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Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
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|---|---|
| Apr 13, 2016 |
signed chap.59 |
| Apr 01, 2016 |
delivered to governor |
| Mar 31, 2016 |
returned to assembly passed senate message of necessity - 3 day message 3rd reading cal.515 substituted for s6407c referred to finance delivered to senate passed assembly message of necessity - 3 day message motion to lay upon the table lost motion to amend lost ordered to third reading rules cal.23 rules report cal.23 reported reported referred to rules |
| Mar 30, 2016 |
print number 9007c |
| Mar 30, 2016 |
amend (t) and recommit to ways and means |
| Mar 11, 2016 |
print number 9007b |
| Mar 11, 2016 |
amend (t) and recommit to ways and means |
| Feb 16, 2016 |
print number 9007a |
| Feb 16, 2016 |
amend (t) and recommit to ways and means |
| Jan 14, 2016 |
referred to ways and means |
Assembly Bill A9007C
Signed By Governor2015-2016 Legislative Session
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2016-2017 state fiscal year
download bill text pdfSponsored By
There are no sponsors of this bill.
Archive: Last Bill Status - Signed by Governor
- Introduced
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- In Committee Assembly
- In Committee Senate
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- On Floor Calendar Assembly
- On Floor Calendar Senate
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- Passed Assembly
- Passed Senate
- Delivered to Governor
- Signed By Governor
Actions
Votes
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Floor Vote: Mar 31, 2016
aye (62)- Addabbo Jr.
- Akshar
- Amedore
- Avella
- Bonacic
- Boyle
- Breslin
- Carlucci
- Comrie
- Croci
- DeFrancisco
- Diaz
- Dilan
- Espaillat
- Farley
- Felder
- Flanagan
- Funke
- Gallivan
- Gianaris
- Golden
- Griffo
- Hamilton
- Hannon
- Hassell-Thompson
- Hoylman-Sigal
- Kennedy
- Klein
- Krueger
- LaValle
- Lanza
- Larkin
- Latimer
- Little
- Marcellino
- Marchione
- Martins
- Montgomery
- Murphy
- Nozzolio
- O'Mara
- Ortt
- Panepinto
- Parker
- Peralta
- Perkins
- Persaud
- Ranzenhofer
- Ritchie
- Rivera
- Robach
- Sanders Jr.
- Savino
- Serino
- Serrano
- Seward
- Squadron
- Stavisky
- Stewart-Cousins
- Valesky
- Venditto
- Young
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Bill Amendments
2015-A9007 - Details
- See Senate Version of this Bill:
- S6407
- Law Section:
- Budget Bills
- Laws Affected:
- Amd Various Laws, generally
2015-A9007 - Summary
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2016-2017 state fiscal year; intentionally omitted (Part A); amends the social services law, in relation to facilitating supplemental rebates for fee-for-service pharmaceuticals, and ambulance medical transportation rate adequacy review; amends the social services law, in relation to authorizing the commissioner of health to apply federally established consumer price index penalties for generic drugs, and authorizing the commissioner of health to impose penalties on managed care plans for reporting late or incorrect encounter data
2015-A9007 - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
S. 6407 A. 9007
S E N A T E - A S S E M B L Y
January 14, 2016
___________
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
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
AN ACT to amend 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 the expenditure cap for the
medical assistance program for needy persons (Part A); to amend the
social services law, in relation to provisions relating to transporta-
tion in the managed long term care program; to amend the public health
law, in relation to restricting the managed long term care benefit to
those who are nursing home eligible; to amend the social services law,
in relation to conforming with federal law provisions relating to
spousal contributions, community spouse resource budgeting; to amend
the social services law, in relation to authorizing price ceilings on
blockbuster drugs and reducing reimbursement rates for specialty
drugs; to amend the public health law, in relation to expanding prior
authorization for the clinical drug review program and eliminating
prescriber prevails; to amend the social services law, in relation to
authorizing the commissioner of health to apply federally established
consumer price index penalties for generic drugs, to facilitate
supplemental rebates for fee-for-service pharmaceuticals, to apply
prior authorization requirements for opioid drugs, to impose penalties
on managed care plans for reporting late or incorrect encounter data,
to apply cost sharing limits to medicare Part C claims and to author-
ize funding for the criminal justice pilot program within health home
rates; to amend chapter 59 of the laws of 2011, amending the public
health law and other laws relating to known and projected department
of health state fund Medicaid expenditures, in relation to extending
the expiration of certain provisions thereof; and to repeal certain
provisions of the social services law relating to the authorization of
prescriber prevails in the managed care program (Part B); to amend
chapter 266 of the laws of 1986, amending the civil practice law and
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD12671-01-6
S. 6407 2 A. 9007
rules and other laws relating to malpractice and professional medical
conduct, in relation to apportioning premium for certain policies and
to amend part J of chapter 63 of the laws of 2001 amending chapter 266
of the laws of 1986, amending the civil practice law and rules and
other laws relating to malpractice and professional medical conduct,
in relation to extending certain provisions concerning the hospital
excess liability pool (Part C); to amend chapter 474 of the laws of
1996, amending the education law and other laws relating to rates for
residential healthcare facilities, in relation to extending the
authority of the department of health to make disproportionate share
payments to public hospitals outside of New York City; to amend chap-
ter 649 of the laws of 1996, amending the public health law, the
mental hygiene law and the social services law relating to authorizing
the establishment of special needs plans, in relation to the effec-
tiveness thereof; to repeal subdivision 8 of section 84 of part A of
chapter 56 of the laws of 2013, amending the public health law and
other laws relating to general hospital reimbursement for annual
rates, relating to the effectiveness thereof; to repeal subdivision
(f) of section 129 of part C of chapter 58 of the laws of 2009, amend-
ing the public health law relating to payment by governmental agencies
for general hospital inpatient services, relating to the effectiveness
thereof; and to repeal subdivision (c) of section 122 of part E of
chapter 56 of the laws of 2013, amending the public health law relat-
ing to the general public health work program, relating to the effec-
tiveness thereof (Part D); to amend the public health law and the
insurance law, in relation to the early intervention program for
infants and toddlers with disabilities and their families (Part E); to
amend the public health law, in relation to the health care facility
transformation program (Part F); to amend the public health law, in
relation to authorizing the establishment of limited service clinics
(Part G); to amend 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, in relation
to the effectiveness thereof (Part H); 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 of certain provisions thereof (Part I); to amend chapter
420 of the laws of 2002 amending the education law relating to the
profession of social work, in relation to extending the expiration of
certain provisions thereof; to amend chapter 676 of the laws of 2002
amending the education law relating to the practice of psychology, in
relation to extending the expiration of certain provisions; and to
amend chapter 130 of the laws of 2010 amending the education law and
other laws relating to registration of entities providing certain
professional services and licensure of certain professions, in
relation to extending certain provisions thereof (Part J); to amend
the criminal procedure law, in relation to authorizing restorations to
competency within correctional facility based residential settings
(Part K); to amend the mental hygiene law, in relation to the appoint-
ment of temporary operators for the continued operation of programs
and the provision of services for persons with serious mental illness
and/or developmental disabilities (Part L); to amend the mental
hygiene law, in relation to sharing clinical records with managed care
organizations (Part M); and to amend the facilities development corpo-
ration act, in relation to the definition of mental hygiene facility
(Part N)
S. 6407 3 A. 9007
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 2016-2017
state fiscal year. Each component is wholly contained within a Part
identified as Parts A through N. 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. 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, subdivision (a) as amended by
section 3-e of part B of chapter 58 of the laws of 2010, subdivision (b)
as amended by section 24 of part B of chapter 109 of the laws of 2010,
subdivision (c-1) as added by section 1 of part F of chapter 56 of the
laws of 2012, subdivision (f) as amended by section 23 of part B of
chapter 109 of the laws of 2010, paragraph (iii) of subdivision (g) as
amended by section 2 of part F of chapter 56 of the laws of 2012, subdi-
vision (h) as added by section 61 of part D of chapter 56 of the laws of
2012, is amended to read as follows:
Section 1. (a) Notwithstanding the provisions of section 368-a of the
social services law, or any other provision of law, the department of
health shall provide reimbursement for expenditures made by or on behalf
of social services districts for medical assistance for needy persons,
and the administration thereof, in accordance with the provisions of
this section; provided, however, that this section shall not apply to
amounts expended for health care services under FORMER section 369-ee of
the social services law, which amounts shall be reimbursed in accordance
with paragraph (t) of subdivision 1 of section 368-a of such law and
shall be excluded from all calculations made pursuant to this section;
and provided further that amounts paid to the public hospitals pursuant
to subdivision 14-f of section 2807-c of the public health law and
amounts expended pursuant to: subdivision 12 of section 2808 of the
public health law; sections 211 and 212 of chapter 474 of the laws of
1996, as amended; and sections 11 through 14 of part A and sections 13
and 14 of part B of chapter 1 of the laws of 2002; and amounts paid to
public diagnostic and treatment centers as provided in sections 3-a and
3-b of part B of [the] chapter 58 of the laws of 2010 [which amended
this subdivision], amounts paid to public general hospitals as certified
public expenditures as provided in section 3-c of part B of [the] chap-
ter 58 of the laws of 2010 [which amended this subdivision], and amounts
paid to managed care providers pursuant to section 3-d of part B of
[the] chapter 58 of the laws of 2010 [which amended this subdivision],
shall be excluded from all calculations made pursuant to this section.
(b) Commencing with the period April 1, 2005 though March 31, 2006, a
social services district's yearly net share of medical assistance
expenditures shall be calculated in relation to a reimbursement base
S. 6407 4 A. 9007
year which, for purposes of this section, is defined as January 1, 2005
through December 31, 2005. The final base year expenditure calculation
for each social services district shall be made by the commissioner of
health, and approved by the director of the division of the budget, no
later than June 30, 2006. Such calculations shall be based on actual
expenditures made by or on behalf of social services districts, and
revenues received by social services districts, during the base year and
shall be made without regard to expenditures made, and revenues
received, outside the base year that are related to services provided
during, or prior to, the base year. Such base year calculations shall be
based on the social services district medical assistance shares
provisions in effect on January 1, 2005. Subject to the provisions of
subdivision four of section six of this part, the state/local social
services district relative percentages of the non-federal share of
medical assistance expenditures incurred prior to January 1, 2006 shall
not be subject to adjustment on and after July 1, 2006.
(c) Commencing with the calendar year beginning January 1, 2006,
calendar year social services district medical assistance expenditure
amounts for each social services district shall be calculated by multi-
plying the results of the calculations performed pursuant to paragraph
(b) of this section by a non-compounded trend factor, as follows:
(i) 2006 (January 1, 2006 through December 31, 2006): 3.5%;
(ii) 2007 (January 1, 2007 through December 31, 2007): 6.75% (3.25%
plus the prior year's 3.5%);
(iii) 2008 (January 1, 2008 through December 31, 2008): 9.75% (3%
plus the prior year's 6.75%);
(iv) 2009 (January 1, 2009 through December 31, 2009), and each
succeeding calendar year: prior year's trend factor percentage plus 3%.
(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%.
(C-2) NOTWITHSTANDING ANY PROVISIONS OF SUBDIVISION (C-1) OF THIS
SECTION TO THE CONTRARY, EFFECTIVE APRIL 1, 2016, FOR THE PERIOD JANUARY
1, 2016 THROUGH DECEMBER 31, 2016 AND FOR EACH CALENDAR YEAR THEREAFTER,
THE MEDICAL ASSISTANCE EXPENDITURE AMOUNT FOR A SOCIAL SERVICES DISTRICT
HAVING A POPULATION OF MORE THAN FIVE MILLION SHALL BE EQUAL TO THE
AMOUNT CALCULATED PURSUANT TO SUBDIVISIONS (B) AND (C) OF THIS SECTION.
(d) The base year expenditure amounts calculated pursuant to paragraph
(b) of this section and the calendar year social services district
expenditure amounts calculated pursuant to paragraph (c) of this section
shall be converted into state fiscal year social services district
expenditure cap amounts for each social services district such that each
such state fiscal year amount is proportional to the portions of the two
calendar years within each fiscal year, as follows:
(i) fiscal year 2005-2006 (April 1, 2005 through March 31, 2006): 75%
of the base year amount plus 25% of the 2006 calendar year amount;
S. 6407 5 A. 9007
(ii) fiscal year 2006-2007 (April 1, 2006 through March 31, 2007): 75%
of the 2006 year calendar amount plus 25% of the 2007 calendar year
amount;
(iii) each succeeding fiscal year: 75% of the first calendar year
within that fiscal year's amount plus 25% of the second calendar year
within that fiscal year's amount.
(D-1) NOTWITHSTANDING ANY PROVISIONS OF SUBDIVISION (D) OF THIS
SECTION TO THE CONTRARY, FOR FISCAL YEARS 2015-2016 AND 2016-2017, THE
BASE YEAR EXPENDITURE AMOUNT CALCULATED PURSUANT TO PARAGRAPH (B) OF
THIS SECTION AND THE CALENDAR YEAR SOCIAL SERVICES DISTRICT EXPENDITURE
AMOUNT CALCULATED PURSUANT TO PARAGRAPH (C) OF THIS SECTION SHALL BE
CONVERTED INTO A STATE FISCAL YEAR SOCIAL SERVICES DISTRICT EXPENDITURE
CAP AMOUNT FOR A SOCIAL SERVICES DISTRICT HAVING A POPULATION OF MORE
THAN FIVE MILLION AS FOLLOWS:
(I) FISCAL YEAR 2015-2016 (APRIL 1, 2015 THROUGH MARCH 31, 2016): 75%
OF THE 2015 BASE YEAR AMOUNT PLUS 25% OF THE 2016 CALENDAR YEAR AMOUNT,
IF SUCH 2016 CALENDAR YEAR AMOUNT WERE CALCULATED WITHOUT REGARD TO THE
PROVISIONS OF SUBDIVISION (C-2) OF THIS SECTION;
(II) FISCAL YEAR 2016-2017 (APRIL 1, 2016 THROUGH MARCH 31, 2017): 75%
OF THE 2016 BASE YEAR AMOUNT PLUS 25% OF THE 2017 CALENDAR YEAR AMOUNT;
THIS CAP AMOUNT SHALL BE REDUCED BY ONE-HALF OF THE DIFFERENCE BETWEEN
THIS AMOUNT AND THE CAP AMOUNT FOR THIS PERIOD THAT WOULD RESULT IF
CALCULATED WITHOUT REGARD TO THE PROVISIONS OF SUBDIVISION (C-2) OF THIS
SECTION.
(e) No later than April 1, 2007, the commissioner of health shall
certify the 2006-2007 fiscal year social services district expenditure
cap amounts for each social services district calculated pursuant to
subparagraph (ii) of paragraph (d) of this section and shall communicate
such amounts to the commissioner of taxation and finance.
(f) Subject to paragraph (g) of this section, the state fiscal year
social services district expenditure cap amount calculated for each
social services district pursuant to paragraph (d) of this section shall
be allotted to each district during that fiscal year and paid to the
department in equal weekly amounts in a manner to be determined by the
commissioner and communicated to such districts and, subject to the
provisions of subdivision four of section six of this part, shall repre-
sent each district's maximum responsibility for medical assistance
expenditures governed by this section. HOWEVER, FOR FISCAL YEAR
2016-2017, THE EXPENDITURE CAP AMOUNT CALCULATED FOR A SOCIAL SERVICES
DISTRICT HAVING A POPULATION OF MORE THAN FIVE MILLION SHALL BE PAID TO
THE DEPARTMENT IN WEEKLY AMOUNTS IN A MANNER TO BE DETERMINED BY THE
COMMISSIONER, IN CONSULTATION WITH THE DIRECTOR OF THE DIVISION OF THE
BUDGET, AND COMMUNICATED TO SUCH DISTRICT.
(g) (i) No allotment pursuant to paragraph (f) of this section shall
be applied against a social services district during the period April 1,
2005 through December 31, 2005. Social services district medical
assistance shares shall be determined for such period pursuant to shares
provisions in effect on January 1, 2005.
(ii) For the period January 1, 2006 through June 30, 2006, the commis-
sioner is authorized to allot against each district an amount based on
the commissioner's best estimate of the final base year expenditure
calculation required by paragraph (b) of this section. Upon completion
of such calculation, the commissioner shall, no later than December 31,
2006, reconcile such estimated allotments with the fiscal year social
services district expenditure cap amounts calculated pursuant to subpar-
agraphs (i) and (ii) of paragraph (d) of this section.
S. 6407 6 A. 9007
(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.
(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 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2016.
PART B
Section 1. Subdivision 4 of section 365-h of the social services law,
as separately amended by section 50 of part B and section 24 of part D
of chapter 57 of the laws of 2015, is amended to read as follows:
4. The commissioner of health is authorized to assume responsibility
from a local social services official for the provision and reimburse-
ment of transportation costs under this section. If the commissioner
elects to assume such responsibility, the commissioner shall notify the
local social services official in writing as to the election, the date
upon which the election shall be effective and such information as to
transition of responsibilities as the commissioner deems prudent. The
commissioner is authorized to contract with a transportation manager or
managers to manage transportation services in any local social services
district[, other than transportation services provided or arranged for
enrollees of managed long term care plans issued certificates of author-
ity under section forty-four hundred three-f of the public health law].
S. 6407 7 A. 9007
Any transportation manager or managers selected by the commissioner to
manage transportation services shall have proven experience in coordi-
nating transportation services in a geographic and demographic area
similar to the area in New York state within which the contractor would
manage the provision of services under this section. Such a contract or
contracts may include responsibility for: review, approval and process-
ing of transportation orders; management of the appropriate level of
transportation based on documented patient medical need; and development
of new technologies leading to efficient transportation services. If the
commissioner elects to assume such responsibility from a local social
services district, the commissioner shall examine and, if appropriate,
adopt quality assurance measures that may include, but are not limited
to, global positioning tracking system reporting requirements and
service verification mechanisms. Any and all reimbursement rates devel-
oped by transportation managers under this subdivision shall be subject
to the review and approval of the commissioner.
S 2. Subparagraph (i) of paragraph (b) of subdivision 7 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:
(i) The commissioner shall, to the extent necessary, submit the appro-
priate waivers, including, but not limited to, those authorized pursuant
to sections eleven hundred fifteen and nineteen hundred fifteen of the
federal social security act, or successor provisions, and any other
waivers necessary to achieve the purposes of high quality, integrated,
and cost effective care and integrated financial eligibility policies
under the medical assistance program or pursuant to title XVIII of the
federal social security act. In addition, the commissioner is authorized
to submit the appropriate waivers, including but not limited to those
authorized pursuant to sections eleven hundred fifteen and nineteen
hundred fifteen of the federal social security act or successor
provisions, and any other waivers necessary to require on or after April
first, two thousand twelve, medical assistance recipients who are twen-
ty-one years of age or older and who require community-based long term
care services, as specified by the commissioner, for more than one
hundred and twenty days, to receive such services through an available
plan certified pursuant to this section or other program model that
meets guidelines specified by the commissioner that support coordination
and integration of services; PROVIDED, HOWEVER, THAT THE COMMISSIONER
MAY, THROUGH SUCH WAIVERS, LIMIT ELIGIBILITY TO AVAILABLE PLANS TO
ENROLLEES THAT REQUIRE NURSING FACILITY LEVEL OF CARE. NOTWITHSTANDING
THE FOREGOING, MEDICAL ASSISTANCE RECIPIENTS ENROLLED IN A MANAGED LONG
TERM CARE PLAN ON APRIL FIRST, TWO THOUSAND SIXTEEN MAY CONTINUE TO BE
ELIGIBLE FOR SUCH PLANS, IRRESPECTIVE OF WHETHER THE ENROLLEE MEETS ANY
APPLICABLE NURSING FACILITY LEVEL OF CARE REQUIREMENTS, PROVIDED, HOWEV-
ER, THAT ONCE SUCH RECIPIENTS ARE DISENROLLED FROM THEIR MANAGED LONG
TERM CARE PLAN, ANY APPLICABLE NURSING FACILITY LEVEL OF CARE REQUIRE-
MENTS WOULD APPLY TO FUTURE ELIGIBILITY DETERMINATIONS. Such guidelines
shall address the requirements of paragraphs (a), (b), (c), (d), (e),
(f), (g), (h), and (i) of subdivision three of this section as well as
payment methods that ensure provider accountability for cost effective
quality outcomes. Such other program models may include long term home
health care programs that comply with such guidelines. Copies of such
original waiver applications and amendments thereto shall be provided to
the chairs of the senate finance committee, the assembly ways and means
committee and the senate and assembly health committees simultaneously
with their submission to the federal government.
S. 6407 8 A. 9007
S 3. 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
such relative in accordance with title six of article three OF THIS
CHAPTER and other applicable provisions of law.
S 4. Subparagraph (i) of paragraph (d) of subdivision 2 of section
366-c of the social services law is amended by adding a new clause (C)
to read as follows:
(C) ON AND AFTER JULY FIRST, TWO THOUSAND SIXTEEN, TWENTY-THREE THOU-
SAND EIGHT HUNDRED FORTY-FOUR DOLLARS OR SUCH GREATER AMOUNT AS MAY BE
REQUIRED UNDER FEDERAL LAW;
S 5. Subdivision 7 of section 367-a of the social services law is
amended by adding a new paragraph (g) to read as follows:
(G)(I) THE DEPARTMENT SHALL DEVELOP A LIST OF CRITICAL PRESCRIPTION
DRUGS FOR WHICH THERE IS A SIGNIFICANT PUBLIC INTEREST IN ENSURING
RATIONAL PRICING BY DRUG MANUFACTURERS. IN SELECTING DRUGS FOR POSSIBLE
INCLUSION IN SUCH LIST, FACTORS TO BE CONSIDERED BY THE DEPARTMENT SHALL
INCLUDE, BUT NOT BE LIMITED TO: THE SERIOUSNESS AND PREVALENCE OF THE
DISEASE OR CONDITION THAT IS TREATED BY THE DRUG; THE EXTENT OF UTILIZA-
TION OF THE DRUG; THE AVERAGE WHOLESALE PRICE AND RETAIL PRICE OF THE
DRUG; THE NUMBER OF PHARMACEUTICAL MANUFACTURERS THAT PRODUCE THE DRUG;
WHETHER THERE ARE PHARMACEUTICAL EQUIVALENTS TO THE DRUG; AND THE POTEN-
TIAL IMPACT OF THE COST OF THE DRUG ON PUBLIC HEALTH CARE PROGRAMS,
INCLUDING MEDICAID.
(II) FOR EACH PRESCRIPTION DRUG INCLUDED ON THE CRITICAL PRESCRIPTION
DRUG LIST, THE DEPARTMENT SHALL REQUIRE THE MANUFACTURERS OF SAID
PRESCRIPTION DRUG TO REPORT THE FOLLOWING INFORMATION:
(A) THE ACTUAL COST OF DEVELOPING, MANUFACTURING, PRODUCING (INCLUDING
THE COST PER DOSE OF PRODUCTION), AND DISTRIBUTING SUCH DRUG;
(B) RESEARCH AND DEVELOPMENT COSTS OF THE DRUG INCLUDING PAYMENTS TO
PREDECESSOR ENTITIES CONDUCTING RESEARCH AND DEVELOPMENT, INCLUDING BUT
NOT LIMITED TO BIOTECHNOLOGY COMPANIES, UNIVERSITIES AND MEDICAL
SCHOOLS, AND PRIVATE RESEARCH INSTITUTIONS;
(C) ADMINISTRATIVE, MARKETING, AND ADVERTISING COSTS FOR THE DRUG,
APPORTIONED BY MARKETING ACTIVITIES THAT ARE DIRECTED TO CONSUMERS,
MARKETING ACTIVITIES THAT ARE DIRECTED TO PRESCRIBERS, AND THE TOTAL
COST OF ALL MARKETING AND ADVERTISING THAT IS DIRECTED PRIMARILY TO
CONSUMERS AND PRESCRIBERS IN NEW YORK, INCLUDING BUT NOT LIMITED TO
PRESCRIBER DETAILING, COPAYMENT DISCOUNT PROGRAMS AND DIRECT TO CONSUMER
MARKETING;
(D) PRICES FOR THE DRUG THAT ARE CHARGED TO PURCHASERS OUTSIDE THE
UNITED STATES;
(E) PRICES CHARGED TO TYPICAL PURCHASERS IN NEW YORK, INCLUDING BUT
NOT LIMITED TO PHARMACIES, PHARMACY CHAINS, PHARMACY WHOLESALERS OR
OTHER DIRECT PURCHASERS;
(F) THE AVERAGE REBATES AND DISCOUNTS PROVIDED PER PAYOR TYPE;
S. 6407 9 A. 9007
(G) THE AVERAGE PROFIT MARGIN OF EACH DRUG OVER THE PRIOR FIVE YEAR
PERIOD AND THE PROJECTED PROFIT MARGIN ANTICIPATED FOR SUCH DRUG; AND
(H) CLINICAL INFORMATION INCLUDING BUT NOT LIMITED TO CLINICAL TRIALS
AND CLINICAL OUTCOMES RESEARCH.
(III) THE DEPARTMENT SHALL DEVELOP A STANDARD REPORTING FORM THAT
SATISFIES THE REQUIREMENTS OF SUBPARAGRAPH (II) OF THIS PARAGRAPH.
MANUFACTURERS SHALL PROVIDE THE REQUIRED INFORMATION WITHIN NINETY DAYS
OF THE DEPARTMENT'S REQUEST. ALL INFORMATION DISCLOSED PURSUANT TO
SUBPARAGRAPH (II) OF THIS PARAGRAPH IS CONFIDENTIAL AND SHALL NOT BE
DISCLOSED BY THE DEPARTMENT OR ITS ACTUARY IN A FORM THAT DISCLOSES THE
IDENTITY OF A SPECIFIC MANUFACTURER, OR PRICES CHARGED FOR DRUGS BY SUCH
MANUFACTURER, EXCEPT AS THE COMMISSIONER DETERMINES IS NECESSARY TO
CARRY OUT THE PROVISIONS OF THIS SECTION, OR TO ALLOW THE DEPARTMENT,
THE ATTORNEY GENERAL, THE STATE COMPTROLLER, OR THE CENTERS FOR MEDICARE
AND MEDICAID SERVICES TO PERFORM AUDITS OR INVESTIGATIONS AUTHORIZED BY
LAW.
(IV) FOR EACH CRITICAL PRESCRIPTION DRUG IDENTIFIED BY THE DEPARTMENT,
THE DEPARTMENT SHALL DIRECT ITS ACTUARY TO UTILIZE THE INFORMATION
PROVIDED PURSUANT TO SUBPARAGRAPH (II) OF THIS PARAGRAPH TO CONDUCT A
VALUE-BASED ASSESSMENT OF SUCH DRUG AND ESTABLISH A REASONABLE CEILING
PRICE.
(V) THE COMMISSIONER MAY REQUIRE A DRUG MANUFACTURER TO PROVIDE
REBATES TO THE DEPARTMENT FOR A CRITICAL PRESCRIPTION DRUG WHOSE PRICE
EXCEEDS THE CEILING PRICE FOR THE DRUG ESTABLISHED BY THE DEPARTMENT'S
ACTUARY PURSUANT TO SUBPARAGRAPH (IV) OF THIS PARAGRAPH. SUCH REBATES
SHALL BE IN ADDITION TO ANY REBATES PAYABLE TO THE DEPARTMENT PURSUANT
TO ANY OTHER PROVISION OF FEDERAL OR STATE LAW. THE ADDITIONAL REBATES
AUTHORIZED PURSUANT TO THIS SUBPARAGRAPH SHALL APPLY TO CRITICAL
PRESCRIPTION DRUGS DISPENSED TO ENROLLEES OF MANAGED CARE PROVIDERS
PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE AND TO
CRITICAL PRESCRIPTION DRUGS DISPENSED TO MEDICAID RECIPIENTS WHO ARE NOT
ENROLLEES OF SUCH PROVIDERS.
S 6. Paragraph (b) of subdivision 9 of section 367-a of the social
services law is amended by adding a new subparagraph (iv) to read as
follows:
(IV) NOTWITHSTANDING SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH, IF
THE DRUG DISPENSED IS A DRUG THAT ONE OR MORE MANAGED CARE PROVIDERS
OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE
HAVE DESIGNATED AS A SPECIALTY DRUG, AN AMOUNT THAT DOES NOT EXCEED THE
AMOUNT SUCH PROVIDERS PAY FOR THE DRUG, AS DETERMINED BY THE COMMISSION-
ER BASED ON MANAGED CARE PROVIDERS' ENCOUNTER DATA FOR THE DRUG.
S 7. Section 274 of the public health law is amended by adding a new
subdivision 15 to read as follows:
15. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION, THE
COMMISSIONER MAY REQUIRE PRIOR AUTHORIZATION FOR ANY DRUG AFTER EVALUAT-
ING THE FACTORS SET FORTH IN SUBDIVISION THREE OF THIS SECTION AND PRIOR
TO OBTAINING THE BOARD'S EVALUATION AND RECOMMENDATION REQUIRED BY
SUBDIVISION FOUR OF THIS SECTION. THE BOARD MAY RECOMMEND TO THE COMMIS-
SIONER, PURSUANT TO SUBDIVISION SIX OF THIS SECTION, THAT ANY SUCH PRIOR
AUTHORIZATION REQUIREMENT BE MODIFIED, CONTINUED OR REMOVED.
S 8. Paragraph (b) of subdivision 3 of section 273 of the public
health law, as added by section 10 of part C of chapter 58 of the laws
of 2005, is amended to read as follows:
(b) In the event that the patient does not meet the criteria in para-
graph (a) of this subdivision, the prescriber may provide additional
information to the program to justify the use of a prescription drug
S. 6407 10 A. 9007
that is not on the preferred drug list. The program shall provide a
reasonable opportunity for a prescriber to reasonably present his or her
justification of prior authorization. [If, after consultation with the
program, the prescriber, in his or her reasonable professional judgment,
determines that the use of a prescription drug that is not on the
preferred drug list is warranted, the prescriber's determination shall
be final.] THE PROGRAM WILL CONSIDER THE ADDITIONAL INFORMATION AND THE
JUSTIFICATION PRESENTED TO DETERMINE WHETHER THE USE OF A PRESCRIPTION
DRUG THAT IS NOT ON THE PREFERRED DRUG LIST IS WARRANTED. IN THE CASE OF
ATYPICAL ANTIPSYCHOTICS AND ANTIDEPRESSANTS, IF AFTER CONSULTATION WITH
THE PROGRAM, THE PRESCRIBER, IN HIS OR HER REASONABLE PROFESSIONAL JUDG-
MENT, DETERMINES THAT THE USE OF A PRESCRIPTION DRUG THAT IS NOT ON THE
PREFERRED DRUG LIST IS WARRANTED, THE PRESCRIBER'S DETERMINATION SHALL
BE FINAL.
S 9. Subdivision 25 of section 364-j of the social services law, as
added by section 55 of part D of chapter 56 of the laws of 2012, is
amended to read as follows:
25. [Effective January first, two thousand thirteen, notwithstanding]
NOTWITHSTANDING any provision of law to the contrary, managed care
providers shall cover medically necessary prescription drugs in the
atypical antipsychotic AND ANTIDEPRESSANT therapeutic [class] CLASSES,
including non-formulary drugs, upon demonstration by 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 10. Subdivision 25-a of section 364-j of the social services law is
REPEALED.
S 11. Subdivision 7 of section 367-a of the social services law is
amended by adding a new paragraph (f) to read as follows:
(F) THE COMMISSIONER MAY REQUIRE MANUFACTURERS OF DRUGS OTHER THAN
SINGLE SOURCE DRUGS AND INNOVATOR MULTIPLE SOURCE DRUGS, AS SUCH TERMS
ARE DEFINED IN 42 U.S.C. S 1396R-8(K), TO PROVIDE REBATES TO THE DEPART-
MENT FOR GENERIC DRUGS WHOSE PRICES INCREASE AT A RATE GREATER THAN THE
RATE OF INFLATION. SUCH REBATES SHALL BE IN ADDITION TO ANY REBATES
PAYABLE TO THE DEPARTMENT PURSUANT TO ANY OTHER PROVISION OF FEDERAL OR
STATE LAW. IN DETERMINING THE AMOUNT OF SUCH ADDITIONAL REBATES FOR
GENERIC DRUGS, THE COMMISSIONER MAY USE A METHODOLOGY SIMILAR TO THAT
USED BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES IN DETERMINING THE
AMOUNT OF ANY ADDITIONAL REBATES FOR SINGLE SOURCE AND INNOVATOR MULTI-
PLE SOURCE DRUGS, AS SET FORTH IN 42 U.S.C. S 1396R-8(C)(2). THE ADDI-
TIONAL REBATES AUTHORIZED PURSUANT TO THIS PARAGRAPH SHALL APPLY TO
GENERIC PRESCRIPTION DRUGS DISPENSED TO ENROLLEES OF MANAGED CARE
PROVIDERS PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE
AND TO GENERIC PRESCRIPTION DRUGS DISPENSED TO MEDICAID RECIPIENTS WHO
ARE NOT ENROLLEES OF SUCH PROVIDERS.
S 12. The opening paragraph of paragraph (e) of subdivision 7 of
section 367-a of the social services law, as added by section 1 of part
B of chapter 57 of the laws of 2015, is amended to read as follows:
During the period from April first, two thousand fifteen through March
thirty-first, two thousand seventeen, the commissioner may, in lieu of a
managed care provider, negotiate directly and enter into an agreement
with a pharmaceutical manufacturer for the provision of supplemental
rebates relating to pharmaceutical utilization by enrollees of managed
care providers pursuant to section three hundred sixty-four-j of this
title AND, NOTWITHSTANDING THE PROVISIONS OF SECTION TWO HUNDRED SEVEN-
TY-TWO OF THE PUBLIC HEALTH LAW OR ANY OTHER INCONSISTENT PROVISION OF
S. 6407 11 A. 9007
LAW, MAY ALSO NEGOTIATE DIRECTLY AND ENTER INTO SUCH AN AGREEMENT RELAT-
ING TO PHARMACEUTICAL UTILIZATION BY MEDICAL ASSISTANCE RECIPIENTS NOT
SO ENROLLED. Such rebates shall be limited to drug utilization in the
following classes: antiretrovirals approved by the FDA for the treatment
of HIV/AIDS and hepatitis C agents for which the pharmaceutical manufac-
turer has in effect a rebate agreement with the federal secretary of
health and human services pursuant to 42 U.S.C. S 1396r-8, and for which
the state has established standard clinical criteria. No agreement
entered into pursuant to this paragraph shall have an initial term or be
extended beyond March thirty-first, two thousand twenty.
S 13. Subparagraph (iv) of paragraph (e) of subdivision 7 of section
367-a of the social services law, as added by section 1 of part B of
chapter 57 of the laws of 2015, is amended to read as follows:
(iv) Nothing in this paragraph shall be construed to require a pharma-
ceutical manufacturer to enter into a supplemental rebate agreement with
the commissioner relating to pharmaceutical utilization by enrollees of
managed care providers pursuant to section three hundred sixty-four-j of
this title OR RELATING TO PHARMACEUTICAL UTILIZATION BY MEDICAL ASSIST-
ANCE RECIPIENTS NOT SO ENROLLED.
S 14. Section 364-j of the social services law is amended by adding a
new subdivision 26-a to read as follows:
26-A. MANAGED CARE PROVIDERS SHALL REQUIRE PRIOR AUTHORIZATION OF
PRESCRIPTIONS OF OPIOID ANALGESICS IN EXCESS OF FOUR PRESCRIPTIONS IN A
THIRTY-DAY PERIOD.
S 15. Section 364-j of the social services law is amended by adding a
new subdivision 32 to read as follows:
32. (A) THE COMMISSIONER MAY, IN HIS OR HER DISCRETION, APPLY PENAL-
TIES TO MANAGED CARE ORGANIZATIONS SUBJECT TO THIS SECTION AND ARTICLE
FORTY-FOUR OF THE PUBLIC HEALTH LAW FOR UNTIMELY OR INACCURATE
SUBMISSION OF ENCOUNTER DATA. FOR PURPOSES OF THIS SECTION, "ENCOUNTER
DATA" SHALL MEAN THE TRANSACTIONS REQUIRED TO BE REPORTED UNDER THE
MODEL CONTRACT. ANY PENALTY ASSESSED UNDER THIS SUBDIVISION SHALL BE
CALCULATED AS A PERCENTAGE OF THE ADMINISTRATIVE COMPONENT OF THE MEDI-
CAID PREMIUM CALCULATED BY THE DEPARTMENT.
(B) SUCH PENALTIES SHALL BE AS FOLLOWS:
(I) FOR ENCOUNTER DATA SUBMITTED OR RESUBMITTED PAST THE DEADLINES SET
FORTH IN THE MODEL CONTRACT, MEDICAID PREMIUMS SHALL BE REDUCED BY ONE
AND ONE-HALF PERCENT; AND
(II) FOR INCOMPLETE OR INACCURATE ENCOUNTER DATA THAT FAILS TO CONFORM
TO DEPARTMENT DEVELOPED BENCHMARKS FOR COMPLETENESS AND ACCURACY, MEDI-
CAID PREMIUMS SHALL BE REDUCED BY ONE-HALF PERCENT; AND
(III) FOR SUBMITTED DATA THAT RESULTS IN A REJECTION RATE IN EXCESS OF
TEN PERCENT OF DEPARTMENT DEVELOPED VOLUME BENCHMARKS, MEDICAID PREMIUMS
SHALL BE REDUCED BY ONE HALF-PERCENT.
(C) PENALTIES UNDER THIS SUBDIVISION MAY BE APPLIED TO ANY AND ALL
CIRCUMSTANCES DESCRIBED IN PARAGRAPH (B) OF THIS SUBDIVISION AT A
FREQUENCY DETERMINED BY THE COMMISSIONER. THE COMMISSIONER MAY, IN HIS
OR HER DISCRETION, WAIVE SUCH PENALTY.
S 16. Paragraph (d) of subdivision 1 of section 367-a of the social
services law is amended by adding a new subparagraph (iv) to read as
follows:
(IV) IF A HEALTH PLAN PARTICIPATING IN PART C OF TITLE XVIII OF THE
FEDERAL SOCIAL SECURITY ACT PAYS FOR ITEMS AND SERVICES PROVIDED TO
ELIGIBLE PERSONS WHO ARE ALSO BENEFICIARIES UNDER PART B OF TITLE XVIII
OF THE FEDERAL SOCIAL SECURITY ACT OR TO QUALIFIED MEDICARE BENEFICI-
ARIES, THE AMOUNT PAYABLE FOR SERVICES UNDER THIS TITLE SHALL BE THE
S. 6407 12 A. 9007
AMOUNT OF ANY CO-INSURANCE LIABILITY OF SUCH ELIGIBLE PERSONS PURSUANT
TO FEDERAL LAW IF THEY WERE NOT ELIGIBLE FOR MEDICAL ASSISTANCE OR WERE
NOT QUALIFIED MEDICARE BENEFICIARIES WITH RESPECT TO SUCH BENEFITS UNDER
SUCH PART B, BUT SHALL NOT EXCEED THE AMOUNT THAT OTHERWISE WOULD BE
MADE UNDER THIS TITLE IF PROVIDED TO AN ELIGIBLE PERSON WHO IS NOT A
BENEFICIARY UNDER PART B OR A QUALIFIED MEDICARE BENEFICIARY, LESS THE
AMOUNT PAYABLE BY THE PART C HEALTH PLAN; PROVIDED, HOWEVER, AMOUNTS
PAYABLE UNDER THIS TITLE FOR ITEMS AND SERVICES PROVIDED TO ELIGIBLE
PERSONS WHO ARE ALSO BENEFICIARIES UNDER PART B OR TO QUALIFIED MEDICARE
BENEFICIARIES BY AN AMBULANCE SERVICE UNDER THE AUTHORITY OF AN OPERAT-
ING CERTIFICATE ISSUED PURSUANT TO ARTICLE THIRTY OF THE PUBLIC HEALTH
LAW, A PSYCHOLOGIST LICENSED UNDER ARTICLE ONE HUNDRED FIFTY-THREE OF
THE EDUCATION LAW, OR A FACILITY UNDER THE AUTHORITY OF AN OPERATING
CERTIFICATE ISSUED PURSUANT TO ARTICLE SIXTEEN, THIRTY-ONE OR THIRTY-TWO
OF THE MENTAL HYGIENE LAW AND WITH RESPECT TO OUTPATIENT HOSPITAL AND
CLINIC ITEMS AND SERVICES PROVIDED BY A FACILITY UNDER THE AUTHORITY OF
AN OPERATING CERTIFICATE ISSUED PURSUANT TO ARTICLE TWENTY-EIGHT OF THE
PUBLIC HEALTH LAW, SHALL NOT BE LESS THAN THE AMOUNT OF ANY CO-INSURANCE
LIABILITY OF SUCH ELIGIBLE PERSONS OR SUCH QUALIFIED MEDICARE BENEFICI-
ARIES, OR FOR WHICH SUCH ELIGIBLE PERSONS OR SUCH QUALIFIED MEDICARE
BENEFICIARIES WOULD BE LIABLE UNDER FEDERAL LAW WERE THEY NOT ELIGIBLE
FOR MEDICAL ASSISTANCE OR WERE THEY NOT QUALIFIED MEDICARE BENEFICIARIES
WITH RESPECT TO SUCH BENEFITS UNDER PART B.
S 17. Subdivision 2-b of section 365-l of the social services law, as
added by section 25 of part B of chapter 57 of the laws of 2015, is
amended to read as follows:
2-b. The commissioner is authorized to make [grants] LUMP SUM
PAYMENTS OR ADJUST RATES OF PAYMENT TO PROVIDERS up to a gross amount of
five million dollars, to establish coordination between the health homes
and the criminal justice system and for the integration of information
of health homes with state and local correctional facilities, to the
extent permitted by law. SUCH RATE ADJUSTMENTS MAY BE MADE TO HEALTH
HOMES PARTICIPATING IN A CRIMINAL JUSTICE PILOT PROGRAM WITH THE PURPOSE
OF ENROLLING INCARCERATED INDIVIDUALS WITH SERIOUS MENTAL ILLNESS, TWO
OR MORE CHRONIC CONDITIONS, INCLUDING SUBSTANCE ABUSE DISORDERS, OR
HIV/AIDS, INTO SUCH HEALTH HOME. Health homes receiving funds under this
subdivision shall be required to document and demonstrate the effective
use of funds distributed herein.
S 18. 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 fund medicaid expenditures, as
amended by section 8 of part B of chapter 57 of the laws of 2015, is
amended to read as follows:
1. For state fiscal years 2011-12 through [2016-17] 2017-18, 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
S. 6407 13 A. 9007
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 and state costs or savings from
the basic health plan. Such projections may be adjusted by the director
of the budget to account for increased or expedited department of health
state funds medicaid expenditures as a result of a natural or other type
of disaster, including a governmental declaration of emergency.
S 19. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2016; provided
that:
(a) sections one, two and six of this act shall take effect October 1,
2016;
(b) the amendments to subdivision 4 of section 365-h of the social
services law, made by section one of this act, shall not affect the
expiration and repeal of certain provisions of such section, and shall
expire and be deemed repealed therewith;
(c) the amendments to subparagraph (i) of paragraph (b) of subdivision
7 of section 4403-f of the public health law, made by section two of
this act, shall not affect the expiration of such subdivision or the
repeal of such section, and shall expire or be deemed repealed there-
with;
(d) sections four and sixteen of this act shall take effect July 1,
2016;
(e) the amendments to subdivision 9 of section 367-a of the social
services law, made by section six of this act, shall not affect the
expiration of such subdivision and shall expire therewith;
(f) sections eight, nine and ten of this act shall take effect June 1,
2016;
(g) the amendments to subdivision 25 of section 364-j of the social
services law, made by section nine of this act, shall not affect the
repeal of such section, and shall be deemed repealed therewith;
(h) the amendments to paragraph (e) of subdivision 7 of section 367-a
of the social services law, made by sections twelve and thirteen of this
act shall not affect the repeal of such paragraph and shall be deemed
repealed therewith; and
(i) subdivisions 26-a and 32 of section 364-j of the social services
law, as added by sections fourteen and fifteen of this act shall be
deemed repealed on the same date and in the same manner as such section
is repealed.
PART C
Section 1. Subdivision 1 of section 18 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, is amended by adding a
new paragraph (c) to read as follows:
(C) STARTING WITH THE POLICY YEAR BEGINNING JULY FIRST, TWO THOUSAND
SIXTEEN, AND AT LEAST ONCE EVERY FIVE YEARS THEREAFTER, THE SUPERINTEN-
DENT OF FINANCIAL SERVICES SHALL RANK FROM HIGHEST TO LOWEST EACH CLASS
AND TERRITORY COMBINATION USED FOR THE PURPOSE OF APPORTIONING PREMIUM
FOR POLICIES PURCHASED FROM FUNDS AVAILABLE IN THE HOSPITAL EXCESS
S. 6407 14 A. 9007
LIABILITY POOL ACCORDING TO RELATIVITIES DERIVED FROM THE MEDICAL MALP-
RACTICE INSURANCE POOL'S PRIMARY RATES AND THE APPLICABLE EXCESS TIER
FACTORS. ANNUALLY, THE SUPERINTENDENT SHALL DETERMINE THE CLASS AND
TERRITORY COMBINATIONS FOR WHICH A POLICY OR POLICIES FOR EXCESS INSUR-
ANCE COVERAGE, OR FOR EQUIVALENT EXCESS INSURANCE COVERAGE, MAY BE
PURCHASED FOR ELIGIBLE PHYSICIANS OR DENTISTS WITHIN THE LIMITS OF THE
APPROPRIATION FOR THE HOSPITAL EXCESS LIABILITY POOL. THE SUPERINTENDENT
SHALL GRANT PRIORITY FOR PURCHASING POLICIES IN EACH POLICY YEAR IN
DESCENDING ORDER BEGINNING WITH THE HIGHEST RISK CLASS AND TERRITORY
COMBINATION. THE SUPERINTENDENT AND COMMISSIONER OF HEALTH SHALL NOT BE
OBLIGATED TO PURCHASE ANY MORE POLICIES THAN THE NUMBER OF POLICIES THAT
CAN BE PURCHASED AT THE RATES PROMULGATED ANNUALLY BY THE SUPERINTENDENT
WITHIN THE LIMITS OF THE APPROPRIATION. ONCE THE BALANCE OF THE APPRO-
PRIATION BECOMES INSUFFICIENT TO COVER ALL PHYSICIANS AND DENTISTS WITH-
IN A PARTICULAR CLASS AND TERRITORY COMBINATION, THE REMAINING FUNDS FOR
THAT COMBINATION SHALL BE ALLOCATED, FOR THE PURPOSE OF PURCHASING POLI-
CIES FOR SELECTED ADDITIONAL PHYSICIANS AND DENTISTS WITHIN THAT COMBI-
NATION TO GENERAL HOSPITALS IN PROPORTION TO THEIR SHARE OF THE TOTAL
NUMBER OF PHYSICIANS OR DENTISTS PRACTICING IN SUCH CLASS AND TERRITORY
COMBINATION WHO WERE CERTIFIED BY THE GENERAL HOSPITALS, AND FOR WHOM
POLICIES WERE PURCHASED, IN THE PRIOR YEAR, PROVIDED THAT ANY SHARE OF
LESS THAN ONE PHYSICIAN OR DENTIST SHALL BE DEEMED TO EQUAL ZERO. FOR
THE PURPOSES OF THIS PARAGRAPH, WITH REGARD TO POLICIES ISSUED FOR THE
COVERAGE PERIOD BEGINNING JULY FIRST, TWO THOUSAND SIXTEEN, "PRIOR YEAR"
SHALL MEAN THE POLICY YEAR THAT BEGAN ON JULY FIRST, TWO THOUSAND
FIFTEEN.
S 2. Paragraph (a) of subdivision 1 of section 18 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 1 of part Y of chapter 57 of the laws of 2015, is
amended to read as follows:
(a) The superintendent of financial services and the commissioner of
health or their designee shall, from funds available in the hospital
excess liability pool created pursuant to subdivision 5 of this section,
purchase a policy or policies for excess insurance coverage, as author-
ized by paragraph 1 of subsection (e) of section 5502 of the insurance
law; or from an insurer, other than an insurer described in section 5502
of the insurance law, duly authorized to write such coverage and actual-
ly writing medical malpractice insurance in this state; or shall
purchase equivalent excess coverage in a form previously approved by the
superintendent of financial services for purposes of providing equiv-
alent excess coverage in accordance with section 19 of chapter 294 of
the laws of 1985, for medical or dental malpractice occurrences between
July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988,
between July 1, 1988 and June 30, 1989, between July 1, 1989 and June
30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991
and June 30, 1992, between July 1, 1992 and June 30, 1993, between July
1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995,
between July 1, 1995 and June 30, 1996, between July 1, 1996 and June
30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998
and June 30, 1999, between July 1, 1999 and June 30, 2000, between July
1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002,
between July 1, 2002 and June 30, 2003, between July 1, 2003 and June
30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005
and June 30, 2006, between July 1, 2006 and June 30, 2007, between July
1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009,
S. 6407 15 A. 9007
between July 1, 2009 and June 30, 2010, between July 1, 2010 and June
30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012
and June 30, 2013, between July 1, 2013 and June 30, 2014, between July
1, 2014 and June 30, 2015, [and] between July 1, 2015 and June 30, 2016,
AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 or reimburse the hospital
where the hospital purchases equivalent excess coverage as defined in
subparagraph (i) of paragraph (a) of subdivision 1-a of this section for
medical or dental malpractice occurrences between July 1, 1987 and June
30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989
and June 30, 1990, between July 1, 1990 and June 30, 1991, between July
1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,
between July 1, 1993 and June 30, 1994, between July 1, 1994 and June
30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996
and June 30, 1997, between July 1, 1997 and June 30, 1998, between July
1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000,
between July 1, 2000 and June 30, 2001, between July 1, 2001 and June
30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003
and June 30, 2004, between July 1, 2004 and June 30, 2005, between July
1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007,
between July 1, 2007 and June 30, 2008, between July 1, 2008 and June
30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010
and June 30, 2011, between July 1, 2011 and June 30, 2012, between July
1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014,
between July 1, 2014 and June 30, 2015, [and] between July 1, 2015 and
June 30, 2016, AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 for physicians
or dentists certified as eligible for each such period or periods pursu-
ant to subdivision 2 of this section by a general hospital licensed
pursuant to article 28 of the public health law; provided that no single
insurer shall write more than fifty percent of the total excess premium
for a given policy year; and provided, however, that such eligible
physicians or dentists must have in force an individual policy, from an
insurer licensed in this state 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 during the period of such excess cover-
age for such occurrences or be endorsed as additional insureds under a
hospital professional liability policy which is offered through a volun-
tary attending physician ("channeling") program previously permitted by
the superintendent of financial services during the period of such
excess coverage for such occurrences. During such period, such policy
for excess coverage or such 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, total an aggregate level of two million three
hundred thousand dollars for each claimant and six million nine hundred
thousand dollars for all claimants from all such policies with respect
to occurrences in each of such years provided, however, if the cost of
primary malpractice insurance coverage in excess of one million dollars,
but below the excess medical malpractice insurance coverage provided
pursuant to this act, exceeds the rate of nine percent per annum, then
the required level of primary malpractice insurance coverage in excess
of one million dollars for each claimant shall be in an amount of not
less than the dollar amount of such coverage available at nine percent
per annum; the required level of such coverage for all claimants under
that policy shall be in an amount not less than three times the dollar
amount of coverage for each claimant; and excess coverage, when combined
S. 6407 16 A. 9007
with such primary malpractice insurance coverage, shall increase the
aggregate level for each claimant by one million dollars and three
million dollars for all claimants; and provided further, that, with
respect to policies of primary medical malpractice coverage that include
occurrences between April 1, 2002 and June 30, 2002, such requirement
that coverage be in amounts no less than one million three hundred thou-
sand dollars for each claimant and three million nine hundred thousand
dollars for all claimants for such occurrences shall be effective April
1, 2002.
S 3. Subdivision 3 of section 18 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 2 of
part Y of chapter 57 of the laws of 2015, is amended to read as follows:
(3)(a) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance for medical or dental malpractice
occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
and June 30, 1989, between July 1, 1989 and June 30, 1990, between July
1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992,
between July 1, 1992 and June 30, 1993, between July 1, 1993 and June
30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995
and June 30, 1996, between July 1, 1996 and June 30, 1997, between July
1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999,
between July 1, 1999 and June 30, 2000, between July 1, 2000 and June
30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002
and June 30, 2003, between July 1, 2003 and June 30, 2004, between July
1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006,
between July 1, 2006 and June 30, 2007, between July 1, 2007 and June
30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009
and June 30, 2010, between July 1, 2010 and June 30, 2011, between July
1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, and
between July 1, 2013 and June 30, 2014, between July 1, 2014 and June
30, 2015, [and] between July 1, 2015 and June 30, 2016, AND BETWEEN JULY
1, 2016 AND JUNE 30, 2017 allocable to each general hospital for physi-
cians or dentists certified as eligible for purchase of a policy for
excess insurance coverage by such general hospital in accordance with
subdivision 2 of this section, and may amend such determination and
certification as necessary.
(b) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance or equivalent excess coverage for
medical or dental malpractice occurrences between July 1, 1987 and June
30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989
and June 30, 1990, between July 1, 1990 and June 30, 1991, between July
1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,
between July 1, 1993 and June 30, 1994, between July 1, 1994 and June
30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996
and June 30, 1997, between July 1, 1997 and June 30, 1998, between July
1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000,
between July 1, 2000 and June 30, 2001, between July 1, 2001 and June
30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003
and June 30, 2004, between July 1, 2004 and June 30, 2005, between July
1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007,
between July 1, 2007 and June 30, 2008, between July 1, 2008 and June
30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010
and June 30, 2011, between July 1, 2011 and June 30, 2012, between July
S. 6407 17 A. 9007
1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014,
between July 1, 2014 and June 30, 2015, [and] between July 1, 2015 and
June 30, 2016, AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 allocable to
each general hospital for physicians or dentists certified as eligible
for purchase of a policy for excess insurance coverage or equivalent
excess coverage by such general hospital in accordance with subdivision
2 of this section, and may amend such determination and certification as
necessary. The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
ratable share of such cost allocable to the period July 1, 1987 to
December 31, 1987, to the period January 1, 1988 to June 30, 1988, to
the period July 1, 1988 to December 31, 1988, to the period January 1,
1989 to June 30, 1989, to the period July 1, 1989 to December 31, 1989,
to the period January 1, 1990 to June 30, 1990, to the period July 1,
1990 to December 31, 1990, to the period January 1, 1991 to June 30,
1991, to the period July 1, 1991 to December 31, 1991, to the period
January 1, 1992 to June 30, 1992, to the period July 1, 1992 to December
31, 1992, to the period January 1, 1993 to June 30, 1993, to the period
July 1, 1993 to December 31, 1993, to the period January 1, 1994 to June
30, 1994, to the period July 1, 1994 to December 31, 1994, to the period
January 1, 1995 to June 30, 1995, to the period July 1, 1995 to December
31, 1995, to the period January 1, 1996 to June 30, 1996, to the period
July 1, 1996 to December 31, 1996, to the period January 1, 1997 to June
30, 1997, to the period July 1, 1997 to December 31, 1997, to the period
January 1, 1998 to June 30, 1998, to the period July 1, 1998 to December
31, 1998, to the period January 1, 1999 to June 30, 1999, to the period
July 1, 1999 to December 31, 1999, to the period January 1, 2000 to June
30, 2000, to the period July 1, 2000 to December 31, 2000, to the period
January 1, 2001 to June 30, 2001, to the period July 1, 2001 to June 30,
2002, to the period July 1, 2002 to June 30, 2003, to the period July 1,
2003 to June 30, 2004, to the period July 1, 2004 to June 30, 2005, to
the period July 1, 2005 and June 30, 2006, to the period July 1, 2006
and June 30, 2007, to the period July 1, 2007 and June 30, 2008, to the
period July 1, 2008 and June 30, 2009, to the period July 1, 2009 and
June 30, 2010, to the period July 1, 2010 and June 30, 2011, to the
period July 1, 2011 and June 30, 2012, to the period July 1, 2012 and
June 30, 2013, to the period July 1, 2013 and June 30, 2014, to the
period July 1, 2014 and June 30, 2015, [and] to the period July 1, 2015
and June 30, 2016, AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017.
S 4. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
18 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 3 of part Y of chapter 57 of the
laws of 2015, are amended to read as follows:
(a) To the extent funds available to the hospital excess liability
pool pursuant to subdivision 5 of this section as amended, and pursuant
to section 6 of part J of chapter 63 of the laws of 2001, as may from
time to time be amended, which amended this subdivision, are insuffi-
cient to meet the costs of excess insurance coverage or equivalent
excess coverage for coverage periods during the period July 1, 1992 to
June 30, 1993, during the period July 1, 1993 to June 30, 1994, during
the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
to June 30, 1996, during the period July 1, 1996 to June 30, 1997,
during the period July 1, 1997 to June 30, 1998, during the period July
1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30,
2000, during the period July 1, 2000 to June 30, 2001, during the period
S. 6407 18 A. 9007
July 1, 2001 to October 29, 2001, during the period April 1, 2002 to
June 30, 2002, during the period July 1, 2002 to June 30, 2003, during
the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
to June 30, 2005, during the period July 1, 2005 to June 30, 2006,
during the period July 1, 2006 to June 30, 2007, during the period July
1, 2007 to June 30, 2008, during the period July 1, 2008 to June 30,
2009, during the period July 1, 2009 to June 30, 2010, during the period
July 1, 2010 to June 30, 2011, during the period July 1, 2011 to June
30, 2012, during the period July 1, 2012 to June 30, 2013, during the
period July 1, 2013 to June 30, 2014, during the period July 1, 2014 to
June 30, 2015, [and] during the period July 1, 2015 and June 30, 2016,
AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 allocated or reallocated in
accordance with paragraph (a) of subdivision 4-a of this section to
rates of payment applicable to state governmental agencies, each physi-
cian or dentist for whom a policy for excess insurance coverage or
equivalent excess coverage is purchased for such period shall be respon-
sible for payment to the provider of excess insurance coverage or equiv-
alent excess coverage of an allocable share of such insufficiency, based
on the ratio of the total cost of such coverage for such physician to
the sum of the total cost of such coverage for all physicians applied to
such insufficiency.
(b) Each provider of excess insurance coverage or equivalent excess
coverage covering the period July 1, 1992 to June 30, 1993, or covering
the period July 1, 1993 to June 30, 1994, or covering the period July 1,
1994 to June 30, 1995, or covering the period July 1, 1995 to June 30,
1996, or covering the period July 1, 1996 to June 30, 1997, or covering
the period July 1, 1997 to June 30, 1998, or covering the period July 1,
1998 to June 30, 1999, or covering the period July 1, 1999 to June 30,
2000, or covering the period July 1, 2000 to June 30, 2001, or covering
the period July 1, 2001 to October 29, 2001, or covering the period
April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to
June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
covering the period July 1, 2004 to June 30, 2005, or covering the peri-
od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or
covering the period July 1, 2008 to June 30, 2009, or covering the peri-
od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
covering the period July 1, 2012 to June 30, 2013, or covering the peri-
od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, OR
COVERING THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 shall notify 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 paragraph (a) of this
subdivision. Such amount shall be due from such physician or dentist to
such provider of excess insurance coverage or equivalent 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 July 1, 1992 to June 30, 1993, or covering the period
July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to
June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
covering the period July 1, 1996 to June 30, 1997, or covering the peri-
S. 6407 19 A. 9007
od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or
covering the period July 1, 2000 to June 30, 2001, or covering the peri-
od July 1, 2001 to October 29, 2001, or covering the period April 1,
2002 to June 30, 2002, or covering the period July 1, 2002 to June 30,
2003, or covering the period July 1, 2003 to June 30, 2004, or covering
the period July 1, 2004 to June 30, 2005, or covering the period July 1,
2005 to June 30, 2006, or covering the period July 1, 2006 to June 30,
2007, or covering the period July 1, 2007 to June 30, 2008, or covering
the period July 1, 2008 to June 30, 2009, or covering the period July 1,
2009 to June 30, 2010, or covering the period July 1, 2010 to June 30,
2011, or covering the period July 1, 2011 to June 30, 2012, or covering
the period July 1, 2012 to June 30, 2013, or covering the period July 1,
2013 to June 30, 2014, or covering the period July 1, 2014 to June 30,
2015, or covering the period July 1, 2015 to June 30, 2016, OR COVERING
THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 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 of health 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 July 1, 1992 to June 30,
1993, or covering the period July 1, 1993 to June 30, 1994, or covering
the period July 1, 1994 to June 30, 1995, or covering the period July 1,
1995 to June 30, 1996, or covering the period July 1, 1996 to June 30,
1997, or covering the period July 1, 1997 to June 30, 1998, or covering
the period July 1, 1998 to June 30, 1999, or covering the period July 1,
1999 to June 30, 2000, or covering the period July 1, 2000 to June 30,
2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
ing the period April 1, 2002 to June 30, 2002, or covering the period
July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to
June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or
covering the period July 1, 2005 to June 30, 2006, or covering the peri-
od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or
covering the period July 1, 2009 to June 30, 2010, or covering the peri-
od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or
covering the period July 1, 2013 to June 30, 2014, or covering the peri-
od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
June 30, 2016, OR COVERING THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 that
has made payment to such provider of excess insurance coverage or equiv-
alent excess coverage in accordance with paragraph (b) of this subdivi-
sion 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 hospital excess liability pool any amount
allocable to the period July 1, 1992 to June 30, 1993, and to the period
S. 6407 20 A. 9007
July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June
30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the
period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to
June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to
the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
to June 30, 2001, and to the period July 1, 2001 to October 29, 2001,
and to the period April 1, 2002 to June 30, 2002, and to the period July
1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30,
2004, and to the period July 1, 2004 to June 30, 2005, and to the period
July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June
30, 2007, and to the period July 1, 2007 to June 30, 2008, and to the
period July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to
June 30, 2010, and to the period July 1, 2010 to June 30, 2011, and to
the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
to June 30, 2013, and to the period July 1, 2013 to June 30, 2014, and
to the period July 1, 2014 to June 30, 2015, and to the period July 1,
2015 to June 30, 2016, AND TO THE PERIOD JULY 1, 2016 TO JUNE 30, 2017
received from the hospital excess liability pool for purchase of excess
insurance coverage or equivalent excess coverage covering the period
July 1, 1992 to June 30, 1993, and covering the period July 1, 1993 to
June 30, 1994, and covering the period July 1, 1994 to June 30, 1995,
and covering the period July 1, 1995 to June 30, 1996, and covering the
period July 1, 1996 to June 30, 1997, and covering the period July 1,
1997 to June 30, 1998, and covering the period July 1, 1998 to June 30,
1999, and covering the period July 1, 1999 to June 30, 2000, and cover-
ing the period July 1, 2000 to June 30, 2001, and covering the period
July 1, 2001 to October 29, 2001, and covering the period April 1, 2002
to June 30, 2002, and covering the period July 1, 2002 to June 30, 2003,
and covering the period July 1, 2003 to June 30, 2004, and covering the
period July 1, 2004 to June 30, 2005, and covering the period July 1,
2005 to June 30, 2006, and covering the period July 1, 2006 to June 30,
2007, and covering the period July 1, 2007 to June 30, 2008, and cover-
ing the period July 1, 2008 to June 30, 2009, and covering the period
July 1, 2009 to June 30, 2010, and covering the period July 1, 2010 to
June 30, 2011, and covering the period July 1, 2011 to June 30, 2012,
and covering the period July 1, 2012 to June 30, 2013, and covering the
period July 1, 2013 to June 30, 2014, and covering the period July 1,
2014 to June 30, 2015, and covering the period July 1, 2015 to June 30,
2016, AND COVERING THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 for a physi-
cian or dentist where such excess insurance coverage or equivalent
excess coverage is cancelled in accordance with paragraph (c) of this
subdivision.
S 5. 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 4 of part Y of chap-
ter 57 of the laws of 2015, is amended to read as follows:
S 40. The superintendent of financial services shall establish rates
for policies providing coverage for physicians and surgeons medical
malpractice for the periods commencing July 1, 1985 and ending June 30,
[2016] 2017; 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 superintendent shall direct insurers to establish segregated
accounts for premiums, payments, reserves and investment income attrib-
utable to such premium periods and shall require periodic reports by the
insurers regarding claims and expenses attributable to such periods to
S. 6407 21 A. 9007
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
attributable 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, [2016]
2017, at which time and thereafter such surcharge shall not exceed twen-
ty-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, [2016]
2017 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 superintendent. 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 practice 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 establishing adequate rates and in determining any projected defi-
ciency 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 peri-
od 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 by
the superintendent pursuant to this section are deemed adequate if such
rates would be adequate when taken together with the maximum authorized
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.
S 6. Section 5 and subdivisions (a) and (e) of section 6 of part J of
chapter 63 of the laws of 2001, amending chapter 266 of the laws of
1986, amending the civil practice law and rules and other laws relating
to malpractice and professional medical conduct, as amended by section 5
S. 6407 22 A. 9007
of part Y of chapter 57 of the laws of 2015, are amended to read as
follows:
S 5. The superintendent of financial services and the commissioner of
health shall determine, no later than June 15, 2002, June 15, 2003, June
15, 2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15, 2008,
June 15, 2009, June 15, 2010, June 15, 2011, June 15, 2012, June 15,
2013, June 15, 2014, June 15, 2015, [and] June 15, 2016, AND JUNE 15,
2017 the amount of funds available in the hospital excess liability
pool, created pursuant to section 18 of chapter 266 of the laws of 1986,
and whether such funds are sufficient for purposes of purchasing excess
insurance coverage for eligible participating physicians and dentists
during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June
30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
2007, or July 1, 2007 to June 30, 2008, or July 1, 2008 to June 30,
2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to June 30,
2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June 30,
2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30,
2015, or July 1, 2015 to June 30, 2016, OR JULY 1, 2016 TO JUNE 30, 2017
as applicable.
(a) This section shall be effective only upon a determination, pursu-
ant to section five of this act, by the superintendent of financial
services and the commissioner of health, and a certification of such
determination to the state director of the budget, the chair of the
senate committee on finance and the chair of the assembly committee on
ways and means, that the amount of funds in the hospital excess liabil-
ity pool, created pursuant to section 18 of chapter 266 of the laws of
1986, is insufficient for purposes of purchasing excess insurance cover-
age for eligible participating physicians and dentists during the period
July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1,
2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to
June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30,
2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30,
2016, OR JULY 1, 2016 TO JUNE 30, 2017 as applicable.
(e) The commissioner of health shall transfer for deposit to the
hospital excess liability pool created pursuant to section 18 of chapter
266 of the laws of 1986 such amounts as directed by the superintendent
of financial services for the purchase of excess liability insurance
coverage for eligible participating physicians and dentists for the
policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
2007, as applicable, and the cost of administering the hospital excess
liability pool for such applicable policy year, pursuant to the program
established in chapter 266 of the laws of 1986, as amended, no later
than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June
15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, June 15,
2015, [and] June 15, 2016, AND JUNE 15, 2017 as applicable.
S 7. Notwithstanding any law, rule or regulation to the contrary, only
physicians or dentists who were eligible, and for whom the superinten-
dent of financial services and the commissioner of health, or their
designee, purchased, with funds available in the hospital excess liabil-
S. 6407 23 A. 9007
ity pool, a full or partial policy for excess coverage or equivalent
excess coverage for the coverage period ending the thirtieth of June,
two thousand sixteen, shall be eligible to apply for such coverage for
the coverage period beginning the first of July, two thousand sixteen;
provided, however, if the total number of physicians or dentists for
whom such excess coverage or equivalent excess coverage was purchased
for the policy year ending the thirtieth of June, two thousand sixteen
exceeds the total number of physicians or dentists certified as eligible
for the coverage period beginning the first of July, two thousand
sixteen, then the general hospitals may certify additional eligible
physicians or dentists in a number equal to such general hospital's
proportional share 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 thirti-
eth of June, two thousand sixteen, as applied to the difference between
the number of eligible physicians or dentists for whom a policy for
excess coverage or equivalent excess coverage was purchased for the
coverage period ending the thirtieth of June, two thousand sixteen and
the number of such eligible physicians or dentists who have applied for
excess coverage or equivalent excess coverage for the coverage period
beginning the first of July, two thousand sixteen.
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, 2016, provided,
however, section two of this act shall take effect July 1, 2016.
PART D
Section 1. Paragraph (a) of subdivision 1 of section 212 of chapter
474 of the laws of 1996, amending the education law and other laws
relating to rates for residential healthcare facilities, as amended by
section 2 of part B of chapter 56 of the laws of 2013, is amended to
read as follows:
(a) Notwithstanding any inconsistent provision of law or regulation to
the contrary, effective beginning August 1, 1996, for the period April
1, 1997 through March 31, 1998, April 1, 1998 for the period April 1,
1998 through March 31, 1999, August 1, 1999, for the period April 1,
1999 through March 31, 2000, April 1, 2000, for the period April 1, 2000
through March 31, 2001, April 1, 2001, for the period April 1, 2001
through March 31, 2002, April 1, 2002, for the period April 1, 2002
through March 31, 2003, and for the state fiscal year beginning April 1,
2005 through March 31, 2006, and for the state fiscal year beginning
April 1, 2006 through March 31, 2007, and for the state fiscal year
beginning April 1, 2007 through March 31, 2008, and for the state fiscal
year beginning April 1, 2008 through March 31, 2009, and for the state
fiscal year beginning April 1, 2009 through March 31, 2010, and for the
state fiscal year beginning April 1, 2010 through March 31, 2016, AND
ANNUALLY THEREAFTER, the department of health is authorized to pay
public general hospitals, as defined in subdivision 10 of section 2801
of the public health law, operated by the state of New York or by the
state university of New York or by a county, which shall not include a
city with a population of over one million, of the state of New York,
and those public general hospitals located in the county of Westchester,
the county of Erie or the county of Nassau, additional payments for
inpatient hospital services as medical assistance payments pursuant to
title 11 of article 5 of the social services law for patients eligible
for federal financial participation under title XIX of the federal
S. 6407 24 A. 9007
social security act in medical assistance pursuant to the federal laws
and regulations governing disproportionate share payments to hospitals
up to one hundred percent of each such public general hospital's medical
assistance and uninsured patient losses after all other medical assist-
ance, including disproportionate share payments to such public general
hospital for 1996, 1997, 1998, and 1999, based initially for 1996 on
reported 1994 reconciled data as further reconciled to actual reported
1996 reconciled data, and for 1997 based initially on reported 1995
reconciled data as further reconciled to actual reported 1997 reconciled
data, for 1998 based initially on reported 1995 reconciled data as
further reconciled to actual reported 1998 reconciled data, for 1999
based initially on reported 1995 reconciled data as further reconciled
to actual reported 1999 reconciled data, for 2000 based initially on
reported 1995 reconciled data as further reconciled to actual reported
2000 data, for 2001 based initially on reported 1995 reconciled data as
further reconciled to actual reported 2001 data, for 2002 based initial-
ly on reported 2000 reconciled data as further reconciled to actual
reported 2002 data, and for state fiscal years beginning on April 1,
2005, based initially on reported 2000 reconciled data as further recon-
ciled to actual reported data for 2005, and for state fiscal years
beginning on April 1, 2006, based initially on reported 2000 reconciled
data as further reconciled to actual reported data for 2006, for state
fiscal years beginning on and after April 1, 2007 through March 31,
2009, based initially on reported 2000 reconciled data as further recon-
ciled to actual reported data for 2007 and 2008, respectively, for state
fiscal years beginning on and after April 1, 2009, based initially on
reported 2007 reconciled data, adjusted for authorized Medicaid rate
changes applicable to the state fiscal year, and as further reconciled
to actual reported data for 2009, for state fiscal years beginning on
and after April 1, 2010, based initially on reported reconciled data
from the base year two years prior to the payment year, adjusted for
authorized Medicaid rate changes applicable to the state fiscal year,
and further reconciled to actual reported data from such payment year,
and to actual reported data for each respective succeeding year. The
payments may be added to rates of payment or made as aggregate payments
to an eligible public general hospital.
S 2. Section 10 of chapter 649 of the laws of 1996, amending the
public health law, the mental hygiene law and the social services law
relating to authorizing the establishment of special needs plans, as
amended by section 20 of part D of chapter 59 of the laws of 2011, is
amended to read as follows:
S 10. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after July 1, 1996[; provided,
however, that sections one, two and three of this act shall expire and
be deemed repealed on March 31, 2016 provided, however that the amend-
ments to section 364-j of the social services law made by section four
of this act shall not affect the expiration of such section and shall be
deemed to expire therewith and provided, further, that the provisions of
subdivisions 8, 9 and 10 of section 4401 of the public health law, as
added by section one of this act; section 4403-d of the public health
law as added by section two of this act and the provisions of section
seven of this act, except for the provisions relating to the establish-
ment of no more than twelve comprehensive HIV special needs plans, shall
expire and be deemed repealed on July 1, 2000].
S. 6407 25 A. 9007
S 3. Subdivision 8 of section 84 of part A of chapter 56 of the laws
of 2013, amending the public health law and other laws relating to
general hospital reimbursement for annual rates is REPEALED.
S 4. Subdivision (f) of section 129 of part C of chapter 58 of the
laws of 2009, amending the public health law relating to payment by
governmental agencies for general hospital inpatient services, is
REPEALED.
S 5. Subdivision (c) of section 122 of part E of chapter 56 of the
laws of 2013 amending the public health law relating to the general
public health work program is REPEALED.
S 6. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2016.
PART E
Section 1. Subdivisions 9 and 10 of section 2541 of the public health
law, as added by chapter 428 of the laws of 1992, are amended to read as
follows:
9. "Evaluation" means a multidisciplinary professional, objective
[assessment] EXAMINATION conducted by appropriately qualified personnel
and conducted pursuant to section twenty-five hundred forty-four of this
title to determine a child's eligibility under this title.
10. "Evaluator" means a [team of two or more professionals approved
pursuant to section twenty-five hundred fifty-one of this title] PROVID-
ER APPROVED BY THE DEPARTMENT to conduct screenings and evaluations.
S 2. Section 2541 of the public health law is amended by adding two
new subdivisions 12-a and 15-a to read as follows:
12-A. "MULTIDISCIPLINARY" MEANS THE INVOLVEMENT OF TWO OR MORE SEPA-
RATE DISCIPLINES OR PROFESSIONS, WHICH MAY MEAN THE INVOLVEMENT OF ONE
INDIVIDUAL WHO MEETS THE DEFINITION OF QUALIFIED PERSONNEL AS DEFINED IN
SUBDIVISION FIFTEEN OF THIS SECTION AND WHO IS QUALIFIED, IN ACCORDANCE
WITH STATE LICENSURE, CERTIFICATION OR OTHER COMPARABLE STANDARDS, TO
EVALUATE ALL FIVE DEVELOPMENTAL DOMAINS.
15-A. "SCREENING" MEANS THE PROCEDURES USED BY QUALIFIED PERSONNEL, AS
DEFINED IN SUBDIVISION FIFTEEN OF THIS SECTION, TO DETERMINE WHETHER A
CHILD IS SUSPECTED OF HAVING A DISABILITY AND IN NEED OF EARLY INTER-
VENTION SERVICES, AND SHALL INCLUDE, WHERE AVAILABLE AND APPROPRIATE FOR
THE CHILD, THE ADMINISTRATION OF A STANDARDIZED INSTRUMENT OR INSTRU-
MENTS APPROVED BY THE DEPARTMENT, IN ACCORDANCE WITH SUBDIVISION THREE
OF SECTION TWENTY-FIVE HUNDRED FORTY-FOUR OF THIS TITLE.
S 3. Subdivision 3 of section 2542 of the public health law, as
amended by chapter 231 of the laws of 1993, is amended to read as
follows:
3. [The following persons and entities, within] (A) UNLESS THE PARENT
OBJECTS, WITHIN two working days of identifying an infant or toddler
suspected of having a disability or at risk of having a disability, THE
FOLLOWING PERSONS AND ENTITIES shall refer such infant or toddler to the
early intervention official or the health officer [of the public health
district in which the infant or toddler resides, as designated by the
municipality, but in no event over the objection of the parent made in
accordance with procedures established by the department for use by such
primary referral sources, unless the child has already been referred] OF
THE PUBLIC HEALTH DISTRICT DESIGNATED BY THE MUNICIPALITY IN WHICH THE
INFANT OR TODDLER RESIDES: hospitals, child health care providers, day
care programs, local school districts, public health facilities, early
childhood direction centers and such other social service and health
S. 6407 26 A. 9007
care agencies and providers as the commissioner shall specify in regu-
lation[; provided, however, that the]. THIS SHALL NOT APPLY IF THE
INFANT OR TODDLER HAS ALREADY BEEN REFERRED TO SUCH EARLY INTERVENTION
OFFICIAL OR HEALTH OFFICER. THE department shall establish procedures,
including regulations if required, to ensure that primary referral
sources adequately inform the parent or guardian about the early inter-
vention program, including through brochures and written materials
created or approved by the department.
(B) THE PRIMARY REFERRAL SOURCES IDENTIFIED IN PARAGRAPH (A) OF THIS
SUBDIVISION SHALL, WITH PARENTAL CONSENT, COMPLETE AND TRANSMIT AT THE
TIME OF REFERRAL, A REFERRAL FORM DEVELOPED BY THE DEPARTMENT WHICH
CONTAINS INFORMATION SUFFICIENT TO DOCUMENT THE PRIMARY REFERRAL
SOURCE'S CONCERN OR BASIS FOR SUSPECTING THE CHILD HAS A DISABILITY OR
IS AT RISK OF HAVING A DISABILITY, AND WHERE APPLICABLE, SPECIFIES THE
CHILD'S DIAGNOSED CONDITION THAT ESTABLISHES THE CHILD'S ELIGIBILITY FOR
THE EARLY INTERVENTION PROGRAM. THE PRIMARY REFERRAL SOURCE SHALL INFORM
THE PARENT OF A CHILD WITH A DIAGNOSED CONDITION THAT HAS A HIGH PROBA-
BILITY OF RESULTING IN DEVELOPMENTAL DELAY, THAT (I) ELIGIBILITY FOR THE
PROGRAM MAY BE ESTABLISHED BY MEDICAL OR OTHER RECORDS AND (II) OF THE
IMPORTANCE OF PROVIDING CONSENT FOR THE PRIMARY REFERRAL SOURCE TO TRAN-
SMIT RECORDS OR REPORTS NECESSARY TO SUPPORT THE DIAGNOSIS, OR, FOR
PARENTS OR GUARDIANS OF CHILDREN WHO DO NOT HAVE A DIAGNOSED CONDITION,
RECORDS OR REPORTS THAT WOULD ASSIST IN DETERMINING ELIGIBILITY FOR THE
PROGRAM.
S 4. Section 2544 of the public health law, as added by chapter 428 of
the laws of 1992, paragraph (c) of subdivision 2 as added by section 1
of part A of chapter 56 of the laws of 2012 and subdivision 11 as added
by section 3 of part B3 of chapter 62 of the laws of 2003, is amended to
read as follows:
S 2544. Screening and evaluations. 1. Each child thought to be an
eligible child is entitled to [a multidisciplinary] AN evaluation
CONDUCTED IN ACCORDANCE WITH THIS SECTION, and the early intervention
official shall ensure such evaluation, with parental consent.
2. (a) 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 APPLICABLE SCREENING AND/OR evaluation IN ACCORD-
ANCE WITH THIS SECTION. The parent or evaluator shall immediately noti-
fy the early intervention official of such selection. THE EVALUATOR
SHALL REVIEW THE INFORMATION AND DOCUMENTATION PROVIDED WITH THE REFER-
RAL TO DETERMINE THE APPROPRIATE SCREENING OR EVALUATION PROCESS TO
FOLLOW IN ACCORDANCE WITH THIS SECTION. The evaluator may begin the
SCREENING OR evaluation no sooner than four working days after such
notification, unless otherwise approved by the initial service coordina-
tor.
(b) [the evaluator shall designate an individual as the principal
contact for the multidisciplinary team] INITIAL SERVICE COORDINATORS
SHALL INFORM THE PARENT OF THE APPLICABLE SCREENING OR EVALUATION PROCE-
DURES THAT MAY BE PERFORMED. FOR A CHILD REFERRED TO THE EARLY INTER-
VENTION OFFICIAL WHO HAS A DIAGNOSED PHYSICAL OR MENTAL CONDITION THAT
HAS A HIGH PROBABILITY OF RESULTING IN DEVELOPMENTAL DELAY, THE INITIAL
SERVICE COORDINATOR SHALL INFORM THE PARENT THAT THE EVALUATION OF THE
CHILD SHALL BE CONDUCTED IN ACCORDANCE WITH THE PROCEDURES SET FORTH IN
SUBDIVISION FIVE OF THIS SECTION.
(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-
S. 6407 27 A. 9007
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.
3. [(a) To determine eligibility, an evaluator shall, with parental
consent, either (i) screen a child to determine what type of evaluation,
if any, is warranted, or (ii) provide a multidisciplinary evaluation. In
making the determination whether to provide an evaluation, the evaluator
may rely on a recommendation from a physician or other qualified person
as designated by the commissioner.
(b)] SCREENINGS FOR CHILDREN REFERRED TO THE EARLY INTERVENTION
PROGRAM TO DETERMINE WHETHER THEY ARE SUSPECTED OF HAVING A DISABILITY.
(A) FOR A CHILD REFERRED TO THE EARLY INTERVENTION PROGRAM, THE EVALU-
ATOR SHALL FIRST PERFORM A SCREENING OF THE CHILD, WITH PARENTAL
CONSENT, TO DETERMINE WHETHER THE CHILD IS SUSPECTED OF HAVING A DISA-
BILITY.
(B) THE EVALUATOR SHALL UTILIZE A STANDARDIZED INSTRUMENT OR INSTRU-
MENTS APPROVED BY THE DEPARTMENT TO CONDUCT THE SCREENING. IF THE EVALU-
ATOR DOES NOT UTILIZE A STANDARDIZED INSTRUMENT OR INSTRUMENTS APPROVED
BY THE DEPARTMENT FOR THE SCREENING, THE EVALUATOR SHALL DOCUMENT IN
WRITING WHY SUCH STANDARDIZED INSTRUMENT OR INSTRUMENTS ARE UNAVAILABLE
OR INAPPROPRIATE FOR THE CHILD.
(C) THE EVALUATOR SHALL EXPLAIN THE RESULTS OF THE SCREENING TO THE
PARENT AND SHALL FULLY DOCUMENT THE RESULTS IN WRITING.
(D) If, based upon the screening, a child is [believed to be eligible,
or if otherwise elected by the parent] SUSPECTED OF HAVING A DISABILITY,
the child shall, with [the consent of a parent] PARENTAL CONSENT,
receive [a multidisciplinary evaluation. All evaluations shall be
conducted in accordance with] AN EVALUATION TO BE CONDUCTED IN ACCORD-
ANCE WITH THE PROCEDURES SET FORTH IN SUBDIVISION FOUR OF THIS SECTION,
the coordinated standards and procedures and with regulations promulgat-
ed by the commissioner.
(E) IF, BASED UPON THE SCREENING, A CHILD IS NOT SUSPECTED OF HAVING A
DISABILITY, AN EVALUATION SHALL NOT BE PROVIDED, UNLESS REQUESTED BY THE
PARENT. THE EARLY INTERVENTION OFFICIAL SHALL PROVIDE THE PARENT WITH
WRITTEN NOTICE OF THE SCREENING RESULTS, WHICH SHALL INCLUDE INFORMATION
ON THE PARENT'S RIGHT TO REQUEST AN EVALUATION.
(F) A SCREENING SHALL NOT BE PROVIDED TO CHILDREN WHO ARE REFERRED TO
THE EARLY INTERVENTION PROGRAM WHO HAVE A DIAGNOSED PHYSICAL OR MENTAL
CONDITION WITH A HIGH PROBABILITY OF RESULTING IN DEVELOPMENTAL DELAY
THAT ESTABLISHES ELIGIBILITY FOR THE PROGRAM.
4. The evaluation of [each] A child shall:
(a) INCLUDE THE ADMINISTRATION OF AN EVALUATION STANDARDIZED INSTRU-
MENT OR INSTRUMENTS APPROVED BY THE DEPARTMENT. IF THE EVALUATOR DOES
NOT UTILIZE A STANDARDIZED INSTRUMENT OR INSTRUMENTS APPROVED BY THE
DEPARTMENT AS PART OF THE EVALUATION OF THE CHILD, THE EVALUATOR SHALL
DOCUMENT IN WRITING WHY SUCH STANDARDIZED INSTRUMENT OR INSTRUMENTS ARE
NOT APPROPRIATE OR AVAILABLE FOR THE CHILD;
(B) be conducted by personnel trained to utilize appropriate methods
and procedures;
[(b)] (C) be based on informed clinical opinion;
[(c)] (D) be made without regard to the availability of services in
the municipality or who might provide such services; [and
(d)] (E) with parental consent, include the following:
(i) a review of pertinent records related to the child's current
health status and medical history; AND
S. 6407 28 A. 9007
(ii) an evaluation of the child's level of functioning in each of the
developmental areas set forth in paragraph (c) of subdivision seven of
section twenty-five hundred forty-one of this title[;] TO DETERMINE
WHETHER THE CHILD HAS A DISABILITY AS DEFINED IN THIS TITLE THAT ESTAB-
LISHES THE CHILD'S ELIGIBILITY FOR THE PROGRAM; AND
(F) IF THE CHILD HAS BEEN DETERMINED ELIGIBLE BY THE EVALUATOR AFTER
CONDUCTING THE PROCEDURES SET FORTH IN PARAGRAPHS (A) THROUGH (E) OF
THIS SUBDIVISION, THE EVALUATION SHALL ALSO INCLUDE:
[(iii)] (I) an assessment [of the unique needs of the child in terms
of] FOR THE PURPOSES OF IDENTIFYING THE CHILD'S UNIQUE STRENGTHS AND
NEEDS IN each of the developmental areas [set forth in paragraph (c) of
subdivision seven of section twenty-five hundred forty-one of this
title, including the identification of] AND THE EARLY INTERVENTION
services appropriate to meet those needs;
[(iv)] (II) A FAMILY-DIRECTED ASSESSMENT, IF CONSENTED TO BY THE FAMI-
LY, IN ORDER TO IDENTIFY THE FAMILY'S RESOURCES, PRIORITIES, AND
CONCERNS AND THE SUPPORTS NECESSARY TO ENHANCE THE FAMILY'S CAPACITY TO
MEET THE DEVELOPMENTAL NEEDS OF THE CHILD. THE FAMILY ASSESSMENT SHALL
BE VOLUNTARY ON THE PART OF EACH FAMILY MEMBER PARTICIPATING IN THE
ASSESSMENT;
(III) an [evaluation] ASSESSMENT of the transportation needs of the
child, if any; and
[(v)] (IV) such other matters as the commissioner may prescribe in
regulation.
5. EVALUATIONS FOR CHILDREN WHO ARE REFERRED TO THE EARLY INTERVENTION
OFFICIAL WITH DIAGNOSED PHYSICAL OR MENTAL CONDITIONS THAT HAVE A HIGH
PROBABILITY OF RESULTING IN DEVELOPMENTAL DELAY. (A) IF A CHILD HAS A
DIAGNOSED PHYSICAL OR MENTAL CONDITION THAT HAS A HIGH PROBABILITY OF
RESULTING IN DEVELOPMENTAL DELAY, THE CHILD'S MEDICAL OR OTHER RECORDS
SHALL BE USED, WHEN AVAILABLE, TO ESTABLISH THE CHILD'S ELIGIBILITY FOR
THE PROGRAM.
(B) THE EVALUATOR SHALL, UPON REVIEW OF THE REFERRAL FORM PROVIDED IN
ACCORDANCE WITH SECTION TWENTY-FIVE HUNDRED FORTY-TWO OF THIS TITLE OR
ANY MEDICAL OR OTHER RECORDS, OR AT THE TIME OF INITIAL CONTACT WITH THE
CHILD'S FAMILY, DETERMINE WHETHER THE CHILD HAS A DIAGNOSED CONDITION
THAT ESTABLISHES THE CHILD'S ELIGIBILITY FOR THE PROGRAM. IF THE EVALU-
ATOR HAS REASON TO BELIEVE, AFTER SPEAKING WITH THE CHILD'S FAMILY, THAT
THE CHILD MAY HAVE A DIAGNOSED CONDITION THAT ESTABLISHES THE CHILD'S
ELIGIBILITY BUT THE EVALUATOR HAS NOT BEEN PROVIDED WITH MEDICAL OR
OTHER DOCUMENTATION OF SUCH DIAGNOSIS, THE EVALUATOR SHALL, WITH
PARENTAL CONSENT, OBTAIN SUCH DOCUMENTATION, WHEN AVAILABLE, PRIOR TO
PROCEEDING WITH THE EVALUATION OF THE CHILD.
(C) THE EVALUATOR SHALL REVIEW ALL RECORDS RECEIVED TO DOCUMENT THAT
THE CHILD'S DIAGNOSIS AS SET FORTH IN SUCH RECORDS ESTABLISHES THE
CHILD'S ELIGIBILITY FOR THE EARLY INTERVENTION PROGRAM.
(D) NOTWITHSTANDING SUBDIVISION FOUR OF THIS SECTION, IF THE CHILD'S
ELIGIBILITY FOR THE EARLY INTERVENTION PROGRAM IS ESTABLISHED IN ACCORD-
ANCE WITH THIS SUBDIVISION, THE EVALUATION OF THE CHILD SHALL (I)
CONSIST OF A REVIEW OF THE RESULTS OF THE MEDICAL OR OTHER RECORDS THAT
ESTABLISHED THE CHILD'S ELIGIBILITY, AND ANY OTHER PERTINENT EVALUATIONS
OR RECORDS AVAILABLE AND (II) COMPLY WITH THE PROCEDURES SET FORTH IN
PARAGRAPH (F) OF SUBDIVISION FOUR OF THIS SECTION. THE EVALUATION PROCE-
DURES SET FORTH IN PARAGRAPHS (A) AND (E) OF SUBDIVISION FOUR SHALL NOT
BE REQUIRED OR CONDUCTED.
6. An evaluation shall not include a reference to any specific provid-
er of early intervention services.
S. 6407 29 A. 9007
[6.] 7. Nothing in this section shall restrict an evaluator from
utilizing, in addition to findings from his or her personal examination,
other examinations, evaluations or assessments conducted for such child,
including those conducted prior to the evaluation under this section, if
such examinations, evaluations or assessments are consistent with the
coordinated standards and procedures.
[7.] 8. Following completion of the evaluation, the evaluator shall
provide the parent and service coordinator with a copy of a summary of
the full evaluation. To the extent practicable, the summary shall be
provided in the native language of the parent. Upon request of the
parent, early intervention official or service coordinator, the evalu-
ator shall provide a copy of the full evaluation to such parent, early
intervention official or service coordinator.
[8.] 9. A parent who disagrees with the results of an evaluation may
obtain an additional evaluation or partial evaluation at public expense
to the extent authorized by federal law or regulation.
[9.] 10. Upon receipt of the results of an evaluation, a service coor-
dinator may, with parental consent, require additional diagnostic infor-
mation regarding the condition of the child, provided, however, that
such evaluation or assessment is not unnecessarily duplicative or inva-
sive to the child, and provided further, that:
(a) where the evaluation has established the child's eligibility, such
additional diagnostic information shall be used solely to provide addi-
tional information to the parent and service coordinator regarding the
child's need for services and cannot be a basis for refuting eligibil-
ity;
(b) the service coordinator provides the parent with a written expla-
nation of the basis for requiring additional diagnostic information;
(c) the additional diagnostic procedures are at no expense to the
parent; and
(d) the evaluation is completed and a meeting to develop an IFSP is
held within the time prescribed in subdivision one of section twenty-
five hundred forty-five of this title.
[10.] 11. (a) If the screening indicates that the infant or toddler is
not an eligible child and the parent elects not to have an evaluation,
or if the evaluation indicates that the infant or toddler is not an
eligible child, the service coordinator shall inform the parent of other
programs or services that may benefit such child, and the child's family
and, with parental consent, refer such child to such programs or
services.
(b) A parent may appeal a determination that a child is ineligible
pursuant to the provisions of section twenty-five hundred forty-nine of
this title, provided, however, that a parent may not initiate such
appeal until all evaluations are completed. IN ADDITION, FOR A CHILD
REFERRED TO THE EARLY INTERVENTION OFFICIAL WHO HAS A DIAGNOSED PHYSICAL
OR MENTAL CONDITION THAT ESTABLISHES THE CHILD'S ELIGIBILITY FOR THE
PROGRAM IN ACCORDANCE WITH SUBDIVISION FIVE OF THIS SECTION, THE PARENT
MAY REQUEST, AND SUCH REQUEST SHALL BE GRANTED, THAT THE EVALUATOR
CONDUCT THE EVALUATION PROCEDURES SET FORTH IN PARAGRAPHS (A) THROUGH
(E) OF SUBDIVISION FOUR OF THIS SECTION, PROVIDED, HOWEVER, THAT THE
PARENT MAY NOT MAKE SUCH REQUEST UNTIL THE EVALUATION CONDUCTED IN
ACCORDANCE WITH SUBDIVISION FIVE OF THIS SECTION IS COMPLETED.
[11.] 12. Notwithstanding any other provision of law to the contrary,
where a request has been made to review an IFSP prior to the six-month
interval provided in subdivision seven of section twenty-five hundred
forty-five of this title for purposes of increasing frequency or dura-
S. 6407 30 A. 9007
tion of an approved service, including service coordination, the early
intervention official may require an additional evaluation or partial
evaluation at public expense by an approved evaluator other than the
current provider of service, with parent consent.
S 5. Paragraph (a) of subdivision 3 of section 2559 of the public
health law, is amended by adding two new subparagraphs (iv) and (v) to
read as follows:
(IV) PROVIDERS SHALL SUBMIT ALL CLAIMS, IN ACCORDANCE WITH SUBPARA-
GRAPH (III) OF THIS PARAGRAPH AND WITHIN NINETY DAYS OF THE DATE OF
SERVICE, UNLESS THE SUBMISSION IS DELAYED DUE TO EXTRAORDINARY CIRCUM-
STANCES DOCUMENTED BY THE PROVIDER. ALL CLAIMS SUBMITTED AFTER NINETY
DAYS SHALL BE SUBMITTED WITHIN THIRTY DAYS FROM THE TIME THE PROVIDER
WAS RELIEVED FROM THE EXTRAORDINARY CIRCUMSTANCES THAT PREVIOUSLY
DELAYED A TIMELY SUBMISSION. CLAIMS THAT ARE NOT SUBMITTED WITHIN TIME-
FRAMES SET FORTH WILL NOT BE REIMBURSED BY THE DEPARTMENT'S FISCAL AGENT
FROM THE ESCROW ACCOUNT FUNDED BY MUNICIPAL GOVERNMENTAL PAYERS.
(V) PROVIDERS SHALL ENROLL, ON REQUEST OF THE DEPARTMENT OR THE
DEPARTMENT'S FISCAL AGENT, WITH ONE OR MORE HEALTH CARE CLEARINGHOUSES,
AS NECESSARY, FOR PROCESSING OF CLAIMS TO THIRD PARTY PAYORS AND FOR
RECEIPT OF REMITTANCE ADVICES IN STANDARD ELECTRONIC FORMAT AND IN
COMPLIANCE WITH ANY APPLICABLE FEDERAL OR STATE REGULATIONS WITH RESPECT
TO ELECTRONIC CLAIMS TRANSACTIONS.
S 6. Section 3224-a of the insurance law, as amended by chapter 666 of
the laws of 1997, the opening paragraph and subsections (a), (b) and (c)
as amended and subsections (g) and (h) as added by chapter 237 of the
laws of 2009, paragraph 2 of subsection (d) as amended by section 57-b
of part A of chapter 56 of the laws of 2013, subsection (i) as added by
chapter 297 of the laws of 2012 and subsection (j) as added by section 5
of part H of chapter 60 of the laws of 2014, is amended to read as
follows:
S 3224-a. Standards for prompt, fair and equitable settlement of
claims for health care and payments for health care services. In the
processing of all health care claims submitted under contracts or agree-
ments issued or entered into pursuant to this article and articles
forty-two, forty-three and forty-seven of this chapter and article
forty-four of the public health law and all bills for health care
services rendered by health care providers pursuant to such contracts or
agreements, any insurer or organization or corporation licensed or
certified pursuant to article forty-three or forty-seven of this chapter
or article forty-four of the public health law shall adhere to the
following standards:
(a) Except in a case where the obligation of an insurer or an organ-
ization or corporation licensed or certified pursuant to article forty-
three or forty-seven of this chapter or article forty-four of the public
health law to pay a claim submitted by a policyholder or person covered
under such policy ("covered person") or make a payment to a health care
provider is not reasonably clear, or when there is a reasonable basis
supported by specific information available for review by the super-
intendent that such claim or bill for health care services rendered was
submitted fraudulently, such insurer or organization or corporation
shall pay the claim to a policyholder or covered person or make a
payment to a health care provider within thirty days of receipt of a
claim or bill for services rendered that is transmitted via the internet
or electronic mail, or forty-five days of receipt of a claim or bill for
services rendered that is submitted by other means, such as paper or
facsimile.
S. 6407 31 A. 9007
(A-1) AN INSURER, ORGANIZATION, INCLUDING AN APPROVED ORGANIZATION AS
DEFINED IN SUBDIVISION TWO OF SECTION TWENTY-FIVE HUNDRED TEN OF THE
PUBLIC HEALTH LAW, OR CORPORATION SHALL, WITHIN FIFTEEN BUSINESS DAYS OF
RECEIPT OF A CLAIM OR BILL FOR SERVICES RENDERED UNDER THE EARLY INTER-
VENTION PROGRAM, ESTABLISHED IN TITLE TWO-A OF ARTICLE TWENTY-FIVE OF
THE PUBLIC HEALTH LAW, NOTIFY THE HEALTH CARE PROVIDER, IN A MANNER AND
FORMAT DETERMINED BY THE DEPARTMENT OF HEALTH, THROUGH THE DEPARTMENT OF
HEALTH'S DESIGNATED FISCAL AGENT, WHETHER THE CONTRACT OR AGREEMENT IS
SUBJECT TO THE PROVISIONS OF THIS CHAPTER.
(b) In a case where the obligation of an insurer or an organization or
corporation licensed or certified pursuant to article forty-three or
forty-seven of this chapter or article forty-four of the public health
law to pay a claim or make a payment for health care services rendered
is not reasonably clear due to a good faith dispute regarding the eligi-
bility of a person for coverage, the liability of another insurer or
corporation or organization for all or part of the claim, the amount of
the claim, the benefits covered under a contract or agreement, or the
manner in which services were accessed or provided, an insurer or organ-
ization or corporation shall pay any undisputed portion of the claim in
accordance with this subsection and notify the policyholder, covered
person or health care provider in writing within thirty calendar days of
the receipt of the claim:
(1) that it is not obligated to pay the claim or make the medical
payment, stating the specific reasons why it is not liable; or
(2) to request all additional information needed to determine liabil-
ity to pay the claim or make the health care payment, EXCEPT THAT WITH
RESPECT TO A CLAIM OR BILL FOR SERVICES RENDERED UNDER THE EARLY INTER-
VENTION PROGRAM ESTABLISHED IN TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE
PUBLIC HEALTH LAW, THE INSURER OR CORPORATION OR ORGANIZATION, INCLUDING
AN APPROVED ORGANIZATION AS DEFINED IN SUBDIVISION TWO OF SECTION TWEN-
TY-FIVE HUNDRED TEN OF THE PUBLIC HEALTH LAW, SHALL REQUEST SUCH ADDI-
TIONAL INFORMATION FROM THE HEALTH CARE PROVIDER WITHIN FIFTEEN BUSINESS
DAYS OF RECEIPT OF THE CLAIM.
Upon receipt of the information requested in paragraph two of this
subsection or an appeal of a claim or bill for health care services
denied pursuant to paragraph one of this subsection, an insurer or
organization or corporation licensed or certified pursuant to article
forty-three or forty-seven of this chapter or article forty-four of the
public health law shall comply with subsection (a) of this section.
(c) (1) Except as provided in [paragraph] PARAGRAPHS two AND THREE of
this subsection, each claim or bill for health care services processed
in violation of this section shall constitute a separate violation. In
addition to the penalties provided in this chapter, any insurer or
organization or corporation that fails to adhere to the standards
contained in this section shall be obligated to pay to the health care
provider or person submitting the claim, in full settlement of the claim
or bill for health care services, the amount of the claim or health care
payment plus interest on the amount of such claim or health care payment
of the greater of the rate equal to the rate set by the commissioner of
taxation and finance for corporate taxes pursuant to paragraph one of
subsection (e) of section one thousand ninety-six of the tax law or
twelve percent per annum, to be computed from the date the claim or
health care payment was required to be made. When the amount of interest
due on such a claim is less [then] THAN two dollars, and insurer or
organization or corporation shall not be required to pay interest on
such claim.
S. 6407 32 A. 9007
(2) Where a violation of this section is determined by the superinten-
dent as a result of the superintendent's own investigation, examination,
audit or inquiry, an insurer or organization or corporation licensed or
certified pursuant to article forty-three or forty-seven of this chapter
or article forty-four of the public health law shall not be subject to a
civil penalty prescribed in paragraph one of this subsection, if the
superintendent determines that the insurer or organization or corpo-
ration has otherwise processed at least ninety-eight percent of the
claims submitted in a calendar year in compliance with this section;
provided, however, nothing in this paragraph shall limit, preclude or
exempt an insurer or organization or corporation from payment of a claim
and payment of interest pursuant to this section. This paragraph shall
not apply to violations of this section determined by the superintendent
resulting from individual complaints submitted to the superintendent by
health care providers or policyholders.
(3) WHERE AN INSURER OR ORGANIZATION, INCLUDING AN APPROVED ORGANIZA-
TION AS DEFINED IN SUBDIVISION TWO OF SECTION TWENTY-FIVE HUNDRED TEN OF
THE PUBLIC HEALTH LAW, OR CORPORATION FAILS TO ADHERE TO THE STANDARDS
CONTAINED IN THIS SECTION IN RELATION TO A CLAIM OR BILL FOR SERVICES
SUBMITTED FOR A SERVICE RENDERED UNDER THE EARLY INTERVENTION PROGRAM
ESTABLISHED IN TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH
LAW, THE CLAIM OR BILL FOR SERVICES SHALL BE DEEMED COVERED OR PAYABLE
UNDER THE CONTRACT OR AGREEMENT, AND THE INSURER OR ORGANIZATION OR
CORPORATION SHALL BE OBLIGATED TO PAY SUCH CLAIM OR BILL FOR SERVICES AT
THE HIGHER OF EITHER A RATE ESTABLISHED BY THE COMMISSIONER OF HEALTH OR
A RATE NEGOTIATED BY THE INSURER IN ACCORDANCE WITH REGULATION.
(d) For the purposes of this section:
(1) "policyholder" shall mean a person covered under such policy or a
representative designated by such person; and
(2) "health care provider" shall mean an entity licensed or certified
pursuant to article twenty-eight, thirty-six or forty of the public
health law, a facility licensed pursuant to article nineteen or thirty-
one of the mental hygiene law, a fiscal intermediary operating under
section three hundred sixty five-f of the social services law, AN INDI-
VIDUAL OR AGENCY APPROVED BY THE DEPARTMENT OF HEALTH PURSUANT TO TITLE
TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, a health care
professional licensed, registered or certified pursuant to title eight
of the education law, a dispenser or provider of pharmaceutical
products, services or durable medical equipment, or a representative
designated by such entity or person.
(e) Nothing in this section shall in any way be deemed to impair any
right available to the state to adjust the timing of its payments for
medical assistance pursuant to title eleven of article five of the
social services law, or for child health insurance plan benefits pursu-
ant to title one-a of article twenty-five of the public health law or
otherwise be deemed to require adjustment of payments by the state for
such medical assistance or child health insurance.
(f) In any action brought by the superintendent pursuant to this
section or article twenty-four of this chapter relating to this section
regarding payments for medical assistance pursuant to title eleven of
article five of the social services law, child health insurance plan
benefits pursuant to title one-a of article twenty-five of the public
health law, benefits under the voucher insurance program pursuant to
section one thousand one hundred twenty-one of this chapter, and bene-
fits under the New York state small business health insurance partner-
ship program pursuant to article nine-A of the public health law, it
S. 6407 33 A. 9007
shall be a mitigating factor that the insurer, corporation or organiza-
tion is owed any premium amounts, premium adjustments, stop-loss recov-
eries or other payments from the state or one of its fiscal interme-
diaries under any such program.
(g) Time period for submission of claims. (1) Except as otherwise
provided by law, health care claims must be initially submitted by
health care providers within one hundred twenty days after the date of
service to be valid and enforceable against an insurer or organization
or corporation licensed or certified pursuant to article forty-three or
article forty-seven of this chapter or article forty-four of the public
health law. Provided, however, that nothing in this subsection shall
preclude the parties from agreeing to a time period or other terms which
are more favorable to the health care provider. Provided further that,
in connection with contracts between organizations or corporations
licensed or certified pursuant to article forty-three of this chapter or
article forty-four of the public health law and health care providers
for the provision of services pursuant to section three hundred sixty-
four-j or three hundred sixty-nine-ee of the social services law or
title I-A of article twenty-five of the public health law, nothing here-
in shall be deemed: (i) to preclude the parties from agreeing to a
different time period but in no event less than ninety days; or (ii) to
supersede contract provisions in existence at the time this subsection
takes effect except to the extent that such contracts impose a time
period of less than ninety days.
(2) This subsection shall not abrogate any right or reduce or limit
any additional time period for claim submission provided by law or regu-
lation specifically applicable to coordination of benefits in effect
prior to the effective date of this subsection.
(h) (1) An insurer or organization or corporation licensed or certi-
fied pursuant to article forty-three or article forty-seven of this
chapter or article forty-four of the public health law shall permit a
participating health care provider to request reconsideration of a claim
that is denied exclusively because it was untimely submitted pursuant to
subsection (g) of this section. The insurer or organization or corpo-
ration shall pay such claim pursuant to the provisions of paragraph two
of this subsection if the health care provider can demonstrate both
that: (i) the health care provider's non-compliance was a result of an
unusual occurrence; and (ii) the health care provider has a pattern or
practice of timely submitting claims in compliance with [subdivision]
SUBSECTION (g) of this section.
(2) An insurer or organization or corporation licensed or certified
pursuant to article forty-three or article forty-seven of this chapter
or article forty-four of the public health law may reduce the reimburse-
ment due to a health care provider for an untimely claim that otherwise
meets the requirements of paragraph one of this subsection by an amount
not to exceed twenty-five percent of the amount that would have been
paid had the claim been submitted in a timely manner; provided, however,
that nothing in this subsection shall preclude a health care provider
and an insurer or organization or corporation from agreeing to a lesser
reduction. The provisions of this subsection shall not apply to any
claim submitted three hundred sixty-five days after the date of service,
in which case the insurer or organization or corporation may deny the
claim in full.
(i) Except where the parties have developed a mutually agreed upon
process for the reconciliation of coding disputes that includes a review
of submitted medical records to ascertain the correct coding for
S. 6407 34 A. 9007
payment, a general hospital certified pursuant to article twenty-eight
of the public health law shall, upon receipt of payment of a claim for
which payment has been adjusted based on a particular coding to a
patient including the assignment of diagnosis and procedure, have the
opportunity to submit the affected claim with medical records supporting
the hospital's initial coding of the claim within thirty days of receipt
of payment. Upon receipt of such medical records, an insurer or an
organization or corporation licensed or certified pursuant to article
forty-three or forty-seven of this chapter or article forty-four of the
public health law shall review such information to ascertain the correct
coding for payment and process the claim in accordance with the time-
frames set forth in subsection (a) of this section. In the event the
insurer, organization, or corporation processes the claim consistent
with its initial determination, such decision shall be accompanied by a
statement of the insurer, organization or corporation setting forth the
specific reasons why the initial adjustment was appropriate. An insurer,
organization, or corporation that increases the payment based on the
information submitted by the general hospital, but fails to do so in
accordance with the timeframes set forth in subsection (a) of this
section, shall pay to the general hospital interest on the amount of
such increase at the rate set by the commissioner of taxation and
finance for corporate taxes pursuant to paragraph one of subdivision (e)
of section one thousand ninety-six of the tax law, to be computed from
the end of the forty-five day period after resubmission of the addi-
tional medical record information. Provided, however, a failure to remit
timely payment shall not constitute a violation of this section.
Neither the initial or subsequent processing of the claim by the insur-
er, organization, or corporation shall be deemed an adverse determi-
nation as defined in section four thousand nine hundred of this chapter
if based solely on a coding determination. Nothing in this subsection
shall apply to those instances in which the insurer or organization, or
corporation has a reasonable suspicion of fraud or abuse.
(j) An insurer or an organization or corporation licensed or certified
pursuant to article forty-three or forty-seven of this chapter or arti-
cle forty-four of the public health law or a student health plan estab-
lished or maintained pursuant to section one thousand one hundred twen-
ty-four of this chapter shall accept claims submitted by a policyholder
or covered person, in writing, including through the internet, by elec-
tronic mail or by facsimile.
S 7. Section 3235-a of the insurance law, as added by section 3 of
part C of chapter 1 of the laws of 2002, subsection (c) as amended by
section 17 of part A of chapter 56 of the laws of 2012, is amended to
read as follows:
S 3235-a. Payment for early intervention services. (a) No policy of
accident and health insurance, including contracts issued pursuant to
article forty-three of this chapter, shall exclude coverage for other-
wise covered services solely on the basis that the services constitute
early intervention program services under title two-A of article twen-
ty-five of the public health law.
(b) Where a policy of accident and health insurance, including a
contract issued pursuant to article forty-three of this chapter,
provides coverage for an early intervention program service, such cover-
age shall not be applied against any maximum annual or lifetime monetary
limits set forth in such policy or contract. Visit limitations [and
other terms and conditions of the policy] will continue to apply to
early intervention services. However, any visits used for early inter-
S. 6407 35 A. 9007
vention program services shall not reduce the number of visits otherwise
available under the policy or contract for such services. WHEN SUCH
POLICY OF ACCIDENT AND HEALTH INSURANCE, INCLUDING A CONTRACT ISSUED
PURSUANT TO ARTICLE FORTY-THREE AND SECTION ELEVEN HUNDRED TWENTY OF
THIS CHAPTER, PROVIDES COVERAGE FOR ESSENTIAL HEALTH BENEFITS, AS
DEFINED IN SECTION 1302(B) OF THE AFFORDABLE CARE ACT, 42 U.S.C. S
18022(B), AND CONSTITUTES EARLY INTERVENTION SERVICES AS SET FORTH IN
PARAGRAPH (H) OF SUBDIVISION SEVEN OF SECTION TWENTY-FIVE HUNDRED
FORTY-ONE OF THE PUBLIC HEALTH LAW, OR EARLY INTERVENTION EVALUATION
SERVICES AS SET FORTH IN SUBDIVISION NINE OF SECTION TWENTY-FIVE HUNDRED
FORTY-ONE OF THE PUBLIC HEALTH LAW, A WRITTEN ORDER, REFERRAL, RECOMMEN-
DATION FOR DIAGNOSTIC SERVICES TO DETERMINE PROGRAM ELIGIBILITY, OR THE
INDIVIDUALIZED FAMILY SERVICES PLAN CERTIFIED BY THE EARLY INTERVENTION
OFFICIAL, AS DEFINED IN SECTION TWENTY-FIVE HUNDRED FORTY-ONE OF THE
PUBLIC HEALTH LAW OR SUCH OFFICIAL'S DESIGNEE, SHALL BE SUFFICIENT TO
MEET PRECERTIFICATION, PREAUTHORIZATION AND/OR MEDICAL NECESSITY
REQUIREMENTS IMPOSED UNDER SUCH POLICY.
(C) REIMBURSEMENT FOR ANY EARLY INTERVENTION PROGRAM SERVICE, AS SET
FORTH IN PARAGRAPH (H) OF SUBDIVISION SEVEN OF SECTION TWENTY-FIVE
HUNDRED FORTY-ONE OF THE PUBLIC HEALTH LAW, OR EARLY INTERVENTION EVALU-
ATION SERVICE, AS SET FORTH IN SUBDIVISION NINE OF SECTION TWENTY-FIVE
HUNDRED FORTY-ONE OF THE PUBLIC HEALTH LAW, THAT IS A COVERED SERVICE
UNDER THE POLICY OF ACCIDENT AND HEALTH INSURANCE, INCLUDING A CONTRACT
ISSUED PURSUANT TO ARTICLE FORTY-THREE OF THIS CHAPTER, SHALL BE AT THE
HIGHER OF EITHER A RATE ESTABLISHED BY THE COMMISSIONER OF HEALTH OR A
RATE NEGOTIATED BY THE INSURER IN ACCORDANCE WITH REGULATION.
(D) A POLICY OF ACCIDENT AND HEALTH INSURANCE, INCLUDING A CONTRACT
ISSUED PURSUANT TO ARTICLE FORTY-THREE AND SECTION ELEVEN HUNDRED TWENTY
OF THIS CHAPTER, SHALL NOT DENY COVERAGE BASED ON THE FOLLOWING:
(I) THE LOCATION WHERE SERVICES ARE PROVIDED;
(II) THE DURATION OF THE CHILD'S CONDITION AND/OR THAT THE CHILD'S
CONDITION IS NOT AMENABLE TO SIGNIFICANT IMPROVEMENT WITHIN A CERTAIN
PERIOD OF TIME AS SPECIFIED IN THE POLICY;
(III) THE SERVICE IS NOT A COVERED BENEFIT BUT IS AN ESSENTIAL HEALTH
BENEFIT AS DEFINED IN SECTION 1302(B) OF THE AFFORDABLE CARE ACT, 42
U.S.C. S 18022(B); OR
(IV) THE PROVIDER OF SERVICES IS NOT A PARTICIPATING PROVIDER IN THE
INSURER'S NETWORK.
[(c)] (E) 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. IF AN
INSURER MAKES PAYMENT IN WHOLE OR IN PART FOR A CLAIM OR BILL FOR
SERVICES RENDERED UNDER THE EARLY INTERVENTION PROGRAM ESTABLISHED IN
TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, SUCH
PAYMENT SHALL BE MADE TO THE PROVIDER WHO SUBMITTED THE CLAIM AND NOT TO
THE RENDERING PROFESSIONAL WHO DELIVERED THE SERVICE OR THE COVERED
PERSON REGARDLESS OF WHETHER SUCH PROVIDER IS IN THE INSURER'S NETWORK.
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 writ-
ten request and notice authorizing such release. The service coordinator
S. 6407 36 A. 9007
shall provide such information to the rendering provider assigned to
provide services to the child.
[(d)] (F) No insurer, including a health maintenance organization
issued a certificate of authority under article forty-four of the public
health law and a corporation organized under article forty-three of this
chapter, shall refuse to issue an accident and health insurance policy
or contract or refuse to renew an accident and health insurance policy
or contract solely because the applicant or insured is receiving
services under the early intervention program.
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, 2016; provided
however, that the amendments to section 3224-a of the insurance law as
made by section six of this act and the amendments to section 3235-a of
the insurance law as made by section seven of this act shall apply only
to policies, benefit packages, and contracts issued, renewed, modified,
altered or amended on or after such date.
PART F
Section 1. Section 2825-b of the public health law, as added by
section 2 of part J of chapter 60 of the laws of 2015, is amended to
read as follows:
S 2825-b. [Oneida county health] HEALTH care facility transformation
program: [Oneida county project] STATEWIDE. 1. [An Oneida county] A
STATEWIDE health care facility transformation program is hereby estab-
lished under the joint administration of the commissioner and the presi-
dent of the dormitory authority of the state of New York for the purpose
of strengthening and protecting continued access to health care services
in communities. The program shall provide capital funding in support of
projects [located in the largest population center in Oneida county that
consolidate multiple licensed health care facilities into an integrated
system of care] THAT REPLACE INEFFICIENT AND OUTDATED FACILITIES AS PART
OF A MERGER, CONSOLIDATION, ACQUISITION OR OTHER SIGNIFICANT CORPORATE
RESTRUCTURING ACTIVITY THAT IS PART OF AN OVERALL TRANSFORMATION PLAN
INTENDED TO CREATE A FINANCIALLY SUSTAINABLE SYSTEM OF CARE. The issu-
ance of any bonds or notes hereunder shall be subject to the approval of
the director of the division of the budget, and any projects funded
through the issuance of bonds or notes hereunder shall be approved by
the New York state public authorities control board, as required under
section fifty-one of the public authorities law.
2. The commissioner and the president of the authority shall enter
into an agreement, subject to approval by the director of the budget,
and subject to section sixteen hundred eighty-r of the public authori-
ties law, for the purposes of awarding, distributing, and administering
the funds made available pursuant to this section. Such funds may be
distributed by the commissioner and the president of the authority for
capital grants to general hospitals [for the purposes of consolidating
multiple licensed health care facilities into an integrated system of
care], RESIDENTIAL HEALTH CARE FACILITIES, DIAGNOSTIC AND TREATMENT
CENTERS AND CLINICS LICENSED PURSUANT TO THIS CHAPTER OR THE MENTAL
HYGIENE LAW, PRIMARY CARE PROVIDERS, AND HOME CARE PROVIDERS CERTIFIED
OR LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF THIS CHAPTER, for capital
non-operational works or purposes that support the purposes set forth in
this section. A copy of such agreement, and any amendments thereto,
shall be provided to the chair of the senate finance committee, the
chair of the assembly ways and means committee, and the director of the
S. 6407 37 A. 9007
division of budget no later than thirty days prior to the release of a
request for applications for funding under this program. Projects
awarded, IN WHOLE OR PART, under section twenty-eight hundred twenty-
five of this article shall not be eligible for grants or awards made
available under this section.
3. Notwithstanding section one hundred sixty-three of the state
finance law or any inconsistent provision of law to the contrary, up to
[three] TWO hundred million dollars of the funds appropriated for this
program shall be awarded without a competitive bid or request for
proposal process for capital grants to health care providers (hereafter
"applicants") [located in the county of Oneida]. ELIGIBLE APPLICANTS
SHALL BE THOSE DEEMED BY THE COMMISSIONER TO BE A PROVIDER THAT FULFILLS
OR WILL FULFILL A HEALTH CARE NEED FOR ACUTE INPATIENT, OUTPATIENT,
PRIMARY, HOME CARE OR RESIDENTIAL HEALTH CARE SERVICES IN A COMMUNITY.
4. In determining awards for eligible applicants under this section,
the commissioner and the president of the authority shall consider
criteria including, but not limited to:
(a) the extent to which the proposed capital project will contribute
to the integration of health care services and long term sustainability
of the applicant or preservation of essential health services in the
community or communities served by the applicant;
(b) the extent to which the proposed project or purpose is aligned
with delivery system reform incentive payment ("DSRIP") program goals
and objectives;
(c) CONSIDERATION OF GEOGRAPHIC DISTRIBUTION OF FUNDS;
(D) the relationship between the proposed capital project and identi-
fied community need;
[(d)] (E) THE EXTENT TO WHICH THE APPLICANT HAS ACCESS TO ALTERNATIVE
FINANCING;
(F) the extent that the proposed capital project furthers the develop-
ment of primary care and other outpatient services;
[(e)] (G) the extent to which the proposed capital project benefits
Medicaid enrollees and uninsured individuals;
[(f)] (H) the extent to which the applicant has engaged the community
affected by the proposed capital project and the manner in which commu-
nity engagement has shaped such capital project; and
[(g)] (I) the extent to which the proposed capital project addresses
potential risk to patient safety and welfare.
5. DISBURSEMENT OF AWARDS MADE PURSUANT TO THIS SECTION SHALL BE
CONDITIONED ON THE AWARDEE ACHIEVING CERTAIN PROCESS AND PERFORMANCE
METRICS AND MILESTONES AS DETERMINED IN THE SOLE DISCRETION OF THE
COMMISSIONER. SUCH METRICS AND MILESTONES SHALL BE STRUCTURED TO ENSURE
THAT THE HEALTH CARE TRANSFORMATION AND PROVIDER SUSTAINABILITY GOALS OF
THE PROJECT ARE ACHIEVED, AND SUCH METRICS AND MILESTONES SHALL BE
INCLUDED IN GRANT DISBURSEMENT AGREEMENTS OR OTHER CONTRACTUAL DOCUMENTS
AS REQUIRED BY THE COMMISSIONER.
6. The department shall provide a report on a quarterly basis to the
chairs of the senate finance, assembly ways and means, senate health and
assembly health committees. Such reports shall be submitted no later
than sixty days after the close of the quarter, and shall [conform to
the reporting requirements of subdivision twenty of section twenty-eight
hundred seven of this article, as applicable] INCLUDE, FOR EACH AWARD,
THE NAME OF THE APPLICANT, A DESCRIPTION OF THE PROJECT OR PURPOSE, THE
AMOUNT OF THE AWARD, DISBURSEMENT DATE, AND STATUS OF ACHIEVEMENT OF
PROCESS AND PERFORMANCE METRICS AND MILESTONES PURSUANT TO SUBDIVISION
FIVE OF THIS SECTION.
S. 6407 38 A. 9007
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, 2016.
PART G
Section 1. Section 2801-a of the public health law is amended by
adding a new subdivision 17 to read as follows:
17. (A) DIAGNOSTIC OR TREATMENT CENTERS ESTABLISHED TO PROVIDE HEALTH
CARE SERVICES WITHIN THE SPACE OF A RETAIL BUSINESS OPERATION, SUCH AS A
PHARMACY OR A STORE OPEN TO THE GENERAL PUBLIC, OR WITHIN SPACE USED BY
AN EMPLOYER FOR PROVIDING HEALTH CARE SERVICES TO ITS EMPLOYEES, MAY BE
OPERATED BY LEGAL ENTITIES FORMED UNDER THE LAWS OF THE STATE OF NEW
YORK:
(I) WHOSE STOCKHOLDERS OR MEMBERS, AS APPLICABLE, ARE NOT NATURAL
PERSONS;
(II) WHOSE PRINCIPAL STOCKHOLDERS AND MEMBERS, AS APPLICABLE, AND
CONTROLLING PERSONS COMPLY WITH ALL APPLICABLE REQUIREMENTS OF THIS
SECTION; AND
(III) THAT DEMONSTRATE, TO THE SATISFACTION OF THE PUBLIC HEALTH AND
HEALTH PLANNING COUNCIL, SUFFICIENT EXPERIENCE AND EXPERTISE IN DELIVER-
ING HIGH QUALITY HEALTH CARE SERVICES, AND FURTHER DEMONSTRATE A COMMIT-
MENT TO OPERATE LIMITED SERVICES CLINICS IN MEDICALLY UNDERSERVED AREAS
OF THE STATE. SUCH DIAGNOSTIC AND TREATMENT CENTERS SHALL BE REFERRED TO
IN THIS SECTION AS "LIMITED SERVICES CLINICS".
(B) FOR PURPOSES OF PARAGRAPH (A) OF THIS SUBDIVISION, THE PUBLIC
HEALTH AND HEALTH PLANNING COUNCIL SHALL ADOPT AND AMEND RULES AND REGU-
LATIONS, NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION, TO
ADDRESS ANY MATTER IT DEEMS PERTINENT TO THE ESTABLISHMENT OF LIMITED
SERVICES CLINICS. SUCH RULES AND REGULATIONS SHALL INCLUDE, BUT NOT BE
LIMITED TO, PROVISIONS GOVERNING OR RELATING TO:
(I) ANY DIRECT OR INDIRECT CHANGES OR TRANSFERS OF OWNERSHIP INTERESTS
OR VOTING RIGHTS IN SUCH ENTITIES OR THEIR STOCKHOLDERS OR MEMBERS, AS
APPLICABLE;
(II) PUBLIC HEALTH AND HEALTH PLANNING COUNCIL APPROVAL OF ANY CHANGE
IN CONTROLLING INTERESTS, PRINCIPAL STOCKHOLDERS, CONTROLLING PERSONS,
PARENT COMPANY OR SPONSORS;
(III) OVERSIGHT OF THE OPERATOR AND ITS SHAREHOLDERS OR MEMBERS, AS
APPLICABLE, INCLUDING LOCAL GOVERNANCE OF THE LIMITED SERVICES CLINICS;
AND
(IV) THE CHARACTER AND COMPETENCE AND QUALIFICATIONS OF, AND CHANGES
RELATING TO, THE DIRECTORS AND OFFICERS OF THE OPERATOR AND ITS PRINCI-
PAL STOCKHOLDERS, CONTROLLING PERSONS, PARENT COMPANY OR SPONSORS.
(C) THE FOLLOWING PROVISIONS OF THIS SECTION SHALL NOT APPLY TO LIMIT-
ED SERVICES CLINICS:
(I) PARAGRAPH (A) OF SUBDIVISION THREE OF THIS SECTION;
(II) PARAGRAPH (B) OF SUBDIVISION THREE OF THIS SECTION, RELATING TO
STOCKHOLDERS AND MEMBERS OTHER THAN PRINCIPAL STOCKHOLDERS AND PRINCIPAL
MEMBERS;
(III) PARAGRAPH (C) OF SUBDIVISION FOUR OF THIS SECTION, RELATING TO
THE DISPOSITION OF STOCK OR VOTING RIGHTS; AND
(IV) PARAGRAPH (E) OF SUBDIVISION FOUR OF THIS SECTION, RELATING TO
THE OWNERSHIP OF STOCK OR MEMBERSHIP.
(D) A LIMITED SERVICES CLINIC SHALL BE DEEMED TO BE A "HEALTH CARE
PROVIDER" FOR THE PURPOSES OF TITLE TWO-D OF ARTICLE TWO OF THIS CHAP-
TER. A PRESCRIBER PRACTICING IN A LIMITED SERVICES CLINIC SHALL NOT BE
DEEMED TO BE IN THE EMPLOY OF A PHARMACY OR PRACTICING IN A HOSPITAL FOR
S. 6407 39 A. 9007
PURPOSES OF SUBDIVISION TWO OF SECTION SIXTY-EIGHT HUNDRED SEVEN OF THE
EDUCATION LAW.
(E) THE COMMISSIONER SHALL PROMULGATE REGULATIONS SETTING FORTH OPERA-
TIONAL AND PHYSICAL PLANT STANDARDS FOR LIMITED SERVICES CLINICS, WHICH
MAY BE DIFFERENT FROM THE REGULATIONS OTHERWISE APPLICABLE TO DIAGNOSTIC
OR TREATMENT CENTERS, INCLUDING, BUT NOT LIMITED TO:
(I) REQUIRING THAT LIMITED SERVICES CLINICS ATTAIN AND MAINTAIN
ACCREDITATION AND REQUIRING TIMELY REPORTING TO THE DEPARTMENT IF A
LIMITED SERVICES CLINIC LOSES ITS ACCREDITATION;
(II) DESIGNATING OR LIMITING THE TREATMENTS AND SERVICES THAT MAY BE
PROVIDED, INCLUDING:
(A) LIMITING THE SCOPE OF SERVICES TO THE FOLLOWING, PROVIDED THAT
SUCH SERVICES SHALL NOT INCLUDE MONITORING OR TREATMENT AND SERVICES
OVER PROLONGED PERIODS:
(1) THE PROVISION OF TREATMENT AND SERVICES TO PATIENTS FOR MINOR
ACUTE EPISODIC ILLNESSES OR CONDITIONS;
(2) EPISODIC PREVENTIVE AND WELLNESS TREATMENTS AND SERVICES SUCH AS
IMMUNIZATIONS; AND
(3) TREATMENT AND SERVICES FOR MINOR TRAUMAS THAT ARE NOT REASONABLY
LIKELY TO BE LIFE THREATENING OR POTENTIALLY DISABLING IF AMBULATORY
CARE WITHIN THE CAPACITY OF THE LIMITED SERVICES CLINIC IS PROVIDED;
(B) PROHIBITING THE PROVISION OF SERVICES TO PATIENTS TWENTY-FOUR
MONTHS OF AGE OR YOUNGER;
(C) THE PROVISION OF SPECIFIC IMMUNIZATIONS TO PATIENTS YOUNGER THAN
EIGHTEEN YEARS OF AGE;
(III) REQUIRING LIMITED SERVICES CLINICS TO ACCEPT WALK-INS AND OFFER
EXTENDED BUSINESS HOURS;
(IV) SETTING FORTH GUIDELINES FOR ADVERTISING AND SIGNAGE, WHICH SHALL
INCLUDE SIGNAGE INDICATING THAT PRESCRIPTIONS AND OVER-THE-COUNTER
SUPPLIES MAY BE PURCHASED BY A PATIENT FROM ANY BUSINESS AND DO NOT NEED
TO BE PURCHASED ON-SITE;
(V) SETTING FORTH GUIDELINES FOR DISCLOSURE OF OWNERSHIP INTERESTS,
INFORMED CONSENT, RECORD KEEPING, REFERRAL FOR TREATMENT AND CONTINUITY
OF CARE, CASE REPORTING TO THE PATIENT'S PRIMARY CARE OR OTHER HEALTH
CARE PROVIDERS, DESIGN, CONSTRUCTION, FIXTURES, AND EQUIPMENT; AND
(VI) REQUIRING THE OPERATOR TO DIRECTLY EMPLOY A MEDICAL DIRECTOR WHO
IS LICENSED AND CURRENTLY REGISTERED TO PRACTICE MEDICINE IN THE STATE
OF NEW YORK.
(F) SUCH REGULATIONS ALSO SHALL PROMOTE AND STRENGTHEN PRIMARY CARE BY
REQUIRING LIMITED SERVICES CLINICS TO:
(I) INQUIRE OF EACH PATIENT WHETHER HE OR SHE HAS A PRIMARY CARE
PROVIDER;
(II) MAINTAIN AND REGULARLY UPDATE A LIST OF LOCAL PRIMARY CARE
PROVIDERS AND PROVIDE SUCH LIST TO EACH PATIENT WHO INDICATES THAT HE OR
SHE DOES NOT HAVE A PRIMARY CARE PROVIDER;
(III) REFER PATIENTS TO THEIR PRIMARY CARE PROVIDERS OR OTHER HEALTH
CARE PROVIDERS AS APPROPRIATE;
(IV) TRANSMIT, BY ELECTRONIC MEANS WHENEVER POSSIBLE, RECORDS OF
SERVICES TO PATIENTS' PRIMARY CARE PROVIDERS;
(V) EXECUTE PARTICIPATION AGREEMENTS WITH HEALTH INFORMATION ORGANIZA-
TIONS, ALSO KNOWN AS QUALIFIED ENTITIES, PURSUANT TO WHICH LIMITED
SERVICES CLINICS AGREE TO PARTICIPATE IN THE STATEWIDE HEALTH INFORMA-
TION NETWORK FOR NEW YORK (SHIN-NY); AND
(VI) DECLINE TO TREAT ANY PATIENT FOR THE SAME CONDITION OR ILLNESS
MORE THAN THREE TIMES IN A YEAR.
S. 6407 40 A. 9007
(G) A LIMITED SERVICES CLINIC SHALL PROVIDE TREATMENT WITHOUT DISCRIM-
INATION AS TO SOURCE OF PAYMENT.
(H) NOTWITHSTANDING THIS SUBDIVISION AND OTHER LAW OR REGULATION TO
THE CONTRARY AND SUBJECT TO THE PROVISIONS OF SECTION TWENTY-EIGHT
HUNDRED TWO OF THIS ARTICLE, A DIAGNOSTIC AND TREATMENT CENTER, COMMUNI-
TY HEALTH CENTER OR FEDERALLY QUALIFIED HEALTH CENTER MAY OPERATE A
LIMITED SERVICES CLINIC WHICH MEETS THE REGULATION PROMULGATED PURSUANT
TO PARAGRAPH (E) OF THIS SUBDIVISION REGARDING OPERATIONAL PHYSICAL
PLANT STANDARDS.
(I) IN DETERMINING WHETHER TO APPROVE ADDITIONAL LIMITED SERVICES
CLINIC LOCATIONS, THE DEPARTMENT SHALL CONSIDER WHETHER THE OPERATOR HAS
FULFILLED ITS COMMITMENT TO OPERATE LIMITED SERVICES CLINICS IN
MEDICALLY UNDERSERVED AREAS OF THE STATE.
S 2. This act shall take effect immediately.
PART H
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, as amended
by section 1 of part JJ of chapter 58 of the laws of 2015, 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,
[2016] 2019; and for programs located within the city of New York, the
applicable fiscal periods shall be July 1, 2003 through June 30, 2010
and July 1, 2011 through June 30, [2016] 2019.
S 2. This act shall take effect immediately.
PART I
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 K of
chapter 56 of the laws of 2012, are amended to read as follows:
S 19. Notwithstanding any other provision of law, the commissioner of
mental health shall, until July 1, [2016] 2020, 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, [2016] 2020, 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. 6407 41 A. 9007
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, 2016.
PART J
Section 1. Subdivision a of section 9 of chapter 420 of the laws of
2002 amending the education law relating to the profession of social
work, as amended by section 1 of part AA of chapter 57 of the laws of
2013, is amended to read as follows:
a. Nothing in this act shall prohibit or limit the activities or
services on the part of any person in the employ of a program or service
operated, regulated, funded, or approved by the department of mental
hygiene, the office of children and family services, the office of
temporary and disability assistance, the department of corrections and
community supervision, the state office for the aging, the department of
health, or a local governmental unit as that term is defined in article
41 of the mental hygiene law or a social services district as defined in
section 61 of the social services law, provided, however, this section
shall not authorize the use of any title authorized pursuant to article
154 of the education law, except that this section shall be deemed
repealed on July 1, [2016] 2021.
S 2. Subdivision a of section 17-a of chapter 676 of the laws of 2002
amending the education law relating to the practice of psychology, as
amended by section 2 of part AA of chapter 57 of the laws of 2013, is
amended to read as follows:
a. In relation to activities and services provided under article 153
of the education law, nothing in this act shall prohibit or limit such
activities or services on the part of any person in the employ of a
program or service operated, regulated, funded, or approved by the
department of mental hygiene or the office of children and family
services, or a local governmental unit as that term is defined in arti-
cle 41 of the mental hygiene law or a social services district as
defined in section 61 of the social services law. In relation to activ-
ities and services provided under article 163 of the education law,
nothing in this act shall prohibit or limit such activities or services
on the part of any person in the employ of a program or service oper-
ated, regulated, funded, or approved by the department of mental
hygiene, the office of children and family services, the department of
corrections and community supervision, the office of temporary and disa-
bility assistance, the state office for the aging and the department of
health or a local governmental unit as that term is defined in article
41 of the mental hygiene law or a social services district as defined in
section 61 of the social services law, pursuant to authority granted by
law. This section shall not authorize the use of any title authorized
pursuant to article 153 or 163 of the education law by any such employed
person, except as otherwise provided by such articles respectively.
This section shall be deemed repealed July 1, [2016] 2021.
S 3. Section 16 of chapter 130 of the laws of 2010 amending the educa-
tion law and other laws relating to the registration of entities provid-
ing certain professional services and the licensure of certain
professions, as amended by section 3 of part AA of chapter 57 of the
laws of 2013, is amended to read as follows:
S 16. This act shall take effect immediately; provided that sections
thirteen, fourteen and fifteen of this act shall take effect immediately
S. 6407 42 A. 9007
and shall be deemed to have been in full force and effect on and after
June 1, 2010 and such sections shall be deemed repealed July 1, [2016]
2021; provided further that the amendments to section 9 of chapter 420
of the laws of 2002 amending the education law relating to the profes-
sion of social work made by section thirteen of this act shall repeal on
the same date as such section repeals; provided further that the amend-
ments to section 17-a of chapter 676 of the laws of 2002 amending the
education law relating to the practice of psychology made by section
fourteen of this act shall repeal on the same date as such section
repeals.
S 4. This act shall take effect immediately.
PART K
Section 1. Subdivision 9 of section 730.10 of the criminal procedure
law, as added by section 1 of part Q of chapter 56 of the laws of 2012,
is amended 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; OR (C)
A MENTAL HEALTH UNIT OPERATING WITHIN A CORRECTIONAL FACILITY OR LOCAL
CORRECTIONAL FACILITY PROVIDED HOWEVER THAT ANY SUCH MENTAL HEALTH UNIT
OPERATING WITHIN A LOCAL CORRECTIONAL FACILITY SHALL QUALIFY AS AN
"APPROPRIATE INSTITUTION" ONLY PURSUANT TO THE TERMS OF AN AGREEMENT
BETWEEN THE COMMISSIONER AND THE SHERIFF AND ANY SUCH MENTAL HEALTH UNIT
OPERATING WITHIN A CORRECTIONAL FACILITY SHALL QUALIFY AS AN "APPROPRI-
ATE INSTITUTION" ONLY PURSUANT TO THE TERMS OF AN AGREEMENT BETWEEN THE
COMMISSIONER AND THE COMMISSIONER OF THE DEPARTMENT OF CORRECTIONS AND
COMMUNITY SUPERVISION. Nothing in this article shall be construed as
requiring a hospital, CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACIL-
ITY to consent to providing care and treatment to an incapacitated
person at such hospital, CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL
FACILITY.
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, 2016.
PART L
Section 1. The mental hygiene law is amended by adding a new section
16.25 to read as follows:
S 16.25 TEMPORARY OPERATOR.
(A) FOR THE PURPOSES OF THIS SECTION:
(1) "ESTABLISHED OPERATOR" SHALL MEAN THE PROVIDER OF SERVICES THAT
HAS BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE PURSUANT TO
THIS ARTICLE.
(2) "EXTRAORDINARY FINANCIAL ASSISTANCE" SHALL MEAN STATE FUNDS
PROVIDED TO, OR REQUESTED BY, A PROGRAM FOR THE EXPRESS PURPOSE OF
PREVENTING THE CLOSURE OF THE PROGRAM THAT THE COMMISSIONER FINDS
PROVIDES ESSENTIAL AND NECESSARY SERVICES WITHIN THE COMMUNITY.
(3) "SERIOUS FINANCIAL INSTABILITY" SHALL INCLUDE BUT NOT BE LIMITED
TO DEFAULTING OR VIOLATING MATERIAL COVENANTS OF BOND ISSUES, MISSED
S. 6407 43 A. 9007
MORTGAGE PAYMENTS, MISSED RENT PAYMENTS, A PATTERN OF UNTIMELY PAYMENT
OF DEBTS, FAILURE TO PAY ITS EMPLOYEES OR VENDORS, INSUFFICIENT FUNDS TO
MEET THE GENERAL OPERATING EXPENSES OF THE PROGRAM, FAILURE TO MAINTAIN
REQUIRED DEBT SERVICE COVERAGE RATIOS AND/OR, AS APPLICABLE, FACTORS
THAT HAVE TRIGGERED A WRITTEN EVENT OF DEFAULT NOTICE TO THE OFFICE BY
THE DORMITORY AUTHORITY OF THE STATE OF NEW YORK.
(4) "TEMPORARY OPERATOR" SHALL MEAN ANY PROVIDER OF SERVICES THAT HAS
BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE PURSUANT TO THIS
ARTICLE OR WHICH IS DIRECTLY OPERATED BY THE OFFICE, THAT:
A. AGREES TO PROVIDE SERVICES CERTIFIED PURSUANT TO THIS ARTICLE ON A
TEMPORARY BASIS IN THE BEST INTERESTS OF ITS INDIVIDUALS SERVED BY THE
PROGRAM; AND
B. HAS A HISTORY OF COMPLIANCE WITH APPLICABLE LAWS, RULES, AND REGU-
LATIONS AND A RECORD OF PROVIDING CARE OF GOOD QUALITY, AS DETERMINED BY
THE COMMISSIONER; AND
C. PRIOR TO APPOINTMENT AS TEMPORARY OPERATOR, DEVELOPS A PLAN DETER-
MINED TO BE SATISFACTORY BY THE COMMISSIONER TO ADDRESS THE PROGRAM'S
DEFICIENCIES.
(B) (1) IN THE EVENT THAT: (I) THE ESTABLISHED OPERATOR IS SEEKING
EXTRAORDINARY FINANCIAL ASSISTANCE; (II) OFFICE COLLECTED DATA DEMON-
STRATES THAT THE ESTABLISHED OPERATOR IS EXPERIENCING SERIOUS FINANCIAL
INSTABILITY ISSUES; (III) OFFICE COLLECTED DATA DEMONSTRATES THAT THE
ESTABLISHED OPERATOR'S BOARD OF DIRECTORS OR ADMINISTRATION IS UNABLE OR
UNWILLING TO ENSURE THE PROPER OPERATION OF THE PROGRAM; OR (IV) OFFICE
COLLECTED DATA INDICATES THERE ARE CONDITIONS THAT SERIOUSLY ENDANGER OR
JEOPARDIZE CONTINUED ACCESS TO NECESSARY SERVICES WITHIN THE COMMUNITY,
THE COMMISSIONER SHALL NOTIFY THE ESTABLISHED OPERATOR OF HIS OR HER
INTENTION TO APPOINT A TEMPORARY OPERATOR TO ASSUME SOLE RESPONSIBILITY
FOR THE PROVIDER OF SERVICES' OPERATIONS FOR A LIMITED PERIOD OF TIME.
THE APPOINTMENT OF A TEMPORARY OPERATOR SHALL BE EFFECTUATED PURSUANT TO
THIS SECTION, AND SHALL BE IN ADDITION TO ANY OTHER REMEDIES PROVIDED BY
LAW.
(2) THE ESTABLISHED OPERATOR 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 NECES-
SARY, ENTER INTO AN AGREEMENT WITH THE ESTABLISHED OPERATOR FOR THE
APPOINTMENT OF A TEMPORARY OPERATOR TO RESTORE OR MAINTAIN THE PROVISION
OF QUALITY CARE TO THE INDIVIDUALS UNTIL THE ESTABLISHED OPERATOR CAN
RESUME OPERATIONS WITHIN THE DESIGNATED TIME PERIOD OR OTHER ACTION IS
TAKEN AS DESCRIBED IN SECTION 16.17 OF THIS ARTICLE.
(C) (1) A TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION SHALL
USE HIS OR HER BEST EFFORTS TO IMPLEMENT THE PLAN DEEMED SATISFACTORY BY
THE COMMISSIONER TO CORRECT OR ELIMINATE ANY DEFICIENCIES IN THE PROGRAM
AND TO PROMOTE THE QUALITY AND ACCESSIBILITY OF SERVICES IN THE COMMUNI-
TY SERVED BY THE PROVIDER OF SERVICES.
(2) DURING THE TERM OF APPOINTMENT, THE TEMPORARY OPERATOR SHALL HAVE
THE AUTHORITY TO DIRECT THE STAFF OF THE ESTABLISHED OPERATOR AS NECES-
SARY TO APPROPRIATELY PROVIDE SERVICES FOR INDIVIDUALS. THE TEMPORARY
OPERATOR SHALL, DURING THIS PERIOD, PROVIDE SERVICES IN SUCH A MANNER AS
TO PROMOTE SAFETY AND THE QUALITY AND ACCESSIBILITY OF SERVICES IN THE
COMMUNITY SERVED BY THE ESTABLISHED OPERATOR UNTIL EITHER THE ESTAB-
LISHED OPERATOR CAN RESUME OPERATIONS OR UNTIL THE OFFICE REVOKES THE
OPERATING CERTIFICATE FOR THE SERVICES ISSUED UNDER THIS ARTICLE.
(3) THE ESTABLISHED OPERATOR SHALL GRANT ACCESS TO THE TEMPORARY OPER-
ATOR TO THE ESTABLISHED OPERATOR'S ACCOUNTS AND RECORDS IN ORDER TO
ADDRESS ANY DEFICIENCIES RELATED TO THE PROGRAM EXPERIENCING SERIOUS
S. 6407 44 A. 9007
FINANCIAL INSTABILITY OR AN ESTABLISHED OPERATOR REQUESTING FINANCIAL
ASSISTANCE IN ACCORDANCE WITH THIS SECTION. THE TEMPORARY OPERATOR SHALL
APPROVE ANY FINANCIAL DECISION RELATED TO AN ESTABLISHED PROVIDER'S DAY
TO DAY OPERATIONS OR THE ESTABLISHED PROVIDER'S ABILITY TO PROVIDE
SERVICES.
(4) THE TEMPORARY OPERATOR SHALL NOT BE REQUIRED TO FILE ANY BOND. NO
SECURITY INTEREST IN ANY REAL OR PERSONAL PROPERTY COMPRISING THE ESTAB-
LISHED OPERATOR OR CONTAINED WITHIN THE ESTABLISHED OPERATOR OR IN ANY
FIXTURE OF THE PROGRAM, SHALL BE IMPAIRED OR DIMINISHED IN PRIORITY BY
THE TEMPORARY OPERATOR. NEITHER THE TEMPORARY OPERATOR NOR THE OFFICE
SHALL ENGAGE IN ANY ACTIVITY THAT CONSTITUTES A CONFISCATION OF PROPER-
TY.
(D) THE TEMPORARY OPERATOR SHALL BE ENTITLED TO A REASONABLE FEE, AS
DETERMINED BY THE COMMISSIONER AND SUBJECT TO THE APPROVAL OF THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, AND NECESSARY EXPENSES INCURRED WHILE
SERVING AS A TEMPORARY OPERATOR. THE TEMPORARY OPERATOR SHALL BE LIABLE
ONLY IN ITS CAPACITY AS TEMPORARY OPERATOR FOR INJURY TO PERSON AND
PROPERTY BY REASON OF ITS OPERATION OF SUCH PROGRAM; NO LIABILITY SHALL
INCUR IN THE TEMPORARY OPERATOR'S PERSONAL CAPACITY, EXCEPT FOR GROSS
NEGLIGENCE AND INTENTIONAL ACTS.
(E) (1) THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR
SHALL NOT EXCEED NINETY DAYS. AFTER NINETY DAYS, IF THE COMMISSIONER
DETERMINES THAT TERMINATION OF THE TEMPORARY OPERATOR WOULD CAUSE
SIGNIFICANT DETERIORATION OF THE QUALITY OF, OR ACCESS TO, CARE IN THE
COMMUNITY OR THAT REAPPOINTMENT IS NECESSARY TO CORRECT THE DEFICIENCIES
THAT REQUIRED THE APPOINTMENT OF THE TEMPORARY OPERATOR, THE COMMISSION-
ER MAY AUTHORIZE AN ADDITIONAL NINETY-DAY TERM. HOWEVER, SUCH AUTHORI-
ZATION SHALL INCLUDE THE COMMISSIONER'S REQUIREMENTS FOR CONCLUSION OF
THE TEMPORARY OPERATORSHIP TO BE SATISFIED WITHIN THE ADDITIONAL TERM.
(2) 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:
A. THE ACTIONS TAKEN DURING THE APPOINTMENT TO ADDRESS THE IDENTIFIED
PROGRAM DEFICIENCIES, THE RESUMPTION OF PROGRAM OPERATIONS BY THE ESTAB-
LISHED OPERATOR, OR THE REVOCATION OF AN OPERATING CERTIFICATE ISSUED BY
THE OFFICE;
B. OBJECTIVES FOR THE CONTINUATION OF THE TEMPORARY OPERATORSHIP IF
NECESSARY AND A SCHEDULE FOR SATISFACTION OF SUCH OBJECTIVES; AND
C. IF APPLICABLE, THE RECOMMENDED ACTIONS FOR THE ONGOING PROVISION OF
SERVICES SUBSEQUENT TO THE TEMPORARY OPERATORSHIP.
(3) 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.
(F) (1) THE COMMISSIONER SHALL, UPON MAKING A DETERMINATION OF AN
INTENTION TO APPOINT A TEMPORARY OPERATOR PURSUANT TO PARAGRAPH ONE OF
SUBDIVISION (B) OF THIS SECTION, CAUSE THE ESTABLISHED OPERATOR 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 UNDERLYING 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, THE COMMISSIONER AND THE ESTAB-
S. 6407 45 A. 9007
LISHED OPERATOR SHALL ATTEMPT TO DEVELOP A MUTUALLY SATISFACTORY PLAN OF
CORRECTION AND SCHEDULE FOR IMPLEMENTATION. IN SUCH EVENT, THE COMMIS-
SIONER SHALL NOTIFY THE ESTABLISHED OPERATOR THAT THE COMMISSIONER WILL
ABSTAIN FROM APPOINTING A TEMPORARY OPERATOR CONTINGENT UPON THE ESTAB-
LISHED OPERATOR REMEDIATING THE IDENTIFIED DEFICIENCIES WITHIN THE
AGREED UPON TIMEFRAME.
(2) SHOULD THE COMMISSIONER AND THE ESTABLISHED OPERATOR BE UNABLE TO
ESTABLISH A PLAN OF CORRECTION PURSUANT TO PARAGRAPH ONE 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 THIRTY 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
TEMPORARY OPERATOR IS SUPPORTED BY SUBSTANTIAL EVIDENCE. A COPY OF THE
DECISION SHALL BE SENT TO THE ESTABLISHED OPERATOR.
(3) IF THE DECISION TO APPOINT A TEMPORARY OPERATOR IS UPHELD SUCH
TEMPORARY OPERATOR SHALL BE APPOINTED AS SOON AS IS PRACTICABLE AND
SHALL PROVIDE SERVICES PURSUANT TO THE PROVISIONS OF THIS SECTION.
(G) NOTWITHSTANDING THE APPOINTMENT OF A TEMPORARY OPERATOR, THE
ESTABLISHED OPERATOR SHALL REMAIN OBLIGATED FOR THE CONTINUED PROVISION
OF SERVICES. 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 OF THE PROGRAM HEREUNDER;
NOR SHALL ANYTHING CONTAINED IN THIS SECTION BE CONSTRUED TO SUSPEND
DURING THE TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR OF THE
PROGRAM ANY OBLIGATION OF THE ESTABLISHED OPERATOR OR ANY OTHER PERSON
FOR THE MAINTENANCE AND REPAIR OF THE FACILITY, PROVISION OF UTILITY
SERVICES, 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 2. The mental hygiene law is amended by adding a new section 31.20
to read as follows:
S 31.20 TEMPORARY OPERATOR.
(A) FOR THE PURPOSES OF THIS SECTION:
(1) "ESTABLISHED OPERATOR" SHALL MEAN THE OPERATOR OF A MENTAL HEALTH
PROGRAM THAT HAS BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE
PURSUANT TO THIS ARTICLE.
(2) "EXTRAORDINARY FINANCIAL ASSISTANCE" SHALL MEAN STATE FUNDS
PROVIDED TO, OR REQUESTED BY, A PROGRAM FOR THE EXPRESS PURPOSE OF
PREVENTING THE CLOSURE OF THE PROGRAM THAT THE COMMISSIONER FINDS
PROVIDES ESSENTIAL AND NECESSARY SERVICES WITHIN THE COMMUNITY.
(3) "MENTAL HEALTH PROGRAM" SHALL MEAN A PROVIDER OF SERVICES FOR
PERSONS WITH SERIOUS MENTAL ILLNESS, AS SUCH TERMS ARE DEFINED IN
SECTION 1.03 OF THIS CHAPTER, WHICH IS LICENSED OR OPERATED BY THE
OFFICE.
(4) "OFFICE" SHALL MEAN THE OFFICE OF MENTAL HEALTH.
(5) "SERIOUS FINANCIAL INSTABILITY" SHALL INCLUDE BUT NOT BE LIMITED
TO DEFAULTING OR VIOLATING MATERIAL COVENANTS OF BOND ISSUES, MISSED
MORTGAGE PAYMENTS, A PATTERN OF UNTIMELY PAYMENT OF DEBTS, FAILURE TO
PAY ITS EMPLOYEES OR VENDORS, INSUFFICIENT FUNDS TO MEET THE GENERAL
OPERATING EXPENSES OF THE PROGRAM, FAILURE TO MAINTAIN REQUIRED DEBT
SERVICE COVERAGE RATIOS AND/OR, AS APPLICABLE, FACTORS THAT HAVE TRIG-
S. 6407 46 A. 9007
GERED A WRITTEN EVENT OF DEFAULT NOTICE TO THE OFFICE BY THE DORMITORY
AUTHORITY OF THE STATE OF NEW YORK.
(6) "TEMPORARY OPERATOR" SHALL MEAN ANY OPERATOR OF A MENTAL HEALTH
PROGRAM THAT HAS BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE
PURSUANT TO THIS ARTICLE OR WHICH IS DIRECTLY OPERATED BY THE OFFICE OF
MENTAL HEALTH, THAT:
A. AGREES TO OPERATE A MENTAL HEALTH PROGRAM ON A TEMPORARY BASIS IN
THE BEST INTERESTS OF ITS PATIENTS SERVED BY THE PROGRAM; AND
B. HAS A HISTORY OF COMPLIANCE WITH APPLICABLE LAWS, RULES, AND REGU-
LATIONS AND A RECORD OF PROVIDING CARE OF GOOD QUALITY, AS DETERMINED BY
THE COMMISSIONER; AND
C. PRIOR TO APPOINTMENT AS TEMPORARY OPERATOR, DEVELOPS A PLAN DETER-
MINED TO BE SATISFACTORY BY THE COMMISSIONER TO ADDRESS THE PROGRAM'S
DEFICIENCIES.
(B) (1) IN THE EVENT THAT: (I) THE ESTABLISHED OPERATOR IS SEEKING
EXTRAORDINARY FINANCIAL ASSISTANCE; (II) OFFICE COLLECTED DATA DEMON-
STRATES THAT THE ESTABLISHED OPERATOR IS EXPERIENCING SERIOUS FINANCIAL
INSTABILITY ISSUES; (III) OFFICE COLLECTED DATA DEMONSTRATES THAT THE
ESTABLISHED OPERATOR'S BOARD OF DIRECTORS OR ADMINISTRATION IS UNABLE OR
UNWILLING TO ENSURE THE PROPER OPERATION OF THE PROGRAM; OR (IV) OFFICE
COLLECTED DATA INDICATES THERE ARE CONDITIONS THAT SERIOUSLY ENDANGER OR
JEOPARDIZE CONTINUED ACCESS TO NECESSARY MENTAL HEALTH SERVICES WITHIN
THE COMMUNITY, THE COMMISSIONER SHALL NOTIFY THE ESTABLISHED OPERATOR OF
HIS OR HER INTENTION TO APPOINT A TEMPORARY OPERATOR TO ASSUME SOLE
RESPONSIBILITY FOR THE PROGRAM'S TREATMENT OPERATIONS FOR A LIMITED
PERIOD OF TIME. THE APPOINTMENT OF A TEMPORARY OPERATOR SHALL BE EFFEC-
TUATED PURSUANT TO THIS SECTION, AND SHALL BE IN ADDITION TO ANY OTHER
REMEDIES PROVIDED BY LAW.
(2) THE ESTABLISHED OPERATOR 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 NECES-
SARY, ENTER INTO AN AGREEMENT WITH THE ESTABLISHED OPERATOR FOR THE
APPOINTMENT OF A TEMPORARY OPERATOR TO RESTORE OR MAINTAIN THE PROVISION
OF QUALITY CARE TO THE PATIENTS UNTIL THE ESTABLISHED OPERATOR CAN
RESUME OPERATIONS WITHIN THE DESIGNATED TIME PERIOD; THE PATIENTS MAY BE
TRANSFERRED TO OTHER MENTAL HEALTH PROGRAMS OPERATED OR LICENSED BY THE
OFFICE; OR THE OPERATIONS OF THE MENTAL HEALTH PROGRAM SHOULD BE
COMPLETELY DISCONTINUED.
(C) (1) A TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION SHALL
USE HIS OR HER BEST EFFORTS TO IMPLEMENT THE PLAN DEEMED SATISFACTORY BY
THE COMMISSIONER TO CORRECT OR ELIMINATE ANY DEFICIENCIES IN THE MENTAL
HEALTH PROGRAM AND TO PROMOTE THE QUALITY AND ACCESSIBILITY OF MENTAL
HEALTH SERVICES IN THE COMMUNITY SERVED BY THE MENTAL HEALTH PROGRAM.
(2) IF THE IDENTIFIED DEFICIENCIES CANNOT BE ADDRESSED IN THE TIME
PERIOD DESIGNATED IN THE PLAN, THE PATIENTS SHALL BE TRANSFERRED TO
OTHER APPROPRIATE MENTAL HEALTH PROGRAMS LICENSED OR OPERATED BY THE
OFFICE.
(3) DURING THE TERM OF APPOINTMENT, THE TEMPORARY OPERATOR SHALL HAVE
THE AUTHORITY TO DIRECT THE STAFF OF THE ESTABLISHED OPERATOR AS NECES-
SARY TO APPROPRIATELY TREAT AND/OR TRANSFER THE PATIENTS. THE TEMPORARY
OPERATOR SHALL, DURING THIS PERIOD, OPERATE THE MENTAL HEALTH PROGRAM IN
SUCH A MANNER AS TO PROMOTE SAFETY AND THE QUALITY AND ACCESSIBILITY OF
MENTAL HEALTH SERVICES IN THE COMMUNITY SERVED BY THE ESTABLISHED OPERA-
TOR UNTIL EITHER THE ESTABLISHED OPERATOR CAN RESUME PROGRAM OPERATIONS
OR UNTIL THE PATIENTS ARE APPROPRIATELY TRANSFERRED TO OTHER PROGRAMS
LICENSED OR OPERATED BY THE OFFICE.
S. 6407 47 A. 9007
(4) THE ESTABLISHED OPERATOR SHALL GRANT ACCESS TO THE TEMPORARY OPER-
ATOR TO THE ESTABLISHED OPERATOR'S ACCOUNTS AND RECORDS IN ORDER TO
ADDRESS ANY DEFICIENCIES RELATED TO A MENTAL HEALTH PROGRAM EXPERIENCING
SERIOUS FINANCIAL INSTABILITY OR AN ESTABLISHED OPERATOR REQUESTING
FINANCIAL ASSISTANCE IN ACCORDANCE WITH THIS SECTION. THE TEMPORARY
OPERATOR SHALL APPROVE ANY FINANCIAL DECISION RELATED TO A PROGRAM'S DAY
TO DAY OPERATIONS OR PROGRAM'S ABILITY TO PROVIDE MENTAL HEALTH
SERVICES.
(5) THE TEMPORARY OPERATOR SHALL NOT BE REQUIRED TO FILE ANY BOND. NO
SECURITY INTEREST IN ANY REAL OR PERSONAL PROPERTY COMPRISING THE ESTAB-
LISHED OPERATOR OR CONTAINED WITHIN THE ESTABLISHED OPERATOR OR IN ANY
FIXTURE OF THE MENTAL HEALTH PROGRAM, SHALL BE IMPAIRED OR DIMINISHED IN
PRIORITY BY THE TEMPORARY OPERATOR. NEITHER THE TEMPORARY OPERATOR NOR
THE OFFICE SHALL ENGAGE IN ANY ACTIVITY THAT CONSTITUTES A CONFISCATION
OF PROPERTY.
(D) THE TEMPORARY OPERATOR SHALL BE ENTITLED TO A REASONABLE FEE, AS
DETERMINED BY THE COMMISSIONER AND SUBJECT TO THE APPROVAL OF THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, AND NECESSARY EXPENSES INCURRED WHILE
SERVING AS A TEMPORARY OPERATOR. THE TEMPORARY OPERATOR SHALL BE LIABLE
ONLY IN ITS CAPACITY AS TEMPORARY OPERATOR OF THE MENTAL HEALTH PROGRAM
FOR INJURY TO PERSON AND PROPERTY BY REASON OF ITS OPERATION OF SUCH
PROGRAM; NO LIABILITY SHALL INCUR IN THE TEMPORARY OPERATOR'S PERSONAL
CAPACITY, EXCEPT FOR GROSS NEGLIGENCE AND INTENTIONAL ACTS.
(E) (1) THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR
SHALL NOT EXCEED NINETY DAYS. AFTER NINETY DAYS, IF THE COMMISSIONER
DETERMINES THAT TERMINATION OF THE TEMPORARY OPERATOR WOULD CAUSE
SIGNIFICANT DETERIORATION OF THE QUALITY OF, OR ACCESS TO, MENTAL HEALTH
CARE IN THE COMMUNITY OR THAT REAPPOINTMENT IS NECESSARY TO CORRECT THE
DEFICIENCIES THAT REQUIRED THE APPOINTMENT OF THE TEMPORARY OPERATOR,
THE COMMISSIONER MAY AUTHORIZE AN ADDITIONAL NINETY-DAY TERM. HOWEVER,
SUCH AUTHORIZATION SHALL INCLUDE THE COMMISSIONER'S REQUIREMENTS FOR
CONCLUSION OF THE TEMPORARY OPERATORSHIP TO BE SATISFIED WITHIN THE
ADDITIONAL TERM.
(2) 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:
A. THE ACTIONS TAKEN DURING THE APPOINTMENT TO ADDRESS THE IDENTIFIED
MENTAL HEALTH PROGRAM DEFICIENCIES, THE RESUMPTION OF MENTAL HEALTH
PROGRAM OPERATIONS BY THE ESTABLISHED OPERATOR, OR THE TRANSFER OF THE
PATIENTS TO OTHER PROVIDERS LICENSED OR OPERATED BY THE OFFICE;
B. OBJECTIVES FOR THE CONTINUATION OF THE TEMPORARY OPERATORSHIP IF
NECESSARY AND A SCHEDULE FOR SATISFACTION OF SUCH OBJECTIVES; AND
C. IF APPLICABLE, THE RECOMMENDED ACTIONS FOR THE ONGOING OPERATION OF
THE MENTAL HEALTH PROGRAM SUBSEQUENT TO THE TEMPORARY OPERATORSHIP.
(3) 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.
(F) (1) THE COMMISSIONER SHALL, UPON MAKING A DETERMINATION OF AN
INTENTION TO APPOINT A TEMPORARY OPERATOR PURSUANT TO PARAGRAPH ONE OF
SUBDIVISION (B) OF THIS SECTION CAUSE THE ESTABLISHED OPERATOR 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 UNDERLYING THE
INTENTION TO APPOINT A TEMPORARY OPERATOR, AND THE DATE AND TIME OF A
S. 6407 48 A. 9007
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, THE COMMISSIONER AND THE ESTAB-
LISHED OPERATOR SHALL ATTEMPT TO DEVELOP A MUTUALLY SATISFACTORY PLAN OF
CORRECTION AND SCHEDULE FOR IMPLEMENTATION. IN SUCH EVENT, THE COMMIS-
SIONER SHALL NOTIFY THE ESTABLISHED OPERATOR THAT THE COMMISSIONER WILL
ABSTAIN FROM APPOINTING A TEMPORARY OPERATOR CONTINGENT UPON THE ESTAB-
LISHED OPERATOR REMEDIATING THE IDENTIFIED DEFICIENCIES WITHIN THE
AGREED UPON TIMEFRAME.
(2) SHOULD THE COMMISSIONER AND THE ESTABLISHED OPERATOR BE UNABLE TO
ESTABLISH A PLAN OF CORRECTION PURSUANT TO PARAGRAPH ONE 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 THIRTY 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
TEMPORARY OPERATOR IS SUPPORTED BY SUBSTANTIAL EVIDENCE. A COPY OF THE
DECISION SHALL BE SENT TO THE ESTABLISHED OPERATOR.
(3) IF THE DECISION TO APPOINT A TEMPORARY OPERATOR IS UPHELD SUCH
TEMPORARY OPERATOR SHALL BE APPOINTED AS SOON AS IS PRACTICABLE AND
SHALL OPERATE THE MENTAL HEALTH PROGRAM PURSUANT TO THE PROVISIONS OF
THIS SECTION.
(G) NOTWITHSTANDING THE APPOINTMENT OF A TEMPORARY OPERATOR, THE
ESTABLISHED OPERATOR SHALL REMAIN OBLIGATED FOR THE CONTINUED OPERATION
OF THE MENTAL HEALTH PROGRAM SO THAT SUCH PROGRAM CAN FUNCTION IN A
NORMAL MANNER. 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 OF THE PROGRAM HEREUNDER;
NOR SHALL ANYTHING CONTAINED IN THIS SECTION BE CONSTRUED TO SUSPEND
DURING THE TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR OF THE
PROGRAM ANY OBLIGATION OF THE ESTABLISHED OPERATOR OR ANY OTHER PERSON
FOR THE MAINTENANCE AND REPAIR OF THE FACILITY, PROVISION OF UTILITY
SERVICES, 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 3. This act shall take effect immediately.
PART M
Section 1. Subdivision (d) of section 33.13 of the mental hygiene law,
as amended by section 3 of part E of chapter 111 of the laws of 2010, is
amended to read as follows:
(d) Nothing in this section shall prevent the electronic or other
exchange of information concerning patients or clients, including iden-
tification, between and among (i) facilities or others providing
services for such patients or clients pursuant to an approved local
services plan, as defined in article forty-one of this chapter, or
pursuant to agreement with the department, and (ii) the department or
any of its licensed or operated facilities. NEITHER SHALL ANYTHING IN
THIS SECTION PREVENT THE EXCHANGE OF INFORMATION CONCERNING PATIENTS OR
CLIENTS, INCLUDING IDENTIFICATION, BETWEEN FACILITIES AND MANAGED CARE
ORGANIZATIONS, BEHAVIORAL HEALTH ORGANIZATIONS, HEALTH HOMES OR OTHER
S. 6407 49 A. 9007
ENTITIES AUTHORIZED BY THE DEPARTMENT OR THE DEPARTMENT OF HEALTH TO
PROVIDE, ARRANGE FOR OR COORDINATE HEALTH CARE SERVICES FOR SUCH
PATIENTS OR CLIENTS WHO ARE ENROLLED IN OR RECEIVING SERVICES FROM SUCH
ORGANIZATIONS OR ENTITIES. Furthermore, subject to the prior approval of
the commissioner of mental health, hospital emergency services licensed
pursuant to article twenty-eight of the public health law shall be
authorized to exchange information concerning patients or clients elec-
tronically or otherwise with other hospital emergency services licensed
pursuant to article twenty-eight of the public health law and/or hospi-
tals licensed or operated by the office of mental health; provided that
such exchange of information is consistent with standards, developed by
the commissioner of mental health, which are designed to ensure confi-
dentiality of such information. Additionally, information so exchanged
shall be kept confidential and any limitations on the release of such
information imposed on the party giving the information shall apply to
the party receiving the information.
S 2. Subdivision (d) of section 33.13 of the mental hygiene law, as
amended by section 4 of part E of chapter 111 of the laws of 2010, is
amended to read as follows:
(d) Nothing in this section shall prevent the exchange of information
concerning patients or clients, including identification, between (i)
facilities or others providing services for such patients or clients
pursuant to an approved local services plan, as defined in article
forty-one, or pursuant to agreement with the department and (ii) the
department or any of its facilities. NEITHER SHALL ANYTHING IN THIS
SECTION PREVENT THE EXCHANGE OF INFORMATION CONCERNING PATIENTS OR
CLIENTS, INCLUDING IDENTIFICATION, BETWEEN FACILITIES AND MANAGED CARE
ORGANIZATIONS, BEHAVIORAL HEALTH ORGANIZATIONS, HEALTH HOMES OR OTHER
ENTITIES AUTHORIZED BY THE DEPARTMENT OR THE DEPARTMENT OF HEALTH TO
PROVIDE, ARRANGE FOR OR COORDINATE HEALTH CARE SERVICES FOR SUCH
PATIENTS OR CLIENTS WHO ARE ENROLLED IN OR RECEIVING SERVICES FOR SUCH
ORGANIZATIONS OR ENTITIES. Information so exchanged shall be kept confi-
dential and any limitations on the release of such information imposed
on the party giving the information shall apply to the party receiving
the information.
S 3. This act shall take effect immediately; provided that the amend-
ments to subdivision (d) of section 33.13 of the mental hygiene law made
by section one of this act shall be subject to the expiration and rever-
sion of such subdivision pursuant to section 18 of chapter 408 of the
laws of 1999, as amended, when upon such date the provisions of section
two of this act shall take effect.
PART N
Section 1. Subdivision 10 of section 3 of section 1 of chapter 359 of
the laws of 1968, constituting the facilities development corporation
act, as amended by chapter 723 of the laws of 1993, is amended to read
as follows:
10. "Mental hygiene facility" shall mean a building, a unit within a
building, a laboratory, a classroom, a housing unit, a dining hall, an
activities center, a library, real property of any kind or description,
or any structure on or improvement to real property, or an interest in
real property, of any kind or description, owned by or under the juris-
diction of the corporation, including fixtures and equipment which are
an integral part of any such building, unit, structure or improvement, a
walkway, a roadway or a parking lot, and improvements and connections
S. 6407 50 A. 9007
for water, sewer, gas, electrical, telephone, heating, air conditioning
and other utility services, or a combination of any of the foregoing,
whether for patient care and treatment or staff, staff family or service
use, located at or related to any psychiatric center, any developmental
center, or any state psychiatric or research institute or other facility
now or hereafter established under the department. A mental hygiene
facility shall also mean and include a residential care center for
adults, a "community mental health and retardation facility" and a
treatment facility for use in the conduct of an alcoholism or substance
abuse treatment program as defined in the mental hygiene law unless such
residential care center for adults, community mental health and retarda-
tion facility or alcoholism or substance abuse facility is expressly
excepted, or the context clearly requires otherwise, AND SHALL ALSO MEAN
AND INCLUDE ANY TREATMENT FACILITY FOR USE IN THE CONDUCT OF AN ALCOHOL-
ISM OR SUBSTANCE ABUSE TREATMENT PROGRAM THAT IS ALSO OPERATED AS AN
ASSOCIATED HEALTH CARE FACILITY. The definition contained in this subdi-
vision shall not be construed to exclude therefrom a facility owned or
leased by one or more voluntary agencies that is to be financed, refi-
nanced, designed, constructed, acquired, reconstructed, rehabilitated or
improved under any lease, sublease, loan or other financing agreement
entered into with such voluntary agencies, and shall not be construed to
exclude therefrom a facility to be made available from the corporation
to a voluntary agency at the request of the commissioners of the offices
of the department having jurisdiction thereof. The definition contained
in this subdivision shall not be construed to exclude therefrom a facil-
ity with respect to which a voluntary agency has an ownership interest
in, and proprietary lease from, an organization formed for the purpose
of the cooperative ownership of real estate.
S 2. Section 3 of section 1 of chapter 359 of the laws of 1968,
constituting the facilities development corporation act, is amended by
adding a new subdivision 20 to read as follows:
20. "ASSOCIATED HEALTH CARE FACILITY" SHALL MEAN A FACILITY LICENSED
UNDER AND OPERATED PURSUANT TO ARTICLE 28 OF THE PUBLIC HEALTH LAW OR
ANY HEALTH CARE FACILITY LICENSED UNDER AND OPERATED IN ACCORDANCE WITH
ANY OTHER PROVISIONS OF THE PUBLIC HEALTH LAW OR THE MENTAL HYGIENE LAW
THAT PROVIDES HEALTH CARE SERVICES AND/OR TREATMENT TO ALL PERSONS,
REGARDLESS OF WHETHER SUCH PERSONS ARE PERSONS RECEIVING TREATMENT OR
SERVICES FOR ALCOHOL, SUBSTANCE ABUSE, OR CHEMICAL DEPENDENCY.
S 3. 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 N of this act shall be
as specifically set forth in the last section of such Parts.
2015-A9007A - Details
- See Senate Version of this Bill:
- S6407
- Law Section:
- Budget Bills
- Laws Affected:
- Amd Various Laws, generally
2015-A9007A - Summary
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2016-2017 state fiscal year; intentionally omitted (Part A); amends the social services law, in relation to facilitating supplemental rebates for fee-for-service pharmaceuticals, and ambulance medical transportation rate adequacy review; amends the social services law, in relation to authorizing the commissioner of health to apply federally established consumer price index penalties for generic drugs, and authorizing the commissioner of health to impose penalties on managed care plans for reporting late or incorrect encounter data
2015-A9007A - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
S. 6407--A A. 9007--A
S E N A T E - A S S E M B L Y
January 14, 2016
___________
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 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 the expenditure cap for the
medical assistance program for needy persons (Part A); to amend the
social services law, in relation to provisions relating to transporta-
tion in the managed long term care program; to amend the public health
law, in relation to restricting the managed long term care benefit to
those who are nursing home eligible; to amend the social services law,
in relation to conforming with federal law provisions relating to
spousal contributions, community spouse resource budgeting; to amend
the social services law, in relation to authorizing price ceilings on
blockbuster drugs and reducing reimbursement rates for specialty
drugs; to amend the public health law, in relation to expanding prior
authorization for the clinical drug review program and eliminating
prescriber prevails; to amend the social services law, in relation to
authorizing the commissioner of health to apply federally established
consumer price index penalties for generic drugs, to facilitate
supplemental rebates for fee-for-service pharmaceuticals, to apply
prior authorization requirements for opioid drugs, to impose penalties
on managed care plans for reporting late or incorrect encounter data,
to apply cost sharing limits to medicare Part C claims and to author-
ize funding for the criminal justice pilot program within health home
rates; to amend chapter 59 of the laws of 2011, amending the public
health law and other laws relating to known and projected department
of health state fund Medicaid expenditures, in relation to extending
the expiration of certain provisions thereof; and to repeal certain
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD12671-02-6
S. 6407--A 2 A. 9007--A
provisions of the social services law relating to the authorization of
prescriber prevails in the managed care program (Part B); 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 apportioning premium for certain policies; and
to amend part J of chapter 63 of the laws of 2001 amending chapter 266
of the laws of 1986, amending the civil practice law and rules and
other laws relating to malpractice and professional medical conduct,
in relation to extending certain provisions concerning the hospital
excess liability pool (Part C); to amend chapter 474 of the laws of
1996, amending the education law and other laws relating to rates for
residential healthcare facilities, in relation to extending the
authority of the department of health to make disproportionate share
payments to public hospitals outside of New York City; to amend chap-
ter 649 of the laws of 1996, amending the public health law, the
mental hygiene law and the social services law relating to authorizing
the establishment of special needs plans, in relation to the effec-
tiveness thereof; to repeal subdivision 8 of section 84 of part A of
chapter 56 of the laws of 2013, amending the public health law and
other laws relating to general hospital reimbursement for annual
rates, relating to the effectiveness thereof; to repeal subdivision
(f) of section 129 of part C of chapter 58 of the laws of 2009, amend-
ing the public health law relating to payment by governmental agencies
for general hospital inpatient services, relating to the effectiveness
thereof; and to repeal subdivision (c) of section 122 of part E of
chapter 56 of the laws of 2013, amending the public health law relat-
ing to the general public health work program, relating to the effec-
tiveness thereof (Part D); to amend the public health law and the
insurance law, in relation to the early intervention program for
infants and toddlers with disabilities and their families (Part E); to
amend the public health law, in relation to the health care facility
transformation program (Part F); to amend the public health law, in
relation to authorizing the establishment of limited service clinics
(Part G); to amend 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, in relation
to the effectiveness thereof (Part H); 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 of certain provisions thereof (Part I); to amend chapter
420 of the laws of 2002 amending the education law relating to the
profession of social work, in relation to extending the expiration of
certain provisions thereof; to amend chapter 676 of the laws of 2002
amending the education law relating to the practice of psychology, in
relation to extending the expiration of certain provisions; and to
amend chapter 130 of the laws of 2010 amending the education law and
other laws relating to registration of entities providing certain
professional services and licensure of certain professions, in
relation to extending certain provisions thereof (Part J); to amend
the criminal procedure law, in relation to authorizing restorations to
competency within correctional facility based residential settings
(Part K); to amend the mental hygiene law, in relation to the appoint-
ment of temporary operators for the continued operation of programs
and the provision of services for persons with serious mental illness
and/or developmental disabilities; and to amend the social services
law, in relation to the powers and duties of the commissioner of
S. 6407--A 3 A. 9007--A
social services (Part L); to amend the mental hygiene law, in relation
to sharing clinical records with managed care organizations (Part M);
and to amend the facilities development corporation act, in relation
to the definition of mental hygiene facility (Part N)
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 2016-2017
state fiscal year. Each component is wholly contained within a Part
identified as Parts A through N. 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. 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, subdivision (a) as amended by
section 3-e of part B of chapter 58 of the laws of 2010, subdivision (b)
as amended by section 24 of part B of chapter 109 of the laws of 2010,
subdivision (c-1) as added by section 1 of part F of chapter 56 of the
laws of 2012, subdivision (f) as amended by section 23 of part B of
chapter 109 of the laws of 2010, paragraph (iii) of subdivision (g) as
amended by section 2 of part F of chapter 56 of the laws of 2012, subdi-
vision (h) as added by section 61 of part D of chapter 56 of the laws of
2012, is amended to read as follows:
Section 1. (a) Notwithstanding the provisions of section 368-a of the
social services law, or any other provision of law, the department of
health shall provide reimbursement for expenditures made by or on behalf
of social services districts for medical assistance for needy persons,
and the administration thereof, in accordance with the provisions of
this section; provided, however, that this section shall not apply to
amounts expended for health care services under FORMER section 369-ee of
the social services law, which amounts shall be reimbursed in accordance
with paragraph (t) of subdivision 1 of section 368-a of such law and
shall be excluded from all calculations made pursuant to this section;
and provided further that amounts paid to the public hospitals pursuant
to subdivision 14-f of section 2807-c of the public health law and
amounts expended pursuant to: subdivision 12 of section 2808 of the
public health law; sections 211 and 212 of chapter 474 of the laws of
1996, as amended; and sections 11 through 14 of part A and sections 13
and 14 of part B of chapter 1 of the laws of 2002; and amounts paid to
public diagnostic and treatment centers as provided in sections 3-a and
3-b of part B of [the] chapter 58 of the laws of 2010 [which amended
this subdivision], amounts paid to public general hospitals as certified
public expenditures as provided in section 3-c of part B of [the] chap-
ter 58 of the laws of 2010 [which amended this subdivision], and amounts
S. 6407--A 4 A. 9007--A
paid to managed care providers pursuant to section 3-d of part B of
[the] chapter 58 of the laws of 2010 [which amended this subdivision],
shall be excluded from all calculations made pursuant to this section.
(b) Commencing with the period April 1, 2005 though March 31, 2006, a
social services district's yearly net share of medical assistance
expenditures shall be calculated in relation to a reimbursement base
year which, for purposes of this section, is defined as January 1, 2005
through December 31, 2005. The final base year expenditure calculation
for each social services district shall be made by the commissioner of
health, and approved by the director of the division of the budget, no
later than June 30, 2006. Such calculations shall be based on actual
expenditures made by or on behalf of social services districts, and
revenues received by social services districts, during the base year and
shall be made without regard to expenditures made, and revenues
received, outside the base year that are related to services provided
during, or prior to, the base year. Such base year calculations shall be
based on the social services district medical assistance shares
provisions in effect on January 1, 2005. Subject to the provisions of
subdivision four of section six of this part, the state/local social
services district relative percentages of the non-federal share of
medical assistance expenditures incurred prior to January 1, 2006 shall
not be subject to adjustment on and after July 1, 2006.
(c) Commencing with the calendar year beginning January 1, 2006,
calendar year social services district medical assistance expenditure
amounts for each social services district shall be calculated by multi-
plying the results of the calculations performed pursuant to paragraph
(b) of this section by a non-compounded trend factor, as follows:
(i) 2006 (January 1, 2006 through December 31, 2006): 3.5%;
(ii) 2007 (January 1, 2007 through December 31, 2007): 6.75% (3.25%
plus the prior year's 3.5%);
(iii) 2008 (January 1, 2008 through December 31, 2008): 9.75% (3%
plus the prior year's 6.75%);
(iv) 2009 (January 1, 2009 through December 31, 2009), and each
succeeding calendar year: prior year's trend factor percentage plus 3%.
(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%.
(C-2) NOTWITHSTANDING ANY PROVISIONS OF SUBDIVISION (C-1) OF THIS
SECTION TO THE CONTRARY, EFFECTIVE APRIL 1, 2016, FOR THE PERIOD JANUARY
1, 2016 THROUGH DECEMBER 31, 2016 AND FOR EACH CALENDAR YEAR THEREAFTER,
THE MEDICAL ASSISTANCE EXPENDITURE AMOUNT FOR A SOCIAL SERVICES DISTRICT
HAVING A POPULATION OF MORE THAN FIVE MILLION SHALL BE EQUAL TO THE
AMOUNT CALCULATED PURSUANT TO SUBDIVISIONS (B) AND (C) OF THIS SECTION.
(d) The base year expenditure amounts calculated pursuant to paragraph
(b) of this section and the calendar year social services district
expenditure amounts calculated pursuant to paragraph (c) of this section
shall be converted into state fiscal year social services district
S. 6407--A 5 A. 9007--A
expenditure cap amounts for each social services district such that each
such state fiscal year amount is proportional to the portions of the two
calendar years within each fiscal year, as follows:
(i) fiscal year 2005-2006 (April 1, 2005 through March 31, 2006): 75%
of the base year amount plus 25% of the 2006 calendar year amount;
(ii) fiscal year 2006-2007 (April 1, 2006 through March 31, 2007): 75%
of the 2006 year calendar amount plus 25% of the 2007 calendar year
amount;
(iii) each succeeding fiscal year: 75% of the first calendar year
within that fiscal year's amount plus 25% of the second calendar year
within that fiscal year's amount.
(D-1) NOTWITHSTANDING ANY PROVISIONS OF SUBDIVISION (D) OF THIS
SECTION TO THE CONTRARY, FOR FISCAL YEARS 2015-2016 AND 2016-2017, THE
BASE YEAR EXPENDITURE AMOUNT CALCULATED PURSUANT TO PARAGRAPH (B) OF
THIS SECTION AND THE CALENDAR YEAR SOCIAL SERVICES DISTRICT EXPENDITURE
AMOUNT CALCULATED PURSUANT TO PARAGRAPH (C) OF THIS SECTION SHALL BE
CONVERTED INTO A STATE FISCAL YEAR SOCIAL SERVICES DISTRICT EXPENDITURE
CAP AMOUNT FOR A SOCIAL SERVICES DISTRICT HAVING A POPULATION OF MORE
THAN FIVE MILLION AS FOLLOWS:
(I) FISCAL YEAR 2015-2016 (APRIL 1, 2015 THROUGH MARCH 31, 2016): 75%
OF THE 2015 BASE YEAR AMOUNT PLUS 25% OF THE 2016 CALENDAR YEAR AMOUNT,
IF SUCH 2016 CALENDAR YEAR AMOUNT WERE CALCULATED WITHOUT REGARD TO THE
PROVISIONS OF SUBDIVISION (C-2) OF THIS SECTION;
(II) FISCAL YEAR 2016-2017 (APRIL 1, 2016 THROUGH MARCH 31, 2017): 75%
OF THE 2016 BASE YEAR AMOUNT PLUS 25% OF THE 2017 CALENDAR YEAR AMOUNT;
THIS CAP AMOUNT SHALL BE REDUCED BY ONE-HALF OF THE DIFFERENCE BETWEEN
THIS AMOUNT AND THE CAP AMOUNT FOR THIS PERIOD THAT WOULD RESULT IF
CALCULATED WITHOUT REGARD TO THE PROVISIONS OF SUBDIVISION (C-2) OF THIS
SECTION.
(e) No later than April 1, 2007, the commissioner of health shall
certify the 2006-2007 fiscal year social services district expenditure
cap amounts for each social services district calculated pursuant to
subparagraph (ii) of paragraph (d) of this section and shall communicate
such amounts to the commissioner of taxation and finance.
(f) Subject to paragraph (g) of this section, the state fiscal year
social services district expenditure cap amount calculated for each
social services district pursuant to paragraph (d) of this section shall
be allotted to each district during that fiscal year and paid to the
department in equal weekly amounts in a manner to be determined by the
commissioner and communicated to such districts and, subject to the
provisions of subdivision four of section six of this part, shall repre-
sent each district's maximum responsibility for medical assistance
expenditures governed by this section. HOWEVER, FOR FISCAL YEAR
2016-2017, THE EXPENDITURE CAP AMOUNT CALCULATED FOR A SOCIAL SERVICES
DISTRICT HAVING A POPULATION OF MORE THAN FIVE MILLION SHALL BE PAID TO
THE DEPARTMENT IN WEEKLY AMOUNTS IN A MANNER TO BE DETERMINED BY THE
COMMISSIONER, IN CONSULTATION WITH THE DIRECTOR OF THE DIVISION OF THE
BUDGET, AND COMMUNICATED TO SUCH DISTRICT.
(g) (i) No allotment pursuant to paragraph (f) of this section shall
be applied against a social services district during the period April 1,
2005 through December 31, 2005. Social services district medical
assistance shares shall be determined for such period pursuant to shares
provisions in effect on January 1, 2005.
(ii) For the period January 1, 2006 through June 30, 2006, the commis-
sioner is authorized to allot against each district an amount based on
the commissioner's best estimate of the final base year expenditure
S. 6407--A 6 A. 9007--A
calculation required by paragraph (b) of this section. Upon completion
of such calculation, the commissioner shall, no later than December 31,
2006, reconcile such estimated allotments with the fiscal year social
services district expenditure cap amounts calculated pursuant to subpar-
agraphs (i) and (ii) of paragraph (d) of this section.
(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.
(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 2. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2016.
PART B
Section 1. Subdivision 4 of section 365-h of the social services law,
as separately amended by section 50 of part B and section 24 of part D
of chapter 57 of the laws of 2015, is amended to read as follows:
4. The commissioner of health is authorized to assume responsibility
from a local social services official for the provision and reimburse-
ment of transportation costs under this section. If the commissioner
elects to assume such responsibility, the commissioner shall notify the
local social services official in writing as to the election, the date
upon which the election shall be effective and such information as to
transition of responsibilities as the commissioner deems prudent. The
S. 6407--A 7 A. 9007--A
commissioner is authorized to contract with a transportation manager or
managers to manage transportation services in any local social services
district[, other than transportation services provided or arranged for
enrollees of managed long term care plans issued certificates of author-
ity under section forty-four hundred three-f of the public health law].
Any transportation manager or managers selected by the commissioner to
manage transportation services shall have proven experience in coordi-
nating transportation services in a geographic and demographic area
similar to the area in New York state within which the contractor would
manage the provision of services under this section. Such a contract or
contracts may include responsibility for: review, approval and process-
ing of transportation orders; management of the appropriate level of
transportation based on documented patient medical need; and development
of new technologies leading to efficient transportation services. If the
commissioner elects to assume such responsibility from a local social
services district, the commissioner shall examine and, if appropriate,
adopt quality assurance measures that may include, but are not limited
to, global positioning tracking system reporting requirements and
service verification mechanisms. Any and all reimbursement rates devel-
oped by transportation managers under this subdivision shall be subject
to the review and approval of the commissioner.
S 2. Subparagraph (i) of paragraph (b) of subdivision 7 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:
(i) The commissioner shall, to the extent necessary, submit the appro-
priate waivers, including, but not limited to, those authorized pursuant
to sections eleven hundred fifteen and nineteen hundred fifteen of the
federal social security act, or successor provisions, and any other
waivers necessary to achieve the purposes of high quality, integrated,
and cost effective care and integrated financial eligibility policies
under the medical assistance program or pursuant to title XVIII of the
federal social security act. In addition, the commissioner is authorized
to submit the appropriate waivers, including but not limited to those
authorized pursuant to sections eleven hundred fifteen and nineteen
hundred fifteen of the federal social security act or successor
provisions, and any other waivers necessary to require on or after April
first, two thousand twelve, medical assistance recipients who are twen-
ty-one years of age or older and who require community-based long term
care services, as specified by the commissioner, for more than one
hundred and twenty days, to receive such services through an available
plan certified pursuant to this section or other program model that
meets guidelines specified by the commissioner that support coordination
and integration of services; PROVIDED, HOWEVER, THAT THE COMMISSIONER
MAY, THROUGH SUCH WAIVERS, LIMIT ELIGIBILITY TO AVAILABLE PLANS TO
ENROLLEES THAT REQUIRE NURSING FACILITY LEVEL OF CARE. NOTWITHSTANDING
THE FOREGOING, MEDICAL ASSISTANCE RECIPIENTS ENROLLED IN A MANAGED LONG
TERM CARE PLAN ON APRIL FIRST, TWO THOUSAND SIXTEEN MAY CONTINUE TO BE
ELIGIBLE FOR SUCH PLANS, IRRESPECTIVE OF WHETHER THE ENROLLEE MEETS ANY
APPLICABLE NURSING FACILITY LEVEL OF CARE REQUIREMENTS, PROVIDED, HOWEV-
ER, THAT ONCE SUCH RECIPIENTS ARE DISENROLLED FROM THEIR MANAGED LONG
TERM CARE PLAN, ANY APPLICABLE NURSING FACILITY LEVEL OF CARE REQUIRE-
MENTS WOULD APPLY TO FUTURE ELIGIBILITY DETERMINATIONS. Such guidelines
shall address the requirements of paragraphs (a), (b), (c), (d), (e),
(f), (g), (h), and (i) of subdivision three of this section as well as
payment methods that ensure provider accountability for cost effective
quality outcomes. Such other program models may include long term home
S. 6407--A 8 A. 9007--A
health care programs that comply with such guidelines. Copies of such
original waiver applications and amendments thereto shall be provided to
the chairs of the senate finance committee, the assembly ways and means
committee and the senate and assembly health committees simultaneously
with their submission to the federal government.
S 3. 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
such relative in accordance with title six of article three OF THIS
CHAPTER and other applicable provisions of law.
S 4. Subparagraph (i) of paragraph (d) of subdivision 2 of section
366-c of the social services law is amended by adding a new clause (C)
to read as follows:
(C) ON AND AFTER JULY FIRST, TWO THOUSAND SIXTEEN, TWENTY-THREE THOU-
SAND EIGHT HUNDRED FORTY-FOUR DOLLARS OR SUCH GREATER AMOUNT AS MAY BE
REQUIRED UNDER FEDERAL LAW;
S 5. Subdivision 7 of section 367-a of the social services law is
amended by adding a new paragraph (g) to read as follows:
(G)(I) THE DEPARTMENT SHALL DEVELOP A LIST OF CRITICAL PRESCRIPTION
DRUGS FOR WHICH THERE IS A SIGNIFICANT PUBLIC INTEREST IN ENSURING
RATIONAL PRICING BY DRUG MANUFACTURERS. IN SELECTING DRUGS FOR POSSIBLE
INCLUSION IN SUCH LIST, FACTORS TO BE CONSIDERED BY THE DEPARTMENT SHALL
INCLUDE, BUT NOT BE LIMITED TO: THE SERIOUSNESS AND PREVALENCE OF THE
DISEASE OR CONDITION THAT IS TREATED BY THE DRUG; THE EXTENT OF UTILIZA-
TION OF THE DRUG; THE AVERAGE WHOLESALE PRICE AND RETAIL PRICE OF THE
DRUG; THE NUMBER OF PHARMACEUTICAL MANUFACTURERS THAT PRODUCE THE DRUG;
WHETHER THERE ARE PHARMACEUTICAL EQUIVALENTS TO THE DRUG; AND THE POTEN-
TIAL IMPACT OF THE COST OF THE DRUG ON PUBLIC HEALTH CARE PROGRAMS,
INCLUDING MEDICAID.
(II) FOR EACH PRESCRIPTION DRUG INCLUDED ON THE CRITICAL PRESCRIPTION
DRUG LIST, THE DEPARTMENT SHALL REQUIRE THE MANUFACTURERS OF SAID
PRESCRIPTION DRUG TO REPORT THE FOLLOWING INFORMATION:
(A) THE ACTUAL COST OF DEVELOPING, MANUFACTURING, PRODUCING (INCLUDING
THE COST PER DOSE OF PRODUCTION), AND DISTRIBUTING SUCH DRUG;
(B) RESEARCH AND DEVELOPMENT COSTS OF THE DRUG INCLUDING PAYMENTS TO
PREDECESSOR ENTITIES CONDUCTING RESEARCH AND DEVELOPMENT, INCLUDING BUT
NOT LIMITED TO BIOTECHNOLOGY COMPANIES, UNIVERSITIES AND MEDICAL
SCHOOLS, AND PRIVATE RESEARCH INSTITUTIONS;
(C) ADMINISTRATIVE, MARKETING, AND ADVERTISING COSTS FOR THE DRUG,
APPORTIONED BY MARKETING ACTIVITIES THAT ARE DIRECTED TO CONSUMERS,
MARKETING ACTIVITIES THAT ARE DIRECTED TO PRESCRIBERS, AND THE TOTAL
COST OF ALL MARKETING AND ADVERTISING THAT IS DIRECTED PRIMARILY TO
CONSUMERS AND PRESCRIBERS IN NEW YORK, INCLUDING BUT NOT LIMITED TO
PRESCRIBER DETAILING, COPAYMENT DISCOUNT PROGRAMS AND DIRECT TO CONSUMER
MARKETING;
(D) PRICES FOR THE DRUG THAT ARE CHARGED TO PURCHASERS OUTSIDE THE
UNITED STATES;
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(E) PRICES CHARGED TO TYPICAL PURCHASERS IN NEW YORK, INCLUDING BUT
NOT LIMITED TO PHARMACIES, PHARMACY CHAINS, PHARMACY WHOLESALERS OR
OTHER DIRECT PURCHASERS;
(F) THE AVERAGE REBATES AND DISCOUNTS PROVIDED PER PAYOR TYPE;
(G) THE AVERAGE PROFIT MARGIN OF EACH DRUG OVER THE PRIOR FIVE YEAR
PERIOD AND THE PROJECTED PROFIT MARGIN ANTICIPATED FOR SUCH DRUG; AND
(H) CLINICAL INFORMATION INCLUDING BUT NOT LIMITED TO CLINICAL TRIALS
AND CLINICAL OUTCOMES RESEARCH.
(III) THE DEPARTMENT SHALL DEVELOP A STANDARD REPORTING FORM THAT
SATISFIES THE REQUIREMENTS OF SUBPARAGRAPH (II) OF THIS PARAGRAPH.
MANUFACTURERS SHALL PROVIDE THE REQUIRED INFORMATION WITHIN NINETY DAYS
OF THE DEPARTMENT'S REQUEST. ALL INFORMATION DISCLOSED PURSUANT TO
SUBPARAGRAPH (II) OF THIS PARAGRAPH IS CONFIDENTIAL AND SHALL NOT BE
DISCLOSED BY THE DEPARTMENT OR ITS ACTUARY IN A FORM THAT DISCLOSES THE
IDENTITY OF A SPECIFIC MANUFACTURER, OR PRICES CHARGED FOR DRUGS BY SUCH
MANUFACTURER, EXCEPT AS THE COMMISSIONER DETERMINES IS NECESSARY TO
CARRY OUT THE PROVISIONS OF THIS SECTION, OR TO ALLOW THE DEPARTMENT,
THE ATTORNEY GENERAL, THE STATE COMPTROLLER, OR THE CENTERS FOR MEDICARE
AND MEDICAID SERVICES TO PERFORM AUDITS OR INVESTIGATIONS AUTHORIZED BY
LAW.
(IV) FOR EACH CRITICAL PRESCRIPTION DRUG IDENTIFIED BY THE DEPARTMENT,
THE DEPARTMENT SHALL DIRECT ITS ACTUARY TO UTILIZE THE INFORMATION
PROVIDED PURSUANT TO SUBPARAGRAPH (II) OF THIS PARAGRAPH TO CONDUCT A
VALUE-BASED ASSESSMENT OF SUCH DRUG AND ESTABLISH A REASONABLE CEILING
PRICE.
(V) THE COMMISSIONER MAY REQUIRE A DRUG MANUFACTURER TO PROVIDE
REBATES TO THE DEPARTMENT FOR A CRITICAL PRESCRIPTION DRUG WHOSE PRICE
EXCEEDS THE CEILING PRICE FOR THE DRUG ESTABLISHED BY THE DEPARTMENT'S
ACTUARY PURSUANT TO SUBPARAGRAPH (IV) OF THIS PARAGRAPH. SUCH REBATES
SHALL BE IN ADDITION TO ANY REBATES PAYABLE TO THE DEPARTMENT PURSUANT
TO ANY OTHER PROVISION OF FEDERAL OR STATE LAW. THE ADDITIONAL REBATES
AUTHORIZED PURSUANT TO THIS SUBPARAGRAPH SHALL APPLY TO CRITICAL
PRESCRIPTION DRUGS DISPENSED TO ENROLLEES OF MANAGED CARE PROVIDERS
PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE AND TO
CRITICAL PRESCRIPTION DRUGS DISPENSED TO MEDICAID RECIPIENTS WHO ARE NOT
ENROLLEES OF SUCH PROVIDERS.
S 6. Paragraph (b) of subdivision 9 of section 367-a of the social
services law is amended by adding a new subparagraph (iv) to read as
follows:
(IV) NOTWITHSTANDING SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH, IF
THE DRUG DISPENSED IS A DRUG THAT ONE OR MORE MANAGED CARE PROVIDERS
OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE
HAVE DESIGNATED AS A SPECIALTY DRUG, AN AMOUNT THAT DOES NOT EXCEED THE
AMOUNT SUCH PROVIDERS PAY FOR THE DRUG, AS DETERMINED BY THE COMMISSION-
ER BASED ON MANAGED CARE PROVIDERS' ENCOUNTER DATA FOR THE DRUG.
S 7. Section 274 of the public health law is amended by adding a new
subdivision 15 to read as follows:
15. NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION, THE
COMMISSIONER MAY REQUIRE PRIOR AUTHORIZATION FOR ANY DRUG AFTER EVALUAT-
ING THE FACTORS SET FORTH IN SUBDIVISION THREE OF THIS SECTION AND PRIOR
TO OBTAINING THE BOARD'S EVALUATION AND RECOMMENDATION REQUIRED BY
SUBDIVISION FOUR OF THIS SECTION. THE BOARD MAY RECOMMEND TO THE COMMIS-
SIONER, PURSUANT TO SUBDIVISION SIX OF THIS SECTION, THAT ANY SUCH PRIOR
AUTHORIZATION REQUIREMENT BE MODIFIED, CONTINUED OR REMOVED.
S. 6407--A 10 A. 9007--A
S 8. Paragraph (b) of subdivision 3 of section 273 of the public
health law, as added by section 10 of part C of chapter 58 of the laws
of 2005, is amended to read as follows:
(b) In the event that the patient does not meet the criteria in para-
graph (a) of this subdivision, the prescriber may provide additional
information to the program to justify the use of a prescription drug
that is not on the preferred drug list. The program shall provide a
reasonable opportunity for a prescriber to reasonably present his or her
justification of prior authorization. [If, after consultation with the
program, the prescriber, in his or her reasonable professional judgment,
determines that the use of a prescription drug that is not on the
preferred drug list is warranted, the prescriber's determination shall
be final.] THE PROGRAM WILL CONSIDER THE ADDITIONAL INFORMATION AND THE
JUSTIFICATION PRESENTED TO DETERMINE WHETHER THE USE OF A PRESCRIPTION
DRUG THAT IS NOT ON THE PREFERRED DRUG LIST IS WARRANTED. IN THE CASE OF
ATYPICAL ANTIPSYCHOTICS AND ANTIDEPRESSANTS, IF AFTER CONSULTATION WITH
THE PROGRAM, THE PRESCRIBER, IN HIS OR HER REASONABLE PROFESSIONAL JUDG-
MENT, DETERMINES THAT THE USE OF A PRESCRIPTION DRUG THAT IS NOT ON THE
PREFERRED DRUG LIST IS WARRANTED, THE PRESCRIBER'S DETERMINATION SHALL
BE FINAL.
S 9. Subdivision 25 of section 364-j of the social services law, as
added by section 55 of part D of chapter 56 of the laws of 2012, is
amended to read as follows:
25. [Effective January first, two thousand thirteen, notwithstanding]
NOTWITHSTANDING any provision of law to the contrary, managed care
providers shall cover medically necessary prescription drugs in the
atypical antipsychotic AND ANTIDEPRESSANT therapeutic [class] CLASSES,
including non-formulary drugs, upon demonstration by 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 10. Subdivision 25-a of section 364-j of the social services law is
REPEALED.
S 11. Subdivision 7 of section 367-a of the social services law is
amended by adding a new paragraph (f) to read as follows:
(F) THE COMMISSIONER MAY REQUIRE MANUFACTURERS OF DRUGS OTHER THAN
SINGLE SOURCE DRUGS AND INNOVATOR MULTIPLE SOURCE DRUGS, AS SUCH TERMS
ARE DEFINED IN 42 U.S.C. S 1396R-8(K), TO PROVIDE REBATES TO THE DEPART-
MENT FOR GENERIC DRUGS WHOSE PRICES INCREASE AT A RATE GREATER THAN THE
RATE OF INFLATION. SUCH REBATES SHALL BE IN ADDITION TO ANY REBATES
PAYABLE TO THE DEPARTMENT PURSUANT TO ANY OTHER PROVISION OF FEDERAL OR
STATE LAW. IN DETERMINING THE AMOUNT OF SUCH ADDITIONAL REBATES FOR
GENERIC DRUGS, THE COMMISSIONER MAY USE A METHODOLOGY SIMILAR TO THAT
USED BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES IN DETERMINING THE
AMOUNT OF ANY ADDITIONAL REBATES FOR SINGLE SOURCE AND INNOVATOR MULTI-
PLE SOURCE DRUGS, AS SET FORTH IN 42 U.S.C. S 1396R-8(C)(2). THE ADDI-
TIONAL REBATES AUTHORIZED PURSUANT TO THIS PARAGRAPH SHALL APPLY TO
GENERIC PRESCRIPTION DRUGS DISPENSED TO ENROLLEES OF MANAGED CARE
PROVIDERS PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE
AND TO GENERIC PRESCRIPTION DRUGS DISPENSED TO MEDICAID RECIPIENTS WHO
ARE NOT ENROLLEES OF SUCH PROVIDERS.
S 12. The opening paragraph of paragraph (e) of subdivision 7 of
section 367-a of the social services law, as added by section 1 of part
B of chapter 57 of the laws of 2015, is amended to read as follows:
During the period from April first, two thousand fifteen through March
thirty-first, two thousand seventeen, the commissioner may, in lieu of a
S. 6407--A 11 A. 9007--A
managed care provider, negotiate directly and enter into an agreement
with a pharmaceutical manufacturer for the provision of supplemental
rebates relating to pharmaceutical utilization by enrollees of managed
care providers pursuant to section three hundred sixty-four-j of this
title AND, NOTWITHSTANDING THE PROVISIONS OF SECTION TWO HUNDRED SEVEN-
TY-TWO OF THE PUBLIC HEALTH LAW OR ANY OTHER INCONSISTENT PROVISION OF
LAW, MAY ALSO NEGOTIATE DIRECTLY AND ENTER INTO SUCH AN AGREEMENT RELAT-
ING TO PHARMACEUTICAL UTILIZATION BY MEDICAL ASSISTANCE RECIPIENTS NOT
SO ENROLLED. Such rebates shall be limited to drug utilization in the
following classes: antiretrovirals approved by the FDA for the treatment
of HIV/AIDS and hepatitis C agents for which the pharmaceutical manufac-
turer has in effect a rebate agreement with the federal secretary of
health and human services pursuant to 42 U.S.C. S 1396r-8, and for which
the state has established standard clinical criteria. No agreement
entered into pursuant to this paragraph shall have an initial term or be
extended beyond March thirty-first, two thousand twenty.
S 13. Subparagraph (iv) of paragraph (e) of subdivision 7 of section
367-a of the social services law, as added by section 1 of part B of
chapter 57 of the laws of 2015, is amended to read as follows:
(iv) Nothing in this paragraph shall be construed to require a pharma-
ceutical manufacturer to enter into a supplemental rebate agreement with
the commissioner relating to pharmaceutical utilization by enrollees of
managed care providers pursuant to section three hundred sixty-four-j of
this title OR RELATING TO PHARMACEUTICAL UTILIZATION BY MEDICAL ASSIST-
ANCE RECIPIENTS NOT SO ENROLLED.
S 14. Section 364-j of the social services law is amended by adding a
new subdivision 26-a to read as follows:
26-A. MANAGED CARE PROVIDERS SHALL REQUIRE PRIOR AUTHORIZATION OF
PRESCRIPTIONS OF OPIOID ANALGESICS IN EXCESS OF FOUR PRESCRIPTIONS IN A
THIRTY-DAY PERIOD.
S 15. Section 364-j of the social services law is amended by adding a
new subdivision 32 to read as follows:
32. (A) THE COMMISSIONER MAY, IN HIS OR HER DISCRETION, APPLY PENAL-
TIES TO MANAGED CARE ORGANIZATIONS SUBJECT TO THIS SECTION AND ARTICLE
FORTY-FOUR OF THE PUBLIC HEALTH LAW FOR UNTIMELY OR INACCURATE
SUBMISSION OF ENCOUNTER DATA. FOR PURPOSES OF THIS SECTION, "ENCOUNTER
DATA" SHALL MEAN THE TRANSACTIONS REQUIRED TO BE REPORTED UNDER THE
MODEL CONTRACT. ANY PENALTY ASSESSED UNDER THIS SUBDIVISION SHALL BE
CALCULATED AS A PERCENTAGE OF THE ADMINISTRATIVE COMPONENT OF THE MEDI-
CAID PREMIUM CALCULATED BY THE DEPARTMENT.
(B) SUCH PENALTIES SHALL BE AS FOLLOWS:
(I) FOR ENCOUNTER DATA SUBMITTED OR RESUBMITTED PAST THE DEADLINES SET
FORTH IN THE MODEL CONTRACT, MEDICAID PREMIUMS SHALL BE REDUCED BY ONE
AND ONE-HALF PERCENT; AND
(II) FOR INCOMPLETE OR INACCURATE ENCOUNTER DATA THAT FAILS TO CONFORM
TO DEPARTMENT DEVELOPED BENCHMARKS FOR COMPLETENESS AND ACCURACY, MEDI-
CAID PREMIUMS SHALL BE REDUCED BY ONE-HALF PERCENT; AND
(III) FOR SUBMITTED DATA THAT RESULTS IN A REJECTION RATE IN EXCESS OF
TEN PERCENT OF DEPARTMENT DEVELOPED VOLUME BENCHMARKS, MEDICAID PREMIUMS
SHALL BE REDUCED BY ONE HALF-PERCENT.
(C) PENALTIES UNDER THIS SUBDIVISION MAY BE APPLIED TO ANY AND ALL
CIRCUMSTANCES DESCRIBED IN PARAGRAPH (B) OF THIS SUBDIVISION AT A
FREQUENCY DETERMINED BY THE COMMISSIONER. THE COMMISSIONER MAY, IN HIS
OR HER DISCRETION, WAIVE SUCH PENALTY.
S. 6407--A 12 A. 9007--A
S 16. Paragraph (d) of subdivision 1 of section 367-a of the social
services law is amended by adding a new subparagraph (iv) to read as
follows:
(IV) IF A HEALTH PLAN PARTICIPATING IN PART C OF TITLE XVIII OF THE
FEDERAL SOCIAL SECURITY ACT PAYS FOR ITEMS AND SERVICES PROVIDED TO
ELIGIBLE PERSONS WHO ARE ALSO BENEFICIARIES UNDER PART B OF TITLE XVIII
OF THE FEDERAL SOCIAL SECURITY ACT OR TO QUALIFIED MEDICARE BENEFICI-
ARIES, THE AMOUNT PAYABLE FOR SERVICES UNDER THIS TITLE SHALL BE THE
AMOUNT OF ANY CO-INSURANCE LIABILITY OF SUCH ELIGIBLE PERSONS PURSUANT
TO FEDERAL LAW IF THEY WERE NOT ELIGIBLE FOR MEDICAL ASSISTANCE OR WERE
NOT QUALIFIED MEDICARE BENEFICIARIES WITH RESPECT TO SUCH BENEFITS UNDER
SUCH PART B, BUT SHALL NOT EXCEED THE AMOUNT THAT OTHERWISE WOULD BE
MADE UNDER THIS TITLE IF PROVIDED TO AN ELIGIBLE PERSON WHO IS NOT A
BENEFICIARY UNDER PART B OR A QUALIFIED MEDICARE BENEFICIARY, LESS THE
AMOUNT PAYABLE BY THE PART C HEALTH PLAN; PROVIDED, HOWEVER, AMOUNTS
PAYABLE UNDER THIS TITLE FOR ITEMS AND SERVICES PROVIDED TO ELIGIBLE
PERSONS WHO ARE ALSO BENEFICIARIES UNDER PART B OR TO QUALIFIED MEDICARE
BENEFICIARIES BY AN AMBULANCE SERVICE UNDER THE AUTHORITY OF AN OPERAT-
ING CERTIFICATE ISSUED PURSUANT TO ARTICLE THIRTY OF THE PUBLIC HEALTH
LAW, A PSYCHOLOGIST LICENSED UNDER ARTICLE ONE HUNDRED FIFTY-THREE OF
THE EDUCATION LAW, OR A FACILITY UNDER THE AUTHORITY OF AN OPERATING
CERTIFICATE ISSUED PURSUANT TO ARTICLE SIXTEEN, THIRTY-ONE OR THIRTY-TWO
OF THE MENTAL HYGIENE LAW AND WITH RESPECT TO OUTPATIENT HOSPITAL AND
CLINIC ITEMS AND SERVICES PROVIDED BY A FACILITY UNDER THE AUTHORITY OF
AN OPERATING CERTIFICATE ISSUED PURSUANT TO ARTICLE TWENTY-EIGHT OF THE
PUBLIC HEALTH LAW, SHALL NOT BE LESS THAN THE AMOUNT OF ANY CO-INSURANCE
LIABILITY OF SUCH ELIGIBLE PERSONS OR SUCH QUALIFIED MEDICARE BENEFICI-
ARIES, OR FOR WHICH SUCH ELIGIBLE PERSONS OR SUCH QUALIFIED MEDICARE
BENEFICIARIES WOULD BE LIABLE UNDER FEDERAL LAW WERE THEY NOT ELIGIBLE
FOR MEDICAL ASSISTANCE OR WERE THEY NOT QUALIFIED MEDICARE BENEFICIARIES
WITH RESPECT TO SUCH BENEFITS UNDER PART B.
S 17. Subdivision 2-b of section 365-l of the social services law, as
added by section 25 of part B of chapter 57 of the laws of 2015, is
amended to read as follows:
2-b. The commissioner is authorized to make [grants] LUMP SUM
PAYMENTS OR ADJUST RATES OF PAYMENT TO PROVIDERS up to a gross amount of
five million dollars, to establish coordination between the health homes
and the criminal justice system and for the integration of information
of health homes with state and local correctional facilities, to the
extent permitted by law. SUCH RATE ADJUSTMENTS MAY BE MADE TO HEALTH
HOMES PARTICIPATING IN A CRIMINAL JUSTICE PILOT PROGRAM WITH THE PURPOSE
OF ENROLLING INCARCERATED INDIVIDUALS WITH SERIOUS MENTAL ILLNESS, TWO
OR MORE CHRONIC CONDITIONS, INCLUDING SUBSTANCE ABUSE DISORDERS, OR
HIV/AIDS, INTO SUCH HEALTH HOME. Health homes receiving funds under this
subdivision shall be required to document and demonstrate the effective
use of funds distributed herein.
S 18. 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 fund medicaid expenditures, as
amended by section 8 of part B of chapter 57 of the laws of 2015, is
amended to read as follows:
1. For state fiscal years 2011-12 through [2016-17] 2017-18, 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
S. 6407--A 13 A. 9007--A
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 and state costs or savings from
the basic health plan. Such projections may be adjusted by the director
of the budget to account for increased or expedited department of health
state funds medicaid expenditures as a result of a natural or other type
of disaster, including a governmental declaration of emergency.
S 19. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2016; provided
that:
(a) sections one, two and six of this act shall take effect October 1,
2016;
(b) the amendments to subdivision 4 of section 365-h of the social
services law, made by section one of this act, shall not affect the
expiration and repeal of certain provisions of such section, and shall
expire and be deemed repealed therewith;
(c) the amendments to subparagraph (i) of paragraph (b) of subdivision
7 of section 4403-f of the public health law, made by section two of
this act, shall not affect the expiration of such subdivision or the
repeal of such section, and shall expire or be deemed repealed there-
with;
(d) sections four and sixteen of this act shall take effect July 1,
2016;
(e) the amendments to subdivision 9 of section 367-a of the social
services law, made by section six of this act, shall not affect the
expiration of such subdivision and shall expire therewith;
(f) sections eight, nine and ten of this act shall take effect June 1,
2016;
(g) the amendments to subdivision 25 of section 364-j of the social
services law, made by section nine of this act, shall not affect the
repeal of such section, and shall be deemed repealed therewith;
(h) the amendments to paragraph (e) of subdivision 7 of section 367-a
of the social services law, made by sections twelve and thirteen of this
act shall not affect the repeal of such paragraph and shall be deemed
repealed therewith; and
(i) subdivisions 26-a and 32 of section 364-j of the social services
law, as added by sections fourteen and fifteen of this act shall be
deemed repealed on the same date and in the same manner as such section
is repealed.
PART C
S. 6407--A 14 A. 9007--A
Section 1. Subdivision 1 of section 18 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, is amended by adding a
new paragraph (c) to read as follows:
(C) STARTING WITH THE POLICY YEAR BEGINNING JULY FIRST, TWO THOUSAND
SIXTEEN, AND AT LEAST ONCE EVERY FIVE YEARS THEREAFTER, THE SUPERINTEN-
DENT OF FINANCIAL SERVICES SHALL RANK FROM HIGHEST TO LOWEST EACH CLASS
AND TERRITORY COMBINATION USED FOR THE PURPOSE OF APPORTIONING PREMIUM
FOR POLICIES PURCHASED FROM FUNDS AVAILABLE IN THE HOSPITAL EXCESS
LIABILITY POOL ACCORDING TO RELATIVITIES DERIVED FROM THE MEDICAL MALP-
RACTICE INSURANCE POOL'S PRIMARY RATES AND THE APPLICABLE EXCESS TIER
FACTORS. ANNUALLY, THE SUPERINTENDENT SHALL DETERMINE THE CLASS AND
TERRITORY COMBINATIONS FOR WHICH A POLICY OR POLICIES FOR EXCESS INSUR-
ANCE COVERAGE, OR FOR EQUIVALENT EXCESS INSURANCE COVERAGE, MAY BE
PURCHASED FOR ELIGIBLE PHYSICIANS OR DENTISTS WITHIN THE LIMITS OF THE
APPROPRIATION FOR THE HOSPITAL EXCESS LIABILITY POOL. THE SUPERINTENDENT
SHALL GRANT PRIORITY FOR PURCHASING POLICIES IN EACH POLICY YEAR IN
DESCENDING ORDER BEGINNING WITH THE HIGHEST RISK CLASS AND TERRITORY
COMBINATION. THE SUPERINTENDENT AND COMMISSIONER OF HEALTH SHALL NOT BE
OBLIGATED TO PURCHASE ANY MORE POLICIES THAN THE NUMBER OF POLICIES THAT
CAN BE PURCHASED AT THE RATES PROMULGATED ANNUALLY BY THE SUPERINTENDENT
WITHIN THE LIMITS OF THE APPROPRIATION. ONCE THE BALANCE OF THE APPRO-
PRIATION BECOMES INSUFFICIENT TO COVER ALL PHYSICIANS AND DENTISTS WITH-
IN A PARTICULAR CLASS AND TERRITORY COMBINATION, THE REMAINING FUNDS FOR
THAT COMBINATION SHALL BE ALLOCATED, FOR THE PURPOSE OF PURCHASING POLI-
CIES FOR SELECTED ADDITIONAL PHYSICIANS AND DENTISTS WITHIN THAT COMBI-
NATION TO GENERAL HOSPITALS IN PROPORTION TO THEIR SHARE OF THE TOTAL
NUMBER OF PHYSICIANS OR DENTISTS PRACTICING IN SUCH CLASS AND TERRITORY
COMBINATION WHO WERE CERTIFIED BY THE GENERAL HOSPITALS, AND FOR WHOM
POLICIES WERE PURCHASED, IN THE PRIOR YEAR, PROVIDED THAT ANY SHARE OF
LESS THAN ONE PHYSICIAN OR DENTIST SHALL BE DEEMED TO EQUAL ZERO. FOR
THE PURPOSES OF THIS PARAGRAPH, WITH REGARD TO POLICIES ISSUED FOR THE
COVERAGE PERIOD BEGINNING JULY FIRST, TWO THOUSAND SIXTEEN, "PRIOR YEAR"
SHALL MEAN THE POLICY YEAR THAT BEGAN ON JULY FIRST, TWO THOUSAND
FIFTEEN.
S 2. Paragraph (a) of subdivision 1 of section 18 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 1 of part Y of chapter 57 of the laws of 2015, is
amended to read as follows:
(a) The superintendent of financial services and the commissioner of
health or their designee shall, from funds available in the hospital
excess liability pool created pursuant to subdivision 5 of this section,
purchase a policy or policies for excess insurance coverage, as author-
ized by paragraph 1 of subsection (e) of section 5502 of the insurance
law; or from an insurer, other than an insurer described in section 5502
of the insurance law, duly authorized to write such coverage and actual-
ly writing medical malpractice insurance in this state; or shall
purchase equivalent excess coverage in a form previously approved by the
superintendent of financial services for purposes of providing equiv-
alent excess coverage in accordance with section 19 of chapter 294 of
the laws of 1985, for medical or dental malpractice occurrences between
July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988,
between July 1, 1988 and June 30, 1989, between July 1, 1989 and June
30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991
and June 30, 1992, between July 1, 1992 and June 30, 1993, between July
S. 6407--A 15 A. 9007--A
1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995,
between July 1, 1995 and June 30, 1996, between July 1, 1996 and June
30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998
and June 30, 1999, between July 1, 1999 and June 30, 2000, between July
1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002,
between July 1, 2002 and June 30, 2003, between July 1, 2003 and June
30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005
and June 30, 2006, between July 1, 2006 and June 30, 2007, between July
1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009,
between July 1, 2009 and June 30, 2010, between July 1, 2010 and June
30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012
and June 30, 2013, between July 1, 2013 and June 30, 2014, between July
1, 2014 and June 30, 2015, [and] between July 1, 2015 and June 30, 2016,
AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 or reimburse the hospital
where the hospital purchases equivalent excess coverage as defined in
subparagraph (i) of paragraph (a) of subdivision 1-a of this section for
medical or dental malpractice occurrences between July 1, 1987 and June
30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989
and June 30, 1990, between July 1, 1990 and June 30, 1991, between July
1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,
between July 1, 1993 and June 30, 1994, between July 1, 1994 and June
30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996
and June 30, 1997, between July 1, 1997 and June 30, 1998, between July
1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000,
between July 1, 2000 and June 30, 2001, between July 1, 2001 and June
30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003
and June 30, 2004, between July 1, 2004 and June 30, 2005, between July
1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007,
between July 1, 2007 and June 30, 2008, between July 1, 2008 and June
30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010
and June 30, 2011, between July 1, 2011 and June 30, 2012, between July
1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014,
between July 1, 2014 and June 30, 2015, [and] between July 1, 2015 and
June 30, 2016, AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 for physicians
or dentists certified as eligible for each such period or periods pursu-
ant to subdivision 2 of this section by a general hospital licensed
pursuant to article 28 of the public health law; provided that no single
insurer shall write more than fifty percent of the total excess premium
for a given policy year; and provided, however, that such eligible
physicians or dentists must have in force an individual policy, from an
insurer licensed in this state 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 during the period of such excess cover-
age for such occurrences or be endorsed as additional insureds under a
hospital professional liability policy which is offered through a volun-
tary attending physician ("channeling") program previously permitted by
the superintendent of financial services during the period of such
excess coverage for such occurrences. During such period, such policy
for excess coverage or such 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, total an aggregate level of two million three
hundred thousand dollars for each claimant and six million nine hundred
thousand dollars for all claimants from all such policies with respect
to occurrences in each of such years provided, however, if the cost of
S. 6407--A 16 A. 9007--A
primary malpractice insurance coverage in excess of one million dollars,
but below the excess medical malpractice insurance coverage provided
pursuant to this act, exceeds the rate of nine percent per annum, then
the required level of primary malpractice insurance coverage in excess
of one million dollars for each claimant shall be in an amount of not
less than the dollar amount of such coverage available at nine percent
per annum; the required level of such coverage for all claimants under
that policy shall be in an amount not less than three times the dollar
amount of coverage for each claimant; and excess coverage, when combined
with such primary malpractice insurance coverage, shall increase the
aggregate level for each claimant by one million dollars and three
million dollars for all claimants; and provided further, that, with
respect to policies of primary medical malpractice coverage that include
occurrences between April 1, 2002 and June 30, 2002, such requirement
that coverage be in amounts no less than one million three hundred thou-
sand dollars for each claimant and three million nine hundred thousand
dollars for all claimants for such occurrences shall be effective April
1, 2002.
S 3. Subdivision 3 of section 18 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 2 of
part Y of chapter 57 of the laws of 2015, is amended to read as follows:
(3)(a) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance for medical or dental malpractice
occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
and June 30, 1989, between July 1, 1989 and June 30, 1990, between July
1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992,
between July 1, 1992 and June 30, 1993, between July 1, 1993 and June
30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995
and June 30, 1996, between July 1, 1996 and June 30, 1997, between July
1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999,
between July 1, 1999 and June 30, 2000, between July 1, 2000 and June
30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002
and June 30, 2003, between July 1, 2003 and June 30, 2004, between July
1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006,
between July 1, 2006 and June 30, 2007, between July 1, 2007 and June
30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009
and June 30, 2010, between July 1, 2010 and June 30, 2011, between July
1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, and
between July 1, 2013 and June 30, 2014, between July 1, 2014 and June
30, 2015, [and] between July 1, 2015 and June 30, 2016, AND BETWEEN JULY
1, 2016 AND JUNE 30, 2017 allocable to each general hospital for physi-
cians or dentists certified as eligible for purchase of a policy for
excess insurance coverage by such general hospital in accordance with
subdivision 2 of this section, and may amend such determination and
certification as necessary.
(b) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance or equivalent excess coverage for
medical or dental malpractice occurrences between July 1, 1987 and June
30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989
and June 30, 1990, between July 1, 1990 and June 30, 1991, between July
1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,
between July 1, 1993 and June 30, 1994, between July 1, 1994 and June
30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996
S. 6407--A 17 A. 9007--A
and June 30, 1997, between July 1, 1997 and June 30, 1998, between July
1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000,
between July 1, 2000 and June 30, 2001, between July 1, 2001 and June
30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003
and June 30, 2004, between July 1, 2004 and June 30, 2005, between July
1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007,
between July 1, 2007 and June 30, 2008, between July 1, 2008 and June
30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010
and June 30, 2011, between July 1, 2011 and June 30, 2012, between July
1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014,
between July 1, 2014 and June 30, 2015, [and] between July 1, 2015 and
June 30, 2016, AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 allocable to
each general hospital for physicians or dentists certified as eligible
for purchase of a policy for excess insurance coverage or equivalent
excess coverage by such general hospital in accordance with subdivision
2 of this section, and may amend such determination and certification as
necessary. The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
ratable share of such cost allocable to the period July 1, 1987 to
December 31, 1987, to the period January 1, 1988 to June 30, 1988, to
the period July 1, 1988 to December 31, 1988, to the period January 1,
1989 to June 30, 1989, to the period July 1, 1989 to December 31, 1989,
to the period January 1, 1990 to June 30, 1990, to the period July 1,
1990 to December 31, 1990, to the period January 1, 1991 to June 30,
1991, to the period July 1, 1991 to December 31, 1991, to the period
January 1, 1992 to June 30, 1992, to the period July 1, 1992 to December
31, 1992, to the period January 1, 1993 to June 30, 1993, to the period
July 1, 1993 to December 31, 1993, to the period January 1, 1994 to June
30, 1994, to the period July 1, 1994 to December 31, 1994, to the period
January 1, 1995 to June 30, 1995, to the period July 1, 1995 to December
31, 1995, to the period January 1, 1996 to June 30, 1996, to the period
July 1, 1996 to December 31, 1996, to the period January 1, 1997 to June
30, 1997, to the period July 1, 1997 to December 31, 1997, to the period
January 1, 1998 to June 30, 1998, to the period July 1, 1998 to December
31, 1998, to the period January 1, 1999 to June 30, 1999, to the period
July 1, 1999 to December 31, 1999, to the period January 1, 2000 to June
30, 2000, to the period July 1, 2000 to December 31, 2000, to the period
January 1, 2001 to June 30, 2001, to the period July 1, 2001 to June 30,
2002, to the period July 1, 2002 to June 30, 2003, to the period July 1,
2003 to June 30, 2004, to the period July 1, 2004 to June 30, 2005, to
the period July 1, 2005 and June 30, 2006, to the period July 1, 2006
and June 30, 2007, to the period July 1, 2007 and June 30, 2008, to the
period July 1, 2008 and June 30, 2009, to the period July 1, 2009 and
June 30, 2010, to the period July 1, 2010 and June 30, 2011, to the
period July 1, 2011 and June 30, 2012, to the period July 1, 2012 and
June 30, 2013, to the period July 1, 2013 and June 30, 2014, to the
period July 1, 2014 and June 30, 2015, [and] to the period July 1, 2015
and June 30, 2016, AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017.
S 4. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
18 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 3 of part Y of chapter 57 of the
laws of 2015, are amended to read as follows:
(a) To the extent funds available to the hospital excess liability
pool pursuant to subdivision 5 of this section as amended, and pursuant
to section 6 of part J of chapter 63 of the laws of 2001, as may from
S. 6407--A 18 A. 9007--A
time to time be amended, which amended this subdivision, are insuffi-
cient to meet the costs of excess insurance coverage or equivalent
excess coverage for coverage periods during the period July 1, 1992 to
June 30, 1993, during the period July 1, 1993 to June 30, 1994, during
the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
to June 30, 1996, during the period July 1, 1996 to June 30, 1997,
during the period July 1, 1997 to June 30, 1998, during the period July
1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30,
2000, during the period July 1, 2000 to June 30, 2001, during the period
July 1, 2001 to October 29, 2001, during the period April 1, 2002 to
June 30, 2002, during the period July 1, 2002 to June 30, 2003, during
the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
to June 30, 2005, during the period July 1, 2005 to June 30, 2006,
during the period July 1, 2006 to June 30, 2007, during the period July
1, 2007 to June 30, 2008, during the period July 1, 2008 to June 30,
2009, during the period July 1, 2009 to June 30, 2010, during the period
July 1, 2010 to June 30, 2011, during the period July 1, 2011 to June
30, 2012, during the period July 1, 2012 to June 30, 2013, during the
period July 1, 2013 to June 30, 2014, during the period July 1, 2014 to
June 30, 2015, [and] during the period July 1, 2015 and June 30, 2016,
AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 allocated or reallocated in
accordance with paragraph (a) of subdivision 4-a of this section to
rates of payment applicable to state governmental agencies, each physi-
cian or dentist for whom a policy for excess insurance coverage or
equivalent excess coverage is purchased for such period shall be respon-
sible for payment to the provider of excess insurance coverage or equiv-
alent excess coverage of an allocable share of such insufficiency, based
on the ratio of the total cost of such coverage for such physician to
the sum of the total cost of such coverage for all physicians applied to
such insufficiency.
(b) Each provider of excess insurance coverage or equivalent excess
coverage covering the period July 1, 1992 to June 30, 1993, or covering
the period July 1, 1993 to June 30, 1994, or covering the period July 1,
1994 to June 30, 1995, or covering the period July 1, 1995 to June 30,
1996, or covering the period July 1, 1996 to June 30, 1997, or covering
the period July 1, 1997 to June 30, 1998, or covering the period July 1,
1998 to June 30, 1999, or covering the period July 1, 1999 to June 30,
2000, or covering the period July 1, 2000 to June 30, 2001, or covering
the period July 1, 2001 to October 29, 2001, or covering the period
April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to
June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
covering the period July 1, 2004 to June 30, 2005, or covering the peri-
od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or
covering the period July 1, 2008 to June 30, 2009, or covering the peri-
od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
covering the period July 1, 2012 to June 30, 2013, or covering the peri-
od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, OR
COVERING THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 shall notify 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 paragraph (a) of this
subdivision. Such amount shall be due from such physician or dentist to
S. 6407--A 19 A. 9007--A
such provider of excess insurance coverage or equivalent 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 July 1, 1992 to June 30, 1993, or covering the period
July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to
June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
covering the period July 1, 1996 to June 30, 1997, or covering the peri-
od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or
covering the period July 1, 2000 to June 30, 2001, or covering the peri-
od July 1, 2001 to October 29, 2001, or covering the period April 1,
2002 to June 30, 2002, or covering the period July 1, 2002 to June 30,
2003, or covering the period July 1, 2003 to June 30, 2004, or covering
the period July 1, 2004 to June 30, 2005, or covering the period July 1,
2005 to June 30, 2006, or covering the period July 1, 2006 to June 30,
2007, or covering the period July 1, 2007 to June 30, 2008, or covering
the period July 1, 2008 to June 30, 2009, or covering the period July 1,
2009 to June 30, 2010, or covering the period July 1, 2010 to June 30,
2011, or covering the period July 1, 2011 to June 30, 2012, or covering
the period July 1, 2012 to June 30, 2013, or covering the period July 1,
2013 to June 30, 2014, or covering the period July 1, 2014 to June 30,
2015, or covering the period July 1, 2015 to June 30, 2016, OR COVERING
THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 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 of health 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 July 1, 1992 to June 30,
1993, or covering the period July 1, 1993 to June 30, 1994, or covering
the period July 1, 1994 to June 30, 1995, or covering the period July 1,
1995 to June 30, 1996, or covering the period July 1, 1996 to June 30,
1997, or covering the period July 1, 1997 to June 30, 1998, or covering
the period July 1, 1998 to June 30, 1999, or covering the period July 1,
1999 to June 30, 2000, or covering the period July 1, 2000 to June 30,
2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
ing the period April 1, 2002 to June 30, 2002, or covering the period
July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to
June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or
covering the period July 1, 2005 to June 30, 2006, or covering the peri-
od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or
covering the period July 1, 2009 to June 30, 2010, or covering the peri-
od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or
covering the period July 1, 2013 to June 30, 2014, or covering the peri-
S. 6407--A 20 A. 9007--A
od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
June 30, 2016, OR COVERING THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 that
has made payment to such provider of excess insurance coverage or equiv-
alent excess coverage in accordance with paragraph (b) of this subdivi-
sion 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 hospital excess liability pool any amount
allocable to the period July 1, 1992 to June 30, 1993, and to the period
July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June
30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the
period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to
June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to
the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
to June 30, 2001, and to the period July 1, 2001 to October 29, 2001,
and to the period April 1, 2002 to June 30, 2002, and to the period July
1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30,
2004, and to the period July 1, 2004 to June 30, 2005, and to the period
July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June
30, 2007, and to the period July 1, 2007 to June 30, 2008, and to the
period July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to
June 30, 2010, and to the period July 1, 2010 to June 30, 2011, and to
the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
to June 30, 2013, and to the period July 1, 2013 to June 30, 2014, and
to the period July 1, 2014 to June 30, 2015, and to the period July 1,
2015 to June 30, 2016, AND TO THE PERIOD JULY 1, 2016 TO JUNE 30, 2017
received from the hospital excess liability pool for purchase of excess
insurance coverage or equivalent excess coverage covering the period
July 1, 1992 to June 30, 1993, and covering the period July 1, 1993 to
June 30, 1994, and covering the period July 1, 1994 to June 30, 1995,
and covering the period July 1, 1995 to June 30, 1996, and covering the
period July 1, 1996 to June 30, 1997, and covering the period July 1,
1997 to June 30, 1998, and covering the period July 1, 1998 to June 30,
1999, and covering the period July 1, 1999 to June 30, 2000, and cover-
ing the period July 1, 2000 to June 30, 2001, and covering the period
July 1, 2001 to October 29, 2001, and covering the period April 1, 2002
to June 30, 2002, and covering the period July 1, 2002 to June 30, 2003,
and covering the period July 1, 2003 to June 30, 2004, and covering the
period July 1, 2004 to June 30, 2005, and covering the period July 1,
2005 to June 30, 2006, and covering the period July 1, 2006 to June 30,
2007, and covering the period July 1, 2007 to June 30, 2008, and cover-
ing the period July 1, 2008 to June 30, 2009, and covering the period
July 1, 2009 to June 30, 2010, and covering the period July 1, 2010 to
June 30, 2011, and covering the period July 1, 2011 to June 30, 2012,
and covering the period July 1, 2012 to June 30, 2013, and covering the
period July 1, 2013 to June 30, 2014, and covering the period July 1,
2014 to June 30, 2015, and covering the period July 1, 2015 to June 30,
2016, AND COVERING THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 for a physi-
cian or dentist where such excess insurance coverage or equivalent
excess coverage is cancelled in accordance with paragraph (c) of this
subdivision.
S 5. 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 4 of part Y of chap-
ter 57 of the laws of 2015, is amended to read as follows:
S. 6407--A 21 A. 9007--A
S 40. The superintendent of financial services shall establish rates
for policies providing coverage for physicians and surgeons medical
malpractice for the periods commencing July 1, 1985 and ending June 30,
[2016] 2017; 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 superintendent shall direct insurers to establish segregated
accounts for premiums, payments, reserves and investment income attrib-
utable 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
attributable 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, [2016]
2017, at which time and thereafter such surcharge shall not exceed twen-
ty-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, [2016]
2017 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 superintendent. 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 practice 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 establishing adequate rates and in determining any projected defi-
ciency 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 peri-
od 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 by
S. 6407--A 22 A. 9007--A
the superintendent pursuant to this section are deemed adequate if such
rates would be adequate when taken together with the maximum authorized
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.
S 6. Section 5 and subdivisions (a) and (e) of section 6 of part J of
chapter 63 of the laws of 2001, amending chapter 266 of the laws of
1986, amending the civil practice law and rules and other laws relating
to malpractice and professional medical conduct, as amended by section 5
of part Y of chapter 57 of the laws of 2015, are amended to read as
follows:
S 5. The superintendent of financial services and the commissioner of
health shall determine, no later than June 15, 2002, June 15, 2003, June
15, 2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15, 2008,
June 15, 2009, June 15, 2010, June 15, 2011, June 15, 2012, June 15,
2013, June 15, 2014, June 15, 2015, [and] June 15, 2016, AND JUNE 15,
2017 the amount of funds available in the hospital excess liability
pool, created pursuant to section 18 of chapter 266 of the laws of 1986,
and whether such funds are sufficient for purposes of purchasing excess
insurance coverage for eligible participating physicians and dentists
during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June
30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
2007, or July 1, 2007 to June 30, 2008, or July 1, 2008 to June 30,
2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to June 30,
2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June 30,
2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30,
2015, or July 1, 2015 to June 30, 2016, OR JULY 1, 2016 TO JUNE 30, 2017
as applicable.
(a) This section shall be effective only upon a determination, pursu-
ant to section five of this act, by the superintendent of financial
services and the commissioner of health, and a certification of such
determination to the state director of the budget, the chair of the
senate committee on finance and the chair of the assembly committee on
ways and means, that the amount of funds in the hospital excess liabil-
ity pool, created pursuant to section 18 of chapter 266 of the laws of
1986, is insufficient for purposes of purchasing excess insurance cover-
age for eligible participating physicians and dentists during the period
July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1,
2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to
June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30,
2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30,
2016, OR JULY 1, 2016 TO JUNE 30, 2017 as applicable.
(e) The commissioner of health shall transfer for deposit to the
hospital excess liability pool created pursuant to section 18 of chapter
266 of the laws of 1986 such amounts as directed by the superintendent
of financial services for the purchase of excess liability insurance
coverage for eligible participating physicians and dentists for the
policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
2007, as applicable, and the cost of administering the hospital excess
liability pool for such applicable policy year, pursuant to the program
S. 6407--A 23 A. 9007--A
established in chapter 266 of the laws of 1986, as amended, no later
than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June
15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, June 15,
2015, [and] June 15, 2016, AND JUNE 15, 2017 as applicable.
S 7. Notwithstanding any law, rule or regulation to the contrary, only
physicians or dentists who were eligible, and for whom the superinten-
dent of financial services and the commissioner of health, or their
designee, purchased, with funds available in the hospital excess liabil-
ity pool, a full or partial policy for excess coverage or equivalent
excess coverage for the coverage period ending the thirtieth of June,
two thousand sixteen, shall be eligible to apply for such coverage for
the coverage period beginning the first of July, two thousand sixteen;
provided, however, if the total number of physicians or dentists for
whom such excess coverage or equivalent excess coverage was purchased
for the policy year ending the thirtieth of June, two thousand sixteen
exceeds the total number of physicians or dentists certified as eligible
for the coverage period beginning the first of July, two thousand
sixteen, then the general hospitals may certify additional eligible
physicians or dentists in a number equal to such general hospital's
proportional share 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 thirti-
eth of June, two thousand sixteen, as applied to the difference between
the number of eligible physicians or dentists for whom a policy for
excess coverage or equivalent excess coverage was purchased for the
coverage period ending the thirtieth of June, two thousand sixteen and
the number of such eligible physicians or dentists who have applied for
excess coverage or equivalent excess coverage for the coverage period
beginning the first of July, two thousand sixteen.
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, 2016, provided,
however, section two of this act shall take effect July 1, 2016.
PART D
Section 1. Paragraph (a) of subdivision 1 of section 212 of chapter
474 of the laws of 1996, amending the education law and other laws
relating to rates for residential healthcare facilities, as amended by
section 2 of part B of chapter 56 of the laws of 2013, is amended to
read as follows:
(a) Notwithstanding any inconsistent provision of law or regulation to
the contrary, effective beginning August 1, 1996, for the period April
1, 1997 through March 31, 1998, April 1, 1998 for the period April 1,
1998 through March 31, 1999, August 1, 1999, for the period April 1,
1999 through March 31, 2000, April 1, 2000, for the period April 1, 2000
through March 31, 2001, April 1, 2001, for the period April 1, 2001
through March 31, 2002, April 1, 2002, for the period April 1, 2002
through March 31, 2003, and for the state fiscal year beginning April 1,
2005 through March 31, 2006, and for the state fiscal year beginning
April 1, 2006 through March 31, 2007, and for the state fiscal year
beginning April 1, 2007 through March 31, 2008, and for the state fiscal
year beginning April 1, 2008 through March 31, 2009, and for the state
fiscal year beginning April 1, 2009 through March 31, 2010, and for the
state fiscal year beginning April 1, 2010 through March 31, 2016, AND
ANNUALLY THEREAFTER, the department of health is authorized to pay
S. 6407--A 24 A. 9007--A
public general hospitals, as defined in subdivision 10 of section 2801
of the public health law, operated by the state of New York or by the
state university of New York or by a county, which shall not include a
city with a population of over one million, of the state of New York,
and those public general hospitals located in the county of Westchester,
the county of Erie or the county of Nassau, additional payments for
inpatient hospital services as medical assistance payments pursuant to
title 11 of article 5 of the social services law for patients eligible
for federal financial participation under title XIX of the federal
social security act in medical assistance pursuant to the federal laws
and regulations governing disproportionate share payments to hospitals
up to one hundred percent of each such public general hospital's medical
assistance and uninsured patient losses after all other medical assist-
ance, including disproportionate share payments to such public general
hospital for 1996, 1997, 1998, and 1999, based initially for 1996 on
reported 1994 reconciled data as further reconciled to actual reported
1996 reconciled data, and for 1997 based initially on reported 1995
reconciled data as further reconciled to actual reported 1997 reconciled
data, for 1998 based initially on reported 1995 reconciled data as
further reconciled to actual reported 1998 reconciled data, for 1999
based initially on reported 1995 reconciled data as further reconciled
to actual reported 1999 reconciled data, for 2000 based initially on
reported 1995 reconciled data as further reconciled to actual reported
2000 data, for 2001 based initially on reported 1995 reconciled data as
further reconciled to actual reported 2001 data, for 2002 based initial-
ly on reported 2000 reconciled data as further reconciled to actual
reported 2002 data, and for state fiscal years beginning on April 1,
2005, based initially on reported 2000 reconciled data as further recon-
ciled to actual reported data for 2005, and for state fiscal years
beginning on April 1, 2006, based initially on reported 2000 reconciled
data as further reconciled to actual reported data for 2006, for state
fiscal years beginning on and after April 1, 2007 through March 31,
2009, based initially on reported 2000 reconciled data as further recon-
ciled to actual reported data for 2007 and 2008, respectively, for state
fiscal years beginning on and after April 1, 2009, based initially on
reported 2007 reconciled data, adjusted for authorized Medicaid rate
changes applicable to the state fiscal year, and as further reconciled
to actual reported data for 2009, for state fiscal years beginning on
and after April 1, 2010, based initially on reported reconciled data
from the base year two years prior to the payment year, adjusted for
authorized Medicaid rate changes applicable to the state fiscal year,
and further reconciled to actual reported data from such payment year,
and to actual reported data for each respective succeeding year. The
payments may be added to rates of payment or made as aggregate payments
to an eligible public general hospital.
S 2. Section 10 of chapter 649 of the laws of 1996, amending the
public health law, the mental hygiene law and the social services law
relating to authorizing the establishment of special needs plans, as
amended by section 20 of part D of chapter 59 of the laws of 2011, is
amended to read as follows:
S 10. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after July 1, 1996[; provided,
however, that sections one, two and three of this act shall expire and
be deemed repealed on March 31, 2016 provided, however that the amend-
ments to section 364-j of the social services law made by section four
of this act shall not affect the expiration of such section and shall be
S. 6407--A 25 A. 9007--A
deemed to expire therewith and provided, further, that the provisions of
subdivisions 8, 9 and 10 of section 4401 of the public health law, as
added by section one of this act; section 4403-d of the public health
law as added by section two of this act and the provisions of section
seven of this act, except for the provisions relating to the establish-
ment of no more than twelve comprehensive HIV special needs plans, shall
expire and be deemed repealed on July 1, 2000].
S 3. Subdivision 8 of section 84 of part A of chapter 56 of the laws
of 2013, amending the public health law and other laws relating to
general hospital reimbursement for annual rates is REPEALED.
S 4. Subdivision (f) of section 129 of part C of chapter 58 of the
laws of 2009, amending the public health law relating to payment by
governmental agencies for general hospital inpatient services, is
REPEALED.
S 5. Subdivision (c) of section 122 of part E of chapter 56 of the
laws of 2013 amending the public health law relating to the general
public health work program is REPEALED.
S 6. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2016.
PART E
Section 1. Subdivisions 9 and 10 of section 2541 of the public health
law, as added by chapter 428 of the laws of 1992, are amended to read as
follows:
9. "Evaluation" means a multidisciplinary professional, objective
[assessment] EXAMINATION conducted by appropriately qualified personnel
and conducted pursuant to section twenty-five hundred forty-four of this
title to determine a child's eligibility under this title.
10. "Evaluator" means a [team of two or more professionals approved
pursuant to section twenty-five hundred fifty-one of this title] PROVID-
ER APPROVED BY THE DEPARTMENT to conduct screenings and evaluations.
S 2. Section 2541 of the public health law is amended by adding two
new subdivisions 12-a and 15-a to read as follows:
12-A. "MULTIDISCIPLINARY" MEANS THE INVOLVEMENT OF TWO OR MORE SEPA-
RATE DISCIPLINES OR PROFESSIONS, WHICH MAY MEAN THE INVOLVEMENT OF ONE
INDIVIDUAL WHO MEETS THE DEFINITION OF QUALIFIED PERSONNEL AS DEFINED IN
SUBDIVISION FIFTEEN OF THIS SECTION AND WHO IS QUALIFIED, IN ACCORDANCE
WITH STATE LICENSURE, CERTIFICATION OR OTHER COMPARABLE STANDARDS, TO
EVALUATE ALL FIVE DEVELOPMENTAL DOMAINS.
15-A. "SCREENING" MEANS THE PROCEDURES USED BY QUALIFIED PERSONNEL, AS
DEFINED IN SUBDIVISION FIFTEEN OF THIS SECTION, TO DETERMINE WHETHER A
CHILD IS SUSPECTED OF HAVING A DISABILITY AND IN NEED OF EARLY INTER-
VENTION SERVICES, AND SHALL INCLUDE, WHERE AVAILABLE AND APPROPRIATE FOR
THE CHILD, THE ADMINISTRATION OF A STANDARDIZED INSTRUMENT OR INSTRU-
MENTS APPROVED BY THE DEPARTMENT, IN ACCORDANCE WITH SUBDIVISION THREE
OF SECTION TWENTY-FIVE HUNDRED FORTY-FOUR OF THIS TITLE.
S 3. Subdivision 3 of section 2542 of the public health law, as
amended by chapter 231 of the laws of 1993, is amended to read as
follows:
3. [The following persons and entities, within] (A) UNLESS THE PARENT
OBJECTS, WITHIN two working days of identifying an infant or toddler
suspected of having a disability or at risk of having a disability, THE
FOLLOWING PERSONS AND ENTITIES shall refer such infant or toddler to the
early intervention official or the health officer [of the public health
district in which the infant or toddler resides, as designated by the
S. 6407--A 26 A. 9007--A
municipality, but in no event over the objection of the parent made in
accordance with procedures established by the department for use by such
primary referral sources, unless the child has already been referred] OF
THE PUBLIC HEALTH DISTRICT DESIGNATED BY THE MUNICIPALITY IN WHICH THE
INFANT OR TODDLER RESIDES: hospitals, child health care providers, day
care programs, local school districts, public health facilities, early
childhood direction centers and such other social service and health
care agencies and providers as the commissioner shall specify in regu-
lation[; provided, however, that the]. THIS SHALL NOT APPLY IF THE
INFANT OR TODDLER HAS ALREADY BEEN REFERRED TO SUCH EARLY INTERVENTION
OFFICIAL OR HEALTH OFFICER. THE department shall establish procedures,
including regulations if required, to ensure that primary referral
sources adequately inform the parent or guardian about the early inter-
vention program, including through brochures and written materials
created or approved by the department.
(B) THE PRIMARY REFERRAL SOURCES IDENTIFIED IN PARAGRAPH (A) OF THIS
SUBDIVISION SHALL, WITH PARENTAL CONSENT, COMPLETE AND TRANSMIT AT THE
TIME OF REFERRAL, A REFERRAL FORM DEVELOPED BY THE DEPARTMENT WHICH
CONTAINS INFORMATION SUFFICIENT TO DOCUMENT THE PRIMARY REFERRAL
SOURCE'S CONCERN OR BASIS FOR SUSPECTING THE CHILD HAS A DISABILITY OR
IS AT RISK OF HAVING A DISABILITY, AND WHERE APPLICABLE, SPECIFIES THE
CHILD'S DIAGNOSED CONDITION THAT ESTABLISHES THE CHILD'S ELIGIBILITY FOR
THE EARLY INTERVENTION PROGRAM. THE PRIMARY REFERRAL SOURCE SHALL INFORM
THE PARENT OF A CHILD WITH A DIAGNOSED CONDITION THAT HAS A HIGH PROBA-
BILITY OF RESULTING IN DEVELOPMENTAL DELAY, THAT (I) ELIGIBILITY FOR THE
PROGRAM MAY BE ESTABLISHED BY MEDICAL OR OTHER RECORDS AND (II) OF THE
IMPORTANCE OF PROVIDING CONSENT FOR THE PRIMARY REFERRAL SOURCE TO TRAN-
SMIT RECORDS OR REPORTS NECESSARY TO SUPPORT THE DIAGNOSIS, OR, FOR
PARENTS OR GUARDIANS OF CHILDREN WHO DO NOT HAVE A DIAGNOSED CONDITION,
RECORDS OR REPORTS THAT WOULD ASSIST IN DETERMINING ELIGIBILITY FOR THE
PROGRAM.
S 4. Section 2544 of the public health law, as added by chapter 428 of
the laws of 1992, paragraph (c) of subdivision 2 as added by section 1
of part A of chapter 56 of the laws of 2012 and subdivision 11 as added
by section 3 of part B3 of chapter 62 of the laws of 2003, is amended to
read as follows:
S 2544. Screening and evaluations. 1. Each child thought to be an
eligible child is entitled to [a multidisciplinary] AN evaluation
CONDUCTED IN ACCORDANCE WITH THIS SECTION, and the early intervention
official shall ensure such evaluation, with parental consent.
2. (a) 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 APPLICABLE SCREENING AND/OR evaluation IN ACCORD-
ANCE WITH THIS SECTION. The parent or evaluator shall immediately noti-
fy the early intervention official of such selection. THE EVALUATOR
SHALL REVIEW THE INFORMATION AND DOCUMENTATION PROVIDED WITH THE REFER-
RAL TO DETERMINE THE APPROPRIATE SCREENING OR EVALUATION PROCESS TO
FOLLOW IN ACCORDANCE WITH THIS SECTION. The evaluator may begin the
SCREENING OR evaluation no sooner than four working days after such
notification, unless otherwise approved by the initial service coordina-
tor.
(b) [the evaluator shall designate an individual as the principal
contact for the multidisciplinary team] INITIAL SERVICE COORDINATORS
SHALL INFORM THE PARENT OF THE APPLICABLE SCREENING OR EVALUATION PROCE-
DURES THAT MAY BE PERFORMED. FOR A CHILD REFERRED TO THE EARLY INTER-
VENTION OFFICIAL WHO HAS A DIAGNOSED PHYSICAL OR MENTAL CONDITION THAT
S. 6407--A 27 A. 9007--A
HAS A HIGH PROBABILITY OF RESULTING IN DEVELOPMENTAL DELAY, THE INITIAL
SERVICE COORDINATOR SHALL INFORM THE PARENT THAT THE EVALUATION OF THE
CHILD SHALL BE CONDUCTED IN ACCORDANCE WITH THE PROCEDURES SET FORTH IN
SUBDIVISION FIVE OF THIS SECTION.
(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.
3. [(a) To determine eligibility, an evaluator shall, with parental
consent, either (i) screen a child to determine what type of evaluation,
if any, is warranted, or (ii) provide a multidisciplinary evaluation. In
making the determination whether to provide an evaluation, the evaluator
may rely on a recommendation from a physician or other qualified person
as designated by the commissioner.
(b)] SCREENINGS FOR CHILDREN REFERRED TO THE EARLY INTERVENTION
PROGRAM TO DETERMINE WHETHER THEY ARE SUSPECTED OF HAVING A DISABILITY.
(A) FOR A CHILD REFERRED TO THE EARLY INTERVENTION PROGRAM, THE EVALU-
ATOR SHALL FIRST PERFORM A SCREENING OF THE CHILD, WITH PARENTAL
CONSENT, TO DETERMINE WHETHER THE CHILD IS SUSPECTED OF HAVING A DISA-
BILITY.
(B) THE EVALUATOR SHALL UTILIZE A STANDARDIZED INSTRUMENT OR INSTRU-
MENTS APPROVED BY THE DEPARTMENT TO CONDUCT THE SCREENING. IF THE EVALU-
ATOR DOES NOT UTILIZE A STANDARDIZED INSTRUMENT OR INSTRUMENTS APPROVED
BY THE DEPARTMENT FOR THE SCREENING, THE EVALUATOR SHALL DOCUMENT IN
WRITING WHY SUCH STANDARDIZED INSTRUMENT OR INSTRUMENTS ARE UNAVAILABLE
OR INAPPROPRIATE FOR THE CHILD.
(C) THE EVALUATOR SHALL EXPLAIN THE RESULTS OF THE SCREENING TO THE
PARENT AND SHALL FULLY DOCUMENT THE RESULTS IN WRITING.
(D) If, based upon the screening, a child is [believed to be eligible,
or if otherwise elected by the parent] SUSPECTED OF HAVING A DISABILITY,
the child shall, with [the consent of a parent] PARENTAL CONSENT,
receive [a multidisciplinary evaluation. All evaluations shall be
conducted in accordance with] AN EVALUATION TO BE CONDUCTED IN ACCORD-
ANCE WITH THE PROCEDURES SET FORTH IN SUBDIVISION FOUR OF THIS SECTION,
the coordinated standards and procedures and with regulations promulgat-
ed by the commissioner.
(E) IF, BASED UPON THE SCREENING, A CHILD IS NOT SUSPECTED OF HAVING A
DISABILITY, AN EVALUATION SHALL NOT BE PROVIDED, UNLESS REQUESTED BY THE
PARENT. THE EARLY INTERVENTION OFFICIAL SHALL PROVIDE THE PARENT WITH
WRITTEN NOTICE OF THE SCREENING RESULTS, WHICH SHALL INCLUDE INFORMATION
ON THE PARENT'S RIGHT TO REQUEST AN EVALUATION.
(F) A SCREENING SHALL NOT BE PROVIDED TO CHILDREN WHO ARE REFERRED TO
THE EARLY INTERVENTION PROGRAM WHO HAVE A DIAGNOSED PHYSICAL OR MENTAL
CONDITION WITH A HIGH PROBABILITY OF RESULTING IN DEVELOPMENTAL DELAY
THAT ESTABLISHES ELIGIBILITY FOR THE PROGRAM.
4. The evaluation of [each] A child shall:
(a) INCLUDE THE ADMINISTRATION OF AN EVALUATION STANDARDIZED INSTRU-
MENT OR INSTRUMENTS APPROVED BY THE DEPARTMENT. IF THE EVALUATOR DOES
NOT UTILIZE A STANDARDIZED INSTRUMENT OR INSTRUMENTS APPROVED BY THE
DEPARTMENT AS PART OF THE EVALUATION OF THE CHILD, THE EVALUATOR SHALL
DOCUMENT IN WRITING WHY SUCH STANDARDIZED INSTRUMENT OR INSTRUMENTS ARE
NOT APPROPRIATE OR AVAILABLE FOR THE CHILD;
S. 6407--A 28 A. 9007--A
(B) be conducted by personnel trained to utilize appropriate methods
and procedures;
[(b)] (C) be based on informed clinical opinion;
[(c)] (D) be made without regard to the availability of services in
the municipality or who might provide such services; [and
(d)] (E) with parental consent, include the following:
(i) a review of pertinent records related to the child's current
health status and medical history; AND
(ii) an evaluation of the child's level of functioning in each of the
developmental areas set forth in paragraph (c) of subdivision seven of
section twenty-five hundred forty-one of this title[;] TO DETERMINE
WHETHER THE CHILD HAS A DISABILITY AS DEFINED IN THIS TITLE THAT ESTAB-
LISHES THE CHILD'S ELIGIBILITY FOR THE PROGRAM; AND
(F) IF THE CHILD HAS BEEN DETERMINED ELIGIBLE BY THE EVALUATOR AFTER
CONDUCTING THE PROCEDURES SET FORTH IN PARAGRAPHS (A) THROUGH (E) OF
THIS SUBDIVISION, THE EVALUATION SHALL ALSO INCLUDE:
[(iii)] (I) an assessment [of the unique needs of the child in terms
of] FOR THE PURPOSES OF IDENTIFYING THE CHILD'S UNIQUE STRENGTHS AND
NEEDS IN each of the developmental areas [set forth in paragraph (c) of
subdivision seven of section twenty-five hundred forty-one of this
title, including the identification of] AND THE EARLY INTERVENTION
services appropriate to meet those needs;
[(iv)] (II) A FAMILY-DIRECTED ASSESSMENT, IF CONSENTED TO BY THE FAMI-
LY, IN ORDER TO IDENTIFY THE FAMILY'S RESOURCES, PRIORITIES, AND
CONCERNS AND THE SUPPORTS NECESSARY TO ENHANCE THE FAMILY'S CAPACITY TO
MEET THE DEVELOPMENTAL NEEDS OF THE CHILD. THE FAMILY ASSESSMENT SHALL
BE VOLUNTARY ON THE PART OF EACH FAMILY MEMBER PARTICIPATING IN THE
ASSESSMENT;
(III) an [evaluation] ASSESSMENT of the transportation needs of the
child, if any; and
[(v)] (IV) such other matters as the commissioner may prescribe in
regulation.
5. EVALUATIONS FOR CHILDREN WHO ARE REFERRED TO THE EARLY INTERVENTION
OFFICIAL WITH DIAGNOSED PHYSICAL OR MENTAL CONDITIONS THAT HAVE A HIGH
PROBABILITY OF RESULTING IN DEVELOPMENTAL DELAY. (A) IF A CHILD HAS A
DIAGNOSED PHYSICAL OR MENTAL CONDITION THAT HAS A HIGH PROBABILITY OF
RESULTING IN DEVELOPMENTAL DELAY, THE CHILD'S MEDICAL OR OTHER RECORDS
SHALL BE USED, WHEN AVAILABLE, TO ESTABLISH THE CHILD'S ELIGIBILITY FOR
THE PROGRAM.
(B) THE EVALUATOR SHALL, UPON REVIEW OF THE REFERRAL FORM PROVIDED IN
ACCORDANCE WITH SECTION TWENTY-FIVE HUNDRED FORTY-TWO OF THIS TITLE OR
ANY MEDICAL OR OTHER RECORDS, OR AT THE TIME OF INITIAL CONTACT WITH THE
CHILD'S FAMILY, DETERMINE WHETHER THE CHILD HAS A DIAGNOSED CONDITION
THAT ESTABLISHES THE CHILD'S ELIGIBILITY FOR THE PROGRAM. IF THE EVALU-
ATOR HAS REASON TO BELIEVE, AFTER SPEAKING WITH THE CHILD'S FAMILY, THAT
THE CHILD MAY HAVE A DIAGNOSED CONDITION THAT ESTABLISHES THE CHILD'S
ELIGIBILITY BUT THE EVALUATOR HAS NOT BEEN PROVIDED WITH MEDICAL OR
OTHER DOCUMENTATION OF SUCH DIAGNOSIS, THE EVALUATOR SHALL, WITH
PARENTAL CONSENT, OBTAIN SUCH DOCUMENTATION, WHEN AVAILABLE, PRIOR TO
PROCEEDING WITH THE EVALUATION OF THE CHILD.
(C) THE EVALUATOR SHALL REVIEW ALL RECORDS RECEIVED TO DOCUMENT THAT
THE CHILD'S DIAGNOSIS AS SET FORTH IN SUCH RECORDS ESTABLISHES THE
CHILD'S ELIGIBILITY FOR THE EARLY INTERVENTION PROGRAM.
(D) NOTWITHSTANDING SUBDIVISION FOUR OF THIS SECTION, IF THE CHILD'S
ELIGIBILITY FOR THE EARLY INTERVENTION PROGRAM IS ESTABLISHED IN ACCORD-
ANCE WITH THIS SUBDIVISION, THE EVALUATION OF THE CHILD SHALL (I)
S. 6407--A 29 A. 9007--A
CONSIST OF A REVIEW OF THE RESULTS OF THE MEDICAL OR OTHER RECORDS THAT
ESTABLISHED THE CHILD'S ELIGIBILITY, AND ANY OTHER PERTINENT EVALUATIONS
OR RECORDS AVAILABLE AND (II) COMPLY WITH THE PROCEDURES SET FORTH IN
PARAGRAPH (F) OF SUBDIVISION FOUR OF THIS SECTION. THE EVALUATION PROCE-
DURES SET FORTH IN PARAGRAPHS (A) AND (E) OF SUBDIVISION FOUR SHALL NOT
BE REQUIRED OR CONDUCTED.
6. An evaluation shall not include a reference to any specific provid-
er of early intervention services.
[6.] 7. Nothing in this section shall restrict an evaluator from
utilizing, in addition to findings from his or her personal examination,
other examinations, evaluations or assessments conducted for such child,
including those conducted prior to the evaluation under this section, if
such examinations, evaluations or assessments are consistent with the
coordinated standards and procedures.
[7.] 8. Following completion of the evaluation, the evaluator shall
provide the parent and service coordinator with a copy of a summary of
the full evaluation. To the extent practicable, the summary shall be
provided in the native language of the parent. Upon request of the
parent, early intervention official or service coordinator, the evalu-
ator shall provide a copy of the full evaluation to such parent, early
intervention official or service coordinator.
[8.] 9. A parent who disagrees with the results of an evaluation may
obtain an additional evaluation or partial evaluation at public expense
to the extent authorized by federal law or regulation.
[9.] 10. Upon receipt of the results of an evaluation, a service coor-
dinator may, with parental consent, require additional diagnostic infor-
mation regarding the condition of the child, provided, however, that
such evaluation or assessment is not unnecessarily duplicative or inva-
sive to the child, and provided further, that:
(a) where the evaluation has established the child's eligibility, such
additional diagnostic information shall be used solely to provide addi-
tional information to the parent and service coordinator regarding the
child's need for services and cannot be a basis for refuting eligibil-
ity;
(b) the service coordinator provides the parent with a written expla-
nation of the basis for requiring additional diagnostic information;
(c) the additional diagnostic procedures are at no expense to the
parent; and
(d) the evaluation is completed and a meeting to develop an IFSP is
held within the time prescribed in subdivision one of section twenty-
five hundred forty-five of this title.
[10.] 11. (a) If the screening indicates that the infant or toddler is
not an eligible child and the parent elects not to have an evaluation,
or if the evaluation indicates that the infant or toddler is not an
eligible child, the service coordinator shall inform the parent of other
programs or services that may benefit such child, and the child's family
and, with parental consent, refer such child to such programs or
services.
(b) A parent may appeal a determination that a child is ineligible
pursuant to the provisions of section twenty-five hundred forty-nine of
this title, provided, however, that a parent may not initiate such
appeal until all evaluations are completed. IN ADDITION, FOR A CHILD
REFERRED TO THE EARLY INTERVENTION OFFICIAL WHO HAS A DIAGNOSED PHYSICAL
OR MENTAL CONDITION THAT ESTABLISHES THE CHILD'S ELIGIBILITY FOR THE
PROGRAM IN ACCORDANCE WITH SUBDIVISION FIVE OF THIS SECTION, THE PARENT
MAY REQUEST, AND SUCH REQUEST SHALL BE GRANTED, THAT THE EVALUATOR
S. 6407--A 30 A. 9007--A
CONDUCT THE EVALUATION PROCEDURES SET FORTH IN PARAGRAPHS (A) THROUGH
(E) OF SUBDIVISION FOUR OF THIS SECTION, PROVIDED, HOWEVER, THAT THE
PARENT MAY NOT MAKE SUCH REQUEST UNTIL THE EVALUATION CONDUCTED IN
ACCORDANCE WITH SUBDIVISION FIVE OF THIS SECTION IS COMPLETED.
[11.] 12. Notwithstanding any other provision of law to the contrary,
where a request has been made to review an IFSP prior to the six-month
interval provided in subdivision seven of section twenty-five hundred
forty-five of this title for purposes of increasing frequency or dura-
tion of an approved service, including service coordination, the early
intervention official may require an additional evaluation or partial
evaluation at public expense by an approved evaluator other than the
current provider of service, with parent consent.
S 5. Paragraph (a) of subdivision 3 of section 2559 of the public
health law, is amended by adding two new subparagraphs (iv) and (v) to
read as follows:
(IV) PROVIDERS SHALL SUBMIT ALL CLAIMS, IN ACCORDANCE WITH SUBPARA-
GRAPH (III) OF THIS PARAGRAPH AND WITHIN NINETY DAYS OF THE DATE OF
SERVICE, UNLESS THE SUBMISSION IS DELAYED DUE TO EXTRAORDINARY CIRCUM-
STANCES DOCUMENTED BY THE PROVIDER. ALL CLAIMS SUBMITTED AFTER NINETY
DAYS SHALL BE SUBMITTED WITHIN THIRTY DAYS FROM THE TIME THE PROVIDER
WAS RELIEVED FROM THE EXTRAORDINARY CIRCUMSTANCES THAT PREVIOUSLY
DELAYED A TIMELY SUBMISSION. CLAIMS THAT ARE NOT SUBMITTED WITHIN TIME-
FRAMES SET FORTH WILL NOT BE REIMBURSED BY THE DEPARTMENT'S FISCAL AGENT
FROM THE ESCROW ACCOUNT FUNDED BY MUNICIPAL GOVERNMENTAL PAYERS.
(V) PROVIDERS SHALL ENROLL, ON REQUEST OF THE DEPARTMENT OR THE
DEPARTMENT'S FISCAL AGENT, WITH ONE OR MORE HEALTH CARE CLEARINGHOUSES,
AS NECESSARY, FOR PROCESSING OF CLAIMS TO THIRD PARTY PAYORS AND FOR
RECEIPT OF REMITTANCE ADVICES IN STANDARD ELECTRONIC FORMAT AND IN
COMPLIANCE WITH ANY APPLICABLE FEDERAL OR STATE REGULATIONS WITH RESPECT
TO ELECTRONIC CLAIMS TRANSACTIONS.
S 6. Section 3224-a of the insurance law, as amended by chapter 666 of
the laws of 1997, the opening paragraph and subsections (a), (b) and (c)
as amended and subsections (g) and (h) as added by chapter 237 of the
laws of 2009, paragraph 2 of subsection (d) as amended by section 57-b
of part A of chapter 56 of the laws of 2013, subsection (i) as added by
chapter 297 of the laws of 2012 and subsection (j) as added by section 5
of part H of chapter 60 of the laws of 2014, is amended to read as
follows:
S 3224-a. Standards for prompt, fair and equitable settlement of
claims for health care and payments for health care services. In the
processing of all health care claims submitted under contracts or agree-
ments issued or entered into pursuant to this article and articles
forty-two, forty-three and forty-seven of this chapter and article
forty-four of the public health law and all bills for health care
services rendered by health care providers pursuant to such contracts or
agreements, any insurer or organization or corporation licensed or
certified pursuant to article forty-three or forty-seven of this chapter
or article forty-four of the public health law shall adhere to the
following standards:
(a) Except in a case where the obligation of an insurer or an organ-
ization or corporation licensed or certified pursuant to article forty-
three or forty-seven of this chapter or article forty-four of the public
health law to pay a claim submitted by a policyholder or person covered
under such policy ("covered person") or make a payment to a health care
provider is not reasonably clear, or when there is a reasonable basis
supported by specific information available for review by the super-
S. 6407--A 31 A. 9007--A
intendent that such claim or bill for health care services rendered was
submitted fraudulently, such insurer or organization or corporation
shall pay the claim to a policyholder or covered person or make a
payment to a health care provider within thirty days of receipt of a
claim or bill for services rendered that is transmitted via the internet
or electronic mail, or forty-five days of receipt of a claim or bill for
services rendered that is submitted by other means, such as paper or
facsimile.
(A-1) AN INSURER, ORGANIZATION, INCLUDING AN APPROVED ORGANIZATION AS
DEFINED IN SUBDIVISION TWO OF SECTION TWENTY-FIVE HUNDRED TEN OF THE
PUBLIC HEALTH LAW, OR CORPORATION SHALL, WITHIN FIFTEEN BUSINESS DAYS OF
RECEIPT OF A CLAIM OR BILL FOR SERVICES RENDERED UNDER THE EARLY INTER-
VENTION PROGRAM, ESTABLISHED IN TITLE TWO-A OF ARTICLE TWENTY-FIVE OF
THE PUBLIC HEALTH LAW, NOTIFY THE HEALTH CARE PROVIDER, IN A MANNER AND
FORMAT DETERMINED BY THE DEPARTMENT OF HEALTH, THROUGH THE DEPARTMENT OF
HEALTH'S DESIGNATED FISCAL AGENT, WHETHER THE CONTRACT OR AGREEMENT IS
SUBJECT TO THE PROVISIONS OF THIS CHAPTER.
(b) In a case where the obligation of an insurer or an organization or
corporation licensed or certified pursuant to article forty-three or
forty-seven of this chapter or article forty-four of the public health
law to pay a claim or make a payment for health care services rendered
is not reasonably clear due to a good faith dispute regarding the eligi-
bility of a person for coverage, the liability of another insurer or
corporation or organization for all or part of the claim, the amount of
the claim, the benefits covered under a contract or agreement, or the
manner in which services were accessed or provided, an insurer or organ-
ization or corporation shall pay any undisputed portion of the claim in
accordance with this subsection and notify the policyholder, covered
person or health care provider in writing within thirty calendar days of
the receipt of the claim:
(1) that it is not obligated to pay the claim or make the medical
payment, stating the specific reasons why it is not liable; or
(2) to request all additional information needed to determine liabil-
ity to pay the claim or make the health care payment, EXCEPT THAT WITH
RESPECT TO A CLAIM OR BILL FOR SERVICES RENDERED UNDER THE EARLY INTER-
VENTION PROGRAM ESTABLISHED IN TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE
PUBLIC HEALTH LAW, THE INSURER OR CORPORATION OR ORGANIZATION, INCLUDING
AN APPROVED ORGANIZATION AS DEFINED IN SUBDIVISION TWO OF SECTION TWEN-
TY-FIVE HUNDRED TEN OF THE PUBLIC HEALTH LAW, SHALL REQUEST SUCH ADDI-
TIONAL INFORMATION FROM THE HEALTH CARE PROVIDER WITHIN FIFTEEN BUSINESS
DAYS OF RECEIPT OF THE CLAIM.
Upon receipt of the information requested in paragraph two of this
subsection or an appeal of a claim or bill for health care services
denied pursuant to paragraph one of this subsection, an insurer or
organization or corporation licensed or certified pursuant to article
forty-three or forty-seven of this chapter or article forty-four of the
public health law shall comply with subsection (a) of this section.
(c) (1) Except as provided in [paragraph] PARAGRAPHS two AND THREE of
this subsection, each claim or bill for health care services processed
in violation of this section shall constitute a separate violation. In
addition to the penalties provided in this chapter, any insurer or
organization or corporation that fails to adhere to the standards
contained in this section shall be obligated to pay to the health care
provider or person submitting the claim, in full settlement of the claim
or bill for health care services, the amount of the claim or health care
payment plus interest on the amount of such claim or health care payment
S. 6407--A 32 A. 9007--A
of the greater of the rate equal to the rate set by the commissioner of
taxation and finance for corporate taxes pursuant to paragraph one of
subsection (e) of section one thousand ninety-six of the tax law or
twelve percent per annum, to be computed from the date the claim or
health care payment was required to be made. When the amount of interest
due on such a claim is less [then] THAN two dollars, and insurer or
organization or corporation shall not be required to pay interest on
such claim.
(2) Where a violation of this section is determined by the superinten-
dent as a result of the superintendent's own investigation, examination,
audit or inquiry, an insurer or organization or corporation licensed or
certified pursuant to article forty-three or forty-seven of this chapter
or article forty-four of the public health law shall not be subject to a
civil penalty prescribed in paragraph one of this subsection, if the
superintendent determines that the insurer or organization or corpo-
ration has otherwise processed at least ninety-eight percent of the
claims submitted in a calendar year in compliance with this section;
provided, however, nothing in this paragraph shall limit, preclude or
exempt an insurer or organization or corporation from payment of a claim
and payment of interest pursuant to this section. This paragraph shall
not apply to violations of this section determined by the superintendent
resulting from individual complaints submitted to the superintendent by
health care providers or policyholders.
(3) WHERE AN INSURER OR ORGANIZATION, INCLUDING AN APPROVED ORGANIZA-
TION AS DEFINED IN SUBDIVISION TWO OF SECTION TWENTY-FIVE HUNDRED TEN OF
THE PUBLIC HEALTH LAW, OR CORPORATION FAILS TO ADHERE TO THE STANDARDS
CONTAINED IN THIS SECTION IN RELATION TO A CLAIM OR BILL FOR SERVICES
SUBMITTED FOR A SERVICE RENDERED UNDER THE EARLY INTERVENTION PROGRAM
ESTABLISHED IN TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH
LAW, THE CLAIM OR BILL FOR SERVICES SHALL BE DEEMED COVERED OR PAYABLE
UNDER THE CONTRACT OR AGREEMENT, AND THE INSURER OR ORGANIZATION OR
CORPORATION SHALL BE OBLIGATED TO PAY SUCH CLAIM OR BILL FOR SERVICES AT
THE HIGHER OF EITHER A RATE ESTABLISHED BY THE COMMISSIONER OF HEALTH OR
A RATE NEGOTIATED BY THE INSURER IN ACCORDANCE WITH REGULATION.
(d) For the purposes of this section:
(1) "policyholder" shall mean a person covered under such policy or a
representative designated by such person; and
(2) "health care provider" shall mean an entity licensed or certified
pursuant to article twenty-eight, thirty-six or forty of the public
health law, a facility licensed pursuant to article nineteen or thirty-
one of the mental hygiene law, a fiscal intermediary operating under
section three hundred sixty five-f of the social services law, AN INDI-
VIDUAL OR AGENCY APPROVED BY THE DEPARTMENT OF HEALTH PURSUANT TO TITLE
TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, a health care
professional licensed, registered or certified pursuant to title eight
of the education law, a dispenser or provider of pharmaceutical
products, services or durable medical equipment, or a representative
designated by such entity or person.
(e) Nothing in this section shall in any way be deemed to impair any
right available to the state to adjust the timing of its payments for
medical assistance pursuant to title eleven of article five of the
social services law, or for child health insurance plan benefits pursu-
ant to title one-a of article twenty-five of the public health law or
otherwise be deemed to require adjustment of payments by the state for
such medical assistance or child health insurance.
S. 6407--A 33 A. 9007--A
(f) In any action brought by the superintendent pursuant to this
section or article twenty-four of this chapter relating to this section
regarding payments for medical assistance pursuant to title eleven of
article five of the social services law, child health insurance plan
benefits pursuant to title one-a of article twenty-five of the public
health law, benefits under the voucher insurance program pursuant to
section one thousand one hundred twenty-one of this chapter, and bene-
fits under the New York state small business health insurance partner-
ship program pursuant to article nine-A of the public health law, it
shall be a mitigating factor that the insurer, corporation or organiza-
tion is owed any premium amounts, premium adjustments, stop-loss recov-
eries or other payments from the state or one of its fiscal interme-
diaries under any such program.
(g) Time period for submission of claims. (1) Except as otherwise
provided by law, health care claims must be initially submitted by
health care providers within one hundred twenty days after the date of
service to be valid and enforceable against an insurer or organization
or corporation licensed or certified pursuant to article forty-three or
article forty-seven of this chapter or article forty-four of the public
health law. Provided, however, that nothing in this subsection shall
preclude the parties from agreeing to a time period or other terms which
are more favorable to the health care provider. Provided further that,
in connection with contracts between organizations or corporations
licensed or certified pursuant to article forty-three of this chapter or
article forty-four of the public health law and health care providers
for the provision of services pursuant to section three hundred sixty-
four-j or three hundred sixty-nine-ee of the social services law or
title I-A of article twenty-five of the public health law, nothing here-
in shall be deemed: (i) to preclude the parties from agreeing to a
different time period but in no event less than ninety days; or (ii) to
supersede contract provisions in existence at the time this subsection
takes effect except to the extent that such contracts impose a time
period of less than ninety days.
(2) This subsection shall not abrogate any right or reduce or limit
any additional time period for claim submission provided by law or regu-
lation specifically applicable to coordination of benefits in effect
prior to the effective date of this subsection.
(h) (1) An insurer or organization or corporation licensed or certi-
fied pursuant to article forty-three or article forty-seven of this
chapter or article forty-four of the public health law shall permit a
participating health care provider to request reconsideration of a claim
that is denied exclusively because it was untimely submitted pursuant to
subsection (g) of this section. The insurer or organization or corpo-
ration shall pay such claim pursuant to the provisions of paragraph two
of this subsection if the health care provider can demonstrate both
that: (i) the health care provider's non-compliance was a result of an
unusual occurrence; and (ii) the health care provider has a pattern or
practice of timely submitting claims in compliance with [subdivision]
SUBSECTION (g) of this section.
(2) An insurer or organization or corporation licensed or certified
pursuant to article forty-three or article forty-seven of this chapter
or article forty-four of the public health law may reduce the reimburse-
ment due to a health care provider for an untimely claim that otherwise
meets the requirements of paragraph one of this subsection by an amount
not to exceed twenty-five percent of the amount that would have been
paid had the claim been submitted in a timely manner; provided, however,
S. 6407--A 34 A. 9007--A
that nothing in this subsection shall preclude a health care provider
and an insurer or organization or corporation from agreeing to a lesser
reduction. The provisions of this subsection shall not apply to any
claim submitted three hundred sixty-five days after the date of service,
in which case the insurer or organization or corporation may deny the
claim in full.
(i) Except where the parties have developed a mutually agreed upon
process for the reconciliation of coding disputes that includes a review
of submitted medical records to ascertain the correct coding for
payment, a general hospital certified pursuant to article twenty-eight
of the public health law shall, upon receipt of payment of a claim for
which payment has been adjusted based on a particular coding to a
patient including the assignment of diagnosis and procedure, have the
opportunity to submit the affected claim with medical records supporting
the hospital's initial coding of the claim within thirty days of receipt
of payment. Upon receipt of such medical records, an insurer or an
organization or corporation licensed or certified pursuant to article
forty-three or forty-seven of this chapter or article forty-four of the
public health law shall review such information to ascertain the correct
coding for payment and process the claim in accordance with the time-
frames set forth in subsection (a) of this section. In the event the
insurer, organization, or corporation processes the claim consistent
with its initial determination, such decision shall be accompanied by a
statement of the insurer, organization or corporation setting forth the
specific reasons why the initial adjustment was appropriate. An insurer,
organization, or corporation that increases the payment based on the
information submitted by the general hospital, but fails to do so in
accordance with the timeframes set forth in subsection (a) of this
section, shall pay to the general hospital interest on the amount of
such increase at the rate set by the commissioner of taxation and
finance for corporate taxes pursuant to paragraph one of subdivision (e)
of section one thousand ninety-six of the tax law, to be computed from
the end of the forty-five day period after resubmission of the addi-
tional medical record information. Provided, however, a failure to remit
timely payment shall not constitute a violation of this section.
Neither the initial or subsequent processing of the claim by the insur-
er, organization, or corporation shall be deemed an adverse determi-
nation as defined in section four thousand nine hundred of this chapter
if based solely on a coding determination. Nothing in this subsection
shall apply to those instances in which the insurer or organization, or
corporation has a reasonable suspicion of fraud or abuse.
(j) An insurer or an organization or corporation licensed or certified
pursuant to article forty-three or forty-seven of this chapter or arti-
cle forty-four of the public health law or a student health plan estab-
lished or maintained pursuant to section one thousand one hundred twen-
ty-four of this chapter shall accept claims submitted by a policyholder
or covered person, in writing, including through the internet, by elec-
tronic mail or by facsimile.
S 7. Section 3235-a of the insurance law, as added by section 3 of
part C of chapter 1 of the laws of 2002, subsection (c) as amended by
section 17 of part A of chapter 56 of the laws of 2012, is amended to
read as follows:
S 3235-a. Payment for early intervention services. (a) No policy of
accident and health insurance, including contracts issued pursuant to
article forty-three of this chapter, shall exclude coverage for other-
wise covered services solely on the basis that the services constitute
S. 6407--A 35 A. 9007--A
early intervention program services under title two-A of article twen-
ty-five of the public health law.
(b) Where a policy of accident and health insurance, including a
contract issued pursuant to article forty-three of this chapter,
provides coverage for an early intervention program service, such cover-
age shall not be applied against any maximum annual or lifetime monetary
limits set forth in such policy or contract. Visit limitations [and
other terms and conditions of the policy] will continue to apply to
early intervention services. However, any visits used for early inter-
vention program services shall not reduce the number of visits otherwise
available under the policy or contract for such services. WHEN SUCH
POLICY OF ACCIDENT AND HEALTH INSURANCE, INCLUDING A CONTRACT ISSUED
PURSUANT TO ARTICLE FORTY-THREE AND SECTION ELEVEN HUNDRED TWENTY OF
THIS CHAPTER, PROVIDES COVERAGE FOR ESSENTIAL HEALTH BENEFITS, AS
DEFINED IN SECTION 1302(B) OF THE AFFORDABLE CARE ACT, 42 U.S.C. S
18022(B), AND CONSTITUTES EARLY INTERVENTION SERVICES AS SET FORTH IN
PARAGRAPH (H) OF SUBDIVISION SEVEN OF SECTION TWENTY-FIVE HUNDRED
FORTY-ONE OF THE PUBLIC HEALTH LAW, OR EARLY INTERVENTION EVALUATION
SERVICES AS SET FORTH IN SUBDIVISION NINE OF SECTION TWENTY-FIVE HUNDRED
FORTY-ONE OF THE PUBLIC HEALTH LAW, A WRITTEN ORDER, REFERRAL, RECOMMEN-
DATION FOR DIAGNOSTIC SERVICES TO DETERMINE PROGRAM ELIGIBILITY, OR THE
INDIVIDUALIZED FAMILY SERVICES PLAN CERTIFIED BY THE EARLY INTERVENTION
OFFICIAL, AS DEFINED IN SECTION TWENTY-FIVE HUNDRED FORTY-ONE OF THE
PUBLIC HEALTH LAW OR SUCH OFFICIAL'S DESIGNEE, SHALL BE SUFFICIENT TO
MEET PRECERTIFICATION, PREAUTHORIZATION AND/OR MEDICAL NECESSITY
REQUIREMENTS IMPOSED UNDER SUCH POLICY.
(C) REIMBURSEMENT FOR ANY EARLY INTERVENTION PROGRAM SERVICE, AS SET
FORTH IN PARAGRAPH (H) OF SUBDIVISION SEVEN OF SECTION TWENTY-FIVE
HUNDRED FORTY-ONE OF THE PUBLIC HEALTH LAW, OR EARLY INTERVENTION EVALU-
ATION SERVICE, AS SET FORTH IN SUBDIVISION NINE OF SECTION TWENTY-FIVE
HUNDRED FORTY-ONE OF THE PUBLIC HEALTH LAW, THAT IS A COVERED SERVICE
UNDER THE POLICY OF ACCIDENT AND HEALTH INSURANCE, INCLUDING A CONTRACT
ISSUED PURSUANT TO ARTICLE FORTY-THREE OF THIS CHAPTER, SHALL BE AT THE
HIGHER OF EITHER A RATE ESTABLISHED BY THE COMMISSIONER OF HEALTH OR A
RATE NEGOTIATED BY THE INSURER IN ACCORDANCE WITH REGULATION.
(D) A POLICY OF ACCIDENT AND HEALTH INSURANCE, INCLUDING A CONTRACT
ISSUED PURSUANT TO ARTICLE FORTY-THREE AND SECTION ELEVEN HUNDRED TWENTY
OF THIS CHAPTER, SHALL NOT DENY COVERAGE BASED ON THE FOLLOWING:
(I) THE LOCATION WHERE SERVICES ARE PROVIDED;
(II) THE DURATION OF THE CHILD'S CONDITION AND/OR THAT THE CHILD'S
CONDITION IS NOT AMENABLE TO SIGNIFICANT IMPROVEMENT WITHIN A CERTAIN
PERIOD OF TIME AS SPECIFIED IN THE POLICY;
(III) THE SERVICE IS NOT A COVERED BENEFIT BUT IS AN ESSENTIAL HEALTH
BENEFIT AS DEFINED IN SECTION 1302(B) OF THE AFFORDABLE CARE ACT, 42
U.S.C. S 18022(B); OR
(IV) THE PROVIDER OF SERVICES IS NOT A PARTICIPATING PROVIDER IN THE
INSURER'S NETWORK.
[(c)] (E) 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. IF AN
INSURER MAKES PAYMENT IN WHOLE OR IN PART FOR A CLAIM OR BILL FOR
S. 6407--A 36 A. 9007--A
SERVICES RENDERED UNDER THE EARLY INTERVENTION PROGRAM ESTABLISHED IN
TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, SUCH
PAYMENT SHALL BE MADE TO THE PROVIDER WHO SUBMITTED THE CLAIM AND NOT TO
THE RENDERING PROFESSIONAL WHO DELIVERED THE SERVICE OR THE COVERED
PERSON REGARDLESS OF WHETHER SUCH PROVIDER IS IN THE INSURER'S NETWORK.
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 writ-
ten request and notice authorizing such release. The service coordinator
shall provide such information to the rendering provider assigned to
provide services to the child.
[(d)] (F) No insurer, including a health maintenance organization
issued a certificate of authority under article forty-four of the public
health law and a corporation organized under article forty-three of this
chapter, shall refuse to issue an accident and health insurance policy
or contract or refuse to renew an accident and health insurance policy
or contract solely because the applicant or insured is receiving
services under the early intervention program.
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, 2016; provided
however, that the amendments to section 3224-a of the insurance law as
made by section six of this act and the amendments to section 3235-a of
the insurance law as made by section seven of this act shall apply only
to policies, benefit packages, and contracts issued, renewed, modified,
altered or amended on or after such date.
PART F
Section 1. Section 2825-b of the public health law, as added by
section 2 of part J of chapter 60 of the laws of 2015, is amended to
read as follows:
S 2825-b. [Oneida county health] HEALTH care facility transformation
program: [Oneida county project] STATEWIDE. 1. [An Oneida county] A
STATEWIDE health care facility transformation program is hereby estab-
lished under the joint administration of the commissioner and the presi-
dent of the dormitory authority of the state of New York for the purpose
of strengthening and protecting continued access to health care services
in communities. The program shall provide capital funding in support of
projects [located in the largest population center in Oneida county that
consolidate multiple licensed health care facilities into an integrated
system of care] THAT REPLACE INEFFICIENT AND OUTDATED FACILITIES AS PART
OF A MERGER, CONSOLIDATION, ACQUISITION OR OTHER SIGNIFICANT CORPORATE
RESTRUCTURING ACTIVITY THAT IS PART OF AN OVERALL TRANSFORMATION PLAN
INTENDED TO CREATE A FINANCIALLY SUSTAINABLE SYSTEM OF CARE. The issu-
ance of any bonds or notes hereunder shall be subject to the approval of
the director of the division of the budget, and any projects funded
through the issuance of bonds or notes hereunder shall be approved by
the New York state public authorities control board, as required under
section fifty-one of the public authorities law.
2. The commissioner and the president of the authority shall enter
into an agreement, subject to approval by the director of the budget,
and subject to section sixteen hundred eighty-r of the public authori-
ties law, for the purposes of awarding, distributing, and administering
the funds made available pursuant to this section. Such funds may be
distributed by the commissioner and the president of the authority for
capital grants to general hospitals [for the purposes of consolidating
S. 6407--A 37 A. 9007--A
multiple licensed health care facilities into an integrated system of
care], RESIDENTIAL HEALTH CARE FACILITIES, DIAGNOSTIC AND TREATMENT
CENTERS AND CLINICS LICENSED PURSUANT TO THIS CHAPTER OR THE MENTAL
HYGIENE LAW, PRIMARY CARE PROVIDERS, AND HOME CARE PROVIDERS CERTIFIED
OR LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF THIS CHAPTER, for capital
non-operational works or purposes that support the purposes set forth in
this section. A copy of such agreement, and any amendments thereto,
shall be provided to the chair of the senate finance committee, the
chair of the assembly ways and means committee, and the director of the
division of budget no later than thirty days prior to the release of a
request for applications for funding under this program. Projects
awarded, IN WHOLE OR PART, under section twenty-eight hundred twenty-
five of this article shall not be eligible for grants or awards made
available under this section.
3. Notwithstanding section one hundred sixty-three of the state
finance law or any inconsistent provision of law to the contrary, up to
[three] TWO hundred million dollars of the funds appropriated for this
program shall be awarded without a competitive bid or request for
proposal process for capital grants to health care providers (hereafter
"applicants") [located in the county of Oneida]. ELIGIBLE APPLICANTS
SHALL BE THOSE DEEMED BY THE COMMISSIONER TO BE A PROVIDER THAT FULFILLS
OR WILL FULFILL A HEALTH CARE NEED FOR ACUTE INPATIENT, OUTPATIENT,
PRIMARY, HOME CARE OR RESIDENTIAL HEALTH CARE SERVICES IN A COMMUNITY.
4. In determining awards for eligible applicants under this section,
the commissioner and the president of the authority shall consider
criteria including, but not limited to:
(a) the extent to which the proposed capital project will contribute
to the integration of health care services and long term sustainability
of the applicant or preservation of essential health services in the
community or communities served by the applicant;
(b) the extent to which the proposed project or purpose is aligned
with delivery system reform incentive payment ("DSRIP") program goals
and objectives;
(c) CONSIDERATION OF GEOGRAPHIC DISTRIBUTION OF FUNDS;
(D) the relationship between the proposed capital project and identi-
fied community need;
[(d)] (E) THE EXTENT TO WHICH THE APPLICANT HAS ACCESS TO ALTERNATIVE
FINANCING;
(F) the extent that the proposed capital project furthers the develop-
ment of primary care and other outpatient services;
[(e)] (G) the extent to which the proposed capital project benefits
Medicaid enrollees and uninsured individuals;
[(f)] (H) the extent to which the applicant has engaged the community
affected by the proposed capital project and the manner in which commu-
nity engagement has shaped such capital project; and
[(g)] (I) the extent to which the proposed capital project addresses
potential risk to patient safety and welfare.
5. DISBURSEMENT OF AWARDS MADE PURSUANT TO THIS SECTION SHALL BE
CONDITIONED ON THE AWARDEE ACHIEVING CERTAIN PROCESS AND PERFORMANCE
METRICS AND MILESTONES AS DETERMINED IN THE SOLE DISCRETION OF THE
COMMISSIONER. SUCH METRICS AND MILESTONES SHALL BE STRUCTURED TO ENSURE
THAT THE HEALTH CARE TRANSFORMATION AND PROVIDER SUSTAINABILITY GOALS OF
THE PROJECT ARE ACHIEVED, AND SUCH METRICS AND MILESTONES SHALL BE
INCLUDED IN GRANT DISBURSEMENT AGREEMENTS OR OTHER CONTRACTUAL DOCUMENTS
AS REQUIRED BY THE COMMISSIONER.
S. 6407--A 38 A. 9007--A
6. The department shall provide a report on a quarterly basis to the
chairs of the senate finance, assembly ways and means, senate health and
assembly health committees. Such reports shall be submitted no later
than sixty days after the close of the quarter, and shall [conform to
the reporting requirements of subdivision twenty of section twenty-eight
hundred seven of this article, as applicable] INCLUDE, FOR EACH AWARD,
THE NAME OF THE APPLICANT, A DESCRIPTION OF THE PROJECT OR PURPOSE, THE
AMOUNT OF THE AWARD, DISBURSEMENT DATE, AND STATUS OF ACHIEVEMENT OF
PROCESS AND PERFORMANCE METRICS AND MILESTONES PURSUANT TO SUBDIVISION
FIVE 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, 2016.
PART G
Section 1. Section 2801-a of the public health law is amended by
adding a new subdivision 17 to read as follows:
17. (A) DIAGNOSTIC OR TREATMENT CENTERS ESTABLISHED TO PROVIDE HEALTH
CARE SERVICES WITHIN THE SPACE OF A RETAIL BUSINESS OPERATION, SUCH AS A
PHARMACY OR A STORE OPEN TO THE GENERAL PUBLIC, OR WITHIN SPACE USED BY
AN EMPLOYER FOR PROVIDING HEALTH CARE SERVICES TO ITS EMPLOYEES, MAY BE
OPERATED BY LEGAL ENTITIES FORMED UNDER THE LAWS OF THE STATE OF NEW
YORK:
(I) WHOSE STOCKHOLDERS OR MEMBERS, AS APPLICABLE, ARE NOT NATURAL
PERSONS;
(II) WHOSE PRINCIPAL STOCKHOLDERS AND MEMBERS, AS APPLICABLE, AND
CONTROLLING PERSONS COMPLY WITH ALL APPLICABLE REQUIREMENTS OF THIS
SECTION; AND
(III) THAT DEMONSTRATE, TO THE SATISFACTION OF THE PUBLIC HEALTH AND
HEALTH PLANNING COUNCIL, SUFFICIENT EXPERIENCE AND EXPERTISE IN DELIVER-
ING HIGH QUALITY HEALTH CARE SERVICES, AND FURTHER DEMONSTRATE A COMMIT-
MENT TO OPERATE LIMITED SERVICES CLINICS IN MEDICALLY UNDERSERVED AREAS
OF THE STATE. SUCH DIAGNOSTIC AND TREATMENT CENTERS SHALL BE REFERRED TO
IN THIS SECTION AS "LIMITED SERVICES CLINICS".
(B) FOR PURPOSES OF PARAGRAPH (A) OF THIS SUBDIVISION, THE PUBLIC
HEALTH AND HEALTH PLANNING COUNCIL SHALL ADOPT AND AMEND RULES AND REGU-
LATIONS, NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION, TO
ADDRESS ANY MATTER IT DEEMS PERTINENT TO THE ESTABLISHMENT OF LIMITED
SERVICES CLINICS. SUCH RULES AND REGULATIONS SHALL INCLUDE, BUT NOT BE
LIMITED TO, PROVISIONS GOVERNING OR RELATING TO:
(I) ANY DIRECT OR INDIRECT CHANGES OR TRANSFERS OF OWNERSHIP INTERESTS
OR VOTING RIGHTS IN SUCH ENTITIES OR THEIR STOCKHOLDERS OR MEMBERS, AS
APPLICABLE;
(II) PUBLIC HEALTH AND HEALTH PLANNING COUNCIL APPROVAL OF ANY CHANGE
IN CONTROLLING INTERESTS, PRINCIPAL STOCKHOLDERS, CONTROLLING PERSONS,
PARENT COMPANY OR SPONSORS;
(III) OVERSIGHT OF THE OPERATOR AND ITS SHAREHOLDERS OR MEMBERS, AS
APPLICABLE, INCLUDING LOCAL GOVERNANCE OF THE LIMITED SERVICES CLINICS;
AND
(IV) THE CHARACTER AND COMPETENCE AND QUALIFICATIONS OF, AND CHANGES
RELATING TO, THE DIRECTORS AND OFFICERS OF THE OPERATOR AND ITS PRINCI-
PAL STOCKHOLDERS, CONTROLLING PERSONS, PARENT COMPANY OR SPONSORS.
(C) THE FOLLOWING PROVISIONS OF THIS SECTION SHALL NOT APPLY TO LIMIT-
ED SERVICES CLINICS:
(I) PARAGRAPH (A) OF SUBDIVISION THREE OF THIS SECTION;
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(II) PARAGRAPH (B) OF SUBDIVISION THREE OF THIS SECTION, RELATING TO
STOCKHOLDERS AND MEMBERS OTHER THAN PRINCIPAL STOCKHOLDERS AND PRINCIPAL
MEMBERS;
(III) PARAGRAPH (C) OF SUBDIVISION FOUR OF THIS SECTION, RELATING TO
THE DISPOSITION OF STOCK OR VOTING RIGHTS; AND
(IV) PARAGRAPH (E) OF SUBDIVISION FOUR OF THIS SECTION, RELATING TO
THE OWNERSHIP OF STOCK OR MEMBERSHIP.
(D) A LIMITED SERVICES CLINIC SHALL BE DEEMED TO BE A "HEALTH CARE
PROVIDER" FOR THE PURPOSES OF TITLE TWO-D OF ARTICLE TWO OF THIS CHAP-
TER. A PRESCRIBER PRACTICING IN A LIMITED SERVICES CLINIC SHALL NOT BE
DEEMED TO BE IN THE EMPLOY OF A PHARMACY OR PRACTICING IN A HOSPITAL FOR
PURPOSES OF SUBDIVISION TWO OF SECTION SIXTY-EIGHT HUNDRED SEVEN OF THE
EDUCATION LAW.
(E) THE COMMISSIONER SHALL PROMULGATE REGULATIONS SETTING FORTH OPERA-
TIONAL AND PHYSICAL PLANT STANDARDS FOR LIMITED SERVICES CLINICS, WHICH
MAY BE DIFFERENT FROM THE REGULATIONS OTHERWISE APPLICABLE TO DIAGNOSTIC
OR TREATMENT CENTERS, INCLUDING, BUT NOT LIMITED TO:
(I) REQUIRING THAT LIMITED SERVICES CLINICS ATTAIN AND MAINTAIN
ACCREDITATION AND REQUIRING TIMELY REPORTING TO THE DEPARTMENT IF A
LIMITED SERVICES CLINIC LOSES ITS ACCREDITATION;
(II) DESIGNATING OR LIMITING THE TREATMENTS AND SERVICES THAT MAY BE
PROVIDED, INCLUDING:
(A) LIMITING THE SCOPE OF SERVICES TO THE FOLLOWING, PROVIDED THAT
SUCH SERVICES SHALL NOT INCLUDE MONITORING OR TREATMENT AND SERVICES
OVER PROLONGED PERIODS:
(1) THE PROVISION OF TREATMENT AND SERVICES TO PATIENTS FOR MINOR
ACUTE EPISODIC ILLNESSES OR CONDITIONS;
(2) EPISODIC PREVENTIVE AND WELLNESS TREATMENTS AND SERVICES SUCH AS
IMMUNIZATIONS; AND
(3) TREATMENT AND SERVICES FOR MINOR TRAUMAS THAT ARE NOT REASONABLY
LIKELY TO BE LIFE THREATENING OR POTENTIALLY DISABLING IF AMBULATORY
CARE WITHIN THE CAPACITY OF THE LIMITED SERVICES CLINIC IS PROVIDED;
(B) PROHIBITING THE PROVISION OF SERVICES TO PATIENTS TWENTY-FOUR
MONTHS OF AGE OR YOUNGER;
(C) THE PROVISION OF SPECIFIC IMMUNIZATIONS TO PATIENTS YOUNGER THAN
EIGHTEEN YEARS OF AGE;
(III) REQUIRING LIMITED SERVICES CLINICS TO ACCEPT WALK-INS AND OFFER
EXTENDED BUSINESS HOURS;
(IV) SETTING FORTH GUIDELINES FOR ADVERTISING AND SIGNAGE, WHICH SHALL
INCLUDE SIGNAGE INDICATING THAT PRESCRIPTIONS AND OVER-THE-COUNTER
SUPPLIES MAY BE PURCHASED BY A PATIENT FROM ANY BUSINESS AND DO NOT NEED
TO BE PURCHASED ON-SITE;
(V) SETTING FORTH GUIDELINES FOR DISCLOSURE OF OWNERSHIP INTERESTS,
INFORMED CONSENT, RECORD KEEPING, REFERRAL FOR TREATMENT AND CONTINUITY
OF CARE, CASE REPORTING TO THE PATIENT'S PRIMARY CARE OR OTHER HEALTH
CARE PROVIDERS, DESIGN, CONSTRUCTION, FIXTURES, AND EQUIPMENT; AND
(VI) REQUIRING THE OPERATOR TO DIRECTLY EMPLOY A MEDICAL DIRECTOR WHO
IS LICENSED AND CURRENTLY REGISTERED TO PRACTICE MEDICINE IN THE STATE
OF NEW YORK.
(F) SUCH REGULATIONS ALSO SHALL PROMOTE AND STRENGTHEN PRIMARY CARE BY
REQUIRING LIMITED SERVICES CLINICS TO:
(I) INQUIRE OF EACH PATIENT WHETHER HE OR SHE HAS A PRIMARY CARE
PROVIDER;
(II) MAINTAIN AND REGULARLY UPDATE A LIST OF LOCAL PRIMARY CARE
PROVIDERS AND PROVIDE SUCH LIST TO EACH PATIENT WHO INDICATES THAT HE OR
SHE DOES NOT HAVE A PRIMARY CARE PROVIDER;
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(III) REFER PATIENTS TO THEIR PRIMARY CARE PROVIDERS OR OTHER HEALTH
CARE PROVIDERS AS APPROPRIATE;
(IV) TRANSMIT, BY ELECTRONIC MEANS WHENEVER POSSIBLE, RECORDS OF
SERVICES TO PATIENTS' PRIMARY CARE PROVIDERS;
(V) EXECUTE PARTICIPATION AGREEMENTS WITH HEALTH INFORMATION ORGANIZA-
TIONS, ALSO KNOWN AS QUALIFIED ENTITIES, PURSUANT TO WHICH LIMITED
SERVICES CLINICS AGREE TO PARTICIPATE IN THE STATEWIDE HEALTH INFORMA-
TION NETWORK FOR NEW YORK (SHIN-NY); AND
(VI) DECLINE TO TREAT ANY PATIENT FOR THE SAME CONDITION OR ILLNESS
MORE THAN THREE TIMES IN A YEAR.
(G) A LIMITED SERVICES CLINIC SHALL PROVIDE TREATMENT WITHOUT DISCRIM-
INATION AS TO SOURCE OF PAYMENT.
(H) NOTWITHSTANDING THIS SUBDIVISION AND OTHER LAW OR REGULATION TO
THE CONTRARY AND SUBJECT TO THE PROVISIONS OF SECTION TWENTY-EIGHT
HUNDRED TWO OF THIS ARTICLE, A DIAGNOSTIC AND TREATMENT CENTER, COMMUNI-
TY HEALTH CENTER OR FEDERALLY QUALIFIED HEALTH CENTER MAY OPERATE A
LIMITED SERVICES CLINIC WHICH MEETS THE REGULATION PROMULGATED PURSUANT
TO PARAGRAPH (E) OF THIS SUBDIVISION REGARDING OPERATIONAL PHYSICAL
PLANT STANDARDS.
(I) IN DETERMINING WHETHER TO APPROVE ADDITIONAL LIMITED SERVICES
CLINIC LOCATIONS, THE DEPARTMENT SHALL CONSIDER WHETHER THE OPERATOR HAS
FULFILLED ITS COMMITMENT TO OPERATE LIMITED SERVICES CLINICS IN
MEDICALLY UNDERSERVED AREAS OF THE STATE.
S 2. This act shall take effect immediately.
PART H
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, as amended
by section 1 of part JJ of chapter 58 of the laws of 2015, 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,
[2016] 2019; and for programs located within the city of New York, the
applicable fiscal periods shall be July 1, 2003 through June 30, 2010
and July 1, 2011 through June 30, [2016] 2019.
S 2. This act shall take effect immediately.
PART I
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 K of
chapter 56 of the laws of 2012, are amended to read as follows:
S 19. Notwithstanding any other provision of law, the commissioner of
mental health shall, until July 1, [2016] 2020, be solely authorized, in
S. 6407--A 41 A. 9007--A
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, [2016] 2020, 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, 2016.
PART J
Section 1. Subdivision a of section 9 of chapter 420 of the laws of
2002 amending the education law relating to the profession of social
work, as amended by section 1 of part AA of chapter 57 of the laws of
2013, is amended to read as follows:
a. Nothing in this act shall prohibit or limit the activities or
services on the part of any person in the employ of a program or service
operated, regulated, funded, or approved by the department of mental
hygiene, the office of children and family services, the office of
temporary and disability assistance, the department of corrections and
community supervision, the state office for the aging, the department of
health, or a local governmental unit as that term is defined in article
41 of the mental hygiene law or a social services district as defined in
section 61 of the social services law, provided, however, this section
shall not authorize the use of any title authorized pursuant to article
154 of the education law, except that this section shall be deemed
repealed on July 1, [2016] 2021.
S 2. Subdivision a of section 17-a of chapter 676 of the laws of 2002
amending the education law relating to the practice of psychology, as
amended by section 2 of part AA of chapter 57 of the laws of 2013, is
amended to read as follows:
a. In relation to activities and services provided under article 153
of the education law, nothing in this act shall prohibit or limit such
activities or services on the part of any person in the employ of a
program or service operated, regulated, funded, or approved by the
department of mental hygiene or the office of children and family
services, or a local governmental unit as that term is defined in arti-
cle 41 of the mental hygiene law or a social services district as
defined in section 61 of the social services law. In relation to activ-
ities and services provided under article 163 of the education law,
nothing in this act shall prohibit or limit such activities or services
on the part of any person in the employ of a program or service oper-
ated, regulated, funded, or approved by the department of mental
hygiene, the office of children and family services, the department of
corrections and community supervision, the office of temporary and disa-
bility assistance, the state office for the aging and the department of
health or a local governmental unit as that term is defined in article
41 of the mental hygiene law or a social services district as defined in
section 61 of the social services law, pursuant to authority granted by
law. This section shall not authorize the use of any title authorized
S. 6407--A 42 A. 9007--A
pursuant to article 153 or 163 of the education law by any such employed
person, except as otherwise provided by such articles respectively.
This section shall be deemed repealed July 1, [2016] 2021.
S 3. Section 16 of chapter 130 of the laws of 2010 amending the educa-
tion law and other laws relating to the registration of entities provid-
ing certain professional services and the licensure of certain
professions, as amended by section 3 of part AA of chapter 57 of the
laws of 2013, is amended to read as follows:
S 16. This act shall take effect immediately; provided that sections
thirteen, fourteen and fifteen of this act shall take effect immediately
and shall be deemed to have been in full force and effect on and after
June 1, 2010 and such sections shall be deemed repealed July 1, [2016]
2021; provided further that the amendments to section 9 of chapter 420
of the laws of 2002 amending the education law relating to the profes-
sion of social work made by section thirteen of this act shall repeal on
the same date as such section repeals; provided further that the amend-
ments to section 17-a of chapter 676 of the laws of 2002 amending the
education law relating to the practice of psychology made by section
fourteen of this act shall repeal on the same date as such section
repeals.
S 4. This act shall take effect immediately.
PART K
Section 1. Subdivision 9 of section 730.10 of the criminal procedure
law, as added by section 1 of part Q of chapter 56 of the laws of 2012,
is amended 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; OR (C)
A MENTAL HEALTH UNIT OPERATING WITHIN A CORRECTIONAL FACILITY OR LOCAL
CORRECTIONAL FACILITY PROVIDED HOWEVER THAT ANY SUCH MENTAL HEALTH UNIT
OPERATING WITHIN A LOCAL CORRECTIONAL FACILITY SHALL QUALIFY AS AN
"APPROPRIATE INSTITUTION" ONLY PURSUANT TO THE TERMS OF AN AGREEMENT
BETWEEN THE COMMISSIONER AND THE SHERIFF AND ANY SUCH MENTAL HEALTH UNIT
OPERATING WITHIN A CORRECTIONAL FACILITY SHALL QUALIFY AS AN "APPROPRI-
ATE INSTITUTION" ONLY PURSUANT TO THE TERMS OF AN AGREEMENT BETWEEN THE
COMMISSIONER AND THE COMMISSIONER OF THE DEPARTMENT OF CORRECTIONS AND
COMMUNITY SUPERVISION. Nothing in this article shall be construed as
requiring a hospital, CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACIL-
ITY to consent to providing care and treatment to an incapacitated
person at such hospital, CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL
FACILITY.
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, 2016.
PART L
Section 1. The mental hygiene law is amended by adding a new section
16.25 to read as follows:
S 16.25 TEMPORARY OPERATOR.
S. 6407--A 43 A. 9007--A
(A) FOR THE PURPOSES OF THIS SECTION:
(1) "ESTABLISHED OPERATOR" SHALL MEAN THE PROVIDER OF SERVICES THAT
HAS BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE PURSUANT TO
THIS ARTICLE.
(2) "EXTRAORDINARY FINANCIAL ASSISTANCE" SHALL MEAN STATE FUNDS
PROVIDED TO, OR REQUESTED BY, A PROGRAM FOR THE EXPRESS PURPOSE OF
PREVENTING THE CLOSURE OF THE PROGRAM THAT THE COMMISSIONER FINDS
PROVIDES ESSENTIAL AND NECESSARY SERVICES WITHIN THE COMMUNITY.
(3) "SERIOUS FINANCIAL INSTABILITY" SHALL INCLUDE BUT NOT BE LIMITED
TO DEFAULTING OR VIOLATING MATERIAL COVENANTS OF BOND ISSUES, MISSED
MORTGAGE PAYMENTS, MISSED RENT PAYMENTS, A PATTERN OF UNTIMELY PAYMENT
OF DEBTS, FAILURE TO PAY ITS EMPLOYEES OR VENDORS, INSUFFICIENT FUNDS TO
MEET THE GENERAL OPERATING EXPENSES OF THE PROGRAM, FAILURE TO MAINTAIN
REQUIRED DEBT SERVICE COVERAGE RATIOS AND/OR, AS APPLICABLE, FACTORS
THAT HAVE TRIGGERED A WRITTEN EVENT OF DEFAULT NOTICE TO THE OFFICE BY
THE DORMITORY AUTHORITY OF THE STATE OF NEW YORK.
(4) "OFFICE" SHALL MEAN THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISA-
BILITIES.
(5) "TEMPORARY OPERATOR" SHALL MEAN ANY PROVIDER OF SERVICES THAT HAS
BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE PURSUANT TO THIS
ARTICLE OR WHICH IS DIRECTLY OPERATED BY THE OFFICE, THAT:
A. AGREES TO PROVIDE SERVICES CERTIFIED PURSUANT TO THIS ARTICLE ON A
TEMPORARY BASIS IN THE BEST INTERESTS OF ITS INDIVIDUALS SERVED BY THE
PROGRAM; AND
B. HAS A HISTORY OF COMPLIANCE WITH APPLICABLE LAWS, RULES, AND REGU-
LATIONS AND A RECORD OF PROVIDING CARE OF GOOD QUALITY, AS DETERMINED BY
THE COMMISSIONER; AND
C. PRIOR TO APPOINTMENT AS TEMPORARY OPERATOR, DEVELOPS A PLAN DETER-
MINED TO BE SATISFACTORY BY THE COMMISSIONER TO ADDRESS THE PROGRAM'S
DEFICIENCIES.
(B) (1) IN THE EVENT THAT: (I) THE ESTABLISHED OPERATOR IS SEEKING
EXTRAORDINARY FINANCIAL ASSISTANCE; (II) OFFICE COLLECTED DATA DEMON-
STRATES THAT THE ESTABLISHED OPERATOR IS EXPERIENCING SERIOUS FINANCIAL
INSTABILITY ISSUES; (III) OFFICE COLLECTED DATA DEMONSTRATES THAT THE
ESTABLISHED OPERATOR'S BOARD OF DIRECTORS OR ADMINISTRATION IS UNABLE OR
UNWILLING TO ENSURE THE PROPER OPERATION OF THE PROGRAM; OR (IV) OFFICE
COLLECTED DATA INDICATES THERE ARE CONDITIONS THAT SERIOUSLY ENDANGER OR
JEOPARDIZE CONTINUED ACCESS TO NECESSARY SERVICES WITHIN THE COMMUNITY,
THE COMMISSIONER SHALL NOTIFY THE ESTABLISHED OPERATOR OF HIS OR HER
INTENTION TO APPOINT A TEMPORARY OPERATOR TO ASSUME SOLE RESPONSIBILITY
FOR THE PROVIDER OF SERVICES' OPERATIONS FOR A LIMITED PERIOD OF TIME.
THE APPOINTMENT OF A TEMPORARY OPERATOR SHALL BE EFFECTUATED PURSUANT TO
THIS SECTION, AND SHALL BE IN ADDITION TO ANY OTHER REMEDIES PROVIDED BY
LAW.
(2) THE ESTABLISHED OPERATOR 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 NECES-
SARY, ENTER INTO AN AGREEMENT WITH THE ESTABLISHED OPERATOR FOR THE
APPOINTMENT OF A TEMPORARY OPERATOR TO RESTORE OR MAINTAIN THE PROVISION
OF QUALITY CARE TO THE INDIVIDUALS UNTIL THE ESTABLISHED OPERATOR CAN
RESUME OPERATIONS WITHIN THE DESIGNATED TIME PERIOD OR OTHER ACTION IS
TAKEN AS DESCRIBED IN SECTION 16.17 OF THIS ARTICLE.
(C) (1) A TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION SHALL
USE HIS OR HER BEST EFFORTS TO IMPLEMENT THE PLAN DEEMED SATISFACTORY BY
THE COMMISSIONER TO CORRECT OR ELIMINATE ANY DEFICIENCIES IN THE PROGRAM
S. 6407--A 44 A. 9007--A
AND TO PROMOTE THE QUALITY AND ACCESSIBILITY OF SERVICES IN THE COMMUNI-
TY SERVED BY THE PROVIDER OF SERVICES.
(2) DURING THE TERM OF APPOINTMENT, THE TEMPORARY OPERATOR SHALL HAVE
THE AUTHORITY TO DIRECT THE STAFF OF THE ESTABLISHED OPERATOR AS NECES-
SARY TO APPROPRIATELY PROVIDE SERVICES FOR INDIVIDUALS. THE TEMPORARY
OPERATOR SHALL, DURING THIS PERIOD, PROVIDE SERVICES IN SUCH A MANNER AS
TO PROMOTE SAFETY AND THE QUALITY AND ACCESSIBILITY OF SERVICES IN THE
COMMUNITY SERVED BY THE ESTABLISHED OPERATOR UNTIL EITHER THE ESTAB-
LISHED OPERATOR CAN RESUME OPERATIONS OR UNTIL THE OFFICE REVOKES THE
OPERATING CERTIFICATE FOR THE SERVICES ISSUED UNDER THIS ARTICLE.
(3) THE ESTABLISHED OPERATOR SHALL GRANT ACCESS TO THE TEMPORARY OPER-
ATOR TO THE ESTABLISHED OPERATOR'S ACCOUNTS AND RECORDS IN ORDER TO
ADDRESS ANY DEFICIENCIES RELATED TO THE PROGRAM EXPERIENCING SERIOUS
FINANCIAL INSTABILITY OR AN ESTABLISHED OPERATOR REQUESTING FINANCIAL
ASSISTANCE IN ACCORDANCE WITH THIS SECTION. THE TEMPORARY OPERATOR SHALL
APPROVE ANY FINANCIAL DECISION RELATED TO AN ESTABLISHED PROVIDER'S DAY
TO DAY OPERATIONS OR THE ESTABLISHED PROVIDER'S ABILITY TO PROVIDE
SERVICES.
(4) THE TEMPORARY OPERATOR SHALL NOT BE REQUIRED TO FILE ANY BOND. NO
SECURITY INTEREST IN ANY REAL OR PERSONAL PROPERTY COMPRISING THE ESTAB-
LISHED OPERATOR OR CONTAINED WITHIN THE ESTABLISHED OPERATOR OR IN ANY
FIXTURE OF THE PROGRAM, SHALL BE IMPAIRED OR DIMINISHED IN PRIORITY BY
THE TEMPORARY OPERATOR. NEITHER THE TEMPORARY OPERATOR NOR THE OFFICE
SHALL ENGAGE IN ANY ACTIVITY THAT CONSTITUTES A CONFISCATION OF PROPER-
TY.
(D) THE TEMPORARY OPERATOR SHALL BE ENTITLED TO A REASONABLE FEE, AS
DETERMINED BY THE COMMISSIONER AND SUBJECT TO THE APPROVAL OF THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, AND NECESSARY EXPENSES INCURRED WHILE
SERVING AS A TEMPORARY OPERATOR. THE TEMPORARY OPERATOR SHALL BE LIABLE
ONLY IN ITS CAPACITY AS TEMPORARY OPERATOR FOR INJURY TO PERSON AND
PROPERTY BY REASON OF ITS OPERATION OF SUCH PROGRAM; NO LIABILITY SHALL
INCUR IN THE TEMPORARY OPERATOR'S PERSONAL CAPACITY, EXCEPT FOR GROSS
NEGLIGENCE AND INTENTIONAL ACTS.
(E) (1) THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR
SHALL NOT EXCEED NINETY DAYS. AFTER NINETY DAYS, IF THE COMMISSIONER
DETERMINES THAT TERMINATION OF THE TEMPORARY OPERATOR WOULD CAUSE
SIGNIFICANT DETERIORATION OF THE QUALITY OF, OR ACCESS TO, CARE IN THE
COMMUNITY OR THAT REAPPOINTMENT IS NECESSARY TO CORRECT THE DEFICIENCIES
THAT REQUIRED THE APPOINTMENT OF THE TEMPORARY OPERATOR, THE COMMISSION-
ER MAY AUTHORIZE AN ADDITIONAL NINETY-DAY TERM. HOWEVER, SUCH AUTHORI-
ZATION SHALL INCLUDE THE COMMISSIONER'S REQUIREMENTS FOR CONCLUSION OF
THE TEMPORARY OPERATORSHIP TO BE SATISFIED WITHIN THE ADDITIONAL TERM.
(2) 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:
A. THE ACTIONS TAKEN DURING THE APPOINTMENT TO ADDRESS THE IDENTIFIED
PROGRAM DEFICIENCIES, THE RESUMPTION OF PROGRAM OPERATIONS BY THE ESTAB-
LISHED OPERATOR, OR THE REVOCATION OF AN OPERATING CERTIFICATE ISSUED BY
THE OFFICE;
B. OBJECTIVES FOR THE CONTINUATION OF THE TEMPORARY OPERATORSHIP IF
NECESSARY AND A SCHEDULE FOR SATISFACTION OF SUCH OBJECTIVES; AND
C. IF APPLICABLE, THE RECOMMENDED ACTIONS FOR THE ONGOING PROVISION OF
SERVICES SUBSEQUENT TO THE TEMPORARY OPERATORSHIP.
(3) THE TERM OF THE INITIAL APPOINTMENT AND OF ANY SUBSEQUENT REAP-
POINTMENT MAY BE TERMINATED PRIOR TO THE EXPIRATION OF THE DESIGNATED
S. 6407--A 45 A. 9007--A
TERM, IF THE ESTABLISHED OPERATOR AND THE COMMISSIONER AGREE ON A PLAN
OF CORRECTION AND THE IMPLEMENTATION OF SUCH PLAN.
(F) (1) THE COMMISSIONER SHALL, UPON MAKING A DETERMINATION OF AN
INTENTION TO APPOINT A TEMPORARY OPERATOR PURSUANT TO PARAGRAPH ONE OF
SUBDIVISION (B) OF THIS SECTION, CAUSE THE ESTABLISHED OPERATOR 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 UNDERLYING 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, THE COMMISSIONER AND THE ESTAB-
LISHED OPERATOR SHALL ATTEMPT TO DEVELOP A MUTUALLY SATISFACTORY PLAN OF
CORRECTION AND SCHEDULE FOR IMPLEMENTATION. IN SUCH EVENT, THE COMMIS-
SIONER SHALL NOTIFY THE ESTABLISHED OPERATOR THAT THE COMMISSIONER WILL
ABSTAIN FROM APPOINTING A TEMPORARY OPERATOR CONTINGENT UPON THE ESTAB-
LISHED OPERATOR REMEDIATING THE IDENTIFIED DEFICIENCIES WITHIN THE
AGREED UPON TIMEFRAME.
(2) SHOULD THE COMMISSIONER AND THE ESTABLISHED OPERATOR BE UNABLE TO
ESTABLISH A PLAN OF CORRECTION PURSUANT TO PARAGRAPH ONE 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 THIRTY 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
TEMPORARY OPERATOR IS SUPPORTED BY SUBSTANTIAL EVIDENCE. A COPY OF THE
DECISION SHALL BE SENT TO THE ESTABLISHED OPERATOR.
(3) IF THE DECISION TO APPOINT A TEMPORARY OPERATOR IS UPHELD SUCH
TEMPORARY OPERATOR SHALL BE APPOINTED AS SOON AS IS PRACTICABLE AND
SHALL PROVIDE SERVICES PURSUANT TO THE PROVISIONS OF THIS SECTION.
(G) NOTWITHSTANDING THE APPOINTMENT OF A TEMPORARY OPERATOR, THE
ESTABLISHED OPERATOR SHALL REMAIN OBLIGATED FOR THE CONTINUED PROVISION
OF SERVICES. 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 OF THE PROGRAM HEREUNDER;
NOR SHALL ANYTHING CONTAINED IN THIS SECTION BE CONSTRUED TO SUSPEND
DURING THE TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR OF THE
PROGRAM ANY OBLIGATION OF THE ESTABLISHED OPERATOR OR ANY OTHER PERSON
FOR THE MAINTENANCE AND REPAIR OF THE FACILITY, PROVISION OF UTILITY
SERVICES, 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 2. The mental hygiene law is amended by adding a new section 31.20
to read as follows:
S 31.20 TEMPORARY OPERATOR.
(A) FOR THE PURPOSES OF THIS SECTION:
(1) "ESTABLISHED OPERATOR" SHALL MEAN THE OPERATOR OF A MENTAL HEALTH
PROGRAM THAT HAS BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE
PURSUANT TO THIS ARTICLE.
(2) "EXTRAORDINARY FINANCIAL ASSISTANCE" SHALL MEAN STATE FUNDS
PROVIDED TO, OR REQUESTED BY, A PROGRAM FOR THE EXPRESS PURPOSE OF
S. 6407--A 46 A. 9007--A
PREVENTING THE CLOSURE OF THE PROGRAM THAT THE COMMISSIONER FINDS
PROVIDES ESSENTIAL AND NECESSARY SERVICES WITHIN THE COMMUNITY.
(3) "MENTAL HEALTH PROGRAM" SHALL MEAN A PROVIDER OF SERVICES FOR
PERSONS WITH SERIOUS MENTAL ILLNESS, AS SUCH TERMS ARE DEFINED IN
SECTION 1.03 OF THIS CHAPTER, WHICH IS LICENSED OR OPERATED BY THE
OFFICE.
(4) "OFFICE" SHALL MEAN THE OFFICE OF MENTAL HEALTH.
(5) "SERIOUS FINANCIAL INSTABILITY" SHALL INCLUDE BUT NOT BE LIMITED
TO DEFAULTING OR VIOLATING MATERIAL COVENANTS OF BOND ISSUES, MISSED
MORTGAGE PAYMENTS, A PATTERN OF UNTIMELY PAYMENT OF DEBTS, FAILURE TO
PAY ITS EMPLOYEES OR VENDORS, INSUFFICIENT FUNDS TO MEET THE GENERAL
OPERATING EXPENSES OF THE PROGRAM, FAILURE TO MAINTAIN REQUIRED DEBT
SERVICE COVERAGE RATIOS AND/OR, AS APPLICABLE, FACTORS THAT HAVE TRIG-
GERED A WRITTEN EVENT OF DEFAULT NOTICE TO THE OFFICE BY THE DORMITORY
AUTHORITY OF THE STATE OF NEW YORK.
(6) "TEMPORARY OPERATOR" SHALL MEAN ANY OPERATOR OF A MENTAL HEALTH
PROGRAM THAT HAS BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE
PURSUANT TO THIS ARTICLE OR WHICH IS DIRECTLY OPERATED BY THE OFFICE OF
MENTAL HEALTH, THAT:
A. AGREES TO OPERATE A MENTAL HEALTH PROGRAM ON A TEMPORARY BASIS IN
THE BEST INTERESTS OF ITS PATIENTS SERVED BY THE PROGRAM; AND
B. HAS A HISTORY OF COMPLIANCE WITH APPLICABLE LAWS, RULES, AND REGU-
LATIONS AND A RECORD OF PROVIDING CARE OF GOOD QUALITY, AS DETERMINED BY
THE COMMISSIONER; AND
C. PRIOR TO APPOINTMENT AS TEMPORARY OPERATOR, DEVELOPS A PLAN DETER-
MINED TO BE SATISFACTORY BY THE COMMISSIONER TO ADDRESS THE PROGRAM'S
DEFICIENCIES.
(B) (1) IN THE EVENT THAT: (I) THE ESTABLISHED OPERATOR IS SEEKING
EXTRAORDINARY FINANCIAL ASSISTANCE; (II) OFFICE COLLECTED DATA DEMON-
STRATES THAT THE ESTABLISHED OPERATOR IS EXPERIENCING SERIOUS FINANCIAL
INSTABILITY ISSUES; (III) OFFICE COLLECTED DATA DEMONSTRATES THAT THE
ESTABLISHED OPERATOR'S BOARD OF DIRECTORS OR ADMINISTRATION IS UNABLE OR
UNWILLING TO ENSURE THE PROPER OPERATION OF THE PROGRAM; OR (IV) OFFICE
COLLECTED DATA INDICATES THERE ARE CONDITIONS THAT SERIOUSLY ENDANGER OR
JEOPARDIZE CONTINUED ACCESS TO NECESSARY MENTAL HEALTH SERVICES WITHIN
THE COMMUNITY, THE COMMISSIONER SHALL NOTIFY THE ESTABLISHED OPERATOR OF
HIS OR HER INTENTION TO APPOINT A TEMPORARY OPERATOR TO ASSUME SOLE
RESPONSIBILITY FOR THE PROGRAM'S TREATMENT OPERATIONS FOR A LIMITED
PERIOD OF TIME. THE APPOINTMENT OF A TEMPORARY OPERATOR SHALL BE EFFEC-
TUATED PURSUANT TO THIS SECTION, AND SHALL BE IN ADDITION TO ANY OTHER
REMEDIES PROVIDED BY LAW.
(2) THE ESTABLISHED OPERATOR 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 NECES-
SARY, ENTER INTO AN AGREEMENT WITH THE ESTABLISHED OPERATOR FOR THE
APPOINTMENT OF A TEMPORARY OPERATOR TO RESTORE OR MAINTAIN THE PROVISION
OF QUALITY CARE TO THE PATIENTS UNTIL THE ESTABLISHED OPERATOR CAN
RESUME OPERATIONS WITHIN THE DESIGNATED TIME PERIOD; THE PATIENTS MAY BE
TRANSFERRED TO OTHER MENTAL HEALTH PROGRAMS OPERATED OR LICENSED BY THE
OFFICE; OR THE OPERATIONS OF THE MENTAL HEALTH PROGRAM SHOULD BE
COMPLETELY DISCONTINUED.
(C) (1) A TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION SHALL
USE HIS OR HER BEST EFFORTS TO IMPLEMENT THE PLAN DEEMED SATISFACTORY BY
THE COMMISSIONER TO CORRECT OR ELIMINATE ANY DEFICIENCIES IN THE MENTAL
HEALTH PROGRAM AND TO PROMOTE THE QUALITY AND ACCESSIBILITY OF MENTAL
HEALTH SERVICES IN THE COMMUNITY SERVED BY THE MENTAL HEALTH PROGRAM.
S. 6407--A 47 A. 9007--A
(2) IF THE IDENTIFIED DEFICIENCIES CANNOT BE ADDRESSED IN THE TIME
PERIOD DESIGNATED IN THE PLAN, THE PATIENTS SHALL BE TRANSFERRED TO
OTHER APPROPRIATE MENTAL HEALTH PROGRAMS LICENSED OR OPERATED BY THE
OFFICE.
(3) DURING THE TERM OF APPOINTMENT, THE TEMPORARY OPERATOR SHALL HAVE
THE AUTHORITY TO DIRECT THE STAFF OF THE ESTABLISHED OPERATOR AS NECES-
SARY TO APPROPRIATELY TREAT AND/OR TRANSFER THE PATIENTS. THE TEMPORARY
OPERATOR SHALL, DURING THIS PERIOD, OPERATE THE MENTAL HEALTH PROGRAM IN
SUCH A MANNER AS TO PROMOTE SAFETY AND THE QUALITY AND ACCESSIBILITY OF
MENTAL HEALTH SERVICES IN THE COMMUNITY SERVED BY THE ESTABLISHED OPERA-
TOR UNTIL EITHER THE ESTABLISHED OPERATOR CAN RESUME PROGRAM OPERATIONS
OR UNTIL THE PATIENTS ARE APPROPRIATELY TRANSFERRED TO OTHER PROGRAMS
LICENSED OR OPERATED BY THE OFFICE.
(4) THE ESTABLISHED OPERATOR SHALL GRANT ACCESS TO THE TEMPORARY OPER-
ATOR TO THE ESTABLISHED OPERATOR'S ACCOUNTS AND RECORDS IN ORDER TO
ADDRESS ANY DEFICIENCIES RELATED TO A MENTAL HEALTH PROGRAM EXPERIENCING
SERIOUS FINANCIAL INSTABILITY OR AN ESTABLISHED OPERATOR REQUESTING
FINANCIAL ASSISTANCE IN ACCORDANCE WITH THIS SECTION. THE TEMPORARY
OPERATOR SHALL APPROVE ANY FINANCIAL DECISION RELATED TO A PROGRAM'S DAY
TO DAY OPERATIONS OR PROGRAM'S ABILITY TO PROVIDE MENTAL HEALTH
SERVICES.
(5) THE TEMPORARY OPERATOR SHALL NOT BE REQUIRED TO FILE ANY BOND. NO
SECURITY INTEREST IN ANY REAL OR PERSONAL PROPERTY COMPRISING THE ESTAB-
LISHED OPERATOR OR CONTAINED WITHIN THE ESTABLISHED OPERATOR OR IN ANY
FIXTURE OF THE MENTAL HEALTH PROGRAM, SHALL BE IMPAIRED OR DIMINISHED IN
PRIORITY BY THE TEMPORARY OPERATOR. NEITHER THE TEMPORARY OPERATOR NOR
THE OFFICE SHALL ENGAGE IN ANY ACTIVITY THAT CONSTITUTES A CONFISCATION
OF PROPERTY.
(D) THE TEMPORARY OPERATOR SHALL BE ENTITLED TO A REASONABLE FEE, AS
DETERMINED BY THE COMMISSIONER AND SUBJECT TO THE APPROVAL OF THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, AND NECESSARY EXPENSES INCURRED WHILE
SERVING AS A TEMPORARY OPERATOR. THE TEMPORARY OPERATOR SHALL BE LIABLE
ONLY IN ITS CAPACITY AS TEMPORARY OPERATOR OF THE MENTAL HEALTH PROGRAM
FOR INJURY TO PERSON AND PROPERTY BY REASON OF ITS OPERATION OF SUCH
PROGRAM; NO LIABILITY SHALL INCUR IN THE TEMPORARY OPERATOR'S PERSONAL
CAPACITY, EXCEPT FOR GROSS NEGLIGENCE AND INTENTIONAL ACTS.
(E) (1) THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR
SHALL NOT EXCEED NINETY DAYS. AFTER NINETY DAYS, IF THE COMMISSIONER
DETERMINES THAT TERMINATION OF THE TEMPORARY OPERATOR WOULD CAUSE
SIGNIFICANT DETERIORATION OF THE QUALITY OF, OR ACCESS TO, MENTAL HEALTH
CARE IN THE COMMUNITY OR THAT REAPPOINTMENT IS NECESSARY TO CORRECT THE
DEFICIENCIES THAT REQUIRED THE APPOINTMENT OF THE TEMPORARY OPERATOR,
THE COMMISSIONER MAY AUTHORIZE AN ADDITIONAL NINETY-DAY TERM. HOWEVER,
SUCH AUTHORIZATION SHALL INCLUDE THE COMMISSIONER'S REQUIREMENTS FOR
CONCLUSION OF THE TEMPORARY OPERATORSHIP TO BE SATISFIED WITHIN THE
ADDITIONAL TERM.
(2) 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:
A. THE ACTIONS TAKEN DURING THE APPOINTMENT TO ADDRESS THE IDENTIFIED
MENTAL HEALTH PROGRAM DEFICIENCIES, THE RESUMPTION OF MENTAL HEALTH
PROGRAM OPERATIONS BY THE ESTABLISHED OPERATOR, OR THE TRANSFER OF THE
PATIENTS TO OTHER PROVIDERS LICENSED OR OPERATED BY THE OFFICE;
B. OBJECTIVES FOR THE CONTINUATION OF THE TEMPORARY OPERATORSHIP IF
NECESSARY AND A SCHEDULE FOR SATISFACTION OF SUCH OBJECTIVES; AND
S. 6407--A 48 A. 9007--A
C. IF APPLICABLE, THE RECOMMENDED ACTIONS FOR THE ONGOING OPERATION OF
THE MENTAL HEALTH PROGRAM SUBSEQUENT TO THE TEMPORARY OPERATORSHIP.
(3) 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.
(F) (1) THE COMMISSIONER SHALL, UPON MAKING A DETERMINATION OF AN
INTENTION TO APPOINT A TEMPORARY OPERATOR PURSUANT TO PARAGRAPH ONE OF
SUBDIVISION (B) OF THIS SECTION CAUSE THE ESTABLISHED OPERATOR 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 UNDERLYING 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, THE COMMISSIONER AND THE ESTAB-
LISHED OPERATOR SHALL ATTEMPT TO DEVELOP A MUTUALLY SATISFACTORY PLAN OF
CORRECTION AND SCHEDULE FOR IMPLEMENTATION. IN SUCH EVENT, THE COMMIS-
SIONER SHALL NOTIFY THE ESTABLISHED OPERATOR THAT THE COMMISSIONER WILL
ABSTAIN FROM APPOINTING A TEMPORARY OPERATOR CONTINGENT UPON THE ESTAB-
LISHED OPERATOR REMEDIATING THE IDENTIFIED DEFICIENCIES WITHIN THE
AGREED UPON TIMEFRAME.
(2) SHOULD THE COMMISSIONER AND THE ESTABLISHED OPERATOR BE UNABLE TO
ESTABLISH A PLAN OF CORRECTION PURSUANT TO PARAGRAPH ONE 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 THIRTY 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
TEMPORARY OPERATOR IS SUPPORTED BY SUBSTANTIAL EVIDENCE. A COPY OF THE
DECISION SHALL BE SENT TO THE ESTABLISHED OPERATOR.
(3) IF THE DECISION TO APPOINT A TEMPORARY OPERATOR IS UPHELD SUCH
TEMPORARY OPERATOR SHALL BE APPOINTED AS SOON AS IS PRACTICABLE AND
SHALL OPERATE THE MENTAL HEALTH PROGRAM PURSUANT TO THE PROVISIONS OF
THIS SECTION.
(G) NOTWITHSTANDING THE APPOINTMENT OF A TEMPORARY OPERATOR, THE
ESTABLISHED OPERATOR SHALL REMAIN OBLIGATED FOR THE CONTINUED OPERATION
OF THE MENTAL HEALTH PROGRAM SO THAT SUCH PROGRAM CAN FUNCTION IN A
NORMAL MANNER. 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 OF THE PROGRAM HEREUNDER;
NOR SHALL ANYTHING CONTAINED IN THIS SECTION BE CONSTRUED TO SUSPEND
DURING THE TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR OF THE
PROGRAM ANY OBLIGATION OF THE ESTABLISHED OPERATOR OR ANY OTHER PERSON
FOR THE MAINTENANCE AND REPAIR OF THE FACILITY, PROVISION OF UTILITY
SERVICES, 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 3. Subdivision (i) of section 17 of the social services law, as
relettered by section 1 of part K3 of chapter 57 of the laws of 2007, is
relettered subdivision (j).
S. 6407--A 49 A. 9007--A
S 4. Section 17 of the social services law is amended by adding a new
subdivision (i) to read as follows:
(I) HAVE THE AUTHORITY TO UNDERTAKE, OR AUTHORIZE A DESIGNEE TO UNDER-
TAKE, AN INVESTIGATION OF THE FINANCIAL MATTERS, THE AFFAIRS AND THE
MANAGEMENT OF ANY EMERGENCY SHELTER, OR OF ANY PERSON, CORPORATION,
SOCIETY, ASSOCIATION OR ORGANIZATION WHICH OPERATES OR HOLDS ITSELF OUT
AS BEING AUTHORIZED TO OPERATE ANY SUCH EMERGENCY SHELTER, OR OF THE
CONDUCT OF ANY OFFICERS OR EMPLOYERS OF ANY SUCH EMERGENCY SHELTER.
PERSONS EMPOWERED BY THE COMMISSIONER OR BY A DESIGNEE TO CONDUCT ANY
SUCH INVESTIGATION ARE HEREBY EMPOWERED TO ISSUE COMPULSORY PROCESS FOR
THE ATTENDANCE OF WITNESSES AND THE PRODUCTION OF PAPERS, TO ADMINISTER
OATHS AND TO EXAMINE PERSONS UNDER OATH, AND TO EXERCISE THE SAME POWERS
IN RESPECT TO THE CONDUCT OF SUCH AN INVESTIGATION AS THOSE BELONGING TO
REFEREES APPOINTED BY THE SUPREME COURT, CONSISTENT WITH, BUT NOT LIMIT-
ED BY, THE AUTHORITY CONFERRED PURSUANT TO PARAGRAPHS (A) AND (B) OF
SUBDIVISION FIVE OF SECTION THIRTY-FOUR OF THIS ARTICLE.
WHENEVER THE COMMISSIONER OR A DESIGNEE HAS DETERMINED AN EMERGENCY
SHELTER DESCRIBED IN THIS SUBDIVISION HAS FAILED TO COMPLY WITH THE
REQUIREMENTS OF STATE OR LOCAL LAWS OR REGULATIONS APPLICABLE TO THE
OPERATION OF SUCH EMERGENCY SHELTER, THEN THE FOLLOWING PROVISIONS
APPLY:
(1) FOR THE PURPOSES OF THIS SECTION:
(I) "BUILDING" SHALL MEAN AN ENTIRE BUILDING OR A UNIT WITHIN THAT
PROVIDES EMERGENCY SHELTER TO HOMELESS PERSONS.
(II) "COMMISSIONER" SHALL MEAN THE COMMISSIONER OF THE OFFICE OR HIS
OR HER DESIGNEE.
(III) "DATA" SHALL MEAN WRITTEN DOCUMENTATION OR KNOWLEDGE OBTAINED
VIA ANNOUNCED OR UNANNOUNCED INSPECTIONS, AUDITS, OR OTHER METHODS MADE
BY ANY STATE OR LOCAL ENTITY AUTHORIZED TO CONDUCT INSPECTIONS OR
AUDITS, INCLUDING STATE OR LOCAL COMPTROLLERS.
(IV) "EMERGENCY SHELTER" MEANS ANY BUILDING WITH OVERNIGHT SLEEPING
ACCOMMODATIONS, THE PRIMARY PURPOSE OF WHICH IS TO PROVIDE TEMPORARY
SHELTER FOR THE HOMELESS IN GENERAL OR FOR SPECIFIC POPULATIONS OF THE
HOMELESS, INCLUDING RESIDENTIAL PROGRAMS FOR VICTIMS OF DOMESTIC
VIOLENCE AND RUNAWAY AND HOMELESS YOUTH PROGRAMS CERTIFIED BY THE OFFICE
OF CHILDREN AND FAMILY SERVICES.
(V) "ESTABLISHED OPERATOR" SHALL MEAN A PROVIDER OF EMERGENCY SHELTER.
(VI) "SERIOUS FINANCIAL, HEALTH OR SAFETY DEFICIENCY" SHALL INCLUDE,
BUT NOT BE LIMITED TO, MISSED MORTGAGE PAYMENTS, MISSED RENT PAYMENTS, A
PATTERN OF UNTIMELY PAYMENT OF DEBTS, FAILURE TO PAY ITS EMPLOYEES OR
VENDORS, INSUFFICIENT FUNDS TO MEET THE GENERAL OPERATING EXPENSES OF
THE PROGRAM, OR A VIOLATION OF LAW, REGULATION, OR CODE WITH RESPECT TO
A BUILDING THAT PROVIDES EMERGENCY SHELTER TO HOMELESS PERSONS, IN WHICH
THERE ARE CONDITIONS THAT ARE DANGEROUS, HAZARDOUS, IMMINENTLY DETRI-
MENTAL TO LIFE OR HEALTH, OR OTHERWISE RENDER THE BUILDING NOT FIT FOR
HUMAN HABITATION.
(VII) "TEMPORARY OPERATOR" SHALL MEAN ANY PROVIDER OF EMERGENCY SHEL-
TER THAT:
(A) AGREES TO PROVIDE EMERGENCY SHELTER PURSUANT TO THIS CHAPTER ON A
TEMPORARY BASIS IN THE BEST INTERESTS OF ITS HOMELESS INDIVIDUALS AND
FAMILIES SERVED BY THE BUILDING;
(B) HAS A HISTORY OF COMPLIANCE WITH APPLICABLE LAWS, RULES, AND REGU-
LATIONS AND A RECORD OF PROVIDING EMERGENCY SHELTER OF GOOD QUALITY, AS
DETERMINED BY THE COMMISSIONER; AND
S. 6407--A 50 A. 9007--A
(C) PRIOR TO APPOINTMENT AS TEMPORARY OPERATOR, DEVELOPS A PLAN DETER-
MINED TO BE SATISFACTORY BY THE COMMISSIONER TO ADDRESS THE BUILDING'S
DEFICIENCIES.
(2) (I) IN THE EVENT THAT: (A) DATA DEMONSTRATES THAT THE BUILDING IS
EXHIBITING A SERIOUS FINANCIAL, HEALTH, OR SAFETY DEFICIENCY; (B) DATA
DEMONSTRATES THAT THE ESTABLISHED OPERATOR IS UNABLE OR UNWILLING TO
ENSURE THE PROPER OPERATION OF THE BUILDING; OR (C) DATA INDICATES THERE
EXIST CONDITIONS THAT SERIOUSLY ENDANGER OR JEOPARDIZE EMERGENCY SHELTER
RESIDENTS, THE COMMISSIONER MAY NOTIFY THE ESTABLISHED OPERATOR OF HIS
OR HER INTENTION TO APPOINT A TEMPORARY OPERATOR TO ASSUME SOLE RESPON-
SIBILITY FOR THE PROVIDER OF THE EMERGENCY SHELTER'S OPERATIONS FOR A
LIMITED PERIOD OF TIME. THE APPOINTMENT OF A TEMPORARY OPERATOR SHALL BE
EFFECTUATED PURSUANT TO THIS SECTION, AND SHALL BE IN ADDITION TO ANY
OTHER REMEDIES PROVIDED BY LAW.
(II) THE ESTABLISHED OPERATOR 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 NECES-
SARY, ENTER INTO AN AGREEMENT WITH THE ESTABLISHED OPERATOR FOR THE
APPOINTMENT OF A TEMPORARY OPERATOR TO RESTORE OR MAINTAIN THE PROVISION
OF QUALITY EMERGENCY SHELTER TO THE EMERGENCY SHELTER RESIDENTS UNTIL
THE ESTABLISHED OPERATOR CAN RESUME OPERATIONS WITHIN THE DESIGNATED
TIME PERIOD OR OTHER ACTION IS TAKEN TO SUSPEND, REVOKE, OR LIMIT THE
AUTHORITY OF THE ESTABLISHED OPERATOR.
(3) (I) A TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION SHALL
USE HIS OR HER BEST EFFORTS TO IMPLEMENT THE PLAN DEEMED SATISFACTORY BY
THE COMMISSIONER TO CORRECT OR ELIMINATE ANY DEFICIENCIES IN THE BUILD-
ING AND TO PROMOTE THE QUALITY AND ACCESSIBILITY OF THE EMERGENCY SHEL-
TER IN THE COMMUNITY SERVED BY THE PROVIDER OF EMERGENCY SHELTER.
(II) DURING THE TERM OF APPOINTMENT, THE TEMPORARY OPERATOR SHALL HAVE
THE AUTHORITY TO DIRECT THE STAFF OF THE ESTABLISHED OPERATOR AS NECES-
SARY TO APPROPRIATELY PROVIDE EMERGENCY SHELTER FOR HOMELESS INDIVIDUALS
AND FAMILIES. THE TEMPORARY OPERATOR SHALL, DURING THIS PERIOD, PROVIDE
EMERGENCY SHELTER IN SUCH A MANNER AS TO PROMOTE SAFETY AND THE QUALITY
AND ACCESSIBILITY OF EMERGENCY SHELTER IN THE COMMUNITY SERVED BY THE
ESTABLISHED OPERATOR UNTIL EITHER THE ESTABLISHED OPERATOR CAN RESUME
OPERATIONS OR UNTIL THE OFFICE REVOKES THE AUTHORITY OF THE EMERGENCY
SHELTER TO OPERATE UNDER THIS CHAPTER.
(III) THE ESTABLISHED OPERATOR SHALL GRANT ACCESS TO THE TEMPORARY
OPERATOR TO THE ESTABLISHED OPERATOR'S ACCOUNTS AND RECORDS IN ORDER TO
ADDRESS ANY SERIOUS FINANCIAL, HEALTH OR SAFETY DEFICIENCY. THE TEMPO-
RARY OPERATOR SHALL APPROVE ANY DECISION RELATED TO AN ESTABLISHED
PROVIDER'S DAY TO DAY OPERATIONS OR THE ESTABLISHED PROVIDER'S ABILITY
TO PROVIDE EMERGENCY SHELTER.
(IV) THE TEMPORARY OPERATOR SHALL NOT BE REQUIRED TO FILE ANY BOND. NO
SECURITY INTEREST IN ANY REAL OR PERSONAL PROPERTY COMPRISING THE ESTAB-
LISHED OPERATOR OR CONTAINED WITHIN THE ESTABLISHED OPERATOR OR IN ANY
FIXTURE OF THE BUILDING, SHALL BE IMPAIRED OR DIMINISHED IN PRIORITY BY
THE TEMPORARY OPERATOR. NEITHER THE TEMPORARY OPERATOR NOR THE OFFICE
SHALL ENGAGE IN ANY ACTIVITY THAT CONSTITUTES A CONFISCATION OF PROPER-
TY.
(4) THE TEMPORARY OPERATOR SHALL BE ENTITLED TO A REASONABLE FEE, AS
DETERMINED BY THE COMMISSIONER AND SUBJECT TO THE APPROVAL OF THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, AND NECESSARY EXPENSES INCURRED WHILE
SERVING AS A TEMPORARY OPERATOR. THE TEMPORARY OPERATOR SHALL BE LIABLE
ONLY IN ITS CAPACITY AS TEMPORARY OPERATOR FOR INJURY TO PERSON AND
PROPERTY BY REASON OF ITS OPERATION OF SUCH BUILDING; NO LIABILITY SHALL
S. 6407--A 51 A. 9007--A
INCUR IN THE TEMPORARY OPERATOR'S PERSONAL CAPACITY, EXCEPT FOR GROSS
NEGLIGENCE AND INTENTIONAL ACTS.
(5) (I) THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR
SHALL NOT EXCEED NINETY DAYS. AFTER NINETY DAYS, IF THE COMMISSIONER
DETERMINES THAT TERMINATION OF THE TEMPORARY OPERATOR WOULD CAUSE
SIGNIFICANT DETERIORATION OF THE QUALITY OF, OR ACCESS TO, EMERGENCY
SHELTER IN THE COMMUNITY OR THAT REAPPOINTMENT IS NECESSARY TO CORRECT
THE DEFICIENCIES THAT REQUIRED THE APPOINTMENT OF THE TEMPORARY OPERA-
TOR, THE COMMISSIONER MAY AUTHORIZE AN ADDITIONAL NINETY-DAY TERM.
HOWEVER, SUCH AUTHORIZATION SHALL INCLUDE THE COMMISSIONER'S REQUIRE-
MENTS FOR CONCLUSION OF THE TEMPORARY OPERATORSHIP TO BE SATISFIED WITH-
IN THE ADDITIONAL TERM.
(II) 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:
(A) THE ACTIONS TAKEN DURING THE APPOINTMENT TO ADDRESS THE IDENTIFIED
BUILDING DEFICIENCIES, THE RESUMPTION OF BUILDING OPERATIONS BY THE
ESTABLISHED OPERATOR, OR THE REVOCATION OF AUTHORITY TO OPERATE AN EMER-
GENCY SHELTER;
(B) OBJECTIVES FOR THE CONTINUATION OF THE TEMPORARY OPERATORSHIP IF
NECESSARY AND A SCHEDULE FOR SATISFACTION OF SUCH OBJECTIVES; AND
(C) IF APPLICABLE, THE RECOMMENDED ACTIONS FOR THE ONGOING PROVISION
OF EMERGENCY SHELTER SUBSEQUENT TO THE TEMPORARY OPERATORSHIP.
(III) 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) (I) THE COMMISSIONER SHALL, UPON MAKING A DETERMINATION OF AN
INTENTION TO APPOINT A TEMPORARY OPERATOR PURSUANT TO SUBPARAGRAPH (I)
OF PARAGRAPH TWO OF THIS SUBDIVISION, CAUSE THE ESTABLISHED OPERATOR 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 UNDERLYING THE
INTENTION TO APPOINT A TEMPORARY OPERATOR, AND THE DATE AND TIME OF A
REQUIRED MEETING WITH THE COMMISSIONER 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, THE COMMISSIONER AND THE ESTABLISHED OPERATOR SHALL
ATTEMPT TO DEVELOP A MUTUALLY SATISFACTORY PLAN OF CORRECTION AND SCHED-
ULE FOR IMPLEMENTATION. IF A MUTUALLY SATISFACTORY PLAN OF CORRECTION
AND SCHEDULE FOR IMPLEMENTATION IS DEVELOPED, THE COMMISSIONER SHALL
NOTIFY THE ESTABLISHED OPERATOR THAT THE COMMISSIONER WILL ABSTAIN FROM
APPOINTING A TEMPORARY OPERATOR CONTINGENT UPON THE ESTABLISHED OPERATOR
REMEDIATING THE IDENTIFIED DEFICIENCIES WITHIN THE AGREED UPON TIME-
FRAME.
(II) SHOULD THE COMMISSIONER AND THE ESTABLISHED OPERATOR BE UNABLE TO
ESTABLISH A PLAN OF CORRECTION PURSUANT TO SUBPARAGRAPH (I) OF THIS
PARAGRAPH, 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 THIRTY 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
TEMPORARY OPERATOR IS SUPPORTED BY SUBSTANTIAL EVIDENCE. A COPY OF THE
DECISION SHALL BE SENT TO THE ESTABLISHED OPERATOR.
S. 6407--A 52 A. 9007--A
(III) IF THE DECISION TO APPOINT A TEMPORARY OPERATOR IS UPHELD SUCH
TEMPORARY OPERATOR SHALL BE APPOINTED AS SOON AS IS PRACTICABLE AND
SHALL PROVIDE EMERGENCY SHELTER PURSUANT TO THE PROVISIONS OF THIS
SECTION.
(7) NOTWITHSTANDING THE APPOINTMENT OF A TEMPORARY OPERATOR, THE
ESTABLISHED OPERATOR SHALL REMAIN OBLIGATED FOR THE CONTINUED PROVISION
OF EMERGENCY SHELTER. 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 OF THE BUILD-
ING HEREUNDER; NOR SHALL ANYTHING CONTAINED IN THIS SECTION BE CONSTRUED
TO SUSPEND DURING THE TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR
OF THE BUILDING ANY OBLIGATION OF THE ESTABLISHED OPERATOR OR ANY OTHER
PERSON FOR THE MAINTENANCE AND REPAIR OF THE BUILDING, PROVISION OF
UTILITY SERVICES, PAYMENT OF TAXES OR OTHER OPERATING AND MAINTENANCE
EXPENSES OF THE BUILDING, NOR OF THE ESTABLISHED OPERATOR OR ANY OTHER
PERSON FOR THE PAYMENT OF MORTGAGES OR LIENS.
S 5. Nothing in section four of this act shall be deemed in any way to
limit the authority of the commissioner of the office of temporary and
disability assistance or the commissioner of the office of children and
family services or his or her designee to take additional actions with
respect to a building that provides emergency shelter, in which there
are conditions that are dangerous, hazardous, imminently detrimental to
life or health, or otherwise render the building not fit for human habi-
tation.
S 6. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2016.
PART M
Section 1. Subdivision (d) of section 33.13 of the mental hygiene law,
as amended by section 3 of part E of chapter 111 of the laws of 2010, is
amended to read as follows:
(d) Nothing in this section shall prevent the electronic or other
exchange of information concerning patients or clients, including iden-
tification, between and among (i) facilities or others providing
services for such patients or clients pursuant to an approved local
services plan, as defined in article forty-one of this chapter, or
pursuant to agreement with the department, and (ii) the department or
any of its licensed or operated facilities. NEITHER SHALL ANYTHING IN
THIS SECTION PREVENT THE EXCHANGE OF INFORMATION CONCERNING PATIENTS OR
CLIENTS, INCLUDING IDENTIFICATION, BETWEEN FACILITIES AND MANAGED CARE
ORGANIZATIONS, BEHAVIORAL HEALTH ORGANIZATIONS, HEALTH HOMES OR OTHER
ENTITIES AUTHORIZED BY THE DEPARTMENT OR THE DEPARTMENT OF HEALTH TO
PROVIDE, ARRANGE FOR OR COORDINATE HEALTH CARE SERVICES FOR SUCH
PATIENTS OR CLIENTS WHO ARE ENROLLED IN OR RECEIVING SERVICES FROM SUCH
ORGANIZATIONS OR ENTITIES. Furthermore, subject to the prior approval of
the commissioner of mental health, hospital emergency services licensed
pursuant to article twenty-eight of the public health law shall be
authorized to exchange information concerning patients or clients elec-
tronically or otherwise with other hospital emergency services licensed
pursuant to article twenty-eight of the public health law and/or hospi-
tals licensed or operated by the office of mental health; provided that
such exchange of information is consistent with standards, developed by
the commissioner of mental health, which are designed to ensure confi-
S. 6407--A 53 A. 9007--A
dentiality of such information. Additionally, information so exchanged
shall be kept confidential and any limitations on the release of such
information imposed on the party giving the information shall apply to
the party receiving the information.
S 2. Subdivision (d) of section 33.13 of the mental hygiene law, as
amended by section 4 of part E of chapter 111 of the laws of 2010, is
amended to read as follows:
(d) Nothing in this section shall prevent the exchange of information
concerning patients or clients, including identification, between (i)
facilities or others providing services for such patients or clients
pursuant to an approved local services plan, as defined in article
forty-one, or pursuant to agreement with the department and (ii) the
department or any of its facilities. NEITHER SHALL ANYTHING IN THIS
SECTION PREVENT THE EXCHANGE OF INFORMATION CONCERNING PATIENTS OR
CLIENTS, INCLUDING IDENTIFICATION, BETWEEN FACILITIES AND MANAGED CARE
ORGANIZATIONS, BEHAVIORAL HEALTH ORGANIZATIONS, HEALTH HOMES OR OTHER
ENTITIES AUTHORIZED BY THE DEPARTMENT OR THE DEPARTMENT OF HEALTH TO
PROVIDE, ARRANGE FOR OR COORDINATE HEALTH CARE SERVICES FOR SUCH
PATIENTS OR CLIENTS WHO ARE ENROLLED IN OR RECEIVING SERVICES FOR SUCH
ORGANIZATIONS OR ENTITIES. Information so exchanged shall be kept confi-
dential and any limitations on the release of such information imposed
on the party giving the information shall apply to the party receiving
the information.
S 3. This act shall take effect immediately; provided that the amend-
ments to subdivision (d) of section 33.13 of the mental hygiene law made
by section one of this act shall be subject to the expiration and rever-
sion of such subdivision pursuant to section 18 of chapter 408 of the
laws of 1999, as amended, when upon such date the provisions of section
two of this act shall take effect.
PART N
Section 1. Subdivision 10 of section 3 of section 1 of chapter 359 of
the laws of 1968, constituting the facilities development corporation
act, as amended by chapter 723 of the laws of 1993, is amended to read
as follows:
10. "Mental hygiene facility" shall mean a building, a unit within a
building, a laboratory, a classroom, a housing unit, a dining hall, an
activities center, a library, real property of any kind or description,
or any structure on or improvement to real property, or an interest in
real property, of any kind or description, owned by or under the juris-
diction of the corporation, including fixtures and equipment which are
an integral part of any such building, unit, structure or improvement, a
walkway, a roadway or a parking lot, and improvements and connections
for water, sewer, gas, electrical, telephone, heating, air conditioning
and other utility services, or a combination of any of the foregoing,
whether for patient care and treatment or staff, staff family or service
use, located at or related to any psychiatric center, any developmental
center, or any state psychiatric or research institute or other facility
now or hereafter established under the department. A mental hygiene
facility shall also mean and include a residential care center for
adults, a "community mental health and retardation facility" and a
treatment facility for use in the conduct of an alcoholism or substance
abuse treatment program as defined in the mental hygiene law unless such
residential care center for adults, community mental health and retarda-
tion facility or alcoholism or substance abuse facility is expressly
S. 6407--A 54 A. 9007--A
excepted, or the context clearly requires otherwise, AND SHALL ALSO MEAN
AND INCLUDE ANY TREATMENT FACILITY FOR USE IN THE CONDUCT OF AN ALCOHOL-
ISM OR SUBSTANCE ABUSE TREATMENT PROGRAM THAT IS ALSO OPERATED AS AN
ASSOCIATED HEALTH CARE FACILITY. The definition contained in this subdi-
vision shall not be construed to exclude therefrom a facility owned or
leased by one or more voluntary agencies that is to be financed, refi-
nanced, designed, constructed, acquired, reconstructed, rehabilitated or
improved under any lease, sublease, loan or other financing agreement
entered into with such voluntary agencies, and shall not be construed to
exclude therefrom a facility to be made available from the corporation
to a voluntary agency at the request of the commissioners of the offices
of the department having jurisdiction thereof. The definition contained
in this subdivision shall not be construed to exclude therefrom a facil-
ity with respect to which a voluntary agency has an ownership interest
in, and proprietary lease from, an organization formed for the purpose
of the cooperative ownership of real estate.
S 2. Section 3 of section 1 of chapter 359 of the laws of 1968,
constituting the facilities development corporation act, is amended by
adding a new subdivision 20 to read as follows:
20. "ASSOCIATED HEALTH CARE FACILITY" SHALL MEAN A FACILITY LICENSED
UNDER AND OPERATED PURSUANT TO ARTICLE 28 OF THE PUBLIC HEALTH LAW OR
ANY HEALTH CARE FACILITY LICENSED UNDER AND OPERATED IN ACCORDANCE WITH
ANY OTHER PROVISIONS OF THE PUBLIC HEALTH LAW OR THE MENTAL HYGIENE LAW
THAT PROVIDES HEALTH CARE SERVICES AND/OR TREATMENT TO ALL PERSONS,
REGARDLESS OF WHETHER SUCH PERSONS ARE PERSONS RECEIVING TREATMENT OR
SERVICES FOR ALCOHOL, SUBSTANCE ABUSE, OR CHEMICAL DEPENDENCY.
S 3. 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 N of this act shall be
as specifically set forth in the last section of such Parts.
2015-A9007B - Details
- See Senate Version of this Bill:
- S6407
- Law Section:
- Budget Bills
- Laws Affected:
- Amd Various Laws, generally
2015-A9007B - Summary
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2016-2017 state fiscal year; intentionally omitted (Part A); amends the social services law, in relation to facilitating supplemental rebates for fee-for-service pharmaceuticals, and ambulance medical transportation rate adequacy review; amends the social services law, in relation to authorizing the commissioner of health to apply federally established consumer price index penalties for generic drugs, and authorizing the commissioner of health to impose penalties on managed care plans for reporting late or incorrect encounter data
2015-A9007B - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
9007--B
I N A S S E M B L Y
January 14, 2016
___________
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 recommit-
ted to said committee
AN ACT intentionally omitted (Part A); to amend the social services law,
in relation to provisions relating to transportation in the managed
long term care program; to amend the public health law, in relation to
restricting the managed long term care benefit to those who are nurs-
ing home eligible; to amend the social services law, in relation to
authorizing the commissioner of health to apply federally established
consumer price index penalties for generic drugs, to facilitate
supplemental rebates for fee-for-service pharmaceuticals, to apply
prior authorization requirements for opioid drugs, to impose penalties
on managed care plans for reporting late or incorrect encounter data,
and to authorize funding for the criminal justice pilot program within
health home rates; to amend the public health law, in relation to
participation in managed long term care plans by medical assistance
recipients in the traumatic brain injury waiver program and the nurs-
ing home transition and diversion waiver program; to amend the social
services law, in relation to fiscal intermediaries in the consumer
directed personal assistance program; to amend the public health law,
in relation to payment rate; to amend the social services law, in
relation to medical assistance for certain inmates at local or state
correctional facilities; to amend the social services law, in relation
to school-based health centers in the managed care program; to amend
the social services law, in relation to services provided by behav-
ioral health and reproductive health care services; to amend th public
health law, in relation to ambulatory care training; to amend the
public health law, in relation to public general hospital indigent
care adjustment; to amend the social services law and the public
health law, in relation to extending the preferred drug program to
medicaid managed care providers and offering the program to other
health plans; and to repeal certain provisions of the social services
law relating thereto; and to authorize the increase of certain
payments made to certain managed care providers (Part B); to amend
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD12671-03-6
A. 9007--B 2
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 apportioning premium for certain policies; and
to amend part J of chapter 63 of the laws of 2001 amending chapter 266
of the laws of 1986, amending the civil practice law and rules and
other laws relating to malpractice and professional medical conduct,
in relation to extending certain provisions concerning the hospital
excess liability pool (Part C); to amend chapter 474 of the laws of
1996, amending the education law and other laws relating to rates for
residential healthcare facilities, in relation to extending the
authority of the department of health to make disproportionate share
payments to public hospitals outside of New York City; to amend chap-
ter 649 of the laws of 1996, amending the public health law, the
mental hygiene law and the social services law relating to authorizing
the establishment of special needs plans, in relation to the effec-
tiveness thereof; to amend chapter 56 of the laws of 2013, amending
the public health law and other laws relating to general hospital
reimbursement for annual rates, relating to the effectiveness thereof;
to amend chapter 58 of the laws of 2009, amending the public health
law relating to payment by governmental agencies for general hospital
inpatient services, relating to the effectiveness thereof; and to
amend chapter 56 of the laws of 2013, amending the public health law
relating to the general public health work program, relating to the
effectiveness thereof (Part D); intentionally omitted (Part E); to
amend the public health law, in relation to establishing the statewide
health care facility transformation program (Part F); to amend the
public health law, in relation to retail clinics (Part G); to amend
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, in relation to the effectiveness
thereof (Part H); 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 of
certain provisions thereof (Part I); to amend the education law, in
relation to permissible assistance in the creation, development and
implementation of service plans relating to the practice of psychol-
ogy, mental health and social work, to amend chapter 420 of the laws
of 2002, amending the education law relating to the profession of
social work, in relation to extending certain provisions thereof, to
amend chapter 676 of the laws of 2002, amending the education law and
other laws relating to defining the practice of psychology, in
relation to extending certain provisions thereof, and to amend chapter
130 of the laws of 2010 amending the education law and other laws
relating to registration of entities providing certain professional
services and licensure of certain professions, in relation to extend-
ing certain provisions thereof (Part J); intentionally omitted (Part
K); to amend the mental hygiene law, in relation to the appointment of
temporary operators for the continued operation of programs and the
provision of services for persons with serious mental illness and/or
developmental disabilities (Part L); to amend the mental hygiene law,
in relation to sharing clinical records with managed care organiza-
tions (Part M); to amend the facilities development corporation act,
in relation to the definition of mental hygiene facility (Part N); to
amend chapter 495 of the laws of 2004 amending the insurance law and
the public health law relating to the New York state health insurance
continuation assistance demonstration project, in relation to the
A. 9007--B 3
effectiveness thereof (Part O); to amend the mental hygiene law, in
relation to the reporting of comprehensive plans of services for
persons with mental disabilities; relating to the office for people
with developmental disabilities omnibus reporting and providing for
the repeal of certain provisions relating thereto upon expiration
thereof (Part P); to amend the social services law, in relation to the
use of EQUAL program funds for adult care facilities; to amend the
public health law, in relation to changes in the application process
for physician loan repayment and physician practice support; and to
amend the public health law, in relation to registering registered
organizations that manufacture medical marihuana (Part Q); to amend
the mental hygiene law, in relation to the preparation of educational
materials relating to substance abuse among students; and to amend the
education law, in relation to the designation of employees to provide
information regarding substance abuse and referrals to students,
parents and staff (Subpart A); to amend the mental hygiene law, in
relation to the distribution of educational materials regarding the
misuse of and addiction to prescription drugs (Subpart B); to amend
the mental hygiene law, in relation to requiring the office of alco-
holism and substance abuse services to develop training materials for
health care providers and qualified health professionals to encourage
implementation of the screening, brief intervention, and referral to
treatment program (Subpart C); to amend the public health law, in
relation to establishing guidelines for hospital substance use disor-
der policies and procedures; and to amend the mental hygiene law, in
relation to the preparation of educational materials to be provided to
health care providers to be disseminated to individuals with confirmed
or suspected substance abuse disorders (Subpart D); to amend the penal
law, in relation to criminal possession of a controlled substance in
the seventh degree; to amend the general business law, in relation to
drug-related paraphernalia; to amend the public health law, in
relation to the sale and possession of hypodermic syringes and
needles; and to repeal section 220.45 of the penal law relating to
criminally possessing a hypodermic instrument (Subpart E); to amend
the mental hygiene law, in relation to the heroin and opioid addiction
wraparound services program and to amend chapter 32 of the laws of
2014, amending the mental hygiene law relating to the heroin and
opioid addiction wraparound services program, in relation to the
effectiveness thereof (Subpart F); to amend the mental hygiene law, in
relation to establishing the sober living task force; and providing
for the repeal of such provisions upon expiration thereof (Subpart G);
to amend the criminal procedure law, in relation to a judicial diver-
sion program for certain felony offenders (Subpart H); to amend the
executive law, in relation to law enforcement assisted diversion
(Subpart I); to amend the criminal procedure law, the civil practice
law and rules and the executive law, in relation to the possession of
opioid antagonists (Subpart J); and to amend the public health law, in
relation to adding cannabimimetic agents to the schedule of controlled
substances (Subpart K)(Part R); and to amend the elder law, in
relation to the supportive service program for classic and neighbor-
hood naturally occurring retirement communities (Part S)
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
A. 9007--B 4
Section 1. This act enacts into law major components of legislation
which are necessary to implement the state fiscal plan for the 2016-2017
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
Intentionally Omitted
PART B
Section 1. Subdivision 4 of section 365-h of the social services law,
as separately amended by section 50 of part B and section 24 of part D
of chapter 57 of the laws of 2015, is amended to read as follows:
4. The commissioner of health is authorized to assume responsibility
from a local social services official for the provision and reimburse-
ment of transportation costs under this section. If the commissioner
elects to assume such responsibility, the commissioner shall notify the
local social services official in writing as to the election, the date
upon which the election shall be effective and such information as to
transition of responsibilities as the commissioner deems prudent. The
commissioner is authorized to contract with a transportation manager or
managers to manage transportation services in any local social services
district, other than transportation services provided or arranged for:
enrollees of managed long term care plans issued certificates of author-
ity under section forty-four hundred three-f of the public health law;
NURSING HOMES AS DEFINED BY SECTION TWENTY-EIGHT HUNDRED ONE OF THE
PUBLIC HEALTH LAW; AND ADULT DAY HEALTH CARE PROGRAMS LOCATED AT A
LICENSED RESIDENTIAL HEALTH CARE FACILITY AS DEFINED BY SECTION TWENTY-
EIGHT HUNDRED ONE OF THE PUBLIC HEALTH LAW OR AN APPROVED EXTENSION SITE
THEREOF. Any transportation manager or managers selected by the commis-
sioner to manage transportation services shall have proven experience in
coordinating transportation services in a geographic and demographic
area similar to the area in New York state within which the contractor
would manage the provision of services under this section. Such a
contract or contracts may include responsibility for: review, approval
and processing of transportation orders; management of the appropriate
level of transportation based on documented patient medical need; and
development of new technologies leading to efficient transportation
services. If the commissioner elects to assume such responsibility from
a local social services district, the commissioner shall examine and, if
appropriate, adopt quality assurance measures that may include, but are
not limited to, global positioning tracking system reporting require-
ments and service verification mechanisms. Any and all reimbursement
rates developed by transportation managers under this subdivision shall
be subject to the review and approval of the commissioner.
S 2. Subparagraph (i) of paragraph (b) of subdivision 7 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:
A. 9007--B 5
(i) The commissioner shall, to the extent necessary, submit the appro-
priate waivers, including, but not limited to, those authorized pursuant
to sections eleven hundred fifteen and nineteen hundred fifteen of the
federal social security act, or successor provisions, and any other
waivers necessary to achieve the purposes of high quality, integrated,
and cost effective care and integrated financial eligibility policies
under the medical assistance program or pursuant to title XVIII of the
federal social security act. In addition, the commissioner is authorized
to submit the appropriate waivers, including but not limited to those
authorized pursuant to sections eleven hundred fifteen and nineteen
hundred fifteen of the federal social security act or successor
provisions, and any other waivers necessary to require on or after April
first, two thousand twelve, medical assistance recipients who are twen-
ty-one years of age or older and who require community-based long term
care services, as specified by the commissioner, for more than one
hundred and twenty days, to receive such services through an available
plan certified pursuant to this section or other program model that
meets guidelines specified by the commissioner that support coordination
and integration of services. THE COMMISSIONER MAY, THROUGH SUCH WAIVERS,
LIMIT ELIGIBILITY TO AVAILABLE PLANS TO ENROLLEES THAT (A) REQUIRE NURS-
ING FACILITY LEVEL OF CARE, OR (B) ARE ELIGIBLE FOR COMMUNITY-BASED LONG
TERM CARE SERVICES WHERE THE SERVICES REQUIRED BY THE ENROLLEE ARE ONLY
AVAILABLE TO THE ENROLLEE THROUGH A PLAN CERTIFIED PURSUANT TO THIS
SECTION. NOTWITHSTANDING THE FOREGOING, MEDICAL ASSISTANCE RECIPIENTS
ENROLLED IN A MANAGED LONG TERM CARE PLAN ON APRIL FIRST, TWO THOUSAND
SIXTEEN MAY CONTINUE TO BE ELIGIBLE FOR SUCH PLANS, IRRESPECTIVE OF
WHETHER THE ENROLLEE MEETS ANY APPLICABLE NURSING FACILITY LEVEL OF CARE
REQUIREMENTS. Such guidelines shall address the requirements of para-
graphs (a), (b), (c), (d), (e), (f), (g), (h), and (i) of subdivision
three of this section as well as payment methods that ensure provider
accountability for cost effective quality outcomes. Such other program
models may include long term home health care programs that comply with
such guidelines. Copies of such original waiver applications and amend-
ments thereto shall be provided to the chairs of the senate finance
committee, the assembly ways and means committee and the senate and
assembly health committees simultaneously with their submission to the
federal government.
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 10. Intentionally omitted.
S 11. Intentionally omitted.
S 12. Intentionally omitted.
S 13. Intentionally omitted.
S 14. Section 364-j of the social services law is amended by adding a
new subdivision 26-a to read as follows:
26-A. MANAGED CARE PROVIDERS SHALL REQUIRE PRIOR AUTHORIZATION OF
PRESCRIPTIONS OF OPIOID ANALGESICS IN EXCESS OF FOUR PRESCRIPTIONS IN A
THIRTY-DAY PERIOD, PROVIDED, HOWEVER, THAT THIS SUBDIVISION SHALL NOT
APPLY IF THE PATIENT IS A RECIPIENT OF HOSPICE CARE, HAS A DIAGNOSIS OF
CANCER OR SICKLE CELL DISEASE, OR ANY OTHER CONDITION OR DIAGNOSIS FOR
A. 9007--B 6
WHICH THE COMMISSIONER OF HEALTH DETERMINES PRIOR AUTHORIZATION IS NOT
REQUIRED.
S 15. Section 364-j of the social services law is amended by adding a
new subdivision 32 to read as follows:
32. (A) THE COMMISSIONER MAY, IN HIS OR HER DISCRETION, APPLY PENAL-
TIES TO MANAGED CARE ORGANIZATIONS SUBJECT TO THIS SECTION AND ARTICLE
FORTY-FOUR OF THE PUBLIC HEALTH LAW FOR UNTIMELY OR INACCURATE
SUBMISSION OF ENCOUNTER DATA. FOR PURPOSES OF THIS SECTION, "ENCOUNTER
DATA" SHALL MEAN THE TRANSACTIONS REQUIRED TO BE REPORTED UNDER THE
MODEL CONTRACT. ANY PENALTY ASSESSED UNDER THIS SUBDIVISION SHALL BE
CALCULATED AS A PERCENTAGE OF THE ADMINISTRATIVE COMPONENT OF THE MEDI-
CAID PREMIUM CALCULATED BY THE DEPARTMENT.
(B) SUCH PENALTIES SHALL BE AS FOLLOWS:
(I) FOR ENCOUNTER DATA SUBMITTED OR RESUBMITTED PAST THE DEADLINES SET
FORTH IN THE MODEL CONTRACT, MEDICAID PREMIUMS SHALL BE REDUCED BY ONE
AND ONE-HALF PERCENT; AND
(II) FOR INCOMPLETE OR INACCURATE ENCOUNTER DATA THAT FAILS TO CONFORM
TO DEPARTMENT DEVELOPED BENCHMARKS FOR COMPLETENESS AND ACCURACY, MEDI-
CAID PREMIUMS SHALL BE REDUCED BY ONE-HALF PERCENT; AND
(III) FOR SUBMITTED DATA THAT RESULTS IN A REJECTION RATE IN EXCESS OF
TEN PERCENT OF DEPARTMENT DEVELOPED VOLUME BENCHMARKS, MEDICAID PREMIUMS
SHALL BE REDUCED BY ONE HALF-PERCENT.
(C) PENALTIES UNDER THIS SUBDIVISION MAY BE APPLIED TO ANY AND ALL
CIRCUMSTANCES DESCRIBED IN PARAGRAPH (B) OF THIS SUBDIVISION FOR A DURA-
TION DETERMINED BY THE COMMISSIONER. IN DETERMINING WHAT, IF ANY, PENAL-
TY TO ASSESS UNDER THIS SUBDIVISION, THE COMMISSIONER SHALL CONSIDER
SUCH MANAGED CARE ORGANIZATIONS' GOOD FAITH ATTEMPT TO SUBMIT ON-TIME,
COMPLETE AND ACCURATE ENCOUNTER DATA.
S 16. Intentionally omitted.
S 17. Subdivision 2-b of section 365-l of the social services law, as
added by section 25 of part B of chapter 57 of the laws of 2015, is
amended to read as follows:
2-b. The commissioner is authorized to make [grants] LUMP SUM
PAYMENTS OR ADJUST RATES OF PAYMENT TO PROVIDERS up to a gross amount of
five million dollars, to establish coordination between the health homes
and the criminal justice system and for the integration of information
of health homes with state and local correctional facilities, to the
extent permitted by law. SUCH RATE ADJUSTMENTS MAY BE MADE TO HEALTH
HOMES PARTICIPATING IN A CRIMINAL JUSTICE PILOT PROGRAM WITH THE PURPOSE
OF ENROLLING INCARCERATED INDIVIDUALS WITH SERIOUS MENTAL ILLNESS, TWO
OR MORE CHRONIC CONDITIONS, INCLUDING SUBSTANCE ABUSE DISORDERS, OR
HIV/AIDS, INTO SUCH HEALTH HOME. Health homes receiving funds under this
subdivision shall be required to document and demonstrate the effective
use of funds distributed herein.
S 18. Intentionally omitted.
S 19. Clauses 2 and 3 of subparagraph (v) of paragraph (b) of subdivi-
sion 7 of section 4403-f of the public health law, as amended by section
48 of part A of chapter 56 of the laws of 2013, are amended and three
new subparagraphs (v-a), (v-b) and (v-c) are added to read as follows:
(2) a participant in the traumatic brain injury waiver program OR A
PERSON WHOSE CIRCUMSTANCES WOULD QUALIFY HIM OR HER FOR THE PROGRAM AS
IT EXISTED ON JANUARY FIRST, TWO THOUSAND FIFTEEN;
(3) a participant in the nursing home transition and diversion waiver
program OR A PERSON WHOSE CIRCUMSTANCES WOULD QUALIFY HIM OR HER FOR THE
PROGRAM AS IT EXISTED ON JANUARY FIRST, TWO THOUSAND FIFTEEN;
A. 9007--B 7
(V-A) FOR PURPOSES OF CLAUSE (2) OF SUBPARAGRAPH (V) OF THIS PARA-
GRAPH, PROGRAM FEATURES SHALL BE SUBSTANTIALLY COMPARABLE TO THOSE
SERVICES OFFERED TO TRAUMATIC BRAIN INJURY WAIVER PARTICIPANTS AS OF
JANUARY FIRST, TWO THOUSAND FIFTEEN, INCLUDING BUT NOT LIMITED TO:
(1) FULL-TIME SERVICE COORDINATORS WHO MAY NOT EXCEED CASELOADS OF
SEVENTEEN PROGRAM PATIENTS PER COORDINATOR AND MAY NOT BE EMPLOYEES OF
THE PARTICIPANT'S MANAGED CARE PLAN;
(2) HOME AND COMMUNITY SUPPORT SERVICES;
(3) POSITIVE BEHAVIORAL INTERVENTIONS AND CAREGIVER SUPPORT SERVICES;
(4) COMMUNITY INTEGRATION COUNSELING SERVICES PROVIDED IN AN INDIVID-
UAL OR GROUP SETTING;
(5) APPROPRIATELY STRUCTURED DAY PROGRAM SERVICES;
(6) INDEPENDENT LIVING SKILLS TRAINING AND DEVELOPMENT SERVICES
PROVIDED IN AN INDIVIDUAL OR GROUP SETTING;
(7) SUBSTANCE ABUSE PROGRAM SERVICES;
(8) ENVIRONMENTAL MODIFICATIONS SERVICES;
(9) ASSISTIVE TECHNOLOGY SERVICES;
(10) TRANSPORTATION SUPPLEMENTS FOR NON-MEDICAL ACTIVITIES THAT
SUPPORT LIVING IN THE COMMUNITY;
(11) COMMUNITY TRANSITIONAL SERVICES;
(12) RESPITE CARE; AND
(13) HOUSING SUBSIDIES SUBJECT TO APPROPRIATION.
THE COMMISSIONER MAY APPLY FOR FEDERAL FINANCIAL PARTICIPATION.
(V-B) FOR PURPOSES OF CLAUSE (3) OF SUBPARAGRAPH (V) OF THIS PARA-
GRAPH, PROGRAM FEATURES SHALL BE SUBSTANTIALLY COMPARABLE TO THOSE
SERVICES OFFERED TO NURSING HOME TRANSITION AND DIVERSION WAIVER PARTIC-
IPANTS AS OF JANUARY FIRST, TWO THOUSAND FIFTEEN, INCLUDING BUT NOT
LIMITED TO:
(1) THOSE SERVICES IDENTIFIED IN SUBPARAGRAPH (V-A) OF THIS SUBPARA-
GRAPH; AND
(2) HOME DELIVERED AND CONGREGATE MEALS.
(V-C) ANY MANAGED LONG TERM CARE PROGRAM OR OTHER CARE COORDINATION
MODEL PROVIDING SERVICES UNDER CLAUSE (2) OR (3) OF SUBPARAGRAPH (V) OF
THIS PARAGRAPH SHALL HAVE AN ADEQUATE NETWORK OF PROVIDERS TO MEET THE
NEEDS OF ENROLLEES AND PROVIDE SERVICES UNDER THIS SUBDIVISION. THEY
SHALL ALSO ENSURE THAT PROVIDERS OF SERVICES TO INDIVIDUALS WITH BRAIN
INJURY HAVE APPROPRIATE AND ADEQUATE TRAINING AND COMPETENCY TO MEET THE
NEEDS OF THIS POPULATION AND PROVIDE A STANDARD OF CARE THAT IS AT LEAST
SUBSTANTIALLY COMPARABLE TO THE 2008 TRAUMATIC BRAIN INJURY WAIVER MANU-
AL OR 2009 NURSING HOME TRANSITION AND DIVERSION WAIVER MANUAL, AS
APPROPRIATE TO THE NEEDS OF THE INDIVIDUAL.
S 20. The department of health shall study and report to the legisla-
ture by December 31, 2017 on the need for and feasibility of repatria-
tion of complex-needs patients placed in out-of-state facilities.
S 21. Section 365-f of the social services law is amended by adding
two new subdivisions 4-a and 4-b to read as follows:
4-A. FISCAL INTERMEDIARY SERVICES. (A) FOR THE PURPOSES OF THIS SUBDI-
VISION:
(I) "FISCAL INTERMEDIARY" MEANS AN ENTITY THAT PROVIDES FISCAL INTER-
MEDIARY SERVICES AND HAS A CONTRACT FOR PROVIDING SUCH SERVICES WITH:
(A) A LOCAL DEPARTMENT OF SOCIAL SERVICES,
(B) AN ORGANIZATION LICENSED UNDER ARTICLE FORTY-FOUR OF THE PUBLIC
HEALTH LAW, OR
(C) AN ACCOUNTABLE CARE ORGANIZATION CERTIFIED UNDER ARTICLE
TWENTY-NINE-E OF THE PUBLIC HEALTH LAW OR AN INTEGRATED DELIVERY SYSTEM
COMPOSED PRIMARILY OF HEALTH CARE PROVIDERS RECOGNIZED BY THE DEPARTMENT
A. 9007--B 8
AS A PERFORMING PROVIDER SYSTEM UNDER THE DELIVERY SYSTEM REFORM INCEN-
TIVE PAYMENT PROGRAM.
(II) FISCAL INTERMEDIARY SERVICES SHALL INCLUDE THE FOLLOWING
SERVICES, PERFORMED ON BEHALF OF THE CONSUMER TO FACILITATE HIS OR HER
ROLE AS THE EMPLOYER:
(A) WAGE AND BENEFIT PROCESSING FOR CONSUMER DIRECTED PERSONAL ASSIST-
ANTS;
(B) PROCESSING ALL INCOME TAX AND OTHER REQUIRED WAGE WITHHOLDINGS;
(C) COMPLYING WITH WORKERS' COMPENSATION, DISABILITY AND UNEMPLOYMENT
REQUIREMENTS;
(D) MAINTAINING PERSONNEL RECORDS FOR EACH CONSUMER DIRECTED PERSONAL
ASSISTANT, INCLUDING TIME SHEETS AND OTHER DOCUMENTATION NEEDED FOR
WAGES AND BENEFIT PROCESSING AND A COPY OF THE MEDICAL DOCUMENTATION
REQUIRED PURSUANT TO REGULATIONS ESTABLISHED BY THE COMMISSIONER;
(E) ENSURING THAT THE HEALTH STATUS OF EACH CONSUMER DIRECTED PERSONAL
ASSISTANT IS ASSESSED PRIOR TO SERVICE DELIVERY PURSUANT TO REGULATIONS
ISSUED BY THE COMMISSIONER;
(F) MAINTAINING RECORDS OF AUTHORIZATIONS OR REAUTHORIZATIONS OF
SERVICES;
(G) MONITORING THE CONSUMER'S OR, IF APPLICABLE, THE DESIGNATED REPRE-
SENTATIVE'S CONTINUING ABILITY TO FULFILL THE CONSUMER'S RESPONSIBIL-
ITIES UNDER THE PROGRAM AND PROMPTLY NOTIFYING THE AUTHORIZING ENTITY OF
ANY CIRCUMSTANCE THAT MAY AFFECT THE CONSUMER'S OR, IF APPLICABLE, THE
DESIGNATED REPRESENTATIVE'S ABILITY TO FULFILL SUCH RESPONSIBILITIES;
(H) COMPLYING WITH REGULATIONS ESTABLISHED BY THE COMMISSIONER SPECI-
FYING THE RESPONSIBILITIES OF PROVIDERS PROVIDING SERVICES UNDER THIS
TITLE; AND
(I) ENTERING INTO A DEPARTMENT APPROVED MEMORANDUM OF UNDERSTANDING
WITH THE CONSUMER THAT DESCRIBES THE PARTIES' RESPONSIBILITIES UNDER
THIS PROGRAM.
(III) FISCAL INTERMEDIARIES ARE NOT RESPONSIBLE FOR, AND FISCAL INTER-
MEDIARY SERVICES SHALL NOT INCLUDE, FULFILLMENT OF THE RESPONSIBILITIES
OF THE CONSUMER OR, IF APPLICABLE, THE CONSUMER'S DESIGNATED REPRESEN-
TATIVE AS ESTABLISHED BY THE COMMISSIONER. A FISCAL INTERMEDIARY'S
RESPONSIBILITIES SHALL NOT INCLUDE: MANAGING THE PLAN OF CARE INCLUDING
RECRUITING AND HIRING A SUFFICIENT NUMBER OF INDIVIDUALS WHO MEET THE
DEFINITION OF CONSUMER DIRECTED PERSONAL ASSISTANT, AS SUCH TERM IS
DEFINED BY THE COMMISSIONER, TO PROVIDE AUTHORIZED SERVICES THAT ARE
INCLUDED ON THE CONSUMER'S PLAN OF CARE; TRAINING, SUPERVISING AND SCHE-
DULING EACH ASSISTANT; TERMINATING THE ASSISTANT'S EMPLOYMENT; AND
ASSURING THAT EACH CONSUMER DIRECTED PERSONAL ASSISTANT COMPETENTLY AND
SAFELY PERFORMS THE PERSONAL CARE SERVICES, HOME HEALTH AIDE SERVICES
AND SKILLED NURSING TASKS THAT ARE INCLUDED ON THE CONSUMER'S PLAN OF
CARE. A FISCAL INTERMEDIARY SHALL EXERCISE REASONABLE CARE IN PROPERLY
CARRYING OUT ITS RESPONSIBILITIES UNDER THE PROGRAM.
(B) NO ENTITY SHALL PROVIDE, DIRECTLY OR THROUGH CONTRACT, FISCAL
INTERMEDIARY SERVICES WITHOUT A LICENSE AS A FISCAL INTERMEDIARY ISSUED
BY THE COMMISSIONER IN ACCORDANCE WITH THIS SUBDIVISION.
(C) AN APPLICATION FOR LICENSURE AS A FISCAL INTERMEDIARY SHALL BE
FILED WITH THE COMMISSIONER, TOGETHER WITH SUCH OTHER FORMS AND INFORMA-
TION AS SHALL BE PRESCRIBED BY, OR ACCEPTABLE TO THE COMMISSIONER. THE
COMMISSIONER SHALL NOT APPROVE AN APPLICATION FOR LICENSURE UNLESS HE OR
SHE IS SATISFIED AS TO THE CHARACTER, COMPETENCE AND STANDING IN THE
COMMUNITY OF THE APPLICANT'S INCORPORATORS, DIRECTORS, SPONSORS, STOCK-
HOLDERS OR OPERATORS AND FINDS THAT THE PERSONNEL, RULES, CONSUMER
CONTRACTS OR AGREEMENTS, AND FISCAL INTERMEDIARY SERVICES ARE FIT AND
A. 9007--B 9
ADEQUATE, AND THAT THE FISCAL INTERMEDIARY SERVICES WILL BE PROVIDED IN
THE MANNER REQUIRED BY THIS SUBDIVISION AND THE RULES AND REGULATIONS
THEREUNDER, IN A MANNER DETERMINED BY THE COMMISSIONER.
(D) NEITHER PUBLIC NEED, TAX STATUS, PROFIT-MAKING STATUS, NOR LICEN-
SURE OR CERTIFICATION PURSUANT TO ARTICLE THIRTY-SIX OF THE PUBLIC
HEALTH LAW SHALL BE CRITERIA FOR LICENSURE. ORGANIZATIONS AUTHORIZED
PURSUANT TO ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW SHALL NOT BE
GRANTED A LICENSE AS A FISCAL INTERMEDIARY.
(E) THE COMMISSIONER SHALL CHARGE TO APPLICANTS FOR THE LICENSURE OF
FISCAL INTERMEDIARIES AN APPLICATION FEE OF TWO THOUSAND DOLLARS.
4-B. PROCEEDINGS INVOLVING THE LICENSE OF A FISCAL INTERMEDIARY. (A) A
LICENSE OF A FISCAL INTERMEDIARY MAY BE REVOKED, SUSPENDED, LIMITED OR
ANNULLED BY THE COMMISSIONER ON PROOF THAT IT HAS FAILED TO COMPLY WITH
THE PROVISIONS OF SUBDIVISION FOUR-A OF THIS SECTION OR REGULATIONS
PROMULGATED HEREUNDER.
(B) NO SUCH LICENSE SHALL BE REVOKED, SUSPENDED, LIMITED, ANNULLED OR
DENIED WITHOUT A HEARING. HOWEVER, A LICENSE MAY BE TEMPORARILY
SUSPENDED OR LIMITED WITHOUT A HEARING FOR A PERIOD NOT IN EXCESS OF
THIRTY DAYS UPON WRITTEN NOTICE TO THE FISCAL INTERMEDIARY FOLLOWING A
FINDING BY THE DEPARTMENT THAT THE PUBLIC HEALTH OR SAFETY IS IN IMMI-
NENT DANGER. SUCH PERIOD MAY BE RENEWED FOR UP TO TWO ADDITIONAL PERIODS
NOT IN EXCESS OF THIRTY DAYS, EACH UPON WRITTEN NOTICE, INCLUDING AN
OPPORTUNITY TO SUBMIT EVIDENCE AND WRITTEN ARGUMENT IN OPPOSITION TO THE
RENEWAL, AND A CONTINUED FINDING UNDER THIS PARAGRAPH.
(C) THE COMMISSIONER SHALL FIX A TIME AND PLACE FOR THE HEARING. A
COPY OF THE CHARGES, TOGETHER WITH THE NOTICE OF THE TIME AND PLACE OF
THE HEARING, SHALL BE SERVED IN PERSON OR MAILED BY REGISTERED OR CERTI-
FIED MAIL TO THE FISCAL INTERMEDIARY AT LEAST TWENTY-ONE DAYS BEFORE THE
DATE FIXED FOR THE HEARING. THE FISCAL INTERMEDIARY SHALL FILE WITH THE
DEPARTMENT NOT LESS THAN EIGHT DAYS PRIOR TO THE HEARING, A WRITTEN
ANSWER TO THE CHARGES.
(D) ALL ORDERS OR DETERMINATIONS UNDER THIS SUBDIVISION SHALL BE
SUBJECT TO REVIEW AS PROVIDED IN ARTICLE SEVENTY-EIGHT OF THE CIVIL
PRACTICE LAW AND RULES.
S 22. Intentionally omitted.
S 22-a. Subdivision 8 of section 4403-f of the public health law, as
amended by section 40-a of part B of chapter 57 of the laws of 2015, 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.
EFFECTIVE FOR RATES ESTABLISHED ON AND AFTER APRIL FIRST, TWO THOUSAND
SIXTEEN, WHERE COSTS ARE INCREASED IN A REGION DUE TO ELEMENTS OF
GEOGRAPHY, REGIONAL RESOURCE LIMITATIONS, POPULATION DENSITY AND/OR
OTHER REGIONAL FACTORS THE COMMISSIONER SHALL APPLY A POSITIVE REGIONAL
ADJUSTMENT TO THE RATES FOR PROGRAMS SERVING SUCH REGIONS. 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
A. 9007--B 10
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. In setting such payment
rates, the commissioner shall consider costs borne by the managed care
program PLANS AND SERVICE PROVIDERS to ensure actuarially sound and
adequate rates of payment to ensure quality of care. SOUND AND ADEQUATE
RATES SHALL INCLUDE BUT NOT BE LIMITED TO:
(A) COMPENSATION NECESSARY FOR RECRUITMENT AND RETENTION OF SUFFICIENT
DIRECT CARE AND SUPPORT STAFF IN COMPLIANCE WITH STATE AND FEDERAL WAGE,
MINIMUM WAGE, AND OVERTIME COMPENSATION BENEFITS, AS WELL AS WORKERS'
COMPENSATION, OTHER LABOR MANDATES, AND THE EXIGENCIES OF COMPETITIVE
LABOR MARKET;
(B) COMPLIANCE WITH STATE AND FEDERAL PROGRAM MANDATES, INCLUDING BUT
NOT LIMITED TO: "CONDITIONS OF PARTICIPATION" UNDER 42 CODE OF FEDERAL
REGULATIONS, CH. IV, PART 484;
(C) QUALITY ASSURANCE AND IMPROVEMENT PROGRAMS OF PROVIDERS AND
MANAGED LONG TERM CARE PLANS; AND
(D) OTHER COSTS AS THE COMMISSIONER SHALL DETERMINE ARE NECESSARY FOR
ENROLLEE NEEDS AND QUALITY MANAGED LONG TERM CARE PLAN AND PROVIDER
OPERATIONS, INCLUDING COSTS INCURRED FOR PARTICIPATION IN THE DELIVERY
SYSTEM REFORM INCENTIVE PAYMENT PROGRAM, FULLY INTEGRATED DUALS ADVAN-
TAGE PLANS, VALUE BASED PAYMENT METHODS AND OTHER STATE MEDICAID REFORM
INITIATIVES.
S 22-b. Subdivision 13 of section 3614 of the public health law, as
added by section 4 of part H of chapter 59 of the laws of 2011, para-
graph (a) as amended by section 22 of part D of chapter 57 of the laws
of 2015, is amended to read as follows:
13. (a) Notwithstanding any inconsistent provision of law or regu-
lation and subject to the availability of federal financial partic-
ipation, effective April first, two thousand twelve through March thir-
ty-first, two thousand nineteen, payments by government agencies for
services provided by certified home health agencies, except for such
services provided to children under eighteen years of age and other
discreet groups as may be determined by the commissioner pursuant to
regulations, shall be based on episodic payments. In establishing such
payments, a statewide base price shall be established for each sixty day
episode of care and adjusted by a regional wage index factor and an
individual patient case mix index. Such episodic payments may be further
adjusted: (I) for low utilization cases and to reflect a percentage
limitation of the cost for high-utilization cases that exceed outlier
thresholds of such payments; AND (II) TO REFLECT ADDITIONAL COSTS
CONSISTENT WITH SUBDIVISION EIGHT OF SECTION FORTY-FOUR HUNDRED THREE-F
OF THIS CHAPTER.
(b) Initial base year episodic payments shall be based on Medicaid
paid claims, as determined and adjusted by the commissioner to achieve
savings comparable to the prior state fiscal year, for services provided
by all certified home health agencies in the base year two thousand
nine. Subsequent base year episodic payments may be based on Medicaid
paid claims for services provided by all certified home health agencies
in a base year subsequent to two thousand nine, as determined by the
commissioner, provided, however, that such base year adjustment shall be
made not less frequently than every three years AND BE SUBJECT TO
FURTHER ADJUSTMENTS FOR ADDITIONAL COSTS UNDER PARAGRAPH (A) OF THIS
SUBDIVISION. In determining case mix, each patient shall be classified
using a system based on measures which may include, but not limited to,
A. 9007--B 11
clinical and functional measures, as reported on the federal Outcome and
Assessment Information Set (OASIS), as may be amended.
(c) The commissioner may require agencies to collect and submit any
data required to implement this subdivision. The commissioner may
promulgate regulations to implement the provisions of this subdivision.
S 22-c. Paragraph (c) of subdivision 18 of section 364-j of the social
services law, as added by section 40-c of part B of chapter 57 of the
laws of 2015, is amended to read as follows:
(c) In setting such reimbursement methodologies, the department shall
consider costs borne by the managed care program PLANS AND SERVICE
PROVIDERS to ensure actuarially sound and adequate rates of payment to
ensure quality of care CONSISTENT WITH SUBDIVISION EIGHT OF SECTION
FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW.
S 23. Subdivision 1-a of section 366 of the social services law, as
added by chapter 355 of the laws of 2007, is amended to read as follows:
1-a. Notwithstanding any other provision of law, in the event that a
person who is an inmate of a state or local correctional facility, as
defined in section two of the correction law, was in receipt of medical
assistance pursuant to this title immediately prior to being admitted to
such facility, such person shall remain eligible for medical assistance
while an inmate, except that no medical assistance shall be furnished
pursuant to this title for any care, services, or supplies provided
during such time as the person is an inmate; provided, however, that
nothing herein shall be deemed as preventing the provision of medical
assistance for inpatient hospital services furnished to an inmate at a
hospital outside of the premises of such correctional facility OR PURSU-
ANT TO OTHER FEDERAL AUTHORITY AUTHORIZING THE PROVISION OF MEDICAL
ASSISTANCE TO AN INMATE OF A STATE OR LOCAL CORRECTIONAL FACILITY DURING
THE THIRTY DAYS PRIOR TO RELEASE, to the extent that federal financial
participation is available for the costs of such services. Upon release
from such facility, such person shall continue to be eligible for
receipt of medical assistance furnished pursuant to this title until
such time as the person is determined to no longer be eligible for
receipt of such assistance. To the extent permitted by federal law, the
time during which such person is an inmate shall not be included in any
calculation of when the person must recertify his or her eligibility for
medical assistance in accordance with this article. THE STATE SHALL SEEK
FEDERAL AUTHORITY TO PROVIDE MEDICAL ASSISTANCE FOR TRANSITIONAL
SERVICES INCLUDING BUT NOT LIMITED TO MEDICAL, PRESCRIPTION, AND CARE
COORDINATION SERVICES FOR HIGH NEEDS INMATES IN STATE AND LOCAL CORREC-
TIONAL FACILITIES DURING THE THIRTY DAYS PRIOR TO RELEASE.
S 24. Section 369-gg of the social services law is amended by adding a
new subdivision 8-a to read as follows:
8-A. AN INDIVIDUAL WHO IS PERMANENTLY RESIDING IN THE UNITED STATES
UNDER COLOR OF LAW, AND WHOSE IMMIGRATION STATUS RENDERS HIM OR HER
INELIGIBLE FOR FEDERAL FINANCIAL PARTICIPATION IN THE BASIC HEALTH
PROGRAM UNDER 42 U.S.C. SECTION 18051, BUT OTHERWISE MEETS THE ELIGIBIL-
ITY REQUIREMENTS IN SUBDIVISION THREE OF THIS SECTION, SHALL BE ELIGIBLE
FOR THE BASIC HEALTH PROGRAM, WITHOUT REGARD TO FEDERAL FINANCIAL
PARTICIPATION.
S 25. Subdivision 1 of section 364-j of the social services law is
amended by adding a new paragraph (w) to read as follows:
(W) "SCHOOL-BASED HEALTH CENTER". A CLINIC LICENSED UNDER ARTICLE
TWENTY-EIGHT OF THE PUBLIC HEALTH LAW OR SPONSORED BY A FACILITY
LICENSED UNDER THE PUBLIC HEALTH LAW WHICH PROVIDES PRIMARY HEALTH CARE
SERVICES INCLUDING URGENT CARE, WELL CHILD CARE, REPRODUCTIVE HEALTH
A. 9007--B 12
CARE, DENTAL CARE, BEHAVIORAL HEALTH SERVICES, VISION CARE, AND MANAGE-
MENT OF CHRONIC DISEASES TO CHILDREN AND ADOLESCENTS WITHIN AN ELEMENTA-
RY, SECONDARY OR PREKINDERGARTEN PUBLIC SCHOOL SETTING.
S 26. Subdivision 2 of section 364-j of the social services law is
amended by adding a new paragraph (d) to read as follows:
(D) THE COMMISSIONER OF HEALTH SHALL BE AUTHORIZED TO INCLUDE THE
SERVICES OF A SCHOOL-BASED HEALTH CENTER IN THE MANAGED CARE PROGRAM
PURSUANT TO THIS SECTION ON AND AFTER JULY FIRST, TWO THOUSAND SEVEN-
TEEN.
S 27. Subdivision 3 of section 364-j of the social services law is
amended by adding a new paragraph (d-2) to read as follows:
(D-2) BEHAVIORAL HEALTH AND REPRODUCTIVE HEALTH CARE SERVICES PROVIDED
BY SCHOOL-BASED-HEALTH CENTERS SHALL NOT BE PROVIDED TO MEDICAL ASSIST-
ANCE RECIPIENTS THROUGH MANAGED CARE PROGRAMS ESTABLISHED PURSUANT TO
THIS SECTION, AND SHALL CONTINUE TO BE PROVIDED OUTSIDE OF MANAGED CARE
PROGRAMS IN ACCORDANCE WITH APPLICABLE REIMBURSEMENT METHODOLOGIES.
APPLICABLE REIMBURSEMENT METHODOLOGIES SHALL MEAN:
(I) FOR SCHOOL-BASED HEALTH CENTERS SPONSORED BY A FEDERALLY QUALIFIED
HEALTH CENTER, RATES OF REIMBURSEMENT AND REQUIREMENTS IN ACCORDANCE
WITH THOSE MANDATED BY 42 U.S.C. SECS. 1396A(BB), 1396(M)(2)(A)(IX) AND
1936(A)(13)(C); AND
(II) FOR SCHOOL-BASED HEALTH CENTERS SPONSORED BY AN ENTITY LICENSED
PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW THAT IS NOT A
FEDERALLY QUALIFIED HEALTH CENTER, RATES OF REIMBURSEMENT AT THE FEE FOR
SERVICE RATE FOR SUCH SERVICES IN EFFECT PRIOR TO THE ENACTMENT OF THIS
CHAPTER FOR THE AMBULATORY PATIENT GROUP RATE FOR THE APPLICABLE
SERVICE.
(III) FOR THE PURPOSES OF THIS PARAGRAPH, THE TERM "BEHAVIORAL HEALTH
SERVICES" SHALL MEAN PRIMARY PREVENTION, INDIVIDUAL MENTAL HEALTH
ASSESSMENT, TREATMENT AND FOLLOW-UP, CRISIS INTERVENTION, GROUP AND
FAMILY COUNSELING, AND SHORT AND LONG-TERM COUNSELING.
S 28. Paragraph (c) of subdivision 5-a of section 2807-m of the public
health law, as amended by section 9 of part B of chapter 60 of the laws
of 2014, is amended to read as follows:
(c) (I) Ambulatory care training. 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 for the period January first, two thousand nine through December
thirty-first, two thousand nine, four million nine hundred thousand
dollars for the period January first, two thousand ten through December
thirty-first, two thousand ten, one million two hundred twenty-five
thousand dollars for the period January first, two thousand eleven
through March thirty-first, two thousand eleven, four million three
hundred thousand dollars each state fiscal year for the period April
first, two thousand eleven through March thirty-first, two thousand
fourteen, and up to four million sixty thousand dollars each state
fiscal year for the period April first, two thousand fourteen through
March thirty-first, two thousand seventeen, shall be set aside and
reserved by the commissioner from the regional pools established pursu-
ant to subdivision two of this section and shall be available for
distributions to sponsoring institutions to be directed to support clin-
ical training of medical students and residents in free-standing ambula-
tory care settings, including community health centers and private prac-
tices. Such funding shall be allocated regionally with two-thirds of the
available funding going to New York city and one-third of the available
funding going to the rest of the state and shall be distributed to spon-
A. 9007--B 13
soring institutions in each region pursuant to a request for application
or request for proposal process with preference being given to sponsor-
ing institutions which provide training in sites located in underserved
rural or inner-city areas and those that include medical students in
such training.
(II) 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, ANY FUNDING NOT AWARDED IN
ACCORDANCE WITH SUBPARAGRAPH (I) OF THIS PARAGRAPH SHALL BE DISTRIBUTED
ON A PER RESIDENT BASIS TO TEACHING HEALTH CENTERS IN NEW YORK STATE
AWARDED FUNDING PURSUANT TO SECTION 5508 OF THE PATIENT AND PROTECTION
AFFORDABLE CARE ACT AMENDING TITLE VII OF THE UNITED STATES PUBLIC
HEALTH SERVICE ACT WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL
PROCESS.
S 29. Subdivision 14-f of section 2807-c of the public health law, as
amended by section 2 of part C of chapter 56 of the laws of 2013, is
amended to read as follows:
14-f. Public general hospital indigent care adjustment. Notwithstand-
ing any inconsistent provision of this section and subject to the avail-
ability of federal financial participation, payment for inpatient hospi-
tal services for persons eligible for payments made by state
governmental agencies for the period January first, nineteen hundred
ninety-seven through December thirty-first, nineteen hundred ninety-nine
and periods on and after January first, two thousand applicable to
patients eligible for federal financial participation under title XIX of
the federal social security act in medical assistance provided pursuant
to title eleven of article five of the social services law determined in
accordance with this section shall include for eligible public general
hospitals a public general hospital indigent care adjustment equal to
the aggregate amount of the adjustments provided for such public general
hospital for the period January first, nineteen hundred ninety-six
through December thirty-first, nineteen hundred ninety-six pursuant to
subdivisions fourteen-a and fourteen-d of this section on an annualized
basis, provided, however, that for periods on and after January first,
two thousand thirteen an annual amount of four hundred twelve million
dollars shall be allocated to eligible major public hospitals [based on
each hospital's proportionate share of medicaid and uninsured losses to
total medicaid and uninsured losses for all eligible major public hospi-
tals, net of any disproportionate share hospital payments received
pursuant to sections twenty-eight hundred seven-k and twenty-eight
hundred seven-w of this article] IN ACCORDANCE WITH SUBPARAGRAPH (I) OF
PARAGRAPH (B) OF SUBDIVISION FIVE-D OF SECTION TWENTY-EIGHT HUNDRED
SEVEN-K OF THIS ARTICLE AND REGULATIONS ESTABLISHED THEREUNDER. The
adjustment may be made to rates of payment or as aggregate payments to
an eligible hospital.
S 30. The social services law is amended by adding a new section 365-i
to read as follows:
S 365-I. PRESCRIPTION DRUGS IN MEDICAID MANAGED CARE PROGRAMS. 1.
DEFINITIONS. (A) THE DEFINITIONS OF TERMS IN SECTION TWO HUNDRED SEVENTY
OF THE PUBLIC HEALTH LAW SHALL APPLY TO THIS SECTION.
(B) AS USED IN THIS SECTION, UNLESS THE CONTEXT CLEARLY REQUIRES
OTHERWISE:
(I) "MANAGED CARE PROVIDER" MEANS A MANAGED CARE PROVIDER UNDER
SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS ARTICLE, A MANAGED LONG TERM
CARE PLAN UNDER SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH
LAW, OR ANY OTHER ENTITY THAT PROVIDES OR ARRANGES FOR THE PROVISION OF
A. 9007--B 14
MEDICAL ASSISTANCE SERVICES AND SUPPLIES TO PARTICIPANTS DIRECTLY OR
INDIRECTLY (INCLUDING BY REFERRAL), INCLUDING CASE MANAGEMENT, INCLUDING
THE MANAGED CARE PROVIDER'S AUTHORIZED AGENTS.
(II) "PARTICIPANT" MEANS A MEDICAL ASSISTANCE RECIPIENT WHO RECEIVES,
IS REQUIRED TO RECEIVE OR ELECTS TO RECEIVE HIS OR HER MEDICAL ASSIST-
ANCE SERVICES FROM A MANAGED CARE PROVIDER.
2. PROVIDING AND PAYMENT FOR PRESCRIPTION DRUGS FOR MEDICAID MANAGED
CARE PROVIDER PARTICIPANTS. NOTWITHSTANDING ANY INCONSISTENT PROVISION
OF LAW OR REGULATION AND SUBJECT TO THE AVAILABILITY OF FEDERAL FINAN-
CIAL PARTICIPATION, WHICH THE COMMISSIONER OF THE DEPARTMENT OF HEALTH
SHALL SEEK, PRESCRIPTION DRUGS ELIGIBLE FOR REIMBURSEMENT UNDER THIS
ARTICLE PRESCRIBED IN RELATION TO A SERVICE PROVIDED BY A MANAGED CARE
PROVIDER SHALL BE PROVIDED AND PAID FOR UNDER THE PREFERRED DRUG PROGRAM
AND THE CLINICAL DRUG REVIEW PROGRAM UNDER TITLE ONE OF ARTICLE TWO-A OF
THE PUBLIC HEALTH LAW. THE MANAGED CARE PROVIDER SHALL ACCOUNT TO AND
REIMBURSE THE DEPARTMENT FOR THE NET COST TO THE DEPARTMENT FOR
PRESCRIPTION DRUGS PROVIDED TO THE MANAGED CARE PROVIDER'S PARTICIPANTS.
PAYMENT FOR PRESCRIPTION DRUGS SHALL BE INCLUDED IN THE CAPITATION
PAYMENTS TO THE MANAGED CARE PROVIDER FOR SERVICES OR SUPPLIES PROVIDED
TO A MANAGED CARE PROVIDER'S PARTICIPANTS.
S 31. Section 270 of the public health law is amended by adding a new
subdivision 15 to read as follows:
15. "THIRD-PARTY HEALTH CARE PAYER" HAS ITS ORDINARY MEANINGS AND
INCLUDES AN ENTITY SUCH AS A FISCAL ADMINISTRATOR, OR ADMINISTRATIVE
SERVICES PROVIDER THAT PARTICIPATES IN THE ADMINISTRATION OF A
THIRD-PARTY HEALTH CARE PAYER SYSTEM.
S 32. The public health law is amended by adding a new section 274-a
to read as follows:
S 274-A. USE OF PREFERRED DRUG PROGRAM AND CLINICAL DRUG REVIEW
PROGRAM. THE COMMISSIONER SHALL CONTRACT WITH ANY THIRD-PARTY HEALTH
CARE PAYER THAT SO CHOOSES, TO USE THE PREFERRED DRUG PROGRAM AND THE
CLINICAL DRUG REVIEW PROGRAM TO PROVIDE AND PAY FOR PRESCRIPTION DRUGS
FOR THE THIRD-PARTY HEALTH CARE PAYER'S ENROLLEES. TO CONTRACT UNDER
THIS SECTION, THE THIRD-PARTY HEALTH CARE PAYER SHALL PROVIDE COVERAGE
FOR PRESCRIPTION DRUGS AUTHORIZED UNDER THIS TITLE. THE THIRD-PARTY
HEALTH CARE PAYER SHALL ACCOUNT TO AND REIMBURSE THE DEPARTMENT FOR THE
NET COST TO THE DEPARTMENT FOR PRESCRIPTION DRUGS PROVIDED TO THE
THIRD-PARTY HEALTH CARE PAYER'S ENROLLEES. THE CONTRACT SHALL INCLUDE
TERMS REQUIRED BY THE COMMISSIONER.
S 33. Subdivisions 25 and 25-a of section 364-j of the social services
law are REPEALED.
S 34. Notwithstanding any provision of law, rule or regulation to the
contrary, and subject to the availability of federal financial partic-
ipation, for periods on and after April 1, 2015, payments made to
managed care providers, as defined in section 364-j of the social
services law, that have been approved to participate, together with
hospitals operated by a public benefit corporation located in a city of
more than one million persons, in the department's Value Based Payment
Quality Improvement Program may, at the election of the social services
district in which such public benefit corporation is located, be
increased by an annual aggregate amount of up to one hundred twenty
million dollars, which amount shall not be reduced by the amount of any
applicable tax or surcharge; provided, however that, notwithstanding the
social services district medicaid cap provisions of part C of chapter
fifty-eight of the laws of two thousand five, as amended, such social
A. 9007--B 15
services district shall be responsible for payment of one hundred
percent of the non-federal share of such increase.
S 35. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2016; provided
that:
(a) sections one and two of this act shall take effect October 1,
2016;
(b) the amendments to subdivision 4 of section 365-h of the social
services law, made by section one of this act, shall not affect the
expiration and repeal of certain provisions of such section, and shall
expire and be deemed repealed therewith;
(c) the amendments to subparagraph (i) of paragraph (b) of subdivision
7 of section 4403-f of the public health law, made by section two of
this act, shall not affect the expiration of such paragraph or the
repeal of such section, and shall expire or be deemed repealed there-
with;
(d) Intentionally omitted.
(e) Intentionally omitted.
(f) Intentionally omitted.
(g) Intentionally omitted.
(h) Intentionally omitted.
(i) subdivisions 26-a, 32, paragraph (w) of subdivision 1, paragraph
(d) of subdivision 2 and paragraph (d-2) of subdivision 3 of section
364-j of the social services law, as added by sections fourteen,
fifteen, twenty-five, twenty-six and twenty-seven of this act shall be
deemed repealed on the same date and in the same manner as such section
is repealed.
(j) the amendments to paragraph (b) of subdivision 7 of section 4403-f
of the public health law made by section nineteen of this act shall not
affect the expiration and reversion of such paragraph and shall be
deemed to expire therewith; and provided further that such amendments to
section 4403-f of the public health law made by section nineteen of this
act shall not affect the repeal of such section and shall be deemed
repealed therewith;
(k) section twenty-one of this act shall take effect on the first of
July after it shall have become a law; provided that, effective imme-
diately, the commissioner of health shall make regulations and take
other actions, including issuing licenses under section 365-f of the
social services law as amended by this act, to implement this act on
that date;
(l) the amendments to subdivision 8 of section 4403-f of the public
health law made by section twenty-two-a of this act shall not affect the
repeal of such section and shall be deemed repealed therewith;
(m) the amendments to paragraph (c) of subdivision 18 of section 364-j
of the social services law made by section twenty-two-c of this act
shall not affect the repeal of such section and shall be deemed repealed
therewith;
(n) section twenty-three of this act shall take effect on the one
hundred eightieth day after it shall have become a law.
(o) the amendments to subdivision 14-f of section 2807-c of the public
health law made by section twenty-nine of this act shall not affect the
expiration of such subdivision and shall be deemed to expire therewith.
PART C
Section 1. Intentionally omitted.
A. 9007--B 16
S 2. Paragraph (a) of subdivision 1 of section 18 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 1 of part Y of chapter 57 of the laws of 2015, is
amended to read as follows:
(a) The superintendent of financial services and the commissioner of
health or their designee shall, from funds available in the hospital
excess liability pool created pursuant to subdivision 5 of this section,
purchase a policy or policies for excess insurance coverage, as author-
ized by paragraph 1 of subsection (e) of section 5502 of the insurance
law; or from an insurer, other than an insurer described in section 5502
of the insurance law, duly authorized to write such coverage and actual-
ly writing medical malpractice insurance in this state; or shall
purchase equivalent excess coverage in a form previously approved by the
superintendent of financial services for purposes of providing equiv-
alent excess coverage in accordance with section 19 of chapter 294 of
the laws of 1985, for medical or dental malpractice occurrences between
July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988,
between July 1, 1988 and June 30, 1989, between July 1, 1989 and June
30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991
and June 30, 1992, between July 1, 1992 and June 30, 1993, between July
1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995,
between July 1, 1995 and June 30, 1996, between July 1, 1996 and June
30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998
and June 30, 1999, between July 1, 1999 and June 30, 2000, between July
1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002,
between July 1, 2002 and June 30, 2003, between July 1, 2003 and June
30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005
and June 30, 2006, between July 1, 2006 and June 30, 2007, between July
1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009,
between July 1, 2009 and June 30, 2010, between July 1, 2010 and June
30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012
and June 30, 2013, between July 1, 2013 and June 30, 2014, between July
1, 2014 and June 30, 2015, [and] between July 1, 2015 and June 30, 2016,
AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 or reimburse the hospital
where the hospital purchases equivalent excess coverage as defined in
subparagraph (i) of paragraph (a) of subdivision 1-a of this section for
medical or dental malpractice occurrences between July 1, 1987 and June
30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989
and June 30, 1990, between July 1, 1990 and June 30, 1991, between July
1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,
between July 1, 1993 and June 30, 1994, between July 1, 1994 and June
30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996
and June 30, 1997, between July 1, 1997 and June 30, 1998, between July
1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000,
between July 1, 2000 and June 30, 2001, between July 1, 2001 and June
30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003
and June 30, 2004, between July 1, 2004 and June 30, 2005, between July
1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007,
between July 1, 2007 and June 30, 2008, between July 1, 2008 and June
30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010
and June 30, 2011, between July 1, 2011 and June 30, 2012, between July
1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014,
between July 1, 2014 and June 30, 2015, [and] between July 1, 2015 and
June 30, 2016, AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 for physicians
or dentists certified as eligible for each such period or periods pursu-
A. 9007--B 17
ant to subdivision 2 of this section by a general hospital licensed
pursuant to article 28 of the public health law; provided that no single
insurer shall write more than fifty percent of the total excess premium
for a given policy year; and provided, however, that such eligible
physicians or dentists must have in force an individual policy, from an
insurer licensed in this state 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 during the period of such excess cover-
age for such occurrences or be endorsed as additional insureds under a
hospital professional liability policy which is offered through a volun-
tary attending physician ("channeling") program previously permitted by
the superintendent of financial services during the period of such
excess coverage for such occurrences. During such period, such policy
for excess coverage or such 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, total an aggregate level of two million three
hundred thousand dollars for each claimant and six million nine hundred
thousand dollars for all claimants from all such policies with respect
to occurrences in each of such years provided, however, if the cost of
primary malpractice insurance coverage in excess of one million dollars,
but below the excess medical malpractice insurance coverage provided
pursuant to this act, exceeds the rate of nine percent per annum, then
the required level of primary malpractice insurance coverage in excess
of one million dollars for each claimant shall be in an amount of not
less than the dollar amount of such coverage available at nine percent
per annum; the required level of such coverage for all claimants under
that policy shall be in an amount not less than three times the dollar
amount of coverage for each claimant; and excess coverage, when combined
with such primary malpractice insurance coverage, shall increase the
aggregate level for each claimant by one million dollars and three
million dollars for all claimants; and provided further, that, with
respect to policies of primary medical malpractice coverage that include
occurrences between April 1, 2002 and June 30, 2002, such requirement
that coverage be in amounts no less than one million three hundred thou-
sand dollars for each claimant and three million nine hundred thousand
dollars for all claimants for such occurrences shall be effective April
1, 2002.
S 3. Subdivision 3 of section 18 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 2 of
part Y of chapter 57 of the laws of 2015, is amended to read as follows:
(3)(a) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance for medical or dental malpractice
occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
and June 30, 1989, between July 1, 1989 and June 30, 1990, between July
1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992,
between July 1, 1992 and June 30, 1993, between July 1, 1993 and June
30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995
and June 30, 1996, between July 1, 1996 and June 30, 1997, between July
1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999,
between July 1, 1999 and June 30, 2000, between July 1, 2000 and June
30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002
and June 30, 2003, between July 1, 2003 and June 30, 2004, between July
A. 9007--B 18
1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006,
between July 1, 2006 and June 30, 2007, between July 1, 2007 and June
30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009
and June 30, 2010, between July 1, 2010 and June 30, 2011, between July
1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, and
between July 1, 2013 and June 30, 2014, between July 1, 2014 and June
30, 2015, [and] between July 1, 2015 and June 30, 2016, AND BETWEEN JULY
1, 2016 AND JUNE 30, 2017 allocable to each general hospital for physi-
cians or dentists certified as eligible for purchase of a policy for
excess insurance coverage by such general hospital in accordance with
subdivision 2 of this section, and may amend such determination and
certification as necessary.
(b) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance or equivalent excess coverage for
medical or dental malpractice occurrences between July 1, 1987 and June
30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989
and June 30, 1990, between July 1, 1990 and June 30, 1991, between July
1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,
between July 1, 1993 and June 30, 1994, between July 1, 1994 and June
30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996
and June 30, 1997, between July 1, 1997 and June 30, 1998, between July
1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000,
between July 1, 2000 and June 30, 2001, between July 1, 2001 and June
30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003
and June 30, 2004, between July 1, 2004 and June 30, 2005, between July
1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007,
between July 1, 2007 and June 30, 2008, between July 1, 2008 and June
30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010
and June 30, 2011, between July 1, 2011 and June 30, 2012, between July
1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014,
between July 1, 2014 and June 30, 2015, [and] between July 1, 2015 and
June 30, 2016, AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 allocable to
each general hospital for physicians or dentists certified as eligible
for purchase of a policy for excess insurance coverage or equivalent
excess coverage by such general hospital in accordance with subdivision
2 of this section, and may amend such determination and certification as
necessary. The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
ratable share of such cost allocable to the period July 1, 1987 to
December 31, 1987, to the period January 1, 1988 to June 30, 1988, to
the period July 1, 1988 to December 31, 1988, to the period January 1,
1989 to June 30, 1989, to the period July 1, 1989 to December 31, 1989,
to the period January 1, 1990 to June 30, 1990, to the period July 1,
1990 to December 31, 1990, to the period January 1, 1991 to June 30,
1991, to the period July 1, 1991 to December 31, 1991, to the period
January 1, 1992 to June 30, 1992, to the period July 1, 1992 to December
31, 1992, to the period January 1, 1993 to June 30, 1993, to the period
July 1, 1993 to December 31, 1993, to the period January 1, 1994 to June
30, 1994, to the period July 1, 1994 to December 31, 1994, to the period
January 1, 1995 to June 30, 1995, to the period July 1, 1995 to December
31, 1995, to the period January 1, 1996 to June 30, 1996, to the period
July 1, 1996 to December 31, 1996, to the period January 1, 1997 to June
30, 1997, to the period July 1, 1997 to December 31, 1997, to the period
January 1, 1998 to June 30, 1998, to the period July 1, 1998 to December
31, 1998, to the period January 1, 1999 to June 30, 1999, to the period
A. 9007--B 19
July 1, 1999 to December 31, 1999, to the period January 1, 2000 to June
30, 2000, to the period July 1, 2000 to December 31, 2000, to the period
January 1, 2001 to June 30, 2001, to the period July 1, 2001 to June 30,
2002, to the period July 1, 2002 to June 30, 2003, to the period July 1,
2003 to June 30, 2004, to the period July 1, 2004 to June 30, 2005, to
the period July 1, 2005 and June 30, 2006, to the period July 1, 2006
and June 30, 2007, to the period July 1, 2007 and June 30, 2008, to the
period July 1, 2008 and June 30, 2009, to the period July 1, 2009 and
June 30, 2010, to the period July 1, 2010 and June 30, 2011, to the
period July 1, 2011 and June 30, 2012, to the period July 1, 2012 and
June 30, 2013, to the period July 1, 2013 and June 30, 2014, to the
period July 1, 2014 and June 30, 2015, [and] to the period July 1, 2015
and June 30, 2016, AND TO THE PERIOD JULY 1, 2016 AND JUNE 30, 2017.
S 4. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
18 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 3 of part Y of chapter 57 of the
laws of 2015, are amended to read as follows:
(a) To the extent funds available to the hospital excess liability
pool pursuant to subdivision 5 of this section as amended, and pursuant
to section 6 of part J of chapter 63 of the laws of 2001, as may from
time to time be amended, which amended this subdivision, are insuffi-
cient to meet the costs of excess insurance coverage or equivalent
excess coverage for coverage periods during the period July 1, 1992 to
June 30, 1993, during the period July 1, 1993 to June 30, 1994, during
the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
to June 30, 1996, during the period July 1, 1996 to June 30, 1997,
during the period July 1, 1997 to June 30, 1998, during the period July
1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30,
2000, during the period July 1, 2000 to June 30, 2001, during the period
July 1, 2001 to October 29, 2001, during the period April 1, 2002 to
June 30, 2002, during the period July 1, 2002 to June 30, 2003, during
the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
to June 30, 2005, during the period July 1, 2005 to June 30, 2006,
during the period July 1, 2006 to June 30, 2007, during the period July
1, 2007 to June 30, 2008, during the period July 1, 2008 to June 30,
2009, during the period July 1, 2009 to June 30, 2010, during the period
July 1, 2010 to June 30, 2011, during the period July 1, 2011 to June
30, 2012, during the period July 1, 2012 to June 30, 2013, during the
period July 1, 2013 to June 30, 2014, during the period July 1, 2014 to
June 30, 2015, [and] during the period July 1, 2015 and June 30, 2016,
AND DURING THE PERIOD JULY 1, 2016 AND JUNE 30, 2017 allocated or real-
located in accordance with paragraph (a) of subdivision 4-a of this
section to rates of payment applicable to state governmental agencies,
each physician or dentist for whom a policy for excess insurance cover-
age 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
to the sum of the total cost of such coverage for all physicians applied
to such insufficiency.
(b) Each provider of excess insurance coverage or equivalent excess
coverage covering the period July 1, 1992 to June 30, 1993, or covering
the period July 1, 1993 to June 30, 1994, or covering the period July 1,
1994 to June 30, 1995, or covering the period July 1, 1995 to June 30,
1996, or covering the period July 1, 1996 to June 30, 1997, or covering
A. 9007--B 20
the period July 1, 1997 to June 30, 1998, or covering the period July 1,
1998 to June 30, 1999, or covering the period July 1, 1999 to June 30,
2000, or covering the period July 1, 2000 to June 30, 2001, or covering
the period July 1, 2001 to October 29, 2001, or covering the period
April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to
June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
covering the period July 1, 2004 to June 30, 2005, or covering the peri-
od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or
covering the period July 1, 2008 to June 30, 2009, or covering the peri-
od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
covering the period July 1, 2012 to June 30, 2013, or covering the peri-
od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, OR
COVERING THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 shall notify 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 paragraph (a) of this
subdivision. Such amount shall be due from such physician or dentist to
such provider of excess insurance coverage or equivalent 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 July 1, 1992 to June 30, 1993, or covering the period
July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to
June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
covering the period July 1, 1996 to June 30, 1997, or covering the peri-
od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or
covering the period July 1, 2000 to June 30, 2001, or covering the peri-
od July 1, 2001 to October 29, 2001, or covering the period April 1,
2002 to June 30, 2002, or covering the period July 1, 2002 to June 30,
2003, or covering the period July 1, 2003 to June 30, 2004, or covering
the period July 1, 2004 to June 30, 2005, or covering the period July 1,
2005 to June 30, 2006, or covering the period July 1, 2006 to June 30,
2007, or covering the period July 1, 2007 to June 30, 2008, or covering
the period July 1, 2008 to June 30, 2009, or covering the period July 1,
2009 to June 30, 2010, or covering the period July 1, 2010 to June 30,
2011, or covering the period July 1, 2011 to June 30, 2012, or covering
the period July 1, 2012 to June 30, 2013, or covering the period July 1,
2013 to June 30, 2014, or covering the period July 1, 2014 to June 30,
2015, or covering the period July 1, 2015 to June 30, 2016, OR COVERING
THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 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.
A. 9007--B 21
(d) Each provider of excess insurance coverage or equivalent excess
coverage shall notify the superintendent of financial services and the
commissioner of health 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 July 1, 1992 to June 30,
1993, or covering the period July 1, 1993 to June 30, 1994, or covering
the period July 1, 1994 to June 30, 1995, or covering the period July 1,
1995 to June 30, 1996, or covering the period July 1, 1996 to June 30,
1997, or covering the period July 1, 1997 to June 30, 1998, or covering
the period July 1, 1998 to June 30, 1999, or covering the period July 1,
1999 to June 30, 2000, or covering the period July 1, 2000 to June 30,
2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
ing the period April 1, 2002 to June 30, 2002, or covering the period
July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to
June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or
covering the period July 1, 2005 to June 30, 2006, or covering the peri-
od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or
covering the period July 1, 2009 to June 30, 2010, or covering the peri-
od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or
covering the period July 1, 2013 to June 30, 2014, or covering the peri-
od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
June 30, 2016, OR COVERING THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 that
has made payment to such provider of excess insurance coverage or equiv-
alent excess coverage in accordance with paragraph (b) of this subdivi-
sion 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 hospital excess liability pool any amount
allocable to the period July 1, 1992 to June 30, 1993, and to the period
July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June
30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the
period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to
June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to
the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
to June 30, 2001, and to the period July 1, 2001 to October 29, 2001,
and to the period April 1, 2002 to June 30, 2002, and to the period July
1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30,
2004, and to the period July 1, 2004 to June 30, 2005, and to the period
July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June
30, 2007, and to the period July 1, 2007 to June 30, 2008, and to the
period July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to
June 30, 2010, and to the period July 1, 2010 to June 30, 2011, and to
the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
to June 30, 2013, and to the period July 1, 2013 to June 30, 2014, and
to the period July 1, 2014 to June 30, 2015, and to the period July 1,
2015 to June 30, 2016, AND TO THE PERIOD JULY 1, 2016 TO JUNE 30, 2017
received from the hospital excess liability pool for purchase of excess
insurance coverage or equivalent excess coverage covering the period
July 1, 1992 to June 30, 1993, and covering the period July 1, 1993 to
June 30, 1994, and covering the period July 1, 1994 to June 30, 1995,
and covering the period July 1, 1995 to June 30, 1996, and covering the
period July 1, 1996 to June 30, 1997, and covering the period July 1,
1997 to June 30, 1998, and covering the period July 1, 1998 to June 30,
1999, and covering the period July 1, 1999 to June 30, 2000, and cover-
A. 9007--B 22
ing the period July 1, 2000 to June 30, 2001, and covering the period
July 1, 2001 to October 29, 2001, and covering the period April 1, 2002
to June 30, 2002, and covering the period July 1, 2002 to June 30, 2003,
and covering the period July 1, 2003 to June 30, 2004, and covering the
period July 1, 2004 to June 30, 2005, and covering the period July 1,
2005 to June 30, 2006, and covering the period July 1, 2006 to June 30,
2007, and covering the period July 1, 2007 to June 30, 2008, and cover-
ing the period July 1, 2008 to June 30, 2009, and covering the period
July 1, 2009 to June 30, 2010, and covering the period July 1, 2010 to
June 30, 2011, and covering the period July 1, 2011 to June 30, 2012,
and covering the period July 1, 2012 to June 30, 2013, and covering the
period July 1, 2013 to June 30, 2014, and covering the period July 1,
2014 to June 30, 2015, and covering the period July 1, 2015 to June 30,
2016, AND COVERING THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 for a physi-
cian or dentist where such excess insurance coverage or equivalent
excess coverage is cancelled in accordance with paragraph (c) of this
subdivision.
S 5. 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 4 of part Y of chap-
ter 57 of the laws of 2015, is amended to read as follows:
S 40. The superintendent of financial services shall establish rates
for policies providing coverage for physicians and surgeons medical
malpractice for the periods commencing July 1, 1985 and ending June 30,
[2016] 2017; 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 superintendent shall direct insurers to establish segregated
accounts for premiums, payments, reserves and investment income attrib-
utable 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
attributable 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, [2016]
2017, at which time and thereafter such surcharge shall not exceed twen-
ty-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, [2016]
2017 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 superintendent. 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
A. 9007--B 23
for responding in damages for liability arising out of such physician's
or surgeon's practice 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 establishing adequate rates and in determining any projected defi-
ciency 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 peri-
od 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 by
the superintendent pursuant to this section are deemed adequate if such
rates would be adequate when taken together with the maximum authorized
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.
S 6. Section 5 and subdivisions (a) and (e) of section 6 of part J of
chapter 63 of the laws of 2001, amending chapter 266 of the laws of
1986, amending the civil practice law and rules and other laws relating
to malpractice and professional medical conduct, as amended by section 5
of part Y of chapter 57 of the laws of 2015, are amended to read as
follows:
S 5. The superintendent of financial services and the commissioner of
health shall determine, no later than June 15, 2002, June 15, 2003, June
15, 2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15, 2008,
June 15, 2009, June 15, 2010, June 15, 2011, June 15, 2012, June 15,
2013, June 15, 2014, June 15, 2015, [and] June 15, 2016, AND JUNE 15,
2017 the amount of funds available in the hospital excess liability
pool, created pursuant to section 18 of chapter 266 of the laws of 1986,
and whether such funds are sufficient for purposes of purchasing excess
insurance coverage for eligible participating physicians and dentists
during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June
30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
2007, or July 1, 2007 to June 30, 2008, or July 1, 2008 to June 30,
2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to June 30,
2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June 30,
2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30,
2015, or July 1, 2015 to June 30, 2016, OR JULY 1, 2016 TO JUNE 30,
2017, as applicable.
(a) This section shall be effective only upon a determination, pursu-
ant to section five of this act, by the superintendent of financial
services and the commissioner of health, and a certification of such
determination to the state director of the budget, the chair of the
senate committee on finance and the chair of the assembly committee on
ways and means, that the amount of funds in the hospital excess liabil-
A. 9007--B 24
ity pool, created pursuant to section 18 of chapter 266 of the laws of
1986, is insufficient for purposes of purchasing excess insurance cover-
age for eligible participating physicians and dentists during the period
July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1,
2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to
June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30,
2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30,
2016, OR JULY 1, 2016 TO JUNE 30, 2017, as applicable.
(e) The commissioner of health shall transfer for deposit to the
hospital excess liability pool created pursuant to section 18 of chapter
266 of the laws of 1986 such amounts as directed by the superintendent
of financial services for the purchase of excess liability insurance
coverage for eligible participating physicians and dentists for the
policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
2007, as applicable, and the cost of administering the hospital excess
liability pool for such applicable policy year, pursuant to the program
established in chapter 266 of the laws of 1986, as amended, no later
than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June
15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, June 15,
2015, [and] June 15, 2016, AND JUNE 15, 2017, as applicable.
S 7. Notwithstanding any law, rule or regulation to the contrary, only
physicians or dentists who were eligible, and for whom the superinten-
dent of financial services and the commissioner of health, or their
designee, purchased, with funds available in the hospital excess liabil-
ity pool, a full or partial policy for excess coverage or equivalent
excess coverage for the coverage period ending the thirtieth of June,
two thousand sixteen, shall be eligible to apply for such coverage for
the coverage period beginning the first of July, two thousand sixteen;
provided, however, if the total number of physicians or dentists for
whom such excess coverage or equivalent excess coverage was purchased
for the policy year ending the thirtieth of June, two thousand sixteen
exceeds the total number of physicians or dentists certified as eligible
for the coverage period beginning the first of July, two thousand
sixteen, then the general hospitals may certify additional eligible
physicians or dentists in a number equal to such general hospital's
proportional share 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 thirti-
eth of June, two thousand sixteen, as applied to the difference between
the number of eligible physicians or dentists for whom a policy for
excess coverage or equivalent excess coverage was purchased for the
coverage period ending the thirtieth of June, two thousand sixteen and
the number of such eligible physicians or dentists who have applied for
excess coverage or equivalent excess coverage for the coverage period
beginning the first of July, two thousand sixteen.
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, 2016, provided,
however, section two of this act shall take effect July 1, 2016.
PART D
A. 9007--B 25
Section 1. Paragraph (a) of subdivision 1 of section 212 of chapter
474 of the laws of 1996, amending the education law and other laws
relating to rates for residential healthcare facilities, as amended by
section 2 of part B of chapter 56 of the laws of 2013, is amended to
read as follows:
(a) Notwithstanding any inconsistent provision of law or regulation to
the contrary, effective beginning August 1, 1996, for the period April
1, 1997 through March 31, 1998, April 1, 1998 for the period April 1,
1998 through March 31, 1999, August 1, 1999, for the period April 1,
1999 through March 31, 2000, April 1, 2000, for the period April 1, 2000
through March 31, 2001, April 1, 2001, for the period April 1, 2001
through March 31, 2002, April 1, 2002, for the period April 1, 2002
through March 31, 2003, and for the state fiscal year beginning April 1,
2005 through March 31, 2006, and for the state fiscal year beginning
April 1, 2006 through March 31, 2007, and for the state fiscal year
beginning April 1, 2007 through March 31, 2008, and for the state fiscal
year beginning April 1, 2008 through March 31, 2009, and for the state
fiscal year beginning April 1, 2009 through March 31, 2010, and for the
state fiscal year beginning April 1, 2010 through March 31, [2016,]
2019, the department of health is authorized to pay public general
hospitals, as defined in subdivision 10 of section 2801 of the public
health law, operated by the state of New York or by the state university
of New York or by a county, which shall not include a city with a popu-
lation of over one million, of the state of New York, and those public
general hospitals located in the county of Westchester, the county of
Erie or the county of Nassau, additional payments for inpatient hospital
services as medical assistance payments pursuant to title 11 of article
5 of the social services law for patients eligible for federal financial
participation under title XIX of the federal social security act in
medical assistance pursuant to the federal laws and regulations govern-
ing disproportionate share payments to hospitals up to one hundred
percent of each such public general hospital's medical assistance and
uninsured patient losses after all other medical assistance, including
disproportionate share payments to such public general hospital for
1996, 1997, 1998, and 1999, based initially for 1996 on reported 1994
reconciled data as further reconciled to actual reported 1996 reconciled
data, and for 1997 based initially on reported 1995 reconciled data as
further reconciled to actual reported 1997 reconciled data, for 1998
based initially on reported 1995 reconciled data as further reconciled
to actual reported 1998 reconciled data, for 1999 based initially on
reported 1995 reconciled data as further reconciled to actual reported
1999 reconciled data, for 2000 based initially on reported 1995 recon-
ciled data as further reconciled to actual reported 2000 data, for 2001
based initially on reported 1995 reconciled data as further reconciled
to actual reported 2001 data, for 2002 based initially on reported 2000
reconciled data as further reconciled to actual reported 2002 data, and
for state fiscal years beginning on April 1, 2005, based initially on
reported 2000 reconciled data as further reconciled to actual reported
data for 2005, and for state fiscal years beginning on April 1, 2006,
based initially on reported 2000 reconciled data as further reconciled
to actual reported data for 2006, for state fiscal years beginning on
and after April 1, 2007 through March 31, 2009, based initially on
reported 2000 reconciled data as further reconciled to actual reported
data for 2007 and 2008, respectively, for state fiscal years beginning
on and after April 1, 2009, based initially on reported 2007 reconciled
data, adjusted for authorized Medicaid rate changes applicable to the
A. 9007--B 26
state fiscal year, and as further reconciled to actual reported data for
2009, for state fiscal years beginning on and after April 1, 2010, based
initially on reported reconciled data from the base year two years prior
to the payment year, adjusted for authorized Medicaid rate changes
applicable to the state fiscal year, and further reconciled to actual
reported data from such payment year, and to actual reported data for
each respective succeeding year. The payments may be added to rates of
payment or made as aggregate payments to an eligible public general
hospital.
S 2. Section 10 of chapter 649 of the laws of 1996, amending the
public health law, the mental hygiene law and the social services law
relating to authorizing the establishment of special needs plans, as
amended by section 20 of part D of chapter 59 of the laws of 2011, is
amended to read as follows:
S 10. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after July 1, 1996; provided,
however, that sections one, two and three of this act shall expire and
be deemed repealed on March 31, [2016] 2020 provided, however that the
amendments to section 364-j of the social services law made by section
four of this act shall not affect the expiration of such section and
shall be deemed to expire therewith and provided, further, that the
provisions of subdivisions 8, 9 and 10 of section 4401 of the public
health law, as added by section one of this act; section 4403-d of the
public health law as added by section two of this act and the provisions
of section seven of this act, except for the provisions relating to the
establishment of no more than twelve comprehensive HIV special needs
plans, shall expire and be deemed repealed on July 1, 2000.
S 3. Subdivision 8 of section 84 of part A of chapter 56 of the laws
of 2013, amending the public health law and other laws relating to
general hospital reimbursement for annual rates, as amended by section
14 of part C of chapter 60 of the laws of 2014, is amended to read as
follows:
8. section forty-eight-a of this act shall expire and be deemed
repealed [January 1, 2018] MARCH 31, 2020;
S 4. Subdivision (f) of section 129 of part C of chapter 58 of the
laws of 2009, amending the public health law relating to payment by
governmental agencies for general hospital inpatient services, as
amended by section 1 of part B of chapter 56 of the laws of 2013, is
amended to read as follows:
(f) section twenty-five of this act shall expire and be deemed
repealed April 1, [2016] 2019;
S 5. Subdivision (c) of section 122 of part E of chapter 56 of the
laws of 2013 amending the public health law relating to the general
public health work program is amended to read as follows:
(c) section fifty of this act shall take effect immediately and shall
expire [three] SIX years after it becomes law;
S 6. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2016.
PART E
Intentionally Omitted
PART F
A. 9007--B 27
Section 1. The public health law is amended by adding a new section
2825-d to read as follows:
S 2825-D. HEALTH CARE FACILITY TRANSFORMATION PROGRAM: STATEWIDE. 1.
A STATEWIDE HEALTH CARE FACILITY TRANSFORMATION PROGRAM IS HEREBY ESTAB-
LISHED UNDER THE JOINT ADMINISTRATION OF THE COMMISSIONER AND THE PRESI-
DENT OF THE DORMITORY AUTHORITY OF THE STATE OF NEW YORK FOR THE PURPOSE
OF STRENGTHENING AND PROTECTING CONTINUED ACCESS TO HEALTH CARE SERVICES
IN COMMUNITIES. THE PROGRAM SHALL PROVIDE CAPITAL FUNDING IN SUPPORT OF
PROJECTS THAT REPLACE INEFFICIENT AND OUTDATED FACILITIES AS PART OF A
MERGER, CONSOLIDATION, ACQUISITION OR OTHER SIGNIFICANT CORPORATE
RESTRUCTURING ACTIVITY THAT IS PART OF AN OVERALL TRANSFORMATION PLAN
INTENDED TO CREATE A FINANCIALLY SUSTAINABLE SYSTEM OF CARE. THE ISSU-
ANCE OF ANY BONDS OR NOTES HEREUNDER SHALL BE SUBJECT TO THE APPROVAL OF
THE DIRECTOR OF THE DIVISION OF THE BUDGET, AND ANY PROJECTS FUNDED
THROUGH THE ISSUANCE OF BONDS OR NOTES HEREUNDER SHALL BE APPROVED BY
THE NEW YORK STATE PUBLIC AUTHORITIES CONTROL BOARD, AS REQUIRED UNDER
SECTION FIFTY-ONE OF THE PUBLIC AUTHORITIES LAW.
2. THE COMMISSIONER AND THE PRESIDENT OF THE AUTHORITY SHALL ENTER
INTO AN AGREEMENT, SUBJECT TO APPROVAL BY THE DIRECTOR OF THE BUDGET,
AND SUBJECT TO SECTION SIXTEEN HUNDRED EIGHTY-R OF THE PUBLIC AUTHORI-
TIES LAW, FOR THE PURPOSES OF AWARDING, DISTRIBUTING, AND ADMINISTERING
THE FUNDS MADE AVAILABLE PURSUANT TO THIS SECTION. SUCH FUNDS MAY BE
DISTRIBUTED BY THE COMMISSIONER AND THE PRESIDENT OF THE AUTHORITY FOR
CAPITAL GRANTS TO GENERAL HOSPITALS, RESIDENTIAL HEALTH CARE FACILITIES,
DIAGNOSTIC AND TREATMENT CENTERS AND CLINICS LICENSED PURSUANT TO THIS
CHAPTER OR THE MENTAL HYGIENE LAW, PRIMARY CARE PROVIDERS, AND HOME CARE
PROVIDERS CERTIFIED OR LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF THIS
CHAPTER, FOR CAPITAL NON-OPERATIONAL WORKS OR PURPOSES THAT SUPPORT THE
PURPOSES SET FORTH IN THIS SECTION. A COPY OF SUCH AGREEMENT, AND ANY
AMENDMENTS THERETO, SHALL BE PROVIDED TO THE CHAIR OF THE SENATE FINANCE
COMMITTEE, THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE, AND THE
DIRECTOR OF THE DIVISION OF BUDGET NO LATER THAN THIRTY DAYS PRIOR TO
THE RELEASE OF A REQUEST FOR APPLICATIONS FOR FUNDING UNDER THIS
PROGRAM. PROJECTS AWARDED, IN WHOLE OR IN PART, UNDER SECTION
TWENTY-EIGHT HUNDRED TWENTY-FIVE OF THIS ARTICLE SHALL NOT BE ELIGIBLE
FOR GRANTS OR AWARDS MADE AVAILABLE UNDER THIS SECTION.
3. NOTWITHSTANDING SECTION ONE HUNDRED SIXTY-THREE OF THE STATE
FINANCE LAW OR ANY INCONSISTENT PROVISION OF LAW TO THE CONTRARY, UP TO
TWO HUNDRED MILLION DOLLARS OF THE FUNDS APPROPRIATED FOR THIS PROGRAM
SHALL BE AWARDED WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROC-
ESS FOR CAPITAL GRANTS TO HEALTH CARE PROVIDERS (HEREAFTER "APPLI-
CANTS"). ELIGIBLE APPLICANTS SHALL BE THOSE DEEMED BY THE COMMISSIONER
TO BE A PROVIDER THAT FULFILLS OR WILL FULFILL A HEALTH CARE NEED FOR
ACUTE INPATIENT, OUTPATIENT, PRIMARY, HOME CARE OR RESIDENTIAL HEALTH
CARE SERVICES IN A COMMUNITY.
4. IN DETERMINING AWARDS FOR ELIGIBLE APPLICANTS UNDER THIS SECTION,
THE COMMISSIONER AND THE PRESIDENT OF THE AUTHORITY SHALL CONSIDER
CRITERIA INCLUDING, BUT NOT LIMITED TO:
(A) THE EXTENT TO WHICH THE PROPOSED CAPITAL PROJECT WILL CONTRIBUTE
TO THE INTEGRATION OF HEALTH CARE SERVICES AND LONG TERM SUSTAINABILITY
OF THE APPLICANT OR PRESERVATION OF ESSENTIAL HEALTH SERVICES IN THE
COMMUNITY OR COMMUNITIES SERVED BY THE APPLICANT;
(B) THE EXTENT TO WHICH THE PROPOSED PROJECT OR PURPOSE IS ALIGNED
WITH DELIVERY SYSTEM REFORM INCENTIVE PAYMENT ("DSRIP") PROGRAM GOALS
AND OBJECTIVES;
(C) CONSIDERATION OF GEOGRAPHIC DISTRIBUTION OF FUNDS;
A. 9007--B 28
(D) THE RELATIONSHIP BETWEEN THE PROPOSED CAPITAL PROJECT AND IDENTI-
FIED COMMUNITY NEED;
(E) THE EXTENT TO WHICH THE APPLICANT HAS ACCESS TO ALTERNATIVE
FINANCING;
(F) THE EXTENT THAT THE PROPOSED CAPITAL PROJECT FURTHERS THE DEVELOP-
MENT OF PRIMARY CARE AND OTHER OUTPATIENT SERVICES;
(G) THE EXTENT TO WHICH THE PROPOSED CAPITAL PROJECT BENEFITS MEDICAID
ENROLLEES AND UNINSURED INDIVIDUALS;
(H) THE EXTENT TO WHICH THE APPLICANT HAS ENGAGED THE COMMUNITY
AFFECTED BY THE PROPOSED CAPITAL PROJECT AND THE MANNER IN WHICH COMMU-
NITY ENGAGEMENT HAS SHAPED SUCH CAPITAL PROJECT; AND
(I) THE EXTENT TO WHICH THE PROPOSED CAPITAL PROJECT ADDRESSES POTEN-
TIAL RISK TO PATIENT SAFETY AND WELFARE.
5. DISBURSEMENT OF AWARDS MADE PURSUANT TO THIS SECTION SHALL BE
CONDITIONED ON THE AWARDEE ACHIEVING CERTAIN PROCESS AND PERFORMANCE
METRICS AND MILESTONES AS DETERMINED IN THE SOLE DISCRETION OF THE
COMMISSIONER. SUCH METRICS AND MILESTONES SHALL BE STRUCTURED TO ENSURE
THAT THE HEALTH CARE TRANSFORMATION AND PROVIDER SUSTAINABILITY GOALS OF
THE PROJECT ARE ACHIEVED, AND SUCH METRICS AND MILESTONES SHALL BE
INCLUDED IN GRANT DISBURSEMENT AGREEMENTS OR OTHER CONTRACTUAL DOCUMENTS
AS REQUIRED BY THE COMMISSIONER.
6. THE DEPARTMENT SHALL PROVIDE A REPORT ON A QUARTERLY BASIS TO THE
CHAIRS OF THE SENATE FINANCE, ASSEMBLY WAYS AND MEANS, SENATE HEALTH AND
ASSEMBLY HEALTH COMMITTEES. SUCH REPORTS SHALL BE SUBMITTED NO LATER
THAN SIXTY DAYS AFTER THE CLOSE OF THE QUARTER, AND SHALL INCLUDE, FOR
EACH AWARD, THE NAME OF THE APPLICANT, A DESCRIPTION OF THE PROJECT OR
PURPOSE, THE AMOUNT OF THE AWARD, DISBURSEMENT DATE, AND STATUS OF
ACHIEVEMENT OF PROCESS AND PERFORMANCE METRICS AND MILESTONES PURSUANT
TO SUBDIVISION FIVE 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, 2016.
PART G
Section 1. The public health law is amended by adding a new section
230-e to read as follows:
S 230-E. RETAIL CLINICS. 1. AS USED IN THIS SECTION, "RETAIL CLINIC"
MEANS A FACILITY OR PORTION OF A FACILITY THAT IS OPERATED BY ANY ENTITY
THAT IS AUTHORIZED UNDER THE LAWS OF THIS STATE TO PROVIDE PROFESSIONAL
SERVICES TO THE PUBLIC AND THAT PROVIDES HEALTH CARE SERVICES OR TREAT-
MENT, OTHER THAN PHARMACY, BY A HEALTH CARE PRACTITIONER LICENSED,
CERTIFIED, REGISTERED OR AUTHORIZED TO PRACTICE UNDER TITLE EIGHT OF THE
EDUCATION LAW, ACTING WITHIN HIS OR HER LAWFUL SCOPE OF PRACTICE, THAT:
(A) OPERATES WITHIN THE SPACE OF A RETAIL BUSINESS OPERATION, SUCH AS A
PHARMACY OR A STORE OPEN TO THE GENERAL PUBLIC; (B) IS LABELED, BRANDED,
ADVERTISED OR MARKETED WITH THE NAME OR SYMBOL OF A RETAIL BUSINESS
ENTITY; OR (C) IS LABELED, BRANDED, ADVERTISED OR MARKETED WITH THE NAME
OR SYMBOL OF A BUSINESS ENTITY, OTHER THAN A BUSINESS ENTITY THAT
PROVIDES HEALTH CARE SERVICES OR TREATMENT PROVIDED AT THE FACILITY.
HOWEVER, PROVISION OF SUCH HEALTH CARE SERVICES OR TREATMENT PROVIDED BY
SUCH ENTITIES SHALL NOT BE DEEMED TO BE A RETAIL CLINIC IF IT IS USED
ONLY FOR PROVIDING HEALTH CARE SERVICES TO EMPLOYEES OF THE RETAIL BUSI-
NESS OPERATION.
2. THE TREATMENTS AND SERVICES THAT MAY BE PROVIDED BY A RETAIL CLINIC
SHALL BE LIMITED TO THE PROVISION OF TREATMENT AND SERVICES TO PATIENTS
FOR ACUTE EPISODIC ILLNESS OR CONDITION; EPISODIC PREVENTIVE TREATMENT
A. 9007--B 29
AND SERVICES SUCH AS IMMUNIZATIONS; OPTHALMIC DISPENSING AND OPTHALMO-
LOGIC OR OPTOMETRIC SERVICES PROVIDED IN CONNECTION WITH OPTHALMIC
DISPENSING; OR TREATMENT AND SERVICES FOR MINOR INJURIES THAT ARE NOT
REASONABLY LIKELY TO BE LIFE-THREATENING OR POTENTIALLY DISABLING OR
HAVE COMPLICATIONS IF AMBULATORY CARE WITHIN THE CAPACITY OF THE RETAIL
CLINIC IS PROVIDED; THE TREATMENTS AND SERVICES PROVIDED BY A RETAIL
CLINIC SHALL NOT INCLUDE MONITORING OR TREATMENT AND SERVICES OVER
MULTIPLE VISITS OR PROLONGED PERIODS.
3. A RETAIL CLINIC SHALL BE DEEMED TO BE A "HEALTH CARE PROVIDER" FOR
THE PURPOSES OF TITLE TWO-D OF ARTICLE TWO OF THIS CHAPTER. A PRESCRIBER
PRACTICING IN A RETAIL CLINIC SHALL NOT BE DEEMED TO BE IN THE EMPLOY OF
A PHARMACY OR PRACTICING IN A HOSPITAL FOR PURPOSES OF SUBDIVISION TWO
OF SECTION SIXTY-EIGHT HUNDRED SEVEN OF THE EDUCATION LAW.
4. REGULATIONS OF THE COMMISSIONER. (A) THE COMMISSIONER SHALL
PROMULGATE REGULATIONS SETTING FORTH OPERATIONAL AND PHYSICAL PLANT
STANDARDS FOR RETAIL CLINICS, WHICH MAY BE DIFFERENT FROM THE REGU-
LATIONS OTHERWISE APPLICABLE TO DIAGNOSTIC OR TREATMENT CENTERS, INCLUD-
ING, BUT NOT LIMITED TO:
(I) REQUIRING THAT RETAIL CLINICS ATTAIN AND MAINTAIN ACCREDITATION BY
AN APPROPRIATE ACCREDITING ENTITY APPROVED BY THE COMMISSIONER AND
REQUIRING TIMELY REPORTING TO THE DEPARTMENT IF A RETAIL CLINIC LOSES
ITS ACCREDITATION;
(II) DESIGNATING OR LIMITING THE TREATMENTS AND SERVICES THAT MAY BE
PROVIDED, INCLUDING LIMITING THE SCOPE OF SERVICES TO THE FOLLOWING,
PROVIDED THAT SUCH SERVICES SHALL NOT INCLUDE MONITORING OR TREATMENT
AND SERVICES OVER MULTIPLE VISITS OR PROLONGED PERIODS:
(A) THE PROVISION OF TREATMENT AND SERVICES TO PATIENTS FOR MINOR
ACUTE EPISODIC ILLNESSES OR CONDITIONS;
(B) EPISODIC PREVENTIVE AND WELLNESS TREATMENTS AND SERVICES SUCH AS
IMMUNIZATIONS;
(C) TREATMENT AND SERVICES FOR MINOR INJURIES THAT ARE NOT REASONABLY
LIKELY TO BE LIFE THREATENING OR POTENTIALLY DISABLING OR HAVE COMPLI-
CATIONS IF AMBULATORY CARE WITHIN THE CAPACITY OF THE RETAIL CLINIC IS
PROVIDED;
(D) PROHIBITING THE PROVISION OF SERVICES TO PATIENTS TWENTY-FOUR
MONTHS OF AGE OR YOUNGER;
(III) REQUIRING RETAIL CLINICS TO ACCEPT WALK-INS AND OFFER EXTENDED
BUSINESS HOURS;
(IV) SETTING FORTH GUIDELINES FOR ADVERTISING AND SIGNAGE, WHICH SHALL
INCLUDE SIGNAGE INDICATING THAT PRESCRIPTIONS AND OVER-THE-COUNTER
SUPPLIES MAY BE PURCHASED BY A PATIENT FROM ANY BUSINESS AND DO NOT NEED
TO BE PURCHASED ON-SITE; AND
(V) SETTING FORTH GUIDELINES FOR INFORMED CONSENT, RECORD KEEPING,
REFERRAL FOR TREATMENT AND CONTINUITY OF CARE, CASE REPORTING TO THE
PATIENT'S PRIMARY CARE OR OTHER HEALTH CARE PROVIDERS, DESIGN,
CONSTRUCTION, FIXTURES, AND EQUIPMENT.
(B) SUCH REGULATIONS ALSO SHALL PROMOTE AND STRENGTHEN PRIMARY CARE BY
REQUIRING RETAIL CLINICS TO:
(I) INQUIRE OF EACH PATIENT WHETHER HE OR SHE HAS A PRIMARY CARE
PROVIDER;
(II) MAINTAIN AND REGULARLY UPDATE A LIST OF LOCAL PRIMARY CARE
PROVIDERS AND PROVIDE SUCH LIST TO EACH PATIENT WHO INDICATES THAT HE OR
SHE DOES NOT HAVE A PRIMARY CARE PROVIDER. SUCH ROSTER (A) SHALL BE
DRAWN FROM A LIST OF PRIMARY CARE PROVIDERS AND PERIODICALLY UPDATED BY
THE DEPARTMENT ON ITS WEBSITE (IN A SEARCHABLE FORM) INCLUDING THE
INFORMATION REQUIRES IN CLAUSES (B) AND (C) OF THIS SUBPARAGRAPH,
A. 9007--B 30
LOCATED IN THE ZIP CODE AREA AND ADJACENT ZIP CODE AREAS OF THE RETAIL
CLINIC, AND MAY INCLUDE ADDITIONAL PRIMARY CARE PROVIDERS ADDED BY THE
RETAIL CLINIC; (B) SHALL IDENTIFY PREFERRED PROVIDERS WHO HAVE ACHIEVED
RECOGNITION AS A PATIENT CENTERED MEDICAL HOME (PCMH) OR OTHER SIMILAR
DESIGNATION AND A DESCRIPTION OF WHAT SUCH DESIGNATION MEANS; AND (C)
SHALL INCLUDE FEDERALLY QUALIFIED HEALTH CENTERS AND OTHER PROVIDERS WHO
SERVE MEDICAID, LOW-INCOME, AND UNINSURED PATIENTS, AND PEOPLE WITH
DISABILITIES, AND SHALL IDENTIFY CULTURAL AND LINGUISTIC CAPABILITIES
WHEN AVAILABLE;
(III) REFER PATIENTS TO THEIR PRIMARY CARE PROVIDERS OR OTHER HEALTH
CARE PROVIDERS AS APPROPRIATE;
(IV) TRANSMIT, BY ELECTRONIC MEANS WHENEVER POSSIBLE, RECORDS OF
SERVICES TO PATIENTS' PRIMARY CARE PROVIDERS;
(V) DECLINE TO TREAT ANY PATIENT FOR THE SAME CONDITION OR ILLNESS
MORE THAN THREE TIMES IN A YEAR; AND
(VI) REPORT TO THE DEPARTMENT RELEVANT DATA, AS MAY BE DEEMED NECES-
SARY BY THE DEPARTMENT, RELATED TO SERVICES PROVIDED AND PATIENTS
SERVED, PROVIDED THAT SUCH REPORTING SHALL COMPLY WITH ALL PRIVACY LAWS
RELATED TO PATIENT DATA.
(C) RETAIL CLINICS ALREADY IN OPERATION AT THE TIME THIS SECTION TAKES
EFFECT MUST COMPLY WITH ACCREDITATION REQUIREMENTS UNDER THIS SUBDIVI-
SION WITHIN ONE YEAR AFTER THE EFFECTIVE DATE OF THIS SECTION.
(D) THE DEPARTMENT SHALL ROUTINELY REVIEW THE COMPLIANCE BY RETAIL
CLINICS WITH THE PROVISIONS OF THIS SECTION AND IF A RETAIL CLINIC FAILS
TO COMPLY WITH THE PROVISIONS OF THIS SECTION, OR REGULATIONS ADOPTED
PURSUANT TO THIS SECTION, THE DEPARTMENT SHALL HAVE THE AUTHORITY TO
TAKE ENFORCEMENT ACTIONS UNDER TITLE TWO OF ARTICLE ONE OF THIS CHAPTER.
(E) IN MAKING REGULATIONS UNDER THIS SECTION, THE COMMISSIONER MAY
CONSULT WITH A WORKGROUP INCLUDING, BUT NOT LIMITED TO, REPRESENTATIVES
OF HEALTH CARE CONSUMERS AND REPRESENTATIVES OF PROFESSIONAL SOCIETIES
OF APPROPRIATE HEALTH CARE PROFESSIONALS, INCLUDING THOSE IN PRIMARY
CARE AND OTHER SPECIALTIES.
5. A RETAIL CLINIC SHALL PROVIDE TREATMENT WITHOUT DISCRIMINATION AS
TO SOURCE OF PAYMENT.
6. THE DEPARTMENT SHALL PROVIDE AN ANNUAL REPORT WHICH IT SHALL MAKE
AVAILABLE ON ITS WEBSITE; THE REPORT SHALL INCLUDE LOCATIONS OF RETAIL
CLINICS IN THE STATE AND SHALL INDICATE WHICH CLINICS ARE LOCATED IN
MEDICALLY UNDERSERVED AREAS; SUCH REPORT SHALL ALSO INCLUDE AN ANALYSIS
AS TO WHETHER RETAIL CLINICS HAVE IMPROVED ACCESS TO HEALTH CARE IN
UNDERSERVED AREAS, RECOMMENDATIONS RELATED THERETO AND ANY OTHER INFOR-
MATION THE DEPARTMENT MAY DEEM NECESSARY.
7. THIS SECTION DOES NOT AUTHORIZE ANY FORM OF OWNERSHIP OR ORGANIZA-
TION OF A RETAIL CLINIC OR PRACTICE OF ANY PROFESSION THAT WOULD NOT
OTHERWISE BE LEGAL, AND DOES NOT EXPAND THE SCOPE OF PRACTICE OF ANY
HEALTH CARE PRACTITIONER. WHERE ANY REGULATION UNDER THIS SECTION WOULD
LIMIT THE SCOPE OF SERVICES THAT MAY BE PROVIDED IN A RETAIL CLINIC BY A
HEALTH CARE PRACTITIONER LICENSED, REGISTERED, CERTIFIED OR AUTHORIZED
TO PRACTICE UNDER TITLE EIGHT OF THE EDUCATION LAW, THE REGULATION SHALL
BE MADE BY THE COMMISSIONER IN CONSULTATION WITH THE COMMISSIONER OF
EDUCATION.
8. THE HOST BUSINESS ENTITY OF A RETAIL CLINIC SHALL NOT, DIRECTLY OR
INDIRECTLY, BY CONTRACT, POLICY, COMMUNICATION, INCENTIVE OR OTHERWISE,
INFLUENCE OR SEEK TO INFLUENCE ANY CLINICAL DECISION, POLICY OR PRACTICE
OF ANY HEALTH CARE PRACTITIONER PROVIDING ANY HEALTH CARE SERVICE IN THE
RETAIL CLINIC, INCLUDING PRESCRIBING OR RECOMMENDING DRUGS, DEVICES OR
SUPPLIES OR RECOMMENDING A SOURCE FOR OBTAINING DRUGS, DEVICES OR
A. 9007--B 31
SUPPLIES. THIS SUBDIVISION SHALL NOT PRECLUDE THE HOST BUSINESS ENTITY
FROM ESTABLISHING, CONSISTENT WITH THIS SECTION AND APPLICABLE LAW,
LIMITATIONS ON OR REQUIREMENTS AS TO THE SCOPE OF HEALTH CARE SERVICES
TO BE PROVIDED IN THE RETAIL CLINIC OR ACTIVITIES TO ASSURE MAINTAINING
QUALITY STANDARDS OF HEALTH CARE SERVICES. AS USED IN THIS SECTION,
"HOST BUSINESS ENTITY" MEANS THE RETAIL BUSINESS ORGANIZATION, RETAIL
BUSINESS ENTITY, OR BUSINESS ENTITY WITHIN WHOSE SPACE THE RETAIL CLINIC
IS LOCATED OR WITH WHOSE NAME OR SYMBOL THE RETAIL CLINIC IS LABELED,
BRANDED, ADVERTISED OR MARKETED.
S 2. This act shall take effect on the one hundred eightieth day after
it shall have become a law; provided that effective immediately, the
commissioner of health shall make regulations and take other actions
reasonably necessary to implement the provisions of this act on or
before such effective date.
PART H
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, as amended
by section 1 of part JJ of chapter 58 of the laws of 2015, 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,
[2016] 2017; and for programs located within the city of New York, the
applicable fiscal periods shall be July 1, 2003 through June 30, 2010
and July 1, 2011 through June 30, [2016] 2017.
S 2. This act shall take effect immediately.
PART I
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 K of
chapter 56 of the laws of 2012, are amended to read as follows:
S 19. Notwithstanding any other provision of law, the commissioner of
mental health shall, until July 1, [2016] 2020, 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, [2016] 2020, 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
A. 9007--B 32
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, 2016.
PART J
Section 1. Subdivision 10 of Section 7605 of the education law, as
added by section 4 of part AA of chapter 57 of the laws of 2013, is
amended and a new subdivision 12 is added to read as follows:
10. A person without a license from performing assessments such as
basic information collection, gathering of demographic data, and
informal observations, screening and referral used for general eligibil-
ity for a program or service and determining the functional status of an
individual for the purpose of determining need for services [unrelated
to a behavioral health diagnosis or treatment plan]. Such licensure
shall not be required to [create, develop or implement] PARTICIPATE AS A
MEMBER OF THE TREATMENT TEAM IN THE CREATION, DEVELOPMENT OR IMPLEMENTA-
TION OF a service plan [unrelated to a behavioral health diagnosis or
treatment plan]. Such service plans shall include, but are not limited
to, job training and employability, housing, general public assistance,
in home services and supports or home-delivered meals, investigations
conducted or assessments made by adult or child protective services,
adoption home studies and assessments, family service plans, transition
plans and permanency planning activities, de-escalation techniques, peer
services or skill development. A license under this article shall not be
required for persons to participate as a member of a multi-disciplinary
team to implement a behavioral health services or treatment plan;
provided however, that such team shall include one or more professionals
licensed under this article or articles one hundred thirty-one, one
hundred fifty-four or one hundred sixty-three of this chapter WHO MUST
HAVE A FACE TO FACE VISIT WITH EACH PATIENT PRIOR TO THE RENDERING OF A
DIAGNOSIS; and provided, further, that the activities performed by
members of the team shall be consistent with the scope of practice for
each team member licensed or authorized under title VIII of this chap-
ter, and those who are not so authorized may not engage in the following
restricted practices BUT MAY ASSIST LICENSED PROFESSIONALS AND/OR
MULTI-DISCIPLINARY TEAM MEMBERS WITH: the diagnosis of mental,
emotional, behavioral, addictive and developmental disorders and disa-
bilities; [patient assessment and evaluating;] the provision of
psychotherapeutic treatment; the provision of treatment other than
psychotherapeutic treatment; and/or the development and implementation
of assessment-based treatment plans as defined in section seventy-seven
hundred one of this [chapter] TITLE. AS USED IN THIS SUBDIVISION, THE
TERM "ASSIST" SHALL INCLUDE THOSE FUNCTIONS WHICH ARE EXEMPT UNDER THIS
SUBDIVISION. Provided, further, that nothing in this subdivision shall
be construed as requiring a license for any particular activity or func-
tion based solely on the fact that the activity or function is not list-
ed in this subdivision.
12. NOTHING IN THIS SECTION SHALL BE CONSTRUED TO PROHIBIT OR LIMIT
THE ACTIVITIES OR SERVICES PROVIDED UNDER THIS ARTICLE ON THE PART OF
ANY PERSON WHO, UPON THE EFFECTIVE DATE OF THIS SUBDIVISION, IS IN THE
EMPLOY OF A PROGRAM OR SERVICE, AS DEFINED IN SUBDIVISION B OF SECTION
SEVENTEEN-A OF CHAPTER SIX HUNDRED SEVENTY-SIX OF THE LAWS OF TWO THOU-
SAND TWO, AS AMENDED, FOR THE PERIOD DURING WHICH SUCH PERSON MAINTAINS
EMPLOYMENT IN SUCH PROGRAM; ACTIVITIES AND SERVICES THAT MAY BE
A. 9007--B 33
PERFORMED ARE LIMITED TO THOSE PROVIDED BY SUCH INDIVIDUAL WITHIN THE
PRACTICE OF PSYCHOLOGY, AS DEFINED IN THIS ARTICLE, PRIOR TO THE EFFEC-
TIVE DATE OF THIS SUBDIVISION. THIS SUBDIVISION SHALL NOT AUTHORIZE THE
USE OF ANY TITLE AUTHORIZED PURSUANT TO THIS ARTICLE BY ANY SUCH
EMPLOYED PERSON, EXCEPT AS OTHERWISE PROVIDED BY THIS ARTICLE RESPEC-
TIVELY.
PROVIDED, HOWEVER, THAT ANY PERSON THAT COMMENCES EMPLOYMENT IN SUCH
PROGRAM OR SERVICE ON OR AFTER JULY FIRST, TWO THOUSAND NINETEEN AND
PERFORMS SERVICES THAT ARE RESTRICTED UNDER THIS ARTICLE SHALL BE APPRO-
PRIATELY LICENSED OR AUTHORIZED UNDER THIS ARTICLE.
S 2. Subdivision 7 of section 7706 of the education law, as added by
section 5 of part AA of chapter 57 of the laws of 2013, is amended and a
new subdivision 8 is added to read as follows:
7. Prevent a person without a license from performing assessments such
as basic information collection, gathering of demographic data, and
informal observations, screening and referral used for general eligibil-
ity for a program or service and determining the functional status of an
individual for the purpose of determining need for services [unrelated
to a behavioral health diagnosis or treatment plan]. Such licensure
shall not be required to [create, develop or implement] PARTICIPATE AS A
MEMBER OF THE TREATMENT TEAM IN THE CREATION, DEVELOPMENT OR IMPLEMENTA-
TION OF a service plan [unrelated to a behavioral health diagnosis or
treatment plan]. Such service plans shall include, but are not limited
to, job training and employability, housing, general public assistance,
in home services and supports or home-delivered meals, investigations
conducted or assessments made by adult or child protective services,
adoption home studies and assessments, family service plans, transition
plans and permanency planning activities, de-escalation techniques, peer
services or skill development. A license under this article shall not be
required for persons to participate as a member of a multi-disciplinary
team to implement a behavioral health services or treatment plan;
provided however, that such team shall include one or more professionals
licensed under this article or articles one hundred thirty-one, one
hundred fifty-three or one hundred sixty-three of this chapter WHO MUST
HAVE A FACE TO FACE VISIT WITH EACH PATIENT PRIOR TO THE RENDERING OF A
DIAGNOSIS; and provided, further, that the activities performed by
members of the team shall be consistent with the scope of practice for
each team member licensed or authorized under title VIII of this chap-
ter, and those who are not so authorized may not engage in the following
restricted practices BUT MAY ASSIST LICENSED PROFESSIONALS AND/OR
MULTI-DISCIPLINARY TEAM MEMBERS WITH: the diagnosis of mental,
emotional, behavioral, addictive and developmental disorders and disa-
bilities; [patient assessment and evaluating;] the provision of
psychotherapeutic treatment; the provision of treatment other than
psychotherapeutic treatment; and/or the development and implementation
of assessment-based treatment plans as defined in section seventy-seven
hundred one of this article. AS USED IN THIS SUBDIVISION, THE TERM
"ASSIST" SHALL INCLUDE THOSE FUNCTIONS WHICH ARE EXEMPT UNDER THIS
SUBDIVISION. Provided, further, that nothing in this subdivision shall
be construed as requiring a license for any particular activity or func-
tion based solely on the fact that the activity or function is not list-
ed in this subdivision.
8. NOTHING HEREIN SHALL BE CONSTRUED TO PROHIBIT OR LIMIT THE ACTIV-
ITIES OR SERVICES PROVIDED UNDER THIS ARTICLE ON THE PART OF ANY PERSON
WHO, UPON THE EFFECTIVE DATE OF THIS SUBDIVISION, IS IN THE EMPLOY OF A
PROGRAM OR SERVICE, AS DEFINED IN SECTION NINE OF CHAPTER FOUR HUNDRED
A. 9007--B 34
TWENTY OF THE LAWS OF TWO THOUSAND TWO, AS AMENDED, FOR THE PERIOD
DURING WHICH SUCH PERSON MAINTAINS EMPLOYMENT IN SUCH PROGRAM; ACTIV-
ITIES AND SERVICES THAT MAY BE PERFORMED ARE LIMITED TO THOSE PROVIDED
BY SUCH INDIVIDUAL WITHIN THE PRACTICE OF LICENSED MASTER SOCIAL WORK OR
LICENSED CLINICAL SOCIAL WORK, AS DEFINED IN THIS ARTICLE, PRIOR TO THE
EFFECTIVE DATE OF THIS SUBDIVISION. THIS SUBDIVISION SHALL NOT AUTHORIZE
THE USE OF ANY TITLE AUTHORIZED PURSUANT TO THIS ARTICLE BY ANY SUCH
EMPLOYED PERSON, EXCEPT AS OTHERWISE PROVIDED BY THIS ARTICLE RESPEC-
TIVELY.
PROVIDED, HOWEVER, THAT ANY PERSON THAT COMMENCES EMPLOYMENT IN SUCH
PROGRAM OR SERVICE ON OR AFTER JULY FIRST, TWO THOUSAND NINETEEN AND
PERFORMS SERVICES THAT ARE RESTRICTED UNDER THIS ARTICLE SHALL BE APPRO-
PRIATELY LICENSED OR AUTHORIZED UNDER THIS ARTICLE.
S 3. Section 7707 of the education law is amended by adding a new
subdivision 2-a to read as follows:
2-A. ANY PERSON WHO POSSESSES A MASTER'S OF SOCIAL WORK DEGREE,
ACCEPTABLE TO THE DEPARTMENT, ON THE EFFECTIVE DATE OF THIS SUBDIVISION
AND WHO HAS TWO YEARS OF POST-GRADUATE SOCIAL WORK EMPLOYMENT, AS VERI-
FIED BY A LICENSED SUPERVISOR OR COLLEAGUE ON FORMS ACCEPTABLE TO THE
DEPARTMENT, AND WHO, IN THE DETERMINATION OF THE DEPARTMENT, MEETS ALL
OTHER REQUIREMENTS FOR LICENSURE AS A LICENSED MASTER SOCIAL WORKER AS
DEFINED IN THIS ARTICLE, EXCEPT FOR EXAMINATION, AND WHO FILES WITH THE
DEPARTMENT THE APPLICATION, FEE AND REQUIRED DOCUMENTATION WITHIN ONE
YEAR OF THE EFFECTIVE DATE OF THIS SECTION, SHALL BE LICENSED AS A
LICENSED MASTER SOCIAL WORKER.
S 4. Subdivision 8 of section 8410 of the education law, as added by
section 6 of part AA of chapter 57 of the laws of 2013, is amended and a
new subdivision 9 is added to read as follows:
8. Prevent a person without a license from performing assessments such
as basic information collection, gathering of demographic data, and
informal observations, screening and referral used for general eligibil-
ity for a program or service and determining the functional status of an
individual for the purpose of determining need for services [unrelated
to a behavioral health diagnosis or treatment plan]. Such licensure
shall not be required to [create, develop or implement] PARTICIPATE AS A
MEMBER OF THE TREATMENT TEAM IN THE CREATION, DEVELOPMENT OR IMPLEMENTA-
TION OF a service plan [unrelated to a behavioral health diagnosis or
treatment plan]. Such service plans shall include, but are not limited
to, job training and employability, housing, general public assistance,
in home services and supports or home-delivered meals, investigations
conducted or assessments made by adult or child protective services,
adoption home studies and assessments, family service plans, transition
plans and permanency planning activities, de-escalation techniques, peer
services or skill development. A license under this article shall not be
required for persons to participate as a member of a multi-disciplinary
team to implement a behavioral health services or treatment plan;
provided however, that such team shall include one or more professionals
licensed under this article or articles one hundred thirty-one, one
hundred fifty-three or one hundred fifty-four of this chapter WHO MUST
HAVE A FACE TO FACE VISIT WITH EACH PATIENT PRIOR TO THE RENDERING OF A
DIAGNOSIS; and provided, further, that the activities performed by
members of the team shall be consistent with the scope of practice for
each team member licensed or authorized under title VIII of this chap-
ter, and those who are not so authorized may not engage in the following
restricted practices BUT MAY ASSIST LICENSED PROFESSIONALS AND/OR
MULTI-DISCIPLINARY TEAM MEMBERS WITH: the diagnosis of mental,
A. 9007--B 35
emotional, behavioral, addictive and developmental disorders and disa-
bilities; [patient assessment and evaluating;] the provision of
psychotherapeutic treatment; the provision of treatment other than
psychotherapeutic treatment; and/or the development and implementation
of assessment-based treatment plans as defined in section seventy-seven
hundred one of this chapter. AS USED IN THIS SUBDIVISION, THE TERM
"ASSIST" SHALL INCLUDE THOSE FUNCTIONS THAT ARE EXEMPT UNDER THIS SUBDI-
VISION. Provided, further, that nothing in this subdivision shall be
construed as requiring a license for any particular activity or function
based solely on the fact that the activity or function is not listed in
this subdivision.
9. NOTHING HEREIN SHALL BE CONSTRUED TO PROHIBIT OR LIMIT THE ACTIV-
ITIES OR SERVICES PROVIDED UNDER THIS ARTICLE ON THE PART OF ANY PERSON
WHO, UPON THE EFFECTIVE DATE OF THIS SUBDIVISION, IS IN THE EMPLOY OF A
PROGRAM OR SERVICE, AS DEFINED IN SUBDIVISION B OF SECTION SEVENTEEN-A
OF CHAPTER SIX HUNDRED SEVENTY-SIX OF THE LAWS OF TWO THOUSAND TWO, AS
AMENDED, FOR THE PERIOD DURING WHICH SUCH PERSON MAINTAINS EMPLOYMENT IN
SUCH PROGRAM; ACTIVITIES AND SERVICES THAT MAY BE PERFORMED ARE LIMITED
TO THOSE PROVIDED BY SUCH INDIVIDUAL WITHIN THE PRACTICE OF MENTAL
HEALTH COUNSELING, MARRIAGE AND FAMILY THERAPY, CREATIVE ARTS THERAPY
AND PSYCHOANALYSIS, AS DEFINED IN THIS ARTICLE, PRIOR TO THE EFFECTIVE
DATE OF THIS SECTION. THIS SECTION SHALL NOT AUTHORIZE THE USE OF ANY
TITLE AUTHORIZED PURSUANT TO THIS ARTICLE BY ANY SUCH EMPLOYED PERSON,
EXCEPT AS OTHERWISE PROVIDED BY THIS ARTICLE RESPECTIVELY.
PROVIDED, HOWEVER, THAT ANY PERSON THAT COMMENCES EMPLOYMENT IN SUCH
PROGRAM OR SERVICE ON OR AFTER JULY FIRST, TWO THOUSAND NINETEEN AND
PERFORMS SERVICES THAT ARE RESTRICTED UNDER THIS ARTICLE SHALL BE APPRO-
PRIATELY LICENSED OR AUTHORIZED UNDER THIS ARTICLE.
S 5. No later than July 1, 2017, the department of mental hygiene, the
office of children and family services, the office of temporary and
disability assistance, the department of corrections and community
supervision, the state office for the aging, the department of health,
or a local governmental unit as that term is defined in article 41 of
the mental hygiene law or a social services district as defined in
section 61 of the social services law (hereinafter referred to as "agen-
cies") shall individually or collectively consult with the department to
develop formal guidance for service providers authorized to operate
under the respective agencies to identify the following: (a) the tasks
and functions performed by each agency's service provider workforce
categorized as tasks and functions restricted to licensed personnel
including tasks and functions that do not require a license under arti-
cles 153, 154 and 163 of the education law; (b) costs associated with
employing appropriately licensed or otherwise authorized personnel to
perform tasks and functions that require licensure under such articles
153, 154 and 163 including salary costs and costs associated with
providing support to unlicensed personnel in obtaining appropriate
licensure and funding for costs associated with service providers reach-
ing compliance with applicable licensing laws; (c) any changes in law,
rule or regulation that are necessary to implement the applicable
licensing laws; and (d) an action plan detailing measures that each
state or local agency shall implement to ensure that service providers
and their workforce shall be in compliance with professional licensure
laws applicable to services provided as it relates to each employee
hired on July 1, 2019.
S 6. Subdivision a of section 9 of chapter 420 of the laws of 2002,
amending the education law relating to the profession of social work, as
A. 9007--B 36
amended by section 1 of part AA of chapter 57 of the laws of 2013, is
amended to read as follows:
a. Nothing in this act shall prohibit or limit the activities or
services on the part of any person in the employ of a program or service
operated, regulated, funded, or approved by the department of mental
hygiene, the office of children and family services, the office of
temporary and disability assistance, the department of corrections and
community supervision, the state office for the aging, the department of
health, or a local governmental unit as that term is defined in article
41 of the mental hygiene law or a social services district as defined in
section 61 of the social services law, provided, however, this section
shall not authorize the use of any title authorized pursuant to article
154 of the education law, PROVIDED, FURTHER, THAT ANY PERSON THAT
COMMENCES EMPLOYMENT IN SUCH PROGRAM OR SERVICE ON OR AFTER JULY 1, 2019
AND PERFORMS SERVICES THAT ARE RESTRICTED UNDER ARTICLE 154 OF THE
EDUCATION LAW SHALL BE APPROPRIATELY LICENSED OR AUTHORIZED UNDER THIS
ARTICLE except that this section shall be deemed repealed on July 1,
[2016] 2021.
S 7. Subdivision a of section 17-a of chapter 676 of the laws of 2002
amending the education law relating to the practice of psychology, as
amended by section 2 of part AA of chapter 57 of the laws of 2013, is
amended to read as follows:
a. In relation to activities and services provided under article 153
of the education law, nothing in this act shall prohibit or limit such
activities or services on the part of any person in the employ of a
program or service operated, regulated, funded, or approved by the
department of mental hygiene or the office of children and family
services, or a local governmental unit as that term is defined in arti-
cle 41 of the mental hygiene law or a social services district as
defined in section 61 of the social services law. In relation to activ-
ities and services provided under article 163 of the education law,
nothing in this act shall prohibit or limit such activities or services
on the part of any person in the employ of a program or service oper-
ated, regulated, funded, or approved by the department of mental
hygiene, the office of children and family services, the department of
corrections and community supervision, the office of temporary and disa-
bility assistance, the state office for the aging and the department of
health or a local governmental unit as that term is defined in article
41 of the mental hygiene law or a social services district as defined in
section 61 of the social services law, pursuant to authority granted by
law. This section shall not authorize the use of any title authorized
pursuant to article 153 or 163 of the education law by any such employed
person, except as otherwise provided by such articles respectively.
PROVIDED, FURTHER, THAT ANY PERSON THAT COMMENCES EMPLOYMENT IN SUCH
PROGRAM OR SERVICE ON OR AFTER JULY 1, 2019 AND PERFORMS SERVICES THAT
ARE RESTRICTED UNDER ARTICLE 153 OR 163 OF THE EDUCATION LAW SHALL BE
APPROPRIATELY LICENSED OR AUTHORIZED UNDER THIS ARTICLE. This section
shall be deemed repealed July 1, [2016] 2021.
S 8. Section 16 of chapter 130 of the laws of 2010 amending the educa-
tion law and other laws relating to the registration of entities provid-
ing certain professional services and the licensure of certain
professions, as amended by section 3 of part AA of chapter 57 of the
laws of 2013, is amended to read as follows:
S 16. This act shall take effect immediately; provided that sections
thirteen, fourteen and fifteen of this act shall take effect immediately
and shall be deemed to have been in full force and effect on and after
A. 9007--B 37
June 1, 2010 and such sections shall be deemed repealed July 1, [2016]
2021; PROVIDED, HOWEVER, THAT ANY PERSON THAT COMMENCES EMPLOYMENT IN
SUCH PROGRAM OR SERVICE ON OR AFTER JULY 1, 2019 AND PERFORMS SERVICES
THAT ARE RESTRICTED UNDER ARTICLE 153, 154 OR 163 OF THE EDUCATION LAW
SHALL BE APPROPRIATELY LICENSED OR AUTHORIZED UNDER THIS ARTICLE;
provided further that the amendments to section 9 of chapter 420 of the
laws of 2002 amending the education law relating to the profession of
social work made by section thirteen of this act shall repeal on the
same date as such section repeals; provided further that the amendments
to section 17-a of chapter 676 of the laws of 2002 amending the educa-
tion law relating to the practice of psychology made by section fourteen
of this act shall repeal on the same date as such section repeals.
S 9. This act shall take effect immediately.
PART K
Intentionally Omitted
PART L
Section 1. The mental hygiene law is amended by adding a new section
16.25 to read as follows:
S 16.25 TEMPORARY OPERATOR.
(A) FOR THE PURPOSES OF THIS SECTION:
(1) "ESTABLISHED OPERATOR" SHALL MEAN THE PROVIDER OF SERVICES THAT
HAS BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE PURSUANT TO
THIS ARTICLE.
(2) "EXTRAORDINARY FINANCIAL ASSISTANCE" SHALL MEAN STATE FUNDS
PROVIDED TO, OR REQUESTED BY, A PROGRAM FOR THE EXPRESS PURPOSE OF
PREVENTING THE CLOSURE OF THE PROGRAM THAT THE COMMISSIONER FINDS
PROVIDES ESSENTIAL AND NECESSARY SERVICES WITHIN THE COMMUNITY.
(3) "SERIOUS FINANCIAL INSTABILITY" SHALL INCLUDE BUT NOT BE LIMITED
TO DEFAULTING OR VIOLATING MATERIAL COVENANTS OF BOND ISSUES, MISSED
MORTGAGE PAYMENTS, MISSED RENT PAYMENTS, A PATTERN OF UNTIMELY PAYMENT
OF DEBTS, FAILURE TO PAY ITS EMPLOYEES OR VENDORS, INSUFFICIENT FUNDS TO
MEET THE GENERAL OPERATING EXPENSES OF THE PROGRAM, FAILURE TO MAINTAIN
REQUIRED DEBT SERVICE COVERAGE RATIOS AND/OR, AS APPLICABLE, FACTORS
THAT HAVE TRIGGERED A WRITTEN EVENT OF DEFAULT NOTICE TO THE OFFICE BY
THE DORMITORY AUTHORITY OF THE STATE OF NEW YORK.
(4) "OFFICE" SHALL MEAN THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISA-
BILITIES.
(5) "TEMPORARY OPERATOR" SHALL MEAN ANY PROVIDER OF SERVICES THAT HAS
BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE PURSUANT TO THIS
ARTICLE OR WHICH IS DIRECTLY OPERATED BY THE OFFICE, THAT:
A. AGREES TO PROVIDE SERVICES CERTIFIED PURSUANT TO THIS ARTICLE ON A
TEMPORARY BASIS IN THE BEST INTERESTS OF ITS INDIVIDUALS SERVED BY THE
PROGRAM; AND
B. HAS A HISTORY OF COMPLIANCE WITH APPLICABLE LAWS, RULES, AND REGU-
LATIONS AND A RECORD OF PROVIDING CARE OF GOOD QUALITY, AS DETERMINED BY
THE COMMISSIONER; AND
C. PRIOR TO APPOINTMENT AS TEMPORARY OPERATOR, DEVELOPS A PLAN DETER-
MINED TO BE SATISFACTORY BY THE COMMISSIONER TO ADDRESS THE PROGRAM'S
DEFICIENCIES.
(B) (1) IN THE EVENT THAT: (I) THE ESTABLISHED OPERATOR IS SEEKING
EXTRAORDINARY FINANCIAL ASSISTANCE; (II) OFFICE COLLECTED DATA DEMON-
STRATES THAT THE ESTABLISHED OPERATOR IS EXPERIENCING SERIOUS FINANCIAL
A. 9007--B 38
INSTABILITY ISSUES; (III) OFFICE COLLECTED DATA DEMONSTRATES THAT THE
ESTABLISHED OPERATOR'S BOARD OF DIRECTORS OR ADMINISTRATION IS UNABLE OR
UNWILLING TO ENSURE THE PROPER OPERATION OF THE PROGRAM; OR (IV) OFFICE
COLLECTED DATA INDICATES THERE ARE CONDITIONS THAT SERIOUSLY ENDANGER OR
JEOPARDIZE CONTINUED ACCESS TO NECESSARY SERVICES WITHIN THE COMMUNITY,
THE COMMISSIONER SHALL NOTIFY THE ESTABLISHED OPERATOR OF HIS OR HER
INTENTION TO APPOINT A TEMPORARY OPERATOR TO ASSUME SOLE RESPONSIBILITY
FOR THE PROVIDER OF SERVICES' OPERATIONS FOR A LIMITED PERIOD OF TIME.
THE APPOINTMENT OF A TEMPORARY OPERATOR SHALL BE EFFECTUATED PURSUANT TO
THIS SECTION, AND SHALL BE IN ADDITION TO ANY OTHER REMEDIES PROVIDED BY
LAW.
(2) THE ESTABLISHED OPERATOR 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 NECES-
SARY, ENTER INTO AN AGREEMENT WITH THE ESTABLISHED OPERATOR FOR THE
APPOINTMENT OF A TEMPORARY OPERATOR TO RESTORE OR MAINTAIN THE PROVISION
OF QUALITY CARE TO THE INDIVIDUALS UNTIL THE ESTABLISHED OPERATOR CAN
RESUME OPERATIONS WITHIN THE DESIGNATED TIME PERIOD OR OTHER ACTION IS
TAKEN AS DESCRIBED IN SECTION 16.17 OF THIS ARTICLE.
(C) (1) A TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION SHALL
USE HIS OR HER BEST EFFORTS TO IMPLEMENT THE PLAN DEEMED SATISFACTORY BY
THE COMMISSIONER TO CORRECT OR ELIMINATE ANY DEFICIENCIES IN THE PROGRAM
AND TO PROMOTE THE QUALITY AND ACCESSIBILITY OF SERVICES IN THE COMMUNI-
TY SERVED BY THE PROVIDER OF SERVICES.
(2) DURING THE TERM OF APPOINTMENT, THE TEMPORARY OPERATOR SHALL HAVE
THE AUTHORITY TO DIRECT THE STAFF OF THE ESTABLISHED OPERATOR AS NECES-
SARY TO APPROPRIATELY PROVIDE SERVICES FOR INDIVIDUALS. THE TEMPORARY
OPERATOR SHALL, DURING THIS PERIOD, PROVIDE SERVICES IN SUCH A MANNER AS
TO PROMOTE SAFETY AND THE QUALITY AND ACCESSIBILITY OF SERVICES IN THE
COMMUNITY SERVED BY THE ESTABLISHED OPERATOR UNTIL EITHER THE ESTAB-
LISHED OPERATOR CAN RESUME OPERATIONS OR UNTIL THE OFFICE REVOKES THE
OPERATING CERTIFICATE FOR THE SERVICES ISSUED UNDER THIS ARTICLE.
(3) THE ESTABLISHED OPERATOR SHALL GRANT ACCESS TO THE TEMPORARY OPER-
ATOR TO THE ESTABLISHED OPERATOR'S ACCOUNTS AND RECORDS IN ORDER TO
ADDRESS ANY DEFICIENCIES RELATED TO THE PROGRAM EXPERIENCING SERIOUS
FINANCIAL INSTABILITY OR AN ESTABLISHED OPERATOR REQUESTING FINANCIAL
ASSISTANCE IN ACCORDANCE WITH THIS SECTION. THE TEMPORARY OPERATOR SHALL
APPROVE ANY FINANCIAL DECISION RELATED TO AN ESTABLISHED PROVIDER'S DAY
TO DAY OPERATIONS OR THE ESTABLISHED PROVIDER'S ABILITY TO PROVIDE
SERVICES.
(4) THE TEMPORARY OPERATOR SHALL NOT BE REQUIRED TO FILE ANY BOND. NO
SECURITY INTEREST IN ANY REAL OR PERSONAL PROPERTY COMPRISING THE ESTAB-
LISHED OPERATOR OR CONTAINED WITHIN THE ESTABLISHED OPERATOR OR IN ANY
FIXTURE OF THE PROGRAM, SHALL BE IMPAIRED OR DIMINISHED IN PRIORITY BY
THE TEMPORARY OPERATOR. NEITHER THE TEMPORARY OPERATOR NOR THE OFFICE
SHALL ENGAGE IN ANY ACTIVITY THAT CONSTITUTES A CONFISCATION OF PROPER-
TY.
(D) THE TEMPORARY OPERATOR SHALL BE ENTITLED TO A REASONABLE FEE, AS
DETERMINED BY THE COMMISSIONER AND SUBJECT TO THE APPROVAL OF THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, AND NECESSARY EXPENSES INCURRED WHILE
SERVING AS A TEMPORARY OPERATOR. THE TEMPORARY OPERATOR SHALL BE LIABLE
ONLY IN ITS CAPACITY AS TEMPORARY OPERATOR FOR INJURY TO PERSON AND
PROPERTY BY REASON OF ITS OPERATION OF SUCH PROGRAM; NO LIABILITY SHALL
INCUR IN THE TEMPORARY OPERATOR'S PERSONAL CAPACITY, EXCEPT FOR GROSS
NEGLIGENCE AND INTENTIONAL ACTS.
A. 9007--B 39
(E) (1) THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR
SHALL NOT EXCEED NINETY DAYS. AFTER NINETY DAYS, IF THE COMMISSIONER
DETERMINES THAT TERMINATION OF THE TEMPORARY OPERATOR WOULD CAUSE
SIGNIFICANT DETERIORATION OF THE QUALITY OF, OR ACCESS TO, CARE IN THE
COMMUNITY OR THAT REAPPOINTMENT IS NECESSARY TO CORRECT THE DEFICIENCIES
THAT REQUIRED THE APPOINTMENT OF THE TEMPORARY OPERATOR, THE COMMISSION-
ER MAY AUTHORIZE AN ADDITIONAL NINETY-DAY TERM. HOWEVER, SUCH AUTHORI-
ZATION SHALL INCLUDE THE COMMISSIONER'S REQUIREMENTS FOR CONCLUSION OF
THE TEMPORARY OPERATORSHIP TO BE SATISFIED WITHIN THE ADDITIONAL TERM.
(2) 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:
A. THE ACTIONS TAKEN DURING THE APPOINTMENT TO ADDRESS THE IDENTIFIED
PROGRAM DEFICIENCIES, THE RESUMPTION OF PROGRAM OPERATIONS BY THE ESTAB-
LISHED OPERATOR, OR THE REVOCATION OF AN OPERATING CERTIFICATE ISSUED BY
THE OFFICE;
B. OBJECTIVES FOR THE CONTINUATION OF THE TEMPORARY OPERATORSHIP IF
NECESSARY AND A SCHEDULE FOR SATISFACTION OF SUCH OBJECTIVES; AND
C. IF APPLICABLE, THE RECOMMENDED ACTIONS FOR THE ONGOING PROVISION OF
SERVICES SUBSEQUENT TO THE TEMPORARY OPERATORSHIP.
(3) 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.
(F) (1) THE COMMISSIONER SHALL, UPON MAKING A DETERMINATION OF AN
INTENTION TO APPOINT A TEMPORARY OPERATOR PURSUANT TO PARAGRAPH ONE OF
SUBDIVISION (B) OF THIS SECTION, CAUSE THE ESTABLISHED OPERATOR 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 UNDERLYING 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, THE COMMISSIONER AND THE ESTAB-
LISHED OPERATOR SHALL ATTEMPT TO DEVELOP A MUTUALLY SATISFACTORY PLAN OF
CORRECTION AND SCHEDULE FOR IMPLEMENTATION. IN SUCH EVENT, THE COMMIS-
SIONER SHALL NOTIFY THE ESTABLISHED OPERATOR THAT THE COMMISSIONER WILL
ABSTAIN FROM APPOINTING A TEMPORARY OPERATOR CONTINGENT UPON THE ESTAB-
LISHED OPERATOR REMEDIATING THE IDENTIFIED DEFICIENCIES WITHIN THE
AGREED UPON TIMEFRAME.
(2) SHOULD THE COMMISSIONER AND THE ESTABLISHED OPERATOR BE UNABLE TO
ESTABLISH A PLAN OF CORRECTION PURSUANT TO PARAGRAPH ONE 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 THIRTY 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
TEMPORARY OPERATOR IS SUPPORTED BY SUBSTANTIAL EVIDENCE. A COPY OF THE
DECISION SHALL BE SENT TO THE ESTABLISHED OPERATOR.
(3) IF THE DECISION TO APPOINT A TEMPORARY OPERATOR IS UPHELD SUCH
TEMPORARY OPERATOR SHALL BE APPOINTED AS SOON AS IS PRACTICABLE AND
SHALL PROVIDE SERVICES PURSUANT TO THE PROVISIONS OF THIS SECTION.
A. 9007--B 40
(G) NOTWITHSTANDING THE APPOINTMENT OF A TEMPORARY OPERATOR, THE
ESTABLISHED OPERATOR SHALL REMAIN OBLIGATED FOR THE CONTINUED PROVISION
OF SERVICES. 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 OF THE PROGRAM HEREUNDER;
NOR SHALL ANYTHING CONTAINED IN THIS SECTION BE CONSTRUED TO SUSPEND
DURING THE TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR OF THE
PROGRAM ANY OBLIGATION OF THE ESTABLISHED OPERATOR OR ANY OTHER PERSON
FOR THE MAINTENANCE AND REPAIR OF THE FACILITY, PROVISION OF UTILITY
SERVICES, 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 2. The mental hygiene law is amended by adding a new section 31.20
to read as follows:
S 31.20 TEMPORARY OPERATOR.
(A) FOR THE PURPOSES OF THIS SECTION:
(1) "ESTABLISHED OPERATOR" SHALL MEAN THE OPERATOR OF A MENTAL HEALTH
PROGRAM THAT HAS BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE
PURSUANT TO THIS ARTICLE.
(2) "EXTRAORDINARY FINANCIAL ASSISTANCE" SHALL MEAN STATE FUNDS
PROVIDED TO, OR REQUESTED BY, A PROGRAM FOR THE EXPRESS PURPOSE OF
PREVENTING THE CLOSURE OF THE PROGRAM THAT THE COMMISSIONER FINDS
PROVIDES ESSENTIAL AND NECESSARY SERVICES WITHIN THE COMMUNITY.
(3) "MENTAL HEALTH PROGRAM" SHALL MEAN A PROVIDER OF SERVICES FOR
PERSONS WITH SERIOUS MENTAL ILLNESS, AS SUCH TERMS ARE DEFINED IN
SECTION 1.03 OF THIS CHAPTER, WHICH IS LICENSED OR OPERATED BY THE
OFFICE.
(4) "OFFICE" SHALL MEAN THE OFFICE OF MENTAL HEALTH.
(5) "SERIOUS FINANCIAL INSTABILITY" SHALL INCLUDE BUT NOT BE LIMITED
TO DEFAULTING OR VIOLATING MATERIAL COVENANTS OF BOND ISSUES, MISSED
MORTGAGE PAYMENTS, A PATTERN OF UNTIMELY PAYMENT OF DEBTS, FAILURE TO
PAY ITS EMPLOYEES OR VENDORS, INSUFFICIENT FUNDS TO MEET THE GENERAL
OPERATING EXPENSES OF THE PROGRAM, FAILURE TO MAINTAIN REQUIRED DEBT
SERVICE COVERAGE RATIOS AND/OR, AS APPLICABLE, FACTORS THAT HAVE TRIG-
GERED A WRITTEN EVENT OF DEFAULT NOTICE TO THE OFFICE BY THE DORMITORY
AUTHORITY OF THE STATE OF NEW YORK.
(6) "TEMPORARY OPERATOR" SHALL MEAN ANY OPERATOR OF A MENTAL HEALTH
PROGRAM THAT HAS BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE
PURSUANT TO THIS ARTICLE OR WHICH IS DIRECTLY OPERATED BY THE OFFICE OF
MENTAL HEALTH, THAT:
A. AGREES TO OPERATE A MENTAL HEALTH PROGRAM ON A TEMPORARY BASIS IN
THE BEST INTERESTS OF ITS PATIENTS SERVED BY THE PROGRAM; AND
B. HAS A HISTORY OF COMPLIANCE WITH APPLICABLE LAWS, RULES, AND REGU-
LATIONS AND A RECORD OF PROVIDING CARE OF GOOD QUALITY, AS DETERMINED BY
THE COMMISSIONER; AND
C. PRIOR TO APPOINTMENT AS TEMPORARY OPERATOR, DEVELOPS A PLAN DETER-
MINED TO BE SATISFACTORY BY THE COMMISSIONER TO ADDRESS THE PROGRAM'S
DEFICIENCIES.
(B) (1) IN THE EVENT THAT: (I) THE ESTABLISHED OPERATOR IS SEEKING
EXTRAORDINARY FINANCIAL ASSISTANCE; (II) OFFICE COLLECTED DATA DEMON-
STRATES THAT THE ESTABLISHED OPERATOR IS EXPERIENCING SERIOUS FINANCIAL
INSTABILITY ISSUES; (III) OFFICE COLLECTED DATA DEMONSTRATES THAT THE
ESTABLISHED OPERATOR'S BOARD OF DIRECTORS OR ADMINISTRATION IS UNABLE OR
UNWILLING TO ENSURE THE PROPER OPERATION OF THE PROGRAM; OR (IV) OFFICE
A. 9007--B 41
COLLECTED DATA INDICATES THERE ARE CONDITIONS THAT SERIOUSLY ENDANGER OR
JEOPARDIZE CONTINUED ACCESS TO NECESSARY MENTAL HEALTH SERVICES WITHIN
THE COMMUNITY, THE COMMISSIONER SHALL NOTIFY THE ESTABLISHED OPERATOR OF
HIS OR HER INTENTION TO APPOINT A TEMPORARY OPERATOR TO ASSUME SOLE
RESPONSIBILITY FOR THE PROGRAM'S TREATMENT OPERATIONS FOR A LIMITED
PERIOD OF TIME. THE APPOINTMENT OF A TEMPORARY OPERATOR SHALL BE EFFEC-
TUATED PURSUANT TO THIS SECTION, AND SHALL BE IN ADDITION TO ANY OTHER
REMEDIES PROVIDED BY LAW.
(2) THE ESTABLISHED OPERATOR 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 NECES-
SARY, ENTER INTO AN AGREEMENT WITH THE ESTABLISHED OPERATOR FOR THE
APPOINTMENT OF A TEMPORARY OPERATOR TO RESTORE OR MAINTAIN THE PROVISION
OF QUALITY CARE TO THE PATIENTS UNTIL THE ESTABLISHED OPERATOR CAN
RESUME OPERATIONS WITHIN THE DESIGNATED TIME PERIOD; THE PATIENTS MAY BE
TRANSFERRED TO OTHER MENTAL HEALTH PROGRAMS OPERATED OR LICENSED BY THE
OFFICE; OR THE OPERATIONS OF THE MENTAL HEALTH PROGRAM SHOULD BE
COMPLETELY DISCONTINUED.
(C) (1) A TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION SHALL
USE HIS OR HER BEST EFFORTS TO IMPLEMENT THE PLAN DEEMED SATISFACTORY BY
THE COMMISSIONER TO CORRECT OR ELIMINATE ANY DEFICIENCIES IN THE MENTAL
HEALTH PROGRAM AND TO PROMOTE THE QUALITY AND ACCESSIBILITY OF MENTAL
HEALTH SERVICES IN THE COMMUNITY SERVED BY THE MENTAL HEALTH PROGRAM.
(2) IF THE IDENTIFIED DEFICIENCIES CANNOT BE ADDRESSED IN THE TIME
PERIOD DESIGNATED IN THE PLAN, THE PATIENTS SHALL BE TRANSFERRED TO
OTHER APPROPRIATE MENTAL HEALTH PROGRAMS LICENSED OR OPERATED BY THE
OFFICE.
(3) DURING THE TERM OF APPOINTMENT, THE TEMPORARY OPERATOR SHALL HAVE
THE AUTHORITY TO DIRECT THE STAFF OF THE ESTABLISHED OPERATOR AS NECES-
SARY TO APPROPRIATELY TREAT AND/OR TRANSFER THE PATIENTS. THE TEMPORARY
OPERATOR SHALL, DURING THIS PERIOD, OPERATE THE MENTAL HEALTH PROGRAM IN
SUCH A MANNER AS TO PROMOTE SAFETY AND THE QUALITY AND ACCESSIBILITY OF
MENTAL HEALTH SERVICES IN THE COMMUNITY SERVED BY THE ESTABLISHED OPERA-
TOR UNTIL EITHER THE ESTABLISHED OPERATOR CAN RESUME PROGRAM OPERATIONS
OR UNTIL THE PATIENTS ARE APPROPRIATELY TRANSFERRED TO OTHER PROGRAMS
LICENSED OR OPERATED BY THE OFFICE.
(4) THE ESTABLISHED OPERATOR SHALL GRANT ACCESS TO THE TEMPORARY OPER-
ATOR TO THE ESTABLISHED OPERATOR'S ACCOUNTS AND RECORDS IN ORDER TO
ADDRESS ANY DEFICIENCIES RELATED TO A MENTAL HEALTH PROGRAM EXPERIENCING
SERIOUS FINANCIAL INSTABILITY OR AN ESTABLISHED OPERATOR REQUESTING
FINANCIAL ASSISTANCE IN ACCORDANCE WITH THIS SECTION. THE TEMPORARY
OPERATOR SHALL APPROVE ANY FINANCIAL DECISION RELATED TO A PROGRAM'S DAY
TO DAY OPERATIONS OR PROGRAM'S ABILITY TO PROVIDE MENTAL HEALTH
SERVICES.
(5) THE TEMPORARY OPERATOR SHALL NOT BE REQUIRED TO FILE ANY BOND. NO
SECURITY INTEREST IN ANY REAL OR PERSONAL PROPERTY COMPRISING THE ESTAB-
LISHED OPERATOR OR CONTAINED WITHIN THE ESTABLISHED OPERATOR OR IN ANY
FIXTURE OF THE MENTAL HEALTH PROGRAM, SHALL BE IMPAIRED OR DIMINISHED IN
PRIORITY BY THE TEMPORARY OPERATOR. NEITHER THE TEMPORARY OPERATOR NOR
THE OFFICE SHALL ENGAGE IN ANY ACTIVITY THAT CONSTITUTES A CONFISCATION
OF PROPERTY.
(D) THE TEMPORARY OPERATOR SHALL BE ENTITLED TO A REASONABLE FEE, AS
DETERMINED BY THE COMMISSIONER AND SUBJECT TO THE APPROVAL OF THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, AND NECESSARY EXPENSES INCURRED WHILE
SERVING AS A TEMPORARY OPERATOR. THE TEMPORARY OPERATOR SHALL BE LIABLE
ONLY IN ITS CAPACITY AS TEMPORARY OPERATOR OF THE MENTAL HEALTH PROGRAM
A. 9007--B 42
FOR INJURY TO PERSON AND PROPERTY BY REASON OF ITS OPERATION OF SUCH
PROGRAM; NO LIABILITY SHALL INCUR IN THE TEMPORARY OPERATOR'S PERSONAL
CAPACITY, EXCEPT FOR GROSS NEGLIGENCE AND INTENTIONAL ACTS.
(E) (1) THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR
SHALL NOT EXCEED NINETY DAYS. AFTER NINETY DAYS, IF THE COMMISSIONER
DETERMINES THAT TERMINATION OF THE TEMPORARY OPERATOR WOULD CAUSE
SIGNIFICANT DETERIORATION OF THE QUALITY OF, OR ACCESS TO, MENTAL HEALTH
CARE IN THE COMMUNITY OR THAT REAPPOINTMENT IS NECESSARY TO CORRECT THE
DEFICIENCIES THAT REQUIRED THE APPOINTMENT OF THE TEMPORARY OPERATOR,
THE COMMISSIONER MAY AUTHORIZE AN ADDITIONAL NINETY-DAY TERM. HOWEVER,
SUCH AUTHORIZATION SHALL INCLUDE THE COMMISSIONER'S REQUIREMENTS FOR
CONCLUSION OF THE TEMPORARY OPERATORSHIP TO BE SATISFIED WITHIN THE
ADDITIONAL TERM.
(2) 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:
A. THE ACTIONS TAKEN DURING THE APPOINTMENT TO ADDRESS THE IDENTIFIED
MENTAL HEALTH PROGRAM DEFICIENCIES, THE RESUMPTION OF MENTAL HEALTH
PROGRAM OPERATIONS BY THE ESTABLISHED OPERATOR, OR THE TRANSFER OF THE
PATIENTS TO OTHER PROVIDERS LICENSED OR OPERATED BY THE OFFICE;
B. OBJECTIVES FOR THE CONTINUATION OF THE TEMPORARY OPERATORSHIP IF
NECESSARY AND A SCHEDULE FOR SATISFACTION OF SUCH OBJECTIVES; AND
C. IF APPLICABLE, THE RECOMMENDED ACTIONS FOR THE ONGOING OPERATION OF
THE MENTAL HEALTH PROGRAM SUBSEQUENT TO THE TEMPORARY OPERATORSHIP.
(3) 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.
(F) (1) THE COMMISSIONER SHALL, UPON MAKING A DETERMINATION OF AN
INTENTION TO APPOINT A TEMPORARY OPERATOR PURSUANT TO PARAGRAPH ONE OF
SUBDIVISION (B) OF THIS SECTION CAUSE THE ESTABLISHED OPERATOR 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 UNDERLYING 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, THE COMMISSIONER AND THE ESTAB-
LISHED OPERATOR SHALL ATTEMPT TO DEVELOP A MUTUALLY SATISFACTORY PLAN OF
CORRECTION AND SCHEDULE FOR IMPLEMENTATION. IN SUCH EVENT, THE COMMIS-
SIONER SHALL NOTIFY THE ESTABLISHED OPERATOR THAT THE COMMISSIONER WILL
ABSTAIN FROM APPOINTING A TEMPORARY OPERATOR CONTINGENT UPON THE ESTAB-
LISHED OPERATOR REMEDIATING THE IDENTIFIED DEFICIENCIES WITHIN THE
AGREED UPON TIMEFRAME.
(2) SHOULD THE COMMISSIONER AND THE ESTABLISHED OPERATOR BE UNABLE TO
ESTABLISH A PLAN OF CORRECTION PURSUANT TO PARAGRAPH ONE 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 THIRTY 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
TEMPORARY OPERATOR IS SUPPORTED BY SUBSTANTIAL EVIDENCE. A COPY OF THE
DECISION SHALL BE SENT TO THE ESTABLISHED OPERATOR.
A. 9007--B 43
(3) IF THE DECISION TO APPOINT A TEMPORARY OPERATOR IS UPHELD SUCH
TEMPORARY OPERATOR SHALL BE APPOINTED AS SOON AS IS PRACTICABLE AND
SHALL OPERATE THE MENTAL HEALTH PROGRAM PURSUANT TO THE PROVISIONS OF
THIS SECTION.
(G) NOTWITHSTANDING THE APPOINTMENT OF A TEMPORARY OPERATOR, THE
ESTABLISHED OPERATOR SHALL REMAIN OBLIGATED FOR THE CONTINUED OPERATION
OF THE MENTAL HEALTH PROGRAM SO THAT SUCH PROGRAM CAN FUNCTION IN A
NORMAL MANNER. 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 OF THE PROGRAM HEREUNDER;
NOR SHALL ANYTHING CONTAINED IN THIS SECTION BE CONSTRUED TO SUSPEND
DURING THE TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR OF THE
PROGRAM ANY OBLIGATION OF THE ESTABLISHED OPERATOR OR ANY OTHER PERSON
FOR THE MAINTENANCE AND REPAIR OF THE FACILITY, PROVISION OF UTILITY
SERVICES, 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 3. Intentionally omitted.
S 4. Intentionally omitted.
S 5. Intentionally omitted.
S 6. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2016.
PART M
Section 1. Subdivision (d) of section 33.13 of the mental hygiene law,
as amended by section 3 of part E of chapter 111 of the laws of 2010, is
amended to read as follows:
(d) Nothing in this section shall prevent the electronic or other
exchange of information concerning patients or clients, including iden-
tification, between and among (i) facilities or others providing
services for such patients or clients pursuant to an approved local
services plan, as defined in article forty-one of this chapter, or
pursuant to agreement with the department, and (ii) the department or
any of its licensed or operated facilities. NEITHER SHALL ANYTHING IN
THIS SECTION PREVENT THE EXCHANGE OF INFORMATION CONCERNING PATIENTS OR
CLIENTS, INCLUDING IDENTIFICATION, BETWEEN FACILITIES AND MANAGED CARE
ORGANIZATIONS, BEHAVIORAL HEALTH ORGANIZATIONS, HEALTH HOMES OR OTHER
ENTITIES AUTHORIZED BY THE DEPARTMENT OR THE DEPARTMENT OF HEALTH TO
PROVIDE, ARRANGE FOR OR COORDINATE HEALTH CARE SERVICES FOR SUCH
PATIENTS OR CLIENTS WHO ARE ENROLLED IN OR RECEIVING SERVICES FROM SUCH
ORGANIZATIONS OR ENTITIES. PROVIDED HOWEVER, WRITTEN PATIENT OR CLIENT
CONSENT SHALL BE OBTAINED PRIOR TO THE EXCHANGE OF INFORMATION WHERE
REQUIRED BY 42 USC 290DD-2 AS AMENDED, AND ANY REGULATIONS PROMULGATED
THEREUNDER. Furthermore, subject to the prior approval of the commis-
sioner of mental health, hospital emergency services licensed pursuant
to article twenty-eight of the public health law shall be authorized to
exchange information concerning patients or clients electronically or
otherwise with other hospital emergency services licensed pursuant to
article twenty-eight of the public health law and/or hospitals licensed
or operated by the office of mental health; provided that such exchange
of information is consistent with standards, developed by the commis-
sioner of mental health, which are designed to ensure confidentiality of
such information. Additionally, information so exchanged shall be kept
A. 9007--B 44
confidential and any limitations on the release of such information
imposed on the party giving the information shall apply to the party
receiving the information.
S 2. Subdivision (d) of section 33.13 of the mental hygiene law, as
amended by section 4 of part E of chapter 111 of the laws of 2010, is
amended to read as follows:
(d) Nothing in this section shall prevent the exchange of information
concerning patients or clients, including identification, between (i)
facilities or others providing services for such patients or clients
pursuant to an approved local services plan, as defined in article
forty-one, or pursuant to agreement with the department and (ii) the
department or any of its facilities. NEITHER SHALL ANYTHING IN THIS
SECTION PREVENT THE EXCHANGE OF INFORMATION CONCERNING PATIENTS OR
CLIENTS, INCLUDING IDENTIFICATION, BETWEEN FACILITIES AND MANAGED CARE
ORGANIZATIONS, BEHAVIORAL HEALTH ORGANIZATIONS, HEALTH HOMES OR OTHER
ENTITIES AUTHORIZED BY THE DEPARTMENT OR THE DEPARTMENT OF HEALTH TO
PROVIDE, ARRANGE FOR OR COORDINATE HEALTH CARE SERVICES FOR SUCH
PATIENTS OR CLIENTS WHO ARE ENROLLED IN OR RECEIVING SERVICES FOR SUCH
ORGANIZATIONS OR ENTITIES. PROVIDED HOWEVER, WRITTEN PATIENT OR CLIENT
CONSENT SHALL BE OBTAINED PRIOR TO THE EXCHANGE OF INFORMATION WHERE
REQUIRED BY 42 USC 290DD-2 AS AMENDED, AND ANY REGULATIONS PROMULGATED
THEREUNDER. Information so exchanged shall be kept confidential and any
limitations on the release of such information imposed on the party
giving the information shall apply to the party receiving the informa-
tion.
S 3. Subdivision (f) of section 33.13 of the mental hygiene law, as
amended by chapter 330 of the laws of 1993, is amended to read as
follows:
(f) ALL RECORDS OF IDENTITY, DIAGNOSIS, PROGNOSIS, TREATMENT, CARE
COORDINATION OR ANY OTHER INFORMATION CONTAINED IN A PATIENT OR CLIENT'S
RECORD SHALL BE CONFIDENTIAL UNLESS DISCLOSURE IS PERMITTED UNDER SUBDI-
VISION (C) OF THIS SECTION. Any disclosure made pursuant to this section
shall be limited to that information necessary AND REQUIRED in light of
the reason for disclosure. Information so disclosed shall be kept confi-
dential by the party receiving such information and the limitations on
disclosure in this section shall apply to such party. Except for disclo-
sures made to the mental hygiene legal service, to persons reviewing
information or records in the ordinary course of insuring that a facili-
ty is in compliance with applicable quality of care standards, or to
governmental agents requiring information necessary for payments to be
made to or on behalf of patients or clients pursuant to contract or in
accordance with law, a notation of all such disclosures shall be placed
in the clinical record of that individual who shall be informed of all
such disclosures upon request; provided, however, that for disclosures
made to insurance companies licensed pursuant to the insurance law, such
a notation need only be entered at the time the disclosure is first
made.
S 4. This act shall take effect immediately; provided that the amend-
ments to subdivision (d) of section 33.13 of the mental hygiene law made
by section one of this act shall be subject to the expiration and rever-
sion of such subdivision pursuant to section 18 of chapter 408 of the
laws of 1999, as amended, when upon such date the provisions of section
two of this act shall take effect.
PART N
A. 9007--B 45
Section 1. Subdivision 10 of section 3 of section 1 of chapter 359 of
the laws of 1968, constituting the facilities development corporation
act, as amended by chapter 723 of the laws of 1993, is amended to read
as follows:
10. "Mental hygiene facility" shall mean a building, a unit within a
building, a laboratory, a classroom, a housing unit, a dining hall, an
activities center, a library, real property of any kind or description,
or any structure on or improvement to real property, or an interest in
real property, of any kind or description, owned by or under the juris-
diction of the corporation, including fixtures and equipment which are
an integral part of any such building, unit, structure or improvement, a
walkway, a roadway or a parking lot, and improvements and connections
for water, sewer, gas, electrical, telephone, heating, air conditioning
and other utility services, or a combination of any of the foregoing,
whether for patient care and treatment or staff, staff family or service
use, located at or related to any psychiatric center, any developmental
center, or any state psychiatric or research institute or other facility
now or hereafter established under the department. A mental hygiene
facility shall also mean and include a residential care center for
adults, a "community mental health and retardation facility" and a
treatment facility for use in the conduct of an alcoholism or substance
abuse treatment program as defined in the mental hygiene law unless such
residential care center for adults, community mental health and retarda-
tion facility or alcoholism or substance abuse facility is expressly
excepted, or the context clearly requires otherwise, AND SHALL ALSO MEAN
AND INCLUDE ANY TREATMENT FACILITY FOR USE IN THE CONDUCT OF AN ALCOHOL-
ISM OR SUBSTANCE ABUSE TREATMENT PROGRAM THAT IS ALSO OPERATED AS AN
ASSOCIATED HEALTH CARE FACILITY. The definition contained in this subdi-
vision shall not be construed to exclude therefrom a facility owned or
leased by one or more voluntary agencies that is to be financed, refi-
nanced, designed, constructed, acquired, reconstructed, rehabilitated or
improved under any lease, sublease, loan or other financing agreement
entered into with such voluntary agencies, and shall not be construed to
exclude therefrom a facility to be made available from the corporation
to a voluntary agency at the request of the commissioners of the offices
of the department having jurisdiction thereof. The definition contained
in this subdivision shall not be construed to exclude therefrom a facil-
ity with respect to which a voluntary agency has an ownership interest
in, and proprietary lease from, an organization formed for the purpose
of the cooperative ownership of real estate.
S 2. Section 3 of section 1 of chapter 359 of the laws of 1968,
constituting the facilities development corporation act, is amended by
adding a new subdivision 20 to read as follows:
20. "ASSOCIATED HEALTH CARE FACILITY" SHALL MEAN A FACILITY LICENSED
UNDER AND OPERATED PURSUANT TO ARTICLE 28 OF THE PUBLIC HEALTH LAW OR
ANY HEALTH CARE FACILITY LICENSED UNDER AND OPERATED IN ACCORDANCE WITH
ANY OTHER PROVISIONS OF THE PUBLIC HEALTH LAW OR THE MENTAL HYGIENE LAW
THAT PROVIDES HEALTH CARE SERVICES AND/OR TREATMENT TO ALL PERSONS,
REGARDLESS OF WHETHER SUCH PERSONS ARE PERSONS RECEIVING TREATMENT OR
SERVICES FOR ALCOHOL, SUBSTANCE ABUSE, OR CHEMICAL DEPENDENCY.
S 3. This act shall take effect immediately.
PART O
Section 1. Section 4 of chapter 495 of the laws of 2004, amending the
insurance law and the public health law relating to the New York state
A. 9007--B 46
health insurance continuation assistance demonstration project, as
amended by section 1 of part GG of chapter 58 of the laws of 2015, is
amended to read as follows:
S 4. This act shall take effect on the sixtieth day after it shall
have become a law; provided, however, that this act shall remain in
effect until July 1, [2016] 2017 when upon such date the provisions of
this act shall expire and be deemed repealed; provided, further, that a
displaced worker shall be eligible for continuation assistance retroac-
tive to July 1, 2004.
S 2. This act shall take effect immediately.
PART P
Section 1. Residential registration list. (a) The office for people
with developmental disabilities shall issue a report as a result of its
statewide review of individuals with developmental disabilities current-
ly on the residential registration list, including information regarding
services currently provided to such individuals, and any available
regional information on priority placement approaches and housing needs
for such individuals. The report shall include an update as to the
progress the office has made in meeting the following transformational
housing goals as it relates to the individuals with developmental disa-
bilities currently on the residential registration list:
(1) expanding housing alternatives;
(2) increasing access to rental housing;
(3) building understanding and awareness of housing options for inde-
pendent living among people with developmental disabilities, families,
public and private organizations, developers and direct support profes-
sionals;
(4) assisting with the creation of a sustainable living environment
through funding for home modifications, down payment assistance and home
repairs; and
(5) providing recommendations that can improve housing alternatives.
(b) Using data collected during the statewide review required by this
section, the commissioner of the office for people with developmental
disabilities, in consultation with state agencies, local governmental
units, stakeholders, including individuals with developmental disabili-
ties, parents and guardians of individuals with developmental disabili-
ties, advocates and providers of services for individuals with develop-
mental disabilities, and others as determined appropriate by such
commissioner, shall establish a plan to increase housing alternatives
for such individuals. To the extent possible, the plan shall also
address the housing needs of individuals not currently on the residen-
tial registration list. The plan shall advance the five transformational
housing goals listed in this section.
(c) An update on the plan including any related recommendations and
strategies developed and any policy, rule, or regulation change and
estimated dates and timeframe to implement any recommendation or strate-
gy shall be included in the office's statewide comprehensive plan pursu-
ant to paragraph three of subdivision (b) of section 5.07 of the mental
hygiene law.
S 2. Development of a plan to provide choice of work settings for
individuals with developmental disabilities. (a) The office for people
with developmental disabilities shall provide an update of the plan to
assist individuals currently working in sheltered workshop programs to
transition to integrated community work settings, including any related
A. 9007--B 47
recommendations and strategies, and any policy, rule, or regulation
change and estimated dates and timeframe to implement any recommendation
or strategy, which must be included in the office's statewide comprehen-
sive plan pursuant to paragraph three of subdivision (b) of section 5.07
of the mental hygiene law.
(b) Such plan shall solicit and analyze input from stakeholders of
sheltered workshops, including, but not limited to, individuals current-
ly working in sheltered workshops, providers of workshops, families, and
guardians. The plan shall:
(1) include outreach and education to individuals with developmental
disabilities and their families or guardians throughout the transition
process;
(2) set forth a detailed analysis of options available to meet the
needs and goals of those individuals who currently cannot or choose not
to transition to integrated community work settings;
(3) maximize the ability of an individual to participate in meaningful
community-based activities as part of the individual's person-centered
plan; and
(4) provide for ongoing review of employment goals for each individual
as part of the person-centered planning process.
S 3. Transformation panel. (a) The commissioner of the office for
people with developmental disabilities shall establish a transformation
panel for the purpose of developing a transformation plan which will
include recommendations and strategies for maintaining the fiscal
viability of service and support delivery system for persons with devel-
opmental disabilities and include strategies that will enable the office
to comply with federal and state service delivery requirements and
provide appropriate levels of care.
(b) The panel shall be comprised of the commissioner of the office for
people with developmental disabilities or his or her designee; organiza-
tions or associations which represent the interests of persons with
disabilities, which may include providers of services, consumer repre-
sentatives, advocacy groups, persons with developmental disabilities or
their parents or guardians; and at the discretion of such commissioner
any other individual, entity, or state agency able to support the panel
in completing its tasks described under this section. The panel shall
collaborate with local governmental units.
(c) Panel members shall receive no compensation for their services as
members of the workgroup, but may be reimbursed for actual and necessary
expenses incurred in the performance of their duties.
(d) Transformation plan. The panel shall assist in the development of
a transformation plan by the commissioner of the office for people with
developmental disabilities, as well as make recommendations for the
execution of such plan. The plan will include but not be limited to an
analysis of the following:
(1) increasing and supporting access to self-directed models of care;
(2) enhancing opportunities for individuals to access community inte-
grated housing;
(3) increasing integrated employment opportunities; and
(4) examining the program design and fiscal model for managed care to
appropriately address the needs of individuals with disabilities.
(e) The commissioner of the office for people with developmental disa-
bilities shall include in the office's statewide comprehensive plan
pursuant to paragraph three of subdivision (b) of section 5.07 of the
mental hygiene law, a summary of recommendations and strategies devel-
oped by the panel including any policy, rule, or regulation change and
A. 9007--B 48
estimated dates and timeframe to implement any recommendation or strate-
gy.
S 4. Office for people with developmental disabilities monthly
reports. (a) The commissioner of the office for people with develop-
mental disabilities shall provide monthly status reports to the chairs
of the senate and assembly fiscal committees. Such report shall include
but not be limited to:
(1) current developmental center census by facility;
(2) the number of admissions and discharges to developmental centers
in the prior month;
(3) an explanation of any significant developmental center census
reductions; and
(4) community services provided to individuals leaving developmental
centers, including services provided to individuals with complex needs
as well as the number of individuals receiving community services from
state and from not-for-profit providers.
(b) Such report shall not contain any information made confidential
under federal and/or state law.
S 5. The front door process. (a) The commissioner of the office for
people with developmental disabilities shall make available on the
office website, information regarding the front door process, including
the approach for determining priority residential placements and the
process for individuals to seek access to services.
(b) No later than December 15, 2016, the commissioner of the office
for people with developmental disabilities shall include in the office's
statewide comprehensive plan pursuant to paragraph three of subdivision
(b) of section 5.07 of the mental hygiene law, the extent to which the
front door policy, as it has been implemented, has improved community
education and available service options, connected individual needs to
available services, and enhanced opportunities for self-direction.
S 6. Paragraph 3 of subdivision (b) of section 5.07 of the mental
hygiene law, as amended by section 3 of part N of chapter 56 of the laws
of 2012, is amended to read as follows:
(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 and the advisory council on develop-
mental 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 November of each year in order that such
plan may be considered with the estimates of the offices for the prepa-
ration of the executive budget of the state of New York for the next
succeeding state fiscal year. Such comprehensive plan shall be submitted
to the legislature NO LATER THAN THE FIFTEENTH OF DECEMBER OF EACH YEAR
and also be posted to the website of each office. Statewide plans shall
ensure responsiveness to changing needs and goals and shall reflect the
development of new information and the completion of program evalu-
ations. 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 March of each year. Such interim report
shall include, but need not be limited to:
A. 9007--B 49
S 7. This act shall take effect immediately and shall be subject to
appropriations made specifically available for this purpose; provided,
however that this act shall expire and be deemed repealed April 1, 2017.
PART Q
Section 1. Subdivision 4 of section 461-s of the social services law,
as added by section 6 of part A of chapter 57 of the laws of 2015, is
amended to read as follows:
4. EQUAL program funds shall not be expended for a facility's daily
operating expenses, including employee salaries or benefits[, or for
expenses incurred retrospectively]. EQUAL PROGRAM FUNDS MAY BE USED FOR
EXPENSES INCURRED AT ANY TIME DURING THE FISCAL YEAR FOR WHICH THE FUNDS
WERE APPROPRIATED, PROVIDED THAT, CONSISTENT WITH SUBDIVISION THREE OF
THIS SECTION, THE RESIDENTS' COUNCIL APPROVES SUCH EXPENDITURE PRIOR TO
THE EXPENDITURE BEING INCURRED. EQUAL program funds may be used for
expenditures related to corrective action as required by an inspection
report, provided such expenditure is consistent with subdivision three
of this section.
S 2. Section 2807-m of the public health law is amended by adding a
new subdivision 12 to read as follows:
12. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, APPLICATIONS
FOR PHYSICIAN LOAN REPAYMENT AND PHYSICIAN PRACTICE SUPPORT, SUBMITTED
PURSUANT TO PARAGRAPHS (D) AND (E) OF SUBDIVISION FIVE-A OF THIS
SECTION AND SUBDIVISION TEN OF THIS SECTION, ON OR AFTER APRIL FIRST,
TWO THOUSAND SIXTEEN, SHALL BE SUBJECT TO THE FOLLOWING CHANGES:
(A) FOR THE PERIOD APRIL FIRST, TWO THOUSAND SIXTEEN THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND SEVENTEEN, EIGHT MILLION SIXTY-FIVE THOUSAND
DOLLARS SHALL BE SET ASIDE AND RESERVED BY THE COMMISSIONER FROM THE
REGIONAL POOLS ESTABLISHED IN ACCORDANCE WITH SUBDIVISION TWO OF THIS
SECTION AND SHALL BE AVAILABLE FOR PURPOSES OF BOTH NEW AWARDS FOR
PHYSICIAN LOAN REPAYMENT AND NEW AWARDS FOR PHYSICIAN PRACTICE SUPPORT,
BASED ON APPLICATIONS SUBMITTED IN ACCORDANCE WITH THIS SUBDIVISION.
NEITHER OF THE AWARD PROGRAMS SHALL BE LIMITED TO A SPECIFIC FUNDING
AMOUNT WITHIN THE TOTAL AMOUNT MADE AVAILABLE PURSUANT TO THIS PARA-
GRAPH.
(B) AN APPLICANT MAY APPLY FOR AN AWARD FOR EITHER PHYSICIAN LOAN
REPAYMENT OR PHYSICIAN PRACTICE SUPPORT, BUT NOT BOTH.
(C) AN APPLICANT SHALL AGREE TO PRACTICE FOR THREE YEARS IN AN UNDER-
SERVED AREA AND EACH AWARD SHALL PROVIDE FORTY THOUSAND DOLLARS FOR EACH
OF THE THREE YEARS.
(D) REFERENCES IN PARAGRAPHS (B) THROUGH (E) OF SUBDIVISION TEN OF
THIS SECTION TO PARAGRAPH (A) OF SUBDIVISION TEN OF THIS SECTION SHALL
INSTEAD BE REFERENCES TO THE THREE YEAR PHYSICIAN LOAN REPAYMENT AWARDS
MADE UNDER THIS SUBDIVISION.
(E) THE FUNDING ALLOCATION AND DISTRIBUTION PROVIDED FOR IN PARAGRAPHS
(D) AND (E) OF SUBDIVISION FIVE-A OF THIS SECTION SHALL APPLY TO THE
COMBINED FUNDING AMOUNT PROVIDED FOR IN PARAGRAPH (A) OF THIS SUBDIVI-
SION.
(F) AWARDS SHALL BE MADE ANNUALLY AND TIMED TO BE OF USE FOR JOB
OFFERS MADE TO APPLICANTS.
S 3. Subdivision 9 of section 3365 of the public health law, as added
by chapter 90 of the laws of 2014, is amended to read as follows:
9. (A) The commissioner shall register no more than five registered
organizations that manufacture medical marihuana with no more than
[four] EIGHT dispensing sites wholly owned and operated by such regis-
A. 9007--B 50
tered organization. The commissioner shall ensure that [such] registered
organizations and dispensing sites are geographically distributed across
the state. The [commission] COMMISSIONER may register additional regis-
tered organizations.
(B) THE COMMISSIONER SHALL, BY JANUARY FIRST, TWO THOUSAND SEVENTEEN,
REGISTER AT LEAST FIVE ADDITIONAL REGISTERED ORGANIZATIONS THAT MANUFAC-
TURE MEDICAL MARIHUANA, EACH OF WHICH MAY OPERATE NO MORE THAN EIGHT
DISPENSING SITES. IN DETERMINING WHICH APPLICANTS TO SELECT UNDER THIS
PARAGRAPH:
(I) THE COMMISSIONER SHALL SEEK TO PROVIDE DISPENSARIES IN UNDERSERVED
AREAS; AND (II) WHERE AN APPLICANT WAS AN APPLICANT IN THE COMMISSION-
ER'S INITIAL SELECTION PROCESS UNDER PARAGRAPH (A) OF THIS SUBDIVISION,
THE COMMISSIONER SHALL CONSIDER THE INFORMATION PROVIDED BY THE APPLI-
CANT IN THAT INITIAL PROCESS, TO THE EXTENT IT IS CURRENTLY APPLICABLE,
AND GIVE APPROPRIATE WEIGHT TO THE COMMISSIONER'S EVALUATION OF THE
APPLICANT IN THAT INITIAL PROCESS.
S 4. This act shall take effect immediately; provided, however that
(a) the amendments to section 2807-m of the public health law made by
section two of this act shall be deemed to have been in full force and
effect on and after April 1, 2016; and (b) the amendments to subdivision
9 of section 3365 of the public health law made by section three of this
act shall not affect the repeal of such section and shall be deemed
repealed therewith.
PART R
Section 1. This act enacts into law components of legislation which
are necessary to implement legislation relating to substance abuse. Each
component is wholly contained within a Subpart identified as Subparts A
through K. The effective date for each particular provision contained
within such Subpart is set forth in the last section of such Subpart.
Any provision in any section contained within a Subpart, including the
effective date of the Subpart, 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 Subpart
in which it is found. Section three of this act sets forth the general
effective date of this act.
SUBPART A
Section 1. Section 19.07 of the mental hygiene law is amended by
adding a new subdivision (m) to read as follows:
(M) THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, IN CONSUL-
TATION WITH THE STATE EDUCATION DEPARTMENT, SHALL DEVELOP OR UTILIZE
EXISTING EDUCATIONAL MATERIALS TO BE PROVIDED TO SCHOOL DISTRICTS AND
BOARDS OF COOPERATIVE EDUCATIONAL SERVICES FOR USE IN ADDITION TO OR IN
CONJUNCTION WITH ANY DRUG AND ALCOHOL RELATED CURRICULUM REGARDING THE
MISUSE AND ABUSE OF ALCOHOL, TOBACCO, PRESCRIPTION MEDICATION AND OTHER
DRUGS WITH AN INCREASED FOCUS ON SUBSTANCES THAT ARE MOST PREVALENT
AMONG SCHOOL AGED YOUTH AS SUCH TERM IS DEFINED IN SECTION EIGHT HUNDRED
FOUR OF THE EDUCATION LAW. SUCH MATERIALS SHALL BE AGE APPROPRIATE FOR
SCHOOL AGE CHILDREN, AND TO THE EXTENT PRACTICABLE, SHALL INCLUDE INFOR-
MATION OR RESOURCES FOR PARENTS TO IDENTIFY THE WARNING SIGNS AND
ADDRESS THE RISKS OF SUBSTANCE ABUSE.
S 2. The education law is amended by adding a new section 3037 to read
as follows:
A. 9007--B 51
S 3037. THE SUPERINTENDENT OF EACH SCHOOL DISTRICT, IN CONSULTATION
WITH THE DISTRICT SUPERINTENDENT OF A BOARD OF COOPERATIVE EDUCATIONAL
SERVICES, WHERE APPLICABLE, SHALL DESIGNATE AN EMPLOYEE WHO IS A MEMBER
OF THE SCHOOL DISTRICT STAFF OR AN EMPLOYEE OF THE BOARD OF COOPERATIVE
EDUCATIONAL SERVICES STAFF TO PROVIDE INFORMATION AND REFERRALS TO ANY
STUDENT, PARENT, OR STAFF REGARDING SERVICES AVAILABLE TO SUCH STUDENT
OR STAFF RELATED TO SUBSTANCE USE. WHERE POSSIBLE, SUCH DESIGNATED INDI-
VIDUAL SHALL BE A SCHOOL SOCIAL WORKER, SCHOOL GUIDANCE COUNSELOR, OR
ANY OTHER HEALTH PRACTITIONER OR COUNSELOR EMPLOYED BY THE SCHOOL. ANY
INFORMATION PROVIDED BY A STUDENT, PARENT OR TEACHER TO SUCH DESIGNATED
INDIVIDUAL SHALL BE CONFIDENTIAL, SHALL NOT BE USED IN ANY SCHOOL DISCI-
PLINARY PROCEEDING AND SHALL, IN ADDITION TO ANY OTHER APPLICABLE PRIVI-
LEGE, BE CONSIDERED CONFIDENTIAL IN THE SAME MANNER AS INFORMATION
PROVIDED PURSUANT TO SECTION FORTY-FIVE HUNDRED EIGHT OF THE CIVIL PRAC-
TICE LAW AND RULES. PROVIDED, HOWEVER, THAT NOTHING IN THIS SECTION
SHALL RELIEVE SUCH DESIGNATED INDIVIDUAL OF ANY LEGAL DUTY TO OTHERWISE
REPORT SUCH INFORMATION. SUCH DESIGNATED INDIVIDUAL OR INDIVIDUALS SHALL
UNDERGO ANY NECESSARY TRAINING AS MAY BE REQUIRED BY THE COMMISSIONER.
S 3. This act shall take effect on the one hundred twentieth day after
it shall have become law; provided, however, that effective immediately
the commissioner of education, in consultation with the commissioner of
the office of alcoholism and substance abuse services, shall be author-
ized to adopt regulations necessary to implement the provisions of this
act on or before such effective date.
SUBPART B
Section 1. Section 19.09 of the mental hygiene law is amended by
adding a new subdivision (j) to read as follows:
(J) THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH,
SHALL CREATE OR UTILIZE EXISTING EDUCATIONAL MATERIALS WHICH SHALL
INCLUDE INFORMATION REGARDING THE DANGERS OF MISUSE AND THE POTENTIAL
FOR ADDICTION TO PRESCRIPTION DRUGS, TREATMENT RESOURCES AVAILABLE, THE
PROPER WAY TO DISPOSE OF UNUSED PRESCRIPTION DRUGS AND INFORMATION ON
DRUG DISPOSAL SITES. SUCH MATERIALS SHALL BE MADE AVAILABLE TO PHARMA-
CIES LICENSED BY THE STATE TO DISPENSE PRESCRIPTION DRUGS TO THE PUBLIC
AND HEALTH CARE PROVIDERS, AND MAY BE DISTRIBUTED WITH ANY PRESCRIBED OR
DISPENSED CONTROLLED SUBSTANCE. THE INFORMATION CONTAINED IN SUCH MATE-
RIALS SHALL ALSO BE POSTED ON THE WEBSITE OF THE OFFICE AND THE DEPART-
MENT OF HEALTH. SUCH MATERIALS SHALL BE PROVIDED IN LANGUAGES OTHER THAN
ENGLISH AS DEEMED APPROPRIATE BY SUCH COMMISSIONERS.
S 2. This act shall take effect on the sixtieth day after it shall
become a law.
SUBPART C
Section 1. Section 19.07 of the mental hygiene law is amended by
adding a new subdivision (l) to read as follows:
(L) THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, IN CONSUL-
TATION WITH THE COMMISSIONER OF HEALTH, SHALL PROVIDE AND PUBLISH, IN
ELECTRONIC OR OTHER FORMAT, TRAINING MATERIALS FOR HEALTH CARE PROVID-
ERS, AS DEFINED BY SUBDIVISION SIX OF SECTION TWO HUNDRED THIRTY-EIGHT
OF THE PUBLIC HEALTH LAW, AND QUALIFIED HEALTH PROFESSIONALS, RECOGNIZED
BY THE OFFICE TO ENABLE THE IMPLEMENTATION OF THE SCREENING, BRIEF
INTERVENTION, AND REFERRAL TO TREATMENT PROGRAM (SBIRT). SUCH TRAINING
MATERIALS SHALL INCLUDE ANY AND ALL MATERIALS NECESSARY TO INFORM HEALTH
A. 9007--B 52
CARE PROVIDERS AND QUALIFIED HEALTH PROFESSIONALS OF THE METHOD FOR
ADMINISTERING THE SBIRT PROGRAM TO A PATIENT IN THE CARE OF HEALTH CARE
PROVIDERS OR QUALIFIED HEALTH PROFESSIONALS. SUCH TRAINING MATERIALS
SHALL BE MADE AVAILABLE TO HEALTH CARE PROVIDERS AND QUALIFIED HEALTH
PROFESSIONALS THROUGH THE OFFICIAL WEBSITES OF THE OFFICE AND THE
DEPARTMENT OF HEALTH AND BY ANY OTHER MEANS DEEMED APPROPRIATE BY THE
COMMISSIONER.
S 2. This act shall take effect immediately.
SUBPART D
Section 1. The public health law is amended by adding a new section
2803-u to read as follows:
S 2803-U. HOSPITAL SUBSTANCE USE DISORDER POLICIES AND PROCEDURES. 1.
EVERY GENERAL HOSPITAL SHALL:
(A) DEVELOP, MAINTAIN AND DISSEMINATE WRITTEN POLICIES AND PROCEDURES
FOR THE IDENTIFICATION, ASSESSMENT AND REFERRAL OF CONFIRMED OR
SUSPECTED CASES OF SUBSTANCE USE DISORDERS AS DEFINED IN SECTION 1.03 OF
THE MENTAL HYGIENE LAW;
(B) ESTABLISH AND IMPLEMENT A TRAINING PROGRAM FOR ALL CURRENT AND NEW
EMPLOYEES ENGAGED IN PROVIDING DIRECT CLINICAL SERVICES TO PATIENTS
REGARDING THE POLICIES AND PROCEDURES ESTABLISHED PURSUANT TO THIS
SECTION; AND
(C) IF THE HOSPITAL DOES NOT HAVE OTHER ARRANGEMENTS FOR PROVIDING OR
COORDINATING SERVICES TO INDIVIDUALS WITH SUBSTANCE USE DISORDERS,
CONTACT A SUBSTANCE USE DISORDER SERVICES PROGRAM THAT PROVIDES BEHAV-
IORAL HEALTH SERVICES, AS DEFINED IN SECTION 1.03 OF THE MENTAL HYGIENE
LAW, IN THE GEOGRAPHIC AREA SERVED BY SUCH HOSPITAL TO SEEK AND ESTAB-
LISH THE COORDINATION OF SERVICES TO INDIVIDUALS WITH SUBSTANCE USE
DISORDERS.
2. UPON ADMITTANCE, COMMENCEMENT OF TREATMENT, OR DISCHARGE OF A
CONFIRMED OR SUSPECTED INDIVIDUAL WITH A SUBSTANCE USE DISORDER, SUCH
HOSPITAL SHALL INFORM THE INDIVIDUAL OF THE AVAILABILITY OF THE
SUBSTANCE USE DISORDER TREATMENT SERVICES THAT MAY BE AVAILABLE TO THEM
THROUGH A SUBSTANCE USE DISORDER SERVICES PROGRAM.
3. THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF THE
OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, SHALL MAKE REGU-
LATIONS AS MAY BE NECESSARY AND PROPER TO CARRY OUT THE PROVISIONS OF
THIS SECTION.
S 2. Section 19.07 of the mental hygiene law is amended by adding a
new subdivision (l) to read as follows:
(L) THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, IN CONSUL-
TATION WITH THE DEPARTMENT OF HEALTH, SHALL DEVELOP OR UTILIZE EXISTING
EDUCATIONAL MATERIALS TO BE PROVIDED TO HEALTH CARE PROVIDERS TO DISSEM-
INATE TO CONFIRMED OR SUSPECTED INDIVIDUALS WITH SUBSTANCE USE DISORDERS
DURING DISCHARGE PLANNING PURSUANT TO SECTION TWENTY-EIGHT HUNDRED
THREE-I OF THE PUBLIC HEALTH LAW FROM A GENERAL HOSPITAL. SUCH MATERIALS
SHALL INCLUDE INFORMATION REGARDING TREATMENT AND RECOVERY SERVICES,
INCLUDING BUT NOT LIMITED TO HOW TO RECOGNIZE THE NEED FOR TREATMENT
SERVICES, INFORMATION FOR INDIVIDUALS TO DETERMINE WHAT TREATMENT
RESOURCES ARE AVAILABLE TO THEM, AND ANY OTHER INFORMATION THE COMMIS-
SIONER DEEMS APPROPRIATE.
S 3. This act shall take effect on the one hundred eightieth day after
it shall have become a law; provided, however, that the commissioner of
health, the commissioner of alcohol and substance abuse services, and
A. 9007--B 53
general hospitals shall, respectively, make regulations and take other
actions reasonably necessary to implement this act on such date.
SUBPART E
Section 1. The opening paragraph of section 220.03 of the penal law,
as amended by section 4 of part I of chapter 57 of the laws of 2015, is
amended to read as follows:
A person is guilty of criminal possession of a controlled substance in
the seventh degree when he or she knowingly and unlawfully possesses a
controlled substance; provided, however, that it shall not be a
violation of this section when a person possesses a residual amount of a
controlled substance and that residual amount is in or on a hypodermic
syringe or hypodermic needle [obtained and possessed pursuant to section
thirty-three hundred eighty-one of the public health law, which includes
the state's syringe exchange and pharmacy and medical provider-based
expanded syringe access programs]; nor shall it be a violation of this
section when a person's unlawful possession of a controlled substance is
discovered as a result of seeking immediate health care as defined in
paragraph (b) of subdivision three of section 220.78 of [the penal law]
THIS ARTICLE, for either another person or him or herself because such
person is experiencing a drug or alcohol overdose or other life threat-
ening medical emergency as defined in paragraph (a) of subdivision three
of section 220.78 of the [penal law] THIS ARTICLE.
S 2. Section 220.45 of the penal law is REPEALED.
S 3. Subdivision 2 of section 850 of the general business law, as
amended by chapter 812 of the laws of 1980, is amended to read as
follows:
2. (A) "Drug-related paraphernalia" consists of the following objects
used for the following purposes:
[(a)] (I) Kits, used or designed for the purpose of planting, propa-
gating, cultivating, growing or harvesting of any species of plant which
is a controlled substance or from which a controlled substance can be
derived;
[(b)] (II) Kits, used or designed for the purpose of manufacturing,
compounding, converting, producing, or preparing controlled substances;
[(c)] (III) Isomerization devices, used or designed for the purpose of
increasing the potency of any species of plant which is a controlled
substance;
[(d)] (IV) Scales and balances, used or designed for the purpose of
weighing or measuring controlled substances;
[(e)] (V) Diluents and adulterants, including but not limited to
quinine hydrochloride, mannitol, mannite, dextrose and lactose, used or
designed for the purpose of cutting controlled substances;
[(f)] (VI) Separation gins, used or designed for the purpose of remov-
ing twigs and seeds in order to clean or refine marihuana;
[(g) Hypodermic syringes, needles and other objects, used or designed
for the purpose of parenterally injecting controlled substances into the
human body;
(h)] AND
(VII) Objects, used or designed for the purpose of ingesting, inhal-
ing, or otherwise introducing marihuana, cocaine, hashish, or hashish
oil into the human body.
(B) "DRUG-RELATED PARAPHERNALIA" SHALL NOT INCLUDE HYPODERMIC NEEDLES,
HYPODERMIC SYRINGES AND OTHER OBJECTS USED FOR THE PURPOSE OF PARENTER-
ALLY INJECTING CONTROLLED SUBSTANCES INTO THE HUMAN BODY.
A. 9007--B 54
S 4. Section 3381 of the public health law, as amended by section 9-a
of part B of chapter 58 of the laws of 2007, subdivisions 1, 2 and 3 as
amended by chapter 178 of the laws of 2010, is amended to read as
follows:
S 3381. Sale and possession of hypodermic syringes and hypodermic
needles. 1. It shall be unlawful for any person to sell or furnish to
another person or persons, a hypodermic syringe or hypodermic needle
except:
(a) pursuant to a prescription of a practitioner, which for the
purposes of this section shall include a patient specific prescription
form as provided for in the education law; or
(b) to persons who have been authorized by the commissioner to obtain
and possess such instruments; or
(c) by a pharmacy licensed under article one hundred thirty-seven of
the education law, health care facility licensed under article twenty-
eight of this chapter or a health care practitioner who is otherwise
authorized to prescribe the use of hypodermic needles or syringes within
his or her scope of practice; provided, however, that such sale or
furnishing: (i) shall only be to a person eighteen years of age or
older; AND (ii) [shall be limited to a quantity of ten or less hypoderm-
ic needles or syringes; and (iii)] shall be in accordance with subdivi-
sion [five] FOUR of this section[.] ; OR
(D) UNDER SUBDIVISION THREE OF THIS SECTION.
2. [It shall be unlawful for any person to obtain or possess a hypo-
dermic syringe or hypodermic needle unless such possession has been
authorized by the commissioner or is pursuant to a prescription, or is
pursuant to subdivision five of this section.
3.] Any person selling or furnishing a hypodermic syringe or hypoderm-
ic needle pursuant to a prescription shall record upon the prescription,
his or her signature or electronic signature, and the date of the sale
or furnishing of the hypodermic syringe or hypodermic needle. Such
prescription shall be retained on file for a period of five years and be
readily accessible for inspection by any public officer or employee
engaged in the enforcement of this section. Such prescription may be
refilled not more than the number of times specifically authorized by
the prescriber upon the prescription, provided however no such authori-
zation shall be effective for a period greater than two years from the
date the prescription is signed.
[4] 3. The commissioner shall, subject to subdivision [five] FOUR of
this section, designate persons, or by regulation, classes of persons
who may obtain hypodermic syringes and hypodermic needles without
prescription and the manner in which such transactions may take place
and the records thereof which shall be maintained.
[5] 4. (a) A person eighteen years of age or older may obtain and
possess a hypodermic syringe or hypodermic needle pursuant to paragraph
(c) of subdivision one of this section.
(b) Subject to regulations of the commissioner, a pharmacy licensed
under article one hundred thirty-seven of the education law, a health
care facility licensed under article twenty-eight of this chapter or a
health care practitioner who is otherwise authorized to prescribe the
use of hypodermic needles or syringes within his or her scope of prac-
tice, may obtain and possess hypodermic needles or syringes for the
purpose of selling or furnishing them pursuant to paragraph (c) of
subdivision one of this section or for the purpose of disposing of
them[, provided that such pharmacy, health care facility or health care
practitioner has registered with the department].
A. 9007--B 55
(c) Sale or furnishing of hypodermic syringes or hypodermic needles to
direct consumers pursuant to this subdivision by a pharmacy, health care
facility, or health care practitioner shall be accompanied by a safety
insert. Such safety insert shall be developed or approved by the commis-
sioner and shall include, but not be limited to, (i) information on the
proper use of hypodermic syringes and hypodermic needles; (ii) the risk
of blood borne diseases that may result from the use of hypodermic
syringes and hypodermic needles; (iii) methods for preventing the trans-
mission or contraction of blood borne diseases; (iv) proper hypodermic
syringe and hypodermic needle disposal practices; (v) information on the
dangers of injection drug use, and how to access drug treatment; (vi) a
toll-free phone number for information on the human immunodeficiency
virus; and (vii) information on the safe disposal of hypodermic syringes
and hypodermic needles including the relevant provisions of the environ-
mental conservation law relating to the unlawful release of regulated
medical waste. The safety insert shall be attached to or included in the
hypodermic syringe and hypodermic needle packaging, or shall be given to
the purchaser at the point of sale or furnishing in brochure form.
(d) In addition to the requirements of paragraph (c) of subdivision
one of this section, a pharmacy licensed under article one hundred thir-
ty-seven of the education law may sell or furnish hypodermic needles or
syringes only if such pharmacy[: (i) does not advertise to the public
the availability for retail sale or furnishing of hypodermic needles or
syringes without a prescription; and (ii) at any location where hypo-
dermic needles or syringes are kept for retail sale or furnishing,]
stores such needles and syringes in a manner that makes them available
only to authorized personnel and not openly available to customers.
(e) The commissioner shall promulgate rules and regulations necessary
to implement the provisions of this subdivision which shall include: (I)
STANDARDS FOR ADVERTISING TO THE PUBLIC THE AVAILABILITY FOR RETAIL SALE
OR FURNISHING OF HYPODERMIC SYRINGES OR NEEDLES; AND (II) a requirement
that such pharmacies, health care facilities and health care practition-
ers cooperate in a safe disposal of used hypodermic needles or syringes.
(f) The commissioner may, upon the finding of a violation of this
section, suspend for a determinate period of time the sale or furnishing
of syringes by a specific entity.
[6] 5. The provisions of this section shall not apply to farmers
engaged in livestock production or to those persons supplying farmers
engaged in livestock production, provided that:
(a) Hypodermic syringes and needles shall be stored in a secure,
locked storage container.
(b) At any time the department may request a document outlining:
(i) the number of hypodermic needles and syringes purchased over the
past calendar year;
(ii) a record of all hypodermic needles used over the past calendar
year; and
(iii) a record of all hypodermic needles and syringes destroyed over
the past calendar year.
(c) Hypodermic needles and syringes shall be destroyed in a manner
consistent with the provisions set forth in section thirty-three hundred
eighty-one-a of this article.
S 5. This act shall take effect immediately.
SUBPART F
A. 9007--B 56
Section 1. Section 19.18-a of the mental hygiene law, as added by
chapter 32 of the laws of 2014, is amended to read as follows:
S 19.18-a Heroin and opioid addiction wraparound services [demon-
stration] program.
1. The commissioner, in consultation with the department of health
shall develop a heroin and opioid addiction wraparound services [demon-
stration] program. This program shall provide wraparound services to
adolescent and adult patients during treatment and shall be available to
such patients for a clinically appropriate period for up to nine months
after completion of such treatment program. The commissioner shall iden-
tify and establish where the wraparound services [demonstration] program
will be provided.
2. Wraparound services shall include;
(a) Case management services which address:
(i) Educational resources;
(ii) Legal services;
(iii) Financial services;
(iv) Social services;
(v) Family services; and
(vi) Childcare services;
(b) Peer supports, including peer to peer support groups;
(c) Employment support; and
(d) Transportation assistance.
3. [Not later than two years after the effective date of this section,
the] THE commissioner shall provide the governor, the temporary presi-
dent of the senate, the speaker of the assembly, the chair of the senate
standing committee on alcoholism and drug abuse and the chair of the
assembly committee on alcoholism and drug abuse with a written evalu-
ation of the [demonstration] program. Such evaluation shall address the
overall effectiveness of this [demonstration] program and whether
continuation or expansion of this [demonstration] program is recom-
mended.
S 2. Section 2 of chapter 32 of the laws of 2014, amending the mental
hygiene law relating to the heroin and opioid addiction wraparound
services demonstration program, is amended to read as follows:
S 2. This act shall take effect immediately [and shall expire and be
deemed repealed three years after such effective date].
S 3. This act shall take effect immediately.
SUBPART G
Section 1. The mental hygiene law is amended by adding a new section
19.04 to read as follows:
S 19.04 SOBER LIVING TASK FORCE.
1. DEFINITIONS. AS USED IN THIS SECTION:
(A) "SOBER LIVING RESIDENCE" SHALL MEAN ANY RESIDENCE LOCATED IN NEW
YORK STATE WHERE THE OWNER OR OPERATOR OF SUCH RESIDENCE HOLDS THE RESI-
DENCE OUT TO THE PUBLIC AS AN ALCOHOL AND DRUG FREE LIVING ENVIRONMENT
FOR PERSONS RECOVERING FROM A CHEMICAL DEPENDENCY, WHERE NO FORMAL
TREATMENT SERVICES ARE PROVIDED ON-SITE.
(B) "SOBER LIVING NETWORK" SHALL MEAN A GROUP OF INDEPENDENTLY OPER-
ATED AND SELF-REGULATED SOBER LIVING RESIDENCES LOCATED IN NEW YORK
STATE WHICH COMPLY WITH THE GUIDELINES ISSUED PURSUANT TO THIS SECTION.
2. THE SOBER LIVING TASK FORCE IS HEREBY CREATED, WHICH PURSUANT TO
THE PROVISIONS OF THIS SECTION, SHALL ESTABLISH BEST PRACTICE GUIDELINES
A. 9007--B 57
FOR SOBER LIVING RESIDENCES THAT ILLUSTRATE THE MOST APPROPRIATE AND
EFFECTIVE ENVIRONMENT FOR PERSONS RECOVERING FROM A CHEMICAL DEPENDENCY.
3. THE TASK FORCE SHALL UTILIZE INFORMATION COLLECTED FROM ORGANIZA-
TIONS AND PROGRAMS BOTH IN NEW YORK STATE AND THROUGHOUT THE COUNTRY TO:
(A) ISSUE RECOMMENDATIONS AND GUIDELINES ESTABLISHING BEST PRACTICES
FOR SOBER LIVING RESIDENCES TO PROVIDE AN ALCOHOL AND DRUG FREE SOBER
LIVING ENVIRONMENT;
(B) DEVELOP A PLAN TO ESTABLISH A STATEWIDE SOBER LIVING NETWORK AS
DEFINED IN PARAGRAPH (B) OF SUBDIVISION ONE OF THIS SECTION; AND
(C) IDENTIFY BARRIERS FOR INDIVIDUALS TO ACCESS RECOVERY SERVICES,
RESIDENTIAL TREATMENT FOR CHEMICAL DEPENDENCY AND APPROPRIATE HOUSING
WHERE INDIVIDUALS ARE PROVIDED AN ALCOHOL AND DRUG FREE LIVING ENVIRON-
MENT.
4. (A) THE MEMBERS OF THE TASK FORCE SHALL INCLUDE THE COMMISSIONER OF
THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES OR HIS OR HER
DESIGNEE; THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH OR HIS OR HER
DESIGNEE; THE COMMISSIONER OF THE OFFICE OF TEMPORARY AND DISABILITY
ASSISTANCE OR HIS OR HER DESIGNEE; THE COMMISSIONER OF THE OFFICE OF
HOMES AND COMMUNITY RENEWAL OR HIS OR HER DESIGNEE; ONE REPRESENTATIVE
OF THE NEW YORK STATE LOCAL MENTAL HYGIENE DIRECTORS; AT LEAST TWO
REPRESENTATIVES OF REPUTABLE OWNERS OR OPERATORS OF A RESIDENCE WHICH
CURRENTLY PROVIDES ALCOHOL AND DRUG FREE HOUSING FOR PERSONS IN RECOVERY
WHERE NO FORMAL TREATMENT SERVICES ARE PROVIDED ON-SITE; AT LEAST TWO
REPRESENTATIVES OF CHEMICAL DEPENDENCE RESIDENTIAL TREATMENT PROVIDERS
LICENSED BY THE OFFICE; AT LEAST ONE REPRESENTATIVE WHO IS NOT A PROVID-
ER OF CHEMICAL DEPENDENCE OR MENTAL HEALTH SERVICES AND WHO REPRESENT
NON-GOVERNMENTAL ORGANIZATIONS, SUCH AS NOT-FOR-PROFIT ENTITIES OR OTHER
ORGANIZATIONS CONCERNED WITH THE PROVISION OF HOUSING AND RECOVERY
SERVICES; AND ANY OTHER RELEVANT AGENCY OR PARTICIPANT THAT IS DEEMED
APPROPRIATE. THE COMMISSIONER SHALL BE DESIGNATED AS THE CHAIRPERSON OF
SUCH TASK FORCE AND SHALL SELECT A VICE-CHAIRPERSON AND A SECRETARY.
PRIOR TO THE FIRST MEETING OF THE TASK FORCE, IN CONSULTATION WITH THE
STATE AGENCY MEMBERS OF SUCH TASK FORCE, THE CHAIRPERSON SHALL SELECT UP
TO EIGHT ADDITIONAL MEMBERS WHOM SHALL BE REPRESENTATIVES OF LOCAL
GOVERNMENT AGENCIES IN NEW YORK STATE WHERE THE NEED FOR ALCOHOL AND
DRUG FREE HOUSING IS MOST PREVALENT.
(B) 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.
(C) NO CIVIL ACTION SHALL BE BROUGHT IN ANY COURT AGAINST ANY MEMBER
OF THE SOBER LIVING TASK FORCE FOR ANY ACT OR OMISSION NECESSARY TO THE
DISCHARGE OF HIS OR HER DUTIES AS A MEMBER OF THE TASK FORCE, EXCEPT AS
PROVIDED HEREIN. SUCH MEMBER MAY BE LIABLE FOR DAMAGES IN ANY SUCH
ACTION IF HE OR SHE FAILED TO ACT IN GOOD FAITH AND EXERCISE REASONABLE
CARE. ANY INFORMATION OBTAINED BY A MEMBER OF THE TASK FORCE WHILE
CARRYING OUT HIS OR HER LIMITED DUTIES AS PRESCRIBED IN SUBDIVISION
THREE OF THIS SECTION SHALL ONLY BE UTILIZED IN THEIR CAPACITY AS A
MEMBER OF THE TASK FORCE.
5. NO LATER THAN DECEMBER THIRTY-FIRST IN THE YEAR FOLLOWING THE
EFFECTIVE DATE OF THIS SECTION THE TASK FORCE SHALL PROVIDE A REPORT TO
THE TEMPORARY PRESIDENT OF THE SENATE, THE MINORITY LEADER OF THE
SENATE, THE SPEAKER OF THE ASSEMBLY, THE MINORITY LEADER OF THE ASSEM-
BLY, AND THE CHAIRMAN OF THE APPROPRIATE LEGISLATIVE COMMITTEES. SUCH
REPORT SHALL INCLUDE BUT NOT BE LIMITED TO THE BEST PRACTICES ESTAB-
LISHED FOR SOBER LIVING RESIDENCES; A DESCRIPTION OF THE PLAN THAT
ESTABLISHES A STATEWIDE SOBER LIVING NETWORK; RECOMMENDATIONS BY THE
A. 9007--B 58
TASK FORCE TO REDUCE ACCESS BARRIERS FOR INDIVIDUALS SEEKING RESIDENTIAL
TREATMENT FOR CHEMICAL DEPENDENCY; AND RECOMMENDATIONS FOR ANY OTHER
PROGRAM OR POLICY INITIATIVE THE TASK FORCE DEEMS APPROPRIATE. THE
REPORT SHALL BE POSTED ON THE WEBSITES OF THE APPROPRIATE AGENCIES.
S 2. This act shall take effect on the thirtieth day after it shall
have become a law and shall expire and be deemed repealed one year after
such effective date.
SUBPART H
Section 1. The opening paragraph of subdivision 1 and subdivision 2 of
section 216.00 of the criminal procedure law, the opening paragraph of
subdivision 1 as amended by chapter 90 of the laws of 2014 and subdivi-
sion 2 as added by section 4 of part AAA of chapter 56 of the laws of
2009, are amended to read as follows:
"Eligible defendant" means any person who stands charged in an indict-
ment or a superior court information with a class B, C, D or E felony
offense defined in article one hundred seventy-nine, two hundred twenty
or two hundred twenty-one of the penal law, AN OFFENSE DEFINED IN
SECTIONS 105.10, 105.13, 105.15 AND 105.17 OF THE PENAL LAW PROVIDED
THAT THE UNDERLYING CRIME FOR THE CONSPIRACY CHARGE IS A CLASS B, C, D
OR E FELONY OFFENSE DEFINED IN ARTICLE ONE HUNDRED SEVENTY-NINE, TWO
HUNDRED TWENTY OR TWO HUNDRED TWENTY-ONE OF THE PENAL LAW, AUTO STRIP-
PING IN THE SECOND DEGREE AS DEFINED IN SECTION 165.10 OF THE PENAL LAW,
AUTO STRIPPING IN THE FIRST DEGREE AS DEFINED IN SECTION 165.11 OF THE
PENAL LAW, IDENTITY THEFT IN THE SECOND DEGREE AS DEFINED IN SECTION
190.79 OF THE PENAL LAW, IDENTITY THEFT IN THE FIRST DEGREE AS DEFINED
IN SECTION 190.80 OF THE PENAL LAW, or any other specified offense as
defined in subdivision [four] FIVE of section 410.91 of this chapter,
provided, however, a defendant is not an "eligible defendant" if he or
she:
2. "Alcohol and substance [abuse] USE evaluation" means a written
assessment and report by a court-approved entity or licensed health care
professional experienced in the treatment of alcohol and substance
[abuse] USE DISORDER, or by an addiction and substance [abuse] USE coun-
selor credentialed by the office of alcoholism and substance abuse
services pursuant to section 19.07 of the mental hygiene law, which
shall include:
(a) an evaluation as to whether the defendant has a history of alcohol
or substance [abuse or alcohol or substance dependence] USE DISORDER, as
such terms are defined in the diagnostic and statistical manual of
mental disorders, [fourth] FIFTH edition, and a co-occurring mental
disorder or mental illness and the relationship between such [abuse or
dependence] USE and mental disorder or mental illness, if any;
(b) a recommendation as to whether the defendant's alcohol or
substance [abuse or dependence] USE, if any, could be effectively
addressed by judicial diversion in accordance with this article;
(c) a recommendation as to the treatment modality, level of care and
length of any proposed treatment to effectively address the defendant's
alcohol or substance [abuse or dependence] USE and any co-occurring
mental disorder or illness; and
(d) any other information, factor, circumstance, or recommendation
deemed relevant by the assessing entity or specifically requested by the
court.
A. 9007--B 59
S 2. The opening paragraph of subdivision 1 of section 216.00 of the
criminal procedure law, as added by section 4 of part AAA of chapter 56
of the laws of 2009, is amended to read as follows:
"Eligible defendant" means any person who stands charged in an indict-
ment or a superior court information with a class B, C, D or E felony
offense defined in article two hundred twenty or two hundred twenty-one
of the penal law, AN OFFENSE DEFINED IN SECTIONS 105.10, 105.13, 105.15
AND 105.17 OF THE PENAL LAW PROVIDED THAT THE UNDERLYING CRIME FOR THE
CONSPIRACY CHARGE IS A CLASS B, C, D OR E FELONY OFFENSE DEFINED IN
ARTICLE TWO HUNDRED TWENTY OR TWO HUNDRED TWENTY-ONE OF THE PENAL LAW,
AUTO STRIPPING IN THE SECOND DEGREE AS DEFINED IN SECTION 165.10 OF THE
PENAL LAW, AUTO STRIPPING IN THE FIRST DEGREE AS DEFINED IN SECTION
165.11 OF THE PENAL LAW, IDENTITY THEFT IN THE SECOND DEGREE AS DEFINED
IN SECTION 190.79 OF THE PENAL LAW, IDENTITY THEFT IN THE FIRST DEGREE
AS DEFINED IN SECTION 190.80 OF THE PENAL LAW, or any other specified
offense as defined in subdivision [four] FIVE of section 410.91 of this
chapter, provided, however, a defendant is not an "eligible defendant"
if he or she:
S 3. Section 216.05 of the criminal procedure law, as added by section
4 of part AAA of chapter 56 of the laws of 2009, subdivision 5 and para-
graph (a) of subdivision 9 as amended by chapter 258 of the laws of
2015, and subdivision 8 as amended by chapter 347 of the laws of 2012,
is amended to read as follows:
S 216.05 Judicial diversion program; court procedures.
1. At any time after the arraignment of an eligible defendant, but
prior to the entry of a plea of guilty or the commencement of trial, the
court at the request of the eligible defendant, may order an alcohol and
substance [abuse] USE evaluation. An eligible defendant may decline to
participate in such an evaluation at any time. The defendant shall
provide a written authorization, in compliance with the requirements of
any applicable state or federal laws, rules or regulations authorizing
disclosure of the results of the assessment to the defendant's attorney,
the prosecutor, the local probation department, the court, authorized
court personnel and other individuals specified in such authorization
for the sole purpose of determining whether the defendant should be
offered judicial diversion for treatment for substance [abuse or depend-
ence] USE, alcohol [abuse or dependence] USE and any co-occurring mental
disorder or mental illness.
2. Upon receipt of the completed alcohol and substance [abuse] USE
evaluation report, the court shall provide a copy of the report to the
eligible defendant and the prosecutor.
3. (a) Upon receipt of the evaluation report either party may request
a hearing on the issue of whether the eligible defendant should be
offered alcohol or substance [abuse] USE treatment pursuant to this
article. At such a proceeding, which shall be held as soon as practica-
ble so as to facilitate early intervention in the event that the defend-
ant is found to need alcohol or substance [abuse] USE treatment, the
court may consider oral and written arguments, may take testimony from
witnesses offered by either party, and may consider any relevant
evidence including, but not limited to, evidence that:
(i) the defendant had within the preceding ten years (excluding any
time during which the offender was incarcerated for any reason between
the time of the acts that led to the youthful offender adjudication and
the time of commission of the present offense) been adjudicated a youth-
ful offender for: (A) a violent felony offense as defined in section
70.02 of the penal law; or (B) any offense for which a merit time allow-
A. 9007--B 60
ance is not available pursuant to subparagraph (ii) of paragraph (d) of
subdivision one of section eight hundred three of the correction law;
and
(ii) in the case of a felony offense defined in subdivision [four]
FIVE of section 410.91 of this chapter, OR SECTION 165.09, 165.10,
190.79 OR 190.80 OF THE PENAL LAW, any statement of or submitted by the
victim, as defined in paragraph (a) of subdivision two of section 380.50
of this chapter.
(b) Upon completion of such a proceeding, the court shall consider and
make findings of fact with respect to whether:
(i) the defendant is an eligible defendant as defined in subdivision
one of section 216.00 of this article;
(ii) the defendant has a history of alcohol or substance [abuse or
dependence] USE;
(iii) such alcohol or substance [abuse or dependence] USE is a
contributing factor to the defendant's criminal behavior;
(iv) the defendant's participation in judicial diversion could effec-
tively address such [abuse or dependence] USE; and
(v) institutional confinement of the defendant is or may not be neces-
sary for the protection of the public.
4. When an authorized court determines, pursuant to paragraph (b) of
subdivision three of this section, that an eligible defendant should be
offered alcohol or substance [abuse] USE treatment, or when the parties
and the court agree to an eligible defendant's participation in alcohol
or substance [abuse] USE treatment, an eligible defendant may be allowed
to participate in the judicial diversion program offered by this arti-
cle. Prior to the court's issuing an order granting judicial diversion,
the eligible defendant shall be required to enter a plea of guilty to
the charge or charges; provided, however, that no such guilty plea shall
be required when:
(a) the people and the court consent to the entry of such an order
without a plea of guilty; or
(b) based on a finding of exceptional circumstances, the court deter-
mines that a plea of guilty shall not be required. For purposes of this
subdivision, exceptional circumstances exist when, regardless of the
ultimate disposition of the case, the entry of a plea of guilty is like-
ly to result in severe collateral consequences.
5. The defendant shall agree on the record or in writing to abide by
the release conditions set by the court, which, shall include: partic-
ipation in a specified period of alcohol or substance [abuse] USE treat-
ment at a specified program or programs identified by the court, which
may include periods of detoxification, residential or outpatient treat-
ment, or both, as determined after taking into account the views of the
health care professional who conducted the alcohol and substance [abuse]
USE evaluation and any health care professionals responsible for provid-
ing such treatment or monitoring the defendant's progress in such treat-
ment; and may include: (i) periodic court appearances, which may include
periodic urinalysis; (ii) a requirement that the defendant refrain from
engaging in criminal behaviors; (iii) if the defendant needs treatment
for opioid [abuse or dependence] USE, that he or she may participate in
and receive medically prescribed drug treatments under the care of a
health care professional licensed or certified under title eight of the
education law, acting within his or her lawful scope of practice.
6. Upon an eligible defendant's agreement to abide by the conditions
set by the court, the court shall issue a securing order providing for
bail or release on the defendant's own recognizance and conditioning any
A. 9007--B 61
release upon the agreed upon conditions. The period of alcohol or
substance [abuse] USE treatment shall begin as specified by the court
and as soon as practicable after the defendant's release, taking into
account the availability of treatment, so as to facilitate early inter-
vention with respect to the defendant's abuse or condition and the
effectiveness of the treatment program. In the event that a treatment
program is not immediately available or becomes unavailable during the
course of the defendant's participation in the judicial diversion
program, the court may release the defendant pursuant to the securing
order.
7. When participating in judicial diversion treatment pursuant to this
article, any resident of this state who is covered under a private
health insurance policy or contract issued for delivery in this state
pursuant to article thirty-two, forty-three or forty-seven of the insur-
ance law or article forty-four of the public health law, or who is
covered by a self-funded plan which provides coverage for the diagnosis
and treatment of chemical abuse and chemical dependence however defined
in such policy; shall first seek reimbursement for such treatment in
accordance with the provisions of such policy or contract.
8. During the period of a defendant's participation in the judicial
diversion program, the court shall retain jurisdiction of the defendant,
provided, however, that the court may allow such defendant to reside in
another jurisdiction while participating in a judicial diversion program
under conditions set by the court and agreed to by the defendant pursu-
ant to subdivisions five and six of this section. The court may require
the defendant to appear in court at any time to enable the court to
monitor the defendant's progress in alcohol or substance [abuse] USE
treatment. The court shall provide notice, reasonable under the circum-
stances, to the people, the treatment provider, the defendant and the
defendant's counsel whenever it orders or otherwise requires the appear-
ance of the defendant in court. Failure to appear as required without
reasonable cause therefor shall constitute a violation of the conditions
of the court's agreement with the defendant.
9. (a) If at any time during the defendant's participation in the
judicial diversion program, the court has reasonable grounds to believe
that the defendant has violated a release condition or has failed to
appear before the court as requested, the court shall direct the defend-
ant to appear or issue a bench warrant to a police officer or an appro-
priate peace officer directing him or her to take the defendant into
custody and bring the defendant before the court without unnecessary
delay; provided, however, that under no circumstances shall a defendant
who requires treatment for opioid [abuse or dependence] USE be deemed to
have violated a release condition on the basis of his or her partic-
ipation in medically prescribed drug treatments under the care of a
health care professional licensed or certified under title eight of the
education law, acting within his or her lawful scope of practice. The
provisions of subdivision one of section 530.60 of this chapter relating
to revocation of recognizance or bail shall apply to such proceedings
under this subdivision.
(b) In determining whether a defendant violated a condition of his or
her release under the judicial diversion program, the court may conduct
a summary hearing consistent with due process and sufficient to satisfy
the court that the defendant has, in fact, violated the condition.
(c) If the court determines that the defendant has violated a condi-
tion of his or her release under the judicial diversion program, the
court may modify the conditions thereof, reconsider the order of recog-
A. 9007--B 62
nizance or bail pursuant to subdivision two of section 510.30 of this
chapter, or terminate the defendant's participation in the judicial
diversion program; and when applicable proceed with the defendant's
sentencing in accordance with the agreement. Notwithstanding any
provision of law to the contrary, the court may impose any sentence
authorized for the crime of conviction in accordance with the plea
agreement, or any lesser sentence authorized to be imposed on a felony
drug offender pursuant to paragraph (b) or (c) of subdivision two of
section 70.70 of the penal law taking into account the length of time
the defendant spent in residential treatment and how best to continue
treatment while the defendant is serving that sentence. In determining
what action to take for a violation of a release condition, the court
shall consider all relevant circumstances, including the views of the
prosecutor, the defense and the alcohol or substance [abuse] USE treat-
ment provider, and the extent to which persons who ultimately success-
fully complete a drug treatment regimen sometimes relapse by not
abstaining from alcohol or substance [abuse] USE or by failing to comply
fully with all requirements imposed by a treatment program. The court
shall also consider using a system of graduated and appropriate
responses or sanctions designed to address such inappropriate behaviors,
protect public safety and facilitate, where possible, successful
completion of the alcohol or substance [abuse] USE treatment program.
(d) Nothing in this subdivision shall be construed as preventing a
court from terminating a defendant's participation in the judicial
diversion program for violating a release condition when such a termi-
nation is necessary to preserve public safety. Nor shall anything in
this subdivision be construed as precluding the prosecution of a defend-
ant for the commission of a different offense while participating in the
judicial diversion program.
(e) A defendant may at any time advise the court that he or she wishes
to terminate participation in the judicial diversion program, at which
time the court shall proceed with the case and, where applicable, shall
impose sentence in accordance with the plea agreement. Notwithstanding
any provision of law to the contrary, the court may impose any sentence
authorized for the crime of conviction in accordance with the plea
agreement, or any lesser sentence authorized to be imposed on a felony
drug offender pursuant to paragraph (b) or (c) of subdivision two of
section 70.70 of the penal law taking into account the length of time
the defendant spent in residential treatment and how best to continue
treatment while the defendant is serving that sentence.
10. Upon the court's determination that the defendant has successfully
completed the required period of alcohol or substance [abuse] USE treat-
ment and has otherwise satisfied the conditions required for successful
completion of the judicial diversion program, the court shall comply
with the terms and conditions it set for final disposition when it
accepted the defendant's agreement to participate in the judicial diver-
sion program. Such disposition may include, but is not limited to: (a)
requiring the defendant to undergo a period of interim probation super-
vision and, upon the defendant's successful completion of the interim
probation supervision term, notwithstanding the provision of any other
law, permitting the defendant to withdraw his or her guilty plea and
dismissing the indictment; or (b) requiring the defendant to undergo a
period of interim probation supervision and, upon successful completion
of the interim probation supervision term, notwithstanding the provision
of any other law, permitting the defendant to withdraw his or her guilty
plea, enter a guilty plea to a misdemeanor offense and sentencing the
A. 9007--B 63
defendant as promised in the plea agreement, which may include a period
of probation supervision pursuant to section 65.00 of the penal law; or
(c) allowing the defendant to withdraw his or her guilty plea and
dismissing the indictment.
11. Nothing in this article shall be construed as restricting or
prohibiting courts or district attorneys from using other lawful proce-
dures or models for placing appropriate persons into alcohol or
substance [abuse] USE treatment.
S 4. This act shall take effect immediately; provided, that the amend-
ments to the opening paragraph of subdivision 1 of section 216.00 of the
criminal procedure law made by section one of this act shall be subject
to the expiration and reversion of such paragraph pursuant to section 12
of chapter 90 of the laws of 2014, as amended, when upon such date the
provisions of section two of this act shall take effect.
SUBPART I
Section 1. The executive law is amended by adding a new section 837-s
to read as follows:
S 837-S. LAW ENFORCEMENT ASSISTED DIVERSION. 1. IN COORDINATION WITH
THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, THE DIVISION
SHALL BY REGULATION:
(A) DEVELOP BEST PRACTICES REGARDING LAW ENFORCEMENT ASSISTED DIVER-
SION, WHICH SHALL INCLUDE BUT NOT BE LIMITED TO A PROCEDURE FOR DIVERT-
ING INDIVIDUALS WITH SUBSTANCE USE DISORDERS TO TREATMENT IN LIEU OF
ARREST, AND METHODS FOR MONITORING AND ASSURING THAT SUCH PROCEDURES ARE
USED IN A MANNER THAT IS NON-DISCRIMINATORY WITH RESPECT TO PERSONAL
CHARACTERISTICS OF THE INDIVIDUAL THAT ARE UNRELATED TO THE COMMISSION
OF THE ALLEGED OFFENSE; AND
(B) COLLECT AND ANALYZE STATISTICAL DATA AND ALL OTHER INFORMATION AND
DATA WITH RESPECT TO LAW ENFORCEMENT ASSISTED DIVERSION PROGRAMS ENACTED
BY ANY LAW ENFORCEMENT ENTITY IN THE STATE.
2. THE DIVISION SHALL MAKE AN ANNUAL REPORT TO THE GOVERNOR AND LEGIS-
LATURE, WHICH INCLUDES BUT IS NOT LIMITED TO THE NUMBER OF LAW ENFORCE-
MENT ENTITIES IN THE STATE WHICH HAVE ADOPTED SUCH BEST PRACTICES, THE
EFFICACY OF SUCH BEST PRACTICES, DEMOGRAPHIC AND GEOGRAPHIC INFORMATION,
THE NUMBER OF JURISDICTIONS THAT HAVE IMPLEMENTED LAW ENFORCEMENT
ASSISTED DIVERSION, AND ANY OTHER RELEVANT DATA.
S 2. This act shall take effect on the one hundred eightieth day after
it shall have become a law; provided, however, that effective immediate-
ly, the addition, amendment and/or repeal of any rule or regulation
necessary for the implementation of this act on its effective date are
authorized to be made and completed on or before such effective date.
SUBPART J
Section 1. Section 60.48 of the criminal procedure law is renumbered
section 60.49 and a new section 60.48 is added to read as follows:
S 60.48 POSSESSION OF OPIOID ANTAGONISTS; RECEIPT INTO EVIDENCE.
1. EVIDENCE THAT A PERSON WAS IN POSSESSION OF AN OPIOID ANTAGONIST
MAY NOT BE ADMITTED AT ANY TRIAL, HEARING OR OTHER PROCEEDING IN A PROS-
ECUTION FOR ANY OFFENSE UNDER SECTIONS 220.03, 220.06, 220.09, 220.16,
220.18, OR 220.21 OF THE PENAL LAW FOR THE PURPOSE OF ESTABLISHING PROB-
ABLE CAUSE FOR AN ARREST OR PROVING ANY PERSON'S COMMISSION OF SUCH
OFFENSE.
A. 9007--B 64
2. FOR THE PURPOSES OF THIS SECTION, OPIOID ANTAGONIST IS DEFINED AS A
DRUG APPROVED BY THE FOOD AND DRUG ADMINISTRATION THAT, WHEN ADMINIS-
TERED, NEGATES OR NEUTRALIZES IN WHOLE OR IN PART THE PHARMACOLOGICAL
EFFECTS OF AN OPIOID IN THE BODY AND SHALL BE LIMITED TO NALOXONE AND
OTHER MEDICATIONS APPROVED BY THE DEPARTMENT OF HEALTH FOR SUCH PURPOSE.
S 2. The civil practice law and rules is amended by adding a new
section 4519-a to read as follows:
S 4519-A. POSSESSION OF OPIOID ANTAGONISTS; RECEIPT INTO EVIDENCE. 1.
POSSESSION OF AN OPIOID ANTAGONIST MAY NOT BE RECEIVED IN EVIDENCE IN
ANY TRIAL, HEARING OR PROCEEDING PURSUANT TO SUBDIVISION ONE OF SECTION
TWO HUNDRED THIRTY-ONE AND PARAGRAPH THREE OF SUBDIVISION B OF SECTION
TWO HUNDRED THIRTY-THREE OF THE REAL PROPERTY LAW OR SUBDIVISION FIVE OF
SECTION SEVEN HUNDRED ELEVEN AND SUBDIVISION ONE OF SECTION SEVEN
HUNDRED FIFTEEN OF THE REAL PROPERTY ACTIONS AND PROCEEDINGS LAW AS
EVIDENCE THAT THE BUILDING OR PREMISES ARE BEING USED FOR ILLEGAL TRADE,
MANUFACTURE, OR OTHER ILLEGAL BUSINESS.
2. FOR THE PURPOSES OF THIS SECTION, OPIOID ANTAGONIST SHALL HAVE THE
SAME MEANING AS SET FORTH IN SUBDIVISION TWO OF SECTION 60.48 OF THE
CRIMINAL PROCEDURE LAW.
S 3. The executive law is amended by adding a new section 214-e to
read as follows:
S 214-E. OPIOID ANTAGONIST AWARENESS. THE SUPERINTENDENT, IN COOPER-
ATION WITH THE DEPARTMENT OF HEALTH AND THE OFFICE OF ALCOHOLISM AND
SUBSTANCE ABUSE SERVICES, SHALL, FOR ALL MEMBERS OF THE DIVISION OF
STATE POLICE: (1) DEVELOP, MAINTAIN AND DISSEMINATE APPROPRIATE INSTRUC-
TION REGARDING SECTION 60.48 OF THE CRIMINAL PROCEDURE LAW, AND (2)
ESTABLISH AND IMPLEMENT WRITTEN PROCEDURES AND POLICIES IN THE EVENT A
MEMBER OF THE DIVISION OF STATE POLICE ENCOUNTERS A PERSON WHO POSSESSES
OPIOID ANTAGONISTS.
S 4. Section 841 of the executive law is amended by adding a new
subdivision 7-b to read as follows:
7-B. TAKE SUCH STEPS AS MAY BE NECESSARY TO ENSURE THAT ALL POLICE
OFFICERS AND PEACE OFFICERS CERTIFIED PURSUANT TO SUBDIVISION THREE OF
THIS SECTION RECEIVE APPROPRIATE INSTRUCTION REGARDING SECTION 60.48 OF
THE CRIMINAL PROCEDURE LAW RELATING TO THE INTRODUCTION OF OPIOID ANTAG-
ONISTS INTO EVIDENCE IN CERTAIN CASES.
S 5. This act shall take effect on the sixtieth day after it shall
have become a law and shall apply to all cases pending on and after such
date.
SUBPART K
Section 1. Schedule I of section 3306 of the public health law is
amended by adding a new subdivision (g) to read as follows:
(G) (1) CANNABIMIMETIC AGENTS. UNLESS SPECIFICALLY EXEMPTED OR UNLESS
LISTED IN ANOTHER SCHEDULE, ANY MATERIAL, COMPOUND, MIXTURE, OR PREPARA-
TION THAT IS NOT APPROVED BY THE FEDERAL FOOD AND DRUG ADMINISTRATION
(FDA) WHICH CONTAINS ANY QUANTITY OF CANNABIMIMETIC AGENTS, OR WHICH
CONTAINS THEIR SALTS, ISOMERS, AND SALTS OF ISOMERS WHENEVER THE EXIST-
ENCE OF SUCH SALTS, ISOMERS, AND SALTS OF ISOMERS IS POSSIBLE WITHIN THE
SPECIFIC CHEMICAL DESIGNATION.
(2) AS USED IN THIS SUBDIVISION, THE TERM "CANNABIMIMETIC AGENTS"
MEANS ANY SUBSTANCE THAT IS A CANNABINOID RECEPTOR TYPE 1 (CB1 RECEPTOR)
AGONIST AS DEMONSTRATED BY BINDING STUDIES AND FUNCTIONAL ASSAYS WITHIN
ANY OF THE FOLLOWING STRUCTURAL CLASSES:
A. 9007--B 65
(I) 2-(3-HYDROXYCYCLOHEXYL)PHENOL WITH SUBSTITUTION AT THE 5-POSITION
OF THE PHENOLIC RING BY ALKYL OR ALKENYL, WHETHER OR NOT SUBSTITUTED ON
THE CYCLOHEXYL RING TO ANY EXTENT.
(II) 3-(1-NAPHTHOYL)INDOLE OR 3-(1-NAPHTHYLMETHANE)INDOLE BY SUBSTI-
TUTION AT THE NITROGEN ATOM OF THE INDOLE RING, WHETHER OR NOT FURTHER
SUBSTITUTED ON THE INDOLE RING TO ANY EXTENT, WHETHER OR NOT SUBSTITUTED
ON THE NAPHTHOYL OR NAPHTHYL RING TO ANY EXTENT.
(III) 3-(1-NAPHTHOYL)PYRROLE BY SUBSTITUTION AT THE NITROGEN ATOM OF
THE PYRROLE RING, WHETHER OR NOT FURTHER SUBSTITUTED IN THE PYRROLE RING
TO ANY EXTENT, WHETHER OR NOT SUBSTITUTED ON THE NAPHTHOYL RING TO ANY
EXTENT.
(IV) 1-(1-NAPHTHYLMETHYLENE)INDENE BY SUBSTITUTION OF THE 3-POSITION
OF THE INDENE RING, WHETHER OR NOT FURTHER SUBSTITUTED IN THE INDENE
RING TO ANY EXTENT, WHETHER OR NOT SUBSTITUTED ON THE NAPHTHYL RING TO
ANY EXTENT.
(V) 3-PHENYLACETYLINDOLE OR 3-BENZOYLINDOLE BY SUBSTITUTION AT THE
NITROGEN ATOM OF THE INDOLE RING, WHETHER OR NOT FURTHER SUBSTITUTED IN
THE INDOLE RING TO ANY EXTENT, WHETHER OR NOT SUBSTITUTED ON THE PHENYL
RING TO ANY EXTENT.
(3) SUCH TERM INCLUDES:
(I) 5-(1,1-DIMETHYLHEPTYL)-2-{(1R,3S)-3-HYDROXYCYCLOHEXYL}-PHENOL
(CP-47,497);
(II) 5-(1,1-DIMETHYLOCTYL)-2-{(1R,3S)-3-HYDROXYCYCLOHEXYL}-PHENOL
(CANNABICYCLOHEXANOL OR CP-47,497 C8-HOMOLOG);
(III) 1-PENTYL-3-(1-NAPHTHOYL)INDOLE (JWH-018 AND AM678);
(IV) 1-BUTYL-3-(1-NAPHTHOYL)INDOLE (JWH-073);
(V) 1-HEXYL-3-(1-NAPHTHOYL)INDOLE (JWH-019);
(VI) 1-{2-(4-MORPHOLINYL)ETHYL}-3-(1-NAPHTHOYL)INDOLE (JWH-200);
(VII) 1-PENTYL-3-(2-METHOXYPHENYLACETYL)INDOLE (JWH-250);
(VIII) 1-PENTYL-3-{1-(4-METHOXYNAPHTHOYL)}INDOLE (JWH-081);
(IX) 1-PENTYL-3-(4-METHYL-1-NAPHTHOYL)INDOLE (JWH-122);
(X) 1-PENTYL-3-(4-CHLORO-1-NAPHTHOYL)INDOLE (JWH-398);
(XI) 1-(5-FLUOROPENTYL)-3-(1-NAPHTHOYL)INDOLE (AM2201);
(XII) 1-(5-FLUOROPENTYL)-3-(2-IODOBENZOYL)INDOLE (AM694);
(XIII) 1-PENTYL-3-{(4-METHOXY)-BENZOYL}INDOLE (SR-19 AND RCS-4);
(XIV) 1-CYCLOHEXYLETHYL-3-(2-METHOXYPHENYLACETYL)INDOLE (SR-18 AND
RCS-8); AND
(XV) 1-PENTYL-3-(2-CHLOROPHENYLACETYL)INDOLE (JWH-203).
S 2. This act shall take effect on the ninetieth day after it shall
have become a law.
S 2. Severability clause. If any clause, sentence, paragraph, subdivi-
sion, section or part of this act shall be adjudged by a court of compe-
tent jurisdiction to be invalid, such judgment shall not affect, impair,
or invalidate the remainder thereof, but shall be confined in its opera-
tion 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 3. This act shall take effect immediately, provided, however, that
the applicable effective date of Subparts A through K of this act shall
be as specifically set forth in the last section of such Subparts.
PART S
A. 9007--B 66
Section 1. Section 209 of the elder law, as amended by section 41 of
part A of chapter 58 of the laws of 2010, paragraph (b) of subdivision 1
as separately amended by chapter 348 of the laws of 2010, paragraph (d)
of subdivision 1 as amended by chapter 271 of the laws of 2014, para-
graph (d) of subdivision 4 as separately amended by chapter 410 of the
laws of 2010, and paragraph (k) of subdivision 4, subparagraph (6) of
paragraph (c) of subdivision 5-a, and subdivision 6 as amended by chap-
ter 320 of the laws of 2011, is amended to read as follows:
S 209. Naturally occurring retirement community supportive service
program. 1. As used in this section:
(a) "Advisory committee" or "committee" shall mean the advisory
committee convened by the director for the purposes specified in this
section. Such committee shall be broadly representative of housing and
senior citizen groups, and all geographic areas of the state.
(b) "Older adults" shall mean persons who are sixty years of age or
older.
(c) "Eligible applicant" shall mean a not-for-profit agency specializ-
ing in housing, health or other human services which serves or would
serve the community within which a naturally occurring retirement commu-
nity is located.
(d) "Eligible services" shall mean services including, but not limited
to: case management, care coordination, counseling, health assessment
and monitoring, transportation, socialization activities, home care
facilitation and monitoring, education regarding the signs of elder
abuse and exploitation and available resources for a senior who is a
suspected victim of elder abuse or exploitation, chemical dependence
counseling provided by credentialed alcoholism and substance abuse coun-
selors as defined in paragraph three of subdivision (d) of section 19.07
of the mental hygiene law and referrals to appropriate chemical depend-
ence counseling providers, and other services designed to address the
needs of residents of naturally occurring retirement communities by
helping them extend their independence, improve their quality of life,
and avoid unnecessary hospital and nursing home stays.
(e) "Government assistance" shall mean and be broadly interpreted to
mean any monetary assistance provided by the federal, the state or a
local government, or any agency thereof, or any authority or public
benefit corporation, in any form, including loans or loan subsidies, for
the construction of an apartment building or housing complex for low and
moderate income persons, as such term is defined by the United States
Department of Housing and Urban Development.
(f) "Naturally occurring retirement community", "CLASSIC NATURALLY
OCCURRING RETIREMENT COMMUNITY" OR "CLASSIC NORC" shall mean an apart-
ment building or housing complex which:
(1) [was constructed with government assistance;
(2)] was not originally built for older adults;
[(3)] (2) does not restrict admissions solely to older adults;
[(4)] (3) (A) at least [fifty] FORTY percent of the units have an
occupant who is an older adult [or]; AND
(B) in which at least [twenty-five hundred] TWO HUNDRED FIFTY of the
residents OF AN APARTMENT BUILDING are older adults OR FIVE HUNDRED
RESIDENTS OF A HOUSING COMPLEX ARE OLDER ADULTS; and
[(5)] (4) a majority of the older adults to be served are low or
moderate income, as defined by the United States Department of Housing
and Urban Development.
(G) "NEIGHBORHOOD NATURALLY OCCURRING RETIREMENT COMMUNITY" OR "NEIGH-
BORHOOD NORC" SHALL MEAN A RESIDENTIAL DWELLING OR GROUP OF RESIDENTIAL
A. 9007--B 67
DWELLINGS IN A GEOGRAPHICALLY DEFINED NEIGHBORHOOD OF A MUNICIPALITY
WHICH:
(1) WAS NOT PREDOMINANTLY DEVELOPED FOR OLDER ADULTS;
(2) DOES NOT PREDOMINANTLY RESTRICT ADMISSION TO OLDER ADULTS;
(3) AT LEAST THIRTY PERCENT OF THE UNITS HAVE AN OCCUPANT WHO IS AN
OLDER ADULT;
(4) IS MADE UP OF LOW-RISE BUILDINGS SIX STORIES OR LESS IN HEIGHT
AND/OR SINGLE AND MULTI-FAMILY HOMES.
2. A naturally occurring retirement community supportive service
program is established as a [demonstration] program to be administered
by the director.
3. The director shall be assisted by the advisory committee in the
development of appropriate criteria for the selection of grantees of
funds provided pursuant to this section and programmatic issues as
deemed appropriate by the director.
4. The criteria recommended by the committee and adopted by the direc-
tor for the award of grants shall be consistent with the provisions of
this section and shall include, at a minimum:
(a) the number, size, type and location of the projects to be served,
INCLUDING THE NUMBER, SIZE, TYPE AND LOCATION OF RESIDENTIAL DWELLINGS
OR GROUP OF RESIDENTIAL DWELLINGS SELECTED AS CANDIDATES FOR INCLUSION
IN A NEIGHBORHOOD NATURALLY OCCURRING RETIREMENT COMMUNITY; provided,
that the committee and director shall make reasonable efforts to assure
that geographic balance in the distribution of such projects is main-
tained, consistent with the needs to be addressed, funding available,
applications for eligible applicants, ABILITY TO COORDINATE SERVICES,
other requirements of this section, and other criteria developed by the
committee and director;
(b) the appropriate number and concentration of older adult residents
to be served by an individual project; provided, that such criteria need
not specify, in the case of a project which includes several buildings,
the number of older adults to be served in any individual building;
(c) the demographic characteristics of the residents to be served;
(d) A REQUIREMENT THAT THE APPLICANT DEMONSTRATE THE DEVELOPMENT OR
INTENT TO DEVELOP COMMUNITY WIDE SUPPORT FROM RESIDENTS, NEIGHBORHOOD
ASSOCIATIONS, COMMUNITY GROUPS, NONPROFIT ORGANIZATIONS AND OTHERS;
(E) IN THE CASE OF NEIGHBORHOOD NATURALLY OCCURRING RETIREMENT COMMU-
NITIES, A REQUIREMENT THAT THE BOUNDARIES OF THE GEOGRAPHIC AREA TO BE
SERVED ARE CLEAR AND COHERENT AND CREATE AN IDENTIFIABLE PROGRAM AND
SUPPORTIVE COMMUNITY;
(F) the financial or in-kind support required to be provided to the
project by the owners, managers and residents of the housing development
OR GEOGRAPHICALLY DEFINED AREA; provided, however, that such criteria
need not address whether the funding is public or private, or the source
of such support;
[(e)] (G) the scope and intensity of the services to be provided, and
their appropriateness for the residents proposed to be served. THE
APPLICANT SHALL CONDUCT OR HAVE CONDUCTED A NEEDS ASSESSMENT ON THE
BASIS OF WHICH SUCH APPLICANT SHALL ESTABLISH THE NATURE AND EXTENT OF
SERVICES TO BE PROVIDED; AND FURTHER THAT SUCH SERVICES SHALL PROVIDE A
MIX OF APPROPRIATE SERVICES THAT PROVIDE ACTIVE AND MEANINGFUL PARTIC-
IPATION FOR RESIDENTS. The criteria shall not require that the applicant
agency be the sole provider of such services, but shall require that the
applicant at a minimum actively manage the provision of such services.
SUCH SERVICES MAY BE THE SAME AS SERVICES PROVIDED BY THE LOCAL MUNICI-
PALITY OR OTHER COMMUNITY-BASED ORGANIZATION PROVIDED THAT THOSE
A. 9007--B 68
SERVICES ARE NOT AVAILABLE TO OR DO NOT ENTIRELY MEET THE NEEDS OF THE
RESIDENTS OF THE CLASSIC OR NEIGHBORHOOD NATURALLY OCCURRING RETIREMENT
COMMUNITY;
[(f)] (H) the experience and financial stability of the applicant
agency, provided that the criteria shall require that priority be given
to programs already in operation, including those projects participating
in the resident advisor program administered by the office, [and]
enriched housing programs which meet the requirements of this section,
and PROGRAMS IN EXISTENCE PRIOR TO APRIL FIRST, TWO THOUSAND FIVE WHICH,
EXCEPT FOR DESIGNATION AND FUNDING REQUIREMENTS ESTABLISHED HEREIN,
WOULD HAVE OTHERWISE GENERALLY QUALIFIED AS A NEIGHBORHOOD NATURALLY
OCCURRING RETIREMENT COMMUNITY which have demonstrated to the satisfac-
tion of the director and the committee their fiscal and managerial
stability and programmatic success in serving residents;
[(g)] (I) the [nature and extent of requirements proposed to be estab-
lished] PLAN for active, meaningful participation for residents proposed
to be served in project design, implementation, monitoring, evaluation,
and governance;
[(h)] (J) an agreement by the applicant to participate in the data
collection and evaluation project necessary to complete the report
required by this section;
[(i)] (K) the policy and program roles of the applicant agency and any
other agencies involved in the provision of services or the management
of the project, including the housing development governing body, or
other owners or managers of the apartment buildings and housing
complexes and the residents of such apartment buildings and housing
complexes. The criteria shall require a clear delineation of such policy
and program roles;
[(j)] (L) a requirement that each eligible agency document the need
for the project and financial commitments to it from such sources as the
committee and the director shall deem appropriate given the character
and nature of the proposed project, and written evidence of support from
the appropriate housing development governing body or other owners or
managers of the apartment buildings and housing complexes IN THE CASE OF
CLASSIC NATURALLY OCCURRING RETIREMENT COMMUNITIES, OR THE GEOGRAPH-
ICALLY DEFINED NEIGHBORHOOD IN THE CASE OF NEIGHBORHOOD NATURALLY OCCUR-
RING RETIREMENT COMMUNITIES. The purpose of such documentation shall be
to demonstrate the need for the project, support for it in the areas to
be served, and the financial and managerial ability to sustain the
project;
[(k)] (M) a requirement that any aid provided pursuant to this section
be matched by an [equal] amount EQUAL TO ONE QUARTER OF THE AID
PROVIDED, CONSISTING OF MONETARY SUPPORT, in-kind support [of equal
value], or some combination thereof from other sources, provided that
such in-kind support [to] be utilized only upon approval from the direc-
tor and only to the extent matching funds are not available[,] and that
at least [twenty-five] FIFTY percent of such [amount] REQUIRED MATCH be
contributed by the housing development governing body or other owners or
managers and residents of the apartment buildings and housing complexes,
OR GEOGRAPHICALLY DEFINED AREA, in which the project is proposed, or,
upon approval by the director, sources in neighborhoods contiguous to
the boundaries of the geographic areas served where services may also be
provided pursuant to subdivision [six] SEVEN of this section; [and]
[(l)] (N) the circumstances under which the director may waive all or
part of the requirement for provision of an equal amount of funding from
other sources required pursuant to paragraph [(k)] (M) of this subdivi-
A. 9007--B 69
sion, provided that such criteria shall include provision for waiver at
the discretion of the director upon a finding by the director that the
program will serve a low income or hardship community, and that such
waiver is required to assure that such community receive a fair share of
the funding available. The committee shall develop appropriate criteria
for determining whether a community is a low income or hardship communi-
ty[.];
(O) THE POLICY AND PROGRAM ROLES OF THE APPLICANT AGENCY AND ANY OTHER
AGENCIES INVOLVED IN THE PROVISION OF SERVICES OR THE MANAGEMENT OF THE
NEIGHBORHOOD NATURALLY OCCURRING RETIREMENT COMMUNITY, PROVIDED THAT THE
CRITERIA SHALL REQUIRE A CLEAR DELINEATION OF SUCH POLICY AND PROGRAM
ROLES; AND
(P) NOTWITHSTANDING ANY OTHER PROVISION TO THE CONTRARY, NO CHANGES
MADE PURSUANT TO THE CHAPTER OF THE LAWS OF TWO THOUSAND SIXTEEN WHICH
AMENDED THIS SECTION SHALL AFFECT THE CONTINUATION OF CONTRACTS PURSUANT
TO THIS SECTION AS THEY EXISTED PRIOR TO THE AMENDMENTS MADE BY SUCH
CHAPTER.
(Q) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, THE DIRECTOR
OF THE OFFICE FOR THE AGING SHALL CONTINUE CONTRACTS WITH CLASSIC NORCS
AND NEIGHBORHOOD NORCS FOR ALL SUCH CONTRACTS WHICH WERE EXECUTED ON OR
BEFORE APRIL FIRST, TWO THOUSAND SIXTEEN, WITHOUT ANY ADDITIONAL
REQUIREMENTS THAT SUCH CONTRACTS BE SUBJECT TO COMPETITIVE BIDDING OR A
REQUEST FOR PROPOSALS PROCESS. NOTHING HEREIN SHALL PRECLUDE SUCH CLAS-
SIC NORCS AND NEIGHBORHOOD NORCS FROM RECEIVING ADDITIONAL FUNDING
AWARDS FOR SUCH PROGRAMS.
5. (A) Within amounts specifically appropriated therefor and consist-
ent with the criteria developed and required pursuant to this section
the director shall approve grants to eligible applicants in amounts not
to exceed [one] TWO hundred [fifty] thousand dollars for a project in
any twelve month period. [The director shall not approve more than ten
grants in the first twelve month period after the effective date of this
section.
5-a. The director may, in addition recognize neighborhood naturally
occurring retirement communities, or Neighborhood NORCs, and provide
program support within amounts specifically available by appropriation
therefor, which shall be subject to the requirements, rules and regu-
lations of this section, provided however that:
(a) the term Neighborhood NORC as used in this subdivision shall mean
and refer to a residential dwelling or group of residential dwellings in
a geographically defined neighborhood of a municipality containing not
more than two thousand persons who are older adults reside in at least
forty percent of the units and which is made up of low-rise buildings
six stories or less in height and/or single and multi-family homes and
which area was not originally developed for older adults, and which does
not restrict admission strictly to older adults;
(b) grants to an eligible Neighborhood NORC shall be no less than
sixty thousand dollars for any twelve-month period;
(c) the director shall be assisted by the advisory committee in the
development of criteria for the selection of grants provided pursuant to
this section and programmatic issues as deemed appropriate by the direc-
tor. The criteria recommended by the committee and adopted by the direc-
tor for the award of grants shall be consistent with the provisions of
this subdivision and shall include, at a minimum, the following require-
ments or items of information using such criteria as the advisory
committee and the director shall approve:
A. 9007--B 70
(1) the number, size, type and location of residential dwellings or
group of residential dwellings selected as candidates for neighborhood
NORCs funding. The director shall make reasonable efforts to assure that
geographic balance in the distribution of such grants is maintained,
consistent with the needs to be addressed, funding available, applica-
tions from eligible applicants, ability to coordinate services and other
requirements of this section;
(2) the appropriate number and concentration of older adult residents
to be served by an individual Neighborhood NORC. The criteria need not
specify the number of older adults to be served in any individual build-
ing;
(3) the demographic characteristics of the residents to be served;
(4) a requirement that the applicant demonstrate the development or
intent to develop community wide support from residents, neighborhood
associations, community groups, nonprofit organizations and others;
(5) a requirement that the boundaries of the geographic area to be
served are clear and coherent and create an identifiable program and
supportive community;
(6) a requirement that the applicant commit to raising matching funds,
in-kind support, or some combination thereof from non-state sources,
provided that such in-kind support be utilized only upon approval from
the director and only to the extent matching funds are not available,
equal to fifteen percent of the state grant in the second year after the
program is approved, twenty-five percent in the third year, forty
percent in the fourth year, and fifty percent in the fifth year, and
further commit that in each year, twenty-five percent of such required
matching funds, in-kind support, or combination thereof be raised within
the community served and, upon approval by the director, in neighbor-
hoods contiguous to the boundaries of the geographic areas served where
services may also be provided pursuant to subdivision six of this
section. Such local community matching funds, in-kind support, or combi-
nation thereof shall include but not be limited to: dues, fees for
service, individual and community contributions, and such other funds as
the advisory committee and the director shall deem appropriate;
(7) a requirement that the applicant demonstrate experience and finan-
cial stability;
(8) a requirement that priority in selection be given to programs in
existence prior to the effective date of this subdivision which, except
for designation and funding requirements established herein, would have
otherwise generally qualified as a Neighborhood NORC;
(9) a requirement that the applicant conduct or have conducted a needs
assessment on the basis of which such applicant shall establish the
nature and extent of services to be provided; and further that such
services shall provide a mix of appropriate services that provide active
and meaningful participation for residents;
(10) a requirement that residents to be served shall be involved in
design, implementation, monitoring, evaluation and governance of the
Neighborhood NORC;
(11) an agreement by the applicant that it will participate in the
data collection and evaluation necessary to complete the reporting
requirements as established by the director;
(12) the policy and program roles of the applicant agency and any
other agencies involved in the provision of services or the management
of the Neighborhood NORC, provided that the criteria shall require a
clear delineation of such policy and program roles;
A. 9007--B 71
(13) a requirement that each applicant document the need for the grant
and financial commitments to it from such sources as the advisory
committee and the director shall deem appropriate given the character
and nature of the proposed Neighborhood NORC and written evidence of
support from the community;
(14) the circumstances under which the director may waive all or part
of the requirement for provision of an equal amount of funding from
other sources required pursuant to this subdivision, provided that such
criteria shall include provision for waiver at the discretion of the
director upon a finding by the director that the Neighborhood NORC will
serve a low income or hardship community, and that such waiver is
required to assure that such community receive a fair share of the fund-
ing available. For purposes of this paragraph, a hardship community may
be one that has developed a successful model but which needs additional
time to raise matching funds required herein. An applicant applying for
a hardship exception shall submit a written plan in a form and manner
determined by the director detailing its plans to meet the matching
funds requirement in the succeeding year;
(15) a requirement that any proposed Neighborhood NORC in a geograph-
ically defined neighborhood of a municipality containing more than two
thousand older adults shall require the review and recommendation by the
advisory committee before being approved by the director;
(d) on or before March first, two thousand eight, the director shall
report to the governor and the fiscal and aging committees of the senate
and the assembly concerning the effectiveness of Neighborhood NORCs in
achieving the objectives set forth by this subdivision. Such report
shall address each of the items required for Neighborhood NORCs in
achieving the objectives set forth in this section and such other items
of information as the director shall deem appropriate, including recom-
mendations concerning continuation or modification of the program, and
any recommendations from the advisory committee.
(e) in] GRANTS TO AN ELIGIBLE NEIGHBORHOOD NATURALLY OCCURRING RETIRE-
MENT COMMUNITY SHALL BE NO LESS THAN SIXTY THOUSAND DOLLARS FOR ANY
TWELVE-MONTH PERIOD.
(B) NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, ANY
FUNDING PROVIDED FOR CLASSIC NORCS AND NEIGHBORHOOD NORCS IN ADDITION TO
THE FUNDING ALLOCATED FOR CONTRACTS IN PLACE ON OR BEFORE APRIL FIRST,
TWO THOUSAND SIXTEEN SHALL BE APPORTIONED AS FOLLOWS: (1) HALF OF THE
FUNDING SHALL BE MADE AVAILABLE THROUGH A COMPETITIVE PROCESS FOR
PROGRAMS THAT HAVE AN EXISTING CONTRACT; AND (2) HALF OF THE FUNDING
SHALL BE MADE AVAILABLE THROUGH A COMPETITIVE PROCESS FOR PROPOSALS TO
START NEW PROGRAMS.
6. IN providing program support for [Neighborhood NORCs] NEIGHBORHOOD
NATURALLY OCCURRING RETIREMENT COMMUNITIES as authorized by this subdi-
vision, the director shall in no event divert or transfer funding for
grants or program support from any naturally occurring retirement commu-
nity supportive service programs authorized pursuant to other provisions
of this section.
[6.] 7. The director may allow services provided by a naturally occur-
ring retirement community supportive service program or by a neighbor-
hood naturally occurring retirement community to also include services
to residents who live in neighborhoods contiguous to the boundaries of
the geographic area served by such programs if: (a) the persons served
are older adults; (b) the services affect the health and welfare of such
persons; and (c) the services are provided on a one-time basis in the
year in which they are provided, and not in a manner which is said or
A. 9007--B 72
intended to be continuous. The director may also consent to the
provision of such services by such program if the program has received a
grant which requires services to be provided beyond the geographic boun-
daries of the program. The director shall establish procedures under
which a program may request the ability to provide such services. The
provision of such services shall not affect the funding provided to the
program by the department pursuant to this section.
[7.] 8. The director shall promulgate rules and regulations as neces-
sary to carry out the provisions of this section.
[8.] 9. On or before March first, two thousand [five] EIGHTEEN, AND
EVERY FIVE YEARS THEREAFTER, the director shall report to the governor
and the finance committee of the senate and the ways and means committee
of the assembly concerning the effectiveness of the naturally occurring
retirement community supportive services program[, other than Neighbor-
hood NORCs, as defined in subdivision five-a of this section,] in
achieving the objectives set forth by this section, which include help-
ing to address the needs of residents in such CLASSIC AND NEIGHBORHOOD
naturally occurring retirement communities, assuring access to a contin-
uum of necessary services, increasing private, philanthropic and other
public funding for programs, and preventing unnecessary hospital and
nursing home stays. The report shall also include recommendations
concerning continuation or modification of the program from the director
and the committee, and shall note any divergence between the recommenda-
tions of the director and the committee. The director shall provide the
required information and any other information deemed appropriate to the
report in such form and detail as will be helpful to the legislature and
the governor in determining to extend, eliminate or modify the program
including, but not limited to, the following:
(a) the number, size, type and location of the projects developed and
funded, including the number, kinds and functions of staff in each
program;
(b) the number, size, type and location of the projects proposed but
not funded, and the reasons for denial of funding for such projects;
(c) the age, sex, religion and other appropriate demographic informa-
tion concerning the residents served;
(d) the services provided to residents, reported in such manner as to
allow comparison of services by demographic group and region;
(e) a listing of the services provided by eligible applicants, includ-
ing the number, kind and intensity of such services; and
(f) a listing of other organizations providing services, the number,
kind and intensity of such services, the number of referrals to such
organizations and, to the extent practicable, the outcomes of such
referrals.
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 S of this act shall be
as specifically set forth in the last section of such Parts.
2015-A9007C (ACTIVE) - Details
- See Senate Version of this Bill:
- S6407
- Law Section:
- Budget Bills
- Laws Affected:
- Amd Various Laws, generally
2015-A9007C (ACTIVE) - Summary
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2016-2017 state fiscal year; intentionally omitted (Part A); amends the social services law, in relation to facilitating supplemental rebates for fee-for-service pharmaceuticals, and ambulance medical transportation rate adequacy review; amends the social services law, in relation to authorizing the commissioner of health to apply federally established consumer price index penalties for generic drugs, and authorizing the commissioner of health to impose penalties on managed care plans for reporting late or incorrect encounter data
2015-A9007C (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
S. 6407--C A. 9007--C
S E N A T E - A S S E M B L Y
January 14, 2016
___________
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
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
AN ACT intentionally omitted (Part A); to amend the social services law,
in relation to facilitating supplemental rebates for fee-for-service
pharmaceuticals, and ambulance medical transportation rate adequacy
review; to amend the social services law, in relation to authorizing
the commissioner of health to apply federally established consumer
price index penalties for generic drugs, and authorizing the commis-
sioner of health to impose penalties on managed care plans for report-
ing late or incorrect encounter data; relating to cost-sharing limits
on Medicare part C; to amend part H of chapter 59 of the laws of 2011,
amending the public health law and other laws relating to known and
projected department of health state fund medicaid expenditures, in
relation to reporting requirements for the Medicaid global cap; to
amend the public health law and the social services law, in relation
to the provision of services to certain persons suffering from trau-
matic brain injuries or qualifying for nursing home diversion and
transition services; to amend the public health law, in relation to
rates of payment for certain managed long term care plans; to amend
the social services law, in relation to medical assistance for certain
inmates and authorizing funding for criminal justice pilot program
within health home rates; to amend part H of chapter 59 of the laws of
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD12671-05-6
S. 6407--C 2 A. 9007--C
2011, amending the public health law and other laws relating to known
and projected department of health state fund medicaid expenditures,
in relation to extending the expiration of certain provisions relating
to rates of payment to residential health care facilities based on the
historical costs to the owner, and certain payments to the Citadel
Rehab and Nursing Center at Kingsbridge; to amend the public health
law, in relation to case payment rates for pediatric ventilator
services; directs the commissioner of health to implement a restora-
tive care unit demonstration program; directs the civil service
department to create a title for a medicaid redesign team analyst as a
competitive class position; to amend the social services law and part
C of chapter 60 of the laws of 2014 authorizing the commissioner of
health to negotiate an extension of the terms of the contract executed
by the department of health for actuarial and consulting services, in
relation to the extension of certain contracts; to amend part A of
chapter 56 of the laws of 2013 amending chapter 59 of the laws of 2011
amending the public health law and other laws relating to general
hospital reimbursement for annual rates relating to the cap on local
Medicaid expenditures; to amend chapter 111 of the laws of 2010 relat-
ing to increasing Medicaid payments to providers through managed care
organizations and providing equivalent fees through an ambulatory
patient group methodology, in relation to rate protections for certain
behavioral health providers; and providing for the repeal of certain
provisions upon expiration thereof (Part B); 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 apportioning premium for certain policies; and to amend
part J of chapter 63 of the laws of 2001 amending chapter 266 of the
laws of 1986, amending the civil practice law and rules and other laws
relating to malpractice and professional medical conduct, in relation
to extending certain provisions concerning the hospital excess liabil-
ity pool (Part C); to amend chapter 474 of the laws of 1996, amending
the education law and other laws relating to rates for residential
healthcare facilities, in relation to extending the authority of the
department of health to make disproportionate share payments to public
hospitals outside of New York City; to amend chapter 649 of the laws
of 1996, amending the public health law, the mental hygiene law and
the social services law relating to authorizing the establishment of
special needs plans, in relation to the effectiveness thereof; to
amend chapter 58 of the laws of 2009, amending the public health law
relating to payment by governmental agencies for general hospital
inpatient services, relating to the effectiveness thereof; to amend
the public health law, in relation to temporary operator notification;
to amend chapter 56 of the laws of 2013, amending the public health
law relating to the general public health work program, relating to
the effectiveness thereof; to amend the environmental conservation
law, in relation to cancer incidence and environmental facility maps
project; to amend the public health law, in relation to cancer
mapping; to amend chapter 77 of the laws of 2010, amending the envi-
ronmental conservation law and the public health law relating to an
environmental facility and cancer incidence map, relating to the
effectiveness thereof; to amend chapter 60 of the laws of 2014 amend-
ing the social services law relating to eliminating prescriber
prevails for brand name drugs with generic equivalents, in relation to
the effectiveness thereof; and to repeal subdivision 8 of section 84
of part A of chapter 56 of the laws of 2013, amending the public
S. 6407--C 3 A. 9007--C
health law and other laws relating to general hospital reimbursement
for annual rates, relating thereto (Part D); intentionally omitted
(Part E); relating to grants and loans authorized pursuant to eligible
health care capital programs; and to amend the public health law, in
relation to the health care facility transformation program (Part F);
intentionally omitted (Part G); to amend 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, in relation to the effectiveness thereof (Part H); 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 of certain provisions thereof (Part
I); to amend chapter 420 of the laws of 2002 amending the education
law relating to the profession of social work, in relation to extend-
ing the expiration of certain provisions thereof; to amend chapter 676
of the laws of 2002 amending the education law relating to the prac-
tice of psychology, in relation to extending the expiration of certain
provisions; and to amend chapter 130 of the laws of 2010 amending the
education law and other laws relating to registration of entities
providing certain professional services and licensure of certain
professions, in relation to extending certain provisions thereof (Part
J); intentionally omitted (Part K); to amend the mental hygiene law,
in relation to the appointment of temporary operators for the contin-
ued operation of programs and the provision of services for persons
with serious mental illness and/or developmental disabilities and/or
chemical dependence; and providing for the repeal of certain
provisions upon expiration thereof (Part L); to amend the mental
hygiene law, in relation to sharing clinical records with managed care
organizations (Part M); to amend the facilities development corpo-
ration act, in relation to the definition of mental hygiene facility
(Part N); relating to reports by the office for people with develop-
mental disabilities relating to housing needs; and providing for the
repeal of such provisions upon expiration thereof (Part O); to amend
the mental hygiene law, in relation to services for people with devel-
opmental disabilities (Part P); to amend the mental hygiene law, in
relation to the closure or transfer of a state-operated individualized
residential alternative; and providing for the repeal of such
provisions upon expiration thereof (Part Q); to amend the public
health law and the education law, in relation to electronic
prescriptions; to amend the public health law, in relation to loan
forgiveness and practice support for physicians; to amend the social
services law, in relation to the use of EQUAL program funds for adult
care facilities; to amend the public health law, in relation to policy
changes relating to state aid; to amend the public health law in
relation to the relocation of residential health care facility long-
term ventilator beds; to amend part H of chapter 60 of the laws of
2014, amending the insurance law, the public health law and the finan-
cial services law relating to establishing protections to prevent
surprise medical bills including network adequacy requirements, claim
submission requirements, access to out-of-network care and prohibition
of excessive emergency charges, in relation to the date the report
shall be submitted; and providing for the repeal of certain provisions
upon expiration thereof (Part R); and to amend the elder law, in
relation to the supportive service program for classic and neighbor-
hood naturally occurring retirement communities; and providing for the
repeal of certain provisions upon expiration thereof (Part S)
S. 6407--C 4 A. 9007--C
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 2016-2017
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
Intentionally Omitted
PART B
Section 1. Intentionally omitted.
S 1-a. Ambulance medical transportation rate adequacy review. The
commissioner shall review the rates of reimbursement made through the
medicaid program for ambulance medical transportation for rate adequacy.
By December 31, 2016 the commissioner shall report the findings, of the
rate adequacy review to the temporary president of the senate and the
speaker of the assembly.
S 2. 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 10. Intentionally omitted.
S 11. Subdivision 7 of section 367-a of the social services law is
amended by adding a new paragraph (f) to read as follows:
(F) (1) THE DEPARTMENT MAY REQUIRE MANUFACTURERS OF DRUGS OTHER THAN
SINGLE SOURCE DRUGS AND INNOVATOR MULTIPLE SOURCE DRUGS, AS SUCH TERMS
ARE DEFINED IN 42 U.S.C. S 1396R-8(K), TO PROVIDE REBATES TO THE DEPART-
MENT FOR ANY DRUG THAT HAS INCREASED MORE THAN THREE HUNDRED PERCENT OF
ITS STATE MAXIMUM ACQUISITION COST (SMAC), ON OR AFTER APRIL 1, 2016, IN
COMPARISON TO ITS SMAC AT ANY TIME DURING THE COURSE OF THE PRECEDING
TWELVE MONTHS. THE REQUIRED REBATE SHALL BE LIMITED TO THE AMOUNT BY
WHICH THE CURRENT SMAC FOR THE DRUG EXCEEDS THREE HUNDRED PERCENT OF THE
SMAC FOR THE SAME DRUG AT ANY TIME DURING THE COURSE OF THE PRECEDING
TWELVE MONTHS. SUCH REBATES SHALL BE IN ADDITION TO ANY REBATES PAYABLE
TO THE DEPARTMENT PURSUANT TO ANY OTHER PROVISION OF FEDERAL OR STATE
LAW. NOTHING HEREIN SHALL AFFECT THE DEPARTMENT'S OBLIGATION TO REIM-
BURSE FOR COVERED OUTPATIENT DRUGS PURSUANT TO PARAGRAPH (D) OF THIS
SUBDIVISION.
(2) EXCEPT AS PROVIDED IN SUBPARAGRAPH THREE OF THIS PARAGRAPH, THE
COMMISSIONER SHALL NOT DETERMINE ANY FURTHER REBATES TO BE PAYABLE
PURSUANT TO THIS PARAGRAPH ONCE THE CENTERS FOR MEDICARE AND MEDICAID
S. 6407--C 5 A. 9007--C
SERVICES HAS ADOPTED A FINAL METHODOLOGY FOR DETERMINING THE AMOUNT OF
ADDITIONAL REBATES UNDER THE FEDERAL GENERIC DRUG PRICE INCREASE REBATE
PROGRAM PURSUANT TO 42 U.S.C. S 1396R-8 (C)(3), AS AMENDED BY SECTION
602 OF THE BIPARTISAN BUDGET ACT OF 2015.
(3) DURING STATE FISCAL YEAR 2016-2017, IF THE CENTERS FOR MEDICARE
AND MEDICAID SERVICES HAS ADOPTED A FINAL METHODOLOGY FOR DETERMINING
THE AMOUNT OF ADDITIONAL REBATES UNDER THE FEDERAL GENERIC DRUG PRICE
INCREASE REBATE PROGRAM PURSUANT TO 42 U.S.C. S 1396R-8 (C)(3), AS
AMENDED BY SECTION 602 OF THE BIPARTISAN BUDGET ACT OF 2015, THE DEPART-
MENT MAY COLLECT FOR A GIVEN DRUG THE PORTION OF THE REBATE DETERMINED
UNDER THIS PARAGRAPH THAT IS IN EXCESS OF THE REBATE REQUIRED BY SUCH
FEDERAL REBATE PROGRAM.
(4) THE ADDITIONAL REBATES AUTHORIZED PURSUANT TO THIS PARAGRAPH SHALL
APPLY TO GENERIC PRESCRIPTION DRUGS DISPENSED TO ENROLLEES OF MANAGED
CARE PROVIDERS PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS
TITLE AND TO GENERIC PRESCRIPTION DRUGS DISPENSED TO MEDICAID RECIPIENTS
WHO ARE NOT ENROLLEES OF SUCH PROVIDERS.
(5) BEGINNING IN TWO THOUSAND SEVENTEEN, THE DEPARTMENT SHALL PROVIDE
AN ANNUAL REPORT TO THE LEGISLATURE NO LATER THAN FEBRUARY FIRST SETTING
FORTH:
(I) THE NUMBER OF DRUGS THAT EXCEEDED THE CEILING PRICE ESTABLISHED IN
THIS PARAGRAPH DURING THE PRECEDING YEAR IN COMPARISON TO THE NUMBER OF
DRUGS THAT EXPERIENCED AT LEAST A THREE HUNDRED PERCENT PRICE INCREASE
DURING TWO THOUSAND FOURTEEN AND TWO THOUSAND FIFTEEN;
(II) THE AVERAGE PERCENT AMOUNT ABOVE THE CEILING PRICE OF DRUGS THAT
EXCEEDED THE CEILING PRICE IN THE PRECEDING YEAR IN COMPARISON TO THE
NUMBER OF DRUGS THAT EXPERIENCED A PRICE INCREASE MORE THAN THREE
HUNDRED PERCENT DURING TWO THOUSAND FOURTEEN AND TWO THOUSAND FIFTEEN;
(III) THE NUMBER OF GENERIC DRUGS AVAILABLE TO ENROLLEES IN MEDICAID
FEE FOR SERVICE OR MEDICAID MANAGED CARE, BY FISCAL QUARTER, IN THE
PRECEDING YEAR IN COMPARISON TO THE DRUGS AVAILABLE, BY FISCAL QUARTER,
DURING TWO THOUSAND FOURTEEN AND TWO THOUSAND FIFTEEN; AND
(IV) THE TOTAL DRUG SPEND ON GENERIC DRUGS FOR THE PRECEDING YEAR IN
COMPARISON TO THE TOTAL DRUG SPEND ON GENERIC DRUGS DURING TWO THOUSAND
FOURTEEN AND TWO THOUSAND FIFTEEN.
S 12. The opening paragraph of paragraph (e) of subdivision 7 of
section 367-a of the social services law, as added by section 1 of part
B of chapter 57 of the laws of 2015, is amended to read as follows:
During the period from April first, two thousand fifteen through March
thirty-first, two thousand seventeen, the commissioner may, in lieu of a
managed care provider, negotiate directly and enter into an agreement
with a pharmaceutical manufacturer for the provision of supplemental
rebates relating to pharmaceutical utilization by enrollees of managed
care providers pursuant to section three hundred sixty-four-j of this
title AND MAY ALSO NEGOTIATE DIRECTLY AND ENTER INTO SUCH AN AGREEMENT
RELATING TO PHARMACEUTICAL UTILIZATION BY MEDICAL ASSISTANCE RECIPIENTS
NOT SO ENROLLED. Such rebates shall be limited to drug utilization in
the following classes: antiretrovirals approved by the FDA for the
treatment of HIV/AIDS and hepatitis C agents for which the pharmaceu-
tical manufacturer has in effect a rebate agreement with the federal
secretary of health and human services pursuant to 42 U.S.C. S 1396r-8,
and for which the state has established standard clinical criteria. No
agreement entered into pursuant to this paragraph shall have an initial
term or be extended beyond March thirty-first, two thousand twenty.
S. 6407--C 6 A. 9007--C
S 13. Subparagraph (iv) of paragraph (e) of subdivision 7 of section
367-a of the social services law, as added by section 1 of part B of
chapter 57 of the laws of 2015, is amended to read as follows:
(iv) Nothing in this paragraph shall be construed to require a pharma-
ceutical manufacturer to enter into a supplemental rebate agreement with
the commissioner relating to pharmaceutical utilization by enrollees of
managed care providers pursuant to section three hundred sixty-four-j of
this title OR RELATING TO PHARMACEUTICAL UTILIZATION BY MEDICAL ASSIST-
ANCE RECIPIENTS NOT SO ENROLLED.
S 14. Section 364-j of the social services law is amended by adding a
new subdivision 26-a to read as follows:
26-A. MANAGED CARE PROVIDERS SHALL REQUIRE PRIOR AUTHORIZATION OF
PRESCRIPTIONS OF OPIOID ANALGESICS IN EXCESS OF FOUR PRESCRIPTIONS IN A
THIRTY-DAY PERIOD, PROVIDED, HOWEVER, THAT THIS SUBDIVISION SHALL NOT
APPLY IF THE PATIENT IS A RECIPIENT OF HOSPICE CARE, HAS A DIAGNOSIS OF
CANCER OR SICKLE CELL DISEASE, OR ANY OTHER CONDITION OR DIAGNOSIS FOR
WHICH THE COMMISSIONER OF HEALTH DETERMINES PRIOR AUTHORIZATION IS NOT
REQUIRED.
S 15. Section 364-j of the social services law is amended by adding a
new subdivision 32 to read as follows:
32. (A) THE COMMISSIONER MAY, IN HIS OR HER DISCRETION, APPLY PENAL-
TIES TO MANAGED CARE ORGANIZATIONS SUBJECT TO THIS SECTION AND ARTICLE
FORTY-FOUR OF THE PUBLIC HEALTH LAW, INCLUDING MANAGED LONG TERM CARE
PLANS, FOR UNTIMELY OR INACCURATE SUBMISSION OF ENCOUNTER DATA; PROVIDED
HOWEVER, NO PENALTY SHALL BE ASSESSED IF THE MANAGED CARE ORGANIZATION
SUBMITS, IN GOOD FAITH, TIMELY AND ACCURATE DATA THAT IS NOT SUCCESSFUL-
LY RECEIVED BY THE DEPARTMENT AS A RESULT OF DEPARTMENT SYSTEM FAILURES
OR TECHNICAL ISSUES THAT ARE BEYOND THE CONTROL OF THE MANAGED CARE
ORGANIZATION.
(B) THE COMMISSIONER SHALL CONSIDER THE FOLLOWING PRIOR TO ASSESSING A
PENALTY AGAINST A MANAGED CARE ORGANIZATION AND HAVE THE DISCRETION TO
REDUCE OR ELIMINATE A PENALTY:
(I) THE DEGREE TO WHICH THE DATA SUBMITTED IS INACCURATE AND THE
FREQUENCY OF INACCURATE DATA SUBMISSIONS BY THE MANAGED CARE ORGANIZA-
TION;
(II) THE DEGREE TO WHICH THE DATA SUBMITTED IS UNTIMELY AND THE
FREQUENCY OF UNTIMELY DATA SUBMISSIONS BY THE MANAGED CARE ORGANIZATION;
(III) THE TIMELINESS OF THE MANAGED CARE ORGANIZATION IN CURING OR
CORRECTING INACCURATE OR UNTIMELY DATA;
(IV) WHETHER THE UNTIMELY OR INACCURATE DATA WAS SUBMITTED BY THE
MANAGED CARE ORGANIZATION OR A THIRD PARTY;
(V) WHETHER THE MANAGED CARE ORGANIZATION HAS TAKEN CORRECTIVE ACTION
TO REDUCE THE LIKELIHOOD OF FUTURE INACCURATE OR UNTIMELY DATA
SUBMISSIONS; AND
(VI) WHETHER THE MANAGED CARE ORGANIZATION WAS OR SHOULD HAVE BEEN
AWARE OF INACCURATE OR UNTIMELY DATA.
FOR PURPOSES OF THIS SECTION, "ENCOUNTER DATA" SHALL MEAN THE TRANS-
ACTIONS REQUIRED TO BE REPORTED UNDER THE MODEL CONTRACT. ANY PENALTY
ASSESSED UNDER THIS SUBDIVISION SHALL BE CALCULATED AS A PERCENTAGE OF
THE ADMINISTRATIVE COMPONENT OF THE MEDICAID PREMIUM CALCULATED BY THE
DEPARTMENT.
(C) SUCH PENALTIES SHALL BE AS FOLLOWS:
(I) FOR ENCOUNTER DATA SUBMITTED OR RESUBMITTED PAST THE DEADLINES SET
FORTH IN THE MODEL CONTRACT, MEDICAID PREMIUMS SHALL BE REDUCED BY ONE
AND ONE-HALF PERCENT; AND
S. 6407--C 7 A. 9007--C
(II) FOR INCOMPLETE OR INACCURATE ENCOUNTER DATA THAT FAILS TO CONFORM
TO DEPARTMENT DEVELOPED BENCHMARKS FOR COMPLETENESS AND ACCURACY, MEDI-
CAID PREMIUMS SHALL BE REDUCED BY ONE-HALF PERCENT; AND
(III) FOR SUBMITTED DATA THAT RESULTS IN A REJECTION RATE IN EXCESS OF
TEN PERCENT OF DEPARTMENT DEVELOPED VOLUME BENCHMARKS, MEDICAID PREMIUMS
SHALL BE REDUCED BY ONE-HALF PERCENT.
(D) PENALTIES UNDER THIS SUBDIVISION MAY BE APPLIED TO ANY AND ALL
CIRCUMSTANCES DESCRIBED IN PARAGRAPH (B) OF THIS SUBDIVISION UNTIL THE
MANAGED CARE ORGANIZATION COMPLIES WITH THE REQUIREMENTS FOR SUBMISSION
OF ENCOUNTER DATA. NO PENALTIES FOR LATE, INCOMPLETE OR INACCURATE
ENCOUNTER DATA SHALL BE ASSESSED AGAINST MANAGED CARE ORGANIZATIONS IN
ADDITION TO THOSE PROVIDED FOR IN THIS SUBDIVISION.
S 16. Paragraph (d) of subdivision 1 of section 367-a of the social
services law is amended by adding a new subparagraph (iv) to read as
follows:
(IV) IF A HEALTH PLAN PARTICIPATING IN PART C OF TITLE XVIII OF THE
FEDERAL SOCIAL SECURITY ACT PAYS FOR ITEMS AND SERVICES PROVIDED TO
ELIGIBLE PERSONS WHO ARE ALSO BENEFICIARIES UNDER PART B OF TITLE XVIII
OF THE FEDERAL SOCIAL SECURITY ACT OR TO QUALIFIED MEDICARE BENEFICI-
ARIES, THE AMOUNT PAYABLE FOR SERVICES UNDER THIS TITLE SHALL BE EIGHT-
Y-FIVE PERCENT OF THE AMOUNT OF ANY CO-INSURANCE LIABILITY OF SUCH
ELIGIBLE PERSONS PURSUANT TO FEDERAL LAW IF THEY WERE NOT ELIGIBLE FOR
MEDICAL ASSISTANCE OR WERE NOT QUALIFIED MEDICARE BENEFICIARIES WITH
RESPECT TO SUCH BENEFITS UNDER SUCH PART B; PROVIDED, HOWEVER, AMOUNTS
PAYABLE UNDER THIS TITLE FOR ITEMS AND SERVICES PROVIDED TO ELIGIBLE
PERSONS WHO ARE ALSO BENEFICIARIES UNDER PART B OR TO QUALIFIED MEDICARE
BENEFICIARIES BY AN AMBULANCE SERVICE UNDER THE AUTHORITY OF AN OPERAT-
ING CERTIFICATE ISSUED PURSUANT TO ARTICLE THIRTY OF THE PUBLIC HEALTH
LAW, OR A PSYCHOLOGIST LICENSED UNDER ARTICLE ONE HUNDRED FIFTY-THREE OF
THE EDUCATION LAW, SHALL NOT BE LESS THAN THE AMOUNT OF ANY CO-INSURANCE
LIABILITY OF SUCH ELIGIBLE PERSONS OR SUCH QUALIFIED MEDICARE BENEFICI-
ARIES, OR FOR WHICH SUCH ELIGIBLE PERSONS OR SUCH QUALIFIED MEDICARE
BENEFICIARIES WOULD BE LIABLE UNDER FEDERAL LAW WERE THEY NOT ELIGIBLE
FOR MEDICAL ASSISTANCE OR WERE THEY NOT QUALIFIED MEDICARE BENEFICIARIES
WITH RESPECT TO SUCH BENEFITS UNDER PART B.
S 17. Subdivision 2-b of section 365-l of the social services law, as
added by section 25 of part B of chapter 57 of the laws of 2015, is
amended to read as follows:
2-b. The commissioner is authorized to make [grants] LUMP SUM
PAYMENTS OR ADJUST RATES OF PAYMENT TO PROVIDERS up to a gross amount of
five million dollars, to establish coordination between the health homes
and the criminal justice system and for the integration of information
of health homes with state and local correctional facilities, to the
extent permitted by law. SUCH RATE ADJUSTMENTS MAY BE MADE TO HEALTH
HOMES PARTICIPATING IN A CRIMINAL JUSTICE PILOT PROGRAM WITH THE PURPOSE
OF ENROLLING INCARCERATED INDIVIDUALS WITH SERIOUS MENTAL ILLNESS, TWO
OR MORE CHRONIC CONDITIONS, INCLUDING SUBSTANCE ABUSE DISORDERS, OR
HIV/AIDS, INTO SUCH HEALTH HOME. Health homes receiving funds under this
subdivision shall be required to document and demonstrate the effective
use of funds distributed herein.
S 18. 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 fund medicaid expenditures, as
amended by section 8 of part B of chapter 57 of the laws of 2015, is
amended to read as follows:
S. 6407--C 8 A. 9007--C
1. For state fiscal years 2011-12 through [2016-17] 2017-18, 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 and state costs or savings from
the basic health plan. Such projections may be adjusted by the director
of the budget to account for increased or expedited department of health
state funds medicaid expenditures as a result of a natural or other type
of disaster, including a governmental declaration of emergency.
S 19. Subdivision 5 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 fund medicaid expenditures, is
amended by adding a new paragraph (g) to read as follows:
(G) ANY MATERIAL IMPACT TO THE GLOBAL CAP ANNUAL PROJECTION, ALONG
WITH AN EXPLANATION OF THE VARIANCE FROM THE PROJECTION AT THE TIME OF
THE ENACTED BUDGET. SUCH MATERIAL IMPACTS SHALL INCLUDE, BUT NOT BE
LIMITED TO, POLICY AND PROGRAMMATIC CHANGES, SIGNIFICANT TRANSACTIONS,
AND ANY ACTIONS TAKEN, ADMINISTRATIVE OR OTHERWISE, WHICH WOULD MATE-
RIALLY IMPACT EXPENDITURES UNDER THE GLOBAL CAP. REPORTING REQUIREMENTS
UNDER THIS PARAGRAPH SHALL INCLUDE MATERIAL IMPACTS FROM THE PRECEDING
MONTH AND ANY ANTICIPATED MATERIAL IMPACTS FOR THE MONTH IN WHICH THE
REPORT REQUIRED UNDER THIS SUBDIVISION IS ISSUED, AS WELL AS ANTICIPATED
MATERIAL IMPACTS FOR THE MONTH SUBSEQUENT TO SUCH REPORT.
S 20. Clauses 2 and 3 of subparagraph (v) of paragraph (b) of subdivi-
sion 7 of section 4403-f of the public health law, as amended by section
48 of part A of chapter 56 of the laws of 2013, are amended and four new
subparagraphs (v-a), (v-b), (v-c), and (v-d) are added to read as
follows:
(2) a participant in the traumatic brain injury waiver program OR A
PERSON WHOSE CIRCUMSTANCES WOULD QUALIFY HIM OR HER FOR THE PROGRAM AS
IT EXISTED ON JANUARY FIRST, TWO THOUSAND FIFTEEN;
(3) a participant in the nursing home transition and diversion waiver
program OR A PERSON WHOSE CIRCUMSTANCES WOULD QUALIFY HIM OR HER FOR THE
PROGRAM AS IT EXISTED ON JANUARY FIRST, TWO THOUSAND FIFTEEN;
(V-A) FOR PURPOSES OF CLAUSE TWO OF SUBPARAGRAPH (V) OF THIS PARA-
GRAPH, PROGRAM FEATURES SHALL BE SUBSTANTIALLY COMPARABLE TO THOSE
SERVICES AVAILABLE TO TRAUMATIC BRAIN INJURY WAIVER PARTICIPANTS AS OF
JANUARY FIRST, TWO THOUSAND FIFTEEN, SUBJECT TO FEDERAL FINANCIAL
PARTICIPATION.
S. 6407--C 9 A. 9007--C
(V-B) FOR PURPOSES OF CLAUSE THREE OF SUBPARAGRAPH (V) OF THIS PARA-
GRAPH, PROGRAM FEATURES SHALL BE SUBSTANTIALLY COMPARABLE TO THOSE
SERVICES OFFERED TO NURSING HOME TRANSITION AND DIVERSION WAIVER PARTIC-
IPANTS AS OF JANUARY FIRST, TWO THOUSAND FIFTEEN, SUBJECT TO FEDERAL
FINANCIAL PARTICIPATION.
(V-C) ANY MANAGED CARE PROGRAM PROVIDING SERVICES UNDER CLAUSE TWO OR
THREE OF SUBPARAGRAPH (V) OF THIS PARAGRAPH SHALL HAVE AN ADEQUATE
NETWORK OF TRAINED PROVIDERS TO MEET THE NEEDS OF ENROLLEES AND PROVIDE
SERVICES UNDER THIS SUBDIVISION.
(V-D) ANY INDIVIDUAL PROVIDING SERVICE COORDINATION PURSUANT TO
SUBPARAGRAPH (V-A) OR (V-B) OF THIS PARAGRAPH SHALL EXERCISE HIS OR HER
PROFESSIONAL DUTIES IN THE INTERESTS OF THE PATIENT. NOTHING IN THIS
SUBPARAGRAPH SHALL BE CONSTRUED AS DIMINISHING THE AUTHORITY AND OBLI-
GATIONS OF A MANAGED LONG TERM CARE PLAN UNDER THIS ARTICLE AND ARTICLE
FORTY-NINE OF THIS CHAPTER.
S 20-a. Subdivision 3 of section 364-j of the social services law is
amended by adding a new paragraph (d-2) to read as follows:
(D-2) SERVICES PROVIDED PURSUANT TO WAIVERS, GRANTED PURSUANT TO
SUBSECTION (C) OF SECTION 1915 OF THE FEDERAL SOCIAL SECURITY ACT, TO
PERSONS SUFFERING FROM TRAUMATIC BRAIN INJURIES OR QUALIFYING FOR NURS-
ING HOME DIVERSION AND TRANSITION SERVICES, SHALL NOT BE PROVIDED TO
MEDICAL ASSISTANCE RECIPIENTS THROUGH MANAGED CARE PROGRAMS UNTIL AT
LEAST JANUARY FIRST, TWO THOUSAND EIGHTEEN.
S 21. Subdivision 8 of section 4403-f of the public health law, as
amended by section 40-a of part B of chapter 57 of the laws of 2015, 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.
Payment rates shall be risk-adjusted to take into account the character-
istics of enrollees, or proposed enrollees, including, but not limited
to: frailty, disability level, health and functional status, age,
gender, the nature of services provided to such enrollees, and other
factors as 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. In setting
such payment rates, the commissioner shall consider costs borne by the
managed care program to ensure actuarially sound and adequate rates of
payment to ensure quality of care SHALL COMPLY WITH ALL APPLICABLE LAWS
AND REGULATIONS, STATE AND FEDERAL, INCLUDING REGULATIONS AS TO ACTUARI-
AL SOUNDNESS FOR MEDICAID MANAGED CARE.
S 21-a. Subdivision 1-a of section 366 of the social services law, as
added by chapter 355 of the laws of 2007, is amended to read as follows:
1-a. Notwithstanding any other provision of law, in the event that a
person who is an inmate of a state or local correctional facility, as
defined in section two of the correction law, was in receipt of medical
assistance pursuant to this title immediately prior to being admitted to
such facility, such person shall remain eligible for medical assistance
while an inmate, except that no medical assistance shall be furnished
pursuant to this title for any care, services, or supplies provided
S. 6407--C 10 A. 9007--C
during such time as the person is an inmate; provided, however, that
nothing herein shall be deemed as preventing the provision of medical
assistance for inpatient hospital services furnished to an inmate at a
hospital outside of the premises of such correctional facility OR PURSU-
ANT TO OTHER FEDERAL AUTHORITY AUTHORIZING THE PROVISION OF MEDICAL
ASSISTANCE TO AN INMATE OF A STATE OR LOCAL CORRECTIONAL FACILITY DURING
THE THIRTY DAYS PRIOR TO RELEASE, to the extent that federal financial
participation is available for the costs of such services. Upon release
from such facility, such person shall continue to be eligible for
receipt of medical assistance furnished pursuant to this title until
such time as the person is determined to no longer be eligible for
receipt of such assistance. To the extent permitted by federal law, the
time during which such person is an inmate shall not be included in any
calculation of when the person must recertify his or her eligibility for
medical assistance in accordance with this article. THE STATE MAY SEEK
FEDERAL AUTHORITY TO PROVIDE MEDICAL ASSISTANCE FOR TRANSITIONAL
SERVICES INCLUDING BUT NOT LIMITED TO MEDICAL, PRESCRIPTION, AND CARE
COORDINATION SERVICES FOR HIGH NEEDS INMATES IN STATE AND LOCAL CORREC-
TIONAL FACILITIES DURING THE THIRTY DAYS PRIOR TO RELEASE.
S 22. Notwithstanding any provision of law to the contrary, for rate
periods from April 1, 2016 through March 31, 2046, The Citadel Rehab and
Nursing Center at Kingsbridge, located at 3400 Cannon Place, Bronx, New
York 10463, shall receive one million dollars, annually, for the purpose
of reimbursing expenses related to a facility purchased and transferred
immediately following the operation of such facility under a court-ord-
ered receivership. Such reimbursement shall be state only Medicaid
payments and subject to cash receipts assessment, equity withdrawal
limitations and any other provisions of section 2808 of the public
health law that does not implicate capital reimbursement, and such
reimbursement shall be in addition to real property costs otherwise
reimbursable pursuant to section 2808 of the public health law.
S 23. Subparagraph (i) of paragraph (e-2) of subdivision 4 of section
2807-c of the public health law, as added by section 13 of part C of
chapter 58 of the laws of 2009, is amended to read as follows:
(i) For physical medical rehabilitation services and for chemical
dependency rehabilitation services, the operating cost component of such
rates shall reflect the use of two thousand five operating costs for
each respective category of services as reported by each facility to the
department prior to July first, two thousand nine and as adjusted for
inflation pursuant to paragraph (c) of subdivision ten of this section,
as otherwise modified by any applicable statute, provided, however, that
such two thousand five reported operating costs, but not including
reported direct medical education cost, shall, for rate-setting
purposes, be held to a ceiling of one hundred ten percent of the average
of such reported costs in the region in which the facility is located,
as determined pursuant to clause (E) of subparagraph [(iii)] (IV) of
paragraph (1) of this subdivision; AND PROVIDED, FURTHER, THAT FOR PHYS-
ICAL MEDICAL REHABILITATION SERVICES, THE COMMISSIONER IS AUTHORIZED TO
MAKE ADJUSTMENTS TO SUCH RATES FOR THE PURPOSES OF REIMBURSING PEDIATRIC
VENTILATOR SERVICES.
S 24. Restorative care unit demonstration program. 1. Notwithstanding
any law, rule or regulation to the contrary, the commissioner of health,
within amounts appropriated, shall implement a restorative care unit
demonstration program within one year of the effective date of this
section to reduce hospital admissions and readmissions from residential
health care facilities established pursuant to article 28 of the public
S. 6407--C 11 A. 9007--C
health law, through the establishment of restorative care units. Such
units shall provide higher-intensity treatment services for residents
who are at risk of hospitalization upon an acute change in condition,
and seek to improve the capacity of nursing facilities to identify and
treat higher acuity patients with multiple co-morbidities as effectively
as possible in-situ, rather than through admission to an acute care
facility. The unit shall utilize evidence based tools, as well as: (a) a
critical indicator monitoring system to evaluate performance indicators;
(b) patient-focused education to support advanced care planning and
palliative care decisions; and (c) protocols to effect care monitoring
practices designed to reduce the likelihood of change in patient status
conditions that may require acute care evaluation. A residential health
care facility, established pursuant to article 28 of the public health
law, wishing to establish restorative care units must contract with an
eligible applicant.
2. For the purposes of this section, an eligible applicant must at a
minimum meet the following criteria: (a) be a New York state entity in
good standing; and (b) have demonstrated experience and capacity in
developing and implementing a similar unit as described herein. An
eligible applicant for this demonstration program shall contract with a
residential health care facility, established pursuant to article 28 of
the public health law, with a license in good standing that: (i) employs
a nursing home administrator with at least two years operational experi-
ence; (ii) has a minimum of 160 certified beds; (iii) accepts reimburse-
ment pursuant to title XVIII and title XIX of the federal social securi-
ty act; (iv) has achieved at least a three star overall nursing home
compare rating from the Center for Medicare and Medicaid Services five-
star quality rating system; and (v) operates a discreet dedicated
restorative care unit with a minimum of 18 beds. Additionally, the
contracting facility must have at the time of application, and maintain
during the course of the demonstration, functional wireless internet
connectivity throughout the facility, including backup, with sufficient
bandwidth to support technological monitoring.
3. Restorative care units; requirements. Restorative care units shall
provide on-site healthcare services, including, but not limited to: (a)
radiology; (b) peripherally inserted central catheter insertion; (c)
blood sugar, hemoglobin/hematocrit, electrolytes and blood gases moni-
toring; (d) 12-lead transmissible electrocardiograms; (e) specialized
cardiac services, including rapid response teams, crash carts, and defi-
brillators; (f) telemedicine and telemetry which shall have the capabil-
ity to notify the user, in real time, when an urgent or emergent physio-
logical change has occurred in a patient's condition requiring
intervention, and to generate reports that can be accessed by any
provider, in real time, in any location to allow for immediate clinical
intervention.
4. Electronic health records. For the duration of the demonstration,
the restorative care unit shall utilize and maintain an electronic
health record system that connects to the local regional health informa-
tion organization to facilitate the exchange of health information.
5. The department of health shall monitor the quality and effective-
ness of the demonstration program in reducing hospital admissions and
readmissions over a three year period and shall report to the legisla-
ture, within one year of implementation, on the demonstration program's
effectiveness in providing a higher level of care at lower cost, and
include recommendations regarding the utilization of the restorative
care unit model in the state.
S. 6407--C 12 A. 9007--C
S 25. Within one hundred twenty (120) days of the effective date of
this section, the department of civil service, in consultation with the
department of health, shall create a new title or titles and a new title
series, for a Medicaid Redesign Team Analyst, as a permanent competitive
class. The Medicaid Redesign Team Analyst series will be responsible for
programmatic duties related to health insurance program initiatives such
as implementation of new program initiative tasks, compliance monitoring
and providing technical assistance to state agencies and health care
providers.
S 26. Notwithstanding any inconsistent provision of sections 112 and
163 of the state finance law, or sections 142 and 143 of the economic
development law, or any other contrary provision of law, excepting the
responsible vendor requirements of the state finance law, including, but
not limited to, sections 163 and 139-k of the state finance law, the
commissioner of health is authorized to amend or otherwise extend the
terms of a contract awarded prior to the effective date and entered into
pursuant to subdivision 24 of section 206 of the public health law, as
added by section 39 of part C of chapter 58 of the laws of 2008, and a
contract awarded prior to the effective date and entered into to conduct
enrollment broker and conflict-free evaluation services for the Medicaid
program, both for a period of three years, without a competitive bid or
request for proposal process, upon determination that the existing
contractor is qualified to continue to provide such services, and
provided that efficiency savings are achieved during the period of
extension; and provided, further, that the department of health shall
submit a request for applications for such contract during the time
period specified in this section and may terminate the contract identi-
fied herein prior to expiration of the extension authorized by this
section.
S 27. Section 48 of part C of chapter 60 of the laws of 2014, author-
izing the commissioner of health to negotiate an extension of the terms
of the contract executed by the department of health for actuarial and
consulting services, is amended to read as follows:
S 48. Notwithstanding sections 112 and 163 of the state finance law,
EXCEPTING THE RESPONSIBLE VENDOR REQUIREMENTS OF THE STATE FINANCE LAW,
INCLUDING, BUT NOT LIMITED TO, SECTIONS 163 AND 139-K OF THE STATE
FINANCE LAW, or any other contrary provision of law, the commissioner of
health is authorized to negotiate an extension of the terms of the
contract executed by the department of health for actuarial and consult-
ing services, on September 18, 2009, without a competitive bid or
request for proposal process; provided, however, such extension shall
not extend beyond December 31, [2016] 2017; PROVIDED, HOWEVER, THAT THE
DEPARTMENT OF HEALTH SHALL SUBMIT A REQUEST FOR APPLICATIONS FOR SUCH
CONTRACT DURING THE TIME PERIOD SPECIFIED IN THIS SECTION AND MAY TERMI-
NATE THE CONTRACT IDENTIFIED HEREIN PRIOR TO EXPIRATION OF THE EXTENSION
AUTHORIZED BY THIS SECTION.
S 28. Subdivision 9 of section 365-l of the social services law, as
amended by section 35 of part C of chapter 60 of the laws of 2014, is
amended to read as follows:
9. The contract entered into by the commissioner of health prior to
January first, two thousand thirteen pursuant to subdivision eight of
this section may be amended or modified without the need for a compet-
itive bid or request for proposal process, and without regard to the
provisions of sections one hundred twelve and one hundred sixty-three of
the state finance law, section one hundred forty-two of the economic
development law, or any other provision of law, EXCEPTING THE RESPONSI-
S. 6407--C 13 A. 9007--C
BLE VENDOR REQUIREMENTS OF THE STATE FINANCE LAW, INCLUDING, BUT NOT
LIMITED TO, SECTIONS ONE HUNDRED SIXTY-THREE AND ONE HUNDRED
THIRTY-NINE-K OF THE STATE FINANCE LAW, to allow the purchase of addi-
tional personnel and services, subject to available funding, for the
limited purpose of assisting the department of health with implementing
the Balancing Incentive Program, the Fully Integrated Duals Advantage
Program, the Vital Access Provider Program, the Medicaid waiver amend-
ment associated with the public hospital transformation, the addition of
behavioral health services as a managed care plan benefit, the delivery
system reform incentive payment plan, activities to facilitate the tran-
sition of vulnerable populations to managed care and/or any workgroups
required to be established by the chapter of the laws of two thousand
thirteen that added this subdivision. THE DEPARTMENT IS AUTHORIZED TO
EXTEND SUCH CONTRACT FOR A PERIOD OF ONE YEAR, WITHOUT A COMPETITIVE BID
OR REQUEST FOR PROPOSAL PROCESS, UPON DETERMINATION THAT THE EXISTING
CONTRACTOR IS QUALIFIED TO CONTINUE TO PROVIDE SUCH SERVICES; PROVIDED,
HOWEVER, THAT THE DEPARTMENT OF HEALTH SHALL SUBMIT A REQUEST FOR APPLI-
CATIONS FOR SUCH CONTRACT DURING THE TIME PERIOD SPECIFIED IN THIS
SUBDIVISION AND MAY TERMINATE THE CONTRACT IDENTIFIED HEREIN PRIOR TO
EXPIRATION OF THE EXTENSION AUTHORIZED BY THIS SUBDIVISION.
S 29. Section 48-a of part A of chapter 56 of the laws of 2013 amend-
ing chapter 59 of the laws of 2011 amending the public health law and
other laws relating to general hospital reimbursement for annual rates
relating to the cap on local Medicaid expenditures, as amended by
section 1 of part C of chapter 57 of the laws of 2015, is amended to
read as follows:
S 48-a. 1. Notwithstanding any contrary provision of law, the commis-
sioners of the office of alcoholism and substance abuse services and the
office of mental health are authorized, subject to the approval of the
director of the budget, to transfer to the commissioner of health state
funds to be utilized as the state share for the purpose of increasing
payments under the medicaid program to managed care organizations
licensed under article 44 of the public health law or under article 43
of the insurance law. Such managed care organizations shall utilize such
funds for the purpose of reimbursing providers licensed pursuant to
article 28 of the public health law or article 31 or 32 of the mental
hygiene law for ambulatory behavioral health services, as determined by
the commissioner of health, in consultation with the commissioner of
alcoholism and substance abuse services and the commissioner of the
office of mental health, provided to medicaid eligible outpatients. Such
reimbursement shall be in the form of fees for such services which are
equivalent to the payments established for such services under the ambu-
latory patient group (APG) rate-setting methodology as utilized by the
department of health, the office of alcoholism and substance abuse
services, or the office of mental health for rate-setting purposes;
provided, however, that the increase to such fees that shall result from
the provisions of this section shall not, in the aggregate and as deter-
mined by the commissioner of health, in consultation with the commis-
sioner of alcoholism and substance abuse services and the commissioner
of the office of mental health, be greater than the increased funds made
available pursuant to this section. The increase of such ambulatory
behavioral health fees to providers available under this section shall
be for all rate periods on and after the effective date of section [13]
1 of part C of chapter [60] 57 of the laws of [2014] 2015 through [June
30, 2017] MARCH 31, 2018 for patients in the city of New York, for all
rate periods on and after the effective date of section [13] 1 of part C
S. 6407--C 14 A. 9007--C
of chapter [60] 57 of the laws of [2014] 2015 through [December 31,
2017] JUNE 30, 2018 for patients outside the city of New York, and for
all rate periods on and after the effective date of such chapter through
[December 31, 2017] JUNE 30, 2018 for all services provided to persons
under the age of twenty-one; provided, however, [that managed] ELIGIBLE
PROVIDERS MAY WORK WITH MANAGED CARE PLANS TO ACHIEVE QUALITY AND EFFI-
CIENCY OBJECTIVES AND ENGAGE IN SHARED SAVINGS. NOTHING IN THIS SECTION
SHALL PROHIBIT MANAGED care organizations and providers [may negotiate]
FROM NEGOTIATING different rates and methods of payment during such
periods described above, subject to the approval of the department of
health. The department of health shall consult with the office of alco-
holism and substance abuse services and the office of mental health in
determining whether such alternative rates shall be approved. The
commissioner of health may, in consultation with the commissioner of
alcoholism and substance abuse services and the commissioner of the
office of mental health, promulgate regulations, including emergency
regulations promulgated prior to October 1, 2015 to establish rates for
ambulatory behavioral health services, as are necessary to implement the
provisions of this section. Rates promulgated under this section shall
be included in the report required under section 45-c of part A of this
chapter.
2. Notwithstanding any contrary provision of law, the fees paid by
managed care organizations licensed under article 44 of the public
health law or under article 43 of the insurance law, to providers
licensed pursuant to article 28 of the public health law or article 31
or 32 of the mental hygiene law, for ambulatory behavioral health
services provided to patients enrolled in the child health insurance
program pursuant to title one-A of article 25 of the public health law,
shall be in the form of fees for such services which are equivalent to
the payments established for such services under the ambulatory patient
group (APG) rate-setting methodology. The commissioner of health shall
consult with the commissioner of alcoholism and substance abuse services
and the commissioner of the office of mental health in determining such
services and establishing such fees. Such ambulatory behavioral health
fees to providers available under this section shall be for all rate
periods on and after the effective date of this chapter through [Decem-
ber 31, 2017] JUNE 30, 2018, provided, however, that managed care organ-
izations and providers may negotiate different rates and methods of
payment during such periods described above, subject to the approval of
the department of health. The department of health shall consult with
the office of alcoholism and substance abuse services and the office of
mental health in determining whether such alternative rates shall be
approved. The report required under section 16-a of part C of chapter
60 of the laws of 2014 shall also include the population of patients
enrolled in the child health insurance program pursuant to title one-A
of article 25 of the public health law in its examination on the transi-
tion of behavioral health services into managed care.
S 30. Section 1 of part H of chapter 111 of the laws of 2010 relating
to increasing Medicaid payments to providers through managed care organ-
izations and providing equivalent fees through an ambulatory patient
group methodology, as amended by section 2 of part C of chapter 57 of
the laws of 2015, is amended to read as follows:
Section 1. a. Notwithstanding any contrary provision of law, the
commissioners of mental health and alcoholism and substance abuse
services are authorized, subject to the approval of the director of the
budget, to transfer to the commissioner of health state funds to be
S. 6407--C 15 A. 9007--C
utilized as the state share for the purpose of increasing payments under
the medicaid program to managed care organizations licensed under arti-
cle 44 of the public health law or under article 43 of the insurance
law. Such managed care organizations shall utilize such funds for the
purpose of reimbursing providers licensed pursuant to article 28 of the
public health law, or pursuant to article 31 or article 32 of the mental
hygiene law for ambulatory behavioral health services, as determined by
the commissioner of health in consultation with the commissioner of
mental health and commissioner of alcoholism and substance abuse
services, provided to medicaid eligible outpatients. Such reimbursement
shall be in the form of fees for such services which are equivalent to
the payments established for such services under the ambulatory patient
group (APG) rate-setting methodology as utilized by the department of
health or by the office of mental health or office of alcoholism and
substance abuse services for rate-setting purposes; provided, however,
that the increase to such fees that shall result from the provisions of
this section shall not, in the aggregate and as determined by the
commissioner of health in consultation with the commissioners of mental
health and alcoholism and substance abuse services, be greater than the
increased funds made available pursuant to this section. The increase of
such behavioral health fees to providers available under this section
shall be for all rate periods on and after the effective date of section
[15] 2 of part C of chapter [60] 57 of the laws of [2014] 2015 through
[June 30, 2017] MARCH 31, 2018 for patients in the city of New York, for
all rate periods on and after the effective date of section [15] 2 of
part C of chapter [60] 57 of the laws of [2014] 2015 through [December
31, 2017] JUNE 30, 2018 for patients outside the city of New York, and
for all rate periods on and after the effective date of section [15] 2
of part C of chapter [60] 57 of the laws of [2014] 2015 through [Decem-
ber 31, 2017] JUNE 30, 2018 for all services provided to persons under
the age of twenty-one; provided, however, [that managed] ELIGIBLE
PROVIDERS MAY WORK WITH MANAGED CARE PLANS TO ACHIEVE QUALITY AND EFFI-
CIENCY OBJECTIVES AND ENGAGE IN SHARED SAVINGS. NOTHING IN THIS SECTION
SHALL PROHIBIT MANAGED care organizations and providers [may negotiate]
FROM NEGOTIATING different rates and methods of payment during such
periods described, subject to the approval of the department of health.
The department of health shall consult with the office of alcoholism and
substance abuse services and the office of mental health in determining
whether such alternative rates shall be approved. The commissioner of
health may, in consultation with the commissioners of mental health and
alcoholism and substance abuse services, promulgate regulations, includ-
ing emergency regulations promulgated prior to October 1, 2013 that
establish rates for behavioral health services, as are necessary to
implement the provisions of this section. Rates promulgated under this
section shall be included in the report required under section 45-c of
part A of chapter 56 of the laws of 2013.
b. Notwithstanding any contrary provision of law, the fees paid by
managed care organizations licensed under article 44 of the public
health law or under article 43 of the insurance law, to providers
licensed pursuant to article 28 of the public health law or article 31
or 32 of the mental hygiene law, for ambulatory behavioral health
services provided to patients enrolled in the child health insurance
program pursuant to title one-A of article 25 of the public health law,
shall be in the form of fees for such services which are equivalent to
the payments established for such services under the ambulatory patient
group (APG) rate-setting methodology. The commissioner of health shall
S. 6407--C 16 A. 9007--C
consult with the commissioner of alcoholism and substance abuse services
and the commissioner of the office of mental health in determining such
services and establishing such fees. Such ambulatory behavioral health
fees to providers available under this section shall be for all rate
periods on and after the effective date of this chapter through [Decem-
ber 31, 2017] JUNE 30, 2018, provided, however, that managed care organ-
izations and providers may negotiate different rates and methods of
payment during such periods described above, subject to the approval of
the department of health. The department of health shall consult with
the office of alcoholism and substance abuse services and the office of
mental health in determining whether such alternative rates shall be
approved. The report required under section 16-a of part C of chapter
60 of the laws of 2014 shall also include the population of patients
enrolled in the child health insurance program pursuant to title one-A
of article 25 of the public health law in its examination on the transi-
tion of behavioral health services into managed care.
S 31. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2016; provided
that:
(a) section eleven of this act shall expire and be deemed repealed
March 31, 2018;
(b) the amendments to paragraph (e) of subdivision 7 of section 367-a
of the social services law, made by sections twelve and thirteen of this
act shall not affect the repeal of such paragraph and shall be deemed
repealed therewith;
(c) subdivisions 26-a and 32 of section 364-j of the social services
law, as added by sections fourteen and fifteen of this act shall be
deemed repealed on the same date and in the same manner as such section
is repealed;
(d) the amendments to subdivisions 7 and 8 of section 4403-f of the
public health law, made by sections twenty and twenty-one of this act,
shall not affect the expiration of such subdivision 7 or the repeal of
such section, and shall expire or be deemed repealed therewith;
(e) section sixteen of this act shall take effect July 1, 2016;
(f) the amendments to section 364-j of the social services law, made
by section twenty-a of this act shall not affect the repeal of such
section and shall be deemed repealed therewith; and
(g) the amendments to section 48-a of part A of chapter 56 of the laws
of 2013 made by section twenty-nine of this act and the amendments to
section 1 of part H of chapter 111 of the laws of 2010 made by section
thirty of this act shall not affect the expiration of such sections and
shall be deemed to expire therewith.
PART C
Section 1. Intentionally omitted.
S 2. Paragraph (a) of subdivision 1 of section 18 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 1 of part Y of chapter 57 of the laws of 2015, is
amended to read as follows:
(a) The superintendent of financial services and the commissioner of
health or their designee shall, from funds available in the hospital
excess liability pool created pursuant to subdivision 5 of this section,
purchase a policy or policies for excess insurance coverage, as author-
ized by paragraph 1 of subsection (e) of section 5502 of the insurance
S. 6407--C 17 A. 9007--C
law; or from an insurer, other than an insurer described in section 5502
of the insurance law, duly authorized to write such coverage and actual-
ly writing medical malpractice insurance in this state; or shall
purchase equivalent excess coverage in a form previously approved by the
superintendent of financial services for purposes of providing equiv-
alent excess coverage in accordance with section 19 of chapter 294 of
the laws of 1985, for medical or dental malpractice occurrences between
July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988,
between July 1, 1988 and June 30, 1989, between July 1, 1989 and June
30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991
and June 30, 1992, between July 1, 1992 and June 30, 1993, between July
1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995,
between July 1, 1995 and June 30, 1996, between July 1, 1996 and June
30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998
and June 30, 1999, between July 1, 1999 and June 30, 2000, between July
1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002,
between July 1, 2002 and June 30, 2003, between July 1, 2003 and June
30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005
and June 30, 2006, between July 1, 2006 and June 30, 2007, between July
1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009,
between July 1, 2009 and June 30, 2010, between July 1, 2010 and June
30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012
and June 30, 2013, between July 1, 2013 and June 30, 2014, between July
1, 2014 and June 30, 2015, [and] between July 1, 2015 and June 30, 2016,
AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 or reimburse the hospital
where the hospital purchases equivalent excess coverage as defined in
subparagraph (i) of paragraph (a) of subdivision 1-a of this section for
medical or dental malpractice occurrences between July 1, 1987 and June
30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989
and June 30, 1990, between July 1, 1990 and June 30, 1991, between July
1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,
between July 1, 1993 and June 30, 1994, between July 1, 1994 and June
30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996
and June 30, 1997, between July 1, 1997 and June 30, 1998, between July
1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000,
between July 1, 2000 and June 30, 2001, between July 1, 2001 and June
30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003
and June 30, 2004, between July 1, 2004 and June 30, 2005, between July
1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007,
between July 1, 2007 and June 30, 2008, between July 1, 2008 and June
30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010
and June 30, 2011, between July 1, 2011 and June 30, 2012, between July
1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014,
between July 1, 2014 and June 30, 2015, [and] between July 1, 2015 and
June 30, 2016, AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 for physicians
or dentists certified as eligible for each such period or periods pursu-
ant to subdivision 2 of this section by a general hospital licensed
pursuant to article 28 of the public health law; provided that no single
insurer shall write more than fifty percent of the total excess premium
for a given policy year; and provided, however, that such eligible
physicians or dentists must have in force an individual policy, from an
insurer licensed in this state 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 during the period of such excess cover-
age for such occurrences or be endorsed as additional insureds under a
S. 6407--C 18 A. 9007--C
hospital professional liability policy which is offered through a volun-
tary attending physician ("channeling") program previously permitted by
the superintendent of financial services during the period of such
excess coverage for such occurrences. During such period, such policy
for excess coverage or such 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, total an aggregate level of two million three
hundred thousand dollars for each claimant and six million nine hundred
thousand dollars for all claimants from all such policies with respect
to occurrences in each of such years provided, however, if the cost of
primary malpractice insurance coverage in excess of one million dollars,
but below the excess medical malpractice insurance coverage provided
pursuant to this act, exceeds the rate of nine percent per annum, then
the required level of primary malpractice insurance coverage in excess
of one million dollars for each claimant shall be in an amount of not
less than the dollar amount of such coverage available at nine percent
per annum; the required level of such coverage for all claimants under
that policy shall be in an amount not less than three times the dollar
amount of coverage for each claimant; and excess coverage, when combined
with such primary malpractice insurance coverage, shall increase the
aggregate level for each claimant by one million dollars and three
million dollars for all claimants; and provided further, that, with
respect to policies of primary medical malpractice coverage that include
occurrences between April 1, 2002 and June 30, 2002, such requirement
that coverage be in amounts no less than one million three hundred thou-
sand dollars for each claimant and three million nine hundred thousand
dollars for all claimants for such occurrences shall be effective April
1, 2002.
S 3. Subdivision 3 of section 18 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 2 of
part Y of chapter 57 of the laws of 2015, is amended to read as follows:
(3)(a) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance for medical or dental malpractice
occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
and June 30, 1989, between July 1, 1989 and June 30, 1990, between July
1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992,
between July 1, 1992 and June 30, 1993, between July 1, 1993 and June
30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995
and June 30, 1996, between July 1, 1996 and June 30, 1997, between July
1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999,
between July 1, 1999 and June 30, 2000, between July 1, 2000 and June
30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002
and June 30, 2003, between July 1, 2003 and June 30, 2004, between July
1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006,
between July 1, 2006 and June 30, 2007, between July 1, 2007 and June
30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009
and June 30, 2010, between July 1, 2010 and June 30, 2011, between July
1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, and
between July 1, 2013 and June 30, 2014, between July 1, 2014 and June
30, 2015, [and] between July 1, 2015 and June 30, 2016, AND BETWEEN JULY
1, 2016 AND JUNE 30, 2017 allocable to each general hospital for physi-
cians or dentists certified as eligible for purchase of a policy for
excess insurance coverage by such general hospital in accordance with
S. 6407--C 19 A. 9007--C
subdivision 2 of this section, and may amend such determination and
certification as necessary.
(b) The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
cost of excess malpractice insurance or equivalent excess coverage for
medical or dental malpractice occurrences between July 1, 1987 and June
30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989
and June 30, 1990, between July 1, 1990 and June 30, 1991, between July
1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993,
between July 1, 1993 and June 30, 1994, between July 1, 1994 and June
30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996
and June 30, 1997, between July 1, 1997 and June 30, 1998, between July
1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000,
between July 1, 2000 and June 30, 2001, between July 1, 2001 and June
30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003
and June 30, 2004, between July 1, 2004 and June 30, 2005, between July
1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007,
between July 1, 2007 and June 30, 2008, between July 1, 2008 and June
30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010
and June 30, 2011, between July 1, 2011 and June 30, 2012, between July
1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014,
between July 1, 2014 and June 30, 2015, [and] between July 1, 2015 and
June 30, 2016, AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 allocable to
each general hospital for physicians or dentists certified as eligible
for purchase of a policy for excess insurance coverage or equivalent
excess coverage by such general hospital in accordance with subdivision
2 of this section, and may amend such determination and certification as
necessary. The superintendent of financial services shall determine and
certify to each general hospital and to the commissioner of health the
ratable share of such cost allocable to the period July 1, 1987 to
December 31, 1987, to the period January 1, 1988 to June 30, 1988, to
the period July 1, 1988 to December 31, 1988, to the period January 1,
1989 to June 30, 1989, to the period July 1, 1989 to December 31, 1989,
to the period January 1, 1990 to June 30, 1990, to the period July 1,
1990 to December 31, 1990, to the period January 1, 1991 to June 30,
1991, to the period July 1, 1991 to December 31, 1991, to the period
January 1, 1992 to June 30, 1992, to the period July 1, 1992 to December
31, 1992, to the period January 1, 1993 to June 30, 1993, to the period
July 1, 1993 to December 31, 1993, to the period January 1, 1994 to June
30, 1994, to the period July 1, 1994 to December 31, 1994, to the period
January 1, 1995 to June 30, 1995, to the period July 1, 1995 to December
31, 1995, to the period January 1, 1996 to June 30, 1996, to the period
July 1, 1996 to December 31, 1996, to the period January 1, 1997 to June
30, 1997, to the period July 1, 1997 to December 31, 1997, to the period
January 1, 1998 to June 30, 1998, to the period July 1, 1998 to December
31, 1998, to the period January 1, 1999 to June 30, 1999, to the period
July 1, 1999 to December 31, 1999, to the period January 1, 2000 to June
30, 2000, to the period July 1, 2000 to December 31, 2000, to the period
January 1, 2001 to June 30, 2001, to the period July 1, 2001 to June 30,
2002, to the period July 1, 2002 to June 30, 2003, to the period July 1,
2003 to June 30, 2004, to the period July 1, 2004 to June 30, 2005, to
the period July 1, 2005 and June 30, 2006, to the period July 1, 2006
and June 30, 2007, to the period July 1, 2007 and June 30, 2008, to the
period July 1, 2008 and June 30, 2009, to the period July 1, 2009 and
June 30, 2010, to the period July 1, 2010 and June 30, 2011, to the
period July 1, 2011 and June 30, 2012, to the period July 1, 2012 and
S. 6407--C 20 A. 9007--C
June 30, 2013, to the period July 1, 2013 and June 30, 2014, to the
period July 1, 2014 and June 30, 2015, [and] to the period July 1, 2015
and June 30, 2016, AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017.
S 4. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
18 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 3 of part Y of chapter 57 of the
laws of 2015, are amended to read as follows:
(a) To the extent funds available to the hospital excess liability
pool pursuant to subdivision 5 of this section as amended, and pursuant
to section 6 of part J of chapter 63 of the laws of 2001, as may from
time to time be amended, which amended this subdivision, are insuffi-
cient to meet the costs of excess insurance coverage or equivalent
excess coverage for coverage periods during the period July 1, 1992 to
June 30, 1993, during the period July 1, 1993 to June 30, 1994, during
the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
to June 30, 1996, during the period July 1, 1996 to June 30, 1997,
during the period July 1, 1997 to June 30, 1998, during the period July
1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30,
2000, during the period July 1, 2000 to June 30, 2001, during the period
July 1, 2001 to October 29, 2001, during the period April 1, 2002 to
June 30, 2002, during the period July 1, 2002 to June 30, 2003, during
the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
to June 30, 2005, during the period July 1, 2005 to June 30, 2006,
during the period July 1, 2006 to June 30, 2007, during the period July
1, 2007 to June 30, 2008, during the period July 1, 2008 to June 30,
2009, during the period July 1, 2009 to June 30, 2010, during the period
July 1, 2010 to June 30, 2011, during the period July 1, 2011 to June
30, 2012, during the period July 1, 2012 to June 30, 2013, during the
period July 1, 2013 to June 30, 2014, during the period July 1, 2014 to
June 30, 2015, [and] during the period July 1, 2015 and June 30, 2016,
AND BETWEEN JULY 1, 2016 AND JUNE 30, 2017 allocated or reallocated in
accordance with paragraph (a) of subdivision 4-a of this section to
rates of payment applicable to state governmental agencies, each physi-
cian or dentist for whom a policy for excess insurance coverage or
equivalent excess coverage is purchased for such period shall be respon-
sible for payment to the provider of excess insurance coverage or equiv-
alent excess coverage of an allocable share of such insufficiency, based
on the ratio of the total cost of such coverage for such physician to
the sum of the total cost of such coverage for all physicians applied to
such insufficiency.
(b) Each provider of excess insurance coverage or equivalent excess
coverage covering the period July 1, 1992 to June 30, 1993, or covering
the period July 1, 1993 to June 30, 1994, or covering the period July 1,
1994 to June 30, 1995, or covering the period July 1, 1995 to June 30,
1996, or covering the period July 1, 1996 to June 30, 1997, or covering
the period July 1, 1997 to June 30, 1998, or covering the period July 1,
1998 to June 30, 1999, or covering the period July 1, 1999 to June 30,
2000, or covering the period July 1, 2000 to June 30, 2001, or covering
the period July 1, 2001 to October 29, 2001, or covering the period
April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to
June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or
covering the period July 1, 2004 to June 30, 2005, or covering the peri-
od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or
covering the period July 1, 2008 to June 30, 2009, or covering the peri-
S. 6407--C 21 A. 9007--C
od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or
covering the period July 1, 2012 to June 30, 2013, or covering the peri-
od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, OR
COVERING THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 shall notify 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 paragraph (a) of this
subdivision. Such amount shall be due from such physician or dentist to
such provider of excess insurance coverage or equivalent 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 July 1, 1992 to June 30, 1993, or covering the period
July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to
June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
covering the period July 1, 1996 to June 30, 1997, or covering the peri-
od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or
covering the period July 1, 2000 to June 30, 2001, or covering the peri-
od July 1, 2001 to October 29, 2001, or covering the period April 1,
2002 to June 30, 2002, or covering the period July 1, 2002 to June 30,
2003, or covering the period July 1, 2003 to June 30, 2004, or covering
the period July 1, 2004 to June 30, 2005, or covering the period July 1,
2005 to June 30, 2006, or covering the period July 1, 2006 to June 30,
2007, or covering the period July 1, 2007 to June 30, 2008, or covering
the period July 1, 2008 to June 30, 2009, or covering the period July 1,
2009 to June 30, 2010, or covering the period July 1, 2010 to June 30,
2011, or covering the period July 1, 2011 to June 30, 2012, or covering
the period July 1, 2012 to June 30, 2013, or covering the period July 1,
2013 to June 30, 2014, or covering the period July 1, 2014 to June 30,
2015, or covering the period July 1, 2015 to June 30, 2016, OR COVERING
THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 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 of health 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 July 1, 1992 to June 30,
1993, or covering the period July 1, 1993 to June 30, 1994, or covering
the period July 1, 1994 to June 30, 1995, or covering the period July 1,
1995 to June 30, 1996, or covering the period July 1, 1996 to June 30,
1997, or covering the period July 1, 1997 to June 30, 1998, or covering
the period July 1, 1998 to June 30, 1999, or covering the period July 1,
1999 to June 30, 2000, or covering the period July 1, 2000 to June 30,
S. 6407--C 22 A. 9007--C
2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
ing the period April 1, 2002 to June 30, 2002, or covering the period
July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to
June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or
covering the period July 1, 2005 to June 30, 2006, or covering the peri-
od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or
covering the period July 1, 2009 to June 30, 2010, or covering the peri-
od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or
covering the period July 1, 2013 to June 30, 2014, or covering the peri-
od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
June 30, 2016, OR COVERING THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 that
has made payment to such provider of excess insurance coverage or equiv-
alent excess coverage in accordance with paragraph (b) of this subdivi-
sion 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 hospital excess liability pool any amount
allocable to the period July 1, 1992 to June 30, 1993, and to the period
July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June
30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the
period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to
June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to
the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
to June 30, 2001, and to the period July 1, 2001 to October 29, 2001,
and to the period April 1, 2002 to June 30, 2002, and to the period July
1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30,
2004, and to the period July 1, 2004 to June 30, 2005, and to the period
July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June
30, 2007, and to the period July 1, 2007 to June 30, 2008, and to the
period July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to
June 30, 2010, and to the period July 1, 2010 to June 30, 2011, and to
the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
to June 30, 2013, and to the period July 1, 2013 to June 30, 2014, and
to the period July 1, 2014 to June 30, 2015, and to the period July 1,
2015 to June 30, 2016, AND TO THE PERIOD JULY 1, 2016 TO JUNE 30, 2017
received from the hospital excess liability pool for purchase of excess
insurance coverage or equivalent excess coverage covering the period
July 1, 1992 to June 30, 1993, and covering the period July 1, 1993 to
June 30, 1994, and covering the period July 1, 1994 to June 30, 1995,
and covering the period July 1, 1995 to June 30, 1996, and covering the
period July 1, 1996 to June 30, 1997, and covering the period July 1,
1997 to June 30, 1998, and covering the period July 1, 1998 to June 30,
1999, and covering the period July 1, 1999 to June 30, 2000, and cover-
ing the period July 1, 2000 to June 30, 2001, and covering the period
July 1, 2001 to October 29, 2001, and covering the period April 1, 2002
to June 30, 2002, and covering the period July 1, 2002 to June 30, 2003,
and covering the period July 1, 2003 to June 30, 2004, and covering the
period July 1, 2004 to June 30, 2005, and covering the period July 1,
2005 to June 30, 2006, and covering the period July 1, 2006 to June 30,
2007, and covering the period July 1, 2007 to June 30, 2008, and cover-
ing the period July 1, 2008 to June 30, 2009, and covering the period
July 1, 2009 to June 30, 2010, and covering the period July 1, 2010 to
June 30, 2011, and covering the period July 1, 2011 to June 30, 2012,
and covering the period July 1, 2012 to June 30, 2013, and covering the
S. 6407--C 23 A. 9007--C
period July 1, 2013 to June 30, 2014, and covering the period July 1,
2014 to June 30, 2015, and covering the period July 1, 2015 to June 30,
2016, AND COVERING THE PERIOD JULY 1, 2016 TO JUNE 30, 2017 for a physi-
cian or dentist where such excess insurance coverage or equivalent
excess coverage is cancelled in accordance with paragraph (c) of this
subdivision.
S 5. 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 4 of part Y of chap-
ter 57 of the laws of 2015, is amended to read as follows:
S 40. The superintendent of financial services shall establish rates
for policies providing coverage for physicians and surgeons medical
malpractice for the periods commencing July 1, 1985 and ending June 30,
[2016] 2017; 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 superintendent shall direct insurers to establish segregated
accounts for premiums, payments, reserves and investment income attrib-
utable 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
attributable 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, [2016]
2017, at which time and thereafter such surcharge shall not exceed twen-
ty-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, [2016]
2017 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 superintendent. 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 practice 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 establishing adequate rates and in determining any projected defi-
S. 6407--C 24 A. 9007--C
ciency 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 peri-
od 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 by
the superintendent pursuant to this section are deemed adequate if such
rates would be adequate when taken together with the maximum authorized
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.
S 6. Section 5 and subdivisions (a) and (e) of section 6 of part J of
chapter 63 of the laws of 2001, amending chapter 266 of the laws of
1986, amending the civil practice law and rules and other laws relating
to malpractice and professional medical conduct, as amended by section 5
of part Y of chapter 57 of the laws of 2015, are amended to read as
follows:
S 5. The superintendent of financial services and the commissioner of
health shall determine, no later than June 15, 2002, June 15, 2003, June
15, 2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15, 2008,
June 15, 2009, June 15, 2010, June 15, 2011, June 15, 2012, June 15,
2013, June 15, 2014, June 15, 2015, [and] June 15, 2016, AND JUNE 15,
2017 the amount of funds available in the hospital excess liability
pool, created pursuant to section 18 of chapter 266 of the laws of 1986,
and whether such funds are sufficient for purposes of purchasing excess
insurance coverage for eligible participating physicians and dentists
during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June
30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
2007, or July 1, 2007 to June 30, 2008, or July 1, 2008 to June 30,
2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to June 30,
2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June 30,
2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30,
2015, or July 1, 2015 to June 30, 2016, OR JULY 1, 2016 TO JUNE 30, 2017
as applicable.
(a) This section shall be effective only upon a determination, pursu-
ant to section five of this act, by the superintendent of financial
services and the commissioner of health, and a certification of such
determination to the state director of the budget, the chair of the
senate committee on finance and the chair of the assembly committee on
ways and means, that the amount of funds in the hospital excess liabil-
ity pool, created pursuant to section 18 of chapter 266 of the laws of
1986, is insufficient for purposes of purchasing excess insurance cover-
age for eligible participating physicians and dentists during the period
July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1,
2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to
June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30,
2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30,
2016, OR JULY 1, 2016 TO JUNE 30, 2017 as applicable.
S. 6407--C 25 A. 9007--C
(e) The commissioner of health shall transfer for deposit to the
hospital excess liability pool created pursuant to section 18 of chapter
266 of the laws of 1986 such amounts as directed by the superintendent
of financial services for the purchase of excess liability insurance
coverage for eligible participating physicians and dentists for the
policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30,
2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30,
2007, as applicable, and the cost of administering the hospital excess
liability pool for such applicable policy year, pursuant to the program
established in chapter 266 of the laws of 1986, as amended, no later
than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June
15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010,
June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, June 15,
2015, [and] June 15, 2016, AND JUNE 15, 2017 as applicable.
S 7. Notwithstanding any law, rule or regulation to the contrary, only
physicians or dentists who were eligible, and for whom the superinten-
dent of financial services and the commissioner of health, or their
designee, purchased, with funds available in the hospital excess liabil-
ity pool, a full or partial policy for excess coverage or equivalent
excess coverage for the coverage period ending the thirtieth of June,
two thousand sixteen, shall be eligible to apply for such coverage for
the coverage period beginning the first of July, two thousand sixteen;
provided, however, if the total number of physicians or dentists for
whom such excess coverage or equivalent excess coverage was purchased
for the policy year ending the thirtieth of June, two thousand sixteen
exceeds the total number of physicians or dentists certified as eligible
for the coverage period beginning the first of July, two thousand
sixteen, then the general hospitals may certify additional eligible
physicians or dentists in a number equal to such general hospital's
proportional share 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 thirti-
eth of June, two thousand sixteen, as applied to the difference between
the number of eligible physicians or dentists for whom a policy for
excess coverage or equivalent excess coverage was purchased for the
coverage period ending the thirtieth of June, two thousand sixteen and
the number of such eligible physicians or dentists who have applied for
excess coverage or equivalent excess coverage for the coverage period
beginning the first of July, two thousand sixteen.
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, 2016, provided,
however, section two of this act shall take effect July 1, 2016.
PART D
Section 1. Paragraph (a) of subdivision 1 of section 212 of chapter
474 of the laws of 1996, amending the education law and other laws
relating to rates for residential healthcare facilities, as amended by
section 2 of part B of chapter 56 of the laws of 2013, is amended to
read as follows:
(a) Notwithstanding any inconsistent provision of law or regulation to
the contrary, effective beginning August 1, 1996, for the period April
1, 1997 through March 31, 1998, April 1, 1998 for the period April 1,
1998 through March 31, 1999, August 1, 1999, for the period April 1,
1999 through March 31, 2000, April 1, 2000, for the period April 1, 2000
S. 6407--C 26 A. 9007--C
through March 31, 2001, April 1, 2001, for the period April 1, 2001
through March 31, 2002, April 1, 2002, for the period April 1, 2002
through March 31, 2003, and for the state fiscal year beginning April 1,
2005 through March 31, 2006, and for the state fiscal year beginning
April 1, 2006 through March 31, 2007, and for the state fiscal year
beginning April 1, 2007 through March 31, 2008, and for the state fiscal
year beginning April 1, 2008 through March 31, 2009, and for the state
fiscal year beginning April 1, 2009 through March 31, 2010, and for the
state fiscal year beginning April 1, 2010 through March 31, 2016, AND
FOR THE STATE FISCAL YEAR BEGINNING APRIL 1, 2016 THROUGH MARCH 31,
2019, the department of health is authorized to pay public general
hospitals, as defined in subdivision 10 of section 2801 of the public
health law, operated by the state of New York or by the state university
of New York or by a county, which shall not include a city with a popu-
lation of over one million, of the state of New York, and those public
general hospitals located in the county of Westchester, the county of
Erie or the county of Nassau, additional payments for inpatient hospital
services as medical assistance payments pursuant to title 11 of article
5 of the social services law for patients eligible for federal financial
participation under title XIX of the federal social security act in
medical assistance pursuant to the federal laws and regulations govern-
ing disproportionate share payments to hospitals up to one hundred
percent of each such public general hospital's medical assistance and
uninsured patient losses after all other medical assistance, including
disproportionate share payments to such public general hospital for
1996, 1997, 1998, and 1999, based initially for 1996 on reported 1994
reconciled data as further reconciled to actual reported 1996 reconciled
data, and for 1997 based initially on reported 1995 reconciled data as
further reconciled to actual reported 1997 reconciled data, for 1998
based initially on reported 1995 reconciled data as further reconciled
to actual reported 1998 reconciled data, for 1999 based initially on
reported 1995 reconciled data as further reconciled to actual reported
1999 reconciled data, for 2000 based initially on reported 1995 recon-
ciled data as further reconciled to actual reported 2000 data, for 2001
based initially on reported 1995 reconciled data as further reconciled
to actual reported 2001 data, for 2002 based initially on reported 2000
reconciled data as further reconciled to actual reported 2002 data, and
for state fiscal years beginning on April 1, 2005, based initially on
reported 2000 reconciled data as further reconciled to actual reported
data for 2005, and for state fiscal years beginning on April 1, 2006,
based initially on reported 2000 reconciled data as further reconciled
to actual reported data for 2006, for state fiscal years beginning on
and after April 1, 2007 through March 31, 2009, based initially on
reported 2000 reconciled data as further reconciled to actual reported
data for 2007 and 2008, respectively, for state fiscal years beginning
on and after April 1, 2009, based initially on reported 2007 reconciled
data, adjusted for authorized Medicaid rate changes applicable to the
state fiscal year, and as further reconciled to actual reported data for
2009, for state fiscal years beginning on and after April 1, 2010, based
initially on reported reconciled data from the base year two years prior
to the payment year, adjusted for authorized Medicaid rate changes
applicable to the state fiscal year, and further reconciled to actual
reported data from such payment year, and to actual reported data for
each respective succeeding year. The payments may be added to rates of
payment or made as aggregate payments to an eligible public general
hospital.
S. 6407--C 27 A. 9007--C
S 2. Section 10 of chapter 649 of the laws of 1996, amending the
public health law, the mental hygiene law and the social services law
relating to authorizing the establishment of special needs plans, as
amended by section 20 of part D of chapter 59 of the laws of 2011, is
amended to read as follows:
S 10. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after July 1, 1996; provided,
however, that sections one, two and three of this act shall expire and
be deemed repealed on March 31, [2016] 2020 provided, however that the
amendments to section 364-j of the social services law made by section
four of this act shall not affect the expiration of such section and
shall be deemed to expire therewith and provided, further, that the
provisions of subdivisions 8, 9 and 10 of section 4401 of the public
health law, as added by section one of this act; section 4403-d of the
public health law as added by section two of this act and the provisions
of section seven of this act, except for the provisions relating to the
establishment of no more than twelve comprehensive HIV special needs
plans, shall expire and be deemed repealed on July 1, 2000.
S 3. Subdivision 8 of section 84 of part A of chapter 56 of the laws
of 2013, amending the public health law and other laws relating to
general hospital reimbursement for annual rates is REPEALED.
S 4. Subdivision (f) of section 129 of part C of chapter 58 of the
laws of 2009, amending the public health law relating to payment by
governmental agencies for general hospital inpatient services, as
amended by section 1 of part B of chapter 56 of the laws of 2013, is
amended to read as follows:
(f) section twenty-five of this act shall expire and be deemed
repealed April 1, [2016] 2019;
S 4-a. Section 2806-a of the public health law is amended by adding a
new subdivision 8 to read as follows:
8. THE COMMISSIONER SHALL CAUSE THE TEMPORARY PRESIDENT OF THE SENATE,
THE SPEAKER OF THE ASSEMBLY, AND THE CHAIRS OF THE SENATE AND THE ASSEM-
BLY HEALTH COMMITTEES TO BE NOTIFIED OF THE APPOINTMENT OF A TEMPORARY
OPERATOR PURSUANT TO PARAGRAPH (A) OF SUBDIVISION TWO OF THIS SECTION
UPON SUCH APPOINTMENT. SUCH NOTIFICATION SHALL INCLUDE, BUT NOT BE
LIMITED TO, THE NAME OF THE ESTABLISHED OPERATOR, THE NAME OF THE
APPOINTED TEMPORARY OPERATOR AND A DESCRIPTION OF THE REASONS FOR SUCH
APPOINTMENT TO THE EXTENT PRACTICABLE UNDER THE CIRCUMSTANCES AND IN THE
SOLE DISCRETION OF THE COMMISSIONER.
S 5. Subdivision (c) of section 122 of part E of chapter 56 of the
laws of 2013 amending the public health law relating to the general
public health work program, is amended to read as follows:
(c) section fifty of this act shall take effect immediately and shall
expire [three] SIX years after it becomes law;
S 5-a. Subdivision 2 of section 3-0317 of the environmental conserva-
tion law, as added by chapter 77 of the laws of 2010, is amended to read
as follows:
2. The department shall, pursuant to established security protocols,
provide to the department of health the GPS coordinates, category of
license or permit, facility identification number, and address on
current environmental facilities that are necessary for the department
of health to develop and maintain cancer incidence and environmental
facility maps required pursuant to section twenty-four hundred one-b of
the public health law, and shall provide any technical assistance neces-
sary for the development of such maps. The department, in consultation
S. 6407--C 28 A. 9007--C
with the department of health, shall update such data [periodically] NOT
LESS THAN ONCE EVERY FIVE YEARS.
S 5-b. Subdivision 9 of section 2401-b of the public health law, as
added by chapter 77 of the laws of 2010, is amended to read as follows:
9. The department shall make available to the public cancer incidence
and environmental facility maps in the manner described in subdivision
four of this section showing cancer clusters by cancer types. Prior to
plotting such data, the department shall use an appropriate statistical
method to detect statistical anomalies for the purpose of identifying
cancer clusters.
[(a)] The department shall make such maps available [as follows:
(i) by June thirtieth, two thousand twelve cancer types listed in
paragraphs (a) through (e) of subdivision five of this section;
(ii) by December thirty-first, two thousand twelve cancer types listed
in paragraphs (f) through (o) of subdivision five of this section; and
(iii) by June thirtieth, two thousand thirteen cancer types listed in
paragraphs (p) through (w) of subdivision five of this section.
(b) The department] ON ITS PUBLIC WEBSITE, AND SHALL, in consultation
with the department of environmental conservation, [shall] update the
maps [periodically.
(c) The department shall post these maps on its public website as soon
as practicable following the dates set forth in paragraph (a) of this
subdivision] NOT LESS THAN ONCE EVERY FIVE YEARS.
S 5-c. Section 5 of chapter 77 of the laws of 2010 amending the envi-
ronmental conservation law and the public health law relating to an
environmental facility and cancer incidence map, is amended to read as
follows:
S 5. This act shall take effect immediately and shall expire and be
deemed repealed March 31, [2016] 2022.
S 6. Subdivision 4-a of section 71 of part C of chapter 60 of the laws
of 2014 amending the social services law relating to eliminating pres-
criber prevails for brand name drugs with generic equivalents, is
amended to read as follows:
4-a. section twenty-two of this act shall take effect April 1, 2014,
and shall be deemed expired January 1, [2017] 2018;
S 7. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2016; provided,
however, that the amendments to section 2806-a of the public health law
made by section four-a of this act, the amendments to section 3-0317 of
the environmental conservation law made by section five-a of this act
and the amendments to section 2401-b of the public health law made by
section five-b of this act shall not affect the repeal of such sections
and shall be deemed repealed therewith.
PART E
Intentionally Omitted
PART F
Section 1. Notwithstanding any inconsistent provision of sections
2825-a, 2825-b and 2825-c of the public health law and section 2825-d of
the public health law as added by section two of this act, hereinafter
referred to as the eligible health care capital programs, and the
provisions of any other law to the contrary:
S. 6407--C 29 A. 9007--C
a. The dormitory authority of the state of New York (DASNY) and the
department of health (DOH) are authorized to make grants or loans in
support of debt restructuring, capital and non-capital projects or
purposes from the amounts appropriated for the eligible health care
capital programs; provided that such projects or purposes facilitate
health care transformation and are intended to create a financially
sustainable system of care. Grants or loans shall not be available to
support general operating expenses unconnected to such authorized
projects or purposes.
b. To the extent that a grant or a loan authorized pursuant to the
eligible health care capital programs or this section is determined to
not qualify under an eligible health care capital program or cannot be
funded with the proceeds of bonds issued pursuant to section 1680-r of
the public authorities law, the director of the budget is authorized to
make a determination to fund the project or purpose with proceeds of
moneys from the New York State Special Infrastructure Account appropri-
ation pursuant to chapter 54 of the laws of 2015, as amended.
c. To the extent that a grant authorized pursuant to the eligible
health care capital programs or this section can be funded with the
proceeds of bonds issued pursuant to section 1680-r of the public
authorities law, the director of the budget is authorized to make a
determination to fund the project or purpose with the proceeds of bonds
issued pursuant to section 1680-r of the public authorities law and any
such projects or purposes shall be approved by the New York state public
authorities control board, as required under section 51 of the public
authorities law.
d. The total amount of funds awarded may not exceed the total amounts
appropriated for the eligible health care capital programs.
e. If DASNY and DOH determine to make funds available in accordance
with subdivision a of this section as a loan, the director of the budget
is authorized to suballocate such funds to the Health Facility Restruc-
turing Pool and such funds would be used in accordance with section 2815
of the public health law. In no event shall the total of such suballo-
cations exceed ten percent of the total amounts appropriated for the
eligible health care capital programs.
f. DASNY and DOH will provide notice to the chair of the senate
finance committee and chair of the assembly ways and means committee no
later than thirty days prior to making an award pursuant to this act,
and such awards shall also be so noted in the quarterly reports required
pursuant to each of the eligible health care capital programs.
S 2. The public health law is amended by adding a new section 2825-d
to read as follows:
S 2825-D. HEALTH CARE FACILITY TRANSFORMATION PROGRAM: STATEWIDE. 1.
A STATEWIDE HEALTH CARE FACILITY TRANSFORMATION PROGRAM IS HEREBY ESTAB-
LISHED UNDER THE JOINT ADMINISTRATION OF THE COMMISSIONER AND THE PRESI-
DENT OF THE DORMITORY AUTHORITY OF THE STATE OF NEW YORK FOR THE PURPOSE
OF STRENGTHENING AND PROTECTING CONTINUED ACCESS TO HEALTH CARE SERVICES
IN COMMUNITIES. THE PROGRAM SHALL PROVIDE CAPITAL FUNDING IN SUPPORT OF
PROJECTS THAT REPLACE INEFFICIENT AND OUTDATED FACILITIES AS PART OF A
MERGER, CONSOLIDATION, ACQUISITION OR OTHER SIGNIFICANT CORPORATE
RESTRUCTURING ACTIVITY THAT IS PART OF AN OVERALL TRANSFORMATION PLAN
INTENDED TO CREATE A FINANCIALLY SUSTAINABLE SYSTEM OF CARE. THE ISSU-
ANCE OF ANY BONDS OR NOTES HEREUNDER SHALL BE SUBJECT TO SECTION SIXTEEN
HUNDRED EIGHTY-R OF THE PUBLIC AUTHORITIES LAW AND THE APPROVAL OF THE
DIRECTOR OF THE DIVISION OF THE BUDGET, AND ANY PROJECTS FUNDED THROUGH
THE ISSUANCE OF BONDS OR NOTES HEREUNDER SHALL BE APPROVED BY THE NEW
S. 6407--C 30 A. 9007--C
YORK STATE PUBLIC AUTHORITIES CONTROL BOARD, AS REQUIRED UNDER SECTION
FIFTY-ONE OF THE PUBLIC AUTHORITIES LAW.
2. THE COMMISSIONER AND THE PRESIDENT OF THE AUTHORITY SHALL ENTER
INTO AN AGREEMENT, SUBJECT TO APPROVAL BY THE DIRECTOR OF THE BUDGET,
AND SUBJECT TO SECTION SIXTEEN HUNDRED EIGHTY-R OF THE PUBLIC AUTHORI-
TIES LAW, FOR THE PURPOSES OF AWARDING, DISTRIBUTING, AND ADMINISTERING
THE FUNDS MADE AVAILABLE PURSUANT TO THIS SECTION. SUCH FUNDS MAY BE
DISTRIBUTED BY THE COMMISSIONER AND THE PRESIDENT OF THE AUTHORITY FOR
CAPITAL GRANTS TO GENERAL HOSPITALS, RESIDENTIAL HEALTH CARE FACILITIES,
DIAGNOSTIC AND TREATMENT CENTERS AND CLINICS LICENSED PURSUANT TO THIS
CHAPTER OR THE MENTAL HYGIENE LAW, FOR CAPITAL NON-OPERATIONAL WORKS OR
PURPOSES THAT SUPPORT THE PURPOSES SET FORTH IN THIS SECTION. A COPY OF
SUCH AGREEMENT, AND ANY AMENDMENTS THERETO, SHALL BE PROVIDED TO THE
CHAIR OF THE SENATE FINANCE COMMITTEE, THE CHAIR OF THE ASSEMBLY WAYS
AND MEANS COMMITTEE, AND THE DIRECTOR OF THE DIVISION OF BUDGET NO LATER
THAN THIRTY DAYS PRIOR TO THE RELEASE OF A REQUEST FOR APPLICATIONS FOR
FUNDING UNDER THIS PROGRAM. PRIORITY SHALL BE GIVEN TO PROJECTS NOT
FUNDED, IN WHOLE OR IN PART, UNDER SECTION TWENTY-EIGHT HUNDRED TWENTY-
FIVE OR TWENTY-EIGHT HUNDRED TWENTY-FIVE-C OF THIS ARTICLE. PROJECTS
AWARDED, IN WHOLE OR PART, UNDER SECTIONS TWENTY-EIGHT HUNDRED
TWENTY-FIVE-A AND TWENTY-EIGHT HUNDRED TWENTY-FIVE-B OF THIS ARTICLE
SHALL NOT BE ELIGIBLE FOR GRANTS OR AWARDS MADE AVAILABLE UNDER THIS
SECTION.
3. NOTWITHSTANDING SECTION ONE HUNDRED SIXTY-THREE OF THE STATE
FINANCE LAW OR ANY INCONSISTENT PROVISION OF LAW TO THE CONTRARY, UP TO
TWO HUNDRED MILLION DOLLARS OF THE FUNDS APPROPRIATED FOR THIS PROGRAM
SHALL BE AWARDED WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROC-
ESS FOR CAPITAL GRANTS TO HEALTH CARE PROVIDERS (HEREAFTER "APPLI-
CANTS"). PROVIDED HOWEVER THAT A MINIMUM OF THIRTY MILLION DOLLARS OF
TOTAL AWARDED FUNDS SHALL BE MADE TO COMMUNITY-BASED HEALTH CARE PROVID-
ERS, WHICH, FOR PURPOSES OF THIS SECTION SHALL BE DEFINED AS A DIAGNOS-
TIC AND TREATMENT CENTER LICENSED OR GRANTED AN OPERATING CERTIFICATE
UNDER THIS ARTICLE; A MENTAL HEALTH CLINIC LICENSED OR GRANTED AN OPER-
ATING CERTIFICATE UNDER ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE LAW; AN
ALCOHOL AND SUBSTANCE ABUSE TREATMENT CLINIC LICENSED OR GRANTED AN
OPERATING CERTIFICATE UNDER ARTICLE THIRTY-TWO OF THE MENTAL HYGIENE
LAW; PRIMARY CARE PROVIDERS; OR A HOME CARE PROVIDER CERTIFIED OR
LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF THIS CHAPTER. ELIGIBLE
APPLICANTS SHALL BE THOSE DEEMED BY THE COMMISSIONER TO BE A PROVIDER
THAT FULFILLS OR WILL FULFILL A HEALTH CARE NEED FOR ACUTE INPATIENT,
OUTPATIENT, PRIMARY, HOME CARE OR RESIDENTIAL HEALTH CARE SERVICES IN A
COMMUNITY.
4. IN DETERMINING AWARDS FOR ELIGIBLE APPLICANTS UNDER THIS SECTION,
THE COMMISSIONER AND THE PRESIDENT OF THE AUTHORITY SHALL CONSIDER
CRITERIA INCLUDING, BUT NOT LIMITED TO:
(A) THE EXTENT TO WHICH THE PROPOSED CAPITAL PROJECT WILL CONTRIBUTE
TO THE INTEGRATION OF HEALTH CARE SERVICES AND LONG TERM SUSTAINABILITY
OF THE APPLICANT OR PRESERVATION OF ESSENTIAL HEALTH SERVICES IN THE
COMMUNITY OR COMMUNITIES SERVED BY THE APPLICANT;
(B) THE EXTENT TO WHICH THE PROPOSED PROJECT OR PURPOSE IS ALIGNED
WITH DELIVERY SYSTEM REFORM INCENTIVE PAYMENT ("DSRIP") PROGRAM GOALS
AND OBJECTIVES;
(C) CONSIDERATION OF GEOGRAPHIC DISTRIBUTION OF FUNDS;
(D) THE RELATIONSHIP BETWEEN THE PROPOSED CAPITAL PROJECT AND IDENTI-
FIED COMMUNITY NEED;
S. 6407--C 31 A. 9007--C
(E) THE EXTENT TO WHICH THE APPLICANT HAS ACCESS TO ALTERNATIVE
FINANCING;
(F) THE EXTENT THAT THE PROPOSED CAPITAL PROJECT FURTHERS THE DEVELOP-
MENT OF PRIMARY CARE AND OTHER OUTPATIENT SERVICES;
(G) THE EXTENT TO WHICH THE PROPOSED CAPITAL PROJECT BENEFITS MEDICAID
ENROLLEES AND UNINSURED INDIVIDUALS;
(H) THE EXTENT TO WHICH THE APPLICANT HAS ENGAGED THE COMMUNITY
AFFECTED BY THE PROPOSED CAPITAL PROJECT AND THE MANNER IN WHICH COMMU-
NITY ENGAGEMENT HAS SHAPED SUCH CAPITAL PROJECT; AND
(I) THE EXTENT TO WHICH THE PROPOSED CAPITAL PROJECT ADDRESSES POTEN-
TIAL RISK TO PATIENT SAFETY AND WELFARE.
5. DISBURSEMENT OF AWARDS MADE PURSUANT TO THIS SECTION SHALL BE
CONDITIONED ON THE AWARDEE ACHIEVING CERTAIN PROCESS AND PERFORMANCE
METRICS AND MILESTONES AS DETERMINED IN THE SOLE DISCRETION OF THE
COMMISSIONER. SUCH METRICS AND MILESTONES SHALL BE STRUCTURED TO ENSURE
THAT THE HEALTH CARE TRANSFORMATION AND PROVIDER SUSTAINABILITY GOALS OF
THE PROJECT ARE ACHIEVED, AND SUCH METRICS AND MILESTONES SHALL BE
INCLUDED IN GRANT DISBURSEMENT AGREEMENTS OR OTHER CONTRACTUAL DOCUMENTS
AS REQUIRED BY THE COMMISSIONER.
6. THE DEPARTMENT SHALL PROVIDE A REPORT ON A QUARTERLY BASIS TO THE
CHAIRS OF THE SENATE FINANCE, ASSEMBLY WAYS AND MEANS, SENATE HEALTH AND
ASSEMBLY HEALTH COMMITTEES. SUCH REPORTS SHALL BE SUBMITTED NO LATER
THAN SIXTY DAYS AFTER THE CLOSE OF THE QUARTER, AND SHALL INCLUDE, FOR
EACH AWARD, THE NAME OF THE APPLICANT, A DESCRIPTION OF THE PROJECT OR
PURPOSE, THE AMOUNT OF THE AWARD, DISBURSEMENT DATE, AND STATUS OF
ACHIEVEMENT OF PROCESS AND PERFORMANCE METRICS AND MILESTONES PURSUANT
TO SUBDIVISION FIVE OF THIS SECTION.
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, 2016.
PART G
Intentionally Omitted
PART H
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, as amended
by section 1 of part JJ of chapter 58 of the laws of 2015, 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,
[2016] 2019; and for programs located within the city of New York, the
applicable fiscal periods shall be July 1, 2003 through June 30, 2010
and July 1, 2011 through June 30, [2016] 2019.
S. 6407--C 32 A. 9007--C
S 2. The office of mental health shall report on the providers
impacted by section one of this act. This information shall be submitted
annually to the governor, the temporary president of the senate and the
speaker of the assembly no later than December 31st of each year.
S 3. This act shall take effect immediately.
PART I
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 K of
chapter 56 of the laws of 2012, are amended to read as follows:
S 19. Notwithstanding any other provision of law, the commissioner of
mental health shall, until July 1, [2016] 2020, 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, [2016] 2020, 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, 2016.
PART J
Section 1. Subdivision a of section 9 of chapter 420 of the laws of
2002 amending the education law relating to the profession of social
work, as amended by section 1 of part AA of chapter 57 of the laws of
2013, is amended to read as follows:
a. Nothing in this act shall prohibit or limit the activities or
services on the part of any person in the employ of a program or service
operated, regulated, funded, or approved by the department of mental
hygiene, the office of children and family services, the office of
temporary and disability assistance, the department of corrections and
community supervision, the state office for the aging, the department of
health, or a local governmental unit as that term is defined in article
41 of the mental hygiene law or a social services district as defined in
section 61 of the social services law, provided, however, this section
shall not authorize the use of any title authorized pursuant to article
154 of the education law, except that this section shall be deemed
repealed on July 1, [2016] 2018.
S 2. Subdivision a of section 17-a of chapter 676 of the laws of 2002
amending the education law relating to the practice of psychology, as
amended by section 2 of part AA of chapter 57 of the laws of 2013, is
amended to read as follows:
a. In relation to activities and services provided under article 153
of the education law, nothing in this act shall prohibit or limit such
activities or services on the part of any person in the employ of a
program or service operated, regulated, funded, or approved by the
department of mental hygiene or the office of children and family
S. 6407--C 33 A. 9007--C
services, or a local governmental unit as that term is defined in arti-
cle 41 of the mental hygiene law or a social services district as
defined in section 61 of the social services law. In relation to activ-
ities and services provided under article 163 of the education law,
nothing in this act shall prohibit or limit such activities or services
on the part of any person in the employ of a program or service oper-
ated, regulated, funded, or approved by the department of mental
hygiene, the office of children and family services, the department of
corrections and community supervision, the office of temporary and disa-
bility assistance, the state office for the aging and the department of
health or a local governmental unit as that term is defined in article
41 of the mental hygiene law or a social services district as defined in
section 61 of the social services law, pursuant to authority granted by
law. This section shall not authorize the use of any title authorized
pursuant to article 153 or 163 of the education law by any such employed
person, except as otherwise provided by such articles respectively.
This section shall be deemed repealed July 1, [2016] 2018.
S 3. Section 16 of chapter 130 of the laws of 2010 amending the educa-
tion law and other laws relating to the registration of entities provid-
ing certain professional services and the licensure of certain
professions, as amended by section 3 of part AA of chapter 57 of the
laws of 2013, is amended to read as follows:
S 16. This act shall take effect immediately; provided that sections
thirteen, fourteen and fifteen of this act shall take effect immediately
and shall be deemed to have been in full force and effect on and after
June 1, 2010 and such sections shall be deemed repealed July 1, [2016]
2018; provided further that the amendments to section 9 of chapter 420
of the laws of 2002 amending the education law relating to the profes-
sion of social work made by section thirteen of this act shall repeal on
the same date as such section repeals; provided further that the amend-
ments to section 17-a of chapter 676 of the laws of 2002 amending the
education law relating to the practice of psychology made by section
fourteen of this act shall repeal on the same date as such section
repeals.
S 4. This act shall take effect immediately.
PART K
Intentionally Omitted
PART L
Section 1. The mental hygiene law is amended by adding a new section
16.25 to read as follows:
S 16.25 TEMPORARY OPERATOR.
(A) FOR THE PURPOSES OF THIS SECTION:
(1) "ESTABLISHED OPERATOR" SHALL MEAN THE PROVIDER OF SERVICES THAT
HAS BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE PURSUANT TO
THIS ARTICLE.
(2) "EXTRAORDINARY FINANCIAL ASSISTANCE" SHALL MEAN STATE FUNDS
PROVIDED TO, OR REQUESTED BY, A PROGRAM FOR THE EXPRESS PURPOSE OF
PREVENTING THE CLOSURE OF THE PROGRAM THAT THE COMMISSIONER FINDS
PROVIDES ESSENTIAL AND NECESSARY SERVICES WITHIN THE COMMUNITY.
(3) "SERIOUS FINANCIAL INSTABILITY" SHALL INCLUDE BUT NOT BE LIMITED
TO DEFAULTING OR VIOLATING MATERIAL COVENANTS OF BOND ISSUES, MISSED
MORTGAGE PAYMENTS, MISSED RENT PAYMENTS, A PATTERN OF UNTIMELY PAYMENT
S. 6407--C 34 A. 9007--C
OF DEBTS, FAILURE TO PAY ITS EMPLOYEES OR VENDORS, INSUFFICIENT FUNDS TO
MEET THE GENERAL OPERATING EXPENSES OF THE PROGRAM, FAILURE TO MAINTAIN
REQUIRED DEBT SERVICE COVERAGE RATIOS AND/OR, AS APPLICABLE, FACTORS
THAT HAVE TRIGGERED A WRITTEN EVENT OF DEFAULT NOTICE TO THE OFFICE BY
THE DORMITORY AUTHORITY OF THE STATE OF NEW YORK.
(4) "OFFICE" SHALL MEAN THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISA-
BILITIES.
(5) "TEMPORARY OPERATOR" SHALL MEAN ANY PROVIDER OF SERVICES THAT HAS
BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE PURSUANT TO THIS
ARTICLE OR WHICH IS DIRECTLY OPERATED BY THE OFFICE, THAT:
A. AGREES TO PROVIDE SERVICES CERTIFIED PURSUANT TO THIS ARTICLE ON A
TEMPORARY BASIS IN THE BEST INTERESTS OF ITS INDIVIDUALS SERVED BY THE
PROGRAM; AND
B. HAS A HISTORY OF COMPLIANCE WITH APPLICABLE LAWS, RULES, AND REGU-
LATIONS AND A RECORD OF PROVIDING CARE OF GOOD QUALITY, AS DETERMINED BY
THE COMMISSIONER; AND
C. PRIOR TO APPOINTMENT AS TEMPORARY OPERATOR, DEVELOPS A PLAN DETER-
MINED TO BE SATISFACTORY BY THE COMMISSIONER TO ADDRESS THE PROGRAM'S
DEFICIENCIES.
(B) (1) IN THE EVENT THAT: (I) THE ESTABLISHED OPERATOR IS SEEKING
EXTRAORDINARY FINANCIAL ASSISTANCE; (II) OFFICE COLLECTED DATA DEMON-
STRATES THAT THE ESTABLISHED OPERATOR IS EXPERIENCING SERIOUS FINANCIAL
INSTABILITY ISSUES; (III) OFFICE COLLECTED DATA DEMONSTRATES THAT THE
ESTABLISHED OPERATOR'S BOARD OF DIRECTORS OR ADMINISTRATION IS UNABLE OR
UNWILLING TO ENSURE THE PROPER OPERATION OF THE PROGRAM; OR (IV) OFFICE
COLLECTED DATA INDICATES THERE ARE CONDITIONS THAT SERIOUSLY ENDANGER OR
JEOPARDIZE CONTINUED ACCESS TO NECESSARY SERVICES WITHIN THE COMMUNITY,
THE COMMISSIONER SHALL NOTIFY THE ESTABLISHED OPERATOR OF HIS OR HER
INTENTION TO APPOINT A TEMPORARY OPERATOR TO ASSUME SOLE RESPONSIBILITY
FOR THE PROVIDER OF SERVICES' OPERATIONS FOR A LIMITED PERIOD OF TIME.
THE APPOINTMENT OF A TEMPORARY OPERATOR SHALL BE EFFECTUATED PURSUANT TO
THIS SECTION, AND SHALL BE IN ADDITION TO ANY OTHER REMEDIES PROVIDED BY
LAW.
(2) THE ESTABLISHED OPERATOR 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 NECES-
SARY, ENTER INTO AN AGREEMENT WITH THE ESTABLISHED OPERATOR FOR THE
APPOINTMENT OF A TEMPORARY OPERATOR TO RESTORE OR MAINTAIN THE PROVISION
OF QUALITY CARE TO THE INDIVIDUALS UNTIL THE ESTABLISHED OPERATOR CAN
RESUME OPERATIONS WITHIN THE DESIGNATED TIME PERIOD OR OTHER ACTION IS
TAKEN AS DESCRIBED IN SECTION 16.17 OF THIS ARTICLE.
(C) (1) A TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION SHALL
USE HIS OR HER BEST EFFORTS TO IMPLEMENT THE PLAN DEEMED SATISFACTORY BY
THE COMMISSIONER TO CORRECT OR ELIMINATE ANY DEFICIENCIES IN THE PROGRAM
AND TO PROMOTE THE QUALITY AND ACCESSIBILITY OF SERVICES IN THE COMMUNI-
TY SERVED BY THE PROVIDER OF SERVICES.
(2) DURING THE TERM OF APPOINTMENT, THE TEMPORARY OPERATOR SHALL HAVE
THE AUTHORITY TO DIRECT THE STAFF OF THE ESTABLISHED OPERATOR AS NECES-
SARY TO APPROPRIATELY PROVIDE SERVICES FOR INDIVIDUALS. THE TEMPORARY
OPERATOR SHALL, DURING THIS PERIOD, PROVIDE SERVICES IN SUCH A MANNER AS
TO PROMOTE SAFETY AND THE QUALITY AND ACCESSIBILITY OF SERVICES IN THE
COMMUNITY SERVED BY THE ESTABLISHED OPERATOR UNTIL EITHER THE ESTAB-
LISHED OPERATOR CAN RESUME OPERATIONS OR UNTIL THE OFFICE REVOKES THE
OPERATING CERTIFICATE FOR THE SERVICES ISSUED UNDER THIS ARTICLE.
(3) THE ESTABLISHED OPERATOR SHALL GRANT ACCESS TO THE TEMPORARY OPER-
ATOR TO THE ESTABLISHED OPERATOR'S ACCOUNTS AND RECORDS IN ORDER TO
S. 6407--C 35 A. 9007--C
ADDRESS ANY DEFICIENCIES RELATED TO THE PROGRAM EXPERIENCING SERIOUS
FINANCIAL INSTABILITY OR AN ESTABLISHED OPERATOR REQUESTING FINANCIAL
ASSISTANCE IN ACCORDANCE WITH THIS SECTION. THE TEMPORARY OPERATOR SHALL
APPROVE ANY FINANCIAL DECISION RELATED TO AN ESTABLISHED PROVIDER'S DAY
TO DAY OPERATIONS OR THE ESTABLISHED PROVIDER'S ABILITY TO PROVIDE
SERVICES.
(4) THE TEMPORARY OPERATOR SHALL NOT BE REQUIRED TO FILE ANY BOND. NO
SECURITY INTEREST IN ANY REAL OR PERSONAL PROPERTY COMPRISING THE ESTAB-
LISHED OPERATOR OR CONTAINED WITHIN THE ESTABLISHED OPERATOR OR IN ANY
FIXTURE OF THE PROGRAM, SHALL BE IMPAIRED OR DIMINISHED IN PRIORITY BY
THE TEMPORARY OPERATOR. NEITHER THE TEMPORARY OPERATOR NOR THE OFFICE
SHALL ENGAGE IN ANY ACTIVITY THAT CONSTITUTES A CONFISCATION OF PROPER-
TY.
(D) THE TEMPORARY OPERATOR SHALL BE ENTITLED TO A REASONABLE FEE, AS
DETERMINED BY THE COMMISSIONER AND SUBJECT TO THE APPROVAL OF THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, AND NECESSARY EXPENSES INCURRED WHILE
SERVING AS A TEMPORARY OPERATOR. THE TEMPORARY OPERATOR SHALL BE LIABLE
ONLY IN ITS CAPACITY AS TEMPORARY OPERATOR FOR INJURY TO PERSON AND
PROPERTY BY REASON OF ITS OPERATION OF SUCH PROGRAM; NO LIABILITY SHALL
INCUR IN THE TEMPORARY OPERATOR'S PERSONAL CAPACITY, EXCEPT FOR GROSS
NEGLIGENCE AND INTENTIONAL ACTS.
(E) (1) THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR
SHALL NOT EXCEED NINETY DAYS. AFTER NINETY DAYS, IF THE COMMISSIONER
DETERMINES THAT TERMINATION OF THE TEMPORARY OPERATOR WOULD CAUSE
SIGNIFICANT DETERIORATION OF THE QUALITY OF, OR ACCESS TO, CARE IN THE
COMMUNITY OR THAT REAPPOINTMENT IS NECESSARY TO CORRECT THE DEFICIENCIES
THAT REQUIRED THE APPOINTMENT OF THE TEMPORARY OPERATOR, THE COMMISSION-
ER MAY AUTHORIZE AN ADDITIONAL NINETY-DAY TERM. HOWEVER, SUCH AUTHORI-
ZATION SHALL INCLUDE THE COMMISSIONER'S REQUIREMENTS FOR CONCLUSION OF
THE TEMPORARY OPERATORSHIP TO BE SATISFIED WITHIN THE ADDITIONAL TERM.
(2) 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:
A. THE ACTIONS TAKEN DURING THE APPOINTMENT TO ADDRESS THE IDENTIFIED
PROGRAM DEFICIENCIES, THE RESUMPTION OF PROGRAM OPERATIONS BY THE ESTAB-
LISHED OPERATOR, OR THE REVOCATION OF AN OPERATING CERTIFICATE ISSUED BY
THE OFFICE;
B. OBJECTIVES FOR THE CONTINUATION OF THE TEMPORARY OPERATORSHIP IF
NECESSARY AND A SCHEDULE FOR SATISFACTION OF SUCH OBJECTIVES; AND
C. IF APPLICABLE, THE RECOMMENDED ACTIONS FOR THE ONGOING PROVISION OF
SERVICES SUBSEQUENT TO THE TEMPORARY OPERATORSHIP.
(3) 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.
(F) (1) THE COMMISSIONER SHALL, UPON MAKING A DETERMINATION OF AN
INTENTION TO APPOINT A TEMPORARY OPERATOR PURSUANT TO PARAGRAPH ONE OF
SUBDIVISION (B) OF THIS SECTION, CAUSE THE ESTABLISHED OPERATOR 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 UNDERLYING 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
S. 6407--C 36 A. 9007--C
ALL RELEVANT FINDINGS. AT SUCH MEETING, THE COMMISSIONER AND THE ESTAB-
LISHED OPERATOR SHALL ATTEMPT TO DEVELOP A MUTUALLY SATISFACTORY PLAN OF
CORRECTION AND SCHEDULE FOR IMPLEMENTATION. IN SUCH EVENT, THE COMMIS-
SIONER SHALL NOTIFY THE ESTABLISHED OPERATOR THAT THE COMMISSIONER WILL
ABSTAIN FROM APPOINTING A TEMPORARY OPERATOR CONTINGENT UPON THE ESTAB-
LISHED OPERATOR REMEDIATING THE IDENTIFIED DEFICIENCIES WITHIN THE
AGREED UPON TIMEFRAME.
(2) SHOULD THE COMMISSIONER AND THE ESTABLISHED OPERATOR BE UNABLE TO
ESTABLISH A PLAN OF CORRECTION PURSUANT TO PARAGRAPH ONE 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 THIRTY 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
TEMPORARY OPERATOR IS SUPPORTED BY SUBSTANTIAL EVIDENCE. A COPY OF THE
DECISION SHALL BE SENT TO THE ESTABLISHED OPERATOR.
(3) IF THE DECISION TO APPOINT A TEMPORARY OPERATOR IS UPHELD SUCH
TEMPORARY OPERATOR SHALL BE APPOINTED AS SOON AS IS PRACTICABLE AND
SHALL PROVIDE SERVICES PURSUANT TO THE PROVISIONS OF THIS SECTION.
(G) NOTWITHSTANDING THE APPOINTMENT OF A TEMPORARY OPERATOR, THE
ESTABLISHED OPERATOR SHALL REMAIN OBLIGATED FOR THE CONTINUED PROVISION
OF SERVICES. 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 OF THE PROGRAM HEREUNDER;
NOR SHALL ANYTHING CONTAINED IN THIS SECTION BE CONSTRUED TO SUSPEND
DURING THE TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR OF THE
PROGRAM ANY OBLIGATION OF THE ESTABLISHED OPERATOR OR ANY OTHER PERSON
FOR THE MAINTENANCE AND REPAIR OF THE FACILITY, PROVISION OF UTILITY
SERVICES, 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.
(H) UPON APPOINTMENT OF A TEMPORARY OPERATOR, THE COMMISSIONER SHALL
CAUSE THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE ASSEM-
BLY, AND THE CHAIRS OF THE SENATE MENTAL HEALTH AND DEVELOPMENTAL DISA-
BILITIES COMMITTEE AND THE ASSEMBLY MENTAL HEALTH COMMITTEE TO BE NOTI-
FIED OF SUCH DETERMINATION. SUCH NOTIFICATION SHALL INCLUDE, BUT NOT BE
LIMITED TO, THE NAME OF THE ESTABLISHED OPERATOR, THE NAME OF THE
APPOINTED TEMPORARY OPERATOR AND A DESCRIPTION OF THE REASONS FOR SUCH
DETERMINATION TO THE EXTENT PRACTICABLE UNDER THE CIRCUMSTANCES AND IN
THE SOLE DISCRETION OF THE COMMISSIONER.
S 2. The mental hygiene law is amended by adding a new section 31.20
to read as follows:
S 31.20 TEMPORARY OPERATOR.
(A) FOR THE PURPOSES OF THIS SECTION:
(1) "ESTABLISHED OPERATOR" SHALL MEAN THE OPERATOR OF A MENTAL HEALTH
PROGRAM THAT HAS BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE
PURSUANT TO THIS ARTICLE.
(2) "EXTRAORDINARY FINANCIAL ASSISTANCE" SHALL MEAN STATE FUNDS
PROVIDED TO, OR REQUESTED BY, A PROGRAM FOR THE EXPRESS PURPOSE OF
PREVENTING THE CLOSURE OF THE PROGRAM THAT THE COMMISSIONER FINDS
PROVIDES ESSENTIAL AND NECESSARY SERVICES WITHIN THE COMMUNITY.
(3) "MENTAL HEALTH PROGRAM" SHALL MEAN A PROVIDER OF SERVICES FOR
PERSONS WITH SERIOUS MENTAL ILLNESS, AS SUCH TERMS ARE DEFINED IN
S. 6407--C 37 A. 9007--C
SECTION 1.03 OF THIS CHAPTER, WHICH IS LICENSED OR OPERATED BY THE
OFFICE.
(4) "OFFICE" SHALL MEAN THE OFFICE OF MENTAL HEALTH.
(5) "SERIOUS FINANCIAL INSTABILITY" SHALL INCLUDE BUT NOT BE LIMITED
TO DEFAULTING OR VIOLATING MATERIAL COVENANTS OF BOND ISSUES, MISSED
MORTGAGE PAYMENTS, A PATTERN OF UNTIMELY PAYMENT OF DEBTS, FAILURE TO
PAY ITS EMPLOYEES OR VENDORS, INSUFFICIENT FUNDS TO MEET THE GENERAL
OPERATING EXPENSES OF THE PROGRAM, FAILURE TO MAINTAIN REQUIRED DEBT
SERVICE COVERAGE RATIOS AND/OR, AS APPLICABLE, FACTORS THAT HAVE TRIG-
GERED A WRITTEN EVENT OF DEFAULT NOTICE TO THE OFFICE BY THE DORMITORY
AUTHORITY OF THE STATE OF NEW YORK.
(6) "TEMPORARY OPERATOR" SHALL MEAN ANY OPERATOR OF A MENTAL HEALTH
PROGRAM THAT HAS BEEN ESTABLISHED AND ISSUED AN OPERATING CERTIFICATE
PURSUANT TO THIS ARTICLE OR WHICH IS DIRECTLY OPERATED BY THE OFFICE OF
MENTAL HEALTH, THAT:
A. AGREES TO OPERATE A MENTAL HEALTH PROGRAM ON A TEMPORARY BASIS IN
THE BEST INTERESTS OF ITS PATIENTS SERVED BY THE PROGRAM; AND
B. HAS A HISTORY OF COMPLIANCE WITH APPLICABLE LAWS, RULES, AND REGU-
LATIONS AND A RECORD OF PROVIDING CARE OF GOOD QUALITY, AS DETERMINED BY
THE COMMISSIONER; AND
C. PRIOR TO APPOINTMENT AS TEMPORARY OPERATOR, DEVELOPS A PLAN DETER-
MINED TO BE SATISFACTORY BY THE COMMISSIONER TO ADDRESS THE PROGRAM'S
DEFICIENCIES.
(B) (1) IN THE EVENT THAT: (I) THE ESTABLISHED OPERATOR IS SEEKING
EXTRAORDINARY FINANCIAL ASSISTANCE; (II) OFFICE COLLECTED DATA DEMON-
STRATES THAT THE ESTABLISHED OPERATOR IS EXPERIENCING SERIOUS FINANCIAL
INSTABILITY ISSUES; (III) OFFICE COLLECTED DATA DEMONSTRATES THAT THE
ESTABLISHED OPERATOR'S BOARD OF DIRECTORS OR ADMINISTRATION IS UNABLE OR
UNWILLING TO ENSURE THE PROPER OPERATION OF THE PROGRAM; OR (IV) OFFICE
COLLECTED DATA INDICATES THERE ARE CONDITIONS THAT SERIOUSLY ENDANGER OR
JEOPARDIZE CONTINUED ACCESS TO NECESSARY MENTAL HEALTH SERVICES WITHIN
THE COMMUNITY, THE COMMISSIONER SHALL NOTIFY THE ESTABLISHED OPERATOR OF
HIS OR HER INTENTION TO APPOINT A TEMPORARY OPERATOR TO ASSUME SOLE
RESPONSIBILITY FOR THE PROGRAM'S TREATMENT OPERATIONS FOR A LIMITED
PERIOD OF TIME. THE APPOINTMENT OF A TEMPORARY OPERATOR SHALL BE EFFEC-
TUATED PURSUANT TO THIS SECTION, AND SHALL BE IN ADDITION TO ANY OTHER
REMEDIES PROVIDED BY LAW.
(2) THE ESTABLISHED OPERATOR 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 NECES-
SARY, ENTER INTO AN AGREEMENT WITH THE ESTABLISHED OPERATOR FOR THE
APPOINTMENT OF A TEMPORARY OPERATOR TO RESTORE OR MAINTAIN THE PROVISION
OF QUALITY CARE TO THE PATIENTS UNTIL THE ESTABLISHED OPERATOR CAN
RESUME OPERATIONS WITHIN THE DESIGNATED TIME PERIOD; THE PATIENTS MAY BE
TRANSFERRED TO OTHER MENTAL HEALTH PROGRAMS OPERATED OR LICENSED BY THE
OFFICE; OR THE OPERATIONS OF THE MENTAL HEALTH PROGRAM SHOULD BE
COMPLETELY DISCONTINUED.
(C) (1) A TEMPORARY OPERATOR APPOINTED PURSUANT TO THIS SECTION SHALL
USE HIS OR HER BEST EFFORTS TO IMPLEMENT THE PLAN DEEMED SATISFACTORY BY
THE COMMISSIONER TO CORRECT OR ELIMINATE ANY DEFICIENCIES IN THE MENTAL
HEALTH PROGRAM AND TO PROMOTE THE QUALITY AND ACCESSIBILITY OF MENTAL
HEALTH SERVICES IN THE COMMUNITY SERVED BY THE MENTAL HEALTH PROGRAM.
(2) IF THE IDENTIFIED DEFICIENCIES CANNOT BE ADDRESSED IN THE TIME
PERIOD DESIGNATED IN THE PLAN, THE PATIENTS SHALL BE TRANSFERRED TO
OTHER APPROPRIATE MENTAL HEALTH PROGRAMS LICENSED OR OPERATED BY THE
OFFICE.
S. 6407--C 38 A. 9007--C
(3) DURING THE TERM OF APPOINTMENT, THE TEMPORARY OPERATOR SHALL HAVE
THE AUTHORITY TO DIRECT THE STAFF OF THE ESTABLISHED OPERATOR AS NECES-
SARY TO APPROPRIATELY TREAT AND/OR TRANSFER THE PATIENTS. THE TEMPORARY
OPERATOR SHALL, DURING THIS PERIOD, OPERATE THE MENTAL HEALTH PROGRAM IN
SUCH A MANNER AS TO PROMOTE SAFETY AND THE QUALITY AND ACCESSIBILITY OF
MENTAL HEALTH SERVICES IN THE COMMUNITY SERVED BY THE ESTABLISHED OPERA-
TOR UNTIL EITHER THE ESTABLISHED OPERATOR CAN RESUME PROGRAM OPERATIONS
OR UNTIL THE PATIENTS ARE APPROPRIATELY TRANSFERRED TO OTHER PROGRAMS
LICENSED OR OPERATED BY THE OFFICE.
(4) THE ESTABLISHED OPERATOR SHALL GRANT ACCESS TO THE TEMPORARY OPER-
ATOR TO THE ESTABLISHED OPERATOR'S ACCOUNTS AND RECORDS IN ORDER TO
ADDRESS ANY DEFICIENCIES RELATED TO A MENTAL HEALTH PROGRAM EXPERIENCING
SERIOUS FINANCIAL INSTABILITY OR AN ESTABLISHED OPERATOR REQUESTING
FINANCIAL ASSISTANCE IN ACCORDANCE WITH THIS SECTION. THE TEMPORARY
OPERATOR SHALL APPROVE ANY FINANCIAL DECISION RELATED TO A PROGRAM'S DAY
TO DAY OPERATIONS OR PROGRAM'S ABILITY TO PROVIDE MENTAL HEALTH
SERVICES.
(5) THE TEMPORARY OPERATOR SHALL NOT BE REQUIRED TO FILE ANY BOND. NO
SECURITY INTEREST IN ANY REAL OR PERSONAL PROPERTY COMPRISING THE ESTAB-
LISHED OPERATOR OR CONTAINED WITHIN THE ESTABLISHED OPERATOR OR IN ANY
FIXTURE OF THE MENTAL HEALTH PROGRAM, SHALL BE IMPAIRED OR DIMINISHED IN
PRIORITY BY THE TEMPORARY OPERATOR. NEITHER THE TEMPORARY OPERATOR NOR
THE OFFICE SHALL ENGAGE IN ANY ACTIVITY THAT CONSTITUTES A CONFISCATION
OF PROPERTY.
(D) THE TEMPORARY OPERATOR SHALL BE ENTITLED TO A REASONABLE FEE, AS
DETERMINED BY THE COMMISSIONER AND SUBJECT TO THE APPROVAL OF THE DIREC-
TOR OF THE DIVISION OF THE BUDGET, AND NECESSARY EXPENSES INCURRED WHILE
SERVING AS A TEMPORARY OPERATOR. THE TEMPORARY OPERATOR SHALL BE LIABLE
ONLY IN ITS CAPACITY AS TEMPORARY OPERATOR OF THE MENTAL HEALTH PROGRAM
FOR INJURY TO PERSON AND PROPERTY BY REASON OF ITS OPERATION OF SUCH
PROGRAM; NO LIABILITY SHALL INCUR IN THE TEMPORARY OPERATOR'S PERSONAL
CAPACITY, EXCEPT FOR GROSS NEGLIGENCE AND INTENTIONAL ACTS.
(E) (1) THE INITIAL TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR
SHALL NOT EXCEED NINETY DAYS. AFTER NINETY DAYS, IF THE COMMISSIONER
DETERMINES THAT TERMINATION OF THE TEMPORARY OPERATOR WOULD CAUSE
SIGNIFICANT DETERIORATION OF THE QUALITY OF, OR ACCESS TO, MENTAL HEALTH
CARE IN THE COMMUNITY OR THAT REAPPOINTMENT IS NECESSARY TO CORRECT THE
DEFICIENCIES THAT REQUIRED THE APPOINTMENT OF THE TEMPORARY OPERATOR,
THE COMMISSIONER MAY AUTHORIZE AN ADDITIONAL NINETY-DAY TERM. HOWEVER,
SUCH AUTHORIZATION SHALL INCLUDE THE COMMISSIONER'S REQUIREMENTS FOR
CONCLUSION OF THE TEMPORARY OPERATORSHIP TO BE SATISFIED WITHIN THE
ADDITIONAL TERM.
(2) 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:
A. THE ACTIONS TAKEN DURING THE APPOINTMENT TO ADDRESS THE IDENTIFIED
MENTAL HEALTH PROGRAM DEFICIENCIES, THE RESUMPTION OF MENTAL HEALTH
PROGRAM OPERATIONS BY THE ESTABLISHED OPERATOR, OR THE TRANSFER OF THE
PATIENTS TO OTHER PROVIDERS LICENSED OR OPERATED BY THE OFFICE;
B. OBJECTIVES FOR THE CONTINUATION OF THE TEMPORARY OPERATORSHIP IF
NECESSARY AND A SCHEDULE FOR SATISFACTION OF SUCH OBJECTIVES; AND
C. IF APPLICABLE, THE RECOMMENDED ACTIONS FOR THE ONGOING OPERATION OF
THE MENTAL HEALTH PROGRAM SUBSEQUENT TO THE TEMPORARY OPERATORSHIP.
(3) THE TERM OF THE INITIAL APPOINTMENT AND OF ANY SUBSEQUENT REAP-
POINTMENT MAY BE TERMINATED PRIOR TO THE EXPIRATION OF THE DESIGNATED
S. 6407--C 39 A. 9007--C
TERM, IF THE ESTABLISHED OPERATOR AND THE COMMISSIONER AGREE ON A PLAN
OF CORRECTION AND THE IMPLEMENTATION OF SUCH PLAN.
(F) (1) THE COMMISSIONER SHALL, UPON MAKING A DETERMINATION OF AN
INTENTION TO APPOINT A TEMPORARY OPERATOR PURSUANT TO PARAGRAPH ONE OF
SUBDIVISION (B) OF THIS SECTION CAUSE THE ESTABLISHED OPERATOR 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 UNDERLYING 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, THE COMMISSIONER AND THE ESTAB-
LISHED OPERATOR SHALL ATTEMPT TO DEVELOP A MUTUALLY SATISFACTORY PLAN OF
CORRECTION AND SCHEDULE FOR IMPLEMENTATION. IN SUCH EVENT, THE COMMIS-
SIONER SHALL NOTIFY THE ESTABLISHED OPERATOR THAT THE COMMISSIONER WILL
ABSTAIN FROM APPOINTING A TEMPORARY OPERATOR CONTINGENT UPON THE ESTAB-
LISHED OPERATOR REMEDIATING THE IDENTIFIED DEFICIENCIES WITHIN THE
AGREED UPON TIMEFRAME.
(2) SHOULD THE COMMISSIONER AND THE ESTABLISHED OPERATOR BE UNABLE TO
ESTABLISH A PLAN OF CORRECTION PURSUANT TO PARAGRAPH ONE 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 THIRTY 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
TEMPORARY OPERATOR IS SUPPORTED BY SUBSTANTIAL EVIDENCE. A COPY OF THE
DECISION SHALL BE SENT TO THE ESTABLISHED OPERATOR.
(3) IF THE DECISION TO APPOINT A TEMPORARY OPERATOR IS UPHELD SUCH
TEMPORARY OPERATOR SHALL BE APPOINTED AS SOON AS IS PRACTICABLE AND
SHALL OPERATE THE MENTAL HEALTH PROGRAM PURSUANT TO THE PROVISIONS OF
THIS SECTION.
(G) NOTWITHSTANDING THE APPOINTMENT OF A TEMPORARY OPERATOR, THE
ESTABLISHED OPERATOR SHALL REMAIN OBLIGATED FOR THE CONTINUED OPERATION
OF THE MENTAL HEALTH PROGRAM SO THAT SUCH PROGRAM CAN FUNCTION IN A
NORMAL MANNER. 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 OF THE PROGRAM HEREUNDER;
NOR SHALL ANYTHING CONTAINED IN THIS SECTION BE CONSTRUED TO SUSPEND
DURING THE TERM OF THE APPOINTMENT OF THE TEMPORARY OPERATOR OF THE
PROGRAM ANY OBLIGATION OF THE ESTABLISHED OPERATOR OR ANY OTHER PERSON
FOR THE MAINTENANCE AND REPAIR OF THE FACILITY, PROVISION OF UTILITY
SERVICES, 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.
(H) UPON APPOINTMENT OF A TEMPORARY OPERATOR, THE COMMISSIONER SHALL
CAUSE THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE ASSEM-
BLY, AND THE CHAIRS OF THE SENATE MENTAL HEALTH AND DEVELOPMENTAL DISA-
BILITIES COMMITTEE AND THE ASSEMBLY MENTAL HEALTH COMMITTEE TO BE NOTI-
FIED OF SUCH DETERMINATION. SUCH NOTIFICATION SHALL INCLUDE, BUT NOT BE
LIMITED TO, THE NAME OF THE ESTABLISHED OPERATOR, THE NAME OF THE
APPOINTED TEMPORARY OPERATOR AND A DESCRIPTION OF THE REASONS FOR SUCH
S. 6407--C 40 A. 9007--C
DETERMINATION TO THE EXTENT PRACTICABLE UNDER THE CIRCUMSTANCES AND IN
THE SOLE DISCRETION OF THE COMMISSIONER.
S 3. Subdivision 6 of section 32.20 of the mental hygiene law is
amended by adding a new paragraph (d) to read as follows:
(D) UPON APPOINTMENT OF A TEMPORARY OPERATOR, THE COMMISSIONER SHALL
CAUSE THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE ASSEM-
BLY, AND THE CHAIRS OF THE SENATE AND ASSEMBLY COMMITTEES ON ALCOHOLISM
AND DRUG ABUSE TO BE NOTIFIED OF SUCH DETERMINATION. SUCH NOTIFICATION
SHALL INCLUDE, BUT NOT BE LIMITED TO, THE NAME OF THE ESTABLISHED OPERA-
TOR, THE NAME OF THE APPOINTED TEMPORARY OPERATOR AND A DESCRIPTION OF
THE REASONS FOR SUCH DETERMINATION TO THE EXTENT PRACTICABLE UNDER THE
CIRCUMSTANCES AND IN THE SOLE DISCRETION OF THE COMMISSIONER.
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, 2016; provided,
however, that sections one and two of this act shall expire and be
deemed repealed on March 31, 2021.
PART M
Section 1. Subdivision (d) of section 33.13 of the mental hygiene law,
as amended by section 3 of part E of chapter 111 of the laws of 2010, is
amended to read as follows:
(d) Nothing in this section shall prevent the electronic or other
exchange of information concerning patients or clients, including iden-
tification, between and among (i) facilities or others providing
services for such patients or clients pursuant to an approved local
services plan, as defined in article forty-one of this chapter, or
pursuant to agreement with the department, and (ii) the department or
any of its licensed or operated facilities. NEITHER SHALL ANYTHING IN
THIS SECTION PREVENT THE EXCHANGE OF INFORMATION CONCERNING PATIENTS OR
CLIENTS, INCLUDING IDENTIFICATION, BETWEEN FACILITIES AND MANAGED CARE
ORGANIZATIONS, BEHAVIORAL HEALTH ORGANIZATIONS, HEALTH HOMES OR OTHER
ENTITIES AUTHORIZED BY THE DEPARTMENT OR THE DEPARTMENT OF HEALTH TO
PROVIDE, ARRANGE FOR OR COORDINATE HEALTH CARE SERVICES FOR SUCH
PATIENTS OR CLIENTS WHO ARE ENROLLED IN OR RECEIVING SERVICES FROM SUCH
ORGANIZATIONS OR ENTITIES. PROVIDED HOWEVER, WRITTEN PATIENT OR CLIENT
CONSENT SHALL BE OBTAINED PRIOR TO THE EXCHANGE OF INFORMATION WHERE
REQUIRED BY 42 USC 290DD-2 AS AMENDED, AND ANY REGULATIONS PROMULGATED
THEREUNDER. Furthermore, subject to the prior approval of the commis-
sioner of mental health, hospital emergency services licensed pursuant
to article twenty-eight of the public health law shall be authorized to
exchange information concerning patients or clients electronically or
otherwise with other hospital emergency services licensed pursuant to
article twenty-eight of the public health law and/or hospitals licensed
or operated by the office of mental health; provided that such exchange
of information is consistent with standards, developed by the commis-
sioner of mental health, which are designed to ensure confidentiality of
such information. Additionally, information so exchanged shall be kept
confidential and any limitations on the release of such information
imposed on the party giving the information shall apply to the party
receiving the information.
S 2. Subdivision (d) of section 33.13 of the mental hygiene law, as
amended by section 4 of part E of chapter 111 of the laws of 2010, is
amended to read as follows:
(d) Nothing in this section shall prevent the exchange of information
concerning patients or clients, including identification, between (i)
S. 6407--C 41 A. 9007--C
facilities or others providing services for such patients or clients
pursuant to an approved local services plan, as defined in article
forty-one, or pursuant to agreement with the department and (ii) the
department or any of its facilities. NEITHER SHALL ANYTHING IN THIS
SECTION PREVENT THE EXCHANGE OF INFORMATION CONCERNING PATIENTS OR
CLIENTS, INCLUDING IDENTIFICATION, BETWEEN FACILITIES AND MANAGED CARE
ORGANIZATIONS, BEHAVIORAL HEALTH ORGANIZATIONS, HEALTH HOMES OR OTHER
ENTITIES AUTHORIZED BY THE DEPARTMENT OR THE DEPARTMENT OF HEALTH TO
PROVIDE, ARRANGE FOR OR COORDINATE HEALTH CARE SERVICES FOR SUCH
PATIENTS OR CLIENTS WHO ARE ENROLLED IN OR RECEIVING SERVICES FROM SUCH
ORGANIZATIONS OR ENTITIES. PROVIDED HOWEVER, WRITTEN PATIENT OR CLIENT
CONSENT SHALL BE OBTAINED PRIOR TO THE EXCHANGE OF INFORMATION WHERE
REQUIRED BY 42 USC 290DD-2 AS AMENDED, AND ANY REGULATIONS PROMULGATED
THEREUNDER. Information so exchanged shall be kept confidential and any
limitations on the release of such information imposed on the party
giving the information shall apply to the party receiving the informa-
tion.
S 3. Subdivision (f) of section 33.13 of the mental hygiene law, as
amended by chapter 330 of the laws of 1993, is amended to read as
follows:
(f) ALL RECORDS OF IDENTITY, DIAGNOSIS, PROGNOSIS, TREATMENT, CARE
COORDINATION OR ANY OTHER INFORMATION CONTAINED IN A PATIENT OR CLIENT'S
RECORD SHALL BE CONFIDENTIAL UNLESS DISCLOSURE IS PERMITTED UNDER SUBDI-
VISION (C) OF THIS SECTION. Any disclosure made pursuant to this section
shall be limited to that information necessary AND REQUIRED in light of
the reason for disclosure. Information so disclosed shall be kept confi-
dential by the party receiving such information and the limitations on
disclosure in this section shall apply to such party. Except for disclo-
sures made to the mental hygiene legal service, to persons reviewing
information or records in the ordinary course of insuring that a facili-
ty is in compliance with applicable quality of care standards, or to
governmental agents requiring information necessary for payments to be
made to or on behalf of patients or clients pursuant to contract or in
accordance with law, a notation of all such disclosures shall be placed
in the clinical record of that individual who shall be informed of all
such disclosures upon request; provided, however, that for disclosures
made to insurance companies licensed pursuant to the insurance law, such
a notation need only be entered at the time the disclosure is first
made.
S 4. This act shall take effect immediately; provided that the amend-
ments to subdivision (d) of section 33.13 of the mental hygiene law made
by section one of this act shall be subject to the expiration and rever-
sion of such subdivision pursuant to section 18 of chapter 408 of the
laws of 1999, as amended, when upon such date the provisions of section
two of this act shall take effect.
PART N
Section 1. Subdivision 10 of section 3 of section 1 of chapter 359 of
the laws of 1968, constituting the facilities development corporation
act, as amended by chapter 723 of the laws of 1993, is amended to read
as follows:
10. "Mental hygiene facility" shall mean a building, a unit within a
building, a laboratory, a classroom, a housing unit, a dining hall, an
activities center, a library, real property of any kind or description,
or any structure on or improvement to real property, or an interest in
S. 6407--C 42 A. 9007--C
real property, of any kind or description, owned by or under the juris-
diction of the corporation, including fixtures and equipment which are
an integral part of any such building, unit, structure or improvement, a
walkway, a roadway or a parking lot, and improvements and connections
for water, sewer, gas, electrical, telephone, heating, air conditioning
and other utility services, or a combination of any of the foregoing,
whether for patient care and treatment or staff, staff family or service
use, located at or related to any psychiatric center, any developmental
center, or any state psychiatric or research institute or other facility
now or hereafter established under the department. A mental hygiene
facility shall also mean and include a residential care center for
adults, a "community mental health and retardation facility" and a
treatment facility for use in the conduct of an alcoholism or substance
abuse treatment program as defined in the mental hygiene law unless such
residential care center for adults, community mental health and retarda-
tion facility or alcoholism or substance abuse facility is expressly
excepted, or the context clearly requires otherwise, AND SHALL ALSO MEAN
AND INCLUDE ANY TREATMENT FACILITY FOR USE IN THE CONDUCT OF AN ALCOHOL-
ISM OR SUBSTANCE ABUSE TREATMENT PROGRAM THAT IS ALSO OPERATED AS AN
ASSOCIATED HEALTH CARE FACILITY. The definition contained in this subdi-
vision shall not be construed to exclude therefrom a facility owned or
leased by one or more voluntary agencies that is to be financed, refi-
nanced, designed, constructed, acquired, reconstructed, rehabilitated or
improved under any lease, sublease, loan or other financing agreement
entered into with such voluntary agencies, and shall not be construed to
exclude therefrom a facility to be made available from the corporation
to a voluntary agency at the request of the commissioners of the offices
of the department having jurisdiction thereof. The definition contained
in this subdivision shall not be construed to exclude therefrom a facil-
ity with respect to which a voluntary agency has an ownership interest
in, and proprietary lease from, an organization formed for the purpose
of the cooperative ownership of real estate.
S 2. Section 3 of section 1 of chapter 359 of the laws of 1968,
constituting the facilities development corporation act, is amended by
adding a new subdivision 20 to read as follows:
20. "ASSOCIATED HEALTH CARE FACILITY" SHALL MEAN A FACILITY LICENSED
UNDER AND OPERATED PURSUANT TO ARTICLE 28 OF THE PUBLIC HEALTH LAW OR
ANY HEALTH CARE FACILITY LICENSED UNDER AND OPERATED IN ACCORDANCE WITH
ANY OTHER PROVISIONS OF THE PUBLIC HEALTH LAW OR THE MENTAL HYGIENE LAW
THAT PROVIDES HEALTH CARE SERVICES AND/OR TREATMENT TO ALL PERSONS,
REGARDLESS OF WHETHER SUCH PERSONS ARE PERSONS RECEIVING TREATMENT OR
SERVICES FOR ALCOHOL, SUBSTANCE ABUSE, OR CHEMICAL DEPENDENCY.
S 3. This act shall take effect immediately.
PART O
Section 1. On or before October 1, 2016, the commissioner of develop-
mental disabilities shall issue a report to the temporary president of
the senate and the speaker of the assembly to include the following:
(a) Progress the office has made in meeting the housing needs of indi-
viduals with developmental disabilities, including through:
(1) its ongoing review of the residential registration list, including
information regarding services currently provided to individuals on the
list and any available information on priority placement approaches and
housing needs for such individuals;
S. 6407--C 43 A. 9007--C
(2) increasing access to rental housing, supportive housing, and other
independent living options;
(3) building understanding and awareness of housing options for inde-
pendent living among people with developmental disabilities, families,
public and private organizations, developers and direct support profes-
sionals; and
(4) assisting with the creation of a sustainable living environment
through funding for home modifications, down payment assistance and home
repairs; and
(b) An update on the implementation of the report and recommendations
of the transformation panel, including implementation of the panel's
recommendations to:
(1) increase and support access to self-directed models of care;
(2) enhance opportunities for individuals to access community inte-
grated housing;
(3) increase integrated employment opportunities; and
(4) examine the program design and fiscal model for managed care to
appropriately address the needs of individuals with developmental disa-
bilities.
S 2. This act shall take effect immediately; provided, however, that
this act shall be subject to appropriations made specifically available
for this purpose and shall expire and be deemed repealed April 1, 2017.
PART P
Section 1. Section 13.41 of the mental hygiene law, as added by
section 1 of part E of chapter 60 of the laws of 2014, is amended by
adding two new subdivisions (d) and (e) to read as follows:
(D) INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES WHO WERE EMPLOYED IN
SHELTERED WORKSHOPS ON OR AFTER JULY FIRST, TWO THOUSAND THIRTEEN WHO
ARE NOT INTERESTED IN WORKING OR WHO ARE NOT ABLE TO WORK IN A PROVI-
DER-OWNED BUSINESS OR PRIVATE BUSINESS IN THE COMMUNITY SHALL, TO THE
EXTENT PRACTICABLE AND IN ACCORDANCE WITH THE PRINCIPLES OF PERSON-CEN-
TERED PLANNING, BE AFFORDED THE OPTION OF RECEIVING OTHER SERVICES OF
THE OFFICE, INCLUDING, BUT NOT LIMITED TO PATHWAY TO EMPLOYMENT, COMMU-
NITY PREVOCATIONAL, DAY HABILITATION, COMMUNITY HABILITATION AND
SELF-DIRECTED SERVICES. THE PROVISION OF SUCH SERVICES SHALL CONSIDER,
BUT NOT BE LIMITED TO, THE FOLLOWING FACTORS:
(1) ASSESSMENT OF THE INDIVIDUAL'S SKILLS, INCLUDING SOCIAL BEHAVIOR,
ABILITY TO HANDLE STRESS, ABILITY TO WORK WITH OTHERS, JOB PERFORMANCE,
COMMUNICATION SKILLS, WORK ETHIC, AND INTERESTS;
(2) ASSESSMENT OF THE INDIVIDUAL'S SITUATION, INCLUDING TRANSPORTATION
NEEDS, FAMILY SUPPORTS, AND PHYSICAL AND MENTAL HEALTH; AND
(3) CREATION OF OPPORTUNITIES TO EXPLORE DIFFERENT COMMUNITY AND
VOLUNTEER EXPERIENCES TO OBTAIN INFORMATION THAT WILL BE USED TO CREATE
A PERSON-CENTERED PLAN.
(E) FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES WHO WERE EMPLOYED
IN SHELTERED WORKSHOPS ON OR AFTER JULY FIRST, TWO THOUSAND THIRTEEN
INTERESTED IN RETIREMENT, OFFICE SERVICES SHALL FOCUS ON CONNECTING
INDIVIDUALS TO RETIREMENT-RELATED ACTIVITIES, INCLUDING PARTICIPATING IN
SENIOR AND COMMUNITY CENTER ACTIVITIES, AND OTHER LOCAL ACTIVITIES FOR
RETIREES.
S 2. This act shall take effect immediately.
PART Q
S. 6407--C 44 A. 9007--C
Section 1. Section 13.17 of the mental hygiene law is amended by
adding a new subdivision (d) to read as follows:
(D) IN THE EVENT OF A CLOSURE OR TRANSFER OF A STATE-OPERATED INDIVID-
UALIZED RESIDENTIAL ALTERNATIVE (IRA), THE COMMISSIONER SHALL:
1. PROVIDE APPROPRIATE AND TIMELY NOTIFICATION TO THE TEMPORARY PRESI-
DENT OF THE SENATE, AND THE SPEAKER OF THE ASSEMBLY, AND TO APPROPRIATE
REPRESENTATIVES OF IMPACTED LABOR ORGANIZATIONS. SUCH NOTIFICATION TO
THE REPRESENTATIVES OF IMPACTED LABOR ORGANIZATIONS SHALL BE MADE AS
SOON AS PRACTICABLE, BUT NO LESS THAN FORTY-FIVE DAYS PRIOR TO SUCH
CLOSURE OR TRANSFER EXCEPT IN THE CASE OF EXIGENT CIRCUMSTANCES IMPACT-
ING THE HEALTH, SAFETY, OR WELFARE OF THE RESIDENTS OF THE IRA AS DETER-
MINED BY THE OFFICE. PROVIDED, HOWEVER, THAT NOTHING HEREIN SHALL LIMIT
THE ABILITY OF THE OFFICE TO EFFECTUATE SUCH CLOSURE OR TRANSFER; AND
2. MAKE REASONABLE EFFORTS TO CONFER WITH THE AFFECTED WORKFORCE AND
ANY OTHER PARTY HE OR SHE DEEMS APPROPRIATE TO INFORM SUCH AFFECTED
WORKFORCE, THE RESIDENTS OF THE IRA, AND THEIR FAMILY MEMBERS, WHERE
APPROPRIATE, OF THE PROPOSED CLOSURE OR TRANSFER PLAN.
S 2. This act shall take effect immediately and shall expire and be
deemed repealed March 31, 2018.
PART R
Section 1. Section 281 of the public health law is amended by adding a
new subdivision 7 to read as follows:
7. NOTWITHSTANDING ANY OTHER PROVISION OF THIS SECTION OR ANY OTHER
LAW TO THE CONTRARY, A PRACTITIONER SHALL NOT BE REQUIRED TO ISSUE
PRESCRIPTIONS ELECTRONICALLY IF HE OR SHE CERTIFIES TO THE DEPARTMENT,
IN A MANNER SPECIFIED BY THE DEPARTMENT, THAT HE OR SHE WILL NOT ISSUE
MORE THAN TWENTY-FIVE PRESCRIPTIONS DURING A TWELVE MONTH PERIOD.
PRESCRIPTIONS IN BOTH ORAL AND WRITTEN FORM FOR BOTH CONTROLLED
SUBSTANCES AND NON-CONTROLLED SUBSTANCES SHALL BE INCLUDED IN DETERMIN-
ING WHETHER THE PRACTITIONER WILL REACH THE LIMIT OF TWENTY-FIVE
PRESCRIPTIONS.
(A) A CERTIFICATION SHALL BE SUBMITTED IN ADVANCE OF THE TWELVE-MONTH
CERTIFICATION PERIOD, EXCEPT THAT A TWELVE-MONTH CERTIFICATION SUBMITTED
ON OR BEFORE JULY FIRST, TWO THOUSAND SIXTEEN, MAY BEGIN MARCH
TWENTY-SEVEN, TWO THOUSAND SIXTEEN.
(B) A PRACTITIONER WHO HAS MADE A CERTIFICATION UNDER THIS SUBDIVISION
MAY SUBMIT AN ADDITIONAL CERTIFICATION ON OR BEFORE THE EXPIRATION OF
THE CURRENT TWELVE-MONTH CERTIFICATION PERIOD, FOR A MAXIMUM OF THREE
TWELVE-MONTH CERTIFICATIONS.
(C) A PRACTITIONER MAY MAKE A CERTIFICATION UNDER THIS SUBDIVISION
REGARDLESS OF WHETHER HE OR SHE HAS PREVIOUSLY RECEIVED A WAIVER UNDER
PARAGRAPH (C) OF SUBDIVISION THREE OF THIS SECTION.
S 2. Section 6810 of the education law is amended by adding a new
subdivisions 15 to read as follows:
15. NOTWITHSTANDING ANY OTHER PROVISIONS OF THIS SECTION OR ANY OTHER
LAW TO THE CONTRARY, A PRACTITIONER SHALL NOT BE REQUIRED TO ISSUE
PRESCRIPTIONS ELECTRONICALLY IF HE OR SHE CERTIFIES TO THE DEPARTMENT OF
HEALTH, IN A MANNER SPECIFIED BY THE DEPARTMENT OF HEALTH, THAT HE OR
SHE WILL NOT ISSUE MORE THAN TWENTY-FIVE PRESCRIPTIONS DURING A TWELVE
MONTH PERIOD. PRESCRIPTIONS IN BOTH ORAL AND WRITTEN FORM FOR BOTH
CONTROLLED SUBSTANCES AND NON-CONTROLLED SUBSTANCES SHALL BE INCLUDED IN
DETERMINING WHETHER THE PRACTITIONER WILL REACH THE LIMIT OF TWENTY-FIVE
PRESCRIPTIONS.
S. 6407--C 45 A. 9007--C
(A) A CERTIFICATION SHALL BE SUBMITTED IN ADVANCE OF THE TWELVE-MONTH
CERTIFICATION PERIOD, EXCEPT THAT A TWELVE-MONTH CERTIFICATION SUBMITTED
ON OR BEFORE ON JULY FIRST,TWO THOUSAND SIXTEEN, MAY BEGIN MARCH TWEN-
TY-SEVENTH, TWO THOUSAND SIXTEEN.
(B) A PRACTITIONER WHO HAS MADE A CERTIFICATION UNDER THIS SUBDIVISION
MAY SUBMIT AN ADDITIONAL CERTIFICATION ON OR BEFORE THE EXPIRATION OF
THE CURRENT TWELVE-MONTH CERTIFICATION PERIOD, FOR A MAXIMUM OF THREE
TWELVE-MONTH CERTIFICATIONS.
(C) A PRACTITIONER MAY MAKE A CERTIFICATION UNDER THIS SUBDIVISION
REGARDLESS OF WHETHER HE OR SHE HAS PREVIOUSLY RECEIVED A WAIVER UNDER
PARAGRAPHS (C) OF SUBDIVISION TEN OF THIS SECTION.
S 3. Section 2807-m of the public health law is amended by adding a
new subdivision 12 to read as follows:
12. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, APPLICATIONS
SUBMITTED ON OR AFTER APRIL FIRST, TWO THOUSAND SIXTEEN, FOR THE PHYSI-
CIAN LOAN REPAYMENT PROGRAM PURSUANT TO PARAGRAPH (D) OF SUBDIVISION
FIVE-A OF THIS SECTION AND SUBDIVISION TEN OF THIS SECTION OR THE PHYSI-
CIAN PRACTICE SUPPORT PROGRAM PURSUANT TO PARAGRAPH (E) OF SUBDIVISION
FIVE-A OF THIS SECTION, SHALL BE SUBJECT TO THE FOLLOWING CHANGES:
(A) AWARDS SHALL BE MADE FROM THE TOTAL FUNDING AVAILABLE FOR NEW
AWARDS UNDER THE PHYSICIAN LOAN REPAYMENT PROGRAM AND THE PHYSICIAN
PRACTICE SUPPORT PROGRAM, WITH NEITHER PROGRAM LIMITED TO A SPECIFIC
FUNDING AMOUNT WITHIN SUCH TOTAL FUNDING AVAILABLE;
(B) AN APPLICANT MAY APPLY FOR AN AWARD FOR EITHER PHYSICIAN LOAN
REPAYMENT OR PHYSICIAN PRACTICE SUPPORT, BUT NOT BOTH;
(C) AN APPLICANT SHALL AGREE TO PRACTICE FOR THREE YEARS IN AN UNDER-
SERVED AREA AND EACH AWARD SHALL PROVIDE UP TO FORTY THOUSAND DOLLARS
FOR EACH OF THE THREE YEARS; AND
(D) TO THE EXTENT PRACTICABLE, AWARDS SHALL BE TIMED TO BE OF USE FOR
JOB OFFERS MADE TO APPLICANTS.
S 4. Subdivisions 1 and 4 of section 461-s of the social services law,
subdivision 1 as added by section 21 of part D of chapter 56 of the laws
of 2012 and subdivision 4 as added by section 6 of part A of chapter 57
of the laws of 2015, are amended to read as follows:
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 facility resi-
dents 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. ON
OR BEFORE JUNE FIRST OF EACH YEAR, THE DEPARTMENT SHALL MAKE AVAILABLE
THE APPLICATION FOR EQUAL PROGRAM FUNDS.
4. EQUAL program funds shall not be expended for a facility's daily
operating expenses, including employee salaries or benefits, or for
expenses incurred retrospectively, EXCEPT THAT EXPENDITURES MAY BE
INCURRED PRIOR TO THE APPROVAL OF THE FACILITY'S APPLICATION FOR SUCH
FISCAL YEAR, PROVIDED THAT: (A) CONSISTENT WITH SUBDIVISION THREE OF
THIS SECTION, THE RESIDENTS' COUNCIL APPROVES SUCH EXPENDITURE PRIOR TO
THE EXPENDITURE BEING INCURRED, AND THE FACILITY PROVIDES WITH ITS
APPLICATION DOCUMENTATION OF SUCH APPROVAL AND THE DATE THEREOF; AND (B)
THE EXPENDITURE MEETS ALL APPLICABLE REQUIREMENTS PURSUANT TO THIS
SECTION AND IS SUBSEQUENTLY APPROVED BY THE DEPARTMENT. EQUAL program
funds may be used for expenditures related to corrective action as
S. 6407--C 46 A. 9007--C
required by an inspection report, provided such expenditure is consist-
ent with subdivision three of this section.
S 5. Section 616 of the public health law is amended by adding a new
subdivision 3 to read as follows:
3. ADMINISTRATIVE POLICY CHANGES RELATING TO STATE AID SHALL NOT BE
IMPLEMENTED WITHOUT REASONABLE AND STATEWIDE ADVANCE WRITTEN NOTICE TO
MUNICIPALITIES.
S 6. Subdivision 2 of section 2802 of the public health law, as
amended by section 58 of part A of chapter 58 of the laws of 2010, is
amended to read as follows:
2. The commissioner shall not act upon an application for construction
of a hospital until the public health and health planning council and
the health systems agency have had a reasonable time to submit their
recommendations, and unless (a) the applicant has obtained all approvals
and consents required by law for its incorporation or establishment
(including the approval of the public health and health planning council
pursuant to the provisions of this article) provided, however, that the
commissioner may act upon an application for construction by an appli-
cant possessing a valid operating certificate when the application qual-
ifies for review without the recommendation of the council pursuant to
regulations adopted by the council and approved by the commissioner, OR
AS OTHERWISE AUTHORIZED BY THIS SECTION; and (b) the commissioner is
satisfied as to the public need for the construction, at the time and
place and under the circumstances proposed, provided however that, in
the case of an application by a hospital established or operated by an
organization defined in subdivision one of section four hundred eighty-
two-b of the social services law, the needs of the members of the reli-
gious denomination concerned, for care or treatment in accordance with
their religious or ethical convictions, shall be deemed to be public
need.
S 7. Section 2802 of the public health law is amended by adding a new
subdivision 2-c to read as follows:
2-C. AN APPLICATION FOR THE RELOCATION OF LONG-TERM VENTILATOR BEDS
FROM ONE RESIDENTIAL HEALTH CARE FACILITY TO ANOTHER RESIDENTIAL HEALTH
CARE FACILITY WITH COMMON OWNERSHIP SHALL BE SUBJECT, AS DETERMINED BY
THE COMMISSIONER, TO EITHER AN ADMINISTRATIVE OR LIMITED REVIEW BY THE
DEPARTMENT. COMMON OWNERSHIP SHALL BE FOUND WHEN THE OWNERSHIP OR
CONTROLLING INTEREST IN THE OPERATOR OF EACH RESIDENTIAL HEALTH CARE
FACILITY IS THE SAME, PROVIDED THE PERCENTAGE OF OWNERSHIP INTEREST OF
EACH OWNER MAY VARY BETWEEN THE TWO FACILITIES BUT MUST MEET THE WHOLE
IN COMMON OWNERSHIP. FOR PURPOSES OF THIS SUBDIVISION, THE COMMISSIONER,
WHEN MAKING A DETERMINATION OF PUBLIC NEED, MAY CONSIDER ACCESS TO
LONG-TERM VENTILATOR BEDS IN THE AFFECTED PORTIONS OF THE HEALTH SYSTEMS
REGION, AND THE QUALITY OF CARE PROVIDED AT THE FACILITIES WITH COMMON
OWNERSHIP. AT NO TIME SHALL AN APPLICATION SUBMITTED PURSUANT TO THIS
SUBDIVISION RESULT IN A CHANGE IN THE TOTAL COMBINED NUMBER OF LONG-TERM
VENTILATOR AND RESIDENTIAL HEALTH CARE FACILITY BEDS, INCLUDING RESIDEN-
TIAL HEALTH CARE FACILITY BEDS CONVERTED FROM TRANSFERRED LONG-TERM
VENTILATOR BEDS, OPERATED BY THE TWO FACILITIES WITH COMMON OWNERSHIP.
S 8. Subdivision 4 of section 28 of part H of chapter 60 of the laws
of 2014, amending the insurance law, the public health law and the
financial services law relating to establishing protections to prevent
surprise medical bills including network adequacy requirements, claim
submission requirements, access to out-of-network care and prohibition
of excessive emergency charges, is amended to read as follows:
S. 6407--C 47 A. 9007--C
4. The workgroup shall report its findings and make recommendations
for legislation and regulations to the governor, the speaker of the
assembly, the senate majority leader, the chairs of the insurance and
health committees in both the assembly and the senate, and the super-
intendent of the department of financial services no later than [Janu-
ary] OCTOBER 1, 2016.
S 9. This act shall take effect immediately; provided however, that
sections one and two of this act shall take effect on the first of June
next succeeding the date on which it shall have become a law and shall
expire and be deemed repealed four years after such effective date.
PART S
Section 1. Section 209 of the elder law, as amended by section 41 of
part A of chapter 58 of the laws of 2010, paragraph (b) of subdivision 1
as separately amended by chapter 348 of the laws of 2010, paragraph (d)
of subdivision 1 as amended by chapter 271 of the laws of 2014, para-
graph (d) of subdivision 4 as separately amended by chapter 410 of the
laws of 2010, and paragraph (k) of subdivision 4, subparagraph (6) of
paragraph (c) of subdivision 5-a, and subdivision 6 as amended by chap-
ter 320 of the laws of 2011, is amended to read as follows:
S 209. Naturally occurring retirement community supportive service
program. 1. As used in this section:
(a) ["Advisory committee" or "committee" shall mean the advisory
committee convened by the director for the purposes specified in this
section. Such committee shall be broadly representative of housing and
senior citizen groups, and all geographic areas of the state.
(b)] "Older adults" shall mean persons who are sixty years of age or
older.
[(c)] (B) "Eligible applicant" shall mean a not-for-profit agency
specializing in housing, health or other human services which serves or
would serve the community within which a naturally occurring retirement
community is located.
(C) "HEALTH INDICATORS/PERFORMANCE IMPROVEMENT" SHALL MEAN A SURVEY
TOOL, DATABASE, AND PROCESS THAT PROVIDES GRANTEES WITH PERFORMANCE
OUTCOMES DATA.
(d) "Eligible services" shall mean THE FOLLOWING services PROVIDED BY
A CLASSIC OR NEIGHBORHOOD NORC PROGRAM, OR IN COORDINATION WITH OTHER
ENTITIES, including, but not limited to: [case management, care coordi-
nation, counseling, health assessment and monitoring, transportation,
socialization activities, home care facilitation and monitoring, educa-
tion regarding the signs of elder abuse and exploitation and available
resources for a senior who is a suspected victim of elder abuse or
exploitation, chemical dependence counseling provided by credentialed
alcoholism and substance abuse counselors as defined in paragraph three
of subdivision (d) of section 19.07 of the mental hygiene law and refer-
rals to appropriate chemical dependence counseling providers, and other
services designed to address the needs of residents of naturally occur-
ring retirement communities by helping them extend their independence,
improve their quality of life, and avoid unnecessary hospital and nurs-
ing home stays.
(e) "Government assistance" shall mean and be broadly interpreted to
mean any monetary assistance provided by the federal, the state or a
local government, or any agency thereof, or any authority or public
benefit corporation, in any form, including loans or loan subsidies, for
the construction of an apartment building or housing complex for low and
S. 6407--C 48 A. 9007--C
moderate income persons, as such term is defined by the United States
Department of Housing and Urban Development.
(f)] PERSON CENTERED PLANNING, CASE ASSISTANCE, CARE COORDINATION,
INFORMATION AND ASSISTANCE, APPLICATION AND BENEFIT ASSISTANCE, HEALTH
CARE MANAGEMENT AND ASSISTANCE, VOLUNTEER SERVICES, HEALTH PROMOTION AND
LINKAGES TO PREVENTION SERVICES AND SCREENINGS, LINKAGES TO IN-HOME
SERVICES, HEALTH INDICATORS/PERFORMANCE IMPROVEMENT, HOUSEKEEPING/CHORE,
PERSONAL CARE, COUNSELING, SHOPPING AND/OR MEAL PREPARATION ASSISTANCE,
ESCORT, TELEPHONE REASSURANCE, TRANSPORTATION, FRIENDLY VISITING,
SUPPORT GROUPS, PERSONAL EMERGENCY RESPONSE SYSTEMS (PERS), MEALS,
RECREATION, BILL PAYING ASSISTANCE, EDUCATION REGARDING THE SIGNS OF
ELDER ABUSE OR EXPLOITATION AND AVAILABLE RESOURCES FOR A SENIOR WHO IS
A SUSPECTED VICTIM OF ELDER ABUSE OR EXPLOITATION, CHEMICAL DEPENDANCE
COUNSELING PROVIDED BY CREDENTIALED ALCOHOLISM AND SUBSTANCE ABUSE COUN-
SELORS AS DEFINED IN PARAGRAPH THREE OF SUBDIVISION (D) OF SECTION 19.07
OF THE MENTAL HYGIENE LAW AND REFERRALS TO APPROPRIATE CHEMICAL DEPEND-
ENCE COUNSELING PROVIDERS, AND OTHER SERVICES DESIGNED TO ADDRESS THE
NEEDS OF RESIDENTS OF CLASSIC AND NEIGHBORHOOD NORCS BY HELPING THEM
EXTEND THEIR INDEPENDENCE, IMPROVE THEIR QUALITY OF LIFE, AND MAXIMIZE
THEIR WELL-BEING.
(E) "Naturally occurring retirement community", "CLASSIC NATURALLY
OCCURRING RETIREMENT COMMUNITY" OR "CLASSIC NORC" shall mean an apart-
ment building or housing complex which:
(1) [was constructed with government assistance;
(2)] was not [originally] PREDOMINANTLY built for older adults;
[(3)] (2) does not restrict admissions solely to older adults;
[(4)] (3) (A) at least [fifty] FORTY percent of the units have an
occupant who is an older adult [or]; AND
(B) in which at least [twenty-five hundred] TWO HUNDRED FIFTY of the
residents OF AN APARTMENT BUILDING are older adults OR FIVE HUNDRED
RESIDENTS OF A HOUSING COMPLEX ARE OLDER ADULTS; and
[(5)] (4) a majority of the older adults to be served are low or
moderate income, as defined by the United States Department of Housing
and Urban Development.
(F) "NEIGHBORHOOD NATURALLY OCCURRING RETIREMENT COMMUNITY" OR "NEIGH-
BORHOOD NORC" SHALL MEAN A RESIDENTIAL DWELLING OR GROUP OF RESIDENTIAL
DWELLINGS IN A GEOGRAPHICALLY DEFINED NEIGHBORHOOD OR GROUP OF CONTIG-
UOUS NEIGHBORHOODS WHICH:
(1) WAS NOT PREDOMINANTLY DEVELOPED FOR OLDER ADULTS;
(2) DOES NOT PREDOMINANTLY RESTRICT ADMISSION TO OLDER ADULTS;
(3) (A) IN A NON-RURAL AREA, HAS AT LEAST THIRTY PERCENT OF THE RESI-
DENTS WHO ARE OLDER ADULTS OR THE UNITS HAVE AN OCCUPANT WHO IS AN OLDER
ADULT; (B) IN A RURAL AREA, HAS AT LEAST TWENTY PERCENT OF THE RESIDENTS
WHO ARE OLDER ADULTS OR THE UNITS HAVE AN OCCUPANT WHO IS AN OLDER
ADULT; AND
(4) IS MADE UP OF LOW-RISE BUILDINGS SIX STORIES OR LESS AND/OR SINGLE
AND MULTI-FAMILY HOMES, PROVIDED, HOWEVER, THAT APARTMENT BUILDINGS AND
HOUSING COMPLEXES MAY BE INCLUDED IN RURAL AREAS.
(G) "RURAL AREAS" SHALL MEAN COUNTIES WITHIN THE STATE HAVING A POPU-
LATION OF LESS THAN TWO HUNDRED THOUSAND PERSONS INCLUDING THE MUNICI-
PALITIES, INDIVIDUALS, INSTITUTIONS, COMMUNITIES, PROGRAMS, AND SUCH
OTHER ENTITIES OR RESOURCES AS ARE FOUND THEREIN; OR, IN COUNTIES WITH A
POPULATION OF TWO HUNDRED THOUSAND OR MORE, TOWNS WITH A POPULATION
DENSITY OF LESS THAN ONE HUNDRED AND FIFTY PERSONS PER SQUARE MILE
INCLUDING THE VILLAGES, INDIVIDUALS, INSTITUTIONS, COMMUNITIES,
PROGRAMS, AND SUCH OTHER ENTITIES OR RESOURCES AS ARE FOUND THEREIN.
S. 6407--C 49 A. 9007--C
(H) "NON-RURAL AREAS" SHALL MEAN ANY COUNTY, CITY, OR TOWN THAT HAS A
POPULATION OR POPULATION DENSITY GREATER THAN THAT WHICH DEFINES A RURAL
AREA PURSUANT TO THIS SUBDIVISION.
2. A naturally occurring retirement community supportive service
program is established as a [demonstration] program to be administered
by the director.
3. The director shall [be assisted by the advisory committee in the
development of] DEVELOP appropriate criteria for the selection of gran-
tees of funds provided pursuant to this section [and programmatic issues
as deemed appropriate by the director].
4. The criteria [recommended by the committee and adopted by the
director] for the award of grants shall be consistent with the
provisions of this section and shall include, at a minimum:
(a) the number, size, type and location of the projects to be served,
INCLUDING THE NUMBER, SIZE, TYPE AND LOCATION OF RESIDENTIAL DWELLINGS
OR GROUP OF RESIDENTIAL DWELLINGS SELECTED AS CANDIDATES FOR INCLUSION
IN A NEIGHBORHOOD NATURALLY OCCURRING RETIREMENT COMMUNITY; provided,
that the [committee and] director shall make reasonable efforts to
assure that geographic balance in the distribution of such projects is
maintained, consistent with the needs to be addressed, funding avail-
able, applications for eligible applicants, ABILITY TO COORDINATE
SERVICES, other requirements of this section, and other criteria devel-
oped by the [committee and] director;
(b) the appropriate number and concentration of older adult residents
to be served by an individual project; provided, that such criteria need
not specify, in the case of a project which includes several buildings,
the number of older adults to be served in any individual building;
(c) the demographic characteristics of the residents to be served;
(d) A REQUIREMENT THAT THE APPLICANT DEMONSTRATE COMMUNITY WIDE
SUPPORT FROM RESIDENTS, NEIGHBORHOOD ASSOCIATIONS, COMMUNITY GROUPS,
NONPROFIT ORGANIZATIONS AND OTHERS;
(E) IN THE CASE OF NEIGHBORHOOD NATURALLY OCCURRING RETIREMENT COMMU-
NITIES, A REQUIREMENT THAT THE BOUNDARIES OF THE GEOGRAPHIC AREA TO BE
SERVED ARE CLEAR AND COHERENT AND CREATE AN IDENTIFIABLE PROGRAM AND
SUPPORTIVE COMMUNITY;
(F) the financial or in-kind support required to be provided to the
project by the owners, managers and residents of the housing development
OR GEOGRAPHICALLY DEFINED AREA; provided, however, that such criteria
need not address whether the funding is public or private, or the source
of such support;
[(e)] (G) the scope and intensity of the services to be provided, and
their appropriateness for the residents proposed to be served. THE
APPLICANT SHALL HAVE CONDUCTED A NEEDS ASSESSMENT ON THE BASIS OF WHICH
SUCH APPLICANT SHALL ESTABLISH THE NATURE AND EXTENT OF SERVICES TO BE
PROVIDED; AND FURTHER THAT SUCH SERVICES SHALL PROVIDE A MIX OF APPRO-
PRIATE SERVICES THAT PROVIDE ACTIVE AND MEANINGFUL PARTICIPATION FOR
RESIDENTS. The criteria shall not require that the applicant agency be
the sole provider of such services, but shall require that the applicant
at a minimum actively manage the provision of such services. SUCH
SERVICES MAY BE THE SAME AS SERVICES PROVIDED BY THE LOCAL MUNICIPALITY
OR OTHER COMMUNITY-BASED ORGANIZATION PROVIDED THAT THOSE SERVICES ARE
NOT AVAILABLE TO OR DO NOT ENTIRELY MEET THE NEEDS OF THE RESIDENTS OF
THE CLASSIC OR NEIGHBORHOOD NATURALLY OCCURRING RETIREMENT COMMUNITY;
[(f)] (H) the experience and financial stability of the applicant
agency, [provided that the criteria shall require that priority be given
to programs already in operation, including those projects participating
S. 6407--C 50 A. 9007--C
in the resident advisor program administered by the office, and enriched
housing programs which meet the requirements of this section and which
have demonstrated] WHO SHALL DEMONSTRATE to the satisfaction of the
director [and the committee] their fiscal and managerial stability and
programmatic success in serving residents;
[(g)] (I) the [nature and extent of requirements proposed to be estab-
lished] PLAN for active, meaningful participation for residents proposed
to be served in project design, implementation, monitoring, evaluation,
and governance;
[(h)] (J) an agreement by the applicant to participate in [the] data
collection and evaluation [project] necessary to IMPLEMENT PERFORMANCE
MEASURES FOR HEALTH INDICATORS/PERFORMANCE IMPROVEMENT AND complete the
report required by this section;
[(i)] (K) the policy and program roles of the applicant agency and any
other agencies involved in the provision of services or the management
of the project, including COMMUNITY-BASED ORGANIZATIONS, the housing
development governing body, or other owners or managers of the apartment
buildings and housing complexes and the residents of such apartment
buildings and housing complexes. The criteria shall require a clear
delineation of such policy and program roles;
[(j)] (L) a requirement that each eligible agency document the need
for the project and financial commitments to it from such sources as
[the committee and] the director shall deem appropriate given the char-
acter and nature of the proposed project, and written evidence of
support from the appropriate housing development governing body or other
owners or managers of the apartment buildings and housing complexes IN
THE CASE OF CLASSIC NATURALLY OCCURRING RETIREMENT COMMUNITIES, OR THE
GEOGRAPHICALLY DEFINED NEIGHBORHOOD IN THE CASE OF NEIGHBORHOOD
NATURALLY OCCURRING RETIREMENT COMMUNITIES. The purpose of such documen-
tation shall be to demonstrate the need for the project, support for it
in the areas to be served, and the financial and managerial ability to
sustain the project;
[(k)] (M) a requirement that any aid provided pursuant to this section
be matched by an equal amount, in-kind support of equal value, or some
combination thereof from other sources, provided that such in-kind
support [to] be utilized only upon approval from the director and only
to the extent matching funds are not available, and that at least twen-
ty-five percent of such amount be contributed by the housing development
governing body or other owners or managers and residents of the apart-
ment buildings and housing complexes, OR GEOGRAPHICALLY DEFINED AREA, in
which the project is proposed, or, upon approval by the director, sourc-
es in neighborhoods contiguous to the boundaries of the geographic areas
served where services may also be provided pursuant to subdivision six
of this section; [and]
[(l)] (N) the circumstances under which the director may waive all or
part of the requirement for provision of an equal amount of funding from
other sources required pursuant to paragraph [(k)] (M) of this subdivi-
sion, provided that such criteria shall include provision for waiver at
the discretion of the director upon a finding by the director that the
program will serve a low income or hardship community, and that such
waiver is required to assure that such community receive a fair share of
the funding available. The committee shall develop appropriate criteria
for determining whether a community is a low income or hardship communi-
ty[.];
(O) THE POLICY AND PROGRAM ROLES OF THE APPLICANT AGENCY AND ANY OTHER
AGENCIES INVOLVED IN THE PROVISION OF SERVICES OR THE MANAGEMENT OF THE
S. 6407--C 51 A. 9007--C
NEIGHBORHOOD NATURALLY OCCURRING RETIREMENT COMMUNITY, PROVIDED THAT THE
CRITERIA SHALL REQUIRE A CLEAR DELINEATION OF SUCH POLICY AND PROGRAM
ROLES; AND
(P) A PLAN FOR COORDINATION WITH THE DESIGNATED AREA AGENCY ON AGING
TO LEVERAGE ADDITIONAL SERVICES FOR CLASSIC OR NEIGHBORHOOD NORC PARTIC-
IPANTS.
4-A. THE DIRECTOR SHALL DEVELOP A LIST OF PRIORITY AND OPTIONAL
SERVICES FROM THE ELIGIBLE SERVICES LISTED IN PARAGRAPH (D) OF SUBDIVI-
SION ONE OF THIS SECTION WHICH MAY BE USED IN THE SELECTION OF GRANTEES
PURSUANT TO THIS SECTION.
4-B. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, PRIORITY
SHALL BE GIVEN IN ANY COMPETITIVE BIDDING OR REQUEST FOR PROPOSALS PROC-
ESS CONDUCTED FOR THE NATURALLY OCCURRING RETIREMENT COMMUNITY SUPPORT-
IVE SERVICES PROGRAM TO APPLICANTS THAT PROPOSE TO SERVE A BUILDING,
HOUSING COMPLEX, OR CATCHMENT AREA THAT IS BEING SERVED AT THE TIME OF
THE COMPETITIVE BIDDING OR REQUEST FOR PROPOSALS PROCESS.
5. Within amounts specifically appropriated therefor and consistent
with the criteria developed and required pursuant to this section the
director shall approve grants to eligible applicants [in amounts not to
exceed one hundred fifty thousand dollars for a project in any twelve
month period. The director shall not approve more than ten grants in the
first twelve month period after the effective date of this section.
5-a. The director may, in addition recognize neighborhood naturally
occurring retirement communities, or Neighborhood NORCs, and provide
program support within amounts specifically available by appropriation
therefor, which shall be subject to the requirements, rules and regu-
lations of this section, provided however that:
(a) the term Neighborhood NORC as used in this subdivision shall mean
and refer to a residential dwelling or group of residential dwellings in
a geographically defined neighborhood of a municipality containing not
more than two thousand persons who are older adults reside in at least
forty percent of the units and which is made up of low-rise buildings
six stories or less in height and/or single and multi-family homes and
which area was not originally developed for older adults, and which does
not restrict admission strictly to older adults;
(b) grants to an eligible Neighborhood NORC shall be no less than
sixty thousand dollars for any twelve-month period;
(c) the director shall be assisted by the advisory committee in the
development of criteria for the selection of grants provided pursuant to
this section and programmatic issues as deemed appropriate by the direc-
tor. The criteria recommended by the committee and adopted by the direc-
tor for the award of grants shall be consistent with the provisions of
this subdivision and shall include, at a minimum, the following require-
ments or items of information using such criteria as the advisory
committee and the director shall approve:
(1) the number, size, type and location of residential dwellings or
group of residential dwellings selected as candidates for neighborhood
NORCs funding. The director shall make reasonable efforts to assure that
geographic balance in the distribution of such grants is maintained,
consistent with the needs to be addressed, funding available, applica-
tions from eligible applicants, ability to coordinate services and other
requirements of this section;
(2) the appropriate number and concentration of older adult residents
to be served by an individual Neighborhood NORC. The criteria need not
specify the number of older adults to be served in any individual build-
ing;
S. 6407--C 52 A. 9007--C
(3) the demographic characteristics of the residents to be served;
(4) a requirement that the applicant demonstrate the development or
intent to develop community wide support from residents, neighborhood
associations, community groups, nonprofit organizations and others;
(5) a requirement that the boundaries of the geographic area to be
served are clear and coherent and create an identifiable program and
supportive community;
(6) a requirement that the applicant commit to raising matching funds,
in-kind support, or some combination thereof from non-state sources,
provided that such in-kind support be utilized only upon approval from
the director and only to the extent matching funds are not available,
equal to fifteen percent of the state grant in the second year after the
program is approved, twenty-five percent in the third year, forty
percent in the fourth year, and fifty percent in the fifth year, and
further commit that in each year, twenty-five percent of such required
matching funds, in-kind support, or combination thereof be raised within
the community served and, upon approval by the director, in neighbor-
hoods contiguous to the boundaries of the geographic areas served where
services may also be provided pursuant to subdivision six of this
section. Such local community matching funds, in-kind support, or combi-
nation thereof shall include but not be limited to: dues, fees for
service, individual and community contributions, and such other funds as
the advisory committee and the director shall deem appropriate;
(7) a requirement that the applicant demonstrate experience and finan-
cial stability;
(8) a requirement that priority in selection be given to programs in
existence prior to the effective date of this subdivision which, except
for designation and funding requirements established herein, would have
otherwise generally qualified as a Neighborhood NORC;
(9) a requirement that the applicant conduct or have conducted a needs
assessment on the basis of which such applicant shall establish the
nature and extent of services to be provided; and further that such
services shall provide a mix of appropriate services that provide active
and meaningful participation for residents;
(10) a requirement that residents to be served shall be involved in
design, implementation, monitoring, evaluation and governance of the
Neighborhood NORC;
(11) an agreement by the applicant that it will participate in the
data collection and evaluation necessary to complete the reporting
requirements as established by the director;
(12) the policy and program roles of the applicant agency and any
other agencies involved in the provision of services or the management
of the Neighborhood NORC, provided that the criteria shall require a
clear delineation of such policy and program roles;
(13) a requirement that each applicant document the need for the grant
and financial commitments to it from such sources as the advisory
committee and the director shall deem appropriate given the character
and nature of the proposed Neighborhood NORC and written evidence of
support from the community;
(14) the circumstances under which the director may waive all or part
of the requirement for provision of an equal amount of funding from
other sources required pursuant to this subdivision, provided that such
criteria shall include provision for waiver at the discretion of the
director upon a finding by the director that the Neighborhood NORC will
serve a low income or hardship community, and that such waiver is
required to assure that such community receive a fair share of the fund-
S. 6407--C 53 A. 9007--C
ing available. For purposes of this paragraph, a hardship community may
be one that has developed a successful model but which needs additional
time to raise matching funds required herein. An applicant applying for
a hardship exception shall submit a written plan in a form and manner
determined by the director detailing its plans to meet the matching
funds requirement in the succeeding year;
(15) a requirement that any proposed Neighborhood NORC in a geograph-
ically defined neighborhood of a municipality containing more than two
thousand older adults shall require the review and recommendation by the
advisory committee before being approved by the director;
(d) on or before March first, two thousand eight, the director shall
report to the governor and the fiscal and aging committees of the senate
and the assembly concerning the effectiveness of Neighborhood NORCs in
achieving the objectives set forth by this subdivision. Such report
shall address each of the items required for Neighborhood NORCs in
achieving the objectives set forth in this section and such other items
of information as the director shall deem appropriate, including recom-
mendations concerning continuation or modification of the program, and
any recommendations from the advisory committee.
(e) in providing program support for Neighborhood NORCs as authorized
by this subdivision, the director shall in no event divert or transfer
funding for grants or program support from any naturally occurring
retirement community supportive service programs authorized pursuant to
other provisions of this section]. INDIVIDUAL GRANTS AWARDED FOR CLASSIC
NORC PROGRAMS SHALL BE IN AMOUNTS NOT TO EXCEED TWO HUNDRED THOUSAND
($200,000) DOLLARS AND FOR NEIGHBORHOOD NORCS NOT LESS THAN SIXTY THOU-
SAND ($60,000) DOLLARS IN ANY TWELVE MONTH PERIOD.
6. The director may allow services provided by a naturally occurring
retirement community supportive service program or by a neighborhood
naturally occurring retirement community to also include services to
residents who live in neighborhoods contiguous to the boundaries of the
geographic area served by such programs if: (a) the persons served are
older adults; (b) the services affect the health and welfare of such
persons; and (c) the services are provided on a one-time basis in the
year in which they are provided, and not in a manner which is said or
intended to be continuous. The director may also consent to the
provision of such services by such program if the program has received a
grant which requires services to be provided beyond the geographic boun-
daries of the program. The director shall establish procedures under
which a program may request the ability to provide such services. The
provision of such services shall not affect the funding provided to the
program by the department pursuant to this section.
7. The director shall promulgate rules and regulations as necessary to
carry out the provisions of this section.
8. On or before March first, two thousand [five] NINETEEN, AND EVERY
FIVE YEARS THEREAFTER, the director shall report to the governor and the
finance committee of the senate and the ways and means committee of the
assembly concerning the effectiveness of the naturally occurring retire-
ment community supportive services program[, other than Neighborhood
NORCs, as defined in subdivision five-a of this section,] in achieving
the objectives set forth by this section, which include helping to
address the needs of residents in such CLASSIC AND NEIGHBORHOOD
naturally occurring retirement communities, assuring access to a contin-
uum of necessary services, increasing private, philanthropic and other
public funding for programs, and preventing unnecessary hospital and
nursing home stays. The report shall also include recommendations
S. 6407--C 54 A. 9007--C
concerning continuation or modification of the program from the director
[and the committee, and shall note any divergence between the recommen-
dations of the director and the committee]. The director shall provide
the required information and any other information deemed appropriate to
the report in such form and detail as will be helpful to the legislature
and the governor in determining to extend, eliminate or modify the
program including, but not limited to, the following:
(a) the number, size, type and location of the projects developed and
funded, including the number, kinds and functions of staff in each
program;
(b) [the number, size, type and location of the projects proposed but
not funded, and the reasons for denial of funding for such projects;
(c)] the age, sex, religion and other appropriate demographic informa-
tion concerning the residents served;
[(d)] (C) the services provided to residents, reported in such manner
as to allow comparison of services by demographic group and region;
[(e)] (D) a listing of the services provided by eligible applicants,
including the number, kind and intensity of such services; and
[(f)] (E) a listing of [other] PARTNER organizations providing
services, the number, kind and intensity of such services, [the number
of referrals to such organizations] and, to the extent practicable, the
outcomes of such referrals.
S 2. Paragraph (f) of subdivision 1 of section 209 of the elder law is
amended by adding a new subparagraph 6 to read as follows:
(6) NOTWITHSTANDING THE REQUIREMENTS SET FORTH IN SUBPARAGRAPH FOUR OF
THIS PARAGRAPH, IN ORDER TO PREVENT THE DISRUPTION OF SERVICES THROUGH
DECEMBER THIRTY-FIRST, TWO THOUSAND SEVENTEEN, PROGRAMS ESTABLISHED AND
PROVIDING SERVICES AS OF MARCH FIRST, TWO THOUSAND SIXTEEN SHALL BE
ALLOWED TO HAVE FEWER THAN FIFTY PERCENT OF THE UNITS OCCUPIED BY AN
OLDER ADULT AND/OR FEWER THAN TWENTY-FIVE HUNDRED RESIDENTS WHO ARE
OLDER ADULTS.
S 3. Subdivision 5-a of section 209 of the elder law is amended by
adding a new paragraph (f) to read as follows:
(F) NOTWITHSTANDING THE REQUIREMENTS SET FORTH IN PARAGRAPH (A) OF
THIS SUBDIVISION, IN ORDER TO PREVENT THE DISRUPTION OF SERVICES THROUGH
DECEMBER THIRTY-FIRST, TWO THOUSAND SEVENTEEN, PROGRAMS ESTABLISHED AND
PROVIDING SERVICES AS OF MARCH FIRST, TWO THOUSAND SIXTEEN SHALL BE
ALLOWED TO HAVE MORE THAN TWO THOUSAND PERSONS WHO ARE OLDER ADULTS
RESIDING IN THE GEOGRAPHICALLY DEFINED AREA AND/OR FEWER THAN FORTY
PERCENT OF UNITS WITH OLDER ADULTS RESIDING THEREIN.
S 4. This act shall take effect immediately; provided that section one
of this act shall take effect January 1, 2018; and provided further that
sections two and three of this act shall expire and be deemed repealed
on and after December 31, 2017.
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.
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