Enacts into law major components of legislation necessary to implement the state fiscal plan relating to health and mental health
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| Date of Action |
Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|---|---|
| Mar 10, 2015 |
referred to finance |
Enacts into law major components of legislation necessary to implement the state fiscal plan relating to health and mental health; relates to delivery of prescriptions off premises of a pharmacy; relates to physician profiles, the promotion of public and private umbilical cord blood banking, financial responsibility and reimbursement data for early intervention program and electronic health records; relates to establishing the state health innovation plan account
S T A T E O F N E W Y O R K
________________________________________________________________________
4207
2015-2016 Regular Sessions
I N S E N A T E
March 9, 2015
___________
Introduced by COMMITTEE ON RULES -- read twice and ordered printed, and
when printed to be committed to the Committee on Finance
AN ACT to amend the education law, in relation to delivery of
prescriptions off premises of a pharmacy; to amend the public health
law, in relation to physician profiles, the promotion of public and
private umbilical cord blood banking, financial responsibility and
reimbursement data for early intervention program and electronic
health records; to amend the state finance law, in relation to estab-
lishing the state health innovation plan account; to provide more
accountability in expenditures made by the Statewide Health Informa-
tion Network for New York (SHIN-NY); to repeal subdivision 9 of
section 2803 of the public health law relating to reports to the
commissioner of health by general hospitals regarding working condi-
tions and limits on working hours for certain members of the hospi-
tal's staff; and to repeal paragraph (e) of subdivision 13 of section
2995-a of the public health law relating to physician profiles (Part
A); to amend the social services law, in relation to the codification
of the global cap; to amend the public health law, in relation to
hospital payments; to amend parts A and B of chapter 1 of the laws of
2002, relating to the health care reform act of 2000, in relation to
upper payment limits; to amend part B of chapter 59 of the laws of
2011, amending the public health law relating to rates of payment and
medical assistance, in relation to managed care supplemental payments;
to amend part H of chapter 59 of the laws of 2011, amending the public
health law relating to general hospital inpatient reimbursement for
annual rates, in relation to supplemental Medicaid managed care
payments; to amend the public health law, in relation to establishing
an energy efficiency and/or disaster preparedness demonstration
program for residential health care facilities; to amend the social
services law, in relation to working disabled eligibility; to amend
the social services law, in relation to family planning benefits; to
amend the social services law, in relation to foster care; to amend
the public health law, in relation to case payment rates for pediatric
ventilator services; to authorize the commissioner of health to estab-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD20016-01-5
S. 4207 2
lish young adult special populations demonstration programs; to amend
the public health law, in relation to rates of payments at residential
health care facilities and directing the commissioner of health to
allow the provision of off-site services; to amend the social services
law, in relation to prescriber determination and classes of drugs in
Medicaid managed care, establishing a health technology assessment
committee within the medical assistance program; to amend the public
health law, in relation to establishing a hospital-home care-physician
collaboration program; to amend the public health law, in relation to
universal standards for coding of payment of claims for long term care
and electronic payment of claims; to amend the social services law, in
relation to services provided by school-based health centers; to amend
chapter 165 of the laws of 1991, amending the public health law and
other laws relating to establishing payments for medical assistance,
in relation to the effectiveness thereof; to amend the public health
law, in relation to reporting by the commissioner of health on the
health information technology demonstration program; to amend the
social services law, in relation to provision and reimbursement of
transportation costs; to amend the public health law, in relation to
temporary adjustment to reimbursement rates for vital access provid-
ers; to amend the social services law, in relation to expansion of
medical assistance coverage; to amend part H of chapter 59 of the laws
of 2011, amending the public health law and other laws relating to
general hospital inpatient reimbursement for annual rates, in relation
to medicaid payments to nursing homes; to amend the public health law,
in relation to residential health care facilities; to amend the public
health law, in relation to requiring the commissioner of health to
establish an office of accountability; to amend the social services
law, in relation to supplemental medical assistance rates; to amend
the public health law, in relation to quality related measures for
general hospitals receiving payments for inpatient services; to repeal
sections 50, 51, 52 and 53 of part C of chapter 60 of the laws of 2014
amending the social services law and other laws relating to eliminat-
ing prescriber prevails for brand name drugs with generic equivalents,
in relation to eligibility for medical assistance and the basic health
program; to amend the social services law, in relation to requiring
the independent actuary to provide a complete actuarial memorandum; to
repeal certain provisions of the social services law relating to pres-
criber determination and classes of drugs in Medicaid managed care; to
repeal section 365-d of the social services law relating to early and
periodic screening diagnosis and treatment outreach demonstration
projects; to repeal paragraph (e) of subdivision 8 of section 2511 of
the public health law relating to subsidy payments; and providing for
the repeal of certain provisions upon expiration thereof (Part B); to
amend part A of chapter 56 of the laws of 2013 amending chapter 59 of
the laws of 2011 amending the public health law and other laws to
general hospital reimbursement for annual rates relating to the cap on
local Medicaid expenditures, in relation to rates of payment paid to
certain providers by the Child Health Plus Program; and to amend part
H of chapter 111 of the laws of 2010 relating to increasing Medicaid
payments to providers through managed care organizations and providing
equivalent fees through an ambulatory patient group methodology, in
relation to rates of payment paid to certain providers by the Child
Health Plus Program (Part C); to amend chapter 884 of the laws of
1990, amending the public health law relating to authorizing bad debt
and charity care allowances for certified home health agencies, in
S. 4207 3
relation to the effectiveness thereof; to amend chapter 81 of the laws
of 1995, amending the public health law and other laws relating to
medical reimbursement and welfare reform, in relation to the effec-
tiveness thereof; to amend the public health law, in relation to
hospital assessments; to amend chapter 659 of the laws of 1997,
constituting the long term care integration and finance act of 1997,
in relation to the effectiveness thereof; to amend chapter 474 of the
laws of 1996, amending the education law and other laws relating to
rates for residential health care facilities, in relation to the
effectiveness thereof; to amend part C of chapter 58 of the laws of
2007, amending the social services law and other laws relating to
enacting the major components of legislation necessary to implement
the health and mental hygiene budget for the 2007-2008 state fiscal
year, in relation to delay of certain administrative costs; to amend
chapter 81 of the laws of 1995, amending the public health law and
other laws relating to medical reimbursement and welfare reform, in
relation to reimbursements and the effectiveness thereof; to amend
chapter 474 of the laws of 1996, amending the education law and other
laws relating to rates for residential healthcare facilities, in
relation to reimbursements; to amend chapter 451 of the laws of 2007,
amending the public health law, the social services law and the insur-
ance law, relating to providing enhanced consumer and provider
protections, in relation to the effectiveness thereof; to amend the
public health law, in relation to rates of payment for long term home
health care programs and making such provisions permanent; to amend
chapter 303 of the laws of 1999, amending the New York state medical
care facilities finance agency act relating to financing health facil-
ities, in relation to the effectiveness thereof; to amend chapter 165
of the laws of 1991, amending the public health law and other laws
relating to establishing payments for medical assistance, in relation
to the effectiveness thereof; to amend the public authorities law, in
relation to the transfer of certain funds; to amend subdivision (i) of
section 111 of part H of chapter 59 of the laws of 2011, relating to
enacting into law major components of legislation necessary to imple-
ment the health and mental hygiene budget for the 2011-2012 state
fiscal plan, in relation to the effectiveness of program oversight and
administration of managed long term care plans; to amend chapter 659
of the laws of 1997, amending the public health law and other laws
relating to creation of continuing care retirement communities, in
relation to the effectiveness thereof; to amend the public health law,
in relation to residential health care facility, and certified home
health agency services payments; to amend part B of chapter 109 of the
laws of 2010, amending the social services law relating to transporta-
tion costs; to amend the social services law, in relation to contract-
ing for transportation services; to amend chapter 459 of the laws of
1996 amending the public health law relating to recertification of
persons providing emergency medical care, in relation to making such
provisions permanent; to amend chapter 505 of the laws of 1995, amend-
ing the public health law relating to the operation of department of
health facilities, in relation to making such provisions permanent; to
amend the insurance law, in relation to exempting certain insurance
companies from risk-based capital for property/casualty insurance; and
to amend the insurance law, in relation to certain medical malpractice
rates; to amend subdivision (o) of section 111 of part H of chapter 59
of the laws of 2011, amending the public health law relating to state
wide planning and research cooperative system and general powers and
S. 4207 4
duties, in relation to the effectiveness of certain provisions; to
amend chapter 56 of the laws of 2013 amending chapter 59 of the laws
of 2011 amending the public health law and other laws relating to
general hospital reimbursement for annual rates relating to the cap on
local Medicaid expenditures, in relation to extending the provisions
of such chapter; to amend chapter 58 of the laws of 2008 amending the
elder law and other laws relating to reimbursement to participating
provider pharmacies and prescription drug coverage, in relation to the
effectiveness thereof (Part D); to amend the public health law, in
relation to the payment of certain funds for uncompensated care (Part
E); intentionally omitted (Part F); to amend the insurance law, in
relation to rating of individual and small group health insurance
contracts and policies (Part G); to amend the public health law, in
relation to the establishment and operation of limited services clin-
ics (Part H); intentionally omitted (Part I); intentionally omitted
(Part J); to amend the public health law, in relation to streamlining
the certificate of need process for hospitals and diagnostic and
treatment clinics providing primary care, public health and health
planning council reviews, defining "construction" for purposes of
hospitals, eliminating the requirement for a public need for a hospi-
tal prior to its approval by the public health and health planning
council, applications for construction of hospitals and the improper
delegation of authority to a management consultant by the governing
authority of a general hospital (Part K); to amend the public health
law, in relation to office-based surgery workgroups, facility fees,
reporting and ambulatory surgery center accreditation (Part L); to
amend the public health law, in relation to requiring notice and
submission of a plan prior to discontinuing fluoridation of a public
water supply (Part M); intentionally omitted (Part N); to amend chap-
ter 111 of the laws of 2010 relating to the recovery of exempt income
by the office of mental health for community residences and family-
based treatment programs, in relation to the effectiveness thereof
(Part O); to amend the education law, in relation to authorizing
contracts for the provision of special education and related services
for certain patients hospitalized in hospitals operated by the office
of mental health; and to amend part M of chapter 56 of the laws of
2012 amending the education law, relating to authorizing contracts for
the provision of special education and related services for certain
patients hospitalized in hospitals operated by the office of mental
health, in relation to the effectiveness thereof (Part P); to amend
the public health law and the public authorities law, in relation to
establishing a private equity pilot program (Part Q); to amend part A
of chapter 111 of the laws of 2010 amending the mental hygiene law
relating to the receipt of federal and state benefits received by
individuals receiving care in facilities operated by an office of the
department of mental hygiene, in relation to the effectiveness thereof
(Part R); to amend the social services law, the executive law and the
mental hygiene law, in relation to providing professional services to
individuals with developmental disabilities in non-certified settings;
in relation to the exemption of the nurse practice act for direct care
staff in non-certified settings funded, authorized or approved by the
office for people with developmental disabilities; and to repeal
certain provisions of the mental hygiene law relating thereto (Part
S); to amend the mental hygiene law, in relation to clarifying the
authority of the commissioners in the department of mental hygiene to
design and implement time-limited demonstration programs (Part T); to
S. 4207 5
amend the mental hygiene law, in relation to directing the commission-
er of developmental disabilities to establish a procedure through
which persons with developmental disabilities may choose to remain in
a nonintegrated setting (Part U); to amend the mental hygiene law, in
relation to providing state operated opportunities for people with
developmental disabilities (Part V); to amend the mental hygiene law,
in relation to monthly status reports on community investments (Part
W); relating to the administration of services to people with develop-
mental disabilities (Part X); to amend the mental hygiene law, in
relation to requiring an annual geographic analysis of supports and
services in community settings for individuals with developmental
disabilities (Part Y); to amend the education law, in relation to
including nurse practitioners as a provider of services for purposes
of collaborative drug therapy management; and to amend chapter 21 of
the laws of 2011 amending the education law relating to authorizing
pharmacists to perform collaborative drug therapy management with
physicians in certain settings, in relation to making the authori-
zation for pharmacists to perform collaborative drug therapy manage-
ment permanent (Part Z); to amend the mental hygiene law, in relation
to establishing a community housing wait list (Part AA); to amend the
public health law and the education law, in relation to providing for
the use of opioid antagonists in schools for opioid overdose
prevention (Part BB); to amend part A of chapter 56 of the laws of
2013 amending chapter 59 of the laws of 2011 amending the public
health law and other laws relating to general hospital reimbursement
for annual rates relating to the cap on local Medicaid expenditures,
in relation to establishing rate protections for behavioral health
essential providers and the effectiveness thereof; to amend section 1
of part H of chapter 111 of the laws of 2010, relating to increasing
Medicaid payments to providers through managed care organizations and
providing equivalent fees through an ambulatory patient group method-
ology, in relation to transfer of funds and the effectiveness thereof
(Part CC); to amend the mental hygiene law, in relation to integrated
housing for individuals with developmental disabilities (Part DD); to
amend the mental hygiene law, in relation to a temporary adjustment to
reimbursement rates for behavioral health (Part EE); to amend the
public health law, in relation to requiring the commissioner of health
to provide certain records to the temporary president of the senate
and the speaker of the assembly; requiring the commissioner of health
to convene a task force to evaluate and make recommendations related
to increasing the transparency and accountability of the health care
reform act resources fund; and to amend the public health law, in
relation to physician loan repayment awards and the distribution of
grants for the health workforce retraining program; in relation to
covered lives assessments in the Rochester region (Part FF); and to
amend the public health law, in relation to the capital restructuring
program (Part GG)
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 2015-2016
state fiscal year. Each component is wholly contained within a Part
identified as Parts A through GG. The effective date for each particular
S. 4207 6
provision contained within such Part is set forth in the last section of
such Part. Any provision in any section contained within a Part, includ-
ing the effective date of the Part, which makes a reference to a section
"of this act", when used in connection with that particular component,
shall be deemed to mean and refer to the corresponding section of the
Part in which it is found. Section three of this act sets forth the
general effective date of this act.
PART A
Section 1. Intentionally omitted.
S 2. Intentionally omitted.
S 3. Intentionally omitted.
S 4. Intentionally omitted.
S 5. Subdivision 9 of section 2803 of the public health law is
REPEALED.
S 6. Intentionally omitted.
S 7. The second undesignated paragraph of paragraph (a) of subdivision
2 of section 6810 of the education law, as added by chapter 413 of the
laws of 2014, is amended to read as follows:
A pharmacy registered with the department pursuant to section sixty-
eight hundred eight OR SIXTY-EIGHT HUNDRED EIGHT-B of this article may
not deliver a new or refilled prescription off premises without the
consent of the patient or an individual authorized to consent on the
patient's behalf. [Consent shall include one of the following:
(1) the patient or authorized individual's signature of acceptance of
each prescription delivered;
(2) the pharmacy may contact the patient or other authorized individ-
ual for consent to deliver and must document consent in the patient
record; or
(3) for pharmacies that administer refill reminder or medication
adherence programs and deliver off premises, if a signature is not
received on each prescription, then the refill reminder program or medi-
cation adherence program shall be an OPT-IN program that is updated with
patient consent every one hundred eighty days accompanied by a docu-
mented patient record review by a licensed pharmacist from the providing
pharmacy and the patient before continuation of medication delivery can
occur] FOR THE PURPOSES OF THIS SECTION, CONSENT MAY BE OBTAINED IN THE
SAME MANNER AND PROCESS BY WHICH CONSENT IS DEEMED ACCEPTABLE UNDER THE
FEDERAL MEDICARE PART D PROGRAM.
S 8. Paragraph (h) of subdivision 1 of section 2995-a of the public
health law, as added by chapter 542 of the laws of 2000, is amended to
read as follows:
(h) current [speciality] SPECIALTY board certification and date of
certification;
S 9. The opening paragraph of subdivision 1-a of section 2995-a of the
public health law, as added by section 8 of part A of chapter 58 of the
laws of 2010, is amended to read as follows:
Each physician licensed and registered to practice in this state shall
within [one hundred twenty] THIRTY days of the [effective date of this
subdivision] TRANSMITTAL OF AN INITIAL PROFILE SURVEY and upon entering
or updating his or her profile information:
S 10. Subdivisions 3, 4, 6 and 9 of section 2995-a of the public
health law, subdivisions 3, 6 and 9 as added by chapter 542 of the laws
of 2000, and subdivision 4 as amended by chapter 477 of the laws of
2008, are amended to read as follows:
S. 4207 7
3. Each physician who is self-insured for professional medical malp-
ractice shall periodically report to the department on forms and in the
time and manner required by the commissioner the information specified
in paragraph [(f)] (E) of subdivision one of this section, except that
the physician shall report the dollar amount (to the extent of the
physician's information and belief) for each judgment, award and settle-
ment and not a level of significance or context.
4. Each physician shall periodically report to the department on forms
and in the time and manner required by the commissioner any other infor-
mation as is required by the department for the development of profiles
under this section which is not otherwise reasonably obtainable. In
addition to such periodic reports and providing the same information,
each physician shall update his or her profile information within the
six months prior to the expiration date of such physician's registration
period, as a condition of registration renewal under article one hundred
thirty-one of the education law. EXCEPT FOR OPTIONAL INFORMATION
PROVIDED, PHYSICIANS SHALL NOTIFY THE DEPARTMENT OF ANY CHANGE IN THE
PROFILE INFORMATION WITHIN THIRTY DAYS OF SUCH CHANGE.
6. A physician may elect to have his or her profile omit certain
information provided pursuant to paragraphs (l), (m)[,] AND (n) [and
(q)] of subdivision one of this section. In collecting information for
such profiles and disseminating the same, the department shall inform
physicians that they may choose not to provide such information required
pursuant to paragraphs (l), (m)[,] AND (n) [and (q)] of subdivision one
of this section.
9. The department shall, in addition to hard copy physician profiles,
provide for electronic access to and copying of physician profiles
developed pursuant to this section through the system commonly known as
the Internet. THE DEPARTMENT SHALL UPDATE A PHYSICIAN'S ONLINE PROFILE
WITHIN THIRTY DAYS OF RECEIPT OF A COMPLETED PHYSICIAN PROFILE SURVEY OR
ANY CHANGE IN PROFILE INFORMATION.
S 11. Paragraph (d) of subdivision 13 of section 2995-a of the public
health law, as added by chapter 542 of the laws of 2000, is amended to
read as follows:
(d) Report. The department shall provide a report of its determi-
nations and recommendations to the governor and legislature, and make
such report publicly available, [within six months of the effective date
of this section] ON OR BEFORE JANUARY FIRST, TWO THOUSAND SIXTEEN. THE
DEPARTMENT SHALL REPORT ANNUALLY THEREAFTER TO THE LEGISLATURE ON THE
STATUS OF THE PHYSICIAN PROFILES AND ANY RECOMMENDATIONS FOR ADDITIONS,
CONSOLIDATIONS OR OTHER CHANGES DEEMED APPROPRIATE.
S 12. Paragraph (e) of subdivision 13 of subdivision 2995-a of the
public health law is REPEALED.
S 13. Subdivision 16 of section 2995-a of the public health law, as
added by chapter 542 of the laws of 2000, is amended to read as follows:
16. [If, after initial dissemination of the physician data required by
this section, the department determines that any such data is not useful
for making quality determinations, the department shall recommend to the
legislature the necessary statutory changes] HEALTH CARE PLANS SHALL
PROVIDE THE DEPARTMENT WITH A LISTING, BY SPECIALTY, OF ALL PARTICIPAT-
ING PROVIDERS AS REQUIRED TO BE DISCLOSED UNDER PARAGRAPH SEVENTEEN OF
SUBSECTION (A) OF SECTION THREE THOUSAND TWO HUNDRED SEVENTEEN-A OF THE
INSURANCE LAW, PARAGRAPH SEVENTEEN OF SUBSECTION (A) OF SECTION FOUR
THOUSAND THREE HUNDRED TWENTY-FOUR OF THE INSURANCE LAW, AND PARAGRAPH
(R) OF SUBDIVISION ONE OF SECTION FORTY-FOUR HUNDRED EIGHT OF THIS CHAP-
TER. THE HEALTH CARE PLAN SHALL NOTIFY THE DEPARTMENT WITHIN FIFTEEN
S. 4207 8
DAYS OF THE ADDITION OR TERMINATION OF A PROVIDER FROM THE PLAN'S
NETWORK. THE DEPARTMENT SHALL PROVIDE THIS INFORMATION TO THE PHYSICIANS
AT ISSUE AND MAKE THIS INFORMATION AVAILABLE IN PHYSICIAN PROFILES
REQUIRED UNDER THIS SECTION.
S 14. The public health law is amended by adding a new article 43-C to
read as follows:
ARTICLE 43-C
PUBLIC AND PRIVATE UMBILICAL CORD BLOOD BANKING
SECTION 4371. PUBLIC AND PRIVATE UMBILICAL CORD BLOOD BANKING PROGRAM.
S 4371. PUBLIC AND PRIVATE UMBILICAL CORD BLOOD BANKING PROGRAM. 1.
THE PUBLIC AND PRIVATE UMBILICAL CORD BLOOD BANKING PROGRAM IS HEREBY
ESTABLISHED WITHIN THE DEPARTMENT TO PROMOTE PUBLIC AWARENESS OF THE
POTENTIAL BENEFITS OF PUBLIC OR PRIVATE UMBILICAL CORD BLOOD BANKING TO
FACILITATE PRE-DELIVERY ARRANGEMENTS FOR PUBLIC OR PRIVATE BANKING OF
UMBILICAL CORD BLOOD DONATIONS.
2. THE DEPARTMENT SHALL:
A. DEVELOP A PUBLIC EDUCATION AND OUTREACH CAMPAIGN VIA WRITTEN MATE-
RIALS, BROCHURES AND THE INTERNET TO PROMOTE PUBLIC OR PRIVATE UMBILICAL
CORD BLOOD BANKING AWARENESS AND EDUCATION OF THE GENERAL PUBLIC AND
POTENTIAL UMBILICAL CORD BLOOD DONORS OF THE BENEFITS OF PUBLIC OR
PRIVATE UMBILICAL CORD BLOOD BANKING; AND
B. DEVELOP EDUCATIONAL MATERIALS AND BROCHURES WHICH SHALL BE MADE
AVAILABLE TO THE GENERAL PUBLIC AND POTENTIAL UMBILICAL CORD BLOOD
DONORS THROUGH LOCAL DEPARTMENTS OF HEALTH; HEALTH CARE PRACTITIONERS,
INCLUDING OBSTETRICIANS, GYNECOLOGISTS, PEDIATRICIANS, AND MIDWIVES;
HEALTH MAINTENANCE ORGANIZATIONS; HOSPITALS; CLINICS, WALK-IN MEDICAL
CENTERS, MOBILE CARE UNITS, SURGI-CENTERS, AND URGENT CARE CENTERS; AND
CLINICS AND ORGANIZATIONS SERVING PREGNANT WOMEN.
3. THE COMMISSIONER SHALL ACCEPT AND EXPEND ANY GRANTS, AWARDS, OR
OTHER FUNDS OR APPROPRIATIONS AS MAY BE MADE AVAILABLE FOR THE PURPOSES
OF THIS ARTICLE, SUBJECT TO LIMITATIONS AS TO THE APPROVAL OF EXPENDI-
TURES AND AUDIT AS PRESCRIBED FOR STATE FUNDS BY THE STATE FINANCE LAW.
S 15. Section 2557 of the public health law is amended by adding a
new subdivision 4 to read as follows:
4. THE COMMISSIONER SHALL COLLECT DATA, BY MUNICIPALITY, ON THE EARLY
INTERVENTION PROGRAM AUTHORIZED UNDER THIS TITLE FOR PURPOSES OF IMPROV-
ING THE EFFICIENCY, COST, EFFECTIVENESS, AND QUALITY OF SUCH PROGRAM.
SUCH MUNICIPALITY DATA COLLECTION SHALL INCLUDE BUT NOT BE LIMITED TO:
(A) THE NUMBER AND AGES OF CHILDREN ENROLLED IN THE EARLY INTERVENTION
PROGRAM;
(B) THE TOTAL NUMBER OF CHILDREN, WITHIN A MUNICIPALITY, RECEIVING A
SINGLE SERVICE, THE PERCENTAGE OF THOSE CHILDREN BY SERVICE TYPE, AND
THE AVERAGE FREQUENCY OF VISITS PER WEEK FOR SUCH SERVICE TYPE;
(C) THE TOTAL NUMBER OF CHILDREN, WITHIN A MUNICIPALITY, RECEIVING
MULTIPLE SERVICES, THE PERCENTAGE OF THOSE CHILDREN BY SERVICE TYPE, THE
AVERAGE FREQUENCY OF VISITS PER WEEK FOR SUCH SERVICE TYPE AND THE AVER-
AGE NUMBER OF SERVICE TYPES THAT EACH CHILD RECEIVES;
(D) THE TOTAL NUMBER OF CHILDREN, WITHIN A MUNICIPALITY, RECEIVING
SERVICES BY SERVICE TYPE PER WEEK AND THE TOTAL NUMBER OF SERVICES BY
SERVICE TYPE PER WEEK AUTHORIZED BY EARLY INTERVENTION PROVIDERS BY
PROVIDER TYPE INCLUDING APPROVED AGENCIES, INSTITUTIONS, ORGANIZATIONS
AND INDEPENDENT PROVIDERS;
(E) THE NUMBER OF NEW YORK STATE APPROVED AGENCIES, INSTITUTIONS, OR
ORGANIZATIONS PROVIDING EARLY INTERVENTION SERVICES BY SERVICE SPECIALTY
OR SPECIALTIES AND THE NUMBER OF NEW YORK STATE APPROVED INDEPENDENT
S. 4207 9
PROVIDERS OF EARLY INTERVENTION SERVICES BY SERVICE SPECIALTY OR
SPECIALTIES;
(F) THE NUMBER AND PERCENTAGE OF CHILDREN RECEIVING A SINGLE SERVICE
BY TYPE OF NEW YORK APPROVED SERVICE PROVIDER, AND THE NUMBER AND
PERCENTAGE OF CHILDREN RECEIVING MULTIPLE SERVICES BY TYPE OF NEW YORK
STATE APPROVED SERVICE PROVIDER;
(G) THE NUMBER OF SERVICES, BY SERVICE TYPE AND PROVIDER TYPE, THAT
WERE IDENTIFIED ON THE IFSP THAT WERE NOT DELIVERED TO A CHILD;
(H) THE OVERALL NUMBER OF NEW YORK STATE APPROVED EVALUATORS;
(I) THE NUMBER OF FAMILIES RECEIVING FAMILY SUPPORTIVE SERVICES SUCH
AS FAMILY TRAINING, COUNSELING, PARENT SUPPORT GROUPS, AND RESPITE;
(J) THE NUMBER OF CHILDREN THAT HAVE THIRD PARTY REIMBURSEMENT;
(K) THE NUMBER OF MEDICAL ASSISTANCE CLAIMS SUBMITTED. THE PERCENTAGE
OF MEDICAL ASSISTANCE CLAIMS DENIED AND THE PERCENTAGE OF MEDICAL
ASSISTANCE CLAIMS PAID. THE REASONS FOR THE DENIALS.
(L) THE NUMBER OF CLAIMS SUBMITTED FOR OTHER THAN MEDICAL ASSISTANCE.
THE PERCENTAGE OF CLAIMS DENIED FOR OTHER THAN MEDICAL ASSISTANCE AND
THE PERCENTAGE OF CLAIMS PAID FOR OTHER THAN MEDICAL ASSISTANCE. THE
REASONS FOR THE DENIALS.
(M) BY MUNICIPALITY, THE LAPSE IN TIME BETWEEN THE COMPLETION OF A
FINAL IFSP AND THE INITIATION OF SERVICES FOR ALL CHILDREN; AND
(N) THE NUMBER AND DOLLAR AMOUNTS OF CLAIMS SUBMITTED, BY PAYOR, THAT
WERE NOT PAID WITHIN NINETY DAYS AND THE REASONS FOR NON-PAYMENT.
THE COMMISSIONER SHALL COLLECT AND ANALYZE SUCH DATA TO DETERMINE
SERVICE AND UTILIZATION PATTERNS AND PROVIDE APPROPRIATE OVERSIGHT OF
THE PROGRAM. THE COMMISSIONER SHALL REPORT THE INFORMATION AND ANALYSIS
REQUIRED BY THIS SUBDIVISION TO THE TEMPORARY PRESIDENT OF THE SENATE,
THE SPEAKER OF THE ASSEMBLY, THE MINORITY LEADER OF THE SENATE, AND THE
MINORITY LEADER OF THE ASSEMBLY FOR THE PERIOD MAY FIRST, TWO THOUSAND
FIFTEEN TO DECEMBER THIRTY-FIRST, TWO THOUSAND FIFTEEN ON OR BEFORE
MARCH FIRST, TWO THOUSAND SIXTEEN AND FOR EACH CALENDAR YEAR THEREAFTER
ON OR BEFORE MARCH FIRST FOR THE PRECEDING CALENDAR YEAR.
S 16. Title 1 of article 29-D of the public health law is amended by
adding a new section 2997-f to read as follows:
S 2997-F. ELECTRONIC HEALTH RECORDS. 1. ALL HOSPITALS LICENSED UNDER
ARTICLE TWENTY-EIGHT OF THIS CHAPTER, ALL OFFICE-BASED SURGERY PRACTICES
ACCREDITED PURSUANT TO SECTION TWO HUNDRED THIRTY-D OF THIS CHAPTER, AND
ANY HEALTH CARE PROVIDER LICENSED PURSUANT TO TITLE EIGHT OF THE EDUCA-
TION LAW WHO OPERATES A PRACTICE WHICH ACCEPTS UNSCHEDULED, WALK-IN
APPOINTMENTS FROM PATIENTS THAT ARE NOT REGULARLY SEEN BY THE PRACTI-
TIONER AND HAS EXTENDED HOURS OF OPERATION SHALL UTILIZE AND MAINTAIN AN
ELECTRONIC HEALTH RECORD SYSTEM THAT CONNECTS TO THE LOCAL REGIONAL
HEALTH INFORMATION ORGANIZATION TO FACILITATE THE EXCHANGE OF HEALTH
INFORMATION.
2. EACH REGIONAL HEALTH INFORMATION ORGANIZATION SHALL ENSURE IT IS
ACCESSIBLE AND CAPABLE OF CONNECTING ALL HOSPITALS AND HEALTH CARE
PROVIDERS UNDER THIS SECTION, AND ANY OTHER HEALTH CARE PROVIDER OR
QUALIFIED HEALTH ENTITY AND THEIR ELECTRONIC HEALTH RECORD VENDORS,
INCLUDING, BUT NOT LIMITED TO, PRIVATE PHYSICIAN PRACTICES AND COUNTY
HEALTH DEPARTMENTS THAT WISH TO CONNECT TO THE REGIONAL HEALTH INFORMA-
TION ORGANIZATION.
3. HEALTH CARE PROVIDERS MAY APPLY FOR ANY FUNDING AVAILABLE FOR
HEALTH INFORMATION TECHNOLOGY AND ELECTRONIC HEALTH RECORD INFRASTRUC-
TURE INCLUDING, BUT NOT LIMITED TO, THE STATE ELECTRONIC HEALTH RECORDS
LOAN PROGRAM UNDER SECTION TWENTY-EIGHT HUNDRED TWELVE OF THIS CHAPTER.
S. 4207 10
4. THE COMMISSIONER SHALL ESTABLISH A PROCESS BY WHICH THE HEALTH CARE
PROVIDERS COVERED BY THIS SECTION MAY APPLY FOR A WAIVER FROM THE ELEC-
TRONIC HEALTH RECORD REQUIREMENTS IMPOSED BY THIS SECTION DUE TO ECONOM-
IC HARDSHIP, TECHNOLOGICAL LIMITATIONS THAT ARE NOT REASONABLY WITHIN
THE CONTROL OF THE HEALTH CARE PROVIDER, OR OTHER EXCEPTIONAL CIRCUM-
STANCE DEMONSTRATED BY THE HEALTH CARE PROVIDER.
S 17. The state finance law is amended by adding a new section 97-yyyy
to read as follows:
S 97-YYYY. STATE HEALTH INNOVATION PLAN ACCOUNT. 1. THERE IS HEREBY
ESTABLISHED IN THE JOINT CUSTODY OF THE STATE COMPTROLLER AND THE
COMMISSIONER OF HEALTH AN ACCOUNT OF THE MISCELLANEOUS SPECIAL REVENUE
FUND TO BE KNOWN AS THE "STATE HEALTH INNOVATION PLAN ACCOUNT".
2. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, RULE OR REGULATION TO
THE CONTRARY, THE STATE COMPTROLLER IS HEREBY AUTHORIZED AND DIRECTED TO
RECEIVE FOR DEPOSIT TO THE CREDIT OF THE STATE HEALTH INNOVATION PLAN
ACCOUNT, MONIES RECEIVED PURSUANT TO THE STATE INNOVATION MODEL INITI-
ATIVE FROM THE CENTERS FOR MEDICARE AND MEDICAID INNOVATION.
3. MONEYS OF THE ACCOUNT, FOLLOWING APPROPRIATION BY THE LEGISLATURE,
SHALL BE MADE AVAILABLE TO THE DEPARTMENT OF HEALTH FOR SERVICES AND
EXPENSES OF THE STATE HEALTH INNOVATION PLAN.
S 18. Notwithstanding any other provision of law to the contrary, for
periods beginning on or after April 1, 2015, any funds provided to
support the Statewide Health Information Network (SHIN-NY) shall be
contingent on the submission of a plan to the legislature, prepared by
the commissioner of health in consultation with representatives of
hospitals, physicians, other providers and consumers, detailing specif-
ically how funds will be used to:
(1) support hospitals, physicians, and other providers in the achieve-
ment of federal meaningful use requirements;
(2) support DSRIP health information exchange and data requirements to
help performing provider systems and the state meet DSRIP quality goals;
(3) increase participation in regional health information organiza-
tions by providers at reasonable costs to the providers;
(4) finalize patient consent requirements; and
(5) address concerns regarding liability of providers that lawfully
share data that is then misused by other health information exchange
participants.
S 19. This act shall take effect immediately except that:
(a) section seven of this act shall be deemed to have been in full
force and effect on and after October 21, 2014;
(b) section fourteen of this act shall take effect on the one hundred
eightieth day after it shall have become a law; provided that effective
immediately, the addition, amendment and/or repeal of any rule or regu-
lation necessary for the implementation of such section on its effective
date are authorized and directed to be made and completed on or before
such effective date; and
(c) section sixteen of this act shall take effect two years after it
shall have become a law; provided, however, that, effective immediately,
the commissioner of health is authorized to promulgate any rules and
regulations necessary to ensure that regional health care organizations
are capable of complying with the provisions of such section on its
effective date.
PART B
Section 1. Intentionally omitted.
S. 4207 11
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. The social services law is amended by adding a new section 368-g
to read as follows:
S 368-G. LIMITATION ON GROWTH OF MEDICAL ASSISTANCE EXPENDITURES. 1.
CAP ESTABLISHED. (A) NOTWITHSTANDING SECTION NINETY-ONE OF PART H OF
CHAPTER FIFTY-NINE OF THE LAWS OF TWO THOUSAND ELEVEN, AS AMENDED, OR
ANY OTHER CONTRARY PROVISION OF LAW AND SUBJECT TO FEDERAL APPROVALS,
THE YEAR TO YEAR RATE OF GROWTH OF DEPARTMENT STATE FUNDS MEDICAL
ASSISTANCE SPENDING SHALL NOT EXCEED THE TEN YEAR ROLLING AVERAGE OF THE
MEDICAL COMPONENT OF THE CONSUMER PRICE INDEX AS PUBLISHED BY THE UNITED
STATES DEPARTMENT OF LABOR, BUREAU OF LABOR STATISTICS, FOR THE PRECED-
ING TEN YEARS; PROVIDED, HOWEVER, THAT FOR STATE FISCAL YEAR TWO THOU-
SAND THIRTEEN-TWO THOUSAND FOURTEEN OR ANY FISCAL YEAR THEREAFTER, THE
MAXIMUM ALLOWABLE ANNUAL INCREASE IN THE AMOUNT OF THE DEPARTMENT STATE
FUNDS MEDICAL ASSISTANCE SPENDING SHALL BE CALCULATED BY MULTIPLYING THE
DEPARTMENT STATE FUNDS MEDICAL ASSISTANCE SPENDING FOR THE PREVIOUS
YEAR, LESS THE AMOUNT OF ANY DEPARTMENT STATE OPERATIONS SPENDING
INCLUDED THEREIN, BY SUCH TEN YEAR ROLLING AVERAGE.
(B) EXCEPT AS PROVIDED IN PARAGRAPH (C) OF THIS SUBDIVISION, FOR STATE
FISCAL YEAR TWO THOUSAND THIRTEEN-TWO THOUSAND FOURTEEN OR ANY FISCAL
YEAR THEREAFTER, THE SPENDING LIMIT CALCULATED PURSUANT TO PARAGRAPH (A)
OF THIS SUBDIVISION SHALL BE INCREASED BY AN AMOUNT EQUAL TO THE DIFFER-
ENCE BETWEEN THE TOTAL SOCIAL SERVICES DISTRICT MEDICAL ASSISTANCE
EXPENDITURE AMOUNTS CALCULATED FOR SUCH PERIOD IN CONFORMANCE WITH
SUBDIVISIONS (B), (C), (C-1), AND (D) OF SECTION ONE OF PART C OF CHAP-
TER FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND FIVE AND THE TOTAL SOCIAL
SERVICES DISTRICT MEDICAL EXPENDITURE AMOUNTS THAT WOULD HAVE RESULTED
IF THE PROVISIONS OF SUBDIVISION (C-1) OF SUCH SECTION HAD NOT BEEN
APPLIED.
(C) WITH RESPECT TO A SOCIAL SERVICES DISTRICT THAT RESCINDS THE EXER-
CISE OF THE OPTION PROVIDED IN PARAGRAPH (I) OF SUBDIVISION (B) OF
SECTION TWO OF PART C OF CHAPTER FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND
FIVE, FOR STATE FISCAL YEAR TWO THOUSAND THIRTEEN-TWO THOUSAND FOURTEEN
OR ANY FISCAL YEAR THEREAFTER, THE SPENDING LIMIT CALCULATED PURSUANT TO
SUBDIVISION ONE OF THIS SECTION SHALL BE REDUCED BY THE AMOUNT OF THE
MEDICAL ASSISTANCE EXPENDITURE AMOUNT CALCULATED FOR SUCH DISTRICT FOR
SUCH PERIOD.
2. SAVINGS ALLOCATION PLAN. NOTWITHSTANDING SECTION NINETY-TWO OF PART
H OF CHAPTER FIFTY-NINE OF THE LAWS OF TWO THOUSAND ELEVEN, AS AMENDED,
AND ANY OTHER CONTRARY PROVISION OF LAW AND SUBJECT TO THE AVAILABILITY
OF FEDERAL FINANCIAL PARTICIPATION, FOR STATE FISCAL YEARS TWO THOUSAND
ELEVEN-TWO THOUSAND TWELVE THROUGH TWO THOUSAND FIFTEEN-TWO THOUSAND
SIXTEEN, THE DIRECTOR OF THE BUDGET, IN CONSULTATION WITH THE COMMIS-
SIONER, SHALL ASSESS ON A MONTHLY BASIS, AS REFLECTED IN MONTHLY REPORTS
ISSUED PURSUANT TO SUBDIVISION FIVE OF THIS SECTION, KNOWN AND PROJECTED
DEPARTMENT STATE FUNDS MEDICAL ASSISTANCE 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 MEDICAL ASSISTANCE DISBURSEMENTS FOR SUCH PERIOD TO
EXCEED THE PROJECTED DEPARTMENT MEDICAL ASSISTANCE STATE FUNDS DISBURSE-
MENTS IN THE ENACTED BUDGET FINANCIAL PLAN PURSUANT TO SUBDIVISION THREE
S. 4207 12
OF SECTION TWENTY-THREE OF THE STATE FINANCE LAW, THE COMMISSIONER, IN
CONSULTATION WITH THE DIRECTOR OF THE BUDGET, SHALL DEVELOP A MEDICAL
ASSISTANCE SAVINGS ALLOCATION PLAN TO LIMIT SUCH SPENDING TO THE AGGRE-
GATE 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 REVENUES, REDUCTIONS TO LOCAL
SOCIAL SERVICES DISTRICT MEDICAL ASSISTANCE ADMINISTRATION, AND BEGIN-
NING APRIL FIRST, TWO THOUSAND TWELVE, THE OPERATIONAL COSTS OF THE NEW
YORK STATE MEDICAL INDEMNITY FUND. SUCH PROJECTIONS MAY BE ADJUSTED BY
THE DIRECTOR OF THE BUDGET TO ACCOUNT FOR INCREASED OR EXPEDITED DEPART-
MENT OF HEALTH STATE FUNDS MEDICAL ASSISTANCE EXPENDITURES AS A RESULT
OF A NATURAL OR OTHER TYPE OF DISASTER, INCLUDING A GOVERNMENTAL DECLA-
RATION OF EMERGENCY. SUCH MEDICAL ASSISTANCE SAVINGS ALLOCATION PLAN
SHALL BE DESIGNED TO REDUCE THE DEPARTMENT STATE FUNDS MEDICAL ASSIST-
ANCE DISBURSEMENTS AUTHORIZED BY APPROPRIATIONS IN COMPLIANCE WITH THE
FOLLOWING GUIDELINES:
(A) REDUCTIONS SHALL BE MADE IN COMPLIANCE WITH APPLICABLE FEDERAL
LAW, INCLUDING THE PROVISIONS OF THE PATIENT PROTECTION AND AFFORDABLE
CARE ACT (P.L. 111-148), AS AMENDED BY THE HEALTH CARE AND EDUCATION
RECONCILIATION ACT OF 2010 (P.L. 111-152) (COLLECTIVELY "AFFORDABLE CARE
ACT") AND ANY SUBSEQUENT AMENDMENTS THERETO OR REGULATIONS PROMULGATED
THEREUNDER;
(B) REDUCTIONS SHALL BE MADE IN A MANNER THAT COMPLIES WITH THE STATE
MEDICAL ASSISTANCE PLAN APPROVED BY THE FEDERAL CENTERS FOR MEDICARE AND
MEDICAID SERVICES, PROVIDED, HOWEVER, THAT THE COMMISSIONER IS AUTHOR-
IZED TO SUBMIT ANY STATE PLAN AMENDMENT OR SEEK OTHER FEDERAL APPROVAL,
INCLUDING WAIVER AUTHORITY, TO IMPLEMENT THE PROVISIONS OF THE MEDICAL
ASSISTANCE SAVINGS ALLOCATION PLAN THAT MEETS THE OTHER CRITERIA SET
FORTH HEREIN;
(C) REDUCTIONS SHALL BE MADE IN A MANNER THAT MAXIMIZES FEDERAL FINAN-
CIAL PARTICIPATION, TO THE EXTENT PRACTICABLE, INCLUDING ANY FEDERAL
FINANCIAL PARTICIPATION THAT IS AVAILABLE OR IS REASONABLY EXPECTED TO
BECOME AVAILABLE, IN THE DISCRETION OF THE COMMISSIONER, UNDER THE
AFFORDABLE CARE ACT;
(D) REDUCTIONS SHALL BE MADE UNIFORMLY AMONG CATEGORIES OF SERVICES
AND GEOGRAPHIC REGIONS OF THE STATE, TO THE EXTENT PRACTICABLE, AND
SHALL BE MADE UNIFORMLY WITHIN A CATEGORY OF SERVICE, TO THE EXTENT
PRACTICABLE, EXCEPT WHERE THE COMMISSIONER DETERMINES THAT THERE ARE
SUFFICIENT GROUNDS FOR NON-UNIFORMITY, INCLUDING, BUT NOT LIMITED TO:
(I) THE EXTENT TO WHICH SPECIFIC CATEGORIES OF SERVICES CONTRIBUTED TO
DEPARTMENT MEDICAL ASSISTANCE STATE FUNDS SPENDING IN EXCESS OF THE
LIMITS SPECIFIED HEREIN; (II) THE NEED TO MAINTAIN SAFETY NET SERVICES
IN UNDERSERVED COMMUNITIES; OR (III) THE POTENTIAL BENEFITS OF PURSUING
INNOVATIVE PAYMENT MODELS CONTEMPLATED BY THE AFFORDABLE CARE ACT, IN
WHICH CASE SUCH GROUNDS SHALL BE SET FORTH IN THE MEDICAL ASSISTANCE
SAVINGS ALLOCATION PLAN;
(E) REDUCTIONS SHALL BE MADE IN A MANNER THAT DOES NOT UNNECESSARILY
CREATE ADMINISTRATIVE BURDENS FOR MEDICAL ASSISTANCE APPLICANTS AND
RECIPIENTS OR FOR PROVIDERS;
(F) THE COMMISSIONER SHALL SEEK THE INPUT OF THE LEGISLATURE, AS WELL
AS INPUT FROM ORGANIZATIONS REPRESENTING HEALTH CARE PROVIDERS, CONSUM-
ERS, BUSINESSES, WORKERS, HEALTH INSURERS, AND OTHERS WITH RELEVANT
EXPERTISE, IN DEVELOPING SUCH MEDICAL ASSISTANCE SAVINGS ALLOCATION PLAN
TO THE EXTENT THAT ALL OR PART OF SUCH PLAN IS LIKELY, AS DETERMINED BY
S. 4207 13
THE COMMISSIONER, TO HAVE A MATERIAL IMPACT ON THE OVERALL MEDICAL
ASSISTANCE PROGRAM, OR ON PARTICULAR CATEGORIES OF SERVICE, OR ON
PARTICULAR GEOGRAPHIC REGIONS OF THE STATE;
(G)(I) THE COMMISSIONER SHALL POST THE MEDICAL ASSISTANCE SAVINGS
ALLOCATION PLAN ON THE DEPARTMENT'S WEBSITE AND SHALL PROVIDE WRITTEN
COPIES OF SUCH PLAN TO THE CHAIRS OF THE SENATE FINANCE AND THE ASSEMBLY
WAYS AND MEANS COMMITTEES AT LEAST THIRTY DAYS BEFORE THE DATE ON WHICH
IMPLEMENTATION IS EXPECTED TO BEGIN;
(II) THE COMMISSIONER MAY REVISE THE MEDICAL ASSISTANCE SAVINGS ALLO-
CATION PLAN SUBSEQUENT TO THE PROVISION OF NOTICE AND PRIOR TO IMPLEMEN-
TATION BUT IS REQUIRED TO PROVIDE A NEW NOTICE PURSUANT TO SUBPARAGRAPH
(I) OF THIS PARAGRAPH ONLY IF THE COMMISSIONER DETERMINES, IN HIS OR HER
DISCRETION, THAT SUCH REVISIONS MATERIALLY ALTER THE PLAN;
(H) NOTWITHSTANDING THE PROVISIONS OF PARAGRAPHS (F) AND (G) OF THIS
SUBDIVISION, THE COMMISSIONER NEED NOT SEEK THE INPUT DESCRIBED IN PARA-
GRAPH (F) OF THIS SUBDIVISION OR PROVIDE NOTICE PURSUANT TO PARAGRAPH
(G) OF THIS SUBDIVISION IF, IN THE DISCRETION OF THE COMMISSIONER, EXPE-
DITED DEVELOPMENT AND IMPLEMENTATION OF A MEDICAL ASSISTANCE SAVINGS
ALLOCATION PLAN IS NECESSARY DUE TO A PUBLIC HEALTH EMERGENCY; FOR
PURPOSES OF THIS SECTION, A PUBLIC HEALTH EMERGENCY IS DEFINED AS:
(I) A DISASTER, NATURAL OR OTHERWISE, THAT SIGNIFICANTLY INCREASES THE
IMMEDIATE NEED FOR HEALTH CARE PERSONNEL IN AN AREA OF THE STATE;
(II) AN EVENT OR CONDITION THAT CREATES A WIDESPREAD RISK OF EXPOSURE
TO A SERIOUS COMMUNICABLE DISEASE, OR THE POTENTIAL FOR SUCH WIDESPREAD
RISK OF EXPOSURE; OR
(III) ANY OTHER EVENT OR CONDITION DETERMINED BY THE COMMISSIONER TO
CONSTITUTE AN IMMINENT THREAT TO PUBLIC HEALTH; AND
(I) NOTHING IN THIS SECTION SHALL BE DEEMED TO PREVENT ALL OR PART OF
SUCH MEDICAL SAVINGS ALLOCATION PLAN FROM TAKING EFFECT RETROACTIVELY,
TO THE EXTENT PERMITTED BY THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID
SERVICES.
3. POWERS OF THE COMMISSIONER TO ENACT SAVINGS ALLOCATION PLAN. IN
ACCORDANCE WITH THE MEDICAL ASSISTANCE SAVINGS ALLOCATION PLAN, THE
COMMISSIONER SHALL REDUCE DEPARTMENT STATE FUNDS MEDICAL ASSISTANCE
DISBURSEMENTS BY THE AMOUNT OF THE PROJECTED OVERSPENDING THROUGH,
ACTIONS INCLUDING, BUT NOT LIMITED TO MODIFYING OR SUSPENDING REIMBURSE-
MENT METHODS, INCLUDING BUT NOT LIMITED TO ALL FEES, PREMIUM LEVELS AND
RATES OF PAYMENT, NOTWITHSTANDING ANY PROVISION OF LAW THAT SETS A
SPECIFIC AMOUNT OR METHODOLOGY FOR ANY SUCH PAYMENTS OR RATES OF
PAYMENT; MODIFYING MEDICAL ASSISTANCE PROGRAM BENEFITS; SEEKING ALL
NECESSARY FEDERAL APPROVALS, INCLUDING, BUT NOT LIMITED TO WAIVERS,
WAIVER AMENDMENTS; AND SUSPENDING TIME FRAMES FOR NOTICE, APPROVAL OR
CERTIFICATION OF RATE REQUIREMENTS, NOTWITHSTANDING ANY PROVISION OF
LAW, RULE OR REGULATION TO THE CONTRARY, INCLUDING, BUT NOT LIMITED TO,
SECTIONS TWENTY-EIGHT HUNDRED SEVEN AND THIRTY-SIX HUNDRED FOURTEEN OF
THE PUBLIC HEALTH LAW, SECTION EIGHTEEN OF CHAPTER TWO OF THE LAWS OF
NINETEEN HUNDRED EIGHTY-EIGHT, AND SECTION 505.14(H) OF TITLE 18 OF THE
OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW
YORK.
4. CAP DIVIDEND. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND
SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, FOR
STATE FISCAL YEARS BEGINNING ON AND AFTER APRIL FIRST, TWO THOUSAND
FOURTEEN, THE COMMISSIONER OF HEALTH, IN CONSULTATION WITH THE DIRECTOR
OF THE BUDGET, SHALL, PRIOR TO JANUARY FIRST OF EACH YEAR, DETERMINE THE
EXTENT OF SAVINGS THAT HAVE BEEN ACHIEVED AS A RESULT OF THE APPLICATION
OF THE PROVISIONS OF SUBDIVISIONS ONE AND TWO OF THIS SECTION, AND SHALL
S. 4207 14
FURTHER DETERMINE THE AVAILABILITY OF SUCH SAVINGS FOR DISTRIBUTION
DURING THE LAST QUARTER OF SUCH STATE FISCAL YEAR. IN DETERMINING SUCH
SAVINGS THE COMMISSIONER OF HEALTH, IN CONSULTATION WITH THE DIRECTOR OF
THE BUDGET, MAY EXEMPT THE MEDICAL ASSISTANCE ADMINISTRATION PROGRAM
FROM DISTRIBUTIONS UNDER THIS SECTION. THE COMMISSIONER OF HEALTH, IN
CONSULTATION WITH THE DIRECTOR OF THE BUDGET, MAY DISTRIBUTE FUNDS UP TO
AN AMOUNT EQUAL TO SUCH AVAILABLE SAVINGS IN ACCORDANCE WITH A DIVIDEND
ALLOCATION PLAN THAT UTILIZES A METHODOLOGY THAT DISTRIBUTES SUCH FUNDS
PROPORTIONATELY AMONG PROVIDERS AND PLANS IN NEW YORK'S MEDICAL ASSIST-
ANCE PROGRAM. IN DEVELOPING SUCH DIVIDEND ALLOCATION PLAN THE COMMIS-
SIONER OF HEALTH SHALL SEEK THE INPUT OF THE LEGISLATURE, AS WELL AS
ORGANIZATIONS REPRESENTING HEALTH CARE PROVIDERS, CONSUMERS, BUSINESSES,
WORKERS, HEALTH CARE INSURERS AND OTHERS WITH RELEVANT EXPERTISE. SUCH
DIVIDEND ALLOCATION PLAN SHALL UTILIZE THREE YEARS OF THE MOST RECENTLY
AVAILABLE SYSTEM-WIDE EXPENDITURE DATA REFLECTING BOTH MMIS AND MANAGED
CARE ENCOUNTERS. DISTRIBUTIONS TO MANAGED CARE PLANS SHALL BE BASED ON
THE ADMINISTRATIVE OUTLAYS STEMMING FROM PARTICIPATION IN THE MEDICAL
ASSISTANCE PROGRAM. THE COMMISSIONER OF HEALTH MAY IMPOSE MINIMUM THRES-
HOLD AMOUNTS IN DETERMINING PROVIDER ELIGIBILITY FOR DISTRIBUTIONS
PURSUANT TO THIS SECTION. NO LESS THAN FIFTY PERCENT OF THE AMOUNT
AVAILABLE FOR DISTRIBUTION SHALL BE MADE AVAILABLE FOR THE PURPOSE OF
ASSISTING ELIGIBLE PROVIDERS UTILIZING THE METHODOLOGY OUTLINED ABOVE.
THE REMAINDER OF THE DISTRIBUTIONS PURSUANT TO THIS SECTION SHALL BE
MADE AVAILABLE FOR THE PURPOSES OF ENSURING A MINIMUM LEVEL OF ASSIST-
ANCE TO FINANCIALLY DISTRESSED AND CRITICALLY NEEDED PROVIDERS AS IDEN-
TIFIED BY THE COMMISSIONER. THE COMMISSIONER OF HEALTH SHALL POST THE
MEDICAL ASSISTANCE SAVINGS DIVIDEND ALLOCATION PLAN ON THE DEPARTMENT OF
HEALTH'S WEBSITE AND SHALL PROVIDE WRITTEN COPIES OF SUCH PLAN TO THE
CHAIRS OF THE SENATE FINANCE AND THE ASSEMBLY WAYS AND MEANS COMMITTEES
AT LEAST THIRTY DAYS BEFORE THE DATE ON WHICH IMPLEMENTATION IS EXPECTED
TO BEGIN. THE COMMISSIONER OF HEALTH IS AUTHORIZED TO SEEK SUCH FEDERAL
APPROVALS AS MAY BE REQUIRED TO EFFECTUATE THE PROVISIONS OF THIS
SECTION, INCLUDING, BUT NOT LIMITED TO, TO PERMIT PAYMENT OF SUCH
DISTRIBUTIONS AS LUMPS SUMS AND TO SECURE WAIVERS FROM OTHERWISE APPLI-
CABLE FEDERAL UPPER PAYMENT LIMIT RESTRICTIONS ON SUCH PAYMENTS. THE
PROVISIONS OF THIS SECTION ARE SUBJECT TO THE REPORTING REQUIREMENTS SET
FORTH IN SUBDIVISION SEVEN OF THIS SECTION.
5. MONTHLY REPORTS. THE COMMISSIONER, IN CONSULTATION WITH THE DIREC-
TOR OF THE BUDGET, SHALL PREPARE A MONTHLY REPORT THAT SETS FORTH:
(A) KNOWN AND PROJECTED DEPARTMENT MEDICAL ASSISTANCE EXPENDITURES AS
DESCRIBED IN SUBDIVISION ONE OF THIS SECTION, AND FACTORS THAT COULD
RESULT IN MEDICAL ASSISTANCE DISBURSEMENTS FOR THE RELEVANT STATE FISCAL
YEAR TO EXCEED THE PROJECTED DEPARTMENT STATE FUNDS DISBURSEMENTS IN THE
ENACTED BUDGET FINANCIAL PLAN PURSUANT TO SUBDIVISION THREE OF SECTION
TWENTY-THREE OF THE STATE FINANCE LAW, INCLUDING SPENDING INCREASES OR
DECREASES DUE TO ENROLLMENT FLUCTUATIONS, RATE CHANGES, UTILIZATION
CHANGES, MEDICAL ASSISTANCE REDESIGN TEAM (MRT) INVESTMENTS, A SHIFT OF
BENEFICIARIES TO MANAGED CARE AND VARIATIONS IN OFFLINE MEDICAL ASSIST-
ANCE PAYMENTS;
(B) THE ACTIONS TAKEN TO IMPLEMENT ANY MEDICAL ASSISTANCE SAVINGS
ALLOCATION PLAN IMPLEMENTED PURSUANT TO SUBDIVISION FOUR OF THIS
SECTION, INCLUDING INFORMATION CONCERNING THE IMPACT OF SUCH ACTIONS ON
EACH CATEGORY OF SERVICE AND EACH GEOGRAPHIC REGION OF THE STATE;
(C) THE PRICE, INCLUDING, THE BASE RATE PLUS ANY UPCOMING RATE ADJUST-
MENT; UTILIZATION, INCLUDING CURRENT ENROLLMENT, PROJECTED ENROLLMENT
CHANGES AND ACUITY; MEDICAL ASSISTANCE REDESIGN TEAM INITIATIVES;
S. 4207 15
ONE-TIME INITIATIVES AND OTHER INITIATIVES DESCRIBING THE PROPOSED BUDG-
ET ACTION IMPACT; AND ANY PRIOR YEAR INITIATIVE WITH CURRENT AND FUTURE
YEAR IMPACTS FOR THE FOLLOWING CATEGORIES:
(I) INPATIENT;
(II) OUTPATIENT;
(III) EMERGENCY ROOM;
(IV) CLINIC;
(V) NURSING HOMES;
(VI) OTHER LONG TERM CARE;
(VII) MEDICAID MANAGED CARE;
(VIII) FAMILY HEALTH PLUS;
(IX) PHARMACY;
(X) TRANSPORTATION;
(XI) DENTAL;
(XII) NON-INSTITUTIONAL AND OTHER CATEGORIES;
(XIII) AFFORDABLE HOUSING;
(XIV) VITAL ACCESS PROVIDER SERVICES;
(XV) BEHAVIORAL HEALTH VITAL ACCESS PROVIDER SERVICES;
(XVI) FINGER LAKES HEALTH SERVICES AGENCY;
(XVII) AUDIT RECOVERIES AND SETTLEMENTS;
(D) INFORMATION AND DISBURSEMENTS OF GRANTS TO PROVIDERS, INCLUDING
BUT NOT LIMITED TO:
(I) DEMOGRAPHIC INFORMATION OF TARGETED RECIPIENTS;
(II) NUMBER OF RECIPIENTS;
(III) AWARD AMOUNTS AND TIMING OF AWARDS; AND
(E) ANY PROJECTED MEDICAL ASSISTANCE SAVINGS DETERMINED BY THE COMMIS-
SIONER PURSUANT TO SUBDIVISION FOUR OF THIS SECTION AND THE PROPOSED
ALLOCATION PLAN WITH REGARD TO SUCH SAVINGS.
(F) THE MONTHLY REPORTS REQUIRED BY THIS SUBDIVISION SHALL BE PROVIDED
TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF
THE ASSEMBLY, THE CHAIR OF THE SENATE FINANCE COMMITTEE, THE CHAIR OF
THE ASSEMBLY WAYS AND MEANS COMMITTEE, AND THE CHAIRS OF THE SENATE AND
ASSEMBLY HEALTH COMMITTEES. SUCH REPORTS AND RELATED DOCUMENTS PROVIDED
TO THE LEGISLATURE SHALL ALSO BE POSTED ON THE WEBSITE AS MAINTAINED BY
THE DEPARTMENT.
6. EXECUTIVE BUDGET SUMMARY. THE COMMISSIONER, IN CONSULTATION WITH
THE DIRECTOR OF THE BUDGET SHALL, UPON SUBMISSION OF THE EXECUTIVE BUDG-
ET TO THE LEGISLATURE, PROVIDE TO THE LEGISLATURE A DETAILED ACCOUNTING
OF:
(A) THE STATE MEDICAL ASSISTANCE STATE FUNDS EXPENDITURES ON THE CLOSE
OUT OF THE PRIOR YEAR;
(B) A CURRENT YEAR RE-ESTIMATE;
(C) THE PROSPECTIVE TWO-YEAR ESTIMATE; AND
(D) ANY OTHER INFORMATION DEEMED NECESSARY AND APPROPRIATE.
7. STAFF AVAILABILITY AND TRAINING. (A) THE COMMISSIONER AND THE
DIRECTOR OF THE BUDGET SHALL MAKE APPROPRIATE STAFF AVAILABLE TO MEET
WITH THE CHAIRS OF THE HEALTH COMMITTEES OF THE SENATE AND THE ASSEMBLY,
OR THEIR DESIGNEES, UPON THEIR REQUEST AND WITH REASONABLE NOTICE, TO
REVIEW EACH MONTHLY REPORT, AS DESCRIBED IN SUBDIVISION FIVE OF THIS
SECTION.
(B) THE COMMISSIONER SHALL MAKE TRAINING AVAILABLE TO DESIGNATED
LEGISLATIVE STAFF WITH REGARD TO THE SKILLS AND TECHNIQUES NEEDED TO
EFFECTIVELY ACCESS AND REVIEW RELEVANT MEDICAL ASSISTANCE DATA BASES
UNDER THE CONTROL OF THE DEPARTMENT, UPON THEIR REQUEST AND WITH REASON-
ABLE NOTICE.
S 9. Intentionally omitted.
S. 4207 16
S 10. Intentionally omitted.
S 11. Intentionally omitted.
S 12. Intentionally omitted.
S 13. Subdivision (e) of section 2826 of the public health law, as
added by section 27 of part C of chapter 60 of the laws of 2014, is
amended to read as follows:
(e) Notwithstanding any law to the contrary, general hospitals defined
as critical access hospitals pursuant to title XVIII of the federal
social security act shall be allocated no less than [five] SEVEN million
FIVE HUNDRED THOUSAND dollars annually pursuant to this section. The
department of health shall provide a report to the governor and legisla-
ture no later than [December] JUNE first, two thousand [fourteen]
FIFTEEN providing recommendations on how to ensure the financial stabil-
ity of, and preserve patient access to, critical access hospitals,
INCLUDING AN EXAMINATION OF PERMANENT MEDICAID RATE METHODOLOGY CHANGES.
S 14. Section 2826 of the public health law is amended by adding a new
subdivision (f) to read as follows:
(F) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, AND SUBJECT
TO FEDERAL FINANCIAL PARTICIPATION, NO LESS THAN TEN MILLION DOLLARS
SHALL BE ALLOCATED TO PROVIDERS DESCRIBED IN THIS SUBDIVISION; PROVIDED,
HOWEVER THAT IF FEDERAL FINANCIAL PARTICIPATION IS UNAVAILABLE FOR ANY
ELIGIBLE PROVIDER, OR FOR ANY POTENTIAL INVESTMENT UNDER THIS SUBDIVI-
SION THEN THE NON-FEDERAL SHARE OF PAYMENTS PURSUANT TO THIS SUBDIVISION
MAY BE MADE AS STATE GRANTS.
(I) PROVIDERS SERVING RURAL AREAS AS SUCH TERM IS DEFINED IN SECTION
TWO THOUSAND NINE HUNDRED FIFTY-ONE OF THIS CHAPTER, INCLUDING BUT NOT
LIMITED TO HOSPITALS, RESIDENTIAL HEALTH CARE FACILITIES, DIAGNOSTIC AND
TREATMENT CENTERS, AMBULATORY SURGERY CENTERS AND CLINICS SHALL BE
ELIGIBLE FOR ENHANCED PAYMENTS OR REIMBURSEMENT UNDER A SUPPLEMENTAL
RATE METHODOLOGY FOR THE PURPOSE OF PROMOTING ACCESS AND IMPROVING THE
QUALITY OF CARE.
(II) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, AND SUBJECT
TO FEDERAL FINANCIAL PARTICIPATION, ESSENTIAL COMMUNITY PROVIDERS,
WHICH, FOR THE PURPOSES OF THIS SECTION, SHALL MEAN A PROVIDER THAT
OFFERS HEALTH SERVICES WITHIN A DEFINED AND ISOLATED GEOGRAPHIC REGION
WHERE SUCH SERVICES WOULD OTHERWISE BE UNAVAILABLE TO THE POPULATION OF
SUCH REGION, SHALL BE ELIGIBLE FOR ENHANCED PAYMENTS OR REIMBURSEMENT
UNDER A SUPPLEMENTAL RATE METHODOLOGY FOR THE PURPOSE OF PROMOTING
ACCESS AND IMPROVING QUALITY OF CARE. ELIGIBLE PROVIDERS UNDER THIS
PARAGRAPH MAY INCLUDE, BUT ARE NOT LIMITED TO, HOSPITALS, RESIDENTIAL
HEALTH CARE FACILITIES, DIAGNOSTIC AND TREATMENT CENTERS, AMBULATORY
SURGERY CENTERS AND CLINICS.
(III) IN MAKING SUCH PAYMENTS THE COMMISSIONER MAY CONTEMPLATE THE
EXTENT TO WHICH ANY SUCH PROVIDER RECEIVES ASSISTANCE UNDER SUBDIVISION
(A) OF THIS SECTION AND MAY REQUIRE SUCH PROVIDER TO SUBMIT A WRITTEN
PROPOSAL DEMONSTRATING THAT THE NEED FOR MONIES UNDER THIS SUBDIVISION
EXCEEDS MONIES OTHERWISE DISTRIBUTED PURSUANT TO THIS SECTION.
(IV) PAYMENTS UNDER THIS SUBDIVISION MAY INCLUDE, BUT NOT BE LIMITED
TO, TEMPORARY RATE ADJUSTMENTS, LUMP SUM MEDICAID PAYMENTS, SUPPLEMENTAL
RATE METHODOLOGIES AND ANY OTHER PAYMENTS AS DETERMINED BY THE COMMIS-
SIONER.
(V) PAYMENTS UNDER THIS SUBDIVISION SHALL BE SUBJECT TO APPROVAL BY
THE DIRECTOR OF THE BUDGET.
(VI) THE COMMISSIONER MAY PROMULGATE REGULATIONS TO EFFECTUATE THE
PROVISIONS OF THIS SUBDIVISION.
S. 4207 17
S 15. Subparagraph (iv) of paragraph (b) of subdivision 6 of section
367-a of the social services law, as amended by section 40 of part C of
chapter 58 of the laws of 2005, is amended to read as follows:
(iv) individuals [enrolled in health maintenance organizations or
other entities which provide comprehensive health services, or other
managed care programs for services covered by such programs, except that
such persons, other than persons otherwise exempted from co-payments
pursuant to subparagraphs (i), (ii), (iii) and (v) of this paragraph,
and other than those persons enrolled in a managed long term care
program, shall be subject to co-payments as described in subparagraph
(v) of paragraph (d) of this subdivision] WHOSE FAMILY INCOME IS LESS
THAN ONE HUNDRED PERCENT OF THE FEDERAL POVERTY LINE, AS DEFINED IN
SUBPARAGRAPH FOUR OF PARAGRAPH (A) OF SUBDIVISION ONE OF SECTION THREE
HUNDRED SIXTY-SIX OF THIS TITLE, FOR A FAMILY OF THE SAME SIZE; and
S 16. Section 12 of part A of chapter 1 of the laws of 2002, relating
to the health care reform act of 2000, is amended to read as follows:
S 12. Notwithstanding any inconsistent provision of law or regulation
to the contrary, and subject to the availability of federal financial
participation pursuant to title XIX of the federal social security act,
effective for the period September 1, 2001 through March 31, 2002, and
state fiscal years thereafter, UNTIL MARCH 31, 2012, the department of
health is authorized to pay a specialty hospital adjustment to public
general hospitals, as defined in subdivision 10 of section 2801 of the
public health law, other than those operated by the state of New York or
the state university of New York, receiving reimbursement for all inpa-
tient services under title XIX of the federal social security act pursu-
ant to paragraph (e) of subdivision 4 of section 2807-c of the public
health law, and located in a city with a population of over 1 million,
of up to four hundred sixty-three million dollars for the period Septem-
ber 1, 2001 through March 31, 2002 and up to seven hundred ninety-four
million dollars annually for state fiscal years thereafter as medical
assistance payments for inpatient services pursuant to title 11 of arti-
cle 5 of the social services law for patients eligible for federal
financial participation under title XIX of the federal social security
act based on each such hospital's proportionate share of the sum of all
inpatient discharges for all facilities eligible for an adjustment
pursuant to this section for the base year two years prior to the rate
year. Such proportionate share payment may be added to rates of payment
or made as aggregate payments to eligible public general hospitals.
S 17. Section 13 of part B of chapter 1 of the laws of 2002, relating
to the health care reform act of 2000, is amended to read as follows:
S 13. Notwithstanding any inconsistent provision of law or regulation
to the contrary, and subject to the availability of federal financial
participation pursuant to title XIX of the federal social security act,
effective for the period April 1, 2002 through March 31, 2003, and state
fiscal years thereafter UNTIL MARCH 31, 2012, the department of health
is authorized to pay a specialty hospital adjustment to public general
hospitals, as defined in subdivision 10 of section 2801 of the public
health law, other than those operated by the state of New York or the
state university of New York, receiving reimbursement for all inpatient
services under title XIX of the federal social security act pursuant to
paragraph (e) of subdivision 4 of section 2807-c of the public health
law, and located in a city with a population of over one million, of up
to two hundred eighty-six million dollars as medical assistance payments
for inpatient services pursuant to title 11 of article 5 of the social
services law for patients eligible for federal financial participation
S. 4207 18
under title XIX of the federal social security act based on each such
hospital's proportionate share of the sum of all inpatient discharges
for all facilities eligible for an adjustment pursuant to this section
for the base year two years prior to the rate year. Such proportionate
share payment may be added to rates of payment or made as aggregate
payments to eligible hospitals.
S 18. Notwithstanding any inconsistent provision of law or regulation
to the contrary, and subject to the availability of federal financial
participation pursuant to title XIX of the federal social security act,
effective for the period April 1, 2012, through March 31, 2013, and
state fiscal years thereafter, the department of health is authorized to
pay a public hospital adjustment to public general hospitals, as defined
in subdivision 10 of section 2801 of the public health law, other than
those operated by the state of New York or the state university of New
York, and located in a city with a population of over 1 million, of up
to one billion eighty million dollars annually as medical assistance
payments for inpatient services pursuant to title 11 of article 5 of the
social services law for patients eligible for federal financial partic-
ipation under title XIX of the federal social security act based on such
criteria and methodologies as the commissioner may from time to time set
through a memorandum of understanding with the New York city health and
hospitals corporation, and such adjustments shall be paid by means of
one or more estimated payments, with such estimated payments to be
reconciled to the commissioner of health's final adjustment determi-
nations after the disproportionate share hospital payment adjustment
caps have been calculated for such period under sections 1923(f) and (g)
of the federal social security act. Such adjustment payment may be added
to rates of payment or made as aggregate payments to eligible public
general hospitals.
S 19. Section 14 of part A of chapter 1 of the laws of 2002, relating
to the health care reform act of 2000, is amended to read as follows:
S 14. Notwithstanding any inconsistent provision of law, rule or regu-
lation to the contrary, and subject to the availability of federal
financial participation pursuant to title XIX of the federal social
security act, effective for the period January 1, 2002 through March 31,
2002, and state fiscal years thereafter UNTIL MARCH 31, 2011, the
department of health is authorized to increase the operating cost compo-
nent of rates of payment for general hospital outpatient services and
general hospital emergency room services issued pursuant to paragraph
(g) of subdivision 2 of section 2807 of the public health law for public
general hospitals, as defined in subdivision 10 of section 2801 of the
public health law, other than those operated by the state of New York or
the state university of New York, and located in a city with a popu-
lation of over one million, which experienced free patient visits in
excess of twenty percent of their total self-pay and free patient visits
based on data reported on exhibit 33 of their 1999 institutional cost
report and which experienced uninsured outpatient losses in excess of
seventy-five percent of their total inpatient and outpatient uninsured
losses based on data reported on exhibit 47 of their 1999 institutional
cost report, of up to thirty-four million dollars for the period January
1, 2002 through March 31, 2002 and up to one hundred thirty-six million
dollars annually for state fiscal years thereafter as medical assistance
payments for outpatient services 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 based
on each such hospital's proportionate share of the sum of all outpatient
S. 4207 19
visits for all facilities eligible for an adjustment pursuant to this
section for the base year two years prior to the rate year. Such propor-
tionate share payment may be added to rates of payment or made as aggre-
gate payments to eligible public general hospitals.
S 20. Section 14 of part B of chapter 1 of the laws of 2002, relating
to the health care reform act of 2000, is amended to read as follows:
S 14. Notwithstanding any inconsistent provision of law or regulation
to the contrary, and subject to the availability of federal financial
participation pursuant to title XIX of the federal social security act,
effective for the period January 1, 2002 through March 31, 2002, and
state fiscal years thereafter UNTIL MARCH 31, 2011, the department of
health is authorized to increase the operating cost component of rates
of payment for general hospital outpatient services and general hospital
emergency room services issued pursuant to paragraph (g) of subdivision
2 of section 2807 of the public health law for public general hospitals,
as defined in subdivision 10 of section 2801 of the public health law,
other than those operated by the state of New York or the state univer-
sity of New York, and located in a city with a population of over one
million, which experienced free patient visits in excess of twenty
percent of their total self-pay and free patient visits based on data
reported on exhibit 33 of their 1999 institutional cost report and which
experienced uninsured outpatient losses in excess of seventy-five
percent of their total inpatient and outpatient uninsured losses based
on data reported on exhibit 47 of their 1999 institutional cost report,
of up to thirty-seven million dollars for the period January 1, 2002
through March 31, 2002 and one hundred fifty-one million dollars annual-
ly for state fiscal years thereafter as medical assistance payments for
outpatient services 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 based on each such
hospital's proportionate share of the sum of all outpatient visits for
all facilities eligible for an adjustment pursuant to this section for
the base year two years prior to the rate year. Such proportionate share
payment may be added to rates of payment or made as aggregate payments
to eligible public general hospitals.
S 21. Notwithstanding any inconsistent provision of law, rule or regu-
lation to the contrary, and subject to the availability of federal
financial participation pursuant to title XIX of the federal social
security act, effective for the period April 1, 2011 through March 31,
2012, and state fiscal years thereafter, the department of health is
authorized to increase the operating cost component of rates of payment
for general hospital outpatient services and general hospital emergency
room services issued pursuant to paragraph (g) of subdivision 2 of
section 2807 of the public health law for public general hospitals, as
defined in subdivision 10 of section 2801 of the public health law,
other than those operated by the state of New York or the state univer-
sity of New York, and located in a city with a population over one
million, up to two hundred eighty-seven million dollars annually as
medical assistance payments for outpatient services pursuant to title 11
of article 5 of the social services law for patients eligible for feder-
al financial participation under title XIX of the federal social securi-
ty act based on such criteria and methodologies as the commissioner may
from time to time set through a memorandum of understanding with the New
York city health and hospitals corporation, and such adjustments shall
be paid by means of one or more estimated payments, with such estimated
payments to be reconciled to the commissioner of health's final adjust-
S. 4207 20
ment determinations after the disproportionate share hospital payment
adjustment caps have been calculated for such period under sections
1923(f) and (g) of the federal social security act. Such adjustment
payment may be added to rates of payment or made as aggregate payments
to eligible public general hospitals.
S 22. Section 16 of part A of chapter 1 of the laws of 2002, relating
to the health care reform act of 2000, is amended to read as follows:
S 16. Any amounts provided pursuant to sections eleven, twelve, thir-
teen and fourteen of this act shall be effective for purposes of deter-
mining payments for public general hospitals contingent on receipt of
all approvals required by federal law or regulations for federal finan-
cial participation in payments made pursuant to title XIX of the federal
social security act. If federal approvals are not granted for payments
based on such amounts or components thereof, payments to public general
hospitals shall be determined without consideration of such amounts or
such components. Public general hospitals shall refund to the state, or
the state may recoup from prospective payments, any overpayment
received, including those based on a retroactive reduction in the
payments. Any reduction in federal financial participation pursuant to
title XIX of the federal social security act related to federal upper
payment limits APPLICABLE TO PUBLIC GENERAL HOSPITALS OTHER THAN THOSE
OPERATED BY THE STATE UNIVERSITY OF NEW YORK shall be deemed to apply
first to amounts provided pursuant to sections eleven, twelve, thirteen
and fourteen of this act AND SECTIONS SIXTEEN AND NINETEEN OF A CHAPTER
OF THE LAWS OF TWO THOUSAND FIFTEEN.
S 23. Section 20 of part B of chapter 1 of the laws of 2002, relating
to the health care reform act of 2000, is amended to read as follows:
S 20. Any amounts provided pursuant to sections thirteen and fourteen
of this act shall be effective for purposes of determining payments for
public general hospitals contingent on receipt of all approvals required
by federal law or regulations for federal financial participation in
payments made pursuant to title XIX of the federal social security act.
If federal approvals are not granted for payments based on such amounts
or components thereof, payments to public general hospitals shall be
determined without consideration of such amounts or such components.
Public general hospitals shall refund to the state, or the state may
recoup from prospective payments, any overpayment received, including
those based on a retroactive reduction in the payments. Any reduction in
federal financial participation pursuant to title XIX of the federal
social security act related to federal upper payment limits APPLICABLE
TO PUBLIC GENERAL HOSPITALS OTHER THAN THOSE OPERATED BY THE STATE OF
NEW YORK OR THE STATE UNIVERSITY OF NEW YORK shall be deemed to apply
first to amounts provided pursuant to sections thirteen and fourteen of
this act AND SECTIONS SIXTEEN AND NINETEEN OF A CHAPTER OF THE LAWS OF
TWO THOUSAND FIFTEEN.
S 24. Intentionally omitted.
S 25. Intentionally omitted.
S 26. Intentionally omitted.
S 27. Intentionally omitted.
S 28. Sections 50, 51, 52 and 53 of part C of chapter 60 of the laws
of 2014 amending the social services law and other laws relating to
eliminating prescriber prevails for brand name drugs with generic equiv-
alents are REPEALED.
S 29. Section 1 of part B of chapter 59 of the laws of 2011, amending
the public health law relating to rates of payment and medical assist-
ance, is amended to read as follows:
S. 4207 21
Section 1. (a) Notwithstanding any inconsistent provision of law,
rule or regulation to the contrary, and subject to the availability of
federal financial participation, effective for the period April 1, 2011
through March 31, 2012, and each state fiscal year thereafter, the
department of health is authorized to make supplemental Medicaid
payments OR SUPPLEMENTAL MEDICAID MANAGED CARE PAYMENTS for professional
services provided by physicians, nurse practitioners and physician
assistants who are participating in a plan for the management of clin-
ical practice at the State University of New York, in accordance with
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 amounts that will increase fees for such profes-
sional services to an amount equal to the average commercial or Medicare
rate that would otherwise be received for such services rendered by such
physicians, nurse practitioners and physician assistants. The calcu-
lation of such supplemental fee payments shall be made in accordance
with applicable federal law and regulation and subject to the approval
of the division of the budget. Such supplemental Medicaid fee payments
may be added to the professional fees paid under the fee schedule [or],
made as aggregate lump sum payments to eligible clinical practice plans
authorized to receive professional fees OR MADE AS SUPPLEMENTAL PAYMENTS
MADE FOR SUCH PURPOSE AS DESCRIBED HEREIN TO MEDICAID MANAGED CARE
ORGANIZATIONS. SUPPLEMENTAL MEDICAID MANAGED CARE PAYMENTS UNDER THIS
SECTION SHALL BE DISTRIBUTED TO PROVIDERS AS DETERMINED BY THE MANAGED
CARE MODEL CONTRACT AND MAY UTILIZE MANAGED CARE ORGANIZATION REPORTED
ENCOUNTER DATA AND OTHER SUCH METRICS AS DETERMINED BY THE DEPARTMENT OF
HEALTH IN ORDER TO ENSURE RATES OF PAYMENT EQUIVALENT TO THE AVERAGE
COMMERCIAL OR MEDICARE RATE THAT WOULD OTHERWISE BE RECEIVED FOR SUCH
SERVICES RENDERED BY SUCH PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN
ASSISTANTS.
(b) The affiliated State University of New York health science centers
shall be responsible for payment of one hundred percent of the non-fed-
eral share of such supplemental Medicaid payments OR SUPPLEMENTAL MEDI-
CAID MANAGED CARE PAYMENTS for all services provided by physicians,
nurse practitioners and physician assistants who are participating in a
plan for the management of clinical practice, in accordance with section
365-a of the social services law, regardless of whether another social
services district or the department of health may otherwise be responsi-
ble for furnishing medical assistance to the eligible persons receiving
such services.
S 30. Section 93 of part H of chapter 59 of the laws of 2011, amending
the public health law relating to general hospital inpatient reimburse-
ment for annual rates, is amended to read as follows:
S 93. 1. Notwithstanding any inconsistent provision of law, rule or
regulation to the contrary, and subject to the availability of federal
financial participation, effective for the period April 1, 2011 through
March 31, 2012, and each state fiscal year thereafter, the department of
health is authorized to make supplemental Medicaid payments OR SUPPLE-
MENTAL MEDICAID MANAGED CARE PAYMENTS for professional services provided
by physicians, nurse practitioners and physician assistants who are
employed by a public benefit corporation or a non-state operated public
general hospital operated by a public benefit corporation or who are
providing professional services at a facility of such public benefit
corporation as either a member of a practice plan or an employee of a
professional corporation or limited liability corporation under contract
to provide services to patients of such a public benefit corporation, in
S. 4207 22
accordance with 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 amounts that will increase fees for
such professional services to an amount equal to either the Medicare
rate or the average commercial rate that would otherwise be received for
such services rendered by such physicians, nurse practitioners and
physician assistants, provided, however, that such supplemental fee
payments shall not be available with regard to services provided at
facilities participating in the Medicare Teaching Election Amendment.
The calculation of such supplemental fee payments shall be made in
accordance with applicable federal law and regulation and subject to the
approval of the division of the budget. Such supplemental Medicaid fee
payments may be added to the professional fees paid under the fee sched-
ule [or], made as aggregate lump sum payments to entities authorized to
receive professional fees OR MADE AS SUPPLEMENTAL PAYMENTS MADE FOR SUCH
PURPOSE AS DESCRIBED HEREIN TO MEDICAID MANAGED CARE ORGANIZATIONS.
SUPPLEMENTAL MEDICAID MANAGED CARE PAYMENTS UNDER THIS SECTION SHALL BE
DISTRIBUTED TO PROVIDERS AS DETERMINED BY THE MANAGED CARE MODEL
CONTRACT AND MAY UTILIZE MANAGED CARE ORGANIZATION REPORTED ENCOUNTER
DATA AND OTHER SUCH METRICS AS DETERMINED BY THE DEPARTMENT OF HEALTH IN
ORDER TO ENSURE RATES OF PAYMENT EQUIVALENT TO THE AVERAGE COMMERCIAL OR
MEDICARE RATE THAT WOULD OTHERWISE BE RECEIVED FOR SUCH SERVICES
RENDERED BY SUCH PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSIST-
ANTS.
2. The supplemental Medicaid payments OR SUPPLEMENTAL MEDICAID MANAGED
CARE PAYMENTS for professional services authorized by subdivision one of
this section may be made only at the election of the public benefit
corporation or the local social services district in which the non-state
operated public general hospital is located. The electing public benefit
corporation or local social services district shall, notwithstanding the
social services district Medicaid cap provisions of Part C of chapter 58
of the laws of 2005, be responsible for payment of one hundred percent
of the non-federal share of such supplemental Medicaid payments, in
accordance with section 365-a of the social services law, regardless of
whether another social services district or the department of health may
otherwise be responsible for furnishing medical assistance to the eligi-
ble persons receiving such services. Social services district or public
benefit corporation funding of the non-federal share of any such
payments shall be deemed to be voluntary for purposes of the increased
federal medical assistance percentage provisions of the American Recov-
ery and Reinvestment Act of 2009, provided, however, that in the event
the federal Centers for Medicare and Medicaid Services determines that
such non-federal share payments are not voluntary payments for purposes
of such act, the provisions of this section shall be null and void.
S 31. Intentionally omitted.
S 32. Intentionally omitted.
S 33. Intentionally omitted.
S 34. Transportation assessment for people with developmental disabil-
ities and other populations. (a) The commissioner of the office for
people with developmental disabilities is authorized to contract with
one or more entities to conduct an assessment of the mobility and trans-
portation needs of persons with disabilities, including for integrated
employment opportunities in accordance with section 13.41 of the mental
hygiene law, as well as the mentally ill, those who engage in chemical
abuse or are chemically dependent, and the aging. The contractor shall
consult with the office for people with developmental disabilities,
S. 4207 23
department of transportation, department of health, office for the
aging, office of mental health, office of alcoholism and substance abuse
services, and stakeholders including consumer groups, transportation
providers and transportation systems in conducting the assessment. The
assessment shall include but not be limited to: the identification of
locally based transportation providers and transportation systems
equipped to participate in a possible pilot demonstration program;
considerations regarding the availability of public transportation,
public safety concerns and the duplication of services; reporting
requirements for cost savings and evaluation of whether specialized care
needs are being met; recommendations for the implementation of shared
software to enable entities to track services, manage costs among
providers, consolidate routes and provide a registry identifying partic-
ipating clients and any specialized care needs that must be met in order
to effectively provide transportation; recommendations for rate adjust-
ments or reimbursement changes; and identification of any legal, statu-
tory or regulatory, and funding barriers.
(b) Following the assessment, the contractor shall consult with the
office for people with developmental disabilities, department of trans-
portation, department of health, office for the aging, office of mental
health, office of alcoholism and substance abuse services, and stake-
holders including consumer groups, transportation providers and trans-
portation systems for the development of a pilot demonstration program
to coordinate medical and non-medical transportation services, maximize
funding sources, enhance community integration and any other related
tasks.
(c) The contractor shall report its findings from its assessment and
make recommendations regarding the creation of a transportation pilot
demonstration program for persons with disabilities, including for inte-
grated employment opportunities in accordance with section 13.41 of the
mental hygiene law, as well as the mentally ill, those who engage in
chemical abuse or are chemically dependent, and the aging, to the gover-
nor, the temporary president of the senate and the speaker of the assem-
bly no later than January 1, 2016. Any transportation pilot demon-
stration program resulting from the assessment authorized pursuant to
this section shall be subject to legislative approval.
S 35. Intentionally omitted.
S 36. Intentionally omitted.
S 37. Intentionally omitted.
S 38. Section 2808 of the public health law is amended by adding a new
subdivision 27 to read as follows:
27. FOR PERIODS ON OR AFTER APRIL FIRST, TWO THOUSAND FIFTEEN, THE
COMMISSIONER SHALL AUTHORIZE AN ENERGY EFFICIENCY AND/OR DISASTER
PREPAREDNESS DEMONSTRATION PROGRAM FOR RESIDENTIAL HEALTH CARE FACILI-
TIES. SUCH PROGRAM SHALL INCLUDE AN EVALUATION OF FACILITY ENERGY EFFI-
CIENCY AND DISASTER PREPAREDNESS STATUS AND A FACILITY BASED
COST/BENEFIT ANALYSIS OF POTENTIAL MODIFICATIONS. THE DEPARTMENT SHALL
DEVELOP A PLAN FOR THE PROGRAM, SUBJECT TO A MEMORANDUM OF UNDERSTANDING
WITH THE LEGISLATURE THAT, AT A MINIMUM, DETAILS: ELIGIBILITY FOR
PARTICIPATION, FUNDING SOURCES, PROJECTED COST SAVINGS TO FACILITIES AND
THE STATE, THE MANNER IN WHICH SAVINGS MAY BE SHARED BETWEEN THE STATE
AND FACILITIES, AN IMPLEMENTATION TIMELINE AND ANY OTHER PLAN SPECIFIC
INFORMATION AS APPROPRIATE.
S 39. Intentionally omitted.
S 40. Intentionally omitted.
S 41. Intentionally omitted.
S. 4207 24
S 42. Subdivision 12 of section 367-a of the social services law, as
amended by section 63-a of part C of chapter 58 of the laws of 2007, is
amended to read as follows:
12. Prior to receiving medical assistance under subparagraphs [twelve]
FIVE and [thirteen] SIX of paragraph [(a)] (C) of subdivision one of
section three hundred sixty-six of this title, a person whose net avail-
able income is at least one hundred fifty percent of the applicable
federal income official poverty line, as defined and updated by the
United States department of health and human services, must pay a month-
ly premium, in accordance with a procedure to be established by the
commissioner. The amount of such premium shall be twenty-five dollars
for an individual who is otherwise eligible for medical assistance under
such subparagraphs, and fifty dollars for a couple, both of whom are
otherwise eligible for medical assistance under such subparagraphs. No
premium shall be required from a person whose net available income is
less than one hundred fifty percent of the applicable federal income
official poverty line, as defined and updated by the United States
department of health and human services.
S 43. Subparagraph 6 of paragraph (b) of subdivision 1 of section 366
of the social services law, as added by section 1 of part D of chapter
56 of the laws of 2013, is amended to read as follows:
(6) An individual who is not otherwise eligible for medical assistance
under this section is eligible for coverage of family planning services
reimbursed by the federal government at a rate of ninety percent, and
for coverage of those services identified by the commissioner of health
as services generally performed as part of or as a follow-up to a
service eligible for such ninety percent reimbursement, including treat-
ment for sexually transmitted diseases, if his or her income does not
exceed the MAGI-equivalent of two hundred percent of the federal poverty
line for the applicable family size, which shall be calculated in
accordance with guidance issued by the secretary of the United States
department of health and human services[.]; PROVIDED FURTHER THAT THE
COMMISSIONER OF HEALTH IS AUTHORIZED TO ESTABLISH CRITERIA FOR PRESUMP-
TIVE ELIGIBILITY FOR SERVICES PROVIDED PURSUANT TO THIS SUBPARAGRAPH IN
ACCORDANCE WITH ALL APPLICABLE REQUIREMENTS OF FEDERAL LAW OR REGULATION
PERTAINING TO SUCH ELIGIBILITY.
S 44. Subdivision 1 of section 398-b of the social services law, as
added by section 44 of part C of chapter 60 of the laws of 2014, is
amended to read as follows:
1. Notwithstanding any inconsistent provision of law to the contrary
and subject to the availability of federal financial participation, the
commissioner is authorized to make grants [from] UP TO a gross amount of
five million dollars FOR STATE FISCAL YEAR TWO THOUSAND FOURTEEN--FIF-
TEEN AND UP TO A GROSS AMOUNT OF FIFTEEN MILLION DOLLARS FOR STATE
FISCAL YEAR TWO THOUSAND FIFTEEN--SIXTEEN to facilitate the transition
of foster care children placed with voluntary foster care agencies to
managed care. The use of such funds may include providing training and
consulting services to voluntary agencies to [access] ASSESS readiness
and make necessary infrastructure and organizational modifications,
collecting service utilization and other data from voluntary agencies
and other entities, and making investments in health information tech-
nology, including the infrastructure necessary to establish and maintain
electronic health records. Such funds shall be distributed pursuant to a
formula to be developed by the commissioner of health, in consultation
with the commissioner of the office of CHILDREN AND family [and child]
services. In developing such formula the commissioners may take into
S. 4207 25
account size and scope of provider operations as a factor relevant to
eligibility for such funds. Each recipient of such funds shall be
required to document and demonstrate the effective use of funds distrib-
uted herein. IF FEDERAL FINANCIAL PARTICIPATION IS UNAVAILABLE, THEN
THE NONFEDERAL SHARE OF PAYMENTS PURSUANT TO THIS SUBDIVISION MAY BE
MADE AS STATE GRANTS.
S 45. Intentionally omitted.
S 46. Intentionally omitted.
S 47. Intentionally omitted.
S 48. Intentionally omitted.
S 49. 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) of paragraph
(1) of this subdivision; AND PROVIDED, FURTHER, THAT FOR PHYSICAL
MEDICAL REHABILITATION SERVICES, THE COMMISSIONER IS AUTHORIZED TO MAKE
ADJUSTMENTS TO SUCH RATES FOR THE PURPOSES OF REIMBURSING PEDIATRIC
VENTILATOR SERVICES.
S 50. Young adult special populations demonstration programs. The
commissioner of health shall be authorized to establish up to four young
adult special populations demonstration programs to provide cost effec-
tive, necessary services and enhanced quality of care for targeted popu-
lations in order to demonstrate the effectiveness of the programs.
Eligible individuals shall have severe and chronic medical or health
problems, or multiple disabling conditions which may be combined with
developmental disabilities. The programs shall provide more appropriate
settings and services for these individuals, help prevent out of state
placements and allow repatriation back to their home communities. Eligi-
ble operator applicants shall be not-for-profit with demonstrated exper-
tise in caring for the targeted population including persons with severe
and chronic medical or health problems or multiple disabling conditions
and a record of providing quality care.
Funds may include, but not be limited to, start up funds, capital
investments and enhanced rates.
Of the four demonstrations:
(a) at least one shall be designed to serve persons aged twenty-one to
thirty-five years of age who are aging out of pediatric acute care
hospitals or pediatric nursing homes; and
(b) at least one shall be designed to serve persons aged twenty-one to
thirty-five years of age who have a developmental disability in addition
to their severe and chronic medical or health problems and are aging out
of pediatric acute care hospitals, pediatric nursing homes or children's
residential homes operated under the jurisdiction of the office for
persons with developmental disabilities.
S. 4207 26
The department of health shall be responsible for monitoring the qual-
ity and appropriateness and effectiveness of the demonstration programs,
and shall report to the legislature no later than December 31, 2015 on
what efforts it has undertaken toward the establishment of these demon-
stration programs and shall report to the legislature two years follow-
ing the establishment of a demonstration program pursuant to this
section.
S 51. Paragraph d of subdivision 20 of section 2808 of the public
health law, as added by section 8 of part H of section 59 of the laws of
2011, is amended to read as follows:
d. Notwithstanding any contrary provision of law, rule or regulation,
for rate periods on and after April first, two thousand eleven THROUGH
MARCH THIRTY-FIRST, TWO THOUSAND FIFTEEN, the commissioner may reduce or
eliminate the payment factor for return on or return of equity in the
capital cost component of Medicaid rates of payment for services
provided by residential health care facilities.
S 52. Section 2803 of the public health law is amended by adding a new
subdivision 11 to read as follows:
11. NOTWITHSTANDING ANY PROVISION OF LAW, RULE OR REGULATION TO THE
CONTRARY, THE COMMISSIONER SHALL ALLOW DIAGNOSTIC AND TREATMENT CENTERS
AND OUTPATIENT CLINICS OF GENERAL HOSPITALS TO PROVIDE OFF-SITE SERVICES
TO EXISTING PATIENTS IN NEED OF PROFESSIONAL SERVICES AVAILABLE AT THE
DIAGNOSTIC AND TREATMENT CENTER OR GENERAL HOSPITAL OUTPATIENT CLINIC,
BUT, DUE TO THE INDIVIDUAL'S MEDICAL CONDITION, IS UNABLE TO RECEIVE
ON-SITE SERVICES AT THE DIAGNOSTIC AND TREATMENT CENTER OR GENERAL
HOSPITAL OUTPATIENT CLINIC.
S 53. 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 therapeutic class], including non-formulary
drugs[, upon demonstration by]. IF the prescriber[,] DETERMINES after
consulting with the managed care provider, that such drugs, in the
prescriber's reasonable professional judgment, are medically necessary
and warranted, THE PRESCRIBER'S DETERMINATION SHALL BE FINAL.
S 54. Subdivision 25-a of section 364-j of the social services law is
REPEALED.
S 55. Section 365-d of the social services law is REPEALED and a new
section 365-d is added to read as follows:
S 365-D. HEALTH TECHNOLOGY ASSESSMENT COMMITTEE. 1. THE DEPARTMENT
SHALL CONVENE A HEALTH TECHNOLOGY ASSESSMENT COMMITTEE. THE COMMITTEE
SHALL, AT THE REQUEST OF THE COMMISSIONER, PROVIDE ADVICE AND MAKE
RECOMMENDATIONS REGARDING COVERAGE OF HEALTH TECHNOLOGY FOR PURPOSES OF
THE MEDICAL ASSISTANCE PROGRAM. THE COMMISSIONER SHALL CONSULT SUCH
COMMITTEE PRIOR TO ANY DETERMINATION TO EXCLUDE FROM COVERAGE ANY HEALTH
TECHNOLOGY FROM THE MEDICAL ASSISTANCE PROGRAM. FOR PURPOSES OF THIS
SECTION, "HEALTH TECHNOLOGY" MEANS MEDICAL DEVICES AND SURGICAL PROCE-
DURES USED IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE AND
OTHER MEDICAL CONDITIONS.
2. (A) THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE SHALL CONSIST OF
THIRTEEN MEMBERS, SEVEN OF WHOM SHALL BE APPOINTED BY THE COMMISSIONER,
THREE MEMBERS SHALL BE APPOINTED BY THE TEMPORARY PRESIDENT OF THE
SENATE, AND THREE MEMBERS SHALL BE APPOINTED BY THE SPEAKER OF THE
ASSEMBLY. MEMBERS SHALL SERVE THREE YEAR TERMS; EXCEPT THAT FOR THE
S. 4207 27
INITIAL APPOINTMENTS TO THE COMMITTEE, THREE MEMBERS APPOINTED BY THE
COMMISSIONER, AND ONE OF THE MEMBERS APPOINTED BY THE TEMPORARY PRESI-
DENT OF THE SENATE AND BY THE SPEAKER OF THE ASSEMBLY, SHALL SERVE ONE
YEAR TERMS, THREE MEMBERS APPOINTED BY THE COMMISSIONER, AND ONE OF THE
MEMBERS APPOINTED BY THE TEMPORARY PRESIDENT OF THE SENATE AND BY THE
SPEAKER OF THE ASSEMBLY, SHALL SERVE TWO YEAR TERMS; AND THE REMAINING
THREE MEMBERS SHALL SERVE THREE YEAR TERMS. COMMITTEE MEMBERS MAY BE
REAPPOINTED UPON THE COMPLETION OF THEIR TERMS. WITH THE EXCEPTION OF
THE CHAIRPERSON, NO MEMBER OF THE COMMITTEE SHALL BE AN EMPLOYEE OF THE
STATE OR ANY POLITICAL SUBDIVISION OF THE STATE, OTHER THAN FOR HIS OR
HER MEMBERSHIP ON THE COMMITTEE, EXCEPT FOR EMPLOYEES OF HEALTH CARE
FACILITIES OR UNIVERSITIES OPERATED BY THE STATE, A PUBLIC BENEFIT
CORPORATION, THE STATE UNIVERSITY OF NEW YORK OR MUNICIPALITIES.
(B) THE MEMBERSHIP OF SUCH COMMITTEE SHALL BE AS FOLLOWS:
(I) THREE PERSONS LICENSED AND ACTIVELY ENGAGED IN THE PRACTICE OF
MEDICINE IN THIS STATE;
(II) ONE PERSON LICENSED AND ACTIVELY ENGAGED IN THE PRACTICE OF NURS-
ING AS A NURSE PRACTITIONER, OR IN THE PRACTICE OF MIDWIFERY IN THIS
STATE;
(III) ONE PERSON WHO IS A REPRESENTATIVE OF A HEALTH TECHNOLOGY OR
MEDICAL DEVICE ORGANIZATION WITH A REGIONAL, STATEWIDE OR NATIONAL
CONSTITUENCY;
(IV) ONE PERSON WITH EXPERTISE IN HEALTH TECHNOLOGY ASSESSMENT WHO IS
A HEALTH CARE PROFESSIONAL LICENSED UNDER TITLE EIGHT OF THE EDUCATION
LAW;
(V) THREE PERSONS WHO SHALL BE CONSUMERS OR REPRESENTATIVES OF ORGAN-
IZATIONS WITH A REGIONAL OR STATEWIDE CONSTITUENCY AND WHO HAVE BEEN
INVOLVED IN ACTIVITIES RELATED TO HEALTH CARE CONSUMER ADVOCACY;
(VI) ONE PERSON WHO IS A REPRESENTATIVE OF A HOSPITAL ORGANIZATION
WITH A REGIONAL, NATIONAL OR STATEWIDE CONSTITUENCY;
(VII) ONE PERSON WHO IS A REPRESENTATIVE OF A HEALTH INSURANCE OR
MANAGED CARE ORGANIZATION WITH A REGIONAL, NATIONAL OR STATEWIDE CONSTI-
TUENCY;
(VIII) ONE PERSON WHO IS A HEALTH ECONOMIST; AND
(IX) A MEMBER OF THE DEPARTMENT WHO SHALL ACT AS CHAIRPERSON AS DESIG-
NATED BY THE COMMISSIONER.
(C) THE COMMITTEE MAY INVITE AND CONSULT WITH SCIENTIFIC, TECHNICAL OR
CLINICAL EXPERTS WITH DEMONSTRATABLE EXPERIENCE OR KNOWLEDGE OF THE
TECHNOLOGY UNDER REVIEW.
3. THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE SHALL BE A PUBLIC BODY
UNDER ARTICLE SEVEN OF THE PUBLIC OFFICERS LAW AND SUBJECT TO ARTICLE
SIX OF THE PUBLIC OFFICERS LAW. THE DEPARTMENT SHALL PROVIDE INTERNET
ACCESS TO ALL MEETINGS OF SUCH COMMITTEE THROUGH THE DEPARTMENT'S
WEBSITE.
4. THE MEMBERS OF THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE SHALL
RECEIVE NO COMPENSATION FOR THEIR SERVICES BUT SHALL BE REIMBURSED FOR
EXPENSES ACTUALLY AND NECESSARILY INCURRED IN THE PERFORMANCE OF THEIR
DUTIES. COMMITTEE MEMBERS SHALL BE DEEMED TO BE EMPLOYEES OF THE DEPART-
MENT FOR PURPOSES OF SECTION SEVENTEEN OF THE PUBLIC OFFICERS LAW, AND
SHALL NOT PARTICIPATE IN ANY MATTER FOR WHICH A CONFLICT OF INTEREST
EXISTS.
5. THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE SHALL, AT THE REQUEST OF
THE COMMISSIONER, CONSIDER ANY MATTER RELATING TO HEALTH TECHNOLOGY
ASSESSMENT. THE COMMISSIONER SHALL PROVIDE MEMBERS OF THE COMMITTEE
WITH ANY EVIDENCE OR INFORMATION RELATED TO THE HEALTH TECHNOLOGY
ASSESSMENT INCLUDING, BUT NOT LIMITED TO, INFORMATION SUBMITTED BY
S. 4207 28
MEMBERS OF THE PUBLIC. THE COMMISSIONER SHALL PROVIDE SIXTY DAYS PUBLIC
NOTICE ON THE DEPARTMENT'S WEBSITE PRIOR TO ANY MEETING OF THE COMMITTEE
TO DEVELOP RECOMMENDATIONS CONCERNING HEALTH TECHNOLOGY COVERAGE DETER-
MINATIONS. SUCH NOTICE SHALL INCLUDE A DESCRIPTION OF THE PROPOSED
HEALTH TECHNOLOGY TO BE REVIEWED, THE CONDITIONS OR DISEASES IMPACTED BY
THE HEALTH TECHNOLOGY, THE PROPOSALS TO BE CONSIDERED BY THE COMMITTEE,
AND THE SYSTEMATIC EVIDENCE-BASED ASSESSMENT PREPARED IN ACCORDANCE WITH
THIS SUBDIVISION. THE COMMITTEE SHALL ALLOW INTERESTED PARTIES A
REASONABLE OPPORTUNITY TO MAKE AN ORAL PRESENTATION TO THE COMMITTEE
RELATED TO THE HEALTH TECHNOLOGY TO BE REVIEWED AND TO SUBMIT WRITTEN
INFORMATION. THE COMMITTEE SHALL CONSIDER ANY INFORMATION PROVIDED BY
ANY INTERESTED PARTY, INCLUDING, BUT NOT LIMITED TO, HEALTH CARE PROVID-
ERS, HEALTH CARE FACILITIES, PATIENTS, CONSUMERS AND MANUFACTURERS. FOR
ALL HEALTH TECHNOLOGIES SELECTED FOR REVIEW, THE COMMISSIONER SHALL
CONDUCT A SYSTEMATIC EVIDENCE-BASED ASSESSMENT OF THE HEALTH TECHNOLO-
GY'S SAFETY AND CLINICAL EFFICACY. THE ASSESSMENT SHALL USE ESTABLISHED
SYSTEMATIC REVIEW ELEMENTS, SUCH AS A PICO (POPULATION, INTERVENTION,
COMPARATOR AND OUTCOMES) STATEMENT, KEY QUESTIONS, PRESPECIFIED INCLU-
SION AND EXCLUSION CRITERIA, STUDY QUALITY ASSESSMENT, AND DATA SYNTHE-
SIS. UPON COMPLETION, THE SYSTEMATIC, EVIDENCE-BASED ASSESSMENT SHALL BE
MADE AVAILABLE TO THE PUBLIC.
6. THE COMMISSIONER SHALL PROVIDE NOTICE OF ANY COVERAGE RECOMMENDA-
TIONS DEVELOPED BY THE COMMITTEE BY MAKING SUCH INFORMATION AVAILABLE ON
THE DEPARTMENT'S WEBSITE. SUCH PUBLIC NOTICE SHALL INCLUDE: A SUMMARY OF
THE DELIBERATIONS OF THE COMMITTEE; A SUMMARY OF THE POSITIONS OF THOSE
MAKING PUBLIC COMMENTS AT MEETINGS OF THE COMMITTEE AND ANY SAFETY AND
HEALTH OUTCOMES DATA SUBMITTED BY ANY INTERESTED PARTY; THE RESPONSE OF
THE COMMITTEE TO THOSE COMMENTS, IF ANY; THE CLINICAL EVIDENCE UPON
WHICH THE COMMITTEE BASES ITS RECOMMENDATIONS; AND THE FINDINGS AND
RECOMMENDATIONS OF THE COMMITTEE INCLUDING A FINAL EVIDENCE-BASED
SYSTEMATIC ASSESSMENT.
7. THE COMMISSIONER SHALL PROVIDE PUBLIC NOTICE ON THE DEPARTMENT'S
WEBSITE OF HIS OR HER FINAL DETERMINATION, INCLUDING: THE NATURE OF THE
DETERMINATION; AN ANALYSIS OF THE IMPACT OF THE COMMISSIONER'S DETERMI-
NATION ON STATE PUBLIC HEALTH PLAN POPULATIONS AND PROVIDERS; AND THE
PROJECTED FISCAL IMPACT TO THE STATE PUBLIC HEALTH PLAN PROGRAMS OF THE
COMMISSIONER'S DETERMINATION. THE COMMISSIONER'S FINAL DETERMINATION
SHALL NOT OCCUR PRIOR TO THE THIRTIETH DAY FROM THE POSTING OF THE
COMMITTEE'S RECOMMENDATIONS AND FINDINGS ON THE DEPARTMENT'S WEBSITE.
8. THE RECOMMENDATIONS OF THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE,
MADE PURSUANT TO THIS SECTION, SHALL BE BASED ON A REVIEW OF THE
EVIDENCE PRESENTED TO THE COMMITTEE, INCLUDING CLINICAL EFFECTIVENESS,
PATIENT OUTCOMES, IMPACT ON AT RISK AND UNDERSERVED POPULATIONS, AND
SAFETY. THE COMMITTEE SHALL TRIENNIALLY REVIEW PREVIOUS RECOMMENDATIONS
OF THE COMMITTEE AND PERMIT ORAL PRESENTATIONS AND THE SUBMISSION OF NEW
EVIDENCE AT SUCH TRIENNIAL REVIEW. SUCH REVIEW SHALL OCCUR PURSUANT TO
THE PROCEDURE ESTABLISHED IN SUBDIVISIONS FIVE AND SIX OF THIS SECTION.
THE COMMISSIONER MAY ALTER OR REVOKE HIS OR HER FINAL DETERMINATION
AFTER SUCH TRIENNIAL REVIEW PURSUANT TO THE PROCEDURE ESTABLISHED IN
SUBDIVISION SEVEN OF THIS SECTION.
9. THE DEPARTMENT SHALL PROVIDE ADMINISTRATIVE SUPPORT TO THE COMMIT-
TEE.
S 56. The public health law is amended by adding a new section 2805-x
to read as follows:
S 2805-X. HOSPITAL-HOME CARE-PHYSICIAN COLLABORATION PROGRAM. 1. THE
PURPOSE OF THIS SECTION SHALL BE TO FACILITATE INNOVATION IN HOSPITAL,
S. 4207 29
HOME CARE AGENCY AND PHYSICIAN COLLABORATION IN MEETING THE COMMUNITY'S
HEALTH CARE NEEDS. IT SHALL PROVIDE A FRAMEWORK TO SUPPORT VOLUNTARY
INITIATIVES IN COLLABORATION TO IMPROVE PATIENT CARE ACCESS AND MANAGE-
MENT, PATIENT HEALTH OUTCOMES, COST-EFFECTIVENESS IN THE USE OF HEALTH
CARE SERVICES AND COMMUNITY POPULATION HEALTH. SUCH COLLABORATIVE INITI-
ATIVES MAY ALSO INCLUDE PAYORS, SKILLED NURSING FACILITIES AND OTHER
INTERDISCIPLINARY PROVIDERS, PRACTITIONERS AND SERVICE ENTITIES.
2. FOR PURPOSES OF THIS SECTION:
(A) "HOSPITAL" SHALL INCLUDE A GENERAL HOSPITAL AS DEFINED IN THIS
ARTICLE OR OTHER INPATIENT FACILITY FOR REHABILITATION OR SPECIALTY CARE
WITHIN THE DEFINITION OF HOSPITAL IN THIS ARTICLE.
(B) "HOME CARE AGENCY" SHALL MEAN A CERTIFIED HOME HEALTH AGENCY, LONG
TERM HOME HEALTH CARE PROGRAM OR LICENSED HOME CARE SERVICES AGENCY AS
DEFINED IN ARTICLE THIRTY-SIX OF THIS CHAPTER.
(C) "PAYOR" SHALL MEAN A HEALTH PLAN APPROVED PURSUANT TO ARTICLE
FORTY-FOUR OF THIS CHAPTER, OR ARTICLE THIRTY-TWO OR FORTY-THREE OF THE
INSURANCE LAW.
(D) "PRACTITIONER" SHALL MEAN ANY OF THE HEALTH, MENTAL HEALTH OR
HEALTH RELATED PROFESSIONS LICENSED PURSUANT TO TITLE EIGHT OF THE
EDUCATION LAW.
3. THE COMMISSIONER IS AUTHORIZED TO PROVIDE FINANCING INCLUDING, BUT
NOT LIMITED TO, GRANTS OR POSITIVE ADJUSTMENTS IN MEDICAL ASSISTANCE
RATES OR PREMIUM PAYMENTS, TO THE EXTENT OF FUNDS AVAILABLE AND ALLO-
CATED OR APPROPRIATED THEREFOR, INCLUDING FUNDS PROVIDED TO THE STATE
THROUGH FEDERAL WAIVERS, FUNDS MADE AVAILABLE THROUGH STATE APPROPRI-
ATIONS AND/OR FUNDING THROUGH SECTION TWENTY-EIGHT HUNDRED SEVEN-V OF
THIS ARTICLE, AS WELL AS WAIVERS OF REGULATIONS UNDER TITLE TEN OF THE
NEW YORK CODES, RULES AND REGULATIONS, TO SUPPORT THE VOLUNTARY INITI-
ATIVES AND OBJECTIVES OF THIS SECTION.
4. HOSPITAL-HOME CARE-PHYSICIAN COLLABORATIVE INITIATIVES UNDER THIS
SECTION MAY INCLUDE, BUT SHALL NOT BE LIMITED TO:
(A) HOSPITAL-HOME CARE-PHYSICIAN INTEGRATION INITIATIVES, INCLUDING
BUT NOT LIMITED TO:
(I) TRANSITIONS IN CARE INITIATIVES TO HELP EFFECTIVELY TRANSITION
PATIENTS TO POST-ACUTE CARE AT HOME, COORDINATE FOLLOW-UP CARE AND
ADDRESS ISSUES CRITICAL TO CARE PLAN SUCCESS AND READMISSION AVOIDANCE;
(II) CLINICAL PATHWAYS FOR SPECIFIED CONDITIONS, GUIDING PATIENTS'
PROGRESS AND OUTCOME GOALS, AS WELL AS EFFECTIVE HEALTH SERVICES USE;
(III) APPLICATION OF TELEHEALTH/TELEMEDICINE SERVICES IN MONITORING
AND MANAGING PATIENT CONDITIONS, AND PROMOTING SELF-CARE/MANAGEMENT,
IMPROVED OUTCOMES AND EFFECTIVE SERVICES USE;
(IV) FACILITATION OF PHYSICIAN HOUSE CALLS TO HOMEBOUND PATIENTS
AND/OR TO PATIENTS FOR WHOM SUCH HOME VISITS ARE DETERMINED NECESSARY
AND EFFECTIVE FOR PATIENT CARE MANAGEMENT;
(V) ADDITIONAL MODELS FOR PREVENTION OF AVOIDABLE HOSPITAL READMIS-
SIONS AND EMERGENCY ROOM VISITS;
(VI) HEALTH HOME DEVELOPMENT;
(VII) DEVELOPMENT AND DEMONSTRATION OF NEW MODELS OF INTEGRATED OR
COLLABORATIVE CARE AND CARE MANAGEMENT NOT OTHERWISE ACHIEVABLE THROUGH
EXISTING MODELS; AND
(VIII) BUNDLED PAYMENT DEMONSTRATIONS FOR HOSPITAL-TO-POST-ACUTE-CARE
FOR SPECIFIED CONDITIONS OR CATEGORIES OF CONDITIONS, IN PARTICULAR,
CONDITIONS PREDISPOSED TO HIGH PREVALENCE OF READMISSION, INCLUDING
THOSE CURRENTLY SUBJECT TO FEDERAL/STATE PENALTY, AND OTHER DISCHARGES
WITH EXTENSIVE POST-ACUTE NEEDS;
S. 4207 30
(B) RECRUITMENT, TRAINING AND RETENTION OF HOSPITAL/HOME CARE DIRECT
CARE STAFF AND PHYSICIANS, IN GEOGRAPHIC OR CLINICAL AREAS OF DEMON-
STRATED NEED. SUCH INITIATIVES MAY INCLUDE, BUT ARE NOT LIMITED TO, THE
FOLLOWING ACTIVITIES:
(I) OUTREACH AND PUBLIC EDUCATION ABOUT THE NEED AND VALUE OF SERVICE
IN HEALTH OCCUPATIONS;
(II) TRAINING/CONTINUING EDUCATION AND REGULATORY FACILITATION FOR
CROSS-TRAINING TO MAXIMIZE FLEXIBILITY IN THE UTILIZATION OF STAFF,
INCLUDING:
(A) TRAINING OF HOSPITAL NURSES IN HOME CARE;
(B) DUAL CERTIFIED NURSE AIDE/HOME HEALTH AIDE CERTIFICATION; AND
(C) DUAL PERSONAL CARE AIDE/HHA CERTIFICATION;
(III) SALARY/BENEFIT ENHANCEMENT;
(IV) CAREER LADDER DEVELOPMENT; AND
(V) OTHER INCENTIVES TO PRACTICE IN SHORTAGE AREAS; AND
(C) HOSPITAL - HOME CARE - PHYSICIAN COLLABORATIVES FOR THE CARE AND
MANAGEMENT OF SPECIAL NEEDS, HIGH-RISK AND HIGH-COST PATIENTS, INCLUDING
BUT NOT LIMITED TO BEST PRACTICES, AND TRAINING AND EDUCATION OF DIRECT
CARE PRACTITIONERS AND SERVICE EMPLOYEES.
5. HOSPITALS AND HOME CARE AGENCIES WHICH ARE PROVIDED FINANCING OR
WAIVERS PURSUANT TO THIS SECTION SHALL REPORT TO THE COMMISSIONER ON THE
PATIENT, SERVICE AND COST EXPERIENCES PURSUANT TO THIS SECTION, INCLUD-
ING THE EXTENT TO WHICH THE PROJECT GOALS ARE ACHIEVED. THE COMMISSIONER
SHALL COMPILE AND MAKE SUCH REPORTS AVAILABLE ON THE DEPARTMENT'S
WEBSITE.
S 56-a. The public health law is amended by adding two new sections
3614-d and 3614-e to read as follows:
S 3614-D. UNIVERSAL STANDARDS FOR CODING OF PAYMENT OF CLAIMS FOR LONG
TERM CARE. STANDARDS FOR THE CODES OF CLAIMS OF PAYMENTS FOR PERSONAL
CARE, HOME HEALTH CARE SERVICES OR OTHER LONG TERM CARE SERVICES. IN THE
PROCESSING OF CODES OF CLAIMS SUBMITTED UNDER CONTRACTS OR AGREEMENTS
ISSUED OR ENTERED INTO OR BETWEEN CERTIFIED HOME HEALTH AGENCIES, LONG
TERM HOME HEALTH CARE PROGRAMS, LICENSED HOME CARE SERVICES PROGRAMS,
INSURERS, MANAGED LONG TERM CARE PLANS, MANAGED CARE PLANS OR ORGANIZA-
TIONS LICENSED OR OPERATED PURSUANT TO THE PROVISIONS OF THIS CHAPTER,
THE SOCIAL SERVICES LAW, OR THE INSURANCE LAW AND FOR ALL BILLS FOR
PERSONAL CARE, HOME HEALTH CARE SERVICES OR OTHER LONG TERM CARE
SERVICES RENDERED BY LICENSED HOME CARE SERVICES PROGRAMS, CERTIFIED
HOME HEALTH AGENCIES OR LONG TERM HOME HEALTH CARE PROGRAMS PURSUANT TO
SUCH CONTRACTS OR AGREEMENTS, ANY CERTIFIED HOME HEALTH CARE AGENCY,
LONG TERM HOME HEALTH CARE PROGRAM, INSURER, MANAGED LONG TERM CARE
PLANS, MANAGED CARE PLAN, OR ORGANIZATIONS LICENSED OR OPERATED PURSUANT
TO THE PROVISIONS OF THIS CHAPTER, THE SOCIAL SERVICES LAW, THE EXECU-
TIVE LAW OR THE INSURANCE LAW SHALL BE BASED ON UNIVERSAL BILLING CODES
APPROVED BY THE DEPARTMENT OR A NATIONALLY ACCREDITED ORGANIZATION AS
APPROVED BY THE DEPARTMENT; PROVIDED, HOWEVER, SUCH CODING SHALL BE
CONSISTENT WITH ANY CODES DEVELOPED AS PART OF THE UNIFORM ASSESSMENT
SYSTEM FOR LONG TERM CARE ESTABLISHED BY THE DEPARTMENT.
S 3614-E. ELECTRONIC PAYMENT OF CLAIMS. IN THE PAYMENT OF CLAIMS
SUBMITTED UNDER CONTRACTS OR AGREEMENTS ISSUED OR ENTERED INTO OR
BETWEEN CERTIFIED HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE
PROGRAMS, LICENSED HOME CARE SERVICES PROGRAMS, FISCAL INTERMEDIARIES
OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL
SERVICES LAW, INSURERS, MANAGED LONG TERM CARE PLANS, MANAGED CARE PLANS
OR ORGANIZATIONS LICENSED OR OPERATED PURSUANT TO THE PROVISIONS OF THIS
CHAPTER, THE SOCIAL SERVICES LAW OR THE INSURANCE LAW AND FOR ALL BILLS
S. 4207 31
FOR PERSONAL CARE, HOME HEALTH CARE SERVICES, CONSUMER DIRECTED PERSONAL
ASSISTANCE SERVICES OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-
FIVE-F OF THE SOCIAL SERVICES LAW OR OTHER LONG TERM CARE SERVICES
RENDERED BY LICENSED HOME CARE SERVICES PROGRAMS, CERTIFIED HOME HEALTH
AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS OR A FISCAL INTERMEDIARY
OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL
SERVICES LAW PURSUANT TO SUCH CONTRACTS OR AGREEMENTS, ANY CERTIFIED
HOME HEALTH CARE AGENCY, LONG TERM HOME HEALTH CARE PROGRAM, INSURER,
MANAGED LONG TERM CARE PLAN, MANAGED CARE PLAN OR ORGANIZATION LICENSED
OR OPERATED PURSUANT TO THE PROVISIONS OF THIS CHAPTER, THE SOCIAL
SERVICES LAW, THE EXECUTIVE LAW OR THE INSURANCE LAW, SUCH CLAIMS SHALL
BE PAID VIA ELECTRONIC FUNDS TRANSFER.
S 57. Subdivision 1 of section 364-j of the social services law is
amended by adding two new paragraphs (w) and (w-1) 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
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.
(W-1) "SPONSORING ORGANIZATION". A FACILITY LICENSED UNDER ARTICLE
TWENTY-EIGHT OF THE PUBLIC HEALTH LAW WHICH ACTS AS THE SPONSOR FOR A
SCHOOL-BASED HEALTH CENTER.
S 58. 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 FIFTEEN
COMMENCING WITH NO FEWER THAN THREE SCHOOL-BASED HEALTH CENTERS THAT
VOLUNTEER TO BE PART OF A PILOT PROJECT FOR A PERIOD OF TWO YEARS. THE
COMMISSIONER OF HEALTH SHALL PROVIDE AN INTERIM REPORT ON THE IMPLEMEN-
TATION OF THE PILOT PROJECT TO THE TEMPORARY PRESIDENT OF THE SENATE AND
THE SPEAKER OF THE ASSEMBLY ON OR BEFORE JULY FIRST, TWO THOUSAND
SIXTEEN. THE COMMISSIONER OF HEALTH SHALL PROVIDE A FINAL REPORT ON THE
IMPLEMENTATION OF THE PILOT PROJECT TO THE TEMPORARY PRESIDENT OF THE
SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR BEFORE JANUARY FIRST, TWO
THOUSAND SEVENTEEN. SUCH INTERIM AND FINAL REPORTS SHALL INCLUDE BUT NOT
BE LIMITED TO INFORMATION CONCERNING ACCESS BY CHILDREN AND ADOLESCENTS
TO PRIMARY HEALTH CARE SERVICES, URGENT CARE SERVICES, SERVICES FOR THE
MANAGEMENT OF CHRONIC DISEASE, WELL CHILD CARE, AND DENTAL CARE, AND THE
TIMELINESS AND ADEQUACY OF PAYMENT TO SCHOOL-BASED HEALTH CENTERS BY
MANAGED CARE PROVIDERS.
ON AND AFTER JULY FIRST, TWO THOUSAND SEVENTEEN, THE COMMISSIONER OF
HEALTH IS AUTHORIZED TO INCLUDE THE SERVICES OF A SCHOOL-BASED HEALTH
CENTER IN THE MANAGED CARE PROGRAM SUBJECT TO A PHASED-IN SCHEDULE BASED
ON GEOGRAPHY AND THE CAPABILITY OF THE SCHOOL-BASED HEALTH CENTER AND
THE MANAGED CARE PROVIDER TO PARTICIPATE IN THE PROGRAM. SUCH ASSESSMENT
OF CAPABILITY TO PARTICIPATE IN THE PROGRAM SHALL BE MADE BY THE COMMIS-
SIONER OF HEALTH AFTER CONSULTATION WITH THE INVOLVED SCHOOL-BASED
HEALTH CENTER, SPONSORING ORGANIZATION AND THE MANAGED CARE PROVIDER.
THE COMMISSIONER OF HEALTH SHALL TAKE INTO CONSIDERATION, ANY RELEVANT
FINDINGS OF THE FINAL AND INTERIM REPORTS.
S 59. Subdivision 3 of section 364-j of the social services law is
amended by adding a new paragraph (d-2) to read as follows:
S. 4207 32
(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 60. Subdivision (c) of section 62 of chapter 165 of the laws of
1991, amending the public health law and other laws relating to estab-
lishing payments for medical assistance, as amended by section 26 of
part D of chapter 59 of the laws of 2011, is amended to read as follows:
(c) [section 364-j of the social services law, as amended by section
eight of this act and subdivision 6 of section 367-a of the social
services law as added by section twelve of this act shall expire and be
deemed repealed on March 31, 2015 and] provided [further], that the
amendments to the provisions of section 364-j of the social services law
made by section eight of this act shall only apply to managed care
programs approved on or after the effective date of this act;
S 61. Subdivision 18-a of section 206 of the public health law, as
amended by section 11 of part A of chapter 58 of the laws of 2010, para-
graphs (b) and (d) as amended by section 16 of part A of chapter 60 of
the laws of 2014, paragraph (c) as amended by chapter 132 of the laws of
2014, is amended to read as follows:
18-a. [(a)] Health information technology demonstration program. (A)
(i) The commissioner is authorized to issue grant funding to one or more
organizations broadly representative of physicians licensed in this
state, from funds made available for the purpose of funding research and
demonstration projects under subparagraph (ii) of this paragraph
designed to promote the development of electronic health information
exchange technologies in order to facilitate the adoption of interopera-
ble health records.
(ii) Project funding shall be disbursed to projects pursuant to a
request for proposals based on criteria relating to promoting the effi-
cient and effective delivery of quality physician services. Demon-
stration projects eligible for funding under this paragraph shall
include, but not be limited to:
(A) efforts to incentivize electronic health record adoption;
(B) interconnection of physicians through regional collaborations;
(C) efforts to promote personalized health care and consumer choice;
(D) efforts to enhance health care outcomes and health status general-
ly through interoperable public health surveillance systems and stream-
lined quality monitoring.
S. 4207 33
(iii) The department shall issue a report to the governor, the tempo-
rary president of the senate and the speaker of the assembly within one
year following the issuance of the grants. Such report shall contain, at
a minimum, the following information: the demonstration projects imple-
mented pursuant to this paragraph, their date of implementation, their
costs and the appropriateness of a broader application of the health
information technology program to increase the quality and efficiency of
health care across the state.
(b) The commissioner shall:
(i) convene a workgroup to:
(A) evaluate the state's health information technology infrastructure
and systems, as well as other related plans and projects designed to
make improvements or modifications to such infrastructure and systems
including, but not limited to, the all payor database (APD), the state
planning and research cooperative system (SPARCS), regional health
information organizations (RHIOs), the statewide health information
network of New York (SHIN-NY) and medical assistance eligibility
systems; and
(B) develop recommendations for the state to move toward a comprehen-
sive health claims and clinical database aimed at improving quality of
care, efficiency, cost of care and patient satisfaction available in a
self-sustainable, non-duplicative, interactive and interoperable manner
that ensures safeguards for privacy, confidentiality and security;
(ii) submit [a] AN INTERIM report to the governor [and], the temporary
president of the senate and the speaker of the assembly, which shall
[fully consider the evaluation and recommendations of the workgroup]
DETAIL THE CONCERNS AND ISSUES ASSOCIATED WITH ESTABLISHING THE STATE'S
HEALTH INFORMATION TECHNOLOGY INFRASTRUCTURE CONSIDERED BY THE
WORKGROUP, on or before December first, two thousand fourteen[.]; AND
(III) SUBMIT A REPORT TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF THE
SENATE AND THE SPEAKER OF THE ASSEMBLY, WHICH SHALL FULLY CONSIDER THE
EVALUATION AND RECOMMENDATIONS OF THE WORKGROUP, ON OR BEFORE DECEMBER
FIRST, TWO THOUSAND FIFTEEN.
(c) The members of the workgroup shall include, at a minimum, three
members who represent RHIOs, two members employed by the department who
are involved in the development of the SHIN-NY and the APD, two members
who represent physicians, two members who represent hospitals, two
members who represent home care agencies, one member who represents
federally qualified health centers, ONE MEMBER WHO REPRESENTS COUNTY
HEALTH COMMISSIONERS, the chair of the senate health committee or his or
her designee, the chair of the assembly health committee or his or her
designee, and other individuals with expertise in matters relevant to
the charge of the workgroup.
(d) The commissioner may make such rules and regulations as may be
necessary to implement federal policies and disburse funds as required
by the American Recovery and Reinvestment Act of 2009 and to promote the
development of a self-sufficient SHIN-NY to enable widespread, non-du-
plicative interoperability among disparate health information systems,
including electronic health records, personal health records, health
care claims, payment and other administrative data, and public health
information systems, while protecting privacy and security. Such rules
and regulations shall include, but not be limited to, requirements for
organizations covered by 42 U.S.C. 17938 or any other organizations that
exchange health information through the SHIN-NY or any other statewide
health information system recommended by the workgroup. The commissioner
shall consider the FINAL REPORT AND recommendations of the workgroup. If
S. 4207 34
the commissioner acts in a manner inconsistent with the recommendations
of the workgroup, he or she shall provide the reasons therefor.
S 62. Subdivision 4 of section 365-h of the social services law, as
amended by section 20 of part B of chapter 109 of the laws of 2010, 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.
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. Notwithstanding any
inconsistent provision of sections one hundred twelve and one hundred
sixty-three of the state finance law, or section one hundred forty-two
of the economic development law, or any other law, the commissioner is
authorized to enter into a contract or contracts under this subdivision
without a competitive bid or request for proposal process, provided,
however, that:
(a) the department shall post on its website, for a period of no less
than thirty days:
(i) a description of the proposed services to be provided pursuant to
the contract or contracts;
(ii) the criteria for selection of a contractor or contractors;
(iii) the period of time during which a prospective contractor may
seek selection, which shall be no less than thirty days after such
information is first posted on the website; and
(iv) the manner by which a prospective contractor may seek such
selection, which may include submission by electronic means;
(b) all reasonable and responsive submissions that are received from
prospective contractors in timely fashion shall be reviewed by the
commissioner; and
(c) the commissioner shall select such contractor or contractors that,
in his or her discretion, are best suited to serve the purposes of this
section.
S. 4207 35
S 63. Section 2826 of the public health law, as added by section 27 of
part C of chapter 60 of the laws of 2014, is amended to read as follows:
S 2826. [Temporary] VITAL ACCESS PROVIDER; TEMPORARY adjustment to
reimbursement rates. (a) Notwithstanding any provision of law to the
contrary, within funds appropriated and subject to the availability of
federal financial participation, the commissioner may grant approval of
a temporary adjustment to the non-capital components of rates, or make
temporary lump-sum Medicaid payments, to eligible general hospitals,
skilled nursing facilities, clinics and home care providers, provided
however, that should federal financial participation not be available
for any eligible provider, then payments pursuant to this subdivision
may be made as grants and shall not be deemed to be medical assistance
payments.
(b) Eligible providers shall include:
(i) providers undergoing closure;
(ii) providers impacted by the closure of other health care providers;
(iii) providers subject to mergers, acquisitions, consolidations or
restructuring; or
(iv) providers impacted by the merger, acquisition, consolidation or
restructuring of other health care providers.
(c) Providers seeking temporary rate adjustments under this section
shall demonstrate through submission of a written proposal to the
commissioner that the additional resources provided by a temporary rate
adjustment will achieve one or more of the following:
(i) protect or enhance access to care;
(ii) protect or enhance quality of care;
(iii) improve the cost effectiveness of the delivery of health care
services; or
(iv) otherwise protect or enhance the health care delivery system[, as
determined by the commissioner].
(d) (i) Such written proposal shall be submitted to the commissioner
at least sixty days prior to the requested effective date of the tempo-
rary rate adjustment, and shall include a proposed budget to achieve the
goals of the proposal. Any Medicaid payment issued pursuant to this
section shall be in effect for a specified period of time as determined
by the commissioner, of up to three years. At the end of the specified
timeframe such payments or adjustments to the non-capital component of
rates shall cease, and the provider shall be reimbursed in accordance
with the otherwise applicable rate-setting methodology as set forth in
applicable statutes and regulations. The commissioner may establish, as
a condition of receiving such temporary rate adjustments or grants,
benchmarks and goals to be achieved in conformity with the provider's
written proposal as approved by the commissioner and may also require
that the facility submit such periodic reports concerning the achieve-
ment of such benchmarks and goals as the commissioner deems necessary.
Failure to achieve satisfactory progress, as determined by the commis-
sioner, in accomplishing such benchmarks and goals shall be a basis for
ending the facility's temporary rate adjustment or grant prior to the
end of the specified timeframe. (ii) The commissioner [may] SHALL
require that applications submitted pursuant to this section be submit-
ted in response to and in accordance with a Request For Applications or
a Request For Proposals issued by the commissioner.
(e) FOR THE PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND FIFTEEN, TO
THE EXTENT PRACTICABLE BASED ON SUBMITTED RESPONSES TO THE COMMISSION-
ER'S REQUEST FOR APPLICATIONS OR REQUEST FOR PROPOSALS, THE COMMISSIONER
SHALL MAKE TEMPORARY ADJUSTMENTS TO RATES OF ELIGIBLE PROVIDERS WITHIN
S. 4207 36
AMOUNTS MADE AVAILABLE EQUITABLY ACROSS THE STATE; PROVIDED, HOWEVER,
THAT AT LEAST FORTY PERCENT OF FUNDS MADE AVAILABLE ANNUALLY SHALL BE
AWARDED TO ELIGIBLE PROVIDERS WHO ARE LOCATED IN COUNTIES WHOSE POPU-
LATION AT THE MOST RECENT CENSUS DOES NOT EXCEED NINE HUNDRED
TWENTY-FIVE THOUSAND AND WHOSE POPULATION PER SQUARE MILE DOES NOT
EXCEED ONE THOUSAND TWO HUNDRED.
(F) Notwithstanding any law to the contrary, general hospitals defined
as critical access hospitals pursuant to title XVIII of the federal
social security act shall be allocated no less than five million dollars
annually pursuant to this section. The department [of health] shall
provide a report to the governor and legislature no later than December
first, two thousand fourteen providing recommendations on how to ensure
the financial stability of, and preserve patient access to, critical
access hospitals.
(G) FOR PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND FIFTEEN, THE
COMMISSIONER SHALL PROVIDE A REPORT ON A QUARTERLY BASIS TO THE CHAIRS
OF THE SENATE FINANCE, ASSEMBLY WAYS AND MEANS, SENATE HEALTH AND ASSEM-
BLY HEALTH COMMITTEES WITH REGARD TO THE STATUS OF THE VITAL ACCESS
PROVIDER (VAP) TEMPORARY RATE ADJUSTMENT PROGRAM. SUCH REPORTS SHALL BE
SUBMITTED NO LATER THAN SIXTY DAYS AFTER THE CLOSE OF THE QUARTER, AND
SHALL INCLUDE THE MOST CURRENT INFORMATION ON VITAL ACCESS PROVIDER
TEMPORARY RATE ADJUSTMENTS OR GRANTS. THE REPORTS SHALL INCLUDE FOR ANY
VAP TEMPORARY RATE ADJUSTMENT OR GRANT MADE:
(I) THE AMOUNT OF ANY RATE ADJUSTMENT OR GRANT FOR ALL YEARS OF THE
AWARD;
(II) A DESCRIPTION OF HOW THE TEMPORARY RATE ADJUSTMENT OR GRANT
RECIPIENT WILL ACHIEVE ANY OF THE GOALS OF THE VITAL ACCESS PROVIDER
TEMPORARY RATE ADJUSTMENT PROGRAM PURSUANT TO SUBDIVISION (C) OF THIS
SECTION AND ANY ADDITIONAL INFORMATION OR FACTORS TAKEN INTO CONSIDER-
ATION BY THE COMMISSIONER IN APPROVING A TEMPORARY RATE ADJUSTMENT OR
GRANT PURSUANT TO THIS SECTION;
(III) THE STATUS OF THE TEMPORARY RATE ADJUSTMENT OR GRANT RECIPIENT
IN MEETING THE BENCHMARK OR GOALS ESTABLISHED BY THE COMMISSIONER;
(IV) A SUMMARY OF ANY PERIODIC REPORTS REQUIRED BY THE COMMISSIONER AS
A CONDITION OF RECEIVING A TEMPORARY RATE ADJUSTMENT OR GRANT; AND
(V) INFORMATION ON PROJECT SPENDING AND BUDGET.
(H) THE COMMISSIONER SHALL PROVIDE ON AN ANNUAL BASIS TO THE CHAIRS OF
THE SENATE FINANCE, ASSEMBLY WAYS AND MEANS, SENATE HEALTH AND ASSEMBLY
HEALTH COMMITTEES A SUMMARY OF THE STATEWIDE GEOGRAPHIC DISTRIBUTION OF
FUNDS.
S 64. The opening paragraph of subdivision 2 of section 363-a of the
social services law is designated paragraph (a) and a new paragraph (b)
is added to read as follows:
(B) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTION TWO HUNDRED
ONE OF THE PUBLIC HEALTH LAW, THIS SECTION OR ANY OTHER PROVISION OF
LAW, AMENDMENTS PROMULGATED BY THE DEPARTMENT OF HEALTH THAT WOULD ADD A
NEW COVERED BENEFIT OR BENEFITS, OR EXPANSION OF BENEFIT COVERAGE, UNDER
THE STATE'S MEDICAID PROGRAM SHALL REQUIRE LEGISLATIVE APPROVAL PRIOR TO
THE EFFECTIVE DATE OF ANY CHANGE TO THE PLAN.
S 65. Paragraph 2 of subdivision (a) of section 90 of part H of chap-
ter 59 of the laws of 2011, amending the public health law and other
laws, relating to general hospital inpatient reimbursement for annual
rates, as amended by section 38 of part C of chapter 60 of the laws of
2014, is amended and two new paragraphs 3 and 4 are added to read as
follows:
S. 4207 37
(2) [Alternative] SUBJECT TO PARAGRAPH THREE OF THIS SUBDIVISION,
ALTERNATIVE methods of cost containment as authorized and implemented
pursuant to paragraph one of this subdivision shall continue to be
applied and maintained for periods on and after April 1, 2014, provided,
however, that the commissioner of health, in consultation with the
director of the budget, is authorized to terminate such alternative
methods upon a finding that they are no longer necessary to maintain
essential cost savings; PROVIDED, FURTHER, HOWEVER, THAT ON AND AFTER
APRIL FIRST, TWO THOUSAND FIFTEEN THIS PARAGRAPH SHALL NOT APPLY TO
FACILITIES OPERATING PURSUANT TO ARTICLE SIXTEEN OF THE MENTAL HYGIENE
LAW.
(3) NOTWITHSTANDING ANY PROVISION OF LAW OR REGULATION TO THE CONTRARY
AND SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, THE
COMMISSIONER SHALL INCREASE MEDICAID PAYMENTS TO NURSING HOMES AND ADULT
DAY HEALTH CARE PROGRAMS BY ONE PERCENT FOR ALL PERIODS ON AND AFTER
APRIL 1, 2015 DURING WHICH AN ALTERNATIVE METHOD OF COST CONTAINMENT IS
APPLIED AND MAINTAINED PURSUANT TO PARAGRAPH TWO OF THIS SUBDIVISION.
FOR THIS PURPOSE, RATES OF PAYMENT TO MEDICAID MANAGED CARE PLANS SHALL
BE INCREASED BY ONE PERCENT FOR SUCH SERVICES, AND SUCH PLANS SHALL
REFLECT SUCH RATE INCREASES IN THE RATES PAID TO THE PROVIDERS OF SUCH
SERVICES. IF AND UNTIL SUCH TIME AS THE COMMISSIONER OF HEALTH RECEIVES
FROM THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES FINAL
APPROVAL OF THE REVISION IN RATES OF PAYMENT AUTHORIZED BY THIS PARA-
GRAPH AND FINAL APPROVAL OF THE UNIVERSAL SETTLEMENT OF NURSING HOME
RATE APPEALS AND LAWSUITS, THE ALTERNATIVE METHOD OF COST CONTAINMENT
APPLIED AND MAINTAINED TO NURSING HOMES AND ADULT DAY HEALTH ARE
PROGRAMS PURSUANT TO PARAGRAPH TWO OF THIS SUBDIVISION SHALL BE
SUSPENDED AND BE OF NO FORCE OR EFFECT UNTIL THE EFFECTIVE DATE OF SUCH
APPROVALS.
(4) NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, THE
0.8 PERCENT NON-REIMBURSABLE ASSESSMENT ALTERNATIVE METHOD OF COST
CONTAINMENT IMPOSED UPON SKILLED NURSING FACILITIES PURSUANT TO THE
PROVISIONS OF PARAGRAPH ONE OF THIS SUBDIVISION BEGINNING FOR THE STATE
FISCAL YEAR APRIL 1, 2011 SHALL END ON MARCH 31, 2014. ASSESSMENT
PAYMENTS MADE BY SKILLED NURSING PROVIDERS FOR THE PERIOD ON AND AFTER
APRIL 1, 2014 THROUGH MARCH 31, 2015 SHALL BE REFUNDED TO SUCH PROVID-
ERS. THIS ASSESSMENT MAY BE REINSTITUTED PROSPECTIVELY IN FUTURE FISCAL
YEARS UPON THE RATIFICATION OF A LEGALLY BINDING UNIVERSAL SETTLEMENT
BETWEEN THE STATE AND ALL AFFECTED SKILLED NURSING PROVIDERS FOR CERTAIN
RATE APPEALS AND LITIGATION BROUGHT BY CURRENT OR FORMER OWNERS RELATING
TO THE STATE'S PRE-PRICING RATE METHODOLOGY.
S 66. Paragraph (d) of subdivision 2-a of section 2808 of the public
health law, as added by chapter 483 of the laws of 1978, is amended to
read as follows:
(d) For facilities granted operating certificates on or after March
tenth, nineteen hundred seventy-five, recognition of real property costs
in such regulations shall be based upon historical costs to the owner of
the facility, provided that payment for real property costs shall not be
in excess of the actual debt service, including principal and interest,
and payment with respect to owner's equity, AND FURTHER PROVIDED THAT,
EFFECTIVE APRIL FIRST, TWO THOUSAND FIFTEEN, THE COMMISSIONER MAY MODIFY
SUCH PAYMENTS FOR REAL PROPERTY COSTS FOR PURPOSES OF EFFECTUATING A
SHARED SAVINGS PROGRAM, WHEREBY FACILITIES SHARE A MINIMUM OF FIFTY
PERCENT OF SAVINGS, FOR FACILITIES THAT ELECT TO REFINANCE THEIR MORT-
GAGE LOANS. For purposes of this subdivision, owner's equity shall be
calculated without regard to any surplus created by revaluation of
S. 4207 38
assets and shall not include amounts resulting from mortgage amorti-
zation where the payment therefor has been provided by real property
cost reimbursement.
S 67. Subdivision 1 of section 206 of the public health law is amended
by adding a new paragraph (v) to read as follows:
(V) ESTABLISH AN OFFICE OF ACCOUNTABILITY WITHIN THE DEPARTMENT. THE
OFFICE OF ACCOUNTABILITY SHALL BE RESPONSIBLE FOR ENSURING ALL WORK-
GROUPS REQUIRED UNDER THIS CHAPTER ARE TIMELY CONVENED AND ALL REPORTS
REQUIRED UNDER THIS CHAPTER ARE TIMELY DISTRIBUTED. THE OFFICE SHALL
REVIEW AND REPORT TO THE LEGISLATURE BY JANUARY FIRST, TWO THOUSAND
SIXTEEN, AND ANNUALLY THEREAFTER, ON THE FOLLOWING:
(1) THE DATE EACH STATUTORILY REQUIRED REPORT WAS DISTRIBUTED, AND TO
WHOM IT WAS DISTRIBUTED;
(2) ANY REPORTS THAT WERE REQUIRED BY LAW AND NOT PROVIDED, WITH AN
EXPLANATION OF WHY SUCH REPORT WAS NOT PROVIDED;
(3) RECOMMENDATIONS FOR STREAMLINING REPORTING REQUIREMENTS WHICH MAY
INCLUDE RECOMMENDED STATUTORY AMENDMENTS TO MAKE REPORT DEADLINES AND
RECIPIENTS MORE CONSISTENT, TO PROVIDE THE REPORTS IN ELECTRONIC FORMAT,
TO CONSOLIDATE ANY RELATED REPORTING REQUIREMENTS, OR TO REPEAL REPORT-
ING REQUIREMENTS NO LONGER DEEMED NECESSARY;
(4) ALL CURRENTLY ACTIVE WORKGROUPS, AD HOC WORKGROUPS, ADVISORY
COMMITTEES OR TASKFORCES THE DEPARTMENT IS RUNNING OR ENGAGED IN EITHER
DIRECTLY OR IN COMBINATION WITH OTHER AGENCIES OR DEPARTMENTS AND THE
STATUS OF EACH SUCH GROUP; AND
(5) ANY STATUTORILY REQUIRED WORKGROUP THAT HAS NOT MET WITHIN THE
LAST YEAR, WITH AN EXPLANATION OF WHY THIS GROUP IS INACTIVE, WHICH MAY
INCLUDE A RECOMMENDATION TO REPEAL THE WORKGROUP IF THE PURPOSE OF THE
GROUP HAVE BEEN FULFILLED.
THIS REPORT MAY BE PROVIDED ELECTRONICALLY AND SHALL BE PROVIDED TO THE
TEMPORARY PRESIDENT OF THE SENATE, SPEAKER OF THE ASSEMBLY, CHAIR OF THE
SENATE STANDING COMMITTEE ON HEALTH, AND THE CHAIR OF THE ASSEMBLY
HEALTH COMMITTEE.
S 68. Paragraph (t) of subdivision 1 of section 206 of the public
health law, as added by section 112 of part E of chapter 56 of the laws
of 2013, is amended to read as follows:
(t) [The department shall submit as part of its annual report prepared
pursuant to] SUBMIT AN ANNUAL REPORT TO THE LEGISLATURE ON OR BEFORE THE
FIFTEENTH DAY OF MAY, FOR THE PRECEDING CALENDAR YEAR, AS REQUIRED BY
section one hundred sixty-four of the executive law[, which may be
submitted in electronic format,]. THE ANNUAL REPORT SHALL BE A compre-
hensive [information including, but not limited to, a detailed
description] REPORT of the department's mission, priorities and goals
for the upcoming year, achievements of the past year, ONGOING INITI-
ATIVES and any relevant data and statistics. THE ANNUAL REPORT SHALL
PROVIDE A LIST OF ALL OTHER REPORTS ISSUED BY THE DEPARTMENT WITHIN THE
PRECEDING YEAR, AND INFORMATION ON HOW SUCH REPORTS CAN BE OBTAINED.
THIS REPORT MAY BE PROVIDED ELECTRONICALLY AND SHALL BE PROVIDED TO THE
TEMPORARY PRESIDENT OF THE SENATE, SPEAKER OF THE ASSEMBLY, CHAIR OF THE
SENATE STANDING COMMITTEE ON HEALTH, AND THE CHAIR OF THE ASSEMBLY
HEALTH COMMITTEE.
S 69. The opening paragraph of subdivision 1 and subdivision 3 of
section 367-s of the social services law, as amended by section 8 of
part C of chapter 60 of the laws of 2014, are amended to read as
follows:
Notwithstanding any provision of law to the contrary, a supplemental
medical assistance payment shall be made on an annual basis to providers
S. 4207 39
of emergency medical transportation services in an aggregate amount not
to exceed four million dollars for two thousand six, six million dollars
for two thousand seven, six million dollars for two thousand eight,
[and] six million dollars for the period May first, two thousand four-
teen through March thirty-first, two thousand fifteen, AND SIX MILLION
DOLLARS ANNUALLY BEGINNING WITH THE PERIOD APRIL FIRST, TWO THOUSAND
FIFTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SIXTEEN pursuant to the
following methodology:
3. If all necessary approvals under federal law and regulation are not
obtained to receive federal financial participation in the payments
authorized by this section, payments under this section shall be made in
an aggregate amount not to exceed two million dollars for two thousand
six, three million dollars for two thousand seven, three million dollars
for two thousand eight [and], three million dollars for the period May
first, two thousand fourteen through March thirty-first, two thousand
fifteen, AND THREE MILLION DOLLARS ANNUALLY BEGINNING WITH THE PERIOD
APRIL FIRST, TWO THOUSAND FIFTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
SAND SIXTEEN. In such case, the multiplier set forth in paragraph (b) of
subdivision one of this section shall be deemed to be two million
dollars or three million dollars as applicable to the annual period.
S 70. Paragraph (e) of subdivision 8 of section 2511 of the public
health law is REPEALED.
S 71. Subparagraph (v) of paragraph (b) of subdivision 35 of section
2807-c of the public health law, as amended by section 67-a of part C of
chapter 60 of the laws of 2014, is amended to read as follows:
(v) such regulations shall incorporate quality related measures,
including, but not limited to, potentially preventable re-admissions
(PPRs) and provide for rate adjustments or payment disallowances related
to PPRs and other potentially preventable negative outcomes (PPNOs),
which shall be calculated in accordance with methodologies as determined
by the commissioner, provided, however, that such methodologies shall be
based on a comparison of the actual and risk adjusted expected number of
PPRs and other PPNOs in a given hospital and with benchmarks established
by the commissioner and provided further that such rate adjustments or
payment disallowances shall result in an aggregate reduction in Medicaid
payments of no less than thirty-five million dollars for the period July
first, two thousand ten through March thirty-first, two thousand eleven
and no less than fifty-one million dollars for annual periods beginning
April first, two thousand eleven through March thirty-first, two thou-
sand [fifteen] SIXTEEN, provided further that such aggregate reductions
shall be offset by Medicaid payment reductions occurring as a result of
decreased PPRs during the period July first, two thousand ten through
March thirty-first, two thousand eleven and the period April first, two
thousand eleven through March thirty-first, two thousand [fifteen]
SIXTEEN and as a result of decreased PPNOs during the period April
first, two thousand eleven through March thirty-first, two thousand
[fifteen] SIXTEEN; and provided further that for the period July first,
two thousand ten through March thirty-first, two thousand [fifteen]
SIXTEEN, such rate adjustments or payment disallowances shall not apply
to behavioral health PPRs; or to readmissions that occur on or after
fifteen days following an initial admission. By no later than July
first, two thousand eleven the commissioner shall enter into consulta-
tions with representatives of the health care facilities subject to this
section regarding potential prospective revisions to applicable method-
ologies and benchmarks set forth in regulations issued pursuant to this
subparagraph;
S. 4207 40
S 72. Subdivision 18 of section 364-j of the social services law is
amended by adding two new paragraphs (c) and (d) to read as follows:
(C) THE DEPARTMENT OF HEALTH SHALL REQUIRE THE INDEPENDENT ACTUARY
SELECTED PURSUANT TO PARAGRAPH (B) OF THIS SUBDIVISION TO PROVIDE A
COMPLETE ACTUARIAL MEMORANDUM, ALONG WITH ALL ACTUARIAL ASSUMPTIONS MADE
AND ALL OTHER DATA, MATERIALS AND METHODOLOGIES USED IN THE DEVELOPMENT
OF RATES, TO MANAGED CARE PROVIDERS THIRTY DAYS PRIOR TO SUBMISSION OF
SUCH RATES TO THE CENTERS OF MEDICARE AND MEDICAID SERVICES FOR
APPROVAL. MANAGED CARE PROVIDERS MAY REQUEST ADDITIONAL REVIEW OF THE
ACTUARIAL SOUNDNESS OF THE RATE SETTING PROCESS AND/OR METHODOLOGY.
(D) THE DEPARTMENT OF HEALTH SHALL ANNUALLY PROVIDE TO THE TEMPORARY
PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY THE ANNUAL MEDI-
CAID MANAGED CARE OPERATING REPORTS SUBMITTED TO THE DEPARTMENT FROM
MANAGED CARE PLANS THAT CONTRACT WITH THE STATE TO MANAGE SERVICES
PROVIDED UNDER THE MEDICAID PROGRAM.
S 73. Notwithstanding any inconsistent provision of law, rule or regu-
lation to the contrary, for purposes of implementing the provisions of
the public health law and the social services law, references to titles
XIX and XXI of the federal social security act in the public health law
and the social services law shall be deemed to include and also to mean
any successor titles thereto under the federal social security act.
S 74. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988, and
18 NYCRR 505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended and without
force or effect for purposes of implementing the provisions of this act.
S 75. Severability clause. If any clause, sentence, paragraph, subdi-
vision, section or part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment shall not affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation to the clause, sentence, paragraph, subdivision, section or
part thereof directly involved in the controversy in which such judgment
shall have been rendered. It is hereby declared to be the intent of the
legislature that this act would have been enacted even if such invalid
provisions had not been included herein.
S 76. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2015, section
eight of this act shall expire and be deemed repealed March 31, 2016:
1. section thirteen of this act shall take effect June 1, 2015;
2. any rules or regulations necessary to implement the provisions of
this act may be promulgated and any procedures, forms, or instructions
necessary for such implementation may be adopted and issued on or after
the date this act shall have become a law;
3. this act shall not be construed to alter, change, affect, impair or
defeat any rights, obligations, duties or interests accrued, incurred or
conferred prior to the effective date of this act;
4. the commissioner of health and the superintendent of financial
services and any appropriate council may take steps necessary to imple-
ment this act prior to its effective date;
5. notwithstanding any inconsistent provision of the state administra-
tive procedure act or any other provision of law, rule or regulation,
the commissioner of health and the superintendent of financial services
and any appropriate council is authorized to adopt or amend or promul-
gate on an emergency basis any regulation he or she or such council
S. 4207 41
determines necessary to implement any provision of this act on its
effective date;
6. the provisions of this act shall become effective notwithstanding
the failure of the commissioner of health or the superintendent of
financial services or any council to adopt or amend or promulgate regu-
lations implementing this act;
7. sections fifty-three and fifty-four of this act shall take effect
on the sixtieth day after it shall have become a law; provided that
effective immediately, the commissioner of health may make regulations
and take other actions necessary to implement such sections on such
effective date; provided further that the amendments to section 364-j of
the social services law made by section fifty-three of this act shall
not affect the repeal of such section and shall be deemed repealed ther-
ewith;
7-a. section fifty-six-a of this act shall apply to any coding of
payment of claims for long term care on or after January 1, 2016;
8. sections fifty-seven, fifty-eight and fifty-nine of this act shall
take effect June 30, 2015; provided, further, that the amendments to
section 364-j of the social services law made by sections fifty-seven,
fifty-eight and fifty-nine of this act shall not affect the repeal of
such section as provided in section 11 of chapter 710 of the laws of
1988, as amended, and shall be deemed repealed therewith;
9. the amendments to paragraphs (b) and (d) of subdivision 18-a of
section 206 of the public health law, made by section sixty-one of this
act, shall not affect the expiration of such paragraphs and shall expire
therewith;
10. the amendments to subdivision 4 of section 365-h of the social
services law, made by section sixty-two of this act, shall not affect
the repeal of such section and shall be deemed repealed therewith;
11. the amendments to subdivision 18 of section 364-j of the social
services law made by section seventy-two of this act shall not affect
the repeal of such section and shall be deemed to be repealed therewith;
and
12. section seventy of this act shall take effect January 1, 2016.
PART C
Section 1. Section 48-a of 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, as amended by
section 13 of part C of chapter 60 of the laws of 2014, 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
S. 4207 42
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 [the] SECTION
13 OF PART C OF chapter 60 of the laws of 2014 [which amended this
section] through December 31, [2016] 2018 for patients in the city of
New York, for all rate periods on and after the effective date of [the]
SECTION 13 OF PART C OF chapter 60 of the laws of 2014 [which amended
this section] through [June 30, 2017] DECEMBER 31, 2018 for patients
outside the city of New York, and for all rate periods on and after the
effective date of such chapter [of the laws of 2014 which amended this
section] through December 31, [2017] 2018 for all services provided to
persons under the age of twenty-one; provided, however, that managed
care organizations and providers may negotiate different rates and meth-
ods 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 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 neces-
sary 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 DECEMBER
31, 2018 FOR PATIENTS IN THE CITY OF NEW YORK, AND FOR ALL RATE PERIODS
ON AND AFTER THE EFFECTIVE DATE OF THIS CHAPTER THROUGH DECEMBER 31,
2018 FOR PATIENTS OUTSIDE THE CITY OF NEW YORK, PROVIDED, HOWEVER, THAT
MANAGED CARE ORGANIZATIONS AND PROVIDERS MAY NEGOTIATE DIFFERENT RATES
AND METHODS OF PAYMENT DURING SUCH PERIODS DESCRIBED ABOVE, SUBJECT TO
S. 4207 43
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.
S 2. 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 15 of part C of chapter 60 of
the laws of 2014, 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
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 [the]
SECTION 15 OF PART C OF chapter 60 of the laws of 2014 [which amended
this section] through December 31, [2016] 2018 for patients in the city
of New York, for all rate periods on and after the effective date of
[the] SECTION 15 OF PART C OF chapter 60 of the laws of 2014 [which
amended this section] through [June 30, 2017] DECEMBER 31, 2018 for
patients outside the city of New York, and for all rate periods on and
after the effective date of [the] SECTION 15 OF PART C OF chapter 60 of
the laws of 2014 [which amended this section] through December 31,
[2017] 2018 for all services provided to persons under the age of twen-
ty-one; provided, however, that managed care organizations and providers
may negotiate 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
S. 4207 44
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
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 DECEMBER
31, 2018 FOR PATIENTS IN THE CITY OF NEW YORK, AND FOR ALL RATE PERIODS
ON AND AFTER THE EFFECTIVE DATE OF THIS CHAPTER THROUGH DECEMBER 31,
2018 FOR PATIENTS OUTSIDE THE CITY OF NEW YORK, PROVIDED, HOWEVER, THAT
MANAGED CARE ORGANIZATIONS 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.
S 3. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal social security act in the public health law and the social
services law shall be deemed to include and also to mean any successor
titles thereto under the federal social security act.
S 4. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988, and
18 NYCRR 505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended and without
force or effect for purposes of implementing the provisions of this act.
S 5. 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 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 6. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2015. Provided,
however that:
1. any rules or regulations necessary to implement the provisions of
this act may be promulgated and any procedures, forms, or instructions
necessary for such implementation may be adopted and issued on or after
the date this act shall have become a law;
S. 4207 45
2. this act shall not be construed to alter, change, affect, impair or
defeat any rights, obligations, duties or interests accrued, incurred or
conferred prior to the effective date of this act;
3. the commissioner of health and the superintendent of the department
of financial services and any appropriate council may take any steps
necessary to implement this act prior to its effective date;
4. notwithstanding any inconsistent provision of the state administra-
tive procedure act or any other provision of law, rule or regulation,
the commissioner of health and the superintendent of the department of
financial services and any appropriate council is authorized to adopt or
amend or promulgate on an emergency basis any regulation he or she or
such council determines necessary to implement any provision of this act
on its effective date;
5. the provisions of this act shall become effective notwithstanding
the failure of the commissioner of health or the superintendent of the
department of financial services or any council to adopt or amend or
promulgate regulations implementing this act; and
6. the amendments to section 48-a of part A of chapter 56 of the laws
of 2013 made by section one of this act shall not affect the repeal of
such section and shall be deemed repealed therewith and the amendments
to section 1 of part H of chapter 111 of the laws of 2010 made by
section two of this act shall not affect the expiration of such section
and shall be deemed to expire therewith.
PART D
Section 1. Section 11 of chapter 884 of the laws of 1990, amending the
public health law relating to authorizing bad debt and charity care
allowances for certified home health agencies, as amended by section 3
of part B of chapter 56 of the laws of 2013, is amended to read as
follows:
S 11. This act shall take effect immediately and:
(a) sections one and three shall expire on December 31, 1996,
(b) sections four through ten shall expire on June 30, [2015] 2017,
and
(c) provided that the amendment to section 2807-b of the public health
law by section two of this act shall not affect the expiration of such
section 2807-b as otherwise provided by law and shall be deemed to
expire therewith.
S 2. Subdivision 2 of section 246 of chapter 81 of the laws of 1995,
amending the public health law and other laws relating to medical
reimbursement and welfare reform, as amended by section 4 of part B of
chapter 56 of the laws of 2013, is amended to read as follows:
2. Sections five, seven through nine, twelve through fourteen, and
eighteen of this act shall be deemed to have been in full force and
effect on and after April 1, 1995 through March 31, 1999 and on and
after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
through March 31, 2003 and on and after April 1, 2003 through March 31,
2006 and on and after April 1, 2006 through March 31, 2007 and on and
after April 1, 2007 through March 31, 2009 and on and after April 1,
2009 through March 31, 2011 and sections twelve, thirteen and fourteen
of this act shall be deemed to be in full force and effect on and after
April 1, 2011 through March 31, 2015 AND ON AND AFTER APRIL 1, 2015
THROUGH MARCH 31, 2017;
S. 4207 46
S 3. Subparagraph (vi) of paragraph (b) of subdivision 2 of section
2807-d of the public health law, as amended by section 5 of part B of
chapter 56 of the laws of 2013, is amended to read as follows:
(vi) Notwithstanding any contrary provision of this paragraph or any
other provision of law or regulation to the contrary, for residential
health care facilities the assessment shall be six percent of each resi-
dential health care facility's gross receipts received from all patient
care services and other operating income on a cash basis for the period
April first, two thousand two through March thirty-first, two thousand
three for hospital or health-related services, including adult day
services; provided, however, that residential health care facilities'
gross receipts attributable to payments received pursuant to title XVIII
of the federal social security act (medicare) shall be excluded from the
assessment; provided, however, that for all such gross receipts received
on or after April first, two thousand three through March thirty-first,
two thousand five, such assessment shall be five percent, and further
provided that for all such gross receipts received on or after April
first, two thousand five through March thirty-first, two thousand nine,
and on or after April first, two thousand nine through March thirty-
first, two thousand eleven such assessment shall be six percent, and
further provided that for all such gross receipts received on or after
April first, two thousand eleven through March thirty-first, two thou-
sand thirteen such assessment shall be six percent, and further provided
that for all such gross receipts received on or after April first, two
thousand thirteen through March thirty-first, two thousand fifteen such
assessment shall be six percent, AND FURTHER PROVIDED THAT FOR ALL SUCH
GROSS RECEIPTS RECEIVED ON OR AFTER APRIL FIRST, TWO THOUSAND FIFTEEN
THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SEVENTEEN SUCH ASSESSMENT SHALL
BE SIX PERCENT.
S 4. Section 88 of chapter 659 of the laws of 1997, constituting the
long term care integration and finance act of 1997, as amended by
section 6 of part B of chapter 56 of the laws of 2013, is amended to
read as follows:
S 88. Notwithstanding any provision of law to the contrary, all oper-
ating demonstrations, as such term is defined in paragraph (c) of subdi-
vision 1 of section 4403-f of the public health law as added by section
eighty-two of this act, due to expire prior to January 1, 2001 shall be
deemed to [expire on December 31, 2015] REMAIN IN FULL FORCE AND EFFECT
SUBSEQUENT TO SUCH DATE.
S 5. Subdivision 1 of section 194 of chapter 474 of the laws of 1996,
amending the education law and other laws relating to rates for residen-
tial health care facilities, as amended by section 9 of part B of chap-
ter 56 of the laws of 2013, is amended to read as follows:
1. Notwithstanding any inconsistent provision of law or regulation,
the trend factors used to project reimbursable operating costs to the
rate period for purposes of determining rates of payment pursuant to
article 28 of the public health law for residential health care facili-
ties for reimbursement of inpatient services provided to patients eligi-
ble for payments made by state governmental agencies on and after April
1, 1996 through March 31, 1999 and for payments made on and after July
1, 1999 through March 31, 2000 and on and after April 1, 2000 through
March 31, 2003 and on and after April 1, 2003 through March 31, 2007 and
on and after April 1, 2007 through March 31, 2009 and on and after April
1, 2009 through March 31, 2011 and on and after April 1, 2011 through
March 31, 2013 and on and after April 1, 2013 through March 31, 2015,
AND ON AND AFTER APRIL 1, 2015 THROUGH MARCH 31, 2017 shall reflect no
S. 4207 47
trend factor projections or adjustments for the period April 1, 1996,
through March 31, 1997.
S 6. Subdivision 1 of section 89-a of part C of chapter 58 of the laws
of 2007, amending the social services law and other laws relating to
enacting the major components of legislation necessary to implement the
health and mental hygiene budget for the 2007-2008 state fiscal year, as
amended by section 10 of part B of chapter 56 of the laws of 2013, is
amended to read as follows:
1. Notwithstanding paragraph (c) of subdivision 10 of section 2807-c
of the public health law and section 21 of chapter 1 of the laws of
1999, as amended, and any other inconsistent provision of law or regu-
lation to the contrary, in determining rates of payments by state
governmental agencies effective for services provided beginning April 1,
2006, through March 31, 2009, and on and after April 1, 2009 through
March 31, 2011, and on and after April 1, 2011 through March 31, 2013,
and on and after April 1, 2013 through March 31, 2015, AND ON AND AFTER
APRIL 1, 2015 THROUGH MARCH 31, 2017 for inpatient and outpatient
services provided by general hospitals and for inpatient services and
outpatient adult day health care services provided by residential health
care facilities pursuant to article 28 of the public health law, the
commissioner of health shall apply a trend factor projection of two and
twenty-five hundredths percent attributable to the period January 1,
2006 through December 31, 2006, and on and after January 1, 2007,
provided, however, that on reconciliation of such trend factor for the
period January 1, 2006 through December 31, 2006 pursuant to paragraph
(c) of subdivision 10 of section 2807-c of the public health law, such
trend factor shall be the final US Consumer Price Index (CPI) for all
urban consumers, as published by the US Department of Labor, Bureau of
Labor Statistics less twenty-five hundredths of a percentage point.
S 7. Paragraph (f) of subdivision 1 of section 64 of chapter 81 of the
laws of 1995, amending the public health law and other laws relating to
medical reimbursement and welfare reform, as amended by section 11 of
part B of chapter 56 of the laws of 2013, is amended to read as follows:
(f) Prior to February 1, 2001, February 1, 2002, February 1, 2003,
February 1, 2004, February 1, 2005, February 1, 2006, February 1, 2007,
February 1, 2008, February 1, 2009, February 1, 2010, February 1, 2011,
February 1, 2012, February 1, 2013 [and], February 1, 2014 [and], Febru-
ary 1, 2015, FEBRUARY 1, 2016 AND FEBRUARY 1, 2017 the commissioner of
health shall calculate the result of the statewide total of residential
health care facility days of care provided to beneficiaries of title
XVIII of the federal social security act (medicare), divided by the sum
of such days of care plus days of care provided to residents eligible
for payments pursuant to title 11 of article 5 of the social services
law minus the number of days provided to residents receiving hospice
care, expressed as a percentage, for the period commencing January 1,
through November 30, of the prior year respectively, based on such data
for such period. This value shall be called the 2000, 2001, 2002, 2003,
2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and],
2015, 2016 AND 2017 statewide target percentage respectively.
S 8. Subparagraph (ii) of paragraph (b) of subdivision 3 of section 64
of chapter 81 of the laws of 1995, amending the public health law and
other laws relating to medical reimbursement and welfare reform, as
amended by section 12 of part B of chapter 56 of the laws of 2013, is
amended to read as follows:
(ii) If the 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND
S. 4207 48
2017 statewide target percentages are not for each year at least three
percentage points higher than the statewide base percentage, the commis-
sioner of health shall determine the percentage by which the statewide
target percentage for each year is not at least three percentage points
higher than the statewide base percentage. The percentage calculated
pursuant to this paragraph shall be called the 1997, 1998, 2000, 2001,
2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013,
2014 [and], 2015, 2016 AND 2017 statewide reduction percentage respec-
tively. If the 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
2007, 2008, 2009, 2010, 2011, 2012, 2013[;], 2014 [and], 2015, 2016 AND
2017 statewide target percentage for the respective year is at least
three percentage points higher than the statewide base percentage, the
statewide reduction percentage for the respective year shall be zero.
S 9. Subparagraph (iii) of paragraph (b) of subdivision 4 of section
64 of chapter 81 of the laws of 1995, amending the public health law and
other laws relating to medical reimbursement and welfare reform, as
amended by section 13 of part B of chapter 56 of the laws of 2013, is
amended to read as follows:
(iii) The 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008,
2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 statewide
reduction percentage shall be multiplied by one hundred two million
dollars respectively to determine the 1998, 2000, 2001, 2002, 2003,
2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and],
2015, 2016 AND 2017 statewide aggregate reduction amount. If the 1998
and the 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009,
2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 statewide
reduction percentage shall be zero respectively, there shall be no 1998,
2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011,
2012, 2013, 2014 [and], 2015, 2016 AND 2017 reduction amount.
S 10. Section 228 of chapter 474 of the laws of 1996, amending the
education law and other laws relating to rates for residential health
care facilities, as amended by section 14-a of part B of chapter 56 of
the laws of 2013, is amended to read as follows:
S 228. 1. Definitions. (a) Regions, for purposes of this section,
shall mean a downstate region to consist of Kings, New York, Richmond,
Queens, Bronx, Nassau and Suffolk counties and an upstate region to
consist of all other New York state counties. A certified home health
agency or long term home health care program shall be located in the
same county utilized by the commissioner of health for the establishment
of rates pursuant to article 36 of the public health law.
(b) Certified home health agency (CHHA) shall mean such term as
defined in section 3602 of the public health law.
(c) Long term home health care program (LTHHCP) shall mean such term
as defined in subdivision 8 of section 3602 of the public health law.
(d) Regional group shall mean all those CHHAs and LTHHCPs, respective-
ly, located within a region.
(e) Medicaid revenue percentage, for purposes of this section, shall
mean CHHA and LTHHCP revenues attributable to services provided to
persons eligible for payments pursuant to title 11 of article 5 of the
social services law divided by such revenues plus CHHA and LTHHCP reven-
ues attributable to services provided to beneficiaries of Title XVIII of
the federal social security act (medicare).
(f) Base period, for purposes of this section, shall mean calendar
year 1995.
(g) Target period. For purposes of this section, the 1996 target peri-
od shall mean August 1, 1996 through March 31, 1997, the 1997 target
S. 4207 49
period shall mean January 1, 1997 through November 30, 1997, the 1998
target period shall mean January 1, 1998 through November 30, 1998, the
1999 target period shall mean January 1, 1999 through November 30, 1999,
the 2000 target period shall mean January 1, 2000 through November 30,
2000, the 2001 target period shall mean January 1, 2001 through November
30, 2001, the 2002 target period shall mean January 1, 2002 through
November 30, 2002, the 2003 target period shall mean January 1, 2003
through November 30, 2003, the 2004 target period shall mean January 1,
2004 through November 30, 2004, and the 2005 target period shall mean
January 1, 2005 through November 30, 2005, the 2006 target period shall
mean January 1, 2006 through November 30, 2006, and the 2007 target
period shall mean January 1, 2007 through November 30, 2007 and the 2008
target period shall mean January 1, 2008 through November 30, 2008, and
the 2009 target period shall mean January 1, 2009 through November 30,
2009 and the 2010 target period shall mean January 1, 2010 through
November 30, 2010 and the 2011 target period shall mean January 1, 2011
through November 30, 2011 and the 2012 target period shall mean January
1, 2012 through November 30, 2012 and the 2013 target period shall mean
January 1, 2013 through November 30, 2013, and the 2014 target period
shall mean January 1, 2014 through November 30, 2014 and the 2015 target
period shall mean January 1, 2015 through November 30, 2015 AND THE 2016
TARGET PERIOD SHALL MEAN JANUARY 1, 2016 THROUGH NOVEMBER 30, 2016 AND
THE 2017 TARGET PERIOD SHALL MEAN JANUARY 1, 2017 THROUGH NOVEMBER 30,
2017.
2. (a) Prior to February 1, 1997, for each regional group the commis-
sioner of health shall calculate the 1996 medicaid revenue percentages
for the period commencing August 1, 1996 to the last date for which such
data is available and reasonably accurate.
(b) Prior to February 1, 1998, prior to February 1, 1999, prior to
February 1, 2000, prior to February 1, 2001, prior to February 1, 2002,
prior to February 1, 2003, prior to February 1, 2004, prior to February
1, 2005, prior to February 1, 2006, prior to February 1, 2007, prior to
February 1, 2008, prior to February 1, 2009, prior to February 1, 2010,
prior to February 1, 2011, prior to February 1, 2012, prior to February
1, 2013, prior to February 1, 2014 [and], prior to February 1, 2015, AND
PRIOR TO FEBRUARY 1, 2016 AND PRIOR TO FEBRUARY 1, 2017 for each
regional group the commissioner of health shall calculate the prior
year's medicaid revenue percentages for the period commencing January 1
through November 30 of such prior year.
3. By September 15, 1996, for each regional group the commissioner of
health shall calculate the base period medicaid revenue percentage.
4. (a) For each regional group, the 1996 target medicaid revenue
percentage shall be calculated by subtracting the 1996 medicaid revenue
reduction percentages from the base period medicaid revenue percentages.
The 1996 medicaid revenue reduction percentage, taking into account
regional and program differences in utilization of medicaid and medicare
services, for the following regional groups shall be equal to:
(i) one and one-tenth percentage points for CHHAs located within the
downstate region;
(ii) six-tenths of one percentage point for CHHAs located within the
upstate region;
(iii) one and eight-tenths percentage points for LTHHCPs located with-
in the downstate region; and
(iv) one and seven-tenths percentage points for LTHHCPs located within
the upstate region.
S. 4207 50
(b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,
2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 for
each regional group, the target medicaid revenue percentage for the
respective year shall be calculated by subtracting the respective year's
medicaid revenue reduction percentage from the base period medicaid
revenue percentage. The medicaid revenue reduction percentages for 1997,
1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010,
2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017, taking into account
regional and program differences in utilization of medicaid and medicare
services, for the following regional groups shall be equal to for each
such year:
(i) one and one-tenth percentage points for CHHAs located within the
downstate region;
(ii) six-tenths of one percentage point for CHHAs located within the
upstate region;
(iii) one and eight-tenths percentage points for LTHHCPs located with-
in the downstate region; and
(iv) one and seven-tenths percentage points for LTHHCPs located within
the upstate region.
(c) For each regional group, the 1999 target medicaid revenue percent-
age shall be calculated by subtracting the 1999 medicaid revenue
reduction percentage from the base period medicaid revenue percentage.
The 1999 medicaid revenue reduction percentages, taking into account
regional and program differences in utilization of medicaid and medicare
services, for the following regional groups shall be equal to:
(i) eight hundred twenty-five thousandths (.825) of one percentage
point for CHHAs located within the downstate region;
(ii) forty-five hundredths (.45) of one percentage point for CHHAs
located within the upstate region;
(iii) one and thirty-five hundredths percentage points (1.35) for
LTHHCPs located within the downstate region; and
(iv) one and two hundred seventy-five thousandths percentage points
(1.275) for LTHHCPs located within the upstate region.
5. (a) For each regional group, if the 1996 medicaid revenue percent-
age is not equal to or less than the 1996 target medicaid revenue
percentage, the commissioner of health shall compare the 1996 medicaid
revenue percentage to the 1996 target medicaid revenue percentage to
determine the amount of the shortfall which, when divided by the 1996
medicaid revenue reduction percentage, shall be called the 1996
reduction factor. These amounts, expressed as a percentage, shall not
exceed one hundred percent. If the 1996 medicaid revenue percentage is
equal to or less than the 1996 target medicaid revenue percentage, the
1996 reduction factor shall be zero.
(b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016, AND
2017, for each regional group, if the medicaid revenue percentage for
the respective year is not equal to or less than the target medicaid
revenue percentage for such respective year, the commissioner of health
shall compare such respective year's medicaid revenue percentage to such
respective year's target medicaid revenue percentage to determine the
amount of the shortfall which, when divided by the respective year's
medicaid revenue reduction percentage, shall be called the reduction
factor for such respective year. These amounts, expressed as a percent-
age, shall not exceed one hundred percent. If the medicaid revenue
percentage for a particular year is equal to or less than the target
S. 4207 51
medicaid revenue percentage for that year, the reduction factor for that
year shall be zero.
6. (a) For each regional group, the 1996 reduction factor shall be
multiplied by the following amounts to determine each regional group's
applicable 1996 state share reduction amount:
(i) two million three hundred ninety thousand dollars ($2,390,000) for
CHHAs located within the downstate region;
(ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
within the upstate region;
(iii) one million two hundred seventy thousand dollars ($1,270,000)
for LTHHCPs located within the downstate region; and
(iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
located within the upstate region.
For each regional group reduction, if the 1996 reduction factor shall
be zero, there shall be no 1996 state share reduction amount.
(b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,
2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017, for
each regional group, the reduction factor for the respective year shall
be multiplied by the following amounts to determine each regional
group's applicable state share reduction amount for such respective
year:
(i) two million three hundred ninety thousand dollars ($2,390,000) for
CHHAs located within the downstate region;
(ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
within the upstate region;
(iii) one million two hundred seventy thousand dollars ($1,270,000)
for LTHHCPs located within the downstate region; and
(iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
located within the upstate region.
For each regional group reduction, if the reduction factor for a
particular year shall be zero, there shall be no state share reduction
amount for such year.
(c) For each regional group, the 1999 reduction factor shall be multi-
plied by the following amounts to determine each regional group's appli-
cable 1999 state share reduction amount:
(i) one million seven hundred ninety-two thousand five hundred dollars
($1,792,500) for CHHAs located within the downstate region;
(ii) five hundred sixty-two thousand five hundred dollars ($562,500)
for CHHAs located within the upstate region;
(iii) nine hundred fifty-two thousand five hundred dollars ($952,500)
for LTHHCPs located within the downstate region; and
(iv) four hundred forty-two thousand five hundred dollars ($442,500)
for LTHHCPs located within the upstate region.
For each regional group reduction, if the 1999 reduction factor shall
be zero, there shall be no 1999 state share reduction amount.
7. (a) For each regional group, the 1996 state share reduction amount
shall be allocated by the commissioner of health among CHHAs and LTHHCPs
on the basis of the extent of each CHHA's and LTHHCP's failure to
achieve the 1996 target medicaid revenue percentage, calculated on a
provider specific basis utilizing revenues for this purpose, expressed
as a proportion of the total of each CHHA's and LTHHCP's failure to
achieve the 1996 target medicaid revenue percentage within the applica-
ble regional group. This proportion shall be multiplied by the applica-
ble 1996 state share reduction amount calculation pursuant to paragraph
(a) of subdivision 6 of this section. This amount shall be called the
1996 provider specific state share reduction amount.
S. 4207 52
(b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND
2017 for each regional group, the state share reduction amount for the
respective year shall be allocated by the commissioner of health among
CHHAs and LTHHCPs on the basis of the extent of each CHHA's and LTHHCP's
failure to achieve the target medicaid revenue percentage for the appli-
cable year, calculated on a provider specific basis utilizing revenues
for this purpose, expressed as a proportion of the total of each CHHA's
and LTHHCP's failure to achieve the target medicaid revenue percentage
for the applicable year within the applicable regional group. This
proportion shall be multiplied by the applicable year's state share
reduction amount calculation pursuant to paragraph (b) or (c) of subdi-
vision 6 of this section. This amount shall be called the provider
specific state share reduction amount for the applicable year.
8. (a) The 1996 provider specific state share reduction amount shall
be due to the state from each CHHA and LTHHCP and may be recouped by the
state by March 31, 1997 in a lump sum amount or amounts from payments
due to the CHHA and LTHHCP pursuant to title 11 of article 5 of the
social services law.
(b) The provider specific state share reduction amount for 1997, 1998,
1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010,
2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 respectively, shall be
due to the state from each CHHA and LTHHCP and each year the amount due
for such year may be recouped by the state by March 31 of the following
year in a lump sum amount or amounts from payments due to the CHHA and
LTHHCP pursuant to title 11 of article 5 of the social services law.
9. CHHAs and LTHHCPs shall submit such data and information at such
times as the commissioner of health may require for purposes of this
section. The commissioner of health may use data available from third-
party payors.
10. On or about June 1, 1997, for each regional group the commissioner
of health shall calculate for the period August 1, 1996 through March
31, 1997 a medicaid revenue percentage, a reduction factor, a state
share reduction amount, and a provider specific state share reduction
amount in accordance with the methodology provided in paragraph (a) of
subdivision 2, paragraph (a) of subdivision 5, paragraph (a) of subdivi-
sion 6 and paragraph (a) of subdivision 7 of this section. The provider
specific state share reduction amount calculated in accordance with this
subdivision shall be compared to the 1996 provider specific state share
reduction amount calculated in accordance with paragraph (a) of subdivi-
sion 7 of this section. Any amount in excess of the amount determined in
accordance with paragraph (a) of subdivision 7 of this section shall be
due to the state from each CHHA and LTHHCP and may be recouped in
accordance with paragraph (a) of subdivision 8 of this section. If the
amount is less than the amount determined in accordance with paragraph
(a) of subdivision 7 of this section, the difference shall be refunded
to the CHHA and LTHHCP by the state no later than July 15, 1997. CHHAs
and LTHHCPs shall submit data for the period August 1, 1996 through
March 31, 1997 to the commissioner of health by April 15, 1997.
11. If a CHHA or LTHHCP fails to submit data and information as
required for purposes of this section:
(a) such CHHA or LTHHCP shall be presumed to have no decrease in medi-
caid revenue percentage between the applicable base period and the
applicable target period for purposes of the calculations pursuant to
this section; and
S. 4207 53
(b) the commissioner of health shall reduce the current rate paid to
such CHHA and such LTHHCP by state governmental agencies pursuant to
article 36 of the public health law by one percent for a period begin-
ning on the first day of the calendar month following the applicable due
date as established by the commissioner of health and continuing until
the last day of the calendar month in which the required data and infor-
mation are submitted.
12. The commissioner of health shall inform in writing the director of
the budget and the chair of the senate finance committee and the chair
of the assembly ways and means committee of the results of the calcu-
lations pursuant to this section.
S 11. Subdivision 5-a of section 246 of chapter 81 of the laws of
1995, amending the public health law and other laws relating to medical
reimbursement and welfare reform, as amended by section 15 of part B of
chapter 56 of the laws of 2013, is amended to read as follows:
5-a. Section sixty-four-a of this act shall be deemed to have been in
full force and effect on and after April 1, 1995 through March 31, 1999
and on and after July 1, 1999 through March 31, 2000 and on and after
April 1, 2000 through March 31, 2003 and on and after April 1, 2003
through March 31, 2007, and on and after April 1, 2007 through March 31,
2009, and on and after April 1, 2009 through March 31, 2011, and on and
after April 1, 2011 through March 31, 2013, and on and after April 1,
2013 through March 31, 2015, AND ON AND AFTER APRIL 1, 2015 THROUGH
MARCH 31, 2017;
S 12. Section 64-b of chapter 81 of the laws of 1995, amending the
public health law and other laws relating to medical reimbursement and
welfare reform, as amended by section 16 of part B of chapter 56 of the
laws of 2013, is amended to read as follows:
S 64-b. Notwithstanding any inconsistent provision of law, the
provisions of subdivision 7 of section 3614 of the public health law, as
amended, shall remain and be in full force and effect on April 1, 1995
through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
and after April 1, 2000 through March 31, 2003 and on and after April 1,
2003 through March 31, 2007, and on and after April 1, 2007 through
March 31, 2009, and on and after April 1, 2009 through March 31, 2011,
and on and after April 1, 2011 through March 31, 2013, and on and after
April 1, 2013 through March 31, 2015, AND ON AND AFTER APRIL 1, 2015
THROUGH MARCH 31, 2017.
S 13. Subdivision 1 of section 20 of chapter 451 of the laws of 2007,
amending the public health law, the social services law and the insur-
ance law, relating to providing enhanced consumer and provider
protections, as amended by section 17 of part B of chapter 56 of the
laws of 2013, is amended to read as follows:
1. sections four, eleven and thirteen of this act shall take effect
immediately and shall expire and be deemed repealed June 30, [2015]
2017;
S 14. The opening paragraph of subdivision 7-a of section 3614 of the
public health law, as amended by section 18 of part B of chapter 56 of
the laws of 2013, is amended to read as follows:
Notwithstanding any inconsistent provision of law or regulation, for
the purposes of establishing rates of payment by governmental agencies
for long term home health care programs for the period April first, two
thousand five, through December thirty-first, two thousand five, and for
the period January first, two thousand six through March thirty-first,
two thousand seven, and on and after April first, two thousand seven
through March thirty-first, two thousand nine, and on and after April
S. 4207 54
first, two thousand nine through March thirty-first, two thousand elev-
en, and on and after April first, two thousand eleven through March
thirty-first, two thousand thirteen and on and after April first, two
thousand thirteen through March thirty-first, two thousand fifteen, AND
ON AND AFTER APRIL 1ST, TWO THOUSAND FIFTEEN THROUGH MARCH THIRTY-FIRST,
TWO THOUSAND SEVENTEEN the reimbursable base year administrative and
general costs of a provider of services shall not exceed the statewide
average of total reimbursable base year administrative and general costs
of such providers of services.
S 15. Subdivision 12 of section 246 of chapter 81 of the laws of 1995,
amending the public health law and other laws relating to medical
reimbursement and welfare reform, as amended by section 21 of part B of
chapter 56 of the laws of 2013, is amended to read as follows:
12. Sections one hundred five-b through one hundred five-f of this act
shall expire March 31, [2015] 2017.
S 16. Section 3 of chapter 303 of the laws of 1999, amending the New
York state medical care facilities finance agency act relating to
financing health facilities, as amended by section 30 of part A of chap-
ter 59 of the laws of 2011, is amended to read as follows:
S 3. This act shall take effect immediately, provided, however, that
subdivision 15-a of section 5 of section 1 of chapter 392 of the laws of
1973, as added by section one of this act, shall expire and be deemed
repealed June 30, [2015] 2019; and provided further, however, that the
expiration and repeal of such subdivision 15-a shall not affect or
impair in any manner any health facilities bonds issued, or any lease or
purchase of a health facility executed, pursuant to such subdivision
15-a prior to its expiration and repeal and that, with respect to any
such bonds issued and outstanding as of June 30, [2015] 2019, the
provisions of such subdivision 15-a as they existed immediately prior to
such expiration and repeal shall continue to apply through the latest
maturity date of any such bonds, or their earlier retirement or redemp-
tion, for the sole purpose of authorizing the issuance of refunding
bonds to refund bonds previously issued pursuant thereto.
S 17. Subdivision (c) of section 62 of chapter 165 of the laws of
1991, amending the public health law and other laws relating to estab-
lishing payments for medical assistance, as amended by section 26 of
part D of chapter 59 of the laws of 2011, is amended to read as follows:
(c) section 364-j of the social services law, as amended by section
eight of this act and subdivision 6 of section 367-a of the social
services law as added by section twelve of this act shall expire and be
deemed repealed on March 31, [2015] 2019 and provided further, that the
amendments to the provisions of section 364-j of the social services law
made by section eight of this act shall only apply to managed care
programs approved on or after the effective date of this act;
S 18. Subdivision 3 of section 1680-j of the public authorities law,
as amended by section 9 of part C of chapter 59 of the laws of 2011, is
amended to read as follows:
3. Notwithstanding any law to the contrary, and in accordance with
section four of the state finance law, the comptroller is hereby author-
ized and directed to transfer from the health care reform act (HCRA)
resources fund (061) to the general fund, upon the request of the direc-
tor of the budget, up to $6,500,000 on or before March 31, 2006, and the
comptroller is further hereby authorized and directed to transfer from
the healthcare reform act (HCRA); Resources fund (061) to the Capital
Projects Fund, upon the request of the director of budget, up to
$139,000,000 for the period April 1, 2006 through March 31, 2007, up to
S. 4207 55
$171,100,000 for the period April 1, 2007 through March 31, 2008, up to
$208,100,000 for the period April 1, 2008 through March 31, 2009, up to
$151,600,000 for the period April 1, 2009 through March 31, 2010, up to
$215,743,000 for the period April 1, 2010 through March 31, 2011, up to
$433,366,000 for the period April 1, 2011 through March 31, 2012, up to
$150,806,000 for the period April 1, 2012 through March 31, 2013, up to
$78,071,000 for the period April 1, 2013 through March 31, 2014, and up
to $86,005,000 for the period April 1, 2014 through March 31, 2015, AND
UP TO $86,005,000 FOR THE PERIOD APRIL 1, 2015 THROUGH DECEMBER 31,
2017.
S 19. Subdivision (i) of section 111 of part H of chapter 59 of the
laws of 2011, relating to enacting into law major components of legis-
lation necessary to implement the health and mental hygiene budget for
the 2011-2012 state fiscal plan, is amended to read as follows:
(i) the amendments to paragraph (b) and subparagraph (i) of paragraph
(g) of subdivision 7 of section 4403-f of the public health law made by
section forty-one-b of this act shall expire and be repealed April 1,
[2015] 2019;
S 20. Section 97 of chapter 659 of the laws of 1997, amending the
public health law and other laws relating to creation of continuing care
retirement communities, as amended by section 65-b of part A of chapter
57 of the laws of 2006, is amended to read as follows:
S 97. This act shall take effect immediately, provided, however, that
the amendments to subdivision 4 of section 854 of the general municipal
law made by section seventy of this act shall not affect the expiration
of such subdivision and shall be deemed to expire therewith and provided
further that sections sixty-seven and sixty-eight of this act shall
apply to taxable years beginning on or after January 1, 1998 and
provided further that sections eighty-one through eighty-seven of this
act shall expire and be deemed repealed on December 31, [2015] 2019 and
provided further, however, that the amendments to section ninety of this
act shall take effect January 1, 1998 and shall apply to all policies,
contracts, certificates, riders or other evidences of coverage of long
term care insurance issued, renewed, altered or modified pursuant to
section 3229 of the insurance law on or after such date.
S 21. Paragraph (b) of subdivision 17 of section 2808 of the public
health law, as amended by section 98 of part H of chapter 59 of the laws
of 2011, is amended to read as follows:
(b) Notwithstanding any inconsistent provision of law or regulation to
the contrary, for the state fiscal [year] YEARS beginning April first,
two thousand ten and ending March thirty-first, two thousand [fifteen]
NINETEEN, the commissioner shall not be required to revise certified
rates of payment established pursuant to this article for rate periods
prior to April first, two thousand [fifteen] NINETEEN, based on consid-
eration of rate appeals filed by residential health care facilities or
based upon adjustments to capital cost reimbursement as a result of
approval by the commissioner of an application for construction under
section twenty-eight hundred two of this article, in excess of an aggre-
gate annual amount of eighty million dollars for each such state fiscal
year provided, however, that for the period April first, two thousand
eleven through March thirty-first, two thousand twelve such aggregate
annual amount shall be fifty million dollars. In revising such rates
within such fiscal limit, the commissioner shall, in prioritizing such
rate appeals, include consideration of which facilities the commissioner
determines are facing significant financial hardship as well as such
other considerations as the commissioner deems appropriate and, further,
S. 4207 56
the commissioner is authorized to enter into agreements with such facil-
ities or any other facility to resolve multiple pending rate appeals
based upon a negotiated aggregate amount and may offset such negotiated
aggregate amounts against any amounts owed by the facility to the
department, including, but not limited to, amounts owed pursuant to
section twenty-eight hundred seven-d of this article; provided, however,
that the commissioner's authority to negotiate such agreements resolving
multiple pending rate appeals as hereinbefore described shall continue
on and after April first, two thousand [fifteen] NINETEEN. Rate adjust-
ments made pursuant to this paragraph remain fully subject to approval
by the director of the budget in accordance with the provisions of
subdivision two of section twenty-eight hundred seven of this article.
S 22. Paragraph (a) of 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, is amended to read as follows:
(a) Notwithstanding any inconsistent provision of law or regulation
and subject to the availability of federal financial participation,
effective April first, two thousand twelve through March thirty-first,
two thousand [fifteen] 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 for low utilization cases and to reflect a percentage limita-
tion of the cost for high-utilization cases that exceed outlier thresh-
olds of such payments.
S 23. Subdivision (a) of section 40 of part B of chapter 109 of the
laws of 2010, amending the social services law relating to transporta-
tion costs, is amended to read as follows:
(a) sections two, three, three-a, three-b, three-c, three-d, three-e
and twenty-one of this act shall take effect July 1, 2010; sections
fifteen, sixteen, seventeen, eighteen and nineteen of this act shall
take effect January 1, 2011; and provided further that section twenty of
this act shall be deemed repealed [four] SIX years after the date the
contract entered into pursuant to section 365-h of the social services
law, as amended by section twenty of this act, is executed; provided
that the commissioner of health shall notify the legislative bill draft-
ing commission upon the execution of the contract entered into pursuant
to section 367-h of the social services law in order that the commission
may maintain an accurate and timely effective data base of the official
text of the laws of the state of New York in furtherance of effectuating
the provisions of section 44 of the legislative law and section 70-b of
the public officers law;
S 24. Subdivision 4 of section 365-h of the social services law, as
added by section 20 of part B of chapter 109 of the laws of 2010, 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. 4207 57
commissioner is authorized to contract with a transportation manager or
managers to manage transportation services in any local social services
district. 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. [Notwith-
standing any inconsistent provision of sections one hundred twelve and
one hundred sixty-three of the state finance law, or section one hundred
forty-two of the economic development law, or any other law, the commis-
sioner is authorized to enter into a contract or contracts under this
subdivision without a competitive bid or request for proposal process,
provided, however, that:
(a) the department shall post on its website, for a period of no less
than thirty days:
(i) a description of the proposed services to be provided pursuant to
the contract or contracts;
(ii) the criteria for selection of a contractor or contractors;
(iii) the period of time during which a prospective contractor may
seek selection, which shall be no less than thirty days after such
information is first posted on the website; and
(iv) the manner by which a prospective contractor may seek such
selection, which may include submission by electronic means;
(b) all reasonable and responsive submissions that are received from
prospective contractors in timely fashion shall be reviewed by the
commissioner; and
(c) the commissioner shall select such contractor or contractors that,
in his or her discretion, are best suited to serve the purposes of this
section.]
S 25. Intentionally omitted.
S 26. Section 2 of chapter 459 of the laws of 1996, amending the
public health law relating to recertification of persons providing emer-
gency medical care, as amended by chapter 106 of the laws of 2011, is
amended to read as follows:
S 2. This act shall take effect immediately and shall expire and be
deemed repealed July 1, [2015] 2018.
S 27. Section 4 of chapter 505 of the laws of 1995, amending the
public health law relating to the operation of department of health
facilities, as amended by section 29 of part A of chapter 59 of the laws
of 2011, is amended to read as follows:
S 4. This act shall take effect immediately; provided, however, that
the provisions of paragraph (b) of subdivision 4 of section 409-c of the
public health law, as added by section three of this act, shall take
effect January 1, 1996 [and shall expire and be deemed repealed twenty
years from the effective date thereof].
S. 4207 58
S 28. Subdivision (o) of section 111 of part H of chapter 59 of the
laws of 2011, amending the public health law relating to the statewide
health information network of New York and the statewide planning and
research cooperative system and general powers and duties, is amended to
read as follows:
(o) sections thirty-eight and thirty-eight-a of this act shall expire
and be deemed repealed March 31, [2015] 2017;
S 29. Section 4-a of 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 relat-
ing to the cap on local Medicaid expenditures, is amended to read as
follows:
S 4-a. Notwithstanding paragraph (c) of subdivision 10 of section
2807-c of the public health law, section 21 of chapter 1 of the laws of
1999, or any other contrary provision of law, in determining rates of
payments by state governmental agencies effective for services provided
on and after January 1, [2015] 2017 through March 31, [2015] 2017, for
inpatient and outpatient services provided by general hospitals, for
inpatient services and adult day health care outpatient services
provided by residential health care facilities pursuant to article 28 of
the public health law, except for residential health care facilities or
units of such facilities providing services primarily to children under
twenty-one years of age, for home health care services provided pursuant
to article 36 of the public health law by certified home health agen-
cies, long term home health care programs and AIDS home care programs,
and for personal care services provided pursuant to section 365-a of the
social services law, the commissioner of health shall apply no greater
than zero trend factors attributable to the [2015] 2017 calendar year in
accordance with paragraph (c) of subdivision 10 of section 2807-c of the
public health law, provided, however, that such no greater than zero
trend factors attributable to such [2015] 2017 calendar year shall also
be applied to rates of payment provided on and after January 1, [2015]
2017 through March 31, [2015] 2017 for personal care services provided
in those local social services districts, including New York city, whose
rates of payment for such services are established by such local social
services districts pursuant to a rate-setting exemption issued by the
commissioner of health to such local social services districts in
accordance with applicable regulations, and provided further, however,
that for rates of payment for assisted living program services provided
on and after January 1, [2015] 2017 through March 31, [2015] 2017, such
trend factors attributable to the [2015] 2017 calendar year shall be
established at no greater than zero percent.
S 30. Section 1325 of the insurance law, as added by chapter 489 of
the laws of 2012, is amended to read as follows:
S 1325. Exemption. For the purposes of exempting certain insurance
companies from the provisions of section one thousand three hundred
twenty-four of this article, the superintendent shall exempt, through
December thirty-first, two thousand [sixteen] NINETEEN, those stock and
non-stock insurance companies to which subparagraph (B) of paragraph two
of subsection (b) of such section applies.
S 31. Subsection (c) of section 2343 of the insurance law, as amended
by chapter 489 of the laws of 2012, is amended to read as follows:
(c) Notwithstanding any other provision of this chapter, no applica-
tion for an order of rehabilitation or liquidation of a domestic insurer
whose primary liability arises from the business of medical malpractice
insurance, as that term is defined in subsection (b) of section five
S. 4207 59
thousand five hundred one of this chapter, shall be made on the grounds
specified in subsection (a) or (c) of section seven thousand four
hundred two of this chapter at any time prior to December thirty-first,
two thousand [sixteen] NINETEEN.
S 32. Section 32 of part A of chapter 58 of the laws of 2008, amending
the elder law and other laws relating to reimbursement to participating
provider pharmacies and prescription drug coverage, as amended by
section 37 of part A of chapter 60 of the laws of 2014, is amended to
read as follows:
S 32. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2008; provided
however, that sections one, six-a, nineteen, twenty, twenty-four, and
twenty-five of this act shall take effect July 1, 2008; provided however
that sections sixteen, seventeen and eighteen of this act shall expire
April 1, 2017; provided, however, that the amendments made by section
twenty-eight of this act shall take effect on the same date as section 1
of chapter 281 of the laws of 2007 takes effect; provided further, that
sections twenty-nine, thirty, and thirty-one of this act shall take
effect October 1, 2008; provided further, that section twenty-seven of
this act shall take effect January 1, 2009; and provided further, that
section twenty-seven of this act shall expire and be deemed repealed
March 31, [2015] 2017; and provided, further, however, that the amend-
ments to subdivision 1 of section 241 of the education law made by
section twenty-nine of this act shall not affect the expiration of such
subdivision and shall be deemed to expire therewith and provided that
the amendments to section 272 of the public health law made by section
thirty of this act shall not affect the repeal of such section and shall
be deemed repealed therewith.
S 33. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal social security act in the public health law and the social
services law shall be deemed to include and also to mean any successor
titles thereto under the federal social security act.
S 34. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988, and
18 NYCRR 505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended and without
force or effect for purposes of implementing the provisions of this act.
S 35. Severability clause. If any clause, sentence, paragraph, subdi-
vision, section or part of this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment shall not affect,
impair or invalidate the remainder thereof, but shall be confined in its
operation to the clause, sentence, paragraph, subdivision, section or
part thereof directly involved in the controversy in which such judgment
shall have been rendered. It is hereby declared to be the intent of the
legislature that this act would have been enacted even if such invalid
provisions had not been included herein.
S 36. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2015 provided,
that:
1. section eighteen of this act shall take effect on the same date as
the reversion of subdivision 3 of section 1680-j of the public authori-
ties law as provided in subdivision (a) of section 70 of part HH of
chapter 57 of the laws of 2013, as amended;
S. 4207 60
2. any rules or regulations necessary to implement the provisions of
this act may be promulgated and any procedures, forms, or instructions
necessary for such implementation may be adopted and issued on or after
the date this act shall have become a law;
3. this act shall not be construed to alter, change, affect, impair or
defeat any rights, obligations, duties or interests accrued, incurred or
conferred prior to the effective date of this act;
4. the commissioner of health and the superintendent of the department
of financial services and any appropriate council may take any steps
necessary to implement this act prior to its effective date;
5. the provisions of this act shall become effective notwithstanding
the failure of the commissioner of health or the superintendent of the
department of financial services or any council to adopt or amend or
promulgate regulations implementing this act.
PART E
Section 1. Subdivision 5-d of section 2807-k of the public health
law, as added by section 1 of part C of chapter 56 of the laws of 2013,
is amended to read as follows:
5-d. (a) Notwithstanding any inconsistent provision of this section,
section twenty-eight hundred seven-w of this article or any other
contrary provision of law, and subject to the availability of federal
financial participation, for periods on and after January first, two
thousand thirteen, through December thirty-first, two thousand [fifteen]
EIGHTEEN, all funds available for distribution pursuant to this section,
except for funds distributed pursuant to subparagraph (v) of paragraph
(b) of subdivision five-b of this section, and all funds available for
distribution pursuant to section twenty-eight hundred seven-w of this
article, shall be reserved and set aside and distributed in accordance
with the provisions of this subdivision.
(b) The commissioner shall promulgate regulations, and may promulgate
emergency regulations, establishing methodologies for the distribution
of funds as described in paragraph (a) of this subdivision and such
regulations shall include, but not be limited to, the following:
(i) Such regulations shall establish methodologies for determining
each facility's relative uncompensated care need amount based on unin-
sured inpatient and outpatient units of service from the cost reporting
year two years prior to the distribution year, multiplied by the appli-
cable medicaid rates in effect January first of the distribution year,
as summed and adjusted by a statewide cost adjustment factor and reduced
by the sum of all payment amounts collected from such uninsured
patients, and as further adjusted by application of a nominal need
computation that shall take into account each facility's medicaid inpa-
tient share.
(ii) Annual distributions pursuant to such regulations for the two
thousand thirteen through two thousand [fifteen] EIGHTEEN calendar years
shall be in accord with the following:
(A) one hundred thirty-nine million four hundred thousand dollars
shall be distributed as Medicaid Disproportionate Share Hospital ("DSH")
payments to major public general hospitals; and
(B) nine hundred ninety-four million nine hundred thousand dollars as
Medicaid DSH payments to eligible general hospitals, other than major
public general hospitals.
(iii)(A) Such regulations shall establish transition adjustments to
the distributions made pursuant to clauses (A) and (B) of subparagraph
S. 4207 61
(ii) of this paragraph such that no facility experiences a reduction in
indigent care pool payments pursuant to this subdivision that is greater
than the percentages, as specified in clause (C) of this subparagraph as
compared to the average distribution that each such facility received
for the three calendar years prior to two thousand thirteen pursuant to
this section and section twenty-eight hundred seven-w of this article.
(B) Such regulations shall also establish adjustments limiting the
increases in indigent care pool payments experienced by facilities
pursuant to this subdivision by an amount that will be, as determined by
the commissioner and in conjunction with such other funding as may be
available for this purpose, sufficient to ensure full funding for the
transition adjustment payments authorized by clause (A) of this subpara-
graph.
(C) No facility shall experience a reduction in indigent care pool
payments pursuant to this subdivision that: for the calendar year begin-
ning January first, two thousand thirteen, is greater than two and one-
half percent; for the calendar year beginning January first, two thou-
sand fourteen, is greater than five percent; and, for the calendar year
beginning on January first, two thousand fifteen, is greater than seven
and one-half percent, AND FOR THE CALENDAR YEAR BEGINNING ON JANUARY
FIRST, TWO THOUSAND SIXTEEN, IS GREATER THAN TEN PERCENT; AND FOR THE
CALENDAR YEAR BEGINNING ON JANUARY FIRST, TWO THOUSAND SEVENTEEN, IS
GREATER THAN TWELVE AND ONE-HALF PERCENT; AND FOR THE CALENDAR YEAR
BEGINNING ON JANUARY FIRST, TWO THOUSAND EIGHTEEN, IS GREATER THAN
FIFTEEN PERCENT.
(iv) Such regulations shall reserve one percent of the funds available
for distribution in the two thousand fourteen [and], two thousand
fifteen AND TWO THOUSAND SIXTEEN calendar years pursuant to this subdi-
vision, subdivision fourteen-f of section twenty-eight hundred seven-c
of this article, and sections two hundred eleven and two hundred twelve
of chapter four hundred seventy-four of the laws of nineteen hundred
ninety-six, in a "financial assistance compliance pool" and shall estab-
lish methodologies for the distribution of such pool funds to facilities
based on their level of compliance, as determined by the commissioner,
with the provisions of subdivision nine-a of this section.
(c) The commissioner shall annually report to the governor and the
legislature on the distribution of funds under this subdivision includ-
ing, but not limited to:
(i) the impact on safety net providers, including community providers,
rural general hospitals and major public general hospitals;
(ii) the provision of indigent care by units of services and funds
distributed by general hospitals; and
(iii) the extent to which access to care has been enhanced.
S 2. Intentionally omitted
S 3. Notwithstanding any inconsistent provision of law, rule or regu-
lation, for purposes of implementing the provisions of the public health
law and the social services law, references to titles XIX and XXI of the
federal social security act in the public health law and the social
services law shall be deemed to include and also to mean any successor
titles thereto under the federal social security act.
S 4. Notwithstanding any inconsistent provision of law, rule or regu-
lation, the effectiveness of the provisions of sections 2807 and 3614 of
the public health law, section 18 of chapter 2 of the laws of 1988, and
18 NYCRR 505.14(h), as they relate to time frames for notice, approval
or certification of rates of payment, are hereby suspended and without
force or effect for purposes of implementing the provisions of this act.
S. 4207 62
S 5. 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 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 6. This act shall take effect immediately and shall be deemed to
have been in full force and effect on and after April 1, 2015; provided,
that:
a. any rules or regulations necessary to implement the provisions of
this act may be promulgated and any procedures, forms, or instructions
necessary for such implementation may be adopted and issued on or after
the date this act shall have become a law;
b. this act shall not be construed to alter, change, affect, impair or
defeat any rights, obligations, duties or interests accrued, incurred or
conferred prior to the effective date of this act;
c. the commissioner of health and the superintendent of financial
services and any appropriate council may take any steps necessary to
implement this act prior to its effective date;
d. the provisions of this act shall become effective notwithstanding
the failure of the commissioner of health or the superintendent of
financial services or any council to adopt or amend or promulgate regu-
lations implementing this act.
PART F
Intentionally Omitted
PART G
Section 1. Intentionally Omitted
S 2. Intentionally Omitted
S 3. Intentionally Omitted
S 4. Intentionally Omitted
S 5. Intentionally Omitted
S 6. Intentionally Omitted
S 7. Paragraph 1 of subsection (a) of section 3231 of the insurance
law, as amended by section 69 of part D of chapter 56 of the laws of
2013, is amended to read as follows:
(1) No individual health insurance policy and no group health insur-
ance policy covering between one and fifty employees or members of the
group, EXCEPT AS SET FORTH IN SUBSECTION (H) OF THIS SECTION, or between
one and one hundred employees or members of the group for policies
issued or renewed on or after January first, two thousand sixteen exclu-
sive of spouses and dependents, hereinafter referred to as a small
group, providing hospital and/or medical benefits, including medicare
supplemental insurance, shall be issued in this state unless such policy
is community rated and, notwithstanding any other provisions of law, the
underwriting of such policy involves no more than the imposition of a
pre-existing condition limitation if otherwise permitted by this arti-
cle.
S. 4207 63
S 8. Paragraph 1 of subsection (h) of section 3231 of the insurance
law, as added by chapter 501 of the laws of 1992, is amended to read as
follows:
(1) Notwithstanding any other provision of this chapter, no insurer,
subsidiary of an insurer, or controlled person of a holding company
system may act as an administrator or claims paying agent, as opposed to
an insurer, on behalf of small groups which, if they purchased insur-
ance, would be subject to this section. No insurer, subsidiary of an
insurer, or controlled person of a holding company may provide stop
loss, catastrophic or reinsurance coverage to small groups which, if
they purchased insurance, would be subject to this section. FOR PURPOSES
OF THIS SUBSECTION, "SMALL GROUP" SHALL MEAN A GROUP COMPRISED OF
BETWEEN ONE AND FIFTY EMPLOYEES OR MEMBERS, EXCLUSIVE OF SPOUSES AND
DEPENDENTS.
S 9. Paragraph 1 of subsection (a) of section 4317 of the insurance
law, as amended by section 72 of part D of chapter 56 of the laws of
2013, is amended to read as follows:
(1) No individual health insurance contract and no group health insur-
ance contract covering between one and fifty employees or members of the
group, EXCEPT AS SET FORTH IN SUBSECTION (E) OF THIS SECTION, or between
one and one hundred employees or members of the group for policies
issued or renewed on or after January first, two thousand sixteen exclu-
sive of spouses and dependents, including contracts for which the premi-
ums are paid by a remitting agent for a group, hereinafter referred to
as a small group, providing hospital and/or medical benefits, including
Medicare supplemental insurance, shall be issued in this state unless
such contract is community rated and, notwithstanding any other
provisions of law, the underwriting of such contract involves no more
than the imposition of a pre-existing condition limitation if otherwise
permitted by this article.
S 10. Paragraph 1 of subsection (e) of section 4317 of the insurance
law, as amended by section 72 of part D of chapter 56 of the laws of
2013, is amended to read as follows:
(1) Notwithstanding any other provision of this chapter, no insurer,
subsidiary of an insurer, or controlled person of a holding company
system may act as an administrator or claims paying agent, as opposed to
an insurer, on behalf of small groups which, if they purchased insur-
ance, would be subject to this section. No insurer, subsidiary of an
insurer, or controlled person of a holding company may provide stop
loss, catastrophic or reinsurance coverage to small groups which, if
they purchased insurance, would be subject to this section. FOR
PURPOSES OF THIS SUBSECTION, "SMALL GROUP" SHALL MEAN A GROUP COMPRISED
OF BETWEEN ONE AND FIFTY EMPLOYEES OR MEMBERS, EXCLUSIVE OF SPOUSES AND
DEPENDENTS.
S 11. This act shall take effect immediately.
PART H
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
S. 4207 64
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 DELIVERING HIGH QUALITY HEALTH CARE SERVICES. 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 INDI-
RECT 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 PRINCIPAL 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, RELAT-
ING 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 SERVICE 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 SERVICE CLINIC LOSES ITS ACCREDITATION;
(II) DESIGNATING OR LIMITING THE TREATMENTS AND SERVICES THAT MAY BE
PROVIDED, INCLUDING:
(1) PROHIBITING THE PROVISION OF SERVICES TO PATIENTS TWENTY-FOUR
MONTHS OF AGE OR YOUNGER;
(2) THE PROVISION OF SPECIFIC IMMUNIZATIONS TO PATIENTS YOUNGER THAN
EIGHTEEN YEARS OF AGE;
(III) REQUIRING LIMITED SERVICE CLINICS TO ACCEPT WALK-INS AND OFFER
EXTENDED BUSINESS HOURS;
(IV) SETTING FORTH GUIDELINES FOR ADVERTISING AND SIGNAGE, DISCLOSURE
OF OWNERSHIP INTERESTS, INFORMED CONSENT, RECORD KEEPING, REFERRAL FOR
TREATMENT AND CONTINUITY OF CARE, CASE REPORTING TO THE PATIENT'S PRIMA-
RY CARE OR OTHER HEALTH CARE PROVIDERS, DESIGN, CONSTRUCTION, FIXTURES,
S. 4207 65
AND EQUIPMENT. SIGNAGE SHALL ALSO BE REQUIRED TO INDICATE 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) 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
THROUGH: (I) THE INTEGRATION OF SERVICES PROVIDED BY LIMITED SERVICES
CLINICS WITH THE SERVICES PROVIDED BY THE PATIENT'S OTHER HEALTH CARE
PROVIDERS; AND (II) THE REFERRAL OF PATIENTS TO APPROPRIATE HEALTH CARE
PROVIDERS, INCLUDING APPROPRIATE TRANSMISSION OF PATIENT HEALTH RECORDS.
(G) A LIMITED SERVICES CLINIC SHALL PROVIDE TREATMENT WITHOUT DISCRIM-
INATION AS TO RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, DISABILITY,
SEXUAL ORIENTATION OR SOURCE OF PAYMENT.
(H) NOTWITHSTANDING THIS SUBDIVISION AND ANY 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 (D) OF THIS SUBDIVISION REGARDING OPERATIONAL AND PHYSICAL
PLANT STANDARDS FOR LIMITED SERVICES CLINICS.
S 1-a. Section 2802 of the public health law is amended by adding a
new subdivision 8 to read as follows:
8. NOTWITHSTANDING ANY LAW, RULE OR REGULATION TO THE CONTRARY, A
GENERAL HOSPITAL ESTABLISHED PURSUANT TO SECTION TWENTY-EIGHT HUNDRED
ONE-A OF THIS ARTICLE MAY SUBMIT AN APPLICATION PURSUANT TO THIS SECTION
TO OPERATE A LIMITED SERVICES CLINIC THAT MEETS THE REGULATIONS PROMUL-
GATED PURSUANT TO PARAGRAPH (D) OF SUBDIVISION SEVENTEEN OF SECTION
TWENTY-EIGHT HUNDRED ONE-A OF THIS ARTICLE REGARDING OPERATIONAL AND
PHYSICAL PLANT STANDARDS.
S 2. Intentionally omitted.
S 3. Intentionally omitted.
S 4. Intentionally omitted.
S 5. Intentionally omitted.
S 6. This act shall take effect immediately.
PART I
Intentionally omitted.
PART J
Intentionally Omitted
PART K
Section 1. Subdivisions 1, 2 and 3 of section 2802 of the public
health law, subdivisions 1 and 2 as amended by section 58 of part A of
chapter 58 of the laws of 2010, subdivision 3 as amended by chapter 609
of the laws of 1982 and paragraph (e) of subdivision 3 as amended by
chapter 731 of the laws of 1993, are amended to read as follows:
1. An application for such construction shall be filed with the
department, together with such other forms and information as shall be
prescribed by, or acceptable to, the department. Thereafter the depart-
ment shall forward a copy of the application and accompanying documents
S. 4207 66
to the public health and health planning council, and the health systems
agency, if any, having geographical jurisdiction of the area where the
hospital is located.
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; 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 subdivi-
sion one of section four hundred eighty-two-b of the social services
law, the needs of the members of the religious denomination concerned,
for care or treatment in accordance with their religious or ethical
convictions, shall be deemed to be public need[.]; AND FURTHER PROVIDED
THAT: (I) AN APPLICATION BY A GENERAL HOSPITAL OR DIAGNOSTIC AND TREAT-
MENT CENTER, ESTABLISHED UNDER THIS ARTICLE, TO CONSTRUCT A FACILITY TO
PROVIDE PRIMARY CARE SERVICES, AS DEFINED IN REGULATION, MAY BE APPROVED
WITHOUT REGARD FOR PUBLIC NEED; OR (II) AN APPLICATION BY A GENERAL
HOSPITAL OR A DIAGNOSTIC AND TREATMENT CENTER, ESTABLISHED UNDER THIS
ARTICLE, TO UNDERTAKE CONSTRUCTION THAT DOES NOT INVOLVE A CHANGE IN
CAPACITY, THE TYPES OF SERVICES PROVIDED, MAJOR MEDICAL EQUIPMENT,
FACILITY REPLACEMENT, OR THE GEOGRAPHIC LOCATION OF SERVICES, MAY BE
APPROVED WITHOUT REGARD FOR PUBLIC NEED.
3. Subject to the provisions of paragraph (b) of subdivision two OF
THIS SECTION, the commissioner in approving the construction of a hospi-
tal shall take into consideration and be empowered to request informa-
tion and advice as to (a) the availability of facilities or services
such as preadmission, ambulatory or home care services which may serve
as alternatives or substitutes for the whole or any part of the proposed
hospital construction;
(b) the need for special equipment in view of existing utilization of
comparable equipment at the time and place and under the circumstances
proposed;
(c) the possible economies and improvements in service to be antic-
ipated from the operation of joint central services including, but not
limited to laboratory, research, radiology, pharmacy, laundry and
purchasing;
(d) the adequacy of financial resources and sources of future revenue,
PROVIDED THAT THE COMMISSIONER MAY, BUT IS NOT REQUIRED TO, CONSIDER THE
ADEQUACY OF FINANCIAL RESOURCES AND SOURCES OF FUTURE REVENUE IN
RELATION TO APPLICATIONS UNDER SUBPARAGRAPHS (I) AND (II) OF PARAGRAPH
(B) OF SUBDIVISION TWO OF THIS SECTION; and
(e) whether the facility is currently in substantial compliance with
all applicable codes, rules and regulations, provided, however, that the
commissioner shall not disapprove an application solely on the basis
that the facility is not currently in substantial compliance, if the
application is specifically:
(i) to correct life safety code or patient care deficiencies;
S. 4207 67
(ii) to correct deficiencies which are necessary to protect the life,
health, safety and welfare of facility patients, residents or staff;
(iii) for replacement of equipment that no longer meets the generally
accepted operational standards existing for such equipment at the time
it was acquired; and
(iv) for decertification of beds and services.
S 2. Subdivisions 1, 2 and 3 of section 2807-z of the public health
law, as amended by chapter 400 of the laws of 2012, are amended to read
as follows:
1. Notwithstanding any provision of this chapter or regulations or any
other state law or regulation, for any eligible capital project as
defined in subdivision six of this section, the department shall have
thirty days [of] AFTER receipt of the certificate of need OR
CONSTRUCTION application, PURSUANT TO SECTION TWENTY-EIGHT HUNDRED TWO
OF THIS ARTICLE, for a limited or administrative review to deem such
application complete. If the department determines the application is
incomplete or that more information is required, the department shall
notify the applicant in writing within thirty days of the date of the
application's submission, and the applicant shall have twenty business
days to provide additional information or otherwise correct the defi-
ciency in the application.
2. For an eligible capital project requiring a limited or administra-
tive review, within ninety days of the department deeming the applica-
tion complete, the department shall make a decision to approve or disap-
prove the certificate of need OR CONSTRUCTION application for such
project. If the department determines to disapprove the project, the
basis for such disapproval shall be provided in writing; however, disap-
proval shall not be based on the incompleteness of the application. If
the department fails to take action to approve or disapprove the appli-
cation within ninety days of the certificate of need application being
deemed complete, the application will be deemed approved.
3. For an eligible capital project requiring full review by the coun-
cil, the certificate of need OR CONSTRUCTION application shall be placed
on the next council agenda following the department deeming the applica-
tion complete.
S 3. Section 2801-a of the public health law is amended by adding a
new subdivision 3-b to read as follows:
3-B. NOTWITHSTANDING ANY OTHER PROVISIONS OF THIS CHAPTER TO THE
CONTRARY, THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL MAY APPROVE THE
ESTABLISHMENT OF DIAGNOSTIC OR TREATMENT CENTERS TO BE ISSUED OPERATING
CERTIFICATES FOR THE PURPOSE OF PROVIDING PRIMARY CARE, AS DEFINED BY
THE COMMISSIONER IN REGULATIONS, WITHOUT REGARD TO THE REQUIREMENTS OF
PUBLIC NEED AND FINANCIAL RESOURCES AS SET FORTH IN SUBDIVISION THREE OF
THIS SECTION.
S 4. Subdivision 3 of section 2801-a of the public health law, as
amended by section 57 of part A of chapter 58 of the laws of 2010, is
amended to read as follows:
3. The public health and health planning council shall not approve a
certificate of incorporation, articles of organization or application
for establishment unless it is satisfied, insofar as applicable, as to
(a) the public need for the existence of the institution at the time and
place and under the circumstances proposed, provided, however, that in
the case of an institution proposed to be established or operated by an
organization defined in subdivision one of section one hundred seventy-
two-a of the executive law, the needs of the members of the religious
denomination concerned, for care or treatment in accordance with their
S. 4207 68
religious or ethical convictions, shall be deemed to be public need; (b)
the character, competence, and standing in the community, of the
proposed incorporators, directors, sponsors, MEMBERS, PRINCIPAL MEMBERS,
stockholders, [members] PRINCIPAL STOCKHOLDERS or operators; with
respect to any proposed incorporator, director, sponsor, MEMBER, PRINCI-
PAL MEMBER, stockholder, [member] PRINCIPAL STOCKHOLDER or operator who
is already or within the past [ten] FIVE years has been an incorporator,
director, sponsor, member, principal stockholder, principal member, or
operator of any hospital, private proprietary home for adults, residence
for adults, or non-profit home for the aged or blind which has been
issued an operating certificate by the state department of social
services, or a halfway house, hostel or other residential facility or
institution for the care, custody or treatment of the mentally disabled
which is subject to approval by the department of mental hygiene, no
approval shall be granted unless the public health and health planning
council, having afforded an adequate opportunity to members of health
systems agencies, if any, having geographical jurisdiction of the area
where the institution is to be located to be heard, shall affirmatively
find by substantial evidence as to each such incorporator, director,
sponsor, MEMBER, PRINCIPAL MEMBER, principal stockholder or operator
that a substantially consistent high level of care is being or was being
rendered in each such hospital, home, residence, halfway house, hostel,
or other residential facility or institution with which such person is
or was affiliated; for the purposes of this paragraph, the public health
and health planning council shall adopt rules and regulations, subject
to the approval of the commissioner, to establish the criteria to be
used to determine whether a substantially consistent high level of care
has been rendered, provided, however, that there shall not be a finding
that a substantially consistent high level of care has been rendered
where there have been violations of the state hospital code, or other
applicable rules and regulations, that (i) threatened to directly affect
the health, safety or welfare of any patient or resident, and (ii) were
recurrent or were not promptly corrected, UNLESS THE PROPOSED INCORPORA-
TOR, DIRECTOR, SPONSOR, MEMBER, PRINCIPAL MEMBER, STOCKHOLDER, PRINCIPAL
STOCKHOLDER, OR OPERATOR DEMONSTRATES, AND THE PUBLIC HEALTH AND HEALTH
PLANNING COUNCIL FINDS, THAT THE VIOLATIONS CANNOT BE ATTRIBUTED TO THE
ACTION OR INACTION OF SUCH PROPOSED INCORPORATOR, DIRECTOR, SPONSOR,
MEMBER, PRINCIPAL MEMBER, STOCKHOLDER, PRINCIPAL STOCKHOLDER, OR OPERA-
TOR DUE TO THE TIMING, EXTENT OR MANNER OF THE AFFILIATION; (c) the
financial resources of the proposed institution and its sources of
future revenues; and (d) such other matters as it shall deem pertinent.
S 5. Paragraphs (b) and (c) of subdivision 4 of section 2801-a of the
public health law, as amended by section 57 of part A of chapter 58 of
the laws of 2010, are amended to read as follows:
(b) [(i)] Any transfer, assignment or other disposition of ten percent
or more of [an] DIRECT OR INDIRECT interest or voting rights in [a part-
nership or limited liability company, which is the] AN operator of a
hospital to a new STOCKHOLDER, partner or member, OR ANY TRANSFER,
ASSIGNMENT OR OTHER DISPOSITION OF A DIRECT OR INDIRECT INTEREST OR
VOTING RIGHTS OF SUCH AN OPERATOR WHICH RESULTS IN THE OWNERSHIP OR
CONTROL OF MORE THAN TEN PERCENT OF THE INTEREST OR VOTING RIGHTS OF
SUCH OPERATOR BY ANY PERSON NOT PREVIOUSLY APPROVED BY THE PUBLIC HEALTH
AND HEALTH PLANNING COUNCIL, OR ITS PREDECESSOR, FOR THAT OPERATOR shall
be approved by the public health and health planning council, in accord-
ance with the provisions of subdivisions two and three of this section,
except that: (A) any such change shall be subject to the approval by the
S. 4207 69
public health and health planning council in accordance with paragraph
(b) of subdivision three of this section only with respect to the new
STOCKHOLDER, partner or member, and any remaining STOCKHOLDERS, partners
or members who have not been previously approved for that facility in
accordance with such paragraph, and (B) such change shall not be subject
to paragraph (a) of subdivision three of this section. IN THE ABSENCE OF
SUCH APPROVAL, THE OPERATING CERTIFICATE OF SUCH HOSPITAL SHALL BE
SUBJECT TO REVOCATION OR SUSPENSION.
[(ii)] (C) (I) With respect to a transfer, assignment or disposition
involving less than ten percent of [an] A DIRECT OR INDIRECT interest or
voting rights in [such partnership or limited liability company] AN
OPERATOR OF A HOSPITAL to a new STOCKHOLDER, partner or member, no prior
approval of the public health and health planning council shall be
required EXCEPT WHERE REQUIRED BY PARAGRAPH (B) OF THIS SUBDIVISION.
However, no such transaction shall be effective unless at least ninety
days prior to the intended effective date thereof, the [partnership or
limited liability company] OPERATOR fully completes and files with the
public health and health planning council notice on a form, to be devel-
oped by the public health and health planning council, which shall
disclose such information as may reasonably be necessary for the public
health and health planning council to determine whether it should bar
the transaction for any of the reasons set forth in item (A), (B), (C)
or (D) below. Within ninety days from the date of receipt of such
notice, the public health and health planning council may bar any trans-
action under this subparagraph: (A) if the equity position of the [part-
nership or limited liability company,] OPERATOR, determined in accord-
ance with generally accepted accounting principles, would be reduced as
a result of the transfer, assignment or disposition; (B) if the trans-
action would result in the ownership of a [partnership or membership]
DIRECT OR INDIRECT interest OR VOTING RIGHTS by any persons who have
been convicted of a felony described in subdivision five of section
twenty-eight hundred six of this article; (C) if there are reasonable
grounds to believe that the proposed transaction does not satisfy the
character and competence criteria set forth in subdivision three of this
section; or (D) UPON THE RECOMMENDATION OF THE DEPARTMENT, if the trans-
action, together with all transactions under this subparagraph for the
[partnership] OPERATOR, or successor, during any five year period would,
in the aggregate, involve twenty-five percent or more of the interest in
the [partnership] OPERATOR. The public health and health planning coun-
cil shall state specific reasons for barring any transaction under this
subparagraph and shall so notify each party to the proposed transaction.
[(iii) With respect to a transfer, assignment or disposition of an
interest or voting rights in such partnership or limited liability
company to any remaining partner or member, which transaction involves
the withdrawal of the transferor from the partnership or limited liabil-
ity company, no prior approval of the public health and health planning
council shall be required. However, no such transaction shall be effec-
tive unless at least ninety days prior to the intended effective date
thereof, the partnership or limited liability company fully completes
and files with the public health and health planning council notice on a
form, to be developed by the public health and health planning council,
which shall disclose such information as may reasonably be necessary for
the public health and health planning council to determine whether it
should bar the transaction for the reason set forth below. Within ninety
days from the date of receipt of such notice, the public health and
health planning council may bar any transaction under this subparagraph
S. 4207 70
if the equity position of the partnership or limited liability company,
determined in accordance with generally accepted accounting principles,
would be reduced as a result of the transfer, assignment or disposition.
The public health and health planning council shall state specific
reasons for barring any transaction under this subparagraph and shall so
notify each party to the proposed transaction.
(c) Any transfer, assignment or other disposition of ten percent or
more of the stock or voting rights thereunder of a corporation which is
the operator of a hospital or which is a member of a limited liability
company which is the operator of a hospital to a new stockholder, or any
transfer, assignment or other disposition of the stock or voting rights
thereunder of such a corporation which results in the ownership or
control of more than ten percent of the stock or voting rights there-
under of such corporation by any person not previously approved by the
public health and health planning council, or its predecessor, for that
corporation shall be subject to approval by the public health and health
planning council, in accordance with the provisions of subdivisions two
and three of this section and rules and regulations pursuant thereto;
except that: any such transaction shall be subject to the approval by
the public health and health planning council in accordance with para-
graph (b) of subdivision three of this section only with respect to a
new stockholder or a new principal stockholder; and shall not be subject
to paragraph (a) of subdivision three of this section. In the absence of
such approval, the operating certificate of such hospital shall be
subject to revocation or suspension.]
(II) No prior approval of the public health and health planning coun-
cil shall be required with respect to a transfer, assignment or disposi-
tion of ten percent or more of [the stock] A DIRECT OR INDIRECT INTEREST
or voting rights [thereunder of a corporation which is the] IN AN opera-
tor of a hospital [or which is a member of a limited liability company
which is the owner of a hospital] to any person previously approved by
the public health and health planning council, or its predecessor, for
that [corporation] OPERATOR. However, no such transaction shall be
effective unless at least ninety days prior to the intended effective
date thereof, the [stockholder] OPERATOR FULLY completes and files with
the public health and health planning council notice on forms to be
developed by the public health and health planning council, which shall
disclose such information as may reasonably be necessary for the public
health and health planning council to determine whether it should bar
the transaction. Such transaction will be final as of the intended
effective date unless, prior thereto, the public health and health plan-
ning council shall state specific reasons for barring such transactions
under this paragraph and shall notify each party to the proposed trans-
action. Nothing in this paragraph shall be construed as permitting a
person not previously approved by the public health and health planning
council for that [corporation] OPERATOR to become the owner of ten
percent or more of the [stock of a corporation which is] INTEREST OR
VOTING RIGHTS, DIRECTLY OR INDIRECTLY, IN the operator of a hospital [or
which is a member of a limited liability company which is the owner of a
hospital] without first obtaining the approval of the public health and
health planning council.
S 6. Subdivision 1 of section 3611-a of the public health law, as
amended by section 67 of part A of chapter 58 of the laws of 2010, is
amended to read as follows:
1. Any change in the person who, or any transfer, assignment, or other
disposition of an interest or voting rights of ten percent or more, or
S. 4207 71
any transfer, assignment or other disposition which results in the
ownership or control of an interest or voting rights of ten percent or
more, in a limited liability company or a partnership which is the oper-
ator of a licensed home care services agency or a certified home health
agency shall be approved by the public health and health planning coun-
cil, in accordance with the provisions of subdivision four of section
thirty-six hundred five of this article relative to licensure or subdi-
vision two of section thirty-six hundred six of this article relative to
certificate of approval, except that:
(a) Public health and health planning council approval shall be
required only with respect to the person, or the member or partner that
is acquiring the interest or voting rights; and
(b) With respect to certified home health agencies, such change shall
not be subject to the public need assessment described in paragraph (a)
of subdivision two of section thirty-six hundred six of this article.
(c) IN THE ABSENCE OF SUCH APPROVAL, THE LICENSE OR CERTIFICATE OF
APPROVAL SHALL BE SUBJECT TO REVOCATION OR SUSPENSION.
(D) (I) No prior approval of the public health and health planning
council shall be required with respect to a transfer, assignment or
disposition of:
[(i)] (A) an interest or voting rights to any person previously
approved by the public health and health planning council, or its prede-
cessor, for that operator; or
[(ii)] (B) an interest or voting rights of less than ten percent in
the operator. [However, no]
(II) NO such transaction UNDER SUBPARAGRAPH (I) OF THIS PARAGRAPH
shall be effective unless at least ninety days prior to the intended
effective date thereof, the [partner or member] OPERATOR completes and
files with the public health and health planning council notice on forms
to be developed by the public health council, which shall disclose such
information as may reasonably be necessary for the public health and
health planning council to determine whether it should bar the trans-
action. Such transaction will be final as of the intended effective date
unless, prior thereto, the public health and health planning council
shall state specific reasons for barring such transactions under this
paragraph and shall notify each party to the proposed transaction.
S 7. Subdivision 5 of section 2801 of the public health law, as added
by chapter 795 of the laws of 1965 and as renumbered by chapter 653 of
the laws of 1975, is amended to read as follows:
5. "Construction" means the erection, building, [or] substantial
[acquisition, alteration,] reconstruction, [improvement, extension or
modification] OR SUBSTANTIAL CHANGE IN CLINICAL SERVICES of a hospital,
including [its equipment;] the inspection and supervision thereof[; and
the studies, surveys, designs, plans, working drawings, specifications,
procedures and other actions necessary thereto].
S 8. Subdivisions 3 and 3-a of section 2801-a of the public health
law, as amended by section 57 of part A of chapter 58 of the laws of
2010, are amended to read as follows:
3. The public health and health planning council shall not approve a
certificate of incorporation, articles of organization or application
for establishment unless it is satisfied, insofar as applicable, as to
[(a) the public need for the existence of the institution at the time
and place and under the circumstances proposed, provided, however, that
in the case of an institution proposed to be established or operated by
an organization defined in subdivision one of section one hundred seven-
ty-two-a of the executive law, the needs of the members of the religious
S. 4207 72
denomination concerned, for care or treatment in accordance with their
religious or ethical convictions, shall be deemed to be public need;
(b)] the character, competence, and standing in the community, of the
proposed incorporators, directors, sponsors, stockholders, members or
operators; with respect to any proposed incorporator, director, sponsor,
stockholder, member or operator who is already or within the past [ten]
FIVE years has been an incorporator, director, sponsor, member, princi-
pal stockholder, principal member, or operator of any hospital, private
proprietary home for adults, residence for adults, or non-profit home
for the aged or blind which has been issued an operating certificate by
the [state] department [of social services], or a halfway house, hostel
or other residential facility or institution for the care, custody or
treatment of the mentally disabled which is subject to approval by the
department of mental hygiene, no approval shall be granted unless the
public health and health planning council, having afforded an adequate
opportunity to members of [health systems agencies] FINGER LAKES HEALTH
SYSTEM AGENCY, if any, having geographical jurisdiction of the area
where the institution is to be located to be heard, shall affirmatively
find by substantial evidence as to each such incorporator, director,
sponsor, principal stockholder or operator that a substantially consist-
ent high level of care is being or was being rendered in each such
hospital, home, residence, halfway house, hostel, or other residential
facility or institution with which such person is or was affiliated; for
the purposes of this paragraph, the public health and health planning
council shall adopt rules and regulations, subject to the approval of
the commissioner, to establish the criteria to be used to determine
whether a substantially consistent high level of care has been rendered,
provided, however, that there shall not be a finding that a substantial-
ly consistent high level of care has been rendered where there have been
violations of the state hospital code, or other applicable rules and
regulations, that [(i)] (A) threatened to directly affect the health,
safety or welfare of any patient or resident, and [(ii)] (B) were recur-
rent or were not promptly corrected; [(c)] the financial resources of
the proposed institution and its sources of future revenues; and [(d)]
such other matters as it shall deem pertinent.
3-a. Notwithstanding any other provisions of this chapter, the public
health council is hereby empowered to approve the establishment, for
demonstration purposes, of not more than one existing hospital within
the geographical jurisdiction of each health systems agency established
under the provisions of subdivision (c) of section twenty-nine hundred
four of this chapter. The purposes of such hospitals shall be to offer
and provide nursing home services, board and lodging to persons requir-
ing such services within one hospital. [The public health council may
approve the establishment of such hospitals without regard to the
requirement of public need as set forth in subdivision three of this
section.]
S 9. Subparagraph (i) of paragraph (b) of subdivision 4 of section
2801-a of the public health law, as amended by section 57 of part A of
chapter 58 of the laws of 2010, is amended to read as follows:
(i) Any transfer, assignment or other disposition of ten percent or
more of an interest or voting rights in a partnership or limited liabil-
ity company, which is the operator of a hospital to a new partner or
member, shall be approved by the public health and health planning coun-
cil, in accordance with the provisions of subdivisions two and three of
this section, except that[: (A)] any such change shall be subject to the
approval by the public health and health planning council in accordance
S. 4207 73
with [paragraph (b) of] subdivision three of this section only with
respect to the new partner or member, and any remaining partners or
members who have not been previously approved for that facility in
accordance with such [paragraph, and (B) such change shall not be
subject to paragraph (a) of] subdivision [three of this section].
S 10. Paragraph (c) of subdivision 4 of section 2801-a of the public
health law, as amended by section 57 of part A of chapter 58 of the laws
of 2010, is amended to read as follows:
(c) Any transfer, assignment or other disposition of ten percent or
more of the stock or voting rights thereunder of a corporation which is
the operator of a hospital or which is a member of a limited liability
company which is the operator of a hospital to a new stockholder, or any
transfer, assignment or other disposition of the stock or voting rights
thereunder of such a corporation which results in the ownership or
control of more than ten percent of the stock or voting rights there-
under of such corporation by any person not previously approved by the
public health and health planning council, or its predecessor, for that
corporation shall be subject to approval by the public health and health
planning council, in accordance with the provisions of subdivisions two
and three of this section and rules and regulations pursuant thereto;
except that: any such transaction shall be subject to the approval by
the public health and health planning council in accordance with [para-
graph (b) of] subdivision three of this section only with respect to a
new stockholder or a new principal stockholder[; and shall not be
subject to paragraph (a) of subdivision three of this section]. In the
absence of such approval, the operating certificate of such hospital
shall be subject to revocation or suspension. No prior approval of the
public health and health planning council shall be required with respect
to a transfer, assignment or disposition of ten percent or more of the
stock or voting rights thereunder of a corporation which is the operator
of a hospital or which is a member of a limited liability company which
is the owner of a hospital to any person previously approved by the
public health and health planning council, or its predecessor, for that
corporation. However, no such transaction shall be effective unless at
least ninety days prior to the intended effective date thereof, the
stockholder completes and files with the public health and health plan-
ning council notice on forms to be developed by the public health and
health planning council, which shall disclose such information as may
reasonably be necessary for the public health and health planning coun-
cil to determine whether it should bar the transaction. Such transaction
will be final as of the intended effective date unless, prior thereto,
the public health and health planning council shall state specific
reasons for barring such transactions under this paragraph and shall
notify each party to the proposed transaction. Nothing in this paragraph
shall be construed as permitting a person not previously approved by the
public health and health planning council for that corporation to become
the owner of ten percent or more of the stock of a corporation which is
the operator of a hospital or which is a member of a limited liability
company which is the owner of a hospital without first obtaining the
approval of the public health and health planning council.
S 11. Subparagraph (i) of paragraph (g) and subparagraph (i) of para-
graph (h) of subdivision 4 of section 2801-a of the public health law,
as amended by section 57 of part A of chapter 58 of the laws of 2010,
are amended to read as follows:
S. 4207 74
(i) the character, competence and standing in the community of each
proposed trustee operator pursuant to the provisions of [paragraph (b)
of] subdivision three of this section; and
(i) the character, competence and standing in the community of the
proposed conservator operator or committee operator pursuant to the
provisions of [paragraph (b) of] subdivision three of this section; and
S 12. Paragraph (a) of subdivision 14 of section 2801-a of the public
health law, as amended by section 57 of part A of chapter 58 of the laws
of 2010, is amended to read as follows:
(a) The public health and health planning council may approve the
establishment of not-for-profit rural health networks as defined in
article twenty-nine-A of this chapter, pursuant to the provisions of
subdivisions two and three of this section, except that the public
health and health planning council shall not consider the [public need
for and] financial resources and sources of future revenues of such
networks which do not seek approval to operate a hospital. In addition
to character and competence, the public health and health planning coun-
cil may take into consideration available network plans.
S 13. Paragraph (b) of subdivision 15 of section 2801-a of the public
health law, as amended by section 57 of part A of chapter 58 of the laws
of 2010, is amended to read as follows:
(b) The following provisions of this section shall not apply to diag-
nostic or treatment centers operated pursuant to this subdivision: (i)
[paragraph (b) of] subdivision three of this section, relating to stock-
holders and members; (ii) paragraph (c) of subdivision four of this
section, relating to the disposition of stock or voting rights; and
(iii) paragraph (e) of subdivision four of this section, relating to the
ownership of stock or membership.
S 14. Subdivision 4 of section 2801-e of the public health law, as
added by chapter 750 of the laws of 2004, is amended to read as follows:
4. Any reductions in the number of operational residential health care
facility beds resulting from this demonstration shall not be considered
to create additional public need for residential health care facility
beds [under this article].
S 15. Paragraph (c) of subdivision 6 of section 2801-e of the public
health law, as amended by chapter 257 of the laws of 2005, is amended to
read as follows:
(c) The commissioner may, as necessary, waive existing methodologies
for determining public need under [this article,] article thirty-six of
this chapter and article seven of the social services law, as well as
enrollment limitations under section forty-four hundred three-f of this
chapter, to accommodate permanent conversions of beds to other programs
or services on the basis that any such increases in capacity are linked
to commensurate reductions in the number of residential health care
facility beds.
S 16. 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] FINGER LAKES HEALTH SYSTEM 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 appli-
S. 4207 75
cation for construction by an applicant possessing a valid operating
certificate when the application qualifies for review without the recom-
mendation of the council pursuant to regulations adopted by the council
and approved by the commissioner[; 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 religious denomi-
nation concerned, for care or treatment in accordance with their reli-
gious or ethical convictions, shall be deemed to be public need].
S 17. Paragraph (a) of subdivision 6 of section 2806 of the public
health law, as amended by chapter 77 of the laws of 1977, such subdivi-
sion as renumbered by chapter 896 of the laws of 1977, is amended to
read as follows:
(a) Notwithstanding the provisions of subdivisions two through four of
this section, the commissioner shall suspend, limit, modify, or revoke a
hospital operating certificate, after taking into consideration [the
total number of beds necessary to meet the public need,] the availabili-
ty of facilities or services such as preadmission, ambulatory, home care
or other services which may serve as alternatives or substitutes for the
whole or any part of any such hospital facility, and, in the case of
modification, the level of care and the nature and type of services
provided or required by all or some of the patients in or seeking admis-
sion to such hospital facility, and whether such level of care is
consistent with the operating certificate of the hospital, and after
finding that suspending, limiting, modifying, or revoking the operating
certificate of such facility would be within the public interest [in
order to conserve health resources by restricting the number of beds
and/or the level of services to those which are actually needed].
S 18. Paragraph (f) of subdivision 6 of section 2806 of the public
health law, as added by chapter 769 of the laws of 1977, is amended to
read as follows:
(f) In determining whether there is a [public need] NECESSITY for any
services or facilities as required by this subdivision, the commissioner
shall consider the advice of the state health planning and development
agency designated pursuant to the provisions of the national health
planning and resources development act of nineteen hundred seventy-four
and any amendments thereto and the state health plan developed there-
under.
S 19. Subdivision 1 of section 2874-a of the public health law, as
added by chapter 934 of the laws of 1985, is amended to read as follows:
1. The medical care facilities finance agency shall not make a mort-
gage loan to eligible secured hospital borrowers unless [the commission-
er has recommended the project based on public need,] the hospital
discloses the financial resources available to it, and the hospital
complies with the provisions of article twenty-eight of this chapter. In
considering the financial resources available to support a project, the
commissioner shall take into account programs designed to offset eligi-
ble secured hospital borrowers' past and current unmet bad debt and
charity care losses.
S 20. Section 2802 of the public health law is amended by adding two
new subdivisions 8 and 9 to read as follows:
8. NOTWITHSTANDING ANY LAW, RULE, OR REGULATION TO THE CONTRARY, THIS
SUBDIVISION SHALL APPLY TO ANY APPLICATION FOR CONSTRUCTION REQUIRED
UNDER THIS SECTION WITH THE EXCEPTION OF THOSE FEDERALLY QUALIFIED
S. 4207 76
HEALTH CENTER CAPITAL PROJECTS SUBJECT TO SECTION TWENTY-EIGHT HUNDRED
SEVEN-Z OF THIS ARTICLE.
(A) FOR AN APPLICATION REQUIRING A LIMITED OR ADMINISTRATIVE REVIEW,
WITHIN NINETY CALENDAR DAYS OF THE DEPARTMENT DEEMING THE APPLICATION
COMPLETE, THE COMMISSIONER SHALL MAKE A DECISION TO APPROVE OR DISAP-
PROVE THE APPLICATION. IF THE COMMISSIONER DETERMINES TO DISAPPROVE THE
APPLICATION, THE BASIS FOR SUCH DISAPPROVAL SHALL BE PROVIDED IN WRIT-
ING; HOWEVER, DISAPPROVAL SHALL NOT BE BASED ON THE INCOMPLETENESS OF
THE APPLICATION. IF THE COMMISSIONER FAILS TO TAKE ACTION TO APPROVE OR
DISAPPROVE THE APPLICATION WITHIN NINETY CALENDAR DAYS OF THE APPLICA-
TION BEING DEEMED COMPLETE, THE APPLICATION SHALL BE DEEMED APPROVED.
(B) FOR AN APPLICATION REQUIRING FULL REVIEW BY THE COUNCIL, THE
APPLICATION SHALL BE PLACED ON THE NEXT COUNCIL AGENDA FOLLOWING THE
DEPARTMENT DEEMING THE APPLICATION COMPLETE.
(C) WHERE THE COMMISSIONER OR DEPARTMENT REQUIRES THE APPLICANT TO
SUBMIT INFORMATION TO SATISFY A CONTINGENCY FOR A CONSTRUCTION PROJECT,
THE COMMISSIONER OR DEPARTMENT SHALL HAVE THIRTY CALENDAR DAYS TO REVIEW
AND APPROVE OR DISAPPROVE THE SUBMITTED INFORMATION. IF THE COMMISSIONER
OR DEPARTMENT DETERMINES THAT THE SUBMITTED INFORMATION IS INCOMPLETE,
IT SHALL SO NOTIFY THE APPLICANT IN WRITING AND PROVIDE THE APPLICANT
WITH TEN CALENDAR DAYS TO CORRECT THE DEFICIENCY OR PROVIDE ADDITIONAL
INFORMATION. IF THE COMMISSIONER OR DEPARTMENT DETERMINES THAT THE
SUBMITTED INFORMATION DOES NOT SATISFY THE CONTINGENCY, THE BASIS FOR
SUCH DISAPPROVAL SHALL BE PROVIDED IN WRITING; HOWEVER, DISAPPROVAL
SHALL NOT BE BASED ON THE INCOMPLETENESS OF THE APPLICATION. WITHIN
FIFTEEN CALENDAR DAYS OF COMPLETE SATISFACTION OF A CONTINGENCY, THE
COMMISSIONER OR DEPARTMENT SHALL TRANSMIT THE FINAL APPROVAL LETTER TO
THE APPLICANT.
(D) THE DEPARTMENT SHALL DEVELOP EXPEDITED PRE-OPENING SURVEY PROC-
ESSES FOR APPLICATIONS APPROVED UNDER THIS SECTION, BUT UNDER NO CIRCUM-
STANCES SHALL PRE-OPENING SURVEY REVIEWS BE SCHEDULED LATER THAN THIRTY
CALENDAR DAYS AFTER FINAL APPROVAL, CONSTRUCTION COMPLETION AND NOTIFI-
CATION OF SUCH COMPLETION OF THE DEPARTMENT.
9. WITH REGARD TO ANY CONSTRUCTION PROJECT REQUIRING SUBMISSION OF AN
APPLICATION PURSUANT TO THIS SECTION WHERE THE COMMISSIONER HAS DETER-
MINED THAT A WRITTEN CERTIFICATION BY AN ARCHITECT OR ENGINEER LICENSED
PURSUANT TO ARTICLE ONE HUNDRED FORTY-FIVE OR ONE HUNDRED FORTY-SEVEN OF
THE EDUCATION LAW THAT THE PROJECT MEETS APPLICABLE REGULATIONS OF THE
DEPARTMENT CAN BE ACCEPTED, THE SUBMISSION BY THE APPLICANT OF SUCH
COMPLETE AND FULLY EXECUTED CERTIFICATION BY CERTIFIED OR REGISTERED
MAIL WITH A RETURN RECEIPT SIGNED BY THE DEPARTMENT SHALL CONSTITUTE A
FULFILLMENT OF THE CERTIFICATION REQUIREMENT AND THE DEPARTMENT SHALL
PROCEED WITH THE PROCESSING OF SUCH APPLICATION. NOTHING IN THIS SECTION
SHALL BE CONSTRUED AS PROHIBITING THE DEPARTMENT UPON SURVEY FROM
REQUIRING SUBSEQUENT CORRECTIONS TO THE PROJECT TO MEET THE APPLICABLE
REGULATIONS.
S 21. Subdivision 1 of section 2806-a of the public health law is
amended by adding a new paragraph (g) to read as follows:
(G) "IMPROPER DELEGATION OF AUTHORITY TO A MANAGEMENT CONSULTANT BY
THE GOVERNING AUTHORITY OR OPERATOR" OF A GENERAL HOSPITAL SHALL
INCLUDE, BUT NOT BE LIMITED TO, THE DELEGATION OF (I) AUTHORITY TO HIRE
OR FIRE THE ADMINISTRATOR OR OTHER KEY MANAGEMENT EMPLOYEES; (II) MAIN-
TENANCE AND CONTROL OF THE BOOKS AND RECORDS; (III) AUTHORITY OVER THE
DISPOSITION OF ASSETS AND THE INCURRING OF LIABILITIES ON BEHALF OF THE
FACILITY; AND (IV) THE ADOPTION AND ENFORCEMENT OF POLICIES REGARDING
THE OPERATION OF THE FACILITY. THE CRITERIA SET FORTH IN THIS PARAGRAPH
S. 4207 77
SHALL NOT BE THE SOLE DETERMINING FACTORS, BUT INDICATORS TO BE CONSID-
ERED WITH SUCH OTHER FACTORS THAT MAY BE PERTINENT IN PARTICULAR
INSTANCES. PROFESSIONAL EXPERTISE SHALL BE EXERCISED IN THE UTILIZATION
OF THE CRITERIA. ALL OF THE LISTED INDICIA NEED NOT BE PRESENT IN A
GIVEN INSTANCE FOR THERE TO BE AN IMPROPER DELEGATION OF AUTHORITY.
S 22. Paragraph (a) of subdivision 2 of section 2806-a of the public
health law, as added by section 50 of part E of chapter 56 of the laws
of 2013, is amended to read as follows:
(a) In the event that: (i) a facility seeks extraordinary financial
assistance and the commissioner finds that the facility is experiencing
serious financial instability that is jeopardizing existing or continued
access to essential services within the community, or (ii) the commis-
sioner finds that there are conditions within the facility that serious-
ly endanger the life, health or safety of residents or patients, the
commissioner may appoint a temporary operator to assume sole control and
sole responsibility for the operations of that facility, OR (III) THE
COMMISSIONER FINDS THAT THERE HAS BEEN AN IMPROPER DELEGATION OF AUTHOR-
ITY TO A MANAGEMENT CONSULTANT BY THE GOVERNING AUTHORITY OR OPERATOR OF
A GENERAL HOSPITAL, THE COMMISSIONER SHALL APPOINT A TEMPORARY OPERATOR
TO ASSUME SOLE CONTROL AND SOLE RESPONSIBILITY FOR THE OPERATIONS OF
THAT FACILITY. The appointment of the temporary operator shall be effec-
tuated pursuant to this section and shall be in addition to any other
remedies provided by law.
S 23. Subdivision 5 of section 2806-a of the public health law, as
added by section 50 of part E of chapter 56 of the laws of 2013, is
amended to read as follows:
5. (a) The initial term of the appointment of the temporary operator
shall not exceed one hundred eighty days. After one hundred eighty days,
if the commissioner determines that termination of the temporary opera-
tor would cause significant deterioration of the quality of, or access
to, health care or residential care in the community or that reappoint-
ment is necessary to correct the conditions within the facility that
seriously endanger the life, health or safety of residents or patients,
or the financial instability that required the appointment of the tempo-
rary operator, the commissioner may authorize up to two additional nine-
ty-day terms.
(b) Upon the completion of the two ninety-day terms referenced in
paragraph (a) of this subdivision,
(i) if the established operator is the debtor in a bankruptcy proceed-
ing, and the commissioner determines that the temporary operator
requires additional terms to operate the facility during the pendency of
the bankruptcy proceeding and to carry out any plan resulting from the
proceeding, the commissioner may reappoint the temporary operator for
additional ninety-day terms until the termination of the bankruptcy
proceeding, provided that the commissioner shall provide for notice and
a hearing as set forth in subdivision six of this section; [or]
(ii) if the established operator requests the reappointment of the
temporary operator, the commissioner may reappoint the temporary opera-
tor for one additional ninety-day term, pursuant to an agreement between
the established operator, the temporary operator and the department[.];
OR
(III) IF THE COMMISSIONER FINDS THAT CONDITIONS REGARDING THE IMPROPER
DELEGATION OF AUTHORITY TO A MANAGEMENT CONSULTANT BY THE GOVERNING
AUTHORITY OR OPERATOR OF A GENERAL HOSPITAL HAVE NOT BEEN REMEDIED, HE
SHALL SUBMIT A RECOMMENDATION TO THE PUBLIC HEALTH AND HEALTH PLANNING
S. 4207 78
COUNCIL FOR REMEDIAL ACTION PURSUANT TO PARAGRAPH (I) OF SUBDIVISION
FOUR OF SECTION TWENTY-EIGHT HUNDRED ONE-A OF THIS ARTICLE.
(c) Within fourteen days prior to the termination of each term of the
appointment of the temporary operator, the temporary operator shall
submit to the commissioner and to the established operator a report
describing:
(i) the actions taken during the appointment to address such deficien-
cies and financial instability,
(ii) objectives for the continuation of the temporary operatorship if
necessary and a schedule for satisfaction of such objectives,
(iii) recommended actions for the ongoing operation of the facility
subsequent to the term of the temporary operator INCLUDING RECOMMENDA-
TIONS REGARDING THE PROPER MANAGEMENT OF THE FACILITY AND ONGOING AGREE-
MENTS WITH MANAGEMENT CONSULTANTS; and
(iv) with respect to the first ninety-day term referenced in paragraph
(a) of this subdivision, a plan for sustainable operation to avoid
closure, or transformation of the facility which may include any option
permissible under this chapter or the social services law and implement-
ing regulations thereof. The report shall reflect best efforts to
produce a full and complete accounting.
(d) 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.
S 24. Subdivision 4 of section 2801-a of the public health law is
amended by adding a new paragraph (i) to read as follows:
(I) UPON RECOMMENDATION BY THE COMMISSIONER, IF THE PUBLIC HEALTH AND
HEALTH PLANNING COUNCIL FINDS BY SUBSTANTIAL EVIDENCE THAT AN IMPROPER
DELEGATION OF AUTHORITY TO A MANAGEMENT CONSULTANT BY A GOVERNING
AUTHORITY OR OPERATOR OF A GENERAL HOSPITAL HAS OCCURRED AS DEFINED BY
PARAGRAPH (G) OF SUBDIVISION ONE OF SECTION TWENTY-EIGHT HUNDRED SIX-A
OF THIS ARTICLE, THE OPERATING CERTIFICATE OF SUCH HOSPITAL SHALL BE
SUBJECT TO REVOCATION OR SUSPENSION.
S 25. This act shall take effect immediately; provided, however, that
sections seven through twenty of this act shall take effect January 1,
2016; provided, further, that the amendments to subdivision 1 of section
2874-a of the public health law, made by section nineteen of this act,
shall not affect the expiration of such section and shall be deemed to
expire therewith; and provided, further, that the amendments to section
2806-a of the public health law, made by sections twenty-one, twenty-two
and twenty-three of this act, shall not affect the expiration and repeal
of such section, and shall be deemed repealed therewith.
PART L
Section 1. Section 230-d of the public health law is amended by adding
two new subdivisions 6 and 7 to read as follows:
6. THE COMMISSIONER SHALL CONVENE AN OFFICE-BASED SURGERY WORKGROUP TO
REVIEW THE SCOPE OF OFFICE-BASED SURGERY. THE WORKGROUP SHALL BE
COMPRISED OF STAKEHOLDERS AND EXPERTS IN THE FIELD OF OFFICE-BASED
SURGERY, WHICH SHALL AT A MINIMUM INCLUDE NO LESS THAN FIVE PHYSICIANS
CURRENTLY ACCREDITED IN OFFICE-BASED SURGERY AND NO LESS THAN TWO
LICENSED ANESTHESIOLOGISTS, TWO LICENSED CHIROPRACTORS, AND TWO LICENSED
PODIATRISTS. THE WORKGROUP SHALL EXAMINE THE SCOPE OF OFFICE-BASED
SURGERY IN NEW YORK AND WHETHER CERTAIN SURGICAL PROCEDURES NOT CURRENT-
LY PROVIDED IN THIS SETTING SHOULD BE, WHETHER CERTAIN SURGICAL PROCE-
S. 4207 79
DURES CURRENTLY PROVIDED SHOULD NOT BE PROVIDED IN THIS SETTING, AND
WHETHER NON-SURGICAL PROCEDURES INVOLVING CERTAIN LEVELS OF ANESTHESIA
SHOULD BE PROVIDED WITHIN THIS SETTING. IN EXAMINING THE SCOPE OF
OFFICE-BASED SURGERY, THE WORKGROUP SHALL CONSIDER WHAT OTHER STATES
COVER UNDER THIS ACCREDITATION AND WHAT MEDICARE COVERS IN THIS SETTING.
THE WORKGROUP SHALL REPORT AND RECOMMEND ANY STATUTORY CHANGES THEY DEEM
APPROPRIATE TO THE LEGISLATURE. SUCH REPORT SHALL BE SUBMITTED TO THE
TEMPORARY PRESIDENT OF THE SENATE, SPEAKER OF THE ASSEMBLY, CHAIR OF THE
SENATE STANDING COMMITTEE ON HEALTH AND CHAIR OF THE ASSEMBLY HEALTH
COMMITTEE BY DECEMBER FIRST, TWO THOUSAND FIFTEEN.
7. EVERY OFFICE-BASED SURGERY PRACTICE WITH FULL ACCREDITED STATUS
SHALL BE ELIGIBLE TO SEEK PAYMENT FROM A HEALTH PLAN FOR COSTS RELATED
TO THE USE OF SUCH SURGERY LOCATION OR SETTING. SUCH FEE IS IN ADDITION
TO THE FEE CHARGED BY THE LICENSEE FOR THE PERFORMANCE OF THE COVERED
OFFICE-BASED SURGERY INVOLVING AN INSURED OR A HEALTH PLAN ENROLLEE;
PROVIDED THAT THE HEALTH PLAN ALSO REIMBURSES FOR COSTS RELATED TO THE
USE OF A SURGERY LOCATION OR SETTING CHARGED IN CONNECTION WITH THE SAME
COVERED PROCEDURE PERFORMED AT A HOSPITAL OR AMBULATORY SURGERY CENTER
ORGANIZED PURSUANT TO ARTICLE TWENTY-EIGHT OF THIS CHAPTER. WHEN CALCU-
LATING THE APPROPRIATE RATE OF OFFICE-BASED SURGERY RELATED REIMBURSE-
MENT, A HEALTH PLAN MAY ALSO TAKE INTO CONSIDERATION CERTAIN COMPARABLE
AND NON-COMPARABLE COSTS AND OBLIGATIONS OF AMBULATORY SURGERY CENTERS
AND HOSPITALS AND ADJUST RATES ACCORDINGLY AND IN A REASONABLE MANNER.
S 2. Paragraph (b) of subdivision 1 of section 230-d of the public
health law, as added by chapter 365 of the laws of 2007, is amended to
read as follows:
(b) "Adverse event" means (i) patient death within thirty days; (ii)
unplanned transfer to a hospital OR EMERGENCY DEPARTMENT VISIT WITHIN
SEVENTY-TWO HOURS OF OFFICE-BASED SURGERY; (iii) unscheduled hospital
admission OR ASSIGNMENT TO OBSERVATION SERVICES, within seventy-two
hours of the office-based surgery, for longer than twenty-four hours; or
(iv) any other serious or life-threatening event.
S 3. The section heading and subdivisions 1 and 2 of section 2998-e of
the public health law, as added by chapter 365 of the laws of 2007, are
amended to read as follows:
Reporting [of adverse events] in office based surgery. 1. The commis-
sioner shall enter into agreements with accrediting agencies pursuant to
which the accrediting agencies shall REQUIRE ALL OFFICE-BASED SURGICAL
PRACTICES TO CONDUCT QUALITY IMPROVEMENT AND QUALITY ASSURANCE ACTIV-
ITIES AND UTILIZE AMERICAN BOARD OF MEDICAL SPECIALTIES (ABMS) OR EQUIV-
ALENT CERTIFICATION, HOSPITAL PRIVILEGING OR OTHER EQUIVALENT METHODS TO
DETERMINE COMPETENCY OF PRACTITIONERS TO PERFORM OFFICE-BASED SURGERY.
THE ACCREDITING AGENCY SHALL report[, at a minimum, aggregate] data [on
adverse events] for all office-based surgical practices accredited by
the accrediting agencies to the department. The department may disclose
reports of aggregate data to the public.
2. The information required to be collected, maintained and reported
directly to the department AND THE ACCREDITING AGENCIES, AND MAINTAINED
BY OFFICE-BASED SURGERY PRACTICES UNDER QUALITY IMPROVEMENT AND QUALITY
ASSURANCE ACTIVITIES pursuant to section two hundred thirty-d of this
chapter shall be kept confidential and shall not be released, except to
the department and except as required or permitted under subdivision
nine-a and subparagraph (v) of paragraph (a) of subdivision ten of
section two hundred thirty of this chapter. Notwithstanding any other
provision of law, none of [such information] THE INFORMATION COLLECTED,
MAINTAINED AND REPORTED TO THE DEPARTMENT OR THE ACCREDITING AGENCIES,
S. 4207 80
AND MAINTAINED BY THE OFFICE-BASED SURGERY PRACTICES UNDER QUALITY
IMPROVEMENT AND QUALITY ASSURANCE ACTIVITIES PURSUANT TO THIS SECTION
shall be subject to disclosure under article six of the public officers
law or article thirty-one of the civil practice law and rules.
S 4. Section 2806 of the public health law is amended by adding a new
subdivision 1-a to read as follows:
1-A. ANY AMBULATORY SURGERY CENTER THAT MAINTAINS AN ACCREDITATION
STATUS IN ADDITION TO ITS LICENSURE UNDER THIS ARTICLE SHALL BE SUBJECT
TO A HEARING PURSUANT TO THIS SECTION IN ORDER TO DETERMINE WHETHER ITS
OPERATING CERTIFICATION SHOULD BE SUSPENDED OR REVOKED UPON THE REMOVAL
OF ACCREDITATION BY ANY ACCREDITING BODY.
S 5. This act shall take effect immediately, except that section three
of this act shall take effect on the ninetieth day after it shall have
become a law.
PART M
Section 1. Subdivisions 1 and 2 of section 1100-a of the public health
law, as added by chapter 258 of the laws of 1996, are amended and two
new subdivisions 3 and 4 are added to read as follows:
1. Notwithstanding any contrary provision of law, rule, regulation or
code, any county, city, town or village that owns both its public water
system and the water supply for such system may by local law provide
whether a fluoride compound shall [or shall not] be added to such public
water supply.
2. Any county, wherein a public authority owns both its public water
system and the water supply for such system, may by local law provide
whether a fluoride compound shall [or shall not] be added to such public
water supply.
3. NO COUNTY, CITY, TOWN OR VILLAGE, INCLUDING A COUNTY WHEREIN A
PUBLIC AUTHORITY OWNS BOTH ITS PUBLIC WATER SYSTEM AND THE WATER SUPPLY
FOR SUCH SYSTEM, THAT FLUORIDATES A PUBLIC WATER SUPPLY OR CAUSES A
PUBLIC WATER SUPPLY TO BE FLUORIDATED, SHALL DISCONTINUE THE ADDITION OF
A FLUORIDE COMPOUND TO SUCH PUBLIC WATER SUPPLY UNLESS IT HAS FIRST
COMPLIED WITH THE FOLLOWING REQUIREMENTS:
(A) ISSUE A NOTICE TO THE PUBLIC OF THE PRELIMINARY DETERMINATION TO
DISCONTINUE FLUORIDATION FOR COMMENT, WHICH SHALL INCLUDE THE JUSTIFICA-
TION FOR THE PROPOSED DISCONTINUANCE, ALTERNATIVES TO FLUORIDATION
AVAILABLE, AND A SUMMARY OF CONSULTATIONS WITH HEALTH PROFESSIONALS AND
THE DEPARTMENT CONCERNING THE PROPOSED DISCONTINUANCE. SUCH NOTICE MAY,
BUT IS NOT REQUIRED TO, INCLUDE PUBLICATION IN LOCAL NEWSPAPERS.
"CONSULTATIONS WITH HEALTH PROFESSIONALS" MAY INCLUDE FORMAL STUDIES BY
HIRED PROFESSIONALS, INFORMAL CONSULTATIONS WITH LOCAL PUBLIC HEALTH
OFFICIALS OR OTHER HEALTH PROFESSIONALS, OR OTHER CONSULTATIONS,
PROVIDED THAT THE NATURE OF SUCH CONSULTATIONS AND THE IDENTITY OF SUCH
PROFESSIONALS SHALL BE IDENTIFIED IN THE PUBLIC NOTICE. "ALTERNATIVES TO
FLUORIDATION" MAY INCLUDE FORMAL ALTERNATIVES PROVIDED BY OR AT THE
EXPENSE OF THE COUNTY, CITY, TOWN OR VILLAGE, OR OTHER ALTERNATIVES
AVAILABLE TO THE PUBLIC. ANY PUBLIC COMMENTS RECEIVED IN RESPONSE TO
SUCH NOTICE SHALL BE ADDRESSED BY THE COUNTY, CITY, TOWN OR VILLAGE IN
THE ORDINARY COURSE OF BUSINESS; AND
(B) PROVIDE THE DEPARTMENT AT LEAST NINETY DAYS PRIOR WRITTEN NOTICE
OF THE INTENT TO DISCONTINUE AND SUBMIT A PLAN FOR DISCONTINUANCE THAT
INCLUDES BUT IS NOT LIMITED TO THE NOTICE THAT WILL BE PROVIDED TO THE
PUBLIC, CONSISTENT WITH PARAGRAPH (A) OF THIS SUBDIVISION, OF THE DETER-
MINATION TO DISCONTINUE FLUORIDATION OF THE WATER SUPPLY, INCLUDING THE
S. 4207 81
DATE OF SUCH DISCONTINUANCE AND ALTERNATIVES TO FLUORIDATION, IF ANY,
THAT WILL BE MADE AVAILABLE IN THE COMMUNITY, AND THAT INCLUDES INFORMA-
TION AS MAY BE REQUIRED UNDER THE SANITARY CODE.
4. THE COMMISSIONER IS HEREBY AUTHORIZED, WITHIN AMOUNTS APPROPRIATED
THEREFOR, TO MAKE GRANTS TO COUNTIES, CITIES, TOWNS OR VILLAGES THAT OWN
THEIR PUBLIC WATER SYSTEM AND THE WATER SUPPLY FOR SUCH SYSTEM, INCLUD-
ING A COUNTY WHEREIN A PUBLIC AUTHORITY OWNS BOTH ITS PUBLIC WATER
SYSTEM AND THE WATER SUPPLY FOR SUCH SYSTEM, FOR THE PURPOSE OF PROVID-
ING ASSISTANCE TOWARDS THE COSTS OF INSTALLATION, INCLUDING BUT NOT
LIMITED TO TECHNICAL AND ADMINISTRATIVE COSTS ASSOCIATED WITH PLANNING,
DESIGN AND CONSTRUCTION, AND START-UP OF FLUORIDATION SYSTEMS, AND
REPLACING, REPAIRING OR UPGRADING OF FLUORIDATION EQUIPMENT FOR SUCH
PUBLIC WATER SYSTEMS. GRANT FUNDING SHALL NOT BE AVAILABLE FOR ASSIST-
ANCE TOWARDS THE COSTS AND EXPENSES OF OPERATION OF THE FLUORIDATION
SYSTEM, AS DETERMINED BY THE DEPARTMENT. THE GRANT APPLICATIONS SHALL
INCLUDE SUCH INFORMATION AS REQUIRED BY THE COMMISSIONER. IN MAKING THE
GRANT AWARDS, THE COMMISSIONER SHALL CONSIDER THE DEMONSTRATED NEED FOR
INSTALLATION OF NEW FLUORIDATION EQUIPMENT OR REPLACING, REPAIRING OR
UPGRADING OF EXISTING FLUORIDATION EQUIPMENT, AND SUCH OTHER CRITERIA AS
DETERMINED BY THE COMMISSIONER. GRANT AWARDS SHALL BE MADE ON A COMPET-
ITIVE BASIS AND BE SUBJECT TO SUCH CONDITIONS AS MAY BE DETERMINED BY
THE COMMISSIONER.
S 2. This act shall take effect immediately.
PART N
Intentionally Omitted
PART O
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 C of chapter 58 of the laws of 2014, 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,
[2015] 2016; 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, [2015] 2016.
S 2. This act shall take effect immediately.
PART P
S. 4207 82
Section 1. Subparagraph 9 of paragraph h of subdivision 4 of section
1950 of the education law, as added by section 1 of part M of chapter 56
of the laws of 2012, is amended to read as follows:
(9) To enter into contracts with the commissioner of the office of
mental health, to provide special education [and], related services AND
ANY ALTERNATIVE EDUCATION PROGRAMS PROVIDED BY THE BOARD OF COOPERATIVE
EDUCATIONAL SERVICES TO COMPONENT SCHOOL DISTRICTS, in accordance with
subdivision six-b of section thirty-two hundred two of this chapter to
patients hospitalized in hospitals operated by the office of mental
health who are between the ages of five and twenty-one who have not
received a high school diploma. Any such proposed contract shall be
subject to the review by the commissioner and his [and] OR her determi-
nation that it is an approved cooperative educational service. Services
provided pursuant to such contracts shall be provided at cost and
approved by the commissioner of the office of mental health and the
director of the division of the budget, and the board of cooperative
educational services shall not be authorized to charge any costs
incurred in providing such services to its component school districts.
S 2. The opening paragraph of subdivision 6-b of section 3202 of the
education law, as added by section 2 of part M of chapter 56 of the laws
of 2012, is amended to read as follows:
The commissioner of mental health may meet his or her obligations
under section 33.11 of the mental hygiene law by contracting pursuant to
this subdivision for educational services for children between the ages
of five and twenty-one who do not hold a high school diploma and who are
hospitalized in hospitals operated by the office of mental health with
the trustees or board of education of any school district for educa-
tional services or with a board of cooperative educational services for
the provision of special education [and], related services AND ANY
ALTERNATIVE EDUCATION PROGRAMS PROVIDED BY THE BOARD OF COOPERATIVE
EDUCATIONAL SERVICES TO COMPONENT SCHOOL DISTRICTS to such children in
accordance with their individualized education programs. The costs of
such education shall not be a charge upon a school district pursuant to
section 33.11 of the mental hygiene law.
S 3. Section 4 of part M of chapter 56 of the laws of 2012 amending
the education law, relating to authorizing contracts for the provision
of special education and related services for certain patients hospital-
ized in hospitals operated by the office of mental health, is amended to
read as follows:
S 4. This act shall take effect July 1, 2012 and shall expire June 30,
[2015] 2018, when upon such date the provisions of this act shall be
deemed repealed.
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, 2015, provided,
however, that:
a. The amendments to subparagraph 9 of paragraph h of subdivision 4 of
section 1950 of the education law made by section one of this act shall
not affect the repeal of such subparagraph and shall be deemed repealed
therewith; and
b. The amendments to the opening paragraph of subdivision 6-b of
section 3202 of the education law made by section two of this act shall
not affect the repeal of such subdivision and shall be deemed repealed
therewith.
PART Q
S. 4207 83
Section 1. Section 2801-a of the public health law is amended by
adding a new subdivision 17 to read as follows:
17. (A) THE COMMISSIONER IS AUTHORIZED TO ESTABLISH A PILOT PROGRAM TO
ASSIST IN RESTRUCTURING HEALTH CARE DELIVERY SYSTEMS BY ALLOWING FOR
INCREASED CAPITAL INVESTMENT. PURSUANT TO THE PILOT PROGRAM, THE PUBLIC
HEALTH AND HEALTH PLANNING COUNCIL SHALL APPROVE THE ESTABLISHMENT, IN
ACCORDANCE WITH THE PROVISIONS OF PARAGRAPHS (F), (G) AND (H) OF THIS
SUBDIVISION AND SUBDIVISION THREE OF THIS SECTION, OF NO MORE THAN TEN
BUSINESS CORPORATIONS FORMED UNDER THE BUSINESS CORPORATION LAW. SUCH
BUSINESS CORPORATIONS SHALL AFFILIATE, THE EXTENT OF THE AFFILIATION TO
BE DETERMINED BY THE COMMISSIONER, WITH AT LEAST ONE ACADEMIC MEDICAL
INSTITUTION OR TEACHING HOSPITAL APPROVED BY THE COMMISSIONER. A BUSI-
NESS CORPORATION SHALL NOT BE ELIGIBLE TO PARTICIPATE IN THIS PROGRAM IF
ANY OF ITS STOCK, OR THAT OF ANY OF ITS DIRECT OR INDIRECT OWNERS, IS OR
WILL BE TRADED ON A PUBLIC STOCK EXCHANGE OR ON AN OVER-THE-COUNTER
MARKET.
(B) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, BUSINESS
CORPORATIONS ESTABLISHED PURSUANT TO THIS SUBDIVISION SHALL BE DEEMED
ELIGIBLE TO PARTICIPATE IN DEBT FINANCING PROVIDED BY THE DORMITORY
AUTHORITY OF THE STATE OF NEW YORK, LOCAL DEVELOPMENT CORPORATIONS AND
ECONOMIC DEVELOPMENT CORPORATIONS.
(C) THE FOLLOWING PROVISIONS OF THIS CHAPTER SHALL NOT APPLY TO BUSI-
NESS CORPORATIONS ESTABLISHED PURSUANT TO THIS SUBDIVISION: (I) PARA-
GRAPH (B) OF SUBDIVISION THREE OF THIS SECTION, RELATING TO STOCKHOLD-
ERS, OTHER THAN PRINCIPAL STOCKHOLDERS; (II) PARAGRAPH (C) OF
SUBDIVISION FOUR OF THIS SECTION, RELATING TO THE DISPOSITION OF STOCK
OR VOTING RIGHTS; (III) PARAGRAPHS (D) AND (E) OF SUBDIVISION FOUR OF
THIS SECTION, RELATING TO THE OWNERSHIP OF STOCK; AND (IV) PARAGRAPH (A)
OF SUBDIVISION THREE OF SECTION FOUR THOUSAND FOUR OF THIS CHAPTER,
RELATING TO THE OWNERSHIP OF STOCK. NOTWITHSTANDING THE FOREGOING, THE
PUBLIC HEALTH AND HEALTH PLANNING COUNCIL MAY REQUIRE THE DISCLOSURE OF
THE IDENTITY OF STOCKHOLDERS.
(D) THE CORPORATE POWERS AND PURPOSES OF A BUSINESS CORPORATION ESTAB-
LISHED AS AN OPERATOR PURSUANT TO THIS SUBDIVISION SHALL BE LIMITED TO
THE OWNERSHIP AND OPERATION, OR OPERATION, OF A HOSPITAL OR HOSPITALS
SPECIFICALLY NAMED AND THE LOCATION OR LOCATIONS OF WHICH ARE SPECIF-
ICALLY DESIGNATED BY STREET ADDRESS, CITY, TOWN, VILLAGE OR LOCALITY AND
COUNTY; PROVIDED, HOWEVER, THAT THE CORPORATE POWERS AND PURPOSES MAY
ALSO INCLUDE THE OWNERSHIP AND OPERATION, OR OPERATION, OF A CERTIFIED
HOME HEALTH AGENCY OR LICENSED HOME CARE SERVICES AGENCY OR AGENCIES AS
DEFINED IN ARTICLE THIRTY-SIX OF THIS CHAPTER OR A HOSPICE OR HOSPICES
AS DEFINED IN ARTICLE FORTY OF THIS CHAPTER, IF THE CORPORATION HAS
RECEIVED ALL APPROVALS REQUIRED UNDER SUCH LAW TO OWN AND OPERATE, OR
OPERATE, SUCH HOME CARE SERVICES AGENCY OR AGENCIES OR HOSPICE OR
HOSPICES. SUCH CORPORATE POWERS AND PURPOSES SHALL NOT BE MODIFIED,
AMENDED OR DELETED WITHOUT THE PRIOR APPROVAL OF THE COMMISSIONER.
(E)(1) IN DISCHARGING THE DUTIES OF THEIR RESPECTIVE POSITIONS, THE
BOARD OF DIRECTORS, COMMITTEES OF THE BOARD AND INDIVIDUAL DIRECTORS AND
OFFICERS OF A BUSINESS CORPORATION ESTABLISHED PURSUANT TO THIS SUBDIVI-
SION SHALL CONSIDER THE EFFECTS OF ANY ACTION UPON:
(A) THE ABILITY OF THE BUSINESS CORPORATION TO ACCOMPLISH ITS PURPOSE;
(B) THE SHAREHOLDERS OF THE BUSINESS CORPORATION;
(C) THE EMPLOYEES AND WORKFORCE OF THE HOSPITAL OR HOSPITALS;
(D) THE INTERESTS OF PATIENTS OF THE HOSPITAL OR HOSPITALS;
S. 4207 84
(E) COMMUNITY AND SOCIETAL CONSIDERATIONS, INCLUDING THOSE OF ANY
COMMUNITY IN WHICH FACILITIES OF THE HOSPITAL OR HOSPITALS ARE LOCATED;
AND
(F) THE SHORT-TERM AND LONG-TERM INTERESTS OF THE BUSINESS CORPO-
RATION, INCLUDING BENEFITS THAT MAY ACCRUE TO THE BUSINESS CORPORATION
FROM ITS LONG-TERM PLANS.
(2) THE CONSIDERATION OF INTERESTS AND FACTORS IN THE MANNER REQUIRED
BY SUBPARAGRAPH ONE OF THIS PARAGRAPH:
(A) SHALL NOT CONSTITUTE A VIOLATION OF THE PROVISIONS OF SECTION
SEVEN HUNDRED FIFTEEN OR SEVEN HUNDRED SEVENTEEN OF THE BUSINESS CORPO-
RATION LAW; AND
(B) IS IN ADDITION TO THE ABILITY OF DIRECTORS TO CONSIDER INTERESTS
AND FACTORS AS PROVIDED IN SECTION SEVEN HUNDRED SEVENTEEN OF THE BUSI-
NESS CORPORATION LAW.
(F) WHILE ANY DECISION TO APPROVE A BUSINESS CORPORATION UNDER THIS
SECTION MUST WEIGH AND BALANCE A NUMBER OF FACTORS, IN DETERMINING
WHETHER TO APPROVE A BUSINESS CORPORATION UNDER THIS SECTION, THE PUBLIC
HEALTH AND HEALTH PLANNING COUNCIL, IN CONSULTATION WITH THE COMMISSION-
ER, SHALL CONSIDER THE EXTENT TO WHICH THE BUSINESS CORPORATION:
(1) PROVIDES FOR EITHER EQUAL OR MAJORITY GOVERNANCE RIGHTS OF THE
NOT-FOR-PROFIT HOSPITAL PARTNER, REGARDLESS OF EQUITY STAKES, THROUGH
WEIGHTED CLASS VOTING STRUCTURE OR OTHERWISE;
(2) INCORPORATES A REPRESENTATIVE GOVERNANCE MODEL THAT:
(A) CLEARLY DELINEATES AUTHORITY AND RESPONSIBILITY FOR THE HOSPITAL'S
OPERATIONS; AND
(B) DEFINES MECHANISMS FOR APPROVAL OF DESIGNATED SHAREHOLDERS OR
INVESTORS;
(3) IS INCORPORATED AS A BENEFIT CORPORATION UNDER THE BUSINESS CORPO-
RATION LAW;
(4) COMMITS TO MAINTAINING OR ENHANCING EXISTING LEVELS OF SERVICES,
CHARITY CARE AND CORE COMMUNITY BENEFITS;
(5) IDENTIFIES AN ACTIONABLE STRATEGY TO MONITOR AND MAINTAIN OR
IMPROVE QUALITY OF CARE;
(6) EXPLAINS THE LEVEL OF CAPITAL COMMITMENT AND THE MECHANISM OR
MECHANISMS FOR INFUSING CAPITAL INTO THE NOT-FOR-PROFIT HOSPITAL PART-
NER;
(7) EXPLAINS HOW IT WILL RETAIN THE WORKFORCE, EITHER IN EXISTING JOBS
OR THROUGH RETRAINING, AND ADDRESSES OBLIGATIONS OWED TO EMPLOYEE BENE-
FIT PLANS AND PENSIONS;
(8) WILL CREATE A FOUNDATION TO ADDRESS THE PUBLIC HEALTH NEEDS OF THE
COMMUNITY; AND
(9) IDENTIFIES HOW PROFIT DISTRIBUTIONS SHALL BE MADE IN A WAY TO
ENSURE THAT THE COMMUNITY'S ACCESS TO QUALITY CARE AND CORE COMMUNITY
BENEFITS ARE NOT COMPROMISED AND ACCESS TO CAPITAL IS NOT COMPROMISED.
NONE OF THE FOREGOING FACTORS SHALL BE DISPOSITIVE IN THE APPROVAL OR
DISAPPROVAL OF THE BUSINESS CORPORATION.
(G) NO BUSINESS CORPORATION SHALL BE APPROVED UNDER THIS SECTION THAT
FAILS TO ATTEST THAT IT WILL PROVIDE THE NOT-FOR-PROFIT HOSPITAL PARTNER
WITH THE EXCLUSIVE AUTHORITY OVER FUNCTIONS RELATING TO ITS EXEMPT
STATUS.
(H) THE BOARD OF DIRECTORS OF A BUSINESS CORPORATION ESTABLISHED
PURSUANT TO THIS SUBDIVISION SHALL BE DEEMED A "GOVERNING BODY" FOR THE
PURPOSES OF SECTION TWENTY-EIGHT HUNDRED THREE-L OF THIS ARTICLE AND
SHALL COMPLY WITH THE PROVISIONS OF SUCH SECTION, REGARDLESS OF THE
CORPORATION'S PROFIT-MAKING STATUS.
S. 4207 85
(I) A SALE, LEASE, CONVEYANCE, EXCHANGE, TRANSFER, OR OTHER DISPOSI-
TION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE BUSINESS CORPO-
RATION SHALL NOT BE EFFECTIVE UNLESS THE TRANSACTION IS APPROVED BY THE
COMMISSIONER.
NO SUCH TRANSACTION MAY OCCUR WITHIN THREE YEARS OF THE COMMISSIONER'S
APPROVAL OF THE BUSINESS CORPORATION'S PARTICIPATION IN THE DEMON-
STRATION PROJECT. IN APPROVING SUCH A TRANSACTION, THE COMMISSIONER
SHALL CONSIDER, AMONG OTHER THINGS, WHETHER THE TRANSACTION:
(1) IMPOSES SAFEGUARDS TO PROTECT QUALITY AND ACCESS TO CORE COMMUNITY
SERVICES DURING THE TRANSITION TO THE NEW INVESTOR;
(2) REQUIRES THE SUBSEQUENT INVESTOR TO GUARANTEE ALL OBLIGATIONS,
INCLUDING THOSE DESCRIBED IN SUBPARAGRAPH SEVEN OF PARAGRAPH (F) OF THIS
SUBDIVISION;
(3) WILL MAINTAIN THE HOSPITAL GOVERNANCE STRUCTURE; AND
(4) IMPOSES MINIMUM CAPITALIZATION CRITERIA POST-TRANSACTION.
(J) NO LATER THAN THREE YEARS AFTER THE ESTABLISHMENT OF A BUSINESS
CORPORATION UNDER THIS SUBDIVISION, THE COMMISSIONER SHALL PROVIDE THE
GOVERNOR, THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE
ASSEMBLY WITH A WRITTEN EVALUATION OF THE PILOT PROGRAM. SUCH EVALUATION
SHALL ADDRESS THE OVERALL EFFECTIVENESS OF THE PROGRAM IN ALLOWING FOR
ACCESS TO CAPITAL INVESTMENT AND THE IMPACT SUCH ACCESS MAY HAVE ON THE
QUALITY OF CARE PROVIDED BY HOSPITALS OPERATED BY BUSINESS CORPORATIONS
ESTABLISHED UNDER THIS SUBDIVISION.
S 2. Paragraph (b) of subdivision 2 of section 1676 of the public
authorities law is amended by adding a new undesignated paragraph to
read as follows:
SUCH BUSINESS CORPORATIONS AS ARE ESTABLISHED PURSUANT TO SUBDIVISION
SEVENTEEN OF SECTION TWENTY-EIGHT HUNDRED ONE-A OF THE PUBLIC HEALTH LAW
FOR THE ACQUISITION, CONSTRUCTION, RECONSTRUCTION, REHABILITATION AND
IMPROVEMENT, OR OTHERWISE PROVIDING, FURNISHING AND EQUIPPING OF A
HOSPITAL OR HOSPITALS.
S 3. Subdivision 1 of section 1680 of the public authorities law is
amended by adding a new undesignated paragraph to read as follows:
SUCH BUSINESS CORPORATIONS AS ARE ESTABLISHED PURSUANT TO SUBDIVISION
SEVENTEEN OF SECTION TWENTY-EIGHT HUNDRED ONE-A OF THE PUBLIC HEALTH LAW
FOR THE ACQUISITION, CONSTRUCTION, RECONSTRUCTION, REHABILITATION AND
IMPROVEMENT, OR OTHERWISE PROVIDING, FURNISHING AND EQUIPPING OF A
HOSPITAL OR HOSPITALS.
S 4. This act shall take effect immediately.
PART R
Section 1. Section 3 of part A of chapter 111 of the laws of 2010
amending the mental hygiene law relating to the receipt of federal and
state benefits received by individuals receiving care in facilities
operated by an office of the department of mental hygiene, as amended by
section 1 of part B of chapter 58 of the laws of 2014, is amended to
read as follows:
S 3. This act shall take effect immediately; and shall expire and be
deemed repealed June 30, [2015] 2018.
S 2. This act shall take effect immediately.
PART S
Section 1. Section 366 of the social services law is amended by adding
a new subdivision 7-a to read as follows:
S. 4207 86
7-A. A. THE COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMIS-
SIONER OF DEVELOPMENTAL DISABILITIES SHALL APPLY FOR A HOME AND COMMUNI-
TY-BASED WAIVER, PURSUANT TO SUBDIVISION (C) OF SECTION NINETEEN HUNDRED
FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT, IN ORDER TO PROVIDE HOME AND
COMMUNITY-BASED SERVICES FOR A POPULATION OF PERSONS WITH DEVELOPMENTAL
DISABILITIES, AS SUCH TERM IS DEFINED IN SECTION 1.03 OF THE MENTAL
HYGIENE LAW.
B. PERSONS ELIGIBLE FOR PARTICIPATION IN THE WAIVER PROGRAM SHALL:
(I) HAVE A DEVELOPMENTAL DISABILITY AS SUCH TERM IS DEFINED IN SUBDI-
VISION TWENTY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW;
(II) MEET THE LEVEL OF CARE CRITERIA PROVIDED BY AN INTERMEDIATE CARE
FACILITY FOR THE DEVELOPMENTALLY DISABLED;
(III) BE ELIGIBLE FOR MEDICAID;
(IV) LIVE AT HOME OR IN AN INDIVIDUALIZED RESIDENTIAL ALTERNATIVE,
COMMUNITY RESIDENCE OR FAMILY CARE HOME, OPERATED, FUNDED OR LICENSED BY
THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES OR OTHER APPROPRI-
ATE COMMUNITY SETTING AS DEFINED IN REGULATION BY THE COMMISSIONER OF
DEVELOPMENTAL DISABILITIES;
(V) BE CAPABLE OF BEING CARED FOR IN THE COMMUNITY IF PROVIDED WITH
SUCH SERVICES AS RESPITE, HOME ADAPTATION, OR OTHER HOME AND COMMUNITY-
BASED SERVICES, OTHER THAN ROOM AND BOARD, AS MAY BE APPROVED BY THE
SECRETARY OF THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES, IN
ADDITION TO OTHER SERVICES PROVIDED UNDER THIS TITLE, AS DETERMINED BY
THE ASSESSMENT REQUIRED BY PARAGRAPH C OF THIS SUBDIVISION;
(VI) HAVE A DEMONSTRATED NEED FOR HOME AND COMMUNITY BASED WAIVER
SERVICES; AND
(VII) MEET SUCH OTHER CRITERIA AS MAY BE ESTABLISHED BY THE COMMIS-
SIONER OF HEALTH AND THE COMMISSIONER OF DEVELOPMENTAL DISABILITIES, AS
MAY BE NECESSARY TO ADMINISTER THE PROVISIONS OF THIS SUBDIVISION.
C. THE COMMISSIONER OF DEVELOPMENTAL DISABILITIES SHALL ASSESS THE
ELIGIBILITY OF PERSONS ENROLLED, OR SEEKING TO ENROLL, IN THE WAIVER
PROGRAM. THE ASSESSMENT SHALL INCLUDE, BUT NEED NOT BE LIMITED TO, AN
EVALUATION OF THE HEALTH, PSYCHO-SOCIAL, DEVELOPMENTAL, HABILITATION AND
ENVIRONMENTAL NEEDS OF THE PERSON AND SHALL SERVE AS THE BASIS FOR THE
DEVELOPMENT AND PROVISION OF AN APPROPRIATE PERSON CENTERED PLAN OF CARE
FOR SUCH PERSON. THE ASSESSMENT SHALL EMPLOY A VALID MEASURE.
D. THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES SHALL UNDER-
TAKE OR ARRANGE FOR THE DEVELOPMENT OF A WRITTEN PERSON CENTERED PLAN OF
CARE FOR EACH PERSON ENROLLED IN THE WAIVER. SUCH PERSON CENTERED PLAN
OF CARE SHALL DESCRIBE THE PROVISION OF HOME AND COMMUNITY BASED WAIVER
SERVICES CONSISTENT WITH THE ASSESSMENT FOR EACH PERSON.
E. THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES SHALL REVIEW
THE PLAN OF CARE AND AUTHORIZE THOSE HOME AND COMMUNITY BASED SERVICES
TO BE INCLUDED IN THE PLAN OF CARE, TAKING INTO ACCOUNT THE PERSON'S
ASSESSED NEEDS, VALUED OUTCOMES AND AVAILABLE RESOURCES USING A VALID
MEASURE.
F. THE COMMISSIONERS OF DEVELOPMENTAL DISABILITIES AND HEALTH SHALL
DETERMINE QUALITY STANDARDS FOR ORGANIZATIONS PROVIDING SERVICES UNDER
SUCH WAIVER AND SHALL AUTHORIZE ORGANIZATIONS THAT MEET SUCH STANDARDS
TO PROVIDE SUCH SERVICES.
G. THE COMMISSIONERS OF DEVELOPMENTAL DISABILITIES AND HEALTH SHALL
PROMULGATE RULES AND REGULATIONS AS NECESSARY TO EFFECTUATE THE
PROVISIONS OF THIS SECTION.
H. THIS SUBDIVISION SHALL BE EFFECTIVE ONLY IF, AND AS LONG AS, FEDER-
AL FINANCIAL PARTICIPATION IS AVAILABLE FOR EXPENDITURES INCURRED UNDER
THIS SUBDIVISION.
S. 4207 87
S 2. Paragraph (a) of subdivision 4 of section 488 of the social
services law, as added by section 1 of part B of chapter 501 of the laws
of 2012, is amended to read as follows:
(a) a facility or program in which services are provided and which is
operated, licensed or certified by the office of mental health, the
office for people with developmental disabilities or the office of alco-
holism and substance abuse services, including but not limited to
psychiatric centers, inpatient psychiatric units of a general hospital,
developmental centers, intermediate care facilities, community resi-
dences, group homes and family care homes, provided, however, that such
term shall not include a secure treatment facility as defined in section
10.03 of the mental hygiene law, SERVICES DEFINED IN SUBPARAGRAPH FOUR
OF SUBDIVISION (A) OF SECTION 16.03 OF THE MENTAL HYGIENE LAW, or
services provided in programs or facilities that are operated by the
office of mental health and located in state correctional facilities
under the jurisdiction of the department of corrections and community
supervision;
S 3. Subdivision 2 of section 550 of the executive law, as added by
section 3 of part A of chapter 501 of the laws of 2012, is amended to
read as follows:
2. "Mental hygiene facility" shall mean a facility as defined in
subdivision six of section 1.03 of the mental hygiene law and facilities
for the operation of which an operating certificate is required pursuant
to article sixteen or thirty-one of the mental hygiene law and including
family care homes. "Mental hygiene facility" also means a secure treat-
ment facility as defined by article ten of the mental hygiene law. THIS
TERM SHALL NOT INCLUDE SERVICES DEFINED IN SUBPARAGRAPH FOUR OF SUBDIVI-
SION (A) OF SECTION 16.03 OF THE MENTAL HYGIENE LAW.
S 4. Subdivisions 3, 4, 5 and 22 of section 1.03 of the mental hygiene
law, subdivision 3 as amended by chapter 223 of the laws of 1992, subdi-
vision 4 as added by chapter 978 of the laws of 1977, subdivision 5 as
amended by chapter 75 of the laws of 2006, and subdivision 22 as amended
by chapter 255 of the laws of 2002, are amended to read as follows:
3. "Mental disability" means mental illness, [mental retardation]
INTELLECTUAL DISABILITY, developmental disability, alcoholism, substance
dependence, or chemical dependence. [A mentally disabled person is one
who has a mental disability.]
4. "Services for [the mentally disabled] PERSONS WITH A MENTAL DISA-
BILITY" means examination, diagnosis, care, treatment, rehabilitation,
SUPPORTS, HABILITATION or training of the mentally disabled.
5. "Provider of services" means an individual, association, corpo-
ration, partnership, limited liability company, or public or private
agency, other than an agency or department of the state, which provides
services for [the mentally disabled] PERSONS WITH A MENTAL DISABILITY.
It shall not include any part of a hospital as defined in article twen-
ty-eight of the public health law which is not being operated for the
purpose of providing services for the mentally disabled. No provider of
services shall be subject to the regulation or control of the department
or one of its offices except as such regulation or control is provided
for by other provisions of this chapter.
22. "Developmental disability" means a disability of a person which:
(a) (1) is attributable to [mental retardation] INTELLECTUAL DISABILI-
TY, cerebral palsy, epilepsy, neurological impairment, familial dysauto-
nomia or autism;
(2) is attributable to any other condition of a person found to be
closely related to [mental retardation] INTELLECTUAL DISABILITY because
S. 4207 88
such condition results in similar impairment of general intellectual
functioning or adaptive behavior to that of [mentally retarded] INTEL-
LECTUALLY DISABLED persons or requires treatment and services similar to
those required for such person; or
(3) is attributable to dyslexia resulting from a disability described
in subparagraph (1) or (2) of this paragraph;
(b) originates before such person attains age twenty-two;
(c) has continued or can be expected to continue indefinitely; and
(d) constitutes a substantial handicap to such person's ability to
function normally in society.
S 5. Intentionally omitted.
S 6. Subdivision (a) of section 16.03 of the mental hygiene law is
amended by adding a new paragraph 4 to read as follows:
(4) THE PROVISION OF HOME AND COMMUNITY BASED SERVICES APPROVED UNDER
A WAIVER PROGRAM AUTHORIZED PURSUANT TO SUBDIVISION (C) OF SECTION NINE-
TEEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT AND SUBDIVISIONS
SEVEN AND SEVEN-A OF SECTION THREE HUNDRED SIXTY-SIX OF THE SOCIAL
SERVICES LAW.
S 7. Section 16.03 of the mental hygiene law is amended by adding a
new subdivision (f) to read as follows:
(F) NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, THE
PROVISION OF LICENSED NURSING SERVICES SHALL BE AUTHORIZED AS PART OF
THE PROGRAMS CERTIFIED PURSUANT TO THIS ARTICLE.
S 8. Subdivision (a), paragraphs 2, 3, and 6 of subdivision (c), para-
graphs 1 and 4 of subdivision (d), subdivision (e), and subdivision (i)
of section 16.05 of the mental hygiene law, subdivision (a), paragraphs
2, 3, and 6 of subdivision (c), paragraphs 1 and 4 of subdivision (d)
and subdivision (e) as added by chapter 786 of the laws of 1983, para-
graph 6 of subdivision (c) and paragraph 4 of subdivision (d) as renum-
bered by chapter 618 of the laws of 1990, and subdivision (i) as amended
by chapter 37 of the laws of 2011, are amended to read as follows:
(a)(1) Application for an operating certificate shall be made upon
forms prescribed by the commissioner.
(2) Application shall be made by the person or entity responsible for
operation of the facility OR PROVISION OF SERVICES AS DESCRIBED IN
SUBDIVISION FOUR OF SECTION 16.03 OF THIS ARTICLE. Applications shall
be in writing, shall be verified and shall contain such information as
required by the commissioner.
(2) The character, competence and standing in the community of the
person or entity responsible for operating the facility OR PROVIDING
SERVICES;
(3) The financial resources of the proposed facility OR PROVIDER OF
SERVICES and its sources of future revenues;
(6) In the case of residential facilities, that arrangements have been
made with other providers of services for the provision of health,
habilitation, day treatment, education, sheltered workshop, transporta-
tion or other services as may be necessary to meet the needs of
[clients] INDIVIDUALS who will reside in the facility; and
(1) the financial resources of the proposed facility OR PROVIDER OF
SERVICES and its sources of future revenues;
(4) in the case of residential facilities, that arrangements have been
made with other providers of services for the provision of health,
habilitation, day treatment, education, sheltered workshop, transporta-
tion or other services as may be necessary to meet the needs of
[clients] INDIVIDUALS who will reside in the facility; and
S. 4207 89
(e) The commissioner may disapprove an application for an operating
certificate, may authorize fewer services than applied for, and may
place limitations or conditions on the operating certificate including,
but not limited to compliance with a time limited plan of correction of
any deficiency which does not threaten the health or well-being of any
[client] INDIVIDUALS. In such cases the applicant shall be given an
opportunity to be heard, at a public hearing if requested by the appli-
cant.
(i) In the event that the holder of an operating certificate for a
residential facility issued by the commissioner pursuant to this article
wishes to cease the operation or conduct of any of the activities, as
defined in paragraph one OR FOUR of subdivision (a) of section 16.03 of
this article, for which such certificate has been issued or to cease
operation of any one or more of facilities for which such certificate
has been issued; wishes to transfer ownership, possession or operation
of the premises and facilities upon which such activities are being
conducted or to transfer ownership, possession or operation of any one
or more of the premises or facilities for which such certificate has
been issued; or elects not to apply to the commissioner for re-certifi-
cation upon the expiration of any current period of certification, it
shall be the duty of such certificate holder to give to the commissioner
written notice of such intention not less than sixty days prior to the
intended effective date of such transaction. Such notice shall set forth
a detailed plan which makes provision for the safe and orderly transfer
of each person with a developmental disability served by such certif-
icate holder pursuant to such certificate into a program of services
appropriate to such person's on-going needs and/or for the continuous
provision of a lawfully operated program of such activities and services
at the premises and facilities to be conveyed by the certificate holder.
Such certificate holder shall not cease to provide any such services to
any such person with a developmental disability under any of the circum-
stances described in this section until the notice and plan required
hereby are received, reviewed and approved by the commissioner. For the
purposes of this paragraph, the requirement of prior notice and contin-
uous provision of programs and services by the certificate holder shall
not apply to those situations and changes in circumstances directly
affecting the certificate holder that are not reasonably foreseeable at
the time of occurrence, including, but not limited to, death or other
sudden incapacitating disability or infirmity. Written notice shall be
given to the commissioner as soon as reasonably possible thereafter in
the manner set forth within this subdivision.
S 9. Paragraph 1 of subdivision (a) of section 16.09 of the mental
hygiene law, as added by chapter 786 of the laws of 1983, is amended to
read as follows:
(1) "Facility" is limited to a facility in which services are offered
for which an operating certificate is required by this article. For the
purposes of this section facility shall include family care homes BUT
SHALL NOT INCLUDE THE PROVISION OF SERVICES, AS DEFINED IN PARAGRAPH
FOUR OF SUBDIVISION (A) OF SECTION 16.03 OF THIS ARTICLE, OUTSIDE OF A
FACILITY.
S 10. The section heading and subdivision (a) of section 16.11 of the
mental hygiene law are REPEALED and a new section heading and subdivi-
sion (a) are added to read as follows:
OVERSIGHT OF FACILITIES AND SERVICES. (A) THE COMMISSIONER SHALL
PROVIDE FOR THE OVERSIGHT OF FACILITIES AND PROVIDERS OF SERVICES HOLD-
ING OPERATING CERTIFICATES PURSUANT TO SECTION 16.03 OF THIS ARTICLE AND
S. 4207 90
SHALL PROVIDE FOR THE ANNUAL REVIEW OF SUCH FACILITIES AND PROVIDERS IN
IMPLEMENTING THE REQUIREMENTS OF THE OFFICE AND IN PROVIDING QUALITY
CARE AND PERSON CENTERED AND COMMUNITY BASED SERVICES.
(1) THE REVIEW OF FACILITIES ISSUED AN OPERATING CERTIFICATE PURSUANT
TO THIS ARTICLE SHALL INCLUDE A SITE VISIT TO OCCUR AT LEAST TWICE
DURING EACH CALENDAR YEAR AND SHALL BE WITHOUT PRIOR NOTICE. AREAS OF
REVIEW SHALL INCLUDE, BUT NOT BE LIMITED TO, A REVIEW OF A FACILITY'S:
PHYSICAL PLANT, FIRE SAFETY PROCEDURES, HEALTH CARE, PROTECTIVE OVER-
SIGHT, ABUSE AND NEGLECT PREVENTION, AND REPORTING PROCEDURES.
(2) THE REVIEW OF PROVIDERS OF SERVICES, AS DEFINED IN PARAGRAPH FOUR
OF SUBDIVISION (A) OF SECTION 16.03 OF THIS ARTICLE, SHALL ENSURE THAT
THE PROVIDER OF SERVICES COMPLIES WITH ALL THE REQUIREMENTS OF THE
APPLICABLE FEDERAL HOME AND COMMUNITY BASED SERVICES WAIVER PROGRAM AND
APPLICABLE FEDERAL REGULATION, SUBDIVISIONS SEVEN AND SEVEN-A OF SECTION
THREE HUNDRED SIXTY-SIX OF THE SOCIAL SERVICES LAW AND RULES AND REGU-
LATIONS ADOPTED BY THE COMMISSIONER.
S 11. Subdivisions (b), (c), (d), and (e) of section 16.11 of the
mental hygiene law, subdivision (b) as amended by chapter 37 of the laws
of 2011, and subdivisions (c), (d) and (e) as added by chapter 786 of
the laws of 1983, are amended to read as follows:
(b) The commissioner shall have the power to conduct investigations
into the operations of any PROVIDER OF SERVICE, person or entity which
holds an operating certificate issued by the office, into the operation
of any facility, SERVICE or program issued an operating certificate by
the office and into the operations, related to the provision of services
regulated by this chapter, of any person or entity providing a residence
for one or more unrelated persons with developmental disabilities.
(c) In conducting an inspection or investigation, the commissioner or
his OR HER authorized representative shall have the power to inspect
facilities, conduct interviews of clients, interview personnel, examine
and copy all records, including financial and medical records of the
facility OR PROVIDER OF SERVICES, and obtain such other information as
may be required in order to carry out his OR HER responsibilities under
this chapter.
(d) In conducting any inspection or investigation under this chapter,
the commissioner or his OR HER authorized representative is empowered to
subpoena witnesses, compel their attendance, administer oaths to
witnesses, examine witnesses under oath, and require the production of
any books or papers deemed relevant to the investigation, inspection, or
hearing. A subpoena issued under this section shall be regulated by the
civil practice law and rules.
(e) The supreme court may enjoin persons or entities subject to
inspection or investigation pursuant to this article to cooperate with
the commissioner and to allow the commissioner access to PROVIDERS OF
SERVICES, facilities, records, clients and personnel as necessary to
enable the commissioner to conduct the inspection or investigation.
S 12. Section 16.17 of the mental hygiene law, as added by chapter 786
of the laws of 1983, subdivision (a) and paragraph 2 and subparagraph b
of paragraph 1 of subdivision (b) as amended and subparagraph d of para-
graph 1 of subdivision (b) as relettered by chapter 169 of the laws of
1992, subdivision (b) as amended by chapter 856 of the laws of 1985, the
opening paragraph and subparagraph c of paragraph 1 of subdivision (b)
as amended by chapter 37 of the laws of 2011, subparagraph d of para-
graph 1 of subdivision (b) as added by chapter 618 of the laws of 1990,
paragraph 4 of subdivision (b) as amended by chapter 168 of the laws of
2010, paragraph 1 of subdivision (f) as amended by chapter 601 of the
S. 4207 91
laws of 2007, subdivision (g) as amended by chapter 24 of the laws of
2007, and subdivision (h) as amended by chapter 306 of the laws of 1995,
is amended to read as follows:
S 16.17 Suspension, revocation, or limitation of an operating certif-
icate.
(a) The commissioner may revoke, suspend, or limit an operating
certificate or impose the penalties described in subparagraph a, b, c or
d of paragraph one of subdivision (b) or in subdivision (g) of this
section upon a determination that the holder of the certificate has
failed to comply with the terms of its operating certificate or with the
provisions of any applicable statute, rule or regulation. The holder of
the certificate shall be given notice and an opportunity to be heard
prior to any such determination except that no such notice and opportu-
nity to be heard shall be necessary prior to an emergency suspension or
limitation of the facility's OR PROVIDER OF SERVICES' operating certif-
icate imposed pursuant to paragraph one of subdivision (b) of this
section, nor shall such notice and opportunity to be heard be necessary
should the commissioner, in his OR HER discretion, decide to issue sepa-
rate operating certificates to each facility OR PROVIDER OF SERVICES
formerly included under the services authorized by one operating certif-
icate to the provider of services.
(b) (1) An operating certificate may be temporarily suspended or
limited without a prior hearing for a period not in excess of sixty days
upon written notice to the facility OR PROVIDER OF SERVICES following a
finding by the office for people with developmental disabilities that a
[client's] INDIVIDUAL'S health or safety is in imminent danger. Upon
such finding and notice, the power of the commissioner temporarily to
suspend or limit an operating certificate shall include, but shall not
be limited to, the power to:
a. Prohibit or limit the placement of new [clients] INDIVIDUALS in the
facility OR SERVICES;
b. Remove or cause to be removed some or all of the [clients] INDIVID-
UALS in the facility OR SERVICES;
c. Suspend or limit or cause to be suspended or limited the payment of
any governmental funds to the facility OR PROVIDER OF SERVICES provided
that such action shall not in any way jeopardize the health, safety and
welfare of any person with a developmental disability in such program or
facility OR SERVICES;
d. Prohibit or limit the placement of new [clients] INDIVIDUALS,
remove or cause to be removed some or all [clients] INDIVIDUALS, or
suspend or limit or cause to be suspended or limited the payment of any
governmental funds, in or to any one or more of the facilities OR
PROVIDER OF SERVICES authorized pursuant to an operating certificate
[issued to a provider of services].
(2) At any time subsequent to the suspension or limitation of any
operating certificate pursuant to paragraph one of this subdivision
where said suspension or limitation is the result of correctable phys-
ical plant, staffing or program deficiencies, the facility OR PROVIDER
OF SERVICES may request the office to [reinspect] REVIEW the facility OR
PROVIDER OF SERVICES to redetermine whether a physical plant, staffing
or program deficiency continues to exist. After the receipt of such a
request, the office shall [reinspect] REVIEW the facility OR PROVIDER OF
SERVICES within ten days and in the event that the previously found
physical plant, staffing or program deficiency has been corrected, the
suspension or limitation shall be withdrawn. If the physical plant,
staffing or program deficiency has not been corrected, the commissioner
S. 4207 92
shall not thereafter be required to [reinspect] REVIEW the facility OR
PROVIDER OF SERVICES during the emergency period of suspension or limi-
tation.
(3) During the sixty day suspension or limitation period provided for
in paragraph one of this subdivision the commissioner shall determine
whether to reinstate or remove the limitations on the facility's OR
PROVIDER OF SERVICES' operating certificate or to revoke, suspend or
limit the operating certificate pursuant to subdivision (a) of this
section. Should the commissioner choose to revoke, suspend or limit the
operating certificate, then the emergency suspension or limitation
provided for in this subdivision shall remain in effect pending the
outcome of an administrative hearing on the revocation, suspension or
limitation.
(4) The facility operator OR PROVIDER OF SERVICES, within ten days of
the date when the emergency suspension or limitation pursuant to para-
graph one of this subdivision is first imposed, may request an evidenti-
ary hearing to contest the validity of the emergency suspension or limi-
tation. Such an evidentiary hearing shall commence within ten days of
the facility operator's OR PROVIDER'S request and no request for an
adjournment shall be granted without the concurrence of the facility
operator OR PROVIDER OF SERVICE, office for people with developmental
disabilities, and the hearing officer. The evidentiary hearing shall be
limited to those violations of federal and state law and regulations
that existed at the time of the emergency suspension or limitation and
which gave rise to the emergency suspension or limitation. The emergency
suspension or limitation shall be upheld upon a determination that the
office for people with developmental disabilities had reasonable cause
to believe that a [client's] INDIVIDUAL'S health or safety was in immi-
nent danger. A record of such hearing shall be made available to the
facility operator OR PROVIDER OF SERVICE upon request. Should the
commissioner determine to revoke, suspend or limit [the facility's] AN
operating certificate pursuant to subdivision (a) of this section, no
administrative hearing on that action shall commence prior to the
conclusion of the evidentiary hearing. The commissioner shall issue a
ruling within ten days after the receipt of the hearing officer's
report.
(c) When the holder of an operating certificate shall request an
opportunity to be heard, 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 regis-
tered or certified mail to the facility OR PROVIDER OF SERVICES at least
ten days before the date fixed for the hearing. The facility OR PROVIDER
OF SERVICES shall file with the office, not less than three days prior
to the hearing, a written answer to the charges.
(d) (1) When a hearing must be afforded pursuant to this section or
other provisions of this article, the commissioner, acting as hearing
officer, or any person designated by him OR HER as hearing officer,
shall have power to:
a. administer oaths and affirmations;
b. issue subpoenas, which shall be regulated by the civil practice law
and rules;
c. take testimony; or
d. control the conduct of the hearing.
(2) The rules of evidence observed by courts need not be observed
except that the rules of privilege recognized by law shall be respected.
Irrelevant or unduly repetitious evidence may be excluded.
S. 4207 93
(3) All parties shall have the right of counsel and be afforded an
opportunity to present evidence and cross-examine witnesses.
(4) If evidence at the hearing relates to the identity, condition, or
clinical record of [a client] AN INDIVIDUAL, the hearing officer may
exclude all persons from the room except parties to the proceeding,
their counsel and the witness. The record of such proceeding shall not
be available to anyone outside the office, other than a party to the
proceeding or his counsel, except by order of a court of record.
(5) The commissioner may establish regulations to govern the hearing
procedure and the process of determination of the proceeding.
(6) The commissioner shall issue a ruling within ten days after the
termination of the hearing or, if a hearing officer has been designated,
within ten days from the hearing officer's report.
(e) All orders or determinations hereunder shall be subject to review
as provided in article seventy-eight of the civil practice law and
rules.
(f) (1) Except as provided in paragraph two of this subdivision,
anything contained in this section to the contrary notwithstanding, an
operating certificate of a facility OR PROVIDER OF SERVICE shall be
revoked upon a finding by the office that any individual, member of a
partnership or shareholder of a corporation to whom or to which an oper-
ating certificate has been issued, has been convicted of a class A, B or
C felony or a felony related in any way to any activity or program
subject to the regulations, supervision, or administration of the office
or of the office of temporary and disability assistance, the department
of health, or another office of the department of mental hygiene, or in
violation of the public officers law in a court of competent jurisdic-
tion of the state, or in a court in another jurisdiction for an act
which would have been a class A, B or C felony in this state or a felony
in any way related to any activity or program which would be subject to
the regulations, supervision, or administration of the office or of the
office of temporary and disability assistance, the department of health,
or another office of the department of mental hygiene, or for an act
which would be in violation of the public officers law. The commissioner
shall not revoke or limit the operating certificate of any facility OR
PROVIDER OF SERVICE, solely because of the conviction, whether in the
courts of this state or in the courts of another jurisdiction, more than
ten years prior to the effective date of such revocation or limitation,
of any person of a felony, or what would amount to a felony if committed
within the state, unless the commissioner makes a determination that
such conviction was related to an activity or program subject to the
regulations, supervision, and administration of the office or of the
office of temporary and disability assistance, the department of health,
or another office of the department of mental hygiene, or in violation
of the public officers law.
(2) In the event one or more members of a partnership or shareholders
of a corporation shall have been convicted of a felony as described in
paragraph one of this subdivision, the commissioner shall, in addition
to his OR HER other powers, limit the existing operating certificate of
such partnership or corporation so that it shall apply only to the
remaining partner or shareholders, as the case may be, provided that
every such convicted person immediately and completely ceases and with-
draws from participation in the management and operation of the facility
OR PROVIDER OF SERVICES and further provided that a change of ownership
or transfer of stock is completed without delay, and provided that such
partnership or corporation shall immediately reapply for a certificate
S. 4207 94
of operation pursuant to subdivision (a) of section 16.05 of this arti-
cle.
(g) The commissioner may impose a fine upon a finding that the holder
of the certificate has failed to comply with the terms of the operating
certificate or with the provisions of any applicable statute, rule or
regulation. The maximum amount of such fine shall be one thousand
dollars per day or fifteen thousand dollars per violation.
Such penalty may be recovered by an action brought by the commissioner
in any court of competent jurisdiction OR BY OFFSETTING SUCH PENALTY
AGAINST A FUTURE MEDICAID OR OFFICE PAYMENT TO SUCH PROVIDER.
Such penalty may be released or compromised by the commissioner before
the matter has been referred to the attorney general. Any such penalty
may be released or compromised and any action commenced to recover the
same may be settled or discontinued by the attorney general with the
consent of the commissioner.
(h) Where a proceeding has been brought pursuant to section 16.27 of
this article, and a receiver appointed pursuant thereto, the commission-
er may assume operation of the facility subject to such receivership,
upon termination of such receivership, and upon showing to the court
having jurisdiction over such receivership that no voluntary associ-
ation, not-for-profit corporation or other appropriate provider is will-
ing to assume operation of the facility subject to receivership and is
capable of meeting the requirements of this article; provided that the
commissioner notifies the chairman of the assembly ways and means
committee, the chairman of the senate finance committee and the director
of the budget of his intention to assume operation of such facility upon
service of the order to show cause upon the owner or operator of the
facility, pursuant to subdivision (b) of section 16.27 of this article.
S 13. Paragraph 5 of subdivision (a) of section 16.29 of the mental
hygiene law, as amended by section 9 of part C of chapter 501 of the
laws of 2012, is amended to read as follows:
(5) removing a service recipient when it is determined that there is a
risk to such person if he or she continues to remain in a facility OR
SERVICE PROGRAM; and
S 14. Paragraph (ii) of subdivision (c) of section 16.29 of the mental
hygiene law, as amended by section 9 of part C of chapter 501 of the
laws of 2012, is amended to read as follows:
(ii) development and implementation of a plan of prevention and reme-
diation, in the event an investigation of a report of an alleged report-
able incident exists and such reportable incident may be attributed in
whole or in part to noncompliance by the facility OR PROVIDER OF
SERVICES with the provisions of this chapter or regulations of the
office applicable to the operation of such facility OR PROVIDER OF
SERVICES. Any plan of prevention and remediation required to be devel-
oped pursuant to this subdivision by a facility supervised by the office
shall be submitted to and approved by such office in accordance with
time limits established by regulations of such office. Implementation of
the plan shall be monitored by such office. In reviewing the continued
qualifications of a residential facility OR PROVIDER OF SERVICES or
program for an operating certificate, the office shall evaluate such
facility's OR PROVIDER OF SERVICE'S compliance with plans of prevention
and remediation developed and implemented pursuant to this subdivision.
S 15. This act shall take effect immediately.
PART T
S. 4207 95
Section 1. Subdivision (a) of section 41.35 of the mental hygiene law,
as amended by chapter 658 of the laws of 1977, is amended to read as
follows:
(a) The commissioners of the offices in the department shall cause to
be developed plans for three or more time-limited demonstration
programs, the purpose of which shall be to test and evaluate new methods
or arrangements for organizing, financing, staffing and providing
services for the mentally disabled in order to determine the desirabil-
ity of such methods or arrangements. Subject to regulations established
by the commissioners and notwithstanding 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, such programs may include but shall not be limited to comprehensive
organizational structures to serve all mentally disabled persons within
the purview of a local governmental unit, innovative financing and
staffing arrangements and specific programs to serve the mentally disa-
bled. Such demonstration programs shall be consistent with established
statewide goals and objectives and local comprehensive plans, shall be
developed in conjunction with the local comprehensive planning process,
and shall be submitted to the single agent jointly designated by the
commissioners of the department for review and approval by the commis-
sioner or commissioners having jurisdiction of the services.
S 2. This act shall take effect immediately.
PART U
Section 1. Short title. This act shall be known and may be cited as the
"employment first choice act".
S 2. Legislative intent. The legislature hereby supports increasing
access to integrated employment settings for individuals with develop-
mental disabilities. The legislature additionally finds, however, that
the policy to increase integrated employment opportunities shall not
preclude an individual's right to choose either an integrated or nonin-
tegrated setting in accordance with such individual's personal wishes.
Furthermore, the legislature supports an individual's wish to remain in
a nonintegrated setting in order to, among other personal priorities,
retain friendships, continue their participation in their community as
they so choose, and, in some instances, maintain their ability to earn a
paycheck.
The legislature, therefore, finds that individuals with developmental
disabilities, who currently participate in a nonintegrated setting,
should be allowed to choose to remain in such a setting. To require such
individuals to transition out of this chosen environment undermines the
guiding Supreme Court decision in Olmstead v. L.C., which held that the
Americans with Disabilities Act of 1990 requires placement of individ-
uals with developmental disabilities in integrated settings rather than
nonintegrated settings, but only when such a transfer is not opposed by
the affected individual. The legislature, therefore, declares this act
to be a priority of the state's actions affecting individuals with
developmental disabilities.
S 3. The mental hygiene law is amended by adding a new section 16.02
to read as follows:
S 16.02 INDIVIDUAL'S RIGHT OF CHOICE.
ANY INDIVIDUAL WITH A DEVELOPMENTAL DISABILITY WHO IS PARTICIPATING IN
A NONINTEGRATED SETTING INCLUDING, BUT NOT LIMITED TO, A SHELTERED WORK-
SHOP, AND WHO CHOOSES TO REMAIN IN A NONINTEGRATED SETTING MAY SEEK
S. 4207 96
ACCOMMODATION FROM THE COMMISSIONER TO ALLOW SUCH PLACEMENT, PROVIDED
THAT PENDING SUCH REQUEST THE INDIVIDUAL MAY REMAIN IN THE NONINTEGRATED
SETTING.
(A) ACCOMMODATIONS SHALL BE GRANTED AT THE DISCRETION OF THE COMMIS-
SIONER, WHO MAY ALSO REQUIRE THAT THE INDIVIDUAL HAS COMPLETED AT LEAST
ONE OF THE FOLLOWING:
(1) PARTICIPATION IN AT LEAST ONE VOCATIONAL ASSESSMENT EVERY FIVE
YEARS IN ACCORDANCE WITH REGULATIONS PROMULGATED BY THE COMMISSIONER.
THE PRIMARY PURPOSE OF A VOCATIONAL ASSESSMENT SHALL BE TO DETERMINE AN
INDIVIDUAL'S INTERESTS, STRENGTHS AND ABILITIES, IN ORDER TO IDENTIFY A
SUITABLE MATCH BETWEEN THE INDIVIDUAL AND A COMPETITIVE INTEGRATED
EMPLOYMENT SETTING;
(2) COMPLETION OF ONE TRIAL INTEGRATED WORK EXPERIENCE EVERY FIVE
YEARS, WHICH CAN INCLUDE ANY WORK EXPERIENCE WITH OR WITHOUT PAY IN
WHICH THE INDIVIDUAL WORKS ALONGSIDE NON-DISABLED COWORKERS, CUSTOMERS
OR PEERS, WITH THE APPROPRIATE SERVICES AND SUPPORTS FOR A SUFFICIENT
PERIOD OF TIME TO ESTABLISH WHETHER AN INDIVIDUAL'S INTERESTS, SKILLS
AND ABILITIES ARE WELL-SUITED FOR THE PARTICULAR JOB. THE TRIAL INTE-
GRATED WORK EXPERIENCE SHALL BE SELECTED THROUGH A PERSON-CENTERED PLAN-
NING PROCESS AND SHALL BE INDIVIDUALLY TAILORED TO EACH PERSON. ALTERNA-
TIVELY, THE COMMISSIONER SHALL CONSIDER THE INDIVIDUAL'S DEMONSTRATION
OF AN INABILITY TO PARTICIPATE IN AN INTEGRATED WORK SETTING DUE TO A
DOCUMENTED MEDICAL CONDITION THAT POSES AN IMMEDIATE AND SERIOUS THREAT
TO THE INDIVIDUAL'S HEALTH OR SAFETY, OR THE HEALTH OR SAFETY OF OTHERS
IN AN INTEGRATED WORK SETTING;
(3) RECEIPT OF OUTREACH, EDUCATION AND SUPPORT SERVICES IN ACCORDANCE
WITH REGULATIONS PROMULGATED BY THE COMMISSIONER. OUTREACH, EDUCATION
AND SUPPORT SERVICES ARE SERVICES DESIGNED TO EXPLAIN THE BENEFITS OF
SUPPORTED EMPLOYMENT, AS DEFINED IN SUBDIVISION ELEVEN OF SECTION ONE
THOUSAND TWO OF THE EDUCATION LAW, THAT ADDRESS CONCERNS OF FAMILIES AND
PERCEIVED OBSTACLES TO PARTICIPATION, AND ARE DESIGNED TO ENCOURAGE
INDIVIDUALS IN DAY ACTIVITY SERVICE PROGRAMS, INCLUDING IN SHELTERED
WORKSHOPS AND FACILITY-BASED DAY PROGRAMS, AND THEIR FAMILIES TO SEEK
SUPPORTED EMPLOYMENT SERVICES, AS DEFINED UNDER SUBDIVISION TWELVE OF
SECTION ONE THOUSAND TWO OF THE EDUCATION LAW; OR
(4) INVOLVEMENT IN A BENEFITS COUNSELING CONSULTATION IN ACCORDANCE
WITH REGULATIONS PROMULGATED BY THE COMMISSIONER. A BENEFIT COUNSELING
CONSULTATION SHALL PROVIDE INFORMATION TO THE INDIVIDUAL AND HIS OR HER
FAMILY OR GUARDIAN ABOUT THE IMPACT OF EARNED INCOME ON THE INDIVIDUAL'S
PUBLIC BENEFITS.
(B) THE OFFICE SHALL ENSURE THAT INDIVIDUALS WHO ARE GRANTED ACCOMMO-
DATION TO PARTICIPATE IN A NONINTEGRATED SETTING SHALL CONTINUE TO
RECEIVE SERVICES AND ANY ADDITIONAL SERVICES THE OFFICE DETERMINES ARE
NECESSARY TO ENABLE THE INDIVIDUAL'S MEANINGFUL PARTICIPATION IN THE
CHOSEN SETTING.
(C) THE PROCEDURES FOR OBTAINING ACCOMMODATION TO REMAIN IN A NONINTE-
GRATED SETTING SHALL NOT SUPERSEDE NOR BAR THE INDIVIDUAL'S CHOICE TO
REMAIN IN A NONINTEGRATED SETTING.
(D) THE ACCOMMODATION TO REMAIN IN A NONINTEGRATED SETTING SHALL NOT
DIMINISH THE INDIVIDUAL'S ELIGIBILITY FOR RECEIPT OF SERVICES UNDER
TITLE ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW, AND SUCH INDI-
VIDUAL'S ELIGIBILITY TO RECEIVE SUCH SERVICES SHALL BE SUBSTANTIALLY
SIMILAR TO BENEFITS THAT WOULD HAVE BEEN RECEIVED HAD THE INDIVIDUAL
CHOSEN TO PARTICIPATE IN AN INTEGRATED SETTING.
S. 4207 97
(E) THE COMMISSIONER IS AUTHORIZED TO ISSUE, AMEND OR REPEAL ANY REGU-
LATIONS AS HE OR SHE SHALL DEEM NECESSARY TO IMPLEMENT THE PROVISIONS OF
THIS SECTION.
S 4. The commissioner of developmental disabilities shall amend and
resubmit to the Federal Centers for Medicare and Medicaid Services the
final New York plan to increase competitive employment opportunities for
people with developmental disabilities, as approved on May 1, 2014, in
order to secure the continued federal financial participation for prevo-
cational services and any other necessary federal funds for those indi-
viduals choosing a sheltered workshop setting pursuant to section 16.02
of the mental hygiene law. The plan, as amended according to this
section, shall stipulate that facility-based prevocational services
shall continue to be eligible for federal funding, as allowed by such
centers' stated policy that its regulations do not prohibit individuals
from receiving prevocational services in a facility-based setting, such
as a sheltered workshop, as referenced in its Informational Bulletin on
Employment Services dated September 16, 2011, and its related document
titled "HCBS Final Regulations 42 C.F.R. Part 441: Questions and Answers
Regarding Home and Community-Based Settings; Public Notice and
Comments".
S 5. This act shall take effect immediately.
PART V
Section 1. Section 13.17 of the mental hygiene law is amended by
adding a new subdivision (d) to read as follows:
(D) 1. THE COMMISSIONER SHALL ENSURE FOR CONTINUITY OF CARE FOR INDI-
VIDUALS WITH A DEVELOPMENTAL DISABILITY TRANSITIONING TO LESS RESTRIC-
TIVE SETTINGS PURSUANT TO ANY CLOSURE, CONSOLIDATION, MERGER OR ANY
OTHER ACTION THAT DIMINISHES CURRENT STATE OPERATED SERVICES. THE
COMMISSIONER SHALL ENSURE THAT INDIVIDUALS WITH A DEVELOPMENTAL DISABIL-
ITY SO AFFECTED ARE GIVEN THE OPTION OF TRANSITIONING TO STATE OPERATED
SERVICES WITHIN THE DEVELOPMENTALLY DISABLED SERVICE OFFICES REGION
WHERE THEY ARE CURRENTLY RECEIVING SERVICES. IF NO SUCH STATE SERVICE AS
REQUESTED BY THE INDIVIDUALS WITH A DEVELOPMENTAL DISABILITY OR THEIR
PARENT, GUARDIAN OR ADVOCATE ARE AVAILABLE THEN SUCH INDIVIDUAL SHALL
REMAIN IN THE FACILITY OR RESIDENCE UNTIL SAID SERVICES ARE AVAILABLE.
THE COMMISSIONER SHALL DOCUMENT EACH OFFER OF STATE OPERATED OPPORTU-
NITIES AND SHALL RETAIN A RECORD OF THE SERVICES OFFERED.
2. IN THE EVENT NO SERVICES DESIRED BY THE INDIVIDUALS THAT ARE DEVEL-
OPMENTALLY DISABLED ARE EITHER AVAILABLE OR EXIST WITHIN CURRENT STATE
OPERATED SERVICES, THE OFFICE SHALL RECORD THE NAME, PARENT, GUARDIAN OR
ADVOCATE AND SERVICES THEY ARE SEEKING. THE COMMISSIONER SHALL DEVELOP A
RECORD OF SERVICES FOR STATE OPERATED SUPPORTIVE PLACEMENT OPTIONS THAT
ARE NOT AVAILABLE WITH A PLAN TO ADDRESS THE UNMET NEEDS FOR THE FOLLOW-
ING FISCAL YEAR. SUCH COMMISSIONER SHALL SUBMIT THE PLAN TO THE TEMPO-
RARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY NO LATER
THAN DECEMBER THIRTY-FIRST OF EACH YEAR.
S 2. This act shall take effect immediately.
PART W
Section 1. Section 7.17 of the mental hygiene law is amended by adding
a new subdivision (g) to read as follows:
(G) THE COMMISSIONER SHALL PROVIDE MONTHLY STATUS REPORTS ON COMMUNITY
INVESTMENTS AND THE IMPACT ON INPATIENT CENSUS TO THE CHAIRS OF THE
S. 4207 98
SENATE FINANCE COMMITTEE AND THE ASSEMBLY WAYS AND MEANS COMMITTEE. SUCH
REPORT SHALL INCLUDE, BUT NOT BE LIMITED TO:
(1) A STATE OPERATED PSYCHIATRIC FACILITY CENSUS;
(2) LOW TO HIGH CENSUS RANGE;
(3) AVERAGE DAILY CENSUS;
(4) ADMISSIONS AND DISCHARGES;
(5) PSYCHIATRIC READMISSIONS TO HOSPITALS AND EMERGENCY ROOMS FOR
STATE PC DISCHARGES;
(6) PSYCHIATRIC READMISSIONS TO HOSPITALS AND EMERGENCY ROOMS FOR
ARTICLE TWENTY-EIGHT AND ARTICLE THIRTY-ONE HOSPITALS PSYCHIATRIC UNIT
DISCHARGES;
(7) MEDICAID EMERGENCY ROOM PSYCHIATRIC VISITS;
(8) DESCRIPTIONS OF NEW COMMUNITY SERVICE REINVESTMENTS;
(9) AN EXPLANATION OF ANY MATERIAL CENSUS REDUCTIONS;
(10) MEDIAN LENGTH OF STAY AT EACH FACILITY;
(11) THE NUMBER OF INDIVIDUALS WHO ARE LONG STAY AT EACH FACILITY;
(12) THE NUMBER OF INDIVIDUALS OUT OF THE CATCHMENT AREA ADMITTED INTO
FACILITIES IN THE CATCHMENT AREA;
(13) THE NUMBER OF INDIVIDUALS IN THE CATCHMENT AREA ADMITTED INTO
FACILITIES OUT OF THE CATCHMENT AREA;
(14) ARTICLE TWENTY-EIGHT AND THIRTY-ONE HOSPITAL REINVESTMENT SUMMA-
RIES PURSUANT TO CHAPTER FIFTY-THREE OF THE LAWS OF TWO THOUSAND FOUR-
TEEN FOR SERVICES AND EXPENSES OF THE MEDICAL ASSISTANCE PROGRAM TO
ADDRESS COMMUNITY MENTAL HEALTH SERVICE NEEDS RESULTING FROM THE
REDUCTION OF PSYCHIATRIC INPATIENT SERVICES; AND
(15) A GLOSSARY OF SERVICES.
S 2. Section 13.17 of the mental hygiene law, as amended by section 1
of part J of chapter 56 of the laws of 2012, is amended to read as
follows:
S 13.17 Programs, services, and operations in the office for people with
developmental disabilities.
(a) The commissioner shall establish policy and procedures for the
organization, administration, and service delivery system under his or
her jurisdiction and shall make provision for the effective rendition of
supports and services to individuals with developmental disabilities.
(b) There shall be, within the state operations offices of the office,
the developmental disabilities services offices named below serving the
areas either currently or previously served by a school, for the care
and treatment of persons with developmental disabilities and for
research and teaching in the science and skills required for the care
and treatment of such persons with developmental disabilities:
Bernard M. Fineson Developmental Disabilities Services Office
Brooklyn Developmental Disabilities Services Office
Broome Developmental Disabilities Services Office
Capital District Developmental Disabilities Services Office
Central New York Developmental Disabilities Services Office
Finger Lakes Developmental Disabilities Services Office
Institute for Basic Research in Developmental Disabilities
Hudson Valley Developmental Disabilities Services Office
Metro New York Developmental Disabilities Services Office
Long Island Developmental Disabilities Services Office
Sunmount Developmental Disabilities Services Office
Taconic Developmental Disabilities Services Office
Western New York Developmental Disabilities Services Office
Staten Island Developmental Disabilities Services Office
S. 4207 99
The New York State Institute for Basic Research in Developmental Disa-
bilities is designated as an institute for the conduct of medical
research and other scientific investigation directed towards furthering
knowledge of the etiology, diagnosis, treatment and prevention of devel-
opmental disabilities.
(c) The commissioner shall establish, at his or her discretion, devel-
opmental disabilities regional offices and shall establish state oper-
ations offices that provide for the direct delivery of supports and
services by the office for people with developmental disabilities.
[(c)] (D) The commissioner may authorize other offices of the depart-
ment and any public or private non-profit organization or political
subdivision of the state to deliver supports and services to individuals
with developmental disabilities, not inconsistent with the programs and
objectives of the office in any facility under his jurisdiction. The
commissioner may permit any facility under his jurisdiction to operate
programs for persons with mental disabilities, not inconsistent with
programs and objectives of the department, under contracts or agreements
with other offices within the department.
(E) THE COMMISSIONER SHALL PROVIDE MONTHLY STATUS REPORTS TO THE
CHAIRS OF THE SENATE FINANCE COMMITTEE AND THE ASSEMBLY WAYS AND MEANS
COMMITTEE. SUCH REPORT SHALL INCLUDE, BUT NOT BE LIMITED TO:
(1) CURRENT CENSUS BY FACILITY;
(2) ADMISSIONS AND DISCHARGES;
(3) THE NUMBER OF INDIVIDUALS WHO ARE LONG STAY AT EACH FACILITY;
(4) AN EXPLANATION OF ANY SIGNIFICANT CENSUS REDUCTIONS; AND
(5) COMMUNITY SERVICES PROVIDED TO INDIVIDUALS LEAVING FACILITIES,
INCLUDING THOSE INDIVIDUALS WITH COMPLEX NEEDS.
S 3. This act shall take effect immediately.
PART X
Section 1. The commissioner of the office for people with develop-
mental disabilities, in collaboration with the developmental disabili-
ties advisory council established pursuant to section 13.05 of the
mental hygiene law, shall develop a plan for implementing the front door
process. Such commissioner shall submit the plan to the temporary presi-
dent of the senate and the speaker of the assembly no later than January
1, 2016 and implement guidelines putting the plan into effect on or
after April 1, 2016, but no later than July 1, 2016. The plan shall:
(a) Provide clear and specific guidelines outlining the criteria for
when self-direction is and is not appropriate for individuals.
(b) Provide guidelines for a clear, expeditious and transparent proc-
ess for allocating residential placements and other critical services to
persons based on their individual needs. Such process shall be consist-
ent across the state and where exceptions are made such exceptions shall
be made in explicit recognition of clear and rational factors. Such
guidelines shall:
(1) Ensure that critical needs are met in a timely fashion;
(2) Provide an expedited appeals process to review and finally deter-
mine authorized requests for critical services when the state has not
granted such a request promptly considering the circumstances, provided,
however, that such appeal must be authorized if the request has not been
granted within ten business days;
(3) Provide linguistically and culturally appropriate information on
services and access to services in a universally clear and transparent
manner;
S. 4207 100
(4) Provide designated staff which may include a Medicaid service
coordinator to assist prospective service recipients and their families
with navigating the front door process;
(5) Provide a process to ensure that people in crisis are not subject
to the front door process and receive immediate services;
(6) Report on the extent to which the front door policy, as it has
been implemented, is consistent with applicable requirements for the
home and community based waiver regarding timeliness of decisions,
comprehensiveness of necessary services, choice, persons centered plan-
ning and other matters affecting the appropriateness and adequacy of
services for people with developmental disabilities.
(7) Provide guidelines to facilitate and support the evaluation of
post-secondary options for individuals with developmental disabilities
consistent with subparagraph 5 of paragraph b of subdivision 1 of
section 4402 of the education law.
S 2. This act shall take effect immediately.
PART Y
Section 1. Section 13.15 of the mental hygiene law is amended by
adding a new subdivision (c) to read as follows:
(C) (1) FOR PURPOSES OF THIS SUBDIVISION, THE FOLLOWING TERMS SHALL
HAVE THE FOLLOWING MEANINGS:
(A) "DIRECT SUPPORT PROFESSIONALS" MEANS DIRECT SUPPORT WORKERS,
DIRECT CARE WORKERS, PERSONAL ASSISTANTS, PERSONAL ATTENDANTS, AND PARA-
PROFESSIONALS THAT PROVIDE ASSISTANCE TO INDIVIDUALS WITH DEVELOPMENTAL
DISABILITIES IN THE FORM OF DAILY LIVING, AND PROVIDE THE HABILITATION,
REHABILITATION, AND VOCATIONAL AND EDUCATIONAL NEEDS OF THESE INDIVID-
UALS.
(B) "LICENSED PROFESSIONALS" MEANS PHYSICIANS, DENTISTS, DENTAL
HYGIENISTS, DENTAL ASSISTANTS, NURSE PRACTITIONERS, LICENSED PRACTICAL
NURSES, REGISTERED NURSES, PSYCHIATRISTS, PSYCHOLOGISTS, LICENSED MASTER
SOCIAL WORKERS, OR LICENSED CLINICAL SOCIAL WORKERS, LICENSED TO PRAC-
TICE PURSUANT TO THE EDUCATION LAW AND OTHER QUALIFIED MENTAL HEALTH
PROFESSIONALS.
(C) "SUPPORTS AND SERVICES" MEANS DIRECT SUPPORT PROFESSIONALS,
LICENSED PROFESSIONALS, EMPLOYMENT, TRANSPORTATION, DAY AND RESIDENTIAL
SERVICES, INCLUDING, BUT NOT LIMITED TO, PRIVATE RESIDENCES, COMMUNITY-
INTEGRATED LIVING ARRANGEMENTS, SUPPORTED RESIDENTIAL PROGRAMS, SUPER-
VISED RESIDENTIAL PROGRAMS, OR SUPPORTIVE HOUSING PROGRAMS.
(2) THE COMMISSIONER SHALL CONDUCT AN ANNUAL GEOGRAPHIC ANALYSIS OF
SUPPORTS AND SERVICES IN COMMUNITY SETTINGS FOR INDIVIDUALS WITH DEVEL-
OPMENTAL DISABILITIES IN EACH COUNTY OF THE STATE IN ORDER TO IDENTIFY
GAPS BETWEEN SUPPORTS AND SERVICES CURRENTLY PROVIDED AND SUPPORTS AND
SERVICES BEING REQUESTED BY INDIVIDUALS IN EACH COUNTY OF THE STATE. THE
ANALYSIS SHALL BE BASED UPON INFORMATION CURRENTLY MAINTAINED BY THE
OFFICE.
(A) THE COMMISSIONER SHALL CATEGORIZE THE NEEDS FOR DEVELOPMENTAL
DISABILITY SERVICES WITHIN A FRAMEWORK THAT ENCOMPASSES THREE LEVELS OF
URGENCY OF NEEDS. THESE LEVEL OF SUPPORT NEEDS ARE: (I) EMERGENCY NEED,
FOR THOSE PERSONS WITH DEVELOPMENTAL DISABILITIES IN NEED OF IMMEDIATE
SUPPORT EITHER DAY SUPPORT OR IN-HOME OR OUT-OF-HOME PLACEMENT; (II)
CRITICAL NEED FOR THOSE INDIVIDUALS WHO WILL HAVE A NEED FOR SUPPORTS OR
SERVICES WITHIN ONE YEAR; AND (III) PLANNING FOR NEED, FOR THOSE INDI-
VIDUALS WHOSE SUPPORT NEEDS ARE ONE TO FIVE YEARS AWAY, OR WHERE THE
CAREGIVER'S PHYSICAL AND MENTAL WELL-BEING OR ABILITY IS COMPROMISED.
S. 4207 101
(B) THE GEOGRAPHIC ANALYSIS SHALL INCLUDE:
(I) THE STATEWIDE NUMBER OF INDIVIDUALS SEEKING SERVICES;
(II) INDIVIDUALS WHO HAVE REGISTERED FOR RESIDENTIAL PLACEMENT, RESI-
DENTIAL SUPPORTS IN THE COMMUNITY, DAY SERVICE SUPPORT, HOME AND COMMU-
NITY-BASED WAIVER SUPPORT, EMPLOYMENT SUPPORT, BEHAVIORAL HEALTH
SERVICES AND SUPPORTS, OR OTHER COMMUNITY-BASED SUPPORT;
(III) RESIDENTIAL REGISTRY DATA SUCH AS:
(I) THE TYPE OF SUPPORTS AND SERVICES SUCH INDIVIDUALS ARE SEEKING AND
THE TYPES OF SUPPORTS AND SERVICES SUCH INDIVIDUAL IS EXPECTED TO
REQUIRE BASED UPON INDIVIDUAL SERVICES PLANNING MODEL (ISPM) GROUPING
SCORES DIVIDED INTO CERTIFIED OUT-OF-HOME, SUPERVISED, SUPPORTIVE PLACE-
MENT NEEDS AND OTHER NON-PLACEMENT NEEDS AND THE NUMBER OF SUCH PERSONS
WHO ARE MEDICALLY FRAIL REQUIRING INTENSIVE MEDICAL CARE;
(II) NON-CERTIFIED RESIDENTIAL PLACEMENTS OUTSIDE THE PARENT'S OR
PARENTS' OR OTHER FAMILY CAREGIVER'S HOME;
(III) THE NUMBER OF INDIVIDUALS EXPECTED TO REQUIRE HOME AND COMMUNITY
SERVICES WAIVER-FUNDED HABILITATION SERVICES AT HOME;
(IV) THE TOTAL NUMBER OF INDIVIDUALS, WHO HAVE BEEN IDENTIFIED AS IN
NEED OF SUPPORTS AND SERVICES WHO HAVE RECEIVED THESE SUPPORTS AND
SERVICES AND ANY GAP BETWEEN SUPPORTS AND SERVICES REQUESTED AND THE
SUPPORTS AND SERVICES PROVIDED;
(V) THE NUMBER OF EMERGENCY NEED RESIDENTIAL PLACEMENTS FOR THE PAST
YEAR AND OTHER SUPPORTS AND SERVICES PROVIDED ON AN EMERGENCY BASIS;
(VI) THE NUMBER OF INDIVIDUALS WHO ARE CURRENTLY RECEIVING SUPPORTS
AND SERVICES, INCLUDING RESIDENTIAL SERVICES, WHO ARE AWAITING AN ALTER-
NATIVE PLACEMENT OR ALTERNATIVE SUPPORT AND SERVICE DELIVERY OPTIONS;
(VII) THE NUMBER OF INDIVIDUALS THE COMMISSIONER HAS IDENTIFIED AS
HAVING AN EMERGENCY NEED, FOR THOSE PERSONS WITH DEVELOPMENTAL DISABILI-
TIES IN NEED OF IMMEDIATE SUPPORT EITHER DAY SUPPORT OR IN-HOME OR OUT-
OF-HOME PLACEMENT; CRITICAL NEED FOR THOSE INDIVIDUALS WHO WILL HAVE A
NEED FOR SUPPORTS OR SERVICES WITHIN ONE YEAR; AND PLANNING FOR NEED,
FOR THOSE INDIVIDUALS WHOSE SUPPORT NEEDS ARE ONE TO FIVE YEARS AWAY, OR
WHERE THE CAREGIVER'S PHYSICAL AND MENTAL WELL-BEING OR ABILITY IS
COMPROMISED; AND
(VIII) ANY OTHER INFORMATION DEEMED NECESSARY BY THE COMMISSIONER.
(3) IN ORDER TO PERFORM THE GEOGRAPHIC ANALYSIS OR TO GATHER DATA FOR
PURPOSES OF PERFORMING THE GEOGRAPHIC ANALYSIS, THE COMMISSIONER MAY
WORK IN COOPERATION AND AGREEMENT WITH OTHER OFFICES, DEPARTMENTS OR
AGENCIES OF THE STATE, LOCAL OR FEDERAL GOVERNMENT, OR OTHER ORGANIZA-
TIONS AND INDIVIDUALS, WHICH MAY INCLUDE PROVIDERS OF SERVICES FOR
PERSONS WITH DEVELOPMENTAL DISABILITIES, REPRESENTATIVES FROM EMPLOYEE
ORGANIZATIONS REPRESENTING DIRECT CARE WORKERS, CONSUMER REPRESENTATIVES
INCLUDING PERSONS WITH DEVELOPMENTAL DISABILITIES, OR THEIR PARENTS OR
GUARDIANS.
(4) THE COMMISSIONER SHALL MAKE PUBLIC EACH ANNUAL ANALYSIS NO LATER
THAN THE FIRST DAY OF THE FIRST MONTH FOLLOWING THE END OF THE PRECEDING
YEAR, BY POSTING THE DATA ON THE OFFICE WEBSITE.
S 2. This act shall take effect immediately.
PART Z
Section 1. Section 6801-a of the education law, as added by chapter 21
of the laws of 2011, is amended to read as follows:
S 6801-a. Collaborative drug therapy management [demonstration
program]. 1. As used in this section, the following terms shall have the
following meanings:
S. 4207 102
a. "Collaborative drug therapy management" shall mean the performance
of services by a pharmacist relating to the review, evaluation and
management of drug therapy to a patient, who is being treated by a
physician OR NURSE PRACTITIONER for a specific disease or disease state,
in accordance with a written agreement or protocol with a voluntarily
participating physician OR NURSE PRACTITIONER and in accordance with the
policies, procedures, and protocols of the facility. Such agreement or
protocol as entered into by the physician OR NURSE PRACTITIONER and a
pharmacist, may include, and shall be limited to:
(i) [adjusting or managing] PRESCRIBING IN ORDER TO ADJUST OR MANAGE a
drug regimen of a patient, pursuant to a patient specific written order
or protocol made by the patient's physician OR NURSE PRACTITIONER, which
may include adjusting drug strength, frequency of administration or
route of administration. Adjusting the drug regimen shall not include
substituting or selecting a different drug which differs from that
initially prescribed by the patient's physician OR NURSE PRACTITIONER
unless such substitution is expressly authorized in the written order or
protocol. The pharmacist shall be required to immediately enter into the
patient record any change or changes made to the patient's drug therapy
and shall use any reasonable means or method established by the facility
or the department to notify any of the patient's other treating physi-
cians OR NURSE PRACTITIONERS with whom he or she does not have a written
agreement or protocol regarding such changes. The patient's physician OR
NURSE PRACTITIONER may prohibit, by written instruction, any adjustment
or change in the patient's drug regimen by the pharmacist;
(ii) evaluating and, only if specifically authorized by the protocol
and only to the extent necessary to discharge the responsibilities set
forth in this section, ordering clinical laboratory tests related to the
drug therapy management for the specific disease or disease state speci-
fied within the protocol; and
(iii) only if specifically authorized by the protocol and only to the
extent necessary to discharge the responsibilities set forth in this
section, ordering or performing routine patient monitoring functions as
may be necessary in the drug therapy management, including the collect-
ing and reviewing of patient histories, and ordering or checking patient
vital signs, including pulse, temperature, blood pressure and respira-
tion.
b. "Written agreement or protocol" shall mean a written document,
pursuant to and consistent with any applicable state or federal require-
ments, that addresses a specific disease or disease state and that
describes the nature and scope of collaborative drug therapy management
to be undertaken by the pharmacist, in collaboration with the partic-
ipating physician OR NURSE PRACTITIONER, in accordance with the
provisions of this section.
c. "Physician OR NURSE PRACTITIONER" shall mean the physician OR NURSE
PRACTITIONER, selected by or assigned to a patient, who has primary
responsibility for the treatment and care of the patient for the disease
or disease state that is the subject of the collaborative drug therapy
management.
d. "Facility" shall mean a [teaching] hospital, [including any diag-
nostic center, treatment center, or hospital-based outpatient depart-
ment, however, for the purposes of this section, residential health care
facilities and nursing homes shall be excluded] AS DEFINED BY SUBDIVI-
SION ONE OF SECTION TWENTY-EIGHT HUNDRED ONE OF THE PUBLIC HEALTH LAW.
[For the purposes of this section, a "teaching hospital" shall mean a
hospital licensed pursuant to article twenty-eight of the public health
S. 4207 103
law that is eligible to receive direct or indirect graduate medical
education payments pursuant to article twenty-eight of the public health
law.] IN ADDITION, A FACILITY MAY ALSO INCLUDE UP TO FIFTEEN COMMUNITY-
PRACTICE SITES, SELECTED BY THE DEPARTMENT IN CONSULTATION WITH THE
DEPARTMENT OF HEALTH, WHERE PHARMACISTS AND PHYSICIANS OR NURSE PRACTI-
TIONERS MAY PROPOSE TO ENTER INTO COLLABORATIVE ARRANGEMENTS, PURSUANT
TO THE PROVISIONS OF THIS SECTION. SUCH SITES SHALL BE SELECTED BASED
UPON A REVIEW OF APPLICATIONS SUBMITTED TO THE DEPARTMENT BY SUCH PHAR-
MACISTS AND PHYSICIANS OR NURSE PRACTITIONERS, WHICH DEMONSTRATE THAT
THE APPLICANTS CAN SATISFY THE REQUIREMENTS OF THIS SECTION.
2. a. A pharmacist who meets the experience requirements of paragraph
b of this subdivision and who is EITHER employed by or otherwise affil-
iated with a facility OR IS PARTICIPATING WITH A COMMUNITY-PRACTICE SITE
SELECTED PURSUANT TO PARAGRAPH D OF SUBDIVISION ONE OF THIS SECTION
shall be permitted to enter into a written agreement or protocol with a
physician OR NURSE PRACTITIONER authorizing collaborative drug therapy
management, subject to the limitations set forth in this section, within
the scope of such employment [or], affiliation OR PARTICIPATION.
b. A participating pharmacist must:
(i)(A) have been awarded either a master of science in clinical phar-
macy or a doctor of pharmacy degree;
(B) maintain a current unrestricted license; and
(C) have a minimum of two years experience, of which at least one year
of such experience shall include clinical experience in a health facili-
ty, which involves consultation with physicians OR NURSE PRACTITIONERS
with respect to drug therapy and may include a residency at a facility
involving such consultation; or
(ii)(A) have been awarded a bachelor of science in pharmacy;
(B) maintain a current unrestricted license; and
(C) within the last seven years, have a minimum of three years experi-
ence, of which at least one year of such experience shall include clin-
ical experience in a health facility, which involves consultation with
physicians OR NURSE PRACTITIONERS with respect to drug therapy and may
include a residency at a facility involving such consultation.
c. Notwithstanding any provision of this section, nothing herein shall
authorize the pharmacist to diagnose disease. In the event that a treat-
ing physician OR NURSE PRACTITIONER may disagree with the exercise of
professional judgment by the pharmacist, the judgment of the treating
physician OR NURSE PRACTITIONER shall prevail.
3. The physician OR NURSE PRACTITIONER who is a party to a written
agreement or protocol authorizing collaborative drug therapy management
IN A FACILITY SETTING shall be employed by or otherwise affiliated with
the same facility with which the pharmacist is also employed or affil-
iated.
4. The existence of a written agreement or protocol on collaborative
drug therapy management and the patient's right to choose to not partic-
ipate in collaborative drug therapy management shall be disclosed to any
patient who is eligible to receive collaborative drug therapy manage-
ment. Collaborative drug therapy management shall not be utilized unless
the patient or the patient's authorized representative consents, in
writing, to such management. If the patient or the patient's authorized
representative consents, it shall be noted on the patient's medical
record. If the patient or the patient's authorized representative who
consented to collaborative drug therapy management chooses to no longer
participate in such management, at any time, it shall be noted on the
patient's medical record. In addition, the existence of the written
S. 4207 104
agreement or protocol and the patient's consent to such management shall
be disclosed to the patient's primary physician OR NURSE PRACTITIONER
and any other treating physician OR NURSE PRACTITIONER or healthcare
provider.
5. Participation in a written agreement or protocol authorizing colla-
borative drug therapy management shall be voluntary, and no patient,
physician, NURSE PRACTITIONER, pharmacist, or facility shall be required
to participate.
6. Nothing in this section shall be deemed to limit the scope of prac-
tice of pharmacy nor be deemed to limit the authority of pharmacists and
physicians OR NURSE PRACTITIONERS to engage in medication management
prior to the effective date of this section and to the extent authorized
by law.
S 2. Section 5 of chapter 21 of the laws of 2011 amending the educa-
tion law relating to authorizing pharmacists to perform collaborative
drug therapy management with physicians in certain settings, as amended
by chapter 125 of the laws of 2014, is amended to read as follows:
S 5. This act shall take effect on the one hundred twentieth day after
it shall have become a law [and shall expire 4 years after such effec-
tive date when upon such date the provisions of this act shall be deemed
repealed]; provided, however, that the amendments to subdivision 1 of
section 6801 of the education law made by section one of this act shall
be subject to the expiration and reversion of such subdivision pursuant
to section 8 of chapter 563 of the laws of 2008, when upon such date the
provisions of section one-a of this act shall take effect; provided,
further, that effective immediately, the addition, amendment and/or
repeal of any rule or regulation necessary for the implementation of
this act on its effective date is authorized and directed to be made and
completed on or before such effective date.
S 3. This act shall take effect immediately; provided, however, that
section two of this act shall take effect on the one hundred twentieth
day after it shall have become a law; provided that, effective imme-
diately, the addition, amendment and/or repeal of any rule or regulation
necessary for the implementation of this act on its effective date is
authorized and directed to be made and completed on or before such
effective date.
PART AA
Section 1. Section 7.17 of the mental hygiene law is amended by adding
a new subdivision (g) to read as follows:
(G) THE COMMISSIONER SHALL ESTABLISH THE SINGLE POINT OF ACCESS WAIT
LIST FOR INDIVIDUALS SEEKING HOUSING AND RELATED SERVICES WITHIN THE
OFFICE OF MENTAL HEALTH SERVICES SYSTEM.
(1) THE COMMISSIONER SHALL USE THE DATA REPORTED TO THE OFFICE BY
COUNTIES AND THIRD PARTY ENTITIES CONTRACTED TO PROVIDE SINGLE POINT OF
ACCESS SUPPORT SERVICES AS REQUIRED BY PARAGRAPH SEVENTEEN OF SUBDIVI-
SION (A) OF SECTION 41.13 OF THIS CHAPTER, TO GENERATE THE SINGLE POINT
OF ACCESS WAIT LIST FOR INDIVIDUALS SEEKING HOUSING AND RELATED SERVICES
WITHIN THE OFFICE OF MENTAL HEALTH SERVICES SYSTEM.
(2) THE INFORMATION PROVIDED IN THE SINGLE POINT OF ACCESS WAIT LIST
SHALL INCLUDE BUT NOT BE LIMITED TO:
(I) THE NAME OF EACH PERSON WHO IS REFERRED TO, APPLIES FOR, IS ADMIT-
TED TO, WITHDRAWS AN APPLICATION FOR OR IS DENIED ACCESS TO HOUSING
PROGRAMS OR RELATED SERVICES THROUGH EACH COUNTY'S SINGLE POINT OF
ACCESS PROGRAM;
S. 4207 105
(II) THE NAMES OF PERSONS REFERRED TO A HOUSING SERVICES PROVIDER BY
THE COUNTY OR THIRD PARTY ENTITY CONTRACTED TO PROVIDE SINGLE POINT OF
ACCESS SUPPORT SERVICES VIA THE SINGLE POINT OF ACCESS PROGRAM;
(III) THE NAME OF EACH PERSON RECEIVING MENTAL HEALTH RESIDENTIAL
SERVICES OR PLACED IN HOUSING VIA THE SINGLE POINT OF ACCESS PROGRAM;
AND
(IV) ANY OTHER INFORMATION AS THE COMMISSIONER MAY REQUIRE.
(3) THE COMMISSIONER SHALL MAKE PUBLIC THE SINGLE POINT OF ACCESS WAIT
LIST BY POSTING THE DATA, ABSENT PERSONAL IDENTIFICATION INFORMATION ON
THE OFFICE OF MENTAL HEALTH WEBSITE. THE COMMISSIONER SHALL REGULARLY
UPDATE THE OFFICE OF MENTAL HEALTH WEBSITE TO ACCURATELY REFLECT CHANGES
TO THE SINGLE POINT OF ACCESS WAIT LIST AS NEW DATA IS REPORTED BUT
SHALL NOT EXCEED A PERIOD LONGER THAN SEVENTY DAYS BETWEEN UPDATES.
(4) THE COMMISSIONER SHALL ESTABLISH POLICIES, PROCEDURES AND FORMS
FOR THE SINGLE POINT OF ACCESS WAIT LIST IN ORDER TO ENSURE COUNTIES AND
THIRD PARTY ENTITIES CONTRACTED TO PROVIDE SINGLE POINT OF ACCESS
SUPPORT SERVICES ARE ABLE TO SUBMIT WAIT LIST INFORMATION, AS OUTLINED
BY PARAGRAPHS SEVENTEEN, EIGHTEEN AND NINETEEN OF SUBDIVISION (A) OF
SECTION 41.13 OF THIS CHAPTER, DIRECTLY TO THE OFFICE VIA ELECTRONIC
MEANS. SUCH POLICIES, PROCEDURES AND FORMS SHALL SAFEGUARD THE CONFIDEN-
TIALITY OF INFORMATION CONCERNING PERSONS SEEKING HOUSING, AND ACCORD
EACH PERSON ON THE WAIT LIST AN OPPORTUNITY TO RECEIVE A WRITTEN COPY OF
HIS OR HER PERSONAL INFORMATION MAINTAINED ON THE WAIT LIST. SUCH POLI-
CIES AND PROCEDURES SHALL PROVIDE FOR THE SINGLE POINT OF ACCESS WAIT
LIST TO INCLUDE ALL PERSONS ON ANY LOCAL WAIT LIST FOR HOUSING BEFORE
THE EFFECTIVE DATE OF THIS SUBDIVISION AND THE DATE UPON WHICH EACH SUCH
PERSON WAS FIRST PLACED ON SUCH WAIT LIST. SUCH LIST SHALL ALSO INCLUDE
PERSONS WHO ARE PLACED ON ANY SUCH LOCAL WAIT LIST ON OR AFTER THE
EFFECTIVE DATE OF THIS SUBDIVISION.
(5) THE COMMISSIONER SHALL PREPARE A REPORT ON THE SINGLE POINT OF
ACCESS WAIT LIST OF PERSONS SEEKING HOUSING WITHIN THE MENTAL HEALTH
SYSTEM. THE REPORT SHALL INCLUDE BUT NOT BE LIMITED TO: (I) THE NUMBER
OF ADULTS REFERRED TO THE SINGLE POINT OF ACCESS WAIT LIST; (II) THE
NUMBER OF ADULTS THAT APPLIED FOR EACH CATEGORY OF RESIDENTIAL SERVICE;
(III) THE NUMBER OF ADULTS ADMITTED TO EACH CATEGORY OF RESIDENTIAL
SERVICE; (IV) THE NUMBER OF ADULTS DENIED ADMISSION FOR EACH CATEGORY OF
RESIDENTIAL SERVICE; (V) THE NUMBER OF ADULTS WHO WITHDREW APPLICATIONS
FOR EACH CATEGORY OF RESIDENTIAL SERVICE; AND (VI) THE NUMBER OF ADULTS
ON THE SINGLE POINT OF ACCESS WAIT LIST FOR EACH CATEGORY OF RESIDENTIAL
SERVICE. SUCH REPORT SHALL INCLUDE FOR EACH CATEGORY AND COUNTY, THE
NUMBER OF MONTHS ON THE SINGLE POINT OF ACCESS WAIT LIST FOR EACH
PERSON. SUCH REPORT SHALL INCLUDE THE TYPES, CAPACITIES AND VACANCY
RATES OF RESIDENTIAL SERVICES OFFERED IN EACH COUNTY. THE REPORTS SHALL
INCLUDE ANY ACTIONS TAKEN BY THE OFFICE TO REDUCE THE LENGTH OF THE
SINGLE POINT OF ACCESS WAIT LIST FOR EACH CATEGORY OF RESIDENTIAL
SERVICES, INCLUDING THE METHODS BY WHICH THE OFFICE PRIORITIZES THE
PROVISIONS OF SERVICES TO PERSONS ON THE SINGLE POINT OF ACCESS WAIT
LIST AND THE ACTIONS OF THE OFFICE TO INFORM THE PUBLIC ABOUT THE SINGLE
POINT OF ACCESS WAIT LIST AND THE AVAILABILITY OF COMMUNITY HOUSING AND
SERVICES FOR ADULTS WITH A DOCUMENTED MENTAL ILLNESS. THE OFFICE SHALL
SUBMIT THE REPORT TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF THE SENATE
AND THE SPEAKER OF THE ASSEMBLY ON OR BEFORE JANUARY FIRST, TWO THOUSAND
SEVENTEEN AND QUARTERLY THEREAFTER.
S 2. Subdivision (a) of section 41.13 of the mental hygiene law is
amended by adding three new paragraphs 17, 18 and 19 to read as follows:
S. 4207 106
17. USING DATA CONTAINED IN THE SINGLE POINT OF ACCESS DATABASE,
REPORT EVERY SIXTY DAYS TO THE OFFICE THE NAME OF EACH PERSON WHO IS
REFERRED TO, APPLIES FOR, IS ADMITTED TO, WITHDRAWS AN APPLICATION FOR
OR IS DENIED ACCESS TO HOUSING PROGRAMS OR RELATED SERVICES THROUGH THE
COUNTY'S SINGLE POINT OF ACCESS PROGRAM, ALONG WITH SUCH OTHER INFORMA-
TION AS THE COMMISSIONER MAY REQUIRE.
18. USING DATA CONTAINED IN THE SINGLE POINT OF ACCESS DATABASE,
REPORT THE NAMES OF PERSONS REFERRED TO A HOUSING SERVICES PROVIDER BY
THE COUNTY OR THIRD PARTY ENTITY CONTRACTED TO PROVIDE SINGLE POINT OF
ACCESS SUPPORT SERVICES VIA THE SINGLE POINT OF ACCESS PROGRAM TO THE
OFFICE, ALONG WITH SUCH OTHER INFORMATION AS THE COMMISSIONER MAY
REQUIRE.
19. USING DATA CONTAINED IN THE SINGLE POINT OF ACCESS DATABASE,
REPORT THE NAME OF EACH PERSON RECEIVING MENTAL HEALTH RESIDENTIAL
SERVICES OR PLACED IN HOUSING, ALONG WITH SUCH OTHER INFORMATION AS THE
COMMISSIONER MAY REQUIRE.
S 3. This act shall take effect on the one hundred twentieth 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 and directed to be made and completed on or before such
effective date.
PART BB
Section 1. Subparagraph (iv) of paragraph (a) of subdivision 3 of
section 3309 of the public health law, as added by chapter 42 of the
laws of 2014, is amended to read as follows:
(iv) "Opioid antagonist recipient" or "recipient" means a person at
risk of experiencing an opioid-related overdose, or a family member,
friend or other person in a position to assist a person experiencing or
at risk of experiencing an opioid-related overdose, or an organization
registered as an opioid overdose prevention program pursuant to this
section, OR A SCHOOL DISTRICT, BOARD OF COOPERATIVE EDUCATIONAL
SERVICES, COUNTY VOCATIONAL EDUCATION AND EXTENSION BOARD, CHARTER
SCHOOL, NON-PUBLIC ELEMENTARY AND/OR SECONDARY SCHOOL IN THE STATE OR
ANY PERSON EMPLOYED BY SUCH DISTRICT, BOARD OR SCHOOL.
S 2. Subdivision 4 of section 3309 of the public health law, as
amended by chapter 42 of the laws of 2014, is amended to read as
follows:
4. Use of an opioid antagonist pursuant to this section shall be
considered first aid or emergency treatment for the purpose of any stat-
ute relating to liability.
A recipient, opioid overdose prevention program, SCHOOL DISTRICT,
BOARD OF COOPERATIVE EDUCATIONAL SERVICES, COUNTY VOCATIONAL EDUCATION
AND EXTENSION BOARD, CHARTER SCHOOL, NON-PUBLIC ELEMENTARY AND/OR
SECONDARY SCHOOL IN THE STATE, OR ANY PERSON EMPLOYED BY SUCH DISTRICT,
BOARD OR SCHOOL under this section, acting reasonably and in good faith
in compliance with this section, shall not be subject to criminal, civil
or administrative liability solely by reason of such action.
S 3. Subdivision 3 of section 3309 of the public health law, as added
by chapter 34 of the laws of 2014, is renumbered subdivision 3-a.
S 4. The education law is amended by adding a new section 922 to read
as follows:
S 922. OPIOID OVERDOSE PREVENTION. 1. SCHOOL DISTRICTS, BOARDS OF
COOPERATIVE EDUCATIONAL SERVICES, COUNTY VOCATIONAL EDUCATION AND EXTEN-
S. 4207 107
SION BOARDS, CHARTER SCHOOLS, AND NON-PUBLIC ELEMENTARY AND SECONDARY
SCHOOLS IN THIS STATE MAY PROVIDE AND MAINTAIN ON-SITE IN EACH INSTRUC-
TIONAL SCHOOL FACILITY OPIOID ANTAGONISTS, AS DEFINED IN SECTION THREE
THOUSAND THREE HUNDRED NINE OF THE PUBLIC HEALTH LAW, IN QUANTITIES AND
TYPES DEEMED BY THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER
OF HEALTH, TO BE ADEQUATE TO ENSURE READY AND APPROPRIATE ACCESS FOR USE
DURING EMERGENCIES TO ANY STUDENT OR STAFF HAVING OPIOID OVERDOSE WHETH-
ER OR NOT THERE IS A PREVIOUS HISTORY OF OPIOID ABUSE.
2. SCHOOL DISTRICTS, BOARDS OF COOPERATIVE EDUCATIONAL SERVICES, COUN-
TY VOCATIONAL EDUCATION AND EXTENSION BOARDS, CHARTER SCHOOLS, AND NON-
PUBLIC ELEMENTARY AND SECONDARY SCHOOLS IN THIS STATE OR ANY PERSON
EMPLOYED BY ANY SUCH ENTITY MAY ADMINISTER AN OPIOID ANTAGONIST IN THE
EVENT OF AN EMERGENCY PURSUANT TO THE REQUIREMENTS OF SECTION THREE
THOUSAND THREE HUNDRED NINE OF THE PUBLIC HEALTH LAW.
S 5. Subdivision 4 of section 6909 of the education law is amended by
adding a new paragraph (f) to read as follows:
(F) THE URGENT OR EMERGENCY TREATMENT OF OPIOID RELATED OVERDOSE OR
SUSPECTED OPIOID RELATED OVERDOSE.
S 6. Subdivision 6 of section 6527 of the education law is amended by
adding a new paragraph (f) to read as follows:
(F) THE URGENT OR EMERGENCY TREATMENT OF OPIOID RELATED OVERDOSE OR
SUSPECTED OPIOID RELATED OVERDOSE.
S 7. This act shall take effect immediately.
PART CC
Section 1. Section 48-a of 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, as amended by
section 13 of part C of chapter 60 of the laws of 2014, is amended to
read as follows:
S 48-a. Notwithstanding any contrary provision of law, the commission-
ers 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
S. 4207 108
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 the chapter
of the laws of [2014] 2015 which amended this section through [December
31, 2016] JUNE 30, 2018 for patients in the city of New York, for all
rate periods on and after the effective date of the chapter of the laws
of [2014] 2015 which amended this section through [June 30, 2017]
SEPTEMBER 30, 2018 for patients outside the city of New York, and for
all rate periods on and after the effective date of such chapter of the
laws of [2014] 2015 which amended this section through December 31,
[2017] 2018 for all services provided to persons under the age of twen-
ty-one; provided, however, that managed care organizations 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 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 promul-
gated prior to October 1, 2015 to establish rates for ambulatory behav-
ioral 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.
S 2. Subdivision 8 of section 84 of 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, 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] 2019;
S 3. 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 15 of part C of chapter 60 of
the laws of 2014, is amended to read as follows:
Section 1. Notwithstanding any contrary provision of law, the commis-
sioners 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 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 reimburs-
ing 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 estab-
lished 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
S. 4207 109
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 the chapter of the laws
of [2014] 2015 which amended this section through [December 31, 2016]
JUNE 30, 2018 for patients in the city of New York, for all rate periods
on and after the effective date of the chapter of the laws of [2014]
2015 which amended this section through [June 30, 2017] SEPTEMBER 30,
2018 for patients outside the city of New York, and for all rate periods
on and after the effective date of the chapter of the laws of [2014]
2015 which amended this section through December 31, [2017] 2018 for all
services provided to persons under the age of twenty-one; provided,
however, that managed care organizations and providers may negotiate
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, including 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 chap-
ter 56 of the laws of 2013.
S 4. Section 2 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 16 of part C of chapter 60 of
the laws of 2014, is amended to read as follows:
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, 2010, and shall
expire on January 1, [2018] 2019.
S 5. Subdivision 7-a of section 84 of part A of chapter 56 of the laws
of 2013, amending the public health law and other laws relating to state
health mental hygiene budget for the 2013-14 state fiscal year, as added
by section 16-b of part C of chapter 60 of the laws of 2014, is amended
to read as follows:
7-a. section forty-five-c of this act shall expire and be deemed
repealed January 1, [2018] 2019;
S 6. This act shall take effect immediately.
PART DD
Section 1. The mental hygiene law is amended by adding a new section
13.43 to read as follows:
S 13.43 INTEGRATED HOUSING PLAN.
(A) THE COMMISSIONER, IN CONSULTATION WITH THE DEVELOPMENTAL DISABILI-
TIES ADVISORY COUNCIL, THE DEPARTMENT OF HEALTH, THE DIVISION OF HOUSING
AND COMMUNITY RENEWAL, THE MOST INTEGRATED SETTINGS COORDINATING COUNCIL
AND OTHER AGENCIES AS DETERMINED APPROPRIATE BY THE COMMISSIONER, SHALL
ESTABLISH A PLAN TO INCREASE HOUSING OPPORTUNITIES FOR PEOPLE WITH
S. 4207 110
DEVELOPMENTAL DISABILITIES. THE PLAN SHALL INCLUDE, BUT NOT BE LIMITED
TO:
(1) THE CREATION AND MAINTENANCE OF A LIST OF AFFORDABLE AND ACCESSI-
BLE RENTAL UNITS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES; AND
(2) IDENTIFICATION OF STRATEGIES TO FACILITATE INDIVIDUALS RECEIVING
OR ELIGIBLE FOR HOME AND COMMUNITY BASED (HCBS) WAIVERS TO LIVE IN THEIR
OWN HOME, LEASED APARTMENT OR FAMILY'S HOME, WHEN SUCH A PLACEMENT IS
THEIR INFORMED CHOICE AND THE MOST INTEGRATED SETTING APPROPRIATE TO
THEIR NEEDS. ANY SUCH STRATEGIES AT A MINIMUM SHALL ADDRESS:
(I) FACILITATING OPPORTUNITIES FOR INDIVIDUALS WITH DEVELOPMENTAL
DISABILITIES, INCLUDING STUDENTS TRANSITIONING FROM EDUCATIONAL PROGRAMS
TO LIVE INDEPENDENTLY IN THEIR OWN HOME OR APARTMENT AND AWAY FROM THEIR
PARENTAL HOME;
(II) INCREASING AFFORDABLE AND ACCESSIBLE RENTAL UNITS FOR INDIVIDUALS
WITH DEVELOPMENTAL DISABILITIES;
(III) INCREASING AND EXPANDING ACCESS TO RENTAL SUBSIDIES FOR INDIVID-
UALS WITH DEVELOPMENTAL DISABILITIES;
(IV) DEVELOPING AN EDUCATIONAL PROGRAM ABOUT INDIVIDUAL LIVING OPTIONS
FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, FAMILIES, PUBLIC AND
PRIVATE ORGANIZATIONS, DEVELOPERS AND MEDICAID SERVICE COORDINATORS;
(V) ANALYZING POTENTIAL FEDERAL AND STATE POLICY CHANGES THAT WILL
FACILITATE INCREASED ACCESS AND AVAILABILITY OF SERVICES AND SUPPORTS
THAT PERMIT INDIVIDUALS TO CHOOSE MORE INDEPENDENT LIVING OPTIONS; AND
(VI) ASSESSING AND ADVANCING COORDINATED PLAN IMPLEMENTATION.
(B) THE COMMISSIONER, IN CONSULTATION WITH THE DEVELOPMENTAL DISABILI-
TIES ADVISORY COUNCIL, THE DEPARTMENT OF HEALTH, THE DIVISION OF HOUSING
AND COMMUNITY RENEWAL, THE MOST INTEGRATED SETTINGS COORDINATING COUNCIL
AND OTHER AGENCIES AS DETERMINED APPROPRIATE BY THE COMMISSIONER, SHALL
DEVELOP THE PLAN WITH INPUT FROM STAKEHOLDERS, INCLUDING INDIVIDUALS
WITH DEVELOPMENTAL DISABILITIES, PARENTS AND GUARDIANS OF INDIVIDUALS
WITH DEVELOPMENTAL DISABILITIES, ADVOCATES AND PROVIDERS OF SERVICES FOR
INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES.
(C) THE PLAN REQUIRED PURSUANT TO THIS SECTION SHALL BE DEVELOPED AND
SUBMITTED TO THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF
THE ASSEMBLY AND POSTED ON THE WEBSITE OF THE OFFICE ON OR BEFORE APRIL
FIRST, TWO THOUSAND SIXTEEN. SUCH PLAN SHALL BE REASSESSED AND UPDATED
AT LEAST ANNUALLY THEREAFTER, ON OR BEFORE THE THIRTY-FIRST DAY OF JANU-
ARY, TO ENSURE RESPONSIVENESS TO CHANGING NEEDS AND GOALS, TO REFLECT
THE DEVELOPMENT OF NEW INFORMATION, AND TO REFLECT ACHIEVEMENT OF HOUS-
ING TRANSFORMATION GOALS, EVALUATION OF SUCCESSFUL INTEGRATED HOUSING
STRATEGIES AND MILESTONES TO MEET INTEGRATED HOUSING GOALS. SUCH UPDATED
PLAN SHALL BE POSTED ON THE WEBSITE OF THE OFFICE, AND SUBMITTED TO THE
TEMPORARY PRESIDENT OF THE SENATE AND SPEAKER OF THE ASSEMBLY.
S 2. This act shall take effect immediately.
PART EE
Section 1. The mental hygiene law is amended by adding a new section
31.38 to read as follows:
S 31.38 TEMPORARY ADJUSTMENT TO REIMBURSEMENT RATES FOR BEHAVIORAL
HEALTH.
(A) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, WITHIN FUNDS
APPROPRIATED AND SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL
PARTICIPATION, THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER
OF HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE
ABUSE SERVICES, MAY GRANT APPROVAL OF A TEMPORARY ADJUSTMENT TO THE
S. 4207 111
NON-CAPITAL COMPONENTS OF RATES, OR MAKE TEMPORARY LUMP-SUM MEDICAID
PAYMENTS, TO ELIGIBLE PROVIDERS LICENSED UNDER THIS ARTICLE OR ARTICLE
THIRTY-TWO OF THIS CHAPTER, PROVIDED HOWEVER, THAT SHOULD FEDERAL FINAN-
CIAL PARTICIPATION NOT BE AVAILABLE FOR ANY ELIGIBLE PROVIDER, THEN
PAYMENTS PURSUANT TO THIS SUBDIVISION MAY BE MADE AS GRANTS AND SHALL
NOT BE DEEMED TO BE MEDICAL ASSISTANCE PAYMENTS.
(B) ELIGIBLE PROVIDERS SHALL INCLUDE:
(I) PROVIDERS UNDERGOING CLOSURE;
(II) PROVIDERS IMPACTED BY THE CLOSURE OF OTHER HEALTH CARE PROVIDERS;
(III) PROVIDERS SUBJECT TO MERGERS, ACQUISITIONS, CONSOLIDATIONS OR
RESTRUCTURING; OR
(IV) PROVIDERS IMPACTED BY THE MERGER, ACQUISITION, CONSOLIDATION OR
RESTRUCTURING OF OTHER HEALTH CARE PROVIDERS.
(C) PROVIDERS SEEKING TEMPORARY RATE ADJUSTMENTS UNDER THIS SECTION
SHALL DEMONSTRATE THROUGH SUBMISSION OF A WRITTEN PROPOSAL TO THE
COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH AND THE
COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES,
THAT THE ADDITIONAL RESOURCES PROVIDED BY A TEMPORARY RATE ADJUSTMENT
WILL ACHIEVE ONE OR MORE OF THE FOLLOWING:
(I) PROTECT OR ENHANCE ACCESS TO CARE;
(II) PROTECT OR ENHANCE QUALITY OF CARE;
(III) IMPROVE THE COST EFFECTIVENESS OF THE DELIVERY OF HEALTH CARE
SERVICES; OR
(IV) OTHERWISE PROTECT OR ENHANCE THE HEALTH CARE DELIVERY SYSTEM, AS
DETERMINED BY THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF
HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE
ABUSE SERVICES.
(D) (I) SUCH WRITTEN PROPOSAL SHALL BE SUBMITTED TO THE COMMISSIONER,
THE COMMISSIONER OF HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCO-
HOLISM AND SUBSTANCE ABUSE SERVICES, AT LEAST SIXTY DAYS PRIOR TO THE
REQUESTED EFFECTIVE DATE OF THE TEMPORARY RATE ADJUSTMENT, AND SHALL
INCLUDE A PROPOSED BUDGET TO ACHIEVE THE GOALS OF THE PROPOSAL. ANY
MEDICAID PAYMENT ISSUED PURSUANT TO THIS SECTION SHALL BE IN EFFECT FOR
A SPECIFIED PERIOD OF TIME AS DETERMINED BY THE COMMISSIONER, IN CONSUL-
TATION WITH THE COMMISSIONER OF HEALTH AND THE COMMISSIONER OF THE
OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, OF UP TO THREE YEARS.
AT THE END OF THE SPECIFIED TIMEFRAME SUCH PAYMENTS OR ADJUSTMENTS TO
THE NON-CAPITAL COMPONENT OF RATES SHALL CEASE, AND THE PROVIDER SHALL
BE REIMBURSED IN ACCORDANCE WITH THE OTHERWISE APPLICABLE RATE-SETTING
METHODOLOGY AS SET FORTH IN APPLICABLE STATUTES AND REGULATIONS. THE
COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH AND THE
COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES,
MAY ESTABLISH, AS A CONDITION OF RECEIVING SUCH TEMPORARY RATE ADJUST-
MENTS OR GRANTS, BENCHMARKS AND GOALS TO BE ACHIEVED IN CONFORMITY WITH
THE PROVIDER'S WRITTEN PROPOSAL AS APPROVED BY THE COMMISSIONER, IN
CONSULTATION WITH THE COMMISSIONER OF HEALTH AND THE COMMISSIONER OF THE
OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, AND MAY ALSO REQUIRE
THAT THE FACILITY SUBMIT SUCH PERIODIC REPORTS CONCERNING THE ACHIEVE-
MENT OF SUCH BENCHMARKS AND GOALS AS THE COMMISSIONER, IN CONSULTATION
WITH THE COMMISSIONER OF HEALTH AND THE COMMISSIONER OF THE OFFICE OF
ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, DEEMS NECESSARY. FAILURE TO
ACHIEVE SATISFACTORY PROGRESS, AS DETERMINED BY THE COMMISSIONER, IN
CONSULTATION WITH THE COMMISSIONER OF HEALTH AND THE COMMISSIONER OF THE
OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, IN ACCOMPLISHING SUCH
BENCHMARKS AND GOALS SHALL BE A BASIS FOR ENDING THE FACILITY'S TEMPO-
RARY RATE ADJUSTMENT OR GRANT PRIOR TO THE END OF THE SPECIFIED TIME-
S. 4207 112
FRAME. (II) THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF
HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE
ABUSE SERVICES, MAY REQUIRE THAT APPLICATIONS SUBMITTED PURSUANT TO THIS
SECTION BE SUBMITTED IN RESPONSE TO AND IN ACCORDANCE WITH A REQUEST FOR
APPLICATIONS OR A REQUEST FOR PROPOSALS ISSUED BY THE COMMISSIONER, IN
CONSULTATION WITH THE COMMISSIONER OF HEALTH AND THE COMMISSIONER OF THE
OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES.
(E) NOTWITHSTANDING ANY LAW TO THE CONTRARY, ANY PROGRAMS AND FACILI-
TIES ISSUED OPERATING CERTIFICATES UNDER THIS ARTICLE OR ARTICLE THIR-
TY-TWO OF THIS CHAPTER SHALL BE ALLOCATED NO LESS THAN THIRTY MILLION
DOLLARS ANNUALLY PURSUANT TO THIS SECTION.
S 2. This act shall take effect immediately.
PART FF
Section 1. Subdivision 2 of section 2807-y of the public health law,
as added by section 67 of part B of chapter 58 of the laws of 2005, is
amended to read as follows:
2. In the event contracts with the article forty-three insurance law
plans or other commissioner's designees are effectuated, the commission-
er shall conduct annual audits of the receipt and distribution of the
funds AND SHALL PROVIDE RECORDS OF ALL REVENUES AND DISBURSEMENTS MADE
FROM ALLOWANCES AND ASSESSMENTS LISTED IN SUBDIVISION ONE OF THIS
SECTION TO THE TEMPORARY PRESIDENT OF THE SENATE AND SPEAKER OF THE
ASSEMBLY ON AN ANNUAL BASIS BEGINNING JANUARY FIRST, TWO THOUSAND
SIXTEEN.
S 2. HCRA modernization task force: The commissioner of health shall
convene a task force to evaluate and make recommendations related to
increasing the transparency and accountability of the health care reform
act resources fund (HCRA fund), to evaluate and modernize the provisions
of law related to the health care reform act (HCRA), and to restore
integrity and purpose to the HCRA program. The task force shall: be
provided a detailed accounting of revenues and disbursements made
through HCRA and the HCRA fund; assess the extent to which HCRA revenues
are expended toward their originally intended purpose; evaluate and
recommend a timeframe by which any state costs associated with Medicaid
shall be wholly funded by the general fund; assess the impact any feder-
al law enacted since 2009 has had on indigent care costs in the state,
and make recommendations for updating and modernizing the HCRA statute.
The task force shall be composed of the commissioner of health, and
stakeholders with institutional knowledge regarding the provisions of
HCRA and the disbursements from the HCRA fund, including but not limited
to representatives of health plans, managed care plans, hospitals,
physicians, other health care providers, the HCRA pool administrator,
and the office of the state comptroller. At least one such stakeholder
shall be appointed to the task force by the temporary president of the
senate and one by the speaker of the assembly. The task force shall be
convened not later than June 30, 2015 and shall submit its report to the
governor, the temporary president of the senate and the speaker of the
assembly no later than December 31, 2015.
S 3. Subdivision 10 of section 2807-m of the public health law is
amended by adding two new paragraphs (g) and (h) to read as follows:
(G) NO LATER THAN JULY FIRST, TWO THOUSAND FIFTEEN, THE COMMISSIONER
SHALL ISSUE A NEW REQUEST FOR APPLICATIONS FOR PHYSICIAN LOAN REPAYMENT
AWARDS, AND NO LATER THAN JULY FIRST, TWO THOUSAND SIXTEEN, THE COMMIS-
SIONER SHALL ISSUE ANOTHER REQUEST FOR SUCH APPLICATIONS.
S. 4207 113
(H) THE COMMISSIONER SHALL APPOINT A WORK GROUP OF INTERESTED PARTIES
BY SEPTEMBER FIRST, TWO THOUSAND FIFTEEN, TO EVALUATE WHETHER CHANGES
ARE NECESSARY IN ORDER TO ENHANCE THE PROGRAM, AND TO MAKE RECOMMENDA-
TIONS FOR ANY CHANGES. A REPORT, CONTAINING THE RECOMMENDATIONS OF THE
WORK GROUP, SHALL BE SUBMITTED TO THE GOVERNOR, THE CHAIRS OF THE SENATE
HEALTH AND FINANCE COMMITTEES, AND THE CHAIRS OF THE ASSEMBLY HEALTH AND
WAYS AND MEANS COMMITTEES BY OCTOBER FIRST, TWO THOUSAND SIXTEEN.
S 4. Subdivision 1 of section 2807-v of the public health law is
amended by adding a new paragraph (iii) to read as follows:
(III) NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, AND IN ADDITION
TO FUNDS PROVIDED PURSUANT TO PARAGRAPH (D) OF SUBDIVISION FIVE-A OF
SECTION TWENTY-EIGHT HUNDRED SEVEN-M OF THIS ARTICLE, FUNDS SHALL BE
RESERVED AND ACCUMULATED FROM YEAR TO YEAR AND SHALL BE AVAILABLE FOR
THE PURPOSE OF FUNDING THE PHYSICIAN LOAN REPAYMENT PROGRAM PURSUANT TO
SUBDIVISION TEN OF SECTION TWENTY-EIGHT HUNDRED SEVEN-M OF THIS ARTICLE
IN THE FOLLOWING AMOUNTS:
(I) TWO MILLION DOLLARS FOR THE PERIOD APRIL FIRST, TWO THOUSAND
FIFTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SIXTEEN; AND
(II) FOUR MILLION FIVE HUNDRED THOUSAND DOLLARS FOR THE PERIOD APRIL
FIRST, TWO THOUSAND SIXTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND
SEVENTEEN.
THE ADDITIONAL FUNDS OF TWO MILLION DOLLARS FOR THE PERIOD APRIL
FIRST, TWO THOUSAND FIFTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND
SIXTEEN SHALL FUND THE FIRST YEAR LOAN REPAYMENT FOR ONE HUNDRED NEW
AWARDS, AND THE ADDITIONAL FUNDS OF FOUR MILLION FIVE HUNDRED THOUSAND
DOLLARS FOR THE PERIOD APRIL FIRST, TWO THOUSAND SIXTEEN THROUGH MARCH
THIRTY-FIRST, TWO THOUSAND SEVENTEEN SHALL FUND THE FIRST YEAR LOAN
REPAYMENT FOR ANOTHER ONE HUNDRED NEW AWARDS AND THE SECOND YEAR LOAN
REPAYMENT FOR THE PRIOR YEAR AWARDS. NOTWITHSTANDING ANY CONTRARY
PROVISION OF LAW AND SUBJECT TO THE EXTENSION OF THE HEALTH CARE REFORM
ACT OF 1996, SUFFICIENT FUNDS SHALL BE SET ASIDE AND RESERVED BY THE
COMMISSIONER FOR STATE FISCAL YEARS ON AND AFTER APRIL FIRST, TWO THOU-
SAND SEVENTEEN, AND SHALL BE AVAILABLE FOR PURPOSES OF PHYSICIAN LOAN
REPAYMENT IN ACCORDANCE WITH SUBDIVISION TEN OF SECTION TWENTY-EIGHT
HUNDRED SEVEN-M OF THIS ARTICLE IN AMOUNTS SUFFICIENT TO AT LEAST FUND
THE REMAINING YEAR COMMITMENTS FOR AWARDS MADE PRIOR TO APRIL FIRST, TWO
THOUSAND SEVENTEEN.
S 5. Subdivision 2 of section 2807-g of the public health law, as
added by chapter 1 of the laws of 1999, is amended to read as follows:
2. Grants shall be made on a competitive basis by region, in accord-
ance with the amount raised in the region, PROVIDED THAT NO LESS THAN
TWO AND ONE-HALF PERCENT OF THE TOTAL FUNDS MADE AVAILABLE IN ANY
REQUEST FOR PROPOSALS SHALL BE MADE AVAILABLE IN ANY REGION, with pref-
erence within regions given to areas and eligible organizations that
have experienced or are likely to experience job loss because of changes
in the health care system. If, at the conclusion of the regional compet-
itive contract award process, there are excess funds available within
any regional allocation, such funds shall be redistributed to regions
where there is a shortage of funds available for programs which other-
wise qualify for funding pursuant to this section. IF A GRANT RECIPIENT
HAS RECEIVED GRANT AWARDS FOR THE SAME WORKFORCE RETRAINING PROJECT IN
MULTIPLE REGIONS, SUCH GRANT RECIPIENT, WITH THE APPROVAL OF THE COMMIS-
SIONER, MAY REDISTRIBUTE FUNDS AMONG SAID REGIONS.
S 6. Subdivision 6 of section 2807-s of the public health law is
amended by adding a new paragraph (g) to read as follows:
S. 4207 114
(G) A FURTHER GROSS ANNUAL AMOUNT ALLOCATED TO THE ROCHESTER REGION
BEGINNING JANUARY FIRST, TWO THOUSAND SIXTEEN SHALL BE ONE HUNDRED TEN
MILLION DOLLARS. SUCH AMOUNT SHALL BE EXCLUDED FROM ALL COMPUTATIONS AND
ADJUSTMENTS MADE PURSUANT TO PARAGRAPH (B) OF SUBDIVISION SIX OF SECTION
TWO THOUSAND EIGHT HUNDRED SEVEN-T OF THIS ARTICLE.
S 7. Subdivision 7 of section 2807-s of the public health law is
amended by adding a new paragraph (d) to read as follows:
(D)(I) FIVE MILLION DOLLARS OF THE FUNDS ALLOCATED PURSUANT TO PARA-
GRAPH (G) OF SUBDIVISION SIX OF THIS SECTION SHALL BE DISTRIBUTED TO A
REGIONAL HEALTH PLANNING ORGANIZATION FOR USE IN FUNDING REGIONAL HEALTH
CARE IMPROVEMENT PROJECTS. THE REGIONAL HEALTH PLANNING ORGANIZATION
SHALL DISBURSE THOSE FUNDS IN ACCORDANCE WITH THIS PARAGRAPH, OR PURSU-
ANT TO GRANTS MADE BY THE ORGANIZATION IN ACCORDANCE WITH THIS PARA-
GRAPH. DISTRIBUTION OF ANY GRANT FUNDS ADMINISTERED BY THE REGIONAL
HEALTH PLANNING ORGANIZATION SHALL BE PURSUANT TO A MULTI-STAKEHOLDER
PROCESS. THE REGIONAL HEALTH CARE IMPROVEMENT GRANT FUND PROJECTS SHALL
INCLUDE THREE MILLION DOLLARS PER YEAR FOR A SHARED COMMUNITY HEALTH
INFRASTRUCTURE DESIGNED ON THE BASIS OF COLLABORATIVE COMMUNITY EFFORTS,
INCLUDING COMMUNITY-WIDE PATIENT SAFETY AND QUALITY IMPROVEMENT
PROGRAMS, ELIMINATION OF HEALTH DISPARITIES, HEALTH INFORMATION TECHNOL-
OGY, AND TWO MILLION DOLLARS TO FUND THE REGIONAL HEALTH PLANNING ORGAN-
IZATION. THE HEALTH PLANNING ORGANIZATION SHALL USE REASONABLE EFFORTS
TO GENERATE MATCHING FUND CONTRIBUTIONS IN THE FORM OF GRANTS, DONATIONS
AND OTHER CONTRIBUTIONS.
(II) ONE HUNDRED FIVE MILLION DOLLARS OF THE FUNDS ALLOCATED PURSUANT
TO PARAGRAPH (G) OF SUBDIVISION SIX OF THIS SECTION SHALL BE ALLOCATED
TO A NOT-FOR-PROFIT ORGANIZATION OR ASSOCIATION THAT HAS BEEN DESIGNATED
THROUGH A MULTI-STAKEHOLDER PROCESS, WHICH SHALL DISTRIBUTE THOSE FUNDS
TO ALL OF THE HOSPITALS IN THE REGION ENGAGED IN GRADUATE MEDICAL EDUCA-
TION IN ORDER TO FUND GRADUATE MEDICAL EDUCATION. ONE HUNDRED MILLION
DOLLARS OF SUCH FUNDING SHALL BE DISTRIBUTED PROPORTIONALLY TO EACH OF
THE HOSPITALS IN AMOUNTS WHICH REFLECT EACH HOSPITAL'S CURRENT COSTS FOR
GRADUATE MEDICAL EDUCATION, AND FIVE MILLION DOLLARS OF UNREIMBURSED
ADMINISTRATIVE AND OTHER GRADUATE MEDICAL EDUCATION RELATED COSTS SHALL
BE ALLOCATED IN THE SAME PROPORTIONS. ONE HUNDRED MILLION DOLLARS OF THE
DISTRIBUTED FUNDS SHALL BE IN LIEU OF CURRENT FUNDING OF SUCH COSTS AS
CURRENTLY INCLUDED IN CLAIMS PAYMENTS BY SPECIFIED THIRD PARTY PAYORS IN
THE REGION RESULTING IN A REDUCTION IN THE AMOUNT PAID BY SUCH THIRD
PARTY PAYORS IN AN AMOUNT EQUAL TO THE ONE HUNDRED MILLION DOLLARS.
PRIOR TO THE ALLOCATION OF FUNDS PURSUANT TO THIS SUBDIVISION, THE
PARTICIPATING HOSPITALS AND SUCH THIRD PARTY PAYORS SHALL DEVELOP A
PROCESS FOR THE DISTRIBUTION OF SUCH FUNDS AND A MECHANISM TO ENSURE
THAT THE REQUIRED REDUCTION OF PAYMENTS BY SUCH THIRD PARTY PAYORS TO
THE HOSPITALS OCCURS. THE AFFECTED HOSPITALS AND THE THIRD PARTY PAYORS
IN THE REGION SHALL SELECT AN INDEPENDENT THIRD PARTY TO DETERMINE THE
REDUCTIONS WHICH SHALL OCCUR FROM PREVIOUSLY NEGOTIATED RATES FOR CLAIMS
PAYMENTS TO SUCH HOSPITALS BY SPECIFIED THIRD PARTY PAYORS IN ORDER TO
AVOID DUPLICATE FUNDING PURSUANT TO THIS PARAGRAPH. PRIOR TO THE IMPLE-
MENTATION OF THESE PROVISIONS, A REPORT SHALL BE PREPARED BY SUCH INDE-
PENDENT THIRD PARTY TO ANALYZE THE ANTICIPATED IMPACT OF THESE
PROVISIONS ON GRADUATE MEDICAL EDUCATION AND THE PROMOTION OF COMMUNITY
HEALTH IN THE ROCHESTER REGION. THE REPORT WILL CONSIDER: THE IMPACT OF
THE PROPOSAL ON THE DEVELOPMENT AND RETENTION OF THE PHYSICIAN WORKFORCE
IN ROCHESTER AND THE SURROUNDING REGION AS A RESULT OF ITS EFFECTS ON
THE SUPPORT OF GRADUATE MEDICAL EDUCATION; THE IMPACT OF THE PROPOSAL ON
THE HEALTHCARE COMMUNITY (INCLUDING HOSPITALS AND OTHER HEALTHCARE
S. 4207 115
PROVIDERS), THIRD PARTY PAYORS, THE BUSINESS COMMUNITY AND CONSUMERS;
AND THE OVERALL IMPACT OF THE PROPOSAL ON THE HEALTHCARE DELIVERY SYSTEM
IN THE ROCHESTER REGION, INCLUDING ITS SUPPORT FOR COMMUNITY HEALTH
INITIATIVES AND HEALTHCARE PLANNING. THE REPORT WILL BE SUBMITTED TO THE
SPEAKER OF THE ASSEMBLY, THE TEMPORARY PRESIDENT OF THE SENATE AND TO
THE COMMISSIONER OF HEALTH NO LATER THAN OCTOBER 1, 2015.
S 8. This act shall take effect immediately; provided, however, that
the amendments made to section 2807-s of the public health law made by
sections six and seven of this act shall not affect the expiration of
such section and shall be deemed to expire therewith.
PART GG
Section 1. Section 2825 of the public health law, as added by section
8 of part A of chapter 60 of the laws of 2014, is amended to read as
follows:
S 2825. Capital restructuring financing program. 1. A capital restruc-
turing financing program is hereby established under the joint adminis-
tration of the commissioner and the president of the dormitory authority
of the state of New York, SUBJECT TO AN APPROPRIATION, for the purpose
of enhancing the quality, financial viability and efficiency of New
York's health care delivery system by transforming the system into a
more rational patient-centered care system that promotes population
health and improved well-being for all New Yorkers. The issuance of any
bonds or notes hereunder shall further 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. For the period April first, two thousand [fourteen] FIFTEEN through
March thirty-first, two thousand twenty-one, funds made available [for
expenditure] pursuant to this section [may] SHALL be distributed by the
commissioner and the president of the authority, in consultation with
the commissioners of the office of mental health, office for people with
developmental disabilities and office for alcoholism and substance abuse
services, as applicable, [for:
(a) capital grants to general hospitals, residential health care
facilities, diagnostics and treatment centers, and clinics licensed
pursuant to this chapter or the mental hygiene law, assisted living
programs, primary care providers, and home care providers certified or
licensed pursuant to article thirty-six of this chapter (collectively
"applicants") that qualify for payments under the delivery system reform
incentive payment program (DSRIP), in which case funding under this
paragraph shall be requested in such applicant's DSRIP application. Such
capital grant projects include, but are not limited to; closures, merg-
ers, restructuring, improvements to infrastructure, development of
primary care service capacity, development of telehealth infrastructure,
the promotion of integrated delivery systems that strengthen and protect
continued access to essential health care services and other transforma-
tional projects as determined by the commissioner and the president of
the authority.
(b) 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, assisted living
programs, primary care providers, home care providers, certified or
licensed pursuant to article thirty-six of this chapter (collectively
S. 4207 116
"applicants") that are non-qualifying and non-participating applicants
under paragraph (a) of this subdivision, for capital non-operational
works or purposes that support the purposes set forth in this section.
Such capital grant projects include, but are not limited to;] PURSUANT
TO A PROCESS AND PLAN APPROVED BY THE GOVERNOR, TEMPORARY PRESIDENT OF
THE SENATE AND THE SPEAKER OF THE ASSEMBLY.
(A) I. UPON APPROVAL OF A PROCESS AND PLAN, FUNDS SHALL BE DISTRIBUTED
TO SUPPORT DEBT RETIREMENT, NON-OPERATIONAL CAPITAL PROJECTS AND NON-CA-
PITAL PROJECTS, INCLUDING BUT NOT LIMITED TO PROJECTS RELATED TO
closures, mergers, restructuring, improvements to infrastructure, devel-
opment of primary care service capacity, development of telehealth
infrastructure, [the promotion of integrated delivery systems that
strengthen and protect continued access to essential health care
services] ESTABLISHMENT OR EXPANSION OF HEALTH INFORMATION TECHNOLOGY,
ESTABLISHMENT OF THE STATEWIDE HEALTH INFORMATION NETWORK OF NEW YORK,
AND THE ESTABLISHMENT OF AN ALL PAYER DATABASE WITH THE DEPARTMENT.
II. CRITERIA ESTABLISHED FOR APPLICANTS INTENDING TO RETIRE DEBT MUST
INCLUDE REQUIREMENTS TO DEMONSTRATE A REASONABLE RESTRUCTURING PLAN,
WHICH DEMONSTRATES LONG TERM SUSTAINABILITY OF THE APPLICANT.
(B) ELIGIBLE FUNDING RECIPIENTS SHALL INCLUDE GENERAL HOSPITALS, RESI-
DENTIAL HEALTH CARE FACILITIES, DIAGNOSTIC AND TREATMENT CENTERS, CLIN-
ICS LICENSED PURSUANT TO THIS CHAPTER OR THE MENTAL HYGIENE LAW,
ASSISTED LIVING PROGRAMS, PRIMARY CARE PROVIDERS, HOME CARE PROVIDERS
CERTIFIED OR LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF THIS CHAPTER,
COMMUNITY HEALTH CARE PROVIDERS, AND FACILITIES AND PROVIDERS THAT ARE
AFFILIATED WITH OR LEADS OF A PERFORMING PROVIDER SYSTEM (PPS) IN THE
DELIVERY SYSTEM REFORM INCENTIVE PROGRAM (DSRIP), AND REGIONAL HEALTH
INFORMATION ORGANIZATIONS.
3. 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 authorities
law, as added by [a] chapter FIFTY-FIVE of the laws of two thousand
fourteen, for the purposes of awarding, distributing, and administering
the funds made available pursuant to this section.
[(a) For capital grant projects under paragraph (a) of subdivision two
of this section, the evaluation of applications shall be submitted
pursuant to the process described in paragraph (b) of subdivision twenty
of section twenty-eight hundred seven of this article; provided, howev-
er, that such capital grant projects shall not be subject to review by
the federal Centers for Medicare and Medicaid services.
(b)] For monies allocated under [paragraph (b) of] subdivision two of
this section:
[(i)] (A) the department shall post on its website, for a period of no
less than thirty days:
[(A)] (I) the process by which such applications shall be reviewed;
[(B)] (II) the criteria by which such applications shall be judged;
and
[(C)] (III) a list of approved and denied applications subsequent to
such determination.
[(ii)] (B) the evaluation of applications shall be reviewed by the
department, pursuant to a process to be determined by the department[.
Applications shall then be subject to review by the panel established
pursuant to paragraph (b) of subdivision twenty of section twenty-eight
hundred seven of this article, which shall submit its recommendations to
the commissioner for final determination. Determination of awards for
funds allocated under paragraph (b) of subdivision two of this section,
S. 4207 117
shall include] INCLUDING, but not [be] limited to the following crite-
ria:
[(A)] (I) eligibility requirements for applicants;
[(B)] (II) statewide geographic distribution of funds;
[(C)] (III) minimum and maximum amounts of funding to be awarded under
the program;
[(D)] (IV) the relationship between the project proposed by an appli-
cant and identified community need;
[(E)] (V) the extent to which the applicant has access to alternative
financing;
[(F)] (VI) the extent to which the proposed project furthers the
purposes set forth [in this section;
(G) the extent that the proposed project furthers the development of
primary care;
(H) the extent to which the proposed project benefits Medicaid enrol-
lees and uninsured individuals;
(I) the extent to which the proposed project addresses potential risk
to patient safety and welfare;
(J) the extent that the proposed project involves an applicant that
receives or has applied for a temporary rate adjustment pursuant to
applicable regulations; and
(K) the extent to which the proposed project will contribute to the
long term sustainability of the applicant] BY THE PLAN APPROVED TO ALLO-
CATE FUNDS.
The commissioner 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.
S 2. Paragraphs (b) and (e) of subdivision 20 of section 2807 of the
public health law, as added by section 8-a of part A of chapter 60 of
the laws of 2014, are amended to read as follows:
(b) The commissioner shall establish an advisory panel to provide
assistance with regard to the DSRIP program. The panel shall be charged
with reviewing recommendations for DSRIP funding made by the state's
contracted DSRIP assessor and advising the commissioner regarding the
results of such review. [Such panel shall also review applications under
paragraph (b) of subdivision two of section twenty-eight hundred twen-
ty-five of this article.] Panel membership shall be comprised of indi-
viduals with significant health care system experience. Members may not
be elected officials or employed by providers that would benefit from
DSRIP funding, and must not have any conflict of interest that would
prevent them from providing an impartial review of DSRIP assessor recom-
mendations. The panel shall consist of members appointed by the commis-
sioner and shall in addition consist of one member appointed by the
[majority leader] TEMPORARY PRESIDENT of the New York state senate, and
one member appointed by the speaker of the New York state assembly. The
panel shall carry out the review of DSRIP recommendations in strict
accordance with all requirements set forth in the state's federal 1115
Medicaid waiver standard terms and conditions. The panel shall submit
its recommendations to the commissioner for final determination, in
accordance with all requirements set forth in the state's federal 1115
Medicaid waiver standard terms and conditions. The commissioner may
modify the requirements of this paragraph and paragraph (c) of this
subdivision if such modifications are required by the federal CMS.
S. 4207 118
(e) Notwithstanding any provision of law to the contrary, the commis-
sioners of the department of health, the office of mental health, the
office for people with developmental disabilities, and the office of
alcoholism and substance abuse services are authorized to waive any
regulatory requirements as are necessary, consistent with applicable
law, to allow applicants under this subdivision [and paragraph (a) of
subdivision two of section twenty-eight hundred twenty-five of this
article] to avoid duplication of requirements and to allow the efficient
implementation of the proposed project; provided, however, that regu-
lations pertaining to patient safety may not be waived, nor shall any
regulations be waived if such waiver would risk patient safety. Such
waiver shall not exceed the life of the project or such shorter time
periods as the authorizing commissioner may determine. Any regulatory
relief granted pursuant to this subdivision shall be described, includ-
ing each regulations waived and the project it relates to, in the report
provided pursuant to paragraph (c) of this subdivision.
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 GG of this act shall be
as specifically set forth in the last section of such Parts.
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