, EXCESSIVE EXECUTIVE COMPENSATION, OR PROMOTION OF

S. 6256--A                         61                         A. 9056--A

FEDERAL OR STATE LEGISLATIVE AND REGULATORY  MODIFICATIONS  PURSUANT  TO
SECTION 1411(C) OF THE FEDERAL ACT.
  5.  THE  MONEYS OF THE EXCHANGE SHALL, EXCEPT AS OTHERWISE PROVIDED IN
THIS SECTION, BE DEPOSITED IN A GENERAL  ACCOUNT  CALLED  THE  NEW  YORK
HEALTH  BENEFIT EXCHANGE ACCOUNT AND SUCH OTHER ACCOUNTS AS THE EXCHANGE
MAY DEEM NECESSARY, PURSUANT TO RESOLUTION OF THE BOARD, FOR THE  TRANS-
ACTION  OF ITS BUSINESS AND SHALL BE PAID OUT AS AUTHORIZED BY THE CHAIR
OF THE BOARD OR BY SUCH OTHER PERSON OR PERSONS AS THE CHAIR MAY  DESIG-
NATE.
  6.  NO  FUNDS OF THE EXCHANGE SHALL BE TRANSFERRED TO THE GENERAL FUND
OR ANY SPECIAL REVENUE FUND OR SHALL BE USED FOR ANY PURPOSE OTHER  THAN
THE  PURPOSES  SET FORTH IN THIS ARTICLE.  NO FUNDS SHALL BE TRANSFERRED
FROM THE GENERAL FUND OR ANY SPECIAL REVENUE FUND TO THE EXCHANGE  WITH-
OUT AN APPROPRIATION.
  7. THE ACCOUNTS OF THE EXCHANGE SHALL BE SUBJECT TO SUPERVISION OF THE
COMPTROLLER  AND  SUCH  ACCOUNTS  SHALL  INCLUDE RECEIPTS, EXPENDITURES,
CONTRACTS AND OTHER MATTERS WHICH PERTAIN TO THE FISCAL SOUNDNESS OF THE
EXCHANGE.
  8. NOTWITHSTANDING ANY LAW TO THE CONTRARY,  AND  IN  ACCORDANCE  WITH
SECTION  FOUR  OF THE STATE FINANCE LAW, UPON REQUEST OF THE DIRECTOR OF
THE BUDGET, IN CONSULTATION WITH THE  COMMISSIONER,  THE  SUPERINTENDENT
AND  THE  CHAIR  OF  THE BOARD, THE COMPTROLLER IS HEREBY AUTHORIZED AND
DIRECTED TO SUBALLOCATE OR TRANSFER SPECIAL REVENUE FEDERAL FUNDS APPRO-
PRIATED TO THE DEPARTMENT OF HEALTH FOR PLANNING AND IMPLEMENTING  VARI-
OUS  HEALTHCARE  AND  INSURANCE REFORM INITIATIVES AUTHORIZED BY FEDERAL
LEGISLATION, INCLUDING, BUT NOT LIMITED TO, THE PATIENT  PROTECTION  AND
AFFORDABLE  CARE  ACT  (P.L.  111-148) AND THE HEALTH CARE AND EDUCATION
RECONCILIATION ACT OF 2010 (P.L. 111-152) TO THE NEW YORK  STATE  HEALTH
BENEFIT  EXCHANGE.  MONEYS  SUBALLOCATED OR TRANSFERRED PURSUANT TO THIS
SECTION SHALL BE PAID OUT OF THE FUND UPON  AUDIT  AND  WARRANT  OF  THE
STATE COMPTROLLER ON VOUCHERS CERTIFIED OR APPROVED BY THE EXCHANGE.
  S  3988.  STUDIES  AND  RECOMMENDATIONS.    1.  (A) THE EXCHANGE SHALL
CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF, AND SHALL MAKE  RECOMMENDA-
TIONS  UPON,  THE  ESSENTIAL HEALTH BENEFITS IDENTIFIED BY THE SECRETARY
PURSUANT TO SECTION 1302(B) OF THE  FEDERAL  ACT  AND  OF  THE  BENEFITS
REQUIRED  UNDER  THE INSURANCE LAW OR REGULATIONS PROMULGATED THEREUNDER
THAT ARE NOT DETERMINED BY THE SECRETARY TO BE  ESSENTIAL  HEALTH  BENE-
FITS. SUCH STUDY AND RECOMMENDATIONS SHALL ADDRESS MATTERS INCLUDING BUT
NOT LIMITED TO:
  (I)  WHETHER  THE ESSENTIAL HEALTH BENEFITS REQUIRED TO BE INCLUDED IN
POLICIES AND CONTRACTS SOLD THROUGH THE EXCHANGE SHOULD BE SOLD TO SIMI-
LARLY SITUATED INDIVIDUALS AND GROUPS PURCHASING COVERAGE OUTSIDE OF THE
EXCHANGE;
  (II) WHETHER ANY BENEFITS REQUIRED UNDER THE INSURANCE  LAW  OR  REGU-
LATIONS  PROMULGATED  THEREUNDER  THAT  ARE  NOT IDENTIFIED AS ESSENTIAL
HEALTH BENEFITS BY THE SECRETARY SHOULD NO LONGER BE REQUIRED  IN  POLI-
CIES OR CONTRACTS SOLD EITHER THROUGH THE EXCHANGE OR TO SIMILARLY SITU-
ATED INDIVIDUALS AND GROUPS OUTSIDE OF THE EXCHANGE;
  (III) THE COSTS OF EXTENDING ANY BENEFITS REQUIRED UNDER THE INSURANCE
LAW OR REGULATIONS PROMULGATED THEREUNDER TO POLICIES AND CONTRACTS SOLD
THROUGH THE EXCHANGE; AND
  (IV)   MECHANISMS   TO   FINANCE   ANY   COSTS   PURSUANT  TO  SECTION
1311(D)(3)(B)(II) OF THE FEDERAL ACT OF EXTENDING ANY BENEFITS  REQUIRED
UNDER  THE  INSURANCE LAW OR REGULATIONS PROMULGATED THEREUNDER TO POLI-
CIES AND CONTRACTS SOLD THROUGH THE EXCHANGE.

S. 6256--A                         62                         A. 9056--A

  (B) IN MAKING ITS RECOMMENDATIONS, THE  EXCHANGE  SHALL  CONSIDER  THE
INDIVIDUAL  AND SMALL GROUP MARKETS OUTSIDE OF THE EXCHANGE AND CONSIDER
APPROACHES TO PREVENT MARKETPLACE DISRUPTION, REMAIN CONSISTENT WITH THE
EXCHANGE AND AVOID ANTI-SELECTION.
  (C) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY  PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  2. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND SHALL MAKE RECOMMENDATIONS UPON: (I) WHETHER INSURERS  PARTICIPATING
IN THE EXCHANGE SHOULD BE REQUIRED TO OFFER ALL HEALTH PLANS SOLD IN THE
EXCHANGE  TO  INDIVIDUALS OR SMALL GROUPS PURCHASING COVERAGE OUTSIDE OF
THE EXCHANGE;
  (II) WHETHER THE INDIVIDUAL AND SMALL GROUP MARKETS SHOULD  BE  PLACED
ENTIRELY INSIDE THE EXCHANGE;
  (III)  WHETHER  THE BENEFITS IN THE INDIVIDUAL AND SMALL GROUP MARKETS
SHOULD BE STANDARDIZED INSIDE THE EXCHANGE OR  INSIDE  AND  OUTSIDE  THE
EXCHANGE;
  (IV) HOW TO DEVELOP AND IMPLEMENT THE TRANSITIONAL REINSURANCE PROGRAM
FOR  THE  INDIVIDUAL  MARKET  AND  ANY  OTHER RISK ADJUSTMENT MECHANISMS
DEVELOPED IN ACCORDANCE WITH SECTIONS 1341, 1342 AND 1343 OF THE FEDERAL
ACT;
  (V) WHETHER TO MERGE THE INDIVIDUAL AND SMALL GROUP  HEALTH  INSURANCE
MARKETS  FOR  RATING  PURPOSES  INCLUDING AN ANALYSIS OF THE IMPACT SUCH
MERGER WOULD HAVE ON PREMIUMS;
  (VI) WHETHER TO INCREASE THE SIZE OF SMALL EMPLOYERS FROM  AN  AVERAGE
OF  AT  LEAST  ONE BUT NOT MORE THAN FIFTY EMPLOYEES TO AN AVERAGE OF AT
LEAST ONE BUT NOT MORE THAN  ONE  HUNDRED  EMPLOYEES  PRIOR  TO  JANUARY
FIRST, TWO THOUSAND SIXTEEN;
  (VII)  HOW  TO ACCOUNT FOR SOLE PROPRIETORS IN DEFINING "SMALL EMPLOY-
ERS"; AND
  (VIII) WHETHER TO REVISE THE DEFINITION OF  "SMALL  EMPLOYER"  OUTSIDE
THE  EXCHANGE  TO BE CONSISTENT WITH THE DEFINITION AS IT APPLIES WITHIN
THE EXCHANGE.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON  OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  3. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND  SHALL MAKE RECOMMENDATIONS UPON, WHETHER THE STATE SHOULD ESTABLISH
A BASIC HEALTH PLAN PROGRAM IDENTIFIED  BY  THE  SECRETARY  PURSUANT  TO
SECTION 1331 OF THE FEDERAL ACT.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY  PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  4. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND SHALL MAKE RECOMMENDATIONS UPON, THE ADVANTAGES AND DISADVANTAGES OF
THE EXCHANGE SERVING AS AN ACTIVE PURCHASER, A SELECTIVE CONTRACTOR,  OR
CLEARINGHOUSE OF INSURANCE.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY  PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  5. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND SHALL MAKE RECOMMENDATIONS UPON, (I) THE ANTICIPATED ANNUAL  OPERAT-
ING  EXPENSES OF THE EXCHANGE, INCLUDING BUT NOT LIMITED TO THE DEVELOP-
MENT OF ANY MULTI-YEAR FINANCIAL MODELS; AND (II) THE OPTIONS TO  GENER-
ATE  FUNDING  FOR  THE  ONGOING  OPERATION  AND  SELF-SUFFICIENCY OF THE

S. 6256--A                         63                         A. 9056--A

EXCHANGE INCLUDING BUT NOT LIMITED  TO  ASSESSMENTS  UPON  INSURERS  AND
PROVIDERS.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY  PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  6. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND SHALL MAKE RECOMMENDATIONS UPON, THE BENCHMARK  BENEFITS  IDENTIFIED
BY  THE  SECRETARY  AND OF THE BENEFITS REQUIRED UNDER THE PUBLIC HEALTH
LAW OR THE SOCIAL SERVICES LAW  OR  REGULATIONS  PROMULGATED  THEREUNDER
THAT  ARE NOT DETERMINED BY THE SECRETARY TO BE BENCHMARK BENEFITS. SUCH
STUDY AND RECOMMENDATIONS SHALL ADDRESS MATTERS INCLUDING BUT NOT LIMIT-
ED TO:
  (I) WHETHER ANY BENEFITS REQUIRED UNDER THE PUBLIC HEALTH LAW  OR  THE
SOCIAL  SERVICES  LAW OR REGULATIONS PROMULGATED THEREUNDER THAT ARE NOT
IDENTIFIED AS BENCHMARK BENEFITS BY THE SECRETARY SHOULD CONTINUE TO  BE
REQUIRED  AS COVERED BENEFITS AVAILABLE TO NEWLY MEDICAID-ELIGIBLE INDI-
VIDUALS INSIDE THE EXCHANGE;
  (II) THE COSTS OF EXTENDING ANY BENEFITS  REQUIRED  UNDER  THE  PUBLIC
HEALTH  LAW OR THE SOCIAL SERVICES LAW OR REGULATIONS PROMULGATED THERE-
UNDER AS COVERED BENEFITS AVAILABLE TO NEWLY MEDICAID-ELIGIBLE  INDIVID-
UALS THROUGH THE EXCHANGE; AND
  (III)  MECHANISMS  TO FINANCE ANY COSTS PURSUANT TO THE FEDERAL ACT OF
EXTENDING ANY BENEFITS REQUIRED UNDER  THE  PUBLIC  HEALTH  LAW  OR  THE
SOCIAL  SERVICES  LAW  OR REGULATIONS PROMULGATED THEREUNDER TO POLICIES
AND CONTRACTS SOLD THROUGH THE EXCHANGE.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON  OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  7.  (A) THE EXCHANGE SHALL MAKE RECOMMENDATIONS UPON THE IMPACT OF THE
ESTABLISHMENT AND OPERATION OF THE EXCHANGE  ON  THE  HEALTHY  NEW  YORK
PROGRAM  ESTABLISHED  PURSUANT TO SECTION FORTY-THREE HUNDRED TWENTY-SIX
OF THE INSURANCE LAW AND THE FAMILY  HEALTH  PLUS  EMPLOYER  PARTNERSHIP
PROGRAM  ESTABLISHED  PURSUANT TO SECTION THREE HUNDRED SIXTY-NINE-FF OF
THE SOCIAL SERVICES LAW.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON  OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  8. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND  SHALL  MAKE  RECOMMENDATIONS  UPON, PROCEDURES UNDER WHICH LICENSED
HEALTH INSURANCE PRODUCERS, CHAMBERS OF COMMERCE  AND  BUSINESS  ASSOCI-
ATIONS MAY ENROLL INDIVIDUALS AND EMPLOYERS IN ANY QUALIFIED HEALTH PLAN
IN  THE  INDIVIDUAL OR SMALL GROUP MARKET AS SOON AS THE PLAN IS OFFERED
THROUGH THE EXCHANGE; AND TO ASSIST INDIVIDUALS IN APPLYING FOR  PREMIUM
TAX  CREDITS  AND  COST-SHARING  REDUCTIONS  FOR  PLANS SOLD THROUGH THE
EXCHANGE; AND
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND SPEAKER  OF  THE  ASSEMBLY  ON  OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  9. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND  SHALL  MAKE  RECOMMENDATIONS  UPON, THE CRITERIA FOR ELIGIBILITY TO
SERVE AS A NAVIGATOR FOR PURPOSES OF SECTION 1311(I) OF THE FEDERAL ACT,
ANY GUIDANCE ISSUED THEREUNDER AND SUBDIVISION FOURTEEN OF SECTION THIR-
TY-NINE HUNDRED EIGHTY-FOUR OF THIS ARTICLE.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON  OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.

S. 6256--A                         64                         A. 9056--A

  10.  (A)  THE  EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY
OF, AND SHALL MAKE RECOMMENDATIONS UPON, THE ROLE  OF  THE  EXCHANGE  IN
DECREASING  HEALTH  DISPARITIES IN HEALTH CARE SERVICES AND PERFORMANCE,
INCLUDING BUT NOT LIMITED TO DISPARITIES ON THE BASIS OF RACE OR ETHNIC-
ITY,  IN  ACCORDANCE WITH SECTION FORTY-THREE HUNDRED TWO OF THE FEDERAL
ACT.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON  OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  11.  (A)  THE  EXCHANGE SHALL MAKE RECOMMENDATIONS UPON WHETHER AND TO
WHAT EXTENT HEALTH  SAVINGS  ACCOUNTS  SHOULD  BE  OFFERED  THROUGH  THE
EXCHANGE.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY  PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  12. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE  CONDUCTED  A  STUDY
OF,  AND SHALL MAKE RECOMMENDATIONS UPON, WHETHER TO ALLOW LARGE EMPLOY-
ERS TO PARTICIPATE IN THE EXCHANGE BEGINNING JANUARY FIRST, TWO THOUSAND
SEVENTEEN, AND SHALL TAKE INTO ACCOUNT  ANY  EXCESS  OF  PREMIUM  GROWTH
OUTSIDE  OF  THE  EXCHANGE AS COMPARED TO THE RATE OF SUCH GROWTH INSIDE
THE EXCHANGE.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON  OR
BEFORE DECEMBER FIRST, TWO THOUSAND FIFTEEN.
  13.  THE  EXCHANGE  SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND SHALL MAKE RECOMMENDATIONS UPON, THE INTEGRATION  OF  PUBLIC  HEALTH
INSURANCE  PROGRAMS,  INCLUDING  MEDICAID, CHILD HEALTH PLUS, AND FAMILY
HEALTH PLUS WITHIN THE EXCHANGE, WHICH MAY INCLUDE SUCH REPORTS  AS  ARE
PERIODICALLY  SUBMITTED TO THE SECRETARY, ON OR BEFORE AUGUST FIRST, TWO
THOUSAND TWELVE.
  14. NOTWITHSTANDING ANY PROVISION OF SUBDIVISIONS ONE THROUGH THIRTEEN
OF THIS SECTION, IF THE EXCHANGE  DETERMINES  THAT  ANY  RECOMMENDATIONS
REQUIRED UNDER ANY SUCH SUBDIVISION CANNOT BE SUBMITTED BY THE SPECIFIED
DATE  BECAUSE FEDERAL GUIDANCE OR REGULATIONS NECESSARY TO COMPLETE SUCH
RECOMMENDATIONS HAS NOT BEEN ISSUED, THE EXCHANGE MAY  ESTABLISH  A  NEW
AND REASONABLE DATE FOR SUCH COMPLETION AND SUBMISSION.
  15. (A) ANY OF THE STUDIES REQUIRED UNDER THIS SECTION MAY BE COMBINED
WITH  OTHER  STUDIES REQUIRED UNDER THIS SECTION OR OTHERWISE UNDERTAKEN
BY THE EXCHANGE TO THE EXTENT FEASIBLE AND TIMELY.
  (B) IN LIEU OF CONDUCTING OR  CAUSING  TO  BE  CONDUCTED  ANY  OF  THE
STUDIES  REQUIRED  UNDER  THIS  SECTION,  THE EXCHANGE MAY RELY UPON ANY
OTHER STUDY OR STUDIES, IN WHOLE OR IN PART, COMPLETED PRIOR TO THE DATE
ON WHICH THE EXCHANGE  SUBMITS  ITS  RECOMMENDATIONS,  IF  THE  EXCHANGE
DETERMINES THAT SUCH STUDY OR STUDIES ARE SUFFICIENTLY RELIABLE.
  16.  THE EXCHANGE SHALL HAVE NO AUTHORITY, WHETHER EXPRESS OR IMPLIED,
TO IMPLEMENT ANY RECOMMENDATION ON THE ISSUES SET FORTH IN  SUBDIVISIONS
ONE  THROUGH TWELVE OF THIS SECTION WITHOUT FURTHER STATUTORY AUTHORITY;
PROVIDED, HOWEVER, THAT NOTHING IN THIS SUBDIVISION SHALL BE  DEEMED  TO
ALTER ANY POWERS EXPRESSLY GRANTED ELSEWHERE IN THIS ARTICLE.
  S  3989. TAX EXEMPTION AND TAX CONTRACT BY THE STATE.  1. IT IS HEREBY
DETERMINED THAT THE CREATION OF THE EXCHANGE AND THE FULFILLMENT OF  ITS
CORPORATE  PURPOSES  IS IN ALL RESPECTS FOR THE BENEFIT OF THE PEOPLE OF
THIS STATE AND IS A PUBLIC PURPOSE. ACCORDINGLY, THE EXCHANGE  SHALL  BE
REGARDED  AS  PERFORMING AN ESSENTIAL GOVERNMENTAL FUNCTION IN THE EXER-
CISE OF THE POWERS CONFERRED UPON IT BY THIS ARTICLE, AND  THE  EXCHANGE
SHALL  NOT BE REQUIRED TO PAY ANY FEES, TAXES, SPECIAL AD VALOREM LEVIES

S. 6256--A                         65                         A. 9056--A

OR ASSESSMENTS OF ANY KIND, WHETHER STATE OR LOCAL,  INCLUDING  BUT  NOT
LIMITED TO FEES, TAXES, SPECIAL AD VALOREM LEVIES OR ASSESSMENTS ON REAL
PROPERTY,  FRANCHISE  TAXES, SALES TAXES, TRANSFER TAXES, MORTGAGE TAXES
OR  OTHER  TAXES,  UPON  OR  WITH RESPECT TO ANY PROPERTY OWNED BY IT OR
UNDER ITS JURISDICTION, CONTROL OR SUPERVISION, OR UPON THE USES  THERE-
OF,  OR UPON OR WITH RESPECT TO ITS ACTIVITIES OR OPERATIONS IN FURTHER-
ANCE OF THE POWERS CONFERRED UPON IT BY THIS ARTICLE, OR  UPON  OR  WITH
RESPECT  TO ANY FARES, TOLLS, RENTALS, RATES, CHARGES, FEES, REVENUES OR
OTHER INCOME RECEIVED BY THE EXCHANGE.
  2. THE EXCHANGE MAY PAY, OR MAY ENTER INTO AGREEMENTS WITH ANY  COUNTY
OR  MUNICIPALITY  TO  PAY,  A  SUM  OR  SUMS ANNUALLY OR OTHERWISE OR TO
PROVIDE OTHER CONSIDERATIONS WITH RESPECT TO REAL PROPERTY OWNED BY  THE
EXCHANGE LOCATED WITHIN SUCH COUNTY OR MUNICIPALITY.
  S  3990.  OFFICERS AND EMPLOYEES. 1. THE BOARD SHALL HAVE THE POWER TO
APPOINT EMPLOYEES TO SERVE AS SENIOR MANAGERIAL STAFF OF THE EXCHANGE AS
NECESSARY, WHO SHALL BE DESIGNATED TO BE IN THE EXEMPT  CLASS  OF  CIVIL
SERVICE. THE BOARD SHALL ALSO HAVE THE POWER TO FIX THE SALARIES OF SUCH
EMPLOYEES.
  2.  ANY  NEWLY  HIRED  EMPLOYEES  WHO  ARE NOT DESIGNATED TO BE IN THE
EXEMPT CLASS OF CIVIL  SERVICE  PURSUANT  TO  SUBDIVISION  ONE  OF  THIS
SECTION  AND WHO ARE NOT SUBJECT TO THE TRANSFER PROVISIONS SET FORTH IN
SUBDIVISIONS FOUR, FIVE AND SIX OF THIS SECTION SHALL BE CONSIDERED  FOR
PURPOSES  OF  ARTICLE  FOURTEEN  OF  THE  CIVIL SERVICE LAW TO BE PUBLIC
EMPLOYEES IN THE CIVIL SERVICE OF THE STATE, AND SHALL  BE  ASSIGNED  TO
THE  APPROPRIATE  COLLECTIVE BARGAINING UNIT BY THE EXCHANGE IN THE SAME
MANNER AND CONSISTENT WITH THOSE EMPLOYEES DESCRIBED IN SUBDIVISION  SIX
OF THIS SECTION.
  3.  ANY  PUBLIC  OFFICER  OR EMPLOYEE OF A STATE DEPARTMENT, AGENCY OR
COMMISSION MAY BE TRANSFERRED TO THE EXCHANGE  WITHOUT  EXAMINATION  AND
WITHOUT  LOSS  OF  ANY  CIVIL  SERVICE  STATUS OR RIGHTS TO A COMPARABLE
OFFICE, POSITION OR EMPLOYMENT WITH THE EXCHANGE; PROVIDED, HOWEVER,  NO
SUCH TRANSFER MAY BE MADE WITHOUT THE CONSENT OF THE HEAD OF THE DEPART-
MENT,  AGENCY OR COMMISSION.  TRANSFERS SHALL BE MADE PURSUANT TO SUBDI-
VISION TWO OF SECTION SEVENTY OF THE CIVIL SERVICE LAW.
  4. THE SALARY OR COMPENSATION OF ANY SUCH OFFICER OR  EMPLOYEE,  AFTER
SUCH TRANSFER, SHALL BE PAID BY THE EXCHANGE.
  5.  ANY  OFFICER  OR  EMPLOYEE TRANSFERRED TO THE EXCHANGE PURSUANT TO
THIS SECTION, WHO ARE MEMBERS OF OR BENEFIT UNDER ANY  EXISTING  PENSION
OR  RETIREMENT FUND OR SYSTEM, SHALL CONTINUE TO HAVE ALL RIGHTS, PRIVI-
LEGES, OBLIGATIONS AND STATUS WITH RESPECT TO SUCH FUND OR SYSTEM AS ARE
NOW PRESCRIBED BY LAW, BUT DURING THE PERIOD OF THEIR EMPLOYMENT BY  THE
EXCHANGE,  ALL  CONTRIBUTIONS TO SUCH FUNDS OR SYSTEMS TO BE PAID BY THE
EMPLOYER ON ACCOUNT OF SUCH OFFICERS OR EMPLOYEES SHALL BE PAID  BY  THE
EXCHANGE.
  6. A TRANSFERRED EMPLOYEE SHALL REMAIN IN THE SAME COLLECTIVE BARGAIN-
ING UNIT AS WAS THE CASE PRIOR TO HIS OR HER TRANSFER; SUCCESSOR EMPLOY-
EES  TO THE POSITIONS HELD BY SUCH TRANSFERRED EMPLOYEES SHALL, CONSIST-
ENT WITH THE PROVISIONS OF ARTICLE FOURTEEN OF THE CIVIL SERVICE LAW, BE
INCLUDED IN THE SAME UNIT AS THEIR PREDECESSORS.  EMPLOYEES  SERVING  IN
POSITIONS  IN NEWLY CREATED TITLES SHALL BE ASSIGNED TO THE SAME COLLEC-
TIVE BARGAINING UNIT AS THEY WOULD  HAVE  BEEN  ASSIGNED  TO  WERE  SUCH
TITLES  CREATED  PRIOR  TO  THE  ESTABLISHMENT  OF THE EXCHANGE. NOTHING
CONTAINED IN THIS ARTICLE SHALL BE CONSTRUED (A) TO DIMINISH THE  RIGHTS
OF  EMPLOYEES  PURSUANT  TO  A COLLECTIVE BARGAINING AGREEMENT OR (B) TO
AFFECT EXISTING LAW WITH RESPECT TO AN APPLICATION TO THE PUBLIC EMPLOY-

S. 6256--A                         66                         A. 9056--A

MENT RELATIONS BOARD SEEKING A DESIGNATION BY  THE  BOARD  THAT  CERTAIN
PERSONS ARE MANAGERIAL OR CONFIDENTIAL.
  S  3991.  LIMITATION OF LIABILITY; INDEMNIFICATION.  THE PROVISIONS OF
SECTIONS SEVENTEEN AND NINETEEN OF THE  PUBLIC  OFFICERS  LAW  SHALL  BE
APPLICABLE  TO  EXCHANGE  EMPLOYEES, AS SUCH TERM IS DEFINED IN SECTIONS
SEVENTEEN AND NINETEEN OF THE PUBLIC OFFICERS  LAW;  PROVIDED,  HOWEVER,
THAT NOTHING CONTAINED WITHIN THIS SECTION SHALL BE DEEMED TO PERMIT THE
EXCHANGE  TO EXTEND THE PROVISIONS OF SECTIONS SEVENTEEN AND NINETEEN OF
THE PUBLIC OFFICERS LAW UPON ANY INDEPENDENT CONTRACTOR.
  S 3992. CONTINGENCY FOR FEDERAL FUNDING.   THE IMPLEMENTATION  OF  THE
PROVISIONS  OF  THIS  ARTICLE  SHALL BE CONTINGENT, AS DETERMINED BY THE
DIRECTOR OF THE BUDGET, ON THE AVAILABILITY OF SUFFICIENT FEDERAL FINAN-
CIAL SUPPORT FOR THE PLANNING AND  IMPLEMENTATION  OF  HEALTH  CARE  AND
INSURANCE REFORM INITIATIVES AUTHORIZED BY FEDERAL LEGISLATION TO ESTAB-
LISH AND IMPLEMENT THE HEALTH BENEFIT EXCHANGE.
  S 3993. CONSTRUCTION.  NOTHING IN THIS ARTICLE, AND NO ACTION TAKEN BY
THE EXCHANGE PURSUANT HERETO, SHALL BE CONSTRUED TO:
  1.  PREEMPT  OR  SUPERSEDE  THE AUTHORITY OF THE SUPERINTENDENT OR THE
COMMISSIONER; OR
  2. EXEMPT INSURERS, INSURANCE PRODUCERS OR QUALIFIED HEALTH PLANS FROM
THE PUBLIC HEALTH LAW OR THE INSURANCE LAW AND  REGULATIONS  PROMULGATED
THEREUNDER.
  S 3. Subdivision 1 of section 17 of the public officers law is amended
by adding a new paragraph (x) to read as follows:
  (X)  FOR  PURPOSES  OF THIS SECTION, THE TERM "EMPLOYEE" SHALL INCLUDE
DIRECTORS, OFFICERS  AND  EMPLOYEES  OF  THE  NEW  YORK  HEALTH  BENEFIT
EXCHANGE ESTABLISHED PURSUANT TO ARTICLE TEN-E OF THE PUBLIC AUTHORITIES
LAW.
  S 4. Subdivision 1 of section 19 of the public officers law is amended
by adding a new paragraph (j) to read as follows:
  (J)  FOR  PURPOSES  OF THIS SECTION, THE TERM "EMPLOYEE" SHALL INCLUDE
DIRECTORS, OFFICERS  AND  EMPLOYEES  OF  THE  NEW  YORK  HEALTH  BENEFIT
EXCHANGE ESTABLISHED PURSUANT TO ARTICLE TEN-E OF THE PUBLIC AUTHORITIES
LAW.
  S  5.  If any provision or application of this act shall be held to be
invalid, or to violate or be inconsistent with  any  applicable  federal
law  or  regulation,  that shall not affect other provisions or applica-
tions of this act which can be given effect without  that  provision  or
application;  and  to  that end, the provisions and applications of this
act are severable; provided, however, that nothing in this section shall
be deemed to invalidate the provisions of section  3992  of  the  public
authorities law, as added by section two of this act.
  S  6. If the federal act is held to be unconstitutional by the supreme
court of the United States or repealed by the  United  States  Congress,
the  legislature  shall  convene  within  180  days  of such decision or
congressional act to consider appropriate legislative options.
  S 7. This act shall take effect immediately; provided,  however,  that
until such time as the members of the board of directors of the New York
health benefit exchange are initially appointed pursuant to section 3982
of  the public authorities law, as added by section two of this act, and
the first meeting of such board is convened, nothing in this  act  shall
be deemed to prevent the commissioner of health or the superintendent of
financial services from applying for, accepting the award of, and spend-
ing  any available grant money pertaining to the establishment or opera-
tion of such exchange for purposes consistent with this act or,  at  any

S. 6256--A                         67                         A. 9056--A

time, from accepting or spending grant money awarded prior to the enact-
ment of this act.

                                 PART F

  Section  1.  Section  1  of  part C of chapter 58 of the laws of 2005,
authorizing reimbursements for expenditures made  by  or  on  behalf  of
social  services  districts for medical assistance for needy persons and
the administration thereof, is amended by adding a new subdivision (c-1)
to read as follows:
  (C-1) NOTWITHSTANDING  ANY  PROVISIONS  OF  SUBDIVISION  (C)  OF  THIS
SECTION TO THE CONTRARY, EFFECTIVE APRIL 1, 2013, FOR THE PERIOD JANUARY
1, 2013 THROUGH DECEMBER 31, 2013 AND FOR EACH CALENDAR YEAR THEREAFTER,
THE  MEDICAL  ASSISTANCE  EXPENDITURE  AMOUNT  FOR  THE  SOCIAL SERVICES
DISTRICT FOR SUCH PERIOD SHALL BE EQUAL TO THE PREVIOUS CALENDAR  YEAR'S
MEDICAL ASSISTANCE EXPENDITURE AMOUNT, EXCEPT THAT:
  (1)  FOR  THE  PERIOD  JANUARY  1, 2013 THROUGH DECEMBER 31, 2013, THE
PREVIOUS CALENDAR YEAR MEDICAL ASSISTANCE  EXPENDITURE  AMOUNT  WILL  BE
INCREASED BY 2%;
  (2)  FOR  THE  PERIOD  JANUARY  1, 2014 THROUGH DECEMBER 31, 2014, THE
PREVIOUS CALENDAR YEAR MEDICAL ASSISTANCE  EXPENDITURE  AMOUNT  WILL  BE
INCREASED BY 1%.
  S  2.  Paragraph  (iii)  of  subdivision (g) of section 1 of part C of
chapter 58 of the laws of 2005, authorizing reimbursements for  expendi-
tures  made  by  or  on  behalf of social services districts for medical
assistance for needy persons and the administration thereof, as  amended
by section 59 of part A of chapter 57 of the laws of 2006, is amended to
read as follows:
  (iii)  During each state fiscal year subject to the provisions of this
section AND PRIOR TO STATE FISCAL YEAR 2015-16, the  commissioner  shall
maintain  an  accounting,  for each social services district, of the net
amounts that would have been expended by, or on behalf of, such district
had the social services district medical assistance shares provisions in
effect on January 1, 2005 been applied to such district.   For  purposes
of  this paragraph, fifty percent of the payments made by New York State
to the secretary of the federal department of health and human  services
pursuant  to  section 1935(c) of the social security act shall be deemed
to be payments made on behalf of social services districts;  such  fifty
percent share shall be apportioned to each district in the same ratio as
the  number of "full-benefit dual eligible individuals," as that term is
defined in section 1935(c)(6) of such act, for whom  such  district  has
fiscal  responsibility  pursuant  to  section 365 of the social services
law, relates to the total of such individuals for  whom  districts  have
fiscal  responsibility.   As soon as practicable after the conclusion of
each such fiscal year, but in no event later than six months  after  the
conclusion  of  each  such fiscal year, the commissioner shall reconcile
such net amounts  with  such  fiscal  year's  social  services  district
expenditure  cap  amount.  Such  reconciliation shall be based on actual
expenditures made by or on behalf  of  social  services  districts,  and
revenues  received by social services districts, during such fiscal year
and shall be made without regard  to  expenditures  made,  and  revenues
received, outside such fiscal year that are related to services provided
during,  or  prior  to,  such fiscal year. The commissioner shall pay to
each social  services  district  the  amount,  if  any,  by  which  such
district's expenditure cap amount exceeds such net amount.

S. 6256--A                         68                         A. 9056--A

  S  3. Paragraph (i) of subdivision (b) of section 2 of part C of chap-
ter 58 of the laws of 2005, authorizing reimbursements for  expenditures
made by or on behalf of social services districts for medical assistance
for  needy  persons and the administration thereof, is amended and a new
paragraph (iii) is added to read as follows:
  (i)  A social services district shall exercise the option described in
this section through the adoption of a resolution by its local  legisla-
tive body, in the form set forth in subparagraph (ii) of this paragraph,
to  elect  the medical assistance reimbursement methodology set forth in
paragraph (a) of this section and to elect the tax intercept methodology
set forth in subdivision (f) of section 1261 of the tax law or  subdivi-
sion  (g) of section 1261 and subdivision (h) of section 1313 of the tax
law, as applicable. A social services district, acting through its local
legislative body, is hereby authorized to adopt such a resolution.  Such
a  resolution  shall  be  effective only if it is adopted exactly as set
forth in subparagraph (ii) of this paragraph no later than September 30,
2007, and a certified copy of such resolution is mailed to  the  commis-
sioner  of  health  by  certified mail by such date. The commissioner of
health shall, no later than October 31, 2007, certify to the commission-
er of taxation and finance a list of  those  social  services  districts
which  have  elected  the  option  described  in  this section. A social
services district [shall have no authority to rescind the  exercise  of]
THAT  ELECTED  the  option described in this section, ACTING THROUGH ITS
LOCAL LEGISLATIVE BODY, MAY REPEAL THAT ELECTION BY  ADOPTING  A  RESOL-
UTION  EXACTLY  AS  SET FORTH IN PARAGRAPH (III) OF THIS SUBDIVISION AND
MAILING A CERTIFIED COPY OF SUCH REPEAL RESOLUTION TO  THE  COMMISSIONER
OF  HEALTH  NO  LATER  THAN JANUARY 1, 2013.  THE COMMISSIONER OF HEALTH
SHALL, WITHIN TWO WEEKS OF RECEIVING ANY SUCH COPY OF A CERTIFIED REPEAL
RESOLUTION BY CERTIFIED MAIL FROM A SOCIAL SERVICES DISTRICT, CERTIFY IN
WRITING TO THE COMMISSIONER OF TAXATION AND FINANCE THE NAME OF ANY SUCH
SOCIAL SERVICES DISTRICT THAT ADOPTED SUCH A RESOLUTION  TO  REPEAL  ITS
ELECTION. UPON RECEIVING SUCH WRITTEN CERTIFICATION, THE COMMISSIONER OF
TAXATION  AND  FINANCE  SHALL NO LONGER CALCULATE THE MEDICAID AMOUNT OF
SUCH COUNTY UNDER SUBDIVISION (F) OF SECTION 1261 OF THE  TAX  LAW,  AND
THE  AMOUNT  DUE  SUCH COUNTY UNDER SUBDIVISION (C) OF SUCH SECTION 1261
SHALL NO LONGER BE REDUCED BY SUCH MEDICAID AMOUNT, EFFECTIVE THE  FIRST
DAY OF THE MONTH NEXT COMMENCING AT LEAST 10 DAYS AFTER THE COMMISSIONER
OF  TAXATION  AND  FINANCE  HAS  RECEIVED SUCH WRITTEN CERTIFICATION. IF
EVERY SOCIAL SERVICE DISTRICT  THAT  ELECTED  SUCH  OPTION  REPEALS  ITS
ELECTION  AND  THE  COMMISSIONER  OF  HEALTH CERTIFIES IN WRITING TO THE
COMMISSIONER OF TAXATION AND FINANCE THAT  EVERY  SUCH  SOCIAL  SERVICES
DISTRICT  HAS  REPEALED  ITS  ELECTION, THEN SUBDIVISIONS (F) AND (G) OF
SECTION 1261 AND SUBDIVISION (H) OF SECTION 1313  OF  THE  TAX  LAW  TAX
SHALL  BE  REPEALED  AND  THE  PHRASE "OR A TAX REVENUE INTERCEPT AMOUNT
CALCULATED PURSUANT TO SUBDIVISION (F) OR (G) OF SECTION 1261 OF THE TAX
LAW" IN SECTION FOUR OF THIS ACT SHALL BE DELETED, EFFECTIVE  THE  FIRST
DAY  OF  THE  MONTH  NEXT  COMMENCING AT LEAST 10 DAYS AFTER THE DATE ON
WHICH THE COMMISSIONER OF TAXATION AND  FINANCE  RECEIVES  SUCH  WRITTEN
CERTIFICATION FROM THE COMMISSIONER OF HEALTH. AT THE SAME TIME THAT THE
COMMISSIONER  OF  HEALTH MAKES SUCH CERTIFICATION TO THE COMMISSIONER OF
TAXATION AND FINANCE THAT EVERY COUNTY HAS REPEALED  ITS  ELECTION,  THE
COMMISSIONER  OF  HEALTH SHALL ALSO NOTIFY THE LEGISLATIVE BILL DRAFTING
COMMISSION THAT EVERY SOCIAL SERVICE DISTRICT THAT ELECTED  SUCH  OPTION
HAS  REPEALED  ITS  ELECTION IN ORDER THAT THE LEGISLATIVE BILL DRAFTING
COMMISSION MAY MAINTAIN AN ACCURATE AND TIMELY DATA BASE OF THE OFFICIAL
TEXT OF THE LAWS OF THE STATE OF NEW YORK IN  FURTHERANCE  OF  EFFECTING

S. 6256--A                         69                         A. 9056--A

THE  PROVISIONS OF SECTION 44 OF THE LEGISLATIVE LAW AND SECTION 70-B OF
THE PUBLIC OFFICERS LAW.
  (III) FORM OF RESOLUTION.
  BE IT ENACTED BY THE (COUNTY) OF (INSERT COUNTY'S NAME) AS FOLLOWS:
  SECTION ONE. THE (COUNTY) OF (INSERT COUNTY'S NAME) HEREBY REPEALS ITS
ELECTION  IN  2007  OF  THE  MEDICAL ASSISTANCE REIMBURSEMENT OPTION AND
REVENUE INTERCEPT FOR MEDICAID PURPOSES DESCRIBED IN SECTION 2 OF  CHAP-
TER 58 OF THE LAWS OF 2005.
  SECTION 2. THIS RESOLUTION SHALL TAKE EFFECT IMMEDIATELY.
  S  4. Part C of chapter 58 of the laws of 2005, authorizing reimburse-
ments for expenditures made by or on behalf of social services districts
for medical assistance for needy persons and the administration thereof,
is amended by adding a new section 4-a to read as follows:
  S 4-A. (A) FOR STATE FISCAL YEAR 2012-13, AND FOR  EACH  STATE  FISCAL
YEAR  THEREAFTER,  A  SOCIAL SERVICES DISTRICT WILL BE REIMBURSED BY THE
STATE FOR THE FULL NON-FEDERAL SHARE OF EXPENDITURES BY THE DISTRICT FOR
THE ADMINISTRATION OF THE MEDICAL ASSISTANCE PROGRAM, NOT TO EXCEED  THE
ADMINISTRATIVE  CAP AMOUNT DETERMINED IN ACCORDANCE WITH SUBDIVISION (B)
OF THIS SECTION. ANY PORTION OF THE NON-FEDERAL SHARE OF  SUCH  EXPENDI-
TURES  IN EXCESS OF THE ADMINISTRATIVE CAP AMOUNT SHALL BE THE RESPONSI-
BILITY OF THE SOCIAL SERVICES DISTRICT AND SHALL BE IN ADDITION  TO  THE
MEDICAL  ASSISTANCE  EXPENDITURE  AMOUNT  CALCULATED  IN ACCORDANCE WITH
SUBDIVISIONS (B), (C), (C-1), AND (D) OF SECTION ONE OF THIS ACT. BEGIN-
NING IN STATE FISCAL YEAR 2013-14, NO REIMBURSEMENT  WILL  BE  MADE  FOR
ADMINISTRATIVE EXPENDITURES IN EXCESS OF SUCH CAP.
  (B) THE ADMINISTRATIVE CAP AMOUNT FOR A SOCIAL SERVICES DISTRICT SHALL
BE EQUAL TO A PERCENTAGE OF THE AMOUNT INCLUDED IN THE STATE FISCAL YEAR
2011-12  ENACTED  BUDGET FOR THE NON-FEDERAL SHARE OF MEDICAL ASSISTANCE
ADMINISTRATIVE COSTS PURSUANT TO  THIS  SECTION.  EACH  SOCIAL  SERVICES
DISTRICT'S  PERCENTAGE  SHALL  BE  EQUAL  TO  THE  PERCENTAGE OF MEDICAL
ASSISTANCE ADMINISTRATIVE COSTS CLAIMED BY SUCH  DISTRICT  IN  THE  2011
CALENDAR YEAR IN RELATION TO ALL OTHER SOCIAL SERVICES DISTRICTS.
  (C) NOTWITHSTANDING THE PROVISIONS OF SUBDIVISION (B) OF THIS SECTION,
THE  COMMISSIONER OF HEALTH MAY, AT HIS OR HER SOLE DISCRETION, REDUCE A
SOCIAL SERVICES DISTRICT'S ADMINISTRATIVE CAP AMOUNT TO  ACCOUNT  FOR  A
REDUCTION  IN  THE  SCOPE  OR  VOLUME  OF  THE DISTRICT'S ADMINISTRATIVE
RESPONSIBILITIES, INCLUDING BUT NOT LIMITED TO SUCH A REDUCTION  RESULT-
ING  FROM  THE PROCESS OF CONVERTING THE MEDICAL ASSISTANCE PROGRAM TO A
DEPARTMENT-ADMINISTERED PROGRAM PURSUANT TO SECTION 365-N OF THE  SOCIAL
SERVICES LAW.
  S  5.  Section 91 of part H of chapter 59 of the laws of 2011 amending
the public health law  and  other  laws  relating  to  general  hospital
reimbursement for annual rates is amended to read as follows:
  S 91. 1. Notwithstanding any inconsistent provision of state law, rule
or  regulation to the contrary, subject to federal approval, the year to
year rate of growth of department of health state funds Medicaid  spend-
ing  shall not exceed the ten year rolling average of the medical compo-
nent of the consumer price index  as  published  by  the  United  States
department  of  labor, bureau of labor statistics, for the preceding ten
years.
  2. EXCEPT AS PROVIDED IN SUBDIVISION THREE OF THIS SECTION, FOR  STATE
FISCAL  YEAR  2013-14  AND FOR EACH FISCAL YEAR THEREAFTER, THE SPENDING
LIMIT CALCULATED PURSUANT TO SUBDIVISION ONE OF THIS  SECTION  SHALL  BE
INCREASED  BY AN AMOUNT EQUAL TO THE DIFFERENCE BETWEEN THE TOTAL SOCIAL
SERVICES DISTRICT MEDICAL ASSISTANCE EXPENDITURE AMOUNTS CALCULATED  FOR
SUCH PERIOD IN CONFORMANCE WITH SUBDIVISIONS (B), (C), (C-1), AND (D) OF

S. 6256--A                         70                         A. 9056--A

SECTION  1  OF  PART  C  OF CHAPTER 58 OF THE LAWS OF 2005 AND THE TOTAL
SOCIAL SERVICES DISTRICT MEDICAL EXPENDITURE  AMOUNTS  THAT  WOULD  HAVE
RESULTED  IF THE PROVISIONS OF SUBDIVISION (C-1) OF SUCH SECTION HAD NOT
BEEN APPLIED.
  3.  WITH RESPECT TO A SOCIAL SERVICES DISTRICT THAT RESCINDS THE EXER-
CISE OF THE OPTION PROVIDED IN  PARAGRAPH  (I)  OF  SUBDIVISION  (B)  OF
SECTION  2 OF PART C OF CHAPTER 58 OF THE LAWS OF 2005, FOR STATE FISCAL
YEAR 2013-14 AND FOR EACH FISCAL YEAR  THEREAFTER,  THE  SPENDING  LIMIT
CALCULATED  PURSUANT TO SUBDIVISION ONE OF THIS SECTION SHALL BE REDUCED
BY THE AMOUNT OF THE MEDICAL ASSISTANCE  EXPENDITURE  AMOUNT  CALCULATED
FOR SUCH DISTRICT FOR SUCH PERIOD.
  S  6. The social services law is amended by adding a new section 365-n
to read as follows:
  S 365-N. DEPARTMENT ASSUMPTION OF PROGRAM ADMINISTRATION.  1. LEGISLA-
TIVE INTENT. (A) THE  LEGISLATURE  FINDS  THAT  TO  ENSURE  THE  MEDICAL
ASSISTANCE  PROGRAM CONTINUES TO FUNCTION IN AN EFFICIENT MANNER TO MAKE
HIGH QUALITY MEDICAL CARE, SERVICES, AND SUPPLIES AVAILABLE TO  ELIGIBLE
PERSONS,  AND  TO ACHIEVE TIMELY COMPLIANCE WITH THE REQUIREMENTS OF THE
PATIENT PROTECTION AND AFFORDABLE CARE ACT RELATED TO THE  EXPANSION  OF
THE  MEDICAL  ASSISTANCE  PROGRAM  AND  THE  CREATION  OF  A HEALTH CARE
EXCHANGE, IT IS NECESSARY TO CONVERT THE PROGRAM OF  MEDICAL  ASSISTANCE
FROM  ONE PRIMARILY ADMINISTERED BY SOCIAL SERVICES DISTRICTS, UNDER THE
SUPERVISION OF THE DEPARTMENT OF HEALTH ("DEPARTMENT"), TO ONE  ADMINIS-
TERED  BY  THE  DEPARTMENT,  WITH  SUCH  ASSISTANCE FROM SOCIAL SERVICES
DISTRICTS AS THE COMMISSIONER OF HEALTH ("COMMISSIONER")  MAY  DETERMINE
NECESSARY,  AND THAT SUCH CONVERSION SHOULD BE COMPLETED BY APRIL FIRST,
TWO THOUSAND EIGHTEEN.   RECOGNIZING THE COMPLEXITY  AND  DIFFICULTY  OF
COMPLETING  THIS  CONVERSION WITHIN SUCH TIME FRAME, IT IS THE INTENT OF
THE LEGISLATURE TO GRANT THE COMMISSIONER BROAD AUTHORITY AND FLEXIBILI-
TY TO TAKE ACTIONS NECESSARY TO ACHIEVE THIS GOAL, AS DETERMINED BY  THE
COMMISSIONER,  AND  TO  HAVE THE PROVISIONS OF THIS SECTION CONSTRUED IN
LIGHT OF THE AUTHORITY AND FLEXIBILITY SO GRANTED. THE ADMINISTRATION OF
THE PROGRAM BY THE DEPARTMENT MAY BE ACCOMPLISHED  THROUGH  THE  USE  OF
DEPARTMENT  STAFF,  CONTRACTED ENTITIES, OR SOME COMBINATION THEREOF, AS
DETERMINED ADVISABLE BY THE COMMISSIONER TO ACHIEVE THE  GOALS  OF  THIS
SECTION,  SUBJECT TO THE LIMITATIONS PRESCRIBED HEREIN. THE COMMISSIONER
WILL CONSULT WITH SOCIAL SERVICES DISTRICTS IN FORMULATING  THE  OPTIMAL
PLAN FOR IMPLEMENTING THIS CONVERSION.
  (B)  THE  LEGISLATURE FURTHER FINDS THAT THE CONTINUED, UNINTERRUPTED,
ADEQUATE AND EFFICIENT OPERATION OF FUNCTIONS RELATED TO MEDICAL ASSIST-
ANCE ELIGIBILITY AND COVERED  BENEFITS  IS  NECESSARY  FOR  THE  GENERAL
WELFARE  OF  THE  PEOPLE  OF THE STATE; THAT SUCH OPERATION INVOLVES AND
REQUIRES PERSONNEL WITH TRAINING, PRACTICAL EXPERIENCE AND KNOWLEDGE  IN
MEDICAL  ASSISTANCE ELIGIBILITY AND COVERED BENEFITS; AND THAT REQUIRING
COMPETITIVE EXAMINATION FOR APPOINTMENT OF PERSONS CURRENTLY  PERFORMING
SUCH  FUNCTIONS  IN COUNTIES IN THE STATE TO POSITIONS IN THE CLASSIFIED
SERVICE OF THE STATE UPON  THE  ASSUMPTION  OF  SUCH  FUNCTIONS  BY  THE
DEPARTMENT  WOULD  IRREPARABLY  DISRUPT, DELAY AND IMPEDE OPERATIONS AND
INTERRUPT THE CONTINUANCE AND PERFORMANCE OF IMPORTANT SERVICES.
  2. NOTWITHSTANDING THE PROVISIONS OF TITLE TWO  OF  ARTICLE  THREE  OF
THIS  CHAPTER OR OF SECTION THREE HUNDRED SIXTY-FIVE OF THIS TITLE OR OF
ANY OTHER LAW TO THE CONTRARY, THE COMMISSIONER IS  AUTHORIZED  TO  TAKE
ANY  AND ALL ACTIONS NECESSARY TO TRANSFER RESPONSIBILITY FOR THE ADMIN-
ISTRATION  OF  THE  MEDICAL  ASSISTANCE  PROGRAM  FROM  SOCIAL  SERVICES
DISTRICTS TO THE DEPARTMENT.

S. 6256--A                         71                         A. 9056--A

  3. FOR PURPOSES OF THIS SECTION, ADMINISTRATION OF THE MEDICAL ASSIST-
ANCE  PROGRAM INCLUDES PROCESSING APPLICATIONS FOR BENEFITS AND SERVICES
AVAILABLE UNDER THIS TITLE AND TITLE ELEVEN-D OF  THIS  ARTICLE,  MAKING
DETERMINATIONS  OF INITIAL AND ONGOING ELIGIBILITY FOR SUCH BENEFITS AND
SERVICES AND MAKING COVERAGE DETERMINATIONS WITH RESPECT TO BENEFITS AND
SERVICES REQUIRING PRIOR AUTHORIZATION, NOTIFYING APPLICANTS AND RECIPI-
ENTS  OF  THESE DETERMINATIONS AND OF THEIR RIGHTS AND RESPONSIBILITIES,
AUTHORIZING BENEFITS AND SERVICES FOR PERSONS FOUND ELIGIBLE, EXERCISING
SUBROGATION RIGHTS WITH  RESPECT  TO  AMOUNTS  RECEIVED  FROM  INSURANCE
CARRIERS  OR  OTHER  LIABLE  THIRD  PARTIES, IMPOSING LIENS AND PURSUING
RECOVERIES, AND ANY OTHER TASKS AND FUNCTIONS IDENTIFIED BY THE  COMMIS-
SIONER.
  4.  NOTWITHSTANDING  THE  PROVISIONS  OF  THE CIVIL SERVICE LAW OR ANY
PROVISIONS TO THE CONTRARY CONTAINED IN ANY GENERAL, SPECIAL,  OR  LOCAL
LAWS,  ALL LAWFUL APPOINTEES OF A COUNTY PERFORMING FUNCTIONS RELATED TO
MEDICAL ASSISTANCE ELIGIBILITY AND COVERED BENEFITS AS OF THE  EFFECTIVE
DATE  OF  THIS SECTION WILL BE ELIGIBLE TO TRANSFER TO APPROPRIATE POSI-
TIONS IN THE DEPARTMENT OF HEALTH CLASSIFIED TO PERFORM  SUCH  FUNCTIONS
WITHOUT  FURTHER  EXAMINATION  OR QUALIFICATION AND, UPON SUCH TRANSFER,
WILL HAVE ALL THE RIGHTS AND PRIVILEGES OF  THE  JURISDICTIONAL  CLASSI-
FICATION  TO  WHICH  SUCH  POSITIONS  MAY BE ALLOCATED IN THE CLASSIFIED
SERVICE OF THE STATE.
  5. SUBJECT TO THE PROVISIONS OF SUBDIVISIONS SIX  AND  SEVEN  OF  THIS
SECTION,  THE  COMMISSIONER  MAY  CONTRACT  WITH  ONE  OR MORE ENTITIES,
INCLUDING UNITS OF LOCAL GOVERNMENT, FOR THE PURPOSE OF  EXERCISING  HIS
OR  HER AUTHORITY UNDER THIS SECTION. SUCH ENTITIES MAY BE CONTRACTED TO
PERFORM ALL OR A PORTION OF THE FUNCTIONS DESCRIBED IN SUBDIVISION THREE
OF THIS SECTION, AND MAY PERFORM SUCH  FUNCTIONS  WITH  RESPECT  TO  THE
ENTIRE  STATE OR WITH RESPECT TO A SPECIFIC REGION OR REGIONS, AS DETER-
MINED BY THE COMMISSIONER. IN NO EVENT, HOWEVER, SHALL  THE  DEPARTMENT,
BY MEANS OF SUCH A CONTRACT, DELEGATE ITS AUTHORITY TO EXERCISE ADMINIS-
TRATIVE  DISCRETION  IN  THE  ADMINISTRATION OR SUPERVISION OF THE STATE
PLAN FOR MEDICAL ASSISTANCE SUBMITTED PURSUANT TO SECTION THREE  HUNDRED
SIXTY-THREE-A  OF  THIS  TITLE,  OR  TO ISSUE POLICIES, RULES, AND REGU-
LATIONS ON PROGRAM MATTERS, NOR MAY ANY CONTRACTED ENTITY BE  GIVEN  THE
AUTHORITY  TO  CHANGE  OR  DISAPPROVE ANY ADMINISTRATIVE DECISION OF THE
DEPARTMENT, OR OTHERWISE SUBSTITUTE THE ENTITY'S JUDGMENT  FOR  THAT  OF
THE  DEPARTMENT  WITH RESPECT TO THE APPLICATION OF POLICIES, RULES, AND
REGULATIONS ISSUED BY THE DEPARTMENT.
  6. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE  HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTIONS
ONE HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVEL-
OPMENT  LAW, OR ANY OTHER CONTRARY PROVISION OF LAW, THE COMMISSIONER IS
AUTHORIZED TO  AMEND  THE  TERMS  OF  EXISTING  CONTRACTS,  INCLUDING  A
CONTRACT ENTERED INTO PURSUANT TO SUBDIVISION TWENTY-FOUR OF SECTION TWO
HUNDRED SIX OF THE PUBLIC HEALTH LAW, AS ADDED BY SECTION THIRTY-NINE OF
PART C OF CHAPTER FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND EIGHT, WITHOUT
A  COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS, UPON A DETERMINATION
THAT THE EXISTING CONTRACTOR IS QUALIFIED TO PROVIDE ASSISTANCE WITH ONE
OR MORE FUNCTIONS RELATED TO THE ADMINISTRATION OF THE  MEDICAL  ASSIST-
ANCE PROGRAM OR TO ACHIEVING THE GOALS OF THIS SECTION.
  7.  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTIONS
ONE HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVEL-
OPMENT LAW, OR ANY OTHER CONTRARY PROVISION OF LAW, THE COMMISSIONER  IS
AUTHORIZED  TO ENTER INTO A CONTRACT OR CONTRACTS UNDER THIS SUBDIVISION

S. 6256--A                         72                         A. 9056--A

WITHOUT A COMPETITIVE BID OR REQUEST  FOR  PROPOSAL  PROCESS,  PROVIDED,
HOWEVER,  THAT  WITH  RESPECT  TO A CONTRACT WITH AN ENTITY OTHER THAN A
LOCAL UNIT OF GOVERNMENT:
  (A)  THE DEPARTMENT SHALL POST ON ITS WEBSITE, FOR A PERIOD OF NO LESS
THAN THIRTY DAYS:
  (I) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACT OR CONTRACTS;
  (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (III)  THE  PERIOD  OF  TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY
SEEK SELECTION, WHICH SHALL BE NO  LESS  THAN  THIRTY  DAYS  AFTER  SUCH
INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
  (IV)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (B) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE  RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONER; AND
  (C) THE COMMISSIONER SHALL SELECT SUCH CONTRACTOR OR CONTRACTORS THAT,
IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE PURPOSES OF  THIS
SECTION.
  8. THE COMMISSIONER SHALL PROMULGATE SUCH REGULATIONS AS MAY BE NECES-
SARY  TO CARRY OUT THE PROVISIONS OF THIS SECTION, WHICH REGULATIONS MAY
BE PROMULGATED ON AN EMERGENCY  BASIS.  IN  ADDITION,  THE  COMMISSIONER
SHALL  MAKE  ANY AMENDMENTS TO THE STATE PLAN FOR MEDICAL ASSISTANCE, OR
DEVELOP AND SUBMIT AN APPLICATION FOR ANY WAIVER OR APPROVAL  UNDER  THE
FEDERAL  SOCIAL  SECURITY  ACT,  THAT  MAY BE NECESSARY TO CARRY OUT THE
PROVISIONS OF THIS SECTION.
  S 7. Subdivision 7 of section 369 of the social services law, as added
by section 71-a of part C of chapter 58 of the laws of 2008, is  amended
to read as follows:
  7.  Notwithstanding  any provision of law to the contrary, the depart-
ment [may commence] SHALL, WHEN IT DETERMINES NECESSARY PROGRAM FEATURES
ARE IN PLACE, ASSUME  SOLE  RESPONSIBILITY  FOR  COMMENCING  actions  or
proceedings  in accordance with the provisions of this section, sections
one hundred one, one hundred four, one hundred four-b, paragraph (a)  of
subdivision  three  of section three hundred sixty-six, subparagraph one
of paragraph (h) of subdivision four of section three hundred sixty-six,
and paragraph (b) of subdivision two of section three hundred sixty-sev-
en-a of  this  chapter,  to  recover  the  cost  of  medical  assistance
furnished pursuant to this title and title eleven-D of this article. The
department  is  authorized to contract with an entity that shall conduct
activities on behalf of the department  pursuant  to  this  subdivision.
PRIOR  TO  ASSUMING SUCH RESPONSIBILITY FROM A SOCIAL SERVICES DISTRICT,
THE DEPARTMENT OF HEALTH  SHALL,  IN  CONSULTATION  WITH  THE  DISTRICT,
DEFINE  THE  SCOPE  OF  THE  SERVICES  THE  DISTRICT WILL BE REQUIRED TO
PERFORM ON BEHALF OF THE DEPARTMENT OF HEALTH PURSUANT TO THIS  SUBDIVI-
SION.
  S  8. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal social security act in the public  health  law  and  the  social
services  law  shall be deemed to include and also to mean any successor
titles thereto under the federal social security act.
  S 9. Notwithstanding any inconsistent provision of law, rule or  regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the  public health law, section 18 of chapter 2 of the laws of 1988, and
18 NYCRR 505.14(h), as they relate to time frames for  notice,  approval

S. 6256--A                         73                         A. 9056--A

or  certification  of rates of payment, are hereby suspended and without
force or effect for purposes of implementing the provisions of this act.
  S  10. Severability clause. If any clause, sentence, paragraph, subdi-
vision, section or part of this act shall be adjudged by  any  court  of
competent  jurisdiction  to  be invalid, such judgment shall not affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation to the clause, sentence, paragraph,  subdivision,  section  or
part thereof directly involved in the controversy in which such judgment
shall  have been rendered. It is hereby declared to be the intent of the
legislature that this act would have been enacted even if  such  invalid
provisions had not been included herein.
  S  11.  This  act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012,  provided
that:
  1. section one of this act shall take effect April 1, 2013;
  2.  any  rules or regulations necessary to implement the provisions of
this act may be promulgated and any procedures, forms,  or  instructions
necessary  for such implementation may be adopted and issued on or after
the date this act shall have become a law;
  3. this act shall not be construed to alter, change, affect, impair or
defeat any rights, obligations, duties or interests accrued, incurred or
conferred prior to the effective date of this act;
  4. the commissioner of health  and  the  superintendent  of  financial
services  and  any  appropriate  council may take any steps necessary to
implement this act prior to its effective date;
  5. notwithstanding any inconsistent provision of the state administra-
tive procedure act or any other provision of law,  rule  or  regulation,
the  commissioner of health and the superintendent of financial services
and any appropriate council is authorized to adopt or amend  or  promul-
gate  on  an  emergency  basis  any regulation he or she or such council
determines necessary to implement any  provision  of  this  act  on  its
effective date;
  6.  the amendment to section 91 of part H of chapter 59 of the laws of
2011, amending the public health law and other laws relating to  general
hospital  reimbursement  for  annual rates, made by section five of this
act shall take effect on the same date and in the same  manner  as  such
section takes effect;
  7.  the  provisions of this act shall become effective notwithstanding
the failure of the commissioner  of  health  or  the  superintendent  of
financial  services or any council to adopt or amend or promulgate regu-
lations implementing this act.

                                 PART G

  Section 1. Subdivision 1 of section 79 of part C of chapter 58 of  the
laws of 2005 relating to the preferred drug program is amended and a new
subdivision 1-a is added  to read as follows:
  1.  sections  ten  [through],  ELEVEN,  TWELVE AND fifteen of this act
shall expire and be deemed repealed on and after June 15, [2012] 2019;
  1-A. SECTION FOURTEEN OF THIS ACT SHALL EXPIRE AND BE DEEMED  REPEALED
ON AND AFTER JUNE 15, 2012;
  S  2.  Subparagraph  (v) of paragraph (b) of subdivision 35 of section
2807-c of the public health law, as amended by section 35-a of part H of
chapter 59 of the laws of 2011, is amended to read as follows:
  (v) such  regulations  shall  incorporate  quality  related  measures,
including,  but  not  limited  to, potentially preventable re-admissions

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(PPRs) and provide for rate adjustments or payment disallowances related
to PPRs and other potentially  preventable  negative  outcomes  (PPNOs),
which shall be calculated in accordance with methodologies as determined
by the commissioner, provided, however, that such methodologies shall be
based on a comparison of the actual and risk adjusted expected number of
PPRs and other PPNOs in a given hospital and with benchmarks established
by  the  commissioner and provided further that such rate adjustments or
payment disallowances shall result in an aggregate reduction in Medicaid
payments of no less than thirty-five million dollars for the period July
first, two thousand ten through March thirty-first, two thousand  eleven
and no less than fifty-one million dollars for [the period] ANNUAL PERI-
ODS  BEGINNING  April  first,  two thousand eleven through March thirty-
first, two thousand [twelve] THIRTEEN, provided further that such aggre-
gate reductions shall be offset by Medicaid payment reductions occurring
as a result of decreased PPRs during the period July first, two thousand
ten through March thirty-first, two thousand eleven and the period April
first, two thousand eleven  through  March  thirty-first,  two  thousand
[twelve]  THIRTEEN  and as a result of decreased PPNOs during the period
April first, two thousand eleven through March thirty-first,  two  thou-
sand  [twelve]  THIRTEEN;  and provided further that for the period July
first,  two  thousand  ten  through  March  thirty-first,  two  thousand
[twelve]  THIRTEEN, such rate adjustments or payment disallowances shall
not apply to behavioral health PPRs; or to readmissions that occur on or
after fifteen days following an initial admission. By no later than July
first, two thousand eleven the commissioner shall enter  into  consulta-
tions with representatives of the health care facilities subject to this
section  regarding potential prospective revisions to applicable method-
ologies and benchmarks set forth in regulations issued pursuant to  this
subparagraph;
  S  3.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012.

                                 PART H

  Section 1.  Section 4 of part C of chapter 57 of  the  laws  of  2006,
relating  to  establishing  a  cost  of living adjustment for designated
human services programs, as amended by section 2 of part F of chapter 59
of the laws of 2011, is amended to read as follows:
  S 4. This act shall take effect immediately and  shall  be  deemed  to
have  been in full force and effect on and after April 1, 2006; provided
section one of this act shall expire and be  deemed  repealed  April  1,
[2015]  2012; provided, further, that sections two and three of this act
shall expire and be deemed repealed December 31, 2009.
  S 2.   Notwithstanding any other provision of  law  to  the  contrary,
effective  April 1, 2013 and annually thereafter, state agencies includ-
ing, but not limited to, the office for people with developmental  disa-
bilities,  office  of  mental health, office of alcoholism and substance
abuse services, office of children and family services, office of tempo-
rary and disability assistance, department of  health,  office  for  the
aging, division of criminal justice services, office of victim services,
and  state  education department that operate, license, certify, or fund
providers of services shall develop and calculate annual adjustments  to
established  payments to providers of such services, based on factors to
be determined by the commissioner of the agency. Such adjustments  shall
be  based on performance metrics to be developed by the commissioners of
such agencies which shall include, but not be limited to  the  following

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to the extent practicable:  the actual costs of providing such services,
the percentages of administrative costs, the determination and levels of
executive  compensation,  and  such other criteria as such commissioners
may determine. Such annual adjustments shall be subject to any necessary
federal  approvals and restrictions. The amount of any annual adjustment
and the metrics used to determine such adjustment shall  be  subject  to
the review and approval of the director of the budget.
  S  3.    Notwithstanding  any  other provision of law to the contrary,
commencing on April 1, 2012, the commissioner or director of each  state
agency  subject  to  section  two  of this act shall have the authority,
subject to approval by the director of the budget, to  promulgate  regu-
lations  or to address by other means the extent and nature of a provid-
er's administrative costs and  executive  compensation  which  shall  be
eligible  to  be reimbursed with state financial assistance or state-au-
thorized payments for operating expenses. Each agency shall require that
providers of services that receive reimbursements directly or indirectly
from such agency must comply with the following restrictions:
  (a) No less than seventy-five percent of the state  financial  assist-
ance  or  state-authorized  payments  for  operating  expenses  shall be
directed to provide direct care or services rather than to  support  the
costs  of  administration,  as these terms are defined by the applicable
state agency in implementing these requirements. This  percentage  shall
increase  by  five percent each year until it shall, no later than April
1, 2015, remain at no less than eighty-five percent thereafter.
  (b) To the extent practicable, reimbursement shall not be provided for
compensation paid or given to any  executive  by  such  provider  in  an
amount  greater  than  $199,000  per  annum; provided, however, that the
commissioner of each state agency shall have discretion to  adjust  this
figure  annually based on appropriate factors subject to the approval of
the director of the budget, but in no event  shall  such  figure  exceed
Level I of the federal government's Rates of Basic Pay for the Executive
Schedule  promulgated  by  the United States Office of Personnel Manage-
ment.  The applicable state agency shall define these terms as necessary
in implementing these requirements.
  A provider's failure to comply with the  requirements  established  by
the  applicable  state agency may, in the sole discretion of the commis-
sioner of each state agency, form the basis for termination or non-rene-
wal of the agency's contract with or continued support of the  provider.
Upon  a  showing  of good cause, a provider may be granted a waiver from
compliance with these requirements in whole or in part  subject  to  the
approval of the applicable state agency and the director of the budget.
  S  4.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012.

                                 PART I

  Section 1. Notwithstanding any inconsistent provision of sections  one
hundred  twelve and one hundred sixty-three of the state finance law, or
section one hundred forty-two of the economic development  law,  or  any
other  law  to the contrary, the commissioner of developmental disabili-
ties, pursuant to a pilot program  established  in  accordance  with  an
application  made under section 1115 of the federal social security act,
42 U.S.C. 1315, is authorized to enter  into  a  contract  or  contracts
without  a  competitive  bid  or  request for proposal process, with the
approval of the director of the budget, provided, however, that:

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  (a) the office for people with developmental disabilities  shall  post
on  its  website,  for  a  period  of not less than thirty days, a pilot
application, and the following information:
  (i)  a description of the proposed services to be provided pursuant to
the pilot program;
  (ii) the procedure for application to participate in the pilot program
and criteria for selection of an applicant to participate in  the  pilot
program;
  (iii) the period of time during which an applicant may seek selection,
which  shall be no less than thirty days after such information is first
posted on the website; and
  (iv) the manner by which an applicant may seek such  selection,  which
may include submission by electronic means;
  (b)  all  reasonable and responsive submissions that are received from
applicants in a timely fashion shall be reviewed  by  the  commissioner;
and
  (c)  the  commissioner of developmental disabilities shall select such
applicant or applicants that, in  the  commissioner's  discretion,  have
demonstrated  the  ability to effectively, efficiently, and economically
provide services pursuant to  the  pilot  program;  have  the  requisite
expertise  and  financial resources; have demonstrated that their direc-
tors, sponsors, members, managers, partners or operators have the requi-
site character, competence and standing in the community, and  are  best
suited to serve the purposes of this section.
  S 2. This act shall take effect immediately.

                                 PART J

  Section  1. Section 13.17 of the mental hygiene law, as added by chap-
ter 978 of the laws of 1977, the section heading as amended  by  chapter
168  of the laws of 2010, subdivisions (b) and (d) as amended by chapter
37 of the laws of 2011, and subdivision (c) as amended by chapter 538 of
the laws of 1987, is amended to read as follows:
S 13.17 Programs, services, and operations [of facilities] in the office
          for people with developmental disabilities.
  (a) The commissioner shall establish policy  and  procedures  for  the
organization,  administration, and [operation of the facilities] SERVICE
DELIVERY SYSTEM under his OR  HER  jurisdiction[.  He]  AND  shall  make
provision  for  the  effective  rendition  of  SUPPORTS  AND services to
[patients by such  facilities  or  office  personnel]  INDIVIDUALS  WITH
DEVELOPMENTAL DISABILITIES.
  (b)  [There  shall  be  in  the  office the developmental disabilities
services offices named below  serving  the  areas  either  currently  or
previously  served  by  a  school, for the care and treatment of persons
with developmental disabilities and for research  and  teaching  in  the
science  and  skills required for the care and treatment of such persons
with developmental disabilities:
  Bernard M. Fineson Developmental Disabilities Services Office
  Brooklyn Developmental Disabilities Services Office
  Broome Developmental Disabilities Services Office
  Capital District Developmental Disabilities Services Office
  Central New York Developmental Disabilities Services Office
  Finger Lakes Developmental Disabilities Services Office
  Institute for Basic Research in Developmental Disabilities
  Hudson Valley Developmental Disabilities Services Office
  Metro New York Developmental Disabilities Services Office

S. 6256--A                         77                         A. 9056--A

  Long Island Developmental Disabilities Services Office
  Sunmount Developmental Disabilities Services Office
  Taconic Developmental Disabilities Services Office
  Western New York Developmental Disabilities Services Office
  Staten Island Developmental Disabilities Services Office
  The New York State Institute for Basic Research in Developmental Disa-
bilities  is  designated  as  an  institute  for  the conduct of medical
research and other scientific investigation directed towards  furthering
knowledge of the etiology, diagnosis, treatment and prevention of devel-
opmental disabilities.
  (c)]  The  commissioner shall establish [the areas which each facility
or], AT HIS OR  HER  DISCRETION,  developmental  disabilities  [services
office  under his jurisdiction shall serve and the categories of clients
which shall be served thereby]  REGIONAL  OFFICES  AND  SHALL  ESTABLISH
STATE  OPERATIONS  OFFICES  THAT  PROVIDE  FOR  THE  DIRECT  DELIVERY OF
SUPPORTS AND SERVICES BY THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL  DISA-
BILITIES.
  [(d)] (C) The commissioner may [permit] AUTHORIZE other offices of the
department  and  any  public or private non-profit organization or poli-
tical subdivision of the state to [operate programs for persons] DELIVER
SUPPORTS AND SERVICES TO INDIVIDUALS with  developmental  disabilities[,
not  inconsistent  with the programs and objectives of the office in any
facility under his jurisdiction. The commissioner may permit any facili-
ty under his jurisdiction to operate programs for  persons  with  mental
disabilities,  not  inconsistent  with  programs  and  objectives of the
department, under contracts or agreements with other offices within  the
department].
  S  2. Section 13.19 of the mental hygiene law, as added by chapter 978
of the laws of 1977, subdivisions (a) and (d) as amended by chapter  168
of  the laws of 2010, and subdivision (e) as added by chapter 307 of the
laws of 1979, is amended to read as follows:
S 13.19 Personnel of the office; regulations.
  (a) The commissioner may, within the  amounts  appropriated  therefor,
appoint  and  remove  in accordance with law and applicable rules of the
state civil service commission,  such  officers  and  employees  of  the
office for people with developmental disabilities [and school and facil-
ity officers and employees who are designated managerial or confidential
pursuant  to article fourteen of the civil service law] as are necessary
for efficient administration.  THE COMMISSIONER SHALL, IN EXERCISING HIS
OR   HER   APPOINTING   AUTHORITY,   TAKE,   CONSISTENT   WITH   ARTICLE
TWENTY-THREE-A OF THE CORRECTION LAW, ALL REASONABLE AND NECESSARY STEPS
TO  ENSURE  THAT ANY SUCH PERSON SO APPOINTED HAS NOT PREVIOUSLY ENGAGED
IN ANY ACT IN VIOLATION OF ANY LAW WHICH COULD COMPROMISE THE HEALTH AND
SAFETY OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES.
  (b) [The director of a hospital or institute in the office shall  have
professional  qualifications  and  experience  to  be  prescribed by the
commissioner.
  (c)] Notwithstanding the provisions of any other law, the  [positions]
POSITION  of  [psychiatrist  III and] deputy director in [any] AN office
facility may be filled BY NEW HIRE OR by promotion open to employees [of
all such facilities] who possess  the  minimum  qualifications  for  the
[respective  positions.  Promotion lists which are established for those
positions shall be general eligible promotion lists from which names are
certified in the order of final earned ratings and  from  which  certif-
ication  shall  not be subdivided by the facility or department in which

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such persons are employed. Nothing in this subdivision shall prevent the
use of open competitive examinations] POSITION.
  [(d)]  (C)  The  use  of  volunteers [at facilities] in the office for
people with developmental disabilities shall be encouraged. The  commis-
sioner may establish regulations governing such volunteer services.
  [(e)]  (D)  Where,  and  to  the extent that, an agreement between the
state and an employee organization  entered  into  pursuant  to  article
fourteen  of  the  civil  service  law  so provides, the commissioner is
authorized to implement the provisions of  such  agreement  relating  to
discipline consistent with the terms thereof.
  S  3. Section 13.21 of the mental hygiene law, as added by chapter 978
of the laws of 1977, the section heading and subdivisions (a) and (c) as
amended by chapter 168 of the laws of 2010, subdivision (b)  as  amended
by  chapter 558 of the laws of 2011, subdivision (d) as added by chapter
355 of the laws of 1987 and subdivision (e) as added by chapter  492  of
the  laws  of 1978 and as relettered by chapter 355 of the laws of 1987,
is amended to read as follows:
S 13.21 Directors of [schools] STATE  OPERATIONS  OFFICES  AND  DEVELOP-
          MENTAL  DISABILITIES REGIONAL OFFICES in the office for people
          with developmental disabilities.
  (a) The [director] DIRECTORS of [a school] BOTH THE  STATE  OPERATIONS
OFFICES  AND  DEVELOPMENTAL  DISABILITIES REGIONAL OFFICES in the office
for people with developmental disabilities shall  be  appointed  by  the
commissioner  [and shall be its chief executive officer. The director of
a school  shall  be  the  director  of  the  developmental  disabilities
services  office  serving  the  areas  designated by the commissioner in
regulation, and in such context, the term facility shall also  refer  to
such  developmental  disabilities  services  office]. Each such director
shall be in the non-competitive class and designated as confidential  as
defined  by  subdivision two-a of section forty-two of the civil service
law and shall serve at the pleasure of  the  commissioner.  [Except  for
school  and facility officers and employees for which subdivision (a) of
section 13.19 of this article makes the commissioner the appointing  and
removing authority, the director of a school shall have the power, with-
in  amounts  appropriated  therefor, to appoint and remove in accordance
with law and applicable rules of the state civil service commission such
officers and employees of the facility of which he or she is director as
are necessary for its efficient administration. He or she shall in exer-
cising his or her appointing authority  take,  consistent  with  article
twenty-three-A of the correction law, all reasonable and necessary steps
to  insure  that any such person so appointed has not previously engaged
in any act in violation of any law which could compromise the health and
safety of patients in the facility of which he or she is  director.]  He
or she shall manage the [facility, and administer its personnel system,]
STATE  OPERATIONS  OFFICE  OR DEVELOPMENTAL DISABILITIES REGIONAL OFFICE
subject to applicable law, the regulations of the commissioner, and  the
rules  of  the  state civil service commission. [Before the commissioner
shall issue any such regulation or any amendment or revision thereof, he
or she shall consult with the directors of schools in the office regard-
ing its suitability.] The  [director]  DIRECTORS  OF  THE  DEVELOPMENTAL
DISABILITIES  REGIONAL  OFFICES AND STATE OPERATIONS OFFICES shall main-
tain effective [supervision] OVERSIGHT of all parts of [the facility and
over all persons employed therein or coming thereon and]  THEIR  RESPEC-
TIVE  OFFICES. THE DIRECTORS OF STATE OPERATIONS OFFICES shall generally
[direct] PROVIDE FOR the [care  and  treatment  of  patients.  Directors
presently  serving  at  facilities of the office shall continue to serve

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under  the  terms  of  their  original  appointment]  ADMINISTRATION  OF
SUPPORTS  AND SERVICES TO INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES IN
STATE OPERATED PROGRAMS. DIRECTORS OF REGIONAL OFFICES  SHALL  GENERALLY
OVERSEE  THE ADMINISTRATION OF SUPPORTS AND SERVICES TO INDIVIDUALS WITH
DEVELOPMENTAL  DISABILITIES  IN  SETTINGS  OUTSIDE  THE  STATE  OPERATED
PROGRAMS.
  (b)  Such [director] DIRECTORS shall have the responsibility of seeing
that there is humane treatment of [the  patients  at  his  facility  and
shall  investigate  every case of alleged patient abuse or mistreatment]
INDIVIDUALS  WITH  DEVELOPMENTAL  DISABILITIES  RECEIVING  SERVICES   IN
SETTINGS  OPERATED,  LICENSED,  CERTIFIED,  FUNDED  OR  APPROVED BY THIS
OFFICE.  [The] A director OF STATE OPERATIONS shall notify  immediately,
and  in any event within three working days the board of visitors of the
facility and the mental hygiene legal service located in the same  judi-
cial department as [the hospital, school or institution] THE STATE OPER-
ATIONS  OFFICE  of  every complaint of patient abuse or mistreatment and
shall inform the board and the  mental  hygiene  legal  service  of  the
results of his OR HER investigation. If it appears that a crime may have
been  committed, the STATE OPERATIONS director shall give notice thereof
to the district attorney or other appropriate law  enforcement  official
as  soon  as possible, and in any event within three working days unless
it appears that the  crime  includes  an  employee,  intern,  volunteer,
consultant,  contractor, or visitor and the alleged conduct caused phys-
ical injury or the patient was subject to unauthorized  sexual  contact,
or  if it appears the crime is endangering the welfare of an incompetent
or physically disabled person pursuant to section 260.25  of  the  penal
law, or if the crime was any felony under state or federal law, then the
district  attorney or other appropriate law enforcement official must be
contacted immediately, and in any event no later than twenty-four hours.
  (c) In any investigation into the treatment  and  care  of  [patients]
INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES or the conduct, performance,
or  neglect  of duty of officers or employees, the [director of a school
in the office for people with developmental  disabilities]  COMMISSIONER
OR HIS OR HER DESIGNEE shall be authorized to subpoena witnesses, compel
their attendance, administer oaths to witnesses, examine witnesses under
oath,  and require the production of any books or papers deemed relevant
to the inquiry or investigation. A subpoena issued  under  this  section
shall be regulated by the civil practice law and rules.
  (d) [Such] THE director of a [school] STATE OPERATIONS OFFICE shall be
responsible  for the provision of STATE OPERATED community developmental
disabilities services, in those areas that the commissioner may  assign.
Such  responsibility  shall,  consistent  with article forty-one of this
chapter, include the operation of STATE OPERATED facilities[,]  AND  the
development  of  needed  facilities[, and the provision of assistance to
service providers in such areas and any necessarily related  activities.
All  powers  and duties as set forth in this section shall apply to such
responsibilities]. REGIONAL  DIRECTORS  SHALL  BE  RESPONSIBLE  FOR  THE
PROVISION  OF  COMMUNITY DEVELOPMENTAL DISABILITIES SERVICES TO INDIVID-
UALS IN SETTINGS OTHER THEN STATE OPERATED PROGRAMS. THE REGIONAL DIREC-
TOR'S RESPONSIBILITY SHALL, CONSISTENT WITH ARTICLE  FORTY-ONE  OF  THIS
CHAPTER,  INCLUDE  THE  OVERSIGHT  OF FACILITIES AND PROGRAMS OTHER THAN
THOSE OPERATED BY THE STATE.
  (e) Each [facility] STATE OPERATIONS director  of  the  office  shall,
upon  notice  from  the  commissioner or upon knowledge that programs of
such facility may be contracted or terminated, implement  procedures  to

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ensure  timely notification to affected employees. Such procedures shall
include, but not be limited to:
  (1)  dissemination  and  posting of all decisions, policies and proce-
dures with respect to all aspects of such actions and  their  impact  on
facility staff; and
  (2) compliance with all requirements and protection of employee rights
pursuant  to  collective bargaining agreements with the designated legal
representative of the employees and the civil service law.
  S 4. Section 13.33 of the mental hygiene law, as added by chapter  978
of  the  laws  of  1977, subdivision (a) as amended by chapter 37 of the
laws of 2011, subdivision (d) as amended by chapter 686 of the  laws  of
1995,  subdivisions (f) and (h) as amended by chapter 175 of the laws of
1986, subdivision (i) as amended by chapter 14  of  the  laws  of  1990,
paragraph  1  of subdivision (i) as amended by chapter 75 of the laws of
1992, paragraph 2 of subdivision (i) and subdivision (m) as  amended  by
chapter  168  of the laws of 2010, subdivision (j) as amended by chapter
264 of the laws of 1980 and subdivisions (j) and (k)  as  relettered  by
chapter  84  of  the laws of 1980, subdivision (l) as amended by chapter
406 of the laws of 1994, and subdivision (n) as amended by  chapter  662
of the laws of 1995, is amended to read as follows:
S 13.33 Boards of visitors.
  (a) Each [developmental disabilities services] STATE OPERATIONS office
under  the  jurisdiction of the commissioner shall have a MINIMUM OF ONE
board of visitors consisting of at least seven but not more  than  four-
teen  members[;  provided,  however,  that the Central New York develop-
mental disabilities services office  shall  have  a  board  of  visitors
consisting  of  at  least  ten, but not more than seventeen members; and
that the Finger Lakes developmental disabilities services  office  shall
have  a  board of visitors consisting of at least fourteen, but not more
than twenty-one members. When a school is replaced  by  a  developmental
disabilities  services  office,  the  members  of that school's board of
visitors shall continue to serve their terms as the  board  of  visitors
for   the  new  developmental  disabilities  services  office].  Members
appointed or reappointed after the effective date of this chapter  shall
be  appointed by the governor, by and with the advice and consent of the
senate.  Members shall be appointed for four year terms to expire on the
thirty-first day of December of the fourth year of the  term  of  office
provided  however,  when  more  than three terms expire in any one year,
members may be appointed for terms of fewer years as designated  by  the
governor  so  that  no  more than three members' terms expire in any one
year. All terms of office shall expire on the thirty-first day of Decem-
ber of the designated year. A  member  whose  term  has  expired  shall,
however,  remain  in  office  until  such  member's  successor  has been
appointed and has taken office, or until such member shall have resigned
or have been removed from office in  the  manner  hereinafter  provided.
Should  any  member resign or be removed from office, the governor shall
promptly submit, for senate consent, a successor candidate to  fill  the
remaining  term  of  the vacated office. A visitor may be removed by the
governor for cause after notice and an opportunity for a hearing on  the
charges.  In  making  appointments  to  boards of visitors, the governor
shall endeavor to ensure that the membership of each  such  board  shall
adequately  reflect  the  composition  of  the  community or communities
served by the [facility] STATE OPERATIONS OFFICE, that the membership of
each such board includes at least three individuals who are  parents  or
relatives  of  patients  or  of  former  patients and that the remainder
includes only those persons, including former patients, who  shall  have

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expressed  an  active  interest  in, or shall have obtained professional
knowledge in the care of persons with developmental disabilities  or  in
developmental disability endeavors generally.
  (b) No elected state officer or member of the legislature may serve as
a visitor.
  (c)  If  the  [facility]  STATE  OPERATIONS  OFFICE serves an area, as
established by the regulations of the commissioner, the  visitors  shall
reside  at the time of appointment or reappointment in such area. [If no
specific area is designated, the visitors shall reside at  the  time  of
appointment  or  reappointment  in  the developmental disabilities area,
established by the commissioner, in which the facility is located.]
  (d) Each board shall, at the first meeting of each calendar year elect
one member to serve as president of the board and one member to serve as
secretary; provided however, that no member may serve for more than  two
consecutive years as president.
  (e)  Visitors  shall  not receive compensation but shall be reimbursed
for their actual expenses in connection with their service as visitors.
  (f) (1) Each board of visitors shall hold six bi-monthly regular meet-
ings annually, but a greater number of regular meetings may be scheduled
by the board. Each board of visitors shall establish in their by-laws or
otherwise, in writing, whether these six meetings shall be  held  during
months represented by odd numbers or months represented by even numbers.
The  president  of the board shall notify the chairman of the commission
on quality of care [for the mentally disabled] AND ADVOCACY FOR  PERSONS
WITH  DISABILITIES  and  the [facility] STATE OPERATIONS director of the
determination  made  concerning  the  designated  months  for  the   six
bi-monthly regular meetings. The president of the board, the commission-
er, the director, or the members as determined by the rules of the board
may  call special meetings. The board may require the director to submit
a report at each  meeting.  Each  board  shall  keep  a  record  of  its
proceedings  and  activities.  A  member  of a board of visitors who has
failed to attend three consecutive bi-monthly regular meetings shall  be
considered  to  have  vacated his office unless otherwise ordered by the
governor. The board shall cause notice of any of its public meetings  to
be sent to the mental hygiene legal service located in the same judicial
department  as  the  school. The mental hygiene legal service may send a
representative to any such public meeting, and may request the board  to
review  patient  complaints or investigate alleged incidents of abuse or
mistreatment. The board shall notify the appropriate  representative  of
the  mental hygiene legal service of the board's actions and findings in
relation to any such request.
  (2) The president of the board of visitors shall notify  a  member  by
certified  or  registered mail return receipt requested when such member
of the board has failed to attend any two consecutive bi-monthly regular
meetings. This notice shall be sent within ten days following the second
meeting and shall include the dates  of  the  two  meetings  which  were
missed, the date of the next bi-monthly regular meeting, and a statement
concerning the consequences of failure to attend the next meeting.
  (3)  Within  three  days  after  the  third  consecutive  absence at a
bi-monthly regular meeting by a member, the president of  the  board  of
visitors  shall  notify, in writing, the governor, the commissioner, the
chairman of the commission on quality of care [for  the  mentally  disa-
bled]  AND  ADVOCACY  FOR  PERSONS  WITH DISABILITIES and the [facility]
STATE OPERATIONS director of such absences. The president of  the  board
of  visitors shall send a copy of this notice by registered or certified
mail return receipt requested to the member to  whom  it  pertains.  The

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member may petition the governor to excuse his absences. If the governor
does  not  excuse the absences within forty-five days of the date of the
third consecutive meeting absence, the office of  the  member  shall  be
deemed vacated.
  (g)  Upon the request of the commissioner or the director, or upon the
board's initiative, the board shall consult, advise, and work  with  the
director  with  respect  to community relations, conditions at the STATE
OPERATED facility, preliminary plans for construction  and  alterations,
and programs and activities of the STATE OPERATED facility.
  (h)  Each board or any member of the board may visit and inspect [the]
A STATE OPERATED facility WHICH IS IN THE CATCHMENT AREA  OF  THE  STATE
OPERATIONS  REGION  IN  WHICH  SUCH  MEMBER OR MEMBERS SERVE at any time
without prior notice and may report on conditions to  the  governor,  to
the  commissioner and to the chairman of the state commission on quality
of care [for the mentally disabled] AND ADVOCACY FOR PERSONS WITH  DISA-
BILITIES.  In addition, each board shall ensure that a member or commit-
tee of members shall inspect [the] SUCH facility once every three months
without prior notice. A report on conditions may  be  submitted  to  the
governor, to the commissioner or to the chairman of the state commission
on  quality of care [for the mentally disabled] AND ADVOCACY FOR PERSONS
WITH DISABILITIES. Each board member shall visit and inspect  [the]  ANY
SUCH  facility  at  least twice during each calendar year. Within thirty
days after the conclusion of each calendar year, the  president  of  the
board  of  visitors  shall  notify  the  governor, the commissioner, the
chairman of the commission on quality of care [for  the  mentally  disa-
bled]  AND  ADVOCACY  FOR  PERSONS WITH DISABILITIES, and the [facility]
STATE OPERATIONS director, if any member of  the  board  has  failed  to
visit  and  inspect  [the]  ANY SUCH facility at least twice during that
year. The president of the board of visitors shall send a copy  of  this
notice  by  certified or registered mail return receipt requested to the
member to whom it pertains. A member of a  board  of  visitors  who  has
failed to visit and inspect [the] A facility at least twice a year shall
be considered to have vacated his OR HER office unless otherwise ordered
by  the  governor  within  forty-five days after the end of the calendar
year. The board shall have the power to investigate all charges  against
the  STATE OPERATIONS director and all cases of alleged patient abuse or
mistreatment made against any employee  and  shall  have  the  power  to
interview patients and employees of the [facility] FACILITIES in pursuit
of  such  investigations. In conducting such an investigation, the board
shall have the power, in accordance with  the  civil  practice  law  and
rules,  to  subpoena witnesses, compel their testimony, administer oaths
to witnesses, examine witnesses under oath, and require  the  production
of  any books or papers deemed relevant to the investigation. A board or
a member may include in the report or separately at any time any  matter
pertaining  to the management and affairs of [the facility] SUCH FACILI-
TIES and may make recommendations to the governor, to  the  commissioner
and  to the chairman of the state commission on quality of care [for the
mentally disabled] AND ADVOCACY  FOR  PERSONS  WITH  DISABILITIES.  Each
board  member shall enter in a book, kept at each SUCH facility for that
purpose, the date of each visit.
  (i) (1) Any member or members of the board may  visit  and  inspect  a
family  care  home, which is within the catchment area of the [school on
the board of] STATE OPERATIONS REGION IN which such  member  or  members
serve.  Such  member or members shall be granted access to such facility
and to all books, records and data pertaining to  such  facility  deemed
necessary  for  carrying  out  the  purposes of such visit. Information,

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books, records or data which are confidential as provided by  law  shall
be  kept confidential and any limitations on the release thereof imposed
by law upon the party furnishing the information, books, records or data
shall  apply  to  such  member  or  members of the board. After any such
visits or inspections, a report containing findings and  recommendations
may  be  submitted  to the governor, to the commissioner or to the state
commission on quality of care [for the mentally disabled]  AND  ADVOCACY
FOR PERSONS WITH DISABILITIES.
  (2)  Any member or members of the board may visit and inspect a commu-
nity residence operated by the  office  for  people  with  developmental
disabilities,  which  is within the catchment area of the [school on the
board of] STATE OPERATIONS REGION IN which such member or members serve.
Such member or members shall be granted access to such facility  and  to
all books, records and data pertaining to such facility deemed necessary
for carrying out the purposes of such visit and inspection. Information,
books,  records  or data which are confidential as provided by law shall
be kept confidential and any limitations on the release thereof  imposed
by law upon the party furnishing the information, books, records or data
shall  apply  to  such  member  or  members of the board. After any such
visits or inspection, a report containing findings  and  recommendations
shall  be  submitted promptly to the commissioner and to the chairman of
the state commission on quality of care and advocacy  for  persons  with
disabilities.
  (j) Once each year, each board shall make an independent assessment of
conditions  at  [the facility] SUCH FACILITIES and shall submit a report
on the assessment and recommendations to the governor,  to  the  commis-
sioner  and  to  the chairman of the state commission on quality of care
[for the mentally disabled] AND ADVOCACY FOR PERSONS WITH DISABILITIES.
  (k) The commissioner shall notify the board of visitors of a  [school]
FACILITY  under his OR HER jurisdiction of the proposed appointment of a
STATE OPERATIONS director [to such facility] or the proposed transfer of
a STATE OPERATIONS director [from such facility], with  a  request  that
the  board  report  an  expression  of its opinion of the appointment or
transfer and, if it objects thereto, the reasons for such objection.
  (l) The commissioner  shall  appoint  representatives  of  the  office
[department]  to  serve  as liaison between the office and the boards of
visitors. At least once each year the commissioner shall meet  with  the
boards  collectively.  The  commissioner,  or his OR HER designee, shall
meet quarterly with representatives of boards of visitors.
  (m) Members of the boards of visitors shall be considered officers  of
the  office  for people with developmental disabilities for the purposes
of sections seventy-three, to the extent provided therein, and  seventy-
four  of  the  public  officers law relating to business or professional
activities by state officers and employees and the code of ethics.
  (n) Each member shall attend, within one year of the initial  appoint-
ment  or  any  subsequent reappointment, an orientation training program
provided by the commission on quality of care [for  the  mentally  disa-
bled]  AND  ADVOCACY FOR PERSONS WITH DISABILITIES for members of boards
of visitors. The chairman of the commission on quality of care [for  the
mentally  disabled]  AND  ADVOCACY  FOR  PERSONS WITH DISABILITIES shall
notify the governor and the appointed member of any such member's  fail-
ure to attend such a training program. A member who has failed to attend
such a training program scheduled for such member shall be considered to
have  vacated his office unless otherwise ordered by the governor within
forty-five days after the notice.

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  S 5. Paragraph (c) of subdivision 3 of  section  2963  of  the  public
health  law,  as added by chapter 818 of the laws of 1987, is amended to
read as follows:
  (c) If the attending physician determines that a patient lacks capaci-
ty  because  of a developmental disability, the concurring determination
required by paragraph (a) of this subdivision shall  be  provided  by  a
physician  or  psychologist employed by [a school named in section 13.17
of the mental hygiene law] THE  OFFICE  FOR  PEOPLE  WITH  DEVELOPMENTAL
DISABILITIES,  or  who  has  been employed for a minimum of two years to
render care and service in a facility operated or licensed by the office
[of mental retardation and] FOR PEOPLE WITH developmental  disabilities,
or who has been approved by the commissioner of [mental retardation and]
developmental disabilities in accordance with regulations promulgated by
such  commissioner.  Such  regulations shall require that a physician or
psychologist possess specialized training or three years  experience  in
treating developmental disabilities.
  S  6.  Paragraph  (c)  of  subdivision 2 of section 2981 of the public
health law, as added by chapter 752 of the laws of 1990, is  amended  to
read as follows:
  (c)  For  persons  who reside in a mental hygiene facility operated or
licensed by the office [of  mental  retardation  and]  FOR  PEOPLE  WITH
developmental  disabilities, at least one witness shall be an individual
who is not affiliated with the facility and at least one  witness  shall
be  a  physician  or  clinical psychologist who either is employed by [a
school named in section 13.17 of the mental hygiene law] THE OFFICE  FOR
PEOPLE  WITH  DEVELOPMENTAL  DISABILITIES or who has been employed for a
minimum of two years to render care and service in a  facility  operated
or  licensed  by  the office [of mental retardation and] FOR PEOPLE WITH
developmental disabilities, or who has been approved by the commissioner
of [mental retardation and]  developmental  disabilities  in  accordance
with  regulations  approved  by the commissioner. Such regulations shall
require that a physician or clinical  psychologist  possess  specialized
training  or  three years experience in treating developmental disabili-
ties.
  S 7. Paragraph (c) of subdivision 1 of  section  2983  of  the  public
health  law,  as added by chapter 752 of the laws of 1990, is amended to
read as follows:
  (c) If the attending physician determines that a patient lacks capaci-
ty because of a developmental disability, the  attending  physician  who
makes  the  determination  must  be, or must consult, for the purpose of
confirming the determination, with a physician or clinical  psychologist
who either is employed by [a school named in section 13.17 of the mental
hygiene  law]  THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, or
who has been employed for a minimum of two  years  to  render  care  and
service  in  a  facility  operated  or licensed by the office [of mental
retardation and] FOR PEOPLE WITH developmental disabilities, or who  has
been  approved  by the commissioner of [mental retardation and] develop-
mental disabilities in accordance with regulations promulgated  by  such
commissioner.  Such  regulations shall require that a physician or clin-
ical psychologist possess specialized training or three years experience
in treating developmental disabilities. A record  of  such  consultation
shall be included in the patient's medical record.
  S 8. Subparagraph ii of paragraph c of subdivision 3 of section 2994-c
of  the public health law, as added by chapter 8 of the laws of 2010, is
amended to read as follows:

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  (ii) If the attending physician makes an initial determination that  a
patient  lacks decision-making capacity because of mental retardation or
a developmental disability, either such physician must have the  follow-
ing  qualifications,  or  another professional with the following quali-
fications  must  independently determine whether the patient lacks deci-
sion-making capacity: a physician or clinical psychologist who either is
employed by [a school named in section 13.17 of the mental hygiene  law,
or  who  has been employed for a minimum of two years to render care and
service in a facility operated or licensed by]  the  office  [of  mental
retardation  and] FOR PEOPLE WITH developmental disabilities, or who has
been approved by the commissioner of [mental retardation  and]  develop-
mental  disabilities  in accordance with regulations promulgated by such
commissioner. Such regulations shall require that a physician  or  clin-
ical psychologist possess specialized training or three years experience
in  treating  developmental  disabilities. A record of such consultation
shall be included in the patient's medical record.
  S 9. Subdivision 10 of section 2994-aa of the public  health  law,  as
added by chapter 8 of the laws of 2010, is amended to read as follows:
  10.  "Hospital" means a general hospital as defined in subdivision ten
of section twenty-eight hundred one of this chapter  and  a  residential
health  care facility as defined in subdivision three of section twenty-
eight hundred one of this chapter or a hospital as defined  in  subdivi-
sion ten of section 1.03 of the mental hygiene law [or a school named in
section 13.17 of the mental hygiene law].
  S  10.  Subdivision  6 of section 2994-dd of the public health law, as
added by chapter 8 of the laws of 2010, is amended to read as follows:
  6. The commissioner may authorize the use of one or  more  alternative
forms  for  issuing  a nonhospital order not to resuscitate (in place of
the standard form prescribed by the commissioner under  subdivision  two
of  this  section).  Such  alternative form or forms may also be used to
issue a non-hospital do not intubate order. Any such  alternative  forms
intended  for use for persons with [mental retardation or] developmental
disabilities or persons with mental illness who are incapable of  making
their  own  health  care  decisions or who have a guardian of the person
appointed pursuant to article eighty-one of the mental  hygiene  law  or
article  seventeen-A of the surrogate's court procedure act must also be
approved by the commissioner of [mental retardation  and]  developmental
disabilities  or  the  commissioner of mental health, as appropriate. An
alternative form under this subdivision  shall  otherwise  conform  with
applicable  federal  and  state  law.  This  subdivision does not limit,
restrict or impair the use of an alternative form for issuing  an  order
not  to  resuscitate  in  a  general hospital or residential health care
facility under article twenty-eight of this chapter or a hospital  under
subdivision  ten  of section 1.03 of the mental hygiene law [or a school
under section 13.17 of the mental hygiene law].
  S 11. Subparagraph (B) of paragraph (vi) of subdivision (c) of section
958 of the general municipal law, as amended by chapter 708 of the  laws
of 1993, is amended to read as follows:
  (B) a state-operated hospital or facility listed in [sections] SECTION
7.17  [or 13.17] of the mental hygiene law OR A FACILITY OPERATED BY THE
OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, which has been desig-
nated by either the commissioner of mental health or the commissioner of
[mental retardation and] developmental disabilities for  contraction  or
discontinuance.    Provided however, that not more than one-third of the
zones designated pursuant to paragraph (iii) or (iv) of subdivision  (b)

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of  section nine hundred sixty OF THIS ARTICLE, shall be based on appli-
cations filed pursuant to THIS paragraph [(vi) of this subdivision].
  S  12. Paragraph (b) of subdivision 4 of section 6810 of the education
law, as added by chapter 519 of the laws of 2002, is amended to read  as
follows:
  (b)  Oral  prescriptions  for  patients  in general hospitals, nursing
homes, residential health care facilities as defined in section  twenty-
eight  hundred  one  of  the  public health law, hospitals as defined in
subdivision ten of section 1.03 of the mental hygiene law, or  [develop-
mental  centers or developmental disabilities services offices listed in
subdivision (b) of section 13.17 of the mental hygiene  law]  FACILITIES
OPERATED  BY  THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, may
be communicated to a pharmacist serving as a  vendor  of  pharmaceutical
services  based upon a contractual arrangement by an agent designated by
and under the direction of the prescriber or the institution. Such agent
shall be a health care practitioner currently  licensed  and  registered
under this title.
  S  13. Paragraph (b) of subdivision 7 of section 6810 of the education
law, as amended by chapter 519 of the laws of 2002, is amended  to  read
as follows:
  (b)  With  respect  to  drugs  other  than  controlled substances, the
provisions of this subdivision shall not apply to  pharmacists  employed
by  or  providing  services under contract to general hospitals, nursing
homes, residential health care facilities as defined in section  twenty-
eight  hundred  one  of  the  public health law, hospitals as defined in
subdivision ten of section 1.03 of the mental hygiene law, or  [develop-
mental  centers or developmental disabilities services offices listed in
subdivision (b) of section 13.17 of the mental hygiene  law]  FACILITIES
OPERATED  BY  THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, who
dispense drugs in the course of said employment  or  in  the  course  of
providing  such  services  under  contract. With respect to such pharma-
cists, each prescription shall be  transcribed  on  a  patient  specific
prescription form.
  S  14.  Paragraph  1  of subdivision (b) of section 5.05 of the mental
hygiene law, as amended by chapter 168 of the laws of 2010,  is  amended
to read as follows:
  (1)  The  commissioners of the office of mental health, the office for
people with developmental disabilities and the office of alcoholism  and
substance  abuse  services shall constitute an inter-office coordinating
council which, consistent with the autonomy of each office  for  matters
within  its  jurisdiction,  shall  ensure  that the state policy for the
prevention, care,  treatment  and  rehabilitation  of  individuals  with
mental  illness  and  developmental  disabilities,  alcoholism,  alcohol
abuse, substance abuse, substance dependence, and chemical dependence is
planned,  developed  and  implemented  comprehensively;  that  gaps   in
services  to  individuals  with multiple disabilities are eliminated and
that no person is denied treatment and services because he  or  she  has
more than one disability; that procedures for the regulation of programs
which  offer  care and treatment for more than one class of persons with
mental disabilities be coordinated between the offices having  jurisdic-
tion  over  such programs; and that research projects of the institutes,
as identified in section 7.17 [or 13.17] of this chapter OR AS  OPERATED
BY  THE  OFFICE  FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, are coordi-
nated to maximize the success and cost effectiveness  of  such  projects
and to eliminate wasteful duplication.

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  S  15.  Subdivision (b) of section 13.11 of the mental hygiene law, as
added by chapter 978 of the laws of 1977, is amended to read as follows:
  (b)  The commissioner shall control the organization of the office and
may continue, establish, discontinue, expand,  and  contract  facilities
under  his  OR  HER  jurisdiction.  [The facilities set forth in section
13.17 may not be discontinued by the commissioner.] Units and facilities
shall have such  functions,  duties,  and  responsibilities  as  may  be
assigned to them by the commissioner.
  S 16. Subdivisions 1 and 2 of section 13.34 of the mental hygiene law,
as  amended  by  chapter 542 of the laws of 2011, are amended to read as
follows:
  1. There shall be at each developmental  center  facility  [listed  in
section 13.17 of this article], an ombudsman who shall be an employee of
the commission on quality of care and advocacy for persons with disabil-
ities  under article forty-five of this chapter and who shall be respon-
sible for receiving and responding to any complaints regarding  individ-
ual  clients  residing  in  such  facility. The ombudsman shall have the
following powers and duties:
  i. to advise and consult with parents, guardians,  correspondents  and
other  interested  persons  with  respect  to  any complaints, or issues
related to the conditions of clients' residents;
  ii. to review and attempt to remedy specific complaints with responsi-
ble and appropriate staff;
  iii. where it appears that care has not been rendered as  required  by
applicable standards to refer the complaint to the appropriate agency or
body for its attention;
  iv.  to  receive  and  keep confidential any complaint, information or
inquiry from any source. The records of the ombudsman shall be confiden-
tial, and shall not be available to the public;
  v. to advise and consult with the board of visitors  of  the  develop-
mental  center served by the ombudsman with respect to any complaints or
issues relating to conditions of client's  residence  and  to  regularly
attend the meetings of such board; and
  vi.  to meet with the commissioner, or a representative of the commis-
sioner, on a quarterly basis regarding systemic issues  in  the  ombuds-
man's jurisdiction.
  2.  The  president  of  the  board  of visitors of each [developmental
center facility listed in section 13.17 of this article] REGION  IN  THE
CATCHMENT  AREA  OF  THE  STATE  OPERATIONS  REGION IN WHICH SUCH MEMBER
SERVES, shall, in consultation with the members of such board, recommend
three persons to serve as ombudsman at  the  facility.  In  making  such
recommendation,  the president shall also consider the expressed opinion
of parents, guardians and correspondents of  clients  residing  at  such
facility.  The  persons so recommended as ombudsman shall have expressed
an active interest or shall have had professional knowledge in  advocat-
ing  for persons who are mentally disabled. The commission on quality of
care and advocacy for persons with disabilities shall select one of  the
recommended persons as ombudsman. The ombudsman may only be removed from
office for just cause.  An individual appointed as ombudsman shall be an
exempt  class  employee  as  defined  by  section forty-one of the civil
service law and may be removed by the commissioner upon the  recommenda-
tion  of  the president of the board of visitors, for cause after notice
and opportunity for a hearing on the charges.
  S 17. Subdivision 1 of section 157 of  the  social  services  law,  as
amended  by  section 43 of part B of chapter 436 of the laws of 1997, is
amended to read as follows:

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  1. Safety net assistance means  allowances  pursuant  to  section  one
hundred  thirty-one-a  OF  THIS ARTICLE for all support, maintenance and
need, and costs of suitable training in a trade to enable  a  person  to
become  self-supporting,  furnished eligible needy persons in accordance
with applicable provisions of law, by a municipal corporation, or a town
where safety net assistance is a town charge, to persons or their depen-
dents  in  their abode or habitation whenever possible and includes such
relief granted to veterans under existing  laws  but  does  not  include
hospital  or  institutional  care,  except as otherwise provided in this
subdivision, or family assistance    or  medical  assistance  for  needy
persons granted under titles ten and eleven OF THIS ARTICLE, respective-
ly,  or  aid  to  persons receiving federal supplemental security income
payments and/or additional state payments.   Safety net  assistance  may
also  be provided in a family home or boarding home, operated in compli-
ance with the regulations of the department, and on  and  after  January
first, nineteen hundred seventy-four, in facilities in which a person is
receiving  family  care  or residential care, as those terms are used in
title six of [article five of] this [chapter] ARTICLE,  and  to  persons
receiving  care in a facility supervised by the office of alcoholism and
substance abuse SERVICES or in a residential facility for  the  mentally
disabled  approved,  licensed or operated by the office of mental health
or the office [of mental retardation and] FOR PEOPLE WITH  developmental
disabilities,  other than those facilities defined in [sections] SECTION
7.17 [and 13.17] of the mental hygiene law, IN  A  DEVELOPMENTAL  CENTER
FACILITY  OPERATED BY THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILI-
TIES or residential care centers for adults operated by  the  office  of
mental  health,  when such type of care is deemed necessary. Payments to
such homes and facilities for care  and  maintenance  provided  by  them
shall  be  at  rates  established pursuant to law and regulations of the
department. The  department,  however,  shall  not  establish  rates  of
payment  to such homes or facilities without approval of the director of
the budget.
  S 18. Subparagraph (i) of paragraph (a) and clause A  of  subparagraph
(i)  of  paragraph  (e) of subdivision 4 of section 1750-b of the surro-
gate's court procedure act, as added by chapter 500 of the laws of 2002,
are amended to read as follows:
  (i) be employed by [a developmental disabilities services office named
in section 13.17 of the mental hygiene law] THE OFFICE FOR  PEOPLE  WITH
DEVELOPMENTAL DISABILITIES, or
  A.  be employed by [a developmental disabilities services office named
in section 13.17 of the mental hygiene law] THE OFFICE FOR  PEOPLE  WITH
DEVELOPMENTAL DISABILITIES, or
  S  19.  (a)  Wherever  the  terms  "directors of office facilities" or
"directors of schools" or "director of facilities" appear in the  mental
hygiene law in reference to a facility operated by the office for people
with  developmental  disabilities,  such  terms  are  hereby  changed to
"directors of state operations offices".
  (b) Wherever the term "developmental  disabilities  services  offices"
appears in the mental hygiene law, such term is hereby changed to "state
operations office".
  (c)  The  legislative  bill  drafting commission is hereby directed to
effectuate this provision, and  shall  be  guided  by  a  memorandum  of
instruction  setting forth the specific provisions of law to be amended.
Such memorandum shall be transmitted to the  legislative  bill  drafting
commission within sixty days of enactment of this provision.  Such memo-
randum  shall be issued jointly by the governor, the temporary president

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of the senate and the speaker of the assembly, or  by  the  delegate  of
each.
  S 20. This act shall take effect immediately.

                                 PART K

  Section  1.  Sections  19  and  21  of chapter 723 of the laws of 1989
amending the mental hygiene law and other laws relating to comprehensive
psychiatric emergency programs, as amended by section 1  of  part  F  of
chapter 58 of the laws of 2008, are amended to read as follows:
  S  19. Notwithstanding any other provision of law, the commissioner of
mental health shall, until July 1, [2012] 2016, be solely authorized, in
his or her discretion,  to  designate  those  general  hospitals,  local
governmental units and voluntary agencies which may apply and be consid-
ered  for the approval and issuance of an operating certificate pursuant
to article 31 of the mental hygiene law for the operation of  a  compre-
hensive psychiatric emergency program.
  S  21.  This  act shall take effect immediately, and sections one, two
and four through twenty of this act  shall  remain  in  full  force  and
effect,  until  July  1,  [2012]  2016, at which time the amendments and
additions made by such sections of  this  act  shall  be  deemed  to  be
repealed,  and  any  provision of law amended by any of such sections of
this act shall revert to its text as it existed prior to  the  effective
date of this act.
  S  2.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012.

                                 PART L

  Section 1. Legislative findings. It is the finding of the  legislature
that  the integration and coordination of physical and behavioral health
services results in an improvement in  the  quality  of  services  being
provided  to  recipients,  with  a resultant improvement in outcomes and
reduction in the costs of care. It is the further finding of the  legis-
lature  that  the  reduction  or elimination of redundant or unnecessary
licensing and oversight requirements and procedures will facilitate  the
provision  of integrated and coordinated care and result in a more effi-
cient use of governmental resources.
  S 2. (a) Notwithstanding any law, rule or regulation to the  contrary,
two or more of the commissioners of the department of health, the office
of  mental health, the office of alcoholism and substance abuse services
or the office for people with  developmental  disabilities  are  jointly
authorized  to  establish operating, reporting and construction require-
ments, as well as joint survey requirements and procedures for  entities
that:
  (1)  can  demonstrate  experience  and  competence  in the delivery of
health, mental health,  alcohol  and  substance  abuse  services  and/or
services  to persons with developmental disabilities and the capacity to
offer the integrated delivery of such services at locations  as  may  be
approved by two or more of the respective commissioners; and
  (2)  meet  the  standards  that  may  be established by the respective
commissioners for the provision of  such  services;  provided,  however,
that  an  entity  meeting  the  standards  established  pursuant to this
section shall not be required  to  be  an  integrated  service  provider
pursuant to subdivision 7 of section 365-l of the social services law.

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  (b)  In  establishing one or more sets of joint requirements or proce-
dures for entities described in this section, the commissioners  of  the
department  of  health, the office of mental health, the office of alco-
holism and substance abuse services, and/or the office for  people  with
developmental  disabilities  are  authorized  to  waive  any  regulatory
requirements, or to determine that compliance with  another  commission-
er's  regulatory  requirements  shall  be  deemed to meet the regulatory
requirements of his or her agency, as may be necessary or  desirable  to
avoid duplication of requirements and/or to permit the integrated deliv-
ery  of health and behavioral health services in an efficient and effec-
tive manner.
  (c) The  authority  granted  the  commissioners  in  this  section  is
intended  to  complement  and  supplement  the authority granted to such
commissioners pursuant to subdivision 7 of section 365-l of  the  social
services law.
  S  3.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012.

                                 PART M

  Section 1. Legislative findings. It is the finding of the  legislature
that  patients  hospitalized  in  facilities  operated  by the office of
mental health who are between the ages of five and twenty-one are  enti-
tled  to receive an education comparable to that which they would other-
wise be entitled to receive in their local school districts pursuant  to
the education law and the regulations of the commissioner of education.
  S  2.  (a) Notwithstanding any other provision of law to the contrary,
the office of mental health shall be authorized to enter into an  agree-
ment  with  the state education department for the purposes of providing
education programming and services for patients  residing  in  hospitals
operated by the office of mental health who are between the ages of five
and twenty-one, that is comparable to that which they would otherwise be
entitled  to  receive  in  their  local school districts pursuant to the
education law and the regulations of the commissioner.  The commissioner
of education shall be authorized  to  require  local  school  districts,
including  the  school district located in a city with a million persons
or more, and/or boards of cooperative educational  services  to  provide
such comparable educational programming and services, provided, however,
the  commissioner  of  mental  health  shall  be  authorized to contract
directly with local school  districts,  including  the  school  district
located in a city with a million persons or more, and/or boards of coop-
erative  educational  services  to  provide  such comparable educational
programming and services.   Such comparable  education  programming  and
services  for  such  children shall be authorized to be provided, in the
2012-2013 and 2013-2014 and 2014-2015 school years within a city with  a
population  of a million persons or more, and in the 2013-2014 and 2014-
2015 school year in the rest of the state, in accordance with  implemen-
tation standards issued by the commissioner of education, and in accord-
ance  with  a  plan  for  educational  services  jointly approved by the
commissioners of education and mental health.
  (b) The commissioner of education, or pursuant to contract the commis-
sioner of mental health, shall reimburse districts and boards of cooper-
ative educational services for unreimbursed, approved expenses  for  the
cost of such programming and services for such children pursuant to this
section, as may be determined through a reimbursement methodology devel-

S. 6256--A                         91                         A. 9056--A

oped  by  the  commissioner of education and approved by the director of
the budget.
  (c) The commissioner of mental health, with the approval of the direc-
tor  of  the  budget,  shall  be  authorized  to transfer funding to the
commissioner of education for the provision of  educational  programming
and services to patients residing in hospitals operated by the office of
mental health who are between the ages of five and twenty-one.
  S  3.  The  commissioners of education and mental health shall jointly
submit to the governor and to the temporary president of the senate  and
the  speaker  of  the assembly a report by February 1, 2015, which shall
state whether additional actions should be taken to ensure that children
who are patients residing in hospitals operated by the office of  mental
health receive education programming and services that are comparable to
that  which  they  would otherwise be entitled to receive in their local
school districts pursuant to education law and the  regulations  of  the
commissioner.  Such  commissioners shall also recommend whether this act
should be amended and whether it should be made permanent.
  S 4. This act shall take effect July 1, 2012 and shall expire June 30,
2015 when upon such date the provisions of  this  act  shall  be  deemed
repealed.

                                 PART N

  Section 1. Section 1.03 of the mental hygiene law is amended by adding
two new subdivisions 56 and 57 to read as follows:
  56.   "SUBSTANCE  USE  DISORDER"  MEANS  THE  MISUSE,  DEPENDENCE,  OR
ADDICTION TO ALCOHOL AND/OR LEGAL OR ILLEGAL DRUGS  LEADING  TO  EFFECTS
THAT  ARE DETRIMENTAL TO THE INDIVIDUAL'S PHYSICAL AND MENTAL HEALTH, OR
THE WELFARE OF OTHERS  AND  SHALL  INCLUDE  ALCOHOLISM,  ALCOHOL  ABUSE,
SUBSTANCE  ABUSE,  SUBSTANCE DEPENDENCE, CHEMICAL ABUSE, AND/OR CHEMICAL
DEPENDENCE.
  57. "SUBSTANCE USE DISORDER SERVICES" SHALL MEAN AND INCLUDE  EXAMINA-
TION,  EVALUATION, DIAGNOSIS, CARE, TREATMENT, REHABILITATION, OR TRAIN-
ING OF PERSONS WITH  SUBSTANCE  USE  DISORDERS  AND  THEIR  FAMILIES  OR
SIGNIFICANT OTHERS.
  S 2. The mental hygiene law is amended by adding a new section 5.06 to
read as follows:
S 5.06 BEHAVIORAL HEALTH SERVICES ADVISORY COUNCIL.
  (A)  THERE IS HEREBY CREATED WITHIN THE DEPARTMENT A BEHAVIORAL HEALTH
SERVICES ADVISORY COUNCIL, THE PURPOSE OF WHICH SHALL BE TO  ADVISE  THE
OFFICES  OF MENTAL HEALTH AND ALCOHOLISM AND SUBSTANCE ABUSE SERVICES ON
MATTERS RELATING TO THE PROVISION OF BEHAVIORAL HEALTH SERVICES;  ISSUES
OF  JOINT  CONCERN  TO THE OFFICES, INCLUDING THE INTEGRATION OF VARIOUS
BEHAVIORAL HEALTH SERVICES AND  THE  INTEGRATION  OF  BEHAVIORAL  HEALTH
SERVICES  WITH  HEALTH  SERVICES;  AND ISSUES RELATED TO THE DELIVERY OF
BEHAVIORAL HEALTH SERVICES THAT  ARE  RESPONSIVE  TO  LOCAL,  STATE  AND
FEDERAL  CONCERNS.  THE  COUNCIL  SHALL  CONSIST  OF THE COMMISSIONER OF
MENTAL HEALTH AND THE COMMISSIONER OF  ALCOHOLISM  AND  SUBSTANCE  ABUSE
SERVICES  WHO SHALL NOT HAVE THE RIGHT TO VOTE, THE CHAIR OF THE CONFER-
ENCE OF LOCAL MENTAL HYGIENE DIRECTORS OR HIS OR HER DESIGNEE, AND TWEN-
TY-EIGHT MEMBERS APPOINTED BY THE GOVERNOR.  MEMBERS SHALL BE  APPOINTED
ONLY  IF THEY HAVE PROFESSIONAL KNOWLEDGE IN THE CARE OF PERSONS RECEIV-
ING BEHAVIORAL HEALTH SERVICES, OR AN ACTIVE INTEREST IN THE  BEHAVIORAL
HEALTH SERVICES SYSTEM.
  (B)  THE GOVERNOR SHALL DESIGNATE ONE OF THE MEMBERS OF THE COUNCIL AS
CHAIR. AT LEAST ONE-HALF OF THE MEMBERS OF  THE  COUNCIL  SHALL  NOT  BE

S. 6256--A                         92                         A. 9056--A

PROVIDERS  OF  BEHAVIORAL  HEALTH SERVICES.   MEMBERSHIP SHALL REFLECT A
BALANCED REPRESENTATION OF PERSONS WITH INTERESTS IN MENTAL  HEALTH  AND
SUBSTANCE USE DISORDER SERVICES AND SHALL INCLUDE:
  (1)  AT  LEAST  FIVE  CURRENT OR FORMER CONSUMERS OF BEHAVIORAL HEALTH
SERVICES;
  (2) AT LEAST THREE INDIVIDUALS WHO ARE PARENTS OR RELATIVES OF CURRENT
OR FORMER CONSUMERS OF BEHAVIORAL HEALTH SERVICES;
  (3) AT LEAST THREE MEMBERS WHO ARE NOT PROVIDERS OF BEHAVIORAL  HEALTH
SERVICES  AND WHO REPRESENT NON-GOVERNMENTAL ORGANIZATIONS, SUCH AS NOT-
FOR-PROFIT  ENTITIES  REPRESENTING  HEALTH  OR  BEHAVIORAL  HEALTH  CARE
EMPLOYEES, OR OTHER ORGANIZATIONS CONCERNED WITH THE PROVISION OF BEHAV-
IORAL HEALTH SERVICES;
  (4)  AT LEAST FIVE REPRESENTATIVES OF PROVIDERS OF SERVICES TO PERSONS
WITH MENTAL ILLNESS AND AT LEAST FIVE REPRESENTATIVES  OF  PROVIDERS  OF
SERVICES  TO  PERSONS WITH SUBSTANCE USE DISORDERS, AT LEAST TWO OF WHOM
SHALL BE PHYSICIANS;
  (5) ONE MEMBER APPOINTED ON THE RECOMMENDATION OF THE DIRECTOR OF  THE
DIVISION OF VETERANS' AFFAIRS;
  (6) ONE MEMBER APPOINTED ON THE RECOMMENDATION OF THE ADJUTANT GENERAL
OF THE DIVISION OF MILITARY AND NAVAL AFFAIRS;
  (7) AT LEAST THREE REPRESENTATIVES OF LOCAL GOVERNMENTS OR OTHER STATE
AND  LOCAL  AGENCIES  CONCERNED  WITH THE PROVISION OF BEHAVIORAL HEALTH
SERVICES; AND
  (8) AT LEAST TWO MEMBERS WHO ARE ALSO MEMBERS OF THE PUBLIC HEALTH AND
HEALTH PLANNING COUNCIL PURSUANT TO SECTION TWO HUNDRED  TWENTY  OF  THE
PUBLIC HEALTH LAW.
  (C)  MEMBERS  SHALL  BE  APPOINTED  FOR TERMS OF THREE YEARS PROVIDED,
HOWEVER, THAT  OF  THE  MEMBERS  FIRST  APPOINTED,  ONE-THIRD  SHALL  BE
APPOINTED  FOR  ONE  YEAR TERMS AND ONE-THIRD SHALL BE APPOINTED FOR TWO
YEAR TERMS. VACANCIES SHALL BE FILLED IN THE  SAME  MANNER  AS  ORIGINAL
APPOINTMENTS FOR THE REMAINDER OF ANY UNEXPIRED TERM. NO PERSON SHALL BE
AN APPOINTED MEMBER OF THE COUNCIL FOR MORE THAN SIX YEARS IN ANY PERIOD
OF TWELVE CONSECUTIVE YEARS.
  (D)  THE  COUNCIL SHALL MEET AT LEAST FOUR TIMES IN EACH FULL CALENDAR
YEAR. THE COUNCIL SHALL MEET AT THE  REQUEST  OF  ITS  CHAIR  OR  EITHER
COMMISSIONER.
  (E)  THE COUNCIL SHALL ESTABLISH SUCH COMMITTEES AS IT DEEMS NECESSARY
TO ADDRESS THE SERVICE NEEDS  OF  SPECIAL  POPULATIONS  AND  TO  ADDRESS
PARTICULAR  SUBJECTS  OF IMPORTANCE IN THE DEVELOPMENT AND MANAGEMENT OF
BEHAVIORAL HEALTH SERVICES.
  (F) THE COUNCIL MAY CONSIDER ANY MATTER RELATING TO THE IMPROVEMENT OF
BEHAVIORAL HEALTH SERVICES IN THE STATE AND SHALL ADVISE THE COMMISSION-
ERS ON ANY SUCH MATTER, INCLUDING, BUT NOT LIMITED TO:
  (1) CARE AND SERVICES TO PERSONS  WITH  BEHAVIORAL  HEALTH  DISORDERS,
INCLUDING  SPECIAL  AND  UNDERSERVED  POPULATIONS  AS  DETERMINED BY THE
COMMISSIONER;
  (2) FINANCING BEHAVIORAL HEALTH SERVICES;
  (3) INTEGRATION OF BEHAVIORAL HEALTH SERVICES WITH HEALTH SERVICES;
  (4) CARE AND SERVICES  FOR  PERSONS  WITH  CO-OCCURRING  DISORDERS  OR
MULTIPLE DISABILITIES;
  (5) PREVENTION OF BEHAVIORAL HEALTH DISORDERS; AND
  (6) IMPROVEMENT OF CARE IN STATE OPERATED OR COMMUNITY BASED PROGRAMS,
RECRUITMENT,  EDUCATION AND TRAINING OF QUALIFIED DIRECT CARE PERSONNEL,
AND PROTECTION OF THE INTERESTS OF EMPLOYEES AFFECTED BY ADJUSTMENTS  IN
THE BEHAVIORAL HEALTH SERVICE SYSTEM.

S. 6256--A                         93                         A. 9056--A

  (G)  THE  COUNCIL SHALL, IN COOPERATION WITH THE COMMISSIONERS, ESTAB-
LISH STATEWIDE GOALS AND OBJECTIVES FOR SERVICES TO PERSONS WITH  BEHAV-
IORAL HEALTH DISORDERS, PURSUANT TO SECTION 5.07 OF THIS ARTICLE.
  (H)  (1) THE COUNCIL SHALL REVIEW THE PORTION OF THE STATEWIDE PLAN TO
BE DEVELOPED AND UPDATED  ANNUALLY  BY  THE  COMMISSIONERS  PURSUANT  TO
SECTION  5.07  OF THIS ARTICLE AND REPORT ITS RECOMMENDATIONS THEREON TO
THE COMMISSIONERS.
  (2) THE COUNCIL SHALL REVIEW ANY MENTAL HEALTH OR SUBSTANCE USE COMPO-
NENT OF STATEWIDE HEALTH PLANS DEVELOPED IN ACCORDANCE WITH ANY APPLICA-
BLE FEDERAL LAW AND SHALL REPORT  ITS  RECOMMENDATIONS  THEREON  TO  THE
COMMISSIONERS.
  (I) THE COUNCIL SHALL REVIEW APPLICATIONS FILED IN ACCORDANCE WITH:
  (1)  SECTION  31.22  OF  THIS CHAPTER FOR APPROVAL OF INCORPORATION OR
ESTABLISHMENT OF A FACILITY, AND  SECTION  31.23  OF  THIS  CHAPTER  FOR
APPROVAL  OF  THE CONSTRUCTION OF A FACILITY FOR WHICH APPROVAL FROM THE
COMMISSIONER OF MENTAL HEALTH IS REQUIRED; AND
  (2) SECTION 32.29 OR 32.31 OF THIS CHAPTER FOR  APPROVAL  OF  INCORPO-
RATION OR ESTABLISHMENT OR CONSTRUCTION OF A FACILITY FOR WHICH APPROVAL
TO OPERATE IS REQUIRED FROM THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE
ABUSE  SERVICES  PURSUANT  TO ARTICLE THIRTY-TWO OF THIS CHAPTER, AND AS
OTHERWISE REQUESTED BY SUCH COMMISSIONER;
  (J) AT LEAST SIXTY DAYS PRIOR TO THE COMMISSIONERS' FINAL APPROVAL  OF
RULES  AND  REGULATIONS  UNDER THEIR RESPECTIVE JURISDICTION, OTHER THAN
EMERGENCY RULES AND REGULATIONS AND REGULATIONS PROMULGATED PURSUANT  TO
SECTION  43.01  OF  THIS  CHAPTER,  THE  COMMISSIONERS SHALL SUBMIT SUCH
PROPOSED RULES AND REGULATIONS TO THE COUNCIL FOR ITS REVIEW. THE  COUN-
CIL  SHALL  REVIEW  ALL  PROPOSED  RULES  AND REGULATIONS AND REPORT ITS
RECOMMENDATIONS THEREON TO THE  COMMISSIONERS  WITHIN  SIXTY  DAYS.  THE
COMMISSIONER  HAVING  STATUTORY  JURISDICTION  OVER THE PROPOSED RULE OR
REGULATION SHALL NOT ACT IN A MANNER INCONSISTENT WITH  THE  RECOMMENDA-
TIONS  OF  THE  COUNCIL  WITHOUT  FIRST  APPEARING BEFORE THE COUNCIL TO
REPORT THE REASONS THEREFOR. THE COUNCIL, UPON A MAJORITY  VOTE  OF  ITS
MEMBERS,  MAY REQUIRE THAT AN ALTERNATIVE APPROACH TO THE PROPOSED RULES
AND REGULATIONS BE PUBLISHED WITH THE NOTICE OF THE PROPOSED  RULES  AND
REGULATIONS PURSUANT TO SECTION TWO HUNDRED TWO OF THE STATE ADMINISTRA-
TIVE  PROCEDURE  ACT. WHEN AN ALTERNATIVE APPROACH IS PUBLISHED PURSUANT
TO THIS SECTION, THE COMMISSIONER HAVING STATUTORY JURISDICTION  OF  THE
SUBJECT  PROPOSED  RULE  OR  REGULATION  SHALL STATE THE REASONS FOR NOT
SELECTING SUCH ALTERNATIVE APPROACH.
  (K) THE COUNCIL, BY A MAJORITY VOTE OF ITS MEMBERS, MAY PROPOSE  RULES
AND  REGULATIONS ON ANY MATTER WITHIN THE REGULATORY JURISDICTION OF THE
OFFICES OF MENTAL HEALTH OR ALCOHOLISM  AND  SUBSTANCE  ABUSE  SERVICES,
OTHER  THAN  ESTABLISHMENT OF FEE SCHEDULES PURSUANT TO SECTION 43.01 OF
THIS CHAPTER, AND FORWARD SUCH PROPOSED RULES AND  REGULATIONS  TO  BOTH
COMMISSIONERS FOR REVIEW AND CONSIDERATION, PROVIDED, HOWEVER, THAT ONLY
THE  APPROVAL  OF  THE  COMMISSIONER  WITH STATUTORY JURISDICTION OF THE
PROPOSED RULE OR REGULATION SHALL BE REQUIRED. PRIOR TO SUCH COMMISSION-
ER'S FINAL APPROVAL AND PROMULGATION OF SUCH PROPOSED  RULES  AND  REGU-
LATIONS, IF SUCH RULES AND REGULATIONS ARE MODIFIED IN ANY RESPECT, THEY
SHALL  BE  SUBMITTED  TO THE COUNCIL PURSUANT TO SUBDIVISION (J) OF THIS
SECTION. IF SUCH COMMISSIONER DETERMINES NOT TO PROMULGATE SUCH PROPOSED
RULES AND REGULATIONS, THE COMMISSIONER SHALL APPEAR BEFORE THE  COUNCIL
TO REPORT THE REASONS THEREFOR.
  (L) THE MEMBERS OF THE COUNCIL SHALL RECEIVE NO COMPENSATION FOR THEIR
SERVICES  BUT  SHALL BE REIMBURSED FOR EXPENSES ACTUALLY AND NECESSARILY
INCURRED IN THE PERFORMANCE OF THEIR DUTIES.

S. 6256--A                         94                         A. 9056--A

  (M) THE COMMISSIONERS, UPON REQUEST OF THE  COUNCIL,  SHALL  DESIGNATE
ONE OR MORE OFFICERS OR EMPLOYEES FROM EITHER OR BOTH OFFICES TO PROVIDE
ADMINISTRATIVE SUPPORT SERVICES TO THE COUNCIL, AND MAY ASSIGN FROM TIME
TO TIME SUCH OTHER EMPLOYEES AS THE COUNCIL MAY REQUEST.
  (N)  NO  CIVIL ACTION SHALL BE BROUGHT IN ANY COURT AGAINST ANY MEMBER
OF THE BEHAVIORAL HEALTH SERVICES ADVISORY COUNCIL  FOR  ANY  ACT  DONE,
FAILURE  TO  ACT, OR STATEMENT OR OPINION MADE, WHILE DISCHARGING HIS OR
HER DUTIES AS A MEMBER OF THE COUNCIL, WITHOUT LEAVE FROM A  JUSTICE  OF
THE  SUPREME  COURT,  FIRST  HAD  AND OBTAINED. IN ANY EVENT SUCH MEMBER
SHALL NOT BE LIABLE FOR DAMAGES IN ANY SUCH ACTION IF HE  OR  SHE  SHALL
HAVE  ACTED IN GOOD FAITH, WITH REASONABLE CARE AND UPON PROBABLE CAUSE.
MEMBERS OF THE COUNCIL SHALL  BE  CONSIDERED  PUBLIC  OFFICERS  FOR  THE
PURPOSES OF SECTION SEVENTEEN OF THE PUBLIC OFFICERS LAW.
  (O) THE COUNCIL MAY ESTABLISH SUCH COMMITTEES AS IT DEEMS NECESSARY.
  (P) THE COUNCIL MAY ESTABLISH WRITTEN BYLAWS.
  (Q)  FOR  PURPOSES OF THIS SECTION, "BEHAVIORAL HEALTH SERVICES" SHALL
MEAN EXAMINATION, DIAGNOSIS, CARE, TREATMENT, REHABILITATION, OR  TRAIN-
ING  FOR  PERSONS  WITH MENTAL ILLNESS AND/OR FOR PERSONS WITH SUBSTANCE
USE OR COMPULSIVE GAMBLING DISORDERS.
  S 3. The section heading, subdivision (a), the opening  paragraph  and
paragraphs  1  and  3  of subdivision (b) and subdivision (c) of section
5.07 of the mental hygiene law, the section heading as amended by  chap-
ter  55  of the laws of 1992, subdivision (a), the opening paragraph and
paragraphs 1 and 3 of subdivision (b) and subdivision (c) as amended  by
chapter  223  of  the  laws  of  1992, paragraph 1 of subdivision (a) as
amended by chapter 37 of the laws of  2011,  the  opening  paragraph  of
paragraph  1 of subdivision (b) as amended by chapter 168 of the laws of
2010, subparagraphs h and i as amended and subparagraph j of paragraph 1
of subdivision (b) as added by chapter 413 of the laws of 2009 and para-
graph 3 of subdivision (b) as renumbered by chapter 322 of the  laws  of
1992, are amended to read as follows:
Establishment  of [statewide goals and objectives;] statewide comprehen-
         sive plans of services for [the mentally disabled] PERSONS WITH
         MENTAL DISABILITIES.
  (a) (1) The [mental health] BEHAVIORAL HEALTH services ADVISORY  coun-
cil  and  the  advisory [councils] COUNCIL on developmental disabilities
[and alcoholism and substance abuse  services]  shall  [each  establish]
PROVIDE  RECOMMENDATIONS  FOR statewide PRIORITIES AND goals [and objec-
tives] to guide comprehensive planning, resource allocation  and  evalu-
ation  processes  for  state  and local services for persons with mental
illness, developmental disabilities [and], AND/OR those [suffering  from
chemical  abuse  or  dependence,  respectively]  WITH  SUBSTANCE  USE OR
COMPULSIVE GAMBLING DISORDERS. Such goals and objectives shall:
  a. be measurable in terms of attainment AND FOCUSED  ON  OUTCOMES  FOR
THOSE BEING SERVED;
  b.  be DEVELOPED IN COLLABORATION WITH, AND communicated to, providers
of services, department facilities,  consumers  and  consumer  represen-
tatives, and other appropriate state and local governmental agencies;
  c.  [require  that all state and local public and private services for
persons with mental disabilities be organized, staffed and  financed  to
best  meet  the  needs  of  all persons with mental disabilities whether
receiving in-patient or non in-patient services;
  d.] reflect the  partnership  between  state  and  local  governmental
units; and

S. 6256--A                         95                         A. 9056--A

  [e.]  D.  emphasize [that gaps in services be filled and that services
are provided to persons with mental disabilities] THE NEED TO  INTEGRATE
BEHAVIORAL HEALTH AND HEALTH SERVICES.
  (2) Such advisory councils shall [establish, review, augment or delete
from such goals and objectives, as appropriate,] ACCOMPLISH THEIR DUTIES
by means of a [continuing annual goal-setting] process which is:
  a. open, visible and accessible to the public; and
  b.  consistent  with  the  statewide  AND FEDERALLY MANDATED planning,
appropriation and evaluation processes and activities  for  services  to
[the mentally disabled] PERSONS WITH MENTAL DISABILITIES.
  (3) The advisory councils are hereby empowered to hold public hearings
and meetings to enable them to accomplish their duties.
  Statewide  comprehensive  plan for services to [the mentally disabled]
PERSONS WITH MENTAL DISABILITIES.
  (1) The office of mental health, the office for people  with  develop-
mental  disabilities  and  the  office of alcoholism and substance abuse
services shall [each] formulate a  statewide  comprehensive  [five-year]
plan  for the provision of all state and local services for persons with
mental illness [and], developmental  disabilities,  [and]  AND/OR  those
[suffering from alcoholism and] WITH substance [abuse, respectively] USE
OR  COMPULSIVE  GAMBLING DISORDERS.   [Each] THE STATEWIDE COMPREHENSIVE
plan shall be [formulated from] BASED UPON AN ANALYSIS OF local [compre-
hensive] SERVICES plans developed by each local governmental unit,  with
participation  of  consumers, consumer groups, providers of services and
departmental facilities [furnishing] THAT FURNISH services  to  individ-
uals  with  mental disabilities [of the area] in conformance with state-
wide PRIORITIES AND goals [and objectives] established [by] WITH  RECOM-
MENDATIONS  OF  the  advisory  council  of  each office. [Each] THE plan
shall:
  a. identify [needs and problems which must  be  addressed  during  the
next  ensuing  five years which such plan encompasses] STATEWIDE PRIORI-
TIES;
  b. specify [time-limited] STATEWIDE goals [to meet those  needs]  THAT
REFLECT  THE  STATEWIDE PRIORITIES AND ARE FOCUSED ON OBTAINING POSITIVE
MEASURABLE OUTCOMES;
  c. [identify resources to achieve the goals, including but not limited
to resource reallocations;
  d. establish] PROPOSE STRATEGIES AND INITIATIVES TO ADDRESS THE prior-
ities [for resource allocation] AND FACILITATE ACHIEVEMENT OF  STATEWIDE
GOALS;
  [e.  define  the  authority  and  responsibility  for  state and local
participation in the delivery of services] D.    IDENTIFY  SERVICES  AND
SUPPORTS,  WHICH  MAY  INCLUDE  PROGRAMS  RUN  OR LED BY PEERS, THAT ARE
DESIGNED TO PROMOTE THE HEALTH  AND  WELLNESS  OF  PERSONS  WITH  MENTAL
ILLNESS,  DEVELOPMENTAL DISABILITIES, AND/OR SUBSTANCE USE OR COMPULSIVE
GAMBLING DISORDERS;
  [f. propose programs to achieve the goals, which programs may  include
direct  services, development of multi-purpose facilities, contracts for
services, and innovative financial and organizational relationships with
public and private providers;
  g. identify services and programs that assist the  informal  caregiver
to  care  for the mentally disabled; make recommendations to enhance the
ability of the informal caregiver to continue providing care; and devel-
op strategies for creating informal caregivers for clients in the commu-
nity who do not have a system in place;

S. 6256--A                         96                         A. 9056--A

  h. analyze] E. PROVIDE ANALYSIS OF current and anticipated utilization
of state and local, and public and private facilities  [and],  programs,
SERVICES, AND/OR SUPPORTS;
  [i.] F. encourage and promote PERSON-CENTERED, CULTURALLY AND LINGUIS-
TICALLY  COMPETENT  community-based  programs, SERVICES, AND/OR SUPPORTS
which reflect the  partnership  between  state  and  local  governmental
units; and
  [j.]  G. include progress reports on the implementation of both short-
term and long-term  recommendations  of  the  children's  plan  required
pursuant  to  section four hundred eighty-three-f of the social services
law.
  (3) The commissioners of each of the offices shall be responsible  for
the  development  of such statewide [five-year] plan for services within
the jurisdiction of their respective offices and after giving due notice
shall conduct one or more public hearings on such plan.  The  BEHAVIORAL
HEALTH SERVICES advisory council [of each office] AND THE ADVISORY COUN-
CIL ON DEVELOPMENTAL DISABILITIES shall review the statewide [five year]
COMPREHENSIVE  plan  developed  by such office OR OFFICES and report its
recommendations thereon to  such  commissioner  OR  COMMISSIONERS.  Each
commissioner  shall  submit the plan, with appropriate modifications, to
the governor no later than the first day of [October] NOVEMBER  of  each
year in order that such plan may be considered with the estimates of the
offices  for the preparation of the executive budget of the state of New
York for the next succeeding state  fiscal  year.    [Each  commissioner
shall also submit such plan to the legislature. The statewide plan] SUCH
PLANS  SHALL  ALSO  BE  POSTED  TO THE WEBSITE OF EACH OFFICE. STATEWIDE
PLANS shall [be reassessed and updated at least  annually  to  encompass
the  next ensuing five years to] ensure responsiveness to changing needs
and goals and [to] SHALL reflect the development of new information  and
the  completion of program evaluations. [An interim report detailing the
commissioner's actions in fulfilling the requirements of this section in
preparation of the plan and modifications in the plan of services  being
considered  by  the  commissioner shall be submitted to the governor and
the legislature on or before the fifteenth day of February of each year.
Such interim report shall include, but need not be limited to:
  (a) actions to include participation of  consumers,  consumer  groups,
providers  of  services and departmental facilities, as required by this
subdivision; and
  (b) any modifications in the plan of services being considered by  the
commissioner,  to  include:  (i)  compelling  budgetary, programmatic or
clinical justifications  or  other  major  appropriate  reason  for  any
significant  new  statewide  programs  or  policy  changes  from a prior
(approved) five year comprehensive plan; and (ii) procedures to  involve
or inform local governmental units of such actions or plans.
  (c) Three year capital plan. (1) On or before July first of each year,
the  commissioners  of  the  offices of the department of mental hygiene
shall each submit to the advisory council of their respective offices  a
statewide three year capital plan for facilities within the jurisdiction
of  their  respective  offices.  The  capital  plan  shall set forth the
projects proposed to be designed, constructed, acquired,  reconstructed,
rehabilitated  or  otherwise substantially altered pursuant to appropri-
ation to meet the capital development needs of the  respective  agencies
for  the  next  ensuing three years; the years of such plan shall corre-
spond to the years of the statewide five year plan as required by subdi-
vision (b) of this section.

S. 6256--A                         97                         A. 9056--A

  (2) Such plan for each office shall include but not be  limited  to  a
detailed  project  schedule indicating the location by county or borough
and estimated cost of each project, the anticipated dates on  which  the
design  and  construction  of  the  project is to commence, the proposed
method  of financing for the project, the estimated economic life of the
project  and  whether  the  proposed  project  constitutes  design,  new
construction or rehabilitation.
  (3)  Such  plan  shall  further  specify  for each project whether the
project is to be a residential or nonresidential facility,  a  state  or
voluntary  operated  facility,  and, the number of clients, by source of
clients, proposed to utilize the facility. The information on the source
of the client shall include but not  be  limited  to  identification  of
clients  currently  living  independently,  or at home with families, or
with caretakers, clients defined by their respective agencies as special
populations, or clients currently residing in an  institutional  setting
under the jurisdiction of the offices of the department.
  (4)  The  advisory council of the appropriate office shall review such
plan and report its recommendation to the  commissioner  for  inclusion,
provided, however, that the mental health services council shall forward
its  comments  on the capital plan of the office of mental health to the
mental health planning council which shall forward such  recommendations
after  review  to  the  commissioner  of mental health. The commissioner
shall submit his or her plan with  the  formal  recommendations  of  the
advisory  council  of  his  or her office and any subsequent appropriate
modifications to the governor no later than the first day of October  of
each  year  or  concurrent  with  the annual submission of estimates and
information required by section one of article seven of the constitution
in order that such plans shall be considered with the estimates  of  the
offices  for the preparation of the executive budget of the state of New
York for the next succeeding state fiscal year. The commissioners  shall
also  submit  such plans to the chairmen of the senate finance committee
and the assembly ways and means committee.
  (5) Each statewide three year capital plan  for  facilities  shall  be
evaluated  and  revised  annually  to  encompass the fiscal year then in
progress and the next ensuing two fiscal years to ensure  responsiveness
to  the  changing  needs and goals of the department, and to reflect the
development of new information and project completion.]
  S 4. Section 7.05 of the mental hygiene law is REPEALED.
  S 5. Subdivision (c) of section 13.05 of the mental  hygiene  law,  as
amended  by  chapter  37  of  the  laws  of  2011, is amended to read as
follows:
  (c) The developmental disabilities  advisory  council  shall  have  no
executive,  administrative  or appointive duties. The council shall have
the duty to foster public understanding and acceptance of  developmental
disabilities. It shall, in cooperation with the commissioner of develop-
mental  disabilities,  [establish] PROVIDE RECOMMENDATIONS FOR statewide
PRIORITIES AND goals [and objectives] for services for individuals  with
developmental  disabilities and shall advise the commissioner on matters
related to development and  implementation  of  the  [OPWDD's  triennial
state   developmental  disabilities]  STATEWIDE  comprehensive  plan  as
required under [paragraph two of subdivision (b)  of]  section  5.07  of
this  chapter. The advisory council shall have the power to consider any
matter relating to the improvement of the state developmental  disabili-
ties program and shall advise the commissioner of developmental disabil-
ities  thereon  and  on  any matter relating to the performance of their
duties with relation to individuals with developmental disabilities  and

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on  policies,  goals, budget and operation of developmental disabilities
services.
  S 6. Section 19.05 of the mental hygiene law is REPEALED.
  S  7.  Subdivision  (c) of section 41.16 of the mental hygiene law, as
amended by section 16 of part E of chapter 111 of the laws of  2010,  is
amended to read as follows:
  (c)  A  local services plan shall be developed, in accordance with the
regulations of the  commissioner  or  commissioners  of  the  office  or
offices  of  the  department  having jurisdiction of the services by the
local governmental unit or units which shall  direct  and  administer  a
local comprehensive planning process for its geographic area, consistent
with statewide goals and objectives established pursuant to section 5.07
of this chapter. The planning process shall involve the directors of any
department   facilities,  directors  of  hospital  based  mental  health
services, directors of community mental health centers, THE DIRECTOR  OF
THE  LOCAL OFFICE FOR THE AGING OR HIS OR HER REPRESENTATIVE, consumers,
consumer groups, voluntary agencies, other providers  of  services,  and
local correctional facilities and other local criminal justice agencies.
The  local  governmental  unit,  or  units, shall determine the proposed
local services plan to be submitted for approval.  If  any  provider  of
services  including  facilities in the department, or any representative
of the consumer or community interests within the local  planning  proc-
ess,  disputes  any  element  of the proposed plan for the area which it
serves, the objection shall be presented in writing to the  director  of
the  local  governmental unit. If such dispute cannot be resolved to the
satisfaction of all parties, the director shall determine the plan to be
submitted. If requested and supplied by the objecting party,  a  written
objection  to  the plan shall be appended thereto and transmitted to the
single agent of the department jointly designated by the commissioners.
  S 8.  Section 220 of the public health law, as amended by  section  45
of  part  A  of  chapter  58  of the laws of 2010, is amended to read as
follows:
  S 220. Public health  and  health  planning  council;  appointment  of
members.  There  shall  continue to be in the department a public health
and health planning council to consist of the commissioner and  fourteen
members  to  be appointed by the governor with the advice and consent of
the senate; provided that effective December first,  two  thousand  ten,
the  membership  of  the  council  shall consist of the commissioner and
twenty-four members to be appointed by the governor with the advice  and
consent  of the senate. Membership on the council shall be reflective of
the diversity of the state's population including, but not  limited  to,
the  various  geographic  areas  and population densities throughout the
state. The members shall include representatives of  the  public  health
system,  health  care  providers  that  comprise the state's health care
delivery system, individuals with expertise in the clinical and adminis-
trative aspects of health care delivery, issues  affecting  health  care
consumers,  health  planning,  health  care financing and reimbursement,
health care regulation and compliance, and public health practice and at
least two members shall also  be  members  of  the  [mental]  BEHAVIORAL
health  services ADVISORY council; at least four members shall be repre-
sentatives of general hospitals or  nursing  homes;  and  at  least  one
member  shall  be a representative of each of the following groups: home
care agencies, diagnostic and treatment  centers,  health  care  payors,
labor  organizations for health care employees, and health care consumer
advocacy organizations.

S. 6256--A                         99                         A. 9056--A

  S 9. This act shall take effect immediately and  shall  be  deemed  to
have been in full force and effect on and after April 1, 2012; provided,
however,  that sections one through six of this act shall take effect on
the one hundred twentieth day after it shall have become a law.

                                 PART O

  Section  1. Subdivision (b) of section 7.17 of the mental hygiene law,
as amended by section 1 of part G of chapter 59 of the laws of 2011,  is
amended to read as follows:
  (b)  There  shall  be  in the office the hospitals named below for the
care, treatment and rehabilitation of persons with  mental  illness  and
for  research  and  teaching  in the science and skills required for the
care, treatment and rehabilitation of such persons with mental illness.
  Greater Binghamton Health Center
  Bronx Psychiatric Center
  Buffalo Psychiatric Center
  Capital District Psychiatric Center
  Central New York Psychiatric Center
  Creedmoor Psychiatric Center
  Elmira Psychiatric Center
  [Hudson River Psychiatric Center
  Kingsboro Psychiatric Center]
  Kirby Forensic Psychiatric Center
  Manhattan Psychiatric Center
  Mid-Hudson Forensic Psychiatric Center
  Mohawk Valley Psychiatric Center
  Nathan S. Kline Institute for Psychiatric Research
  New York State Psychiatric Institute
  Pilgrim Psychiatric Center
  Richard H. Hutchings Psychiatric Center
  Rochester Psychiatric Center
  Rockland Psychiatric Center
  St. Lawrence Psychiatric Center
  South Beach Psychiatric Center
  [Bronx Children's Psychiatric Center
  Brooklyn Children's Center
  Queens Children's Psychiatric Center]
  NEW YORK CITY CHILDREN'S CENTER
  Rockland Children's Psychiatric Center
  Sagamore Children's Psychiatric Center
  Western New York Children's Psychiatric Center
  The New York State Psychiatric  Institute  and  The  Nathan  S.  Kline
Institute  for Psychiatric Research are designated as institutes for the
conduct of medical research and other scientific investigation  directed
towards  furthering  knowledge of the etiology, diagnosis, treatment and
prevention of mental illness.  [The  Brooklyn  Children's  Center  is  a
facility operated by the office to provide community-based mental health
services for children with serious emotional disturbances.]
  S  2.  Notwithstanding  the  provisions of subdivisions (b) and (e) of
section 7.17 of the mental hygiene law,  section  41.55  of  the  mental
hygiene  law,  or  any  other  law to the contrary, the office of mental
health is authorized to close, consolidate, reduce, transfer  or  other-
wise redesign services of hospitals, other facilities and programs oper-
ated  by  the  office  of  mental  health,  and to implement significant
service reductions and reconfigurations according  to  this  section  as

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shall be determined by the commissioner of mental health to be necessary
for  the cost-effective and efficient operation of such hospitals, other
facilities and programs. One of the intents of actions taken that result
in   closure,  consolidation,  reduction,  transfer  or  other  redesign
services of hospitals is to reinvest appropriate levels of  funding  for
community based mental health services and programs as determined by the
commissioner  of  mental  health  with approval from the director of the
division of the budget.
  (a) In addition to the closure, consolidation or merger of one or more
facilities, the commissioner of mental health is authorized  to  perform
any  significant  service  reductions  that  would  reduce inpatient bed
capacity, which shall include but not be limited to, closures  of  wards
at  a  state-operated  psychiatric  center  or the conversion of beds to
transitional placement programs, provided that the commissioner  provide
at least 30 days notice of such reductions to the temporary president of
the  senate and the speaker of the assembly and simultaneously post such
notice upon its public website. In assessing which  significant  service
reductions to undertake, the commissioner shall consider data related to
inpatient  census,  indicating  nonutilization  or  under utilization of
beds, and the efficient operation of facilities.
  (b) At least sixty days prior  to  the  anticipated  closure,  consol-
idation  or  merger of any hospitals named in subdivision (b) of section
7.17 of the mental hygiene law, the commissioner of mental health  shall
provide notice of such closure, consolidation or merger to the temporary
president  of  the senate, and speaker of the assembly, the chief execu-
tive officer of the county in which the facility is located,  and  shall
post  such  notice  upon  its  public website. The commissioner shall be
authorized to conduct any and  all  preparatory  actions  which  may  be
required  to  effectuate such closures during such sixty day period.  In
assessing which of such  hospitals  to  close,  the  commissioner  shall
consider the following factors: (1) the size, scope and type of services
provided  by  the  hospital;  (2)  the  relative quality of the care and
treatment provided by the hospital, as may be informed  by  internal  or
external  quality  or  accreditation reviews; (3) the current and antic-
ipated long-term need for the types of services provided by the facility
within its catchment area, which may include, but  not  be  limited  to,
services  for adults or children, or other specialized services, such as
forensic services; (4) the availability of staff sufficient  to  address
the  current  and anticipated long term service needs; (5) the long term
capital investment required to ensure that the facility  meets  relevant
state  and federal regulatory and capital construction requirements, and
national accreditation standards; (6) the proximity of the  facility  to
other facilities with space that could accommodate anticipated need, the
relative  cost  of any necessary renovations of such space, the relative
potential operating efficiency of such facilities, and the  size,  scope
and  types of services provided by the other facilities; (7) anticipated
savings based upon economies of scale or other  factors;  (8)  community
mental  health services available in the facility catchment area and the
ability of such community mental health services to meet the  behavioral
health needs of the impacted consumers; (9) the obligations of the state
to  place  persons with mental disabilities in community settings rather
than in institutions, when appropriate; and (10) the anticipated  impact
of the closure on access to mental health services.
  (c)  Any  transfers of inpatient capacity or any resulting transfer of
functions shall be authorized to be made by the commissioner  of  mental
health  and  any transfer of personnel upon such transfer of capacity or

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transfer of functions shall  be  accomplished  in  accordance  with  the
provisions of section 70 of the civil service law.
  S 3. Severability clause. If any clause, sentence, paragraph, subdivi-
sion,  section  or  part  of  this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair,  or  invalidate  the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph,  subdivision,  section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included herein.
  S 4. This act shall take effect immediately and  shall  be  deemed  to
have  been in full force and effect on and after April 1, 2012; provided
that the date for the closure of Kingsboro psychiatric center  shall  be
on a date certified by the commissioner of mental health.

                                 PART P

  Section 1. Subdivision (o) of section 10.03 of the mental hygiene law,
as  amended  by  chapter  168 of the laws of 2010, is amended to read as
follows:
  (o) "Secure treatment facility" means a facility or  a  portion  of  a
facility,  designated  by  the commissioner, that may include a facility
located on the grounds of a correctional facility, that is staffed  with
personnel from the office of mental health or the office for people with
developmental disabilities for the purposes of providing care and treat-
ment  to  persons  confined  under  this article, and persons defined in
paragraph five of subdivision (g) of this section. Personnel from  these
same  agencies  may  provide security services, provided that such staff
are adequately trained in security methods and so equipped as  to  mini-
mize  the  risk  or  danger of escape.   THE COMMISSIONER SHALL HAVE THE
DISCRETION TO ENTER INTO AGREEMENTS FOR THE PROVISION OF CARE AND TREAT-
MENT TO PERSONS HELD AT A SECURE TREATMENT  FACILITY  PURSUANT  TO  THIS
ARTICLE, OR FOR THE PROVISION OF APPROPRIATE SECURITY SERVICES, BY INDI-
VIDUALS WHO ARE NOT PERSONNEL OF SUCH AGENCIES.
  S  2.  Subdivision  (k) of section 10.06 of the mental hygiene law, as
amended by section 118-c of subpart B of part C of  chapter  62  of  the
laws of 2011, is amended to read as follows:
  (k) At the conclusion of the hearing, the court shall determine wheth-
er  there  is  probable  cause  to  believe that the respondent is a sex
offender requiring civil management. If the court determines that proba-
ble cause has not been established,  the  court  shall  issue  an  order
dismissing  the  petition,  and  the  respondent's  release  shall be in
accordance with other applicable provisions of law. If the court  deter-
mines  that  probable  cause  has  been established: (i) the court shall
order that the respondent be committed to a  secure  treatment  facility
designated  by the commissioner for care, treatment and control upon his
or her release, provided, however, that a respondent who otherwise would
be required to be transferred to  a  secure  treatment  facility  [may,]
SHALL  REMAIN IN THE CUSTODY OF THE DEPARTMENT OF CORRECTIONS AND COMMU-
NITY SUPERVISION PENDING THE OUTCOME OF THE PROCEEDINGS UNDER THIS ARTI-
CLE UNTIL HE OR SHE HAS REACHED THE MAXIMUM EXPIRATION  OF  HIS  OR  HER
SENTENCE  OR  HAS BEEN APPROVED FOR RELEASE TO PAROLE SUPERVISION BY THE
STATE BOARD OF PAROLE, PROVIDED, FURTHER THAT A RESPONDENT MAY,  upon  a
written consent signed by the respondent and his or her counsel, consent
to  remain in the custody of the department of corrections and community

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supervision pending the outcome of the proceedings under  this  article,
and  that  such  consent may be revoked in writing at any time; (ii) the
court shall set a date for trial in accordance with subdivision  (a)  of
section  10.07  of  this  article; and (iii) the respondent shall not be
released pending the completion of such trial.
  S 3. Subdivision (f) of section 10.07 of the mental  hygiene  law,  as
added by chapter 7 of the laws of 2007, is amended to read as follows:
  (f)  If  the  jury, or the court if a jury trial is waived, determines
that the respondent is a detained sex offender who suffers from a mental
abnormality, then the court shall consider whether the respondent  is  a
dangerous sex offender requiring confinement or a sex offender requiring
strict  and  intensive  supervision.  The  parties  may offer additional
evidence, and the court shall hear argument, as to that  issue.  If  the
court  finds  by clear and convincing evidence that the respondent has a
mental abnormality involving such a strong predisposition to commit  sex
offenses, and such an inability to control behavior, that the respondent
is  likely  to  be  a danger to others and to commit sex offenses if not
confined to a secure treatment facility, then the court shall  find  the
respondent to be a dangerous sex offender requiring confinement. In such
case,  the  respondent shall be committed to a secure treatment facility
for care, treatment, and control until such time as he or she no  longer
requires  confinement.  FAILURE  OF  A  DANGEROUS SEX OFFENDER REQUIRING
CONFINEMENT TO MEANINGFULLY PARTICIPATE IN TREATMENT IN A SECURE  TREAT-
MENT  FACILITY SHALL CONSTITUTE A VIOLATION OF THE ORDER OF CONFINEMENT.
If the court does not find that the respondent is a dangerous sex offen-
der requiring confinement, then the court shall make a finding of dispo-
sition that the respondent is a sex offender requiring strict and inten-
sive supervision, and the respondent shall be subject to  a  regimen  of
strict  and  intensive  supervision  and  treatment  in  accordance with
section 10.11 of this article. In making a finding of  disposition,  the
court  shall  consider  the  conditions  that  would be imposed upon the
respondent if subject to a regimen of strict and intensive  supervision,
and  all  available information about the prospects for the respondent's
possible re-entry into the community.
  S 4. Section 10.08 of the mental hygiene law is amended  by  adding  a
new subdivision (i) to read as follows:
  (I)  AT ANY PROCEEDING CONDUCTED PURSUANT TO THIS ARTICLE OTHER THAN A
TRIAL CONDUCTED PURSUANT TO SECTION 10.07 OF THIS ARTICLE, THE  RESPOND-
ENT OR ANY WITNESS SHALL BE PERMITTED, UPON GOOD CAUSE SHOWN, TO MAKE AN
ELECTRONIC  APPEARANCE IN THE COURT BY MEANS OF AN INDEPENDENT AUDIO-VI-
SUAL SYSTEM, AS THAT TERM IS  DEFINED  IN  SUBDIVISION  ONE  OF  SECTION
182.10 OF THE CRIMINAL PROCEDURE LAW, FOR PURPOSES OF A COURT APPEARANCE
OR  FOR  GIVING TESTIMONY. IT SHALL CONSTITUTE GOOD CAUSE THAT A WITNESS
IS CURRENTLY EMPLOYED BY THE STATE AT A  SECURE  TREATMENT  FACILITY  OR
ANOTHER WORK LOCATION, UNLESS THERE ARE COMPELLING CIRCUMSTANCES REQUIR-
ING  THE  WITNESS'S  PERSONAL  PRESENCE  AT  THE COURT PROCEEDING.   FOR
PURPOSES OF  THIS  SUBDIVISION,  AN  "ELECTRONIC  APPEARANCE"  MEANS  AN
APPEARANCE  AT  WHICH  A PARTICIPANT IS NOT PRESENT IN THE COURT, BUT IN
WHICH: (I) ALL OF THE PARTICIPANTS ARE ABLE TO SEE AND HEAR  THE  SIMUL-
TANEOUS  REPRODUCTIONS  OF  THE VOICES AND IMAGES OF THE JUDGE, COUNSEL,
RESPONDENT OR ANY OTHER APPROPRIATE PARTICIPANT,  AND  (II)  COUNSEL  IS
PRESENT  WITH  THE  RESPONDENT OR THE RESPONDENT AND COUNSEL ARE ABLE TO
SEE AND HEAR EACH OTHER AND  ENGAGE  IN  PRIVATE  CONVERSATION.  WHEN  A
RESPONDENT  OR  A  WITNESS  MAKES  AN  ELECTRONIC  APPEARANCE, THE COURT
STENOGRAPHER SHALL RECORD ANY STATEMENTS IN THE SAME MANNER  AS  IF  THE
RESPONDENT  OR  WITNESS  HAD MADE A PERSONAL APPEARANCE. NOTHING IN THIS

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SUBDIVISION SHALL BE CONSTRUED TO PROHIBIT THE RESPONDENT OR ANY WITNESS
FROM MAKING AN ELECTRONIC APPEARANCE IN THE COURT AT A  TRIAL  CONDUCTED
PURSUANT  TO  SECTION  10.07  OF THIS ARTICLE BY MEANS OF AN INDEPENDENT
AUDIO-VISUAL SYSTEM, UPON GOOD CAUSE SHOWN AND CONSENT OF THE PARTIES.
  S  5. The section heading and subdivisions (a), (b), (c), (d), and (f)
of section 10.09 of the mental hygiene law, as added by chapter 7 of the
laws of 2007, are amended to read as follows:
[Annual] BIENNIAL examinations and petitions for discharge.
  (a) The commissioner shall provide  the  respondent  and  counsel  for
respondent  with  [an  annual] A BIENNIAL written notice of the right to
petition the court for discharge. The notice shall contain  a  form  for
the waiver of the right to petition for discharge.
  (b)  The commissioner shall also assure that each respondent committed
under this article shall have an examination for evaluation  of  his  or
her  mental  condition  made  at  least once every [year] TWO YEARS by a
psychiatric examiner who shall report to the  commissioner  his  or  her
written  findings  as to whether the respondent is currently a dangerous
sex offender requiring confinement. At such time,  the  respondent  also
shall have the right to be evaluated by an independent psychiatric exam-
iner.    If  the respondent is financially unable to obtain an examiner,
the court shall appoint an examiner of the  respondent's  choice  to  be
paid  within  the  limits  prescribed by law. Following such evaluation,
each psychiatric examiner shall report his or her findings in writing to
the commissioner and to counsel for respondent. The  commissioner  shall
review  relevant  records  and  reports,  along with the findings of the
psychiatric examiners, and shall make a determination in writing  as  to
whether  the  respondent is currently a dangerous sex offender requiring
confinement.
  (c) The commissioner shall [annually] BIENNIALLY  forward  the  notice
and  waiver form, along with a report including the commissioner's writ-
ten determination and the findings of the  psychiatric  examination,  to
the supreme or county court where the respondent is located.
  (d) The court shall hold an evidentiary hearing as to retention of the
respondent within forty-five days if it appears from one of the [annual]
BIENNIAL  submissions to the court under subdivision (c) of this section
(i) that the respondent has petitioned, or has not affirmatively  waived
the  right to petition, for discharge, or (ii) that even if the respond-
ent has waived the right to petition, and the  commissioner  has  deter-
mined  that  the  respondent  remains a dangerous sex offender requiring
confinement, the court finds on the basis of the materials described  in
subdivision  (b) of this section that there is a substantial issue as to
whether the  respondent  remains  a  dangerous  sex  offender  requiring
confinement. At an evidentiary hearing on that issue under this subdivi-
sion, the attorney general shall have the burden of proof.
  (f)  The  respondent  may at any time petition the court for discharge
and/or release to the community under a regimen of strict and  intensive
supervision  and  treatment.  Upon  review of the respondent's petition,
other than in connection with [annual] BIENNIAL reviews as described  in
subdivisions  (a), (b) and (d) of this section, the court may order that
an evidentiary hearing be held, or may deny an evidentiary  hearing  and
deny  the petition upon a finding that the petition is frivolous or does
not provide sufficient basis for reexamination prior to the next  [annu-
al]  BIENNIAL  review.  If the court orders an evidentiary hearing under
this subdivision, the attorney general shall have the burden of proof as
to whether the respondent is currently a dangerous sex offender  requir-
ing confinement.

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  S  6.  Subdivision  (a) of section 10.10 of the mental hygiene law, as
added by chapter 7 of the laws of 2007, is amended to read as follows:
  (a)  If the respondent is found to be a dangerous sex offender requir-
ing confinement and committed  to  a  secure  treatment  facility,  that
facility  shall  provide  care, treatment, and control of the respondent
until such time that a court discharges  the  respondent  in  accordance
with the provisions of this article. FAILURE OF A DANGEROUS SEX OFFENDER
REQUIRING  CONFINEMENT  TO  MEANINGFULLY  PARTICIPATE  IN TREATMENT IN A
SECURE TREATMENT FACILITY SHALL CONSTITUTE A VIOLATION OF THE  ORDER  OF
CONFINEMENT.
  S  7.  Subdivision  (c) of section 10.11 of the mental hygiene law, as
amended by section 118-e of subpart B of part C of  chapter  62  of  the
laws of 2011, is amended to read as follows:
  (c)  An  order  for  a regimen of strict and intensive supervision and
treatment places the person in the custody and control of the department
of corrections and community supervision. A person ordered to undergo  a
regimen  of  strict  and intensive supervision and treatment pursuant to
this article is subject to lawful conditions set by the  court  and  the
department  of  corrections and community supervision.  A VIOLATION OF A
CONDITION OF THE REGIMEN OF STRICT AND INTENSIVE SUPERVISION AND  TREAT-
MENT FOR A PERSON UNDER COMMUNITY SUPERVISION, AS DEFINED IN SUBDIVISION
THREE OF SECTION TWO HUNDRED FIFTY-NINE OF THE EXECUTIVE LAW, MAY BE THE
BASIS   FOR  REVOCATION  OF  PAROLE  PURSUANT  TO  SECTION  TWO  HUNDRED
FIFTY-NINE-I OF THE EXECUTIVE LAW. A PERSON WHO INTENTIONALLY VIOLATES A
MATERIAL CONDITION OF THE REGIMEN OF STRICT  AND  INTENSIVE  SUPERVISION
AND TREATMENT SHALL BE GUILTY OF A CLASS E FELONY.
  S 8. Section 120.05 of the penal law is amended by adding a new subdi-
vision 13 to read as follows:
  13.  HAVING BEEN FOUND TO BE A SEX OFFENDER REQUIRING CIVIL MANAGEMENT
AND WHILE CONFINED IN A SECURE TREATMENT FACILITY, AS DEFINED IN SECTION
7.18 OF THE MENTAL HYGIENE LAW, WITH INTENT TO CAUSE PHYSICAL INJURY  TO
ANOTHER  PERSON,  HE  CAUSES  SUCH  INJURY  TO SUCH PERSON OR TO A THIRD
PERSON.
  S 9. This act shall take effect immediately.

                                 PART Q

  Section 1. Section 730.10 of the criminal procedure law is amended  by
adding a new subdivision 9 to read as follows:
  9.  "APPROPRIATE  INSTITUTION"  MEANS:  (A) A HOSPITAL OPERATED BY THE
OFFICE OF MENTAL HEALTH OR A DEVELOPMENTAL CENTER OPERATED BY THE OFFICE
FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES;  (B)  A  LOCAL  CORRECTIONAL
FACILITY,  AS  SUCH  TERMS  ARE DEFINED IN SECTION TWO OF THE CORRECTION
LAW, WHICH OPERATES A MENTAL HEALTH UNIT; OR (C) A HOSPITAL LICENSED  BY
THE  DEPARTMENT  OF HEALTH WHICH OPERATES A PSYCHIATRIC UNIT LICENSED BY
THE OFFICE OF MENTAL HEALTH, AS DETERMINED BY THE COMMISSIONER.
  S 2. Subdivision 1 of section 730.40 of the criminal procedure law, as
amended by chapter 231 of the laws  of  2008,  is  amended  to  read  as
follows:
  1. When a local criminal court, following a hearing conducted pursuant
to  subdivision  three  or four of section 730.30, is satisfied that the
defendant is not an incapacitated person, the  criminal  action  against
him  OR  HER  must  proceed. If it is satisfied that the defendant is an
incapacitated person, or if no motion for such a hearing is  made,  such
court  must  issue  a final or temporary order of observation committing
him OR HER to the custody of the commissioner for care and treatment  in

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an  appropriate  institution for a period not to exceed ninety days from
the date of the order, provided,  however,  that  the  commissioner  may
designate  an appropriate hospital for placement of a defendant for whom
a  final  order  of  observation has been issued, where such hospital is
licensed by the office of mental health and has agreed to  accept,  upon
referral  by  the  commissioner,  defendants  subject to final orders of
observation issued under this subdivision. When a local  criminal  court
accusatory  instrument  other  than  a  felony  complaint has been filed
against the defendant, such court must issue a final order  of  observa-
tion[; when]. WHEN a felony complaint has been filed against the defend-
ant,  such  court must issue a temporary order of observation COMMITTING
HIM OR HER TO THE JURISDICTION OF THE COMMISSIONER FOR CARE  AND  TREAT-
MENT  IN  AN  APPROPRIATE  INSTITUTION  OR ON AN OUT-PATIENT BASIS FOR A
PERIOD NOT TO EXCEED NINETY DAYS FROM THE DATE  OF  SUCH  ORDER,  except
that,  with  the  consent of the district attorney, it may issue a final
order of observation.
  S 3. Subdivision 1 of section 730.50 of the criminal procedure law, as
amended by chapter 231 of the laws  of  2008,  is  amended  to  read  as
follows:
  1.  When  a  superior court, following a hearing conducted pursuant to
subdivision three or four of  section  730.30,  is  satisfied  that  the
defendant  is  not  an incapacitated person, the criminal action against
him OR HER must proceed. If it is satisfied that  the  defendant  is  an
incapacitated  person,  or  if  no motion for such a hearing is made, it
must adjudicate him OR HER an incapacitated person,  and  must  issue  a
final  order  of observation or an order of commitment. When the indict-
ment does not charge a felony or when the defendant has  been  convicted
of  an  offense  other  than a felony, such court (a) must issue a final
order of observation committing the defendant  to  the  custody  of  the
commissioner  for care and treatment in an appropriate institution for a
period not to exceed ninety days from the date of such order,  provided,
however, that the commissioner may designate an appropriate hospital for
placement  of a defendant for whom a final order of observation has been
issued, where such hospital is licensed by the office of  mental  health
and  has agreed to accept, upon referral by the commissioner, defendants
subject to final orders of observation issued  under  this  subdivision,
and  (b)  must  dismiss  the  indictment filed in such court against the
defendant, and such dismissal constitutes a bar to  any  further  prose-
cution  of  the charge or charges contained in such indictment. When the
indictment charges a felony or when the defendant has been convicted  of
a  felony, it must issue an order of commitment committing the defendant
to the [custody] JURISDICTION of the commissioner for care and treatment
in an appropriate institution OR ON AN OUT-PATIENT BASIS  for  a  period
not to exceed one year from the date of such order. Upon the issuance of
an order of commitment, the court must exonerate the defendant's bail if
he  OR  SHE  was  previously at liberty on bail; PROVIDED, HOWEVER, THAT
EXONERATION OF BAIL IS NOT REQUIRED WHEN A DEFENDANT IS COMMITTED TO THE
JURISDICTION OF THE COMMISSIONER FOR CARE AND TREATMENT  ON  AN  OUT-PA-
TIENT BASIS.
  S 4. This act shall take effect immediately.

                                 PART R

  Section  1.    Section  1 of part D of chapter 111 of the laws of 2010
relating to the recovery of exempt income by the office of mental health

S. 6256--A                         106                        A. 9056--A

for community residences and family-based treatment programs is  amended
to read as follows:
  Section  1. The office of mental health is authorized to recover fund-
ing from  community  residences  and  family-based  treatment  providers
licensed  by  the  office  of mental health, consistent with contractual
obligations of such providers, and notwithstanding any other  inconsist-
ent  provision  of law to the contrary, in an amount equal to 50 percent
of the income received by such providers which exceeds the fixed  amount
of  annual  Medicaid  revenue limitations, as established by the commis-
sioner of mental health. Recovery of such excess income shall be for the
following fiscal periods: for programs in counties  located  outside  of
the  city of New York, the applicable fiscal periods shall be January 1,
2003 through December 31, 2009 AND JANUARY 1, 2011 THROUGH DECEMBER  31,
2013; and for programs located within the city of New York, the applica-
ble  fiscal periods shall be July 1, 2003 through June 30, 2010 AND JULY
1, 2011 THROUGH JUNE 30, 2013.
  S 2. This act shall take effect immediately.
  S 2. Severability clause. If any clause, sentence, paragraph, subdivi-
sion, section or part of this act shall be  adjudged  by  any  court  of
competent  jurisdiction  to  be invalid, such judgment shall not affect,
impair, or invalidate the remainder thereof, but shall  be  confined  in
its  operation  to the clause, sentence, paragraph, subdivision, section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the legislature that this act would  have  been  enacted  even  if  such
invalid provisions had not been included herein.
  S  3.  This  act shall take effect immediately provided, however, that
the applicable effective date of Parts A through R of this act shall  be
as specifically set forth in the last section of such Parts.

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

    S. 6256--B                                            A. 9056--B

                      S E N A T E - A S S E M B L Y

                            January 17, 2012
                               ___________

IN  SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti-
  cle seven of the Constitution -- read twice and ordered  printed,  and
  when  printed to be committed to the Committee on Finance -- committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee  --  committee  discharged,  bill  amended,  ordered
  reprinted as amended and recommitted to said committee

IN  ASSEMBLY  --  A  BUDGET  BILL, submitted by the Governor pursuant to
  article seven of the Constitution -- read once  and  referred  to  the
  Committee  on  Ways  and  Means -- committee discharged, bill amended,
  ordered reprinted as amended and  recommitted  to  said  committee  --
  again  reported from said committee with amendments, ordered reprinted
  as amended and recommitted to said committee

AN ACT to amend the public health law, in relation to requiring the  use
  of  network  providers  for  evaluations  or  services under the early
  intervention program, state aid reimbursement  to  municipalities  for
  respite services, and service coordination; to repeal subdivision 7 of
  section  2551  and  subdivision 4 of section 2557 of the public health
  law, relating to administering early intervention services;  to  amend
  the public health law, in relation to requiring that each municipality
  be responsible for providing early intervention services; to amend the
  public  health  law,  in relation to removing the authorization of the
  commissioner of health to collect data from counties on  early  inter-
  vention  programs for the purpose of improving efficiency, cost effec-
  tiveness and quality; to amend the public health law, in  relation  to
  requiring  health  maintenance  organizations  to include coverage for
  otherwise covered services that are  part  of  an  early  intervention
  program;  to amend the insurance law, in relation to payment for early
  intervention services; to amend the  education  law,  in  relation  to
  special  education  services  and programs for preschool children with
  handicapping conditions; and to repeal subdivision 18 of section  4403
  of  the  education law, relating to the power of the education depart-
  ment to approve the provision of early intervention services (Part A);
  to amend the public authorities law, in relation to funding and  oper-
  ations  of  the  Roswell  Park Cancer Institute (Part B); to amend the
  public health law, in relation to establishment of an electronic death
  registration system (Part C); to  amend  the  public  health  law,  in

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

                      [ ] is old law to be omitted.
                                                           LBD12671-03-2

S. 6256--B                          2                         A. 9056--B

  relation  to establishing the supportive housing development reinvest-
  ment program; to amend the social services law, in relation to  appli-
  cability  of the assisted living program; to amend the social services
  law, in relation to including podiatry services and lactation services
  under  the term medical assistance; to amend the public health law and
  education law,  in  relation  to  medical  prescriptions  for  limited
  English  proficient  individuals; to amend the social services law, in
  relation to education, outreach services  and  facilitated  enrollment
  activities  for certain aged, blind and disabled persons; to amend the
  public health law, in relation to including certain  violations  by  a
  pharmacy as professional misconduct; expanding prenatal care programs,
  establishing  the  primary care service corps practitioner loan repay-
  ment program, requiring changes in directors of not-for-profit  corpo-
  rations  that  operate  hospitals  to  be  approved by the department,
  authorizing the commissioner of health to temporarily suspend or limit
  hospital  operating  certificates,  revoking  of  hospital   operating
  certificates,  appointment  and  duties  of  temporary  operators of a
  general hospital  or  diagnostic  and  treatment  center,  authorizing
  moneys  in the medical indemnity fund to be invested in obligations of
  the United States or the state or obligations where the principal  and
  interest  are  guaranteed by the United States or the state and moneys
  distributed  as  non-Medicaid  grants  to  non-major  public  academic
  medical  centers;  to  amend  the  social services law, in relation to
  prescriptions of opioid analgesics and brand  name  drugs  covered  by
  medical  assistance;  to  amend  the public health law, in relation to
  notice requirement for preferred drug program, payment to the  commis-
  sioner  of  health  by  third-party  payors,  audit of payments to the
  commissioner of health, electronic submission of reports by hospitals,
  and changing the definition of eligible applicant; to amend the social
  services law, in relation to  medical  assistance  where  relative  is
  absent  or  refuses  or fails to provide necessary care;  to amend the
  public health law, in relation to third-party payor's election to make
  payments; to amend the elder law, in relation to the  elderly  pharma-
  ceutical  insurance  coverage program; to amend the public health law,
  in relation to reserved bed days; to amend the social services law, in
  relation  to  the  personal  care  services  worker  recruitment   and
  retention  program; to amend the public health law, in relation to the
  tobacco control and insurance initiatives pool distributions; to amend
  the  social  services  law,  in  relation  to  certain  public  school
  districts  and  state  operated/state  supported schools; to amend the
  public health law, in relation to the licensure of home care  services
  agencies;  to  amend  the  social services law, in relation to managed
  care programs; to amend the public health  law,  in  relation  to  the
  distribution of the professional education pools; to amend chapter 584
  of  the laws of 2011, amending the public authorities law, relating to
  the powers and duties of the dormitory authority of the state  of  New
  York  relative  to  the  establishment  of  subsidiaries  for  certain
  purposes, in relation to the effectiveness thereof; to  amend  chapter
  119  of  the  laws  of  1997 relating to authorizing the department of
  health to establish certain payments to general hospitals, in relation
  to costs incurred in  excess  of  revenues  by  general  hospitals  in
  providing  services  in  eligible  programs  to uninsured patients and
  patients eligible for Medicaid assistance; to amend subdivision  1  of
  section  92  of  part H of chapter 59 of the laws of 2011, relating to
  known and projected department of health state funds Medicaid expendi-
  tures, in relation to the effectiveness thereof; to amend  section  90

S. 6256--B                          3                         A. 9056--B

  of  part  H  of  chapter  59 of the laws of 2011, relating to types of
  appropriations exempt from certain reductions, in relation to  certain
  payments  with regard to local governments; to amend section 1 of part
  C  of  chapter  58  of  the  laws  of  2005,  relating  to authorizing
  reimbursements for  expenditures  made  by  or  on  behalf  of  social
  services  districts  for  medical assistance for needy persons and the
  administration thereof, in relation to Medicaid reimbursement; and  to
  repeal  certain  provisions  of  the  public  health  law,  the social
  services law and the elder law relating thereto (Part D); to amend the
  public authorities law and the public officers law, in relation to the
  establishment of the New York Health Benefit  Exchange  (Part  E);  to
  amend  chapter  58  of the laws of 2005 authorizing reimbursements for
  expenditures made by or on behalf of  social  services  districts  for
  medical  assistance  for needy persons and the administration thereof,
  in relation to an administrative cap on such program; to amend chapter
  59 of the laws of 2011, amending the public health law and other  laws
  relating  to  general  hospital  reimbursement  for  annual  rates, in
  relation to the cap on local Medicaid expenditures; and to  amend  the
  social  services  law,  in  relation  to  the department assumption of
  program administration for medical assistance (Part F); to  amend  the
  public  health  law, in relation to regulations for computing hospital
  inpatient rates and to amend chapter 58 of the laws of  2005  relating
  to the preferred drug program, in relation to the effectiveness there-
  of  (Part  G);  to  amend  chapter 57 of the laws of 2006, relating to
  establishing a cost of living adjustment for designated human services
  programs,  in  relation  to  foregoing  such  adjustment  during   the
  2012-2013  state  fiscal  year; and in relation to directing limits on
  state reimbursement  for  executive  compensation  and  administrative
  costs (Part H); in relation to contracts by the office for people with
  developmental  disabilities  made  under  section  1115 of the federal
  social security act (Part I); to amend the  mental  hygiene  law,  the
  public  health  law, the general municipal law, the education law, the
  social services law, and  the  surrogate's  court  procedure  act,  in
  relation  to the office for people with developmental disabilities and
  the creation of developmental disabilities regional offices and  state
  operations  offices (Part J); to amend chapter 723 of the laws of 1989
  amending the mental hygiene law and other laws relating to  comprehen-
  sive  psychiatric  emergency  programs,  in  relation to extending the
  repeal of certain provisions thereof (Part K); to permit  the  commis-
  sioners  of the department of health, the office of mental health, the
  office of alcoholism and substance abuse services and the  office  for
  people  with  developmental disabilities the regulatory flexibility to
  more efficiently  and  effectively  integrate  health  and  behavioral
  health  services  (Part  L); to permit the office of mental health and
  the state education department to enter into an agreement for purposes
  of providing education programming for patients residing in  hospitals
  operated  by  the  office of mental health who are between the ages of
  five and twenty-one; and providing for the repeal of  such  provisions
  upon  expiration thereof (Part M); to amend the mental hygiene law and
  the public health law, in  relation  to  the  statewide  comprehensive
  services  plan  for people with mental disabilities and in relation to
  the local planning process; and to repeal certain  provisions  of  the
  mental  hygiene  law  relating  thereto  (Part N); to amend the mental
  hygiene law, in relation to the closure and the reduction in  size  of
  certain  facilities  serving  persons with mental illness (Part O); to
  amend the mental hygiene law, in relation to amending procedures under

S. 6256--B                          4                         A. 9056--B

  the sex offender management and treatment act, and to amend the  penal
  law,   in   relation  to  providing  criminal  penalties  for  certain
  violations of orders of commitment and  strict  and  intensive  super-
  vision and treatment (Part P); to amend the criminal procedure law, in
  relation  to  providing  for outpatient capacity restoration of felony
  defendants, or restoration at psychiatric units of jails or article 28
  hospitals (Part Q); 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 R); and to amend the public health
  law, in relation  to  consolidating  the  excess  medical  malpractice
  liability  coverage  pool;  and to repeal section 18 of chapter 266 of
  the laws of 1986, amending the civil practice law and rules and  other
  laws  relating  to  medical  and  dental malpractice, relating thereto
  (Part S)

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

  Section  1.  This  act enacts into law major components of legislation
which are necessary to implement the state fiscal plan for the 2012-2013
state fiscal year. Each component is  wholly  contained  within  a  Part
identified  as Parts A through S. The effective date for each particular
provision contained within such Part is set forth in the last section of
such Part. Any provision in any section contained within a Part, includ-
ing the effective date of the Part, which makes a reference to a section
"of this act", when used in connection with that  particular  component,
shall  be  deemed  to mean and refer to the corresponding section of the
Part in which it is found. Section three of  this  act  sets  forth  the
general effective date of this act.

                                 PART A

  Section  1.    Paragraph  (a)  of subdivision 2 of section 2544 of the
public health law, as added by chapter 428  of  the  laws  of  1992,  is
amended and a new paragraph (c) is added to read as follows:
  (a)  [The]  SUBJECT  TO  THE PROVISIONS OF SECTION TWENTY-FIVE HUNDRED
FORTY-FIVE-A OF THIS TITLE, THE parent may select an evaluator from  the
list  of approved evaluators as described in section twenty-five hundred
forty-two of this title to conduct the evaluation. The parent or  evalu-
ator  shall  immediately  notify the early intervention official of such
selection.  The evaluator may begin the evaluation no sooner  than  four
working  days  after such notification, unless otherwise approved by the
initial service coordinator.
  (C) IF, IN CONSULTATION WITH THE EVALUATOR,  THE  SERVICE  COORDINATOR
IDENTIFIES A CHILD THAT IS POTENTIALLY ELIGIBLE FOR PROGRAMS OR SERVICES
OFFERED  BY OR UNDER THE AUSPICES OF THE OFFICE FOR PEOPLE WITH DEVELOP-
MENTAL DISABILITIES, THE SERVICE COORDINATOR SHALL, WITH PARENT CONSENT,
NOTIFY THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL  DISABILITIES'  REGIONAL
DEVELOPMENTAL  DISABILITIES SERVICES OFFICE OF THE POTENTIAL ELIGIBILITY
OF SUCH CHILD FOR SAID PROGRAMS OR SERVICES.
  S 2. Subdivision 1, the opening paragraph of subdivision 2 and  subdi-
vision  7  of section 2545 of the public health law, as added by chapter
428 of the laws of 1992, are amended to read as follows:

S. 6256--B                          5                         A. 9056--B

  1. If the evaluator determines that the infant or toddler is an eligi-
ble child, the early intervention official shall convene a meeting, at a
time and place convenient to the parent, consisting of the parent,  such
official,  the  evaluator,  A REPRESENTATIVE FROM THE CHILD'S INSURER OR
HEALTH MAINTENANCE ORGANIZATION, WHICH SHALL INCLUDE THE MEDICAL ASSIST-
ANCE  PROGRAM OR THE CHILD HEALTH INSURANCE PROGRAM ESTABLISHED IN TITLE
ONE-A OF THIS ARTICLE, OR ANY OTHER GOVERNMENTAL THIRD PARTY  PAYOR,  IF
THE  CHILD  HAS COVERAGE THROUGH AN INSURER OR HEALTH MAINTENANCE ORGAN-
IZATION AND THE REPRESENTATIVE IS AVAILABLE TO ATTEND THE MEETING ON THE
DATE AND TIME CHOSEN BY THE EARLY  INTERVENTION  OFFICIAL,  the  initial
service  coordinator and any other persons who the parent or the initial
service coordinator, with the parent's consent,  invite,  provided  that
such  meeting  shall be held no later than forty-five days from the date
that the early intervention official was first contacted  regarding  the
child,  except under exceptional circumstances prescribed by the commis-
sioner. The early intervention official, at or  prior  to  the  time  of
scheduling  the  meeting, shall inform the parent of the right to invite
any person to the meeting.   IF  THE  REPRESENTATIVE  FROM  THE  CHILD'S
INSURER  OR  HEALTH  MAINTENANCE ORGANIZATION IS NOT AVAILABLE TO ATTEND
THE MEETING IN PERSON ON THE DATE AND TIME CHOSEN BY  THE  EARLY  INTER-
VENTION  OFFICIAL,  ARRANGEMENTS  MAY  BE  MADE FOR THE REPRESENTATIVE'S
INVOLVEMENT IN THE MEETING BY PARTICIPATION IN  A  TELEPHONE  CONFERENCE
CALL OR BY OTHER MEANS.
  The  early  intervention  official,  A REPRESENTATIVE FROM THE CHILD'S
INSURER OR HEALTH MAINTENANCE  ORGANIZATION,  WHICH  SHALL  INCLUDE  THE
MEDICAL  ASSISTANCE PROGRAM OR THE CHILD HEALTH INSURANCE PROGRAM ESTAB-
LISHED IN TITLE ONE-A OF THIS ARTICLE, OR ANY OTHER  GOVERNMENTAL  THIRD
PARTY  PAYOR,  IF  THE  CHILD  HAS COVERAGE THROUGH AN INSURER OR HEALTH
MAINTENANCE ORGANIZATION AND THE REPRESENTATIVE IS AVAILABLE  TO  ATTEND
THE  MEETING ON THE DATE AND TIME CHOSEN BY THE EARLY INTERVENTION OFFI-
CIAL, initial service coordinator, parent and evaluator shall develop an
IFSP for an eligible child whose  parents  request  services.  The  IFSP
shall be in writing and shall include, but not be limited to:
  7.  The  IFSP  shall  be  reviewed at six month intervals and shall be
evaluated annually by the early intervention official, A  REPRESENTATIVE
FROM THE CHILD'S INSURER OR HEALTH MAINTENANCE ORGANIZATION, WHICH SHALL
INCLUDE  THE  MEDICAL  ASSISTANCE  PROGRAM OR THE CHILD HEALTH INSURANCE
PROGRAM ESTABLISHED IN TITLE ONE-A OF THIS ARTICLE, OR ANY OTHER GOVERN-
MENTAL THIRD PARTY PAYOR, IF THE CHILD HAS COVERAGE THROUGH  AN  INSURER
OR  HEALTH  MAINTENANCE ORGANIZATION AND THE REPRESENTATIVE IS AVAILABLE
TO PARTICIPATE IN THE REVIEW OR ATTEND ON THE DATE AND  TIME  CHOSEN  BY
THE EARLY INTERVENTION OFFICIAL, THE service coordinator, the parent and
providers  of services to the eligible child.  Upon request of a parent,
the plan may be reviewed by such persons at more frequent intervals.  IF
THE REPRESENTATIVE FROM THE CHILD'S INSURER OR HEALTH MAINTENANCE ORGAN-
IZATION IS NOT AVAILABLE TO PARTICIPATE  IN  THE  REVIEW  OR  ATTEND  IN
PERSON  ON  THE DATE AND TIME CHOSEN BY THE EARLY INTERVENTION OFFICIAL,
ARRANGEMENTS MAY BE MADE FOR THE REPRESENTATIVE'S INVOLVEMENT BY PARTIC-
IPATION IN A TELEPHONE CONFERENCE CALL OR BY OTHER MEANS.
  S 2-a. Section 2545 of the public health law is amended  by  adding  a
new subdivision 10 to read as follows:
  10.  THE SERVICE COORDINATOR SHALL ENSURE THAT THE IFSP, INCLUDING ANY
AMENDMENTS THERETO, IS IMPLEMENTED IN A TIMELY MANNER BUT NOT LATER THAN
THIRTY DAYS AFTER THE PROJECTED DATES FOR INITIATION OF THE SERVICES  AS
SET FORTH IN THE PLAN.

S. 6256--B                          6                         A. 9056--B

  S  3.  The public health law is amended by adding a new section 2545-a
to read as follows:
  S  2545-A.  USE  OF  NETWORK PROVIDERS.   FOR CHILDREN REFERRED TO THE
EARLY INTERVENTION PROGRAM ON OR AFTER JANUARY FIRST, TWO THOUSAND THIR-
TEEN, IF A CHILD  HAS  COVERAGE  UNDER  AN  INSURANCE  POLICY,  PLAN  OR
CONTRACT,  INCLUDING  COVERAGE  AVAILABLE  UNDER  THE MEDICAL ASSISTANCE
PROGRAM OR THE CHILD HEALTH INSURANCE PROGRAM ESTABLISHED IN TITLE ONE-A
OF THIS ARTICLE OR UNDER ANY OTHER GOVERNMENTAL THIRD PARTY  PAYOR,  AND
THE INSURANCE POLICY, PLAN OR CONTRACT PROVIDES COVERAGE FOR EVALUATIONS
OR  SERVICES  THAT  MAY  BE RENDERED TO THE CHILD UNDER THE EARLY INTER-
VENTION PROGRAM, THE SERVICE COORDINATOR, OR, IN ACCORDANCE WITH SECTION
TWENTY-FIVE HUNDRED FORTY-FOUR OF THIS TITLE, THE PARENT,  WITH  RESPECT
TO  EVALUATIONS,  SHALL SELECT A PROVIDER APPROVED BY THE DEPARTMENT AND
WITHIN THE INSURER'S OR HEALTH MAINTENANCE  ORGANIZATION'S  NETWORK,  IF
APPLICABLE,  FOR  THE PROVISION OF SUCH EVALUATION OR SERVICES, PROVIDED
HOWEVER THAT THIS SUBDIVISION SHALL NOT APPLY UNDER THE FOLLOWING CONDI-
TIONS:
  1. THERE IS NO PROVIDER IN THE INSURER'S OR HEALTH MAINTENANCE  ORGAN-
IZATION'S NETWORK THAT IS AVAILABLE OR APPROPRIATE TO RECEIVE THE REFER-
RAL  AND  TO  CONDUCT THE EVALUATION OR TO BEGIN PROVIDING SERVICES IN A
TIMELY MANNER IN ACCORDANCE WITH THE CHILD'S IFSP;
  2. INSURANCE OR HEALTH PLAN BENEFITS HAVE BEEN EXHAUSTED; OR
  3. THE CHILD HAS A DEMONSTRATED NEED, AS DETERMINED BY THE INSURER  OR
HEALTH  MAINTENANCE  ORGANIZATION,  IF  APPLICABLE, FOR AN EVALUATION OR
SERVICE RENDERED BY A PROVIDER WHO DOES NOT HOLD AN AGREEMENT  WITH  THE
CHILD'S  INSURER OR HEALTH MAINTENANCE ORGANIZATION FOR THE PROVISION OF
SUCH EVALUATION OR SERVICE.
  S 4. Subdivision 2 of section  2547  of  the  public  health  law,  as
amended  by  chapter  231  of  the  laws  of 1993, is amended to read as
follows:
  2. In addition to respite services provided  pursuant  to  subdivision
one  of  this  section and subject to the amounts appropriated therefor,
the state shall  reimburse  the  municipality  IN  ACCORDANCE  WITH  THE
PERCENTAGE OF STATE AID REIMBURSEMENT FOR APPROVED COSTS AS SET FORTH IN
SUBDIVISION  TWO  OF  SECTION  TWENTY-FIVE  HUNDRED  FIFTY-SEVEN OF THIS
TITLE, for [fifty percent of] the costs of respite services provided  to
eligible  children  and  their  families  with the approval of the early
intervention official.
  S 5. Section 2548 of the public health law, as amended by  section  20
of  part  H  of  chapter  686 of the laws of 2003, is amended to read as
follows:
  S 2548. Transition plan. To the extent that a toddler with a disabili-
ty is thought to be eligible for services pursuant to section forty-four
hundred ten of the education  law,  the  [early  intervention  official]
SERVICE  COORDINATOR  shall notify in writing the committee on preschool
special education of the local school  district  in  which  an  eligible
child  resides  of  the  potential  transition  of  such child and, with
parental consent, arrange for a conference among the  service  coordina-
tor,  the  parent  and  the  chairperson  of  the preschool committee on
special education or his or her designee at  least  ninety  days  before
such  child  would  be  eligible  for  services under section forty-four
hundred ten of the education law to review the child's  program  options
and to establish a transition plan, if appropriate. If a parent does not
consent to a conference with the service coordinator and the chairperson
of  the  preschool committee on special education or his or her designee
to determine whether the child should be  referred  for  services  under

S. 6256--B                          7                         A. 9056--B

section  forty-four  hundred  ten of the education law, and the child is
not determined to be eligible by  the  committee  on  preschool  special
education  for  such  services  prior to the child's third birthday, the
child's eligibility for early intervention program services shall end at
the child's third birthday.
  S  6.  Subdivision  2  of  section  2550  of the public health law, as
amended by section 5 of part B3 of chapter 62 of the laws  of  2003,  is
amended to read as follows:
  2. In meeting the requirements of subdivision one of this section, the
lead  agency  shall  adopt  and  use proper methods of administering the
early intervention program, including:
  (a) establishing standards for evaluators,  service  coordinators  and
providers of early intervention services;
  (b) approving, and periodically re-approving evaluators, service coor-
dinators  and  providers of early intervention services who meet depart-
ment standards; PROVIDED HOWEVER THAT THE DEPARTMENT  MAY  REQUIRE  THAT
APPROVED  EVALUATORS, SERVICE COORDINATORS AND PROVIDERS OF EARLY INTER-
VENTION SERVICES ENTER INTO AGREEMENTS WITH THE DEPARTMENT IN  ORDER  TO
CONDUCT EVALUATIONS OR RENDER SERVICE COORDINATION OR EARLY INTERVENTION
SERVICES  IN  THE  EARLY INTERVENTION PROGRAM. SUCH AGREEMENTS SHALL SET
FORTH THE TERMS AND CONDITIONS OF PARTICIPATION IN THE PROGRAM.  IF  THE
DEPARTMENT  REQUIRES  THAT SUCH PROVIDERS ENTER INTO AGREEMENTS WITH THE
DEPARTMENT FOR PARTICIPATION IN THE PROGRAM, "APPROVAL" OR "APPROVED" AS
USED IN THIS TITLE SHALL MEAN A PROVIDER WHO IS APPROVED BY THE  DEPART-
MENT  IN  ACCORDANCE WITH DEPARTMENT REGULATIONS AND HAS ENTERED INTO AN
AGREEMENT WITH THE DEPARTMENT FOR THE PROVISION OF EVALUATIONS,  SERVICE
COORDINATION OR EARLY INTERVENTION SERVICES.
  A  LESS-THAN-ARMS-LENGTH  RELATIONSHIP  SHALL  NOT  EXIST  BETWEEN THE
SERVICE COORDINATOR, EVALUATOR AND THE PROVIDER  AUTHORIZED  TO  DELIVER
EARLY  INTERVENTION  SERVICES  TO THE CHILD, UNLESS APPROVAL OF THE LEAD
AGENCY,  IN  CONSULTATION  WITH  THE  EARLY  INTERVENTION  OFFICIAL,  IS
OBTAINED.  PROVIDED  FURTHER THAT, UNLESS AUTHORIZED BY THE LEAD AGENCY,
IN CONSULTATION WITH THE EARLY INTERVENTION  OFFICIAL,  UPON  A  FINDING
THAT  IT  HAS  BEEN  DEMONSTRATED  THAT AN APPROVED PROVIDER IS THE ONLY
APPROPRIATE PROVIDER AVAILABLE TO RENDER THE  SERVICES  RECOMMENDED  FOR
SUCH  CHILD,  THE  SERVICE  COORDINATOR,  THE  EVALUATOR SELECTED BY THE
PARENT AND THE PROVIDER RECOMMENDED TO DELIVER SERVICES TO  SUCH  CHILD,
AND  ANY  AGENCY  UNDER  WHICH  SUCH  SERVICE  COORDINATOR, EVALUATOR OR
PROVIDER IS EMPLOYED BY OR UNDER CONTRACT WITH, SHALL NOT  BE  THE  SAME
ENTITY.
  ALL  APPROVED EVALUATORS AND PROVIDERS OF EARLY INTERVENTION SERVICES,
HEREINAFTER COLLECTIVELY REFERRED TO AS "PROVIDER"  OR  "PROVIDERS"  FOR
PURPOSES OF THIS SUBPARAGRAPH, SHALL ESTABLISH AND MAINTAIN CONTRACTS OR
AGREEMENTS  WITH  A  SUFFICIENT NUMBER OF INSURERS OR HEALTH MAINTENANCE
ORGANIZATIONS, INCLUDING THE MEDICAL ASSISTANCE  PROGRAM  OR  THE  CHILD
HEALTH  INSURANCE PROGRAM ESTABLISHED UNDER TITLE ONE-A OF THIS ARTICLE,
AS DETERMINED NECESSARY BY THE COMMISSIONER TO MEET  INSURER  OR  HEALTH
MAINTENANCE  ORGANIZATION  NETWORK ADEQUACY; PROVIDED, HOWEVER, THAT THE
DEPARTMENT MAY, IN ITS DISCRETION, APPROVE A PROVIDER WHO DOES NOT  HAVE
A  CONTRACT OR AGREEMENT WITH ONE OR MORE INSURERS OR HEALTH MAINTENANCE
ORGANIZATIONS IF THE PROVIDER RENDERS A SERVICE THAT MEETS A UNIQUE NEED
FOR SUCH SERVICE UNDER THE EARLY INTERVENTION PROGRAM.  APPROVED PROVID-
ERS SHALL SUBMIT TO THE DEPARTMENT, INFORMATION AND DOCUMENTATION OF THE
INSURERS AND HEALTH MAINTENANCE ORGANIZATIONS, WITH WHICH  THE  PROVIDER
HOLDS  AN  AGREEMENT OR CONTRACT. A PROVIDER'S APPROVAL WITH THE DEPART-
MENT TO DELIVER EVALUATIONS OR EARLY INTERVENTION SERVICES SHALL  TERMI-

S. 6256--B                          8                         A. 9056--B

NATE  IF THE PROVIDER FAILS TO PROVIDE SUCH INFORMATION OR DOCUMENTATION
ACCEPTABLE TO THE DEPARTMENT OF ITS CONTRACTS OR AGREEMENTS WITH  INSUR-
ERS OR HEALTH MAINTENANCE ORGANIZATIONS AS REQUESTED BY THE DEPARTMENT;
  (c)  [compiling  and  disseminating  to  the  municipalities  lists of
approved evaluators, service coordinators and providers of early  inter-
vention services;
  (d)] monitoring of agencies, institutions and organizations under this
title  and  agencies,  institutions  and  organizations  providing early
intervention services which are under the jurisdiction of a state  early
intervention service agency;
  [(e)]  (D)  enforcing  any obligations imposed on those agencies under
this title or Part H of the federal individuals with disabilities educa-
tion act and its regulations;
  [(f)] (E) providing training and technical assistance to  those  agen-
cies,  institutions  and  organizations,  including  initial and ongoing
training and technical assistance to municipalities to help enable  them
to  identify,  locate  and  evaluate  eligible  children, develop IFSPs,
ensure the provision of appropriate early intervention services, promote
the development of new services, where there is a demonstrated need  for
such  services  and afford procedural safeguards to infants and toddlers
and their families;
  [(g)] (F) correcting deficiencies that are identified through monitor-
ing; and
  [(h)] (G) in monitoring early intervention services, the  commissioner
shall  provide  municipalities  with  the results of any review of early
intervention services undertaken and shall  provide  the  municipalities
with the opportunity to comment thereon.
  S  7.  Subdivision  7  of  section  2551  of  the public health law is
REPEALED, and subdivisions 8, 9 and 10 are renumbered subdivisions 7,  8
and 9.
  S  8.   Section 2552 of the public health law, as added by chapter 428
of the laws of 1992, subdivisions 2 and 3 as amended by chapter  231  of
the  laws of 1993, and subdivision 4 as added by section 6 of part B3 of
chapter 62 of the laws of 2003, is amended to read as follows:
  S 2552. Responsibility of municipality.  1. Each municipality shall be
responsible for ensuring that the early intervention services  contained
in  an  IFSP  are  provided  to eligible children and their families who
reside in such municipality [and may contract with approved providers of
early intervention services for such purpose].  THE SERVICE  COORDINATOR
SHALL  REPORT, IN A MANNER AND FORMAT AS DETERMINED BY THE MUNICIPALITY,
ON THE DELIVERY OF SERVICES TO AN ELIGIBLE CHILD IN ACCORDANCE WITH  THE
ELIGIBLE CHILD'S IFSP. A MUNICIPALITY MAY REQUEST THAT THE PARENT SELECT
A NEW SERVICE COORDINATOR OR REQUIRE THAT THE SERVICE COORDINATOR SELECT
A  NEW  PROVIDER  OF SERVICES IF THE MUNICIPALITY FINDS THAT THE SERVICE
COORDINATOR HAS NOT BEEN  PERFORMING  HIS  OR  HER  RESPONSIBILITIES  AS
REQUIRED  BY  THIS  TITLE  OR  THAT  SERVICES  HAVE NOT BEEN PROVIDED IN
ACCORDANCE WITH THE ELIGIBLE CHILD'S IFSP.
  2. [After consultation with early intervention officials, the  commis-
sioner  shall develop procedures to permit a municipality to contract or
otherwise make arrangements with other municipalities  for  an  eligible
child and the child's family to receive services from such other munici-
palities.
  3.  The  municipality  shall  monitor claims for service reimbursement
authorized by this title and shall verify such claims prior to  payment.
The municipality shall inform the commissioner of discrepancies in bill-
ing and when payment is to be denied or withheld by the municipality.

S. 6256--B                          9                         A. 9056--B

  4.]  The early intervention official shall require an eligible child's
parent to furnish the parents'  and  eligible  child's  social  security
numbers  for the purpose of the department's and municipality's adminis-
tration of the program.
  S  9.  Subdivision  1  of  section  2557  of the public health law, as
amended by section 4 of part C of chapter 1 of  the  laws  of  2002,  is
amended to read as follows:
  1.  The  approved  costs,  OTHER THAN THOSE REIMBURSABLE IN ACCORDANCE
WITH SECTION TWENTY-FIVE HUNDRED  FIFTY-NINE  OF  THIS  TITLE,  for  [an
eligible]  A  child  who  receives  an evaluation and early intervention
services pursuant to this title shall be a charge upon the  municipality
wherein the eligible child resides or, where the services are covered by
the  medical  assistance  program,  upon the social services district of
fiscal responsibility with respect to those eligible  children  who  are
also  eligible  for medical assistance. All approved costs shall be paid
in the first instance and at least quarterly by the appropriate  govern-
ing  body  or  officer  of  the municipality upon vouchers presented and
audited in the same manner as the case of other claims against the muni-
cipality. Notwithstanding the insurance law  or  regulations  thereunder
relating  to  the  permissible  exclusion of payments for services under
governmental programs, no such exclusion shall  apply  with  respect  to
payments  made pursuant to this title. Notwithstanding the insurance law
or any other law or agreement to the contrary, benefits under this title
shall be considered secondary to any [plan of insurance or state govern-
ment benefit program] INSURANCE POLICY, PLAN OR CONTRACT under which  an
eligible child may have coverage, INCLUDING COVERAGE AVAILABLE UNDER THE
MEDICAL  ASSISTANCE PROGRAM OR THE CHILD HEALTH INSURANCE PROGRAM ESTAB-
LISHED IN TITLE ONE-A OF THIS ARTICLE, OR UNDER ANY  OTHER  GOVERNMENTAL
THIRD  PARTY  PAYOR.   Nothing in this section shall increase or enhance
coverages provided for within  an  insurance  contract  subject  to  the
provisions of this title.
  S  9-a.  Subdivision  4  of  section  2557 of the public health law is
REPEALED and subdivisions 2 and 5, subdivision 2 as added by chapter 428
of the laws of 1992 and subdivision 5 as added by section 7 of  part  B3
of chapter 62 of the laws of 2003, are amended to read as follows:
  2. The department shall reimburse the approved costs paid by a munici-
pality  for the purposes of this title, other than those reimbursable by
AN INSURER OR HEALTH MAINTENANCE  ORGANIZATION,  OR  GOVERNMENTAL  THIRD
PARTY  PAYOR INCLUDING the medical assistance program or [by third party
payors] THE CHILD HEALTH INSURANCE PROGRAM ESTABLISHED IN TITLE ONE-A OF
THIS ARTICLE, in an amount of fifty percent of the  amount  expended  in
accordance with the rules and regulations of the commissioner; PROVIDED,
HOWEVER,  THAT IN THE DISCRETION OF THE DEPARTMENT AND WITH THE APPROVAL
OF THE DIRECTOR OF THE DIVISION OF THE BUDGET, THE DEPARTMENT MAY  REIM-
BURSE  MUNICIPALITIES  IN  AN  AMOUNT  GREATER THAN FIFTY PERCENT OF THE
AMOUNT EXPENDED.  Such state reimbursement to the municipality shall not
be paid prior to April first of the year in which the approved costs are
paid by  the  municipality,  PROVIDED,  HOWEVER  THAT,  SUBJECT  TO  THE
APPROVAL  OF  THE  DIRECTOR  OF  THE BUDGET, THE DEPARTMENT MAY PAY SUCH
STATE AID REIMBURSEMENT TO THE MUNICIPALITY PRIOR TO SUCH DATE.
  5. [The  department  shall]  (A)  THE  COMMISSIONER,  IN  HIS  OR  HER
DISCRETION, IS AUTHORIZED TO contract with [an independent organization]
ONE  OR  MORE ENTITIES to act as the fiscal agent for the department AND
MUNICIPALITIES WITH RESPECT TO FISCAL MANAGEMENT AND  PAYMENT  OF  EARLY
INTERVENTION  CLAIMS. MUNICIPALITIES SHALL GRANT SUFFICIENT AUTHORITY TO
THE FISCAL AGENT TO ACT ON THEIR BEHALF. MUNICIPALITIES, AND  INDIVIDUAL

S. 6256--B                         10                         A. 9056--B

AND  AGENCY PROVIDERS AS DEFINED BY THE COMMISSIONER IN REGULATION SHALL
UTILIZE SUCH FISCAL AGENT FOR PAYMENT OF EARLY  INTERVENTION  CLAIMS  AS
DETERMINED  BY  THE  DEPARTMENT  AND  SHALL PROVIDE SUCH INFORMATION AND
DOCUMENTATION AS REQUIRED BY THE DEPARTMENT AND NECESSARY FOR THE FISCAL
AGENT TO CARRY OUT ITS DUTIES.
  (B)  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTION ONE HUNDRED
TWELVE OR ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE
HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE  ECONOMIC  DEVELOP-
MENT  LAW,  OR  ANY OTHER CONTRARY PROVISION OF LAW, THE COMMISSIONER IS
AUTHORIZED TO ENTER INTO A CONTRACT OR CONTRACTS UNDER PARAGRAPH (A)  OF
THIS SUBDIVISION WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROC-
ESS, PROVIDED, HOWEVER, THAT:
  (I)  THE DEPARTMENT SHALL POST ON ITS WEBSITE, FOR A PERIOD OF NO LESS
THAN THIRTY DAYS:
  (1) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACT OR CONTRACTS;
  (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (3)  THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY SEEK
SELECTION, WHICH SHALL BE NO LESS THAN THIRTY DAYS AFTER  SUCH  INFORMA-
TION IS FIRST POSTED ON THE WEBSITE; AND
  (4)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (II) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  A  TIMELY FASHION SHALL BE REVIEWED BY THE
COMMISSIONER; AND
  (III) THE COMMISSIONER SHALL SELECT  SUCH  CONTRACTOR  OR  CONTRACTORS
THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE PURPOSES OF
THIS SECTION.
  (C)  PARAGRAPH (B) OF THIS SUBDIVISION SHALL APPLY ONLY TO THE INITIAL
CONTRACT OR CONTRACTS NECESSARY TO OBTAIN THE SERVICES OF A FISCAL AGENT
FOR EARLY INTERVENTION PROGRAM FISCAL MANAGEMENT AND  PAYMENT  OF  EARLY
INTERVENTION  CLAIMS  AND SHALL NOT APPLY TO SUBSEQUENT CONTRACTS NEEDED
TO MAINTAIN SUCH SERVICES, AS DETERMINED BY THE COMMISSIONER IN  HIS  OR
HER  DISCRETION.    [A municipality may elect to utilize the services of
such organization for early intervention program fiscal  management  and
claiming  as determined by the commissioner or may select an independent
agent to act as the fiscal agent for such municipality or may act as its
own fiscal agent.]
  S 10. Subdivision 4 of section 2558 of the public health law, as added
by chapter 428 of the laws of 1992, is amended to read as follows:
  4. Local contribution. The municipality of residence shall  be  finan-
cially  responsible  for  the  local contribution in the amount of fifty
percent of the [approved costs] AMOUNT EXPENDED PROVIDED, HOWEVER,  THAT
IN  THE DISCRETION OF THE DEPARTMENT AND WITH THE APPROVAL OF THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, IN ACCORDANCE WITH SUBDIVISION TWO OF
SECTION TWENTY-FIVE HUNDRED FIFTY-SEVEN OF THIS  TITLE,  THE  DEPARTMENT
MAY  REQUIRE  THAT MUNICIPALITIES BE FINANCIALLY RESPONSIBLE FOR A LOCAL
CONTRIBUTION IN  AN  AMOUNT  LESS  THAN  FIFTY  PERCENT  OF  THE  AMOUNT
EXPENDED.   The commissioner shall certify to the comptroller the amount
of the local contribution owed by each municipality to  the  state.  The
comptroller  shall  deduct  the  amount of such local contribution first
from any moneys due the municipality  pursuant  to  section  twenty-five
hundred fifty-six of this title and then from any other moneys due or to
become due to the municipality.
  S  11. Paragraphs (a), (c) and (d) of subdivision 3 of section 2559 of
the public health law, paragraph (a) as amended  and  paragraph  (d)  as

S. 6256--B                         11                         A. 9056--B

added  by chapter 231 of the laws of 1993, subparagraphs (i) and (ii) of
paragraph (a) as added by chapter 406 of the laws of 2011, and paragraph
(c) as added by chapter 428 of the laws of 1992 are amended to  read  as
follows:
  (a)  Providers  of  EVALUATIONS AND early intervention services [and],
INCLUDING transportation services, HEREINAFTER COLLECTIVELY REFERRED  TO
IN  THIS  SUBDIVISION  AS  "PROVIDER" OR "PROVIDERS", shall in the first
instance and where applicable, seek payment from all [third party payors
including governmental agencies] INSURERS AND HEALTH MAINTENANCE  ORGAN-
IZATIONS,  INCLUDING THE MEDICAL ASSISTANCE PROGRAM AND THE CHILD HEALTH
INSURANCE PROGRAM ESTABLISHED IN TITLE ONE-A OF  THIS  ARTICLE  AND  ANY
OTHER  GOVERNMENTAL  THIRD PARTY PAYORS prior to claiming payment from a
given municipality for EVALUATIONS CONDUCTED UNDER THE PROGRAM  AND  FOR
services  rendered to eligible children, provided that, [for the purpose
of seeking payment from the medical assistance  program  or  from  other
third  party  payors,  the  municipality shall be deemed the provider of
such early intervention services to the extent  that  the  provider  has
promptly furnished to the municipality adequate and complete information
necessary  to  support  the  municipality  billing, and provided further
that] the obligation to seek payment shall not apply to a  payment  from
[a  third  party  payor]  AN INSURER who is not prohibited from applying
such payment, and will apply such payment,  to  an  annual  or  lifetime
limit specified in the insured's policy.
  (i)  Parents  shall  provide [and] the municipality [shall obtain] AND
SERVICE COORDINATOR information on any  [plan  of  insurance]  INSURANCE
POLICY, PLAN OR CONTRACT under which an eligible child has coverage.
  (ii)  Parents shall provide the municipality AND THE SERVICE COORDINA-
TOR with a written referral from a primary care provider  as  documenta-
tion,  for  eligible  children, of the medical necessity of early inter-
vention services.
  (III) PROVIDERS SHALL UTILIZE THE DEPARTMENT'S FISCAL AGENT  AND  DATA
SYSTEM  FOR  CLAIMING PAYMENT FROM INSURERS OR HEALTH MAINTENANCE ORGAN-
IZATIONS FOR EVALUATIONS AND SERVICES RENDERED UNDER  THE  EARLY  INTER-
VENTION PROGRAM.
  (IV)  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, RULE OR REGU-
LATION, PAYMENTS MADE BY ANY INSURER OR HEALTH MAINTENANCE  ORGANIZATION
FOR  EVALUATIONS  AND  SERVICES  PROVIDED  UNDER  THE EARLY INTERVENTION
PROGRAM SHALL BE AT RATES  ESTABLISHED  UNDER  AN  AGREEMENT  NEGOTIATED
BETWEEN  THE  INSURER OR HEALTH MAINTENANCE ORGANIZATION, IF APPLICABLE,
PROVIDED, HOWEVER, THAT IF THE INSURER OR HEALTH  MAINTENANCE  ORGANIZA-
TION  MAINTAINS  A  NETWORK  OF PROVIDERS AND A CHILD HAS A DEMONSTRATED
NEED, AS DETERMINED BY THE INSURER OR HEALTH  MAINTENANCE  ORGANIZATION,
IF  APPLICABLE,  FOR AN EVALUATION OR SERVICE RENDERED BY A PROVIDER WHO
IS NOT WITHIN THE INSURER OR HEALTH MAINTENANCE ORGANIZATION'S  NETWORK,
PAYMENT  TO  SUCH  OUT OF NETWORK PROVIDER SHALL BE MADE AT RATES ESTAB-
LISHED BY THE COMMISSIONER IN ACCORDANCE WITH REGULATION.
  (V) PAYMENTS MADE BY ANY INSURER OR HEALTH MAINTENANCE  PROGRAM  SHALL
BE  CONSIDERED PAYMENTS IN FULL FOR SUCH SERVICES AND THE PROVIDER SHALL
NOT SEEK ADDITIONAL PAYMENT FROM THE MUNICIPALITY, CHILD, OR HIS OR  HER
PARENTS  FOR  ANY  PORTION OF THE COSTS OF SAID SERVICES. NOTHING HEREIN
SHALL PROHIBIT AN INSURER OR HEALTH MAINTENANCE ORGANIZATION FROM APPLY-
ING A COPAYMENT, COINSURANCE OR DEDUCTIBLE AS SET FORTH IN THE POLICY OR
PLAN.  PAYMENTS FOR COPAYMENTS, COINSURANCE OR DEDUCTIBLES SHALL BE MADE
IN ACCORDANCE WITH PARAGRAPH (B) OF THIS SUBDIVISION.
  (VI) WHEN PAYMENT UNDER AN INSURANCE POLICY, PLAN OR CONTRACT  IS  NOT
AVAILABLE  OR  HAS  BEEN  EXHAUSTED,  PROVIDERS  SHALL  SEEK PAYMENT FOR

S. 6256--B                         12                         A. 9056--B

SERVICES IN ACCORDANCE WITH SECTION TWENTY-FIVE HUNDRED  FIFTY-SEVEN  OF
THIS TITLE; PROVIDED, HOWEVER, THAT IF THE SERVICE PROVIDED IS A COVERED
BENEFIT  UNDER  THE POLICY, PLAN OR CONTRACT AND PAYMENT HAS BEEN DENIED
ON  GROUNDS  OTHER  THAN THAT BENEFITS HAVE BEEN EXHAUSTED, THE PROVIDER
SHALL EXHAUST ALL APPEALS OF SAID DENIAL PRIOR TO  CLAIMING  PAYMENT  TO
THE  MUNICIPALITY FOR THE SERVICE IN ACCORDANCE WITH SECTION TWENTY-FIVE
HUNDRED FIFTY-SEVEN OF THIS TITLE. PROVIDERS SHALL  NOT  DISCONTINUE  OR
DELAY  SERVICES  TO  ELIGIBLE  CHILDREN  PENDING PAYMENT OF THE CLAIM OR
DETERMINATIONS OF ANY APPEAL DENIALS.
  (c) Payments made for early intervention services under  an  insurance
policy  or  health  benefit plan, INCLUDING PAYMENTS MADE BY THE MEDICAL
ASSISTANCE PROGRAM OR THE CHILD  HEALTH  INSURANCE  PROGRAM  ESTABLISHED
UNDER  TITLE  ONE-A  OF  THIS  ARTICLE OR OTHER GOVERNMENTAL THIRD PARTY
PAYOR, which are provided as part of an IFSP pursuant to  section  twen-
ty-five  hundred  forty-five  of  this title shall not be applied by the
insurer or plan administrator against any  maximum  lifetime  or  annual
limits  specified  in  the  policy  or health benefits plan, pursuant to
section eleven of the chapter of the laws of nineteen hundred ninety-two
which added this title.
  [(d) A municipality, or its designee,  shall  be  subrogated,  to  the
extent  of  the expenditures by such municipality for early intervention
services furnished to persons eligible for benefits under this title, to
any rights such person may have or  be  entitled  to  from  third  party
reimbursement. The right of subrogation does not attach to benefits paid
or  provided  under  any health insurance policy or health benefits plan
prior to receipt of written notice of the exercise of subrogation rights
by the insurer or plan administrator providing such benefits.]
  S 12. Subdivision 7 of section 2510  of  the  public  health  law,  as
amended  by  section 21 of part B of chapter 109 of the laws of 2010, is
amended to read as follows:
  7. "Covered health care services" means: the services  of  physicians,
optometrists,  nurses,  nurse  practitioners, midwives and other related
professional personnel  which  are  provided  on  an  outpatient  basis,
including  routine well-child visits; diagnosis and treatment of illness
and injury; inpatient health care services; laboratory tests; diagnostic
x-rays; prescription and  non-prescription  drugs  and  durable  medical
equipment; radiation therapy; chemotherapy; hemodialysis; emergency room
services;  hospice  services;  emergency,  preventive and routine dental
care, including medically necessary orthodontia but  excluding  cosmetic
surgery;  emergency,  preventive  and  routine  vision  care,  including
eyeglasses; speech and hearing services; and, inpatient  and  outpatient
mental  health,  alcohol  and substance abuse services as defined by the
commissioner in consultation with the superintendent.   "COVERED  HEALTH
CARE  SERVICES"  SHALL ALSO INCLUDE EARLY INTERVENTION SERVICES PROVIDED
PURSUANT TO TITLE TWO-A OF THIS ARTICLE UP TO THE  SCOPE  AND  LEVEL  OF
COVERAGE FOR THE SAME SERVICES PROVIDED PURSUANT TO THIS SUBDIVISION, AS
DEFINED  BY  THE  COMMISSIONER. "Covered health care services" shall not
include drugs, procedures and supplies for  the  treatment  of  erectile
dysfunction  when provided to, or prescribed for use by, a person who is
required to register as a sex offender pursuant to article six-C of  the
correction  law,  provided  that  any  denial of coverage of such drugs,
procedures or supplies shall provide  the  patient  with  the  means  of
obtaining  additional  information  concerning  both  the denial and the
means of challenging such denial.
  S 13. Intentionally omitted.

S. 6256--B                         13                         A. 9056--B

  S 14. Paragraph (b) of subdivision 5 of section  4403  of  the  public
health law is relettered paragraph (c), paragraph (c), as added by chap-
ter 705 of the laws of 1996, is amended and a new paragraph (b) is added
to read as follows:
  (B) UPON THE EFFECTIVE DATE OF THIS PARAGRAPH AND AT THE TIME OF EVERY
THREE  YEAR  REVIEW BY THE COMMISSIONER AS SET FORTH IN PARAGRAPH (A) OF
THIS SUBDIVISION, AND UPON APPLICATION FOR EXPANSION  OF  SERVICE  AREA,
THE  HEALTH MAINTENANCE ORGANIZATION SHALL DEMONSTRATE THAT IT MAINTAINS
AN ADEQUATE NETWORK OF PROVIDERS WHO ARE APPROVED TO DELIVER EVALUATIONS
AND EARLY INTERVENTION PROGRAM SERVICES IN ACCORDANCE WITH TITLE II-A OF
ARTICLE TWENTY-FIVE OF THIS CHAPTER, BY SHOWING TO THE  SATISFACTION  OF
THE  COMMISSIONER  THAT  (I)  THERE ARE A SUFFICIENT NUMBER OF GEOGRAPH-
ICALLY ACCESSIBLE PARTICIPATING PROVIDERS; AND (II) THERE ARE SUFFICIENT
PROVIDERS IN EACH AREA OF SPECIALTY OF PRACTICE TO MEET THE NEEDS OF THE
ENROLLMENT POPULATION.
  [(c)] (D) Each organization shall report on an annual basis the number
of enrollees and the number of participating providers in each organiza-
tion.  EACH HEALTH MAINTENANCE ORGANIZATION SHALL MAKE  PUBLICLY  AVAIL-
ABLE AND UPDATE ON A QUARTERLY BASIS, THE NAMES OF PARTICIPATING PROVID-
ERS IN THE HEALTH MAINTENANCE ORGANIZATION'S NETWORK WHO ARE APPROVED TO
DELIVER  EVALUATIONS  AND EARLY INTERVENTION PROGRAM SERVICES IN ACCORD-
ANCE WITH TITLE II-A OF ARTICLE TWENTY-FIVE OF THIS CHAPTER.
  S 15. Section 4406 of the public health law is amended by adding a new
subdivision 6 to read as follows:
  6. (A) NO SUBSCRIBER CONTRACT OR BENEFIT PACKAGE SHALL EXCLUDE  COVER-
AGE FOR OTHERWISE COVERED SERVICES SOLELY ON THE BASIS THAT THE SERVICES
CONSTITUTE EARLY INTERVENTION PROGRAM SERVICES UNDER TITLE II-A OF ARTI-
CLE TWENTY-FIVE OF THIS CHAPTER.
  (B)  WHERE  A SUBSCRIBER CONTRACT OR BENEFIT PACKAGE PROVIDES COVERAGE
FOR A SERVICE THAT IS PROVIDED UNDER THE EARLY INTERVENTION PROGRAM  AND
IS  OTHERWISE  COVERED UNDER THE SUBSCRIBER CONTRACT OR BENEFIT PACKAGE,
SUCH COVERAGE SHALL NOT BE APPLIED AGAINST ANY MAXIMUM ANNUAL  OR  LIFE-
TIME  MONETARY  LIMITS  SET FORTH IN SUCH SUBSCRIBER CONTRACT OR BENEFIT
PACKAGE. VISIT  LIMITATIONS  AND  OTHER  TERMS  AND  CONDITIONS  OF  THE
SUBSCRIBER  CONTRACT  OR BENEFIT PACKAGE WILL CONTINUE TO APPLY TO EARLY
INTERVENTION SERVICES. HOWEVER, ANY VISITS USED FOR  EARLY  INTERVENTION
PROGRAM  SERVICES SHALL NOT REDUCE THE NUMBER OF VISITS OTHERWISE AVAIL-
ABLE UNDER THE SUBSCRIBER CONTRACT OR BENEFIT PACKAGE FOR SUCH  SERVICES
THAT ARE NOT PROVIDED UNDER THE EARLY INTERVENTION PROGRAM.
  (C) THE HEALTH MAINTENANCE ORGANIZATION SHALL PROVIDE THE MUNICIPALITY
AND  SERVICE  COORDINATOR  WITH  INFORMATION  ON  THE EXTENT OF BENEFITS
AVAILABLE TO AN ENROLLEE UNDER SUCH SUBSCRIBER CONTRACT OR BENEFIT PACK-
AGE WITHIN FIFTEEN DAYS OF THE HEALTH MAINTENANCE ORGANIZATION'S RECEIPT
OF WRITTEN REQUEST AND NOTICE AUTHORIZING SUCH RELEASE.
  (D) NO  HEALTH  MAINTENANCE  ORGANIZATION  SHALL  REFUSE  TO  ISSUE  A
SUBSCRIBER  CONTRACT  OR BENEFIT PACKAGE OR REFUSE TO RENEW A SUBSCRIBER
CONTRACT OR BENEFIT PACKAGE SOLELY BECAUSE THE APPLICANT OR ENROLLEE  IS
RECEIVING SERVICES UNDER THE EARLY INTERVENTION PROGRAM.
  (E) HEALTH MAINTENANCE ORGANIZATIONS SHALL ACCEPT CLAIMS SUBMITTED FOR
PAYMENT  UNDER  THE  CONTRACT  FROM  A PROVIDER THROUGH THE DEPARTMENT'S
FISCAL AGENT AND DATA  SYSTEM  FOR  SUCH  CLAIMING.  HEALTH  MAINTENANCE
ORGANIZATIONS  SHALL,  IN A MANNER AND FORMAT AS REQUIRED BY THE DEPART-
MENT, PROVIDE THE DEPARTMENT WITH INFORMATION ON  CLAIMS  SUBMITTED  FOR
EVALUATIONS  AND  EARLY INTERVENTION SERVICES PROVIDED TO CHILDREN UNDER
THE EARLY INTERVENTION PROGRAM AND DISPOSITION OF SUCH CLAIMS.

S. 6256--B                         14                         A. 9056--B

  (F) WHERE A SUBSCRIBER CONTRACT OR BENEFIT PACKAGE  PROVIDES  COVERAGE
FOR  AN  EVALUATION  OR  SERVICE  PROVIDED  UNDER THE EARLY INTERVENTION
PROGRAM, REIMBURSEMENT FOR SUCH EVALUATION OR SERVICE SHALL BE AT  RATES
NEGOTIATED BY THE HEALTH MAINTENANCE ORGANIZATION AND PROVIDER PROVIDED,
HOWEVER,  THAT  IF A CHILD HAS A DEMONSTRATED NEED, AS DETERMINED BY THE
HEALTH MAINTENANCE ORGANIZATION, FOR AN EVALUATION OR  SERVICE  RENDERED
BY  A  PROVIDER  WHO  DOES NOT HOLD AN AGREEMENT WITH THE CHILD'S HEALTH
MAINTENANCE ORGANIZATION  FOR  THE  PROVISION  OF  SERVICES  TO  COVERED
PERSONS,  PAYMENT TO SUCH OUT OF NETWORK PROVIDER SHALL BE MADE AT RATES
ESTABLISHED BY THE COMMISSIONER IN ACCORDANCE WITH REGULATION.
  (G) HEALTH MAINTENANCE ORGANIZATIONS SHALL ENSURE THAT THE  TERMS  AND
CONDITIONS  CONTAINED IN SUBSCRIBER CONTRACTS OR BENEFIT PACKAGES RELAT-
ING TO PROVISION OF SERVICES TO CHILDREN UNDER  THE  EARLY  INTERVENTION
PROGRAM  COMPLIES WITH TITLE II-A OF ARTICLE TWENTY-FIVE OF THIS CHAPTER
AND WITH STANDARDS SET FORTH IN PART C OF THE INDIVIDUALS WITH DISABILI-
TIES EDUCATION ACT, AS AMENDED  BY  THE  INDIVIDUALS  WITH  DISABILITIES
EDUCATION IMPROVEMENT ACT OF 2004.
  S 16.  Intentionally omitted.
  S  17. Subsections (c) and (e) of section 3235-a of the insurance law,
subsection (c) as amended and subsection (e) as added by chapter 406  of
the laws of 2011, are amended, and a new subsection (f) is added to read
as follows:
  (c)  [Any  right  of  subrogation  to benefits which a municipality is
entitled in accordance  with  paragraph  (d)  of  subdivision  three  of
section twenty-five hundred fifty-nine of the public health law shall be
valid  and  enforceable  to  the extent benefits are available under any
accident and health insurance policy. The right of subrogation does  not
attach  to  insurance  benefits  paid or provided under any accident and
health insurance policy prior to  receipt  by  the  insurer  of  written
notice  from  the  municipality.  Upon  the insurer's receipt of written
request and notice from the municipality that such right of  subrogation
has  been  granted to such municipality and that the insured has author-
ized the release of information to the municipality,  the]  THE  insurer
shall  provide the municipality AND SERVICE COORDINATOR with information
on the extent of benefits available to the  covered  person  under  such
policy  WITHIN  FIFTEEN DAYS OF THE INSURER'S RECEIPT OF WRITTEN REQUEST
AND NOTICE AUTHORIZING SUCH RELEASE.
  (e) [Written claim for early intervention program  services  shall  be
submitted  by  the  municipality  as  the  approved  provider within one
hundred fifty days from the date of service.] WHERE A POLICY OF ACCIDENT
AND HEALTH INSURANCE, INCLUDING A CONTRACT ISSUED  PURSUANT  TO  ARTICLE
FORTY-THREE OF THIS CHAPTER, UTILIZES A NETWORK OF PROVIDERS, THE INSUR-
ER SHALL DEMONSTRATE TO THE SUPERINTENDENT THAT IT MAINTAINS AN ADEQUATE
NETWORK  OF  PROVIDERS WHO ARE APPROVED TO DELIVER EVALUATIONS AND EARLY
INTERVENTION PROGRAM SERVICES IN ACCORDANCE WITH TITLE II-A  OF  ARTICLE
TWENTY-FIVE OF THE PUBLIC HEALTH LAW BY DOCUMENTING THAT (I) THERE ARE A
SUFFICIENT  NUMBER OF GEOGRAPHICALLY ACCESSIBLE PARTICIPATING PROVIDERS;
AND (II) THERE ARE SUFFICIENT PROVIDERS IN EACH  AREA  OF  SPECIALTY  OF
PRACTICE TO MEET THE NEEDS OF THE ENROLLMENT POPULATION.  WHERE A POLICY
OF  ACCIDENT  AND HEALTH INSURANCE, INCLUDING A CONTRACT ISSUED PURSUANT
TO ARTICLE FORTY-THREE OF THIS CHAPTER, PROVIDES COVERAGE FOR AN  EVALU-
ATION   OR  SERVICE  PROVIDED  UNDER  THE  EARLY  INTERVENTION  PROGRAM,
REIMBURSEMENT FOR SUCH EVALUATION OR SERVICE SHALL BE AT  RATES  NEGOTI-
ATED BY THE INSURER AND PROVIDER, IF APPLICABLE, PROVIDED, HOWEVER, THAT
IF A CHILD HAS A DEMONSTRATED NEED FOR AN EVALUATION OR SERVICE RENDERED
BY  A  PROVIDER  WHO DOES NOT HOLD AN AGREEMENT WITH THE CHILD'S INSURER

S. 6256--B                         15                         A. 9056--B

FOR THE PROVISION OF  SERVICES  TO  COVERED  PERSONS,  PAYMENT  TO  SUCH
PROVIDER  SHALL  BE  MADE  AT  RATES  ESTABLISHED BY THE COMMISSIONER OF
HEALTH IN ACCORDANCE WITH REGULATION.
  (F)  NOTHING  IN THIS SECTION SHALL BE DEEMED TO LIMIT THE SUPERINTEN-
DENT'S AUTHORITY TO IMPOSE NETWORK ADEQUACY REQUIREMENTS ON INSURERS  IN
GENERAL.
  S 18. Subdivision 18 of section 4403 of the education law is REPEALED.
  S  19. Paragraph f of subdivision 3 and the opening paragraph of para-
graph a of subdivision 9 of  section  4410  of  the  education  law,  as
amended  by  chapter  82  of  the  laws  of 1995, are amended to read as
follows:
  f. After notification by [an early intervention  official]  A  SERVICE
COORDINATOR,  as defined in section twenty-five hundred forty-one of the
public health law, that a child receiving  services  pursuant  to  title
II-A  of  article  twenty-five of the public health law potentially will
transition to receiving services under this section and that  a  confer-
ence  is to be convened to review the child's program options and estab-
lish a transition plan, which conference must occur at least ninety days
before such child would be eligible for services under this section, the
chairperson of the committee on preschool special education of the local
school district or his or her designee in which such child resides shall
participate in the conference.
  Providers of special services or programs shall apply to  the  commis-
sioner  for  program  approval on a form prescribed by the commissioner;
such application shall include, but not be limited to, a listing of  the
services to be provided, the population to be served, a plan for provid-
ing  services  in the least restrictive environment and a description of
its evaluation component,  if  any.  [Providers  of  early  intervention
services seeking approval pursuant to subdivision seven of section twen-
ty-five  hundred  fifty-one  of the public health law shall apply to the
commissioner for such approval on a form prescribed by  the  commission-
er.]  The  commissioner  shall approve programs in accordance with regu-
lations adopted for such purpose  and  shall  periodically  review  such
programs  at  which time the commissioner shall provide the municipality
in which the program is located or  for  which  the  municipality  bears
fiscal  responsibility  an opportunity for comment within thirty days of
the review. In collaboration with municipalities and representatives  of
approved   programs,  the  commissioner  shall  develop  procedures  for
conducting such reviews. Municipalities shall be allowed to  participate
in  such  departmental review process. Such review shall be conducted by
individuals with appropriate experience as determined by the commission-
er and shall be conducted not more than once every three years.
  S 20. Intentionally omitted.
  S 21. Intentionally omitted.
  S 22. Intentionally omitted.
  S 23. This act shall take effect January 1, 2013;  provided,  however,
that:
  1.  the  amendments  to  subdivision  7  of section 2510 of the public
health law made by section twelve of this act shall not affect the expi-
ration of such subdivision and shall be deemed to expire therewith;
  2. the requirements contained in subparagraph (iv) of paragraph (a) of
subdivision 3 of section 2559 of the public  health  law,  as  added  by
section  eleven  of  this act, paragraph (f) of subdivision 6 of section
4406 of the public health law, as added by section fifteen of this  act,
and subsection (e) of section 3235-a of the insurance law, as amended by
section  seventeen  of  this  act, as such sections pertain to requiring

S. 6256--B                         16                         A. 9056--B

that an insurer or health maintenance organization  make  payment  to  a
provider  who  is not within the insurer or health maintenance organiza-
tion's network at rates established by the  commissioner  of  health  in
accordance  with  regulation,  if  a  child  has a demonstrated need, as
determined by the insurer or health maintenance organization, if  appli-
cable,  for  an  evaluation or service rendered by a provider who is not
within the insurer or health maintenance organization's  network,  shall
apply  only to policies, benefit packages and contracts issued, renewed,
modified, altered or amended on or after  the  effective  date  of  such
sections of this act; and
  3. sections two-a, four, five, seven, eight, nine-a, ten, eighteen and
nineteen of this act shall take effect April 1, 2013.

                                 PART B

  Section  1.  Subdivisions  9,  10 and 11 of section 3555 of the public
authorities law, as added by chapter 5 of the laws of 1997, are  amended
to read as follows:
  9. to determine the conditions under which a physician may be extended
the privilege of practicing within a health facility under the jurisdic-
tion of the corporation, to promulgate internal policies for the conduct
of  all  persons, physicians and allied health practitioners within such
facility, and to appoint and grant privileges to qualified and competent
clinical practitioners; [and]
  10. except as provided in this subdivision or as expressly limited  by
any  applicable  state  law  or regulation, and in support of the powers
granted by subdivisions five and six of this section,  to  form  and  to
participate  in  the formation of one or more corporations, and to exer-
cise and perform such purposes, powers, duties, functions or  activities
through  one  or more subsidiary corporations or other entities owned or
controlled wholly or in part by the corporation, which shall  be  formed
pursuant  to the business corporation law, the limited liability company
law, the not-for-profit corporation law, or  the  partnership  law;  any
such subsidiary may be authorized to act as a general or limited partner
in  a  partnership  or  as  a member of a limited liability company, and
enter into an arrangement calling for an initial and subsequent  payment
or  payments or contributions to capital by such subsidiary in consider-
ation of an interest in revenues or other contractual rights.  An entity
shall be deemed a subsidiary corporation whenever and  so  long  as  (a)
more than half of any voting shares or other membership interest of such
subsidiary are owned or held by the corporation or (b) a majority of the
directors,  trustees  or members of such subsidiary are designees of the
corporation[.];
  11. TO ACCEPT FUNDING FROM THE STATE  PURSUANT  TO  PARAGRAPH  (O)  OF
SUBDIVISION  ONE  OF  SECTION TWENTY-EIGHT HUNDRED SEVEN-V OF THE PUBLIC
HEALTH LAW OR PURSUANT TO SECTION TWENTY-EIGHT HUNDRED EIGHTEEN  OF  THE
PUBLIC HEALTH LAW, PROVIDED, HOWEVER, THAT AS A CONDITION FOR RECEIPT OF
SUCH  FUNDS THE CORPORATION IS REQUIRED TO TAKE ALL NECESSARY AND APPRO-
PRIATE STEPS AND ARRANGEMENTS, INCLUDING BUT NOT  LIMITED  TO,  ENTERING
INTO  AN  ARRANGEMENT  FOR  MERGER OR OTHER AFFILIATION WITH ONE OR MORE
HEALTH CARE,  ACADEMIC  OR  OTHER  ENTITIES,  LOCATED  WITHIN  THE  SAME
GEOGRAPHICAL REGION AS THE CORPORATION, FOR THE PURPOSE OF PROMOTING THE
CONTINUED FINANCIAL VIABILITY OF THE CORPORATION, PROTECTING AND PROMOT-
ING  THE  HEALTH OF THE PATIENTS SERVED BY ITS HEALTH FACILITIES AND, TO
THE EXTENT POSSIBLE, CONTRIBUTING TO THE ECONOMIC REVITALIZATION OF  THE
REGION BY BECOMING OPERATIONALLY AND FISCALLY INDEPENDENT OF THE DEPART-

S. 6256--B                         17                         A. 9056--B

MENT  OF  HEALTH BY NO LATER THAN MARCH THIRTY-FIRST, TWO THOUSAND FOUR-
TEEN, AND PROVIDED FURTHER, HOWEVER, THAT  THE  COMMISSIONER  OF  HEALTH
SHALL  MONITOR  SUCH  STEPS AND ARRANGEMENTS, ESTABLISH GOALS AND BENCH-
MARKS  FOR  THE  ACHIEVEMENT  OF  SUCH INDEPENDENCE, INTERCEDE AS DEEMED
NECESSARY AND  APPROPRIATE  AND  DELAY  OR  PRECLUDE  THE  CORPORATION'S
RECEIPT OF SUCH FUNDS IN THE EVENT THE COMMISSIONER OF HEALTH DETERMINES
THAT SUCH GOALS AND BENCHMARKS HAVE NOT BEEN MET.
  12.  No  subsidiary  of  the corporation shall own, operate, manage or
control the existing research, education, acute inpatient or  outpatient
facilities  and  services now operated by the Roswell Park Cancer Insti-
tute.
  S 2. This act shall take effect April 1, 2012.

                                 PART C

  Section 1. The public health law is amended by adding  a  new  section
4148 to read as follows:
  S 4148. ELECTRONIC DEATH REGISTRATION SYSTEM. 1. LEGISLATIVE FINDINGS.
THE  LEGISLATURE  FINDS THAT IT IS NECESSARY TO UPDATE AND MODERNIZE THE
STATE'S SYSTEM OF  FILING  AND  MAINTAINING  INFORMATION  AND  DOCUMENTS
RELATED  TO  THE REGISTRATION OF DEATH. AN ELECTRONIC DEATH REGISTRATION
SYSTEM WILL PROMOTE ACCURACY AND PROVIDE FOR MORE TIMELY TRANSMISSION OF
DOCUMENTATION, PROMOTING EFFICIENCY IN THE OPERATIONS OF THE DEPARTMENT,
WHICH OVERSEES THE DEATH REGISTRATION FILING PROCESS; LOCAL  REGISTRARS,
WHICH ACCEPT AND FILE CERTIFICATES OF DEATH AND ISSUE BURIAL AND REMOVAL
PERMITS;  HEALTH  CARE  INSTITUTIONS  AND  PRACTITIONERS,  CORONERS  AND
MEDICAL EXAMINERS, WHICH PREPARE CERTIFICATES  OF  DEATH;  AND  LICENSED
FUNERAL  DIRECTORS AND UNDERTAKERS, WHO REQUIRE PROMPT ACCESS TO CERTIF-
ICATES OF DEATH TO CONDUCT BURIALS AND FUNERALS  IN  A  TIMELY  FASHION.
LICENSED FUNERAL DIRECTORS AND UNDERTAKERS HAVE EXPRESSED THEIR INTEREST
IN PARTNERING WITH THE DEPARTMENT TO SUPPORT THE ESTABLISHMENT AND MAIN-
TENANCE  OF SUCH SYSTEM THROUGH A CONTRIBUTION, TENDERED FOR EACH BURIAL
AND REMOVAL PERMIT ISSUED TO A LICENSED FUNERAL DIRECTOR OR  UNDERTAKER,
IN THE AMOUNT OF TWENTY DOLLARS.
  2.  THE DEPARTMENT IS HEREBY AUTHORIZED AND DIRECTED TO DESIGN, IMPLE-
MENT AND MAINTAIN AN ELECTRONIC DEATH REGISTRATION SYSTEM  FOR  COLLECT-
ING,  STORING, RECORDING, TRANSMITTING, AMENDING, CORRECTING AND AUTHEN-
TICATING INFORMATION, AS NECESSARY AND APPROPRIATE TO COMPLETE  A  DEATH
REGISTRATION,  AND  TO  GENERATE  SUCH  DOCUMENTS  AS  DETERMINED BY THE
DEPARTMENT IN RELATION TO A DEATH OCCURRING IN THIS STATE. THE  CONTRIB-
UTION  REFERENCED  IN SUBDIVISION ONE OF THIS SECTION SHALL BE COLLECTED
FOR EACH BURIAL OR REMOVAL PERMIT ISSUED ON OR AFTER THE EFFECTIVE  DATE
OF THIS SECTION FROM THE LICENSED FUNERAL DIRECTOR OR UNDERTAKER TO WHOM
SUCH  PERMIT  IS  ISSUED,  IN THE MANNER SPECIFIED BY THE DEPARTMENT AND
SHALL BE USED SOLELY FOR THE PURPOSE SET FORTH IN SUBDIVISION 1 OF  THIS
SECTION.
  3.  COMMENCING  ON  JANUARY  FIRST,  TWO THOUSAND FOURTEEN, OR AS SOON
THEREAFTER AS THE COMMISSIONER  REASONABLY  DETERMINES  IS  FEASIBLE  IN
LIGHT  OF  THE INTENT OF THIS SECTION, THE DEPARTMENT SHALL REQUIRE THAT
DEATHS OCCURRING WITHIN THIS STATE MUST BE REGISTERED  USING  THE  ELEC-
TRONIC DEATH REGISTRATION SYSTEM ESTABLISHED IN THIS SECTION. ELECTRONIC
DEATH  REGISTRATION MAY BE PHASED IN, AS DETERMINED BY THE COMMISSIONER,
FOR DEATHS OCCURRING IN THE STATE UNTIL THE ELECTRONIC  DEATH  REGISTRA-
TION SYSTEM IS FULLY IMPLEMENTED IN THE STATE.
  4. COMMENCING ON JANUARY FIRST, TWO THOUSAND FOURTEEN, OR ON SUCH DATE
DETERMINED  BY  THE  COMMISSIONER  PURSUANT  TO  SUBDIVISION  3  OF THIS

S. 6256--B                         18                         A. 9056--B

SECTION, ALL PERSONS REQUIRED TO REGISTER A DEATH OR FILE A  CERTIFICATE
OF DEATH UNDER THIS ARTICLE, AND SUCH OTHERS AS MAY BE AUTHORIZED BY THE
COMMISSIONER,  SHALL  HAVE  ACCESS  TO THE ELECTRONIC DEATH REGISTRATION
SYSTEM  FOR  THE  PURPOSE  OF  ENTERING INFORMATION REQUIRED TO EXECUTE,
COMPLETE AND FILE A CERTIFICATE OF DEATH OR TO RETRIEVE SUCH INFORMATION
OR GENERATE DOCUMENTATION FROM THE ELECTRONIC DEATH REGISTRATION SYSTEM.
THE CONFIDENTIALITY PROVISIONS IN SECTION FORTY-ONE HUNDRED  FORTY-SEVEN
OF THIS TITLE SHALL APPLY TO INFORMATION MAINTAINED IN THIS SYSTEM.
  5. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, COMMENCING ON
OR  AFTER  JANUARY  FIRST, TWO THOUSAND FOURTEEN, OR ON SUCH DATE DETER-
MINED BY THE COMMISSIONER PURSUANT TO SUBDIVISION 3 OF THIS SECTION, ANY
REQUIREMENT OF THIS TITLE FOR A SIGNATURE OF ANY PERSON SHALL BE  DEEMED
SATISFIED  BY  THE USE BY SUCH PERSON OF DIGITAL SIGNATURE PROVIDED SUCH
PERSON IS AUTHORIZED IN ACCORDANCE WITH THIS SECTION TO  USE  THE  ELEC-
TRONIC DEATH REGISTRATION SYSTEM.
  S  2.  Subdivision  1  of  section 4100-a of the public health law, as
amended by chapter 644 of the laws of 1988, is amended and a new  subdi-
vision 5 is added to read as follows:
  1.  The term "certified copy" means a photographic reproduction in the
form of a photocopy or a microfilm print of the original certificate  OR
ELECTRONICALLY PRODUCED PRINT OF THE ORIGINAL CERTIFICATE, COMMENCING ON
OR  AFTER  JANUARY  FIRST,  TWO  THOUSAND FOURTEEN, and certified by the
commissioner, his designated representative, a local registrar  [or  his
deputy], DEPUTY REGISTRAR OR SUB-REGISTRAR as a true copy thereof.
  5.  THE  TERM  "ELECTRONIC  DEATH  REGISTRATION SYSTEM" MEANS THE DATA
SYSTEM CREATED AND MAINTAINED BY THE DEPARTMENT FOR COLLECTING, STORING,
RECORDING, TRANSMITTING, AMENDING, CORRECTING AND AUTHENTICATING  INFOR-
MATION,  AS  NECESSARY AND APPROPRIATE TO COMPLETE A DEATH REGISTRATION,
AND TO GENERATE SUCH DOCUMENTS AS DETERMINED BY THE DEPARTMENT,  INCLUD-
ING  PERMITS  OR  CERTIFICATES,  RELATING  TO  A DEATH OCCURRING IN THIS
STATE.
  S 3. Subdivision 1 of section 4140 of the public health law is amended
to read as follows:
  1. The death of each person who has died in this state shall be regis-
tered immediately and not later than seventy-two hours  after  death  or
the  finding  of  a dead human body, by filing with the registrar of the
district in which the death occurred or the body was found a certificate
of such death, [which certificate shall be upon the form]  IN  A  MANNER
AND  FORMAT  AS  prescribed  by  the  commissioner,  WHICH SHALL INCLUDE
THROUGH ELECTRONIC MEANS IN ACCORDANCE WITH  SECTION  FORTY-ONE  HUNDRED
FORTY-EIGHT OF THIS TITLE.
  S  4.  Section  4141-a of the public health law, as amended by chapter
153 of the laws of 2011, is amended to read as follows:
  S 4141-a. Death certificate; duties of hospital administrator. When  a
death occurs in a hospital, except in those cases where certificates are
issued  by  coroners  or medical examiners, the person in charge of such
hospital or his or her designated representative shall promptly  present
the certificate to the physician or nurse practitioner in attendance, or
a physician or nurse practitioner acting in his or her behalf, who shall
promptly  certify to the facts of death, provide the medical information
required by the certificate, sign the medical certificate of death,  and
thereupon  return  such certificate to such person, so that the seventy-
two hour registration time limit prescribed in section four thousand one
hundred forty of this title can be met; PROVIDED, HOWEVER THAT  COMMENC-
ING  ON  OR  AFTER JANUARY FIRST, TWO THOUSAND FOURTEEN, OR ON SUCH DATE
DETERMINED BY THE COMMISSIONER PURSUANT TO SUBDIVISION 3 OF SECTION 4148

S. 6256--B                         19                         A. 9056--B

OF THIS TITLE, INFORMATION AND SIGNATURES REQUIRED BY THIS SECTION SHALL
BE OBTAINED AND  MADE  IN  ACCORDANCE  WITH  SECTION  FORTY-ONE  HUNDRED
FORTY-EIGHT OF THIS TITLE.
  S  5. Section 4142 of the public health law is amended by adding a new
subdivision (e) to read as follows:
  (E) NOTWITHSTANDING ANY CONTRARY PROVISIONS OF LAW AS MAY BE SET FORTH
IN THIS SECTION, COMMENCING ON OR  AFTER  JANUARY  FIRST,  TWO  THOUSAND
FOURTEEN,  OR  ON  SUCH  DATE DETERMINED BY THE COMMISSIONER PURSUANT TO
SUBDIVISION 3 OF SECTION 4148 OF THIS TITLE, INFORMATION AND  SIGNATURES
REQUIRED  BY  THIS  SUBDIVISION SHALL BE OBTAINED AND MADE IN ACCORDANCE
WITH SECTION FORTY-ONE HUNDRED FORTY-EIGHT OF THIS TITLE.
  S 6. Paragraph (b) of subdivision  2  and  subdivisions  3  and  5  of
section 4144 of the public health law, paragraph (b) of subdivision 2 as
amended  by  chapter  153  of  the  laws of 2011, are amended to read as
follows:
  (b) Verbal permission to remove a body of a deceased person  from  the
county  in  which death occurred or the body was found to a non-adjacent
county within the state of New York, as provided in subdivision  one  of
this section, shall be issued by the said registrar of vital statistics,
upon  request  by telephone of a licensed funeral director or undertaker
who holds a certificate of death signed by the  attending  physician  or
nurse  practitioner,  OR FOR DEATHS OCCURRING ON OR AFTER JANUARY FIRST,
TWO THOUSAND FOURTEEN, OR ON SUCH DATE DETERMINED  BY  THE  COMMISSIONER
PURSUANT  TO  SUBDIVISION  3 OF SECTION 4148 OF THIS TITLE, SUCH CERTIF-
ICATE OF DEATH SIGNED BY THE ATTENDING PHYSICIAN OR  NURSE  PRACTITIONER
IS AVAILABLE ELECTRONICALLY IN ACCORDANCE WITH SECTION FORTY-ONE HUNDRED
FORTY-EIGHT  OF THIS TITLE, showing that the death resulted from natural
causes and was not a result of accidental, suicidal, homicidal or  other
external causes.
  3.  No  registrar  of  vital  statistics shall receive any fee for the
issuance of burial or removal  permits  under  this  chapter  EXCEPT  AS
REFERENCED  BY  SECTION  FORTY-ONE HUNDRED FORTY-EIGHT OF THIS TITLE AND
other than the compensation provided in this article.
  5. If the interment, or other disposition of the body  of  a  deceased
person  is  to  be  made  within the state, the wording of the burial or
removal permit may be limited to a statement by the registrar, and  over
his  signature,  that  a  satisfactory certificate of death, having been
filed with him, as required by law,  permission  is  granted  to  inter,
remove  or  otherwise  dispose  of the body, stating the name, age, sex,
cause of death, and other necessary details [upon the form prescribed by
the commissioner] IN A MANNER AND FORMAT  AS  MAY  BE  REQUIRED  BY  THE
COMMISSIONER.
  S  7.  Subdivisions  1 and 4 of section 4161 of the public health law,
subdivision 1 as amended by chapter 589 of the laws of 1991 and subdivi-
sion 4 as amended by chapter 153 of the laws of  2011,  are  amended  to
read as follows:
  1.  The certificate of fetal death and the report of fetal death shall
contain such information and be in such form  as  the  commissioner  may
prescribe;  PROVIDED  HOWEVER THAT COMMENCING ON OR AFTER JANUARY FIRST,
TWO THOUSAND FOURTEEN, OR ON SUCH DATE DETERMINED  BY  THE  COMMISSIONER
PURSUANT  TO  SUBDIVISION  3 OF THIS SECTION, INFORMATION AND SIGNATURES
REQUIRED BY THIS SUBDIVISION SHALL BE OBTAINED AND  MADE  IN  ACCORDANCE
WITH  SECTION FORTY-ONE HUNDRED FORTY-EIGHT OF THIS ARTICLE, except that
unless requested by the woman neither the certificate nor the report  of
fetal  death  shall  contain  the name of the woman, her social security
number or any other information which would permit her to be  identified

S. 6256--B                         20                         A. 9056--B

except  as  provided  in this subdivision. The report shall state that a
certificate of fetal death was filed with the commissioner and the  date
of  such  filing.  The commissioner shall develop a unique, confidential
identifier  to  be  used on the certificate of fetal death to be used in
connection with the exercise of the commissioner's authority to  monitor
the  quality  of  care  provided by any individual or entity licensed to
perform an abortion in this state and to  permit  coordination  of  data
concerning  the  medical history of the woman for purposes of conducting
surveillance scientific studies and research pursuant to the  provisions
of  paragraph  (j) of subdivision one of section two hundred six of this
chapter.
  4. When a fetal death occurs in a  hospital,  except  in  those  cases
where  certificates  are  issued  by  coroners or medical examiners, the
person in charge of such hospital or his  or  her  designated  represen-
tative  shall promptly present the certificate to the physician or nurse
practitioner in attendance, or a physician or nurse practitioner  acting
in  his  or her behalf, who shall promptly certify to the facts of birth
and of fetal death, provide the  medical  information  required  by  the
certificate, sign the medical certificate of birth and death, and there-
upon  return  such  certificate  to such person, so that the seventy-two
hour registration time limit prescribed in  section  four  thousand  one
hundred  sixty of this title can be met; PROVIDED, HOWEVER THAT COMMENC-
ING ON OR AFTER JANUARY FIRST, TWO THOUSAND FOURTEEN, OR  ON  SUCH  DATE
DETERMINED BY THE COMMISSIONER PURSUANT TO SUBDIVISION 3 OF SECTION 4148
OF THIS ARTICLE, INFORMATION AND SIGNATURES REQUIRED BY THIS SUBDIVISION
SHALL  BE OBTAINED AND MADE IN ACCORDANCE WITH SECTION FORTY-ONE HUNDRED
FORTY-EIGHT OF THIS ARTICLE.
  S 8. Subdivision 3 of section 4171 of the public health law is amended
to read as follows:
  3. All certificates, either of birth or death, shall be written  legi-
bly, in durable black ink, [and no] PROVIDED HOWEVER, THAT COMMENCING ON
OR  AFTER  JANUARY  FIRST, TWO THOUSAND FOURTEEN, OR ON SUCH DATE DETER-
MINED BY THE COMMISSIONER PURSUANT TO SUBDIVISION 3 OF SECTION  4148  OF
THIS  ARTICLE,  DEATH CERTIFICATES SHALL BE COMPLETED IN ACCORDANCE WITH
SECTION FORTY-ONE HUNDRED FORTY-EIGHT OF THIS ARTICLE.  NO  certificate,
WHETHER FILED IN PAPER FORM OR DEATH CERTIFICATE FILED ELECTRONICALLY IN
ACCORDANCE  WITH  SECTION FORTY-ONE HUNDRED FORTY-EIGHT OF THIS ARTICLE,
shall be held to be complete and correct that does not supply all of the
items of information called for therein, or satisfactorily  account  for
their omission.
  S  9.  This act shall take effect immediately; provided, however, that
if chapter 153 of the laws of 2011 is not in effect on  such  date  then
the  amendments  made  to section 4141-a of the public health law, para-
graph (b) of subdivision 2 of section 4144 of the public health law  and
subdivision 4 of section 4161 of the public health law by sections four,
six  and  seven  of this act shall take effect on the same date and same
manner as chapter 153 of  the  laws  of  2011,  takes  effect;  provided
further  that  the  commissioner  of  health is authorized to promulgate
regulations as necessary to implement the provisions of this act.

                                 PART D

  Section 1. The public health law is amended by adding  a  new  section
2823 to read as follows:
  S  2823.  SUPPORTIVE  HOUSING  DEVELOPMENT  REINVESTMENT PROGRAM.   1.
NOTWITHSTANDING SECTIONS ONE HUNDRED TWELVE AND ONE HUNDRED  SIXTY-THREE

S. 6256--B                         21                         A. 9056--B

OF  THE  STATE  FINANCE  LAW  OR  SECTIONS ONE HUNDRED FORTY-TWO AND ONE
HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOPMENT LAW OR ANY OTHER CONTRA-
RY PROVISION OF LAW,  REINVESTMENT  FUNDS  FOR  SUPPORTIVE  HOUSING  FOR
VULNERABLE  POPULATIONS  SHALL BE ALLOCATED ANNUALLY BY THE COMMISSIONER
BASED UPON THE FOLLOWING CRITERIA:
  (A) THE EFFICIENCY AND EFFECTIVENESS OF THE USE  OF  FUNDING  FOR  THE
DEVELOPMENT  OF  ADEQUATE  AND  ACCESSIBLE HOUSING TO SUPPORT VULNERABLE
PERSONS IN THE COMMUNITY AND TO ENSURE ACCESS TO SUPPORTS  NECESSARY  TO
MAXIMIZE EXPECTED OUTCOMES; AND
  (B)  OTHER  RELEVANT  FACTORS  RELATING TO THE MAINTENANCE OF EXISTING
SUPPORTIVE HOUSING AND THE DEVELOPMENT OF  NEW  SUPPORTIVE  HOUSING  AND
ASSOCIATED SERVICES.
  2.  AMOUNTS  PROVIDED  PURSUANT  TO THIS SECTION SHALL BE USED ONLY TO
FUND HOUSING  DEVELOPMENT  ACTIVITIES  AND  OTHER  GENERAL  PROGRAMMATIC
ACTIVITIES  TO  HELP  ENSURE  A  STABLE SYSTEM OF SUPPORTIVE HOUSING FOR
VULNERABLE PERSONS IN THE COMMUNITY.
  3. THE COMMISSIONER IS AUTHORIZED AND EMPOWERED  TO  MAKE  INSPECTIONS
AND  EXAMINE RECORDS OF ANY ENTITY FUNDED PURSUANT TO SUBDIVISION TWO OF
THIS SECTION. SUCH EXAMINATION SHALL INCLUDE ALL  MEDICAL,  SERVICE  AND
FINANCIAL  RECORDS,  RECEIPTS, DISBURSEMENTS, CONTRACTS, LOANS AND OTHER
MONEYS RELATING TO THE FINANCIAL OPERATION OF THE PROVIDER.
  4. THE AMOUNT OF SUPPORTIVE HOUSING DEVELOPMENT REINVESTMENT FUNDS FOR
THE DEPARTMENT SHALL BE ITEMIZED IN  THE  ANNUAL  BUDGET  IN  AN  AMOUNT
DETERMINED  BY THE COMMISSIONER, SUBJECT TO THE APPROVAL OF THE DIRECTOR
OF THE BUDGET.  THIS AMOUNT SHALL INCLUDE THE  AMOUNT  OF  GENERAL  FUND
SAVINGS  DIRECTLY  RELATED  TO  INPATIENT  HOSPITAL AND NURSING HOME BED
DECERTIFICATION AND/OR FACILITY CLOSURE.    THE  METHODOLOGIES  USED  TO
CALCULATE  THE  SAVINGS  SHALL  BE DEVELOPED BY THE COMMISSIONER AND THE
DIRECTOR OF THE BUDGET. IN NO EVENT  SHALL  THE  FULL  ANNUAL  VALUE  OF
SUPPORTIVE  HOUSING  DEVELOPMENT  REINVESTMENT  PROGRAMS ATTRIBUTABLE TO
INPATIENT HOSPITAL AND NURSING HOME BED DECERTIFICATION AND/OR  FACILITY
CLOSURE EXCEED THE TWELVE MONTH VALUE OF THE DEPARTMENT OF HEALTH GENER-
AL  FUND  REDUCTIONS RESULTING FROM SUCH DECERTIFICATION AND/OR FACILITY
CLOSURE.
  5. THE ANNUAL SUPPORTIVE HOUSING  DEVELOPMENT  REINVESTMENT  APPROPRI-
ATION  SHALL  REFLECT A PROPORTION OF THE AMOUNT OF GENERAL FUND SAVINGS
RESULTING FROM SUBDIVISION FOUR OF THIS SECTION. WITHIN ANY FISCAL  YEAR
WHERE APPROPRIATION INCREASES ARE RECOMMENDED FOR THE SUPPORTIVE HOUSING
DEVELOPMENT  REINVESTMENT  PROGRAM,  INSOFAR  AS PROJECTED BED DECERTIF-
ICATION AND/OR FACILITY CLOSURES DO NOT OCCUR AS ESTIMATED, AND  GENERAL
FUND  SAVINGS DO NOT RESULT, THEN THE REINVESTMENT APPROPRIATIONS MAY BE
REDUCED IN THE NEXT YEAR'S ANNUAL BUDGET ITEMIZATION.
  6. AMOUNTS MADE AVAILABLE TO THE SUPPORTIVE HOUSING DEVELOPMENT  REIN-
VESTMENT  PROGRAM OF THE DEPARTMENT SHALL BE SUBJECT TO ANNUAL APPROPRI-
ATIONS THEREFOR.
  7. NO PROVISION IN THIS SECTION SHALL CREATE OR BE  DEEMED  TO  CREATE
ANY RIGHT, INTEREST OR ENTITLEMENT TO SERVICES OR FUNDS THAT ARE SUBJECT
TO  THIS SECTION, OR TO ANY OTHER SERVICES OR FUNDS, WHETHER TO INDIVID-
UALS, LOCALITIES, PROVIDERS OR OTHERS, INDIVIDUALLY OR COLLECTIVELY.
  8. ALL APPROPRIATIONS FOR  SUPPORTIVE  HOUSING  DEVELOPMENT  SHALL  BE
ADJUSTED  IN  THE  FOLLOWING FISCAL YEAR TO REFLECT THE VARIANCE BETWEEN
THE INITIAL AND REVISED ESTIMATES OF BED DECERTIFICATION AND/OR FACILITY
CLOSURE.
  9. THE COMMISSIONER SHALL PROMULGATE REGULATIONS, AND  MAY  PROMULGATE
EMERGENCY REGULATIONS, TO EFFECTUATE THE PROVISIONS OF THIS SECTION.

S. 6256--B                         22                         A. 9056--B

  S  2.  Paragraph  (e)  of subdivision 1 of section 461-l of the social
services law, as added by chapter 165 of the laws of 1991, is amended to
read as follows:
  (e)  "Services"  shall  mean all services for which full payment to an
assisted living program is included in the capitated  rate  of  payment,
which  shall include personal care services, home care services and such
other services as the commissioner in conjunction with the  commissioner
of health determine by regulation must be included in the capitated rate
of  payment,  and  which  the  assisted living program shall provide, or
arrange for the provision of, through contracts with a  social  services
district, [a] long term home health care [program or a] PROGRAMS, certi-
fied  home health [agency, and] AGENCIES, AND/OR other qualified provid-
ers.
  S 3. Paragraphs (b) and (d) of subdivision 2 of section 461-l  of  the
social  services  law,  as  added by chapter 165 of the laws of 1991 and
subparagraph (iii) of paragraph (d) as amended by  chapter  569  of  the
laws of 2000, are amended to read as follows:
  (b)  If  an  assisted  living  program  itself is not a certified home
health agency or long term home health care program, the assisted living
program shall contract with [a] ONE OR MORE certified home health [agen-
cy or] AGENCIES AND/OR long term home health care [program] PROGRAMS for
the provision of services pursuant to article thirty-six of  the  public
health law. [An assisted living program shall contract with no more than
one  certified home health agency or long term home health care program,
provided, however, that the commissioner and the commissioner of  health
may approve additional contracts for good cause.]
  (d)  Patient services and care. (i) An assisted living program[, or if
the assisted living program itself does not include  a  long  term  home
health  care  program or certified home health agency an assisted living
program and a long term home  health  care  program  or  certified  home
health agency,] shall conduct an initial assessment to determine whether
a  person would otherwise require placement in a residential health care
facility if not for the availability of the assisted living program  and
is appropriate for admission to an assisted living program. The assisted
living  program  shall  forward  such assessment of a medical assistance
applicant or recipient to the appropriate social services district.
  (ii) No person shall be determined eligible for  and  admitted  to  an
assisted living program unless the assisted living program [and the long
term  home  health care program or the certified home health care agency
agree, based on the initial assessment,] FINDS that the person meets the
criteria provided in paragraph (d) of subdivision one  of  this  section
and  unless  the  appropriate  social services district prior authorizes
payment for services.
  (iii) Appropriate services shall be provided  to  an  eligible  person
only  in  accordance  with a plan of care which is based upon an initial
assessment and periodic reassessments conducted by  an  assisted  living
program[,  or  if  the assisted living program itself does not include a
long term home health care program or certified home  health  agency  an
assisted  living  program  and  a  long term home health care program or
certified home health agency]. A  reassessment  shall  be  conducted  as
frequently as is required to respond to changes in the resident's condi-
tion  and  ensure immediate access to necessary and appropriate services
by the resident, but in no event less frequently  than  once  every  six
months. No person shall be admitted to or retained in an assisted living
program  unless  [the assisted living program, and long term home health
care program or certified home health agency are in agreement that]  the

S. 6256--B                         23                         A. 9056--B

person  can  be  safely  and  adequately cared for with the provision of
services determined by such assessment or reassessment.
  S  4.  Paragraph  (i)  of subdivision 3 of section 461-l of the social
services law is REPEALED.
  S 5.  Notwithstanding any contrary provision of law, inpatient  hospi-
tals licensed pursuant to the Mental Hygiene Law by the Office of Mental
Health shall be subject to audit fees as set forth in regulations issued
by  the  Department  of  Health  pursuant to S2807-c(35)(b)(xiii) of the
Public Health Law, with regard to cost reports submitted to the  Depart-
ment of Health on and after April 1, 2012.
  S  6.  Subdivision  2  of  section 365-a of the social services law is
amended by adding four new paragraphs (w), (x), (y) and (z) to  read  as
follows:
  (W)  PODIATRY  SERVICES  FOR  INDIVIDUALS WITH A DIAGNOSIS OF DIABETES
MELLITUS; PROVIDED, HOWEVER, THAT THE PROVISIONS OF THIS PARAGRAPH SHALL
NOT TAKE EFFECT UNLESS ALL NECESSARY APPROVALS  UNDER  FEDERAL  LAW  AND
REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL FINANCIAL PARTICIPATION
IN  THE  COSTS  OF  HEALTH CARE SERVICES PROVIDED PURSUANT TO THIS PARA-
GRAPH.
  (X) LACTATION COUNSELING SERVICES FOR PREGNANT  AND  POSTPARTUM  WOMEN
WHEN  SUCH  SERVICES  ARE  ORDERED  BY A PHYSICIAN, REGISTERED PHYSICIAN
ASSISTANT,  REGISTERED  NURSE  PRACTITIONER,  OR  LICENSED  MIDWIFE  AND
PROVIDED  BY  A  CERTIFIED  LACTATION  CONSULTANT,  AS DETERMINED BY THE
COMMISSIONER OF HEALTH; PROVIDED, HOWEVER, THAT THE PROVISIONS  OF  THIS
PARAGRAPH  SHALL  NOT  TAKE  EFFECT UNLESS ALL NECESSARY APPROVALS UNDER
FEDERAL LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL  FINAN-
CIAL  PARTICIPATION IN THE COSTS OF HEALTH CARE SERVICES PROVIDED PURSU-
ANT TO THIS PARAGRAPH. NOTHING IN THIS PARAGRAPH SHALL BE  CONSTRUED  TO
MODIFY ANY LICENSURE, CERTIFICATION OR SCOPE OF PRACTICE PROVISION UNDER
TITLE EIGHT OF THE EDUCATION LAW.
  (Y)  HARM  REDUCTION COUNSELING AND SERVICES TO REDUCE OR MINIMIZE THE
ADVERSE HEALTH CONSEQUENCES ASSOCIATED WITH  DRUG  USE,  PROVIDED  BY  A
QUALIFIED  DRUG  TREATMENT  PROGRAM  OR COMMUNITY-BASED ORGANIZATION, AS
DETERMINED BY THE COMMISSIONER OF HEALTH; PROVIDED,  HOWEVER,  THAT  THE
PROVISIONS  OF THIS PARAGRAPH SHALL NOT TAKE EFFECT UNLESS ALL NECESSARY
APPROVALS UNDER FEDERAL LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE
FEDERAL FINANCIAL PARTICIPATION IN THE COSTS  OF  HEALTH  CARE  SERVICES
PROVIDED  PURSUANT TO THIS PARAGRAPH. NOTHING IN THIS PARAGRAPH SHALL BE
CONSTRUED TO MODIFY ANY LICENSURE, CERTIFICATION OR  SCOPE  OF  PRACTICE
PROVISION UNDER TITLE EIGHT OF THE EDUCATION LAW.
  (Z)  HEPATITIS C WRAP-AROUND SERVICES TO PROMOTE CARE COORDINATION AND
INTEGRATION WHEN ORDERED BY A PHYSICIAN, REGISTERED PHYSICIAN ASSISTANT,
REGISTERED NURSE PRACTITIONER, OR LICENSED MIDWIFE, AND  PROVIDED  BY  A
QUALIFIED  PROFESSIONAL,  AS  DETERMINED  BY THE COMMISSIONER OF HEALTH.
SUCH SERVICES MAY INCLUDE CLIENT OUTREACH, IDENTIFICATION  AND  RECRUIT-
MENT,  HEPATITIS  C  EDUCATION  AND COUNSELING, COORDINATION OF CARE AND
ADHERENCE TO TREATMENT, ASSISTANCE IN OBTAINING APPROPRIATE  ENTITLEMENT
SERVICES, PEER SUPPORT AND OTHER SUPPORTIVE SERVICES; PROVIDED, HOWEVER,
THAT  THE  PROVISIONS OF THIS PARAGRAPH SHALL NOT TAKE EFFECT UNLESS ALL
NECESSARY APPROVALS UNDER FEDERAL LAW AND REGULATION HAVE BEEN  OBTAINED
TO  RECEIVE  FEDERAL FINANCIAL PARTICIPATION IN THE COSTS OF HEALTH CARE
SERVICES PROVIDED PURSUANT TO THIS PARAGRAPH.  NOTHING IN THIS PARAGRAPH
SHALL BE CONSTRUED TO MODIFY ANY LICENSURE, CERTIFICATION  OR  SCOPE  OF
PRACTICE PROVISION UNDER TITLE EIGHT OF THE EDUCATION LAW.

S. 6256--B                         24                         A. 9056--B

  S  7.  Paragraph  (g)  of subdivision 2 of section 365-a of the social
services law, as amended by section 23 of part H of chapter  59  of  the
laws of 2011, is amended to read as follows:
  (g)  sickroom  supplies,  eyeglasses, prosthetic appliances and dental
prosthetic appliances furnished in accordance with  the  regulations  of
the department; provided further that: (i) the commissioner of health is
authorized  to implement a preferred diabetic supply program wherein the
department of  health  will  receive  enhanced  rebates  from  preferred
manufacturers  of  glucometers and test strips, and may subject non-pre-
ferred manufacturers' glucometers and test strips to prior authorization
under section two hundred seventy-three of the public health  law;  (ii)
enteral  formula  therapy  and  nutritional  supplements  are limited to
coverage only for nasogastric, jejunostomy, or gastrostomy tube  feeding
or  for  treatment of an inborn metabolic disorder, or to address growth
and development problems in children, OR, SUBJECT  TO  STANDARDS  ESTAB-
LISHED  BY  THE  COMMISSIONER,  FOR  PERSONS  WITH  A  DIAGNOSIS  OF HIV
INFECTION, AIDS OR HIV-RELATED ILLNESS; (iii) prescription footwear  and
inserts  are limited to coverage only when used as an integral part of a
lower limb orthotic appliance, as part of a diabetic treatment plan,  or
to  address  growth  and  development  problems  in  children;  and (iv)
compression and support stockings are limited to coverage only for preg-
nancy or treatment of venous stasis ulcers;
  S 8. Subdivision 9 of section 4403-c  of  the  public  health  law  is
amended to read as follows:
  9.  Notwithstanding  any  other  provision of law, a comprehensive HIV
special needs plan  certified  pursuant  to  this  section  shall  limit
enrollment  to HIV positive persons, [but may enroll related children up
to the age of nineteen] EXCEPT FOR THE  FOLLOWING  PERSONS  WHO  MAY  BE
ENROLLED regardless of their HIV status[.]:
  (A) RELATED CHILDREN UP TO THE AGE OF TWENTY-ONE; AND
  (B)  HIGH  NEED POPULATIONS THAT WOULD BENEFIT FROM RECEIVING SERVICES
THROUGH A PLAN CERTIFIED PURSUANT TO THIS SECTION, AS DETERMINED BY  THE
COMMISSIONER.
  S  9.    Paragraph (f) of subdivision 1 of section 367-a of the social
services law as added by section 1 of Part E of chapter 58 of  the  laws
of 2008, is amended to read as follows:
  (f)  Amounts  payable  under  this title for medical assistance in the
form of outpatient mental health services under  article  thirty-one  OR
OUTPATIENT  CHEMICAL  DEPENDENCE  SERVICES  INCLUDING  OPIOID  TREATMENT
SERVICES UNDER ARTICLE THIRTY-TWO of the mental hygiene law provided  to
eligible  persons who are also beneficiaries under part B of title XVIII
of the federal social security act shall not be less than  the  approved
medical assistance payment level less the amount payable under part B.
  S  10.  Paragraph  (d)  of subdivision 2 of section 3332 of the public
health law, as amended by chapter 178 of the laws of  2010,  is  amended
and a new paragraph (e) is added to read as follows:
  (d)  the  date upon which such prescription was actually signed by the
prescribing practitioner[.]; AND
  (E) IF THE PATIENT IS A  LIMITED  ENGLISH  PROFICIENT  INDIVIDUAL,  AS
DEFINED  IN  SECTION THREE THOUSAND THREE HUNDRED NINETY-EIGHT-A OF THIS
CHAPTER, INDICATION OF SUCH  STATUS  AND  INDICATION  OF  THE  PATIENT'S
PRIMARY LANGUAGE.
  S  11.    Section 3333 of the public health law is amended by adding a
new subdivision 6 to read as follows:
  6. IF THE PHARMACIST KNOWS OR HAS REASON TO KNOW THAT THE PATIENT IS A
LIMITED ENGLISH PROFICIENT INDIVIDUAL, AS DEFINED IN SECTION THREE THOU-

S. 6256--B                         25                         A. 9056--B

SAND THREE HUNDRED NINETY-EIGHT-A OF THIS CHAPTER, THE PHARMACIST  SHALL
PROVIDE  FOR  TRANSLATION  OR  OTHER  LANGUAGE  SERVICES  AS REQUIRED IN
SECTION THREE THOUSAND THREE HUNDRED  NINETY-EIGHT-A  OF  THIS  CHAPTER,
UNLESS DOING SO WOULD COMPROMISE THE CARE OF THE PATIENT.
  S  12.  Paragraphs (b) and (c) of subdivision 1 of section 3334 of the
public health law, as amended by chapter 178 of the laws  of  2010,  are
amended and a new paragraph (d) is added to read as follows:
  (b)  dispense  the  substance in conformity with the labeling require-
ments applicable to the type of prescription which would be required but
for the emergency; [and]
  (c) make a good faith effort to verify the practitioner's identity, if
the practitioner is unknown to the pharmacist[.]; AND
  (D) IF THE PHARMACIST KNOWS OR HAS REASON TO KNOW THAT THE PATIENT  IS
A  LIMITED  ENGLISH  PROFICIENT  INDIVIDUAL, AS DEFINED IN SECTION THREE
THOUSAND THREE HUNDRED NINETY-EIGHT-A OF THIS  CHAPTER,  THE  PHARMACIST
SHALL  PROVIDE FOR TRANSLATION OR OTHER LANGUAGE SERVICES AS REQUIRED IN
SECTION THREE THOUSAND THREE HUNDRED  NINETY-EIGHT-A  OF  THIS  CHAPTER,
UNLESS DOING SO WOULD COMPROMISE THE CARE OF THE PATIENT.
  S  13.  Subdivision  1  of  section  3337  of the public health law is
amended by adding a new paragraph (d) to read as follows:
  (D) IF THE PHARMACIST KNOWS OR HAS REASON TO KNOW THAT THE PATIENT  IS
A  LIMITED  ENGLISH  PROFICIENT  INDIVIDUAL, AS DEFINED IN SECTION THREE
THOUSAND THREE HUNDRED NINETY-EIGHT-A OF THIS  CHAPTER,  THE  PHARMACIST
SHALL  PROVIDE FOR TRANSLATION OR OTHER LANGUAGE SERVICES AS REQUIRED IN
SECTION THREE THOUSAND THREE HUNDRED  NINETY-EIGHT-A  OF  THIS  CHAPTER,
UNLESS DOING SO WOULD COMPROMISE THE CARE OF THE PATIENT.
  S  14.    Subdivision  1  of section 3338 of the public health law, as
amended by section 12 of part A of chapter 58 of the laws  of  2004,  is
amended to read as follows:
  1.  Official  New  York state prescription forms shall be prepared and
issued by the department in the FORMAT, manner and detail as the commis-
sioner in consultation with the commissioner of education may, by  regu-
lation, require, and, each form shall be serialized. Such forms shall be
furnished to practitioners authorized to write such prescriptions and to
institutional  dispensers.  Such prescription blanks shall not be trans-
ferable.
  S 15. Subdivision b of section 6804 of the education law, as added  by
chapter 987 of the laws of 1971, is amended to read as follows:
  b. To regulate and control the sale, distribution, character and stan-
dard of drugs, poisons, cosmetics, devices and new drugs, INCLUDING, BUT
NOT  LIMITED  TO,  IN  CONJUNCTION  WITH THE COMMISSIONER OF HEALTH, THE
DEVELOPMENT OF REQUIREMENTS  RELATED  TO  THE  SALE,  DISTRIBUTION,  AND
DISPENSING  OF  DRUGS  AND  NEW  DRUGS  TO  ADDRESS THE SPECIAL NEEDS OF
PERSONS WHO ARE ELDERLY, OF LIMITED VISION OR OF LIMITED ENGLISH  PROFI-
CIENCY,
  S 16. Section 6810 of the education law is amended by adding three new
subdivisions 10, 11 and 12 to read as follows:
  10.  COVERED  PHARMACIES,  AS  DEFINED IN SECTION THREE THOUSAND THREE
HUNDRED NINETY-EIGHT-A OF THE PUBLIC HEALTH  LAW,  MUST  PROVIDE  TRANS-
LATION  AND  INTERPRETATION  SERVICES FOR PATIENTS HAVING LIMITED PROFI-
CIENCY IN ENGLISH, SUBJECT TO REGULATIONS OF THE  COMMISSIONER  AND  THE
PROVISIONS OF SECTION THREE THOUSAND THREE HUNDRED NINETY-EIGHT-A OF THE
PUBLIC HEALTH LAW.
  11.  IF  THE  PATIENT  IS  LIMITED  ENGLISH  PROFICIENT, AS DEFINED IN
SECTION THREE THOUSAND THREE HUNDRED NINETY-EIGHT-A OF THE PUBLIC HEALTH

S. 6256--B                         26                         A. 9056--B

LAW, INDICATION OF SUCH STATUS AND INDICATION OF THE  PATIENT'S  PRIMARY
LANGUAGE.
  12.  IF THE PHARMACIST KNOWS OR HAS REASON TO KNOW THAT THE PATIENT IS
OF LIMITED ENGLISH PROFICIENCY, AS DEFINED  IN  SECTION  THREE  THOUSAND
THREE  HUNDRED  NINETY-EIGHT-A  OF THE PUBLIC HEALTH LAW, THE PHARMACIST
SHALL PROVIDE FOR TRANSLATION OR OTHER LANGUAGE SERVICES AS REQUIRED  IN
SUCH SECTION, UNLESS DOING SO WOULD COMPROMISE THE CARE OF THE PATIENT.
  S 17. The public health law is amended by adding a new article 33-B to
read as follows:
                              ARTICLE 33-B
                 STANDARDS FOR PRESCRIPTION MEDICATIONS
SECTION 3398.   APPLICATION.
        3398-A. INTERPRETATION REQUIREMENTS FOR PRESCRIPTION DRUGS.
  S 3398. APPLICATION. THIS ARTICLE APPLIES TO MEDICATIONS PRESCRIBED BY
PRACTITIONERS  AUTHORIZED  TO  PRESCRIBE  MEDICATIONS, INCLUDING BUT NOT
LIMITED TO CONTROLLED SUBSTANCES, PURSUANT TO TITLE EIGHT OF THE  EDUCA-
TION  LAW;  PROVIDED,  HOWEVER, THAT TO THE EXTENT THERE IS ANY CONFLICT
BETWEEN THE PROVISIONS OF THIS ARTICLE AND  THE  PROVISIONS  OF  ARTICLE
THIRTY-THREE  OF THIS TITLE WITH RESPECT TO PRESCRIPTIONS FOR CONTROLLED
SUBSTANCES, THE PROVISIONS OF ARTICLE THIRTY-THREE OF THIS  TITLE  SHALL
CONTROL.
  S  3398-A. INTERPRETATION REQUIREMENTS FOR PRESCRIPTION DRUGS.  1. FOR
THE PURPOSES OF THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOW-
ING MEANINGS:
  (A) "COVERED PHARMACY" MEANS ANY PHARMACY THAT IS PART OF A  GROUP  OF
FIVE  OR MORE PHARMACIES OWNED BY THE SAME CORPORATE ENTITY, OR WHICH IS
A MAIL ORDER PHARMACY.  FOR PURPOSES OF THIS SECTION, "CORPORATE ENTITY"
SHALL INCLUDE RELATED SUBSIDIARIES, AFFILIATES, SUCCESSORS, OR ASSIGNEES
DOING BUSINESS AS OR OPERATING UNDER A COMMON NAME OR TRADING SYMBOL;
  (B) "LIMITED ENGLISH PROFICIENT INDIVIDUAL" OR "LEP INDIVIDUAL"  MEANS
AN INDIVIDUAL WHO IDENTIFIES AS BEING, OR IS EVIDENTLY, UNABLE TO SPEAK,
READ  OR WRITE ENGLISH AT A LEVEL THAT PERMITS SUCH INDIVIDUAL TO UNDER-
STAND HEALTH RELATED  AND  PHARMACEUTICAL  INFORMATION  COMMUNICATED  IN
ENGLISH;
  (C)"TRANSLATE"  SHALL  MEAN  THE CONVERSION OF A WRITTEN TEXT FROM ONE
LANGUAGE INTO AN EQUIVALENT WRITTEN TEXT IN ANOTHER LANGUAGE BY AN INDI-
VIDUAL COMPETENT TO DO SO AND UTILIZING ALL NECESSARY PHARMACEUTICAL AND
HEALTH-RELATED TERMINOLOGY;
  (D) "COMPETENT ORAL INTERPRETATION" MEANS ORAL COMMUNICATION IN  WHICH
A  PERSON  ACTING  AS  AN  INTERPRETER  COMPREHENDS A SPOKEN MESSAGE AND
RE-EXPRESSES THAT MESSAGE ACCURATELY IN ANOTHER LANGUAGE, UTILIZING  ALL
NECESSARY PHARMACEUTICAL AND HEALTH-RELATED TERMINOLOGY, SO AS TO ENABLE
AN  LEP INDIVIDUAL TO RECEIVE ALL NECESSARY INFORMATION IN THE LEP INDI-
VIDUAL'S PRIMARY LANGUAGE;
  (E) "PHARMACY PRIMARY LANGUAGES" SHALL MEAN THE  TOP  SEVEN  LANGUAGES
SPOKEN  BY LEP INDIVIDUALS IN THIS STATE AS DETERMINED BIENNIALLY BY THE
STATE BOARD OF PHARMACY BASED ON DATA  FROM  THE  MOST  RECENT  AMERICAN
COMMUNITY SURVEY FROM THE UNITED STATES CENSUS BUREAU AND OTHER RELEVANT
DATA SOURCES;
  (F) "MAIL ORDER PHARMACY" SHALL MEAN A PHARMACY THAT DISPENSES MOST OF
ITS  PRESCRIPTIONS  THROUGH  THE  UNITED  STATES POSTAL SERVICE OR OTHER
DELIVERY SERVICES.
  2. (A) EVERY COVERED PHARMACY SHALL PROVIDE FREE, COMPETENT  ORAL  AND
WRITTEN  INTERPRETATION  SERVICES,  TO  EACH  LEP  INDIVIDUAL  FILLING A
PRESCRIPTION AT OR THROUGH SUCH COVERED PHARMACY, IN  THE  LEP  INDIVID-
UAL'S  PRIMARY  LANGUAGE  FOR  THE PURPOSE OF COUNSELING SUCH INDIVIDUAL

S. 6256--B                         27                         A. 9056--B

ABOUT HIS OR HER PRESCRIPTION MEDICATIONS AND INTERPRETING LABEL  INFOR-
MATION,  OR  WHEN SOLICITING INFORMATION NECESSARY TO MAINTAIN A PATIENT
MEDICATION PROFILE, UNLESS THE LEP INDIVIDUAL  IS  OFFERED  AND  REFUSES
SUCH SERVICES;
  (B)  EVERY  COVERED PHARMACY SHALL PROVIDE FREE, COMPETENT ORAL INTER-
PRETATION OF PRESCRIPTION MEDICATION LABELS, WARNING  LABELS  AND  OTHER
WRITTEN  MATERIAL  TO  EACH  LEP INDIVIDUAL FILLING A PRESCRIPTION AT OR
THROUGH SUCH COVERED PHARMACY UNLESS THE LEP INDIVIDUAL IS  OFFERED  AND
REFUSES  SUCH SERVICES, OR THE MEDICATION LABEL WARNING LABELS AND OTHER
WRITTEN MATERIALS HAVE ALREADY BEEN TRANSLATED INTO THE LANGUAGE  SPOKEN
BY THE LEP INDIVIDUAL;
  (C)  THE  SERVICES REQUIRED BY THIS SECTION MAY BE PROVIDED BY A STAFF
MEMBER OF  THE  COVERED  PHARMACY  OR  A  THIRD-PARTY  CONTRACTOR.  SUCH
SERVICES MUST BE PROVIDED ON AN IMMEDIATE BASIS BUT NEED NOT BE PROVIDED
IN-PERSON OR FACE-TO-FACE.
  3.  EVERY COVERED PHARMACY SHALL CONSPICUOUSLY POST, AT OR ADJACENT TO
EACH COUNTER OVER WHICH PRESCRIPTION DRUGS  ARE  SOLD,  AND  EVERY  MAIL
ORDER PHARMACY, SHALL INCLUDE IN THE PACKAGE IN WHICH PRESCRIPTION DRUGS
ARE  DELIVERED,  A NOTIFICATION OF THE RIGHT TO FREE LANGUAGE ASSISTANCE
SERVICES FOR LEP INDIVIDUALS AS PROVIDED FOR IN SUBDIVISION TWO OF  THIS
SECTION.  SUCH  NOTIFICATIONS  SHALL BE PROVIDED IN THE PHARMACY PRIMARY
LANGUAGES. THE SIZE, STYLE AND PLACEMENT OF SUCH NOTICE SHALL BE  DETER-
MINED IN ACCORDANCE WITH RULES PROMULGATED BY THE COMMISSIONER.
  4.  ANY  PERSON AGGRIEVED BY A FAILURE TO RECEIVE SERVICES REQUIRED BY
THIS SECTION SHALL HAVE A CAUSE OF ACTION ONLY AGAINST THE COVERED PHAR-
MACY IN ANY COURT OF COMPETENT JURISDICTION FOR DAMAGES, INCLUDING PUNI-
TIVE DAMAGES, AND FOR INJUNCTIVE RELIEF AND SUCH OTHER REMEDIES  AS  MAY
BE APPROPRIATE.
  5.  THIS  SECTION  SHALL  PREEMPT ANY CONTRARY LOCAL LAW OR ORDINANCE,
EXCEPT THAT THIS SECTION SHALL NOT PREEMPT OR SUPERSEDE  LOCAL  LAWS  OR
ORDINANCES  IMPOSING  ADDITIONAL  OR  STRICTER  REQUIREMENTS RELATING TO
INTERPRETATION OR TRANSLATION SERVICES IN PHARMACIES.
  S 18. Section 6509 of the education law is amended  by  adding  a  new
subdivision 15 to read as follows:
  (15)  A  VIOLATION OF SUBDIVISION TWO OR THREE OF SECTION THIRTY-THREE
HUNDRED NINETY-EIGHT-A OF THE PUBLIC HEALTH LAW, BUT ONLY AS TO A  PHAR-
MACY AND NOT AS TO AN INDIVIDUAL LICENSED PHARMACIST.
  S  19.   Subdivisions (f) and (g) of section 2522 of the public health
law, as amended by chapter 484 of the laws of 2009, are  amended  and  a
new subdivision (h) is added to read as follows:
  (f)  follow-up  of  patient  participation  in prenatal care services;
[and]
  (g) identification of regional perinatal health care  system  barriers
and  limitations that lead to poor perinatal outcomes and development of
strategies to address such barriers and limitations[.]; AND
  (H) COORDINATION OF SERVICE DELIVERY BY COMMUNITY-BASED  ORGANIZATIONS
AMONG  HEALTH  CARE  PROVIDERS AND HEALTH PLANS USING HEALTH INFORMATION
TECHNOLOGY AND UNIFORM SCREENING CRITERIA FOR PERINATAL RISK.
  S 20. Intentionally Omitted.
  S 21. Intentionally Omitted.
  S 22. Section 366 of the social services law is amended  by  adding  a
new subdivision 15 to read as follows:
  15.  (A)  THE  COMMISSIONER  MAY CONTRACT WITH ONE OR MORE ENTITIES TO
ENGAGE IN  EDUCATION,  OUTREACH  SERVICES,  AND  FACILITATED  ENROLLMENT
ACTIVITIES FOR AGED, BLIND, AND DISABLED PERSONS WHO MAY BE ELIGIBLE FOR
COVERAGE UNDER THIS TITLE.

S. 6256--B                         28                         A. 9056--B

  (B) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTIONS
ONE HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVEL-
OPMENT  LAW, OR ANY OTHER CONTRARY PROVISION OF LAW, THE COMMISSIONER IS
AUTHORIZED  TO ENTER INTO A CONTRACT OR CONTRACTS UNDER THIS SUBDIVISION
WITHOUT A COMPETITIVE BID OR REQUEST  FOR  PROPOSAL  PROCESS,  PROVIDED,
HOWEVER, THAT:
  (I)  THE DEPARTMENT SHALL POST ON ITS WEBSITE, FOR A PERIOD OF NO LESS
THAN THIRTY DAYS:
  (1) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACT OR CONTRACTS;
  (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (3)  THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY SEEK
SELECTION, WHICH SHALL BE NO LESS THAN THIRTY DAYS AFTER  SUCH  INFORMA-
TION IS FIRST POSTED ON THE WEBSITE; AND
  (4)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (II) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONER; AND
  (III) THE COMMISSIONER SHALL SELECT  SUCH  CONTRACTOR  OR  CONTRACTORS
THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE PURPOSES OF
THIS SUBDIVISION.
  S  23. The public health law is amended by adding a new article 9-B to
read as follows:
                                ARTICLE 9-B
         PRIMARY CARE SERVICE CORPS PRACTITIONER LOAN REPAYMENT
                                 PROGRAM
SECTION 923. DEFINITIONS.
        924. PRIMARY CARE  SERVICE  CORPS  PRACTITIONER  LOAN  REPAYMENT
        PROGRAM.
  S  923.  DEFINITIONS.   THE FOLLOWING WORDS OR PHRASES AS USED IN THIS
SECTION SHALL HAVE THE FOLLOWING MEANINGS:
  1. "UNDERSERVED AREA" MEANS AN AREA  OR  MEDICALLY  UNDERSERVED  POPU-
LATION  DESIGNATED  BY  THE COMMISSIONER AS HAVING A SHORTAGE OF PRIMARY
CARE PHYSICIANS, OTHER PRIMARY CARE PRACTITIONERS, DENTAL  PRACTITIONERS
OR MENTAL HEALTH PRACTITIONERS.
  2. "PRIMARY CARE SERVICE CORPS PRACTITIONER" MEANS A PHYSICIAN ASSIST-
ANT,  NURSE  PRACTITIONER, NURSE MIDWIFE, GENERAL OR PEDODONTIC DENTIST,
DENTAL HYGIENIST, CLINICAL PSYCHOLOGIST, LICENSED CLINICAL SOCIAL  WORK-
ER,  PSYCHIATRIC NURSE PRACTITIONER, LICENSED MARRIAGE AND FAMILY THERA-
PIST, OR A LICENSED MENTAL HEALTH COUNSELOR,  WHO  IS  LICENSED,  REGIS-
TERED,  OR  CERTIFIED  TO  PRACTICE  IN  NEW YORK STATE AND WHO PROVIDES
COORDINATED PRIMARY CARE SERVICES, INCLUDING, BUT NOT LIMITED  TO,  ORAL
HEALTH AND MENTAL HEALTH SERVICES.
  3.  "PHYSICIAN  ASSISTANT"  MEANS  A PERSON WHO HAS BEEN REGISTERED AS
SUCH PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE-B OF THE EDUCATION LAW.
  4. "NURSE PRACTITIONER" MEANS A PERSON WHO HAS BEEN CERTIFIED AS  SUCH
PURSUANT TO SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW.
  5. "NURSE MIDWIFE" MEANS A PERSON WHO HAS BEEN LICENSED AS SUCH PURSU-
ANT TO SECTION SIXTY-NINE HUNDRED FIFTY-FIVE OF THE EDUCATION LAW.
  6.  "PSYCHOLOGIST" MEANS A PERSON WHO HAS BEEN LICENSED AS SUCH PURSU-
ANT TO SECTION SEVENTY-SIX HUNDRED THREE OF THE EDUCATION LAW.
  7. "LICENSED CLINICAL SOCIAL WORKER"  MEANS  A  PERSON  WHO  HAS  BEEN
LICENSED  AS  SUCH  PURSUANT TO SECTION SEVENTY-SEVEN HUNDRED TWO OF THE
EDUCATION LAW.

S. 6256--B                         29                         A. 9056--B

  8. "PSYCHIATRIC NURSE PRACTITIONER" MEANS A NURSE PRACTITIONER WHO, BY
REASON OF TRAINING AND EXPERIENCE, PROVIDES A FULL SPECTRUM OF PSYCHIAT-
RIC CARE, ASSESSING, DIAGNOSING, AND MANAGING THE PREVENTION AND  TREAT-
MENT OF PSYCHIATRIC DISORDERS AND MENTAL HEALTH PROBLEMS.
  9.  "LICENSED  MARRIAGE  AND  FAMILY THERAPIST" MEANS A PERSON WHO HAS
BEEN LICENSED AS SUCH PURSUANT TO SECTION EIGHTY-FOUR HUNDRED  THREE  OF
THE EDUCATION LAW.
  10.  "LICENSED  MENTAL  HEALTH  COUNSELOR" MEANS A PERSON WHO HAS BEEN
LICENSED AS SUCH PURSUANT TO SECTION  EIGHTY-FOUR  HUNDRED  TWO  OF  THE
EDUCATION LAW.
  11.  "GENERAL  OR  PEDODONTIC  DENTIST"  MEANS  A  PERSON WHO HAS BEEN
LICENSED OR OTHERWISE AUTHORIZED TO PRACTICE DENTISTRY PURSUANT TO ARTI-
CLE ONE HUNDRED THIRTY-THREE OF THE EDUCATION  LAW  EXCLUDING  ORTHODON-
TISTS, ENDODONTISTS AND PERIODONTISTS.
  12.  "DENTAL  HYGIENIST"  MEANS  A  PERSON WHO IS LICENSED TO PRACTICE
DENTAL HYGIENE PURSUANT TO SECTION SIXTY-SIX HUNDRED NINE OF THE  EDUCA-
TION LAW.
  S 924. PRIMARY CARE SERVICE CORPS PRACTITIONER LOAN REPAYMENT PROGRAM.
1. THE COMMISSIONER IS AUTHORIZED, WITHIN AMOUNTS AVAILABLE THEREFOR, TO
MAKE  LOAN REPAYMENT AWARDS TO ELIGIBLE PRIMARY CARE SERVICE CORPS PRAC-
TITIONERS WHO AGREE TO PRACTICE FULL-TIME IN AN UNDERSERVED AREA IN  NEW
YORK  STATE, IN AMOUNTS TO BE DETERMINED BY THE COMMISSIONER, BUT NOT TO
EXCEED THIRTY-TWO THOUSAND DOLLARS PER YEAR FOR ANY YEAR IN  WHICH  SUCH
PRACTITIONERS PROVIDE FULL-TIME ELIGIBLE OBLIGATED SERVICE.
  2.  LOAN REPAYMENT AWARDS MADE TO A PRIMARY CARE SERVICE CORPS PRACTI-
TIONER PURSUANT TO SUBDIVISION ONE OF THIS SECTION SHALL NOT EXCEED  THE
TOTAL QUALIFYING OUTSTANDING DEBT OF THE PRACTITIONER FROM STUDENT LOANS
TO  COVER  TUITION  AND  OTHER  RELATED EDUCATIONAL EXPENSES, MADE BY OR
GUARANTEED BY THE FEDERAL OR STATE GOVERNMENT, OR MADE BY A  LENDING  OR
EDUCATIONAL  INSTITUTION  APPROVED  UNDER TITLE IV OF THE FEDERAL HIGHER
EDUCATION ACT. LOAN REPAYMENT AWARDS SHALL BE USED SOLELY TO REPAY  SUCH
OUTSTANDING DEBT.
  3.  IN  THE EVENT THAT ANY COMMITMENT PURSUANT TO THE AGREEMENT REFER-
ENCED IN SUBDIVISION ONE OF THIS SECTION IS NOT FULFILLED, THE RECIPIENT
SHALL BE RESPONSIBLE FOR REPAYMENT IN AMOUNTS WHICH SHALL BE  CALCULATED
IN  ACCORDANCE  WITH THE FORMULA SET FORTH IN SUBDIVISION (B) OF SECTION
TWO HUNDRED FIFTY-FOUR-O OF TITLE FORTY-TWO OF THE UNITED  STATES  CODE,
AS AMENDED.
  4.  THE  COMMISSIONER  IS  AUTHORIZED TO APPLY ANY FUNDS AVAILABLE FOR
PURPOSES OF SUBDIVISION ONE OF THIS SECTION FOR USE  AS  MATCHING  FUNDS
FOR  ANY AVAILABLE FEDERAL GRANTS FOR THE PURPOSE OF ASSISTING STATES IN
OPERATING LOAN REPAYMENT PROGRAMS.
  5. THE COMMISSIONER MAY POSTPONE, CHANGE OR WAIVE  THE  SERVICE  OBLI-
GATION AND REPAYMENTS AMOUNTS SET FORTH IN SUBDIVISIONS ONE AND THREE OF
THIS  SECTION,  RESPECTIVELY, IN INDIVIDUAL CIRCUMSTANCES WHERE THERE IS
COMPELLING NEED OR HARDSHIP.
  6. IN ORDER TO BE ELIGIBLE TO RECEIVE A  LOAN  REPAYMENT  AWARD  UNDER
THIS  SECTION,  A PRIMARY CARE SERVICE CORPS PRACTITIONER MUST MEET SITE
AND SERVICE ELIGIBILITY CRITERIA AS DETERMINED BY THE COMMISSIONER.
  7. THE COMMISSIONER SHALL PROMULGATE REGULATIONS NECESSARY TO EFFECTU-
ATE THE PROVISIONS AND PURPOSES OF THIS ARTICLE.
  S 24.  Paragraph (a) of subdivision 4 of section 2801-a of the  public
health law, as amended by section 57 of part A of chapter 58 of the laws
of 2010, is amended to read as follows:
  (a)  Any  change in the person who is the operator of a hospital shall
be approved by the public health and health planning council in  accord-

S. 6256--B                         30                         A. 9056--B

ance  with the provisions of subdivisions two and three of this section.
NO CHANGE IN THE DIRECTORS OF A NOT-FOR-PROFIT CORPORATION THAT  IS  THE
OPERATOR  OF  A HOSPITAL SHALL BE EFFECTIVE UNLESS, AT LEAST ONE HUNDRED
TWENTY  DAYS  PRIOR  TO  THE INTENDED EFFECTIVE DATE THEREOF, THE CORPO-
RATION FULLY COMPLETES AND FILES WITH THE DEPARTMENT NOTICE ON  A  FORM,
TO BE DEVELOPED BY THE DEPARTMENT, WHICH SHALL DISCLOSE SUCH INFORMATION
AS  MAY  REASONABLY BE NECESSARY FOR THE DEPARTMENT TO DETERMINE WHETHER
IT SHOULD BAR THE CHANGE IN DIRECTORS. Notwithstanding any  inconsistent
provision  of  this paragraph, any change by a natural person who is the
operator of a hospital seeking to transfer part of his or  her  interest
in such hospital to another person or persons so as to create a partner-
ship  shall  be  approved in accordance with the provisions of paragraph
(b) of this subdivision.
  S 25. Section 2806 of the public health law is amended by adding a new
subdivision 2-a to read as follows:
  2-A. (A) THE COMMISSIONER MAY TEMPORARILY SUSPEND OR LIMIT AN  OPERAT-
ING  CERTIFICATE OF A NOT-FOR-PROFIT CORPORATION WITHOUT A HEARING UPON:
(I) THE COMMENCEMENT BY THE DEPARTMENT OF AN ACTION TO REVOKE,  SUSPEND,
LIMIT  OR  ANNUL  THE OPERATING CERTIFICATE PURSUANT TO PARAGRAPH (A) OF
SUBDIVISION ONE OF THIS SECTION DUE TO REPEATED VIOLATIONS OF THIS ARTI-
CLE OR RULES AND REGULATIONS PROMULGATED THEREUNDER; (II) THE INDICTMENT
ON FELONY CHARGES OF ANY MEMBER OF THE CORPORATION'S BOARD OF  DIRECTORS
OR  (III)  NOTICE  FROM  THE ATTORNEY GENERAL OF AN ACTION TO REMOVE ANY
MEMBER OF THE CORPORATION'S BOARD OF DIRECTORS PURSUANT TO PARAGRAPH (D)
OF SECTION SEVEN HUNDRED SIX OF THE NOT-FOR-PROFIT CORPORATION LAW. SUCH
SUSPENSION OR LIMITATION  OF  THE  OPERATING  CERTIFICATE  SHALL  REMAIN
EFFECTIVE  UNTIL  THE  RESOLUTION  OF  THE  CRIMINAL  ACTION THAT IS THE
SUBJECT OF THE INDICTMENT OR UNTIL THE RESOLUTION OF THE ACTION  OF  THE
ATTORNEY GENERAL, AS APPLICABLE.
  (B)  IN  THE  EVENT  ONE  OR MORE MEMBERS OF A BOARD OF DIRECTORS OF A
NOT-FOR-PROFIT CORPORATION ARE THE SUBJECT OF  AN  ACTION  TO  LIMIT  AN
OPERATING  CERTIFICATE  PURSUANT  TO PARAGRAPH (A) OF SUBDIVISION ONE OF
THIS SECTION, HAVE BEEN INDICTED ON FELONY CHARGES, OR ARE  THE  SUBJECT
OF  AN  ACTION FOR REMOVAL BY THE ATTORNEY GENERAL AS DESCRIBED IN PARA-
GRAPH (A) OF THIS SUBDIVISION, THE COMMISSIONER MAY, IN ADDITION TO  HIS
OR  HER  OTHER  POWERS, LIMIT THE EXISTING OPERATING CERTIFICATE OF SUCH
CORPORATION SO THAT IT SHALL APPLY ONLY TO THE REMAINING MEMBERS OF  THE
BOARD  OF  DIRECTORS  PROVIDED THAT: (I) EVERY SUCH PERSON SUBJECT TO AN
ACTION TO LIMIT THE OPERATING CERTIFICATE PURSUANT TO PARAGRAPH  (A)  OF
SUBDIVISION  ONE  OF  THIS SECTION, EVERY SUCH INDICTED PERSON, OR EVERY
SUCH PERSON SUBJECT TO AN  ACTION  FOR  REMOVAL  SHALL  IMMEDIATELY  AND
COMPLETELY  CEASE  AND  WITHDRAW FROM PARTICIPATION, IN ANY CAPACITY, IN
THE MANAGEMENT, GOVERNANCE OR OPERATION OF THE HOSPITAL;  AND  (II)  THE
COMMISSIONER HAS FOUND THAT THE REMAINING MEMBERS OF THE BOARD OF DIREC-
TORS ARE OF SUCH CHARACTER, EXPERIENCE, COMPETENCE AND STANDING SO AS TO
GIVE REASONABLE ASSURANCE OF THEIR ABILITY TO CONDUCT THE AFFAIRS OF THE
CORPORATION  IN  ITS  BEST  INTERESTS AND IN THE PUBLIC INTEREST. IF THE
CONDITIONS SET FORTH IN SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH ARE
NOT MET, OR IF THE LIMITATION OF THE OPERATING  CERTIFICATE  UNDER  THIS
PARAGRAPH  RESULTS  IN  A BOARD OF DIRECTORS OF LESS THAN THREE MEMBERS,
THE COMMISSIONER SHALL TEMPORARILY  SUSPEND  THE  OPERATING  CERTIFICATE
PURSUANT TO PARAGRAPH (A) OF THIS SUBDIVISION.
  (C)  NOTWITHSTANDING PARAGRAPHS (A) AND (B) OF THIS SUBDIVISION, WHERE
THE COMMISSIONER HAS FOUND THAT THE SUSPENSION OF A  HOSPITAL  OPERATING
CERTIFICATE  PURSUANT  TO  THIS  SECTION  WOULD  JEOPARDIZE  EXISTING OR
CONTINUED ACCESS TO NECESSARY SERVICES WITHIN THE COMMUNITY, THE COMMIS-

S. 6256--B                         31                         A. 9056--B

SIONER MAY APPOINT TEMPORARY MEMBERS OF THE BOARD OF DIRECTORS TO  OPER-
ATE  AND  MANAGE  THE HOSPITAL UNDER THE EXISTING OPERATING CERTIFICATE,
UNTIL THE RESOLUTION OF THE CRIMINAL ACTION, ATTORNEY GENERAL ACTION  OR
ACTION BY THE DEPARTMENT DESCRIBED IN PARAGRAPH (A) OF THIS SUBDIVISION,
AS APPLICABLE.
  S  26.  Paragraphs (a) and (b) of subdivision 5 of section 2806 of the
public health law, paragraph (a) as amended by section 20 of part LL  of
chapter  56  of the laws of 2010 and paragraph (b) as amended by chapter
607 of the laws of 1981, are amended to read as follows:
  (a) Except as provided in paragraphs (b) and (d) of this  subdivision,
anything  contained  in  this section or in a certificate of relief from
disabilities or a certificate of good conduct issued pursuant to article
twenty-three of the correction law to the  contrary  notwithstanding,  a
hospital operating certificate of a hospital under control of a control-
ling person as defined in paragraph (a) of subdivision twelve of section
twenty-eight  hundred  one-a  of  this  article, or under control of any
other entity, shall be revoked upon a finding  by  the  department  that
such  controlling  person  or  any  individual, member of a partnership,
MEMBER OF A LIMITED LIABILITY COMPANY, MEMBER OF A BOARD  OF  DIRECTORS,
or shareholder of a corporation to whom or to which an operating certif-
icate  has  been issued, has been convicted of a class A, B or C felony,
or a felony related in any way to any activity or program subject to the
regulations, supervision, or administration of the department or of  the
office  of  temporary  and  disability assistance or in violation of the
public officers law in a court of competent jurisdiction in  the  state,
or  of  a  crime outside the state which, if committed within the state,
would have been a class A, B or C felony or a felony related in any  way
to  any  activity or program subject to the regulations, supervision, or
administration of the department or of the office of temporary and disa-
bility assistance or in violation of the public officers law.
  (b) In the event one or more members of a  partnership,  MEMBER  OF  A
LIMITED LIABILITY COMPANY, MEMBER OF A BOARD OF DIRECTORS, or sharehold-
ers  of a corporation shall have been convicted of a felony as described
in paragraph (a) of this subdivision, the commissioner shall,  in  addi-
tion  to  his  other powers, limit the existing operating certificate of
such partnership or corporation so that  it  shall  apply  only  to  the
remaining  partner,  MEMBER  OF A LIMITED LIABILITY COMPANY, MEMBER OF A
BOARD OF DIRECTORS, or shareholders, as the case may be,  provided  that
every  such convicted person immediately and completely ceases and with-
draws from participation, IN ANY CAPACITY, in the management and  opera-
tion  of  the  hospital,  and  further  provided that an application for
approval of change of ownership, CHANGE OF BOARD MEMBERSHIP, or transfer
of stock is  filed  without  delay  in  accordance  with  the  pertinent
provisions of section twenty-eight hundred one-a of this [chapter] ARTI-
CLE.
  S  27. The public health law is amended by adding a new section 2806-a
to read as follows:
  S 2806-A. TEMPORARY OPERATOR. 1. FOR THE  PURPOSES  OF  THIS  SECTION:
(A)  THE TERM "ADULT CARE FACILITY" SHALL MEAN AN ADULT HOME OR ENRICHED
HOUSING PROGRAM  LICENSED  PURSUANT  TO  ARTICLE  SEVEN  OF  THE  SOCIAL
SERVICES  LAW OR AN ASSISTED LIVING RESIDENCE LICENSED PURSUANT TO ARTI-
CLE FORTY-SIX-B OF THIS CHAPTER; (B)  THE  TERM  "ESTABLISHED  OPERATOR"
SHALL MEAN THE OPERATOR OF AN ADULT CARE FACILITY, A GENERAL HOSPITAL OR
A  DIAGNOSTIC  AND TREATMENT CENTER THAT HAS BEEN ESTABLISHED AND ISSUED
AN OPERATING CERTIFICATE AS SUCH PURSUANT TO THIS ARTICLE; (C) THE  TERM
"FACILITY"  SHALL MEAN (I) A GENERAL HOSPITAL OR A DIAGNOSTIC AND TREAT-

S. 6256--B                         32                         A. 9056--B

MENT CENTER THAT HAS BEEN ISSUED AN OPERATING CERTIFICATE AS SUCH PURSU-
ANT TO THIS ARTICLE; OR (II) AN ADULT CARE FACILITY; AND  (D)  THE  TERM
"TEMPORARY OPERATOR" SHALL MEAN ANY PERSON OR ENTITY THAT:
  (I)  AGREES  TO  OPERATE  A  FACILITY ON A TEMPORARY BASIS IN THE BEST
INTERESTS OF ITS RESIDENTS OR PATIENTS AND THE COMMUNITY SERVED  BY  THE
FACILITY; AND
  (II) HAS DEMONSTRATED THAT HE OR SHE HAS THE CHARACTER, COMPETENCE AND
FINANCIAL  ABILITY TO OPERATE THE FACILITY IN COMPLIANCE WITH APPLICABLE
STANDARDS.
  2. (A) WHEN A STATEMENT OF DEFICIENCIES HAS BEEN ISSUED BY THE DEPART-
MENT AND UPON A DETERMINATION  BY  THE  COMMISSIONER  THAT  THERE  EXIST
SIGNIFICANT  MANAGEMENT  FAILURES, INCLUDING BUT NOT LIMITED TO ADMINIS-
TRATIVE, OPERATIONAL OR CLINICAL DEFICIENCIES OR FINANCIAL  INSTABILITY,
IN  A FACILITY THAT (I) SERIOUSLY ENDANGER THE LIFE, HEALTH OR SAFETY OF
RESIDENTS OR PATIENTS OR (II) JEOPARDIZE EXISTING OR CONTINUED ACCESS TO
NECESSARY SERVICES WITHIN THE COMMUNITY,  HE  OR  SHE  SHALL  APPOINT  A
TEMPORARY  OPERATOR  TO ASSUME SOLE CONTROL OVER AND SOLE RESPONSIBILITY
FOR THE OPERATIONS OF THAT FACILITY.   THE APPOINTMENT  OF  A  TEMPORARY
OPERATOR SHALL BE IN ADDITION TO ANY OTHER REMEDIES PROVIDED BY LAW.
  (B) THE ESTABLISHED OPERATOR OF A FACILITY MAY AT ANY TIME REQUEST THE
COMMISSIONER  TO  APPOINT  A  TEMPORARY  OPERATOR. UPON RECEIVING SUCH A
REQUEST, THE COMMISSIONER MAY, IF HE OR  SHE  DETERMINES  THAT  SUCH  AN
ACTION IS NECESSARY TO RESTORE OR MAINTAIN THE PROVISION OF QUALITY CARE
TO  THE  RESIDENTS  OR PATIENTS, ENTER INTO AN AGREEMENT WITH THE ESTAB-
LISHED OPERATOR FOR THE APPOINTMENT OF A TEMPORARY  OPERATOR  TO  ASSUME
SOLE  CONTROL  OVER  AND  SOLE RESPONSIBILITY FOR THE OPERATIONS OF THAT
FACILITY.
  3. A TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION  SHALL  USE
HIS  OR  HER  BEST  EFFORTS  TO  CORRECT  OR ELIMINATE ANY DEFICIENCIES,
MANAGEMENT FAILURES OR FINANCIAL INSTABILITY  IN  THE  FACILITY  AND  TO
PROMOTE  THE  QUALITY  AND  ACCESSIBILITY OF HEALTH CARE SERVICES IN THE
COMMUNITY SERVED BY THE FACILITY.  SUCH  CORRECTION  OR  ELIMINATION  OF
DEFICIENCIES,  MANAGEMENT  FAILURES  OR  FINANCIAL INSTABILITY SHALL NOT
INCLUDE MAJOR ALTERATIONS OF THE PHYSICAL  STRUCTURE  OF  THE  FACILITY.
DURING  THE TERM OF HIS OR HER APPOINTMENT, THE TEMPORARY OPERATOR SHALL
HAVE THE AUTHORITY TO DIRECT THE  MANAGEMENT  OF  THE  FACILITY  IN  ALL
ASPECTS  OF  OPERATION AND SHALL BE AFFORDED FULL ACCESS TO THE ACCOUNTS
AND RECORDS OF THE FACILITY. THE TEMPORARY OPERATOR SHALL,  DURING  THIS
PERIOD,  OPERATE  THE FACILITY IN SUCH A MANNER AS TO PROMOTE SAFETY AND
TO PROMOTE THE QUALITY AND ACCESSIBILITY  OF  HEALTH  CARE  SERVICES  OR
RESIDENTIAL  CARE IN THE COMMUNITY SERVED BY THE FACILITY. THE TEMPORARY
OPERATOR SHALL HAVE  THE  POWER  TO  LET  CONTRACTS  THEREFOR  OR  INCUR
EXPENSES ON BEHALF OF THE FACILITY, PROVIDED THAT WHERE INDIVIDUAL ITEMS
OF  REPAIRS,  IMPROVEMENTS  OR SUPPLIES EXCEED TEN THOUSAND DOLLARS, THE
TEMPORARY OPERATOR SHALL OBTAIN PRICE QUOTATIONS  FROM  AT  LEAST  THREE
REPUTABLE  SOURCES. THE TEMPORARY OPERATOR SHALL NOT BE REQUIRED TO FILE
ANY BOND. NO SECURITY INTEREST IN ANY REAL OR PERSONAL PROPERTY COMPRIS-
ING THE FACILITY OR CONTAINED WITHIN THE FACILITY, OR IN ANY FIXTURE  OF
THE  FACILITY, SHALL BE IMPAIRED OR DIMINISHED IN PRIORITY BY THE TEMPO-
RARY OPERATOR. NEITHER THE TEMPORARY OPERATOR NOR THE  DEPARTMENT  SHALL
ENGAGE IN ANY ACTIVITY THAT CONSTITUTES A CONFISCATION OF PROPERTY WITH-
OUT THE PAYMENT OF FAIR COMPENSATION.
  4.  THE  TEMPORARY  OPERATOR SHALL BE ENTITLED TO A REASONABLE FEE, AS
DETERMINED BY THE COMMISSIONER, AND NECESSARY EXPENSES  INCURRED  DURING
HIS OR HER PERFORMANCE AS TEMPORARY OPERATOR, TO BE PAID FROM THE REVEN-
UE  OF  THE  FACILITY.    THE  TEMPORARY OPERATOR SHALL COLLECT INCOMING

S. 6256--B                         33                         A. 9056--B

PAYMENTS FROM ALL SOURCES AND APPLY THEM FIRST TO THE REASONABLE FEE AND
TO COSTS INCURRED IN THE PERFORMANCE OF HIS OR HER FUNCTIONS  AS  TEMPO-
RARY OPERATOR. THE TEMPORARY OPERATOR SHALL BE LIABLE ONLY IN HIS OR HER
CAPACITY  AS  TEMPORARY  OPERATOR  FOR  INJURY TO PERSON AND PROPERTY BY
REASON OF CONDITIONS OF THE FACILITY IN  A  CASE  WHERE  AN  ESTABLISHED
OPERATOR  WOULD HAVE BEEN LIABLE; HE OR SHE SHALL NOT HAVE ANY LIABILITY
IN HIS OR HER PERSONAL CAPACITY, EXCEPT FOR GROSS NEGLIGENCE AND  INTEN-
TIONAL ACTS.
  5.  (A)  THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR
SHALL NOT EXCEED ONE HUNDRED EIGHTY DAYS. AFTER ONE HUNDRED EIGHTY DAYS,
IF THE COMMISSIONER DETERMINES THAT TERMINATION OF THE TEMPORARY  OPERA-
TOR  WOULD  CAUSE SIGNIFICANT DETERIORATION OF THE QUALITY OF, OR ACCESS
TO, HEALTH CARE OR RESIDENTIAL CARE IN THE COMMUNITY OR THAT  REAPPOINT-
MENT  IS  NECESSARY  TO  CORRECT THE DEFICIENCIES, MANAGEMENT FAILURE OR
FINANCIAL INSTABILITY THAT REQUIRED THE  APPOINTMENT  OF  THE  TEMPORARY
OPERATOR, THE COMMISSIONER MAY AUTHORIZE UP TO TWO ADDITIONAL NINETY DAY
TERMS.    WITHIN  FOURTEEN DAYS PRIOR TO THE TERMINATION OF EACH TERM OF
THE APPOINTMENT OF THE TEMPORARY OPERATOR, THE TEMPORARY OPERATOR  SHALL
SUBMIT  TO  THE  COMMISSIONER  AND  TO THE ESTABLISHED OPERATOR A REPORT
DESCRIBING THE ACTIONS TAKEN DURING  THE  APPOINTMENT  TO  ADDRESS  SUCH
DEFICIENCIES,  MANAGEMENT  FAILURES  AND/OR  FINANCIAL  INSTABILITY. THE
REPORT SHALL REFLECT  BEST  EFFORTS  TO  PRODUCE  A  FULL  AND  COMPLETE
ACCOUNTING.
  (B)  UPON  THE  COMPLETION  OF  THE TWO NINETY DAY TERMS REFERENCED IN
PARAGRAPH (A) OF THIS SUBDIVISION, IF THE COMMISSIONER  DETERMINES  THAT
TERMINATION  OF  THE  TEMPORARY OPERATOR WOULD CAUSE SIGNIFICANT DETERI-
ORATION OF THE QUALITY OF, OR ACCESS TO, HEALTH CARE OR RESIDENTIAL CARE
IN THE COMMUNITY OR THAT REAPPOINTMENT  IS  NECESSARY  TO  CONTINUE  THE
CORRECTION  OF  THE DEFICIENCIES, MANAGEMENT FAILURE OR FINANCIAL INSTA-
BILITY THAT REQUIRED THE APPOINTMENT  OF  THE  TEMPORARY  OPERATOR,  THE
COMMISSIONER  MAY REAPPOINT THE TEMPORARY OPERATOR FOR ADDITIONAL NINETY
DAY TERMS, PROVIDED THAT THE COMMISSIONER SHALL PROVIDE FOR  NOTICE  AND
THE  OPPORTUNITY  FOR  A HEARING AS SET FORTH IN SUBDIVISION SIX OF THIS
SECTION.
  (C) THE TERM OF THE INITIAL APPOINTMENT AND OF  ANY  SUBSEQUENT  REAP-
POINTMENT  MAY  BE  TERMINATED PRIOR TO THE EXPIRATION OF THE DESIGNATED
TERM, IF THE ESTABLISHED OPERATOR AND THE COMMISSIONER AGREE ON  A  PLAN
OF CORRECTION AND THE IMPLEMENTATION OF SUCH PLAN.
  6.  THE  COMMISSIONER  SHALL, UPON MAKING A DETERMINATION TO APPOINT A
TEMPORARY OPERATOR PURSUANT TO PARAGRAPH (A) OF SUBDIVISION TWO OF  THIS
SECTION OR REAPPOINT A TEMPORARY OPERATOR FOR THE FIRST ADDITIONAL NINE-
TY  DAY  TERM  PURSUANT  TO  PARAGRAPH  (A)  OF SUBDIVISION FIVE OF THIS
SECTION, CAUSE THE ESTABLISHED OPERATOR OF THE FACILITY TO  BE  NOTIFIED
OF  THE  DETERMINATION  BY REGISTERED OR CERTIFIED MAIL ADDRESSED TO THE
PRINCIPAL OFFICE OF THE ESTABLISHED OPERATOR. IF THE COMMISSIONER DETER-
MINES THAT ADDITIONAL REAPPOINTMENTS PURSUANT TO PARAGRAPH (B) OF SUBDI-
VISION FIVE OF THIS SECTION ARE REQUIRED, THE COMMISSIONER  SHALL  AGAIN
CAUSE  THE  ESTABLISHED  OPERATOR OF THE FACILITY TO BE NOTIFIED OF SUCH
DETERMINATION BY REGISTERED OR CERTIFIED MAIL ADDRESSED TO THE PRINCIPAL
OFFICE OF THE ESTABLISHED OPERATOR AT THE COMMENCEMENT OF THE  FIRST  OF
EVERY  TWO  ADDITIONAL TERMS.   UPON RECEIPT OF SUCH NOTIFICATION AT THE
PRINCIPAL OFFICE OF THE ESTABLISHED OPERATOR AND BEFORE  THE  EXPIRATION
OF TEN DAYS THEREAFTER, THE ESTABLISHED OPERATOR MAY REQUEST AN ADMINIS-
TRATIVE  HEARING  ON THE DETERMINATION TO BEGIN NO LATER THAN SIXTY DAYS
FROM THE DATE OF THE APPOINTMENT OR REAPPOINTMENT OF THE TEMPORARY OPER-
ATOR. ANY SUCH HEARING SHALL BE STRICTLY LIMITED TO THE ISSUE OF WHETHER

S. 6256--B                         34                         A. 9056--B

THE DETERMINATION OF THE COMMISSIONER WHICH RESULTED IN THE  APPOINTMENT
OR REAPPOINTMENT IS SUPPORTED BY SUBSTANTIAL EVIDENCE.
  7.  NO  PROVISION CONTAINED IN THIS SECTION SHALL BE DEEMED TO RELIEVE
THE ESTABLISHED OPERATOR OR ANY OTHER PERSON OF ANY  CIVIL  OR  CRIMINAL
LIABILITY  INCURRED,  OR  ANY  DUTY IMPOSED BY LAW, BY REASON OF ACTS OR
OMISSIONS OF THE ESTABLISHED OPERATOR OR ANY OTHER PERSON PRIOR  TO  THE
APPOINTMENT  OF  ANY  TEMPORARY  OPERATOR  HEREUNDER; NOR SHALL ANYTHING
CONTAINED IN THIS SECTION BE CONSTRUED TO SUSPEND DURING THE TERM OF THE
APPOINTMENT OF THE TEMPORARY OPERATOR ANY OBLIGATION OF THE  ESTABLISHED
OPERATOR OR ANY OTHER PERSON FOR THE PAYMENT OF TAXES OR OTHER OPERATING
AND MAINTENANCE EXPENSES OF THE FACILITY NOR OF THE ESTABLISHED OPERATOR
OR ANY OTHER PERSON FOR THE PAYMENT OF MORTGAGES OR LIENS.
  S  28.  Section  2  of  chapter  584 of the laws of 2011, amending the
public authorities law, relating to the powers and duties of the  dormi-
tory authority of the state of New York relative to the establishment of
subsidiaries for certain purposes, is amended to read as follows:
  S  2.  This  act shall take effect immediately and shall expire and be
deemed repealed ON July 1, [2012] 2015; provided however, that the expi-
ration of this act shall not impair  or  otherwise  affect  any  of  the
powers,  duties,  responsibilities,  functions, rights or liabilities of
any subsidiary duly  created  pursuant  to  subdivision  twenty-five  of
section 1678 of the public authorities law prior to such expiration.
  S  29.    Subdivision 1 of section 2999-i of the public health law, as
added by section 52 of part H of chapter 59 of  the  laws  of  2011,  is
amended to read as follows:
  1. (A) The commissioner of taxation and finance shall be the custodian
of  the  fund  and  the  special account established pursuant to section
ninety-nine-t of the state finance law. All payments from the fund shall
be made by the commissioner of taxation and  finance  upon  certificates
signed by the superintendent of financial services, or his or her desig-
nee,  as hereinafter provided. The fund shall be separate and apart from
any other fund and from all other state monies; PROVIDED, HOWEVER,  THAT
MONIES OF THE FUND MAY BE INVESTED AS SET FORTH IN PARAGRAPH (B) OF THIS
SUBDIVISION.   No monies from the fund shall be transferred to any other
fund, nor shall any such monies be applied to the making of any  payment
for any purpose other than the purpose set forth in this title.
  (B)  ANY MONIES OF THE FUND NOT REQUIRED FOR IMMEDIATE USE MAY, AT THE
DISCRETION OF THE COMMISSIONER OF  FINANCIAL  SERVICES  IN  CONSULTATION
WITH  THE  COMMISSIONER  OF  HEALTH  AND  THE DIRECTOR OF THE BUDGET, BE
INVESTED BY THE COMMISSIONER OF TAXATION AND FINANCE IN  OBLIGATIONS  OF
THE UNITED STATES OR THE STATE OR OBLIGATIONS THE PRINCIPAL AND INTEREST
OF  WHICH ARE GUARANTEED BY THE UNITED STATES OR THE STATE. THE PROCEEDS
OF ANY SUCH INVESTMENT SHALL BE RETAINED BY THE FUND  AS  ASSETS  TO  BE
USED FOR THE PURPOSES OF THE FUND.
  S  30.  Subdivision  9  of  section  2803  of the public health law is
REPEALED.
  S 31. Paragraph (b) of subdivision 1-a of section 2802 of  the  public
health law, as amended by chapter 174 of the laws of 2011, is amended to
read as follows:
  (b)  repair  or  maintenance,  regardless  of  cost, including routine
purchases and the acquisition  of  minor  equipment  undertaken  in  the
course  of  a  hospital's inventory control functions; PROVIDED THAT FOR
PROJECTS UNDER THIS PARAGRAPH WITH A TOTAL COST OF  UP  TO  SIX  MILLION
DOLLARS, NO WRITTEN NOTICE SHALL BE REQUIRED;
  S  32.   Subdivision 1 of section 1 of chapter 119 of the laws of 1997
relating to authorizing the department of health  to  establish  certain

S. 6256--B                         35                         A. 9056--B

payments  to  general  hospitals,  as amended by section 1 of part S2 of
chapter 62 of the laws of 2003, is amended to read as follows:
  1.  Notwithstanding  any  inconsistent provision of law or regulation,
effective for the period [April 1, 1997 through March 31, 1998] APRIL 1,
2012 THROUGH DECEMBER 31, 2012 and for annual periods beginning  [April]
JANUARY  1 thereafter, the [department] DEPARTMENT of [health] HEALTH is
authorized to pay voluntary non-profit general hospitals as  defined  in
subdivision  10  of  section  2801  of  the public health law additional
payments for inpatient hospital services as medical assistance  payments
pursuant to title 11 of article 5 of the social services law and federal
law  and regulations governing disproportionate share payments, based on
the [amount of state aid for which such general hospitals  are  eligible
pursuant  to  articles  25,  26  and 41 of the mental hygiene law and as
identified in subdivision 2 of this section] COSTS INCURRED IN EXCESS OF
REVENUES BY GENERAL HOSPITALS IN PROVIDING SERVICES IN ELIGIBLE PROGRAMS
TO UNINSURED PATIENTS AND  PATIENTS  ELIGIBLE  FOR  MEDICAL  ASSISTANCE.
Payment made pursuant to this section shall not exceed each such general
hospital's cost of providing services to uninsured patients and patients
eligible for medical assistance pursuant to title 11 of article 5 of the
social  services  law  after taking into consideration all other medical
assistance received, including disproportionate share payments  made  to
such  general hospital, and payments from or on behalf of such uninsured
patients, and shall also not exceed the total amount of state aid, iden-
tified by subdivision 2 of  this  section,  available  to  such  general
hospital  by  law.  Payments  made to such general hospitals pursuant to
this section shall be made in lieu of any state aid  payments  available
to such general hospital by law.
  S  33.  Subdivision  1  of section 241 of the elder law, as amended by
section 29 of part A of chapter 58 of the laws of 2008,  is  amended  to
read as follows:
  1.  "Covered  drug"  shall  mean a drug dispensed subject to a legally
authorized prescription pursuant to section sixty-eight hundred  ten  of
the  education  law,  and  insulin,  an  insulin  syringe, or an insulin
needle. Such term shall not include: (a)  any  drug  determined  by  the
commissioner  of the federal food and drug administration to be ineffec-
tive or unsafe; (b) any drug dispensed in a package, or form  of  dosage
or administration, as to which the commissioner of health finally deter-
mines in accordance with the provisions of section two hundred fifty-two
of this title that a less expensive package, or form of dosage or admin-
istration,  is  available that is pharmaceutically equivalent and equiv-
alent in its therapeutic effect for the general  health  characteristics
of  the  eligible program participant population; (c) any device for the
aid or correction of vision; (d) any drug, including vitamins, which  is
generally  available  without  a physician's prescription; and (e) drugs
for the treatment of sexual or erectile dysfunction, unless  such  drugs
are  used  to  treat a condition, other than sexual or erectile dysfunc-
tion, for which the drugs have been approved by  the  federal  food  and
drug  administration; and (f) a brand name drug for which a multi-source
therapeutically and generically equivalent drug, as  determined  by  the
federal  food  and  drug administration, is available, unless previously
authorized by the elderly  pharmaceutical  insurance  coverage  program,
provided,  however,  that the [elderly pharmaceutical insurance coverage
panel] COMMISSIONER is authorized to exempt, for good cause  shown,  any
brand  name  drug  from such restriction, and provided further that such
restriction shall not  apply  to  any  drug  that  is  included  on  the
preferred  drug list under section two hundred seventy-two of the public

S. 6256--B                         36                         A. 9056--B

health law or is in the clinical drug review program under  section  two
hundred  seventy-four  of  the  public health law to the extent that the
preferred drug program and the clinical drug review program are  applied
to  the  elderly  pharmaceutical  insurance coverage program pursuant to
section two hundred seventy-five of the public health  law,  or  to  any
drug  covered  under  a  program  participant's Medicare part D or other
primary insurance plan. Any of the drugs  enumerated  in  the  preceding
sentence  shall  be considered a covered drug or a prescription drug for
purposes of this article if it is added to the preferred drug list under
article two-A of the public health law.  For the purpose of this  title,
except  as  otherwise  provided in this section, a covered drug shall be
dispensed in quantities no greater than  a  thirty  day  supply  or  one
hundred  units, whichever is greater. In the case of a drug dispensed in
a form of administration other than a tablet  or  capsule,  the  maximum
allowed  quantity shall be a thirty day supply; the [panel] COMMISSIONER
is authorized  to  approve  exceptions  to  these  limits  for  specific
products  following consideration of recommendations from pharmaceutical
or medical experts regarding commonly packaged quantities, unusual forms
of administration, length of treatment or  cost  effectiveness.  In  the
case of a drug prescribed pursuant to section thirty-three hundred thir-
ty-two of the public health law to treat one of the conditions that have
been  enumerated by the commissioner of health pursuant to regulation as
warranting the prescribing of greater than a  thirty  day  supply,  such
drug  shall  be  dispensed  in  quantities  not  to exceed a three month
supply.
  S 33-a. Subdivision 1 of section 241 of the elder law, as  amended  by
section  12  of  part B of chapter 57 of the laws of 2006, is amended to
read as follows:
  1. "Covered drug" shall mean a drug dispensed  subject  to  a  legally
authorized  prescription  pursuant to section sixty-eight hundred ten of
the education law, and  insulin,  an  insulin  syringe,  or  an  insulin
needle.  Such  term  shall  not  include: (a) any drug determined by the
commissioner of the federal food and drug administration to be  ineffec-
tive  or  unsafe; (b) any drug dispensed in a package, or form of dosage
or administration, as to which the commissioner of health finally deter-
mines in accordance with the provisions of section two hundred fifty-two
of this title that a less expensive package, or form of dosage or admin-
istration, is available that is pharmaceutically equivalent  and  equiv-
alent  in  its therapeutic effect for the general health characteristics
of the eligible program participant population; (c) any device  for  the
aid  or  correction of vision, or any drug, including vitamins, which is
generally available without a physician's prescription;  and  (d)  drugs
for  the  treatment of sexual or erectile dysfunction, unless such drugs
are used to treat a condition, other than sexual  or  erectile  dysfunc-
tion,  for  which  the  drugs have been approved by the federal food and
drug administration. For the purpose of this title, except as  otherwise
provided  in  this section, a covered drug shall be dispensed in quanti-
ties no greater than a thirty day supply or one hundred units, whichever
is greater. In the case of a drug dispensed in a form of  administration
other  than a tablet or capsule, the maximum allowed quantity shall be a
thirty day supply; the [panel] COMMISSIONER  is  authorized  to  approve
exceptions to these limits for specific products following consideration
of  recommendations  from  pharmaceutical  or  medical experts regarding
commonly packaged quantities, unusual forms of administration, length of
treatment or cost effectiveness. In the case of a drug prescribed pursu-
ant to section thirty-three hundred thirty-two of the public health  law

S. 6256--B                         37                         A. 9056--B

to  treat one of the conditions that have been enumerated by the commis-
sioner of health pursuant to regulation as warranting the prescribing of
greater than a thirty day supply, such drug shall be dispensed in  quan-
tities not to exceed a three month supply.
  S  33-b.  Paragraph  (f)  of subdivision 3 of section 242 of the elder
law, as amended by section 3-d of part A of chapter 59 of  the  laws  of
2011, is amended to read as follows:
  (f)  As  a  condition  of eligibility for benefits under this title, a
program participant is required to be enrolled in Medicare part D and to
maintain such enrollment.   FOR UNMARRIED PARTICIPANTS  WITH  INDIVIDUAL
ANNUAL  INCOME  LESS  THAN OR EQUAL TO TWENTY-THREE THOUSAND DOLLARS AND
MARRIED PARTICIPANTS WITH JOINT ANNUAL INCOME  LESS  THAN  OR  EQUAL  TO
TWENTY-NINE  THOUSAND  DOLLARS,  THE  ELDERLY  PHARMACEUTICAL  INSURANCE
COVERAGE PROGRAM SHALL PAY FOR THE PORTION OF THE PART D MONTHLY PREMIUM
THAT IS THE RESPONSIBILITY OF THE PARTICIPANT.  SUCH  PAYMENT  SHALL  BE
LIMITED  TO  THE  LOW-INCOME BENCHMARK PREMIUM AMOUNT ESTABLISHED BY THE
FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES AND ANY OTHER  AMOUNT
WHICH  SUCH  AGENCY  ESTABLISHES  UNDER  ITS  DE MINIMUS PREMIUM POLICY,
EXCEPT THAT SUCH PAYMENTS MADE ON BEHALF OF PARTICIPANTS ENROLLED  IN  A
MEDICARE  ADVANTAGE  PLAN  MAY  EXCEED  THE LOW-INCOME BENCHMARK PREMIUM
AMOUNT IF DETERMINED TO BE COST EFFECTIVE TO THE PROGRAM.
  S 33-c. Paragraph (b) of subdivision 2 of section  243  of  the  elder
law,  as  amended  by section 3-g of part A of chapter 59 of the laws of
2011, is amended to read as follows:
  (b) notifying [each eligible program participant in writing  upon  the
commencement  of  the annual coverage period of such participant's cost-
sharing responsibilities pursuant to section two hundred forty-seven  of
this  title.  The  contractor  shall  also notify] each eligible program
participant of any adjustment of the co-payment schedule by mail no less
than thirty days prior to the effective date  of  such  adjustments  and
shall inform such eligible program participants of the date such adjust-
ments shall take effect;
  S 33-d. Section 245 of the elder law is REPEALED.
  S  33-e.  Subdivision  1  of section 247 of the elder law, as added by
section 3-j of part A of chapter 59 of the laws of 2011, is  amended  to
read as follows:
  1.  As  a  condition  of  eligibility  for  benefits under this title,
participants must [maintain Medicare part D  coverage  and  pay  monthly
premiums  to  their  Medicare  part D drug plan] BE ENROLLED IN MEDICARE
PART D AND MAINTAIN SUCH ENROLLMENT.
  S 33-f. Subdivision 1 of section 249 of the elder law, as  amended  by
section  111  of part C of chapter 58 of the laws of 2009, is amended to
read as follows:
  1. The state shall offer an opportunity to participate in this program
to all provider pharmacies as defined in section two  hundred  forty-one
of  this  title, provided, however, that the participation of pharmacies
registered in the state pursuant to section sixty-eight hundred  eight-b
of the education law shall be limited to state assistance provided under
this  title  for  prescription  drugs covered by a program participant's
medicare [or other] drug plan.
  S 33-g. Subdivisions 1 and 2 of section  253  of  the  elder  law  are
amended to read as follows:
  1.  In  counties  having a population of seventy-five thousand or less
that are in proximity to the state boundary and which are determined  by
the  [executive  director]  COMMISSIONER  OF HEALTH to be not adequately
served by provider pharmacies registered in New  York,  and  in  Fishers

S. 6256--B                         38                         A. 9056--B

Island in the town of Southold, Suffolk county, the [executive director]
COMMISSIONER  may  approve as provider pharmacies, pharmacies located in
New Jersey, Connecticut, Vermont, Pennsylvania  or  Massachusetts.  Such
approvals  shall  be made after (a) consideration of the convenience and
necessity of New York residents in the rural areas served by such  phar-
macies,  (b)  consideration of the quality of service of such pharmacies
and the standing of such pharmacies with the governmental board or agen-
cy of the state in which such pharmacy is located,  (c)  the  [executive
director]  COMMISSIONER  shall  give  all licensed pharmacies within the
county notice of his or  her  intention  to  approve  such  out-of-state
provider  pharmacies,  and (d) the [executive director] COMMISSIONER has
held a public hearing at which he or she has determined  factually  that
the licensed pharmacies within such county are not adequately serving as
provider pharmacies.
  2.  The  [executive director] COMMISSIONER OF HEALTH shall investigate
and determine whether certification shall be granted within ninety  days
of  the filing of an application for certification by the governing body
of any city, town or village, within a county determined by the  [execu-
tive  director]  COMMISSIONER  to  be  not adequately served by provider
pharmacies registered in New York pursuant to subdivision  one  of  this
section, claiming to be lacking adequate pharmaceutical service.
  S  34.    Subdivision  25 of section 2808 of the public health law, as
added by section 31 of part B of  chapter  109  of  the  laws  of  2010,
subparagraph  (iii) of paragraph (b) as amended and subparagraph (iv) of
paragraph (b) as added by section 69 of part H of chapter 59 of the laws
of 2011, is amended to read as follows:
  25. Reserved bed  days.  (a)  For  purposes  of  this  subdivision,  a
"reserved bed day" is a day for which a governmental agency pays a resi-
dential  health care facility to reserve a bed for a person eligible for
medical assistance pursuant to title  eleven  of  article  five  of  the
social  services  law  while he or she is temporarily hospitalized or on
leave of absence from the facility.
  (b) Notwithstanding any other provisions of this section or any  other
law  or  regulation  to  the contrary, for reserved bed days provided on
behalf of persons twenty-one years of age or older:
  (i) payments for reserved  bed  days  shall  be  made  at  ninety-five
percent  of  the  Medicaid  rate  otherwise  payable to the facility for
services provided on behalf of such person;
  (ii) payment to a facility for reserved bed days provided on behalf of
such person for temporary hospitalizations may not exceed fourteen  days
in any twelve month period;
  (iii)  payment  to a facility for reserved bed days provided on behalf
of such person for non-hospitalization leaves of absence may not  exceed
ten days in any twelve month period[; and
  (iv)  payments  for  reserved  bed days for temporary hospitalizations
shall only be made to a residential health care  facility  if  at  least
fifty  percent  of the facility's residents eligible to participate in a
Medicare managed care plan are enrolled in such a plan].
  (C)(I) NOTWITHSTANDING ANY CONTRARY PROVISION OF THIS  SUBDIVISION  OR
ANY  OTHER  LAW  AND  SUBJECT  TO  THE AVAILABILITY OF FEDERAL FINANCIAL
PARTICIPATION, FOR RATE PERIODS ON AND AFTER APRIL FIRST,  TWO  THOUSAND
TWELVE,  WITH  REGARD  TO  SERVICES  PROVIDED TO RESIDENTIAL HEALTH CARE
FACILITY RESIDENTS TWENTY-ONE YEARS OF AGE AND OLDER,  THE  COMMISSIONER
SHALL  PROMULGATE REGULATIONS, AND MAY PROMULGATE EMERGENCY REGULATIONS,
EFFECTIVE FOR PERIODS ON AND AFTER APRIL  FIRST,  TWO  THOUSAND  TWELVE,
ESTABLISHING REIMBURSEMENT RATES FOR RESERVED BED DAYS, PROVIDED, HOWEV-

S. 6256--B                         39                         A. 9056--B

ER,   THAT  SUCH  REGULATIONS  SHALL  ACHIEVE  AN  AGGREGATE  ANNUALIZED
REDUCTION IN REIMBURSEMENT FOR SUCH RESERVED BED DAYS OF  NO  LESS  THAN
FORTY MILLION DOLLARS, AS DETERMINED BY THE COMMISSIONER.
  (II)  IN  THE EVENT THE COMMISSIONER DETERMINES THAT FEDERAL FINANCIAL
PARTICIPATION WILL NOT BE AVAILABLE FOR RATE ADJUSTMENTS  MADE  PURSUANT
TO  SUBPARAGRAPH (I) OF THIS PARAGRAPH OR REGULATIONS PROMULGATED THERE-
UNDER, THEN, FOR RATE PERIODS ON AND AFTER  APRIL  FIRST,  TWO  THOUSAND
TWELVE,  MEDICAID  RATES  FOR  INPATIENT  SERVICES SHALL NOT INCLUDE ANY
FACTOR OR PAYMENT AMOUNT FOR SUCH RESERVED BED DAYS WITH REGARD TO RESI-
DENTS TWENTY-ONE YEARS OF AGE AND OLDER.
  (III) IN THE EVENT THE PROVISIONS OF SUBPARAGRAPH (II) OF  THIS  PARA-
GRAPH  ARE INVOKED AND IMPLEMENTED BY THE COMMISSIONER, THEN THE COMMIS-
SIONER SHALL PROMULGATE REGULATIONS, AND MAY PROMULGATE EMERGENCY  REGU-
LATIONS,  EFFECTIVE  FOR  RATE  PERIODS  ON  OR  AFTER  APRIL FIRST, TWO
THOUSAND TWELVE, PROVIDING UPWARD REVISIONS  TO  MEDICAID  RATES  ISSUED
PURSUANT  TO  SUBDIVISION TWO-C OF THIS SECTION, PROVIDED, HOWEVER, THAT
SUCH UPWARD REVISIONS SHALL NOT  IN  AGGREGATE,  AS  DETERMINED  BY  THE
COMMISSIONER,  EXCEED,  ON  AN  ANNUAL BASIS, AN AMOUNT EQUAL TO CURRENT
ANNUAL MEDICAID PAYMENTS FOR  RESERVED  BED  DAYS,  LESS  FORTY  MILLION
DOLLARS.
  S  35. Paragraphs (l) and (m) of subdivision 1 of section 367-q of the
social services law, as added by section 22 of part C of chapter  59  of
the laws of 2011, are amended to read as follows:
  (l)  for  the  period  April  first, two thousand twelve through March
thirty-first, two thousand thirteen, UP  TO  twenty-eight  million  five
hundred thousand dollars; and
  (m)  for  the  period April first, two thousand thirteen through March
thirty-first, two thousand fourteen, UP  TO  twenty-eight  million  five
hundred thousand dollars.
  S  35-a.  Clause (K) of subparagraph (i) of paragraph (bb) of subdivi-
sion 1 of section 2807-v of the public health law, as amended by section
8 of part C of chapter 59 of the laws of 2011, is  amended  to  read  as
follows:
  (K)  UP  TO  one  hundred thirty-six million dollars each state fiscal
year for the period April first, two thousand eleven through March thir-
ty-first, two thousand fourteen.
  S 35-b. Subparagraph (xi)  of  paragraph  (cc)  of  subdivision  1  of
section 2807-v of the public health law, as amended by section 8 of part
C of chapter 59 of the laws of 2011, is amended to read as follows:
  (xi)  UP  TO  eleven  million  two hundred thousand dollars each state
fiscal year for the period April  first,  two  thousand  eleven  through
March thirty-first, two thousand fourteen.
  S  35-c.  Subparagraph  (vii)  of  paragraph (ccc) of subdivision 1 of
section 2807-v of the public health law, as amended by section 8 of part
C of chapter 59 of the laws of 2011, is amended to read as follows:
  (vii) UP TO fifty million dollars each state fiscal year for the peri-
od April first, two thousand  eleven  through  March  thirty-first,  two
thousand fourteen.
  S 36.  Paragraph (g-1) of subdivision 2 of section 365-a of the social
services  law,  as  amended by section 23 of part H of chapter 59 of the
laws of 2011, is amended to read as follows:
  (g-1) drugs provided on an in-patient basis, those drugs contained  on
the  list established by regulation of the commissioner of health pursu-
ant to subdivision four of this section, and those drugs which  may  not
be  dispensed  without a prescription as required by section sixty-eight
hundred ten of the education law and which the  commissioner  of  health

S. 6256--B                         40                         A. 9056--B

shall determine to be reimbursable based upon such factors as the avail-
ability  of  such  drugs  or  alternatives at low cost if purchased by a
medicaid recipient, or the essential nature of such drugs  as  described
by such commissioner in regulations, provided, however, that such drugs,
exclusive  of long-term maintenance drugs, shall be dispensed in quanti-
ties no greater than a thirty day supply or one hundred doses, whichever
is greater; provided further that the commissioner of health is  author-
ized  to  require  prior  authorization for any refill of a prescription
when less than seventy-five percent of the previously  dispensed  amount
per  fill  should have been used were the product used as normally indi-
cated; provided further that the commissioner of health is authorized to
require prior authorization of prescriptions  of  opioid  analgesics  in
excess  of  four prescriptions in a thirty-day period in accordance with
section two hundred seventy-three of the public health law, EXCEPT  THAT
PRIOR  AUTHORIZATION  MAY  BE DENIED IF THE DEPARTMENT, AFTER GIVING THE
PRESCRIBER A REASONABLE OPPORTUNITY TO PRESENT A  JUSTIFICATION,  DETER-
MINES  THAT  THE  ADDITIONAL  PRESCRIPTION  IS  NOT MEDICALLY NECESSARY;
medical assistance shall not include any drug provided on other than  an
in-patient  basis for which a recipient is charged or a claim is made in
the case of a prescription drug, in excess of the  maximum  reimbursable
amounts  to  be established by department regulations in accordance with
standards established by the secretary of the United  States  department
of  health and human services, or, in the case of a drug not requiring a
prescription, in excess of the maximum reimbursable  amount  established
by  the  commissioner of health pursuant to paragraph (a) of subdivision
four of this section;
  S 37. Subdivision 6 of section 368-d of the social  services  law,  as
added  by  section  6  of  part  H of chapter 59 of the laws of 2011, is
amended to read as follows:
  6. The commissioner shall evaluate the results of the study  conducted
pursuant  to  subdivision four of this section to determine, after iden-
tification of actual direct and indirect costs incurred by public school
districts and state operated[/] AND state supported  schools  FOR  BLIND
AND  DEAF  STUDENTS, whether it is advisable to claim federal reimburse-
ment for expenditures under this section as  certified  public  expendi-
tures.  In the event such claims are submitted, if federal reimbursement
received for certified public expenditures on behalf of medical  assist-
ance  recipients  whose  assistance and care are the responsibility of a
social services district [in a  city  with  a  population  of  over  two
million,]  results  in  a decrease in the state share of annual expendi-
tures pursuant to this section for such recipients, then to  the  extent
that  the amount of any such decrease when combined with any decrease in
the state share of annual expenditures described in subdivision five  of
section  three hundred sixty-eight-e of this title exceeds fifty million
dollars IN STATE FISCAL YEAR 2011-12, OR  EXCEEDS  ONE  HUNDRED  MILLION
DOLLARS  IN STATE FISCAL YEAR 2012-13 OR ANY FISCAL YEAR THEREAFTER, the
excess  amount  shall  be  transferred  to  such  [city]  PUBLIC  SCHOOL
DISTRICTS  AND  STATE OPERATED AND STATE SUPPORTED SCHOOLS FOR BLIND AND
DEAF STUDENTS IN AMOUNTS PROPORTIONAL TO THEIR  PERCENTAGE  CONTRIBUTION
TO  THE STATEWIDE SAVINGS.  Any such excess amount transferred shall not
be considered a revenue received by such  social  services  district  in
determining  the  district's  actual medical assistance expenditures for
purposes of paragraph (b) of section one of part  C  of  chapter  fifty-
eight of the laws of two thousand five.

S. 6256--B                         41                         A. 9056--B

  S  38.  Subdivision  5 of section 368-e of the social services law, as
added by section 7 of part H of chapter 59  of  the  laws  of  2011,  is
amended to read as follows:
  5.  The commissioner shall evaluate the results of the study conducted
pursuant to subdivision three of this section to determine, after  iden-
tification  of actual direct and indirect costs incurred by counties for
medical care, services, and supplies furnished  to  pre-school  children
with  handicapping  conditions, whether it is advisable to claim federal
reimbursement for expenditures under this section  as  certified  public
expenditures.  In  the  event  such  claims  are  submitted,  if federal
reimbursement received for certified public expenditures  on  behalf  of
medical  assistance recipients whose assistance and care are the respon-
sibility of a social services district [in a city with a  population  of
over  two  million],  results in a decrease in the state share of annual
expenditures pursuant to this section for such recipients, then  to  the
extent  that  the  amount  of  any  such decrease when combined with any
decrease in the state share of annual expenditures described in subdivi-
sion six of section three hundred sixty-eight-d of  this  title  exceeds
fifty  million  dollars  IN  STATE  FISCAL  YEAR 2011-12, OR EXCEEDS ONE
HUNDRED MILLION DOLLARS IN STATE FISCAL YEAR 2012-13 OR ANY FISCAL  YEAR
THEREAFTER,  the excess amount shall be transferred to such [city] COUN-
TIES IN AMOUNTS PROPORTIONAL TO THEIR  PERCENTAGE  CONTRIBUTION  TO  THE
STATEWIDE  SAVINGS.    Any  such  excess amount transferred shall not be
considered a revenue received by such social services district in deter-
mining  the  district's  actual  medical  assistance  expenditures   for
purposes  of  paragraph  (b)  of section one of part C of chapter fifty-
eight of the laws of two thousand five.
  S 39. Subparagraph (i) of paragraph (a-1) of subdivision 4 of  section
365-a  of the social services law, as amended by section 46 of part C of
chapter 58 of the laws of 2009, is amended to read as follows:
  (i) a brand name drug for which  a  multi-source  therapeutically  and
generically  equivalent drug, as determined by the federal food and drug
administration,  is  available,  unless  previously  authorized  by  the
department  of  health.  The  commissioner  of  health  is authorized to
exempt, for good cause shown, any brand name drug from the  restrictions
imposed  by this subparagraph[. This subparagraph shall not apply to any
drug that is in a therapeutic class included on the preferred drug  list
under  section two hundred seventy-two of the public health law or is in
the clinical drug review program under section two hundred  seventy-four
of the public health law];
  S  40.    Subdivision  8  of  section 272 of the public health law, as
amended by section 5 of part B of chapter 109 of the laws  of  2010,  is
amended to read as follows:
  8. The commissioner shall provide notice of any recommendations devel-
oped  by  the  committee  regarding the preferred drug program, at least
five days before any final determination by the commissioner, by  making
such  information  available  on  the department's website. [Such public
notice shall include: a summary of the deliberations of the committee; a
summary of the positions of those making public comments at meetings  of
the  committee; the response of the committee to those comments, if any;
and the findings and recommendations of the committee.]
  S 41. Paragraphs (e), (f) and (g) of subdivision 1 of section 367-a of
the social services law, paragraph (e) as added by chapter  433  of  the
laws  of  1997, paragraph (f) as added by section 1 of part E of chapter
58 of the laws of 2008, paragraph (g) as added by section 65-a of part H
of chapter 59 of the laws of 2011, are amended to read as follows:

S. 6256--B                         42                         A. 9056--B

  (e) Amounts payable under this title for  medical  assistance  in  the
form  of  clinic services pursuant to article twenty-eight of the public
health law and article sixteen of the mental  hygiene  law  provided  to
eligible  persons DIAGNOSED WITH A DEVELOPMENTAL DISABILITY who are also
beneficiaries  under  part  [b]  B of title [xviii] XVIII of the federal
social security act [and who are also], OR PROVIDED TO PERSONS diagnosed
with a DEVELOPMENTAL disability WHO ARE QUALIFIED MEDICARE BENEFICIARIES
UNDER PART B OF TITLE XVIII OF SUCH ACT  shall  not  be  less  than  the
approved  medical assistance payment level less the amount payable under
part [b] B.
  (f) Amounts payable under this title for  medical  assistance  in  the
form  of  outpatient  mental health services under article thirty-one of
the mental hygiene law provided to eligible persons who are also benefi-
ciaries under part B of title XVIII of the federal social  security  act
OR  PROVIDED  TO  QUALIFIED MEDICARE BENEFICIARIES UNDER PART B OF TITLE
XVIII OF SUCH ACT shall not be less than the approved medical assistance
payment level less the amount payable under part B.
  (g) Notwithstanding any provision of this  section  to  the  contrary,
amounts  payable  under this title for medical assistance in the form of
hospital outpatient services or diagnostic and treatment center services
pursuant to article twenty-eight of the public health  law  provided  to
eligible  persons who are also beneficiaries under part B of title XVIII
of the federal social security act OR  PROVIDED  TO  QUALIFIED  MEDICARE
BENEFICIARIES  UNDER  PART B OF TITLE XVIII OF SUCH ACT shall not exceed
the approved medical assistance payment level less  the  amount  payable
under part B.
  S 42. Subdivision 6 of section 2818 of the public health law, as added
by  section 25-a of part A of chapter 59 of the laws of 2011, is amended
to read as follows:
  6. Notwithstanding any contrary provision of  this  section,  sections
one hundred twelve and one hundred sixty-three of the state finance law,
or  any  other contrary provision of law, subject to available appropri-
ations, funds available for expenditure pursuant to this section may  be
distributed by the commissioner without a competitive bid or request for
proposal  process for grants to general hospitals, DIAGNOSTIC AND TREAT-
MENT CENTERS, and residential health care facilities for the purpose  of
facilitating  closures,  mergers and restructuring of such facilities in
order to strengthen and protect continued  access  to  essential  health
care resources. Prior to an [awarded] AWARD being granted to an eligible
applicant without a competitive bid or request for proposal process, the
commissioner shall notify the chair of the senate finance committee, the
chair  of  the assembly ways and means committee and the director of the
division of budget of the intent to grant such  an  award.  Such  notice
shall  include  information  regarding  how the eligible applicant meets
criteria established pursuant to this section.
  S 43. Paragraph (a) of subdivision 8-a of section 2807-j of the public
health law, as amended by section 16 of part D of chapter 57 of the laws
of 2006, is amended to read as follows:
  (a) Payments and reports submitted or required to be submitted to  the
commissioner  or to the commissioner's designee pursuant to this section
and section twenty-eight hundred seven-s of this article  by  designated
providers  of  services  and by third-party payors which have elected to
make payments directly to the  commissioner  or  to  the  commissioner's
designee in accordance with subdivision five-a of this section, shall be
subject to audit by the commissioner for a period of six years following
the  close  of  the calendar year in which such payments and reports are

S. 6256--B                         43                         A. 9056--B

due, after which such payments shall be deemed final and not subject  to
further  adjustment  or reconciliation, INCLUDING THROUGH OFFSET ADJUST-
MENTS OR RECONCILIATIONS MADE BY DESIGNATED PROVIDERS OF SERVICES OR  BY
THIRD-PARTY  PAYORS WITH REGARD TO SUBSEQUENT PAYMENTS, provided, howev-
er, that nothing herein shall be construed as precluding the commission-
er from pursuing collection of any such payments which are identified as
delinquent within such six year  period,  or  which  are  identified  as
delinquent  as a result of an audit commenced within such six year peri-
od, or from conducting an audit of any adjustment or reconciliation made
by a designated provider of services or by a third party payor which has
elected to make such  payments  directly  to  the  commissioner  or  the
commissioner's  designee,  OR  FROM CONDUCTING AN AUDIT OF PAYMENTS MADE
PRIOR TO SUCH SIX YEAR PERIOD WHICH ARE  FOUND  TO  BE  COMMINGLED  WITH
PAYMENTS  WHICH  ARE  OTHERWISE SUBJECT TO TIMELY AUDIT PURSUANT TO THIS
SECTION.
  S 44.  Paragraph (a) of subdivision 10 of section 2807-t of the public
health law, as amended by section 17 of part D of chapter 57 of the laws
of 2006, is amended to read as follows:
  (a) Payments and reports submitted or required to be submitted to  the
commissioner  or to the commissioner's designee pursuant to this section
by specified third-party payors shall be subject to audit by the commis-
sioner for a period of six years following the  close  of  the  calendar
year  in  which  such  payments  and  reports  are due, after which such
payments shall be deemed final and not subject to further adjustment  or
reconciliation,  INCLUDING THROUGH OFFSET ADJUSTMENTS OR RECONCILIATIONS
MADE BY SUCH SPECIFIED THIRD-PARTY  PAYORS  WITH  REGARD  TO  SUBSEQUENT
PAYMENTS,  provided,  however, that nothing herein shall be construed as
precluding  the  commissioner  from  pursuing  collection  of  any  such
payments which are identified as delinquent within such six year period,
or  which are identified as delinquent as a result of an audit commenced
within such six year period, or from conducting an audit of any  adjust-
ments  and  reconciliation  made by a specified third party payor within
such six year period, OR FROM CONDUCTING AN AUDIT OF PAYMENTS MADE PRIOR
TO SUCH SIX YEAR PERIOD WHICH ARE FOUND TO BE COMMINGLED  WITH  PAYMENTS
WHICH ARE OTHERWISE SUBJECT TO TIMELY AUDIT PURSUANT TO THIS SECTION.
  S  45.  Subdivision  7  of  section 2807-d of the public health law is
amended by adding a new paragraph (f) to read as follows:
  (F) PAYMENTS AND REPORTS SUBMITTED OR REQUIRED TO BE SUBMITTED TO  THE
COMMISSIONER  OR TO THE COMMISSIONER'S DESIGNEE PURSUANT TO THIS SECTION
SHALL BE SUBJECT TO AUDIT BY THE COMMISSIONER FOR A PERIOD OF SIX  YEARS
FOLLOWING  THE  CLOSE  OF  THE  CALENDAR YEAR IN WHICH SUCH PAYMENTS AND
REPORTS ARE DUE, AFTER WHICH SUCH PAYMENTS SHALL BE DEEMED FINAL AND NOT
SUBJECT TO  FURTHER  ADJUSTMENT  OR  RECONCILIATION,  INCLUDING  THROUGH
OFFSET  ADJUSTMENTS  OR RECONCILIATIONS MADE TO SUBSEQUENT PAYMENTS MADE
PURSUANT TO THIS SECTION, PROVIDED, HOWEVER, THAT NOTHING  HEREIN  SHALL
BE  CONSTRUED AS PRECLUDING THE COMMISSIONER FROM PURSUING COLLECTION OF
ANY SUCH PAYMENTS WHICH ARE IDENTIFIED AS  DELINQUENT  WITHIN  SUCH  SIX
YEAR  PERIOD,  OR  WHICH  ARE IDENTIFIED AS DELINQUENT AS A RESULT OF AN
AUDIT COMMENCED WITHIN SUCH SIX YEAR PERIOD, OR FROM CONDUCTING AN AUDIT
OF ANY ADJUSTMENT OR RECONCILIATION MADE BY A HOSPITAL.
  S 46.  Paragraph (f) of subdivision 18 of section 2807-c of the public
health law, as amended by section 15 of part D of chapter 57 of the laws
of 2006, is amended to read as follows:
  (f) Payments of assessments and allowances required to be submitted by
general hospitals pursuant to this subdivision and subdivisions fourteen
and fourteen-b of this section and paragraph (a) of subdivision  two  of

S. 6256--B                         44                         A. 9056--B

section twenty-eight hundred seven-d of this article shall be subject to
audit  by the commissioner for a period of six years following the close
of the calendar year in which such payments are due,  after  which  such
payments  shall be deemed final and not subject to further adjustment or
reconciliation, INCLUDING THROUGH OFFSET ADJUSTMENTS OR  RECONCILIATIONS
MADE  BY GENERAL HOSPITALS WITH REGARD TO SUBSEQUENT PAYMENTS, provided,
however, that nothing  herein  shall  be  construed  as  precluding  the
commissioner from pursuing collection of any such assessments and allow-
ances which are identified as delinquent within such six year period, or
which  are  identified  as  delinquent as a result of an audit commenced
within such six year audit period, or from conducting an  audit  of  any
adjustment  or reconciliation made by a general hospital within such six
year period, OR FROM CONDUCTING AN AUDIT OF PAYMENTS MADE PRIOR TO  SUCH
SIX YEAR PERIOD WHICH ARE FOUND TO BE COMMINGLED WITH PAYMENTS WHICH ARE
OTHERWISE  SUBJECT  TO  TIMELY  AUDIT  PURSUANT TO THIS SECTION. General
hospitals which, in the course of such an audit, fail to produce data or
documentation requested in furtherance of such an audit,  within  thirty
days  of such request may be assessed a civil penalty of up to ten thou-
sand dollars for each such failure, provided, however, that  such  civil
penalty shall not be imposed if the hospital demonstrates good cause for
such  failure.   The imposition of such civil penalties shall be subject
to the provisions of section twelve-a of this chapter.
  S 47.  Paragraph (e) of subdivision 2-a of section 2807 of the  public
health  law  is  amended  by  adding a new subparagraph (iii) to read as
follows:
  (III) REGULATIONS ISSUED PURSUANT TO THIS  PARAGRAPH  MAY  INCORPORATE
QUALITY  RELATED MEASURES LIMITING OR EXCLUDING REIMBURSEMENT RELATED TO
POTENTIALLY PREVENTABLE CONDITIONS AND COMPLICATIONS.
  S 48.  Paragraph (c) of subdivision 7 of section 2807-d of the  public
health  law,  as added by chapter 938 of the laws of 1990, is amended to
read as follows:
  (c) The reports shall be in such form as  may  be  prescribed  by  the
commissioner  to  accurately  disclose information required to implement
this section, PROVIDED, HOWEVER, THAT FOR  PERIODS  ON  AND  AFTER  JULY
FIRST,  TWO  THOUSAND  TWELVE,  SUCH  REPORTS AND ANY ASSOCIATED CERTIF-
ICATIONS SHALL BE SUBMITTED ELECTRONICALLY IN A FORM AS MAY BE  REQUIRED
BY THE COMMISSIONER.
  S  48-a. Subparagraph (i) of paragraph (a) of subdivision 7 of section
2807-j of the public health law, as amended by section 36 of part  B  of
chapter 58 of the laws of 2008, is amended to read as follows;
  (i)  Every designated provider of services shall submit reports of net
patient service revenues received for or on account of patient  services
for  each  month which shall be in such form as may be prescribed by the
commissioner to accurately disclose information  required  to  implement
this section. For periods on and after January first, two thousand five,
reports by designated providers of services shall be submitted electron-
ically  in  a  form  as  may  be required by the commissioner; provided,
however, any designated provider of  services  is  not  prohibited  from
submitting  reports  electronically  on  a voluntary basis prior to such
date,  AND  PROVIDED  FURTHER,  HOWEVER,  THAT   ALL   SUCH   ELECTRONIC
SUBMISSIONS SUBMITTED ON AND AFTER JULY FIRST, TWO THOUSAND TWELVE SHALL
BE  VERIFIED  WITH  AN ELECTRONIC SIGNATURE AS PRESCRIBED BY THE COMMIS-
SIONER.
  S 48-b. Subparagraph (ii) of paragraph (b) of subdivision 7 of section
2807-j of the public health law, as amended by section 25 of part A3  of
chapter 62 of the laws of 2003, is amended to read as follows:

S. 6256--B                         45                         A. 9056--B

  (ii)  For  periods on and after July first, two thousand four, reports
submitted on a monthly basis by third-party payors  in  accordance  with
subparagraph (i) of this paragraph and reports submitted on a monthly or
annual  basis by payors acting in an administrative services capacity on
behalf  of  electing  third-party payors in accordance with subparagraph
(i) of this paragraph shall be made electronically in a form as  may  be
required  by the commissioner; provided, however, any third-party payor,
except payors acting in an administrative services capacity on behalf of
electing third-party payors, which, on or after January first, two thou-
sand four, elects to make payments directly to the commissioner  or  the
commissioner's  designee  pursuant  to subdivision five of this section,
shall be subject to this subparagraph only after one full year  of  pool
payment experience which results in reports being submitted on a monthly
basis,   AND   PROVIDED  FURTHER,  HOWEVER,  THAT  ALL  SUCH  ELECTRONIC
SUBMISSIONS SUBMITTED ON AND AFTER JULY FIRST, TWO THOUSAND TWELVE SHALL
BE VERIFIED WITH AN ELECTRONIC SIGNATURE AS PRESCRIBED  BY  THE  COMMIS-
SIONER.    This  subparagraph  shall  not be interpreted to prohibit any
third-party payor from submitting reports electronically on a  voluntary
basis.
  S  48-c.  Subparagraph  (ii)  of  paragraph  (b)  of subdivision 20 of
section 2807-c of the public health law, as added by section 26 of  part
A3 of chapter 62 of the laws of 2003, is amended to read as follows:
  (ii)  For  periods  on  and  after  January  first, two thousand five,
reports submitted by general hospitals to implement the  assessment  set
forth  in  subdivision eighteen of this section shall be submitted elec-
tronically in a form as may be required by the  commissioner;  provided,
however,  general  hospitals  are not prohibited from submitting reports
electronically on a voluntary basis prior to  such  date,  AND  PROVIDED
FURTHER,  HOWEVER, THAT ALL SUCH ELECTRONIC SUBMISSIONS SUBMITTED ON AND
AFTER JULY FIRST, TWO THOUSAND TWELVE SHALL BE VERIFIED  WITH  AN  ELEC-
TRONIC SIGNATURE AS PRESCRIBED BY THE COMMISSIONER.
  S  49.    Subdivision  8  of section 3605 of the public health law, as
added by chapter 959 of the laws of 1984, is amended to read as follows:
  8. Agencies licensed pursuant to this section but not certified pursu-
ant to section three thousand six hundred eight of this  article,  shall
not  be  qualified  to  participate  as  a  home health agency under the
provisions of title XVIII or XIX of  the  federal  Social  Security  Act
provided, however, an agency which has a contract with a state agency or
its locally designated office OR, AS SPECIFIED BY THE COMMISSIONER, WITH
A  MANAGED  CARE  ORGANIZATION PARTICIPATING IN THE MANAGED CARE PROGRAM
ESTABLISHED PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL
SERVICES LAW OR WITH A MANAGED LONG TERM CARE PLAN ESTABLISHED  PURSUANT
TO  SECTION  FORTY-FOUR  HUNDRED  THREE-F  OF  THIS CHAPTER, may receive
reimbursement under title XIX of the federal Social Security Act.
  S 50. Subdivision 6 of section 365-f of the  social  services  law  is
renumbered  subdivision  7  and  a new subdivision 6 is added to read as
follows:
  6. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION  OR  ANY
OTHER  CONTRARY  PROVISION  OF  LAW,  MANAGED  CARE PROGRAMS ESTABLISHED
PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE AND MANAGED
LONG TERM CARE PLANS AND  OTHER  CARE  COORDINATION  MODELS  ESTABLISHED
PURSUANT  TO  SECTION  FOUR  THOUSAND FOUR HUNDRED THREE-F OF THE PUBLIC
HEALTH LAW SHALL OFFER CONSUMER DIRECTED PERSONAL ASSISTANCE PROGRAMS TO
ENROLLEES.

S. 6256--B                         46                         A. 9056--B

  S 51.  Subparagraph (ii) of paragraph (e) of subdivision 4 of  section
364-j  of the social services law, as amended by section 14 of part C of
chapter 58 of the laws of 2004, is amended to read as follows:
  (ii) In any social services district which has implemented a mandatory
managed  care program pursuant to this section, the requirements of this
subparagraph shall apply to the extent consistent with federal  law  and
regulations.  The  department  of  health, may contract with one or more
independent organizations to provide enrollment counseling  and  enroll-
ment  services,  for  participants  required  to  enroll in managed care
programs, for each social services district [requesting the services  of
an  enrollment  broker]  WHICH  HAS IMPLEMENTED A MANDATORY MANAGED CARE
PROGRAM. To select such organizations, the department  of  health  shall
issue  a request for proposals (RFP), shall evaluate proposals submitted
in response to such RFP  and,  pursuant  to  such  RFP,  shall  award  a
contract  to  one  or  more qualified and responsive organizations. Such
organizations shall not be owned, operated, or controlled by any govern-
mental agency, managed care provider, comprehensive  HIV  special  needs
plan, mental health special needs plan, or medical services provider.
  S  52.  Paragraph (b) of subdivision 1 of section 4403-f of the public
health law is REPEALED and paragraphs (c)  and  (d),  paragraph  (c)  as
relettered by section 7 of part C of chapter 58 of the laws of 2007, are
relettered paragraphs (b) and (c).
  S 53.  The opening paragraph of subdivision 2 of section 4403-f of the
public  health  law,  as amended by section 8 of part C of chapter 58 of
the laws of 2007, is amended to read as follows:
  An [eligible] applicant shall submit an application for a  certificate
of  authority  to  operate  a  managed  long  term  care plan upon forms
prescribed by the commissioner. Such [eligible] applicant  shall  submit
information  and  documentation to the commissioner which shall include,
but not be limited to:
  S 54.  Paragraph (b) of subdivision 4 of section 4403-f of the  public
health law, as added by section 5 of part C of chapter 58 of the laws of
2010, is amended to read as follows:
  (b)  Standards  established  pursuant  to  this  subdivision  shall be
adequate to protect the interests of enrollees in managed long term care
plans.  The commissioner shall be satisfied that the  [eligible]  appli-
cant  is  financially sound, and has made adequate provisions to pay for
services.
  S 55.  Paragraph (c) of subdivision 6 of section 4403-f of the  public
health  law,  as  amended by section 41-b of part H of chapter 59 of the
laws of 2011, is amended to read as follows:
  (c) For the period beginning April  first,  two  thousand  twelve  and
ending  March thirty-first, two thousand fifteen, the majority leader of
the senate and the speaker of the assembly may  each  recommend  to  the
commissioner, in writing, up to four [eligible] applicants to convert to
be  approved  managed  long  term care plans. An applicant shall only be
approved and issued a  certificate  of  authority  if  the  commissioner
determines  that  the  applicant  meets  the requirements of subdivision
three of this section. The majority leader of the senate or the  speaker
of  the  assembly  may  assign  their authority to recommend one or more
applicants under this section to the commissioner.
  S 56.  Paragraph (a) of subdivision 3 of section  366  of  the  social
services  law, as amended by chapter 110 of the laws of 1971, is amended
to read as follows:
  (a) Medical assistance shall  be  furnished  to  applicants  in  cases
where,  although  such  applicant has a responsible relative with suffi-

S. 6256--B                         47                         A. 9056--B

cient income and resources to provide medical assistance  as  determined
by  the  regulations  of the department, the income and resources of the
responsible relative are not available to such applicant because of  the
absence  of such relative [or] AND the refusal or failure of such ABSENT
relative to provide the necessary care and assistance.   In such  cases,
however,  the  furnishing  of  such  assistance  shall create an implied
contract with such relative, and the cost thereof may be recovered  from
such  relative  in  accordance  with  title six of article three OF THIS
CHAPTER and other applicable provisions of law.
  S 57. Subdivision 1 of section 92 of 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 funds Medicaid expenditures, is
amended to read as follows:
  1.  For  state fiscal years 2011-12 [and 2012-13] THROUGH 2013-14, the
director of the budget, in consultation with the commissioner of  health
referenced  as "commissioner" for purposes of this section, shall assess
on a monthly basis, as reflected in monthly reports pursuant to subdivi-
sion five of this section known and projected department of health state
funds medicaid expenditures by category of  service  and  by  geographic
regions,  as  defined  by  the  commissioner, and if the director of the
budget determines that such expenditures are expected to cause  medicaid
disbursements  for  such  period  to  exceed the projected department of
health medicaid state funds disbursements in the enacted  budget  finan-
cial  plan  pursuant to subdivision 3 of section 23 of the state finance
law, the commissioner of health, in consultation with  the  director  of
the  budget,  shall  develop a medicaid savings allocation plan to limit
such spending to the aggregate limit  level  specified  in  the  enacted
budget  financial  plan,  provided,  however,  such  projections  may be
adjusted by the director of the budget to account for any changes in the
New York state federal medical assistance percentage amount  established
pursuant  to the federal social security act, changes in provider reven-
ues, REDUCTIONS TO LOCAL SOCIAL  SERVICES  DISTRICT  MEDICAL  ASSISTANCE
ADMINISTRATION, and beginning April 1, 2012 the operational costs of the
New York state medical indemnity fund.
  S 58.  Paragraph (b) of section 90 of part H of chapter 59 of the laws
of 2011, amending the public health law and other laws relating to types
of  appropriations exempt from certain reductions, is amended to read as
follows:
  (b) The  following  types  of  appropriations  shall  be  exempt  from
reductions pursuant to this section:
  (i)  any  reductions that would violate federal law including, but not
limited to, payments required pursuant to the federal Medicare program;
  (ii) any reductions related to payments pursuant to article 32,  arti-
cle 31 and article 16 of the mental hygiene law;
  (iii) payments the state is obligated to make pursuant to court orders
or judgments;
  (iv)  payments  for  which  the non-federal share does not reflect any
state funding; [and]
  (v) at the discretion of the commissioner of health and  the  director
of  the  budget,  payments  with regard to which it is determined by the
commissioner of health and the director of the budget  that  application
of  reductions  pursuant  to  this section would result, by operation of
federal law, in a lower federal medical assistance percentage applicable
to such payments; AND
  (VI) PAYMENTS MADE WITH  REGARD  TO  THE  EARLY  INTERVENTION  PROGRAM
PURSUANT TO SECTION 2540 OF THE PUBLIC HEALTH LAW.

S. 6256--B                         48                         A. 9056--B

  S  59.  Subparagraph (ii) of paragraph (a) of subdivision 5 of section
2807-j of the public health law, as amended by section 23 of part A-3 of
chapter 62 of the laws of 2003, is amended to read as follows:
  (ii) An election shall remain in effect unless revoked in writing by a
specified  third-party payor, which revocation shall be effective on the
first day of the next [calendar year quarter] MONTH, provided that  such
payor  has provided notice of its intention to so revoke at least [thir-
ty] TWENTY days prior to the beginning of such [calendar quarter] MONTH.
  S 60. Paragraph (b) of subdivision 5-a of section 2807-m of the public
health law is amended by adding a new clause (H) to read as follows:
  (H) NOTWITHSTANDING ANY INCONSISTENT PROVISION  OF  THIS  SUBDIVISION,
FOR PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND THIRTEEN, ECRIP GRANT
AWARDS SHALL BE MADE IN ACCORDANCE WITH RULES AND REGULATIONS PROMULGAT-
ED BY THE COMMISSIONER.
  S  61. Section 1 of part C of chapter 58 of the laws of 2005, relating
to authorizing reimbursements for expenditures made by or on  behalf  of
social  services  districts for medical assistance for needy persons and
the administration thereof, is amended by adding a new  subdivision  (h)
to read as follows:
  (H)  NOTWITHSTANDING  THE  PROVISIONS  OF  SECTION 368-A OF THE SOCIAL
SERVICES LAW OR ANY OTHER CONTRARY PROVISION OF  LAW,  NO  REIMBURSEMENT
SHALL  BE  MADE  FOR  SOCIAL SERVICES DISTRICTS' CLAIMS SUBMITTED ON AND
AFTER THE EFFECTIVE DATE OF THIS PARAGRAPH,  FOR  DISTRICT  EXPENDITURES
INCURRED  PRIOR  TO  JANUARY  1,  2006,  INCLUDING,  BUT NOT LIMITED TO,
EXPENDITURES FOR SERVICES PROVIDED TO INDIVIDUALS WHO WERE ELIGIBLE  FOR
MEDICAL  ASSISTANCE  PURSUANT  TO SECTION THREE HUNDRED SIXTY-SIX OF THE
SOCIAL SERVICES LAW  AS  A  RESULT  OF  A  MENTAL  DISABILITY,  FORMERLY
REFERRED TO AS HUMAN SERVICES OVERBURDEN AID TO COUNTIES.
  S  62.    Notwithstanding  any  inconsistent provision of law, rule or
regulation, for purposes of implementing the provisions  of  the  public
health law and the social services law, references to titles XIX and XXI
of  the  federal  social  security  act in the public health law and the
social services law shall be deemed to include  and  also  to  mean  any
successor titles thereto under the federal social security act.
  S 63. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the  public health law, section 18 of chapter 2 of the laws of 1988, and
18 NYCRR 505.14(h), as they relate to time frames for  notice,  approval
or  certification  of rates of payment, are hereby suspended and without
force or effect for purposes of implementing the provisions of this act.
  S 64.  Severability clause. If any clause, sentence, paragraph, subdi-
vision, section or part of this act shall be adjudged by  any  court  of
competent  jurisdiction  to  be invalid, such judgment shall not affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation to the clause, sentence, paragraph,  subdivision,  section  or
part thereof directly involved in the controversy in which such judgment
shall  have been rendered. It is hereby declared to be the intent of the
legislature that this act would have been enacted even if  such  invalid
provisions had not been included herein.
  S  65.  This act shall take effect immediately, and shall be deemed to
have been in full force and effect on and after April 1, 2012, provided,
however, that:
  (a) the commissioner of health may  promulgate  emergency  regulations
necessary  to  effectuate the provisions of sections two, three and four
of this act; and

S. 6256--B                         49                         A. 9056--B

  (a-1) provided, further, that the amendments to section 1  of  chapter
119 of the laws of 1997 made by section thirty-two of this act, relating
to authorizing the department of health to establish certain payments to
general  hospitals,  shall  be subject to the expiration of such chapter
and shall be deemed expired therewith;
  (a-2)  provided,  further,  that  the  amendments  to subdivision 1 of
section 241 of the elder law made by section thirty-three  of  this  act
shall  be  subject  to  the expiration and reversion of such subdivision
pursuant to section 79 of part C of chapter 58 of the laws of  2005,  as
amended, when upon such date the provisions of section thirty-three-a of
this act shall take effect;
  (b)  the  amendments  to  paragraph  (a-1) of subdivision 4 of section
365-a of the social services law made by section thirty-nine of this act
shall not affect the expiration and  reversion  of  such  paragraph  and
shall be deemed to expire therewith;
  (c)  provided,  further,  that  the  amendments  to section 272 of the
public health law made by section forty of this act shall not affect the
repeal of such section and shall be deemed repealed therewith;
  (d) provided, further, that the amendments to section  2807-j  of  the
public  health  law  made by sections forty-three, forty-eight-a, forty-
eight-b and fifty-nine of this act shall not affect  the  expiration  of
such section and shall be deemed to expire therewith;
  (e)  provided,  further,  that the amendments to section 2807-t of the
public health law made by section  forty-four  of  this  act  shall  not
affect  the  expiration  of  such  section and shall be deemed to expire
therewith;
  (f) provided, further, that the amendments to section  4403-f  of  the
public  health  law, made by sections fifty-two, fifty-three, fifty-four
and fifty-five of this act shall not affect the repeal of  such  section
and shall be deemed to repeal therewith;
  (g)  provided,  further,  that  the amendments to subparagraph (ii) of
paragraph (e) of subdivision 4 of section 364-j of the  social  services
law made by section fifty-one of this act shall not affect the repeal of
such section and shall be deemed repealed therewith;
  (h)  provided,  further,  that sections ten, eleven, twelve, thirteen,
fourteen, fifteen, sixteen, seventeen and eighteen  of  this  act  shall
take effect April 1, 2013;
  (i)  provided,  further,  that  any  rules or regulations necessary to
implement the provisions of this act may be promulgated and  any  proce-
dures,  forms,  or instructions necessary for such implementation may be
adopted and issued on or after the date this act  shall  have  become  a
law;
  (j)  provided, further, that this act shall not be construed to alter,
change, affect, impair or defeat  any  rights,  obligations,  duties  or
interests  accrued, incurred or conferred prior to the effective date of
this act;
  (k) provided, further, that the commissioner of health and the  super-
intendent of financial services and any appropriate council may take any
steps necessary to implement this act prior to its effective date;
  (k-1)  provided,  further,  that the amendments to section 2802 of the
public health law made by section thirty-one  of  this  act  shall  take
effect  on  the same date and in the same manner as section 1 of chapter
174 of the laws of 2011 takes effect, whichever is later;
  (l) provided, further, that notwithstanding any inconsistent provision
of the state administrative procedure act or any other provision of law,
rule or regulation, the commissioner of health and the superintendent of

S. 6256--B                         50                         A. 9056--B

financial services and any appropriate council is authorized to adopt or
amend or promulgate on an emergency basis any regulation he  or  she  or
such council determines necessary to implement any provision of this act
on its effective date; and
  (m)  provided,  further,  that the provisions of this act shall become
effective notwithstanding the failure of the commissioner of  health  or
the  superintendent  of  financial  services  or any council to adopt or
amend or promulgate regulations implementing this act.

                                 PART E

  Section 1. This act shall be known and may be cited as the  "New  York
Health Benefit Exchange Act".
  S  2.  The  public  authorities law is amended by adding a new article
10-E to read as follows:
                               ARTICLE 10-E
                    NEW YORK HEALTH BENEFIT EXCHANGE
SECTION 3980. STATEMENT OF POLICY AND PURPOSES.
        3981. DEFINITIONS.
        3982. ESTABLISHMENT OF THE NEW YORK HEALTH BENEFIT EXCHANGE.
        3983. GENERAL POWERS OF THE EXCHANGE.
        3984. FUNCTIONS OF THE EXCHANGE.
        3985. SPECIAL FUNCTIONS OF THE EXCHANGE RELATED TO  HEALTH  PLAN
                 CERTIFICATION AND QUALIFIED HEALTH PLAN OVERSIGHT.
        3986. REGIONAL ADVISORY COMMITTEES.
        3987. FUNDING OF THE EXCHANGE.
        3988. STUDIES AND RECOMMENDATIONS.
        3989. TAX EXEMPTION AND TAX CONTRACT BY THE STATE.
        3990. OFFICERS AND EMPLOYEES.
        3991. LIMITATION OF LIABILITY; INDEMNIFICATION.
        3992. CONTINGENCY FOR FEDERAL FUNDING.
        3993. CONSTRUCTION.
  S  3980. STATEMENT OF POLICY AND PURPOSES. THE PURPOSE OF THIS ARTICLE
IS TO ESTABLISH AN AMERICAN HEALTH BENEFIT  EXCHANGE  IN  NEW  YORK,  IN
CONFORMANCE WITH THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT,
PUBLIC  LAW  111-148, AS AMENDED BY THE HEALTH CARE AND EDUCATION RECON-
CILIATION ACT OF 2010, PUBLIC LAW 111-152.  THE EXCHANGE  SHALL  FACILI-
TATE  ENROLLMENT  IN HEALTH COVERAGE, THE PURCHASE AND SALE OF QUALIFIED
HEALTH PLANS IN THE INDIVIDUAL MARKET IN THIS STATE, AND ENROLL INDIVID-
UALS IN HEALTH COVERAGE FOR WHICH THEY ARE ELIGIBLE IN  ACCORDANCE  WITH
FEDERAL LAW. THE EXCHANGE ALSO SHALL INCORPORATE A SMALL BUSINESS HEALTH
OPTIONS  PROGRAM  ("SHOP") TO ASSIST QUALIFIED EMPLOYERS IN FACILITATING
THE ENROLLMENT OF THEIR EMPLOYEES IN QUALIFIED HEALTH PLANS  OFFERED  IN
THE  GROUP  MARKET.    IT  IS THE INTENT OF THE LEGISLATURE, THROUGH THE
ESTABLISHMENT OF THE EXCHANGE, TO PROMOTE QUALITY AND AFFORDABLE  HEALTH
COVERAGE  AND  CARE,  REDUCE  THE NUMBER OF UNINSURED PERSONS, PROVIDE A
TRANSPARENT MARKETPLACE, EDUCATE CONSUMERS AND ASSIST  INDIVIDUALS  WITH
ACCESS  TO  COVERAGE,  PREMIUM  ASSISTANCE  TAX CREDITS AND COST-SHARING
REDUCTIONS.
  S 3981. DEFINITIONS. FOR PURPOSES OF THIS ARTICLE, THE FOLLOWING DEFI-
NITIONS SHALL APPLY:
  1. "BOARD" OR "BOARD OF DIRECTORS" MEANS THE BOARD OF DIRECTORS OF THE
EXCHANGE.
  2. "REGIONAL ADVISORY COMMITTEES" MEANS THE NEW  YORK  HEALTH  BENEFIT
EXCHANGE REGIONAL ADVISORY COMMITTEES ESTABLISHED PURSUANT TO THIS ARTI-
CLE.

S. 6256--B                         51                         A. 9056--B

  3. "COMMISSIONER" MEANS THE COMMISSIONER OF HEALTH.
  4.  "EXCHANGE"  MEANS THE NEW YORK HEALTH BENEFIT EXCHANGE ESTABLISHED
PURSUANT TO THIS ARTICLE.
  5. "FEDERAL ACT" MEANS THE PATIENT PROTECTION AND AFFORDABLE CARE ACT,
PUBLIC LAW 111-148, AS AMENDED BY THE HEALTH CARE AND  EDUCATION  RECON-
CILIATION  ACT OF 2010, PUBLIC LAW 111-152, AND ANY REGULATIONS OR GUID-
ANCE ISSUED THEREUNDER.
  6. "HEALTH PLAN" MEANS A POLICY, CONTRACT OR CERTIFICATE,  OFFERED  OR
ISSUED  BY AN INSURER TO PROVIDE, DELIVER, ARRANGE FOR, PAY FOR OR REIM-
BURSE ANY OF THE COSTS OF HEALTH CARE SERVICES. HEALTH  PLAN  SHALL  NOT
INCLUDE THE FOLLOWING:
  (A) ACCIDENT INSURANCE OR DISABILITY INCOME INSURANCE, OR ANY COMBINA-
TION THEREOF;
  (B) COVERAGE ISSUED AS A SUPPLEMENT TO LIABILITY INSURANCE;
  (C)  LIABILITY  INSURANCE,  INCLUDING  GENERAL LIABILITY INSURANCE AND
AUTOMOBILE LIABILITY INSURANCE;
  (D) WORKERS' COMPENSATION OR SIMILAR INSURANCE;
  (E) AUTOMOBILE NO-FAULT INSURANCE;
  (F) CREDIT INSURANCE;
  (G) OTHER SIMILAR INSURANCE COVERAGE, AS SPECIFIED  IN  FEDERAL  REGU-
LATIONS,  UNDER  WHICH  BENEFITS FOR MEDICAL CARE ARE SECONDARY OR INCI-
DENTAL TO OTHER INSURANCE BENEFITS;
  (H) LIMITED SCOPE DENTAL OR VISION BENEFITS,  BENEFITS  FOR  LONG-TERM
CARE  INSURANCE,  NURSING  HOME  INSURANCE,  HOME CARE INSURANCE, OR ANY
COMBINATION THEREOF, OR SUCH  OTHER  SIMILAR,  LIMITED  BENEFITS  HEALTH
INSURANCE  AS  SPECIFIED  IN  FEDERAL  REGULATIONS,  IF THE BENEFITS ARE
PROVIDED UNDER A SEPARATE POLICY, CERTIFICATE OR CONTRACT  OF  INSURANCE
OR ARE OTHERWISE NOT AN INTEGRAL PART OF THE PLAN;
  (I)  COVERAGE ONLY FOR A SPECIFIED DISEASE OR ILLNESS, HOSPITAL INDEM-
NITY, OR OTHER FIXED INDEMNITY COVERAGE;
  (J) MEDICARE SUPPLEMENTAL INSURANCE AS DEFINED IN  SECTION  1882(G)(1)
OF  THE FEDERAL SOCIAL SECURITY ACT, COVERAGE SUPPLEMENTAL TO THE COVER-
AGE PROVIDED UNDER CHAPTER 55 OF TITLE 10 OF THE UNITED STATES CODE,  OR
SIMILAR  SUPPLEMENTAL  COVERAGE PROVIDED UNDER A GROUP HEALTH PLAN IF IT
IS OFFERED AS A SEPARATE POLICY, CERTIFICATE OR CONTRACT  OF  INSURANCE;
OR
  (K)  THE  MEDICAL INDEMNITY FUND ESTABLISHED PURSUANT TO TITLE FOUR OF
ARTICLE TWENTY-NINE-D OF THE PUBLIC HEALTH LAW.
  7. "INSURER" MEANS AN INSURANCE COMPANY SUBJECT TO ARTICLE  THIRTY-TWO
OR  FORTY-THREE  OF THE INSURANCE LAW, OR A HEALTH MAINTENANCE ORGANIZA-
TION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR OF THE PUBLIC  HEALTH  LAW
THAT  CONTRACTS  OR OFFERS TO CONTRACT TO PROVIDE, DELIVER, ARRANGE, PAY
OR REIMBURSE ANY OF THE COSTS OF HEALTH CARE SERVICES.
  8. "QUALIFIED DENTAL PLAN" MEANS A LIMITED SCOPE DENTAL PLAN  THAT  IS
ISSUED   BY   AN  INSURER  AND  CERTIFIED  IN  ACCORDANCE  WITH  SECTION
THIRTY-NINE HUNDRED EIGHTY-FIVE OF THIS ARTICLE.
  9. "QUALIFIED EMPLOYER" MEANS A SMALL EMPLOYER THAT ELECTS TO MAKE ITS
FULL-TIME EMPLOYEES ELIGIBLE FOR ONE  OR  MORE  QUALIFIED  HEALTH  PLANS
THROUGH THE EXCHANGE.
  10.  "QUALIFIED  HEALTH PLAN" MEANS A HEALTH PLAN THAT IS ISSUED BY AN
INSURER AND CERTIFIED IN ACCORDANCE  WITH  SECTION  THIRTY-NINE  HUNDRED
EIGHTY-FIVE OF THIS ARTICLE.
  11.  "QUALIFIED  INDIVIDUAL"  MEANS  AN INDIVIDUAL, INCLUDING A MINOR,
WHO:
  (A) IS SEEKING TO ENROLL IN A QUALIFIED HEALTH PLAN OFFERED  TO  INDI-
VIDUALS THROUGH THE EXCHANGE;

S. 6256--B                         52                         A. 9056--B

  (B) RESIDES IN THIS STATE;
  (C)  AT THE TIME OF ENROLLMENT, IS NOT INCARCERATED, OTHER THAN INCAR-
CERATION PENDING THE DISPOSITION OF CHARGES; AND
  (D) IS, AND IS REASONABLY EXPECTED TO BE, FOR THE  ENTIRE  PERIOD  FOR
WHICH  ENROLLMENT  IS SOUGHT, A CITIZEN OR NATIONAL OF THE UNITED STATES
OR AN ALIEN LAWFULLY PRESENT IN THE UNITED STATES.
  12. "SECRETARY" MEANS THE SECRETARY OF THE UNITED STATES DEPARTMENT OF
HEALTH AND HUMAN SERVICES.
  13. "SHOP" MEANS THE SMALL BUSINESS HEALTH OPTIONS PROGRAM DESIGNED TO
ASSIST QUALIFIED EMPLOYERS IN THIS STATE IN FACILITATING THE  ENROLLMENT
OF THEIR EMPLOYEES IN QUALIFIED HEALTH PLANS OFFERED IN THE GROUP MARKET
IN THIS STATE.
  14. "SMALL EMPLOYER" MEANS, FOR PLAN YEARS PRIOR TO JANUARY FIRST, TWO
THOUSAND  SIXTEEN,  AN EMPLOYER THAT EMPLOYED AN AVERAGE OF AT LEAST ONE
BUT NOT MORE THAN FIFTY EMPLOYEES ON BUSINESS DAYS DURING THE  PRECEDING
CALENDAR  YEAR. FOR PLAN YEARS BEGINNING ON AND AFTER JANUARY FIRST, TWO
THOUSAND SIXTEEN, SMALL EMPLOYER MEANS  AN  EMPLOYER  THAT  EMPLOYED  AN
AVERAGE OF AT LEAST ONE BUT NOT MORE THAN ONE HUNDRED EMPLOYEES ON BUSI-
NESS  DAYS DURING THE PRECEDING CALENDAR YEAR. FOR PURPOSES OF THE DEFI-
NITION OF SMALL EMPLOYER:
  (A) ALL PERSONS TREATED AS A SINGLE  EMPLOYER  UNDER  SUBSECTION  (B),
(C),  (M)  OR  (O)  OF  SECTION 414 OF THE INTERNAL REVENUE CODE OF 1986
SHALL BE TREATED AS A SINGLE EMPLOYER;
  (B) AN EMPLOYER AND ANY PREDECESSOR EMPLOYER SHALL  BE  TREATED  AS  A
SINGLE EMPLOYER;
  (C)  ALL EMPLOYEES SHALL BE COUNTED, INCLUDING PART-TIME EMPLOYEES AND
EMPLOYEES WHO ARE NOT ELIGIBLE FOR COVERAGE THROUGH THE EMPLOYER;
  (D) IF AN EMPLOYER WAS  NOT  IN  EXISTENCE  THROUGHOUT  THE  PRECEDING
CALENDAR  YEAR,  THEN  THE  DETERMINATION  OF WHETHER THAT EMPLOYER IS A
SMALL EMPLOYER SHALL BE BASED UPON THE AVERAGE NUMBER OF EMPLOYEES  THAT
THE  EMPLOYER  REASONABLY  EXPECTS  TO  EMPLOY  ON  BUSINESS DAYS IN THE
CURRENT CALENDAR YEAR;
  (E) IF A QUALIFIED EMPLOYER THAT MAKES ENROLLMENT IN QUALIFIED  HEALTH
PLANS  AVAILABLE  TO  ITS  EMPLOYEES THROUGH THE EXCHANGE CEASES TO BE A
SMALL EMPLOYER BY REASON OF AN INCREASE IN THE NUMBER OF ITS  EMPLOYEES,
THEN  THE  EMPLOYER SHALL CONTINUE TO BE TREATED AS A QUALIFIED EMPLOYER
FOR PURPOSES OF THIS ARTICLE FOR THE PERIOD BEGINNING WITH THE  INCREASE
AND  ENDING  WITH THE FIRST DAY ON WHICH THE EMPLOYER DOES NOT MAKE SUCH
ENROLLMENT AVAILABLE TO ITS EMPLOYEES; AND
  (F) NOTWITHSTANDING PARAGRAPHS (A) THROUGH (E) OF THIS SUBDIVISION, AN
EMPLOYER ALSO SHALL BE CONSIDERED A SMALL EMPLOYER IF  THE  COVERAGE  IT
OFFERS  WOULD BE CONSIDERED SMALL GROUP COVERAGE UNDER THE INSURANCE LAW
AND REGULATIONS PROMULGATED THEREUNDER PROVIDED THAT IT IS NOT OTHERWISE
PROHIBITED UNDER THE FEDERAL ACT.
  15. "SMALL GROUP MARKET" MEANS THE HEALTH INSURANCE MARKET UNDER WHICH
INDIVIDUALS RECEIVE HEALTH INSURANCE COVERAGE ON  BEHALF  OF  THEMSELVES
AND  THEIR  DEPENDENTS THROUGH A GROUP HEALTH PLAN MAINTAINED BY A SMALL
EMPLOYER.
  16. "SUPERINTENDENT" MEANS THE SUPERINTENDENT OF FINANCIAL SERVICES.
  S 3982. ESTABLISHMENT OF THE NEW YORK HEALTH  BENEFIT  EXCHANGE.    1.
THERE  IS HEREBY CREATED A PUBLIC BENEFIT CORPORATION TO BE KNOWN AS THE
NEW YORK HEALTH BENEFIT EXCHANGE.  SUCH  CORPORATION  SHALL  BE  A  BODY
CORPORATE AND POLITIC.
  2.  THE PURPOSE OF THE EXCHANGE IS TO FACILITATE THE PURCHASE AND SALE
OF QUALIFIED HEALTH PLANS, ASSIST QUALIFIED  EMPLOYERS  IN  FACILITATING
THE  ENROLLMENT OF THEIR EMPLOYEES IN QUALIFIED HEALTH PLANS THROUGH THE

S. 6256--B                         53                         A. 9056--B

SMALL BUSINESS HEALTH OPTIONS  PROGRAM,  ENROLL  INDIVIDUALS  IN  HEALTH
COVERAGE  FOR WHICH THEY ARE ELIGIBLE IN ACCORDANCE WITH FEDERAL LAW AND
CARRY OUT OTHER FUNCTIONS SET FORTH IN THIS ARTICLE.
  3. (A) THE EXCHANGE SHALL BE GOVERNED BY A BOARD OF DIRECTORS CONSIST-
ING  OF NINE VOTING DIRECTORS, INCLUDING THE COMMISSIONER AND THE SUPER-
INTENDENT, WHO SHALL SERVE AS EX OFFICIO DIRECTORS.
  (B) SEVEN DIRECTORS SHALL BE APPOINTED BY THE GOVERNOR,  TWO  OF  WHOM
SHALL BE APPOINTED UPON THE RECOMMENDATION OF THE TEMPORARY PRESIDENT OF
THE SENATE AND TWO OF WHOM SHALL BE APPOINTED UPON THE RECOMMENDATION OF
THE SPEAKER OF THE ASSEMBLY.  EACH PERSON APPOINTED AS A DIRECTOR PURSU-
ANT TO THIS PARAGRAPH SHALL HAVE EXPERTISE IN ONE OR MORE OF THE FOLLOW-
ING AREAS:
  (I) INDIVIDUAL HEALTH CARE COVERAGE;
  (II) SMALL EMPLOYER HEALTH CARE COVERAGE;
  (III) HEALTH BENEFITS ADMINISTRATION;
  (IV) HEALTH CARE FINANCE;
  (V) PUBLIC OR PRIVATE HEALTH CARE DELIVERY SYSTEMS; AND
  (VI) PURCHASING HEALTH PLAN COVERAGE.
  (C) RECOMMENDATIONS AND APPOINTMENTS SHALL TAKE INTO CONSIDERATION THE
EXPERTISE  OF OTHER DIRECTORS RECOMMENDED AND APPOINTED PURSUANT TO THIS
SUBDIVISION, SO THAT THE BOARD COMPOSITION REFLECTS A DIVERSITY OF EXPE-
RIENCE AND COMPLIES WITH ANY REGULATIONS ISSUED BY THE SECRETARY  PURSU-
ANT TO THE FEDERAL ACT.
  (D)  RECOMMENDATIONS  BY THE TEMPORARY PRESIDENT OF THE SENATE AND THE
SPEAKER OF THE ASSEMBLY SHALL BE MADE WITHIN THIRTY DAYS OF  THE  EFFEC-
TIVE  DATE  OF  THIS  ARTICLE,  WITHIN SIXTY DAYS OF THE OCCURRENCE OF A
VACANCY OR WITHIN SIXTY DAYS PRIOR TO THE EXPIRATION OF A TERM.
  4. THE GOVERNOR SHALL APPOINT A CHAIR OF  THE  BOARD  FROM  AMONG  THE
DIRECTORS  WHO SHALL BE SUBJECT TO THE ADVICE AND CONSENT OF THE SENATE.
ANY DIRECTOR APPOINTED BY THE GOVERNOR AS CHAIR OF THE BOARD  MAY  SERVE
AS  ACTING  CHAIR UNTIL SUCH TIME AS A VOTE FOR CONFIRMATION IS TAKEN BY
THE SENATE. NO DIRECTOR APPOINTED AS CHAIR  SHALL  SERVE  AS  CHAIR,  OR
CONTINUE  TO  SERVE  AS  ACTING  CHAIR,  IF  THE SENATE HAS VOTED NOT TO
CONFIRM SUCH DIRECTOR AS CHAIR.
  5. (A) THE TERMS OF THE DIRECTORS, OTHER THAN THE  EX  OFFICIO  DIREC-
TORS, SHALL BE THREE YEARS, PROVIDED, HOWEVER, THAT THE INITIAL TERMS OF
ONE  OF  THE  DIRECTORS  APPOINTED  UPON RECOMMENDATION OF THE TEMPORARY
PRESIDENT OF THE SENATE, ONE OF THE DIRECTORS APPOINTED UPON RECOMMENDA-
TION OF THE SPEAKER OF THE ASSEMBLY, AND ONE OF THE DIRECTORS  APPOINTED
BY THE GOVERNOR WITHOUT RECOMMENDATION SHALL BE FOR TWO YEARS.
  (B) VACANCIES OCCURRING OTHERWISE THAN BY EXPIRATION OF TERM OF OFFICE
SHALL  BE  FILLED  FOR  THE  UNEXPIRED  TERM  IN THE MANNER PROVIDED FOR
ORIGINAL APPOINTMENT.
  6. THE DIRECTORS SHALL NOT RECEIVE ANY COMPENSATION FOR THEIR SERVICES
AS DIRECTORS.
  7. (A) EACH DIRECTOR SHALL HAVE THE RESPONSIBILITY AND  DUTY  TO  MEET
THE  REQUIREMENTS  OF  THIS ARTICLE, THE FEDERAL ACT, AND ALL APPLICABLE
STATE AND FEDERAL LAWS AND REGULATIONS TO SERVE THE PUBLIC  INTEREST  OF
THE  INDIVIDUALS  AND  SMALL  BUSINESSES  SEEKING  HEALTH  CARE COVERAGE
THROUGH THE EXCHANGE, CONSISTENT WITH SECTION TWENTY-EIGHT HUNDRED TWEN-
TY-FOUR OF THIS CHAPTER.
  (B) EACH DIRECTOR SHALL  BE  A  STATE  OFFICER  OR  EMPLOYEE  FOR  THE
PURPOSES  OF SECTIONS SEVENTY-THREE AND SEVENTY-FOUR OF THE PUBLIC OFFI-
CERS LAW.
  (C) NO DIRECTOR MAY BE EMPLOYED OR OTHERWISE RETAINED BY THE EXCHANGE.

S. 6256--B                         54                         A. 9056--B

  8. (A) THE BOARD MAY CREATE SUCH COMMITTEES AS THE BOARD DEEMS  NECES-
SARY.  THE FIRST MEETING OF THE BOARD SHALL BE HELD WITHIN FOURTEEN DAYS
AFTER ALL DIRECTORS ARE INITIALLY APPOINTED.   AT THE FIRST  MEETING  OF
THE  BOARD,  AND AT THE FIRST MEETING IN EACH SUBSEQUENT YEAR, THE BOARD
SHALL  ELECT  FROM  AMONG  ITS  MEMBERS A SECRETARY AND A TREASURER. THE
BOARD ALSO SHALL ELECT SUCH OTHER OFFICERS AS IT SHALL  DEEM  NECESSARY.
THE  OFFICERS  SO  ELECTED  SHALL  HAVE  SUCH  POWERS  AND DUTIES AS ARE
ASSIGNED BY THE BY-LAWS AND THIS CHAPTER.
  (B) THE BOARD, AND ANY COMMITTEE THEREOF, MAY HOLD MEETINGS  BY  ELEC-
TRONIC MEANS CONSISTENT WITH ARTICLE SEVEN OF THE PUBLIC OFFICERS LAW.
  S  3983.  GENERAL  POWERS OF THE EXCHANGE. THE EXCHANGE SHALL HAVE THE
FOLLOWING POWERS TO BE USED IN FURTHERANCE OF ITS CORPORATE PURPOSES:
  1. TO SUE AND BE SUED AND TO PARTICIPATE IN ACTIONS  AND  PROCEEDINGS,
WHETHER JUDICIAL, ADMINISTRATIVE, ARBITRATIVE OR OTHERWISE;
  2.  TO  HAVE A CORPORATE SEAL, AND TO ALTER SUCH SEAL AT PLEASURE, AND
TO USE IT BY CAUSING IT OR A FACSIMILE TO BE  AFFIXED  OR  IMPRESSED  OR
REPRODUCED IN ANY OTHER MANNER;
  3.  TO  PURCHASE,  RECEIVE,  TAKE  BY  GRANT, GIFT, DEVISE, BEQUEST OR
OTHERWISE, LEASE, OR OTHERWISE ACQUIRE, OWN, HOLD, IMPROVE, EMPLOY,  USE
AND OTHERWISE DEAL IN AND WITH, REAL OR PERSONAL PROPERTY, OR ANY INTER-
EST THEREIN, WHEREVER SITUATED;
  4. TO SELL, CONVEY, LEASE, EXCHANGE, TRANSFER OR OTHERWISE DISPOSE OF,
OR  MORTGAGE  OR PLEDGE, OR CREATE A SECURITY INTEREST IN, ALL OR ANY OF
ITS PROPERTY, OR ANY INTEREST THEREIN, WHEREVER SITUATED;
  5. TO MAKE CONTRACTS,  GIVE  GUARANTEES  AND  INCUR  LIABILITIES,  AND
BORROW  MONEY;  PROVIDED,  HOWEVER,  THAT  THE  EXCHANGE SHALL NOT ISSUE
BONDS;
  6. TO INVEST AND REINVEST ITS  FUNDS,  AND  TAKE  AND  HOLD  REAL  AND
PERSONAL  PROPERTY  AS  SECURITY  FOR  THE PAYMENT OF FUNDS SO LOANED OR
INVESTED;
  7. TO MAKE AND ALTER BY-LAWS FOR ITS ORGANIZATION AND MANAGEMENT;
  8. TO MAKE AND ALTER RULES AND REGULATIONS AS NECESSARY  TO  IMPLEMENT
THE  PROVISIONS  OF THIS ARTICLE, SUBJECT TO THE PROVISIONS OF THE STATE
ADMINISTRATIVE PROCEDURE ACT;
  9. TO HIRE EMPLOYEES,  CONSISTENT  WITH  SECTION  THIRTY-NINE  HUNDRED
NINETY OF THIS ARTICLE;
  10. TO DESIGNATE THE DEPOSITORIES OF ITS MONEY;
  11. TO ESTABLISH ITS FISCAL YEAR;
  12. TO INSURE OR OTHERWISE PROVIDE FOR THE INSURANCE OF THE EXCHANGE'S
PROPERTY  OR OPERATIONS AND AGAINST SUCH OTHER RISKS AS THE EXCHANGE MAY
DEEM ADVISABLE;
  13. TO RECEIVE AND SPEND MONEY FOR ANY OF ITS  CORPORATE  PURPOSES  IN
ACCORDANCE WITH THIS ARTICLE; AND
  14.  TO  APPLY FOR, ACCEPT THE AWARD OF, AND SPEND ANY AVAILABLE GRANT
MONEY.
  S 3984. FUNCTIONS OF THE EXCHANGE.  THE EXCHANGE SHALL:
  1. (A) MAKE AVAILABLE QUALIFIED HEALTH PLANS TO QUALIFIED  INDIVIDUALS
AND  QUALIFIED EMPLOYERS BEGINNING ON OR BEFORE JANUARY FIRST, TWO THOU-
SAND FOURTEEN, PROVIDED THAT COVERAGE UNDER SUCH QUALIFIED  PLANS  SHALL
NOT BECOME EFFECTIVE PRIOR TO SUCH DATE AND SHALL NOT MAKE AVAILABLE ANY
HEALTH PLAN THAT IS NOT A QUALIFIED HEALTH PLAN;
  (B) MAKE AVAILABLE QUALIFIED DENTAL PLANS TO QUALIFIED INDIVIDUALS AND
QUALIFIED  EMPLOYERS  BEGINNING ON OR BEFORE JANUARY FIRST, TWO THOUSAND
FOURTEEN, PROVIDED THAT COVERAGE UNDER SUCH QUALIFIED DENTAL PLANS SHALL
NOT BECOME EFFECTIVE  PRIOR  TO  SUCH  DATE,  EITHER  SEPARATELY  OR  IN
CONJUNCTION  WITH  A QUALIFIED HEALTH PLAN, IF SUCH PLAN PROVIDES PEDIA-

S. 6256--B                         55                         A. 9056--B

TRIC DENTAL BENEFITS MEETING THE REQUIREMENTS OF  SECTION  1302(B)(1)(J)
OF THE FEDERAL ACT;
  2.  ASSIGN  A RATING TO EACH QUALIFIED HEALTH PLAN OFFERED THROUGH THE
EXCHANGE IN ACCORDANCE WITH THE  CRITERIA  DEVELOPED  BY  THE  SECRETARY
PURSUANT  TO  SECTION  1311(C)(3) OF THE FEDERAL ACT, AND DETERMINE EACH
QUALIFIED HEALTH PLAN'S LEVEL OF COVERAGE IN ACCORDANCE WITH REGULATIONS
ISSUED BY THE SECRETARY PURSUANT TO SECTION 1302(D)(2)(A) OF THE FEDERAL
ACT;
  3. UTILIZE A STANDARDIZED FORMAT FOR PRESENTING HEALTH BENEFIT OPTIONS
IN THE EXCHANGE, INCLUDING THE USE OF THE UNIFORM  OUTLINE  OF  COVERAGE
ESTABLISHED UNDER SECTION 2715 OF THE FEDERAL PUBLIC HEALTH SERVICE ACT;
  4.  PROVIDE  FOR ENROLLMENT PERIODS PURSUANT TO THE FEDERAL ACT OR THE
INSURANCE LAW, WHICHEVER IS IN THE BEST INTEREST OF  QUALIFIED  INDIVID-
UALS  AND  QUALIFIED  EMPLOYERS, AFTER THE INITIAL ENROLLMENT PERIOD HAS
BEEN ESTABLISHED AS REQUIRED IN THE FEDERAL ACT; PROVIDED, HOWEVER, THAT
IF ENROLLMENT PERIODS PURSUANT TO THE INSURANCE LAW CONFLICT WITH  RULES
ADOPTED BY THE SECRETARY, THEN ENROLLMENT PERIODS PURSUANT TO THE FEDER-
AL ACT SHALL APPLY;
  5.  IMPLEMENT  PROCEDURES  FOR  THE CERTIFICATION, RECERTIFICATION AND
DECERTIFICATION OF HEALTH PLANS AS QUALIFIED  HEALTH  PLANS,  CONSISTENT
WITH  GUIDELINES  DEVELOPED BY THE SECRETARY PURSUANT TO SECTION 1311(C)
OF THE FEDERAL ACT AND SECTION THIRTY-NINE HUNDRED EIGHTY-FIVE  OF  THIS
ARTICLE;
  6.  REQUIRE  QUALIFIED HEALTH PLANS TO OFFER THOSE BENEFITS DETERMINED
BY THE SECRETARY TO BE ESSENTIAL HEALTH  BENEFITS  PURSUANT  TO  SECTION
1302(B)  OF  THE  FEDERAL  ACT  (EXCEPT  AS PROVIDED IN PARAGRAPH (B) OF
SUBDIVISION ONE OF SECTION THREE THOUSAND NINE  HUNDRED  EIGHTY-FIVE  OF
THIS  ARTICLE)  AND SUCH ADDITIONAL BENEFITS AS MAY BE REQUIRED PURSUANT
TO THE INSURANCE LAW, PROVIDED THAT THE STATE HAS ASSUMED  THE  COST  OF
SUCH  ADDITIONAL BENEFITS AS REQUIRED UNDER SECTION 1311(D)(3)(B) OF THE
FEDERAL ACT;
  7. ENSURE THAT INSURERS OFFERING HEALTH PLANS THROUGH THE EXCHANGE  DO
NOT CHARGE AN INDIVIDUAL A FEE OR PENALTY FOR TERMINATION OF COVERAGE;
  8.  PROVIDE  FOR  THE  OPERATION  OF  A TOLL-FREE TELEPHONE HOTLINE TO
RESPOND TO REQUESTS FOR ASSISTANCE;
  9. MAINTAIN AN INTERNET WEBSITE THROUGH WHICH ENROLLEES  AND  PROSPEC-
TIVE ENROLLEES OF QUALIFIED HEALTH PLANS MAY OBTAIN STANDARDIZED COMPAR-
ATIVE INFORMATION ON SUCH PLANS AND PUBLIC HEALTH PROGRAMS;
  10.  ESTABLISH  AND MAKE AVAILABLE BY ELECTRONIC MEANS A CALCULATOR TO
DETERMINE THE ACTUAL COST OF  COVERAGE  AFTER  THE  APPLICATION  OF  ANY
PREMIUM  TAX  CREDIT  UNDER  SECTION 36B OF THE INTERNAL REVENUE CODE OF
1986 AND ANY COST-SHARING REDUCTION UNDER SECTION 1402  OF  THE  FEDERAL
ACT;
  11.  ESTABLISH  A  PROGRAM  UNDER  WHICH THE EXCHANGE AWARDS GRANTS TO
ENTITIES TO SERVE AS NAVIGATORS, IN ACCORDANCE WITH SECTION  1311(I)  OF
THE FEDERAL ACT AND REGULATIONS ADOPTED THEREUNDER;
  12.  IN  ACCORDANCE WITH SECTION 1413 OF THE FEDERAL ACT, INFORM INDI-
VIDUALS OF ELIGIBILITY REQUIREMENTS FOR THE MEDICAID PROGRAM UNDER TITLE
XIX OF THE SOCIAL SECURITY ACT, THE CHILDREN'S HEALTH INSURANCE  PROGRAM
(CHIP)  UNDER  TITLE  XXI  OF  THE SOCIAL SECURITY ACT OR ANY APPLICABLE
STATE OR LOCAL PUBLIC HEALTH INSURANCE PROGRAM AND IF, THROUGH SCREENING
OF THE APPLICATION BY THE EXCHANGE, THE EXCHANGE  DETERMINES  THAT  SUCH
INDIVIDUALS  ARE  ELIGIBLE FOR ANY SUCH PROGRAM, ENROLL SUCH INDIVIDUALS
IN SUCH PROGRAM;
  13. PURSUANT TO SECTION 1411 OF THE FEDERAL ACT, GRANT A CERTIFICATION
ATTESTING THAT, FOR PURPOSES OF THE  INDIVIDUAL  RESPONSIBILITY  PENALTY

S. 6256--B                         56                         A. 9056--B

UNDER  SECTION 5000A OF THE INTERNAL REVENUE CODE OF 1986, AN INDIVIDUAL
IS EXEMPT FROM THE INDIVIDUAL RESPONSIBILITY  REQUIREMENT  OR  FROM  THE
PENALTY IMPOSED BY THAT SECTION BECAUSE:
  (A) THERE IS NO AFFORDABLE QUALIFIED HEALTH PLAN AVAILABLE THROUGH THE
EXCHANGE OR THE INDIVIDUAL'S EMPLOYER, COVERING THE INDIVIDUAL; OR
  (B) THE INDIVIDUAL MEETS THE REQUIREMENTS FOR ANY OTHER SUCH EXEMPTION
FROM THE INDIVIDUAL RESPONSIBILITY REQUIREMENT OR PENALTY;
  14.  TRANSMIT  TO THE SECRETARY OF THE UNITED STATES DEPARTMENT OF THE
TREASURY:
  (A) A LIST OF THE INDIVIDUALS TO WHOM THE EXCHANGE GRANTED  A  CERTIF-
ICATION  UNDER  SUBDIVISION THIRTEEN OF THIS SECTION, INCLUDING THE NAME
AND TAXPAYER IDENTIFICATION NUMBER OF EACH INDIVIDUAL;
  (B) THE NAME AND TAXPAYER IDENTIFICATION NUMBER OF EACH INDIVIDUAL WHO
WAS AN EMPLOYEE OF AN EMPLOYER WHO WAS DETERMINED TO BE ELIGIBLE FOR THE
PREMIUM TAX CREDIT UNDER SECTION 36B OF THE  INTERNAL  REVENUE  CODE  OF
1986 BECAUSE:
  (I)  THE EMPLOYER DID NOT PROVIDE MINIMUM ESSENTIAL COVERAGE AS DETER-
MINED BY THE SECRETARY PURSUANT TO SECTION 1311(D) OF THE  FEDERAL  ACT;
OR
  (II)  THE  EMPLOYER  PROVIDED THE MINIMUM ESSENTIAL COVERAGE AS DETER-
MINED BY THE SECRETARY PURSUANT TO SECTION 1311(D) OF THE  FEDERAL  ACT,
BUT IT WAS DETERMINED UNDER SECTION 36B(C)(2)(C) OF THE INTERNAL REVENUE
CODE OF 1986 TO EITHER BE UNAFFORDABLE TO THE EMPLOYEE OR TO NOT PROVIDE
THE REQUIRED MINIMUM ACTUARIAL VALUE; AND
  (C) THE NAME AND TAXPAYER IDENTIFICATION NUMBER OF:
  (I)  EACH  INDIVIDUAL  WHO  NOTIFIES  THE EXCHANGE PURSUANT TO SECTION
1411(B)(4) OF THE FEDERAL ACT THAT HE OR SHE HAS CHANGED EMPLOYERS; AND
  (II) EACH INDIVIDUAL WHO CEASES COVERAGE UNDER A QUALIFIED HEALTH PLAN
DURING A PLAN YEAR AND THE EFFECTIVE DATE OF THAT CESSATION;
  15. PROVIDE TO EACH EMPLOYER THE NAME OF EACH EMPLOYEE OF THE EMPLOYER
DESCRIBED IN PARAGRAPH (B) OF SUBDIVISION FOURTEEN OF THIS  SECTION  WHO
CEASES COVERAGE UNDER A QUALIFIED HEALTH PLAN DURING A PLAN YEAR AND THE
EFFECTIVE DATE OF THE CESSATION;
  16.  OPERATE A SMALL BUSINESS HEALTH OPTIONS PROGRAM ("SHOP") PURSUANT
TO SECTION 1311 OF THE FEDERAL ACT  THROUGH  WHICH  QUALIFIED  EMPLOYERS
ACCESS COVERAGE FOR THEIR EMPLOYEES, AND MAY:
  (A) PERMIT QUALIFIED EMPLOYERS TO SPECIFY A LEVEL OF COVERAGE SO THEIR
EMPLOYEES  MAY  ENROLL  IN ANY QUALIFIED HEALTH PLAN OFFERED THROUGH THE
SHOP AT THE SPECIFIED LEVEL OF COVERAGE OR,  UNLESS  PROHIBITED  BY  THE
FEDERAL  ACT,  PROVIDE  A SPECIFIC AMOUNT OR OTHER PAYMENT FORMULATED IN
ACCORDANCE WITH THE FEDERAL ACT TO BE USED AS PART OF AN EMPLOYEE CHOICE
PLAN; AND
  (B) PROVIDE PREMIUM AGGREGATION AND OTHER RELATED SERVICES TO MINIMIZE
ADMINISTRATIVE BURDENS FOR QUALIFIED EMPLOYERS;
  17. ENTER INTO AGREEMENTS AS NECESSARY WITH:  (A)  FEDERAL  AND  STATE
AGENCIES  AND  OTHER  STATE  EXCHANGES TO CARRY OUT ITS RESPONSIBILITIES
UNDER  THIS  ARTICLE,  PROVIDED   SUCH   AGREEMENTS   INCLUDE   ADEQUATE
PROTECTIONS WITH RESPECT TO THE CONFIDENTIALITY OF ANY INFORMATION TO BE
SHARED AND COMPLY WITH ALL STATE AND FEDERAL LAWS AND REGULATIONS; AND
  (B)  LOCAL  DEPARTMENTS OF SOCIAL SERVICES TO COORDINATE ENROLLMENT IN
OTHER SOCIAL SERVICES PROGRAMS, AS APPROPRIATE, PROVIDED SUCH AGREEMENTS
INCLUDE ADEQUATE PROTECTIONS WITH RESPECT TO THE CONFIDENTIALITY OF  ANY
INFORMATION  TO BE SHARED AND COMPLY WITH ALL STATE AND FEDERAL LAWS AND
REGULATIONS;
  18. PERFORM DUTIES REQUIRED BY THE SECRETARY OR THE SECRETARY  OF  THE
UNITED  STATES  DEPARTMENT OF THE TREASURY RELATED TO DETERMINING ELIGI-

S. 6256--B                         57                         A. 9056--B

BILITY FOR PREMIUM TAX  CREDITS,  REDUCED  COST-SHARING,  OR  INDIVIDUAL
RESPONSIBILITY REQUIREMENT EXEMPTIONS;
  19.  MEET  FINANCIAL  INTEGRITY REQUIREMENTS UNDER SECTION 1313 OF THE
FEDERAL ACT AND THIS CHAPTER, INCLUDING:
  (A) KEEPING AN ACCURATE ACCOUNTING OF ALL  ACTIVITIES,  RECEIPTS,  AND
EXPENDITURES  AND ANNUALLY SUBMITTING TO THE SECRETARY A REPORT CONCERN-
ING SUCH ACCOUNTINGS, WITH A COPY OF SUCH REPORT PROVIDED TO THE  GOVER-
NOR, THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEM-
BLY; AND
  (B)  FULLY  COOPERATING WITH ANY INVESTIGATION CONDUCTED BY THE SECRE-
TARY PURSUANT TO THE SECRETARY'S AUTHORITY UNDER  SECTION  1313  OF  THE
FEDERAL ACT AND ALLOWING THE SECRETARY, IN COORDINATION WITH THE INSPEC-
TOR  GENERAL  OF  THE  UNITED  STATES  DEPARTMENT  OF  HEALTH  AND HUMAN
SERVICES, TO:
  (I) INVESTIGATE THE AFFAIRS OF THE EXCHANGE;
  (II) EXAMINE THE PROPERTIES AND RECORDS OF THE EXCHANGE; AND
  (III) REQUIRE PERIODIC REPORTS IN RELATION TO THE ACTIVITIES UNDERTAK-
EN BY THE EXCHANGE;
  20. (A) CONSULT WITH  THE  REGIONAL  ADVISORY  COMMITTEES  ESTABLISHED
PURSUANT TO SECTION THIRTY-NINE HUNDRED EIGHTY-SIX OF THIS ARTICLE; AND
  (B)  CONSULT WITH STAKEHOLDERS RELEVANT TO CARRYING OUT THE ACTIVITIES
REQUIRED UNDER THIS ARTICLE, INCLUDING BUT NOT LIMITED TO:
  (I) HEALTH CARE CONSUMERS WHO ARE ENROLLEES IN HEALTH PLANS;
  (II) INDIVIDUALS AND ENTITIES WITH EXPERIENCE IN FACILITATING  ENROLL-
MENT IN HEALTH PLANS;
  (III)  REPRESENTATIVES  OF SMALL BUSINESSES AND SELF-EMPLOYED INDIVID-
UALS;
  (IV) STATE MEDICAID OFFICES, INCLUDING  LOCAL  DEPARTMENTS  OF  SOCIAL
SERVICES;
  (V) ADVOCATES FOR ENROLLING HARD TO REACH POPULATIONS;
  (VI) HEALTH CARE PROVIDERS; AND
  (VII) INSURERS;
  21.  SUBMIT  INFORMATION PROVIDED BY EXCHANGE APPLICANTS FOR VERIFICA-
TION AS REQUIRED BY SECTION 1411(C) OF THE FEDERAL ACT;
  22. ESTABLISH RULES AND REGULATIONS, PURSUANT TO SUBDIVISION EIGHT  OF
SECTION  THIRTY-NINE  HUNDRED  EIGHTY-THREE OF THIS ARTICLE, THAT DO NOT
CONFLICT WITH OR PREVENT THE APPLICATION OF REGULATIONS  PROMULGATED  BY
THE SECRETARY; AND
  23.  DETERMINE ELIGIBILITY, PROVIDE NOTICES, AND PROVIDE OPPORTUNITIES
FOR APPEAL AND REDETERMINATION IN ACCORDANCE WITH  THE  REQUIREMENTS  OF
SECTIONS 1411 AND 1413 OF THE FEDERAL ACT.
  S  3985.  SPECIAL  FUNCTIONS  OF  THE  EXCHANGE RELATED TO HEALTH PLAN
CERTIFICATION AND QUALIFIED HEALTH PLAN  OVERSIGHT.    1.  HEALTH  PLANS
CERTIFIED BY THE EXCHANGE SHALL MEET THE FOLLOWING REQUIREMENTS:
  (A) THE INSURER OFFERING THE HEALTH PLAN:
  (I) IS LICENSED OR CERTIFIED BY THE SUPERINTENDENT OR COMMISSIONER AND
MEETS  THE  REQUIREMENTS  OF SECTION 1301(A)(1)(C)(I) OF THE FEDERAL ACT
AND ANY GUIDANCE ISSUED THEREUNDER;
  (II) OFFERS AT LEAST ONE QUALIFIED HEALTH PLAN IN EACH OF  THE  SILVER
AND GOLD LEVELS;
  (III)  HAS FILED WITH AND RECEIVED APPROVAL FROM THE SUPERINTENDENT OF
ITS PREMIUM RATES AND POLICY OR CONTRACT FORMS PURSUANT TO THE INSURANCE
LAW AND THE PUBLIC HEALTH LAW;
  (IV) DOES NOT CHARGE ANY CANCELLATION FEES OR PENALTIES  IN  VIOLATION
OF  SUBDIVISION SEVEN OF SECTION THIRTY-NINE HUNDRED EIGHTY-FOUR OF THIS
ARTICLE; AND

S. 6256--B                         58                         A. 9056--B

  (V) COMPLIES WITH THE REGULATIONS DEVELOPED  BY  THE  SECRETARY  UNDER
SECTION  1311(C)  OF  THE FEDERAL ACT AND SUCH OTHER REQUIREMENTS AS THE
EXCHANGE MAY ESTABLISH;
  (B)  THE HEALTH PLAN: (I) PROVIDES THE ESSENTIAL HEALTH BENEFITS PACK-
AGE DESCRIBED IN SECTION 1302(A) OF THE FEDERAL ACT  AND  INCLUDES  SUCH
ADDITIONAL  BENEFITS  AS  MAY BE REQUIRED PURSUANT TO THE INSURANCE LAW,
PROVIDED THAT THE STATE HAS ASSUMED THE COST OF SUCH ADDITIONAL BENEFITS
AS REQUIRED UNDER SECTION 1311(D)(3)(B) OF THE FEDERAL ACT, EXCEPT  THAT
THE HEALTH PLAN SHALL NOT BE REQUIRED TO PROVIDE ESSENTIAL BENEFITS THAT
DUPLICATE THE MINIMUM BENEFITS OF QUALIFIED DENTAL PLANS IF:
  (A)  THE  EXCHANGE  HAS  DETERMINED THAT AT LEAST ONE QUALIFIED DENTAL
PLAN IS AVAILABLE TO SUPPLEMENT THE HEALTH PLAN'S COVERAGE; AND
  (B) THE INSURER MAKES PROMINENT DISCLOSURE AT THE TIME IT  OFFERS  THE
HEALTH  PLAN, IN A FORM APPROVED BY THE EXCHANGE, THAT THE PLAN DOES NOT
PROVIDE THE FULL RANGE OF ESSENTIAL PEDIATRIC BENEFITS, AND THAT  QUALI-
FIED DENTAL PLANS PROVIDING THOSE BENEFITS AND OTHER DENTAL BENEFITS NOT
COVERED BY THE PLAN ARE OFFERED THROUGH THE EXCHANGE;
  (II)  PROVIDES  AT  LEAST  A  BRONZE  LEVEL  OF COVERAGE AS DEFINED IN
SECTION 1302(D) OF THE FEDERAL ACT, UNLESS THE PLAN IS  CERTIFIED  AS  A
QUALIFIED CATASTROPHIC PLAN, AS DEFINED IN SECTION 1302(E) OF THE FEDER-
AL   ACT,  AND  SHALL  ONLY  BE  OFFERED  TO  INDIVIDUALS  ELIGIBLE  FOR
CATASTROPHIC COVERAGE;
  (III) HAS COST-SHARING REQUIREMENTS, INCLUDING DEDUCTIBLES,  WHICH  DO
NOT  EXCEED  THE LIMITS ESTABLISHED UNDER SECTION 1302(C) OF THE FEDERAL
ACT AND ANY REQUIREMENTS OF THE EXCHANGE;
  (IV) COMPLIES WITH REGULATIONS PROMULGATED BY THE  SECRETARY  PURSUANT
TO  SECTION  1311(C) OF THE FEDERAL ACT, WHICH INCLUDE MINIMUM STANDARDS
IN THE AREAS OF MARKETING PRACTICES, NETWORK ADEQUACY, ESSENTIAL  COMMU-
NITY PROVIDERS IN UNDERSERVED AREAS, ACCREDITATION, QUALITY IMPROVEMENT,
UNIFORM ENROLLMENT FORMS AND DESCRIPTIONS OF COVERAGE AND INFORMATION ON
QUALITY MEASURES FOR HEALTH BENEFIT PLAN PERFORMANCE;
  (V) COMPLIES WITH THE INSURANCE LAW AND THE PUBLIC HEALTH LAW REQUIRE-
MENTS  APPLICABLE TO HEALTH INSURANCE ISSUED IN THIS STATE AND ANY REGU-
LATIONS PROMULGATED PURSUANT  THERETO  THAT  DO  NOT  CONFLICT  WITH  OR
PREVENT THE APPLICATION OF FEDERAL REQUIREMENTS; AND
  (C)  THE  EXCHANGE  DETERMINES  THAT  MAKING THE HEALTH PLAN AVAILABLE
THROUGH THE EXCHANGE IS IN THE INTEREST  OF  QUALIFIED  INDIVIDUALS  AND
QUALIFIED EMPLOYERS IN THIS STATE.
  2. THE EXCHANGE SHALL NOT EXCLUDE A HEALTH PLAN:
  (A) ON THE BASIS THAT THE HEALTH PLAN IS A FEE-FOR-SERVICE PLAN;
  (B)  THROUGH THE IMPOSITION OF PREMIUM PRICE CONTROLS BY THE EXCHANGE;
OR
  (C) ON THE BASIS THAT THE HEALTH PLAN PROVIDES TREATMENTS NECESSARY TO
PREVENT PATIENTS' DEATHS IN CIRCUMSTANCES THE  EXCHANGE  DETERMINES  ARE
INAPPROPRIATE OR TOO COSTLY.
  3.  THE  EXCHANGE  SHALL  REQUIRE  EACH  INSURER  CERTIFIED OR SEEKING
CERTIFICATION OF A HEALTH PLAN AS A QUALIFIED HEALTH PLAN TO:
  (A) SUBMIT A JUSTIFICATION FOR ANY PREMIUM INCREASE  TO  THE  EXCHANGE
PRIOR TO IMPLEMENTATION OF SUCH INCREASE.  THE INSURER SHALL PROMINENTLY
POST THE INFORMATION ON ITS INTERNET WEBSITE; PROVIDED, HOWEVER, THAT IF
INFORMATION  SUBMITTED  TO  THE  SUPERINTENDENT AS A JUSTIFICATION FOR A
PREMIUM RATE ADJUSTMENT PURSUANT TO THE INSURANCE  LAW,  OR  INFORMATION
POSTED  TO  AN  INSURER'S  INTERNET  WEBSITE,  OTHERWISE  MEETS  FEDERAL
REQUIREMENTS, THEN SUBMISSION OF A COPY OF THE SAME JUSTIFICATION TO THE
EXCHANGE OR USE OF THE SAME POSTING SHALL BE DEEMED SUFFICIENT  TO  MEET
THE REQUIREMENTS OF THIS SECTION.  THE EXCHANGE SHALL TAKE THIS INFORMA-

S. 6256--B                         59                         A. 9056--B

TION,  AND  THE  INFORMATION  AND  THE  RECOMMENDATIONS  PROVIDED TO THE
EXCHANGE BY THE SUPERINTENDENT UNDER SECTION 1003  OF  THE  FEDERAL  ACT
(RELATING  TO  PATTERNS OR PRACTICES OF EXCESSIVE OR UNJUSTIFIED PREMIUM
INCREASES),  INTO  CONSIDERATION  WHEN  DETERMINING WHETHER TO ALLOW THE
INSURER TO MAKE HEALTH PLANS AVAILABLE THROUGH THE EXCHANGE.  SUCH  RATE
INCREASES  SHALL  BE SUBJECT TO THE PRIOR APPROVAL OF THE SUPERINTENDENT
PURSUANT TO THE INSURANCE LAW;
  (B)(I) MAKE AVAILABLE TO THE PUBLIC AND SUBMIT TO  THE  EXCHANGE,  THE
SECRETARY AND THE SUPERINTENDENT, ACCURATE AND TIMELY DISCLOSURE OF:
  (A) CLAIMS PAYMENT POLICIES AND PRACTICES;
  (B) PERIODIC FINANCIAL DISCLOSURES;
  (C) DATA ON ENROLLMENT AND DISENROLLMENT;
  (D) DATA ON THE NUMBER OF CLAIMS THAT ARE DENIED;
  (E) DATA ON RATING PRACTICES;
  (F)  INFORMATION ON COST-SHARING AND PAYMENTS WITH RESPECT TO ANY OUT-
OF-NETWORK COVERAGE;
  (G) INFORMATION ON ENROLLEE AND PARTICIPANT RIGHTS UNDER  TITLE  I  OF
THE FEDERAL ACT; AND
  (H) OTHER INFORMATION AS DETERMINED APPROPRIATE BY THE SECRETARY;
  (II) THE INFORMATION SHALL BE PROVIDED IN PLAIN LANGUAGE, AS THAT TERM
IS  DEFINED IN SECTION 1311(E)(3)(B) OF THE FEDERAL ACT, AND IN GUIDANCE
JOINTLY ISSUED THEREUNDER BY THE SECRETARY AND THE FEDERAL SECRETARY  OF
LABOR; AND
  (C) PROVIDE TO INDIVIDUALS, IN A TIMELY MANNER UPON THE REQUEST OF THE
INDIVIDUAL,  THE  AMOUNT  OF COST-SHARING, INCLUDING DEDUCTIBLES, COPAY-
MENTS, AND COINSURANCE, UNDER THE INDIVIDUAL'S HEALTH PLAN  OR  COVERAGE
THAT  THE INDIVIDUAL WOULD BE RESPONSIBLE FOR PAYING WITH RESPECT TO THE
FURNISHING OF A SPECIFIC ITEM OR SERVICE BY A PARTICIPATING PROVIDER. AT
A MINIMUM, THIS INFORMATION SHALL BE MADE AVAILABLE  TO  THE  INDIVIDUAL
THROUGH  AN  INTERNET  WEBSITE  AND  THROUGH OTHER MEANS FOR INDIVIDUALS
WITHOUT ACCESS TO THE INTERNET; PROVIDED, HOWEVER, THAT  TO  THE  EXTENT
THAT  REQUIREMENTS UNDER THE INSURANCE LAW OR THE PUBLIC HEALTH LAW MEET
THE STANDARDS OF THE FEDERAL ACT,  AN  INSURER'S  COMPLIANCE  WITH  SUCH
STATE  REQUIREMENTS SHALL BE SUFFICIENT TO MEET THE REQUIREMENTS OF THIS
SECTION.
  4. (A) THE PROVISIONS OF THIS ARTICLE THAT APPLY TO  QUALIFIED  HEALTH
PLANS  ALSO SHALL APPLY TO THE EXTENT RELEVANT TO QUALIFIED DENTAL PLANS
EXCEPT AS MODIFIED IN ACCORDANCE WITH THE PROVISIONS OF  PARAGRAPHS  (B)
AND (C) OF THIS SUBDIVISION OR OTHERWISE REQUIRED BY THE EXCHANGE.
  (B)  THE  QUALIFIED  DENTAL  PLAN  SHALL BE LIMITED TO DENTAL AND ORAL
HEALTH BENEFITS, WITHOUT SUBSTANTIALLY DUPLICATING THE BENEFITS TYPICAL-
LY OFFERED BY HEALTH BENEFIT PLANS WITHOUT DENTAL  COVERAGE,  AND  SHALL
INCLUDE,   AT   A  MINIMUM,  THE  ESSENTIAL  PEDIATRIC  DENTAL  BENEFITS
PRESCRIBED BY THE SECRETARY PURSUANT TO  SECTION  1302(B)(1)(J)  OF  THE
FEDERAL ACT, AND SUCH OTHER DENTAL BENEFITS AS THE EXCHANGE OR SECRETARY
MAY SPECIFY IN REGULATIONS.
  (C)  INSURERS  MAY  JOINTLY  OFFER  A  COMPREHENSIVE  PLAN THROUGH THE
EXCHANGE IN WHICH AN INSURER PROVIDES  THE  DENTAL  BENEFITS  THROUGH  A
QUALIFIED DENTAL PLAN AND AN INSURER PROVIDES THE OTHER BENEFITS THROUGH
A  QUALIFIED  HEALTH PLAN, PROVIDED THAT THE PLANS ARE PRICED SEPARATELY
AND ALSO ARE MADE AVAILABLE FOR PURCHASE SEPARATELY AT THE SAME PRICE.
  S 3986. REGIONAL ADVISORY COMMITTEES. 1. THERE ARE HEREBY CREATED  THE
NEW YORK HEALTH BENEFIT EXCHANGE REGIONAL ADVISORY COMMITTEES ("ADVISORY
COMMITTEES"). ONE REGIONAL ADVISORY COMMITTEE SHALL BE ESTABLISHED WITH-
IN  EACH  OF  FIVE  REGIONS,  TO BE KNOWN AS THE "NEW YORK CITY REGION,"
"METROPOLITAN SUBURBAN REGION," "NORTHERN REGION," "CENTRAL REGION"  AND

S. 6256--B                         60                         A. 9056--B

"WESTERN  REGION."  THE  BOARD SHALL DETERMINE THE COUNTIES THAT MAKE UP
SUCH REGIONS.
  2. EACH REGIONAL ADVISORY COMMITTEE SHALL BE COMPRISED OF FIVE MEMBERS
APPOINTED  BY  THE  GOVERNOR,  ONE  OF  WHOM SHALL BE APPOINTED UPON THE
RECOMMENDATION OF THE TEMPORARY PRESIDENT OF THE SENATE AND ONE OF  WHOM
SHALL  BE APPOINTED UPON THE RECOMMENDATION OF THE SPEAKER OF THE ASSEM-
BLY.
  3. TERMS SHALL BE THREE  YEARS.    MEMBERS  SHALL  SERVE  UNTIL  THEIR
SUCCESSORS ARE APPOINTED. MEMBERS MAY SERVE UP TO TWO CONSECUTIVE TERMS.
  4.  VACANCIES  SHALL BE FILLED IN THE SAME MANNER AS ORIGINAL APPOINT-
MENTS, AND SUCCESSORS SHALL SERVE FOR THE  REMAINDER  OF  THE  UNEXPIRED
TERM TO WHICH THEY ARE APPOINTED.
  5.  RECOMMENDATIONS  BY  THE TEMPORARY PRESIDENT OF THE SENATE AND THE
SPEAKER OF THE ASSEMBLY SHALL BE MADE WITHIN SIXTY DAYS OF THE EFFECTIVE
DATE OF THIS ARTICLE OR THE OCCURRENCE OF A  VACANCY,  OR  WITHIN  SIXTY
DAYS PRIOR TO THE EXPIRATION OF A TERM.
  6. THE MEMBERS OF EACH REGIONAL ADVISORY COMMITTEE SHALL INCLUDE:
  (A)  REPRESENTATIVES  FROM THE FOLLOWING CATEGORIES, BUT NOT MORE THAN
TWO FROM ANY SINGLE CATEGORY:
  (I) HEALTH PLAN CONSUMER ADVOCATES;
  (II) SMALL BUSINESS CONSUMER REPRESENTATIVES;
  (III) HEALTH CARE PROVIDER REPRESENTATIVES;
  (IV) REPRESENTATIVES OF THE HEALTH INSURANCE INDUSTRY;
  (B) REPRESENTATIVES FROM THE FOLLOWING CATEGORIES, BUT NOT  MORE  THAN
ONE FROM EITHER CATEGORY:
  (I) LICENSED INSURANCE PRODUCERS; AND
  (II) REPRESENTATIVES OF LABOR ORGANIZATIONS.
  7.  THE BOARD SHALL SELECT THE CHAIR OF EACH REGIONAL ADVISORY COMMIT-
TEE FROM AMONG THE MEMBERS OF SUCH  COMMITTEE.  THE  BOARD  SHALL  ADOPT
RULES  FOR  THE  GOVERNANCE OF THE REGIONAL ADVISORY COMMITTEES AND EACH
REGIONAL ADVISORY COMMITTEE SHALL MEET AT LEAST ONCE EACH QUARTER AND AT
SUCH OTHER TIMES AS DETERMINED BY THE BOARD TO BE NECESSARY.
  8. MEMBERS OF THE REGIONAL ADVISORY  COMMITTEES  SHALL  SERVE  WITHOUT
COMPENSATION.
  9.  THE REGIONAL ADVISORY COMMITTEES SHALL MAKE FINDINGS AND RECOMMEN-
DATIONS REGARDING REGIONAL VARIATIONS IN THE OPERATION OF THE  EXCHANGE,
WHICH  SHALL  BE  SUBMITTED  TO  THE  BOARD  OF DIRECTORS, POSTED ON THE
WEBSITE OF THE EXCHANGE, AND CONSIDERED BY THE  BOARD  IN  A  REASONABLY
TIMELY  FASHION.  SUCH  FINDINGS AND RECOMMENDATIONS SHALL BE MADE ON AN
ANNUAL BASIS, ON A DATE DETERMINED BY THE BOARD, AND AT SUCH OTHER TIMES
AS THE BOARD OR ANY REGIONAL ADVISORY COMMITTEE DEEMS APPROPRIATE.
  S 3987. FUNDING OF THE EXCHANGE.  1. THE EXCHANGE SHALL BE FINANCIALLY
SELF-SUFFICIENT BY JANUARY FIRST, TWO THOUSAND FIFTEEN.
  2. THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF, AND
SHALL REPORT ITS RECOMMENDATIONS UPON, THE OPTIONS TO  GENERATE  FUNDING
FOR  THE  ONGOING OPERATION OF THE EXCHANGE, AS PROVIDED FOR IN SUBDIVI-
SION EIGHT OF SECTION THIRTY-NINE HUNDRED EIGHTY-EIGHT OF  THIS  ARTICLE
AND  SUBJECT  TO  THE PROVISIONS OF SUBDIVISIONS FOURTEEN AND FIFTEEN OF
SUCH SECTION.
  3.  THE EXCHANGE SHALL PUBLISH ON ITS INTERNET WEBSITE  THE  FEES  AND
ANY  OTHER  PAYMENTS  REQUIRED  BY  THE EXCHANGE, AND THE ADMINISTRATIVE
COSTS OF THE EXCHANGE, TO EDUCATE CONSUMERS ON SUCH COSTS AND THE AMOUNT
OF MONIES LOST TO WASTE, FRAUD AND ABUSE.
  4. THE EXCHANGE SHALL NOT UTILIZE ANY FUNDS INTENDED FOR THE  ADMINIS-
TRATIVE  AND  OPERATIONAL  EXPENSES  OF THE EXCHANGE FOR STAFF RETREATS,
PROMOTIONAL GIVEAWAYS, EXCESSIVE EXECUTIVE COMPENSATION, OR PROMOTION OF

S. 6256--B                         61                         A. 9056--B

FEDERAL OR STATE LEGISLATIVE AND REGULATORY  MODIFICATIONS  PURSUANT  TO
SECTION 1411(C) OF THE FEDERAL ACT.
  5.  THE  MONEYS OF THE EXCHANGE SHALL, EXCEPT AS OTHERWISE PROVIDED IN
THIS SECTION, BE DEPOSITED IN A GENERAL  ACCOUNT  CALLED  THE  NEW  YORK
HEALTH  BENEFIT EXCHANGE ACCOUNT AND SUCH OTHER ACCOUNTS AS THE EXCHANGE
MAY DEEM NECESSARY, PURSUANT TO RESOLUTION OF THE BOARD, FOR THE  TRANS-
ACTION  OF ITS BUSINESS AND SHALL BE PAID OUT AS AUTHORIZED BY THE CHAIR
OF THE BOARD OR BY SUCH OTHER PERSON OR PERSONS AS THE CHAIR MAY  DESIG-
NATE.
  6.  NO  FUNDS OF THE EXCHANGE SHALL BE TRANSFERRED TO THE GENERAL FUND
OR ANY SPECIAL REVENUE FUND OR SHALL BE USED FOR ANY PURPOSE OTHER  THAN
THE  PURPOSES  SET FORTH IN THIS ARTICLE.  NO FUNDS SHALL BE TRANSFERRED
FROM THE GENERAL FUND OR ANY SPECIAL REVENUE FUND TO THE EXCHANGE  WITH-
OUT AN APPROPRIATION.
  7. THE ACCOUNTS OF THE EXCHANGE SHALL BE SUBJECT TO SUPERVISION OF THE
COMPTROLLER  AND  SUCH  ACCOUNTS  SHALL  INCLUDE RECEIPTS, EXPENDITURES,
CONTRACTS AND OTHER MATTERS WHICH PERTAIN TO THE FISCAL SOUNDNESS OF THE
EXCHANGE.
  8. NOTWITHSTANDING ANY LAW TO THE CONTRARY,  AND  IN  ACCORDANCE  WITH
SECTION  FOUR  OF THE STATE FINANCE LAW, UPON REQUEST OF THE DIRECTOR OF
THE BUDGET, IN CONSULTATION WITH THE  COMMISSIONER,  THE  SUPERINTENDENT
AND  THE  CHAIR  OF  THE BOARD, THE COMPTROLLER IS HEREBY AUTHORIZED AND
DIRECTED TO SUBALLOCATE OR TRANSFER SPECIAL REVENUE FEDERAL FUNDS APPRO-
PRIATED TO THE DEPARTMENT OF HEALTH FOR PLANNING AND IMPLEMENTING  VARI-
OUS  HEALTHCARE  AND  INSURANCE REFORM INITIATIVES AUTHORIZED BY FEDERAL
LEGISLATION, INCLUDING, BUT NOT LIMITED TO, THE PATIENT  PROTECTION  AND
AFFORDABLE  CARE  ACT  (P.L.  111-148) AND THE HEALTH CARE AND EDUCATION
RECONCILIATION ACT OF 2010 (P.L. 111-152) TO THE NEW YORK  STATE  HEALTH
BENEFIT  EXCHANGE.  MONEYS  SUBALLOCATED OR TRANSFERRED PURSUANT TO THIS
SECTION SHALL BE PAID OUT OF THE FUND UPON  AUDIT  AND  WARRANT  OF  THE
STATE COMPTROLLER ON VOUCHERS CERTIFIED OR APPROVED BY THE EXCHANGE.
  S  3988.  STUDIES  AND  RECOMMENDATIONS.    1.  (A) THE EXCHANGE SHALL
CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF, AND SHALL MAKE  RECOMMENDA-
TIONS  UPON,  THE  ESSENTIAL HEALTH BENEFITS IDENTIFIED BY THE SECRETARY
PURSUANT TO SECTION 1302(B) OF THE  FEDERAL  ACT  AND  OF  THE  BENEFITS
REQUIRED  UNDER  THE INSURANCE LAW OR REGULATIONS PROMULGATED THEREUNDER
THAT ARE NOT DETERMINED BY THE SECRETARY TO BE  ESSENTIAL  HEALTH  BENE-
FITS. SUCH STUDY AND RECOMMENDATIONS SHALL ADDRESS MATTERS INCLUDING BUT
NOT LIMITED TO:
  (I)  WHETHER  THE ESSENTIAL HEALTH BENEFITS REQUIRED TO BE INCLUDED IN
POLICIES AND CONTRACTS SOLD THROUGH THE EXCHANGE SHOULD BE SOLD TO SIMI-
LARLY SITUATED INDIVIDUALS AND GROUPS PURCHASING COVERAGE OUTSIDE OF THE
EXCHANGE;
  (II) WHETHER ANY BENEFITS REQUIRED UNDER THE INSURANCE  LAW  OR  REGU-
LATIONS  PROMULGATED  THEREUNDER  THAT  ARE  NOT IDENTIFIED AS ESSENTIAL
HEALTH BENEFITS BY THE SECRETARY SHOULD NO LONGER BE REQUIRED  IN  POLI-
CIES OR CONTRACTS SOLD EITHER THROUGH THE EXCHANGE OR TO SIMILARLY SITU-
ATED INDIVIDUALS AND GROUPS OUTSIDE OF THE EXCHANGE;
  (III) THE COSTS OF EXTENDING ANY BENEFITS REQUIRED UNDER THE INSURANCE
LAW OR REGULATIONS PROMULGATED THEREUNDER TO POLICIES AND CONTRACTS SOLD
THROUGH THE EXCHANGE; AND
  (IV)   MECHANISMS   TO   FINANCE   ANY   COSTS   PURSUANT  TO  SECTION
1311(D)(3)(B)(II) OF THE FEDERAL ACT OF EXTENDING ANY BENEFITS  REQUIRED
UNDER  THE  INSURANCE LAW OR REGULATIONS PROMULGATED THEREUNDER TO POLI-
CIES AND CONTRACTS SOLD THROUGH THE EXCHANGE.

S. 6256--B                         62                         A. 9056--B

  (B) IN MAKING ITS RECOMMENDATIONS, THE  EXCHANGE  SHALL  CONSIDER  THE
INDIVIDUAL  AND SMALL GROUP MARKETS OUTSIDE OF THE EXCHANGE AND CONSIDER
APPROACHES TO PREVENT MARKETPLACE DISRUPTION, REMAIN CONSISTENT WITH THE
EXCHANGE AND AVOID ANTI-SELECTION.
  (C) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY  PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  2. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND SHALL MAKE RECOMMENDATIONS UPON: (I) WHETHER INSURERS  PARTICIPATING
IN THE EXCHANGE SHOULD BE REQUIRED TO OFFER ALL HEALTH PLANS SOLD IN THE
EXCHANGE  TO  INDIVIDUALS OR SMALL GROUPS PURCHASING COVERAGE OUTSIDE OF
THE EXCHANGE;
  (II) WHETHER THE INDIVIDUAL AND SMALL GROUP MARKETS SHOULD  BE  PLACED
ENTIRELY INSIDE THE EXCHANGE;
  (III)  WHETHER  THE BENEFITS IN THE INDIVIDUAL AND SMALL GROUP MARKETS
SHOULD BE STANDARDIZED INSIDE THE EXCHANGE OR  INSIDE  AND  OUTSIDE  THE
EXCHANGE;
  (IV) HOW TO DEVELOP AND IMPLEMENT THE TRANSITIONAL REINSURANCE PROGRAM
FOR  THE  INDIVIDUAL  MARKET  AND  ANY  OTHER RISK ADJUSTMENT MECHANISMS
DEVELOPED IN ACCORDANCE WITH SECTIONS 1341, 1342 AND 1343 OF THE FEDERAL
ACT;
  (V) WHETHER TO MERGE THE INDIVIDUAL AND SMALL GROUP  HEALTH  INSURANCE
MARKETS  FOR  RATING  PURPOSES  INCLUDING AN ANALYSIS OF THE IMPACT SUCH
MERGER WOULD HAVE ON PREMIUMS;
  (VI) WHETHER TO INCREASE THE SIZE OF SMALL EMPLOYERS FROM  AN  AVERAGE
OF  AT  LEAST  ONE BUT NOT MORE THAN FIFTY EMPLOYEES TO AN AVERAGE OF AT
LEAST ONE BUT NOT MORE THAN  ONE  HUNDRED  EMPLOYEES  PRIOR  TO  JANUARY
FIRST, TWO THOUSAND SIXTEEN;
  (VII)  HOW  TO ACCOUNT FOR SOLE PROPRIETORS IN DEFINING "SMALL EMPLOY-
ERS"; AND
  (VIII) WHETHER TO REVISE THE DEFINITION OF  "SMALL  EMPLOYER"  OUTSIDE
THE  EXCHANGE  TO BE CONSISTENT WITH THE DEFINITION AS IT APPLIES WITHIN
THE EXCHANGE.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON  OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  3. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND  SHALL MAKE RECOMMENDATIONS UPON, WHETHER THE STATE SHOULD ESTABLISH
A BASIC HEALTH PLAN PROGRAM IDENTIFIED  BY  THE  SECRETARY  PURSUANT  TO
SECTION 1331 OF THE FEDERAL ACT.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY  PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  4. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND SHALL MAKE RECOMMENDATIONS UPON, THE ADVANTAGES AND DISADVANTAGES OF
THE EXCHANGE SERVING AS AN ACTIVE PURCHASER, A SELECTIVE CONTRACTOR,  OR
CLEARINGHOUSE OF INSURANCE.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY  PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  5. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND SHALL MAKE RECOMMENDATIONS UPON, (I) THE ANTICIPATED ANNUAL  OPERAT-
ING  EXPENSES OF THE EXCHANGE, INCLUDING BUT NOT LIMITED TO THE DEVELOP-
MENT OF ANY MULTI-YEAR FINANCIAL MODELS; AND (II) THE OPTIONS TO  GENER-
ATE  FUNDING  FOR  THE  ONGOING  OPERATION  AND  SELF-SUFFICIENCY OF THE

S. 6256--B                         63                         A. 9056--B

EXCHANGE INCLUDING BUT NOT LIMITED  TO  ASSESSMENTS  UPON  INSURERS  AND
PROVIDERS.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY  PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  6. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND SHALL MAKE RECOMMENDATIONS UPON, THE BENCHMARK  BENEFITS  IDENTIFIED
BY  THE  SECRETARY  AND OF THE BENEFITS REQUIRED UNDER THE PUBLIC HEALTH
LAW OR THE SOCIAL SERVICES LAW  OR  REGULATIONS  PROMULGATED  THEREUNDER
THAT  ARE NOT DETERMINED BY THE SECRETARY TO BE BENCHMARK BENEFITS. SUCH
STUDY AND RECOMMENDATIONS SHALL ADDRESS MATTERS INCLUDING BUT NOT LIMIT-
ED TO:
  (I) WHETHER ANY BENEFITS REQUIRED UNDER THE PUBLIC HEALTH LAW  OR  THE
SOCIAL  SERVICES  LAW OR REGULATIONS PROMULGATED THEREUNDER THAT ARE NOT
IDENTIFIED AS BENCHMARK BENEFITS BY THE SECRETARY SHOULD CONTINUE TO  BE
REQUIRED  AS COVERED BENEFITS AVAILABLE TO NEWLY MEDICAID-ELIGIBLE INDI-
VIDUALS INSIDE THE EXCHANGE;
  (II) THE COSTS OF EXTENDING ANY BENEFITS  REQUIRED  UNDER  THE  PUBLIC
HEALTH  LAW OR THE SOCIAL SERVICES LAW OR REGULATIONS PROMULGATED THERE-
UNDER AS COVERED BENEFITS AVAILABLE TO NEWLY MEDICAID-ELIGIBLE  INDIVID-
UALS THROUGH THE EXCHANGE; AND
  (III)  MECHANISMS  TO FINANCE ANY COSTS PURSUANT TO THE FEDERAL ACT OF
EXTENDING ANY BENEFITS REQUIRED UNDER  THE  PUBLIC  HEALTH  LAW  OR  THE
SOCIAL  SERVICES  LAW  OR REGULATIONS PROMULGATED THEREUNDER TO POLICIES
AND CONTRACTS SOLD THROUGH THE EXCHANGE.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON  OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  7.  (A) THE EXCHANGE SHALL MAKE RECOMMENDATIONS UPON THE IMPACT OF THE
ESTABLISHMENT AND OPERATION OF THE EXCHANGE  ON  THE  HEALTHY  NEW  YORK
PROGRAM  ESTABLISHED  PURSUANT TO SECTION FORTY-THREE HUNDRED TWENTY-SIX
OF THE INSURANCE LAW AND THE FAMILY  HEALTH  PLUS  EMPLOYER  PARTNERSHIP
PROGRAM  ESTABLISHED  PURSUANT TO SECTION THREE HUNDRED SIXTY-NINE-FF OF
THE SOCIAL SERVICES LAW.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON  OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  8. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND  SHALL  MAKE  RECOMMENDATIONS  UPON, PROCEDURES UNDER WHICH LICENSED
HEALTH INSURANCE PRODUCERS, CHAMBERS OF COMMERCE  AND  BUSINESS  ASSOCI-
ATIONS MAY ENROLL INDIVIDUALS AND EMPLOYERS IN ANY QUALIFIED HEALTH PLAN
IN  THE  INDIVIDUAL OR SMALL GROUP MARKET AS SOON AS THE PLAN IS OFFERED
THROUGH THE EXCHANGE; AND TO ASSIST INDIVIDUALS IN APPLYING FOR  PREMIUM
TAX  CREDITS  AND  COST-SHARING  REDUCTIONS  FOR  PLANS SOLD THROUGH THE
EXCHANGE; AND
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND SPEAKER  OF  THE  ASSEMBLY  ON  OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  9. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND  SHALL  MAKE  RECOMMENDATIONS  UPON, THE CRITERIA FOR ELIGIBILITY TO
SERVE AS A NAVIGATOR FOR PURPOSES OF SECTION 1311(I) OF THE FEDERAL ACT,
ANY GUIDANCE ISSUED THEREUNDER AND SUBDIVISION FOURTEEN OF SECTION THIR-
TY-NINE HUNDRED EIGHTY-FOUR OF THIS ARTICLE.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON  OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.

S. 6256--B                         64                         A. 9056--B

  10.  (A)  THE  EXCHANGE SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY
OF, AND SHALL MAKE RECOMMENDATIONS UPON, THE ROLE  OF  THE  EXCHANGE  IN
DECREASING  HEALTH  DISPARITIES IN HEALTH CARE SERVICES AND PERFORMANCE,
INCLUDING BUT NOT LIMITED TO DISPARITIES ON THE BASIS OF RACE OR ETHNIC-
ITY,  IN  ACCORDANCE WITH SECTION FORTY-THREE HUNDRED TWO OF THE FEDERAL
ACT.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON  OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  11.  (A)  THE  EXCHANGE SHALL MAKE RECOMMENDATIONS UPON WHETHER AND TO
WHAT EXTENT HEALTH  SAVINGS  ACCOUNTS  SHOULD  BE  OFFERED  THROUGH  THE
EXCHANGE.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY  PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR
BEFORE AUGUST FIRST, TWO THOUSAND TWELVE.
  12. (A) THE EXCHANGE SHALL CONDUCT OR CAUSE TO BE  CONDUCTED  A  STUDY
OF,  AND SHALL MAKE RECOMMENDATIONS UPON, WHETHER TO ALLOW LARGE EMPLOY-
ERS TO PARTICIPATE IN THE EXCHANGE BEGINNING JANUARY FIRST, TWO THOUSAND
SEVENTEEN, AND SHALL TAKE INTO ACCOUNT  ANY  EXCESS  OF  PREMIUM  GROWTH
OUTSIDE  OF  THE  EXCHANGE AS COMPARED TO THE RATE OF SUCH GROWTH INSIDE
THE EXCHANGE.
  (B) THE EXCHANGE SHALL SUBMIT ITS RECOMMENDATIONS TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY ON  OR
BEFORE DECEMBER FIRST, TWO THOUSAND FIFTEEN.
  13.  THE  EXCHANGE  SHALL CONDUCT OR CAUSE TO BE CONDUCTED A STUDY OF,
AND SHALL MAKE RECOMMENDATIONS UPON, THE INTEGRATION  OF  PUBLIC  HEALTH
INSURANCE  PROGRAMS,  INCLUDING  MEDICAID, CHILD HEALTH PLUS, AND FAMILY
HEALTH PLUS WITHIN THE EXCHANGE, WHICH MAY INCLUDE SUCH REPORTS  AS  ARE
PERIODICALLY  SUBMITTED TO THE SECRETARY, ON OR BEFORE AUGUST FIRST, TWO
THOUSAND TWELVE.
  14. NOTWITHSTANDING ANY PROVISION OF SUBDIVISIONS ONE THROUGH THIRTEEN
OF THIS SECTION, IF THE EXCHANGE  DETERMINES  THAT  ANY  RECOMMENDATIONS
REQUIRED UNDER ANY SUCH SUBDIVISION CANNOT BE SUBMITTED BY THE SPECIFIED
DATE  BECAUSE FEDERAL GUIDANCE OR REGULATIONS NECESSARY TO COMPLETE SUCH
RECOMMENDATIONS HAS NOT BEEN ISSUED, THE EXCHANGE MAY  ESTABLISH  A  NEW
AND REASONABLE DATE FOR SUCH COMPLETION AND SUBMISSION.
  15. (A) ANY OF THE STUDIES REQUIRED UNDER THIS SECTION MAY BE COMBINED
WITH  OTHER  STUDIES REQUIRED UNDER THIS SECTION OR OTHERWISE UNDERTAKEN
BY THE EXCHANGE TO THE EXTENT FEASIBLE AND TIMELY.
  (B) IN LIEU OF CONDUCTING OR  CAUSING  TO  BE  CONDUCTED  ANY  OF  THE
STUDIES  REQUIRED  UNDER  THIS  SECTION,  THE EXCHANGE MAY RELY UPON ANY
OTHER STUDY OR STUDIES, IN WHOLE OR IN PART, COMPLETED PRIOR TO THE DATE
ON WHICH THE EXCHANGE  SUBMITS  ITS  RECOMMENDATIONS,  IF  THE  EXCHANGE
DETERMINES THAT SUCH STUDY OR STUDIES ARE SUFFICIENTLY RELIABLE.
  16.  THE EXCHANGE SHALL HAVE NO AUTHORITY, WHETHER EXPRESS OR IMPLIED,
TO IMPLEMENT ANY RECOMMENDATION ON THE ISSUES SET FORTH IN  SUBDIVISIONS
ONE  THROUGH TWELVE OF THIS SECTION WITHOUT FURTHER STATUTORY AUTHORITY;
PROVIDED, HOWEVER, THAT NOTHING IN THIS SUBDIVISION SHALL BE  DEEMED  TO
ALTER ANY POWERS EXPRESSLY GRANTED ELSEWHERE IN THIS ARTICLE.
  S  3989. TAX EXEMPTION AND TAX CONTRACT BY THE STATE.  1. IT IS HEREBY
DETERMINED THAT THE CREATION OF THE EXCHANGE AND THE FULFILLMENT OF  ITS
CORPORATE  PURPOSES  IS IN ALL RESPECTS FOR THE BENEFIT OF THE PEOPLE OF
THIS STATE AND IS A PUBLIC PURPOSE. ACCORDINGLY, THE EXCHANGE  SHALL  BE
REGARDED  AS  PERFORMING AN ESSENTIAL GOVERNMENTAL FUNCTION IN THE EXER-
CISE OF THE POWERS CONFERRED UPON IT BY THIS ARTICLE, AND  THE  EXCHANGE
SHALL  NOT BE REQUIRED TO PAY ANY FEES, TAXES, SPECIAL AD VALOREM LEVIES

S. 6256--B                         65                         A. 9056--B

OR ASSESSMENTS OF ANY KIND, WHETHER STATE OR LOCAL,  INCLUDING  BUT  NOT
LIMITED TO FEES, TAXES, SPECIAL AD VALOREM LEVIES OR ASSESSMENTS ON REAL
PROPERTY,  FRANCHISE  TAXES, SALES TAXES, TRANSFER TAXES, MORTGAGE TAXES
OR  OTHER  TAXES,  UPON  OR  WITH RESPECT TO ANY PROPERTY OWNED BY IT OR
UNDER ITS JURISDICTION, CONTROL OR SUPERVISION, OR UPON THE USES  THERE-
OF,  OR UPON OR WITH RESPECT TO ITS ACTIVITIES OR OPERATIONS IN FURTHER-
ANCE OF THE POWERS CONFERRED UPON IT BY THIS ARTICLE, OR  UPON  OR  WITH
RESPECT  TO ANY FARES, TOLLS, RENTALS, RATES, CHARGES, FEES, REVENUES OR
OTHER INCOME RECEIVED BY THE EXCHANGE.
  2. THE EXCHANGE MAY PAY, OR MAY ENTER INTO AGREEMENTS WITH ANY  COUNTY
OR  MUNICIPALITY  TO  PAY,  A  SUM  OR  SUMS ANNUALLY OR OTHERWISE OR TO
PROVIDE OTHER CONSIDERATIONS WITH RESPECT TO REAL PROPERTY OWNED BY  THE
EXCHANGE LOCATED WITHIN SUCH COUNTY OR MUNICIPALITY.
  S  3990.  OFFICERS AND EMPLOYEES. 1. THE BOARD SHALL HAVE THE POWER TO
APPOINT EMPLOYEES TO SERVE AS SENIOR MANAGERIAL STAFF OF THE EXCHANGE AS
NECESSARY, WHO SHALL BE DESIGNATED TO BE IN THE EXEMPT  CLASS  OF  CIVIL
SERVICE. THE BOARD SHALL ALSO HAVE THE POWER TO FIX THE SALARIES OF SUCH
EMPLOYEES.
  2.  ANY  NEWLY  HIRED  EMPLOYEES  WHO  ARE NOT DESIGNATED TO BE IN THE
EXEMPT CLASS OF CIVIL  SERVICE  PURSUANT  TO  SUBDIVISION  ONE  OF  THIS
SECTION  AND WHO ARE NOT SUBJECT TO THE TRANSFER PROVISIONS SET FORTH IN
SUBDIVISIONS FOUR, FIVE AND SIX OF THIS SECTION SHALL BE CONSIDERED  FOR
PURPOSES  OF  ARTICLE  FOURTEEN  OF  THE  CIVIL SERVICE LAW TO BE PUBLIC
EMPLOYEES IN THE CIVIL SERVICE OF THE STATE, AND SHALL  BE  ASSIGNED  TO
THE  APPROPRIATE  COLLECTIVE BARGAINING UNIT BY THE EXCHANGE IN THE SAME
MANNER AND CONSISTENT WITH THOSE EMPLOYEES DESCRIBED IN SUBDIVISION  SIX
OF THIS SECTION.
  3.  ANY  PUBLIC  OFFICER  OR EMPLOYEE OF A STATE DEPARTMENT, AGENCY OR
COMMISSION MAY BE TRANSFERRED TO THE EXCHANGE  WITHOUT  EXAMINATION  AND
WITHOUT  LOSS  OF  ANY  CIVIL  SERVICE  STATUS OR RIGHTS TO A COMPARABLE
OFFICE, POSITION OR EMPLOYMENT WITH THE EXCHANGE; PROVIDED, HOWEVER,  NO
SUCH TRANSFER MAY BE MADE WITHOUT THE CONSENT OF THE HEAD OF THE DEPART-
MENT,  AGENCY OR COMMISSION.  TRANSFERS SHALL BE MADE PURSUANT TO SUBDI-
VISION TWO OF SECTION SEVENTY OF THE CIVIL SERVICE LAW.
  4. THE SALARY OR COMPENSATION OF ANY SUCH OFFICER OR  EMPLOYEE,  AFTER
SUCH TRANSFER, SHALL BE PAID BY THE EXCHANGE.
  5.  ANY  OFFICER  OR  EMPLOYEE TRANSFERRED TO THE EXCHANGE PURSUANT TO
THIS SECTION, WHO ARE MEMBERS OF OR BENEFIT UNDER ANY  EXISTING  PENSION
OR  RETIREMENT FUND OR SYSTEM, SHALL CONTINUE TO HAVE ALL RIGHTS, PRIVI-
LEGES, OBLIGATIONS AND STATUS WITH RESPECT TO SUCH FUND OR SYSTEM AS ARE
NOW PRESCRIBED BY LAW, BUT DURING THE PERIOD OF THEIR EMPLOYMENT BY  THE
EXCHANGE,  ALL  CONTRIBUTIONS TO SUCH FUNDS OR SYSTEMS TO BE PAID BY THE
EMPLOYER ON ACCOUNT OF SUCH OFFICERS OR EMPLOYEES SHALL BE PAID  BY  THE
EXCHANGE.
  6. A TRANSFERRED EMPLOYEE SHALL REMAIN IN THE SAME COLLECTIVE BARGAIN-
ING UNIT AS WAS THE CASE PRIOR TO HIS OR HER TRANSFER; SUCCESSOR EMPLOY-
EES  TO THE POSITIONS HELD BY SUCH TRANSFERRED EMPLOYEES SHALL, CONSIST-
ENT WITH THE PROVISIONS OF ARTICLE FOURTEEN OF THE CIVIL SERVICE LAW, BE
INCLUDED IN THE SAME UNIT AS THEIR PREDECESSORS.  EMPLOYEES  SERVING  IN
POSITIONS  IN NEWLY CREATED TITLES SHALL BE ASSIGNED TO THE SAME COLLEC-
TIVE BARGAINING UNIT AS THEY WOULD  HAVE  BEEN  ASSIGNED  TO  WERE  SUCH
TITLES  CREATED  PRIOR  TO  THE  ESTABLISHMENT  OF THE EXCHANGE. NOTHING
CONTAINED IN THIS ARTICLE SHALL BE CONSTRUED (A) TO DIMINISH THE  RIGHTS
OF  EMPLOYEES  PURSUANT  TO  A COLLECTIVE BARGAINING AGREEMENT OR (B) TO
AFFECT EXISTING LAW WITH RESPECT TO AN APPLICATION TO THE PUBLIC EMPLOY-

S. 6256--B                         66                         A. 9056--B

MENT RELATIONS BOARD SEEKING A DESIGNATION BY  THE  BOARD  THAT  CERTAIN
PERSONS ARE MANAGERIAL OR CONFIDENTIAL.
  S  3991.  LIMITATION OF LIABILITY; INDEMNIFICATION.  THE PROVISIONS OF
SECTIONS SEVENTEEN AND NINETEEN OF THE  PUBLIC  OFFICERS  LAW  SHALL  BE
APPLICABLE  TO  EXCHANGE  EMPLOYEES, AS SUCH TERM IS DEFINED IN SECTIONS
SEVENTEEN AND NINETEEN OF THE PUBLIC OFFICERS  LAW;  PROVIDED,  HOWEVER,
THAT NOTHING CONTAINED WITHIN THIS SECTION SHALL BE DEEMED TO PERMIT THE
EXCHANGE  TO EXTEND THE PROVISIONS OF SECTIONS SEVENTEEN AND NINETEEN OF
THE PUBLIC OFFICERS LAW UPON ANY INDEPENDENT CONTRACTOR.
  S 3992. CONTINGENCY FOR FEDERAL FUNDING.   THE IMPLEMENTATION  OF  THE
PROVISIONS  OF  THIS  ARTICLE  SHALL BE CONTINGENT, AS DETERMINED BY THE
DIRECTOR OF THE BUDGET, ON THE AVAILABILITY OF SUFFICIENT FEDERAL FINAN-
CIAL SUPPORT FOR THE PLANNING AND  IMPLEMENTATION  OF  HEALTH  CARE  AND
INSURANCE REFORM INITIATIVES AUTHORIZED BY FEDERAL LEGISLATION TO ESTAB-
LISH AND IMPLEMENT THE HEALTH BENEFIT EXCHANGE.
  S 3993. CONSTRUCTION.  NOTHING IN THIS ARTICLE, AND NO ACTION TAKEN BY
THE EXCHANGE PURSUANT HERETO, SHALL BE CONSTRUED TO:
  1.  PREEMPT  OR  SUPERSEDE  THE AUTHORITY OF THE SUPERINTENDENT OR THE
COMMISSIONER; OR
  2. EXEMPT INSURERS, INSURANCE PRODUCERS OR QUALIFIED HEALTH PLANS FROM
THE PUBLIC HEALTH LAW OR THE INSURANCE LAW AND  REGULATIONS  PROMULGATED
THEREUNDER.
  S 3. Subdivision 1 of section 17 of the public officers law is amended
by adding a new paragraph (x) to read as follows:
  (X)  FOR  PURPOSES  OF THIS SECTION, THE TERM "EMPLOYEE" SHALL INCLUDE
DIRECTORS, OFFICERS  AND  EMPLOYEES  OF  THE  NEW  YORK  HEALTH  BENEFIT
EXCHANGE ESTABLISHED PURSUANT TO ARTICLE TEN-E OF THE PUBLIC AUTHORITIES
LAW.
  S 4. Subdivision 1 of section 19 of the public officers law is amended
by adding a new paragraph (j) to read as follows:
  (J)  FOR  PURPOSES  OF THIS SECTION, THE TERM "EMPLOYEE" SHALL INCLUDE
DIRECTORS, OFFICERS  AND  EMPLOYEES  OF  THE  NEW  YORK  HEALTH  BENEFIT
EXCHANGE ESTABLISHED PURSUANT TO ARTICLE TEN-E OF THE PUBLIC AUTHORITIES
LAW.
  S  5.  If any provision or application of this act shall be held to be
invalid, or to violate or be inconsistent with  any  applicable  federal
law  or  regulation,  that shall not affect other provisions or applica-
tions of this act which can be given effect without  that  provision  or
application;  and  to  that end, the provisions and applications of this
act are severable; provided, however, that nothing in this section shall
be deemed to invalidate the provisions of section  3992  of  the  public
authorities law, as added by section two of this act.
  S  6. If the federal act is held to be unconstitutional by the supreme
court of the United States or repealed by the  United  States  Congress,
the  legislature  shall  convene  within  180  days  of such decision or
congressional act to consider appropriate legislative options.
  S 7. This act shall take effect immediately; provided,  however,  that
until such time as the members of the board of directors of the New York
health benefit exchange are initially appointed pursuant to section 3982
of  the public authorities law, as added by section two of this act, and
the first meeting of such board is convened, nothing in this  act  shall
be deemed to prevent the commissioner of health or the superintendent of
financial services from applying for, accepting the award of, and spend-
ing  any available grant money pertaining to the establishment or opera-
tion of such exchange for purposes consistent with this act or,  at  any

S. 6256--B                         67                         A. 9056--B

time, from accepting or spending grant money awarded prior to the enact-
ment of this act.

                                 PART F

  Section  1.  Section  1  of  part C of chapter 58 of the laws of 2005,
authorizing reimbursements for expenditures made  by  or  on  behalf  of
social  services  districts for medical assistance for needy persons and
the administration thereof, is amended by adding a new subdivision (c-1)
to read as follows:
  (C-1) NOTWITHSTANDING  ANY  PROVISIONS  OF  SUBDIVISION  (C)  OF  THIS
SECTION TO THE CONTRARY, EFFECTIVE APRIL 1, 2013, FOR THE PERIOD JANUARY
1, 2013 THROUGH DECEMBER 31, 2013 AND FOR EACH CALENDAR YEAR THEREAFTER,
THE  MEDICAL  ASSISTANCE  EXPENDITURE  AMOUNT  FOR  THE  SOCIAL SERVICES
DISTRICT FOR SUCH PERIOD SHALL BE EQUAL TO THE PREVIOUS CALENDAR  YEAR'S
MEDICAL ASSISTANCE EXPENDITURE AMOUNT, EXCEPT THAT:
  (1)  FOR  THE  PERIOD  JANUARY  1, 2013 THROUGH DECEMBER 31, 2013, THE
PREVIOUS CALENDAR YEAR MEDICAL ASSISTANCE  EXPENDITURE  AMOUNT  WILL  BE
INCREASED BY 2%;
  (2)  FOR  THE  PERIOD  JANUARY  1, 2014 THROUGH DECEMBER 31, 2014, THE
PREVIOUS CALENDAR YEAR MEDICAL ASSISTANCE  EXPENDITURE  AMOUNT  WILL  BE
INCREASED BY 1%.
  S  2.  Paragraph  (iii)  of  subdivision (g) of section 1 of part C of
chapter 58 of the laws of 2005, authorizing reimbursements for  expendi-
tures  made  by  or  on  behalf of social services districts for medical
assistance for needy persons and the administration thereof, as  amended
by section 59 of part A of chapter 57 of the laws of 2006, is amended to
read as follows:
  (iii)  During each state fiscal year subject to the provisions of this
section AND PRIOR TO STATE FISCAL YEAR 2015-16, the  commissioner  shall
maintain  an  accounting,  for each social services district, of the net
amounts that would have been expended by, or on behalf of, such district
had the social services district medical assistance shares provisions in
effect on January 1, 2005 been applied to such district.   For  purposes
of  this paragraph, fifty percent of the payments made by New York State
to the secretary of the federal department of health and human  services
pursuant  to  section 1935(c) of the social security act shall be deemed
to be payments made on behalf of social services districts;  such  fifty
percent share shall be apportioned to each district in the same ratio as
the  number of "full-benefit dual eligible individuals," as that term is
defined in section 1935(c)(6) of such act, for whom  such  district  has
fiscal  responsibility  pursuant  to  section 365 of the social services
law, relates to the total of such individuals for  whom  districts  have
fiscal  responsibility.   As soon as practicable after the conclusion of
each such fiscal year, but in no event later than six months  after  the
conclusion  of  each  such fiscal year, the commissioner shall reconcile
such net amounts  with  such  fiscal  year's  social  services  district
expenditure  cap  amount.  Such  reconciliation shall be based on actual
expenditures made by or on behalf  of  social  services  districts,  and
revenues  received by social services districts, during such fiscal year
and shall be made without regard  to  expenditures  made,  and  revenues
received, outside such fiscal year that are related to services provided
during,  or  prior  to,  such fiscal year. The commissioner shall pay to
each social  services  district  the  amount,  if  any,  by  which  such
district's expenditure cap amount exceeds such net amount.

S. 6256--B                         68                         A. 9056--B

  S  3. Paragraph (i) of subdivision (b) of section 2 of part C of chap-
ter 58 of the laws of 2005, authorizing reimbursements for  expenditures
made by or on behalf of social services districts for medical assistance
for  needy  persons and the administration thereof, is amended and a new
paragraph (iii) is added to read as follows:
  (i)  A social services district shall exercise the option described in
this section through the adoption of a resolution by its local  legisla-
tive body, in the form set forth in subparagraph (ii) of this paragraph,
to  elect  the medical assistance reimbursement methodology set forth in
paragraph (a) of this section and to elect the tax intercept methodology
set forth in subdivision (f) of section 1261 of the tax law or  subdivi-
sion  (g) of section 1261 and subdivision (h) of section 1313 of the tax
law, as applicable. A social services district, acting through its local
legislative body, is hereby authorized to adopt such a resolution.  Such
a  resolution  shall  be  effective only if it is adopted exactly as set
forth in subparagraph (ii) of this paragraph no later than September 30,
2007, and a certified copy of such resolution is mailed to  the  commis-
sioner  of  health  by  certified mail by such date. The commissioner of
health shall, no later than October 31, 2007, certify to the commission-
er of taxation and finance a list of  those  social  services  districts
which  have  elected  the  option  described  in  this section. A social
services district [shall have no authority to rescind the  exercise  of]
THAT  ELECTED  the  option described in this section, ACTING THROUGH ITS
LOCAL LEGISLATIVE BODY, MAY REPEAL THAT ELECTION BY  ADOPTING  A  RESOL-
UTION  EXACTLY  AS  SET FORTH IN PARAGRAPH (III) OF THIS SUBDIVISION AND
MAILING A CERTIFIED COPY OF SUCH REPEAL RESOLUTION TO  THE  COMMISSIONER
OF  HEALTH  NO  LATER  THAN JANUARY 1, 2013.  THE COMMISSIONER OF HEALTH
SHALL, WITHIN TWO WEEKS OF RECEIVING ANY SUCH COPY OF A CERTIFIED REPEAL
RESOLUTION BY CERTIFIED MAIL FROM A SOCIAL SERVICES DISTRICT, CERTIFY IN
WRITING TO THE COMMISSIONER OF TAXATION AND FINANCE THE NAME OF ANY SUCH
SOCIAL SERVICES DISTRICT THAT ADOPTED SUCH A RESOLUTION  TO  REPEAL  ITS
ELECTION. UPON RECEIVING SUCH WRITTEN CERTIFICATION, THE COMMISSIONER OF
TAXATION  AND  FINANCE  SHALL NO LONGER CALCULATE THE MEDICAID AMOUNT OF
SUCH COUNTY UNDER SUBDIVISION (F) OF SECTION 1261 OF THE  TAX  LAW,  AND
THE  AMOUNT  DUE  SUCH COUNTY UNDER SUBDIVISION (C) OF SUCH SECTION 1261
SHALL NO LONGER BE REDUCED BY SUCH MEDICAID AMOUNT, EFFECTIVE THE  FIRST
DAY OF THE MONTH NEXT COMMENCING AT LEAST 10 DAYS AFTER THE COMMISSIONER
OF  TAXATION  AND  FINANCE  HAS  RECEIVED SUCH WRITTEN CERTIFICATION. IF
EVERY SOCIAL SERVICE DISTRICT  THAT  ELECTED  SUCH  OPTION  REPEALS  ITS
ELECTION  AND  THE  COMMISSIONER  OF  HEALTH CERTIFIES IN WRITING TO THE
COMMISSIONER OF TAXATION AND FINANCE THAT  EVERY  SUCH  SOCIAL  SERVICES
DISTRICT  HAS  REPEALED  ITS  ELECTION, THEN SUBDIVISIONS (F) AND (G) OF
SECTION 1261 AND SUBDIVISION (H) OF SECTION 1313  OF  THE  TAX  LAW  TAX
SHALL  BE  REPEALED  AND  THE  PHRASE "OR A TAX REVENUE INTERCEPT AMOUNT
CALCULATED PURSUANT TO SUBDIVISION (F) OR (G) OF SECTION 1261 OF THE TAX
LAW" IN SECTION FOUR OF THIS ACT SHALL BE DELETED, EFFECTIVE  THE  FIRST
DAY  OF  THE  MONTH  NEXT  COMMENCING AT LEAST 10 DAYS AFTER THE DATE ON
WHICH THE COMMISSIONER OF TAXATION AND  FINANCE  RECEIVES  SUCH  WRITTEN
CERTIFICATION FROM THE COMMISSIONER OF HEALTH. AT THE SAME TIME THAT THE
COMMISSIONER  OF  HEALTH MAKES SUCH CERTIFICATION TO THE COMMISSIONER OF
TAXATION AND FINANCE THAT EVERY COUNTY HAS REPEALED  ITS  ELECTION,  THE
COMMISSIONER  OF  HEALTH SHALL ALSO NOTIFY THE LEGISLATIVE BILL DRAFTING
COMMISSION THAT EVERY SOCIAL SERVICE DISTRICT THAT ELECTED  SUCH  OPTION
HAS  REPEALED  ITS  ELECTION IN ORDER THAT THE LEGISLATIVE BILL DRAFTING
COMMISSION MAY MAINTAIN AN ACCURATE AND TIMELY DATA BASE OF THE OFFICIAL
TEXT OF THE LAWS OF THE STATE OF NEW YORK IN  FURTHERANCE  OF  EFFECTING

S. 6256--B                         69                         A. 9056--B

THE  PROVISIONS OF SECTION 44 OF THE LEGISLATIVE LAW AND SECTION 70-B OF
THE PUBLIC OFFICERS LAW.
  (III) FORM OF RESOLUTION.
  BE IT ENACTED BY THE (COUNTY) OF (INSERT COUNTY'S NAME) AS FOLLOWS:
  SECTION ONE. THE (COUNTY) OF (INSERT COUNTY'S NAME) HEREBY REPEALS ITS
ELECTION  IN  2007  OF  THE  MEDICAL ASSISTANCE REIMBURSEMENT OPTION AND
REVENUE INTERCEPT FOR MEDICAID PURPOSES DESCRIBED IN SECTION 2 OF  CHAP-
TER 58 OF THE LAWS OF 2005.
  SECTION 2. THIS RESOLUTION SHALL TAKE EFFECT IMMEDIATELY.
  S  4. Part C of chapter 58 of the laws of 2005, authorizing reimburse-
ments for expenditures made by or on behalf of social services districts
for medical assistance for needy persons and the administration thereof,
is amended by adding a new section 4-a to read as follows:
  S 4-A. (A) FOR STATE FISCAL YEAR 2012-13, AND FOR  EACH  STATE  FISCAL
YEAR  THEREAFTER,  A  SOCIAL SERVICES DISTRICT WILL BE REIMBURSED BY THE
STATE FOR THE FULL NON-FEDERAL SHARE OF EXPENDITURES BY THE DISTRICT FOR
THE ADMINISTRATION OF THE MEDICAL ASSISTANCE PROGRAM, NOT TO EXCEED  THE
ADMINISTRATIVE  CAP AMOUNT DETERMINED IN ACCORDANCE WITH SUBDIVISION (B)
OF THIS SECTION. ANY PORTION OF THE NON-FEDERAL SHARE OF  SUCH  EXPENDI-
TURES  IN EXCESS OF THE ADMINISTRATIVE CAP AMOUNT SHALL BE THE RESPONSI-
BILITY OF THE SOCIAL SERVICES DISTRICT AND SHALL BE IN ADDITION  TO  THE
MEDICAL  ASSISTANCE  EXPENDITURE  AMOUNT  CALCULATED  IN ACCORDANCE WITH
SUBDIVISIONS (B), (C), (C-1), AND (D) OF SECTION ONE OF THIS ACT. BEGIN-
NING IN STATE FISCAL YEAR 2013-14, NO REIMBURSEMENT  WILL  BE  MADE  FOR
ADMINISTRATIVE EXPENDITURES IN EXCESS OF SUCH CAP.
  (B) THE ADMINISTRATIVE CAP AMOUNT FOR A SOCIAL SERVICES DISTRICT SHALL
BE EQUAL TO A PERCENTAGE OF THE AMOUNT INCLUDED IN THE STATE FISCAL YEAR
2011-12  ENACTED  BUDGET FOR THE NON-FEDERAL SHARE OF MEDICAL ASSISTANCE
ADMINISTRATIVE COSTS PURSUANT TO  THIS  SECTION.  EACH  SOCIAL  SERVICES
DISTRICT'S  PERCENTAGE  SHALL  BE  EQUAL  TO  THE  PERCENTAGE OF MEDICAL
ASSISTANCE ADMINISTRATIVE COSTS CLAIMED BY SUCH  DISTRICT  IN  THE  2011
CALENDAR YEAR IN RELATION TO ALL OTHER SOCIAL SERVICES DISTRICTS.
  (C) NOTWITHSTANDING THE PROVISIONS OF SUBDIVISION (B) OF THIS SECTION,
THE  COMMISSIONER OF HEALTH MAY, AT HIS OR HER SOLE DISCRETION, REDUCE A
SOCIAL SERVICES DISTRICT'S ADMINISTRATIVE CAP AMOUNT TO  ACCOUNT  FOR  A
REDUCTION  IN  THE  SCOPE  OR  VOLUME  OF  THE DISTRICT'S ADMINISTRATIVE
RESPONSIBILITIES, INCLUDING BUT NOT LIMITED TO SUCH A REDUCTION  RESULT-
ING  FROM  THE PROCESS OF CONVERTING THE MEDICAL ASSISTANCE PROGRAM TO A
DEPARTMENT-ADMINISTERED PROGRAM PURSUANT TO SECTION 365-N OF THE  SOCIAL
SERVICES LAW.
  S  5.  Section 91 of part H of chapter 59 of the laws of 2011 amending
the public health law  and  other  laws  relating  to  general  hospital
reimbursement for annual rates is amended to read as follows:
  S 91. 1. Notwithstanding any inconsistent provision of state law, rule
or  regulation to the contrary, subject to federal approval, the year to
year rate of growth of department of health state funds Medicaid  spend-
ing  shall not exceed the ten year rolling average of the medical compo-
nent of the consumer price index  as  published  by  the  United  States
department  of  labor, bureau of labor statistics, for the preceding ten
years.
  2. EXCEPT AS PROVIDED IN SUBDIVISION THREE OF THIS SECTION, FOR  STATE
FISCAL  YEAR  2013-14  AND FOR EACH FISCAL YEAR THEREAFTER, THE SPENDING
LIMIT CALCULATED PURSUANT TO SUBDIVISION ONE OF THIS  SECTION  SHALL  BE
INCREASED  BY AN AMOUNT EQUAL TO THE DIFFERENCE BETWEEN THE TOTAL SOCIAL
SERVICES DISTRICT MEDICAL ASSISTANCE EXPENDITURE AMOUNTS CALCULATED  FOR
SUCH PERIOD IN CONFORMANCE WITH SUBDIVISIONS (B), (C), (C-1), AND (D) OF

S. 6256--B                         70                         A. 9056--B

SECTION  1  OF  PART  C  OF CHAPTER 58 OF THE LAWS OF 2005 AND THE TOTAL
SOCIAL SERVICES DISTRICT MEDICAL EXPENDITURE  AMOUNTS  THAT  WOULD  HAVE
RESULTED  IF THE PROVISIONS OF SUBDIVISION (C-1) OF SUCH SECTION HAD NOT
BEEN APPLIED.
  3.  WITH RESPECT TO A SOCIAL SERVICES DISTRICT THAT RESCINDS THE EXER-
CISE OF THE OPTION PROVIDED IN  PARAGRAPH  (I)  OF  SUBDIVISION  (B)  OF
SECTION  2 OF PART C OF CHAPTER 58 OF THE LAWS OF 2005, FOR STATE FISCAL
YEAR 2013-14 AND FOR EACH FISCAL YEAR  THEREAFTER,  THE  SPENDING  LIMIT
CALCULATED  PURSUANT TO SUBDIVISION ONE OF THIS SECTION SHALL BE REDUCED
BY THE AMOUNT OF THE MEDICAL ASSISTANCE  EXPENDITURE  AMOUNT  CALCULATED
FOR SUCH DISTRICT FOR SUCH PERIOD.
  S  6. The social services law is amended by adding a new section 365-n
to read as follows:
  S 365-N. DEPARTMENT ASSUMPTION OF PROGRAM ADMINISTRATION.  1. LEGISLA-
TIVE INTENT. (A) THE  LEGISLATURE  FINDS  THAT  TO  ENSURE  THE  MEDICAL
ASSISTANCE  PROGRAM CONTINUES TO FUNCTION IN AN EFFICIENT MANNER TO MAKE
HIGH QUALITY MEDICAL CARE, SERVICES, AND SUPPLIES AVAILABLE TO  ELIGIBLE
PERSONS,  AND  TO ACHIEVE TIMELY COMPLIANCE WITH THE REQUIREMENTS OF THE
PATIENT PROTECTION AND AFFORDABLE CARE ACT RELATED TO THE  EXPANSION  OF
THE  MEDICAL  ASSISTANCE  PROGRAM  AND  THE  CREATION  OF  A HEALTH CARE
EXCHANGE, IT IS NECESSARY TO CONVERT THE PROGRAM OF  MEDICAL  ASSISTANCE
FROM  ONE PRIMARILY ADMINISTERED BY SOCIAL SERVICES DISTRICTS, UNDER THE
SUPERVISION OF THE DEPARTMENT OF HEALTH ("DEPARTMENT"), TO ONE  ADMINIS-
TERED  BY  THE  DEPARTMENT,  WITH  SUCH  ASSISTANCE FROM SOCIAL SERVICES
DISTRICTS AS THE COMMISSIONER OF HEALTH ("COMMISSIONER")  MAY  DETERMINE
NECESSARY,  AND THAT SUCH CONVERSION SHOULD BE COMPLETED BY APRIL FIRST,
TWO THOUSAND EIGHTEEN.   RECOGNIZING THE COMPLEXITY  AND  DIFFICULTY  OF
COMPLETING  THIS  CONVERSION WITHIN SUCH TIME FRAME, IT IS THE INTENT OF
THE LEGISLATURE TO GRANT THE COMMISSIONER BROAD AUTHORITY AND FLEXIBILI-
TY TO TAKE ACTIONS NECESSARY TO ACHIEVE THIS GOAL, AS DETERMINED BY  THE
COMMISSIONER,  AND  TO  HAVE THE PROVISIONS OF THIS SECTION CONSTRUED IN
LIGHT OF THE AUTHORITY AND FLEXIBILITY SO GRANTED. THE ADMINISTRATION OF
THE PROGRAM BY THE DEPARTMENT MAY BE ACCOMPLISHED  THROUGH  THE  USE  OF
DEPARTMENT  STAFF,  CONTRACTED ENTITIES, OR SOME COMBINATION THEREOF, AS
DETERMINED ADVISABLE BY THE COMMISSIONER TO ACHIEVE THE  GOALS  OF  THIS
SECTION,  SUBJECT TO THE LIMITATIONS PRESCRIBED HEREIN. THE COMMISSIONER
WILL CONSULT WITH SOCIAL SERVICES DISTRICTS IN FORMULATING  THE  OPTIMAL
PLAN FOR IMPLEMENTING THIS CONVERSION.
  (B)  THE  LEGISLATURE FURTHER FINDS THAT THE CONTINUED, UNINTERRUPTED,
ADEQUATE AND EFFICIENT OPERATION OF FUNCTIONS RELATED TO MEDICAL ASSIST-
ANCE ELIGIBILITY AND COVERED  BENEFITS  IS  NECESSARY  FOR  THE  GENERAL
WELFARE  OF  THE  PEOPLE  OF THE STATE; THAT SUCH OPERATION INVOLVES AND
REQUIRES PERSONNEL WITH TRAINING, PRACTICAL EXPERIENCE AND KNOWLEDGE  IN
MEDICAL  ASSISTANCE ELIGIBILITY AND COVERED BENEFITS; AND THAT REQUIRING
COMPETITIVE EXAMINATION FOR APPOINTMENT OF PERSONS CURRENTLY  PERFORMING
SUCH  FUNCTIONS  IN COUNTIES IN THE STATE TO POSITIONS IN THE CLASSIFIED
SERVICE OF THE STATE UPON  THE  ASSUMPTION  OF  SUCH  FUNCTIONS  BY  THE
DEPARTMENT  WOULD  IRREPARABLY  DISRUPT, DELAY AND IMPEDE OPERATIONS AND
INTERRUPT THE CONTINUANCE AND PERFORMANCE OF IMPORTANT SERVICES.
  2. NOTWITHSTANDING THE PROVISIONS OF TITLE TWO  OF  ARTICLE  THREE  OF
THIS  CHAPTER OR OF SECTION THREE HUNDRED SIXTY-FIVE OF THIS TITLE OR OF
ANY OTHER LAW TO THE CONTRARY, THE COMMISSIONER IS  AUTHORIZED  TO  TAKE
ANY  AND ALL ACTIONS NECESSARY TO TRANSFER RESPONSIBILITY FOR THE ADMIN-
ISTRATION  OF  THE  MEDICAL  ASSISTANCE  PROGRAM  FROM  SOCIAL  SERVICES
DISTRICTS TO THE DEPARTMENT.

S. 6256--B                         71                         A. 9056--B

  3. FOR PURPOSES OF THIS SECTION, ADMINISTRATION OF THE MEDICAL ASSIST-
ANCE  PROGRAM INCLUDES PROCESSING APPLICATIONS FOR BENEFITS AND SERVICES
AVAILABLE UNDER THIS TITLE AND TITLE ELEVEN-D OF  THIS  ARTICLE,  MAKING
DETERMINATIONS  OF INITIAL AND ONGOING ELIGIBILITY FOR SUCH BENEFITS AND
SERVICES AND MAKING COVERAGE DETERMINATIONS WITH RESPECT TO BENEFITS AND
SERVICES REQUIRING PRIOR AUTHORIZATION, NOTIFYING APPLICANTS AND RECIPI-
ENTS  OF  THESE DETERMINATIONS AND OF THEIR RIGHTS AND RESPONSIBILITIES,
AUTHORIZING BENEFITS AND SERVICES FOR PERSONS FOUND ELIGIBLE, EXERCISING
SUBROGATION RIGHTS WITH  RESPECT  TO  AMOUNTS  RECEIVED  FROM  INSURANCE
CARRIERS  OR  OTHER  LIABLE  THIRD  PARTIES, IMPOSING LIENS AND PURSUING
RECOVERIES, AND ANY OTHER TASKS AND FUNCTIONS IDENTIFIED BY THE  COMMIS-
SIONER.
  4.  NOTWITHSTANDING  THE  PROVISIONS  OF  THE CIVIL SERVICE LAW OR ANY
PROVISIONS TO THE CONTRARY CONTAINED IN ANY GENERAL, SPECIAL,  OR  LOCAL
LAWS,  ALL LAWFUL APPOINTEES OF A COUNTY PERFORMING FUNCTIONS RELATED TO
MEDICAL ASSISTANCE ELIGIBILITY AND COVERED BENEFITS AS OF THE  EFFECTIVE
DATE  OF  THIS SECTION WILL BE ELIGIBLE TO TRANSFER TO APPROPRIATE POSI-
TIONS IN THE DEPARTMENT OF HEALTH CLASSIFIED TO PERFORM  SUCH  FUNCTIONS
WITHOUT  FURTHER  EXAMINATION  OR QUALIFICATION AND, UPON SUCH TRANSFER,
WILL HAVE ALL THE RIGHTS AND PRIVILEGES OF  THE  JURISDICTIONAL  CLASSI-
FICATION  TO  WHICH  SUCH  POSITIONS  MAY BE ALLOCATED IN THE CLASSIFIED
SERVICE OF THE STATE.
  5. SUBJECT TO THE PROVISIONS OF SUBDIVISIONS SIX  AND  SEVEN  OF  THIS
SECTION,  THE  COMMISSIONER  MAY  CONTRACT  WITH  ONE  OR MORE ENTITIES,
INCLUDING UNITS OF LOCAL GOVERNMENT, FOR THE PURPOSE OF  EXERCISING  HIS
OR  HER AUTHORITY UNDER THIS SECTION. SUCH ENTITIES MAY BE CONTRACTED TO
PERFORM ALL OR A PORTION OF THE FUNCTIONS DESCRIBED IN SUBDIVISION THREE
OF THIS SECTION, AND MAY PERFORM SUCH  FUNCTIONS  WITH  RESPECT  TO  THE
ENTIRE  STATE OR WITH RESPECT TO A SPECIFIC REGION OR REGIONS, AS DETER-
MINED BY THE COMMISSIONER. IN NO EVENT, HOWEVER, SHALL  THE  DEPARTMENT,
BY MEANS OF SUCH A CONTRACT, DELEGATE ITS AUTHORITY TO EXERCISE ADMINIS-
TRATIVE  DISCRETION  IN  THE  ADMINISTRATION OR SUPERVISION OF THE STATE
PLAN FOR MEDICAL ASSISTANCE SUBMITTED PURSUANT TO SECTION THREE  HUNDRED
SIXTY-THREE-A  OF  THIS  TITLE,  OR  TO ISSUE POLICIES, RULES, AND REGU-
LATIONS ON PROGRAM MATTERS, NOR MAY ANY CONTRACTED ENTITY BE  GIVEN  THE
AUTHORITY  TO  CHANGE  OR  DISAPPROVE ANY ADMINISTRATIVE DECISION OF THE
DEPARTMENT, OR OTHERWISE SUBSTITUTE THE ENTITY'S JUDGMENT  FOR  THAT  OF
THE  DEPARTMENT  WITH RESPECT TO THE APPLICATION OF POLICIES, RULES, AND
REGULATIONS ISSUED BY THE DEPARTMENT.
  6. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE  HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTIONS
ONE HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVEL-
OPMENT  LAW, OR ANY OTHER CONTRARY PROVISION OF LAW, THE COMMISSIONER IS
AUTHORIZED TO  AMEND  THE  TERMS  OF  EXISTING  CONTRACTS,  INCLUDING  A
CONTRACT ENTERED INTO PURSUANT TO SUBDIVISION TWENTY-FOUR OF SECTION TWO
HUNDRED SIX OF THE PUBLIC HEALTH LAW, AS ADDED BY SECTION THIRTY-NINE OF
PART C OF CHAPTER FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND EIGHT, WITHOUT
A  COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS, UPON A DETERMINATION
THAT THE EXISTING CONTRACTOR IS QUALIFIED TO PROVIDE ASSISTANCE WITH ONE
OR MORE FUNCTIONS RELATED TO THE ADMINISTRATION OF THE  MEDICAL  ASSIST-
ANCE PROGRAM OR TO ACHIEVING THE GOALS OF THIS SECTION.
  7.  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTIONS
ONE HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVEL-
OPMENT LAW, OR ANY OTHER CONTRARY PROVISION OF LAW, THE COMMISSIONER  IS
AUTHORIZED  TO ENTER INTO A CONTRACT OR CONTRACTS UNDER THIS SUBDIVISION

S. 6256--B                         72                         A. 9056--B

WITHOUT A COMPETITIVE BID OR REQUEST  FOR  PROPOSAL  PROCESS,  PROVIDED,
HOWEVER,  THAT  WITH  RESPECT  TO A CONTRACT WITH AN ENTITY OTHER THAN A
LOCAL UNIT OF GOVERNMENT:
  (A)  THE DEPARTMENT SHALL POST ON ITS WEBSITE, FOR A PERIOD OF NO LESS
THAN THIRTY DAYS:
  (I) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACT OR CONTRACTS;
  (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (III)  THE  PERIOD  OF  TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY
SEEK SELECTION, WHICH SHALL BE NO  LESS  THAN  THIRTY  DAYS  AFTER  SUCH
INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
  (IV)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (B) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE  RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
COMMISSIONER; AND
  (C) THE COMMISSIONER SHALL SELECT SUCH CONTRACTOR OR CONTRACTORS THAT,
IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE PURPOSES OF  THIS
SECTION.
  8. THE COMMISSIONER SHALL PROMULGATE SUCH REGULATIONS AS MAY BE NECES-
SARY  TO CARRY OUT THE PROVISIONS OF THIS SECTION, WHICH REGULATIONS MAY
BE PROMULGATED ON AN EMERGENCY  BASIS.  IN  ADDITION,  THE  COMMISSIONER
SHALL  MAKE  ANY AMENDMENTS TO THE STATE PLAN FOR MEDICAL ASSISTANCE, OR
DEVELOP AND SUBMIT AN APPLICATION FOR ANY WAIVER OR APPROVAL  UNDER  THE
FEDERAL  SOCIAL  SECURITY  ACT,  THAT  MAY BE NECESSARY TO CARRY OUT THE
PROVISIONS OF THIS SECTION.
  S 7. Subdivision 7 of section 369 of the social services law, as added
by section 71-a of part C of chapter 58 of the laws of 2008, is  amended
to read as follows:
  7.  Notwithstanding  any provision of law to the contrary, the depart-
ment [may commence] SHALL, WHEN IT DETERMINES NECESSARY PROGRAM FEATURES
ARE IN PLACE, ASSUME  SOLE  RESPONSIBILITY  FOR  COMMENCING  actions  or
proceedings  in accordance with the provisions of this section, sections
one hundred one, one hundred four, one hundred four-b, paragraph (a)  of
subdivision  three  of section three hundred sixty-six, subparagraph one
of paragraph (h) of subdivision four of section three hundred sixty-six,
and paragraph (b) of subdivision two of section three hundred sixty-sev-
en-a of  this  chapter,  to  recover  the  cost  of  medical  assistance
furnished pursuant to this title and title eleven-D of this article. The
department  is  authorized to contract with an entity that shall conduct
activities on behalf of the department  pursuant  to  this  subdivision.
PRIOR  TO  ASSUMING SUCH RESPONSIBILITY FROM A SOCIAL SERVICES DISTRICT,
THE DEPARTMENT OF HEALTH  SHALL,  IN  CONSULTATION  WITH  THE  DISTRICT,
DEFINE  THE  SCOPE  OF  THE  SERVICES  THE  DISTRICT WILL BE REQUIRED TO
PERFORM ON BEHALF OF THE DEPARTMENT OF HEALTH PURSUANT TO THIS  SUBDIVI-
SION.
  S  8. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal social security act in the public  health  law  and  the  social
services  law  shall be deemed to include and also to mean any successor
titles thereto under the federal social security act.
  S 9. Notwithstanding any inconsistent provision of law, rule or  regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the  public health law, section 18 of chapter 2 of the laws of 1988, and
18 NYCRR 505.14(h), as they relate to time frames for  notice,  approval

S. 6256--B                         73                         A. 9056--B

or  certification  of rates of payment, are hereby suspended and without
force or effect for purposes of implementing the provisions of this act.
  S  10. Severability clause. If any clause, sentence, paragraph, subdi-
vision, section or part of this act shall be adjudged by  any  court  of
competent  jurisdiction  to  be invalid, such judgment shall not affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation to the clause, sentence, paragraph,  subdivision,  section  or
part thereof directly involved in the controversy in which such judgment
shall  have been rendered. It is hereby declared to be the intent of the
legislature that this act would have been enacted even if  such  invalid
provisions had not been included herein.
  S  11.  This  act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012,  provided
that:
  1. section one of this act shall take effect April 1, 2013;
  2.  any  rules or regulations necessary to implement the provisions of
this act may be promulgated and any procedures, forms,  or  instructions
necessary  for such implementation may be adopted and issued on or after
the date this act shall have become a law;
  3. this act shall not be construed to alter, change, affect, impair or
defeat any rights, obligations, duties or interests accrued, incurred or
conferred prior to the effective date of this act;
  4. the commissioner of health  and  the  superintendent  of  financial
services  and  any  appropriate  council may take any steps necessary to
implement this act prior to its effective date;
  5. notwithstanding any inconsistent provision of the state administra-
tive procedure act or any other provision of law,  rule  or  regulation,
the  commissioner of health and the superintendent of financial services
and any appropriate council is authorized to adopt or amend  or  promul-
gate  on  an  emergency  basis  any regulation he or she or such council
determines necessary to implement any  provision  of  this  act  on  its
effective date;
  6.  the amendment to section 91 of part H of chapter 59 of the laws of
2011, amending the public health law and other laws relating to  general
hospital  reimbursement  for  annual rates, made by section five of this
act shall take effect on the same date and in the same  manner  as  such
section takes effect;
  7.  the  provisions of this act shall become effective notwithstanding
the failure of the commissioner  of  health  or  the  superintendent  of
financial  services or any council to adopt or amend or promulgate regu-
lations implementing this act.

                                 PART G

  Section 1. Subdivision 1 of section 79 of part C of chapter 58 of  the
laws of 2005 relating to the preferred drug program is amended and a new
subdivision 1-a is added  to read as follows:
  1.  sections  ten  [through],  ELEVEN,  TWELVE AND fifteen of this act
shall expire and be deemed repealed on and after June 15, [2012] 2019;
  1-A. SECTION FOURTEEN OF THIS ACT SHALL EXPIRE AND BE DEEMED  REPEALED
ON AND AFTER JUNE 15, 2012;
  S  2.  Subparagraph  (v) of paragraph (b) of subdivision 35 of section
2807-c of the public health law, as amended by section 35-a of part H of
chapter 59 of the laws of 2011, is amended to read as follows:
  (v) such  regulations  shall  incorporate  quality  related  measures,
including,  but  not  limited  to, potentially preventable re-admissions

S. 6256--B                         74                         A. 9056--B

(PPRs) and provide for rate adjustments or payment disallowances related
to PPRs and other potentially  preventable  negative  outcomes  (PPNOs),
which shall be calculated in accordance with methodologies as determined
by the commissioner, provided, however, that such methodologies shall be
based on a comparison of the actual and risk adjusted expected number of
PPRs and other PPNOs in a given hospital and with benchmarks established
by  the  commissioner and provided further that such rate adjustments or
payment disallowances shall result in an aggregate reduction in Medicaid
payments of no less than thirty-five million dollars for the period July
first, two thousand ten through March thirty-first, two thousand  eleven
and no less than fifty-one million dollars for [the period] ANNUAL PERI-
ODS  BEGINNING  April  first,  two thousand eleven through March thirty-
first, two thousand [twelve] THIRTEEN, provided further that such aggre-
gate reductions shall be offset by Medicaid payment reductions occurring
as a result of decreased PPRs during the period July first, two thousand
ten through March thirty-first, two thousand eleven and the period April
first, two thousand eleven  through  March  thirty-first,  two  thousand
[twelve]  THIRTEEN  and as a result of decreased PPNOs during the period
April first, two thousand eleven through March thirty-first,  two  thou-
sand  [twelve]  THIRTEEN;  and provided further that for the period July
first,  two  thousand  ten  through  March  thirty-first,  two  thousand
[twelve]  THIRTEEN, such rate adjustments or payment disallowances shall
not apply to behavioral health PPRs; or to readmissions that occur on or
after fifteen days following an initial admission. By no later than July
first, two thousand eleven the commissioner shall enter  into  consulta-
tions with representatives of the health care facilities subject to this
section  regarding potential prospective revisions to applicable method-
ologies and benchmarks set forth in regulations issued pursuant to  this
subparagraph;
  S  3.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012.

                                 PART H

  Section 1.  Section 4 of part C of chapter 57 of  the  laws  of  2006,
relating  to  establishing  a  cost  of living adjustment for designated
human services programs, as amended by section 2 of part F of chapter 59
of the laws of 2011, is amended to read as follows:
  S 4. This act shall take effect immediately and  shall  be  deemed  to
have  been in full force and effect on and after April 1, 2006; provided
section one of this act shall expire and be  deemed  repealed  April  1,
[2015]  2012; provided, further, that sections two and three of this act
shall expire and be deemed repealed December 31, 2009.
  S 2.   Notwithstanding any other provision of  law  to  the  contrary,
effective  April 1, 2013 and annually thereafter, state agencies includ-
ing, but not limited to, the office for people with developmental  disa-
bilities,  office  of  mental health, office of alcoholism and substance
abuse services, office of children and family services, office of tempo-
rary and disability assistance, department of  health,  office  for  the
aging, division of criminal justice services, office of victim services,
and  state  education department that operate, license, certify, or fund
providers of services shall develop and calculate annual adjustments  to
established  payments to providers of such services, based on factors to
be determined by the commissioner of the agency. Such adjustments  shall
be  based on performance metrics to be developed by the commissioners of
such agencies which shall include, but not be limited to  the  following

S. 6256--B                         75                         A. 9056--B

to the extent practicable:  the actual costs of providing such services,
the percentages of administrative costs, the determination and levels of
executive  compensation,  and  such other criteria as such commissioners
may determine. Such annual adjustments shall be subject to any necessary
federal  approvals and restrictions. The amount of any annual adjustment
and the metrics used to determine such adjustment shall  be  subject  to
the review and approval of the director of the budget.
  S  3.    Notwithstanding  any  other provision of law to the contrary,
commencing on April 1, 2012, the commissioner or director of each  state
agency  subject  to  section  two  of this act shall have the authority,
subject to approval by the director of the budget, to  promulgate  regu-
lations  or to address by other means the extent and nature of a provid-
er's administrative costs and  executive  compensation  which  shall  be
eligible  to  be reimbursed with state financial assistance or state-au-
thorized payments for operating expenses. Each agency shall require that
providers of services that receive reimbursements directly or indirectly
from such agency must comply with the following restrictions:
  (a) No less than seventy-five percent of the state  financial  assist-
ance  or  state-authorized  payments  for  operating  expenses  shall be
directed to provide direct care or services rather than to  support  the
costs  of  administration,  as these terms are defined by the applicable
state agency in implementing these requirements. This  percentage  shall
increase  by  five percent each year until it shall, no later than April
1, 2015, remain at no less than eighty-five percent thereafter.
  (b) To the extent practicable, reimbursement shall not be provided for
compensation paid or given to any  executive  by  such  provider  in  an
amount  greater  than  $199,000  per  annum; provided, however, that the
commissioner of each state agency shall have discretion to  adjust  this
figure  annually based on appropriate factors subject to the approval of
the director of the budget, but in no event  shall  such  figure  exceed
Level I of the federal government's Rates of Basic Pay for the Executive
Schedule  promulgated  by  the United States Office of Personnel Manage-
ment.  The applicable state agency shall define these terms as necessary
in implementing these requirements.
  A provider's failure to comply with the  requirements  established  by
the  applicable  state agency may, in the sole discretion of the commis-
sioner of each state agency, form the basis for termination or non-rene-
wal of the agency's contract with or continued support of the  provider.
Upon  a  showing  of good cause, a provider may be granted a waiver from
compliance with these requirements in whole or in part  subject  to  the
approval of the applicable state agency and the director of the budget.
  S  4.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012.

                                 PART I

  Section 1. Notwithstanding any inconsistent provision of sections  one
hundred  twelve and one hundred sixty-three of the state finance law, or
section one hundred forty-two of the economic development  law,  or  any
other  law  to the contrary, the commissioner of developmental disabili-
ties, pursuant to a pilot program  established  in  accordance  with  an
application  made under section 1115 of the federal social security act,
42 U.S.C. 1315, is authorized to enter  into  a  contract  or  contracts
without  a  competitive  bid  or  request for proposal process, with the
approval of the director of the budget, provided, however, that:

S. 6256--B                         76                         A. 9056--B

  (a) the office for people with developmental disabilities  shall  post
on  its  website,  for  a  period  of not less than thirty days, a pilot
application, and the following information:
  (i)  a description of the proposed services to be provided pursuant to
the pilot program;
  (ii) the procedure for application to participate in the pilot program
and criteria for selection of an applicant to participate in  the  pilot
program;
  (iii) the period of time during which an applicant may seek selection,
which  shall be no less than thirty days after such information is first
posted on the website; and
  (iv) the manner by which an applicant may seek such  selection,  which
may include submission by electronic means;
  (b)  all  reasonable and responsive submissions that are received from
applicants in a timely fashion shall be reviewed  by  the  commissioner;
and
  (c)  the  commissioner of developmental disabilities shall select such
applicant or applicants that, in  the  commissioner's  discretion,  have
demonstrated  the  ability to effectively, efficiently, and economically
provide services pursuant to  the  pilot  program;  have  the  requisite
expertise  and  financial resources; have demonstrated that their direc-
tors, sponsors, members, managers, partners or operators have the requi-
site character, competence and standing in the community, and  are  best
suited to serve the purposes of this section.
  S 2. This act shall take effect immediately.

                                 PART J

  Section  1. Section 13.17 of the mental hygiene law, as added by chap-
ter 978 of the laws of 1977, the section heading as amended  by  chapter
168  of the laws of 2010, subdivisions (b) and (d) as amended by chapter
37 of the laws of 2011, and subdivision (c) as amended by chapter 538 of
the laws of 1987, is amended to read as follows:
S 13.17 Programs, services, and operations [of facilities] in the office
          for people with developmental disabilities.
  (a) The commissioner shall establish policy  and  procedures  for  the
organization,  administration, and [operation of the facilities] SERVICE
DELIVERY SYSTEM under his OR  HER  jurisdiction[.  He]  AND  shall  make
provision  for  the  effective  rendition  of  SUPPORTS  AND services to
[patients by such  facilities  or  office  personnel]  INDIVIDUALS  WITH
DEVELOPMENTAL DISABILITIES.
  (b)  [There  shall  be  in  the  office the developmental disabilities
services offices named below  serving  the  areas  either  currently  or
previously  served  by  a  school, for the care and treatment of persons
with developmental disabilities and for research  and  teaching  in  the
science  and  skills required for the care and treatment of such persons
with developmental disabilities:
  Bernard M. Fineson Developmental Disabilities Services Office
  Brooklyn Developmental Disabilities Services Office
  Broome Developmental Disabilities Services Office
  Capital District Developmental Disabilities Services Office
  Central New York Developmental Disabilities Services Office
  Finger Lakes Developmental Disabilities Services Office
  Institute for Basic Research in Developmental Disabilities
  Hudson Valley Developmental Disabilities Services Office
  Metro New York Developmental Disabilities Services Office

S. 6256--B                         77                         A. 9056--B

  Long Island Developmental Disabilities Services Office
  Sunmount Developmental Disabilities Services Office
  Taconic Developmental Disabilities Services Office
  Western New York Developmental Disabilities Services Office
  Staten Island Developmental Disabilities Services Office
  The New York State Institute for Basic Research in Developmental Disa-
bilities  is  designated  as  an  institute  for  the conduct of medical
research and other scientific investigation directed towards  furthering
knowledge of the etiology, diagnosis, treatment and prevention of devel-
opmental disabilities.
  (c)]  The  commissioner shall establish [the areas which each facility
or], AT HIS OR  HER  DISCRETION,  developmental  disabilities  [services
office  under his jurisdiction shall serve and the categories of clients
which shall be served thereby]  REGIONAL  OFFICES  AND  SHALL  ESTABLISH
STATE  OPERATIONS  OFFICES  THAT  PROVIDE  FOR  THE  DIRECT  DELIVERY OF
SUPPORTS AND SERVICES BY THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL  DISA-
BILITIES.
  [(d)] (C) The commissioner may [permit] AUTHORIZE other offices of the
department  and  any  public or private non-profit organization or poli-
tical subdivision of the state to [operate programs for persons] DELIVER
SUPPORTS AND SERVICES TO INDIVIDUALS with  developmental  disabilities[,
not  inconsistent  with the programs and objectives of the office in any
facility under his jurisdiction. The commissioner may permit any facili-
ty under his jurisdiction to operate programs for  persons  with  mental
disabilities,  not  inconsistent  with  programs  and  objectives of the
department, under contracts or agreements with other offices within  the
department].
  S  2. Section 13.19 of the mental hygiene law, as added by chapter 978
of the laws of 1977, subdivisions (a) and (d) as amended by chapter  168
of  the laws of 2010, and subdivision (e) as added by chapter 307 of the
laws of 1979, is amended to read as follows:
S 13.19 Personnel of the office; regulations.
  (a) The commissioner may, within the  amounts  appropriated  therefor,
appoint  and  remove  in accordance with law and applicable rules of the
state civil service commission,  such  officers  and  employees  of  the
office for people with developmental disabilities [and school and facil-
ity officers and employees who are designated managerial or confidential
pursuant  to article fourteen of the civil service law] as are necessary
for efficient administration.  THE COMMISSIONER SHALL, IN EXERCISING HIS
OR   HER   APPOINTING   AUTHORITY,   TAKE,   CONSISTENT   WITH   ARTICLE
TWENTY-THREE-A OF THE CORRECTION LAW, ALL REASONABLE AND NECESSARY STEPS
TO  ENSURE  THAT ANY SUCH PERSON SO APPOINTED HAS NOT PREVIOUSLY ENGAGED
IN ANY ACT IN VIOLATION OF ANY LAW WHICH COULD COMPROMISE THE HEALTH AND
SAFETY OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES.
  (b) [The director of a hospital or institute in the office shall  have
professional  qualifications  and  experience  to  be  prescribed by the
commissioner.
  (c)] Notwithstanding the provisions of any other law, the  [positions]
POSITION  of  [psychiatrist  III and] deputy director in [any] AN office
facility may be filled BY NEW HIRE OR by promotion open to employees [of
all such facilities] who possess  the  minimum  qualifications  for  the
[respective  positions.  Promotion lists which are established for those
positions shall be general eligible promotion lists from which names are
certified in the order of final earned ratings and  from  which  certif-
ication  shall  not be subdivided by the facility or department in which

S. 6256--B                         78                         A. 9056--B

such persons are employed. Nothing in this subdivision shall prevent the
use of open competitive examinations] POSITION.
  [(d)]  (C)  The  use  of  volunteers [at facilities] in the office for
people with developmental disabilities shall be encouraged. The  commis-
sioner may establish regulations governing such volunteer services.
  [(e)]  (D)  Where,  and  to  the extent that, an agreement between the
state and an employee organization  entered  into  pursuant  to  article
fourteen  of  the  civil  service  law  so provides, the commissioner is
authorized to implement the provisions of  such  agreement  relating  to
discipline consistent with the terms thereof.
  S  3. Section 13.21 of the mental hygiene law, as added by chapter 978
of the laws of 1977, the section heading and subdivisions (a) and (c) as
amended by chapter 168 of the laws of 2010, subdivision (b)  as  amended
by  chapter 558 of the laws of 2011, subdivision (d) as added by chapter
355 of the laws of 1987 and subdivision (e) as added by chapter  492  of
the  laws  of 1978 and as relettered by chapter 355 of the laws of 1987,
is amended to read as follows:
S 13.21 Directors of [schools] STATE  OPERATIONS  OFFICES  AND  DEVELOP-
          MENTAL  DISABILITIES REGIONAL OFFICES in the office for people
          with developmental disabilities.
  (a) The [director] DIRECTORS of [a school] BOTH THE  STATE  OPERATIONS
OFFICES  AND  DEVELOPMENTAL  DISABILITIES REGIONAL OFFICES in the office
for people with developmental disabilities shall  be  appointed  by  the
commissioner  [and shall be its chief executive officer. The director of
a school  shall  be  the  director  of  the  developmental  disabilities
services  office  serving  the  areas  designated by the commissioner in
regulation, and in such context, the term facility shall also  refer  to
such  developmental  disabilities  services  office]. Each such director
shall be in the non-competitive class and designated as confidential  as
defined  by  subdivision two-a of section forty-two of the civil service
law and shall serve at the pleasure of  the  commissioner.  [Except  for
school  and facility officers and employees for which subdivision (a) of
section 13.19 of this article makes the commissioner the appointing  and
removing authority, the director of a school shall have the power, with-
in  amounts  appropriated  therefor, to appoint and remove in accordance
with law and applicable rules of the state civil service commission such
officers and employees of the facility of which he or she is director as
are necessary for its efficient administration. He or she shall in exer-
cising his or her appointing authority  take,  consistent  with  article
twenty-three-A of the correction law, all reasonable and necessary steps
to  insure  that any such person so appointed has not previously engaged
in any act in violation of any law which could compromise the health and
safety of patients in the facility of which he or she is  director.]  He
or she shall manage the [facility, and administer its personnel system,]
STATE  OPERATIONS  OFFICE  OR DEVELOPMENTAL DISABILITIES REGIONAL OFFICE
subject to applicable law, the regulations of the commissioner, and  the
rules  of  the  state civil service commission. [Before the commissioner
shall issue any such regulation or any amendment or revision thereof, he
or she shall consult with the directors of schools in the office regard-
ing its suitability.] The  [director]  DIRECTORS  OF  THE  DEVELOPMENTAL
DISABILITIES  REGIONAL  OFFICES AND STATE OPERATIONS OFFICES shall main-
tain effective [supervision] OVERSIGHT of all parts of [the facility and
over all persons employed therein or coming thereon and]  THEIR  RESPEC-
TIVE  OFFICES. THE DIRECTORS OF STATE OPERATIONS OFFICES shall generally
[direct] PROVIDE FOR the [care  and  treatment  of  patients.  Directors
presently  serving  at  facilities of the office shall continue to serve

S. 6256--B                         79                         A. 9056--B

under  the  terms  of  their  original  appointment]  ADMINISTRATION  OF
SUPPORTS  AND SERVICES TO INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES IN
STATE OPERATED PROGRAMS. DIRECTORS OF REGIONAL OFFICES  SHALL  GENERALLY
OVERSEE  THE ADMINISTRATION OF SUPPORTS AND SERVICES TO INDIVIDUALS WITH
DEVELOPMENTAL  DISABILITIES  IN  SETTINGS  OUTSIDE  THE  STATE  OPERATED
PROGRAMS.
  (b)  Such [director] DIRECTORS shall have the responsibility of seeing
that there is humane treatment of [the  patients  at  his  facility  and
shall  investigate  every case of alleged patient abuse or mistreatment]
INDIVIDUALS  WITH  DEVELOPMENTAL  DISABILITIES  RECEIVING  SERVICES   IN
SETTINGS  OPERATED,  LICENSED,  CERTIFIED,  FUNDED  OR  APPROVED BY THIS
OFFICE.  [The] A director OF STATE OPERATIONS shall notify  immediately,
and  in any event within three working days the board of visitors of the
facility and the mental hygiene legal service located in the same  judi-
cial department as [the hospital, school or institution] THE STATE OPER-
ATIONS  OFFICE  of  every complaint of patient abuse or mistreatment and
shall inform the board and the  mental  hygiene  legal  service  of  the
results of his OR HER investigation. If it appears that a crime may have
been  committed, the STATE OPERATIONS director shall give notice thereof
to the district attorney or other appropriate law  enforcement  official
as  soon  as possible, and in any event within three working days unless
it appears that the  crime  includes  an  employee,  intern,  volunteer,
consultant,  contractor, or visitor and the alleged conduct caused phys-
ical injury or the patient was subject to unauthorized  sexual  contact,
or  if it appears the crime is endangering the welfare of an incompetent
or physically disabled person pursuant to section 260.25  of  the  penal
law, or if the crime was any felony under state or federal law, then the
district  attorney or other appropriate law enforcement official must be
contacted immediately, and in any event no later than twenty-four hours.
  (c) In any investigation into the treatment  and  care  of  [patients]
INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES or the conduct, performance,
or  neglect  of duty of officers or employees, the [director of a school
in the office for people with developmental  disabilities]  COMMISSIONER
OR HIS OR HER DESIGNEE shall be authorized to subpoena witnesses, compel
their attendance, administer oaths to witnesses, examine witnesses under
oath,  and require the production of any books or papers deemed relevant
to the inquiry or investigation. A subpoena issued  under  this  section
shall be regulated by the civil practice law and rules.
  (d) [Such] THE director of a [school] STATE OPERATIONS OFFICE shall be
responsible  for the provision of STATE OPERATED community developmental
disabilities services, in those areas that the commissioner may  assign.
Such  responsibility  shall,  consistent  with article forty-one of this
chapter, include the operation of STATE OPERATED facilities[,]  AND  the
development  of  needed  facilities[, and the provision of assistance to
service providers in such areas and any necessarily related  activities.
All  powers  and duties as set forth in this section shall apply to such
responsibilities]. REGIONAL  DIRECTORS  SHALL  BE  RESPONSIBLE  FOR  THE
PROVISION  OF  COMMUNITY DEVELOPMENTAL DISABILITIES SERVICES TO INDIVID-
UALS IN SETTINGS OTHER THEN STATE OPERATED PROGRAMS. THE REGIONAL DIREC-
TOR'S RESPONSIBILITY SHALL, CONSISTENT WITH ARTICLE  FORTY-ONE  OF  THIS
CHAPTER,  INCLUDE  THE  OVERSIGHT  OF FACILITIES AND PROGRAMS OTHER THAN
THOSE OPERATED BY THE STATE.
  (e) Each [facility] STATE OPERATIONS director  of  the  office  shall,
upon  notice  from  the  commissioner or upon knowledge that programs of
such facility may be contracted or terminated, implement  procedures  to

S. 6256--B                         80                         A. 9056--B

ensure  timely notification to affected employees. Such procedures shall
include, but not be limited to:
  (1)  dissemination  and  posting of all decisions, policies and proce-
dures with respect to all aspects of such actions and  their  impact  on
facility staff; and
  (2) compliance with all requirements and protection of employee rights
pursuant  to  collective bargaining agreements with the designated legal
representative of the employees and the civil service law.
  S 4. Section 13.33 of the mental hygiene law, as added by chapter  978
of  the  laws  of  1977, subdivision (a) as amended by chapter 37 of the
laws of 2011, subdivision (d) as amended by chapter 686 of the  laws  of
1995,  subdivisions (f) and (h) as amended by chapter 175 of the laws of
1986, subdivision (i) as amended by chapter 14  of  the  laws  of  1990,
paragraph  1  of subdivision (i) as amended by chapter 75 of the laws of
1992, paragraph 2 of subdivision (i) and subdivision (m) as  amended  by
chapter  168  of the laws of 2010, subdivision (j) as amended by chapter
264 of the laws of 1980 and subdivisions (j) and (k)  as  relettered  by
chapter  84  of  the laws of 1980, subdivision (l) as amended by chapter
406 of the laws of 1994, and subdivision (n) as amended by  chapter  662
of the laws of 1995, is amended to read as follows:
S 13.33 Boards of visitors.
  (a) Each [developmental disabilities services] STATE OPERATIONS office
under  the  jurisdiction of the commissioner shall have a MINIMUM OF ONE
board of visitors consisting of at least seven but not more  than  four-
teen  members[;  provided,  however,  that the Central New York develop-
mental disabilities services office  shall  have  a  board  of  visitors
consisting  of  at  least  ten, but not more than seventeen members; and
that the Finger Lakes developmental disabilities services  office  shall
have  a  board of visitors consisting of at least fourteen, but not more
than twenty-one members. When a school is replaced  by  a  developmental
disabilities  services  office,  the  members  of that school's board of
visitors shall continue to serve their terms as the  board  of  visitors
for   the  new  developmental  disabilities  services  office].  Members
appointed or reappointed after the effective date of this chapter  shall
be  appointed by the governor, by and with the advice and consent of the
senate.  Members shall be appointed for four year terms to expire on the
thirty-first day of December of the fourth year of the  term  of  office
provided  however,  when  more  than three terms expire in any one year,
members may be appointed for terms of fewer years as designated  by  the
governor  so  that  no  more than three members' terms expire in any one
year. All terms of office shall expire on the thirty-first day of Decem-
ber of the designated year. A  member  whose  term  has  expired  shall,
however,  remain  in  office  until  such  member's  successor  has been
appointed and has taken office, or until such member shall have resigned
or have been removed from office in  the  manner  hereinafter  provided.
Should  any  member resign or be removed from office, the governor shall
promptly submit, for senate consent, a successor candidate to  fill  the
remaining  term  of  the vacated office. A visitor may be removed by the
governor for cause after notice and an opportunity for a hearing on  the
charges.  In  making  appointments  to  boards of visitors, the governor
shall endeavor to ensure that the membership of each  such  board  shall
adequately  reflect  the  composition  of  the  community or communities
served by the [facility] STATE OPERATIONS OFFICE, that the membership of
each such board includes at least three individuals who are  parents  or
relatives  of  patients  or  of  former  patients and that the remainder
includes only those persons, including former patients, who  shall  have

S. 6256--B                         81                         A. 9056--B

expressed  an  active  interest  in, or shall have obtained professional
knowledge in the care of persons with developmental disabilities  or  in
developmental disability endeavors generally.
  (b) No elected state officer or member of the legislature may serve as
a visitor.
  (c)  If  the  [facility]  STATE  OPERATIONS  OFFICE serves an area, as
established by the regulations of the commissioner, the  visitors  shall
reside  at the time of appointment or reappointment in such area. [If no
specific area is designated, the visitors shall reside at  the  time  of
appointment  or  reappointment  in  the developmental disabilities area,
established by the commissioner, in which the facility is located.]
  (d) Each board shall, at the first meeting of each calendar year elect
one member to serve as president of the board and one member to serve as
secretary; provided however, that no member may serve for more than  two
consecutive years as president.
  (e)  Visitors  shall  not receive compensation but shall be reimbursed
for their actual expenses in connection with their service as visitors.
  (f) (1) Each board of visitors shall hold six bi-monthly regular meet-
ings annually, but a greater number of regular meetings may be scheduled
by the board. Each board of visitors shall establish in their by-laws or
otherwise, in writing, whether these six meetings shall be  held  during
months represented by odd numbers or months represented by even numbers.
The  president  of the board shall notify the chairman of the commission
on quality of care [for the mentally disabled] AND ADVOCACY FOR  PERSONS
WITH  DISABILITIES  and  the [facility] STATE OPERATIONS director of the
determination  made  concerning  the  designated  months  for  the   six
bi-monthly regular meetings. The president of the board, the commission-
er, the director, or the members as determined by the rules of the board
may  call special meetings. The board may require the director to submit
a report at each  meeting.  Each  board  shall  keep  a  record  of  its
proceedings  and  activities.  A  member  of a board of visitors who has
failed to attend three consecutive bi-monthly regular meetings shall  be
considered  to  have  vacated his office unless otherwise ordered by the
governor. The board shall cause notice of any of its public meetings  to
be sent to the mental hygiene legal service located in the same judicial
department  as  the  school. The mental hygiene legal service may send a
representative to any such public meeting, and may request the board  to
review  patient  complaints or investigate alleged incidents of abuse or
mistreatment. The board shall notify the appropriate  representative  of
the  mental hygiene legal service of the board's actions and findings in
relation to any such request.
  (2) The president of the board of visitors shall notify  a  member  by
certified  or  registered mail return receipt requested when such member
of the board has failed to attend any two consecutive bi-monthly regular
meetings. This notice shall be sent within ten days following the second
meeting and shall include the dates  of  the  two  meetings  which  were
missed, the date of the next bi-monthly regular meeting, and a statement
concerning the consequences of failure to attend the next meeting.
  (3)  Within  three  days  after  the  third  consecutive  absence at a
bi-monthly regular meeting by a member, the president of  the  board  of
visitors  shall  notify, in writing, the governor, the commissioner, the
chairman of the commission on quality of care [for  the  mentally  disa-
bled]  AND  ADVOCACY  FOR  PERSONS  WITH DISABILITIES and the [facility]
STATE OPERATIONS director of such absences. The president of  the  board
of  visitors shall send a copy of this notice by registered or certified
mail return receipt requested to the member to  whom  it  pertains.  The

S. 6256--B                         82                         A. 9056--B

member may petition the governor to excuse his absences. If the governor
does  not  excuse the absences within forty-five days of the date of the
third consecutive meeting absence, the office of  the  member  shall  be
deemed vacated.
  (g)  Upon the request of the commissioner or the director, or upon the
board's initiative, the board shall consult, advise, and work  with  the
director  with  respect  to community relations, conditions at the STATE
OPERATED facility, preliminary plans for construction  and  alterations,
and programs and activities of the STATE OPERATED facility.
  (h)  Each board or any member of the board may visit and inspect [the]
A STATE OPERATED facility WHICH IS IN THE CATCHMENT AREA  OF  THE  STATE
OPERATIONS  REGION  IN  WHICH  SUCH  MEMBER OR MEMBERS SERVE at any time
without prior notice and may report on conditions to  the  governor,  to
the  commissioner and to the chairman of the state commission on quality
of care [for the mentally disabled] AND ADVOCACY FOR PERSONS WITH  DISA-
BILITIES.  In addition, each board shall ensure that a member or commit-
tee of members shall inspect [the] SUCH facility once every three months
without prior notice. A report on conditions may  be  submitted  to  the
governor, to the commissioner or to the chairman of the state commission
on  quality of care [for the mentally disabled] AND ADVOCACY FOR PERSONS
WITH DISABILITIES. Each board member shall visit and inspect  [the]  ANY
SUCH  facility  at  least twice during each calendar year. Within thirty
days after the conclusion of each calendar year, the  president  of  the
board  of  visitors  shall  notify  the  governor, the commissioner, the
chairman of the commission on quality of care [for  the  mentally  disa-
bled]  AND  ADVOCACY  FOR  PERSONS WITH DISABILITIES, and the [facility]
STATE OPERATIONS director, if any member of  the  board  has  failed  to
visit  and  inspect  [the]  ANY SUCH facility at least twice during that
year. The president of the board of visitors shall send a copy  of  this
notice  by  certified or registered mail return receipt requested to the
member to whom it pertains. A member of a  board  of  visitors  who  has
failed to visit and inspect [the] A facility at least twice a year shall
be considered to have vacated his OR HER office unless otherwise ordered
by  the  governor  within  forty-five days after the end of the calendar
year. The board shall have the power to investigate all charges  against
the  STATE OPERATIONS director and all cases of alleged patient abuse or
mistreatment made against any employee  and  shall  have  the  power  to
interview patients and employees of the [facility] FACILITIES in pursuit
of  such  investigations. In conducting such an investigation, the board
shall have the power, in accordance with  the  civil  practice  law  and
rules,  to  subpoena witnesses, compel their testimony, administer oaths
to witnesses, examine witnesses under oath, and require  the  production
of  any books or papers deemed relevant to the investigation. A board or
a member may include in the report or separately at any time any  matter
pertaining  to the management and affairs of [the facility] SUCH FACILI-
TIES and may make recommendations to the governor, to  the  commissioner
and  to the chairman of the state commission on quality of care [for the
mentally disabled] AND ADVOCACY  FOR  PERSONS  WITH  DISABILITIES.  Each
board  member shall enter in a book, kept at each SUCH facility for that
purpose, the date of each visit.
  (i) (1) Any member or members of the board may  visit  and  inspect  a
family  care  home, which is within the catchment area of the [school on
the board of] STATE OPERATIONS REGION IN which such  member  or  members
serve.  Such  member or members shall be granted access to such facility
and to all books, records and data pertaining to  such  facility  deemed
necessary  for  carrying  out  the  purposes of such visit. Information,

S. 6256--B                         83                         A. 9056--B

books, records or data which are confidential as provided by  law  shall
be  kept confidential and any limitations on the release thereof imposed
by law upon the party furnishing the information, books, records or data
shall  apply  to  such  member  or  members of the board. After any such
visits or inspections, a report containing findings and  recommendations
may  be  submitted  to the governor, to the commissioner or to the state
commission on quality of care [for the mentally disabled]  AND  ADVOCACY
FOR PERSONS WITH DISABILITIES.
  (2)  Any member or members of the board may visit and inspect a commu-
nity residence operated by the  office  for  people  with  developmental
disabilities,  which  is within the catchment area of the [school on the
board of] STATE OPERATIONS REGION IN which such member or members serve.
Such member or members shall be granted access to such facility  and  to
all books, records and data pertaining to such facility deemed necessary
for carrying out the purposes of such visit and inspection. Information,
books,  records  or data which are confidential as provided by law shall
be kept confidential and any limitations on the release thereof  imposed
by law upon the party furnishing the information, books, records or data
shall  apply  to  such  member  or  members of the board. After any such
visits or inspection, a report containing findings  and  recommendations
shall  be  submitted promptly to the commissioner and to the chairman of
the state commission on quality of care and advocacy  for  persons  with
disabilities.
  (j) Once each year, each board shall make an independent assessment of
conditions  at  [the facility] SUCH FACILITIES and shall submit a report
on the assessment and recommendations to the governor,  to  the  commis-
sioner  and  to  the chairman of the state commission on quality of care
[for the mentally disabled] AND ADVOCACY FOR PERSONS WITH DISABILITIES.
  (k) The commissioner shall notify the board of visitors of a  [school]
FACILITY  under his OR HER jurisdiction of the proposed appointment of a
STATE OPERATIONS director [to such facility] or the proposed transfer of
a STATE OPERATIONS director [from such facility], with  a  request  that
the  board  report  an  expression  of its opinion of the appointment or
transfer and, if it objects thereto, the reasons for such objection.
  (l) The commissioner  shall  appoint  representatives  of  the  office
[department]  to  serve  as liaison between the office and the boards of
visitors. At least once each year the commissioner shall meet  with  the
boards  collectively.  The  commissioner,  or his OR HER designee, shall
meet quarterly with representatives of boards of visitors.
  (m) Members of the boards of visitors shall be considered officers  of
the  office  for people with developmental disabilities for the purposes
of sections seventy-three, to the extent provided therein, and  seventy-
four  of  the  public  officers law relating to business or professional
activities by state officers and employees and the code of ethics.
  (n) Each member shall attend, within one year of the initial  appoint-
ment  or  any  subsequent reappointment, an orientation training program
provided by the commission on quality of care [for  the  mentally  disa-
bled]  AND  ADVOCACY FOR PERSONS WITH DISABILITIES for members of boards
of visitors. The chairman of the commission on quality of care [for  the
mentally  disabled]  AND  ADVOCACY  FOR  PERSONS WITH DISABILITIES shall
notify the governor and the appointed member of any such member's  fail-
ure to attend such a training program. A member who has failed to attend
such a training program scheduled for such member shall be considered to
have  vacated his office unless otherwise ordered by the governor within
forty-five days after the notice.

S. 6256--B                         84                         A. 9056--B

  S 5. Paragraph (c) of subdivision 3 of  section  2963  of  the  public
health  law,  as added by chapter 818 of the laws of 1987, is amended to
read as follows:
  (c) If the attending physician determines that a patient lacks capaci-
ty  because  of a developmental disability, the concurring determination
required by paragraph (a) of this subdivision shall  be  provided  by  a
physician  or  psychologist employed by [a school named in section 13.17
of the mental hygiene law] THE  OFFICE  FOR  PEOPLE  WITH  DEVELOPMENTAL
DISABILITIES,  or  who  has  been employed for a minimum of two years to
render care and service in a facility operated or licensed by the office
[of mental retardation and] FOR PEOPLE WITH developmental  disabilities,
or who has been approved by the commissioner of [mental retardation and]
developmental disabilities in accordance with regulations promulgated by
such  commissioner.  Such  regulations shall require that a physician or
psychologist possess specialized training or three years  experience  in
treating developmental disabilities.
  S  6.  Paragraph  (c)  of  subdivision 2 of section 2981 of the public
health law, as added by chapter 752 of the laws of 1990, is  amended  to
read as follows:
  (c)  For  persons  who reside in a mental hygiene facility operated or
licensed by the office [of  mental  retardation  and]  FOR  PEOPLE  WITH
developmental  disabilities, at least one witness shall be an individual
who is not affiliated with the facility and at least one  witness  shall
be  a  physician  or  clinical psychologist who either is employed by [a
school named in section 13.17 of the mental hygiene law] THE OFFICE  FOR
PEOPLE  WITH  DEVELOPMENTAL  DISABILITIES or who has been employed for a
minimum of two years to render care and service in a  facility  operated
or  licensed  by  the office [of mental retardation and] FOR PEOPLE WITH
developmental disabilities, or who has been approved by the commissioner
of [mental retardation and]  developmental  disabilities  in  accordance
with  regulations  approved  by the commissioner. Such regulations shall
require that a physician or clinical  psychologist  possess  specialized
training  or  three years experience in treating developmental disabili-
ties.
  S 7. Paragraph (c) of subdivision 1 of  section  2983  of  the  public
health  law,  as added by chapter 752 of the laws of 1990, is amended to
read as follows:
  (c) If the attending physician determines that a patient lacks capaci-
ty because of a developmental disability, the  attending  physician  who
makes  the  determination  must  be, or must consult, for the purpose of
confirming the determination, with a physician or clinical  psychologist
who either is employed by [a school named in section 13.17 of the mental
hygiene  law]  THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, or
who has been employed for a minimum of two  years  to  render  care  and
service  in  a  facility  operated  or licensed by the office [of mental
retardation and] FOR PEOPLE WITH developmental disabilities, or who  has
been  approved  by the commissioner of [mental retardation and] develop-
mental disabilities in accordance with regulations promulgated  by  such
commissioner.  Such  regulations shall require that a physician or clin-
ical psychologist possess specialized training or three years experience
in treating developmental disabilities. A record  of  such  consultation
shall be included in the patient's medical record.
  S 8. Subparagraph ii of paragraph c of subdivision 3 of section 2994-c
of  the public health law, as added by chapter 8 of the laws of 2010, is
amended to read as follows:

S. 6256--B                         85                         A. 9056--B

  (ii) If the attending physician makes an initial determination that  a
patient  lacks decision-making capacity because of mental retardation or
a developmental disability, either such physician must have the  follow-
ing  qualifications,  or  another professional with the following quali-
fications  must  independently determine whether the patient lacks deci-
sion-making capacity: a physician or clinical psychologist who either is
employed by [a school named in section 13.17 of the mental hygiene  law,
or  who  has been employed for a minimum of two years to render care and
service in a facility operated or licensed by]  the  office  [of  mental
retardation  and] FOR PEOPLE WITH developmental disabilities, or who has
been approved by the commissioner of [mental retardation  and]  develop-
mental  disabilities  in accordance with regulations promulgated by such
commissioner. Such regulations shall require that a physician  or  clin-
ical psychologist possess specialized training or three years experience
in  treating  developmental  disabilities. A record of such consultation
shall be included in the patient's medical record.
  S 9. Subdivision 10 of section 2994-aa of the public  health  law,  as
added by chapter 8 of the laws of 2010, is amended to read as follows:
  10.  "Hospital" means a general hospital as defined in subdivision ten
of section twenty-eight hundred one of this chapter  and  a  residential
health  care facility as defined in subdivision three of section twenty-
eight hundred one of this chapter or a hospital as defined  in  subdivi-
sion ten of section 1.03 of the mental hygiene law [or a school named in
section 13.17 of the mental hygiene law].
  S  10.  Subdivision  6 of section 2994-dd of the public health law, as
added by chapter 8 of the laws of 2010, is amended to read as follows:
  6. The commissioner may authorize the use of one or  more  alternative
forms  for  issuing  a nonhospital order not to resuscitate (in place of
the standard form prescribed by the commissioner under  subdivision  two
of  this  section).  Such  alternative form or forms may also be used to
issue a non-hospital do not intubate order. Any such  alternative  forms
intended  for use for persons with [mental retardation or] developmental
disabilities or persons with mental illness who are incapable of  making
their  own  health  care  decisions or who have a guardian of the person
appointed pursuant to article eighty-one of the mental  hygiene  law  or
article  seventeen-A of the surrogate's court procedure act must also be
approved by the commissioner of [mental retardation  and]  developmental
disabilities  or  the  commissioner of mental health, as appropriate. An
alternative form under this subdivision  shall  otherwise  conform  with
applicable  federal  and  state  law.  This  subdivision does not limit,
restrict or impair the use of an alternative form for issuing  an  order
not  to  resuscitate  in  a  general hospital or residential health care
facility under article twenty-eight of this chapter or a hospital  under
subdivision  ten  of section 1.03 of the mental hygiene law [or a school
under section 13.17 of the mental hygiene law].
  S 11. Subparagraph (B) of paragraph (vi) of subdivision (c) of section
958 of the general municipal law, as amended by chapter 708 of the  laws
of 1993, is amended to read as follows:
  (B) a state-operated hospital or facility listed in [sections] SECTION
7.17  [or 13.17] of the mental hygiene law OR A FACILITY OPERATED BY THE
OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, which has been desig-
nated by either the commissioner of mental health or the commissioner of
[mental retardation and] developmental disabilities for  contraction  or
discontinuance.    Provided however, that not more than one-third of the
zones designated pursuant to paragraph (iii) or (iv) of subdivision  (b)

S. 6256--B                         86                         A. 9056--B

of  section nine hundred sixty OF THIS ARTICLE, shall be based on appli-
cations filed pursuant to THIS paragraph [(vi) of this subdivision].
  S  12. Paragraph (b) of subdivision 4 of section 6810 of the education
law, as added by chapter 519 of the laws of 2002, is amended to read  as
follows:
  (b)  Oral  prescriptions  for  patients  in general hospitals, nursing
homes, residential health care facilities as defined in section  twenty-
eight  hundred  one  of  the  public health law, hospitals as defined in
subdivision ten of section 1.03 of the mental hygiene law, or  [develop-
mental  centers or developmental disabilities services offices listed in
subdivision (b) of section 13.17 of the mental hygiene  law]  FACILITIES
OPERATED  BY  THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, may
be communicated to a pharmacist serving as a  vendor  of  pharmaceutical
services  based upon a contractual arrangement by an agent designated by
and under the direction of the prescriber or the institution. Such agent
shall be a health care practitioner currently  licensed  and  registered
under this title.
  S  13. Paragraph (b) of subdivision 7 of section 6810 of the education
law, as amended by chapter 519 of the laws of 2002, is amended  to  read
as follows:
  (b)  With  respect  to  drugs  other  than  controlled substances, the
provisions of this subdivision shall not apply to  pharmacists  employed
by  or  providing  services under contract to general hospitals, nursing
homes, residential health care facilities as defined in section  twenty-
eight  hundred  one  of  the  public health law, hospitals as defined in
subdivision ten of section 1.03 of the mental hygiene law, or  [develop-
mental  centers or developmental disabilities services offices listed in
subdivision (b) of section 13.17 of the mental hygiene  law]  FACILITIES
OPERATED  BY  THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, who
dispense drugs in the course of said employment  or  in  the  course  of
providing  such  services  under  contract. With respect to such pharma-
cists, each prescription shall be  transcribed  on  a  patient  specific
prescription form.
  S  14.  Paragraph  1  of subdivision (b) of section 5.05 of the mental
hygiene law, as amended by chapter 168 of the laws of 2010,  is  amended
to read as follows:
  (1)  The  commissioners of the office of mental health, the office for
people with developmental disabilities and the office of alcoholism  and
substance  abuse  services shall constitute an inter-office coordinating
council which, consistent with the autonomy of each office  for  matters
within  its  jurisdiction,  shall  ensure  that the state policy for the
prevention, care,  treatment  and  rehabilitation  of  individuals  with
mental  illness  and  developmental  disabilities,  alcoholism,  alcohol
abuse, substance abuse, substance dependence, and chemical dependence is
planned,  developed  and  implemented  comprehensively;  that  gaps   in
services  to  individuals  with multiple disabilities are eliminated and
that no person is denied treatment and services because he  or  she  has
more than one disability; that procedures for the regulation of programs
which  offer  care and treatment for more than one class of persons with
mental disabilities be coordinated between the offices having  jurisdic-
tion  over  such programs; and that research projects of the institutes,
as identified in section 7.17 [or 13.17] of this chapter OR AS  OPERATED
BY  THE  OFFICE  FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, are coordi-
nated to maximize the success and cost effectiveness  of  such  projects
and to eliminate wasteful duplication.

S. 6256--B                         87                         A. 9056--B

  S  15.  Subdivision (b) of section 13.11 of the mental hygiene law, as
added by chapter 978 of the laws of 1977, is amended to read as follows:
  (b)  The commissioner shall control the organization of the office and
may continue, establish, discontinue, expand,  and  contract  facilities
under  his  OR  HER  jurisdiction.  [The facilities set forth in section
13.17 may not be discontinued by the commissioner.] Units and facilities
shall have such  functions,  duties,  and  responsibilities  as  may  be
assigned to them by the commissioner.
  S 16. Subdivisions 1 and 2 of section 13.34 of the mental hygiene law,
as  amended  by  chapter 542 of the laws of 2011, are amended to read as
follows:
  1. There shall be at each developmental  center  facility  [listed  in
section 13.17 of this article], an ombudsman who shall be an employee of
the commission on quality of care and advocacy for persons with disabil-
ities  under article forty-five of this chapter and who shall be respon-
sible for receiving and responding to any complaints regarding  individ-
ual  clients  residing  in  such  facility. The ombudsman shall have the
following powers and duties:
  i. to advise and consult with parents, guardians,  correspondents  and
other  interested  persons  with  respect  to  any complaints, or issues
related to the conditions of clients' residents;
  ii. to review and attempt to remedy specific complaints with responsi-
ble and appropriate staff;
  iii. where it appears that care has not been rendered as  required  by
applicable standards to refer the complaint to the appropriate agency or
body for its attention;
  iv.  to  receive  and  keep confidential any complaint, information or
inquiry from any source. The records of the ombudsman shall be confiden-
tial, and shall not be available to the public;
  v. to advise and consult with the board of visitors  of  the  develop-
mental  center served by the ombudsman with respect to any complaints or
issues relating to conditions of client's  residence  and  to  regularly
attend the meetings of such board; and
  vi.  to meet with the commissioner, or a representative of the commis-
sioner, on a quarterly basis regarding systemic issues  in  the  ombuds-
man's jurisdiction.
  2.  The  president  of  the  board  of visitors of each [developmental
center facility listed in section 13.17 of this article] REGION  IN  THE
CATCHMENT  AREA  OF  THE  STATE  OPERATIONS  REGION IN WHICH SUCH MEMBER
SERVES, shall, in consultation with the members of such board, recommend
three persons to serve as ombudsman at  the  facility.  In  making  such
recommendation,  the president shall also consider the expressed opinion
of parents, guardians and correspondents of  clients  residing  at  such
facility.  The  persons so recommended as ombudsman shall have expressed
an active interest or shall have had professional knowledge in  advocat-
ing  for persons who are mentally disabled. The commission on quality of
care and advocacy for persons with disabilities shall select one of  the
recommended persons as ombudsman. The ombudsman may only be removed from
office for just cause.  An individual appointed as ombudsman shall be an
exempt  class  employee  as  defined  by  section forty-one of the civil
service law and may be removed by the commissioner upon the  recommenda-
tion  of  the president of the board of visitors, for cause after notice
and opportunity for a hearing on the charges.
  S 17. Subdivision 1 of section 157 of  the  social  services  law,  as
amended  by  section 43 of part B of chapter 436 of the laws of 1997, is
amended to read as follows:

S. 6256--B                         88                         A. 9056--B

  1. Safety net assistance means  allowances  pursuant  to  section  one
hundred  thirty-one-a  OF  THIS ARTICLE for all support, maintenance and
need, and costs of suitable training in a trade to enable  a  person  to
become  self-supporting,  furnished eligible needy persons in accordance
with applicable provisions of law, by a municipal corporation, or a town
where safety net assistance is a town charge, to persons or their depen-
dents  in  their abode or habitation whenever possible and includes such
relief granted to veterans under existing  laws  but  does  not  include
hospital  or  institutional  care,  except as otherwise provided in this
subdivision, or family assistance    or  medical  assistance  for  needy
persons granted under titles ten and eleven OF THIS ARTICLE, respective-
ly,  or  aid  to  persons receiving federal supplemental security income
payments and/or additional state payments.   Safety net  assistance  may
also  be provided in a family home or boarding home, operated in compli-
ance with the regulations of the department, and on  and  after  January
first, nineteen hundred seventy-four, in facilities in which a person is
receiving  family  care  or residential care, as those terms are used in
title six of [article five of] this [chapter] ARTICLE,  and  to  persons
receiving  care in a facility supervised by the office of alcoholism and
substance abuse SERVICES or in a residential facility for  the  mentally
disabled  approved,  licensed or operated by the office of mental health
or the office [of mental retardation and] FOR PEOPLE WITH  developmental
disabilities,  other than those facilities defined in [sections] SECTION
7.17 [and 13.17] of the mental hygiene law, IN  A  DEVELOPMENTAL  CENTER
FACILITY  OPERATED BY THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILI-
TIES or residential care centers for adults operated by  the  office  of
mental  health,  when such type of care is deemed necessary. Payments to
such homes and facilities for care  and  maintenance  provided  by  them
shall  be  at  rates  established pursuant to law and regulations of the
department. The  department,  however,  shall  not  establish  rates  of
payment  to such homes or facilities without approval of the director of
the budget.
  S 18. Subparagraph (i) of paragraph (a) and clause A  of  subparagraph
(i)  of  paragraph  (e) of subdivision 4 of section 1750-b of the surro-
gate's court procedure act, as added by chapter 500 of the laws of 2002,
are amended to read as follows:
  (i) be employed by [a developmental disabilities services office named
in section 13.17 of the mental hygiene law] THE OFFICE FOR  PEOPLE  WITH
DEVELOPMENTAL DISABILITIES, or
  A.  be employed by [a developmental disabilities services office named
in section 13.17 of the mental hygiene law] THE OFFICE FOR  PEOPLE  WITH
DEVELOPMENTAL DISABILITIES, or
  S  19.  (a)  Wherever  the  terms  "directors of office facilities" or
"directors of schools" or "director of facilities" appear in the  mental
hygiene law in reference to a facility operated by the office for people
with  developmental  disabilities,  such  terms  are  hereby  changed to
"directors of state operations offices".
  (b) Wherever the term "developmental  disabilities  services  offices"
appears in the mental hygiene law, such term is hereby changed to "state
operations office".
  (c)  The  legislative  bill  drafting commission is hereby directed to
effectuate this provision, and  shall  be  guided  by  a  memorandum  of
instruction  setting forth the specific provisions of law to be amended.
Such memorandum shall be transmitted to the  legislative  bill  drafting
commission within sixty days of enactment of this provision.  Such memo-
randum  shall be issued jointly by the governor, the temporary president

S. 6256--B                         89                         A. 9056--B

of the senate and the speaker of the assembly, or  by  the  delegate  of
each.
  S 20. This act shall take effect immediately.

                                 PART K

  Section  1.  Sections  19  and  21  of chapter 723 of the laws of 1989
amending the mental hygiene law and other laws relating to comprehensive
psychiatric emergency programs, as amended by section 1  of  part  F  of
chapter 58 of the laws of 2008, are amended to read as follows:
  S  19. Notwithstanding any other provision of law, the commissioner of
mental health shall, until July 1, [2012] 2016, be solely authorized, in
his or her discretion,  to  designate  those  general  hospitals,  local
governmental units and voluntary agencies which may apply and be consid-
ered  for the approval and issuance of an operating certificate pursuant
to article 31 of the mental hygiene law for the operation of  a  compre-
hensive psychiatric emergency program.
  S  21.  This  act shall take effect immediately, and sections one, two
and four through twenty of this act  shall  remain  in  full  force  and
effect,  until  July  1,  [2012]  2016, at which time the amendments and
additions made by such sections of  this  act  shall  be  deemed  to  be
repealed,  and  any  provision of law amended by any of such sections of
this act shall revert to its text as it existed prior to  the  effective
date of this act.
  S  2.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012.

                                 PART L

  Section 1. Legislative findings. It is the finding of the  legislature
that  the integration and coordination of physical and behavioral health
services results in an improvement in  the  quality  of  services  being
provided  to  recipients,  with  a resultant improvement in outcomes and
reduction in the costs of care. It is the further finding of the  legis-
lature  that  the  reduction  or elimination of redundant or unnecessary
licensing and oversight requirements and procedures will facilitate  the
provision  of integrated and coordinated care and result in a more effi-
cient use of governmental resources.
  S 2. (a) Notwithstanding any law, rule or regulation to the  contrary,
two or more of the commissioners of the department of health, the office
of  mental health, the office of alcoholism and substance abuse services
or the office for people with  developmental  disabilities  are  jointly
authorized  to  establish operating, reporting and construction require-
ments, as well as joint survey requirements and procedures for  entities
that:
  (1)  can  demonstrate  experience  and  competence  in the delivery of
health, mental health,  alcohol  and  substance  abuse  services  and/or
services  to persons with developmental disabilities and the capacity to
offer the integrated delivery of such services at locations  as  may  be
approved by two or more of the respective commissioners; and
  (2)  meet  the  standards  that  may  be established by the respective
commissioners for the provision of  such  services;  provided,  however,
that  an  entity  meeting  the  standards  established  pursuant to this
section shall not be required  to  be  an  integrated  service  provider
pursuant to subdivision 7 of section 365-l of the social services law.

S. 6256--B                         90                         A. 9056--B

  (b)  In  establishing one or more sets of joint requirements or proce-
dures for entities described in this section, the commissioners  of  the
department  of  health, the office of mental health, the office of alco-
holism and substance abuse services, and/or the office for  people  with
developmental  disabilities  are  authorized  to  waive  any  regulatory
requirements, or to determine that compliance with  another  commission-
er's  regulatory  requirements  shall  be  deemed to meet the regulatory
requirements of his or her agency, as may be necessary or  desirable  to
avoid duplication of requirements and/or to permit the integrated deliv-
ery  of health and behavioral health services in an efficient and effec-
tive manner.
  (c) The  authority  granted  the  commissioners  in  this  section  is
intended  to  complement  and  supplement  the authority granted to such
commissioners pursuant to subdivision 7 of section 365-l of  the  social
services law.
  S  3.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012.

                                 PART M

  Section 1. Legislative findings. It is the finding of the  legislature
that  patients  hospitalized  in  facilities  operated  by the office of
mental health who are between the ages of five and twenty-one are  enti-
tled  to receive an education comparable to that which they would other-
wise be entitled to receive in their local school districts pursuant  to
the education law and the regulations of the commissioner of education.
  S  2.  (a) Notwithstanding any other provision of law to the contrary,
the office of mental health shall be authorized to enter into an  agree-
ment  with  the state education department for the purposes of providing
education programming and services for patients  residing  in  hospitals
operated by the office of mental health who are between the ages of five
and twenty-one, that is comparable to that which they would otherwise be
entitled  to  receive  in  their  local school districts pursuant to the
education law and the regulations of the commissioner.  The commissioner
of education shall be authorized  to  require  local  school  districts,
including  the  school district located in a city with a million persons
or more, and/or boards of cooperative educational  services  to  provide
such comparable educational programming and services, provided, however,
the  commissioner  of  mental  health  shall  be  authorized to contract
directly with local school  districts,  including  the  school  district
located in a city with a million persons or more, and/or boards of coop-
erative  educational  services  to  provide  such comparable educational
programming and services.   Such comparable  education  programming  and
services  for  such  children shall be authorized to be provided, in the
2012-2013 and 2013-2014 and 2014-2015 school years within a city with  a
population  of a million persons or more, and in the 2013-2014 and 2014-
2015 school year in the rest of the state, in accordance with  implemen-
tation standards issued by the commissioner of education, and in accord-
ance  with  a  plan  for  educational  services  jointly approved by the
commissioners of education and mental health.
  (b) The commissioner of education, or pursuant to contract the commis-
sioner of mental health, shall reimburse districts and boards of cooper-
ative educational services for unreimbursed, approved expenses  for  the
cost of such programming and services for such children pursuant to this
section, as may be determined through a reimbursement methodology devel-

S. 6256--B                         91                         A. 9056--B

oped  by  the  commissioner of education and approved by the director of
the budget.
  (c) The commissioner of mental health, with the approval of the direc-
tor  of  the  budget,  shall  be  authorized  to transfer funding to the
commissioner of education for the provision of  educational  programming
and services to patients residing in hospitals operated by the office of
mental health who are between the ages of five and twenty-one.
  S  3.  The  commissioners of education and mental health shall jointly
submit to the governor and to the temporary president of the senate  and
the  speaker  of  the assembly a report by February 1, 2015, which shall
state whether additional actions should be taken to ensure that children
who are patients residing in hospitals operated by the office of  mental
health receive education programming and services that are comparable to
that  which  they  would otherwise be entitled to receive in their local
school districts pursuant to education law and the  regulations  of  the
commissioner.  Such  commissioners shall also recommend whether this act
should be amended and whether it should be made permanent.
  S 4. This act shall take effect July 1, 2012 and shall expire June 30,
2015 when upon such date the provisions of  this  act  shall  be  deemed
repealed.

                                 PART N

  Section 1. Section 1.03 of the mental hygiene law is amended by adding
two new subdivisions 56 and 57 to read as follows:
  56.   "SUBSTANCE  USE  DISORDER"  MEANS  THE  MISUSE,  DEPENDENCE,  OR
ADDICTION TO ALCOHOL AND/OR LEGAL OR ILLEGAL DRUGS  LEADING  TO  EFFECTS
THAT  ARE DETRIMENTAL TO THE INDIVIDUAL'S PHYSICAL AND MENTAL HEALTH, OR
THE WELFARE OF OTHERS  AND  SHALL  INCLUDE  ALCOHOLISM,  ALCOHOL  ABUSE,
SUBSTANCE  ABUSE,  SUBSTANCE DEPENDENCE, CHEMICAL ABUSE, AND/OR CHEMICAL
DEPENDENCE.
  57. "SUBSTANCE USE DISORDER SERVICES" SHALL MEAN AND INCLUDE  EXAMINA-
TION,  EVALUATION, DIAGNOSIS, CARE, TREATMENT, REHABILITATION, OR TRAIN-
ING OF PERSONS WITH  SUBSTANCE  USE  DISORDERS  AND  THEIR  FAMILIES  OR
SIGNIFICANT OTHERS.
  S 2. The mental hygiene law is amended by adding a new section 5.06 to
read as follows:
S 5.06 BEHAVIORAL HEALTH SERVICES ADVISORY COUNCIL.
  (A)  THERE IS HEREBY CREATED WITHIN THE DEPARTMENT A BEHAVIORAL HEALTH
SERVICES ADVISORY COUNCIL, THE PURPOSE OF WHICH SHALL BE TO  ADVISE  THE
OFFICES  OF MENTAL HEALTH AND ALCOHOLISM AND SUBSTANCE ABUSE SERVICES ON
MATTERS RELATING TO THE PROVISION OF BEHAVIORAL HEALTH SERVICES;  ISSUES
OF  JOINT  CONCERN  TO THE OFFICES, INCLUDING THE INTEGRATION OF VARIOUS
BEHAVIORAL HEALTH SERVICES AND  THE  INTEGRATION  OF  BEHAVIORAL  HEALTH
SERVICES  WITH  HEALTH  SERVICES;  AND ISSUES RELATED TO THE DELIVERY OF
BEHAVIORAL HEALTH SERVICES THAT  ARE  RESPONSIVE  TO  LOCAL,  STATE  AND
FEDERAL  CONCERNS.  THE  COUNCIL  SHALL  CONSIST  OF THE COMMISSIONER OF
MENTAL HEALTH AND THE COMMISSIONER OF  ALCOHOLISM  AND  SUBSTANCE  ABUSE
SERVICES  WHO SHALL NOT HAVE THE RIGHT TO VOTE, THE CHAIR OF THE CONFER-
ENCE OF LOCAL MENTAL HYGIENE DIRECTORS OR HIS OR HER DESIGNEE, AND TWEN-
TY-EIGHT MEMBERS APPOINTED BY THE GOVERNOR.  MEMBERS SHALL BE  APPOINTED
ONLY  IF THEY HAVE PROFESSIONAL KNOWLEDGE IN THE CARE OF PERSONS RECEIV-
ING BEHAVIORAL HEALTH SERVICES, OR AN ACTIVE INTEREST IN THE  BEHAVIORAL
HEALTH SERVICES SYSTEM.
  (B)  THE GOVERNOR SHALL DESIGNATE ONE OF THE MEMBERS OF THE COUNCIL AS
CHAIR. AT LEAST ONE-HALF OF THE MEMBERS OF  THE  COUNCIL  SHALL  NOT  BE

S. 6256--B                         92                         A. 9056--B

PROVIDERS  OF  BEHAVIORAL  HEALTH SERVICES.   MEMBERSHIP SHALL REFLECT A
BALANCED REPRESENTATION OF PERSONS WITH INTERESTS IN MENTAL  HEALTH  AND
SUBSTANCE USE DISORDER SERVICES AND SHALL INCLUDE:
  (1)  AT  LEAST  FIVE  CURRENT OR FORMER CONSUMERS OF BEHAVIORAL HEALTH
SERVICES;
  (2) AT LEAST THREE INDIVIDUALS WHO ARE PARENTS OR RELATIVES OF CURRENT
OR FORMER CONSUMERS OF BEHAVIORAL HEALTH SERVICES;
  (3) AT LEAST THREE MEMBERS WHO ARE NOT PROVIDERS OF BEHAVIORAL  HEALTH
SERVICES  AND WHO REPRESENT NON-GOVERNMENTAL ORGANIZATIONS, SUCH AS NOT-
FOR-PROFIT  ENTITIES  REPRESENTING  HEALTH  OR  BEHAVIORAL  HEALTH  CARE
EMPLOYEES, OR OTHER ORGANIZATIONS CONCERNED WITH THE PROVISION OF BEHAV-
IORAL HEALTH SERVICES;
  (4)  AT LEAST FIVE REPRESENTATIVES OF PROVIDERS OF SERVICES TO PERSONS
WITH MENTAL ILLNESS AND AT LEAST FIVE REPRESENTATIVES  OF  PROVIDERS  OF
SERVICES  TO  PERSONS WITH SUBSTANCE USE DISORDERS, AT LEAST TWO OF WHOM
SHALL BE PHYSICIANS;
  (5) ONE MEMBER APPOINTED ON THE RECOMMENDATION OF THE DIRECTOR OF  THE
DIVISION OF VETERANS' AFFAIRS;
  (6) ONE MEMBER APPOINTED ON THE RECOMMENDATION OF THE ADJUTANT GENERAL
OF THE DIVISION OF MILITARY AND NAVAL AFFAIRS;
  (7) AT LEAST THREE REPRESENTATIVES OF LOCAL GOVERNMENTS OR OTHER STATE
AND  LOCAL  AGENCIES  CONCERNED  WITH THE PROVISION OF BEHAVIORAL HEALTH
SERVICES; AND
  (8) AT LEAST TWO MEMBERS WHO ARE ALSO MEMBERS OF THE PUBLIC HEALTH AND
HEALTH PLANNING COUNCIL PURSUANT TO SECTION TWO HUNDRED  TWENTY  OF  THE
PUBLIC HEALTH LAW.
  (C)  MEMBERS  SHALL  BE  APPOINTED  FOR TERMS OF THREE YEARS PROVIDED,
HOWEVER, THAT  OF  THE  MEMBERS  FIRST  APPOINTED,  ONE-THIRD  SHALL  BE
APPOINTED  FOR  ONE  YEAR TERMS AND ONE-THIRD SHALL BE APPOINTED FOR TWO
YEAR TERMS. VACANCIES SHALL BE FILLED IN THE  SAME  MANNER  AS  ORIGINAL
APPOINTMENTS FOR THE REMAINDER OF ANY UNEXPIRED TERM. NO PERSON SHALL BE
AN APPOINTED MEMBER OF THE COUNCIL FOR MORE THAN SIX YEARS IN ANY PERIOD
OF TWELVE CONSECUTIVE YEARS.
  (D)  THE  COUNCIL SHALL MEET AT LEAST FOUR TIMES IN EACH FULL CALENDAR
YEAR. THE COUNCIL SHALL MEET AT THE  REQUEST  OF  ITS  CHAIR  OR  EITHER
COMMISSIONER.
  (E)  THE COUNCIL SHALL ESTABLISH SUCH COMMITTEES AS IT DEEMS NECESSARY
TO ADDRESS THE SERVICE NEEDS  OF  SPECIAL  POPULATIONS  AND  TO  ADDRESS
PARTICULAR  SUBJECTS  OF IMPORTANCE IN THE DEVELOPMENT AND MANAGEMENT OF
BEHAVIORAL HEALTH SERVICES.
  (F) THE COUNCIL MAY CONSIDER ANY MATTER RELATING TO THE IMPROVEMENT OF
BEHAVIORAL HEALTH SERVICES IN THE STATE AND SHALL ADVISE THE COMMISSION-
ERS ON ANY SUCH MATTER, INCLUDING, BUT NOT LIMITED TO:
  (1) CARE AND SERVICES TO PERSONS  WITH  BEHAVIORAL  HEALTH  DISORDERS,
INCLUDING  SPECIAL  AND  UNDERSERVED  POPULATIONS  AS  DETERMINED BY THE
COMMISSIONER;
  (2) FINANCING BEHAVIORAL HEALTH SERVICES;
  (3) INTEGRATION OF BEHAVIORAL HEALTH SERVICES WITH HEALTH SERVICES;
  (4) CARE AND SERVICES  FOR  PERSONS  WITH  CO-OCCURRING  DISORDERS  OR
MULTIPLE DISABILITIES;
  (5) PREVENTION OF BEHAVIORAL HEALTH DISORDERS; AND
  (6) IMPROVEMENT OF CARE IN STATE OPERATED OR COMMUNITY BASED PROGRAMS,
RECRUITMENT,  EDUCATION AND TRAINING OF QUALIFIED DIRECT CARE PERSONNEL,
AND PROTECTION OF THE INTERESTS OF EMPLOYEES AFFECTED BY ADJUSTMENTS  IN
THE BEHAVIORAL HEALTH SERVICE SYSTEM.

S. 6256--B                         93                         A. 9056--B

  (G)  THE  COUNCIL SHALL, IN COOPERATION WITH THE COMMISSIONERS, ESTAB-
LISH STATEWIDE GOALS AND OBJECTIVES FOR SERVICES TO PERSONS WITH  BEHAV-
IORAL HEALTH DISORDERS, PURSUANT TO SECTION 5.07 OF THIS ARTICLE.
  (H)  (1) THE COUNCIL SHALL REVIEW THE PORTION OF THE STATEWIDE PLAN TO
BE DEVELOPED AND UPDATED  ANNUALLY  BY  THE  COMMISSIONERS  PURSUANT  TO
SECTION  5.07  OF THIS ARTICLE AND REPORT ITS RECOMMENDATIONS THEREON TO
THE COMMISSIONERS.
  (2) THE COUNCIL SHALL REVIEW ANY MENTAL HEALTH OR SUBSTANCE USE COMPO-
NENT OF STATEWIDE HEALTH PLANS DEVELOPED IN ACCORDANCE WITH ANY APPLICA-
BLE FEDERAL LAW AND SHALL REPORT  ITS  RECOMMENDATIONS  THEREON  TO  THE
COMMISSIONERS.
  (I) THE COUNCIL SHALL REVIEW APPLICATIONS FILED IN ACCORDANCE WITH:
  (1)  SECTION  31.22  OF  THIS CHAPTER FOR APPROVAL OF INCORPORATION OR
ESTABLISHMENT OF A FACILITY, AND  SECTION  31.23  OF  THIS  CHAPTER  FOR
APPROVAL  OF  THE CONSTRUCTION OF A FACILITY FOR WHICH APPROVAL FROM THE
COMMISSIONER OF MENTAL HEALTH IS REQUIRED; AND
  (2) SECTION 32.29 OR 32.31 OF THIS CHAPTER FOR  APPROVAL  OF  INCORPO-
RATION OR ESTABLISHMENT OR CONSTRUCTION OF A FACILITY FOR WHICH APPROVAL
TO OPERATE IS REQUIRED FROM THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE
ABUSE  SERVICES  PURSUANT  TO ARTICLE THIRTY-TWO OF THIS CHAPTER, AND AS
OTHERWISE REQUESTED BY SUCH COMMISSIONER;
  (J) AT LEAST SIXTY DAYS PRIOR TO THE COMMISSIONERS' FINAL APPROVAL  OF
RULES  AND  REGULATIONS  UNDER THEIR RESPECTIVE JURISDICTION, OTHER THAN
EMERGENCY RULES AND REGULATIONS AND REGULATIONS PROMULGATED PURSUANT  TO
SECTION  43.01  OF  THIS  CHAPTER,  THE  COMMISSIONERS SHALL SUBMIT SUCH
PROPOSED RULES AND REGULATIONS TO THE COUNCIL FOR ITS REVIEW. THE  COUN-
CIL  SHALL  REVIEW  ALL  PROPOSED  RULES  AND REGULATIONS AND REPORT ITS
RECOMMENDATIONS THEREON TO THE  COMMISSIONERS  WITHIN  SIXTY  DAYS.  THE
COMMISSIONER  HAVING  STATUTORY  JURISDICTION  OVER THE PROPOSED RULE OR
REGULATION SHALL NOT ACT IN A MANNER INCONSISTENT WITH  THE  RECOMMENDA-
TIONS  OF  THE  COUNCIL  WITHOUT  FIRST  APPEARING BEFORE THE COUNCIL TO
REPORT THE REASONS THEREFOR. THE COUNCIL, UPON A MAJORITY  VOTE  OF  ITS
MEMBERS,  MAY REQUIRE THAT AN ALTERNATIVE APPROACH TO THE PROPOSED RULES
AND REGULATIONS BE PUBLISHED WITH THE NOTICE OF THE PROPOSED  RULES  AND
REGULATIONS PURSUANT TO SECTION TWO HUNDRED TWO OF THE STATE ADMINISTRA-
TIVE  PROCEDURE  ACT. WHEN AN ALTERNATIVE APPROACH IS PUBLISHED PURSUANT
TO THIS SECTION, THE COMMISSIONER HAVING STATUTORY JURISDICTION  OF  THE
SUBJECT  PROPOSED  RULE  OR  REGULATION  SHALL STATE THE REASONS FOR NOT
SELECTING SUCH ALTERNATIVE APPROACH.
  (K) THE COUNCIL, BY A MAJORITY VOTE OF ITS MEMBERS, MAY PROPOSE  RULES
AND  REGULATIONS ON ANY MATTER WITHIN THE REGULATORY JURISDICTION OF THE
OFFICES OF MENTAL HEALTH OR ALCOHOLISM  AND  SUBSTANCE  ABUSE  SERVICES,
OTHER  THAN  ESTABLISHMENT OF FEE SCHEDULES PURSUANT TO SECTION 43.01 OF
THIS CHAPTER, AND FORWARD SUCH PROPOSED RULES AND  REGULATIONS  TO  BOTH
COMMISSIONERS FOR REVIEW AND CONSIDERATION, PROVIDED, HOWEVER, THAT ONLY
THE  APPROVAL  OF  THE  COMMISSIONER  WITH STATUTORY JURISDICTION OF THE
PROPOSED RULE OR REGULATION SHALL BE REQUIRED. PRIOR TO SUCH COMMISSION-
ER'S FINAL APPROVAL AND PROMULGATION OF SUCH PROPOSED  RULES  AND  REGU-
LATIONS, IF SUCH RULES AND REGULATIONS ARE MODIFIED IN ANY RESPECT, THEY
SHALL  BE  SUBMITTED  TO THE COUNCIL PURSUANT TO SUBDIVISION (J) OF THIS
SECTION. IF SUCH COMMISSIONER DETERMINES NOT TO PROMULGATE SUCH PROPOSED
RULES AND REGULATIONS, THE COMMISSIONER SHALL APPEAR BEFORE THE  COUNCIL
TO REPORT THE REASONS THEREFOR.
  (L) THE MEMBERS OF THE COUNCIL SHALL RECEIVE NO COMPENSATION FOR THEIR
SERVICES  BUT  SHALL BE REIMBURSED FOR EXPENSES ACTUALLY AND NECESSARILY
INCURRED IN THE PERFORMANCE OF THEIR DUTIES.

S. 6256--B                         94                         A. 9056--B

  (M) THE COMMISSIONERS, UPON REQUEST OF THE  COUNCIL,  SHALL  DESIGNATE
ONE OR MORE OFFICERS OR EMPLOYEES FROM EITHER OR BOTH OFFICES TO PROVIDE
ADMINISTRATIVE SUPPORT SERVICES TO THE COUNCIL, AND MAY ASSIGN FROM TIME
TO TIME SUCH OTHER EMPLOYEES AS THE COUNCIL MAY REQUEST.
  (N)  NO  CIVIL ACTION SHALL BE BROUGHT IN ANY COURT AGAINST ANY MEMBER
OF THE BEHAVIORAL HEALTH SERVICES ADVISORY COUNCIL  FOR  ANY  ACT  DONE,
FAILURE  TO  ACT, OR STATEMENT OR OPINION MADE, WHILE DISCHARGING HIS OR
HER DUTIES AS A MEMBER OF THE COUNCIL, WITHOUT LEAVE FROM A  JUSTICE  OF
THE  SUPREME  COURT,  FIRST  HAD  AND OBTAINED. IN ANY EVENT SUCH MEMBER
SHALL NOT BE LIABLE FOR DAMAGES IN ANY SUCH ACTION IF HE  OR  SHE  SHALL
HAVE  ACTED IN GOOD FAITH, WITH REASONABLE CARE AND UPON PROBABLE CAUSE.
MEMBERS OF THE COUNCIL SHALL  BE  CONSIDERED  PUBLIC  OFFICERS  FOR  THE
PURPOSES OF SECTION SEVENTEEN OF THE PUBLIC OFFICERS LAW.
  (O) THE COUNCIL MAY ESTABLISH SUCH COMMITTEES AS IT DEEMS NECESSARY.
  (P) THE COUNCIL MAY ESTABLISH WRITTEN BYLAWS.
  (Q)  FOR  PURPOSES OF THIS SECTION, "BEHAVIORAL HEALTH SERVICES" SHALL
MEAN EXAMINATION, DIAGNOSIS, CARE, TREATMENT, REHABILITATION, OR  TRAIN-
ING  FOR  PERSONS  WITH MENTAL ILLNESS AND/OR FOR PERSONS WITH SUBSTANCE
USE OR COMPULSIVE GAMBLING DISORDERS.
  S 3. The section heading, subdivision (a), the opening  paragraph  and
paragraphs  1  and  3  of subdivision (b) and subdivision (c) of section
5.07 of the mental hygiene law, the section heading as amended by  chap-
ter  55  of the laws of 1992, subdivision (a), the opening paragraph and
paragraphs 1 and 3 of subdivision (b) and subdivision (c) as amended  by
chapter  223  of  the  laws  of  1992, paragraph 1 of subdivision (a) as
amended by chapter 37 of the laws of  2011,  the  opening  paragraph  of
paragraph  1 of subdivision (b) as amended by chapter 168 of the laws of
2010, subparagraphs h and i as amended and subparagraph j of paragraph 1
of subdivision (b) as added by chapter 413 of the laws of 2009 and para-
graph 3 of subdivision (b) as renumbered by chapter 322 of the  laws  of
1992, are amended to read as follows:
Establishment  of [statewide goals and objectives;] statewide comprehen-
         sive plans of services for [the mentally disabled] PERSONS WITH
         MENTAL DISABILITIES.
  (a) (1) The [mental health] BEHAVIORAL HEALTH services ADVISORY  coun-
cil  and  the  advisory [councils] COUNCIL on developmental disabilities
[and alcoholism and substance abuse  services]  shall  [each  establish]
PROVIDE  RECOMMENDATIONS  FOR statewide PRIORITIES AND goals [and objec-
tives] to guide comprehensive planning, resource allocation  and  evalu-
ation  processes  for  state  and local services for persons with mental
illness, developmental disabilities [and], AND/OR those [suffering  from
chemical  abuse  or  dependence,  respectively]  WITH  SUBSTANCE  USE OR
COMPULSIVE GAMBLING DISORDERS. Such goals and objectives shall:
  a. be measurable in terms of attainment AND FOCUSED  ON  OUTCOMES  FOR
THOSE BEING SERVED;
  b.  be DEVELOPED IN COLLABORATION WITH, AND communicated to, providers
of services, department facilities,  consumers  and  consumer  represen-
tatives, and other appropriate state and local governmental agencies;
  c.  [require  that all state and local public and private services for
persons with mental disabilities be organized, staffed and  financed  to
best  meet  the  needs  of  all persons with mental disabilities whether
receiving in-patient or non in-patient services;
  d.] reflect the  partnership  between  state  and  local  governmental
units; and

S. 6256--B                         95                         A. 9056--B

  [e.]  D.  emphasize [that gaps in services be filled and that services
are provided to persons with mental disabilities] THE NEED TO  INTEGRATE
BEHAVIORAL HEALTH AND HEALTH SERVICES.
  (2) Such advisory councils shall [establish, review, augment or delete
from such goals and objectives, as appropriate,] ACCOMPLISH THEIR DUTIES
by means of a [continuing annual goal-setting] process which is:
  a. open, visible and accessible to the public; and
  b.  consistent  with  the  statewide  AND FEDERALLY MANDATED planning,
appropriation and evaluation processes and activities  for  services  to
[the mentally disabled] PERSONS WITH MENTAL DISABILITIES.
  (3) The advisory councils are hereby empowered to hold public hearings
and meetings to enable them to accomplish their duties.
  Statewide  comprehensive  plan for services to [the mentally disabled]
PERSONS WITH MENTAL DISABILITIES.
  (1) The office of mental health, the office for people  with  develop-
mental  disabilities  and  the  office of alcoholism and substance abuse
services shall [each] formulate a  statewide  comprehensive  [five-year]
plan  for the provision of all state and local services for persons with
mental illness [and], developmental  disabilities,  [and]  AND/OR  those
[suffering from alcoholism and] WITH substance [abuse, respectively] USE
OR  COMPULSIVE  GAMBLING DISORDERS.   [Each] THE STATEWIDE COMPREHENSIVE
plan shall be [formulated from] BASED UPON AN ANALYSIS OF local [compre-
hensive] SERVICES plans developed by each local governmental unit,  with
participation  of  consumers, consumer groups, providers of services and
departmental facilities [furnishing] THAT FURNISH services  to  individ-
uals  with  mental disabilities [of the area] in conformance with state-
wide PRIORITIES AND goals [and objectives] established [by] WITH  RECOM-
MENDATIONS  OF  the  advisory  council  of  each office. [Each] THE plan
shall:
  a. identify [needs and problems which must  be  addressed  during  the
next  ensuing  five years which such plan encompasses] STATEWIDE PRIORI-
TIES;
  b. specify [time-limited] STATEWIDE goals [to meet those  needs]  THAT
REFLECT  THE  STATEWIDE PRIORITIES AND ARE FOCUSED ON OBTAINING POSITIVE
MEASURABLE OUTCOMES;
  c. [identify resources to achieve the goals, including but not limited
to resource reallocations;
  d. establish] PROPOSE STRATEGIES AND INITIATIVES TO ADDRESS THE prior-
ities [for resource allocation] AND FACILITATE ACHIEVEMENT OF  STATEWIDE
GOALS;
  [e.  define  the  authority  and  responsibility  for  state and local
participation in the delivery of services] D.    IDENTIFY  SERVICES  AND
SUPPORTS,  WHICH  MAY  INCLUDE  PROGRAMS  RUN  OR LED BY PEERS, THAT ARE
DESIGNED TO PROMOTE THE HEALTH  AND  WELLNESS  OF  PERSONS  WITH  MENTAL
ILLNESS,  DEVELOPMENTAL DISABILITIES, AND/OR SUBSTANCE USE OR COMPULSIVE
GAMBLING DISORDERS;
  [f. propose programs to achieve the goals, which programs may  include
direct  services, development of multi-purpose facilities, contracts for
services, and innovative financial and organizational relationships with
public and private providers;
  g. identify services and programs that assist the  informal  caregiver
to  care  for the mentally disabled; make recommendations to enhance the
ability of the informal caregiver to continue providing care; and devel-
op strategies for creating informal caregivers for clients in the commu-
nity who do not have a system in place;

S. 6256--B                         96                         A. 9056--B

  h. analyze] E. PROVIDE ANALYSIS OF current and anticipated utilization
of state and local, and public and private facilities  [and],  programs,
SERVICES, AND/OR SUPPORTS;
  [i.] F. encourage and promote PERSON-CENTERED, CULTURALLY AND LINGUIS-
TICALLY  COMPETENT  community-based  programs, SERVICES, AND/OR SUPPORTS
which reflect the  partnership  between  state  and  local  governmental
units; and
  [j.]  G. include progress reports on the implementation of both short-
term and long-term  recommendations  of  the  children's  plan  required
pursuant  to  section four hundred eighty-three-f of the social services
law.
  (3) The commissioners of each of the offices shall be responsible  for
the  development  of such statewide [five-year] plan for services within
the jurisdiction of their respective offices and after giving due notice
shall conduct one or more public hearings on such plan.  The  BEHAVIORAL
HEALTH SERVICES advisory council [of each office] AND THE ADVISORY COUN-
CIL ON DEVELOPMENTAL DISABILITIES shall review the statewide [five year]
COMPREHENSIVE  plan  developed  by such office OR OFFICES and report its
recommendations thereon to  such  commissioner  OR  COMMISSIONERS.  Each
commissioner  shall  submit the plan, with appropriate modifications, to
the governor no later than the first day of [October] NOVEMBER  of  each
year in order that such plan may be considered with the estimates of the
offices  for the preparation of the executive budget of the state of New
York for the next succeeding state  fiscal  year.    [Each  commissioner
shall also submit such plan to the legislature. The statewide plan] SUCH
PLANS  SHALL  ALSO  BE  POSTED  TO THE WEBSITE OF EACH OFFICE. STATEWIDE
PLANS shall [be reassessed and updated at least  annually  to  encompass
the  next ensuing five years to] ensure responsiveness to changing needs
and goals and [to] SHALL reflect the development of new information  and
the  completion of program evaluations. [An interim report detailing the
commissioner's actions in fulfilling the requirements of this section in
preparation of the plan and modifications in the plan of services  being
considered  by  the  commissioner shall be submitted to the governor and
the legislature on or before the fifteenth day of February of each year.
Such interim report shall include, but need not be limited to:
  (a) actions to include participation of  consumers,  consumer  groups,
providers  of  services and departmental facilities, as required by this
subdivision; and
  (b) any modifications in the plan of services being considered by  the
commissioner,  to  include:  (i)  compelling  budgetary, programmatic or
clinical justifications  or  other  major  appropriate  reason  for  any
significant  new  statewide  programs  or  policy  changes  from a prior
(approved) five year comprehensive plan; and (ii) procedures to  involve
or inform local governmental units of such actions or plans.
  (c) Three year capital plan. (1) On or before July first of each year,
the  commissioners  of  the  offices of the department of mental hygiene
shall each submit to the advisory council of their respective offices  a
statewide three year capital plan for facilities within the jurisdiction
of  their  respective  offices.  The  capital  plan  shall set forth the
projects proposed to be designed, constructed, acquired,  reconstructed,
rehabilitated  or  otherwise substantially altered pursuant to appropri-
ation to meet the capital development needs of the  respective  agencies
for  the  next  ensuing three years; the years of such plan shall corre-
spond to the years of the statewide five year plan as required by subdi-
vision (b) of this section.

S. 6256--B                         97                         A. 9056--B

  (2) Such plan for each office shall include but not be  limited  to  a
detailed  project  schedule indicating the location by county or borough
and estimated cost of each project, the anticipated dates on  which  the
design  and  construction  of  the  project is to commence, the proposed
method  of financing for the project, the estimated economic life of the
project  and  whether  the  proposed  project  constitutes  design,  new
construction or rehabilitation.
  (3)  Such  plan  shall  further  specify  for each project whether the
project is to be a residential or nonresidential facility,  a  state  or
voluntary  operated  facility,  and, the number of clients, by source of
clients, proposed to utilize the facility. The information on the source
of the client shall include but not  be  limited  to  identification  of
clients  currently  living  independently,  or at home with families, or
with caretakers, clients defined by their respective agencies as special
populations, or clients currently residing in an  institutional  setting
under the jurisdiction of the offices of the department.
  (4)  The  advisory council of the appropriate office shall review such
plan and report its recommendation to the  commissioner  for  inclusion,
provided, however, that the mental health services council shall forward
its  comments  on the capital plan of the office of mental health to the
mental health planning council which shall forward such  recommendations
after  review  to  the  commissioner  of mental health. The commissioner
shall submit his or her plan with  the  formal  recommendations  of  the
advisory  council  of  his  or her office and any subsequent appropriate
modifications to the governor no later than the first day of October  of
each  year  or  concurrent  with  the annual submission of estimates and
information required by section one of article seven of the constitution
in order that such plans shall be considered with the estimates  of  the
offices  for the preparation of the executive budget of the state of New
York for the next succeeding state fiscal year. The commissioners  shall
also  submit  such plans to the chairmen of the senate finance committee
and the assembly ways and means committee.
  (5) Each statewide three year capital plan  for  facilities  shall  be
evaluated  and  revised  annually  to  encompass the fiscal year then in
progress and the next ensuing two fiscal years to ensure  responsiveness
to  the  changing  needs and goals of the department, and to reflect the
development of new information and project completion.]
  S 4. Section 7.05 of the mental hygiene law is REPEALED.
  S 5. Subdivision (c) of section 13.05 of the mental  hygiene  law,  as
amended  by  chapter  37  of  the  laws  of  2011, is amended to read as
follows:
  (c) The developmental disabilities  advisory  council  shall  have  no
executive,  administrative  or appointive duties. The council shall have
the duty to foster public understanding and acceptance of  developmental
disabilities. It shall, in cooperation with the commissioner of develop-
mental  disabilities,  [establish] PROVIDE RECOMMENDATIONS FOR statewide
PRIORITIES AND goals [and objectives] for services for individuals  with
developmental  disabilities and shall advise the commissioner on matters
related to development and  implementation  of  the  [OPWDD's  triennial
state   developmental  disabilities]  STATEWIDE  comprehensive  plan  as
required under [paragraph two of subdivision (b)  of]  section  5.07  of
this  chapter. The advisory council shall have the power to consider any
matter relating to the improvement of the state developmental  disabili-
ties program and shall advise the commissioner of developmental disabil-
ities  thereon  and  on  any matter relating to the performance of their
duties with relation to individuals with developmental disabilities  and

S. 6256--B                         98                         A. 9056--B

on  policies,  goals, budget and operation of developmental disabilities
services.
  S 6. Section 19.05 of the mental hygiene law is REPEALED.
  S  7.  Subdivision  (c) of section 41.16 of the mental hygiene law, as
amended by section 16 of part E of chapter 111 of the laws of  2010,  is
amended to read as follows:
  (c)  A  local services plan shall be developed, in accordance with the
regulations of the  commissioner  or  commissioners  of  the  office  or
offices  of  the  department  having jurisdiction of the services by the
local governmental unit or units which shall  direct  and  administer  a
local comprehensive planning process for its geographic area, consistent
with statewide goals and objectives established pursuant to section 5.07
of this chapter. The planning process shall involve the directors of any
department   facilities,  directors  of  hospital  based  mental  health
services, directors of community mental health centers, THE DIRECTOR  OF
THE  LOCAL OFFICE FOR THE AGING OR HIS OR HER REPRESENTATIVE, consumers,
consumer groups, voluntary agencies, other providers  of  services,  and
local correctional facilities and other local criminal justice agencies.
The  local  governmental  unit,  or  units, shall determine the proposed
local services plan to be submitted for approval.  If  any  provider  of
services  including  facilities in the department, or any representative
of the consumer or community interests within the local  planning  proc-
ess,  disputes  any  element  of the proposed plan for the area which it
serves, the objection shall be presented in writing to the  director  of
the  local  governmental unit. If such dispute cannot be resolved to the
satisfaction of all parties, the director shall determine the plan to be
submitted. If requested and supplied by the objecting party,  a  written
objection  to  the plan shall be appended thereto and transmitted to the
single agent of the department jointly designated by the commissioners.
  S 8.  Section 220 of the public health law, as amended by  section  45
of  part  A  of  chapter  58  of the laws of 2010, is amended to read as
follows:
  S 220. Public health  and  health  planning  council;  appointment  of
members.  There  shall  continue to be in the department a public health
and health planning council to consist of the commissioner and  fourteen
members  to  be appointed by the governor with the advice and consent of
the senate; provided that effective December first,  two  thousand  ten,
the  membership  of  the  council  shall consist of the commissioner and
twenty-four members to be appointed by the governor with the advice  and
consent  of the senate. Membership on the council shall be reflective of
the diversity of the state's population including, but not  limited  to,
the  various  geographic  areas  and population densities throughout the
state. The members shall include representatives of  the  public  health
system,  health  care  providers  that  comprise the state's health care
delivery system, individuals with expertise in the clinical and adminis-
trative aspects of health care delivery, issues  affecting  health  care
consumers,  health  planning,  health  care financing and reimbursement,
health care regulation and compliance, and public health practice and at
least two members shall also  be  members  of  the  [mental]  BEHAVIORAL
health  services ADVISORY council; at least four members shall be repre-
sentatives of general hospitals or  nursing  homes;  and  at  least  one
member  shall  be a representative of each of the following groups: home
care agencies, diagnostic and treatment  centers,  health  care  payors,
labor  organizations for health care employees, and health care consumer
advocacy organizations.

S. 6256--B                         99                         A. 9056--B

  S 9. This act shall take effect immediately and  shall  be  deemed  to
have been in full force and effect on and after April 1, 2012; provided,
however,  that sections one through six of this act shall take effect on
the one hundred twentieth day after it shall have become a law.

                                 PART O

  Section  1. Subdivision (b) of section 7.17 of the mental hygiene law,
as amended by section 1 of part G of chapter 59 of the laws of 2011,  is
amended to read as follows:
  (b)  There  shall  be  in the office the hospitals named below for the
care, treatment and rehabilitation of persons with  mental  illness  and
for  research  and  teaching  in the science and skills required for the
care, treatment and rehabilitation of such persons with mental illness.
  Greater Binghamton Health Center
  Bronx Psychiatric Center
  Buffalo Psychiatric Center
  Capital District Psychiatric Center
  Central New York Psychiatric Center
  Creedmoor Psychiatric Center
  Elmira Psychiatric Center
  [Hudson River Psychiatric Center
  Kingsboro Psychiatric Center]
  Kirby Forensic Psychiatric Center
  Manhattan Psychiatric Center
  Mid-Hudson Forensic Psychiatric Center
  Mohawk Valley Psychiatric Center
  Nathan S. Kline Institute for Psychiatric Research
  New York State Psychiatric Institute
  Pilgrim Psychiatric Center
  Richard H. Hutchings Psychiatric Center
  Rochester Psychiatric Center
  Rockland Psychiatric Center
  St. Lawrence Psychiatric Center
  South Beach Psychiatric Center
  [Bronx Children's Psychiatric Center
  Brooklyn Children's Center
  Queens Children's Psychiatric Center]
  NEW YORK CITY CHILDREN'S CENTER
  Rockland Children's Psychiatric Center
  Sagamore Children's Psychiatric Center
  Western New York Children's Psychiatric Center
  The New York State Psychiatric  Institute  and  The  Nathan  S.  Kline
Institute  for Psychiatric Research are designated as institutes for the
conduct of medical research and other scientific investigation  directed
towards  furthering  knowledge of the etiology, diagnosis, treatment and
prevention of mental illness.  [The  Brooklyn  Children's  Center  is  a
facility operated by the office to provide community-based mental health
services for children with serious emotional disturbances.]
  S  2.  Notwithstanding  the  provisions of subdivisions (b) and (e) of
section 7.17 of the mental hygiene law,  section  41.55  of  the  mental
hygiene  law,  or  any  other  law to the contrary, the office of mental
health is authorized to close, consolidate, reduce, transfer  or  other-
wise redesign services of hospitals, other facilities and programs oper-
ated  by  the  office  of  mental  health,  and to implement significant
service reductions and reconfigurations according  to  this  section  as

S. 6256--B                         100                        A. 9056--B

shall be determined by the commissioner of mental health to be necessary
for  the cost-effective and efficient operation of such hospitals, other
facilities and programs. One of the intents of actions taken that result
in   closure,  consolidation,  reduction,  transfer  or  other  redesign
services of hospitals is to reinvest appropriate levels of  funding  for
community based mental health services and programs as determined by the
commissioner  of  mental  health  with approval from the director of the
division of the budget.
  (a) In addition to the closure, consolidation or merger of one or more
facilities, the commissioner of mental health is authorized  to  perform
any  significant  service  reductions  that  would  reduce inpatient bed
capacity, which shall include but not be limited to, closures  of  wards
at  a  state-operated  psychiatric  center  or the conversion of beds to
transitional placement programs, provided that the commissioner  provide
at least 30 days notice of such reductions to the temporary president of
the  senate and the speaker of the assembly and simultaneously post such
notice upon its public website. In assessing which  significant  service
reductions to undertake, the commissioner shall consider data related to
inpatient  census,  indicating  nonutilization  or  under utilization of
beds, and the efficient operation of facilities.
  (b) At least sixty days prior  to  the  anticipated  closure,  consol-
idation  or  merger of any hospitals named in subdivision (b) of section
7.17 of the mental hygiene law, the commissioner of mental health  shall
provide notice of such closure, consolidation or merger to the temporary
president  of  the senate, and speaker of the assembly, the chief execu-
tive officer of the county in which the facility is located,  and  shall
post  such  notice  upon  its  public website. The commissioner shall be
authorized to conduct any and  all  preparatory  actions  which  may  be
required  to  effectuate such closures during such sixty day period.  In
assessing which of such  hospitals  to  close,  the  commissioner  shall
consider the following factors: (1) the size, scope and type of services
provided  by  the  hospital;  (2)  the  relative quality of the care and
treatment provided by the hospital, as may be informed  by  internal  or
external  quality  or  accreditation reviews; (3) the current and antic-
ipated long-term need for the types of services provided by the facility
within its catchment area, which may include, but  not  be  limited  to,
services  for adults or children, or other specialized services, such as
forensic services; (4) the availability of staff sufficient  to  address
the  current  and anticipated long term service needs; (5) the long term
capital investment required to ensure that the facility  meets  relevant
state  and federal regulatory and capital construction requirements, and
national accreditation standards; (6) the proximity of the  facility  to
other facilities with space that could accommodate anticipated need, the
relative  cost  of any necessary renovations of such space, the relative
potential operating efficiency of such facilities, and the  size,  scope
and  types of services provided by the other facilities; (7) anticipated
savings based upon economies of scale or other  factors;  (8)  community
mental  health services available in the facility catchment area and the
ability of such community mental health services to meet the  behavioral
health needs of the impacted consumers; (9) the obligations of the state
to  place  persons with mental disabilities in community settings rather
than in institutions, when appropriate; and (10) the anticipated  impact
of the closure on access to mental health services.
  (c)  Any  transfers of inpatient capacity or any resulting transfer of
functions shall be authorized to be made by the commissioner  of  mental
health  and  any transfer of personnel upon such transfer of capacity or

S. 6256--B                         101                        A. 9056--B

transfer of functions shall  be  accomplished  in  accordance  with  the
provisions of section 70 of the civil service law.
  S 3. Severability clause. If any clause, sentence, paragraph, subdivi-
sion,  section  or  part  of  this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair,  or  invalidate  the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph,  subdivision,  section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included herein.
  S 4. This act shall take effect immediately and  shall  be  deemed  to
have  been in full force and effect on and after April 1, 2012; provided
that the date for the closure of Kingsboro psychiatric center  shall  be
on a date certified by the commissioner of mental health.

                                 PART P

  Section 1. Subdivision (o) of section 10.03 of the mental hygiene law,
as  amended  by  chapter  168 of the laws of 2010, is amended to read as
follows:
  (o) "Secure treatment facility" means a facility or  a  portion  of  a
facility,  designated  by  the commissioner, that may include a facility
located on the grounds of a correctional facility, that is staffed  with
personnel from the office of mental health or the office for people with
developmental disabilities for the purposes of providing care and treat-
ment  to  persons  confined  under  this article, and persons defined in
paragraph five of subdivision (g) of this section. Personnel from  these
same  agencies  may  provide security services, provided that such staff
are adequately trained in security methods and so equipped as  to  mini-
mize  the  risk  or  danger of escape.   THE COMMISSIONER SHALL HAVE THE
DISCRETION TO ENTER INTO AGREEMENTS FOR THE PROVISION OF CARE AND TREAT-
MENT TO PERSONS HELD AT A SECURE TREATMENT  FACILITY  PURSUANT  TO  THIS
ARTICLE, OR FOR THE PROVISION OF APPROPRIATE SECURITY SERVICES, BY INDI-
VIDUALS WHO ARE NOT PERSONNEL OF SUCH AGENCIES.
  S  2.  Subdivision  (k) of section 10.06 of the mental hygiene law, as
amended by section 118-c of subpart B of part C of  chapter  62  of  the
laws of 2011, is amended to read as follows:
  (k) At the conclusion of the hearing, the court shall determine wheth-
er  there  is  probable  cause  to  believe that the respondent is a sex
offender requiring civil management. If the court determines that proba-
ble cause has not been established,  the  court  shall  issue  an  order
dismissing  the  petition,  and  the  respondent's  release  shall be in
accordance with other applicable provisions of law. If the court  deter-
mines  that  probable  cause  has  been established: (i) the court shall
order that the respondent be committed to a  secure  treatment  facility
designated  by the commissioner for care, treatment and control upon his
or her release, provided, however, that a respondent who otherwise would
be required to be transferred to  a  secure  treatment  facility  [may,]
SHALL  REMAIN IN THE CUSTODY OF THE DEPARTMENT OF CORRECTIONS AND COMMU-
NITY SUPERVISION PENDING THE OUTCOME OF THE PROCEEDINGS UNDER THIS ARTI-
CLE UNTIL HE OR SHE HAS REACHED THE MAXIMUM EXPIRATION  OF  HIS  OR  HER
SENTENCE  OR  HAS BEEN APPROVED FOR RELEASE TO PAROLE SUPERVISION BY THE
STATE BOARD OF PAROLE, PROVIDED, FURTHER THAT A RESPONDENT MAY,  upon  a
written consent signed by the respondent and his or her counsel, consent
to  remain in the custody of the department of corrections and community

S. 6256--B                         102                        A. 9056--B

supervision pending the outcome of the proceedings under  this  article,
and  that  such  consent may be revoked in writing at any time; (ii) the
court shall set a date for trial in accordance with subdivision  (a)  of
section  10.07  of  this  article; and (iii) the respondent shall not be
released pending the completion of such trial.
  S 3. Subdivision (f) of section 10.07 of the mental  hygiene  law,  as
added by chapter 7 of the laws of 2007, is amended to read as follows:
  (f)  If  the  jury, or the court if a jury trial is waived, determines
that the respondent is a detained sex offender who suffers from a mental
abnormality, then the court shall consider whether the respondent  is  a
dangerous sex offender requiring confinement or a sex offender requiring
strict  and  intensive  supervision.  The  parties  may offer additional
evidence, and the court shall hear argument, as to that  issue.  If  the
court  finds  by clear and convincing evidence that the respondent has a
mental abnormality involving such a strong predisposition to commit  sex
offenses, and such an inability to control behavior, that the respondent
is  likely  to  be  a danger to others and to commit sex offenses if not
confined to a secure treatment facility, then the court shall  find  the
respondent to be a dangerous sex offender requiring confinement. In such
case,  the  respondent shall be committed to a secure treatment facility
for care, treatment, and control until such time as he or she no  longer
requires  confinement.  FAILURE  OF  A  DANGEROUS SEX OFFENDER REQUIRING
CONFINEMENT TO MEANINGFULLY PARTICIPATE IN TREATMENT IN A SECURE  TREAT-
MENT  FACILITY SHALL CONSTITUTE A VIOLATION OF THE ORDER OF CONFINEMENT.
If the court does not find that the respondent is a dangerous sex offen-
der requiring confinement, then the court shall make a finding of dispo-
sition that the respondent is a sex offender requiring strict and inten-
sive supervision, and the respondent shall be subject to  a  regimen  of
strict  and  intensive  supervision  and  treatment  in  accordance with
section 10.11 of this article. In making a finding of  disposition,  the
court  shall  consider  the  conditions  that  would be imposed upon the
respondent if subject to a regimen of strict and intensive  supervision,
and  all  available information about the prospects for the respondent's
possible re-entry into the community.
  S 4. Section 10.08 of the mental hygiene law is amended  by  adding  a
new subdivision (i) to read as follows:
  (I)  AT ANY PROCEEDING CONDUCTED PURSUANT TO THIS ARTICLE OTHER THAN A
TRIAL CONDUCTED PURSUANT TO SECTION 10.07 OF THIS ARTICLE, THE  RESPOND-
ENT OR ANY WITNESS SHALL BE PERMITTED, UPON GOOD CAUSE SHOWN, TO MAKE AN
ELECTRONIC  APPEARANCE IN THE COURT BY MEANS OF AN INDEPENDENT AUDIO-VI-
SUAL SYSTEM, AS THAT TERM IS  DEFINED  IN  SUBDIVISION  ONE  OF  SECTION
182.10 OF THE CRIMINAL PROCEDURE LAW, FOR PURPOSES OF A COURT APPEARANCE
OR  FOR  GIVING TESTIMONY. IT SHALL CONSTITUTE GOOD CAUSE THAT A WITNESS
IS CURRENTLY EMPLOYED BY THE STATE AT A  SECURE  TREATMENT  FACILITY  OR
ANOTHER WORK LOCATION, UNLESS THERE ARE COMPELLING CIRCUMSTANCES REQUIR-
ING  THE  WITNESS'S  PERSONAL  PRESENCE  AT  THE COURT PROCEEDING.   FOR
PURPOSES OF  THIS  SUBDIVISION,  AN  "ELECTRONIC  APPEARANCE"  MEANS  AN
APPEARANCE  AT  WHICH  A PARTICIPANT IS NOT PRESENT IN THE COURT, BUT IN
WHICH: (I) ALL OF THE PARTICIPANTS ARE ABLE TO SEE AND HEAR  THE  SIMUL-
TANEOUS  REPRODUCTIONS  OF  THE VOICES AND IMAGES OF THE JUDGE, COUNSEL,
RESPONDENT OR ANY OTHER APPROPRIATE PARTICIPANT,  AND  (II)  COUNSEL  IS
PRESENT  WITH  THE  RESPONDENT OR THE RESPONDENT AND COUNSEL ARE ABLE TO
SEE AND HEAR EACH OTHER AND  ENGAGE  IN  PRIVATE  CONVERSATION.  WHEN  A
RESPONDENT  OR  A  WITNESS  MAKES  AN  ELECTRONIC  APPEARANCE, THE COURT
STENOGRAPHER SHALL RECORD ANY STATEMENTS IN THE SAME MANNER  AS  IF  THE
RESPONDENT  OR  WITNESS  HAD MADE A PERSONAL APPEARANCE. NOTHING IN THIS

S. 6256--B                         103                        A. 9056--B

SUBDIVISION SHALL BE CONSTRUED TO PROHIBIT THE RESPONDENT OR ANY WITNESS
FROM MAKING AN ELECTRONIC APPEARANCE IN THE COURT AT A  TRIAL  CONDUCTED
PURSUANT  TO  SECTION  10.07  OF THIS ARTICLE BY MEANS OF AN INDEPENDENT
AUDIO-VISUAL SYSTEM, UPON GOOD CAUSE SHOWN AND CONSENT OF THE PARTIES.
  S  5. The section heading and subdivisions (a), (b), (c), (d), and (f)
of section 10.09 of the mental hygiene law, as added by chapter 7 of the
laws of 2007, are amended to read as follows:
[Annual] BIENNIAL examinations and petitions for discharge.
  (a) The commissioner shall provide  the  respondent  and  counsel  for
respondent  with  [an  annual] A BIENNIAL written notice of the right to
petition the court for discharge. The notice shall contain  a  form  for
the waiver of the right to petition for discharge.
  (b)  The commissioner shall also assure that each respondent committed
under this article shall have an examination for evaluation  of  his  or
her  mental  condition  made  at  least once every [year] TWO YEARS by a
psychiatric examiner who shall report to the  commissioner  his  or  her
written  findings  as to whether the respondent is currently a dangerous
sex offender requiring confinement. At such time,  the  respondent  also
shall have the right to be evaluated by an independent psychiatric exam-
iner.    If  the respondent is financially unable to obtain an examiner,
the court shall appoint an examiner of the  respondent's  choice  to  be
paid  within  the  limits  prescribed by law. Following such evaluation,
each psychiatric examiner shall report his or her findings in writing to
the commissioner and to counsel for respondent. The  commissioner  shall
review  relevant  records  and  reports,  along with the findings of the
psychiatric examiners, and shall make a determination in writing  as  to
whether  the  respondent is currently a dangerous sex offender requiring
confinement.
  (c) The commissioner shall [annually] BIENNIALLY  forward  the  notice
and  waiver form, along with a report including the commissioner's writ-
ten determination and the findings of the  psychiatric  examination,  to
the supreme or county court where the respondent is located.
  (d) The court shall hold an evidentiary hearing as to retention of the
respondent within forty-five days if it appears from one of the [annual]
BIENNIAL  submissions to the court under subdivision (c) of this section
(i) that the respondent has petitioned, or has not affirmatively  waived
the  right to petition, for discharge, or (ii) that even if the respond-
ent has waived the right to petition, and the  commissioner  has  deter-
mined  that  the  respondent  remains a dangerous sex offender requiring
confinement, the court finds on the basis of the materials described  in
subdivision  (b) of this section that there is a substantial issue as to
whether the  respondent  remains  a  dangerous  sex  offender  requiring
confinement. At an evidentiary hearing on that issue under this subdivi-
sion, the attorney general shall have the burden of proof.
  (f)  The  respondent  may at any time petition the court for discharge
and/or release to the community under a regimen of strict and  intensive
supervision  and  treatment.  Upon  review of the respondent's petition,
other than in connection with [annual] BIENNIAL reviews as described  in
subdivisions  (a), (b) and (d) of this section, the court may order that
an evidentiary hearing be held, or may deny an evidentiary  hearing  and
deny  the petition upon a finding that the petition is frivolous or does
not provide sufficient basis for reexamination prior to the next  [annu-
al]  BIENNIAL  review.  If the court orders an evidentiary hearing under
this subdivision, the attorney general shall have the burden of proof as
to whether the respondent is currently a dangerous sex offender  requir-
ing confinement.

S. 6256--B                         104                        A. 9056--B

  S  6.  Subdivision  (a) of section 10.10 of the mental hygiene law, as
added by chapter 7 of the laws of 2007, is amended to read as follows:
  (a)  If the respondent is found to be a dangerous sex offender requir-
ing confinement and committed  to  a  secure  treatment  facility,  that
facility  shall  provide  care, treatment, and control of the respondent
until such time that a court discharges  the  respondent  in  accordance
with the provisions of this article. FAILURE OF A DANGEROUS SEX OFFENDER
REQUIRING  CONFINEMENT  TO  MEANINGFULLY  PARTICIPATE  IN TREATMENT IN A
SECURE TREATMENT FACILITY SHALL CONSTITUTE A VIOLATION OF THE  ORDER  OF
CONFINEMENT.
  S  7.  Subdivision  (c) of section 10.11 of the mental hygiene law, as
amended by section 118-e of subpart B of part C of  chapter  62  of  the
laws of 2011, is amended to read as follows:
  (c)  An  order  for  a regimen of strict and intensive supervision and
treatment places the person in the custody and control of the department
of corrections and community supervision. A person ordered to undergo  a
regimen  of  strict  and intensive supervision and treatment pursuant to
this article is subject to lawful conditions set by the  court  and  the
department  of  corrections and community supervision.  A VIOLATION OF A
CONDITION OF THE REGIMEN OF STRICT AND INTENSIVE SUPERVISION AND  TREAT-
MENT FOR A PERSON UNDER COMMUNITY SUPERVISION, AS DEFINED IN SUBDIVISION
THREE OF SECTION TWO HUNDRED FIFTY-NINE OF THE EXECUTIVE LAW, MAY BE THE
BASIS   FOR  REVOCATION  OF  PAROLE  PURSUANT  TO  SECTION  TWO  HUNDRED
FIFTY-NINE-I OF THE EXECUTIVE LAW. A PERSON WHO INTENTIONALLY VIOLATES A
MATERIAL CONDITION OF THE REGIMEN OF STRICT  AND  INTENSIVE  SUPERVISION
AND TREATMENT SHALL BE GUILTY OF A CLASS E FELONY.
  S 8. Section 120.05 of the penal law is amended by adding a new subdi-
vision 13 to read as follows:
  13.  HAVING BEEN FOUND TO BE A SEX OFFENDER REQUIRING CIVIL MANAGEMENT
AND WHILE CONFINED IN A SECURE TREATMENT FACILITY, AS DEFINED IN SECTION
7.18 OF THE MENTAL HYGIENE LAW, WITH INTENT TO CAUSE PHYSICAL INJURY  TO
ANOTHER  PERSON,  HE  CAUSES  SUCH  INJURY  TO SUCH PERSON OR TO A THIRD
PERSON.
  S 9. This act shall take effect immediately.

                                 PART Q

  Section 1. Section 730.10 of the criminal procedure law is amended  by
adding a new subdivision 9 to read as follows:
  9.  "APPROPRIATE  INSTITUTION"  MEANS:  (A) A HOSPITAL OPERATED BY THE
OFFICE OF MENTAL HEALTH OR A DEVELOPMENTAL CENTER OPERATED BY THE OFFICE
FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES;  (B)  A  LOCAL  CORRECTIONAL
FACILITY,  AS  SUCH  TERMS  ARE DEFINED IN SECTION TWO OF THE CORRECTION
LAW, WHICH OPERATES A MENTAL HEALTH UNIT; OR (C) A HOSPITAL LICENSED  BY
THE  DEPARTMENT  OF HEALTH WHICH OPERATES A PSYCHIATRIC UNIT LICENSED BY
THE OFFICE OF MENTAL HEALTH, AS DETERMINED BY THE COMMISSIONER.
  S 2. Subdivision 1 of section 730.40 of the criminal procedure law, as
amended by chapter 231 of the laws  of  2008,  is  amended  to  read  as
follows:
  1. When a local criminal court, following a hearing conducted pursuant
to  subdivision  three  or four of section 730.30, is satisfied that the
defendant is not an incapacitated person, the  criminal  action  against
him  OR  HER  must  proceed. If it is satisfied that the defendant is an
incapacitated person, or if no motion for such a hearing is  made,  such
court  must  issue  a final or temporary order of observation committing
him OR HER to the custody of the commissioner for care and treatment  in

S. 6256--B                         105                        A. 9056--B

an  appropriate  institution for a period not to exceed ninety days from
the date of the order, provided,  however,  that  the  commissioner  may
designate  an appropriate hospital for placement of a defendant for whom
a  final  order  of  observation has been issued, where such hospital is
licensed by the office of mental health and has agreed to  accept,  upon
referral  by  the  commissioner,  defendants  subject to final orders of
observation issued under this subdivision. When a local  criminal  court
accusatory  instrument  other  than  a  felony  complaint has been filed
against the defendant, such court must issue a final order  of  observa-
tion[; when]. WHEN a felony complaint has been filed against the defend-
ant,  such  court must issue a temporary order of observation COMMITTING
HIM OR HER TO THE JURISDICTION OF THE COMMISSIONER FOR CARE  AND  TREAT-
MENT  IN  AN  APPROPRIATE  INSTITUTION  OR ON AN OUT-PATIENT BASIS FOR A
PERIOD NOT TO EXCEED NINETY DAYS FROM THE DATE  OF  SUCH  ORDER,  except
that,  with  the  consent of the district attorney, it may issue a final
order of observation.
  S 3. Subdivision 1 of section 730.50 of the criminal procedure law, as
amended by chapter 231 of the laws  of  2008,  is  amended  to  read  as
follows:
  1.  When  a  superior court, following a hearing conducted pursuant to
subdivision three or four of  section  730.30,  is  satisfied  that  the
defendant  is  not  an incapacitated person, the criminal action against
him OR HER must proceed. If it is satisfied that  the  defendant  is  an
incapacitated  person,  or  if  no motion for such a hearing is made, it
must adjudicate him OR HER an incapacitated person,  and  must  issue  a
final  order  of observation or an order of commitment. When the indict-
ment does not charge a felony or when the defendant has  been  convicted
of  an  offense  other  than a felony, such court (a) must issue a final
order of observation committing the defendant  to  the  custody  of  the
commissioner  for care and treatment in an appropriate institution for a
period not to exceed ninety days from the date of such order,  provided,
however, that the commissioner may designate an appropriate hospital for
placement  of a defendant for whom a final order of observation has been
issued, where such hospital is licensed by the office of  mental  health
and  has agreed to accept, upon referral by the commissioner, defendants
subject to final orders of observation issued  under  this  subdivision,
and  (b)  must  dismiss  the  indictment filed in such court against the
defendant, and such dismissal constitutes a bar to  any  further  prose-
cution  of  the charge or charges contained in such indictment. When the
indictment charges a felony or when the defendant has been convicted  of
a  felony, it must issue an order of commitment committing the defendant
to the [custody] JURISDICTION of the commissioner for care and treatment
in an appropriate institution OR ON AN OUT-PATIENT BASIS  for  a  period
not to exceed one year from the date of such order. Upon the issuance of
an order of commitment, the court must exonerate the defendant's bail if
he  OR  SHE  was  previously at liberty on bail; PROVIDED, HOWEVER, THAT
EXONERATION OF BAIL IS NOT REQUIRED WHEN A DEFENDANT IS COMMITTED TO THE
JURISDICTION OF THE COMMISSIONER FOR CARE AND TREATMENT  ON  AN  OUT-PA-
TIENT BASIS.
  S 4. This act shall take effect immediately.

                                 PART R

  Section  1.    Section  1 of part D of chapter 111 of the laws of 2010
relating to the recovery of exempt income by the office of mental health

S. 6256--B                         106                        A. 9056--B

for community residences and family-based treatment programs is  amended
to read as follows:
  Section  1. The office of mental health is authorized to recover fund-
ing from  community  residences  and  family-based  treatment  providers
licensed  by  the  office  of mental health, consistent with contractual
obligations of such providers, and notwithstanding any other  inconsist-
ent  provision  of law to the contrary, in an amount equal to 50 percent
of the income received by such providers which exceeds the fixed  amount
of  annual  Medicaid  revenue limitations, as established by the commis-
sioner of mental health. Recovery of such excess income shall be for the
following fiscal periods: for programs in counties  located  outside  of
the  city of New York, the applicable fiscal periods shall be January 1,
2003 through December 31, 2009 AND JANUARY 1, 2011 THROUGH DECEMBER  31,
2013; and for programs located within the city of New York, the applica-
ble  fiscal periods shall be July 1, 2003 through June 30, 2010 AND JULY
1, 2011 THROUGH JUNE 30, 2013.
  S 2. This act shall take effect immediately.

                                 PART S

  Section 1. Section 18 of chapter 266 of the laws of 1986, amending the
civil practice law and rules and other  laws  relating  to  medical  and
dental malpractice, is REPEALED.
  S  2.  Any  rules  or regulations promulgated by the superintendent of
insurance or the commissioner of health pursuant to  the  provisions  of
section 18 of chapter 266 of the laws of 1986 shall survive such repeal,
and  shall  be  applicable  to  the excess medical malpractice liability
coverage pool and related provisions as created by section three of this
act.
  The repeal of section 18 of chapter 266 of the laws of 1986 as  effec-
tuated  by  section one of this act shall not affect the rights or obli-
gations of any physician, dentist, insurer or general  hospital  related
to  excess  or  equivalent  excess  coverage  purchased  pursuant to the
provisions of section 18 of chapter 266 of the laws of 1986 that were in
effect prior to the date this act takes effect; nor shall the repeal  of
section  18 of chapter 266 of the laws of 1986 as effectuated by section
one of this act affect the rights or obligations of any claimant against
excess or equivalent excess coverage that was purchased pursuant to  the
provisions of section 18 of chapter 266 of the laws of 1986 that were in
effect prior to the date this act takes effect.
  S  3.  The  public health law is amended by adding a new section 23 to
read as follows:
  S 23. EXCESS MEDICAL MALPRACTICE LIABILITY  COVERAGE  POOL.  1.    THE
HOSPITAL  EXCESS  LIABILITY  POOL  ESTABLISHED  BY  SUBDIVISION  FIVE OF
SECTION EIGHTEEN OF CHAPTER TWO HUNDRED SIXTY-SIX OF THE LAWS  OF  NINE-
TEEN  HUNDRED EIGHTY-SIX, AS AMENDED BY CHAPTER TWO HUNDRED FIFTY-SIX OF
THE LAWS OF NINETEEN HUNDRED NINETY-THREE  SHALL  BE  CONTINUED  AND  IS
HEREBY RENAMED THE "EXCESS MEDICAL MALPRACTICE LIABILITY COVERAGE POOL."
THE EXCESS MEDICAL MALPRACTICE LIABILITY COVERAGE POOL SHALL BE OVERSEEN
BY  THE  SUPERINTENDENT  OF FINANCIAL SERVICES AND THE COMMISSIONER, AND
SHALL CONSIST OF FUNDS CURRENTLY IN OR OWED TO THE EXCESS LIABILITY POOL
AS OF THE EFFECTIVE DATE OF THIS SECTION, AND FUNDS APPROPRIATED FOR THE
PURPOSES OF THE EXCESS MEDICAL MALPRACTICE LIABILITY COVERAGE POOL.
  2. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE  HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTIONS
ONE HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVEL-

S. 6256--B                         107                        A. 9056--B

OPMENT  LAW,  OR ANY OTHER CONTRARY PROVISION OF LAW, THE SUPERINTENDENT
OF FINANCIAL SERVICES MAY ENTER INTO A CONTRACT OR CONTRACTS UNDER  THIS
SUBDIVISION  WITHOUT  A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS,
PROVIDED, HOWEVER, THAT:
  (A)  THE  DEPARTMENT  OF FINANCIAL SERVICES SHALL POST ON ITS WEBSITE,
FOR A PERIOD OF NO LESS THAN THIRTY DAYS:
  (I) A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT  TO
THE CONTRACT OR CONTRACTS;
  (II) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (III)  THE  PERIOD  OF  TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY
SEEK SELECTION, WHICH SHALL BE NO  LESS  THAN  THIRTY  DAYS  AFTER  SUCH
INFORMATION IS FIRST POSTED ON THE WEBSITE; AND
  (IV)  THE  MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR MAY SEEK SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (B) ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE  RECEIVED  FROM
PROSPECTIVE  CONTRACTORS  IN  TIMELY  FASHION  SHALL  BE REVIEWED BY THE
SUPERINTENDENT OF FINANCIAL SERVICES; AND
  (C)  THE  SUPERINTENDENT  OF  FINANCIAL  SERVICES  SHALL  SELECT  SUCH
CONTRACTOR  OR  CONTRACTORS  THAT,  IN  THE  SUPERINTENDENT OF FINANCIAL
SERVICES' DISCRETION, ARE BEST SUITED TO  SERVE  THE  PURPOSES  OF  THIS
SUBDIVISION.
  3.  (A)  THE SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER
OR THEIR DESIGNEES SHALL, FROM FUNDS AVAILABLE  IN  THE  EXCESS  MEDICAL
MALPRACTICE  LIABILITY COVERAGE POOL CREATED PURSUANT TO SUBDIVISION ONE
OF THIS SECTION, PURCHASE A POLICY  OR  POLICIES  FOR  EXCESS  INSURANCE
COVERAGE, OR FOR EQUIVALENT EXCESS COVERAGE, FOR MEDICAL OR DENTAL MALP-
RACTICE OCCURRENCES BETWEEN THE FIRST OF JULY OF A GIVEN YEAR AND ENDING
THE  THIRTIETH  OF  JUNE  OF THE NEXT SUCCEEDING YEAR, OR TO REIMBURSE A
GENERAL HOSPITAL WHERE THE HOSPITAL PURCHASES EQUIVALENT EXCESS COVERAGE
FOR MEDICAL OR DENTAL MALPRACTICE OCCURRENCES BETWEEN THE FIRST OF  JULY
IN  A GIVEN YEAR AND ENDING THE THIRTIETH OF JUNE IN THE SUCCEEDING YEAR
FOR ELIGIBLE PHYSICIANS OR DENTISTS AS CERTIFIED BY A  GENERAL  HOSPITAL
LICENSED  PURSUANT TO ARTICLE TWENTY-EIGHT OF THIS CHAPTER FOR EACH SUCH
PERIOD OR PERIODS.
  (B) SUCH POLICIES MAY BE PURCHASED PURSUANT TO SECTION  FIVE  THOUSAND
FIVE HUNDRED TWO OF THE INSURANCE LAW, OR FROM AN INSURER, DULY LICENSED
IN  THIS STATE TO WRITE PERSONAL INJURY LIABILITY INSURANCE AND ACTUALLY
WRITING MEDICAL MALPRACTICE INSURANCE IN THIS STATE.
  (C) NO SINGLE INSURER SHALL WRITE MORE THAN FIFTY PERCENT OF THE TOTAL
EXCESS PREMIUM FOR A GIVEN POLICY  YEAR,  UNLESS  UPON  REQUEST  BY  THE
INSURER,  THE SUPERINTENDENT OF FINANCIAL SERVICES IN WRITING DETERMINED
THAT EXCEEDING SUCH LIMIT WOULD NOT BE HARMFUL TO THE  POLICYHOLDER  AND
THE PEOPLE OF THE STATE.
  4.  (A)  FOR  THE  PURPOSES  OF  THIS  SECTION, "ELIGIBLE PHYSICIAN OR
DENTIST" SHALL A MEAN A PHYSICIAN OR DENTIST, EXCLUDING A FACULTY  PRAC-
TICE PHYSICIAN OR DENTIST, WHO:
  (I) IS PRIMARILY ENGAGED IN THE PRIVATE PRACTICE OF MEDICINE, OR IS AN
EMPLOYEE OF AN ELIGIBLE HOSPITAL;
  (II)  HAS  PROFESSIONAL  PRIVILEGES  IN  THE  GENERAL HOSPITAL THAT IS
CERTIFYING THE PHYSICIAN'S OR DENTIST'S ELIGIBILITY;
  (III) IS PROVIDING EMERGENCY MEDICAL  OR  DENTAL  SERVICES,  INCLUDING
EMERGENCY   MEDICAL  SCREENING  EXAMINATIONS,  TREATMENT  FOR  EMERGENCY
MEDICAL CONDITIONS, INCLUDING LABOR AND DELIVERY, OR TREATMENT FOR EMER-
GENCY DENTAL CONDITIONS TO PERSONS IN NEED  OF  SUCH  TREATMENT  AT  THE
GENERAL HOSPITAL THAT IS CERTIFYING THEIR ELIGIBILITY; AND

S. 6256--B                         108                        A. 9056--B

  (IV)  (1)  HAS  IN  FORCE COVERAGE UNDER AN INDIVIDUAL POLICY OR GROUP
POLICY WRITTEN IN ACCORDANCE WITH THE PROVISIONS OF THE  INSURANCE  LAW,
PAID FOR SOLELY BY SUCH PHYSICIAN OR DENTIST OR HIS OR HER PRIVATE PRAC-
TICE,  FROM  AN  INSURER LICENSED IN THIS STATE TO WRITE PERSONAL INJURY
LIABILITY  INSURANCE,  OF  PRIMARY  MALPRACTICE  INSURANCE  COVERAGE  IN
AMOUNTS OF NO LESS THAN ONE MILLION THREE HUNDRED THOUSAND  DOLLARS  FOR
EACH  CLAIMANT  AND  THREE MILLION NINE HUNDRED THOUSAND DOLLARS FOR ALL
CLAIMANTS UNDER THAT POLICY AND COVERING THE SAME  TIME  PERIOD  AS  THE
EXCESS INSURANCE COVERAGE;
  (2)  IN  THE CASE OF AN EMPLOYEE OF AN ELIGIBLE HOSPITAL, HAS IN FORCE
AN INDIVIDUAL POLICY OR GROUP POLICY  WRITTEN  IN  ACCORDANCE  WITH  THE
PROVISIONS  OF  THE  INSURANCE  LAW,  PARTIALLY OR FULLY PURCHASED BY AN
ELIGIBLE HOSPITAL, FROM AN INSURER  LICENSED  IN  THIS  STATE  TO  WRITE
PERSONAL  INJURY  LIABILITY  INSURANCE, OF PRIMARY MALPRACTICE INSURANCE
COVERAGE IN AMOUNTS OF NO LESS THAN ONE MILLION THREE  HUNDRED  THOUSAND
DOLLARS  FOR  EACH  CLAIMANT  AND  THREE  MILLION  NINE HUNDRED THOUSAND
DOLLARS FOR ALL CLAIMANTS UNDER THAT POLICY AND COVERING THE  SAME  TIME
PERIOD AS THE EXCESS INSURANCE COVERAGE; OR
  (3)  IS  ENDORSED AS AN ADDITIONAL INSURED UNDER A VOLUNTARY ATTENDING
PHYSICIAN ("CHANNELING") PROGRAM PREVIOUSLY PERMITTED BY THE SUPERINTEN-
DENT OF INSURANCE AND COVERING THE SAME TIME PERIOD  AS  THE  EQUIVALENT
EXCESS COVERAGE.
  (B)  THE  EXCESS  COVERAGE  OR  EQUIVALENT EXCESS COVERAGE SHALL, WHEN
COMBINED WITH THE PHYSICIAN'S OR DENTIST'S PRIMARY MALPRACTICE INSURANCE
COVERAGE OR COVERAGE PROVIDED THROUGH A  VOLUNTARY  ATTENDING  PHYSICIAN
("CHANNELING")  PROGRAM  PREVIOUSLY  PERMITTED  BY THE SUPERINTENDENT OF
INSURANCE, TOTAL AN AGGREGATE LEVEL OF COVERAGE  OF  TWO  MILLION  THREE
HUNDRED  THOUSAND DOLLARS FOR EACH CLAIMANT AND SIX MILLION NINE HUNDRED
THOUSAND DOLLARS FOR ALL CLAIMANTS WITH RESPECT  TO  OCCURRENCES  DURING
THE POLICY PERIOD.
  (C)  THE  EQUIVALENT  EXCESS  COVERAGE  SHALL PROVIDE FOR PAYMENT ONLY
AFTER COVERAGE  AVAILABLE  THROUGH  THE  VOLUNTARY  ATTENDING  PHYSICIAN
("CHANNELING") PROGRAM HAS BEEN EXHAUSTED DURING THE POLICY PERIOD.
  (D)  IN  THE  EVENT  THAT AN ELIGIBLE PHYSICIAN OR DENTIST HAS PROFES-
SIONAL PRIVILEGES IN MORE THAN ONE GENERAL HOSPITAL,  THE  CERTIFICATION
OF  THE  PHYSICIAN'S  OR  DENTIST'S ELIGIBILITY SHALL BE PROVIDED BY THE
GENERAL HOSPITAL DESIGNATED BY SUCH PHYSICIAN OR DENTIST AS THE  GENERAL
HOSPITAL WITH WHICH THE PHYSICIAN OR DENTIST IS PRIMARILY AFFILIATED, AS
MAY BE DEFINED PURSUANT TO REGULATIONS PROMULGATED BY THE COMMISSIONER.
  5. FOR THE PURPOSES OF THIS SECTION THE TERM "ELIGIBLE HOSPITAL" SHALL
MEAN  A GENERAL HOSPITAL THAT HAS BEEN DETERMINED BY THE COMMISSIONER IN
CONSULTATION WITH THE SUPERINTENDENT OF FINANCIAL SERVICES TO:
  (A) HAVE ADEQUATELY DEMONSTRATED THAT  HIGH  COSTS  FOR,  OR  LACK  OF
AVAILABILITY  OF,  MEDICAL  MALPRACTICE LIABILITY COVERAGE HAVE IMPAIRED
THE HOSPITAL'S ABILITY TO ATTRACT AND  RETAIN  PHYSICIANS  AND  DENTISTS
PRACTICING  IN  FIELDS FOR WHICH THERE IS HIGH DEMAND BASED ON THE RATIO
OF PATIENT VOLUME TO AVAILABLE PHYSICIANS; AND
  (B) BE A VITAL ACCESS PROVIDER; AND
  (C) HAVE ADEQUATELY DEMONSTRATED  THAT  THE  GENERAL  HOSPITAL  IS  IN
FINANCIAL DISTRESS.
  6. FOR THE PURPOSES OF THIS SECTION "EQUIVALENT EXCESS COVERAGE" SHALL
MEAN  A  POLICY  OR  POLICIES  OF  INSURANCE  FOR A PHYSICIAN OR DENTIST
INSURED UNDER A VOLUNTARY  ATTENDING  PHYSICIAN  ("CHANNELING")  PROGRAM
PREVIOUSLY  PERMITTED  BY  THE  SUPERINTENDENT  OF  INSURANCE INSURING A
PHYSICIAN OR DENTIST AGAINST  MEDICAL  OR  DENTAL  MALPRACTICE  WITH  AN
AGGREGATE  LEVEL  OF  COVERAGE PROVIDING NOT LESS THAN TWO MILLION THREE

S. 6256--B                         109                        A. 9056--B

HUNDRED THOUSAND DOLLARS FOR EACH CLAIMANT AND SIX MILLION NINE  HUNDRED
THOUSAND DOLLARS FOR ALL CLAIMANTS DURING THE POLICY PERIOD. SUCH COVER-
AGE LIMITS SHALL BE REDUCED BY PAYMENTS MADE ON BEHALF OF SUCH PHYSICIAN
OR DENTIST UNDER A HOSPITAL PROFESSIONAL LIABILITY POLICY WRITTEN PURSU-
ANT TO A VOLUNTARY ATTENDING PHYSICIAN ("CHANNELING") PROGRAM PREVIOUSLY
PERMITTED BY THE SUPERINTENDENT OF INSURANCE, IN AN AMOUNT NOT TO EXCEED
TWO  MILLION  THREE  HUNDRED  THOUSAND DOLLARS FOR EACH CLAIMANT AND SIX
MILLION NINE HUNDRED THOUSAND DOLLARS  FOR  ALL  CLAIMANTS  DURING  SUCH
POLICY PERIOD FOR EACH SUCH PHYSICIAN OR DENTIST.
  7.  FOR  THE  PURPOSES  OF THIS SECTION, A PHYSICIAN OR DENTIST IN THE
"PRIVATE PRACTICE OF MEDICINE" SHALL MEAN A  PHYSICIAN  OR  DENTIST  WHO
RECEIVES  THE  LARGEST  PERCENTAGE OF HIS OR HER INCOME DERIVED FROM THE
PROVISION OF MEDICAL SERVICES, FROM BILLS:
  (A) ISSUED DIRECTLY BY THE PHYSICIAN OR DENTIST;
  (B) ISSUED DIRECTLY BY A CORPORATION, ORGANIZED  FOR  THE  PURPOSE  OF
PROVIDING  MEDICAL  OR  DENTAL  CARE, THAT IS NOT OWNED BY, AND IS NOT A
SUBSIDIARY OF, A GENERAL HOSPITAL, OR ISSUED BY A VENDOR  CONTRACTED  BY
THAT  CORPORATION  FOR THE PURPOSES OF BILLING, FOR SERVICES RENDERED BY
THE PHYSICIAN OR DENTIST; OR
  (C) ISSUED BY A GENERAL HOSPITAL FOR SERVICES RENDERED BY A  PHYSICIAN
OR  DENTIST WHO HAS IN FORCE AN INDIVIDUAL MEDICAL MALPRACTICE INSURANCE
POLICY THAT IS PURCHASED SOLELY BY THE PHYSICIAN OR DENTIST OR AN ORGAN-
IZATION DESCRIBED IN PARAGRAPH (B) OF THIS SUBDIVISION, FROM AN  INSURER
LICENSED  IN THIS STATE TO WRITE PERSONAL INJURY LIABILITY INSURANCE, OF
PRIMARY MEDICAL MALPRACTICE INSURANCE COVERAGE IN  AMOUNTS  OF  NO  LESS
THAN  ONE  MILLION  THREE HUNDRED THOUSAND DOLLARS FOR EACH CLAIMANT AND
THREE MILLION NINE HUNDRED THOUSAND DOLLARS FOR ALL CLAIMANTS.
  8. (A) TO THE EXTENT FUNDS AVAILABLE TO THE EXCESS MEDICAL MALPRACTICE
LIABILITY COVERAGE POOL PURSUANT TO SUBDIVISION ONE OF THIS SECTION  ARE
INSUFFICIENT  TO  MEET  THE COSTS OF EXCESS INSURANCE COVERAGE OR EQUIV-
ALENT EXCESS COVERAGE FOR COVERAGE PERIODS  DURING  THE  PERIOD  BETWEEN
JULY  FIRST  OF  A  GIVEN YEAR AND JUNE THIRTIETH OF THE NEXT SUCCEEDING
YEAR, BEGINNING JULY FIRST, TWO THOUSAND TWELVE AND ENDING JUNE  THIRTI-
ETH,  TWO  THOUSAND FOURTEEN EACH PHYSICIAN OR DENTIST FOR WHOM A POLICY
FOR EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE IS PURCHASED
FOR SUCH PERIOD SHALL BE RESPONSIBLE FOR  PAYMENT  TO  THE  PROVIDER  OF
EXCESS  INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE OF AN ALLOCABLE
SHARE OF SUCH INSUFFICIENCY, BASED ON THE RATIO OF  THE  TOTAL  COST  OF
SUCH COVERAGE FOR SUCH PHYSICIAN OR DENTIST TO THE SUM OF THE TOTAL COST
OF SUCH COVERAGE FOR ALL PHYSICIANS OR DENTISTS APPLIED TO SUCH INSUFFI-
CIENCY.
  (B)  EACH  PROVIDER  OF EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS
COVERAGE COVERING THE PERIOD BETWEEN JULY FIRST OF A GIVEN YEAR AND JUNE
THIRTIETH OF THE NEXT SUCCEEDING YEAR, BEGINNING JULY FIRST,  TWO  THOU-
SAND TWELVE AND ENDING JUNE THIRTIETH, TWO THOUSAND FOURTEEN SHALL NOTI-
FY  A  COVERED PHYSICIAN OR DENTIST BY MAIL, MAILED TO THE ADDRESS SHOWN
ON THE LAST APPLICATION FOR  EXCESS  INSURANCE  COVERAGE  OR  EQUIVALENT
EXCESS  COVERAGE, OF THE AMOUNT DUE TO SUCH PROVIDER FROM SUCH PHYSICIAN
OR DENTIST FOR SUCH COVERAGE PERIOD DETERMINED IN ACCORDANCE WITH  PARA-
GRAPH (A) OF THIS SUBDIVISION. SUCH AMOUNT SHALL BE DUE FROM SUCH PHYSI-
CIAN  OR DENTIST TO SUCH PROVIDER OF EXCESS INSURANCE COVERAGE OR EQUIV-
ALENT  EXCESS  COVERAGE  IN  A  TIME  AND  MANNER  DETERMINED   BY   THE
SUPERINTENDENT OF FINANCIAL SERVICES.
  (C)  IF  A PHYSICIAN OR DENTIST LIABLE FOR PAYMENT OF A PORTION OF THE
COSTS OF EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE  COVER-
ING  THE PERIOD BETWEEN JULY FIRST OF A GIVEN YEAR AND JUNE THIRTIETH OF

S. 6256--B                         110                        A. 9056--B

THE NEXT SUCCEEDING YEAR, BEGINNING JULY FIRST, TWO THOUSAND TWELVE  AND
ENDING  JUNE  THIRTIETH,  TWO THOUSAND FOURTEEN DETERMINED IN ACCORDANCE
WITH PARAGRAPH (A) OF THIS SUBDIVISION FAILS,  REFUSES  OR  NEGLECTS  TO
MAKE  PAYMENT TO THE PROVIDER OF EXCESS INSURANCE COVERAGE OR EQUIVALENT
EXCESS COVERAGE IN SUCH TIME AND MANNER AS DETERMINED BY THE SUPERINTEN-
DENT OF FINANCIAL SERVICES PURSUANT TO PARAGRAPH (B)  OF  THIS  SUBDIVI-
SION,  EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE PURCHASED
FOR SUCH PHYSICIAN OR DENTIST IN ACCORDANCE WITH THIS SECTION  FOR  SUCH
COVERAGE  PERIOD SHALL BE CANCELLED AND SHALL BE NULL AND VOID AS OF THE
FIRST DAY ON OR AFTER THE COMMENCEMENT OF  A  POLICY  PERIOD  WHERE  THE
LIABILITY FOR PAYMENT PURSUANT TO THIS SUBDIVISION HAS NOT BEEN MET.
  (D)  EACH  PROVIDER  OF EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS
COVERAGE SHALL NOTIFY THE SUPERINTENDENT OF FINANCIAL SERVICES  AND  THE
COMMISSIONER  OR  THEIR  DESIGNEE OF EACH PHYSICIAN AND DENTIST ELIGIBLE
FOR PURCHASE OF A POLICY FOR EXCESS  INSURANCE  COVERAGE  OR  EQUIVALENT
EXCESS  COVERAGE  COVERING THE PERIOD BETWEEN JULY FIRST OF A GIVEN YEAR
AND JUNE THIRTIETH OF THE NEXT SUCCEEDING YEAR,  BEGINNING  JULY  FIRST,
TWO  THOUSAND  TWELVE  AND  ENDING JUNE THIRTIETH, TWO THOUSAND FOURTEEN
THAT HAS MADE PAYMENT TO SUCH PROVIDER OF EXCESS INSURANCE  COVERAGE  OR
EQUIVALENT  EXCESS  COVERAGE  IN  ACCORDANCE  WITH PARAGRAPH (B) OF THIS
SUBDIVISION AND OF EACH PHYSICIAN AND DENTIST WHO HAS FAILED, REFUSED OR
NEGLECTED TO MAKE SUCH PAYMENT.
  (E) A PROVIDER OF  EXCESS  INSURANCE  COVERAGE  OR  EQUIVALENT  EXCESS
COVERAGE SHALL REFUND TO THE EXCESS MEDICAL MALPRACTICE LIABILITY COVER-
AGE  POOL  ANY  AMOUNT  ALLOCABLE  TO THE PERIOD BETWEEN JULY FIRST OF A
GIVEN YEAR AND JUNE THIRTIETH OF THE  NEXT  SUCCEEDING  YEAR,  BEGINNING
JULY  FIRST, TWO THOUSAND TWELVE AND ENDING JUNE THIRTIETH, TWO THOUSAND
FOURTEEN RECEIVED FROM THE EXCESS MEDICAL MALPRACTICE LIABILITY COVERAGE
POOL FOR PURCHASE OF EXCESS  INSURANCE  COVERAGE  OR  EQUIVALENT  EXCESS
COVERAGE COVERING THE PERIOD BETWEEN JULY FIRST OF A GIVEN YEAR AND JUNE
THIRTIETH  OF  THE NEXT SUCCEEDING YEAR, BEGINNING JULY FIRST, TWO THOU-
SAND TWELVE AND ENDING JUNE  THIRTIETH,  TWO  THOUSAND  FOURTEEN  FOR  A
PHYSICIAN  OR DENTIST WHERE SUCH EXCESS INSURANCE COVERAGE OR EQUIVALENT
EXCESS COVERAGE IS CANCELLED IN ACCORDANCE WITH PARAGRAPH  (C)  OF  THIS
SUBDIVISION.
  (F) A POLICY OR POLICIES OF EXCESS MEDICAL MALPRACTICE COVERAGE ISSUED
TO  OR  ON  BEHALF  OF AN ELIGIBLE PHYSICIAN OR DENTIST PURSUANT TO THIS
SECTION SHALL BE WRITTEN UPON AND GIVE EFFECT TO THE CHOICE OF AN INSUR-
ER BY THE PHYSICIAN OR DENTIST,  PROVIDED,  HOWEVER,  THAT  SUCH  CHOICE
SHALL BE MADE AMONG INSURERS WRITING EXCESS COVERAGE POLICIES IN ACCORD-
ANCE WITH THIS SECTION AND FURTHER PROVIDED THAT NO PHYSICIAN OR DENTIST
SHALL  BE COMPELLED TO BE INSURED BY AN INSURER PROVIDING PRIMARY COVER-
AGE NOR SHALL SUCH INSURER PROVIDING SUCH PRIMARY COVERAGE BE  COMPELLED
TO  WRITE COVERAGE OF SUCH ELIGIBLE PHYSICIAN OR DENTIST FOR SUCH EXCESS
COVERAGE, IN WHICH CASE THE ELIGIBLE PHYSICIAN  OR  DENTIST  MAY  SELECT
ANOTHER  INSURER  WRITING  SUCH  EXCESS COVERAGE IN ACCORDANCE WITH THIS
SECTION.
  9. ANY INSURER ISSUING POLICIES OF EXCESS OR EQUIVALENT EXCESS  COVER-
AGE  IN  ACCORDANCE  WITH  SUBDIVISION ONE OF THIS SECTION MAY, NOTWITH-
STANDING ANY PROVISIONS OF THE INSURANCE LAW, RETURN TO  THE  STATE,  IN
WHOLE  OR IN PART, THE MONEYS REIMBURSED BY THE STATE IN ACCORDANCE WITH
THIS SECTION FOR SPECIFIED POLICY PERIODS, UPON A CERTIFICATION  TO  THE
INSURER  BY  THE  SUPERINTENDENT  OF  FINANCIAL SERVICES THAT THERE IS A
REASONABLE LIKELIHOOD ON AN ACTUARIAL BASIS  THAT  THE  MONEYS  RETURNED
WILL  NOT  BE NEEDED TO PAY FOR THE EXPECTED LIABILITIES INCURRED BY THE
INSURER FOR SUCH POLICY PERIODS.

S. 6256--B                         111                        A. 9056--B

  10. THE SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER  MAY
ADOPT  AND MAY AMEND SUCH REGULATIONS AS ARE NECESSARY TO EFFECTUATE THE
PROVISIONS OF THIS SECTION.
  S 4. This act shall take effect immediately.
  S 2. Severability clause. If any clause, sentence, paragraph, subdivi-
sion,  section  or  part  of  this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair,  or  invalidate  the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph,  subdivision,  section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included herein.
  S 3. This act shall take effect immediately  provided,  however,  that
the  applicable effective date of Parts A through S of this act shall be
as specifically set forth in the last section of such Parts.

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

                                 6256--C

                            I N  S E N A T E

                            January 17, 2012
                               ___________

A  BUDGET  BILL,  submitted by the Governor pursuant to article seven of
  the Constitution -- read twice and ordered printed, and  when  printed
  to  be  committed to the Committee on Finance -- committee discharged,
  bill amended, ordered reprinted as amended  and  recommitted  to  said
  committee  -- committee discharged, bill amended, ordered reprinted as
  amended and recommitted to said  committee  --  committee  discharged,
  bill  amended,  ordered  reprinted  as amended and recommitted to said
  committee

AN ACT to repeal subdivision 4 of section 2557 of the public health law,
  relating to administering early intervention services;  to  amend  the
  public  health law, in relation to requiring that each municipality be
  responsible for providing early intervention services;  to  amend  the
  public  health  law,  in relation to removing the authorization of the
  commissioner of health to collect data from counties on  early  inter-
  vention  programs for the purpose of improving efficiency, cost effec-
  tiveness and quality; and to amend the insurance law, in  relation  to
  the  right  of  subrogation  (Part A); intentionally omitted (Part B);
  intentionally omitted (Part C); to amend the social services  law,  in
  relation  to  supportive housing, the assisted living program, medical
  assistance for needy persons, payments to insurance,  eligibility  for
  medical assistance, reimbursement to public school districts and state
  operated  schools  operating  pursuant to article eighty-five, eighty-
  seven or eighty-eight of the education law, reimbursement to  counties
  for   pre-school   children  with  handicapping  conditions,  consumer
  directed personal assistance program, managed care programs; to  amend
  the  public  health  law,  in  relation  to payments to certified home
  health agencies, HIV special needs plan certification, temporary oper-
  ators,  the  New  York  state  medical  indemnity  fund,  approval  of
  construction of hospitals, rates of payment to residential facilities,
  patient  services  payments,  assessments  on  covered lives, hospital
  assessments, hospital reimbursements, licensure of home care  services
  agencies,  managed  long term care plans, the New York state workgroup
  on Medicaid reimbursement  for  medically  fragile  children,  medical
  assistance  recoupments and reductions, HEAL NY capital grant program,
  health workforce retraining program, establishment or incorporation of
  hospitals; to amend the mental hygiene law, in relation to  compliance
  with  operational  standards by hospitals, compliance with operational

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

                      [ ] is old law to be omitted.
                                                           LBD12671-05-2

S. 6256--C                          2

  standards by certain providers; to amend chapter 584 of  the  laws  of
  2011,  amending the public authorities law, relating to the powers and
  duties of the dormitory authority of the state of New York relative to
  the establishment of subsidiaries for certain purposes, in relation to
  the  effectiveness  thereof; to amend chapter 119 of the laws of 1997,
  relating to authorizing the department of health to establish  certain
  payments to general hospitals, in relation to costs incurred in excess
  of  revenues  by  general hospitals for providing services in eligible
  programs; 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 funds Medicaid expenditures, in relation to
  reductions to local social services district medical assistance admin-
  istration; to amend part H of chapter 59 of the laws of 2011, amending
  the public health law and other laws, relating to types  of  appropri-
  ations exempt from certain reductions, in relation to payments made to
  the early intervention program; and to repeal subdivision 9 of section
  2803  of  the  public  health  law, relating to commissioner audits of
  general hospitals; and providing for the repeal of certain  provisions
  upon  expiration  thereof (Part D); intentionally omitted (Part E); to
  amend chapter 58 of the laws of 2005  authorizing  reimbursements  for
  expenditures  made  by  or  on behalf of social services districts for
  medical assistance for needy persons and the  administration  thereof,
  in relation to an administrative cap on such program; to amend chapter
  59  of the laws of 2011, amending the public health law and other laws
  relating to  general  hospital  reimbursement  for  annual  rates,  in
  relation  to  the cap on local Medicaid expenditures; and to amend the
  social services law, in  relation  to  the  department  assumption  of
  program  administration  for medical assistance (Part F); to amend the
  public health law, in relation to regulations for  computing  hospital
  inpatient  rates  and to amend chapter 58 of the laws of 2005 relating
  to the preferred drug program, in relation to the effectiveness there-
  of (Part G); to amend chapter 57 of the  laws  of  2006,  relating  to
  establishing a cost of living adjustment for designated human services
  programs,   in  relation  to  foregoing  such  adjustment  during  the
  2012-2013 state fiscal year and to  amend  the  not-for-profit  corpo-
  ration  law,  in relation to compensation of executives; and providing
  for the repeal of certain provisions upon the expiration thereof (Part
  H); intentionally omitted (Part I); intentionally omitted (Part J); to
  amend chapter 723 of the laws of 1989 amending the mental hygiene  law
  and   other  laws  relating  to  comprehensive  psychiatric  emergency
  programs, in relation to the effectiveness thereof (Part K); to  amend
  the  state administrative procedure act, in relation to the establish-
  ment of operating, reporting and construction requirements for certain
  agencies and offices (Part L); to amend the  mental  hygiene  law,  in
  relation  to  permitting  the  office  of  mental health and the state
  education department to  enter  into  an  agreement  for  purposes  of
  providing  education  programming  for  patients residing in hospitals
  operated by the office of mental health who are between  the  ages  of
  five  and  twenty-one; and providing for the repeal of such provisions
  upon expiration thereof (Part M); to amend the mental hygiene law  and
  the  public  health  law,  in  relation to the statewide comprehensive
  services plan for people with mental disabilities and in  relation  to
  the  local  planning  process; and to repeal certain provisions of the
  mental hygiene law relating thereto (Part  N);  intentionally  omitted
  (Part  O);  to  amend  the  mental hygiene law, in relation to service
  reductions relating to operations of the office of  mental  health  or

S. 6256--C                          3

  the  office  for people with developmental disabilities (Part O-1); to
  amend the mental hygiene law, in relation to amending procedures under
  the sex offender management and treatment act, and to amend the  penal
  law,   in   relation  to  providing  criminal  penalties  for  certain
  violations of orders of commitment and  strict  and  intensive  super-
  vision  and  treatment  (Part  P);  intentionally omitted (Part Q); 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  R);  in  relation  to  the  excess medical malpractice
  liability coverage pool (Part S); requiring a report  and  recommenda-
  tions  regarding  funding  pursuant  to the options for people through
  services initiative (Part T); to amend the elder law, in  relation  to
  the  program  for  elderly  pharmaceutical  insurance coverage; and to
  repeal certain provisions of such law relating thereto  (Part  U);  to
  amend  the  social  services  law,  in  relation  to the definition of
  "estate" for purposes of recovery of medical assistance benefits  paid
  to  a  deceased recipient; to amend the public health law, in relation
  to telemedicine credentialing, establishing a  rural  home  telehealth
  delivery  demonstration  study  program,  and  managed  long term care
  plans; to amend the public authorities law, in relation to  the  Clif-
  ton-Fine  Health  Care Corporation; to amend the public health law, in
  relation to state aid and public  health  emergencies;  to  amend  the
  insurance  law,  in relation to the New York state health care quality
  and cost containment commission in relation to  statutory  association
  membership, and in relation to certain exemptions; to amend the public
  health  law, in relation to the prescription pain medication awareness
  program, the physician loan repayment program; to amend chapter 58  of
  the  laws  of 2010, amending chapter 474 of the laws of 1996, amending
  the education law and other laws relating  to  rates  for  residential
  healthcare facilities and other laws relating to Medicaid payments, in
  relation  to  seeking federal approvals to establish payment methodol-
  ogies with accountable care organizations; to  amend the public health
  law, in relation to limited or administrative review, establishment of
  a triage system of care and the general hospital indigent  care  pool;
  to repeal title 5 of article 10-C of the public authorities law relat-
  ing  to the Clifton-Fine Health Care Corporation; 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,
  in relation to surplus requirements and to  repeal  paragraph  (e)  of
  subdivision  8  of  section 2511 of the public health law, relating to
  the adjustment of subsidy payments and to repeal section 1325  of  the
  insurance  law,  relating  to  exemptions  (Part  V); and to amend the
  mental hygiene law, in relation to transferring the alcohol  and  drug
  rehabilitation  program  from  the department of motor vehicles to the
  office of alcoholism and  substance  abuse  services;  and  to  repeal
  section 1196 of the vehicle and traffic law relating thereto (Part W)

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

  Section 1. This act enacts into law major  components  of  legislation
which are necessary to implement the state fiscal plan for the 2012-2013
state  fiscal  year.  Each  component  is wholly contained within a Part
identified as Parts A through W. The effective date for each  particular

S. 6256--C                          4

provision contained within such Part is set forth in the last section of
such Part. Any provision in any section contained within a Part, includ-
ing the effective date of the Part, which makes a reference to a section
"of  this  act", when used in connection with that particular component,
shall be deemed to mean and refer to the corresponding  section  of  the
Part  in  which  it  is  found. Section three of this act sets forth the
general effective date of this act.

                                 PART A

  Section 1. Intentionally omitted.
  S 2. Intentionally omitted.
  S 2-a. Intentionally omitted.
  S 3. Intentionally omitted.
  S 4. Intentionally omitted.
  S 5. Intentionally omitted.
  S 6. Intentionally omitted.
  S 7. Intentionally omitted.
  S 8. Intentionally omitted.
  S 9. Intentionally omitted.
  S 9-a. Subdivision 4 of section 2557  of  the  public  health  law  is
REPEALED and subdivisions 2 and 5, subdivision 2 as added by chapter 428
of  the  laws of 1992 and subdivision 5 as added by section 7 of part B3
of chapter 62 of the laws of 2003, are amended to read as follows:
  2. The department shall reimburse the approved costs paid by a munici-
pality for the purposes of this title, other than those reimbursable  by
AN  INSURER  OR  HEALTH  MAINTENANCE ORGANIZATION, OR GOVERNMENTAL THIRD
PARTY PAYOR INCLUDING the medical assistance program [or by third  party
payors], in an amount of fifty percent of the amount expended in accord-
ance  with  the  rules  and  regulations  of the commissioner; PROVIDED,
HOWEVER, THAT IN THE DISCRETION OF THE DEPARTMENT AND WITH THE  APPROVAL
OF  THE DIRECTOR OF THE DIVISION OF THE BUDGET, THE DEPARTMENT MAY REIM-
BURSE MUNICIPALITIES IN AN AMOUNT GREATER  THAN  FIFTY  PERCENT  OF  THE
AMOUNT EXPENDED.  Such state reimbursement to the municipality shall not
be paid prior to April first of the year in which the approved costs are
paid  by  the  municipality,  PROVIDED,  HOWEVER  THAT,  SUBJECT  TO THE
APPROVAL OF THE DIRECTOR OF THE BUDGET,  THE  DEPARTMENT  MAY  PAY  SUCH
STATE AID REIMBURSEMENT TO THE MUNICIPALITY PRIOR TO SUCH DATE.
  5.  The  department  shall contract with [an independent organization]
ONE OR MORE ENTITIES to act as the fiscal agent for the  department  AND
MUNICIPALITIES  WITH  RESPECT  TO FISCAL MANAGEMENT AND PAYMENT OF EARLY
INTERVENTION CLAIMS. MUNICIPALITIES SHALL GRANT SUFFICIENT AUTHORITY  TO
THE  FISCAL AGENT TO ACT ON THEIR BEHALF. MUNICIPALITIES, AND INDIVIDUAL
AND AGENCY PROVIDERS AS DEFINED BY THE COMMISSIONER IN REGULATION  SHALL
UTILIZE  SUCH  FISCAL  AGENT FOR PAYMENT OF EARLY INTERVENTION CLAIMS AS
DETERMINED BY THE DEPARTMENT AND  SHALL  PROVIDE  SUCH  INFORMATION  AND
DOCUMENTATION AS REQUIRED BY THE DEPARTMENT AND NECESSARY FOR THE FISCAL
AGENT TO CARRY OUT ITS DUTIES.  [A municipality may elect to utilize the
services  of  such  organization  for  early intervention program fiscal
management and claiming as determined by the commissioner or may  select
an independent agent to act as the fiscal agent for such municipality or
may act as its own fiscal agent.]
  S 10. Subdivision 4 of section 2558 of the public health law, as added
by chapter 428 of the laws of 1992, is amended to read as follows:
  4.  Local  contribution. The municipality of residence shall be finan-
cially responsible for the local contribution in  the  amount  of  fifty

S. 6256--C                          5

percent  of the [approved costs] AMOUNT EXPENDED PROVIDED, HOWEVER, THAT
IN THE DISCRETION OF THE DEPARTMENT AND WITH THE APPROVAL OF THE  DIREC-
TOR OF THE DIVISION OF THE BUDGET, IN ACCORDANCE WITH SUBDIVISION TWO OF
SECTION  TWENTY-FIVE  HUNDRED  FIFTY-SEVEN OF THIS TITLE, THE DEPARTMENT
MAY REQUIRE THAT MUNICIPALITIES BE FINANCIALLY RESPONSIBLE FOR  A  LOCAL
CONTRIBUTION  IN  AN  AMOUNT  LESS  THAN  FIFTY  PERCENT  OF  THE AMOUNT
EXPENDED.  The commissioner shall certify to the comptroller the  amount
of  the  local  contribution owed by each municipality to the state. The
comptroller shall deduct the amount of  such  local  contribution  first
from  any  moneys  due  the municipality pursuant to section twenty-five
hundred fifty-six of this title and then from any other moneys due or to
become due to the municipality.
  S 11. Paragraphs (a), (c) and (d) of subdivision 3 of section 2559  of
the  public  health  law,  paragraph (a) as amended and paragraph (d) as
added by chapter 231 of the laws of 1993, subparagraphs (i) and (ii)  of
paragraph (a) as added by chapter 406 of the laws of 2011, and paragraph
(c)  as added by chapter 428 of the laws of 1992, are amended to read as
follows:
  (a) Providers of early intervention services [and],  INCLUDING  trans-
portation  services, HEREINAFTER COLLECTIVELY REFERRED TO IN THIS SUBDI-
VISION AS "PROVIDER" OR "PROVIDERS", shall in  the  first  instance  and
where  applicable,  seek  payment from all [third party payors including
governmental agencies] INSURERS AND  HEALTH  MAINTENANCE  ORGANIZATIONS,
INCLUDING  THE  MEDICAL  ASSISTANCE  PROGRAM  AND ANY OTHER GOVERNMENTAL
THIRD PARTY PAYORS prior to claiming payment from a  given  municipality
for EVALUATIONS CONDUCTED UNDER THE PROGRAM AND FOR services rendered to
eligible  children,  provided  that, [for the purpose of seeking payment
from the medical assistance program or from other  third  party  payors,
the municipality shall be deemed the provider of such early intervention
services  to  the extent that the provider has promptly furnished to the
municipality adequate and complete information necessary to support  the
municipality  billing, and provided further that] the obligation to seek
payment shall not apply to a payment  from  [a  third  party  payor]  AN
INSURER who is not prohibited from applying such payment, and will apply
such  payment, to an annual or lifetime limit specified in the insured's
policy.
  (i) [Parents shall provide and the municipality shall obtain  informa-
tion  on  any plan of insurance under which an eligible child has cover-
age.
  (ii) Parents shall provide the municipality with  a  written  referral
from a primary care provider as documentation, for eligible children, of
the  medical  necessity of early intervention services.] PROVIDERS SHALL
UTILIZE THE DEPARTMENT'S FISCAL  AGENT  AND  DATA  SYSTEM  FOR  CLAIMING
PAYMENT  FROM  INSURERS  OR  HEALTH MAINTENANCE ORGANIZATIONS FOR EVALU-
ATIONS AND SERVICES RENDERED UNDER THE EARLY INTERVENTION PROGRAM.
  (c) Payments made for early intervention services under  an  insurance
policy  or  health  benefit plan, INCLUDING PAYMENTS MADE BY THE MEDICAL
ASSISTANCE PROGRAM OR OTHER GOVERNMENTAL THIRD PARTY  PAYOR,  which  are
provided  as  part  of  an  IFSP pursuant to section twenty-five hundred
forty-five of this title shall not be applied by  the  insurer  or  plan
administrator against any maximum lifetime or annual limits specified in
the  policy  or  health benefits plan, pursuant to section eleven of the
chapter of the laws of nineteen  hundred  ninety-two  which  added  this
title.
  [(d)  A  municipality,  or  its  designee, shall be subrogated, to the
extent of the expenditures by such municipality for  early  intervention

S. 6256--C                          6

services furnished to persons eligible for benefits under this title, to
any  rights  such  person  may  have  or be entitled to from third party
reimbursement. The right of subrogation does not attach to benefits paid
or  provided  under  any health insurance policy or health benefits plan
prior to receipt of written notice of the exercise of subrogation rights
by the insurer or plan administrator providing such benefits.]
  S 12. Intentionally omitted.
  S 13. Intentionally omitted.
  S 14. Intentionally omitted.
  S 15. Intentionally omitted.
  S 16.  Intentionally omitted.
  S 17. Subsection (c) of  section  3235-a  of  the  insurance  law,  as
amended  by  chapter  406  of  the  laws  of 2011, is amended to read as
follows:
  [(c) Any right of subrogation to  benefits  which  a  municipality  is
entitled  in  accordance  with  paragraph  (d)  of  subdivision three of
section twenty-five hundred fifty-nine of the public health law shall be
valid and enforceable to the extent benefits  are  available  under  any
accident  and health insurance policy. The right of subrogation does not
attach to insurance benefits paid or provided  under  any  accident  and
health  insurance  policy  prior  to  receipt  by the insurer of written
notice from the municipality. Upon  the  insurer's  receipt  of  written
request  and notice from the municipality that such right of subrogation
has been granted to such municipality and that the insured  has  author-
ized  the  release of information to the municipality, the insurer shall
provide the municipality with information  on  the  extent  of  benefits
available to the covered person under such policy.]
  S 18. Intentionally omitted.
  S 19. Intentionally omitted.
  S 20. Intentionally omitted.
  S 21. Intentionally omitted.
  S 22. Intentionally omitted.
  S  23.  This act shall take effect January 1, 2013; provided, however,
that sections nine-a and ten of this act  shall  take  effect  April  1,
2013;  and provided further that, absent explicit language expressly and
unequivocally  stating  a  legislative  intent  to  the  contrary,   all
provisions  of  this act are irrefutably presumed to operate in a wholly
prospective manner.  Provisions shall be considered to operate  retroac-
tively, and therefore in violation of this paragraph, if applied in such
a manner as to alter, change, affect, impair or defeat any rights, obli-
gations, duties or interests accrued, incurred or conferred prior to the
effective  date  of  this  act.  Furthermore, the provisions of this act
shall neither apply to, nor be applied based upon the occasion of,  acts
occurring prior to it becoming law.

                                 PART B
                          Intentionally omitted

                                 PART C
                          Intentionally omitted

                                 PART D

S. 6256--C                          7

  Section  1.  Legislative  intent.  The  legislature  hereby finds that
supportive housing is  a  matter  of  importance  to  the  state,  which
requires  both comprehensive evaluation and thoughtful deliberation. The
legislature further finds that,  given  the  intricacies  of  supportive
housing,  the exercise of legislative authority should be judicious and,
when undertaken, so done with care and precision. Therefore, it  is  the
intent of the legislature to task the department of health with develop-
ing  a detailed approach to supportive housing, in consultation with all
relevant stakeholders, for consideration by the senate and the assembly.
  S 1-a. The department of health, in  consultation  with  all  relevant
stakeholders,  shall  develop  a  report  and  recommendations regarding
supportive housing. Such report and recommendations shall contain infor-
mation including, but not limited to: criteria used  to  evaluate  effi-
ciency  and effectiveness of projects, the potential number of people to
be served, the  location  of  potential  projects,  and  other  relevant
factors  related  to  the maintenance of existing supportive housing and
the development of new supportive  housing.  By  January  1,  2013,  the
department  of  health  shall submit such report and recommendations, as
well as draft legislation that would implement any  proposals  contained
therein, to the temporary president of the senate and the speaker of the
assembly for their consideration.
  S 1-b. The amount of supportive housing development reinvestment funds
for  the  department  shall  be  appropriated in the annual budget. This
amount shall include the amount of general fund savings directly related
to inpatient hospital and nursing home bed decertification and/or facil-
ity closure.  The methodologies used to calculate the savings  shall  be
developed  by  the  commissioner and the director of budget and shall be
submitted to the temporary president of the senate and  the  speaker  of
the  assembly.    Proposals for grant programs or other such methods for
disbursing funds shall be submitted to  the  respective  chairs  of  the
finance  committee  of  the  senate  and ways and means committee of the
assembly and shall require legislative approval prior to implementation.
  S 1-c. The annual supportive housing development  reinvestment  appro-
priation shall reflect the amount of general fund savings resulting from
section 1-b of this act.
  S  1-d.  No  provision in this act shall create or be deemed to create
any right, interest, or  entitlement  to  services  or  funds  that  are
subject  to  this section, or to any other services or funds, whether to
individuals, localities, providers, or others, individually  or  collec-
tively.
  S  1-e. All appropriations for supportive housing development shall be
adjusted in the following fiscal year to reflect  the  variance  between
the initial and revised estimates of bed decertification and/or facility
closure.
  S  2.  Paragraph  (e)  of subdivision 1 of section 461-l of the social
services law, as added by chapter 165 of the laws of 1991, is amended to
read as follows:
  (e) "Services" shall mean all services for which full  payment  to  an
assisted  living  program  is included in the capitated rate of payment,
which shall include personal care services, home care services and  such
other  services as the commissioner in conjunction with the commissioner
of health determine by regulation must be included in the capitated rate
of payment, and which the assisted  living  program  shall  provide,  or
arrange  for  the provision of, through contracts with a social services
district, [a] long term home health care [program or a] PROGRAMS, certi-
fied home health [agency, and] AGENCIES, AND other qualified providers.

S. 6256--C                          8

  S 3.  Paragraphs (b) and (d) of subdivision 2 of section 461-l of  the
social  services  law,  as  added by chapter 165 of the laws of 1991 and
subparagraph (iii) of paragraph (d) as amended by  chapter  569  of  the
laws of 2000, are amended to read as follows:
  (b)  If  an  assisted  living  program  itself is not a certified home
health agency or long term home health care program, the assisted living
program shall contract with [a] ONE OR MORE certified home health [agen-
cy or] AGENCIES AND long term home health care  [program]  PROGRAMS  for
the  provision  of services pursuant to article thirty-six of the public
health law. [An assisted living program shall contract with no more than
one certified home health agency or long term home health care  program,
provided,  however, that the commissioner and the commissioner of health
may approve additional contracts for good cause.]
  (d) Patient services and care. (i) An assisted living program[, or  if
the  assisted  living  program  itself does not include a long term home
health care program or certified home health agency an  assisted  living
program  and  a  long  term  home  health care program or certified home
health agency,] shall, EITHER DIRECTLY OR THROUGH CONTRACT WITH  A  LONG
TERM  HOME  HEALTH CARE PROGRAM OR CERTIFIED HOME HEALTH AGENCY, conduct
an initial assessment to determine  whether  a  person  would  otherwise
require  placement  in a residential health care facility if not for the
availability of the assisted  living  program  and  is  appropriate  for
admission  to  an  assisted living program. [The assisted living program
shall forward such assessment  of  a  medical  assistance  applicant  or
recipient to the appropriate social services district.]
  (ii)  No  person  shall  be determined eligible for and admitted to an
assisted living program unless the assisted living program [and the long
term home health care program or the certified home health  care  agency
agree, based on the initial assessment,] FINDS that the person meets the
criteria  provided  in  paragraph (d) of subdivision one of this section
[and unless the appropriate social services  district  prior  authorizes
payment for services].
  (iii)  Appropriate  services  shall  be provided to an eligible person
only in accordance with a plan of care which is based  upon  an  initial
assessment  and  periodic  reassessments conducted by an assisted living
program[, or if the assisted living program itself does  not  include  a
long  term  home  health care program or certified home health agency an
assisted living program and a long term  home  health  care  program  or
certified home health agency] EITHER DIRECTLY OR THROUGH CONTRACT WITH A
LONG  TERM  HOME  HEALTH CARE PROGRAM OR CERTIFIED HOME HEALTH AGENCY. A
reassessment shall be conducted as frequently as is required to  respond
to  changes  in  the resident's condition and ensure immediate access to
necessary and appropriate services by the resident, but in no event less
frequently than once every six months. No person shall be admitted to or
retained in an assisted  living  program  unless  [the  assisted  living
program, and long term home health care program or certified home health
agency  are  in  agreement that] the person can be safely and adequately
cared for with the provision of services determined by  such  assessment
or reassessment.
  (iv) To the maximum extent possible and consistent with staffing stan-
dards,  assisted  living  programs  shall  achieve economic efficiencies
through the provision of shared services including, but not limited  to,
shared aides.
  S  4.  Paragraph  (i)  of subdivision 3 of section 461-l of the social
services law, as amended by section 16 of part D of chapter  58  of  the
laws of 2009, is amended to read as follows:

S. 6256--C                          9

  (i) The commissioner of health is authorized to add up to six thousand
assisted  living  program  beds  to  the gross number of assisted living
program beds having been determined to be available as of  April  first,
two  thousand nine[, provided that, for each assisted living program bed
so  added,  a nursing home bed has been decertified upon the application
of the nursing home operator or that  the  commissioner  of  health  has
found pursuant to subdivision six of section twenty-eight hundred six of
the  public  health  law  that  any assisted living program bed so added
would serve as a more appropriate alternative  to  a  certified  nursing
home  bed  and  has accordingly limited or revoked the operating certif-
icate of the nursing home providing that  certified  nursing  home  bed,
provided  further  that nothing]. NOTHING herein shall be interpreted as
prohibiting any eligible applicant from submitting  an  application  for
any  assisted  living  program  bed so added. The commissioner of health
shall not be required to review  on  a  comparative  basis  applications
submitted  for  assisted  living  program beds made available under this
paragraph. The commissioner of health shall only authorize the  addition
of six thousand beds pursuant to a five year plan.
  S  4-a.  Paragraph  (a) of subdivision 6 of section 3614 of the public
health law, as amended by section 17 of part D of chapter 58 of the laws
of 2009, is amended to read as follows:
  (a) The commissioner shall, subject  to  the  approval  of  the  state
director  of  the  budget,  establish  capitated  rates  of  payment for
services provided by assisted living programs as  defined  by  paragraph
(a) of subdivision one of section four hundred sixty-one-l of the social
services law. THE COMMISSIONER SHALL ALSO ADJUST THE RATES OF PAYMENT TO
ACCOUNT  FOR  PREADMISSION  ASSESSMENTS  CONDUCTED  BY  ASSISTED  LIVING
PROGRAMS. Such rates of payment shall be related to  costs  incurred  by
residential  health  care  facilities.  The rates shall reflect the wage
equalization factor established  by  the  commissioner  for  residential
health  care  facilities  in  the  region  in  which the assisted living
program is provided and real property capital construction costs associ-
ated with the construction of a free-standing  assisted  living  program
such rate shall include a payment equal to the cost of interest owed and
depreciation  costs  of  such construction. The rates shall also reflect
the efficient provision  of  a  quality  and  quantity  of  services  to
patients in such residential health care facilities, with needs compara-
ble  to  the needs of residents served in such assisted living programs.
Such rates of payment shall be equal to fifty  percent  of  the  amounts
which otherwise would have been expended, based upon the mean prices for
the  first  of  July,  nineteen  hundred  ninety-two (utilizing nineteen
hundred eighty-three costs) for freestanding, low intensity  residential
health  care facilities with less than three hundred beds, and for years
subsequent to nineteen hundred ninety-two,  adjusted  for  inflation  in
accordance  with  the  provisions  of subdivision ten of section twenty-
eight hundred seven-c of this chapter, to provide the appropriate  level
of  care for such residents in residential health care facilities in the
applicable wage equalization factor regions  plus  an  amount  equal  to
capital  construction  costs  associated  with  the  construction  of an
assisted living program facility as provided for in this subdivision.
  S 5.  Notwithstanding any contrary provision of law, inpatient  hospi-
tals licensed pursuant to the Mental Hygiene Law by the Office of Mental
Health shall be subject to audit fees as set forth in regulations issued
by  the  Department  of  Health  pursuant to S2807-c(35)(b)(xiii) of the
Public Health Law, with regard to cost reports submitted to the  Depart-
ment of Health on and after April 1, 2012.

S. 6256--C                         10

  S  6.  Subdivision  2  of  section 365-a of the social services law is
amended by adding two new paragraphs (w) and (x) to read as follows:
  (W)  PODIATRY  SERVICES  FOR  INDIVIDUALS WITH A DIAGNOSIS OF DIABETES
MELLITUS; PROVIDED, HOWEVER, THAT THE PROVISIONS OF THIS PARAGRAPH SHALL
NOT TAKE EFFECT UNLESS ALL NECESSARY APPROVALS  UNDER  FEDERAL  LAW  AND
REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL FINANCIAL PARTICIPATION
IN  THE  COSTS  OF  HEALTH CARE SERVICES PROVIDED PURSUANT TO THIS PARA-
GRAPH.
  (X) LACTATION COUNSELING SERVICES FOR PREGNANT  AND  POSTPARTUM  WOMEN
WHEN  SUCH  SERVICES  ARE  ORDERED  BY A PHYSICIAN, REGISTERED PHYSICIAN
ASSISTANT,  REGISTERED  NURSE  PRACTITIONER,  OR  LICENSED  MIDWIFE  AND
PROVIDED  BY  A  CERTIFIED  LACTATION  CONSULTANT,  AS DETERMINED BY THE
COMMISSIONER OF HEALTH; PROVIDED, HOWEVER, THAT THE PROVISIONS  OF  THIS
PARAGRAPH  SHALL  NOT  TAKE  EFFECT UNLESS ALL NECESSARY APPROVALS UNDER
FEDERAL LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL  FINAN-
CIAL  PARTICIPATION IN THE COSTS OF HEALTH CARE SERVICES PROVIDED PURSU-
ANT TO THIS PARAGRAPH. NOTHING IN THIS PARAGRAPH SHALL BE  CONSTRUED  TO
MODIFY ANY LICENSURE, CERTIFICATION OR SCOPE OF PRACTICE PROVISION UNDER
TITLE EIGHT OF THE EDUCATION LAW.
  S  7.  Paragraph  (g)  of subdivision 2 of section 365-a of the social
services law, as amended by section 23 of part H of chapter  59  of  the
laws of 2011, is amended to read as follows:
  (g)  sickroom  supplies,  eyeglasses, prosthetic appliances and dental
prosthetic appliances furnished in accordance with  the  regulations  of
the department; provided further that: (i) the commissioner of health is
authorized  to implement a preferred diabetic supply program wherein the
department of  health  will  receive  enhanced  rebates  from  preferred
manufacturers  of  glucometers and test strips, and may subject non-pre-
ferred manufacturers' glucometers and test strips to prior authorization
under section two hundred seventy-three of the public health  law;  (ii)
enteral  formula  therapy  and  nutritional  supplements  are limited to
coverage only for nasogastric, jejunostomy, or gastrostomy tube  feeding
or  for  treatment of an inborn metabolic disorder, or to address growth
and development problems in children, OR, SUBJECT  TO  STANDARDS  ESTAB-
LISHED  BY  THE  COMMISSIONER,  FOR  PERSONS  WITH  A  DIAGNOSIS  OF HIV
INFECTION, AIDS OR HIV-RELATED ILLNESS, CANCER, DIABETES AND RENAL FAIL-
URE; (iii) prescription footwear and inserts  are  limited  to  coverage
only  when  used as an integral part of a lower limb orthotic appliance,
as part of a diabetic treatment plan, or to address growth and  develop-
ment  problems  in  children; and (iv) compression and support stockings
are limited to coverage only for pregnancy or treatment of venous stasis
ulcers;
  S 8. Subdivision 9 of section 4403-c of  the  public  health  law,  as
added by chapter 649 of the laws of 1996, is amended to read as follows:
  9.  Notwithstanding  any  other  provision of law, a comprehensive HIV
special needs plan  certified  pursuant  to  this  section  shall  limit
enrollment to HIV positive persons but may enroll related children up to
the age of [nineteen] TWENTY-ONE regardless of their HIV status.
  S  9.    Paragraph (f) of subdivision 1 of section 367-a of the social
services law, as added by section 1 of part E of chapter 58 of the  laws
of 2008, is amended to read as follows:
  (f)  Amounts  payable  under  this title for medical assistance in the
form of outpatient mental health services under  article  thirty-one  OR
OUTPATIENT  CHEMICAL  DEPENDENCE  SERVICES  INCLUDING  OPIOID  TREATMENT
SERVICES UNDER ARTICLE THIRTY-TWO of the mental hygiene law provided  to
eligible  persons who are also beneficiaries under part B of title XVIII

S. 6256--C                         11

of the federal social security act shall not be less than  the  approved
medical assistance payment level less the amount payable under part B.
  S 10. Intentionally omitted.
  S 11. Intentionally omitted.
  S 12. Intentionally omitted.
  S 13. Intentionally omitted.
  S 14. Intentionally omitted.
  S 15. Intentionally omitted.
  S 16. Intentionally omitted.
  S 17. Intentionally omitted.
  S 18. Intentionally omitted.
  S 19. Intentionally omitted.
  S 20. Intentionally omitted.
  S 21. Intentionally omitted.
  S  22.  Section  366 of the social services law is amended by adding a
new subdivision 15 to read as follows:
  15. THE COMMISSIONER MAY CONTRACT WITH ONE OR MORE ENTITIES TO  ENGAGE
IN  EDUCATION,  OUTREACH SERVICES, AND FACILITATED ENROLLMENT ACTIVITIES
FOR AGED, BLIND, AND DISABLED PERSONS WHO MAY BE ELIGIBLE  FOR  COVERAGE
UNDER THIS TITLE.
  S 23. Intentionally omitted.
  S 24. Intentionally omitted.
  S 25. Intentionally omitted.
  S 26. Intentionally omitted.
  S  27. The public health law is amended by adding a new section 2806-a
to read as follows:
  S 2806-A. TEMPORARY OPERATOR. 1. FOR THE PURPOSES OF THIS SECTION:
  (A) THE TERM "ADULT  CARE  FACILITY"  SHALL  MEAN  AN  ADULT  HOME  OR
ENRICHED  HOUSING  PROGRAM  LICENSED  PURSUANT  TO  ARTICLE SEVEN OF THE
SOCIAL SERVICES LAW OR AN ASSISTED LIVING RESIDENCE LICENSED PURSUANT TO
ARTICLE FORTY-SIX-B OF THIS CHAPTER;
  (B) THE TERM "ESTABLISHED OPERATOR" SHALL  MEAN  THE  OPERATOR  OF  AN
ADULT  CARE  FACILITY,  A GENERAL HOSPITAL OR A DIAGNOSTIC AND TREATMENT
CENTER THAT HAS BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE  AS
SUCH PURSUANT TO THIS ARTICLE;
  (C)  THE  TERM "FACILITY" SHALL MEAN (I) A GENERAL HOSPITAL OR A DIAG-
NOSTIC AND TREATMENT CENTER THAT HAS BEEN ISSUED  AN  OPERATING  CERTIF-
ICATE AS SUCH PURSUANT TO THIS ARTICLE; OR (II) AN ADULT CARE FACILITY;
  (D)  THE  TERM  "TEMPORARY  OPERATOR"  SHALL MEAN ANY PERSON OR ENTITY
THAT:
  (I) AGREES TO OPERATE A FACILITY ON A  TEMPORARY  BASIS  IN  THE  BEST
INTERESTS  OF  ITS RESIDENTS OR PATIENTS AND THE COMMUNITY SERVED BY THE
FACILITY;
  (II) HAS DEMONSTRATED THAT HE OR SHE HAS THE CHARACTER, COMPETENCE AND
FINANCIAL ABILITY TO OPERATE THE FACILITY IN COMPLIANCE WITH  APPLICABLE
STANDARDS; AND
  (III)  PRIOR TO HIS OR HER APPOINTMENT AS TEMPORARY OPERATOR, PROVIDES
THE COMMISSIONER WITH A WORK PLAN SATISFACTORY TO  THE  COMMISSIONER  TO
ADDRESS  THE  FACILITY'S  DEFICIENCIES AND SERIOUS FINANCIAL INSTABILITY
AND A SCHEDULE FOR IMPLEMENTATION OF SUCH PLAN.
  (E) THE TERM "SERIOUS FINANCIAL INSTABILITY" SHALL INCLUDE BUT NOT  BE
LIMITED  TO DEFAULTING OR VIOLATING KEY COVENANTS OF BOND ISSUES, MISSED
MORTGAGE PAYMENTS, GENERAL UNTIMELY PAYMENT OF DEBTS, FAILURE  TO  MAIN-
TAIN  REQUIRED  DEBT  SERVICE COVERAGE RATIOS OR, AS APPLICABLE, FACTORS
THAT HAVE TRIGGERED A WRITTEN EVENT OF DEFAULT NOTICE TO THE  DEPARTMENT
BY THE DORMITORY AUTHORITY OF THE STATE OF NEW YORK; AND

S. 6256--C                         12

  (F)  THE  TERM  "EXTRAORDINARY  FINANCIAL ASSISTANCE" SHALL MEAN STATE
FUNDS PROVIDED TO A  FACILITY  UPON  SUCH  FACILITY'S  REQUEST  FOR  THE
EXPRESS  PURPOSE  OF  PREVENTING  THE  CLOSURE  OF THE FACILITY THAT THE
COMMISSIONER FINDS PROVIDES ESSENTIAL AND NECESSARY SERVICES WITHIN  THE
COMMUNITY.  SUCH  FUNDS MAY BE DERIVED FROM EXISTING PROGRAMS WITHIN THE
DEPARTMENT, SPECIAL APPROPRIATIONS, OR OTHER FUNDS.
  2.(A) IN THE EVENT THAT: (I) THE DEPARTMENT IMPOSED  A  PENALTY  ON  A
FACILITY  WITHIN  THE  PRIOR TWELVE MONTHS; (II) THE FACILITY IS SEEKING
EXTRAORDINARY FINANCIAL ASSISTANCE; (III) THE  COMMISSIONER  FINDS  THAT
THERE  EXISTS  SERIOUS  FINANCIAL INSTABILITY; AND (IV) THE COMMISSIONER
FINDS THAT THERE ARE CONDITIONS THAT SERIOUSLY ENDANGER THE LIFE, HEALTH
OR SAFETY OF RESIDENTS OR PATIENTS AND JEOPARDIZE EXISTING OR  CONTINUED
ACCESS  TO  NECESSARY  SERVICES  WITHIN  THE COMMUNITY, THE COMMISSIONER
SHALL NOTIFY THE FACILITY OF HIS OR HER INTENTION TO APPOINT A TEMPORARY
OPERATOR TO ASSUME SOLE RESPONSIBILITY FOR THE OPERATIONS OF THAT FACIL-
ITY. THE APPOINTMENT OF TEMPORARY OPERATOR SHALL BE EFFECTUATED PURSUANT
TO THIS SECTION AND SHALL BE IN ADDITION TO ANY OTHER REMEDIES  PROVIDED
BY LAW.
  (B) THE ESTABLISHED OPERATOR OF A FACILITY MAY AT ANY TIME REQUEST THE
COMMISSIONER  TO  APPOINT  A  TEMPORARY  OPERATOR. UPON RECEIVING SUCH A
REQUEST, THE COMMISSIONER MAY, IF HE OR  SHE  DETERMINES  THAT  SUCH  AN
ACTION IS NECESSARY TO RESTORE OR MAINTAIN THE PROVISION OF QUALITY CARE
TO  THE  RESIDENTS  OR  PATIENTS  AND ALLEVIATE THE FACILITY'S FINANCIAL
INSTABILITY, ENTER INTO AN AGREEMENT WITH THE ESTABLISHED  OPERATOR  FOR
THE  APPOINTMENT  OF  A TEMPORARY OPERATOR TO ASSUME SOLE RESPONSIBILITY
FOR THE OPERATIONS OF THAT FACILITY.
  3. A TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION  SHALL  USE
HIS  OR  HER  BEST  EFFORTS  TO  IMPLEMENT THE WORK PLAN PROVIDED TO THE
COMMISSIONER TO CORRECT OR  ELIMINATE  ANY  DEFICIENCIES  AND  FINANCIAL
INSTABILITY IN THE FACILITY AND TO PROMOTE THE QUALITY AND ACCESSIBILITY
OF  HEALTH  CARE  SERVICES IN THE COMMUNITY SERVED BY THE FACILITY. SUCH
CORRECTION OR ELIMINATION OF DEFICIENCIES AND SERIOUS  FINANCIAL  INSTA-
BILITY  SHALL NOT INCLUDE MAJOR ALTERATIONS OF THE PHYSICAL STRUCTURE OF
THE FACILITY. DURING THE TERM OF HIS OR HER APPOINTMENT,  THE  TEMPORARY
OPERATOR SHALL HAVE THE AUTHORITY TO DIRECT THE MANAGEMENT OF THE FACIL-
ITY IN ALL ASPECTS OF OPERATION AND SHALL BE AFFORDED FULL ACCESS TO THE
ACCOUNTS  AND  RECORDS  OF  THE  FACILITY. THE TEMPORARY OPERATOR SHALL,
DURING THIS PERIOD, OPERATE THE FACILITY IN SUCH A MANNER AS TO  PROMOTE
SAFETY  AND  THE  QUALITY  AND  ACCESSIBILITY OF HEALTH CARE SERVICES OR
RESIDENTIAL CARE IN THE COMMUNITY SERVED BY THE FACILITY  AND  ELIMINATE
SERIOUS  FINANCIAL  INSTABILITY.  THE  TEMPORARY OPERATOR SHALL HAVE THE
POWER TO LET CONTRACTS THEREFOR OR  INCUR  EXPENSES  ON  BEHALF  OF  THE
FACILITY,  PROVIDED THAT WHERE INDIVIDUAL ITEMS OF REPAIRS, IMPROVEMENTS
OR SUPPLIES EXCEED TEN THOUSAND DOLLARS, THE  TEMPORARY  OPERATOR  SHALL
OBTAIN  PRICE  QUOTATIONS  FROM  AT  LEAST  THREE REPUTABLE SOURCES. THE
TEMPORARY OPERATOR SHALL NOT BE REQUIRED TO FILE ANY BOND.  NO  SECURITY
INTEREST  IN  ANY  REAL  OR PERSONAL PROPERTY COMPRISING THE FACILITY OR
CONTAINED WITHIN THE FACILITY, OR IN ANY FIXTURE OF THE FACILITY,  SHALL
BE IMPAIRED OR DIMINISHED IN PRIORITY BY THE TEMPORARY OPERATOR. NEITHER
THE  TEMPORARY  OPERATOR NOR THE DEPARTMENT SHALL ENGAGE IN ANY ACTIVITY
THAT CONSTITUTES A CONFISCATION OF PROPERTY.
  4. THE TEMPORARY OPERATOR SHALL BE ENTITLED TO A  REASONABLE  FEE,  AS
DETERMINED  BY  THE COMMISSIONER, AND NECESSARY EXPENSES INCURRED DURING
HIS OR HER PERFORMANCE AS TEMPORARY OPERATOR, TO BE PAID FROM THE REVEN-
UE OF THE  FACILITY.  THE  TEMPORARY  OPERATOR  SHALL  COLLECT  INCOMING
PAYMENTS  FROM  ALL  SOURCES  AND  APPLY THEM FIRST TO THE CORRECTION OF

S. 6256--C                         13

DEFICIENCIES AND THE REDUCTION OF  SERIOUS  FINANCIAL  INSTABILITY.  THE
TEMPORARY OPERATOR SHALL BE LIABLE ONLY IN HIS OR HER CAPACITY AS TEMPO-
RARY  OPERATOR FOR INJURY TO PERSON AND PROPERTY BY REASON OF CONDITIONS
OF  THE FACILITY IN A CASE WHERE AN ESTABLISHED OPERATOR WOULD HAVE BEEN
LIABLE; HE OR SHE SHALL NOT HAVE ANY LIABILITY IN HIS  OR  HER  PERSONAL
CAPACITY, EXCEPT FOR GROSS NEGLIGENCE AND INTENTIONAL ACTS.
  5.  (A)  THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR
SHALL NOT EXCEED ONE HUNDRED EIGHTY DAYS. AFTER ONE HUNDRED EIGHTY DAYS,
IF THE COMMISSIONER DETERMINES THAT TERMINATION OF THE TEMPORARY  OPERA-
TOR  WOULD  CAUSE SIGNIFICANT DETERIORATION OF THE QUALITY OF, OR ACCESS
TO, HEALTH CARE OR RESIDENTIAL CARE IN THE COMMUNITY OR THAT  REAPPOINT-
MENT  IS NECESSARY TO CORRECT THE DEFICIENCIES AND FINANCIAL INSTABILITY
THAT REQUIRED THE APPOINTMENT OF THE TEMPORARY OPERATOR, THE COMMISSION-
ER MAY AUTHORIZE UP TO TWO ADDITIONAL NINETY DAY TERMS.   HOWEVER,  SUCH
AUTHORIZATION  SHALL INCLUDE THE COMMISSIONER'S REQUIREMENTS FOR CONCLU-
SION OF THE TEMPORARY OPERATORSHIP TO BE SATISFIED WITHIN THE ADDITIONAL
TERM OR TERMS.
  (B) WITHIN FOURTEEN DAYS PRIOR TO THE TERMINATION OF EACH TERM OF  THE
APPOINTMENT  OF  THE  TEMPORARY  OPERATOR,  THE TEMPORARY OPERATOR SHALL
SUBMIT TO THE COMMISSIONER AND TO  THE  ESTABLISHED  OPERATOR  A  REPORT
DESCRIBING:
  (I) THE ACTIONS TAKEN DURING THE APPOINTMENT TO ADDRESS SUCH DEFICIEN-
CIES AND FINANCIAL INSTABILITY,
  (II)  OBJECTIVES FOR THE CONTINUATION OF THE TEMPORARY OPERATORSHIP IF
NECESSARY AND A SCHEDULE FOR SATISFACTION OF SUCH OBJECTIVES, AND
  (III) RECOMMENDED ACTIONS FOR THE ONGOING OPERATION  OF  THE  FACILITY
SUBSEQUENT  TO THE TEMPORARY OPERATORSHIP. THE REPORT SHALL REFLECT BEST
EFFORTS TO PRODUCE A FULL AND COMPLETE ACCOUNTING.
  (C) THE TERM OF THE INITIAL APPOINTMENT AND OF  ANY  SUBSEQUENT  REAP-
POINTMENT  MAY  BE  TERMINATED PRIOR TO THE EXPIRATION OF THE DESIGNATED
TERM, IF THE ESTABLISHED OPERATOR AND THE COMMISSIONER AGREE ON  A  PLAN
OF CORRECTION AND THE IMPLEMENTATION OF SUCH PLAN.
  6.  (A)  THE  COMMISSIONER  SHALL,  UPON  MAKING A DETERMINATION OF AN
INTENTION TO APPOINT A TEMPORARY OPERATOR PURSUANT TO PARAGRAPH  (A)  OF
SUBDIVISION  TWO  OF  THIS SECTION CAUSE THE ESTABLISHED OPERATOR OF THE
FACILITY TO BE NOTIFIED OF THE INTENTION BY REGISTERED OR CERTIFIED MAIL
ADDRESSED TO THE PRINCIPAL OFFICE  OF  THE  ESTABLISHED  OPERATOR.  SUCH
NOTIFICATION SHALL INCLUDE A DETAILED DESCRIPTION OF THE FINDINGS UNDER-
LYING  THE  INTENTION  TO APPOINT A TEMPORARY OPERATOR, AND THE DATE AND
TIME OF A REQUIRED MEETING WITH  THE  COMMISSIONER  AND/OR  HIS  OR  HER
DESIGNEE WITHIN TEN BUSINESS DAYS OF THE RECEIPT OF SUCH NOTICE. AT SUCH
MEETING,  THE  ESTABLISHED OPERATOR SHALL HAVE THE OPPORTUNITY TO REVIEW
AND DISCUSS ALL RELEVANT FINDINGS. AT SUCH MEETING OR WITHIN  TEN  ADDI-
TIONAL  BUSINESS  DAYS,  THE  COMMISSIONER  AND THE ESTABLISHED OPERATOR
SHALL DEVELOP A MUTUALLY SATISFACTORY PLAN OF  CORRECTION  AND  SCHEDULE
FOR  IMPLEMENTATION.  IN  SUCH  EVENT, THE COMMISSIONER SHALL NOTIFY THE
ESTABLISHED OPERATOR THAT THE COMMISSIONER NO LONGER INTENDS TO  APPOINT
A TEMPORARY OPERATOR.
  (B)  SHOULD THE COMMISSIONER AND THE ESTABLISHED OPERATOR BE UNABLE TO
ESTABLISH A PLAN OF CORRECTION PURSUANT TO PARAGRAPH (A) OF THIS  SUBDI-
VISION,  OR  SHOULD  THE  ESTABLISHED  OPERATOR  FAIL  TO RESPOND TO THE
COMMISSIONER'S INITIAL NOTIFICATION, THERE SHALL  BE  AN  ADMINISTRATIVE
HEARING ON THE COMMISSIONER'S DETERMINATION TO APPOINT A TEMPORARY OPER-
ATOR  TO  BEGIN  NO LATER THAN SIXTY DAYS FROM THE DATE OF THE NOTICE TO
THE ESTABLISHED OPERATOR. ANY SUCH HEARING SHALL BE STRICTLY LIMITED  TO
THE  ISSUE OF WHETHER THE DETERMINATION OF THE COMMISSIONER TO APPOINT A

S. 6256--C                         14

TEMPORARY OPERATOR IS SUPPORTED BY SUBSTANTIAL EVIDENCE. A COPY  OF  THE
DECISION  SHALL  BE  SENT  TO  THE  ESTABLISHED OPERATOR TOGETHER WITH A
NOTICE OF THE RIGHT TO JUDICIAL REVIEW IN ACCORDANCE WITH THE PROVISIONS
OF ARTICLE SEVENTY-EIGHT OF THE CIVIL PRACTICE LAW AND RULES.
  (C)  IF  THE  DECISION  TO APPOINT A TEMPORARY OPERATOR IS UPHELD SUCH
TEMPORARY OPERATOR SHALL BE APPOINTED AS  SOON  AS  IS  PRACTICABLE  AND
SHALL OPERATE PURSUANT TO THE PROVISIONS OF THIS SECTION.
  (D) THE COMMISSIONER SHALL, UPON MAKING A DETERMINATION TO REAPPOINT A
TEMPORARY  OPERATOR  FOR AN ADDITIONAL NINETY DAY TERM PURSUANT TO PARA-
GRAPH (A) OF SUBDIVISION FIVE OF THIS  SECTION,  CAUSE  THE  ESTABLISHED
OPERATOR  OF  THE FACILITY TO BE NOTIFIED OF THE DETERMINATION BY REGIS-
TERED OR CERTIFIED MAIL ADDRESSED TO THE PRINCIPAL OFFICE OF THE  ESTAB-
LISHED  OPERATOR.  UPON  RECEIPT  OF  SUCH NOTIFICATION AT THE PRINCIPAL
OFFICE OF THE ESTABLISHED OPERATOR AND BEFORE THE EXPIRATION OF TEN DAYS
THEREAFTER, THE ESTABLISHED OPERATOR MAY REQUEST AN ADMINISTRATIVE HEAR-
ING ON THE DETERMINATION TO BEGIN NO LATER THAN  THIRTY  DAYS  FROM  THE
DATE  OF  THE REAPPOINTMENT OF THE TEMPORARY OPERATOR.  ANY SUCH HEARING
SHALL BE STRICTLY LIMITED TO THE ISSUE OF WHETHER THE  DETERMINATION  OF
THE  COMMISSIONER  TO  REAPPOINT  THE TEMPORARY OPERATOR IS SUPPORTED BY
SUBSTANTIAL EVIDENCE.
  7. NO PROVISION CONTAINED IN THIS SECTION SHALL BE DEEMED  TO  RELIEVE
THE  ESTABLISHED  OPERATOR  OR ANY OTHER PERSON OF ANY CIVIL OR CRIMINAL
LIABILITY INCURRED, OR ANY DUTY IMPOSED BY LAW, BY  REASON  OF  ACTS  OR
OMISSIONS  OF  THE ESTABLISHED OPERATOR OR ANY OTHER PERSON PRIOR TO THE
APPOINTMENT OF ANY TEMPORARY  OPERATOR  HEREUNDER;  NOR  SHALL  ANYTHING
CONTAINED IN THIS SECTION BE CONSTRUED TO SUSPEND DURING THE TERM OF THE
APPOINTMENT  OF THE TEMPORARY OPERATOR ANY OBLIGATION OF THE ESTABLISHED
OPERATOR OR ANY OTHER PERSON FOR THE PAYMENT OF TAXES OR OTHER OPERATING
AND MAINTENANCE EXPENSES OF THE FACILITY NOR OF THE ESTABLISHED OPERATOR
OR ANY OTHER PERSON FOR THE PAYMENT OF MORTGAGES OR LIENS.
  S 28. Section 2 of chapter 584 of  the  laws  of  2011,  amending  the
public  authorities law, relating to the powers and duties of the dormi-
tory authority of the state of New York relative to the establishment of
subsidiaries for certain purposes, is amended to read as follows:
  S 2. This act shall take effect immediately and shall  expire  and  be
deemed repealed ON July 1, [2012] 2015; provided however, that the expi-
ration  of  this  act  shall  not  impair or otherwise affect any of the
powers, duties, responsibilities, functions, rights  or  liabilities  of
any  subsidiary  duly  created  pursuant  to  subdivision twenty-five of
section 1678 of the public authorities law prior to such expiration.
  S 28-a. Paragraph (a) of subdivision 25 of section 1678 of the  public
authorities  law,  as  amended  by  chapter  584 of the laws of 2011, is
amended to read as follows:
  25. (a) To form one or more subsidiaries for the purpose  of  limiting
the  potential liability of the authority when exercising the powers and
duties conferred upon the authority by THIS article [eight of this chap-
ter] in connection with  the  exercise  of  remedies  by  the  authority
against  any borrower REGULATED UNDER ARTICLE TWENTY-EIGHT OF THE PUBLIC
HEALTH LAW that has defaulted in its obligations under its  loan  agree-
ment  or  mortgage  with the authority and for which an event of default
has been declared by the authority. Each such subsidiary created  pursu-
ant  to  this  subdivision  may  exercise and perform one or more of the
purposes, powers, duties, functions, rights and responsibilities of  the
authority  (other  than the issuance of indebtedness) in connection with
real and personal property with respect to which the authority holds  or
held  a mortgage, security interest or other collateral interest includ-

S. 6256--C                         15

ing: (i) bidding for, taking, holding, selling, conveying, assigning  or
transferring   title  to  such  property;  (ii)  entering  into  leases,
subleases, operating agreements, security agreements, loan agreements or
other  encumbrances  or  arrangements  with  regard to such property and
acting in a manner consistent with the rights, obligations or  responsi-
bilities  of  the  owner of such property pursuant to such agreements or
encumbrances; (iii)  assuming  any  indebtedness  or  other  liabilities
secured  by such property. Notwithstanding any other provision of law to
the contrary, but in all instances subject  to  the  provisions  of  any
contract  with bondholders, the transfer of title to any such subsidiary
or any other actions taken  by  the  authority  or  such  subsidiary  to
enforce  the authority's rights under the mortgage, security interest or
other collateral interest or to protect, acquire, manage or  dispose  of
the  property shall be deemed to be a corporate purpose of the authority
and shall not impair the validity of any bonds,  notes  or  other  obli-
gations  of  the  authority  to which the mortgage, security interest or
other collateral interest relates.
  S 29.  Subdivision 1 of section 2999-i of the public  health  law,  as
added  by  section  52  of  part H of chapter 59 of the laws of 2011, is
amended to read as follows:
  1. (A) The commissioner of taxation and finance shall be the custodian
of the fund and the special  account  established  pursuant  to  section
ninety-nine-t of the state finance law. All payments from the fund shall
be  made  by  the commissioner of taxation and finance upon certificates
signed by the superintendent of financial services, or his or her desig-
nee, as hereinafter provided. The fund shall be separate and apart  from
any  other fund and from all other state monies; PROVIDED, HOWEVER, THAT
MONIES OF THE FUND MAY BE INVESTED AS SET FORTH IN PARAGRAPH (B) OF THIS
SUBDIVISION.  No monies from the fund shall be transferred to any  other
fund,  nor shall any such monies be applied to the making of any payment
for any purpose other than the purpose set forth in this title.
  (B) ANY MONIES OF THE FUND NOT REQUIRED FOR IMMEDIATE USE MAY, AT  THE
DISCRETION  OF  THE  COMMISSIONER  OF FINANCIAL SERVICES IN CONSULTATION
WITH THE COMMISSIONER OF HEALTH AND  THE  DIRECTOR  OF  THE  BUDGET,  BE
INVESTED  BY  THE COMMISSIONER OF TAXATION AND FINANCE IN OBLIGATIONS OF
THE UNITED STATES OR THE STATE OR OBLIGATIONS THE PRINCIPAL AND INTEREST
OF WHICH ARE GUARANTEED BY THE UNITED STATES OR THE STATE. THE  PROCEEDS
OF  ANY  SUCH  INVESTMENT  SHALL BE RETAINED BY THE FUND AS ASSETS TO BE
USED FOR THE PURPOSES OF THE FUND.
  S 30. Subdivision 9 of section  2803  of  the  public  health  law  is
REPEALED.
  S  31.  Paragraph (b) of subdivision 1-a of section 2802 of the public
health law, as amended by chapter 174 of the laws of 2011, is amended to
read as follows:
  (b) repair or  maintenance,  regardless  of  cost,  including  routine
purchases  and  the  acquisition  of  minor  equipment undertaken in the
course of a hospital's inventory control functions;  PROVIDED  THAT  FOR
PROJECTS  UNDER  THIS  PARAGRAPH  WITH A TOTAL COST OF UP TO SIX MILLION
DOLLARS, NO WRITTEN NOTICE SHALL BE REQUIRED;
  S 32.  Subdivision 1 of section 1 of chapter 119 of the laws  of  1997
relating  to  authorizing  the department of health to establish certain
payments to general hospitals, as amended by section 1  of  part  S2  of
chapter 62 of the laws of 2003, is amended to read as follows:
  1.  Notwithstanding  any  inconsistent provision of law or regulation,
effective for the period [April 1, 1997 through March 31, 1998] APRIL 1,
2012 THROUGH DECEMBER 31, 2012 and for annual periods beginning  [April]

S. 6256--C                         16

JANUARY  1 thereafter, the [department] DEPARTMENT of [health] HEALTH is
authorized to pay voluntary non-profit general hospitals as  defined  in
subdivision  10  of  section  2801  of  the public health law additional
payments  for inpatient hospital services as medical assistance payments
pursuant to title 11 of article 5 of the social services law and federal
law and regulations governing disproportionate share payments, based  on
the  [amount  of state aid for which such general hospitals are eligible
pursuant to articles 25, 26 and 41 of the  mental  hygiene  law  and  as
identified in subdivision 2 of this section] COSTS INCURRED IN EXCESS OF
REVENUES BY GENERAL HOSPITALS IN PROVIDING SERVICES IN ELIGIBLE PROGRAMS
TO  UNINSURED  PATIENTS  AND  PATIENTS  ELIGIBLE FOR MEDICAL ASSISTANCE.
Payment made pursuant to this section shall not exceed each such general
hospital's cost of providing services to uninsured patients and patients
eligible for medical assistance pursuant to title 11 of article 5 of the
social services law after taking into consideration  all  other  medical
assistance  received,  including disproportionate share payments made to
such general hospital, and payments from or on behalf of such  uninsured
patients, and shall also not exceed the total amount of state aid, iden-
tified  by  subdivision  2  of  this  section, available to such general
hospital by law. Payments made to such  general  hospitals  pursuant  to
this  section  shall be made in lieu of any state aid payments available
to such general hospital by law.
  S 33. Intentionally omitted.
  S 34.  Subdivision 25 of section 2808 of the  public  health  law,  as
added  by  section  31  of  part  B  of chapter 109 of the laws of 2010,
subparagraph (iii) as amended and subparagraph (iv) of paragraph (b)  as
added  by  section  69  of  part H of chapter 59 of the laws of 2011, is
amended to read as follows:
  25. Reserved bed  days.  (a)  For  purposes  of  this  subdivision,  a
"reserved bed day" is a day for which a governmental agency pays a resi-
dential  health care facility to reserve a bed for a person eligible for
medical assistance pursuant to title  eleven  of  article  five  of  the
social  services  law  while he or she is temporarily hospitalized or on
leave of absence from the facility.
  (b) Notwithstanding any other provisions of this section or any  other
law  or  regulation  to  the contrary, for reserved bed days provided on
behalf of persons twenty-one years of age or older:
  (i) payments for reserved  bed  days  shall  be  made  at  ninety-five
percent  of  the  Medicaid  rate  otherwise  payable to the facility for
services provided on behalf of such person;
  (ii) payment to a facility for reserved bed days provided on behalf of
such person for temporary hospitalizations may not exceed fourteen  days
in any twelve month period;
  (iii)  payment  to a facility for reserved bed days provided on behalf
of such person for non-hospitalization leaves of absence may not  exceed
ten days in any twelve month period[; and
  (iv)  payments  for  reserved  bed days for temporary hospitalizations
shall only be made to a residential health care  facility  if  at  least
fifty  percent  of the facility's residents eligible to participate in a
Medicare managed care plan are enrolled in such a plan].
  (C) NOTWITHSTANDING ANY CONTRARY PROVISION OF THIS SUBDIVISION OR  ANY
OTHER  LAW  AND SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTIC-
IPATION, FOR RATE PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND TWELVE,
WITH REGARD TO SERVICES PROVIDED TO  RESIDENTIAL  HEALTH  CARE  FACILITY
RESIDENTS TWENTY-ONE YEARS OF AGE AND OLDER, THE COMMISSIONER IN CONSUL-
TATION  WITH RELEVANT STAKEHOLDERS, SHALL DEVELOP A REPORT AND RECOMMEN-

S. 6256--C                         17

DATION REGARDING RESERVED BED DAYS. SUCH REPORT SHALL  CONTAIN  INFORMA-
TION AND DATA COLLECTED OVER A TWO YEAR PERIOD BEGINNING JANUARY 1, 2011
INCLUDING  BUT NOT LIMITED TO: THE EXTENT TO WHICH RESERVED BED DAYS ARE
UTILIZED;  THE  NUMBER OF FACILITIES THAT RECEIVED REVENUE FROM RESERVED
BED DAYS; THE TOTAL  ANNUAL  COST  TO  THE  STATE  FOR  EACH  YEAR;  AND
REIMBURSEMENT  METHODOLOGY  FOR THE CURRENT RATES. THE SUBSEQUENT RECOM-
MENDATION SHALL ACHIEVE AN AGGREGATE ANNUALIZED REDUCTION IN  REIMBURSE-
MENT  FOR  SUCH RESERVED BED DAYS OF NO LESS THAN FORTY MILLION DOLLARS.
ON OR BEFORE JANUARY  30,  2013,  THE  COMMISSIONER  SHALL  SUBMIT  SUCH
REPORT,  AS WELL AS DRAFT LEGISLATION THAT WOULD IMPLEMENT ANY PROPOSALS
CONTAINED THEREIN, TO THE TEMPORARY PRESIDENT  OF  THE  SENATE  AND  THE
SPEAKER  OF  THE  ASSEMBLY FOR THEIR CONSIDERATION. NO REGULATORY ACTION
RELATING TO THE REPORT AND RECOMMENDATION SHALL BE APPROVED  OR  REVISED
PRIOR TO LEGISLATIVE APPROVAL OF A MEASURE OR MEASURES RELATING THERETO.
  S 35. Intentionally omitted.
  S 36.  Paragraph (g-1) of subdivision 2 of section 365-a of the social
services  law,  as  amended by section 23 of part H of chapter 59 of the
laws of 2011, is amended to read as follows:
  (g-1) drugs provided on an in-patient basis, those drugs contained  on
the  list established by regulation of the commissioner of health pursu-
ant to subdivision four of this section, and those drugs which  may  not
be  dispensed  without a prescription as required by section sixty-eight
hundred ten of the education law and which the  commissioner  of  health
shall determine to be reimbursable based upon such factors as the avail-
ability  of  such  drugs  or  alternatives at low cost if purchased by a
medicaid recipient, or the essential nature of such drugs  as  described
by such commissioner in regulations, provided, however, that such drugs,
exclusive  of long-term maintenance drugs, shall be dispensed in quanti-
ties no greater than a thirty day supply or one hundred doses, whichever
is greater; provided further that the commissioner of health is  author-
ized  to  require  prior  authorization for any refill of a prescription
when less than seventy-five percent of the previously  dispensed  amount
per  fill  should have been used were the product used as normally indi-
cated; provided further that the commissioner of health is authorized to
require prior authorization of prescriptions  of  opioid  analgesics  in
excess  of  four prescriptions in a thirty-day period in accordance with
section two hundred seventy-three of the public health law, EXCEPT  THAT
PRIOR  AUTHORIZATION  MAY  BE DENIED IF THE DEPARTMENT, AFTER GIVING THE
PRESCRIBER A REASONABLE OPPORTUNITY TO PRESENT A  JUSTIFICATION,  DETER-
MINES  THAT  THE  ADDITIONAL  PRESCRIPTION  IS  NOT MEDICALLY NECESSARY;
medical assistance shall not include any drug provided on other than  an
in-patient  basis for which a recipient is charged or a claim is made in
the case of a prescription drug, in excess of the  maximum  reimbursable
amounts  to  be established by department regulations in accordance with
standards established by the secretary of the United  States  department
of  health and human services, or, in the case of a drug not requiring a
prescription, in excess of the maximum reimbursable  amount  established
by  the  commissioner of health pursuant to paragraph (a) of subdivision
four of this section;
  S 37. Subdivision 6 of section 368-d of the social  services  law,  as
added  by  section  6  of  part  H of chapter 59 of the laws of 2011, is
amended to read as follows:
  6. The commissioner shall evaluate the results of the study  conducted
pursuant  to  subdivision four of this section to determine, after iden-
tification of actual direct and indirect costs incurred by public school
districts and state operated[/] AND state supported  schools  FOR  BLIND

S. 6256--C                         18

AND  DEAF  STUDENTS, whether it is advisable to claim federal reimburse-
ment for expenditures under this section as  certified  public  expendi-
tures.  In the event such claims are submitted, if federal reimbursement
received  for certified public expenditures on behalf of medical assist-
ance recipients whose assistance and care are the  responsibility  of  a
social  services  district  [in  a  city  with  a population of over two
million,] results in a decrease in the state share  of  annual  expendi-
tures  pursuant  to this section for such recipients, then to the extent
that the amount of any such decrease when combined with any decrease  in
the  state share of annual expenditures described in subdivision five of
section three hundred sixty-eight-e of this title exceeds fifty  million
dollars  IN  STATE  FISCAL  YEAR 2011-12, OR EXCEEDS ONE HUNDRED MILLION
DOLLARS IN STATE FISCAL YEAR 2012-13 OR ANY FISCAL YEAR THEREAFTER,  the
excess  amount  shall  be  transferred  to  such  [city]  PUBLIC  SCHOOL
DISTRICTS AND STATE OPERATED AND STATE SUPPORTED SCHOOLS FOR  BLIND  AND
DEAF  STUDENTS  IN AMOUNTS PROPORTIONAL TO THEIR PERCENTAGE CONTRIBUTION
TO THE STATEWIDE SAVINGS.  Any such excess amount transferred shall  not
be  considered  a  revenue  received by such social services district in
determining the district's actual medical  assistance  expenditures  for
purposes  of  paragraph  (b)  of section one of part C of chapter fifty-
eight of the laws of two thousand five.
  S 38. Subdivision 5 of section 368-e of the social  services  law,  as
added  by  section  7  of  part  H of chapter 59 of the laws of 2011, is
amended to read as follows:
  5. The commissioner shall evaluate the results of the study  conducted
pursuant  to subdivision three of this section to determine, after iden-
tification of actual direct and indirect costs incurred by counties  for
medical  care,  services,  and supplies furnished to pre-school children
with handicapping conditions, whether it is advisable to  claim  federal
reimbursement  for  expenditures  under this section as certified public
expenditures. In  the  event  such  claims  are  submitted,  if  federal
reimbursement  received  for  certified public expenditures on behalf of
medical assistance recipients whose assistance and care are the  respon-
sibility  of  a social services district [in a city with a population of
over two million], results in a decrease in the state  share  of  annual
expenditures  pursuant  to this section for such recipients, then to the
extent that the amount of any  such  decrease  when  combined  with  any
decrease in the state share of annual expenditures described in subdivi-
sion  six  of  section three hundred sixty-eight-d of this title exceeds
fifty million dollars IN STATE  FISCAL  YEAR  2011-12,  OR  EXCEEDS  ONE
HUNDRED  MILLION DOLLARS IN STATE FISCAL YEAR 2012-13 OR ANY FISCAL YEAR
THEREAFTER, the excess amount shall be transferred to such [city]  COUN-
TIES  IN  AMOUNTS  PROPORTIONAL  TO THEIR PERCENTAGE CONTRIBUTION TO THE
STATEWIDE SAVINGS.   Any such excess amount  transferred  shall  not  be
considered a revenue received by such social services district in deter-
mining   the  district's  actual  medical  assistance  expenditures  for
purposes of paragraph (b) of section one of part  C  of  chapter  fifty-
eight of the laws of two thousand five.
  S  39. Subparagraph (i) of paragraph (a-1) of subdivision 4 of section
365-a of the social services law, as amended by section 46 of part C  of
chapter 58 of the laws of 2009, is amended to read as follows:
  (i)  a  brand  name  drug for which a multi-source therapeutically and
generically equivalent drug, as determined by the federal food and  drug
administration,  is  available,  unless  previously  authorized  by  the
department of health.  The  commissioner  of  health  is  authorized  to
exempt,  for good cause shown, any brand name drug from the restrictions

S. 6256--C                         19

imposed by this subparagraph[. This subparagraph shall not apply to  any
drug  that is in a therapeutic class included on the preferred drug list
under section two hundred seventy-two of the public health law or is  in
the  clinical drug review program under section two hundred seventy-four
of the public health law];
  S 40. Intentionally omitted.
  S 41. Paragraphs (e), (f) and (g) of subdivision 1 of section 367-a of
the social services law, paragraph (e) as added by chapter  433  of  the
laws  of  1997, paragraph (f) as added by section 1 of part E of chapter
58 of the laws of 2008, paragraph (g) as added by section 65-a of part H
of chapter 59 of the laws of 2011, are amended to read as follows:
  (e) Amounts payable under this title for  medical  assistance  in  the
form  of  clinic services pursuant to article twenty-eight of the public
health law and article sixteen of the mental  hygiene  law  provided  to
eligible  persons DIAGNOSED WITH A DEVELOPMENTAL DISABILITY who are also
beneficiaries under part [b] B of title [xviii]  XVIII  of  the  federal
social security act [and who are also], OR PROVIDED TO PERSONS diagnosed
with a DEVELOPMENTAL disability WHO ARE QUALIFIED MEDICARE BENEFICIARIES
UNDER  PART  B  OF  TITLE  XVIII  OF SUCH ACT shall not be less than the
approved medical assistance payment level less the amount payable  under
part [b] B.
  (f)  Amounts  payable  under  this title for medical assistance in the
form of outpatient mental health services under  article  thirty-one  of
the mental hygiene law provided to eligible persons who are also benefi-
ciaries  under  part B of title XVIII of the federal social security act
OR PROVIDED TO QUALIFIED MEDICARE BENEFICIARIES UNDER PART  B  OF  TITLE
XVIII OF SUCH ACT shall not be less than the approved medical assistance
payment level less the amount payable under part B.
  (g)  Notwithstanding  any  provision  of this section to the contrary,
amounts payable under this title for medical assistance in the  form  of
hospital outpatient services or diagnostic and treatment center services
pursuant  to  article  twenty-eight of the public health law provided to
eligible persons who are also beneficiaries under part B of title  XVIII
of  the  federal  social  security act OR PROVIDED TO QUALIFIED MEDICARE
BENEFICIARIES UNDER PART B OF TITLE XVIII OF SUCH ACT shall  not  exceed
the  approved  medical  assistance payment level less the amount payable
under part B.
  S 42. Intentionally omitted.
  S 43. Paragraph (a) of subdivision 8-a of section 2807-j of the public
health law, as amended by section 16 of part D of chapter 57 of the laws
of 2006, is amended to read as follows:
  (a) Payments and reports submitted or required to be submitted to  the
commissioner  or to the commissioner's designee pursuant to this section
and section twenty-eight hundred seven-s of this article  by  designated
providers  of  services  and by third-party payors which have elected to
make payments directly to the  commissioner  or  to  the  commissioner's
designee in accordance with subdivision five-a of this section, shall be
subject to audit by the commissioner for a period of six years following
the  close  of  the calendar year in which such payments and reports are
due, after which such payments shall be deemed final and not subject  to
further  adjustment  or reconciliation, INCLUDING THROUGH OFFSET ADJUST-
MENTS OR RECONCILIATIONS MADE BY DESIGNATED PROVIDERS OF SERVICES OR  BY
THIRD-PARTY  PAYORS WITH REGARD TO SUBSEQUENT PAYMENTS, provided, howev-
er, that nothing herein shall be construed as precluding the commission-
er from pursuing collection of any such payments which are identified as
delinquent within such six year  period,  or  which  are  identified  as

S. 6256--C                         20

delinquent  as a result of an audit commenced within such six year peri-
od, or from conducting an audit of any adjustment or reconciliation made
by a designated provider of services or by a third party payor which has
elected  to  make  such  payments  directly  to  the commissioner or the
commissioner's designee, OR FROM CONDUCTING AN AUDIT  OF  PAYMENTS  MADE
PRIOR  TO  SUCH  SIX  YEAR  PERIOD WHICH ARE FOUND TO BE COMMINGLED WITH
PAYMENTS WHICH ARE OTHERWISE SUBJECT TO TIMELY AUDIT  PURSUANT  TO  THIS
SECTION.
  S 44.  Paragraph (a) of subdivision 10 of section 2807-t of the public
health law, as amended by section 17 of part D of chapter 57 of the laws
of 2006, is amended to read as follows:
  (a)  Payments and reports submitted or required to be submitted to the
commissioner or to the commissioner's designee pursuant to this  section
by specified third-party payors shall be subject to audit by the commis-
sioner  for  a  period  of six years following the close of the calendar
year in which such payments  and  reports  are  due,  after  which  such
payments  shall be deemed final and not subject to further adjustment or
reconciliation, INCLUDING THROUGH OFFSET ADJUSTMENTS OR  RECONCILIATIONS
MADE  BY  SUCH  SPECIFIED  THIRD-PARTY  PAYORS WITH REGARD TO SUBSEQUENT
PAYMENTS, provided, however, that nothing herein shall be  construed  as
precluding  the  commissioner  from  pursuing  collection  of  any  such
payments which are identified as delinquent within such six year period,
or which are identified as delinquent as a result of an audit  commenced
within  such six year period, or from conducting an audit of any adjust-
ments and reconciliation made by a specified third  party  payor  within
such six year period, OR FROM CONDUCTING AN AUDIT OF PAYMENTS MADE PRIOR
TO  SUCH  SIX YEAR PERIOD WHICH ARE FOUND TO BE COMMINGLED WITH PAYMENTS
WHICH ARE OTHERWISE SUBJECT TO TIMELY AUDIT PURSUANT TO THIS SECTION.
  S 45. Subdivision 7 of section 2807-d of  the  public  health  law  is
amended by adding a new paragraph (f) to read as follows:
  (F)  PAYMENTS AND REPORTS SUBMITTED OR REQUIRED TO BE SUBMITTED TO THE
COMMISSIONER OR TO THE COMMISSIONER'S DESIGNEE PURSUANT TO THIS  SECTION
SHALL  BE SUBJECT TO AUDIT BY THE COMMISSIONER FOR A PERIOD OF SIX YEARS
FOLLOWING THE CLOSE OF THE CALENDAR YEAR  IN  WHICH  SUCH  PAYMENTS  AND
REPORTS ARE DUE, AFTER WHICH SUCH PAYMENTS SHALL BE DEEMED FINAL AND NOT
SUBJECT  TO  FURTHER  ADJUSTMENT  OR  RECONCILIATION,  INCLUDING THROUGH
OFFSET ADJUSTMENTS OR RECONCILIATIONS MADE TO SUBSEQUENT  PAYMENTS  MADE
PURSUANT  TO  THIS SECTION, PROVIDED, HOWEVER, THAT NOTHING HEREIN SHALL
BE CONSTRUED AS PRECLUDING THE COMMISSIONER FROM PURSUING COLLECTION  OF
ANY  SUCH  PAYMENTS  WHICH  ARE IDENTIFIED AS DELINQUENT WITHIN SUCH SIX
YEAR PERIOD, OR WHICH ARE IDENTIFIED AS DELINQUENT AS  A  RESULT  OF  AN
AUDIT COMMENCED WITHIN SUCH SIX YEAR PERIOD, OR FROM CONDUCTING AN AUDIT
OF ANY ADJUSTMENT OR RECONCILIATION MADE BY A HOSPITAL.
  S 46.  Paragraph (f) of subdivision 18 of section 2807-c of the public
health law, as amended by section 15 of part D of chapter 57 of the laws
of 2006, is amended to read as follows:
  (f) Payments of assessments and allowances required to be submitted by
general hospitals pursuant to this subdivision and subdivisions fourteen
and  fourteen-b  of this section and paragraph (a) of subdivision two of
section twenty-eight hundred seven-d of this article shall be subject to
audit by the commissioner for a period of six years following the  close
of  the  calendar  year in which such payments are due, after which such
payments shall be deemed final and not subject to further adjustment  or
reconciliation,  INCLUDING THROUGH OFFSET ADJUSTMENTS OR RECONCILIATIONS
MADE BY GENERAL HOSPITALS WITH REGARD TO SUBSEQUENT PAYMENTS,  provided,
however,  that  nothing  herein  shall  be  construed  as precluding the

S. 6256--C                         21

commissioner from pursuing collection of any such assessments and allow-
ances which are identified as delinquent within such six year period, or
which are identified as delinquent as a result  of  an  audit  commenced
within  such  six  year audit period, or from conducting an audit of any
adjustment or reconciliation made by a general hospital within such  six
year  period, OR FROM CONDUCTING AN AUDIT OF PAYMENTS MADE PRIOR TO SUCH
SIX YEAR PERIOD WHICH ARE FOUND TO BE COMMINGLED WITH PAYMENTS WHICH ARE
OTHERWISE SUBJECT TO TIMELY AUDIT  PURSUANT  TO  THIS  SECTION.  General
hospitals which, in the course of such an audit, fail to produce data or
documentation  requested  in furtherance of such an audit, within thirty
days of such request may be assessed a civil penalty of up to ten  thou-
sand  dollars  for each such failure, provided, however, that such civil
penalty shall not be imposed if the hospital demonstrates good cause for
such failure.  The imposition of such civil penalties shall  be  subject
to the provisions of section twelve-a of this chapter.
  S  47.  Paragraph (e) of subdivision 2-a of section 2807 of the public
health law is amended by adding a new  subparagraph  (iii)  to  read  as
follows:
  (III)  REGULATIONS  ISSUED  PURSUANT TO THIS PARAGRAPH MAY INCORPORATE
QUALITY RELATED MEASURES LIMITING OR EXCLUDING REIMBURSEMENT RELATED  TO
POTENTIALLY  PREVENTABLE CONDITIONS AND COMPLICATIONS; PROVIDED HOWEVER,
SUCH QUALITY RELATED MEASURES SHALL NOT INCLUDE ANY  PREVENTABLE  CONDI-
TIONS AND COMPLICATIONS NOT IDENTIFIED FOR MEDICARE NONPAYMENT OR LIMIT-
ED PAYMENT.
  S  48.  Paragraph (c) of subdivision 7 of section 2807-d of the public
health law, as added by chapter 938 of the laws of 1990, is  amended  to
read as follows:
  (c)  The  reports  shall  be  in such form as may be prescribed by the
commissioner to accurately disclose information  required  to  implement
this  section,  PROVIDED,  HOWEVER,  THAT  FOR PERIODS ON AND AFTER JULY
FIRST, TWO THOUSAND TWELVE, SUCH  REPORTS  AND  ANY  ASSOCIATED  CERTIF-
ICATIONS  SHALL BE SUBMITTED ELECTRONICALLY IN A FORM AS MAY BE REQUIRED
BY THE COMMISSIONER.
  S 48-a. Subparagraph (i) of paragraph (a) of subdivision 7 of  section
2807-j  of  the public health law, as amended by section 36 of part B of
chapter 58 of the laws of 2008, is amended to read as follows;
  (i) Every designated provider of services shall submit reports of  net
patient  service revenues received for or on account of patient services
for each month which shall be in such form as may be prescribed  by  the
commissioner  to  accurately  disclose information required to implement
this section. For periods on and after January first, two thousand five,
reports by designated providers of services shall be submitted electron-
ically in a form as may  be  required  by  the  commissioner;  provided,
however,  any  designated  provider  of  services is not prohibited from
submitting reports electronically on a voluntary  basis  prior  to  such
date,   AND   PROVIDED   FURTHER,  HOWEVER,  THAT  ALL  SUCH  ELECTRONIC
SUBMISSIONS SUBMITTED ON AND AFTER JULY FIRST, TWO THOUSAND TWELVE SHALL
BE VERIFIED WITH AN ELECTRONIC SIGNATURE AS PRESCRIBED  BY  THE  COMMIS-
SIONER.
  S 48-b. Subparagraph (ii) of paragraph (b) of subdivision 7 of section
2807-j  of the public health law, as amended by section 25 of part A3 of
chapter 62 of the laws of 2003, is amended to read as follows:
  (ii) For periods on and after July first, two thousand  four,  reports
submitted  on  a  monthly basis by third-party payors in accordance with
subparagraph (i) of this paragraph and reports submitted on a monthly or
annual basis by payors acting in an administrative services capacity  on

S. 6256--C                         22

behalf  of  electing  third-party payors in accordance with subparagraph
(i) of this paragraph shall be made electronically in a form as  may  be
required  by the commissioner; provided, however, any third-party payor,
except payors acting in an administrative services capacity on behalf of
electing third-party payors, which, on or after January first, two thou-
sand  four,  elects to make payments directly to the commissioner or the
commissioner's designee pursuant to subdivision five  of  this  section,
shall  be  subject to this subparagraph only after one full year of pool
payment experience which results in reports being submitted on a monthly
basis,  AND  PROVIDED  FURTHER,  HOWEVER,  THAT  ALL   SUCH   ELECTRONIC
SUBMISSIONS SUBMITTED ON AND AFTER JULY FIRST, TWO THOUSAND TWELVE SHALL
BE  VERIFIED  WITH  AN ELECTRONIC SIGNATURE AS PRESCRIBED BY THE COMMIS-
SIONER.   This subparagraph shall not be  interpreted  to  prohibit  any
third-party  payor from submitting reports electronically on a voluntary
basis.
  S 48-c. Subparagraph (ii)  of  paragraph  (b)  of  subdivision  20  of
section  2807-c of the public health law, as added by section 26 of part
A3 of chapter 62 of the laws of 2003, is amended to read as follows:
  (ii) For periods on  and  after  January  first,  two  thousand  five,
reports  submitted  by general hospitals to implement the assessment set
forth in subdivision eighteen of this section shall be  submitted  elec-
tronically  in  a form as may be required by the commissioner; provided,
however, general hospitals are not prohibited  from  submitting  reports
electronically  on  a  voluntary  basis prior to such date, AND PROVIDED
FURTHER, HOWEVER, THAT ALL SUCH ELECTRONIC SUBMISSIONS SUBMITTED ON  AND
AFTER  JULY  FIRST,  TWO THOUSAND TWELVE SHALL BE VERIFIED WITH AN ELEC-
TRONIC SIGNATURE AS PRESCRIBED BY THE COMMISSIONER.
  S 49.  Subdivision 8 of section 3605 of  the  public  health  law,  as
added by chapter 959 of the laws of 1984, is amended to read as follows:
  8. Agencies licensed pursuant to this section but not certified pursu-
ant  to  section three thousand six hundred eight of this article, shall
not be qualified to participate  as  a  home  health  agency  under  the
provisions  of  title  XVIII  or  XIX of the federal Social Security Act
provided, however, an agency which has a contract with a state agency or
its locally designated office OR, AS SPECIFIED BY THE COMMISSIONER, WITH
A MANAGED CARE ORGANIZATION PARTICIPATING IN THE  MANAGED  CARE  PROGRAM
ESTABLISHED PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL
SERVICES  LAW OR WITH A MANAGED LONG TERM CARE PLAN ESTABLISHED PURSUANT
TO SECTION FORTY-FOUR HUNDRED  THREE-F  OF  THIS  CHAPTER,  may  receive
reimbursement under title XIX of the federal Social Security Act.
  S  50.  Subdivision  6  of section 365-f of the social services law is
renumbered subdivision 7 and a new subdivision 6 is  added  to  read  as
follows:
  6.  NOTWITHSTANDING  ANY INCONSISTENT PROVISION OF THIS SECTION OR ANY
OTHER CONTRARY PROVISION  OF  LAW,  MANAGED  CARE  PROGRAMS  ESTABLISHED
PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE AND MANAGED
LONG  TERM  CARE  PLANS  AND  OTHER CARE COORDINATION MODELS ESTABLISHED
PURSUANT TO SECTION FOUR THOUSAND FOUR HUNDRED  THREE-F  OF  THE  PUBLIC
HEALTH  LAW  MAY OFFER CONSUMER DIRECTED PERSONAL ASSISTANCE PROGRAMS TO
ENROLLEES.
  S 51. Intentionally omitted.
  S 52. Paragraph (b) of subdivision 1 of section 4403-f of  the  public
health  law,  as added by chapter 659 of the laws of 1997, is amended to
read as follows:
  (b) "Eligible applicant" means an entity controlled or wholly owned by
one or more of the following: a hospital as defined in  subdivision  one

S. 6256--C                         23

of  section twenty-eight hundred one of this chapter; a home care agency
licensed or certified pursuant to article thirty-six  of  this  chapter;
[an] A NEW OR EXISTING entity that has received a certificate of author-
ity  pursuant  to  sections forty-four hundred three, forty-four hundred
three-a or forty-four hundred eight-a of this  article  (as  amended  by
chapter  six hundred thirty-nine of the laws of nineteen hundred ninety-
six), or a health  maintenance  organization  authorized  under  article
forty-three of the insurance law; or a not-for-profit organization which
has a history of providing or coordinating health care services and long
term  care services to the elderly and disabled; PROVIDED, HOWEVER, THAT
ALL SUCH APPLICANTS SHALL ALSO COMPLY WITH DEPARTMENT  OF  HEALTH  REGU-
LATIONS RELATED TO MANAGED CARE.
  S 53. Intentionally omitted.
  S 54. Intentionally omitted.
  S 55. Intentionally omitted.
  S 56. Intentionally omitted.
  S  57. Subdivision 1 of section 92 of 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 funds Medicaid expenditures, is
amended to read as follows:
  1. For state fiscal years 2011-12 and 2012-13,  the  director  of  the
budget,  in  consultation with the commissioner of health, referenced as
"commissioner" for purposes of this section, shall assess on  a  monthly
basis,  as  reflected in monthly reports pursuant to subdivision five of
this section known and projected, department of health state funds medi-
caid expenditures by category of service and by geographic  regions,  as
defined  by  the  commissioner, and if the director of the budget deter-
mines that such expenditures are expected to  cause  medicaid  disburse-
ments for such period to exceed the projected department of health medi-
caid  state  funds  disbursements  in  the enacted budget financial plan
pursuant to subdivision 3 of section 23 of the state  finance  law,  the
commissioner of health, in consultation with the director of the budget,
shall  develop a medicaid savings allocation plan to limit such spending
to the aggregate limit level specified in the enacted  budget  financial
plan,  provided, however, such projections may be adjusted by the direc-
tor of the budget to account for any  changes  in  the  New  York  state
federal medical assistance percentage amount established pursuant to the
federal social security act, changes in provider revenues, REDUCTIONS TO
LOCAL  SOCIAL  SERVICES  DISTRICT MEDICAL ASSISTANCE ADMINISTRATION, and
beginning April 1, 2012 the operational costs  of  the  New  York  state
medical indemnity fund.
  S 58.  Paragraph (b) of section 90 of part H of chapter 59 of the laws
of 2011, amending the public health law and other laws relating to types
of  appropriations exempt from certain reductions, is amended to read as
follows:
  (b) The  following  types  of  appropriations  shall  be  exempt  from
reductions pursuant to this section:
  (i)  any  reductions that would violate federal law including, but not
limited to, payments required pursuant to the federal Medicare program;
  (ii) any reductions related to payments pursuant to article 32,  arti-
cle 31 and article 16 of the mental hygiene law;
  (iii) payments the state is obligated to make pursuant to court orders
or judgments;
  (iv)  payments  for  which  the non-federal share does not reflect any
state funding; [and]

S. 6256--C                         24

  (v) at the discretion of the commissioner of health and  the  director
of  the  budget,  payments  with regard to which it is determined by the
commissioner of health and the director of the budget  that  application
of  reductions  pursuant  to  this section would result, by operation of
federal law, in a lower federal medical assistance percentage applicable
to such payments; AND
  (VI)  PAYMENTS  MADE  WITH  REGARD  TO  THE EARLY INTERVENTION PROGRAM
PURSUANT TO SECTION 2540 OF THE PUBLIC HEALTH LAW.
  S 59. Subparagraph (ii) of paragraph (a) of subdivision 5  of  section
2807-j  of the public health law, as amended by section 23 of part A3 of
chapter 62 of the laws of 2003, is amended to read as follows:
  (ii) An election shall remain in effect unless revoked in writing by a
specified third-party payor, which revocation shall be effective on  the
first  day of the next [calendar year quarter] MONTH, provided that such
payor has provided notice of its intention to so revoke at least  [thir-
ty] TWENTY days prior to the beginning of such [calendar quarter] MONTH.
  S 60. Intentionally omitted.
  S 61. Intentionally omitted.
  S 62.  The public health law is amended by adding a new section 2804-b
to read as follows:
  S  2804-B.  NEW  YORK  STATE  WORKGROUP  ON MEDICAID REIMBURSEMENT FOR
MEDICALLY FRAGILE CHILDREN. 1. THE  COMMISSIONER  SHALL,  WITHIN  THIRTY
DAYS  OF THE EFFECTIVE DATE OF THIS SECTION, CONVENE AND CHAIR, DIRECTLY
OR THROUGH A DESIGNEE OR DESIGNEES, A MEDICAID  REIMBURSEMENT  WORKGROUP
FOR  MEDICALLY FRAGILE CHILDREN TO EXAMINE, EVALUATE, AND PROVIDE RECOM-
MENDATIONS ON THE ADEQUACY AND VIABILITY OF MEDICAID REIMBURSEMENT RATES
TO  CERTAIN  PEDIATRIC  PROVIDERS  WHO  PROVIDE  CRITICAL  SERVICES  FOR
MEDICALLY FRAGILE CHILDREN.
  2.  SUCH  WORKGROUP  SHALL  BE  COMPRISED OF STAKEHOLDERS OF MEDICALLY
FRAGILE CHILDREN, INCLUDING PROVIDERS OF PEDIATRIC NURSING HOMES,  HOME-
CARE  AGENCIES  AFFILIATED  WITH PEDIATRIC NURSING HOMES, AND DIAGNOSTIC
AND TREATMENT CENTERS WHICH PRIMARILY SERVE MEDICALLY FRAGILE  CHILDREN,
AND  OTHER  EXPERTS CHOSEN BY THE COMMISSIONER. MEMBERS OF THE WORKGROUP
SHALL HAVE DEMONSTRATED KNOWLEDGE AND EXPERIENCE IN  PROVIDING  CARE  TO
MEDICALLY FRAGILE CHILDREN IN PEDIATRIC NURSING HOMES, HOMECARE AGENCIES
AFFILIATED  WITH  PEDIATRIC  NURSING HOMES, AND DIAGNOSTIC AND TREATMENT
CENTERS WHICH PRIMARILY  SERVE  MEDICALLY  FRAGILE  CHILDREN,  INCLUDING
PROVIDERS  WHO  PROVIDE  CARE  PRIMARILY TO THE MEDICAID POPULATION. THE
PRESENCE OF A MAJORITY OF THE MEMBERS SHALL CONSTITUTE A QUORUM. MEMBERS
SHALL RECEIVE NO COMPENSATION FOR THEIR SERVICES, BUT SHALL  BE  ALLOWED
ACTUAL AND NECESSARY EXPENSES IN THE PERFORMANCE OF THEIR DUTIES.
  3.  THE  WORKGROUP  SHALL  DEVELOP  AND  RECOMMEND CHANGES TO MEDICAID
REIMBURSEMENT RATES  FOR  PEDIATRIC  NURSING  HOMES,  HOMECARE  AGENCIES
AFFILIATED  WITH  PEDIATRIC  NURSING HOMES, AND DIAGNOSTIC AND TREATMENT
CENTERS PRIMARILY PROVIDING CARE TO MEDICALLY FRAGILE CHILDREN,  INCLUD-
ING BUT NOT LIMITED TO:
  (A)  THE  ADEQUACY  OF CURRENT AMBULATORY PATIENT GROUP (APG) RATES OF
REIMBURSEMENT FOR PEDIATRIC DIAGNOSTIC AND TREATMENT CENTERS THAT PRIMA-
RILY PROVIDE REHABILITATION AND  CARE  TO  MEDICALLY  FRAGILE  CHILDREN,
RECOMMENDING  MODIFICATIONS, WHERE APPROPRIATE, TO PROTECT THE VIABILITY
OF SUCH FACILITIES. SUCH  RECOMMENDATIONS  SHALL  INCLUDE,  BUT  NOT  BE
LIMITED  TO,  AN ANALYSIS OF WHETHER SUCH FACILITIES SHALL RECEIVE SEPA-
RATE AND DISTINCT APG BASE RATES, AND ANY OTHER MODIFICATIONS TO THE APG
METHODOLOGY TO ENSURE THAT SUCH RATES ADEQUATELY REIMBURSE THE  COST  OF
PROVIDING REHABILITATION AND CARE TO MEDICALLY FRAGILE CHILDREN;

S. 6256--C                         25

  (B)  THE  ADEQUACY  AND  APPROPRIATENESS  OF THE CURRENT REIMBURSEMENT
METHODOLOGY FOR PEDIATRIC NURSING HOMES, AND  HOMECARE  AGENCIES  AFFIL-
IATED  WITH  PEDIATRIC  NURSING HOMES, RECOMMENDING MODIFICATIONS, WHERE
APPROPRIATE, TO PROTECT THE VIABILITY OF SUCH FACILITIES. SUCH RECOMMEN-
DATIONS  SHALL  INCLUDE, BUT NOT BE LIMITED TO, THE DEVELOPMENT OF A NEW
PEDIATRIC NURSING HOME RATE, THE DEVELOPMENT OF NEW RATES  FOR  HOMECARE
AGENCIES AFFILIATED WITH PEDIATRIC NURSING HOMES, THE APPROPRIATE USE OF
CASE  MIX  ADJUSTMENTS  FOR THIS POPULATION, ANY ADDITIONAL SUPPLEMENTAL
ADJUSTMENTS THAT ARE DEEMED NECESSARY AND  APPROPRIATE,  AND  ANY  OTHER
REVISIONS  NECESSARY  TO ENSURE THAT SUCH RATES ADEQUATELY REIMBURSE THE
COST OF PROVIDING REHABILITATION AND CARE TO MEDICALLY FRAGILE CHILDREN;
  (C) THE MEDICAID MANAGED CARE PREMIUM METHODOLOGY TO  PEDIATRIC  DIAG-
NOSTIC AND TREATMENT CENTERS PRIMARILY PROVIDING REHABILITATION AND CARE
TO  MEDICALLY  FRAGILE  CHILDREN,  AND  WHETHER SUCH PLAN PREMIUMS SHALL
INCLUDE AN ADD-ON TO  REFLECT  THE  AMBULATORY  PATIENT  GROUP  RATE  OF
REIMBURSEMENT;
  (D)  THE TRANSITION OF THE PEDIATRIC NURSING HOME POPULATION AND BENE-
FIT INTO MEDICAID MANAGED CARE, INCLUDING HOMECARE  AGENCIES  AFFILIATED
WITH  PEDIATRIC  NURSING  HOMES,  AND  WHETHER  SUCH  A TRANSITION WOULD
PROVIDE ADEQUATE REIMBURSEMENT TO SUCH FACILITIES  TAKING  INTO  ACCOUNT
THE  COST  OF PROVIDING CARE TO MEDICALLY FRAGILE CHILDREN NECESSARY AND
APPROPRIATE TO MEET THEIR NURSING AND RELATED  CARE  NEEDS  AS  WELL  AS
THEIR  DEVELOPMENTAL NEEDS. SUCH ANALYSIS SHALL ALSO INCLUDE AN EXAMINA-
TION OF THE DEPARTMENT'S CASE MIX INDEX (CMI) AND CONSIDERATION  OF  THE
DEVELOPMENT  OF  A NEW OR MODIFIED CMI THAT ADEQUATELY CAPTURES THE COST
OF PROVIDING CARE TO MEDICALLY FRAGILE CHILDREN;
  (E) THE EVALUATION OF ALTERNATIVES TO MAINSTREAM MEDICAID MANAGED CARE
FOR MEDICALLY FRAGILE CHILDREN RESIDING IN PEDIATRIC NURSING  HOMES  AND
PEDIATRIC  DIAGNOSTIC  AND TREATMENT CENTERS PRIMARILY SERVING MEDICALLY
FRAGILE CHILDREN, OR SERVED BY HOMECARE AGENCIES AFFILIATED WITH  PEDIA-
TRIC NURSING HOMES, INCLUDING THE DEVELOPMENT OF DEMONSTRATION PROJECTS,
TO  TEST ALTERNATIVE PAYMENT AND CARE MANAGEMENT MODELS FOR THIS COMPLEX
PATIENT POPULATION.  SUCH  EVALUATION  SHALL  INCLUDE  CONSIDERATION  OF
WHETHER  PEDIATRIC  NURSING  HOMES AND/OR PEDIATRIC SPECIALTY DIAGNOSTIC
AND TREATMENT CENTERS SHALL REMAIN IN FEE-FOR-SERVICE MEDICAID;
  (F) THE EXAMINATION OF PROVIDING RETROACTIVE, TEMPORARY,  OR  PROSPEC-
TIVE  RATE  RELIEF TO PROVIDERS WITH DEMONSTRATED FINANCIAL HARDSHIP WHO
EXCLUSIVELY PROVIDE CARE TO MEDICALLY FRAGILE CHILDREN;
  (G) A COST-BENEFIT ANALYSIS, INCLUDING BUT NOT LIMITED  TO,  EXAMINING
HOW  SUCH  SERVICES  PROVIDED  TO  MEDICALLY FRAGILE CHILDREN IN NURSING
HOMES, HOMECARE AGENCIES AFFILIATED WITH PEDIATRIC  NURSING  HOMES,  AND
PEDIATRIC  DIAGNOSTIC  AND TREATMENT CENTERS ARE COST EFFECTIVE COMPARED
TO OTHER ALTERNATIVES OF CARE SUCH AS ACUTE CARE SETTINGS;
  (H) CONSIDERATION OF  THE  MEASURES  NEEDED  TO  MAINTAIN  FINANCIALLY
VIABLE  PEDIATRIC PROVIDERS IN THE STATE SUFFICIENT TO MEET THE NEEDS OF
THE STATE'S MEDIALLY FRAGILE CHILDREN; AND
  (I) ANY OTHER AREAS DEEMED APPROPRIATE BY THE COMMISSIONER OR  MEMBERS
OF THE WORKGROUP.
  4.  PRIOR TO JANUARY FIRST, TWO THOUSAND THIRTEEN, THE WORKGROUP SHALL
PRESENT ITS FINDINGS AND RECOMMENDATIONS IN A REPORT, AND SHALL  PROVIDE
SUCH  REPORT  TO  THE  COMMISSIONER  OF  HEALTH, THE CHAIR OF THE SENATE
FINANCE COMMITTEE, THE CHAIR OF THE ASSEMBLY WAYS AND  MEANS  COMMITTEE,
THE  CHAIR  OF THE SENATE HEALTH COMMITTEE AND THE CHAIR OF THE ASSEMBLY
HEALTH COMMITTEE.
  5. NOTWITHSTANDING ANY OTHER LAW TO THE CONTRARY, SERVICES PROVIDED TO
MEDICALLY FRAGILE CHILDREN RESIDING IN PEDIATRIC NURSING HOMES,  RECEIV-

S. 6256--C                         26

ING  SERVICES  AT  HOMECARE  AGENCIES  AFFILIATED WITH PEDIATRIC NURSING
HOMES, OR RECEIVING SERVICES AT PEDIATRIC REHABILITATION DIAGNOSTIC  AND
TREATMENT  CENTERS LICENSED PURSUANT TO THIS ARTICLE SHALL BE REIMBURSED
AT  A  FEE-FOR-SERVICE  MEDICAID  RATE  DURING THE DELIBERATIONS OF THIS
WORKGROUP AND UNTIL SUCH REPORT IS  FINALIZED  AND  DISTRIBUTED  TO  THE
COMMISSIONER  OF  HEALTH, THE CHAIR OF THE SENATE FINANCE COMMITTEE, THE
CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE, THE CHAIR OF THE  SENATE
HEALTH  COMMITTEE  AND  THE  CHAIR OF THE ASSEMBLY HEALTH COMMITTEE. ANY
CHANGE IN REIMBURSEMENT  METHODOLOGY  NECESSARY  AS  A  RESULT  OF  THIS
PROVISION  SHALL  BE IMPLEMENTED BY THE DEPARTMENT WITHIN THIRTY DAYS OF
THE EFFECTIVE DATE OF THIS SECTION. FINDINGS AND RECOMMENDATIONS IN  THE
WORKGROUP'S  REPORT SHALL BE APPROVED, REVISED OR REJECTED BY THE LEGIS-
LATURE PRIOR TO THE ADOPTION OF AN ALTERNATIVE  REIMBURSEMENT  METHODOL-
OGY.
  S 63. The public health law is amended by adding a new section 3621 to
read as follows:
  S  3621. MEDICAL ASSISTANCE RECOUPMENTS AND REDUCTIONS.  NOTWITHSTAND-
ING ANY OTHER PROVISION OF LAW TO  THE  CONTRARY,  ON  AND  AFTER  APRIL
FIRST,  TWO  THOUSAND  NINE,  ANY  RECOUPMENTS  OR REDUCTIONS IN MEDICAL
ASSISTANCE PAYMENTS FOR LICENSED HOME CARE SERVICES AGENCIES AND  CERTI-
FIED  HOME  HEALTH  AGENCIES LICENSED PURSUANT TO THIS ARTICLE OR FISCAL
INTERMEDIARIES OPERATING PURSUANT TO SECTION THREE HUNDRED  SIXTY-FIVE-F
OF THE SOCIAL SERVICES LAW SHALL NOT BE SUBJECT TO INTEREST AND ANY SUCH
RECOUPMENTS  OR REDUCTIONS IN MEDICAL ASSISTANCE PAYMENTS SHALL BE PAYA-
BLE IN EQUITABLE MONTHLY AMOUNTS OVER TWO  YEARS  ON  OR  AFTER  JANUARY
FIRST,  TWO  THOUSAND TWELVE UNLESS AN INCREASED PAYMENT IS REQUESTED BY
AN AGENCY.
  S 64. Subdivision 2-a of section 2807 of  the  public  health  law  is
amended by adding a new paragraph (j) to read as follows:
  (J)  NOTWITHSTANDING  ANY  OTHER  PROVISION OF THIS SUBDIVISION OR ANY
OTHER PROVISION OF LAW TO THE CONTRARY, ON AND AFTER  APRIL  FIRST,  TWO
THOUSAND  TWELVE,  RATES  OF PAYMENT FOR DIAGNOSTIC AND TREATMENT CENTER
SERVICES, EMERGENCY  SERVICES,  GENERAL  HOSPITAL  OUTPATIENT  SERVICES,
AMBULATORY  SURGICAL SERVICES AND REFERRED AMBULATORY SERVICES, PROVIDED
BY A RURAL HOSPITAL DESIGNATED AS A CRITICAL ACCESS HOSPITAL IN  ACCORD-
ANCE  WITH TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT SHALL BE EQUAL
TO ONE HUNDRED ONE PERCENT OF THE REASONABLE  COSTS  OF  A  FACILITY  IN
PROVIDING  SUCH  SERVICES  TO  PATIENTS  ELIGIBLE  FOR  PAYMENTS MADE IN
ACCORDANCE WITH THIS SUBDIVISION. REASONABLE COSTS SHALL  BE  DETERMINED
IN  A  MANNER  CONSISTENT WITH THAT USED TO DETERMINE PAYMENT FOR OUTPA-
TIENT CRITICAL ACCESS HOSPITAL SERVICES  PROVIDED  TO  BENEFICIARIES  OF
TITLE  XVIII  OF THE FEDERAL SOCIAL SECURITY ACT. FOR FACILITIES WITHOUT
ADEQUATE COST EXPERIENCE, SUCH RATES SHALL BE BASED  ON  BUDGETED  COSTS
SUBSEQUENTLY  ADJUSTED  TO  ONE HUNDRED ONE PERCENT OF REASONABLE ACTUAL
COSTS.
  S 65. Subdivision 6 of section 2818 of the public health law, as added
by section 25-a of part A of chapter 59 of the laws of 2011, is  amended
to read as follows:
  6.  Notwithstanding  any  contrary provision of this section, sections
one hundred twelve and one hundred sixty-three of the state finance law,
or any other contrary provision of law, subject to  available  appropri-
ations,  funds available for expenditure pursuant to this section may be
distributed by the commissioner without a competitive bid or request for
proposal process for grants to general hospitals and residential  health
care  facilities  for  the purpose of facilitating closures, mergers and
restructuring of such facilities in  order  to  strengthen  and  protect

S. 6256--C                         27

continued  access  to essential health care resources. PROVIDED HOWEVER,
THAT TO THE EXTENT PRACTICABLE, THE COMMISSIONER SHALL  DISTRIBUTE  SUCH
FUNDS  EQUITABLY  AMONG  ECONOMIC  REGIONS  OF THE STATE CONSISTENT WITH
SECTION  TWO  HUNDRED THIRTY-ONE OF THE ECONOMIC DEVELOPMENT LAW, EXCEPT
THAT NOT MORE THAN FIFTY PERCENT OF SUCH FUNDS SHALL BE DISTRIBUTED TO A
PARTICULAR REGION. Prior to an  [awarded]  AWARD  being  granted  to  an
eligible  applicant  without  a  competitive bid or request for proposal
process, the commissioner shall notify the chair of the  senate  finance
committee,  the  chair  of the assembly ways and means committee and the
director of the division of budget of the intent to grant such an award.
Such notice shall include information regarding how the eligible  appli-
cant meets criteria established pursuant to this section.
  S 66. Intentionally omitted.
  S 67. The director of the budget, in consultation with the commission-
er  of  health, shall establish a method for shared savings to be appor-
tioned among payors and providers and shall make recommendations to  the
governor  and the senate majority leader and the speaker of the assembly
for inclusion in the 2013-14 Executive Budget  on  such  shared  savings
method,  as  well as recommendations on modifications or continuation of
sections 91 and 92 of part H of chapter 59 of the laws of 2011.
  S 68. Intentionally omitted.
  S 69. 1. Findings. The legislature finds that across the United States
long term acute care hospitals (LTACs) successfully provide  acute  care
on  a  long-term basis to clinically complex patients. Such patients are
typically frail seniors with multiple medical conditions, who require  a
level  of long-term, intensive monitoring that is not available in other
long term care options. It is estimated that approximately  1%  of  non-
pediatric/maternal  hospital discharges are eligible for placement in an
LTAC, meaning that there is an unmet need in New York state for slightly
over 2000 LTAC beds to treat eligible patients. Nationwide, New York  is
one of only a handful of states that do not currently recognize the LTAC
model,  notwithstanding  the  fact that the federal Centers for Medicare
and Medicaid Services (CMS), recognizing the need to encourage this type
of care, provide an enhanced Medicare rate for LTACs.
  The legislature further finds that, in the interest of  ensuring  that
the  sort  of  clinically  complex  patients served by LTACs receive the
services most appropriate to their needs, it is useful  and  appropriate
to  undertake  a  comprehensive study of the appropriateness of formally
recognizing and encouraging the establishment of LTAC hospitals  in  New
York state.
  2.  Study.  The commissioner of health is hereby required to study and
make recommendations concerning the establishment of LTAC  hospitals  in
New  York state. Such study shall include an evaluation of and recommen-
dations concerning:
  (a) The distinctions  between  LTAC  services  as  offered  in  states
formally  recognizing  the  LTAC model and services currently offered in
New York state;
  (b) The number of patients who would be eligible for LTAC services  in
New  York state should the LTAC model be established here, the nature of
the services currently being accessed by those patients, the sources  of
payment  for  the services   currently being accessed by those patients,
and the potential improvement in patient outcomes in the event  of  LTAC
establishment;
  (c) The relative quality of providers currently offering LTAC services
in other states;

S. 6256--C                         28

  (d) The legal, financial and other impediments to the establishment of
services of similar quality in New York state;
  (e)  The  potential impact of LTAC establishment on hospital occupancy
and average length of stay in New York state;
  (f) the potential impact of LTAC establishment on nursing  home  occu-
pancy;
  (g)  The fiscal implications of the establishment of LTAC services for
both the state and for existing hospitals and  other  providers  in  New
York  state,  taking  into  account  potential  reductions in the losses
currently attributable to unreimbursed patient days  and  reductions  in
occupancy and average length of stay; and
  (h)  The overall appropriateness of formally recognizing and encourag-
ing the establishment of LTAC hospitals in New York state.
  3. Report. The commissioner of health shall publicly  issue  a  report
reflecting  such  evaluations and recommendations no later than the date
that is six months from the effective date of this act.
  S 70. Section 31.08 of the mental hygiene law, as added by section  55
of  part  H  of  chapter  59  of the laws of 2011, is amended to read as
follows:
S 31.08 Compliance with operational standards by hospitals.
  (a) Notwithstanding the provisions of section 31.07 of  this  article,
with  respect to a [hospital as defined in section 1.03 of this chapter,
which is a] ward, wing, unit, or other part of a hospital, as defined in
article twenty-eight of the public health law, which provides  INPATIENT
SERVICES,  OUTPATIENT  services, OR BOTH for persons with mental illness
pursuant to an operating certificate issued  by  the  commissioner,  the
requirements of section 31.07 of this article may be deemed to be met if
such  hospital has been accredited by The Joint Commission, or any other
hospital accrediting organization to which the Centers for Medicare  and
Medicaid Services has granted deeming status, and which the commissioner
shall have determined has accrediting standards sufficient to assure the
commissioner  that  hospitals  so  accredited are in compliance with the
provisions of this chapter and applicable laws, rules and regulations in
regard to services provided at such wing, ward, unit or other part of  a
hospital.  Such  accreditation  shall  have  the  same legal effect as a
determination by the commissioner under section 31.07  of  this  article
that the hospital is in compliance with such provisions. The commission-
er  may  exempt any such hospital from the annual inspection and visita-
tion requirements established in section 31.07 of this article, provided
that:
  1. such hospital has a history of compliance with such  provisions  of
law,  rules and regulations and a record of providing good quality care,
as determined by the commissioner;
  2. a copy of the survey report and the certificate of accreditation of
The Joint Commission  or  other  approved  accrediting  organization  is
submitted  by  the accrediting body or the hospital to the commissioner,
within seven days of issuance to the hospital;
  3. The Joint Commission or other accrediting organization  has  agreed
to  and  does evaluate, as part of its accreditation survey, any minimal
operational standards established by the commissioner which are in addi-
tion to the minimal operational standards of accreditation of The  Joint
Commission or other accrediting organization; and
  4.  there are no constraints placed upon access by the commissioner to
The Joint Commission or other approved accrediting  organization  survey
reports,  plans  of correction, interim self-evaluation reports, notices
of noncompliance, progress reports on correction of areas of  noncompli-

S. 6256--C                         29

ance, or any other related reports, information, communications or mate-
rials regarding such hospital.
  (b)  Any  hospital  AS  DEFINED  IN ARTICLE TWENTY-EIGHT OF THE PUBLIC
HEALTH LAW, WHICH IS governed by the provisions of  subdivision  (a)  of
this  section  shall at all times be subject to inspection or visitation
by the commissioner to determine compliance with applicable  law,  regu-
lations,  standards or conditions as deemed necessary by the commission-
er. Any such hospital shall be subject to the full  range  of  licensing
enforcement authority of the commissioner.
  (c)  Any  hospital  AS  DEFINED  IN ARTICLE TWENTY-EIGHT OF THE PUBLIC
HEALTH LAW, WHICH IS governed by the provisions of  subdivision  (a)  of
this  section  shall notify the commissioner immediately upon receipt of
notice by The Joint Commission or other approved  accrediting  organiza-
tion,  or any communication the hospital may receive that such organiza-
tion will be recommending that such hospital not be accredited, not have
its accreditation renewed, or have its accreditation terminated, or upon
receipt of notice or other communication from the Centers  for  Medicare
and  Medicaid  Services regarding a determination that the hospital will
be terminated from participation in the Medicare program because  it  is
not  in  compliance with one or more conditions of participation in such
program, or has deficiencies that either individually or in  combination
jeopardize the health and safety of patients or are of such character as
to seriously limit the provider's capacity to render adequate care.
  S  71. Section 32.14 of the mental hygiene law, as added by section 56
of part H of chapter 59 of the laws of  2011,  is  amended  to  read  as
follows:
S 32.14 Compliance  with  operational  standards by CERTAIN providers of
          services [in hospitals].
  (a) Notwithstanding the provisions of section 32.13 of  this  article,
with  respect  to  a  provider of services as defined in section 1.03 of
this chapter that occupies a ward, wing, unit, or other part of a hospi-
tal, as defined in article twenty-eight of the public health law,  which
provides  INPATIENT  SERVICES,  OUTPATIENT  services OR BOTH for persons
with mental disabilities pursuant to an operating certificate issued  by
the  commissioner, the requirements of section 32.13 of this article may
be deemed to be met if such hospital has been accredited  by  The  Joint
Commission,  or  any other accrediting organization to which the Centers
for Medicare and Medicaid Services has granted deeming status, and which
the commissioner shall have determined has accrediting standards  suffi-
cient  to assure the commissioner that providers of services occupying a
ward, wing, unit or other part of such hospital  so  accredited  are  in
compliance  with  the  provisions  of  this chapter and applicable laws,
rules and regulations in regard to services provided at such ward, wing,
unit or other part of a hospital. Such accreditation shall have the same
legal effect as a determination by the commissioner under section  32.13
of this article that the provider of services is in compliance with such
provisions.  The  commissioner may exempt any such provider of services,
in regard to services provided at such ward, wing, unit or other part of
a hospital, from  the  annual  inspection  and  visitation  requirements
established in section 32.13 of this article, provided that:
  1.  such  provider  of  services has a history of compliance with such
provisions of law, rules and regulations and a record of providing  good
quality care, as determined by the commissioner;
  2. a copy of the survey report and the certificate of accreditation of
The  Joint  Commission  or  other  approved  accrediting organization is
submitted by the accrediting body or the provider  of  services  to  the

S. 6256--C                         30

commissioner,  within  seven  days  of  issuance  to  such  provider  of
services;
  3. The Joint Commission or other approved accrediting organization has
agreed  to  and  does evaluate, as part of its accreditation survey, any
minimal operational standards established by the commissioner which  are
in addition to the minimal operational standards of accreditation of The
Joint Commission or other accrediting organization; and
  4.  there are no constraints placed upon access by the commissioner to
The Joint Commission or other approved accrediting  organization  survey
reports,  plans  of correction, interim self-evaluation reports, notices
of noncompliance, progress reports on correction of areas of  noncompli-
ance, or any other related reports, information, communications or mate-
rials regarding such provider of services.
  (b) Any provider of services governed by the provisions of subdivision
(a) of this section shall at all times be subject to inspection or visi-
tation  by the commissioner to determine compliance with applicable law,
regulations, standards or conditions as deemed necessary by the  commis-
sioner. Any such provider of services shall be subject to the full range
of certification enforcement authority of the commissioner.
  (c) Any provider of services governed by the provisions of subdivision
(a)  of  this  section  shall  notify  the commissioner immediately upon
receipt of notice by The Joint Commission or other approved  accrediting
organization,  or any communication the provider of services may receive
that such organization  will  be  recommending  that  such  provider  of
services  not be accredited, not have its accreditation renewed, or have
its accreditation terminated, or upon receipt of notice or other  commu-
nication from the Centers for Medicare and Medicaid Services regarding a
determination  that  the  provider  of  services will be terminated from
participation in the Medicare or Medicaid program because it is  not  in
compliance with one or more conditions of participation in such program,
or  has deficiencies that either individually or in combination jeopard-
ize the health and safety of patients or are of  such  character  as  to
seriously limit the provider's capacity to render adequate care.
  S  72.  Subdivisions  2 of section 2807-g of the public health law, as
added by chapter 1 of the laws of 1999, is amended to read as follows:
  2. Grants shall be made on a competitive basis by region,  in  accord-
ance  with  the  amount raised in the region, PROVIDED THAT NO LESS THAN
TWO AND ONE-HALF PERCENT OF  THE  TOTAL  FUNDS  MADE  AVAILABLE  IN  ANY
REQUEST FOR PROPOSALS, SHALL BE MADE AVAILABLE IN ANY REGION, with pref-
erence  within  regions  given  to areas and eligible organizations that
have experienced or are likely to experience job loss because of changes
in the health care system. If, at the conclusion of the regional compet-
itive contract award process, there are excess  funds  available  within
any  regional  allocation,  such funds shall be redistributed to regions
where there is a shortage of funds available for programs  which  other-
wise qualify for funding pursuant to this section. IF, A GRANT RECIPIENT
HAS  RECEIVED GRANT AWARDS FOR THE SAME WORKFORCE RETRAINING PROJECT, IN
MULTIPLE REGIONS, SUCH GRANT RECIPIENT, WITH THE APPROVAL OF THE COMMIS-
SIONER, MAY REDISTRIBUTE FUNDS AMONG SAID REGIONS.
  S 73. Section 364-j of the social services law is amended by adding  a
new subdivision 25 to read as follows:
  25.  NOTWITHSTANDING  ANY  OTHER  PROVISION  OF  LAW  TO THE CONTRARY,
MANAGED CARE PROVIDERS  SHALL  COVER  MEDICALLY  NECESSARY  PRESCRIPTION
DRUGS,  INCLUDING  PREFERRED NON-FORMULARY DRUGS, UPON THE DEMONSTRATION
BY THE PRESCRIBER, AFTER CONSULTING WITH THE MANAGED CARE PROVIDER, THAT

S. 6256--C                         31

SUCH  DRUGS,  IN  HIS  OR  HER  REASONABLE  PROFESSIONAL  JUDGMENT,  ARE
MEDICALLY NECESSARY AND WARRANTED.
  S  74.  Paragraph  (c) of subdivision 6 of section 367-a of the social
services law, as amended by chapter 41 of the laws of 1992,  is  amended
by adding a new subparagraph (iv) to read as follows:
  (IV)  THE  CO-PAYMENT FOR EMERGENCY ROOM SERVICES PROVIDED FOR NON-UR-
GENT OR NON-EMERGENCY MEDICAL CARE SHALL BE SIX DOLLARS AND FORTY CENTS;
PROVIDED HOWEVER THAT CO-PAYMENTS PURSUANT TO  THIS  SUBPARAGRAPH  SHALL
NOT  BE  REQUIRED  WITH RESPECT TO EMERGENCY SERVICES OR FAMILY PLANNING
SERVICES AND SUPPLIES.
  S 74-a. Paragraph (c) of subdivision 6 of section 367-a of the  social
services law, as added by chapter 165 of the laws of 1991, is amended to
read as follows:
  (c)  (I)  Co-payments  charged  pursuant to this subdivision shall not
exceed the following table:

    State's payment                  Maximum copayment
    for the services               chargeable to recipient
      $10 or less                           $.50
      $10.01 to $25                        $1.00
      $25.01 to $50                        $2.00
      $50.01 or more                       $3.00

  (II) THE CO-PAYMENT FOR EMERGENCY ROOM SERVICES PROVIDED  FOR  NON-UR-
GENT OR NON-EMERGENCY MEDICAL CARE SHALL BE SIX DOLLARS AND FORTY CENTS;
PROVIDED  HOWEVER  THAT  CO-PAYMENTS PURSUANT TO THIS SUBPARAGRAPH SHALL
NOT BE REQUIRED WITH RESPECT TO EMERGENCY SERVICES  OR  FAMILY  PLANNING
SERVICES AND SUPPLIES.
  S  75.  Section 2801-a of the public health law is amended by adding a
new subdivision 17 to read as follows:
  17. (A) THE COMMISSIONER SHALL ESTABLISH  UP  TO  SEVEN  DEMONSTRATION
PROJECTS  TO  DEVELOP,  EVALUATE  AND  IMPLEMENT  A FLEXIBLE APPROACH TO
ALLOWING EQUITY INVESTORS TO INVEST IN AND HOLD AN  EQUITY  INTEREST  AS
OPERATORS  OF  HEALTH CARE FACILITIES. EACH DEMONSTRATION IS DESIGNED TO
PROMOTE THE DEVELOPMENT OF NEW SOURCES OF CAPITAL FOR THE  OPERATION  OF
THE RESPECTIVE HEALTH CARE FACILITIES AND TO EVALUATE THE IMPACT PRIVATE
EQUITY INVESTMENT HAS ON THE QUALITY OF CARE.
  (B)  FOR  PURPOSES  OF  RESIDENTIAL  HEALTH  CARE  DEMONSTRATIONS, THE
COMMISSIONER MAY  APPROVE  DEMONSTRATION  PROJECTS  EACH  INVOLVING  THE
PURCHASE  OF  BETWEEN  EIGHT AND TWELVE EXISTING RESIDENTIAL HEALTH CARE
FACILITIES WHICH HAVE HISTORIES OF PROVIDING HIGH QUALITY CARE TO  RESI-
DENTS. SUCH DEMONSTRATION PROJECTS SHALL BE LOCATED IN DIFFERENT REGIONS
OF  THE  STATE.  EACH OF THE RESIDENTIAL HEALTH CARE FACILITIES WITHIN A
DEMONSTRATION PROJECT SHALL BE OWNED BY A COMMON GROUP OF OPERATING  AND
EQUITY   INVESTOR   INTERESTS.   PROPOSED  RESIDENTIAL  HEALTH  FACILITY
PURCHASES THAT HAVE NOT  CLOSED  PRIOR  TO  APRIL  FIRST,  TWO  THOUSAND
TWELVE,  ARE  ELIGIBLE FOR INCLUSION IN THE DEMONSTRATION PROGRAM FOR UP
TO TWELVE RESIDENTIAL HEALTH CARE FACILITIES IN EACH PROJECT.
  (C) AN EQUITY INVESTOR SHALL PARTICIPATE IN EACH FACILITY THROUGH  THE
CREATION  OF  LIMITED  LIABILITY  COMPANIES WHICH WILL BE ESTABLISHED TO
OPERATE THE RESIDENTIAL OR HOSPITAL HEALTH CARE FACILITIES.
  (D) THE HEALTH CARE FACILITIES MAY BE OPERATED  BY  LIMITED  LIABILITY
COMPANIES  FORMED  UNDER  THE  LAWS  OF  NEW  YORK WHOSE MEMBERS ARE NOT
NATURAL PERSONS PROVIDED THAT  AT  LEAST  ONE  MEMBER  OF  SUCH  LIMITED
LIABILITIES  COMPANIES  IS A NATURAL PERSON OF SUFFICIENT EXPERIENCE AND
EXPERTISE IN DELIVERING HIGH QUALITY HEALTH CARE, OR NURSING  OR  HEALTH

S. 6256--C                         32

RELATED  CARE PROVIDED THAT THE EQUITY INVESTOR DELEGATES, TO THE SATIS-
FACTION OF THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL, RESPONSIBILITY
FOR THE DAY TO DAY MANAGEMENT AND OPERATION OF THE FACILITY.
  (E) THE PROVISIONS OF PARAGRAPH (B) OF SUBDIVISION THREE AND PARAGRAPH
(C)  OF  SUBDIVISION  FOUR OF THIS SECTION SHALL NOT APPLY TO THE EQUITY
INVESTOR OR ITS OWNERS PROVIDED THE PUBLIC HEALTH  AND  HEALTH  PLANNING
COUNCIL  MAY  REQUIRE COMMERCIALLY REASONABLE DISCLOSURE OF THE IDENTITY
OF THE LIMITED LIABILITY MEMBERS. COMMERCIALLY REASONABLE SHALL NOT MEAN
THE  DISCLOSURE  OF  EACH  INVESTOR  IF  THE  NUMBER  IS  GREATER   THAN
THIRTY-FIVE.
  (F)  THE  PROVISIONS  OF PARAGRAPHS (E) AND (F) OF SUBDIVISION FOUR OF
THIS SECTION SHALL NOT APPLY TO RESIDENTIAL HEALTH  FACILITIES  OPERATED
PURSUANT  TO  THIS  SUBDIVISION OR TO HEALTH FACILITIES PURSUANT TO THIS
CHAPTER. NOTHING IN THIS SECTION  SHALL  PROHIBIT  A  LIMITED  LIABILITY
COMPANY  FROM  BEING  THE SOLE MEMBER OF THE LIMITED LIABILITY COMPANIES
REFERRED TO IN PARAGRAPHS (C) AND (D) OF THIS SUBDIVISION  PROVIDED  THE
FORMER LIMITED LIABILITY COMPANY OR AT LEAST ONE OF ITS MEMBERS CONFORMS
TO THE REQUIREMENTS OF THOSE PARAGRAPHS.
  (G)  HEALTH  CARE  FACILITIES  AND  RESIDENTIAL HEALTH CARE FACILITIES
PARTICIPATING IN THIS DEMONSTRATION PROGRAM  SHALL  BE  SUBJECT  TO  ALL
OPERATING  STANDARDS  AS  SET  FORTH IN THIS CHAPTER AND THE REGULATIONS
PROMULGATED HEREUNDER AND SHALL BE SUBJECT TO  ANY  PROVISIONS  OF  THIS
CHAPTER FOR FAILURE TO COMPLY WITH SUCH STANDARDS.
  (H)  NO LATER THAN TWO YEARS AFTER THE FIRST FACILITY COMMENCES OPERA-
TION UNDER THIS DEMONSTRATION PROGRAM, THE  COMMISSIONER  SHALL  PROVIDE
THE  GOVERNOR,  THE MAJORITY LEADER OF THE SENATE AND THE SPEAKER OF THE
ASSEMBLY WITH A WRITTEN EVALUATION OF THE DEMONSTRATION  PROGRAMS.  SUCH
EVALUATION  SHALL  ADDRESS  THE  OVERALL EFFECTIVENESS OF THE PROGRAM IN
PROVIDING ACCESS TO CAPITAL INVESTMENT BY RESIDENTIAL HEALTH CARE FACIL-
ITIES AND EVALUATE THE IMPACT PRIVATE EQUITY INVESTMENT HAS ON THE QUAL-
ITY OF CARE AS EVIDENCED BY STAFF RETENTION AND QUALITY INDICATORS.
  (I) HEALTH CARE FACILITIES PARTICIPATING IN THIS DEMONSTRATION PROGRAM
SHALL SUBMIT IN ADDITION TO WHAT IS OTHERWISE REQUIRED BY  THIS  CHAPTER
QUALITY REPORTS AS REQUIRED AND DIRECTED BY THE COMMISSIONER.
  S  76.    Subdivision 8 of section 4403-f of the public health law, as
amended by section 21 of part C of chapter 58 of the laws  of  2007,  is
amended to read as follows:
  8.  Payment  rates  for managed long term care plan enrollees eligible
for medical assistance. The commissioner shall establish  payment  rates
for  services  provided  to  enrollees  eligible  under title XIX of the
federal social security act. Such payment  rates  shall  be  subject  to
approval by the director of the division of the budget and shall reflect
savings to both state and local governments when compared to costs which
would  be incurred by such program if enrollees were to receive compara-
ble health and long term care services on a fee-for-service basis in the
geographic region in which such services are proposed  to  be  provided,
HOWEVER, THAT ON OR AFTER APRIL FIRST, TWO THOUSAND TWELVE, SUCH PAYMENT
RATES SHALL EXCLUDE THE CAPITAL COST COMPONENT OF NURSING HOME AND ADULT
DAY  HEALTH CARE RATES, WHICH SHALL NOT BE THE RESPONSIBILITY OF MANAGED
LONG TERM CARE PLANS BUT SHALL CONTINUE TO  BE  REIMBURSED  DIRECTLY  TO
SUCH  NURSING HOME AND ADULT DAY HEALTH CARE PROVIDERS ON A FEE-FOR-SER-
VICE BASIS UNDER THE  PREVAILING  REIMBURSEMENT  METHODOLOGIES.  Payment
rates shall be risk-adjusted to take into account the characteristics of
enrollees, or proposed enrollees, including, but not limited to:  frail-
ty,  disability  level,  health  and functional status, age, gender, the
nature of services provided to such  enrollees,  and  other  factors  as

S. 6256--C                         33

determined  by  the commissioner. The risk adjusted premiums may also be
combined with disincentives or requirements  designed  to  mitigate  any
incentives to obtain higher payment categories.
  S  76-a. Section 364-j of the social services law is amended by adding
a new subdivision 10-b to read as follows:
  10-B. FOR MANAGED CARE PROVIDERS WITH NEGOTIATED RATES OF PAYMENT  FOR
NURSING  HOME  AND/OR  ADULT DAY HEALTH CARE SERVICES UNDER CONTRACTS IN
EFFECT ON OR AFTER APRIL FIRST, TWO THOUSAND TWELVE, SUCH PAYMENT  RATES
SHALL  EXCLUDE  THE CAPITAL COST COMPONENT OF NURSING HOME AND ADULT DAY
HEALTH CARE RATES, WHICH SHALL NOT BE THE RESPONSIBILITY OF MANAGED CARE
PROVIDERS BUT SHALL CONTINUE TO BE REIMBURSED DIRECTLY TO  SUCH  NURSING
HOME  AND  ADULT  DAY  HEALTH  CARE PROVIDERS ON A FEE-FOR SERVICE BASIS
UNDER THE PREVAILING REIMBURSEMENT METHODOLOGIES.
  S 77.   Notwithstanding any inconsistent provision  of  law,  rule  or
regulation,  for  purposes  of implementing the provisions of the public
health law and the social services law, references to titles XIX and XXI
of the federal social security act in the  public  health  law  and  the
social  services  law  shall  be  deemed to include and also to mean any
successor titles thereto under the federal social security act.
  S 78. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988,  and
18  NYCRR  505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended  and  without
force or effect for purposes of implementing the provisions of this act.
  S 79.  Severability clause. If any clause, sentence, paragraph, subdi-
vision,  section  or  part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation  to  the  clause, sentence, paragraph, subdivision, section or
part thereof directly involved in the controversy in which such judgment
shall have been rendered. It is hereby declared to be the intent of  the
legislature  that  this act would have been enacted even if such invalid
provisions had not been included herein.
  S 80. This act shall take effect immediately, and shall be  deemed  to
have been in full force and effect on and after April 1, 2012, provided,
however, that:
  (a)  the  amendments  to  section 1 of chapter 119 of the laws of 1997
made by section thirty-two of this  act,  relating  to  authorizing  the
department of health to establish certain payments to general hospitals,
shall  be  subject to the expiration of such chapter and shall be deemed
expired therewith;
  (b) provided, further that the amendments to  section  4403-c  of  the
public health law made by section eight of this act, shall be subject to
the repeal of such section and shall be deemed repealed therewith;
  (c)  the  amendments  to  paragraph  (a-1) of subdivision 4 of section
365-a of the social services law made by section thirty-nine of this act
shall not affect the expiration and  reversion  of  such  paragraph  and
shall be deemed to expire therewith;
  (c-1)  provided,  further,  that  section  forty-one of this act shall
expire and be deemed repealed March 31, 2014;
  (d) provided, further, that the amendments to section  2807-j  of  the
public  health  law  made by sections forty-three, forty-eight-a, forty-
eight-b and fifty-nine of this act shall not affect  the  expiration  of
such section and shall be deemed to expire therewith;

S. 6256--C                         34

  (e)  provided,  further,  that the amendments to section 2807-t of the
public health law made by section  forty-four  of  this  act  shall  not
affect  the  expiration  of  such  section and shall be deemed to expire
therewith;
  (e-1)  provided further that the amendments to paragraph (a) of subdi-
vision 25 of section 1678 of the public authorities law made by  section
twenty-eight-a  of  this  act  shall  not  affect the expiration of such
subdivision and shall be deemed to expire therewith;
  (f) provided, further, that the amendments to section  4403-f  of  the
public  health  law,  made  by  section  fifty-two of this act shall not
affect the repeal of such section and shall be deemed to  repeal  there-
with;
  (g) provided further, absent explicit language expressly and unequivo-
cally  stating  a  legislative intent to the contrary, all provisions of
this act are irrefutably presumed to operate  in  a  wholly  prospective
manner.    Provisions  shall be considered to operate retroactively, and
therefore in violation of this subdivision, if applied in such a  manner
as  to  alter, change, affect, impair or defeat any rights, obligations,
duties or interests accrued, incurred or conferred prior to  the  effec-
tive  date  of  this  act. Furthermore, the provisions of this act shall
neither apply to, nor be applied based upon the occasion of, acts occur-
ring prior to it becoming law;
  (h) provided, further, that the amendments to paragraph (c) of  subdi-
vision  6  of  section  367-a of the social services law made by section
seventy-four of this act shall be subject to the expiration  and  rever-
sion of such paragraph pursuant to section 62 of chapter 165 of the laws
of  1991,  as  amended,  when  upon  such date the provisions of section
seventy-four-a of this act shall take effect;
  (i) provided, further, that any  rules  or  regulations  necessary  to
implement  the  provisions of this act may be promulgated and any proce-
dures, forms, or instructions necessary for such implementation  may  be
adopted  and  issued  on  or after the date this act shall have become a
law;
  (j) provided, further, that this act shall not be construed to  alter,
change,  affect,  impair  or  defeat  any rights, obligations, duties or
interests accrued, incurred or conferred prior to the effective date  of
this act;
  (k)  provided,  further,  that the provisions of this act shall become
effective notwithstanding the failure of the commissioner of  health  or
the  superintendent  of  financial  services  or any council to adopt or
amend or promulgate regulations implementing this act;
  (l) provided, further that the  amendment  to  section  364-j  of  the
social  services law made by section seventy-three of this act shall not
affect the repeal of such section and shall be  deemed  repealed  there-
with;
  (m)  provided,  further  that  amendments  to subdivision 8 of section
4403-f of the public health law made by section seventy-six of this  act
shall not affect the repeal of such section and shall be deemed repealed
therewith; and
  (n)  provided  further, that section twenty-seven of this act shall be
deemed repealed eighteen months after such effective date.

                                 PART E
                          Intentionally omitted

S. 6256--C                         35

                                 PART F

  Section  1.  Section  1  of  part C of chapter 58 of the laws of 2005,
authorizing reimbursements for expenditures made  by  or  on  behalf  of
social  services  districts for medical assistance for needy persons and
the administration thereof, is amended by adding a new subdivision (c-1)
to read as follows:
  (C-1) NOTWITHSTANDING  ANY  PROVISIONS  OF  SUBDIVISION  (C)  OF  THIS
SECTION TO THE CONTRARY, EFFECTIVE OCTOBER 1, 2012, FOR THE PERIOD OCTO-
BER  1, 2012 THROUGH DECEMBER 31, 2012 AND FOR EACH CALENDAR YEAR THERE-
AFTER, THE MEDICAL ASSISTANCE EXPENDITURE AMOUNT FOR THE SOCIAL SERVICES
DISTRICT FOR SUCH PERIOD SHALL BE EQUAL TO THE PREVIOUS CALENDAR  YEAR'S
MEDICAL ASSISTANCE EXPENDITURE AMOUNT, EXCEPT THAT:
  (1)  FOR  THE  PERIOD OCTOBER 1, 2012 THROUGH DECEMBER 31, 2012, FOR A
CITY WITH A POPULATION OF TWO MILLION OR  MORE,  THE  PREVIOUS  CALENDAR
YEAR  MEDICAL ASSISTANCE EXPENDITURE AMOUNT WILL BE INCREASED BY 2%; FOR
THE PERIOD OCTOBER 1, 2012 THROUGH DECEMBER  31,  2012,  FOR  ALL  OTHER
SOCIAL SERVICES DISTRICTS, THE PREVIOUS CALENDAR YEAR MEDICAL ASSISTANCE
EXPENDITURE AMOUNT WILL BE INCREASED BY 1%;
  (2)  FOR  THE  PERIOD JANUARY 1, 2013 THROUGH DECEMBER 31, 2013, FOR A
CITY WITH A POPULATION OF TWO MILLION OR  MORE,  THE  PREVIOUS  CALENDAR
YEAR  MEDICAL ASSISTANCE EXPENDITURE AMOUNT WILL BE INCREASED BY 2%; FOR
THE PERIOD JANUARY 1, 2013 THROUGH DECEMBER  31,  2013,  FOR  ALL  OTHER
SOCIAL SERVICES DISTRICTS, THE PREVIOUS CALENDAR YEAR MEDICAL ASSISTANCE
EXPENDITURE AMOUNT WILL BE INCREASED BY 1%;
  (3)  FOR  THE  PERIOD JANUARY 1, 2014 THROUGH DECEMBER 31, 2014, FOR A
CITY WITH A POPULATION OF TWO MILLION OR  MORE,  THE  PREVIOUS  CALENDAR
YEAR  MEDICAL ASSISTANCE EXPENDITURE AMOUNT WILL BE INCREASED BY 2%; FOR
THE PERIOD JANUARY 1, 2014 THROUGH DECEMBER  31,  2014,  FOR  ALL  OTHER
SOCIAL SERVICES DISTRICTS, THE PREVIOUS CALENDAR YEAR MEDICAL ASSISTANCE
EXPENDITURE AMOUNT WILL BE INCREASED BY 0%;
  (4)  FOR  THE  PERIOD JANUARY 1, 2015 THROUGH DECEMBER 31, 2015, FOR A
CITY WITH A POPULATION OF TWO MILLION OR  MORE,  THE  PREVIOUS  CALENDAR
YEAR  MEDICAL ASSISTANCE EXPENDITURE AMOUNT WILL BE INCREASED BY 1%; FOR
THE PERIOD JANUARY 1, 2015 THROUGH DECEMBER  31,  2015,  FOR  ALL  OTHER
SOCIAL SERVICES DISTRICTS, THE PREVIOUS CALENDAR YEAR MEDICAL ASSISTANCE
EXPENDITURE AMOUNT WILL BE INCREASED BY 0%.
  S  2.  Paragraph  (iii)  of  subdivision (g) of section 1 of part C of
chapter 58 of the laws of 2005, authorizing reimbursements for  expendi-
tures  made  by  or  on  behalf of social services districts for medical
assistance for needy persons and the administration thereof, as  amended
by section 59 of part A of chapter 57 of the laws of 2006, is amended to
read as follows:
  (iii)  During each state fiscal year subject to the provisions of this
section AND PRIOR TO STATE FISCAL YEAR 2015-16, the  commissioner  shall
maintain  an  accounting,  for each social services district, of the net
amounts that would have been expended by, or on behalf of, such district
had the social services district medical assistance shares provisions in
effect on January 1, 2005 been applied to such district.   For  purposes
of  this paragraph, fifty percent of the payments made by New York State
to the secretary of the federal department of health and human  services
pursuant  to  section 1935(c) of the social security act shall be deemed
to be payments made on behalf of social services districts;  such  fifty
percent share shall be apportioned to each district in the same ratio as
the  number of "full-benefit dual eligible individuals," as that term is
defined in section 1935(c)(6) of such act, for whom  such  district  has

S. 6256--C                         36

fiscal  responsibility  pursuant  to  section 365 of the social services
law, relates to the total of such individuals for  whom  districts  have
fiscal  responsibility.   As soon as practicable after the conclusion of
each  such  fiscal year, but in no event later than six months after the
conclusion of each such fiscal year, the  commissioner  shall  reconcile
such  net  amounts  with  such  fiscal  year's  social services district
expenditure cap amount. Such reconciliation shall  be  based  on  actual
expenditures  made  by  or  on  behalf of social services districts, and
revenues received by social services districts, during such fiscal  year
and  shall  be  made  without  regard to expenditures made, and revenues
received, outside such fiscal year that are related to services provided
during, or prior to, such fiscal year. The  commissioner  shall  pay  to
each  social  services  district  the  amount,  if  any,  by  which such
district's expenditure cap amount exceeds such net amount.
  S 3. Paragraph (i) of subdivision (b) of section 2 of part C of  chap-
ter  58 of the laws of 2005, authorizing reimbursements for expenditures
made by or on behalf of social services districts for medical assistance
for needy persons and the administration thereof, is amended and  a  new
paragraph (iii) is added to read as follows:
  (i)  A social services district shall exercise the option described in
this section through the adoption of a resolution by its local  legisla-
tive body, in the form set forth in subparagraph (ii) of this paragraph,
to  elect  the medical assistance reimbursement methodology set forth in
paragraph (a) of this section and to elect the tax intercept methodology
set forth in subdivision (f) of section 1261 of the tax law or  subdivi-
sion  (g) of section 1261 and subdivision (h) of section 1313 of the tax
law, as applicable. A social services district, acting through its local
legislative body, is hereby authorized to adopt such a resolution.  Such
a  resolution  shall  be  effective only if it is adopted exactly as set
forth in subparagraph (ii) of this paragraph no later than September 30,
2007, and a certified copy of such resolution is mailed to  the  commis-
sioner  of  health  by  certified mail by such date. The commissioner of
health shall, no later than October 31, 2007, certify to the commission-
er of taxation and finance a list of  those  social  services  districts
which  have  elected  the  option  described  in  this section. A social
services district [shall have no authority to rescind the  exercise  of]
THAT  ELECTED  the  option described in this section, ACTING THROUGH ITS
LOCAL LEGISLATIVE BODY, MAY REPEAL THAT ELECTION BY  ADOPTING  A  RESOL-
UTION  EXACTLY  AS  SET FORTH IN PARAGRAPH (III) OF THIS SUBDIVISION AND
MAILING A CERTIFIED COPY OF SUCH REPEAL RESOLUTION TO  THE  COMMISSIONER
OF  HEALTH  NO  LATER  THAN JANUARY 1, 2013.  THE COMMISSIONER OF HEALTH
SHALL, WITHIN TWO WEEKS OF RECEIVING ANY SUCH COPY OF A CERTIFIED REPEAL
RESOLUTION BY CERTIFIED MAIL FROM A SOCIAL SERVICES DISTRICT, CERTIFY IN
WRITING TO THE COMMISSIONER OF TAXATION AND FINANCE THE NAME OF ANY SUCH
SOCIAL SERVICES DISTRICT THAT ADOPTED SUCH A RESOLUTION  TO  REPEAL  ITS
ELECTION. UPON RECEIVING SUCH WRITTEN CERTIFICATION, THE COMMISSIONER OF
TAXATION  AND  FINANCE  SHALL NO LONGER CALCULATE THE MEDICAID AMOUNT OF
SUCH COUNTY UNDER SUBDIVISION (F) OF SECTION 1261 OF THE  TAX  LAW,  AND
THE  AMOUNT  DUE  SUCH COUNTY UNDER SUBDIVISION (C) OF SUCH SECTION 1261
SHALL NO LONGER BE REDUCED BY SUCH MEDICAID AMOUNT, EFFECTIVE THE  FIRST
DAY OF THE MONTH NEXT COMMENCING AT LEAST 10 DAYS AFTER THE COMMISSIONER
OF  TAXATION  AND  FINANCE  HAS  RECEIVED SUCH WRITTEN CERTIFICATION. IF
EVERY SOCIAL SERVICE DISTRICT  THAT  ELECTED  SUCH  OPTION  REPEALS  ITS
ELECTION  AND  THE  COMMISSIONER  OF  HEALTH CERTIFIES IN WRITING TO THE
COMMISSIONER OF TAXATION AND FINANCE THAT  EVERY  SUCH  SOCIAL  SERVICES
DISTRICT  HAS  REPEALED  ITS  ELECTION, THEN SUBDIVISIONS (F) AND (G) OF

S. 6256--C                         37

SECTION 1261 AND SUBDIVISION (H) OF SECTION 1313  OF  THE  TAX  LAW  TAX
SHALL  BE  REPEALED  AND  THE  PHRASE "OR A TAX REVENUE INTERCEPT AMOUNT
CALCULATED PURSUANT TO SUBDIVISION (F) OR (G) OF SECTION 1261 OF THE TAX
LAW"  IN  SECTION FOUR OF THIS ACT SHALL BE DELETED, EFFECTIVE THE FIRST
DAY OF THE MONTH NEXT COMMENCING AT LEAST 10  DAYS  AFTER  THE  DATE  ON
WHICH  THE  COMMISSIONER  OF  TAXATION AND FINANCE RECEIVES SUCH WRITTEN
CERTIFICATION FROM THE COMMISSIONER OF HEALTH. AT THE SAME TIME THAT THE
COMMISSIONER OF HEALTH MAKES SUCH CERTIFICATION TO THE  COMMISSIONER  OF
TAXATION  AND  FINANCE  THAT EVERY COUNTY HAS REPEALED ITS ELECTION, THE
COMMISSIONER OF HEALTH SHALL ALSO NOTIFY THE LEGISLATIVE  BILL  DRAFTING
COMMISSION  THAT  EVERY SOCIAL SERVICE DISTRICT THAT ELECTED SUCH OPTION
HAS REPEALED ITS ELECTION IN ORDER THAT THE  LEGISLATIVE  BILL  DRAFTING
COMMISSION MAY MAINTAIN AN ACCURATE AND TIMELY DATA BASE OF THE OFFICIAL
TEXT  OF  THE  LAWS OF THE STATE OF NEW YORK IN FURTHERANCE OF EFFECTING
THE PROVISIONS OF SECTION 44 OF THE LEGISLATIVE LAW AND SECTION 70-B  OF
THE PUBLIC OFFICERS LAW.
  (III) FORM OF RESOLUTION.
  BE IT ENACTED BY THE (COUNTY) OF (INSERT COUNTY'S NAME) AS FOLLOWS:
  SECTION ONE. THE (COUNTY) OF (INSERT COUNTY'S NAME) HEREBY REPEALS ITS
ELECTION  IN  2007  OF  THE  MEDICAL ASSISTANCE REIMBURSEMENT OPTION AND
REVENUE INTERCEPT FOR MEDICAID PURPOSES DESCRIBED IN SECTION 2 OF  CHAP-
TER 58 OF THE LAWS OF 2005.
  SECTION 2. THIS RESOLUTION SHALL TAKE EFFECT IMMEDIATELY.
  S 4. Intentionally omitted.
  S  5.  Section 91 of part H of chapter 59 of the laws of 2011 amending
the public health law  and  other  laws  relating  to  general  hospital
reimbursement for annual rates is amended to read as follows:
  S 91. 1. Notwithstanding any inconsistent provision of state law, rule
or  regulation to the contrary, subject to federal approval, the year to
year rate of growth of department of health state funds Medicaid  spend-
ing  shall not exceed the ten year rolling average of the medical compo-
nent of the consumer price index  as  published  by  the  United  States
department  of  labor, bureau of labor statistics, for the preceding ten
years.
  2. EXCEPT AS PROVIDED IN SUBDIVISION THREE OF THIS SECTION, FOR  STATE
FISCAL  YEAR  2013-14  AND FOR EACH FISCAL YEAR THEREAFTER, THE SPENDING
LIMIT CALCULATED PURSUANT TO SUBDIVISION ONE OF THIS  SECTION  SHALL  BE
INCREASED  BY AN AMOUNT EQUAL TO THE DIFFERENCE BETWEEN THE TOTAL SOCIAL
SERVICES DISTRICT MEDICAL ASSISTANCE EXPENDITURE AMOUNTS CALCULATED  FOR
SUCH PERIOD IN CONFORMANCE WITH SUBDIVISIONS (B), (C), (C-1), AND (D) OF
SECTION  1  OF  PART  C  OF CHAPTER 58 OF THE LAWS OF 2005 AND THE TOTAL
SOCIAL SERVICES DISTRICT MEDICAL EXPENDITURE  AMOUNTS  THAT  WOULD  HAVE
RESULTED  IF THE PROVISIONS OF SUBDIVISION (C-1) OF SUCH SECTION HAD NOT
BEEN APPLIED.
  3. WITH RESPECT TO A SOCIAL SERVICES DISTRICT THAT RESCINDS THE  EXER-
CISE  OF  THE  OPTION  PROVIDED  IN  PARAGRAPH (I) OF SUBDIVISION (B) OF
SECTION 2 OF PART C OF CHAPTER 58 OF THE LAWS OF 2005, FOR STATE  FISCAL
YEAR  2013-14  AND  FOR  EACH FISCAL YEAR THEREAFTER, THE SPENDING LIMIT
CALCULATED PURSUANT TO SUBDIVISION ONE OF THIS SECTION SHALL BE  REDUCED
BY  THE  AMOUNT  OF THE MEDICAL ASSISTANCE EXPENDITURE AMOUNT CALCULATED
FOR SUCH DISTRICT FOR SUCH PERIOD.
  S 6. Intentionally omitted.
  S 6-a. 1. The legislature hereby finds that proposing  to  assume  the
local administration of Medicaid is a matter of importance to the state,
which  requires  both  comprehensive  evaluation and thoughtful deliber-
ation. The legislature further finds that, given the intricacies of  the

S. 6256--C                         38

Medicaid  program, the exercise of legislative authority should be judi-
cious and, when undertaken, so done with care and precision.  Therefore,
it is the intent of the legislature to task the commissioner  of  health
with developing a detailed approach to providing relief to counties with
regard  to  the cost of administering the Medicaid program, in consulta-
tion with all relevant stakeholders, for consideration by the Senate and
the Assembly.
  2. The commissioner of health, in consultation with  the  commissioner
of  labor,  shall  develop  a  report  and recommendations regarding the
reduction of local costs for Medicaid administration.  Such  report  and
recommendations shall contain information including, but not limited to:
proposals  to  transition  current county responsibilities to the state;
methods for ensuring continuity of services; estimated fiscal impacts on
counties and the state as a result of a proposed transition;  and  plans
for  transitioning the workforce, and its impact on labor organizations.
By January 1, 2013, the commissioner of health shall submit such  report
and  recommendations,  as well as draft legislation that would implement
any proposals contained therein,  to  the  temporary  president  of  the
senate and the speaker of the assembly for their consideration.
  S 7. Subdivision 7 of section 369 of the social services law, as added
by  section 71-a of part C of chapter 58 of the laws of 2008, is amended
to read as follows:
  7. Notwithstanding any provision of law to the contrary,  the  depart-
ment [may commence] SHALL, WHEN IT DETERMINES NECESSARY PROGRAM FEATURES
ARE  IN  PLACE,  ASSUME  SOLE  RESPONSIBILITY  FOR COMMENCING actions or
proceedings in accordance with the provisions of this section,  sections
one  hundred one, one hundred four, one hundred four-b, paragraph (a) of
subdivision three of section three hundred sixty-six,  subparagraph  one
of paragraph (h) of subdivision four of section three hundred sixty-six,
and paragraph (b) of subdivision two of section three hundred sixty-sev-
en-a  of  this  chapter,  to  recover  the  cost  of  medical assistance
furnished pursuant to this title and title eleven-D of this article. The
department is authorized to contract with an entity that  shall  conduct
activities  on  behalf  of  the department pursuant to this subdivision.
PRIOR TO ASSUMING SUCH RESPONSIBILITY FROM A SOCIAL  SERVICES  DISTRICT,
THE  DEPARTMENT  OF  HEALTH  SHALL,  IN  CONSULTATION WITH THE DISTRICT,
DEFINE THE SCOPE OF THE  SERVICES  THE  DISTRICT  WILL  BE  REQUIRED  TO
PERFORM  ON BEHALF OF THE DEPARTMENT OF HEALTH PURSUANT TO THIS SUBDIVI-
SION.
  S 8. Notwithstanding any inconsistent provision of law, rule or  regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal  social  security  act  in  the public health law and the social
services law shall be deemed to include and also to mean  any  successor
titles thereto under the federal social security act.
  S  9. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988,  and
18  NYCRR  505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended  and  without
force or effect for purposes of implementing the provisions of this act.
  S  10. Severability clause. If any clause, sentence, paragraph, subdi-
vision, section or part of this act shall be adjudged by  any  court  of
competent  jurisdiction  to  be invalid, such judgment shall not affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation to the clause, sentence, paragraph,  subdivision,  section  or

S. 6256--C                         39

part thereof directly involved in the controversy in which such judgment
shall  have been rendered. It is hereby declared to be the intent of the
legislature that this act would have been enacted even if  such  invalid
provisions had not been included herein.
  S  11.  This  act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012,  provided
that:
  1. section one of this act shall take effect April 1, 2013;
  2.  any  rules or regulations necessary to implement the provisions of
this act may be promulgated and any procedures, forms,  or  instructions
necessary  for such implementation may be adopted and issued on or after
the date this act shall have become a law;
  3. this act shall not be construed to alter, change, affect, impair or
defeat any rights, obligations, duties or interests accrued, incurred or
conferred prior to the effective date of this act;
  4. the commissioner of health  and  the  superintendent  of  financial
services  and  any  appropriate  council may take any steps necessary to
implement this act prior to its effective date;
  5. notwithstanding any inconsistent provision of the state administra-
tive procedure act or any other provision of law,  rule  or  regulation,
the  commissioner of health and the superintendent of financial services
and any appropriate council is authorized to adopt or amend  or  promul-
gate  on  an  emergency  basis  any regulation he or she or such council
determines necessary to implement any  provision  of  this  act  on  its
effective date;
  6.  the amendment to section 91 of part H of chapter 59 of the laws of
2011, amending the public health law and other laws relating to  general
hospital  reimbursement  for  annual rates, made by section five of this
act shall take effect on the same date and in the same  manner  as  such
section takes effect;
  7.  the  provisions of this act shall become effective notwithstanding
the failure of the commissioner  of  health  or  the  superintendent  of
financial  services or any council to adopt or amend or promulgate regu-
lations implementing this act.

                                 PART G

  Section 1. Subdivision 1 of section 79 of part C of chapter 58 of  the
laws  of  2005 relating to the preferred drug program is amended to read
as follows:
  1. sections ten [through], ELEVEN, TWELVE  AND  fifteen  of  this  act
shall expire and be deemed repealed on and after June 15, [2012] 2019;
  S  2.  Subparagraph  (v) of paragraph (b) of subdivision 35 of section
2807-c of the public health law, as amended by section 35-a of part H of
chapter 59 of the laws of 2011, is amended to read as follows:
  (v) such  regulations  shall  incorporate  quality  related  measures,
including,  but  not  limited  to, potentially preventable re-admissions
(PPRs) and provide for rate adjustments or payment disallowances related
to PPRs and other potentially  preventable  negative  outcomes  (PPNOs),
which shall be calculated in accordance with methodologies as determined
by the commissioner, provided, however, that such methodologies shall be
based on a comparison of the actual and risk adjusted expected number of
PPRs and other PPNOs in a given hospital and with benchmarks established
by  the  commissioner and provided further that such rate adjustments or
payment disallowances shall result in an aggregate reduction in Medicaid
payments of no less than thirty-five million dollars for the period July

S. 6256--C                         40

first, two thousand ten through March thirty-first, two thousand  eleven
and no less than fifty-one million dollars for [the period] ANNUAL PERI-
ODS  BEGINNING  April  first,  two thousand eleven through March thirty-
first, two thousand [twelve] THIRTEEN, provided further that such aggre-
gate reductions shall be offset by Medicaid payment reductions occurring
as a result of decreased PPRs during the period July first, two thousand
ten through March thirty-first, two thousand eleven and the period April
first,  two  thousand  eleven  through  March thirty-first, two thousand
[twelve] THIRTEEN and as a result of decreased PPNOs during  the  period
April  first,  two thousand eleven through March thirty-first, two thou-
sand [twelve] THIRTEEN; and provided further that for  the  period  July
first,  two  thousand  ten  through  March  thirty-first,  two  thousand
[twelve] THIRTEEN, such rate adjustments or payment disallowances  shall
not apply to behavioral health PPRs; or to readmissions that occur on or
after fifteen days following an initial admission. By no later than July
first,  two  thousand eleven the commissioner shall enter into consulta-
tions with representatives of the health care facilities subject to this
section regarding potential prospective revisions to applicable  method-
ologies  and benchmarks set forth in regulations issued pursuant to this
subparagraph;
  S 3. This act shall take effect immediately and  shall  be  deemed  to
have been in full force and effect on and after April 1, 2012; provided,
however,  absent explicit language expressly and unequivocally stating a
legislative intent to the contrary, all provisions of this act are irre-
futably presumed to operate in a wholly prospective manner.   Provisions
shall be considered to operate retroactively, and therefore in violation
of  this  paragraph,  if  applied  in such a manner as to alter, change,
affect, impair or defeat any rights, obligations,  duties  or  interests
accrued,  incurred or conferred prior to the effective date of this act.
Furthermore, the provisions of this act shall neither apply to,  nor  be
applied  based upon the occasion of, acts occurring prior to it becoming
law.

                                 PART H

  Section 1. Subdivisions 3-b and 3-c of section 1 of part C of  chapter
57  of  the  laws  of  2006,  relating  to establishing a cost of living
adjustment for designated human services programs, as amended by section
1 of part F of chapter 59 of the laws of 2011, are amended  to  read  as
follows:
  3-b.  Notwithstanding  any  inconsistent  provision  of law, beginning
April 1, 2009 and ending March 31, [2012] 2013, the commissioners  shall
not  include  a  COLA for the purpose of establishing rates of payments,
contracts or any other form of reimbursement.
  3-c. Notwithstanding any  inconsistent  provision  of  law,  beginning
April 1, [2012] 2013 and ending March 31, [2015] 2016, the commissioners
shall develop the COLA under this section using the actual U.S. consumer
price  index  for  all  urban  consumers (CPI-U) published by the United
States department of labor, bureau of labor statistics  for  the  twelve
month  period  ending  in  July  of  the budget year prior to such state
fiscal  year,  for  the  purpose  of  establishing  rates  of  payments,
contracts or any other form of reimbursement.
  S  2.  Section 4 of part C of chapter 57 of the laws of 2006, relating
to establishing  a  cost  of  living  adjustment  for  designated  human
services  programs,  as  amended by section 2 of part F of chapter 59 of
the laws of 2011, is amended to read as follows:

S. 6256--C                         41

  S 4. This act shall take effect immediately and  shall  be  deemed  to
have  been in full force and effect on and after April 1, 2006; provided
section one of this act shall expire and be  deemed  repealed  April  1,
[2015]  2016; provided, further, that sections two and three of this act
shall expire and be deemed repealed December 31, 2009.
  S  3.  The  director  of  budget,  in consultation with state agencies
including, but not limited to, the office for people with  developmental
disabilities,   office  of  mental  health,  office  of  alcoholism  and
substance abuse services, office of children and family services, office
of temporary and disability assistance, department of health, office for
the aging, division of criminal justice services, and office  of  victim
services, as well as state education department and potentially impacted
providers  of  services,  shall  develop  a  report  and recommendations
regarding  the  establishment  of  annual  adjustments  to   established
payments  as  an alternative to the cost of living adjustment for desig-
nated human services programs. Such  report  and  recommendations  shall
contain  detailed  information  including,  but  not  limited  to: which
providers would be subject to such annual adjustments; what factors such
adjustments would be based upon; how  such  factors  would  be  used  in
calculating  such  annual  adjustments;  and what the anticipated fiscal
impact of such annual adjustments would be.  By  January  1,  2013,  the
director of budget shall submit such report and recommendations, as well
as draft legislation that would implement any proposals contained there-
in,  to  the  temporary  president  of the senate and the speaker of the
assembly for their consideration.
  S 4. Subparagraph 12 of paragraph (a) of section 202 of  the  not-for-
profit corporation law is amended to read as follows:
  (12)  To  elect or appoint officers, employees and other agents of the
corporation, define their duties, fix their reasonable compensation  and
the  reasonable  compensation  of  directors, and to indemnify corporate
personnel.  Such  compensation  shall  be  commensurate  with   services
performed, AND SUBJECT, WHERE APPLICABLE, TO SECTION SEVEN HUNDRED TWEN-
TY-SEVEN OF THIS CHAPTER.
  S  5.  Paragraph  (a) of section 717 of the not-for-profit corporation
law, as amended by chapter 490 of the laws of 2010, is amended  to  read
as follows:
  (a) Directors and officers shall discharge the duties of their respec-
tive  positions  in  good  faith and with the care an ordinarily prudent
person in a like position would exercise  under  similar  circumstances.
The  factors  set  forth in subparagraph one of paragraph (e) of section
552 (Standard of conduct in  managing  and  investing  an  institutional
fund),  if  relevant, must be considered by a governing board delegating
investment management of institutional funds  pursuant  to  section  514
(Delegation  of investment management).  For purposes of this paragraph,
the term institutional fund is defined  in  section  551  (Definitions).
FURTHERMORE, ANY COMPENSATION PROVIDED TO DIRECTORS, OFFICERS, EMPLOYEES
AND OTHER AGENTS OF THE CORPORATION MUST BE REASONABLE AND, WHERE APPLI-
CABLE, IS SUBJECT TO SECTION SEVEN HUNDRED TWENTY-SEVEN OF THIS ARTICLE.
  S  6.  Paragraph  (a) of section 719 of the not-for-profit corporation
law is amended by adding a new subparagraph 6 to read as follows:
  (6) THE PROVISION OF EXCESSIVE COMPENSATION  TO  DIRECTORS,  OFFICERS,
EMPLOYEES  AND  OTHER  AGENTS OF THE CORPORATION IN VIOLATION OF SECTION
SEVEN HUNDRED TWENTY-SEVEN OF THIS ARTICLE, WHERE APPLICABLE.
  S 7. Paragraph (d) of section 719 of  the  not-for-profit  corporation
law is amended by adding a new subparagraph 6 to read as follows:

S. 6256--C                         42

  (6)  UPON REIMBURSEMENT TO THE CORPORATION OF THE AMOUNT OF ANY EXCES-
SIVE COMPENSATION PROVIDED IN VIOLATION OF SECTION SEVEN  HUNDRED  TWEN-
TY-SEVEN  OF  THIS ARTICLE, TO BE SUBROGATED TO THE RIGHTS OF THE CORPO-
RATION AGAINST A DIRECTOR, OFFICER, EMPLOYEE OR OTHER AGENT WHO RECEIVED
THE EXCESSIVE COMPENSATION.
  S 8. Clauses (A) and (B) of subparagraph 1 of paragraph (a) of section
720  of  the  not-for-profit  corporation  law  are  amended  to read as
follows:
  (A) The neglect  of,  [or]  THE  failure  to  perform,  or  ANY  other
violation  of  his duties in the management and disposition of corporate
assets committed to his charge.
  (B) The acquisition by himself, transfer to others, loss or  waste  of
corporate  assets due to any neglect of, [or] THE failure to perform, or
ANY other violation of his duties, INCLUDING VIOLATIONS OF SECTION SEVEN
HUNDRED TWENTY-SEVEN OF THIS ARTICLE, PURSUANT TO SECTION SEVEN  HUNDRED
SEVENTEEN OF THIS ARTICLE.
  S  9.  The  not-for-profit  corporation law is amended by adding a new
section 727 to read as follows:
S 727. COMPENSATION OF EXECUTIVES.
  (A) DEFINITIONS. FOR THE PURPOSES OF THIS  SECTION,  UNLESS  OTHERWISE
EXPRESSLY STATED OR CONTEXT CLEARLY REQUIRES:
  (1)  "COMPENSATION"  MEANS  THE  AGGREGATE  VALUE OF ECONOMIC BENEFITS
CONFERRED IN EXCHANGE FOR THE PERFORMANCE OF SERVICES THAT ARE  INCLUDED
FOR PURPOSES OF DETERMINING REASONABLENESS UNDER SECTION 26 U.S.C. 4958,
AS  FURTHER  SPECIFIED  IN  26  CFR  S53.4958-4(B)(II)(B), OR SUCCEEDING
PROVISIONS.
  (2) "EXECUTIVE" MEANS ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL
INFLUENCE OVER THE AFFAIRS OF A PROVIDER OF SERVICES, AS  REFERENCED  IN
26  U.S.C. S4958(F)(1)(A) AND FURTHER SPECIFIED IN 26 CFR S53.4958-3(C),
OR SUCCEEDING PROVISIONS.
  (3) "FAMILY MEMBER" MEANS A SPOUSE, SIBLING (BY WHOLE OR HALF  BLOOD),
SPOUSE  OF  A  SIBLING (BY WHOLE OR HALF BLOOD), ANCESTOR, CHILD, GRAND-
CHILD,  GREAT-GRANDCHILD,  AND  SPOUSE  OF  A  CHILD,  GRANDCHILD,   AND
GREAT-GRANDCHILD.
  (4)  "PROVIDER  OF  SERVICES"  MEANS  A NOT-FOR-PROFIT CORPORATION, AS
DEFINED IN SECTION ONE HUNDRED TWO OF THIS CHAPTER, OPERATING A  PROGRAM
OR  PROGRAMS  THAT  ARE  ELIGIBLE  FOR THE HUMAN SERVICES COST OF LIVING
ADJUSTMENTS, PURSUANT TO PART C OF CHAPTER FIFTY-SEVEN OF  THE  LAWS  OF
TWO THOUSAND SIX.
  (B)  COMPENSATION EXCHANGED BY A PROVIDER OF SERVICES FOR THE PERFORM-
ANCE OF SERVICES BY AN EXECUTIVE MUST BE REASONABLE CONSIDERING  FACTORS
INCLUDING,  BUT  NOT  LIMITED  TO: COMPENSATION LEVELS PAID BY SIMILARLY
SITUATED ORGANIZATIONS, WHETHER OR NOT THEY QUALIFY AS A  NOT-FOR-PROFIT
CORPORATION  AS  DEFINED IN SECTION ONE HUNDRED TWO OF THIS CHAPTER; THE
AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA OF THE  APPLICA-
BLE PROVIDER OF SERVICES; CURRENT COMPENSATION SURVEYS COMPILED BY INDE-
PENDENT  FIRMS;  AND  ACTUAL  WRITTEN  OFFERS  FROM SIMILAR INSTITUTIONS
COMPETING FOR THE SERVICES OF THE APPLICABLE EXECUTIVE.
  (1) FOR THE PURPOSES OF THIS SECTION, WHETHER AN ORGANIZATION IS SIMI-
LARLY SITUATED SHALL BE DETERMINED BASED ON FACTORS INCLUDING,  BUT  NOT
LIMITED TO: GROSS ANNUAL REVENUE; GEOGRAPHIC LOCATION; AND THE DIVERSITY
AND COMPLEXITY OF PROGRAMS.
  (2)(A) PROVIDERS OF SERVICES MUST ANNUALLY SUBMIT A COMPLETED INTERNAL
REVENUE  SERVICE  FORM  990,  OR A COMPARABLE FORM DEVELOPED PURSUANT TO
SUBCLAUSE (I) OF CLAUSE (B) OF THIS SUBPARAGRAPH, TO THE AGENCY OR AGEN-
CIES UNDER THE AUSPICES OF WHICH THE PROVIDER OPERATES.

S. 6256--C                         43

  (B) THE COMMISSIONERS OF THE  OFFICE  FOR  PEOPLE  WITH  DEVELOPMENTAL
DISABILITIES,   OFFICE  OF  MENTAL  HEALTH,  OFFICE  OF  ALCOHOLISM  AND
SUBSTANCE ABUSE  SERVICES,  OFFICE  OF  CHILDREN  AND  FAMILY  SERVICES,
DEPARTMENT OF HEALTH, AND OFFICE FOR THE AGING SHALL JOINTLY:
  (I)  DEVELOP A FORM FOR USE BY THOSE PROVIDERS OF SERVICES WHO ARE NOT
REQUIRED BY FEDERAL LAW TO COMPLETE AN  INTERNAL  REVENUE  SERVICE  FORM
990. SUCH FORM SHALL REQUIRE NO MORE INFORMATION THAN THAT WHICH MUST BE
SUBMITTED ON INTERNAL REVENUE SERVICE FORM 990;
  (II)  PROMULGATE  REGULATIONS  THAT  ALLOW  A  PROVIDER OF SERVICES TO
SUBMIT ONE COMPLETED INTERNAL REVENUE SERVICE FORM 990, OR ONE COMPLETED
COMPARABLE FORM, THROUGH  THE  POSTAL  SERVICE  OR  ELECTRONICALLY,  FOR
DISTRIBUTION  TO  ALL  AGENCIES UNDER THE AUSPICES OF WHICH THE PROVIDER
OPERATES; AND
  (III) ESTABLISH UNIFORM PROCEDURES FOR REVIEWING SUBMITTED FORMS; AND,
UPON A DETERMINATION THAT EXECUTIVE COMPENSATION APPEARS TO BE EXCESSIVE
IN VIOLATION OF THE STANDARDS ESTABLISHED IN THIS SECTION, FOR REFERRING
SUCH CASES TO THE ATTORNEY GENERAL FOR FURTHER INQUIRY.
  (C) ANNUAL COMPENSATION EXCHANGED BY A PROVIDER OF  SERVICES  FOR  THE
PERFORMANCE  OF  SERVICES BY AN EXECUTIVE SHALL BE CONSIDERED REASONABLE
IF IT DOES NOT EXCEED LEVEL I OF THE FEDERAL GOVERNMENT'S RATES OF BASIC
PAY FOR THE EXECUTIVE SCHEDULE PROMULGATED BY THE UNITED  STATES  OFFICE
OF PERSONNEL MANAGEMENT.
  (D)  ANNUAL  COMPENSATION  EXCHANGED BY A PROVIDER OF SERVICES FOR THE
PERFORMANCE OF SERVICES BY AN EXECUTIVE THAT DOES EXCEED LEVEL I OF  THE
FEDERAL GOVERNMENT'S RATES OF BASIC PAY FOR THE EXECUTIVE SCHEDULE SHALL
BE PRESUMED TO BE REASONABLE IF THE FOLLOWING FOUR CONDITIONS ARE SATIS-
FIED:
  (1)  THE  COMPENSATION IS APPROVED IN ADVANCE BY AN AUTHORIZED BODY OF
THE PROVIDER OF SERVICES THAT IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO
NOT HAVE A  CONFLICT  OF  INTEREST  WITH  RESPECT  TO  THE  COMPENSATION
ARRANGEMENT.
  (A) AN AUTHORIZED BODY MEANS EITHER:
  (I)  THE  GOVERNING BODY (I.E., THE BOARD OF DIRECTORS, BOARD OF TRUS-
TEES, OR EQUIVALENT CONTROLLING BODY) OF THE ORGANIZATION;
  (II) A COMMITTEE OF THE GOVERNING BODY, WHICH IS AUTHORIZED TO ACT  ON
BEHALF OF THE GOVERNING BODY PURSUANT TO THIS CHAPTER; OR
  (III)  OTHER PARTIES AUTHORIZED BY THE GOVERNING BODY OF THE ORGANIZA-
TION TO ACT ON ITS BEHALF  BY  FOLLOWING  PROCEDURES  SPECIFIED  BY  THE
GOVERNING  BODY  IN APPROVING COMPENSATION ARRANGEMENTS, AS PERMITTED BY
THIS CHAPTER.
  (B) FOR THE PURPOSES OF DETERMINING WHETHER THE REQUIREMENTS  OF  THIS
PARAGRAPH HAVE BEEN MET WITH RESPECT TO A SPECIFIC COMPENSATION ARRANGE-
MENT,  AN  INDIVIDUAL  IS NOT INCLUDED IN THE AUTHORIZED BODY WHEN IT IS
REVIEWING A TRANSACTION IF THAT INDIVIDUAL MEETS WITH OTHER MEMBERS ONLY
TO ANSWER QUESTIONS, AND OTHERWISE RECUSES HIMSELF OR HERSELF  FROM  THE
MEETING  AND IS NOT PRESENT DURING DEBATE AND VOTING ON THE COMPENSATION
ARRANGEMENT.
  (C) A MEMBER OF THE AUTHORIZED BODY DOES NOT HAVE A CONFLICT OF INTER-
EST WITH RESPECT TO A COMPENSATION ARRANGEMENT ONLY IF THE MEMBER:
  (I) IS NOT AN EXECUTIVE PARTICIPATING IN, OR ECONOMICALLY  BENEFITTING
FROM,  THE  COMPENSATION ARRANGEMENT; AND IS NOT A FAMILY MEMBER OF SUCH
AN EXECUTIVE;
  (II) IS NOT IN AN EMPLOYMENT RELATIONSHIP SUBJECT TO THE DIRECTION  OR
CONTROL OF ANY EXECUTIVE, OR THE FAMILY MEMBER OF ANY EXECUTIVE, PARTIC-
IPATING  IN  OR  ECONOMICALLY BENEFITTING FROM THE COMPENSATION ARRANGE-
MENT;

S. 6256--C                         44

  (III) DOES NOT  RECEIVE  COMPENSATION  OR  OTHER  PAYMENT  SUBJECT  TO
APPROVAL  BY  ANY  EXECUTIVE,  OR  THE  FAMILY  MEMBER OF ANY EXECUTIVE,
PARTICIPATING IN  OR  ECONOMICALLY  BENEFITTING  FROM  THE  COMPENSATION
ARRANGEMENT;
  (IV)  HAS  NO MATERIAL FINANCIAL INTEREST AFFECTED BY THE COMPENSATION
ARRANGEMENT; AND
  (V) DOES NOT APPROVE A TRANSACTION PROVIDING ECONOMIC BENEFITS TO  ANY
EXECUTIVE,  OR  THE FAMILY MEMBER OF ANY EXECUTIVE, PARTICIPATING IN THE
COMPENSATION ARRANGEMENT, WHO IN TURN HAS APPROVED  OR  WILL  APPROVE  A
TRANSACTION PROVIDING ECONOMIC BENEFITS TO THE MEMBER.
  (2)  THE  AUTHORIZED BODY OBTAINED AND RELIED UPON APPROPRIATE DATA AS
TO COMPARABILITY PRIOR TO MAKING ITS DETERMINATION.
  (A) AN AUTHORIZED BODY HAS APPROPRIATE DATA AS  TO  COMPARABILITY  IF,
GIVEN  THE  KNOWLEDGE  AND  EXPERTISE OF ITS MEMBERS, IT HAS INFORMATION
SUFFICIENT TO DETERMINE WHETHER  THE  COMPENSATION  ARRANGEMENT  IN  ITS
ENTIRETY IS REASONABLE. RELEVANT INFORMATION INCLUDES, BUT IS NOT LIMIT-
ED  TO:  COMPENSATION  LEVELS  PAID BY SIMILARLY SITUATED ORGANIZATIONS,
WHETHER OR NOT THEY QUALIFY AS A NOT-FOR-PROFIT CORPORATION  AS  DEFINED
IN  SECTION ONE HUNDRED TWO OF THIS CHAPTER; THE AVAILABILITY OF SIMILAR
SERVICES IN THE GEOGRAPHIC AREA OF THE APPLICABLE PROVIDER OF  SERVICES;
CURRENT  COMPENSATION  SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL
WRITTEN OFFERS FROM SIMILAR INSTITUTIONS COMPETING FOR THE  SERVICES  OF
THE APPLICABLE EXECUTIVE.
  (B)  HOWEVER,  FOR  SMALL  ORGANIZATIONS  WITH  ANNUAL  GROSS RECEIPTS
(INCLUDING CONTRIBUTIONS) OF LESS THAN  ONE  MILLION  DOLLARS  REVIEWING
COMPENSATION  ARRANGEMENTS,  THE  AUTHORIZED  BODY WILL BE CONSIDERED TO
HAVE APPROPRIATE DATA AS TO COMPARABILITY IF IT HAS DATA ON COMPENSATION
PAID BY THREE COMPARABLE PROVIDERS OF SERVICES IN THE  SAME  OR  SIMILAR
COMMUNITIES FOR SIMILAR SERVICES.
  (I)  FOR  THE PURPOSES OF DETERMINING WHETHER THE ABOVE RULE FOR SMALL
ORGANIZATIONS APPLIES, AN ORGANIZATION MAY CALCULATE  ITS  ANNUAL  GROSS
RECEIPTS  BASED  ON  AN  AVERAGE  OF ITS GROSS RECEIPTS DURING THE THREE
PRIOR  TAXABLE  YEARS.  IF  ANY  APPLICABLE  PROVIDER  OF  SERVICES   IS
CONTROLLED  BY  OR CONTROLS ANOTHER ENTITY, THE ANNUAL GROSS RECEIPTS OF
SUCH ORGANIZATIONS MUST BE AGGREGATED TO DETERMINE APPLICABILITY.
  (II) FOR PURPOSES OF THIS PARAGRAPH, CONTROL BY AN APPLICABLE PROVIDER
OF SERVICES MEANS:
  (1) IN THE CASE OF A STOCK CORPORATION, OWNERSHIP (BY VOTE  OR  VALUE)
OF MORE THAN FIFTY PERCENT OF THE STOCK IN SUCH CORPORATION;
  (2) IN THE CASE OF A PARTNERSHIP, OWNERSHIP OF MORE THAN FIFTY PERCENT
OF THE PROFITS INTERESTS OR CAPITAL INTERESTS IN THE PARTNERSHIP;
  (3)  IN  THE CASE OF A NONSTOCK ORGANIZATION (I.E., AN ENTITY IN WHICH
NO PERSON HOLDS A PROPRIETARY INTEREST), THAT AT LEAST FIFTY PERCENT  OF
THE  DIRECTORS OR TRUSTEES OF THE PROVIDER OF SERVICES ARE EITHER REPRE-
SENTATIVES (INCLUDING TRUSTEES, DIRECTORS, AGENTS, OR EMPLOYEES) OF,  OR
DIRECTLY OR INDIRECTLY CONTROLLED BY, AN APPLICABLE TAX-EXEMPT ORGANIZA-
TION; OR
  (4)  IN  THE  CASE  OF  ANY OTHER ENTITY, OWNERSHIP OF MORE THAN FIFTY
PERCENT OF THE BENEFICIAL INTEREST IN THE ENTITY.
  (3) THE AUTHORIZED BODY ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETER-
MINATION CONCURRENTLY WITH MAKING THAT DETERMINATION.
  (A) FOR A DECISION TO BE DOCUMENTED ADEQUATELY, THE WRITTEN  OR  ELEC-
TRONIC RECORDS OF THE AUTHORIZED BODY MUST NOTE:
  (I)  THE  TERMS  OF THE TRANSACTION THAT WAS APPROVED, AND THE DATE IT
WAS APPROVED;

S. 6256--C                         45

  (II) THE MEMBERS OF THE AUTHORIZED BODY WHO WERE PRESENT DURING DEBATE
ON THE TRANSACTION THAT WAS APPROVED, AND THOSE WHO VOTED ON IT;
  (III)  THE  COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE AUTHOR-
IZED BODY, AND HOW THE DATA WAS OBTAINED; AND
  (IV) ANY ACTIONS TAKEN WITH RESPECT TO  CONSIDERATION  OF  THE  TRANS-
ACTION  BY  ANYONE  WHO IS OTHERWISE A MEMBER OF THE AUTHORIZED BODY BUT
WHO HAD A CONFLICT OF INTEREST WITH RESPECT TO THE TRANSACTION.
  (B) IF THE AUTHORIZED BODY DETERMINES THAT REASONABLE COMPENSATION FOR
A SPECIFIC ARRANGEMENT IS HIGHER OR LOWER THAN THE RANGE OF COMPARABILI-
TY DATA OBTAINED, THE AUTHORIZED BODY MUST  RECORD  THE  BASIS  FOR  ITS
DETERMINATION.  FOR  A  DECISION  TO BE DOCUMENTED CONCURRENTLY, RECORDS
MUST BE PREPARED BEFORE THE LATER OF THE NEXT MEETING OF THE  AUTHORIZED
BODY  OR  SIXTY DAYS AFTER THE FINAL ACTION OR ACTIONS OF THE AUTHORIZED
BODY ARE TAKEN. RECORDS MUST BE REVIEWED AND APPROVED BY THE  AUTHORIZED
BODY AS REASONABLE, ACCURATE AND COMPLETE WITHIN A REASONABLE TIME PERI-
OD THEREAFTER.
  (4)  THE COMPENSATION PROVIDED TO THE EXECUTIVE BY THE AUTHORIZED BODY
DOES NOT EXCEED THE HIGHEST COMPENSATION PROVIDED BY A  SIMILARLY  SITU-
ATED ORGANIZATION FOR SIMILAR SERVICES, AS IDENTIFIED IN THE COMPARABIL-
ITY DATA, BY MORE THAN TEN PERCENT.
  (E) IF THE FOUR CONDITIONS OF PARAGRAPH (D) OF THIS SECTION ARE SATIS-
FIED,  THEN  THE PERSON OR ENTITY BRINGING AN ACTION FOR RELIEF PURSUANT
TO SECTION SEVEN HUNDRED TWENTY OF THIS ARTICLE MAY REBUT  THE  PRESUMP-
TION THAT ARISES UNDER PARAGRAPH (D) OF THIS SECTION ONLY IF IT DEVELOPS
SUFFICIENT CONTRARY EVIDENCE TO REBUT THE PROBATIVE VALUE OF THE COMPAR-
ABILITY  DATA  RELIED  UPON  BY THE AUTHORIZED BODY. WITH RESPECT TO ANY
FIXED PAYMENT, REBUTTAL EVIDENCE IS  LIMITED  TO  EVIDENCE  RELATING  TO
FACTS  AND CIRCUMSTANCES EXISTING ON THE DATE THE PARTIES ENTER INTO THE
CONTRACT PURSUANT TO WHICH THE PAYMENT IS MADE (EXCEPT IN THE  EVENT  OF
SUBSTANTIAL   NONPERFORMANCE).  WITH  RESPECT  TO  ALL  OTHER  PAYMENTS,
REBUTTAL EVIDENCE MAY INCLUDE FACTS AND CIRCUMSTANCES UP TO AND  INCLUD-
ING THE DATE OF PAYMENT.
  S  10.  The  director  of  budget, in consultation with state agencies
including, but not limited to, the office for people with  developmental
disabilities,   office  of  mental  health,  office  of  alcoholism  and
substance abuse services, office of children and family services, office
of temporary and disability assistance, department of health, and office
for the aging, shall develop a report and recommendations regarding  the
executive  compensation provided by for-profit corporations that receive
significant state financial assistance or state-authorized payments,  as
well  as not-for-profit corporations that are not eligible for a cost of
living adjustment for designated human services  programs  that  receive
state  financial  assistance  or state-authorized payments for operating
expenses. Such report and recommendations shall contain detailed  infor-
mation  including,  but  not limited to: a plan to establish a system to
ensure that executive compensation  provided  by  such  corporations  is
reasonable;  how such a system would be developed and implemented; which
providers would be  subject  to  such  a  system;  how  "executive"  and
"compensation," or other such terms, would be defined; how such a system
would impact providers under the auspices of more than one agency, divi-
sion  or department; and how many providers would be in violation of any
requirements of such a system at the time of implementation.  By January
1, 2013, the director of budget shall submit such report and recommenda-
tions, as well as draft legislation that would implement  any  proposals
contained  therein,  to  the  temporary  president of the senate and the
speaker of the assembly for their consideration.

S. 6256--C                         46

  S 11. The director of budget,  in  consultation  with  state  agencies
including,  but not limited to, the office for people with developmental
disabilities,  office  of  mental  health,  office  of  alcoholism   and
substance abuse services, office of children and family services, office
of temporary and disability assistance, department of health, and office
for  the  aging, shall develop reports and recommendations regarding the
provisions implemented by sections four, five,  six,  seven,  eight  and
nine  of  this  act.  Such  reports  and  recommendations  shall contain
detailed information including, but not limited to: The effectiveness of
such provisions; accounts of actions taken by agencies and the  attorney
general  pursuant  to such provisions; and recommendations regarding any
modifications to, and the extension of, such provisions. The director of
budget shall submit an interim report and recommendations on January  1,
2013,  and  a  final report and recommendations, as well as draft legis-
lation that would implement any proposals contained therein, on  January
1, 2014, to the temporary president of the senate and the speaker of the
assembly for their consideration.
  S  12.  The  director  of  budget, in consultation with state agencies
including, but not limited to, the office for people with  developmental
disabilities,   office  of  mental  health,  office  of  alcoholism  and
substance abuse services, office of children and family services, office
of temporary and disability assistance, department of health, office for
the aging, division of criminal justice services, and office  of  victim
services,  as  well as the education department and potentially impacted
providers of  services,  shall  develop  a  report  and  recommendations
regarding  the  administrative  costs  of  for-profit  corporations that
receive  significant  state  financial  assistance  or  state-authorized
payments  and  not-for-profit  corporations that receive state financial
assistance or state-authorized payments  for  operating  expenses.  Such
report and recommendations shall follow the convening of provider panels
by  each agency, division and department that would implement the recom-
mendations; and each panel shall include representation of each type  of
provider operating under the auspices of the conducting agency, division
and  department. Each panel shall promulgate testimony, to be adopted by
a majority vote of the members of each panel,  and  all  such  testimony
shall  be  included  in  the report and recommendations. Such report and
recommendations shall also contain detailed information  including,  but
not  limited to: a plan to establish a system to ensure that administra-
tive expenditures incurred by such providers is reasonable; how any such
system would be developed and  implemented;  which  providers  would  be
subject  to  such  a  system;  how "administrative costs" and other such
terms would be defined; how  such  limitations  would  impact  providers
under  the auspices of more than one agency, division or department; and
how many providers would be in violation of any requirements of  such  a
system  at  the time of implementation. By January 1, 2013, the director
of budget shall submit such report and recommendations, as well as draft
legislation that would implement any proposals contained therein, to the
temporary president of the senate and the speaker of  the  assembly  for
their consideration.
  S 13. This act shall take effect immediately; provided, however, that:
  (a) sections four, five, six, seven, eight, and nine of this act shall
take  effect  on  the  sixtieth  day after it shall have become law; and
shall expire on March 31, 2014, when upon such date  the  provisions  of
these sections shall be deemed repealed;

S. 6256--C                         47

  (b)  if  this  act  shall have become a law on or after April 1, 2012,
sections one, two, three, ten, eleven and twelve of this  act  shall  be
deemed to have been in full force and effect on and after April 1, 2012;
  (c) the amendments to section 1 of part C of chapter 57 of the laws of
2006 made by section one of this act shall not affect the repeal of such
section and shall be deemed repealed therewith;
  (d)  the  commissioners  of  the  office for people with developmental
disabilities,  office  of  mental  health,  office  of  alcoholism   and
substance  abuse  services,  office  of  children  and  family services,
department of health, office for the aging, and the division of criminal
justice services shall immediately take the necessary actions to  ensure
that  forms  and regulations required by section nine of this act are in
place on such effective date. Further, whereas the authority to  promul-
gate  regulations  and make rules is derived from an express or implicit
statutory grant provided by the legislature, all agencies, divisions and
departments of the state are hereby prohibited from  promulgating  regu-
lations  and  making  rules  pursuant to 9 NYCRR 8.38, or that otherwise
address the extent and nature of a provider's administrative  costs  and
executive  compensation,  except  as required and necessary to implement
the provisions of section nine of this act.
  (e) absent explicit language expressly  and  unequivocally  stating  a
legislative intent to the contrary, all provisions of this act are irre-
futably  presumed to operate in a wholly prospective manner.  Provisions
shall be considered to operate retroactively, and therefore in violation
of this act, if applied in such a manner as to  alter,  change,  affect,
impair  or  defeat any rights, obligations, duties or interests accrued,
incurred or conferred prior to the effective date of this act.  Further-
more,  the provisions of this act shall neither apply to, nor be applied
based upon the occasion of, acts occurring prior to it becoming law.

                                 PART I
                          Intentionally omitted

                                 PART J
                          Intentionally omitted

                                 PART K

  Section 1. Sections 19 and 21 of chapter  723  of  the  laws  of  1989
amending the mental hygiene law and other laws relating to comprehensive
psychiatric  emergency  programs,  as  amended by section 1 of part F of
chapter 58 of the laws of 2008, are amended to read as follows:
  S 19. Notwithstanding any other provision of law, the commissioner  of
mental health shall, until July 1, [2012] 2016, be solely authorized, in
his  or  her  discretion,  to  designate  those general hospitals, local
governmental units and voluntary agencies which may apply and be consid-
ered for the approval and issuance of an operating certificate  pursuant
to  article  31 of the mental hygiene law for the operation of a compre-
hensive psychiatric emergency program.
  S 21. This act shall take effect immediately, and  sections  one,  two
and  four  through  twenty  of  this  act shall remain in full force and
effect, until July 1, [2012] 2016, at  which  time  the  amendments  and
additions  made  by  such  sections  of  this  act shall be deemed to be
repealed, and any provision of law amended by any of  such  sections  of

S. 6256--C                         48

this  act  shall revert to its text as it existed prior to the effective
date of this act.
  S  2.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012; provided,
however, that absent explicit language expressly and unequivocally stat-
ing a legislative intent to the contrary, all provisions of this act are
irrefutably  presumed  to  operate  in  a  wholly  prospective   manner.
Provisions  shall  be considered to operate retroactively, and therefore
in violation of this paragraph, if applied in such a manner as to alter,
change, affect, impair or defeat  any  rights,  obligations,  duties  or
interests  accrued, incurred or conferred prior to the effective date of
this act. Furthermore, the provisions of this act  shall  neither  apply
to,  nor  be applied based upon the occasion of, acts occurring prior to
it becoming law.

                                 PART L

  Section 1. The state administrative procedure act is amended by adding
a new section 208 to read as follows:
  S 208. ESTABLISHMENT OF OPERATING, REPORTING AND CONSTRUCTION REQUIRE-
MENTS FOR CERTAIN AGENCIES AND OFFICES.   1.  NOTWITHSTANDING  ANY  LAW,
RULE  OR REGULATION TO THE CONTRARY, TWO OR MORE OF THE COMMISSIONERS OF
THE DEPARTMENT OF HEALTH, THE OFFICE OF MENTAL  HEALTH,  THE  OFFICE  OF
ALCOHOLISM  AND  SUBSTANCE  ABUSE SERVICES OR THE OFFICE FOR PEOPLE WITH
DEVELOPMENTAL DISABILITIES ARE JOINTLY AUTHORIZED TO  ESTABLISH  OPERAT-
ING,  REPORTING  AND  CONSTRUCTION REQUIREMENTS, AS WELL AS JOINT SURVEY
REQUIREMENTS AND PROCEDURES, FOR ENTITIES OPERATING UNDER  THE  AUSPICES
OF EACH AGENCY OF WHICH A PARTICIPATING COMMISSIONER IS THE HEAD THAT:
  (A)  CAN  DEMONSTRATE  EXPERIENCE  AND  COMPETENCE  IN THE DELIVERY OF
SERVICES OVERSEEN BY EACH AGENCY OF WHICH A  PARTICIPATING  COMMISSIONER
IS  THE  HEAD, AND THE CAPACITY TO OFFER THE INTEGRATED DELIVERY OF SUCH
SERVICES AT LOCATIONS AS MAY BE APPROVED BY TWO OR MORE OF  THE  RESPEC-
TIVE COMMISSIONERS; AND
  (B)  MEET  THE  STANDARDS THAT MAY BE ESTABLISHED BY THE PARTICIPATING
COMMISSIONERS FOR THE PROVISION OF  SUCH  SERVICES;  PROVIDED,  HOWEVER,
THAT  AN  ENTITY  MEETING  THE  STANDARDS  ESTABLISHED  PURSUANT TO THIS
SECTION SHALL NOT BE REQUIRED  TO  BE  AN  INTEGRATED  SERVICE  PROVIDER
PURSUANT  TO  SUBDIVISION SEVEN OF SECTION THREE HUNDRED SIXTY-FIVE-L OF
THE SOCIAL SERVICES LAW.
  2. IN ESTABLISHING ONE OR MORE SETS OF JOINT  REQUIREMENTS  OR  PROCE-
DURES FOR ENTITIES DESCRIBED IN THIS SECTION, EACH PARTICIPATING COMMIS-
SIONER  IS AUTHORIZED TO WAIVE ANY REGULATORY REQUIREMENTS, OR TO DETER-
MINE  THAT  COMPLIANCE   WITH   ANOTHER   PARTICIPATING   COMMISSIONER'S
REGULATORY  REQUIREMENTS SHALL BE DEEMED TO MEET THE REGULATORY REQUIRE-
MENTS OF HIS OR HER AGENCY, AS MAY BE NECESSARY OR  DESIRABLE  TO  AVOID
DUPLICATION  OF REQUIREMENTS AND/OR TO PERMIT THE INTEGRATED DELIVERY OF
HEALTH AND BEHAVIORAL HEALTH SERVICES  IN  AN  EFFICIENT  AND  EFFECTIVE
MANNER.
  3.  ALL OPERATING, REPORTING AND CONSTRUCTION REQUIREMENTS, AS WELL AS
JOINT SURVEY REQUIREMENTS AND PROCEDURES, PROMULGATED PURSUANT  TO  THIS
SECTION  SHALL  BE SO DONE IN A MANNER SUCH THAT THEY INCREASE EFFICIEN-
CIES, PROMOTE TRANSPARENCY, AND REDUCE ADMINISTRATIVE BURDENS.  FURTHER-
MORE, SUCH REQUIREMENTS AND PROCEDURES, AS WELL AS ALL ACTIONS  PURSUANT
TO  SUBDIVISION  TWO  OF  THIS  SECTION, SHALL NEITHER CONFLICT WITH NOR
OTHERWISE MODIFY ANY STATUTORY REQUIREMENTS PERTAINING TO ENTITIES OPER-
ATING UNDER THE AUSPICES OF THE DEPARTMENT  OF  HEALTH,  THE  OFFICE  OF

S. 6256--C                         49

MENTAL HEALTH, THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, OR
THE  OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES. THE PROMULGATION
OF ANY REGULATIONS OR RULES PURSUANT TO THIS SECTION SHALL BE SUBJECT TO
SECTION  TWO  HUNDRED  TWO  OF THIS ARTICLE, PROVIDED, HOWEVER, THAT THE
ADOPTION OF EMERGENCY RULES PURSUANT TO SUBDIVISION SIX OF  SECTION  TWO
HUNDRED TWO OF THIS ARTICLE SHALL BE PROHIBITED FOR THE PURPOSES OF THIS
SECTION.
  S  2.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012; provided,
however, that absent explicit language expressly and unequivocally stat-
ing a legislative intent to the contrary, all provisions of this act are
irrefutably  presumed  to  operate  in  a  wholly  prospective   manner.
Provisions  shall  be considered to operate retroactively, and therefore
in violation of this paragraph, if applied in such a manner as to alter,
change, affect, impair or defeat  any  rights,  obligations,  duties  or
interests  accrued, incurred or conferred prior to the effective date of
this act. Furthermore, the provisions of this act  shall  neither  apply
to,  nor  be applied based upon the occasion of, acts occurring prior to
it becoming law.

                                 PART M

  Section 1. The mental hygiene law is amended by adding a  new  section
9.52 to read as follows:
S  9.52  PILOT  PROGRAMS TO PROVIDE EDUCATIONAL PROGRAMMING AND SERVICES
          FOR CERTAIN PATIENTS.
  NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, THE OFFICE
OF MENTAL HEALTH SHALL BE AUTHORIZED  TO  ESTABLISH  PILOT  PROGRAMS  TO
PROVIDE  EDUCATIONAL  PROGRAMMING  AND  SERVICES  TO  PATIENTS,  WHO ARE
BETWEEN THE AGES OF FIVE AND TWENTY-ONE AND RESIDE IN HOSPITALS OPERATED
BY THE OFFICE OF MENTAL HEALTH, THAT IS COMPARABLE TO  THAT  WHICH  THEY
WOULD OTHERWISE RECEIVE IN THEIR LOCAL SCHOOL DISTRICTS. THE COMMISSION-
ER OF MENTAL HEALTH MAY CONTRACT WITH THE STATE EDUCATION DEPARTMENT, OR
DIRECTLY  WITH  LOCAL  SCHOOL DISTRICTS AND BOARDS OF COOPERATIVE EDUCA-
TIONAL SERVICES, TO PROVIDE SUCH PROGRAMMING AND SERVICES. FURTHER,  THE
COMMISSIONER  OF  EDUCATION  MAY,  PURSUANT  TO SUCH A CONTRACT WITH THE
COMMISSIONER OF MENTAL HEALTH, REQUEST THAT LOCAL SCHOOL  DISTRICTS  AND
BOARDS  OF COOPERATIVE EDUCATIONAL SERVICES PROVIDE SUCH PROGRAMMING AND
SERVICES. HOWEVER, NOTHING IN THIS SECTION SHALL BE CONSTRUED AS REQUIR-
ING PARTICIPATION BY ANY LOCAL SCHOOL DISTRICT OR BOARD  OF  COOPERATIVE
EDUCATIONAL  SERVICES.  SUCH  PILOT PROGRAMS SHALL OPERATE IN ACCORDANCE
WITH IMPLEMENTATION STANDARDS ISSUED BY THE COMMISSIONER  OF  EDUCATION,
AND  IN ACCORDANCE WITH A PLAN FOR EDUCATIONAL SERVICES JOINTLY APPROVED
BY THE COMMISSIONERS OF EDUCATION AND MENTAL HEALTH.
  (A) THE COMMISSIONER WHO CONTRACTS WITH A  LOCAL  SCHOOL  DISTRICT  OR
BOARD  OF  COOPERATIVE  EDUCATIONAL  SERVICES SHALL FULLY REIMBURSE SUCH
LOCAL SCHOOL DISTRICT OR BOARD OF COOPERATIVE EDUCATIONAL  SERVICES  FOR
ALL  UNREIMBURSED,  APPROVED  EXPENSES  ASSOCIATED WITH THE PROVISION OF
EDUCATIONAL PROGRAMMING AND SERVICES,  PURSUANT  TO  THE  TERMS  OF  THE
CONTRACT.
  (B) THE COMMISSIONER OF MENTAL HEALTH, WITH THE APPROVAL OF THE DIREC-
TOR  OF  THE  BUDGET,  SHALL  BE  AUTHORIZED  TO TRANSFER FUNDING TO THE
COMMISSIONER OF EDUCATION TO THE EXTENT  NECESSARY  TO  REIMBURSE  LOCAL
SCHOOL  DISTRICTS  OR BOARDS OF COOPERATIVE EDUCATIONAL SERVICES FOR THE
PROVISION OF EDUCATIONAL PROGRAMMING AND SERVICES TO  PATIENTS  RESIDING

S. 6256--C                         50

IN HOSPITALS OPERATED BY THE OFFICE OF MENTAL HEALTH WHO ARE BETWEEN THE
AGES OF FIVE AND TWENTY-ONE.
  S  2.  The  commissioners of education and mental health shall jointly
submit to the governor, and to the temporary president of the senate and
the speaker of the assembly, a report and recommendations by January  1,
2015,  which  shall  provide  detailed proposals regarding whether addi-
tional actions should be taken  to  ensure  that  children  residing  in
hospitals  operated  by  the  office  of mental health receive education
programming and services comparable to that which they  would  otherwise
receive in their local school districts, as required by state and feder-
al  law.    Such report and recommendations shall also recommend whether
the pilot program established by this act should be modified and whether
such programs should be expanded and made permanent.
  S 3. This act shall take effect July 1, 2012 and shall expire June 30,
2015, when upon such date the provisions of this  act  shall  be  deemed
repealed; provided, however, that absent explicit language expressly and
unequivocally   stating  a  legislative  intent  to  the  contrary,  all
provisions of this act are irrefutably presumed to operate in  a  wholly
prospective  manner.  Provisions shall be considered to operate retroac-
tively, and therefore in violation of this section, if applied in such a
manner as to alter, change, affect, impair or defeat any  rights,  obli-
gations, duties or interests accrued, incurred or conferred prior to the
effective  date  of  this  act.  Furthermore, the provisions of this act
shall neither apply to, nor be applied based upon the occasion of,  acts
occurring prior to it becoming law.

                                 PART N

  Section 1. Section 1.03 of the mental hygiene law is amended by adding
three new subdivisions 56, 57 and 58 to read as follows:
  56.  "SUBSTANCE  USE  DISORDER" MEANS A CONDITION CAUSING THE REPEATED
MISUSE OF, DEPENDENCE ON, OR ADDICTION TO ALCOHOL AND/OR LEGAL OR  ILLE-
GAL  DRUGS  LEADING  TO EFFECTS THAT ARE DETRIMENTAL TO THE INDIVIDUAL'S
PHYSICAL AND MENTAL HEALTH, OR THE WELFARE OF OTHERS AND  SHALL  INCLUDE
ALCOHOLISM, ALCOHOL ABUSE, SUBSTANCE ABUSE, SUBSTANCE DEPENDENCE, CHEMI-
CAL ABUSE, AND/OR CHEMICAL DEPENDENCE.
  57.  "SUBSTANCE USE DISORDER SERVICES" SHALL MEAN AND INCLUDE EXAMINA-
TION, EVALUATION, DIAGNOSIS, CARE, TREATMENT, REHABILITATION, OR  TRAIN-
ING  OF  PERSONS WITH SUBSTANCE USE DISORDERS, AS WELL AS COUNSELING AND
TRAINING PROVIDED TO THEIR FAMILIES OR SIGNIFICANT OTHERS.
  58. "BEHAVIORAL HEALTH SERVICES" SHALL  MEAN  EXAMINATION,  DIAGNOSIS,
CARE,  TREATMENT,  REHABILITATION,  OR  TRAINING FOR PERSONS WITH MENTAL
ILLNESS, A SUBSTANCE USE DISORDER AND/OR A COMPULSIVE GAMBLING DISORDER.
  S 2. The mental hygiene law is amended by adding a new section 5.06 to
read as follows:
S 5.06 BEHAVIORAL HEALTH SERVICES ADVISORY COUNCIL.
  (A) THERE IS HEREBY CREATED WITHIN THE DEPARTMENT A BEHAVIORAL  HEALTH
SERVICES  ADVISORY  COUNCIL, THE PURPOSE OF WHICH SHALL BE TO ADVISE THE
OFFICES OF MENTAL HEALTH AND ALCOHOLISM AND SUBSTANCE ABUSE SERVICES  ON
MATTERS  RELATING TO THE PROVISION OF BEHAVIORAL HEALTH SERVICES; ISSUES
OF JOINT CONCERN TO THE OFFICES, INCLUDING THE  INTEGRATION  OF  VARIOUS
BEHAVIORAL  HEALTH  SERVICES  AND  THE  INTEGRATION OF BEHAVIORAL HEALTH
SERVICES WITH HEALTH SERVICES; AND ISSUES RELATED  TO  THE  DELIVERY  OF
BEHAVIORAL  HEALTH  SERVICES  THAT  ARE  RESPONSIVE  TO LOCAL, STATE AND
FEDERAL CONCERNS. THE COUNCIL SHALL  CONSIST  OF  THE  COMMISSIONERS  OF
MENTAL  HEALTH AND OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, WHO SHALL

S. 6256--C                         51

NOT HAVE THE RIGHT TO VOTE, THE CHAIR OF THE CONFERENCE OF LOCAL  MENTAL
HYGIENE  DIRECTORS  OR  HIS  OR  HER  DESIGNEE, AND TWENTY-EIGHT MEMBERS
APPOINTED BY THE GOVERNOR UPON THE ADVICE AND  CONSENT  OF  THE  SENATE.
MEMBERS  SHALL  BE APPOINTED ONLY IF THEY HAVE PROFESSIONAL KNOWLEDGE IN
THE CARE OF PERSONS RECEIVING BEHAVIORAL HEALTH SERVICES, OR  AN  ACTIVE
INTEREST IN THE BEHAVIORAL HEALTH SERVICES SYSTEM.
  (B)  THE  COUNCIL SHALL ELECT, BY MAJORITY VOTE, ONE OF THE MEMBERS OF
THE COUNCIL AS CHAIR. AT LEAST ONE-HALF OF THE MEMBERS  OF  THE  COUNCIL
SHALL  NOT BE PROVIDERS OF BEHAVIORAL HEALTH SERVICES.  MEMBERSHIP SHALL
REFLECT A BALANCED REPRESENTATION OF PERSONS WITH  INTERESTS  IN  MENTAL
HEALTH AND SUBSTANCE USE DISORDER SERVICES AND SHALL INCLUDE:
  (1)  AT  LEAST  SIX  CURRENT  OR FORMER CONSUMERS OF BEHAVIORAL HEALTH
SERVICES, INCLUDING THREE CURRENT OR FORMER CONSUMERS OF  MENTAL  HEALTH
SERVICES AND THREE CURRENT OR FORMER CONSUMERS OF SUBSTANCE USE DISORDER
SERVICES,  ONE  OF  WHOM  SHALL  BE A VETERAN WHO HAS SERVED IN A COMBAT
THEATER OR COMBAT ZONE OF OPERATIONS AND  IS  A  MEMBER  OF  A  VETERANS
ORGANIZATION;
  (2) AT LEAST THREE INDIVIDUALS WHO ARE PARENTS OR RELATIVES OF CURRENT
OR FORMER CONSUMERS OF BEHAVIORAL HEALTH SERVICES;
  (3)  AT LEAST THREE MEMBERS WHO ARE NOT PROVIDERS OF BEHAVIORAL HEALTH
SERVICES AND WHO REPRESENT NON-GOVERNMENTAL ORGANIZATIONS, SUCH AS  NOT-
FOR-PROFIT  ENTITIES  REPRESENTING  HEALTH  OR  BEHAVIORAL  HEALTH  CARE
EMPLOYEES, PRIVATE PAYORS OF BEHAVIORAL HEALTH SERVICES, OR OTHER ORGAN-
IZATIONS CONCERNED WITH THE PROVISION OF BEHAVIORAL HEALTH SERVICES;
  (4) AT LEAST FIVE REPRESENTATIVES OF PROVIDERS OF SERVICES TO  PERSONS
WITH  MENTAL  ILLNESS  AND AT LEAST FIVE REPRESENTATIVES OF PROVIDERS OF
SERVICES TO PERSONS WITH SUBSTANCE USE DISORDERS, AT LEAST TWO  OF  WHOM
SHALL  BE  PHYSICIANS  AND  AT  LEAST  ONE  OF  WHOM SHALL HAVE PROVIDED
SERVICES TO VETERANS WHO SERVED IN A COMBAT THEATER OR  COMBAT  ZONE  OF
OPERATIONS;
  (5)  ONE MEMBER APPOINTED ON THE RECOMMENDATION OF THE DIRECTOR OF THE
DIVISION OF VETERANS' AFFAIRS;
  (6) ONE MEMBER APPOINTED ON THE RECOMMENDATION OF THE ADJUTANT GENERAL
OF THE DIVISION OF MILITARY AND NAVAL AFFAIRS;
  (7) AT LEAST THREE REPRESENTATIVES OF LOCAL GOVERNMENTS OR OTHER STATE
AND LOCAL AGENCIES CONCERNED WITH THE  PROVISION  OF  BEHAVIORAL  HEALTH
SERVICES; AND
  (8) AT LEAST TWO MEMBERS WHO ARE ALSO MEMBERS OF THE PUBLIC HEALTH AND
HEALTH  PLANNING  COUNCIL  PURSUANT TO SECTION TWO HUNDRED TWENTY OF THE
PUBLIC HEALTH LAW.
  (C) MEMBERS SHALL BE APPOINTED FOR  TERMS  OF  THREE  YEARS  PROVIDED,
HOWEVER,  THAT  OF  THE  MEMBERS  FIRST  APPOINTED,  ONE-THIRD  SHALL BE
APPOINTED FOR ONE YEAR TERMS AND ONE-THIRD SHALL BE  APPOINTED  FOR  TWO
YEAR TERMS. INITIAL APPOINTMENTS SHALL BE MADE WITHIN ONE HUNDRED TWENTY
DAYS  OF THE DATE ON WHICH THIS SECTION SHALL HAVE BECOME A LAW.  VACAN-
CIES SHALL BE FILLED IN THE SAME MANNER AS ORIGINAL APPOINTMENTS FOR THE
REMAINDER OF ANY UNEXPIRED TERM. NO PERSON SHALL BE AN APPOINTED  MEMBER
OF  THE  COUNCIL FOR MORE THAN SIX YEARS IN ANY PERIOD OF TWELVE CONSEC-
UTIVE YEARS.
  (D) THE COUNCIL SHALL MEET AT LEAST FOUR TIMES IN EACH  FULL  CALENDAR
YEAR.  THE  COUNCIL  SHALL  MEET  AT  THE REQUEST OF ITS CHAIR OR EITHER
COMMISSIONER.
  (E) THE COUNCIL SHALL ESTABLISH SUCH COMMITTEES AS IT DEEMS  NECESSARY
TO  ADDRESS  THE  SERVICE  NEEDS  OF  SPECIAL POPULATIONS AND TO ADDRESS
PARTICULAR SUBJECTS OF IMPORTANCE IN THE DEVELOPMENT AND  MANAGEMENT  OF
BEHAVIORAL HEALTH SERVICES.

S. 6256--C                         52

  (F) THE COUNCIL MAY CONSIDER ANY MATTER RELATING TO THE IMPROVEMENT OF
BEHAVIORAL HEALTH SERVICES IN THE STATE AND SHALL ADVISE THE COMMISSION-
ERS ON ANY SUCH MATTER, INCLUDING, BUT NOT LIMITED TO:
  (1)  CARE  AND  SERVICES  TO PERSONS WITH BEHAVIORAL HEALTH DISORDERS,
INCLUDING SPECIAL AND  UNDERSERVED  POPULATIONS  AS  DETERMINED  BY  THE
COMMISSIONER;
  (2) FINANCING BEHAVIORAL HEALTH SERVICES;
  (3) INTEGRATION OF BEHAVIORAL HEALTH SERVICES WITH HEALTH SERVICES;
  (4)  CARE  AND  SERVICES  FOR  PERSONS  WITH CO-OCCURRING DISORDERS OR
MULTIPLE DISABILITIES;
  (5) PREVENTION OF BEHAVIORAL HEALTH DISORDERS; AND
  (6) IMPROVEMENT OF CARE IN STATE OPERATED OR COMMUNITY BASED PROGRAMS,
RECRUITMENT, EDUCATION AND TRAINING OF QUALIFIED DIRECT CARE  PERSONNEL,
AND  PROTECTION OF THE INTERESTS OF EMPLOYEES AFFECTED BY ADJUSTMENTS IN
THE BEHAVIORAL HEALTH SERVICE SYSTEM.
  (G) THE COUNCIL SHALL, IN COOPERATION WITH THE  COMMISSIONERS,  ESTAB-
LISH  STATEWIDE GOALS AND OBJECTIVES FOR SERVICES TO PERSONS WITH BEHAV-
IORAL HEALTH DISORDERS, PURSUANT TO SECTION 5.07 OF THIS ARTICLE.
  (H) (1) THE COUNCIL SHALL REVIEW THE PORTION OF THE STATEWIDE PLAN  TO
BE  DEVELOPED  AND  UPDATED  ANNUALLY  BY  THE COMMISSIONERS PURSUANT TO
SECTION 5.07 OF THIS ARTICLE, AND REPORT ITS RECOMMENDATIONS THEREON  TO
THE COMMISSIONERS.
  (2) THE COUNCIL SHALL REVIEW ANY MENTAL HEALTH OR SUBSTANCE USE COMPO-
NENT OF STATEWIDE HEALTH PLANS DEVELOPED IN ACCORDANCE WITH ANY APPLICA-
BLE  FEDERAL  LAW,  AND  SHALL REPORT ITS RECOMMENDATIONS THEREON TO THE
COMMISSIONERS.
  (I) THE COUNCIL SHALL REVIEW APPLICATIONS, AFTER HAVING  RECEIVED  ALL
NECESSARY INFORMATION FROM THE COMMISSIONERS, FILED IN ACCORDANCE WITH:
  (1)  SECTION  31.22  OF  THIS CHAPTER FOR APPROVAL OF INCORPORATION OR
ESTABLISHMENT OF A FACILITY, AND  SECTION  31.23  OF  THIS  CHAPTER  FOR
APPROVAL  OF  THE CONSTRUCTION OF A FACILITY FOR WHICH APPROVAL FROM THE
COMMISSIONER OF MENTAL HEALTH IS REQUIRED; AND
  (2) SECTION 32.29 OR 32.31 OF THIS CHAPTER FOR  APPROVAL  OF  INCORPO-
RATION OR ESTABLISHMENT OR CONSTRUCTION OF A FACILITY FOR WHICH APPROVAL
TO OPERATE IS REQUIRED FROM THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE
ABUSE  SERVICES  PURSUANT  TO ARTICLE THIRTY-TWO OF THIS CHAPTER, AND AS
OTHERWISE REQUESTED BY SUCH COMMISSIONER;
  (J) THE COUNCIL SHALL ISSUE A REPORT AND RECOMMENDATIONS PERTAINING TO
ANY SIGNIFICANT SERVICE REDUCTION  PROPOSED  BY  THE  OFFICE  OF  MENTAL
HEALTH.  SUCH REPORT AND RECOMMENDATIONS SHALL CONTAIN DETAILED INFORMA-
TION  INCLUDING, BUT NOT LIMITED TO: HOW MANY PATIENTS WOULD BE AFFECTED
BY THE SERVICE  REDUCTION;  WHERE  PATIENTS  AFFECTED  BY  SUCH  SERVICE
REDUCTION MAY BE PLACED, CONSIDERING THE CAPACITY, RESOURCES AND SECURI-
TY OF POTENTIAL RECIPIENT FACILITIES; THE ABILITY OF AFFECTED LOCALITIES
TO PROVIDE HIGH QUALITY AND EFFECTIVE SERVICES TO AFFECTED PATIENTS; AND
SUGGESTIONS  RELATED  TO  COMMUNITY  REINVESTMENT.  UPON COMPLETION, THE
COUNCIL SHALL SUBMIT ITS REPORT AND  RECOMMENDATIONS  TO  THE  TEMPORARY
PRESIDENT  OF  THE  SENATE  AND  THE  SPEAKER  OF THE ASSEMBLY FOR THEIR
CONSIDERATION.
  (K) AT LEAST SIXTY DAYS PRIOR TO THE COMMISSIONERS' FINAL APPROVAL  OF
RULES  AND  REGULATIONS  UNDER THEIR RESPECTIVE JURISDICTION, OTHER THAN
EMERGENCY RULES AND REGULATIONS AND REGULATIONS PROMULGATED PURSUANT  TO
SECTION  43.01  OF  THIS  CHAPTER,  THE  COMMISSIONERS SHALL SUBMIT SUCH
PROPOSED RULES AND REGULATIONS TO THE COUNCIL FOR ITS REVIEW. THE  COUN-
CIL  SHALL  REVIEW  ALL  PROPOSED  RULES  AND REGULATIONS AND REPORT ITS
RECOMMENDATIONS THEREON TO THE  COMMISSIONERS  WITHIN  SIXTY  DAYS.  THE

S. 6256--C                         53

COMMISSIONER  HAVING  STATUTORY  JURISDICTION  OVER THE PROPOSED RULE OR
REGULATION SHALL NOT ACT IN A MANNER INCONSISTENT WITH  THE  RECOMMENDA-
TIONS  OF  THE  COUNCIL  WITHOUT  FIRST  APPEARING BEFORE THE COUNCIL TO
REPORT  THE  REASONS  THEREFOR. THE COUNCIL, UPON A MAJORITY VOTE OF ITS
MEMBERS, MAY REQUIRE THAT AN ALTERNATIVE APPROACH TO THE PROPOSED  RULES
AND  REGULATIONS  BE PUBLISHED WITH THE NOTICE OF THE PROPOSED RULES AND
REGULATIONS PURSUANT TO SECTION TWO HUNDRED TWO OF THE STATE ADMINISTRA-
TIVE PROCEDURE ACT. WHEN AN ALTERNATIVE APPROACH IS  PUBLISHED  PURSUANT
TO  THIS  SECTION, THE COMMISSIONER HAVING STATUTORY JURISDICTION OF THE
SUBJECT PROPOSED RULE OR REGULATION SHALL ALSO PUBLISH THE  REASONS  FOR
NOT SELECTING SUCH ALTERNATIVE APPROACH.
  (L)  THE COUNCIL, BY A MAJORITY VOTE OF ITS MEMBERS, MAY PROPOSE RULES
AND REGULATIONS ON ANY MATTER WITHIN THE REGULATORY JURISDICTION OF  THE
OFFICES  OF  MENTAL  HEALTH  OR ALCOHOLISM AND SUBSTANCE ABUSE SERVICES,
OTHER THAN ESTABLISHMENT OF FEE SCHEDULES PURSUANT TO SECTION  43.01  OF
THIS  CHAPTER,  AND  FORWARD SUCH PROPOSED RULES AND REGULATIONS TO BOTH
COMMISSIONERS FOR REVIEW AND CONSIDERATION; PROVIDED, HOWEVER, THAT ONLY
THE APPROVAL OF THE COMMISSIONER  WITH  STATUTORY  JURISDICTION  OF  THE
PROPOSED RULE OR REGULATION SHALL BE REQUIRED. PRIOR TO SUCH COMMISSION-
ER'S  FINAL  APPROVAL  AND PROMULGATION OF SUCH PROPOSED RULES AND REGU-
LATIONS, IF SUCH RULES AND REGULATIONS ARE MODIFIED IN ANY RESPECT, THEY
SHALL BE SUBMITTED TO THE COUNCIL PURSUANT TO SUBDIVISION  (K)  OF  THIS
SECTION. IF SUCH COMMISSIONER DETERMINES NOT TO PROMULGATE SUCH PROPOSED
RULES  AND REGULATIONS, THE COMMISSIONER SHALL APPEAR BEFORE THE COUNCIL
TO REPORT THE REASONS THEREFOR.
  (M) THE MEMBERS OF THE COUNCIL SHALL RECEIVE NO COMPENSATION FOR THEIR
SERVICES, BUT SHALL BE REIMBURSED FOR EXPENSES ACTUALLY AND  NECESSARILY
INCURRED IN THE PERFORMANCE OF THEIR DUTIES.
  (N)  THE  COMMISSIONERS,  UPON REQUEST OF THE COUNCIL, SHALL DESIGNATE
ONE OR MORE OFFICERS OR EMPLOYEES FROM EITHER OR BOTH OFFICES TO PROVIDE
ADMINISTRATIVE SUPPORT SERVICES TO THE COUNCIL, AND MAY ASSIGN FROM TIME
TO TIME SUCH OTHER EMPLOYEES AS THE COUNCIL MAY REQUEST.
  (O) NO CIVIL ACTION SHALL BE BROUGHT IN ANY COURT AGAINST  ANY  MEMBER
OF  THE  BEHAVIORAL  HEALTH  SERVICES ADVISORY COUNCIL FOR ANY ACT DONE,
FAILURE TO ACT, OR STATEMENT OR OPINION MADE, WHILE DISCHARGING  HIS  OR
HER  DUTIES  AS A MEMBER OF THE COUNCIL, WITHOUT LEAVE FROM A JUSTICE OF
THE SUPREME COURT, FIRST HAD AND OBTAINED. IN  ANY  EVENT,  SUCH  MEMBER
SHALL NOT BE LIABLE FOR DAMAGES IN ANY SUCH ACTION IF HE OR SHE ACTED IN
GOOD  FAITH,  WITH  REASONABLE CARE AND UPON PROBABLE CAUSE.  MEMBERS OF
THE COUNCIL SHALL BE CONSIDERED PUBLIC  OFFICERS  FOR  THE  PURPOSES  OF
SECTION SEVENTEEN OF THE PUBLIC OFFICERS LAW.
  (P) THE COUNCIL MAY ESTABLISH WRITTEN BYLAWS.
  S  3.  The  section heading, subdivision (a) and the opening paragraph
and paragraphs 1 and 3 of subdivision (b) of section 5.07 of the  mental
hygiene law, the section heading as amended by chapter 55 of the laws of
1992,  subdivision  (a) and the opening paragraph and paragraphs 1 and 3
of subdivision (b) as amended by chapter 223 of the laws of 1992,  para-
graph 1 of subdivision (a) as amended by chapter 37 of the laws of 2011,
the  opening  paragraph  of paragraph 1 of subdivision (b) as amended by
chapter 168 of the laws of 2010, subparagraphs h and i  as  amended  and
subparagraph j of paragraph 1 of subdivision (b) as added by chapter 413
of  the laws of 2009 and paragraph 3 of subdivision (b) as renumbered by
chapter 322 of the laws of 1992, are amended to read as follows:
Establishment of [statewide goals and objectives;] statewide  comprehen-
         sive plans of services for [the mentally disabled] PERSONS WITH
         MENTAL DISABILITIES.

S. 6256--C                         54

  (a)  (1) The [mental health] BEHAVIORAL HEALTH services ADVISORY coun-
cil and the advisory [councils] COUNCIL  on  developmental  disabilities
[and  alcoholism  and  substance  abuse services] shall [each] establish
statewide PRIORITIES AND goals [and objectives] to  guide  comprehensive
planning,  resource  allocation  and  evaluation processes for state and
local services for persons with mental illness, developmental  disabili-
ties  [and],  AND/OR those [suffering from chemical abuse or dependence,
respectively] WITH SUBSTANCE USE OR COMPULSIVE GAMBLING DISORDERS.  Such
goals and objectives shall:
  a.  be  measurable  in terms of attainment AND FOCUSED ON OUTCOMES FOR
THOSE BEING SERVED;
  b. be DEVELOPED IN COLLABORATION WITH, AND communicated to,  providers
of  services,  department  facilities,  consumers and consumer represen-
tatives, and other appropriate state and local governmental agencies;
  c. require that all state and local public and  private  services  for
persons  with  mental disabilities be organized, staffed and financed to
best meet the needs of all  persons  with  mental  disabilities  whether
receiving in-patient or non in-patient services;
  d. reflect the partnership between state and local governmental units;
and
  e.    emphasize [that gaps in services be filled and that services are
provided to persons with mental  disabilities]  THE  NEED  TO  INTEGRATE
BEHAVIORAL HEALTH AND HEALTH SERVICES.
  (2) Such advisory councils shall [establish, review, augment or delete
from such goals and objectives, as appropriate,] ACCOMPLISH THEIR DUTIES
by means of a [continuing annual goal-setting] process which is:
  a. open, visible and accessible to the public; and
  b.  consistent  with  the  statewide  AND FEDERALLY MANDATED planning,
appropriation and evaluation processes, and activities for  services  to
[the mentally disabled] PERSONS WITH MENTAL DISABILITIES.
  (3) The advisory councils are hereby empowered to hold public hearings
and meetings to enable them to accomplish their duties.
  Statewide  comprehensive  plan for services to [the mentally disabled]
PERSONS WITH MENTAL DISABILITIES.
  (1) The office of mental health, the office for people  with  develop-
mental  disabilities,  and  the office of alcoholism and substance abuse
services shall [each] JOINTLY formulate a statewide comprehensive  five-
year  plan for the provision of all state and local services for persons
with  mental  illness  [and],  developmental  disabilities,  [and  those
suffering  from  alcoholism  and] AND/OR substance [abuse, respectively]
USE OR COMPULSIVE GAMBLING DISORDERS.  [Each] THE  STATEWIDE  COMPREHEN-
SIVE  plan  shall  be  [formulated from] BASED UPON AN ANALYSIS OF local
[comprehensive] SERVICES plans  developed  by  each  local  governmental
unit,  IN  CONSULTATION  with  [participation  of]  consumers,  consumer
groups, providers of services, and departmental facilities  [furnishing]
THAT  FURNISH  BEHAVIORAL  HEALTH  services  [to individuals with mental
disabilities of the area], AND SHALL BE in  conformance  with  statewide
PRIORITIES  AND  goals  [and  objectives]  established by the BEHAVIORAL
SERVICES advisory council [of each office] AND THE ADVISORY  COUNCIL  ON
DEVELOPMENTAL DISABILITIES. [Each] THE plan shall:
  a.  identify  needs and problems [which] THAT must be addressed during
the next ensuing five years which such plan encompasses;
  b. [specify time-limited goals to meet those needs;
  c.] identify resources to achieve the goals, including but not limited
to resource reallocations;

S. 6256--C                         55

  [d. establish] C. PROPOSE STRATEGIES AND INITIATIVES  TO  ADDRESS  THE
priorities  [for  resource  allocation]  AND  FACILITATE  ACHIEVEMENT OF
STATEWIDE GOALS;
  [e.  define  the  authority  and  responsibility  for  state and local
participation in the delivery of services] D.    IDENTIFY  SERVICES  AND
SUPPORTS,  WHICH  MAY  INCLUDE  PROGRAMS  RUN  OR LED BY PEERS, THAT ARE
DESIGNED TO PROMOTE THE HEALTH  AND  WELLNESS  OF  PERSONS  WITH  MENTAL
ILLNESS,  DEVELOPMENTAL DISABILITIES, AND/OR SUBSTANCE USE OR COMPULSIVE
GAMBLING DISORDERS;
  [f.] E. propose programs [to achieve the  goals,  which  programs  may
include]  AND  MEASURES INCLUDING direct services, development of multi-
purpose facilities, contracts for services, and innovative financial and
organizational  relationships  with  public  and  private  providers  TO
ACHIEVE GOALS;
  [g.] F. identify services and programs that assist the informal [care-
giver  to  care]  CAREGIVERS for the mentally disabled; make recommenda-
tions to enhance the ability  of  the  informal  caregiver  to  continue
providing  care; and develop strategies for creating informal caregivers
for clients in the community who do not have a system in place;
  [h. analyze] G. PROVIDE ANALYSIS OF current and  anticipated  utiliza-
tion  of  state  and  local,  and  public  and private facilities [and],
programs, SERVICES AND/OR SUPPORTS;
  [i.] H. encourage and promote PERSON-CENTERED, CULTURALLY AND LINGUIS-
TICALLY  COMPETENT  community-based  programs  [which],  SERVICES,   AND
SUPPORTS  THAT  reflect  the partnership between state and local govern-
mental units; and
  [j.] I. include progress reports on the implementation of both  short-
term  and  long-term  recommendations  of  the  children's plan required
pursuant to section four hundred eighty-three-f of the  social  services
law.
  (3)  The commissioners of each of the offices shall be responsible for
the development of such statewide five-year plan for services within the
jurisdiction of their respective offices and, after giving  due  notice,
shall  conduct  one or more public hearings on such plan. The BEHAVIORAL
HEALTH SERVICES advisory council [of each office] AND THE ADVISORY COUN-
CIL ON DEVELOPMENTAL DISABILITIES shall review the statewide  five  year
COMPREHENSIVE  plan  developed  by  such [office] OFFICES and report its
recommendations thereon to [such commissioner] THE  COMMISSIONERS.  Each
commissioner  shall  submit the plan, with appropriate modifications, to
the governor no later than the first day of [October] NOVEMBER  of  each
year in order that such plan may be considered with the estimates of the
offices  for the preparation of the executive budget of the state of New
York for the next succeeding state fiscal year.  [Each commissioner] THE
COMMISSIONERS shall also submit  such  plan  to  the  legislature[.  The
statewide  plan], AND SHALL EACH POST IT ON THE WEBSITE OF THEIR RESPEC-
TIVE OFFICE. STATEWIDE PLANS shall be reassessed and  updated  at  least
annually  to encompass the next ensuing five years to ensure responsive-
ness to changing needs and goals, and [to] SHALL reflect the development
of new information and the completion of program evaluations. An interim
report detailing [the] EACH commissioner's  actions  in  fulfilling  the
requirements  of  this  section in preparation of the plan and modifica-
tions in the plan of services being considered by the commissioner shall
be submitted to the governor  and  the  legislature  on  or  before  the
fifteenth  day  of  February  of  each  year.  Such interim report shall
include, but need not be limited to:

S. 6256--C                         56

  (a) actions to include participation of  consumers,  consumer  groups,
providers  of  services and departmental facilities, as required by this
subdivision; and
  (b)  any modifications in the plan of services being considered by the
commissioner, to include:  (i)  compelling  budgetary,  programmatic  or
clinical  justifications  or  other  major  appropriate  reason  for any
significant new statewide  programs  or  policy  changes  from  a  prior
(approved)  five year comprehensive plan; and (ii) procedures to involve
or inform local governmental units of such actions or plans.
  S 4. Section 7.05 of the mental hygiene law is REPEALED.
  S 5. Subdivision (c) of section 13.05 of the mental  hygiene  law,  as
amended  by  chapter  37  of  the  laws  of  2011, is amended to read as
follows:
  (c) The developmental disabilities  advisory  council  shall  have  no
executive,  administrative  or appointive duties. The council shall have
the duty to foster public understanding and acceptance of  developmental
disabilities. It shall, in cooperation with the commissioner of develop-
mental  disabilities,  establish  statewide  PRIORITIES  AND  goals [and
objectives] for services for individuals with developmental disabilities
and shall advise the commissioner on matters related to development  and
implementation  of  the [OPWDD's triennial state developmental disabili-
ties] STATEWIDE comprehensive plan as required under [paragraph  two  of
subdivision  (b)  of] section 5.07 of this chapter. The advisory council
shall have the power to consider any matter relating to the  improvement
of  the  state  developmental  disabilities program and shall advise the
commissioner of developmental disabilities thereon  and  on  any  matter
relating to the performance of their duties with relation to individuals
with developmental disabilities and on policies, goals, budget and oper-
ation of developmental disabilities services.
  S 6. Section 19.05 of the mental hygiene law is REPEALED.
  S 7. Intentionally omitted.
  S  8.   Section 220 of the public health law, as amended by section 45
of part A of chapter 58 of the laws of  2010,  is  amended  to  read  as
follows:
  S  220.  Public  health  and  health  planning council; appointment of
members. There shall continue to be in the department  a  public  health
and  health planning council to consist of the commissioner and fourteen
members to be appointed by the governor with the advice and  consent  of
the  senate;  provided  that effective December first, two thousand ten,
the membership of the council shall  consist  of  the  commissioner  and
twenty-four  members to be appointed by the governor with the advice and
consent of the senate. Membership on the council shall be reflective  of
the  diversity  of the state's population including, but not limited to,
the various geographic areas and  population  densities  throughout  the
state.  The  members  shall include representatives of the public health
system, health care providers that  comprise  the  state's  health  care
delivery system, individuals with expertise in the clinical and adminis-
trative  aspects  of  health care delivery, issues affecting health care
consumers, health planning, health  care  financing  and  reimbursement,
health care regulation and compliance, and public health practice and at
least  two  members  shall  also  be  members of the [mental] BEHAVIORAL
health services ADVISORY council; at least four members shall be  repre-
sentatives  of  general  hospitals  or  nursing  homes; and at least one
member shall be a representative of each of the following  groups:  home
care  agencies,  diagnostic  and  treatment centers, health care payors,

S. 6256--C                         57

labor organizations for health care employees, and health care  consumer
advocacy organizations.
  S  9.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012; provided,
however, that sections one through six of this act shall take effect  on
the one hundred twentieth day after it shall have become a law; provided
further,  however,  that the governor shall immediately take all actions
necessary to appoint members to the behavioral health services  council,
as  required  by  subdivision  (c) of section 5.06 of the mental hygiene
law, as added by section two of this act; and provided further, however,
that absent explicit language  expressly  and  unequivocally  stating  a
legislative intent to the contrary, all provisions of this act are irre-
futably  presumed  to operate in a wholly prospective manner. Provisions
shall be considered to operate retroactively, and therefore in violation
of this paragraph, if applied in such a  manner  as  to  alter,  change,
affect,  impair  or  defeat any rights, obligations, duties or interests
accrued, incurred or conferred prior to the effective date of this  act.
Furthermore  the  provisions  of this act shall neither apply to, nor be
applied based upon the occasion of, acts occurring prior to it  becoming
law.

                                 PART O
                          Intentionally Omitted

                                PART O-1

  Section  1.  Notwithstanding the provisions of part G of chapter 59 of
the laws of 2011, or any  other  inconsistent  provisions  of  law,  the
closure,  consolidation  or  redesign  of any ward, service, facility or
program operated by the office of mental health or the office for people
with developmental disabilities, which is scheduled to be  completed  on
or  after  April 1, 2012, shall be subject to sections 7.17 and 13.17 of
the mental hygiene law, as amended by sections two  and  three  of  this
act.
  S  2.  Subdivision  (f)  of  section 7.17 of the mental hygiene law is
relettered subdivision (g) and a new subdivision (f) is added to read as
follows:
  (F) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, PRIOR TO IMPLE-
MENTING ANY SIGNIFICANT SERVICE REDUCTION OTHER THAN THE  CLOSURE  OF  A
HOSPITAL  ESTABLISHED  IN  SUBDIVISION  (B)  OF THIS SECTION, THE OFFICE
SHALL FIRST ENTER INTO A MEMORANDUM OF UNDERSTANDING WITH THE  TEMPORARY
PRESIDENT  OF  THE  SENATE  AND  THE  SPEAKER  OF  THE ASSEMBLY. FOR THE
PURPOSES OF  THIS  SUBDIVISION,  SIGNIFICANT  SERVICE  REDUCTIONS  SHALL
INCLUDE  THE  CLOSURE,  CONSOLIDATION  OR REDESIGN OF A WARD, SERVICE OR
PROGRAM, AS WELL AS ANY OTHER ACTION THAT  WOULD  REDUCE  INPATIENT  BED
CAPACITY  OF  A  FACILITY  BY TEN BEDS OR MORE. SUCH MEMORANDA OF UNDER-
STANDING SHALL ONLY BE ENTERED INTO AFTER REVIEW  AND  CONSIDERATION  OF
THE  REPORT AND RECOMMENDATIONS ISSUED BY THE BEHAVIORAL HEALTH SERVICES
ADVISORY COUNCIL, PURSUANT TO SUBDIVISION (J) OF SECTION  5.06  OF  THIS
CHAPTER  AS  ADDED  BY PART N OF THE CHAPTER OF THE LAWS OF TWO THOUSAND
TWELVE WHICH ADDED THIS SUBDIVISION.
  S 3. Section 13.17 of the mental hygiene law is amended  by  adding  a
new subdivision (e) to read as follows:
  (E) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, PRIOR TO IMPLE-
MENTING  ANY  SIGNIFICANT  SERVICE REDUCTION OTHER THAN THE CLOSURE OF A

S. 6256--C                         58

DEVELOPMENTAL DISABILITIES SERVICES OFFICE  ESTABLISHED  IN  SUBDIVISION
(B)  OF  THIS SECTION, THE OFFICE SHALL FIRST ENTER INTO A MEMORANDUM OF
UNDERSTANDING WITH THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER
OF  THE  ASSEMBLY.    FOR  THE PURPOSES OF THIS SUBDIVISION, SIGNIFICANT
SERVICE REDUCTIONS SHALL INCLUDE THE CLOSURE, CONSOLIDATION OR  REDESIGN
OF  A  WARD,  SERVICE,  DEVELOPMENTAL  CENTER OR PROGRAM, AS WELL AS ANY
OTHER ACTION THAT WOULD REDUCE INPATIENT BED CAPACITY OF A  FACILITY  BY
TEN  BEDS OR MORE. SUCH MEMORANDA OF UNDERSTANDING SHALL ONLY BE ENTERED
INTO AFTER REVIEW AND CONSIDERATION OF THE  REPORT  AND  RECOMMENDATIONS
ISSUED  BY  THE DEVELOPMENTAL DISABILITIES ADVISORY COUNCIL, PURSUANT TO
SUBDIVISION (J) OF SECTION 13.05 OF THIS CHAPTER.
  S 4. Section 13.05 of the mental hygiene law is amended  by  adding  a
new subdivision (g) to read as follows:
  (G) THE COUNCIL SHALL ISSUE A REPORT AND RECOMMENDATIONS PERTAINING TO
ANY SIGNIFICANT SERVICE REDUCTION PROPOSED BY THE OFFICE FOR PEOPLE WITH
DEVELOPMENTAL   DISABILITIES.  SUCH  REPORT  AND  RECOMMENDATIONS  SHALL
CONTAIN DETAILED INFORMATION INCLUDING, BUT NOT  LIMITED  TO:  HOW  MANY
PATIENTS  WOULD  BE  AFFECTED  BY  THE SERVICE REDUCTION; WHERE PATIENTS
AFFECTED BY SUCH SERVICE REDUCTION MAY BE PLACED, CONSIDERING THE CAPAC-
ITY, RESOURCES AND SECURITY OF POTENTIAL RECIPIENT FACILITIES; THE ABIL-
ITY OF  AFFECTED  LOCALITIES  TO  PROVIDE  HIGH  QUALITY  AND  EFFECTIVE
SERVICES  TO  AFFECTED  PATIENTS;  AND  SUGGESTIONS RELATED TO COMMUNITY
REINVESTMENT. UPON COMPLETION, THE COUNCIL SHALL SUBMIT ITS  REPORT  AND
RECOMMENDATIONS TO THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER
OF THE ASSEMBLY FOR THEIR CONSIDERATION.
  S  5.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012; provided,
however, that the amendments to subdivision (f) of section 7.17  of  the
mental  hygiene law made by section two of this act shall not affect the
repeal of such subdivision  and  shall  be  deemed  repealed  therewith;
provided, further, that absent explicit language expressly and unequivo-
cally  stating  a  legislative intent to the contrary, all provisions of
this act are irrefutably presumed to operate  in  a  wholly  prospective
manner.  Provisions  shall  be  considered to operate retroactively, and
therefore in violation of this paragraph, if applied in such a manner as
to alter, change, affect, impair  or  defeat  any  rights,  obligations,
duties  or  interests accrued, incurred or conferred prior to the effec-
tive date of this act. Furthermore, the provisions  of  this  act  shall
neither apply to, nor be applied based upon the occasion of, acts occur-
ring prior to it becoming law.

                                 PART P

  Section 1. Intentionally omitted.
  S  2.  Subdivision  (k) of section 10.06 of the mental hygiene law, as
amended by section 118-c of subpart B of part C of  chapter  62  of  the
laws of 2011, is amended to read as follows:
  (k) At the conclusion of the hearing, the court shall determine wheth-
er  there  is  probable  cause  to  believe that the respondent is a sex
offender requiring civil management. If the court determines that proba-
ble cause has not been established,  the  court  shall  issue  an  order
dismissing  the  petition,  and  the  respondent's  release  shall be in
accordance with other applicable provisions of law. If the court  deter-
mines  that  probable  cause  has  been established: (i) the court shall
order that the respondent be committed to a  secure  treatment  facility
designated  by the commissioner for care, treatment and control upon his

S. 6256--C                         59

or her release, provided, however, that a respondent who otherwise would
be required to be transferred to  a  secure  treatment  facility  [may,]
SHALL  REMAIN IN THE CUSTODY OF THE DEPARTMENT OF CORRECTIONS AND COMMU-
NITY SUPERVISION PENDING THE OUTCOME OF THE PROCEEDINGS UNDER THIS ARTI-
CLE  UNTIL  HE  OR  SHE HAS REACHED THE MAXIMUM EXPIRATION OF HIS OR HER
SENTENCE OR HAS BEEN APPROVED FOR RELEASE TO PAROLE SUPERVISION  BY  THE
STATE  BOARD  OF PAROLE, PROVIDED, FURTHER THAT A RESPONDENT MAY, upon a
written consent signed by the respondent and his or her counsel, consent
to remain in the custody of the department of corrections and  community
supervision  pending  the outcome of the proceedings under this article,
and that such consent may be revoked in writing at any  time;  (ii)  the
court  shall  set a date for trial in accordance with subdivision (a) of
section 10.07 of this article; and (iii) the  respondent  shall  not  be
released pending the completion of such trial.
  S  3.  Subdivision  (f) of section 10.07 of the mental hygiene law, as
added by chapter 7 of the laws of 2007, is amended to read as follows:
  (f) If the jury, or the court if a jury trial  is  waived,  determines
that the respondent is a detained sex offender who suffers from a mental
abnormality,  then  the court shall consider whether the respondent is a
dangerous sex offender requiring confinement or a sex offender requiring
strict and intensive  supervision.  The  parties  may  offer  additional
evidence,  and  the  court shall hear argument, as to that issue. If the
court finds by clear and convincing evidence that the respondent  has  a
mental  abnormality involving such a strong predisposition to commit sex
offenses, and such an inability to control behavior, that the respondent
is likely to be a danger to others and to commit  sex  offenses  if  not
confined  to  a secure treatment facility, then the court shall find the
respondent to be a dangerous sex offender requiring confinement. In such
case, the respondent shall be committed to a secure  treatment  facility
for  care, treatment, and control until such time as he or she no longer
requires confinement. FAILURE OF  A  DANGEROUS  SEX  OFFENDER  REQUIRING
CONFINEMENT  TO MEANINGFULLY PARTICIPATE IN TREATMENT IN A SECURE TREAT-
MENT FACILITY SHALL CONSTITUTE A VIOLATION OF THE ORDER OF  CONFINEMENT.
If the court does not find that the respondent is a dangerous sex offen-
der requiring confinement, then the court shall make a finding of dispo-
sition that the respondent is a sex offender requiring strict and inten-
sive  supervision,  and  the respondent shall be subject to a regimen of
strict and  intensive  supervision  and  treatment  in  accordance  with
section  10.11  of this article. In making a finding of disposition, the
court shall consider the conditions  that  would  be  imposed  upon  the
respondent  if subject to a regimen of strict and intensive supervision,
and all available information about the prospects for  the  respondent's
possible re-entry into the community.
  S  4.  Section  10.08 of the mental hygiene law is amended by adding a
new subdivision (i) to read as follows:
  (I) AT ANY PROCEEDING CONDUCTED PURSUANT TO THIS ARTICLE OTHER THAN  A
TRIAL  CONDUCTED PURSUANT TO SECTION 10.07 OF THIS ARTICLE, THE RESPOND-
ENT OR ANY WITNESS SHALL BE PERMITTED, UPON GOOD CAUSE SHOWN, TO MAKE AN
ELECTRONIC APPEARANCE IN THE COURT BY MEANS OF AN INDEPENDENT  AUDIO-VI-
SUAL  SYSTEM,  AS  THAT  TERM  IS  DEFINED IN SUBDIVISION ONE OF SECTION
182.10 OF THE CRIMINAL PROCEDURE LAW, FOR PURPOSES OF A COURT APPEARANCE
OR FOR GIVING TESTIMONY. IT SHALL CONSTITUTE GOOD CAUSE THAT  A  WITNESS
IS  CURRENTLY  EMPLOYED  BY  THE STATE AT A SECURE TREATMENT FACILITY OR
ANOTHER WORK LOCATION, UNLESS THERE ARE COMPELLING CIRCUMSTANCES REQUIR-
ING THE WITNESS'S PERSONAL  PRESENCE  AT  THE  COURT  PROCEEDING.    FOR
PURPOSES  OF  THIS  SUBDIVISION,  AN  "ELECTRONIC  APPEARANCE"  MEANS AN

S. 6256--C                         60

APPEARANCE AT WHICH A PARTICIPANT IS NOT PRESENT IN THE  COURT,  BUT  IN
WHICH:  (I)  ALL OF THE PARTICIPANTS ARE ABLE TO SEE AND HEAR THE SIMUL-
TANEOUS REPRODUCTIONS OF THE VOICES AND IMAGES OF  THE  JUDGE,  COUNSEL,
RESPONDENT  OR  ANY  OTHER  APPROPRIATE PARTICIPANT, AND (II) COUNSEL IS
PRESENT WITH THE RESPONDENT OR THE RESPONDENT AND COUNSEL  ARE  ABLE  TO
SEE  AND  HEAR  EACH  OTHER  AND  ENGAGE IN PRIVATE CONVERSATION. WHEN A
RESPONDENT OR A  WITNESS  MAKES  AN  ELECTRONIC  APPEARANCE,  THE  COURT
STENOGRAPHER  SHALL  RECORD  ANY STATEMENTS IN THE SAME MANNER AS IF THE
RESPONDENT OR WITNESS HAD MADE A PERSONAL APPEARANCE.  NOTHING  IN  THIS
SUBDIVISION SHALL BE CONSTRUED TO PROHIBIT THE RESPONDENT OR ANY WITNESS
FROM  MAKING  AN ELECTRONIC APPEARANCE IN THE COURT AT A TRIAL CONDUCTED
PURSUANT TO SECTION 10.07 OF THIS ARTICLE BY  MEANS  OF  AN  INDEPENDENT
AUDIO-VISUAL SYSTEM, UPON GOOD CAUSE SHOWN AND CONSENT OF THE PARTIES.
  S  5. The section heading and subdivisions (a), (b), (c), (d), and (f)
of section 10.09 of the mental hygiene law, as added by chapter 7 of the
laws of 2007, are amended to read as follows:
[Annual] BIENNIAL examinations and petitions for discharge.
  (a) The commissioner shall provide  the  respondent  and  counsel  for
respondent  with  [an  annual] A BIENNIAL written notice of the right to
petition the court for discharge. The notice shall contain  a  form  for
the waiver of the right to petition for discharge.
  (b)  The commissioner shall also assure that each respondent committed
under this article shall have an examination for evaluation  of  his  or
her  mental  condition  made  at  least once every [year] TWO YEARS by a
psychiatric examiner who shall report to the  commissioner  his  or  her
written  findings  as to whether the respondent is currently a dangerous
sex offender requiring confinement. At such time,  the  respondent  also
shall have the right to be evaluated by an independent psychiatric exam-
iner.    If  the respondent is financially unable to obtain an examiner,
the court shall appoint an examiner of the  respondent's  choice  to  be
paid  within  the  limits  prescribed by law. Following such evaluation,
each psychiatric examiner shall report his or her findings in writing to
the commissioner and to counsel for respondent. The  commissioner  shall
review  relevant  records  and  reports,  along with the findings of the
psychiatric examiners, and shall make a determination in writing  as  to
whether  the  respondent is currently a dangerous sex offender requiring
confinement.
  (c) The commissioner shall [annually] BIENNIALLY  forward  the  notice
and  waiver form, along with a report including the commissioner's writ-
ten determination and the findings of the  psychiatric  examination,  to
the supreme or county court where the respondent is located.
  (d) The court shall hold an evidentiary hearing as to retention of the
respondent within forty-five days if it appears from one of the [annual]
BIENNIAL  submissions to the court under subdivision (c) of this section
(i) that the respondent has petitioned, or has not affirmatively  waived
the  right to petition, for discharge, or (ii) that even if the respond-
ent has waived the right to petition, and the  commissioner  has  deter-
mined  that  the  respondent  remains a dangerous sex offender requiring
confinement, the court finds on the basis of the materials described  in
subdivision  (b) of this section that there is a substantial issue as to
whether the  respondent  remains  a  dangerous  sex  offender  requiring
confinement. At an evidentiary hearing on that issue under this subdivi-
sion, the attorney general shall have the burden of proof.
  (f)  The  respondent  may at any time petition the court for discharge
and/or release to the community under a regimen of strict and  intensive
supervision  and  treatment.  Upon  review of the respondent's petition,

S. 6256--C                         61

other than in connection with [annual] BIENNIAL reviews as described  in
subdivisions  (a), (b) and (d) of this section, the court may order that
an evidentiary hearing be held, or may deny an evidentiary  hearing  and
deny  the petition upon a finding that the petition is frivolous or does
not provide sufficient basis for reexamination prior to the next  [annu-
al]  BIENNIAL  review.  If the court orders an evidentiary hearing under
this subdivision, the attorney general shall have the burden of proof as
to whether the respondent is currently a dangerous sex offender  requir-
ing confinement.
  S  6.  Subdivision  (a) of section 10.10 of the mental hygiene law, as
added by chapter 7 of the laws of 2007, is amended to read as follows:
  (a) If the respondent is found to be a dangerous sex offender  requir-
ing  confinement  and  committed  to  a  secure treatment facility, that
facility shall provide care, treatment, and control  of  the  respondent
until  such  time  that  a court discharges the respondent in accordance
with the provisions of this article. FAILURE OF A DANGEROUS SEX OFFENDER
REQUIRING CONFINEMENT TO MEANINGFULLY  PARTICIPATE  IN  TREATMENT  IN  A
SECURE  TREATMENT  FACILITY SHALL CONSTITUTE A VIOLATION OF THE ORDER OF
CONFINEMENT.
  S 7. Subdivision (c) of section 10.11 of the mental  hygiene  law,  as
amended  by  section  118-e  of subpart B of part C of chapter 62 of the
laws of 2011, is amended to read as follows:
  (c) An order for a regimen of strict  and  intensive  supervision  and
treatment places the person in the custody and control of the department
of  corrections and community supervision. A person ordered to undergo a
regimen of strict and intensive supervision and  treatment  pursuant  to
this  article  is  subject to lawful conditions set by the court and the
department of corrections and community supervision.  A VIOLATION  OF  A
CONDITION  OF THE REGIMEN OF STRICT AND INTENSIVE SUPERVISION AND TREAT-
MENT FOR A PERSON UNDER COMMUNITY SUPERVISION, AS DEFINED IN SUBDIVISION
THREE OF SECTION TWO HUNDRED FIFTY-NINE OF THE EXECUTIVE LAW, MAY BE THE
BASIS  FOR  REVOCATION  OF  PAROLE  PURSUANT  TO  SECTION  TWO   HUNDRED
FIFTY-NINE-I OF THE EXECUTIVE LAW. A PERSON WHO INTENTIONALLY VIOLATES A
MATERIAL  CONDITION  OF  THE REGIMEN OF STRICT AND INTENSIVE SUPERVISION
AND TREATMENT SHALL BE GUILTY OF A CLASS E FELONY.
  S 8. Section 120.05 of the penal law is amended by adding a new subdi-
vision 13 to read as follows:
  13. HAVING BEEN FOUND TO BE A SEX OFFENDER REQUIRING CIVIL  MANAGEMENT
AND WHILE CONFINED IN A SECURE TREATMENT FACILITY, AS DEFINED IN SECTION
7.18  OF THE MENTAL HYGIENE LAW, WITH INTENT TO CAUSE PHYSICAL INJURY TO
ANOTHER PERSON, HE CAUSES SUCH INJURY TO  SUCH  PERSON  OR  TO  A  THIRD
PERSON.
  S  9.  This act shall take effect immediately; provided, however, that
absent explicit language expressly and unequivocally stating a  legisla-
tive  intent to the contrary, all provisions of this act are irrefutably
presumed to operate in a wholly prospective manner.  Provisions shall be
considered to operate retroactively, and therefore in violation of  this
paragraph,  if  applied  in  such  a manner as to alter, change, affect,
impair or defeat any rights, obligations, duties or  interests  accrued,
incurred  or conferred prior to the effective date of this act. Further-
more, the provisions of this act shall neither apply to, nor be  applied
based upon the occasion of, acts occurring prior to it becoming law.

                                 PART Q
                          Intentionally omitted

S. 6256--C                         62

                                 PART R

  Section  1.    Section  1 of part D of 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 is  amended
to read as follows:
  Section  1. The office of mental health is authorized to recover fund-
ing from  community  residences  and  family-based  treatment  providers
licensed  by  the  office  of mental health, consistent with contractual
obligations of such providers, and notwithstanding any other  inconsist-
ent  provision  of law to the contrary, in an amount equal to 50 percent
of the income received by such providers which exceeds the fixed  amount
of  annual  Medicaid  revenue limitations, as established by the commis-
sioner of mental health. Recovery of such excess income shall be for the
following fiscal periods: for programs in counties  located  outside  of
the  city of New York, the applicable fiscal periods shall be January 1,
2003 through December 31, 2009 AND JANUARY 1, 2011 THROUGH DECEMBER  31,
2013; and for programs located within the city of New York, the applica-
ble  fiscal periods shall be July 1, 2003 through June 30, 2010 AND JULY
1, 2011 THROUGH JUNE 30, 2013.
  S 2. This act shall take effect immediately; provided,  however,  that
absent  explicit language expressly and unequivocally stating a legisla-
tive intent to the contrary, all provisions of this act are  irrefutably
presumed  to operate in a wholly prospective manner. Provisions shall be
considered to operate retroactively, and therefore in violation of  this
paragraph,  if  applied  in  such  a manner as to alter, change, affect,
impair or defeat any rights, obligations, duties or  interests  accrued,
incurred  or conferred prior to the effective date of this act. Further-
more, the provisions of this act shall neither apply to, nor be  applied
based upon the occasion of, acts occurring prior to it becoming law.

                                 PART S

  Section  1.    Pursuant  to  a  chapter  of the laws of 2012, the laws
governing the excess medical malpractice liability coverage  pool  shall
be  amended to mitigate the extent to which funds available to such pool
are insufficient to fund coverage for eligible physicians and dentists.
  S 2. This act shall take effect immediately, provided,  however,  that
absent  explicit language expressly and unequivocally stating a legisla-
tive intent to the contrary, all provisions of this act are  irrefutably
presumed to operate in a wholly prospective manner.  Provisions shall be
considered  to operate retroactively, and therefore in violation of this
paragraph, if applied in such a manner  as  to  alter,  change,  affect,
impair  or  defeat any rights, obligations, duties or interests accrued,
incurred or conferred prior to the effective date of this act.  Further-
more,  the provisions of this act shall neither apply to, nor be applied
based upon the occasion of, acts occurring prior to it becoming law.

                                 PART T

  Section 1.   The comptroller, in  consultation  with  the  office  for
people  with  developmental  disabilities,  shall  develop  a report and
recommendations evaluating funding provided pursuant to the options  for
people  through  services  initiative.  Such  report and recommendations
shall contain information including, but not limited  to:  whether  such
funding  is  adequate  to  support the provision of services by agencies

S. 6256--C                         63

receiving such grants; how many service providers have been subject to a
reduction in initiative funding since the program's  inception;  whether
the  base  year  used  in  calculating awards should be reevaluated; and
proposals  for  modifying  existing  funding  methodology. By January 1,
2013, the comptroller shall submit such report and  recommendations,  as
well  as  draft legislation that would implement any proposals contained
therein, to the temporary president of the senate and the speaker of the
assembly for their consideration.
  S 2. This act shall take effect immediately and  shall  be  deemed  to
have been in full force and effect on and after April 1, 2012; provided,
however, that absent explicit language expressly and unequivocally stat-
ing a legislative intent to the contrary, all provisions of this act are
irrefutably   presumed  to  operate  in  a  wholly  prospective  manner.
Provisions shall be considered to operate retroactively,  and  therefore
in  violation  of this section, if applied in such a manner as to alter,
change, affect, impair or defeat  any  rights,  obligations,  duties  or
interests  accrued, incurred or conferred prior to the effective date of
this act. Furthermore, the provisions of this act  shall  neither  apply
to,  nor  be applied based upon the occasion of, acts occurring prior to
it becoming law.

                                 PART U

  Section 1. Paragraph (f) of subdivision 3 of section 242 of the  elder
law,  as  amended  by section 3-d of part A of chapter 59 of the laws of
2011, is amended to read as follows:
  (f) As a condition of CONTINUED eligibility for  benefits  under  this
title,  IF  a  program  participant IS ELIGIBLE FOR MEDICARE PART D DRUG
COVERAGE UNDER SECTION 1860D OF THE FEDERAL  SOCIAL  SECURITY  ACT,  THE
PARTICIPANT  is  required  to [be enrolled] ENROLL in Medicare part D AT
THE FIRST AVAILABLE ENROLLMENT PERIOD and to maintain  such  enrollment.
THIS  REQUIREMENT  SHALL  BE  WAIVED  IF SUCH ENROLLMENT WOULD RESULT IN
SIGNIFICANT ADDITIONAL FINANCIAL LIABILITY BY THE  PARTICIPANT,  INCLUD-
ING,  BUT NOT LIMITED TO, INDIVIDUALS IN A MEDICARE ADVANTAGE PLAN WHOSE
COST SHARING WOULD BE INCREASED, OR IF SUCH ENROLLMENT WOULD  RESULT  IN
THE LOSS OF ANY HEALTH COVERAGE THROUGH A UNION OR EMPLOYER PLAN FOR THE
PARTICIPANT,  THE  PARTICIPANT'S SPOUSE OR OTHER DEPENDENT.  THE ELDERLY
PHARMACEUTICAL INSURANCE COVERAGE PROGRAM SHALL PROVIDE PREMIUM  ASSIST-
ANCE FOR ALL PARTICIPANTS ENROLLED IN MEDICARE PART D AS FOLLOWS:
  (I)  FOR  PARTICIPANTS  WITH  COMPREHENSIVE COVERAGE UNDER SECTION TWO
HUNDRED FORTY-SEVEN OF THIS TITLE, THE ELDERLY PHARMACEUTICAL  INSURANCE
COVERAGE PROGRAM SHALL PAY FOR THE PORTION OF THE PART D MONTHLY PREMIUM
THAT  IS  THE  RESPONSIBILITY  OF THE PARTICIPANT. SUCH PAYMENT SHALL BE
LIMITED TO THE LOW-INCOME BENCHMARK PREMIUM AMOUNT  ESTABLISHED  BY  THE
FEDERAL  CENTERS FOR MEDICARE AND MEDICAID SERVICES AND ANY OTHER AMOUNT
WHICH SUCH AGENCY ESTABLISHES  UNDER  ITS  DE  MINIMUS  PREMIUM  POLICY,
EXCEPT  THAT  SUCH PAYMENTS MADE ON BEHALF OF PARTICIPANTS ENROLLED IN A
MEDICARE ADVANTAGE PLAN MAY  EXCEED  THE  LOW-INCOME  BENCHMARK  PREMIUM
AMOUNT IF DETERMINED TO BE COST EFFECTIVE TO THE PROGRAM.
  (II)  FOR  PARTICIPANTS  WITH  CATASTROPHIC COVERAGE UNDER SECTION TWO
HUNDRED FORTY-EIGHT OF THIS TITLE, THE ELDERLY PHARMACEUTICAL  INSURANCE
COVERAGE  PROGRAM SHALL CREDIT THE PARTICIPANT'S ANNUAL PERSONAL COVERED
DRUG EXPENDITURE AMOUNT REQUIRED UNDER THIS TITLE BY AN AMOUNT EQUAL  TO
THE  ANNUAL  LOW-INCOME  BENCHMARK  PREMIUM  AMOUNT  ESTABLISHED  BY THE
CENTERS FOR MEDICARE AND MEDICAID SERVICES, PRORATED FOR  THE  REMAINING
PORTION  OF  THE PARTICIPANT'S ELDERLY PHARMACEUTICAL INSURANCE COVERAGE

S. 6256--C                         64

PROGRAM COVERAGE PERIOD. THE ELDERLY PHARMACEUTICAL  INSURANCE  COVERAGE
PROGRAM   SHALL,   AT   APPROPRIATE   TIMES,  NOTIFY  PARTICIPANTS  WITH
CATASTROPHIC COVERAGE UNDER SECTION  TWO  HUNDRED  FORTY-SEVEN  OF  THIS
TITLE  OF THEIR RIGHT TO COORDINATE THE ANNUAL COVERAGE PERIOD WITH THAT
OF MEDICARE PART D, ALONG WITH THE POSSIBLE ADVANTAGES AND DISADVANTAGES
OF DOING SO.
  S 2. Subdivision 6 of section 241 of the  elder  law,  as  amended  by
section  2  of  part  A of chapter 59 of the laws of 2011, is amended to
read as follows:
  6. "Annual coverage period" shall mean the period  of  twelve  consec-
utive  calendar months for which an eligible program participant has met
the [requirements of section two hundred forty-two] APPLICATION  FEE  OR
DEDUCTIBLE  REQUIREMENTS,  AS  THE  CASE MAY BE, OF SECTIONS TWO HUNDRED
FORTY-SEVEN AND TWO HUNDRED FORTY-EIGHT of this title.
  S 3. Subdivisions 8 and  9  of  section  241  of  the  elder  law  are
REPEALED.
  S  4.  Subdivision  1  of  section 242 of the elder law, as amended by
section 3 of part A of chapter 59 of the laws of  2011,  is  amended  to
read as follows:
  1.  Persons  eligible  for  COMPREHENSIVE  coverage  under SECTION TWO
HUNDRED FORTY-SEVEN OF this title shall include:
  (a) any unmarried resident who is at least sixty-five years  of  age[,
who  is  enrolled in Medicare part D,] and whose income for the calendar
year immediately preceding the effective date  of  the  annual  coverage
period  beginning  on or after January first, two thousand five, is less
than or equal  to  [thirty-five]  TWENTY  thousand  dollars.  After  the
initial  determination  of eligibility, each eligible individual must be
redetermined eligible at least every twenty-four months; and
  (b) any married resident who is at least sixty-five years of age[, who
is enrolled in Medicare part D,] and whose income for the calendar  year
immediately  preceding  the effective date of the annual coverage period
when combined with the income in the same calendar year of such  married
person's  spouse  beginning on or after January first, two thousand one,
is less than or equal to [fifty] TWENTY-SIX thousand dollars. After  the
initial  determination  of eligibility, each eligible individual must be
redetermined eligible at least every twenty-four months.
  S 5. Section 242 of the elder law is amended by adding a new  subdivi-
sion 2 to read as follows:
  2.  PERSONS  ELIGIBLE  FOR  CATASTROPHIC  COVERAGE  UNDER  SECTION TWO
HUNDRED FORTY-EIGHT OF THIS TITLE SHALL INCLUDE:
  (A) ANY UNMARRIED RESIDENT WHO IS AT LEAST SIXTY-FIVE YEARS OF AGE AND
WHOSE INCOME FOR THE CALENDAR YEAR IMMEDIATELY PRECEDING  THE  EFFECTIVE
DATE  OF THE ANNUAL COVERAGE PERIOD BEGINNING ON OR AFTER JANUARY FIRST,
TWO THOUSAND ONE, IS MORE THAN TWENTY THOUSAND AND LESS THAN OR EQUAL TO
THIRTY-FIVE THOUSAND DOLLARS. AFTER THE INITIAL DETERMINATION OF  ELIGI-
BILITY,  EACH ELIGIBLE INDIVIDUAL MUST BE REDETERMINED ELIGIBLE AT LEAST
EVERY TWENTY-FOUR MONTHS; AND
  (B) ANY MARRIED RESIDENT WHO IS AT LEAST SIXTY-FIVE YEARS OF  AGE  AND
WHOSE  INCOME  FOR THE CALENDAR YEAR IMMEDIATELY PRECEDING THE EFFECTIVE
DATE OF THE ANNUAL COVERAGE PERIOD WHEN COMBINED WITH THE INCOME IN  THE
SAME CALENDAR YEAR OF SUCH MARRIED PERSON'S SPOUSE BEGINNING ON OR AFTER
JANUARY  FIRST,  TWO  THOUSAND  ONE,  IS  MORE  THAN TWENTY-SIX THOUSAND
DOLLARS AND LESS THAN OR EQUAL TO  FIFTY  THOUSAND  DOLLARS.  AFTER  THE
INITIAL  DETERMINATION  OF ELIGIBILITY, EACH ELIGIBLE INDIVIDUAL MUST BE
REDETERMINED ELIGIBLE AT LEAST EVERY TWENTY-FOUR MONTHS.

S. 6256--C                         65

  S 6. Paragraph (c) of subdivision 3 of section 242 of the elder law is
REPEALED and a new paragraph (c) is added to read as follows:
  (C)(1)  THE  FACT  THAT  SOME  OF  AN  INDIVIDUAL'S  PRESCRIPTION DRUG
EXPENSES ARE PAID OR REIMBURSABLE UNDER THE PROVISIONS OF  THE  MEDICARE
PROGRAM  SHALL  NOT  DISQUALIFY AN INDIVIDUAL, IF HE OR SHE IS OTHERWISE
ELIGIBLE, FROM RECEIVING ASSISTANCE UNDER THIS TITLE. IN SUCH CASES, THE
STATE SHALL PAY THE PORTION OF THE COST OF THOSE PRESCRIPTIONS FOR QUAL-
IFIED DRUGS FOR WHICH NO PAYMENT OR REIMBURSEMENT IS MADE BY  THE  MEDI-
CARE PROGRAM OR ANY FEDERALLY FUNDED PRESCRIPTION DRUG BENEFIT, LESS THE
PARTICIPANT'S CO-PAYMENT REQUIRED ON THE AMOUNT NOT PAID BY THE MEDICARE
PROGRAM.
  (2)  COVERAGE  UNDER  THIS PARAGRAPH SHALL BE AVAILABLE ONLY AFTER THE
PARTICIPANT HAS FIRST EXHAUSTED THE FIRST TWO LEVELS OF APPEAL AVAILABLE
UNDER PART D OF TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT (FN1) AND
THE APPEAL HAS BEEN DENIED. DURING THE COVERAGE DETERMINATION AND APPEAL
PERIOD, THE ELDERLY  PHARMACEUTICAL  INSURANCE  COVERAGE  PROGRAM  SHALL
PROVIDE  UP TO A NINETY DAY SUPPLY OF THE PRESCRIBED MEDICATION, OR SUCH
LESSER SUPPLY AS SPECIFIED ON THE PRESCRIPTION, IF: (I)  THE  PHARMACIST
NOTIFIES  THE PRESCRIBER THAT THE PARTICIPANT'S MEDICARE PART D PLAN AND
THE  ELDERLY  PHARMACEUTICAL  INSURANCE  COVERAGE  PROGRAM  HAVE  DENIED
PAYMENT  FOR  THE  PRESCRIBED MEDICATION AND THAT IF THE PRESCRIBER DOES
NOT CHOOSE TO CHANGE THE PRESCRIPTION TO A DRUG THAT IS COVERED  BY  THE
PARTICIPANT'S  MEDICARE  PART  D  PLAN, A MEDICARE PART D APPEAL MUST BE
PURSUED; AND (II) THE PRESCRIBER  NOTIFIES  THE  ELDERLY  PHARMACEUTICAL
INSURANCE  COVERAGE PROGRAM OF THE PRESCRIBER'S INTENT TO PROVIDE NECES-
SARY INFORMATION AND COOPERATION IN THE PURSUIT OF THE MEDICARE  PART  D
APPEAL. IN INSTANCES WHERE THE PHARMACIST IS UNABLE TO IMMEDIATELY REACH
THE  PRESCRIBER,  THE  ELDERLY PHARMACEUTICAL INSURANCE COVERAGE PROGRAM
SHALL, UPON THE REQUEST OF THE PHARMACIST, AUTHORIZE A THREE  DAY  EMER-
GENCY  SUPPLY  OF  THE PRESCRIBED MEDICATION. THE ELDERLY PHARMACEUTICAL
INSURANCE COVERAGE PROGRAM SHALL AUTHORIZE SUCH  ADDITIONAL  NINETY  DAY
SUPPLIES  OF  THE PRESCRIBED MEDICATION, OR SUCH LESSER SUPPLY AS SPECI-
FIED ON THE  PRESCRIPTION,  AND  SUCH  ADDITIONAL  THREE  DAY  EMERGENCY
SUPPLIES  AS  REQUIRED  TO  ENSURE COVERAGE OF THE PRESCRIBED MEDICATION
DURING THE PENDENCY OF THE MEDICARE PART D APPEAL.
  (3) THE PARTICIPANT  REGISTRATION  FEE  CHARGED  TO  ELIGIBLE  PROGRAM
PARTICIPANTS  FOR COMPREHENSIVE COVERAGE PURSUANT TO SECTION TWO HUNDRED
FORTY-SEVEN OF THIS TITLE SHALL BE WAIVED FOR THE PORTION OF THE  ANNUAL
COVERAGE  PERIOD THAT THE PARTICIPANT IS ALSO ENROLLED AS A FULL SUBSIDY
INDIVIDUAL IN A PRESCRIPTION DRUG OR MA-PD PLAN UNDER PART  D  OF  TITLE
XVIII OF THE FEDERAL SOCIAL SECURITY ACT.
  S  7.  Subdivision  3  of  section  242 of the elder law is amended by
adding a new paragraph (d) to read as follows:
  (D) THE ELDERLY PHARMACEUTICAL INSURANCE COVERAGE PROGRAM  IS  AUTHOR-
IZED   TO   APPLY   FOR   TRANSITIONAL  ASSISTANCE  UNDER  THE  MEDICARE
PRESCRIPTION DRUG DISCOUNT PROGRAM WITH A SPECIFIC  DRUG  DISCOUNT  CARD
UNDER TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT ON BEHALF OF APPLI-
CANTS  AND  ELIGIBLE  PROGRAM PARTICIPANTS UNDER THIS TITLE. THE ELDERLY
PHARMACEUTICAL INSURANCE COVERAGE PROGRAM SHALL PROVIDE  APPLICANTS  AND
ELIGIBLE  PROGRAM  PARTICIPANTS  WITH  PRIOR  WRITTEN NOTICE OF, AND THE
OPPORTUNITY TO DECLINE, SUCH AUTOMATIC ENROLLMENT.
  S 8. Paragraph (e) of subdivision 3 of section 242 of the  elder  law,
as  amended  by section 3-d of part A of chapter 59 of the laws of 2011,
is amended to read as follows:
  (e) As a condition of CONTINUED eligibility for  benefits  under  this
title,  if a program participant's income indicates that the participant

S. 6256--C                         66

could be eligible for an income-related subsidy under  section  1860D-14
of  the  federal social security act by either applying for such subsidy
or by enrolling in a medicare savings program as  a  qualified  medicare
beneficiary  (QMB),  a specified low-income medicare beneficiary (SLMB),
or a qualifying individual (QI), a program participant  is  required  to
provide,  and to authorize the elderly pharmaceutical insurance coverage
program to obtain, any information or documentation required  to  estab-
lish  the  participant's  eligibility for such subsidy, and to authorize
the elderly pharmaceutical insurance coverage program to apply on behalf
of the participant for the subsidy or the medicare savings program.  The
elderly  pharmaceutical  insurance coverage program shall make a reason-
able effort to notify the program participant of  his  or  her  need  to
provide any of the above required information. After a reasonable effort
has  been  made to contact the participant, a participant shall be noti-
fied in writing that he or she has sixty days to provide  such  required
information.  If  such  information is not provided within the sixty day
period, the participant's coverage may be terminated.
  S 9. Subdivision 3 of section 242 of  the  elder  law  is  amended  by
adding a new paragraph (g) to read as follows:
  (G)  THE  ELDERLY PHARMACEUTICAL INSURANCE COVERAGE PROGRAM IS AUTHOR-
IZED AND DIRECTED TO CONDUCT AN ENROLLMENT PROGRAM TO FACILITATE, IN  AS
PROMPT  AND STREAMLINED A FASHION AS POSSIBLE, THE ENROLLMENT INTO MEDI-
CARE PART D OF PROGRAM PARTICIPANTS WHO ARE REQUIRED BY  THE  PROVISIONS
OF  THIS  SECTION TO ENROLL IN PART D. PROVIDED, HOWEVER, THAT A PARTIC-
IPANT SHALL NOT BE PREVENTED FROM RECEIVING HIS OR HER DRUGS IMMEDIATELY
AT THE PHARMACY UNDER  THE  ELDERLY  PHARMACEUTICAL  INSURANCE  COVERAGE
PROGRAM AS A RESULT OF SUCH PARTICIPANT'S ENROLLMENT IN MEDICARE PART D.
  S  10. Paragraph (h) of subdivision 3 of section 242 of the elder law,
as amended by section 3-f of part A of chapter 59 of the laws  of  2011,
is amended to read as follows:
  (h)  [The] IN ORDER TO MAXIMIZE PRESCRIPTION DRUG COVERAGE UNDER MEDI-
CARE PART D, THE elderly pharmaceutical insurance  coverage  program  is
authorized  to  represent  program  participants  under this title [with
respect to their Medicare part D] IN THE PURSUIT OF SUCH coverage.  SUCH
REPRESENTATION SHALL NOT RESULT IN ANY ADDITIONAL FINANCIAL LIABILITY ON
BEHALF OF SUCH PROGRAM PARTICIPANTS AND SHALL INCLUDE, BUT NOT BE LIMIT-
ED TO, THE FOLLOWING ACTIONS:
  (I) APPLICATION FOR THE PREMIUM AND COST-SHARING SUBSIDIES  ON  BEHALF
OF ELIGIBLE PROGRAM PARTICIPANTS;
  (II) ENROLLMENT IN A PRESCRIPTION DRUG PLAN OR MA-PD PLAN; THE ELDERLY
PHARMACEUTICAL  INSURANCE COVERAGE PROGRAM SHALL PROVIDE PROGRAM PARTIC-
IPANTS WITH PRIOR WRITTEN NOTICE OF, AND THE OPPORTUNITY TO DECLINE SUCH
FACILITATED ENROLLMENT SUBJECT, HOWEVER, TO THE PROVISIONS OF  PARAGRAPH
(F) OF THIS SUBDIVISION;
  (III) PURSUIT OF APPEALS, GRIEVANCES, OR COVERAGE DETERMINATIONS.
  S  11. Section 243 of the elder law, as amended by section 3-g of part
A of chapter 59 of the laws of 2011, is amended to read as follows:
  S 243. Pharmaceutical insurance  contract.  1.  The  [commissioner  of
health]  ELDERLY  PHARMACEUTICAL  INSURANCE  COVERAGE PANEL, ESTABLISHED
PURSUANT TO SECTION TWO HUNDRED FORTY-FOUR OF THIS TITLE shall,  subject
to  the  approval  of  the director of the budget, enter into a contract
with one or more contractors to assist in carrying out the provisions of
this title. Such contractual arrangements shall be  made  subject  to  a
competitive  process  pursuant to the state finance law and shall ensure
that state  payments  for  the  contractor's  necessary  and  legitimate
expenses  for  the  administration  of  this  program are limited to the

S. 6256--C                         67

amount specified in advance, and that such payments shall not exceed the
amount appropriated therefor in  any  fiscal  year.  The  [commissioner]
PANEL  shall,  AT  EACH  OF ITS REGULARLY SCHEDULED MEETINGS, review the
contract  pricing  provisions  to  assure  that  the  level  of contract
payments are in the best interest of the state, giving consideration  to
the total level of participant enrollment achieved, the volume of claims
processed, and such other factors as may be relevant in order to contain
state  expenditures.  In  the event that the [commissioner] PANEL deter-
mines that the contract payment provisions do not protect  the  interest
of  the  state,  the  [commissioner]  EXECUTIVE  DIRECTOR shall initiate
contract negotiations for the purpose  of  modifying  contract  payments
and/or scope requirements.
  2.  The  responsibilities  of  the  contractor  or  contractors  shall
include, but need not be limited to:
  (a) providing for a method of determining, on an annual basis and upon
their application therefor,  the  eligibility  of  persons  pursuant  to
section  two  hundred forty-two of this title within a reasonable period
of time, including alternative methods for such determination of  eligi-
bility, such as through the mail or home visits, where reasonable and/or
necessary,  and  for  notifying  applicants of such eligibility determi-
nations;
  (b) notifying each eligible program participant in  writing  upon  the
commencement  of  the annual coverage period of such participant's cost-
sharing responsibilities pursuant  to  [section]  SECTIONS  two  hundred
forty-seven  AND  TWO  HUNDRED FORTY-EIGHT of this title. The contractor
shall also notify each eligible program participant of any adjustment of
the co-payment schedule by mail no less than thirty days  prior  to  the
effective  date  of  such  adjustments  and  shall  inform such eligible
program participants of the date such adjustments shall take effect;
  (c) issuing an identification card to each [eligible] program  partic-
ipant WHO IS ELIGIBLE TO PURCHASE PRESCRIBED COVERED DRUGS FOR AN AMOUNT
SPECIFIED   PURSUANT   TO  SUBDIVISION  THREE  OF  SECTION  TWO  HUNDRED
FORTY-SEVEN OR SUBDIVISION THREE OF SECTION TWO HUNDRED  FORTY-EIGHT  OF
THIS  TITLE.  THE DATES OF THE ANNUAL COVERAGE PERIOD SHALL BE IMPRINTED
ON THE CARD. WHEN AN  ELIGIBLE  PROGRAM  PARTICIPANT  MEETS  THE  ANNUAL
LIMITS  ON  POINT  OF  SALE CO-PAYMENTS SET FORTH IN SUBDIVISION FOUR OF
SECTION TWO HUNDRED FORTY-SEVEN  OR  SUBDIVISION  FOUR  OF  SECTION  TWO
HUNDRED FORTY-EIGHT OF THIS TITLE, EITHER NEW IDENTIFICATION CARDS SHALL
BE  ISSUED  TO  SUCH  PARTICIPANT  INDICATING  WAIVER OF SUCH CO-PAYMENT
REQUIREMENTS FOR THE REMAINDER OF THE  ANNUAL  COVERAGE  PERIOD  OR  THE
CONTRACTOR  SHALL  DEVELOP AND IMPLEMENT AN ALTERNATIVE METHOD TO PERMIT
THE PURCHASE OF COVERED DRUGS WITHOUT A CO-PAYMENT REQUIREMENT;
  (d) DEVELOPING AND  IMPLEMENTING  THE  SYSTEM  FOR  THOSE  INDIVIDUALS
ELECTING  THE  DEDUCTIBLE  OPTION  TO RECORD THEIR PERSONAL COVERED DRUG
EXPENDITURES IN ACCORDANCE WITH SUBDIVISION THREE OF SECTION TWO HUNDRED
FORTY-EIGHT OF THIS TITLE. SUCH RECORDKEEPING SYSTEM SHALL  BE  PROVIDED
TO  EACH  SUCH PARTICIPANT AT A NOMINAL CHARGE WHICH SHALL BE SUBJECT TO
THE APPROVAL OF THE PANEL. THE CONTRACTOR SHALL ALSO  REIMBURSE  PARTIC-
IPANTS  FOR  PERSONAL  COVERED DRUG EXPENDITURES MADE IN EXCESS OF THEIR
DEDUCTIBLE REQUIREMENTS, LESS THE CO-PAYMENTS  REQUIRED  BY  SUBDIVISION
FOUR  OF  SECTION  TWO  HUNDRED FORTY-EIGHT OF THIS TITLE, MADE PRIOR TO
THEIR RECEIPT OF AN IDENTIFICATION CARD ISSUED IN ACCORDANCE WITH  PARA-
GRAPH (C) OF THIS SUBDIVISION;
  (E)  processing  of claims for reimbursement to participating provider
pharmacies pursuant to section two hundred fifty of this title;

S. 6256--C                         68

  [(e)] (F) performing or causing to be  performed  utilization  reviews
for  such  purposes  as  may be required by the [commissioner of health]
ELDERLY PHARMACEUTICAL INSURANCE COVERAGE PANEL;
  [(f)]  (G)  conducting  audits  and  surveys of participating provider
pharmacies as specified pursuant to the  terms  and  conditions  of  the
contract; and
  [(g)]  (H)  coordinating  coverage  with insurance companies and other
public and private organizations offering such coverage for those eligi-
ble program participants  having  partial  coverage  for  covered  drugs
through  third-party sources, and providing for recoupment of any dupli-
cate reimbursement paid by the state on behalf of such eligible  program
participants.
  3.  The  contractor  or  contractors shall be required to provide such
reports as may be deemed  necessary  by  the  [commissioner  of  health]
ELDERLY PHARMACEUTICAL INSURANCE COVERAGE PANEL and shall maintain files
in  a  manner  and  format  approved  by  the  [commissioner]  EXECUTIVE
DIRECTOR.
  4. The contractor or contractors may contract  with  private  not-for-
profit or proprietary corporations, or with entities of local government
within  the  state  of  New  York,  to  perform  such obligations of the
contractor or contractors as the [commissioner of health] ELDERLY  PHAR-
MACEUTICAL INSURANCE COVERAGE PANEL shall permit.
  S  12.  Section 244 of the elder law is REPEALED and a new section 244
is added to read as follows:
  S 244. ELDERLY PHARMACEUTICAL INSURANCE COVERAGE PANEL.   1. THERE  IS
HEREBY  ESTABLISHED WITHIN THE EXECUTIVE DEPARTMENT, A PANEL TO BE KNOWN
AS THE ELDERLY PHARMACEUTICAL INSURANCE COVERAGE PANEL  HEREINBEFORE  OR
HEREINAFTER REFERRED TO AS THE PANEL.
  2.  THE PANEL SHALL CONSIST OF THE COMMISSIONERS OF THE DEPARTMENTS OF
EDUCATION AND HEALTH, THE SUPERINTENDENT OF FINANCIAL SERVICES, AND  THE
DIRECTORS  OF  THE OFFICE FOR THE AGING AND THE DIVISION OF BUDGET. EACH
PANEL MEMBER MAY DESIGNATE AN OFFICER OF HIS OR HER  RESPECTIVE  DEPART-
MENT,  OFFICE,  OR  DIVISION TO REPRESENT AND EXERCISE ALL THE POWERS OF
SUCH PANEL MEMBER AS THE CASE MAY BE AT ALL MEETINGS OF THE  PANEL  FROM
WHICH SUCH PANEL MEMBER MAY BE ABSENT.
  3.  THE  DIRECTOR  OF THE OFFICE FOR THE AGING AND THE COMMISSIONER OF
HEALTH SHALL SERVE AS CO-CHAIRS OF THE PANEL.
  4. THE PANEL SHALL MEET AT SUCH TIMES  AS  MAY  BE  REQUESTED  BY  THE
CO-CHAIRS,  PROVIDED  THAT  THE  PANEL  SHALL MEET AT LEAST FOUR TIMES A
YEAR.
  5. THE PANEL SHALL:
  (A) SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE BUDGET,  PROMULGATE
PROGRAM  REGULATIONS  PURSUANT  TO SECTION TWO HUNDRED FORTY-SIX OF THIS
TITLE;
  (B) DETERMINE THE ANNUAL SCHEDULE OF COST-SHARING RESPONSIBILITIES  OF
ELIGIBLE   PROGRAM   PARTICIPANTS   PURSUANT  TO  SECTIONS  TWO  HUNDRED
FORTY-SEVEN AND TWO HUNDRED FORTY-EIGHT OF THIS TITLE;
  (C) ENTER INTO CONTRACTS PURSUANT TO SECTION TWO  HUNDRED  FORTY-THREE
OF THIS TITLE;
  (D)  RECOMMEND  AND IMPLEMENT ALTERNATIVE PROGRAM IMPROVEMENTS FOR THE
EFFICIENT AND EFFECTIVE OPERATION OF THE PROGRAM IN ACCORDANCE WITH  THE
PROVISIONS OF THIS TITLE;
  (E)  ESTABLISH  OR CONTRACT FOR A THERAPEUTIC DRUG MONITORING PROGRAM.
SUCH PROGRAM SHALL MONITOR THERAPEUTIC  DRUG  USE  OF  ELIGIBLE  PROGRAM
PARTICIPANTS  IN  AN  EFFORT  TO  PREVENT  THE  INCORRECT OR UNNECESSARY
CONSUMPTION OF SUCH THERAPEUTIC DRUGS;

S. 6256--C                         69

  (F) DEVELOP AND IMPLEMENT, IN COOPERATION WITH AREA  OFFICES  FOR  THE
AGING, AN OUTREACH PROGRAM TO INFORM THE ELDERLY OF BENEFITS THEY MAY BE
ENTITLED  TO  PURSUANT  TO THIS TITLE, AND TO MAKE AVAILABLE INFORMATION
CONCERNING THE PROGRAM FOR ELDERLY PHARMACEUTICAL INSURANCE COVERAGE AND
BENEFITS  TO  WHICH  THEY  MAY  BE  ENTITLED THROUGH A PRESCRIPTION DRUG
COVERAGE PROGRAM FUNDED BY THE FEDERAL GOVERNMENT;
  (G) PREPARE AN ANNUAL REPORT AND SUBMIT SUCH REPORT  TO  THE  GOVERNOR
AND THE LEGISLATURE NO LATER THAN THE FIRST DAY OF JANUARY OF EACH YEAR.
THE  PANEL  SHOULD INCLUDE IN THE REPORT A SUMMARY OF THE ADMINISTRATIVE
COST CONTAINMENT INITIATIVES COMPLETED DURING THE  YEAR.    SUCH  REPORT
SHALL,  AT  A  MINIMUM, CONTAIN ANNUAL STATISTICAL INFORMATION REGARDING
THE NUMBER OF PERSONS ENROLLED IN THE  PROGRAM  BY  MARITAL  STATUS  AND
INCOME  LEVEL,  THE  TOTAL AND PER CAPITA NUMBER OF PRESCRIPTIONS FILLED
AND TOTAL STATE REIMBURSEMENT AND PARTICIPANT  CO-PAYMENT  EXPENDITURES,
BY INCOME LEVELS, THE TOTAL NUMBERS OF PRESCRIPTIONS FILLED WITH GENERIC
DRUGS,  BRAND  NAME  DRUGS  AND SOLE SOURCE DRUGS, THE AUTHORIZATION AND
SUBSTITUTION RATE FOR THE TOTAL NUMBERS  OF  PRESCRIPTIONS  FILLED  WITH
GENERIC,  BRAND  NAME AND SOLE SOURCE DRUGS, THE DISTRIBUTION OF THE TOP
THREE HUNDRED MOST COMMONLY USED DRUGS BY VOLUME AND  COST,  A  DISTRIB-
UTION  OF  ALL  PRESCRIPTIONS BY VOLUME AND PRICE, THE ANNUAL PERCENTAGE
INCREASE IN THE COST OF THESE DRUGS, NUMBERS OF  PARTICIPATING  PROVIDER
PHARMACIES, RECIPIENTS AND PAYMENTS BY COUNTY, THE AMOUNT OF COST RECOV-
ERIES FOR THE PERIOD COVERED IN THE REPORT, PROJECTIONS OF PROGRAM COSTS
FOR THE FOLLOWING TWO YEARS, AND AN EVALUATION OF THE PERFORMANCE OF THE
PROGRAM  CONTRACTOR  OR CONTRACTORS AND OF THE COST EFFECTIVENESS OF ALL
OUTREACH EFFORTS;
  (H) PREPARE AN EVALUATION REPORT ON THE EXPERIENCE OF THE PROGRAM  FOR
THE  GOVERNOR AND THE LEGISLATURE NO LATER THAN NOVEMBER FIRST, NINETEEN
HUNDRED NINETY-FIVE. SUCH REPORT SHOULD INCLUDE THE  RECOMMENDATIONS  OF
THE  PANEL CONCERNING THE CONTINUATION OF THE PROGRAM BEYOND ITS EXPIRA-
TION;
  (I) ESTABLISH POLICIES AND PROCEDURES TO ALLOW INDIVIDUALS WHO PARTIC-
IPATE IN THE CATASTROPHIC DEDUCTIBLE PLAN ON DECEMBER THIRTY-FIRST,  TWO
THOUSAND TO CONTINUE TO RECEIVE BENEFITS UNDER THE PROVISIONS OF SECTION
TWO   HUNDRED   FORTY-EIGHT   OF   THIS  TITLE  IN  EFFECT  ON  DECEMBER
THIRTY-FIRST, TWO THOUSAND, IF AND FOR AS LONG AS THE ENROLLEE SO CHOOS-
ES;
  (J) FACILITATE IMPLEMENTATION OF AN  EXPANDED  ELDERLY  PHARMACEUTICAL
INSURANCE  COVERAGE  PROGRAM  ON  JANUARY  FIRST,  TWO  THOUSAND ONE, BY
COMMENCING NO LATER THAN OCTOBER FIRST, TWO  THOUSAND,  OUTREACH  ACTIV-
ITIES,  INCLUDING BUT NOT LIMITED TO THE DISSEMINATION OF INFORMATION TO
LOCAL GOVERNMENTS AND SENIOR CITIZEN PROVIDER ADVOCACY GROUPS  REGARDING
SUCH  EXPANDED  PROGRAM. THE PANEL SHALL MAKE APPLICATIONS AVAILABLE FOR
THE EXPANDED ELDERLY PHARMACEUTICAL INSURANCE COVERAGE PROGRAM ON  OCTO-
BER FIRST, TWO THOUSAND; AND
  (K)  ENTER  INTO  AN  AGREEMENT  WITH  ONE  OR MORE SPONSORS OF A DRUG
DISCOUNT CARD PROGRAM OR A PRESCRIPTION DRUG PLAN AUTHORIZED UNDER TITLE
XVIII OF THE FEDERAL SOCIAL SECURITY ACT, TO SERVE AS AN  ENDORSED  EPIC
DRUG DISCOUNT CARD PROGRAM OR PRESCRIPTION DRUG PLAN FOR THE PURPOSES OF
EFFECTIVE COORDINATION OF BENEFITS.
  6.  THE PANEL MEMBERS SHALL RECEIVE NO COMPENSATION FOR THEIR SERVICES
AS PANEL MEMBERS.
  7. THERE SHALL BE AN ADVISORY COMMITTEE  TO  THE  PANEL  COMPRISED  OF
TWELVE  PERSONS.  FOUR MEMBERS SHALL BE APPOINTED BY THE GOVERNOR, THREE
MEMBERS SHALL BE APPOINTED BY THE TEMPORARY PRESIDENT OF THE SENATE, ONE
MEMBER SHALL BE APPOINTED BY THE MINORITY LEADER OF  THE  SENATE,  THREE

S. 6256--C                         70

MEMBERS SHALL BE APPOINTED BY THE SPEAKER OF THE ASSEMBLY AND ONE MEMBER
SHALL BE APPOINTED BY THE MINORITY LEADER OF THE ASSEMBLY. THE COMMITTEE
MEMBERS  SHALL  BE REPRESENTATIVES OF CONSUMERS, PHARMACISTS, PHARMACEU-
TICAL  DRUG  MANUFACTURERS  AND PHARMACEUTICAL WHOLESALERS. NO LESS THAN
FIFTY PERCENT OF THE COMMITTEE MEMBERSHIP SHALL REPRESENT THE CONSUMERS.
THE EXECUTIVE DIRECTOR SHALL CONSULT THE ADVISORY COMMITTEE AND CONSIDER
ITS RECOMMENDATIONS CONCERNING THE IMPLEMENTATION OF  THIS  PROGRAM  AND
THE POLICIES GOVERNING THE CONTINUED OPERATION OF THIS PROGRAM.  COMMIT-
TEE  MEMBERS  SHALL RECEIVE NO COMPENSATION FOR THEIR SERVICES BUT SHALL
BE ALLOWED THEIR ACTUAL AND NECESSARY EXPENSES INCURRED IN THE  PERFORM-
ANCE OF THEIR DUTIES.
  S  13. The section heading of section 247 of the elder law, as amended
by section 3-i of part A of chapter 59 of the laws of 2011,  is  amended
to read as follows:
  Cost-sharing  responsibilities  of  eligible  program participants FOR
COMPREHENSIVE COVERAGE.
  S 14. Subdivision 1 of section 247 of the elder law is REPEALED and  a
new subdivision 1 is added to read as follows:
  1. REGISTRATION FEE. ELIGIBLE INDIVIDUALS MEETING THE REGISTRATION FEE
REQUIREMENTS  OF  THIS SECTION MAY PURCHASE PRESCRIBED COVERED DRUGS FOR
AN AMOUNT SPECIFIED BY SUBDIVISION THREE OF THIS SECTION, SUBJECT TO THE
LIMITS ON POINT OF SALE CO-PAYMENTS SPECIFIED  BY  SUBDIVISION  FOUR  OF
THIS SECTION.
  S  15. Subdivision 2 of section 247 of the elder law, as renumbered by
section 3-k of part A of chapter 59 of the laws of 2011,  is  renumbered
subdivision  3  and  two  new  subdivisions 2 and 4 are added to read as
follows:
  2. REGISTRATION FEE SCHEDULE. ELIGIBLE INDIVIDUALS  ELECTING  TO  MEET
THE  REQUIREMENTS OF THIS SUBDIVISION SHALL PAY A QUARTERLY REGISTRATION
FEE IN A MANNER AND FORM DETERMINED BY THE EXECUTIVE  DIRECTOR;  AT  THE
OPTION  OF THE PARTICIPANT, THE REGISTRATION FEE MAY BE PAID ANNUALLY IN
A LUMP SUM UPON THE BEGINNING OF THE ANNUAL COVERAGE PERIOD. NO ELIGIBLE
INDIVIDUAL ELECTING TO MEET THE REQUIREMENTS OF THIS  SUBDIVISION  SHALL
HAVE  HIS PARTICIPATION IN THE PROGRAM LAPSE BY VIRTUE OF NON-PAYMENT OF
THE APPLICABLE REGISTRATION  FEE  UNLESS  THE  CONTRACTOR  HAS  PROVIDED
NOTIFICATION  OF  THE  AMOUNT AND DUE DATE THEREOF, AND MORE THAN THIRTY
DAYS HAVE ELAPSED SINCE THE DUE DATE OF  THE  INDIVIDUAL'S  REGISTRATION
FEE. THE REGISTRATION FEE TO BE CHARGED TO ELIGIBLE PROGRAM PARTICIPANTS
FOR COMPREHENSIVE COVERAGE UNDER THIS OPTION SHALL BE IN ACCORDANCE WITH
THE FOLLOWING SCHEDULE:
  (A)  QUARTERLY  REGISTRATION  FEES  FOR  UNMARRIED  INDIVIDUAL PROGRAM
PARTICIPANTS:
INDIVIDUAL INCOME OF $5,000 OR LESS                    $2.00
INDIVIDUAL INCOME OF $5,001 TO $6,000                  $2.00
INDIVIDUAL INCOME OF $6,001 TO $7,000                  $4.00
INDIVIDUAL INCOME OF $7,001 TO $8,000                  $5.50
INDIVIDUAL INCOME OF $8,001 TO $9,000                  $7.00
INDIVIDUAL INCOME OF $9,001 TO $10,000                 $9.00
INDIVIDUAL INCOME OF $10,001 TO $11,000                $10.00
INDIVIDUAL INCOME OF $11,001 TO $12,000                $11.50
INDIVIDUAL INCOME OF $12,001 TO $13,000                $13.50
INDIVIDUAL INCOME OF $13,001 TO $14,000                $15.00
INDIVIDUAL INCOME OF $14,001 TO $15,000                $20.00
INDIVIDUAL INCOME OF $15,001 TO $16,000                $27.50
INDIVIDUAL INCOME OF $16,001 TO $17,000                $35.00
INDIVIDUAL INCOME OF $17,001 TO $18,000                $42.50

S. 6256--C                         71

INDIVIDUAL INCOME OF $18,001 TO $19,000                $50.00
INDIVIDUAL INCOME OF $19,001 TO $20,000                $57.50
  (B)  QUARTERLY  REGISTRATION  FEES FOR EACH MARRIED INDIVIDUAL PROGRAM
PARTICIPANT:
JOINT INCOME OF $5,000 OR LESS                         $2.00
JOINT INCOME OF $5,001 TO $6,000                       $2.00
JOINT INCOME OF $6,001 TO $7,000                       $3.00
JOINT INCOME OF $7,001 TO $8,000                       $4.00
JOINT INCOME OF $8,001 TO $9,000                       $5.00
JOINT INCOME OF $9,001 TO $10,000                      $6.00
JOINT INCOME OF $10,001 TO $11,000                     $7.00
JOINT INCOME OF $11,001 TO $12,000                     $8.00
JOINT INCOME OF $12,001 TO $13,000                     $9.00
JOINT INCOME OF $13,001 TO $14,000                     $10.00
JOINT INCOME OF $14,001 TO $15,000                     $10.00
JOINT INCOME OF $15,001 TO $16,000                     $21.00
JOINT INCOME OF $16,001 TO $17,000                     $26.50
JOINT INCOME OF $17,001 TO $18,000                     $31.50
JOINT INCOME OF $18,001 TO $19,000                     $37.50
JOINT INCOME OF $19,001 TO $20,000                     $43.00
JOINT INCOME OF $20,001 TO $21,000                     $48.50
JOINT INCOME OF $21,001 TO $22,000                     $54.00
JOINT INCOME OF $22,001 TO $23,000                     $59.50
JOINT INCOME OF $23,001 TO $24,000                     $65.00
JOINT INCOME OF $24,001 TO $25,000                     $68.75
JOINT INCOME OF $25,001 TO $26,000                     $75.00
  (C) IN THE EVENT THAT THE STATE EXPENDITURES PER  PARTICIPANT  MEETING
THE  REGISTRATION  FEE  REQUIREMENTS  OF  THIS SUBDIVISION, EXCLUSIVE OF
EXPENDITURES FOR PROGRAM ADMINISTRATION, IN THE PROGRAM YEAR  COMMENCING
OCTOBER  FIRST,  NINETEEN HUNDRED EIGHTY-EIGHT, AND IN EACH PROGRAM YEAR
THEREAFTER, EXCEED SUCH EXPENDITURES IN THE PREVIOUS PROGRAM YEAR  BY  A
MINIMUM  OF  TEN PERCENT, THE ANNUAL REGISTRATION FEES SET FORTH IN THIS
SUBDIVISION  MAY,  UNLESS  OTHERWISE  PROVIDED  BY  LAW,  BE  INCREASED,
PRO-RATA,  FOR  THE SUBSEQUENT PROGRAM YEAR, PROVIDED THAT SUCH INCREASE
SHALL NOT EXCEED SEVEN AND ONE-HALF PERCENT OF THE PRIOR YEAR  REGISTRA-
TION FEES AS MAY HAVE BEEN ADJUSTED IN ACCORDANCE WITH THIS PARAGRAPH.
  (D)  IN  THE  EVENT  THAT THE STATE EXPENDITURES PER SUCH PARTICIPANT,
INCURRED PURSUANT TO THIS SUBDIVISION,  EXCLUSIVE  OF  EXPENDITURES  FOR
PROGRAM  ADMINISTRATION,  IN  THE PROGRAM YEAR COMMENCING OCTOBER FIRST,
NINETEEN HUNDRED EIGHTY-EIGHT, AND IN EACH PROGRAM YEAR THEREAFTER,  ARE
LESS THAN SUCH EXPENDITURES IN THE PREVIOUS PROGRAM YEAR BY A MINIMUM OF
TEN  PERCENT, THE ANNUAL REGISTRATION FEES SET FORTH IN THIS SUBDIVISION
MAY, UNLESS OTHERWISE PROVIDED BY LAW, BE DECREASED, PRO-RATA,  FOR  THE
SUBSEQUENT  PROGRAM  YEAR,  PROVIDED THAT SUCH DECREASE SHALL NOT EXCEED
SEVEN AND ONE-HALF PERCENT OF THE PRIOR YEAR REGISTRATION  FEES  AS  MAY
HAVE BEEN ADJUSTED IN ACCORDANCE WITH THIS PARAGRAPH.
  (E)  THE DETERMINATION TO ADJUST ANNUAL REGISTRATION FEES SET FORTH IN
THIS SUBDIVISION SHALL FOLLOW A REVIEW OF SUCH FACTORS AS  THE  RELATIVE
FINANCIAL  CAPACITY  OF THE STATE AND SUCH ELIGIBLE PROGRAM PARTICIPANTS
TO SUPPORT SUCH ADJUSTMENTS AND CHANGES IN THE CONSUMER PRICE INDEX. THE
FREQUENCY OF SUCH ADJUSTMENTS SHALL NOT EXCEED ONCE IN ANY PROGRAM  YEAR
AND  SUCH  ADJUSTMENTS SHALL NOT BECOME EFFECTIVE FOR INDIVIDUAL PROGRAM
PARTICIPANTS PRIOR TO THE FIRST DAY OF THE NEXT ANNUAL  COVERAGE  PERIOD
FOR EACH PARTICIPANT.
  4.  LIMITS  ON  POINT OF SALE CO-PAYMENTS. DURING EACH ANNUAL COVERAGE
PERIOD NO POINT OF SALE CO-PAYMENT AS SET FORTH IN SUBDIVISION THREE  OF

S. 6256--C                         72

THIS  SECTION  SHALL  BE  REQUIRED  TO BE MADE FOR THE REMAINDER OF SUCH
PERIOD BY ANY ELIGIBLE PROGRAM  PARTICIPANT  WHO  HAS  ALREADY  INCURRED
CO-PAYMENTS IN EXCESS OF THE LIMITS SET FORTH IN THE FOLLOWING SCHEDULE:
  (A)  LIMITS  ON  CO-PAYMENTS  BY UNMARRIED INDIVIDUAL ELIGIBLE PROGRAM
PARTICIPANTS:
INDIVIDUAL INCOME OF $5,000 OR LESS                 NO MORE THAN $340
INDIVIDUAL INCOME OF $5,001 TO $6,000               NO MORE THAN $408
INDIVIDUAL INCOME OF $6,001 TO $7,000               NO MORE THAN $476
INDIVIDUAL INCOME OF $7,001 TO $8,000               NO MORE THAN $544
INDIVIDUAL INCOME OF $8,001 TO $9,000               NO MORE THAN $612
INDIVIDUAL INCOME OF $9,001 TO $10,000              NO MORE THAN $700
INDIVIDUAL INCOME OF $10,001 TO $11,000             NO MORE THAN $720
INDIVIDUAL INCOME OF $11,001 TO $12,000             NO MORE THAN $827
INDIVIDUAL INCOME OF $12,001 TO $13,000             NO MORE THAN $896
INDIVIDUAL INCOME OF $13,001 TO $14,000             NO MORE THAN $964
INDIVIDUAL INCOME OF $14,001 TO $15,000             NO MORE THAN $1,016
INDIVIDUAL INCOME OF $15,001 TO $16,000             NO MORE THAN $1,034
INDIVIDUAL INCOME OF $16,001 TO $17,000             NO MORE THAN $1,052
INDIVIDUAL INCOME OF $17,001 TO $18,000             NO MORE THAN $1,070
INDIVIDUAL INCOME OF $18,001 TO $19,000             NO MORE THAN $1,088
INDIVIDUAL INCOME OF $19,001 TO $20,000             NO MORE THAN $1,160
  (B) LIMITS ON CO-PAYMENTS BY EACH MARRIED INDIVIDUAL ELIGIBLE PROGRAM
PARTICIPANT:
JOINT INCOME OF $5,000 OR LESS                      NO MORE THAN $291
JOINT INCOME OF $5,001 TO $6,000                    NO MORE THAN $342
JOINT INCOME OF $6,001 TO $7,000                    NO MORE THAN $399
JOINT INCOME OF $7,001 TO $8,000                    NO MORE THAN $456
JOINT INCOME OF $8,001 TO $9,000                    NO MORE THAN $513
JOINT INCOME OF $9,001 TO $10,000                   NO MORE THAN $570
JOINT INCOME OF $10,001 TO $11,000                  NO MORE THAN $622
JOINT INCOME OF $11,001 TO $12,000                  NO MORE THAN $641
JOINT INCOME OF $12,001 TO $13,000                  NO MORE THAN $660
JOINT INCOME OF $13,001 TO $14,000                  NO MORE THAN $684
JOINT INCOME OF $14,001 TO $15,000                  NO MORE THAN $710
JOINT INCOME OF $15,001 TO $16,000                  NO MORE THAN $826
JOINT INCOME OF $16,001 TO $17,000                  NO MORE THAN $877
JOINT INCOME OF $17,001 TO $18,000                  NO MORE THAN $928
JOINT INCOME OF $18,001 TO $19,000                  NO MORE THAN $980
JOINT INCOME OF $19,001 TO $20,000                  NO MORE THAN $990
JOINT INCOME OF $20,001 TO $21,000                  NO MORE THAN $1,008
JOINT INCOME OF $21,001 TO $22,000                  NO MORE THAN $1,026
JOINT INCOME OF $22,001 TO $23,000                  NO MORE THAN $1,044
JOINT INCOME OF $23,001 TO $24,000                  NO MORE THAN $1,062
JOINT INCOME OF $24,001 TO $25,000                  NO MORE THAN $1,080
JOINT INCOME OF $25,001 TO $26,000                  NO MORE THAN $1,150
  (C) EFFECTIVE OCTOBER FIRST, NINETEEN HUNDRED EIGHTY-EIGHT, THE LIMITS
ON POINT OF SALE CO-PAYMENTS AS SET FORTH IN  THIS  SUBDIVISION  MAY  BE
ADJUSTED  BY  THE  PANEL ON THE ANNIVERSARY DATE OF EACH PROGRAM PARTIC-
IPANT'S ANNUAL COVERAGE PERIOD, AND SUCH ADJUSTMENT SHALL BE  IN  EFFECT
FOR THE DURATION OF THAT ANNUAL COVERAGE PERIOD. ANY SUCH ANNUAL ADJUST-
MENT  SHALL BE MADE USING A PERCENTAGE ADJUSTMENT FACTOR WHICH SHALL NOT
EXCEED ONE-HALF OF THE DIFFERENCE BETWEEN  THE  YEAR-TO-YEAR  PERCENTAGE
INCREASE  IN  THE  CONSUMER  PRICE  INDEX  FOR  ALL  URBAN CONSUMERS, AS
PUBLISHED BY THE UNITED STATES DEPARTMENT OF LABOR, AND, IF LARGER,  THE
YEAR-TO-YEAR  PERCENTAGE  INCREASE  IN  THE  AGGREGATE  AVERAGE  COST OF
COVERED DRUGS PURCHASED UNDER THIS TITLE, WHICH YEAR-TO-YEAR  PERCENTAGE

S. 6256--C                         73

INCREASE  IN SUCH COST SHALL BE DETERMINED BY COMPARISON OF SUCH COST IN
THE SAME MONTH OF EACH OF THE APPROPRIATE  SUCCESSIVE  YEARS;  PROVIDED,
HOWEVER,  THAT FOR ANY SUCH ADJUSTMENT BASED WHOLLY ON EXPERIENCE IN THE
PROGRAM  YEAR  COMMENCING  OCTOBER FIRST, NINETEEN HUNDRED EIGHTY-SEVEN,
THE YEAR-TO-YEAR PERCENTAGE INCREASE IN SUCH COST SHALL BE DETERMINED BY
COMPARISON OF SUCH COST IN EACH OF TWO MONTHS NO LESS THAN  FIVE  MONTHS
APART  AND  WITHIN  SUCH PROGRAM YEAR, WHICH COMPARISON SHALL BE ANNUAL-
IZED. SUCH PERCENTAGE ADJUSTMENT FACTOR SHALL BE THE SAME AS  THAT  USED
TO  DETERMINE ANY SIMILAR ANNUAL ADJUSTMENT FOR THE SAME ANNUAL COVERAGE
PERIODS PURSUANT TO THE PROVISIONS OF SUBDIVISION FOUR  OF  SECTION  TWO
HUNDRED FORTY-EIGHT OF THIS TITLE.
  (D)  SUCH  ANNUAL  ADJUSTMENTS  SHALL BE CALCULATED BY MULTIPLYING THE
PERCENTAGE ADJUSTMENT FACTOR BY (1) TEN PERCENT AND APPLYING THE RESULT-
ING PERCENTAGE TO THE UPPER INCOME LIMITATION OF EACH INCOME  LEVEL  FOR
UNMARRIED  INDIVIDUALS  CONTAINED  IN THIS SUBDIVISION, AND BY (2) SEVEN
AND ONE-HALF PERCENT AND APPLYING THE RESULTING PERCENTAGE TO THE  UPPER
INCOME LIMITATION OF EACH INCOME LEVEL FOR MARRIED INDIVIDUALS CONTAINED
IN  THIS SUBDIVISION; EACH RESULT OF SUCH CALCULATIONS, MINUS ANY APPLI-
CABLE REGISTRATION FEE INCREASES MADE PURSUANT  TO  SUBDIVISION  TWO  OF
THIS  SECTION  AND PLUS THE RESULT OF APPLYING THE PERCENTAGE ADJUSTMENT
FACTOR TO THE SUM OF ANY SUCH ANNUAL ADJUSTMENTS APPLICABLE THERETO  FOR
ANY PRIOR ANNUAL COVERAGE PERIOD, SHALL BE THE AMOUNT BY WHICH THE LIMIT
ON  CO-PAYMENTS  FOR  EACH  SUCH  INCOME LEVEL MAY BE ADJUSTED, AND SUCH
AMOUNT SHALL BE IN ADDITION TO ANY SUCH AMOUNT OR AMOUNTS APPLICABLE  TO
PRIOR ANNUAL COVERAGE PERIODS.
  (E)  THE  DETERMINATION  TO ADJUST THE LIMITS ON POINT OF SALE CO-PAY-
MENTS SET FORTH IN THIS  SUBDIVISION  SHALL  FOLLOW  A  REVIEW  OF  SUCH
FACTORS  AS THE RELATIVE FINANCIAL CAPACITY OF THE STATE AND SUCH ELIGI-
BLE PROGRAM PARTICIPANTS TO SUPPORT SUCH ADJUSTMENTS.
  S 16. Paragraph (a) of subdivision 3 of section 247 of the elder  law,
as  amended  by section 3-k of part A of chapter 59 of the laws of 2011,
such subdivision as renumbered  by  section  fifteen  of  this  act,  is
amended to read as follows:
  (a)  [A]  UPON  SATISFACTION  OF THE REGISTRATION FEE PURSUANT TO THIS
SECTION AN ELIGIBLE program participant must pay a point of sale co-pay-
ment as set forth in paragraph (b) of this subdivision at  the  time  of
each  purchase of a COVERED drug prescribed for such individual [that is
described in paragraph (c) of subdivision three of section  two  hundred
forty-two of this title]. SUCH CO-PAYMENT SHALL NOT BE WAIVED OR REDUCED
IN  WHOLE  OR IN PART SUBJECT TO THE LIMITS PROVIDED BY SUBDIVISION FOUR
OF THIS SECTION.
  S 17. The elder law is amended by adding a new section 248 to read  as
follows:
  S  248. COST-SHARING RESPONSIBILITIES OF ELIGIBLE PROGRAM PARTICIPANTS
FOR CATASTROPHIC COVERAGE. 1. DEDUCTIBLE. ELIGIBLE  INDIVIDUALS  MEETING
THE  DEDUCTIBLE  REQUIREMENTS  OF  THIS  SECTION MAY PURCHASE PRESCRIBED
COVERED DRUGS FOR AN AMOUNT  SPECIFIED  BY  SUBDIVISION  THREE  OF  THIS
SECTION, SUBJECT TO THE LIMITS ON POINT OF SALE CO-PAYMENTS SPECIFIED BY
SUBDIVISION FOUR OF THIS SECTION.
  2.  DEDUCTIBLE  SCHEDULE.  ELIGIBLE  INDIVIDUALS  ELECTING TO MEET THE
REQUIREMENTS OF THIS SUBDIVISION  SHALL  INCUR  AN  AMOUNT  OF  PERSONAL
COVERED  DRUG  EXPENDITURES  DURING ANY ANNUAL COVERAGE PERIOD WHICH ARE
NOT REIMBURSED BY ANY OTHER PUBLIC OR PRIVATE THIRD PARTY PAYMENT SOURCE
OR INSURANCE PLAN, AND SHALL BE DEEMED  TO  HAVE  MET  THEIR  DEDUCTIBLE
REQUIREMENTS  FOR  THE  REMAINDER  OF  SUCH  ANNUAL COVERAGE PERIOD. THE
AMOUNT OF PERSONAL COVERED DRUG EXPENDITURES TO BE INCURRED BY  ELIGIBLE

S. 6256--C                         74

PROGRAM  PARTICIPANTS  FOR CATASTROPHIC COVERAGE UNDER THIS OPTION SHALL
BE IN ACCORDANCE WITH THE FOLLOWING SCHEDULE:
  (A) ANNUAL PERSONAL COVERED DRUG EXPENDITURES FOR UNMARRIED INDIVIDUAL
ELIGIBLE PROGRAM PARTICIPANTS:
INDIVIDUAL INCOME OF $20,001 TO $21,000                $530
INDIVIDUAL INCOME OF $21,001 TO $22,000                $550
INDIVIDUAL INCOME OF $22,001 TO $23,000                $580
INDIVIDUAL INCOME OF $23,001 TO $24,000                $720
INDIVIDUAL INCOME OF $24,001 TO $25,000                $750
INDIVIDUAL INCOME OF $25,001 TO $26,000                $780
INDIVIDUAL INCOME OF $26,001 TO $27,000                $810
INDIVIDUAL INCOME OF $27,001 TO $28,000                $840
INDIVIDUAL INCOME OF $28,001 TO $29,000                $870
INDIVIDUAL INCOME OF $29,001 TO $30,000                $900
INDIVIDUAL INCOME OF $30,001 TO $31,000                $930
INDIVIDUAL INCOME OF $31,001 TO $32,000                $960
INDIVIDUAL INCOME OF $32,001 TO $33,000                $1,160
INDIVIDUAL INCOME OF $33,001 TO $34,000                $1,190
INDIVIDUAL INCOME OF $34,001 TO $35,000                $1,230
  (B) ANNUAL PERSONAL COVERED DRUG EXPENDITURES FOR EACH MARRIED
INDIVIDUAL ELIGIBLE PROGRAM PARTICIPANT:
JOINT INCOME OF $26,001 TO $27,000                     $650
JOINT INCOME OF $27,001 TO $28,000                     $675
JOINT INCOME OF $28,001 TO $29,000                     $700
JOINT INCOME OF $29,001 TO $30,000                     $725
JOINT INCOME OF $30,001 TO $31,000                     $900
JOINT INCOME OF $31,001 TO $32,000                     $930
JOINT INCOME OF $32,001 TO $33,000                     $960
JOINT INCOME OF $33,001 TO $34,000                     $990
JOINT INCOME OF $34,001 TO $35,000                     $1,020
JOINT INCOME OF $35,001 TO $36,000                     $1,050
JOINT INCOME OF $36,001 TO $37,000                     $1,080
JOINT INCOME OF $37,001 TO $38,000                     $1,110
JOINT INCOME OF $38,001 TO $39,000                     $1,140
JOINT INCOME OF $39,001 TO $40,000                     $1,170
JOINT INCOME OF $40,001 TO $41,000                     $1,200
JOINT INCOME OF $41,001 TO $42,000                     $1,230
JOINT INCOME OF $42,001 TO $43,000                     $1,260
JOINT INCOME OF $43,001 TO $44,000                     $1,290
JOINT INCOME OF $44,001 TO $45,000                     $1,320
JOINT INCOME OF $45,001 TO $46,000                     $1,575
JOINT INCOME OF $46,001 TO $47,000                     $1,610
JOINT INCOME OF $47,001 TO $48,000                     $1,645
JOINT INCOME OF $48,001 TO $49,000                     $1,680
JOINT INCOME OF $49,001 TO $50,000                     $1,715
  (C)  IN THE EVENT THAT THE STATE EXPENDITURES PER PARTICIPANT ELECTING
TO MEET THE DEDUCTIBLE REQUIREMENTS OF THIS  SUBDIVISION,  EXCLUSIVE  OF
EXPENDITURES  FOR PROGRAM ADMINISTRATION, IN THE PROGRAM YEAR COMMENCING
OCTOBER FIRST, NINETEEN HUNDRED EIGHTY-EIGHT, AND IN EACH  PROGRAM  YEAR
THEREAFTER,  EXCEED  SUCH EXPENDITURES IN THE PREVIOUS PROGRAM YEAR BY A
MINIMUM OF TEN PERCENT, THE ANNUAL PERSONAL  COVERED  DRUG  EXPENDITURES
SET  FORTH IN THIS SUBDIVISION MAY, UNLESS OTHERWISE PROVIDED BY LAW, BE
INCREASED, PRO-RATA, FOR THE SUBSEQUENT PROGRAM YEAR, PROVIDED THAT SUCH
INCREASE SHALL NOT EXCEED EIGHT  PERCENT  OF  THE  PRIOR  YEAR  PERSONAL
COVERED  DRUG  EXPENDITURES AS MAY HAVE BEEN ADJUSTED IN ACCORDANCE WITH
THIS PARAGRAPH.

S. 6256--C                         75

  (D) IN THE EVENT THAT THE STATE  EXPENDITURES  PER  SUCH  PARTICIPANT,
INCURRED  PURSUANT  TO  THIS  SUBDIVISION, EXCLUSIVE OF EXPENDITURES FOR
PROGRAM ADMINISTRATION, IN THE PROGRAM YEAR  COMMENCING  OCTOBER  FIRST,
NINETEEN  HUNDRED EIGHTY-EIGHT, AND IN EACH PROGRAM YEAR THEREAFTER, ARE
LESS THAN SUCH EXPENDITURES IN THE PREVIOUS PROGRAM YEAR BY A MINIMUM OF
TEN  PERCENT, THE ANNUAL PERSONAL COVERED DRUG EXPENDITURES SET FORTH IN
THIS SUBDIVISION MAY, UNLESS OTHERWISE PROVIDED BY  LAW,  BE  DECREASED,
PRO-RATA,  FOR  THE SUBSEQUENT PROGRAM YEAR, PROVIDED THAT SUCH DECREASE
SHALL NOT EXCEED EIGHT PERCENT OF THE PRIOR YEAR PERSONAL  COVERED  DRUG
EXPENDITURES  AS  MAY  HAVE  BEEN ADJUSTED IN ACCORDANCE WITH THIS PARA-
GRAPH.
  (E) THE DETERMINATION TO ADJUST ANNUAL PERSONAL COVERED DRUG  EXPENDI-
TURES  SET  FORTH  IN  THIS  SUBDIVISION,  SHALL FOLLOW A REVIEW OF SUCH
FACTORS AS THE RELATIVE FINANCIAL CAPACITY OF THE STATE AND SUCH  ELIGI-
BLE  PROGRAM PARTICIPANTS TO SUPPORT SUCH ADJUSTMENTS AND CHANGES IN THE
CONSUMER PRICE INDEX. THE FREQUENCY OF SUCH ADJUSTMENTS SHALL NOT EXCEED
ONCE IN ANY TWELVE MONTH PERIOD AND SUCH ADJUSTMENTS  SHALL  NOT  BECOME
EFFECTIVE  FOR INDIVIDUAL PROGRAM PARTICIPANTS PRIOR TO THE FIRST DAY OF
THE NEXT ANNUAL COVERAGE PERIOD FOR EACH PARTICIPANT.
  3. POINT OF SALE CO-PAYMENT. (A) UPON SATISFACTION OF  THE  DEDUCTIBLE
REQUIREMENTS  PURSUANT  TO  SUBDIVISION TWO OF THIS SECTION, AN ELIGIBLE
PROGRAM PARTICIPANT SHALL PAY A POINT OF SALE CO-PAYMENT AS SET FORTH IN
PARAGRAPH (B) OF THIS SUBDIVISION AT THE TIME  OF  EACH  PURCHASE  OF  A
COVERED  DRUG  PRESCRIBED FOR SUCH INDIVIDUAL. SUCH CO-PAYMENT SHALL NOT
BE WAIVED OR REDUCED IN WHOLE OR IN PART, SUBJECT TO THE LIMITS PROVIDED
BY SUBDIVISION FOUR OF THIS SECTION.
  (B) THE POINT OF SALE CO-PAYMENT  AMOUNTS  WHICH  ARE  TO  BE  CHARGED
ELIGIBLE  PROGRAM PARTICIPANTS SHALL BE IN ACCORDANCE WITH THE FOLLOWING
SCHEDULE:
FOR EACH PRESCRIPTION OF COVERED
DRUGS COSTING $15.00 OR LESS                           $3.00
FOR EACH PRESCRIPTION OF COVERED
DRUGS COSTING $15.01 TO $35.00                         $7.00
FOR EACH PRESCRIPTION OF COVERED
DRUGS COSTING $35.01 TO $55.00                         $15.00
FOR EACH PRESCRIPTION OF COVERED
DRUGS COSTING $55.01 OR MORE                           $20.00
  (C) FOR THE PURPOSES OF  THE  FOREGOING  SCHEDULE  OF  POINT  OF  SALE
CO-PAYMENTS,  "COSTING"  SHALL  MEAN  THE  AMOUNT OF REIMBURSEMENT WHICH
SHALL BE PAID BY THE STATE  TO  A  PARTICIPATING  PROVIDER  PHARMACY  IN
ACCORDANCE  WITH  SECTION TWO HUNDRED FIFTY OF THIS TITLE PLUS THE POINT
OF SALE CO-PAYMENT, CALCULATED AS OF THE DATE OF SALE.
  4. ANNUAL LIMITS ON POINT OF  SALE  CO-PAYMENTS.  DURING  EACH  ANNUAL
COVERAGE  PERIOD,  NO POINT OF SALE CO-PAYMENTS AS SET FORTH IN SUBDIVI-
SION THREE OF THIS SECTION SHALL BE REQUIRED TO BE MADE FOR THE  REMAIN-
DER  OF  SUCH  PERIOD  BY  ANY  ELIGIBLE PROGRAM PARTICIPANT MEETING THE
PERSONAL COVERED DRUG EXPENDITURE REQUIREMENTS  OF  SUBDIVISION  TWO  OF
THIS  SECTION  IN EXCESS OF THE LIMITS SET FORTH IN THE FOLLOWING SCHED-
ULE:
  (A) LIMITS ON CO-PAYMENTS BY  UNMARRIED  INDIVIDUAL  ELIGIBLE  PROGRAM
PARTICIPANTS:
INDIVIDUAL INCOME OF $20,001 TO $21,000           NO MORE THAN $1,050
INDIVIDUAL INCOME OF $21,001 TO $22,000           NO MORE THAN $1,100
INDIVIDUAL INCOME OF $22,001 TO $23,000           NO MORE THAN $1,150
INDIVIDUAL INCOME OF $23,001 TO $24,000           NO MORE THAN $1,200
INDIVIDUAL INCOME OF $24,001 TO $25,000           NO MORE THAN $1,250

S. 6256--C                         76

INDIVIDUAL INCOME OF $25,001 TO $26,000           NO MORE THAN $1,300
INDIVIDUAL INCOME OF $26,001 TO $27,000           NO MORE THAN $1,350
INDIVIDUAL INCOME OF $27,001 TO $28,000           NO MORE THAN $1,400
INDIVIDUAL INCOME OF $28,001 TO $29,000           NO MORE THAN $1,450
INDIVIDUAL INCOME OF $29,001 TO $30,000           NO MORE THAN $1,500
INDIVIDUAL INCOME OF $30,001 TO $31,000           NO MORE THAN $1,550
INDIVIDUAL INCOME OF $31,001 TO $32,000           NO MORE THAN $1,600
INDIVIDUAL INCOME OF $32,001 TO $33,000           NO MORE THAN $1,650
INDIVIDUAL INCOME OF $33,001 TO $34,000           NO MORE THAN $1,700
INDIVIDUAL INCOME OF $34,001 TO $35,000           NO MORE THAN $1,750
  (B)  LIMITS ON CO-PAYMENTS BY EACH MARRIED INDIVIDUAL ELIGIBLE PROGRAM
PARTICIPANT:
JOINT INCOME OF $26,001 TO $27,000                NO MORE THAN $1,080
JOINT INCOME OF $27,001 TO $28,000                NO MORE THAN $1,120
JOINT INCOME OF $28,001 TO $29,000                NO MORE THAN $1,160
JOINT INCOME OF $29,001 TO $30,000                NO MORE THAN $1,200
JOINT INCOME OF $30,001 TO $31,000                NO MORE THAN $1,240
JOINT INCOME OF $31,001 TO $32,000                NO MORE THAN $1,280
JOINT INCOME OF $32,001 TO $33,000                NO MORE THAN $1,320
JOINT INCOME OF $33,001 TO $34,000                NO MORE THAN $1,360
JOINT INCOME OF $34,001 TO $35,000                NO MORE THAN $1,400
JOINT INCOME OF $35,001 TO $36,000                NO MORE THAN $1,440
JOINT INCOME OF $36,001 TO $37,000                NO MORE THAN $1,480
JOINT INCOME OF $37,001 TO $38,000                NO MORE THAN $1,520
JOINT INCOME OF $38,001 TO $39,000                NO MORE THAN $1,560
JOINT INCOME OF $39,001 TO $40,000                NO MORE THAN $1,600
JOINT INCOME OF $40,001 TO $41,000                NO MORE THAN $1,640
JOINT INCOME OF $41,001 TO $42,000                NO MORE THAN $1,680
JOINT INCOME OF $42,001 TO $43,000                NO MORE THAN $1,720
JOINT INCOME OF $43,001 TO $44,000                NO MORE THAN $1,760
JOINT INCOME OF $44,001 TO $45,000                NO MORE THAN $1,800
JOINT INCOME OF $45,001 TO $46,000                NO MORE THAN $1,840
JOINT INCOME OF $46,001 TO $47,000                NO MORE THAN $1,880
JOINT INCOME OF $47,001 TO $48,000                NO MORE THAN $1,920
JOINT INCOME OF $48,001 TO $49,000                NO MORE THAN $1,960
JOINT INCOME OF $49,001 TO $50,000                NO MORE THAN $2,000
  (C) EFFECTIVE OCTOBER FIRST, NINETEEN HUNDRED EIGHTY-EIGHT, THE LIMITS
ON POINT OF SALE CO-PAYMENTS AS SET FORTH IN  THIS  SUBDIVISION  MAY  BE
ADJUSTED  BY  THE  PANEL ON THE ANNIVERSARY DATE OF EACH PROGRAM PARTIC-
IPANT'S ANNUAL COVERAGE PERIOD, AND SUCH ADJUSTMENT SHALL BE  IN  EFFECT
FOR THE DURATION OF THAT ANNUAL COVERAGE PERIOD. ANY SUCH ANNUAL ADJUST-
MENT  SHALL BE MADE USING A PERCENTAGE ADJUSTMENT FACTOR WHICH SHALL NOT
EXCEED ONE-HALF OF THE DIFFERENCE BETWEEN  THE  YEAR-TO-YEAR  PERCENTAGE
INCREASE  IN  THE  CONSUMER  PRICE  INDEX  FOR  ALL  URBAN CONSUMERS, AS
PUBLISHED BY THE UNITED STATES DEPARTMENT OF LABOR, AND, IF LARGER,  THE
YEAR-TO-YEAR  PERCENTAGE  INCREASE  IN  THE  AGGREGATE  AVERAGE  COST OF
COVERED DRUGS PURCHASED UNDER THIS TITLE, WHICH YEAR-TO-YEAR  PERCENTAGE
INCREASE  IN SUCH COST SHALL BE DETERMINED BY COMPARISON OF SUCH COST IN
THE SAME MONTH OF EACH OF THE APPROPRIATE  SUCCESSIVE  YEARS;  PROVIDED,
HOWEVER,  THAT FOR ANY SUCH ADJUSTMENT BASED WHOLLY ON EXPERIENCE IN THE
PROGRAM YEAR COMMENCING OCTOBER FIRST,  NINETEEN  HUNDRED  EIGHTY-SEVEN,
THE YEAR-TO-YEAR PERCENTAGE INCREASE IN SUCH COST SHALL BE DETERMINED BY
COMPARISON  OF  SUCH COST IN EACH OF TWO MONTHS NO LESS THAN FIVE MONTHS
APART AND WITHIN SUCH PROGRAM YEAR, WHICH COMPARISON  SHALL  BE  ANNUAL-
IZED.  SUCH  PERCENTAGE ADJUSTMENT FACTOR SHALL BE THE SAME AS THAT USED
TO DETERMINE ANY SIMILAR ANNUAL ADJUSTMENT FOR THE SAME ANNUAL  COVERAGE

S. 6256--C                         77

PERIODS  PURSUANT  TO  THE PROVISIONS OF SUBDIVISION FOUR OF SECTION TWO
HUNDRED FORTY-SEVEN OF THIS TITLE.  SUCH  ANNUAL  ADJUSTMENTS  SHALL  BE
CALCULATED  BY  MULTIPLYING  THE PERCENTAGE ADJUSTMENT FACTOR BY (1) TEN
PERCENT  AND APPLYING THE RESULTING PERCENTAGE TO THE UPPER INCOME LIMI-
TATION OF EACH INCOME LEVEL FOR UNMARRIED INDIVIDUALS CONTAINED IN  THIS
SUBDIVISION,  AND  BY  (2)  SEVEN  AND ONE-HALF PERCENT AND APPLYING THE
RESULTING PERCENTAGE TO THE UPPER INCOME LIMITATION OF EACH INCOME LEVEL
FOR MARRIED INDIVIDUALS CONTAINED IN THIS SUBDIVISION;  EACH  RESULT  OF
SUCH CALCULATIONS, MINUS ANY APPLICABLE DEDUCTIBLE INCREASES MADE PURSU-
ANT  TO  SUBDIVISION TWO OF THIS SECTION AND PLUS THE RESULT OF APPLYING
THE PERCENTAGE ADJUSTMENT FACTOR TO THE SUM OF ANY SUCH  ANNUAL  ADJUST-
MENTS  APPLICABLE THERETO FOR ANY PRIOR ANNUAL COVERAGE PERIOD, SHALL BE
THE AMOUNT BY WHICH THE LIMIT ON CO-PAYMENTS FOR EACH SUCH INCOME  LEVEL
MAY BE ADJUSTED, AND SUCH AMOUNT SHALL BE IN ADDITION TO ANY SUCH AMOUNT
OR AMOUNTS APPLICABLE TO PRIOR ANNUAL COVERAGE PERIODS.
  (D)  THE  DETERMINATION  TO ADJUST THE LIMITS ON POINT OF SALE CO-PAY-
MENTS SET FORTH IN THIS  SUBDIVISION  SHALL  FOLLOW  A  REVIEW  OF  SUCH
FACTORS  AS THE RELATIVE FINANCIAL CAPACITY OF THE STATE AND SUCH ELIGI-
BLE PROGRAM PARTICIPANT TO SUPPORT SUCH ADJUSTMENTS.
  S 18. Section 250 of the elder law, as amended by section 3-m of  part
A of chapter 59 of the laws of 2011, is amended to read as follows:
  S  250.  Reimbursement  to  participating  provider pharmacies. 1. The
amount of reimbursement which shall be paid by the state  to  a  partic-
ipating  provider  pharmacy  [filling  or refilling a prescription for a
drug that is described in paragraph (c) of subdivision three of  section
two  hundred  forty-two  of  this  title] FOR ANY COVERED DRUG FILLED OR
REFILLED FOR ANY ELIGIBLE PROGRAM PARTICIPANT  shall  be  equal  to  the
allowed amount defined as follows, minus the point of sale co-payment as
required  by  [section] SECTIONS two hundred forty-seven AND TWO HUNDRED
FORTY-EIGHT of this title:
  (a) Multiple source covered drugs. Except for brand  name  drugs  that
are  required  by the prescriber to be dispensed as written, the allowed
amount for a multiple source covered drug shall equal the lower of:
  (1) The pharmacy's usual and customary charge to the  general  public,
taking  into consideration any quantity and promotional discounts to the
general public at the time of purchase, or
  (2) The upper limit, if any, set by the centers for medicare and medi-
caid services for such multiple source drug, or
  (3) Average wholesale price discounted by twenty-five percent, or
  (4) The maximum allowable cost, if any, established by the commission-
er of health pursuant to paragraph (e) of subdivision  nine  of  section
three hundred sixty-seven-a of the social services law.
  Plus  a  dispensing fee for drugs reimbursed pursuant to subparagraphs
two, three, and four of this paragraph, as defined in paragraph  (c)  of
this subdivision.
  (b)  Other  covered  drugs.  The  allowed  amount for brand name drugs
required by the prescriber to be dispensed as written  and  for  covered
drugs  other  than multiple source drugs shall be determined by applying
the lower of:
  (1) Average wholesale price discounted by sixteen and twenty-five  one
hundredths percent, plus a dispensing fee as defined in paragraph (c) of
this subdivision, or
  (2)  The  pharmacy's usual and customary charge to the general public,
taking into consideration any quantity and promotional discounts to  the
general public at the time of purchase.

S. 6256--C                         78

  (c)  As  required  by  paragraphs  (a)  and (b) of this subdivision, a
dispensing fee of four dollars fifty cents will apply to  generic  drugs
and  a  dispensing  fee of three dollars fifty cents will apply to brand
name drugs.
  2. For purposes of determining the amount of reimbursement which shall
be  paid  to  a  participating  provider  pharmacy, the [commissioner of
health] PANEL shall determine or  cause  to  be  determined,  through  a
statistically  valid  survey,  the  quantities of each covered drug that
participating provider pharmacies buy most frequently. Using the  result
of  this  survey, the contractor shall update every thirty days the list
of average wholesale prices upon which such reimbursement is  determined
using  nationally  recognized  and  most  recently revised sources. Such
price revisions shall be made available to  all  participating  provider
pharmacies.  The  pharmacist  shall  be reimbursed based on the price in
effect at the time the covered drug is dispensed.
  3. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, THE  PROGRAM
FOR  ELDERLY  PHARMACEUTICAL  INSURANCE  COVERAGE  SHALL  REIMBURSE  FOR
COVERED DRUGS WHICH ARE DISPENSED UNDER THE PROGRAM BY A PROVIDER  PHAR-
MACY  ONLY  PURSUANT  TO  THE  TERMS  OF  A REBATE AGREEMENT BETWEEN THE
PROGRAM AND THE MANUFACTURER (AS  DEFINED  UNDER  SECTION  1927  OF  THE
FEDERAL  SOCIAL  SECURITY ACT) OF SUCH COVERED DRUGS; PROVIDED, HOWEVER,
THAT:
  (1) ANY AGREEMENT BETWEEN THE PROGRAM AND A MANUFACTURER ENTERED  INTO
BEFORE  AUGUST  FIRST,  NINETEEN  HUNDRED NINETY-ONE, SHALL BE DEEMED TO
HAVE BEEN ENTERED INTO ON APRIL FIRST, NINETEEN HUNDRED NINETY-ONE;  AND
PROVIDED  FURTHER, THAT IF A MANUFACTURER HAS NOT ENTERED INTO AN AGREE-
MENT  WITH  THE  DEPARTMENT  BEFORE  AUGUST  FIRST,   NINETEEN   HUNDRED
NINETY-ONE,  SUCH  AGREEMENT  SHALL  NOT BE EFFECTIVE UNTIL APRIL FIRST,
NINETEEN HUNDRED NINETY-TWO, UNLESS SUCH AGREEMENT PROVIDES THAT REBATES
WILL BE RETROACTIVELY CALCULATED AS IF THE AGREEMENT HAD BEEN IN  EFFECT
ON APRIL FIRST, NINETEEN HUNDRED NINETY-ONE; AND
  (2) THE PROGRAM MAY REIMBURSE FOR ANY COVERED DRUGS PURSUANT TO SUBDI-
VISIONS  ONE  AND TWO OF THIS SECTION, FOR WHICH A REBATE AGREEMENT DOES
NOT EXIST AND WHICH ARE DETERMINED BY THE ELDERLY PHARMACEUTICAL  INSUR-
ANCE COVERAGE PANEL TO BE ESSENTIAL TO THE HEALTH OF PERSONS PARTICIPAT-
ING IN THE PROGRAM; AND LIKELY TO PROVIDE EFFECTIVE THERAPY OR DIAGNOSIS
FOR  A  DISEASE NOT ADEQUATELY TREATED OR DIAGNOSED BY ANY OTHER COVERED
DRUG; AND WHICH ARE RECOMMENDED  FOR  REIMBURSEMENT  BY  THE  PANEL  AND
APPROVED BY THE COMMISSIONER OF HEALTH.
  (B) THE REBATE AGREEMENT BETWEEN SUCH MANUFACTURER AND THE PROGRAM FOR
ELDERLY  PHARMACEUTICAL  INSURANCE  COVERAGE  SHALL  UTILIZE FOR COVERED
DRUGS THE IDENTICAL FORMULA USED TO DETERMINE  THE  REBATE  FOR  FEDERAL
FINANCIAL  PARTICIPATION  FOR  DRUGS, PURSUANT TO SECTION 1927(C) OF THE
FEDERAL SOCIAL SECURITY ACT, TO  DETERMINE  THE  AMOUNT  OF  THE  REBATE
PURSUANT TO THIS SUBDIVISION.
  (C) THE AMOUNT OF REBATE PURSUANT TO PARAGRAPH (B) OF THIS SUBDIVISION
SHALL  BE  CALCULATED BY MULTIPLYING THE REQUIRED REBATE FORMULAS BY THE
TOTAL NUMBER OF UNITS OF EACH DOSAGE FORM AND  STRENGTH  DISPENSED.  THE
REBATE  AGREEMENT SHALL ALSO PROVIDE FOR PERIODIC PAYMENT OF THE REBATE,
PROVISION OF INFORMATION TO THE PROGRAM, AUDITS, VERIFICATION  OF  DATA,
DAMAGES TO THE PROGRAM FOR ANY DELAY OR NON-PRODUCTION OF NECESSARY DATA
BY THE MANUFACTURER AND FOR THE CONFIDENTIALITY OF INFORMATION.
  (D)  THE  PROGRAM  IN PROVIDING UTILIZATION DATA TO A MANUFACTURER (AS
PROVIDED FOR UNDER SECTION 1927 (B) OF THE FEDERAL SOCIAL SECURITY  ACT)
SHALL  PROVIDE  SUCH  DATA  BY ZIP CODE, IF REQUESTED, FOR THE TOP THREE

S. 6256--C                         79

HUNDRED MOST COMMONLY USED DRUGS BY VOLUME COVERED UNDER A REBATE AGREE-
MENT.
  (E) ANY FUNDS COLLECTED PURSUANT TO ANY REBATE AGREEMENTS ENTERED INTO
WITH  A  MANUFACTURER  PURSUANT  TO THIS SUBDIVISION, SHALL BE DEPOSITED
INTO THE  ELDERLY  PHARMACEUTICAL  INSURANCE  COVERAGE  PROGRAM  PREMIUM
ACCOUNT.
  4.  Notwithstanding  any  other provision of law, entities which offer
insurance coverage for provision of and/or reimbursement for  pharmaceu-
tical    expenses,    including    but    not   limited   to,   entities
licensed/certified pursuant to  article  thirty-two,  forty-two,  forty-
three  or  forty-four  of the insurance law (employees welfare funds) or
article forty-four of the public health  law,  shall  participate  in  a
benefit  recovery  program  with  the  elderly  pharmaceutical insurance
coverage (EPIC) program which includes, but is not limited to,  a  semi-
annual  match  of  EPIC's file of enrollees against the entity's file of
insured to identify individuals enrolled in both plans with claims  paid
within the twenty-four months preceding the date the entity receives the
match request information from EPIC. Such entity shall indicate if phar-
maceutical  coverage  is  available  from  the  entity  for  the insured
persons, list the copayment or other payment obligations of the  insured
persons  applicable to the pharmaceutical coverage, and (after receiving
necessary claim information from EPIC) list the amounts which the entity
would have paid for the pharmaceutical claims for those identified indi-
viduals and the entity shall reimburse EPIC for pharmaceutical  expenses
paid  by EPIC that are covered under the contract between the entity and
its insured in only those instances where the  entity  has  not  already
made  payment  of  the  claim.  Reimbursement  of the net amount payable
(after rebates and discounts) that would have been paid under the cover-
age issued by the entity will be made by the entity to EPIC within sixty
days of receipt from EPIC of the  standard  data  in  electronic  format
necessary  for  the  entity  to adjudicate the claim and if the standard
data is provided to the entity by EPIC in paper format  payment  by  the
entity  shall  be made within one hundred eighty days.  After completing
at least one match process with EPIC in  electronic  format,  an  entity
shall  be entitled to elect a monthly or bi-monthly match process rather
than a semi-annual match process.
  [4.] 5. Notwithstanding any other provision of law, the  [commissioner
of health] PANEL shall maximize the coordination of benefits for persons
enrolled under Title XVIII of the federal social security act (medicare)
and enrolled under this title in order to facilitate medicare payment of
claims.  The  [commissioner  of  health] PANEL may select an independent
contractor, through  a  request-for-proposal  process,  to  implement  a
centralized  coordination  of benefits system under this subdivision for
individuals qualified  in  both  the  elderly  pharmaceutical  insurance
coverage (EPIC) program and medicare programs who receive medications or
other  covered  products  from a pharmacy provider currently enrolled in
the elderly pharmaceutical insurance coverage (EPIC) program.
  [5.] 6. (A) The EPIC program shall be the payor  of  last  resort  for
individuals  qualified  in  both the EPIC program and title XVIII of the
federal social security  act  (Medicare).    FOR  SUCH  INDIVIDUALS,  NO
REIMBURSEMENT  SHALL  BE  AVAILABLE UNDER EPIC FOR COVERED DRUG EXPENSES
EXCEPT:
  (I) WHERE A PRESCRIPTION DRUG PLAN AUTHORIZED BY PART D OF THE FEDERAL
SOCIAL SECURITY ACT (REFERRED TO IN THIS SUBDIVISION AS A MEDICARE  PART
D  PLAN)  HAS  APPROVED  COVERAGE  AND EPIC HAS AN OBLIGATION UNDER THIS

S. 6256--C                         80

TITLE TO PAY A PORTION OF THE PARTICIPANT'S COST-SHARING  RESPONSIBILITY
UNDER MEDICARE PART D; OR
  (II)  WHERE THE PROVIDER PHARMACY HAS CERTIFIED THAT A MEDICARE PART D
PLAN HAS DENIED COVERAGE.
  (B) IF THE PROVIDER PHARMACY CERTIFIES AS SET  FORTH  IN  SUBPARAGRAPH
(II)  OF  PARAGRAPH  (A) OF THIS SUBDIVISION, THE EPIC PROGRAM SHALL PAY
FOR THE DRUG AS THE PRIMARY PAYOR UPON A SHOWING OF COMPLIANCE WITH  THE
NOTIFICATION  AND APPEAL PROVISIONS OF SUBPARAGRAPH TWO OF PARAGRAPH (C)
OF SUBDIVISION THREE OF SECTION TWO HUNDRED FORTY-TWO OF THIS TITLE.
  S 19. Section 254 of the elder law, as amended by section 3-n of  part
A of chapter 59 of the laws of 2011, is amended to read as follows:
  S  254. Cost of living adjustment. 1. Within amounts appropriated, the
[commissioner of health] PANEL  shall  adjust  the  program  eligibility
standards  set  forth  in  subdivision  [one] TWO of section two hundred
forty-two of this title to account for increases in the cost of living.
  2. THE PANEL SHALL FURTHER ADJUST INDIVIDUAL AND JOINT INCOME  CATEGO-
RIES  SET  FORTH  IN  SUBDIVISIONS  TWO  AND FOUR OF SECTION TWO HUNDRED
FORTY-EIGHT OF THIS TITLE TO CONFORM TO THE ADJUSTMENTS MADE PURSUANT TO
SUBDIVISION ONE OF THIS SECTION.
  S 20. This act shall take effect April  1,  2012;  provided,  however,
that if this act shall not have become a law on or before April 1, 2012,
this  act shall take effect immediately and shall be deemed to have been
in full force and effect on and after April 1, 2012.

                                 PART V

  Section 1.  Subdivision 6 of section 369 of the social  services  law,
as amended by section 53 of part H of chapter 59 of the laws of 2011, is
amended to read as follows:
  6.  For  purposes of this section, [an individual's] THE TERM "estate"
[includes] MEANS all [of the individual's] real  and  personal  property
and  other  assets  INCLUDED  WITHIN THE INDIVIDUAL'S ESTATE AND passing
under the terms of a valid will or  by  intestacy.  [Pursuant  to  regu-
lations  adopted  by  the  commissioner,  which may be promulgated on an
emergency basis, an individual's estate also includes any other property
in which the individual has any legal title or interest at the  time  of
death,  including  jointly  held  property,  retained  life estates, and
interests in trusts, to the extent of such interests; provided, however,
that a claim against a recipient of such  property  by  distribution  or
survival  shall  be limited to the value of the property received or the
amount of medical assistance benefits otherwise recoverable pursuant  to
this  section,  whichever  is less. Nothing in this subdivision shall be
construed as authorizing the department or a social services district to
impose liens or make recoveries that  are  prohibited  by  federal  laws
governing the medical assistance program.]
  S  2.  Section 2801 of the public health law is amended by adding five
new subdivisions 11, 12, 13, 14 and 15 to read as follows:
  11. "DISTANT SITE" MEANS A SITE AT WHICH A  HEALTH  CARE  PROVIDER  IS
LOCATED  WHILE PROVIDING HEALTH CARE SERVICES BY MEANS OF A TELECOMMUNI-
CATIONS SYSTEM.
  12. "HEALTH CARE PROVIDER" MEANS A HEALTH CARE PROVIDER AS DEFINED  IN
SECTION TWO HUNDRED THIRTY-EIGHT OF THIS CHAPTER.
  13.  "ORIGINATING  SITE" MEANS A SITE AT WHICH A PATIENT IS LOCATED AT
THE TIME HEALTH CARE SERVICES ARE PROVIDED TO HIM OR HER BY MEANS  OF  A
TELECOMMUNICATIONS SYSTEM.

S. 6256--C                         81

  14.  "TELEHEALTH" MEANS THE MODE OF DELIVERING HEALTH CARE SERVICES BY
MEANS OF INFORMATION AND COMMUNICATIONS TECHNOLOGIES INCLUDING, BUT  NOT
LIMITED  TO,  TELEPHONES,  FACSIMILE MACHINES, ELECTRONIC MAIL SERVICES,
REMOTE PATIENT MONITORING DEVICES OR OTHER ELECTRONIC MEANS WHICH FACIL-
ITATE  THE  ASSESSMENT,  DIAGNOSIS,  CONSULTATION, TREATMENT, EDUCATION,
CARE MANAGEMENT AND SELF MANAGEMENT OF A  PATIENT'S  HEALTH  CARE  WHILE
SUCH  PATIENT IS AT THE ORIGINATING SITE AND THE HEALTH CARE PROVIDER IS
AT A DISTANT SITE. SUCH TERM SHALL INCLUDE TELEMEDICINE.
  15. "TELEMEDICINE" MEANS THE DELIVERY OF CLINICAL HEALTH CARE SERVICES
BY MEANS OF REAL TIME  TWO-WAY  ELECTRONIC  AUDIO-VISUAL  COMMUNICATIONS
WHICH  FACILITATE  THE  ASSESSMENT,  DIAGNOSIS, CONSULTATION, TREATMENT,
EDUCATION, CARE MANAGEMENT AND SELF MANAGEMENT  OF  A  PATIENT'S  HEALTH
CARE  WHILE  SUCH PATIENT IS AT THE ORIGINATING SITE AND THE HEALTH CARE
PROVIDER IS AT A DISTANT SITE.
  S 3. The public health law is amended by adding a new  section  2805-u
to read as follows:
  S  2805-U. TELEMEDICINE CREDENTIALING.  1. (A) WITH REGARD TO A HEALTH
CARE PROVIDER WHO WILL BE PROVIDING PATIENT CONSULTATIONS THROUGH  TELE-
MEDICINE,  AN ORIGINATING SITE HOSPITAL MAY ENTER INTO AN AGREEMENT WITH
A DISTANT SITE HOSPITAL PROVIDING THAT:
  (1) THE DISTANT SITE  HOSPITAL  RECEIVES  AND  COLLECTS  CREDENTIALING
INFORMATION  AND PERFORMS ALL REQUIRED VERIFICATION ACTIVITIES OTHERWISE
REQUIRED OF THE ORIGINATING SITE HOSPITAL BY THIS ARTICLE, AND  ACTS  ON
BEHALF OF THE ORIGINATING SITE HOSPITAL FOR SUCH CREDENTIALING PURPOSES;
PROVIDED  HOWEVER,  THAT SUCH AGREEMENT ESTABLISHES THAT THE ORIGINATING
SITE HOSPITAL RETAINS ULTIMATE RESPONSIBILITY FOR THE PHYSICIAN  CREDEN-
TIALING; AND
  (2)  THE  DISTANT  SITE  HOSPITAL PERFORMS THE PEER REVIEW AND QUALITY
ASSURANCE/QUALITY IMPROVEMENT ACTIVITIES OTHERWISE REQUIRED OF THE ORIG-
INATING SITE HOSPITAL BY  THIS  ARTICLE;  PROVIDED  HOWEVER,  THAT  SUCH
AGREEMENT  ESTABLISHES  THAT THE ORIGINATING SITE HOSPITAL RETAINS ULTI-
MATE RESPONSIBILITY FOR THE PEER REVIEW  AND  QUALITY  ASSURANCE/QUALITY
IMPROVEMENT ACTIVITIES.
  (B)  AN ORIGINATING HOSPITAL HAVING A DISTANT SITE HEALTH CARE PROVID-
ER, WHO HOLDS CURRENT PRIVILEGES  AT  THE  ORIGINATING  HOSPITAL  OR  IS
GRANTED  PRIVILEGES  IN  ACCORDANCE  WITH  THIS  SECTION,  SHALL PROVIDE
EVIDENCE OF ANY INTERNAL REVIEW OF THE DISTANT SITE HEALTH CARE  PROVID-
ER'S  PERFORMANCE OF SUCH PRIVILEGES AND SUCH PERFORMANCE INFORMATION TO
THE DISTANT SITE HEALTH CARE PROVIDER'S DISTANT SITE HOSPITAL FOR USE IN
THE PERIODIC APPRAISAL OF THE DISTANT SITE HEALTH CARE  PROVIDER.  AT  A
MINIMUM,  THIS  INFORMATION SHALL INCLUDE ALL ADVERSE EVENTS THAT RESULT
FROM THE TELEMEDICINE SERVICES PROVIDED BY THE DISTANT SITE HEALTH  CARE
PROVIDER  TO THE ORIGINATING SITE HOSPITAL'S PATIENTS AND ALL COMPLAINTS
THE ORIGINATING SITE HOSPITAL HAS RECEIVED ABOUT THE DISTANT SITE HEALTH
CARE PROVIDER.
  (C) NOTHING CONTAINED IN THIS SUBDIVISION SHALL BE CONSTRUED AS ALLOW-
ING AN ORIGINATING SITE HOSPITAL TO DELEGATE ITS DECISION MAKING AUTHOR-
ITY FOR GRANTING MEDICAL STAFF MEMBERSHIP OR PROFESSIONAL PRIVILEGES.
  (D) FOR PURPOSES OF THIS SUBDIVISION, A DISTANT SITE HOSPITAL  MAY  BE
AN  OUT OF STATE HOSPITAL, PROVIDED THAT THE OUT OF STATE HOSPITAL MEETS
MEDICARE REQUIREMENTS ESTABLISHED FOR PERFORMING SUCH SERVICES ON BEHALF
OF AN ORIGINATING SITE HOSPITAL.
  2. THE AGREEMENT ENTERED INTO BETWEEN AN ORIGINATING SITE HOSPITAL AND
DISTANT SITE HOSPITAL SHALL BE IN  WRITING  AND  SHALL,  AT  A  MINIMUM,
INCLUDE THE FOLLOWING PROVISIONS:

S. 6256--C                         82

  (A)  THE  CATEGORIES OF HEALTH CARE PROVIDERS THAT ARE ELIGIBLE CANDI-
DATES FOR APPOINTMENT TO THE DISTANT SITE HOSPITAL MEDICAL STAFF;
  (B) THE CREDENTIALING INFORMATION COLLECTED AND THE REQUIRED VERIFICA-
TION  ACTIVITIES  PERFORMED BY THE DISTANT SITE HOSPITAL AND RELIED UPON
BY THE ORIGINATING SITE HOSPITAL IN CONSIDERING THE  RECOMMENDATIONS  OF
THE EXISTING MEMBERS OF THE DISTANT SITE MEDICAL STAFF;
  (C)  THE  MEMBERS  OF  THE  ORIGINATING  SITE  HOSPITAL  MEDICAL STAFF
APPOINTED TO CONSIDER THE RECOMMENDATIONS OF THE EXISTING MEMBERS OF THE
DISTANT SITE MEDICAL STAFF;
  (D) THAT THE INDIVIDUAL DISTANT SITE HEALTH  CARE  PROVIDER  PROVIDING
THE  TELEMEDICINE  SERVICES  IS PRIVILEGED AT THE DISTANT SITE HOSPITAL;
AND
  (E) THAT THE INDIVIDUAL DISTANT SITE  HEALTH  CARE  PROVIDER  HOLDS  A
LICENSE ISSUED PURSUANT TO TITLE EIGHT OF THE EDUCATION LAW OR A LICENSE
RECOGNIZED BY THIS STATE.
  3.  NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, AN ORIGINATING SITE
HOSPITAL SHALL NOT BE REQUIRED TO PROVIDE A PHYSICAL EXAMINATION  OR  TO
MAINTAIN  RECORDED  MEDICAL HISTORY INCLUDING IMMUNIZATIONS FOR A HEALTH
CARE PROVIDER PROVIDING CONSULTATIONS SOLELY THROUGH TELEMEDICINE FROM A
DISTANT SITE HOSPITAL.
  S 4. Subdivision 3-c of section 3614  of  the  public  health  law  is
amended by adding a new paragraph (e) to read as follows:
  (E)  THE  COMMISSIONER  SHALL,  WITHIN  MONIES  APPROPRIATED THEREFOR,
ESTABLISH A RURAL HOME TELEHEALTH DELIVERY DEMONSTRATION  STUDY  PROGRAM
IN  COUNTIES  HAVING  A  POPULATION  OF NOT LESS THAN ONE HUNDRED THIRTY
THOUSAND AND NOT MORE THAN ONE HUNDRED FORTY THOUSAND, ACCORDING TO  THE
TWO THOUSAND TEN DECENNIAL FEDERAL CENSUS. THE COMMISSIONER SHALL DIRECT
A  HOME  HEALTH  ORGANIZATION  SERVING  IN SUCH COUNTY TO STUDY PATIENTS
RECEIVING TELEHEALTH SERVICES, PURSUANT TO THIS  SUBDIVISION,  WHO  HAVE
BEEN  DIAGNOSED  WITH  CONGESTIVE HEART FAILURE, DIABETES AND/OR CHRONIC
PULMONARY OBSTRUCTIVE DISEASE,  AND  WHOSE  MEDICAL,  FUNCTIONAL  AND/OR
ENVIRONMENTAL  NEEDS  ARE APPROPRIATELY MET AT HOME THROUGH THE APPLICA-
TION OF TELEHEALTH SERVICES INTERVENTIONS. SUCH A STUDY SHALL  DETERMINE
THE  COST OF PROVIDING TELEHEALTH SERVICES, THE QUALITY OF CARE PROVIDED
THROUGH TELEHEALTH SERVICES AND THE OUTCOMES OF PATIENTS RECEIVING  SUCH
TELEHEALTH  SERVICES.  THE  COMMISSIONER SHALL REIMBURSE THE HOME HEALTH
ORGANIZATION FOR CONDUCTING THE STUDY WITH  AMOUNTS  APPROPRIATED  UNDER
THIS  SUBDIVISION. THE HOME HEALTH ORGANIZATION SHALL EVALUATE THE FIND-
INGS OF THE STUDY AND REPORT TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF
THE SENATE, THE SPEAKER OF THE ASSEMBLY, THE COMMISSIONER, AND THE CHAIR
OF THE LEGISLATIVE COMMISSION ON RURAL  RESOURCES  ON  ITS  FINDINGS  OF
PROVIDING  TELEHEALTH  SERVICES FOR EACH CONDITION, SO AS TO PROVIDE THE
COST BENCHMARKS WITH AND WITHOUT TELEHEALTH CARE, AS WELL  AS  PROVIDING
COST  BENEFIT  MEASUREMENTS IN TERMS OF THE QUALITY BENEFIT OUTCOMES FOR
EACH OF THE CONDITIONS ADDRESSED VIA TELEHEALTH.
  S 5. Paragraph (h) of subdivision 3 of section 4403-f  of  the  public
health  law,  as  amended by section 41-a of part H of chapter 59 of the
laws of 2011, is amended to read as follows:
  (h) that the contractual arrangements for providers of health and long
term care services in the benefit package are sufficient to  ensure  the
availability and accessibility of such services to the proposed enrolled
population  consistent with THIS PARAGRAPH AND guidelines established by
the commissioner;  with  respect  to  individuals  in  receipt  of  such
services  [prior  to  enrollment],  such  guidelines  shall  require the
managed long term  care  plan  to  contract  with  agencies  [currently]
providing  such  services AT THE TIME OF ENROLLMENT, WHICH SHALL INCLUDE

S. 6256--C                         83

BUT NOT BE LIMITED TO CERTIFIED HOME HEALTH  AGENCIES,  LONG  TERM  HOME
HEALTH  CARE  PROGRAMS  AND  LICENSED  HOME CARE SERVICE AGENCIES ACTING
UNDER SECTION THIRTY-SIX HUNDRED FOURTEEN OF THIS CHAPTER, in  order  to
promote  continuity  of care. In addition, such guidelines shall require
managed long term care  plans  to  offer  and  cover  consumer  directed
personal  assistance  services  for  eligible individuals who elect such
services pursuant to section three hundred sixty-five-f  of  the  social
services law; and FOR SERVICES PROVIDED PRIOR TO ENROLLMENT, TO CONTINUE
THE  INDIVIDUAL'S ESTABLISHED PLAN OF CARE WHICH SHALL BE SUBJECT TO THE
NEXT COMPREHENSIVE ASSESSMENT OF THE PATIENT; AND
  S 6. Section 4403-f of the public health law is amended  by  adding  a
new subdivision 11 to read as follows:
  11.  ADDITIONAL SAFEGUARDS. NOTWITHSTANDING ANY INCONSISTENT PROVISION
OF THIS SECTION OR SECTION THREE  HUNDRED  SIXTY-FOUR-J  OF  THE  SOCIAL
SERVICES  LAW,  THE  FOLLOWING  ADDITIONAL SAFEGUARDS SHALL APPLY TO THE
INITIAL IMPLEMENTATION OF MANDATORY ENROLLMENT PURSUANT TO THIS  SECTION
OR   PARAGRAPH  (E)  OF  SUBDIVISION  THREE  OF  SECTION  THREE  HUNDRED
SIXTY-FOUR-J OF THE SOCIAL SERVICES LAW:
  (A) THE ESTABLISHMENT OF A REASONABLE TIMETABLE AND PLAN FOR IMPLEMEN-
TATION AND TRANSITION BY CONSUMERS, PLANS AND PROVIDERS, WHICH SHALL  BE
DEVELOPED BY THE COMMISSIONER WITH INPUT FROM REPRESENTATIVES OF CONSUM-
ERS, PLANS AND PROVIDERS AND SHALL:
  (I) ENSURE A PROCESS FOR READILY-UNDERSTANDABLE NOTICE TO CONSUMERS OF
OPTIONS  AND  IMPENDING  ACTIONS  AFFECTING OR RELATING TO THE HOME CARE
SERVICES THEY RECEIVE;
  (II) ENSURE A PROCESS FOR CONSUMER  ENROLLMENT  INTO  PLANS  WHICH  IS
CLEAR  TO  CONSUMERS,  AVOIDS  DISRUPTION OF THEIR PROVIDER SERVICES AND
EASES TRANSITION;
  (III) PERMIT REASONABLE TIME AND OPPORTUNITY FOR PLANS' AND PROVIDERS'
GOOD FAITH PURSUIT OF CONTRACTS,  PROGRAM  CHANGES  OR  STATE  APPROVALS
RELEVANT TO PLAN IMPLEMENTATION;
  (IV) MEET SUCH OTHER CRITERIA AS THE COMMISSIONER DETERMINES NECESSARY
FOR SUCH PLAN; AND
  (V)  BE  PROMINENTLY  POSTED  FOR  PUBLIC  ACCESS  ON THE DEPARTMENT'S
WEBSITE;
  (B) CONTINUITY OF CARE AND ACCESS  PROVISIONS  FOR  PATIENTS  AND  FOR
PLAN/PROVIDER CONTRACTING WHICH SHALL ENSURE THAT:
  (I) A PATIENT WITH A PRE-ESTABLISHED PLAN OF CARE PROVIDED BY A CERTI-
FIED  HOME  HEALTH  AGENCY  OR  LONG  TERM  HOME HEALTH CARE PROGRAM, OR
PROVIDED PURSUANT TO THE PERSONAL CARE  OR  CONSUMER  DIRECTED  PERSONAL
ASSISTANCE SERVICE PROGRAMS, SHALL HAVE SUCH CARE PLAN CONTINUED SUBJECT
TO THE PATIENT'S NEXT COMPREHENSIVE ASSESSMENT;
  (II)  SERVICES  PROVIDED  BY SUCH AGENCIES SHALL BE INCLUSIVE OF THEIR
SUBCONTRACTS  AND/OR  SERVICE  ARRANGEMENTS  WITH  LICENSED  HOME   CARE
SERVICES  AGENCIES  AND  OTHER PROVIDERS FOR THE SERVICES FOR WHICH SUCH
AGENCIES ARE RESPONSIBLE IN THE PLAN OF CARE, INCLUDING BUT NOT  LIMITED
TO:    NURSING,  THERAPY,  SOCIAL WORK, AIDE SERVICES, MEDICAL SUPPLIES,
EQUIPMENT AND APPLIANCES; AND
  (III) A PATIENT RECEIVING SERVICES UNDER ARTICLE  THIRTY-SIX  OF  THIS
CHAPTER  SHALL BE ENTITLED TO CONTINUE RECEIVING THOSE SERVICES FROM THE
ENTITY PROVIDING THEM, OR OTHER  SUCH  AGENCY,  PROVIDED  THAT  (A)  THE
NATURE OR LEVEL OF SERVICES MAY BE MODIFIED AS A RESULT OF THE PATIENT'S
COMPREHENSIVE  ASSESSMENT;  AND  (B) THE ENTITY IS QUALIFIED AND ABLE TO
PROVIDE THE SERVICES CALLED FOR BY THE PATIENT'S  COMPREHENSIVE  ASSESS-
MENT.

S. 6256--C                         84

  (C)  DELINEATION  OF  RESPONSIBILITIES  FOR  SERVICE DELIVERY AND CARE
COORDINATION, SO AS TO AVOID CONFLICT, DUPLICATION AND OMISSION OF DUTY,
AND MAINTAIN COMPLIANCE WITH STATE AND FEDERAL STATUTE  AND  REGULATION,
INCLUDING  THE  PROVISIONS  OF  THIS SECTION, ARTICLE THIRTY-SIX OF THIS
CHAPTER  AND  SECTION  THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES
LAW.
  (D)   ADEQUACY OF PAYMENT TO  THOSE  AGENCIES  LICENSED  OR  CERTIFIED
PURSUANT  TO  ARTICLE  THIRTY-SIX  OF THIS CHAPTER PROVIDING DIRECT CARE
SERVICES TO THE ENROLLED POPULATION, WHICH SHALL BE  REASONABLY  RELATED
TO THE COST OF PROVIDING EFFICIENT, CONSISTENT AND HIGH QUALITY SERVICES
REQUIRED BY THE PLAN OF CARE.
  S  7.  The  public  authorities law is amended by adding a new section
3622 to read as follows:
  S 3622. TERMINATION OF THE CORPORATION. 1. NOTWITHSTANDING  ANY  OTHER
PROVISION OF LAW TO THE CONTRARY, THE BOARD SHALL WIND UP THE AFFAIRS OF
THE  CORPORATION  ON OR BEFORE DECEMBER THIRTY-FIRST, TWO THOUSAND THIR-
TEEN, ON WHICH DATE THE CORPORATION SHALL CEASE TO EXIST.
  2. ALL  OF  THE  ASSETS,  FUNCTIONS,  POWERS,  RIGHTS  AND  PRIVILEGES
POSSESSED  BY  AND ALL OF THE LIABILITIES, OBLIGATIONS AND DUTIES OF THE
CORPORATION, INCLUDING THE FUNCTIONS, POWERS, OBLIGATIONS AND DUTIES  OF
ITS  BOARD,  OTHER THAN THOSE APPLICABLE TO A PUBLIC BENEFIT CORPORATION
BUT NOT TO A CORPORATION ORGANIZED AND EXISTING UNDER THE NOT-FOR-PROFIT
CORPORATION LAW, SHALL, ON OR BEFORE DECEMBER THIRTY-FIRST, TWO THOUSAND
THIRTEEN, BE TRANSFERRED AND ASSIGNED TO, ASSUMED BY AND  DEVOLVED  UPON
THE  CLIFTON-FINE  HEALTH  CARE CORPORATION, A CORPORATION ORGANIZED AND
EXISTING UNDER THE NOT-FOR-PROFIT CORPORATION LAW.
  3. ON OR BEFORE DECEMBER  THIRTY-FIRST,  TWO  THOUSAND  THIRTEEN,  THE
CORPORATION  AND ITS BOARD SHALL DELIVER TO THE CLIFTON-FINE HEALTH CARE
CORPORATION, A CORPORATION ORGANIZED AND EXISTING UNDER THE NOT-FOR-PRO-
FIT CORPORATION LAW, ALL OF THE CORPORATION'S BOOKS, PAPERS, RECORDS AND
PROPERTY.
  4. ANY BUSINESS OR OTHER MATTER UNDERTAKEN OR COMMENCED BY THE  CORPO-
RATION  OR  ITS  BOARD PERTAINING TO OR CONNECTED WITH THE ASSETS, FUNC-
TIONS, POWERS, RIGHTS, PRIVILEGES, LIABILITIES, OBLIGATIONS  AND  DUTIES
HEREBY  TRANSFERRED  AND ASSIGNED TO THE CLIFTON-FINE HEALTH CARE CORPO-
RATION, A CORPORATION ORGANIZED AND EXISTING  UNDER  THE  NOT-FOR-PROFIT
CORPORATION  LAW,  SHALL, FROM AND AFTER SUCH TRANSFER, BE CONDUCTED AND
COMPLETED BY THE CLIFTON-FINE HEALTH  CARE  CORPORATION,  A  CORPORATION
ORGANIZED  AND EXISTING UNDER THE NOT-FOR-PROFIT CORPORATION LAW, IN THE
SAME MANNER AND UNDER THE SAME TERMS AND CONDITIONS AND  WITH  THE  SAME
EFFECT AS IF CONDUCTED AND COMPLETED BY THE CORPORATION OR ITS BOARD.
  5.  ALL  RULES, REGULATIONS, ACTS, DETERMINATIONS AND DECISIONS OF THE
CORPORATION OR ITS BOARD PERTAINING TO THE ASSETS, LIABILITIES AND FUNC-
TIONS HEREIN TRANSFERRED AND ASSIGNED, IN FORCE  AT  THE  TIME  OF  SUCH
TRANSFER,  ASSIGNMENT,  ASSUMPTION OR DEVOLUTION SHALL CONTINUE IN FORCE
AND EFFECT AS RULES, REGULATIONS, ACTS, DETERMINATIONS AND DECISIONS  OF
THE  CLIFTON-FINE  HEALTH  CARE CORPORATION, A CORPORATION ORGANIZED AND
EXISTING UNDER THE NOT-FOR-PROFIT CORPORATION LAW, UNTIL  DULY  MODIFIED
OR ABROGATED BY SUCH CORPORATION.
  6. WHENEVER THE CORPORATION OR ITS BOARD ARE REFERRED TO OR DESIGNATED
IN  ANY  LAW,  CONTRACT OR DOCUMENT PERTAINING TO THE FUNCTIONS, POWERS,
OBLIGATIONS AND DUTIES HEREBY TRANSFERRED TO AND ASSIGNED TO  THE  CLIF-
TON-FINE  HEALTH  CARE CORPORATION, A CORPORATION ORGANIZED AND EXISTING
UNDER THE NOT-FOR-PROFIT CORPORATION LAW, SUCH REFERENCE OR  DESIGNATION
SHALL  BE DEEMED TO REFER TO THE CLIFTON-FINE HEALTH CARE CORPORATION, A

S. 6256--C                         85

CORPORATION ORGANIZED AND EXISTING UNDER THE NOT-FOR-PROFIT  CORPORATION
LAW.
  7.  NO  EXISTING  RIGHT  OR  REMEDY  OF  ANY  CHARACTER SHALL BE LOST,
IMPAIRED OR AFFECTED BY REASON OF THIS SECTION OTHER THAN THOSE APPLICA-
BLE TO A PUBLIC BENEFIT CORPORATION AND NOT TO A  CORPORATION  ORGANIZED
AND EXISTING UNDER THE NOT-FOR-PROFIT CORPORATION LAW.
  8.  NO  ACTION  PENDING  AT  ANY  TIME  ON  THE EFFECTIVE DATE OF THIS
SECTION, BROUGHT BY OR AGAINST THE CORPORATION OR  ITS  BOARD  SHALL  BE
AFFECTED  BY  ANY  PROVISION OF THIS SECTION, BUT THE SAME MAY BE PROSE-
CUTED OR DEFENDED IN THE NAME OF THE  CLIFTON-FINE  HEALTH  CARE  CORPO-
RATION,  A  CORPORATION  ORGANIZED AND EXISTING UNDER THE NOT-FOR-PROFIT
CORPORATION LAW, AND SUCH CORPORATION SHALL,  UPON  APPLICATION  TO  THE
COURT, BE SUBSTITUTED AS A PARTY.
  9.  ON  OR  BEFORE  DECEMBER  THIRTY-FIRST, TWO THOUSAND THIRTEEN, THE
CORPORATION SHALL REPAY ALL  OF  ITS  OUTSTANDING  TAX-EXEMPT  BONDS  OR
NOTES,  IF  ANY, INCLUDING ITS NOTES AND BONDS, IF ANY, AND TRANSFER ALL
OF ITS RIGHTS, PROPERTIES AND ASSETS, OF WHATEVER KIND, TO THE  CLIFTON-
FINE HEALTH CARE CORPORATION, A CORPORATION ORGANIZED AND EXISTING UNDER
THE NOT-FOR-PROFIT CORPORATION LAW.
  10.  NOTWITHSTANDING  ANY  OTHER  PROVISION  OF  APPLICABLE LAW TO THE
CONTRARY, THE TRANSFER PROVIDED FOR IN THIS  SECTION  SHALL  REQUIRE  NO
FURTHER  APPROVAL  OR  CONSENT  UNDER ANY PROVISION OF THE PUBLIC HEALTH
LAW, THE MENTAL HYGIENE LAW, THE SOCIAL SERVICES LAW OR ANY OTHER LAW OR
REGULATION OF THE STATE.
  S 8. Title 5  of  article  10-C  of  the  public  authorities  law  is
REPEALED.
  S 9. Intentionally omitted.
  S 10. Section 621 of the public health law, as amended by section 5 of
part A of chapter 58 of the laws of 2008, is amended to read as follows:
  S 621. State aid; public health emergencies. If the state commissioner
or  a  county  health  department or part-county department of health or
municipality, with the approval of the  state  commissioner,  determines
that  there is an imminent threat to public health, the department shall
reimburse counties or municipalities at fifty per centum for the cost of
emergency measures as approved by the  department  and  subject  to  the
approval  of the director of the budget, EXCEPT THAT AERIAL SPRAYING FOR
MOSQUITOES ON STATE LAND SHALL BE REIMBURSED AT ONE HUNDRED PER  CENTUM,
WITHIN  AMOUNTS  APPROPRIATED.   Such funds shall be made available from
funds appropriated for public health emergencies, only to those counties
or municipalities, which have expended all other state aid which may  be
available   for  related  activities  and  have  developed  measures  to
adequately address the  emergency.  Reimbursement  is  conditioned  upon
availability of appropriated funds. For purposes of this section, "muni-
cipality"  means  a health department of a city that is not located in a
county or part-county health district or a county in which the  legisla-
ture has the powers and duties of a board of health of a county or part-
county  health district and cities with a population of over one million
persons.
  S 11. Subsection (a) of section 213 of the insurance law, as added  by
section  1  of  part  L of chapter 57 of the laws of 2007, is amended to
read as follows:
  (a) There is hereby established within the department a commission, to
be known as the "New York state health care quality and cost containment
commission". The commission shall consist of thirteen members  appointed
by  the  governor,  one of whom shall be the superintendent, one of whom
shall be the commissioner of health, and six of whom shall be  appointed

S. 6256--C                         86

on the recommendation of the legislative leaders, two on the recommenda-
tion of the temporary president of the senate, two on the recommendation
of the speaker of the assembly, one on the recommendation of the minori-
ty  leader  of the senate, and one on the recommendation of the minority
leader of the assembly. IN THE EVENT THAT LEGISLATIVE APPOINTMENT RECOM-
MENDATIONS ARE NOT MADE WITHIN THIRTY DAYS OF THE EFFECTIVE DATE OF  THE
CHAPTER  OF  THE  LAWS OF TWO THOUSAND TWELVE THAT AMENDED THIS SECTION,
SUCH APPOINTMENT OR APPOINTMENTS SHALL REVERT TO THE GOVERNOR WHO  SHALL
MAKE  SUCH  APPOINTMENT  OR APPOINTMENTS WITHIN THIRTY DAYS. All members
shall serve at the pleasure of the  governor,  and  vacancies  shall  be
appointed  in  the  same manner as original appointments. Members of the
commission shall serve without compensation, but shall be reimbursed for
reasonable travel expenses. In making appointments  to  the  commission,
the  governor  shall ensure that the interests of health care consumers,
small businesses, the medical community and health plans are represented
on the commission.
  S 12.  The public health law is amended by adding a new section 3309-a
to read as follows:
  S 3309-A. PRESCRIPTION PAIN MEDICATION AWARENESS PROGRAM.  1. THERE IS
HEREBY ESTABLISHED WITHIN THE DEPARTMENT A PRESCRIPTION PAIN  MEDICATION
AWARENESS  PROGRAM  TO  EDUCATE THE PUBLIC AND HEALTH CARE PRACTITIONERS
ABOUT THE  RISKS  ASSOCIATED  WITH  PRESCRIBING  AND  TAKING  CONTROLLED
SUBSTANCE PAIN MEDICATIONS.
  2.  WITHIN THE AMOUNTS APPROPRIATED, THE COMMISSIONER, IN CONSULTATION
WITH THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM  AND  SUBSTANCE  ABUSE
SERVICES, SHALL:
  (A)  DEVELOP  AND  CONDUCT  A  PUBLIC  HEALTH EDUCATION MEDIA CAMPAIGN
DESIGNED TO ALERT YOUTH, PARENTS AND THE GENERAL  POPULATION  ABOUT  THE
RISKS  ASSOCIATED  WITH  PRESCRIPTION  PAIN  MEDICATIONS AND THE NEED TO
PROPERLY DISPOSE OF ANY UNUSED MEDICATION. IN DEVELOPING THIS  CAMPAIGN,
THE  COMMISSIONER SHALL CONSULT WITH AND USE INFORMATION PROVIDED BY THE
WORK GROUP ESTABLISHED PURSUANT TO SUBDIVISION (B) OF THIS  SECTION  AND
OTHER RELEVANT PROFESSIONAL ORGANIZATIONS. THE CAMPAIGN SHALL INCLUDE AN
INTERNET  WEBSITE PROVIDING INFORMATION FOR PARENTS, CHILDREN AND HEALTH
CARE PROFESSIONALS ON THE  RISKS  ASSOCIATED  WITH  TAKING  OPIOIDS  AND
RESOURCES  AVAILABLE  TO THOSE NEEDING ASSISTANCE WITH PRESCRIPTION PAIN
MEDICATION  ADDICTION.  SUCH  WEBSITE  SHALL  ALSO  PROVIDE  INFORMATION
REGARDING   WHERE   INDIVIDUALS   MAY  PROPERLY  DISPOSE  OF  CONTROLLED
SUBSTANCES IN THEIR COMMUNITY AND INCLUDE ACTIVE LINKS TO FURTHER INFOR-
MATION AND RESOURCES. THE CAMPAIGN SHALL BEGIN NO LATER  THAN  SEPTEMBER
FIRST, TWO THOUSAND TWELVE.
  (B)  ESTABLISH  A  WORK  GROUP, NO LATER THAN JUNE FIRST, TWO THOUSAND
TWELVE, WHICH SHALL BE COMPOSED OF EXPERTS IN THE FIELDS  OF  PALLIATIVE
AND  CHRONIC CARE PAIN MANAGEMENT AND ADDICTION MEDICINE. MEMBERS OF THE
WORK GROUP SHALL RECEIVE NO COMPENSATION FOR THEIR SERVICES,  BUT  SHALL
BE  ALLOWED  ACTUAL  AND  NECESSARY EXPENSES IN THE PERFORMANCE OF THEIR
DUTIES PURSUANT TO THIS SECTION. THE WORK GROUP SHALL:
  (I) REPORT TO THE COMMISSIONER REGARDING THE DEVELOPMENT OF  RECOMMEN-
DATIONS  AND  MODEL  COURSES FOR CONTINUING MEDICAL EDUCATION, REFRESHER
COURSES AND OTHER TRAINING MATERIALS FOR LICENSED  HEALTH  CARE  PROFES-
SIONALS  ON APPROPRIATE USE OF PRESCRIPTION PAIN MEDICATION. SUCH RECOM-
MENDATIONS, MODEL COURSES AND OTHER TRAINING MATERIALS SHALL BE  SUBMIT-
TED  TO  THE COMMISSIONER, WHO SHALL MAKE SUCH INFORMATION AVAILABLE FOR
THE USE IN MEDICAL EDUCATION, RESIDENCY PROGRAMS,  FELLOWSHIP  PROGRAMS,
AND  FOR  USE  IN CONTINUING MEDICATION EDUCATION PROGRAMS NO LATER THAN
JANUARY FIRST, TWO THOUSAND THIRTEEN;

S. 6256--C                         87

  (II) NO LATER THAN  JANUARY  FIRST,  TWO  THOUSAND  THIRTEEN,  PROVIDE
OUTREACH  AND  ASSISTANCE  TO  HEALTH CARE PROFESSIONAL ORGANIZATIONS TO
ENCOURAGE AND FACILITATE CONTINUING MEDICAL EDUCATION TRAINING  PROGRAMS
FOR  THEIR  MEMBERS  REGARDING APPROPRIATE PRESCRIBING PRACTICES AND THE
RISKS ASSOCIATED WITH PRESCRIPTION PAIN MEDICATION.
  (III)  PROVIDE INFORMATION TO THE COMMISSIONER FOR USE IN THE DEVELOP-
MENT AND CONTINUED UPDATE OF THE PUBLIC  AWARENESS  CAMPAIGN,  INCLUDING
INFORMATION,  RESOURCES, AND ACTIVE WEB LINKS THAT SHOULD BE INCLUDED ON
THE WEBSITE.
  3. THE COMMISSIONER SHALL REPORT TO THE GOVERNOR, THE TEMPORARY PRESI-
DENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY NO LATER  THAN  MARCH
FIRST,  TWO  THOUSAND  THIRTEEN,  AND  ANNUALLY  THEREAFTER, ON THE WORK
GROUP'S FINDINGS. THE REPORT SHALL INCLUDE INFORMATION ON  OPIOID  OVER-
DOSE  DEATHS,  EMERGENCY  ROOM  UTILIZATION  FOR THE TREATMENT OF OPIOID
OVERDOSE, THE UTILIZATION OF PRE-HOSPITAL ADDICTION SERVICES AND  RECOM-
MENDATIONS TO REDUCE OPIOID ADDICTION AND THE CONSEQUENCES THEREOF.
  S  13.  Paragraphs (d) and (e) of subdivision 5-a of section 2807-m of
the public health law, as amended by section 26 of part C of chapter  59
of the laws of 2011, are amended to read as follows:
  (d)  Physician  loan repayment program. One million nine hundred sixty
thousand dollars for  the  period  January  first,  two  thousand  eight
through  December  thirty-first,  two  thousand  eight, one million nine
hundred sixty thousand dollars for the period January first,  two  thou-
sand  nine through December thirty-first, two thousand nine, one million
nine hundred sixty thousand dollars for the period  January  first,  two
thousand  ten  through  December  thirty-first,  two  thousand ten, four
hundred ninety thousand dollars for the period January first, two  thou-
sand  eleven  through  March  thirty-first, two thousand eleven, and one
million seven hundred thousand dollars each state fiscal  year  for  the
period  April first, two thousand eleven through March thirty-first, two
thousand fourteen, shall be set aside and reserved by  the  commissioner
from  the regional pools established pursuant to subdivision two of this
section and shall be available for purposes of physician loan  repayment
in accordance with subdivision ten of this section. [Such] NOTWITHSTAND-
ING  ANY CONTRARY PROVISION OF THIS SECTION, SECTIONS ONE HUNDRED TWELVE
AND ONE HUNDRED SIXTY-THREE OF THE  STATE  FINANCE  LAW,  OR  ANY  OTHER
CONTRARY  PROVISION  OF  LAW, SUCH funding shall be allocated regionally
with one-third of available funds going to New York city and  two-thirds
of  available funds going to the rest of the state and shall be distrib-
uted in a manner to be determined by the commissioner WITHOUT A  COMPET-
ITIVE BID OR REQUEST FOR PROPOSAL PROCESS as follows:
  (i) Funding shall first be awarded to repay loans of up to twenty-five
physicians  who  train  in  primary care or specialty tracks in teaching
general hospitals, and who enter and remain in primary care or specialty
practices in underserved communities, as determined by the commissioner.
  (ii) After distributions in accordance with subparagraph (i)  of  this
paragraph, all remaining funds shall be awarded to repay loans of physi-
cians  who  enter  and  remain in primary care or specialty practices in
underserved communities, as determined by  the  commissioner,  including
but  not  limited  to  physicians working in general hospitals, or other
health care facilities.
  (iii) In no case shall less than fifty percent of the funds  available
pursuant  to  this  paragraph be distributed in accordance with subpara-
graphs (i) and (ii) of this paragraph to physicians identified by gener-
al hospitals.

S. 6256--C                         88

  (e) Physician practice support. Four  million  nine  hundred  thousand
dollars  for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight, four million nine hundred thousand
dollars annually for the period January first, two thousand nine through
December  thirty-first,  two thousand ten, one million two hundred twen-
ty-five thousand dollars for the  period  January  first,  two  thousand
eleven through March thirty-first, two thousand eleven, and four million
three  hundred  thousand  dollars  each state fiscal year for the period
April first, two thousand eleven through March thirty-first,  two  thou-
sand  fourteen, shall be set aside and reserved by the commissioner from
the regional pools established  pursuant  to  subdivision  two  of  this
section  and  shall  be  available  for  purposes  of physician practice
support. [Such] NOTWITHSTANDING ANY CONTRARY PROVISION OF THIS  SECTION,
SECTIONS  ONE  HUNDRED  TWELVE  AND ONE HUNDRED SIXTY-THREE OF THE STATE
FINANCE LAW, OR ANY OTHER CONTRARY PROVISION OF LAW, SUCH funding  shall
be  allocated  regionally with one-third of available funds going to New
York city and two-thirds of available funds going to  the  rest  of  the
state  and  shall  be  distributed  in  a manner to be determined by the
commissioner WITHOUT A COMPETITIVE BID OR REQUEST FOR  PROPOSAL  PROCESS
as follows:
  (i)  Preference in funding shall first be accorded to teaching general
hospitals for up to twenty-five awards, to  support  costs  incurred  by
physicians  trained in primary or specialty tracks who thereafter estab-
lish or join practices in underserved communities, as determined by  the
commissioner.
  (ii)  After  distributions in accordance with subparagraph (i) of this
paragraph, all remaining funds shall be awarded to physicians to support
the cost of establishing or joining practices  in  underserved  communi-
ties,  as  determined  by  the  commissioner, and to hospitals and other
health care providers to recruit new physicians to provide  services  in
underserved communities, as determined by the commissioner.
  (iii)  In no case shall less than fifty percent of the funds available
pursuant to this  paragraph  be  distributed  to  general  hospitals  in
accordance with subparagraphs (i) and (ii) of this paragraph.
  S  14.  Subdivision  5-a of section 2807-m of the public health law is
amended by adding a new paragraph (e-1) to read as follows:
  (E-1) WORK GROUP.  FOR FUNDING AVAILABLE PURSUANT  TO  PARAGRAPHS  (D)
AND (E) OF THIS SUBDIVISION:
  (I)  THE  DEPARTMENT  SHALL  APPOINT A WORK GROUP FROM RECOMMENDATIONS
MADE BY ASSOCIATIONS  REPRESENTING  PHYSICIANS,  GENERAL  HOSPITALS  AND
OTHER  HEALTH CARE FACILITIES TO DEVELOP A STREAMLINED APPLICATION PROC-
ESS BY JUNE FIRST, TWO THOUSAND TWELVE.
  (II) SUBJECT TO AVAILABLE FUNDING, APPLICATIONS SHALL BE ACCEPTED ON A
CONTINUOUS BASIS. THE DEPARTMENT SHALL PROVIDE TECHNICAL  ASSISTANCE  TO
APPLICANTS  TO FACILITATE THEIR COMPLETION OF APPLICATIONS. AN APPLICANT
SHALL BE NOTIFIED IN WRITING  BY  THE  DEPARTMENT  WITHIN  TEN  DAYS  OF
RECEIPT  OF AN APPLICATION AS TO WHETHER THE APPLICATION IS COMPLETE AND
IF THE APPLICATION IS INCOMPLETE, WHAT INFORMATION IS  OUTSTANDING.  THE
DEPARTMENT  SHALL ACT ON AN APPLICATION WITHIN THIRTY DAYS OF RECEIPT OF
A COMPLETE APPLICATION.
  S 15. Intentionally omitted.
  S 16. Section 18 of part B of chapter 58 of the laws of 2010, amending
chapter 474 of the laws of 1996, amending the education  law  and  other
laws  relating  to rates for residential healthcare facilities and other
laws relating to Medicaid payments, as amended by section 67 of  part  H
of chapter 59 of the laws of 2011, is amended to read as follows:

S. 6256--C                         89

  S  18.  Notwithstanding  any contrary provision of law, surcharges and
assessments due and owing pursuant to sections 2807-j, 2807-s and 2807-t
of the public health law AND SUBDIVISION 18 OF  SECTION  2807-C  OF  THE
PUBLIC  HEALTH LAW for any period prior to January 1, [2011] 2012, which
are  paid and accompanied by all required reports and which are received
on or before December 31, [2011] 2012 shall not be subject  to  interest
or  penalties as otherwise provided in such sections, provided, however,
that such reports may be based on estimates  by  payors  and  designated
providers  of  services of the amounts owed, subject to subsequent audit
by the commissioner  of  health  or  the  commissioner's  designee,  and
provided  further,  however,  with regard to all principal, interest and
penalty amounts collected by the commissioner of  health  prior  to  the
effective  date  of this act, the penalty provisions of sections 2807-j,
2807-s and 2807-t of the public health law AND SUBDIVISION 18 OF SECTION
2807-C OF THE PUBLIC HEALTH LAW shall remain in full  force  and  effect
and  such  amounts  collected shall not be subject to further adjustment
pursuant to this section, and provided further, however,  that  payments
of  principal amounts of surcharges and assessments which were paid late
and received prior to the effective  date  of  this  provision,  and  in
regard  to  which  interest and penalty amounts have not been collected,
shall not be subject to  such  interest  and  penalties,  and  provided,
further, however, that the provisions of this section shall not apply to
delinquent  amounts  which  have  been  referred  by the commissioner of
health for  recoupment  or  collection  proceeding.    Furthermore,  the
provisions  of  this section shall not apply to any surcharge or assess-
ment payments made in response to a final audit finding  issued  by  the
commissioner of health or the commissioner's designee.
  S  17. The public health law is amended by adding a new section 2807-z
to read as follows:
  S 2807-Z.  LIMITED OR ADMINISTRATIVE REVIEW.  1.  NOTWITHSTANDING  ANY
PROVISION OF THIS CHAPTER OR REGULATIONS OR ANY OTHER STATE LAW OR REGU-
LATION,  FOR  ANY ELIGIBLE CAPITAL PROJECT AS DEFINED IN SUBDIVISION SIX
OF THIS SECTION, THE DEPARTMENT SHALL HAVE THIRTY DAYS OF RECEIPT OF THE
CERTIFICATE OF NEED APPLICATION FOR A LIMITED OR  ADMINISTRATIVE  REVIEW
TO  DEEM  SUCH  APPLICATION  COMPLETE.  IF THE DEPARTMENT DETERMINES THE
APPLICATION IS INCOMPLETE OR THAT  MORE  INFORMATION  IS  REQUIRED,  THE
DEPARTMENT  SHALL  NOTIFY THE APPLICANT IN WRITING WITHIN THIRTY DAYS OF
THE DATE OF THE APPLICATION'S SUBMISSION, AND THE APPLICANT  SHALL  HAVE
TWENTY  BUSINESS  DAYS  TO  PROVIDE  ADDITIONAL INFORMATION OR OTHERWISE
CORRECT THE DEFICIENCY IN THE APPLICATION.
  2. FOR AN ELIGIBLE CAPITAL PROJECT REQUIRING A LIMITED OR  ADMINISTRA-
TIVE  REVIEW,  WITHIN NINETY DAYS OF THE DEPARTMENT DEEMING THE APPLICA-
TION COMPLETE, THE DEPARTMENT SHALL MAKE A DECISION TO APPROVE  (AND  IN
THE  CASE  OF  LIMITED  REVIEWS)  OR  DISAPPROVE THE CERTIFICATE OF NEED
APPLICATION FOR SUCH PROJECT. IF THE DEPARTMENT DETERMINES TO DISAPPROVE
THE PROJECT, THE BASIS FOR SUCH DISAPPROVAL SHALL BE PROVIDED  IN  WRIT-
ING;  HOWEVER,  DISAPPROVAL  SHALL NOT BE BASED ON THE INCOMPLETENESS OF
THE APPLICATION. IF THE DEPARTMENT FAILS TO TAKE ACTION  TO  APPROVE  OR
DISAPPROVE THE APPLICATION WITHIN NINETY DAYS OF THE CERTIFICATE OF NEED
APPLICATION  BEING  DEEMED  COMPLETE,  THE  APPLICATION  WILL  BE DEEMED
APPROVED.
  3. FOR AN ELIGIBLE CAPITAL PROJECT REQUIRING FULL REVIEW BY THE PUBLIC
HEALTH AND HEALTH PLANNING COUNCIL, THE CERTIFICATE OF NEED  APPLICATION
SHALL  BE PLACED ON THE NEXT PHHPC AGENDA FOLLOWING THE DEPARTMENT DEEM-
ING THE APPLICATION COMPLETE.

S. 6256--C                         90

  4. WHERE THE COMMISSIONER OR  DEPARTMENT  REQUIRES  THE  APPLICANT  TO
SUBMIT  A  CONTINGENCY  SUBMISSION  FOR AN ELIGIBLE CAPITAL PROJECT, THE
COMMISSIONER OR DEPARTMENT SHALL HAVE THIRTY DAYS TO REVIEW AND  APPROVE
OR DISAPPROVE THE CONTINGENCY SUBMISSION. IF THE COMMISSIONER OR DEPART-
MENT  DETERMINES THAT THE CONTINGENCY SUBMISSION IS INCOMPLETE, IT SHALL
SO NOTIFY THE APPLICANT IN WRITING AND PROVIDE THE  APPLICANT  WITH  TEN
BUSINESS  DAYS  TO CORRECT THE DEFICIENCY OR PROVIDE ADDITIONAL INFORMA-
TION. IF THE COMMISSIONER OR DEPARTMENT  DETERMINES  TO  DISAPPROVE  THE
CONTINGENCY  OF  THE SUBMISSION, THE BASIS FOR SUCH DISAPPROVAL SHALL BE
PROVIDED IN WRITING; HOWEVER, DISAPPROVAL SHALL  NOT  BE  BASED  ON  THE
INCOMPLETENESS  OF  THE  APPLICATION.  WITHIN  FIFTEEN  DAYS OF COMPLETE
CONTINGENCY SATISFACTION, THE COMMISSIONER OR DEPARTMENT SHALL  TRANSMIT
THE FINAL APPROVAL LETTER TO THE APPLICANT.
  5. THE DEPARTMENT SHALL DEVELOP EXPEDITED PRE-OPENING SURVEY PROCESSES
FOR  ELIGIBLE  CAPITAL  PROJECTS  APPROVED UNDER SUBDIVISION ONE OF THIS
SECTION, BUT UNDER NO CIRCUMSTANCES SHALL PRE-OPENING SURVEY REVIEWS  BE
SCHEDULED LATER THAN THIRTY DAYS AFTER FINAL APPROVAL.
  6. "ELIGIBLE CAPITAL PROJECT" SHALL MEAN:
  (A)  A  PROJECT  WHOSE  TOTAL  BUDGET IS THREE MILLION DOLLARS OR MORE
FUNDED WITH FEDERAL MONIES PURSUANT TO SECTION 330 OF THE PUBLIC  HEALTH
SERVICE (PHS), 42 USC 254B, AS AMENDED; OR
  (B)  A  PROJECT  WHOSE  TOTAL  BUDGET IS THREE MILLION DOLLARS OR MORE
FUNDED WITH FEDERAL MONIES PURSUANT TO THE FEDERAL CAPITAL  DEVELOPMENT-
BUILDING  CAPACITY (CD-BC) GRANT PROGRAM AND IMMEDIATE FACILITY IMPROVE-
MENTS (CD-IFI) GRANT PROGRAM, AS AUTHORIZED BY  THE  PATIENT  PROTECTION
AND  AFFORDABLE  CARE  ACT (AFFORDABLE CARE ACT)((P.L. 111-148), SECTION
10503(C)).
  CAPITAL PROTECTS FUNDED IN WHOLE OR IN PART THROUGH SECTION 330 OF THE
PUBLIC HEALTH SERVICE (PHS), 42 USC 254B, AS  AMENDED,  OR  WHOSE  TOTAL
BUDGET  IS  LESS  THAN THREE MILLION DOLLARS SHALL NOT BE SUBJECT TO THE
PROVISIONS OF THIS SECTION OR THE FEDERAL  CAPITAL  DEVELOPMENT-BUILDING
CAPACITY  (CD-BC)  GRANT  PROGRAM  AND  IMMEDIATE  FACILITY IMPROVEMENTS
(CD-IFI) GRANT PROGRAM, AS AUTHORIZED  BY  THE  PATIENT  PROTECTION  AND
AFFORDABLE  CARE  ACT  (AFFORDABLE  CARE  ACT)((P.L.   111-148), SECTION
10503(C)), SHALL NOT BE SUBJECT TO THE REQUIREMENTS SET  FORTH  IN  THIS
SECTION  OR  ANY  OTHER  LAW OR REGULATION REGARDING CERTIFICATE OF NEED
PROCESS OR REQUIREMENTS.
  S 18. Paragraph (e) of subdivision 8 of section  2511  of  the  public
health law is REPEALED.
  S  19.  Pursuant  to  a chapter of the laws of 2012, the department of
health, in consultation with the  office  of  alcoholism  and  substance
abuse  services, shall establish a diversion pilot program for detoxifi-
cation of opioid prescription pain medication on an outpatient  or  non-
medical  residential short term stay basis; one short term stay residen-
tial demonstration shall be established in each of  the  following  four
regions:    Western  New York; Central New York; Staten Island; and Long
Island.
  S 20. Section 2803 of the public health law is amended by adding a new
subdivision 8-a to read as follows:
  8-A. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW TO THE  CONTRA-
RY,  THE COMMISSIONER SHALL DEVELOP A PROGRAM TO FACILITATE THE USE OF A
TRIAGE SYSTEM OF CARE IN EMERGENCY ROOMS OF HOSPITALS THAT  ARE  SUBJECT
TO  THE  PROVISIONS  OF  THIS  ARTICLE.  IN  DEVELOPING SUCH PROGRAM THE
COMMISSIONER SHALL CONSIDER THE MANNER IN WHICH SUCH A SYSTEM  WOULD  BE
COORDINATED, HOW SUCH A SYSTEM WOULD PROVIDE GREATER EFFICIENCY, PROVIDE
COST  SAVINGS  TO  PUBLIC  HEALTH PROGRAMS AND A HIGHER QUALITY OF CARE.

S. 6256--C                         91

WITHIN ONE YEAR FROM THE ENACTMENT OF  SUCH  PROGRAM,  THE  COMMISSIONER
SHALL  SUBMIT  A REPORT TO THE TEMPORARY PRESIDENT OF THE SENATE AND THE
SPEAKER OF THE ASSEMBLY REGARDING: THE IMPACT OF SUCH A  SYSTEM  ON  THE
COST  OF  MEDICAID  COVERED SERVICES IN THE HOSPITAL SETTING; QUALITY OF
CARE IN FACILITIES; ALONG WITH ANY OTHER DATA AS MAY BE APPROPRIATE.
  S 21. Subdivision 1 of section 2807-k of  the  public  health  law  is
amended by adding a new paragraph (i) to read as follows:
  (I)  "QUALIFIED INDEPENDENT CLINIC" SHALL MEAN AN INDEPENDENT NON-PRO-
FIT CANCER CENTER, WHICH IS NOT AFFILIATED WITH AN EXISTING HOSPITAL  OR
HEALTH CARE FACILITY.
  S  22.  Section 2807-k of the public health law is amended by adding a
new subdivision 2-a to read as follows:
  2-A. NOTWITHSTANDING ANY OF THE PROVISIONS OF THIS SECTION,  A  QUALI-
FIED INDEPENDENT CLINIC SHALL BENEFIT FROM THE GENERAL HOSPITAL INDIGENT
CARE POOL IN THE SAME MANNER AS A QUALIFIED HOSPITAL-CONTROLLED DIAGNOS-
TIC AND TREATMENT CENTER.
  S  22-a.  Subdivision 35 of section 2807-c of the public health law is
amended by adding a new paragraph (j) to read as follows:
  (J) NOTWITHSTANDING SUBPARAGRAPH (IV) OF PARAGRAPH (B) OF THIS  SUBDI-
VISION  OR  ANY OTHER PROVISION OF LAW OR REGULATION TO THE CONTRARY, ON
AND AFTER APRIL FIRST, TWO THOUSAND TWELVE, A GENERAL HOSPITAL  THAT  AS
OF  JANUARY  FIRST,  TWO  THOUSAND  TEN HAD FORTY INPATIENT BEDS AND WAS
LOCATED IN A COUNTY WITH  A  POPULATION  BETWEEN  SEVENTY  THOUSAND  AND
SEVENTY-FIVE  THOUSAND  SHALL  HAVE  ITS  HIP JOINT REPLACEMENT AND KNEE
JOINT REPLACEMENT CASES CLASSIFIED AND WEIGHTED BASED ON THE  DIAGNOSIS-
RELATED GROUPS AND WEIGHTS IN EFFECT ON DECEMBER THIRTY-FIRST, TWO THOU-
SAND SEVEN PURSUANT TO SUBDIVISION THREE OF THIS SECTION.
  S  23. Section 1325 of the insurance law is REPEALED and a new section
1325 is added to read as follows:
  S 1325. EXEMPTION. (A) FOR THE PURPOSES OF EXEMPTING CERTAIN INSURANCE
COMPANIES FROM THE PROVISIONS OF  SECTION  ONE  THOUSAND  THREE  HUNDRED
TWENTY-FOUR  OF  THIS  ARTICLE,  THE  SUPERINTENDENT  SHALL EXEMPT UNTIL
DECEMBER THIRTY-FIRST, TWO THOUSAND FIFTEEN, THOSE STOCK  AND  NON-STOCK
INSURANCE  COMPANIES  TO  WHICH  SUBPARAGRAPH  (B)  OF  PARAGRAPH TWO OF
SUBSECTION (B) OF SUCH SECTION APPLIES.
  (B) THE SUPERINTENDENT SHALL NOT LATER THAN JUNE THIRTIETH, TWO  THOU-
SAND  FIFTEEN AND AFTER CONSULTATION WITH THE COMMISSIONER OF HEALTH AND
DOMESTIC MEDICAL MALPRACTICE INSURERS WRITING MEDICAL MALPRACTICE INSUR-
ANCE IN THIS STATE, PROMULGATE, FOR APPLICATION DURING THE NEXT SUCCEED-
ING CALENDAR YEAR, A REGULATION  WHICH  PROVIDES  A  SEPARATE  FINANCIAL
SECURITY  STANDARD  FOR THOSE STOCK AND NON-STOCK INSURANCE COMPANIES TO
WHICH SUBPARAGRAPH (B) OF PARAGRAPH TWO OF SUBSECTION (B) OF SECTION ONE
THOUSAND THREE HUNDRED TWENTY-FOUR OF THIS ARTICLE APPLY.  SUCH STANDARD
SHALL BE SUFFICIENTLY DISTINCT FROM THAT PROVIDED FOR IN THIS CHAPTER OR
RELATED REGULATION OR UTILIZED BY THE SUPERINTENDENT IN THE  EXAMINATION
OF  PROPERTY  AND  CASUALTY CARRIERS SO AS TO REFLECT THE UNIQUE MARKET,
FINANCIAL AND LEGAL OBLIGATIONS IMPOSED UPON MEDICAL MALPRACTICE  INSUR-
ANCE CARRIERS BY THIS CHAPTER. FURTHER, THE REGULATION SHALL INCLUDE NEW
STATUTORY  FINANCIAL STATEMENT BLANKS AND EXAMINATION PROTOCOLS CONSIST-
ENT WITH THE NEW STANDARD.
  S 24. The insurance law is amended by adding a  new  section  1326  to
read as follows:
  S  1326.  STATUTORY  ASSOCIATION  MEMBERSHIP.  (A) FOR THOSE STOCK AND
NON-STOCK COMPANIES TO  WHICH  SUBPARAGRAPH  (B)  OF  PARAGRAPH  TWO  OF
SUBSECTION (B) OF SECTION ONE THOUSAND THREE HUNDRED TWENTY-FOUR OF THIS
ARTICLE APPLIES, NO LIABILITIES ARISING FROM THE OBLIGATIONS OF AN ASSO-

S. 6256--C                         92

CIATION  AUTHORIZED  PURSUANT  TO  SUBPARAGRAPH  (D) OF PARAGRAPH TWO OF
SUBSECTION (C) OF SECTION FIVE THOUSAND FIVE HUNDRED TWO OF THIS CHAPTER
SHALL BE DUE AND OWING FROM SUCH COMPANIES UNLESS AND UNTIL  SUCH  OBLI-
GATIONS  CAN  ONLY BE SATISFIED, AFTER CONSIDERATION OF ALL RESOURCES OF
THE ASSOCIATION, INCLUDING BUT NOT LIMITED TO CURRENT PREMIUM INCOME, BY
A CONTRIBUTION FROM SUCH COMPANIES, AND THE COMPANIES  ARE  NOTIFIED  OF
SAME  BY  SUCH  ASSOCIATION  NOT LESS THAN THREE HUNDRED SIXTY-FIVE DAYS
PRIOR TO THE DATE UPON WHICH SUCH OBLIGATION SHALL BE DUE AND OWING, AND
SHALL ONLY RELATE TO OBLIGATIONS OF THE ASSOCIATION  THAT  ARE  ACTUALLY
DUE  AND  OWING BY THE ASSOCIATION IN THAT YEAR IN WHICH CONTRIBUTION IS
TO BE MADE BY THE COMPANIES. SUCH LIABILITIES SHALL  NOT  BE  AGGREGATED
FOR  ANY  OTHER  YEAR  EXCEPT  THAT IN WHICH THE CONTRIBUTION IS DUE AND
OWING OR PREVIOUS YEARS FOR WHICH CONTRIBUTIONS HAVE NOT BEEN SATISFIED;
FURTHER, SUCH LIABILITIES  AND  THE  CONTRIBUTIONS  THEREFOR  SHALL  NOT
INCLUDE  ANY  CONTINGENT LIABILITIES OF THE ASSOCIATION FOR THE YEAR FOR
WHICH CONTRIBUTIONS ARE REQUESTED;  PROVIDED,  HOWEVER,  THAT  COMPANIES
SHALL  MAINTAIN  AT  ALL TIMES A RESERVE OF NOT LESS THAN TEN PERCENT OF
THEIR RESPECTIVE AND PROPORTIONATE LIABILITIES OF THE AGGREGATE  DEFICIT
OF  THE ASSOCIATION, AS SUCH RESPECTIVE AND PROPORTIONATE LIABILITIES OF
THE AGGREGATE DEFICIT ARE REPORTED BY THE  ASSOCIATION  CONSISTENT  WITH
THE PROVISIONS OF THIS SECTION. COMPANIES SHALL EACH YEAR INCREASE MINI-
MUM  RESERVES MAINTAINED FOR THESE PURPOSES, ASSUMING THEY ARE LESS THAN
ONE HUNDRED PERCENT OF THEIR RESPECTIVE AND PROPORTIONATE LIABILITY  FOR
THE  AGGREGATE DEFICIT OF THE ASSOCIATION, BY THE PERCENTAGE INCREASE IN
THE AGGREGATE DEFICIT, IF ANY, FROM THE PREVIOUS YEAR.
  (B) FURTHER, COMPANIES, UPON RECEIPT OF NOTICE OF SUCH RESPECTIVE  AND
PROPORTIONATE  OBLIGATION  FOR  THE  LIABILITY OF THE AGGREGATE DEFICIT,
SHALL HAVE THE RIGHT TO DEMAND AN  AUDIT  OF  THE  COMPUTATION  OF  SUCH
RESPECTIVE  AND  PROPORTIONATE  OBLIGATION AT THE EXPENSE OF THE ASSOCI-
ATION, AND SUCH AUDIT SHALL BE COMPLETED AND REPORTED TO THE  REQUESTING
COMPANY BEFORE ANY SUCH PAYMENTS ARE MADE BY THE REQUESTING COMPANY.
  (C)  IN CONJUNCTION WITH THE REGULATIONS TO BE PROMULGATED PURSUANT TO
THE PROVISIONS OF SECTION THIRTEEN HUNDRED TWENTY-FIVE OF THIS  ARTICLE,
THE SUPERINTENDENT SHALL UNDERTAKE A STUDY OF SUCH STATUTORY ASSOCIATION
AS  DEFINED  IN  SUBSECTION (A) OF THIS SECTION AND ASSESS THE AGGREGATE
DEFICITS THEREOF, IF ANY, AND DETERMINE THE AMOUNT AND DURATION OF  SUCH
AGGREGATE  DEFICITS  AND  INCORPORATE  SUCH METHODS FOR REMEDIATING SUCH
DEFICITS, INCLUDING BUT NOT LIMITED TO SURCHARGES ON POLICIES ISSUED  BY
OR ON BEHALF OF SUCH ASSOCIATIONS, INTO THE REGULATIONS TO BE PROMULGAT-
ED  ASSUMING SUCH IS OTHERWISE WITHIN THE PROVINCE OF THE SUPERINTENDENT
TO IMPLEMENT BY REGULATION.
  S 25. Subsection (c) of section 2343 of the insurance  law,  as  sepa-
rately  amended  by  section 19 of part C and section 106-a of part H of
chapter 59 of the laws of 2011, is amended to read as follows:
  (c) Notwithstanding any other provision of this chapter,  no  applica-
tion for an order of rehabilitation or liquidation of a domestic insurer
whose  primary liability arises from the business of medical malpractice
insurance, as that term is defined in subsection  (b)  of  section  five
thousand  five hundred one of this chapter, shall be made on the grounds
specified in subsection (a)  or  (c)  of  section  seven  thousand  four
hundred  two  of  this chapter at any time prior to [June thirtieth, two
thousand fourteen] DECEMBER THIRTY-FIRST, TWO THOUSAND FIFTEEN.
  S 26. Section 40 of chapter 266 of the  laws  of  1986,  amending  the
civil  practice law and rules and other laws relating to malpractice and
professional medical conduct, as amended by section  18  of  part  C  of
chapter 59 of the laws of 2011, is amended to read as follows:

S. 6256--C                         93

  S  40. The superintendent of insurance shall establish rates for poli-
cies providing coverage for physicians and surgeons medical  malpractice
for  the  periods  commencing  July  1,  1985  and ending June 30, 2014;
provided, however, that notwithstanding any other provision of law,  the
superintendent  shall not establish or approve any increase in rates for
the period commencing July 1, 2009 and ending June 30, 2010. The  super-
intendent  shall  direct  insurers  to establish segregated accounts for
premiums, payments, reserves and investment income attributable to  such
premium  periods  and  shall  require  periodic  reports by the insurers
regarding claims and expenses attributable to such  periods  to  monitor
whether  such  accounts  will  be sufficient to meet incurred claims and
expenses. On or after July 1, 1989, the superintendent  shall  impose  a
surcharge  on premiums to satisfy a projected deficiency that is attrib-
utable to the premium levels established pursuant to  this  section  for
such  periods;  provided,  however, that such annual surcharge shall not
exceed eight percent of the established rate  until  July  1,  2014,  at
which  time  and  thereafter such surcharge shall not exceed twenty-five
percent of the approved adequate rate, and that such  annual  surcharges
shall continue for such period of time as shall be sufficient to satisfy
such  deficiency.  The  superintendent  shall  not impose such surcharge
during the period commencing July 1, 2009 and ending June 30, 2010.   On
and  after  July 1, 1989, the surcharge prescribed by this section shall
be retained by insurers to the extent that they insured  physicians  and
surgeons  during  the July 1, 1985 through June 30, 2014 policy periods;
in the event and to the extent physicians and surgeons were  insured  by
another  insurer  during  such  periods,  all or a pro rata share of the
surcharge, as the case may be, shall be remitted to such  other  insurer
in accordance with rules and regulations to be promulgated by the super-
intendent.    Surcharges collected from physicians and surgeons who were
not insured during such policy periods shall be  apportioned  among  all
insurers  in  proportion  to  the premium written by each insurer during
such policy periods; if a physician or surgeon was insured by an insurer
subject to rates established by the superintendent  during  such  policy
periods,  and  at  any  time  thereafter  a hospital, health maintenance
organization, employer or institution is responsible for  responding  in
damages for liability arising out of such physician's or surgeon's prac-
tice of medicine, such responsible entity shall also remit to such prior
insurer  the  equivalent  amount  that  would  then  be  collected  as a
surcharge if the physician or surgeon had continued to remain insured by
such prior insurer. In the event  any  insurer  that  provided  coverage
during  such  policy  periods  is  in liquidation, the property/casualty
insurance security fund shall receive the portion of surcharges to which
the insurer in liquidation would  have  been  entitled.  The  surcharges
authorized  herein  shall be deemed to be income earned for the purposes
of section 2303 of the insurance law.  The superintendent, in establish-
ing adequate rates and in determining any projected deficiency  pursuant
to  the  requirements  of this section and the insurance law, shall give
substantial weight, determined in his discretion and  judgment,  to  the
prospective  anticipated  effect of any regulations promulgated and laws
enacted and the public benefit of   stabilizing  malpractice  rates  and
minimizing  rate  level  fluctuation during the period of time necessary
for the development of more reliable statistical experience  as  to  the
efficacy  of  such  laws  and  regulations  affecting medical, dental or
podiatric malpractice enacted or promulgated in 1985, 1986, by this  act
and  at  any other time.  Notwithstanding any provision of the insurance
law, rates  already  established  and  to  be  established  AND  SURPLUS

S. 6256--C                         94

REQUIRED  by the superintendent pursuant to this section [are] OR OTHER-
WISE BY THE INSURANCE LAW SHALL BE deemed adequate  if  such  rates  AND
SURPLUS  would  be adequate when taken together with the maximum author-
ized  annual  surcharges  to  be imposed for a reasonable period of time
whether or not any such annual surcharge has been actually imposed as of
the establishment of such rates OR SURPLUS REQUIREMENTS.
  S 27. Severability clause. If any clause, sentence, paragraph,  subdi-
vision,  section  or  part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair,  or  invalidate  the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph,  subdivision,  section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included therein.
  S 28. This act shall take effect April 1, 2012; provided that:
  (a) the amendments to section 369 of the social services law  made  by
section  one  of  this  act  shall  take effect immediately and shall be
deemed to have been in full force and effect on and after April 1, 2011,
such  that  any  rules  or  regulations  promulgated  pursuant  to   the
provisions  of  section  53  of part H of chapter 59 of the laws of 2011
shall be repealed therewith;
  (b) section seven of this act shall take effect December 31, 2013;
  (c) section eight of this act shall take effect on the  thirtieth  day
after this act shall have become a law;
  (d) the amendments to paragraph (h) of subdivision 3 of section 4403-f
of  the  public  health  law  made by section five of this act shall not
affect the repeal of such section and shall be  deemed  repealed  there-
with;
  (e)  section  eighteen of this act shall take effect April 1, 2013 and
shall not apply to any subsidy payments made to  approved  organizations
on or after such date;
  (f)  the  amendments  to  section  1325  of  the insurance law made by
section twenty-three of this act shall take effect immediately; and
  (g) absent explicit language expressly  and  unequivocally  stating  a
legislative intent to the contrary, all provisions of this act are irre-
futably  presumed  to operate in a wholly prospective manner. Provisions
shall be considered to operate retroactively, and therefore in violation
of this section, if applied in  such  a  manner  as  to  alter,  change,
affect,  impair  or  defeat any rights, obligations, duties or interests
accrued, incurred or conferred prior to the effective date of this  act.
Furthermore,  the  provisions of this act shall neither apply to, nor be
applied based upon the occasion of, acts occurring prior to its becoming
law.

                                 PART W

  Section 1. Notwithstanding any other provision of law to the contrary,
the department of motor vehicles is hereby authorized  to  transfer  the
alcohol  and drug rehabilitation program established pursuant to section
1196 of the vehicle and traffic law to  the  office  of  alcoholism  and
substance abuse services. Oversight and responsibility for the operation
of  such  program  shall  be  assumed  by the office and any regulations
necessary for the continued operation and oversight of the program shall
be promulgated by the commissioner  of  the  office  of  alcoholism  and

S. 6256--C                         95

substance  abuse services in consultation with the commissioner of motor
vehicles.
  S 2. Section 1196 of the vehicle and traffic law is REPEALED.
  S 3. Any rules or regulations promulgated by the commissioner of motor
vehicles  pursuant  to the provisions of section 1196 of the vehicle and
traffic law shall survive  such  repeal,  and  shall  be  applicable  to
section  19.26  of  the  mental hygiene law, as added by section four of
this act.
  S 4. The mental hygiene law is amended by adding a new  section  19.26
to read as follows:
S 19.26 ALCOHOL AND DRUG REHABILITATION PROGRAM.
  1.  PROGRAM  ESTABLISHMENT. THERE IS HEREBY ESTABLISHED AN ALCOHOL AND
DRUG  REHABILITATION  PROGRAM  WITHIN  THE  OFFICE  OF  ALCOHOLISM   AND
SUBSTANCE  ABUSE  SERVICES.  THE  COMMISSIONER SHALL ESTABLISH, BY REGU-
LATION, THE INSTRUCTIONAL AND REHABILITATIVE  ASPECTS  OF  THE  PROGRAM.
SUCH  PROGRAM  SHALL  CONSIST OF AT LEAST FIFTEEN HOURS AND INCLUDE, BUT
NEED NOT BE LIMITED TO, CLASSROOM INSTRUCTION IN AREAS DEEMED  APPROPRI-
ATE  BY  THE  COMMISSIONER.  NO  PERSON  SHALL  BE REQUIRED TO ATTEND OR
PARTICIPATE IN SUCH PROGRAM OR ANY ASPECT THEREOF FOR A PERIOD EXCEEDING
EIGHT MONTHS EXCEPT UPON THE RECOMMENDATION OF THE DEPARTMENT OF  MENTAL
HYGIENE  OR  APPROPRIATE  HEALTH  OFFICIALS ADMINISTERING THE PROGRAM ON
BEHALF OF A MUNICIPALITY.
  2. CURRICULUM. THE FORM, CONTENT AND METHOD  OF  PRESENTATION  OF  THE
VARIOUS  ASPECTS OF SUCH PROGRAM SHALL BE ESTABLISHED BY THE COMMISSION-
ER. IN THE DEVELOPMENT OF THE  FORM,  CURRICULUM  AND  CONTENT  OF  SUCH
PROGRAM,  THE  COMMISSIONER  MAY CONSULT WITH THE COMMISSIONER OF MENTAL
HEALTH AND ANY OTHER STATE AGENCY, DEPARTMENT OR OFFICE, AND MAY REQUEST
AND RECEIVE ASSISTANCE FROM THEM. THE COMMISSIONER IS ALSO AUTHORIZED TO
DEVELOP MORE THAN ONE CURRICULUM AND COURSE CONTENT FOR SUCH PROGRAM  IN
ORDER TO MEET THE VARYING REHABILITATIVE NEEDS OF PARTICIPANTS.
  3.  WHERE AVAILABLE. A COURSE IN SUCH PROGRAM SHALL BE AVAILABLE IN AT
LEAST EVERY COUNTY IN THE STATE, EXCEPT WHERE  THE  COMMISSIONER  DETER-
MINES  THAT  THERE IS NOT A SUFFICIENT NUMBER OR ALCOHOL OR DRUG-RELATED
TRAFFIC OFFENSES IN A  COUNTY  TO  MANDATE  THE  ESTABLISHMENT  OF  SAID
COURSE;  AND  PROVIDED THAT PROVISIONS BE MADE FOR THE RESIDENTS OF SAID
COUNTY TO ATTEND A COURSE IN ANOTHER COUNTY WHERE A COURSE EXISTS.
  4. ELIGIBILITY. PARTICIPATION IN THE PROGRAM SHALL BE LIMITED TO THOSE
PERSONS WHO HAVE BEEN: CONVICTED  OF  ALCOHOL  OR  DRUG-RELATED  TRAFFIC
OFFENSES;  ADJUDICATED  YOUTHFUL  OFFENDERS  FOR ALCOHOL OR DRUG-RELATED
TRAFFIC OFFENSES; OR FOUND TO HAVE BEEN OPERATING A MOTOR VEHICLE  AFTER
HAVING  CONSUMED ALCOHOL, IN VIOLATION OF SECTION ELEVEN HUNDRED NINETY-
TWO-A OF THE VEHICLE AND TRAFFIC LAW, CHOOSE TO  PARTICIPATE,  AND  MEET
THE  REQUIREMENTS  FOR PARTICIPATION ESTABLISHED BY THIS SECTION AND THE
REGULATIONS PROMULGATED THEREUNDER; PROVIDED, HOWEVER, THE JUDGE  IMPOS-
ING  SENTENCE MAY PROHIBIT THE DEFENDANT FROM ENROLLING IN SUCH PROGRAM.
THE COMMISSIONER MAY ALSO EXERCISE DISCRETION BY  REJECTING  ANY  PERSON
FROM PARTICIPATION REFERRED TO SUCH PROGRAM AND NOTHING HEREIN CONTAINED
SHALL  BE  CONSTRUED AS CREATING A RIGHT TO BE INCLUDED IN ANY COURSE OR
PROGRAM ESTABLISHED UNDER THIS SECTION. IN ADDITION, NO PERSON SHALL  BE
PERMITTED  TO  TAKE PART IN SUCH PROGRAM IF, DURING THE FIVE YEARS IMME-
DIATELY PRECEDING COMMISSION  OF  AN  ALCOHOL  OR  DRUG-RELATED  TRAFFIC
OFFENSE   OR  A  FINDING  OF  A  VIOLATION  OF  SECTION  ELEVEN  HUNDRED
NINETY-TWO-A OF THE VEHICLE AND TRAFFIC LAW,  SUCH  PERSON  HAS  PARTIC-
IPATED  IN  A  PROGRAM  ESTABLISHED  PURSUANT  TO  THIS  ARTICLE OR BEEN
CONVICTED OF A VIOLATION OF ANY SUBDIVISION OF  SECTION  ELEVEN  HUNDRED
NINETY-TWO OF THE VEHICLE AND TRAFFIC LAW OTHER THAN A VIOLATION COMMIT-

S. 6256--C                         96

TED  PRIOR  TO  NOVEMBER FIRST, NINETEEN HUNDRED EIGHTY-EIGHT, FOR WHICH
SUCH PERSON DID NOT PARTICIPATE IN SUCH  PROGRAM.  IN  THE  EXERCISE  OF
DISCRETION,  THE  COMMISSIONER SHALL HAVE THE RIGHT TO EXPEL ANY PARTIC-
IPANT FROM THE PROGRAM WHO FAILS TO SATISFY THE REQUIREMENTS FOR PARTIC-
IPATION IN SUCH PROGRAM OR WHO FAILS TO SATISFACTORILY PARTICIPATE IN OR
ATTEND   ANY  ASPECT  OF  SUCH  PROGRAM.  NOTWITHSTANDING  ANY  CONTRARY
PROVISIONS OF THIS CHAPTER, SATISFACTORY PARTICIPATION IN AND COMPLETION
OF A COURSE IN SUCH PROGRAM SHALL  RESULT  IN  THE  TERMINATION  OF  ANY
SENTENCE  OF  IMPRISONMENT  THAT  MAY  HAVE  BEEN IMPOSED BY REASON OF A
CONVICTION THEREFOR; PROVIDED, HOWEVER, THAT NOTHING CONTAINED  IN  THIS
SECTION SHALL DELAY THE COMMENCEMENT OF SUCH SENTENCE.
  5.  EFFECT  OF  COMPLETION. EXCEPT AS PROVIDED IN SUBPARAGRAPH NINE OF
PARAGRAPH (B) OF SUBDIVISION TWO OF SECTION ELEVEN HUNDRED  NINETY-THREE
OR  IN SUBPARAGRAPH THREE OF PARAGRAPH (D) OF SUBDIVISION TWO OF SECTION
ELEVEN HUNDRED NINETY-FOUR OF THE VEHICLE AND TRAFFIC LAW, UPON SUCCESS-
FUL COMPLETION OF A COURSE IN SUCH PROGRAM AS CERTIFIED BY ITS  ADMINIS-
TRATOR,  A  PARTICIPANT MAY APPLY TO THE COMMISSIONER OF MOTOR VEHICLES,
ON A FORM PROVIDED FOR THAT PURPOSE, FOR THE TERMINATION OF THE  SUSPEN-
SION  OR  REVOCATION  ORDER  ISSUED  AS  A  RESULT  OF THE PARTICIPANT'S
CONVICTION THAT CAUSED THE PARTICIPATION IN SUCH COURSE. IN THE EXERCISE
OF DISCRETION, UPON RECEIPT OF SUCH APPLICATION, AND UPON PAYMENT OF ANY
CIVIL PENALTIES FOR WHICH THE APPLICANT MAY BE LIABLE, THE  COMMISSIONER
OF  MOTOR  VEHICLES  IS AUTHORIZED TO TERMINATE SUCH ORDER OR ORDERS AND
RETURN THE PARTICIPANT'S LICENSE, OR REINSTATE THE PRIVILEGE OF  OPERAT-
ING  A  MOTOR  VEHICLE IN THIS STATE. HOWEVER, THE COMMISSIONER OF MOTOR
VEHICLES SHALL NOT ISSUE ANY NEW LICENSE NOR RESTORE ANY  LICENSE  WHERE
SAID  ISSUANCE  OF  RESTORAL IS PROHIBITED BY SUBDIVISION TWO OF SECTION
ELEVEN HUNDRED NINETY-THREE OF THE VEHICLE AND TRAFFIC LAW.
  6. FEES. THE COMMISSIONER SHALL ESTABLISH A SCHEDULE  OF  FEES  TO  BE
PAID  BY  OR ON BEHALF OF EACH PARTICIPANT IN THE PROGRAM, AND MAY, FROM
TIME TO TIME, MODIFY SAME. SUCH FEES SHALL DEFRAY THE  ONGOING  EXPENSES
OF  THE  PROGRAM.  PROVIDED, HOWEVER, THAT PURSUANT TO AN AGREEMENT WITH
THE DEPARTMENT A MUNICIPALITY, DEPARTMENT THEREOF, OR OTHER  AGENCY  MAY
CONDUCT A COURSE IN SUCH PROGRAM WITH ALL OR PART OF THE EXPENSE OF SUCH
COURSE AND PROGRAM BEING BORNE BY SUCH MUNICIPALITY, DEPARTMENT OR AGEN-
CY.  IN NO EVENT SHALL SUCH FEE BE REFUNDABLE, EITHER FOR REASONS OF THE
PARTICIPANT'S WITHDRAWAL OR EXPULSION FROM SUCH PROGRAM OR OTHERWISE.
  7. CONDITIONAL LICENSE. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION
OF THIS CHAPTER, PARTICIPANTS IN THE  PROGRAM,  EXCEPT  THOSE  PENALIZED
UNDER  PARAGRAPH  (D) OF SUBDIVISION ONE OF SECTION ELEVEN HUNDRED NINE-
TY-THREE OF THE VEHICLE AND TRAFFIC LAW FOR ANY VIOLATION OF SUBDIVISION
TWO, THREE, OR FOUR OF SECTION ELEVEN HUNDRED NINETY-TWO OF THE  VEHICLE
AND  TRAFFIC  LAW,  MAY,  AT THE DISCRETION OF THE COMMISSIONER OF MOTOR
VEHICLES, BE ISSUED A CONDITIONAL DRIVER'S LICENSE; OR IF THE HOLDER  OF
A  LICENSE  ISSUED  BY  ANOTHER JURISDICTION VALID FOR OPERATION IN THIS
STATE, A CONDITIONAL PRIVILEGE OF OPERATING  A  MOTOR  VEHICLE  IN  THIS
STATE.   SUCH A CONDITIONAL LICENSE OR PRIVILEGE SHALL BE VALID ONLY FOR
USE, BY THE HOLDER THEREOF: (1) ENROUTE TO AND FROM THE  HOLDER'S  PLACE
OF  EMPLOYMENT; (2) IF THE HOLDER'S EMPLOYMENT REQUIRES THE OPERATION OF
A MOTOR VEHICLE THEN DURING THE HOURS THEREOF; (3) ENROUTE TO AND FROM A
CLASS OR AN ACTIVITY THAT IS AN AUTHORIZED PART OF THE ALCOHOL AND  DRUG
REHABILITATION  PROGRAM  AND AT WHICH HIS OR HER ATTENDANCE IS REQUIRED;
(4) ENROUTE TO AND FROM A CLASS  OR  COURSE  AT  AN  ACCREDITED  SCHOOL,
COLLEGE  OR  UNIVERSITY OR AT A STATE APPROVED INSTITUTION OF VOCATIONAL
OR TECHNICAL TRAINING; (5) TO OR FROM  COURT  ORDERED  PROBATION  ACTIV-
ITIES;  (6)  TO  AND  FROM A MOTOR VEHICLE OFFICE FOR THE TRANSACTION OF

S. 6256--C                         97

BUSINESS RELATING TO SUCH LICENSE OR  PROGRAM;  (7)  FOR  A  THREE  HOUR
CONSECUTIVE DAYTIME PERIOD, CHOSEN BY THE ADMINISTRATORS OF THE PROGRAM,
ON A DAY DURING WHICH THE PARTICIPANT IS NOT ENGAGED IN USUAL EMPLOYMENT
OR  VOCATION; (8) ENROUTE TO AND FROM A MEDICAL EXAMINATION OR TREATMENT
AS PART OF A NECESSARY MEDICAL TREATMENT FOR SUCH PARTICIPANT OR  MEMBER
OF  THE  PARTICIPANT'S HOUSEHOLD, AS EVIDENCED BY A WRITTEN STATEMENT TO
THAT EFFECT FROM A LICENSED MEDICAL PRACTITIONER; AND (9) ENROUTE TO AND
FROM A PLACE, INCLUDING A SCHOOL, AT WHICH A CHILD OR  CHILDREN  OF  THE
HOLDER  ARE  CARED FOR ON A REGULAR BASIS AND WHICH IS NECESSARY FOR THE
HOLDER TO MAINTAIN SUCH HOLDER'S EMPLOYMENT OR ENROLLMENT AT AN  ACCRED-
ITED SCHOOL, COLLEGE OR UNIVERSITY OR AT A STATE APPROVED INSTITUTION OF
VOCATIONAL OR TECHNICAL TRAINING. SUCH LICENSE OR PRIVILEGE SHALL REMAIN
IN EFFECT DURING THE TERM OF THE SUSPENSION OR REVOCATION OF THE PARTIC-
IPANT'S  LICENSE OR PRIVILEGE UNLESS EARLIER REVOKED BY THE COMMISSIONER
OF MOTOR VEHICLES.
  (B) THE CONDITIONAL LICENSE OR PRIVILEGE DESCRIBED IN PARAGRAPH (A) OF
THIS SUBDIVISION SHALL BE IN A FORM PRESCRIBED BY  THE  COMMISSIONER  OF
MOTOR  VEHICLES, AND SHALL HAVE INDICATED THEREIN THE CONDITIONS IMPOSED
BY SUCH PARAGRAPH.
  (C) UPON RECEIPT OF A CONDITIONAL  LICENSE  ISSUED  PURSUANT  TO  THIS
SECTION,  ANY ORDER ISSUED BY A JUDGE, JUSTICE OR MAGISTRATE PURSUANT TO
PARAGRAPH (C) OF SUBDIVISION TWO OF SECTION ELEVEN HUNDRED  NINETY-THREE
OF THE VEHICLE AND TRAFFIC LAW SHALL BE SURRENDERED TO THE DEPARTMENT OF
MOTOR VEHICLES.
  (D)  THE COMMISSIONER OF MOTOR VEHICLES SHALL REQUIRE APPLICANTS FOR A
CONDITIONAL LICENSE TO PAY A FEE OF SEVENTY-FIVE DOLLARS FOR  PROCESSING
COSTS.  SUCH  FEES  ASSESSED UNDER THIS SUBDIVISION SHALL BE PAID TO THE
COMMISSIONER FOR DEPOSIT TO THE GENERAL FUND AND SHALL BE IN ADDITION TO
ANY FEES ESTABLISHED BY THE COMMISSIONER PURSUANT TO SUBDIVISION SIX  OF
THIS  SECTION TO DEFRAY THE COSTS OF THE ALCOHOL AND DRUG REHABILITATION
PROGRAM.
  (E) THE CONDITIONAL LICENSE OR PRIVILEGES DESCRIBED IN  THIS  SUBDIVI-
SION  MAY  BE  REVOKED BY THE COMMISSIONER OF MOTOR VEHICLES, FOR SUFFI-
CIENT CAUSE INCLUDING, BUT NOT LIMITED TO, FAILURE TO  REGISTER  IN  THE
PROGRAM,   FAILURE  TO  ATTEND  OR  SATISFACTORILY  PARTICIPATE  IN  THE
SESSIONS, CONVICTION OF ANY TRAFFIC INFRACTION OTHER THAN ONE  INVOLVING
PARKING,  STOPPING  OR STANDING OR CONVICTION OF ANY ALCOHOL OR DRUG-RE-
LATED TRAFFIC OFFENSE, MISDEMEANOR OR FELONY. IN ADDITION,  THE  COMMIS-
SIONER  OF  MOTOR  VEHICLES  SHALL  HAVE  THE RIGHT, AFTER A HEARING, TO
REVOKE THE CONDITIONAL LICENSE OR PRIVILEGE UPON RECEIVING  NOTIFICATION
OR  EVIDENCE THAT THE OFFENDER IS NOT ATTEMPTING IN GOOD FAITH TO ACCEPT
REHABILITATION. IN THE EVENT OF SUCH REVOCATION, THE  FEE  DESCRIBED  IN
SUBDIVISION SIX OF THIS SECTION SHALL NOT BE REFUNDED.
  (F)  IT  SHALL BE A TRAFFIC INFRACTION FOR THE HOLDER OF A CONDITIONAL
LICENSE OR PRIVILEGE TO OPERATE A MOTOR VEHICLE UPON  A  PUBLIC  HIGHWAY
FOR  ANY  USE  OTHER  THAN THOSE AUTHORIZED PURSUANT TO PARAGRAPH (A) OF
THIS SUBDIVISION. WHEN A  PERSON  IS  CONVICTED  OF  THIS  OFFENSE,  THE
SENTENCE  OF  THE  COURT  MUST  BE  A  FINE OF NOT LESS THAN TWO HUNDRED
DOLLARS NOR MORE THAN FIVE HUNDRED DOLLARS OR A TERM OF IMPRISONMENT  OF
NOT  MORE  THAN  FIFTEEN DAYS OR BOTH SUCH FINE AND IMPRISONMENT.  ADDI-
TIONALLY, THE CONDITIONAL LICENSE OR PRIVILEGES DESCRIBED IN THIS SUBDI-
VISION SHALL BE REVOKED BY  THE  COMMISSIONER  OF  MOTOR  VEHICLES  UPON
RECEIVING  NOTIFICATION  FROM THE COURT THAT THE HOLDER THEREOF HAS BEEN
CONVICTED OF THIS OFFENSE.
  (G) NOTWITHSTANDING ANYTHING TO THE CONTRARY CONTAINED  IN  A  CERTIF-
ICATE  OF  RELIEF  FROM  DISABILITIES  OR  A CERTIFICATE OF GOOD CONDUCT

S. 6256--C                         98

ISSUED PURSUANT TO ARTICLE  TWENTY-THREE  OF  THE  CORRECTION  LAW,  ANY
CONDITIONAL  LICENSE  OR  PRIVILEGE  ISSUED  TO  A PERSON CONVICTED OF A
VIOLATION OF ANY SUBDIVISION OF SECTION ELEVEN HUNDRED NINETY-TWO OF THE
VEHICLE  AND  TRAFFIC  LAW  SHALL  NOT BE VALID FOR THE OPERATION OF ANY
COMMERCIAL MOTOR VEHICLE. IN ADDITION, NO SUCH  CONDITIONAL  LICENSE  OR
PRIVILEGE  SHALL  BE  VALID FOR THE OPERATION OF A TAXICAB AS DEFINED IN
THE VEHICLE AND TRAFFIC LAW.
  (H) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF  THIS  CHAPTER,  THE
CONDITIONAL LICENSE DESCRIBED IN THIS SUBDIVISION MAY, PURSUANT TO REGU-
LATIONS  ESTABLISHED BY THE COMMISSIONER OF MOTOR VEHICLES, BE ISSUED TO
A PERSON WHOSE LICENSE HAS BEEN SUSPENDED PENDING  PROSECUTION  PURSUANT
TO  SUBPARAGRAPH  SEVEN  OF  PARAGRAPH (E) OF SUBDIVISION TWO OF SECTION
ELEVEN HUNDRED NINETY-THREE OF THE VEHICLE AND TRAFFIC LAW.
  S 5. This act shall take effect immediately; provided,  however,  that
absent  explicit language expressly and unequivocally stating a legisla-
tive intent to the contrary, all provisions of this act are  irrefutably
presumed  to operate in a wholly prospective manner. Provisions shall be
considered to operate retroactively, and therefore in violation of  this
paragraph,  if  applied  in  such  a manner as to alter, change, affect,
impair or defeat any rights, obligations, duties or  interests  accrued,
incurred  or conferred prior to the effective date of this act. Further-
more, the provisions of this act shall neither apply to, nor be  applied
based upon the occasion of, acts occurring prior to it becoming law.
  S 2. Severability clause. If any clause, sentence, paragraph, subdivi-
sion,  section  or  part  of  this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair,  or  invalidate  the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph,  subdivision,  section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included herein.
  S 3. This act shall take effect immediately  provided,  however,  that
the  applicable effective date of Parts A through W of this act shall be
as specifically set forth in the last section of such Parts.

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

    S. 6256--D                                            A. 9056--D

                      S E N A T E - A S S E M B L Y

                            January 17, 2012
                               ___________

IN  SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti-
  cle seven of the Constitution -- read twice and ordered  printed,  and
  when  printed to be committed to the Committee on Finance -- committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee  --  committee  discharged,  bill  amended,  ordered
  reprinted  as  amended  and recommitted to said committee -- committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee  --  committee  discharged,  bill  amended,  ordered
  reprinted as amended and recommitted to said committee

IN  ASSEMBLY  --  A  BUDGET  BILL, submitted by the Governor pursuant to
  article seven of the Constitution -- read once  and  referred  to  the
  Committee  on  Ways  and  Means -- committee discharged, bill amended,
  ordered reprinted as amended and  recommitted  to  said  committee  --
  again  reported from said committee with amendments, ordered reprinted
  as amended and recommitted to said committee --  again  reported  from
  said  committee  with  amendments,  ordered  reprinted  as amended and
  recommitted to said committee -- again reported  from  said  committee
  with  amendments, ordered reprinted as amended and recommitted to said
  committee

AN ACT to amend the public health law, in  relation  to  evaluations  or
  services under the early intervention program for infants and toddlers
  with disabilities and their families, state aid reimbursement to muni-
  cipalities  for  respite services, and service coordination; to repeal
  subdivision 7 of section 2551 and subdivision 4 of section 2557 of the
  public  health  law,  relating  to  administering  early  intervention
  services;  to  amend  the  public health law, in relation to requiring
  that each municipality be responsible for providing early intervention
  services; to amend the public health law,  in  relation  to  requiring
  health  maintenance  organizations  to  include coverage for otherwise
  covered services that are part of an early  intervention  program;  to
  amend the insurance law, in relation to payment for early intervention
  services;  to repeal subsection (e) of section 3235-a of the insurance
  law relating to claims for early  intervention  program  services;  to
  amend the education law, in relation to special education services and
  programs  for  preschool children with handicapping conditions; and to
  repeal subdivision 18 of section 4403 of the education  law,  relating

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

                      [ ] is old law to be omitted.
                                                           LBD12671-06-2

S. 6256--D                          2                         A. 9056--D

  to  the  power of the education department to approve the provision of
  early intervention services (Part A); to amend the public  authorities
  law,  in relation to funding and operations of the Roswell Park Cancer
  Institute  (Part  B);  intentionally  omitted  (Part  C); to amend the
  public health law, in relation to establishing the supportive  housing
  development reinvestment program; to amend the social services law, in
  relation to applicability of the assisted living program; to amend the
  social  services  law,  in relation to including podiatry services and
  lactation services under the term medical  assistance;  to  amend  the
  public  health  law,  in  relation  to comprehensive HIV special needs
  plan, in relation to HEAL-NY, and in relation to the EQUAL program; to
  amend the social services law,  in  relation  to  education,  outreach
  services and facilitated enrollment activities for certain aged, blind
  and  disabled  persons; to amend the public health law, in relation to
  expanding  prenatal  care  programs,  establishing  the  primary  care
  service  corps practitioner loan repayment program, authorizing moneys
  in the medical indemnity fund to be invested  in  obligations  of  the
  United  States  or  the  state  or obligations where the principal and
  interest are guaranteed by the United States or the state  and  moneys
  distributed  as  non-Medicaid  grants  to  non-major  public  academic
  medical centers; to amend the public authorities law, in  relation  to
  the  powers  of  the  dormitory  authority;  directs  a  workgroup  on
  medically fragile  children;  to  amend  the  public  health  law,  in
  relation  to notice requirement for preferred drug program, payment to
  the commissioner of health by third-party payors, audit of payments to
  the commissioner of health, electronic submission of reports by hospi-
  tals, and changing the definition of eligible applicant; to amend  the
  social  services law, in relation to medical assistance where relative
  is absent or refuses or fails to provide necessary care; to amend  the
  public health law, in relation to third-party payor's election to make
  payments;  to amend the public health law, in relation to reserved bed
  days; to amend the social services law, in relation  to  the  personal
  care  services  worker recruitment and retention program; to amend the
  public health law, in relation to the tobacco  control  and  insurance
  initiatives  pool  distributions; to amend the social services law, in
  relation to certain public school districts and  state  operated/state
  supported  schools; to amend the public health law, in relation to the
  licensure of home care services agencies; to amend the social services
  law, in relation to managed care programs; to amend the public  health
  law,  in  relation  to  the distribution of the professional education
  pools; to amend chapter 584 of the laws of 2011, amending  the  public
  authorities  law,  relating  to the powers and duties of the dormitory
  authority of the state of New York relative to  the  establishment  of
  subsidiaries  for  certain  purposes, in relation to the effectiveness
  thereof; to amend chapter 119 of the laws of 1997 relating to  author-
  izing the department of health to establish certain payments to gener-
  al  hospitals,  in relation to costs incurred in excess of revenues by
  general hospitals in providing services in eligible programs to  unin-
  sured patients and patients eligible for Medicaid assistance; to amend
  subdivision  1  of  section  92 of part H of chapter 59 of the laws of
  2011, relating to known and projected department of health state funds
  Medicaid expenditures, in relation to the  effectiveness  thereof;  to
  amend section 90 of part H of chapter 59 of the laws of 2011, relating
  to types of appropriations exempt from certain reductions, in relation
  to certain payments with regard to local governments; to amend section
  1 of part C of chapter 58 of the laws of 2005, relating to authorizing

S. 6256--D                          3                         A. 9056--D

  reimbursements  for  expenditures  made  by  or  on  behalf  of social
  services districts for medical assistance for needy  persons  and  the
  administration  thereof, in relation to Medicaid reimbursement; and to
  repeal  certain  provisions  of the public health law relating thereto
  (Part D); intentionally omitted (Part E); to amend chapter 58  of  the
  laws of 2005 authorizing reimbursements for expenditures made by or on
  behalf  of  social services districts for medical assistance for needy
  persons and the administration thereof, in relation to an  administra-
  tive  cap  on  such  program; to amend chapter 59 of the laws of 2011,
  amending the public health law and  other  laws  relating  to  general
  hospital  reimbursement  for  annual  rates, in relation to the cap on
  local Medicaid expenditures; to amend  the  social  services  law,  in
  relation  to  the  department assumption of program administration for
  medical assistance; and providing for the repeal of certain provisions
  of the social services law upon expiration thereof (Part F); to  amend
  the public health law, in relation to regulations for computing hospi-
  tal inpatient rates and to amend chapter 58 of the laws of 2005 relat-
  ing  to  the  preferred drug program, in relation to the effectiveness
  thereof (Part G); to amend chapter 57 of the laws of 2006, relating to
  establishing a cost of living adjustment for designated human services
  programs,  in  relation  to  foregoing  such  adjustment  during   the
  2012-2013  state fiscal year (Part H); intentionally omitted (Part I);
  to amend the mental hygiene law, the public health  law,  the  general
  municipal  law,  the  education  law,  the social services law and the
  surrogate's court procedure act, in relation to the office for  people
  with  developmental  disabilities  and  the  creation of developmental
  disabilities  regional  offices  and  state  operations  offices;  and
  providing for the repeal of certain provisions upon expiration thereof
  (Part J); to amend chapter 723 of the laws of 1989 amending the mental
  hygiene law and other laws relating to comprehensive psychiatric emer-
  gency  programs,  in  relation  to  extending  the  repeal  of certain
  provisions thereof (Part  K);  to  permit  the  commissioners  of  the
  department of health, the office of mental health, the office of alco-
  holism  and  substance  abuse  services and the office for people with
  developmental disabilities the regulatory flexibility  to  more  effi-
  ciently   and  effectively  integrate  health  and  behavioral  health
  services (Part L); to amend the education law, in relation to  author-
  izing  contracts  for  the  provision of special education and related
  services for certain patients hospitalized in  hospitals  operated  by
  the  office  of  mental  health  and  providing for the repeal of such
  provisions upon expiration thereof  (Part  M);  to  amend  the  mental
  hygiene  law  and  the public health law, in relation to the statewide
  comprehensive services plan for people with mental disabilities and in
  relation  to  the  local  planning  process;  and  to  repeal  certain
  provisions  of  the  mental  hygiene law relating thereto (Part N); to
  amend the mental hygiene law, in  relation  to  the  closure  and  the
  reduction  in  size  of certain facilities serving persons with mental
  illness; and providing for the repeal of such provisions upon  expira-
  tion thereof (Part O); to amend the mental hygiene law, in relation to
  amending  procedures  under  the sex offender management and treatment
  act (Part P); to amend the criminal  procedure  law,  in  relation  to
  providing  for outpatient capacity restoration of felony defendants at
  article 28 hospitals (Part Q); 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 R); in relation to  the

S. 6256--D                          4                         A. 9056--D

  excess  medical  malpractice  liability coverage pool (Part S); and to
  amend the elder law, in relation to the program for elderly pharmaceu-
  tical insurance coverage; and to repeal certain provisions of such law
  relating thereto (Part T)

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

  Section 1. This act enacts into law major  components  of  legislation
which are necessary to implement the state fiscal plan for the 2012-2013
state  fiscal  year.  Each  component  is wholly contained within a Part
identified as Parts A through T. The effective date for each  particular
provision contained within such Part is set forth in the last section of
such Part. Any provision in any section contained within a Part, includ-
ing the effective date of the Part, which makes a reference to a section
"of  this  act", when used in connection with that particular component,
shall be deemed to mean and refer to the corresponding  section  of  the
Part  in  which  it  is  found. Section three of this act sets forth the
general effective date of this act.

                                 PART A

  Section 1.  Subdivision 2 of section 2544 of the public health law  is
amended by adding a new paragraph (c) to read as follows:
  (C)  IF,  IN  CONSULTATION WITH THE EVALUATOR, THE SERVICE COORDINATOR
IDENTIFIES A CHILD THAT IS POTENTIALLY ELIGIBLE FOR PROGRAMS OR SERVICES
OFFERED BY OR UNDER THE AUSPICES OF THE OFFICE FOR PEOPLE WITH  DEVELOP-
MENTAL DISABILITIES, THE SERVICE COORDINATOR SHALL, WITH PARENT CONSENT,
NOTIFY  THE  OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES' REGIONAL
DEVELOPMENTAL DISABILITIES SERVICES OFFICE OF THE POTENTIAL  ELIGIBILITY
OF SUCH CHILD FOR SAID PROGRAMS OR SERVICES.
  S 2. Intentionally omitted.
  S  2-a.  Section  2545 of the public health law is amended by adding a
new subdivision 10 to read as follows:
  10. THE SERVICE COORDINATOR SHALL ENSURE THAT THE IFSP, INCLUDING  ANY
AMENDMENTS THERETO, IS IMPLEMENTED IN A TIMELY MANNER BUT NOT LATER THAN
THIRTY  DAYS AFTER THE PROJECTED DATES FOR INITIATION OF THE SERVICES AS
SET FORTH IN THE PLAN.
  S 3. Intentionally omitted.
  S 4. Subdivision 2 of section  2547  of  the  public  health  law,  as
amended  by  chapter  231  of  the  laws  of 1993, is amended to read as
follows:
  2. In addition to respite services provided  pursuant  to  subdivision
one  of  this  section and subject to the amounts appropriated therefor,
the state shall  reimburse  the  municipality  IN  ACCORDANCE  WITH  THE
PERCENTAGE OF STATE AID REIMBURSEMENT FOR APPROVED COSTS AS SET FORTH IN
SUBDIVISION  TWO  OF  SECTION  TWENTY-FIVE  HUNDRED  FIFTY-SEVEN OF THIS
TITLE, for [fifty percent of] the costs of respite services provided  to
eligible  children  and  their  families  with the approval of the early
intervention official.
  S 5. Section 2548 of the public health law, as amended by  section  20
of  part  H  of  chapter  686 of the laws of 2003, is amended to read as
follows:
  S 2548. Transition plan. To the extent that a toddler with a disabili-
ty is thought to be eligible for services pursuant to section forty-four

S. 6256--D                          5                         A. 9056--D

hundred ten of the education  law,  the  [early  intervention  official]
SERVICE  COORDINATOR  shall notify in writing the committee on preschool
special education of the local school  district  in  which  an  eligible
child  resides  of  the  potential  transition  of  such child and, with
parental consent, arrange for a conference among the  service  coordina-
tor,  the  parent  and  the  chairperson  of  the preschool committee on
special education or his or her designee at  least  ninety  days  before
such  child  would  be  eligible  for  services under section forty-four
hundred ten of the education law to review the child's  program  options
and to establish a transition plan, if appropriate. If a parent does not
consent to a conference with the service coordinator and the chairperson
of  the  preschool committee on special education or his or her designee
to determine whether the child should be  referred  for  services  under
section  forty-four  hundred  ten of the education law, and the child is
not determined to be eligible by  the  committee  on  preschool  special
education  for  such  services  prior to the child's third birthday, the
child's eligibility for early intervention program services shall end at
the child's third birthday.
  S 6. Subdivision 2 of section  2550  of  the  public  health  law,  as
amended  by  section  5 of part B3 of chapter 62 of the laws of 2003, is
amended to read as follows:
  2. In meeting the requirements of subdivision one of this section, the
lead agency shall adopt and use  proper  methods  of  administering  the
early intervention program, including:
  (a)  establishing  standards  for evaluators, service coordinators and
providers of early intervention services;
  (b) approving, and periodically re-approving evaluators, service coor-
dinators and providers of early intervention services who  meet  depart-
ment  standards;  PROVIDED  HOWEVER THAT THE DEPARTMENT MAY REQUIRE THAT
APPROVED EVALUATORS, SERVICE COORDINATORS AND PROVIDERS OF EARLY  INTER-
VENTION  SERVICES  ENTER INTO AGREEMENTS WITH THE DEPARTMENT IN ORDER TO
CONDUCT EVALUATIONS OR RENDER SERVICE COORDINATION OR EARLY INTERVENTION
SERVICES IN THE EARLY INTERVENTION PROGRAM. SUCH  AGREEMENTS  SHALL  SET
FORTH  THE  TERMS AND CONDITIONS OF PARTICIPATION IN THE PROGRAM. IF THE
DEPARTMENT REQUIRES THAT SUCH PROVIDERS ENTER INTO AGREEMENTS  WITH  THE
DEPARTMENT FOR PARTICIPATION IN THE PROGRAM, "APPROVAL" OR "APPROVED" AS
USED  IN THIS TITLE SHALL MEAN A PROVIDER WHO IS APPROVED BY THE DEPART-
MENT IN ACCORDANCE WITH DEPARTMENT REGULATIONS AND HAS ENTERED  INTO  AN
AGREEMENT  WITH THE DEPARTMENT FOR THE PROVISION OF EVALUATIONS, SERVICE
COORDINATION OR EARLY INTERVENTION SERVICES.  THE DEPARTMENT  SHALL  USE
BEST  EFFORTS  TO  ENSURE  PROVIDER  CAPACITY  IN THE EARLY INTERVENTION
PROGRAM.
  (c) [compiling  and  disseminating  to  the  municipalities  lists  of
approved  evaluators, service coordinators and providers of early inter-
vention services;
  (d)] monitoring of agencies, institutions and organizations under this
title and  agencies,  institutions  and  organizations  providing  early
intervention  services which are under the jurisdiction of a state early
intervention service agency;
  [(e)] (D) enforcing any obligations imposed on  those  agencies  under
this title or Part H of the federal individuals with disabilities educa-
tion act and its regulations;
  [(f)]  (E)  providing training and technical assistance to those agen-
cies, institutions and  organizations,  including  initial  and  ongoing
training  and technical assistance to municipalities to help enable them
to identify, locate  and  evaluate  eligible  children,  develop  IFSPs,

S. 6256--D                          6                         A. 9056--D

ensure the provision of appropriate early intervention services, promote
the  development of new services, where there is a demonstrated need for
such services and afford procedural safeguards to infants  and  toddlers
and their families;
  [(g)] (F) correcting deficiencies that are identified through monitor-
ing; and
  [(h)]  (G) in monitoring early intervention services, the commissioner
shall provide municipalities with the results of  any  review  of  early
intervention  services  undertaken  and shall provide the municipalities
with the opportunity to comment thereon.
  S 7. Subdivision 7 of  section  2551  of  the  public  health  law  is
REPEALED,  and subdivisions 8, 9 and 10 are renumbered subdivisions 7, 8
and 9.
  S 8.  Section 2552 of the public health law, as added by  chapter  428
of  the  laws of 1992, subdivisions 2 and 3 as amended by chapter 231 of
the laws of 1993, and subdivision 4 as added by section 6 of part B3  of
chapter 62 of the laws of 2003, is amended to read as follows:
  S 2552. Responsibility of municipality.  1. Each municipality shall be
responsible  for ensuring that the early intervention services contained
in an IFSP are provided to eligible  children  and  their  families  who
reside in such municipality [and may contract with approved providers of
early intervention services for such purpose].  A MUNICIPALITY MAY MONI-
TOR, WHICH MAY INCLUDE SITE VISITATION, EVALUATORS AND PROVIDERS OF SUCH
SERVICES WITHIN THE MUNICIPALITY IN ACCORDANCE WITH THIS TITLE AND REGU-
LATIONS PROMULGATED HEREUNDER, INCLUDING MAKING THE DETERMINATIONS SPEC-
IFIED  IN  THIS  SECTION.    THE  SERVICE COORDINATOR SHALL REPORT, IN A
MANNER AND FORMAT AS DETERMINED BY THE MUNICIPALITY, ON THE DELIVERY  OF
SERVICES  TO  AN  ELIGIBLE CHILD IN ACCORDANCE WITH THE ELIGIBLE CHILD'S
IFSP. A MUNICIPALITY MAY REQUEST THAT THE PARENT SELECT  A  NEW  SERVICE
COORDINATOR OR REQUIRE THAT THE SERVICE COORDINATOR SELECT A NEW PROVID-
ER  OF  SERVICES  IF THE MUNICIPALITY FINDS THAT THE SERVICE COORDINATOR
HAS NOT BEEN PERFORMING HIS OR HER RESPONSIBILITIES AS REQUIRED BY  THIS
TITLE  OR  THAT  SERVICES  HAVE NOT BEEN PROVIDED IN ACCORDANCE WITH THE
ELIGIBLE CHILD'S IFSP.  IF THE EARLY  INTERVENTION  OFFICIAL  DETERMINES
THAT  THE  EVALUATOR  HAS NOT FOLLOWED THE REQUIREMENTS IN THIS TITLE OR
REGULATIONS PROMULGATED HEREUNDER, THE EARLY INTERVENTION  OFFICIAL  MAY
REQUIRE  THAT  THE EVALUATOR IMMEDIATELY SUBMIT ADDITIONAL DOCUMENTATION
TO SUPPORT THE ELIGIBILITY DETERMINATION.  IF  THE  EVALUATOR  DOES  NOT
PROVIDE  THE  REQUESTED  DOCUMENTATION,  OR  THE  DOCUMENTATION PROVIDED
CONTINUES TO BE INCONSISTENT WITH THE  REQUIREMENTS  OF  THIS  TITLE  OR
REGULATIONS, THE EARLY INTERVENTION OFFICIAL CAN REQUIRE THAT THE PARENT
SELECT  ANOTHER  EVALUATOR  TO CONDUCT A MULTIDISCIPLINARY EVALUATION TO
DETERMINE WHETHER THE CHILD MEETS ELIGIBILITY FOR PROGRAM SERVICES.
  2. [After consultation with early intervention officials, the  commis-
sioner  shall develop procedures to permit a municipality to contract or
otherwise make arrangements with other municipalities  for  an  eligible
child and the child's family to receive services from such other munici-
palities.
  3.  The  municipality  shall  monitor claims for service reimbursement
authorized by this title and shall verify such claims prior to  payment.
The municipality shall inform the commissioner of discrepancies in bill-
ing and when payment is to be denied or withheld by the municipality.
  4.]  The early intervention official shall require an eligible child's
parent to furnish the parents'  and  eligible  child's  social  security
numbers  for the purpose of the department's and municipality's adminis-
tration of the program.

S. 6256--D                          7                         A. 9056--D

  S 9. Intentionally omitted.
  S  9-a.  Subdivision  4  of  section  2557 of the public health law is
REPEALED and subdivisions 2 and 5, subdivision 2 as added by chapter 428
of the laws of 1992 and subdivision 5 as added by section 7 of  part  B3
of chapter 62 of the laws of 2003, are amended to read as follows:
  2. The department shall reimburse the approved costs paid by a munici-
pality  for the purposes of this title, other than those reimbursable by
the medical assistance program or by third party payors, in an amount of
fifty percent of the amount expended in accordance with  the  rules  and
regulations   of  the  commissioner;  PROVIDED,  HOWEVER,  THAT  IN  THE
DISCRETION OF THE DEPARTMENT AND WITH THE APPROVAL OF  THE  DIRECTOR  OF
THE  DIVISION OF THE BUDGET, THE DEPARTMENT MAY REIMBURSE MUNICIPALITIES
IN AN AMOUNT GREATER THAN FIFTY PERCENT OF THE AMOUNT  EXPENDED.    Such
state reimbursement to the municipality shall not be paid prior to April
first  of  the  year in which the approved costs are paid by the munici-
pality, PROVIDED, HOWEVER THAT, SUBJECT TO THE APPROVAL OF THE  DIRECTOR
OF  THE  BUDGET,  THE DEPARTMENT MAY PAY SUCH STATE AID REIMBURSEMENT TO
THE MUNICIPALITY PRIOR TO SUCH DATE.
  5. [The  department  shall]  (A)  THE  COMMISSIONER,  IN  HIS  OR  HER
DISCRETION, IS AUTHORIZED TO contract with [an independent organization]
ONE  OR  MORE ENTITIES to act as the fiscal agent for the department AND
MUNICIPALITIES WITH RESPECT TO FISCAL MANAGEMENT AND  PAYMENT  OF  EARLY
INTERVENTION  CLAIMS. MUNICIPALITIES SHALL GRANT SUFFICIENT AUTHORITY TO
THE FISCAL AGENT TO ACT ON THEIR BEHALF. MUNICIPALITIES, AND  INDIVIDUAL
AND  AGENCY PROVIDERS AS DEFINED BY THE COMMISSIONER IN REGULATION SHALL
UTILIZE SUCH FISCAL AGENT FOR PAYMENT OF EARLY  INTERVENTION  CLAIMS  AS
DETERMINED  BY  THE  DEPARTMENT  AND  SHALL PROVIDE SUCH INFORMATION AND
DOCUMENTATION AS REQUIRED BY THE DEPARTMENT AND NECESSARY FOR THE FISCAL
AGENT TO CARRY OUT ITS DUTIES.
  (B) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTION ONE  HUNDRED
TWELVE OR ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, SECTIONS ONE
HUNDRED  FORTY-TWO  AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVELOP-
MENT LAW, OR ANY OTHER CONTRARY PROVISION OF LAW,  THE  COMMISSIONER  IS
AUTHORIZED  TO ENTER INTO A CONTRACT OR CONTRACTS UNDER PARAGRAPH (A) OF
THIS SUBDIVISION WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROC-
ESS, PROVIDED, HOWEVER, THAT:
  (I) THE DEPARTMENT SHALL POST ON ITS WEBSITE, FOR A PERIOD OF NO  LESS
THAN THIRTY DAYS:
  (1)  A DESCRIPTION OF THE PROPOSED SERVICES TO BE PROVIDED PURSUANT TO
THE CONTRACT OR CONTRACTS;
  (2) THE CRITERIA FOR SELECTION OF A CONTRACTOR OR CONTRACTORS;
  (3) THE PERIOD OF TIME DURING WHICH A PROSPECTIVE CONTRACTOR MAY  SEEK
SELECTION,  WHICH  SHALL BE NO LESS THAN THIRTY DAYS AFTER SUCH INFORMA-
TION IS FIRST POSTED ON THE WEBSITE; AND
  (4) THE MANNER  BY  WHICH  A  PROSPECTIVE  CONTRACTOR  MAY  SEEK  SUCH
SELECTION, WHICH MAY INCLUDE SUBMISSION BY ELECTRONIC MEANS;
  (II)  ALL REASONABLE AND RESPONSIVE SUBMISSIONS THAT ARE RECEIVED FROM
PROSPECTIVE CONTRACTORS IN A TIMELY FASHION SHALL  BE  REVIEWED  BY  THE
COMMISSIONER; AND
  (III)  THE  COMMISSIONER  SHALL  SELECT SUCH CONTRACTOR OR CONTRACTORS
THAT, IN HIS OR HER DISCRETION, ARE BEST SUITED TO SERVE THE PURPOSES OF
THIS SECTION.
  (C) PARAGRAPH (B) OF THIS SUBDIVISION SHALL APPLY ONLY TO THE  INITIAL
CONTRACT OR CONTRACTS NECESSARY TO OBTAIN THE SERVICES OF A FISCAL AGENT
FOR  EARLY  INTERVENTION  PROGRAM FISCAL MANAGEMENT AND PAYMENT OF EARLY
INTERVENTION CLAIMS AND SHALL NOT APPLY TO SUBSEQUENT  CONTRACTS  NEEDED

S. 6256--D                          8                         A. 9056--D

TO  MAINTAIN  SUCH SERVICES, AS DETERMINED BY THE COMMISSIONER IN HIS OR
HER DISCRETION.  [A municipality may elect to utilize  the  services  of
such  organization  for early intervention program fiscal management and
claiming  as determined by the commissioner or may select an independent
agent to act as the fiscal agent for such municipality or may act as its
own fiscal agent.]
  S 10. Subdivision 4 of section 2558 of the public health law, as added
by chapter 428 of the laws of 1992, is amended to read as follows:
  4. Local contribution. The municipality of residence shall  be  finan-
cially  responsible  for  the  local contribution in the amount of fifty
percent of the [approved costs] AMOUNT EXPENDED PROVIDED, HOWEVER,  THAT
IN  THE DISCRETION OF THE DEPARTMENT AND WITH THE APPROVAL OF THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, IN ACCORDANCE WITH SUBDIVISION TWO OF
SECTION TWENTY-FIVE HUNDRED FIFTY-SEVEN OF THIS  TITLE,  THE  DEPARTMENT
MAY  REQUIRE  THAT MUNICIPALITIES BE FINANCIALLY RESPONSIBLE FOR A LOCAL
CONTRIBUTION IN  AN  AMOUNT  LESS  THAN  FIFTY  PERCENT  OF  THE  AMOUNT
EXPENDED.   The commissioner shall certify to the comptroller the amount
of the local contribution owed by each municipality to  the  state.  The
comptroller  shall  deduct  the  amount of such local contribution first
from any moneys due the municipality  pursuant  to  section  twenty-five
hundred fifty-six of this title and then from any other moneys due or to
become due to the municipality.
  S  11. Paragraphs (a), (c) and (d) of subdivision 3 of section 2559 of
the public health law, paragraph (a) as amended  and  paragraph  (d)  as
added  by chapter 231 of the laws of 1993, subparagraphs (i) and (ii) of
paragraph (a) as added by chapter 406 of the laws of 2011, and paragraph
(c) as added by chapter 428 of the laws of 1992, are amended to read  as
follows:
  (a)  Providers  of  EVALUATIONS  AND  early intervention services [and
transportation services], HEREINAFTER COLLECTIVELY REFERRED TO  IN  THIS
SUBDIVISION  AS  "PROVIDER"  OR "PROVIDERS", shall in the first instance
and where applicable, seek payment from all third party payors including
governmental agencies prior to claiming payment  from  a  given  munici-
pality  for  EVALUATIONS  CONDUCTED  UNDER  THE PROGRAM AND FOR services
rendered to eligible children, provided that, [for the purpose of  seek-
ing  payment  from  the  medical  assistance program or from other third
party payors, the municipality shall be  deemed  the  provider  of  such
early intervention services to the extent that the provider has promptly
furnished  to  the municipality adequate and complete information neces-
sary to support the municipality billing, and provided further that] the
obligation to seek payment shall not apply to a  payment  from  a  third
party  payor  who is not prohibited from applying such payment, and will
apply such payment, to an annual or  lifetime  limit  specified  in  the
insured's policy.
  (i)  Parents  shall  provide [and] the municipality [shall obtain] AND
SERVICE COORDINATOR information on any  [plan  of  insurance]  INSURANCE
POLICY, PLAN OR CONTRACT under which an eligible child has coverage.
  (ii)  Parents shall provide the municipality AND THE SERVICE COORDINA-
TOR with a written referral from a primary care provider  as  documenta-
tion,  for  eligible  children, of the medical necessity of early inter-
vention services.
  (III) PROVIDERS SHALL UTILIZE THE DEPARTMENT'S FISCAL AGENT  AND  DATA
SYSTEM  FOR CLAIMING PAYMENT FOR EVALUATIONS AND SERVICES RENDERED UNDER
THE EARLY INTERVENTION PROGRAM.
  (c) Payments made for early intervention services under  an  insurance
policy  or  health  benefit plan, INCLUDING PAYMENTS MADE BY THE MEDICAL

S. 6256--D                          9                         A. 9056--D

ASSISTANCE PROGRAM OR OTHER GOVERNMENTAL THIRD PARTY  PAYOR,  which  are
provided  as  part  of  an  IFSP pursuant to section twenty-five hundred
forty-five of this title shall not be applied by  the  insurer  or  plan
administrator against any maximum lifetime or annual limits specified in
the  policy  or  health benefits plan, pursuant to section eleven of the
chapter of the laws of nineteen  hundred  ninety-two  which  added  this
title.
  (d) A municipality, or its designee, AND A PROVIDER shall be subrogat-
ed,  to the extent of the expenditures by such municipality OR for early
intervention services furnished to persons eligible for  benefits  under
this  title,  to  any rights such person may have or be entitled to from
third party reimbursement. THE  PROVIDER  SHALL  SUBMIT  NOTICE  TO  THE
INSURER  OR  PLAN  ADMINISTRATOR OF HIS OR HER EXERCISE OF SUCH RIGHT OF
SUBROGATION UPON THE PROVIDER'S ASSIGNMENT  AS  THE  EARLY  INTERVENTION
SERVICE PROVIDER FOR THE CHILD. The right of subrogation does not attach
to benefits paid or provided under any health insurance policy or health
benefits  plan  prior  to  receipt  of written notice of the exercise of
subrogation rights by the insurer or plan administrator  providing  such
benefits.
  S 12. Intentionally omitted.
  S 13. Intentionally omitted.
  S 14. Intentionally omitted.
  S 15. Intentionally omitted.
  S  16.  Subsection  (e)  of  section  3235-a  of  the insurance law is
REPEALED.
  S 17. Subsection (c) of  section  3235-a  of  the  insurance  law,  as
amended  by  chapter  406  of  the  laws  of 2011, is amended to read as
follows:
  (c) Any right of subrogation  to  benefits  which  a  municipality  OR
PROVIDER  is  entitled  in  accordance with paragraph (d) of subdivision
three of section twenty-five hundred fifty-nine of the public health law
shall be valid and enforceable to  the  extent  benefits  are  available
under any accident and health insurance policy. The right of subrogation
does  not  attach to insurance benefits paid or provided under any acci-
dent and health insurance policy prior to  receipt  by  the  insurer  of
written  notice  from the municipality OR PROVIDER, AS APPLICABLE. [Upon
the insurer's receipt of written request and  notice  from  the  munici-
pality  that  such right of subrogation has been granted to such munici-
pality and that the insured has authorized the release of information to
the municipality, the] THE insurer shall provide  the  municipality  AND
SERVICE COORDINATOR with information on the extent of benefits available
to  the  covered  person  under  such  policy WITHIN FIFTEEN DAYS OF THE
INSURER'S  RECEIPT  OF  WRITTEN  REQUEST  AND  NOTICE  AUTHORIZING  SUCH
RELEASE.   THE SERVICE COORDINATOR SHALL PROVIDE SUCH INFORMATION TO THE
RENDERING PROVIDER ASSIGNED TO PROVIDE SERVICES TO THE CHILD.
  S 18. Subdivision 18 of section 4403 of the education law is REPEALED.
  S 19. Paragraph f of subdivision 3 and the opening paragraph of  para-
graph  a  of  subdivision  9  of  section  4410 of the education law, as
amended by chapter 82 of the laws  of  1995,  are  amended  to  read  as
follows:
  f.  After  notification  by [an early intervention official] A SERVICE
COORDINATOR, as defined in section twenty-five hundred forty-one of  the
public  health  law,  that  a child receiving services pursuant to title
II-A of article twenty-five of the public health  law  potentially  will
transition  to  receiving services under this section and that a confer-
ence is to be convened to review the child's program options and  estab-

S. 6256--D                         10                         A. 9056--D

lish a transition plan, which conference must occur at least ninety days
before such child would be eligible for services under this section, the
chairperson of the committee on preschool special education of the local
school district or his or her designee in which such child resides shall
participate in the conference.
  Providers  of  special services or programs shall apply to the commis-
sioner for program approval on a form prescribed  by  the  commissioner;
such  application shall include, but not be limited to, a listing of the
services to be provided, the population to be served, a plan for provid-
ing services in the least restrictive environment and a  description  of
its  evaluation  component,  if  any.  [Providers  of early intervention
services seeking approval pursuant to subdivision seven of section twen-
ty-five hundred fifty-one of the public health law shall  apply  to  the
commissioner  for  such approval on a form prescribed by the commission-
er.] The commissioner shall approve programs in  accordance  with  regu-
lations  adopted  for  such  purpose  and shall periodically review such
programs at which time the commissioner shall provide  the  municipality
in  which  the  program  is  located or for which the municipality bears
fiscal responsibility an opportunity for comment within thirty  days  of
the  review. In collaboration with municipalities and representatives of
approved  programs,  the  commissioner  shall  develop  procedures   for
conducting  such reviews. Municipalities shall be allowed to participate
in such departmental review process. Such review shall be  conducted  by
individuals with appropriate experience as determined by the commission-
er and shall be conducted not more than once every three years.
  S 20. Intentionally omitted.
  S 21. Intentionally omitted.
  S 22. Intentionally omitted.
  S  23.  This act shall take effect January 1, 2013; provided, however,
that sections two-a, four, five, seven, eight, nine-a, ten, eighteen and
nineteen of this act shall take effect April 1, 2013.

                                 PART B

  Section 1. Subdivisions 9, 10 and 11 of section  3555  of  the  public
authorities  law, as added by chapter 5 of the laws of 1997, are amended
to read as follows:
  9. to determine the conditions under which a physician may be extended
the privilege of practicing within a health facility under the jurisdic-
tion of the corporation, to promulgate internal policies for the conduct
of all persons, physicians and allied health practitioners  within  such
facility, and to appoint and grant privileges to qualified and competent
clinical practitioners; [and]
  10.  except as provided in this subdivision or as expressly limited by
any applicable state law or regulation, and in  support  of  the  powers
granted  by  subdivisions  five  and six of this section, to form and to
participate in the formation of one or more corporations, and  to  exer-
cise  and perform such purposes, powers, duties, functions or activities
through one or more subsidiary corporations or other entities  owned  or
controlled  wholly  or in part by the corporation, which shall be formed
pursuant to the business corporation law, the limited liability  company
law,  the  not-for-profit  corporation  law, or the partnership law; any
such subsidiary may be authorized to act as a general or limited partner
in a partnership or as a member of  a  limited  liability  company,  and
enter  into an arrangement calling for an initial and subsequent payment
or payments or contributions to capital by such subsidiary in  consider-

S. 6256--D                         11                         A. 9056--D

ation of an interest in revenues or other contractual rights.  An entity
shall  be  deemed  a  subsidiary corporation whenever and so long as (a)
more than half of any voting shares or other membership interest of such
subsidiary are owned or held by the corporation or (b) a majority of the
directors,  trustees  or members of such subsidiary are designees of the
corporation[.];
  11.  TO TAKE ALL NECESSARY AND APPROPRIATE STEPS AND  ARRANGEMENTS  TO
DEVELOP  A  PLAN AND, ON OR BEFORE JANUARY FIRST, TWO THOUSAND FOURTEEN,
SEEK THE NECESSARY APPROVALS TO EXECUTE SUCH PLAN WHICH MAY INCLUDE  BUT
ARE  NOT  LIMITED TO ENTERING INTO ARRANGEMENTS, MERGERS OR OTHER AFFIL-
IATIONS WITH ONE OR MORE HEALTH CARE, ACADEMIC OR OTHER ENTITIES FOR THE
PURPOSES OF PROTECTING AND PROMOTING THE HEALTH OF THE  PATIENTS  SERVED
BY  ITS  HEALTH  FACILITIES,  ADVANCING  THE  CORPORATION'S  MISSION  OF
CONDUCTING INNOVATIVE RESEARCH INTO THE CAUSES AND TREATMENT OF  CANCER,
SECURING  ITS  FINANCIAL  VIABILITY AND ACHIEVING OPERATIONAL AND FISCAL
INDEPENDENCE FROM THE STATE, AND TO THE EXTENT POSSIBLE, CONTRIBUTING TO
THE ECONOMIC REVITALIZATION OF THE REGION; PROVIDED THAT THE COMMISSION-
ER OF HEALTH SHALL MONITOR SUCH STEPS AND ARRANGEMENTS  AND  PARTICIPATE
WITH  THE  CORPORATION  IN ESTABLISHMENT OF GOALS AND BENCHMARKS FOR THE
ACHIEVEMENT  OF  SUCH  INDEPENDENCE,  AND  THE  CORPORATION  SHALL  MAKE
REQUESTS  FOR  ASSISTANCE AND APPROVALS NEEDED TO EXECUTE SUCH STEPS AND
ARRANGEMENTS.
  12. No subsidiary of the corporation shall  own,  operate,  manage  or
control  the existing research, education, acute inpatient or outpatient
facilities and services now operated by the Roswell Park  Cancer  Insti-
tute.
  S 2. This act shall take effect April 1, 2012.

                                 PART C

                          Intentionally omitted

                                 PART D

  Section  1.  The  public health law is amended by adding a new section
2823 to read as follows:
  S 2823. SUPPORTIVE HOUSING DEVELOPMENT PROGRAM.  1. FOR  THE  PURPOSES
OF  THIS  SECTION  "ELIGIBLE  APPLICANT"  SHALL MEAN (A) A UNIT OF LOCAL
GOVERNMENT, OR (B) A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN IN  EXIST-
ENCE FOR A PERIOD OF AT LEAST ONE YEAR PRIOR TO APPLICATION AND HAS BEEN
ENGAGED IN SUPPORTIVE HOUSING PROGRAMS FOR VULNERABLE POPULATIONS.
  2. GRANTS PROVIDED PURSUANT TO THIS SECTION SHALL BE USED ONLY TO FUND
HOUSING DEVELOPMENT ACTIVITIES AND OTHER GENERAL PROGRAMMATIC ACTIVITIES
TO  HELP  ENSURE  A  STABLE  SYSTEM OF SUPPORTIVE HOUSING FOR VULNERABLE
PERSONS IN THE COMMUNITY. REINVESTMENT FUNDS FOR SUPPORTIVE HOUSING  FOR
VULNERABLE  POPULATIONS, WHICH ARE GENERAL FUND SAVINGS DIRECTLY RELATED
TO INPATIENT HOSPITAL AND NURSING HOME BED DECERTIFICATION AND/OR FACIL-
ITY CLOSURE, SHALL BE ALLOCATED ANNUALLY BY THE COMMISSIONER BASED  UPON
THE FOLLOWING CRITERIA:
  (A)  THE  EFFICIENCY  AND  EFFECTIVENESS OF THE USE OF FUNDING FOR THE
DEVELOPMENT OF ADEQUATE AND ACCESSIBLE  HOUSING  TO  SUPPORT  VULNERABLE
PERSONS  IN  THE COMMUNITY AND TO ENSURE ACCESS TO SUPPORTS NECESSARY TO
MAXIMIZE EXPECTED OUTCOMES; AND
  (B) OTHER RELEVANT FACTORS RELATING TO  THE  MAINTENANCE  OF  EXISTING
SUPPORTIVE  HOUSING  AND  THE  DEVELOPMENT OF NEW SUPPORTIVE HOUSING AND
ASSOCIATED SERVICES.

S. 6256--D                         12                         A. 9056--D

  3. THE COMMISSIONER SHALL ESTABLISH AN APPLICATION  PROCESS  BY  WHICH
ELIGIBLE APPLICANTS MAY APPLY FOR A GRANT UNDER THIS SECTION. THE APPLI-
CATION SHALL INCLUDE:
  (A)  THE  GEOGRAPHIC  AREA  IN  WHICH  THE  HOUSING/SERVICES  SHALL BE
PROVIDED;
  (B) A DETAILED DESCRIPTION OF THE HOUSING/SERVICES TO BE PROVIDED;
  (C) A PLAN FOR THE EFFICIENT AND EFFECTIVE  USE  OF  FUNDING  FOR  THE
DEVELOPMENT  OF  ADEQUATE  AND  ACCESSIBLE HOUSING TO SUPPORT VULNERABLE
PERSONS IN THE COMMUNITY;
  (D) OTHER RELEVANT FACTORS RELATING TO THE  NEED  FOR  MAINTENANCE  OF
EXISTING  SUPPORTIVE HOUSING AND THE DEVELOPMENT OF NEW SUPPORTIVE HOUS-
ING AND ASSOCIATED SERVICES; AND
  (E) ANY OTHER INFORMATION THAT THE  COMMISSIONER  DEEMS  RELEVANT  AND
APPROPRIATE.
  4.  GRANTEES  UNDER  THIS SECTION SHALL FILE AN ANNUAL REPORT WITH THE
COMMISSIONER, IN SUCH FORM AND WITH SUCH INFORMATION  AND  DATA  AS  THE
COMMISSIONER  PRESCRIBES  DETAILING  THE  EXPENDITURE OF GRANT FUNDS. IN
ADDITION,  THE  COMMISSIONER  IS  AUTHORIZED  AND  EMPOWERED   TO   MAKE
INSPECTIONS  AND EXAMINE RECORDS OF ANY ENTITY FUNDED PURSUANT TO SUBDI-
VISION TWO OF THIS SECTION. SUCH EXAMINATION SHALL INCLUDE ALL  MEDICAL,
SERVICE AND FINANCIAL RECORDS, RECEIPTS, DISBURSEMENTS, CONTRACTS, LOANS
AND OTHER MONEYS RELATING TO THE FINANCIAL OPERATION OF THE PROVIDER.
  5. THE AMOUNT OF SUPPORTIVE HOUSING DEVELOPMENT REINVESTMENT FUNDS FOR
THE  DEPARTMENT  SHALL BE SUBJECT TO ANNUAL APPROPRIATION. THE METHODOL-
OGIES USED TO CALCULATE THE SAVINGS SHALL BE DEVELOPED  BY  THE  COMMIS-
SIONER AND THE DIRECTOR OF THE BUDGET. IN NO EVENT SHALL THE FULL ANNUAL
VALUE  OF SUPPORTIVE HOUSING DEVELOPMENT REINVESTMENT PROGRAMS ATTRIBUT-
ABLE TO INPATIENT HOSPITAL AND NURSING HOME BED  DECERTIFICATION  AND/OR
FACILITY  CLOSURE  EXCEED  THE  TWELVE  MONTH VALUE OF THE DEPARTMENT OF
HEALTH GENERAL  FUND  REDUCTIONS  RESULTING  FROM  SUCH  DECERTIFICATION
AND/OR FACILITY CLOSURE.
  6.  THE  ANNUAL  SUPPORTIVE HOUSING DEVELOPMENT REINVESTMENT APPROPRI-
ATION SHALL REFLECT A PROPORTION OF THE AMOUNT OF GENERAL  FUND  SAVINGS
RESULTING  FROM SUBDIVISION FIVE OF THIS SECTION. WITHIN ANY FISCAL YEAR
WHERE APPROPRIATION INCREASES ARE RECOMMENDED FOR THE SUPPORTIVE HOUSING
DEVELOPMENT REINVESTMENT PROGRAM, INSOFAR  AS  PROJECTED  BED  DECERTIF-
ICATION  AND/OR FACILITY CLOSURES DO NOT OCCUR AS ESTIMATED, AND GENERAL
FUND SAVINGS DO NOT RESULT, THEN THE REINVESTMENT APPROPRIATIONS MAY  BE
REDUCED IN THE NEXT YEAR'S ANNUAL BUDGET ITEMIZATION.
  7.  NO  PROVISION  IN THIS SECTION SHALL CREATE OR BE DEEMED TO CREATE
ANY RIGHT, INTEREST OR ENTITLEMENT TO SERVICES OR FUNDS THAT ARE SUBJECT
TO THIS SECTION, OR TO ANY OTHER SERVICES OR FUNDS, WHETHER TO  INDIVID-
UALS, LOCALITIES, PROVIDERS OR OTHERS, INDIVIDUALLY OR COLLECTIVELY.
  8.  THE  COMMISSIONER SHALL PROMULGATE REGULATIONS, AND MAY PROMULGATE
EMERGENCY REGULATIONS, TO EFFECTUATE THE PROVISIONS OF THIS SECTION.
  S 2. Paragraph (e) of subdivision 1 of section  461-l  of  the  social
services law, as added by chapter 165 of the laws of 1991, is amended to
read as follows:
  (e)  "Services"  shall  mean all services for which full payment to an
assisted living program is included in the capitated  rate  of  payment,
which  shall include personal care services, home care services and such
other services as the commissioner in conjunction with the  commissioner
of health determine by regulation must be included in the capitated rate
of  payment,  and  which  the  assisted living program shall provide, or
arrange for the provision of, through contracts with a  social  services

S. 6256--D                         13                         A. 9056--D

district, [a] long term home health care [program or a] PROGRAMS, certi-
fied home health [agency, and] AGENCIES, AND other qualified providers.
  S  3.  Paragraphs (b) and (d) of subdivision 2 of section 461-l of the
social services law, as added by chapter 165 of the  laws  of  1991  and
subparagraph  (iii)  of  paragraph  (d) as amended by chapter 569 of the
laws of 2000, are amended to read as follows:
  (b) If an assisted living program  itself  is  not  a  certified  home
health agency or long term home health care program, the assisted living
program shall contract with [a] ONE OR MORE certified home health [agen-
cy or] AGENCIES AND/OR long term home health care [program] PROGRAMS for
the  provision  of services pursuant to article thirty-six of the public
health law. [An assisted living program shall contract with no more than
one certified home health agency or long term home health care  program,
provided,  however, that the commissioner and the commissioner of health
may approve additional contracts for good cause.]
  (d) Patient services and care. (i) An assisted living program[, or  if
the  assisted  living  program  itself does not include a long term home
health care program or certified home health agency an  assisted  living
program  and  a  long  term  home  health care program or certified home
health agency,] shall, EITHER DIRECTLY OR THROUGH CONTRACT WITH  A  LONG
TERM  HOME  HEALTH CARE PROGRAM OR CERTIFIED HOME HEALTH AGENCY, conduct
an initial assessment to determine  whether  a  person  would  otherwise
require  placement  in a residential health care facility if not for the
availability of the assisted  living  program  and  is  appropriate  for
admission  to  an assisted living program.  [The assisted living program
shall forward such assessment  of  a  medical  assistance  applicant  or
recipient to the appropriate social services district.]
  (ii)  No  person  shall  be determined eligible for and admitted to an
assisted living program unless the assisted living program [and the long
term home health care program or the certified home health  care  agency
agree, based on the initial assessment,] FINDS that the person meets the
criteria  provided  in  paragraph (d) of subdivision one of this section
[and unless the appropriate social services  district  prior  authorizes
payment for services].
  (iii)  Appropriate  services  shall  be provided to an eligible person
only in accordance with a plan of care which is based  upon  an  initial
assessment  and  periodic  reassessments conducted by an assisted living
program[, or if the assisted living program itself does  not  include  a
long  term  home  health care program or certified home health agency an
assisted living program and a long term  home  health  care  program  or
certified  home health agency], EITHER DIRECTLY OR THROUGH CONTRACT WITH
A LONG TERM HOME HEALTH CARE PROGRAM OR CERTIFIED HOME HEALTH AGENCY.  A
reassessment  shall be conducted as frequently as is required to respond
to changes in the resident's condition and ensure  immediate  access  to
necessary and appropriate services by the resident, but in no event less
frequently than once every six months. No person shall be admitted to or
retained  in  an  assisted  living  program  unless [the assisted living
program, and long term home health care program or certified home health
agency are in agreement that] the person can be  safely  and  adequately
cared  for  with the provision of services determined by such assessment
or reassessment.
  S 4. Paragraph (i) of subdivision 3 of section  461-l  of  the  social
services  law,  as  amended by section 16 of part D of chapter 58 of the
laws of 2009, is amended to read as follows:
  (i) The commissioner of health is authorized to add up to six thousand
assisted living program beds to the  gross  number  of  assisted  living

S. 6256--D                         14                         A. 9056--D

program  beds  having been determined to be available as of April first,
two thousand nine[, provided that, for each assisted living program  bed
so  added,  a nursing home bed has been decertified upon the application
of  the  nursing  home  operator  or that the commissioner of health has
found pursuant to subdivision six of section twenty-eight hundred six of
the public health law that any assisted  living  program  bed  so  added
would  serve  as  a  more appropriate alternative to a certified nursing
home bed and has accordingly limited or revoked  the  operating  certif-
icate  of  the  nursing  home providing that certified nursing home bed,
provided further that nothing]. NOTHING herein shall be  interpreted  as
prohibiting  any  eligible  applicant from submitting an application for
any assisted living program bed so added.  The  commissioner  of  health
shall  not  be  required  to  review on a comparative basis applications
submitted for assisted living program beds  made  available  under  this
paragraph.  The commissioner of health shall only authorize the addition
of six thousand beds pursuant to a five year plan.
  S 4-a. Paragraph (a) of subdivision 6 of section 3614  of  the  public
health law, as amended by section 17 of part D of chapter 58 of the laws
of 2009, is amended to read as follows:
  (a)  The  commissioner  shall,  subject  to  the approval of the state
director of  the  budget,  establish  capitated  rates  of  payment  for
services  provided  by  assisted living programs as defined by paragraph
(a) of subdivision one of section four hundred sixty-one-l of the social
services law.  Such rates of payment shall be related to costs  incurred
by  residential health care facilities. The rates shall reflect the wage
equalization factor established  by  the  commissioner  for  residential
health  care  facilities  in  the  region  in  which the assisted living
program is provided and real property capital construction costs associ-
ated with the construction of a free-standing  assisted  living  program
such rate shall include a payment equal to the cost of interest owed and
depreciation  costs  of  such construction. The rates shall also reflect
the efficient provision  of  a  quality  and  quantity  of  services  to
patients in such residential health care facilities, with needs compara-
ble  to  the needs of residents served in such assisted living programs.
Such rates of payment shall be equal to fifty  percent  of  the  amounts
which otherwise would have been expended, based upon the mean prices for
the  first  of  July,  nineteen  hundred  ninety-two (utilizing nineteen
hundred eighty-three costs) for freestanding, low intensity  residential
health  care facilities with less than three hundred beds, and for years
subsequent to nineteen hundred ninety-two,  adjusted  for  inflation  in
accordance  with  the  provisions  of subdivision ten of section twenty-
eight hundred seven-c of this chapter, to provide the appropriate  level
of  care for such residents in residential health care facilities in the
applicable wage equalization factor regions  plus  an  amount  equal  to
capital  construction  costs  associated  with  the  construction  of an
assisted living program facility as provided for  in  this  subdivision.
THE  COMMISSIONER  SHALL ALSO PROMULGATE REGULATIONS, AND MAY PROMULGATE
EMERGENCY REGULATIONS, TO PROVIDE  FOR  REIMBURSEMENT  OF  THE  COST  OF
PREADMISSION ASSESSMENTS CONDUCTED DIRECTLY BY ASSISTED LIVING PROGRAMS.
  S  5.  Notwithstanding any contrary provision of law, inpatient hospi-
tals licensed pursuant to the mental hygiene law by the office of mental
health shall be subject to audit fees as set forth in regulations issued
by the department of health pursuant to subparagraph (xiii) of paragraph
(D) of subdivision 35 of section 2807-c of the public health  law,  with
regard  to  cost  reports  submitted  to the department of health on and
after April 1, 2012.

S. 6256--D                         15                         A. 9056--D

  S 6. Subdivision 2 of section 365-a of  the  social  services  law  is
amended  by  adding four new paragraphs (w), (x), (y) and (z) to read as
follows:
  (W)  PODIATRY  SERVICES  FOR  INDIVIDUALS WITH A DIAGNOSIS OF DIABETES
MELLITUS; PROVIDED, HOWEVER, THAT THE PROVISIONS OF THIS PARAGRAPH SHALL
NOT TAKE EFFECT UNLESS ALL NECESSARY APPROVALS  UNDER  FEDERAL  LAW  AND
REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL FINANCIAL PARTICIPATION
IN  THE  COSTS  OF  HEALTH CARE SERVICES PROVIDED PURSUANT TO THIS PARA-
GRAPH.
  (X) LACTATION COUNSELING SERVICES FOR PREGNANT  AND  POSTPARTUM  WOMEN
WHEN  SUCH  SERVICES  ARE  ORDERED  BY A PHYSICIAN, REGISTERED PHYSICIAN
ASSISTANT,  REGISTERED  NURSE  PRACTITIONER,  OR  LICENSED  MIDWIFE  AND
PROVIDED  BY  A  CERTIFIED  LACTATION  CONSULTANT,  AS DETERMINED BY THE
COMMISSIONER OF HEALTH; PROVIDED, HOWEVER, THAT THE PROVISIONS  OF  THIS
PARAGRAPH  SHALL  NOT  TAKE  EFFECT UNLESS ALL NECESSARY APPROVALS UNDER
FEDERAL LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL  FINAN-
CIAL  PARTICIPATION IN THE COSTS OF HEALTH CARE SERVICES PROVIDED PURSU-
ANT TO THIS PARAGRAPH. NOTHING IN THIS PARAGRAPH SHALL BE  CONSTRUED  TO
MODIFY ANY LICENSURE, CERTIFICATION OR SCOPE OF PRACTICE PROVISION UNDER
TITLE EIGHT OF THE EDUCATION LAW.
  (Y)  HARM  REDUCTION COUNSELING AND SERVICES TO REDUCE OR MINIMIZE THE
ADVERSE HEALTH CONSEQUENCES ASSOCIATED WITH  DRUG  USE,  PROVIDED  BY  A
QUALIFIED  DRUG  TREATMENT  PROGRAM  OR COMMUNITY-BASED ORGANIZATION, AS
DETERMINED BY THE COMMISSIONER OF HEALTH; PROVIDED,  HOWEVER,  THAT  THE
PROVISIONS  OF THIS PARAGRAPH SHALL NOT TAKE EFFECT UNLESS ALL NECESSARY
APPROVALS UNDER FEDERAL LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE
FEDERAL FINANCIAL PARTICIPATION IN THE COSTS  OF  HEALTH  CARE  SERVICES
PROVIDED  PURSUANT TO THIS PARAGRAPH. NOTHING IN THIS PARAGRAPH SHALL BE
CONSTRUED TO MODIFY ANY LICENSURE, CERTIFICATION OR  SCOPE  OF  PRACTICE
PROVISION UNDER TITLE EIGHT OF THE EDUCATION LAW.
  (Z)  HEPATITIS C WRAP-AROUND SERVICES TO PROMOTE CARE COORDINATION AND
INTEGRATION WHEN ORDERED BY A PHYSICIAN, REGISTERED PHYSICIAN ASSISTANT,
REGISTERED NURSE PRACTITIONER, OR LICENSED MIDWIFE, AND  PROVIDED  BY  A
QUALIFIED  PROFESSIONAL,  AS  DETERMINED  BY THE COMMISSIONER OF HEALTH.
SUCH SERVICES MAY INCLUDE CLIENT OUTREACH, IDENTIFICATION  AND  RECRUIT-
MENT,  HEPATITIS  C  EDUCATION  AND COUNSELING, COORDINATION OF CARE AND
ADHERENCE TO TREATMENT, ASSISTANCE IN OBTAINING APPROPRIATE  ENTITLEMENT
SERVICES, PEER SUPPORT AND OTHER SUPPORTIVE SERVICES; PROVIDED, HOWEVER,
THAT  THE  PROVISIONS OF THIS PARAGRAPH SHALL NOT TAKE EFFECT UNLESS ALL
NECESSARY APPROVALS UNDER FEDERAL LAW AND REGULATION HAVE BEEN  OBTAINED
TO  RECEIVE  FEDERAL FINANCIAL PARTICIPATION IN THE COSTS OF HEALTH CARE
SERVICES PROVIDED PURSUANT TO THIS PARAGRAPH.  NOTHING IN THIS PARAGRAPH
SHALL BE CONSTRUED TO MODIFY ANY LICENSURE, CERTIFICATION  OR  SCOPE  OF
PRACTICE PROVISION UNDER TITLE EIGHT OF THE EDUCATION LAW.
  S  7.  Paragraph  (g)  of subdivision 2 of section 365-a of the social
services law, as amended by section 23 of part H of chapter  59  of  the
laws of 2011, is amended to read as follows:
  (g)  sickroom  supplies,  eyeglasses, prosthetic appliances and dental
prosthetic appliances furnished in accordance with  the  regulations  of
the department; provided further that: (i) the commissioner of health is
authorized  to implement a preferred diabetic supply program wherein the
department of  health  will  receive  enhanced  rebates  from  preferred
manufacturers  of  glucometers and test strips, and may subject non-pre-
ferred manufacturers' glucometers and test strips to prior authorization
under section two hundred seventy-three of the public health  law;  (ii)
enteral  formula  therapy  and  nutritional  supplements  are limited to

S. 6256--D                         16                         A. 9056--D

coverage only for nasogastric, jejunostomy, or gastrostomy tube  feeding
[or],  for  treatment  of  an  inborn  metabolic disorder, or to address
growth and development problems in children, OR,  SUBJECT  TO  STANDARDS
ESTABLISHED  BY  THE  COMMISSIONER,  FOR PERSONS WITH A DIAGNOSIS OF HIV
INFECTION, AIDS OR HIV-RELATED ILLNESS OR OTHER DISEASES AND CONDITIONS;
(iii) prescription footwear and inserts are  limited  to  coverage  only
when  used  as  an  integral part of a lower limb orthotic appliance, as
part of a diabetic treatment plan, or to address growth and  development
problems  in  children;  and  (iv) compression and support stockings are
limited to coverage only for pregnancy or  treatment  of  venous  stasis
ulcers;
  S  8.  Subdivision  9  of  section 4403-c of the public health law, as
added by chapter 649 of the laws of 1996, is amended to read as follows:
  9. Notwithstanding any other provision of  law,  a  comprehensive  HIV
special  needs  plan  certified  pursuant  to  this  section shall limit
enrollment to HIV positive persons [but may enroll related  children  up
to  the  age  of  nineteen], EXCEPT FOR THE FOLLOWING PERSONS WHO MAY BE
ENROLLED regardless of their HIV status[.]:
  (A) RELATED CHILDREN UP TO THE AGE OF TWENTY-ONE; AND
  (B) INDIVIDUALS WHO ARE HOMELESS OR WHO ARE MEMBERS OF OTHER HIGH NEED
POPULATIONS WHICH, IN THE DISCRETION OF THE COMMISSIONER, WOULD  BENEFIT
FROM  RECEIVING  SERVICES  THROUGH  A  PLAN  CERTIFIED  PURSUANT TO THIS
SECTION; PROVIDED HOWEVER, THAT RATES PAID TO SPECIAL  NEEDS  PLANS  FOR
SUCH  POPULATIONS  SHALL  BE COMPARABLE TO RATES PAID FOR THE SAME POPU-
LATIONS IN OTHER MANAGED CARE PLANS.
  S 9.  Paragraph (f) of subdivision 1 of section 367-a  of  the  social
services  law, as added by section 1 of part E of chapter 58 of the laws
of 2008, is amended to read as follows:
  (f) Amounts payable under this title for  medical  assistance  in  the
form  of  outpatient  mental health services under article thirty-one OR
OUTPATIENT  CHEMICAL  DEPENDENCE  SERVICES  INCLUDING  OPIOID  TREATMENT
SERVICES  UNDER ARTICLE THIRTY-TWO of the mental hygiene law provided to
eligible persons who are also beneficiaries under part B of title  XVIII
of  the  federal social security act shall not be less than the approved
medical assistance payment level less the amount payable under part B.
  S 10. Intentionally omitted.
  S 11. Intentionally omitted.
  S 12. Intentionally omitted.
  S 13. Intentionally omitted.
  S 14. Intentionally omitted.
  S 15. Intentionally omitted.
  S 16. Intentionally omitted.
  S 17. Intentionally omitted.
  S 18. Intentionally omitted.
  S 19.  Subdivisions (f) and (g) of section 2522 of the  public  health
law,  as  amended  by chapter 484 of the laws of 2009, are amended and a
new subdivision (h) is added to read as follows:
  (f) follow-up of patient  participation  in  prenatal  care  services;
[and]
  (g)  identification  of regional perinatal health care system barriers
and limitations that lead to poor perinatal outcomes and development  of
strategies to address such barriers and limitations[.]; AND
  (H)  COORDINATION OF SERVICE DELIVERY BY COMMUNITY-BASED ORGANIZATIONS
AMONG HEALTH CARE PROVIDERS AND HEALTH PLANS  USING  HEALTH  INFORMATION
TECHNOLOGY AND UNIFORM SCREENING CRITERIA FOR PERINATAL RISK.

S. 6256--D                         17                         A. 9056--D

  S  20.    Subdivision  6  of section 2818 of the public health law, as
added by section 25-a of part A of chapter 59 of the laws  of  2011,  is
amended to read as follows:
  6.  Notwithstanding  any  contrary provision of this section, sections
one hundred twelve and one hundred sixty-three of the state finance law,
or any other contrary provision of law, subject to  available  appropri-
ations,  funds available for expenditure pursuant to this section may be
distributed by the commissioner without a competitive bid or request for
proposal process for grants to general hospitals and residential  health
care  facilities  for  the purpose of facilitating closures, mergers and
restructuring of such facilities in  order  to  strengthen  and  protect
continued  access  to essential health care resources. PROVIDED HOWEVER,
THAT TO THE EXTENT PRACTICABLE, THE COMMISSIONER SHALL AWARD SUCH GRANTS
EQUITABLY AMONG HEALTH PLANNING  REGIONS  OF  THE  STATE.  Prior  to  an
[awarded] AWARD being granted to an eligible applicant without a compet-
itive bid or request for proposal process, the commissioner shall notify
the  chair  of  the  senate finance committee, the chair of the assembly
ways and means committee and the director of the division of  budget  of
the intent to grant such an award. Such notice shall include information
regarding how the eligible applicant meets criteria established pursuant
to this section.
  S  21.    The  social  services law is amended by adding a new section
461-s to read as follows:
  S 461-S. ENHANCING THE QUALITY OF ADULT LIVING PROGRAM FOR ADULT  CARE
FACILITIES.  1.  THE COMMISSIONER OF HEALTH SHALL ESTABLISH THE ENHANCED
QUALITY OF ADULT LIVING PROGRAM (REFERRED TO  IN  THIS  SECTION  AS  THE
"EQUAL PROGRAM" OR THE "PROGRAM") FOR ADULT CARE FACILITIES. THE PROGRAM
SHALL BE TARGETED AT IMPROVING THE QUALITY OF LIFE FOR ADULT CARE FACIL-
ITY  RESIDENTS  BY MEANS OF GRANTS TO FACILITIES FOR SPECIFIED PURPOSES.
THE DEPARTMENT OF HEALTH, SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE
BUDGET, SHALL DEVELOP AN ALLOCATION METHODOLOGY TAKING INTO ACCOUNT  THE
FINANCIAL STATUS AND SIZE OF THE FACILITY AS WELL AS RESIDENT NEEDS.
  2.  NO  PAYMENT SHALL BE MADE UNDER THE PROGRAM TO A FACILITY THAT HAS
RECEIVED OFFICIAL WRITTEN NOTICE FROM THE DEPARTMENT OF A PROPOSED REVO-
CATION, SUSPENSION, LIMITATION OR DENIAL  OF  THE  OPERATOR'S  OPERATING
CERTIFICATE.
  3. PRIOR TO APPLYING FOR EQUAL PROGRAM FUNDS, A FACILITY SHALL RECEIVE
APPROVAL  OF  ITS  EXPENDITURE  PLAN FROM THE RESIDENTS' COUNCIL FOR THE
FACILITY.
  S 22. Section 366 of the social services law is amended  by  adding  a
new subdivision 15 to read as follows:
  15.  THE COMMISSIONER MAY CONTRACT WITH ONE OR MORE ENTITIES TO ENGAGE
IN  EDUCATION,  OUTREACH SERVICES, AND FACILITATED ENROLLMENT ACTIVITIES
FOR AGED, BLIND, AND DISABLED PERSONS WHO MAY BE ELIGIBLE  FOR  COVERAGE
UNDER THIS TITLE.
  S  23. The public health law is amended by adding a new article 9-B to
read as follows:
                                ARTICLE 9-B
         PRIMARY CARE SERVICE CORPS PRACTITIONER LOAN REPAYMENT
                                 PROGRAM
SECTION 923. DEFINITIONS.
        924. PRIMARY CARE  SERVICE  CORPS  PRACTITIONER  LOAN  REPAYMENT
        PROGRAM.
  S  923.  DEFINITIONS.   THE FOLLOWING WORDS OR PHRASES AS USED IN THIS
SECTION SHALL HAVE THE FOLLOWING MEANINGS:

S. 6256--D                         18                         A. 9056--D

  1. "UNDERSERVED AREA" MEANS AN AREA  OR  MEDICALLY  UNDERSERVED  POPU-
LATION  DESIGNATED  BY  THE COMMISSIONER AS HAVING A SHORTAGE OF PRIMARY
CARE PHYSICIANS, OTHER PRIMARY CARE PRACTITIONERS, DENTAL  PRACTITIONERS
OR MENTAL HEALTH PRACTITIONERS.
  2. "PRIMARY CARE SERVICE CORPS PRACTITIONER" MEANS A PHYSICIAN ASSIST-
ANT,  NURSE PRACTITIONER, MIDWIFE, GENERAL OR PEDODONTIC DENTIST, DENTAL
HYGIENIST,  CLINICAL  PSYCHOLOGIST,  LICENSED  CLINICAL  SOCIAL  WORKER,
PSYCHIATRIC  NURSE PRACTITIONER, LICENSED MARRIAGE AND FAMILY THERAPIST,
OR A LICENSED MENTAL HEALTH COUNSELOR, WHO IS LICENSED,  REGISTERED,  OR
CERTIFIED  TO  PRACTICE  IN  NEW YORK STATE AND WHO PROVIDES COORDINATED
PRIMARY CARE SERVICES, INCLUDING, BUT NOT LIMITED TO,  ORAL  HEALTH  AND
MENTAL HEALTH SERVICES AND MEETS THE NATIONAL HEALTH SERVICE CORPS STATE
LOAN REPAYMENT PROGRAM ELIGIBILITY CRITERIA.
  3.  "PHYSICIAN  ASSISTANT"  MEANS  A PERSON WHO HAS BEEN REGISTERED AS
SUCH PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE-B OF THE  EDUCATION  LAW
AND MEETS THE NATIONAL HEALTH SERVICE CORPS STATE LOAN REPAYMENT PROGRAM
ELIGIBILITY CRITERIA.
  4.  "NURSE PRACTITIONER" MEANS A PERSON WHO HAS BEEN CERTIFIED AS SUCH
PURSUANT TO SECTION SIXTY-NINE HUNDRED TEN  OF  THE  EDUCATION  LAW  AND
MEETS  THE  NATIONAL  HEALTH  SERVICE CORPS STATE LOAN REPAYMENT PROGRAM
ELIGIBILITY CRITERIA.
  5. "MIDWIFE" MEANS A PERSON WHO HAS BEEN LICENSED AS SUCH PURSUANT  TO
SECTION SIXTY-NINE HUNDRED FIFTY-FIVE OF THE EDUCATION LAW AND MEETS THE
NATIONAL  HEALTH  SERVICE CORPS STATE LOAN REPAYMENT PROGRAM ELIGIBILITY
CRITERIA.
  6. "PSYCHOLOGIST" MEANS A PERSON WHO HAS BEEN LICENSED AS SUCH  PURSU-
ANT  TO SECTION SEVENTY-SIX HUNDRED THREE OF THE EDUCATION LAW AND MEETS
THE NATIONAL HEALTH SERVICE CORPS STATE LOAN REPAYMENT PROGRAM ELIGIBIL-
ITY CRITERIA.
  7. "LICENSED CLINICAL SOCIAL WORKER"  MEANS  A  PERSON  WHO  HAS  BEEN
LICENSED  AS  SUCH  PURSUANT TO SECTION SEVENTY-SEVEN HUNDRED TWO OF THE
EDUCATION LAW AND MEETS THE NATIONAL HEALTH  SERVICE  CORPS  STATE  LOAN
REPAYMENT PROGRAM ELIGIBILITY CRITERIA.
  8. "PSYCHIATRIC NURSE PRACTITIONER" MEANS A NURSE PRACTITIONER WHO, BY
REASON OF TRAINING AND EXPERIENCE, PROVIDES A FULL SPECTRUM OF PSYCHIAT-
RIC  CARE, ASSESSING, DIAGNOSING, AND MANAGING THE PREVENTION AND TREAT-
MENT OF PSYCHIATRIC DISORDERS AND MENTAL HEALTH PROBLEMS AND  MEETS  THE
NATIONAL  HEALTH  SERVICE CORPS STATE LOAN REPAYMENT PROGRAM ELIGIBILITY
CRITERIA.
  9. "LICENSED MARRIAGE AND FAMILY THERAPIST" MEANS  A  PERSON  WHO  HAS
BEEN  LICENSED  AS SUCH PURSUANT TO SECTION EIGHTY-FOUR HUNDRED THREE OF
THE EDUCATION LAW AND MEETS THE NATIONAL HEALTH SERVICE CORPS STATE LOAN
REPAYMENT PROGRAM ELIGIBILITY CRITERIA.
  10. "LICENSED MENTAL HEALTH COUNSELOR" MEANS A  PERSON  WHO  HAS  BEEN
LICENSED  AS  SUCH  PURSUANT  TO  SECTION EIGHTY-FOUR HUNDRED TWO OF THE
EDUCATION LAW AND MEETS THE NATIONAL HEALTH  SERVICE  CORPS  STATE  LOAN
REPAYMENT PROGRAM ELIGIBILITY CRITERIA.
  11.  "GENERAL  OR  PEDODONTIC  DENTIST"  MEANS  A  PERSON WHO HAS BEEN
LICENSED OR OTHERWISE AUTHORIZED TO PRACTICE DENTISTRY PURSUANT TO ARTI-
CLE ONE HUNDRED THIRTY-THREE OF THE EDUCATION  LAW  EXCLUDING  ORTHODON-
TISTS,  ENDODONTISTS  AND  PERIODONTISTS  AND  MEETS THE NATIONAL HEALTH
SERVICE CORPS STATE LOAN REPAYMENT PROGRAM ELIGIBILITY CRITERIA.
  12. "DENTAL HYGIENIST" MEANS A PERSON  WHO  IS  LICENSED  TO  PRACTICE
DENTAL  HYGIENE PURSUANT TO SECTION SIXTY-SIX HUNDRED NINE OF THE EDUCA-
TION LAW AND MEETS THE NATIONAL HEALTH SERVICE CORPS STATE  LOAN  REPAY-
MENT PROGRAM ELIGIBILITY CRITERIA.

S. 6256--D                         19                         A. 9056--D

  S 924. PRIMARY CARE SERVICE CORPS PRACTITIONER LOAN REPAYMENT PROGRAM.
1. THE COMMISSIONER IS AUTHORIZED, WITHIN AMOUNTS AVAILABLE THEREFOR, TO
MAKE  LOAN REPAYMENT AWARDS TO ELIGIBLE PRIMARY CARE SERVICE CORPS PRAC-
TITIONERS WHO AGREE TO PRACTICE FULL-TIME IN AN UNDERSERVED AREA IN  NEW
YORK  STATE, IN AMOUNTS TO BE DETERMINED BY THE COMMISSIONER, BUT NOT TO
EXCEED THIRTY-TWO THOUSAND DOLLARS PER YEAR FOR ANY YEAR IN  WHICH  SUCH
PRACTITIONERS PROVIDE FULL-TIME ELIGIBLE OBLIGATED SERVICE.
  2.  LOAN REPAYMENT AWARDS MADE TO A PRIMARY CARE SERVICE CORPS PRACTI-
TIONER PURSUANT TO SUBDIVISION ONE OF THIS SECTION SHALL NOT EXCEED  THE
TOTAL QUALIFYING OUTSTANDING DEBT OF THE PRACTITIONER FROM STUDENT LOANS
TO  COVER  TUITION  AND  OTHER  RELATED EDUCATIONAL EXPENSES, MADE BY OR
GUARANTEED BY THE FEDERAL OR STATE GOVERNMENT, OR MADE BY A  LENDING  OR
EDUCATIONAL  INSTITUTION  APPROVED  UNDER TITLE IV OF THE FEDERAL HIGHER
EDUCATION ACT. LOAN REPAYMENT AWARDS SHALL BE USED SOLELY TO REPAY  SUCH
OUTSTANDING DEBT.
  3.  IN  THE EVENT THAT ANY COMMITMENT PURSUANT TO THE AGREEMENT REFER-
ENCED IN SUBDIVISION ONE OF THIS SECTION IS NOT FULFILLED, THE RECIPIENT
SHALL BE RESPONSIBLE FOR REPAYMENT IN AMOUNTS WHICH SHALL BE  CALCULATED
IN  ACCORDANCE  WITH THE FORMULA SET FORTH IN SUBDIVISION (B) OF SECTION
TWO HUNDRED FIFTY-FOUR-O OF TITLE FORTY-TWO OF THE UNITED  STATES  CODE,
AS AMENDED.
  4.  THE  COMMISSIONER  IS  AUTHORIZED TO APPLY ANY FUNDS AVAILABLE FOR
PURPOSES OF SUBDIVISION ONE OF THIS SECTION FOR USE  AS  MATCHING  FUNDS
FOR  ANY AVAILABLE FEDERAL GRANTS FOR THE PURPOSE OF ASSISTING STATES IN
OPERATING LOAN REPAYMENT PROGRAMS.
  5. THE COMMISSIONER MAY POSTPONE, CHANGE OR WAIVE  THE  SERVICE  OBLI-
GATION AND REPAYMENTS AMOUNTS SET FORTH IN SUBDIVISIONS ONE AND THREE OF
THIS  SECTION,  RESPECTIVELY, IN INDIVIDUAL CIRCUMSTANCES WHERE THERE IS
COMPELLING NEED OR HARDSHIP.
  6. IN ORDER TO BE ELIGIBLE TO RECEIVE A  LOAN  REPAYMENT  AWARD  UNDER
THIS  SECTION,  A PRIMARY CARE SERVICE CORPS PRACTITIONER MUST MEET SITE
AND SERVICE ELIGIBILITY CRITERIA AS DETERMINED BY THE COMMISSIONER.
  7. THE COMMISSIONER SHALL PROMULGATE REGULATIONS NECESSARY TO EFFECTU-
ATE THE PROVISIONS AND PURPOSES OF THIS ARTICLE.
  S 24. Intentionally omitted.
  S 25. Intentionally omitted.
  S 26. Section 2803 of the public health law is amended by adding a new
subdivision 8-a to read as follows:
  8-A. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW TO THE  CONTRA-
RY,  THE COMMISSIONER SHALL DEVELOP A PROGRAM TO FACILITATE THE USE OF A
TRIAGE SYSTEM OF CARE IN EMERGENCY ROOMS OF HOSPITALS THAT  ARE  SUBJECT
TO  THE  PROVISIONS  OF  THIS  ARTICLE.  IN  DEVELOPING SUCH PROGRAM THE
COMMISSIONER SHALL CONSIDER THE MANNER IN WHICH SUCH A SYSTEM  WOULD  BE
COORDINATED, HOW SUCH A SYSTEM WOULD PROVIDE GREATER EFFICIENCY, PROVIDE
COST  SAVINGS  TO  PUBLIC  HEALTH PROGRAMS AND A HIGHER QUALITY OF CARE.
WITHIN ONE YEAR FROM THE ENACTMENT OF  SUCH  PROGRAM,  THE  COMMISSIONER
SHALL  SUBMIT  A REPORT TO THE TEMPORARY PRESIDENT OF THE SENATE AND THE
SPEAKER OF THE ASSEMBLY REGARDING: THE IMPACT OF SUCH A  SYSTEM  ON  THE
COST  OF  MEDICAID  COVERED SERVICES IN THE HOSPITAL SETTING; QUALITY OF
CARE IN FACILITIES; ALONG WITH ANY OTHER DATA AS MAY BE APPROPRIATE.
  S 27. Intentionally omitted.
  S 28. Section 2 of chapter 584 of  the  laws  of  2011,  amending  the
public  authorities law, relating to the powers and duties of the dormi-
tory authority of the state of New York relative to the establishment of
subsidiaries for certain purposes, is amended to read as follows:

S. 6256--D                         20                         A. 9056--D

  S 2. This act shall take effect immediately and shall  expire  and  be
deemed repealed ON July 1, [2012] 2014; provided however, that the expi-
ration  of  this  act  shall  not  impair or otherwise affect any of the
powers, duties, responsibilities, functions, rights  or  liabilities  of
any  subsidiary  duly  created  pursuant  to  subdivision twenty-five of
section 1678 of the public authorities law prior to such expiration.
  S 28-a. Paragraph (a) of subdivision 25 of section 1678 of the  public
authorities  law,  as  amended  by  chapter  584 of the laws of 2011, is
amended to read as follows:
  (a) To form one or more subsidiaries for the purpose of  limiting  the
potential  liability  of  the  authority  when exercising the powers and
duties conferred upon the authority by THIS article [eight of this chap-
ter] in connection with  the  exercise  of  remedies  by  the  authority
against  any borrower REGULATED UNDER ARTICLE TWENTY-EIGHT OF THE PUBLIC
HEALTH LAW that has defaulted in its obligations under its  loan  agree-
ment  or  mortgage  with the authority and for which an event of default
has been declared by the authority. Each such subsidiary created  pursu-
ant  to  this  subdivision  may  exercise and perform one or more of the
purposes, powers, duties, functions, rights and responsibilities of  the
authority  (other  than the issuance of indebtedness) in connection with
real and personal property with respect to which the authority holds  or
held  a mortgage, security interest or other collateral interest includ-
ing: (i) bidding for, taking, holding, selling, conveying, assigning  or
transferring   title  to  such  property;  (ii)  entering  into  leases,
subleases, operating agreements, security agreements, loan agreements or
other encumbrances or arrangements with  regard  to  such  property  and
acting  in a manner consistent with the rights, obligations or responsi-
bilities of the owner of such property pursuant to  such  agreements  or
encumbrances;  (iii)  assuming  any  indebtedness  or  other liabilities
secured by such property. Notwithstanding any other provision of law  to
the  contrary,  but  in  all  instances subject to the provisions of any
contract with bondholders, the transfer of title to any such  subsidiary
or  any  other  actions  taken  by  the  authority or such subsidiary to
enforce the authority's rights under the mortgage, security interest  or
other  collateral  interest or to protect, acquire, manage or dispose of
the property shall be deemed to be a corporate purpose of the  authority
and  shall  not  impair  the validity of any bonds, notes or other obli-
gations of the authority to which the  mortgage,  security  interest  or
other collateral interest relates.
  S  29.    Subdivision 1 of section 2999-i of the public health law, as
added by section 52 of part H of chapter 59 of  the  laws  of  2011,  is
amended to read as follows:
  1. (A) The commissioner of taxation and finance shall be the custodian
of  the  fund  and  the  special account established pursuant to section
ninety-nine-t of the state finance law. All payments from the fund shall
be made by the commissioner of taxation and  finance  upon  certificates
signed by the superintendent of financial services, or his or her desig-
nee,  as hereinafter provided. The fund shall be separate and apart from
any other fund and from all other state monies; PROVIDED, HOWEVER,  THAT
MONIES OF THE FUND MAY BE INVESTED AS SET FORTH IN PARAGRAPH (B) OF THIS
SUBDIVISION.   No monies from the fund shall be transferred to any other
fund, nor shall any such monies be applied to the making of any  payment
for any purpose other than the purpose set forth in this title.
  (B)  ANY MONIES OF THE FUND NOT REQUIRED FOR IMMEDIATE USE MAY, AT THE
DISCRETION OF THE COMMISSIONER OF  FINANCIAL  SERVICES  IN  CONSULTATION
WITH  THE  COMMISSIONER  OF  HEALTH  AND  THE DIRECTOR OF THE BUDGET, BE

S. 6256--D                         21                         A. 9056--D

INVESTED BY THE COMMISSIONER OF TAXATION AND FINANCE IN  OBLIGATIONS  OF
THE UNITED STATES OR THE STATE OR OBLIGATIONS THE PRINCIPAL AND INTEREST
OF  WHICH ARE GUARANTEED BY THE UNITED STATES OR THE STATE. THE PROCEEDS
OF  ANY  SUCH  INVESTMENT  SHALL BE RETAINED BY THE FUND AS ASSETS TO BE
USED FOR THE PURPOSES OF THE FUND.
  S 30. Intentionally omitted.
  S 31. Paragraph (b) of subdivision 1-a of section 2802 of  the  public
health law, as amended by chapter 174 of the laws of 2011, is amended to
read as follows:
  (b)  repair  or  maintenance,  regardless  of  cost, including routine
purchases and the acquisition  of  minor  equipment  undertaken  in  the
course  of  a  hospital's inventory control functions; PROVIDED THAT FOR
PROJECTS UNDER THIS PARAGRAPH WITH A TOTAL COST OF  UP  TO  SIX  MILLION
DOLLARS, NO WRITTEN NOTICE SHALL BE REQUIRED;
  S  32.   Subdivision 1 of section 1 of chapter 119 of the laws of 1997
relating to authorizing the department of health  to  establish  certain
payments  to  general  hospitals,  as amended by section 1 of part S2 of
chapter 62 of the laws of 2003, is amended to read as follows:
  1. Notwithstanding any inconsistent provision of  law  or  regulation,
effective for the period [April 1, 1997 through March 31, 1998] APRIL 1,
2012  THROUGH DECEMBER 31, 2012 and for annual periods beginning [April]
JANUARY 1 thereafter, the [department] DEPARTMENT of [health] HEALTH  is
authorized  to  pay voluntary non-profit general hospitals as defined in
subdivision 10 of section 2801  of  the  public  health  law  additional
payments  for inpatient hospital services as medical assistance payments
pursuant to title 11 of article 5 of the social services law and federal
law and regulations governing disproportionate share payments, based  on
the  [amount  of state aid for which such general hospitals are eligible
pursuant to articles 25, 26 and 41 of the  mental  hygiene  law  and  as
identified in subdivision 2 of this section] COSTS INCURRED IN EXCESS OF
REVENUES BY GENERAL HOSPITALS IN PROVIDING SERVICES IN ELIGIBLE PROGRAMS
TO  UNINSURED  PATIENTS  AND  PATIENTS  ELIGIBLE FOR MEDICAL ASSISTANCE.
Payment made pursuant to this section shall not exceed each such general
hospital's cost of providing services to uninsured patients and patients
eligible for medical assistance pursuant to title 11 of article 5 of the
social services law after taking into consideration  all  other  medical
assistance  received,  including disproportionate share payments made to
such general hospital, and payments from or on behalf of such  uninsured
patients, and shall also not exceed the total amount of state aid, iden-
tified  by  subdivision  2  of  this  section, available to such general
hospital by law. Payments made to such  general  hospitals  pursuant  to
this  section  shall be made in lieu of any state aid payments available
to such general hospital by law.
  S 33. Intentionally omitted.
  S 33-a. Intentionally omitted.
  S 33-b. Intentionally omitted.
  S 33-c. Intentionally omitted.
  S 33-d. Intentionally omitted.
  S 33-e. Intentionally omitted.
  S 33-f. Intentionally omitted.
  S 33-g. Intentionally omitted.
  S 34.  Subdivision 25 of section 2808 of the  public  health  law,  as
added  by  section  31  of  part  B  of chapter 109 of the laws of 2010,
subparagraph (iii) of paragraph (b) as amended and subparagraph (iv)  of
paragraph (b) as added by section 69 of part H of chapter 59 of the laws
of 2011, is amended to read as follows:

S. 6256--D                         22                         A. 9056--D

  25.  Reserved  bed  days.  (a)  For  purposes  of  this subdivision, a
"reserved bed day" is a day for which a governmental agency pays a resi-
dential health care facility to reserve a bed for a person eligible  for
medical  assistance  pursuant  to  title  eleven  of article five of the
social  services  law  while he or she is temporarily hospitalized or on
leave of absence from the facility.
  (b) Notwithstanding any other provisions of this section or any  other
law  or  regulation  to  the contrary, for reserved bed days provided on
behalf of persons twenty-one years of age or older:
  (i) payments for reserved  bed  days  shall  be  made  at  ninety-five
percent  of  the  Medicaid  rate  otherwise  payable to the facility for
services provided on behalf of such person;
  (ii) payment to a facility for reserved bed days provided on behalf of
such person for temporary hospitalizations may not exceed fourteen  days
in any twelve month period;
  (iii)  payment  to a facility for reserved bed days provided on behalf
of such person for non-hospitalization leaves of absence may not  exceed
ten days in any twelve month period[; and
  (iv)  payments  for  reserved  bed days for temporary hospitalizations
shall only be made to a residential health care  facility  if  at  least
fifty  percent  of the facility's residents eligible to participate in a
Medicare managed care plan are enrolled in such a plan].
  (C)(I) NOTWITHSTANDING ANY CONTRARY PROVISION OF THIS  SUBDIVISION  OR
ANY  OTHER  LAW  AND  SUBJECT  TO  THE AVAILABILITY OF FEDERAL FINANCIAL
PARTICIPATION, WITH REGARD TO SERVICES PROVIDED  TO  RESIDENTIAL  HEALTH
CARE  FACILITY  RESIDENTS TWENTY-ONE YEARS OF AGE AND OLDER, THE COMMIS-
SIONER SHALL PROMULGATE REGULATIONS, AND MAY PROMULGATE EMERGENCY  REGU-
LATIONS,  EFFECTIVE  FOR  PERIODS  ON AND AFTER JULY FIRST, TWO THOUSAND
TWELVE, ESTABLISHING REIMBURSEMENT RATES FOR RESERVED BED DAYS.
  (II) SUCH REGULATIONS SHALL, FOR EACH MEDICAID PATIENT FOR ANY  TWELVE
MONTH  PERIOD,  PROVIDE FOR REIMBURSEMENT FOR RESERVED BED DAYS FOR: (A)
UP TO AN AGGREGATE OF FOURTEEN DAYS FOR HOSPITALIZATIONS AND  FOR  OTHER
THERAPEUTIC  LEAVE OF ABSENCES CONSISTENT WITH A PLAN OF CARE ORDERED BY
SUCH PATIENT'S TREATING HEALTH CARE  PROFESSIONAL;  AND  (B)  UP  TO  AN
AGGREGATE OF TEN DAYS OF OTHER LEAVES OF ABSENCE.
  (III)  NO  LATER  THAN  THIRTY  DAYS  AFTER PROMULGATION OF SUCH REGU-
LATIONS, THE COMMISSIONER SHALL ADVISE THE  CHAIRS  OF  THE  SENATE  AND
ASSEMBLY  FINANCE  AND  HEALTH  COMMITTEES  OF  THE PROJECTED REDUCTIONS
EXPECTED TO BE ACHIEVED UNDER THE METHODOLOGY SET FORTH  IN  SUCH  REGU-
LATIONS.
  (IV)  IN  THE  EVENT THE COMMISSIONER DETERMINES, IN CONSULTATION WITH
THE DIRECTOR OF THE BUDGET, THAT THE REGULATIONS PROMULGATED PURSUANT TO
SUBPARAGRAPH (I) OF THIS PARAGRAPH  SHALL  ACHIEVE  PROJECTED  AGGREGATE
MEDICAID  SAVINGS, AS DETERMINED BY THE COMMISSIONER, OF LESS THAN FORTY
MILLION DOLLARS FOR THE STATE FISCAL YEAR  BEGINNING  APRIL  FIRST,  TWO
THOUSAND TWELVE, AND EACH STATE FISCAL YEAR THEREAFTER, THE COMMISSIONER
SHALL  ESTABLISH  A PROSPECTIVE PER DIEM RATE ADJUSTMENT FOR ALL NURSING
HOMES, OTHER THAN NURSING HOMES PROVIDING SERVICES PRIMARILY TO CHILDREN
UNDER THE AGE OF TWENTY-ONE, SUFFICIENT TO ACHIEVE  SUCH  FORTY  MILLION
DOLLARS IN SAVINGS FOR EACH SUCH STATE FISCAL YEAR.
  S  34-a. Notwithstanding any contrary provision of law, the department
of health shall consult with stakeholders  about  effectively  extending
managed  long  term care to the nursing home population in a manner that
reasonably addresses concerns regarding capital financing and its impact
on payment rates.

S. 6256--D                         23                         A. 9056--D

  S 34-b. Workgroup on medicaid payment for services for medically frag-
ile children. 1. The commissioner of health and the commissioner of  the
office  for  people  with  developmental  disabilities shall convene and
co-chair, directly or through a designee or designees,  a  workgroup  on
Medicaid  payment  for services for medically fragile children (referred
to in this section as the "workgroup") to make  recommendations  on  the
adequacy  and  viability  of Medicaid payment rates to certain pediatric
providers who provide critical services for medically  fragile  children
including  recommendations  on  appropriate models for care coordination
and the transition of the pediatric nursing home population and  benefit
into Medicaid managed care, including home care agencies affiliated with
pediatric  nursing  homes  and  diagnostic  and  treatment centers which
primarily serve medically fragile children.
  2. The workgroup shall be comprised of stakeholders of medically frag-
ile children, including providers or representatives of pediatric  nurs-
ing  homes,  home  care  agencies affiliated with such pediatric nursing
homes  and  diagnostic  and  treatment  centers  which  primarily  serve
medically  fragile children (including pediatric rehabilitation diagnos-
tic and treatment centers), representatives  of  families  of  medically
fragile children, and other experts on Medicaid payment for services for
medically fragile children. Members (other than representatives of fami-
lies  of  medically  fragile children) shall have demonstrated knowledge
and experience in providing care to medically fragile children in pedia-
tric nursing homes  and  diagnostic  and  treatment  centers,  including
providers  who  provide  care  primarily  to the Medicaid population, or
expertise in Medicaid  payment  for  such  services.  Members  shall  be
permitted to participate in workgroup meetings by telephone or videocon-
ference,  and  reasonable efforts shall be made to enhance opportunities
for in-person participation in meetings by  members  who  are  represen-
tatives of families of medically fragile children.
  3. The commissioners shall present the findings and recommendations of
the department of health, the office for people with developmental disa-
bilities  and  the  workgroup  to  the governor, the chair of the senate
finance committee, the chair of the assembly ways and  means  committee,
the  chair  of the senate health committee and the chair of the assembly
health committee by October 1, 2012 at which time  the  workgroup  shall
terminate  its  work  and be relieved of all responsibilities and duties
hereunder. During the timeframe in which the workgroup is  deliberating,
the commissioner of health shall take steps to assist pediatric rehabil-
itation clinics.
  S  35. Paragraphs (l) and (m) of subdivision 1 of section 367-q of the
social services law, as added by section 22 of part C of chapter  59  of
the laws of 2011, are amended to read as follows:
  (l)  for  the  period  April  first, two thousand twelve through March
thirty-first, two thousand thirteen, UP  TO  twenty-eight  million  five
hundred thousand dollars; and
  (m)  for  the  period April first, two thousand thirteen through March
thirty-first, two thousand fourteen, UP  TO  twenty-eight  million  five
hundred thousand dollars.
  S  35-a.  Clause (K) of subparagraph (i) of paragraph (bb) of subdivi-
sion 1 of section 2807-v of the public health law, as amended by section
8 of part C of chapter 59 of the laws of 2011, is  amended  to  read  as
follows:
  (K)  UP  TO  one  hundred thirty-six million dollars each state fiscal
year for the period April first, two thousand eleven through March thir-
ty-first, two thousand fourteen.

S. 6256--D                         24                         A. 9056--D

  S 35-b. Subparagraph (xi)  of  paragraph  (cc)  of  subdivision  1  of
section 2807-v of the public health law, as amended by section 8 of part
C of chapter 59 of the laws of 2011, is amended to read as follows:
  (xi)  UP  TO  eleven  million  two hundred thousand dollars each state
fiscal year for the period April  first,  two  thousand  eleven  through
March thirty-first, two thousand fourteen.
  S  35-c.  Subparagraph  (vii)  of  paragraph (ccc) of subdivision 1 of
section 2807-v of the public health law, as amended by section 8 of part
C of chapter 59 of the laws of 2011, is amended to read as follows:
  (vii) UP TO fifty million dollars each state fiscal year for the peri-
od April first, two thousand  eleven  through  March  thirty-first,  two
thousand fourteen.
  S  36. The public health law is amended by adding a new section 2807-z
to read as follows:
  S 2807-Z.  LIMITED OR ADMINISTRATIVE REVIEW.  1.  NOTWITHSTANDING  ANY
PROVISION OF THIS CHAPTER OR REGULATIONS OR ANY OTHER STATE LAW OR REGU-
LATION,  FOR  ANY ELIGIBLE CAPITAL PROJECT AS DEFINED IN SUBDIVISION SIX
OF THIS SECTION, THE DEPARTMENT SHALL HAVE THIRTY DAYS OF RECEIPT OF THE
CERTIFICATE OF NEED APPLICATION FOR A LIMITED OR  ADMINISTRATIVE  REVIEW
TO  DEEM  SUCH  APPLICATION  COMPLETE.  IF THE DEPARTMENT DETERMINES THE
APPLICATION IS INCOMPLETE OR THAT  MORE  INFORMATION  IS  REQUIRED,  THE
DEPARTMENT  SHALL  NOTIFY THE APPLICANT IN WRITING WITHIN THIRTY DAYS OF
THE DATE OF THE APPLICATION'S SUBMISSION, AND THE APPLICANT  SHALL  HAVE
TWENTY  BUSINESS  DAYS  TO  PROVIDE  ADDITIONAL INFORMATION OR OTHERWISE
CORRECT THE DEFICIENCY IN THE APPLICATION.
  2. FOR AN ELIGIBLE CAPITAL PROJECT REQUIRING A LIMITED OR  ADMINISTRA-
TIVE  REVIEW,  WITHIN NINETY DAYS OF THE DEPARTMENT DEEMING THE APPLICA-
TION COMPLETE, THE DEPARTMENT SHALL MAKE A DECISION TO APPROVE  (AND  IN
THE  CASE  OF  LIMITED  REVIEWS)  OR  DISAPPROVE THE CERTIFICATE OF NEED
APPLICATION FOR SUCH PROJECT. IF THE DEPARTMENT DETERMINES TO DISAPPROVE
THE PROJECT, THE BASIS FOR SUCH DISAPPROVAL SHALL BE PROVIDED  IN  WRIT-
ING;  HOWEVER,  DISAPPROVAL  SHALL NOT BE BASED ON THE INCOMPLETENESS OF
THE APPLICATION. IF THE DEPARTMENT FAILS TO TAKE ACTION  TO  APPROVE  OR
DISAPPROVE THE APPLICATION WITHIN NINETY DAYS OF THE CERTIFICATE OF NEED
APPLICATION  BEING  DEEMED  COMPLETE,  THE  APPLICATION  WILL  BE DEEMED
APPROVED.
  3. FOR AN ELIGIBLE CAPITAL PROJECT REQUIRING FULL REVIEW BY THE PUBLIC
HEALTH AND HEALTH PLANNING COUNCIL, THE CERTIFICATE OF NEED  APPLICATION
SHALL  BE PLACED ON THE NEXT PHHPC AGENDA FOLLOWING THE DEPARTMENT DEEM-
ING THE APPLICATION COMPLETE.
  4. WHERE THE COMMISSIONER OR  DEPARTMENT  REQUIRES  THE  APPLICANT  TO
SUBMIT  A  CONTINGENCY  SUBMISSION  FOR AN ELIGIBLE CAPITAL PROJECT, THE
COMMISSIONER OR DEPARTMENT SHALL HAVE THIRTY DAYS TO REVIEW AND  APPROVE
OR DISAPPROVE THE CONTINGENCY SUBMISSION. IF THE COMMISSIONER OR DEPART-
MENT  DETERMINES THAT THE CONTINGENCY SUBMISSION IS INCOMPLETE, IT SHALL
SO NOTIFY THE APPLICANT IN WRITING AND PROVIDE THE  APPLICANT  WITH  TEN
BUSINESS  DAYS  TO CORRECT THE DEFICIENCY OR PROVIDE ADDITIONAL INFORMA-
TION. IF THE COMMISSIONER OR DEPARTMENT  DETERMINES  TO  DISAPPROVE  THE
CONTINGENCY  OF  THE SUBMISSION, THE BASIS FOR SUCH DISAPPROVAL SHALL BE
PROVIDED IN WRITING; HOWEVER, DISAPPROVAL SHALL  NOT  BE  BASED  ON  THE
INCOMPLETENESS  OF  THE  APPLICATION.  WITHIN  FIFTEEN  DAYS OF COMPLETE
CONTINGENCY SATISFACTION, THE COMMISSIONER OR DEPARTMENT SHALL  TRANSMIT
THE FINAL APPROVAL LETTER TO THE APPLICANT.
  5. THE DEPARTMENT SHALL DEVELOP EXPEDITED PRE-OPENING SURVEY PROCESSES
FOR  ELIGIBLE  CAPITAL  PROJECTS  APPROVED UNDER SUBDIVISION ONE OF THIS

S. 6256--D                         25                         A. 9056--D

SECTION, BUT UNDER NO CIRCUMSTANCES SHALL PRE-OPENING SURVEY REVIEWS  BE
SCHEDULED LATER THAN THIRTY DAYS AFTER FINAL APPROVAL.
  6. "ELIGIBLE CAPITAL PROJECT" SHALL MEAN:
  (A)  A  PROJECT  WHOSE  TOTAL  BUDGET IS THREE MILLION DOLLARS OR MORE
FUNDED WITH FEDERAL MONIES PURSUANT TO SECTION 330 OF THE PUBLIC  HEALTH
SERVICE (PHS), 42 USC 254B, AS AMENDED; OR
  (B)  A  PROJECT  WHOSE  TOTAL  BUDGET IS THREE MILLION DOLLARS OR MORE
FUNDED WITH FEDERAL MONIES PURSUANT TO THE FEDERAL CAPITAL  DEVELOPMENT-
BUILDING  CAPACITY (CD-BC) GRANT PROGRAM AND IMMEDIATE FACILITY IMPROVE-
MENTS (CD-IFI) GRANT PROGRAM, AS AUTHORIZED BY  THE  PATIENT  PROTECTION
AND  AFFORDABLE  CARE  ACT (AFFORDABLE CARE ACT)((P.L. 111-148), SECTION
10503(C)).
  CAPITAL PROTECTS FUNDED IN WHOLE OR IN PART THROUGH SECTION 330 OF THE
PUBLIC HEALTH SERVICE (PHS), 42 USC 254B, AS  AMENDED,  OR  WHOSE  TOTAL
BUDGET  IS  LESS  THAN THREE MILLION DOLLARS SHALL NOT BE SUBJECT TO THE
PROVISIONS OF THIS SECTION OR THE FEDERAL  CAPITAL  DEVELOPMENT-BUILDING
CAPACITY  (CD-BC)  GRANT  PROGRAM  AND  IMMEDIATE  FACILITY IMPROVEMENTS
(CD-IFI) GRANT PROGRAM, AS AUTHORIZED  BY  THE  PATIENT  PROTECTION  AND
AFFORDABLE  CARE  ACT  (AFFORDABLE  CARE  ACT)((P.L.   111-148), SECTION
10503(C)), SHALL NOT BE SUBJECT TO THE REQUIREMENTS SET  FORTH  IN  THIS
SECTION  OR  ANY  OTHER  LAW OR REGULATION REGARDING CERTIFICATE OF NEED
PROCESS OR REQUIREMENTS.
  S 37. Subdivision 6 of section 368-d of the social  services  law,  as
added  by  section  6  of  part  H of chapter 59 of the laws of 2011, is
amended to read as follows:
  6. The commissioner shall evaluate the results of the study  conducted
pursuant  to  subdivision four of this section to determine, after iden-
tification of actual direct and indirect costs incurred by public school
districts and state operated[/] AND state supported  schools  FOR  BLIND
AND  DEAF  STUDENTS, whether it is advisable to claim federal reimburse-
ment for expenditures under this section as  certified  public  expendi-
tures.  In the event such claims are submitted, if federal reimbursement
received for certified public expenditures on behalf of medical  assist-
ance  recipients  whose  assistance and care are the responsibility of a
social services district [in a  city  with  a  population  of  over  two
million,]  results  in  a decrease in the state share of annual expendi-
tures pursuant to this section for such recipients, then to  the  extent
that  the amount of any such decrease when combined with any decrease in
the state share of annual expenditures described in subdivision five  of
section  three  hundred  sixty-eight-e of this title exceeds ONE HUNDRED
fifty million dollars FOR THE PERIOD APRIL 1,  2011  THROUGH  MARCH  31,
2013,  OR EXCEEDS ONE HUNDRED MILLION DOLLARS IN STATE FISCAL YEAR 2012-
13 OR ANY FISCAL YEAR THEREAFTER, the excess amount shall be transferred
to such [city] PUBLIC SCHOOL DISTRICTS  AND  STATE  OPERATED  AND  STATE
SUPPORTED SCHOOLS FOR BLIND AND DEAF STUDENTS IN AMOUNTS PROPORTIONAL TO
THEIR PERCENTAGE CONTRIBUTION TO THE STATEWIDE SAVINGS.  Any such excess
amount  transferred  shall  not be considered a revenue received by such
social services district in determining the  district's  actual  medical
assistance  expenditures for purposes of paragraph (b) of section one of
part C of chapter fifty-eight of the laws of two thousand five.
  S 38. Subdivision 5 of section 368-e of the social  services  law,  as
added  by  section  7  of  part  H of chapter 59 of the laws of 2011, is
amended to read as follows:
  5. The commissioner shall evaluate the results of the study  conducted
pursuant  to subdivision three of this section to determine, after iden-
tification of actual direct and indirect costs incurred by counties  for

S. 6256--D                         26                         A. 9056--D

medical  care,  services,  and supplies furnished to pre-school children
with handicapping conditions, whether it is advisable to  claim  federal
reimbursement  for  expenditures  under this section as certified public
expenditures.  In  the  event  such  claims  are  submitted,  if federal
reimbursement received for certified public expenditures  on  behalf  of
medical  assistance recipients whose assistance and care are the respon-
sibility of a social services district [in a city with a  population  of
over  two  million],  results in a decrease in the state share of annual
expenditures pursuant to this section for such recipients, then  to  the
extent  that  the  amount  of  any  such decrease when combined with any
decrease in the state share of annual expenditures described in subdivi-
sion six of section three hundred sixty-eight-d of  this  title  exceeds
ONE  HUNDRED  fifty million dollars FOR THE PERIOD APRIL 1, 2011 THROUGH
MARCH 31, 2013, OR EXCEEDS ONE HUNDRED MILLION DOLLARS IN  STATE  FISCAL
YEAR  2012-13  OR ANY FISCAL YEAR THEREAFTER, the excess amount shall be
transferred to such [city] COUNTIES IN  AMOUNTS  PROPORTIONAL  TO  THEIR
PERCENTAGE  CONTRIBUTION  TO  THE  STATEWIDE  SAVINGS.   Any such excess
amount transferred shall not be considered a revenue  received  by  such
social  services  district  in determining the district's actual medical
assistance expenditures for purposes of paragraph (b) of section one  of
part C of chapter fifty-eight of the laws of two thousand five.
  S  39. Subparagraph (i) of paragraph (a-1) of subdivision 4 of section
365-a of the social services law, as amended by section 46 of part C  of
chapter 58 of the laws of 2009, is amended to read as follows:
  (i)  a  brand  name  drug for which a multi-source therapeutically and
generically equivalent drug, as determined by the federal food and  drug
administration,  is  available,  unless  previously  authorized  by  the
department of health.  The  commissioner  of  health  is  authorized  to
exempt,  for good cause shown, any brand name drug from the restrictions
imposed by this subparagraph[. This subparagraph shall not apply to  any
drug  that is in a therapeutic class included on the preferred drug list
under section two hundred seventy-two of the public health law or is  in
the  clinical drug review program under section two hundred seventy-four
of the public health law];
  S 40. Paragraph (u) of subdivision 4 of section 364-j  of  the  social
services law, as added by section 19 of part H of chapter 59 of the laws
of 2011, is amended to read as follows:
  (u)  A  managed  care provider that provides coverage for prescription
drugs shall permit each participant  to  fill  any  mail  order  covered
prescription,  at  his or her option, at any mail order pharmacy or non-
mail-order retail pharmacy in the managed care provider network, if  the
non-mail-order retail pharmacy offers to accept a price that is compara-
ble  to  that  of  the  mail order pharmacy. EVERY NON-MAIL-ORDER RETAIL
PHARMACY IN THE MANAGED CARE PROVIDER'S  NETWORK  WITH  RESPECT  TO  ANY
PRESCRIPTION  DRUG  SHALL BE DEEMED TO BE IN THE MANAGED CARE PROVIDER'S
NETWORK FOR EVERY COVERED PRESCRIPTION DRUG; PROVIDED, HOWEVER, THAT THE
MANAGED CARE PROVIDER MAY LIMIT ITS NETWORK OF PHARMACIES FOR  SPECIFIED
DRUGS,  APPROVED BY THE COMMISSIONER, BASED ON CLINICAL, PROFESSIONAL OR
COST CRITERIA. SUCH LIMITATION SHALL NOT BE BASED SOLELY ON COST.
  S 40-a. Subparagraph (vii)  of  paragraph  (b)  of  subdivision  7  of
section  4403-f  of  the  public health law, as added by section 41-b of
part H of chapter 59 of the laws of 2011, is amended to read as follows:
  (vii) Managed long term care provided and  plans  certified  or  other
care  coordination  model  established  pursuant to this paragraph shall
comply with the provisions of paragraphs (d), (i), [and]  (t),  AND  (U)
and  subparagraph  (iii) of paragraph (a) and subparagraph (iv) of para-

S. 6256--D                         27                         A. 9056--D

graph (e) of subdivision four of section three hundred  sixty-four-j  of
the social services law.
  S 41. Paragraphs (e), (f) and (g) of subdivision 1 of section 367-a of
the  social  services  law, paragraph (e) as added by chapter 433 of the
laws of 1997, paragraph (f) as added by section 1 of part E  of  chapter
58 of the laws of 2008, paragraph (g) as added by section 65-a of part H
of chapter 59 of the laws of 2011, are amended to read as follows:
  (e)  Amounts  payable  under  this title for medical assistance in the
form of clinic services pursuant to article twenty-eight of  the  public
health  law  and  article  sixteen of the mental hygiene law provided to
eligible persons DIAGNOSED WITH A DEVELOPMENTAL DISABILITY who are  also
beneficiaries  under  part  [b]  B of title [xviii] XVIII of the federal
social security act [and who are also], OR PROVIDED TO PERSONS diagnosed
with a DEVELOPMENTAL disability WHO ARE QUALIFIED MEDICARE BENEFICIARIES
UNDER PART B OF TITLE XVIII OF SUCH ACT  shall  not  be  less  than  the
approved  medical assistance payment level less the amount payable under
part [b] B.
  (f) Amounts payable under this title for  medical  assistance  in  the
form  of  outpatient  mental health services under article thirty-one of
the mental hygiene law provided to eligible persons who are also benefi-
ciaries under part B of title XVIII of the federal social  security  act
OR  PROVIDED  TO  QUALIFIED MEDICARE BENEFICIARIES UNDER PART B OF TITLE
XVIII OF SUCH ACT shall not be less than the approved medical assistance
payment level less the amount payable under part B.
  (g) Notwithstanding any provision of this  section  to  the  contrary,
amounts  payable  under this title for medical assistance in the form of
hospital outpatient services or diagnostic and treatment center services
pursuant to article twenty-eight of the public health  law  provided  to
eligible  persons who are also beneficiaries under part B of title XVIII
of the federal social security act OR  PROVIDED  TO  QUALIFIED  MEDICARE
BENEFICIARIES  UNDER  PART B OF TITLE XVIII OF SUCH ACT shall not exceed
the approved medical assistance payment level less  the  amount  payable
under part B.
  S 42. Intentionally omitted.
  S 43. Paragraph (a) of subdivision 8-a of section 2807-j of the public
health law, as amended by section 16 of part D of chapter 57 of the laws
of 2006, is amended to read as follows:
  (a)  Payments and reports submitted or required to be submitted to the
commissioner or to the commissioner's designee pursuant to this  section
and  section  twenty-eight hundred seven-s of this article by designated
providers of services and by third-party payors which  have  elected  to
make  payments  directly  to  the  commissioner or to the commissioner's
designee in accordance with subdivision five-a of this section, shall be
subject to audit by the commissioner for a period of six years following
the close of the calendar year in which such payments  and  reports  are
due,  after which such payments shall be deemed final and not subject to
further adjustment or reconciliation, INCLUDING THROUGH  OFFSET  ADJUST-
MENTS  OR RECONCILIATIONS MADE BY DESIGNATED PROVIDERS OF SERVICES OR BY
THIRD-PARTY PAYORS WITH REGARD TO SUBSEQUENT PAYMENTS, provided,  howev-
er, that nothing herein shall be construed as precluding the commission-
er from pursuing collection of any such payments which are identified as
delinquent  within  such  six  year  period,  or which are identified as
delinquent as a result of an audit commenced within such six year  peri-
od, or from conducting an audit of any adjustment or reconciliation made
by a designated provider of services or by a third party payor which has
elected  to  make  such  payments  directly  to  the commissioner or the

S. 6256--D                         28                         A. 9056--D

commissioner's designee, OR FROM CONDUCTING AN AUDIT  OF  PAYMENTS  MADE
PRIOR  TO  SUCH  SIX  YEAR  PERIOD WHICH ARE FOUND TO BE COMMINGLED WITH
PAYMENTS WHICH ARE OTHERWISE SUBJECT TO TIMELY AUDIT  PURSUANT  TO  THIS
SECTION.
  S 44.  Paragraph (a) of subdivision 10 of section 2807-t of the public
health law, as amended by section 17 of part D of chapter 57 of the laws
of 2006, is amended to read as follows:
  (a)  Payments and reports submitted or required to be submitted to the
commissioner or to the commissioner's designee pursuant to this  section
by specified third-party payors shall be subject to audit by the commis-
sioner  for  a  period  of six years following the close of the calendar
year in which such payments  and  reports  are  due,  after  which  such
payments  shall be deemed final and not subject to further adjustment or
reconciliation, INCLUDING THROUGH OFFSET ADJUSTMENTS OR  RECONCILIATIONS
MADE  BY  SUCH  SPECIFIED  THIRD-PARTY  PAYORS WITH REGARD TO SUBSEQUENT
PAYMENTS, provided, however, that nothing herein shall be  construed  as
precluding  the  commissioner  from  pursuing  collection  of  any  such
payments which are identified as delinquent within such six year period,
or which are identified as delinquent as a result of an audit  commenced
within  such six year period, or from conducting an audit of any adjust-
ments and reconciliation made by a specified third  party  payor  within
such six year period, OR FROM CONDUCTING AN AUDIT OF PAYMENTS MADE PRIOR
TO  SUCH  SIX YEAR PERIOD WHICH ARE FOUND TO BE COMMINGLED WITH PAYMENTS
WHICH ARE OTHERWISE SUBJECT TO TIMELY AUDIT PURSUANT TO THIS SECTION.
  S 45. Subdivision 7 of section 2807-d of  the  public  health  law  is
amended by adding a new paragraph (f) to read as follows:
  (F)  PAYMENTS AND REPORTS SUBMITTED OR REQUIRED TO BE SUBMITTED TO THE
COMMISSIONER OR TO THE COMMISSIONER'S DESIGNEE PURSUANT TO THIS  SECTION
SHALL  BE SUBJECT TO AUDIT BY THE COMMISSIONER FOR A PERIOD OF SIX YEARS
FOLLOWING THE CLOSE OF THE CALENDAR YEAR  IN  WHICH  SUCH  PAYMENTS  AND
REPORTS ARE DUE, AFTER WHICH SUCH PAYMENTS SHALL BE DEEMED FINAL AND NOT
SUBJECT  TO  FURTHER  ADJUSTMENT  OR  RECONCILIATION,  INCLUDING THROUGH
OFFSET ADJUSTMENTS OR RECONCILIATIONS MADE TO SUBSEQUENT  PAYMENTS  MADE
PURSUANT  TO  THIS SECTION, PROVIDED, HOWEVER, THAT NOTHING HEREIN SHALL
BE CONSTRUED AS PRECLUDING THE COMMISSIONER FROM PURSUING COLLECTION  OF
ANY  SUCH  PAYMENTS  WHICH  ARE IDENTIFIED AS DELINQUENT WITHIN SUCH SIX
YEAR PERIOD, OR WHICH ARE IDENTIFIED AS DELINQUENT AS  A  RESULT  OF  AN
AUDIT COMMENCED WITHIN SUCH SIX YEAR PERIOD, OR FROM CONDUCTING AN AUDIT
OF ANY ADJUSTMENT OR RECONCILIATION MADE BY A HOSPITAL.
  S 46.  Paragraph (f) of subdivision 18 of section 2807-c of the public
health law, as amended by section 15 of part D of chapter 57 of the laws
of 2006, is amended to read as follows:
  (f) Payments of assessments and allowances required to be submitted by
general hospitals pursuant to this subdivision and subdivisions fourteen
and  fourteen-b  of this section and paragraph (a) of subdivision two of
section twenty-eight hundred seven-d of this article shall be subject to
audit by the commissioner for a period of six years following the  close
of  the  calendar  year in which such payments are due, after which such
payments shall be deemed final and not subject to further adjustment  or
reconciliation,  INCLUDING THROUGH OFFSET ADJUSTMENTS OR RECONCILIATIONS
MADE BY GENERAL HOSPITALS WITH REGARD TO SUBSEQUENT PAYMENTS,  provided,
however,  that  nothing  herein  shall  be  construed  as precluding the
commissioner from pursuing collection of any such assessments and allow-
ances which are identified as delinquent within such six year period, or
which are identified as delinquent as a result  of  an  audit  commenced
within  such  six  year audit period, or from conducting an audit of any

S. 6256--D                         29                         A. 9056--D

adjustment or reconciliation made by a general hospital within such  six
year  period, OR FROM CONDUCTING AN AUDIT OF PAYMENTS MADE PRIOR TO SUCH
SIX YEAR PERIOD WHICH ARE FOUND TO BE COMMINGLED WITH PAYMENTS WHICH ARE
OTHERWISE  SUBJECT  TO  TIMELY  AUDIT  PURSUANT TO THIS SECTION. General
hospitals which, in the course of such an audit, fail to produce data or
documentation requested in furtherance of such an audit,  within  thirty
days  of such request may be assessed a civil penalty of up to ten thou-
sand dollars for each such failure, provided, however, that  such  civil
penalty shall not be imposed if the hospital demonstrates good cause for
such  failure.   The imposition of such civil penalties shall be subject
to the provisions of section twelve-a of this chapter.
  S 47.  Paragraph (e) of subdivision 2-a of section 2807 of the  public
health  law  is  amended  by  adding a new subparagraph (iii) to read as
follows:
  (III) REGULATIONS ISSUED PURSUANT TO THIS  PARAGRAPH  MAY  INCORPORATE
QUALITY  RELATED MEASURES LIMITING OR EXCLUDING REIMBURSEMENT RELATED TO
POTENTIALLY PREVENTABLE CONDITIONS AND COMPLICATIONS; PROVIDED  HOWEVER,
SUCH  QUALITY  RELATED MEASURES SHALL NOT INCLUDE ANY PREVENTABLE CONDI-
TIONS AND COMPLICATIONS NOT IDENTIFIED FOR MEDICARE NONPAYMENT OR LIMIT-
ED PAYMENT.
  S 48.  Paragraph (c) of subdivision 7 of section 2807-d of the  public
health  law,  as added by chapter 938 of the laws of 1990, is amended to
read as follows:
  (c) The reports shall be in such form as  may  be  prescribed  by  the
commissioner  to  accurately  disclose information required to implement
this section, PROVIDED, HOWEVER, THAT FOR  PERIODS  ON  AND  AFTER  JULY
FIRST,  TWO  THOUSAND  TWELVE,  SUCH  REPORTS AND ANY ASSOCIATED CERTIF-
ICATIONS SHALL BE SUBMITTED ELECTRONICALLY IN A FORM AS MAY BE  REQUIRED
BY THE COMMISSIONER.
  S  48-a. Subparagraph (i) of paragraph (a) of subdivision 7 of section
2807-j of the public health law, as amended by section 36 of part  B  of
chapter 58 of the laws of 2008, is amended to read as follows;
  (i)  Every designated provider of services shall submit reports of net
patient service revenues received for or on account of patient  services
for  each  month which shall be in such form as may be prescribed by the
commissioner to accurately disclose information  required  to  implement
this section. For periods on and after January first, two thousand five,
reports by designated providers of services shall be submitted electron-
ically  in  a  form  as  may  be required by the commissioner; provided,
however, any designated provider of  services  is  not  prohibited  from
submitting  reports  electronically  on  a voluntary basis prior to such
date,  AND  PROVIDED  FURTHER,  HOWEVER,  THAT   ALL   SUCH   ELECTRONIC
SUBMISSIONS SUBMITTED ON AND AFTER JULY FIRST, TWO THOUSAND TWELVE SHALL
BE  VERIFIED  WITH  AN ELECTRONIC SIGNATURE AS PRESCRIBED BY THE COMMIS-
SIONER.
  S 48-b. Subparagraph (ii) of paragraph (b) of subdivision 7 of section
2807-j of the public health law, as amended by section 25 of part A3  of
chapter 62 of the laws of 2003, is amended to read as follows:
  (ii)  For  periods on and after July first, two thousand four, reports
submitted on a monthly basis by third-party payors  in  accordance  with
subparagraph (i) of this paragraph and reports submitted on a monthly or
annual  basis by payors acting in an administrative services capacity on
behalf of electing third-party payors in  accordance  with  subparagraph
(i)  of  this paragraph shall be made electronically in a form as may be
required by the commissioner; provided, however, any third-party  payor,
except payors acting in an administrative services capacity on behalf of

S. 6256--D                         30                         A. 9056--D

electing third-party payors, which, on or after January first, two thou-
sand  four,  elects to make payments directly to the commissioner or the
commissioner's designee pursuant to subdivision five  of  this  section,
shall  be  subject to this subparagraph only after one full year of pool
payment experience which results in reports being submitted on a monthly
basis,  AND  PROVIDED  FURTHER,  HOWEVER,  THAT  ALL   SUCH   ELECTRONIC
SUBMISSIONS SUBMITTED ON AND AFTER JULY FIRST, TWO THOUSAND TWELVE SHALL
BE  VERIFIED  WITH  AN ELECTRONIC SIGNATURE AS PRESCRIBED BY THE COMMIS-
SIONER.   This subparagraph shall not be  interpreted  to  prohibit  any
third-party  payor from submitting reports electronically on a voluntary
basis.
  S 48-c. Subparagraph (ii)  of  paragraph  (b)  of  subdivision  20  of
section  2807-c of the public health law, as added by section 26 of part
A3 of chapter 62 of the laws of 2003, is amended to read as follows:
  (ii) For periods on  and  after  January  first,  two  thousand  five,
reports  submitted  by general hospitals to implement the assessment set
forth in subdivision eighteen of this section shall be  submitted  elec-
tronically  in  a form as may be required by the commissioner; provided,
however, general hospitals are not prohibited  from  submitting  reports
electronically  on  a  voluntary  basis prior to such date, AND PROVIDED
FURTHER, HOWEVER, THAT ALL SUCH ELECTRONIC SUBMISSIONS SUBMITTED ON  AND
AFTER  JULY  FIRST,  TWO THOUSAND TWELVE SHALL BE VERIFIED WITH AN ELEC-
TRONIC SIGNATURE AS PRESCRIBED BY THE COMMISSIONER.
  S 49.  Subdivision 8 of section 3605 of  the  public  health  law,  as
added by chapter 959 of the laws of 1984, is amended to read as follows:
  8. Agencies licensed pursuant to this section but not certified pursu-
ant  to  section three thousand six hundred eight of this article, shall
not be qualified to participate  as  a  home  health  agency  under  the
provisions  of  title  XVIII  or  XIX of the federal Social Security Act
provided, however, an agency which has a contract with a state agency or
its locally designated office OR, AS SPECIFIED BY THE COMMISSIONER, WITH
A MANAGED CARE ORGANIZATION PARTICIPATING IN THE  MANAGED  CARE  PROGRAM
ESTABLISHED PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THE SOCIAL
SERVICES  LAW OR WITH A MANAGED LONG TERM CARE PLAN ESTABLISHED PURSUANT
TO SECTION FORTY-FOUR HUNDRED  THREE-F  OF  THIS  CHAPTER,  may  receive
reimbursement under title XIX of the federal Social Security Act.
  S  50.  Subdivision  6  of section 365-f of the social services law is
renumbered subdivision 7 and a new subdivision 6 is  added  to  read  as
follows:
  6.  NOTWITHSTANDING  ANY INCONSISTENT PROVISION OF THIS SECTION OR ANY
OTHER CONTRARY PROVISION  OF  LAW,  MANAGED  CARE  PROGRAMS  ESTABLISHED
PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE AND MANAGED
LONG  TERM  CARE  PLANS  AND  OTHER CARE COORDINATION MODELS ESTABLISHED
PURSUANT TO SECTION FOUR THOUSAND FOUR HUNDRED  THREE-F  OF  THE  PUBLIC
HEALTH LAW SHALL OFFER CONSUMER DIRECTED PERSONAL ASSISTANCE PROGRAMS TO
ENROLLEES.
  S  51.  Subdivision  3-c  of  section 3614 of the public health law is
amended by adding a new paragraph (e) to read as follows:
  (E) THE  COMMISSIONER  SHALL,  WITHIN  MONIES  APPROPRIATED  THEREFOR,
ESTABLISH  A  RURAL HOME TELEHEALTH DELIVERY DEMONSTRATION STUDY PROGRAM
IN COUNTIES HAVING A POPULATION OF NOT  LESS  THAN  ONE  HUNDRED  THIRTY
THOUSAND  AND NOT MORE THAN ONE HUNDRED FORTY THOUSAND, ACCORDING TO THE
TWO THOUSAND TEN DECENNIAL FEDERAL CENSUS. THE COMMISSIONER SHALL DIRECT
A HOME HEALTH ORGANIZATION SERVING IN  SUCH  COUNTY  TO  STUDY  PATIENTS
RECEIVING  TELEHEALTH  SERVICES,  PURSUANT TO THIS SUBDIVISION, WHO HAVE
BEEN DIAGNOSED WITH CONGESTIVE HEART FAILURE,  DIABETES  AND/OR  CHRONIC

S. 6256--D                         31                         A. 9056--D

PULMONARY  OBSTRUCTIVE  DISEASE,  AND  WHOSE  MEDICAL, FUNCTIONAL AND/OR
ENVIRONMENTAL NEEDS ARE APPROPRIATELY MET AT HOME THROUGH  THE  APPLICA-
TION  OF TELEHEALTH SERVICES INTERVENTIONS. SUCH A STUDY SHALL DETERMINE
THE  COST OF PROVIDING TELEHEALTH SERVICES, THE QUALITY OF CARE PROVIDED
THROUGH TELEHEALTH SERVICES AND THE OUTCOMES OF PATIENTS RECEIVING  SUCH
TELEHEALTH  SERVICES.  THE  COMMISSIONER SHALL REIMBURSE THE HOME HEALTH
ORGANIZATION FOR CONDUCTING THE STUDY WITH  AMOUNTS  APPROPRIATED  UNDER
THIS  SUBDIVISION. THE HOME HEALTH ORGANIZATION SHALL EVALUATE THE FIND-
INGS OF THE STUDY AND REPORT TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF
THE SENATE, THE SPEAKER OF THE ASSEMBLY, THE COMMISSIONER, AND THE CHAIR
OF THE LEGISLATIVE COMMISSION ON RURAL  RESOURCES  ON  ITS  FINDINGS  OF
PROVIDING  TELEHEALTH  SERVICES FOR EACH CONDITION, SO AS TO PROVIDE THE
COST BENCHMARKS WITH AND WITHOUT TELEHEALTH CARE, AS WELL  AS  PROVIDING
COST  BENEFIT  MEASUREMENTS IN TERMS OF THE QUALITY BENEFIT OUTCOMES FOR
EACH OF THE CONDITIONS ADDRESSED VIA TELEHEALTH.
  S 52.  The public health law is amended by adding a new section 3309-a
to read as follows:
  S 3309-A. PRESCRIPTION PAIN MEDICATION AWARENESS PROGRAM.  1. THERE IS
HEREBY ESTABLISHED WITHIN THE DEPARTMENT A PRESCRIPTION PAIN  MEDICATION
AWARENESS  PROGRAM  TO  EDUCATE THE PUBLIC AND HEALTH CARE PRACTITIONERS
ABOUT THE  RISKS  ASSOCIATED  WITH  PRESCRIBING  AND  TAKING  CONTROLLED
SUBSTANCE PAIN MEDICATIONS.
  2.  WITHIN THE AMOUNTS APPROPRIATED, THE COMMISSIONER, IN CONSULTATION
WITH THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM  AND  SUBSTANCE  ABUSE
SERVICES, SHALL:
  (A)  DEVELOP  AND  CONDUCT  A  PUBLIC  HEALTH EDUCATION MEDIA CAMPAIGN
DESIGNED TO ALERT YOUTH, PARENTS AND THE GENERAL  POPULATION  ABOUT  THE
RISKS  ASSOCIATED  WITH  PRESCRIPTION  PAIN  MEDICATIONS AND THE NEED TO
PROPERLY DISPOSE OF ANY UNUSED MEDICATION. IN DEVELOPING THIS  CAMPAIGN,
THE  COMMISSIONER SHALL CONSULT WITH AND USE INFORMATION PROVIDED BY THE
WORK GROUP ESTABLISHED PURSUANT TO SUBDIVISION (B) OF THIS  SECTION  AND
OTHER RELEVANT PROFESSIONAL ORGANIZATIONS. THE CAMPAIGN SHALL INCLUDE AN
INTERNET  WEBSITE PROVIDING INFORMATION FOR PARENTS, CHILDREN AND HEALTH
CARE PROFESSIONALS ON THE  RISKS  ASSOCIATED  WITH  TAKING  OPIOIDS  AND
RESOURCES  AVAILABLE  TO THOSE NEEDING ASSISTANCE WITH PRESCRIPTION PAIN
MEDICATION  ADDICTION.  SUCH  WEBSITE  SHALL  ALSO  PROVIDE  INFORMATION
REGARDING   WHERE   INDIVIDUALS   MAY  PROPERLY  DISPOSE  OF  CONTROLLED
SUBSTANCES IN THEIR COMMUNITY AND INCLUDE ACTIVE LINKS TO FURTHER INFOR-
MATION AND RESOURCES. THE CAMPAIGN SHALL BEGIN NO LATER  THAN  SEPTEMBER
FIRST, TWO THOUSAND TWELVE.
  (B)  ESTABLISH  A  WORK  GROUP, NO LATER THAN JUNE FIRST, TWO THOUSAND
TWELVE, WHICH SHALL BE COMPOSED OF EXPERTS IN THE FIELDS  OF  PALLIATIVE
AND  CHRONIC CARE PAIN MANAGEMENT AND ADDICTION MEDICINE. MEMBERS OF THE
WORK GROUP SHALL RECEIVE NO COMPENSATION FOR THEIR SERVICES,  BUT  SHALL
BE  ALLOWED  ACTUAL  AND  NECESSARY EXPENSES IN THE PERFORMANCE OF THEIR
DUTIES PURSUANT TO THIS SECTION. THE WORK GROUP SHALL:
  (I) REPORT TO THE COMMISSIONER REGARDING THE DEVELOPMENT OF  RECOMMEN-
DATIONS  AND  MODEL  COURSES FOR CONTINUING MEDICAL EDUCATION, REFRESHER
COURSES AND OTHER TRAINING MATERIALS FOR LICENSED  HEALTH  CARE  PROFES-
SIONALS  ON APPROPRIATE USE OF PRESCRIPTION PAIN MEDICATION. SUCH RECOM-
MENDATIONS, MODEL COURSES AND OTHER TRAINING MATERIALS SHALL BE  SUBMIT-
TED  TO  THE COMMISSIONER, WHO SHALL MAKE SUCH INFORMATION AVAILABLE FOR
THE USE IN MEDICAL EDUCATION, RESIDENCY PROGRAMS,  FELLOWSHIP  PROGRAMS,
AND  FOR  USE  IN CONTINUING MEDICATION EDUCATION PROGRAMS NO LATER THAN
JANUARY FIRST, TWO THOUSAND THIRTEEN;

S. 6256--D                         32                         A. 9056--D

  (II) NO LATER THAN  JANUARY  FIRST,  TWO  THOUSAND  THIRTEEN,  PROVIDE
OUTREACH  AND  ASSISTANCE  TO  HEALTH CARE PROFESSIONAL ORGANIZATIONS TO
ENCOURAGE AND FACILITATE CONTINUING MEDICAL EDUCATION TRAINING  PROGRAMS
FOR  THEIR  MEMBERS  REGARDING APPROPRIATE PRESCRIBING PRACTICES AND THE
RISKS ASSOCIATED WITH PRESCRIPTION PAIN MEDICATION; AND
  (III)  PROVIDE INFORMATION TO THE COMMISSIONER FOR USE IN THE DEVELOP-
MENT AND CONTINUED UPDATE OF THE PUBLIC  AWARENESS  CAMPAIGN,  INCLUDING
INFORMATION,  RESOURCES, AND ACTIVE WEB LINKS THAT SHOULD BE INCLUDED ON
THE WEBSITE.
  3. THE COMMISSIONER SHALL REPORT TO THE GOVERNOR, THE TEMPORARY PRESI-
DENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY NO LATER  THAN  MARCH
FIRST,  TWO  THOUSAND  THIRTEEN,  AND  ANNUALLY  THEREAFTER, ON THE WORK
GROUP'S FINDINGS. THE REPORT SHALL INCLUDE INFORMATION ON  OPIOID  OVER-
DOSE  DEATHS,  EMERGENCY  ROOM  UTILIZATION  FOR THE TREATMENT OF OPIOID
OVERDOSE, THE UTILIZATION OF PRE-HOSPITAL ADDICTION SERVICES AND  RECOM-
MENDATIONS TO REDUCE OPIOID ADDICTION AND THE CONSEQUENCES THEREOF.
  S  53.  Paragraphs (d) and (e) of subdivision 5-a of section 2807-m of
the public health law, as amended by section 26 of part C of chapter  59
of the laws of 2011, are amended to read as follows:
  (d)  Physician  loan repayment program. One million nine hundred sixty
thousand dollars for  the  period  January  first,  two  thousand  eight
through  December  thirty-first,  two  thousand  eight, one million nine
hundred sixty thousand dollars for the period January first,  two  thou-
sand  nine through December thirty-first, two thousand nine, one million
nine hundred sixty thousand dollars for the period  January  first,  two
thousand  ten  through  December  thirty-first,  two  thousand ten, four
hundred ninety thousand dollars for the period January first, two  thou-
sand  eleven  through  March  thirty-first, two thousand eleven, and one
million seven hundred thousand dollars each state fiscal  year  for  the
period  April first, two thousand eleven through March thirty-first, two
thousand fourteen, shall be set aside and reserved by  the  commissioner
from  the regional pools established pursuant to subdivision two of this
section and shall be available for purposes of physician loan  repayment
in accordance with subdivision ten of this section. [Such] NOTWITHSTAND-
ING  ANY CONTRARY PROVISION OF THIS SECTION, SECTIONS ONE HUNDRED TWELVE
AND ONE HUNDRED SIXTY-THREE OF THE  STATE  FINANCE  LAW,  OR  ANY  OTHER
CONTRARY  PROVISION  OF  LAW, SUCH funding shall be allocated regionally
with one-third of available funds going to New York city and  two-thirds
of  available funds going to the rest of the state and shall be distrib-
uted in a manner to be determined by the commissioner WITHOUT A  COMPET-
ITIVE BID OR REQUEST FOR PROPOSAL PROCESS as follows:
  (i) Funding shall first be awarded to repay loans of up to twenty-five
physicians  who  train  in  primary care or specialty tracks in teaching
general hospitals, and who enter and remain in primary care or specialty
practices in underserved communities, as determined by the commissioner.
  (ii) After distributions in accordance with subparagraph (i)  of  this
paragraph, all remaining funds shall be awarded to repay loans of physi-
cians  who  enter  and  remain in primary care or specialty practices in
underserved communities, as determined by  the  commissioner,  including
but  not  limited  to  physicians working in general hospitals, or other
health care facilities.
  (iii) In no case shall less than fifty percent of the funds  available
pursuant  to  this  paragraph be distributed in accordance with subpara-
graphs (i) and (ii) of this paragraph to physicians identified by gener-
al hospitals.

S. 6256--D                         33                         A. 9056--D

  (e) Physician practice support. Four  million  nine  hundred  thousand
dollars  for the period January first, two thousand eight through Decem-
ber thirty-first, two thousand eight, four million nine hundred thousand
dollars annually for the period January first, two thousand nine through
December  thirty-first,  two thousand ten, one million two hundred twen-
ty-five thousand dollars for the  period  January  first,  two  thousand
eleven through March thirty-first, two thousand eleven, and four million
three  hundred  thousand  dollars  each state fiscal year for the period
April first, two thousand eleven through March thirty-first,  two  thou-
sand  fourteen, shall be set aside and reserved by the commissioner from
the regional pools established  pursuant  to  subdivision  two  of  this
section  and  shall  be  available  for  purposes  of physician practice
support. [Such] NOTWITHSTANDING ANY CONTRARY PROVISION OF THIS  SECTION,
SECTIONS  ONE  HUNDRED  TWELVE  AND ONE HUNDRED SIXTY-THREE OF THE STATE
FINANCE LAW, OR ANY OTHER CONTRARY PROVISION OF LAW, SUCH funding  shall
be  allocated  regionally with one-third of available funds going to New
York city and two-thirds of available funds going to  the  rest  of  the
state  and  shall  be  distributed  in  a manner to be determined by the
commissioner WITHOUT A COMPETITIVE BID OR REQUEST FOR  PROPOSAL  PROCESS
as follows:
  (i)  Preference in funding shall first be accorded to teaching general
hospitals for up to twenty-five awards, to  support  costs  incurred  by
physicians  trained in primary or specialty tracks who thereafter estab-
lish or join practices in underserved communities, as determined by  the
commissioner.
  (ii)  After  distributions in accordance with subparagraph (i) of this
paragraph, all remaining funds shall be awarded to physicians to support
the cost of establishing or joining practices  in  underserved  communi-
ties,  as  determined  by  the  commissioner, and to hospitals and other
health care providers to recruit new physicians to provide  services  in
underserved communities, as determined by the commissioner.
  (iii)  In no case shall less than fifty percent of the funds available
pursuant to this  paragraph  be  distributed  to  general  hospitals  in
accordance with subparagraphs (i) and (ii) of this paragraph.
  S  54.  Subdivision  5-a of section 2807-m of the public health law is
amended by adding a new paragraph (e-1) to read as follows:
  (E-1) WORK GROUP.  FOR FUNDING AVAILABLE PURSUANT  TO  PARAGRAPHS  (D)
AND (E) OF THIS SUBDIVISION:
  (I)  THE  DEPARTMENT  SHALL  APPOINT A WORK GROUP FROM RECOMMENDATIONS
MADE BY ASSOCIATIONS  REPRESENTING  PHYSICIANS,  GENERAL  HOSPITALS  AND
OTHER  HEALTH CARE FACILITIES TO DEVELOP A STREAMLINED APPLICATION PROC-
ESS BY JUNE FIRST, TWO THOUSAND TWELVE.
  (II) SUBJECT TO AVAILABLE FUNDING, APPLICATIONS SHALL BE ACCEPTED ON A
CONTINUOUS BASIS. THE DEPARTMENT SHALL PROVIDE TECHNICAL  ASSISTANCE  TO
APPLICANTS  TO FACILITATE THEIR COMPLETION OF APPLICATIONS. AN APPLICANT
SHALL BE NOTIFIED IN WRITING  BY  THE  DEPARTMENT  WITHIN  TEN  DAYS  OF
RECEIPT  OF AN APPLICATION AS TO WHETHER THE APPLICATION IS COMPLETE AND
IF THE APPLICATION IS INCOMPLETE, WHAT INFORMATION IS  OUTSTANDING.  THE
DEPARTMENT  SHALL ACT ON AN APPLICATION WITHIN THIRTY DAYS OF RECEIPT OF
A COMPLETE APPLICATION.
  S 55. Section 364-j of the social services law is amended by adding  a
new subdivision 25 to read as follows:
  25.  EFFECTIVE  JANUARY  FIRST, TWO THOUSAND THIRTEEN, NOTWITHSTANDING
ANY PROVISION OF LAW TO THE CONTRARY, MANAGED CARE PROVIDERS SHALL COVER
MEDICALLY NECESSARY PRESCRIPTION DRUGS  IN  THE  ATYPICAL  ANTIPSYCHOTIC
THERAPEUTIC  CLASS, INCLUDING NON-FORMULARY DRUGS, UPON DEMONSTRATION BY

S. 6256--D                         34                         A. 9056--D

THE PRESCRIBER, AFTER CONSULTING WITH THE MANAGED  CARE  PROVIDER,  THAT
SUCH  DRUGS,  IN  THE PRESCRIBER'S REASONABLE PROFESSIONAL JUDGMENT, ARE
MEDICALLY NECESSARY AND WARRANTED.
  S  56.  Subdivision  6  of  section 369 of the social services law, as
amended by section 53 of part H of chapter 59 of the laws  of  2011,  is
amended to read as follows:
  6.  For  purposes of this section, [an individual's] THE TERM "estate"
[includes] MEANS all [of the individual's] real  and  personal  property
and  other  assets  INCLUDED  WITHIN THE INDIVIDUAL'S ESTATE AND passing
under the terms of a valid will or  by  intestacy.  [Pursuant  to  regu-
lations  adopted  by  the  commissioner,  which may be promulgated on an
emergency basis, an individual's estate also includes any other property
in which the individual has any legal title or interest at the  time  of
death,  including  jointly  held  property,  retained  life estates, and
interests in trusts, to the extent of such interests; provided, however,
that a claim against a recipient of such  property  by  distribution  or
survival  shall  be limited to the value of the property received or the
amount of medical assistance benefits otherwise recoverable pursuant  to
this  section,  whichever  is less. Nothing in this subdivision shall be
construed as authorizing the department or a social services district to
impose liens or make recoveries that  are  prohibited  by  federal  laws
governing the medical assistance program.]
  S 56-a. Paragraph (b) of subdivision 7 of section 4403-f of the public
health  law  is  amended  by adding a new subparagraph (viii) to read as
follows:
  (VIII) (1) THE COMMISSIONER SHALL REPORT BIANNUALLY ON THE IMPLEMENTA-
TION OF THIS SUBDIVISION. THE REPORTS SHALL INCLUDE, BUT NOT BE  LIMITED
TO:
  (A)  SATISFACTION OF ENROLLEES WITH CARE COORDINATION/CASE MANAGEMENT;
TIMELINESS OF CARE;
  (B) SERVICE UTILIZATION DATA INCLUDING CHANGES IN  THE  LEVEL,  HOURS,
FREQUENCY, AND TYPES OF SERVICES AND PROVIDERS;
  (C) ENROLLMENT DATA, INCLUDING AUTO-ASSIGNMENT RATES BY PLAN;
  (D) QUALITY DATA; AND
  (E)  CONTINUITY  OF CARE FOR PARTICIPANTS AS THEY MOVE TO MANAGED LONG
TERM CARE, WITH RESPECT TO COMMUNITY BASED AND NURSING HOME POPULATIONS,
INCLUDING PEDIATRIC NURSING  HOME  POPULATIONS,  AND  MEDICALLY  FRAGILE
CHILDREN  BEING  SERVED  BY HOME CARE AGENCIES AFFILIATED WITH PEDIATRIC
NURSING HOMES AND DIAGNOSTIC AND  TREATMENT  CENTERS  PRIMARILY  SERVING
MEDICALLY FRAGILE CHILDREN.
  (2)  THE  COMMISSIONER  SHALL  PUBLISH  THE REPORT ON THE DEPARTMENT'S
WEBSITE AND PROVIDE NOTICE TO THE TEMPORARY PRESIDENT OF THE SENATE, THE
SPEAKER OF THE ASSEMBLY, THE CHAIR OF THE SENATE STANDING  COMMITTEE  ON
HEALTH,  THE  CHAIR  OF  THE  ASSEMBLY HEALTH COMMITTEE AND THE MEDICAID
MANAGED CARE ADVISORY REVIEW PANEL UPON AVAILABILITY OF THE REPORT.  THE
INITIAL  REPORT  SHALL  BE  PROVIDED  BY  SEPTEMBER  FIRST, TWO THOUSAND
TWELVE. THE REPORTS SHALL BE MADE AVAILABLE BY EACH FEBRUARY FIRST,  AND
SEPTEMBER  FIRST  THEREAFTER.  SUCH  REPORTS SHALL BE FORMATTED TO ALLOW
COMPARISONS BETWEEN PLANS.
  S 56-b. Section 4403-f of the public health law is amended by adding a
new subdivision 11 to read as follows:
  11. THE DEPARTMENT SHALL DEVELOP TRANSITION  AND  CONTINUITY  OF  CARE
POLICIES  FOR  PARTICIPANTS  IN HOME AND COMMUNITY BASED LONG TERM CARE,
INCLUDING THE LONG TERM HOME  HEALTH  CARE  PROGRAM,  AS  THEY  MOVE  TO
MANAGED LONG TERM CARE PLANS ADDRESSING:

S. 6256--D                         35                         A. 9056--D

  (A)  A TIMETABLE AND PLAN FOR IMPLEMENTATION AND TRANSITION BY PARTIC-
IPANTS, PLANS AND PROVIDERS;
  (B)  INFORMATIVE  DISCLOSURE  OF PARTICIPANTS' OPTIONS AS TO IMPENDING
ACTIONS AFFECTING OR RELATING TO THE HOME CARE SERVICES THEY RECEIVE;
  (C) REASONABLE  OPPORTUNITY  FOR  PLANS'  AND  PROVIDERS'  GOOD  FAITH
PURSUIT  OF  CONTRACTS,  PROGRAM  CHANGES OR STATE APPROVALS RELEVANT TO
PLAN IMPLEMENTATION;
  (D) NOTICE THAT A PARTICIPANT WITH A PREVIOUSLY  ESTABLISHED  PLAN  OF
CARE PROVIDED BY A CERTIFIED HOME HEALTH AGENCY OR LONG TERM HOME HEALTH
CARE  PROGRAM,  OR  PROVIDED  PURSUANT  TO THE PERSONAL CARE OR CONSUMER
DIRECTED PERSONAL ASSISTANCE SERVICE PROGRAMS, MAY ELECT  TO  HAVE  SUCH
CARE  PLAN  CONTINUED  SUBJECT  TO  THE PARTICIPANT'S NEXT COMPREHENSIVE
ASSESSMENT; AND
  (E) DELINEATION OF RESPONSIBILITIES  FOR  SERVICE  DELIVERY  AND  CARE
COORDINATION,  SO  AS  TO  AVOID  CONFLICT,  DUPLICATION AND UNNECESSARY
DISRUPTION OF DIRECT CARE STAFFING FOR THE PATIENT, AND MAINTAIN COMPLI-
ANCE WITH STATE  AND  FEDERAL  STATUTE  AND  REGULATION,  INCLUDING  THE
PROVISIONS  OF  THIS  SECTION,  ARTICLE  THIRTY-SIX  OF THIS CHAPTER AND
SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES LAW.
  IN ADDITION, THE DEPARTMENT SHALL PROVIDE TECHNICAL ASSISTANCE TO LONG
TERM HOME HEALTH CARE PROVIDERS  WITH  CONTRACTING  OPTIONS  UNDER  THIS
SECTION.  THE  DEPARTMENT  SHALL  WORK WITH AFFECTED STAKEHOLDERS IN THE
DEVELOPMENT OF THESE POLICIES.
  S 56-c. Notwithstanding any inconsistent law or regulation, an  exist-
ing long term home health care program making application to the commis-
sioner  of  health  for  the  issuance of a certificate of approval as a
general purpose certified home health care agency shall  be  granted  an
expedited  review  and  the  commissioner  of  health  may waive certain
elements of such review in his or her sole discretion.
  S 57. Subdivision 1 of section 92 of 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 funds Medicaid expenditures, is
amended to read as follows:
  1.  For  state fiscal years 2011-12 [and 2012-13] THROUGH 2013-14, the
director of the budget, in consultation with the commissioner of  health
referenced  as "commissioner" for purposes of this section, shall assess
on a monthly basis, as reflected in monthly reports pursuant to subdivi-
sion five of this section known and projected department of health state
funds medicaid expenditures by category of  service  and  by  geographic
regions,  as  defined  by  the  commissioner, and if the director of the
budget determines that such expenditures are expected to cause  medicaid
disbursements  for  such  period  to  exceed the projected department of
health medicaid state funds disbursements in the enacted  budget  finan-
cial  plan  pursuant to subdivision 3 of section 23 of the state finance
law, the commissioner of health, in consultation with  the  director  of
the  budget,  shall  develop a medicaid savings allocation plan to limit
such spending to the aggregate limit  level  specified  in  the  enacted
budget  financial  plan,  provided,  however,  such  projections  may be
adjusted by the director of the budget to account for any changes in the
New York state federal medical assistance percentage amount  established
pursuant  to the federal social security act, changes in provider reven-
ues, REDUCTIONS TO LOCAL SOCIAL  SERVICES  DISTRICT  MEDICAL  ASSISTANCE
ADMINISTRATION, and beginning April 1, 2012 the operational costs of the
New York state medical indemnity fund.
  S 58.  Paragraph (b) of section 90 of part H of chapter 59 of the laws
of 2011, amending the public health law and other laws relating to types

S. 6256--D                         36                         A. 9056--D

of  appropriations exempt from certain reductions, is amended to read as
follows:
  (b)  The  following  types  of  appropriations  shall  be  exempt from
reductions pursuant to this section:
  (i) any reductions that would violate federal law including,  but  not
limited to, payments required pursuant to the federal Medicare program;
  (ii)  any reductions related to payments pursuant to article 32, arti-
cle 31 and article 16 of the mental hygiene law;
  (iii) payments the state is obligated to make pursuant to court orders
or judgments;
  (iv) payments for which the non-federal share  does  not  reflect  any
state funding; [and]
  (v)  at  the discretion of the commissioner of health and the director
of the budget, payments with regard to which it  is  determined  by  the
commissioner  of  health and the director of the budget that application
of reductions pursuant to this section would  result,  by  operation  of
federal law, in a lower federal medical assistance percentage applicable
to such payments; AND
  (VI)  PAYMENTS  MADE  WITH  REGARD  TO  THE EARLY INTERVENTION PROGRAM
PURSUANT TO SECTION 2540 OF THE PUBLIC HEALTH LAW.
  S 59. Subparagraph (ii) of paragraph (a) of subdivision 5  of  section
2807-j of the public health law, as amended by section 23 of part A-3 of
chapter 62 of the laws of 2003, is amended to read as follows:
  (ii) An election shall remain in effect unless revoked in writing by a
specified  third-party payor, which revocation shall be effective on the
first day of the next [calendar year quarter] MONTH, provided that  such
payor  has provided notice of its intention to so revoke at least [thir-
ty] TWENTY days prior to the beginning of such [calendar quarter] MONTH.
  S 60. Paragraph (b) of subdivision 5-a of section 2807-m of the public
health law is amended by adding  a  new  subparagraph  (H)  to  read  as
follows:
  (H)  NOTWITHSTANDING  ANY  INCONSISTENT PROVISION OF THIS SUBDIVISION,
FOR PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND THIRTEEN, ECRIP GRANT
AWARDS SHALL BE MADE IN ACCORDANCE WITH RULES AND REGULATIONS PROMULGAT-
ED BY THE COMMISSIONER.  SUCH REGULATIONS SHALL, AT A MINIMUM:
  (1) PROVIDE THAT ECRIP GRANT AWARDS SHALL BE MADE WITH  THE  OBJECTIVE
OF  SECURING  FEDERAL FUNDING FOR BIOMEDICAL RESEARCH, TRAINING CLINICAL
RESEARCHERS, RECRUITING NATIONAL LEADERS AS FACULTY TO ACT  AS  MENTORS,
AND TRAINING RESIDENTS AND FELLOWS IN BIOMEDICAL RESEARCH SKILLS;
  (2)  PROVIDE THAT ECRIP GRANT APPLICANTS MAY INCLUDE INTERDISCIPLINARY
RESEARCH TEAMS COMPRISED OF TEACHING GENERAL HOSPITALS ACTING IN COLLAB-
ORATION WITH ENTITIES INCLUDING BUT  NOT  LIMITED  TO  MEDICAL  CENTERS,
HOSPITALS, UNIVERSITIES AND LOCAL HEALTH DEPARTMENTS;
  (3) PROVIDE THAT APPLICATIONS FOR ECRIP GRANT AWARDS SHALL BE BASED ON
SUCH  INFORMATION REQUESTED BY THE COMMISSIONER, WHICH SHALL INCLUDE BUT
NOT BE LIMITED TO HOSPITAL-SPECIFIC DATA;
  (4) ESTABLISH THE QUALIFICATIONS FOR  INVESTIGATORS  AND  OTHER  STAFF
REQUIRED FOR GRANT PROJECTS ELIGIBLE FOR ECRIP GRANT AWARDS; AND
  (5)  ESTABLISH A METHODOLOGY FOR THE DISTRIBUTION OF FUNDS UNDER ECRIP
GRANT AWARDS.
  S 61. Section 1 of part C of chapter 58 of the laws of 2005,  relating
to  authorizing  reimbursements for expenditures made by or on behalf of
social services districts for medical assistance for needy  persons  and
the  administration  thereof, is amended by adding a new subdivision (h)
to read as follows:

S. 6256--D                         37                         A. 9056--D

  (H) NOTWITHSTANDING THE PROVISIONS OF  SECTION  368-A  OF  THE  SOCIAL
SERVICES  LAW  OR  ANY OTHER CONTRARY PROVISION OF LAW, NO REIMBURSEMENT
SHALL BE MADE FOR SOCIAL SERVICES DISTRICTS'  CLAIMS  SUBMITTED  ON  AND
AFTER  THE  EFFECTIVE  DATE OF THIS PARAGRAPH, FOR DISTRICT EXPENDITURES
INCURRED  PRIOR  TO  JANUARY  1,  2006,  INCLUDING,  BUT NOT LIMITED TO,
EXPENDITURES FOR SERVICES PROVIDED TO INDIVIDUALS WHO WERE ELIGIBLE  FOR
MEDICAL  ASSISTANCE  PURSUANT  TO SECTION THREE HUNDRED SIXTY-SIX OF THE
SOCIAL SERVICES LAW  AS  A  RESULT  OF  A  MENTAL  DISABILITY,  FORMERLY
REFERRED TO AS HUMAN SERVICES OVERBURDEN AID TO COUNTIES.
  S  61-a.    Section 32 of the public health law is amended by adding a
new subdivision 6-a to read as follows:
  6-A. TO POST ON THE DEPARTMENT'S INTERNET WEBSITE,  WITHIN  REASONABLY
PROMPT FASHION, ALL FINAL ADMINISTRATIVE DETERMINATIONS ISSUED BY ADMIN-
ISTRATIVE  LAW JUDGES IN CONNECTION WITH ANY ACTIONS TAKEN BY THE OFFICE
PURSUANT TO THIS TITLE;
  S 62.   Notwithstanding any inconsistent provision  of  law,  rule  or
regulation,  for  purposes  of implementing the provisions of the public
health law and the social services law, references to titles XIX and XXI
of the federal social security act in the  public  health  law  and  the
social  services  law  shall  be  deemed to include and also to mean any
successor titles thereto under the federal social security act.
  S 63. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988,  and
18  NYCRR  505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended  and  without
force or effect for purposes of implementing the provisions of this act.
  S 64.  Severability clause. If any clause, sentence, paragraph, subdi-
vision,  section  or  part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation  to  the  clause, sentence, paragraph, subdivision, section or
part thereof directly involved in the controversy in which such judgment
shall have been rendered. It is hereby declared to be the intent of  the
legislature  that  this act would have been enacted even if such invalid
provisions had not been included herein.
  S 65. This act shall take effect immediately, and shall be  deemed  to
have been in full force and effect on and after April 1, 2012, provided,
however, that:
  (a)  the  commissioner  of health may promulgate emergency regulations
necessary to effectuate the provisions of sections two, three  and  four
of this act;
  (b)  the  amendments  to  section  4403-c  of the public health law by
section eight of this act shall not affect the repeal  of  such  section
and shall be deemed to be repealed therewith;
  (b-1)  the  amendments  made  to subdivision 25 of section 1678 of the
public authorities law by section twenty-eight-a of this act  shall  not
affect the expiration of such subdivision and shall expire therewith;
  (c) provided, further, that the amendments to section 1 of chapter 119
of  the laws of 1997 made by section thirty-two of this act, relating to
authorizing the department of health to establish  certain  payments  to
general  hospitals,  shall  be subject to the expiration of such chapter
and shall be deemed expired therewith;
  (d) the amendments to paragraph (a-1)  of  subdivision  4  of  section
365-a of the social services law made by section thirty-nine of this act

S. 6256--D                         38                         A. 9056--D

shall  not  affect  the  expiration  and reversion of such paragraph and
shall be deemed to expire therewith;
  (e)  provided,  further,  that the amendments to section 2807-j of the
public health law made by sections  forty-three,  forty-eight-a,  forty-
eight-b  and  fifty-nine  of this act shall not affect the expiration of
such section and shall be deemed to expire therewith;
  (f) provided, further, that the amendments to section  2807-t  of  the
public  health  law  made  by  section  forty-four of this act shall not
affect the expiration of such section and  shall  be  deemed  to  expire
therewith;
  (g)  provided,  further,  that the amendments to section 4403-f of the
public health law, made by sections forty-a, fifty-six-a and fifty-six-b
of this act shall not affect the repeal of such  section  and  shall  be
deemed to repeal therewith;
  (h)  provided,  further,  that  the amendments to section 364-j of the
social services law made by sections forty and fifty-five  of  this  act
shall not affect the repeal of such section and shall be deemed repealed
therewith;
  (i)  provided, further, that section fifty-five of this act shall take
effect January 1, 2013;
  (j) provided, further, that any  rules  or  regulations  necessary  to
implement  the  provisions of this act may be promulgated and any proce-
dures, forms, or instructions necessary for such implementation  may  be
adopted  and  issued  on  or after the date this act shall have become a
law;
  (k) provided, further, that this act shall not be construed to  alter,
change,  affect,  impair  or  defeat  any rights, obligations, duties or
interests accrued, incurred or conferred prior to the effective date  of
this act;
  (l)  provided, further, that the commissioner of health and the super-
intendent of financial services and any appropriate council may take any
steps necessary to implement this act prior to its effective date;
  (m) provided, further, that notwithstanding any inconsistent provision
of the state administrative procedure act or any other provision of law,
rule or regulation, the commissioner of health and the superintendent of
financial services and any appropriate council is authorized to adopt or
amend or promulgate on an emergency basis any regulation he  or  she  or
such council determines necessary to implement any provision of this act
on its effective date; and
  (n)  provided,  further,  that the provisions of this act shall become
effective notwithstanding the failure of the commissioner of  health  or
the  superintendent  of  financial  services  or any council to adopt or
amend or promulgate regulations implementing this act.

                                 PART E
                          Intentionally Omitted

                                 PART F

  Section 1. Section 1 of part C of chapter 58  of  the  laws  of  2005,
authorizing  reimbursements  for  expenditures  made  by or on behalf of
social services districts for medical assistance for needy  persons  and
the administration thereof, is amended by adding a new subdivision (c-1)
to read as follows:

S. 6256--D                         39                         A. 9056--D

  (C-1)  NOTWITHSTANDING  ANY  PROVISIONS  OF  SUBDIVISION  (C)  OF THIS
SECTION TO THE CONTRARY, EFFECTIVE APRIL 1, 2013, FOR THE PERIOD JANUARY
1, 2013 THROUGH DECEMBER 31, 2013 AND FOR EACH CALENDAR YEAR THEREAFTER,
THE MEDICAL  ASSISTANCE  EXPENDITURE  AMOUNT  FOR  THE  SOCIAL  SERVICES
DISTRICT  FOR SUCH PERIOD SHALL BE EQUAL TO THE PREVIOUS CALENDAR YEAR'S
MEDICAL ASSISTANCE EXPENDITURE AMOUNT, EXCEPT THAT:
  (1) FOR THE PERIOD JANUARY 1, 2013  THROUGH  DECEMBER  31,  2013,  THE
PREVIOUS  CALENDAR  YEAR  MEDICAL  ASSISTANCE EXPENDITURE AMOUNT WILL BE
INCREASED BY 2%;
  (2) FOR THE PERIOD JANUARY 1, 2014  THROUGH  DECEMBER  31,  2014,  THE
PREVIOUS  CALENDAR  YEAR  MEDICAL  ASSISTANCE EXPENDITURE AMOUNT WILL BE
INCREASED BY 1%.
  S 2. Paragraph (iii) of subdivision (g) of section  1  of  part  C  of
chapter  58 of the laws of 2005, authorizing reimbursements for expendi-
tures made by or on behalf of  social  services  districts  for  medical
assistance  for needy persons and the administration thereof, as amended
by section 59 of part A of chapter 57 of the laws of 2006, is amended to
read as follows:
  (iii) During each state fiscal year subject to the provisions of  this
section  AND  PRIOR TO STATE FISCAL YEAR 2015-16, the commissioner shall
maintain an accounting, for each social services district,  of  the  net
amounts that would have been expended by, or on behalf of, such district
had the social services district medical assistance shares provisions in
effect  on  January 1, 2005 been applied to such district.  For purposes
of this paragraph, fifty percent of the payments made by New York  State
to  the secretary of the federal department of health and human services
pursuant to section 1935(c) of the social security act shall  be  deemed
to  be  payments made on behalf of social services districts; such fifty
percent share shall be apportioned to each district in the same ratio as
the number of "full-benefit dual eligible individuals," as that term  is
defined  in  section  1935(c)(6) of such act, for whom such district has
fiscal responsibility pursuant to section 365  of  the  social  services
law,  relates  to  the total of such individuals for whom districts have
fiscal responsibility.  As soon as practicable after the  conclusion  of
each  such  fiscal year, but in no event later than six months after the
conclusion of each such fiscal year, the  commissioner  shall  reconcile
such  net  amounts  with  such  fiscal  year's  social services district
expenditure cap amount. Such reconciliation shall  be  based  on  actual
expenditures  made  by  or  on  behalf of social services districts, and
revenues received by social services districts, during such fiscal  year
and  shall  be  made  without  regard to expenditures made, and revenues
received, outside such fiscal year that are related to services provided
during, or prior to, such fiscal year. The  commissioner  shall  pay  to
each  social  services  district  the  amount,  if  any,  by  which such
district's expenditure cap amount exceeds such net amount.
  S 3. Paragraph (i) of subdivision (b) of section 2 of part C of  chap-
ter  58 of the laws of 2005, authorizing reimbursements for expenditures
made by or on behalf of social services districts for medical assistance
for needy persons and the administration thereof, is amended and  a  new
paragraph (iii) is added to read as follows:
  (i)  A social services district shall exercise the option described in
this section through the adoption of a resolution by its local  legisla-
tive body, in the form set forth in subparagraph (ii) of this paragraph,
to  elect  the medical assistance reimbursement methodology set forth in
paragraph (a) of this section and to elect the tax intercept methodology
set forth in subdivision (f) of section 1261 of the tax law or  subdivi-

S. 6256--D                         40                         A. 9056--D

sion  (g) of section 1261 and subdivision (h) of section 1313 of the tax
law, as applicable. A social services district, acting through its local
legislative body, is hereby authorized to adopt such a resolution.  Such
a  resolution  shall  be  effective only if it is adopted exactly as set
forth in subparagraph (ii) of this paragraph no later than September 30,
2007, and a certified copy of such resolution is mailed to  the  commis-
sioner  of  health  by  certified mail by such date. The commissioner of
health shall, no later than October 31, 2007, certify to the commission-
er of taxation and finance a list of  those  social  services  districts
which  have  elected  the  option  described  in  this section. A social
services district [shall have no authority to rescind the  exercise  of]
THAT  ELECTED  the  option described in this section, ACTING THROUGH ITS
LOCAL LEGISLATIVE BODY, MAY REPEAL THAT ELECTION BY  ADOPTING  A  RESOL-
UTION  EXACTLY  AS  SET FORTH IN PARAGRAPH (III) OF THIS SUBDIVISION AND
MAILING A CERTIFIED COPY OF SUCH REPEAL RESOLUTION TO  THE  COMMISSIONER
OF  HEALTH  NO  LATER  THAN JANUARY 1, 2013.  THE COMMISSIONER OF HEALTH
SHALL, WITHIN TWO WEEKS OF RECEIVING ANY SUCH COPY OF A CERTIFIED REPEAL
RESOLUTION BY CERTIFIED MAIL FROM A SOCIAL SERVICES DISTRICT, CERTIFY IN
WRITING TO THE COMMISSIONER OF TAXATION AND FINANCE THE NAME OF ANY SUCH
SOCIAL SERVICES DISTRICT THAT ADOPTED SUCH A RESOLUTION  TO  REPEAL  ITS
ELECTION. UPON RECEIVING SUCH WRITTEN CERTIFICATION, THE COMMISSIONER OF
TAXATION  AND  FINANCE  SHALL NO LONGER CALCULATE THE MEDICAID AMOUNT OF
SUCH COUNTY UNDER SUBDIVISION (F) OF SECTION 1261 OF THE  TAX  LAW,  AND
THE  AMOUNT  DUE  SUCH COUNTY UNDER SUBDIVISION (C) OF SUCH SECTION 1261
SHALL NO LONGER BE REDUCED BY SUCH MEDICAID AMOUNT, EFFECTIVE THE  FIRST
DAY OF THE MONTH NEXT COMMENCING AT LEAST 10 DAYS AFTER THE COMMISSIONER
OF  TAXATION  AND  FINANCE  HAS  RECEIVED SUCH WRITTEN CERTIFICATION. IF
EVERY SOCIAL SERVICE DISTRICT  THAT  ELECTED  SUCH  OPTION  REPEALS  ITS
ELECTION  AND  THE  COMMISSIONER  OF  HEALTH CERTIFIES IN WRITING TO THE
COMMISSIONER OF TAXATION AND FINANCE THAT  EVERY  SUCH  SOCIAL  SERVICES
DISTRICT  HAS  REPEALED  ITS  ELECTION, THEN SUBDIVISIONS (F) AND (G) OF
SECTION 1261 AND SUBDIVISION (H) OF SECTION 1313  OF  THE  TAX  LAW  TAX
SHALL  BE  REPEALED  AND  THE  PHRASE "OR A TAX REVENUE INTERCEPT AMOUNT
CALCULATED PURSUANT TO SUBDIVISION (F) OR (G) OF SECTION 1261 OF THE TAX
LAW" IN SECTION FOUR OF THIS ACT SHALL BE DELETED, EFFECTIVE  THE  FIRST
DAY  OF  THE  MONTH  NEXT  COMMENCING AT LEAST 10 DAYS AFTER THE DATE ON
WHICH THE COMMISSIONER OF TAXATION AND  FINANCE  RECEIVES  SUCH  WRITTEN
CERTIFICATION FROM THE COMMISSIONER OF HEALTH. AT THE SAME TIME THAT THE
COMMISSIONER  OF  HEALTH MAKES SUCH CERTIFICATION TO THE COMMISSIONER OF
TAXATION AND FINANCE THAT EVERY COUNTY HAS REPEALED  ITS  ELECTION,  THE
COMMISSIONER  OF  HEALTH SHALL ALSO NOTIFY THE LEGISLATIVE BILL DRAFTING
COMMISSION THAT EVERY SOCIAL SERVICE DISTRICT THAT ELECTED  SUCH  OPTION
HAS  REPEALED  ITS  ELECTION IN ORDER THAT THE LEGISLATIVE BILL DRAFTING
COMMISSION MAY MAINTAIN AN ACCURATE AND TIMELY DATA BASE OF THE OFFICIAL
TEXT OF THE LAWS OF THE STATE OF NEW YORK IN  FURTHERANCE  OF  EFFECTING
THE  PROVISIONS OF SECTION 44 OF THE LEGISLATIVE LAW AND SECTION 70-B OF
THE PUBLIC OFFICERS LAW.
  (III) FORM OF RESOLUTION.
  BE IT ENACTED BY THE (COUNTY) OF (INSERT COUNTY'S NAME) AS FOLLOWS:
  SECTION ONE. THE (COUNTY) OF (INSERT COUNTY'S NAME) HEREBY REPEALS ITS
ELECTION IN 2007 OF THE  MEDICAL  ASSISTANCE  REIMBURSEMENT  OPTION  AND
REVENUE  INTERCEPT FOR MEDICAID PURPOSES DESCRIBED IN SECTION 2 OF CHAP-
TER 58 OF THE LAWS OF 2005.
  SECTION 2. THIS RESOLUTION SHALL TAKE EFFECT IMMEDIATELY.
  S 4. Part C of chapter 58 of the laws of 2005, authorizing  reimburse-
ments for expenditures made by or on behalf of social services districts

S. 6256--D                         41                         A. 9056--D

for medical assistance for needy persons and the administration thereof,
is amended by adding a new section 4-a to read as follows:
  S  4-A.  (A)  FOR STATE FISCAL YEAR 2012-13, AND FOR EACH STATE FISCAL
YEAR THEREAFTER, A SOCIAL SERVICES DISTRICT WILL BE  REIMBURSED  BY  THE
STATE FOR THE FULL NON-FEDERAL SHARE OF EXPENDITURES BY THE DISTRICT FOR
THE  ADMINISTRATION OF THE MEDICAL ASSISTANCE PROGRAM, NOT TO EXCEED THE
ADMINISTRATIVE CAP AMOUNT DETERMINED IN ACCORDANCE WITH SUBDIVISION  (B)
OF  THIS  SECTION. ANY PORTION OF THE NON-FEDERAL SHARE OF SUCH EXPENDI-
TURES IN EXCESS OF THE ADMINISTRATIVE CAP AMOUNT SHALL BE THE  RESPONSI-
BILITY  OF  THE SOCIAL SERVICES DISTRICT AND SHALL BE IN ADDITION TO THE
MEDICAL ASSISTANCE EXPENDITURE  AMOUNT  CALCULATED  IN  ACCORDANCE  WITH
SUBDIVISIONS (B), (C), (C-1), AND (D) OF SECTION ONE OF THIS ACT. BEGIN-
NING  IN  STATE  FISCAL  YEAR 2013-14, NO REIMBURSEMENT WILL BE MADE FOR
ADMINISTRATIVE EXPENDITURES IN EXCESS OF SUCH CAP.
  (B) THE ADMINISTRATIVE CAP AMOUNT FOR A SOCIAL SERVICES DISTRICT SHALL
BE EQUAL TO A PERCENTAGE OF THE AMOUNT INCLUDED IN THE STATE FISCAL YEAR
2011-12 ENACTED BUDGET FOR THE NON-FEDERAL SHARE OF  MEDICAL  ASSISTANCE
ADMINISTRATIVE  COSTS  PURSUANT  TO  THIS  SECTION. EACH SOCIAL SERVICES
DISTRICT'S PERCENTAGE SHALL  BE  EQUAL  TO  THE  PERCENTAGE  OF  MEDICAL
ASSISTANCE  ADMINISTRATIVE  COSTS  CLAIMED  BY SUCH DISTRICT IN THE 2011
CALENDAR YEAR IN RELATION TO ALL OTHER SOCIAL SERVICES DISTRICTS.
  (C) NOTWITHSTANDING THE PROVISIONS OF SUBDIVISION (B) OF THIS SECTION,
THE COMMISSIONER OF HEALTH MAY, AT HIS OR HER SOLE DISCRETION, REDUCE  A
SOCIAL  SERVICES  DISTRICT'S  ADMINISTRATIVE CAP AMOUNT TO ACCOUNT FOR A
REDUCTION IN THE  SCOPE  OR  VOLUME  OF  THE  DISTRICT'S  ADMINISTRATIVE
RESPONSIBILITIES,  INCLUDING BUT NOT LIMITED TO SUCH A REDUCTION RESULT-
ING FROM THE PROCESS OF CONVERTING THE MEDICAL ASSISTANCE PROGRAM  TO  A
DEPARTMENT-ADMINISTERED  PROGRAM PURSUANT TO SECTION 365-N OF THE SOCIAL
SERVICES LAW.
  (D) IF, FOR STATE FISCAL YEAR 2012-13 AND FOR ANY  STATE  FISCAL  YEAR
THEREAFTER,  THE  AGGREGATE  AMOUNT  OF  ADMINISTRATIVE COSTS CLAIMED OR
PROJECTED TO BE CLAIMED BY ALL SOCIAL SERVICES DISTRICTS  IS  LESS  THAN
THE  NON-FEDERAL  FINANCIAL PLAN APPROPRIATION FOR THE ADMINISTRATION OF
THE MEDICAL ASSISTANCE PROGRAM FOR  THAT  FISCAL  YEAR,  THE  DIFFERENCE
BETWEEN  SUCH  AGGREGATE  AMOUNT  OF CLAIMS OR PROJECTED CLAIMS AND SUCH
APPROPRIATION SHALL BE USED FOR REIMBURSEMENT TO THOSE DISTRICTS  DETER-
MINED  BY  THE  COMMISSIONER,  WITH  THE APPROVAL OF THE DIRECTOR OF THE
BUDGET, TO HAVE CLAIMS OR PROJECTED CLAIMS FOR REASONABLE ADMINISTRATIVE
COSTS WHICH EXCEED OR ARE PROJECTED TO  EXCEED  THE  ADMINISTRATIVE  CAP
AMOUNT  AS ESTABLISHED PURSUANT TO SUBDIVISION (B) OF THIS SECTION. SUCH
REIMBURSEMENT SHALL BE ACCOMPLISHED BY ALLOCATING  PROPORTIONALLY  AMONG
SUCH DISTRICTS THE AGGREGATE AMOUNT OF SUCH EXCESS.
  S  5.  Section 91 of part H of chapter 59 of the laws of 2011 amending
the public health law  and  other  laws  relating  to  general  hospital
reimbursement for annual rates is amended to read as follows:
  S 91. 1. Notwithstanding any inconsistent provision of state law, rule
or  regulation to the contrary, subject to federal approval, the year to
year rate of growth of department of health state funds Medicaid  spend-
ing  shall not exceed the ten year rolling average of the medical compo-
nent of the consumer price index  as  published  by  the  United  States
department  of  labor, bureau of labor statistics, for the preceding ten
years.
  2. EXCEPT AS PROVIDED IN SUBDIVISION THREE OF THIS SECTION, FOR  STATE
FISCAL  YEAR  2013-14  AND FOR EACH FISCAL YEAR THEREAFTER, THE SPENDING
LIMIT CALCULATED PURSUANT TO SUBDIVISION ONE OF THIS  SECTION  SHALL  BE
INCREASED  BY AN AMOUNT EQUAL TO THE DIFFERENCE BETWEEN THE TOTAL SOCIAL

S. 6256--D                         42                         A. 9056--D

SERVICES DISTRICT MEDICAL ASSISTANCE EXPENDITURE AMOUNTS CALCULATED  FOR
SUCH PERIOD IN CONFORMANCE WITH SUBDIVISIONS (B), (C), (C-1), AND (D) OF
SECTION  1  OF  PART  C  OF CHAPTER 58 OF THE LAWS OF 2005 AND THE TOTAL
SOCIAL  SERVICES  DISTRICT  MEDICAL  EXPENDITURE AMOUNTS THAT WOULD HAVE
RESULTED IF THE PROVISIONS OF SUBDIVISION (C-1) OF SUCH SECTION HAD  NOT
BEEN APPLIED.
  3.  WITH RESPECT TO A SOCIAL SERVICES DISTRICT THAT RESCINDS THE EXER-
CISE OF THE OPTION PROVIDED IN  PARAGRAPH  (I)  OF  SUBDIVISION  (B)  OF
SECTION  2 OF PART C OF CHAPTER 58 OF THE LAWS OF 2005, FOR STATE FISCAL
YEAR 2013-14 AND FOR EACH FISCAL YEAR  THEREAFTER,  THE  SPENDING  LIMIT
CALCULATED  PURSUANT TO SUBDIVISION ONE OF THIS SECTION SHALL BE REDUCED
BY THE AMOUNT OF THE MEDICAL ASSISTANCE  EXPENDITURE  AMOUNT  CALCULATED
FOR SUCH DISTRICT FOR SUCH PERIOD.
  S  6. The social services law is amended by adding a new section 365-n
to read as follows:
  S 365-N. DEPARTMENT OF HEALTH ASSUMPTION  OF  PROGRAM  ADMINISTRATION.
1.  NOTWITHSTANDING THE PROVISIONS OF TITLE TWO OF ARTICLE THREE OF THIS
CHAPTER OR OF SECTION THREE HUNDRED SIXTY-FIVE OF THIS TITLE OR  OF  ANY
OTHER  LAW TO THE CONTRARY, THE COMMISSIONER OF HEALTH (COMMISSIONER) IS
AUTHORIZED TO TAKE ACTIONS EXPLICITLY AUTHORIZED BY  THIS  SECTION  THAT
ARE  NECESSARY  TO TRANSFER RESPONSIBILITY FOR THE ADMINISTRATION OF THE
MEDICAL ASSISTANCE PROGRAM FROM LOCAL SOCIAL SERVICES DISTRICTS  TO  THE
DEPARTMENT  OF  HEALTH  (DEPARTMENT) BY MARCH THIRTY-FIRST, TWO THOUSAND
EIGHTEEN.
  2. FOR PURPOSES OF THIS SECTION, THE  ADMINISTRATION  OF  THE  MEDICAL
ASSISTANCE  PROGRAM  INCLUDES:  PROCESSING APPLICATIONS FOR BENEFITS AND
SERVICES AVAILABLE UNDER THIS TITLE AND TITLE ELEVEN-D OF THIS  ARTICLE;
MAKING  DETERMINATIONS OF INITIAL AND ONGOING ELIGIBILITY FOR SUCH BENE-
FITS AND SERVICES; MAKING COVERAGE DETERMINATIONS WITH RESPECT TO  BENE-
FITS  AND  SERVICES  REQUIRING PRIOR AUTHORIZATION; NOTIFYING APPLICANTS
AND RECIPIENTS OF THESE DETERMINATIONS AND OF THEIR RIGHTS AND RESPONSI-
BILITIES, AUTHORIZING BENEFITS AND SERVICES FOR PERSONS FOUND  ELIGIBLE;
EXERCISING  SUBROGATION  RIGHTS  WITH  RESPECT  TO AMOUNTS RECEIVED FROM
INSURANCE CARRIERS OR OTHER LIABLE THIRD  PARTIES;  IMPOSING  LIENS  AND
PURSUING  RECOVERIES;  AND ANY OTHER SUCH TASKS AND FUNCTIONS IDENTIFIED
BY THE COMMISSIONER.
  3. NOTWITHSTANDING SECTIONS SIXTY-ONE, SIXTY-THREE, SEVENTY,  SEVENTY-
EIGHT, SEVENTY-NINE, EIGHTY-ONE AND EIGHT-ONE-A OF THE CIVIL SERVICE LAW
OR  ANY PROVISIONS TO THE CONTRARY CONTAINED IN ANY GENERAL, SPECIAL, OR
LOCAL LAWS, ALL LAWFUL APPOINTEES OF A COUNTY PERFORMING  THE  FUNCTIONS
ESTABLISHED  IN SUBDIVISION TWO OF THIS SECTION AS OF THE EFFECTIVE DATE
OF THIS SECTION WILL BE ELIGIBLE FOR VOLUNTARY TRANSFER  TO  APPROPRIATE
POSITIONS,  IN THE DEPARTMENT, THAT ARE CLASSIFIED TO PERFORM SUCH FUNC-
TIONS WITHOUT FURTHER EXAMINATION, QUALIFICATION, OR PROBATIONARY  PERI-
OD;  AND, UPON SUCH TRANSFER, WILL HAVE ALL THE RIGHTS AND PRIVILEGES OF
THE JURISDICTIONAL CLASSIFICATION TO WHICH SUCH POSITIONS ARE  ALLOCATED
IN THE CLASSIFIED SERVICE OF THE STATE.
  4.  WITHIN  ONE  HUNDRED  TWENTY  DAYS  OF  THE EFFECTIVE DATE OF THIS
SECTION, THE DEPARTMENT SHALL DEVELOP AND IMPLEMENT A  LOCAL  DEPARTMENT
OF SOCIAL SERVICES STATEMENT OF INTEREST. THE STATEMENT OF INTEREST WILL
ELICIT  FROM  LOCAL DEPARTMENTS OF SOCIAL SERVICES THEIR INTEREST IN AND
CAPACITY TO CONTRACT WITH THE DEPARTMENT TO PERFORM THE FUNCTIONS ESTAB-
LISHED IN SUBDIVISION TWO OF THIS SECTION. TO THE EXTENT PRACTICABLE AND
IN THE BEST INTEREST OF THE MEDICAL ASSISTANCE PROGRAM,  THE  DEPARTMENT
SHALL  CONTRACT WITH LOCAL SOCIAL SERVICES DISTRICTS TO PERFORM ALL OR A
PORTION OF THE FUNCTIONS DESCRIBED IN SUBDIVISION TWO OF  THIS  SECTION.

S. 6256--D                         43                         A. 9056--D

IN NO EVENT, HOWEVER, SHALL THE DEPARTMENT, BY MEANS OF SUCH A CONTRACT,
DELEGATE  ITS  AUTHORITY  TO  EXERCISE  ADMINISTRATIVE DISCRETION IN THE
ADMINISTRATION OR SUPERVISION OF THE STATE PLAN FOR  MEDICAL  ASSISTANCE
SUBMITTED PURSUANT TO SECTION THREE HUNDRED SIXTY-THREE-A OF THIS TITLE,
OR  TO ISSUE POLICIES, RULES, AND REGULATIONS ON PROGRAM MATTERS NOR MAY
ANY CONTRACTED ENTITY BE GIVEN THE AUTHORITY TO CHANGE OR DISAPPROVE ANY
ADMINISTRATIVE DECISION OF THE DEPARTMENT, OR OTHERWISE SUBSTITUTE  SUCH
ENTITY'S  JUDGMENT FOR THAT OF THE DEPARTMENT WITH RESPECT TO THE APPLI-
CATION OF POLICIES, RULES, AND REGULATIONS  ISSUED  BY  THE  DEPARTMENT.
NOTWITHSTANDING  ANY  INCONSISTENT  PROVISION  OF  SECTIONS  ONE HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTIONS
ONE HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVEL-
OPMENT LAW, OR ANY OTHER CONTRARY PROVISION OF LAW, THE COMMISSIONER  IS
AUTHORIZED  TO  ENTER  INTO  A CONTRACT WITH LOCAL DEPARTMENTS OF SOCIAL
SERVICES WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS.
  5. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTIONS ONE  HUNDRED
TWELVE AND ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, OR SECTIONS
ONE HUNDRED FORTY-TWO AND ONE HUNDRED FORTY-THREE OF THE ECONOMIC DEVEL-
OPMENT  LAW, OR ANY OTHER CONTRARY PROVISION OF LAW, THE COMMISSIONER IS
AUTHORIZED TO AMEND THE TERMS OF CONTRACTS AWARDED PRIOR TO  THE  EFFEC-
TIVE DATE OF THIS SECTION, INCLUDING A CONTRACT ENTERED INTO PURSUANT TO
SUBDIVISION  TWENTY-FOUR OF SECTION TWO HUNDRED SIX OF THE PUBLIC HEALTH
LAW, AS ADDED BY SECTION THIRTY-NINE OF PART C OF CHAPTER FIFTY-EIGHT OF
THE LAWS OF TWO THOUSAND EIGHT, WITHOUT A COMPETITIVE BID OR REQUEST FOR
PROPOSAL PROCESS, UPON A DETERMINATION THAT THE EXISTING  CONTRACTOR  IS
QUALIFIED  TO  PROVIDE ASSISTANCE WITH ONE OR MORE FUNCTIONS ESTABLISHED
IN SUBDIVISION TWO OF THIS SECTION. SUCH AMENDMENTS SHALL BE LIMITED  TO
IMPLEMENTATION OF: (I) AUTOMATION ENHANCEMENTS, INCLUDING BUT NOT LIMIT-
ED  TO,  THE  MEDICARE  SAVINGS  PROGRAM AND THE FAMILY PLANNING BENEFIT
PROGRAM; (II) PROCESSES FOR VERIFICATION OF THIRD  PARTY  INSURANCE  AND
PROCESSING  ENROLLMENT  IN  MEDICAL  ASSISTANCE  WITH THIRD PARTY HEALTH
INSURANCE; (III) PROCEDURES THAT WILL INCREASE EFFICIENCIES  AT  ENROLL-
MENT  CENTERS;  (IV)  AN ASSET VERIFICATION SYSTEM; AND (V) PROCESSES TO
COMPLY WITH FEDERAL LAW, INCLUDING, BUT NOT LIMITED TO, THE USE OF MODI-
FIED ADJUSTED GROSS INCOME IN ELIGIBILITY DETERMINATIONS.
  6. THE COMMISSIONER SHALL SUBMIT AN ANNUAL  REPORT  TO  THE  GOVERNOR,
TEMPORARY PRESIDENT OF THE SENATE, SPEAKER OF THE ASSEMBLY, THE CHAIR OF
THE SENATE HEALTH COMMITTEE AND THE CHAIR OF THE ASSEMBLY HEALTH COMMIT-
TEE  BY  DECEMBER THIRTY-FIRST, BEGINNING IN TWO THOUSAND TWELVE AND FOR
EACH YEAR THEREAFTER UNTIL THE YEAR FOLLOWING FULL IMPLEMENTATION.   THE
INITIAL  REPORT  SHALL  CONSIST  OF  MODIFICATIONS TO THE PLAN DEVELOPED
PURSUANT TO SECTION FORTY-SEVEN-B OF PART B OF  CHAPTER  FIFTY-EIGHT  OF
THE  LAWS OF TWO THOUSAND TEN, AND SHALL INCLUDE ANTICIPATED IMPLEMENTA-
TION OF THE REVISED PLAN, ITS ELEMENTS, A TIMELINE FOR SUCH  IMPLEMENTA-
TION,  RECOMMENDATIONS FOR LEGISLATIVE ACTION, AND SUCH OTHER MATTERS AS
MAY BE PERTINENT.
  THE REPORT SHALL INCLUDE A PLAN AND TIMELINE FOR THE STATE TO:
  (I) ASSUME SPECIFIC FUNCTIONS RELATED TO  THE  ADMINISTRATION  OF  THE
MEDICAL  ASSISTANCE  PROGRAM;  (II)  COORDINATE  THE  IMPLEMENTATION  OF
PROVISIONS OF FEDERAL LAW WITH THE ASSUMPTION OF THE  ADMINISTRATION  OF
THE  MEDICAL  ASSISTANCE PROGRAM; AND (III) ADDRESS THE FINANCING OF THE
MEDICAL ASSISTANCE PROGRAM ADMINISTRATION AND ANY ASSOCIATED ADMINISTRA-
TIVE COST RELIEF TO LOCAL SOCIAL SERVICES DISTRICTS.  THE  REPORT  SHALL
ALSO  INDICATE  ANY  FUNCTION  THAT  THE  STATE  INTENDS TO ENTER INTO A
CONTRACT WITH A PUBLIC AND/OR PRIVATE ENTITY TO PERFORM, AND THE DATE IN
WHICH THE STATE ANTICIPATES ENTERING INTO ANY SUCH  CONTRACT.  IN  ADDI-

S. 6256--D                         44                         A. 9056--D

TION,  REPORTS  SHALL,  AT  A  MINIMUM,  INDICATE:  (I) ANY PROGRESS THE
DEPARTMENT HAS MADE REGARDING ITS PROPOSED TIMELINE, INCLUDING A SUMMARY
OF ALL FUNCTIONS ASSUMED BY THE STATE DURING THE PREVIOUS YEAR; (II) ANY
ANTICIPATED  AND/OR  ACTUAL  DELAY FROM THE PROPOSED TIMELINE; (III) THE
REASON FOR ANY SUCH DELAY; AND (IV) ACTIONS THE DEPARTMENT HAS UNDERTAK-
EN TO MITIGATE ANY SUCH DELAY.
  7. THE COMMISSIONER SHALL PROMULGATE SUCH REGULATIONS THAT ARE  NECES-
SARY  TO  CARRY  OUT  THE  PROVISIONS  OF THIS SECTION. IN ADDITION, THE
COMMISSIONER SHALL MAKE ANY AMENDMENTS TO THE  STATE  PLAN  FOR  MEDICAL
ASSISTANCE,  OR  DEVELOP  AND  SUBMIT  AN  APPLICATION FOR ANY WAIVER OR
APPROVAL UNDER THE FEDERAL SOCIAL SECURITY ACT, THAT ARE  NECESSARY  AND
REQUIRED TO CARRY OUT THE PROVISIONS OF THIS SECTION.
  S 7. Subdivision 7 of section 369 of the social services law, as added
by  section 71-a of part C of chapter 58 of the laws of 2008, is amended
to read as follows:
  7. Notwithstanding any provision of law to the contrary,  the  depart-
ment [may commence] SHALL, WHEN IT DETERMINES NECESSARY PROGRAM FEATURES
ARE  IN  PLACE,  ASSUME  SOLE  RESPONSIBILITY  FOR COMMENCING actions or
proceedings in accordance with the provisions of this section,  sections
one  hundred one, one hundred four, one hundred four-b, paragraph (a) of
subdivision three of section three hundred sixty-six,  subparagraph  one
of paragraph (h) of subdivision four of section three hundred sixty-six,
and paragraph (b) of subdivision two of section three hundred sixty-sev-
en-a  of  this  chapter,  to  recover  the  cost  of  medical assistance
furnished pursuant to this title and title eleven-D of this article. The
department is authorized to contract with an entity that  shall  conduct
activities  on  behalf  of  the department pursuant to this subdivision.
PRIOR TO ASSUMING SUCH RESPONSIBILITY FROM A SOCIAL  SERVICES  DISTRICT,
THE  DEPARTMENT  OF  HEALTH  SHALL,  IN  CONSULTATION WITH THE DISTRICT,
DEFINE THE SCOPE OF THE  SERVICES  THE  DISTRICT  WILL  BE  REQUIRED  TO
PERFORM  ON BEHALF OF THE DEPARTMENT OF HEALTH PURSUANT TO THIS SUBDIVI-
SION.
  S 8. Notwithstanding any inconsistent provision of law, rule or  regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal  social  security  act  in  the public health law and the social
services law shall be deemed to include and also to mean  any  successor
titles thereto under the federal social security act.
  S  9. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988,  and
18  NYCRR  505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended  and  without
force or effect for purposes of implementing the provisions of this act.
  S  10. Severability clause. If any clause, sentence, paragraph, subdi-
vision, section or part of this act shall be adjudged by  any  court  of
competent  jurisdiction  to  be invalid, such judgment shall not affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation to the clause, sentence, paragraph,  subdivision,  section  or
part thereof directly involved in the controversy in which such judgment
shall  have been rendered. It is hereby declared to be the intent of the
legislature that this act would have been enacted even if  such  invalid
provisions had not been included herein.
  S  11.  This  act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012,  provided
that:

S. 6256--D                         45                         A. 9056--D

  1. section one of this act shall take effect April 1, 2013;
  2.  any  rules or regulations necessary to implement the provisions of
this act may be promulgated and any procedures, forms,  or  instructions
necessary  for such implementation may be adopted and issued on or after
the date this act shall have become a law;
  3. this act shall not be construed to alter, change, affect, impair or
defeat any rights, obligations, duties or interests accrued, incurred or
conferred prior to the effective date of this act;
  4. the commissioner of health  and  the  superintendent  of  financial
services  and  any  appropriate  council may take any steps necessary to
implement this act prior to its effective date;
  5. notwithstanding any inconsistent provision of the state administra-
tive procedure act or any other provision of law,  rule  or  regulation,
the  commissioner of health and the superintendent of financial services
and any appropriate council is authorized to adopt or amend  or  promul-
gate  on  an  emergency  basis  any regulation he or she or such council
determines necessary to implement any  provision  of  this  act  on  its
effective date;
  6.  the amendment to section 91 of part H of chapter 59 of the laws of
2011, amending the public health law and other laws relating to  general
hospital  reimbursement  for  annual rates, made by section five of this
act shall take effect on the same date and in the same  manner  as  such
section takes effect;
  7.  the  provisions of this act shall become effective notwithstanding
the failure of the commissioner  of  health  or  the  superintendent  of
financial  services or any council to adopt or amend or promulgate regu-
lations implementing this act;
  8. subdivision 5 of section 365-n of the social services law, as added
by section six of this act shall expire and be deemed repealed March 31,
2015.

                                 PART G

  Section 1. Subdivision 1 of section 79 of part C of chapter 58 of  the
laws  of  2005 relating to the preferred drug program is amended to read
as follows:
  1. [sections ten through fifteen] SECTION FOURTEEN of this  act  shall
expire and be deemed repealed on and after June 15, 2012;
  S  2.  Subparagraph  (v) of paragraph (b) of subdivision 35 of section
2807-c of the public health law, as amended by section 35-a of part H of
chapter 59 of the laws of 2011, is amended to read as follows:
  (v) such  regulations  shall  incorporate  quality  related  measures,
including,  but  not  limited  to, potentially preventable re-admissions
(PPRs) and provide for rate adjustments or payment disallowances related
to PPRs and other potentially  preventable  negative  outcomes  (PPNOs),
which shall be calculated in accordance with methodologies as determined
by the commissioner, provided, however, that such methodologies shall be
based on a comparison of the actual and risk adjusted expected number of
PPRs and other PPNOs in a given hospital and with benchmarks established
by  the  commissioner and provided further that such rate adjustments or
payment disallowances shall result in an aggregate reduction in Medicaid
payments of no less than thirty-five million dollars for the period July
first, two thousand ten through March thirty-first, two thousand  eleven
and no less than fifty-one million dollars for [the period] ANNUAL PERI-
ODS  BEGINNING  April  first,  two thousand eleven through March thirty-
first, two thousand [twelve] THIRTEEN, provided further that such aggre-

S. 6256--D                         46                         A. 9056--D

gate reductions shall be offset by Medicaid payment reductions occurring
as a result of decreased PPRs during the period July first, two thousand
ten through March thirty-first, two thousand eleven and the period April
first,  two  thousand  eleven  through  March thirty-first, two thousand
[twelve] THIRTEEN and as a result of decreased PPNOs during  the  period
April  first,  two thousand eleven through March thirty-first, two thou-
sand [twelve] THIRTEEN; and provided further that for  the  period  July
first,  two  thousand  ten  through  March  thirty-first,  two  thousand
[twelve] THIRTEEN, such rate adjustments or payment disallowances  shall
not apply to behavioral health PPRs; or to readmissions that occur on or
after fifteen days following an initial admission. By no later than July
first,  two  thousand eleven the commissioner shall enter into consulta-
tions with representatives of the health care facilities subject to this
section regarding potential prospective revisions to applicable  method-
ologies  and benchmarks set forth in regulations issued pursuant to this
subparagraph;
  S 3. This act shall take effect immediately and  shall  be  deemed  to
have been in full force and effect on and after April 1, 2012.

                                 PART H

  Section  1.    Subdivisions  3-b and 3-c of section 1 and section 4 of
part C of chapter 57 of the laws of 2006,  relating  to  establishing  a
cost of living adjustment for designated human services programs, subdi-
visions  3-b  and 3-c of section 1 as amended by section 1 and section 4
as amended by section 2 of part F of chapter 59 of the laws of 2011,  is
amended to read as follows:
  3-b.  Notwithstanding  any  inconsistent  provision  of law, beginning
April 1, 2009 and ending March 31, [2012] 2013, the commissioners  shall
not  include  a  COLA for the purpose of establishing rates of payments,
contracts or any other form of reimbursement.
  3-c. Notwithstanding any  inconsistent  provision  of  law,  beginning
April 1, [2012] 2013 and ending March 31, [2015] 2016, the commissioners
shall develop the COLA under this section using the actual U.S. consumer
price  index  for  all  urban  consumers (CPI-U) published by the United
States department of labor, bureau of labor statistics  for  the  twelve
month  period  ending  in  July  of  the budget year prior to such state
fiscal  year,  for  the  purpose  of  establishing  rates  of  payments,
contracts or any other form of reimbursement.
  S  4.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2006;  provided
section  one  of  this  act shall expire and be deemed repealed April 1,
[2015] 2016; provided, further, that sections two and three of this  act
shall expire and be deemed repealed December 31, 2009.
  S  2.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012; provided,
however, that the amendments to section 1 of part C of chapter 57 of the
laws of 2006 made by section one of this act shall not affect the repeal
of such section and shall be deemed repealed therewith.

                                 PART I
                          Intentionally Omitted

                                 PART J

S. 6256--D                         47                         A. 9056--D

  Section 1. Section 13.17 of the mental hygiene law, as added by  chap-
ter  978  of the laws of 1977, the section heading as amended by chapter
168 of the laws of 2010, subdivisions (b) and (d) as amended by  chapter
37  of the laws of 2011 and subdivision (c) as amended by chapter 538 of
the laws of 1987, is amended to read as follows:
S 13.17 Programs, services, and operations [of facilities] in the office
          for people with developmental disabilities.
  (a)  The  commissioner  shall  establish policy and procedures for the
organization, administration, and [operation of the facilities]  SERVICE
DELIVERY  SYSTEM  under  his  OR  HER  jurisdiction[. He] AND shall make
provision for the  effective  rendition  of  SUPPORTS  AND  services  to
[patients  by  such  facilities  or  office  personnel] INDIVIDUALS WITH
DEVELOPMENTAL DISABILITIES.
  (b) There shall be [in], WITHIN THE STATE OPERATIONS  OFFICES  OF  the
office,  the  developmental  disabilities  services  offices named below
serving the areas either currently or previously served by a school, for
the care and treatment of persons with  developmental  disabilities  and
for  research  and  teaching  in the science and skills required for the
care and treatment of such persons with developmental disabilities:
  Bernard M. Fineson Developmental Disabilities Services Office
  Brooklyn Developmental Disabilities Services Office
  Broome Developmental Disabilities Services Office
  Capital District Developmental Disabilities Services Office
  Central New York Developmental Disabilities Services Office
  Finger Lakes Developmental Disabilities Services Office
  Institute for Basic Research in Developmental Disabilities
  Hudson Valley Developmental Disabilities Services Office
  Metro New York Developmental Disabilities Services Office
  Long Island Developmental Disabilities Services Office
  Sunmount Developmental Disabilities Services Office
  Taconic Developmental Disabilities Services Office
  Western New York Developmental Disabilities Services Office
  Staten Island Developmental Disabilities Services Office
  The New York State Institute for Basic Research in Developmental Disa-
bilities is designated as  an  institute  for  the  conduct  of  medical
research  and other scientific investigation directed towards furthering
knowledge of the etiology, diagnosis, treatment and prevention of devel-
opmental disabilities.
  (c) The commissioner shall establish [the areas  which  each  facility
or],  AT  HIS  OR  HER  DISCRETION, developmental disabilities [services
office under his jurisdiction shall serve and the categories of  clients
which  shall  be  served  thereby]  REGIONAL OFFICES AND SHALL ESTABLISH
STATE OPERATIONS  OFFICES  THAT  PROVIDE  FOR  THE  DIRECT  DELIVERY  OF
SUPPORTS  AND SERVICES BY THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISA-
BILITIES.
  [(d)] (C) The commissioner may [permit] AUTHORIZE other offices of the
department and any public or private non-profit  organization  or  poli-
tical subdivision of the state to [operate programs for persons] DELIVER
SUPPORTS  AND  SERVICES  TO INDIVIDUALS with developmental disabilities,
not inconsistent with the programs and objectives of the office  in  any
facility under his jurisdiction. The commissioner may permit any facili-
ty  under  his  jurisdiction to operate programs for persons with mental
disabilities, not inconsistent  with  programs  and  objectives  of  the
department,  under contracts or agreements with other offices within the
department.

S. 6256--D                         48                         A. 9056--D

  S 2. Section 13.19 of the mental hygiene law, as added by chapter  978
of  the laws of 1977, subdivisions (a) and (d) as amended by chapter 168
of the laws of 2010 and subdivision (e) as added by chapter 307  of  the
laws of 1979, is amended to read as follows:
S 13.19 Personnel of the office; regulations.
  (a)  The  commissioner  may, within the amounts appropriated therefor,
appoint and remove in accordance with law and applicable  rules  of  the
state  civil  service  commission,  such  officers  and employees of the
office for people with developmental disabilities [and school and facil-
ity officers and employees who are designated managerial or confidential
pursuant to article fourteen of the civil service law] as are  necessary
for efficient administration.  THE COMMISSIONER SHALL, IN EXERCISING HIS
OR   HER   APPOINTING   AUTHORITY,   TAKE,   CONSISTENT   WITH   ARTICLE
TWENTY-THREE-A OF THE CORRECTION LAW, ALL REASONABLE AND NECESSARY STEPS
TO ENSURE THAT ANY SUCH PERSON SO APPOINTED HAS NOT  PREVIOUSLY  ENGAGED
IN  ANY  ACT IN VIOLATION OF ANY LAW WHICH INDICATES A PROPENSITY TO ACT
IN A MANNER THAT WOULD COMPROMISE THE HEALTH AND SAFETY  OF  INDIVIDUALS
WITH DEVELOPMENTAL DISABILITIES.
  (b)  The  director of a hospital or institute in the office shall have
professional qualifications and  experience  to  be  prescribed  by  the
commissioner.
  (c)  Notwithstanding  the provisions of any other law, the [positions]
POSITION of [psychiatrist III and] deputy director in  [any]  AN  office
facility may be filled BY NEW HIRE OR by promotion open to employees [of
all  such  facilities]  who  possess  the minimum qualifications for the
[respective positions. Promotion lists which are established  for  those
positions shall be general eligible promotion lists from which names are
certified  in  the  order of final earned ratings and from which certif-
ication shall not be subdivided by the facility or department  in  which
such persons are employed. Nothing in this subdivision shall prevent the
use of open competitive examinations] POSITION.
  [(d)]  (C)  The  use  of  volunteers [at facilities] in the office for
people with developmental disabilities shall be encouraged. The  commis-
sioner may establish regulations governing such volunteer services.
  [(e)]  (D)  Where,  and  to  the extent that, an agreement between the
state and an employee organization  entered  into  pursuant  to  article
fourteen  of  the  civil  service  law  so provides, the commissioner is
authorized to implement the provisions of  such  agreement  relating  to
discipline consistent with the terms thereof.
  S  3. Section 13.21 of the mental hygiene law, as added by chapter 978
of the laws of 1977, the section heading and subdivisions (a) and (c) as
amended by chapter 168 of the laws of 2010, subdivision (b)  as  amended
by  chapter 558 of the laws of 2011, subdivision (d) as added by chapter
355 of the laws of 1987 and subdivision (e) as added by chapter  492  of
the  laws  of 1978 and as relettered by chapter 355 of the laws of 1987,
is amended to read as follows:
S 13.21 Directors of [schools] STATE  OPERATIONS  OFFICES  AND  DEVELOP-
          MENTAL  DISABILITIES REGIONAL OFFICES in the office for people
          with developmental disabilities.
  (a) The [director] DIRECTORS of [a school] BOTH THE  STATE  OPERATIONS
OFFICES  AND  DEVELOPMENTAL  DISABILITIES REGIONAL OFFICES in the office
for people with developmental disabilities shall  be  appointed  by  the
commissioner  [and shall be its chief executive officer. The director of
a school  shall  be  the  director  of  the  developmental  disabilities
services  office  serving  the  areas  designated by the commissioner in
regulation, and in such context, the term facility shall also  refer  to

S. 6256--D                         49                         A. 9056--D

such  developmental  disabilities  services  office]. Each such director
shall be in the non-competitive class and designated as confidential  as
defined  by  subdivision two-a of section forty-two of the civil service
law  and  shall  serve  at the pleasure of the commissioner. [Except for
school and facility officers and employees for which subdivision (a)  of
section  13.19 of this article makes the commissioner the appointing and
removing authority, the director of a school shall have the power, with-
in amounts appropriated therefor, to appoint and  remove  in  accordance
with law and applicable rules of the state civil service commission such
officers and employees of the facility of which he or she is director as
are  necessary  for  its  efficient  administration.] He or she shall in
exercising his or her appointing authority take, consistent with article
twenty-three-A of the correction law, all reasonable and necessary steps
to insure that any such person so appointed has not  previously  engaged
in  any act in violation of any law which [could] INDICATES A PROPENSITY
TO ACT IN A MANNER THAT  WOULD  compromise  the  health  and  safety  of
patients in the facility of which he or she is director. He or she shall
manage  the [facility, and administer its personnel system,] STATE OPER-
ATIONS OFFICE OR DEVELOPMENTAL DISABILITIES REGIONAL OFFICE AND ADMINIS-
TER ITS PERSONNEL SYSTEM subject to applicable law, the  regulations  of
the  commissioner,  and the rules of the state civil service commission.
[Before the commissioner shall issue any such regulation or  any  amend-
ment  or revision thereof, he or she shall consult with the directors of
schools in the office regarding its suitability.] The [director]  DIREC-
TORS  OF THE DEVELOPMENTAL DISABILITIES REGIONAL OFFICES AND STATE OPER-
ATIONS OFFICES shall maintain effective supervision of all parts of [the
facility and over all persons employed therein or  coming  thereon  and]
THEIR  RESPECTIVE  OFFICES.  THE  DIRECTORS  OF STATE OPERATIONS OFFICES
shall  generally  [direct]  PROVIDE  FOR  the  [care  and  treatment  of
patients.  Directors presently serving at facilities of the office shall
continue to serve under the terms of their original appointment]  ADMIN-
ISTRATION  OF  SUPPORTS  AND  SERVICES TO INDIVIDUALS WITH DEVELOPMENTAL
DISABILITIES IN STATE OPERATED PROGRAMS. DIRECTORS OF  REGIONAL  OFFICES
SHALL  GENERALLY  OVERSEE THE ADMINISTRATION OF SUPPORTS AND SERVICES TO
INDIVIDUALS WITH DEVELOPMENTAL  DISABILITIES  IN  SETTINGS  OUTSIDE  THE
STATE OPERATED PROGRAMS.
  (b)  Such [director] DIRECTORS shall have the responsibility of seeing
that there is humane treatment of [the  patients  at  his  facility  and
shall  investigate  every case of alleged patient abuse or mistreatment]
INDIVIDUALS  WITH  DEVELOPMENTAL  DISABILITIES  RECEIVING  SERVICES   IN
SETTINGS  OPERATED,  LICENSED,  CERTIFIED,  FUNDED  OR  APPROVED BY THIS
OFFICE.  [The] A director OF A  STATE  OPERATIONS  OFFICE  shall  notify
immediately,  and  in  any event within three working days, the board of
visitors of the facility and the mental hygiene legal service located in
the same judicial department as [the hospital,  school  or  institution]
THE  STATE  OPERATIONS  OFFICE  of  every  complaint of patient abuse or
mistreatment and shall inform the board and  the  mental  hygiene  legal
service of the results of his OR HER investigation. If it appears that a
crime  may  have  been  committed,  [the] SUCH STATE OPERATIONS director
shall give notice thereof to the district attorney or other  appropriate
law  enforcement  official  as soon as possible, and in any event within
three working days unless it appears that the crime includes an  employ-
ee,  intern,  volunteer,  consultant,  contractor,  or  visitor  and the
alleged conduct caused physical injury or the  patient  was  subject  to
unauthorized  sexual  contact, or if it appears the crime is endangering
the welfare of an incompetent or physically disabled person pursuant  to

S. 6256--D                         50                         A. 9056--D

section  260.25  of  the penal law, or if the crime was any felony under
state or federal law, then the district attorney  or  other  appropriate
law enforcement official must be contacted immediately, and in any event
no later than twenty-four hours.
  (c)  In  any  investigation  into the treatment and care of [patients]
INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES or the conduct, performance,
or neglect of duty of officers or employees, the [director of  a  school
in  the  office for people with developmental disabilities] COMMISSIONER
OR HIS OR HER DESIGNEE shall be authorized to subpoena witnesses, compel
their attendance, administer oaths to witnesses, examine witnesses under
oath, and require the production of any books or papers deemed  relevant
to  the  inquiry  or investigation. A subpoena issued under this section
shall be regulated by the civil practice law and rules.
  (d) [Such] THE director of a [school] STATE OPERATIONS OFFICE shall be
responsible for the provision of STATE OPERATED community  developmental
disabilities  services[,]  in  those  areas  that  the  commissioner may
assign. Such responsibility shall, consistent with article forty-one  of
this  chapter, include the operation of STATE OPERATED facilities[,] AND
the development of needed facilities[, and the provision  of  assistance
to  service  providers  in such areas and any necessarily related activ-
ities.  All powers and duties as set forth in this section  shall  apply
to  such responsibilities]. THE DIRECTOR OF A DEVELOPMENTAL DISABILITIES
REGIONAL OFFICE SHALL BE RESPONSIBLE  FOR  THE  PROVISION  OF  COMMUNITY
DEVELOPMENTAL  DISABILITIES  SERVICES  TO  INDIVIDUALS IN SETTINGS OTHER
THAN STATE OPERATED PROGRAMS. SUCH  REGIONAL  DIRECTOR'S  RESPONSIBILITY
SHALL,  CONSISTENT  WITH  ARTICLE FORTY-ONE OF THIS CHAPTER, INCLUDE THE
OVERSIGHT OF FACILITIES AND PROGRAMS OTHER THAN THOSE  OPERATED  BY  THE
STATE.
  (e)  Each  [facility]  STATE  OPERATIONS director of the office shall,
upon notice from the commissioner or upon  knowledge  that  programs  of
such  facility  may be contracted or terminated, implement procedures to
ensure timely notification to affected employees. Such procedures  shall
include, but not be limited to:
  (1)  dissemination  and  posting of all decisions, policies and proce-
dures with respect to all aspects of such actions and  their  impact  on
facility staff; and
  (2) compliance with all requirements and protection of employee rights
pursuant  to  collective bargaining agreements with the designated legal
representative of the employees and the civil service law.
  S 4. Section 13.33 of the mental hygiene law, as added by chapter  978
of  the  laws  of  1977, subdivision (a) as amended by chapter 37 of the
laws of 2011, subdivision (d) as amended by chapter 686 of the  laws  of
1995,  subdivisions (f) and (h) as amended by chapter 175 of the laws of
1986, subdivision (i) as amended by chapter 14  of  the  laws  of  1990,
paragraph  1  of subdivision (i) as amended by chapter 75 of the laws of
1992, paragraph 2 of subdivision (i) and subdivision (m) as  amended  by
chapter  168  of the laws of 2010, subdivision (j) as amended by chapter
264 of the laws of 1980 and subdivisions (j) and (k)  as  relettered  by
chapter  84  of  the laws of 1980, subdivision (l) as amended by chapter
406 of the laws of 1994 and subdivision (n) as amended by chapter 662 of
the laws of 1995, is amended to read as follows:
S 13.33 Boards of visitors.
  (a) Each [developmental disabilities services] STATE OPERATIONS office
under the jurisdiction of the commissioner shall have a MINIMUM  OF  ONE
board  of  visitors consisting of at least seven but not more than four-
teen members[; provided, however, that the  Central  New  York  develop-

S. 6256--D                         51                         A. 9056--D

mental  disabilities  services  office  shall  have  a board of visitors
consisting of at least ten, but not more  than  seventeen  members;  and
that  the  Finger Lakes developmental disabilities services office shall
have  a  board of visitors consisting of at least fourteen, but not more
than twenty-one members. When a school is replaced  by  a  developmental
disabilities  services  office,  the  members  of that school's board of
visitors shall continue to serve their terms as the  board  of  visitors
for   the  new  developmental  disabilities  services  office].  Members
appointed or reappointed after the effective date of this chapter  shall
be  appointed by the governor, by and with the advice and consent of the
senate.  Members shall be appointed for four year terms to expire on the
thirty-first day of December of the fourth year of the  term  of  office
provided  however,  when  more  than three terms expire in any one year,
members may be appointed for terms of fewer years as designated  by  the
governor  so  that  no  more than three members' terms expire in any one
year. All terms of office shall expire on the thirty-first day of Decem-
ber of the designated year. A  member  whose  term  has  expired  shall,
however,  remain  in  office  until  such  member's  successor  has been
appointed and has taken office, or until such member shall have resigned
or have been removed from office in  the  manner  hereinafter  provided.
Should  any  member resign or be removed from office, the governor shall
promptly submit, for senate consent, a successor candidate to  fill  the
remaining  term  of  the vacated office. A visitor may be removed by the
governor for cause after notice and an opportunity for a hearing on  the
charges.  In  making  appointments  to  boards of visitors, the governor
shall endeavor to ensure that the membership of each  such  board  shall
adequately  reflect  the  composition  of  the  community or communities
served by the [facility] STATE OPERATIONS OFFICE, that the membership of
each such board includes at least three individuals who are  parents  or
relatives  of  patients  or  of  former  patients and that the remainder
includes only those persons, including former patients, who  shall  have
expressed  an  active  interest  in, or shall have obtained professional
knowledge in the care of persons with developmental disabilities  or  in
developmental disability endeavors generally.
  (b) No elected state officer or member of the legislature may serve as
a visitor.
  (c) [If the facility serves an area] EACH VISITOR SHALL RESIDE, AT THE
TIME OF APPOINTMENT OR REAPPOINTMENT, IN THE AREA, as established by the
regulations  of the commissioner, [the visitors shall reside at the time
of appointment or reappointment in such area] SERVED BY THE STATE  OPER-
ATED  OFFICE  THAT IT OVERSEES.  [If no specific area is designated, the
visitors shall reside at the time of appointment or reappointment in the
developmental disabilities area, established  by  the  commissioner,  in
which the facility is located.]
  (d) Each board shall, at the first meeting of each calendar year elect
one member to serve as president of the board and one member to serve as
secretary;  provided however, that no member may serve for more than two
consecutive years as president.
  (e) Visitors shall not receive compensation but  shall  be  reimbursed
for their actual expenses in connection with their service as visitors.
  (f) (1) Each board of visitors shall hold six bi-monthly regular meet-
ings annually, but a greater number of regular meetings may be scheduled
by the board. Each board of visitors shall establish in their by-laws or
otherwise,  in  writing, whether these six meetings shall be held during
months represented by odd numbers or months represented by even numbers.
The president of the board shall notify the chairman of  the  commission

S. 6256--D                         52                         A. 9056--D

on  quality of care [for the mentally disabled] AND ADVOCACY FOR PERSONS
WITH DISABILITIES and the [facility] STATE OPERATIONS  director  of  the
determination   made  concerning  the  designated  months  for  the  six
bi-monthly regular meetings. The president of the board, the commission-
er, the director, or the members as determined by the rules of the board
may  call special meetings. The board may require the director to submit
a report at each  meeting.  Each  board  shall  keep  a  record  of  its
proceedings  and  activities.  A  member  of a board of visitors who has
failed to attend three consecutive bi-monthly regular meetings shall  be
considered  to  have  vacated his office unless otherwise ordered by the
governor. The board shall cause notice of any of its public meetings  to
be sent to the mental hygiene legal service located in the same judicial
department  as the [school] STATE OPERATIONS OFFICE.  The mental hygiene
legal service may send a representative to any such public meeting,  and
may  request  the  board  to  review  patient  complaints or investigate
alleged incidents of abuse or mistreatment. The board shall  notify  the
appropriate  representative  of  the mental hygiene legal service of the
board's actions and findings in relation to any such request.
  (2) The president of the board of visitors shall notify  a  member  by
certified  or  registered mail return receipt requested when such member
of the board has failed to attend any two consecutive bi-monthly regular
meetings. This notice shall be sent within ten days following the second
meeting and shall include the dates  of  the  two  meetings  which  were
missed, the date of the next bi-monthly regular meeting, and a statement
concerning the consequences of failure to attend the next meeting.
  (3)  Within  three  days  after  the  third  consecutive  absence at a
bi-monthly regular meeting by a member, the president of  the  board  of
visitors  shall  notify, in writing, the governor, the commissioner, the
chairman of the commission on quality of care [for  the  mentally  disa-
bled]  AND  ADVOCACY  FOR  PERSONS  WITH DISABILITIES and the [facility]
STATE OPERATIONS director of such absences. The president of  the  board
of  visitors shall send a copy of this notice by registered or certified
mail return receipt requested to the member to  whom  it  pertains.  The
member may petition the governor to excuse his absences. If the governor
does  not  excuse the absences within forty-five days of the date of the
third consecutive meeting absence, the office of  the  member  shall  be
deemed vacated.
  (g)  Upon the request of the commissioner or the director, or upon the
board's initiative, the board shall consult, advise, and work  with  the
director  with  respect  to  community  relations, conditions at [the] A
STATE OPERATED facility, preliminary plans for construction  and  alter-
ations, and programs and activities of [the] A STATE OPERATED facility.
  (h)  Each board or any member of the board may visit and inspect [the]
A STATE OPERATED facility THAT IS IN THE CATCHMENT  AREA  OF  THE  STATE
OPERATIONS  REGION  IN  WHICH  SUCH  MEMBER OR MEMBERS SERVE at any time
without prior notice and may report on conditions to  the  governor,  to
the  commissioner and to the chairman of the state commission on quality
of care [for the mentally disabled] AND ADVOCACY FOR PERSONS WITH  DISA-
BILITIES  AND,  SUBJECT  TO  CONFIDENTIAL  INFORMATION BEING REDACTED TO
PROTECT THE CONFIDENTIALITY OF INDIVIDUALS  IN  SUCH  FACILITY,  TO  THE
TEMPORARY  PRESIDENT  OF  THE SENATE AND TO THE SPEAKER OF THE ASSEMBLY.
In addition, each board shall ensure  that  a  member  or  committee  of
members  shall inspect [the] SUCH facility once every three months with-
out prior notice. A report on conditions may be submitted to the  gover-
nor,  to  the commissioner or to the chairman of the state commission on
quality of care [for the mentally disabled]  AND  ADVOCACY  FOR  PERSONS

S. 6256--D                         53                         A. 9056--D

WITH DISABILITIES AND, SUBJECT TO CONFIDENTIAL INFORMATION BEING REDACT-
ED  TO  PROTECT  THE CONFIDENTIALITY OF INDIVIDUALS IN SUCH FACILITY, TO
THE TEMPORARY PRESIDENT  OF  THE  SENATE  AND  TO  THE  SPEAKER  OF  THE
ASSEMBLY.    Each  board  member  shall visit and inspect [the] ANY SUCH
facility at least twice during each calendar year.  Within  thirty  days
after  the  conclusion of each calendar year, the president of the board
of visitors shall notify the governor, the commissioner, the chairman of
the commission on quality of care [for the mentally disabled] AND  ADVO-
CACY  FOR PERSONS WITH DISABILITIES, and the [facility] STATE OPERATIONS
director, if any member of the board has failed  to  visit  and  inspect
[the]  ANY  SUCH facility at least twice during that year. The president
of the board of visitors shall send a copy of this notice  by  certified
or  registered  mail  return  receipt requested to the member to whom it
pertains. A member of a board of visitors who has failed  to  visit  and
inspect  [the]  A  facility at least twice a year shall be considered to
have vacated his OR HER office unless otherwise ordered by the  governor
within  forty-five  days  after  the end of the calendar year. The board
shall have the power to investigate all charges against the STATE  OPER-
ATIONS  director, and all cases of alleged patient abuse or mistreatment
made against any  employee,  and  shall  have  the  power  to  interview
patients  and  employees of the [facility] FACILITIES in pursuit of such
investigations. In conducting such an  investigation,  the  board  shall
have  the power, in accordance with the civil practice law and rules, to
subpoena  witnesses,  compel  their  testimony,  administer   oaths   to
witnesses,  examine  witnesses under oath, and require the production of
any books or papers deemed relevant to the investigation. A board  or  a
member  may  include  in the report or separately at any time any matter
pertaining to the management and affairs of [the facility] SUCH  FACILI-
TIES  and  may make recommendations to the governor, to the commissioner
and to the chairman of the state commission on quality of care [for  the
mentally  disabled]  AND  ADVOCACY  FOR  PERSONS WITH DISABILITIES. Each
board member shall enter in a book, kept at each SUCH facility for  that
purpose, the date of each visit.
  (i)  (1)  Any  member  or members of the board may visit and inspect a
family care home[, which] THAT is  within  the  catchment  area  of  the
[school on the board of] STATE OPERATIONS REGION IN which such member or
members  serve.  Such  member or members shall be granted access to such
facility and to all books, records and data pertaining to such  facility
deemed  necessary  for carrying out the purposes of such visit. Informa-
tion, books, records or data [which] THAT are confidential  as  provided
by  law  shall  be  kept confidential and any limitations on the release
thereof imposed by law upon the party furnishing the information, books,
records or data shall apply to such member  or  members  of  the  board.
After  any  such visits or inspections, a report containing findings and
recommendations may be submitted to the governor, to the commissioner or
to the state commission on quality of care [for the  mentally  disabled]
AND  ADVOCACY  FOR PERSONS WITH DISABILITIES AND SUBJECT TO CONFIDENTIAL
INFORMATION BEING REDACTED TO PROTECT THE CONFIDENTIALITY OF INDIVIDUALS
IN SUCH FACILITY TO THE TEMPORARY PRESIDENT OF THE  SENATE  AND  TO  THE
SPEAKER OF THE ASSEMBLY.
  (2)  Any member or members of the board may visit and inspect a commu-
nity residence operated by the  office  for  people  with  developmental
disabilities[,  which]  THAT is within the catchment area of the [school
on the board of] STATE OPERATIONS REGION IN which such member or members
serve. Such member or members shall be granted access to  such  facility
and  to  all  books, records and data pertaining to such facility deemed

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necessary for carrying out the purposes of such  visit  and  inspection.
Information,  books,  records  or  data [which] THAT are confidential as
provided by law shall be kept confidential and any  limitations  on  the
release  thereof  imposed  by law upon the party furnishing the informa-
tion, books, records or data shall apply to such member  or  members  of
the  board.  After  any  such  visits or inspection, a report containing
findings and recommendations shall be submitted promptly to the  commis-
sioner  and  to  the chairman of the state commission on quality of care
and advocacy for persons with disabilities.
  (j) Once each year, each board shall make an independent assessment of
conditions at [the facility] SUCH FACILITIES and shall submit  a  report
on  the  assessment  and recommendations to the governor, to the commis-
sioner, TO THE TEMPORARY PRESIDENT OF THE SENATE, TO THE SPEAKER OF  THE
ASSEMBLY  and to the chairman of the state commission on quality of care
[for the mentally disabled] AND ADVOCACY FOR PERSONS WITH DISABILITIES.
  (k) The commissioner shall notify the board of visitors of a  [school]
FACILITY  under his OR HER jurisdiction of the proposed appointment of a
STATE OPERATIONS director [to such facility] or the proposed transfer of
a STATE OPERATIONS director [from such facility], with  a  request  that
the  board  report  an  expression  of its opinion of the appointment or
transfer and, if it objects thereto, the reasons for such objection.
  (l) The commissioner  shall  appoint  representatives  of  the  office
[department]  to  serve  as liaison between the office and the boards of
visitors. At least once each year the commissioner shall meet  with  the
boards  collectively.  The  commissioner,  or his OR HER designee, shall
meet quarterly with representatives of boards of visitors.
  (m) Members of the boards of visitors shall be considered officers  of
the  office  for people with developmental disabilities for the purposes
of sections seventy-three, to the extent provided therein, and  seventy-
four  of  the  public  officers law relating to business or professional
activities by state officers and employees and the code of ethics.
  (n) Each member shall attend, within one year of the initial  appoint-
ment  or  any  subsequent reappointment, an orientation training program
provided by the commission on quality of care [for  the  mentally  disa-
bled]  AND  ADVOCACY FOR PERSONS WITH DISABILITIES for members of boards
of visitors. The chairman of the commission on quality of care [for  the
mentally  disabled]  AND  ADVOCACY  FOR  PERSONS WITH DISABILITIES shall
notify the governor and the appointed member of any such member's  fail-
ure to attend such a training program. A member who has failed to attend
such a training program scheduled for such member shall be considered to
have  vacated his office unless otherwise ordered by the governor within
forty-five days after the notice.
  S 5. Paragraph (c) of subdivision 3 of  section  2963  of  the  public
health  law,  as added by chapter 818 of the laws of 1987, is amended to
read as follows:
  (c) If the attending physician determines that a patient lacks capaci-
ty because of a developmental disability, the  concurring  determination
required  by  paragraph  (a)  of this subdivision shall be provided by a
physician or psychologist employed by a [school] DEVELOPMENTAL DISABILI-
TIES SERVICES OFFICE named in section 13.17 of the mental  hygiene  law,
or  who  has been employed for a minimum of two years to render care and
service in a facility operated or licensed  by  the  office  [of  mental
retardation  and] FOR PEOPLE WITH developmental disabilities, or who has
been approved by the commissioner of [mental retardation  and]  develop-
mental  disabilities  in accordance with regulations promulgated by such
commissioner.  Such  regulations  shall  require  that  a  physician  or

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psychologist  possess  specialized training or three years experience in
treating developmental disabilities.
  S  6.  Paragraph  (c)  of  subdivision 2 of section 2981 of the public
health law, as added by chapter 752 of the laws of 1990, is  amended  to
read as follows:
  (c)  For  persons  who reside in a mental hygiene facility operated or
licensed by the office [of  mental  retardation  and]  FOR  PEOPLE  WITH
developmental  disabilities, at least one witness shall be an individual
who is not affiliated with the facility and at least one  witness  shall
be  a  physician  or  clinical  psychologist who either is employed by a
[school] DEVELOPMENTAL DISABILITIES SERVICES  OFFICE  named  in  section
13.17  of  the mental hygiene law or who has been employed for a minimum
of two years to render care  and  service  in  a  facility  operated  or
licensed  by  the  office  [of  mental  retardation and] FOR PEOPLE WITH
developmental disabilities, or [who] has been approved  by  the  commis-
sioner of [mental retardation and] developmental disabilities in accord-
ance  with  regulations  approved  by the commissioner. Such regulations
shall require that a physician or clinical psychologist possess special-
ized training or three years experience in treating developmental  disa-
bilities.
  S  7.  Paragraph  (c)  of  subdivision 1 of section 2983 of the public
health law, as added by chapter 752 of the laws of 1990, is  amended  to
read as follows:
  (c) If the attending physician determines that a patient lacks capaci-
ty  because  of  a developmental disability, the attending physician who
makes the determination must be, or must consult,  for  the  purpose  of
confirming  the determination, with a physician or clinical psychologist
who either is employed by a [school] DEVELOPMENTAL DISABILITIES SERVICES
OFFICE named in section 13.17 of the mental hygiene law, or who has been
employed for a minimum of two years to render  care  and  service  in  a
facility  operated or licensed by the office [of mental retardation and]
FOR PEOPLE WITH developmental disabilities, or [who] has  been  approved
by  the commissioner of [mental retardation and] developmental disabili-
ties in accordance with regulations promulgated  by  such  commissioner.
Such regulations shall require that a physician or clinical psychologist
possess  specialized  training  or  three  years  experience in treating
developmental disabilities. A  record  of  such  consultation  shall  be
included in the patient's medical record.
  S  8.  Subparagraph  ii  of  paragraph (c) of subdivision 3 of section
2994-c of the public health law, as added by chapter 8 of  the  laws  of
2010, is amended to read as follows:
  (ii)  If the attending physician makes an initial determination that a
patient lacks decision-making capacity because  of  [mental  retardation
or]  a  developmental  disability,  either  such physician must have the
following qualifications, or another  professional  with  the  following
qualifications  must  independently  determine whether the patient lacks
decision-making capacity:  a  physician  or  clinical  psychologist  who
either  is  employed  by  a [school] DEVELOPMENTAL DISABILITIES SERVICES
OFFICE named in section 13.17 of the mental hygiene law, or who has been
employed for a minimum of two years to render  care  and  service  in  a
facility  operated or licensed by the office [of mental retardation and]
FOR PEOPLE WITH developmental disabilities, or [who] has  been  approved
by  the commissioner of [mental retardation and] developmental disabili-
ties in accordance with regulations promulgated  by  such  commissioner.
Such regulations shall require that a physician or clinical psychologist
possess  specialized  training  or  three  years  experience in treating

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developmental disabilities. A  record  of  such  consultation  shall  be
included in the patient's medical record.
  S  9.  Subdivision  10 of section 2994-aa of the public health law, as
added by chapter 8 of the laws of 2010, is amended to read as follows:
  10. "Hospital" means a general hospital as defined in subdivision  ten
of  section  twenty-eight  hundred one of this chapter and a residential
health care facility as defined in subdivision three of section  twenty-
eight  hundred  one of this chapter or a hospital as defined in subdivi-
sion ten of section 1.03 of the mental hygiene law or a [school]  DEVEL-
OPMENTAL  DISABILITIES  SERVICES  OFFICE  named  in section 13.17 of the
mental hygiene law.
  S 10. Subdivision 6 of section 2994-dd of the public  health  law,  as
added by chapter 8 of the laws of 2010, is amended to read as follows:
  6.  The  commissioner may authorize the use of one or more alternative
forms for issuing a nonhospital order not to resuscitate  (in  place  of
the  standard  form prescribed by the commissioner under subdivision two
of this section). Such alternative form or forms may  also  be  used  to
issue  a  non-hospital do not intubate order. Any such alternative forms
intended for use for persons with [mental retardation or]  developmental
disabilities  or persons with mental illness who are incapable of making
their own health care decisions or who have a  guardian  of  the  person
appointed  pursuant  to  article eighty-one of the mental hygiene law or
article seventeen-A of the surrogate's court procedure act must also  be
approved  by  the commissioner of [mental retardation and] developmental
disabilities or the commissioner of mental health,  as  appropriate.  An
alternative  form  under  this  subdivision shall otherwise conform with
applicable federal and state  law.  This  subdivision  does  not  limit,
restrict  or  impair the use of an alternative form for issuing an order
not to resuscitate in a general  hospital  or  residential  health  care
facility  under article twenty-eight of this chapter or a hospital under
subdivision ten of section 1.03 of the mental hygiene law [or  a  school
under section 13.17 of the mental hygiene law].
  S 11. Subparagraph (B) of paragraph (vi) of subdivision (c) of section
958  of the general municipal law, as amended by chapter 708 of the laws
of 1993, is amended to read as follows:
  (B) a state-operated hospital or facility listed in [sections] SECTION
7.17 or 13.17 of the mental hygiene law [which], OR A FACILITY  OPERATED
BY  THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, THAT has been
designated by either the commissioner of mental health  or  the  commis-
sioner  of  [mental  retardation  and]  developmental  disabilities  for
contraction or discontinuance.   Provided however, that  not  more  than
one-third of the zones designated pursuant to paragraph (iii) or (iv) of
subdivision  (b) of section nine hundred sixty OF THIS ARTICLE, shall be
based on applications filed pursuant to THIS  paragraph  [(vi)  of  this
subdivision].
  S  12. Paragraph (b) of subdivision 4 of section 6810 of the education
law, as added by chapter 519 of the laws of 2002, is amended to read  as
follows:
  (b)  Oral  prescriptions  for  patients  in general hospitals, nursing
homes, residential health care facilities as defined in section  twenty-
eight  hundred  one  of  the  public health law, hospitals as defined in
subdivision ten of section 1.03 of the mental hygiene law, or  [develop-
mental  centers or developmental disabilities services offices listed in
subdivision (b) of section 13.17 of the mental hygiene  law]  FACILITIES
OPERATED  BY  THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, may
be communicated to a pharmacist serving as a  vendor  of  pharmaceutical

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services  based upon a contractual arrangement by an agent designated by
and under the direction of the prescriber or the institution. Such agent
shall be a health care practitioner currently  licensed  and  registered
under this title.
  S  13. Paragraph (b) of subdivision 7 of section 6810 of the education
law, as amended by chapter 519 of the laws of 2002, is amended  to  read
as follows:
  (b)  With  respect  to  drugs  other  than  controlled substances, the
provisions of this subdivision shall not apply to  pharmacists  employed
by  or  providing  services under contract to general hospitals, nursing
homes, residential health care facilities as defined in section  twenty-
eight  hundred  one  of  the  public health law, hospitals as defined in
subdivision ten of section 1.03 of the mental hygiene law, or  [develop-
mental  centers or developmental disabilities services offices listed in
subdivision (b) of section 13.17 of the mental hygiene  law]  FACILITIES
OPERATED  BY  THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, who
dispense drugs in the course of said employment  or  in  the  course  of
providing  such  services  under  contract. With respect to such pharma-
cists, each prescription shall be  transcribed  on  a  patient  specific
prescription form.
  S  14.  Paragraph  1  of subdivision (b) of section 5.05 of the mental
hygiene law, as amended by chapter 168 of the laws of 2010,  is  amended
to read as follows:
  (1)  The  commissioners of the office of mental health, the office for
people with developmental disabilities and the office of alcoholism  and
substance  abuse  services shall constitute an inter-office coordinating
council which, consistent with the autonomy of each office  for  matters
within  its  jurisdiction,  shall  ensure  that the state policy for the
prevention, care,  treatment  and  rehabilitation  of  individuals  with
mental  illness  and  developmental  disabilities,  alcoholism,  alcohol
abuse, substance abuse, substance dependence, and chemical dependence is
planned,  developed  and  implemented  comprehensively;  that  gaps   in
services  to  individuals  with multiple disabilities are eliminated and
that no person is denied treatment and services because he  or  she  has
more than one disability; that procedures for the regulation of programs
which  offer  care and treatment for more than one class of persons with
mental disabilities be coordinated between the offices having  jurisdic-
tion  over  such programs; and that research projects of the institutes,
as identified in section 7.17 or 13.17 of this chapter OR AS OPERATED BY
THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES,  are  coordinated
to  maximize  the success and cost effectiveness of such projects and to
eliminate wasteful duplication.
  S 15. Subdivision (b) of section 13.11 of the mental hygiene  law,  as
added by chapter 978 of the laws of 1977, is amended to read as follows:
  (b)  The commissioner shall control the organization of the office and
may continue, establish, discontinue, expand,  and  contract  facilities
under his OR HER jurisdiction. The facilities set forth in section 13.17
IN STATE OPERATIONS OFFICES may not be discontinued by the commissioner.
Units and facilities shall have such functions, duties, and responsibil-
ities as may be assigned to them by the commissioner.
  S 16. Subdivisions 1 and 2 of section 13.34 of the mental hygiene law,
as  amended  by  chapter 542 of the laws of 2011, are amended to read as
follows:
  1. There shall be at each  developmental  center  facility  listed  in
section  13.17 of this article, an ombudsman who shall be an employee of
the commission on quality of care and advocacy for persons with disabil-

S. 6256--D                         58                         A. 9056--D

ities under article forty-five of this chapter and who shall be  respon-
sible  for receiving and responding to any complaints regarding individ-
ual clients residing in such facility.  The  ombudsman  shall  have  the
following powers and duties:
  i.  to  advise and consult with parents, guardians, correspondents and
other interested persons with  respect  to  any  complaints,  or  issues
related to the conditions of clients' residents;
  ii. to review and attempt to remedy specific complaints with responsi-
ble and appropriate staff;
  iii.  where  it appears that care has not been rendered as required by
applicable standards to refer the complaint to the appropriate agency or
body for its attention;
  iv. to receive and keep confidential  any  complaint,  information  or
inquiry from any source. The records of the ombudsman shall be confiden-
tial, and shall not be available to the public;
  v.  to  advise and consult with the board of visitors [of the develop-
mental center] served by the ombudsman with respect to any complaints or
issues relating to conditions of client's residence, TREATMENT AND  CARE
and to regularly attend the meetings of such board; and
  vi.  to meet with the commissioner, or a representative of the commis-
sioner, on a quarterly basis regarding systemic issues  in  the  ombuds-
man's jurisdiction.
  2.  The  president  of  the  board  of visitors of each [developmental
center facility listed in section 13.17 of this article] CATCHMENT  AREA
OF  THE  STATE  OPERATIONS REGION IN WHICH SUCH MEMBER SERVES, shall, in
consultation with the members of such board, recommend three persons  to
serve  as  ombudsman at the facility. In making such recommendation, the
president shall also consider the expressed opinion of parents,  guardi-
ans and correspondents of clients residing at such facility. The persons
so  recommended  as ombudsman shall have expressed an active interest or
shall have had professional knowledge in advocating for persons who  are
mentally  disabled.  The  commission on quality of care and advocacy for
persons with disabilities shall select one of the recommended persons as
ombudsman. The ombudsman may only be removed from office for just cause.
An individual appointed as ombudsman shall be an exempt  class  employee
as  defined  by  section  forty-one  of the civil service law and may be
removed by the commissioner upon the recommendation of the president  of
the  board  of  visitors,  for  cause after notice and opportunity for a
hearing on the charges.
  S 17. Subdivision 1 of section 157 of  the  social  services  law,  as
amended  by  section 43 of part B of chapter 436 of the laws of 1997, is
amended to read as follows:
  1. Safety net assistance means  allowances  pursuant  to  section  one
hundred  thirty-one-a  OF  THIS ARTICLE for all support, maintenance and
need, and costs of suitable training in a trade to enable  a  person  to
become  self-supporting,  furnished eligible needy persons in accordance
with applicable provisions of law, by a municipal corporation, or a town
where safety net assistance is a town charge, to persons or their depen-
dents in their abode or habitation whenever possible and  includes  such
relief  granted  to  veterans  under  existing laws but does not include
hospital or institutional care, except as  otherwise  provided  in  this
subdivision,  or  family  assistance    or  medical assistance for needy
persons granted under titles ten and eleven OF THIS ARTICLE, respective-
ly, or aid to persons receiving  federal  supplemental  security  income
payments  and/or  additional state payments.   Safety net assistance may
also be provided in a family home or boarding home, operated in  compli-

S. 6256--D                         59                         A. 9056--D

ance  with  the  regulations of the department, and on and after January
first, nineteen hundred seventy-four, in facilities in which a person is
receiving family care or residential care, as those terms  are  used  in
title  six  of  [article five of] this [chapter] ARTICLE, and to persons
receiving care in a facility supervised by the office of alcoholism  and
substance  abuse  SERVICES or in a residential facility for the mentally
disabled approved, licensed or operated by the office of  mental  health
or  the office [of mental retardation and] FOR PEOPLE WITH developmental
disabilities, other than those facilities defined in sections  7.17  and
13.17  of  the  mental  hygiene  law, IN A DEVELOPMENTAL CENTER FACILITY
OPERATED BY THE OFFICE FOR PEOPLE  WITH  DEVELOPMENTAL  DISABILITIES  or
residential  care  centers  for  adults operated by the office of mental
health, when such type of care is deemed  necessary.  Payments  to  such
homes  and facilities for care and maintenance provided by them shall be
at rates established pursuant to law and regulations of the  department.
The  department,  however,  shall not establish rates of payment to such
homes or facilities without approval of the director of the budget.
  S 18. Subparagraph (i) of paragraph (a) and clause A  of  subparagraph
(i)  of  paragraph  (e) of subdivision 4 of section 1750-b of the surro-
gate's court procedure act, as added by chapter 500 of the laws of 2002,
are amended to read as follows:
  (i) be employed by a developmental disabilities services office  named
in section 13.17 of the mental hygiene law OR EMPLOYED BY THE OFFICE FOR
PEOPLE  WITH DEVELOPMENTAL DISABILITIES TO PROVIDE TREATMENT AND CARE TO
PEOPLE WITH DEVELOPMENTAL DISABILITIES, or
  A. be employed by a developmental disabilities services  office  named
in section 13.17 of the mental hygiene law OR EMPLOYED BY THE OFFICE FOR
PEOPLE  WITH DEVELOPMENTAL DISABILITIES TO PROVIDE TREATMENT AND CARE TO
PEOPLE WITH DEVELOPMENTAL DISABILITIES, or
  S 19. (a) Wherever the  terms  "directors  of  office  facilities"  or
"directors  of schools" or "director of facilities" appear in the mental
hygiene law in reference to a facility operated by the office for people
with developmental  disabilities,  such  terms  are  hereby  changed  to
"directors of state operations offices".
  (b)  The  legislative  bill  drafting commission is hereby directed to
effectuate this provision, and  shall  be  guided  by  a  memorandum  of
instruction  setting forth the specific provisions of law to be amended.
Such memorandum shall be transmitted to the  legislative  bill  drafting
commission within sixty days of enactment of this provision.  Such memo-
randum  shall be issued jointly by the governor, the temporary president
of the senate and the speaker of the assembly, or  by  the  delegate  of
each.
  S  20.  The  commissioner  of the office for people with developmental
disabilities shall provide notification to the  temporary  president  of
the  senate  and  the  speaker  of  the  assembly  sixty days prior to a
reduction in capacity of twenty persons or more or closure of a develop-
mental center or other institutional setting which is  subject  to  such
reduction  or closure pursuant to such commissioner's planned downsizing
and closing of institutional capacity.
  S 21. This act shall take effect immediately, provided  however,  that
on or before May 31, 2012 the office for people with developmental disa-
bilities  shall submit a report to the temporary president of the senate
and the speaker  of  the  assembly  on  implementation  related  to  the
restructuring of developmental disabilities services offices. The office
shall  also publish the report on the office's website. The report shall
include but not be limited to: the plan timeline for transition of  each

S. 6256--D                         60                         A. 9056--D

of  the  developmental  disabilities  service offices into a state oper-
ations offices of the office for people with developmental disabilities;
the location of each state operations office, its catchment area, and  a
list  of  services that will be administered under its jurisdiction; and
the location of each developmental  disabilities  regional  office,  its
catchment  area,  and  a  list  of  programs under its jurisdiction; and
provided further that section twenty of this act  shall  expire  and  be
deemed repealed on March 31, 2013.

                                 PART K

  Section  1.  Sections  19  and  21  of chapter 723 of the laws of 1989
amending the mental hygiene law and other laws relating to comprehensive
psychiatric emergency programs, as amended by section 1  of  part  F  of
chapter 58 of the laws of 2008, are amended to read as follows:
  S  19. Notwithstanding any other provision of law, the commissioner of
mental health shall, until July 1, [2012] 2016, be solely authorized, in
his or her discretion,  to  designate  those  general  hospitals,  local
governmental units and voluntary agencies which may apply and be consid-
ered  for the approval and issuance of an operating certificate pursuant
to article 31 of the mental hygiene law for the operation of  a  compre-
hensive psychiatric emergency program.
  S  21.  This  act shall take effect immediately, and sections one, two
and four through twenty of this act  shall  remain  in  full  force  and
effect,  until  July  1,  [2012]  2016, at which time the amendments and
additions made by such sections of  this  act  shall  be  deemed  to  be
repealed,  and  any  provision of law amended by any of such sections of
this act shall revert to its text as it existed prior to  the  effective
date of this act.
  S  2.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012.

                                 PART L

  Section 1.  (a) Notwithstanding any law, rule  or  regulation  to  the
contrary,  two or more of the commissioners of the department of health,
the office of mental health, the  office  of  alcoholism  and  substance
abuse  services or the office for people with developmental disabilities
are  jointly  authorized   to   establish   operating,   reporting   and
construction  requirements,  as  well  as  joint survey requirements and
procedures for entities operating under the auspices of one or more such
agencies, that:
  (1) can demonstrate experience  and  competence  in  the  delivery  of
health,  mental  health,  alcohol  and  substance  abuse services and/or
services to persons with developmental disabilities and the capacity  to
offer  the  integrated  delivery of such services at locations as may be
approved by two or more of the respective commissioners; and
  (2) meet the standards that  may  be  established  by  the  respective
commissioners  for  the  provision  of such services; provided, however,
that an entity  meeting  the  standards  established  pursuant  to  this
section  shall  not  be  required  to  be an integrated service provider
pursuant to subdivision seven of section three hundred  sixty-five-l  of
the social services law.
  (b)  In  establishing one or more sets of joint requirements or proce-
dures for entities described in this section, each participating commis-
sioner is authorized to waive any regulatory requirements, or to  deter-

S. 6256--D                         61                         A. 9056--D

mine   that   compliance   with   another  participating  commissioner's
regulatory requirements shall be deemed to meet the regulatory  require-
ments  of  his  or her agency, as may be necessary or desirable to avoid
duplication  of requirements and/or to permit the integrated delivery of
health and behavioral health services  in  an  efficient  and  effective
manner.
  (c)  The  authority  granted  the  commissioners  in  this  section is
intended to complement and supplement  the  authority  granted  to  such
commissioners  pursuant  to  subdivision  seven of section three hundred
sixty-five-l of the social services law.
  (d) All operating, reporting and construction requirements, as well as
joint survey requirements and procedures, promulgated pursuant  to  this
section  shall be so done as to increase efficiencies, and reduce admin-
istrative burdens. The affected agency will post a notice on its website
when regulations are waived or regulatory  requirements  are  deemed  to
have  been  met.  No  regulation promulgated under this section, nor any
action taken pursuant to subdivision (b) of this section, shall conflict
with statutory requirements pertaining to entities operating  under  the
auspices  of  the department of health, the office of mental health, the
office of alcoholism and substance abuse services,  or  the  office  for
people  with  developmental  disabilities. The promulgation of any regu-
lation or rule, and the adoption of any emergency rule, pursuant to this
section, shall be done in accordance with section two hundred two of the
state administrative procedure act.
  S 2. This act shall take effect immediately and  shall  be  deemed  to
have been in full force and effect on and after April 1, 2012.

                                 PART M

  Section  1. Paragraph h of subdivision 4 of section 1950 of the educa-
tion law is amended by adding a new subparagraph 9 to read as follows:
  (9) TO ENTER INTO CONTRACTS WITH THE COMMISSIONER  OF  THE  OFFICE  OF
MENTAL  HEALTH,  TO  PROVIDE  SPECIAL EDUCATION AND RELATED SERVICES, IN
ACCORDANCE WITH SUBDIVISION SIX-B OF SECTION THIRTY-TWO HUNDRED  TWO  OF
THIS  CHAPTER  TO  PATIENTS  HOSPITALIZED  IN  HOSPITALS OPERATED BY THE
OFFICE OF MENTAL HEALTH WHO ARE BETWEEN THE AGES OF FIVE AND  TWENTY-ONE
WHO  HAVE NOT RECEIVED A HIGH SCHOOL DIPLOMA. ANY SUCH PROPOSED CONTRACT
SHALL BE SUBJECT TO THE REVIEW BY  THE  COMMISSIONER  AND  HIS  AND  HER
DETERMINATION  THAT  IT  IS AN APPROVED COOPERATIVE EDUCATIONAL SERVICE.
SERVICES PROVIDED PURSUANT TO SUCH CONTRACTS SHALL BE PROVIDED  AT  COST
AND  APPROVED BY THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH AND THE
DIRECTOR OF THE DIVISION OF THE BUDGET, AND  THE  BOARD  OF  COOPERATIVE
EDUCATIONAL  SERVICES  SHALL  NOT  BE  AUTHORIZED  TO CHARGE ANY   COSTS
INCURRED IN PROVIDING SUCH SERVICES TO ITS COMPONENT SCHOOL DISTRICTS.
  S 2. Section 3202 of the education law is  amended  by  adding  a  new
subdivision 6-b to read as follows:
  6-B. THE COMMISSIONER OF MENTAL HEALTH MAY MEET HIS OR HER OBLIGATIONS
UNDER SECTION 33.11 OF THE MENTAL HYGIENE LAW BY CONTRACTING PURSUANT TO
THIS  SUBDIVISION FOR EDUCATIONAL SERVICES FOR CHILDREN BETWEEN THE AGES
OF FIVE AND TWENTY-ONE WHO DO NOT HOLD A HIGH SCHOOL DIPLOMA AND WHO ARE
HOSPITALIZED IN HOSPITALS OPERATED BY THE OFFICE OF MENTAL  HEALTH  WITH
THE  TRUSTEES  OR  BOARD  OF EDUCATION OF ANY SCHOOL DISTRICT FOR EDUCA-
TIONAL SERVICES OR WITH A BOARD OF COOPERATIVE EDUCATIONAL SERVICES  FOR
THE PROVISION OF SPECIAL EDUCATION AND RELATED SERVICES TO SUCH CHILDREN
IN ACCORDANCE WITH THEIR INDIVIDUALIZED EDUCATION PROGRAMS. THE COSTS OF

S. 6256--D                         62                         A. 9056--D

SUCH  EDUCATION SHALL NOT BE A CHARGE UPON A SCHOOL DISTRICT PURSUANT TO
SECTION 33.11 OF THE MENTAL HYGIENE LAW.
  (1)  THE  EDUCATION  DEPARTMENT SHALL REIMBURSE THE SCHOOL DISTRICT OR
BOARD OF COOPERATIVE EDUCATIONAL SERVICES PROVIDING EDUCATIONAL SERVICES
PURSUANT TO THIS SUBDIVISION FOR THE FULL COST OF ALL SERVICES  PURSUANT
TO THE TERMS OF SUCH CONTRACT.
  (2) THE COMMISSIONER OF MENTAL HEALTH, WITH THE APPROVAL OF THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, SHALL BE AUTHORIZED TO TRANSFER FUND-
ING  TO  THE  COMMISSIONER OF EDUCATION TO THE EXTENT NECESSARY TO REIM-
BURSE SCHOOL DISTRICTS AND BOARDS OF  COOPERATIVE  EDUCATIONAL  SERVICES
FOR SERVICES AND EDUCATIONAL PROGRAMMING PROVIDED UNDER SUCH CONTRACTS.
  (3)  NOTWITHSTANDING  ANY PROVISION OF LAW TO THE CONTRARY, NOTHING IN
THIS SUBDIVISION OR SUBPARAGRAPH NINE OF PARAGRAPH H OF SUBDIVISION FOUR
OF SECTION NINETEEN HUNDRED FIFTY OF THIS CHAPTER SHALL BE CONSTRUED  AS
REQUIRING PARTICIPATION BY ANY LOCAL SCHOOL DISTRICT OR BOARD OF COOPER-
ATIVE EDUCATIONAL SERVICES.
  S  3.  The  commissioner  of  mental  health, in consultation with the
commissioner of education, shall submit to  the  governor,  and  to  the
temporary  president  of  the  senate and the speaker of the assembly, a
report and recommendations by December 15, 2014, on the number of  chil-
dren  hospitalized  in hospitals operated by the office of mental health
who received educational services from school districts  and  boards  of
cooperative  educational services pursuant to the provisions of this act
in the 2012-2013 and 2013-2014 school years and the projected number  to
be  served  in the 2014-2015 school year, the services provided to these
children, and the actual or projected  cost  of  such  services.    Such
report  shall  also  provide  detailed proposals regarding whether addi-
tional actions should be taken to ensure that children  hospitalized  in
hospitals  operated  by  the office of mental health continue to receive
education programming and services as required by state and federal law.
  S 4. This act shall take effect July 1, 2012 and shall expire June 30,
2015, when upon such date the provisions of this  act  shall  be  deemed
repealed.

                                 PART N

  Section 1. Section 1.03 of the mental hygiene law is amended by adding
three new subdivisions 56, 57 and 58 to read as follows:
  56.  "SUBSTANCE  USE  DISORDER" MEANS THE MISUSE OF, DEPENDENCE ON, OR
ADDICTION TO ALCOHOL AND/OR LEGAL OR ILLEGAL DRUGS  LEADING  TO  EFFECTS
THAT  ARE DETRIMENTAL TO THE INDIVIDUAL'S PHYSICAL AND MENTAL HEALTH, OR
THE WELFARE OF OTHERS  AND  SHALL  INCLUDE  ALCOHOLISM,  ALCOHOL  ABUSE,
SUBSTANCE  ABUSE,  SUBSTANCE DEPENDENCE, CHEMICAL ABUSE, AND/OR CHEMICAL
DEPENDENCE.
  57. "SUBSTANCE USE DISORDER SERVICES" SHALL MEAN AND INCLUDE  EXAMINA-
TION,  EVALUATION, DIAGNOSIS, CARE, TREATMENT, REHABILITATION, OR TRAIN-
ING OF PERSONS WITH  SUBSTANCE  USE  DISORDERS  AND  THEIR  FAMILIES  OR
SIGNIFICANT OTHERS.
  58.  "BEHAVIORAL  HEALTH SERVICES" MEANS EXAMINATION, DIAGNOSIS, CARE,
TREATMENT, REHABILITATION, OR TRAINING FOR PERSONS WITH MENTAL  ILLNESS,
SUBSTANCE USE DISORDER, OR COMPULSIVE GAMBLING DISORDER.
  S 2. The mental hygiene law is amended by adding a new section 5.06 to
read as follows:
S 5.06 BEHAVIORAL HEALTH SERVICES ADVISORY COUNCIL.
  (A)  THERE IS HEREBY CREATED WITHIN THE DEPARTMENT A BEHAVIORAL HEALTH
SERVICES ADVISORY COUNCIL, THE PURPOSE OF WHICH SHALL BE TO  ADVISE  THE

S. 6256--D                         63                         A. 9056--D

OFFICES  OF MENTAL HEALTH AND ALCOHOLISM AND SUBSTANCE ABUSE SERVICES ON
MATTERS RELATING TO THE PROVISION OF BEHAVIORAL HEALTH SERVICES;  ISSUES
OF  JOINT  CONCERN  TO THE OFFICES, INCLUDING THE INTEGRATION OF VARIOUS
BEHAVIORAL  HEALTH  SERVICES  AND  THE  INTEGRATION OF BEHAVIORAL HEALTH
SERVICES WITH HEALTH SERVICES; AND ISSUES RELATED  TO  THE  DELIVERY  OF
BEHAVIORAL  HEALTH  SERVICES  THAT  ARE  RESPONSIVE  TO LOCAL, STATE AND
FEDERAL CONCERNS. THE COUNCIL SHALL  CONSIST  OF  THE  COMMISSIONERS  OF
MENTAL  HEALTH AND OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, WHO SHALL
NOT HAVE THE RIGHT TO VOTE, THE CHAIR OF THE CONFERENCE OF LOCAL  MENTAL
HYGIENE  DIRECTORS  OR  HIS  OR  HER  DESIGNEE, AND TWENTY-EIGHT MEMBERS
APPOINTED BY THE GOVERNOR, UPON THE ADVICE AND CONSENT  OF  THE  SENATE.
MEMBERS  SHALL  BE APPOINTED ONLY IF THEY HAVE PROFESSIONAL KNOWLEDGE IN
THE CARE OF PERSONS RECEIVING BEHAVIORAL HEALTH SERVICES, OR  AN  ACTIVE
INTEREST IN THE BEHAVIORAL HEALTH SERVICES SYSTEM.
  (B)  THE GOVERNOR SHALL DESIGNATE ONE OF THE MEMBERS OF THE COUNCIL AS
CHAIR. AT LEAST ONE-HALF OF THE MEMBERS OF  THE  COUNCIL  SHALL  NOT  BE
PROVIDERS  OF  BEHAVIORAL  HEALTH SERVICES.   MEMBERSHIP SHALL REFLECT A
BALANCED REPRESENTATION OF PERSONS WITH INTERESTS IN MENTAL  HEALTH  AND
SUBSTANCE USE DISORDER SERVICES AND SHALL INCLUDE:
  (1)  AT  LEAST  FIVE  CURRENT OR FORMER CONSUMERS OF BEHAVIORAL HEALTH
SERVICES;
  (2) AT LEAST THREE INDIVIDUALS WHO ARE PARENTS OR RELATIVES OF CURRENT
OR FORMER CONSUMERS OF BEHAVIORAL HEALTH SERVICES;
  (3) AT LEAST THREE MEMBERS WHO ARE NOT PROVIDERS OF BEHAVIORAL  HEALTH
SERVICES  AND WHO REPRESENT NON-GOVERNMENTAL ORGANIZATIONS, SUCH AS NOT-
FOR-PROFIT  ENTITIES  REPRESENTING  HEALTH  OR  BEHAVIORAL  HEALTH  CARE
EMPLOYEES, PRIVATE PAYORS OF BEHAVIORAL HEALTH SERVICES, OR OTHER ORGAN-
IZATIONS CONCERNED WITH THE PROVISION OF BEHAVIORAL HEALTH SERVICES;
  (4)  AT LEAST FIVE REPRESENTATIVES OF PROVIDERS OF SERVICES TO PERSONS
WITH MENTAL ILLNESS AND AT LEAST FIVE REPRESENTATIVES  OF  PROVIDERS  OF
SERVICES  TO  PERSONS WITH SUBSTANCE USE DISORDERS, AT LEAST TWO OF WHOM
SHALL BE PHYSICIANS AND  AT  LEAST  ONE  OF  WHOM  SHALL  HAVE  PROVIDED
SERVICES  TO  VETERANS  WHO SERVED IN A COMBAT THEATER OR COMBAT ZONE OF
OPERATIONS;
  (5) ONE MEMBER APPOINTED ON THE RECOMMENDATION OF THE  STATE  DIRECTOR
OF  THE  DIVISION  OF  VETERANS' AFFAIRS AND ONE MEMBER APPOINTED ON THE
RECOMMENDATION OF THE ADJUTANT GENERAL OF THE DIVISION OF  MILITARY  AND
NAVAL AFFAIRS, AT LEAST ONE OF WHOM SHALL BE A CURRENT OR FORMER CONSUM-
ER OF MENTAL HEALTH SERVICES OR SUBSTANCE USE DISORDER SERVICES WHO IS A
VETERAN  WHO HAS SERVED IN A COMBAT THEATER OR COMBAT ZONE OF OPERATIONS
AND IS A MEMBER OF A VETERANS ORGANIZATION;
  (6) AT LEAST THREE REPRESENTATIVES OF LOCAL GOVERNMENTS OR OTHER STATE
AND LOCAL AGENCIES CONCERNED WITH THE  PROVISION  OF  BEHAVIORAL  HEALTH
SERVICES; AND
  (7) AT LEAST TWO MEMBERS WHO ARE ALSO MEMBERS OF THE PUBLIC HEALTH AND
HEALTH  PLANNING  COUNCIL  PURSUANT TO SECTION TWO HUNDRED TWENTY OF THE
PUBLIC HEALTH LAW.
  (C) MEMBERS SHALL BE APPOINTED FOR  TERMS  OF  THREE  YEARS  PROVIDED,
HOWEVER,  THAT  OF  THE  MEMBERS  FIRST  APPOINTED,  ONE-THIRD  SHALL BE
APPOINTED FOR ONE YEAR TERMS AND ONE-THIRD SHALL BE  APPOINTED  FOR  TWO
YEAR  TERMS.  VACANCIES  SHALL  BE FILLED IN THE SAME MANNER AS ORIGINAL
APPOINTMENTS FOR THE REMAINDER OF ANY UNEXPIRED TERM. NO PERSON SHALL BE
AN APPOINTED MEMBER OF THE COUNCIL FOR MORE THAN SIX YEARS IN ANY PERIOD
OF TWELVE CONSECUTIVE YEARS.

S. 6256--D                         64                         A. 9056--D

  (D) THE COUNCIL SHALL MEET AT LEAST FOUR TIMES IN EACH  FULL  CALENDAR
YEAR.  THE  COUNCIL  SHALL  MEET  AT  THE REQUEST OF ITS CHAIR OR EITHER
COMMISSIONER.
  (E)  THE COUNCIL SHALL ESTABLISH SUCH COMMITTEES AS IT DEEMS NECESSARY
TO ADDRESS THE SERVICE NEEDS  OF  SPECIAL  POPULATIONS  AND  TO  ADDRESS
PARTICULAR  SUBJECTS  OF IMPORTANCE IN THE DEVELOPMENT AND MANAGEMENT OF
BEHAVIORAL HEALTH SERVICES.
  (F) THE COUNCIL MAY CONSIDER ANY MATTER RELATING TO THE IMPROVEMENT OF
BEHAVIORAL HEALTH SERVICES IN THE STATE AND SHALL ADVISE THE COMMISSION-
ERS ON ANY SUCH MATTER, INCLUDING, BUT NOT LIMITED TO:
  (1) CARE AND SERVICES TO PERSONS  WITH  BEHAVIORAL  HEALTH  DISORDERS,
INCLUDING  SPECIAL  AND  UNDERSERVED  POPULATIONS  AS  DETERMINED BY THE
COMMISSIONER;
  (2) FINANCING BEHAVIORAL HEALTH SERVICES;
  (3) INTEGRATION OF BEHAVIORAL HEALTH SERVICES WITH HEALTH SERVICES;
  (4) CARE AND SERVICES  FOR  PERSONS  WITH  CO-OCCURRING  DISORDERS  OR
MULTIPLE DISABILITIES;
  (5) PREVENTION OF BEHAVIORAL HEALTH DISORDERS; AND
  (6) IMPROVEMENT OF CARE IN STATE OPERATED OR COMMUNITY BASED PROGRAMS,
RECRUITMENT,  EDUCATION AND TRAINING OF QUALIFIED DIRECT CARE PERSONNEL,
AND PROTECTION OF THE INTERESTS OF EMPLOYEES AFFECTED BY ADJUSTMENTS  IN
THE BEHAVIORAL HEALTH SERVICE SYSTEM.
  (G)  THE  COUNCIL SHALL, IN COOPERATION WITH THE COMMISSIONERS, ESTAB-
LISH STATEWIDE GOALS AND OBJECTIVES FOR SERVICES TO PERSONS WITH  BEHAV-
IORAL HEALTH DISORDERS, PURSUANT TO SECTION 5.07 OF THIS ARTICLE.
  (H)  (1) THE COUNCIL SHALL REVIEW THE PORTION OF THE STATEWIDE PLAN TO
BE DEVELOPED AND UPDATED  ANNUALLY  BY  THE  COMMISSIONERS  PURSUANT  TO
SECTION  5.07 OF THIS ARTICLE, AND REPORT ITS RECOMMENDATIONS THEREON TO
THE COMMISSIONERS.
  (2) THE COUNCIL SHALL REVIEW ANY MENTAL HEALTH OR SUBSTANCE USE COMPO-
NENT OF STATEWIDE HEALTH PLANS DEVELOPED IN ACCORDANCE WITH ANY APPLICA-
BLE FEDERAL LAW, AND SHALL REPORT ITS  RECOMMENDATIONS  THEREON  TO  THE
COMMISSIONERS.
  (I) THE COUNCIL SHALL REVIEW APPLICATIONS FILED IN ACCORDANCE WITH:
  (1)  SECTION  31.22  OF  THIS CHAPTER FOR APPROVAL OF INCORPORATION OR
ESTABLISHMENT OF A FACILITY, AND  SECTION  31.23  OF  THIS  CHAPTER  FOR
APPROVAL  OF  THE CONSTRUCTION OF A FACILITY FOR WHICH APPROVAL FROM THE
COMMISSIONER OF MENTAL HEALTH IS REQUIRED; AND
  (2) SECTION 32.29 OR 32.31 OF THIS CHAPTER FOR  APPROVAL  OF  INCORPO-
RATION OR ESTABLISHMENT OR CONSTRUCTION OF A FACILITY FOR WHICH APPROVAL
TO OPERATE IS REQUIRED FROM THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE
ABUSE  SERVICES  PURSUANT  TO ARTICLE THIRTY-TWO OF THIS CHAPTER, AND AS
OTHERWISE REQUESTED BY SUCH COMMISSIONER;
  (J)  THE  COUNCIL  SHALL  BE  NOTIFIED  OF,  AND  MAY  REVIEW  AT  ITS
DISCRETION,  ANY  CLOSURE  OF A HOSPITAL OR WARD THEREOF OPERATED BY THE
OFFICE OF MENTAL HEALTH OR OFFICE  OF  ALCOHOLISM  AND  SUBSTANCE  ABUSE
SERVICES,  AND  MAY ISSUE RECOMMENDATIONS PERTAINING TO ISSUES INCLUDING
COMMUNITY REINVESTMENT AND CONTINUITY OF CARE. ALL SUCH  RECOMMENDATIONS
SHALL  BE  PROVIDED  TO  THE RELEVANT COMMISSIONER OR COMMISSIONERS, THE
TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY.
  (K) AT LEAST SIXTY DAYS PRIOR TO THE COMMISSIONERS' FINAL APPROVAL  OF
RULES  AND  REGULATIONS  UNDER THEIR RESPECTIVE JURISDICTION, OTHER THAN
EMERGENCY RULES AND REGULATIONS AND REGULATIONS PROMULGATED PURSUANT  TO
SECTION  43.01  OF  THIS  CHAPTER,  THE  COMMISSIONERS SHALL SUBMIT SUCH
PROPOSED RULES AND REGULATIONS TO THE COUNCIL FOR ITS REVIEW. THE  COUN-
CIL  SHALL  REVIEW  ALL  PROPOSED  RULES  AND REGULATIONS AND REPORT ITS

S. 6256--D                         65                         A. 9056--D

RECOMMENDATIONS THEREON TO THE  COMMISSIONERS  WITHIN  SIXTY  DAYS.  THE
COMMISSIONER  HAVING  STATUTORY  JURISDICTION  OVER THE PROPOSED RULE OR
REGULATION SHALL NOT ACT IN A MANNER INCONSISTENT WITH  THE  RECOMMENDA-
TIONS  OF  THE  COUNCIL  WITHOUT  FIRST  APPEARING BEFORE THE COUNCIL TO
REPORT THE REASONS THEREFOR. THE COUNCIL, UPON A MAJORITY  VOTE  OF  ITS
MEMBERS,  MAY REQUIRE THAT AN ALTERNATIVE APPROACH TO THE PROPOSED RULES
AND REGULATIONS BE PUBLISHED WITH THE NOTICE OF THE PROPOSED  RULES  AND
REGULATIONS PURSUANT TO SECTION TWO HUNDRED TWO OF THE STATE ADMINISTRA-
TIVE  PROCEDURE  ACT. WHEN AN ALTERNATIVE APPROACH IS PUBLISHED PURSUANT
TO THIS SECTION, THE COMMISSIONER HAVING STATUTORY JURISDICTION  OF  THE
SUBJECT  PROPOSED  RULE  OR  REGULATION  SHALL STATE THE REASONS FOR NOT
SELECTING SUCH ALTERNATIVE APPROACH.
  (L) THE COUNCIL, BY A MAJORITY VOTE OF ITS MEMBERS, MAY PROPOSE  RULES
AND  REGULATIONS ON ANY MATTER WITHIN THE REGULATORY JURISDICTION OF THE
OFFICES OF MENTAL HEALTH OR ALCOHOLISM  AND  SUBSTANCE  ABUSE  SERVICES,
OTHER  THAN  ESTABLISHMENT OF FEE SCHEDULES PURSUANT TO SECTION 43.01 OF
THIS CHAPTER, AND FORWARD SUCH PROPOSED RULES AND  REGULATIONS  TO  BOTH
COMMISSIONERS FOR REVIEW AND CONSIDERATION; PROVIDED, HOWEVER, THAT ONLY
THE  APPROVAL  OF  THE  COMMISSIONER  WITH STATUTORY JURISDICTION OF THE
PROPOSED RULE OR REGULATION SHALL BE REQUIRED. PRIOR TO SUCH COMMISSION-
ER'S FINAL APPROVAL AND PROMULGATION OF SUCH PROPOSED  RULES  AND  REGU-
LATIONS, IF SUCH RULES AND REGULATIONS ARE MODIFIED IN ANY RESPECT, THEY
SHALL  BE  SUBMITTED  TO THE COUNCIL PURSUANT TO SUBDIVISION (K) OF THIS
SECTION. IF SUCH COMMISSIONER DETERMINES NOT TO PROMULGATE SUCH PROPOSED
RULES AND REGULATIONS, THE COMMISSIONER SHALL APPEAR BEFORE THE  COUNCIL
TO REPORT THE REASONS THEREFOR.
  (M) THE MEMBERS OF THE COUNCIL SHALL RECEIVE NO COMPENSATION FOR THEIR
SERVICES  BUT  SHALL BE REIMBURSED FOR EXPENSES ACTUALLY AND NECESSARILY
INCURRED IN THE PERFORMANCE OF THEIR DUTIES.
  (N) THE COMMISSIONERS, UPON REQUEST OF THE  COUNCIL,  SHALL  DESIGNATE
ONE OR MORE OFFICERS OR EMPLOYEES FROM EITHER OR BOTH OFFICES TO PROVIDE
ADMINISTRATIVE SUPPORT SERVICES TO THE COUNCIL, AND MAY ASSIGN FROM TIME
TO TIME SUCH OTHER EMPLOYEES AS THE COUNCIL MAY REQUEST.
  (O)  NO  CIVIL ACTION SHALL BE BROUGHT IN ANY COURT AGAINST ANY MEMBER
OF THE BEHAVIORAL HEALTH SERVICES ADVISORY COUNCIL  FOR  ANY  ACT  DONE,
FAILURE  TO  ACT, OR STATEMENT OR OPINION MADE, WHILE DISCHARGING HIS OR
HER DUTIES AS A MEMBER OF THE COUNCIL, WITHOUT LEAVE FROM A  JUSTICE  OF
THE  SUPREME  COURT,  FIRST  HAD AND OBTAINED. IN ANY EVENT, SUCH MEMBER
SHALL NOT BE LIABLE FOR DAMAGES IN ANY SUCH ACTION IF HE OR SHE ACTED IN
GOOD FAITH, WITH REASONABLE CARE AND UPON PROBABLE CAUSE.    MEMBERS  OF
THE  COUNCIL  SHALL  BE  CONSIDERED  PUBLIC OFFICERS FOR THE PURPOSES OF
SECTION SEVENTEEN OF THE PUBLIC OFFICERS LAW.
  (P) THE COUNCIL MAY ESTABLISH WRITTEN BYLAWS.
  S 3. The section heading, subdivision (a), the opening  paragraph  and
paragraphs  1  and  3  of subdivision (b) and subdivision (c) of section
5.07 of the mental hygiene law, the section heading as amended by  chap-
ter  55  of the laws of 1992, subdivision (a), the opening paragraph and
paragraphs 1 and 3 of subdivision (b) and subdivision (c) as amended  by
chapter  223  of  the  laws  of  1992, paragraph 1 of subdivision (a) as
amended by chapter 37 of the laws of  2011,  the  opening  paragraph  of
paragraph  1 of subdivision (b) as amended by chapter 168 of the laws of
2010, subparagraphs h and i as amended and subparagraph j of paragraph 1
of subdivision (b) as added by chapter 413 of the laws of 2009 and para-
graph 3 of subdivision (b) as renumbered by chapter 322 of the  laws  of
1992, are amended to read as follows:

S. 6256--D                         66                         A. 9056--D

Establishment  of [statewide goals and objectives;] statewide comprehen-
         sive plans of services for [the mentally disabled] PERSONS WITH
         MENTAL DISABILITIES.
  (a)  (1) The [mental health] BEHAVIORAL HEALTH services ADVISORY coun-
cil and the advisory [councils] COUNCIL  on  developmental  disabilities
[and  alcoholism  and  substance  abuse services] shall [each establish]
PROVIDE RECOMMENDATIONS FOR statewide PRIORITIES AND goals  [and  objec-
tives]  to  guide comprehensive planning, resource allocation and evalu-
ation processes for state and local services  for  persons  with  mental
illness,  developmental disabilities [and], AND/OR those [suffering from
chemical abuse  or  dependence,  respectively]  WITH  SUBSTANCE  USE  OR
COMPULSIVE GAMBLING DISORDERS. Such goals and objectives shall:
  a.  be  measurable  in terms of attainment AND FOCUSED ON OUTCOMES FOR
THOSE BEING SERVED;
  b. be DEVELOPED IN COLLABORATION WITH, AND communicated to,  providers
of  services,  department  facilities,  consumers and consumer represen-
tatives, and other appropriate state and local governmental agencies;
  c. [require that all state and local public and private  services  for
persons  with  mental disabilities be organized, staffed and financed to
best meet the needs of all  persons  with  mental  disabilities  whether
receiving in-patient or non in-patient services;
  d.]  reflect  the  partnership  between  state  and local governmental
units; and
  [e.] D. emphasize [that gaps in services be filled and  that  services
are  provided to persons with mental disabilities] THE NEED TO INTEGRATE
BEHAVIORAL HEALTH AND HEALTH SERVICES.
  (2) Such advisory councils shall [establish, review, augment or delete
from such goals and objectives, as appropriate,] ACCOMPLISH THEIR DUTIES
by means of a [continuing annual goal-setting] process which is:
  a. open, visible and accessible to the public; and
  b. consistent with the  statewide  AND  FEDERALLY  MANDATED  planning,
appropriation  and  evaluation  processes and activities for services to
[the mentally disabled] PERSONS WITH MENTAL DISABILITIES.
  (3) The advisory councils are hereby empowered to hold public hearings
and meetings to enable them to accomplish their duties.
  Statewide comprehensive plan for services to [the  mentally  disabled]
PERSONS WITH MENTAL DISABILITIES.
  (1)  The  office of mental health, the office for people with develop-
mental disabilities and the office of  alcoholism  and  substance  abuse
services shall [each] formulate a statewide comprehensive five-year plan
for  the  provision  of  all  state  and local services for persons with
mental illness [and], developmental  disabilities,  [and]  AND/OR  those
[suffering from alcoholism and] WITH substance [abuse, respectively] USE
OR  COMPULSIVE  GAMBLING DISORDERS.   [Each] THE STATEWIDE COMPREHENSIVE
plan shall be [formulated from] BASED UPON AN ANALYSIS OF local [compre-
hensive] SERVICES plans developed by each local governmental unit, [with
participation of]  IN  CONSULTATION  WITH  consumers,  consumer  groups,
providers  of  services  and  departmental  facilities [furnishing] THAT
FURNISH BEHAVIORAL HEALTH services [to individuals with mental disabili-
ties of the area] in conformance with  statewide  PRIORITIES  AND  goals
[and objectives] established [by] WITH RECOMMENDATIONS OF the BEHAVIORAL
HEALTH SERVICES advisory council [of each office] AND THE ADVISORY COUN-
CIL ON DEVELOPMENTAL DISABILITIES. [Each] THE plan shall:
  a.  identify  [needs  and  problems which must be addressed during the
next ensuing five years which such plan encompasses]  STATEWIDE  PRIORI-
TIES;

S. 6256--D                         67                         A. 9056--D

  b.  specify  [time-limited] STATEWIDE goals [to meet those needs] THAT
REFLECT THE STATEWIDE PRIORITIES AND ARE FOCUSED ON  OBTAINING  POSITIVE
MEASURABLE OUTCOMES;
  c. [identify resources to achieve the goals, including but not limited
to resource reallocations;
  d. establish] PROPOSE STRATEGIES AND INITIATIVES TO ADDRESS THE prior-
ities  [for resource allocation] AND FACILITATE ACHIEVEMENT OF STATEWIDE
GOALS;
  [e. define the  authority  and  responsibility  for  state  and  local
participation  in  the  delivery of services] D.   IDENTIFY SERVICES AND
SUPPORTS, WHICH MAY INCLUDE PROGRAMS RUN  OR  LED  BY  PEERS,  THAT  ARE
DESIGNED  TO  PROMOTE  THE  HEALTH  AND  WELLNESS OF PERSONS WITH MENTAL
ILLNESS, DEVELOPMENTAL DISABILITIES, AND/OR SUBSTANCE USE OR  COMPULSIVE
GAMBLING DISORDERS;
  [f.  propose programs to achieve the goals, which programs may include
direct services, development of multi-purpose facilities, contracts  for
services, and innovative financial and organizational relationships with
public and private providers;
  g.  identify  services and programs that assist the informal caregiver
to care for the mentally disabled; make recommendations to  enhance  the
ability of the informal caregiver to continue providing care; and devel-
op strategies for creating informal caregivers for clients in the commu-
nity who do not have a system in place;
  h. analyze] E. PROVIDE ANALYSIS OF current and anticipated utilization
of  state  and local, and public and private facilities [and], programs,
SERVICES, AND/OR SUPPORTS;
  [i.] F. encourage and promote PERSON-CENTERED, CULTURALLY AND LINGUIS-
TICALLY COMPETENT  community-based  programs  [which]  ,  SERVICES,  AND
SUPPORTS  THAT  reflect  the partnership between state and local govern-
mental units; and
  [j.] G. include progress reports on the implementation of both  short-
term  and  long-term  recommendations  of  the  children's plan required
pursuant to section four hundred eighty-three-f of the  social  services
law.
  (3)  The commissioners of each of the offices shall be responsible for
the development of such statewide five-year plan for services within the
jurisdiction of their respective offices and  after  giving  due  notice
shall  conduct  one or more public hearings on such plan. The BEHAVIORAL
HEALTH SERVICES advisory council [of each office] AND THE ADVISORY COUN-
CIL ON DEVELOPMENTAL DISABILITIES shall review the statewide  five  year
COMPREHENSIVE  plan  developed  by such office OR OFFICES and report its
recommendations thereon to  such  commissioner  OR  COMMISSIONERS.  Each
commissioner  shall  submit the plan, with appropriate modifications, to
the governor no later than the first day of [October] NOVEMBER  of  each
year in order that such plan may be considered with the estimates of the
offices  for the preparation of the executive budget of the state of New
York for the next succeeding state  fiscal  year.    [Each  commissioner
shall also submit such plan to the legislature. The statewide plan] SUCH
COMPREHENSIVE  PLAN  SHALL  BE  SUBMITTED TO THE LEGISLATURE AND ALSO BE
POSTED TO THE WEBSITE OF EACH OFFICE. STATEWIDE PLANS  shall  [be  reas-
sessed  and updated at least annually to encompass the next ensuing five
years to] ensure responsiveness to changing needs  and  goals  and  [to]
SHALL  reflect  the development of new information and the completion of
program evaluations. An  interim  report  detailing  the  commissioner's
actions in fulfilling the requirements of this section in preparation of
the  plan  and modifications in the plan of services being considered by

S. 6256--D                         68                         A. 9056--D

the commissioner shall be submitted to the governor and the  legislature
on  or  before  the fifteenth day of [February] MARCH of each year. Such
interim report shall include, but need not be limited to:
  (a)  actions  to  include participation of consumers, consumer groups,
providers of services and departmental facilities, as required  by  this
subdivision; and
  (b)  any modifications in the plan of services being considered by the
commissioner, to include:  (i)  compelling  budgetary,  programmatic  or
clinical  justifications  or  other  major  appropriate  reason  for any
significant new statewide  programs  or  policy  changes  from  a  prior
(approved)  five year comprehensive plan; and (ii) procedures to involve
or inform local governmental units of such actions or plans.
  (c) Three year capital plan. (1) On or before July first of each year,
the commissioners of the offices of the  department  of  mental  hygiene
shall  each submit to the advisory council of their respective offices a
statewide three year capital plan for facilities within the jurisdiction
of their respective offices.  The  capital  plan  shall  set  forth  the
projects  proposed to be designed, constructed, acquired, reconstructed,
rehabilitated or otherwise substantially altered pursuant  to  appropri-
ation  to  meet the capital development needs of the respective agencies
for the next ensuing three years; the years of such  plan  shall  corre-
spond to the years of the statewide five year plan as required by subdi-
vision (b) of this section.
  (2)  Such  plan  for each office shall include but not be limited to a
detailed project schedule indicating the location by county  or  borough
and  estimated  cost of each project, the anticipated dates on which the
design and construction of the project  is  to  commence,  the  proposed
method  of financing for the project, the estimated economic life of the
project  and  whether  the  proposed  project  constitutes  design,  new
construction or rehabilitation.
  (3)  Such  plan  shall  further  specify  for each project whether the
project is to be a residential or nonresidential facility,  a  state  or
voluntary  operated  facility,  and, the number of clients, by source of
clients, proposed to utilize the facility. The information on the source
of the client shall include but not  be  limited  to  identification  of
clients  currently  living  independently,  or at home with families, or
with caretakers, clients defined by their respective agencies as special
populations, or clients currently residing in an  institutional  setting
under the jurisdiction of the offices of the department.
  (4)  The  advisory council of the appropriate office shall review such
plan and report its recommendation to the  commissioner  for  inclusion,
provided, however, that the [mental] BEHAVIORAL health services ADVISORY
council  shall forward its comments on the capital plan of the office of
mental health to the mental health planning council which shall  forward
such  recommendations after review to the commissioner of mental health.
The commissioner shall submit his or her plan with the formal  recommen-
dations  of the advisory council of his or her office and any subsequent
appropriate modifications to the governor no later than the first day of
[October] NOVEMBER of each year or concurrent with the annual submission
of estimates and information required by section one of article seven of
the constitution in order that such plans shall be considered  with  the
estimates  of the offices for the preparation of the executive budget of
the state of New York for the next succeeding  state  fiscal  year.  The
commissioners shall also submit such plans to the chairmen of the senate
finance committee and the assembly ways and means committee.

S. 6256--D                         69                         A. 9056--D

  (5)  Each  statewide  three  year capital plan for facilities shall be
evaluated and revised annually to encompass  the  fiscal  year  then  in
progress  and the next ensuing two fiscal years to ensure responsiveness
to the changing needs and goals of the department, and  to  reflect  the
development of new information and project completion.
  S 4. Section 7.05 of the mental hygiene law is REPEALED.
  S  5.  Subdivision  (c) of section 13.05 of the mental hygiene law, as
amended by chapter 37 of the  laws  of  2011,  is  amended  to  read  as
follows:
  (c)  The  developmental  disabilities  advisory  council shall have no
executive, administrative or appointive duties. The council  shall  have
the  duty to foster public understanding and acceptance of developmental
disabilities. It shall, in cooperation with the commissioner of develop-
mental disabilities, [establish] PROVIDE RECOMMENDATIONS  FOR  statewide
PRIORITIES  AND goals [and objectives] for services for individuals with
developmental disabilities and shall advise the commissioner on  matters
related  to  development  and  implementation  of the [OPWDD's triennial
state  developmental  disabilities]  STATEWIDE  comprehensive  plan   as
required  under  [paragraph  two  of subdivision (b) of] section 5.07 of
this chapter. The advisory council shall have the power to consider  any
matter  relating to the improvement of the state developmental disabili-
ties program and shall advise the commissioner of developmental disabil-
ities thereon and on any matter relating to  the  performance  of  their
duties  with relation to individuals with developmental disabilities and
on policies, goals, budget and operation of  developmental  disabilities
services.
  S 6. Section 19.05 of the mental hygiene law is REPEALED.
  S  7.   Section 220 of the public health law, as amended by section 45
of part A of chapter 58 of the laws of  2010,  is  amended  to  read  as
follows:
  S  220.  Public  health  and  health  planning council; appointment of
members. There shall continue to be in the department  a  public  health
and  health planning council to consist of the commissioner and fourteen
members to be appointed by the governor with the advice and  consent  of
the  senate;  provided  that effective December first, two thousand ten,
the membership of the council shall  consist  of  the  commissioner  and
twenty-four  members to be appointed by the governor with the advice and
consent of the senate. Membership on the council shall be reflective  of
the  diversity  of the state's population including, but not limited to,
the various geographic areas and  population  densities  throughout  the
state.  The  members  shall include representatives of the public health
system, health care providers that  comprise  the  state's  health  care
delivery system, individuals with expertise in the clinical and adminis-
trative  aspects  of  health care delivery, issues affecting health care
consumers, health planning, health  care  financing  and  reimbursement,
health care regulation and compliance, and public health practice and at
least  two  members  shall  also  be  members of the [mental] BEHAVIORAL
health services ADVISORY council; at least four members shall be  repre-
sentatives  of  general  hospitals  or  nursing  homes; and at least one
member shall be a representative of each of the following  groups:  home
care  agencies,  diagnostic  and  treatment centers, health care payors,
labor organizations for health care employees, and health care  consumer
advocacy organizations.
  S  8.  This  act  shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2012; provided,
however, that sections one, two and five of this act shall  take  effect

S. 6256--D                         70                         A. 9056--D

on  the  one hundred eightieth day after it shall have become a law, and
sections three, four and six of this act shall take effect upon  certif-
ication  by  the  commissioner  of mental health and the commissioner of
alcoholism  and  substance  abuse  services  that  the behavioral health
services advisory council has sufficient confirmed membership to perform
its functions, powers and duties pursuant to section two  of  this  act;
provided  that the commissioner of mental health shall notify the legis-
lative bill drafting commission upon the date that such commissioner and
the commissioner of alcoholism and substance abuse services have  certi-
fied that the behavioral health services advisory council has sufficient
confirmed  membership  to  perform  its  functions, powers and duties in
order that the commission may maintain an accurate and timely  effective
data  base  of the official text of the laws of the state of New York in
furtherance of effectuating the provisions of section 44 of the legisla-
tive law and section 70-b of the public officers law.

                                 PART O

  Section 1. Subdivision (b) of section 7.17 of the mental hygiene  law,
as  amended by section 1 of part G of chapter 59 of the laws of 2011, is
amended to read as follows:
  (b) There shall be in the office the hospitals  named  below  for  the
care,  treatment  and  rehabilitation of persons with mental illness and
for research and teaching in the science and  skills  required  for  the
care, treatment and rehabilitation of such persons with mental illness.
  Greater Binghamton Health Center
  Bronx Psychiatric Center
  Buffalo Psychiatric Center
  Capital District Psychiatric Center
  Central New York Psychiatric Center
  Creedmoor Psychiatric Center
  Elmira Psychiatric Center
  [Hudson River Psychiatric Center]
  Kingsboro Psychiatric Center
  Kirby Forensic Psychiatric Center
  Manhattan Psychiatric Center
  Mid-Hudson Forensic Psychiatric Center
  Mohawk Valley Psychiatric Center
  Nathan S. Kline Institute for Psychiatric Research
  New York State Psychiatric Institute
  Pilgrim Psychiatric Center
  Richard H. Hutchings Psychiatric Center
  Rochester Psychiatric Center
  Rockland Psychiatric Center
  St. Lawrence Psychiatric Center
  South Beach Psychiatric Center
  [Bronx Children's Psychiatric Center
  Brooklyn Children's Center
  Queens Children's Psychiatric Center]
  NEW YORK CITY CHILDREN'S CENTER
  Rockland Children's Psychiatric Center
  Sagamore Children's Psychiatric Center
  Western New York Children's Psychiatric Center
  The  New  York  State  Psychiatric  Institute  and The Nathan S. Kline
Institute for Psychiatric Research are designated as institutes for  the
conduct  of medical research and other scientific investigation directed

S. 6256--D                         71                         A. 9056--D

towards furthering knowledge of the etiology, diagnosis,  treatment  and
prevention  of  mental  illness.  [The  Brooklyn  Children's Center is a
facility operated by the office to provide community-based mental health
services for children with serious emotional disturbances.] WHENEVER THE
TERM  BRONX CHILDREN'S PSYCHIATRIC CENTER, BROOKLYN CHILDREN'S PSYCHIAT-
RIC CENTER AND QUEENS CHILDREN'S PSYCHIATRIC CENTER IS  REFERRED  TO  OR
DESIGNATED  IN  ANY  REGULATION,  CONTRACT OR DOCUMENT PERTAINING TO THE
FUNCTIONS,  POWERS,  OBLIGATIONS  AND  DUTIES  HEREBY  TRANSFERRED   AND
ASSIGNED,  SUCH REFERENCE OR DESIGNATION SHALL BE DEEMED TO REFER TO THE
NEW YORK CITY CHILDREN'S CENTER.
  S 2. Notwithstanding the provisions of subdivisions  (b)  and  (e)  of
section  7.17  of  the  mental  hygiene law, section 41.55 of the mental
hygiene law, or any other law to the  contrary,  the  office  of  mental
health  is  authorized to close, consolidate, reduce, transfer or other-
wise redesign services of hospitals, other facilities and programs oper-
ated by the office  of  mental  health,  and  to  implement  significant
service  reductions  and  reconfigurations  according to this section as
shall be determined by the commissioner of mental health to be necessary
for the cost-effective and efficient operation of such hospitals,  other
facilities and programs. One of the intents of actions taken that result
in  closure,  consolidation,  reduction,  transfer  or other redesign of
services of hospitals is to reinvest savings such that,  to  the  extent
practicable,  comparable  or  greater  levels  of community based mental
health services will be provided to persons with mental illness in  need
of  services within the catchment areas of such hospitals, as determined
by the commissioner of mental health with approval from the director  of
the division of the budget.
  (a) In addition to the closure, consolidation or merger of one or more
facilities,  the  commissioner of mental health is authorized to perform
any significant service  reductions  that  would  reduce  inpatient  bed
capacity  by  up to 400 beds, which shall include but not be limited to,
closures of wards at a state-operated psychiatric center or the  conver-
sion  of  beds  to  transitional  placement  programs, provided that the
commissioner provide at least 45 days notice of such reductions  to  the
temporary  president  of  the senate and the speaker of the assembly and
simultaneously post such notice upon its public  website.  In  assessing
which  significant  service  reductions  to  undertake, the commissioner
shall consider data related to inpatient census, indicating  nonutiliza-
tion or under utilization of beds, and the efficient operation of facil-
ities.
  (b)  At  least 75 days prior to the anticipated closure, consolidation
or merger of any hospitals named in subdivision (b) of section  7.17  of
the  mental hygiene law, the commissioner of mental health shall provide
notice of such closure, consolidation or merger to the temporary  presi-
dent  of  the  senate,  and speaker of the assembly, the chief executive
officer of the county in which the facility is located, and  shall  post
such  notice  upon its public website. The commissioner shall be author-
ized to conduct any and all preparatory actions which may be required to
effectuate such closures during such 75 day period.  In assessing  which
of  such hospitals to close, the commissioner shall consider the follow-
ing factors: (1) the size, scope and type of services  provided  by  the
hospital; (2) the relative quality of the care and treatment provided by
the  hospital,  as  may  be  informed by internal or external quality or
accreditation reviews; (3) the current and  anticipated  long-term  need
for  the types of services provided by the facility within its catchment
area, which may include, but not be limited to, services for  adults  or

S. 6256--D                         72                         A. 9056--D

children,  or other specialized services, such as forensic services; (4)
the availability of staff sufficient to address the current  and  antic-
ipated  long  term  service  needs; (5) the long term capital investment
required  to  ensure  that the facility meets relevant state and federal
regulatory and capital construction requirements, and national  accredi-
tation  standards; (6) the proximity of the facility to other facilities
with space that could accommodate anticipated need, the relative cost of
any necessary renovations of such space, the relative potential  operat-
ing  efficiency  of  such  facilities,  and the size, scope and types of
services provided by the other facilities; (7) anticipated savings based
upon economies of scale or other factors; (8)  community  mental  health
services  available  in  the  facility catchment area and the ability of
such community mental health services  to  meet  the  behavioral  health
needs  of  the  impacted  consumers; (9) the obligations of the state to
place persons with mental disabilities in community settings rather than
in institutions, when appropriate; and (10) the  anticipated  impact  of
the closure on access to mental health services.
  (c)  Any  transfers of inpatient capacity or any resulting transfer of
functions shall be authorized to be made by the commissioner  of  mental
health  and  any transfer of personnel upon such transfer of capacity or
transfer of functions shall  be  accomplished  in  accordance  with  the
provisions of section 70 of the civil service law.
  S 3. Severability clause. If any clause, sentence, paragraph, subdivi-
sion,  section  or  part  of  this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair,  or  invalidate  the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph,  subdivision,  section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included herein.
  S 4. This act shall take effect immediately and  shall  be  deemed  to
have  been in full force and effect on and after April 1, 2012; provided
that the date for any closure or  consolidation  pursuant  to  this  act
shall  be  on a date certified by the commissioner of mental health; and
provided further, however, that this act  shall  expire  and  be  deemed
repealed March 31, 2013.

                                 PART P

  Section  1.  Section  10.06  of  the  mental hygiene law is amended by
adding a new subdivision (l) to read as follows:
  (L) (1) IF A RESPONDENT WHO  IS  TRANSFERRED  TO  A  SECURE  TREATMENT
FACILITY  PURSUANT  TO  SUBDIVISION  (K)  OF  THIS  SECTION, HAS NOT YET
REACHED HIS OR HER MAXIMUM EXPIRATION DATE ON THE UNDERLYING DETERMINATE
OR INDETERMINATE SENTENCE OF IMPRISONMENT, IS  SIGNIFICANTLY  DISRUPTIVE
OF  THE  TREATMENT PROGRAM AT SUCH SECURE TREATMENT FACILITY, THE PERSON
IN CHARGE OF TREATMENT PROGRAMS AT SUCH FACILITY MAY INITIATE A PROCEED-
ING TO OBTAIN AN ORDER THAT THE RESPONDENT SHALL BE TRANSFERRED  TO  THE
CUSTODY  OF  THE DEPARTMENT OF CORRECTIONS AND COMMUNITY SUPERVISION FOR
SUCH CONDUCT.
  (2) SUCH A PROCEEDING SHALL BE INITIATED BY A  WRITTEN  NOTICE  SERVED
UPON  THE  RESPONDENT, AND PROVIDED BY MAIL TO HIS OR HER COUNSEL (OR BY
ELECTRONIC MAIL OR FACSIMILE TO A DESTINATION IDENTIFIED BY SUCH COUNSEL
FOR SUCH PURPOSE). SUCH NOTICE SHALL IDENTIFY IN DETAIL THE DATES, TIMES
AND NATURE OF THE ALLEGED MISCONDUCT PURSUANT TO PARAGRAPH ONE  OF  THIS

S. 6256--D                         73                         A. 9056--D

SUBDIVISION,  THE POSSIBLE SANCTIONS, AND THE DATE, TIME AND LOCATION OF
THE HEARING.
  (3)  A  HEARING ON THE ALLEGATIONS SHALL BE HELD NO LESS THAN TEN DAYS
NOR MORE THAN SIXTY DAYS AFTER SUCH NOTICE IS SERVED ON  THE  RESPONDENT
AND  PROVIDED  TO  HIS OR HER COUNSEL. THE HEARING SHALL BE CONDUCTED BY
THE DIRECTOR OF THE SECURE TREATMENT FACILITY, OR HIS OR  HER  DESIGNEE.
THE  RESPONDENT  MAY BE REPRESENTED BY COUNSEL. EVIDENCE SHALL BE INTRO-
DUCED THROUGH WITNESSES AND DOCUMENTS, IF ANY, AND BOTH  THE  PERSON  IN
CHARGE  OF  THE TREATMENT PROGRAM PRESENTING THE CASE AND THE RESPONDENT
MAY CALL AND CROSS-EXAMINE WITNESSES AND  PRESENT  DOCUMENTARY  EVIDENCE
RELEVANT TO THE QUESTION OF WHETHER THE RESPONDENT HAS BEEN SIGNIFICANT-
LY DISRUPTIVE OF THE TREATMENT PROGRAM. THE PRESIDING OFFICER MAY ACCEPT
SUCH  EVIDENCE  WITHOUT  APPLYING  FORMAL  STATE  OR  FEDERAL  RULES  OF
EVIDENCE. THE HEARING SHALL BE RECORDED OR A STENOGRAPHIC RECORD OF  THE
PROCEEDING  SHALL  BE  KEPT. WHEN HEARING THE MATTER AND, IF THE ALLEGA-
TIONS ARE SUSTAINED, THE PRESIDING OFFICER SHALL CONSIDER  THE  RESPOND-
ENT'S  MENTAL  HEALTH  CONDITION  AND  ITS EFFECT, IF ANY, ON HIS OR HER
CONDUCT.
  (4) AT THE CONCLUSION OF THE HEARING,  IF  THE  PRESIDING  OFFICER  IS
SATISFIED  THAT THERE IS A PREPONDERANCE OF EVIDENCE THAT THE RESPONDENT
HAS BEEN SIGNIFICANTLY DISRUPTIVE OF THE TREATMENT PROGRAM AT THE SECURE
TREATMENT FACILITY, THE PRESIDING OFFICER SHALL SO FIND.  IN SUCH EVENT,
THE PRESIDING OFFICER MAY ORDER THE RESPONDENT'S TRANSFER  BACK  TO  THE
CUSTODY OF THE DEPARTMENT OF CORRECTIONS AND COMMUNITY SUPERVISION FOR A
PERIOD  OF UP TO SIX MONTHS, PROVIDED HOWEVER, THAT WHEN SUCH RESPONDENT
REACHES THE MAXIMUM EXPIRATION DATE OF HIS OR HER UNDERLYING SENTENCE HE
OR SHE SHALL BE RETURNED TO A SECURE TREATMENT FACILITY UNLESS HE OR SHE
CONSENTS IN WRITING AS PROVIDED IN SUBDIVISION (K) OF  THIS  SECTION  TO
REMAINING  IN THE CUSTODY OF THE DEPARTMENT OF CORRECTIONS AND COMMUNITY
SUPERVISION AND PROVIDED FURTHER THAT HE OR SHE SHALL BE RETURNED  TO  A
SECURE TREATMENT FACILITY IF THE FINAL ORDER ISSUED PURSUANT TO SUBDIVI-
SION (F) OF SECTION 10.07 OF THIS ARTICLE REQUIRES PLACEMENT IN A SECURE
TREATMENT FACILITY.
  (5)  AT  THE  CONCLUSION  OF  THE HEARING, THE PRESIDING OFFICER SHALL
PREPARE A WRITTEN STATEMENT, TO BE MADE AVAILABLE TO THE RESPONDENT  AND
HIS  OR  HER COUNSEL, INDICATING THE EVIDENCE RELIED ON, THE REASONS FOR
THE DETERMINATION AND SPECIFYING  THE  PROCEDURES  AND  TIME  FRAME  FOR
ADMINISTRATIVE  APPEAL  TO  THE  COMMISSIONER.  THE DETERMINATION MAY BE
APPEALED TO THE COMMISSIONER IN ACCORDANCE WITH  PROCEDURES  ESTABLISHED
IN WRITING BY THE DEPARTMENT. THE RESPONDENT SHALL BE GIVEN AT LEAST TEN
DAYS  AFTER  NOTICE  OF  THE DETERMINATION HAS BEEN SERVED AND THE TRAN-
SCRIPT OR RECORDING OF THE PROCEEDING (WITH  APPROPRIATE  ACCESS  EQUIP-
MENT)  HAS  BEEN  PROVIDED  TO PERFECT THE APPEAL. THE RESPONDENT MAY BE
REPRESENTED BY COUNSEL ON THE ADMINISTRATIVE APPEAL.
  S 2. Section 10.08 of the mental hygiene law is amended  by  adding  a
new subdivision (i) to read as follows:
  (I)  (1)  AT A PROCEEDING CONDUCTED PURSUANT TO SUBDIVISION (G) OR (H)
OF SECTION 10.06 OF THIS  ARTICLE,  A  PSYCHIATRIC  EXAMINER  CALLED  TO
TESTIFY MAY BE PERMITTED, UPON GOOD CAUSE SHOWN, TO TESTIFY BY ELECTRON-
IC  APPEARANCE  IN  THE  COURT  BY  MEANS OF AN INDEPENDENT AUDIO-VISUAL
SYSTEM, AS THAT PHRASE IS DEFINED IN SUBDIVISION ONE OF  SECTION  182.10
OF  THE CRIMINAL PROCEDURE LAW. IT SHALL CONSTITUTE GOOD CAUSE TO PERMIT
SUCH AN ELECTRONIC APPEARANCE THAT SUCH PROPOSED  WITNESS  IS  CURRENTLY
EMPLOYED  BY  THE  STATE  AT A SECURE TREATMENT FACILITY OR ANOTHER WORK
LOCATION  UNLESS  THERE  ARE  COMPELLING  CIRCUMSTANCES  REQUIRING   THE
WITNESS' PERSONAL PRESENCE AT THE COURT PROCEEDING.

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  (2)  A  COPY  OF  ANY CLINICAL RECORD OR OTHER DOCUMENT THAT THE PARTY
CALLING SUCH PSYCHIATRIC EXAMINER INTENDS TO PRESENT TO THE  WITNESS  OR
INTRODUCE  DURING  THE  DIRECT TESTIMONY OF SUCH PSYCHIATRIC EXAMINER BY
ELECTRONIC APPEARANCE SHALL BE PROVIDED TO OPPOSING COUNSEL  AND,  IN  A
MANNER  CONSISTENT  WITH  SECTION 33.16 OF THIS CHAPTER, THE RESPONDENT:
(I) FIVE DAYS OR MORE BEFORE THE DATE SUCH PERSON IS CALLED  TO  TESTIFY
BY  ELECTRONIC APPEARANCE AT A PROCEEDING CONDUCTED PURSUANT TO SUBDIVI-
SION (G) OF SECTION 10.06 OF THIS ARTICLE, AND (II) TWENTY-FOUR HOURS OR
MORE BEFORE THE DATE SUCH PERSON IS  CALLED  TO  TESTIFY  BY  ELECTRONIC
APPEARANCE AT A PROCEEDING CONDUCTED PURSUANT TO SUBDIVISION (H) OF SUCH
SECTION 10.06.
  (3)  EXCEPT  AS PROVIDED IN PARAGRAPH FOUR OF THIS SUBDIVISION, COPIES
OF CLINICAL RECORDS AND DOCUMENTS NOT MADE AVAILABLE TO OPPOSING COUNSEL
AND, WHERE APPLICABLE, THE RESPONDENT AS REQUIRED BY  PARAGRAPH  TWO  OF
THIS  SUBDIVISION  SHALL NOT BE PERMITTED TO BE PRESENTED TO THE WITNESS
ON DIRECT EXAMINATION OR INTRODUCED IN EVIDENCE WITHOUT THE  CONSENT  OF
OPPOSING  COUNSEL  PROVIDED, HOWEVER, THAT WHERE GOOD CAUSE IS SHOWN WHY
SUCH CLINICAL RECORD OR OTHER DOCUMENT WAS NOT PROVIDED SUFFICIENTLY  IN
ADVANCE  AS  REQUIRED  BY  THIS  SUBDIVISION, THE COURT SHALL ALLOW SUCH
CLINICAL RECORD OR OTHER DOCUMENT TO BE PROVIDED BY  APPROPRIATE  MEANS,
INCLUDING  BUT  NOT  LIMITED  TO FACSIMILE OR ELECTRONIC MEANS, AND THEN
USED OR CONSIDERED IN THE SAME MANNER AS IF  TIMELY  ADVANCE  DISCLOSURE
HAD BEEN MADE.
  (4)  THE  COURT  SHALL ORDER THAT COPIES OF CLINICAL RECORDS AND OTHER
DOCUMENTS  RELEVANT  FOR  CROSS-EXAMINATION,  RE-DIRECT  EXAMINATION  OR
RE-CROSS EXAMINATION OF SUCH WITNESS TESTIFYING BY ELECTRONIC MEANS, NOT
OTHERWISE PROVIDED PURSUANT TO THIS SUBDIVISION, BE PROVIDED TO OPPOSING
COUNSEL  AND, IN A MANNER CONSISTENT WITH SECTION 33.16 OF THIS CHAPTER,
THE RESPONDENT, BY APPROPRIATE  MEANS,  INCLUDING  BUT  NOT  LIMITED  TO
FACSIMILE OR OTHER ELECTRONIC MEANS.
  (5) FOR PURPOSES OF THIS SUBDIVISION, AN "ELECTRONIC APPEARANCE" MEANS
AN APPEARANCE AT WHICH A PARTICIPANT IS NOT PRESENT IN THE COURT, BUT IN
WHICH  ALL OF THE PARTICIPANTS ARE ABLE TO SEE AND HEAR THE SIMULTANEOUS
REPRODUCTIONS OF THE VOICES AND IMAGES OF THE JUDGE, COUNSEL, RESPONDENT
AND ANY OTHER APPROPRIATE PARTICIPANT. WHEN A WITNESS MAKES AN ELECTRON-
IC APPEARANCE PURSUANT TO THIS SUBDIVISION, THE COURT STENOGRAPHER SHALL
RECORD ANY STATEMENTS IN THE SAME MANNER AS IF THE WITNESS  HAD  MADE  A
PERSONAL APPEARANCE.
  S  3.  Subdivision  (b) of section 10.09 of the mental hygiene law, as
added by chapter 7 of the laws of 2007, is amended to read as follows:
  (b) The commissioner shall also assure that each respondent  committed
under  this  article  shall have an examination for evaluation of his or
her mental condition made at least once every year (CALCULATED FROM  THE
DATE  ON  WHICH  THE  SUPREME  OR  COUNTY  COURT  JUDGE  LAST ORDERED OR
CONFIRMED THE NEED FOR CONTINUED CONFINEMENT PURSUANT TO THIS ARTICLE OR
THE DATE ON WHICH THE  RESPONDENT  WAIVED  THE  RIGHT  TO  PETITION  FOR
DISCHARGE  PURSUANT  TO THIS SECTION, WHICHEVER IS LATER, AS APPLICABLE)
CONDUCTED by a psychiatric examiner who shall report to the commissioner
his or her written findings as to whether the respondent is currently  a
dangerous sex offender requiring confinement. At such time, the respond-
ent  also shall have the right to be evaluated by an independent psychi-
atric examiner.  If the respondent is financially unable  to  obtain  an
examiner, the court shall appoint an examiner of the respondent's choice
to  be  paid  within the limits prescribed by law. Following such evalu-
ation, each psychiatric examiner shall report his  or  her  findings  in
writing  to  the commissioner and to counsel for respondent. The commis-

S. 6256--D                         75                         A. 9056--D

sioner shall review relevant records and reports, along with  the  find-
ings  of  the  psychiatric  examiners, and shall make a determination in
writing as to whether the respondent is currently a dangerous sex offen-
der requiring confinement.
  S 4. This act shall take effect immediately.

                                 PART Q

  Section  1. Section 730.10 of the criminal procedure law is amended by
adding a new subdivision 9 to read as follows:
  9. "APPROPRIATE INSTITUTION" MEANS: (A) A  HOSPITAL  OPERATED  BY  THE
OFFICE OF MENTAL HEALTH OR A DEVELOPMENTAL CENTER OPERATED BY THE OFFICE
FOR  PEOPLE  WITH DEVELOPMENTAL DISABILITIES; OR (B) A HOSPITAL LICENSED
BY THE DEPARTMENT OF HEALTH WHICH OPERATES A PSYCHIATRIC  UNIT  LICENSED
BY  THE  OFFICE  OF  MENTAL  HEALTH,  AS  DETERMINED BY THE COMMISSIONER
PROVIDED, HOWEVER, THAT ANY SUCH HOSPITAL THAT IS NOT  OPERATED  BY  THE
STATE SHALL QUALIFY AS AN "APPROPRIATE INSTITUTION" ONLY PURSUANT TO THE
TERMS OF AN AGREEMENT BETWEEN THE COMMISSIONER AND THE HOSPITAL. NOTHING
IN THIS ARTICLE SHALL BE CONSTRUED AS REQUIRING A HOSPITAL TO CONSENT TO
PROVIDING  CARE  AND TREATMENT TO AN INCAPACITATED PERSON AT SUCH HOSPI-
TAL.
  S 2. Subdivision 1 of section 730.40 of the criminal procedure law, as
amended by chapter 231 of the laws  of  2008,  is  amended  to  read  as
follows:
  1. When a local criminal court, following a hearing conducted pursuant
to  subdivision  three  or four of section 730.30, is satisfied that the
defendant is not an incapacitated person, the  criminal  action  against
him  OR  HER  must  proceed. If it is satisfied that the defendant is an
incapacitated person, or if no motion for such a hearing is  made,  such
court  must  issue  a final or temporary order of observation committing
him OR HER to the custody of the commissioner for care and treatment  in
an  appropriate  institution for a period not to exceed ninety days from
the date of the order, provided,  however,  that  the  commissioner  may
designate  an appropriate hospital for placement of a defendant for whom
a final order of observation has been issued,  where  such  hospital  is
licensed  by  the office of mental health and has agreed to accept, upon
referral by the commissioner, defendants  subject  to  final  orders  of
observation  issued  under this subdivision. When a local criminal court
accusatory instrument other than  a  felony  complaint  has  been  filed
against  the  defendant, such court must issue a final order of observa-
tion[; when]. WHEN a felony complaint has been filed against the defend-
ant, such court must issue a temporary order of  observation  COMMITTING
HIM  OR HER TO THE CUSTODY OF THE COMMISSIONER FOR CARE AND TREATMENT IN
AN APPROPRIATE INSTITUTION OR, UPON THE CONSENT OF THE  DISTRICT  ATTOR-
NEY,  COMMITTING  HIM OR HER TO THE CUSTODY OF THE COMMISSIONER FOR CARE
AND TREATMENT ON AN OUT-PATIENT BASIS, FOR A PERIOD NOT TO EXCEED NINETY
DAYS FROM THE DATE OF SUCH ORDER, except that, with the consent  of  the
district attorney, it may issue a final order of observation.
  S 3. Subdivision 1 of section 730.50 of the criminal procedure law, as
amended  by  chapter  231  of  the  laws  of 2008, is amended to read as
follows:
  1. When a superior court, following a hearing  conducted  pursuant  to
subdivision  three  or  four  of  section  730.30, is satisfied that the
defendant is not an incapacitated person, the  criminal  action  against
him  OR  HER  must  proceed. If it is satisfied that the defendant is an
incapacitated person, or if no motion for such a  hearing  is  made,  it

S. 6256--D                         76                         A. 9056--D

must  adjudicate  him  OR  HER an incapacitated person, and must issue a
final order of observation or an order of commitment. When  the  indict-
ment  does  not charge a felony or when the defendant has been convicted
of  an  offense  other  than a felony, such court (a) must issue a final
order of observation committing the defendant  to  the  custody  of  the
commissioner  for care and treatment in an appropriate institution for a
period not to exceed ninety days from the date of such order,  provided,
however, that the commissioner may designate an appropriate hospital for
placement  of a defendant for whom a final order of observation has been
issued, where such hospital is licensed by the office of  mental  health
and  has agreed to accept, upon referral by the commissioner, defendants
subject to final orders of observation issued  under  this  subdivision,
and  (b)  must  dismiss  the  indictment filed in such court against the
defendant, and such dismissal constitutes a bar to  any  further  prose-
cution  of  the charge or charges contained in such indictment. When the
indictment charges a felony or when the defendant has been convicted  of
a  felony, it must issue an order of commitment committing the defendant
to the custody of the commissioner for care and treatment in  an  appro-
priate  institution  OR,  UPON  THE  CONSENT  OF  THE DISTRICT ATTORNEY,
COMMITTING HIM OR HER TO THE CUSTODY OF THE COMMISSIONER  FOR  CARE  AND
TREATMENT  ON  AN OUT-PATIENT BASIS, for a period not to exceed one year
from the date of such order. Upon the issuance of an  order  of  commit-
ment,  the  court  must  exonerate the defendant's bail if he OR SHE was
previously at liberty on bail; PROVIDED, HOWEVER,  THAT  EXONERATION  OF
BAIL IS NOT REQUIRED WHEN A DEFENDANT IS COMMITTED TO THE CUSTODY OF THE
COMMISSIONER FOR CARE AND TREATMENT ON AN OUT-PATIENT BASIS.
  S 4. This act shall take effect immediately.

                                 PART R

  Section  1.    Section  1 of part D of 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 is  amended
to read as follows:
  Section  1. The office of mental health is authorized to recover fund-
ing from  community  residences  and  family-based  treatment  providers
licensed  by  the  office  of mental health, consistent with contractual
obligations of such providers, and notwithstanding any other  inconsist-
ent  provision  of law to the contrary, in an amount equal to 50 percent
of the income received by such providers which exceeds the fixed  amount
of  annual  Medicaid  revenue limitations, as established by the commis-
sioner of mental health. Recovery of such excess income shall be for the
following fiscal periods: for programs in counties  located  outside  of
the  city of New York, the applicable fiscal periods shall be January 1,
2003 through December 31, 2009 AND JANUARY 1, 2011 THROUGH DECEMBER  31,
2013; and for programs located within the city of New York, the applica-
ble  fiscal periods shall be July 1, 2003 through June 30, 2010 AND JULY
1, 2011 THROUGH JUNE 30, 2013.
  S 2. This act shall take effect immediately.

                                 PART S

  Section 1.  Notwithstanding any law, rule or regulation to the contra-
ry, only physicians or dentists who were  eligible,  and  for  whom  the
superintendent  of financial services and the commissioner of health, or
their designee, purchased, with funds available in the  hospital  excess

S. 6256--D                         77                         A. 9056--D

liability  pool,  a full or partial policy for excess coverage or equiv-
alent excess coverage for the coverage periods ending the  thirtieth  of
June,  two thousand ten, the thirtieth of June, two thousand eleven, and
the  thirtieth  of  June, two thousand twelve shall be eligible to apply
for such coverage for the coverage period beginning the first  of  July,
two  thousand  twelve. If the total number of physicians or dentists for
whom such excess coverage or equivalent excess  coverage  was  purchased
with  funds  available  in  the hospital excess liability pool as of the
thirtieth of June, two thousand ten is more than  the  total  number  of
physicians  and  dentists  certified as eligible for the coverage period
beginning the first of July,  two  thousand  twelve,  then  the  general
hospitals  may  certify additional eligible physicians or dentists up to
the greater of the total number  of  physicians  or  dentists  for  whom
excess  coverage  or equivalent excess coverage was purchased with funds
available in the hospital excess liability pool as of the  thirtieth  of
June,  two  thousand  ten,  or  one  thousand  physicians  or  dentists;
provided, however, that  no  general  hospital  may  certify  additional
eligible  physicians or dentists in a greater number than the proportion
of its physicians and dentists for whom excess  coverage  or  equivalent
excess  coverage  was  purchased  with  funds  available in the hospital
excess liability pool as of the thirtieth of June, two thousand  ten  as
applied  to  the  difference  between  the total eligible physicians and
dentists for the coverage period beginning the first of July, two  thou-
sand  twelve  and  the  total  eligible physicians and dentists for whom
excess coverage or equivalent excess coverage was purchased  with  funds
available  in  the hospital excess liability pool as of the thirtieth of
June, two thousand ten.
  S 2. The superintendent of financial services and the commissioner  of
health  shall  prepare  a report that includes, but is not limited to: a
review of the nature and  extent  of  affiliations  between  physicians,
dentists,  general hospitals, private practices and universities; and an
actuarial analysis of the adequacy of  premiums  paid  by  the  hospital
excess liability pool for excess coverage and equivalent excess coverage
with  regard  to  liabilities and claims history, and relative to budget
appropriations to the hospital excess liability pool. The  report  shall
also include recommendations to support the sustainability of the excess
medical  malpractice liability coverage pool, maintaining the assumption
that the future annual appropriations for the pool will not  exceed  the
amount  appropriated  for  the  pool  in  state fiscal year two thousand
twelve-thirteen.  The  superintendent  of  financial  services  and  the
commissioner  of  health shall submit the report to the governor, tempo-
rary president of the senate and speaker of the assembly by the first of
November, two thousand twelve.
  S 3. This act shall take effect immediately.

                                 PART T

  Section 1. Paragraph (f) of subdivision 3 of section 242 of the  elder
law,  as  amended  by section 3-d of part A of chapter 59 of the laws of
2011, is amended to read as follows:
  (f) As a condition of eligibility for benefits  under  this  title,  a
program participant is required to be enrolled in Medicare part D and to
maintain  such  enrollment.   FOR UNMARRIED PARTICIPANTS WITH INDIVIDUAL
ANNUAL INCOME LESS THAN OR EQUAL TO TWENTY-THREE  THOUSAND  DOLLARS  AND
MARRIED  PARTICIPANTS  WITH  JOINT  ANNUAL  INCOME LESS THAN OR EQUAL TO
TWENTY-NINE  THOUSAND  DOLLARS,  THE  ELDERLY  PHARMACEUTICAL  INSURANCE

S. 6256--D                         78                         A. 9056--D

COVERAGE PROGRAM SHALL PAY FOR THE PORTION OF THE PART D MONTHLY PREMIUM
THAT  IS  THE  RESPONSIBILITY  OF THE PARTICIPANT. SUCH PAYMENT SHALL BE
LIMITED TO THE LOW-INCOME BENCHMARK PREMIUM AMOUNT  ESTABLISHED  BY  THE
FEDERAL  CENTERS FOR MEDICARE AND MEDICAID SERVICES AND ANY OTHER AMOUNT
WHICH SUCH AGENCY ESTABLISHES UNDER ITS DE MINIMUS PREMIUM POLICY.
  S 1-a. Subdivision 1 of section 241 of the elder law,  as  amended  by
section  29  of  part A of chapter 58 of the laws of 2008, is amended to
read as follows:
  1. "Covered drug" shall mean a drug dispensed  subject  to  a  legally
authorized  prescription  pursuant to section sixty-eight hundred ten of
the education law, and  insulin,  an  insulin  syringe,  or  an  insulin
needle.  Such  term  shall  not  include: (a) any drug determined by the
commissioner of the federal food and drug administration to be  ineffec-
tive  or  unsafe; (b) any drug dispensed in a package, or form of dosage
or administration, as to which the commissioner of health finally deter-
mines in accordance with the provisions of section two hundred fifty-two
of this title that a less expensive package, or form of dosage or admin-
istration, is available that is pharmaceutically equivalent  and  equiv-
alent  in  its therapeutic effect for the general health characteristics
of the eligible program participant population; (c) any device  for  the
aid  or correction of vision; (d) any drug, including vitamins, which is
generally available without a physician's prescription;  and  (e)  drugs
for  the  treatment of sexual or erectile dysfunction, unless such drugs
are used to treat a condition, other than sexual  or  erectile  dysfunc-
tion,  for  which  the  drugs have been approved by the federal food and
drug administration; and (f) a brand name drug for which a  multi-source
therapeutically  and  generically  equivalent drug, as determined by the
federal food and drug administration, is  available,  unless  previously
authorized  by  the  elderly  pharmaceutical insurance coverage program,
provided, however, that the [elderly pharmaceutical  insurance  coverage
panel]  COMMISSIONER  is authorized to exempt, for good cause shown, any
brand name drug from such restriction, and provided  further  that  such
restriction  shall  not  apply  to  any  drug  that  is  included on the
preferred drug list under section two hundred seventy-two of the  public
health  law  or is in the clinical drug review program under section two
hundred seventy-four of the public health law to  the  extent  that  the
preferred  drug program and the clinical drug review program are applied
to the elderly pharmaceutical insurance  coverage  program  pursuant  to
section  two  hundred  seventy-five  of the public health law, or to any
drug covered under a program participant's  Medicare  part  D  or  other
primary  insurance  plan.  Any  of the drugs enumerated in the preceding
sentence shall be considered a covered drug or a prescription  drug  for
purposes of this article if it is added to the preferred drug list under
article  two-A of the public health law.  For the purpose of this title,
except as otherwise provided in this section, a covered  drug  shall  be
dispensed  in  quantities  no  greater  than  a thirty day supply or one
hundred units, whichever is greater. In the case of a drug dispensed  in
a  form  of  administration  other than a tablet or capsule, the maximum
allowed quantity shall be a thirty day supply; the [panel]  COMMISSIONER
is  authorized  to  approve  exceptions  to  these  limits  for specific
products following consideration of recommendations from  pharmaceutical
or medical experts regarding commonly packaged quantities, unusual forms
of  administration,  length  of  treatment or cost effectiveness. In the
case of a drug prescribed pursuant to section thirty-three hundred thir-
ty-two of the public health law to treat one of the conditions that have
been enumerated by the commissioner of health pursuant to regulation  as

S. 6256--D                         79                         A. 9056--D

warranting  the  prescribing  of  greater than a thirty day supply, such
drug shall be dispensed in  quantities  not  to  exceed  a  three  month
supply.
  S  1-b.  Subdivision  1 of section 241 of the elder law, as amended by
section 12 of part B of chapter 57 of the laws of 2006,  is  amended  to
read as follows:
  1.  "Covered  drug"  shall  mean a drug dispensed subject to a legally
authorized prescription pursuant to section sixty-eight hundred  ten  of
the  education  law,  and  insulin,  an  insulin  syringe, or an insulin
needle. Such term shall not include: (a)  any  drug  determined  by  the
commissioner  of the federal food and drug administration to be ineffec-
tive or unsafe; (b) any drug dispensed in a package, or form  of  dosage
or administration, as to which the commissioner of health finally deter-
mines in accordance with the provisions of section two hundred fifty-two
of this title that a less expensive package, or form of dosage or admin-
istration,  is  available that is pharmaceutically equivalent and equiv-
alent in its therapeutic effect for the general  health  characteristics
of  the  eligible program participant population; (c) any device for the
aid or correction of vision, or any drug, including vitamins,  which  is
generally  available  without  a physician's prescription; and (d) drugs
for the treatment of sexual or erectile dysfunction, unless  such  drugs
are  used  to  treat a condition, other than sexual or erectile dysfunc-
tion, for which the drugs have been approved by  the  federal  food  and
drug  administration. For the purpose of this title, except as otherwise
provided in this section, a covered drug shall be dispensed  in  quanti-
ties no greater than a thirty day supply or one hundred units, whichever
is  greater. In the case of a drug dispensed in a form of administration
other than a tablet or capsule, the maximum allowed quantity shall be  a
thirty  day  supply;  the  [panel] COMMISSIONER is authorized to approve
exceptions to these limits for specific products following consideration
of recommendations from  pharmaceutical  or  medical  experts  regarding
commonly packaged quantities, unusual forms of administration, length of
treatment or cost effectiveness. In the case of a drug prescribed pursu-
ant  to section thirty-three hundred thirty-two of the public health law
to treat one of the conditions that have been enumerated by the  commis-
sioner of health pursuant to regulation as warranting the prescribing of
greater  than a thirty day supply, such drug shall be dispensed in quan-
tities not to exceed a three month supply.
  S 2. Subdivision 6 of section 241 of the  elder  law,  as  amended  by
section  2  of  part  A of chapter 59 of the laws of 2011, is amended to
read as follows:
  6. "Annual coverage period" shall mean the period  of  twelve  consec-
utive  calendar months for which an eligible program participant has met
the [requirements of section two hundred forty-two] APPLICATION  FEE  OR
DEDUCTIBLE  REQUIREMENTS,  AS  THE  CASE MAY BE, OF SECTIONS TWO HUNDRED
FORTY-SEVEN AND TWO HUNDRED FORTY-EIGHT of this title.
  S 3. Subdivision 8 of section 241 of the elder  law  is  REPEALED  and
subdivision 9 is renumbered subdivision 8.
  S  4.  Subdivision  1  of  section 242 of the elder law, as amended by
section 3 of part A of chapter 59 of the laws of  2011,  is  amended  to
read as follows:
  1.  Persons  eligible  for  COMPREHENSIVE  coverage  under SECTION TWO
HUNDRED FORTY-SEVEN OF this title shall include:
  (a) any unmarried resident who is at least sixty-five years  of  age[,
who  is  enrolled in Medicare part D,] and whose income for the calendar
year immediately preceding the effective date  of  the  annual  coverage

S. 6256--D                         80                         A. 9056--D

period  beginning  on or after January first, two thousand five, is less
than or equal  to  [thirty-five]  TWENTY  thousand  dollars.  After  the
initial  determination  of eligibility, each eligible individual must be
redetermined eligible at least every twenty-four months; and
  (b) any married resident who is at least sixty-five years of age[, who
is  enrolled in Medicare part D,] and whose income for the calendar year
immediately preceding the effective date of the annual  coverage  period
when  combined with the income in the same calendar year of such married
person's spouse beginning on or after January first, two  thousand  one,
is  less than or equal to [fifty] TWENTY-SIX thousand dollars. After the
initial determination of eligibility, each eligible individual  must  be
redetermined eligible at least every twenty-four months.
  S  5. Section 242 of the elder law is amended by adding a new subdivi-
sion 2 to read as follows:
  2. PERSONS  ELIGIBLE  FOR  CATASTROPHIC  COVERAGE  UNDER  SECTION  TWO
HUNDRED FORTY-EIGHT OF THIS TITLE SHALL INCLUDE:
  (A) ANY UNMARRIED RESIDENT WHO IS AT LEAST SIXTY-FIVE YEARS OF AGE AND
WHOSE  INCOME  FOR THE CALENDAR YEAR IMMEDIATELY PRECEDING THE EFFECTIVE
DATE OF THE ANNUAL COVERAGE PERIOD BEGINNING ON OR AFTER JANUARY  FIRST,
TWO THOUSAND ONE, IS MORE THAN TWENTY THOUSAND AND LESS THAN OR EQUAL TO
THIRTY-FIVE  THOUSAND DOLLARS. AFTER THE INITIAL DETERMINATION OF ELIGI-
BILITY, EACH ELIGIBLE INDIVIDUAL MUST BE REDETERMINED ELIGIBLE AT  LEAST
EVERY TWENTY-FOUR MONTHS; AND
  (B)  ANY  MARRIED RESIDENT WHO IS AT LEAST SIXTY-FIVE YEARS OF AGE AND
WHOSE INCOME FOR THE CALENDAR YEAR IMMEDIATELY PRECEDING  THE  EFFECTIVE
DATE  OF THE ANNUAL COVERAGE PERIOD WHEN COMBINED WITH THE INCOME IN THE
SAME CALENDAR YEAR OF SUCH MARRIED PERSON'S SPOUSE BEGINNING ON OR AFTER
JANUARY FIRST, TWO  THOUSAND  ONE,  IS  MORE  THAN  TWENTY-SIX  THOUSAND
DOLLARS  AND  LESS  THAN  OR  EQUAL TO FIFTY THOUSAND DOLLARS. AFTER THE
INITIAL DETERMINATION OF ELIGIBILITY, EACH ELIGIBLE INDIVIDUAL  MUST  BE
REDETERMINED ELIGIBLE AT LEAST EVERY TWENTY-FOUR MONTHS.
  S 6. Paragraph (c) of subdivision 3 of section 242 of the elder law is
REPEALED and a new paragraph (c) is added to read as follows:
  (C)  THE  PARTICIPANT  REGISTRATION  FEE  CHARGED  TO ELIGIBLE PROGRAM
PARTICIPANTS FOR COMPREHENSIVE COVERAGE PURSUANT TO SECTION TWO  HUNDRED
FORTY-SEVEN  OF THIS TITLE SHALL BE WAIVED FOR THE PORTION OF THE ANNUAL
COVERAGE PERIOD THAT THE PARTICIPANT IS ALSO ENROLLED AS A FULL  SUBSIDY
INDIVIDUAL  IN  A  PRESCRIPTION DRUG OR MA-PD PLAN UNDER PART D OF TITLE
XVIII OF THE FEDERAL SOCIAL SECURITY ACT.
  S 7. Intentionally omitted.
  S 8. Intentionally omitted.
  S 9. Intentionally omitted.
  S 10. Intentionally omitted.
  S 11. Intentionally omitted.
  S 12. Intentionally omitted.
  S 12-a. Section 242 of the elder law is amended by adding a new subdi-
vision 4 to read as follows:
  4. AS A CONDITION  OF  ELIGIBILITY  FOR  BENEFITS  UNDER  THIS  TITLE,
PARTICIPANTS  MUST  BE  ENROLLED  IN  MEDICARE  PART D AND MAINTAIN SUCH
ENROLLMENT. FOR PERSONS WHO MEET THE ELIGIBILITY REQUIREMENTS TO PARTIC-
IPATE IN THE ELDERLY  PHARMACEUTICAL  INSURANCE  COVERAGE  PROGRAM,  THE
PROGRAM WILL PAY FOR A DRUG COVERED BY THE PERSON'S MEDICARE PART D PLAN
OR A DRUG IN A MEDICARE PART D EXCLUDED DRUG CLASS, AS DEFINED IN SUBDI-
VISION  EIGHT  OF  SECTION TWO HUNDRED FORTY-ONE OF THIS TITLE, PROVIDED
THAT SUCH DRUG IS A COVERED DRUG,  AS  DEFINED  IN  SUBDIVISION  ONE  OF
SECTION  TWO  HUNDRED  FORTY-ONE OF THIS TITLE, AND THAT THE PARTICIPANT

S. 6256--D                         81                         A. 9056--D

COMPLIES WITH THE POINT OF SALE CO-PAYMENT  REQUIREMENTS  SET  FORTH  IN
SECTIONS  TWO  HUNDRED  FORTY-SEVEN  AND TWO HUNDRED FORTY-EIGHT OF THIS
TITLE. NO PAYMENT SHALL BE MADE FOR MEDICARE PART D PLAN DEDUCTIBLES.
  S 12-b. Section 245 of the elder law is REPEALED.
  S  12-c.  Subdivision 1 of section 249 of the elder law, as amended by
section 111 of part C of chapter 58 of the laws of 2009, is  amended  to
read as follows:
  1. The state shall offer an opportunity to participate in this program
to  all  provider pharmacies as defined in section two hundred forty-one
of this title, provided, however, that the participation  of  pharmacies
registered  in the state pursuant to section sixty-eight hundred eight-b
of the education law shall be limited to state assistance provided under
this title for prescription drugs covered  by  a  program  participant's
medicare [or other] drug plan.
  S  12-d.  Subdivisions  1  and  2  of section 253 of the elder law are
amended to read as follows:
  1. In counties having a population of seventy-five  thousand  or  less
that  are in proximity to the state boundary and which are determined by
the [executive director] COMMISSIONER OF HEALTH  to  be  not  adequately
served  by  provider  pharmacies  registered in New York, and in Fishers
Island in the town of Southold, Suffolk county, the [executive director]
COMMISSIONER may approve as provider pharmacies, pharmacies  located  in
New  Jersey,  Connecticut,  Vermont, Pennsylvania or Massachusetts. Such
approvals shall be made after (a) consideration of the  convenience  and
necessity  of New York residents in the rural areas served by such phar-
macies, (b) consideration of the quality of service of  such  pharmacies
and the standing of such pharmacies with the governmental board or agen-
cy  of  the  state in which such pharmacy is located, (c) the [executive
director] COMMISSIONER shall give all  licensed  pharmacies  within  the
county  notice  of  his  or  her  intention to approve such out-of-state
provider pharmacies, and (d) the [executive director]  COMMISSIONER  has
held  a  public hearing at which he or she has determined factually that
the licensed pharmacies within such county are not adequately serving as
provider pharmacies.
  2. The [executive director] COMMISSIONER OF HEALTH  shall  investigate
and  determine whether certification shall be granted within ninety days
of the filing of an application for certification by the governing  body
of  any city, town or village, within a county determined by the [execu-
tive director] COMMISSIONER to be  not  adequately  served  by  provider
pharmacies  registered  in  New York pursuant to subdivision one of this
section, claiming to be lacking adequate pharmaceutical service.
  S 13. The section heading of section 247 of the elder law, as  amended
by  section  3-i of part A of chapter 59 of the laws of 2011, is amended
to read as follows:
  Cost-sharing responsibilities of  eligible  program  participants  FOR
COMPREHENSIVE COVERAGE.
  S  14. Subdivision 1 of section 247 of the elder law is REPEALED and a
new subdivision 1 is added to read as follows:
  1. REGISTRATION FEE. ELIGIBLE INDIVIDUALS MEETING THE REGISTRATION FEE
REQUIREMENTS OF THIS SECTION MAY PURCHASE PRESCRIBED COVERED  DRUGS  FOR
AN AMOUNT SPECIFIED BY SUBDIVISION THREE OF THIS SECTION, SUBJECT TO THE
LIMITS  ON  POINT  OF  SALE CO-PAYMENTS SPECIFIED BY SUBDIVISION FOUR OF
THIS SECTION.
  S 15. Subdivision 2 of section 247 of the elder law, as renumbered  by
section  3-k  of part A of chapter 59 of the laws of 2011, is renumbered

S. 6256--D                         82                         A. 9056--D

subdivision 3 and two new subdivisions 2 and 4  are  added  to  read  as
follows:
  2.  REGISTRATION  FEE  SCHEDULE. ELIGIBLE INDIVIDUALS ELECTING TO MEET
THE REQUIREMENTS OF THIS SUBDIVISION SHALL PAY A QUARTERLY  REGISTRATION
FEE  IN  A  MANNER AND FORM DETERMINED BY THE EXECUTIVE DIRECTOR; AT THE
OPTION OF THE PARTICIPANT, THE REGISTRATION FEE MAY BE PAID ANNUALLY  IN
A LUMP SUM UPON THE BEGINNING OF THE ANNUAL COVERAGE PERIOD. NO ELIGIBLE
INDIVIDUAL  ELECTING  TO MEET THE REQUIREMENTS OF THIS SUBDIVISION SHALL
HAVE HIS PARTICIPATION IN THE PROGRAM LAPSE BY VIRTUE OF NON-PAYMENT  OF
THE  APPLICABLE  REGISTRATION  FEE  UNLESS  THE  CONTRACTOR HAS PROVIDED
NOTIFICATION OF THE AMOUNT AND DUE DATE THEREOF, AND  MORE  THAN  THIRTY
DAYS  HAVE  ELAPSED  SINCE THE DUE DATE OF THE INDIVIDUAL'S REGISTRATION
FEE. THE REGISTRATION FEE TO BE CHARGED TO ELIGIBLE PROGRAM PARTICIPANTS
FOR COMPREHENSIVE COVERAGE UNDER THIS OPTION SHALL BE IN ACCORDANCE WITH
THE FOLLOWING SCHEDULE:
  (A) QUARTERLY  REGISTRATION  FEES  FOR  UNMARRIED  INDIVIDUAL  PROGRAM
PARTICIPANTS:
INDIVIDUAL INCOME OF $5,000 OR LESS                    $2.00
INDIVIDUAL INCOME OF $5,001 TO $6,000                  $2.00
INDIVIDUAL INCOME OF $6,001 TO $7,000                  $4.00
INDIVIDUAL INCOME OF $7,001 TO $8,000                  $5.50
INDIVIDUAL INCOME OF $8,001 TO $9,000                  $7.00
INDIVIDUAL INCOME OF $9,001 TO $10,000                 $9.00
INDIVIDUAL INCOME OF $10,001 TO $11,000                $10.00
INDIVIDUAL INCOME OF $11,001 TO $12,000                $11.50
INDIVIDUAL INCOME OF $12,001 TO $13,000                $13.50
INDIVIDUAL INCOME OF $13,001 TO $14,000                $15.00
INDIVIDUAL INCOME OF $14,001 TO $15,000                $20.00
INDIVIDUAL INCOME OF $15,001 TO $16,000                $27.50
INDIVIDUAL INCOME OF $16,001 TO $17,000                $35.00
INDIVIDUAL INCOME OF $17,001 TO $18,000                $42.50
INDIVIDUAL INCOME OF $18,001 TO $19,000                $50.00
INDIVIDUAL INCOME OF $19,001 TO $20,000                $57.50
  (B)  QUARTERLY  REGISTRATION  FEES FOR EACH MARRIED INDIVIDUAL PROGRAM
PARTICIPANT:
JOINT INCOME OF $5,000 OR LESS                         $2.00
JOINT INCOME OF $5,001 TO $6,000                       $2.00
JOINT INCOME OF $6,001 TO $7,000                       $3.00
JOINT INCOME OF $7,001 TO $8,000                       $4.00
JOINT INCOME OF $8,001 TO $9,000                       $5.00
JOINT INCOME OF $9,001 TO $10,000                      $6.00
JOINT INCOME OF $10,001 TO $11,000                     $7.00
JOINT INCOME OF $11,001 TO $12,000                     $8.00
JOINT INCOME OF $12,001 TO $13,000                     $9.00
JOINT INCOME OF $13,001 TO $14,000                     $10.00
JOINT INCOME OF $14,001 TO $15,000                     $10.00
JOINT INCOME OF $15,001 TO $16,000                     $21.00
JOINT INCOME OF $16,001 TO $17,000                     $26.50
JOINT INCOME OF $17,001 TO $18,000                     $31.50
JOINT INCOME OF $18,001 TO $19,000                     $37.50
JOINT INCOME OF $19,001 TO $20,000                     $43.00
JOINT INCOME OF $20,001 TO $21,000                     $48.50
JOINT INCOME OF $21,001 TO $22,000                     $54.00
JOINT INCOME OF $22,001 TO $23,000                     $59.50
JOINT INCOME OF $23,001 TO $24,000                     $65.00

S. 6256--D                         83                         A. 9056--D

JOINT INCOME OF $24,001 TO $25,000                     $68.75
JOINT INCOME OF $25,001 TO $26,000                     $75.00
  (C)  IN  THE EVENT THAT THE STATE EXPENDITURES PER PARTICIPANT MEETING
THE REGISTRATION FEE REQUIREMENTS  OF  THIS  SUBDIVISION,  EXCLUSIVE  OF
EXPENDITURES  FOR PROGRAM ADMINISTRATION, IN THE PROGRAM YEAR COMMENCING
OCTOBER FIRST, NINETEEN HUNDRED EIGHTY-EIGHT, AND IN EACH  PROGRAM  YEAR
THEREAFTER,  EXCEED  SUCH EXPENDITURES IN THE PREVIOUS PROGRAM YEAR BY A
MINIMUM OF TEN PERCENT, THE ANNUAL REGISTRATION FEES SET FORTH  IN  THIS
SUBDIVISION  MAY,  UNLESS  OTHERWISE  PROVIDED  BY  LAW,  BE  INCREASED,
PRO-RATA, FOR THE SUBSEQUENT PROGRAM YEAR, PROVIDED THAT  SUCH  INCREASE
SHALL  NOT EXCEED SEVEN AND ONE-HALF PERCENT OF THE PRIOR YEAR REGISTRA-
TION FEES AS MAY HAVE BEEN ADJUSTED IN ACCORDANCE WITH THIS PARAGRAPH.
  (D) IN THE EVENT THAT THE STATE  EXPENDITURES  PER  SUCH  PARTICIPANT,
INCURRED  PURSUANT  TO  THIS  SUBDIVISION, EXCLUSIVE OF EXPENDITURES FOR
PROGRAM ADMINISTRATION, IN THE PROGRAM YEAR  COMMENCING  OCTOBER  FIRST,
NINETEEN  HUNDRED EIGHTY-EIGHT, AND IN EACH PROGRAM YEAR THEREAFTER, ARE
LESS THAN SUCH EXPENDITURES IN THE PREVIOUS PROGRAM YEAR BY A MINIMUM OF
TEN PERCENT, THE ANNUAL REGISTRATION FEES SET FORTH IN THIS  SUBDIVISION
MAY,  UNLESS  OTHERWISE PROVIDED BY LAW, BE DECREASED, PRO-RATA, FOR THE
SUBSEQUENT PROGRAM YEAR, PROVIDED THAT SUCH DECREASE  SHALL  NOT  EXCEED
SEVEN  AND  ONE-HALF  PERCENT OF THE PRIOR YEAR REGISTRATION FEES AS MAY
HAVE BEEN ADJUSTED IN ACCORDANCE WITH THIS PARAGRAPH.
  (E) THE DETERMINATION TO ADJUST ANNUAL REGISTRATION FEES SET FORTH  IN
THIS  SUBDIVISION  SHALL FOLLOW A REVIEW OF SUCH FACTORS AS THE RELATIVE
FINANCIAL CAPACITY OF THE STATE AND SUCH ELIGIBLE  PROGRAM  PARTICIPANTS
TO SUPPORT SUCH ADJUSTMENTS AND CHANGES IN THE CONSUMER PRICE INDEX. THE
FREQUENCY  OF SUCH ADJUSTMENTS SHALL NOT EXCEED ONCE IN ANY PROGRAM YEAR
AND SUCH ADJUSTMENTS SHALL NOT BECOME EFFECTIVE FOR  INDIVIDUAL  PROGRAM
PARTICIPANTS  PRIOR  TO THE FIRST DAY OF THE NEXT ANNUAL COVERAGE PERIOD
FOR EACH PARTICIPANT.
  4. LIMITS ON POINT OF SALE CO-PAYMENTS. DURING  EACH  ANNUAL  COVERAGE
PERIOD  NO POINT OF SALE CO-PAYMENT AS SET FORTH IN SUBDIVISION THREE OF
THIS SECTION SHALL BE REQUIRED TO BE MADE  FOR  THE  REMAINDER  OF  SUCH
PERIOD  BY  ANY  ELIGIBLE  PROGRAM  PARTICIPANT WHO HAS ALREADY INCURRED
CO-PAYMENTS IN EXCESS OF THE LIMITS SET FORTH IN THE FOLLOWING SCHEDULE:
  (A) LIMITS ON CO-PAYMENTS BY  UNMARRIED  INDIVIDUAL  ELIGIBLE  PROGRAM
PARTICIPANTS:
INDIVIDUAL INCOME OF $5,000 OR LESS                 NO MORE THAN $340
INDIVIDUAL INCOME OF $5,001 TO $6,000               NO MORE THAN $408
INDIVIDUAL INCOME OF $6,001 TO $7,000               NO MORE THAN $476
INDIVIDUAL INCOME OF $7,001 TO $8,000               NO MORE THAN $544
INDIVIDUAL INCOME OF $8,001 TO $9,000               NO MORE THAN $612
INDIVIDUAL INCOME OF $9,001 TO $10,000              NO MORE THAN $700
INDIVIDUAL INCOME OF $10,001 TO $11,000             NO MORE THAN $720
INDIVIDUAL INCOME OF $11,001 TO $12,000             NO MORE THAN $827
INDIVIDUAL INCOME OF $12,001 TO $13,000             NO MORE THAN $896
INDIVIDUAL INCOME OF $13,001 TO $14,000             NO MORE THAN $964
INDIVIDUAL INCOME OF $14,001 TO $15,000             NO MORE THAN $1,016
INDIVIDUAL INCOME OF $15,001 TO $16,000             NO MORE THAN $1,034
INDIVIDUAL INCOME OF $16,001 TO $17,000             NO MORE THAN $1,052
INDIVIDUAL INCOME OF $17,001 TO $18,000             NO MORE THAN $1,070
INDIVIDUAL INCOME OF $18,001 TO $19,000             NO MORE THAN $1,088
INDIVIDUAL INCOME OF $19,001 TO $20,000             NO MORE THAN $1,160
  (B) LIMITS ON CO-PAYMENTS BY EACH MARRIED INDIVIDUAL ELIGIBLE PROGRAM
PARTICIPANT:

S. 6256--D                         84                         A. 9056--D

JOINT INCOME OF $5,000 OR LESS                      NO MORE THAN $291
JOINT INCOME OF $5,001 TO $6,000                    NO MORE THAN $342
JOINT INCOME OF $6,001 TO $7,000                    NO MORE THAN $399
JOINT INCOME OF $7,001 TO $8,000                    NO MORE THAN $456
JOINT INCOME OF $8,001 TO $9,000                    NO MORE THAN $513
JOINT INCOME OF $9,001 TO $10,000                   NO MORE THAN $570
JOINT INCOME OF $10,001 TO $11,000                  NO MORE THAN $622
JOINT INCOME OF $11,001 TO $12,000                  NO MORE THAN $641
JOINT INCOME OF $12,001 TO $13,000                  NO MORE THAN $660
JOINT INCOME OF $13,001 TO $14,000                  NO MORE THAN $684
JOINT INCOME OF $14,001 TO $15,000                  NO MORE THAN $710
JOINT INCOME OF $15,001 TO $16,000                  NO MORE THAN $826
JOINT INCOME OF $16,001 TO $17,000                  NO MORE THAN $877
JOINT INCOME OF $17,001 TO $18,000                  NO MORE THAN $928
JOINT INCOME OF $18,001 TO $19,000                  NO MORE THAN $980
JOINT INCOME OF $19,001 TO $20,000                  NO MORE THAN $990
JOINT INCOME OF $20,001 TO $21,000                  NO MORE THAN $1,008
JOINT INCOME OF $21,001 TO $22,000                  NO MORE THAN $1,026
JOINT INCOME OF $22,001 TO $23,000                  NO MORE THAN $1,044
JOINT INCOME OF $23,001 TO $24,000                  NO MORE THAN $1,062
JOINT INCOME OF $24,001 TO $25,000                  NO MORE THAN $1,080
JOINT INCOME OF $25,001 TO $26,000                  NO MORE THAN $1,150
  (C) EFFECTIVE OCTOBER FIRST, NINETEEN HUNDRED EIGHTY-EIGHT, THE LIMITS
ON  POINT  OF  SALE  CO-PAYMENTS AS SET FORTH IN THIS SUBDIVISION MAY BE
ADJUSTED BY THE PANEL ON THE ANNIVERSARY DATE OF  EACH  PROGRAM  PARTIC-
IPANT'S  ANNUAL  COVERAGE PERIOD, AND SUCH ADJUSTMENT SHALL BE IN EFFECT
FOR THE DURATION OF THAT ANNUAL COVERAGE PERIOD. ANY SUCH ANNUAL ADJUST-
MENT SHALL BE MADE USING A PERCENTAGE ADJUSTMENT FACTOR WHICH SHALL  NOT
EXCEED  ONE-HALF  OF  THE DIFFERENCE BETWEEN THE YEAR-TO-YEAR PERCENTAGE
INCREASE IN THE  CONSUMER  PRICE  INDEX  FOR  ALL  URBAN  CONSUMERS,  AS
PUBLISHED  BY THE UNITED STATES DEPARTMENT OF LABOR, AND, IF LARGER, THE
YEAR-TO-YEAR PERCENTAGE  INCREASE  IN  THE  AGGREGATE  AVERAGE  COST  OF
COVERED  DRUGS PURCHASED UNDER THIS TITLE, WHICH YEAR-TO-YEAR PERCENTAGE
INCREASE IN SUCH COST SHALL BE DETERMINED BY COMPARISON OF SUCH COST  IN
THE  SAME  MONTH  OF EACH OF THE APPROPRIATE SUCCESSIVE YEARS; PROVIDED,
HOWEVER, THAT FOR ANY SUCH ADJUSTMENT BASED WHOLLY ON EXPERIENCE IN  THE
PROGRAM  YEAR  COMMENCING  OCTOBER FIRST, NINETEEN HUNDRED EIGHTY-SEVEN,
THE YEAR-TO-YEAR PERCENTAGE INCREASE IN SUCH COST SHALL BE DETERMINED BY
COMPARISON OF SUCH COST IN EACH OF TWO MONTHS NO LESS THAN  FIVE  MONTHS
APART  AND  WITHIN  SUCH PROGRAM YEAR, WHICH COMPARISON SHALL BE ANNUAL-
IZED. SUCH PERCENTAGE ADJUSTMENT FACTOR SHALL BE THE SAME AS  THAT  USED
TO  DETERMINE ANY SIMILAR ANNUAL ADJUSTMENT FOR THE SAME ANNUAL COVERAGE
PERIODS PURSUANT TO THE PROVISIONS OF SUBDIVISION FOUR  OF  SECTION  TWO
HUNDRED FORTY-EIGHT OF THIS TITLE.
  (D)  SUCH  ANNUAL  ADJUSTMENTS  SHALL BE CALCULATED BY MULTIPLYING THE
PERCENTAGE ADJUSTMENT FACTOR BY (1) TEN PERCENT AND APPLYING THE RESULT-
ING PERCENTAGE TO THE UPPER INCOME LIMITATION OF EACH INCOME  LEVEL  FOR
UNMARRIED  INDIVIDUALS  CONTAINED  IN THIS SUBDIVISION, AND BY (2) SEVEN
AND ONE-HALF PERCENT AND APPLYING THE RESULTING PERCENTAGE TO THE  UPPER
INCOME LIMITATION OF EACH INCOME LEVEL FOR MARRIED INDIVIDUALS CONTAINED
IN  THIS SUBDIVISION; EACH RESULT OF SUCH CALCULATIONS, MINUS ANY APPLI-
CABLE REGISTRATION FEE INCREASES MADE PURSUANT  TO  SUBDIVISION  TWO  OF
THIS  SECTION  AND PLUS THE RESULT OF APPLYING THE PERCENTAGE ADJUSTMENT
FACTOR TO THE SUM OF ANY SUCH ANNUAL ADJUSTMENTS APPLICABLE THERETO  FOR
ANY PRIOR ANNUAL COVERAGE PERIOD, SHALL BE THE AMOUNT BY WHICH THE LIMIT
ON  CO-PAYMENTS  FOR  EACH  SUCH  INCOME LEVEL MAY BE ADJUSTED, AND SUCH

S. 6256--D                         85                         A. 9056--D

AMOUNT SHALL BE IN ADDITION TO ANY SUCH AMOUNT OR AMOUNTS APPLICABLE  TO
PRIOR ANNUAL COVERAGE PERIODS.
  (E)  THE  DETERMINATION  TO ADJUST THE LIMITS ON POINT OF SALE CO-PAY-
MENTS SET FORTH IN THIS  SUBDIVISION  SHALL  FOLLOW  A  REVIEW  OF  SUCH
FACTORS  AS THE RELATIVE FINANCIAL CAPACITY OF THE STATE AND SUCH ELIGI-
BLE PROGRAM PARTICIPANTS TO SUPPORT SUCH ADJUSTMENTS.
  S 16. Paragraph (a) of subdivision 3 of section 247 of the elder  law,
as  amended  by section 3-k of part A of chapter 59 of the laws of 2011,
such subdivision as renumbered  by  section  fifteen  of  this  act,  is
amended to read as follows:
  (a)  [A]  UPON  SATISFACTION  OF THE REGISTRATION FEE PURSUANT TO THIS
SECTION AN ELIGIBLE program participant must pay a point of sale co-pay-
ment as set forth in paragraph (b) of this subdivision at  the  time  of
each  purchase of a COVERED drug prescribed for such individual [that is
described in paragraph (c) of subdivision three of section  two  hundred
forty-two of this title]. SUCH CO-PAYMENT SHALL NOT BE WAIVED OR REDUCED
IN  WHOLE  OR IN PART SUBJECT TO THE LIMITS PROVIDED BY SUBDIVISION FOUR
OF THIS SECTION.
  S 17. The elder law is amended by adding a new section 248 to read  as
follows:
  S  248. COST-SHARING RESPONSIBILITIES OF ELIGIBLE PROGRAM PARTICIPANTS
FOR CATASTROPHIC COVERAGE. 1. DEDUCTIBLE. ELIGIBLE  INDIVIDUALS  MEETING
THE  DEDUCTIBLE  REQUIREMENTS  OF  THIS  SECTION MAY PURCHASE PRESCRIBED
COVERED DRUGS FOR AN AMOUNT  SPECIFIED  BY  SUBDIVISION  THREE  OF  THIS
SECTION, SUBJECT TO THE LIMITS ON POINT OF SALE CO-PAYMENTS SPECIFIED BY
SUBDIVISION FOUR OF THIS SECTION.
  2.  DEDUCTIBLE  SCHEDULE.  ELIGIBLE  INDIVIDUALS  ELECTING TO MEET THE
REQUIREMENTS OF THIS SUBDIVISION  SHALL  INCUR  AN  AMOUNT  OF  PERSONAL
COVERED  DRUG  EXPENDITURES  DURING ANY ANNUAL COVERAGE PERIOD WHICH ARE
NOT REIMBURSED BY ANY OTHER PUBLIC OR PRIVATE THIRD PARTY PAYMENT SOURCE
OR INSURANCE PLAN, AND SHALL BE DEEMED  TO  HAVE  MET  THEIR  DEDUCTIBLE
REQUIREMENTS  FOR  THE  REMAINDER  OF  SUCH  ANNUAL COVERAGE PERIOD. THE
AMOUNT OF PERSONAL COVERED DRUG EXPENDITURES TO BE INCURRED BY  ELIGIBLE
PROGRAM  PARTICIPANTS  FOR CATASTROPHIC COVERAGE UNDER THIS OPTION SHALL
BE IN ACCORDANCE WITH THE FOLLOWING SCHEDULE:
  (A) ANNUAL PERSONAL COVERED DRUG EXPENDITURES FOR UNMARRIED INDIVIDUAL
ELIGIBLE PROGRAM PARTICIPANTS:
INDIVIDUAL INCOME OF $20,001 TO $21,000                $530
INDIVIDUAL INCOME OF $21,001 TO $22,000                $550
INDIVIDUAL INCOME OF $22,001 TO $23,000                $580
INDIVIDUAL INCOME OF $23,001 TO $24,000                $720
INDIVIDUAL INCOME OF $24,001 TO $25,000                $750
INDIVIDUAL INCOME OF $25,001 TO $26,000                $780
INDIVIDUAL INCOME OF $26,001 TO $27,000                $810
INDIVIDUAL INCOME OF $27,001 TO $28,000                $840
INDIVIDUAL INCOME OF $28,001 TO $29,000                $870
INDIVIDUAL INCOME OF $29,001 TO $30,000                $900
INDIVIDUAL INCOME OF $30,001 TO $31,000                $930
INDIVIDUAL INCOME OF $31,001 TO $32,000                $960
INDIVIDUAL INCOME OF $32,001 TO $33,000                $1,160
INDIVIDUAL INCOME OF $33,001 TO $34,000                $1,190
INDIVIDUAL INCOME OF $34,001 TO $35,000                $1,230
  (B) ANNUAL PERSONAL COVERED DRUG EXPENDITURES FOR EACH MARRIED
INDIVIDUAL ELIGIBLE PROGRAM PARTICIPANT:
JOINT INCOME OF $26,001 TO $27,000                     $650
JOINT INCOME OF $27,001 TO $28,000                     $675

S. 6256--D                         86                         A. 9056--D

JOINT INCOME OF $28,001 TO $29,000                     $700
JOINT INCOME OF $29,001 TO $30,000                     $725
JOINT INCOME OF $30,001 TO $31,000                     $900
JOINT INCOME OF $31,001 TO $32,000                     $930
JOINT INCOME OF $32,001 TO $33,000                     $960
JOINT INCOME OF $33,001 TO $34,000                     $990
JOINT INCOME OF $34,001 TO $35,000                     $1,020
JOINT INCOME OF $35,001 TO $36,000                     $1,050
JOINT INCOME OF $36,001 TO $37,000                     $1,080
JOINT INCOME OF $37,001 TO $38,000                     $1,110
JOINT INCOME OF $38,001 TO $39,000                     $1,140
JOINT INCOME OF $39,001 TO $40,000                     $1,170
JOINT INCOME OF $40,001 TO $41,000                     $1,200
JOINT INCOME OF $41,001 TO $42,000                     $1,230
JOINT INCOME OF $42,001 TO $43,000                     $1,260
JOINT INCOME OF $43,001 TO $44,000                     $1,290
JOINT INCOME OF $44,001 TO $45,000                     $1,320
JOINT INCOME OF $45,001 TO $46,000                     $1,575
JOINT INCOME OF $46,001 TO $47,000                     $1,610
JOINT INCOME OF $47,001 TO $48,000                     $1,645
JOINT INCOME OF $48,001 TO $49,000                     $1,680
JOINT INCOME OF $49,001 TO $50,000                     $1,715
  (C)  IN THE EVENT THAT THE STATE EXPENDITURES PER PARTICIPANT ELECTING
TO MEET THE DEDUCTIBLE REQUIREMENTS OF THIS  SUBDIVISION,  EXCLUSIVE  OF
EXPENDITURES  FOR PROGRAM ADMINISTRATION, IN THE PROGRAM YEAR COMMENCING
OCTOBER FIRST, NINETEEN HUNDRED EIGHTY-EIGHT, AND IN EACH  PROGRAM  YEAR
THEREAFTER,  EXCEED  SUCH EXPENDITURES IN THE PREVIOUS PROGRAM YEAR BY A
MINIMUM OF TEN PERCENT, THE ANNUAL PERSONAL  COVERED  DRUG  EXPENDITURES
SET  FORTH IN THIS SUBDIVISION MAY, UNLESS OTHERWISE PROVIDED BY LAW, BE
INCREASED, PRO-RATA, FOR THE SUBSEQUENT PROGRAM YEAR, PROVIDED THAT SUCH
INCREASE SHALL NOT EXCEED EIGHT  PERCENT  OF  THE  PRIOR  YEAR  PERSONAL
COVERED  DRUG  EXPENDITURES AS MAY HAVE BEEN ADJUSTED IN ACCORDANCE WITH
THIS PARAGRAPH.
  (D) IN THE EVENT THAT THE STATE  EXPENDITURES  PER  SUCH  PARTICIPANT,
INCURRED  PURSUANT  TO  THIS  SUBDIVISION, EXCLUSIVE OF EXPENDITURES FOR
PROGRAM ADMINISTRATION, IN THE PROGRAM YEAR  COMMENCING  OCTOBER  FIRST,
NINETEEN  HUNDRED EIGHTY-EIGHT, AND IN EACH PROGRAM YEAR THEREAFTER, ARE
LESS THAN SUCH EXPENDITURES IN THE PREVIOUS PROGRAM YEAR BY A MINIMUM OF
TEN PERCENT, THE ANNUAL PERSONAL COVERED DRUG EXPENDITURES SET FORTH  IN
THIS  SUBDIVISION  MAY,  UNLESS OTHERWISE PROVIDED BY LAW, BE DECREASED,
PRO-RATA, FOR THE SUBSEQUENT PROGRAM YEAR, PROVIDED THAT  SUCH  DECREASE
SHALL  NOT  EXCEED EIGHT PERCENT OF THE PRIOR YEAR PERSONAL COVERED DRUG
EXPENDITURES AS MAY HAVE BEEN ADJUSTED IN  ACCORDANCE  WITH  THIS  PARA-
GRAPH.
  (E)  THE DETERMINATION TO ADJUST ANNUAL PERSONAL COVERED DRUG EXPENDI-
TURES SET FORTH IN THIS SUBDIVISION,  SHALL  FOLLOW  A  REVIEW  OF  SUCH
FACTORS  AS THE RELATIVE FINANCIAL CAPACITY OF THE STATE AND SUCH ELIGI-
BLE PROGRAM PARTICIPANTS TO SUPPORT SUCH ADJUSTMENTS AND CHANGES IN  THE
CONSUMER PRICE INDEX. THE FREQUENCY OF SUCH ADJUSTMENTS SHALL NOT EXCEED
ONCE  IN  ANY  TWELVE MONTH PERIOD AND SUCH ADJUSTMENTS SHALL NOT BECOME
EFFECTIVE FOR INDIVIDUAL PROGRAM PARTICIPANTS PRIOR TO THE FIRST DAY  OF
THE NEXT ANNUAL COVERAGE PERIOD FOR EACH PARTICIPANT.
  3.  POINT  OF SALE CO-PAYMENT. (A) UPON SATISFACTION OF THE DEDUCTIBLE
REQUIREMENTS PURSUANT TO SUBDIVISION TWO OF THIS  SECTION,  AN  ELIGIBLE
PROGRAM PARTICIPANT SHALL PAY A POINT OF SALE CO-PAYMENT AS SET FORTH IN
PARAGRAPH  (B)  OF  THIS  SUBDIVISION  AT THE TIME OF EACH PURCHASE OF A

S. 6256--D                         87                         A. 9056--D

COVERED DRUG PRESCRIBED FOR SUCH INDIVIDUAL. SUCH CO-PAYMENT  SHALL  NOT
BE WAIVED OR REDUCED IN WHOLE OR IN PART, SUBJECT TO THE LIMITS PROVIDED
BY SUBDIVISION FOUR OF THIS SECTION.
  (B)  THE  POINT  OF  SALE  CO-PAYMENT  AMOUNTS WHICH ARE TO BE CHARGED
ELIGIBLE PROGRAM PARTICIPANTS SHALL BE IN ACCORDANCE WITH THE  FOLLOWING
SCHEDULE:
FOR EACH PRESCRIPTION OF COVERED
DRUGS COSTING $15.00 OR LESS                           $3.00
FOR EACH PRESCRIPTION OF COVERED
DRUGS COSTING $15.01 TO $35.00                         $7.00
FOR EACH PRESCRIPTION OF COVERED
DRUGS COSTING $35.01 TO $55.00                         $15.00
FOR EACH PRESCRIPTION OF COVERED
DRUGS COSTING $55.01 OR MORE                           $20.00
  (C)  FOR  THE  PURPOSES  OF  THE  FOREGOING  SCHEDULE OF POINT OF SALE
CO-PAYMENTS, "COSTING" SHALL MEAN  THE  AMOUNT  OF  REIMBURSEMENT  WHICH
SHALL  BE  PAID  BY  THE  STATE  TO A PARTICIPATING PROVIDER PHARMACY IN
ACCORDANCE WITH SECTION TWO HUNDRED FIFTY OF THIS TITLE PLUS  THE  POINT
OF SALE CO-PAYMENT, CALCULATED AS OF THE DATE OF SALE.
  4.  ANNUAL  LIMITS  ON  POINT  OF SALE CO-PAYMENTS. DURING EACH ANNUAL
COVERAGE PERIOD, NO POINT OF SALE CO-PAYMENTS AS SET FORTH  IN  SUBDIVI-
SION  THREE OF THIS SECTION SHALL BE REQUIRED TO BE MADE FOR THE REMAIN-
DER OF SUCH PERIOD BY  ANY  ELIGIBLE  PROGRAM  PARTICIPANT  MEETING  THE
PERSONAL  COVERED  DRUG  EXPENDITURE  REQUIREMENTS OF SUBDIVISION TWO OF
THIS SECTION IN EXCESS OF THE LIMITS SET FORTH IN THE  FOLLOWING  SCHED-
ULE:
  (A)  LIMITS  ON  CO-PAYMENTS  BY UNMARRIED INDIVIDUAL ELIGIBLE PROGRAM
PARTICIPANTS:
INDIVIDUAL INCOME OF $20,001 TO $21,000           NO MORE THAN $1,050
INDIVIDUAL INCOME OF $21,001 TO $22,000           NO MORE THAN $1,100
INDIVIDUAL INCOME OF $22,001 TO $23,000           NO MORE THAN $1,150
INDIVIDUAL INCOME OF $23,001 TO $24,000           NO MORE THAN $1,200
INDIVIDUAL INCOME OF $24,001 TO $25,000           NO MORE THAN $1,250
INDIVIDUAL INCOME OF $25,001 TO $26,000           NO MORE THAN $1,300
INDIVIDUAL INCOME OF $26,001 TO $27,000           NO MORE THAN $1,350
INDIVIDUAL INCOME OF $27,001 TO $28,000           NO MORE THAN $1,400
INDIVIDUAL INCOME OF $28,001 TO $29,000           NO MORE THAN $1,450
INDIVIDUAL INCOME OF $29,001 TO $30,000           NO MORE THAN $1,500
INDIVIDUAL INCOME OF $30,001 TO $31,000           NO MORE THAN $1,550
INDIVIDUAL INCOME OF $31,001 TO $32,000           NO MORE THAN $1,600
INDIVIDUAL INCOME OF $32,001 TO $33,000           NO MORE THAN $1,650
INDIVIDUAL INCOME OF $33,001 TO $34,000           NO MORE THAN $1,700
INDIVIDUAL INCOME OF $34,001 TO $35,000           NO MORE THAN $1,750
  (B) LIMITS ON CO-PAYMENTS BY EACH MARRIED INDIVIDUAL ELIGIBLE  PROGRAM
PARTICIPANT:
JOINT INCOME OF $26,001 TO $27,000                NO MORE THAN $1,080
JOINT INCOME OF $27,001 TO $28,000                NO MORE THAN $1,120
JOINT INCOME OF $28,001 TO $29,000                NO MORE THAN $1,160
JOINT INCOME OF $29,001 TO $30,000                NO MORE THAN $1,200
JOINT INCOME OF $30,001 TO $31,000                NO MORE THAN $1,240
JOINT INCOME OF $31,001 TO $32,000                NO MORE THAN $1,280
JOINT INCOME OF $32,001 TO $33,000                NO MORE THAN $1,320
JOINT INCOME OF $33,001 TO $34,000                NO MORE THAN $1,360
JOINT INCOME OF $34,001 TO $35,000                NO MORE THAN $1,400
JOINT INCOME OF $35,001 TO $36,000                NO MORE THAN $1,440
JOINT INCOME OF $36,001 TO $37,000                NO MORE THAN $1,480

S. 6256--D                         88                         A. 9056--D

JOINT INCOME OF $37,001 TO $38,000                NO MORE THAN $1,520
JOINT INCOME OF $38,001 TO $39,000                NO MORE THAN $1,560
JOINT INCOME OF $39,001 TO $40,000                NO MORE THAN $1,600
JOINT INCOME OF $40,001 TO $41,000                NO MORE THAN $1,640
JOINT INCOME OF $41,001 TO $42,000                NO MORE THAN $1,680
JOINT INCOME OF $42,001 TO $43,000                NO MORE THAN $1,720
JOINT INCOME OF $43,001 TO $44,000                NO MORE THAN $1,760
JOINT INCOME OF $44,001 TO $45,000                NO MORE THAN $1,800
JOINT INCOME OF $45,001 TO $46,000                NO MORE THAN $1,840
JOINT INCOME OF $46,001 TO $47,000                NO MORE THAN $1,880
JOINT INCOME OF $47,001 TO $48,000                NO MORE THAN $1,920
JOINT INCOME OF $48,001 TO $49,000                NO MORE THAN $1,960
JOINT INCOME OF $49,001 TO $50,000                NO MORE THAN $2,000
  (C) EFFECTIVE OCTOBER FIRST, NINETEEN HUNDRED EIGHTY-EIGHT, THE LIMITS
ON  POINT  OF  SALE  CO-PAYMENTS AS SET FORTH IN THIS SUBDIVISION MAY BE
ADJUSTED BY THE COMMISSIONER ON THE ANNIVERSARY  DATE  OF  EACH  PROGRAM
PARTICIPANT'S  ANNUAL  COVERAGE  PERIOD, AND SUCH ADJUSTMENT SHALL BE IN
EFFECT FOR THE DURATION OF THAT ANNUAL COVERAGE PERIOD. ANY SUCH  ANNUAL
ADJUSTMENT  SHALL  BE  MADE  USING  A PERCENTAGE ADJUSTMENT FACTOR WHICH
SHALL NOT EXCEED ONE-HALF OF THE  DIFFERENCE  BETWEEN  THE  YEAR-TO-YEAR
PERCENTAGE INCREASE IN THE CONSUMER PRICE INDEX FOR ALL URBAN CONSUMERS,
AS  PUBLISHED  BY THE UNITED STATES DEPARTMENT OF LABOR, AND, IF LARGER,
THE YEAR-TO-YEAR PERCENTAGE INCREASE IN THE AGGREGATE  AVERAGE  COST  OF
COVERED  DRUGS PURCHASED UNDER THIS TITLE, WHICH YEAR-TO-YEAR PERCENTAGE
INCREASE IN SUCH COST SHALL BE DETERMINED BY COMPARISON OF SUCH COST  IN
THE  SAME  MONTH  OF EACH OF THE APPROPRIATE SUCCESSIVE YEARS; PROVIDED,
HOWEVER, THAT FOR ANY SUCH ADJUSTMENT BASED WHOLLY ON EXPERIENCE IN  THE
PROGRAM  YEAR  COMMENCING  OCTOBER FIRST, NINETEEN HUNDRED EIGHTY-SEVEN,
THE YEAR-TO-YEAR PERCENTAGE INCREASE IN SUCH COST SHALL BE DETERMINED BY
COMPARISON OF SUCH COST IN EACH OF TWO MONTHS NO LESS THAN  FIVE  MONTHS
APART  AND  WITHIN  SUCH PROGRAM YEAR, WHICH COMPARISON SHALL BE ANNUAL-
IZED. SUCH PERCENTAGE ADJUSTMENT FACTOR SHALL BE THE SAME AS  THAT  USED
TO  DETERMINE ANY SIMILAR ANNUAL ADJUSTMENT FOR THE SAME ANNUAL COVERAGE
PERIODS PURSUANT TO THE PROVISIONS OF SUBDIVISION FOUR  OF  SECTION  TWO
HUNDRED  FORTY-SEVEN  OF  THIS  TITLE.  SUCH ANNUAL ADJUSTMENTS SHALL BE
CALCULATED BY MULTIPLYING THE PERCENTAGE ADJUSTMENT FACTOR  BY  (1)  TEN
PERCENT  AND APPLYING THE RESULTING PERCENTAGE TO THE UPPER INCOME LIMI-
TATION OF EACH INCOME LEVEL FOR UNMARRIED INDIVIDUALS CONTAINED IN  THIS
SUBDIVISION,  AND  BY  (2)  SEVEN  AND ONE-HALF PERCENT AND APPLYING THE
RESULTING PERCENTAGE TO THE UPPER INCOME LIMITATION OF EACH INCOME LEVEL
FOR MARRIED INDIVIDUALS CONTAINED IN THIS SUBDIVISION;  EACH  RESULT  OF
SUCH CALCULATIONS, MINUS ANY APPLICABLE DEDUCTIBLE INCREASES MADE PURSU-
ANT  TO  SUBDIVISION TWO OF THIS SECTION AND PLUS THE RESULT OF APPLYING
THE PERCENTAGE ADJUSTMENT FACTOR TO THE SUM OF ANY SUCH  ANNUAL  ADJUST-
MENTS  APPLICABLE THERETO FOR ANY PRIOR ANNUAL COVERAGE PERIOD, SHALL BE
THE AMOUNT BY WHICH THE LIMIT ON CO-PAYMENTS FOR EACH SUCH INCOME  LEVEL
MAY BE ADJUSTED, AND SUCH AMOUNT SHALL BE IN ADDITION TO ANY SUCH AMOUNT
OR AMOUNTS APPLICABLE TO PRIOR ANNUAL COVERAGE PERIODS.
  (D)  THE  DETERMINATION  TO ADJUST THE LIMITS ON POINT OF SALE CO-PAY-
MENTS SET FORTH IN THIS  SUBDIVISION  SHALL  FOLLOW  A  REVIEW  OF  SUCH
FACTORS  AS THE RELATIVE FINANCIAL CAPACITY OF THE STATE AND SUCH ELIGI-
BLE PROGRAM PARTICIPANT TO SUPPORT SUCH ADJUSTMENTS.
  S 18. Section 250 of the elder law, as amended by section 3-m of  part
A of chapter 59 of the laws of 2011, is amended to read as follows:
  S  250.  Reimbursement  to  participating  provider pharmacies. 1. The
amount of reimbursement which shall be paid by the state  to  a  partic-

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ipating  provider  pharmacy  [filling  or refilling a prescription for a
drug that is described in paragraph (c) of subdivision three of  section
two  hundred  forty-two  of  this  title] FOR ANY COVERED DRUG FILLED OR
REFILLED  FOR  ANY  ELIGIBLE  PROGRAM  PARTICIPANT shall be equal to the
allowed amount defined as follows, minus the point of sale co-payment as
required by [section] SECTIONS two hundred forty-seven AND  TWO  HUNDRED
FORTY-EIGHT of this title:
  (a)  Multiple  source  covered drugs. Except for brand name drugs that
are required by the prescriber to be dispensed as written,  the  allowed
amount for a multiple source covered drug shall equal the lower of:
  (1)  The  pharmacy's usual and customary charge to the general public,
taking into consideration any quantity and promotional discounts to  the
general public at the time of purchase, or
  (2) The upper limit, if any, set by the centers for medicare and medi-
caid services for such multiple source drug, or
  (3) Average wholesale price discounted by twenty-five percent, or
  (4) The maximum allowable cost, if any, established by the commission-
er  of  health  pursuant to paragraph (e) of subdivision nine of section
three hundred sixty-seven-a of the social services law.
  Plus a dispensing fee for drugs reimbursed pursuant  to  subparagraphs
two,  three,  and four of this paragraph, as defined in paragraph (c) of
this subdivision.
  (b) Other covered drugs. The  allowed  amount  for  brand  name  drugs
required  by  the  prescriber to be dispensed as written and for covered
drugs other than multiple source drugs shall be determined  by  applying
the lower of:
  (1)  Average wholesale price discounted by sixteen and twenty-five one
hundredths percent, plus a dispensing fee as defined in paragraph (c) of
this subdivision, or
  (2) The pharmacy's usual and customary charge to the  general  public,
taking  into consideration any quantity and promotional discounts to the
general public at the time of purchase.
  (c) As required by paragraphs (a)  and  (b)  of  this  subdivision,  a
dispensing  fee  of four dollars fifty cents will apply to generic drugs
and a dispensing fee of three dollars fifty cents will  apply  to  brand
name drugs.
  2. For purposes of determining the amount of reimbursement which shall
be paid to a participating provider pharmacy, the commissioner of health
shall determine or cause to be determined, through a statistically valid
survey,  the quantities of each covered drug that participating provider
pharmacies buy most frequently. Using the result  of  this  survey,  the
contractor  shall update every thirty days the list of average wholesale
prices upon which such  reimbursement  is  determined  using  nationally
recognized and most recently revised sources. Such price revisions shall
be  made available to all participating provider pharmacies. The pharma-
cist shall be reimbursed based on the price in effect at  the  time  the
covered drug is dispensed.
  3.  (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW, THE PROGRAM
FOR  ELDERLY  PHARMACEUTICAL  INSURANCE  COVERAGE  SHALL  REIMBURSE  FOR
COVERED  DRUGS WHICH ARE DISPENSED UNDER THE PROGRAM BY A PROVIDER PHAR-
MACY ONLY PURSUANT TO THE  TERMS  OF  A  REBATE  AGREEMENT  BETWEEN  THE
PROGRAM  AND  THE  MANUFACTURER  (AS  DEFINED  UNDER SECTION 1927 OF THE
FEDERAL SOCIAL SECURITY ACT) OF SUCH COVERED DRUGS;  PROVIDED,  HOWEVER,
THAT:
  (1)  ANY AGREEMENT BETWEEN THE PROGRAM AND A MANUFACTURER ENTERED INTO
BEFORE AUGUST FIRST, NINETEEN HUNDRED NINETY-ONE,  SHALL  BE  DEEMED  TO

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HAVE  BEEN ENTERED INTO ON APRIL FIRST, NINETEEN HUNDRED NINETY-ONE; AND
PROVIDED FURTHER, THAT IF A MANUFACTURER HAS NOT ENTERED INTO AN  AGREE-
MENT   WITH   THE  DEPARTMENT  BEFORE  AUGUST  FIRST,  NINETEEN  HUNDRED
NINETY-ONE,  SUCH  AGREEMENT  SHALL  NOT BE EFFECTIVE UNTIL APRIL FIRST,
NINETEEN HUNDRED NINETY-TWO, UNLESS SUCH AGREEMENT PROVIDES THAT REBATES
WILL BE RETROACTIVELY CALCULATED AS IF THE AGREEMENT HAD BEEN IN  EFFECT
ON APRIL FIRST, NINETEEN HUNDRED NINETY-ONE; AND
  (2) THE PROGRAM MAY REIMBURSE FOR ANY COVERED DRUGS PURSUANT TO SUBDI-
VISIONS  ONE  AND TWO OF THIS SECTION, FOR WHICH A REBATE AGREEMENT DOES
NOT EXIST AND WHICH ARE DETERMINED BY THE COMMISSIONER TO  BE  ESSENTIAL
TO  THE  HEALTH  OF  PERSONS PARTICIPATING IN THE PROGRAM; AND LIKELY TO
PROVIDE EFFECTIVE THERAPY OR DIAGNOSIS  FOR  A  DISEASE  NOT  ADEQUATELY
TREATED OR DIAGNOSED BY ANY OTHER COVERED DRUG.
  (B) THE REBATE AGREEMENT BETWEEN SUCH MANUFACTURER AND THE PROGRAM FOR
ELDERLY  PHARMACEUTICAL  INSURANCE  COVERAGE  SHALL  UTILIZE FOR COVERED
DRUGS THE IDENTICAL FORMULA USED TO DETERMINE  THE  REBATE  FOR  FEDERAL
FINANCIAL  PARTICIPATION  FOR  DRUGS, PURSUANT TO SECTION 1927(C) OF THE
FEDERAL SOCIAL SECURITY ACT, TO  DETERMINE  THE  AMOUNT  OF  THE  REBATE
PURSUANT TO THIS SUBDIVISION.
  (C) THE AMOUNT OF REBATE PURSUANT TO PARAGRAPH (B) OF THIS SUBDIVISION
SHALL  BE  CALCULATED BY MULTIPLYING THE REQUIRED REBATE FORMULAS BY THE
TOTAL NUMBER OF UNITS OF EACH DOSAGE FORM AND  STRENGTH  DISPENSED.  THE
REBATE  AGREEMENT SHALL ALSO PROVIDE FOR PERIODIC PAYMENT OF THE REBATE,
PROVISION OF INFORMATION TO THE PROGRAM, AUDITS, VERIFICATION  OF  DATA,
DAMAGES TO THE PROGRAM FOR ANY DELAY OR NON-PRODUCTION OF NECESSARY DATA
BY THE MANUFACTURER AND FOR THE CONFIDENTIALITY OF INFORMATION.
  (D)  THE  PROGRAM  IN PROVIDING UTILIZATION DATA TO A MANUFACTURER (AS
PROVIDED FOR UNDER SECTION 1927 (B) OF THE FEDERAL SOCIAL SECURITY  ACT)
SHALL  PROVIDE  SUCH  DATA  BY ZIP CODE, IF REQUESTED, FOR THE TOP THREE
HUNDRED MOST COMMONLY USED DRUGS BY VOLUME COVERED UNDER A REBATE AGREE-
MENT.
  (E) ANY FUNDS COLLECTED PURSUANT TO ANY REBATE AGREEMENTS ENTERED INTO
WITH A MANUFACTURER PURSUANT TO THIS  SUBDIVISION,  SHALL  BE  DEPOSITED
INTO  THE  ELDERLY  PHARMACEUTICAL  INSURANCE  COVERAGE  PROGRAM PREMIUM
ACCOUNT.
  4. Notwithstanding any other provision of law,  entities  which  offer
insurance  coverage for provision of and/or reimbursement for pharmaceu-
tical   expenses,   including   but    not    limited    to,    entities
licensed/certified  pursuant  to  article  thirty-two, forty-two, forty-
three or forty-four of the insurance law (employees  welfare  funds)  or
article  forty-four  of  the  public  health law, shall participate in a
benefit recovery  program  with  the  elderly  pharmaceutical  insurance
coverage  (EPIC)  program which includes, but is not limited to, a semi-
annual match of EPIC's file of enrollees against the  entity's  file  of
insured  to identify individuals enrolled in both plans with claims paid
within the twenty-four months preceding the date the entity receives the
match request information from EPIC. Such entity shall indicate if phar-
maceutical coverage  is  available  from  the  entity  for  the  insured
persons,  list the copayment or other payment obligations of the insured
persons applicable to the pharmaceutical coverage, and (after  receiving
necessary claim information from EPIC) list the amounts which the entity
would have paid for the pharmaceutical claims for those identified indi-
viduals  and the entity shall reimburse EPIC for pharmaceutical expenses
paid by EPIC that are covered under the contract between the entity  and
its  insured  in  only  those instances where the entity has not already
made payment of the claim.  Reimbursement  of  the  net  amount  payable

S. 6256--D                         91                         A. 9056--D

(after rebates and discounts) that would have been paid under the cover-
age issued by the entity will be made by the entity to EPIC within sixty
days  of  receipt  from  EPIC  of the standard data in electronic format
necessary  for  the  entity  to adjudicate the claim and if the standard
data is provided to the entity by EPIC in paper format  payment  by  the
entity  shall  be made within one hundred eighty days.  After completing
at least one match process with EPIC in  electronic  format,  an  entity
shall  be entitled to elect a monthly or bi-monthly match process rather
than a semi-annual match process.
  [4.] 5. Notwithstanding any other provision of law,  the  commissioner
of  health  shall  maximize  the  coordination  of  benefits for persons
enrolled under Title XVIII of the federal social security act (medicare)
and enrolled under this title in order to facilitate medicare payment of
claims. The commissioner of health may select an independent contractor,
through a request-for-proposal process, to implement a centralized coor-
dination of benefits system under this subdivision for individuals qual-
ified in both  the  elderly  pharmaceutical  insurance  coverage  (EPIC)
program  and  medicare programs who receive medications or other covered
products from a pharmacy provider  currently  enrolled  in  the  elderly
pharmaceutical insurance coverage (EPIC) program.
  [5.]  6.  The EPIC program shall be the payor of last resort for indi-
viduals qualified in both the EPIC program and title XVIII of the feder-
al social security act (Medicare).
  S 19. Section 254 of the elder law, as amended by section 3-n of  part
A of chapter 59 of the laws of 2011, is amended to read as follows:
  S  254. Cost of living adjustment. 1. Within amounts appropriated, the
commissioner of health shall adjust the  program  eligibility  standards
set  forth  in subdivision [one] TWO of section two hundred forty-two of
this title to account for increases in the cost of living.
  2. THE COMMISSIONER SHALL FURTHER ADJUST INDIVIDUAL AND  JOINT  INCOME
CATEGORIES SET FORTH IN SUBDIVISIONS TWO AND FOUR OF SECTION TWO HUNDRED
FORTY-EIGHT OF THIS TITLE TO CONFORM TO THE ADJUSTMENTS MADE PURSUANT TO
SUBDIVISION ONE OF THIS SECTION.
  S  19-a.  Subdivision  5  of section 244 of the elder law, as added by
section 3-h of part A of chapter 59 of the laws of 2011, is amended  and
a new subdivision 6 is added to read as follows:
  5.  establishing  or  contracting  for  a  therapeutic drug monitoring
program, for the purpose of monitoring therapeutic drug use by  eligible
program  participants  in an effort to prevent the incorrect or unneces-
sary consumption of such therapeutic drugs[.]; AND
  6. MONITOR THE PROVISION OF SERVICES PURSUANT TO CONTRACTUAL  ARRANGE-
MENTS  ENTERED  INTO PURSUANT TO SECTION TWO HUNDRED FORTY-THREE OF THIS
TITLE AND EXAMINE AND REVIEW ALL  DOCUMENTS  AND  OTHER  INFORMATION  TO
ASSURE COMPLIANCE WITH ALL PROVISIONS OF THIS ARTICLE WHETHER SUCH DOCU-
MENTS  OR  OTHER  INFORMATION ARE UNDER THE CONTROL OF A CONTRACTOR OR A
PARTICIPATING PROVIDER PHARMACY.
  S 20. This act shall take effect January 1, 2013,  provided  that  the
amendments  to  subdivision  1  of  section 241 of the elder law made by
section one-a of this act shall be subject to the expiration and  rever-
sion  of such subdivision pursuant to section 79 of part C of chapter 58
of the laws of 2005, as amended, when upon such date the  provisions  of
section one-b of this act shall take effect.
  S 2. Severability clause. If any clause, sentence, paragraph, subdivi-
sion,  section  or  part  of  this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair,  or  invalidate  the remainder thereof, but shall be confined in

S. 6256--D                         92                         A. 9056--D

its operation to the clause, sentence, paragraph,  subdivision,  section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included herein.
  S 3. This act shall take effect immediately  provided,  however,  that
the  applicable effective date of Parts A through T of this act shall be
as specifically set forth in the last section of such Parts.