Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
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Apr 12, 2018 |
signed chap.57 |
Apr 02, 2018 |
delivered to governor |
Mar 30, 2018 |
returned to senate passed assembly message of necessity - 3 day message motion to amend lost ordered to third reading rules cal.21 substituted for a9507c referred to ways and means delivered to assembly passed senate message of necessity - 3 day message ordered to third reading cal.737 print number 7507c |
Mar 30, 2018 |
amend (t) and recommit to finance |
Mar 13, 2018 |
print number 7507b |
Mar 13, 2018 |
amend (t) and recommit to finance |
Feb 16, 2018 |
print number 7507a |
Feb 16, 2018 |
amend (t) and recommit to finance |
Jan 18, 2018 |
referred to finance |
Senate Bill S7507C
Signed By Governor2017-2018 Legislative Session
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2018-2019 state fiscal year
download bill text pdfSponsored By
There are no sponsors of this bill.
Archive: Last Bill Status - Signed by Governor
- Introduced
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- In Committee Assembly
- In Committee Senate
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- On Floor Calendar Assembly
- On Floor Calendar Senate
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- Passed Assembly
- Passed Senate
- Delivered to Governor
- Signed By Governor
Actions
Votes
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Floor Vote: Mar 30, 2018
aye (59)- Addabbo Jr.
- Akshar
- Alcantara
- Amedore
- Avella
- Bailey
- Benjamin
- Bonacic
- Boyle
- Breslin
- Brooks
- Carlucci
- Comrie
- DeFrancisco
- Dilan
- Felder
- Flanagan
- Funke
- Gallivan
- Gianaris
- Golden
- Griffo
- Hamilton
- Hannon
- Helming
- Hoylman-Sigal
- Jacobs
- Kaminsky
- Kavanagh
- Kennedy
- Klein
- Krueger
- LaValle
- Lanza
- Larkin
- Little
- Marcellino
- Marchione
- Montgomery
- Murphy
- O'Mara
- Ortt
- Parker
- Peralta
- Persaud
- Phillips
- Ranzenhofer
- Ritchie
- Rivera
- Robach
- Sanders Jr.
- Savino
- Serino
- Seward
- Stavisky
- Stewart-Cousins
- Tedisco
- Valesky
- Young
absent (1)excused (1)
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Mar 30, 2018 - Finance Committee Vote
S7507C29Aye0Nay8Aye with Reservations0Absent0Excused0Abstained -
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Bill Amendments
2017-S7507 - Details
2017-S7507 - Summary
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2018-2019 state fiscal year; relates to distributions from the general hospital indigent care pool; directs a review of the feasibility of creating a burn center in Kings county; and relates to rates of reimbursement for certain residential health care facilities (Part A)
2017-S7507 - Sponsor Memo
BILL NUMBER: S7507 SPONSOR: BUDGET TITLE OF BILL: An act to amend the public health law, in relation to establishing a temporary workgroup on capital rate methodology for capi- tal expenditures to hospitals and residential nursing facilities; and to amend the social services law, in relation to standard coverage for physical therapy services under medical assistance for needy persons programs (Part A); to amend the public health law, in relation to payments to residential health care facilities; to amend the social services law and the public health law, in relation to assisted living program providers licensed in the state; to amend the social services law, in relation to payments for certain medical assistance provided to eligible persons participating in the New York traumatic brain injury waiver program; and to repeal certain provisions of section 366 of the social services law relating to furnishing medical assistance (Part B); to amend the social services law and the public health law, in relation to health homes and penalties for managed care providers (Part C); to amend the social services law and the public health law, in relation to drug coverage, updating the professional dispensing fee, copayments, pharmacist physician collaboration and comprehensive medication manage- ment; and to repeal certain provisions of the social services law relat- ing thereto (Part D); to amend the social services law, in relation to
reimbursement of transportation costs, reimbursement of emergency trans- portation services and supplemental transportation payments; and repeal- ing certain provisions of such law relating thereto (Part E); providing for not-for-profit and tax exempt corporations' Medicaid capitation rates (Part F); to amend the public health law, in relation to authoriz- ing certain retail practices to offer health services (Part G); to amend the education law, in relation to the practice of nursing by certified registered nurse anesthetists (Part H); to amend the social services law and the public health law, in relation to managed care organizations (Part I); to amend the state finance law, in relation to the false claims act (Part J); authorizing the department of health to require certain health care providers to report on costs incurred; and to amend chapter 59 of the laws of 2011 amending the public health law and other laws relating to known and projected department of health state fund medicaid expenditures, in relation to extending the medicaid global cap (Part K); to amend the social services law and the public health law, in relation to the child health insurance program (Part L); to amend chap- ter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, in relation to apportioning premium for certain policies; to amend part J of chapter 63 of the laws of 2001 amending chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, relating to the effec- tiveness of certain provisions of such chapter, in relation to extending certain provisions concerning the hospital excess liability pool; and to amend part H of chapter 57 of the laws of 2017, amending the New York Health Care Reform Act of 1996 and other laws relating to extending certain provisions relating thereto, in relation to extending provisions relating to excess coverage (Part M); to amend part C of chapter 57 of the laws of 2006, establishing a cost of living adjustment for desig- nated human services, in relation to the determination thereof; and to repeal certain provisions thereof relating to eligible programs (Part N); to amend the public health law and the insurance law, in relation to the early intervention program for infants and toddlers with disabili- ties and their families (Part O); to amend the public health law, in relation to the empire clinical research investigator program and hospi- tal resident hour audits; and to repeal certain provisions of the public health law relating thereto (Part P); to amend the public health law, in relation to the health care facility transformation program (Part Q); to amend the public health law, the executive law, and the real property law, in relation to lead abatement and enforcement (Part R); to amend the public health law and the social services law, in relation to the establishment of community paramedicine collaboratives (Subpart A); to amend the public health law and the mental hygiene law, in relation to integrated services (Subpart B); and to amend the public health law, in relation to the definitions of telehealth provider, originating site and remote patient monitoring (Subpart C)(Part S); to amend chapter 59 of the laws of 2016, amending the social services law and other laws relat- ing to authorizing the commissioner of health to apply federally estab- lished consumer price index penalties for generic drugs, and authorizing the commissioner of health to impose penalties on managed care plans for reporting late or incorrect encounter data, in relation to the effec- tiveness of certain provisions of such chapter; to amend chapter 58 of the laws of 2007, amending the social services law and other laws relat- ing to adjustments of rates, in relation to the effectiveness of certain provisions of such chapter; to amend chapter 54 of the laws of 2016, amending part C of chapter 58 of the laws of 2005, authorizing reimbursements for expenditures made by or on behalf of social services districts for medical assistance for needy persons and administration thereof, in relation to the effectiveness thereof; to amend chapter 906 of the laws of 1984, amending the social services law relating to expanding medical assistance eligibility and the scope of services available to certain persons with disabilities, in relation to the effectiveness thereof; and 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 rates of payments (Part T); to amend part NN of chapter 58 of the laws of 2015 amending the mental hygiene law relating to clarifying the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs, in relation to the effectiveness thereof (Part U); to amend chapter 62 of the laws of 2003, amending the mental hygiene law and the state finance law relating to the community mental health support and workforce reinvestment program, the membership of subcommittees for mental health of community services boards and the duties of such subcommittees and creating the community mental health and workforce reinvestment account, in relation to extending such provisions relating thereto (Part V); to amend the criminal procedure law, in relation to amending the definition of appro- priate institution; and providing for the repeal of such provisions upon expiration thereof (Part W); to amend 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 X); to amend the education law, in relation to persons practicing in certain licensed programs or services who are exempt from practice requirements of professionals licensed by the department of education; to amend chapter 420 of the laws of 2002, amending the education law relating to the profession of social work, in relation to extending the expiration of certain provisions thereof; to amend chapter 676 of the laws of 2002, amending the education law relat- ing to the practice of psychology, in relation to extending the expira- tion of certain provisions; and to amend chapter 130 of the laws of 2010, amending the education law and other laws relating to the regis- tration of entities providing certain professional services and licen- sure of certain professions, in relation to extending certain provisions thereof (Part Y); to amend the social services law, in relation to adding demonstration waivers to waivers allowable for home and communi- ty-based services; to amend the social services law, in relation to adding successor federal waivers to waivers granted under subsection (c) of section 1915 of the federal social security law, in relation to nurs- ing facility services; to amend the social services law, in relation to waivers for high quality and integrated care; 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 fiscal year, in relation to the effectiveness thereof; to amend the mental hygiene law, in relation to adding new and successor federal waivers to waivers in relation to home and community-based services; to amend part A of chapter 56 of the laws of 2013, 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 2013-2014 state fiscal year, in relation to the effectiveness of certain provisions thereof; to amend the public health law, in relation to expansion of comprehensive health services 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 extending provisions thereof; to amend the public health law, in relation to managed long term care plans, health and long term care services and developmental disability individual support and care coordination organizations; 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 extending the provisions thereof; to amend the mental hygiene law, in relation to reimbursement rates; and to amend chapter 710 of the laws of 1988, amending the social services law and the education law relating to medical assistance eligi- bility of certain persons and providing for managed medical care demon- stration programs, in relation to extending the provisions thereof (Part Z); and to amend part C of chapter 57 of the laws of 2006, relating to establishing a cost of living adjustment for designated human services programs, in relation to the inclusion and development of certain cost of living adjustments (Part AA) PURPOSE: This bill contains provisions needed to implement the Health and Mental Hygiene portions of the FY 2019 Executive Budget. This memorandum describes Parts A through AA of the bill which are described wholly within the parts listed below. Part A - Hospital related Medicaid Redesign Team recommendations. PURPOSE: This bill would make statutory changes necessary to implement hospital- related Medicaid Redesign Team recommendations. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Section one of this bill would amend Public Health Law by adding a new § 2827 to establish a temporary workgroup to make recommendations on streamlining the Medicaid capital rate methodology for hospitals and nursing homes that achieves a one percent reduction to Medicaid capital expenditures. Section two of this bill would amend subdivision 5-d of § 2807-k of the Public Health Law to extend the Indigent Care Pool provisions through December 31, 2019. Section three of this bill would amend subdivision 14-a of § 2807 of the Public Health Law to create a penalty pool by creating performance targets for hospitals to reduce potentially preventable emergency department visits, reduce or eliminate the payment of rates based on the quality and safety scores of a hospital, and facilitate necessary quali- ty improvements in hospitals. Ten million dollars annually from the penalty pool will be reinvested into preventive services including increasing access to physical therapy, expanding coverage for social workers in hospitals, and implementing a diabetes prevention program. Section four of this bill would amend subdivision 2-a of § 2807 of the Public Health Law to increase the cap on Physical Therapy (PT) visits from twenty visits per year to forty visits per year, associated with the investment cited in section three of this bill. Section five of this bill would amend subdivision 2 of § 365-a of the Social Services Law to expand social worker coverage in Article 28 settings, associated with the investment cited in section three of this bill. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget and the State's multi-year Financial Plan by keeping overall Medicaid spending within capped levels, which are indexed to the ten- year rolling average of the medical component of the Consumer Price Index, as proscribed in current statute. The hospital related proposals in this section account for $11.7 million State share in savings in FY 2019 and $13.0 million State share in savings in FY 2020. EFFECTIVE DATE: This bill would take effect April 1, 2018. Part B - Long-term care-related Medicaid Redesign Team recommendations. PURPOSE: This bill would make statutory changes necessary to implement long-term care-related Medicaid Redesign Team recommendations. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Section one of this bill would amend Public Health Law § 2808 to impose an annual two percent poor performance penalty on nursing homes with a one-star health facility quality rating, as reported by an independent assessor, to link payments for Medicaid nursing home services to quality outcomes. Section two of this bill would amend Social Services Law § 461-1 to allow current Assisted Living Program (ALP) providers to add up to nine additional slots by redistributing unused ALP slots, permitting up to 500 new ALP slots in counties with no or limited ALP capacity and up to 500 new slots in counties where current occupancy exceeds 85 percent. Additionally a voucher demonstration project for up to 200 persons with dementia in non- Medicaid assisted living facilities will be created. Section three of this bill would amend Public Health Law § 4403-f to reserve enrollment in Managed Long Term Care (MLTC) plans for individ- uals demonstrating a long-term need for home and community based services, specifically those who score a 9 or above on the Universal Assessment System (UAS) for New York and require at least 120 consec- utive days of community-based long term care. Section four of this bill would amend Public Health Law § 4403-f to improve care coordination by requiring continuous MLTC plan enrollment for 12 months. Section five of this bill would amend Public Health Law § 4403-f to eliminate duplication of care management services provided to MLTC members residing in nursing homes for longer than six months by provid- ing their care through fee-for-service. Section six of this bill would amend Social Services Law § 366 to conform state law with federal law with regard to spousal contributions and responsibilities for spouses residing together in the community. Section seven of this bill would amend Social Services Law § 366-c to align the minimum level of resources retained by the spouse of a Medi- caid recipient in order to qualify for Medicaid long term care eligibil- ity withthe Federal minimum ($24,180). Section eight of this bill would amend Social Services Law § 367-a to adjust the freestanding clinic rate for Medicare Part B beneficiaries participating in the traumatic brain injury waiver program to be at or above the approved medical assistance payment level less the amount payable under Medicare Part B. Section nine of this bill would add a new section of unconsolidated law to authorize the Department of Health (DOH) to conduct a study of home and community based services in rural areas of the State. Depending on the results of the analysis, DOH could provide a targeted Medicaid rate enhancement for fee-for-service personal care and waiver programs. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget and the State's multi-year Financial Plan by keeping overall Medicaid spending within capped levels, which are indexed to the ten- year rolling average of the medical component of the Consumer Price Index, as proscribed in current statute. The Long Term Care proposals in this section account for $106.5 million State share in savings in FY 2019 and $157.4 million State share in savings in FY 2020. EFFECTIVE DATE: All sections of this bill would take effect immediately, except for section four, which would take effect on October 1, 2018. Part C - Medicaid Managed Care related recommendations. PURPOSE: This bill would make statutory changes necessary to achieve efficiencies in the Medicaid managed care and Health Homes programs. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Section 1 of this bill would amend Social Services Law § 365-I(2) to add Medicaid managed care enrollees to those eligible to receive incentive payments for participating in wellness activities and for avoiding unnecessary hospitalizations and unnecessary utilization of hospital emergency department services. Section 2 of this bill would amend Social Services Law § 365-I by adding a new subdivision 2-d to establish enrollment targets for special needs managed care plans and compels plans to work collaboratively with health home providers to achieve these targets. Penalties may be assessed to plans that fail to meet established participation targets, except for failure of a health home to work collaboratively. Section 3 of this bill would amend Public Health Law § 2899 paragraph 6 to require criminal history record checks for employees of health homes, subcontractors of health homes, or of any entity that provides home and community based services to enrollees who are diagnosed with develop- mental disability or under 21 years of age. Section 4 of this bill would amend Public Health Law § 2899-a subdivi- sion 9 paragraph (b) by establishing reimbursement subject to the avail- ability of Federal funding, for expanded criminal history record checks. Section 5 of this bill would amend Public Health Law § 2899-a subdivi- sion 10 by requiring health homes, subcontractors of health homes, or any entity that provides home and community based services to enrollees who are diagnosed with developmental disability or under 21 years of age to conduct appropriate direct observation and evaluation of employees whose criminal history information check and determination are pending. Section 6 of this bill would amend Social Services Law § 424-a subdivi- sion 3 by providing access to information contained in the statewide central register of child abuse and maltreatment for health homes, subcontractors of health homes, or any entity that provides home and community based services to enrollees who are diagnosed with develop- mental disability or under 21 years of age. Section 7 of this bill would amend Social Services Law § 413 subdivision 1 paragraph a to require employees of health homes, subcontractors of health homes, or any entity that provides home and community based services to enrollees who are diagnosed with developmental disability or are under 21 years of age to report child abuse or maltreatment. Section 8 of this bill would amend Social Services Law § 364-j to penal- ize managed care plans for failure to submit a performing provider system (PPS) partnership plan by July 1, 2018. Penalties would be effec- tuated via a 0.85 percent reduction in a plans' monthly capitated reimbursement rate. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget and the State's multi-year Financial Plan by keeping overall Medicaid spending within capped levels, which are indexed to the ten- year rolling average of the medical component of the Consumer Price Index, as proscribed in current statute. The proposals in this section account for $25.9 million in savings in FY 2019 and $23.9 million in FY 2020. EFFECTIVE DATE: This bill would take effect April 1, 2018. Part D - Pharmaceutical-re- lated Medicaid Redesign Team recommendations. PURPOSE: This bill would make statutory changes necessary to implement pharmaceu- tical-related Medicaid Redesign Team recommendations. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Section one of this bill would amend Social Services Law § 367-a to update pharmacy co-payment rates to align with Federal requirements. Sections two and three of this bill would amend Social Services Law § 365-a and § 367-a to align coverage for non-prescription drugs and over- the-counter products with other states and the Federal Medicare Part D program, and to increase the required co-payment amount for such products from $0.50 to $1.00. Sections four and five of this bill would amend Public Health Law § 273 and Social Services Law § 364-j to reduce inappropriate prescribing by eliminating the prescriber's right of final determination in both FFS and managed care when the justification for use is not clinically supported. Section six of this bill would amend Public Health Law by adding a new § 280-c to allow physicians, nurse practitioners and pharmacists to provide comprehensive medication management to patients with a chronic disease or diseases who have not met clinical goals of therapy, are at risk for hospitalization, or whom the physician or nurse practitioner deems to need comprehensive medication management services. Partic- ipation by the patient in comprehensive medication management is volun- tary. Section seven of this bill would amend Social Services Law § 365-a to build on the State's effort to combat the opioid crisis by requiring a treatment plan and attestation of prescriber monitoring, including a patient-prescriber agreement when opioids are being prescribed for pain lasting more than three months or past the time of normal tissue heal- ing. Additionally the drug formulary is modified to encourage access to non-opioid alternatives. Patients being treated for cancer that is not in remission, in hospice or other end-of-life care, or whose pain is being managed as palliative care are exempted from these requirements. Section eight of the bill would amend Public Health Law § 280 by extend- ing the pharmacy drug cap through State fiscal year 2020. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget and the State's multi-year Financial Plan by keeping overall Medicaid spending within capped levels, which are indexed to the ten- year rolling average of the medical component of the CPI as proscribed in current statute. The pharmacy proposals in this section account for $29.8 million in net State savings in FY 2019 and $38.4 million in net State savings in FY 2020 EFFECTIVE DATE: This bill would take effect April 1, 2018 except that sections two and three take effect July 1, 2018. Part E - Transportation-related Medicaid Redesign Team recommendations. PURPOSE: This bill would make statutory changes necessary to achieve efficiencies in transportation-related Medicaid Redesign Team recommendations. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Section one of this bill would amend Social Services Law § 365-h subdi- vision 4 to carve-out the transportation benefit from the Managed Long Term Care (not including PACE plans) benefit package. This benefit would be delivered on a fee-for-service basis through the State's Trans- portation Manager consistent with Mainstream Managed Care. Section two of this bill would repeal Social Services Law § 367-s*2 to eliminate the supplemental payment to emergency medical transportation providers. The funding associated with the repeal of this payment would be reinvested into ambulance reimbursement rates based on recommenda- tions contained within the statutorily required Medicaid Transportation Rate Adequacy Report. Section three of this bill would repeal Social Services Law § 365-h subdivision 5 to eliminate the supplemental payment to rural transporta- tion networks. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the 2019 Executive Budget and the State's multi-year Financial Plan by keeping overall Medicaid spending within capped levels, which are indexed to the ten- year rolling average of the medical component of the CPI as proscribed in current statute. The Transportation proposals in this section account for $13.0 million in savings in FY 2019 and $19.0 million in FY 2020. EFFECTIVE DATE: This bill will take effect April 1, 2018 except that section one takes effect October 1, 2018. Part F - Reprogram Excess Medicaid Managed Care Reserves. PURPOSE: This bill will ensure appropriate Medicaid financing of managed care plans while preserving necessary contingent reserves. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: This bill would allow the Commissioner of Health to make Medicaid rate adjustments in the case of Medicaid managed care plans with reserves in excess of the minimum contingent reserve requirement. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget. EFFECTIVE DATE: This bill would take effect April 1, 2018. Part G - Authorizing Health Services Offered by Retail Practices. PURPOSE: This bill would authorize the provision of certain health services in retail settings by "retail practices". These retail practices would offer certain basic health services in a retail setting such as a phar- macy, grocery store, or shopping mall that would provide basic treatment and referral for common healthcare complaints. Studies have shown that retail clinics are 40-80% less expensive than alternate sites of care while providing commensurate quality. Retail practices offer extended hours with no appointment needed, increasing access to primary care services and providing an alternative to emergen- cy room care. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Section one of this bill would amend the Public Health Law by enacting a new Article 29-J to authorize the provision of certain health services in retail settings. Public Health Law § 2999-hh would set forth applicable definitions and define a "retail practice" as an entity located within a retail business that is open to the public with access to the retail practice from with- in the main premises of the retail operation. Retail practices would be staffed at all times by a physician, physician assistant, or nurse prac- titioner and are authorized to offer 'retail health services'. Retail health services include treatment for minor acute episodic illnesses or conditions, periodic wellness treatment including immuniza- tions, treatment of minor traumas, administration of opioid antagonists in case of an emergency, and limited behavioral health screening and referral, and may include certain laboratory tests. Retail health services do not include procedures utilizing sedation or anesthesia, care for patients under 24 months of age, vaccinations for individuals between 24 months and 18 years of age other than flu shots, employer provided on-site health services, educational courses on health topics, or services provided on a time-limited basis such as flu clinics or health fairs. Public Health Law § 2999-ii would define "retail practice sponsors" as business entities organized under the laws of New York, which could include professional corporations, business corporations, and entities licensed under PHL Article 28. This would permit, for example, general hospitals and diagnostic and treatment centers including federally qual- ified health centers, to serve as retail practice sponsors. Public Health Law § 2999-jj would provide that retail practices would have to: provide treatment without discrimination as to source of payment, which requires a retail practice to accept Medicaid; offer a sliding payment scale to patients without health care coverage and provide such patients with information on enrolling in the New York State of Health, the State's health plan marketplace; accept walk-in patients and offer extended business hours; post online a list of services they offer together with the prices of such services; and post signs to advise that prescriptions and over-the-counter supplies can be purchased elsewhere. Further, retail practices must enter into and maintain at least one collaborative relationship with a hospital, physician's practice, accountable care organization, or Performing Provider System under the Delivery System Reform Incentive Payment (DSRIP) Program; ask patients whether they have primary care providers and provide a list of local providers to those patients indicating that they do not; refer patients to other providers as appropriate; participate in electronic health records and the Statewide Health Information Network for New York (SHIN-NY); and attain and maintain accreditation. Public Health Law § 2999-kk would require that retail practices obtain and maintain accreditation and provide for the Department to approve accrediting agencies. Public Health Law § 2999-1I would set forth additional provisions such as clarifying that this new section of law does not change the scope of practice of any licensed or certified practitioner. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget and the State's multi-year Financial Plan by increasing access to cost-effective primary care services for Medicaid recipients and will reduce unnecessary emergency room visits by providing care in the most appropriate setting. This bill would generate $5 million in annual State savings in FY 2019 and FY 2020. EFFECTIVE DATE: This bill would take effect immediately. Part H - Expand scope of practice for certified nurse anesthetists (CRNAs). PURPOSE: This bill would codify the practice of nurse anesthesia and authorize Certified Registered Nurse Anesthetists (CRNAs) to practice to the full extent of their education and training, consistent with other States, to increase access to cost-effective anesthesia services while maintaining high quality of care. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Section one of the bill would add a new Education Law § 6902(4) to permit registered professional nurses who are certified as CRNAs pursu- ant to a new Education Law § 6912 to practice "nurse anesthesia." Currently, the scope of this practice is defined in Department of Health regulations. Nurse anesthesia must be provided in collaboration with a qualified, licensed physician and includes: the administration of anesthesia and anesthesia related care to patients; preanesthesia evaluation and prepa- ration; anesthetic induction, maintenance and emergence; post anesthesia care; perianesthesia nursing and clinical support functions; and pain management. The new section specifies that CRNAs may work in: general hospitals, hospital outpatient surgical departments, and diagnostic and treatment centers licensed by the Department of Health and authorized to provide sedation, anesthesia services, and/or pain management in connection with such licensure; practices where office-based surgery is performed or pain management services are provided; and dentists' and periodontists' offices where sedation and/or anesthesia services are provided. The new section also provides that anesthesia services offered by the provider, including services provided by CRNAs, shall be directed by a physician who is responsible for the clinical aspects of all anesthesia services offered by the provider and is qualified to determine the need for and administer anesthesia. Section 2 of the bill would add a new Education Law § 6912 regarding the education, training and licensure requirements for CRNAs. In order to be certified, CRNAs must be licensed registered nurses who have completed an accredited program who are certified by a State Education Department (SED) recognized national certifying body. Applicants must apply to SED and pay a $50 application fee, with registration required triennially. Currently practicing CRNAs would have two years to obtain certification within two years of the effective date of this bill and may practice while his or her application is pending. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget as it achieves $5.0 million annually in savings within the Global Cap. EFFECTIVE DATE: This bill would take effect immediately. Part I - Medicaid Integrity. PURPOSE: This bill would make statutory changes necessary to clarify OMIG's authority to recover overpayments and to ensure program integrity within the Medicaid Managed Care and Managed Long Term Care programs. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Section one and two of this bill would amend Social Services Law § 364-j to add two new subdivisions clarifying that payments made by the Medi- caid program to a managed care organization (MCO), and from an MCO to any subcontractor or provider, are public funds, and requiring that MCOs recover overpayments from subcontractors or providers when such overpay- ments have been identified by a State audit or investigation. Section three of this bill would amend Social Services Law § 364-j to add a new subdivision requiring MCOs to refer all cases of potential fraud, waste or abuse to OMIG, in conformance with federal law. In instances where an MCO has actual knowledge of an act of fraud being committed and willfully fails to refer to OMIG, OMIG may impose a fine of up to $100,000 for each determination. Section four of this bill would amend Public Health Law to add a new section § 37 to permit OMIG to impose fines (up to $5,000 for a provider or $100,000 for a MCO) for failure to comply with the rules, regu- lations, or directives of the Medicaid program, including instances when an MCO submits a cost report containing errors, or intentionally or systematically submits inaccurate encounter data to the state. Section five of this bill would amend Social Services Law § 364-j to create an express exception to the prohibition on assessing penalties for late, incomplete or inaccurate encounter data, in cases of fraud or abuse. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget and the State's multi-year Financial Plan by keeping overall Medicaid spending within capped levels, which are indexed to the ten- year rolling average of the medical component of the Consumer Price Index, as proscribed in current statute. The Medicaid Integrity proposals in this section account for $5 million in savings in FY 2019 and $10 million in savings in FY 2020. EFFECTIVE DATE: This bill would take effect 90 days after enactment. Part J - Amend New York State's False Claims Act penalties to align with the Federal False Claims Act. PURPOSE: This bill would amend New York State's False Claims Act penalties to align with the Federal False Claims Act penalties in order to preserve enhanced recovery benefits. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: This bill would amend subdivision 1 of section 189 of the State Finance Law to automatically adjust the minimum and maximum penalty amounts to equal the civil penalty allowed under the Federal False Claims Act, if and as the penalties are adjusted for inflation. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget because states that enact compliant False Claims Acts are permit- ted to reduce the FMAP paid to the Federal Government by 10%, allowing the State to keep a greater share of fraud recoveries. In FY 2016, NYS received $13.5 million attributable to the 10% enhancement for compli- ance with the Federal False Claims Act. EFFECTIVE DATE: This bill would take effect immediately. Part K - Extend the Medicaid Global Cap and other miscellaneous Medi- caid-related proposals. PURPOSE: This bill would make statutory changes necessary to extend the Medicaid Global Cap and implement other miscellaneous Medicaid-related proposals. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Section one authorizes the Department of Health to require any Medicaid provider within fee-for-service or managed care to submit cost report- ing. Section two would amend the Laws of 2017 to extend the Medicaid Global Cap budgeting construct through FY 2020. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget and the State's multiyear Financial Plan by keeping overall Medi- caid spending within capped levels, which are indexed to the ten-year rolling average of the medical component of the CPI as proscribed in current statute. EFFECTIVE DATE: This bill would take effect immediately. Part L - Child Health Plus related recommendations. PURPOSE: This bill would provide the Executive with the authority to make changes to the Child Health Plus program in the event that Congress does not reauthorize Federal funding and to achieve efficiencies within the program. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Section 1 of this bill would amend § 2511 of the Public Health Law to allow the State to make necessary programmatic changes in the event that Congress reduces or eliminates Federal funding for the Child Health Plus program on and after October 1, 2017. The Director and Commissioner will notify the Legislature of the amount of funding that has been reduced and the actions being taken to align program spending with current State funding levels. Section 2 of this bill would amend Social Services Law § 369 subdivision seven by adding the Child Health Plus program the list of programs which are eligible to contract with outside entities for the purpose of conducting third party liability recoveries to ensure an efficient use of public resources. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget and the State's multi-year Financial Plan. This bill will also allow the State to make necessary programmatic changes in the event that Federal funding for the Child Health Plus program is reduced or elimi- nated. EFFECTIVE DATE: This bill would take effect April 1, 2018. Part M - Extend the Physicians Excess Medical Malpractice Program for one year. PURPOSE: This bill would extend the provisions of the Excess Medical Malpractice program through June 30, 2019. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Sections one through six amend chapter 266 of the laws of 1986 to extend the hospital excess liability pool by one year through June 30, 2019. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget in order to continue the Excess Medical Malpractice program. EFFECTIVE DATE: This bill would take effect immediately. Part N - Discontinue COLA payments to certain Department of Health providers. PURPOSE: This bill would discontinue Cost of Living Adjustment (COLA) payments to certain DOH providers. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: In 2006, DOH and other human service agencies authorized COLA payments within certain programs. The COLA payments were indexed to the Consumer Price Index, and currently set at 0.2%. However, COLA payments were not made regularly. These payments were last paid in FY 2017. This proposal would discontinue COLA payments within certain DOH programs. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget to achieve savings of $19.9 million in FY 2019. EFFECTIVE DATE: This bill would take effect April 1, 2018. Part 0 - Reform the Early Intervention program. PURPOSE: This bill would reform the Early Intervention (El) program by streamlin- ing the eligibility process and ensuring appropriate health insurance reimbursement for covered El services. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: EI provides a comprehensive array of therapeutic and support services to children under age three with confirmed disabilities (e.g., autism, cerebral palsy, Down Syndrome) or developmental delays in physical, cognitive, communication, social-emotional, or adaptive development. Services are provided at no cost to families participating in the program. The program is financed by a combination of State, local government, Medicaid, and commercial insurance dollars. Currently, a child may be referred to EI when the child's parent or a "primary referral source" - such as a health care provider - believes that the child is suspected of having a developmental delay or certain diagnosed conditions. A multidisciplinary evaluation and assessment is conducted to determine the child's eligibility for EI. If the evaluator determines that the child is eligible, an Individualized Family Services Plan (IFSP) is developed, setting forth the services plan for the child and identifying the providers who would provide those services. Sections 1 through 4 would decrease the time from referral to the provision of services and reduce unnecessary testing by streamlining the evaluation process and tailoring the process to the child. Reducing unnecessary evaluations will also increase provider capacity to deliver services. Sections 1 and 2 would amend Public Health Law § 2541 to revise the definitions of "evaluation" and "evaluator" and to define the terms, "partial evaluation," "multidisciplinary" and "screening." Section 3 would amend Public Health Law § 2542(3) to require persons who refer children to El to inform parents that, for children with a diag- nosed physical or mental condition, eligibility would be established through a records review. Section 4 would amend PHL § 2544 to: *Require service coordinators to inform parents of the screening, evalu- ation, and review procedures; *Require screenings for children referred to EI to determine if they are suspected of having a disability; if, based on the screening, a child is suspected of having a disability, then an evaluation will be conducted; *Establish that for children with a diagnosed physical or mental condi- tion eligibility would be established using the child's medical or other records; *Establish that if a child is found eligible, he or she will receive: an assessment to identify the services appropriate to meet his or her needs, a voluntary family-directed assessment, and an assessment of any transportation needs; and *Require that, following a request by a parent, a full evaluation be conducted for a child who has a diagnosed physical or mental condition who was found ineligible following a records review. EI Providers are required to seek reimbursement from third party payers in the first instance, including health insurers and Medicaid. Even though approximately 40 percent of children in EI have private health insurance, such insurers deny the majority of EI claims submitted. EI services not covered by third party payers (private insurers or Medi- caid) are reimbursed by the county in which the child resides. County governments are subsequently reimbursed by the State for 49 percent of the amount they reimburse providers. Reforms enacted in SFY 2013 established a direct relationship between third party payers and a State Fiscal Agent (SFA) to manage EI claims. However, in SFY 2017 alone, 82 percent of claims submitted to private insurers were denied --insurers received $67 million in claim submissions, of which they only paid $12 million in reimbursement. This is only 2 percent of total EI expenditures ($660 million), compared with 43 percent ($282 million) paid by Medicaid, 26 percent ($172 million) paid by the State, and 29 percent ($193 million) paid by counties. Sections 5 through 16 would better define health insurer requirements and increase the enforcement capacity of the Department of Financial Services (DFS). Section 5 would amend Insurance Law § 3235-a to require insurers to: *Pay for EI services that are covered under the child's insurance poli- cy; and *Consider an IFSP signed by the child's health care provider, as part of a medical necessity review for EI services. Sections 6 and 7 would amend Public Health Law § 2559 to require the parent to provide, or allow others (the county, service coordinator, or provider) to obtain, the health care provider's signature on the IFSP, as required by section 5. Additionally, section 6 would require providers, with assistance from the SFA, to appeal insurer payment denials prior to submitting such claims to the county for payment. Pursuing at least one level of appeal would allow DFS to identify and address patterns of denials for EI services that are inconsistent with the Insurance Law. Sections 8 through 15 would amend Articles 49 of the Public Health Law and Insurance Law to clarify that EI providers and services are subject to the utilization review and external appeal requirements in New York State Law. Section 16 would amend Insurance Law § 109 to increase the maximum fine for entities regulated under the Insurance Law that are found to have improperly paid a claim or made a false statement to DFS. Section 17 would establish that providers will receive a two percent rate increase upon enactment of the requirement that they appeal insurer payment denials. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget to achieve a total net savings of $3.2 million in FY 2019 and $9.5 million once annualized. Additionally, this bill would drive local savings of $9.8 million annually. EFFECTIVE DATE: This bill would take effect April 1, 2018. Part P - Eliminate certain Health Care Reform Act (HCRA) programs. PURPOSE: This bill would eliminate certain programs funded by the Health Care Reform Act (HCRA) to achieve administrative and financial efficiencies. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Sections one and two of this bill would amend sections 2807-m and 2807-s to eliminate the ECRIP program. ECRIP provides funding to eligible institutions to train physicians in clinical research and support projects but provides no direct care services. Funding for this program is duplicative of coordinated biomedical research funding made available through the State's life science initiatives. Section three of this program eliminates the requirement for hospital resident hour working audits to be performed annually. The Department of Health will substitute an attestation requirement going forward wherein hospitals certify that they are in compliance with applicable working hour and working condition requirements; however, the elimination of this program does not prohibit the State from performing targeted inves- tigations into hospital compliance if necessary. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget because it achieves $7.74 million annually in Financial Plan savings. EFFECTIVE DATE: This bill would take effect immediately. Part Q - Authorize additional capital support for the health care providers. PURPOSE: This bill would provide additional health care capital support to health care providers by establishing a new statewide Health Care Facility Transformation Program. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: The Executive Budget continues past efforts providing capital support to health care providers through the creation of a third Health Care Facil- ity Transformation Program. Funding of $425 million, which will be made available to eligible health care systems statewide, would be financed through a combination of bonds issued by the Dormitory Authority of the State of New York (DASNY) and hard dollar capital funding. Section 1 would create a new section § 2825-f of the Public Health Law in order to establish a Statewide Health Care Facility Transformation Program. This Program would provide funding to support capital projects, debt retirement, working capital and other non-capital projects that facilitate transformative activities including merger and consolidation, acquisition and other activities intended to create financially sustain- able systems of care, preserve or expand essential health care services, modernize facilities and infrastructure, foster participation in value based payments arrangements including but not limited to contracts with managed care plans and accountable care organizations, increase the quality of resident care in residential health care facilities, or improve health information technology infrastructure, including tele- health. Of this amount, $60 million will be made available specifically for community-based health care providers. These providers include diag- nostic and treatment centers, mental health clinics, alcohol and substance abuse treatment clinics, primary care providers, home care providers, and assisted living programs. Within the $60 million, up to $20 million will be made available specifically for assisted living facilities. Additionally, $45 million will be made available to residen- tial health care facilities. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget because continued support to the Health care Facility Transforma- tion Program is essential to support the needs of health care facilities throughout the State. Funding of $425 million would be financed through bonds issued by the Dormitory Authority of the State of New York (DASNY). EFFECTIVE DATE: This bill would take effect April 1, 2018 Part R - Reduce the Risk of Exposure to Lead Paint in Residential and Non-Residential Settings. PURPOSE: This bill would take measures to reduce the risk of exposure to lead paint. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: This bill would strengthen lead paint regulations by requiring munici- palities that administer the Uniform Fire Prevention and Building Code ("Uniform Code") to report inspection and remediation outcome summaries to the Department of Health. It would require local code enforcement officers to conduct periodic inspections, and would establish protections for tenants from reporting suspected violations. It would also enable the Commissioner of Health to work with the Department of Housing and Community Renewal and other relevant agencies to inspect residential and nonresidential properties and to ensure implementation of lead remediation measures. Section 1 would amend Public Health Law § 1373 to require municipalities that administer the Uniform Code, and contain areas identified as "high risk" by the Commissioner of Health, to submit reports to DOH summariz- ing the outcome of inspections and remediation conducted. Section 2 would amend Executive Law § 378 to include a presumption that all paint in and on residential and non-residential buildings and struc- tures built before January 1, 1978 is lead-based, and would require that these buildings be maintained so that the paint does not deteriorate more than minimally. Section 3 would amend Executive Law § 381 to require the Department of State (DOS) to issue regulations requiring local code enforcement offi- cers to conduct periodic inspections of local residential property to ensure compliance with Uniform Code requirements for lead paint. Addi- tionally, DOS would be required to issue regulations concerning remedies to abate such violations, including certification by a lead-based paint inspector that a building does not contain lead paint and that deteri- orated paint violations have been abated. Section 4 would amend Real Property Law § 23-b to create anti-retalia- tion protections for tenants. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget. EFFECTIVE DATE: This bill would take effect 180 days after it becomes a law. Part S - Regulatory Modernization Initiative related Medicaid Redesign Team recommendations. PURPOSE: This bill would make statutory changes that would implement program and policy changes to effectuate the recommendations of the Regulatory Modernization Initiative (RMI) for the purpose of aligning health care best practices with transformative changes to the laws that govern the health care system. These changes will facilitate an environment where providers, payers, and patients are best positioned to ensure access, promote patient safety, and lower costs. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Subpart A of this bill would amend Public Health Law § 3001 and create a new Public Health Law §§ 2805-z and 3001-a to permit health care provid- ers to collaborate on community paramedicine programs that allow emer- gency medical personnel to provide care within their certification, training, and experience in residential settings. Community paramedi- cine collaboratives would include, at a minimum: (1) a general hospi- tal, nursing home, or diagnostic and treatment center; (2) a physician; (3) an emergency medical services provider; and (4) where the services are provided in a private residence, a home care services program. Collaboratives would be required to provide notification to the Depart- ment of Health (DOH) of the commencement of a community paramedicine program and would be required to report to DOH on their activities and outcomes. Under the direction of a physician, community paramedicine programs would support objectives identified by the collaboratives and could include models that focus on providing post-discharge care following hospital admissions for the purpose of avoiding readmissions; evaluat- ing, stabilizing, or treating nursing home residents to avoid preventa- ble emergency transport to a hospital emergency room; and assisting individuals in self-managing their health or behavioral health condi- tions and minimizing environmental hazards in the home. These programs are anticipated to support the efforts of providers moving to value- based payment models. The bill also would amend Social Services Law § 3fi5-a to authorize Medicaid reimbursement for community paramedicine services, subject to federal financial participation. Subpart B of this bill would amend Public Health Law § 2801 and Mental Hygiene Law §§ 31.02 and 32.05 to clarify that providers licensed or certified under Public Health Law Article 28 or Mental Hygiene Law Arti- cles 31 or 32 may provide integrated primary care, mental health and/or substance use disorder services when authorized to do so by DOH, the Office of Mental Health (OMH), or the Office of Alcoholism and Substance Abuse Services (OASAS) pursuant to regulation without needing a second or third license or certification from one of the other agencies. These changes would facilitate the ability of providers to address the co-oc- curring needs of their patients, promoting better overall coordination and accessibility of care and improved patient outcomes. Subpart C of this bill would amend Public Health Law § 2999-cc to expand the definition of "originating site" for purposes of Medicaid reimburse- ment for telehealth services to include a patient's residence as well as any other location where the patient may be temporarily located. This bill would also add credentialed alcoholism and substance abuse counse- lors, authorized early intervention providers, and any other providers (as determined in regulation by OMH, OASAS, and the Office for People With Developmental Disabilities in consultation with DOH) to the list of medical professionals eligible to provide telehealth services. Finally, the bill would clarify that "remote patient monitoring," which is the transmission of data to a distant telehealth provider for use in moni- toring and managing medical conditions, could encompass follow-up tele- phone calls or additional interactive requests for the transmission of data in response to previous transmissions. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget and the State's multi-year Financial Plan by keeping overall Medicaid spending within capped levels, which are indexed to the ten- year rolling average of the medical component of the Consumer Price Index, as proscribed in current statute. These RMI proposals account for $3.9 million in State share savings in FY 2019 and $6.8 million in State share savings in FY 2020. EFFECTIVE DATE: Subpart A of this bill would take effect immediately. Subpart B of this bill would take effect 180 days after enactment. Subpart C of this bill would take effect 90 days after enactment. Part T - Extend various provisions of the Public Health and Social Services Laws. PURPOSE: This bill would extend various expiring laws to maintain Financial Plan savings by continuing certain previously enacted Medicaid and health savings initiatives authorized in the Public Health and Social Services Laws. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Section one of this bill would amend Chapter 59 of the laws of 2016, extending the Department's ability to require drug manufacturers to provide rebates for any drug that has increased more than 300 hundred percent of its state maximum acquisition cost (SMAC) through April 1, 2023. Section two of this bill would amend Chapter 58 of the laws of 2007, extending authorization for spousal budgeting in long-term care waiver programs, including Managed Long Term Care, through April 1, 2023. Section three of this bill would amend Chapter 54 of the laws of 2016, extending a Statewide Medicaid integrity and efficiency initiative for the purpose of achieving new audit recoveries through April 1, 2023. Section four of this bill would amend Chapter 906 of the laws of 1984, extending the authority of the State to continue the Care at Home (CAH) I and II waivers which provide community-based services to physically disabled children who require hospital or skilled nursing home level of care, allowing the child to reside at home instead of in an institution, through April 1, 2023. Section five of this bill would amend Chapter 56 of the laws of 2013, maintaining the elimination of a trend factor for general hospital reimbursement through December 31, 2019. Section six of this bill would provide for an immediate effective date. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget because it ensures the continuation of $516.4 million in previ- ously enacted State Financial Plan savings. EFFECTIVE DATE: This bill would take effect immediately. Part U - Extending existing processes for certain time-limited demon- stration programs for specialized inpatient psychiatry units for chil- dren and adults. PURPOSE: This bill would extend existing processes for certain time-limited demonstration programs for specialized inpatient psychiatric units for children and adults. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: This bill would amend chapter 58 of the laws of 2015 by extending the relevant fiscal period to March 31, 2021, for certain time-limited demonstration programs for evaluating new methods of services for indi- viduals with intellectual and/or developmental disabilities (I/DD). BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget as it would test and evaluate the delivery of essential services for at-risk individuals. EFFECTIVE DATE: This bill would take effect immediately and expire on March 31, 2021. Part V - Extend community reinvestment for State psychiatric center inpatient bed closures. PURPOSE: This bill would extend community reinvestment for State psychiatric center inpatient bed closures for three years. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: This bill would extend for three years current law requiring the Office of Mental Health (OMH) to reinvest $110,000 per inpatient bed closure for community mental healthservices. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget and would allow OMH to continue its practice of community mental health support reinvestment due to inpatient bed closures at a rate of $110,000 per bed. EFFECTIVE DATE: This bill would take effect immediately. Part W - Authorizes the establishment of voluntary restoration to compe- tency programs within locally-operated jails and State prisons. PURPOSE: This bill would authorize the Office of Mental Health (OMH) to permit restoration to competency within local and State operated jail-based residential settings provided such entities agree to participate in such a program. Such voluntary programs would be available in separate resi- dential mental health units. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: This proposal would amend Section 730.10 of the Criminal Procedure Law (CPL) to authorize the establishment of jail-based restoration to compe- tency programs, for felony defendants pending judicial hearings, within locally-operated jails and State prisons operated by the Department of Corrections and Community Supervision (DOCCS), subject to the facility's consent. Specifically, NYS counties would be authorized to voluntarily develop residential mental health pod unit(s) within local jails for the purposes of housing, treating, and restoring felony-level defendants to competency as they await trial. Similarly, this proposal would author- ize DOCCS to voluntarily develop similar restoration unit(s) within the NYS correctional system by agreement with OMH. Currently, New York State CPL Section 730.10 provides that felony-level defendants may be restored to competency in an: a) OMH psychiatric center; b) psychiatric unit within an Art. 28 hospital; or c) outpatient basis in the community. This proposal would expand CPL to allow restora- tion to competency to take place in mental health unit(s) operated with- in a State or local correctional facility, subject to the facility's consent. Up to $850K of State Aid grants may be made available to aid in the development of local mental health unit(s) and any unit created in New York City will be limited to 25 beds. OMH currently supports approximately 300 inpatient forensic beds that are used to serve an estimated 625 annual admissions of felony defend- ants deemed incompetent to stand trial. The cost per restoration is approximately $128,000 and the State and counties each pay 50 percent. By contrast, it is estimated that the per bed costs to restore these defendants in a jail-based setting is roughly one-third of the cost at a State psychiatric center (approximately $42,500 per restoration annual- ly). Since counties reimburse OMH for the costs of any restorations that occur at State hospitals, this proposal would save participating coun- ties 33 percent of what they spend for such services or approximately $21,500 per restoration. Additionally, any county that consents to operate a jail-based restoration program would be eligible for addi- tional State grant funding for the design, planning, construction and/or the operation of such program. OMH plans to reinvest up to $850K in savings for such purposes. This proposal also authorizes OMH to provide eight full time clinical staff to augment a restoration unit at DOCCS, should the facility consent to doing so. Restorations to competency in jail-based residential settings have been implemented or have legislative authority in nine other states (includ- ing California, Virginia and Wisconsin). BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget and generate OMH operational savings of $4.2 million and DOCCS operational savings of $1.1 million when fully annualized (including fringe). This proposal will also result in lower costs for participating local governments and a portion of these savings would be reinvested to support local governments and DOCCS operational costs. EFFECTIVE DATE: This bill would take effect immediately. Part X- Extend authority for Office of Mental Health (OMH) and Office for People with Developmental Disabilities (OPWDD) facility directors to act as representative payees consistent with federal law and regu- lations. PURPOSE: This bill would extend for three years the authority of OMH and OPWDD facility directors to act as representative payees to use funds for the cost of a resident's care and treatment. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: This bill would amend Chapter 58 of the Laws of 2015 to extend the authority of state facility directors who act as federally-appointed representative payees to use funds for the cost of a resident's care and treatment, consistent with federal law and regulations. This bill would continue current statute and existing practice that the application of funds for a person's care and treatment does not violate a facility director's fiduciary obligations Facility directors who act as represen- tative payees must still comply with applicable federal laws and regu- lations. The amendments enacted under Chapter 58 of the Laws of 2015, and continued here, provide enhanced transparency and maintain addi- tional parameters for the use of funds. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget and will avoid a potential loss of $7 million from OMH and $69 million from OPWDD in revenue on an annual basis. EFFECTIVE DATE: This bill would take effect immediately. Part Y - This bill clarifies the responsibilities and tasks that require psychology, social work, or mental health licensure for individuals working in certain programs and services that are regulated, operated, funded or approved by the Office of Mental Health (OMH), the Office for People with Developmental Disabilities (OPWDD), the Office for Alcohol- ism and Substance Abuse Services (OASAS), the Department of Health (DOH), the State Office for the Aging (SOFA), the Office of Children and Family Services (OCFS), the Department of Corrections and Community Services (DOCCS), the Office for Temporary and Disability Assistance (OTDA), and/or local governmental units or social service districts. PURPOSE: This bill clarifies which tasks and assignments performed by persons employed by a program or service operated, regulated, funded or approved by OMH, OPWDD, OASAS, DOH, SOFA, OCFS, DOCCS, OTDA, and/or a local governmental units or a social services district require psychology, social work, or mental health practitioner licensure. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Education Law Articles 153, 154 and 163 define the scope of practice for psychologists, social workers, and mental health practitioners. Since 2002, persons employed in programs regulated, operated, funded or approved by OMH, OPWDD, OASAS, DOH, SOFA, OCFS, DOCCS, OTDA, and/or local governmental units or social services districts have been exempt from these licensure requirements. This exemption was most recently extended for a two-year period in the FY 2015-16 enacted budget. This bill would amend Education Law to delineate those services which do and do not require licensure. For example, it would clarify that peer services, coordination of benefit counseling, and domestic violence assistance, among others, do not require licensure. Although the bill would not extend the existing exemption, it would permit those who have been employed or obtain employment on or before July 1, 2020 to continue to benefit from the existing exemption. This will preserve continuity of employment and assure an effective transi- tion to the new standards without a disruption in services. Any person employed after July 1, 2020 would need to meet the requirements of the newly-defined scope of practice. BUDGET IMPLICATIONS: Applying current licensure requirements to staff in regulated programs would result in annual costs of $324 million, including costs for the state-provided services and services provided by entities licensed and regulated by the State. Clarifying which tasks and assignments require psychology, social work, or mental health practitioner licensure would avoid these additional costs. EFFECTIVE DATE: This bill would take effect immediately. Part Z - This bill would correct statutory references with respect to OPWDD waiver services, extend OPWDD's managed care authority, and make technical amendments to that authority. PURPOSE: The Office for People With Developmental Disabilities (OPWDD) is transi- tioning its waiver services from section 1915(c) of the Social Security Act to section 1115. The bill would update statutory references in light of this transition. Further, the bill would extend OPWDD's managed care authority, currently due to expire in 2019, and make technical amend- ments to that authority. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Sections 1, 2, 3, 5, 6, 7, 8, and 9 would amend statutory references to reference to section 1115 of the Social Security Act, consistent with the transition of OPWDD services to this waiver authority. Sections 4, 10, 12, and 17 would extend certain provisions of various state laws. Sections 11 and 13 would amend affiliation requirements to allow a managed care organization to affiliate with an entity or entities that are controlled by non-profit organizations to provide care coordination services. This amendment would allow care coordination organizations, which are entities controlled by non-profit organizations, to provide care coordination services to managed care organizations. Sections 14 and 15 would clarify that health and long term care services to be provided by managed care plans authorized under Public Health Law 4403-g would include comprehensive health services and other services to be determined by the commissioners of OPWDD and the Department of Health. Section 16 would clarify that the readiness and capability of managed care plans would include the ability to organize, market, manage, promote, and operate a health and long term care services plans. Section 18 would assure that managed care networks provide comprehensive coverage. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget because failing to transfer the 1115 waiver amendment into the appropriate provision of law would potentially deprive OPWDD of the ability to properly license and certify providers of services to persons with developmental disabilities. Amendments are also necessary to permit the flow of Medicaid funding to those services. Finally, without an extension of managed care authority, the OPWDD system will not be able to move beyond the system of fee-for-service reimbursement and will not experience the improvements and efficiencies of managed care service environments. EFFECTIVE DATE: This bill would take effect immediately. Part AA - Human Services COLA. PURPOSE: This bill would eliminate the statutory Human Services Cost of Living Adjustment for the period of April 1, 2018 to March 31, 2019. SUMMARY OF PROVISIONS AND STATEMENT IN SUPPORT: Section 1 establishes that there shall not be a new Cost of Living Adjustment (COLA) for the period beginning April 1, 2018 and ending March 31, 2019. It also provides that when a COLA is provided beginning April 1, 2018, those provisions will be in place for three years. Section 2 provides for an effective date of April 1, 2018. BUDGET IMPLICATIONS: Enactment of this bill is necessary to implement the FY 2019 Executive Budget because this legislation will result in savings to the Financial Plan of $19.12 Million for FY 2019. EFFECTIVE DATE: This bill would take effect on and after April 1, 2018. The provisions of this act shall take effect immediately, provided, however, that the applicable effective date of each part of this act shall be as specifically set forth in the last section of such part.
2017-S7507 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ S. 7507 A. 9507 S E N A T E - A S S E M B L Y January 18, 2018 ___________ IN SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti- cle seven of the Constitution -- read twice and ordered printed, and when printed to be committed to the Committee on Finance IN ASSEMBLY -- A BUDGET BILL, submitted by the Governor pursuant to article seven of the Constitution -- read once and referred to the Committee on Ways and Means AN ACT to amend the public health law, in relation to establishing a temporary workgroup on capital rate methodology for capital expendi- tures to hospitals and residential nursing facilities; and to amend the social services law, in relation to standard coverage for physical therapy services under medical assistance for needy persons programs (Part A); to amend the public health law, in relation to payments to residential health care facilities; to amend the social services law and the public health law, in relation to assisted living program providers licensed in the state; to amend the social services law, in relation to payments for certain medical assistance provided to eligi- ble persons participating in the New York traumatic brain injury waiv- er program; and to repeal certain provisions of section 366 of the social services law relating to furnishing medical assistance (Part B); to amend the social services law and the public health law, in relation to health homes and penalties for managed care providers (Part C); to amend the social services law and the public health law, in relation to drug coverage, updating the professional dispensing fee, copayments, pharmacist physician collaboration and comprehensive medication management; and to repeal certain provisions of the social services law relating thereto (Part D); to amend the social services law, in relation to reimbursement of transportation costs, reimburse- ment of emergency transportation services and supplemental transporta- tion payments; and repealing certain provisions of such law relating thereto (Part E); providing for not-for-profit and tax exempt corpo- rations' Medicaid capitation rates (Part F); to amend the public health law, in relation to authorizing certain retail practices to offer health services (Part G); to amend the education law, in relation to the practice of nursing by certified registered nurse anesthetists (Part H); to amend the social services law and the public health law, in relation to managed care organizations (Part I); to
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD12671-01-8 S. 7507 2 A. 9507 amend the state finance law, in relation to the false claims act (Part J); authorizing the department of health to require certain health care providers to report on costs incurred; and to amend chapter 59 of the laws of 2011 amending the public health law and other laws relat- ing to known and projected department of health state fund medicaid expenditures, in relation to extending the medicaid global cap (Part K); to amend the social services law and the public health law, in relation to the child health insurance program (Part L); to amend chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, in relation to apportioning premium for certain policies; to amend part J of chapter 63 of the laws of 2001 amending chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, relat- ing to the effectiveness of certain provisions of such chapter, in relation to extending certain provisions concerning the hospital excess liability pool; and to amend part H of chapter 57 of the laws of 2017, amending the New York Health Care Reform Act of 1996 and other laws relating to extending certain provisions relating thereto, in relation to extending provisions relating to excess coverage (Part M); to amend part C of chapter 57 of the laws of 2006, establishing a cost of living adjustment for designated human services, in relation to the determination thereof; and to repeal certain provisions thereof relating to eligible programs (Part N); to amend the public health law and the insurance law, in relation to the early intervention program for infants and toddlers with disabilities and their families (Part O); to amend the public health law, in relation to the empire clinical research investigator program and hospital resident hour audits; and to repeal certain provisions of the public health law relating thereto (Part P); to amend the public health law, in relation to the health care facility transformation program (Part Q); to amend the public health law, the executive law, and the real property law, in relation to lead abatement and enforcement (Part R); to amend the public health law and the social services law, in relation to the establishment of community paramedicine collaboratives (Subpart A); to amend the public health law and the mental hygiene law, in relation to integrated services (Subpart B); and to amend the public health law, in relation to the definitions of telehealth provider, originating site and remote patient monitoring (Subpart C)(Part S); to amend chapter 59 of the laws of 2016, amending the social services law and other laws relating to authorizing the commissioner of health to apply federally estab- lished consumer price index penalties for generic drugs, and authoriz- ing the commissioner of health to impose penalties on managed care plans for reporting late or incorrect encounter data, in relation to the effectiveness of certain provisions of such chapter; to amend chapter 58 of the laws of 2007, amending the social services law and other laws relating to adjustments of rates, in relation to the effec- tiveness of certain provisions of such chapter; to amend chapter 54 of the laws of 2016, amending part C of chapter 58 of the laws of 2005, authorizing reimbursements for expenditures made by or on behalf of social services districts for medical assistance for needy persons and administration thereof, in relation to the effectiveness thereof; to amend chapter 906 of the laws of 1984, amending the social services law relating to expanding medical assistance eligibility and the scope of services available to certain persons with disabilities, in relation to the effectiveness thereof; and to amend chapter 56 of the S. 7507 3 A. 9507 laws of 2013, amending chapter 59 of the laws of 2011 amending the public health law and other laws relating to general hospital reimbursement for annual rates relating to the cap on local Medicaid expenditures, in relation to rates of payments (Part T); to amend part NN of chapter 58 of the laws of 2015 amending the mental hygiene law relating to clarifying the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs, in relation to the effectiveness thereof (Part U); to amend chapter 62 of the laws of 2003, amending the mental hygiene law and the state finance law relating to the community mental health support and workforce reinvestment program, the membership of subcommittees for mental health of community services boards and the duties of such subcommittees and creating the community mental health and workforce reinvestment account, in relation to extending such provisions relating thereto (Part V); to amend the criminal procedure law, in relation to amending the definition of appropriate institu- tion; and providing for the repeal of such provisions upon expiration thereof (Part W); to amend 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 X); to amend the education law, in relation to persons practicing in certain licensed programs or services who are exempt from practice requirements of professionals licensed by the department of education; to amend chapter 420 of the laws of 2002, amending the education law relating to the profession of social work, in relation to extending the expiration of certain provisions thereof; to amend chapter 676 of the laws of 2002, amending the education law relating to the practice of psychology, in relation to extending the expiration of certain provisions; and to amend chap- ter 130 of the laws of 2010, amending the education law and other laws relating to the registration of entities providing certain profes- sional services and licensure of certain professions, in relation to extending certain provisions thereof (Part Y); to amend the social services law, in relation to adding demonstration waivers to waivers allowable for home and community-based services; to amend the social services law, in relation to adding successor federal waivers to waiv- ers granted under subsection (c) of section 1915 of the federal social security law, in relation to nursing facility services; to amend the social services law, in relation to waivers for high quality and inte- grated care; to amend part C of chapter 58 of the laws of 2007, amend- ing 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 fiscal year, in relation to the effectiveness thereof; to amend the mental hygiene law, in relation to adding new and successor federal waivers to waivers in relation to home and community-based services; to amend part A of chapter 56 of the laws of 2013, 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 2013-2014 state fiscal year, in relation to the effectiveness of certain provisions thereof; to amend the public health law, in relation to expansion of comprehensive health services 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 communi- ties, in relation to extending provisions thereof; to amend the public S. 7507 4 A. 9507 health law, in relation to managed long term care plans, health and long term care services and developmental disability individual support and care coordination organizations; to amend chapter 165 of the laws of 1991, amending the public health law and other laws relat- ing to establishing payments for medical assistance, in relation to extending the provisions thereof; to amend the mental hygiene law, in relation to reimbursement rates; and to amend chapter 710 of the laws of 1988, amending the social services law and the education law relat- ing to medical assistance eligibility of certain persons and providing for managed medical care demonstration programs, in relation to extending the provisions thereof (Part Z); and to amend part C of chapter 57 of the laws of 2006, relating to establishing a cost of living adjustment for designated human services programs, in relation to the inclusion and development of certain cost of living adjustments (Part AA) 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 2018-2019 state fiscal year. Each component is wholly contained within a Part identified as Parts A through AA. The effective date for each particular provision contained within such Part is set forth in the last section of such Part. Any provision in any section contained within a Part, includ- ing the effective date of the Part, which makes a reference to a section "of this act", when used in connection with that particular component, shall be deemed to mean and refer to the corresponding section of the Part in which it is found. Section three of this act sets forth the general effective date of this act. PART A Section 1. The public health law is amended by adding a new section 2827 to read as follows: § 2827. TEMPORARY WORKGROUP ON CAPITAL RATE METHODOLOGY. (A) THE COMMISSIONER SHALL CONVENE A TEMPORARY WORKGROUP COMPRISED OF REPRESEN- TATIVES OF HOSPITALS AND RESIDENTIAL NURSING FACILITIES, AS WELL AS REPRESENTATIVES FROM THE DEPARTMENT, TO DEVELOP RECOMMENDATIONS FOR STREAMLINING THE CAPITAL REIMBURSEMENT METHODOLOGY TO ACHIEVE A ONE PERCENT REDUCTION IN CAPITAL EXPENDITURES TO HOSPITALS AND RESIDENTIAL NURSING FACILITIES, INCLUDING ASSOCIATED SPECIALTY AND ADULT DAY HEALTH CARE UNITS. PENDING THE DEVELOPMENT OF THE WORKGROUP'S RECOMMENDATIONS AND THE IMPLEMENTATION OF ANY SUCH RECOMMENDATIONS ACCEPTED BY THE COMMISSIONER, THE COMMISSIONER SHALL BE AUTHORIZED TO REDUCE THE OVERALL AMOUNT OF CAPITAL REIMBURSEMENT AS NECESSARY TO ACHIEVE A ONE PERCENT REDUCTION IN CAPITAL EXPENDITURES BEGINNING WITH STATE FISCAL YEAR TWO THOUSAND EIGHTEEN--TWO THOUSAND NINETEEN. (B) THE COMMISSIONER MAY PROMULGATE REGULATIONS TO EFFECTUATE THE PROVISIONS OF THIS SECTION. § 2. Subdivision 5-d of section 2807-k of the public health law, as amended by section 1 of part E of chapter 57 of the laws of 2015, 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 S. 7507 5 A. 9507 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 [eigh- teen] NINETEEN, 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 [eighteen] NINETEEN 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 (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 Janu- ary first, two thousand sixteen, is greater than ten percent; and for the calendar year beginning on January first, two thousand seventeen, is S. 7507 6 A. 9507 greater than twelve and one-half percent; and for the calendar year beginning on January first, two thousand eighteen, is greater than fifteen percent; AND FOR THE CALENDAR YEAR BEGINNING ON JANUARY FIRST, TWO THOUSAND NINETEEN, IS GREATER THAN SEVENTEEN AND ONE-HALF PERCENT. (iv) Such regulations shall reserve one percent of the funds available for distribution in the two thousand fourteen and two thousand fifteen calendar years, and for calendar years thereafter, pursuant to this subdivision, 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 establish 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. § 3. Subdivision 14-a of section 2807 of the public health law, as added by section 11 of part B of chapter 57 of the laws of 2015, is amended to read as follows: 14-a. (A) Notwithstanding any provision of law to the contrary, and subject to federal financial participation, the commissioner is author- ized to establish, pursuant to regulations, a statewide general hospital quality pool for the purpose of incentivizing and facilitating quality improvements in general hospitals. (B) SUCH REGULATIONS SHALL INCLUDE PROVISIONS: (I) TO CREATE A PERFORMANCE TARGET TO REDUCE POTENTIALLY PREVENTABLE EMERGENCY DEPARTMENT VISITS; (II) TO REDUCE OR ELIMINATE THE PAYMENT OF THE RATES, PUBLISHED BY THE DEPARTMENT ON THE HOSPITAL INPATIENT PUBLICATION SCHEDULES AND HOSPITAL AMBULATORY PATIENT GROUP SCHEDULES, WHICH ARE PAID BY CONTRACTORS TO HOSPITALS, BASED ON THE QUALITY AND SAFETY SCORES OF A HOSPITAL AS DETERMINED BY THE DEPARTMENT; AND (III) TO FACILITATE NECESSARY QUALITY IMPROVEMENTS IN HOSPITALS, AS DETERMINED BY THE COMMISSIONER. (C) Awards from such pool shall be subject to approval by the director of budget. If federal financial participation is unavailable, then the non-federal share of awards made pursuant to this subdivision may be made as state grants. [(a)] (D) Thirty days prior to adopting or applying a methodology or procedure for making an allocation or modification to an allocation made pursuant to this subdivision, the commissioner shall provide written notice to the chairs of the senate finance committee, the assembly ways and means committee, and the senate and assembly health committees with regard to the intent to adopt or apply the methodology or procedure, including a detailed explanation of the methodology or procedure. [(b)] (E) Thirty days prior to executing an allocation or modification to an allocation made pursuant to this subdivision, the commissioner shall provide written notice to the chairs of the senate finance commit- tee, the assembly ways and means committee, and the senate and assembly health committees with regard to the intent to distribute such funds. S. 7507 7 A. 9507 Such notice shall include, but not be limited to, information on the methodology used to distribute the funds, the facility specific allo- cations of the funds, any facility specific project descriptions or requirements for receiving such funds, the multi-year impacts of these allocations, and the availability of federal matching funds. The commis- sioner shall provide quarterly reports to the chair of the senate finance committee and the chair of the assembly ways and means committee on the distribution and disbursement of such funds. (F) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW OR REGULATION TO THE CONTRARY, THE HOSPITAL QUALITY POOL SHALL ALLOCATE TEN MILLION DOLLARS ANNUALLY TO EXPAND PREVENTATIVE SERVICES AS THE COMMISSIONER MAY DETERMINE IN REGULATION. SUCH PREVENTATIVE SERVICES MAY INCLUDE BUT NOT BE LIMITED TO MENTAL HEALTH COUNSELING PROVIDED BY A LICENSED CLINICAL SOCIAL WORKER OR A LICENSED MASTER SOCIAL WORKER, PHYSICAL THERAPY, DIABETES PREVENTION, OR TREATMENT BY AN APPLIED BEHAVIOR ANALYST. § 4. Subparagraph (ii) of paragraph (f) of subdivision 2-a of section 2807 of the public health law, as amended by section 43 of part B of chapter 58 of the laws of 2010, is amended to read as follows: (ii) notwithstanding the provisions of paragraphs (a) and (b) of this subdivision, for periods on and after January first, two thousand nine, the following services provided by general hospital outpatient depart- ments and diagnostic and treatment centers shall be reimbursed with rates of payment based entirely upon the ambulatory patient group meth- odology as described in paragraph (e) of this subdivision, provided, however, that the commissioner may utilize existing payment methodol- ogies or may promulgate regulations establishing alternative payment methodologies for one or more of the services specified in this subpara- graph, effective for periods on and after March first, two thousand nine: (A) services provided in accordance with the provisions of paragraphs (q) and (r) of subdivision two of section three hundred sixty-five-a of the social services law; and (B) all services, but only with regard to additional payment amounts, as determined in accordance with regulations issued in accordance with paragraph (e) of this subdivision, for the provision of such services during times outside the facility's normal hours of operation, as deter- mined in accordance with criteria set forth in such regulations; and (C) individual psychotherapy services provided by licensed social workers, in accordance with licensing criteria set forth in applicable regulations[, to persons under the age of twenty-one and to persons requiring such services as a result of or related to pregnancy or giving birth]; and (D) individual psychotherapy services provided by licensed social workers, in accordance with licensing criteria set forth in applicable regulations, at diagnostic and treatment centers that provided, billed for, and received payment for these services between January first, two thousand seven and December thirty-first, two thousand seven; (E) services provided to pregnant women pursuant to paragraph (s) of subdivision two of section three hundred sixty-five-a of the social services law and, for periods on and after January first, two thousand ten, all other services provided pursuant to such paragraph (s) and services provided pursuant to paragraph (t) of subdivision two of section three hundred sixty-five-a of the social services law; (F) wheelchair evaluation services and eyeglass dispensing services; and S. 7507 8 A. 9507 (G) immunization services, effective for services rendered on and after June tenth, two thousand nine. § 5. Paragraph (h) of subdivision 2 of section 365-a of the social services law, as amended by chapter 220 of the laws of 2011, is amended to read as follows: (h) speech therapy, and when provided at the direction of a physician or nurse practitioner, physical therapy including related rehabilitative services and occupational therapy; provided, however, that speech thera- py[, physical therapy] and occupational therapy [each] shall be limited to coverage of twenty visits per year; PHYSICAL THERAPY SHALL BE LIMITED TO COVERAGE OF FORTY VISITS PER YEAR; such limitation shall not apply to persons with developmental disabilities or, notwithstanding any other provision of law to the contrary, to persons with traumatic brain inju- ry; § 6. This act shall take effect immediately. PART B Section 1. Subdivision 2-c of section 2808 of the public health law is amended by adding a new paragraph (g) to read as follows: (G) THE COMMISSIONER SHALL REDUCE MEDICAID REVENUE TO A RESIDENTIAL HEALTH CARE FACILITY IN A PAYMENT YEAR BY TWO PERCENT IF IN EACH OF THE TWO MOST RECENT PAYMENT YEARS FOR WHICH NEW YORK STATE NURSING HOME QUALITY INITIATIVE DATA IS AVAILABLE, THE FACILITY WAS RANKED IN THE LOWEST TWO QUINTILES OF FACILITIES BASED ON ITS NURSING HOME QUALITY INITIATIVE PERFORMANCE, AND WAS RANKED IN THE LOWEST QUINTILE IN THE MOST RECENT PAYMENT YEAR. THE COMMISSIONER MAY WAIVE THE APPLICATION OF THIS PARAGRAPH TO A FACILITY IF THE COMMISSIONER DETERMINES THAT THE FACILITY IS IN EXTREME FINANCIAL DISTRESS. § 2. Subdivision 3 of section 461-l of the social services law is amended by adding four new paragraphs (k), (l), (m) and (n) to read as follows: (K)(I) EXISTING ASSISTED LIVING PROGRAM PROVIDERS LICENSED ON OR BEFORE APRIL FIRST, TWO THOUSAND EIGHTEEN MAY APPLY TO THE DEPARTMENT FOR UP TO NINE ADDITIONAL ASSISTED LIVING PROGRAM BEDS, BY A DEADLINE TO BE DETERMINED BY THE DEPARTMENT. THE DEPARTMENT MAY UTILIZE AN EXPEDITED REVIEW PROCESS TO ALLOW ELIGIBLE APPLICANTS IN GOOD STANDING THE ABILITY TO BE LICENSED FOR THE ADDITIONAL BEDS WITHIN NINETY DAYS OF THE DEPART- MENT'S RECEIPT OF A SATISFACTORY APPLICATION. ELIGIBLE APPLICANTS ARE THOSE THAT: DO NOT REQUIRE MAJOR RENOVATION OR CONSTRUCTION; SERVE ONLY PUBLIC PAY INDIVIDUALS; AND ARE IN SUBSTANTIAL COMPLIANCE WITH APPROPRI- ATE STATE AND LOCAL REQUIREMENTS AS DETERMINED BY THE DEPARTMENT. (II) EXISTING ASSISTED LIVING PROGRAM PROVIDERS LICENSED ON OR BEFORE APRIL FIRST, TWO THOUSAND TWENTY MAY SUBMIT ADDITIONAL APPLICATIONS FOR UP TO NINE ADDITIONAL ASSISTED LIVING PROGRAM BEDS ON JUNE THIRTIETH, TWO THOUSAND TWENTY, AND BY A DEADLINE TO BE DETERMINED BY THE DEPART- MENT. EVERY TWO YEARS THEREAFTER, EXISTING PROVIDERS LICENSED ON OR BEFORE APRIL FIRST OF SUCH YEAR MAY SUBMIT SUCH APPLICATIONS ON JUNE THIRTIETH OF SUCH YEAR, AND BY A DEADLINE TO BE DETERMINED BY THE DEPARTMENT. THE NUMBER OF ADDITIONAL ASSISTED LIVING PROGRAM BEDS SHALL BE BASED ON THE TOTAL NUMBER OF PREVIOUSLY AWARDED BEDS EITHER WITHDRAWN BY THE APPLICANT OR DENIED BY THE DEPARTMENT. (L) THE COMMISSIONER OF HEALTH IS AUTHORIZED TO SOLICIT AND AWARD APPLICATIONS FOR UP TO A TOTAL OF FIVE HUNDRED NEW ASSISTED LIVING PROGRAM BEDS IN THOSE COUNTIES WHERE THERE IS ONE OR NO ASSISTED LIVING S. 7507 9 A. 9507 PROGRAM PROVIDERS, PURSUANT TO CRITERIA TO BE DETERMINED BY THE COMMIS- SIONER. (M) THE COMMISSIONER OF HEALTH IS AUTHORIZED TO SOLICIT AND AWARD APPLICATIONS FOR UP TO FIVE HUNDRED NEW ASSISTED LIVING PROGRAM BEDS IN COUNTIES WHERE UTILIZATION OF EXISTING ASSISTED LIVING PROGRAM BEDS EXCEEDS EIGHTY-FIVE PERCENT. ALL APPLICANTS SHALL COMPLY WITH FEDERAL HOME AND COMMUNITY-BASED SETTINGS REQUIREMENTS, AS SET FORTH IN 42 CFR PART 441 SUBPART G. TO BE ELIGIBLE FOR AN AWARD, AN APPLICANT MUST AGREE TO: (I) SERVE ONLY PUBLIC PAY INDIVIDUALS; (II) DEVELOP AND EXECUTE COLLABORATIVE AGREEMENTS WITHIN TWENTY-FOUR MONTHS OF AN APPLICATION BEING MADE TO THE DEPARTMENT, IN ACCORDANCE WITH GUIDANCE TO BE PUBLISHED BY THE DEPARTMENT, BETWEEN AT LEAST ONE OF EACH OF THE FOLLOWING ENTITIES: AN ADULT CARE FACILITY; A RESIDENTIAL HEALTH CARE FACILITY; AND A GENERAL HOSPITAL; (III) ENTER INTO AN AGREEMENT WITH AN EXISTING MANAGED CARE ENTITY; AND (IV) PARTICIPATE IN VALUE BASED PAYMENT MODELS, WHERE SUCH MODELS ARE AVAILABLE FOR PARTICIPATION. (N) THE COMMISSIONER OF HEALTH IS AUTHORIZED TO CREATE A PROGRAM TO SUBSIDIZE THE COST OF ASSISTED LIVING FOR THOSE INDIVIDUALS LIVING WITH ALZHEIMER'S DISEASE AND DEMENTIA WHO ARE NOT ELIGIBLE FOR MEDICAL ASSISTANCE PURSUANT TO TITLE ELEVEN OF ARTICLE FIVE OF THIS CHAPTER. THE PROGRAM SHALL AUTHORIZE UP TO TWO HUNDRED VOUCHERS TO INDIVIDUALS THROUGH AN APPLICATION PROCESS AND PAY FOR UP TO SEVENTY-FIVE PERCENT OF THE AVERAGE PRIVATE PAY RATE IN THE RESPECTIVE REGION. THE COMMISSIONER MAY PROPOSE RULES AND REGULATIONS TO EFFECTUATE THIS PROVISION. § 3. Subparagraph (i) of paragraph (b) of subdivision 7 of section 4403-f of the public health law, as amended by section 41-b of part H of chapter 59 of the laws of 2011, is amended to read as follows: (i) The commissioner shall, to the extent necessary, submit the appro- priate waivers, including, but not limited to, those authorized pursuant to sections eleven hundred fifteen and nineteen hundred fifteen of the federal social security act, or successor provisions, and any other waivers necessary to achieve the purposes of high quality, integrated, and cost effective care and integrated financial eligibility policies under the medical assistance program or pursuant to title XVIII of the federal social security act. In addition, the commissioner is authorized to submit the appropriate waivers, including but not limited to those authorized pursuant to sections eleven hundred fifteen and nineteen hundred fifteen of the federal social security act or successor provisions, and any other waivers necessary to require on or after April first, two thousand twelve, medical assistance recipients who are twen- ty-one years of age or older and who require community-based long term care services, as specified by the commissioner, for more than one hundred and twenty days, to receive such services through an available plan certified pursuant to this section or other program model that meets guidelines specified by the commissioner that support coordination and integration of services. Such guidelines shall address the require- ments of paragraphs (a), (b), (c), (d), (e), (f), (g), (h), and (i) of subdivision three of this section as well as payment methods that ensure provider accountability for cost effective quality outcomes. Such other program models may include long term home health care programs that comply with such guidelines. Copies of such original waiver applications and amendments thereto shall be provided to the chairs of the senate finance committee, the assembly ways and means committee and the senate S. 7507 10 A. 9507 and assembly health committees simultaneously with their submission to the federal government. ON OR AFTER OCTOBER FIRST, TWO THOUSAND EIGHTEEN, THE COMMISSIONER MAY, THROUGH SUCH AN APPROVED WAIVER, LIMIT ENROLLMENT IN A PLAN CERTI- FIED UNDER THIS SECTION TO INDIVIDUALS WHO ACHIEVE A SCORE OF NINE OR ABOVE WHEN ASSESSED USING THE UNIFORM ASSESSMENT SYSTEM FOR NEW YORK ASSESSMENT TOOL AND WHO REQUIRE COMMUNITY-BASED LONG TERM CARE SERVICES FOR A CONTINUOUS PERIOD OF MORE THAN ONE HUNDRED TWENTY DAYS FROM THE DATE OF ENROLLMENT AND FROM THE DATES WHEN CONTINUING ENROLLMENT IS REAUTHORIZED; HOWEVER, MEDICAL ASSISTANCE RECIPIENTS ENROLLED IN A MANAGED LONG TERM CARE PLAN ON OCTOBER FIRST, TWO THOUSAND EIGHTEEN MAY CONTINUE TO BE ELIGIBLE FOR SUCH PLANS, IRRESPECTIVE OF WHETHER THE ENROLLEE MEETS THESE LEVEL OF CARE REQUIREMENTS, PROVIDED THAT ONCE SUCH RECIPIENTS ARE DISENROLLED FROM THEIR MANAGED LONG TERM CARE PLAN, ANY APPLICABLE LEVEL OF CARE REQUIREMENTS WOULD APPLY TO FUTURE ELIGIBILITY DETERMINATIONS. § 4. Subparagraphs (vii) and (viii) of paragraph (b) of subdivision 7 of section 4403-f of the public health law are redesignated as subpara- graphs (viii) and (ix) and a new subparagraph (vii) is added to read as follows: (VII) IF ANOTHER MANAGED LONG TERM CARE PLAN CERTIFIED UNDER THIS SECTION IS AVAILABLE, MEDICAL ASSISTANCE RECIPIENTS REQUIRED TO ENROLL IN SUCH PLANS PURSUANT TO THIS SECTION MAY CHANGE PLANS WITHOUT CAUSE WITHIN THIRTY DAYS OF NOTIFICATION OF ENROLLMENT OR THE EFFECTIVE DATE OF ENROLLMENT INTO A PLAN, WHICHEVER IS LATER, BY MAKING A REQUEST OF THE LOCAL SOCIAL SERVICES DISTRICT OR ENTITY DESIGNATED BY THE DEPART- MENT, EXCEPT THAT SUCH PERIOD SHALL BE FORTY-FIVE DAYS FOR RECIPIENTS WHO HAVE BEEN ASSIGNED TO A PROVIDER BY THE COMMISSIONER. HOWEVER, AFTER SUCH THIRTY OR FORTY-FIVE DAY PERIOD, WHICHEVER IS APPLICABLE, A RECIPI- ENT MAY BE PROHIBITED FROM CHANGING PLANS MORE FREQUENTLY THAN ONCE EVERY TWELVE MONTHS, AS PERMITTED BY FEDERAL LAW, EXCEPT FOR GOOD CAUSE AS DETERMINED BY THE COMMISSIONER. § 5. Clauses 11 and 12 of subparagraph (v) of paragraph (b) of subdi- vision 7 of section 4403-f of the public health law, as amended by section 48 of part A of chapter 56 of the laws of 2013, are amended to read as follows: (11) a person who is eligible for medical assistance pursuant to para- graph (b) of subdivision four of section three hundred sixty-six of the social services law; [and] (12) Native Americans; AND (13) A PERSON WHO IS PERMANENTLY PLACED IN A NURSING HOME FOR A CONSECUTIVE PERIOD OF SIX MONTHS OR MORE. § 6. Paragraph (a) of subdivision 3 of section 366 of the social services law is REPEALED and a new paragraph (a) is added to read as follows: (A) MEDICAL ASSISTANCE SHALL BE FURNISHED WITHOUT CONSIDERATION OF THE INCOME AND RESOURCES OF AN APPLICANT'S LEGALLY RESPONSIBLE RELATIVE IF THE APPLICANT'S ELIGIBILITY WOULD NORMALLY BE DETERMINED BY COMPARING THE AMOUNT OF AVAILABLE INCOME AND/OR RESOURCES OF THE APPLICANT, INCLUDING AMOUNTS DEEMED AVAILABLE TO THE APPLICANT FROM LEGALLY RESPON- SIBLE RELATIVES, TO AN APPLICABLE ELIGIBILITY STANDARD, AND: (1) (I) THE LEGALLY RESPONSIBLE RELATIVE IS A COMMUNITY SPOUSE, AS DEFINED IN SECTION THREE HUNDRED SIXTY-SIX-C OF THIS TITLE; (II) SUCH RELATIVE IS REFUSING TO MAKE HIS OR HER INCOME AND/OR RESOURCES AVAILABLE TO MEET THE COST OF NECESSARY MEDICAL CARE, SERVICES, AND SUPPLIES; AND S. 7507 11 A. 9507 (III) THE APPLICANT EXECUTES AN ASSIGNMENT OF SUPPORT FROM THE COMMU- NITY SPOUSE IN FAVOR OF THE SOCIAL SERVICES DISTRICT AND THE DEPARTMENT, UNLESS THE APPLICANT IS UNABLE TO EXECUTE SUCH ASSIGNMENT DUE TO PHYS- ICAL OR MENTAL IMPAIRMENT OR TO DENY ASSISTANCE WOULD CREATE AN UNDUE HARDSHIP, AS DEFINED BY THE COMMISSIONER; OR (2) THE LEGALLY RESPONSIBLE RELATIVE IS ABSENT FROM THE APPLICANT'S HOUSEHOLD, AND FAILS OR REFUSES TO MAKE HIS OR HER INCOME AND/OR RESOURCES AVAILABLE TO MEET THE COST OF NECESSARY MEDICAL CARE, SERVICES, AND SUPPLIES. IN SUCH CASES, HOWEVER, THE FURNISHING OF SUCH ASSISTANCE SHALL CREATE AN IMPLIED CONTRACT WITH SUCH RELATIVE, AND THE COST THEREOF MAY BE RECOVERED FROM SUCH RELATIVE IN ACCORDANCE WITH TITLE SIX OF ARTICLE THREE OF THIS CHAPTER AND OTHER APPLICABLE PROVISIONS OF LAW. § 7. Subparagraph (i) of paragraph (d) of subdivision 2 of section 366-c of the social services law is amended by adding a new clause (C) to read as follows: (C) ON AND AFTER JULY FIRST, TWO THOUSAND EIGHTEEN, TWENTY-FOUR THOU- SAND ONE HUNDRED EIGHTY DOLLARS OR SUCH GREATER AMOUNT AS MAY BE REQUIRED UNDER FEDERAL LAW; § 8. Subdivision 1 of section 367-a of the social services law is amended by adding a new paragraph (h) to read as follows: (H) AMOUNTS PAYABLE UNDER THIS TITLE FOR MEDICAL ASSISTANCE IN THE FORM OF FREESTANDING CLINIC SERVICES PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW PROVIDED TO ELIGIBLE PERSONS PARTICIPATING IN THE NEW YORK TRAUMATIC BRAIN INJURY WAIVER PROGRAM WHO ARE ALSO BENEFICI- ARIES UNDER PART B OF TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT OR WHO ARE QUALIFIED MEDICARE BENEFICIARIES UNDER PART B OF TITLE XVIII OF SUCH ACT SHALL NOT BE LESS THAN THE APPROVED MEDICAL ASSISTANCE PAYMENT LEVEL LESS THE AMOUNT PAYABLE UNDER PART B. § 9. The commissioner of health shall conduct a study of home and community based services available to recipients of the Medicaid program in rural areas of the state. Such study shall include a review and anal- ysis of factors affecting such availability, including but not limited to transportation costs, costs of direct care personnel including home health aides, personal care attendants and other direct service person- nel, opportunities for telehealth services, and technological advances to improve efficiencies. Consistent with the results of the study, the commissioner of health is authorized to provide a targeted Medicaid rate enhancement to fee-for-service personal care rates and rates under Medi- caid waiver programs such as the nursing home transition and diversion waiver and the traumatic brain injury program waiver, in an aggregate amount of three million dollars minus the cost of conducting the study; provided further, that nothing in this section shall be deemed to affect payment for the costs of the study and any related Medicaid rate enhancement if federal participation is not available for such costs. § 10. This act shall take effect immediately; provided, however, that the amendments made to paragraph (b) of subdivision 7 of section 4403-f of the public health law made by sections three, four and five of this act shall not affect the expiration of such paragraph pursuant to subdi- vision (i) of section 111 of part H of chapter 59 of the laws of 2011, as amended, and shall be deemed to expire therewith; provided, further, that the amendments to paragraph (b) of subdivision 7 of section 4403-f of the public health law made by sections three, four and five of this act shall not affect the repeal of such section pursuant to chapter 659 of the laws of 1997, as amended, and shall be deemed repealed therewith; S. 7507 12 A. 9507 provided, further, that section four of this act shall take effect on October 1, 2018. PART C Section 1. Subdivision 2 of section 365-l of the social services law, as amended by section 1 of part S of chapter 57 of the laws of 2017, is amended to read as follows: 2. In addition to payments made for health home services pursuant to subdivision one of this section, the commissioner is authorized to pay additional amounts: (A) to providers of health home services that meet process or outcome standards specified by the commissioner; AND (B) TO MEDICAID MANAGED CARE ENROLLEES WHO ARE MEMBERS OF HEALTH HOMES IN THE FORM OF INCENTIVE PAYMENTS TO REWARD SUCH ENROLLEES FOR PARTICIPATING IN WELLNESS ACTIVITIES AND FOR AVOIDING UNNECESSARY HOSPITALIZATIONS AND UNNECESSARY UTILIZATION OF HOSPITAL EMERGENCY DEPARTMENT SERVICES. Such additional amounts may be paid with state funds only if federal finan- cial participation for such payments is unavailable. § 2. Section 365-l of the social services law is amended by adding a new subdivision 2-d to read as follows: 2-D. THE COMMISSIONER SHALL ESTABLISH TARGETS FOR HEALTH HOME PARTIC- IPATION BY ENROLLEES OF SPECIAL NEEDS MANAGED CARE PLANS DESIGNATED PURSUANT TO SUBDIVISION FOUR OF SECTION THREE HUNDRED SIXTY-FIVE-M OF THIS TITLE AND BY HIGH-RISK ENROLLEES OF OTHER MEDICAID MANAGED CARE PLANS OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE, AND SHALL REQUIRE THE MANAGED CARE PROVIDERS TO WORK COLLABORA- TIVELY WITH HEALTH HOMES TO ACHIEVE SUCH TARGETS. THE COMMISSIONER MAY ASSESS PENALTIES UNDER THIS SUBDIVISION AGAINST MANAGED CARE PROVIDERS THAT FAIL TO MEET THE PARTICIPATION TARGETS ESTABLISHED PURSUANT TO THIS SUBDIVISION, EXCEPT THAT MANAGED CARE PROVIDERS SHALL NOT BE PENALIZED FOR THE FAILURE OF A HEALTH HOME TO WORK COLLABORATIVELY TOWARD MEETING THE PARTICIPATION TARGETS. § 3. Subdivision 6 of section 2899 of the public health law, as amended by chapter 471 of the laws of 2016, is amended to read as follows: 6. "Provider" shall mean (A) any residential health care facility licensed under article twenty-eight of this chapter; or any certified home health agency, licensed home care services agency or long term home health care program certified under article thirty-six of this chapter; any hospice program certified pursuant to article forty of this chapter; or any adult home, enriched housing program or residence for adults licensed under article seven of the social services law; OR (B) A HEALTH HOME, OR ANY SUBCONTRACTOR OF SUCH HEALTH HOME, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT TO PROVIDE HEALTH HOME SERVICES TO ALL THOSE ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVEL- OPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWENTY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW, OR ANY ENTITY THAT PROVIDES HOME AND COMMUNITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT. § 4. Paragraph (b) of subdivision 9 of section 2899-a of the public health law, as added by chapter 331 of the laws of 2006, is amended to read as follows: S. 7507 13 A. 9507 (b) Residential health care facilities licensed pursuant to article twenty-eight of this chapter and certified home health care agencies and long-term home health care programs certified or approved pursuant to article thirty-six of this chapter OR A HEALTH HOME, OR ANY SUBCONTRAC- TOR OF SUCH HEALTH HOME, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT TO PROVIDE HEALTH HOME SERVICES TO ALL THOSE ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVELOPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWENTY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW, OR ANY ENTITY THAT PROVIDES HOME AND COMMUNITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT, may, subject to the availability of federal financial participation, claim as reimbursable costs under the medical assistance program, costs reflect- ing the fee established pursuant to law by the division of criminal justice services for processing a criminal history information check, the fee imposed by the federal bureau of investigation for a national criminal history check, and costs associated with obtaining the finger- prints, provided, however, that for the purposes of determining rates of payment pursuant to article twenty-eight of this chapter for residential health care facilities, such reimbursable fees and costs shall be reflected as timely as practicable in such rates within the applicable rate period. § 5. Subdivision 10 of section 2899-a of the public health law, as amended by chapter 206 of the laws of 2017, is amended to read as follows: 10. Notwithstanding subdivision eleven of section eight hundred forty-five-b of the executive law, a certified home health agency, licensed home care services agency or long term home health care program certified, licensed or approved under article thirty-six of this chapter or a home care services agency exempt from certification or licensure under article thirty-six of this chapter, a hospice program under arti- cle forty of this chapter, or an adult home, enriched housing program or residence for adults licensed under article seven of the social services law, OR A HEALTH HOME, OR ANY SUBCONTRACTOR OF SUCH HEALTH HOME, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT TO PROVIDE HEALTH HOME SERVICES TO ALL ENROLLEES ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVELOPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWEN- TY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW, OR ANY ENTITY THAT PROVIDES HOME AND COMMU- NITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT may temporarily approve a prospective employee while the results of the criminal history information check and the determination are pending, upon the condition that the provider conducts appropriate direct observation and evaluation of the temporary employee, while he or she is temporarily employed, and the care recipi- ent. The results of such observations shall be documented in the tempo- rary employee's personnel file and shall be maintained. For purposes of providing such appropriate direct observation and evaluation, the provider shall utilize an individual employed by such provider with a minimum of one year's experience working in an agency certified, licensed or approved under article thirty-six of this chapter or an adult home, enriched housing program or residence for adults licensed S. 7507 14 A. 9507 under article seven of the social services law, A HEALTH HOME, OR ANY SUBCONTRACTOR OF SUCH HEALTH HOME, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT TO PROVIDE HEALTH HOME SERVICES TO THOSE ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVELOPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWENTY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW, OR ANY ENTITY THAT PROVIDES HOME AND COMMUNITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT. If the temporary employee is working under contract with another provider certified, licensed or approved under article thirty-six of this chap- ter, such contract provider's appropriate direct observation and evalu- ation of the temporary employee, shall be considered sufficient for the purposes of complying with this subdivision. § 6. Subdivision 3 of section 424-a of the social services law, as amended by section 3 of part Q of chapter 56 of the laws of 2017, is amended to read as follows: 3. For purposes of this section, the term "provider" or "provider agency" shall mean: an authorized agency; the office of children and family services; juvenile detention facilities subject to the certif- ication of the office of children and family services; programs estab- lished pursuant to article nineteen-H of the executive law; non-residen- tial or residential programs or facilities licensed or operated by the office of mental health or the office for people with developmental disabilities except family care homes; licensed child day care centers, including head start programs which are funded pursuant to title V of the federal economic opportunity act of nineteen hundred sixty-four, as amended; early intervention service established pursuant to section twenty-five hundred forty of the public health law; preschool services established pursuant to section forty-four hundred ten of the education law; school-age child care programs; special act school districts as enumerated in chapter five hundred sixty-six of the laws of nineteen hundred sixty-seven, as amended; programs and facilities licensed by the office of alcoholism and substance abuse services; residential schools which are operated, supervised or approved by the education department; HEALTH HOMES, OR ANY SUBCONTRACT OR OF SUCH HEALTH HOMES, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT OF HEALTH TO PROVIDE HEALTH HOME SERVICES TO ALL THOSE ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVELOPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWEN- TY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THIS CHAPTER, OR ANY ENTITY THAT PROVIDES HOME AND COMMUNITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT; publicly-funded emergency shelters for families with children, provided, however, for purposes of this section, when the provider or provider agency is a publicly-funded emergency shelter for families with children, then all references in this section to the "potential for regular and substantial contact with individuals who are cared for by the agency" shall mean the potential for regular and substantial contact with children who are served by such shelter; and any other facility or provider agency, as defined in subdivision four of section four hundred eighty-eight of this chapter, in regard to the employment of staff, or use of providers of goods and services and staff of such providers, consultants, interns and volunteers. S. 7507 15 A. 9507 § 7. Paragraph (a) of subdivision 1 of section 413 of the social services law, as amended by section 2 of part Q of chapter 56 of the laws of 2017, is amended to read as follows: (a) The following persons and officials are required to report or cause a report to be made in accordance with this title when they have reasonable cause to suspect that a child coming before them in their professional or official capacity is an abused or maltreated child, or when they have reasonable cause to suspect that a child is an abused or maltreated child where the parent, guardian, custodian or other person legally responsible for such child comes before them in their profes- sional or official capacity and states from personal knowledge facts, conditions or circumstances which, if correct, would render the child an abused or maltreated child: any physician; registered physician assist- ant; surgeon; medical examiner; coroner; dentist; dental hygienist; osteopath; optometrist; chiropractor; podiatrist; resident; intern; psychologist; registered nurse; social worker; emergency medical techni- cian; licensed creative arts therapist; licensed marriage and family therapist; licensed mental health counselor; licensed psychoanalyst; licensed behavior analyst; certified behavior analyst assistant; hospi- tal personnel engaged in the admission, examination, care or treatment of persons; a Christian Science practitioner; school official, which includes but is not limited to school teacher, school guidance counse- lor, school psychologist, school social worker, school nurse, school administrator or other school personnel required to hold a teaching or administrative license or certificate; full or part-time compensated school employee required to hold a temporary coaching license or profes- sional coaching certificate; social services worker; employee of a publ- icly-funded emergency shelter for families with children; director of a children's overnight camp, summer day camp or traveling summer day camp, as such camps are defined in section thirteen hundred ninety-two of the public health law; day care center worker; school-age child care worker; provider of family or group family day care; employee or volunteer in a residential care facility for children that is licensed, certified or operated by the office of children and family services; or any other child care or foster care worker; mental health professional; substance abuse counselor; alcoholism counselor; all persons credentialed by the office of alcoholism and substance abuse services; EMPLOYEES OF A HEALTH HOME OR HEALTH HOME CARE MANAGEMENT AGENCY CONTRACTING WITH A HEALTH HOME AS DESIGNATED BY THE DEPARTMENT OF HEALTH AND AUTHORIZED UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THIS CHAPTER OR SUCH EMPLOYEES WHO PROVIDE HOME AND COMMUNITY BASED SERVICES UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURI- TY ACT; peace officer; police officer; district attorney or assistant district attorney; investigator employed in the office of a district attorney; or other law enforcement official. § 8. Section 364-j of the social services law is amended by adding a new subdivision 34 to read as follows: 34. (A) THE COMMISSIONER MAY, IN HIS OR HER DISCRETION, APPLY PENAL- TIES TO MANAGED CARE PROVIDERS THAT DO NOT SUBMIT A PERFORMING PROVIDER SYSTEM PARTNERSHIP PLAN BY JULY FIRST, TWO THOUSAND EIGHTEEN, IN ACCORD- ANCE WITH ANY SUBMISSION GUIDELINES ISSUED BY THE DEPARTMENT PRIOR THER- ETO. FOR PURPOSES OF THIS SUBDIVISION, "PERFORMING PROVIDER SYSTEM PART- NERSHIP PLAN" SHALL MEAN A PLAN SUBMITTED BY SUCH MANAGED CARE PROVIDERS TO THE DEPARTMENT THAT INCLUDES BOTH SHORT AND LONG TERM APPROACHES FOR EFFECTIVE COLLABORATION WITH EACH PERFORMING PROVIDER SYSTEM WITHIN ITS SERVICE AREA. S. 7507 16 A. 9507 (B) SUCH PENALTIES SHALL BE AS FOLLOWS: FOR MANAGED CARE PROVIDERS THAT DO NOT SUBMIT A PERFORMING PROVIDER SYSTEM PARTNERSHIP PLAN IN ACCORDANCE WITH THIS SUBDIVISION, MEDICAID PREMIUMS SHALL BE REDUCED BY EIGHTY-FIVE ONE-HUNDREDTHS OF ONE PERCENT FOR THE RATE PERIOD FROM APRIL FIRST, TWO THOUSAND EIGHTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND NINETEEN. § 9. This act shall take effect immediately; provided, however, that the amendments made to subdivision 6 of section 2899 of the public health law made by section three of this act shall take effect on the same date and in the same manner as section 8 of chapter 471 of the laws of 2016, as amended, takes effect and shall not affect the expiration of such subdivision and shall be deemed expired therewith; provided further, however, that the amendments made to section 364-j of the social services law made by section eight of this act shall not affect the repeal of such section and shall be deemed repealed therewith. PART D Section 1. Paragraph (d) of subdivision 9 of section 367-a of the social services law, as amended by section 7 of part D of chapter 57 of the laws of 2017, is amended to read as follows: (d) In addition to the amounts paid pursuant to paragraph (b) of this subdivision, the department shall pay a professional pharmacy dispensing fee for each such drug dispensed in the amount of ten dollars AND EIGHT CENTS per prescription or written order of a practitioner; provided, however that this professional dispensing fee will not apply to drugs that are available without a prescription as required by section sixty- eight hundred ten of the education law but do not meet the definition of a covered outpatient drug pursuant to Section 1927K of the Social Secu- rity Act. § 2. Paragraph (a) of subdivision 4 of section 365-a of the social services law, as amended by chapter 493 of the laws of 2010, is amended to read as follows: (a) drugs which may be dispensed without a prescription as required by section sixty-eight hundred ten of the education law; provided, however, that the state commissioner of health may by regulation specify certain of such drugs which may be reimbursed as an item of medical assistance in accordance with the price schedule established by such commissioner. Notwithstanding any other provision of law, [additions] MODIFICATIONS to the list of drugs reimbursable under this paragraph may be filed as regulations by the commissioner of health without prior notice and comment; § 3. Paragraph (c) of subdivision 6 of section 367-a of the social services law is amended by adding a new subparagraph (v) to read as follows: (V) NOTWITHSTANDING ANY OTHER PROVISION OF THIS PARAGRAPH, CO-PAYMENTS CHARGED FOR DRUGS DISPENSED WITHOUT A PRESCRIPTION AS REQUIRED BY SECTION SIXTY-EIGHT HUNDRED TEN OF THE EDUCATION LAW BUT WHICH ARE REIM- BURSED AS AN ITEM OF MEDICAL ASSISTANCE PURSUANT TO PARAGRAPH (A) OF SUBDIVISION FOUR OF SECTION THREE HUNDRED SIXTY-FIVE-A OF THIS TITLE SHALL BE ONE DOLLAR. § 4. Paragraph (b) of subdivision 3 of section 273 of the public health law, as added by section 10 of part C of chapter 58 of the laws of 2005, is amended to read as follows: (b) In the event that the patient does not meet the criteria in para- graph (a) of this subdivision, the prescriber may provide additional S. 7507 17 A. 9507 information to the program to justify the use of a prescription drug that is not on the preferred drug list. The program shall provide a reasonable opportunity for a prescriber to reasonably present his or her justification of prior authorization. [If, after consultation with the program, the prescriber, in his or her reasonable professional judgment, determines that the use of a prescription drug that is not on the preferred drug list is warranted, the prescriber's determination shall be final.] THE PROGRAM WILL CONSIDER THE ADDITIONAL INFORMATION AND THE JUSTIFICATION PRESENTED TO DETERMINE WHETHER THE USE OF A PRESCRIPTION DRUG THAT IS NOT ON THE PREFERRED DRUG LIST IS WARRANTED. § 5. Subdivisions 25 and 25-a of section 364-j of the social services law are REPEALED. § 6. The public health law is amended by adding a new section 280-c to read as follows: § 280-C. COMPREHENSIVE MEDICATION MANAGEMENT. 1. DEFINITIONS. FOR PURPOSES OF THIS SECTION: (A) QUALIFIED PHARMACIST. THE TERM "QUALIFIED PHARMACIST" SHALL MEAN A PHARMACIST WHO MAINTAINS A CURRENT UNRESTRICTED LICENSE PURSUANT TO ARTICLE ONE HUNDRED THIRTY-SEVEN OF THE EDUCATION LAW, WHO HAS A MINIMUM OF TWO YEARS OF EXPERIENCE IN PATIENT CARE AS A PRACTICING PHARMACIST WITHIN THE LAST FIVE YEARS, AND WHO HAS DEMONSTRATED COMPETENCY IN THE MEDICATION MANAGEMENT OF PATIENTS WITH A CHRONIC DISEASE OR DISEASES, INCLUDING BUT NOT LIMITED TO, THE COMPLETION OF ONE OR MORE PROGRAMS WHICH ARE ACCREDITED BY THE ACCREDITATION COUNCIL FOR PHARMACY EDUCA- TION, RECOGNIZED BY THE EDUCATION DEPARTMENT AND ACCEPTABLE TO THE PATIENT'S TREATING PHYSICIAN. (B) COMPREHENSIVE MEDICATION MANAGEMENT. THE TERM "COMPREHENSIVE MEDI- CATION MANAGEMENT" SHALL MEAN A PROGRAM CONDUCTED BY A QUALIFIED PHARMA- CIST THAT ENSURES A PATIENT'S MEDICATIONS, WHETHER PRESCRIPTION OR NONPRESCRIPTION, ARE INDIVIDUALLY ASSESSED TO DETERMINE THAT EACH MEDI- CATION IS APPROPRIATE FOR THE PATIENT, EFFECTIVE FOR THE MEDICAL CONDI- TION, SAFE GIVEN COMORBIDITIES AND OTHER MEDICATIONS BEING TAKEN, AND ABLE TO BE TAKEN BY THE PATIENT AS INTENDED. COMPREHENSIVE MEDICATION MANAGEMENT CONDUCTED BY A QUALIFIED PHARMACIST SHALL INCLUDE SHARING OF APPLICABLE PATIENT CLINICAL INFORMATION WITH THE TREATING PHYSICIAN AS SPECIFIED IN THE COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL. (C) COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL. THE TERM "COMPREHEN- SIVE MEDICATION MANAGEMENT PROTOCOL" MEANS A WRITTEN DOCUMENT PURSUANT TO AND CONSISTENT WITH ANY APPLICABLE STATE AND FEDERAL REQUIREMENTS, THAT IS ENTERED INTO VOLUNTARILY BY EITHER A PHYSICIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW OR A NURSE PRAC- TITIONER CERTIFIED PURSUANT TO SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW, AND A QUALIFIED PHARMACIST WHICH ADDRESSES A CHRONIC DISEASE OR DISEASES AS DETERMINED BY THE TREATING PHYSICIAN OR NURSE PRACTITIONER AND THAT DESCRIBES THE NATURE AND SCOPE OF THE COMPREHEN- SIVE MEDICATION MANAGEMENT SERVICES TO BE PERFORMED BY THE QUALIFIED PHARMACIST, IN ACCORDANCE WITH THE PROVISIONS OF THIS SECTION. COMPRE- HENSIVE MEDICATION MANAGEMENT PROTOCOLS BETWEEN LICENSED PHYSICIANS OR NURSE PRACTITIONERS AND QUALIFIED PHARMACISTS SHALL BE MADE AVAILABLE TO THE DEPARTMENT FOR REVIEW AND TO ENSURE COMPLIANCE WITH THIS ARTICLE, UPON REQUEST. 2. AUTHORIZATION TO ESTABLISH COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOLS. A PHYSICIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY- ONE OF THE EDUCATION LAW OR A NURSE PRACTITIONER CERTIFIED PURSUANT TO SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW SHALL BE AUTHORIZED TO VOLUNTARILY ESTABLISH A COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL S. 7507 18 A. 9507 WITH A QUALIFIED PHARMACIST TO PROVIDE COMPREHENSIVE MEDICATION MANAGE- MENT SERVICES FOR A PATIENT WHO HAS NOT MET CLINICAL GOALS OF THERAPY, IS AT RISK FOR HOSPITALIZATION, OR FOR WHOM THE PHYSICIAN OR NURSE PRAC- TITIONER DEEMS IT IS NECESSARY TO RECEIVE COMPREHENSIVE MEDICATION MANAGEMENT SERVICES. PARTICIPATION BY THE PATIENT IN COMPREHENSIVE MEDI- CATION MANAGEMENT SERVICES SHALL BE VOLUNTARY. 3. SCOPE OF COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOLS. (A) UNDER A COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL, A QUALIFIED PHARMACIST SHALL BE PERMITTED TO: (I) ADJUST OR MANAGE A DRUG REGIMEN FOR THE PATIENT, PURSUANT TO THE PATIENT SPECIFIC ORDER OR PROTOCOL ESTABLISHED BY THE PATIENT'S TREATING 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 TREATING PHYSICIAN OR NURSE PRACTITIONER UNLESS SUCH SUBSTI- TUTION IS EXPRESSLY AUTHORIZED IN THE WRITTEN ORDER OR PROTOCOL. THE QUALIFIED PHARMACIST SHALL BE REQUIRED TO IMMEDIATELY DOCUMENT IN THE PATIENT'S MEDICAL RECORD CHANGES MADE TO THE DRUG THERAPY. THE PATIENT'S TREATING PHYSICIAN OR NURSE PRACTITIONER MAY PROHIBIT, BY WRITTEN INSTRUCTION, ANY ADJUSTMENT OR CHANGE IN THE PATIENT'S DRUG REGIMEN BY THE QUALIFIED PHARMACIST; (II) EVALUATE AND ONLY IF SPECIFICALLY AUTHORIZED BY THE PROTOCOL, AND ONLY TO THE EXTENT NECESSARY TO DISCHARGE THE RESPONSIBILITY SET FORTH IN THIS SECTION, ORDER OR PERFORM ROUTINE PATIENT MONITORING FUNCTIONS OR DISEASE STATE LABORATORY TESTS RELATED TO THE DRUG THERAPY COMPREHEN- SIVE MEDICATION MANAGEMENT FOR THE SPECIFIC CHRONIC DISEASE OR DISEASES SPECIFIED WITHIN THE WRITTEN AGREEMENT OR COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL; (III) ONLY IF SPECIFICALLY AUTHORIZED BY THE WRITTEN ORDER OR PROTOCOL AND ONLY TO THE EXTENT NECESSARY TO DISCHARGE THE RESPONSIBILITIES SET FORTH IN THIS SECTION, ORDER OR PERFORM ROUTINE PATIENT MONITORING FUNC- TIONS AS MAY BE NECESSARY IN THE DRUG THERAPY MANAGEMENT, INCLUDING THE COLLECTING AND REVIEWING OF PATIENT HISTORIES, AND ORDERING OR CHECKING PATIENT VITAL SIGNS, INCLUDING PULSE, TEMPERATURE, BLOOD PRESSURE, WEIGHT AND RESPIRATION; AND (IV) ACCESS THE COMPLETE PATIENT MEDICAL RECORD MAINTAINED BY THE TREATING PHYSICIAN OR NURSE PRACTITIONER WITH WHOM THE QUALIFIED PHARMA- CIST HAS THE COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL AND SHALL DOCUMENT ANY ADJUSTMENTS MADE PURSUANT TO THE PROTOCOL IN THE PATIENT'S MEDICAL RECORD AND SHALL NOTIFY THE PATIENT'S TREATING PHYSICIAN OR NURSE PRACTITIONER OF ANY ADJUSTMENTS IN A TIMELY MANNER ELECTRONICALLY OR BY OTHER MEANS. (B) UNDER NO CIRCUMSTANCES SHALL THE QUALIFIED PHARMACIST BE PERMITTED TO DELEGATE COMPREHENSIVE MEDICATION MANAGEMENT SERVICES TO ANY OTHER LICENSED PHARMACIST OR OTHER PHARMACY PERSONNEL. 4. MEDICATION ADJUSTMENTS. ANY MEDICATION ADJUSTMENTS MADE BY THE QUALIFIED PHARMACIST PURSUANT TO THE COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL, INCLUDING ADJUSTMENTS IN DRUG STRENGTH, FREQUENCY OR ROUTE OF ADMINISTRATION, OR INITIATION OF A DRUG WHICH DIFFERS FROM THAT INITIAL- LY PRESCRIBED AND AS DOCUMENTED IN THE PATIENT MEDICAL RECORD, SHALL BE DEEMED AN ORAL PRESCRIPTION AUTHORIZED BY AN AGENT OF THE PATIENT'S TREATING PHYSICIAN OR NURSE PRACTITIONER AND SHALL BE DISPENSED CONSIST- ENT WITH SECTION SIXTY-EIGHT HUNDRED TEN OF THE EDUCATION LAW. FOR THE PURPOSES OF THIS SECTION, A PHARMACIST WHO IS NOT AN EMPLOYEE OF THE S. 7507 19 A. 9507 PHYSICIAN OR NURSE PRACTITIONER MAY BE AUTHORIZED TO SERVE AS AN AGENT OF THE PHYSICIAN OR NURSE PRACTITIONER. 5. REFERRALS. A PHYSICIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW OR A NURSE PRACTITIONER CERTIFIED PURSU- ANT TO SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW, WHO HAS RESPONSIBILITY FOR THE TREATMENT AND CARE OF A PATIENT FOR A CHRONIC DISEASE OR DISEASES AS DETERMINED BY THE PHYSICIAN OR NURSE PRACTITIONER MAY REFER THE PATIENT TO A QUALIFIED PHARMACIST FOR COMPREHENSIVE MEDI- CATION MANAGEMENT SERVICES, PURSUANT TO THE COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL THAT THE PHYSICIAN OR NURSE PRACTITIONER HAS ESTAB- LISHED WITH THE QUALIFIED PHARMACIST. THE PROTOCOL AGREEMENT SHALL AUTHORIZE THE PHARMACIST TO SERVE AS AN AGENT OF THE PHYSICIAN OR NURSE PRACTITIONER AS DEFINED BY THE PROTOCOL. SUCH REFERRAL SHALL BE DOCU- MENTED IN THE PATIENT'S MEDICAL RECORD. 6. PATIENT PARTICIPATION. PARTICIPATION IN COMPREHENSIVE MEDICATION MANAGEMENT SERVICES SHALL BE VOLUNTARY, AND NO PATIENT, PHYSICIAN, NURSE PRACTITIONER OR PHARMACIST SHALL BE REQUIRED TO PARTICIPATE. THE REFER- RAL OF A PATIENT FOR COMPREHENSIVE MEDICATION MANAGEMENT SERVICES AND THE PATIENT'S RIGHT TO CHOOSE NOT TO PARTICIPATE SHALL BE DISCLOSED TO THE PATIENT. COMPREHENSIVE MEDICATION MANAGEMENT SERVICES SHALL NOT BE UTILIZED UNLESS THE PATIENT OR THE PATIENT'S AUTHORIZED REPRESENTATIVE CONSENTS, IN WRITING, TO SUCH SERVICES. SUCH CONSENT SHALL BE NOTED IN THE PATIENT'S MEDICAL RECORD. IF THE PATIENT OR THE PATIENT'S AUTHORIZED REPRESENTATIVE WHO CONSENTED CHOOSES TO NO LONGER PARTICIPATE IN SUCH SERVICES, AT ANY TIME, THE SERVICES SHALL BE DISCONTINUED AND IT SHALL BE NOTED IN THE PATIENT'S MEDICAL RECORD. § 7. Subdivision 4 of section 365-a of the social services law is amended by adding a new paragraph (h) to read as follows: (H) OPIOIDS PRESCRIBED TO A PATIENT INITIATING OR BEING MAINTAINED ON OPIOID TREATMENT FOR PAIN WHICH HAS LASTED MORE THAN THREE MONTHS OR PAST THE TIME OF NORMAL TISSUE HEALING, UNLESS THE MEDICAL RECORD CONTAINS A WRITTEN TREATMENT PLAN THAT INCLUDES: GOALS FOR PAIN MANAGE- MENT AND FUNCTIONAL IMPROVEMENT BASED ON DIAGNOSIS; INFORMATION ON WHETHER NON-OPIOID THERAPIES HAVE BEEN TRIED AND OPTIMIZED OR ARE CONTRAINDICATED; A STATEMENT THAT THE PRESCRIBER HAS EXPLAINED TO THE PATIENT THE RISKS OF AND ALTERNATIVES TO OPIOID TREATMENT; AN EVALUATION OF THE PATIENT FOR RISK FACTORS OF HARM AND MISUSE OF OPIOIDS; AN ASSESSMENT OF THE PATIENT'S ADHERENCE TO TREATMENT WITH RESPECT TO OTHER CONDITIONS TREATED BY THE SAME PROVIDER; THE SIGNATURE OF THE PATIENT AND/OR AN ATTESTATION BY THE PRESCRIBER THAT THE PATIENT VERBALLY AGREED TO THE TREATMENT PLAN; AND ANY OTHER INFORMATION REQUIRED BY THE DEPART- MENT. SUCH TREATMENT PLAN SHALL BE UPDATED TWICE WITHIN THE YEAR IMME- DIATELY FOLLOWING ITS INITIATION AND ANNUALLY THEREAFTER. THE REQUIRE- MENTS OF THIS PARAGRAPH SHALL NOT APPLY IN THE CASE OF PATIENTS WHO ARE BEING TREATED FOR CANCER THAT IS NOT IN REMISSION, WHO ARE IN HOSPICE OR OTHER END-OF-LIFE CARE, OR WHOSE PAIN IS BEING TREATED AS PART OF PALLI- ATIVE CARE PRACTICES. § 8. Subdivision 2 of section 280 of the public health law, as amended by section 1 of part D of chapter 57 of the laws of 2017, is amended to read as follows: 2. The commissioner shall establish a year to year department of health state-funds Medicaid drug spending growth target as follows: (a) for state fiscal year two thousand seventeen--two thousand eigh- teen, be limited to the ten-year rolling average of the medical compo- nent of the consumer price index plus five percent and minus a pharmacy savings target of fifty-five million dollars; [and] S. 7507 20 A. 9507 (b) for state fiscal year two thousand eighteen--two thousand nine- teen, be limited to the ten-year rolling average of the medical compo- nent of the consumer price index plus four percent and minus a pharmacy savings target of eighty-five million dollars[.]; AND (C) FOR STATE FISCAL YEAR TWO THOUSAND NINETEEN--TWO THOUSAND TWENTY, BE LIMITED TO THE TEN-YEAR ROLLING AVERAGE OF THE MEDICAL COMPONENT OF THE CONSUMER PRICE INDEX PLUS FOUR PERCENT AND MINUS A PHARMACY SAVINGS TARGET OF EIGHTY-FIVE MILLION DOLLARS. § 9. This act shall take effect immediately and shall be deemed to have been in full force and effect on and after April 1, 2018; provided, however, that sections two and three of this act shall take effect July 1, 2018; and provided further, however, that the amendments to paragraph (d) of subdivision 9 and paragraph (c) of subdivision 6 of section 367-a of the social services law made by sections one and three, respec- tively, of this act shall not affect the expiration or repeal of such provisions and shall expire or be deemed repealed therewith. PART E Section 1. Subdivision 4 of section 365-h of the social services law, as separately amended by section 50 of part B and section 24 of part D of chapter 57 of the laws of 2015, is amended to read as follows: 4. The commissioner of health is authorized to assume responsibility from a local social services official for the provision and reimburse- ment of transportation costs under this section. If the commissioner elects to assume such responsibility, the commissioner shall notify the local social services official in writing as to the election, the date upon which the election shall be effective and such information as to transition of responsibilities as the commissioner deems prudent. The commissioner is authorized to contract with a transportation manager or managers to manage transportation services in any local social services district, other than transportation services provided or arranged for enrollees of [managed long term care plans issued certificates of authority under section forty-four hundred three-f of the public health law] A PROGRAM DESIGNATED AS A PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) AS AUTHORIZED BY FEDERAL PUBLIC LAW 1053-33, SUBTITLE 1 OF TITLE IV OF THE BALANCED BUDGET ACT OF 1997. Any transportation manager or managers selected by the commissioner to manage transporta- tion services shall have proven experience in coordinating transporta- tion 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 requirements and service verification mech- anisms. Any and all reimbursement rates developed by transportation managers under this subdivision shall be subject to the review and approval of the commissioner. § 2. The opening paragraph of subdivision 1 and subdivision 3 of section 367-s of the social services law, as amended by section 53 of S. 7507 21 A. 9507 part B of chapter 57 of the laws of 2015, 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 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, six million dollars for the period May first, two thousand fourteen through March thirty-first, two thousand fifteen, and six million dollars [annu- ally beginning with] ON AN ANNUAL BASIS FOR the period April first, two thousand fifteen through March thirty-first, two thousand [sixteen] EIGHTEEN 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, 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] ON AN ANNUAL BASIS FOR the period April first, two thousand fifteen through March thirty- first, two thousand [sixteen] EIGHTEEN. 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. § 3. Subdivision 5 of section 365-h of the social services law is REPEALED. § 4. This act shall take effect immediately and shall be deemed to have been in full force and effect on and after April 1, 2018; provided, however, that section one of this act shall take effect October 1, 2018; provided, further that the amendments to subdivision 4 of section 365-h of the social services law made by section one of this act shall not affect the repeal of such section and shall expire and be deemed repealed therewith. PART F Section 1. Notwithstanding any inconsistent provision of law, rule or regulation to the contrary, if a Medicaid managed care plan or managed long term care plan that has been issued a certificate of authority pursuant to article 44 of the public health law and that satisfies the definition of corporation in subparagraph 5 of paragraph (a) of section 102 of the not-for-profit corporation law or is exempt from taxation under section 501 of the Internal Revenue Code of 1986 has an aggregate accumulated contingent reserve, across all of its Medicaid lines of business, in an amount that exceeds the minimum contingent reserve amount required by regulations of the department of health, the commis- sioner of health shall be authorized to make prospective adjustments to the Medicaid capitation rates of such plan and shall apply any relevant criteria as determined necessary in his or her discretion, in order to achieve a reduction in Medicaid reimbursement to the plan equal to the amount of the excess, or such lesser amount as determined by the commis- sioner of health. § 2. This act shall take effect April 1, 2018. PART G S. 7507 22 A. 9507 Section 1. The public health law is amended by adding a new article 29-J to read as follows: ARTICLE 29-J HEALTH SERVICES OFFERED BY RETAIL PRACTICES SECTION 2999-HH. DEFINITIONS. 2999-II. RETAIL PRACTICE SPONSORS. 2999-JJ. RETAIL PRACTICES. 2999-KK. ACCREDITATION. 2999-LL. OTHER LAWS. § 2999-HH. DEFINITIONS. FOR PURPOSES OF THIS ARTICLE: 1. "REPORTABLE EVENT" SHALL MEAN: (A) THE TRANSFER OF AN INDIVIDUAL WHO VISITS A RETAIL PRACTICE TO A HOSPITAL OR EMERGENCY DEPARTMENT DURING SUCH VISIT; OR (B) THE DEATH OF AN INDIVIDUAL WHO VISITS A RETAIL PRACTICE DURING SUCH VISIT. 2. "COLLABORATIVE RELATIONSHIP" SHALL MEAN AN ARRANGEMENT BETWEEN A RETAIL PRACTICE AND ONE OR MORE OF THE FOLLOWING ENTITIES LOCATED WITHIN THE SAME GEOGRAPHIC REGION AS THE RETAIL PRACTICE, DESIGNED TO FACILI- TATE DEVELOPMENT AND IMPLEMENTATION OF STRATEGIES THAT SUPPORT THE PROVISION OF COORDINATED CARE WITHIN THE POPULATION SERVED BY THE PARTIES TO SUCH RELATIONSHIP: (A) A HOSPITAL LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF THIS CHAP- TER; (B) A PHYSICIAN PRACTICE; (C) AN ACCOUNTABLE CARE ORGANIZATION CERTIFIED PURSUANT TO ARTICLE TWENTY-NINE-E OF THIS CHAPTER; OR (D) A PERFORMING PROVIDER SYSTEM UNDER THE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT PROGRAM. 3. "RETAIL HEALTH SERVICES" SHALL MEAN THE SERVICES OFFERED AND PROVIDED BY A RETAIL PRACTICE. (A) RETAIL HEALTH SERVICES SHALL INCLUDE: (I) THE PROVISION OF TREATMENT AND SERVICES TO PATIENTS FOR MINOR ACUTE EPISODIC ILLNESSES OR CONDITIONS; (II) EPISODIC PREVENTIVE AND WELLNESS TREATMENTS AND SERVICES SUCH AS IMMUNIZATIONS, EXCEPT AS OTHERWISE SPECIFIED IN PARAGRAPH (C) OF THIS SUBDIVISION; (III) TREATMENT AND SERVICES FOR MINOR TRAUMAS THAT ARE NOT REASONABLY LIKELY TO BE LIFE THREATENING OR POTENTIALLY DISABLING IF AMBULATORY CARE WITHIN THE CAPACITY OF THE RETAIL PRACTICE IS PROVIDED; (IV) ADMINISTRATION OF AN OPIOID ANTAGONIST IN THE EVENT OF AN EMER- GENCY; AND (V) LIMITED SCREENING AND REFERRAL FOR BEHAVIORAL HEALTH CONDITIONS. (B) RETAIL HEALTH SERVICES MAY INCLUDE LABORATORY TESTS AT THE OPTION OF THE RETAIL PRACTICE, PROVIDED THAT: (I) SUCH TESTS ARE ADMINISTERED SOLELY AS AN ADJUNCT TO TREATMENT OF PATIENTS VISITING THE RETAIL PRACTICE, WITH ALL SPECIMENS COLLECTED AND TESTING PERFORMED ON-SITE; (II) SUCH TESTS ARE "WAIVED TESTS", MEANING A CLINICAL LABORATORY TEST THAT HAS BEEN DESIGNATED AS A WAIVED TEST OR IS OTHERWISE SUBJECT TO CERTIFICATE OF WAIVER REQUIREMENTS PURSUANT TO THE FEDERAL CLINICAL LABORATORY IMPROVEMENT ACT OF NINETEEN HUNDRED EIGHTY-EIGHT, AS AMENDED; AND (III) THE RETAIL PRACTICE OBTAINS APPROVAL FROM THE DEPARTMENT PURSU- ANT TO SECTION FIVE HUNDRED SEVENTY-NINE OF THIS CHAPTER. (C) RETAIL HEALTH SERVICES SHALL NOT INCLUDE: S. 7507 23 A. 9507 (I) THE PERFORMANCE OF PROCEDURES INVOLVING THE PROVISION OF SEDATION OR ANESTHESIA; (II) THE PROVISION OF SERVICES TO PATIENTS TWENTY-FOUR MONTHS OF AGE OR YOUNGER; (III) THE PROVISION OF IMMUNIZATIONS TO PATIENTS BETWEEN TWENTY-FOUR MONTHS AND EIGHTEEN YEARS OF AGE, OTHER THAN IMMUNIZATIONS AGAINST INFLUENZA; (IV) SERVICES PROVIDED BY PHARMACISTS PURSUANT TO ARTICLE ONE HUNDRED THIRTY-SEVEN OF THE EDUCATION LAW; (V) HEALTH SERVICES PROVIDED ON-SITE BY AN EMPLOYER TO ITS EMPLOYEES IN A RETAIL BUSINESS OPERATION; (V) HEALTH SERVICES PROVIDED ON A TIME-LIMITED BASIS SUCH AS FLU CLIN- ICS OR HEALTH FAIRS; OR (VI) EDUCATIONAL COURSES OFFERED TO INDIVIDUALS ON HEALTH TOPICS, INCLUDING INSTRUCTION IN SELF-MANAGEMENT OF MEDICAL CONDITIONS. 4. "RETAIL PRACTICE" SHALL MEAN AN ENTITY WHICH: (A) IS LOCATED WITHIN THE SPACE OF A RETAIL BUSINESS OPERATION OPEN TO THE GENERAL PUBLIC, SUCH THAT CUSTOMER ACCESS TO THE RETAIL PRACTICE LOCATION IS AVAILABLE WITHIN THE MAIN PREMISES OF THE RETAIL OPERATION; (B) PROVIDES RETAIL HEALTH SERVICES, AS DEFINED IN SUBDIVISION THREE OF THIS SECTION; (C) IS ESTABLISHED AND OVERSEEN BY A RETAIL PRACTICE SPONSOR, AS DEFINED IN SUBDIVISION FIVE OF THIS SECTION; (D) IS STAFFED AT ALL TIMES BY, AT A MINIMUM, ONE OR MORE OF THE FOLLOWING: A PHYSICIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIR- TY-ONE OF THE EDUCATION LAW, A PHYSICIAN ASSISTANT LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE-A OF THE EDUCATION LAW, AND/OR A NURSE PRACTITIONER LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-NINE OF THE EDUCATION LAW; PROVIDED THAT NO MORE THAN FOUR PHYSICIAN ASSISTANTS EMPLOYED BY A RETAIL PRACTICE SPONSOR SHALL BE SUPERVISED BY A SINGLE PHYSICIAN; AND (E) IS ACCREDITED AS SET FORTH IN SECTION TWENTY-NINE HUNDRED NINETY- NINE-KK OF THIS ARTICLE. 5. "RETAIL PRACTICE SPONSOR" SHALL MEAN AN ENTITY FORMED UNDER THE LAWS OF THE STATE OF NEW YORK, WHICH MAY INCLUDE STOCKHOLDERS OR MEMBERS WHICH ARE NOT NATURAL PERSONS, AND WHICH OPERATES ONE OR MORE RETAIL PRACTICES. RETAIL PRACTICE SPONSORS MAY INCLUDE BUSINESS CORPORATIONS, AND GENERAL HOSPITALS, NURSING HOMES, AND DIAGNOSTIC AND TREATMENT CENTERS LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF THIS CHAPTER. § 2999-II. RETAIL PRACTICE SPONSORS. 1. NOTWITHSTANDING ANY LAW TO THE CONTRARY, A RETAIL PRACTICE SPONSOR MAY OPERATE ONE OR MORE RETAIL PRAC- TICES TO PROVIDE RETAIL HEALTH SERVICES IN ACCORDANCE WITH THIS ARTICLE. 2. A RETAIL PRACTICE SPONSOR SHALL: (A) EMPLOY OR OTHERWISE RETAIN THE SERVICES OF A MEDICAL DIRECTOR WHO IS LICENSED AND CURRENTLY REGISTERED TO PRACTICE MEDICINE IN THE STATE OF NEW YORK TO OVERSEE THE DEVELOPMENT OF AND ADHERENCE TO MEDICAL POLI- CIES AND PROCEDURES USED IN THE RETAIL PRACTICES OPERATED BY THE RETAIL PRACTICE SPONSOR; (B) ESTABLISH AND MAINTAIN POLICIES AND PROCEDURES REQUIRING RETAIL PRACTICES TO COMPLY WITH THE PROVISIONS OF SECTION TWENTY-NINE HUNDRED NINETY-NINE-JJ OF THIS ARTICLE; (C) NOTIFY THE DEPARTMENT WHEN IT IS PREPARED TO COMMENCE OPERATION OF A RETAIL PRACTICE BY: (I) IDENTIFYING THE CORPORATE NAME OF THE RETAIL PRACTICE SPONSOR, PROVIDING DOCUMENTATION OF ITS ORGANIZATION UNDER THE LAWS OF THE STATE S. 7507 24 A. 9507 OF NEW YORK, AND IDENTIFYING THE INDIVIDUAL WHO WILL SERVE AS THE POINT OF CONTACT BETWEEN THE RETAIL PRACTICE SPONSOR AND THE DEPARTMENT; (II) IDENTIFYING THE LOCATION OF THE RETAIL PRACTICE, THE SERVICES TO BE OFFERED BY THE RETAIL PRACTICE, THE NAME OF THE INDIVIDUAL EMPLOYED WITH THE OVERALL RESPONSIBILITY FOR THE ON-SITE MANAGEMENT OF THE RETAIL PRACTICE, AND THE STAFFING PLAN FOR THE RETAIL PRACTICE; (III) IDENTIFYING THE ENTITIES WITH WHICH THE RETAIL PRACTICE WILL COLLABORATE PURSUANT TO SUBDIVISION TWO OF SECTION TWENTY-NINE HUNDRED NINETY-NINE-HH OF THIS ARTICLE; AND (IV) IDENTIFYING THE DATE ON WHICH IT ANTICIPATES THAT THE RETAIL PRACTICE WILL BE OPEN FOR BUSINESS; (D) PROMPTLY UPDATE THE DEPARTMENT AS TO ANY CHANGES IN THE INFORMA- TION REQUIRED UNDER SUBDIVISION THREE OF THIS SECTION; AND (E) PROVIDE INFORMATION TO THE DEPARTMENT AT A FREQUENCY AND IN A MANNER DETERMINED BY THE DEPARTMENT, WHICH AT A MINIMUM SHALL INCLUDE AN ANNUAL REPORT THAT PROVIDES DATA, FOR EACH RETAIL PRACTICE OPERATED BY THE RETAIL PRACTICE, ON: (I) THE NUMBER OF VISITS THAT OCCURRED DURING THE TIMEFRAME IDENTIFIED BY THE DEPARTMENT; (II) THE SERVICES PROVIDED TO PATIENTS; (III) THE SOURCE OF PAYMENT FOR SERVICES PROVIDED; (IV) THE NUMBER OF REFERRALS TO PRIMARY CARE PRACTITIONERS MADE; AND (V) THE NUMBER OF REPORTABLE EVENTS THAT OCCURRED. 3. (A) IN DISCHARGING THE DUTIES OF THEIR RESPECTIVE POSITIONS, THE BOARD OF DIRECTORS, COMMITTEES OF THE BOARD, AND INDIVIDUAL DIRECTORS AND OFFICERS OF A RETAIL PRACTICE SPONSOR THAT OPERATES THREE OR MORE RETAIL PRACTICES SHALL CONSIDER THE EFFECTS OF ANY ACTION UPON: (I) THE ABILITY OF THE BUSINESS CORPORATION TO ACCOMPLISH ITS PURPOSE; (II) THE SHAREHOLDERS OF THE BUSINESS CORPORATION; (III) THE INTERESTS OF PATIENTS OF THE RETAIL PRACTICES; (IV) COMMUNITY AND SOCIETAL CONSIDERATIONS, INCLUDING THOSE OF THE COMMUNITIES IN WHICH RETAIL PRACTICES ARE LOCATED. (B) THE CONSIDERATION OF INTERESTS AND FACTORS IN THE MANNER REQUIRED IN PARAGRAPH (A) OF THIS SUBDIVISION: (I) SHALL NOT CONSTITUTE A VIOLATION OF THE PROVISIONS OF SECTION SEVEN HUNDRED FIFTEEN OR SEVEN HUNDRED SEVENTEEN OF THE BUSINESS CORPO- RATION LAW; AND (II) 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. (C) A RETAIL PRACTICE SPONSOR THAT OPERATES THREE OR MORE RETAIL PRAC- TICES SHALL PUBLISH ON A PUBLICLY AVAILABLE WEBSITE A DESCRIPTION OF HOW ITS OPERATION OF EXISTING AND PLANNED RETAIL PRACTICES: (I) WILL IMPROVE ACCESS TO SERVICES IN THE COMMUNITIES WHERE THEY ARE LOCATED; (II) SUPPORTS A COMMITMENT TO OFFER ASSISTANCE TO INDIVIDUALS WHO DO NOT HAVE HEALTH CARE COVERAGE; (III) SUPPORTS AN OVERALL COMMITMENT BY THE RETAIL PRACTICE SPONSOR TO OPERATE SOME OF ITS RETAIL PRACTICES IN MEDICALLY UNDERSERVED AREAS OF THE STATE AS DEFINED BY THE COMMISSIONER; AND (IV) WILL OTHERWISE BENEFIT THE COMMUNITIES WHERE THEY ARE LOCATED. § 2999-JJ. RETAIL PRACTICES. 1. RETAIL HEALTH SERVICES SHALL NOT BE PROVIDED IN A RETAIL BUSINESS OPERATION OPEN TO THE PUBLIC EXCEPT IN ACCORDANCE WITH THIS ARTICLE. 2. NOTWITHSTANDING ANY LAW TO THE CONTRARY, A RETAIL PRACTICE SHALL: (A) PROVIDE RETAIL HEALTH SERVICES AND ONLY RETAIL HEALTH SERVICES; S. 7507 25 A. 9507 (B) PROVIDE TREATMENT WITHOUT DISCRIMINATION AS TO SOURCE OF PAYMENT; (C) MAINTAIN A POLICY OFFERING A SLIDING SCALE FOR PAYMENT FOR PATIENTS WHO DO NOT HAVE HEALTH CARE COVERAGE AND PUBLISH SUCH POLICY ON A PUBLICLY AVAILABLE WEBSITE; (D) PROVIDE TO PATIENTS WHO INDICATE THAT THEY DO NOT HAVE HEALTH CARE COVERAGE INFORMATION ON THE STATE HEALTH BENEFIT EXCHANGE, INCLUDING THE WEBSITE ADDRESS FOR THE EXCHANGE AND CONTACT INFORMATION FOR LOCAL NAVI- GATORS OFFERING IN-PERSON ENROLLMENT ASSISTANCE; (E) ACCEPT WALK-IN PATIENTS WITHOUT PREVIOUSLY SCHEDULED APPOINTMENTS; (F) OFFER BUSINESS HOURS FOR A MINIMUM OF TWELVE HOURS PER DAY AND SIX DAYS PER WEEK OR, IF THE RETAIL BUSINESS IN WHICH THE RETAIL PRACTICE IS LOCATED IS OPEN FOR LESS THAN TWELVE HOURS PER DAY AND SIX DAYS PER WEEK, THEN THE RETAIL PRACTICE SHALL OFFER THE SAME BUSINESS HOURS AS THE RETAIL BUSINESS; (G) PUBLISH A LIST OF THE RETAIL HEALTH SERVICES IT OFFERS ON A PUBLICLY AVAILABLE WEBSITE TOGETHER WITH THE PRICES OF SUCH SERVICES; (H) POST SIGNS IN A CONSPICUOUS LOCATION IN LARGE TYPE STATING 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; (I) ENTER INTO AND MAINTAIN AT LEAST ONE COLLABORATIVE RELATIONSHIP AS DEFINED IN SUBDIVISION TWO OF SECTION TWENTY-NINE HUNDRED NINETY-NINE-HH OF THIS ARTICLE; (J) INQUIRE OF EACH PATIENT WHETHER HE OR SHE HAS A PRIMARY CARE PROVIDER; (K) MAINTAIN AND REGULARLY UPDATE A LIST OF LOCAL PRIMARY CARE PROVID- ERS AND PROVIDE SUCH LIST TO EACH PATIENT WHO INDICATES THAT HE OR SHE DOES NOT HAVE A PRIMARY CARE PROVIDER; (L) REFER PATIENTS TO THEIR PRIMARY CARE PROVIDERS OR OTHER HEALTH CARE PROVIDERS AS APPROPRIATE; (M) TRANSMIT, BY ELECTRONIC MEANS WHENEVER POSSIBLE, RECORDS OF SERVICES TO PATIENTS' PRIMARY CARE PROVIDERS AND MAINTAIN RECORDS OF SERVICES FOR A MINIMUM OF SIX YEARS; (N) EXECUTE PARTICIPATION AGREEMENTS WITH HEALTH INFORMATION ORGANIZA- TIONS, ALSO KNOWN AS QUALIFIED ENTITIES, PURSUANT TO WHICH THE RETAIL PRACTICE SHALL AGREE TO PARTICIPATE IN THE STATEWIDE HEALTH INFORMATION NETWORK FOR NEW YORK (SHIN-NY); (O) ATTAIN AND MAINTAIN ACCREDITATION PURSUANT TO SECTION TWENTY-NINE HUNDRED NINETY-NINE-KK OF THIS SECTION; AND (P) REPORT REPORTABLE EVENTS TO THE ACCREDITING ENTITY WITHIN THREE BUSINESS DAYS OF THE OCCURRENCE OF SUCH REPORTABLE EVENT. 3. ENTITIES MEETING THE DEFINITION OF A RETAIL PRACTICE AS SET FORTH IN THIS ARTICLE AND PROVIDING SERVICES ON OR BEFORE THE EFFECTIVE DATE OF THIS ARTICLE SHALL HAVE ONE HUNDRED TWENTY DAYS AFTER SUCH EFFECTIVE DATE TO NOTIFY THE DEPARTMENT OF COMPLIANCE THEREWITH. § 2999-KK. ACCREDITATION. 1. A RETAIL PRACTICE SHALL BE REQUIRED TO ATTAIN AND MAINTAIN ACCREDITATION BY A NATIONALLY RECOGNIZED ACCREDITING ENTITY AS DETERMINED BY THE DEPARTMENT. 2. THE ACCREDITING ENTITY SHALL BE REQUIRED TO NOTIFY THE DEPARTMENT PROMPTLY IF A RETAIL PRACTICE LOSES ITS ACCREDITATION. 3. THE ACCREDITING ENTITY SHALL BE REQUIRED TO REPORT DATA ON ALL RETAIL PRACTICES ACCREDITED BY SUCH ENTITY TO THE COMMISSIONER. § 2999-LL. OTHER LAWS. 1. NOTHING IN THIS ARTICLE SHALL BE DEEMED TO ALTER THE SCOPE OF PRACTICE OF ANY PRACTITIONER LICENSED OR CERTIFIED UNDER TITLE EIGHT OF THE EDUCATION LAW. 2. NOTHING IN THIS ARTICLE SHALL BE DEEMED TO MITIGATE THE RESPONSI- BILITY OF ANY INDIVIDUAL PRACTITIONER LICENSED OR CERTIFIED UNDER TITLE S. 7507 26 A. 9507 EIGHT OF THE EDUCATION LAW FROM ACCOUNTABILITY FOR HIS OR HER ACTIONS UNDER APPLICABLE PROVISIONS OF LAW. 3. A RETAIL PRACTICE SHALL BE DEEMED TO BE A "HEALTH CARE PROVIDER" FOR THE PURPOSES OF TITLE TWO-D OF ARTICLE TWO OF THIS CHAPTER. 4. A PRESCRIBER PRACTICING IN A RETAIL PRACTICE 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. § 2. This act shall take effect immediately. PART H Section 1. Section 6902 of the education law is amended by adding a new subdivision 4 to read as follows: 4. (A) THE PRACTICE OF REGISTERED PROFESSIONAL NURSING BY A CERTIFIED REGISTERED NURSE ANESTHETIST, CERTIFIED UNDER SECTION SIXTY-NINE HUNDRED TWELVE OF THIS ARTICLE MAY INCLUDE THE PRACTICE OF NURSE ANESTHESIA. (I) SUBJECT TO THE PROVISIONS OF PARAGRAPH (E) OF THIS SUBDIVISION, NURSE ANESTHESIA INCLUDES: THE ADMINISTRATION OF ANESTHESIA AND ANES- THESIA RELATED CARE TO PATIENTS; PRE-ANESTHESIA EVALUATION AND PREPARA- TION; ANESTHETIC INDUCTION, MAINTENANCE AND EMERGENCE; POST ANESTHESIA CARE; PERIANESTHESIA NURSING AND CLINICAL SUPPORT FUNCTIONS; AND PAIN MANAGEMENT. (II) NURSE ANESTHESIA MUST BE PROVIDED IN COLLABORATION WITH A LICENSED PHYSICIAN QUALIFIED TO DETERMINE THE NEED FOR ANESTHESIA SERVICES, PROVIDED SUCH SERVICES ARE PERFORMED IN ACCORDANCE WITH A WRITTEN PRACTICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS AS SET FORTH IN PARAGRAPH (B) OF THIS SUBDIVISION OR PURSUANT TO COLLABORATIVE RELATIONSHIPS AS SET FORTH IN PARAGRAPH (C) OF THIS SUBDIVISION, WHICH- EVER IS APPLICABLE. (III) PRESCRIPTIONS FOR DRUGS, DEVICES, AND ANESTHETIC AGENTS, ANES- THESIA RELATED AGENTS, AND PAIN MANAGEMENT AGENTS MAY BE ISSUED BY A CERTIFIED REGISTERED NURSE ANESTHETIST, IN ACCORDANCE WITH THE WRITTEN PRACTICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS DESCRIBED IN PARAGRAPH (B) OF THIS SUBDIVISION IF APPLICABLE. THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL OBTAIN A CERTIFICATE FROM THE DEPARTMENT UPON SUCCESS- FULLY COMPLETING A PROGRAM INCLUDING AN APPROPRIATE PHARMACOLOGY COMPO- NENT, OR ITS EQUIVALENT, AS ESTABLISHED BY THE COMMISSIONER'S REGU- LATIONS, PRIOR TO PRESCRIBING UNDER THIS SUBPARAGRAPH. THE CERTIFICATE ISSUED UNDER SECTION SIXTY-NINE HUNDRED TWELVE OF THIS ARTICLE SHALL STATE WHETHER THE CERTIFIED REGISTERED NURSE ANESTHETIST HAS SUCCESSFUL- LY COMPLETED SUCH A PROGRAM OR EQUIVALENT AND IS AUTHORIZED TO PRESCRIBE UNDER THIS SUBDIVISION. (B) A CERTIFIED REGISTERED NURSE ANESTHETIST CERTIFIED UNDER SECTION SIXTY-NINE HUNDRED TWELVE OF THIS ARTICLE AND PRACTICING FOR THIRTY-SIX HUNDRED HOURS OR LESS SHALL DO SO IN ACCORDANCE WITH A WRITTEN PRACTICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS AGREED UPON BY A LICENSED PHYSICIAN QUALIFIED BY EDUCATION AND EXPERIENCE TO DETERMINE THE NEED FOR ANESTHESIA. (I) THE WRITTEN PRACTICE AGREEMENT SHALL INCLUDE EXPLICIT PROVISIONS FOR THE RESOLUTION OF ANY DISAGREEMENT BETWEEN THE COLLABORATING PHYSI- CIAN AND THE CERTIFIED REGISTERED NURSE ANESTHETIST REGARDING A MATTER OF ANESTHESIA OR PAIN MANAGEMENT TREATMENT THAT IS WITHIN THE SCOPE OF PRACTICE OF BOTH. TO THE EXTENT THE PRACTICE AGREEMENT DOES NOT SO PROVIDE, THEN THE COLLABORATING PHYSICIAN'S TREATMENT SHALL PREVAIL. S. 7507 27 A. 9507 (II) EACH PRACTICE AGREEMENT SHALL PROVIDE FOR PATIENT RECORDS REVIEW BY THE COLLABORATING PHYSICIAN IN A TIMELY FASHION BUT IN NO EVENT LESS OFTEN THAN EVERY THREE MONTHS. THE NAMES OF THE CERTIFIED REGISTERED NURSE ANESTHETIST AND THE COLLABORATING PHYSICIAN SHALL BE CLEARLY POST- ED IN THE PRACTICE SETTING OF THE CERTIFIED REGISTERED NURSE ANESTHE- TIST. (III) THE PRACTICE PROTOCOL SHALL REFLECT CURRENT ACCEPTED MEDICAL AND NURSING PRACTICE. THE PROTOCOLS SHALL BE FILED WITH THE DEPARTMENT WITHIN NINETY DAYS OF THE COMMENCEMENT OF THE PRACTICE AND MAY BE UPDATED PERIODICALLY. THE COMMISSIONER SHALL MAKE REGULATIONS ESTABLISH- ING THE PROCEDURE FOR THE REVIEW OF PROTOCOLS AND THE DISPOSITION OF ANY ISSUES ARISING FROM SUCH REVIEW. (C) A CERTIFIED REGISTERED NURSE ANESTHETIST CERTIFIED UNDER SECTION SIXTY-NINE HUNDRED TWELVE OF THIS ARTICLE AND PRACTICING FOR MORE THAN THIRTY-SIX HUNDRED HOURS SHALL HAVE COLLABORATIVE RELATIONSHIPS WITH ONE OR MORE LICENSED PHYSICIANS QUALIFIED TO DETERMINE THE NEED FOR ANES- THESIA SERVICES OR A HOSPITAL, LICENSED UNDER ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, THAT PROVIDES SERVICES THROUGH LICENSED PHYSI- CIANS QUALIFIED TO DETERMINE THE NEED FOR ANESTHESIA SERVICES AND HAVING PRIVILEGES AT SUCH INSTITUTION. (I) FOR PURPOSES OF THIS PARAGRAPH, "COLLABORATIVE RELATIONSHIPS" SHALL MEAN THAT THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL COMMU- NICATE, WHETHER IN PERSON, BY TELEPHONE OR THROUGH WRITTEN (INCLUDING ELECTRONIC) MEANS, WITH A LICENSED PHYSICIAN QUALIFIED TO DETERMINE THE NEED FOR ANESTHESIA SERVICES OR, IN THE CASE OF A HOSPITAL, COMMUNICATE WITH A LICENSED PHYSICIAN QUALIFIED TO DETERMINE THE NEED FOR ANESTHESIA SERVICES AND HAVING PRIVILEGES AT SUCH HOSPITAL, FOR THE PURPOSES OF EXCHANGING INFORMATION, AS NEEDED, IN ORDER TO PROVIDE COMPREHENSIVE PATIENT CARE AND TO MAKE REFERRALS AS NECESSARY. (II) AS EVIDENCE THAT THE CERTIFIED REGISTERED NURSE ANESTHETIST MAIN- TAINS COLLABORATIVE RELATIONSHIPS, THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL COMPLETE AND MAINTAIN A FORM, CREATED BY THE DEPART- MENT, TO WHICH THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL ATTEST, THAT DESCRIBES SUCH COLLABORATIVE RELATIONSHIPS. SUCH FORM SHALL ALSO REFLECT THE CERTIFIED REGISTERED NURSE ANESTHETIST'S ACKNOWLEDGEMENT THAT IF REASONABLE EFFORTS TO RESOLVE ANY DISPUTE THAT MAY ARISE WITH THE COLLABORATING PHYSICIAN OR, IN THE CASE OF A COLLABORATION WITH A HOSPITAL, WITH A LICENSED PHYSICIAN QUALIFIED TO DETERMINE THE NEED FOR ANESTHESIA SERVICES AND HAVING PRIVILEGES AT SUCH HOSPITAL, ABOUT A PATIENT'S CARE ARE NOT SUCCESSFUL, THE RECOMMENDATION OF THE PHYSICIAN SHALL PREVAIL. SUCH FORM SHALL BE UPDATED AS NEEDED AND MAY BE SUBJECT TO REVIEW BY THE DEPARTMENT. THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL MAINTAIN DOCUMENTATION THAT SUPPORTS SUCH COLLABORATIVE RELATION- SHIPS. (D) NOTHING IN THIS SUBDIVISION SHALL BE DEEMED TO LIMIT OR DIMINISH THE PRACTICE OF THE PROFESSION OF NURSING AS A REGISTERED PROFESSIONAL NURSE UNDER THIS ARTICLE OR ANY OTHER LAW, RULE, REGULATION OR CERTIF- ICATION, NOR TO DENY ANY REGISTERED PROFESSIONAL NURSE THE RIGHT TO DO ANY ACT OR ENGAGE IN ANY PRACTICE AUTHORIZED BY THIS ARTICLE OR ANY OTHER LAW, RULE, REGULATION OR CERTIFICATION. (E)(I) ANESTHESIA SERVICES MAY BE PROVIDED BY CERTIFIED REGISTERED NURSE ANESTHETISTS ONLY IN THE FOLLOWING SETTINGS: (A) GENERAL HOSPITALS, HOSPITAL OUTPATIENT SURGICAL DEPARTMENTS, AND DIAGNOSTIC AND TREATMENT CENTERS LICENSED BY THE DEPARTMENT OF HEALTH PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW AND AUTHORIZED S. 7507 28 A. 9507 TO PROVIDE SEDATION, ANESTHESIA SERVICES, AND/OR PAIN MANAGEMENT SERVICES IN CONNECTION WITH SUCH LICENSURE; (B) PRACTICES WHERE OFFICE-BASED SURGERY, AS DEFINED BY SECTION TWO HUNDRED-THIRTY-D OF THE PUBLIC HEALTH LAW, IS PERFORMED AND/OR PAIN MANAGEMENT SERVICES ARE PROVIDED; AND (C) DENTISTS' AND PERIODONTISTS' OFFICES WHERE SEDATION AND/OR ANES- THESIA SERVICES ARE PROVIDED. (II) ANESTHESIA SERVICES OFFERED IN SUCH SETTINGS, INCLUDING SERVICES PROVIDED BY CERTIFIED REGISTERED NURSE ANESTHETISTS, SHALL BE DIRECTED BY A PHYSICIAN, DENTIST, OR PERIODONTIST, AS APPLICABLE, WHO IS RESPON- SIBLE FOR THE CLINICAL ASPECTS OF ALL ANESTHESIA SERVICES OFFERED BY THE PROVIDER AND IS QUALIFIED TO DETERMINE THE NEED FOR AND ADMINISTER ANES- THESIA. SUCH PHYSICIAN SHALL HAVE THE DISCRETION TO ESTABLISH PARAMETERS FOR SUPERVISION OF CERTIFIED REGISTERED NURSE ANESTHETISTS WHERE HE OR SHE MAKES A REASONABLE DETERMINATION THAT THE CIRCUMSTANCES OF A PARTIC- ULAR CASE OR TYPE OF CASES, ALTHOUGH WITHIN THE SCOPE OF PRACTICE OF A CERTIFIED REGISTERED NURSE ANESTHETIST AS SET FORTH IN PARAGRAPH (A) OF THIS SUBDIVISION, ARE OF SUCH COMPLEXITY THAT THEY SHOULD BE CONDUCTED UNDER SUPERVISION. IN SUCH CASES, SUCH SUPERVISION SHALL BE PROVIDED BY AN ANESTHESIOLOGIST WHO IS IMMEDIATELY AVAILABLE AS NEEDED OR BY THE OPERATING PHYSICIAN WHO IS QUALIFIED TO DETERMINE THE NEED FOR ANES- THESIA SERVICES AND SUPERVISE THE ADMINISTRATION OF ANESTHESIA. § 2. The education law is amended by adding a new section 6912 to read as follows: § 6912. CERTIFICATES FOR NURSE ANESTHESIA PRACTICE. 1. FOR ISSUANCE OF A CERTIFICATE TO PRACTICE AS A CERTIFIED REGISTERED NURSE ANESTHETIST UNDER SUBDIVISION FOUR OF SECTION SIXTY-NINE HUNDRED TWO OF THIS ARTI- CLE, THE APPLICANT SHALL FULFILL THE FOLLOWING REQUIREMENTS: (A) APPLICATION: FILE AN APPLICATION WITH THE DEPARTMENT; (B) LICENSE: BE LICENSED AS A REGISTERED PROFESSIONAL NURSE IN THE STATE; (C) EDUCATION: (I) HAVE SATISFACTORILY COMPLETED EDUCATIONAL PREPARA- TION FOR PROVISION OF THESE SERVICES IN A PROGRAM REGISTERED BY THE DEPARTMENT OR IN A PROGRAM ACCREDITED BY A NATIONAL BODY RECOGNIZED BY THE DEPARTMENT OR DETERMINED BY THE DEPARTMENT TO BE THE EQUIVALENT; AND (II) SUBMIT EVIDENCE OF CURRENT CERTIFICATION OR RECERTIFICATION BY A NATIONAL CERTIFYING BODY, RECOGNIZED BY THE DEPARTMENT; (D) FEES: PAY A FEE TO THE DEPARTMENT OF FIFTY DOLLARS FOR AN INITIAL CERTIFICATE AUTHORIZING NURSE ANESTHESIA PRACTICE AND A TRIENNIAL REGIS- TRATION FEE OF THIRTY DOLLARS; AND (E) INFORMATION AND DOCUMENTATION: IN CONJUNCTION WITH AND AS A CONDI- TION OF EACH TRIENNIAL REGISTRATION, PROVIDE TO THE DEPARTMENT, AND THE DEPARTMENT SHALL COLLECT, SUCH INFORMATION AND DOCUMENTATION REQUIRED BY THE DEPARTMENT, IN CONSULTATION WITH THE DEPARTMENT OF HEALTH, AS IS NECESSARY TO ENABLE THE DEPARTMENT OF HEALTH TO EVALUATE ACCESS TO NEED- ED SERVICES IN THIS STATE, INCLUDING, BUT NOT LIMITED TO, THE LOCATION AND TYPE OF SETTING WHEREIN THE CERTIFIED REGISTERED NURSE ANESTHETIST PRACTICES AND OTHER INFORMATION THE DEPARTMENT, IN CONSULTATION WITH THE DEPARTMENT OF HEALTH, DEEMS RELEVANT. THE DEPARTMENT OF HEALTH, IN CONSULTATION WITH THE DEPARTMENT, SHALL MAKE SUCH DATA AVAILABLE IN AGGREGATE, DE-IDENTIFIED FORM ON A PUBLICLY ACCESSIBLE WEBSITE. ADDI- TIONALLY, IN CONJUNCTION WITH EACH TRIENNIAL REGISTRATION, THE DEPART- MENT, IN CONSULTATION WITH THE DEPARTMENT OF HEALTH, SHALL PROVIDE INFORMATION ON REGISTERING IN THE DONATE LIFE REGISTRY FOR ORGAN AND TISSUE DONATION, INCLUDING THE WEBSITE ADDRESS FOR SUCH REGISTRY. S. 7507 29 A. 9507 AFTER A CERTIFIED REGISTERED NURSE ANESTHETIST'S INITIAL REGISTRATION, REGISTRATION UNDER THIS SECTION SHALL BE COTERMINOUS WITH THE CERTIFIED REGISTERED NURSE ANESTHETIST'S REGISTRATION AS A PROFESSIONAL NURSE. 2. ONLY A PERSON CERTIFIED UNDER THIS SECTION SHALL USE THE TITLE "CERTIFIED REGISTERED NURSE ANESTHETIST," EXCEPT AS SET FORTH IN SUBDI- VISION THREE OF THIS SECTION. 3. NOTHING IN THIS SECTION SHALL BE DEEMED FROM PREVENTING ANY OTHER PROFESSIONAL LICENSED OR CERTIFIED UNDER THIS CHAPTER OR THE PUBLIC HEALTH LAW FROM CARRYING OUT ANY RESPONSIBILITIES ESTABLISHED BY RELE- VANT SECTIONS OF SUCH CHAPTERS. 4. AN INDIVIDUAL WHO MEETS THE REQUIREMENTS FOR CERTIFICATION AS A CERTIFIED REGISTERED NURSE ANESTHETIST AND WHO HAS BEEN PERFORMING THE DUTIES OF A CERTIFIED REGISTERED NURSE ANESTHETIST FOR TWO OF THE FIVE YEARS PRIOR TO THE EFFECTIVE DATE OF THIS ARTICLE MAY BE CERTIFIED WITH- OUT MEETING ADDITIONAL REQUIREMENTS, PROVIDED THAT SUCH INDIVIDUAL SUBMITS AN APPLICATION, INCLUDING AN ATTESTATION FROM THE APPLICANT'S SUPERVISING PHYSICIAN AS TO THE APPLICANT'S EXPERIENCE AND COMPETENCE, TO THE DEPARTMENT WITHIN TWO YEARS OF THE EFFECTIVE DATE OF THIS SECTION. SUCH INDIVIDUAL MAY USE THE TITLE "CERTIFIED REGISTERED NURSE ANESTHETIST" IN CONNECTION WITH THAT PRACTICE WHILE SUCH APPLICATION IS PENDING. 5. (A) A REGISTERED PROFESSIONAL NURSE LICENSED UNDER SECTION SIXTY- NINE HUNDRED FIVE OF THIS ARTICLE WHO HAS SATISFACTORILY COMPLETED A PROGRAM OF EDUCATIONAL PREPARATION AS PROVIDED IN SUBDIVISION ONE OF THIS SECTION MAY, FOR A PERIOD NOT TO EXCEED TWENTY-FOUR MONTHS IMME- DIATELY FOLLOWING THE COMPLETION OF SUCH EDUCATIONAL PROGRAM, PRACTICE NURSE ANESTHESIA UNDER SUBDIVISION FOUR OF SECTION SIXTY-NINE HUNDRED TWO OF THIS ARTICLE AS A GRADUATE NURSE ANESTHETIST IN THE SAME MANNER AS A CERTIFIED REGISTERED NURSE ANESTHETIST UNDER THAT SUBDIVISION. (B) A REGISTERED PROFESSIONAL NURSE LICENSED UNDER SECTION SIXTY-NINE HUNDRED FIVE OF THIS ARTICLE WHO IS DULY ENROLLED IN A PROGRAM OF EDUCA- TIONAL PREPARATION MAY PRACTICE NURSE ANESTHESIA AS A STUDENT NURSE ANESTHETIST UNDER THE SUPERVISION OF AN ANESTHESIOLOGIST OR A CERTIFIED REGISTERED NURSE ANESTHETIST, WHO IS IMMEDIATELY AVAILABLE AS NEEDED. § 3. This act shall take effect immediately. PART I Section 1. Section 364-j of the social services law is amended by adding a new subdivision 34 to read as follows: 34. MONIES PAID BY THE DEPARTMENT TO MANAGED CARE ORGANIZATIONS ARE PUBLIC FUNDS AND RETAIN THEIR STATUS AS PUBLIC FUNDS REGARDLESS OF ANY PAYMENTS MADE BY THE MANAGED CARE ORGANIZATION TO SUBCONTRACTORS OR PROVIDERS. § 2. Section 364-j of the social services law is amended by adding a new subdivision 35 to read as follows: 35. RECOVERY OF OVERPAYMENTS FROM NETWORK PROVIDERS. (A) WHERE THE MEDICAID INSPECTOR GENERAL, DURING THE COURSE OF AN AUDIT OR INVESTI- GATION, IDENTIFIES IMPROPER MEDICAL ASSISTANCE PAYMENTS MADE BY A MANAGED CARE ORGANIZATION TO ITS SUBCONTRACTOR OR SUBCONTRACTORS OR PROVIDER OR PROVIDERS, THE STATE SHALL HAVE THE RIGHT TO RECOVER THE IMPROPER PAYMENT FROM THE SUBCONTRACTOR OR SUBCONTRACTORS, PROVIDER OR PROVIDERS, OR THE MANAGED CARE ORGANIZATION. (B) WHERE THE STATE IS UNSUCCESSFUL IN RECOVERING THE IMPROPER PAYMENT FROM THE SUBCONTRACTOR OR SUBCONTRACTORS OR PROVIDER OR PROVIDERS, THE MEDICAID INSPECTOR GENERAL MAY REQUIRE THE MANAGED CARE ORGANIZATION TO S. 7507 30 A. 9507 RECOVER THE IMPROPER MEDICAL ASSISTANCE PAYMENTS IDENTIFIED IN PARAGRAPH (A) OF THIS SUBDIVISION. THE MANAGED CARE ORGANIZATION SHALL REMIT TO THE STATE THE FULL AMOUNT OF THE IDENTIFIED IMPROPER PAYMENT NO LATER THAN SIX MONTHS AFTER RECEIVING NOTICE OF THE OVERPAYMENT. (C) THE MANAGED CARE ORGANIZATION MAY CHARGE ITS SUBCONTRACTOR OR SUBCONTRACTORS OR PROVIDER OR PROVIDERS A COLLECTION FEE TO ACCOUNT FOR THE REASONABLE COSTS INCURRED BY THE MANAGED CARE ORGANIZATION TO COLLECT THE DEBT. ANY COLLECTION FEE IMPOSED SHALL NOT EXCEED FIVE PERCENT OF THE TOTAL AMOUNT OWED. § 3. Section 364-j of the social services law is amended by adding a new subdivision 36 to read as follows: 36. REPORTING ACTS OF FRAUD. (A) ALL MANAGED CARE ORGANIZATIONS SHALL PROMPTLY REFER TO THE OFFICE OF THE MEDICAID INSPECTOR GENERAL ALL CASES OF POTENTIAL FRAUD, WASTE, OR ABUSE. (B) ANY MANAGED CARE ORGANIZATION MAKING A COMPLAINT OR FURNISHING A REPORT, REFERRAL, INFORMATION OR RECORDS IN GOOD FAITH PURSUANT TO THIS SECTION SHALL BE IMMUNE FROM CIVIL LIABILITY FOR MAKING SUCH COMPLAINT, REFERRAL, OR REPORT TO THE OFFICE OF THE MEDICAID INSPECTOR GENERAL. (C) A MANAGED CARE ORGANIZATION THAT WILLFULLY FAILS TO PROMPTLY MAKE A REFERRAL TO THE MEDICAID INSPECTOR GENERAL WHEN THERE IS ACTUAL KNOW- LEDGE THAT AN ACT OF FRAUD IS BEING OR HAS BEEN COMMITTED MAY BE FINED IN AN AMOUNT NOT EXCEEDING ONE HUNDRED THOUSAND DOLLARS FOR EACH DETER- MINATION. § 4. The public health law is amended by adding a new section 37 to read as follows: § 37. VIOLATIONS OF MEDICAL ASSISTANCE PROGRAM LAWS, REGULATIONS OR DIRECTIVES; FINES. 1. (A) ANY INDIVIDUAL OR ENTITY PARTICIPATING IN THE MEDICAL ASSISTANCE PROGRAM THAT FAILS TO COMPLY WITH OR VIOLATES ANY STATUTE, RULE, REGULATION, OR DIRECTIVE OF THE MEDICAL ASSISTANCE PROGRAM, MAY BE FINED IN AN AMOUNT NOT EXCEEDING THE SUM OF FIVE THOU- SAND DOLLARS FOR EACH VIOLATION. (B) EVERY FAILURE TO COMPLY WITH OR VIOLATION OF ANY STATUTE, RULE, REGULATION, OR DIRECTIVE OF THE MEDICAL ASSISTANCE PROGRAM SHALL BE A SEPARATE AND DISTINCT OFFENSE AND, IN THE CASE OF A CONTINUING VIOLATION, EVERY DAY'S CONTINUANCE THEREOF SHALL BE A SEPARATE AND DISTINCT OFFENSE. 2. (A) ANY ENTITY AUTHORIZED TO OPERATE UNDER ARTICLE FORTY-FOUR OF THIS CHAPTER OR ARTICLE FORTY-THREE OF THE INSURANCE LAW, INCLUDING ANY SUBCONTRACTOR OR PROVIDER THEREOF, AND PARTICIPATING IN THE MEDICAL ASSISTANCE PROGRAM THAT FAILS TO COMPLY WITH OR VIOLATES ANY STATUTE, RULE, REGULATION, OR DIRECTIVE OF THE MEDICAL ASSISTANCE PROGRAM, OR ANY TERM OF ITS CONTRACT WITH THE DEPARTMENT, MAY BE FINED IN AN AMOUNT NOT EXCEEDING THE SUM OF FIVE THOUSAND DOLLARS FOR EACH VIOLATION. (B) EVERY FAILURE TO COMPLY WITH OR VIOLATION OF ANY STATUTE, RULE, REGULATION, OR DIRECTIVE OF THE MEDICAL ASSISTANCE PROGRAM, OR TERM OF THE ENTITY'S CONTRACT WITH THE DEPARTMENT SHALL BE A SEPARATE AND DISTINCT OFFENSE AND, IN THE CASE OF A CONTINUING VIOLATION, EVERY DAY'S CONTINUANCE THEREOF SHALL BE A SEPARATE AND DISTINCT OFFENSE. 3. ANY ENTITY PARTICIPATING IN THE MEDICAL ASSISTANCE PROGRAM AND AUTHORIZED TO OPERATE UNDER ARTICLE FORTY-FOUR OF THIS CHAPTER OR ARTI- CLE FORTY-THREE OF THE INSURANCE LAW THAT SUBMITS A COST REPORT TO THE MEDICAL ASSISTANCE PROGRAM THAT CONTAINS DATA WHICH IS INTENTIONALLY OR SYSTEMATICALLY INACCURATE OR IMPROPER, MAY BE FINED IN AN AMOUNT NOT EXCEEDING ONE HUNDRED THOUSAND DOLLARS FOR EACH DETERMINATION. 4. ANY ENTITY AUTHORIZED TO OPERATE UNDER ARTICLE FORTY-FOUR OF THIS CHAPTER OR ARTICLE FORTY-THREE OF THE INSURANCE LAW, AND PARTICIPATING S. 7507 31 A. 9507 IN THE MEDICAL ASSISTANCE PROGRAM THAT INTENTIONALLY OR SYSTEMATICALLY SUBMITS INACCURATE ENCOUNTER DATA TO THE STATE MAY BE FINED IN AN AMOUNT NOT EXCEEDING ONE HUNDRED THOUSAND DOLLARS FOR EACH DETERMINATION. 5. THE MEDICAID INSPECTOR GENERAL SHALL, IN CONSULTATION WITH THE COMMISSIONER, CONSIDER THE FOLLOWING PRIOR TO ASSESSING A FINE AGAINST AN INDIVIDUAL OR ENTITY UNDER THIS SECTION AND HAVE THE DISCRETION TO REDUCE OR ELIMINATE A FINE UNDER THIS SECTION: (A) THE EFFECT, IF ANY, ON THE QUALITY OF MEDICAL CARE PROVIDED TO OR ARRANGED FOR RECIPIENTS OF MEDICAL ASSISTANCE AS A RESULT OF THE ACTS OF THE INDIVIDUAL OR ENTITY; (B) THE AMOUNT OF DAMAGES TO THE PROGRAM; (C) THE DEGREE OF CULPABILITY OF THE INDIVIDUAL OR ENTITY IN COMMIT- TING THE PROSCRIBED ACTIONS AND ANY MITIGATING CIRCUMSTANCES; (D) ANY PRIOR VIOLATIONS COMMITTED BY THE INDIVIDUAL OR ENTITY RELAT- ING TO THE MEDICAL ASSISTANCE PROGRAM, MEDICARE OR ANY OTHER SOCIAL SERVICES PROGRAMS WHICH RESULTED IN EITHER CRIMINAL OR ADMINISTRATIVE SANCTION, PENALTY, OR FINE; (E) THE DEGREE TO WHICH FACTORS GIVING RISE TO THE PROSCRIBED ACTIONS WERE OUT OF THE CONTROL OF THE INDIVIDUAL OR ENTITY; (F) THE NUMBER AND NATURE OF THE VIOLATIONS OR OTHER RELATED OFFENSES; (G) ANY OTHER FACTS RELATING TO THE NATURE AND SERIOUSNESS OF THE VIOLATIONS INCLUDING ANY EXCULPATORY FACTS; AND/OR (H) ANY OTHER RELEVANT FACTORS. 6. THE MEDICAID INSPECTOR GENERAL SHALL, IN CONSULTATION WITH THE COMMISSIONER, PROMULGATE REGULATIONS ENUMERATING THOSE VIOLATIONS WHICH MAY RESULT IN A FINE PURSUANT TO SUBDIVISIONS ONE AND TWO OF THIS SECTION, THE AMOUNTS OF ANY FINES WHICH MAY BE ASSESSED UNDER THIS SECTION, AND THE APPEAL RIGHTS AFFORDED TO INDIVIDUALS OR ENTITIES SUBJECT TO A FINE. § 5. Paragraph (d) of subdivision 32 of section 364-j of the social services law, as added by section 15 of part B of chapter 59 of the laws of 2016, is amended to read as follows: (d) (I) Penalties under this subdivision may be applied to any and all circumstances described in paragraph (b) of this subdivision until the managed care organization complies with the requirements for submission of encounter data. (II) No penalties for late, incomplete or inaccurate encounter data shall be assessed against managed care organizations in addition to those provided for in this subdivision, PROVIDED, HOWEVER, THAT NOTHING IN THIS PARAGRAPH SHALL PROHIBIT THE IMPOSITION OF PENAL- TIES, IN CASES OF FRAUD OR ABUSE, OTHERWISE AUTHORIZED BY LAW. § 6. This act shall take effect on the ninetieth day after it shall have become a law; provided, however, that the amendments to section 364-j of the social services law made by sections one, two, three and five of this act shall not affect the repeal of such section and shall be deemed repealed therewith. PART J Section 1. Paragraph (h) of subdivision 1 of section 189 of the state finance law, as amended by section 8 of part A of chapter 56 of the laws of 2013, is amended to read as follows: (h) knowingly conceals or knowingly and improperly avoids or decreases an obligation to pay or transmit money or property to the state or a local government, or conspires to do the same; shall be liable to the state or a local government, as applicable, for a civil penalty of not less than six thousand dollars and not more than twelve thousand S. 7507 32 A. 9507 dollars, AS ADJUSTED TO BE EQUAL TO THE CIVIL PENALTY ALLOWED UNDER THE FEDERAL FALSE CLAIMS ACT, 31 U.S.C. SEC. 3729, ET SEQ., AS AMENDED, AS ADJUSTED FOR INFLATION BY THE FEDERAL CIVIL PENALTIES INFLATION ADJUST- MENT ACT OF 1990, AS AMENDED (28 U.S.C. 2461 NOTE; PUB. L. NO. 101-410), plus three times the amount of all damages, including consequential damages, which the state or local government sustains because of the act of that person. § 2. This act shall take effect immediately. PART K Section 1. Notwithstanding any contrary provision of law, the depart- ment of health is authorized to require any Medicaid-enrolled provider, and any health care provider that is part of a network of providers of a managed care organization operating pursuant to section 364-j of the social services law or section 4403-f of the public health law, to report on costs incurred by the provider in rendering health care services to Medicaid beneficiaries. The department of health may specify the frequency and format of such reports, determine the type and amount of information to be submitted, and require the submission of supporting documentation. In the case of a provider in a managed care network, the department of health may require the managed care organization to obtain the required information from the network provider on behalf of the department. § 2. Subdivision 1 of section 92 of part H of chapter 59 of the laws of 2011, amending the public health law and other laws relating to known and projected department of health state fund medicaid expenditures, as amended by section 1 of part G of chapter 57 of the laws of 2017, is amended to read as follows: 1. For state fiscal years 2011-12 through [2018-19] 2019-20, the director of the budget, in consultation with the commissioner of health referenced as "commissioner" for purposes of this section, shall assess on a monthly basis, as reflected in monthly reports pursuant to subdivi- sion five of this section known and projected department of health state funds medicaid expenditures by category of service and by geographic regions, as defined by the commissioner, and if the director of the budget determines that such expenditures are expected to cause medicaid disbursements for such period to exceed the projected department of health medicaid state funds disbursements in the enacted budget finan- cial plan pursuant to subdivision 3 of section 23 of the state finance law, the commissioner of health, in consultation with the director of the budget, shall develop a medicaid savings allocation plan to limit such spending to the aggregate limit level specified in the enacted budget financial plan, provided, however, such projections may be adjusted by the director of the budget to account for any changes in the New York state federal medical assistance percentage amount established pursuant to the federal social security act, changes in provider reven- ues, reductions to local social services district medical assistance administration, minimum wage increases, and beginning April 1, 2012 the operational costs of the New York state medical indemnity fund and state costs or savings from the basic health plan. Such projections may be adjusted by the director of the budget to account for increased or expe- dited department of health state funds medicaid expenditures as a result of a natural or other type of disaster, including a governmental decla- ration of emergency. § 3. This act shall take effect immediately. S. 7507 33 A. 9507 PART L Section 1. Subdivision 7 of section 369 of the social services law, as amended by section 7 of part F of chapter 56 of the laws of 2012, is amended to read as follows: 7. Notwithstanding any provision of law to the contrary, the depart- ment shall, when it determines necessary program features are in place, assume sole responsibility for commencing actions or proceedings in accordance with the provisions of this section, sections one hundred one, one hundred four, one hundred four-b, paragraph (a) of subdivision three of section three hundred sixty-six, subparagraph one of paragraph (h) of subdivision four of section three hundred sixty-six, and para- graph (b) of subdivision two of section three hundred sixty-seven-a of this chapter, to recover the cost of medical assistance furnished pursu- ant to this title and title eleven-D of this article. The department is authorized to contract with an entity that shall conduct activities on behalf of the department pursuant to this subdivision, AND MAY CONTRACT WITH AN ENTITY TO CONDUCT SIMILAR ACTIVITIES ON BEHALF OF THE CHILD HEALTH INSURANCE PROGRAM ESTABLISHED PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW TO THE EXTENT ALLOWED BY LAW. Prior to assuming such responsibility from a social services district, the department of health shall, in consultation with the district, define the scope of the services the district will be required to perform on behalf of the department of health pursuant to this subdivi- sion. § 2. Section 2511 of the public health law is amended by adding a new subdivision 22 to read as follows: 22. NOTWITHSTANDING THE PROVISIONS OF THIS SECTION, SECTION TWENTY- FIVE HUNDRED TEN OF THIS TITLE, AND ANY OTHER INCONSISTENT PROVISION OF LAW, IN THE EVENT FEDERAL FUNDING PURSUANT TO TITLE XXI OF THE FEDERAL SOCIAL SECURITY ACT IS REDUCED OR ELIMINATED ON AND AFTER OCTOBER FIRST, TWO THOUSAND SEVENTEEN: (A) THE DIRECTOR OF THE DIVISION OF THE BUDGET, IN CONSULTATION WITH THE COMMISSIONER, SHALL IDENTIFY THE AMOUNT OF SUCH REDUCTION OR ELIMI- NATION AND NOTIFY THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY IN WRITING THAT THE FEDERAL ACTIONS WILL REDUCE OR ELIM- INATE EXPECTED FUNDING TO NEW YORK STATE BY SUCH AMOUNT. (B) THE DIRECTOR OF THE DIVISION OF THE BUDGET, IN CONSULTATION WITH THE COMMISSIONER, SHALL DETERMINE IF PROGRAMMATIC CHANGES ARE NECESSARY TO CONTINUE COVERING ELIGIBLE CHILDREN WITHIN STATE-ONLY FUNDING LEVELS, IDENTIFY AVAILABLE RESOURCES OR ACTIONS, IDENTIFY SPECIFIC CHANGES NEED- ED TO ALIGN THE PROGRAM WITH CURRENT FUNDING LEVELS, AND ESTABLISH A PLAN FOR IMPLEMENTING SUCH CHANGES WHICH MAY INCLUDE EMERGENCY REGU- LATIONS PROMULGATED BY THE COMMISSIONER. SUCH PLAN SHALL BE SUBMITTED TO THE LEGISLATURE PRIOR TO ITS IMPLEMENTATION. § 3. This act shall take effect immediately. PART M Section 1. Paragraph (a) of subdivision 1 of section 18 of chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, as amended by section 15 of part H of chapter 57 of the laws of 2017, is amended to read as follows: (a) The superintendent of financial services and the commissioner of health or their designee shall, from funds available in the hospital S. 7507 34 A. 9507 excess liability pool created pursuant to subdivision 5 of this section, purchase a policy or policies for excess insurance coverage, as author- ized by paragraph 1 of subsection (e) of section 5502 of the insurance law; or from an insurer, other than an insurer described in section 5502 of the insurance law, duly authorized to write such coverage and actual- ly writing medical malpractice insurance in this state; or shall purchase equivalent excess coverage in a form previously approved by the superintendent of financial services for purposes of providing equiv- alent excess coverage in accordance with section 19 of chapter 294 of the laws of 1985, for medical or dental malpractice occurrences between July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007, between July 1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010 and June 30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014, between July 1, 2014 and June 30, 2015, between July 1, 2015 and June 30, 2016, between July 1, 2016 and June 30, 2017, [and] between July 1, 2017 and June 30, 2018, AND BETWEEN JULY 1, 2018 AND JUNE 30, 2019 or reimburse the hospital where the hospital purchases equivalent excess coverage as defined in subparagraph (i) of paragraph (a) of subdivision 1-a of this section for medical or dental malpractice occurrences between July 1, 1987 and June 30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007, between July 1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010 and June 30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014, between July 1, 2014 and June 30, 2015, between July 1, 2015 and June 30, 2016, between July 1, 2016 and June 30, 2017, [and] between July 1, 2017 and June 30, 2018, AND BETWEEN JULY 1, 2018 AND JUNE 30, 2019 for physicians or dentists certified as eligible for each such period or periods pursuant to subdivision 2 of this section by a general hospital licensed pursuant to article 28 of the public health law; provided that no single insurer shall write more than fifty percent of the total excess premium for a given policy year; and provided, however, that such eligible physicians or dentists must have in force an individ- S. 7507 35 A. 9507 ual policy, from an insurer licensed in this state of primary malprac- tice insurance coverage in amounts of no less than one million three hundred thousand dollars for each claimant and three million nine hundred thousand dollars for all claimants under that policy during the period of such excess coverage for such occurrences or be endorsed as additional insureds under a hospital professional liability policy which is offered through a voluntary attending physician ("channeling") program previously permitted by the superintendent of financial services during the period of such excess coverage for such occurrences. During such period, such policy for excess coverage or such equivalent excess coverage shall, when combined with the physician's or dentist's primary malpractice insurance coverage or coverage provided through a voluntary attending physician ("channeling") program, total an aggregate level of two million three hundred thousand dollars for each claimant and six million nine hundred thousand dollars for all claimants from all such policies with respect to occurrences in each of such years provided, however, if the cost of primary malpractice insurance coverage in excess of one million dollars, but below the excess medical malpractice insur- ance coverage provided pursuant to this act, exceeds the rate of nine percent per annum, then the required level of primary malpractice insur- ance coverage in excess of one million dollars for each claimant shall be in an amount of not less than the dollar amount of such coverage available at nine percent per annum; the required level of such coverage for all claimants under that policy shall be in an amount not less than three times the dollar amount of coverage for each claimant; and excess coverage, when combined with such primary malpractice insurance cover- age, shall increase the aggregate level for each claimant by one million dollars and three million dollars for all claimants; and provided further, that, with respect to policies of primary medical malpractice coverage that include occurrences between April 1, 2002 and June 30, 2002, such requirement that coverage be in amounts no less than one million three hundred thousand dollars for each claimant and three million nine hundred thousand dollars for all claimants for such occur- rences shall be effective April 1, 2002. § 2. Subdivision 3 of section 18 of chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, as amended by section 16 of part H of chapter 57 of the laws of 2017, is amended to read as follows: (3)(a) The superintendent of financial services shall determine and certify to each general hospital and to the commissioner of health the cost of excess malpractice insurance for medical or dental malpractice occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007, between July 1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010 and June 30, 2011, between July S. 7507 36 A. 9507 1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, and between July 1, 2013 and June 30, 2014, between July 1, 2014 and June 30, 2015, between July 1, 2015 and June 30, 2016, and between July 1, 2016 and June 30, 2017, [and] between July 1, 2017 and June 30, 2018, AND BETWEEN JULY 1, 2018 AND JUNE 30, 2019 allocable to each general hospital for physicians or dentists certified as eligible for purchase of a policy for excess insurance coverage by such general hospital in accordance with subdivision 2 of this section, and may amend such deter- mination and certification as necessary. (b) The superintendent of financial services shall determine and certify to each general hospital and to the commissioner of health the cost of excess malpractice insurance or equivalent excess coverage for medical or dental malpractice occurrences between July 1, 1987 and June 30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007, between July 1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010 and June 30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014, between July 1, 2014 and June 30, 2015, between July 1, 2015 and June 30, 2016, [and] between July 1, 2016 and June 30, 2017, [and] between July 1, 2017 and June 30, 2018, AND BETWEEN JULY 1, 2018 AND JUNE 30, 2019 allocable to each general hospital for physicians or dentists certified as eligible for purchase of a policy for excess insurance coverage or equivalent excess coverage by such general hospital in accordance with subdivision 2 of this section, and may amend such deter- mination and certification as necessary. The superintendent of financial services shall determine and certify to each general hospital and to the commissioner of health the ratable share of such cost allocable to the period July 1, 1987 to December 31, 1987, to the period January 1, 1988 to June 30, 1988, to the period July 1, 1988 to December 31, 1988, to the period January 1, 1989 to June 30, 1989, to the period July 1, 1989 to December 31, 1989, to the period January 1, 1990 to June 30, 1990, to the period July 1, 1990 to December 31, 1990, to the period January 1, 1991 to June 30, 1991, to the period July 1, 1991 to December 31, 1991, to the period January 1, 1992 to June 30, 1992, to the period July 1, 1992 to December 31, 1992, to the period January 1, 1993 to June 30, 1993, to the period July 1, 1993 to December 31, 1993, to the period January 1, 1994 to June 30, 1994, to the period July 1, 1994 to December 31, 1994, to the period January 1, 1995 to June 30, 1995, to the period July 1, 1995 to December 31, 1995, to the period January 1, 1996 to June 30, 1996, to the period July 1, 1996 to December 31, 1996, to the period January 1, 1997 to June 30, 1997, to the period July 1, 1997 to December 31, 1997, to the period January 1, 1998 to June 30, 1998, to the period July 1, 1998 to December 31, 1998, to the period January 1, 1999 to June 30, 1999, to the period July 1, 1999 to December 31, 1999, to the period January 1, 2000 to June 30, 2000, to the period July 1, 2000 to December S. 7507 37 A. 9507 31, 2000, to the period January 1, 2001 to June 30, 2001, to the period July 1, 2001 to June 30, 2002, to the period July 1, 2002 to June 30, 2003, to the period July 1, 2003 to June 30, 2004, to the period July 1, 2004 to June 30, 2005, to the period July 1, 2005 and June 30, 2006, to the period July 1, 2006 and June 30, 2007, to the period July 1, 2007 and June 30, 2008, to the period July 1, 2008 and June 30, 2009, to the period July 1, 2009 and June 30, 2010, to the period July 1, 2010 and June 30, 2011, to the period July 1, 2011 and June 30, 2012, to the period July 1, 2012 and June 30, 2013, to the period July 1, 2013 and June 30, 2014, to the period July 1, 2014 and June 30, 2015, to the period July 1, 2015 and June 30, 2016, and between July 1, 2016 and June 30, 2017, and to the period July 1, 2017 [and] TO June 30, 2018, AND TO THE PERIOD JULY 1, 2018 TO JUNE 30, 2019. § 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section 18 of chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, as amended by section 17 of part H of chapter 57 of the laws of 2017, are amended to read as follows: (a) To the extent funds available to the hospital excess liability pool pursuant to subdivision 5 of this section as amended, and pursuant to section 6 of part J of chapter 63 of the laws of 2001, as may from time to time be amended, which amended this subdivision, are insuffi- cient to meet the costs of excess insurance coverage or equivalent excess coverage for coverage periods during the period July 1, 1992 to June 30, 1993, during the period July 1, 1993 to June 30, 1994, during the period July 1, 1994 to June 30, 1995, during the period July 1, 1995 to June 30, 1996, during the period July 1, 1996 to June 30, 1997, during the period July 1, 1997 to June 30, 1998, during the period July 1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30, 2000, during the period July 1, 2000 to June 30, 2001, during the period July 1, 2001 to October 29, 2001, during the period April 1, 2002 to June 30, 2002, during the period July 1, 2002 to June 30, 2003, during the period July 1, 2003 to June 30, 2004, during the period July 1, 2004 to June 30, 2005, during the period July 1, 2005 to June 30, 2006, during the period July 1, 2006 to June 30, 2007, during the period July 1, 2007 to June 30, 2008, during the period July 1, 2008 to June 30, 2009, during the period July 1, 2009 to June 30, 2010, during the period July 1, 2010 to June 30, 2011, during the period July 1, 2011 to June 30, 2012, during the period July 1, 2012 to June 30, 2013, during the period July 1, 2013 to June 30, 2014, during the period July 1, 2014 to June 30, 2015, during the period July 1, 2015 [and] TO June 30, 2016, during the period July 1, 2016 [and] TO June 30, 2017, [and] during the period July 1, 2017 [and] TO June 30, 2018, AND DURING THE PERIOD JULY 1, 2018 TO JUNE 30, 2019 allocated or reallocated in accordance with paragraph (a) of subdivision 4-a of this section to rates of payment applicable to state governmental agencies, each physician or dentist for whom a policy for excess insurance coverage or equivalent excess cover- age is purchased for such period shall be responsible for payment to the provider of excess insurance coverage or equivalent excess coverage of an allocable share of such insufficiency, based on the ratio of the total cost of such coverage for such physician to the sum of the total cost of such coverage for all physicians applied to such insufficiency. (b) Each provider of excess insurance coverage or equivalent excess coverage covering the period July 1, 1992 to June 30, 1993, or covering the period July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to June 30, 1995, or covering the period July 1, 1995 to June 30, S. 7507 38 A. 9507 1996, or covering the period July 1, 1996 to June 30, 1997, or covering the period July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or covering the period July 1, 2000 to June 30, 2001, or covering the period July 1, 2001 to October 29, 2001, or covering the period April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or covering the peri- od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or covering the peri- od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or covering the peri- od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, or covering the period July 1, 2016 to June 30, 2017, or covering the peri- od July 1, 2017 to June 30, 2018, OR COVERING THE PERIOD JULY 1, 2018 TO JUNE 30, 2019 shall notify a covered physician or dentist by mail, mailed to the address shown on the last application for excess insurance coverage or equivalent excess coverage, of the amount due to such provider from such physician or dentist for such coverage period deter- mined in accordance with paragraph (a) of this subdivision. Such amount shall be due from such physician or dentist to such provider of excess insurance coverage or equivalent excess coverage in a time and manner determined by the superintendent of financial services. (c) If a physician or dentist liable for payment of a portion of the costs of excess insurance coverage or equivalent excess coverage cover- ing the period July 1, 1992 to June 30, 1993, or covering the period July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or covering the period July 1, 1996 to June 30, 1997, or covering the peri- od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or covering the period July 1, 2000 to June 30, 2001, or covering the peri- od July 1, 2001 to October 29, 2001, or covering the period April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or covering the period July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or covering the period July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or covering the period July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, or covering the period July 1, 2016 to June 30, 2017, or covering the period July 1, 2017 to June 30, 2018, OR COVERING THE PERIOD JULY 1, 2018 TO JUNE 30, 2019 determined in accordance with paragraph (a) of this subdivision fails, refuses or neglects to make payment to the provider of excess insurance coverage or equivalent excess coverage in such time and manner as determined by the superintendent of financial services pursuant to paragraph (b) of this subdivision, excess insurance coverage or equiv- alent excess coverage purchased for such physician or dentist in accord- ance with this section for such coverage period shall be cancelled and S. 7507 39 A. 9507 shall be null and void as of the first day on or after the commencement of a policy period where the liability for payment pursuant to this subdivision has not been met. (d) Each provider of excess insurance coverage or equivalent excess coverage shall notify the superintendent of financial services and the commissioner of health or their designee of each physician and dentist eligible for purchase of a policy for excess insurance coverage or equivalent excess coverage covering the period July 1, 1992 to June 30, 1993, or covering the period July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or covering the period July 1, 1996 to June 30, 1997, or covering the period July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or covering the period July 1, 2000 to June 30, 2001, or covering the period July 1, 2001 to October 29, 2001, or cover- ing the period April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or covering the period July 1, 2005 to June 30, 2006, or covering the peri- od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or covering the period July 1, 2009 to June 30, 2010, or covering the peri- od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or covering the period July 1, 2013 to June 30, 2014, or covering the peri- od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, or covering the period July 1, 2016 to June 30, 2017, or covering the period July 1, 2017 to June 30, 2018, OR COVERING THE PERI- OD JULY 1, 2018 TO JUNE 30, 2019 that has made payment to such provider of excess insurance coverage or equivalent excess coverage in accordance with paragraph (b) of this subdivision and of each physician and dentist who has failed, refused or neglected to make such payment. (e) A provider of excess insurance coverage or equivalent excess coverage shall refund to the hospital excess liability pool any amount allocable to the period July 1, 1992 to June 30, 1993, and to the period July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June 30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000 to June 30, 2001, and to the period July 1, 2001 to October 29, 2001, and to the period April 1, 2002 to June 30, 2002, and to the period July 1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30, 2004, and to the period July 1, 2004 to June 30, 2005, and to the period July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June 30, 2007, and to the period July 1, 2007 to June 30, 2008, and to the period July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to June 30, 2010, and to the period July 1, 2010 to June 30, 2011, and to the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012 to June 30, 2013, and to the period July 1, 2013 to June 30, 2014, and to the period July 1, 2014 to June 30, 2015, and to the period July 1, 2015 to June 30, 2016, to the period July 1, 2016 to June 30, 2017, and to the period July 1, 2017 to June 30, 2018, AND TO THE PERIOD JULY 1, 2018 TO JUNE 30, 2019 received from the hospital excess liability pool for purchase of excess insurance coverage or equivalent excess coverage covering the period July 1, 1992 to June 30, 1993, and covering the S. 7507 40 A. 9507 period July 1, 1993 to June 30, 1994, and covering the period July 1, 1994 to June 30, 1995, and covering the period July 1, 1995 to June 30, 1996, and covering the period July 1, 1996 to June 30, 1997, and cover- ing the period July 1, 1997 to June 30, 1998, and covering the period July 1, 1998 to June 30, 1999, and covering the period July 1, 1999 to June 30, 2000, and covering the period July 1, 2000 to June 30, 2001, and covering the period July 1, 2001 to October 29, 2001, and covering the period April 1, 2002 to June 30, 2002, and covering the period July 1, 2002 to June 30, 2003, and covering the period July 1, 2003 to June 30, 2004, and covering the period July 1, 2004 to June 30, 2005, and covering the period July 1, 2005 to June 30, 2006, and covering the period July 1, 2006 to June 30, 2007, and covering the period July 1, 2007 to June 30, 2008, and covering the period July 1, 2008 to June 30, 2009, and covering the period July 1, 2009 to June 30, 2010, and cover- ing the period July 1, 2010 to June 30, 2011, and covering the period July 1, 2011 to June 30, 2012, and covering the period July 1, 2012 to June 30, 2013, and covering the period July 1, 2013 to June 30, 2014, and covering the period July 1, 2014 to June 30, 2015, and covering the period July 1, 2015 to June 30, 2016, and covering the period July 1, 2016 to June 30, 2017, and covering the period July 1, 2017 to June 30, 2018, AND COVERING THE PERIOD JULY 1, 2018 TO JUNE 30, 2019 for a physi- cian or dentist where such excess insurance coverage or equivalent excess coverage is cancelled in accordance with paragraph (c) of this subdivision. § 4. Section 40 of chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, as amended by section 18 of part H of chapter 57 of the laws of 2017, is amended to read as follows: § 40. The superintendent of financial services shall establish rates for policies providing coverage for physicians and surgeons medical malpractice for the periods commencing July 1, 1985 and ending June 30, [2018] 2019; provided, however, that notwithstanding any other provision of law, the superintendent shall not establish or approve any increase in rates for the period commencing July 1, 2009 and ending June 30, 2010. The superintendent shall direct insurers to establish segregated accounts for premiums, payments, reserves and investment income attrib- utable to such premium periods and shall require periodic reports by the insurers regarding claims and expenses attributable to such periods to monitor whether such accounts will be sufficient to meet incurred claims and expenses. On or after July 1, 1989, the superintendent shall impose a surcharge on premiums to satisfy a projected deficiency that is attributable to the premium levels established pursuant to this section for such periods; provided, however, that such annual surcharge shall not exceed eight percent of the established rate until July 1, [2018] 2019, at which time and thereafter such surcharge shall not exceed twen- ty-five percent of the approved adequate rate, and that such annual surcharges shall continue for such period of time as shall be sufficient to satisfy such deficiency. The superintendent shall not impose such surcharge during the period commencing July 1, 2009 and ending June 30, 2010. On and after July 1, 1989, the surcharge prescribed by this section shall be retained by insurers to the extent that they insured physicians and surgeons during the July 1, 1985 through June 30, [2018] 2019 policy periods; in the event and to the extent physicians and surgeons were insured by another insurer during such periods, all or a pro rata share of the surcharge, as the case may be, shall be remitted to such other insurer in accordance with rules and regulations to be S. 7507 41 A. 9507 promulgated by the superintendent. Surcharges collected from physicians and surgeons who were not insured during such policy periods shall be apportioned among all insurers in proportion to the premium written by each insurer during such policy periods; if a physician or surgeon was insured by an insurer subject to rates established by the superintendent during such policy periods, and at any time thereafter a hospital, health maintenance organization, employer or institution is responsible for responding in damages for liability arising out of such physician's or surgeon's practice of medicine, such responsible entity shall also remit to such prior insurer the equivalent amount that would then be collected as a surcharge if the physician or surgeon had continued to remain insured by such prior insurer. In the event any insurer that provided coverage during such policy periods is in liquidation, the property/casualty insurance security fund shall receive the portion of surcharges to which the insurer in liquidation would have been entitled. The surcharges authorized herein shall be deemed to be income earned for the purposes of section 2303 of the insurance law. The superintendent, in establishing adequate rates and in determining any projected defi- ciency pursuant to the requirements of this section and the insurance law, shall give substantial weight, determined in his discretion and judgment, to the prospective anticipated effect of any regulations promulgated and laws enacted and the public benefit of stabilizing malpractice rates and minimizing rate level fluctuation during the peri- od of time necessary for the development of more reliable statistical experience as to the efficacy of such laws and regulations affecting medical, dental or podiatric malpractice enacted or promulgated in 1985, 1986, by this act and at any other time. Notwithstanding any provision of the insurance law, rates already established and to be established by the superintendent pursuant to this section are deemed adequate if such rates would be adequate when taken together with the maximum authorized annual surcharges to be imposed for a reasonable period of time whether or not any such annual surcharge has been actually imposed as of the establishment of such rates. § 5. Section 5 and subdivisions (a) and (e) of section 6 of part J of chapter 63 of the laws of 2001, amending chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, relating to the effec- tiveness of certain provisions of such chapter, as amended by section 19 of part H of chapter 57 of the laws of 2017, are amended to read as follows: § 5. The superintendent of financial services and the commissioner of health shall determine, no later than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010, June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, June 15, 2015, June 15, 2016, June 15, 2017, [and] June 15, 2018, AND JUNE 15, 2019 the amount of funds available in the hospital excess liability pool, created pursuant to section 18 of chap- ter 266 of the laws of 1986, and whether such funds are sufficient for purposes of purchasing excess insurance coverage for eligible partic- ipating physicians and dentists during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30, S. 7507 42 A. 9507 2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30, 2016, or July 1, 2016 to June 30, 2017, or [to] July 1, 2017 to June 30, 2018, OR JULY 1, 2018 TO JUNE 30, 2019 as applicable. (a) This section shall be effective only upon a determination, pursu- ant to section five of this act, by the superintendent of financial services and the commissioner of health, and a certification of such determination to the state director of the budget, the chair of the senate committee on finance and the chair of the assembly committee on ways and means, that the amount of funds in the hospital excess liabil- ity pool, created pursuant to section 18 of chapter 266 of the laws of 1986, is insufficient for purposes of purchasing excess insurance cover- age for eligible participating physicians and dentists during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30, 2016, or July 1, 2016 to June 30, 2017, or July 1, 2017 to June 30, 2018, OR JULY 1, 2018 TO JUNE 30, 2019 as applicable. (e) The commissioner of health shall transfer for deposit to the hospital excess liability pool created pursuant to section 18 of chapter 266 of the laws of 1986 such amounts as directed by the superintendent of financial services for the purchase of excess liability insurance coverage for eligible participating physicians and dentists for the policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, as applicable, and the cost of administering the hospital excess liability pool for such applicable policy year, pursuant to the program established in chapter 266 of the laws of 1986, as amended, no later than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010, June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, June 15, 2015, June 15, 2016, June 15, 2017, [and] June 15, 2018, AND JUNE 15, 2019 as applicable. § 6. Section 20 of part H of chapter 57 of the laws of 2017, amending the New York Health Care Reform Act of 1996 and other laws relating to extending certain provisions thereto, is amended to read as follows: § 20. Notwithstanding any law, rule or regulation to the contrary, only physicians or dentists who were eligible, and for whom the super- intendent of financial services and the commissioner of health, or their designee, purchased, with funds available in the hospital excess liabil- ity pool, a full or partial policy for excess coverage or equivalent excess coverage for the coverage period ending the thirtieth of June, two thousand [seventeen] EIGHTEEN, shall be eligible to apply for such coverage for the coverage period beginning the first of July, two thou- sand [seventeen] EIGHTEEN; provided, however, if the total number of physicians or dentists for whom such excess coverage or equivalent excess coverage was purchased for the policy year ending the thirtieth of June, two thousand [seventeen] EIGHTEEN exceeds the total number of physicians or dentists certified as eligible for the coverage period beginning the first of July, two thousand [seventeen] EIGHTEEN, then the general hospitals may certify additional eligible physicians or dentists in a number equal to such general hospital's proportional share of the S. 7507 43 A. 9507 total number of physicians or dentists for whom excess coverage or equivalent excess coverage was purchased with funds available in the hospital excess liability pool as of the thirtieth of June, two thousand [seventeen] EIGHTEEN, as applied to the difference between the number of eligible physicians or dentists for whom a policy for excess coverage or equivalent excess coverage was purchased for the coverage period ending the thirtieth of June, two thousand [seventeen] EIGHTEEN and the number of such eligible physicians or dentists who have applied for excess coverage or equivalent excess coverage for the coverage period beginning the first of July, two thousand [seventeen] EIGHTEEN. § 7. This act shall take effect immediately. PART N Section 1. The opening paragraph of subdivision 1 of section 1 of part C of chapter 57 of the laws of 2006, establishing a cost of living adjustment for designated human services, is amended to read as follows: Subject to available appropriations, the commissioners of the office of mental health, office of mental retardation and developmental disa- bilities, office of alcoholism and substance abuse services, [department of health,] office of children and family services and the state office for the aging shall establish an annual cost of living adjustment (COLA), subject to the approval of the director of the budget, effective April first of each state fiscal year, provided, however, that in state fiscal year 2006-07, the cost of living adjustment will be effective October first, to project for the effects of inflation, for rates of payments, contracts or any other form of reimbursement for the programs listed in paragraphs (i), (ii), (iii), (iv)[,] AND (v) [and (vi)] of subdivision four of this section. The COLA shall be applied to the appropriate portion of reimbursable costs or contract amounts. § 2. Paragraph (iv) of subdivision 4 of section 1 of part C of chapter 57 of the laws of 2006, establishing a cost of living adjustment for designated human services, is REPEALED and paragraphs (v) and (vi) are renumbered paragraphs (iv) and (v). § 3. This act shall take effect immediately. PART O Section 1. Subdivisions 9 and 10 of section 2541 of the public health law, as added by chapter 428 of the laws of 1992, are amended to read as follows: 9. "Evaluation" means a multidisciplinary professional, objective [assessment] EXAMINATION conducted by appropriately qualified personnel and conducted pursuant to section twenty-five hundred forty-four of this title to determine a child's eligibility under this title. 10. "Evaluator" means a [team of two or more professionals approved pursuant to section twenty-five hundred fifty-one of this title] PROVID- ER APPROVED BY THE DEPARTMENT to conduct screenings and evaluations. § 2. Section 2541 of the public health law is amended by adding three new subdivisions 12-a, 14-a and 15-a to read as follows: 12-A. "MULTIDISCIPLINARY" MEANS THE INVOLVEMENT OF TWO OR MORE SEPA- RATE DISCIPLINES OR PROFESSIONS, WHICH MAY MEAN THE INVOLVEMENT OF ONE INDIVIDUAL WHO MEETS THE DEFINITION OF QUALIFIED PERSONNEL AS DEFINED IN SUBDIVISION FIFTEEN OF THIS SECTION AND WHO IS QUALIFIED, IN ACCORDANCE WITH STATE LICENSURE, CERTIFICATION OR OTHER COMPARABLE STANDARDS, TO EVALUATE ALL FIVE DEVELOPMENTAL DOMAINS. S. 7507 44 A. 9507 14-A. A "PARTIAL EVALUATION" SHALL MEAN AN EVALUATION IN A SINGLE DEVELOPMENTAL AREA FOR PURPOSES OF DETERMINING ELIGIBILITY, AND MAY ALSO MEAN AN EXAMINATION OF THE CHILD TO DETERMINE THE NEED FOR A MODIFICA- TION TO THE CHILD'S INDIVIDUALIZED FAMILY SERVICE PLAN. 15-A. "SCREENING" MEANS THE PROCEDURES USED BY QUALIFIED PERSONNEL, AS DEFINED IN SUBDIVISION FIFTEEN OF THIS SECTION, TO DETERMINE WHETHER A CHILD IS SUSPECTED OF HAVING A DISABILITY AND IN NEED OF EARLY INTER- VENTION SERVICES, AND SHALL INCLUDE, WHERE AVAILABLE AND APPROPRIATE FOR THE CHILD, THE ADMINISTRATION OF A STANDARDIZED INSTRUMENT OR INSTRU- MENTS APPROVED BY THE DEPARTMENT, IN ACCORDANCE WITH SUBDIVISION THREE OF SECTION TWENTY-FIVE HUNDRED FORTY-FOUR OF THIS TITLE. § 3. Subdivision 3 of section 2542 of the public health law, as amended by chapter 231 of the laws of 1993, is amended to read as follows: 3. [The] (A) UNLESS AN INFANT OR TODDLER HAS ALREADY BEEN REFERRED TO THE EARLY INTERVENTION PROGRAM OR THE HEALTH OFFICER OF THE PUBLIC HEALTH DISTRICT IN WHICH THE INFANT OR TODDLER RESIDES, AS DESIGNATED BY THE MUNICIPALITY, THE following persons and entities, within two working days of identifying an infant or toddler suspected of having a disabili- ty or at risk of having a disability, shall refer such infant or toddler to the early intervention official or the health officer [of the public health district in which the infant or toddler resides, as designated by the municipality], AS APPLICABLE, but in no event over the objection of the parent made in accordance with procedures established by the depart- ment for use by such primary referral sources[, unless the child has already been referred]: hospitals, child health care providers, day care programs, local school districts, public health facilities, early childhood direction centers and such other social service and health care agencies and providers as the commissioner shall specify in regu- lation; provided, however, that the department shall establish proce- dures, including regulations if required, to ensure that primary refer- ral sources adequately inform the parent or guardian about the early intervention program, including through brochures and written materials created or approved by the department. (B) THE PRIMARY REFERRAL SOURCES IDENTIFIED IN PARAGRAPH (A) OF THIS SUBDIVISION SHALL, WITH PARENTAL CONSENT, COMPLETE AND TRANSMIT AT THE TIME OF REFERRAL, A REFERRAL FORM DEVELOPED BY THE DEPARTMENT WHICH CONTAINS INFORMATION SUFFICIENT TO DOCUMENT THE PRIMARY REFERRAL SOURCE'S CONCERN OR BASIS FOR SUSPECTING THE CHILD HAS A DISABILITY OR IS AT RISK OF HAVING A DISABILITY, AND WHERE APPLICABLE, SPECIFIES THE CHILD'S DIAGNOSED CONDITION THAT ESTABLISHES THE CHILD'S ELIGIBILITY FOR THE EARLY INTERVENTION PROGRAM. THE PRIMARY REFERRAL SOURCE SHALL INFORM THE PARENT OF A CHILD WITH A DIAGNOSED CONDITION THAT HAS A HIGH PROBA- BILITY OF RESULTING IN DEVELOPMENTAL DELAY, THAT (I) ELIGIBILITY FOR THE PROGRAM MAY BE ESTABLISHED BY MEDICAL OR OTHER RECORDS AND (II) OF THE IMPORTANCE OF PROVIDING CONSENT FOR THE PRIMARY REFERRAL SOURCE TO TRAN- SMIT RECORDS OR REPORTS NECESSARY TO SUPPORT THE DIAGNOSIS, OR, FOR PARENTS OR GUARDIANS OF CHILDREN WHO DO NOT HAVE A DIAGNOSED CONDITION, RECORDS OR REPORTS THAT WOULD ASSIST IN DETERMINING ELIGIBILITY FOR THE PROGRAM. § 4. Section 2544 of the public health law, as added by chapter 428 of the laws of 1992, paragraph (c) of subdivision 2 as added by section 1 of part A of chapter 56 of the laws of 2012 and subdivision 11 as added by section 3 of part B3 of chapter 62 of the laws of 2003, is amended to read as follows: S. 7507 45 A. 9507 § 2544. Screening and evaluations. 1. Each child thought to be an eligible child is entitled to [a multidisciplinary] AN evaluation CONDUCTED IN ACCORDANCE WITH THIS SECTION, and the early intervention official shall ensure such evaluation, with parental consent. 2. (a) [The] SUBJECT TO THE PROVISIONS OF THIS TITLE, THE parent may select an evaluator from the list of approved evaluators as described in section twenty-five hundred forty-two of this title to conduct the APPLICABLE SCREENING AND/OR evaluation IN ACCORDANCE WITH THIS SECTION. The parent or evaluator shall immediately notify the early intervention official of such selection. THE EVALUATOR SHALL REVIEW THE INFORMATION AND DOCUMENTATION PROVIDED WITH THE REFERRAL TO DETERMINE THE APPROPRI- ATE SCREENING OR EVALUATION PROCESS TO FOLLOW IN ACCORDANCE WITH THIS SECTION. The evaluator may begin the SCREENING OR evaluation no sooner than four working days after such notification, unless otherwise approved by the initial service coordinator. (b) [the evaluator shall designate an individual as the principal contact for the multidisciplinary team] INITIAL SERVICE COORDINATORS SHALL INFORM THE PARENT OF THE APPLICABLE SCREENING OR EVALUATION PROCE- DURES THAT MAY BE PERFORMED. FOR A CHILD REFERRED TO THE EARLY INTER- VENTION OFFICIAL WHO HAS A DIAGNOSED PHYSICAL OR MENTAL CONDITION THAT HAS A HIGH PROBABILITY OF RESULTING IN DEVELOPMENTAL DELAY, THE INITIAL SERVICE COORDINATOR SHALL INFORM THE PARENT THAT THE EVALUATION OF THE CHILD SHALL BE CONDUCTED IN ACCORDANCE WITH THE PROCEDURES SET FORTH IN SUBDIVISION FIVE OF THIS SECTION. (c) If, in consultation with the evaluator, the service coordinator identifies a child that is potentially eligible for programs or services offered by or under the auspices of the office for people with develop- mental disabilities, the service coordinator shall, with parent consent, notify the office for people with developmental disabilities' regional developmental disabilities services office of the potential eligibility of such child for said programs or services. 3. [(a) To determine eligibility, an evaluator shall, with parental consent, either (i) screen a child to determine what type of evaluation, if any, is warranted, or (ii) provide a multidisciplinary evaluation. In making the determination whether to provide an evaluation, the evaluator may rely on a recommendation from a physician or other qualified person as designated by the commissioner. (b)] SCREENINGS FOR CHILDREN REFERRED TO THE EARLY INTERVENTION PROGRAM TO DETERMINE WHETHER THEY ARE SUSPECTED OF HAVING A DISABILITY. (A) FOR A CHILD REFERRED TO THE EARLY INTERVENTION PROGRAM, THE EVALU- ATOR SHALL FIRST PERFORM A SCREENING OF THE CHILD, WITH PARENTAL CONSENT, TO DETERMINE WHETHER THE CHILD IS SUSPECTED OF HAVING A DISA- BILITY. (B) THE EVALUATOR SHALL UTILIZE A STANDARDIZED INSTRUMENT OR INSTRU- MENTS APPROVED BY THE DEPARTMENT TO CONDUCT THE SCREENING. IF THE EVALU- ATOR DOES NOT UTILIZE A STANDARDIZED INSTRUMENT OR INSTRUMENTS APPROVED BY THE DEPARTMENT FOR THE SCREENING, THE EVALUATOR SHALL DOCUMENT IN WRITING WHY SUCH STANDARDIZED INSTRUMENT OR INSTRUMENTS ARE UNAVAILABLE OR INAPPROPRIATE FOR THE CHILD. (C) THE EVALUATOR SHALL EXPLAIN THE RESULTS OF THE SCREENING TO THE PARENT AND SHALL FULLY DOCUMENT THE RESULTS IN WRITING. (D) If, based upon the screening, a child is [believed to be eligible, or if otherwise elected by the parent] SUSPECTED OF HAVING A DISABILITY, the child shall, with [the consent of a parent] PARENTAL CONSENT, receive [a multidisciplinary evaluation. All evaluations shall be conducted in accordance with] AN EVALUATION TO BE CONDUCTED IN ACCORD- S. 7507 46 A. 9507 ANCE WITH THE PROCEDURES SET FORTH IN SUBDIVISION FOUR OF THIS SECTION, the coordinated standards and procedures, and [with] regulations promul- gated by the commissioner. (E) IF, BASED UPON THE SCREENING, A CHILD IS NOT SUSPECTED OF HAVING A DISABILITY, AN EVALUATION SHALL NOT BE PROVIDED, UNLESS REQUESTED BY THE PARENT. THE EARLY INTERVENTION OFFICIAL SHALL PROVIDE THE PARENT WITH WRITTEN NOTICE OF THE SCREENING RESULTS, WHICH SHALL INCLUDE INFORMATION ON THE PARENT'S RIGHT TO REQUEST AN EVALUATION. (F) A SCREENING SHALL NOT BE PROVIDED TO CHILDREN WHO ARE REFERRED TO THE EARLY INTERVENTION PROGRAM WHO HAVE A DIAGNOSED PHYSICAL OR MENTAL CONDITION WITH A HIGH PROBABILITY OF RESULTING IN DEVELOPMENTAL DELAY THAT ESTABLISHES ELIGIBILITY FOR THE PROGRAM OR FOR CHILDREN WHO HAVE PREVIOUSLY RECEIVED AN EVALUATION UNDER THE EARLY INTERVENTION PROGRAM. 4. The evaluation of [each] A child shall: (a) INCLUDE THE ADMINISTRATION OF AN EVALUATION INSTRUMENT OR INSTRU- MENTS APPROVED BY THE DEPARTMENT. IF THE EVALUATOR DOES NOT UTILIZE AN INSTRUMENT OR INSTRUMENTS APPROVED BY THE DEPARTMENT AS PART OF THE EVALUATION OF THE CHILD, THE EVALUATOR SHALL DOCUMENT IN WRITING WHY SUCH INSTRUMENT OR INSTRUMENTS ARE NOT APPROPRIATE OR AVAILABLE FOR THE CHILD; (B) be conducted by personnel trained to utilize appropriate methods and procedures; [(b)] (C) be based on informed clinical opinion; [(c)] (D) be made without regard to the availability of services in the municipality or who might provide such services; [and (d)] (E) with parental consent, include the following: (i) a review of pertinent records related to the child's current health status and medical history; AND (ii) an evaluation of the child's level of functioning in each of the developmental areas set forth in paragraph (c) of subdivision seven of section twenty-five hundred forty-one of this title[;] TO DETERMINE WHETHER THE CHILD HAS A DISABILITY AS DEFINED IN THIS TITLE THAT ESTAB- LISHES THE CHILD'S ELIGIBILITY FOR THE PROGRAM; AND (F) IF THE CHILD HAS BEEN DETERMINED ELIGIBLE BY THE EVALUATOR AFTER CONDUCTING THE PROCEDURES SET FORTH IN PARAGRAPHS (A) THROUGH (E) OF THIS SUBDIVISION, THE EVALUATION SHALL ALSO INCLUDE: [(iii)] (I) an assessment [of the unique needs of the child in terms of] FOR THE PURPOSES OF IDENTIFYING THE CHILD'S UNIQUE STRENGTHS AND NEEDS IN each of the developmental areas [set forth in paragraph (c) of subdivision seven of section twenty-five hundred forty-one of this title, including the identification of] AND THE EARLY INTERVENTION services appropriate to meet those needs; [(iv)] (II) A FAMILY-DIRECTED ASSESSMENT, IF CONSENTED TO BY THE FAMI- LY, IN ORDER TO IDENTIFY THE FAMILY'S RESOURCES, PRIORITIES, AND CONCERNS AND THE SUPPORTS NECESSARY TO ENHANCE THE FAMILY'S CAPACITY TO MEET THE DEVELOPMENTAL NEEDS OF THE CHILD. THE FAMILY ASSESSMENT SHALL BE VOLUNTARY ON THE PART OF EACH FAMILY MEMBER PARTICIPATING IN THE ASSESSMENT; (III) an [evaluation] ASSESSMENT of the transportation needs of the child, if any; and [(v)] (IV) such other matters as the commissioner may prescribe in regulation. 5. EVALUATIONS FOR CHILDREN WHO ARE REFERRED TO THE EARLY INTERVENTION OFFICIAL WITH DIAGNOSED PHYSICAL OR MENTAL CONDITIONS THAT HAVE A HIGH PROBABILITY OF RESULTING IN DEVELOPMENTAL DELAY. (A) IF A CHILD HAS A DIAGNOSED PHYSICAL OR MENTAL CONDITION THAT HAS A HIGH PROBABILITY OF S. 7507 47 A. 9507 RESULTING IN DEVELOPMENTAL DELAY, THE CHILD'S MEDICAL OR OTHER RECORDS SHALL BE USED, WHEN AVAILABLE, TO ESTABLISH THE CHILD'S ELIGIBILITY FOR THE PROGRAM. (B) THE EVALUATOR SHALL, UPON REVIEW OF THE REFERRAL FORM PROVIDED IN ACCORDANCE WITH SECTION TWENTY-FIVE HUNDRED FORTY-TWO OF THIS TITLE OR ANY MEDICAL OR OTHER RECORDS, OR AT THE TIME OF INITIAL CONTACT WITH THE CHILD'S FAMILY, DETERMINE WHETHER THE CHILD HAS A DIAGNOSED CONDITION THAT ESTABLISHES THE CHILD'S ELIGIBILITY FOR THE PROGRAM. IF THE EVALU- ATOR HAS REASON TO BELIEVE, AFTER SPEAKING WITH THE CHILD'S FAMILY, THAT THE CHILD MAY HAVE A DIAGNOSED CONDITION THAT ESTABLISHES THE CHILD'S ELIGIBILITY BUT THE EVALUATOR HAS NOT BEEN PROVIDED WITH MEDICAL OR OTHER DOCUMENTATION OF SUCH DIAGNOSIS, THE EVALUATOR SHALL, WITH PARENTAL CONSENT, OBTAIN SUCH DOCUMENTATION, WHEN AVAILABLE, PRIOR TO PROCEEDING WITH THE EVALUATION OF THE CHILD. (C) THE EVALUATOR SHALL REVIEW ALL RECORDS RECEIVED TO DOCUMENT THAT THE CHILD'S DIAGNOSIS AS SET FORTH IN SUCH RECORDS ESTABLISHES THE CHILD'S ELIGIBILITY FOR THE EARLY INTERVENTION PROGRAM. (D) NOTWITHSTANDING SUBDIVISION FOUR OF THIS SECTION, IF THE CHILD'S ELIGIBILITY FOR THE EARLY INTERVENTION PROGRAM IS ESTABLISHED IN ACCORD- ANCE WITH THIS SUBDIVISION, THE EVALUATION OF THE CHILD SHALL (I) CONSIST OF A REVIEW OF THE RESULTS OF THE MEDICAL OR OTHER RECORDS THAT ESTABLISHED THE CHILD'S ELIGIBILITY, AND ANY OTHER PERTINENT EVALUATIONS OR RECORDS AVAILABLE AND (II) COMPLY WITH THE PROCEDURES SET FORTH IN PARAGRAPH (F) OF SUBDIVISION FOUR OF THIS SECTION. THE EVALUATION PROCE- DURES SET FORTH IN PARAGRAPHS (A) THROUGH (E) OF SUBDIVISION FOUR OF THIS SECTION SHALL NOT BE REQUIRED OR CONDUCTED. 6. An evaluation shall not include a reference to any specific provid- er of early intervention services. [6.] 7. Nothing in this section shall restrict an evaluator from utilizing, in addition to findings from his or her personal examination, other examinations, evaluations or assessments conducted for such child, including those conducted prior to the evaluation under this section, if such examinations, evaluations or assessments are consistent with the coordinated standards and procedures. [7.] 8. Following completion of the evaluation, the evaluator shall provide the parent and service coordinator with a copy of a summary of the full evaluation. To the extent practicable, the summary shall be provided in the native language of the parent. Upon request of the parent, early intervention official or service coordinator, the evalu- ator shall provide a copy of the full evaluation to such parent, early intervention official or service coordinator. [8.] 9. A parent who disagrees with the results of an evaluation may obtain an additional evaluation or partial evaluation at public expense to the extent authorized by federal law or regulation. [9.] 10. Upon receipt of the results of an evaluation, a service coor- dinator may, with parental consent, require additional diagnostic infor- mation regarding the condition of the child, provided, however, that such evaluation or assessment is not unnecessarily duplicative or inva- sive to the child, and provided further, that: (a) where the evaluation has established the child's eligibility, such additional diagnostic information shall be used solely to provide addi- tional information to the parent and service coordinator regarding the child's need for services and cannot be a basis for refuting eligibil- ity; (b) the service coordinator provides the parent with a written expla- nation of the basis for requiring additional diagnostic information; S. 7507 48 A. 9507 (c) the additional diagnostic procedures are at no expense to the parent; and (d) the evaluation is completed and a meeting to develop an IFSP is held within the time prescribed in subdivision one of section twenty- five hundred forty-five of this title. [10.] 11. (a) If the screening indicates that the infant or toddler is not an eligible child and the parent elects not to have an evaluation, or if the evaluation indicates that the infant or toddler is not an eligible child, the service coordinator shall inform the parent of other programs or services that may benefit such child, and the child's family and, with parental consent, refer such child to such programs or services. (b) A parent may appeal a determination that a child is ineligible pursuant to the provisions of section twenty-five hundred forty-nine of this title, provided, however, that a parent may not initiate such appeal until all evaluations are completed. IN ADDITION, FOR A CHILD REFERRED TO THE EARLY INTERVENTION OFFICIAL WHO HAS A DIAGNOSED PHYSICAL OR MENTAL CONDITION THAT ESTABLISHES THE CHILD'S ELIGIBILITY FOR THE PROGRAM IN ACCORDANCE WITH SUBDIVISION FIVE OF THIS SECTION, THE PARENT MAY APPEAL THE DENIAL OF A REQUEST TO HAVE THE EVALUATOR CONDUCT THE EVALUATION PROCEDURES SET FORTH IN PARAGRAPHS (A) THROUGH (E) OF SUBDI- VISION FOUR OF THIS SECTION, PROVIDED, HOWEVER, THAT THE PARENT MAY NOT INITIATE THE APPEAL UNTIL THE EVALUATION CONDUCTED IN ACCORDANCE WITH SUBDIVISION FIVE OF THIS SECTION IS COMPLETED. [11.] 12. Notwithstanding any other provision of law to the contrary, where a request has been made to review an IFSP prior to the six-month interval provided in subdivision seven of section twenty-five hundred forty-five of this title for purposes of increasing frequency or dura- tion of an approved service, including service coordination, the early intervention official may require an additional evaluation or partial evaluation at public expense by an approved evaluator other than the current provider of service, with parent consent. § 5. Section 3235-a of the insurance law, as added by section 3 of part C of chapter 1 of the laws of 2002, subsection (c) as amended by section 17 of part A of chapter 56 of the laws of 2012, is amended to read as follows: § 3235-a. Payment for early intervention services. (a) No policy of accident and health insurance, including contracts issued pursuant to article forty-three of this chapter, shall exclude coverage for other- wise covered services solely on the basis that the services constitute early intervention program services under title two-A of article twen- ty-five of the public health law; PROVIDED, HOWEVER, THE INSURER, INCLUDING A HEALTH MAINTENANCE ORGANIZATION ISSUED A CERTIFICATE OF AUTHORITY UNDER ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW AND A CORPO- RATION ORGANIZED UNDER ARTICLE FORTY-THREE OF THIS CHAPTER SHALL PAY FOR SUCH SERVICES TO THE EXTENT THAT THE SERVICES ARE A COVERED BENEFIT UNDER THE POLICY. (b) Where a policy of accident and health insurance, including a contract issued pursuant to article forty-three of this chapter, provides coverage for an early intervention program service, such cover- age shall not be applied against any maximum annual or lifetime monetary limits set forth in such policy or contract. ANY DOCUMENTATION OBTAINED PURSUANT TO SUBPARAGRAPH (II) OF PARAGRAPH (A) OF SUBDIVISION THREE OF SECTION TWENTY-FIVE HUNDRED FIFTY-NINE OF THE PUBLIC HEALTH LAW AND SUBMITTED TO THE INSURER SHALL BE CONSIDERED AS PART OF PRECERTIF- ICATION, PREAUTHORIZATION AND/OR MEDICAL NECESSITY REVIEW IMPOSED UNDER S. 7507 49 A. 9507 SUCH POLICY OF ACCIDENT AND HEALTH INSURANCE, INCLUDING A CONTRACT ISSUED PURSUANT TO ARTICLE FORTY-THREE OF THIS CHAPTER. Visit limita- tions and other terms and conditions of the policy will continue to apply to early intervention services. However, any visits used for early intervention program services shall not reduce the number of visits otherwise available under the policy or contract for such services. (c) Any right of subrogation to benefits which a municipality or provider is entitled in accordance with paragraph (d) of subdivision three of section twenty-five hundred fifty-nine of the public health law shall be valid and enforceable to the extent benefits are available under any accident and health insurance policy. The right of subrogation does not attach to insurance benefits paid or provided under any acci- dent and health insurance policy prior to receipt by the insurer of written notice from the municipality or provider, as applicable. The insurer shall provide [the] SUCH municipality and service coordinator with information on the extent of benefits available to the covered person under such policy within fifteen days of the insurer's receipt of written request and notice authorizing such release. The service coordi- nator shall provide such information to the rendering provider assigned to provide services to the child. (d) No insurer, including a health maintenance organization issued a certificate of authority under article forty-four of the public health law and a corporation organized under article forty-three of this chap- ter, shall refuse to issue an accident and health insurance policy or contract or refuse to renew an accident and health insurance policy or contract solely because the applicant or insured is receiving services under the early intervention program. § 6. Paragraph (a) of subdivision 3 of section 2559 of the public health law, as amended by section 11 of part A of chapter 56 of the laws of 2012, is amended to read as follows: (a) Providers of evaluations and early intervention services, herein- after collectively referred to in this subdivision as "provider" or "providers", shall in the first instance and where applicable, seek payment from all third party payors including governmental agencies prior to claiming payment from a given municipality for evaluations conducted under the program and for services rendered to eligible chil- dren, provided that, the obligation to seek payment shall not apply to a payment from a third party payor who is not prohibited from applying such payment, and will apply such payment, to an annual or lifetime limit specified in the insured's policy. IF SUCH A CLAIM IS DENIED BY A THIRD PARTY PAYOR, THE PROVIDER SHALL REQUEST AN APPEAL OF SUCH DENIAL, IN A MANNER PRESCRIBED BY THE DEPARTMENT, IN ACCORDANCE WITH ARTICLE FORTY-NINE OF THIS CHAPTER AND ARTICLE FORTY-NINE OF THE INSURANCE LAW, AND SHALL RECEIVE A DETERMINATION OF SUCH APPEAL PRIOR TO SUBMITTING A CLAIM FOR PAYMENT FROM ANOTHER THIRD PARTY PAYOR OR FROM THE MUNICI- PALITY. A PROVIDER SHALL NOT DELAY OR DISCONTINUE SERVICES TO ELIGIBLE CHILDREN PENDING PAYMENT OF THE CLAIM OR PENDING A DETERMINATION OF ANY DENIAL FOR PAYMENT THAT HAS BEEN APPEALED. (i) [Parents] IN A FORM PRESCRIBED BY THE DEPARTMENT, PARENTS shall provide the municipality [and], service coordinator AND PROVIDER infor- mation on any insurance policy, plan or contract under which an eligible child has coverage. (ii) [Parents] IN A TIMELINE AND FORMAT AS PRESCRIBED BY THE DEPART- MENT, THE MUNICIPALITY SHALL REQUEST FROM THE PARENT, AND THE PARENT shall provide the municipality [and the service coordinator], WHO SHALL PROVIDE SUCH DOCUMENTATION TO THE SERVICE COORDINATOR AND PROVIDER, S. 7507 50 A. 9507 with: (A) a written ORDER, referral [from a primary care provider as documentation, for eligible children, of] OR RECOMMENDATION, SIGNED BY A PHYSICIAN, PHYSICIAN ASSISTANT OR NURSE PRACTITIONER, FOR THE MEDICAL NECESSITY OF EARLY INTERVENTION EVALUATION SERVICES TO DETERMINE PROGRAM ELIGIBILITY FOR EARLY INTERVENTION SERVICES; (B) A COPY OF AN INDIVIDUALIZED FAMILY SERVICE PLAN AGREED UPON PURSU- ANT TO SECTION TWENTY-FIVE HUNDRED FORTY-FIVE OF THIS TITLE THAT CONTAINS DOCUMENTATION, SIGNED BY A PHYSICIAN, PHYSICIAN ASSISTANT OR NURSE PRACTITIONER ON the medical necessity of early intervention services INCLUDED IN THE INDIVIDUALIZED FAMILY SERVICE PLAN; (C) WRITTEN CONSENT TO CONTACT THE CHILD'S PHYSICIAN, PHYSICIAN ASSISTANT OR NURSE PRACTITIONER FOR PURPOSES OF OBTAINING A SIGNED WRIT- TEN ORDER, REFERRAL, OR RECOMMENDATION AS DOCUMENTATION FOR THE MEDICAL NECESSITY OF EARLY INTERVENTION EVALUATION SERVICES TO DETERMINE PROGRAM ELIGIBILITY FOR EARLY INTERVENTION SERVICES; OR (D) WRITTEN CONSENT TO CONTACT THE CHILD'S PHYSICIAN, PHYSICIAN ASSISTANT OR NURSE PRACTITIONER FOR PURPOSES OF OBTAINING SIGNED DOCUMENTATION OF THE MEDICAL NECESSITY OF EARLY INTERVENTION SERVICES CONTAINED WITHIN THE INDIVIDUALIZED FAMILY SERVICE PLAN AGREED UPON PURSUANT TO SECTION TWENTY-FIVE HUNDRED FORTY-FIVE OF THIS TITLE. (iii) [providers] PROVIDERS shall utilize the department's fiscal agent and data system for claiming payment AND FOR REQUESTING APPEALS OF CLAIMS DENIED BY THIRD PARTY PAYORS, for evaluations and services rendered under the early intervention program. § 7. Paragraph (d) of subdivision 3 of section 2559 of the public health law, as amended by section 11 of part A of chapter 56 of the laws of 2012, is amended to read as follows: (d) A municipality, or its designee, and a provider shall be subrogat- ed, to the extent of the expenditures by such municipality or for early intervention services furnished to persons eligible for benefits under this title, to any rights such person may have or be entitled to from third party reimbursement. The provider SHALL SUBMIT ANY DOCUMENTATION OBTAINED PURSUANT TO SUBPARAGRAPH (II) OF PARAGRAPH (A) OF THIS SUBDIVI- SION AND shall submit notice to the insurer or plan administrator of his or her exercise of such right of subrogation upon the provider's assign- ment as the early intervention service provider for the child. The right of subrogation does not attach to benefits paid or provided under any health insurance policy or health benefits plan prior to receipt of written notice of the exercise of subrogation rights by the insurer or plan administrator providing such benefits. § 8. Subdivision 7 of section 4900 of the public health law, as amended by chapter 558 of the laws of 1999, is amended to read as follows: 7. "Health care provider" means a health care professional or a facil- ity licensed pursuant to articles twenty-eight, thirty-six, forty-four or forty-seven of this chapter [or], a facility licensed pursuant to article nineteen, twenty-three, thirty-one or thirty-two of the mental hygiene law, QUALIFIED PERSONNEL PURSUANT TO TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THIS CHAPTER OR AN AGENCY AS DEFINED BY THE DEPARTMENT OF HEALTH IN REGULATIONS PROMULGATED PURSUANT TO TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THIS CHAPTER. § 9. Subdivision 1 of section 4904 of the public health law, as added by chapter 705 of the laws of 1996, is amended to read as follows: 1. An enrollee, the enrollee's designee and, in connection with retro- spective adverse determinations OR ADVERSE DETERMINATIONS FOR SERVICES RENDERED IN ACCORDANCE TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THIS CHAP- S. 7507 51 A. 9507 TER, an enrollee's health care provider, may appeal an adverse determi- nation rendered by a utilization review agent. § 10. The opening paragraph of subdivision 2 of section 4910 of the public health law, as amended by chapter 237 of the laws of 2009, is amended to read as follows: An enrollee, the enrollee's designee and, in connection with concur- rent and retrospective adverse determinations OR ADVERSE DETERMINATIONS FOR SERVICES RENDERED IN ACCORDANCE WITH TITLE TWO-A OF ARTICLE TWENTY- FIVE OF THIS CHAPTER, an enrollee's health care provider, shall have the right to request an external appeal when: § 11. Paragraph (a) of subdivision 4 of section 4914 of the public health law, as amended by chapter 237 of the laws of 2009, is amended to read as follows: (a) Except as provided in paragraphs (b) and (c) of this subdivision, payment for an external appeal, INCLUDING AN APPEAL FOR SERVICES RENDERED IN ACCORDANCE WITH TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THIS CHAPTER, shall be the responsibility of the health care plan. The health care plan shall make payment to the external appeal agent within forty- five days from the date the appeal determination is received by the health care plan, and the health care plan shall be obligated to pay such amount together with interest thereon calculated at a rate which is the greater of the rate set by the commissioner of taxation and finance for corporate taxes pursuant to paragraph one of subsection (e) of section one thousand ninety-six of the tax law or twelve percent per annum, to be computed from the date the bill was required to be paid, in the event that payment is not made within such forty-five days. § 12. Subsection (g) of section 4900 of the insurance law, as amended by chapter 558 of the laws of 1999, is amended to read as follows: (g) "Health care provider" means a health care professional or a facility licensed pursuant to article twenty-eight, thirty-six, forty- four or forty-seven of the public health law [or], a facility licensed pursuant to article nineteen, twenty-three, thirty-one or thirty-two of the mental hygiene law, QUALIFIED PERSONNEL PURSUANT TO TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, OR AN AGENCY AS DEFINED BY THE DEPARTMENT OF HEALTH IN REGULATIONS PROMULGATED PURSUANT TO TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW. § 13. Subsection (a) of section 4904 of the insurance law, as added by chapter 705 of the laws of 1996, is amended to read as follows: (a) An insured, the insured's designee and, in connection with retro- spective adverse determinations OR ADVERSE DETERMINATIONS FOR SERVICES RENDERED IN ACCORDANCE WITH TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, an insured's health care provider, may appeal an adverse determination rendered by a utilization review agent. § 14. The opening paragraph of subsection (b) of section 4910 of the insurance law, as amended by chapter 237 of the laws of 2009, is amended to read as follows: An insured, the insured's designee and, in connection with concurrent and retrospective adverse determinations OR ADVERSE DETERMINATIONS FOR SERVICES RENDERED IN ACCORDANCE WITH TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, an insured's health care provider, shall have the right to request an external appeal when: § 15. Paragraph 1 of subsection (d) of section 4914 of the insurance law, as amended by chapter 237 of the laws of 2009, is amended to read as follows: (1) Except as provided in paragraphs two and three of this subsection, payment for an external appeal, INCLUDING AN APPEAL FOR SERVICES S. 7507 52 A. 9507 RENDERED IN ACCORDANCE WITH TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, shall be the responsibility of the health care plan. The health care plan shall make payment to the external appeal agent within forty-five days, from the date the appeal determination is received by the health care plan, and the health care plan shall be obligated to pay such amount together with interest thereon calculated at a rate which is the greater of the rate set by the commissioner of taxation and finance for corporate taxes pursuant to paragraph one of subsection (e) of section one thousand ninety-six of the tax law or twelve percent per annum, to be computed from the date the bill was required to be paid, in the event that payment is not made within such forty-five days. § 16. Paragraph 1 of subsection (c) of section 109 of the insurance law, as amended by section 55 of part A of chapter 62 of the laws of 2011, is amended to read as follows: (1) If the superintendent finds after notice and hearing that any [authorized] insurer, representative of the insurer, [licensed] insur- ance agent, [licensed] insurance broker, [licensed] adjuster, or any other person or entity [licensed, certified, registered, or authorized pursuant] SUBJECT to this chapter, has wilfully violated the provisions of this chapter or any regulation promulgated thereunder, then the superintendent may order the person or entity to pay to the people of this state a penalty in a sum not exceeding THE GREATER OF: (I) one thousand dollars for each offense; OR (II) WHERE THE VIOLATION RELATES TO EITHER THE FAILURE TO PAY A CLAIM OR MAKING A FALSE STATEMENT TO THE SUPERINTENDENT OR THE DEPARTMENT, THE GREATER OF (A) TEN THOUSAND DOLLARS FOR EACH OFFENSE, OR (B) A MULTIPLE OF TWO TIMES THE AGGREGATE DAMAGES ATTRIBUTABLE TO THE VIOLATION, OR (C) A MULTIPLE OF TWO TIMES THE AGGREGATE ECONOMIC GAIN ATTRIBUTABLE TO THE VIOLATION. § 17. Upon enactment of the amendments to paragraph (a) of subdivision 3 of section 2559 of the public health law made by section six of this act, providers of early intervention services shall receive a two percent increase in rates of reimbursement for early intervention services provided that for payments made for early intervention services to persons eligible for medical assistance pursuant to title eleven of article five of the social services law, the two percent increase shall be subject to the availability of federal financial participation. § 18. This act shall take effect immediately and shall be deemed to have been in full force and effect on or after April 1, 2018; provided that the amendments to section 3235-a of the insurance law made by section five of this act shall apply only to policies and contracts issued, renewed, modified, altered or amended on or after such date. PART P Section 1. The opening paragraph of paragraph (b) of subdivision 5-a of section 2807-m of the public health law, as amended by section 6 of part H of chapter 57 of the laws of 2017, is amended to read as follows: Nine million one hundred twenty thousand dollars annually for the period January first, two thousand nine through December thirty-first, two thousand ten, and two million two hundred eighty thousand dollars for the period January first, two thousand eleven, through March thir- ty-first, two thousand eleven, nine million one hundred twenty thousand dollars each state fiscal year for the period April first, two thousand eleven through March thirty-first, two thousand fourteen, up to eight million six hundred twelve thousand dollars each state fiscal year for S. 7507 53 A. 9507 the period April first, two thousand fourteen through March thirty- first, two thousand seventeen, and up to eight million six hundred twelve thousand dollars each state fiscal year for the period April first, two thousand seventeen through March thirty-first, two thousand [twenty] EIGHTEEN, shall be set aside and reserved by the commissioner from the regional pools established pursuant to subdivision two of this section to be allocated regionally with two-thirds of the available funding going to New York city and one-third of the available funding going to the rest of the state and shall be available for distribution as follows: § 2. Subparagraph (xiii) of paragraph (a) of subdivision 7 of section 2807-s of the public health law, as amended by section 4 of part H of chapter 57 of the laws of 2017, is amended to read as follows: (xiii) twenty-three million eight hundred thirty-six thousand dollars each state fiscal year for the period April first, two thousand twelve through March thirty-first, TWO THOUSAND EIGHTEEN, AND FIFTEEN MILLION TWO HUNDRED TWENTY-FOUR THOUSAND DOLLARS FOR EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND EIGHTEEN THROUGH MARCH THIRTY- FIRST, two thousand twenty; § 3. Subdivision 9 of section 2803 of the public health law is REPEALED. § 4. This act shall take effect immediately; provided, however, that the amendments to subparagraph (xiii) of paragraph (a) of subdivision 7 of section 2807-s of the public health law made by section two of this act shall not affect the expiration of such section and shall be deemed to expire therewith. PART Q Section 1. The public health law is amended by adding a new section 2825-f to read as follows: § 2825-F. HEALTH CARE FACILITY TRANSFORMATION PROGRAM: STATEWIDE III. 1. A STATEWIDE HEALTH CARE FACILITY TRANSFORMATION PROGRAM IS HEREBY ESTABLISHED UNDER THE JOINT ADMINISTRATION OF THE COMMISSIONER AND THE PRESIDENT OF THE DORMITORY AUTHORITY OF THE STATE OF NEW YORK FOR THE PURPOSE OF STRENGTHENING AND PROTECTING CONTINUED ACCESS TO HEALTH CARE SERVICES IN COMMUNITIES. THE PROGRAM SHALL PROVIDE FUNDING IN SUPPORT OF CAPITAL PROJECTS, DEBT RETIREMENT, WORKING CAPITAL OR OTHER NON-CAPITAL PROJECTS THAT FACILITATE HEALTH CARE TRANSFORMATION ACTIVITIES INCLUD- ING, BUT NOT LIMITED TO, MERGER, CONSOLIDATION, ACQUISITION OR OTHER ACTIVITIES INTENDED TO: (A) CREATE FINANCIALLY SUSTAINABLE SYSTEMS OF CARE; (B) PRESERVE OR EXPAND ESSENTIAL HEALTH CARE SERVICES; (C) MODERN- IZE OBSOLETE FACILITY PHYSICAL PLANTS AND INFRASTRUCTURE; (D) FOSTER PARTICIPATION IN VALUE BASED PAYMENTS ARRANGEMENTS INCLUDING, BUT NOT LIMITED TO, CONTRACTS WITH MANAGED CARE PLANS AND ACCOUNTABLE CARE ORGANIZATIONS; (E) FOR RESIDENTIAL HEALTH CARE FACILITIES, INCREASE THE QUALITY OF RESIDENT CARE OR EXPERIENCE; OR (F) IMPROVE HEALTH INFORMA- TION TECHNOLOGY INFRASTRUCTURE, INCLUDING TELEHEALTH, TO STRENGTHEN THE ACUTE, POST-ACUTE AND LONG-TERM CARE CONTINUUM. GRANTS SHALL NOT BE AVAILABLE TO SUPPORT GENERAL OPERATING EXPENSES. THE ISSUANCE OF ANY BONDS OR NOTES HEREUNDER SHALL BE SUBJECT TO SECTION SIXTEEN HUNDRED EIGHTY-R OF THE PUBLIC AUTHORITIES LAW AND THE APPROVAL OF THE DIRECTOR OF THE DIVISION OF THE BUDGET, AND ANY PROJECTS FUNDED THROUGH THE ISSU- ANCE 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. S. 7507 54 A. 9507 2. THE COMMISSIONER AND THE PRESIDENT OF THE DORMITORY 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, FOR THE PURPOSES OF AWARDING, DISTRIBUTING, AND ADMIN- ISTERING THE FUNDS MADE AVAILABLE PURSUANT TO THIS SECTION. SUCH FUNDS MAY BE DISTRIBUTED BY THE COMMISSIONER FOR GRANTS TO GENERAL HOSPITALS, RESIDENTIAL HEALTH CARE FACILITIES, DIAGNOSTIC AND TREATMENT CENTERS AND CLINICS LICENSED PURSUANT TO THIS CHAPTER OR THE MENTAL HYGIENE LAW, AND COMMUNITY-BASED HEALTH CARE PROVIDERS AS DEFINED IN SUBDIVISION THREE OF THIS SECTION FOR GRANTS IN SUPPORT OF THE PURPOSES SET FORTH IN THIS SECTION. A COPY OF SUCH AGREEMENT, AND ANY AMENDMENTS THERETO, SHALL BE PROVIDED TO THE CHAIR OF THE SENATE FINANCE COMMITTEE, THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE, AND THE DIRECTOR OF THE DIVISION OF THE BUDGET NO LATER THAN THIRTY DAYS PRIOR TO THE RELEASE OF A REQUEST FOR APPLICATIONS FOR FUNDING UNDER THIS PROGRAM. PROJECTS AWARDED, IN WHOLE OR PART, UNDER SECTIONS TWENTY-EIGHT HUNDRED TWENTY-FIVE-A AND TWENTY-EIGHT HUNDRED TWENTY-FIVE-B OF THIS ARTICLE SHALL NOT BE ELIGIBLE FOR GRANTS OR AWARDS MADE AVAILABLE UNDER THIS SECTION. 3. NOTWITHSTANDING SECTION ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW OR ANY INCONSISTENT PROVISION OF LAW TO THE CONTRARY, UP TO FOUR HUNDRED AND TWENTY-FIVE MILLION DOLLARS OF THE FUNDS APPROPRIATED FOR THIS PROGRAM SHALL BE AWARDED WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS FOR GRANTS TO HEALTH CARE PROVIDERS (HEREAFTER "APPLICANTS"). PROVIDED, HOWEVER, THAT A MINIMUM OF: (A) SIXTY MILLION DOLLARS OF TOTAL AWARDED FUNDS SHALL BE MADE TO COMMUNITY-BASED HEALTH CARE PROVIDERS, WHICH FOR PURPOSES OF THIS SECTION SHALL BE DEFINED AS A DIAGNOSTIC AND TREATMENT CENTER LICENSED OR GRANTED AN OPERATING CERTIF- ICATE UNDER THIS ARTICLE; A MENTAL HEALTH CLINIC LICENSED OR GRANTED AN OPERATING CERTIFICATE UNDER ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE LAW; A SUBSTANCE USE DISORDER TREATMENT CLINIC LICENSED OR GRANTED AN OPERATING CERTIFICATE UNDER ARTICLE THIRTY-TWO OF THE MENTAL HYGIENE LAW; A PRIMARY CARE PROVIDER; A HOME CARE PROVIDER CERTIFIED OR LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF THIS CHAPTER; OR AN ASSISTED LIVING PROGRAM APPROVED BY THE DEPARTMENT PURSUANT TO SUBDIVISION ONE OF SECTION FOUR HUNDRED SIXTY ONE-1 OF THE SOCIAL SERVICES LAW; AND (B) FORTY-FIVE MILLION DOLLARS OF THE TOTAL AWARDED FUNDS SHALL BE MADE TO RESIDENTIAL HEALTH CARE FACILITIES. 4. NOTWITHSTANDING ANY INCONSISTENT SUBDIVISION OF THIS SECTION OR ANY OTHER PROVISION OF LAW TO THE CONTRARY, THE COMMISSIONER, WITH THE APPROVAL OF THE DIRECTOR OF THE BUDGET, MAY EXPEND UP TO TWENTY MILLION DOLLARS OF THE FUNDS APPROPRIATED FOR THIS PROGRAM AND DESIGNATED FOR COMMUNITY-BASED HEALTH CARE PROVIDERS PURSUANT TO SUBDIVISION THREE OF THIS SECTION FOR AWARDS MADE PURSUANT TO PARAGRAPH (L) OF SUBDIVISION THREE OF SECTION FOUR HUNDRED SIXTY-ONE-L OF THE SOCIAL SERVICES LAW. 5. IN DETERMINING AWARDS FOR ELIGIBLE APPLICANTS UNDER THIS SECTION, THE COMMISSIONER SHALL CONSIDER CRITERIA INCLUDING, BUT NOT LIMITED TO: (A) THE EXTENT TO WHICH THE PROPOSED PROJECT WILL CONTRIBUTE TO THE INTEGRATION OF HEALTH CARE SERVICES OR THE LONG TERM SUSTAINABILITY OF THE APPLICANT OR PRESERVATION OF ESSENTIAL HEALTH SERVICES IN THE COMMU- NITY OR COMMUNITIES SERVED BY THE APPLICANT; (B) THE EXTENT TO WHICH THE PROPOSED PROJECT OR PURPOSE IS ALIGNED WITH DELIVERY SYSTEM REFORM INCENTIVE PAYMENT ("DSRIP") PROGRAM GOALS AND OBJECTIVES; (C) THE GEOGRAPHIC DISTRIBUTION OF FUNDS; (D) THE RELATIONSHIP BETWEEN THE PROPOSED PROJECT AND IDENTIFIED COMMUNITY NEED; S. 7507 55 A. 9507 (E) THE EXTENT TO WHICH THE APPLICANT HAS ACCESS TO ALTERNATIVE FINANCING; (F) THE EXTENT TO WHICH THE PROPOSED PROJECT FURTHERS THE DEVELOPMENT OF PRIMARY CARE AND OTHER OUTPATIENT SERVICES; (G) THE EXTENT TO WHICH THE PROPOSED PROJECT BENEFITS MEDICAID ENROL- LEES AND UNINSURED INDIVIDUALS; (H) THE EXTENT TO WHICH THE APPLICANT HAS ENGAGED THE COMMUNITY AFFECTED BY THE PROPOSED PROJECT AND THE MANNER IN WHICH COMMUNITY ENGAGEMENT HAS SHAPED SUCH PROJECT; AND (I) THE EXTENT TO WHICH THE PROPOSED PROJECT ADDRESSES POTENTIAL RISK TO PATIENT SAFETY AND WELFARE. 6. DISBURSEMENT OF AWARDS MADE PURSUANT TO THIS SECTION SHALL BE CONDITIONED ON THE AWARDEE ACHIEVING CERTAIN PROCESS AND PERFORMANCE METRICS AND MILESTONES AS DETERMINED IN THE SOLE DISCRETION OF THE COMMISSIONER. SUCH METRICS AND MILESTONES SHALL BE STRUCTURED TO ENSURE THAT THE GOALS OF THE PROJECT ARE ACHIEVED, AND SUCH METRICS AND MILE- STONES SHALL BE INCLUDED IN GRANT DISBURSEMENT AGREEMENTS OR OTHER CONTRACTUAL DOCUMENTS AS REQUIRED BY THE COMMISSIONER. 7. THE DEPARTMENT SHALL PROVIDE A REPORT ON A QUARTERLY BASIS TO THE CHAIRS OF THE SENATE FINANCE, ASSEMBLY WAYS AND MEANS, AND SENATE AND ASSEMBLY HEALTH COMMITTEES, UNTIL SUCH TIME AS THE DEPARTMENT DETERMINES THAT THE PROJECTS THAT RECEIVE FUNDING PURSUANT TO THIS SECTION ARE SUBSTANTIALLY COMPLETE. SUCH REPORTS SHALL BE SUBMITTED NO LATER THAN SIXTY DAYS AFTER THE CLOSE OF THE QUARTER, AND SHALL INCLUDE, FOR EACH AWARD, THE NAME OF THE APPLICANT, A DESCRIPTION OF THE PROJECT OR PURPOSE, THE AMOUNT OF THE AWARD, DISBURSEMENT DATE, AND STATUS OF ACHIEVEMENT OF PROCESS AND PERFORMANCE METRICS AND MILESTONES PURSUANT TO SUBDIVISION SIX OF THIS SECTION. § 2. This act shall take effect immediately and shall be deemed to have been in full force and effect on and after April 1, 2018. PART R Section 1. Section 1373 of the public health law is amended by adding two new subdivisions 1-a and 1-b to read as follows: 1-A. EVERY MUNICIPALITY THAT ADMINISTERS THE NEW YORK STATE UNIFORM FIRE PREVENTION AND BUILDING CODE, AND THAT CONTAINS AN AREA DESIGNATED AS HIGH RISK BY THE COMMISSIONER PURSUANT TO SUBDIVISION ONE OF THIS SECTION, SHALL SUBMIT TO THE DEPARTMENT AGGREGATE REPORTS SUMMARIZING THE OUTCOMES OF INSPECTIONS AND REMEDIATION CONDUCTED PURSUANT TO SUBDI- VISION SEVEN OF SECTION THREE HUNDRED EIGHTY-ONE OF THE EXECUTIVE LAW, IN A FORMAT TO BE DETERMINED BY THE COMMISSIONER IN CONSULTATION WITH THE SECRETARY OF STATE. 1-B. THE COMMISSIONER SHALL HAVE THE AUTHORITY TO MONITOR EACH MUNICI- PALITY'S COMPLIANCE WITH SUBDIVISION SEVEN OF SECTION THREE HUNDRED EIGHTY-ONE OF THE EXECUTIVE LAW, INCLUDING AUTHORITY TO PERFORM INSPECTIONS OF RESIDENTIAL AND NON-RESIDENTIAL PROPERTIES AND TO ENSURE IMPLEMENTATION OF LEAD REMEDIATION MEASURES. § 2. Section 378 of the executive law is amended by adding a new subdivision 17 to read as follows: 17. FOR ANY AREA DESIGNATED AS HIGH RISK BY THE COMMISSIONER OF HEALTH PURSUANT TO SUBDIVISION ONE OF SECTION THIRTEEN HUNDRED SEVENTY-THREE OF THE PUBLIC HEALTH LAW: A. A PRESUMPTION THAT ALL PAINT ON ANY RESIDENTIAL BUILDING ON WHICH THE ORIGINAL CONSTRUCTION WAS COMPLETED PRIOR TO JANUARY FIRST, NINETEEN HUNDRED SEVENTY-EIGHT, AND THE EXTERIOR OF ANY NONRESIDENTIAL STRUCTURE S. 7507 56 A. 9507 ON WHICH THE ORIGINAL CONSTRUCTION WAS COMPLETED PRIOR TO JANUARY FIRST, NINETEEN HUNDRED SEVENTY-EIGHT, IS LEAD-BASED. B. A REQUIREMENT THAT THE INTERIOR AND EXTERIOR OF ANY RESIDENTIAL BUILDING ON WHICH THE ORIGINAL CONSTRUCTION WAS COMPLETED PRIOR TO JANU- ARY FIRST, NINETEEN HUNDRED SEVENTY-EIGHT, AND THE EXTERIOR OF ANY NONRESIDENTIAL STRUCTURE ON WHICH THE ORIGINAL CONSTRUCTION WAS COMPLETED PRIOR TO JANUARY FIRST, NINETEEN HUNDRED SEVENTY-EIGHT, BE MAINTAINED IN A CONDITION SUCH THAT THE PAINT THEREON DOES NOT BECOME DETERIORATED PAINT, UNLESS THE DETERIORATED PAINT SURFACES COMPRISE A MINIMAL SURFACE AREA. § 3. Section 381 of the executive law is amended by adding a new subdivision 7 to read as follows: 7. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, THE SECRETARY SHALL PROMULGATE RULES AND REGULATIONS WITH RESPECT TO AREAS DESIGNATED AS HIGH RISK BY THE COMMISSIONER OF HEALTH PURSUANT TO SUBDIVISION ONE OF SECTION THIRTEEN HUNDRED SEVENTY-THREE OF THE PUBLIC HEALTH LAW: A. REQUIRING THAT LOCAL CODE ENFORCEMENT OFFICERS CONDUCT INSPECTIONS OF RESIDENTIAL RENTAL PROPERTY PERIODICALLY AND AT SPECIFIED TIMES INCLUDING, BUT NOT LIMITED TO, AS PART OF AN APPLICATION FOR A CERTIF- ICATE OF OCCUPANCY, A RENEWAL OF A CERTIFICATE OF OCCUPANCY, OR BASED UPON THE FILING OF A COMPLAINT. SUCH INSPECTIONS SHALL INCLUDE AT A MINIMUM A VISUAL ASSESSMENT FOR DETERIORATED PAINT AND BARE SOIL PRESENT WITHIN THE DRIPLINE OF THE BUILDING. B. ESTABLISHING REMEDIES FOR VIOLATIONS OF UNIFORM CODE PROVISIONS ADOPTED PURSUANT TO SUBDIVISION SEVENTEEN OF SECTION THREE HUNDRED SEVENTY-EIGHT OF THIS ARTICLE, WHICH SHALL INCLUDE AS APPROPRIATE: (I) CERTIFICATION BY A LEAD-BASED PAINT INSPECTOR OR RISK ASSESSOR THAT THE PROPERTY HAS BEEN DETERMINED THROUGH A LEAD-BASED PAINT INSPECTION CONDUCTED IN ACCORDANCE WITH APPROPRIATE FEDERAL REGULATIONS NOT TO CONTAIN LEAD-BASED PAINT. (II) CERTIFICATION BY A LEAD-BASED PAINT INSPECTOR OR RISK ASSESSOR THAT ALL CITED VIOLATIONS HAVE BEEN ABATED, OR INTERIM CONTROLS IMPLE- MENTED, AND CLEARANCE HAS BEEN ACHIEVED IN ACCORDANCE WITH THE UNIFORM CODE. (III) WHERE EXTERIOR DETERIORATED PAINT VIOLATIONS, INCLUDING DETERI- ORATED PAINT VIOLATIONS ON AN OPEN PORCH, AND/OR BARE SOIL VIOLATIONS ARE CITED, OR WHERE INTERIOR DETERIORATED PAINT VIOLATIONS ARE CITED IN A COMMON AREA, CLEARANCE MAY BE ESTABLISHED THROUGH A VISUAL ASSESSMENT BY A LOCAL CODE ENFORCEMENT OFFICER AFTER REDUCTION MEASURES HAVE BEEN IMPLEMENTED. C. ESTABLISHING STANDARDS FOR A CLEARANCE EXAMINATION AND REPORT. § 4. Paragraphs b and c of subdivision 1 of section 223-b of the real property law, as amended by chapter 584 of the laws of 1991, is amended to read as follows: b. Actions taken in good faith, by or in behalf of the tenant, to secure or enforce any rights under the lease or rental agreement, under section two hundred thirty-five-b of this chapter, or under any other law of the state of New York, or of its governmental subdivisions, or of the United States which has as its objective the regulation of premises used for dwelling purposes or which pertains to the offense of rent gouging in the third, second or first degree; [or] c. The tenant's participation in the activities of a tenant's organ- ization; OR D. THE TENANT'S REPORTING OF A SUSPECTED LEAD-BASED PAINT HAZARD TO THE OWNER OR TO ANY STATE OR LOCAL AGENCY. S. 7507 57 A. 9507 § 5. This act shall take effect on the one hundred eightieth day after it shall have become a law. PART S Section 1. This Part enacts into law major components of legislation which are necessary to effectuate recommendations made as part of the Regulatory Modernization Initiative undertaken by the Department of Health. Each component is wholly contained within a Subpart identified as Subparts A through C. The effective date for each particular provision contained within such Subpart is set forth in the last section of such Subpart. Any provision in any section contained within a Subpart, including the effective date of the Subpart, which makes a reference to a section "of this act," when used in connection with that particular component, shall be deemed to mean and refer to the corre- sponding section of the Subpart in which it is found. Section three of this Part sets forth the general effective date of this Part. SUBPART A Section 1. The public health law is amended by adding a new section 2805-z to read as follows: § 2805-Z. COMMUNITY PARAMEDICINE COLLABORATIVES. 1. FOR PURPOSES OF THIS SECTION: (A) A "COMMUNITY PARAMEDICINE COLLABORATIVE" SHALL MEAN AN INITIATIVE COMPRISED OF THE PARTICIPANTS SET FORTH IN SUBDIVISION TWO OF THIS SECTION AND ORGANIZED TO CARRY OUT A COMMUNITY PARAMEDICINE PROGRAM AS DEFINED IN PARAGRAPH (B) OF THIS SUBDIVISION. (B) A "COMMUNITY PARAMEDICINE PROGRAM" SHALL MEAN A PROGRAM CARRIED OUT BY A COMMUNITY PARAMEDICINE COLLABORATIVE FOR THE PURPOSE OF ACHIEV- ING OBJECTIVES IDENTIFIED BY THE COLLABORATIVE, PURSUANT TO WHICH INDI- VIDUALS WHO ARE CERTIFIED UNDER REGULATIONS ISSUED PURSUANT TO SECTION THREE THOUSAND TWO OF THIS CHAPTER SHALL PERFORM COMMUNITY PARAMEDICINE SERVICES IN RESIDENTIAL SETTINGS OTHER THAN THE INITIAL EMERGENCY MEDICAL CARE AND TRANSPORTATION OF SICK AND INJURED PERSONS, PROVIDED THAT SUCH INDIVIDUALS ARE: (I) CERTIFIED PURSUANT TO ARTICLE THIRTY OF THIS CHAPTER; (II) EMPLOYEES OR VOLUNTEERS OF AN EMERGENCY MEDICAL SERVICES PROVIDER THAT PARTICIPATES IN THE COLLABORATIVE; (III) PROVIDING SERVICES THAT ARE WITHIN THEIR EDUCATION OR TRAINING; AND (IV) WORKING UNDER MEDICAL CONTROL AS DEFINED BY SUBDIVISION FIFTEEN OF SECTION THREE THOUSAND ONE OF THIS TITLE. (C) "COMMUNITY PARAMEDICINE SERVICES" SHALL MEAN SERVICES PROVIDED IN RESIDENTIAL SETTINGS BY INDIVIDUALS WHO ARE CERTIFIED UNDER REGULATIONS ISSUED PURSUANT TO SECTION THREE THOUSAND TWO OF THIS CHAPTER AND EMPLOYEES OR VOLUNTEERS OF AN EMERGENCY MEDICAL SERVICES PROVIDER, OTHER THAN THE INITIAL EMERGENCY MEDICAL CARE AND TRANSPORTATION OF SICK AND INJURED PERSONS. (D) AN "EMERGENCY MEDICAL SERVICES PROVIDER" SHALL MEAN AN AMBULANCE SERVICE OR AN ADVANCED LIFE SUPPORT FIRST RESPONSE SERVICE THAT IS CERTIFIED UNDER ARTICLE THIRTY OF THIS CHAPTER TO PROVIDE AMBULANCE OR ADVANCED LIFE SUPPORT FIRST RESPONSE SERVICES AND STAFFED BY INDIVIDUALS WHO ARE CERTIFIED UNDER REGULATIONS ISSUED PURSUANT TO SECTION THREE THOUSAND TWO OF THIS CHAPTER TO PROVIDE BASIC OR ADVANCED LIFE SUPPORT. S. 7507 58 A. 9507 2. (A) AT A MINIMUM, A COMMUNITY PARAMEDICINE COLLABORATIVE SHALL INCLUDE THE PARTICIPATION OF AT LEAST ONE HOSPITAL LICENSED UNDER THIS ARTICLE, AT LEAST ONE PHYSICIAN WHO MAY BUT NEED NOT BE EMPLOYED OR OTHERWISE AFFILIATED WITH A HOSPITAL PARTICIPATING IN SUCH COLLABORA- TIVE, AT LEAST ONE EMERGENCY MEDICAL SERVICES PROVIDER AND, IF THE COMMUNITY PARAMEDICINE SERVICES ARE TO BE PROVIDED IN A PRIVATE RESI- DENCE, AT LEAST ONE HOME CARE SERVICES AGENCY LICENSED OR CERTIFIED UNDER ARTICLE THIRTY-SIX OF THIS CHAPTER. (B) WHERE THE COLLABORATIVE'S OBJECTIVES INCLUDE A FOCUS ON SERVING INDIVIDUALS WITH BEHAVIORAL HEALTH CONDITIONS AND/OR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, THE COLLABORATIVE SHALL INCLUDE THE PARTIC- IPATION OF PROVIDERS OPERATED, LICENSED, OR CERTIFIED BY THE OFFICE OF MENTAL HEALTH, THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, AND/OR THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, AS APPRO- PRIATE. (C) SUCH COLLABORATIVE MAY ALSO INCLUDE ADDITIONAL PARTICIPANTS SUCH AS PAYORS AND LOCAL HEALTH DEPARTMENTS. 3. A COMMUNITY PARAMEDICINE COLLABORATIVE MAY ESTABLISH A COMMUNITY PARAMEDICINE PROGRAM TO PROVIDE COMMUNITY PARAMEDICINE SERVICES TO INDI- VIDUALS LIVING IN RESIDENTIAL SETTINGS FOR THE PURPOSE OF ACHIEVING OBJECTIVES IDENTIFIED BY THE COLLABORATIVE SUCH AS: PREVENTING EMERGEN- CIES, AVOIDABLE EMERGENCY ROOM VISITS, AVOIDABLE MEDICAL TRANSPORT, AND POTENTIALLY AVOIDABLE HOSPITAL ADMISSIONS AND READMISSIONS; IMPROVING OUTCOMES FOLLOWING DISCHARGE FROM A GENERAL HOSPITAL OR OTHER INPATIENT ADMISSION; AND/OR PROMOTING SELF-MANAGEMENT OF HEALTH OR BEHAVIORAL HEALTH CARE CONDITIONS. 4. A COMMUNITY PARAMEDICINE COLLABORATIVE SHALL BE REQUIRED TO PROVIDE OR ARRANGE FOR APPROPRIATE ORIENTATION AND TRAINING FOR STAFF PARTIC- IPATING IN THE COMMUNITY PARAMEDICINE PROGRAM. IN ALL CASES, SUCH ORIEN- TATION AND TRAINING SHALL ADDRESS THE ASSESSMENT OF THE NEEDS OF INDI- VIDUALS WITH BEHAVIORAL HEALTH CONDITIONS AND INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES. 5. AN EMERGENCY MEDICAL SERVICES PROVIDER PARTICIPATING IN A COMMUNITY PARAMEDICINE COLLABORATIVE SHALL: (A) ENSURE THAT THE PROVISION OF COMMUNITY PARAMEDICINE SERVICES OCCURS WITHIN THE PROVIDER'S PRIMARY OPERATING TERRITORY PURSUANT TO ARTICLE THIRTY OF THIS CHAPTER; AND (B) MAKE REASONABLE EFFORTS TO ENSURE THAT IT HAS SUFFICIENTLY STAFFED THE PROVISION OF INITIAL EMERGENCY MEDICAL CARE AND TRANSPORTATION OF SICK AND INJURED PERSONS BEFORE MAKING STAFF AVAILABLE TO PROVIDE COMMUNITY PARAMEDICINE SERVICES. 6. (A) NO COMMUNITY PARAMEDICINE COLLABORATIVE SHALL BEGIN PROVIDING SERVICES UNDER A COMMUNITY PARAMEDICINE PROGRAM UNTIL IT HAS NOTIFIED THE DEPARTMENT OF THE INITIATION OF SUCH COLLABORATIVE BY: (I) IDENTIFYING THE PARTICIPANTS OF THE COLLABORATIVE AND THE INDIVID- UAL WHO WILL SERVE AS THE POINT OF CONTACT; (II) DESCRIBING THE GOALS OF THE COLLABORATIVE IN CARRYING OUT A COMMUNITY PARAMEDICINE PROGRAM; (III) DESCRIBING THE POPULATION TO BE SERVED BY THE COMMUNITY PARAMED- ICINE PROGRAM AND THE GEOGRAPHIC AREA IN WHICH THE PROGRAM WILL FOCUS; (IV) IDENTIFYING THE SERVICES TO BE OFFERED UNDER THE COMMUNITY PARAM- EDICINE PROGRAM AND THE COLLABORATIVE PARTICIPANTS THAT WILL PROVIDE SUCH SERVICES; (V) DESCRIBING THE COLLABORATIVE'S PLAN TO ASSURE, TO THE EXTENT POSSIBLE, THAT CARE PROVIDED UNDER THE COMMUNITY PARAMEDICINE PROGRAM IS COORDINATED WITH OTHER PROVIDERS OF THE INDIVIDUALS SERVED; S. 7507 59 A. 9507 (VI) DESCRIBING THE QUALITY ASSURANCE AND IMPROVEMENT PROCEDURES THAT WILL BE USED BY THE COLLABORATIVE IN CARRYING OUT THE COMMUNITY PARAMED- ICINE PROGRAM; AND (VII) IDENTIFYING THE DATE OF THE ANTICIPATED START OF ACTIVITIES. (B) A COMMUNITY PARAMEDICINE COLLABORATIVE SHALL: (I) PROMPTLY UPDATE THE DEPARTMENT AS TO ANY CHANGES IN THE INFORMA- TION REQUIRED UNDER PARAGRAPH (A) OF THIS SUBDIVISION; AND (II) PROVIDE INFORMATION TO THE DEPARTMENT ABOUT THE COLLABORATIVE'S ACTIVITIES AND OUTCOMES AT A FREQUENCY AND IN A MANNER DETERMINED BY THE DEPARTMENT, WHICH AT A MINIMUM SHALL INCLUDE AN ANNUAL REPORT. 7. NOTHING IN THIS SECTION SHALL BE DEEMED TO PROHIBIT THE PERFORMANCE OF ANY TASKS OR RESPONSIBILITIES BY ANY PERSON LICENSED OR CERTIFIED UNDER THIS CHAPTER OR UNDER TITLE VIII OF THE EDUCATION LAW OR BY ANY ENTITY LICENSED OR CERTIFIED UNDER THIS ARTICLE OR UNDER THE MENTAL HYGIENE LAW, PROVIDED SUCH TASKS OR RESPONSIBILITIES ARE PERMITTED PURSUANT TO SUCH STATUTORY PROVISIONS. § 2. Subdivision 15 of section 3001 of the public health law, as amended by chapter 445 of the laws of 1993, is amended to read as follows: 15. "Medical control" means: (a) advice and direction provided by a physician or under the direction of a physician to certified first responders, emergency medical technicians or advanced emergency medical technicians who are providing medical care at the scene of an emergency or en route to a health care facility; [and] (b) indirect medical control including the written policies, procedures, and protocols for prehospital emergency medical care and transportation developed by the state emergency medical advisory committee, approved by the state emer- gency medical services council and the commissioner, and implemented by regional medical advisory committees; AND (C) IN A COMMUNITY PARAMEDI- CINE PROGRAM ESTABLISHED BY A COMMUNITY PARAMEDICINE COLLABORATIVE PURSUANT TO SECTION TWENTY-EIGHT HUNDRED FIVE-Z OF THIS CHAPTER, ADVICE AND DIRECTION PROVIDED AND POLICIES, PROCEDURES, AND PROTOCOLS ISSUED BY A PHYSICIAN WITHIN THE COLLABORATIVE WHO IS RESPONSIBLE FOR THE OVERALL CLINICAL SUPERVISION OF THE COMMUNITY PARAMEDICINE PROGRAM. § 3. The public health law is amended by adding a new section 3001-a to read as follows: § 3001-A. COMMUNITY PARAMEDICINE SERVICES. NOTWITHSTANDING ANY INCON- SISTENT PROVISION OF THIS ARTICLE, AN INDIVIDUAL WHO IS CERTIFIED UNDER REGULATIONS ISSUED PURSUANT TO SECTION THREE THOUSAND TWO OF THIS ARTI- CLE TO PROVIDE BASIC OR ADVANCED LIFE SUPPORT MAY, IN THE COURSE OF HIS OR HER WORK AS AN EMPLOYEE OR VOLUNTEER OF AN AMBULANCE SERVICE OR AN ADVANCED LIFE SUPPORT FIRST RESPONSE SERVICE CERTIFIED UNDER THIS ARTI- CLE, ALSO PARTICIPATE AS AN EMPLOYEE OR VOLUNTEER OF SUCH SERVICE IN A COMMUNITY PARAMEDICINE PROGRAM ESTABLISHED BY A COMMUNITY PARAMEDICINE COLLABORATIVE PURSUANT TO SECTION TWENTY-EIGHT HUNDRED FIVE-Z OF THIS CHAPTER. § 4. Subdivision 2 of section 365-a of the social services law is amended by adding a new paragraph (ff) to read as follows: (FF) SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, COMMUNITY PARAMEDICINE SERVICES PROVIDED IN ACCORDANCE WITH THE REQUIRE- MENTS OF SECTION TWENTY-EIGHT HUNDRED FIVE-Z OF THE PUBLIC HEALTH LAW. § 5. This act shall take effect immediately. SUBPART B S. 7507 60 A. 9507 Section 1. Subdivision 1 of section 2801 of the public health law, as amended by chapter 397 of the laws of 2016, is amended to read as follows: 1. "Hospital" means a facility or institution engaged principally in providing services by or under the supervision of a physician or, in the case of a dental clinic or dental dispensary, of a dentist, or, in the case of a midwifery birth center, of a midwife, for the prevention, diagnosis or treatment of human disease, pain, injury, deformity or physical condition, including, but not limited to, a general hospital, public health center, diagnostic center, treatment center, dental clin- ic, dental dispensary, rehabilitation center other than a facility used solely for vocational rehabilitation, nursing home, tuberculosis hospi- tal, chronic disease hospital, maternity hospital, midwifery birth center, lying-in-asylum, out-patient department, out-patient lodge, dispensary and a laboratory or central service facility serving one or more such institutions, but the term hospital shall not include an institution, sanitarium or other facility engaged principally in provid- ing services for the prevention, diagnosis or treatment of mental disa- bility and which is subject to the powers of visitation, examination, inspection and investigation of the department of mental hygiene except for those distinct parts of such a facility which provide hospital service. The provisions of this article shall not apply to a facility or institution engaged principally in providing services by or under the supervision of the bona fide members and adherents of a recognized reli- gious organization whose teachings include reliance on spiritual means through prayer alone for healing in the practice of the religion of such organization and where services are provided in accordance with those teachings. NO PROVISION OF THIS ARTICLE OR ANY OTHER PROVISION OF LAW SHALL BE CONSTRUED TO: (A) LIMIT THE VOLUME OF MENTAL HEALTH OR SUBSTANCE USE DISORDER SERVICES THAT CAN BE PROVIDED BY A PROVIDER OF PRIMARY CARE SERVICES LICENSED UNDER THIS ARTICLE AND AUTHORIZED TO PROVIDE INTEGRATED SERVICES IN ACCORDANCE WITH REGULATIONS ISSUED BY THE COMMISSIONER IN CONSULTATION WITH THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, INCLUDING REGULATIONS ISSUED PURSUANT TO SUBDIVISION SEVEN OF SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW OR PART L OF CHAPTER FIFTY-SIX OF THE LAWS OF TWO THOUSAND TWELVE; (B) REQUIRE A PROVIDER LICENSED PURSUANT TO ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE LAW OR CERTIFIED PURSUANT TO ARTICLE THIRTY-TWO OF THE MENTAL HYGIENE LAW TO OBTAIN AN OPERATING CERTIFICATE FROM THE DEPARTMENT IF SUCH PROVIDER HAS BEEN AUTHORIZED TO PROVIDE INTEGRATED SERVICES IN ACCORDANCE WITH REGULATIONS ISSUED BY THE COMMISSIONER IN CONSULTATION WITH THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, INCLUDING REGULATIONS ISSUED PURSUANT TO SUBDIVISION SEVEN OF SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW OR PART L OF CHAPTER FIFTY-SIX OF THE LAWS OF TWO THOUSAND TWELVE. § 2. Section 31.02 of the mental hygiene law is amended by adding a new subdivision (f) to read as follows: (F) NO PROVISION OF THIS ARTICLE OR ANY OTHER PROVISION OF LAW SHALL BE CONSTRUED TO REQUIRE A PROVIDER LICENSED PURSUANT TO ARTICLE TWENTY- EIGHT OF THE PUBLIC HEALTH LAW OR CERTIFIED PURSUANT TO ARTICLE THIRTY- TWO OF THIS CHAPTER TO OBTAIN AN OPERATING CERTIFICATE FROM THE OFFICE OF MENTAL HEALTH IF SUCH PROVIDER HAS BEEN AUTHORIZED TO PROVIDE INTE- GRATED SERVICES IN ACCORDANCE WITH REGULATIONS ISSUED BY THE COMMISSION- ER OF THE OFFICE OF MENTAL HEALTH IN CONSULTATION WITH THE COMMISSIONER S. 7507 61 A. 9507 OF THE DEPARTMENT OF HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCO- HOLISM AND SUBSTANCE ABUSE SERVICES, INCLUDING REGULATIONS ISSUED PURSU- ANT TO SUBDIVISION SEVEN OF SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW OR PART L OF CHAPTER FIFTY-SIX OF THE LAWS OF TWO THOUSAND TWELVE. § 3. Subdivision (b) of section 32.05 of the mental hygiene law, as amended by chapter 204 of the laws of 2007, is amended to read as follows: (b) (I) Methadone, or such other controlled substance designated by the commissioner of health as appropriate for such use, may be adminis- tered to an addict, as defined in section thirty-three hundred two of the public health law, by individual physicians, groups of physicians and public or private medical facilities certified pursuant to article twenty-eight or thirty-three of the public health law as part of a chem- ical dependence program which has been issued an operating certificate by the commissioner pursuant to subdivision (b) of section 32.09 of this article, provided, however, that such administration must be done in accordance with all applicable federal and state laws and regulations. Individual physicians or groups of physicians who have obtained authori- zation from the federal government to administer buprenorphine to addicts may do so without obtaining an operating certificate from the commissioner. (II) NO PROVISION OF THIS ARTICLE OR ANY OTHER PROVISION OF LAW SHALL BE CONSTRUED TO REQUIRE A PROVIDER LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW OR ARTICLE THIRTY-ONE OF THIS CHAPTER TO OBTAIN AN OPERATING CERTIFICATE FROM THE OFFICE OF ALCO- HOLISM AND SUBSTANCE ABUSE SERVICES IF SUCH PROVIDER HAS BEEN AUTHORIZED TO PROVIDE INTEGRATED SERVICES IN ACCORDANCE WITH REGULATIONS ISSUED BY THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES IN CONSULTA- TION WITH THE COMMISSIONER OF THE DEPARTMENT OF HEALTH AND THE COMMIS- SIONER OF THE OFFICE OF MENTAL HEALTH, INCLUDING REGULATIONS ISSUED PURSUANT TO SUBDIVISION SEVEN OF SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW OR PART L OF CHAPTER FIFTY-SIX OF THE LAWS OF TWO THOUSAND TWELVE. § 4. This act shall take effect on the one hundred eightieth day after it shall have become a law; provided, however, that the commissioner of the department of health, the commissioner of the office of mental health, and the commissioner of the office of alcoholism and substance abuse services are authorized to issue any rule or regulation necessary for the implementation of this act on or before its effective date. SUBPART C Section 1. Paragraphs (s) and (t) of subdivision 2 of section 2999-cc of the public health law, as amended by chapter 454 of the laws of 2015, are amended and a new paragraph (u) is added to read as follows: (s) a hospice as defined in article forty of this chapter; [and] (t) CREDENTIALED ALCOHOLISM AND SUBSTANCE ABUSE COUNSELORS CREDEN- TIALED BY THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES OR BY A CREDENTIALING ENTITY APPROVED BY SUCH OFFICE PURSUANT TO SECTION 19.07 OF THE MENTAL HYGIENE LAW; (U) PROVIDERS AUTHORIZED TO PROVIDE SERVICES AND SERVICE COORDINATION UNDER THE EARLY INTERVENTION PROGRAM PURSUANT TO ARTICLE TWENTY-FIVE OF THIS CHAPTER; AND (V) any other provider as determined by the commissioner pursuant to regulation OR, IN CONSULTATION WITH THE COMMISSIONER, BY THE COMMISSION- ER OF THE OFFICE OF MENTAL HEALTH, THE COMMISSIONER OF THE OFFICE OF S. 7507 62 A. 9507 ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, OR THE COMMISSIONER OF THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES PURSUANT TO REGULATION. § 2. Subdivision 3 of section 2999-cc of the public health law, as separately amended by chapters 238 and 285 of the laws of 2017, is amended to read as follows: 3. "Originating site" means a site at which a patient is located at the time health care services are delivered to him or her by means of telehealth. Originating sites shall be limited to (A) facilities licensed under articles twenty-eight and forty of this chapter[,]; (B) facilities as defined in subdivision six of section 1.03 of the mental hygiene law[,]; (C) private physician's or dentist's offices located within the state of New York[,]; (D) any type of adult care facility licensed under title two of article seven of the social services law[,]; (E) public, private and charter elementary and secondary schools, school age child care programs, and child day care centers within the state of New York; and[, when a patient is receiving health care services by means of remote patient monitoring,] (F) the patient's place of resi- dence located within the state of New York or other temporary location located within or outside the state of New York; SUBJECT TO REGULATION ISSUED BY THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH, THE COMMIS- SIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, AND THE COMMISSIONER OF THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES. § 3. Subdivision 7 of section 2999-cc of the public health law, as added by chapter 6 of the laws of 2015, is amended to read as follows: 7. "Remote patient monitoring" means the use of synchronous or asyn- chronous electronic information and communication technologies to collect personal health information and medical data from a patient at an originating site that is transmitted to a telehealth provider at a distant site for use in the treatment and management of medical condi- tions that require frequent monitoring. SUCH TECHNOLOGIES MAY INCLUDE ADDITIONAL INTERACTION TRIGGERED BY PREVIOUS TRANSMISSIONS, SUCH AS INTERACTIVE QUERIES CONDUCTED THROUGH COMMUNICATION TECHNOLOGIES OR BY TELEPHONE. Such conditions shall include, but not be limited to, conges- tive heart failure, diabetes, chronic obstructive pulmonary disease, wound care, polypharmacy, mental or behavioral problems, and technolo- gy-dependent care such as continuous oxygen, ventilator care, total parenteral nutrition or enteral feeding. Remote patient monitoring shall be ordered by a physician licensed pursuant to article one hundred thirty-one of the education law, a nurse practitioner licensed pursuant to article one hundred thirty-nine of the education law, or a midwife licensed pursuant to article one hundred forty of the education law, with which the patient has a substantial and ongoing relationship. § 4. This act shall take effect on the ninetieth day after it shall have become a law; provided, however, that the commissioner of the department of health, the commissioner of the office of mental health, the commissioner of the office of alcoholism and substance abuse services, and the commissioner of the office for people with develop- mental disabilities are authorized to issue any rule or regulation necessary for the implementation of this act on or before its effective date. § 2. Severability clause. If any clause, sentence, paragraph, subdivi- sion, section or subpart 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 S. 7507 63 A. 9507 or subpart 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. § 3. This act shall take effect immediately; provided, however, that the applicable effective date of Subparts A through C of this act shall be as specifically set forth in the last section of such Subparts. PART T Section 1. Subdivision (a) of section 31 of part B of chapter 59 of the laws of 2016, amending the social services law relating to authoriz- ing the commissioner of health to apply federally established consumer price index penalties for generic drugs, and authorizing the commission- er of health to impose penalties on managed care plans for reporting late or incorrect encounter data, is amended to read as follows: (a) section eleven of this act shall expire and be deemed repealed March 31, [2018] 2023; § 2. Subdivision 6-a of section 93 of part C of chapter 58 of the laws of 2007, amending the social services law and other laws relating to adjustments of rates, as amended by section 20 of part B of chapter 56 of the laws of 2013, is amended to read as follows: 6-a. section fifty-seven of this act shall expire and be deemed repealed on [December 31, 2018] MARCH 31, 2023; provided that the amend- ments made by such section to subdivision 4 of section 366-c of the social services law shall apply with respect to determining initial and continuing eligibility for medical assistance, including the continued eligibility of recipients originally determined eligible prior to the effective date of this act, and provided further that such amendments shall not apply to any person or group of persons if it is subsequently determined by the Centers for Medicare and Medicaid services or by a court of competent jurisdiction that medical assistance with federal financial participation is available for the costs of services provided to such person or persons under the provisions of subdivision 4 of section 366-c of the social services law in effect immediately prior to the effective date of this act. § 3. Section 2 of part II of chapter 54 of the laws of 2016, amending part C of chapter 58 of the laws of 2005 authorizing reimbursements for expenditures made by or on behalf of social services districts for medical assistance for needy persons and administration thereof, is amended to read as follows: § 2. This act shall take effect immediately and shall expire and be deemed repealed [two years after it shall have become a law] MARCH 31, 2023. § 4. Section 3 of chapter 906 of the laws of 1984, amending the social services law relating to expanding medical assistance eligibility and the scope of services available to certain persons with disabilities, as amended by section 25-a of part B of chapter 56 of the laws of 2013, is amended to read as follows: § 3. This act shall take effect on the thirtieth day after it shall have become a law and shall be of no further force and effect after [December 31, 2018] MARCH 31, 2023, at which time the provisions of this act shall be deemed to be repealed. § 5. 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- S. 7507 64 A. 9507 ing to the cap on local Medicaid expenditures, as amended by section 9 of part I of chapter 57 of the laws of 2017, is amended to read as follows: § 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, [2019] 2017 through March 31, 2019, for inpa- tient and outpatient services provided by general hospitals, for inpa- tient 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 agencies, 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 2017, 2018, AND 2019 calendar [year] YEARS 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 2017, 2018, AND 2019 calendar [year] YEARS shall also be applied to rates of payment provided on and after January 1, [2019] 2017 through March 31, 2019 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 pursu- ant to a rate-setting exemption issued by the commissioner of health to such local social services districts in accordance with applicable regu- lations[,]; and provided further, however, that for rates of payment for assisted living program services provided on and after January 1, [2019] 2017 through March 31, 2019, such trend factors attributable to the 2017, 2018, AND 2019 calendar [year] YEARS shall be established at no greater than zero percent. § 6. This act shall take effect immediately. PART U Section 1. Section 2 of part NN of chapter 58 of the laws of 2015, amending the mental hygiene law relating to clarifying the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs, is amended to read as follows: § 2. This act shall take effect immediately and shall expire and be deemed repealed March 31, [2018] 2021. § 2. This act shall take effect immediately. PART V Section 1. Section 7 of part R2 of chapter 62 of the laws of 2003, amending the mental hygiene law and the state finance law relating to the community mental health support and workforce reinvestment program, the membership of subcommittees for mental health of community services boards and the duties of such subcommittees and creating the community mental health and workforce reinvestment account, as amended by section S. 7507 65 A. 9507 3 of part G of chapter 60 of the laws of 2014, is amended to read as follows: § 7. This act shall take effect immediately and shall expire March 31, [2018] 2021 when upon such date the provisions of this act shall be deemed repealed. § 2. This act shall take effect immediately. PART W Section 1. Subdivision 9 of section 730.10 of the criminal procedure law, as added by section 1 of part Q of chapter 56 of the laws of 2012, is amended to read as follows: 9. "Appropriate institution" means: (a) a hospital operated by the office of mental health or a developmental center operated by the office for people with developmental disabilities; [or] (b) a hospital licensed by the department of health which operates a psychiatric unit licensed by the office of mental health, as determined by the commissioner provided, however, that any such hospital that is not operated by the state shall qualify as an "appropriate institution" only pursuant to the terms of an agreement between the commissioner and the hospital ; OR (C) A MENTAL HEALTH UNIT OPERATING WITHIN A CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACILITY; PROVIDED HOWEVER, THAT ANY SUCH MENTAL HEALTH UNIT OPERATING WITHIN A LOCAL CORRECTIONAL FACILITY SHALL QUALIFY AS AN "APPROPRIATE INSTITUTION" ONLY PURSUANT TO THE TERMS OF AN AGREEMENT BETWEEN THE COMMISSIONER OF MENTAL HEALTH, DIRECTOR OF COMMUNITY SERVICES AND THE SHERIFF FOR THE RESPECTIVE LOCALITY, AND ANY SUCH MENTAL HEALTH UNIT OPERATING WITHIN A CORRECTIONAL FACILITY SHALL QUALI- FY AS AN "APPROPRIATE INSTITUTION" ONLY PURSUANT TO THE TERMS OF AN AGREEMENT BETWEEN THE COMMISSIONER OF MENTAL HEALTH AND THE COMMISSIONER OF CORRECTIONS AND COMMUNITY SUPERVISION. Nothing in this article shall be construed as requiring a hospital, CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACILITY to consent to providing care and treatment to an incapacitated person at such hospital, CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACILITY. IN A CITY WITH A POPULATION OF MORE THAN ONE MILLION, ANY SUCH UNIT SHALL BE LIMITED TO TWENTY-FIVE BEDS. THE COMMIS- SIONER OF MENTAL HEALTH SHALL PROMULGATE REGULATIONS FOR DEMONSTRATION PROGRAMS TO IMPLEMENT RESTORATION TO COMPETENCY WITHIN A CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACILITY. SUBJECT TO ANNUAL APPROPRI- ATION, THE COMMISSIONER OF MENTAL HEALTH MAY, AT SUCH COMMISSIONER'S DISCRETION, MAKE FUNDS AVAILABLE FOR STATE AID GRANTS TO ANY COUNTY THAT DEVELOPS AND OPERATES A MENTAL HEALTH UNIT WITHIN A LOCAL CORRECTIONAL FACILITY PURSUANT TO THIS SECTION. NOTHING IN THIS ARTICLE SHALL BE CONSTRUED AS REQUIRING A HOSPITAL, CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACILITY TO CONSENT TO PROVIDING CARE AND TREATMENT TO AN INCAPACITATED PERSON AT SUCH HOSPITAL, CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACILITY. § 2. This act shall take effect immediately and shall be deemed to have been in full force and effect on and after April 1, 2018; provided, however, this act shall expire and be deemed repealed March 31, 2023. PART X 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 S. 7507 66 A. 9507 section 1 of part LL of chapter 58 of the laws of 2015, is amended to read as follows: § 3. This act shall take effect immediately; and shall expire and be deemed repealed June 30, [2018] 2021. § 2. This act shall take effect immediately. PART Y Section 1. Subdivision 10 of section 7605 of the education law, as added by section 4 of part AA of chapter 57 of the laws of 2013, is amended and a new subdivision 12 is added to read as follows: 10. (A) A person without a license from: performing assessments such as basic information collection, gathering of demographic data, and informal observations, screening and referral used for general eligibil- ity for a program or service and determining the functional status of an individual for the purpose of determining need for services [unrelated to a behavioral health diagnosis or treatment plan. Such licensure shall not be required to create, develop or implement a service plan unrelated to a behavioral health diagnosis or treatment plan]; COUN- SELING INDIVIDUALS REGARDING THE APPROPRIATENESS OF BENEFITS THEY ARE ELIGIBLE FOR; PROVIDING GENERAL COUNSELING THAT IS NOT PSYCHOTHERAPY AND ASSISTING INDIVIDUALS OR GROUPS WITH DIFFICULT DAY TO DAY PROBLEMS SUCH AS FINDING EMPLOYMENT, LOCATING SOURCES OF ASSISTANCE, AND ORGANIZING COMMUNITY GROUPS TO WORK ON A SPECIFIC PROBLEM; PROVIDING PEER SERVICES; OR TO SELECT FOR SUITABILITY AND PROVIDE SUBSTANCE ABUSE TREATMENT SERVICES OR GROUP RE-ENTRY SERVICES TO INCARCERATED INDIVIDUALS IN STATE CORRECTIONAL FACILITIES. (B) A PERSON WITHOUT A LICENSE FROM CREATING, DEVELOPING OR IMPLEMENT- ING A SERVICE PLAN OR RECOVERY PLAN THAT IS NOT A BEHAVIORAL HEALTH DIAGNOSIS OR TREATMENT PLAN. Such service OR RECOVERY plans shall include, but are not limited to, COORDINATING, EVALUATING OR DETERMINING THE NEED FOR, OR THE PROVISION OF THE FOLLOWING SERVICES: job training and employability[,]; housing[,]; HOMELESS SERVICES AND SHELTERS FOR HOMELESS INDIVIDUALS AND FAMILIES; REFUGEE SERVICES; RESIDENTIAL, DAY OR COMMUNITY HABILITATION SERVICES; general public assistance[,]; in home services and supports or home-delivered meals[, investigations conducted or assessments made by]; RECOVERY SUPPORTS; adult or child protective services INCLUDING INVESTIGATIONS; DETENTION AS DEFINED IN SECTION FIVE HUNDRED TWO OF THE EXECUTIVE LAW; PREVENTION AND RESIDENTIAL SERVICES FOR VICTIMS OF DOMESTIC VIOLENCE; SERVICES FOR RUNAWAY AND HOMELESS YOUTH; FOSTER CARE, ADOPTION, PREVENTIVE SERVICES OR SERVICES IN ACCORD- ANCE WITH AN APPROVED PLAN PURSUANT TO SECTION FOUR HUNDRED FOUR OF THE SOCIAL SERVICES LAW, INCLUDING, adoption AND FOSTER home studies and assessments, family service plans, transition plans [and], permanency planning activities, AND CASE PLANNING OR CASE MANAGEMENT AS SUCH TERMS ARE DEFINED IN PART FOUR HUNDRED TWENTY-EIGHT OF TITLE EIGHTEEN OF THE NEW YORK CODES, RULES AND REGULATIONS; RESIDENTIAL REHABILITATION; HOME AND COMMUNITY BASED SERVICES; AND de-escalation techniques, peer services or skill development. [A license under this article shall not be required for persons to participate] (C)(I) A PERSON WITHOUT A LICENSE FROM PARTICIPATING as a member of a multi-disciplinary team to DEVELOP OR implement a [behavioral health services or] treatment plan; provided [however,] that such team shall include one or more professionals licensed under this article or arti- cles one hundred thirty-one, ONE HUNDRED THIRTY-NINE, one hundred fifty-four or one hundred sixty-three of this chapter WHO MUST DIRECTLY S. 7507 67 A. 9507 OBSERVE EACH PATIENT EITHER IN PERSON OR BY ELECTRONIC MEANS, PRIOR TO THE RENDERING OF A DIAGNOSIS; and provided, further, that the activities performed by members of the team shall be consistent with the scope of practice for each team member licensed or authorized under title VIII of this chapter, and those who are not so authorized may not INDEPENDENTLY engage in the following restricted practices, BUT MAY ASSIST LICENSED PROFESSIONALS OR MULTI-DISCIPLINARY TEAM MEMBERS WITH: the diagnosis of mental, emotional, behavioral, addictive and developmental disorders and disabilities; patient assessment and evaluating; the provision of psychotherapeutic treatment; the provision of treatment other than psychotherapeutic treatment; [and/or] OR the development and implementa- tion of assessment-based treatment plans as defined in section seventy- seven hundred one of this [chapter] TITLE. (II) AS USED IN THIS SUBDIVISION, A TREATMENT PLAN SHALL BE LIMITED TO PLANS FOR TREATMENT WITHIN THE FOLLOWING SETTINGS: FACILITIES OR PROGRAMS OPERATING PURSUANT TO ARTICLE NINETEEN-G OF THE EXECUTIVE LAW OR PURSUANT TO ARTICLES SEVEN, SIXTEEN, THIRTY-ONE AND THIRTY-TWO OF THE MENTAL HYGIENE LAW. (III) AS USED IN THIS SUBDIVISION, THE TERM "ASSIST" SHALL INCLUDE THE PROVISION OF SERVICES WITHIN THE PRACTICE OF PSYCHOLOGY, UNDER THE SUPERVISION OF A PERSON LICENSED UNDER THIS ARTICLE. (D) Provided, further, that nothing in this subdivision shall be construed as requiring a license for any particular activity or function based solely on the fact that the activity or function is not listed in this subdivision. 12. NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, NOTH- ING IN THIS ARTICLE SHALL BE CONSTRUED TO PROHIBIT OR LIMIT THE ACTIV- ITIES OR SERVICES PROVIDED BY ANY PERSON WHO IS EMPLOYED OR WHO COMMENCES EMPLOYMENT IN A PROGRAM OR SERVICE OPERATED, REGULATED, FUND- ED, OR APPROVED BY THE DEPARTMENT OF MENTAL HYGIENE, THE OFFICE OF CHIL- DREN AND FAMILY SERVICES, THE DEPARTMENT OF CORRECTIONS AND COMMUNITY SUPERVISION, THE OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE, THE STATE OFFICE FOR THE AGING AND THE DEPARTMENT OF HEALTH OR A LOCAL GOVERNMENTAL UNIT AS THAT TERM IS DEFINED IN SECTION 41.03 OF THE MENTAL HYGIENE LAW OR A SOCIAL SERVICES DISTRICT AS DEFINED IN SECTION SIXTY- ONE OF THE SOCIAL SERVICES LAW ON OR BEFORE JULY FIRST, TWO THOUSAND TWENTY. PROVIDED, HOWEVER, THAT ANY PERSON WHO COMMENCES EMPLOYMENT IN SUCH PROGRAM OR SERVICE AFTER JULY FIRST, TWO THOUSAND TWENTY AND PERFORMS SERVICES THAT ARE RESTRICTED UNDER THIS ARTICLE SHALL BE APPRO- PRIATELY LICENSED OR AUTHORIZED UNDER THIS ARTICLE. § 2. Paragraph (f) of subdivision 1 of section 7702 of the education law, as amended by chapter 230 of the laws of 2004, is amended and a new paragraph (m) is added to read as follows: (f) [Assist] GENERAL COUNSELING THAT IS NOT PSYCHOTHERAPY, AND ASSIST- ING individuals or groups with difficult day to day problems such as finding employment, locating sources of assistance, and organizing community groups to work on a specific problem. (M) PROVIDE PEER SERVICES. § 3. Subdivision 7 of section 7706 of the education law, as added by section 5 of part AA of chapter 57 of the laws of 2013, is amended and a new subdivision 8 is added to read as follows: 7. (A) Prevent a person without a license from: performing assessments such as basic information collection, gathering of demographic data, and informal observations, screening and referral used for general eligibil- ity for a program or service and determining the functional status of an individual for the purpose of determining need for services [unrelated S. 7507 68 A. 9507 to a behavioral health diagnosis or treatment plan. Such licensure shall not be required to create, develop or implement a service plan unrelated to a behavioral health diagnosis or treatment plan]; COUNSELING INDIVID- UALS REGARDING THE APPROPRIATENESS OF BENEFITS THEY ARE ELIGIBLE FOR; PROVIDING GENERAL COUNSELING THAT IS NOT PSYCHOTHERAPY AND ASSISTING INDIVIDUALS OR GROUPS WITH DIFFICULT DAY TO DAY PROBLEMS SUCH AS FINDING EMPLOYMENT, LOCATING SOURCES OF ASSISTANCE, AND ORGANIZING COMMUNITY GROUPS TO WORK ON A SPECIFIC PROBLEM; PROVIDING PEER SERVICES; OR TO SELECT FOR SUITABILITY AND PROVIDE SUBSTANCE ABUSE TREATMENT SERVICES OR GROUP RE-ENTRY SERVICES TO INCARCERATED INDIVIDUALS IN STATE CORRECTION- AL FACILITIES. (B) PREVENT A PERSON WITHOUT A LICENSE FROM CREATING, DEVELOPING OR IMPLEMENTING A SERVICE PLAN OR RECOVERY PLAN THAT IS NOT A BEHAVIORAL HEALTH DIAGNOSIS OR TREATMENT PLAN. Such service OR RECOVERY plans shall include, but are not limited to, COORDINATING, EVALUATING OR DETERMINING THE NEED FOR, OR THE PROVISION OF THE FOLLOWING SERVICES: job training and employability[,]; housing[,]; HOMELESS SERVICES AND SHELTERS FOR HOMELESS INDIVIDUALS AND FAMILIES; REFUGEE SERVICES; RESIDENTIAL, DAY OR COMMUNITY HABILITATION SERVICES; general public assistance[,]; in home services and supports or home-delivered meals[, investigations conducted or assessments made by]; RECOVERY SUPPORTS; adult or child protective services INCLUDING INVESTIGATIONS; DETENTION AS DEFINED IN SECTION FIVE HUNDRED TWO OF THE EXECUTIVE LAW; PREVENTION AND RESIDENTIAL SERVICES FOR VICTIMS OF DOMESTIC VIOLENCE; SERVICES FOR RUNAWAY AND HOMELESS YOUTH; FOSTER CARE, ADOPTION, PREVENTIVE SERVICES OR SERVICES IN ACCORD- ANCE WITH AN APPROVED PLAN PURSUANT TO SECTION FOUR HUNDRED FOUR OF THE SOCIAL SERVICES LAW, INCLUDING, adoption AND FOSTER home studies and assessments, family service plans, transition plans [and], permanency planning activities, AND CASE PLANNING OR CASE MANAGEMENT AS SUCH TERMS ARE DEFINED IN PART FOUR HUNDRED TWENTY-EIGHT OF TITLE EIGHTEEN OF THE NEW YORK CODES, RULES AND REGULATIONS; RESIDENTIAL REHABILITATION; HOME AND COMMUNITY BASED SERVICES; AND de-escalation techniques, peer services or skill development. [A license under this article shall not be required for persons to participate] (C)(I) PREVENT A PERSON WITHOUT A LICENSE FROM PARTICIPATING as a member of a multi-disciplinary team to DEVELOP OR implement a [behav- ioral health services or] treatment plan; provided [however,] that such team shall include one or more professionals licensed under this article or articles one hundred thirty-one, ONE HUNDRED THIRTY-NINE, one hundred fifty-three or one hundred sixty-three of this chapter WHO MUST DIRECTLY OBSERVE EACH PATIENT EITHER IN PERSON OR BY ELECTRONIC MEANS, PRIOR TO THE RENDERING OF A DIAGNOSIS; and provided, further, that the activities performed by members of the team shall be consistent with the scope of practice for each team member licensed or authorized under title VIII of this chapter, and those who are not so authorized may not INDEPENDENTLY engage in the following restricted practices, BUT MAY ASSIST LICENSED PROFESSIONALS OR MULTI-DISCIPLINARY TEAM MEMBERS WITH: the diagnosis of mental, emotional, behavioral, addictive and developmental disorders and disabilities; patient assessment and evaluating; the provision of psychotherapeutic treatment; the provision of treatment other than psychotherapeutic treatment; [and/or] OR the development and implementa- tion of assessment-based treatment plans as defined in section seventy- seven hundred one of this article. (II) AS USED IN THIS SUBDIVISION, A TREATMENT PLAN SHALL BE LIMITED TO PLANS FOR TREATMENT WITHIN THE FOLLOWING SETTINGS: FACILITIES OR PROGRAMS OPERATING PURSUANT TO ARTICLE NINETEEN-G OF THE EXECUTIVE LAW S. 7507 69 A. 9507 OR PURSUANT TO ARTICLES SEVEN, SIXTEEN, THIRTY-ONE AND THIRTY-TWO OF THE MENTAL HYGIENE LAW. (III) AS USED IN THIS SUBDIVISION, THE TERM "ASSIST" SHALL INCLUDE THE PROVISION OF SERVICES WITHIN THE PRACTICE OF MASTER SOCIAL WORK OR CLIN- ICAL SOCIAL WORK, UNDER THE SUPERVISION OF A PERSON LICENSED UNDER THIS ARTICLE. (D) Provided, further, that nothing in this subdivision shall be construed as requiring a license for any particular activity or function based solely on the fact that the activity or function is not listed in this subdivision. 8. NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, NOTHING IN THIS ARTICLE SHALL BE CONSTRUED TO PROHIBIT OR LIMIT THE ACTIVITIES OR SERVICES PROVIDED BY ANY PERSON WHO IS EMPLOYED OR WHO COMMENCES EMPLOYMENT IN A PROGRAM OR SERVICE OPERATED, REGULATED, FUNDED, OR APPROVED BY THE DEPARTMENT OF MENTAL HYGIENE, THE OFFICE OF CHILDREN AND FAMILY SERVICES, THE DEPARTMENT OF CORRECTIONS AND COMMUNITY SUPER- VISION, THE OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE, THE STATE OFFICE FOR THE AGING AND THE DEPARTMENT OF HEALTH OR A LOCAL GOVERN- MENTAL UNIT AS THAT TERM IS DEFINED IN SECTION 41.03 OF THE MENTAL HYGIENE LAW OR A SOCIAL SERVICES DISTRICT AS DEFINED IN SECTION SIXTY- ONE OF THE SOCIAL SERVICES LAW ON OR BEFORE JULY FIRST, TWO THOUSAND TWENTY. PROVIDED HOWEVER, THAT ANY PERSON WHO COMMENCES EMPLOYMENT IN SUCH PROGRAM OR SERVICE AFTER JULY FIRST, TWO THOUSAND TWENTY AND PERFORMS SERVICES THAT ARE RESTRICTED UNDER THIS ARTICLE SHALL BE APPRO- PRIATELY LICENSED OR AUTHORIZED UNDER THIS ARTICLE. § 4. Subdivision 8 of section 8410 of the education law, as added by section 6 of part AA of chapter 57 of the laws of 2013, is amended and a new subdivision 9 is added to read as follows: 8. (A) Prevent a person without a license from: performing assessments such as basic information collection, gathering of demographic data, and informal observations, screening and referral used for general eligibil- ity for a program or service and determining the functional status of an individual for the purpose of determining need for services [unrelated to a behavioral health diagnosis or treatment plan. Such licensure shall not be required to create, develop or implement a service plan unrelated to a behavioral health diagnosis or treatment plan]; COUN- SELING INDIVIDUALS REGARDING THE APPROPRIATENESS OF BENEFITS THEY ARE ELIGIBLE FOR; PROVIDING GENERAL COUNSELING THAT IS NOT PSYCHOTHERAPY AND ASSISTING INDIVIDUALS OR GROUPS WITH DIFFICULT DAY TO DAY PROBLEMS SUCH AS FINDING EMPLOYMENT, LOCATING SOURCES OF ASSISTANCE, AND ORGANIZING COMMUNITY GROUPS TO WORK ON A SPECIFIC PROBLEM; PROVIDING PEER SERVICES; OR TO SELECT FOR SUITABILITY AND PROVIDE SUBSTANCE ABUSE TREATMENT SERVICES OR GROUP RE-ENTRY SERVICES TO INCARCERATED INDIVIDUALS IN STATE CORRECTIONAL FACILITIES. (B) PREVENT A PERSON WITHOUT A LICENSE FROM CREATING, DEVELOPING OR IMPLEMENTING A SERVICE PLAN OR RECOVERY PLAN THAT IS NOT A BEHAVIORAL HEALTH DIAGNOSIS OR TREATMENT PLAN. Such service OR RECOVERY plans shall include, but are not limited to, COORDINATING, EVALUATING OR DETERMINING THE NEED FOR, OR THE PROVISION OF THE FOLLOWING SERVICES: job training and employability[,]; housing[,]; HOMELESS SERVICES AND SHELTERS FOR HOMELESS INDIVIDUALS AND FAMILIES; REFUGEE SERVICES; RESIDENTIAL, DAY OR COMMUNITY HABILITATION SERVICES; general public assistance[,]; in home services and supports or home-delivered meals[, investigations conducted or assessments made by]; RECOVERY SUPPORTS; adult or child protective services INCLUDING INVESTIGATIONS; DETENTION AS DEFINED IN SECTION FIVE HUNDRED TWO OF THE EXECUTIVE LAW; PREVENTION AND RESIDENTIAL SERVICES S. 7507 70 A. 9507 FOR VICTIMS OF DOMESTIC VIOLENCE; SERVICES FOR RUNAWAY AND HOMELESS YOUTH; FOSTER CARE, ADOPTION, PREVENTIVE SERVICES OR SERVICES IN ACCORD- ANCE WITH AN APPROVED PLAN PURSUANT TO SECTION FOUR HUNDRED FOUR OF THE SOCIAL SERVICES LAW, INCLUDING, adoption AND FOSTER home studies and assessments, family service plans, transition plans [and], permanency planning activities, AND CASE PLANNING OR CASE MANAGEMENT AS SUCH TERMS ARE DEFINED IN PART FOUR HUNDRED TWENTY-EIGHT OF TITLE EIGHTEEN OF THE NEW YORK CODES, RULES AND REGULATIONS; RESIDENTIAL REHABILITATION; HOME AND COMMUNITY BASED SERVICES; AND de-escalation techniques, peer services or skill development. [A license under this article shall not be required for persons to participate] (C)(I) PREVENT A PERSON WITHOUT A LICENSE FROM PARTICIPATING as a member of a multi-disciplinary team to DEVELOP OR implement a [behav- ioral health services or] treatment plan; provided [however,] that such team shall include one or more professionals licensed under this article or articles one hundred thirty-one, ONE HUNDRED THIRTY-NINE, one hundred fifty-three or one hundred fifty-four of this chapter WHO MUST DIRECTLY OBSERVE EACH PATIENT EITHER IN PERSON OR BY ELECTRONIC MEANS, PRIOR TO THE RENDERING OF A DIAGNOSIS; and provided, further, that the activities performed by members of the team shall be consistent with the scope of practice for each team member licensed or authorized under title VIII of this chapter, and those who are not so authorized may not INDEPENDENTLY engage in the following restricted practices, BUT MAY ASSIST LICENSED PROFESSIONALS OR MULTIDISCIPLINARY TEAM MEMBERS WITH: the diagnosis of mental, emotional, behavioral, addictive and developmental disorders and disabilities; patient assessment and evaluating; the provision of psychotherapeutic treatment; the provision of treatment other than psychotherapeutic treatment; [and/or] OR the development and implementa- tion of assessment-based treatment plans as defined in section seventy- seven hundred one of this chapter. (II) AS USED IN THIS SUBDIVISION, A TREATMENT PLAN SHALL BE LIMITED TO PLANS FOR TREATMENT WITHIN THE FOLLOWING SETTINGS: FACILITIES OR PROGRAMS OPERATING PURSUANT TO ARTICLE NINETEEN-G OF THE EXECUTIVE LAW OR PURSUANT TO ARTICLES SEVEN, SIXTEEN, THIRTY-ONE AND THIRTY-TWO OF THE MENTAL HYGIENE LAW. (III) AS USED IN THIS SUBDIVISION, THE TERM "ASSIST" SHALL INCLUDE THE PROVISION OF SERVICES WITHIN THE PRACTICE OF MENTAL HEALTH COUNSELING, MARRIAGE AND FAMILY THERAPY, CREATIVE ARTS THERAPY OR PSYCHOANALYSIS, UNDER THE SUPERVISION OF A PERSON LICENSED UNDER THIS ARTICLE. (D) Provided, further, that nothing in this subdivision shall be construed as requiring a license for any particular activity or function based solely on the fact that the activity or function is not listed in this subdivision. 9. NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, NOTHING IN THIS ARTICLE SHALL BE CONSTRUED TO PROHIBIT OR LIMIT THE ACTIVITIES OR SERVICES PROVIDED BY ANY PERSON WHO IS EMPLOYED OR WHO COMMENCES EMPLOYMENT IN A PROGRAM OR SERVICE OPERATED, REGULATED, FUNDED, OR APPROVED BY THE DEPARTMENT OF MENTAL HYGIENE, THE OFFICE OF CHILDREN AND FAMILY SERVICES, THE DEPARTMENT OF CORRECTIONS AND COMMUNITY SUPER- VISION, THE OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE, THE STATE OFFICE FOR THE AGING AND THE DEPARTMENT OF HEALTH OR A LOCAL GOVERN- MENTAL UNIT AS THAT TERM IS DEFINED IN SECTION 41.03 OF THE MENTAL HYGIENE LAW OR A SOCIAL SERVICES DISTRICT AS DEFINED IN SECTION SIXTY- ONE OF THE SOCIAL SERVICES LAW ON OR BEFORE JULY FIRST, TWO THOUSAND TWENTY. PROVIDED HOWEVER, THAT ANY PERSON WHO COMMENCES EMPLOYMENT IN SUCH PROGRAM OR SERVICE AFTER JULY FIRST, TWO THOUSAND TWENTY AND S. 7507 71 A. 9507 PERFORMS SERVICES THAT ARE RESTRICTED UNDER THIS ARTICLE SHALL BE APPRO- PRIATELY LICENSED OR AUTHORIZED UNDER THIS ARTICLE. § 5. Not later than July 1, 2019 the department of mental hygiene, the office of children and family services, the office of temporary and disability assistance, the department of corrections and community supervision, the state office for the aging, or the department of health (hereinafter referred to as "agencies") shall individually or collec- tively consult with the state education department (hereinafter referred to as "department") to develop formal guidance for service providers authorized to operate under the respective agencies to identify the tasks and functions performed by each agency's service provider work- force categorized as tasks and functions restricted to licensed person- nel including tasks and functions that do not require a license under articles 153, 154 and 163 of the education law. Subsequent to such consultation, and not later than December 31, 2019, the department shall issue guidance to each such agency with respect to each agency's service provider workforce. Each agency may issue additional guidance from time to time, subject to consultation with the department. Notwithstanding any provision of law to the contrary, no person shall be held liable for unauthorized practice of a profession subject to licensure under arti- cles 153, 154 and 163 of the education law if such person acts in accordance with such agency guidance until July 1, 2020, to allow further consultation on guidance as necessary. Upon issuance by such state agency of guidance, the department shall have 180 days from the date of the issuance of such guidance to issue a statement of disagree- ment with the agency's guidance. If the department has issued a state- ment of disagreement, the department and state agency shall engage in a collaborative process to gather input from stakeholders to resolve the issues. § 6. Programs and services operated, regulated, funded, or approved by the department of mental hygiene, the office of children and family services, the department of corrections and community supervision, the office of temporary and disability assistance, the state office for the aging and the department of health or a local governmental unit as the term is defined in section 41.03 of the mental hygiene law or a social services district as defined in section 61 of the social services law shall not be required to receive a waiver pursuant to section 6503-a of the education law and, further, such programs and services shall also be considered to be approved settings for the receipt of supervised experi- ence for the professions governed by articles 153, 154 and 163 of the education law. § 7. Subdivision a of section 9 of chapter 420 of the laws of 2002 amending the education law relating to the profession of social work, as amended by section 1 of part J of chapter 59 of the laws of 2016, is amended to read as follows: a. Nothing in this act shall prohibit or limit the activities or services on the part of any person in the employ of a program or service operated, regulated, funded, or approved by the department of mental hygiene, the office of children and family services, the office of temporary and disability assistance, the department of corrections and community supervision, the state office for the aging, the department of health, or a local governmental unit as that term is defined in article 41 of the mental hygiene law or a social services district as defined in section 61 of the social services law, provided, however, this section shall not authorize the use of any title authorized pursuant to article S. 7507 72 A. 9507 154 of the education law, except that this section shall be deemed repealed on July 1, [2018] 2020. § 8. Subdivision a of section 17-a of chapter 676 of the laws of 2002, amending the education law relating to the practice of psychology, as amended by section 2 of part J of chapter 59 of the laws of 2016, is amended to read as follows: a. In relation to activities and services provided under article 153 of the education law, nothing in this act shall prohibit or limit such activities or services on the part of any person in the employ of a program or service operated, regulated, funded, or approved by the department of mental hygiene or the office of children and family services, or a local governmental unit as that term is defined in arti- cle 41 of the mental hygiene law or a social services district as defined in section 61 of the social services law. In relation to activ- ities and services provided under article 163 of the education law, nothing in this act shall prohibit or limit such activities or services on the part of any person in the employ of a program or service oper- ated, regulated, funded, or approved by the department of mental hygiene, the office of children and family services, the department of corrections and community supervision, the office of temporary and disa- bility assistance, the state office for the aging and the department of health or a local governmental unit as that term is defined in article 41 of the mental hygiene law or a social services district as defined in section 61 of the social services law, pursuant to authority granted by law. This section shall not authorize the use of any title authorized pursuant to article 153 or 163 of the education law by any such employed person, except as otherwise provided by such articles respectively. This section shall be deemed repealed July 1, [2018] 2020. § 9. Section 16 of chapter 130 of the laws of 2010, amending the education law and other laws relating to the registration of entities providing certain professional services and the licensure of certain professions, as amended by section 3 of part J of chapter 59 of the laws of 2016, is amended to read as follows: § 16. This act shall take effect immediately; provided that sections thirteen, fourteen and fifteen of this act shall take effect immediately and shall be deemed to have been in full force and effect on and after June 1, 2010 and such sections shall be deemed repealed July 1, [2018] 2020; provided further that the amendments to section 9 of chapter 420 of the laws of 2002 amending the education law relating to the profes- sion of social work made by section thirteen of this act shall repeal on the same date as such section repeals; provided further that the amend- ments to section 17-a of chapter 676 of the laws of 2002 amending the education law relating to the practice of psychology made by section fourteen of this act shall repeal on the same date as such section repeals. § 10. This act shall take effect immediately. PART Z Section 1. Subparagraph (vii) of paragraph e of subdivision 3 of section 364-j of the social services law, as amended by section 38 of part A of chapter 56 of the laws of 2013, is amended to read as follows: (vii) a person with a developmental or physical disability who receives home and community-based services or care-at-home services through A DEMONSTRATION WAIVER UNDER SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT, existing waivers under section nineteen S. 7507 73 A. 9507 hundred fifteen (c) of the federal social security act, or who has char- acteristics and needs similar to such persons; § 2. Clause (x) of subparagraph 1 of paragraph (e) of subdivision 5 of section 366 of the social services law, as added by section 26-a of part C of chapter 109 of the laws of 2006, is amended to read as follows: (x) "nursing facility services" means nursing care and health related services provided in a nursing facility; a level of care provided in a hospital which is equivalent to the care which is provided in a nursing facility; and care, services or supplies provided pursuant to a waiver granted pursuant to subsection (c) of section 1915 of the federal social security act OR SUCCESSOR FEDERAL WAIVER. § 3. Section 366 of the social services law is amended by adding a new subdivision 7-c to read as follows: 7-C. THE COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMISSIONER OF DEVELOPMENTAL DISABILITIES IS AUTHORIZED TO SUBMIT THE APPROPRIATE WAIVERS, INCLUDING, BUT NOT LIMITED TO, THOSE AUTHORIZED PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT, IN ORDER TO ACHIEVE THE PURPOSES OF HIGH-QUALITY AND INTEGRATED CARE AND SERVICES FOR A POPULATION OF PERSONS WITH DEVELOPMENTAL DISABILITIES, AS SUCH TERM IS DEFINED IN SECTION 1.03 OF THE MENTAL HYGIENE LAW. § 4. Subdivision 6-a of section 93 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 20 of part B of chapter 56 of the laws of 2013, is amended to read as follows: 6-a. section fifty-seven of this act shall expire and be deemed repealed on December 31, [2018] 2024; provided that the amendments made by such section to subdivision 4 of section 366-c of the social services law shall apply with respect to determining initial and continuing eligibility for medical assistance, including the continued eligibility of recipients originally determined eligible prior to the effective date of this act, and provided further that such amendments shall not apply to any person or group of persons if it is subsequently determined by the Centers for Medicare and Medicaid services or by a court of compe- tent jurisdiction that medical assistance with federal financial partic- ipation is available for the costs of services provided to such person or persons under the provisions of subdivision 4 of section 366-c of the social services law in effect immediately prior to the effective date of this act. § 5. Paragraph (a) of subdivision 2 of section 366-c of the social services law, as amended by section 68 of part A of chapter 56 of the laws of 2013, is amended to read as follows: (a) For purposes of this section an "institutionalized spouse" is a person (i) who is in a medical institution or nursing facility and expected to remain in such facility or institution for at least thirty consecutive days; or (ii) who is receiving care, services and supplies pursuant to a waiver pursuant to subsection (c) of section nineteen hundred fifteen of the federal social security act, OR SUCCESSOR TO SUCH WAIVER, or is receiving care, services and supplies in a managed long- term care plan pursuant to section eleven hundred fifteen of the social security act; and (iii) who is married to a person who is not in a medical institution or nursing facility or is not receiving waiver services described in subparagraph (ii) of this paragraph; provided, however, that medical assistance shall be furnished pursuant to this paragraph only if, for so long as, and to the extent that federal finan- S. 7507 74 A. 9507 cial participation is available therefor. The commissioner of health shall make any amendments to the state plan for medical assistance, or apply for any waiver or approval under the federal social security act that are necessary to carry out the provisions of this paragraph. § 6. The closing paragraph of subdivision 4 of section 366-c of the social services law, as amended by section 42 of part D of chapter 58 of the laws of 2009, is amended to read as follows: provided, however, that, to the extent required by federal law, the terms of this subdivision shall not apply to persons who are receiving care, services and supplies pursuant to the following waivers under section 1915(c) of the federal social security act: the nursing facility transition and diversion waiver authorized pursuant to subdivision six-a of section three hundred sixty-six of this title; the traumatic brain injury waiver authorized pursuant to section twenty-seven hundred forty of the public health law, the long term home health care program waiver authorized pursuant to section three hundred sixty-seven-c of this title, and the home and community based services waiver for persons with developmental disabilities, OR SUCCESSOR TO SUCH WAIVER, administered by the office [of mental retardation and] FOR PEOPLE WITH developmental disabilities pursuant to an agreement with the federal centers for medi- care and Medicaid services. § 7. Paragraph 4 of subdivision (a) of section 16.03 of the mental hygiene law, as added by section 6 of part MM of chapter 58 of the laws of 2015, is amended to read as follows: (4) The provision of home and community based services approved under a waiver program authorized pursuant to SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT OR 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, provided that an operating certificate issued pursuant to this paragraph shall only authorize services in a home or community setting. § 8. Paragraph 2 of subdivision (a) of section 16.11 of the mental hygiene law, as added by section 10 of part MM of chapter 58 of the laws of 2015, is amended to read as follows: (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, OR OTHER SUCCESSOR MEDICAID WAIVER PROGRAM, and applicable federal regu- lation, subdivisions seven and seven-a of section three hundred sixty- six of the social services law and rules and regulations adopted by the commissioner. § 9. Subdivision (b) of section 80.03 of the mental hygiene law, as amended by chapter 37 of the laws of 2011, is amended to read as follows: (b) "A patient in need of surrogate decision-making" means a patient as defined in subdivision twenty-three of section 1.03 of this chapter who is: a resident of a mental hygiene facility including a resident of housing programs funded by an office of the department or whose federal funding application was approved by an office of the department or for whom such facility maintains legal admission status therefor; or, receiving home and community-based services for persons with mental disabilities provided pursuant to section 1915 OR 1115 of the federal social security act; or receiving individualized support services; or, case management or service coordination funded, approved, or provided by S. 7507 75 A. 9507 the office for people with developmental disabilities; and, for whom major medical treatment is proposed, and who is determined by the surro- gate decision-making committee to lack the ability to consent to or refuse such treatment, but shall not include minors with parents or persons with legal guardians, committees or conservators who are legally authorized, available and willing to make such health care decisions. Once a person is eligible for surrogate decision-making, such person may continue to receive surrogate decision-making as authorized by this section regardless of a change in residential status. § 10. Subdivision 1-a of section 84 of part A of chapter 56 of the laws of 2013, 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 2013-2014 state fiscal year, is amended to read as follows: [1-a. sections seventy-three through eighty-a shall expire and be deemed repealed September 30, 2019] § 11. Paragraph (a-1) of subdivision 8 of section 4403 of the public health law, as amended by chapter 474 of the laws of 2015, is amended to read as follows: (a-1) If the commissioner and the commissioner of the office for people with developmental disabilities determine that such organization lacks the experience required in paragraph (a) of this subdivision, the organization shall have an affiliation arrangement with an entity or entities that are CONTROLLED BY non-profit ORGANIZATIONS with experience serving persons with developmental disabilities, AS DEMONSTRATED BY CRITERIA TO BE DETERMINED BY THE COMMISSIONER AND THE COMMISSIONER OF THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, WITH SUCH CRITE- RIA including, but not limited to, residential, day, and employment services such that the affiliated entity will coordinate and plan services operated, certified, funded, authorized or approved by the office for people with developmental disabilities or will oversee and approve such coordination and planning; § 12. 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 20 of part D of chapter 57 of the laws of 2015, is amended to read as follows: § 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, [2019] 2024 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. § 13. Paragraph (a-1) of subdivision 12 of section 4403-f of the public health law, as amended by chapter 474 of the laws of 2015, is amended to read as follows: (a-1) If the commissioner and the commissioner of the office for people with developmental disabilities determine that such plan lacks the experience required in paragraph (a) of this subdivision, the plan shall have an affiliation arrangement with an entity or entities that S. 7507 76 A. 9507 are CONTROLLED BY non-profit ORGANIZATIONS with experience serving persons with developmental disabilities, AS DEMONSTRATED BY CRITERIA TO BE DETERMINED BY THE COMMISSIONER AND THE COMMISSIONER OF THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, WITH SUCH CRITERIA including, but not limited to, residential, day and employment services, such that the affiliated entity will coordinate and plan services operated, certi- fied, funded, authorized or approved by the office for people with developmental disabilities or will oversee and approve such coordination and planning; § 14. Paragraph (d) of subdivision 1 of section 4403-g of the public health law, as added by section 73 of part A of chapter 56 of the laws of 2013, is amended to read as follows: (d) "Health and long term care services" means COMPREHENSIVE HEALTH services AND OTHER SERVICES AS DETERMINED BY THE COMMISSIONER AND THE COMMISSIONER OF THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, whether provided by state-operated programs or not-for-profit entities, including, but not limited to, habilitation services, home and communi- ty-based and institution-based long term care services, and ancillary services, that shall include medical supplies and nutritional supple- ments, that are necessary to meet the needs of persons whom the plan is authorized to enroll[, and may include primary care and acute care if the DISCO is authorized to provide or arrange for such services]. Each person enrolled in a DISCO shall receive health and long term care services designed to achieve person-centered outcomes, to enable that person to live in the most integrated setting appropriate to that person's needs, and to enable that person to interact with nondisabled persons to the fullest extent possible in social, workplace and other community settings, provided that all such services are consistent with such person's wishes to the extent that such wishes are known and in accordance with such person's needs. § 15. Paragraph (b) of subdivision 3 of section 4403-g of the public health law, as added by section 73 of part A of chapter 56 of the laws of 2013, is amended to read as follows: (b) A description of the services to be covered by such DISCO, WHICH MUST INCLUDE ALL HEALTH AND LONG TERM CARE SERVICES, AS DEFINED IN PARA- GRAPH (D) OF SUBDIVISION ONE OF THIS SECTION, AND OTHER SERVICES AS DETERMINED BY THE COMMISSIONER AND THE COMMISSIONER OF THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES; § 16. Paragraph (j) of subdivision 4 of section 4403-g of the public health law, as added by section 73 of part A of chapter 56 of the laws of 2013, is amended to read as follows: (j) Readiness and capability [to arrange and manage covered services] OF ORGANIZING, MARKETING, MANAGING, PROMOTING AND OPERATING A HEALTH AND LONG TERM CARE SERVICES PLAN, OR HAS AN AFFILIATION AGREEMENT WITH AN ENTITY THAT HAS SUCH READINESS AND CAPABILITY; § 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 17 of part D of chapter 57 of the laws of 2015, 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, [2019] 2024 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. 7507 77 A. 9507 § 18. Subdivision (c) of section 13.40 of the mental hygiene law, as added by section 72-b of part A of chapter 56 of the laws of 2013, is amended to read as follows: (c) No person with a developmental disability who is receiving or applying for medical assistance and who is receiving, or eligible to receive, services operated, funded, certified, authorized or approved by the office, shall be required to enroll in a DISCO, HMO or MLTC in order to receive such services until program features and reimbursement rates are approved by the commissioner and the commissioner of health, and until such commissioners determine that a sufficient number of plans that are authorized to coordinate care for individuals pursuant to this section or that are authorized to operate and to exclusively enroll persons with developmental disabilities pursuant to subdivision twenty- seven of section three hundred sixty-four-j of the social services law are operating in such person's county of residence to meet the needs of persons with developmental disabilities, and that such entities meet the standards of this section. No person shall be required to enroll in a DISCO, HMO or MLTC in order to receive services operated, funded, certi- fied, authorized or approved by the office until there are at least two entities operating under this section in such person's county of resi- dence, unless federal approval is secured to require enrollment when there are less than two such entities operating in such county. NOTWITH- STANDING THE FOREGOING OR ANY OTHER LAW TO THE CONTRARY, ANY HEALTH CARE PROVIDER: (I) ENROLLED IN THE MEDICAID PROGRAM AND (II) RENDERING HOSPI- TAL SERVICES, AS SUCH TERM IS DEFINED IN SECTION TWENTY-EIGHT HUNDRED ONE OF THE PUBLIC HEALTH LAW, TO AN INDIVIDUAL WITH A DEVELOPMENTAL DISABILITY WHO IS ENROLLED IN A DISCO, HMO OR MLTC, OR A PREPAID HEALTH SERVICES PLAN OPERATING PURSUANT TO SECTION FORTY-FOUR HUNDRED THREE-A OF THE PUBLIC HEALTH LAW, INCLUDING, BUT NOT LIMITED TO, AN INDIVIDUAL WHO IS ENROLLED IN A PLAN AUTHORIZED BY SECTION THREE HUNDRED SIXTY- FOUR-J OR THE SOCIAL SERVICES LAW, SHALL ACCEPT AS FULL REIMBURSEMENT THE NEGOTIATED RATE OR, IN THE EVENT THAT THERE IS NO NEGOTIATED RATE, THE RATE OF PAYMENT THAT THE APPLICABLE GOVERNMENT AGENCY WOULD OTHER- WISE PAY FOR SUCH RENDERED HOSPITAL SERVICES. § 19. Section 11 of chapter 710 of the laws of 1988, amending the social services law and the education law relating to medical assistance eligibility of certain persons and providing for managed medical care demonstration programs, as amended by section 1 of part F of chapter 73 of the laws of 2016, is amended to read as follows: § 11. This act shall take effect immediately; except that the provisions of sections one, two, three, four, eight and ten of this act shall take effect on the ninetieth day after it shall have become a law; and except that the provisions of sections five, six and seven of this act shall take effect January 1, 1989; and except 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 are authorized and directed to be made and completed on or before such effective date; provided, however, that the provisions of section 364-j of the social services law, as added by section one of this act shall expire and be deemed repealed on and after March 31, [2019] 2024, the provisions of section 364-k of the social services law, as added by section two of this act, except subdivision 10 of such section, shall expire and be deemed repealed on and after January 1, 1994, and the provisions of subdivision 10 of section 364-k of the social services law, as added by section two of this act, shall expire and be deemed repealed on January 1, 1995. S. 7507 78 A. 9507 § 20. This act shall take effect immediately; provided, however, that the amendments to subparagraph (vii) of paragraph e of subdivision 3 of section 364-j of the social services law made by section one of this act shall not affect the repeal of such section and shall be deemed repealed therewith; provided further, however, that the amendments to subdivision 4 of section 366-c of the social services law made by section six of this act shall not affect the expiration of such subdivision and shall be deemed to expire therewith; provided further, however, that the amendments to paragraph (a-1) of subdivision 12 of section 4403-f of the public health law made by section thirteen of this act shall not affect the repeal of such section and shall be deemed to be repealed therewith. PART AA Section 1. Subdivisions 3-b and 3-c of section 1 of part C of chapter 57 of the laws of 2006, relating to establishing a cost of living adjustment for designated human services programs, as amended by section 1 of part Q of chapter 57 of the laws of 2017, are amended to read as follows: 3-b. Notwithstanding any inconsistent provision of law, beginning April 1, 2009 and ending March 31, 2016 and beginning April 1, 2017 and ending March 31, [2018] 2019, the commissioners shall not include a COLA for the purpose of establishing rates of payments, contracts or any other form of reimbursement, provided that the commissioners of the office for people with developmental disabilities, the office of mental health, and the office of alcoholism and substance abuse services shall not include a COLA beginning April 1, 2017 and ending March 31, 2019. 3-c. Notwithstanding any inconsistent provision of law, beginning April 1, [2018] 2019 and ending March 31, [2021] 2022, the commissioners shall develop the COLA under this section using the actual U.S. consumer price index for all urban consumers (CPI-U) published by the United States department of labor, bureau of labor statistics for the twelve month period ending in July of the budget year prior to such state fiscal year, for the purpose of establishing rates of payments, contracts or any other form of reimbursement. § 2. This act shall take effect immediately and shall be deemed to have been in full force and effect on and after April 1, 2018; provided, however, that the amendments to section 1 of part C of chapter 57 of the laws of 2006 made by section one of this act shall not affect the repeal of such section and shall be deemed repealed therewith. § 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. § 3. This act shall take effect immediately provided, however, that the applicable effective date of Parts A through AA of this act shall be as specifically set forth in the last section of such Parts.
2017-S7507A - Details
2017-S7507A - Summary
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2018-2019 state fiscal year; relates to distributions from the general hospital indigent care pool; directs a review of the feasibility of creating a burn center in Kings county; and relates to rates of reimbursement for certain residential health care facilities (Part A)
2017-S7507A - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ S. 7507--A A. 9507--A S E N A T E - A S S E M B L Y January 18, 2018 ___________ IN SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti- cle seven of the Constitution -- read twice and ordered printed, and when printed to be committed to the Committee on Finance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee IN ASSEMBLY -- A BUDGET BILL, submitted by the Governor pursuant to article seven of the Constitution -- read once and referred to the Committee on Ways and Means -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the public health law, in relation to establishing a temporary workgroup on capital rate methodology for capital expendi- tures to hospitals and residential nursing facilities; and to amend the social services law, in relation to standard coverage for physical therapy services under medical assistance for needy persons programs (Part A); to amend the public health law, in relation to payments to residential health care facilities; to amend the social services law and the public health law, in relation to assisted living program providers licensed in the state; to amend the social services law, in relation to payments for certain medical assistance provided to eligi- ble persons participating in the New York traumatic brain injury waiv- er program; and to repeal certain provisions of section 366 of the social services law relating to furnishing medical assistance (Part B); to amend the social services law and the public health law, in relation to health homes and penalties for managed care providers (Part C); to amend the social services law and the public health law, in relation to drug coverage, updating the professional dispensing fee, copayments, pharmacist physician collaboration and comprehensive medication management; and to repeal certain provisions of the social services law relating thereto (Part D); to amend the social services law, in relation to reimbursement of transportation costs, reimburse- ment of emergency transportation services and supplemental transporta- tion payments; and repealing certain provisions of such law relating thereto (Part E); providing for not-for-profit and tax exempt corpo- rations' Medicaid capitation rates (Part F); to amend the public health law, in relation to authorizing certain retail practices to offer health services (Part G); to amend the education law, in
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD12671-02-8 S. 7507--A 2 A. 9507--A relation to the practice of nursing by certified registered nurse anesthetists (Part H); to amend the social services law and the public health law, in relation to managed care organizations (Part I); to amend the state finance law, in relation to the false claims act (Part J); authorizing the department of health to require certain health care providers to report on costs incurred; and to amend chapter 59 of the laws of 2011 amending the public health law and other laws relat- ing to known and projected department of health state fund medicaid expenditures, in relation to extending the medicaid global cap (Part K); to amend the social services law and the public health law, in relation to the child health insurance program (Part L); to amend chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, in relation to apportioning premium for certain policies; to amend part J of chapter 63 of the laws of 2001 amending chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, relat- ing to the effectiveness of certain provisions of such chapter, in relation to extending certain provisions concerning the hospital excess liability pool; and to amend part H of chapter 57 of the laws of 2017, amending the New York Health Care Reform Act of 1996 and other laws relating to extending certain provisions relating thereto, in relation to extending provisions relating to excess coverage (Part M); to amend part C of chapter 57 of the laws of 2006, establishing a cost of living adjustment for designated human services, in relation to the determination thereof; and to repeal certain provisions thereof relating to eligible programs (Part N); to amend the public health law and the insurance law, in relation to the early intervention program for infants and toddlers with disabilities and their families (Part O); to amend the public health law, in relation to the empire clinical research investigator program and hospital resident hour audits; and to repeal certain provisions of the public health law relating thereto (Part P); to amend the public health law, in relation to the health care facility transformation program (Part Q); to amend the public health law, the executive law, and the real property law, in relation to areas at a high risk for lead paint (Part R); to amend the public health law and the social services law, in relation to the establish- ment of community paramedicine collaboratives (Subpart A); to amend the public health law and the mental hygiene law, in relation to inte- grated services (Subpart B); and to amend the public health law, in relation to the definitions of telehealth provider, originating site and remote patient monitoring (Subpart C)(Part S); to amend chapter 59 of the laws of 2016, amending the social services law and other laws relating to authorizing the commissioner of health to apply federally established consumer price index penalties for generic drugs, and authorizing the commissioner of health to impose penalties on managed care plans for reporting late or incorrect encounter data, in relation to the effectiveness of certain provisions of such chapter; to amend chapter 58 of the laws of 2007, amending the social services law and other laws relating to adjustments of rates, in relation to the effec- tiveness of certain provisions of such chapter; to amend chapter 54 of the laws of 2016, amending part C of chapter 58 of the laws of 2005, authorizing reimbursements for expenditures made by or on behalf of social services districts for medical assistance for needy persons and administration thereof, in relation to the effectiveness thereof; to amend chapter 906 of the laws of 1984, amending the social services S. 7507--A 3 A. 9507--A law relating to expanding medical assistance eligibility and the scope of services available to certain persons with disabilities, in relation to the effectiveness thereof; and 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 rates of payments (Part T); to amend part NN of chapter 58 of the laws of 2015 amending the mental hygiene law relating to clarifying the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs, in relation to the effectiveness thereof (Part U); to amend chapter 62 of the laws of 2003, amending the mental hygiene law and the state finance law relating to the community mental health support and workforce reinvestment program, the membership of subcommittees for mental health of community services boards and the duties of such subcommittees and creating the community mental health and workforce reinvestment account, in relation to extending such provisions relating thereto (Part V); to amend the criminal procedure law, in relation to amending the definition of appropriate institu- tion; and providing for the repeal of such provisions upon expiration thereof (Part W); to amend 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 X); to amend the education law, in relation to persons practicing in certain licensed programs or services who are exempt from practice requirements of professionals licensed by the department of education; to amend chapter 420 of the laws of 2002, amending the education law relating to the profession of social work, in relation to extending the expiration of certain provisions thereof; to amend chapter 676 of the laws of 2002, amending the education law relating to the practice of psychology, in relation to extending the expiration of certain provisions; and to amend chap- ter 130 of the laws of 2010, amending the education law and other laws relating to the registration of entities providing certain profes- sional services and licensure of certain professions, in relation to extending certain provisions thereof (Part Y); to amend the social services law, in relation to adding demonstration waivers to waivers allowable for home and community-based services; to amend the social services law, in relation to adding successor federal waivers to waiv- ers granted under subsection (c) of section 1915 of the federal social security law, in relation to nursing facility services; to amend the social services law, in relation to waivers for high quality and inte- grated care; to amend the mental hygiene law, in relation to adding new and successor federal waivers to waivers in relation to home and community-based services; to amend part A of chapter 56 of the laws of 2013, 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 2013-2014 state fiscal year, in relation to the effectiveness of certain provisions thereof; to amend the public health law, in relation to expansion of comprehen- sive health services 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 extending provisions thereof; to amend the public health law, in relation to managed long term care plans, health and long term care services and S. 7507--A 4 A. 9507--A developmental disability individual support and care coordination organizations; 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 extending the provisions thereof; to amend the mental hygiene law, in relation to reimbursement rates; and to amend chapter 710 of the laws of 1988, amending the social services law and the education law relating to medical assistance eligibility of certain persons and providing for managed medical care demonstration programs, in relation to extending the provisions there- of (Part Z); to amend part C of chapter 57 of the laws of 2006, relat- ing to establishing a cost of living adjustment for designated human services programs, in relation to the inclusion and development of certain cost of living adjustments (Part AA); to amend the public health law and the penal law, in relation to expanding the list of controlled substances (Part BB); to amend the education law and the public health law, in relation to inquiries or complaints of profes- sional misconduct (Part CC); and to amend the education law, in relation to authorizing a licensed pharmacist to administer influenza vaccine to children between two and eighteen years of age pursuant to a non-patient specific regimen; to amend chapter 563 of the laws of 2008, amending the education law and the public health law relating to immunizing agents to be administered to adults by pharmacists, in relation to making the provisions permanent; to amend chapter 116 of the laws of 2012, amending the education law relating to authorizing a licensed pharmacist and certified nurse practitioner to administer certain immunizing agents, in relation to making certain provisions permanent; and to amend chapter 21 of the laws of 2011, amending the education law relating to authorizing pharmacists to perform collabo- rative drug therapy management with physicians in certain settings, in relation to making certain provisions permanent (Part DD) 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 2018-2019 state fiscal year. Each component is wholly contained within a Part identified as Parts A through DD. The effective date for each particular provision contained within such Part is set forth in the last section of such Part. Any provision in any section contained within a Part, includ- ing the effective date of the Part, which makes a reference to a section "of this act", when used in connection with that particular component, shall be deemed to mean and refer to the corresponding section of the Part in which it is found. Section three of this act sets forth the general effective date of this act. PART A Section 1. The public health law is amended by adding a new section 2827 to read as follows: § 2827. TEMPORARY WORKGROUP ON CAPITAL RATE METHODOLOGY. (A) THE COMMISSIONER SHALL CONVENE A TEMPORARY WORKGROUP COMPRISED OF REPRESEN- TATIVES OF HOSPITALS AND RESIDENTIAL NURSING FACILITIES, AS WELL AS REPRESENTATIVES FROM THE DEPARTMENT, TO DEVELOP RECOMMENDATIONS FOR STREAMLINING THE CAPITAL REIMBURSEMENT METHODOLOGY TO ACHIEVE A ONE S. 7507--A 5 A. 9507--A PERCENT REDUCTION IN CAPITAL EXPENDITURES TO HOSPITALS AND RESIDENTIAL NURSING FACILITIES, INCLUDING ASSOCIATED SPECIALTY AND ADULT DAY HEALTH CARE UNITS. PENDING THE DEVELOPMENT OF THE WORKGROUP'S RECOMMENDATIONS AND THE IMPLEMENTATION OF ANY SUCH RECOMMENDATIONS ACCEPTED BY THE COMMISSIONER, THE COMMISSIONER SHALL BE AUTHORIZED TO REDUCE THE OVERALL AMOUNT OF CAPITAL REIMBURSEMENT AS NECESSARY TO ACHIEVE A ONE PERCENT REDUCTION IN CAPITAL EXPENDITURES BEGINNING WITH STATE FISCAL YEAR TWO THOUSAND EIGHTEEN--TWO THOUSAND NINETEEN. (B) THE COMMISSIONER MAY PROMULGATE REGULATIONS TO EFFECTUATE THE PROVISIONS OF THIS SECTION. § 2. Subdivision 5-d of section 2807-k of the public health law, as amended by section 1 of part E of chapter 57 of the laws of 2015, 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 [eigh- teen] NINETEEN, 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 [eighteen] NINETEEN 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 (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. S. 7507--A 6 A. 9507--A (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 Janu- ary 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; AND FOR THE CALENDAR YEAR BEGINNING ON JANUARY FIRST, TWO THOUSAND NINETEEN, IS GREATER THAN SEVENTEEN AND ONE-HALF PERCENT. (iv) Such regulations shall reserve one percent of the funds available for distribution in the two thousand fourteen and two thousand fifteen calendar years, and for calendar years thereafter, pursuant to this subdivision, 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 establish 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. § 3. Subdivision 14-a of section 2807 of the public health law, as added by section 11 of part B of chapter 57 of the laws of 2015, is amended to read as follows: 14-a. (A) Notwithstanding any provision of law to the contrary, and subject to federal financial participation, the commissioner is author- ized to establish, pursuant to regulations, a statewide general hospital quality pool for the purpose of incentivizing and facilitating quality improvements in general hospitals. (B) SUCH REGULATIONS SHALL INCLUDE PROVISIONS: (I) TO CREATE A PERFORMANCE TARGET TO REDUCE POTENTIALLY PREVENTABLE EMERGENCY DEPARTMENT VISITS; (II) TO REDUCE OR ELIMINATE THE PAYMENT OF THE RATES, PUBLISHED BY THE DEPARTMENT ON THE HOSPITAL INPATIENT PUBLICATION SCHEDULES AND HOSPITAL AMBULATORY PATIENT GROUP SCHEDULES, WHICH ARE PAID BY CONTRACTORS TO HOSPITALS, BASED ON THE QUALITY AND SAFETY SCORES OF A HOSPITAL AS DETERMINED BY THE DEPARTMENT; AND (III) TO FACILITATE NECESSARY QUALITY IMPROVEMENTS IN HOSPITALS, AS DETERMINED BY THE COMMISSIONER. S. 7507--A 7 A. 9507--A (C) Awards from such pool shall be subject to approval by the director of budget. If federal financial participation is unavailable, then the non-federal share of awards made pursuant to this subdivision may be made as state grants. [(a)] (D) Thirty days prior to adopting or applying a methodology or procedure for making an allocation or modification to an allocation made pursuant to this subdivision, the commissioner shall provide written notice to the chairs of the senate finance committee, the assembly ways and means committee, and the senate and assembly health committees with regard to the intent to adopt or apply the methodology or procedure, including a detailed explanation of the methodology or procedure. [(b)] (E) Thirty days prior to executing an allocation or modification to an allocation made pursuant to this subdivision, the commissioner shall provide written notice to the chairs of the senate finance commit- tee, the assembly ways and means committee, and the senate and assembly health committees with regard to the intent to distribute such funds. Such notice shall include, but not be limited to, information on the methodology used to distribute the funds, the facility specific allo- cations of the funds, any facility specific project descriptions or requirements for receiving such funds, the multi-year impacts of these allocations, and the availability of federal matching funds. The commis- sioner shall provide quarterly reports to the chair of the senate finance committee and the chair of the assembly ways and means committee on the distribution and disbursement of such funds. (F) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF LAW OR REGULATION TO THE CONTRARY, THE HOSPITAL QUALITY POOL SHALL ALLOCATE TEN MILLION DOLLARS ANNUALLY TO EXPAND PREVENTATIVE SERVICES AS THE COMMISSIONER MAY DETERMINE IN REGULATION. SUCH PREVENTATIVE SERVICES MAY INCLUDE BUT NOT BE LIMITED TO MENTAL HEALTH COUNSELING PROVIDED BY A LICENSED CLINICAL SOCIAL WORKER OR A LICENSED MASTER SOCIAL WORKER, PHYSICAL THERAPY, DIABETES PREVENTION, OR TREATMENT BY AN APPLIED BEHAVIOR ANALYST. § 4. Subparagraph (ii) of paragraph (f) of subdivision 2-a of section 2807 of the public health law, as amended by section 43 of part B of chapter 58 of the laws of 2010, is amended to read as follows: (ii) notwithstanding the provisions of paragraphs (a) and (b) of this subdivision, for periods on and after January first, two thousand nine, the following services provided by general hospital outpatient depart- ments and diagnostic and treatment centers shall be reimbursed with rates of payment based entirely upon the ambulatory patient group meth- odology as described in paragraph (e) of this subdivision, provided, however, that the commissioner may utilize existing payment methodol- ogies or may promulgate regulations establishing alternative payment methodologies for one or more of the services specified in this subpara- graph, effective for periods on and after March first, two thousand nine: (A) services provided in accordance with the provisions of paragraphs (q) and (r) of subdivision two of section three hundred sixty-five-a of the social services law; and (B) all services, but only with regard to additional payment amounts, as determined in accordance with regulations issued in accordance with paragraph (e) of this subdivision, for the provision of such services during times outside the facility's normal hours of operation, as deter- mined in accordance with criteria set forth in such regulations; and (C) individual psychotherapy services provided by licensed social workers, in accordance with licensing criteria set forth in applicable regulations[, to persons under the age of twenty-one and to persons S. 7507--A 8 A. 9507--A requiring such services as a result of or related to pregnancy or giving birth]; and (D) individual psychotherapy services provided by licensed social workers, in accordance with licensing criteria set forth in applicable regulations, at diagnostic and treatment centers that provided, billed for, and received payment for these services between January first, two thousand seven and December thirty-first, two thousand seven; (E) services provided to pregnant women pursuant to paragraph (s) of subdivision two of section three hundred sixty-five-a of the social services law and, for periods on and after January first, two thousand ten, all other services provided pursuant to such paragraph (s) and services provided pursuant to paragraph (t) of subdivision two of section three hundred sixty-five-a of the social services law; (F) wheelchair evaluation services and eyeglass dispensing services; and (G) immunization services, effective for services rendered on and after June tenth, two thousand nine. § 5. Paragraph (h) of subdivision 2 of section 365-a of the social services law, as amended by chapter 220 of the laws of 2011, is amended to read as follows: (h) speech therapy, and when provided at the direction of a physician or nurse practitioner, physical therapy including related rehabilitative services and occupational therapy; provided, however, that speech thera- py[, physical therapy] and occupational therapy [each] shall be limited to coverage of twenty visits per year; PHYSICAL THERAPY SHALL BE LIMITED TO COVERAGE OF FORTY VISITS PER YEAR; such limitation shall not apply to persons with developmental disabilities or, notwithstanding any other provision of law to the contrary, to persons with traumatic brain inju- ry; § 6. This act shall take effect immediately. PART B Section 1. Subdivision 2-c of section 2808 of the public health law is amended by adding a new paragraph (g) to read as follows: (G) THE COMMISSIONER SHALL REDUCE MEDICAID REVENUE TO A RESIDENTIAL HEALTH CARE FACILITY IN A PAYMENT YEAR BY TWO PERCENT IF IN EACH OF THE TWO MOST RECENT PAYMENT YEARS FOR WHICH NEW YORK STATE NURSING HOME QUALITY INITIATIVE DATA IS AVAILABLE, THE FACILITY WAS RANKED IN THE LOWEST TWO QUINTILES OF FACILITIES BASED ON ITS NURSING HOME QUALITY INITIATIVE PERFORMANCE, AND WAS RANKED IN THE LOWEST QUINTILE IN THE MOST RECENT PAYMENT YEAR. THE COMMISSIONER MAY WAIVE THE APPLICATION OF THIS PARAGRAPH TO A FACILITY IF THE COMMISSIONER DETERMINES THAT THE FACILITY IS IN EXTREME FINANCIAL DISTRESS. § 2. Subdivision 3 of section 461-l of the social services law is amended by adding four new paragraphs (k), (l), (m) and (n) to read as follows: (K)(I) EXISTING ASSISTED LIVING PROGRAM PROVIDERS LICENSED ON OR BEFORE APRIL FIRST, TWO THOUSAND EIGHTEEN MAY APPLY TO THE DEPARTMENT FOR UP TO NINE ADDITIONAL ASSISTED LIVING PROGRAM BEDS, BY A DEADLINE TO BE DETERMINED BY THE DEPARTMENT. THE DEPARTMENT MAY UTILIZE AN EXPEDITED REVIEW PROCESS TO ALLOW ELIGIBLE APPLICANTS IN GOOD STANDING THE ABILITY TO BE LICENSED FOR THE ADDITIONAL BEDS WITHIN NINETY DAYS OF THE DEPART- MENT'S RECEIPT OF A SATISFACTORY APPLICATION. ELIGIBLE APPLICANTS ARE THOSE THAT: DO NOT REQUIRE MAJOR RENOVATION OR CONSTRUCTION; SERVE ONLY S. 7507--A 9 A. 9507--A PUBLIC PAY INDIVIDUALS; AND ARE IN SUBSTANTIAL COMPLIANCE WITH APPROPRI- ATE STATE AND LOCAL REQUIREMENTS AS DETERMINED BY THE DEPARTMENT. (II) EXISTING ASSISTED LIVING PROGRAM PROVIDERS LICENSED ON OR BEFORE APRIL FIRST, TWO THOUSAND TWENTY MAY SUBMIT ADDITIONAL APPLICATIONS FOR UP TO NINE ADDITIONAL ASSISTED LIVING PROGRAM BEDS ON JUNE THIRTIETH, TWO THOUSAND TWENTY, AND BY A DEADLINE TO BE DETERMINED BY THE DEPART- MENT. EVERY TWO YEARS THEREAFTER, EXISTING PROVIDERS LICENSED ON OR BEFORE APRIL FIRST OF SUCH YEAR MAY SUBMIT SUCH APPLICATIONS ON JUNE THIRTIETH OF SUCH YEAR, AND BY A DEADLINE TO BE DETERMINED BY THE DEPARTMENT. THE NUMBER OF ADDITIONAL ASSISTED LIVING PROGRAM BEDS SHALL BE BASED ON THE TOTAL NUMBER OF PREVIOUSLY AWARDED BEDS EITHER WITHDRAWN BY THE APPLICANT OR DENIED BY THE DEPARTMENT. (L) THE COMMISSIONER OF HEALTH IS AUTHORIZED TO SOLICIT AND AWARD APPLICATIONS FOR UP TO A TOTAL OF FIVE HUNDRED NEW ASSISTED LIVING PROGRAM BEDS IN THOSE COUNTIES WHERE THERE IS ONE OR NO ASSISTED LIVING PROGRAM PROVIDERS, PURSUANT TO CRITERIA TO BE DETERMINED BY THE COMMIS- SIONER. (M) THE COMMISSIONER OF HEALTH IS AUTHORIZED TO SOLICIT AND AWARD APPLICATIONS FOR UP TO FIVE HUNDRED NEW ASSISTED LIVING PROGRAM BEDS IN COUNTIES WHERE UTILIZATION OF EXISTING ASSISTED LIVING PROGRAM BEDS EXCEEDS EIGHTY-FIVE PERCENT. ALL APPLICANTS SHALL COMPLY WITH FEDERAL HOME AND COMMUNITY-BASED SETTINGS REQUIREMENTS, AS SET FORTH IN 42 CFR PART 441 SUBPART G. TO BE ELIGIBLE FOR AN AWARD, AN APPLICANT MUST AGREE TO: (I) SERVE ONLY PUBLIC PAY INDIVIDUALS; (II) DEVELOP AND EXECUTE COLLABORATIVE AGREEMENTS WITHIN TWENTY-FOUR MONTHS OF AN APPLICATION BEING MADE TO THE DEPARTMENT, IN ACCORDANCE WITH GUIDANCE TO BE PUBLISHED BY THE DEPARTMENT, BETWEEN AT LEAST ONE OF EACH OF THE FOLLOWING ENTITIES: AN ADULT CARE FACILITY; A RESIDENTIAL HEALTH CARE FACILITY; AND A GENERAL HOSPITAL; (III) ENTER INTO AN AGREEMENT WITH AN EXISTING MANAGED CARE ENTITY; AND (IV) PARTICIPATE IN VALUE BASED PAYMENT MODELS, WHERE SUCH MODELS ARE AVAILABLE FOR PARTICIPATION. (N) THE COMMISSIONER OF HEALTH IS AUTHORIZED TO CREATE A PROGRAM TO SUBSIDIZE THE COST OF ASSISTED LIVING FOR THOSE INDIVIDUALS LIVING WITH ALZHEIMER'S DISEASE AND DEMENTIA WHO ARE NOT ELIGIBLE FOR MEDICAL ASSISTANCE PURSUANT TO TITLE ELEVEN OF ARTICLE FIVE OF THIS CHAPTER. THE PROGRAM SHALL AUTHORIZE UP TO TWO HUNDRED VOUCHERS TO INDIVIDUALS THROUGH AN APPLICATION PROCESS AND PAY FOR UP TO SEVENTY-FIVE PERCENT OF THE AVERAGE PRIVATE PAY RATE IN THE RESPECTIVE REGION. THE COMMISSIONER MAY PROPOSE RULES AND REGULATIONS TO EFFECTUATE THIS PROVISION. § 3. Subparagraph (i) of paragraph (b) of subdivision 7 of section 4403-f of the public health law, as amended by section 41-b of part H of chapter 59 of the laws of 2011, is amended to read as follows: (i) The commissioner shall, to the extent necessary, submit the appro- priate waivers, including, but not limited to, those authorized pursuant to sections eleven hundred fifteen and nineteen hundred fifteen of the federal social security act, or successor provisions, and any other waivers necessary to achieve the purposes of high quality, integrated, and cost effective care and integrated financial eligibility policies under the medical assistance program or pursuant to title XVIII of the federal social security act. In addition, the commissioner is authorized to submit the appropriate waivers, including but not limited to those authorized pursuant to sections eleven hundred fifteen and nineteen hundred fifteen of the federal social security act or successor S. 7507--A 10 A. 9507--A provisions, and any other waivers necessary to require on or after April first, two thousand twelve, medical assistance recipients who are twen- ty-one years of age or older and who require community-based long term care services, as specified by the commissioner, for more than one hundred and twenty days, to receive such services through an available plan certified pursuant to this section or other program model that meets guidelines specified by the commissioner that support coordination and integration of services. Such guidelines shall address the require- ments of paragraphs (a), (b), (c), (d), (e), (f), (g), (h), and (i) of subdivision three of this section as well as payment methods that ensure provider accountability for cost effective quality outcomes. Such other program models may include long term home health care programs that comply with such guidelines. Copies of such original waiver applications and amendments thereto shall be provided to the chairs of the senate finance committee, the assembly ways and means committee and the senate and assembly health committees simultaneously with their submission to the federal government. ON OR AFTER OCTOBER FIRST, TWO THOUSAND EIGHTEEN, THE COMMISSIONER MAY, THROUGH SUCH AN APPROVED WAIVER, LIMIT ENROLLMENT IN A PLAN CERTI- FIED UNDER THIS SECTION TO INDIVIDUALS WHO ACHIEVE A SCORE OF NINE OR ABOVE WHEN ASSESSED USING THE UNIFORM ASSESSMENT SYSTEM FOR NEW YORK ASSESSMENT TOOL AND WHO REQUIRE COMMUNITY-BASED LONG TERM CARE SERVICES FOR A CONTINUOUS PERIOD OF MORE THAN ONE HUNDRED TWENTY DAYS FROM THE DATE OF ENROLLMENT AND FROM THE DATES WHEN CONTINUING ENROLLMENT IS REAUTHORIZED; HOWEVER, MEDICAL ASSISTANCE RECIPIENTS ENROLLED IN A MANAGED LONG TERM CARE PLAN ON OCTOBER FIRST, TWO THOUSAND EIGHTEEN MAY CONTINUE TO BE ELIGIBLE FOR SUCH PLANS, IRRESPECTIVE OF WHETHER THE ENROLLEE MEETS THESE LEVEL OF CARE REQUIREMENTS, PROVIDED THAT ONCE SUCH RECIPIENTS ARE DISENROLLED FROM THEIR MANAGED LONG TERM CARE PLAN, ANY APPLICABLE LEVEL OF CARE REQUIREMENTS WOULD APPLY TO FUTURE ELIGIBILITY DETERMINATIONS. § 4. Subparagraphs (vii) and (viii) of paragraph (b) of subdivision 7 of section 4403-f of the public health law are redesignated as subpara- graphs (viii) and (ix) and a new subparagraph (vii) is added to read as follows: (VII) IF ANOTHER MANAGED LONG TERM CARE PLAN CERTIFIED UNDER THIS SECTION IS AVAILABLE, MEDICAL ASSISTANCE RECIPIENTS REQUIRED TO ENROLL IN SUCH PLANS PURSUANT TO THIS SECTION MAY CHANGE PLANS WITHOUT CAUSE WITHIN THIRTY DAYS OF NOTIFICATION OF ENROLLMENT OR THE EFFECTIVE DATE OF ENROLLMENT INTO A PLAN, WHICHEVER IS LATER, BY MAKING A REQUEST OF THE LOCAL SOCIAL SERVICES DISTRICT OR ENTITY DESIGNATED BY THE DEPART- MENT, EXCEPT THAT SUCH PERIOD SHALL BE FORTY-FIVE DAYS FOR RECIPIENTS WHO HAVE BEEN ASSIGNED TO A PROVIDER BY THE COMMISSIONER. HOWEVER, AFTER SUCH THIRTY OR FORTY-FIVE DAY PERIOD, WHICHEVER IS APPLICABLE, A RECIPI- ENT MAY BE PROHIBITED FROM CHANGING PLANS MORE FREQUENTLY THAN ONCE EVERY TWELVE MONTHS, AS PERMITTED BY FEDERAL LAW, EXCEPT FOR GOOD CAUSE AS DETERMINED BY THE COMMISSIONER. § 5. Clauses 11 and 12 of subparagraph (v) of paragraph (b) of subdi- vision 7 of section 4403-f of the public health law, as amended by section 48 of part A of chapter 56 of the laws of 2013, are amended to read as follows: (11) a person who is eligible for medical assistance pursuant to para- graph (b) of subdivision four of section three hundred sixty-six of the social services law; [and] (12) Native Americans; AND S. 7507--A 11 A. 9507--A (13) A PERSON WHO IS PERMANENTLY PLACED IN A NURSING HOME FOR A CONSECUTIVE PERIOD OF SIX MONTHS OR MORE. § 6. Paragraph (a) of subdivision 3 of section 366 of the social services law is REPEALED and a new paragraph (a) is added to read as follows: (A) MEDICAL ASSISTANCE SHALL BE FURNISHED WITHOUT CONSIDERATION OF THE INCOME AND RESOURCES OF AN APPLICANT'S LEGALLY RESPONSIBLE RELATIVE IF THE APPLICANT'S ELIGIBILITY WOULD NORMALLY BE DETERMINED BY COMPARING THE AMOUNT OF AVAILABLE INCOME AND/OR RESOURCES OF THE APPLICANT, INCLUDING AMOUNTS DEEMED AVAILABLE TO THE APPLICANT FROM LEGALLY RESPON- SIBLE RELATIVES, TO AN APPLICABLE ELIGIBILITY STANDARD, AND: (1) (I) THE LEGALLY RESPONSIBLE RELATIVE IS A COMMUNITY SPOUSE, AS DEFINED IN SECTION THREE HUNDRED SIXTY-SIX-C OF THIS TITLE; (II) SUCH RELATIVE IS REFUSING TO MAKE HIS OR HER INCOME AND/OR RESOURCES AVAILABLE TO MEET THE COST OF NECESSARY MEDICAL CARE, SERVICES, AND SUPPLIES; AND (III) THE APPLICANT EXECUTES AN ASSIGNMENT OF SUPPORT FROM THE COMMU- NITY SPOUSE IN FAVOR OF THE SOCIAL SERVICES DISTRICT AND THE DEPARTMENT, UNLESS THE APPLICANT IS UNABLE TO EXECUTE SUCH ASSIGNMENT DUE TO PHYS- ICAL OR MENTAL IMPAIRMENT OR TO DENY ASSISTANCE WOULD CREATE AN UNDUE HARDSHIP, AS DEFINED BY THE COMMISSIONER; OR (2) THE LEGALLY RESPONSIBLE RELATIVE IS ABSENT FROM THE APPLICANT'S HOUSEHOLD, AND FAILS OR REFUSES TO MAKE HIS OR HER INCOME AND/OR RESOURCES AVAILABLE TO MEET THE COST OF NECESSARY MEDICAL CARE, SERVICES, AND SUPPLIES. IN SUCH CASES, HOWEVER, THE FURNISHING OF SUCH ASSISTANCE SHALL CREATE AN IMPLIED CONTRACT WITH SUCH RELATIVE, AND THE COST THEREOF MAY BE RECOVERED FROM SUCH RELATIVE IN ACCORDANCE WITH TITLE SIX OF ARTICLE THREE OF THIS CHAPTER AND OTHER APPLICABLE PROVISIONS OF LAW. § 7. Subparagraph (i) of paragraph (d) of subdivision 2 of section 366-c of the social services law is amended by adding a new clause (C) to read as follows: (C) ON AND AFTER JULY FIRST, TWO THOUSAND EIGHTEEN, TWENTY-FOUR THOU- SAND ONE HUNDRED EIGHTY DOLLARS OR SUCH GREATER AMOUNT AS MAY BE REQUIRED UNDER FEDERAL LAW; § 8. Subdivision 1 of section 367-a of the social services law is amended by adding a new paragraph (h) to read as follows: (H) AMOUNTS PAYABLE UNDER THIS TITLE FOR MEDICAL ASSISTANCE IN THE FORM OF FREESTANDING CLINIC SERVICES PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW PROVIDED TO ELIGIBLE PERSONS PARTICIPATING IN THE NEW YORK TRAUMATIC BRAIN INJURY WAIVER PROGRAM WHO ARE ALSO BENEFICI- ARIES UNDER PART B OF TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT OR WHO ARE QUALIFIED MEDICARE BENEFICIARIES UNDER PART B OF TITLE XVIII OF SUCH ACT SHALL NOT BE LESS THAN THE APPROVED MEDICAL ASSISTANCE PAYMENT LEVEL LESS THE AMOUNT PAYABLE UNDER PART B. § 9. The commissioner of health shall conduct a study of home and community based services available to recipients of the Medicaid program in rural areas of the state. Such study shall include a review and anal- ysis of factors affecting such availability, including but not limited to transportation costs, costs of direct care personnel including home health aides, personal care attendants and other direct service person- nel, opportunities for telehealth services, and technological advances to improve efficiencies. Consistent with the results of the study, the commissioner of health is authorized to provide a targeted Medicaid rate enhancement to fee-for-service personal care rates and rates under Medi- caid waiver programs such as the nursing home transition and diversion S. 7507--A 12 A. 9507--A waiver and the traumatic brain injury program waiver, in an aggregate amount of three million dollars minus the cost of conducting the study; provided further, that nothing in this section shall be deemed to affect payment for the costs of the study and any related Medicaid rate enhancement if federal participation is not available for such costs. § 10. This act shall take effect immediately; provided, however, that the amendments made to paragraph (b) of subdivision 7 of section 4403-f of the public health law made by sections three, four and five of this act shall not affect the expiration of such paragraph pursuant to subdi- vision (i) of section 111 of part H of chapter 59 of the laws of 2011, as amended, and shall be deemed to expire therewith; provided, further, that the amendments to paragraph (b) of subdivision 7 of section 4403-f of the public health law made by sections three, four and five of this act shall not affect the repeal of such section pursuant to chapter 659 of the laws of 1997, as amended, and shall be deemed repealed therewith; provided, further, that section four of this act shall take effect on October 1, 2018. PART C Section 1. Subdivision 2 of section 365-l of the social services law, as amended by section 1 of part S of chapter 57 of the laws of 2017, is amended to read as follows: 2. In addition to payments made for health home services pursuant to subdivision one of this section, the commissioner is authorized to pay additional amounts: (A) to providers of health home services that meet process or outcome standards specified by the commissioner; AND (B) TO MEDICAID MANAGED CARE ENROLLEES WHO ARE MEMBERS OF HEALTH HOMES IN THE FORM OF INCENTIVE PAYMENTS TO REWARD SUCH ENROLLEES FOR PARTICIPATING IN WELLNESS ACTIVITIES AND FOR AVOIDING UNNECESSARY HOSPITALIZATIONS AND UNNECESSARY UTILIZATION OF HOSPITAL EMERGENCY DEPARTMENT SERVICES. Such additional amounts may be paid with state funds only if federal finan- cial participation for such payments is unavailable. § 2. Section 365-l of the social services law is amended by adding a new subdivision 2-d to read as follows: 2-D. THE COMMISSIONER SHALL ESTABLISH TARGETS FOR HEALTH HOME PARTIC- IPATION BY ENROLLEES OF SPECIAL NEEDS MANAGED CARE PLANS DESIGNATED PURSUANT TO SUBDIVISION FOUR OF SECTION THREE HUNDRED SIXTY-FIVE-M OF THIS TITLE AND BY HIGH-RISK ENROLLEES OF OTHER MEDICAID MANAGED CARE PLANS OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE, AND SHALL REQUIRE THE MANAGED CARE PROVIDERS TO WORK COLLABORA- TIVELY WITH HEALTH HOMES TO ACHIEVE SUCH TARGETS. THE COMMISSIONER MAY ASSESS PENALTIES UNDER THIS SUBDIVISION AGAINST MANAGED CARE PROVIDERS THAT FAIL TO MEET THE PARTICIPATION TARGETS ESTABLISHED PURSUANT TO THIS SUBDIVISION, EXCEPT THAT MANAGED CARE PROVIDERS SHALL NOT BE PENALIZED FOR THE FAILURE OF A HEALTH HOME TO WORK COLLABORATIVELY TOWARD MEETING THE PARTICIPATION TARGETS. § 3. Subdivision 6 of section 2899 of the public health law, as amended by chapter 471 of the laws of 2016, is amended to read as follows: 6. "Provider" shall mean (A) any residential health care facility licensed under article twenty-eight of this chapter; or any certified home health agency, licensed home care services agency or long term home health care program certified under article thirty-six of this chapter; any hospice program certified pursuant to article forty of this chapter; or any adult home, enriched housing program or residence for adults S. 7507--A 13 A. 9507--A licensed under article seven of the social services law; OR (B) A HEALTH HOME, OR ANY SUBCONTRACTOR OF SUCH HEALTH HOME, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT TO PROVIDE HEALTH HOME SERVICES TO ALL THOSE ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVEL- OPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWENTY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW, OR ANY ENTITY THAT PROVIDES HOME AND COMMUNITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT. § 4. Paragraph (b) of subdivision 9 of section 2899-a of the public health law, as added by chapter 331 of the laws of 2006, is amended to read as follows: (b) Residential health care facilities licensed pursuant to article twenty-eight of this chapter and certified home health care agencies and long-term home health care programs certified or approved pursuant to article thirty-six of this chapter OR A HEALTH HOME, OR ANY SUBCONTRAC- TOR OF SUCH HEALTH HOME, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT TO PROVIDE HEALTH HOME SERVICES TO ALL THOSE ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVELOPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWENTY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW, OR ANY ENTITY THAT PROVIDES HOME AND COMMUNITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT, may, subject to the availability of federal financial participation, claim as reimbursable costs under the medical assistance program, costs reflect- ing the fee established pursuant to law by the division of criminal justice services for processing a criminal history information check, the fee imposed by the federal bureau of investigation for a national criminal history check, and costs associated with obtaining the finger- prints, provided, however, that for the purposes of determining rates of payment pursuant to article twenty-eight of this chapter for residential health care facilities, such reimbursable fees and costs shall be reflected as timely as practicable in such rates within the applicable rate period. § 5. Subdivision 10 of section 2899-a of the public health law, as amended by chapter 206 of the laws of 2017, is amended to read as follows: 10. Notwithstanding subdivision eleven of section eight hundred forty-five-b of the executive law, a certified home health agency, licensed home care services agency or long term home health care program certified, licensed or approved under article thirty-six of this chapter or a home care services agency exempt from certification or licensure under article thirty-six of this chapter, a hospice program under arti- cle forty of this chapter, or an adult home, enriched housing program or residence for adults licensed under article seven of the social services law, OR A HEALTH HOME, OR ANY SUBCONTRACTOR OF SUCH HEALTH HOME, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT TO PROVIDE HEALTH HOME SERVICES TO ALL ENROLLEES ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVELOPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWEN- TY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW, OR ANY ENTITY THAT PROVIDES HOME AND COMMU- S. 7507--A 14 A. 9507--A NITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT may temporarily approve a prospective employee while the results of the criminal history information check and the determination are pending, upon the condition that the provider conducts appropriate direct observation and evaluation of the temporary employee, while he or she is temporarily employed, and the care recipi- ent. The results of such observations shall be documented in the tempo- rary employee's personnel file and shall be maintained. For purposes of providing such appropriate direct observation and evaluation, the provider shall utilize an individual employed by such provider with a minimum of one year's experience working in an agency certified, licensed or approved under article thirty-six of this chapter or an adult home, enriched housing program or residence for adults licensed under article seven of the social services law, A HEALTH HOME, OR ANY SUBCONTRACTOR OF SUCH HEALTH HOME, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT TO PROVIDE HEALTH HOME SERVICES TO THOSE ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVELOPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWENTY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW, OR ANY ENTITY THAT PROVIDES HOME AND COMMUNITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT. If the temporary employee is working under contract with another provider certified, licensed or approved under article thirty-six of this chap- ter, such contract provider's appropriate direct observation and evalu- ation of the temporary employee, shall be considered sufficient for the purposes of complying with this subdivision. § 6. Subdivision 3 of section 424-a of the social services law, as amended by section 3 of part Q of chapter 56 of the laws of 2017, is amended to read as follows: 3. For purposes of this section, the term "provider" or "provider agency" shall mean: an authorized agency; the office of children and family services; juvenile detention facilities subject to the certif- ication of the office of children and family services; programs estab- lished pursuant to article nineteen-H of the executive law; non-residen- tial or residential programs or facilities licensed or operated by the office of mental health or the office for people with developmental disabilities except family care homes; licensed child day care centers, including head start programs which are funded pursuant to title V of the federal economic opportunity act of nineteen hundred sixty-four, as amended; early intervention service established pursuant to section twenty-five hundred forty of the public health law; preschool services established pursuant to section forty-four hundred ten of the education law; school-age child care programs; special act school districts as enumerated in chapter five hundred sixty-six of the laws of nineteen hundred sixty-seven, as amended; programs and facilities licensed by the office of alcoholism and substance abuse services; residential schools which are operated, supervised or approved by the education department; HEALTH HOMES, OR ANY SUBCONTRACT OR OF SUCH HEALTH HOMES, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT OF HEALTH TO PROVIDE HEALTH HOME SERVICES TO ALL THOSE ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVELOPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWEN- TY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L S. 7507--A 15 A. 9507--A OF THIS CHAPTER, OR ANY ENTITY THAT PROVIDES HOME AND COMMUNITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT; publicly-funded emergency shelters for families with children, provided, however, for purposes of this section, when the provider or provider agency is a publicly-funded emergency shelter for families with children, then all references in this section to the "potential for regular and substantial contact with individuals who are cared for by the agency" shall mean the potential for regular and substantial contact with children who are served by such shelter; and any other facility or provider agency, as defined in subdivision four of section four hundred eighty-eight of this chapter, in regard to the employment of staff, or use of providers of goods and services and staff of such providers, consultants, interns and volunteers. § 7. Paragraph (a) of subdivision 1 of section 413 of the social services law, as amended by section 2 of part Q of chapter 56 of the laws of 2017, is amended to read as follows: (a) The following persons and officials are required to report or cause a report to be made in accordance with this title when they have reasonable cause to suspect that a child coming before them in their professional or official capacity is an abused or maltreated child, or when they have reasonable cause to suspect that a child is an abused or maltreated child where the parent, guardian, custodian or other person legally responsible for such child comes before them in their profes- sional or official capacity and states from personal knowledge facts, conditions or circumstances which, if correct, would render the child an abused or maltreated child: any physician; registered physician assist- ant; surgeon; medical examiner; coroner; dentist; dental hygienist; osteopath; optometrist; chiropractor; podiatrist; resident; intern; psychologist; registered nurse; social worker; emergency medical techni- cian; licensed creative arts therapist; licensed marriage and family therapist; licensed mental health counselor; licensed psychoanalyst; licensed behavior analyst; certified behavior analyst assistant; hospi- tal personnel engaged in the admission, examination, care or treatment of persons; a Christian Science practitioner; school official, which includes but is not limited to school teacher, school guidance counse- lor, school psychologist, school social worker, school nurse, school administrator or other school personnel required to hold a teaching or administrative license or certificate; full or part-time compensated school employee required to hold a temporary coaching license or profes- sional coaching certificate; social services worker; employee of a publ- icly-funded emergency shelter for families with children; director of a children's overnight camp, summer day camp or traveling summer day camp, as such camps are defined in section thirteen hundred ninety-two of the public health law; day care center worker; school-age child care worker; provider of family or group family day care; employee or volunteer in a residential care facility for children that is licensed, certified or operated by the office of children and family services; or any other child care or foster care worker; mental health professional; substance abuse counselor; alcoholism counselor; all persons credentialed by the office of alcoholism and substance abuse services; EMPLOYEES OF A HEALTH HOME OR HEALTH HOME CARE MANAGEMENT AGENCY CONTRACTING WITH A HEALTH HOME AS DESIGNATED BY THE DEPARTMENT OF HEALTH AND AUTHORIZED UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THIS CHAPTER OR SUCH EMPLOYEES WHO PROVIDE HOME AND COMMUNITY BASED SERVICES UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURI- S. 7507--A 16 A. 9507--A TY ACT; peace officer; police officer; district attorney or assistant district attorney; investigator employed in the office of a district attorney; or other law enforcement official. § 8. Section 364-j of the social services law is amended by adding a new subdivision 34 to read as follows: 34. (A) THE COMMISSIONER MAY, IN HIS OR HER DISCRETION, APPLY PENAL- TIES TO MANAGED CARE PROVIDERS THAT DO NOT SUBMIT A PERFORMING PROVIDER SYSTEM PARTNERSHIP PLAN BY JULY FIRST, TWO THOUSAND EIGHTEEN, IN ACCORD- ANCE WITH ANY SUBMISSION GUIDELINES ISSUED BY THE DEPARTMENT PRIOR THER- ETO. FOR PURPOSES OF THIS SUBDIVISION, "PERFORMING PROVIDER SYSTEM PART- NERSHIP PLAN" SHALL MEAN A PLAN SUBMITTED BY SUCH MANAGED CARE PROVIDERS TO THE DEPARTMENT THAT INCLUDES BOTH SHORT AND LONG TERM APPROACHES FOR EFFECTIVE COLLABORATION WITH EACH PERFORMING PROVIDER SYSTEM WITHIN ITS SERVICE AREA. (B) SUCH PENALTIES SHALL BE AS FOLLOWS: FOR MANAGED CARE PROVIDERS THAT DO NOT SUBMIT A PERFORMING PROVIDER SYSTEM PARTNERSHIP PLAN IN ACCORDANCE WITH THIS SUBDIVISION, MEDICAID PREMIUMS SHALL BE REDUCED BY EIGHTY-FIVE ONE-HUNDREDTHS OF ONE PERCENT FOR THE RATE PERIOD FROM APRIL FIRST, TWO THOUSAND EIGHTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND NINETEEN. § 9. This act shall take effect immediately; provided, however, that the amendments made to subdivision 6 of section 2899 of the public health law made by section three of this act shall take effect on the same date and in the same manner as section 8 of chapter 471 of the laws of 2016, as amended, takes effect and shall not affect the expiration of such subdivision and shall be deemed expired therewith; provided further, however, that the amendments made to section 364-j of the social services law made by section eight of this act shall not affect the repeal of such section and shall be deemed repealed therewith. PART D Section 1. Paragraph (d) of subdivision 9 of section 367-a of the social services law, as amended by section 7 of part D of chapter 57 of the laws of 2017, is amended to read as follows: (d) In addition to the amounts paid pursuant to paragraph (b) of this subdivision, the department shall pay a professional pharmacy dispensing fee for each such drug dispensed in the amount of ten dollars AND EIGHT CENTS per prescription or written order of a practitioner; provided, however that this professional dispensing fee will not apply to drugs that are available without a prescription as required by section sixty- eight hundred ten of the education law but do not meet the definition of a covered outpatient drug pursuant to Section 1927K of the Social Secu- rity Act. § 2. Paragraph (a) of subdivision 4 of section 365-a of the social services law, as amended by chapter 493 of the laws of 2010, is amended to read as follows: (a) drugs which may be dispensed without a prescription as required by section sixty-eight hundred ten of the education law; provided, however, that the state commissioner of health may by regulation specify certain of such drugs which may be reimbursed as an item of medical assistance in accordance with the price schedule established by such commissioner. Notwithstanding any other provision of law, [additions] MODIFICATIONS to the list of drugs reimbursable under this paragraph may be filed as regulations by the commissioner of health without prior notice and comment; S. 7507--A 17 A. 9507--A § 3. Paragraph (c) of subdivision 6 of section 367-a of the social services law is amended by adding a new subparagraph (v) to read as follows: (V) NOTWITHSTANDING ANY OTHER PROVISION OF THIS PARAGRAPH, CO-PAYMENTS CHARGED FOR DRUGS DISPENSED WITHOUT A PRESCRIPTION AS REQUIRED BY SECTION SIXTY-EIGHT HUNDRED TEN OF THE EDUCATION LAW BUT WHICH ARE REIM- BURSED AS AN ITEM OF MEDICAL ASSISTANCE PURSUANT TO PARAGRAPH (A) OF SUBDIVISION FOUR OF SECTION THREE HUNDRED SIXTY-FIVE-A OF THIS TITLE SHALL BE ONE DOLLAR. § 4. Paragraph (b) of subdivision 3 of section 273 of the public health law, as added by section 10 of part C of chapter 58 of the laws of 2005, is amended to read as follows: (b) In the event that the patient does not meet the criteria in para- graph (a) of this subdivision, the prescriber may provide additional information to the program to justify the use of a prescription drug that is not on the preferred drug list. The program shall provide a reasonable opportunity for a prescriber to reasonably present his or her justification of prior authorization. [If, after consultation with the program, the prescriber, in his or her reasonable professional judgment, determines that the use of a prescription drug that is not on the preferred drug list is warranted, the prescriber's determination shall be final.] THE PROGRAM WILL CONSIDER THE ADDITIONAL INFORMATION AND THE JUSTIFICATION PRESENTED TO DETERMINE WHETHER THE USE OF A PRESCRIPTION DRUG THAT IS NOT ON THE PREFERRED DRUG LIST IS WARRANTED. § 5. Subdivisions 25 and 25-a of section 364-j of the social services law are REPEALED. § 6. The public health law is amended by adding a new section 280-c to read as follows: § 280-C. COMPREHENSIVE MEDICATION MANAGEMENT. 1. DEFINITIONS. FOR PURPOSES OF THIS SECTION: (A) QUALIFIED PHARMACIST. THE TERM "QUALIFIED PHARMACIST" SHALL MEAN A PHARMACIST WHO MAINTAINS A CURRENT UNRESTRICTED LICENSE PURSUANT TO ARTICLE ONE HUNDRED THIRTY-SEVEN OF THE EDUCATION LAW, WHO HAS A MINIMUM OF TWO YEARS OF EXPERIENCE IN PATIENT CARE AS A PRACTICING PHARMACIST WITHIN THE LAST FIVE YEARS, AND WHO HAS DEMONSTRATED COMPETENCY IN THE MEDICATION MANAGEMENT OF PATIENTS WITH A CHRONIC DISEASE OR DISEASES, INCLUDING BUT NOT LIMITED TO, THE COMPLETION OF ONE OR MORE PROGRAMS WHICH ARE ACCREDITED BY THE ACCREDITATION COUNCIL FOR PHARMACY EDUCA- TION, RECOGNIZED BY THE EDUCATION DEPARTMENT AND ACCEPTABLE TO THE PATIENT'S TREATING PHYSICIAN. (B) COMPREHENSIVE MEDICATION MANAGEMENT. THE TERM "COMPREHENSIVE MEDI- CATION MANAGEMENT" SHALL MEAN A PROGRAM CONDUCTED BY A QUALIFIED PHARMA- CIST THAT ENSURES A PATIENT'S MEDICATIONS, WHETHER PRESCRIPTION OR NONPRESCRIPTION, ARE INDIVIDUALLY ASSESSED TO DETERMINE THAT EACH MEDI- CATION IS APPROPRIATE FOR THE PATIENT, EFFECTIVE FOR THE MEDICAL CONDI- TION, SAFE GIVEN COMORBIDITIES AND OTHER MEDICATIONS BEING TAKEN, AND ABLE TO BE TAKEN BY THE PATIENT AS INTENDED. COMPREHENSIVE MEDICATION MANAGEMENT CONDUCTED BY A QUALIFIED PHARMACIST SHALL INCLUDE SHARING OF APPLICABLE PATIENT CLINICAL INFORMATION WITH THE TREATING PHYSICIAN AS SPECIFIED IN THE COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL. (C) COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL. THE TERM "COMPREHEN- SIVE MEDICATION MANAGEMENT PROTOCOL" MEANS A WRITTEN DOCUMENT PURSUANT TO AND CONSISTENT WITH ANY APPLICABLE STATE AND FEDERAL REQUIREMENTS, THAT IS ENTERED INTO VOLUNTARILY BY EITHER A PHYSICIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW OR A NURSE PRAC- TITIONER CERTIFIED PURSUANT TO SECTION SIXTY-NINE HUNDRED TEN OF THE S. 7507--A 18 A. 9507--A EDUCATION LAW, AND A QUALIFIED PHARMACIST WHICH ADDRESSES A CHRONIC DISEASE OR DISEASES AS DETERMINED BY THE TREATING PHYSICIAN OR NURSE PRACTITIONER AND THAT DESCRIBES THE NATURE AND SCOPE OF THE COMPREHEN- SIVE MEDICATION MANAGEMENT SERVICES TO BE PERFORMED BY THE QUALIFIED PHARMACIST, IN ACCORDANCE WITH THE PROVISIONS OF THIS SECTION. COMPRE- HENSIVE MEDICATION MANAGEMENT PROTOCOLS BETWEEN LICENSED PHYSICIANS OR NURSE PRACTITIONERS AND QUALIFIED PHARMACISTS SHALL BE MADE AVAILABLE TO THE DEPARTMENT FOR REVIEW AND TO ENSURE COMPLIANCE WITH THIS ARTICLE, UPON REQUEST. 2. AUTHORIZATION TO ESTABLISH COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOLS. A PHYSICIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY- ONE OF THE EDUCATION LAW OR A NURSE PRACTITIONER CERTIFIED PURSUANT TO SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW SHALL BE AUTHORIZED TO VOLUNTARILY ESTABLISH A COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL WITH A QUALIFIED PHARMACIST TO PROVIDE COMPREHENSIVE MEDICATION MANAGE- MENT SERVICES FOR A PATIENT WHO HAS NOT MET CLINICAL GOALS OF THERAPY, IS AT RISK FOR HOSPITALIZATION, OR FOR WHOM THE PHYSICIAN OR NURSE PRAC- TITIONER DEEMS IT IS NECESSARY TO RECEIVE COMPREHENSIVE MEDICATION MANAGEMENT SERVICES. PARTICIPATION BY THE PATIENT IN COMPREHENSIVE MEDI- CATION MANAGEMENT SERVICES SHALL BE VOLUNTARY. 3. SCOPE OF COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOLS. (A) UNDER A COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL, A QUALIFIED PHARMACIST SHALL BE PERMITTED TO: (I) ADJUST OR MANAGE A DRUG REGIMEN FOR THE PATIENT, PURSUANT TO THE PATIENT SPECIFIC ORDER OR PROTOCOL ESTABLISHED BY THE PATIENT'S TREATING 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 TREATING PHYSICIAN OR NURSE PRACTITIONER UNLESS SUCH SUBSTI- TUTION IS EXPRESSLY AUTHORIZED IN THE WRITTEN ORDER OR PROTOCOL. THE QUALIFIED PHARMACIST SHALL BE REQUIRED TO IMMEDIATELY DOCUMENT IN THE PATIENT'S MEDICAL RECORD CHANGES MADE TO THE DRUG THERAPY. THE PATIENT'S TREATING PHYSICIAN OR NURSE PRACTITIONER MAY PROHIBIT, BY WRITTEN INSTRUCTION, ANY ADJUSTMENT OR CHANGE IN THE PATIENT'S DRUG REGIMEN BY THE QUALIFIED PHARMACIST; (II) EVALUATE AND ONLY IF SPECIFICALLY AUTHORIZED BY THE PROTOCOL, AND ONLY TO THE EXTENT NECESSARY TO DISCHARGE THE RESPONSIBILITY SET FORTH IN THIS SECTION, ORDER OR PERFORM ROUTINE PATIENT MONITORING FUNCTIONS OR DISEASE STATE LABORATORY TESTS RELATED TO THE DRUG THERAPY COMPREHEN- SIVE MEDICATION MANAGEMENT FOR THE SPECIFIC CHRONIC DISEASE OR DISEASES SPECIFIED WITHIN THE WRITTEN AGREEMENT OR COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL; (III) ONLY IF SPECIFICALLY AUTHORIZED BY THE WRITTEN ORDER OR PROTOCOL AND ONLY TO THE EXTENT NECESSARY TO DISCHARGE THE RESPONSIBILITIES SET FORTH IN THIS SECTION, ORDER OR PERFORM ROUTINE PATIENT MONITORING FUNC- TIONS AS MAY BE NECESSARY IN THE DRUG THERAPY MANAGEMENT, INCLUDING THE COLLECTING AND REVIEWING OF PATIENT HISTORIES, AND ORDERING OR CHECKING PATIENT VITAL SIGNS, INCLUDING PULSE, TEMPERATURE, BLOOD PRESSURE, WEIGHT AND RESPIRATION; AND (IV) ACCESS THE COMPLETE PATIENT MEDICAL RECORD MAINTAINED BY THE TREATING PHYSICIAN OR NURSE PRACTITIONER WITH WHOM THE QUALIFIED PHARMA- CIST HAS THE COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL AND SHALL DOCUMENT ANY ADJUSTMENTS MADE PURSUANT TO THE PROTOCOL IN THE PATIENT'S MEDICAL RECORD AND SHALL NOTIFY THE PATIENT'S TREATING PHYSICIAN OR S. 7507--A 19 A. 9507--A NURSE PRACTITIONER OF ANY ADJUSTMENTS IN A TIMELY MANNER ELECTRONICALLY OR BY OTHER MEANS. (B) UNDER NO CIRCUMSTANCES SHALL THE QUALIFIED PHARMACIST BE PERMITTED TO DELEGATE COMPREHENSIVE MEDICATION MANAGEMENT SERVICES TO ANY OTHER LICENSED PHARMACIST OR OTHER PHARMACY PERSONNEL. 4. MEDICATION ADJUSTMENTS. ANY MEDICATION ADJUSTMENTS MADE BY THE QUALIFIED PHARMACIST PURSUANT TO THE COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL, INCLUDING ADJUSTMENTS IN DRUG STRENGTH, FREQUENCY OR ROUTE OF ADMINISTRATION, OR INITIATION OF A DRUG WHICH DIFFERS FROM THAT INITIAL- LY PRESCRIBED AND AS DOCUMENTED IN THE PATIENT MEDICAL RECORD, SHALL BE DEEMED AN ORAL PRESCRIPTION AUTHORIZED BY AN AGENT OF THE PATIENT'S TREATING PHYSICIAN OR NURSE PRACTITIONER AND SHALL BE DISPENSED CONSIST- ENT WITH SECTION SIXTY-EIGHT HUNDRED TEN OF THE EDUCATION LAW. FOR THE PURPOSES OF THIS SECTION, A PHARMACIST WHO IS NOT AN EMPLOYEE OF THE PHYSICIAN OR NURSE PRACTITIONER MAY BE AUTHORIZED TO SERVE AS AN AGENT OF THE PHYSICIAN OR NURSE PRACTITIONER. 5. REFERRALS. A PHYSICIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW OR A NURSE PRACTITIONER CERTIFIED PURSU- ANT TO SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW, WHO HAS RESPONSIBILITY FOR THE TREATMENT AND CARE OF A PATIENT FOR A CHRONIC DISEASE OR DISEASES AS DETERMINED BY THE PHYSICIAN OR NURSE PRACTITIONER MAY REFER THE PATIENT TO A QUALIFIED PHARMACIST FOR COMPREHENSIVE MEDI- CATION MANAGEMENT SERVICES, PURSUANT TO THE COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL THAT THE PHYSICIAN OR NURSE PRACTITIONER HAS ESTAB- LISHED WITH THE QUALIFIED PHARMACIST. THE PROTOCOL AGREEMENT SHALL AUTHORIZE THE PHARMACIST TO SERVE AS AN AGENT OF THE PHYSICIAN OR NURSE PRACTITIONER AS DEFINED BY THE PROTOCOL. SUCH REFERRAL SHALL BE DOCU- MENTED IN THE PATIENT'S MEDICAL RECORD. 6. PATIENT PARTICIPATION. PARTICIPATION IN COMPREHENSIVE MEDICATION MANAGEMENT SERVICES SHALL BE VOLUNTARY, AND NO PATIENT, PHYSICIAN, NURSE PRACTITIONER OR PHARMACIST SHALL BE REQUIRED TO PARTICIPATE. THE REFER- RAL OF A PATIENT FOR COMPREHENSIVE MEDICATION MANAGEMENT SERVICES AND THE PATIENT'S RIGHT TO CHOOSE NOT TO PARTICIPATE SHALL BE DISCLOSED TO THE PATIENT. COMPREHENSIVE MEDICATION MANAGEMENT SERVICES SHALL NOT BE UTILIZED UNLESS THE PATIENT OR THE PATIENT'S AUTHORIZED REPRESENTATIVE CONSENTS, IN WRITING, TO SUCH SERVICES. SUCH CONSENT SHALL BE NOTED IN THE PATIENT'S MEDICAL RECORD. IF THE PATIENT OR THE PATIENT'S AUTHORIZED REPRESENTATIVE WHO CONSENTED CHOOSES TO NO LONGER PARTICIPATE IN SUCH SERVICES, AT ANY TIME, THE SERVICES SHALL BE DISCONTINUED AND IT SHALL BE NOTED IN THE PATIENT'S MEDICAL RECORD. § 7. Subdivision 4 of section 365-a of the social services law is amended by adding a new paragraph (h) to read as follows: (H) OPIOIDS PRESCRIBED TO A PATIENT INITIATING OR BEING MAINTAINED ON OPIOID TREATMENT FOR PAIN WHICH HAS LASTED MORE THAN THREE MONTHS OR PAST THE TIME OF NORMAL TISSUE HEALING, UNLESS THE MEDICAL RECORD CONTAINS A WRITTEN TREATMENT PLAN THAT INCLUDES: GOALS FOR PAIN MANAGE- MENT AND FUNCTIONAL IMPROVEMENT BASED ON DIAGNOSIS; INFORMATION ON WHETHER NON-OPIOID THERAPIES HAVE BEEN TRIED AND OPTIMIZED OR ARE CONTRAINDICATED; A STATEMENT THAT THE PRESCRIBER HAS EXPLAINED TO THE PATIENT THE RISKS OF AND ALTERNATIVES TO OPIOID TREATMENT; AN EVALUATION OF THE PATIENT FOR RISK FACTORS OF HARM AND MISUSE OF OPIOIDS; AN ASSESSMENT OF THE PATIENT'S ADHERENCE TO TREATMENT WITH RESPECT TO OTHER CONDITIONS TREATED BY THE SAME PROVIDER; THE SIGNATURE OF THE PATIENT AND/OR AN ATTESTATION BY THE PRESCRIBER THAT THE PATIENT VERBALLY AGREED TO THE TREATMENT PLAN; AND ANY OTHER INFORMATION REQUIRED BY THE DEPART- MENT. SUCH TREATMENT PLAN SHALL BE UPDATED TWICE WITHIN THE YEAR IMME- S. 7507--A 20 A. 9507--A DIATELY FOLLOWING ITS INITIATION AND ANNUALLY THEREAFTER. THE REQUIRE- MENTS OF THIS PARAGRAPH SHALL NOT APPLY IN THE CASE OF PATIENTS WHO ARE BEING TREATED FOR CANCER THAT IS NOT IN REMISSION, WHO ARE IN HOSPICE OR OTHER END-OF-LIFE CARE, OR WHOSE PAIN IS BEING TREATED AS PART OF PALLI- ATIVE CARE PRACTICES. § 8. Subdivision 2 of section 280 of the public health law, as amended by section 1 of part D of chapter 57 of the laws of 2017, is amended to read as follows: 2. The commissioner shall establish a year to year department of health state-funds Medicaid drug spending growth target as follows: (a) for state fiscal year two thousand seventeen--two thousand eigh- teen, be limited to the ten-year rolling average of the medical compo- nent of the consumer price index plus five percent and minus a pharmacy savings target of fifty-five million dollars; [and] (b) for state fiscal year two thousand eighteen--two thousand nine- teen, be limited to the ten-year rolling average of the medical compo- nent of the consumer price index plus four percent and minus a pharmacy savings target of eighty-five million dollars[.]; AND (C) FOR STATE FISCAL YEAR TWO THOUSAND NINETEEN--TWO THOUSAND TWENTY, BE LIMITED TO THE TEN-YEAR ROLLING AVERAGE OF THE MEDICAL COMPONENT OF THE CONSUMER PRICE INDEX PLUS FOUR PERCENT AND MINUS A PHARMACY SAVINGS TARGET OF EIGHTY-FIVE MILLION DOLLARS. § 9. This act shall take effect immediately and shall be deemed to have been in full force and effect on and after April 1, 2018; provided, however, that sections two and three of this act shall take effect July 1, 2018; and provided further, however, that the amendments to paragraph (d) of subdivision 9 and paragraph (c) of subdivision 6 of section 367-a of the social services law made by sections one and three, respec- tively, of this act shall not affect the expiration or repeal of such provisions and shall expire or be deemed repealed therewith. PART E Section 1. Subdivision 4 of section 365-h of the social services law, as separately amended by section 50 of part B and section 24 of part D of chapter 57 of the laws of 2015, is amended to read as follows: 4. The commissioner of health is authorized to assume responsibility from a local social services official for the provision and reimburse- ment of transportation costs under this section. If the commissioner elects to assume such responsibility, the commissioner shall notify the local social services official in writing as to the election, the date upon which the election shall be effective and such information as to transition of responsibilities as the commissioner deems prudent. The commissioner is authorized to contract with a transportation manager or managers to manage transportation services in any local social services district, other than transportation services provided or arranged for enrollees of [managed long term care plans issued certificates of authority under section forty-four hundred three-f of the public health law] A PROGRAM DESIGNATED AS A PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) AS AUTHORIZED BY FEDERAL PUBLIC LAW 105-33, SUBTITLE I OF TITLE IV OF THE BALANCED BUDGET ACT OF 1997. Any transportation manager or managers selected by the commissioner 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 S. 7507--A 21 A. 9507--A 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 requirements and service verification mech- anisms. Any and all reimbursement rates developed by transportation managers under this subdivision shall be subject to the review and approval of the commissioner. § 2. The opening paragraph of subdivision 1 and subdivision 3 of section 367-s of the social services law, as amended by section 53 of part B of chapter 57 of the laws of 2015, 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 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, six million dollars for the period May first, two thousand fourteen through March thirty-first, two thousand fifteen, and six million dollars [annu- ally beginning with] ON AN ANNUAL BASIS FOR the period April first, two thousand fifteen through March thirty-first, two thousand [sixteen] EIGHTEEN 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, 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] ON AN ANNUAL BASIS FOR the period April first, two thousand fifteen through March thirty- first, two thousand [sixteen] EIGHTEEN. 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. § 3. Subdivision 5 of section 365-h of the social services law is REPEALED. § 4. This act shall take effect immediately and shall be deemed to have been in full force and effect on and after April 1, 2018; provided, however, that section one of this act shall take effect October 1, 2018; provided, further that the amendments to subdivision 4 of section 365-h of the social services law made by section one of this act shall not affect the repeal of such section and shall expire and be deemed repealed therewith. PART F Section 1. Notwithstanding any inconsistent provision of law, rule or regulation to the contrary, if a Medicaid managed care plan or managed long term care plan that has been issued a certificate of authority pursuant to article 44 of the public health law and that satisfies the definition of corporation in subparagraph 5 of paragraph (a) of section 102 of the not-for-profit corporation law or is exempt from taxation S. 7507--A 22 A. 9507--A under section 501 of the Internal Revenue Code of 1986 has an aggregate accumulated contingent reserve, across all of its Medicaid lines of business, in an amount that exceeds the minimum contingent reserve amount required by regulations of the department of health, the commis- sioner of health shall be authorized to make prospective adjustments to the Medicaid capitation rates of such plan and shall apply any relevant criteria as determined necessary in his or her discretion, in order to achieve a reduction in Medicaid reimbursement to the plan equal to the amount of the excess, or such lesser amount as determined by the commis- sioner of health. § 2. This act shall take effect April 1, 2018. PART G Section 1. The public health law is amended by adding a new article 29-J to read as follows: ARTICLE 29-J HEALTH SERVICES OFFERED BY RETAIL PRACTICES SECTION 2999-HH. DEFINITIONS. 2999-II. RETAIL PRACTICE SPONSORS. 2999-JJ. RETAIL PRACTICES. 2999-KK. ACCREDITATION. 2999-LL. OTHER LAWS. § 2999-HH. DEFINITIONS. FOR PURPOSES OF THIS ARTICLE: 1. "REPORTABLE EVENT" SHALL MEAN: (A) THE TRANSFER OF AN INDIVIDUAL WHO VISITS A RETAIL PRACTICE TO A HOSPITAL OR EMERGENCY DEPARTMENT DURING SUCH VISIT; OR (B) THE DEATH OF AN INDIVIDUAL WHO VISITS A RETAIL PRACTICE DURING SUCH VISIT. 2. "COLLABORATIVE RELATIONSHIP" SHALL MEAN AN ARRANGEMENT BETWEEN A RETAIL PRACTICE AND ONE OR MORE OF THE FOLLOWING ENTITIES LOCATED WITHIN THE SAME GEOGRAPHIC REGION AS THE RETAIL PRACTICE, DESIGNED TO FACILI- TATE DEVELOPMENT AND IMPLEMENTATION OF STRATEGIES THAT SUPPORT THE PROVISION OF COORDINATED CARE WITHIN THE POPULATION SERVED BY THE PARTIES TO SUCH RELATIONSHIP: (A) A HOSPITAL LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF THIS CHAP- TER; (B) A PHYSICIAN PRACTICE; (C) AN ACCOUNTABLE CARE ORGANIZATION CERTIFIED PURSUANT TO ARTICLE TWENTY-NINE-E OF THIS CHAPTER; OR (D) A PERFORMING PROVIDER SYSTEM UNDER THE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT PROGRAM. 3. "RETAIL HEALTH SERVICES" SHALL MEAN THE SERVICES OFFERED AND PROVIDED BY A RETAIL PRACTICE. (A) RETAIL HEALTH SERVICES SHALL INCLUDE: (I) THE PROVISION OF TREATMENT AND SERVICES TO PATIENTS FOR MINOR ACUTE EPISODIC ILLNESSES OR CONDITIONS; (II) EPISODIC PREVENTIVE AND WELLNESS TREATMENTS AND SERVICES SUCH AS IMMUNIZATIONS, EXCEPT AS OTHERWISE SPECIFIED IN PARAGRAPH (C) OF THIS SUBDIVISION; (III) TREATMENT AND SERVICES FOR MINOR TRAUMAS THAT ARE NOT REASONABLY LIKELY TO BE LIFE THREATENING OR POTENTIALLY DISABLING IF AMBULATORY CARE WITHIN THE CAPACITY OF THE RETAIL PRACTICE IS PROVIDED; (IV) ADMINISTRATION OF AN OPIOID ANTAGONIST IN THE EVENT OF AN EMER- GENCY; AND (V) LIMITED SCREENING AND REFERRAL FOR BEHAVIORAL HEALTH CONDITIONS. S. 7507--A 23 A. 9507--A (B) RETAIL HEALTH SERVICES MAY INCLUDE LABORATORY TESTS AT THE OPTION OF THE RETAIL PRACTICE, PROVIDED THAT: (I) SUCH TESTS ARE ADMINISTERED SOLELY AS AN ADJUNCT TO TREATMENT OF PATIENTS VISITING THE RETAIL PRACTICE, WITH ALL SPECIMENS COLLECTED AND TESTING PERFORMED ON-SITE; (II) SUCH TESTS ARE "WAIVED TESTS", MEANING A CLINICAL LABORATORY TEST THAT HAS BEEN DESIGNATED AS A WAIVED TEST OR IS OTHERWISE SUBJECT TO CERTIFICATE OF WAIVER REQUIREMENTS PURSUANT TO THE FEDERAL CLINICAL LABORATORY IMPROVEMENT ACT OF NINETEEN HUNDRED EIGHTY-EIGHT, AS AMENDED; AND (III) THE RETAIL PRACTICE OBTAINS APPROVAL FROM THE DEPARTMENT PURSU- ANT TO SECTION FIVE HUNDRED SEVENTY-NINE OF THIS CHAPTER. (C) RETAIL HEALTH SERVICES SHALL NOT INCLUDE: (I) THE PERFORMANCE OF PROCEDURES INVOLVING THE PROVISION OF SEDATION OR ANESTHESIA; (II) THE PROVISION OF SERVICES TO PATIENTS TWENTY-FOUR MONTHS OF AGE OR YOUNGER; (III) THE PROVISION OF IMMUNIZATIONS TO PATIENTS BETWEEN TWENTY-FOUR MONTHS AND EIGHTEEN YEARS OF AGE, OTHER THAN IMMUNIZATIONS AGAINST INFLUENZA; (IV) SERVICES PROVIDED BY PHARMACISTS PURSUANT TO ARTICLE ONE HUNDRED THIRTY-SEVEN OF THE EDUCATION LAW; (V) HEALTH SERVICES PROVIDED ON-SITE BY AN EMPLOYER TO ITS EMPLOYEES IN A RETAIL BUSINESS OPERATION; (V) HEALTH SERVICES PROVIDED ON A TIME-LIMITED BASIS SUCH AS FLU CLIN- ICS OR HEALTH FAIRS; OR (VI) EDUCATIONAL COURSES OFFERED TO INDIVIDUALS ON HEALTH TOPICS, INCLUDING INSTRUCTION IN SELF-MANAGEMENT OF MEDICAL CONDITIONS. 4. "RETAIL PRACTICE" SHALL MEAN AN ENTITY WHICH: (A) IS LOCATED WITHIN THE SPACE OF A RETAIL BUSINESS OPERATION OPEN TO THE GENERAL PUBLIC, SUCH THAT CUSTOMER ACCESS TO THE RETAIL PRACTICE LOCATION IS AVAILABLE WITHIN THE MAIN PREMISES OF THE RETAIL OPERATION; (B) PROVIDES RETAIL HEALTH SERVICES, AS DEFINED IN SUBDIVISION THREE OF THIS SECTION; (C) IS ESTABLISHED AND OVERSEEN BY A RETAIL PRACTICE SPONSOR, AS DEFINED IN SUBDIVISION FIVE OF THIS SECTION; (D) IS STAFFED AT ALL TIMES BY, AT A MINIMUM, ONE OR MORE OF THE FOLLOWING: A PHYSICIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIR- TY-ONE OF THE EDUCATION LAW, A PHYSICIAN ASSISTANT LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE-A OF THE EDUCATION LAW, AND/OR A NURSE PRACTITIONER LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-NINE OF THE EDUCATION LAW; PROVIDED THAT NO MORE THAN FOUR PHYSICIAN ASSISTANTS EMPLOYED BY A RETAIL PRACTICE SPONSOR SHALL BE SUPERVISED BY A SINGLE PHYSICIAN; AND (E) IS ACCREDITED AS SET FORTH IN SECTION TWENTY-NINE HUNDRED NINETY- NINE-KK OF THIS ARTICLE. 5. "RETAIL PRACTICE SPONSOR" SHALL MEAN AN ENTITY FORMED UNDER THE LAWS OF THE STATE OF NEW YORK, WHICH MAY INCLUDE STOCKHOLDERS OR MEMBERS WHICH ARE NOT NATURAL PERSONS, AND WHICH OPERATES ONE OR MORE RETAIL PRACTICES. RETAIL PRACTICE SPONSORS MAY INCLUDE BUSINESS CORPORATIONS, AND GENERAL HOSPITALS, NURSING HOMES, AND DIAGNOSTIC AND TREATMENT CENTERS LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF THIS CHAPTER. § 2999-II. RETAIL PRACTICE SPONSORS. 1. NOTWITHSTANDING ANY LAW TO THE CONTRARY, A RETAIL PRACTICE SPONSOR MAY OPERATE ONE OR MORE RETAIL PRAC- TICES TO PROVIDE RETAIL HEALTH SERVICES IN ACCORDANCE WITH THIS ARTICLE. 2. A RETAIL PRACTICE SPONSOR SHALL: S. 7507--A 24 A. 9507--A (A) EMPLOY OR OTHERWISE RETAIN THE SERVICES OF A MEDICAL DIRECTOR WHO IS LICENSED AND CURRENTLY REGISTERED TO PRACTICE MEDICINE IN THE STATE OF NEW YORK TO OVERSEE THE DEVELOPMENT OF AND ADHERENCE TO MEDICAL POLI- CIES AND PROCEDURES USED IN THE RETAIL PRACTICES OPERATED BY THE RETAIL PRACTICE SPONSOR; (B) ESTABLISH AND MAINTAIN POLICIES AND PROCEDURES REQUIRING RETAIL PRACTICES TO COMPLY WITH THE PROVISIONS OF SECTION TWENTY-NINE HUNDRED NINETY-NINE-JJ OF THIS ARTICLE; (C) NOTIFY THE DEPARTMENT WHEN IT IS PREPARED TO COMMENCE OPERATION OF A RETAIL PRACTICE BY: (I) IDENTIFYING THE CORPORATE NAME OF THE RETAIL PRACTICE SPONSOR, PROVIDING DOCUMENTATION OF ITS ORGANIZATION UNDER THE LAWS OF THE STATE OF NEW YORK, AND IDENTIFYING THE INDIVIDUAL WHO WILL SERVE AS THE POINT OF CONTACT BETWEEN THE RETAIL PRACTICE SPONSOR AND THE DEPARTMENT; (II) IDENTIFYING THE LOCATION OF THE RETAIL PRACTICE, THE SERVICES TO BE OFFERED BY THE RETAIL PRACTICE, THE NAME OF THE INDIVIDUAL EMPLOYED WITH THE OVERALL RESPONSIBILITY FOR THE ON-SITE MANAGEMENT OF THE RETAIL PRACTICE, AND THE STAFFING PLAN FOR THE RETAIL PRACTICE; (III) IDENTIFYING THE ENTITIES WITH WHICH THE RETAIL PRACTICE WILL COLLABORATE PURSUANT TO SUBDIVISION TWO OF SECTION TWENTY-NINE HUNDRED NINETY-NINE-HH OF THIS ARTICLE; AND (IV) IDENTIFYING THE DATE ON WHICH IT ANTICIPATES THAT THE RETAIL PRACTICE WILL BE OPEN FOR BUSINESS; (D) PROMPTLY UPDATE THE DEPARTMENT AS TO ANY CHANGES IN THE INFORMA- TION REQUIRED UNDER SUBDIVISION THREE OF THIS SECTION; AND (E) PROVIDE INFORMATION TO THE DEPARTMENT AT A FREQUENCY AND IN A MANNER DETERMINED BY THE DEPARTMENT, WHICH AT A MINIMUM SHALL INCLUDE AN ANNUAL REPORT THAT PROVIDES DATA, FOR EACH RETAIL PRACTICE OPERATED BY THE RETAIL PRACTICE, ON: (I) THE NUMBER OF VISITS THAT OCCURRED DURING THE TIMEFRAME IDENTIFIED BY THE DEPARTMENT; (II) THE SERVICES PROVIDED TO PATIENTS; (III) THE SOURCE OF PAYMENT FOR SERVICES PROVIDED; (IV) THE NUMBER OF REFERRALS TO PRIMARY CARE PRACTITIONERS MADE; AND (V) THE NUMBER OF REPORTABLE EVENTS THAT OCCURRED. 3. (A) IN DISCHARGING THE DUTIES OF THEIR RESPECTIVE POSITIONS, THE BOARD OF DIRECTORS, COMMITTEES OF THE BOARD, AND INDIVIDUAL DIRECTORS AND OFFICERS OF A RETAIL PRACTICE SPONSOR THAT OPERATES THREE OR MORE RETAIL PRACTICES SHALL CONSIDER THE EFFECTS OF ANY ACTION UPON: (I) THE ABILITY OF THE BUSINESS CORPORATION TO ACCOMPLISH ITS PURPOSE; (II) THE SHAREHOLDERS OF THE BUSINESS CORPORATION; (III) THE INTERESTS OF PATIENTS OF THE RETAIL PRACTICES; (IV) COMMUNITY AND SOCIETAL CONSIDERATIONS, INCLUDING THOSE OF THE COMMUNITIES IN WHICH RETAIL PRACTICES ARE LOCATED. (B) THE CONSIDERATION OF INTERESTS AND FACTORS IN THE MANNER REQUIRED IN PARAGRAPH (A) OF THIS SUBDIVISION: (I) SHALL NOT CONSTITUTE A VIOLATION OF THE PROVISIONS OF SECTION SEVEN HUNDRED FIFTEEN OR SEVEN HUNDRED SEVENTEEN OF THE BUSINESS CORPO- RATION LAW; AND (II) 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. (C) A RETAIL PRACTICE SPONSOR THAT OPERATES THREE OR MORE RETAIL PRAC- TICES SHALL PUBLISH ON A PUBLICLY AVAILABLE WEBSITE A DESCRIPTION OF HOW ITS OPERATION OF EXISTING AND PLANNED RETAIL PRACTICES: S. 7507--A 25 A. 9507--A (I) WILL IMPROVE ACCESS TO SERVICES IN THE COMMUNITIES WHERE THEY ARE LOCATED; (II) SUPPORTS A COMMITMENT TO OFFER ASSISTANCE TO INDIVIDUALS WHO DO NOT HAVE HEALTH CARE COVERAGE; (III) SUPPORTS AN OVERALL COMMITMENT BY THE RETAIL PRACTICE SPONSOR TO OPERATE SOME OF ITS RETAIL PRACTICES IN MEDICALLY UNDERSERVED AREAS OF THE STATE AS DEFINED BY THE COMMISSIONER; AND (IV) WILL OTHERWISE BENEFIT THE COMMUNITIES WHERE THEY ARE LOCATED. § 2999-JJ. RETAIL PRACTICES. 1. RETAIL HEALTH SERVICES SHALL NOT BE PROVIDED IN A RETAIL BUSINESS OPERATION OPEN TO THE PUBLIC EXCEPT IN ACCORDANCE WITH THIS ARTICLE. 2. NOTWITHSTANDING ANY LAW TO THE CONTRARY, A RETAIL PRACTICE SHALL: (A) PROVIDE RETAIL HEALTH SERVICES AND ONLY RETAIL HEALTH SERVICES; (B) PROVIDE TREATMENT WITHOUT DISCRIMINATION AS TO SOURCE OF PAYMENT; (C) MAINTAIN A POLICY OFFERING A SLIDING SCALE FOR PAYMENT FOR PATIENTS WHO DO NOT HAVE HEALTH CARE COVERAGE AND PUBLISH SUCH POLICY ON A PUBLICLY AVAILABLE WEBSITE; (D) PROVIDE TO PATIENTS WHO INDICATE THAT THEY DO NOT HAVE HEALTH CARE COVERAGE INFORMATION ON THE STATE HEALTH BENEFIT EXCHANGE, INCLUDING THE WEBSITE ADDRESS FOR THE EXCHANGE AND CONTACT INFORMATION FOR LOCAL NAVI- GATORS OFFERING IN-PERSON ENROLLMENT ASSISTANCE; (E) ACCEPT WALK-IN PATIENTS WITHOUT PREVIOUSLY SCHEDULED APPOINTMENTS; (F) OFFER BUSINESS HOURS FOR A MINIMUM OF TWELVE HOURS PER DAY AND SIX DAYS PER WEEK OR, IF THE RETAIL BUSINESS IN WHICH THE RETAIL PRACTICE IS LOCATED IS OPEN FOR LESS THAN TWELVE HOURS PER DAY AND SIX DAYS PER WEEK, THEN THE RETAIL PRACTICE SHALL OFFER THE SAME BUSINESS HOURS AS THE RETAIL BUSINESS; (G) PUBLISH A LIST OF THE RETAIL HEALTH SERVICES IT OFFERS ON A PUBLICLY AVAILABLE WEBSITE TOGETHER WITH THE PRICES OF SUCH SERVICES; (H) POST SIGNS IN A CONSPICUOUS LOCATION IN LARGE TYPE STATING 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; (I) ENTER INTO AND MAINTAIN AT LEAST ONE COLLABORATIVE RELATIONSHIP AS DEFINED IN SUBDIVISION TWO OF SECTION TWENTY-NINE HUNDRED NINETY-NINE-HH OF THIS ARTICLE; (J) INQUIRE OF EACH PATIENT WHETHER HE OR SHE HAS A PRIMARY CARE PROVIDER; (K) MAINTAIN AND REGULARLY UPDATE A LIST OF LOCAL PRIMARY CARE PROVID- ERS AND PROVIDE SUCH LIST TO EACH PATIENT WHO INDICATES THAT HE OR SHE DOES NOT HAVE A PRIMARY CARE PROVIDER; (L) REFER PATIENTS TO THEIR PRIMARY CARE PROVIDERS OR OTHER HEALTH CARE PROVIDERS AS APPROPRIATE; (M) TRANSMIT, BY ELECTRONIC MEANS WHENEVER POSSIBLE, RECORDS OF SERVICES TO PATIENTS' PRIMARY CARE PROVIDERS AND MAINTAIN RECORDS OF SERVICES FOR A MINIMUM OF SIX YEARS; (N) EXECUTE PARTICIPATION AGREEMENTS WITH HEALTH INFORMATION ORGANIZA- TIONS, ALSO KNOWN AS QUALIFIED ENTITIES, PURSUANT TO WHICH THE RETAIL PRACTICE SHALL AGREE TO PARTICIPATE IN THE STATEWIDE HEALTH INFORMATION NETWORK FOR NEW YORK (SHIN-NY); (O) ATTAIN AND MAINTAIN ACCREDITATION PURSUANT TO SECTION TWENTY-NINE HUNDRED NINETY-NINE-KK OF THIS SECTION; AND (P) REPORT REPORTABLE EVENTS TO THE ACCREDITING ENTITY WITHIN THREE BUSINESS DAYS OF THE OCCURRENCE OF SUCH REPORTABLE EVENT. 3. ENTITIES MEETING THE DEFINITION OF A RETAIL PRACTICE AS SET FORTH IN THIS ARTICLE AND PROVIDING SERVICES ON OR BEFORE THE EFFECTIVE DATE S. 7507--A 26 A. 9507--A OF THIS ARTICLE SHALL HAVE ONE HUNDRED TWENTY DAYS AFTER SUCH EFFECTIVE DATE TO NOTIFY THE DEPARTMENT OF COMPLIANCE THEREWITH. § 2999-KK. ACCREDITATION. 1. A RETAIL PRACTICE SHALL BE REQUIRED TO ATTAIN AND MAINTAIN ACCREDITATION BY A NATIONALLY RECOGNIZED ACCREDITING ENTITY AS DETERMINED BY THE DEPARTMENT. 2. THE ACCREDITING ENTITY SHALL BE REQUIRED TO NOTIFY THE DEPARTMENT PROMPTLY IF A RETAIL PRACTICE LOSES ITS ACCREDITATION. 3. THE ACCREDITING ENTITY SHALL BE REQUIRED TO REPORT DATA ON ALL RETAIL PRACTICES ACCREDITED BY SUCH ENTITY TO THE COMMISSIONER. § 2999-LL. OTHER LAWS. 1. NOTHING IN THIS ARTICLE SHALL BE DEEMED TO ALTER THE SCOPE OF PRACTICE OF ANY PRACTITIONER LICENSED OR CERTIFIED UNDER TITLE EIGHT OF THE EDUCATION LAW. 2. NOTHING IN THIS ARTICLE SHALL BE DEEMED TO MITIGATE THE RESPONSI- BILITY OF ANY INDIVIDUAL PRACTITIONER LICENSED OR CERTIFIED UNDER TITLE EIGHT OF THE EDUCATION LAW FROM ACCOUNTABILITY FOR HIS OR HER ACTIONS UNDER APPLICABLE PROVISIONS OF LAW. 3. A RETAIL PRACTICE SHALL BE DEEMED TO BE A "HEALTH CARE PROVIDER" FOR THE PURPOSES OF TITLE TWO-D OF ARTICLE TWO OF THIS CHAPTER. 4. A PRESCRIBER PRACTICING IN A RETAIL PRACTICE 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. § 2. This act shall take effect immediately. PART H Section 1. Section 6902 of the education law is amended by adding a new subdivision 4 to read as follows: 4. (A) THE PRACTICE OF REGISTERED PROFESSIONAL NURSING BY A CERTIFIED REGISTERED NURSE ANESTHETIST, CERTIFIED UNDER SECTION SIXTY-NINE HUNDRED TWELVE OF THIS ARTICLE MAY INCLUDE THE PRACTICE OF NURSE ANESTHESIA. (I) SUBJECT TO THE PROVISIONS OF PARAGRAPH (E) OF THIS SUBDIVISION, NURSE ANESTHESIA INCLUDES: THE ADMINISTRATION OF ANESTHESIA AND ANES- THESIA RELATED CARE TO PATIENTS; PRE-ANESTHESIA EVALUATION AND PREPARA- TION; ANESTHETIC INDUCTION, MAINTENANCE AND EMERGENCE; POST ANESTHESIA CARE; PERIANESTHESIA NURSING AND CLINICAL SUPPORT FUNCTIONS; AND PAIN MANAGEMENT. (II) NURSE ANESTHESIA MUST BE PROVIDED IN COLLABORATION WITH A LICENSED PHYSICIAN QUALIFIED TO DETERMINE THE NEED FOR ANESTHESIA SERVICES, PROVIDED SUCH SERVICES ARE PERFORMED IN ACCORDANCE WITH A WRITTEN PRACTICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS AS SET FORTH IN PARAGRAPH (B) OF THIS SUBDIVISION OR PURSUANT TO COLLABORATIVE RELATIONSHIPS AS SET FORTH IN PARAGRAPH (C) OF THIS SUBDIVISION, WHICH- EVER IS APPLICABLE. (III) PRESCRIPTIONS FOR DRUGS, DEVICES, AND ANESTHETIC AGENTS, ANES- THESIA RELATED AGENTS, AND PAIN MANAGEMENT AGENTS MAY BE ISSUED BY A CERTIFIED REGISTERED NURSE ANESTHETIST, IN ACCORDANCE WITH THE WRITTEN PRACTICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS DESCRIBED IN PARAGRAPH (B) OF THIS SUBDIVISION IF APPLICABLE. THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL OBTAIN A CERTIFICATE FROM THE DEPARTMENT UPON SUCCESS- FULLY COMPLETING A PROGRAM INCLUDING AN APPROPRIATE PHARMACOLOGY COMPO- NENT, OR ITS EQUIVALENT, AS ESTABLISHED BY THE COMMISSIONER'S REGU- LATIONS, PRIOR TO PRESCRIBING UNDER THIS SUBPARAGRAPH. THE CERTIFICATE ISSUED UNDER SECTION SIXTY-NINE HUNDRED TWELVE OF THIS ARTICLE SHALL STATE WHETHER THE CERTIFIED REGISTERED NURSE ANESTHETIST HAS SUCCESSFUL- S. 7507--A 27 A. 9507--A LY COMPLETED SUCH A PROGRAM OR EQUIVALENT AND IS AUTHORIZED TO PRESCRIBE UNDER THIS SUBDIVISION. (B) A CERTIFIED REGISTERED NURSE ANESTHETIST CERTIFIED UNDER SECTION SIXTY-NINE HUNDRED TWELVE OF THIS ARTICLE AND PRACTICING FOR THIRTY-SIX HUNDRED HOURS OR LESS SHALL DO SO IN ACCORDANCE WITH A WRITTEN PRACTICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS AGREED UPON BY A LICENSED PHYSICIAN QUALIFIED BY EDUCATION AND EXPERIENCE TO DETERMINE THE NEED FOR ANESTHESIA. (I) THE WRITTEN PRACTICE AGREEMENT SHALL INCLUDE EXPLICIT PROVISIONS FOR THE RESOLUTION OF ANY DISAGREEMENT BETWEEN THE COLLABORATING PHYSI- CIAN AND THE CERTIFIED REGISTERED NURSE ANESTHETIST REGARDING A MATTER OF ANESTHESIA OR PAIN MANAGEMENT TREATMENT THAT IS WITHIN THE SCOPE OF PRACTICE OF BOTH. TO THE EXTENT THE PRACTICE AGREEMENT DOES NOT SO PROVIDE, THEN THE COLLABORATING PHYSICIAN'S TREATMENT SHALL PREVAIL. (II) EACH PRACTICE AGREEMENT SHALL PROVIDE FOR PATIENT RECORDS REVIEW BY THE COLLABORATING PHYSICIAN IN A TIMELY FASHION BUT IN NO EVENT LESS OFTEN THAN EVERY THREE MONTHS. THE NAMES OF THE CERTIFIED REGISTERED NURSE ANESTHETIST AND THE COLLABORATING PHYSICIAN SHALL BE CLEARLY POST- ED IN THE PRACTICE SETTING OF THE CERTIFIED REGISTERED NURSE ANESTHE- TIST. (III) THE PRACTICE PROTOCOL SHALL REFLECT CURRENT ACCEPTED MEDICAL AND NURSING PRACTICE. THE PROTOCOLS SHALL BE FILED WITH THE DEPARTMENT WITHIN NINETY DAYS OF THE COMMENCEMENT OF THE PRACTICE AND MAY BE UPDATED PERIODICALLY. THE COMMISSIONER SHALL MAKE REGULATIONS ESTABLISH- ING THE PROCEDURE FOR THE REVIEW OF PROTOCOLS AND THE DISPOSITION OF ANY ISSUES ARISING FROM SUCH REVIEW. (C) A CERTIFIED REGISTERED NURSE ANESTHETIST CERTIFIED UNDER SECTION SIXTY-NINE HUNDRED TWELVE OF THIS ARTICLE AND PRACTICING FOR MORE THAN THIRTY-SIX HUNDRED HOURS SHALL HAVE COLLABORATIVE RELATIONSHIPS WITH ONE OR MORE LICENSED PHYSICIANS QUALIFIED TO DETERMINE THE NEED FOR ANES- THESIA SERVICES OR A HOSPITAL, LICENSED UNDER ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, THAT PROVIDES SERVICES THROUGH LICENSED PHYSI- CIANS QUALIFIED TO DETERMINE THE NEED FOR ANESTHESIA SERVICES AND HAVING PRIVILEGES AT SUCH INSTITUTION. (I) FOR PURPOSES OF THIS PARAGRAPH, "COLLABORATIVE RELATIONSHIPS" SHALL MEAN THAT THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL COMMU- NICATE, WHETHER IN PERSON, BY TELEPHONE OR THROUGH WRITTEN (INCLUDING ELECTRONIC) MEANS, WITH A LICENSED PHYSICIAN QUALIFIED TO DETERMINE THE NEED FOR ANESTHESIA SERVICES OR, IN THE CASE OF A HOSPITAL, COMMUNICATE WITH A LICENSED PHYSICIAN QUALIFIED TO DETERMINE THE NEED FOR ANESTHESIA SERVICES AND HAVING PRIVILEGES AT SUCH HOSPITAL, FOR THE PURPOSES OF EXCHANGING INFORMATION, AS NEEDED, IN ORDER TO PROVIDE COMPREHENSIVE PATIENT CARE AND TO MAKE REFERRALS AS NECESSARY. (II) AS EVIDENCE THAT THE CERTIFIED REGISTERED NURSE ANESTHETIST MAIN- TAINS COLLABORATIVE RELATIONSHIPS, THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL COMPLETE AND MAINTAIN A FORM, CREATED BY THE DEPART- MENT, TO WHICH THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL ATTEST, THAT DESCRIBES SUCH COLLABORATIVE RELATIONSHIPS. SUCH FORM SHALL ALSO REFLECT THE CERTIFIED REGISTERED NURSE ANESTHETIST'S ACKNOWLEDGEMENT THAT IF REASONABLE EFFORTS TO RESOLVE ANY DISPUTE THAT MAY ARISE WITH THE COLLABORATING PHYSICIAN OR, IN THE CASE OF A COLLABORATION WITH A HOSPITAL, WITH A LICENSED PHYSICIAN QUALIFIED TO DETERMINE THE NEED FOR ANESTHESIA SERVICES AND HAVING PRIVILEGES AT SUCH HOSPITAL, ABOUT A PATIENT'S CARE ARE NOT SUCCESSFUL, THE RECOMMENDATION OF THE PHYSICIAN SHALL PREVAIL. SUCH FORM SHALL BE UPDATED AS NEEDED AND MAY BE SUBJECT TO REVIEW BY THE DEPARTMENT. THE CERTIFIED REGISTERED NURSE ANESTHETIST S. 7507--A 28 A. 9507--A SHALL MAINTAIN DOCUMENTATION THAT SUPPORTS SUCH COLLABORATIVE RELATION- SHIPS. (D) NOTHING IN THIS SUBDIVISION SHALL BE DEEMED TO LIMIT OR DIMINISH THE PRACTICE OF THE PROFESSION OF NURSING AS A REGISTERED PROFESSIONAL NURSE UNDER THIS ARTICLE OR ANY OTHER LAW, RULE, REGULATION OR CERTIF- ICATION, NOR TO DENY ANY REGISTERED PROFESSIONAL NURSE THE RIGHT TO DO ANY ACT OR ENGAGE IN ANY PRACTICE AUTHORIZED BY THIS ARTICLE OR ANY OTHER LAW, RULE, REGULATION OR CERTIFICATION. (E)(I) ANESTHESIA SERVICES MAY BE PROVIDED BY CERTIFIED REGISTERED NURSE ANESTHETISTS ONLY IN THE FOLLOWING SETTINGS: (A) GENERAL HOSPITALS, HOSPITAL OUTPATIENT SURGICAL DEPARTMENTS, AND DIAGNOSTIC AND TREATMENT CENTERS LICENSED BY THE DEPARTMENT OF HEALTH PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW AND AUTHORIZED TO PROVIDE SEDATION, ANESTHESIA SERVICES, AND/OR PAIN MANAGEMENT SERVICES IN CONNECTION WITH SUCH LICENSURE; (B) PRACTICES WHERE OFFICE-BASED SURGERY, AS DEFINED BY SECTION TWO HUNDRED-THIRTY-D OF THE PUBLIC HEALTH LAW, IS PERFORMED AND/OR PAIN MANAGEMENT SERVICES ARE PROVIDED; AND (C) DENTISTS' AND PERIODONTISTS' OFFICES WHERE SEDATION AND/OR ANES- THESIA SERVICES ARE PROVIDED. (II) ANESTHESIA SERVICES OFFERED IN SUCH SETTINGS, INCLUDING SERVICES PROVIDED BY CERTIFIED REGISTERED NURSE ANESTHETISTS, SHALL BE DIRECTED BY A PHYSICIAN, DENTIST, OR PERIODONTIST, AS APPLICABLE, WHO IS RESPON- SIBLE FOR THE CLINICAL ASPECTS OF ALL ANESTHESIA SERVICES OFFERED BY THE PROVIDER AND IS QUALIFIED TO DETERMINE THE NEED FOR AND ADMINISTER ANES- THESIA. SUCH PHYSICIAN SHALL HAVE THE DISCRETION TO ESTABLISH PARAMETERS FOR SUPERVISION OF CERTIFIED REGISTERED NURSE ANESTHETISTS WHERE HE OR SHE MAKES A REASONABLE DETERMINATION THAT THE CIRCUMSTANCES OF A PARTIC- ULAR CASE OR TYPE OF CASES, ALTHOUGH WITHIN THE SCOPE OF PRACTICE OF A CERTIFIED REGISTERED NURSE ANESTHETIST AS SET FORTH IN PARAGRAPH (A) OF THIS SUBDIVISION, ARE OF SUCH COMPLEXITY THAT THEY SHOULD BE CONDUCTED UNDER SUPERVISION. IN SUCH CASES, SUCH SUPERVISION SHALL BE PROVIDED BY AN ANESTHESIOLOGIST WHO IS IMMEDIATELY AVAILABLE AS NEEDED OR BY THE OPERATING PHYSICIAN WHO IS QUALIFIED TO DETERMINE THE NEED FOR ANES- THESIA SERVICES AND SUPERVISE THE ADMINISTRATION OF ANESTHESIA. § 2. The education law is amended by adding a new section 6912 to read as follows: § 6912. CERTIFICATES FOR NURSE ANESTHESIA PRACTICE. 1. FOR ISSUANCE OF A CERTIFICATE TO PRACTICE AS A CERTIFIED REGISTERED NURSE ANESTHETIST UNDER SUBDIVISION FOUR OF SECTION SIXTY-NINE HUNDRED TWO OF THIS ARTI- CLE, THE APPLICANT SHALL FULFILL THE FOLLOWING REQUIREMENTS: (A) APPLICATION: FILE AN APPLICATION WITH THE DEPARTMENT; (B) LICENSE: BE LICENSED AS A REGISTERED PROFESSIONAL NURSE IN THE STATE; (C) EDUCATION: (I) HAVE SATISFACTORILY COMPLETED EDUCATIONAL PREPARA- TION FOR PROVISION OF THESE SERVICES IN A PROGRAM REGISTERED BY THE DEPARTMENT OR IN A PROGRAM ACCREDITED BY A NATIONAL BODY RECOGNIZED BY THE DEPARTMENT OR DETERMINED BY THE DEPARTMENT TO BE THE EQUIVALENT; AND (II) SUBMIT EVIDENCE OF CURRENT CERTIFICATION OR RECERTIFICATION BY A NATIONAL CERTIFYING BODY, RECOGNIZED BY THE DEPARTMENT; (D) FEES: PAY A FEE TO THE DEPARTMENT OF FIFTY DOLLARS FOR AN INITIAL CERTIFICATE AUTHORIZING NURSE ANESTHESIA PRACTICE AND A TRIENNIAL REGIS- TRATION FEE OF THIRTY DOLLARS; AND (E) INFORMATION AND DOCUMENTATION: IN CONJUNCTION WITH AND AS A CONDI- TION OF EACH TRIENNIAL REGISTRATION, PROVIDE TO THE DEPARTMENT, AND THE DEPARTMENT SHALL COLLECT, SUCH INFORMATION AND DOCUMENTATION REQUIRED BY S. 7507--A 29 A. 9507--A THE DEPARTMENT, IN CONSULTATION WITH THE DEPARTMENT OF HEALTH, AS IS NECESSARY TO ENABLE THE DEPARTMENT OF HEALTH TO EVALUATE ACCESS TO NEED- ED SERVICES IN THIS STATE, INCLUDING, BUT NOT LIMITED TO, THE LOCATION AND TYPE OF SETTING WHEREIN THE CERTIFIED REGISTERED NURSE ANESTHETIST PRACTICES AND OTHER INFORMATION THE DEPARTMENT, IN CONSULTATION WITH THE DEPARTMENT OF HEALTH, DEEMS RELEVANT. THE DEPARTMENT OF HEALTH, IN CONSULTATION WITH THE DEPARTMENT, SHALL MAKE SUCH DATA AVAILABLE IN AGGREGATE, DE-IDENTIFIED FORM ON A PUBLICLY ACCESSIBLE WEBSITE. ADDI- TIONALLY, IN CONJUNCTION WITH EACH TRIENNIAL REGISTRATION, THE DEPART- MENT, IN CONSULTATION WITH THE DEPARTMENT OF HEALTH, SHALL PROVIDE INFORMATION ON REGISTERING IN THE DONATE LIFE REGISTRY FOR ORGAN AND TISSUE DONATION, INCLUDING THE WEBSITE ADDRESS FOR SUCH REGISTRY. AFTER A CERTIFIED REGISTERED NURSE ANESTHETIST'S INITIAL REGISTRATION, REGISTRATION UNDER THIS SECTION SHALL BE COTERMINOUS WITH THE CERTIFIED REGISTERED NURSE ANESTHETIST'S REGISTRATION AS A PROFESSIONAL NURSE. 2. ONLY A PERSON CERTIFIED UNDER THIS SECTION SHALL USE THE TITLE "CERTIFIED REGISTERED NURSE ANESTHETIST," EXCEPT AS SET FORTH IN SUBDI- VISION THREE OF THIS SECTION. 3. NOTHING IN THIS SECTION SHALL BE DEEMED FROM PREVENTING ANY OTHER PROFESSIONAL LICENSED OR CERTIFIED UNDER THIS CHAPTER OR THE PUBLIC HEALTH LAW FROM CARRYING OUT ANY RESPONSIBILITIES ESTABLISHED BY RELE- VANT SECTIONS OF SUCH CHAPTERS. 4. AN INDIVIDUAL WHO MEETS THE REQUIREMENTS FOR CERTIFICATION AS A CERTIFIED REGISTERED NURSE ANESTHETIST AND WHO HAS BEEN PERFORMING THE DUTIES OF A CERTIFIED REGISTERED NURSE ANESTHETIST FOR TWO OF THE FIVE YEARS PRIOR TO THE EFFECTIVE DATE OF THIS ARTICLE MAY BE CERTIFIED WITH- OUT MEETING ADDITIONAL REQUIREMENTS, PROVIDED THAT SUCH INDIVIDUAL SUBMITS AN APPLICATION, INCLUDING AN ATTESTATION FROM THE APPLICANT'S SUPERVISING PHYSICIAN AS TO THE APPLICANT'S EXPERIENCE AND COMPETENCE, TO THE DEPARTMENT WITHIN TWO YEARS OF THE EFFECTIVE DATE OF THIS SECTION. SUCH INDIVIDUAL MAY USE THE TITLE "CERTIFIED REGISTERED NURSE ANESTHETIST" IN CONNECTION WITH THAT PRACTICE WHILE SUCH APPLICATION IS PENDING. 5. (A) A REGISTERED PROFESSIONAL NURSE LICENSED UNDER SECTION SIXTY- NINE HUNDRED FIVE OF THIS ARTICLE WHO HAS SATISFACTORILY COMPLETED A PROGRAM OF EDUCATIONAL PREPARATION AS PROVIDED IN SUBDIVISION ONE OF THIS SECTION MAY, FOR A PERIOD NOT TO EXCEED TWENTY-FOUR MONTHS IMME- DIATELY FOLLOWING THE COMPLETION OF SUCH EDUCATIONAL PROGRAM, PRACTICE NURSE ANESTHESIA UNDER SUBDIVISION FOUR OF SECTION SIXTY-NINE HUNDRED TWO OF THIS ARTICLE AS A GRADUATE NURSE ANESTHETIST IN THE SAME MANNER AS A CERTIFIED REGISTERED NURSE ANESTHETIST UNDER THAT SUBDIVISION. (B) A REGISTERED PROFESSIONAL NURSE LICENSED UNDER SECTION SIXTY-NINE HUNDRED FIVE OF THIS ARTICLE WHO IS DULY ENROLLED IN A PROGRAM OF EDUCA- TIONAL PREPARATION MAY PRACTICE NURSE ANESTHESIA AS A STUDENT NURSE ANESTHETIST UNDER THE SUPERVISION OF AN ANESTHESIOLOGIST OR A CERTIFIED REGISTERED NURSE ANESTHETIST, WHO IS IMMEDIATELY AVAILABLE AS NEEDED. § 3. This act shall take effect immediately. PART I Section 1. Section 364-j of the social services law is amended by adding a new subdivision 34 to read as follows: 34. MONIES PAID BY THE DEPARTMENT TO MANAGED CARE ORGANIZATIONS ARE PUBLIC FUNDS AND RETAIN THEIR STATUS AS PUBLIC FUNDS REGARDLESS OF ANY PAYMENTS MADE BY THE MANAGED CARE ORGANIZATION TO SUBCONTRACTORS OR PROVIDERS. S. 7507--A 30 A. 9507--A § 2. Section 364-j of the social services law is amended by adding a new subdivision 35 to read as follows: 35. RECOVERY OF OVERPAYMENTS FROM NETWORK PROVIDERS. (A) WHERE THE MEDICAID INSPECTOR GENERAL, DURING THE COURSE OF AN AUDIT OR INVESTI- GATION, IDENTIFIES IMPROPER MEDICAL ASSISTANCE PAYMENTS MADE BY A MANAGED CARE ORGANIZATION TO ITS SUBCONTRACTOR OR SUBCONTRACTORS OR PROVIDER OR PROVIDERS, THE STATE SHALL HAVE THE RIGHT TO RECOVER THE IMPROPER PAYMENT FROM THE SUBCONTRACTOR OR SUBCONTRACTORS, PROVIDER OR PROVIDERS, OR THE MANAGED CARE ORGANIZATION. (B) WHERE THE STATE IS UNSUCCESSFUL IN RECOVERING THE IMPROPER PAYMENT FROM THE SUBCONTRACTOR OR SUBCONTRACTORS OR PROVIDER OR PROVIDERS, THE MEDICAID INSPECTOR GENERAL MAY REQUIRE THE MANAGED CARE ORGANIZATION TO RECOVER THE IMPROPER MEDICAL ASSISTANCE PAYMENTS IDENTIFIED IN PARAGRAPH (A) OF THIS SUBDIVISION. THE MANAGED CARE ORGANIZATION SHALL REMIT TO THE STATE THE FULL AMOUNT OF THE IDENTIFIED IMPROPER PAYMENT NO LATER THAN SIX MONTHS AFTER RECEIVING NOTICE OF THE OVERPAYMENT. (C) THE MANAGED CARE ORGANIZATION MAY CHARGE ITS SUBCONTRACTOR OR SUBCONTRACTORS OR PROVIDER OR PROVIDERS A COLLECTION FEE TO ACCOUNT FOR THE REASONABLE COSTS INCURRED BY THE MANAGED CARE ORGANIZATION TO COLLECT THE DEBT. ANY COLLECTION FEE IMPOSED SHALL NOT EXCEED FIVE PERCENT OF THE TOTAL AMOUNT OWED. § 3. Section 364-j of the social services law is amended by adding a new subdivision 36 to read as follows: 36. REPORTING ACTS OF FRAUD. (A) ALL MANAGED CARE ORGANIZATIONS SHALL PROMPTLY REFER TO THE OFFICE OF THE MEDICAID INSPECTOR GENERAL ALL CASES OF POTENTIAL FRAUD, WASTE, OR ABUSE. (B) ANY MANAGED CARE ORGANIZATION MAKING A COMPLAINT OR FURNISHING A REPORT, REFERRAL, INFORMATION OR RECORDS IN GOOD FAITH PURSUANT TO THIS SECTION SHALL BE IMMUNE FROM CIVIL LIABILITY FOR MAKING SUCH COMPLAINT, REFERRAL, OR REPORT TO THE OFFICE OF THE MEDICAID INSPECTOR GENERAL. (C) A MANAGED CARE ORGANIZATION THAT WILLFULLY FAILS TO PROMPTLY MAKE A REFERRAL TO THE MEDICAID INSPECTOR GENERAL WHEN THERE IS ACTUAL KNOW- LEDGE THAT AN ACT OF FRAUD IS BEING OR HAS BEEN COMMITTED MAY BE FINED IN AN AMOUNT NOT EXCEEDING ONE HUNDRED THOUSAND DOLLARS FOR EACH DETER- MINATION. § 4. The public health law is amended by adding a new section 37 to read as follows: § 37. VIOLATIONS OF MEDICAL ASSISTANCE PROGRAM LAWS, REGULATIONS OR DIRECTIVES; FINES. 1. (A) ANY INDIVIDUAL OR ENTITY PARTICIPATING IN THE MEDICAL ASSISTANCE PROGRAM THAT FAILS TO COMPLY WITH OR VIOLATES ANY STATUTE, RULE, REGULATION, OR DIRECTIVE OF THE MEDICAL ASSISTANCE PROGRAM, MAY BE FINED IN AN AMOUNT NOT EXCEEDING THE SUM OF FIVE THOU- SAND DOLLARS FOR EACH VIOLATION. (B) EVERY FAILURE TO COMPLY WITH OR VIOLATION OF ANY STATUTE, RULE, REGULATION, OR DIRECTIVE OF THE MEDICAL ASSISTANCE PROGRAM SHALL BE A SEPARATE AND DISTINCT OFFENSE AND, IN THE CASE OF A CONTINUING VIOLATION, EVERY DAY'S CONTINUANCE THEREOF SHALL BE A SEPARATE AND DISTINCT OFFENSE. 2. (A) ANY ENTITY AUTHORIZED TO OPERATE UNDER ARTICLE FORTY-FOUR OF THIS CHAPTER OR ARTICLE FORTY-THREE OF THE INSURANCE LAW, INCLUDING ANY SUBCONTRACTOR OR PROVIDER THEREOF, AND PARTICIPATING IN THE MEDICAL ASSISTANCE PROGRAM THAT FAILS TO COMPLY WITH OR VIOLATES ANY STATUTE, RULE, REGULATION, OR DIRECTIVE OF THE MEDICAL ASSISTANCE PROGRAM, OR ANY TERM OF ITS CONTRACT WITH THE DEPARTMENT, MAY BE FINED IN AN AMOUNT NOT EXCEEDING THE SUM OF FIVE THOUSAND DOLLARS FOR EACH VIOLATION. S. 7507--A 31 A. 9507--A (B) EVERY FAILURE TO COMPLY WITH OR VIOLATION OF ANY STATUTE, RULE, REGULATION, OR DIRECTIVE OF THE MEDICAL ASSISTANCE PROGRAM, OR TERM OF THE ENTITY'S CONTRACT WITH THE DEPARTMENT SHALL BE A SEPARATE AND DISTINCT OFFENSE AND, IN THE CASE OF A CONTINUING VIOLATION, EVERY DAY'S CONTINUANCE THEREOF SHALL BE A SEPARATE AND DISTINCT OFFENSE. 3. ANY ENTITY PARTICIPATING IN THE MEDICAL ASSISTANCE PROGRAM AND AUTHORIZED TO OPERATE UNDER ARTICLE FORTY-FOUR OF THIS CHAPTER OR ARTI- CLE FORTY-THREE OF THE INSURANCE LAW THAT SUBMITS A COST REPORT TO THE MEDICAL ASSISTANCE PROGRAM THAT CONTAINS DATA WHICH IS INTENTIONALLY OR SYSTEMATICALLY INACCURATE OR IMPROPER, MAY BE FINED IN AN AMOUNT NOT EXCEEDING ONE HUNDRED THOUSAND DOLLARS FOR EACH DETERMINATION. 4. ANY ENTITY AUTHORIZED TO OPERATE UNDER ARTICLE FORTY-FOUR OF THIS CHAPTER OR ARTICLE FORTY-THREE OF THE INSURANCE LAW, AND PARTICIPATING IN THE MEDICAL ASSISTANCE PROGRAM THAT INTENTIONALLY OR SYSTEMATICALLY SUBMITS INACCURATE ENCOUNTER DATA TO THE STATE MAY BE FINED IN AN AMOUNT NOT EXCEEDING ONE HUNDRED THOUSAND DOLLARS FOR EACH DETERMINATION. 5. THE MEDICAID INSPECTOR GENERAL SHALL, IN CONSULTATION WITH THE COMMISSIONER, CONSIDER THE FOLLOWING PRIOR TO ASSESSING A FINE AGAINST AN INDIVIDUAL OR ENTITY UNDER THIS SECTION AND HAVE THE DISCRETION TO REDUCE OR ELIMINATE A FINE UNDER THIS SECTION: (A) THE EFFECT, IF ANY, ON THE QUALITY OF MEDICAL CARE PROVIDED TO OR ARRANGED FOR RECIPIENTS OF MEDICAL ASSISTANCE AS A RESULT OF THE ACTS OF THE INDIVIDUAL OR ENTITY; (B) THE AMOUNT OF DAMAGES TO THE PROGRAM; (C) THE DEGREE OF CULPABILITY OF THE INDIVIDUAL OR ENTITY IN COMMIT- TING THE PROSCRIBED ACTIONS AND ANY MITIGATING CIRCUMSTANCES; (D) ANY PRIOR VIOLATIONS COMMITTED BY THE INDIVIDUAL OR ENTITY RELAT- ING TO THE MEDICAL ASSISTANCE PROGRAM, MEDICARE OR ANY OTHER SOCIAL SERVICES PROGRAMS WHICH RESULTED IN EITHER CRIMINAL OR ADMINISTRATIVE SANCTION, PENALTY, OR FINE; (E) THE DEGREE TO WHICH FACTORS GIVING RISE TO THE PROSCRIBED ACTIONS WERE OUT OF THE CONTROL OF THE INDIVIDUAL OR ENTITY; (F) THE NUMBER AND NATURE OF THE VIOLATIONS OR OTHER RELATED OFFENSES; (G) ANY OTHER FACTS RELATING TO THE NATURE AND SERIOUSNESS OF THE VIOLATIONS INCLUDING ANY EXCULPATORY FACTS; AND/OR (H) ANY OTHER RELEVANT FACTORS. 6. THE MEDICAID INSPECTOR GENERAL SHALL, IN CONSULTATION WITH THE COMMISSIONER, PROMULGATE REGULATIONS ENUMERATING THOSE VIOLATIONS WHICH MAY RESULT IN A FINE PURSUANT TO SUBDIVISIONS ONE AND TWO OF THIS SECTION, THE AMOUNTS OF ANY FINES WHICH MAY BE ASSESSED UNDER THIS SECTION, AND THE APPEAL RIGHTS AFFORDED TO INDIVIDUALS OR ENTITIES SUBJECT TO A FINE. § 5. Paragraph (d) of subdivision 32 of section 364-j of the social services law, as added by section 15 of part B of chapter 59 of the laws of 2016, is amended to read as follows: (d) (I) Penalties under this subdivision may be applied to any and all circumstances described in paragraph (b) of this subdivision until the managed care organization complies with the requirements for submission of encounter data. (II) No penalties for late, incomplete or inaccurate encounter data shall be assessed against managed care organizations in addition to those provided for in this subdivision, PROVIDED, HOWEVER, THAT NOTHING IN THIS PARAGRAPH SHALL PROHIBIT THE IMPOSITION OF PENAL- TIES, IN CASES OF FRAUD OR ABUSE, OTHERWISE AUTHORIZED BY LAW. § 6. This act shall take effect on the ninetieth day after it shall have become a law; provided, however, that the amendments to section 364-j of the social services law made by sections one, two, three and S. 7507--A 32 A. 9507--A five of this act shall not affect the repeal of such section and shall be deemed repealed therewith. PART J Section 1. Paragraph (h) of subdivision 1 of section 189 of the state finance law, as amended by section 8 of part A of chapter 56 of the laws of 2013, is amended to read as follows: (h) knowingly conceals or knowingly and improperly avoids or decreases an obligation to pay or transmit money or property to the state or a local government, or conspires to do the same; shall be liable to the state or a local government, as applicable, for a civil penalty of not less than six thousand dollars and not more than twelve thousand dollars, AS ADJUSTED TO BE EQUAL TO THE CIVIL PENALTY ALLOWED UNDER THE FEDERAL FALSE CLAIMS ACT, 31 U.S.C. SEC. 3729, ET SEQ., AS AMENDED, AS ADJUSTED FOR INFLATION BY THE FEDERAL CIVIL PENALTIES INFLATION ADJUST- MENT ACT OF 1990, AS AMENDED (28 U.S.C. 2461 NOTE; PUB. L. NO. 101-410), plus three times the amount of all damages, including consequential damages, which the state or local government sustains because of the act of that person. § 2. This act shall take effect immediately. PART K Section 1. Notwithstanding any contrary provision of law, the depart- ment of health is authorized to require any Medicaid-enrolled provider, and any health care provider that is part of a network of providers of a managed care organization operating pursuant to section 364-j of the social services law or section 4403-f of the public health law, to report on costs incurred by the provider in rendering health care services to Medicaid beneficiaries. The department of health may specify the frequency and format of such reports, determine the type and amount of information to be submitted, and require the submission of supporting documentation. In the case of a provider in a managed care network, the department of health may require the managed care organization to obtain the required information from the network provider on behalf of the department. § 2. Subdivision 1 of section 92 of part H of chapter 59 of the laws of 2011, amending the public health law and other laws relating to known and projected department of health state fund medicaid expenditures, as amended by section 1 of part G of chapter 57 of the laws of 2017, is amended to read as follows: 1. For state fiscal years 2011-12 through [2018-19] 2019-20, the director of the budget, in consultation with the commissioner of health referenced as "commissioner" for purposes of this section, shall assess on a monthly basis, as reflected in monthly reports pursuant to subdivi- sion five of this section known and projected department of health state funds medicaid expenditures by category of service and by geographic regions, as defined by the commissioner, and if the director of the budget determines that such expenditures are expected to cause medicaid disbursements for such period to exceed the projected department of health medicaid state funds disbursements in the enacted budget finan- cial plan pursuant to subdivision 3 of section 23 of the state finance law, the commissioner of health, in consultation with the director of the budget, shall develop a medicaid savings allocation plan to limit such spending to the aggregate limit level specified in the enacted S. 7507--A 33 A. 9507--A budget financial plan, provided, however, such projections may be adjusted by the director of the budget to account for any changes in the New York state federal medical assistance percentage amount established pursuant to the federal social security act, changes in provider reven- ues, reductions to local social services district medical assistance administration, minimum wage increases, and beginning April 1, 2012 the operational costs of the New York state medical indemnity fund and state costs or savings from the basic health plan. Such projections may be adjusted by the director of the budget to account for increased or expe- dited department of health state funds medicaid expenditures as a result of a natural or other type of disaster, including a governmental decla- ration of emergency. § 3. This act shall take effect immediately. PART L Section 1. Subdivision 7 of section 369 of the social services law, as amended by section 7 of part F of chapter 56 of the laws of 2012, is amended to read as follows: 7. Notwithstanding any provision of law to the contrary, the depart- ment shall, when it determines necessary program features are in place, assume sole responsibility for commencing actions or proceedings in accordance with the provisions of this section, sections one hundred one, one hundred four, one hundred four-b, paragraph (a) of subdivision three of section three hundred sixty-six, subparagraph one of paragraph (h) of subdivision four of section three hundred sixty-six, and para- graph (b) of subdivision two of section three hundred sixty-seven-a of this chapter, to recover the cost of medical assistance furnished pursu- ant to this title and title eleven-D of this article. The department is authorized to contract with an entity that shall conduct activities on behalf of the department pursuant to this subdivision, AND MAY CONTRACT WITH AN ENTITY TO CONDUCT SIMILAR ACTIVITIES ON BEHALF OF THE CHILD HEALTH INSURANCE PROGRAM ESTABLISHED PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW TO THE EXTENT ALLOWED BY LAW. Prior to assuming such responsibility from a social services district, the department of health shall, in consultation with the district, define the scope of the services the district will be required to perform on behalf of the department of health pursuant to this subdivi- sion. § 2. Section 2511 of the public health law is amended by adding a new subdivision 22 to read as follows: 22. NOTWITHSTANDING THE PROVISIONS OF THIS SECTION, SECTION TWENTY- FIVE HUNDRED TEN OF THIS TITLE, AND ANY OTHER INCONSISTENT PROVISION OF LAW, IN THE EVENT FEDERAL FUNDING PURSUANT TO TITLE XXI OF THE FEDERAL SOCIAL SECURITY ACT IS REDUCED OR ELIMINATED ON AND AFTER OCTOBER FIRST, TWO THOUSAND SEVENTEEN: (A) THE DIRECTOR OF THE DIVISION OF THE BUDGET, IN CONSULTATION WITH THE COMMISSIONER, SHALL IDENTIFY THE AMOUNT OF SUCH REDUCTION OR ELIMI- NATION AND NOTIFY THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY IN WRITING THAT THE FEDERAL ACTIONS WILL REDUCE OR ELIM- INATE EXPECTED FUNDING TO NEW YORK STATE BY SUCH AMOUNT. (B) THE DIRECTOR OF THE DIVISION OF THE BUDGET, IN CONSULTATION WITH THE COMMISSIONER, SHALL DETERMINE IF PROGRAMMATIC CHANGES ARE NECESSARY TO CONTINUE COVERING ELIGIBLE CHILDREN WITHIN STATE-ONLY FUNDING LEVELS, IDENTIFY AVAILABLE RESOURCES OR ACTIONS, IDENTIFY SPECIFIC CHANGES NEED- ED TO ALIGN THE PROGRAM WITH CURRENT FUNDING LEVELS, AND ESTABLISH A S. 7507--A 34 A. 9507--A PLAN FOR IMPLEMENTING SUCH CHANGES WHICH MAY INCLUDE EMERGENCY REGU- LATIONS PROMULGATED BY THE COMMISSIONER. SUCH PLAN SHALL BE SUBMITTED TO THE LEGISLATURE PRIOR TO ITS IMPLEMENTATION. § 3. This act shall take effect immediately. PART M Section 1. Paragraph (a) of subdivision 1 of section 18 of chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, as amended by section 15 of part H of chapter 57 of the laws of 2017, is amended to read as follows: (a) The superintendent of financial services and the commissioner of health or their designee shall, from funds available in the hospital excess liability pool created pursuant to subdivision 5 of this section, purchase a policy or policies for excess insurance coverage, as author- ized by paragraph 1 of subsection (e) of section 5502 of the insurance law; or from an insurer, other than an insurer described in section 5502 of the insurance law, duly authorized to write such coverage and actual- ly writing medical malpractice insurance in this state; or shall purchase equivalent excess coverage in a form previously approved by the superintendent of financial services for purposes of providing equiv- alent excess coverage in accordance with section 19 of chapter 294 of the laws of 1985, for medical or dental malpractice occurrences between July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007, between July 1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010 and June 30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014, between July 1, 2014 and June 30, 2015, between July 1, 2015 and June 30, 2016, between July 1, 2016 and June 30, 2017, [and] between July 1, 2017 and June 30, 2018, AND BETWEEN JULY 1, 2018 AND JUNE 30, 2019 or reimburse the hospital where the hospital purchases equivalent excess coverage as defined in subparagraph (i) of paragraph (a) of subdivision 1-a of this section for medical or dental malpractice occurrences between July 1, 1987 and June 30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004, between July 1, 2004 and June 30, 2005, S. 7507--A 35 A. 9507--A between July 1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007, between July 1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010 and June 30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014, between July 1, 2014 and June 30, 2015, between July 1, 2015 and June 30, 2016, between July 1, 2016 and June 30, 2017, [and] between July 1, 2017 and June 30, 2018, AND BETWEEN JULY 1, 2018 AND JUNE 30, 2019 for physicians or dentists certified as eligible for each such period or periods pursuant to subdivision 2 of this section by a general hospital licensed pursuant to article 28 of the public health law; provided that no single insurer shall write more than fifty percent of the total excess premium for a given policy year; and provided, however, that such eligible physicians or dentists must have in force an individ- ual policy, from an insurer licensed in this state of primary malprac- tice insurance coverage in amounts of no less than one million three hundred thousand dollars for each claimant and three million nine hundred thousand dollars for all claimants under that policy during the period of such excess coverage for such occurrences or be endorsed as additional insureds under a hospital professional liability policy which is offered through a voluntary attending physician ("channeling") program previously permitted by the superintendent of financial services during the period of such excess coverage for such occurrences. During such period, such policy for excess coverage or such equivalent excess coverage shall, when combined with the physician's or dentist's primary malpractice insurance coverage or coverage provided through a voluntary attending physician ("channeling") program, total an aggregate level of two million three hundred thousand dollars for each claimant and six million nine hundred thousand dollars for all claimants from all such policies with respect to occurrences in each of such years provided, however, if the cost of primary malpractice insurance coverage in excess of one million dollars, but below the excess medical malpractice insur- ance coverage provided pursuant to this act, exceeds the rate of nine percent per annum, then the required level of primary malpractice insur- ance coverage in excess of one million dollars for each claimant shall be in an amount of not less than the dollar amount of such coverage available at nine percent per annum; the required level of such coverage for all claimants under that policy shall be in an amount not less than three times the dollar amount of coverage for each claimant; and excess coverage, when combined with such primary malpractice insurance cover- age, shall increase the aggregate level for each claimant by one million dollars and three million dollars for all claimants; and provided further, that, with respect to policies of primary medical malpractice coverage that include occurrences between April 1, 2002 and June 30, 2002, such requirement that coverage be in amounts no less than one million three hundred thousand dollars for each claimant and three million nine hundred thousand dollars for all claimants for such occur- rences shall be effective April 1, 2002. § 2. Subdivision 3 of section 18 of chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, as amended by section 16 of part H of chapter 57 of the laws of 2017, is amended to read as follows: (3)(a) The superintendent of financial services shall determine and certify to each general hospital and to the commissioner of health the cost of excess malpractice insurance for medical or dental malpractice S. 7507--A 36 A. 9507--A occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007, between July 1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010 and June 30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, and between July 1, 2013 and June 30, 2014, between July 1, 2014 and June 30, 2015, between July 1, 2015 and June 30, 2016, and between July 1, 2016 and June 30, 2017, [and] between July 1, 2017 and June 30, 2018, AND BETWEEN JULY 1, 2018 AND JUNE 30, 2019 allocable to each general hospital for physicians or dentists certified as eligible for purchase of a policy for excess insurance coverage by such general hospital in accordance with subdivision 2 of this section, and may amend such deter- mination and certification as necessary. (b) The superintendent of financial services shall determine and certify to each general hospital and to the commissioner of health the cost of excess malpractice insurance or equivalent excess coverage for medical or dental malpractice occurrences between July 1, 1987 and June 30, 1988, between July 1, 1988 and June 30, 1989, between July 1, 1989 and June 30, 1990, between July 1, 1990 and June 30, 1991, between July 1, 1991 and June 30, 1992, between July 1, 1992 and June 30, 1993, between July 1, 1993 and June 30, 1994, between July 1, 1994 and June 30, 1995, between July 1, 1995 and June 30, 1996, between July 1, 1996 and June 30, 1997, between July 1, 1997 and June 30, 1998, between July 1, 1998 and June 30, 1999, between July 1, 1999 and June 30, 2000, between July 1, 2000 and June 30, 2001, between July 1, 2001 and June 30, 2002, between July 1, 2002 and June 30, 2003, between July 1, 2003 and June 30, 2004, between July 1, 2004 and June 30, 2005, between July 1, 2005 and June 30, 2006, between July 1, 2006 and June 30, 2007, between July 1, 2007 and June 30, 2008, between July 1, 2008 and June 30, 2009, between July 1, 2009 and June 30, 2010, between July 1, 2010 and June 30, 2011, between July 1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, between July 1, 2013 and June 30, 2014, between July 1, 2014 and June 30, 2015, between July 1, 2015 and June 30, 2016, [and] between July 1, 2016 and June 30, 2017, [and] between July 1, 2017 and June 30, 2018, AND BETWEEN JULY 1, 2018 AND JUNE 30, 2019 allocable to each general hospital for physicians or dentists certified as eligible for purchase of a policy for excess insurance coverage or equivalent excess coverage by such general hospital in accordance with subdivision 2 of this section, and may amend such deter- mination and certification as necessary. The superintendent of financial services shall determine and certify to each general hospital and to the commissioner of health the ratable share of such cost allocable to the period July 1, 1987 to December 31, 1987, to the period January 1, 1988 to June 30, 1988, to the period July 1, 1988 to December 31, 1988, to the period January 1, 1989 to June 30, 1989, to the period July 1, 1989 to December 31, 1989, to the period January 1, 1990 to June 30, 1990, to S. 7507--A 37 A. 9507--A the period July 1, 1990 to December 31, 1990, to the period January 1, 1991 to June 30, 1991, to the period July 1, 1991 to December 31, 1991, to the period January 1, 1992 to June 30, 1992, to the period July 1, 1992 to December 31, 1992, to the period January 1, 1993 to June 30, 1993, to the period July 1, 1993 to December 31, 1993, to the period January 1, 1994 to June 30, 1994, to the period July 1, 1994 to December 31, 1994, to the period January 1, 1995 to June 30, 1995, to the period July 1, 1995 to December 31, 1995, to the period January 1, 1996 to June 30, 1996, to the period July 1, 1996 to December 31, 1996, to the period January 1, 1997 to June 30, 1997, to the period July 1, 1997 to December 31, 1997, to the period January 1, 1998 to June 30, 1998, to the period July 1, 1998 to December 31, 1998, to the period January 1, 1999 to June 30, 1999, to the period July 1, 1999 to December 31, 1999, to the period January 1, 2000 to June 30, 2000, to the period July 1, 2000 to December 31, 2000, to the period January 1, 2001 to June 30, 2001, to the period July 1, 2001 to June 30, 2002, to the period July 1, 2002 to June 30, 2003, to the period July 1, 2003 to June 30, 2004, to the period July 1, 2004 to June 30, 2005, to the period July 1, 2005 and June 30, 2006, to the period July 1, 2006 and June 30, 2007, to the period July 1, 2007 and June 30, 2008, to the period July 1, 2008 and June 30, 2009, to the period July 1, 2009 and June 30, 2010, to the period July 1, 2010 and June 30, 2011, to the period July 1, 2011 and June 30, 2012, to the period July 1, 2012 and June 30, 2013, to the period July 1, 2013 and June 30, 2014, to the period July 1, 2014 and June 30, 2015, to the period July 1, 2015 and June 30, 2016, and between July 1, 2016 and June 30, 2017, and to the period July 1, 2017 [and] TO June 30, 2018, AND TO THE PERIOD JULY 1, 2018 TO JUNE 30, 2019. § 3. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section 18 of chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, as amended by section 17 of part H of chapter 57 of the laws of 2017, are amended to read as follows: (a) To the extent funds available to the hospital excess liability pool pursuant to subdivision 5 of this section as amended, and pursuant to section 6 of part J of chapter 63 of the laws of 2001, as may from time to time be amended, which amended this subdivision, are insuffi- cient to meet the costs of excess insurance coverage or equivalent excess coverage for coverage periods during the period July 1, 1992 to June 30, 1993, during the period July 1, 1993 to June 30, 1994, during the period July 1, 1994 to June 30, 1995, during the period July 1, 1995 to June 30, 1996, during the period July 1, 1996 to June 30, 1997, during the period July 1, 1997 to June 30, 1998, during the period July 1, 1998 to June 30, 1999, during the period July 1, 1999 to June 30, 2000, during the period July 1, 2000 to June 30, 2001, during the period July 1, 2001 to October 29, 2001, during the period April 1, 2002 to June 30, 2002, during the period July 1, 2002 to June 30, 2003, during the period July 1, 2003 to June 30, 2004, during the period July 1, 2004 to June 30, 2005, during the period July 1, 2005 to June 30, 2006, during the period July 1, 2006 to June 30, 2007, during the period July 1, 2007 to June 30, 2008, during the period July 1, 2008 to June 30, 2009, during the period July 1, 2009 to June 30, 2010, during the period July 1, 2010 to June 30, 2011, during the period July 1, 2011 to June 30, 2012, during the period July 1, 2012 to June 30, 2013, during the period July 1, 2013 to June 30, 2014, during the period July 1, 2014 to June 30, 2015, during the period July 1, 2015 [and] TO June 30, 2016, during the period July 1, 2016 [and] TO June 30, 2017, [and] during the S. 7507--A 38 A. 9507--A period July 1, 2017 [and] TO June 30, 2018, AND DURING THE PERIOD JULY 1, 2018 TO JUNE 30, 2019 allocated or reallocated in accordance with paragraph (a) of subdivision 4-a of this section to rates of payment applicable to state governmental agencies, each physician or dentist for whom a policy for excess insurance coverage or equivalent excess cover- age is purchased for such period shall be responsible for payment to the provider of excess insurance coverage or equivalent excess coverage of an allocable share of such insufficiency, based on the ratio of the total cost of such coverage for such physician to the sum of the total cost of such coverage for all physicians applied to such insufficiency. (b) Each provider of excess insurance coverage or equivalent excess coverage covering the period July 1, 1992 to June 30, 1993, or covering the period July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or covering the period July 1, 1996 to June 30, 1997, or covering the period July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or covering the period July 1, 2000 to June 30, 2001, or covering the period July 1, 2001 to October 29, 2001, or covering the period April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or covering the peri- od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or covering the peri- od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or covering the peri- od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, or covering the period July 1, 2016 to June 30, 2017, or covering the peri- od July 1, 2017 to June 30, 2018, OR COVERING THE PERIOD JULY 1, 2018 TO JUNE 30, 2019 shall notify a covered physician or dentist by mail, mailed to the address shown on the last application for excess insurance coverage or equivalent excess coverage, of the amount due to such provider from such physician or dentist for such coverage period deter- mined in accordance with paragraph (a) of this subdivision. Such amount shall be due from such physician or dentist to such provider of excess insurance coverage or equivalent excess coverage in a time and manner determined by the superintendent of financial services. (c) If a physician or dentist liable for payment of a portion of the costs of excess insurance coverage or equivalent excess coverage cover- ing the period July 1, 1992 to June 30, 1993, or covering the period July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or covering the period July 1, 1996 to June 30, 1997, or covering the peri- od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or covering the period July 1, 2000 to June 30, 2001, or covering the peri- od July 1, 2001 to October 29, 2001, or covering the period April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or covering the period July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or covering the period July 1, S. 7507--A 39 A. 9507--A 2009 to June 30, 2010, or covering the period July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or covering the period July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, or covering the period July 1, 2016 to June 30, 2017, or covering the period July 1, 2017 to June 30, 2018, OR COVERING THE PERIOD JULY 1, 2018 TO JUNE 30, 2019 determined in accordance with paragraph (a) of this subdivision fails, refuses or neglects to make payment to the provider of excess insurance coverage or equivalent excess coverage in such time and manner as determined by the superintendent of financial services pursuant to paragraph (b) of this subdivision, excess insurance coverage or equiv- alent excess coverage purchased for such physician or dentist in accord- ance with this section for such coverage period shall be cancelled and shall be null and void as of the first day on or after the commencement of a policy period where the liability for payment pursuant to this subdivision has not been met. (d) Each provider of excess insurance coverage or equivalent excess coverage shall notify the superintendent of financial services and the commissioner of health or their designee of each physician and dentist eligible for purchase of a policy for excess insurance coverage or equivalent excess coverage covering the period July 1, 1992 to June 30, 1993, or covering the period July 1, 1993 to June 30, 1994, or covering the period July 1, 1994 to June 30, 1995, or covering the period July 1, 1995 to June 30, 1996, or covering the period July 1, 1996 to June 30, 1997, or covering the period July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to June 30, 1999, or covering the period July 1, 1999 to June 30, 2000, or covering the period July 1, 2000 to June 30, 2001, or covering the period July 1, 2001 to October 29, 2001, or cover- ing the period April 1, 2002 to June 30, 2002, or covering the period July 1, 2002 to June 30, 2003, or covering the period July 1, 2003 to June 30, 2004, or covering the period July 1, 2004 to June 30, 2005, or covering the period July 1, 2005 to June 30, 2006, or covering the peri- od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to June 30, 2008, or covering the period July 1, 2008 to June 30, 2009, or covering the period July 1, 2009 to June 30, 2010, or covering the peri- od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to June 30, 2012, or covering the period July 1, 2012 to June 30, 2013, or covering the period July 1, 2013 to June 30, 2014, or covering the peri- od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to June 30, 2016, or covering the period July 1, 2016 to June 30, 2017, or covering the period July 1, 2017 to June 30, 2018, OR COVERING THE PERI- OD JULY 1, 2018 TO JUNE 30, 2019 that has made payment to such provider of excess insurance coverage or equivalent excess coverage in accordance with paragraph (b) of this subdivision and of each physician and dentist who has failed, refused or neglected to make such payment. (e) A provider of excess insurance coverage or equivalent excess coverage shall refund to the hospital excess liability pool any amount allocable to the period July 1, 1992 to June 30, 1993, and to the period July 1, 1993 to June 30, 1994, and to the period July 1, 1994 to June 30, 1995, and to the period July 1, 1995 to June 30, 1996, and to the period July 1, 1996 to June 30, 1997, and to the period July 1, 1997 to June 30, 1998, and to the period July 1, 1998 to June 30, 1999, and to the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000 to June 30, 2001, and to the period July 1, 2001 to October 29, 2001, and to the period April 1, 2002 to June 30, 2002, and to the period July S. 7507--A 40 A. 9507--A 1, 2002 to June 30, 2003, and to the period July 1, 2003 to June 30, 2004, and to the period July 1, 2004 to June 30, 2005, and to the period July 1, 2005 to June 30, 2006, and to the period July 1, 2006 to June 30, 2007, and to the period July 1, 2007 to June 30, 2008, and to the period July 1, 2008 to June 30, 2009, and to the period July 1, 2009 to June 30, 2010, and to the period July 1, 2010 to June 30, 2011, and to the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012 to June 30, 2013, and to the period July 1, 2013 to June 30, 2014, and to the period July 1, 2014 to June 30, 2015, and to the period July 1, 2015 to June 30, 2016, to the period July 1, 2016 to June 30, 2017, and to the period July 1, 2017 to June 30, 2018, AND TO THE PERIOD JULY 1, 2018 TO JUNE 30, 2019 received from the hospital excess liability pool for purchase of excess insurance coverage or equivalent excess coverage covering the period July 1, 1992 to June 30, 1993, and covering the period July 1, 1993 to June 30, 1994, and covering the period July 1, 1994 to June 30, 1995, and covering the period July 1, 1995 to June 30, 1996, and covering the period July 1, 1996 to June 30, 1997, and cover- ing the period July 1, 1997 to June 30, 1998, and covering the period July 1, 1998 to June 30, 1999, and covering the period July 1, 1999 to June 30, 2000, and covering the period July 1, 2000 to June 30, 2001, and covering the period July 1, 2001 to October 29, 2001, and covering the period April 1, 2002 to June 30, 2002, and covering the period July 1, 2002 to June 30, 2003, and covering the period July 1, 2003 to June 30, 2004, and covering the period July 1, 2004 to June 30, 2005, and covering the period July 1, 2005 to June 30, 2006, and covering the period July 1, 2006 to June 30, 2007, and covering the period July 1, 2007 to June 30, 2008, and covering the period July 1, 2008 to June 30, 2009, and covering the period July 1, 2009 to June 30, 2010, and cover- ing the period July 1, 2010 to June 30, 2011, and covering the period July 1, 2011 to June 30, 2012, and covering the period July 1, 2012 to June 30, 2013, and covering the period July 1, 2013 to June 30, 2014, and covering the period July 1, 2014 to June 30, 2015, and covering the period July 1, 2015 to June 30, 2016, and covering the period July 1, 2016 to June 30, 2017, and covering the period July 1, 2017 to June 30, 2018, AND COVERING THE PERIOD JULY 1, 2018 TO JUNE 30, 2019 for a physi- cian or dentist where such excess insurance coverage or equivalent excess coverage is cancelled in accordance with paragraph (c) of this subdivision. § 4. Section 40 of chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, as amended by section 18 of part H of chapter 57 of the laws of 2017, is amended to read as follows: § 40. The superintendent of financial services shall establish rates for policies providing coverage for physicians and surgeons medical malpractice for the periods commencing July 1, 1985 and ending June 30, [2018] 2019; provided, however, that notwithstanding any other provision of law, the superintendent shall not establish or approve any increase in rates for the period commencing July 1, 2009 and ending June 30, 2010. The superintendent shall direct insurers to establish segregated accounts for premiums, payments, reserves and investment income attrib- utable to such premium periods and shall require periodic reports by the insurers regarding claims and expenses attributable to such periods to monitor whether such accounts will be sufficient to meet incurred claims and expenses. On or after July 1, 1989, the superintendent shall impose a surcharge on premiums to satisfy a projected deficiency that is attributable to the premium levels established pursuant to this section S. 7507--A 41 A. 9507--A for such periods; provided, however, that such annual surcharge shall not exceed eight percent of the established rate until July 1, [2018] 2019, at which time and thereafter such surcharge shall not exceed twen- ty-five percent of the approved adequate rate, and that such annual surcharges shall continue for such period of time as shall be sufficient to satisfy such deficiency. The superintendent shall not impose such surcharge during the period commencing July 1, 2009 and ending June 30, 2010. On and after July 1, 1989, the surcharge prescribed by this section shall be retained by insurers to the extent that they insured physicians and surgeons during the July 1, 1985 through June 30, [2018] 2019 policy periods; in the event and to the extent physicians and surgeons were insured by another insurer during such periods, all or a pro rata share of the surcharge, as the case may be, shall be remitted to such other insurer in accordance with rules and regulations to be promulgated by the superintendent. Surcharges collected from physicians and surgeons who were not insured during such policy periods shall be apportioned among all insurers in proportion to the premium written by each insurer during such policy periods; if a physician or surgeon was insured by an insurer subject to rates established by the superintendent during such policy periods, and at any time thereafter a hospital, health maintenance organization, employer or institution is responsible for responding in damages for liability arising out of such physician's or surgeon's practice of medicine, such responsible entity shall also remit to such prior insurer the equivalent amount that would then be collected as a surcharge if the physician or surgeon had continued to remain insured by such prior insurer. In the event any insurer that provided coverage during such policy periods is in liquidation, the property/casualty insurance security fund shall receive the portion of surcharges to which the insurer in liquidation would have been entitled. The surcharges authorized herein shall be deemed to be income earned for the purposes of section 2303 of the insurance law. The superintendent, in establishing adequate rates and in determining any projected defi- ciency pursuant to the requirements of this section and the insurance law, shall give substantial weight, determined in his discretion and judgment, to the prospective anticipated effect of any regulations promulgated and laws enacted and the public benefit of stabilizing malpractice rates and minimizing rate level fluctuation during the peri- od of time necessary for the development of more reliable statistical experience as to the efficacy of such laws and regulations affecting medical, dental or podiatric malpractice enacted or promulgated in 1985, 1986, by this act and at any other time. Notwithstanding any provision of the insurance law, rates already established and to be established by the superintendent pursuant to this section are deemed adequate if such rates would be adequate when taken together with the maximum authorized annual surcharges to be imposed for a reasonable period of time whether or not any such annual surcharge has been actually imposed as of the establishment of such rates. § 5. Section 5 and subdivisions (a) and (e) of section 6 of part J of chapter 63 of the laws of 2001, amending chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, relating to the effec- tiveness of certain provisions of such chapter, as amended by section 19 of part H of chapter 57 of the laws of 2017, are amended to read as follows: § 5. The superintendent of financial services and the commissioner of health shall determine, no later than June 15, 2002, June 15, 2003, June S. 7507--A 42 A. 9507--A 15, 2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010, June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, June 15, 2015, June 15, 2016, June 15, 2017, [and] June 15, 2018, AND JUNE 15, 2019 the amount of funds available in the hospital excess liability pool, created pursuant to section 18 of chap- ter 266 of the laws of 1986, and whether such funds are sufficient for purposes of purchasing excess insurance coverage for eligible partic- ipating physicians and dentists during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30, 2016, or July 1, 2016 to June 30, 2017, or [to] July 1, 2017 to June 30, 2018, OR JULY 1, 2018 TO JUNE 30, 2019 as applicable. (a) This section shall be effective only upon a determination, pursu- ant to section five of this act, by the superintendent of financial services and the commissioner of health, and a certification of such determination to the state director of the budget, the chair of the senate committee on finance and the chair of the assembly committee on ways and means, that the amount of funds in the hospital excess liabil- ity pool, created pursuant to section 18 of chapter 266 of the laws of 1986, is insufficient for purposes of purchasing excess insurance cover- age for eligible participating physicians and dentists during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007 to June 30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June 30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June 30, 2014, or July 1, 2014 to June 30, 2015, or July 1, 2015 to June 30, 2016, or July 1, 2016 to June 30, 2017, or July 1, 2017 to June 30, 2018, OR JULY 1, 2018 TO JUNE 30, 2019 as applicable. (e) The commissioner of health shall transfer for deposit to the hospital excess liability pool created pursuant to section 18 of chapter 266 of the laws of 1986 such amounts as directed by the superintendent of financial services for the purchase of excess liability insurance coverage for eligible participating physicians and dentists for the policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or July 1, 2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, as applicable, and the cost of administering the hospital excess liability pool for such applicable policy year, pursuant to the program established in chapter 266 of the laws of 1986, as amended, no later than June 15, 2002, June 15, 2003, June 15, 2004, June 15, 2005, June 15, 2006, June 15, 2007, June 15, 2008, June 15, 2009, June 15, 2010, June 15, 2011, June 15, 2012, June 15, 2013, June 15, 2014, June 15, 2015, June 15, 2016, June 15, 2017, [and] June 15, 2018, AND JUNE 15, 2019 as applicable. § 6. Section 20 of part H of chapter 57 of the laws of 2017, amending the New York Health Care Reform Act of 1996 and other laws relating to extending certain provisions thereto, is amended to read as follows: § 20. Notwithstanding any law, rule or regulation to the contrary, only physicians or dentists who were eligible, and for whom the super- S. 7507--A 43 A. 9507--A intendent of financial services and the commissioner of health, or their designee, purchased, with funds available in the hospital excess liabil- ity pool, a full or partial policy for excess coverage or equivalent excess coverage for the coverage period ending the thirtieth of June, two thousand [seventeen] EIGHTEEN, shall be eligible to apply for such coverage for the coverage period beginning the first of July, two thou- sand [seventeen] EIGHTEEN; provided, however, if the total number of physicians or dentists for whom such excess coverage or equivalent excess coverage was purchased for the policy year ending the thirtieth of June, two thousand [seventeen] EIGHTEEN exceeds the total number of physicians or dentists certified as eligible for the coverage period beginning the first of July, two thousand [seventeen] EIGHTEEN, then the general hospitals may certify additional eligible physicians or dentists in a number equal to such general hospital's proportional share of the total number of physicians or dentists for whom excess coverage or equivalent excess coverage was purchased with funds available in the hospital excess liability pool as of the thirtieth of June, two thousand [seventeen] EIGHTEEN, as applied to the difference between the number of eligible physicians or dentists for whom a policy for excess coverage or equivalent excess coverage was purchased for the coverage period ending the thirtieth of June, two thousand [seventeen] EIGHTEEN and the number of such eligible physicians or dentists who have applied for excess coverage or equivalent excess coverage for the coverage period beginning the first of July, two thousand [seventeen] EIGHTEEN. § 7. This act shall take effect immediately. PART N Section 1. The opening paragraph of subdivision 1 of section 1 of part C of chapter 57 of the laws of 2006, establishing a cost of living adjustment for designated human services, is amended to read as follows: Subject to available appropriations, the commissioners of the office of mental health, office of mental retardation and developmental disa- bilities, office of alcoholism and substance abuse services, [department of health,] office of children and family services and the state office for the aging shall establish an annual cost of living adjustment (COLA), subject to the approval of the director of the budget, effective April first of each state fiscal year, provided, however, that in state fiscal year 2006-07, the cost of living adjustment will be effective October first, to project for the effects of inflation, for rates of payments, contracts or any other form of reimbursement for the programs listed in paragraphs (i), (ii), (iii), (iv)[,] AND (v) [and (vi)] of subdivision four of this section. The COLA shall be applied to the appropriate portion of reimbursable costs or contract amounts. § 2. Paragraph (iv) of subdivision 4 of section 1 of part C of chapter 57 of the laws of 2006, establishing a cost of living adjustment for designated human services, is REPEALED and paragraphs (v) and (vi) are renumbered paragraphs (iv) and (v). § 3. This act shall take effect immediately. PART O Section 1. Subdivisions 9 and 10 of section 2541 of the public health law, as added by chapter 428 of the laws of 1992, are amended to read as follows: S. 7507--A 44 A. 9507--A 9. "Evaluation" means a multidisciplinary professional, objective [assessment] EXAMINATION conducted by appropriately qualified personnel and conducted pursuant to section twenty-five hundred forty-four of this title to determine a child's eligibility under this title. 10. "Evaluator" means a [team of two or more professionals approved pursuant to section twenty-five hundred fifty-one of this title] PROVID- ER APPROVED BY THE DEPARTMENT to conduct screenings and evaluations. § 2. Section 2541 of the public health law is amended by adding three new subdivisions 12-a, 14-a and 15-a to read as follows: 12-A. "MULTIDISCIPLINARY" MEANS THE INVOLVEMENT OF TWO OR MORE SEPA- RATE DISCIPLINES OR PROFESSIONS, WHICH MAY MEAN THE INVOLVEMENT OF ONE INDIVIDUAL WHO MEETS THE DEFINITION OF QUALIFIED PERSONNEL AS DEFINED IN SUBDIVISION FIFTEEN OF THIS SECTION AND WHO IS QUALIFIED, IN ACCORDANCE WITH STATE LICENSURE, CERTIFICATION OR OTHER COMPARABLE STANDARDS, TO EVALUATE ALL FIVE DEVELOPMENTAL DOMAINS. 14-A. A "PARTIAL EVALUATION" SHALL MEAN AN EVALUATION IN A SINGLE DEVELOPMENTAL AREA FOR PURPOSES OF DETERMINING ELIGIBILITY, AND MAY ALSO MEAN AN EXAMINATION OF THE CHILD TO DETERMINE THE NEED FOR A MODIFICA- TION TO THE CHILD'S INDIVIDUALIZED FAMILY SERVICE PLAN. 15-A. "SCREENING" MEANS THE PROCEDURES USED BY QUALIFIED PERSONNEL, AS DEFINED IN SUBDIVISION FIFTEEN OF THIS SECTION, TO DETERMINE WHETHER A CHILD IS SUSPECTED OF HAVING A DISABILITY AND IN NEED OF EARLY INTER- VENTION SERVICES, AND SHALL INCLUDE, WHERE AVAILABLE AND APPROPRIATE FOR THE CHILD, THE ADMINISTRATION OF A STANDARDIZED INSTRUMENT OR INSTRU- MENTS APPROVED BY THE DEPARTMENT, IN ACCORDANCE WITH SUBDIVISION THREE OF SECTION TWENTY-FIVE HUNDRED FORTY-FOUR OF THIS TITLE. § 3. Subdivision 3 of section 2542 of the public health law, as amended by chapter 231 of the laws of 1993, is amended to read as follows: 3. [The] (A) UNLESS AN INFANT OR TODDLER HAS ALREADY BEEN REFERRED TO THE EARLY INTERVENTION PROGRAM OR THE HEALTH OFFICER OF THE PUBLIC HEALTH DISTRICT IN WHICH THE INFANT OR TODDLER RESIDES, AS DESIGNATED BY THE MUNICIPALITY, THE following persons and entities, within two working days of identifying an infant or toddler suspected of having a disabili- ty or at risk of having a disability, shall refer such infant or toddler to the early intervention official or the health officer [of the public health district in which the infant or toddler resides, as designated by the municipality], AS APPLICABLE, but in no event over the objection of the parent made in accordance with procedures established by the depart- ment for use by such primary referral sources[, unless the child has already been referred]: hospitals, child health care providers, day care programs, local school districts, public health facilities, early childhood direction centers and such other social service and health care agencies and providers as the commissioner shall specify in regu- lation; provided, however, that the department shall establish proce- dures, including regulations if required, to ensure that primary refer- ral sources adequately inform the parent or guardian about the early intervention program, including through brochures and written materials created or approved by the department. (B) THE PRIMARY REFERRAL SOURCES IDENTIFIED IN PARAGRAPH (A) OF THIS SUBDIVISION SHALL, WITH PARENTAL CONSENT, COMPLETE AND TRANSMIT AT THE TIME OF REFERRAL, A REFERRAL FORM DEVELOPED BY THE DEPARTMENT WHICH CONTAINS INFORMATION SUFFICIENT TO DOCUMENT THE PRIMARY REFERRAL SOURCE'S CONCERN OR BASIS FOR SUSPECTING THE CHILD HAS A DISABILITY OR IS AT RISK OF HAVING A DISABILITY, AND WHERE APPLICABLE, SPECIFIES THE CHILD'S DIAGNOSED CONDITION THAT ESTABLISHES THE CHILD'S ELIGIBILITY FOR S. 7507--A 45 A. 9507--A THE EARLY INTERVENTION PROGRAM. THE PRIMARY REFERRAL SOURCE SHALL INFORM THE PARENT OF A CHILD WITH A DIAGNOSED CONDITION THAT HAS A HIGH PROBA- BILITY OF RESULTING IN DEVELOPMENTAL DELAY, THAT (I) ELIGIBILITY FOR THE PROGRAM MAY BE ESTABLISHED BY MEDICAL OR OTHER RECORDS AND (II) OF THE IMPORTANCE OF PROVIDING CONSENT FOR THE PRIMARY REFERRAL SOURCE TO TRAN- SMIT RECORDS OR REPORTS NECESSARY TO SUPPORT THE DIAGNOSIS, OR, FOR PARENTS OR GUARDIANS OF CHILDREN WHO DO NOT HAVE A DIAGNOSED CONDITION, RECORDS OR REPORTS THAT WOULD ASSIST IN DETERMINING ELIGIBILITY FOR THE PROGRAM. § 4. Section 2544 of the public health law, as added by chapter 428 of the laws of 1992, paragraph (c) of subdivision 2 as added by section 1 of part A of chapter 56 of the laws of 2012 and subdivision 11 as added by section 3 of part B3 of chapter 62 of the laws of 2003, is amended to read as follows: § 2544. Screening and evaluations. 1. Each child thought to be an eligible child is entitled to [a multidisciplinary] AN evaluation CONDUCTED IN ACCORDANCE WITH THIS SECTION, and the early intervention official shall ensure such evaluation, with parental consent. 2. (a) [The] SUBJECT TO THE PROVISIONS OF THIS TITLE, THE parent may select an evaluator from the list of approved evaluators as described in section twenty-five hundred forty-two of this title to conduct the APPLICABLE SCREENING AND/OR evaluation IN ACCORDANCE WITH THIS SECTION. The parent or evaluator shall immediately notify the early intervention official of such selection. THE EVALUATOR SHALL REVIEW THE INFORMATION AND DOCUMENTATION PROVIDED WITH THE REFERRAL TO DETERMINE THE APPROPRI- ATE SCREENING OR EVALUATION PROCESS TO FOLLOW IN ACCORDANCE WITH THIS SECTION. The evaluator may begin the SCREENING OR evaluation no sooner than four working days after such notification, unless otherwise approved by the initial service coordinator. (b) [the evaluator shall designate an individual as the principal contact for the multidisciplinary team] INITIAL SERVICE COORDINATORS SHALL INFORM THE PARENT OF THE APPLICABLE SCREENING OR EVALUATION PROCE- DURES THAT MAY BE PERFORMED. FOR A CHILD REFERRED TO THE EARLY INTER- VENTION OFFICIAL WHO HAS A DIAGNOSED PHYSICAL OR MENTAL CONDITION THAT HAS A HIGH PROBABILITY OF RESULTING IN DEVELOPMENTAL DELAY, THE INITIAL SERVICE COORDINATOR SHALL INFORM THE PARENT THAT THE EVALUATION OF THE CHILD SHALL BE CONDUCTED IN ACCORDANCE WITH THE PROCEDURES SET FORTH IN SUBDIVISION FIVE OF THIS SECTION. (c) If, in consultation with the evaluator, the service coordinator identifies a child that is potentially eligible for programs or services offered by or under the auspices of the office for people with develop- mental disabilities, the service coordinator shall, with parent consent, notify the office for people with developmental disabilities' regional developmental disabilities services office of the potential eligibility of such child for said programs or services. 3. [(a) To determine eligibility, an evaluator shall, with parental consent, either (i) screen a child to determine what type of evaluation, if any, is warranted, or (ii) provide a multidisciplinary evaluation. In making the determination whether to provide an evaluation, the evaluator may rely on a recommendation from a physician or other qualified person as designated by the commissioner. (b)] SCREENINGS FOR CHILDREN REFERRED TO THE EARLY INTERVENTION PROGRAM TO DETERMINE WHETHER THEY ARE SUSPECTED OF HAVING A DISABILITY. (A) FOR A CHILD REFERRED TO THE EARLY INTERVENTION PROGRAM, THE EVALU- ATOR SHALL FIRST PERFORM A SCREENING OF THE CHILD, WITH PARENTAL S. 7507--A 46 A. 9507--A CONSENT, TO DETERMINE WHETHER THE CHILD IS SUSPECTED OF HAVING A DISA- BILITY. (B) THE EVALUATOR SHALL UTILIZE A STANDARDIZED INSTRUMENT OR INSTRU- MENTS APPROVED BY THE DEPARTMENT TO CONDUCT THE SCREENING. IF THE EVALU- ATOR DOES NOT UTILIZE A STANDARDIZED INSTRUMENT OR INSTRUMENTS APPROVED BY THE DEPARTMENT FOR THE SCREENING, THE EVALUATOR SHALL DOCUMENT IN WRITING WHY SUCH STANDARDIZED INSTRUMENT OR INSTRUMENTS ARE UNAVAILABLE OR INAPPROPRIATE FOR THE CHILD. (C) THE EVALUATOR SHALL EXPLAIN THE RESULTS OF THE SCREENING TO THE PARENT AND SHALL FULLY DOCUMENT THE RESULTS IN WRITING. (D) If, based upon the screening, a child is [believed to be eligible, or if otherwise elected by the parent] SUSPECTED OF HAVING A DISABILITY, the child shall, with [the consent of a parent] PARENTAL CONSENT, receive [a multidisciplinary evaluation. All evaluations shall be conducted in accordance with] AN EVALUATION TO BE CONDUCTED IN ACCORD- ANCE WITH THE PROCEDURES SET FORTH IN SUBDIVISION FOUR OF THIS SECTION, the coordinated standards and procedures, and [with] regulations promul- gated by the commissioner. (E) IF, BASED UPON THE SCREENING, A CHILD IS NOT SUSPECTED OF HAVING A DISABILITY, AN EVALUATION SHALL NOT BE PROVIDED, UNLESS REQUESTED BY THE PARENT. THE EARLY INTERVENTION OFFICIAL SHALL PROVIDE THE PARENT WITH WRITTEN NOTICE OF THE SCREENING RESULTS, WHICH SHALL INCLUDE INFORMATION ON THE PARENT'S RIGHT TO REQUEST AN EVALUATION. (F) A SCREENING SHALL NOT BE PROVIDED TO CHILDREN WHO ARE REFERRED TO THE EARLY INTERVENTION PROGRAM WHO HAVE A DIAGNOSED PHYSICAL OR MENTAL CONDITION WITH A HIGH PROBABILITY OF RESULTING IN DEVELOPMENTAL DELAY THAT ESTABLISHES ELIGIBILITY FOR THE PROGRAM OR FOR CHILDREN WHO HAVE PREVIOUSLY RECEIVED AN EVALUATION UNDER THE EARLY INTERVENTION PROGRAM. 4. The evaluation of [each] A child shall: (a) INCLUDE THE ADMINISTRATION OF AN EVALUATION INSTRUMENT OR INSTRU- MENTS APPROVED BY THE DEPARTMENT. IF THE EVALUATOR DOES NOT UTILIZE AN INSTRUMENT OR INSTRUMENTS APPROVED BY THE DEPARTMENT AS PART OF THE EVALUATION OF THE CHILD, THE EVALUATOR SHALL DOCUMENT IN WRITING WHY SUCH INSTRUMENT OR INSTRUMENTS ARE NOT APPROPRIATE OR AVAILABLE FOR THE CHILD; (B) be conducted by personnel trained to utilize appropriate methods and procedures; [(b)] (C) be based on informed clinical opinion; [(c)] (D) be made without regard to the availability of services in the municipality or who might provide such services; [and (d)] (E) with parental consent, include the following: (i) a review of pertinent records related to the child's current health status and medical history; AND (ii) an evaluation of the child's level of functioning in each of the developmental areas set forth in paragraph (c) of subdivision seven of section twenty-five hundred forty-one of this title[;] TO DETERMINE WHETHER THE CHILD HAS A DISABILITY AS DEFINED IN THIS TITLE THAT ESTAB- LISHES THE CHILD'S ELIGIBILITY FOR THE PROGRAM; AND (F) IF THE CHILD HAS BEEN DETERMINED ELIGIBLE BY THE EVALUATOR AFTER CONDUCTING THE PROCEDURES SET FORTH IN PARAGRAPHS (A) THROUGH (E) OF THIS SUBDIVISION, THE EVALUATION SHALL ALSO INCLUDE: [(iii)] (I) an assessment [of the unique needs of the child in terms of] FOR THE PURPOSES OF IDENTIFYING THE CHILD'S UNIQUE STRENGTHS AND NEEDS IN each of the developmental areas [set forth in paragraph (c) of subdivision seven of section twenty-five hundred forty-one of this S. 7507--A 47 A. 9507--A title, including the identification of] AND THE EARLY INTERVENTION services appropriate to meet those needs; [(iv)] (II) A FAMILY-DIRECTED ASSESSMENT, IF CONSENTED TO BY THE FAMI- LY, IN ORDER TO IDENTIFY THE FAMILY'S RESOURCES, PRIORITIES, AND CONCERNS AND THE SUPPORTS NECESSARY TO ENHANCE THE FAMILY'S CAPACITY TO MEET THE DEVELOPMENTAL NEEDS OF THE CHILD. THE FAMILY ASSESSMENT SHALL BE VOLUNTARY ON THE PART OF EACH FAMILY MEMBER PARTICIPATING IN THE ASSESSMENT; (III) an [evaluation] ASSESSMENT of the transportation needs of the child, if any; and [(v)] (IV) such other matters as the commissioner may prescribe in regulation. 5. EVALUATIONS FOR CHILDREN WHO ARE REFERRED TO THE EARLY INTERVENTION OFFICIAL WITH DIAGNOSED PHYSICAL OR MENTAL CONDITIONS THAT HAVE A HIGH PROBABILITY OF RESULTING IN DEVELOPMENTAL DELAY. (A) IF A CHILD HAS A DIAGNOSED PHYSICAL OR MENTAL CONDITION THAT HAS A HIGH PROBABILITY OF RESULTING IN DEVELOPMENTAL DELAY, THE CHILD'S MEDICAL OR OTHER RECORDS SHALL BE USED, WHEN AVAILABLE, TO ESTABLISH THE CHILD'S ELIGIBILITY FOR THE PROGRAM. (B) THE EVALUATOR SHALL, UPON REVIEW OF THE REFERRAL FORM PROVIDED IN ACCORDANCE WITH SECTION TWENTY-FIVE HUNDRED FORTY-TWO OF THIS TITLE OR ANY MEDICAL OR OTHER RECORDS, OR AT THE TIME OF INITIAL CONTACT WITH THE CHILD'S FAMILY, DETERMINE WHETHER THE CHILD HAS A DIAGNOSED CONDITION THAT ESTABLISHES THE CHILD'S ELIGIBILITY FOR THE PROGRAM. IF THE EVALU- ATOR HAS REASON TO BELIEVE, AFTER SPEAKING WITH THE CHILD'S FAMILY, THAT THE CHILD MAY HAVE A DIAGNOSED CONDITION THAT ESTABLISHES THE CHILD'S ELIGIBILITY BUT THE EVALUATOR HAS NOT BEEN PROVIDED WITH MEDICAL OR OTHER DOCUMENTATION OF SUCH DIAGNOSIS, THE EVALUATOR SHALL, WITH PARENTAL CONSENT, OBTAIN SUCH DOCUMENTATION, WHEN AVAILABLE, PRIOR TO PROCEEDING WITH THE EVALUATION OF THE CHILD. (C) THE EVALUATOR SHALL REVIEW ALL RECORDS RECEIVED TO DOCUMENT THAT THE CHILD'S DIAGNOSIS AS SET FORTH IN SUCH RECORDS ESTABLISHES THE CHILD'S ELIGIBILITY FOR THE EARLY INTERVENTION PROGRAM. (D) NOTWITHSTANDING SUBDIVISION FOUR OF THIS SECTION, IF THE CHILD'S ELIGIBILITY FOR THE EARLY INTERVENTION PROGRAM IS ESTABLISHED IN ACCORD- ANCE WITH THIS SUBDIVISION, THE EVALUATION OF THE CHILD SHALL (I) CONSIST OF A REVIEW OF THE RESULTS OF THE MEDICAL OR OTHER RECORDS THAT ESTABLISHED THE CHILD'S ELIGIBILITY, AND ANY OTHER PERTINENT EVALUATIONS OR RECORDS AVAILABLE AND (II) COMPLY WITH THE PROCEDURES SET FORTH IN PARAGRAPH (F) OF SUBDIVISION FOUR OF THIS SECTION. THE EVALUATION PROCE- DURES SET FORTH IN PARAGRAPHS (A) THROUGH (E) OF SUBDIVISION FOUR OF THIS SECTION SHALL NOT BE REQUIRED OR CONDUCTED. 6. An evaluation shall not include a reference to any specific provid- er of early intervention services. [6.] 7. Nothing in this section shall restrict an evaluator from utilizing, in addition to findings from his or her personal examination, other examinations, evaluations or assessments conducted for such child, including those conducted prior to the evaluation under this section, if such examinations, evaluations or assessments are consistent with the coordinated standards and procedures. [7.] 8. Following completion of the evaluation, the evaluator shall provide the parent and service coordinator with a copy of a summary of the full evaluation. To the extent practicable, the summary shall be provided in the native language of the parent. Upon request of the parent, early intervention official or service coordinator, the evalu- S. 7507--A 48 A. 9507--A ator shall provide a copy of the full evaluation to such parent, early intervention official or service coordinator. [8.] 9. A parent who disagrees with the results of an evaluation may obtain an additional evaluation or partial evaluation at public expense to the extent authorized by federal law or regulation. [9.] 10. Upon receipt of the results of an evaluation, a service coor- dinator may, with parental consent, require additional diagnostic infor- mation regarding the condition of the child, provided, however, that such evaluation or assessment is not unnecessarily duplicative or inva- sive to the child, and provided further, that: (a) where the evaluation has established the child's eligibility, such additional diagnostic information shall be used solely to provide addi- tional information to the parent and service coordinator regarding the child's need for services and cannot be a basis for refuting eligibil- ity; (b) the service coordinator provides the parent with a written expla- nation of the basis for requiring additional diagnostic information; (c) the additional diagnostic procedures are at no expense to the parent; and (d) the evaluation is completed and a meeting to develop an IFSP is held within the time prescribed in subdivision one of section twenty- five hundred forty-five of this title. [10.] 11. (a) If the screening indicates that the infant or toddler is not an eligible child and the parent elects not to have an evaluation, or if the evaluation indicates that the infant or toddler is not an eligible child, the service coordinator shall inform the parent of other programs or services that may benefit such child, and the child's family and, with parental consent, refer such child to such programs or services. (b) A parent may appeal a determination that a child is ineligible pursuant to the provisions of section twenty-five hundred forty-nine of this title, provided, however, that a parent may not initiate such appeal until all evaluations are completed. IN ADDITION, FOR A CHILD REFERRED TO THE EARLY INTERVENTION OFFICIAL WHO HAS A DIAGNOSED PHYSICAL OR MENTAL CONDITION THAT ESTABLISHES THE CHILD'S ELIGIBILITY FOR THE PROGRAM IN ACCORDANCE WITH SUBDIVISION FIVE OF THIS SECTION, THE PARENT MAY APPEAL THE DENIAL OF A REQUEST TO HAVE THE EVALUATOR CONDUCT THE EVALUATION PROCEDURES SET FORTH IN PARAGRAPHS (A) THROUGH (E) OF SUBDI- VISION FOUR OF THIS SECTION, PROVIDED, HOWEVER, THAT THE PARENT MAY NOT INITIATE THE APPEAL UNTIL THE EVALUATION CONDUCTED IN ACCORDANCE WITH SUBDIVISION FIVE OF THIS SECTION IS COMPLETED. [11.] 12. Notwithstanding any other provision of law to the contrary, where a request has been made to review an IFSP prior to the six-month interval provided in subdivision seven of section twenty-five hundred forty-five of this title for purposes of increasing frequency or dura- tion of an approved service, including service coordination, the early intervention official may require an additional evaluation or partial evaluation at public expense by an approved evaluator other than the current provider of service, with parent consent. § 5. Section 3235-a of the insurance law, as added by section 3 of part C of chapter 1 of the laws of 2002, subsection (c) as amended by section 17 of part A of chapter 56 of the laws of 2012, is amended to read as follows: § 3235-a. Payment for early intervention services. (a) No policy of accident and health insurance, including contracts issued pursuant to article forty-three of this chapter, shall exclude coverage for other- S. 7507--A 49 A. 9507--A wise covered services solely on the basis that the services constitute early intervention program services under title two-A of article twen- ty-five of the public health law; PROVIDED, HOWEVER, THE INSURER, INCLUDING A HEALTH MAINTENANCE ORGANIZATION ISSUED A CERTIFICATE OF AUTHORITY UNDER ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW AND A CORPO- RATION ORGANIZED UNDER ARTICLE FORTY-THREE OF THIS CHAPTER SHALL PAY FOR SUCH SERVICES TO THE EXTENT THAT THE SERVICES ARE A COVERED BENEFIT UNDER THE POLICY. (b) Where a policy of accident and health insurance, including a contract issued pursuant to article forty-three of this chapter, provides coverage for an early intervention program service, such cover- age shall not be applied against any maximum annual or lifetime monetary limits set forth in such policy or contract. ANY DOCUMENTATION OBTAINED PURSUANT TO SUBPARAGRAPH (II) OF PARAGRAPH (A) OF SUBDIVISION THREE OF SECTION TWENTY-FIVE HUNDRED FIFTY-NINE OF THE PUBLIC HEALTH LAW AND SUBMITTED TO THE INSURER SHALL BE CONSIDERED AS PART OF PRECERTIF- ICATION, PREAUTHORIZATION AND/OR MEDICAL NECESSITY REVIEW IMPOSED UNDER SUCH POLICY OF ACCIDENT AND HEALTH INSURANCE, INCLUDING A CONTRACT ISSUED PURSUANT TO ARTICLE FORTY-THREE OF THIS CHAPTER. Visit limita- tions and other terms and conditions of the policy will continue to apply to early intervention services. However, any visits used for early intervention program services shall not reduce the number of visits otherwise available under the policy or contract for such services. (c) Any right of subrogation to benefits which a municipality or provider is entitled in accordance with paragraph (d) of subdivision three of section twenty-five hundred fifty-nine of the public health law shall be valid and enforceable to the extent benefits are available under any accident and health insurance policy. The right of subrogation does not attach to insurance benefits paid or provided under any acci- dent and health insurance policy prior to receipt by the insurer of written notice from the municipality or provider, as applicable. The insurer shall provide [the] SUCH municipality and service coordinator with information on the extent of benefits available to the covered person under such policy within fifteen days of the insurer's receipt of written request and notice authorizing such release. The service coordi- nator shall provide such information to the rendering provider assigned to provide services to the child. (d) No insurer, including a health maintenance organization issued a certificate of authority under article forty-four of the public health law and a corporation organized under article forty-three of this chap- ter, shall refuse to issue an accident and health insurance policy or contract or refuse to renew an accident and health insurance policy or contract solely because the applicant or insured is receiving services under the early intervention program. § 6. Paragraph (a) of subdivision 3 of section 2559 of the public health law, as amended by section 11 of part A of chapter 56 of the laws of 2012, is amended to read as follows: (a) Providers of evaluations and early intervention services, herein- after collectively referred to in this subdivision as "provider" or "providers", shall in the first instance and where applicable, seek payment from all third party payors including governmental agencies prior to claiming payment from a given municipality for evaluations conducted under the program and for services rendered to eligible chil- dren, provided that, the obligation to seek payment shall not apply to a payment from a third party payor who is not prohibited from applying such payment, and will apply such payment, to an annual or lifetime S. 7507--A 50 A. 9507--A limit specified in the insured's policy. IF SUCH A CLAIM IS DENIED BY A THIRD PARTY PAYOR, THE PROVIDER SHALL REQUEST AN APPEAL OF SUCH DENIAL, IN A MANNER PRESCRIBED BY THE DEPARTMENT, IN ACCORDANCE WITH ARTICLE FORTY-NINE OF THIS CHAPTER AND ARTICLE FORTY-NINE OF THE INSURANCE LAW, AND SHALL RECEIVE A DETERMINATION OF SUCH APPEAL PRIOR TO SUBMITTING A CLAIM FOR PAYMENT FROM ANOTHER THIRD PARTY PAYOR OR FROM THE MUNICI- PALITY. A PROVIDER SHALL NOT DELAY OR DISCONTINUE SERVICES TO ELIGIBLE CHILDREN PENDING PAYMENT OF THE CLAIM OR PENDING A DETERMINATION OF ANY DENIAL FOR PAYMENT THAT HAS BEEN APPEALED. (i) [Parents] IN A FORM PRESCRIBED BY THE DEPARTMENT, PARENTS shall provide the municipality [and], service coordinator AND PROVIDER infor- mation on any insurance policy, plan or contract under which an eligible child has coverage. (ii) [Parents] IN A TIMELINE AND FORMAT AS PRESCRIBED BY THE DEPART- MENT, THE MUNICIPALITY SHALL REQUEST FROM THE PARENT, AND THE PARENT shall provide the municipality [and the service coordinator], WHO SHALL PROVIDE SUCH DOCUMENTATION TO THE SERVICE COORDINATOR AND PROVIDER, with: (A) a written ORDER, referral [from a primary care provider as documentation, for eligible children, of] OR RECOMMENDATION, SIGNED BY A PHYSICIAN, PHYSICIAN ASSISTANT OR NURSE PRACTITIONER, FOR THE MEDICAL NECESSITY OF EARLY INTERVENTION EVALUATION SERVICES TO DETERMINE PROGRAM ELIGIBILITY FOR EARLY INTERVENTION SERVICES; (B) A COPY OF AN INDIVIDUALIZED FAMILY SERVICE PLAN AGREED UPON PURSU- ANT TO SECTION TWENTY-FIVE HUNDRED FORTY-FIVE OF THIS TITLE THAT CONTAINS DOCUMENTATION, SIGNED BY A PHYSICIAN, PHYSICIAN ASSISTANT OR NURSE PRACTITIONER ON the medical necessity of early intervention services INCLUDED IN THE INDIVIDUALIZED FAMILY SERVICE PLAN; (C) WRITTEN CONSENT TO CONTACT THE CHILD'S PHYSICIAN, PHYSICIAN ASSISTANT OR NURSE PRACTITIONER FOR PURPOSES OF OBTAINING A SIGNED WRIT- TEN ORDER, REFERRAL, OR RECOMMENDATION AS DOCUMENTATION FOR THE MEDICAL NECESSITY OF EARLY INTERVENTION EVALUATION SERVICES TO DETERMINE PROGRAM ELIGIBILITY FOR EARLY INTERVENTION SERVICES; OR (D) WRITTEN CONSENT TO CONTACT THE CHILD'S PHYSICIAN, PHYSICIAN ASSISTANT OR NURSE PRACTITIONER FOR PURPOSES OF OBTAINING SIGNED DOCUMENTATION OF THE MEDICAL NECESSITY OF EARLY INTERVENTION SERVICES CONTAINED WITHIN THE INDIVIDUALIZED FAMILY SERVICE PLAN AGREED UPON PURSUANT TO SECTION TWENTY-FIVE HUNDRED FORTY-FIVE OF THIS TITLE. (iii) [providers] PROVIDERS shall utilize the department's fiscal agent and data system for claiming payment AND FOR REQUESTING APPEALS OF CLAIMS DENIED BY THIRD PARTY PAYORS, for evaluations and services rendered under the early intervention program. § 7. Paragraph (d) of subdivision 3 of section 2559 of the public health law, as amended by section 11 of part A of chapter 56 of the laws of 2012, is amended to read as follows: (d) A municipality, or its designee, and a provider shall be subrogat- ed, to the extent of the expenditures by such municipality or for early intervention services furnished to persons eligible for benefits under this title, to any rights such person may have or be entitled to from third party reimbursement. The provider SHALL SUBMIT ANY DOCUMENTATION OBTAINED PURSUANT TO SUBPARAGRAPH (II) OF PARAGRAPH (A) OF THIS SUBDIVI- SION AND shall submit notice to the insurer or plan administrator of his or her exercise of such right of subrogation upon the provider's assign- ment as the early intervention service provider for the child. The right of subrogation does not attach to benefits paid or provided under any health insurance policy or health benefits plan prior to receipt of S. 7507--A 51 A. 9507--A written notice of the exercise of subrogation rights by the insurer or plan administrator providing such benefits. § 8. Subdivision 7 of section 4900 of the public health law, as amended by chapter 558 of the laws of 1999, is amended to read as follows: 7. "Health care provider" means a health care professional or a facil- ity licensed pursuant to articles twenty-eight, thirty-six, forty-four or forty-seven of this chapter [or], a facility licensed pursuant to article nineteen, twenty-three, thirty-one or thirty-two of the mental hygiene law, QUALIFIED PERSONNEL PURSUANT TO TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THIS CHAPTER OR AN AGENCY AS DEFINED BY THE DEPARTMENT OF HEALTH IN REGULATIONS PROMULGATED PURSUANT TO TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THIS CHAPTER. § 9. Subdivision 1 of section 4904 of the public health law, as added by chapter 705 of the laws of 1996, is amended to read as follows: 1. An enrollee, the enrollee's designee and, in connection with retro- spective adverse determinations OR ADVERSE DETERMINATIONS FOR SERVICES RENDERED IN ACCORDANCE TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THIS CHAP- TER, an enrollee's health care provider, may appeal an adverse determi- nation rendered by a utilization review agent. § 10. The opening paragraph of subdivision 2 of section 4910 of the public health law, as amended by chapter 237 of the laws of 2009, is amended to read as follows: An enrollee, the enrollee's designee and, in connection with concur- rent and retrospective adverse determinations OR ADVERSE DETERMINATIONS FOR SERVICES RENDERED IN ACCORDANCE WITH TITLE TWO-A OF ARTICLE TWENTY- FIVE OF THIS CHAPTER, an enrollee's health care provider, shall have the right to request an external appeal when: § 11. Paragraph (a) of subdivision 4 of section 4914 of the public health law, as amended by chapter 237 of the laws of 2009, is amended to read as follows: (a) Except as provided in paragraphs (b) and (c) of this subdivision, payment for an external appeal, INCLUDING AN APPEAL FOR SERVICES RENDERED IN ACCORDANCE WITH TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THIS CHAPTER, shall be the responsibility of the health care plan. The health care plan shall make payment to the external appeal agent within forty- five days from the date the appeal determination is received by the health care plan, and the health care plan shall be obligated to pay such amount together with interest thereon calculated at a rate which is the greater of the rate set by the commissioner of taxation and finance for corporate taxes pursuant to paragraph one of subsection (e) of section one thousand ninety-six of the tax law or twelve percent per annum, to be computed from the date the bill was required to be paid, in the event that payment is not made within such forty-five days. § 12. Subsection (g) of section 4900 of the insurance law, as amended by chapter 558 of the laws of 1999, is amended to read as follows: (g) "Health care provider" means a health care professional or a facility licensed pursuant to article twenty-eight, thirty-six, forty- four or forty-seven of the public health law [or], a facility licensed pursuant to article nineteen, twenty-three, thirty-one or thirty-two of the mental hygiene law, QUALIFIED PERSONNEL PURSUANT TO TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, OR AN AGENCY AS DEFINED BY THE DEPARTMENT OF HEALTH IN REGULATIONS PROMULGATED PURSUANT TO TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW. § 13. Subsection (a) of section 4904 of the insurance law, as added by chapter 705 of the laws of 1996, is amended to read as follows: S. 7507--A 52 A. 9507--A (a) An insured, the insured's designee and, in connection with retro- spective adverse determinations OR ADVERSE DETERMINATIONS FOR SERVICES RENDERED IN ACCORDANCE WITH TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, an insured's health care provider, may appeal an adverse determination rendered by a utilization review agent. § 14. The opening paragraph of subsection (b) of section 4910 of the insurance law, as amended by chapter 237 of the laws of 2009, is amended to read as follows: An insured, the insured's designee and, in connection with concurrent and retrospective adverse determinations OR ADVERSE DETERMINATIONS FOR SERVICES RENDERED IN ACCORDANCE WITH TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, an insured's health care provider, shall have the right to request an external appeal when: § 15. Paragraph 1 of subsection (d) of section 4914 of the insurance law, as amended by chapter 237 of the laws of 2009, is amended to read as follows: (1) Except as provided in paragraphs two and three of this subsection, payment for an external appeal, INCLUDING AN APPEAL FOR SERVICES RENDERED IN ACCORDANCE WITH TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, shall be the responsibility of the health care plan. The health care plan shall make payment to the external appeal agent within forty-five days, from the date the appeal determination is received by the health care plan, and the health care plan shall be obligated to pay such amount together with interest thereon calculated at a rate which is the greater of the rate set by the commissioner of taxation and finance for corporate taxes pursuant to paragraph one of subsection (e) of section one thousand ninety-six of the tax law or twelve percent per annum, to be computed from the date the bill was required to be paid, in the event that payment is not made within such forty-five days. § 16. Paragraph 1 of subsection (c) of section 109 of the insurance law, as amended by section 55 of part A of chapter 62 of the laws of 2011, is amended to read as follows: (1) If the superintendent finds after notice and hearing that any [authorized] insurer, representative of the insurer, [licensed] insur- ance agent, [licensed] insurance broker, [licensed] adjuster, or any other person or entity [licensed, certified, registered, or authorized pursuant] SUBJECT to this chapter, has wilfully violated the provisions of this chapter or any regulation promulgated thereunder, then the superintendent may order the person or entity to pay to the people of this state a penalty in a sum not exceeding THE GREATER OF: (I) one thousand dollars for each offense; OR (II) WHERE THE VIOLATION RELATES TO EITHER THE FAILURE TO PAY A CLAIM OR MAKING A FALSE STATEMENT TO THE SUPERINTENDENT OR THE DEPARTMENT, THE GREATER OF (A) TEN THOUSAND DOLLARS FOR EACH OFFENSE, OR (B) A MULTIPLE OF TWO TIMES THE AGGREGATE DAMAGES ATTRIBUTABLE TO THE VIOLATION, OR (C) A MULTIPLE OF TWO TIMES THE AGGREGATE ECONOMIC GAIN ATTRIBUTABLE TO THE VIOLATION. § 17. Upon enactment of the amendments to paragraph (a) of subdivision 3 of section 2559 of the public health law made by section six of this act, providers of early intervention services shall receive a two percent increase in rates of reimbursement for early intervention services provided that for payments made for early intervention services to persons eligible for medical assistance pursuant to title eleven of article five of the social services law, the two percent increase shall be subject to the availability of federal financial participation. S. 7507--A 53 A. 9507--A § 18. This act shall take effect immediately and shall be deemed to have been in full force and effect on or after April 1, 2018; provided that the amendments to section 3235-a of the insurance law made by section five of this act shall apply only to policies and contracts issued, renewed, modified, altered or amended on or after such date. PART P Section 1. The opening paragraph of paragraph (b) of subdivision 5-a of section 2807-m of the public health law, as amended by section 6 of part H of chapter 57 of the laws of 2017, is amended to read as follows: Nine million one hundred twenty thousand dollars annually for the period January first, two thousand nine through December thirty-first, two thousand ten, and two million two hundred eighty thousand dollars for the period January first, two thousand eleven, through March thir- ty-first, two thousand eleven, nine million one hundred twenty thousand dollars each state fiscal year for the period April first, two thousand eleven through March thirty-first, two thousand fourteen, up to eight million six hundred twelve thousand dollars each state fiscal year for the period April first, two thousand fourteen through March thirty- first, two thousand seventeen, and up to eight million six hundred twelve thousand dollars each state fiscal year for the period April first, two thousand seventeen through March thirty-first, two thousand [twenty] EIGHTEEN, shall be set aside and reserved by the commissioner from the regional pools established pursuant to subdivision two of this section to be allocated regionally with two-thirds of the available funding going to New York city and one-third of the available funding going to the rest of the state and shall be available for distribution as follows: § 2. Subparagraph (xiii) of paragraph (a) of subdivision 7 of section 2807-s of the public health law, as amended by section 4 of part H of chapter 57 of the laws of 2017, is amended to read as follows: (xiii) twenty-three million eight hundred thirty-six thousand dollars each state fiscal year for the period April first, two thousand twelve through March thirty-first, TWO THOUSAND EIGHTEEN, AND FIFTEEN MILLION TWO HUNDRED TWENTY-FOUR THOUSAND DOLLARS FOR EACH STATE FISCAL YEAR FOR THE PERIOD APRIL FIRST, TWO THOUSAND EIGHTEEN THROUGH MARCH THIRTY- FIRST, two thousand twenty; § 3. Subdivision 9 of section 2803 of the public health law is REPEALED. § 4. This act shall take effect immediately; provided, however, that the amendments to subparagraph (xiii) of paragraph (a) of subdivision 7 of section 2807-s of the public health law made by section two of this act shall not affect the expiration of such section and shall be deemed to expire therewith. PART Q Section 1. The public health law is amended by adding a new section 2825-f to read as follows: § 2825-F. HEALTH CARE FACILITY TRANSFORMATION PROGRAM: STATEWIDE III. 1. A STATEWIDE HEALTH CARE FACILITY TRANSFORMATION PROGRAM IS HEREBY ESTABLISHED UNDER THE JOINT ADMINISTRATION OF THE COMMISSIONER AND THE PRESIDENT OF THE DORMITORY AUTHORITY OF THE STATE OF NEW YORK FOR THE PURPOSE OF STRENGTHENING AND PROTECTING CONTINUED ACCESS TO HEALTH CARE SERVICES IN COMMUNITIES. THE PROGRAM SHALL PROVIDE FUNDING IN SUPPORT OF S. 7507--A 54 A. 9507--A CAPITAL PROJECTS, DEBT RETIREMENT, WORKING CAPITAL OR OTHER NON-CAPITAL PROJECTS THAT FACILITATE HEALTH CARE TRANSFORMATION ACTIVITIES INCLUD- ING, BUT NOT LIMITED TO, MERGER, CONSOLIDATION, ACQUISITION OR OTHER ACTIVITIES INTENDED TO: (A) CREATE FINANCIALLY SUSTAINABLE SYSTEMS OF CARE; (B) PRESERVE OR EXPAND ESSENTIAL HEALTH CARE SERVICES; (C) MODERN- IZE OBSOLETE FACILITY PHYSICAL PLANTS AND INFRASTRUCTURE; (D) FOSTER PARTICIPATION IN VALUE BASED PAYMENTS ARRANGEMENTS INCLUDING, BUT NOT LIMITED TO, CONTRACTS WITH MANAGED CARE PLANS AND ACCOUNTABLE CARE ORGANIZATIONS; (E) FOR RESIDENTIAL HEALTH CARE FACILITIES, INCREASE THE QUALITY OF RESIDENT CARE OR EXPERIENCE; OR (F) IMPROVE HEALTH INFORMA- TION TECHNOLOGY INFRASTRUCTURE, INCLUDING TELEHEALTH, TO STRENGTHEN THE ACUTE, POST-ACUTE AND LONG-TERM CARE CONTINUUM. GRANTS SHALL NOT BE AVAILABLE TO SUPPORT GENERAL OPERATING EXPENSES. THE ISSUANCE OF ANY BONDS OR NOTES HEREUNDER SHALL BE SUBJECT TO SECTION SIXTEEN HUNDRED EIGHTY-R OF THE PUBLIC AUTHORITIES LAW AND THE APPROVAL OF THE DIRECTOR OF THE DIVISION OF THE BUDGET, AND ANY PROJECTS FUNDED THROUGH THE ISSU- ANCE OF BONDS OR NOTES HEREUNDER SHALL BE APPROVED BY THE NEW YORK STATE PUBLIC AUTHORITIES CONTROL BOARD, AS REQUIRED UNDER SECTION FIFTY-ONE OF THE PUBLIC AUTHORITIES LAW. 2. THE COMMISSIONER AND THE PRESIDENT OF THE DORMITORY 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, FOR THE PURPOSES OF AWARDING, DISTRIBUTING, AND ADMIN- ISTERING THE FUNDS MADE AVAILABLE PURSUANT TO THIS SECTION. SUCH FUNDS MAY BE DISTRIBUTED BY THE COMMISSIONER FOR GRANTS TO GENERAL HOSPITALS, RESIDENTIAL HEALTH CARE FACILITIES, DIAGNOSTIC AND TREATMENT CENTERS AND CLINICS LICENSED PURSUANT TO THIS CHAPTER OR THE MENTAL HYGIENE LAW, AND COMMUNITY-BASED HEALTH CARE PROVIDERS AS DEFINED IN SUBDIVISION THREE OF THIS SECTION FOR GRANTS IN SUPPORT OF THE PURPOSES SET FORTH IN THIS SECTION. A COPY OF SUCH AGREEMENT, AND ANY AMENDMENTS THERETO, SHALL BE PROVIDED TO THE CHAIR OF THE SENATE FINANCE COMMITTEE, THE CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE, AND THE DIRECTOR OF THE DIVISION OF THE BUDGET NO LATER THAN THIRTY DAYS PRIOR TO THE RELEASE OF A REQUEST FOR APPLICATIONS FOR FUNDING UNDER THIS PROGRAM. PROJECTS AWARDED, IN WHOLE OR PART, UNDER SECTIONS TWENTY-EIGHT HUNDRED TWENTY-FIVE-A AND TWENTY-EIGHT HUNDRED TWENTY-FIVE-B OF THIS ARTICLE SHALL NOT BE ELIGIBLE FOR GRANTS OR AWARDS MADE AVAILABLE UNDER THIS SECTION. 3. NOTWITHSTANDING SECTION ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW OR ANY INCONSISTENT PROVISION OF LAW TO THE CONTRARY, UP TO FOUR HUNDRED AND TWENTY-FIVE MILLION DOLLARS OF THE FUNDS APPROPRIATED FOR THIS PROGRAM SHALL BE AWARDED WITHOUT A COMPETITIVE BID OR REQUEST FOR PROPOSAL PROCESS FOR GRANTS TO HEALTH CARE PROVIDERS (HEREAFTER "APPLICANTS"). PROVIDED, HOWEVER, THAT A MINIMUM OF: (A) SIXTY MILLION DOLLARS OF TOTAL AWARDED FUNDS SHALL BE MADE TO COMMUNITY-BASED HEALTH CARE PROVIDERS, WHICH FOR PURPOSES OF THIS SECTION SHALL BE DEFINED AS A DIAGNOSTIC AND TREATMENT CENTER LICENSED OR GRANTED AN OPERATING CERTIF- ICATE UNDER THIS ARTICLE; A MENTAL HEALTH CLINIC LICENSED OR GRANTED AN OPERATING CERTIFICATE UNDER ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE LAW; A SUBSTANCE USE DISORDER TREATMENT CLINIC LICENSED OR GRANTED AN OPERATING CERTIFICATE UNDER ARTICLE THIRTY-TWO OF THE MENTAL HYGIENE LAW; A PRIMARY CARE PROVIDER; A HOME CARE PROVIDER CERTIFIED OR LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF THIS CHAPTER; OR AN ASSISTED LIVING PROGRAM APPROVED BY THE DEPARTMENT PURSUANT TO SUBDIVISION ONE OF SECTION FOUR HUNDRED SIXTY ONE-1 OF THE SOCIAL SERVICES LAW; AND (B) FORTY-FIVE MILLION DOLLARS OF THE TOTAL AWARDED FUNDS SHALL BE MADE TO RESIDENTIAL HEALTH CARE FACILITIES. S. 7507--A 55 A. 9507--A 4. NOTWITHSTANDING ANY INCONSISTENT SUBDIVISION OF THIS SECTION OR ANY OTHER PROVISION OF LAW TO THE CONTRARY, THE COMMISSIONER, WITH THE APPROVAL OF THE DIRECTOR OF THE BUDGET, MAY EXPEND UP TO TWENTY MILLION DOLLARS OF THE FUNDS APPROPRIATED FOR THIS PROGRAM AND DESIGNATED FOR COMMUNITY-BASED HEALTH CARE PROVIDERS PURSUANT TO SUBDIVISION THREE OF THIS SECTION FOR AWARDS MADE PURSUANT TO PARAGRAPH (L) OF SUBDIVISION THREE OF SECTION FOUR HUNDRED SIXTY-ONE-L OF THE SOCIAL SERVICES LAW. 5. IN DETERMINING AWARDS FOR ELIGIBLE APPLICANTS UNDER THIS SECTION, THE COMMISSIONER SHALL CONSIDER CRITERIA INCLUDING, BUT NOT LIMITED TO: (A) THE EXTENT TO WHICH THE PROPOSED PROJECT WILL CONTRIBUTE TO THE INTEGRATION OF HEALTH CARE SERVICES OR THE LONG TERM SUSTAINABILITY OF THE APPLICANT OR PRESERVATION OF ESSENTIAL HEALTH SERVICES IN THE COMMU- NITY OR COMMUNITIES SERVED BY THE APPLICANT; (B) THE EXTENT TO WHICH THE PROPOSED PROJECT OR PURPOSE IS ALIGNED WITH DELIVERY SYSTEM REFORM INCENTIVE PAYMENT ("DSRIP") PROGRAM GOALS AND OBJECTIVES; (C) THE GEOGRAPHIC DISTRIBUTION OF FUNDS; (D) THE RELATIONSHIP BETWEEN THE PROPOSED PROJECT AND IDENTIFIED COMMUNITY NEED; (E) THE EXTENT TO WHICH THE APPLICANT HAS ACCESS TO ALTERNATIVE FINANCING; (F) THE EXTENT TO WHICH THE PROPOSED PROJECT FURTHERS THE DEVELOPMENT OF PRIMARY CARE AND OTHER OUTPATIENT SERVICES; (G) THE EXTENT TO WHICH THE PROPOSED PROJECT BENEFITS MEDICAID ENROL- LEES AND UNINSURED INDIVIDUALS; (H) THE EXTENT TO WHICH THE APPLICANT HAS ENGAGED THE COMMUNITY AFFECTED BY THE PROPOSED PROJECT AND THE MANNER IN WHICH COMMUNITY ENGAGEMENT HAS SHAPED SUCH PROJECT; AND (I) THE EXTENT TO WHICH THE PROPOSED PROJECT ADDRESSES POTENTIAL RISK TO PATIENT SAFETY AND WELFARE. 6. DISBURSEMENT OF AWARDS MADE PURSUANT TO THIS SECTION SHALL BE CONDITIONED ON THE AWARDEE ACHIEVING CERTAIN PROCESS AND PERFORMANCE METRICS AND MILESTONES AS DETERMINED IN THE SOLE DISCRETION OF THE COMMISSIONER. SUCH METRICS AND MILESTONES SHALL BE STRUCTURED TO ENSURE THAT THE GOALS OF THE PROJECT ARE ACHIEVED, AND SUCH METRICS AND MILE- STONES SHALL BE INCLUDED IN GRANT DISBURSEMENT AGREEMENTS OR OTHER CONTRACTUAL DOCUMENTS AS REQUIRED BY THE COMMISSIONER. 7. THE DEPARTMENT SHALL PROVIDE A REPORT ON A QUARTERLY BASIS TO THE CHAIRS OF THE SENATE FINANCE, ASSEMBLY WAYS AND MEANS, AND SENATE AND ASSEMBLY HEALTH COMMITTEES, UNTIL SUCH TIME AS THE DEPARTMENT DETERMINES THAT THE PROJECTS THAT RECEIVE FUNDING PURSUANT TO THIS SECTION ARE SUBSTANTIALLY COMPLETE. SUCH REPORTS SHALL BE SUBMITTED NO LATER THAN SIXTY DAYS AFTER THE CLOSE OF THE QUARTER, AND SHALL INCLUDE, FOR EACH AWARD, THE NAME OF THE APPLICANT, A DESCRIPTION OF THE PROJECT OR PURPOSE, THE AMOUNT OF THE AWARD, DISBURSEMENT DATE, AND STATUS OF ACHIEVEMENT OF PROCESS AND PERFORMANCE METRICS AND MILESTONES PURSUANT TO SUBDIVISION SIX OF THIS SECTION. § 2. This act shall take effect immediately and shall be deemed to have been in full force and effect on and after April 1, 2018. PART R Section 1. Section 1373 of the public health law is amended by adding three new subdivisions 1-a, 1-b and 1-c to read as follows: 1-A. EVERY GOVERNMENTAL UNIT OR AGENCY THAT IS CHARGED WITH OR OTHER- WISE ACCOUNTABLE OR RESPONSIBLE FOR ADMINISTRATION AND ENFORCEMENT OF S. 7507--A 56 A. 9507--A THE NEW YORK STATE UNIFORM FIRE PREVENTION AND BUILDING CODE, OR ANY OTHER APPLICABLE BUILDING AND FIRE PREVENTION CODE, WITH RESPECT TO ANY RESIDENTIAL OR NON-RESIDENTIAL BUILDING THAT IS LOCATED WITHIN AN AREA DESIGNATED AS HIGH RISK BY THE COMMISSIONER PURSUANT TO SUBDIVISION ONE OF THIS SECTION, SHALL SUBMIT TO THE DEPARTMENT AGGREGATE REPORTS SUMMA- RIZING THE OUTCOMES OF INSPECTIONS AND REMEDIATION CONDUCTED PURSUANT TO REGULATIONS ADOPTED BY THE SECRETARY OF STATE PURSUANT TO SUBDIVISION SEVEN OF SECTION THREE HUNDRED EIGHTY-ONE OF THE EXECUTIVE LAW, IN A FORMAT TO BE DETERMINED BY THE COMMISSIONER IN CONSULTATION WITH THE SECRETARY OF STATE. 1-B. (A) THE COMMISSIONER AND THE SECRETARY OF STATE SHALL HAVE THE POWER TO DETERMINE, INDIVIDUALLY OR JOINTLY, IN SUCH MANNER AS HE, SHE, OR THEY DEEM APPROPRIATE, THE STATUS OF COMPLIANCE BY ANY GOVERNMENTAL UNIT OR AGENCY REFERRED TO IN SUBDIVISION ONE-A OF THIS SECTION, INCLUD- ING BUT NOT LIMITED TO ANY CITY WITH A POPULATION OF OVER ONE MILLION, WITH SUBDIVISION SEVEN OF SECTION THREE HUNDRED EIGHTY-ONE OF THE EXECU- TIVE LAW AND THE RULES AND REGULATIONS PROMULGATED THEREUNDER. IF THE COMMISSIONER OR THE SECRETARY OF STATE, INDIVIDUALLY OR JOINTLY, DETER- MINE THAT ANY SUCH GOVERNMENTAL UNIT OR AGENCY IS NOT IN COMPLIANCE WITH SUBDIVISION SEVEN OF SECTION THREE HUNDRED EIGHTY-ONE OF THE EXECUTIVE LAW OR ANY REGULATIONS PROMULGATED THEREUNDER, THE COMMISSIONER MAY TAKE ANY OF THE FOLLOWING ACTIONS, EITHER INDIVIDUALLY OR IN COMBINATION IN ANY SEQUENCE: (I) REFER, OR REQUEST THE SECRETARY OF STATE TO REFER, THE MATTER TO THE ATTORNEY GENERAL TO INSTITUTE IN THE NAME OF THE COMMISSIONER OR THE SECRETARY OF STATE AN ACTION OR PROCEEDING SEEKING APPROPRIATE LEGAL OR EQUITABLE RELIEF TO REQUIRE SUCH GOVERNMENT UNIT OR AGENCY, INCLUDING A CITY WITH A POPULATION OVER ONE MILLION, TO COMPLY WITH SUCH RULES AND REGULATIONS; (II) REQUIRE THE GOVERNMENTAL UNIT OR AGENCY IN VIOLATION OF SUBDIVI- SION SEVEN OF SECTION THREE HUNDRED EIGHTY-ONE OF THE EXECUTIVE LAW, TO CREATE A CORRECTIVE ACTION PLAN, IN CONSULTATION WITH THE LOCAL HEALTH DEPARTMENT, WHICH SHALL REQUIRE THE GOVERNMENT UNIT OR AGENCY TO COME INTO COMPLIANCE WITH SUBDIVISION SEVEN OF SECTION THREE HUNDRED EIGHTY- ONE OF THE EXECUTIVE LAW AND TO DISCONTINUE ANY PAINT CONDITION CONDU- CIVE TO LEAD POISONING IN ANY RESIDENTIAL OR NON-RESIDENTIAL BUILDING LOCATED WITHIN SUCH GOVERNMENT UNIT OR AGENCY'S JURISDICTION; (III) INVESTIGATE AND EXAMINE THE ACTIONS OF THE GOVERNMENTAL UNIT OR AGENCY IN VIOLATION OF SUBDIVISION SEVEN OF SECTION THREE HUNDRED EIGHT- Y-ONE OF THE EXECUTIVE LAW OR OF THE RULES AND REGULATIONS PROMULGATED THEREUNDER, AND DECLARE THAT SUCH GOVERNMENTAL UNIT OR AGENCY IS MAIN- TAINING A PUBLIC NUISANCE AND: (A) REQUIRE THE JURISDICTIONAL LOCAL HEALTH DEPARTMENT TO INVESTIGATE, IDENTIFY, AND ORDER THE DISCONTINUANCE OF A PAINT CONDITION CONDUCIVE TO LEAD POISONING IN ANY RESIDENTIAL OR NON-RESIDENTIAL BUILDING LOCATED WITHIN THE GOVERNMENTAL UNIT OR AGENCY SUBJECT TO THE COMMISSIONER'S DECLARATION OF A PUBLIC NUISANCE; OR (B) INVESTIGATE, IDENTIFY AND ORDER, THE DISCONTINUANCE OF A PAINT CONDITION CONDUCIVE TO LEAD POISONING IN ANY RESIDENTIAL OR NON-RESIDEN- TIAL BUILDING LOCATED WITHIN THE GOVERNMENTAL UNIT OR AGENCY SUBJECT TO THE COMMISSIONER'S DECLARATION OF A PUBLIC NUISANCE. (B) THE EXPENSE OF AN INVESTIGATION PURSUANT TO PARAGRAPH (A) OF THIS SUBDIVISION, AND THE DISCONTINUANCE OF ANY PAINT CONDITIONS CONDUCIVE TO LEAD POISONING IDENTIFIED DURING SUCH INVESTIGATION, SHALL BE PAID BY THE GOVERNMENTAL UNIT OR AGENCY DETERMINED BY THE COMMISSIONER TO HAVE MAINTAINED A PUBLIC NUISANCE PURSUANT TO THIS SUBDIVISION. S. 7507--A 57 A. 9507--A 1-C. ALL PAINT ON ANY RESIDENTIAL BUILDING WHICH IS LOCATED IN AN AREA DESIGNATED AS HIGH RISK BY THE COMMISSIONER PURSUANT TO SUBDIVISION ONE OF THIS SECTION AND ON WHICH THE ORIGINAL CONSTRUCTION WAS COMPLETED PRIOR TO JANUARY FIRST, NINETEEN HUNDRED SEVENTY-EIGHT, AND ALL PAINT ON THE EXTERIOR OF ANY NON-RESIDENTIAL BUILDING WHICH IS LOCATED IN AN AREA DESIGNATED AS HIGH RISK BY THE COMMISSIONER PURSUANT TO SUBDIVISION ONE OF THIS SECTION AND ON WHICH THE ORIGINAL CONSTRUCTION WAS COMPLETED PRIOR TO JANUARY FIRST, NINETEEN HUNDRED SEVENTY-EIGHT, SHALL BE PRESUMED TO BE LEAD-BASED. THIS PRESUMPTION MAY BE OVERCOME BY A CERTIF- ICATION BY A LEAD-BASED PAINT INSPECTOR OR RISK ASSESSOR THAT THE PROP- ERTY HAS BEEN DETERMINED THROUGH A LEAD-BASED PAINT INSPECTION CONDUCTED IN ACCORDANCE WITH APPROPRIATE FEDERAL REGULATIONS NOT TO CONTAIN LEAD- BASED PAINT, OR BY SUCH OTHER MEANS AS MAY BE PRESCRIBED BY THE RULES AND REGULATIONS ADOPTED BY THE SECRETARY OF STATE PURSUANT TO PARAGRAPH C OF SUBDIVISION SEVEN OF SECTION THREE HUNDRED EIGHTY-ONE OF THE EXECU- TIVE LAW. § 2. Section 378 of the executive law is amended by adding a new subdivision 17 to read as follows: 17. FOR ANY AREA DESIGNATED AS HIGH RISK BY THE COMMISSIONER OF HEALTH PURSUANT TO SUBDIVISION ONE OF SECTION THIRTEEN HUNDRED SEVENTY-THREE OF THE PUBLIC HEALTH LAW, A REQUIREMENT THAT THE INTERIOR AND EXTERIOR OF ANY RESIDENTIAL BUILDING THAT IS PRESUMED TO HAVE LEAD-BASED PAINT PURSUANT TO SUBDIVISION ONE-C OF SECTION THIRTEEN HUNDRED SEVENTY-THREE OF THE PUBLIC HEALTH LAW, AND THE EXTERIOR OF ANY NON-RESIDENTIAL BUILD- ING THAT IS PRESUMED TO HAVE LEAD-BASED PAINT PURSUANT TO SUBDIVISION ONE-C OF SECTION THIRTEEN HUNDRED SEVENTY-THREE OF THE PUBLIC HEALTH LAW, BE MAINTAINED IN A CONDITION SUCH THAT THE PAINT THEREON DOES NOT BECOME DETERIORATED PAINT, UNLESS THE DETERIORATED PAINT SURFACES COMPRISE A MINIMAL SURFACE AREA. IN A CITY WITH A POPULATION OF OVER ONE MILLION, SUCH CITY'S LOCAL BUILDING AND FIRE PREVENTION CODES SHALL INCLUDE PROVISIONS AT LEAST AS STRINGENT AS THE PROVISIONS OF THIS SUBDIVISION. § 3. Section 381 of the executive law is amended by adding a new subdivision 7 to read as follows: 7. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, THE SECRETARY, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH, SHALL PROMULGATE RULES AND REGULATIONS WITH RESPECT TO GOVERNMENTAL UNITS AND AGENCIES THAT ARE CHARGED WITH OR OTHERWISE ACCOUNTABLE OR RESPONSIBLE FOR ADMINISTRATION AND ENFORCEMENT OF THE NEW YORK STATE UNIFORM CODE, OR ANY OTHER APPLI- CABLE BUILDING AND FIRE PREVENTION CODE, WITH RESPECT TO ANY RESIDENTIAL OR NON-RESIDENTIAL BUILDING LOCATED IN AN AREA DESIGNATED AS HIGH RISK BY THE COMMISSIONER OF HEALTH PURSUANT TO SUBDIVISION ONE OF SECTION THIRTEEN HUNDRED SEVENTY-THREE OF THE PUBLIC HEALTH LAW: A. REQUIRING THAT SUCH GOVERNMENTAL UNIT OR AGENCY CONDUCT INSPECTIONS OF ALL RESIDENTIAL RENTAL BUILDINGS IN SUCH HIGH RISK AREAS PERIODICALLY AND AT SPECIFIED TIMES INCLUDING, BUT NOT LIMITED TO, AS PART OF AN APPLICATION FOR A CERTIFICATE OF OCCUPANCY, A RENEWAL OF A CERTIFICATE OF OCCUPANCY, OR BASED UPON THE FILING OF A COMPLAINT. SUCH INSPECTIONS SHALL INCLUDE AT A MINIMUM A VISUAL ASSESSMENT FOR DETERIORATED PAINT AND BARE SOIL PRESENT WITHIN THE DRIPLINE OF THE BUILDING. B. ESTABLISHING REMEDIAL ACTIONS THAT SUCH GOVERNMENTAL UNIT OR AGENCY MAY REQUIRE THE OWNER OR OTHER PERSON RESPONSIBLE FOR MAINTENANCE OF THE SUBJECT PROPERTY TO TAKE TO ADDRESS VIOLATIONS OF THE NEW YORK STATE UNIFORM CODE PROVISIONS, AND OTHER APPLICABLE BUILDING AND FIRE PREVENTION CODE PROVISIONS, ADOPTED PURSUANT TO SUBDIVISION SEVENTEEN OF S. 7507--A 58 A. 9507--A SECTION THREE HUNDRED SEVENTY-EIGHT OF THIS ARTICLE, WHICH SHALL INCLUDE AS APPROPRIATE: (I) OBTAINING CERTIFICATION BY A LEAD-BASED PAINT INSPECTOR OR RISK ASSESSOR THAT THE PROPERTY HAS BEEN DETERMINED THROUGH A LEAD-BASED PAINT INSPECTION CONDUCTED IN ACCORDANCE WITH APPROPRIATE FEDERAL REGU- LATIONS NOT TO CONTAIN LEAD-BASED PAINT. (II) OBTAINING CERTIFICATION BY A LEAD-BASED PAINT INSPECTOR OR RISK ASSESSOR THAT ALL CITED VIOLATIONS HAVE BEEN ABATED, OR INTERIM CONTROLS IMPLEMENTED, AND CLEARANCE HAS BEEN ACHIEVED IN ACCORDANCE WITH THE NEW YORK STATE UNIFORM CODE OR OTHER APPLICABLE BUILDING AND FIRE PREVENTION CODES. (III) WHERE EXTERIOR DETERIORATED PAINT VIOLATIONS, INCLUDING DETERI- ORATED PAINT VIOLATIONS ON AN OPEN PORCH, AND/OR BARE SOIL VIOLATIONS ARE CITED, OR WHERE INTERIOR DETERIORATED PAINT VIOLATIONS ARE CITED IN A COMMON AREA, CLEARANCE MAY BE ESTABLISHED THROUGH A VISUAL ASSESSMENT BY A LOCAL CODE ENFORCEMENT OFFICER AFTER REDUCTION MEASURES HAVE BEEN IMPLEMENTED. C. ESTABLISHING STANDARDS FOR A CLEARANCE EXAMINATION AND REPORT AND FOR CERTIFICATIONS OR OTHER DOCUMENTATION REQUIRED TO OVERCOME THE PRESUMPTION CREATED BY SUBDIVISION ONE-C OF SECTION THIRTEEN HUNDRED SEVENTY-THREE OF THE PUBLIC HEALTH LAW. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, THE RULES AND REGULATIONS PROMULGATED PURSUANT TO THIS SUBDIVISION SHALL, WITH RESPECT TO ALL GOVERNMENTAL UNITS AND AGENCIES OTHER THAN CITIES WITH A POPULATION OF OVER ONE MILLION, BE CONSIDERED TO BE PART OF THE MINIMUM STANDARDS ADOPTED PURSUANT TO SUBDIVISION ONE OF THIS SECTION; PROVIDED, HOWEVER, THAT THE CLOSING PARAGRAPH OF SUBDIVISION ONE OF THIS SECTION SHALL NOT APPLY TO INSPECTIONS REQUIRED BY THE RULES AND REGULATIONS PROMULGATED PURSUANT TO THIS SUBDIVISION. ANY GOVERNMENTAL UNIT OR AGENCY OTHER THAN A CITY WITH A POPULATION OF OVER ONE MILLION THAT FAILS TO COMPLY WITH THE RULES AND REGULATIONS PROMULGATED PURSUANT TO THIS SUBDIVISION SHALL BE SUBJECT TO THE ACTIONS AUTHORIZED BY SUBDIVISION FOUR OF THIS SECTION. ANY GOVERNMENTAL UNIT OR AGENCY, INCLUDING BUT NOT LIMITED TO A CITY WITH A POPULATION OF OVER ONE MILLION, THAT FAILS TO COMPLY WITH SUCH RULES AND REGULATIONS SHALL ALSO BE SUBJECT TO THE ACTIONS AUTHOR- IZED BY SUBDIVISION ONE-B OF SECTION THIRTEEN HUNDRED SEVENTY-THREE OF THE PUBLIC HEALTH LAW. § 4. Paragraphs b and c of subdivision 1 of section 223-b of the real property law, as amended by chapter 584 of the laws of 1991, are amended and a new paragraph d is added to read as follows: b. Actions taken in good faith, by or in behalf of the tenant, to secure or enforce any rights under the lease or rental agreement, under section two hundred thirty-five-b of this [chapter] ARTICLE, or under any other law of the state of New York, or of its governmental subdivi- sions, or of the United States which has as its objective the regulation of premises used for dwelling purposes or which pertains to the offense of rent gouging in the third, second or first degree; [or] c. The tenant's participation in the activities of a tenant's organ- ization[.]; OR D. THE TENANT'S REPORTING OF A SUSPECTED LEAD-BASED PAINT HAZARD TO THE OWNER OR TO ANY STATE OR LOCAL AGENCY. § 5. This act shall take effect on the one hundred eightieth day after it shall have become a law; provided that any rules, regulations, local laws, or ordinances necessary to implement the provisions of this act on its effective date are authorized to be made, adopted, or enacted on or before such effective date. S. 7507--A 59 A. 9507--A PART S Section 1. This Part enacts into law major components of legislation which are necessary to effectuate recommendations made as part of the Regulatory Modernization Initiative undertaken by the Department of Health. Each component is wholly contained within a Subpart identified as Subparts A through C. The effective date for each particular provision contained within such Subpart is set forth in the last section of such Subpart. Any provision in any section contained within a Subpart, including the effective date of the Subpart, which makes a reference to a section "of this act," when used in connection with that particular component, shall be deemed to mean and refer to the corre- sponding section of the Subpart in which it is found. Section three of this Part sets forth the general effective date of this Part. SUBPART A Section 1. The public health law is amended by adding a new section 2805-z to read as follows: § 2805-Z. COMMUNITY PARAMEDICINE COLLABORATIVES. 1. FOR PURPOSES OF THIS SECTION: (A) A "COMMUNITY PARAMEDICINE COLLABORATIVE" SHALL MEAN AN INITIATIVE COMPRISED OF THE PARTICIPANTS SET FORTH IN SUBDIVISION TWO OF THIS SECTION AND ORGANIZED TO CARRY OUT A COMMUNITY PARAMEDICINE PROGRAM AS DEFINED IN PARAGRAPH (B) OF THIS SUBDIVISION. (B) A "COMMUNITY PARAMEDICINE PROGRAM" SHALL MEAN A PROGRAM CARRIED OUT BY A COMMUNITY PARAMEDICINE COLLABORATIVE FOR THE PURPOSE OF ACHIEV- ING OBJECTIVES IDENTIFIED BY THE COLLABORATIVE, PURSUANT TO WHICH INDI- VIDUALS WHO ARE CERTIFIED UNDER REGULATIONS ISSUED PURSUANT TO SECTION THREE THOUSAND TWO OF THIS CHAPTER SHALL PERFORM COMMUNITY PARAMEDICINE SERVICES IN RESIDENTIAL SETTINGS OTHER THAN THE INITIAL EMERGENCY MEDICAL CARE AND TRANSPORTATION OF SICK AND INJURED PERSONS, PROVIDED THAT SUCH INDIVIDUALS ARE: (I) CERTIFIED PURSUANT TO ARTICLE THIRTY OF THIS CHAPTER; (II) EMPLOYEES OR VOLUNTEERS OF AN EMERGENCY MEDICAL SERVICES PROVIDER THAT PARTICIPATES IN THE COLLABORATIVE; (III) PROVIDING SERVICES THAT ARE WITHIN THEIR EDUCATION OR TRAINING; AND (IV) WORKING UNDER MEDICAL CONTROL AS DEFINED BY SUBDIVISION FIFTEEN OF SECTION THREE THOUSAND ONE OF THIS TITLE. (C) "COMMUNITY PARAMEDICINE SERVICES" SHALL MEAN SERVICES PROVIDED IN RESIDENTIAL SETTINGS BY INDIVIDUALS WHO ARE CERTIFIED UNDER REGULATIONS ISSUED PURSUANT TO SECTION THREE THOUSAND TWO OF THIS CHAPTER AND EMPLOYEES OR VOLUNTEERS OF AN EMERGENCY MEDICAL SERVICES PROVIDER, OTHER THAN THE INITIAL EMERGENCY MEDICAL CARE AND TRANSPORTATION OF SICK AND INJURED PERSONS. (D) AN "EMERGENCY MEDICAL SERVICES PROVIDER" SHALL MEAN AN AMBULANCE SERVICE OR AN ADVANCED LIFE SUPPORT FIRST RESPONSE SERVICE THAT IS CERTIFIED UNDER ARTICLE THIRTY OF THIS CHAPTER TO PROVIDE AMBULANCE OR ADVANCED LIFE SUPPORT FIRST RESPONSE SERVICES AND STAFFED BY INDIVIDUALS WHO ARE CERTIFIED UNDER REGULATIONS ISSUED PURSUANT TO SECTION THREE THOUSAND TWO OF THIS CHAPTER TO PROVIDE BASIC OR ADVANCED LIFE SUPPORT. 2. (A) AT A MINIMUM, A COMMUNITY PARAMEDICINE COLLABORATIVE SHALL INCLUDE THE PARTICIPATION OF AT LEAST ONE HOSPITAL LICENSED UNDER THIS ARTICLE, AT LEAST ONE PHYSICIAN WHO MAY BUT NEED NOT BE EMPLOYED OR OTHERWISE AFFILIATED WITH A HOSPITAL PARTICIPATING IN SUCH COLLABORA- S. 7507--A 60 A. 9507--A TIVE, AT LEAST ONE EMERGENCY MEDICAL SERVICES PROVIDER AND, IF THE COMMUNITY PARAMEDICINE SERVICES ARE TO BE PROVIDED IN A PRIVATE RESI- DENCE, AT LEAST ONE HOME CARE SERVICES AGENCY LICENSED OR CERTIFIED UNDER ARTICLE THIRTY-SIX OF THIS CHAPTER. (B) WHERE THE COLLABORATIVE'S OBJECTIVES INCLUDE A FOCUS ON SERVING INDIVIDUALS WITH BEHAVIORAL HEALTH CONDITIONS AND/OR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, THE COLLABORATIVE SHALL INCLUDE THE PARTIC- IPATION OF PROVIDERS OPERATED, LICENSED, OR CERTIFIED BY THE OFFICE OF MENTAL HEALTH, THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, AND/OR THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, AS APPRO- PRIATE. (C) SUCH COLLABORATIVE MAY ALSO INCLUDE ADDITIONAL PARTICIPANTS SUCH AS PAYORS AND LOCAL HEALTH DEPARTMENTS. 3. A COMMUNITY PARAMEDICINE COLLABORATIVE MAY ESTABLISH A COMMUNITY PARAMEDICINE PROGRAM TO PROVIDE COMMUNITY PARAMEDICINE SERVICES TO INDI- VIDUALS LIVING IN RESIDENTIAL SETTINGS FOR THE PURPOSE OF ACHIEVING OBJECTIVES IDENTIFIED BY THE COLLABORATIVE SUCH AS: PREVENTING EMERGEN- CIES, AVOIDABLE EMERGENCY ROOM VISITS, AVOIDABLE MEDICAL TRANSPORT, AND POTENTIALLY AVOIDABLE HOSPITAL ADMISSIONS AND READMISSIONS; IMPROVING OUTCOMES FOLLOWING DISCHARGE FROM A GENERAL HOSPITAL OR OTHER INPATIENT ADMISSION; AND/OR PROMOTING SELF-MANAGEMENT OF HEALTH OR BEHAVIORAL HEALTH CARE CONDITIONS. 4. A COMMUNITY PARAMEDICINE COLLABORATIVE SHALL BE REQUIRED TO PROVIDE OR ARRANGE FOR APPROPRIATE ORIENTATION AND TRAINING FOR STAFF PARTIC- IPATING IN THE COMMUNITY PARAMEDICINE PROGRAM. IN ALL CASES, SUCH ORIEN- TATION AND TRAINING SHALL ADDRESS THE ASSESSMENT OF THE NEEDS OF INDI- VIDUALS WITH BEHAVIORAL HEALTH CONDITIONS AND INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES. 5. AN EMERGENCY MEDICAL SERVICES PROVIDER PARTICIPATING IN A COMMUNITY PARAMEDICINE COLLABORATIVE SHALL: (A) ENSURE THAT THE PROVISION OF COMMUNITY PARAMEDICINE SERVICES OCCURS WITHIN THE PROVIDER'S PRIMARY OPERATING TERRITORY PURSUANT TO ARTICLE THIRTY OF THIS CHAPTER; AND (B) MAKE REASONABLE EFFORTS TO ENSURE THAT IT HAS SUFFICIENTLY STAFFED THE PROVISION OF INITIAL EMERGENCY MEDICAL CARE AND TRANSPORTATION OF SICK AND INJURED PERSONS BEFORE MAKING STAFF AVAILABLE TO PROVIDE COMMUNITY PARAMEDICINE SERVICES. 6. (A) NO COMMUNITY PARAMEDICINE COLLABORATIVE SHALL BEGIN PROVIDING SERVICES UNDER A COMMUNITY PARAMEDICINE PROGRAM UNTIL IT HAS NOTIFIED THE DEPARTMENT OF THE INITIATION OF SUCH COLLABORATIVE BY: (I) IDENTIFYING THE PARTICIPANTS OF THE COLLABORATIVE AND THE INDIVID- UAL WHO WILL SERVE AS THE POINT OF CONTACT; (II) DESCRIBING THE GOALS OF THE COLLABORATIVE IN CARRYING OUT A COMMUNITY PARAMEDICINE PROGRAM; (III) DESCRIBING THE POPULATION TO BE SERVED BY THE COMMUNITY PARAMED- ICINE PROGRAM AND THE GEOGRAPHIC AREA IN WHICH THE PROGRAM WILL FOCUS; (IV) IDENTIFYING THE SERVICES TO BE OFFERED UNDER THE COMMUNITY PARAM- EDICINE PROGRAM AND THE COLLABORATIVE PARTICIPANTS THAT WILL PROVIDE SUCH SERVICES; (V) DESCRIBING THE COLLABORATIVE'S PLAN TO ASSURE, TO THE EXTENT POSSIBLE, THAT CARE PROVIDED UNDER THE COMMUNITY PARAMEDICINE PROGRAM IS COORDINATED WITH OTHER PROVIDERS OF THE INDIVIDUALS SERVED; (VI) DESCRIBING THE QUALITY ASSURANCE AND IMPROVEMENT PROCEDURES THAT WILL BE USED BY THE COLLABORATIVE IN CARRYING OUT THE COMMUNITY PARAMED- ICINE PROGRAM; AND (VII) IDENTIFYING THE DATE OF THE ANTICIPATED START OF ACTIVITIES. (B) A COMMUNITY PARAMEDICINE COLLABORATIVE SHALL: S. 7507--A 61 A. 9507--A (I) PROMPTLY UPDATE THE DEPARTMENT AS TO ANY CHANGES IN THE INFORMA- TION REQUIRED UNDER PARAGRAPH (A) OF THIS SUBDIVISION; AND (II) PROVIDE INFORMATION TO THE DEPARTMENT ABOUT THE COLLABORATIVE'S ACTIVITIES AND OUTCOMES AT A FREQUENCY AND IN A MANNER DETERMINED BY THE DEPARTMENT, WHICH AT A MINIMUM SHALL INCLUDE AN ANNUAL REPORT. 7. NOTHING IN THIS SECTION SHALL BE DEEMED TO PROHIBIT THE PERFORMANCE OF ANY TASKS OR RESPONSIBILITIES BY ANY PERSON LICENSED OR CERTIFIED UNDER THIS CHAPTER OR UNDER TITLE VIII OF THE EDUCATION LAW OR BY ANY ENTITY LICENSED OR CERTIFIED UNDER THIS ARTICLE OR UNDER THE MENTAL HYGIENE LAW, PROVIDED SUCH TASKS OR RESPONSIBILITIES ARE PERMITTED PURSUANT TO SUCH STATUTORY PROVISIONS. § 2. Subdivision 15 of section 3001 of the public health law, as amended by chapter 445 of the laws of 1993, is amended to read as follows: 15. "Medical control" means: (a) advice and direction provided by a physician or under the direction of a physician to certified first responders, emergency medical technicians or advanced emergency medical technicians who are providing medical care at the scene of an emergency or en route to a health care facility; [and] (b) indirect medical control including the written policies, procedures, and protocols for prehospital emergency medical care and transportation developed by the state emergency medical advisory committee, approved by the state emer- gency medical services council and the commissioner, and implemented by regional medical advisory committees; AND (C) IN A COMMUNITY PARAMEDI- CINE PROGRAM ESTABLISHED BY A COMMUNITY PARAMEDICINE COLLABORATIVE PURSUANT TO SECTION TWENTY-EIGHT HUNDRED FIVE-Z OF THIS CHAPTER, ADVICE AND DIRECTION PROVIDED AND POLICIES, PROCEDURES, AND PROTOCOLS ISSUED BY A PHYSICIAN WITHIN THE COLLABORATIVE WHO IS RESPONSIBLE FOR THE OVERALL CLINICAL SUPERVISION OF THE COMMUNITY PARAMEDICINE PROGRAM. § 3. The public health law is amended by adding a new section 3001-a to read as follows: § 3001-A. COMMUNITY PARAMEDICINE SERVICES. NOTWITHSTANDING ANY INCON- SISTENT PROVISION OF THIS ARTICLE, AN INDIVIDUAL WHO IS CERTIFIED UNDER REGULATIONS ISSUED PURSUANT TO SECTION THREE THOUSAND TWO OF THIS ARTI- CLE TO PROVIDE BASIC OR ADVANCED LIFE SUPPORT MAY, IN THE COURSE OF HIS OR HER WORK AS AN EMPLOYEE OR VOLUNTEER OF AN AMBULANCE SERVICE OR AN ADVANCED LIFE SUPPORT FIRST RESPONSE SERVICE CERTIFIED UNDER THIS ARTI- CLE, ALSO PARTICIPATE AS AN EMPLOYEE OR VOLUNTEER OF SUCH SERVICE IN A COMMUNITY PARAMEDICINE PROGRAM ESTABLISHED BY A COMMUNITY PARAMEDICINE COLLABORATIVE PURSUANT TO SECTION TWENTY-EIGHT HUNDRED FIVE-Z OF THIS CHAPTER. § 4. Subdivision 2 of section 365-a of the social services law is amended by adding a new paragraph (ff) to read as follows: (FF) SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, COMMUNITY PARAMEDICINE SERVICES PROVIDED IN ACCORDANCE WITH THE REQUIRE- MENTS OF SECTION TWENTY-EIGHT HUNDRED FIVE-Z OF THE PUBLIC HEALTH LAW. § 5. This act shall take effect immediately. SUBPART B Section 1. Subdivision 1 of section 2801 of the public health law, as amended by chapter 397 of the laws of 2016, is amended to read as follows: 1. "Hospital" means a facility or institution engaged principally in providing services by or under the supervision of a physician or, in the case of a dental clinic or dental dispensary, of a dentist, or, in the S. 7507--A 62 A. 9507--A case of a midwifery birth center, of a midwife, for the prevention, diagnosis or treatment of human disease, pain, injury, deformity or physical condition, including, but not limited to, a general hospital, public health center, diagnostic center, treatment center, dental clin- ic, dental dispensary, rehabilitation center other than a facility used solely for vocational rehabilitation, nursing home, tuberculosis hospi- tal, chronic disease hospital, maternity hospital, midwifery birth center, lying-in-asylum, out-patient department, out-patient lodge, dispensary and a laboratory or central service facility serving one or more such institutions, but the term hospital shall not include an institution, sanitarium or other facility engaged principally in provid- ing services for the prevention, diagnosis or treatment of mental disa- bility and which is subject to the powers of visitation, examination, inspection and investigation of the department of mental hygiene except for those distinct parts of such a facility which provide hospital service. The provisions of this article shall not apply to a facility or institution engaged principally in providing services by or under the supervision of the bona fide members and adherents of a recognized reli- gious organization whose teachings include reliance on spiritual means through prayer alone for healing in the practice of the religion of such organization and where services are provided in accordance with those teachings. NO PROVISION OF THIS ARTICLE OR ANY OTHER PROVISION OF LAW SHALL BE CONSTRUED TO: (A) LIMIT THE VOLUME OF MENTAL HEALTH OR SUBSTANCE USE DISORDER SERVICES THAT CAN BE PROVIDED BY A PROVIDER OF PRIMARY CARE SERVICES LICENSED UNDER THIS ARTICLE AND AUTHORIZED TO PROVIDE INTEGRATED SERVICES IN ACCORDANCE WITH REGULATIONS ISSUED BY THE COMMISSIONER IN CONSULTATION WITH THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, INCLUDING REGULATIONS ISSUED PURSUANT TO SUBDIVISION SEVEN OF SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW OR PART L OF CHAPTER FIFTY-SIX OF THE LAWS OF TWO THOUSAND TWELVE; (B) REQUIRE A PROVIDER LICENSED PURSUANT TO ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE LAW OR CERTIFIED PURSUANT TO ARTICLE THIRTY-TWO OF THE MENTAL HYGIENE LAW TO OBTAIN AN OPERATING CERTIFICATE FROM THE DEPARTMENT IF SUCH PROVIDER HAS BEEN AUTHORIZED TO PROVIDE INTEGRATED SERVICES IN ACCORDANCE WITH REGULATIONS ISSUED BY THE COMMISSIONER IN CONSULTATION WITH THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, INCLUDING REGULATIONS ISSUED PURSUANT TO SUBDIVISION SEVEN OF SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW OR PART L OF CHAPTER FIFTY-SIX OF THE LAWS OF TWO THOUSAND TWELVE. § 2. Section 31.02 of the mental hygiene law is amended by adding a new subdivision (f) to read as follows: (F) NO PROVISION OF THIS ARTICLE OR ANY OTHER PROVISION OF LAW SHALL BE CONSTRUED TO REQUIRE A PROVIDER LICENSED PURSUANT TO ARTICLE TWENTY- EIGHT OF THE PUBLIC HEALTH LAW OR CERTIFIED PURSUANT TO ARTICLE THIRTY- TWO OF THIS CHAPTER TO OBTAIN AN OPERATING CERTIFICATE FROM THE OFFICE OF MENTAL HEALTH IF SUCH PROVIDER HAS BEEN AUTHORIZED TO PROVIDE INTE- GRATED SERVICES IN ACCORDANCE WITH REGULATIONS ISSUED BY THE COMMISSION- ER OF THE OFFICE OF MENTAL HEALTH IN CONSULTATION WITH THE COMMISSIONER OF THE DEPARTMENT OF HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCO- HOLISM AND SUBSTANCE ABUSE SERVICES, INCLUDING REGULATIONS ISSUED PURSU- ANT TO SUBDIVISION SEVEN OF SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW OR PART L OF CHAPTER FIFTY-SIX OF THE LAWS OF TWO THOUSAND TWELVE. S. 7507--A 63 A. 9507--A § 3. Subdivision (b) of section 32.05 of the mental hygiene law, as amended by chapter 204 of the laws of 2007, is amended to read as follows: (b) (I) Methadone, or such other controlled substance designated by the commissioner of health as appropriate for such use, may be adminis- tered to an addict, as defined in section thirty-three hundred two of the public health law, by individual physicians, groups of physicians and public or private medical facilities certified pursuant to article twenty-eight or thirty-three of the public health law as part of a chem- ical dependence program which has been issued an operating certificate by the commissioner pursuant to subdivision (b) of section 32.09 of this article, provided, however, that such administration must be done in accordance with all applicable federal and state laws and regulations. Individual physicians or groups of physicians who have obtained authori- zation from the federal government to administer buprenorphine to addicts may do so without obtaining an operating certificate from the commissioner. (II) NO PROVISION OF THIS ARTICLE OR ANY OTHER PROVISION OF LAW SHALL BE CONSTRUED TO REQUIRE A PROVIDER LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW OR ARTICLE THIRTY-ONE OF THIS CHAPTER TO OBTAIN AN OPERATING CERTIFICATE FROM THE OFFICE OF ALCO- HOLISM AND SUBSTANCE ABUSE SERVICES IF SUCH PROVIDER HAS BEEN AUTHORIZED TO PROVIDE INTEGRATED SERVICES IN ACCORDANCE WITH REGULATIONS ISSUED BY THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES IN CONSULTA- TION WITH THE COMMISSIONER OF THE DEPARTMENT OF HEALTH AND THE COMMIS- SIONER OF THE OFFICE OF MENTAL HEALTH, INCLUDING REGULATIONS ISSUED PURSUANT TO SUBDIVISION SEVEN OF SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW OR PART L OF CHAPTER FIFTY-SIX OF THE LAWS OF TWO THOUSAND TWELVE. § 4. This act shall take effect on the one hundred eightieth day after it shall have become a law; provided, however, that the commissioner of the department of health, the commissioner of the office of mental health, and the commissioner of the office of alcoholism and substance abuse services are authorized to issue any rule or regulation necessary for the implementation of this act on or before its effective date. SUBPART C Section 1. Paragraphs (s) and (t) of subdivision 2 of section 2999-cc of the public health law, as amended by chapter 454 of the laws of 2015, are amended and a new paragraph (u) is added to read as follows: (s) a hospice as defined in article forty of this chapter; [and] (t) CREDENTIALED ALCOHOLISM AND SUBSTANCE ABUSE COUNSELORS CREDEN- TIALED BY THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES OR BY A CREDENTIALING ENTITY APPROVED BY SUCH OFFICE PURSUANT TO SECTION 19.07 OF THE MENTAL HYGIENE LAW; (U) PROVIDERS AUTHORIZED TO PROVIDE SERVICES AND SERVICE COORDINATION UNDER THE EARLY INTERVENTION PROGRAM PURSUANT TO ARTICLE TWENTY-FIVE OF THIS CHAPTER; AND (V) any other provider as determined by the commissioner pursuant to regulation OR, IN CONSULTATION WITH THE COMMISSIONER, BY THE COMMISSION- ER OF THE OFFICE OF MENTAL HEALTH, THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, OR THE COMMISSIONER OF THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES PURSUANT TO REGULATION. S. 7507--A 64 A. 9507--A § 2. Subdivision 3 of section 2999-cc of the public health law, as separately amended by chapters 238 and 285 of the laws of 2017, is amended to read as follows: 3. "Originating site" means a site at which a patient is located at the time health care services are delivered to him or her by means of telehealth. Originating sites shall be limited to (A) facilities licensed under articles twenty-eight and forty of this chapter[,]; (B) facilities as defined in subdivision six of section 1.03 of the mental hygiene law[,]; (C) private physician's or dentist's offices located within the state of New York[,]; (D) any type of adult care facility licensed under title two of article seven of the social services law[,]; (E) public, private and charter elementary and secondary schools, school age child care programs, and child day care centers within the state of New York; and[, when a patient is receiving health care services by means of remote patient monitoring,] (F) the patient's place of resi- dence located within the state of New York or other temporary location located within or outside the state of New York; SUBJECT TO REGULATION ISSUED BY THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH, THE COMMIS- SIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, AND THE COMMISSIONER OF THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES. § 3. Subdivision 7 of section 2999-cc of the public health law, as added by chapter 6 of the laws of 2015, is amended to read as follows: 7. "Remote patient monitoring" means the use of synchronous or asyn- chronous electronic information and communication technologies to collect personal health information and medical data from a patient at an originating site that is transmitted to a telehealth provider at a distant site for use in the treatment and management of medical condi- tions that require frequent monitoring. SUCH TECHNOLOGIES MAY INCLUDE ADDITIONAL INTERACTION TRIGGERED BY PREVIOUS TRANSMISSIONS, SUCH AS INTERACTIVE QUERIES CONDUCTED THROUGH COMMUNICATION TECHNOLOGIES OR BY TELEPHONE. Such conditions shall include, but not be limited to, conges- tive heart failure, diabetes, chronic obstructive pulmonary disease, wound care, polypharmacy, mental or behavioral problems, and technolo- gy-dependent care such as continuous oxygen, ventilator care, total parenteral nutrition or enteral feeding. Remote patient monitoring shall be ordered by a physician licensed pursuant to article one hundred thirty-one of the education law, a nurse practitioner licensed pursuant to article one hundred thirty-nine of the education law, or a midwife licensed pursuant to article one hundred forty of the education law, with which the patient has a substantial and ongoing relationship. § 4. This act shall take effect on the ninetieth day after it shall have become a law; provided, however, that the commissioner of the department of health, the commissioner of the office of mental health, the commissioner of the office of alcoholism and substance abuse services, and the commissioner of the office for people with develop- mental disabilities are authorized to issue any rule or regulation necessary for the implementation of this act on or before its effective date. § 2. Severability clause. If any clause, sentence, paragraph, subdivi- sion, section or subpart 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 subpart thereof directly involved in the controversy in which such judgment shall have been rendered. It is hereby declared to be the S. 7507--A 65 A. 9507--A intent of the legislature that this act would have been enacted even if such invalid provisions had not been included herein. § 3. This act shall take effect immediately; provided, however, that the applicable effective date of Subparts A through C of this act shall be as specifically set forth in the last section of such Subparts. PART T Section 1. Subdivision (a) of section 31 of part B of chapter 59 of the laws of 2016, amending the social services law relating to authoriz- ing the commissioner of health to apply federally established consumer price index penalties for generic drugs, and authorizing the commission- er of health to impose penalties on managed care plans for reporting late or incorrect encounter data, is amended to read as follows: (a) section eleven of this act shall expire and be deemed repealed March 31, [2018] 2023; § 2. Subdivision 6-a of section 93 of part C of chapter 58 of the laws of 2007, amending the social services law and other laws relating to adjustments of rates, as amended by section 20 of part B of chapter 56 of the laws of 2013, is amended to read as follows: 6-a. section fifty-seven of this act shall expire and be deemed repealed on [December 31, 2018] MARCH 31, 2023; provided that the amend- ments made by such section to subdivision 4 of section 366-c of the social services law shall apply with respect to determining initial and continuing eligibility for medical assistance, including the continued eligibility of recipients originally determined eligible prior to the effective date of this act, and provided further that such amendments shall not apply to any person or group of persons if it is subsequently determined by the Centers for Medicare and Medicaid services or by a court of competent jurisdiction that medical assistance with federal financial participation is available for the costs of services provided to such person or persons under the provisions of subdivision 4 of section 366-c of the social services law in effect immediately prior to the effective date of this act. § 3. Section 2 of part II of chapter 54 of the laws of 2016, amending part C of chapter 58 of the laws of 2005 authorizing reimbursements for expenditures made by or on behalf of social services districts for medical assistance for needy persons and administration thereof, is amended to read as follows: § 2. This act shall take effect immediately and shall expire and be deemed repealed [two years after it shall have become a law] MARCH 31, 2023. § 4. Section 3 of chapter 906 of the laws of 1984, amending the social services law relating to expanding medical assistance eligibility and the scope of services available to certain persons with disabilities, as amended by section 25-a of part B of chapter 56 of the laws of 2013, is amended to read as follows: § 3. This act shall take effect on the thirtieth day after it shall have become a law and shall be of no further force and effect after [December 31, 2018] MARCH 31, 2023, at which time the provisions of this act shall be deemed to be repealed. § 5. 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, as amended by section 9 S. 7507--A 66 A. 9507--A of part I of chapter 57 of the laws of 2017, is amended to read as follows: § 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, [2019] 2017 through March 31, 2019, for inpa- tient and outpatient services provided by general hospitals, for inpa- tient 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 agencies, 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 2017, 2018, AND 2019 calendar [year] YEARS 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 2017, 2018, AND 2019 calendar [year] YEARS shall also be applied to rates of payment provided on and after January 1, [2019] 2017 through March 31, 2019 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 pursu- ant to a rate-setting exemption issued by the commissioner of health to such local social services districts in accordance with applicable regu- lations[,]; and provided further, however, that for rates of payment for assisted living program services provided on and after January 1, [2019] 2017 through March 31, 2019, such trend factors attributable to the 2017, 2018, AND 2019 calendar [year] YEARS shall be established at no greater than zero percent. § 6. This act shall take effect immediately. PART U Section 1. Section 2 of part NN of chapter 58 of the laws of 2015, amending the mental hygiene law relating to clarifying the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs, is amended to read as follows: § 2. This act shall take effect immediately and shall expire and be deemed repealed March 31, [2018] 2021. § 2. This act shall take effect immediately. PART V Section 1. Section 7 of part R2 of chapter 62 of the laws of 2003, amending the mental hygiene law and the state finance law relating to the community mental health support and workforce reinvestment program, the membership of subcommittees for mental health of community services boards and the duties of such subcommittees and creating the community mental health and workforce reinvestment account, as amended by section 3 of part G of chapter 60 of the laws of 2014, is amended to read as follows: S. 7507--A 67 A. 9507--A § 7. This act shall take effect immediately and shall expire March 31, [2018] 2021 when upon such date the provisions of this act shall be deemed repealed. § 2. This act shall take effect immediately. PART W Section 1. Subdivision 9 of section 730.10 of the criminal procedure law, as added by section 1 of part Q of chapter 56 of the laws of 2012, is amended to read as follows: 9. "Appropriate institution" means: (a) a hospital operated by the office of mental health or a developmental center operated by the office for people with developmental disabilities; [or] (b) a hospital licensed by the department of health which operates a psychiatric unit licensed by the office of mental health, as determined by the commissioner provided, however, that any such hospital that is not operated by the state shall qualify as an "appropriate institution" only pursuant to the terms of an agreement between the commissioner and the hospital ; OR (C) A MENTAL HEALTH UNIT OPERATING WITHIN A CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACILITY; PROVIDED HOWEVER, THAT ANY SUCH MENTAL HEALTH UNIT OPERATING WITHIN A LOCAL CORRECTIONAL FACILITY SHALL QUALIFY AS AN "APPROPRIATE INSTITUTION" ONLY PURSUANT TO THE TERMS OF AN AGREEMENT BETWEEN THE COMMISSIONER OF MENTAL HEALTH, DIRECTOR OF COMMUNITY SERVICES AND THE SHERIFF FOR THE RESPECTIVE LOCALITY, AND ANY SUCH MENTAL HEALTH UNIT OPERATING WITHIN A CORRECTIONAL FACILITY SHALL QUALI- FY AS AN "APPROPRIATE INSTITUTION" ONLY PURSUANT TO THE TERMS OF AN AGREEMENT BETWEEN THE COMMISSIONER OF MENTAL HEALTH AND THE COMMISSIONER OF CORRECTIONS AND COMMUNITY SUPERVISION. Nothing in this article shall be construed as requiring a hospital, CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACILITY to consent to providing care and treatment to an incapacitated person at such hospital, CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACILITY. IN A CITY WITH A POPULATION OF MORE THAN ONE MILLION, ANY SUCH UNIT SHALL BE LIMITED TO TWENTY-FIVE BEDS. THE COMMIS- SIONER OF MENTAL HEALTH SHALL PROMULGATE REGULATIONS FOR DEMONSTRATION PROGRAMS TO IMPLEMENT RESTORATION TO COMPETENCY WITHIN A CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACILITY. SUBJECT TO ANNUAL APPROPRI- ATION, THE COMMISSIONER OF MENTAL HEALTH MAY, AT SUCH COMMISSIONER'S DISCRETION, MAKE FUNDS AVAILABLE FOR STATE AID GRANTS TO ANY COUNTY THAT DEVELOPS AND OPERATES A MENTAL HEALTH UNIT WITHIN A LOCAL CORRECTIONAL FACILITY PURSUANT TO THIS SECTION. NOTHING IN THIS ARTICLE SHALL BE CONSTRUED AS REQUIRING A HOSPITAL, CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACILITY TO CONSENT TO PROVIDING CARE AND TREATMENT TO AN INCAPACITATED PERSON AT SUCH HOSPITAL, CORRECTIONAL FACILITY OR LOCAL CORRECTIONAL FACILITY. § 2. This act shall take effect immediately and shall be deemed to have been in full force and effect on and after April 1, 2018; provided, however, this act shall expire and be deemed repealed March 31, 2023. PART X 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 LL of chapter 58 of the laws of 2015, is amended to read as follows: S. 7507--A 68 A. 9507--A § 3. This act shall take effect immediately; and shall expire and be deemed repealed June 30, [2018] 2021. § 2. This act shall take effect immediately. PART Y Section 1. Subdivision 10 of section 7605 of the education law, as added by section 4 of part AA of chapter 57 of the laws of 2013, is amended and a new subdivision 12 is added to read as follows: 10. (A) A person without a license from: performing assessments such as basic information collection, gathering of demographic data, and informal observations, screening and referral used for general eligibil- ity for a program or service and determining the functional status of an individual for the purpose of determining need for services [unrelated to a behavioral health diagnosis or treatment plan. Such licensure shall not be required to create, develop or implement a service plan unrelated to a behavioral health diagnosis or treatment plan]; COUN- SELING INDIVIDUALS REGARDING THE APPROPRIATENESS OF BENEFITS THEY ARE ELIGIBLE FOR; PROVIDING GENERAL COUNSELING THAT IS NOT PSYCHOTHERAPY AND ASSISTING INDIVIDUALS OR GROUPS WITH DIFFICULT DAY TO DAY PROBLEMS SUCH AS FINDING EMPLOYMENT, LOCATING SOURCES OF ASSISTANCE, AND ORGANIZING COMMUNITY GROUPS TO WORK ON A SPECIFIC PROBLEM; PROVIDING PEER SERVICES; OR TO SELECT FOR SUITABILITY AND PROVIDE SUBSTANCE ABUSE TREATMENT SERVICES OR GROUP RE-ENTRY SERVICES TO INCARCERATED INDIVIDUALS IN STATE CORRECTIONAL FACILITIES. (B) A PERSON WITHOUT A LICENSE FROM CREATING, DEVELOPING OR IMPLEMENT- ING A SERVICE PLAN OR RECOVERY PLAN THAT IS NOT A BEHAVIORAL HEALTH DIAGNOSIS OR TREATMENT PLAN. Such service OR RECOVERY plans shall include, but are not limited to, COORDINATING, EVALUATING OR DETERMINING THE NEED FOR, OR THE PROVISION OF THE FOLLOWING SERVICES: job training and employability[,]; housing[,]; HOMELESS SERVICES AND SHELTERS FOR HOMELESS INDIVIDUALS AND FAMILIES; REFUGEE SERVICES; RESIDENTIAL, DAY OR COMMUNITY HABILITATION SERVICES; general public assistance[,]; in home services and supports or home-delivered meals[, investigations conducted or assessments made by]; RECOVERY SUPPORTS; adult or child protective services INCLUDING INVESTIGATIONS; DETENTION AS DEFINED IN SECTION FIVE HUNDRED TWO OF THE EXECUTIVE LAW; PREVENTION AND RESIDENTIAL SERVICES FOR VICTIMS OF DOMESTIC VIOLENCE; SERVICES FOR RUNAWAY AND HOMELESS YOUTH; FOSTER CARE, ADOPTION, PREVENTIVE SERVICES OR SERVICES IN ACCORD- ANCE WITH AN APPROVED PLAN PURSUANT TO SECTION FOUR HUNDRED FOUR OF THE SOCIAL SERVICES LAW, INCLUDING, adoption AND FOSTER home studies and assessments, family service plans, transition plans [and], permanency planning activities, AND CASE PLANNING OR CASE MANAGEMENT AS SUCH TERMS ARE DEFINED IN PART FOUR HUNDRED TWENTY-EIGHT OF TITLE EIGHTEEN OF THE NEW YORK CODES, RULES AND REGULATIONS; RESIDENTIAL REHABILITATION; HOME AND COMMUNITY BASED SERVICES; AND de-escalation techniques, peer services or skill development. [A license under this article shall not be required for persons to participate] (C)(I) A PERSON WITHOUT A LICENSE FROM PARTICIPATING as a member of a multi-disciplinary team to DEVELOP OR implement a [behavioral health services or] treatment plan; provided [however,] that such team shall include one or more professionals licensed under this article or arti- cles one hundred thirty-one, ONE HUNDRED THIRTY-NINE, one hundred fifty-four or one hundred sixty-three of this chapter WHO MUST DIRECTLY OBSERVE EACH PATIENT EITHER IN PERSON OR BY ELECTRONIC MEANS, PRIOR TO THE RENDERING OF A DIAGNOSIS; and provided, further, that the activities S. 7507--A 69 A. 9507--A performed by members of the team shall be consistent with the scope of practice for each team member licensed or authorized under title VIII of this chapter, and those who are not so authorized may not INDEPENDENTLY engage in the following restricted practices, BUT MAY ASSIST LICENSED PROFESSIONALS OR MULTI-DISCIPLINARY TEAM MEMBERS WITH: the diagnosis of mental, emotional, behavioral, addictive and developmental disorders and disabilities; patient assessment and evaluating; the provision of psychotherapeutic treatment; the provision of treatment other than psychotherapeutic treatment; [and/or] OR the development and implementa- tion of assessment-based treatment plans as defined in section seventy- seven hundred one of this [chapter] TITLE. (II) AS USED IN THIS SUBDIVISION, A TREATMENT PLAN SHALL BE LIMITED TO PLANS FOR TREATMENT WITHIN THE FOLLOWING SETTINGS: FACILITIES OR PROGRAMS OPERATING PURSUANT TO ARTICLE NINETEEN-G OF THE EXECUTIVE LAW OR PURSUANT TO ARTICLES SEVEN, SIXTEEN, THIRTY-ONE AND THIRTY-TWO OF THE MENTAL HYGIENE LAW. (III) AS USED IN THIS SUBDIVISION, THE TERM "ASSIST" SHALL INCLUDE THE PROVISION OF SERVICES WITHIN THE PRACTICE OF PSYCHOLOGY, UNDER THE SUPERVISION OF A PERSON LICENSED UNDER THIS ARTICLE. (D) Provided, further, that nothing in this subdivision shall be construed as requiring a license for any particular activity or function based solely on the fact that the activity or function is not listed in this subdivision. 12. NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, NOTH- ING IN THIS ARTICLE SHALL BE CONSTRUED TO PROHIBIT OR LIMIT THE ACTIV- ITIES OR SERVICES PROVIDED BY ANY PERSON WHO IS EMPLOYED OR WHO COMMENCES EMPLOYMENT IN A PROGRAM OR SERVICE OPERATED, REGULATED, FUND- ED, OR APPROVED BY THE DEPARTMENT OF MENTAL HYGIENE, THE OFFICE OF CHIL- DREN AND FAMILY SERVICES, THE DEPARTMENT OF CORRECTIONS AND COMMUNITY SUPERVISION, THE OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE, THE STATE OFFICE FOR THE AGING AND THE DEPARTMENT OF HEALTH OR A LOCAL GOVERNMENTAL UNIT AS THAT TERM IS DEFINED IN SECTION 41.03 OF THE MENTAL HYGIENE LAW OR A SOCIAL SERVICES DISTRICT AS DEFINED IN SECTION SIXTY- ONE OF THE SOCIAL SERVICES LAW ON OR BEFORE JULY FIRST, TWO THOUSAND TWENTY. PROVIDED, HOWEVER, THAT ANY PERSON WHO COMMENCES EMPLOYMENT IN SUCH PROGRAM OR SERVICE AFTER JULY FIRST, TWO THOUSAND TWENTY AND PERFORMS SERVICES THAT ARE RESTRICTED UNDER THIS ARTICLE SHALL BE APPRO- PRIATELY LICENSED OR AUTHORIZED UNDER THIS ARTICLE. § 2. Paragraph (f) of subdivision 1 of section 7702 of the education law, as amended by chapter 230 of the laws of 2004, is amended and a new paragraph (m) is added to read as follows: (f) [Assist] GENERAL COUNSELING THAT IS NOT PSYCHOTHERAPY, AND ASSIST- ING individuals or groups with difficult day to day problems such as finding employment, locating sources of assistance, and organizing community groups to work on a specific problem. (M) PROVIDE PEER SERVICES. § 3. Subdivision 7 of section 7706 of the education law, as added by section 5 of part AA of chapter 57 of the laws of 2013, is amended and a new subdivision 8 is added to read as follows: 7. (A) Prevent a person without a license from: performing assessments such as basic information collection, gathering of demographic data, and informal observations, screening and referral used for general eligibil- ity for a program or service and determining the functional status of an individual for the purpose of determining need for services [unrelated to a behavioral health diagnosis or treatment plan. Such licensure shall not be required to create, develop or implement a service plan unrelated S. 7507--A 70 A. 9507--A to a behavioral health diagnosis or treatment plan]; COUNSELING INDIVID- UALS REGARDING THE APPROPRIATENESS OF BENEFITS THEY ARE ELIGIBLE FOR; PROVIDING GENERAL COUNSELING THAT IS NOT PSYCHOTHERAPY AND ASSISTING INDIVIDUALS OR GROUPS WITH DIFFICULT DAY TO DAY PROBLEMS SUCH AS FINDING EMPLOYMENT, LOCATING SOURCES OF ASSISTANCE, AND ORGANIZING COMMUNITY GROUPS TO WORK ON A SPECIFIC PROBLEM; PROVIDING PEER SERVICES; OR TO SELECT FOR SUITABILITY AND PROVIDE SUBSTANCE ABUSE TREATMENT SERVICES OR GROUP RE-ENTRY SERVICES TO INCARCERATED INDIVIDUALS IN STATE CORRECTION- AL FACILITIES. (B) PREVENT A PERSON WITHOUT A LICENSE FROM CREATING, DEVELOPING OR IMPLEMENTING A SERVICE PLAN OR RECOVERY PLAN THAT IS NOT A BEHAVIORAL HEALTH DIAGNOSIS OR TREATMENT PLAN. Such service OR RECOVERY plans shall include, but are not limited to, COORDINATING, EVALUATING OR DETERMINING THE NEED FOR, OR THE PROVISION OF THE FOLLOWING SERVICES: job training and employability[,]; housing[,]; HOMELESS SERVICES AND SHELTERS FOR HOMELESS INDIVIDUALS AND FAMILIES; REFUGEE SERVICES; RESIDENTIAL, DAY OR COMMUNITY HABILITATION SERVICES; general public assistance[,]; in home services and supports or home-delivered meals[, investigations conducted or assessments made by]; RECOVERY SUPPORTS; adult or child protective services INCLUDING INVESTIGATIONS; DETENTION AS DEFINED IN SECTION FIVE HUNDRED TWO OF THE EXECUTIVE LAW; PREVENTION AND RESIDENTIAL SERVICES FOR VICTIMS OF DOMESTIC VIOLENCE; SERVICES FOR RUNAWAY AND HOMELESS YOUTH; FOSTER CARE, ADOPTION, PREVENTIVE SERVICES OR SERVICES IN ACCORD- ANCE WITH AN APPROVED PLAN PURSUANT TO SECTION FOUR HUNDRED FOUR OF THE SOCIAL SERVICES LAW, INCLUDING, adoption AND FOSTER home studies and assessments, family service plans, transition plans [and], permanency planning activities, AND CASE PLANNING OR CASE MANAGEMENT AS SUCH TERMS ARE DEFINED IN PART FOUR HUNDRED TWENTY-EIGHT OF TITLE EIGHTEEN OF THE NEW YORK CODES, RULES AND REGULATIONS; RESIDENTIAL REHABILITATION; HOME AND COMMUNITY BASED SERVICES; AND de-escalation techniques, peer services or skill development. [A license under this article shall not be required for persons to participate] (C)(I) PREVENT A PERSON WITHOUT A LICENSE FROM PARTICIPATING as a member of a multi-disciplinary team to DEVELOP OR implement a [behav- ioral health services or] treatment plan; provided [however,] that such team shall include one or more professionals licensed under this article or articles one hundred thirty-one, ONE HUNDRED THIRTY-NINE, one hundred fifty-three or one hundred sixty-three of this chapter WHO MUST DIRECTLY OBSERVE EACH PATIENT EITHER IN PERSON OR BY ELECTRONIC MEANS, PRIOR TO THE RENDERING OF A DIAGNOSIS; and provided, further, that the activities performed by members of the team shall be consistent with the scope of practice for each team member licensed or authorized under title VIII of this chapter, and those who are not so authorized may not INDEPENDENTLY engage in the following restricted practices, BUT MAY ASSIST LICENSED PROFESSIONALS OR MULTI-DISCIPLINARY TEAM MEMBERS WITH: the diagnosis of mental, emotional, behavioral, addictive and developmental disorders and disabilities; patient assessment and evaluating; the provision of psychotherapeutic treatment; the provision of treatment other than psychotherapeutic treatment; [and/or] OR the development and implementa- tion of assessment-based treatment plans as defined in section seventy- seven hundred one of this article. (II) AS USED IN THIS SUBDIVISION, A TREATMENT PLAN SHALL BE LIMITED TO PLANS FOR TREATMENT WITHIN THE FOLLOWING SETTINGS: FACILITIES OR PROGRAMS OPERATING PURSUANT TO ARTICLE NINETEEN-G OF THE EXECUTIVE LAW OR PURSUANT TO ARTICLES SEVEN, SIXTEEN, THIRTY-ONE AND THIRTY-TWO OF THE MENTAL HYGIENE LAW. S. 7507--A 71 A. 9507--A (III) AS USED IN THIS SUBDIVISION, THE TERM "ASSIST" SHALL INCLUDE THE PROVISION OF SERVICES WITHIN THE PRACTICE OF MASTER SOCIAL WORK OR CLIN- ICAL SOCIAL WORK, UNDER THE SUPERVISION OF A PERSON LICENSED UNDER THIS ARTICLE. (D) Provided, further, that nothing in this subdivision shall be construed as requiring a license for any particular activity or function based solely on the fact that the activity or function is not listed in this subdivision. 8. NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, NOTHING IN THIS ARTICLE SHALL BE CONSTRUED TO PROHIBIT OR LIMIT THE ACTIVITIES OR SERVICES PROVIDED BY ANY PERSON WHO IS EMPLOYED OR WHO COMMENCES EMPLOYMENT IN A PROGRAM OR SERVICE OPERATED, REGULATED, FUNDED, OR APPROVED BY THE DEPARTMENT OF MENTAL HYGIENE, THE OFFICE OF CHILDREN AND FAMILY SERVICES, THE DEPARTMENT OF CORRECTIONS AND COMMUNITY SUPER- VISION, THE OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE, THE STATE OFFICE FOR THE AGING AND THE DEPARTMENT OF HEALTH OR A LOCAL GOVERN- MENTAL UNIT AS THAT TERM IS DEFINED IN SECTION 41.03 OF THE MENTAL HYGIENE LAW OR A SOCIAL SERVICES DISTRICT AS DEFINED IN SECTION SIXTY- ONE OF THE SOCIAL SERVICES LAW ON OR BEFORE JULY FIRST, TWO THOUSAND TWENTY. PROVIDED HOWEVER, THAT ANY PERSON WHO COMMENCES EMPLOYMENT IN SUCH PROGRAM OR SERVICE AFTER JULY FIRST, TWO THOUSAND TWENTY AND PERFORMS SERVICES THAT ARE RESTRICTED UNDER THIS ARTICLE SHALL BE APPRO- PRIATELY LICENSED OR AUTHORIZED UNDER THIS ARTICLE. § 4. Subdivision 8 of section 8410 of the education law, as added by section 6 of part AA of chapter 57 of the laws of 2013, is amended and a new subdivision 9 is added to read as follows: 8. (A) Prevent a person without a license from: performing assessments such as basic information collection, gathering of demographic data, and informal observations, screening and referral used for general eligibil- ity for a program or service and determining the functional status of an individual for the purpose of determining need for services [unrelated to a behavioral health diagnosis or treatment plan. Such licensure shall not be required to create, develop or implement a service plan unrelated to a behavioral health diagnosis or treatment plan]; COUN- SELING INDIVIDUALS REGARDING THE APPROPRIATENESS OF BENEFITS THEY ARE ELIGIBLE FOR; PROVIDING GENERAL COUNSELING THAT IS NOT PSYCHOTHERAPY AND ASSISTING INDIVIDUALS OR GROUPS WITH DIFFICULT DAY TO DAY PROBLEMS SUCH AS FINDING EMPLOYMENT, LOCATING SOURCES OF ASSISTANCE, AND ORGANIZING COMMUNITY GROUPS TO WORK ON A SPECIFIC PROBLEM; PROVIDING PEER SERVICES; OR TO SELECT FOR SUITABILITY AND PROVIDE SUBSTANCE ABUSE TREATMENT SERVICES OR GROUP RE-ENTRY SERVICES TO INCARCERATED INDIVIDUALS IN STATE CORRECTIONAL FACILITIES. (B) PREVENT A PERSON WITHOUT A LICENSE FROM CREATING, DEVELOPING OR IMPLEMENTING A SERVICE PLAN OR RECOVERY PLAN THAT IS NOT A BEHAVIORAL HEALTH DIAGNOSIS OR TREATMENT PLAN. Such service OR RECOVERY plans shall include, but are not limited to, COORDINATING, EVALUATING OR DETERMINING THE NEED FOR, OR THE PROVISION OF THE FOLLOWING SERVICES: job training and employability[,]; housing[,]; HOMELESS SERVICES AND SHELTERS FOR HOMELESS INDIVIDUALS AND FAMILIES; REFUGEE SERVICES; RESIDENTIAL, DAY OR COMMUNITY HABILITATION SERVICES; general public assistance[,]; in home services and supports or home-delivered meals[, investigations conducted or assessments made by]; RECOVERY SUPPORTS; adult or child protective services INCLUDING INVESTIGATIONS; DETENTION AS DEFINED IN SECTION FIVE HUNDRED TWO OF THE EXECUTIVE LAW; PREVENTION AND RESIDENTIAL SERVICES FOR VICTIMS OF DOMESTIC VIOLENCE; SERVICES FOR RUNAWAY AND HOMELESS YOUTH; FOSTER CARE, ADOPTION, PREVENTIVE SERVICES OR SERVICES IN ACCORD- S. 7507--A 72 A. 9507--A ANCE WITH AN APPROVED PLAN PURSUANT TO SECTION FOUR HUNDRED FOUR OF THE SOCIAL SERVICES LAW, INCLUDING, adoption AND FOSTER home studies and assessments, family service plans, transition plans [and], permanency planning activities, AND CASE PLANNING OR CASE MANAGEMENT AS SUCH TERMS ARE DEFINED IN PART FOUR HUNDRED TWENTY-EIGHT OF TITLE EIGHTEEN OF THE NEW YORK CODES, RULES AND REGULATIONS; RESIDENTIAL REHABILITATION; HOME AND COMMUNITY BASED SERVICES; AND de-escalation techniques, peer services or skill development. [A license under this article shall not be required for persons to participate] (C)(I) PREVENT A PERSON WITHOUT A LICENSE FROM PARTICIPATING as a member of a multi-disciplinary team to DEVELOP OR implement a [behav- ioral health services or] treatment plan; provided [however,] that such team shall include one or more professionals licensed under this article or articles one hundred thirty-one, ONE HUNDRED THIRTY-NINE, one hundred fifty-three or one hundred fifty-four of this chapter WHO MUST DIRECTLY OBSERVE EACH PATIENT EITHER IN PERSON OR BY ELECTRONIC MEANS, PRIOR TO THE RENDERING OF A DIAGNOSIS; and provided, further, that the activities performed by members of the team shall be consistent with the scope of practice for each team member licensed or authorized under title VIII of this chapter, and those who are not so authorized may not INDEPENDENTLY engage in the following restricted practices, BUT MAY ASSIST LICENSED PROFESSIONALS OR MULTIDISCIPLINARY TEAM MEMBERS WITH: the diagnosis of mental, emotional, behavioral, addictive and developmental disorders and disabilities; patient assessment and evaluating; the provision of psychotherapeutic treatment; the provision of treatment other than psychotherapeutic treatment; [and/or] OR the development and implementa- tion of assessment-based treatment plans as defined in section seventy- seven hundred one of this chapter. (II) AS USED IN THIS SUBDIVISION, A TREATMENT PLAN SHALL BE LIMITED TO PLANS FOR TREATMENT WITHIN THE FOLLOWING SETTINGS: FACILITIES OR PROGRAMS OPERATING PURSUANT TO ARTICLE NINETEEN-G OF THE EXECUTIVE LAW OR PURSUANT TO ARTICLES SEVEN, SIXTEEN, THIRTY-ONE AND THIRTY-TWO OF THE MENTAL HYGIENE LAW. (III) AS USED IN THIS SUBDIVISION, THE TERM "ASSIST" SHALL INCLUDE THE PROVISION OF SERVICES WITHIN THE PRACTICE OF MENTAL HEALTH COUNSELING, MARRIAGE AND FAMILY THERAPY, CREATIVE ARTS THERAPY OR PSYCHOANALYSIS, UNDER THE SUPERVISION OF A PERSON LICENSED UNDER THIS ARTICLE. (D) Provided, further, that nothing in this subdivision shall be construed as requiring a license for any particular activity or function based solely on the fact that the activity or function is not listed in this subdivision. 9. NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, NOTHING IN THIS ARTICLE SHALL BE CONSTRUED TO PROHIBIT OR LIMIT THE ACTIVITIES OR SERVICES PROVIDED BY ANY PERSON WHO IS EMPLOYED OR WHO COMMENCES EMPLOYMENT IN A PROGRAM OR SERVICE OPERATED, REGULATED, FUNDED, OR APPROVED BY THE DEPARTMENT OF MENTAL HYGIENE, THE OFFICE OF CHILDREN AND FAMILY SERVICES, THE DEPARTMENT OF CORRECTIONS AND COMMUNITY SUPER- VISION, THE OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE, THE STATE OFFICE FOR THE AGING AND THE DEPARTMENT OF HEALTH OR A LOCAL GOVERN- MENTAL UNIT AS THAT TERM IS DEFINED IN SECTION 41.03 OF THE MENTAL HYGIENE LAW OR A SOCIAL SERVICES DISTRICT AS DEFINED IN SECTION SIXTY- ONE OF THE SOCIAL SERVICES LAW ON OR BEFORE JULY FIRST, TWO THOUSAND TWENTY. PROVIDED HOWEVER, THAT ANY PERSON WHO COMMENCES EMPLOYMENT IN SUCH PROGRAM OR SERVICE AFTER JULY FIRST, TWO THOUSAND TWENTY AND PERFORMS SERVICES THAT ARE RESTRICTED UNDER THIS ARTICLE SHALL BE APPRO- PRIATELY LICENSED OR AUTHORIZED UNDER THIS ARTICLE. S. 7507--A 73 A. 9507--A § 5. Not later than July 1, 2019 the department of mental hygiene, the office of children and family services, the office of temporary and disability assistance, the department of corrections and community supervision, the state office for the aging, or the department of health (hereinafter referred to as "agencies") shall individually or collec- tively consult with the state education department (hereinafter referred to as "department") to develop formal guidance for service providers authorized to operate under the respective agencies to identify the tasks and functions performed by each agency's service provider work- force categorized as tasks and functions restricted to licensed person- nel including tasks and functions that do not require a license under articles 153, 154 and 163 of the education law. Subsequent to such consultation, and not later than December 31, 2019, the department shall issue guidance to each such agency with respect to each agency's service provider workforce. Each agency may issue additional guidance from time to time, subject to consultation with the department. Notwithstanding any provision of law to the contrary, no person shall be held liable for unauthorized practice of a profession subject to licensure under arti- cles 153, 154 and 163 of the education law if such person acts in accordance with such agency guidance until July 1, 2020, to allow further consultation on guidance as necessary. Upon issuance by such state agency of guidance, the department shall have 180 days from the date of the issuance of such guidance to issue a statement of disagree- ment with the agency's guidance. If the department has issued a state- ment of disagreement, the department and state agency shall engage in a collaborative process to gather input from stakeholders to resolve the issues. § 6. Programs and services operated, regulated, funded, or approved by the department of mental hygiene, the office of children and family services, the department of corrections and community supervision, the office of temporary and disability assistance, the state office for the aging and the department of health or a local governmental unit as the term is defined in section 41.03 of the mental hygiene law or a social services district as defined in section 61 of the social services law shall not be required to receive a waiver pursuant to section 6503-a of the education law and, further, such programs and services shall also be considered to be approved settings for the receipt of supervised experi- ence for the professions governed by articles 153, 154 and 163 of the education law. § 7. Subdivision a of section 9 of chapter 420 of the laws of 2002 amending the education law relating to the profession of social work, as amended by section 1 of part J of chapter 59 of the laws of 2016, is amended to read as follows: a. Nothing in this act shall prohibit or limit the activities or services on the part of any person in the employ of a program or service operated, regulated, funded, or approved by the department of mental hygiene, the office of children and family services, the office of temporary and disability assistance, the department of corrections and community supervision, the state office for the aging, the department of health, or a local governmental unit as that term is defined in article 41 of the mental hygiene law or a social services district as defined in section 61 of the social services law, provided, however, this section shall not authorize the use of any title authorized pursuant to article 154 of the education law, except that this section shall be deemed repealed on July 1, [2018] 2020. S. 7507--A 74 A. 9507--A § 8. Subdivision a of section 17-a of chapter 676 of the laws of 2002, amending the education law relating to the practice of psychology, as amended by section 2 of part J of chapter 59 of the laws of 2016, is amended to read as follows: a. In relation to activities and services provided under article 153 of the education law, nothing in this act shall prohibit or limit such activities or services on the part of any person in the employ of a program or service operated, regulated, funded, or approved by the department of mental hygiene or the office of children and family services, or a local governmental unit as that term is defined in arti- cle 41 of the mental hygiene law or a social services district as defined in section 61 of the social services law. In relation to activ- ities and services provided under article 163 of the education law, nothing in this act shall prohibit or limit such activities or services on the part of any person in the employ of a program or service oper- ated, regulated, funded, or approved by the department of mental hygiene, the office of children and family services, the department of corrections and community supervision, the office of temporary and disa- bility assistance, the state office for the aging and the department of health or a local governmental unit as that term is defined in article 41 of the mental hygiene law or a social services district as defined in section 61 of the social services law, pursuant to authority granted by law. This section shall not authorize the use of any title authorized pursuant to article 153 or 163 of the education law by any such employed person, except as otherwise provided by such articles respectively. This section shall be deemed repealed July 1, [2018] 2020. § 9. Section 16 of chapter 130 of the laws of 2010, amending the education law and other laws relating to the registration of entities providing certain professional services and the licensure of certain professions, as amended by section 3 of part J of chapter 59 of the laws of 2016, is amended to read as follows: § 16. This act shall take effect immediately; provided that sections thirteen, fourteen and fifteen of this act shall take effect immediately and shall be deemed to have been in full force and effect on and after June 1, 2010 and such sections shall be deemed repealed July 1, [2018] 2020; provided further that the amendments to section 9 of chapter 420 of the laws of 2002 amending the education law relating to the profes- sion of social work made by section thirteen of this act shall repeal on the same date as such section repeals; provided further that the amend- ments to section 17-a of chapter 676 of the laws of 2002 amending the education law relating to the practice of psychology made by section fourteen of this act shall repeal on the same date as such section repeals. § 10. This act shall take effect immediately. PART Z Section 1. Subparagraph (vii) of paragraph e of subdivision 3 of section 364-j of the social services law, as amended by section 38 of part A of chapter 56 of the laws of 2013, is amended to read as follows: (vii) a person with a developmental or physical disability who receives home and community-based services or care-at-home services through A DEMONSTRATION WAIVER UNDER SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT, existing waivers under section nineteen hundred fifteen (c) of the federal social security act, or who has char- acteristics and needs similar to such persons; S. 7507--A 75 A. 9507--A § 2. Clause (x) of subparagraph 1 of paragraph (e) of subdivision 5 of section 366 of the social services law, as added by section 26-a of part C of chapter 109 of the laws of 2006, is amended to read as follows: (x) "nursing facility services" means nursing care and health related services provided in a nursing facility; a level of care provided in a hospital which is equivalent to the care which is provided in a nursing facility; and care, services or supplies provided pursuant to a waiver granted pursuant to subsection (c) of section 1915 of the federal social security act OR SUCCESSOR FEDERAL WAIVER. § 3. Section 366 of the social services law is amended by adding a new subdivision 7-c to read as follows: 7-C. THE COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMISSIONER OF DEVELOPMENTAL DISABILITIES IS AUTHORIZED TO SUBMIT THE APPROPRIATE WAIVERS, INCLUDING, BUT NOT LIMITED TO, THOSE AUTHORIZED PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT, IN ORDER TO ACHIEVE THE PURPOSES OF HIGH-QUALITY AND INTEGRATED CARE AND SERVICES FOR A POPULATION OF PERSONS WITH DEVELOPMENTAL DISABILITIES, AS SUCH TERM IS DEFINED IN SECTION 1.03 OF THE MENTAL HYGIENE LAW. § 4. Paragraph (a) of subdivision 2 of section 366-c of the social services law, as amended by section 68 of part A of chapter 56 of the laws of 2013, is amended to read as follows: (a) For purposes of this section an "institutionalized spouse" is a person (i) who is in a medical institution or nursing facility and expected to remain in such facility or institution for at least thirty consecutive days; or (ii) who is receiving care, services and supplies pursuant to a waiver pursuant to subsection (c) of section nineteen hundred fifteen of the federal social security act, OR SUCCESSOR TO SUCH WAIVER, or is receiving care, services and supplies in a managed long- term care plan pursuant to section eleven hundred fifteen of the social security act; and (iii) who is married to a person who is not in a medical institution or nursing facility or is not receiving waiver services described in subparagraph (ii) of this paragraph; provided, however, that medical assistance shall be furnished pursuant to this paragraph only if, for so long as, and to the extent that federal finan- cial participation is available therefor. The commissioner of health shall make any amendments to the state plan for medical assistance, or apply for any waiver or approval under the federal social security act that are necessary to carry out the provisions of this paragraph. § 5. The closing paragraph of subdivision 4 of section 366-c of the social services law, as amended by section 42 of part D of chapter 58 of the laws of 2009, is amended to read as follows: provided, however, that, to the extent required by federal law, the terms of this subdivision shall not apply to persons who are receiving care, services and supplies pursuant to the following waivers under section 1915(c) of the federal social security act: the nursing facility transition and diversion waiver authorized pursuant to subdivision six-a of section three hundred sixty-six of this title; the traumatic brain injury waiver authorized pursuant to section twenty-seven hundred forty of the public health law, the long term home health care program waiver authorized pursuant to section three hundred sixty-seven-c of this title, and the home and community based services waiver for persons with developmental disabilities, OR SUCCESSOR TO SUCH WAIVER, administered by the office [of mental retardation and] FOR PEOPLE WITH developmental disabilities pursuant to an agreement with the federal centers for medi- care and Medicaid services. S. 7507--A 76 A. 9507--A § 6. Paragraph 4 of subdivision (a) of section 16.03 of the mental hygiene law, as added by section 6 of part MM of chapter 58 of the laws of 2015, is amended to read as follows: (4) The provision of home and community based services approved under a waiver program authorized pursuant to SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT OR 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, provided that an operating certificate issued pursuant to this paragraph shall only authorize services in a home or community setting. § 7. Paragraph 2 of subdivision (a) of section 16.11 of the mental hygiene law, as added by section 10 of part MM of chapter 58 of the laws of 2015, is amended to read as follows: (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, OR OTHER SUCCESSOR MEDICAID WAIVER PROGRAM, and applicable federal regu- lation, subdivisions seven and seven-a of section three hundred sixty- six of the social services law and rules and regulations adopted by the commissioner. § 8. Subdivision (b) of section 80.03 of the mental hygiene law, as amended by chapter 37 of the laws of 2011, is amended to read as follows: (b) "A patient in need of surrogate decision-making" means a patient as defined in subdivision twenty-three of section 1.03 of this chapter who is: a resident of a mental hygiene facility including a resident of housing programs funded by an office of the department or whose federal funding application was approved by an office of the department or for whom such facility maintains legal admission status therefor; or, receiving home and community-based services for persons with mental disabilities provided pursuant to section 1915 OR 1115 of the federal social security act; or receiving individualized support services; or, case management or service coordination funded, approved, or provided by the office for people with developmental disabilities; and, for whom major medical treatment is proposed, and who is determined by the surro- gate decision-making committee to lack the ability to consent to or refuse such treatment, but shall not include minors with parents or persons with legal guardians, committees or conservators who are legally authorized, available and willing to make such health care decisions. Once a person is eligible for surrogate decision-making, such person may continue to receive surrogate decision-making as authorized by this section regardless of a change in residential status. § 9. Subdivision 1-a of section 84 of part A of chapter 56 of the laws of 2013, 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 2013-2014 state fiscal year, is amended to read as follows: [1-a. sections seventy-three through eighty-a shall expire and be deemed repealed September 30, 2019] § 10. Paragraph (a-1) of subdivision 8 of section 4403 of the public health law, as amended by chapter 474 of the laws of 2015, is amended to read as follows: (a-1) If the commissioner and the commissioner of the office for people with developmental disabilities determine that such organization S. 7507--A 77 A. 9507--A lacks the experience required in paragraph (a) of this subdivision, the organization shall have an affiliation arrangement with an entity or entities that are CONTROLLED BY non-profit ORGANIZATIONS with experience serving persons with developmental disabilities, AS DEMONSTRATED BY CRITERIA TO BE DETERMINED BY THE COMMISSIONER AND THE COMMISSIONER OF THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, WITH SUCH CRITE- RIA including, but not limited to, residential, day, and employment services such that the affiliated entity will coordinate and plan services operated, certified, funded, authorized or approved by the office for people with developmental disabilities or will oversee and approve such coordination and planning; § 11. 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 20 of part D of chapter 57 of the laws of 2015, is amended to read as follows: § 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, [2019] 2024 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. § 12. Paragraph (a-1) of subdivision 12 of section 4403-f of the public health law, as amended by chapter 474 of the laws of 2015, is amended to read as follows: (a-1) If the commissioner and the commissioner of the office for people with developmental disabilities determine that such plan lacks the experience required in paragraph (a) of this subdivision, the plan shall have an affiliation arrangement with an entity or entities that are CONTROLLED BY non-profit ORGANIZATIONS with experience serving persons with developmental disabilities, AS DEMONSTRATED BY CRITERIA TO BE DETERMINED BY THE COMMISSIONER AND THE COMMISSIONER OF THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, WITH SUCH CRITERIA including, but not limited to, residential, day and employment services, such that the affiliated entity will coordinate and plan services operated, certi- fied, funded, authorized or approved by the office for people with developmental disabilities or will oversee and approve such coordination and planning; § 13. Paragraph (d) of subdivision 1 of section 4403-g of the public health law, as added by section 73 of part A of chapter 56 of the laws of 2013, is amended to read as follows: (d) "Health and long term care services" means COMPREHENSIVE HEALTH services AND OTHER SERVICES AS DETERMINED BY THE COMMISSIONER AND THE COMMISSIONER OF THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES, whether provided by state-operated programs or not-for-profit entities, including, but not limited to, habilitation services, home and communi- ty-based and institution-based long term care services, and ancillary services, that shall include medical supplies and nutritional supple- ments, that are necessary to meet the needs of persons whom the plan is authorized to enroll[, and may include primary care and acute care if S. 7507--A 78 A. 9507--A the DISCO is authorized to provide or arrange for such services]. Each person enrolled in a DISCO shall receive health and long term care services designed to achieve person-centered outcomes, to enable that person to live in the most integrated setting appropriate to that person's needs, and to enable that person to interact with nondisabled persons to the fullest extent possible in social, workplace and other community settings, provided that all such services are consistent with such person's wishes to the extent that such wishes are known and in accordance with such person's needs. § 14. Paragraph (b) of subdivision 3 of section 4403-g of the public health law, as added by section 73 of part A of chapter 56 of the laws of 2013, is amended to read as follows: (b) A description of the services to be covered by such DISCO, WHICH MUST INCLUDE ALL HEALTH AND LONG TERM CARE SERVICES, AS DEFINED IN PARA- GRAPH (D) OF SUBDIVISION ONE OF THIS SECTION, AND OTHER SERVICES AS DETERMINED BY THE COMMISSIONER AND THE COMMISSIONER OF THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES; § 15. Paragraph (j) of subdivision 4 of section 4403-g of the public health law, as added by section 73 of part A of chapter 56 of the laws of 2013, is amended to read as follows: (j) Readiness and capability [to arrange and manage covered services] OF ORGANIZING, MARKETING, MANAGING, PROMOTING AND OPERATING A HEALTH AND LONG TERM CARE SERVICES PLAN, OR HAS AN AFFILIATION AGREEMENT WITH AN ENTITY THAT HAS SUCH READINESS AND CAPABILITY; § 16. 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 17 of part D of chapter 57 of the laws of 2015, 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, [2019] 2024 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; § 17. Subdivision (c) of section 13.40 of the mental hygiene law, as added by section 72-b of part A of chapter 56 of the laws of 2013, is amended to read as follows: (c) No person with a developmental disability who is receiving or applying for medical assistance and who is receiving, or eligible to receive, services operated, funded, certified, authorized or approved by the office, shall be required to enroll in a DISCO, HMO or MLTC in order to receive such services until program features and reimbursement rates are approved by the commissioner and the commissioner of health, and until such commissioners determine that a sufficient number of plans that are authorized to coordinate care for individuals pursuant to this section or that are authorized to operate and to exclusively enroll persons with developmental disabilities pursuant to subdivision twenty- seven of section three hundred sixty-four-j of the social services law are operating in such person's county of residence to meet the needs of persons with developmental disabilities, and that such entities meet the standards of this section. No person shall be required to enroll in a DISCO, HMO or MLTC in order to receive services operated, funded, certi- fied, authorized or approved by the office until there are at least two entities operating under this section in such person's county of resi- dence, unless federal approval is secured to require enrollment when S. 7507--A 79 A. 9507--A there are less than two such entities operating in such county. NOTWITH- STANDING THE FOREGOING OR ANY OTHER LAW TO THE CONTRARY, ANY HEALTH CARE PROVIDER: (I) ENROLLED IN THE MEDICAID PROGRAM AND (II) RENDERING HOSPI- TAL SERVICES, AS SUCH TERM IS DEFINED IN SECTION TWENTY-EIGHT HUNDRED ONE OF THE PUBLIC HEALTH LAW, TO AN INDIVIDUAL WITH A DEVELOPMENTAL DISABILITY WHO IS ENROLLED IN A DISCO, HMO OR MLTC, OR A PREPAID HEALTH SERVICES PLAN OPERATING PURSUANT TO SECTION FORTY-FOUR HUNDRED THREE-A OF THE PUBLIC HEALTH LAW, INCLUDING, BUT NOT LIMITED TO, AN INDIVIDUAL WHO IS ENROLLED IN A PLAN AUTHORIZED BY SECTION THREE HUNDRED SIXTY- FOUR-J OR THE SOCIAL SERVICES LAW, SHALL ACCEPT AS FULL REIMBURSEMENT THE NEGOTIATED RATE OR, IN THE EVENT THAT THERE IS NO NEGOTIATED RATE, THE RATE OF PAYMENT THAT THE APPLICABLE GOVERNMENT AGENCY WOULD OTHER- WISE PAY FOR SUCH RENDERED HOSPITAL SERVICES. § 18. Section 11 of chapter 710 of the laws of 1988, amending the social services law and the education law relating to medical assistance eligibility of certain persons and providing for managed medical care demonstration programs, as amended by section 1 of part F of chapter 73 of the laws of 2016, is amended to read as follows: § 11. This act shall take effect immediately; except that the provisions of sections one, two, three, four, eight and ten of this act shall take effect on the ninetieth day after it shall have become a law; and except that the provisions of sections five, six and seven of this act shall take effect January 1, 1989; and except 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 are authorized and directed to be made and completed on or before such effective date; provided, however, that the provisions of section 364-j of the social services law, as added by section one of this act shall expire and be deemed repealed on and after March 31, [2019] 2024, the provisions of section 364-k of the social services law, as added by section two of this act, except subdivision 10 of such section, shall expire and be deemed repealed on and after January 1, 1994, and the provisions of subdivision 10 of section 364-k of the social services law, as added by section two of this act, shall expire and be deemed repealed on January 1, 1995. § 19. This act shall take effect immediately; provided, however, that the amendments to subparagraph (vii) of paragraph e of subdivision 3 of section 364-j of the social services law made by section one of this act shall not affect the repeal of such section and shall be deemed repealed therewith; provided further, however, that the amendments to subdivision 4 of section 366-c of the social services law made by section five of this act shall not affect the expiration of such subdivision and shall be deemed to expire therewith; provided further, however, that the amendments to paragraph (a-1) of subdivision 12 of section 4403-f of the public health law made by section twelve of this act shall not affect the repeal of such section and shall be deemed to be repealed therewith. PART AA Section 1. Subdivisions 3-b and 3-c of section 1 of part C of chapter 57 of the laws of 2006, relating to establishing a cost of living adjustment for designated human services programs, as amended by section 1 of part Q of chapter 57 of the laws of 2017, are amended to read as follows: 3-b. Notwithstanding any inconsistent provision of law, beginning April 1, 2009 and ending March 31, 2016 and beginning April 1, 2017 and S. 7507--A 80 A. 9507--A ending March 31, [2018] 2019, the commissioners shall not include a COLA for the purpose of establishing rates of payments, contracts or any other form of reimbursement, provided that the commissioners of the office for people with developmental disabilities, the office of mental health, and the office of alcoholism and substance abuse services shall not include a COLA beginning April 1, 2017 and ending March 31, 2019. 3-c. Notwithstanding any inconsistent provision of law, beginning April 1, [2018] 2019 and ending March 31, [2021] 2022, the commissioners shall develop the COLA under this section using the actual U.S. consumer price index for all urban consumers (CPI-U) published by the United States department of labor, bureau of labor statistics for the twelve month period ending in July of the budget year prior to such state fiscal year, for the purpose of establishing rates of payments, contracts or any other form of reimbursement. § 2. This act shall take effect immediately and shall be deemed to have been in full force and effect on and after April 1, 2018; provided, however, that the amendments to section 1 of part C of chapter 57 of the laws of 2006 made by section one of this act shall not affect the repeal of such section and shall be deemed repealed therewith. PART BB Section 1. Section 3302 of the public health law is amended by adding a new subdivision 44 to read as follows: 44. "CONTROLLED SUBSTANCE ANALOG" MEANS (A) A CAPSULE, LIQUID, PILL, POWDER, PRODUCT, SPRAY, TABLET OR OTHER SUBSTANCE, HOWEVER CONSTITUTED: (I) THE CHEMICAL STRUCTURE OF WHICH IS DERIVATIVE OF, OR SUBSTANTIALLY SIMILAR TO, THE CHEMICAL STRUCTURE OF A CONTROLLED SUBSTANCE; OR (II) WHICH HAS A STIMULANT, DEPRESSANT, OR HALLUCINOGENIC EFFECT ON THE CENTRAL NERVOUS SYSTEM THAT IS SUBSTANTIALLY SIMILAR TO OR GREATER THAN THE STIMULANT, DEPRESSANT, OR HALLUCINOGENIC EFFECT ON THE CENTRAL NERVOUS SYSTEM OF A CONTROLLED SUBSTANCE; OR (III) WITH RESPECT TO A PARTICULAR PERSON, WHICH SUCH PERSON REPRES- ENTS OR INTENDS TO HAVE THE STIMULANT, DEPRESSANT, OR HALLUCINOGENIC EFFECT ON THE CENTRAL NERVOUS SYSTEM OF A CONTROLLED SUBSTANCE. (B) "CONTROLLED SUBSTANCE ANALOG" DOES NOT INCLUDE: (I) A CONTROLLED SUBSTANCE; (II) ANY SUBSTANCE FOR WHICH THERE IS AN APPROVED NEW DRUG APPLICA- TION; (III) WITH RESPECT TO A PARTICULAR PERSON, ANY SUBSTANCE, IF AN EXEMPTION IS IN EFFECT FOR INVESTIGATIONAL USE, FOR THAT PERSON, UNDER 21 USCA § 355, TO THE EXTENT THE CONDUCT WITH RESPECT TO THE SUBSTANCE IS PURSUANT TO SUCH EXEMPTION; OR (IV) ANY COMPOUND, MIXTURE, OR PREPARATION THAT CONTAINS ANY CONTROLLED SUBSTANCE OR CONTROLLED SUBSTANCE ANALOG THAT IS NOT FOR ADMINISTRATION TO A HUMAN BEING OR ANIMAL, AND THAT IS PACKAGED IN SUCH A FORM OR CONCENTRATION, OR WITH ADULTERANTS OR DENATURANTS, SO THAT AS PACKAGED IT DOES NOT PRESENT ANY SIGNIFICANT POTENTIAL FOR ABUSE. (C) CONTROLLED SUBSTANCE ANALOG TREATED AS A SCHEDULE I SUBSTANCE. A CONTROLLED SUBSTANCE ANALOG MUST BE TREATED, FOR THE PURPOSES OF ANY NEW YORK STATE STATUTE OR REGULATION, AS A SUBSTANCE INCLUDED IN SCHEDULE I OF SECTION THIRTY-THREE HUNDRED SIX OF THIS ARTICLE. § 2. Subdivision (a) of schedule I of section 3306 of the public health law, as added by chapter 664 of the laws of 1985, is amended to read as follows: S. 7507--A 81 A. 9507--A (a) Schedule I shall consist of the drugs and other substances, by whatever official name, common or usual name, chemical name, or brand name designated, listed in this section, AND CONTROLLED SUBSTANCE ANALOGS AS DEFINED BY SUBDIVISION FORTY-FOUR OF SECTION THIRTY-THREE HUNDRED TWO OF THIS ARTICLE. § 3. Subdivision 5 of section 220.00 of the penal law, as amended by chapter 537 of the laws of 1998, is amended to read as follows: 5. "Controlled substance" means any substance listed in schedule I, II, III, IV or V of section thirty-three hundred six of the public health law other than marihuana, but including concentrated cannabis as defined in paragraph (a) of subdivision four of section thirty-three hundred two of such law, AND INCLUDING CONTROLLED SUBSTANCE ANALOGS AS DEFINED IN SUBDIVISION FORTY-FOUR OF SECTION THIRTY-THREE HUNDRED TWO OF SUCH LAW. § 4. Subdivision (b) of schedule I of section 3306 of the public health law is amended by adding nineteen new paragraphs 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73 and 74 to read as follows: (56) 3,4-DICHLORO-N-{(1-DIMETHYLAMINO) CYCLOHEXYLMETHYL}BENZAMIDE. SOME TRADE OR OTHER NAMES: AH-7921. (57) N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLACETAMIDE (ACETYL FENTA- NYL). (58) N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLBUTYRAMIDE (BUTYRYL FENTA- NYL). (59) N-{1-{2-HYDROXY-2-(THIOPHEN-2-YL)ETHYL}PIPERIDIN-4-YL}-N-PHENYL- PROPIONAMIDE (BETA-HYDROXYTHIOFENTANYL). (60) N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLFURAN-2-CARBOXAMIDE (FURA- NYL FENTANYL). (61) U-47700(3,4-DICHLORO-N-{2-(DIMETHYLAMINIO)CYCLOHEXYL}-N- METHYL- BENZAMIDE). (62) N-PHENYL-N-{1-(2-PHENYLETHYL)PIPERIDIN-4-YL}PROP-2-ENAMIDE (ACRYL FENTANYL OR ACRYLOYLFANTANYL). SOME TRADE OR OTHER NAMES: N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLACRYLAMIDE; N-PHENYL-N-{1-(2- PHENYLETHYL)-4-PIPERIDINYL}-2-PROPENAMIDE. (63) N-(4-FLUOROPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-YL)ISOBUTYRAMIDE. OTHER NAMES: 4-FLUOROISOBUTYRYL FENTANYL, PARA-FLUOROISOBUTYRYL FENTA- NYL). (64) N-(2-FLUOROPHENYL)-N-(1-PHENELTHYLPIPERIDIN-4-YL)PROPIONAMIDE(ORT- HO-FLUOROFENTANYL OR 2-FLUOROFENTANYL). (65) N-(1-PHENELTHYLPIPERIDIN-4-YL)-N-PHENYLTETRAHYDROFURAN-2-CARBOXAMI- DE(TETRAHYDROFURANYL FENTANYL). (66) 2-METHOXY-N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLACETAMIDE(METHOXY- ACETYL FENTANYL). (67) N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLCYCLOPROPANECARBOXAMIDE. SOME TRADE OR OTHER NAMES: CYCLOPROPYL FENTANYL. (68) N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLPENTAMIDE. SOME TRADE OR OTHER NAMES: VALERYL FENTANYL. (69) N-(4-FLUROPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-YL)BUTYRAMIDE. SOME TRADE OR OTHER NAMES: PARA-FLUOROBUTYRYL FENTANYL. (70) N-(4-METHOXYPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-YL)BUTYRAMIDE. SOME TRADE OR OTHER NAMES: PARA-METHOXYBUTYRYL FENTANYL. (71) N-(4-CHLOROPHENYL)-N-(1-PHENETHYLPIPERIDIN-4-YL)ISOBUTYRAMIDE. SOME TRADE OR OTHER NAMES: PARA-CHLORISOBUTYRYL FENTANYL. (72) N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLISOBUTYRAMIDE. SOME TRADE OR OTHER NAMES: ISOBUTYRYL FENTANYL. S. 7507--A 82 A. 9507--A (73) N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLCYCLOPENTANECARBOXAMIDE. SOME TRADE OR OTHER NAMES: CYCLOPENTYL FENTANYL. (74) N-(2-FLUROPHENYL)-2-METHOXY-N-(1-PHENETHYLPIPERIDIN-4-YL)ACETAMIDE. SOME TRADE OR OTHER NAMES: OCFENTANIL. § 5. Subdivision (d) of schedule I of section 3306 of the public health law is amended by adding thirty-six new paragraphs 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70 and 71 to read as follows: (36) 5-METHOXY-N,N-DIMETHYLTRYPTAMINE. (37) ALPHA-METHYLTRYPTAMINE. SOME TRADE OR OTHER NAMES: AMT. (38) 5-METHOXY-N,N-DIISOPROPYLTRYPTAMINE. SOME TRADE OR OTHER NAMES: 5-MEO-DIPT. (39) 5-(1.1-DIMETHYLHEPTYL)-2-{(1R,3S)-3-HYDROXYCYCLOHEXYL}-PHENO1. SOME TRADE OR OTHER NAMES: CP-47,497. (40) 5-(1,1-DIMETHYLOCTYL)-2-{(1R,3S)-3-HYDROXYCYCLOHEXYL}-PHENOL. SOME TRADE OR OTHER NAMES: CANNABICYCLOHEXANOL OR CP-47,497 C8-HOMOLOG. (41) 1-PENTYL-3-(1-NAPHTHOYL)INDOLE. SOME TRADE OF OTHER NAMES: JWH-018 AND AM678. (42) 1-BUTYL-3-(1-NAPHTHOYL)INDOLE. SOME TRADE OF OTHER NAMES: JWH-073. (43) 1-HEXYL-3-(1-NAPHTHOYL)INDOLE. SOME TRADE OF OTHER NAMES: JWH-019. (44) 1-{2-(4-MORPHOLINYL)ETHYL}-3-(1-NAPHTHOYL)INDOLE. SOME TRADE OR OTHER NAMES: JWH-200. (45) 1-PENTYL-3-(2-METHOXYPHENYLACETYL)INDOLE. SOME TRADE OR OTHER NAMES: JWH-250. (46) 1-PENTYL-3-{1-(4-METHOXYNAPHTHOYL)}INDOLE. SOME TRADE OR OTHER NAMES: JWH-081. (47) 1-PENTYL-3-(4-METHYL-1-NAPHTHOYL)INDOLE. SOME TRADE OR OTHER NAMES: JWH-122. (48) 1-PENTYL-3-(4-CHLORO-1-NAPHTHOYL)INDOLE. SOME TRADE OR OTHER NAMES: JWH-398. (49) 1-(5-FLUOROPENTYL)-3-(1-NAPHTHOYL)INDOLE. SOME TRADE OR OTHER NAMES: AM2201. (50) 1-(5-FLUOROPENTYL)-3-(2-IODOBENZOYL)INDOLE. SOME TRADE OR OTHER NAMES: AM694. (51) 1-PENTYL-3-{(4-METHOXY)-BENZOYL}INDOLE. SOME TRADE OR OR OTHER NAMES: SR-19 AND RCS-4. (52) 1-CYCLOHEXYLETHYL-3-(2-METHOXYPHENYLACETYL)INDOLE. SOME TRADE OR OTHER NAMES: SR-18 AND RCS-8. (53) 1-PENTYL-3-(2-CHLOROPHENYLACETYL) INDOLE. SOME TRADE OR OTHER NAMES: JWH-203. (54) (1-PENTYL-1H-INDOL-3-YL)(2,2,3,3-TETRAMETHYLCYCLOPROPYL) METHA- NONE. SOME TRADE OR OTHER NAMES: UR-144. (55) {1-(5-FLUORO-PENTYL)-1H-INDOL-3-YL}(2,2,3,3-TETRAMETHYLCYCLOPROP- YL) METHANONE. SOME TRADE NAMES OR OTHER NAMES: 5-FLUORO-UR-144, XLR11. (56) N-(1-ADAMANTYL)-1-PENTYL-1H-INDAZOLE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: APINACA, AKB48. (57) QUINOLIN-8-YL 1-PENTYL-1H-INDOLE-3-CARBOXYLATE. SOME TRADE OR OTHER NAMES: PB-22; QUPIC. (58) QUINOLIN-8-YL 1-(5-FLUOROPENTYL)-1H-INDOLE-3-CARBOXYLATE. SOME TRADE OR OTHER NAMES: 5-FLUORO-PB-22; 5F-PB-22. (59) N-(1-AMINO-3-METHYL-1-OXOBUTAN-2-YL)-1-(4-FLUOROBENZYL)-1H-INDAZO- LE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: AB-FUBINACA. S. 7507--A 83 A. 9507--A (60) N-(1-AMINO-3,3-DIMETHYL-1-OXOBUTAN-2-YL)-1-PENTYL-1H- INDAZOLE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: ADB-PINACA. (61) N-(1-AMINO-3-METHYL-1-OXOBUTAN-2-YL)-1-(CYCLOHEXYLMETHYL)-1H- INDAZOLE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: AB-CHMINACA. (62) N-(1-AMINO-3-METHYL-1-OXOBUTAN-2-YL)-1-PENTYL-1H-INDAZOLE- 3-CAR- BOXAMIDE. SOME TRADE OR OTHER NAMES: AB-PINACA. (63) {1-(5-FLUOROPENTYL)-1H-INDAZOL-3-YL}(NAPHTHALEN-1-Y1)METHANONE. SOME TRADE OR OTHER NAMES: THJ-2201. (64) N-(1-AMINO-3,3-DIMETHYL-1-OXOBUTAN-2-Y1)-1-(CYCLOHEXYLMETHYL)-1H- INDAZOLE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: MAB-CHMINACA; ADB-CHMINACA. (65) METHYL 2-(1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3, 3-DI- METHYLBUTANOATE. SOME TRADE OR OTHER NAMES: 5F-ADB; 5F-MDMB-PINACA. (66) METHYL 2-(1-(5-FLUOROPENTYL)-1H-INDAZOLE-3- CARBOXAMIDO-3-METHYL- BUTANOATE. SOME TRADE OR OTHER NAMES: 5F-AMB. (67) N-(ADAMANTAN-1-YL)-1-(5-FLUOROPENTYL)-1H-INDAZOLE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: 5F-APINACA, 5F-AKB48. (68) N-(1-AMINO-3,3-DIMETHYL-1-OXOBUTAN-2-YL)-1-(4-FLUOROBENZYL)-1H-IN- DAZOLE-3-CARBOXAMIDE. SOME TRADE OR OTHER NAMES: ADB-FUBINACA. (69) METHYL 2-(1-CYCLOHEXLMETHYL)-1H-INDOLE-3-CARBOXAMIDO)-3,3-DIMETH- YLBUTANOATE. SOME TRADE OR OTHER NAMES: MDMB-CHMICA, MMB-CHMINACA. (70) METHYL 2-(1-(4-FLUOROBENZYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3,3-DIMET- HYLBUTANOATE. SOME TRADE OR OTHER NAMES: MDMB-FUBINACA. (71) METHYL-2(1-(4-FLUROBENZYL)-1H-INDAZOLE-3-CARBOXAMIDO)-3-METHYLBUT- ANOATE. SOME TRADE OR OTHER NAMES: FUB-AMB, MMB-FUBINACA, AMB-FUBINACA. § 6. Section 3308 of the public health law is amended by adding a new subdivision 7 to read as follows: 7. THE COMMISSIONER MAY, BY REGULATION, CLASSIFY AS A SCHEDULE I CONTROLLED SUBSTANCE IN SECTION THIRTY-THREE HUNDRED SIX OF THIS TITLE ANY SUBSTANCE LISTED AS AN OPIATE, A HALLUCINOGENIC SUBSTANCE, A CANNA- BIMIMETIC AGENT OR A FENTANYL-RELATED SUBSTANCE IN SCHEDULE I OF THE FEDERAL SCHEDULES OF CONTROLLED SUBSTANCES IN 21 USC §812 OR 21 CFR §1308.11(B), (D), (G), (H) OR (I). § 7. This act shall take effect on the ninetieth day after it shall have become a law. PART CC Section 1. Subdivision 28 of section 6530 of the education law, as added by chapter 606 of the laws of 1991, is amended to read as follows: 28. Failing to respond within [thirty] TEN days to written communi- cations from the department of health and to make available any relevant records with respect to an inquiry or complaint about the licensee's professional misconduct. The period of [thirty] TEN days shall commence on the date when such communication was delivered personally to the licensee. If the communication is sent from the department of health by registered or certified mail, with return receipt requested, to the address appearing in the last registration, the period of [thirty] TEN days shall commence on the date of delivery to the licensee, as indi- cated by the return receipt; § 2. Subdivision 4 of section 206 of the public health law, as amended by chapter 602 of the laws of 2007, is amended to read as follows: 4. The commissioner may: (a) issue subpoenas, compel the attendance of witnesses and compel them to testify in any matter or proceeding before him, and may also S. 7507--A 84 A. 9507--A require a witness to attend and give testimony in a county where he resides or has a place of business without the payment of any fees; (b) REQUIRE, IN WRITING, THE PRODUCTION OF ANY AND ALL RELEVANT DOCU- MENTS IN THE POSSESSION OR CONTROL OF AN INDIVIDUAL OR ENTITY SUBJECT TO AN INVESTIGATION OR INQUIRY UNDER THIS CHAPTER. UNLESS A SHORTER PERIOD IS SPECIFIED IN SUCH WRITING, AS DETERMINED FOR GOOD CAUSE BY THE COMMISSIONER, THE REQUIRED DOCUMENTS SHALL BE PRODUCED NO LATER THAN TEN DAYS AFTER THE DELIVERY OF THE WRITING. FAILURE BY THE SUBJECT INDIVID- UAL OR ENTITY TO PRODUCE TO THE DEPARTMENT THE REQUIRED DOCUMENTS WITHIN THE TEN DAY OR OTHERWISE SPECIFIED PERIOD SHALL BE A VIOLATION OR FAIL- URE WITHIN THE MEANING OF PARAGRAPH (D) OF THIS SUBDIVISION. EACH ADDI- TIONAL DAY OF NON-PRODUCTION SHALL BE A SEPARATE VIOLATION OR FAILURE; (C) annul or modify an order, regulation, by-law or ordinance of a local board of health concerning a matter which in his judgment affects the public health beyond the territory over which such local board of health has jurisdiction; [(c)] (D) assess any penalty prescribed for a violation of or a fail- ure to comply with any term or provision of this chapter or of any lawful notice, order or regulation pursuant thereto, not exceeding two thousand dollars for every such violation or failure, which penalty may be assessed after a hearing or an opportunity to be heard; [(d)] (E) assess civil penalties against a public water system which provides water to the public for human consumption through pipes or other constructed conveyances, as further defined in the state sanitary code or, in the case of mass gatherings, the person who holds or promotes the mass gathering as defined in subdivision five of section two hundred twenty-five of this article not to exceed twenty-five thou- sand dollars per day, for each violation of or failure to comply with any term or provision of the state sanitary code as it relates to public water systems that serve a population of five thousand or more persons or any mass gatherings, which penalty may be assessed after a hearing or an opportunity to be heard[.]; AND (F) SEEK TO OBTAIN A WARRANT BASED ON PROBABLE CAUSE FROM A JUDICIAL OFFICER AUTHORIZED TO ISSUE A WARRANT. SUCH WARRANT AUTHORIZES THE COMMISSIONER AND ANY PERSON AUTHORIZED BY HIM TO HAVE THE AUTHORITY TO SEARCH ALL GROUNDS, ERECTIONS, VEHICLES, STRUCTURES, APARTMENTS, BUILD- INGS, PLACES AND THE CONTENTS THEREIN AND TO SEIZE ANY BOOKS, RECORDS, PAPERS, DOCUMENTS, COMPUTERS, ELECTRONIC DEVICES AND OTHER PHYSICAL OBJECTS. § 3. Paragraph (b) of subdivision 12 of section 230 of the public health law, as amended by chapter 599 of the laws of 1996, is amended to read as follows: (b) When a licensee has pleaded or been found guilty or convicted of committing an act constituting a felony under New York state law or federal law, or the law of another jurisdiction which, if committed within this state, would have constituted a felony under New York state law, OR WHEN A LICENSEE HAS BEEN CHARGED WITH COMMITTING AN ACT CONSTI- TUTING A FELONY UNDER NEW YORK STATE OR FEDERAL LAW OR THE LAW OF ANOTH- ER JURISDICTION, WHERE THE LICENSEE'S ALLEGED CONDUCT MAY PRESENT A RISK TO PATIENTS OR TO THE PUBLIC, WHICH, IF COMMITTED WITHIN THIS STATE, WOULD HAVE CONSTITUTED A FELONY UNDER NEW YORK STATE LAW, or when the duly authorized professional disciplinary agency of another jurisdiction has made a finding substantially equivalent to a finding that the prac- tice of medicine by the licensee in that jurisdiction constitutes an imminent danger to the health of its people, or when a licensee has been disciplined by a duly authorized professional disciplinary agency of S. 7507--A 85 A. 9507--A another jurisdiction for acts which if committed in this state would have constituted the basis for summary action by the commissioner pursu- ant to paragraph (a) of this subdivision, the commissioner, after a recommendation by a committee of professional conduct of the state board for professional medical conduct, may order the licensee, by written notice, to discontinue or refrain from practicing medicine in whole or in part or to take certain actions authorized pursuant to this title immediately. The order of the commissioner shall constitute summary action against the licensee and become public upon issuance. The summary suspension shall remain in effect until the final conclusion of a hear- ing which shall commence within ninety days of the date of service of the commissioner's order, end within ninety days thereafter and other- wise be held in accordance with paragraph (a) of this subdivision, provided, however, that when the commissioner's order is based upon a finding substantially equivalent to a finding that the practice of medi- cine by the licensee in another jurisdiction constitutes an imminent danger to the health of its people, the hearing shall commence within thirty days after the disciplinary proceedings in that jurisdiction are finally concluded. IF, AT ANY TIME, THE FELONY CHARGE IS DISMISSED, WITHDRAWN OR REDUCED TO A NON-FELONY CHARGE, THE COMMISSIONER'S SUMMARY ORDER SHALL TERMINATE. § 4. This act shall take effect immediately. PART DD Section 1. Subdivisions 2 and 4 of section 6801 of the education law, as amended by chapter 46 of the laws of 2015, are amended to read as follows: 2. A licensed pharmacist may execute a non-patient specific regimen prescribed or ordered by a physician licensed in this state or nurse practitioner certified in this state, pursuant to rules and regulations promulgated by the commissioner. When a licensed pharmacist administers an immunizing agent, he or she shall: (a) report such administration by electronic transmission or [fasci- mile] FACSIMILE to the patient's attending primary health care practi- tioner or practitioners, if any, and, to the extent practicable, make himself or herself available to discuss the outcome of such immuniza- tion, including any adverse reactions, with the attending primary health care practitioner, or to the statewide immunization registry or the citywide immunization registry, as established pursuant to section twen- ty-one hundred sixty-eight of the public health law; and (b) provide information to the patient OR, WHERE APPLICABLE, THE PERSON LEGALLY RESPONSIBLE FOR THE PATIENT, on the importance of having a primary health care practitioner, developed by the commissioner of health; and (c) report such administration, absent of any individually identifi- able health information, to the department of health in a manner required by the commissioner of health[.]; AND (d) prior to administering the immunization, inform the patient OR, WHERE APPLICABLE, THE PERSON LEGALLY RESPONSIBLE FOR THE PATIENT, of the total cost of the immunization or immunizations, subtracting any health insurance subsidization, if applicable. In the case the immunization is not covered, the pharmacist must inform the patient OR, WHERE APPLICA- BLE, THE PERSON LEGALLY RESPONSIBLE FOR THE PATIENT, of the possibility that the immunization may be covered when administered by a primary care physician or practitioner; and S. 7507--A 86 A. 9507--A (e) administer the immunization or immunizations according to the most current recommendations by the advisory committee for immunization prac- tices (ACIP), provided however, that a pharmacist may administer any immunization authorized under this section when specified by a patient specific order. 4. When administering an immunization in a pharmacy, the licensed pharmacist shall provide an area for the immunization that provides for a patient's privacy. The privacy area should include: A. a clearly visible posting of the most current "Recommended Adult Immunization Schedule" published by the advisory committee for immuniza- tion practices (ACIP); AND (B) EDUCATION MATERIALS ON INFLUENZA VACCINATIONS FOR CHILDREN AS DETERMINED BY THE COMMISSIONER AND THE COMMISSIONER OF HEALTH. § 2. Subdivision 22 of section 6802 of the education law, as amended by chapter 46 of the laws of 2015, is amended to read as follows: 22. "Administer", for the purpose of section sixty-eight hundred one of this article, means: A. the direct application of an immunizing agent to adults, whether by injection, ingestion, INHALATION or any other means, pursuant to a patient specific order or non-patient specific regimen prescribed or ordered by a physician or certified nurse practitioner, who has a prac- tice site in the county or adjoining county in which the immunization is administered, for immunizations to prevent influenza, pneumococcal, acute herpes zoster, meningococcal, tetanus, diphtheria or pertussis disease and medications required for emergency treatment of anaphylaxis. If the commissioner of health determines that there is an outbreak of disease, or that there is the imminent threat of an outbreak of disease, then the commissioner of health may issue a non-patient specific regimen applicable statewide. B. THE DIRECT APPLICATION OF AN IMMUNIZING AGENT TO CHILDREN BETWEEN THE AGES OF TWO AND EIGHTEEN YEARS OF AGE, WHETHER BY INJECTION, INGES- TION, INHALATION OR ANY OTHER MEANS, PURSUANT TO A PATIENT SPECIFIC ORDER OR NON-PATIENT SPECIFIC REGIMEN PRESCRIBED OR ORDERED BY A PHYSI- CIAN OR CERTIFIED NURSE PRACTITIONER, WHO HAS A PRACTICE SITE IN THE COUNTY OR ADJOINING COUNTY IN WHICH THE IMMUNIZATION IS ADMINISTERED, FOR IMMUNIZATION TO PREVENT INFLUENZA AND MEDICATIONS REQUIRED FOR EMER- GENCY TREATMENT OF ANAPHYLAXIS RESULTING FROM SUCH IMMUNIZATION. IF THE COMMISSIONER OF HEALTH DETERMINES THAT THERE IS AN OUTBREAK OF INFLUEN- ZA, OR THAT THERE IS THE IMMINENT THREAT OF AN OUTBREAK OF INFLUENZA, THEN THE COMMISSIONER OF HEALTH MAY ISSUE A NON-PATIENT SPECIFIC REGIMEN APPLICABLE STATEWIDE. § 3. Section 8 of chapter 563 of the laws of 2008, amending the educa- tion law and the public health law relating to immunizing agents to be administered to adults by pharmacists, as amended by chapter 46 of the laws of 2015, is amended to read as follows: § 8. This act shall take effect on the ninetieth day after it shall have become a law [and shall expire and be deemed repealed July 1, 2019]. § 4. Section 5 of chapter 116 of the laws of 2012, amending the educa- tion law relating to authorizing a licensed pharmacist and certified nurse practitioner to administer certain immunizing agents, as amended by chapter 46 of the laws of 2015, is amended to read as follows: § 5. This act shall take effect on the ninetieth day after it shall have become a law [and], PROVIDED, HOWEVER, THAT THE PROVISIONS OF SECTIONS ONE, TWO AND FOUR OF THIS ACT shall expire and be deemed repealed July 1, 2019 provided, that: S. 7507--A 87 A. 9507--A (a) the amendments to subdivision 7 of section 6527 of the education law made by section one of this act shall not affect the repeal of such subdivision and shall be deemed to be repealed therewith; (b) the amendments to subdivision 7 of section 6909 of the education law, made by section two of this act shall not affect the repeal of such subdivision and shall be deemed to be repealed therewith; (c) the amendments to subdivision 22 of section 6802 of the education law made by section three of this act shall not affect the repeal of such subdivision and shall be deemed to be repealed therewith; and (d) the amendments to section 6801 of the education law made by section four of this act shall not affect the expiration of such section and shall be deemed to expire therewith. § 5. 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 238 of the laws of 2015, is amended to read as follows: § 5. This act shall take effect on the one hundred twentieth day after it shall have become a law [and], PROVIDED, HOWEVER, THAT THE PROVISIONS OF SECTIONS TWO, THREE, AND FOUR OF THIS ACT shall expire 7 years after such effective date when upon such date the provisions of this act shall be deemed repealed; provided, however, that the amendments to subdivi- sion 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 are authorized and directed to be made and completed on or before such effective date. § 6. This act shall take effect immediately. § 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. § 3. This act shall take effect immediately provided, however, that the applicable effective date of Parts A through DD of this act shall be as specifically set forth in the last section of such Parts.
2017-S7507B - Details
2017-S7507B - Summary
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2018-2019 state fiscal year; relates to distributions from the general hospital indigent care pool; directs a review of the feasibility of creating a burn center in Kings county; and relates to rates of reimbursement for certain residential health care facilities (Part A)
2017-S7507B - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 7507--B I N S E N A T E January 18, 2018 ___________ A BUDGET BILL, submitted by the Governor pursuant to article seven of the Constitution -- read twice and ordered printed, and when printed to be committed to the Committee on Finance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the public health law, in relation to the general hospi- tal indigent care pool; to amend the social services law, in relation to standard coverage for physical therapy services under medical assistance for needy persons programs; to amend the public health law, in relation to payments to rural hospitals designated as critical access hospitals; to amend the public authorities law, in relation to authorizing the Westchester health care corporation to enter into agreements for the creation and operation of a health care delivery system network and to amend the public health law, in relation to reimbursement rates for certain residential health care facilities (Part A); to amend the social services law, in relation to assisted living program providers licensed in the state; to amend the public health law, in relation to eligibility for medical assistance; to amend the public health law, in relation to payments for home and community based long term care services; to amend the social services law, in relation to payments for certain medical assistance provided to eligible persons participating in the New York traumatic brain injury waiver program; to amend the public health law, in relation to requiring the department of health to oversee the appropriateness of services provided to certain high needs patients; to authorize the commissioner of health to conduct a study of home and community based services available to Medicaid recipients in rural areas; to amend the public health law, in relation to medical assistance payments for care in hospice residences; to amend the public health law, in relation to the public health priority initiative; to amend the public health law, in relation to restricting the altering of case-mix adjustments; to amend the public health law, in relation to a review of licensed home care service agencies; and to amend the social services law, in relation to the provision of services to certain persons suffering from traumatic brain injuries or qualifying for nursing home diversion and transition services (Part B); to amend the public health law and
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD12671-04-8 S. 7507--B 2 the social services law, in relation to health homes and penalties for managed care providers; to amend the social services law, in relation to the statewide patient centered medical home program; to amend the public health law, in relation to the multipayor patient centered medical home program; and to amend the social services law in relation to school-based health centers (Part C); to amend the social services law and the public health law, in relation to drug coverage; to amend the public health law, in relation to enacting the drug take back act; to amend the public health law, in relation to prescribing opioids to a minor; to amend the public health law, in relation to limiting the initial prescription of a controlled substance for the alleviation of acute pain from a seven-day supply to a three-day supply and requiring the commissioner of health to develop guidelines for the prescribing of opioid antagonists; to amend the social services law, in relation to limiting medical assistance coverage for opioids; to amend the insurance law, in relation to limiting coverage for opioids; to amend the public health law, in relation to establishing an opioid alterna- tive pilot project; to amend the public health law, in relation to requiring hospital and emergency room physicians to notify a patient's prescriber that such patient is being treated for a controlled substance overdose; to amend the public health law in relation to the labeling of opioids; to amend the public health law, in relation to children and recovering mothers; to amend the public health law, in relation to establishing the infant recovery centers pilot program; to amend the public health law, in relation to requiring facilities to screen newborns for neonatal abstinence syndrome through toxicological screening of infants' meconium or urine; and providing for the repeal of such provisions upon expiration thereof; to amend the insurance law, in relation to providing that coverage for outpatient diagnosis and treatment of substance use disorder shall not be subject to preau- thorization; to amend the mental hygiene law and the education law, in relation to integrated care and the location of pharmacies; to amend the public health law, in relation to audits of pharmacies; to amend the public health law, in relation to prohibited activities by pharma- cy benefit managers; and providing for the repeal of certain provisions upon expiration thereof (Part D); to amend the social services law, in relation to reimbursement of transportation costs and reimbursement of emergency transportation services (Part E); inten- tionally omitted (Part F); to amend the public health law, in relation to authorizing the establishment of limited service clinics (Part G); intentionally omitted (Part H); to amend the social services law and the public health law, in relation to managed care organizations (Part I); to amend the state finance law, in relation to establishing a medicaid false claims act reserve fund (Part J); authorizing the department of health to require certain health care providers to report on costs incurred; to amend chapter 59 of the laws of 2011 amending the public health law and other laws relating to known and projected department of health state fund medicaid expenditures, in relation to extending the medicaid global cap; to amend chapter 59 of the laws of 2011, amending the public health law and other laws relat- ing to general hospital reimbursement for annual rates, in relation to certain time periods; to amend the public health law, in relation to the kidney disease outreach and education program; and to repeal section 6 of part S of chapter 57 of the laws of 2017 relating to authorizing the commissioner of health to sell accounts receivables balances owed to the state by Medicaid providers to financial insti- S. 7507--B 3 tutions (Part K); to amend the social services law, in relation to the child health insurance program; to amend the insurance law, in relation to the definition of small group and in relation to meetings and reports of the New York state health care quality and cost containment commission; to amend the insurance law, in relation to clarifying that continuing care retirement communities are not subject to department of financial services cybersecurity regulations; and to repeal section 7 of chapter 12 of the laws of 2016 relating to direct- ing the superintendent of financial services to contract with an inde- pendent entity to conduct an assessment regarding the impact of the prohibition on the sale of stop loss, catastrophic and reinsurance coverage to the small group market relating thereto (Part L); to amend chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, in relation to apportioning premium for certain policies; to amend part J of chapter 63 of the laws of 2001 amending chapter 266 of the laws of 1986, amending the civil practice law and rules and other laws relating to malpractice and professional medical conduct, relat- ing to the effectiveness of certain provisions of such chapter, in relation to extending certain provisions concerning the hospital excess liability pool; and to amend part H of chapter 57 of the laws of 2017, amending the New York Health Care Reform Act of 1996 and other laws relating to extending certain provisions relating thereto, in relation to extending provisions relating to excess coverage (Part M); to amend part C of chapter 57 of the laws of 2006, establishing a cost of living adjustment for designated human services, in relation to the determination thereof; and to repeal certain provisions thereof relating to eligible programs (Part N); intentionally omitted (Part O); to amend the public health law, in relation to the health force retraining program; and to repeal subdivision 9 of section 2803 of such law relating to hospital audits (Part P); to amend the public health law, in relation to the health care facility transformation program (Part Q); to amend the public health law, in relation to granting schools access to a student's blood lead test results in the statewide immunization information system; lead screening of child care or pre-school enrollees and kindergarten students; and appoint- ments to the advisory council on lead poisoning prevention; and to amend the public health law, in relation to requiring the department of health to establish a statewide plan for lead service line replace- ment (Part R); to amend the public health law, in relation to author- izing collaborative programs for community paramedicine services (Subpart A); to amend the public health law and the mental hygiene law, in relation to integrated services (Subpart B); and to amend the public health law, in relation to the definitions of telehealth provider, originating site and remote patient monitoring; and to amend the social services law, in relation to telehealth under medical assistance (Subpart C)(Part S); to amend chapter 59 of the laws of 2016, amending the social services law and other laws relating to authorizing the commissioner of health to apply federally established consumer price index penalties for generic drugs, and authorizing the commissioner of health to impose penalties on managed care plans for reporting late or incorrect encounter data, in relation to the effec- tiveness of certain provisions of such chapter; to amend chapter 58 of the laws of 2007, amending the social services law and other laws relating to adjustments of rates, in relation to the effectiveness of certain provisions of such chapter; to amend chapter 54 of the laws of S. 7507--B 4 2016, amending part C of chapter 58 of the laws of 2005, authorizing reimbursements for expenditures made by or on behalf of social services districts for medical assistance for needy persons and admin- istration thereof relating to authorizing the commissioner of health to establish a statewide Medicaid integrity and efficiency initiative, in relation to the effectiveness thereof; to amend chapter 906 of the laws of 1984, amending the social services law relating to expanding medical assistance eligibility and the scope of services available to certain persons with disabilities, in relation to the effectiveness thereof; 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 rates of payments and to amend chapter 426 of the laws of 1983, amending the public health law relating to professional misconduct proceedings; and to amend the public health law, in relation to professional misconduct proceedings and the effectiveness of certain provisions thereof (Part T); to amend part NN of chapter 58 of the laws of 2015 amending the mental hygiene law relating to clarifying the authority of the commis- sioners in the department of mental hygiene to design and implement time-limited demonstration programs, in relation to the effectiveness thereof (Part U); to amend chapter 62 of the laws of 2003, amending the mental hygiene law and the state finance law relating to the community mental health support and workforce reinvestment program, the membership of subcommittees for mental health of community services boards and the duties of such subcommittees and creating the community mental health and workforce reinvestment account, in relation to extending such provisions relating thereto (Part V); intentionally omitted (Part W); to amend chapter 111 of the laws of 2010 amending the mental hygiene law relating to the receipt of feder- al and state benefits received by individuals receiving care in facil- ities operated by an office of the department of mental hygiene, in relation to the effectiveness thereof (Part X); to amend the education law, in relation to persons practicing in certain licensed programs or services who are exempt from practice requirements of professionals licensed by the department of education; and establishing a mental health professions task force (Part Y); to amend the social services law, in relation to adding demonstration waivers to waivers allowable for home and community-based services; to amend the social services law, in relation to adding successor federal waivers to waivers grant- ed under subsection (c) of section 1915 of the federal social security law, in relation to nursing facility services; to amend the social services law, in relation to waivers for high quality and integrated care; to amend the mental hygiene law, in relation to adding new and successor federal waivers to waivers in relation to home and communi- ty-based services; to amend part A of chapter 56 of the laws of 2013, 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 2013-2014 state fiscal year, in relation to the effectiveness of certain provisions thereof; to amend the public health law, in relation to expansion of comprehensive health services 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 extending provisions thereof; to amend the public health law, in relation to managed long term care plans, health and long term care services and S. 7507--B 5 developmental disability individual support and care coordination organizations; 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 extending the provisions thereof; to amend the mental hygiene law, in relation to reimbursement rates; and to amend chapter 710 of the laws of 1988, amending the social services law and the education law relating to medical assistance eligibility of certain persons and providing for managed medical care demonstration programs, in relation to extending the provisions there- of (Part Z); to amend part C of chapter 57 of the laws of 2006, relat- ing to establishing a cost of living adjustment for designated human services programs, in relation to the inclusion and development of certain cost of living adjustments and to providing funding to increase salaries and related fringe benefits to direct care workers, direct support professionals and clinical workers employed by not-for- profits funded by the office for people with developmental disabili- ties, the office of mental health and the office of alcoholism and substance abuse services (Part AA); to amend the public health law and the penal law, in relation to expanding the list of controlled substances; and to repeal paragraph 6 of subdivision (c) of schedule II of section 3306 of the public health law, relating thereto (Part BB); intentionally omitted (Part CC); to amend the education law, in relation to authorizing a licensed pharmacist to administer influenza vaccine to children between two and eighteen years of age pursuant to a non-patient specific regimen; to amend chapter 563 of the laws of 2008, amending the education law and the public health law relating to immunizing agents to be administered to adults by pharmacists, in relation to the effectiveness of such provisions; to amend chapter 116 of the laws of 2012, amending the education law relating to authoriz- ing a licensed pharmacist and certified nurse practitioner to adminis- ter certain immunizing agents, in relation to the effectiveness of such provisions; 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 the effectiveness of such provisions (Part DD); to amend the social services law and the elder law, in relation to providing protective services to certain individuals (Part EE); to amend the mental hygiene law, in relation to treatment of sex offen- ders in certain facilities (Part FF); to amend the mental hygiene law, in relation to prohibiting the collocation of certain facilities (Part GG); to amend the mental hygiene law, in relation to notice to local governments of the potential for significant service reductions at certain state-operated hospitals (Part HH); to amend the mental hygiene law, in relation to notification of the closure or transfer of a state-operated individualized residential alternative; and to amend part Q of chapter 59 of the laws of 2016 amending the mental hygiene law relating to the closure or transfer of a state-operated individ- ualized residential alternative, in relation to extending the effec- tiveness thereof (Part II); to amend the mental hygiene law, in relation to authorizing the office of alcoholism and substance abuse services to provide funding to substance use disorder and/or compul- sive gambling programs operated by for profit agencies (Part JJ); to amend the mental hygiene law, in relation to opioid overdose reversal and peer to peer support services (Part KK); to amend the mental hygiene law, in relation to prohibiting deceptive acts and practices for substance use disorder treatment (Part LL); to amend the mental S. 7507--B 6 hygiene law, in relation to establishing the family support and recov- ery services demonstration program; and providing for the repeal of such provisions upon expiration thereof (Part MM); to amend the mental hygiene law, in relation to alcohol and drug free housing (Part NN); to amend the mental hygiene law, in relation to establishing protocols for assisted outpatient treatment for substance abuse (Part OO); to amend the mental hygiene law, in relation to requiring the commission- er of alcoholism and substance abuse services to include a report for services to persons with substance use or compulsive gambling disor- ders in the statewide comprehensive plan of services for persons with mental disabilities (Part PP); to amend the mental hygiene law, in relation to directing the office of alcoholism and substance abuse, services to provide an ombudsman for substance use disorder insurance coverage (Part QQ); to amend the mental hygiene law, in relation to implementing a jail-based substance use disorder treatment and transi- tion services (Part RR); to amend the public health law, in relation to establishing an emergent contaminant contingency fund; to amend the public health law, in relation to the promulgation of regulations for tests for water contaminants by small public water suppliers; to amend the public health law, in relation to public water system coordination summits; and to amend the public health law, in relation to authoriz- ing a voluntary public water system consolidation study (Part SS); and to amend the public health law, in relation to the cancer detection and education program; to amend the public health law, in relation to the implementation of an electronic death registration system; to amend the public health law, in relation to a court ordered guardian- ship demonstration program; to amend the public health law, in relation to grants for not-for-profit corporations which provide fami- ly intervention services relating to Alzheimer's disease; to direct the New York state department of health to conduct a study on the high incidence of asthma and related pulmonary disorders in the boroughs of Brooklyn and Manhattan in the city of New York and to prepare a reme- dial plan; to direct a study of the impact of insurance laws relating to fertility and in vitro fertilization benefits; to amend the public buildings law, in relation to requiring the establishment of lactation rooms in certain public buildings; to amend the insurance law, in relation to requiring donated breast milk to be covered by certain insurance policies; to amend the executive law, in relation to stand- ards requiring assembly group A occupancies and mercantile group M occupancies to have diaper changing stations available for use by both male and female occupants; and to amend the public buildings law, in relation to requiring full family service restroom facilities in public buildings; to amend the public health law, the executive law and the insurance law, in relation to sexual assault forensic exams; to amend the public health law and the executive law, in relation to establishing a sexual assault survivor bill of rights; and to amend the executive law, in relation to maintenance of sexual assault evidence, establishing a victim's right to notice prior to destruction and requiring a study relating to the feasibility of establishing a statewide tracking system for sexual offense evidence kits; and to amend the public health law, in relation to establishing the sexual assault forensic examination telemedicine pilot program (Part TT) THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: S. 7507--B 7 Section 1. This act enacts into law major components of legislation which are necessary to implement the state fiscal plan for the 2018-2019 state fiscal year. Each component is wholly contained within a Part identified as Parts A through TT. The effective date for each particular provision contained within such Part is set forth in the last section of such Part. Any provision in any section contained within a Part, includ- ing the effective date of the Part, which makes a reference to a section "of this act", when used in connection with that particular component, shall be deemed to mean and refer to the corresponding section of the Part in which it is found. Section three of this act sets forth the general effective date of this act. PART A Section 1. Intentionally omitted. § 2. Subdivision 5-d of section 2807-k of the public health law, as amended by section 1 of part E of chapter 57 of the laws of 2015, 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 [eigh- teen] TWENTY, 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 [eighteen] TWENTY 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 (ii) of this paragraph such that no facility experiences a reduction in indigent care pool payments pursuant to this subdivision that is greater S. 7507--B 8 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 Janu- ary 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; AND FOR THE CALENDAR YEAR BEGINNING ON JANUARY FIRST, TWO THOUSAND NINETEEN, IS GREATER THAN SEVENTEEN AND ONE-HALF PERCENT; AND FOR THE CALENDAR YEAR BEGINNING ON JANUARY FIRST, TWO THOUSAND TWEN- TY, IS GREATER THAN TWENTY PERCENT. (iv) Such regulations shall reserve one percent of the funds available for distribution in the two thousand fourteen and two thousand fifteen calendar years, and for calendar years thereafter, pursuant to this subdivision, 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 establish 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. § 3. Intentionally omitted. § 3-a. Subdivision 14-a of section 2807 of the public health law is amended by adding a new paragraph (c) to read as follows: (C) NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, THE COMMISSIONER SHALL NOT TAKE ANY ACTION WITH THE PURPOSE OF REDUCING PAYMENT FOR GENERAL HOSPITAL EMERGENCY SERVICES VISITS PROVIDED TO PATIENTS ELIGIBLE FOR MEDICAL ASSISTANCE PURSUANT TO TITLE ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW, INCLUDING SUCH PATIENTS ENROLLED IN ORGANIZATIONS OPERATING IN ACCORDANCE WITH THE PROVISIONS OF ARTICLE FORTY-FOUR OF THIS CHAPTER OR IN HEALTH MAINTENANCE ORGANIZATIONS ORGANIZED AND OPER- ATING IN ACCORDANCE WITH ARTICLE FORTY-THREE OF THE INSURANCE LAW. § 4. Intentionally omitted. S. 7507--B 9 § 5. Paragraph (h) of subdivision 2 of section 365-a of the social services law, as amended by chapter 220 of the laws of 2011, is amended to read as follows: (h) speech therapy, and when provided at the direction of a physician or nurse practitioner, physical therapy including related rehabilitative services and occupational therapy; provided, however, that speech thera- py[, physical therapy] and occupational therapy each shall be limited to coverage of twenty visits per year; PHYSICAL THERAPY SHALL BE LIMITED TO COVERAGE OF FORTY VISITS PER YEAR; such limitation shall not apply to persons with developmental disabilities or, notwithstanding any other provision of law to the contrary, to persons with traumatic brain inju- ry; § 6. Subdivision 2-a of section 2807 of the public health law is amended by adding a new paragraph (j) to read as follows: (J) NOTWITHSTANDING ANY OTHER PROVISION OF THIS SUBDIVISION OR ANY OTHER PROVISION OF LAW TO THE CONTRARY AND, SUBJECT TO AN APPROPRIATION THEREFOR, ON AND AFTER APRIL FIRST, TWO THOUSAND NINETEEN, RATES OF PAYMENT FOR DIAGNOSTIC AND TREATMENT CENTER SERVICES, EMERGENCY SERVICES, GENERAL HOSPITAL INPATIENT AND OUTPATIENT SERVICES, AMBULATORY SURGICAL SERVICES AND REFERRED AMBULATORY SERVICES, PROVIDED BY A RURAL HOSPITAL DESIGNATED AS A CRITICAL ACCESS HOSPITAL IN ACCORDANCE WITH TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT SHALL BE EQUAL TO ONE HUNDRED ONE PERCENT OF THE REASONABLE COSTS OF A FACILITY IN PROVIDING SUCH SERVICES TO PATIENTS ELIGIBLE FOR PAYMENTS MADE IN ACCORDANCE WITH THIS SUBDIVISION. REASONABLE COSTS SHALL BE DETERMINED IN A MANNER CONSISTENT WITH THAT USED TO DETERMINE PAYMENT FOR OUTPATIENT CRITICAL ACCESS HOSPITAL SERVICES PROVIDED TO BENEFICIARIES OF TITLE XVIII OF THE FEDERAL SOCIAL SECURITY ACT. FOR FACILITIES WITHOUT ADEQUATE COST EXPE- RIENCE, SUCH RATES SHALL BE BASED ON BUDGETED COSTS SUBSEQUENTLY ADJUSTED TO ONE HUNDRED ONE PERCENT OF REASONABLE ACTUAL COSTS. § 7. Notwithstanding any inconsistent provision of law or regulation, the commissioner of health shall not alter the weights under the ambula- tory patient group methodology unless such alteration is part of a rebasing of all the weights assigned to ambulatory patient groups. § 8. Section 3306 of the public authorities law is amended by adding a new subdivision 8 to read as follows: 8. AS SET FORTH IN SECTION THIRTY-THREE HUNDRED ONE OF THIS TITLE, THE CREATION AND OPERATION OF THE WESTCHESTER COUNTY HEALTH CARE CORPORATION IS FOR THE BENEFIT OF THE RESIDENTS OF THE STATE OF NEW YORK AND THE COUNTY OF WESTCHESTER, INCLUDING PERSONS IN NEED OF HEALTH CARE SERVICES WITHOUT THE ABILITY TO PAY, AND IS A STATE, COUNTY, AND PUBLIC PURPOSE. THE CORPORATION HAS ADVISED THAT IT INTENDS TO ENGAGE IN CERTAIN COLLA- BORATIVE ACTIVITIES WITH AND LIMITED TO, HEALTH CARE PROVIDERS IN THE EIGHT LOWER HUDSON VALLEY COUNTIES OF WESTCHESTER, ROCKLAND, DUTCHESS, ORANGE, ULSTER, PUTNAM, SULLIVAN, AND DELAWARE, AS SET FORTH IN SECTION THIRTY-THREE HUNDRED ONE OF THIS TITLE, FOR THE PURPOSE OF PROMOTING, AND ONLY TO THE EXTENT NECESSARY TO PROMOTE, IMPROVED QUALITY OF AND ACCESS TO HEALTH CARE SERVICES AND IMPROVED CLINICAL OUTCOMES, CONSIST- ING OF: (A) DEVELOPMENT OF A NON-EXCLUSIVE JOINT HEALTH INFORMATION TECHNOLOGY PLATFORM; (B) DEVELOPMENT OF A JOINT SET OF CLINICAL QUALITY STANDARDS; (C) COORDINATION AND INTEGRATION OF CLINICAL SERVICE TO REDUCE REDUNDANCY AND INCREASE EFFICIENCY; (D) JOINT DISCUSSIONS WITH RURAL HOSPITALS REGARDING THE POSSIBILITY OF COORDINATING AND INTEGRAT- ING CLINICAL SERVICES; AND (E) JOINT PURCHASING OF SERVICES, SUPPLIES AND EQUIPMENT RELATED TO THE PROVISIONS OF HEALTH CARE SERVICES. TO PROMOTE IMPROVED QUALITY OF AND ACCESS TO HEALTH CARE SERVICES AND S. 7507--B 10 IMPROVED CLINICAL OUTCOMES, AND CONSISTENT WITH THE CORPORATION'S FURTH- ERANCE OF ITS HEALTH CARE PURPOSES THROUGH THE EXERCISE OF THE SPECIAL POWERS EXERCISED PURSUANT TO THIS SECTION AND THE GENERAL POWERS EXER- CISED PURSUANT TO THIS TITLE, IT IS THE POLICY OF THE STATE TO SUPPLANT COMPETITION FOR THE PURPOSE OF IMMUNIZING THE PLANNING AND IMPLEMENTA- TION OF THE ENUMERATED ACTIVITIES BY THE CORPORATION IN COLLABORATION WITH ANY ONE OF THE AFOREMENTIONED ENTITIES FROM LIABILITY UNDER THE FEDERAL AND STATE ANTITRUST LAWS; PROVIDED, HOWEVER, THAT NOTHING IN THIS SUBDIVISION SHALL BE CONSTRUED TO EXTEND SUCH DECLARATION OF POLICY TO ANY ACTIVITIES OTHER THAN THOSE SPECIFICALLY ENUMERATED AND DESCRIBED IN THIS SUBDIVISION, WHICH REMAIN SUBJECT TO ANY AND ALL APPLICABLE STATE AND FEDERAL ANTITRUST LAWS; AND PROVIDED FURTHER THAT SUCH DECLA- RATION OF POLICY SHALL NOT APPLY TO ANY ACTIVITIES THAT IMPROPERLY RESTRICT COMPETITIVE LABOR MARKETS IN VIOLATION OF ALL APPLICABLE STATE AND FEDERAL ANTITRUST LAWS. § 9. Section 4403-f of the public health law is amended by adding a new subdivision 8-a to read as follows: 8-A. RATES FOR CERTAIN RESIDENTIAL HEALTH CARE FACILITIES. NOTWITH- STANDING ANY OTHER PROVISION OF LAW OR REGULATION TO THE CONTRARY, ANY RESIDENTIAL HEALTH CARE FACILITY ESTABLISHED PURSUANT TO ARTICLE TWEN- TY-EIGHT OF THIS CHAPTER LOCATED IN A COUNTY WITH A POPULATION OF MORE THAN SEVENTY-TWO THOUSAND AND LESS THAN SEVENTY-FIVE THOUSAND PERSONS BASED ON THE TWO THOUSAND TEN FEDERAL CENSUS SHALL BE REIMBURSED BY ANY MANAGED LONG TERM CARE PLAN, APPROVED PURSUANT TO THIS SECTION AND CONTRACTING WITH THE DEPARTMENT, AT A RATE OF NO LESS THAN ONE HUNDRED FOUR PERCENT OF THE AVERAGE RATE OF REIMBURSEMENT IN EXISTENCE ON MARCH FIRST, TWO THOUSAND EIGHTEEN FOR SUCH COUNTY. § 9-a. Subdivision 2-c of section 2808 of the public health law is amended by adding a new paragraph (g) to read as follows: (G) NOTWITHSTANDING ANY OTHER PROVISION OF LAW OR REGULATION TO THE CONTRARY, ANY RESIDENTIAL HEALTH CARE FACILITY ESTABLISHED PURSUANT TO THIS ARTICLE LOCATED IN A COUNTY WITH A POPULATION OF MORE THAN SEVEN- TY-TWO THOUSAND AND LESS THEN SEVENTY-FIVE THOUSAND PERSONS BASED ON THE TWO THOUSAND TEN FEDERAL CENSUS, AND OPERATING BETWEEN ONE HUNDRED TEN AND ONE HUNDRED THIRTY BEDS, BEING REIMBURSED BY THE DEPARTMENT ON A FEE-FOR-SERVICES BASIS, SHALL BE REIMBURSED AT A RATE OF NO LESS THAN ONE HUNDRED SEVENTEEN PERCENT OF THE FEE-FOR-SERVICE RATE OF REIMBURSE- MENT CALCULATED PURSUANT TO THIS SECTION FOR THAT FACILITY FOR INPATIENT SERVICES PROVIDED ON OR AFTER MARCH FIRST, TWO THOUSAND EIGHTEEN. § 10. This act shall take effect immediately; provided, however, that the implementation of the provisions of section six of this act shall be subject to the appropriation of moneys specifically for the purposes thereof; and provided, further, that the amendments to section 4403-f of the public health law made by section nine of this act, shall not affect the repeal of such section and shall be deemed repealed therewith. PART B Section 1. Intentionally omitted. § 2. Subdivision 3 of section 461-l of the social services law, as added by chapter 165 of the laws of 1991, subparagraph (iii) of para- graph (a) as amended by chapter 438 of the laws of 1994, paragraphs (b), (c), (e) and (f) as amended by section 82 of part A of chapter 58 of the laws of 2010, paragraph (d) as amended by chapter 591 of the laws of 1999, paragraph (g) as amended by chapter 397 of the laws of 2012, para- graph (h) as added by section 20 of part B of chapter 58 of the laws of S. 7507--B 11 2007, paragraph (i) as amended by section 67 of part C of chapter 60 of the laws of 2014, and paragraph (j) as added by section 70 of part A of chapter 56 of the laws of 2013, is amended to read as follows: 3. Assisted living program approval. (a) An eligible applicant propos- ing to operate an assisted living program OR INCREASE THE NUMBER OF BEDS WITHIN AN EXISTING PROGRAM shall submit an application to the [depart- ment. Upon receipt, the department shall transmit a copy of the applica- tion and accompanying documents to the] department of health. [Such] TO THE EXTENT APPLICABLE, SUCH application shall be in a format and a quan- tity determined by the department OF HEALTH and shall include, but not be limited to: (i) a copy of or an application for an adult care facility operating certificate; (ii) a copy of or an application for a home care services agency license or a copy of a certificate for a certified home health agency or authorization as a long term home health care program; (iii) a copy of a proposed contract with a social services district or in a social services district with a population of one million or more, a copy of a proposed contract with the social services district or the department; (iv) if the applicant is not a long term home health care program or certified home health agency, a copy of a proposed contract with a long term home health care program or certified home health agency for the provisions of services in accordance with article thirty-six of the public health law; and (v) a detailed description of the proposed program including budget, staffing and services. (b) If the application for the proposed program includes an applica- tion for licensure as a home care service agency, the department of health shall forward the application for the proposed program and accom- panying documents to the public health and health planning council for its written approval in accordance with the provisions of section thir- ty-six hundred five of the public health law. (c) An application for an assisted living program shall not be approved unless the commissioner is satisfied as to: (i) the character, competence and standing in the community of the operator of the adult care facility; (ii) the financial responsibility of the operator of the adult care facility; (iii) that the buildings, equipment, staff, standards of care and records of the adult care facility to be employed in the operation comply with applicable law, rule and regulation; (iv) the commissioner of health is satisfied that the licensed home care agency has received the written approval of the public health and health planning council as required by paragraph (b) of this subdivision and the equipment, personnel, rules, standards of care, and home care services provided by the licensed home care agency and certified home health agency or long term home health care program are fit and adequate and will be provided in the manner required by article thirty-six of the public health law and the rules and regulations thereunder; and (v) [the commissioner and] the commissioner of health [are] IS satis- fied as to the public need for the assisted living program BEDS BEING PROPOSED AFTER GIVING CONSIDERATION TO THE SPECIFIC POPULATION BEING SERVED AND RELATIVE CONCENTRATION OF ASSISTED LIVING PROGRAM BEDS IN EXISTENCE IN THE AREA TO BE SERVED. IN APPROVING APPLICATIONS FOR S. 7507--B 12 ASSISTED LIVING PROGRAM BEDS, THE COMMISSIONER OF HEALTH SHALL GIVE PRIORITY TO APPLICANTS WHICH: (1) ARE AN EXISTING ASSISTED LIVING PROVIDER WHO IS SEEKING APPROVAL FOR LESS THAN TEN BEDS UNDER THE DEPARTMENT'S EXPEDITED REVIEW PROCESS AND WHOSE AVERAGE OCCUPANCY OVER THE PRIOR TWELVE MONTH PERIOD IS GREAT- ER THAN NINETY PERCENT; (2) ARE IN COUNTIES WHERE THERE ARE TWO OR FEWER OPERATIONAL ASSISTED LIVING PROGRAM PROVIDERS AND WHERE EXISTING PROVIDERS IN SUCH COUNTIES HAVE OCCUPANCY OVER THE PRIOR TWELVE MONTH PERIOD IN EXCESS OF EIGHTY- FIVE PERCENT; OR (3) ARE IN COUNTIES WHERE EXISTING ASSISTED LIVING PROGRAM BEDS WHICH PROVIDE SERVICES PREDOMINANTLY TO INDIVIDUALS OVER THE AGE OF SIXTY-FIVE HAVE AN AVERAGE OCCUPANCY IN EXCESS OF EIGHTY-FIVE PERCENT OVER THE PRIOR TWELVE MONTH PERIOD. (d) The department OF HEALTH shall not approve an application for an assisted living program OR AN EXPANSION OF AN EXISTING PROGRAM for any eligible applicant who does not meet the requirements of this article, including but not limited to, an eligible applicant who is already or within the past ten years has been an incorporator, director, sponsor, principal stockholder, member or owner of any adult care facility which has been issued an operating certificate by the board or the department, or of a halfway house, hostel or other residential facility or institu- tion for the care, custody or treatment of the mentally disabled which is subject to approval by an office of the department of mental hygiene, or of any residential health care facility or home care agency as defined in the public health law, unless the department, in conjunction with the department of health, finds by substantial evidence as to each such applicant that a substantially consistent high level of care has been rendered in each such facility or institution under which such person is or was affiliated. For the purposes of this paragraph, there may be a finding that a substantially consistent high level of care has been rendered despite a record of violations of applicable rules and regulations, if such violations (i) did not threaten to directly affect the health, safety or welfare of any patient or resident, and (ii) were promptly corrected and not recurrent. (e) The commissioner of health shall provide written notice of approval or disapproval of portions of the proposed application concern- ing a licensed home care agency, certified home health agency or long term home health care program, and, where applicable, of the approval or disapproval of the public health and health planning council [to the commissioner]. If an application receives all the necessary approvals, the commissioner OF HEALTH shall notify the applicant in writing. The commissioner's written approval shall constitute authorization to oper- ate an assisted living program. (f) No assisted living program may be operated without the written approval of [the department,] the department of health and, where appli- cable, the public health and health planning council. (g) Notwithstanding any other provision of law to the contrary, any assisted living program having less than seventy-five authorized bed slots, located in a county with a population of more than one hundred ten thousand and less than one hundred fifty thousand persons based upon the decennial federal census for the year two thousand, and which at any point in time is unable to accommodate individuals awaiting placement into the assisted living program, shall be authorized to increase the number of assisted living beds available for a specified period of time as part of a demonstration program by up to thirty percent of its S. 7507--B 13 approved bed level; provided, however, that such program shall otherwise satisfy all other assisted living program requirements as set forth in this section. In addition, any program which receives such authorization and which at any point on or after July first, two thousand five is unable to accommodate individuals awaiting placement into the assisted program, shall be authorized to further increase the number of assisted living beds available as part of this demonstration program by up to twenty-five percent of its bed level as of July first, two thousand five; provided, however, that such program shall otherwise satisfy all other assisted living program requirements as set forth in this section. (h) The commissioner is authorized to add one thousand five hundred assisted living program beds to the gross number of assisted living program beds having been determined to be available as of April first, two thousand seven. (i) (a) The commissioner of health is authorized to add up to six thousand assisted living program beds to the gross number of assisted living program beds having been determined to be available as of April first, two thousand nine. Nothing herein shall be interpreted as prohib- iting any eligible applicant from submitting an application for any assisted living program bed so added. The commissioner of health shall not be required to review on a comparative basis applications submitted for assisted living program beds made available under this paragraph. The commissioner of health shall only authorize the addition of six thousand beds pursuant to a seven year plan ending prior to January first, two thousand seventeen. (b) The commissioner of health shall provide an annual written report to the chair of the senate standing committee on health and the chair of the assembly health committee no later than January first of each year. Such report shall include, but not be limited to, the number of assisted living program beds made available pursuant to this section by county, the total number of assisted living program beds by county, the number of vacant assisted living program beds by county, and any other informa- tion deemed necessary and appropriate. (j) The commissioner of health is authorized to add up to four thou- sand five hundred assisted living program beds to the gross number of assisted living program beds having been determined to be available as of April first, two thousand twelve. Applicants eligible to submit an application under this paragraph shall be limited to adult homes estab- lished pursuant to section four hundred sixty-one-b of this article with, as of September first, two thousand twelve, a certified capacity of eighty beds or more in which twenty-five percent or more of the resi- dent population are persons with serious mental illness as defined in regulations promulgated by the commissioner of health. The commissioner of health shall not be required to review on a comparative basis appli- cations submitted for assisted living program beds made available under this paragraph. (K)(I) FOR PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND EIGHTEEN, THE COMMISSIONER OF HEALTH IS AUTHORIZED TO ISSUE UP TO ONE THOUSAND ASSISTED LIVING PROGRAM BEDS. APPLICANTS UNDER THIS SUBPARAGRAPH SHALL BE ABLE TO SUBMIT SUCH APPLICATIONS FOR BEDS BEGINNING NO LATER THAN SEPTEMBER FIRST, TWO THOUSAND EIGHTEEN; (II) FOR PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND TWENTY, THE COMMISSIONER OF HEALTH IS AUTHORIZED TO ISSUE UP TO AN ADDITIONAL ONE THOUSAND ASSISTED LIVING PROGRAM BEDS. APPLICANTS UNDER THIS SUBPARA- GRAPH SHALL BE ABLE TO SUBMIT SUCH APPLICATIONS FOR BEDS BEGINNING NO LATER THAN SEPTEMBER FIRST, TWO THOUSAND TWENTY; S. 7507--B 14 (III) FOR PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-TWO, THE COMMISSIONER OF HEALTH IS AUTHORIZED TO ISSUE ASSISTED LIVING PROGRAM BEDS FOR ANY ELIGIBLE APPLICANT THAT SATISFACTORILY DEMONSTRATES THE PUBLIC NEED FOR SUCH BEDS IN THE AREA TO BE SERVED AND MEETS ALL OTHER APPLICABLE REQUIREMENTS OF THIS SECTION. DEMONSTRATED PUBLIC NEED SHALL BE DETERMINED ON A CASE BY CASE BASIS WHENEVER THE COMMISSIONER IS SATISFIED PUBLIC NEED EXISTS AT THE TIME AND PLACE AND UNDER CIRCUM- STANCES PROPOSED BY THE APPLICANT; PROVIDED, HOWEVER, THE PRIOR BED AUTHORIZATIONS IN PARAGRAPHS (H), (I), AND (J) OF THIS SUBDIVISION SHALL CONTINUE IN FULL FORCE AND EFFECT. (L) NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, THE DEPARTMENT SHALL DEVELOP AN EXPEDITED REVIEW AND APPROVAL PROCESS FOR APPLICATIONS FOR UP TO NINE ADDITIONAL BEDS TO AN EXISTING ASSISTED LIVING PROGRAM QUALIFIED AS BEING IN GOOD STANDING UNDER SECTION FOUR HUNDRED SIXTY-ONE-B OF THIS ARTICLE. IN NO EVENT SHALL THE REVIEW BY THE DEPARTMENT OF HEALTH OF AN APPLICATION UNDER THE EXPEDITED APPROVAL PROCESS EXCEED NINETY DAYS. (M) THE COMMISSIONER OF HEALTH IS AUTHORIZED TO CREATE A PROGRAM TO SUBSIDIZE THE COST OF ASSISTED LIVING FOR THOSE INDIVIDUALS LIVING WITH ALZHEIMER'S DISEASE AND DEMENTIA WHO ARE NOT ELIGIBLE FOR MEDICAL ASSISTANCE PURSUANT TO TITLE ELEVEN OF ARTICLE FIVE OF THIS CHAPTER. THE PROGRAM SHALL AUTHORIZE UP TO TWO HUNDRED VOUCHERS TO INDIVIDUALS THROUGH AN APPLICATION PROCESS AND PAY FOR UP TO SEVENTY-FIVE PERCENT OF THE AVERAGE PRIVATE PAY RATE IN THE RESPECTIVE REGION. SUCH COMMISSIONER MAY PROPOSE RULES AND REGULATIONS TO EFFECTUATE THIS PROVISION. § 3. Intentionally omitted. § 4. Intentionally omitted. § 5. Clauses 11 and 12 of subparagraph (v) of paragraph (b) of subdi- vision 7 of section 4403-f of the public health law, as amended by section 48 of part A of chapter 56 of the laws of 2013, are amended and three new clauses 13, 14 and 15 are added to read as follows: (11) a person who is eligible for medical assistance pursuant to para- graph (b) of subdivision four of section three hundred sixty-six of the social services law; [and] (12) Native Americans[.]; (13) A PERSON PARTICIPATING IN A LONG TERM INPATIENT REHABILITATION PROGRAM FOR HEAD INJURED NURSING HOME RESIDENTS; (14) A PERSON PARTICIPATING IN A SPECIALIZED PROGRAM FOR NURSING HOME RESIDENTS REQUIRING BEHAVIORAL INTERVENTIONS; AND (15) A PERSON WHO IS PERMANENTLY PLACED IN A NURSING HOME FOR A CONSECUTIVE PERIOD OF THREE MONTHS OR MORE, PROVIDED HOWEVER SUCH PERSON SHALL BE NOTIFIED THEY ARE BEING DESIGNATED PERMANENTLY PLACED AND SHALL HAVE THE RIGHT TO APPEAL THEIR DESIGNATION. IMPLEMENTATION OF THIS PROVISION SHALL INCLUDE POLICIES AND PROCEDURES TO ENSURE AMERICANS WITH DISABILITIES ACT AND FEDERAL OLMSTEAD COMPLIANCE. § 5-a. Paragraph (c) of subdivision 18 of section 364-j of the social services law, as added by section 55 of part B of chapter 57 of the laws of 2015, is amended to read as follows: (c) (I) IN SETTING SUCH REIMBURSEMENT METHODOLOGIES, THE DEPARTMENT SHALL CONSIDER COSTS BORNE BY THE MANAGED CARE PROGRAM TO ENSURE THAT EACH PLAN RECEIVES ACTUARIALLY SOUND AND ADEQUATE RATES OF PAYMENT TO ENSURE QUALITY OF CARE FOR ITS ENROLLEES. 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 method- ologies used in the development of rates, to managed care providers S. 7507--B 15 thirty days prior to submission of such rates to the centers for medi- care and medicaid services for approval. Managed care providers may request additional review of the actuarial soundness of the rate setting process and/or methodology. (II) IN FULFILLING THE REQUIREMENTS OF THIS PARAGRAPH, THE DEPARTMENT OF HEALTH, IN CONSULTATION WITH THE INDEPENDENT ACTUARY, THE AFFECTED MANAGED CARE PROVIDERS AND OTHER INTERESTED PARTIES, SHALL DEVELOP AND UTILIZE STATISTICALLY VALIDATED ASSESSMENT TOOLS TO DETERMINE THE CARE NEEDS OF INDIVIDUALS ENROLLED IN MANAGED CARE PLANS, WHICH SHALL INVOLVE CONSIDERATION OF VARIABLES INCLUDING, BUT NOT LIMITED TO, PHYSICAL AND BEHAVIORAL FUNCTIONING, ACTIVITIES OF DAILY LIVING AND INSTRUMENTAL ACTIVITIES OF DAILY LIVING, AND PRIMARY OR SECONDARY DIAGNOSES OF COGNI- TIVE IMPAIRMENT OR MENTAL ILLNESS. (III) THE DEPARTMENT SHALL ESTABLISH SEPARATE RATE CELLS TO REFLECT THE COSTS OF CARE FOR SPECIFIC HIGH-NEED AND/OR HIGH-COST ENROLLEES OF MANAGED CARE PROVIDERS OPERATING ON A FULL CAPITATION BASIS AND IN MANAGED LONG TERM CARE PLANS OPERATING IN ACCORDANCE WITH THE PROVISIONS OF SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW. BY JUNE THIRTIETH, TWO THOUSAND EIGHTEEN THE COMMISSIONER SHALL SUBMIT TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES A STATE PLAN AMENDMENT OR OTHER APPROPRIATE APPROVAL OF A CAPITATED RATE WHICH INCLUDES A SEPARATE RATE CELL OR CELLS AND SHALL ALSO INCLUDE POLICIES AND PROCEDURES TO ENSURE AMERICANS WITH DISABILITIES ACT AND FEDERAL OLMSTEAD COMPLIANCE FOR COVERING THE COST OF CARE FOR EACH OF THE FOLLOWING: (A) INDIVIDUALS IN MANAGED CARE PROVIDERS OPERATING ON A FULL CAPITA- TION BASIS AND INDIVIDUALS IN MANAGED LONG TERM CARE PLANS THAT ARE EITHER ALREADY RESIDING IN A SKILLED NURSING HOME OR ARE PLACED IN A SKILLED NURSING HOME; (B) INDIVIDUALS IN MANAGED LONG TERM CARE PLANS, WHO REMAIN IN THE COMMUNITY AND WHO DAILY RECEIVE LIVE-IN OR TWELVE HOURS OR MORE OF PERSONAL CARE OR HOME HEALTH SERVICES; (C) INDIVIDUALS IN FULLY-CAPITATED PLANS WHO SATISFY THE CRITERIA FOR INCLUSION IN A HEALTH AND RECOVERY PLAN FOR PERSONS WITH SERIOUS MENTAL ILLNESS, BUT HAVE NOT BEEN ENROLLED IN SUCH A PLAN; AND (D) SUCH OTHER INDIVIDUALS WHO, BASED ON THE ASSESSMENT OF THEIR CARE NEEDS, THEIR DIAGNOSIS OR OTHER FACTORS, ARE DETERMINED TO PRESENT UNIQUELY HIGH-NEEDS AND ARE LIKELY TO GENERATE HIGH COSTS, AS MAY BE IDENTIFIED BY THE DEPARTMENT. § 5-b. The public health law is amended by adding a new section 3614-f to read as follows: § 3614-F. PAYMENTS FOR HOME AND COMMUNITY BASED LONG TERM CARE SERVICES. THE PAYMENT OF CLAIMS SUBMITTED UNDER CONTRACTS AND/OR AGREE- MENTS WITH INSURERS UNDER THE MEDICAL ASSISTANCE PROGRAM FOR HOME AND COMMUNITY BASED LONG TERM CARE SERVICES PROVIDED UNDER THIS ARTICLE AND BY FISCAL INTERMEDIARIES OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES LAW SHALL PROVIDE THAT ANY FUNDS APPROPRIATED TO COMPENSATE FOR MINIMUM WAGE PURSUANT TO SECTION SIX HUNDRED FIFTY-TWO OF THE LABOR LAW, SHALL NOT BE SUBJECT TO MANAGED CARE RISK ADJUSTMENT ON INSURERS ESTABLISHED PURSUANT TO SUBDIVISION EIGHT OF SECTION FOUR THOUSAND FOUR HUNDRED THREE-F OF THIS CHAPTER. IN ADDITION, THE DISTRIBUTION OF ANY SUCH FUNDS SHALL BE PROVIDED BY INSURERS IN AMENDMENTS TO EXISTING CONTRACTS WITH HOME AND COMMUNITY BASED LONG TERM CARE SERVICES PROVIDED UNDER THIS ARTICLE AND BY FISCAL INTERMEDIARIES OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL SERVICES LAW NINETY DAYS PRIOR TO THE EFFECTIVE DATE OF ANY SUCH LAW OR REGULATION IMPACTING WAGES. INSURERS SHALL PROVIDE SUCH FUNDS IN AN S. 7507--B 16 AMOUNT THAT SUPPLEMENTS ANY CURRENT CONTRACTS AND/OR AGREEMENTS AND SHALL NOT USE SUCH FUNDS TO SUPPLANT PAYMENTS FOR EXISTING SERVICES UNDER THE MEDICAID ASSISTANCE PROGRAM. SUCH INSURERS SHALL INCLUDE BUT NOT BE LIMITED TO MEDICAID MANAGED CARE PLANS AND MEDICAID MANAGED LONG TERM CARE PLANS. § 5-c. Section 4403-f of the public health law is amended by adding a new subdivision 11-b to read as follows: 11-B. WHERE INDIVIDUALS WITH HIGH NEEDS ARE TRANSFERRED INVOLUNTARILY BETWEEN MANAGED LONG TERM CARE PLANS, THE DEPARTMENT SHALL PROVIDE OVER- SIGHT TO ASSURE CONTINUITY OF SERVICES AND DIRECT CARE PROVIDERS. WHERE THE TRANSITION IS RELATED TO THE CLOSURE OF ACQUISITION OF A PLAN SPECIALIZING IN HIGH NEED INDIVIDUALS, THE DEPARTMENT SHALL REVIEW ANY PRIOR AUDIT TO ASCERTAIN THE APPROPRIATENESS OF SERVICES PROVIDED BY THE PLAN THAT IS CLOSING OR BEING ACQUIRED, AND SHALL PROMPTLY CONDUCT A FOLLOW-UP AUDIT OF SERVICES PROVIDED DURING THE FIRST YEAR AFTER THE CLOSURE OF ACQUISITION TO ASSURE THAT THE SERVICES PROVIDED TO SUCH INDIVIDUALS REMAIN SUBSTANTIALLY COMPARABLE TO OR GREATER THAN THOSE SERVICES THEY RECEIVED PRIOR TO THE TRANSFER. THE FOLLOW-UP AUDIT SHALL BE A PUBLIC DOCUMENT. SUCH TRANSFER SHALL NOT DIMINISH ANY OF SUCH AN INDIVIDUAL'S RIGHTS RELATING TO CONTINUITY OF CARE, UTILIZATION REVIEW, OR FAIR HEARING APPEALS. § 6. Intentionally omitted. § 7. Intentionally omitted. § 8. Intentionally omitted. § 8-a. Paragraph (e) of subdivision 1 of section 367-a of the social services law, as amended by section 41 of part D of chapter 56 of the laws of 2012, is amended to read as follows: (e) Amounts payable under this title for medical assistance in the form of clinic services pursuant to article twenty-eight of the public health law and article sixteen of the mental hygiene law provided to eligible persons diagnosed with a developmental disability OR A TRAUMAT- IC BRAIN INJURY who are also beneficiaries under part B of title XVIII of the federal social security act, or provided to persons diagnosed with a developmental disability OR A TRAUMATIC BRAIN INJURY who are qualified medicare beneficiaries under part B of title XVIII of such act shall not be less than the approved medical assistance payment level less the amount payable under part B. § 9. The commissioner of health, in consultation with the rural health council, shall conduct a study of home and community based services available to recipients of the Medicaid program in rural areas of the state. Such study shall include a review and analysis of factors affect- ing such availability, including but not limited to transportation costs, costs of direct care personnel including home health aides, personal care attendants and other direct service personnel, opportu- nities for telehealth services, and technological advances to improve efficiencies. Consistent with the results of the study, the commissioner of health is authorized to provide a targeted Medicaid rate enhancement to fee-for-service personal care rates and rates under Medicaid waiver programs such as the nursing home transition and diversion waiver and the traumatic brain injury program waiver, in an aggregate amount of three million dollars minus the cost of conducting the study; provided further, that nothing in this section shall be deemed to affect payment for the costs of the study and any related Medicaid rate enhancement if federal participation is not available for such costs. § 9-a. Section 4012 of the public health law is amended by adding a new subdivision 5 to read as follows: S. 7507--B 17 5. (A) MEDICAID PAYMENTS TO HOSPICE RESIDENCES SHALL BE IN AN AMOUNT EQUAL TO NINETY-FOUR PERCENT OF THE WEIGHTED AVERAGE MEDICAL ASSISTANCE FEE FOR SERVICE RATE REIMBURSED TO RESIDENTIAL HEALTH CARE FACILITIES LOCATED IN THE MANAGED LONG TERM CARE REGION THAT THE HOSPICE RESIDENCE IS LOCATED. SUCH AVERAGE MEDICAL ASSISTANCE RATE SHALL BE INCLUSIVE OF SPECIALTY UNITS, THE ROOM AND BOARD FURNISHED BY THE HOSPICE RESIDENCE, CASH RECEIPTS ASSESSMENTS AND THE CASE MIX OF THE RESIDENTIAL HEALTH CARE FACILITIES LOCATED IN THE MANAGED LONG TERM CARE REGION THAT SUCH HOSPICE IS LOCATED. SUCH AVERAGE MEDICAL ASSISTANCE RATE SHALL ALSO BE INCLUSIVE OF AN EFFICIENCY FACTOR OF 1.1 MULTIPLIED BY SUCH WEIGHTED AVERAGE RATE; RECRUITMENT AND RETENTION MONIES; AND ANY ADJUSTMENTS MADE FOR MINIMUM WAGE, AS SUCH ADJUSTMENTS ARE APPLIED TO THE RESIDENTIAL HEALTH CARE FACILITIES LOCATED IN THE MANAGED LONG TERM CARE REGION IN WHICH THE HOSPICE RESIDENCE IS LOCATED. (B) UNDER NO CIRCUMSTANCES SHALL THE RATES ESTABLISHED PURSUANT TO THIS SUBDIVISION BE LESS THAN THE RATES ESTABLISHED FOR HOSPICE RESI- DENCES IN EFFECT ON THE EFFECTIVE DATE OF THIS SUBDIVISION AND MANAGED CARE ORGANIZATIONS SHALL REIMBURSE HOSPICE RESIDENCES THE RATE ESTAB- LISHED PURSUANT TO THIS SUBDIVISION FOR A PERIOD OF AT LEAST FIVE YEARS FROM THE DATE HOSPICE RESIDENTS ARE TRANSITIONED TO MANAGED CARE. SUCH REIMBURSEMENT SHALL BE KNOWN AS THE HOSPICE RESIDENCE BENCHMARK RATE. § 9-b. The public health law is amended by adding a new section 3620-a to read as follows: § 3620-A. PUBLIC HEALTH PRIORITY INITIATIVE. 1. THE COMMISSIONER SHALL FACILITATE AND SUPPORT HOME CARE AGENCY ROLES WITHIN THE HEALTH CARE CONTINUUM FOR ADDRESSING PUBLIC HEALTH PRIORITIES IN THE STATE, AND PROMOTING HEALTH IMPROVEMENT AND COST SAVINGS. THE COMMISSIONER SHALL UNDERTAKE THESE PURPOSES THROUGH: INCORPORATION OF HOME CARE IN THE DEPARTMENT'S PREVENTION, PRIMARY CARE, AND PUBLIC HEALTH STRATEGIES; EDUCATION AND PROMOTION OF EVIDENCE-BASED, BEST PRACTICES THAT MAY BE ADOPTED BY HOME CARE IN PRIORITY PUBLIC HEALTH AREAS; ADOPTION OF DEPARTMENTAL POLICIES AND GUIDANCE TO ASSIST HOME CARE RESPONSE AND INTERVENTION; SUPPLEMENTAL RATE FINANCING; STAFF TRAINING; REGULATORY AND PROCEDURAL FLEXIBILITY FOR PRIORITIZATION OF PUBLIC HEALTH RESPONSE; DATA SHARING; PROMOTION OF PUBLIC HEALTH PRIORITY COLLABORATIVES WITH HOME CARE AND CONTINUUM PARTNERS; AND OTHER MEANS THE COMMISSIONER DETERMINES APPROPRIATE. EFFECTIVE APRIL FIRST, TWO THOUSAND EIGHTEEN, THE COMMISSIONER, WITH THE APPROVAL OF THE STATE BUDGET DIRECTOR, IS AUTHORIZED TO DETERMINE AND MAKE AVAILABLE FOR REINVESTMENT TO PARTIC- IPATING PROVIDERS THROUGH INCREASES IN PROVIDER REIMBURSEMENT, A PORTION OF COST SAVINGS ACHIEVED FROM SUCH PUBLIC HEALTH INITIATIVES THROUGH HOME CARE; PROVIDED, HOWEVER, PROVIDER PARTICIPATION UNDER THIS SECTION SHALL BE ON A VOLUNTARY BASIS. 2. PRIORITY PUBLIC HEALTH AREAS UNDER THIS SECTION MAY INCLUDE BUT NOT BE LIMITED TO: PUBLIC EDUCATION, SCREENING AND EARLY INTERVENTION FOR SEPSIS; MEDICATION MANAGEMENT, ESPECIALLY IN CARE TRANSITIONS AND FOR POLY-PHARMACY POPULATIONS; ASTHMA AND OTHER RESPIRATORY CONDITION MANAGEMENT AND HOME ENVIRONMENTAL ASSESSMENT; FALLS PREVENTION SCREEN- ING, EDUCATION AND PREVENTION; OPIOID MANAGEMENT AND OVERUSE OR ABUSE PREVENTION, INCLUDING ALTERNATIVES IN PAIN MANAGEMENT; CARDIOVASCULAR HEALTH; HEALTH CARE DISPARITIES; HIGH RISK PRENATAL AND POST-PARTUM CARE; PALLIATIVE CARE, AND OTHER PRIORITY AREAS IN POPULATION HEALTH WHICH THE COMMISSIONER MAY DESIGNATE. 3. IN IMPLEMENTING THIS SECTION, THE COMMISSIONER SHALL SEEK THE ADVICE OF REPRESENTATIVES OF HOME CARE PROVIDERS, STATE ASSOCIATIONS REPRESENTATIVE OF HOME CARE, STATE ASSOCIATIONS REPRESENTATIVE OF PHYSI- S. 7507--B 18 CIANS, STATE ASSOCIATION REPRESENTATIVE OF COUNTY PUBLIC HEALTH SERVICES AND OTHERS WITH HOME CARE AND/OR PUBLIC HEALTH EXPERTISE WHOM THE COMMISSIONER MAY DESIGNATE. 4. THE COMMISSIONER SHALL COLLECT AND REPORT TO THE LEGISLATURE DATA ON THE ACTIVITIES AND IMPACT OF HOME CARE PUBLIC HEALTH INITIATIVES, INCLUDING A DETERMINATION OF SYSTEM SAVINGS DERIVED/COSTS AVOIDED, AND SHALL MAKE RECOMMENDATIONS FOR FURTHER SUPPORT OF THE GOALS OF THIS SECTION. § 9-c. Notwithstanding any inconsistent provision of law, rule or regulation to the contrary, residential health care facility (RHCF) rates of payment determined pursuant to article 28 of the public health law for services provided on or after October 1, 2012, in facilities which exclusively provide extensive nursing, medical, psychological and counseling support services to children with diverse and complex medical, emotional and social problems, including long-term inpatient rehabilitation services for traumatic brain-injured children, and are located in a city with a population of one million or more shall be based on the operating rate promulgated in RHCF rate appeal number 12451 dated May 24, 2013 and as adjusted by the allowable trend factor on January 1 of each subsequent year. § 9-d. Subdivision 2-c of section 2808 of the public health law is amended by adding a new paragraph (g) to read as follows: (G) FOR PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND EIGHTEEN, CASE- MIX ADJUSTMENTS AUTHORIZED UNDER PARAGRAPH (B) OF THIS SUBDIVISION SHALL NOT BE ALTERED, MODIFIED OR ADJUSTED ON THE BASIS OF REVISED REGULATORY LIMITATIONS ON THE LEVEL OF SUCH ADJUSTMENTS OR ON REVIEWS, AUDITS OR COLLECTION OR SUBMISSION PROTOCOLS OF THE MINIMUM DATA SET; PROVIDED, HOWEVER, THAT THIS PARAGRAPH SHALL NOT APPLY TO AUDITS PERFORMED BY THE OFFICE OF THE MEDICAID INSPECTOR GENERAL NOR TO REVIEWS OR AUDITS FOR THE PURPOSES OF INVESTIGATING FRAUD OR ABUSE UNDER MEDICAID RULES AND REGULATIONS. § 9-e. Section 3612 of the public health law is amended by adding a new subdivision 8 to read as follows: 8. (A) THE DEPARTMENT, IN CONSULTATION WITH THE PUBLIC HEALTH AND PLANNING COUNCIL, SHALL CONDUCT A REVIEW OF LICENSED HOME CARE SERVICES AGENCIES. SUCH REVIEW SHALL TAKE INTO ACCOUNT CONSIDERATIONS OF ACCESS, AVAILABILITY OF WORKFORCE PERSONNEL, UNIQUE COMMUNITY NEEDS, EFFICIENCY AND AFFORDABILITY, REGIONAL NEEDS AND VARIATIONS, AN ANALYSIS OF AVERAGE NUMBER OF CONTRACTS PER PLAN BASED ON REGION, AND SUCH OTHER FACTORS AS MAY BE DETERMINED BY THE DEPARTMENT AND COUNCIL. (B) FOLLOWING THE REVIEW, THE DEPARTMENT AND THE COUNCIL SHALL BY OCTOBER FIRST, TWO THOUSAND EIGHTEEN ESTABLISH: (I) A TRANSITION PLAN DESIGNED TO LIMIT DISRUPTION TO MANAGED LONG TERM CARE PLAN ENROLLEES, PROVIDERS AND THE MANAGED LONG TERM CARE MARKET TAKING INTO CONSIDERATION REGIONAL NEEDS AND VARIATIONS; (II) SPECIFIC LIMITATIONS ON THE NUMBER OF CONTRACTS BETWEEN MANAGED LONG TERM CARE PLANS AND LICENSED HOME CARE SERVICES AGENCIES IN NASSAU COUNTY, SUFFOLK COUNTY, WESTCHESTER COUNTY AND A CITY WITH A POPULATION OF ONE MILLION OR MORE WHICH SHALL NOT EXCEED SEVENTY-FIVE CONTRACTS BY OCTOBER FIRST, TWO THOUSAND EIGHTEEN, SIXTY CONTRACTS BY OCTOBER FIRST, TWO THOUSAND NINETEEN AND FIFTY CONTRACTS BY TWO THOUSAND TWENTY; (III) PROVISIONS PERMITTING MANAGED LONG TERM CARE PLANS THAT COVER ALL REGIONS OF THE STATE TO CONTRACT WITH THE MAXIMUM ALLOWABLE NUMBER OF LICENSED HOME CARE SERVICES AGENCIES ALLOWABLE IN EACH REGION; (IV) A REQUIREMENT THAT IN APPLICABLE REGIONS, A PERCENTAGE OF MANAGED LONG TERM CARE CONTRACTS WITH LICENSED HOME CARE SERVICES AGENCIES BE S. 7507--B 19 WITH QUALIFIED QUALITY INCENTIVE VITAL ACCESS PROVIDER POOL PROVIDERS OR PROVIDERS WHO OTHERWISE DEMONSTRATE A COMMITMENT TO QUALITY; AND (V) A REQUIREMENT THAT A LICENSED HOME CARE SERVICES AGENCY THAT IS CONTRACTED TO PROVIDE FISCAL INTERMEDIARY SERVICES ON BEHALF OF A CONSUMER DIRECTED PERSONAL ASSISTANCE PROGRAM HAVE BOTH DESIGNATIONS CONSIDERED PART OF THE CONTRACT WITH THE MANAGED LONG TERM CARE PLAN. (C) THE DEPARTMENT AND THE COUNCIL SHALL ALSO REVIEW LICENSED HOME CARE SERVICES IN UPSTATE REGIONS AND PROVIDE RECOMMENDATIONS ON WHETHER PROPORTIONAL LIMITS ARE NECESSARY IN THE REGIONS. (D) THE DEPARTMENT AND THE COUNCIL SHALL ALSO PROVIDE RECOMMENDATIONS ON INCENTIVES TO ENCOURAGE CONSOLIDATION OF SUCH AGENCIES AND PLANS INCLUDING, BUT NOT LIMITED TO REGIONAL STATE FINANCIAL ASSISTANCE, AN EXPEDITED CERTIFICATE OF NEED PROCESS FOR MERGERS AND ACQUISITIONS OF LICENSED HOME CARE SERVICES AGENCIES, AND OTHER CHANGES IN THE LICENSURE OR CERTIFICATE OF NEED PROCESS TO FACILITATE THE CHANGE IN OWNERSHIP, CONTROL, MERGER OR ACQUISITIONS OF SUCH AGENCIES OR PLANS. DURING THE PERIOD OF SUCH REVIEW, THE DEPARTMENT SHALL IMPOSE A MORATORIUM ON THE APPROVALS OF ADDITIONAL LICENSED HOME CARE SERVICES AGENCIES SERVING MEDICAL ASSISTANCE BENEFICIARIES, HOWEVER, THE COMMISSIONER MAY APPROVE ADDITIONAL AGENCIES IF IT IS IN THE INTEREST OF PUBLIC HEALTH AND SAFE- TY. ALL LICENSED HOME CARE SERVICES AGENCIES LICENSED AS OF APRIL FIRST, TWO THOUSAND EIGHTEEN SHALL NOT ENGAGE IN MARKETING PRACTICES UNTIL THE REVIEW IS COMPLETE AND THE DEPARTMENT HAS SUBMITTED ITS REPORT PURSUANT TO PARAGRAPH (E) OF THIS SUBDIVISION. (E) THE DEPARTMENT SHALL REPORT TO THE GOVERNOR, THE TEMPORARY PRESI- DENT OF THE SENATE AND THE MINORITY LEADER OF THE SENATE, AND THE SPEAK- ER OF THE ASSEMBLY AND THE MINORITY LEADER OF THE ASSEMBLY ON THE RESULTS OF REVIEWS REQUIRED BY THIS SECTION BY SEPTEMBER FIRST, TWO THOUSAND EIGHTEEN. (F) NOTWITHSTANDING ANY OTHER LAW, RULE OR REGULATION NO LIMITATIONS SHALL BE IMPOSED ON THE NUMBER OF CONTRACTS BETWEEN MANAGED LONG TERM CARE PLANS LICENSED PURSUANT TO SECTION FORTY-FOUR HUNDRED THREE-F OF THIS CHAPTER AND CERTIFIED HOME HEALTH CARE AGENCIES OR LICENSED HOME CARE SERVICES AGENCIES UNTIL THE REQUIREMENTS OF PARAGRAPH (E) OF THIS SUBDIVISION ARE MET. § 9-f. Paragraph (d-2) of subdivision 3 of section 364-j of the social services law, as added by section 20-a of part B of chapter 59 of the laws of 2016, is amended to read as follows: (d-2) Services provided pursuant to waivers, granted pursuant to subsection (c) of section 1915 of the federal social security act, to persons suffering from traumatic brain injuries or qualifying for nurs- ing home diversion and transition services, shall not be provided to medical assistance recipients through managed care programs [until at least January first, two thousand eighteen] ESTABLISHED PURSUANT TO THIS SECTION, AND SHALL CONTINUE TO BE PROVIDED OUTSIDE OF MANAGED CARE PROGRAMS AND IN ACCORDANCE WITH SUCH WAIVER PROGRAMS AS THEY EXISTED ON JANUARY FIRST, TWO THOUSAND FIFTEEN; PROVIDED, FURTHER THAT THE COMMIS- SIONER OF HEALTH IS HEREBY DIRECTED TO TAKE ANY ACTION REQUIRED, INCLUD- ING BUT NOT LIMITED TO FILING WAIVERS AND WAIVER EXTENSIONS AS NECESSARY WITH THE FEDERAL GOVERNMENT, TO CONTINUE THE PROVISION OF SUCH SERVICES. § 10. This act shall take effect immediately; provided, however, that the amendments to paragraph (b) of subdivision 7 of section 4403-f of the public health law made by section five of this act shall not affect the expiration of such paragraph pursuant to subdivision (i) of section 111 of part H of chapter 59 of the laws of 2011, as amended, and shall be deemed to expire therewith; provided, further, that the amendments to S. 7507--B 20 paragraph (b) of subdivision 7 of section 4403-f of the public health law made by section five of this act and the amendments to section 4403-f of the public health law made by section five-c of this act shall not affect the repeal of such section pursuant to chapter 659 of the laws of 1997, as amended, and shall be deemed repealed therewith; provided, further, that the amendments to section 364-j of the social services law, made by section five-a and nine-f of this act shall not affect the expiration and repeal of such section and shall expire and be deemed repealed therewith. PART C Section 1. Intentionally omitted. § 2. Intentionally omitted. § 3. Subdivision 6 of section 2899 of the public health law, as amended by chapter 471 of the laws of 2016, is amended to read as follows: 6. "Provider" shall mean (A) any residential health care facility licensed under article twenty-eight of this chapter; or any certified home health agency, licensed home care services agency or long term home health care program certified under article thirty-six of this chapter; any hospice program certified pursuant to article forty of this chapter; or any adult home, enriched housing program or residence for adults licensed under article seven of the social services law; OR (B) A HEALTH HOME, OR ANY SUBCONTRACTOR OF SUCH HEALTH HOME, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT TO PROVIDE HEALTH HOME SERVICES TO ALL THOSE ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVEL- OPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWENTY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW, OR ANY ENTITY THAT PROVIDES HOME AND COMMUNITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT. § 4. Paragraph (b) of subdivision 9 of section 2899-a of the public health law, as added by chapter 331 of the laws of 2006, is amended to read as follows: (b) Residential health care facilities licensed pursuant to article twenty-eight of this chapter and certified home health care agencies and long-term home health care programs certified or approved pursuant to article thirty-six of this chapter OR A HEALTH HOME, OR ANY SUBCONTRAC- TOR OF SUCH HEALTH HOME, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT TO PROVIDE HEALTH HOME SERVICES TO ALL THOSE ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVELOPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWENTY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW, OR ANY ENTITY THAT PROVIDES HOME AND COMMUNITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT, may, subject to the availability of federal financial participation, claim as reimbursable costs under the medical assistance program, costs reflect- ing the fee established pursuant to law by the division of criminal justice services for processing a criminal history information check, the fee imposed by the federal bureau of investigation for a national criminal history check, and costs associated with obtaining the finger- S. 7507--B 21 prints, provided, however, that for the purposes of determining rates of payment pursuant to article twenty-eight of this chapter for residential health care facilities, such reimbursable fees and costs shall be reflected as timely as practicable in such rates within the applicable rate period. § 5. Subdivision 10 of section 2899-a of the public health law, as amended by chapter 206 of the laws of 2017, is amended to read as follows: 10. Notwithstanding subdivision eleven of section eight hundred forty-five-b of the executive law, a certified home health agency, licensed home care services agency or long term home health care program certified, licensed or approved under article thirty-six of this chapter or a home care services agency exempt from certification or licensure under article thirty-six of this chapter, a hospice program under arti- cle forty of this chapter, or an adult home, enriched housing program or residence for adults licensed under article seven of the social services law, OR A HEALTH HOME, OR ANY SUBCONTRACTOR OF SUCH HEALTH HOME, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT TO PROVIDE HEALTH HOME SERVICES TO ALL ENROLLEES ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVELOPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWEN- TY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW, OR ANY ENTITY THAT PROVIDES HOME AND COMMU- NITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT may temporarily approve a prospective employee while the results of the criminal history information check and the determination are pending, upon the condition that the provider conducts appropriate direct observation and evaluation of the temporary employee, while he or she is temporarily employed, and the care recipi- ent. The results of such observations shall be documented in the tempo- rary employee's personnel file and shall be maintained. For purposes of providing such appropriate direct observation and evaluation, the provider shall utilize an individual employed by such provider with a minimum of one year's experience working in an agency certified, licensed or approved under article thirty-six of this chapter or an adult home, enriched housing program or residence for adults licensed under article seven of the social services law, A HEALTH HOME, OR ANY SUBCONTRACTOR OF SUCH HEALTH HOME, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT TO PROVIDE HEALTH HOME SERVICES TO THOSE ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVELOPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWENTY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THE SOCIAL SERVICES LAW, OR ANY ENTITY THAT PROVIDES HOME AND COMMUNITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT. If the temporary employee is working under contract with another provider certified, licensed or approved under article thirty-six of this chap- ter, such contract provider's appropriate direct observation and evalu- ation of the temporary employee, shall be considered sufficient for the purposes of complying with this subdivision. § 6. Subdivision 3 of section 424-a of the social services law, as amended by section 3 of part Q of chapter 56 of the laws of 2017, is amended to read as follows: S. 7507--B 22 3. For purposes of this section, the term "provider" or "provider agency" shall mean: an authorized agency; the office of children and family services; juvenile detention facilities subject to the certif- ication of the office of children and family services; programs estab- lished pursuant to article nineteen-H of the executive law; non-residen- tial or residential programs or facilities licensed or operated by the office of mental health or the office for people with developmental disabilities except family care homes; licensed child day care centers, including head start programs which are funded pursuant to title V of the federal economic opportunity act of nineteen hundred sixty-four, as amended; early intervention service established pursuant to section twenty-five hundred forty of the public health law; preschool services established pursuant to section forty-four hundred ten of the education law; school-age child care programs; special act school districts as enumerated in chapter five hundred sixty-six of the laws of nineteen hundred sixty-seven, as amended; programs and facilities licensed by the office of alcoholism and substance abuse services; residential schools which are operated, supervised or approved by the education department; HEALTH HOMES, OR ANY SUBCONTRACT OR OF SUCH HEALTH HOMES, WHO CONTRACTS WITH OR IS APPROVED OR OTHERWISE AUTHORIZED BY THE DEPARTMENT OF HEALTH TO PROVIDE HEALTH HOME SERVICES TO ALL THOSE ENROLLED PURSUANT TO A DIAGNOSIS OF A DEVELOPMENTAL DISABILITY AS DEFINED IN SUBDIVISION TWEN- TY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW AND ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THIS CHAPTER, OR ANY ENTITY THAT PROVIDES HOME AND COMMUNITY BASED SERVICES TO ENROLLEES WHO ARE UNDER TWENTY-ONE YEARS OF AGE UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT; publicly-funded emergency shelters for families with children, provided, however, for purposes of this section, when the provider or provider agency is a publicly-funded emergency shelter for families with children, then all references in this section to the "potential for regular and substantial contact with individuals who are cared for by the agency" shall mean the potential for regular and substantial contact with children who are served by such shelter; and any other facility or provider agency, as defined in subdivision four of section four hundred eighty-eight of this chapter, in regard to the employment of staff, or use of providers of goods and services and staff of such providers, consultants, interns and volunteers. § 7. Paragraph (a) of subdivision 1 of section 413 of the social services law, as amended by section 2 of part Q of chapter 56 of the laws of 2017, is amended to read as follows: (a) The following persons and officials are required to report or cause a report to be made in accordance with this title when they have reasonable cause to suspect that a child coming before them in their professional or official capacity is an abused or maltreated child, or when they have reasonable cause to suspect that a child is an abused or maltreated child where the parent, guardian, custodian or other person legally responsible for such child comes before them in their profes- sional or official capacity and states from personal knowledge facts, conditions or circumstances which, if correct, would render the child an abused or maltreated child: any physician; registered physician assist- ant; surgeon; medical examiner; coroner; dentist; dental hygienist; osteopath; optometrist; chiropractor; podiatrist; resident; intern; psychologist; registered nurse; social worker; emergency medical techni- cian; licensed creative arts therapist; licensed marriage and family therapist; licensed mental health counselor; licensed psychoanalyst; S. 7507--B 23 licensed behavior analyst; certified behavior analyst assistant; hospi- tal personnel engaged in the admission, examination, care or treatment of persons; a Christian Science practitioner; school official, which includes but is not limited to school teacher, school guidance counse- lor, school psychologist, school social worker, school nurse, school administrator or other school personnel required to hold a teaching or administrative license or certificate; full or part-time compensated school employee required to hold a temporary coaching license or profes- sional coaching certificate; social services worker; employee of a publ- icly-funded emergency shelter for families with children; director of a children's overnight camp, summer day camp or traveling summer day camp, as such camps are defined in section thirteen hundred ninety-two of the public health law; day care center worker; school-age child care worker; provider of family or group family day care; employee or volunteer in a residential care facility for children that is licensed, certified or operated by the office of children and family services; or any other child care or foster care worker; mental health professional; substance abuse counselor; alcoholism counselor; all persons credentialed by the office of alcoholism and substance abuse services; EMPLOYEES OF A HEALTH HOME OR HEALTH HOME CARE MANAGEMENT AGENCY CONTRACTING WITH A HEALTH HOME AS DESIGNATED BY THE DEPARTMENT OF HEALTH AND AUTHORIZED UNDER SECTION THREE HUNDRED SIXTY-FIVE-L OF THIS CHAPTER OR SUCH EMPLOYEES WHO PROVIDE HOME AND COMMUNITY BASED SERVICES UNDER A DEMONSTRATION PROGRAM PURSUANT TO SECTION ELEVEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURI- TY ACT; peace officer; police officer; district attorney or assistant district attorney; investigator employed in the office of a district attorney; or other law enforcement official. § 8. Intentionally omitted. § 9. Section 364-m of the social services law is amended by adding a new subdivision 4-a to read as follows: 4-A. NOTWITHSTANDING ANY STATUTE, RULE, REGULATION, OR ADMINISTRATIVE DIRECTIVE ISSUED BY THE DEPARTMENT OF HEALTH TO THE CONTRARY, CONSISTENT WITH THE OTHER PROVISIONS OF THIS SECTION, THE COMMISSIONER OF HEALTH SHALL CONTINUE TO MAKE PAYMENTS PURSUANT TO SUBDIVISION FOUR OF THIS SECTION AT THE SAME RATES OF PAYMENT MADE DURING STATE FISCAL YEAR TWO THOUSAND SEVENTEEN. § 10. Section 2959-a of the public health law is amended by adding a new subdivision 7-a to read as follows: 7-A. NOTWITHSTANDING ANY STATUTE, RULE, REGULATION, OR ADMINISTRATIVE DIRECTIVE ISSUED BY THE DEPARTMENT TO THE CONTRARY, CONSISTENT WITH THE OTHER PROVISIONS OF THIS SECTION, THE COMMISSIONER SHALL CONTINUE TO MAKE PAYMENTS PURSUANT TO SUBDIVISION SEVEN OF THIS SECTION AT THE SAME RATES OF PAYMENT MADE DURING STATE FISCAL YEAR TWO THOUSAND SEVENTEEN. § 11. This act shall take effect immediately; provided, however, that the amendments to subdivision 6 of section 2899 of the public health law made by section three of this act shall take effect on the same date and in the same manner as section 8 of chapter 471 of the laws of 2016, as amended, takes effect and shall not affect the expiration of such subdi- vision and shall be deemed expired therewith; provided further, however, that the amendments to section 364-m of the social services law made by section nine of this act shall not affect the repeal of such section and shall be deemed repealed therewith. PART D S. 7507--B 24 Section 1. Paragraph (d) of subdivision 9 of section 367-a of the social services law, as amended by section 7 of part D of chapter 57 of the laws of 2017, is amended to read as follows: (d) In addition to the amounts paid pursuant to paragraph (b) of this subdivision, the department shall pay a professional pharmacy dispensing fee for each such drug dispensed in the amount of ten dollars AND EIGHT CENTS per prescription or written order of a practitioner; provided, however that this professional dispensing fee will not apply to drugs that are available without a prescription as required by section sixty- eight hundred ten of the education law but do not meet the definition of a covered outpatient drug pursuant to Section 1927K of the Social Secu- rity Act. § 2. Intentionally omitted. § 3. Intentionally omitted. § 4. Intentionally omitted. § 5. Intentionally omitted. § 6. Intentionally omitted. § 7. Intentionally omitted. § 8. Section 280 of the public health law, as added by section 1 of part D of chapter 57 of the laws of 2017, is amended to read as follows: § 280. Medicaid drug cap. 1. The legislature hereby finds and declares that there is a significant public interest for the Medicaid program to manage drug costs in a manner that ensures patient access while provid- ing financial stability for the state and participating providers. Since two thousand eleven, the state has taken significant steps to contain costs in the Medicaid program by imposing a statutory limit on annual growth. Drug expenditures, however, continually outpace other cost components causing significant pressure on the state, providers, and patient access operating under the Medicaid [global cap] PROGRAM. It is therefore intended that the department establish a Medicaid drug cap as a separate component within the Medicaid [global cap] PROGRAM as part of a focused and sustained effort to balance the growth of drug expendi- tures with the growth of total Medicaid expenditures. 2. The commissioner shall establish a year to year department of health [state-funds] STATE FUNDS Medicaid drug [spending] EXPENDITURE growth target as follows: (a) for state fiscal year two thousand seventeen--two thousand eigh- teen, be limited to the ten-year [rolling] average of the medical compo- nent of the consumer price index, AS PUBLISHED BY THE UNITED STATES DEPARTMENT OF LABOR, BUREAU OF STATISTICS, FOR THE TEN YEAR PERIOD ENDING SIX MONTHS PRIOR TO THE START OF THE COMING FISCAL YEAR, plus five percent and minus a pharmacy savings target of fifty-five million dollars; and (b) for state fiscal year two thousand eighteen--two thousand nine- teen, be limited to the ten-year [rolling] average of the medical compo- nent of the consumer price index, AS PUBLISHED BY THE UNITED STATES DEPARTMENT OF LABOR, BUREAU OF STATISTICS, FOR THE TEN YEAR PERIOD ENDING SIX MONTHS PRIOR TO THE START OF THE COMING FISCAL YEAR, plus four percent and minus a pharmacy savings target of eighty-five million dollars. 3. The department and the division of the budget shall assess on a quarterly basis the projected total amount to be expended in the year on a cash basis by the Medicaid program for each drug, and the projected annual amount of STATE FUNDS MEDICAID drug expenditures ON A CASH BASIS for all drugs, which shall NOT be a component of the projected depart- ment of health state funds Medicaid expenditures calculated for purposes S. 7507--B 25 of sections ninety-one and ninety-two of part H of chapter fifty-nine of the laws of two thousand eleven. For purposes of this section, state funds Medicaid drug expenditures [include] ARE THE SUM OF THE amounts expended for drugs in both the Medicaid fee-for-service PROGRAM and THE WHOLESALE ACQUISITION COST FOR DRUGS UTILIZED BY RECIPIENTS IN Medicaid managed care programs, minus the amount of any REQUIRED FEDERAL PENAL- TIES, drug rebates or supplemental drug rebates [received by] DUE TO the department, including rebates pursuant to subdivision five of this section with respect to rebate targets. THE DEPARTMENT AND THE DIVISION OF THE BUDGET SHALL REPORT QUARTERLY TO THE DRUG UTILIZATION REVIEW BOARD THE PROJECTED STATE FUNDS MEDICAID DRUG EXPENDITURES INCLUDING THE AMOUNTS, IN AGGREGATE THEREOF, ATTRIBUTABLE TO THE NET COST OF: CHANGES IN THE UTILIZATION OF DRUGS BY MEDICAID RECIPIENTS; CHANGES IN THE NUMBER OF MEDICAID RECIPIENTS; CHANGES IN THE WHOLESALE ACQUISITION COST OF NAME BRAND DRUGS AND CHANGES IN THE WHOLESALE ACQUISITION COST OF GENERIC DRUGS. THE INFORMATION CONTAINED IN THE REPORT SHALL NOT BE PUBLICLY RELEASED IN A MANNER THAT ALLOWS FOR THE IDENTIFICATION OF AN INDIVIDUAL DRUG OR MANUFACTURER OR THAT IS LIKELY TO COMPROMISE THE FINANCIAL, COMPETITIVE, OR PROPRIETARY NATURE OF THE INFORMATION. (a) In the event the director of the budget determines, based on Medi- caid drug expenditures for the previous quarter or other relevant infor- mation, that the total department of health state funds Medicaid drug expenditure is projected to exceed the annual growth limitation imposed by subdivision two of this section, the commissioner may identify and refer drugs to the drug utilization review board established by section three hundred sixty-nine-bb of the social services law for a recommenda- tion as to whether a target supplemental Medicaid rebate should be paid by the manufacturer of the drug to the department and the target amount of the rebate. (b) If the department intends to refer a drug to the drug utilization review board pursuant to paragraph (a) of this subdivision, the depart- ment shall notify the manufacturer of such drug and shall attempt to reach agreement with the manufacturer on a rebate for the drug prior to referring the drug to the drug utilization review board for review. (c) In the event that the commissioner and the manufacturer have previously agreed to a supplemental rebate for a drug pursuant to para- graph (b) of this subdivision or paragraph (e) of subdivision seven of section three hundred sixty-seven-a of the social services law, the drug shall not be referred to the drug utilization review board for any further supplemental rebate for the duration of the previous rebate agreement. (d) The department shall consider a drug's actual cost to the state, including current rebate amounts, prior to seeking an additional rebate pursuant to paragraph (b) or (c) of this subdivision and shall take into consideration whether the manufacturer of the drug is providing signif- icant discounts relative to other drugs covered by the Medicaid program. (e) The commissioner shall be authorized to take the actions described in this section only so long as total Medicaid drug expenditures are projected to exceed the annual growth limitation imposed by subdivision two of this section. 4. In determining whether to recommend a target supplemental rebate for a drug, the drug utilization review board shall consider the actual cost of the drug to the Medicaid program, including federal and state rebates, and may consider, among other things: (a) the drug's impact on the Medicaid drug spending growth target and the adequacy of capitation rates of participating Medicaid managed care S. 7507--B 26 plans, and the drug's affordability and value to the Medicaid program; or (b) significant and unjustified increases in the price of the drug; or (c) whether the drug may be priced disproportionately to its therapeu- tic benefits. 5. (a) If the drug utilization review board recommends a target rebate amount on a drug referred by the commissioner, the commissioner shall require a supplemental rebate to be paid by the drug's manufacturer in an amount not to exceed such target rebate amount. With respect to a rebate required in state fiscal year two thousand seventeen--two thou- sand eighteen, the rebate requirement shall apply beginning with the month of April, two thousand seventeen, without regard to the date the department enters into the rebate agreement with the manufacturer. (b) The supplemental rebate required by paragraph (a) of this subdivi- sion shall apply to drugs dispensed to enrollees of managed care provid- ers pursuant to section three hundred sixty-four-j of the social services law and to drugs dispensed to Medicaid recipients who are not enrollees of such providers. (c) If the drug utilization review board recommends a target rebate amount for a drug and the department is unable to negotiate a rebate from the manufacturer in an amount that is at least seventy-five percent of the target rebate amount, the commissioner is authorized to waive the provisions of paragraph (b) of subdivision three of section two hundred seventy-three of this article and the provisions of subdivisions twen- ty-five and twenty-five-a of section three hundred sixty-four-j of the social services law with respect to such drug; however, this waiver shall not be implemented in situations where it would prevent access by a Medicaid recipient to a drug which is the only treatment for a partic- ular disease or condition. Under no circumstances shall the commissioner be authorized to waive such provisions with respect to more than two drugs in a given time. (d) Where the department and a manufacturer enter into a rebate agree- ment pursuant to this section, which may be in addition to existing rebate agreements entered into by the manufacturer with respect to the same drug, no additional rebates shall be required to be paid by the manufacturer to a managed care provider or any of a managed care provid- er's agents, including but not limited to any pharmacy benefit manager, while the department is collecting the rebate pursuant to this section. (e) In formulating a recommendation concerning a target rebate amount for a drug, the drug utilization review board may consider: (i) publicly available information relevant to the pricing of the drug; (ii) information supplied by the department relevant to the pricing of the drug; (iii) information relating to value-based pricing; (iv) the seriousness and prevalence of the disease or condition that is treated by the drug; (v) the extent of utilization of the drug; (vi) the effectiveness of the drug in treating the conditions for which it is prescribed, or in improving a patient's health, quality of life, or overall health outcomes; (vii) the likelihood that use of the drug will reduce the need for other medical care, including hospitalization; (viii) the average wholesale price, wholesale acquisition cost, retail price of the drug, and the cost of the drug to the Medicaid program minus rebates received by the state; S. 7507--B 27 (ix) in the case of generic drugs, the number of pharmaceutical manufacturers that produce the drug; (x) whether there are pharmaceutical equivalents to the drug; and (xi) information supplied by the manufacturer, if any, explaining the relationship between the pricing of the drug and the cost of development of the drug and/or the therapeutic benefit of the drug, or that is otherwise pertinent to the manufacturer's pricing decision; any such information provided shall be considered confidential and shall not be disclosed by the drug utilization review board in a form that identifies a specific manufacturer or prices charged for drugs by such manufactur- er. 6. (a) If the drug utilization review board recommends a target rebate amount and the department is unsuccessful in entering into a rebate agreement with the manufacturer of the drug satisfactory to the depart- ment, the drug manufacturer shall in that event be required to provide to the department, on a standard reporting form developed by the depart- ment, the following information: (i) the actual cost of developing, manufacturing, producing (including the cost per dose of production), and distributing the drug; (ii) research and development costs of the drug, including payments to predecessor entities conducting research and development, such as biotechnology companies, universities and medical schools, and private research institutions; (iii) administrative, marketing, and advertising costs for the drug, apportioned by marketing activities that are directed to consumers, marketing activities that are directed to prescribers, and the total cost of all marketing and advertising that is directed primarily to consumers and prescribers in New York, including but not limited to prescriber detailing, copayment discount programs, and direct-to-consum- er marketing; (iv) the extent of utilization of the drug; (v) prices for the drug that are charged to purchasers outside the United States; (vi) prices charged to typical purchasers in the state, including but not limited to pharmacies, pharmacy chains, pharmacy wholesalers, or other direct purchasers; (vii) the average rebates and discounts provided per payer type in the State; and (viii) the average profit margin of each drug over the prior five-year period and the projected profit margin anticipated for such drug. (b) All information disclosed pursuant to paragraph (a) of this subdi- vision shall be considered confidential and shall not be disclosed by the department in a form that identifies a specific manufacturer or prices charged for drugs by such manufacturer. 7. (a) If, after taking into account all rebates and supplemental rebates received by the department, including rebates received to date pursuant to this section, total Medicaid drug expenditures are still projected to exceed the annual growth limitation imposed by subdivision two of this section, the commissioner of health may: subject [drugs] ANY DRUG OF A MANUFACTURER THAT THE DRUG UTILIZATION REVIEW BOARD RECOMMENDS A TARGET REBATE AMOUNT FOR THAT HAS NOT ENTERED INTO A SUPPLEMENTAL REBATE AGREEMENT REQUIRED BY THIS SECTION to prior approval in accord- ance with existing processes and procedures[, which may include all drugs of a manufacturer that has not entered into a supplemental rebate agreement required by this section]; directing managed care plans to remove from their Medicaid formularies those drugs [with respect to S. 7507--B 28 which a] THAT THE DRUG UTILIZATION REVIEW BOARD RECOMMENDS A TARGET REBATE AMOUNT FOR AND THE manufacturer has failed to enter into a rebate agreement required by this section; promoting the use of cost effective and clinically appropriate drugs other than those of a manufacturer who HAS A DRUG THAT THE DRUG UTILIZATION REVIEW BOARD RECOMMENDS A TARGET REBATE AMOUNT AND THE MANUFACTURER has failed to enter into a rebate agreement required by this section; allowing [manufacturers] A MANUFAC- TURER OF A DRUG THAT THE DRUG UTILIZATION REVIEW BOARD RECOMMENDS A TARGET REBATE AMOUNT AND THE MANUFACTURER HAS FAILED TO ENTER INTO AN AGREEMENT to accelerate rebate payments under existing rebate contracts; and such other actions as authorized by law. The commissioner shall [provide written notice to the legislature] BRING ANY SUCH RECOMMENDED ACTION BEFORE THE DRUG UTILIZATION REVIEW BOARD thirty days prior to taking action pursuant to this paragraph[, unless action is necessary in the fourth quarter of a fiscal year to prevent total Medicaid drug expenditures from exceeding the limitation imposed by subdivision two of this section, in which case such notice to the legislature may be less than thirty days]. (b) The commissioner shall be authorized to take the actions described in paragraph (a) of this subdivision only so long as total Medicaid drug expenditures are projected to exceed the annual growth limitation imposed by subdivision two of this section. In addition, no such actions shall be deemed to supersede the provisions of paragraph (b) of subdivi- sion three of section two hundred seventy-three of this article or the provisions of subdivisions twenty-five and twenty-five-a of section three hundred sixty-four-j of the social services law, except as allowed by paragraph (c) of subdivision five of this section; provided further that nothing in this section shall prevent access by a Medicaid recipi- ent to a drug which is the only treatment for a particular disease or condition. 8. THE COMMISSIONER SHALL REPORT BY FEBRUARY FIRST ANNUALLY TO THE DRUG UTILIZATION REVIEW BOARD ON SAVINGS ACHIEVED THROUGH THE DRUG CAP IN THE LAST YEAR. SUCH REPORT SHALL PROVIDE DATA ON WHAT SAVINGS WERE ACHIEVED THROUGH ACTIONS PURSUANT TO SUBSECTIONS THREE, FIVE AND SEVEN OF THIS SECTION, RESPECTIVELY, AND WHAT SAVINGS WERE ACHIEVED THROUGH OTHER MEANS AND HOW SUCH SAVINGS WERE CALCULATED AND IMPLEMENTED. § 8-a. The public health law is amended by adding a new article 2-B to read as follows: ARTICLE 2-B DRUG TAKE BACK SECTION 290. DEFINITIONS. 291. DRUG TAKE BACK. 292. COLLECTION. 293. VIOLATIONS. 294. JURISDICTION. § 290. DEFINITIONS. AS USED IN THIS ARTICLE, UNLESS THE CONTEXT CLEAR- LY REQUIRES OTHERWISE: 1. "AUTHORIZED COLLECTOR" MEANS: (A) A PERSON, COMPANY, CORPORATION OR OTHER ENTITY THAT IS REGISTERED WITH THE UNITED STATES DRUG ENFORCEMENT ADMINISTRATION TO COLLECT CONTROLLED SUBSTANCES FOR THE PURPOSES OF SAFE DISPOSAL AND DESTRUCTION; (B) A LAW ENFORCEMENT AGENCY; (C) A MUNICI- PALITY; OR (D) A PERSON, COMPANY, CORPORATION OR OTHER ENTITY AUTHORIZED BY THE DEPARTMENT TO PROVIDE ALTERNATIVE COLLECTION METHODS FOR COVERED DRUGS THAT ARE NOT CONTROLLED SUBSTANCES. 2. "COVERED DRUG" MEANS ANY SUBSTANCE RECOGNIZED AS A DRUG UNDER 21 USC § 321(G)(1), AS AMENDED, THAT IS SOLD, OFFERED FOR SALE OR DISPENSED S. 7507--B 29 IN THE STATE, WHETHER DIRECTLY OR THROUGH A WHOLESALER, IN ANY FORM INCLUDING PRESCRIPTION AND NONPRESCRIPTION DRUGS, DRUGS IN MEDICAL DEVICES AND COMBINATION PRODUCTS, BRAND AND GENERIC DRUGS AND DRUGS FOR VETERINARY USE; PROVIDED HOWEVER, COVERED DRUG SHALL NOT INCLUDE: (A) VITAMINS OR SUPPLEMENTS; (B) HERBAL-BASED REMEDIES AND HOMEOPATHIC DRUGS, PRODUCTS OR REMEDIES; (C) COSMETICS, SOAP (WITH OR WITHOUT GERMI- CIDAL AGENTS), LAUNDRY DETERGENT, BLEACH, HOUSEHOLD CLEANING PRODUCTS, SHAMPOOS, SUNSCREENS, TOOTHPASTE, LIP BALM, ANTIPERSPIRANTS OR OTHER PERSONAL CARE PRODUCTS THAT ARE REGULATED AS BOTH COSMETICS AND NONPRES- CRIPTION DRUGS UNDER THE FEDERAL FOOD, DRUG, AND COSMETIC ACT; (D) PET PESTICIDE PRODUCTS CONTAINED IN PET COLLARS, POWDERS, SHAMPOOS, TOPICAL APPLICATIONS, OR OTHER FORMS; (E) DRUGS THAT ARE BIOLOGICAL PRODUCTS AS DEFINED IN SUBDIVISION TWENTY-SEVEN OF SECTION SIXTY-EIGHT HUNDRED TWO OF THE EDUCATION LAW IF THE MANUFACTURER ALREADY PROVIDES A TAKE BACK PROGRAM; (F) DRUGS FOR WHICH A MANUFACTURER PROVIDES A TAKE BACK PROGRAM AS PART OF A FEDERAL FOOD AND DRUG ADMINISTRATION MANAGED RISK EVALU- ATION AND MITIGATION STRATEGY; (G) MEDICAL DEVICES OR THE COMPONENT PART OF SUCH DEVICES OR ACCESSORIES IF SUCH DEVICE OR COMPONENT PART CONTAINS NO COVERED DRUG; AND (H) DRUGS THAT ARE USED SOLELY IN A CLINICAL SETTING. 3. "MANUFACTURER" MEANS A PERSON, COMPANY, CORPORATION OR OTHER ENTITY ENGAGED IN THE MANUFACTURE OF DRUGS SOLD IN THE STATE. 4. "PHARMACIES" MEANS ALL PHARMACIES REGISTERED UNDER SECTION SIXTY- EIGHT HUNDRED EIGHT OF THE EDUCATION LAW THAT ARE PART OF A GROUP OF TEN OR MORE ESTABLISHMENTS THAT CONDUCT BUSINESS UNDER THE SAME NAME, OR OPERATE UNDER A COMMON OWNERSHIP OR MANAGEMENT, OR PURSUANT TO A FRAN- CHISE AGREEMENT WITH THE SAME FRANCHISOR, AND ALL NONRESIDENT PHARMACIES REGISTERED PURSUANT TO SECTION SIXTY-EIGHT HUNDRED EIGHT-B OF THE EDUCA- TION LAW THAT PROVIDE COVERED DRUGS TO STATE RESIDENTS BY MAIL. 5. "DRUG TAKE BACK ORGANIZATION" MEANS AN ORGANIZATION DESIGNATED BY A MANUFACTURER OR A GROUP OF MANUFACTURERS TO ACT AS AN AGENT ON BEHALF OF THE MANUFACTURER OR GROUP OF MANUFACTURERS TO OPERATE AND IMPLEMENT A DRUG TAKE BACK PROGRAM AS AUTHORIZED BY THIS ARTICLE. 6. "WHOLESALER" MEANS ANY PERSON, COMPANY, CORPORATION OR OTHER ENTITY THAT SELLS OR DISTRIBUTES DRUGS AND COVERED DRUGS FOR RESALE TO AN ENTI- TY IN THE STATE OTHER THAN A CONSUMER. § 291. DRUG TAKE BACK. 1. ANY MANUFACTURER OF A COVERED DRUG SHALL: (A) OPERATE A DRUG TAKE BACK PROGRAM APPROVED BY THE DEPARTMENT INDI- VIDUALLY OR JOINTLY WITH OTHER MANUFACTURERS; (B) ENTER INTO AN AGREEMENT WITH A DRUG TAKE BACK ORGANIZATION WHICH SHALL OPERATE A DRUG TAKE BACK PROGRAM APPROVED BY THE DEPARTMENT; OR (C) ENTER INTO AN AGREEMENT WITH THE DEPARTMENT TO OPERATE A DRUG TAKE BACK PROGRAM ON ITS BEHALF. 2. ANY MANUFACTURER OF A COVERED DRUG, INDIVIDUALLY OR JOINTLY, OR A DRUG TAKE BACK ORGANIZATION CONTRACTED BY A MANUFACTURER OF A COVERED DRUG SHALL WITHIN ONE HUNDRED EIGHTY DAYS FROM THE EFFECTIVE DATE OF THIS SECTION SUBMIT TO THE DEPARTMENT, IN A MANNER AND FORM DETERMINED BY THE DEPARTMENT, A PROPOSED DRUG TAKE BACK PROGRAM THAT MEETS, AT A MINIMUM, THE FOLLOWING REQUIREMENTS: (A) CERTIFIES THE DRUG TAKE BACK PROGRAM WILL ACCEPT ALL COVERED DRUGS REGARDLESS OF WHO PRODUCED THEM; (B) PROVIDES CONTACT INFORMATION FOR THE PERSON SUBMITTING THE PLANNED DRUG TAKE BACK PROGRAM WITH WHOM THE DEPARTMENT SHALL DIRECT ALL INQUIRIES; S. 7507--B 30 (C) DETAILS A PHARMACY COLLECTION SYSTEM TO PROVIDE CONVENIENT, ONGO- ING COLLECTION SERVICES TO ALL PERSONS SEEKING TO DISPOSE OF COVERED DRUGS PURSUANT TO SECTION TWO HUNDRED NINETY-TWO OF THIS ARTICLE; (D) DESCRIBES OTHER COLLECTION METHODS BY WHICH COVERED DRUGS WILL BE COLLECTED BY AUTHORIZED COLLECTORS; (E) EXPLAINS HOW COVERED DRUGS WILL BE SAFELY AND SECURELY TRACKED AND HANDLED FROM COLLECTION THROUGH FINAL DISPOSAL AND DESTRUCTION, POLICIES TO ENSURE SECURITY AND COMPLIANCE WITH ALL APPLICABLE LAWS AND REGU- LATIONS INCLUDING DISPOSAL AND DESTRUCTION AT A PERMITTED HAZARDOUS WASTE DISPOSAL FACILITY MEETING FEDERAL REQUIREMENTS; (F) DESCRIBES THE PUBLIC EDUCATION AND OUTREACH ACTIVITIES THAT WILL BE UNDERTAKEN WHICH SHALL INCLUDE ADVERTISING OF COLLECTION LOCATIONS ON A WEBSITE AND THROUGH USE OF SIGNAGE AND OTHER WRITTEN MATERIALS, AND HOW EFFECTIVENESS WILL BE EVALUATED; (G) DETAILS HOW THE COSTS OF PHARMACY COLLECTION AND OTHER AUTHORIZED COLLECTORS WILL BE REIMBURSED WHICH SHALL INCLUDE COSTS RETROACTIVE TO THE EFFECTIVE DATE OF THIS ARTICLE, AND WHERE MORE THAN ONE MANUFACTURER WILL BE INVOLVED IN THE PLANNED DRUG TAKE BACK PROGRAM, A PLAN FOR THE FAIR AND REASONABLE MANNER OF ALLOCATED COSTS AMONG THE PARTICIPANTS IN SUCH PROGRAM SUCH THAT THE COSTS PAID BY EACH MANUFACTURER IS REASONABLY RELATED TO THE NUMBER OR VALUE OF COVERED DRUGS SOLD IN THE STATE; AND (H) PROVIDES ANY FURTHER INFORMATION DEEMED APPROPRIATE BY THE DEPART- MENT. 3. WITHIN THIRTY DAYS OF THE EFFECTIVE DATE OF THIS SECTION, EACH WHOLESALER THAT SELLS COVERED DRUGS IN OR INTO THE STATE SHALL PROVIDE THE DEPARTMENT WITH A LIST OF MANUFACTURERS THAT PRODUCE COVERED DRUGS. THE DEPARTMENT MAY REQUEST UPDATED LISTS AT ITS DISCRETION. 4. A MANUFACTURER, INDIVIDUALLY OR JOINTLY, MUST PAY ALL ADMINISTRA- TIVE AND OPERATIONAL FEES ASSOCIATED WITH THE DRUG TAKE BACK PROGRAM, INCLUDING THE COST OF COLLECTING, TRANSPORTING AND DISPOSING OF COVERED DRUGS FROM PHARMACIES AND OTHER AUTHORIZED COLLECTORS AND THE RECYCLING OR DISPOSAL, OR BOTH, OF PACKING COLLECTED WITH THE COVERED DRUG. MANUFACTURERS SHALL ALSO PAY COSTS INCURRED BY THE STATE IN THE ADMINIS- TRATION AND ENFORCEMENT OF THE DRUG TAKE BACK PROGRAM. EXCLUSIVE OF FINES AND PENALTIES, THE STATE SHALL ONLY RECOVER ITS ACTUAL COST OF ADMINISTRATION AND ENFORCEMENT. IN INSTANCES WHERE MANUFACTURERS JOINTLY CONDUCT A DRUG TAKE BACK PROGRAM, THE COSTS OF ADMINISTRATION AND ENFORCEMENT SHALL BE FAIRLY AND REASONABLY ALLOCATED SUCH THAT THE PORTION OF COSTS IS REASONABLY RELATED TO THE NUMBER OR VALUE OF COVERED DRUGS THE MANUFACTURERS SELL IN THE STATE. NO MANUFACTURER MAY CHARGE A POINT-OF-SALE OR OTHER FEE TO CONSUMERS, OR A FEE THAT COULD BE PASSED ON TO CONSUMERS, TO RECOUP THE COST OF THEIR DRUG TAKE BACK PROGRAM. 5. WITHIN SIXTY DAYS OF RECEIPT OF A PROPOSED DRUG TAKE BACK PROGRAM, THE DEPARTMENT, IN CONSULTATION WITH THE DEPARTMENT OF ENVIRONMENTAL CONSERVATION, SHALL DETERMINE WHETHER SUCH PROPOSED DRUG TAKE BACK PROGRAM COMPLIES WITH THE REQUIREMENTS OF THIS ARTICLE AND NOTIFY THE APPLICANT. THE DEPARTMENT MAY CONDUCT A NOTICED PUBLIC HEARING PRIOR TO APPROVAL. IF THE DRUG TAKE BACK PROGRAM IS APPROVED, THE DEPARTMENT SHALL NOTIFY THE APPLICANT IN WRITING. IF THE DRUG TAKE BACK PROGRAM IS NOT APPROVED, THE DEPARTMENT SHALL NOTIFY THE APPLICANT IN WRITING AND THE APPLICANT SHALL SUBMIT A REVISED DRUG TAKE BACK PROGRAM PROPOSAL WITHIN THIRTY DAYS. IF THE DEPARTMENT REJECTS THE SUBSEQUENT PROPOSAL, THE MANUFACTURER OR MANUFACTURERS AT ISSUE SHALL BE OUT OF COMPLIANCE WITH THIS ARTICLE AND SUBJECT TO THE ENFORCEMENT PROVISIONS PURSUANT TO SECTION TWO HUNDRED NINETY-FOUR OF THIS ARTICLE. THE DEPARTMENT SHALL S. 7507--B 31 PROVIDE, AND UPDATE ANNUALLY, ON ITS WEBSITE A LIST OF ALL MANUFACTURERS PARTICIPATING IN A DRUG TAKE BACK PROGRAM APPROVED BY THE DEPARTMENT. 6. AT LEAST EVERY THREE YEARS, A MANUFACTURER, JOINTLY OR INDIVIDUAL- LY, OR A DRUG TAKE BACK ORGANIZATION SHALL UPDATE ITS DRUG TAKE BACK PROGRAM AND SUBMIT AN UPDATED PROPOSAL TO THE DEPARTMENT. A MANUFACTURER WHO BEGINS TO OFFER A COVERED DRUG IN THE STATE AFTER THE EFFECTIVE DATE OF THIS ARTICLE, SHALL PROVIDE EVIDENCE OF JOINING AN EXISTING APPROVED DRUG TAKE BACK PROGRAM OR SUBMIT A PROPOSAL FOR A DRUG TAKE BACK PROGRAM WITHIN NINETY DAYS FOLLOWING THE INITIAL OFFER FOR SALE OF A COVERED DRUG. ANY PROPOSED CHANGE TO A DRUG TAKE BACK PROGRAM SHALL BE SUBMITTED IN WRITING AND APPROVED BY THE DEPARTMENT PRIOR TO ANY CHANGE. 7. EACH APPROVED DRUG TAKE BACK PROGRAM SHALL REPORT TO THE DEPARTMENT AT A DATE AND MANNER SET BY THE DEPARTMENT. THE DEPARTMENT SHALL SUBMIT AN ANNUAL REPORT TO THE GOVERNOR, SPEAKER OF THE ASSEMBLY AND TEMPORARY PRESIDENT OF THE SENATE BY JANUARY FIRST DETAILING ALL PROGRAM ACTIV- ITIES, THE VOLUME COLLECTED BY EACH PROGRAM, A DESCRIPTION OF COLLECTION ACTIVITIES, THE NAME AND LOCATION OF ALL COLLECTION SITES, PUBLIC EDUCA- TION AND OUTREACH ACTIVITIES, AND ANY MANUFACTURER OUT OF COMPLIANCE OR SUBJECT TO PENALTIES PURSUANT TO SECTION TWO HUNDRED NINETY-FOUR OF THIS ARTICLE. § 292. COLLECTION. 1. ALL PHARMACIES SHALL PROVIDE FOR THE SAFE COLLECTION OF DRUGS, WHICH SHALL INCLUDE: (A) OFFERING DRUG COLLECTION BY: (I) ON-SITE COLLECTION RECEPTACLES MEETING FEDERAL STANDARDS; (II) MAIL-BACK COLLECTION BY PREPAID ENVELOPES AS AUTHORIZED BY FEDER- AL LAW AND REGULATION; OR (III) OTHER FEDERAL DRUG ENFORCEMENT AGENCY APPROVED METHODS OF COLLECTION. (B) SIGNAGE PROMINENTLY DISPLAYED ADVERTISING SUCH DRUG COLLECTION TO CONSUMERS. 2. ALL DRUG TAKE BACK PROGRAM OPERATORS SHALL NOTIFY OTHER POTENTIAL AUTHORIZED COLLECTORS OF THE OPPORTUNITY TO SERVE AS AN AUTHORIZED COLLECTOR FOR THE DRUG TAKE BACK PROGRAM. PARTICIPATION OF AUTHORIZED COLLECTORS BESIDES PHARMACIES SHALL BE VOLUNTARY. 3. ALL COSTS OF PHARMACIES AND OTHER AUTHORIZED COLLECTORS SHALL BE PAID OR REIMBURSED BY THE MANUFACTURER, JOINTLY OR INDIVIDUALLY, AS PART OF THE DRUG TAKE BACK PROGRAMS REQUIRED BY THIS ARTICLE. § 293. VIOLATIONS. VIOLATION OF THIS ARTICLE SHALL BE SUBJECT TO FINES PURSUANT TO SECTION TWELVE OF THIS CHAPTER. EACH DAY IN WHICH THE VIOLATION CONTINUES SHALL CONSTITUTE A SEPARATE VIOLATION. § 294. JURISDICTION. JURISDICTION OF ALL MATTERS PERTAINING TO DRUG DISPOSAL BY THIS ARTICLE IS VESTED EXCLUSIVELY IN THE STATE. ANY PROVISION OF ANY LOCAL LAW OR ORDINANCE, OR ANY RULE OR REGULATION PROMULGATED PRIOR TO, OR UPON THE EFFECTIVE DATE OF THIS SECTION, SHALL BE PREEMPTED. § 8-b. Section 3343-b of the public health law, as amended by chapter 379 of the laws of 2015, is amended to read as follows: § 3343-b. Safe disposal of unused controlled substances. 1. The department shall oversee a program for the safe disposal of unused controlled substances by consumers in accordance with federal law AND ARTICLE TWO-B OF THIS CHAPTER. Individual members of the public shall be authorized to voluntarily surrender controlled substances listed on schedule II, III, IV or V of section thirty-three hundred six of this article in a secure manner, without identifying themselves. Safe disposal methods shall be publicized consistent with the prescription pain medication awareness program established pursuant to section thir- S. 7507--B 32 ty-three hundred nine-a of this article AND ARTICLE TWO-B OF THIS CHAP- TER. 2. The surrender of a controlled substance pursuant to this section AND ARTICLE TWO-B OF THIS CHAPTER shall not constitute the possession, transfer or sale of such controlled substance for purposes of this arti- cle or the penal law. [3. Disposal sites shall be operated by law enforcement agencies, pharmacies and other Federal Drug Enforcement Administration authorized collectors on a voluntary basis. Nothing in this section shall require any political subdivision of the state to participate in the program established in this section.] § 8-c. The department of health may adopt regulations as necessary to implement and enforce the provisions of title 4 of the public health law. § 8-d. The public health law is amended by adding a new section 3346 to read as follows: § 3346. PRESCRIBING OPIOIDS TO MINORS. 1. AS USED IN THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS: (A) "ANOTHER ADULT AUTHORIZED TO CONSENT TO THE MINOR'S MEDICAL TREAT- MENT" MEANS AN ADULT TO WHOM A MINOR'S PARENT OR GUARDIAN HAS GIVEN WRITTEN AUTHORIZATION TO CONSENT TO THE MINOR'S MEDICAL TREATMENT; (B) "MEDICAL EMERGENCY" MEANS A SITUATION THAT IN A PRACTITIONER'S GOOD FAITH MEDICAL JUDGMENT CREATES AN IMMEDIATE THREAT OF SERIOUS RISK TO THE LIFE OR PHYSICAL HEALTH OF A MINOR; AND (C) "MINOR" MEANS AN INDIVIDUAL UNDER EIGHTEEN YEARS OF AGE WHO IS NOT EMANCIPATED. FOR PURPOSES OF THIS SECTION, AN INDIVIDUAL UNDER EIGHTEEN YEARS OF AGE IS EMANCIPATED ONLY IF THE INDIVIDUAL HAS MARRIED, HAS ENTERED THE ARMED SERVICES OF THE UNITED STATES, HAS BECOME EMPLOYED AND SELF-SUSTAINING, OR OTHERWISE HAS BECOME INDEPENDENT FROM THE CARE AND CONTROL OF THE INDIVIDUAL'S PARENT, GUARDIAN, OR CUSTODIAN. 2. EXCEPT AS PROVIDED IN SUBDIVISION THREE OF THIS SECTION, BEFORE ISSUING FOR A MINOR THE FIRST PRESCRIPTION IN A SINGLE COURSE OF TREAT- MENT FOR A PARTICULAR COMPOUND THAT IS A CONTROLLED SUBSTANCE CONTAINING AN OPIOID, REGARDLESS OF WHETHER THE DOSAGE IS MODIFIED DURING THAT COURSE OF TREATMENT, A PRACTITIONER SHALL: (I) ASSESS WHETHER THE MINOR HAS EVER SUFFERED, OR IS CURRENTLY SUFFERING, FROM MENTAL HEALTH OR SUBSTANCE ABUSE DISORDERS AND WHETHER THE MINOR HAS TAKEN OR IS CURRENTLY TAKING PRESCRIPTION DRUGS FOR TREAT- MENT OF THOSE DISORDERS; (II) DISCUSS WITH THE MINOR AND THE MINOR'S PARENT, GUARDIAN, OR ANOTHER ADULT AUTHORIZED TO CONSENT TO THE MINOR'S MEDICAL TREATMENT ALL OF THE FOLLOWING: (A) THE RISKS OF ADDICTION AND OVERDOSE ASSOCIATED WITH THE CONTROLLED SUBSTANCE CONTAINING AN OPIOID; (B) THE INCREASED RISK OF ADDICTION TO CONTROLLED SUBSTANCES OF INDI- VIDUALS SUFFERING FROM BOTH MENTAL AND SUBSTANCE ABUSE DISORDERS; (C) THE DANGERS OF TAKING CONTROLLED SUBSTANCES CONTAINING AN OPIOID WITH BENZODIAZEPINES, ALCOHOL, OR OTHER CENTRAL NERVOUS SYSTEM DEPRES- SANTS; AND (D) ANY OTHER INFORMATION IN THE PATIENT COUNSELING INFORMATION SECTION OF THE LABELING FOR CONTROLLED SUBSTANCES CONTAINING AN OPIOID REQUIRED UNDER 21 C.F.R. 201.57(C)(18); AND (III) OBTAIN WRITTEN CONSENT FOR THE PRESCRIPTION FROM THE MINOR'S PARENT, GUARDIAN, OR, SUBJECT TO SUBDIVISION FOUR OF THIS SECTION, ANOTHER ADULT AUTHORIZED TO CONSENT TO THE MINOR'S MEDICAL TREATMENT. THE PRACTITIONER SHALL RECORD THE CONSENT ON A FORM PRESCRIBED BY THE S. 7507--B 33 COMMISSIONER. THE FORM SHALL BE SEPARATE FROM ANY OTHER DOCUMENT THE PRACTITIONER USES TO OBTAIN INFORMED CONSENT FOR OTHER TREATMENT PROVIDED TO THE MINOR. THE FORM SHALL CONTAIN ALL OF THE FOLLOWING: (A) THE NAME AND QUANTITY OF THE CONTROLLED SUBSTANCE CONTAINING AN OPIOID BEING PRESCRIBED AND THE AMOUNT OF THE INITIAL DOSE; (B) A STATEMENT INDICATING THAT A CONTROLLED SUBSTANCE IS A DRUG OR OTHER SUBSTANCE THAT THE UNITED STATES DRUG ENFORCEMENT ADMINISTRATION HAS IDENTIFIED AS HAVING A POTENTIAL FOR ABUSE; (C) A STATEMENT CERTIFYING THAT THE PRACTITIONER DISCUSSED WITH THE MINOR AND THE MINOR'S PARENT, GUARDIAN, OR ANOTHER ADULT AUTHORIZED TO CONSENT TO THE MINOR'S MEDICAL TREATMENT THE MATTERS DESCRIBED IN SUBPARAGRAPH (II) OF THIS PARAGRAPH; (D) THE NUMBER OF REFILLS, IF ANY, AUTHORIZED BY THE PRESCRIPTION; AND (E) THE SIGNATURE OF THE MINOR'S PARENT, GUARDIAN, OR ANOTHER ADULT AUTHORIZED TO CONSENT TO THE MINOR'S MEDICAL TREATMENT AND THE DATE OF SIGNING. 3. THE REQUIREMENTS IN SUBDIVISION TWO OF THIS SECTION SHALL NOT APPLY: (A) IF THE MINOR'S TREATMENT WITH A CONTROLLED SUBSTANCE CONTAINING AN OPIOID IS ASSOCIATED WITH OR INCIDENT TO A MEDICAL EMERGENCY; (B) IF IN THE PRACTITIONER'S PROFESSIONAL JUDGMENT, FULFILLING THE REQUIREMENTS OF SUBDIVISION TWO OF THIS SECTION WITH RESPECT TO THE MINOR'S TREATMENT WOULD BE A DETRIMENT TO THE MINOR'S HEALTH OR SAFETY; OR (C) IN OTHER CIRCUMSTANCES DESIGNATED BY THE COMMISSIONER. 4. A SIGNED CONSENT FORM OBTAINED UNDER THIS SECTION SHALL BE MAIN- TAINED IN THE MINOR'S MEDICAL RECORD. § 8-e. Paragraph (b) of subdivision 5 of section 3331 of the public health law, as added by section 1 of part C of chapter 71 of the laws of 2016, is amended and a new paragraph (d) is added to read as follows: (b) Notwithstanding the provisions of paragraph (a) of this subdivi- sion, a practitioner, within the scope of his or her professional opin- ion or discretion, may not prescribe more than a [seven-day] THREE-DAY supply of any schedule II, III, or IV opioid to an ultimate user upon the initial consultation or treatment of such user for acute pain. Upon any subsequent consultations for the same pain, the practitioner may issue, in accordance with paragraph (a) of this subdivision, any appro- priate renewal, refill, or new prescription for the opioid or any other drug. (D) PRIOR TO ISSUING A PRESCRIPTION FOR ANY SCHEDULE II, III OR IV OPIOID TO AN ULTIMATE USER UPON THE INITIAL CONSULTATION OR TREATMENT OF SUCH USER FOR CHRONIC PAIN, THE PRACTITIONER SHALL CONSIDER THE RECOM- MENDATIONS OF THE FEDERAL CENTERS FOR DISEASE CONTROL AND PREVENTION INCLUDING BUT NOT LIMITED TO THE RECOMMENDATION THAT NONPHARMACOLOGIC THERAPY AND NONOPIOIDS PHARMACOLOGIC THERAPIES ARE PREFERRED FOR CHRONIC PAIN, AND THAT AN INITIAL OPIOID PRESCRIPTION SHOULD BE IMMEDIATE RELEASE OPIOIDS NOT EXCEEDING FIFTY MORPHINE MILLIGRAM EQUIVALENTS. § 8-f. The public health law is amended by adding a new section 3346 to read as follows: § 3346. GUIDELINES FOR PRESCRIBING OF OPIOID ANTAGONISTS. 1. THE COMMISSIONER SHALL ADOPT GUIDELINES FOR THE PRESCRIBING OF OPIOID ANTAG- ONISTS WHICH SHALL INCLUDE, BUT NOT BE LIMITED TO: (A) WHEN OPIOID ANTAGONISTS SHOULD BE PRESCRIBED TO INDIVIDUALS TO WHOM AN OPIOID MEDICATION IS ALSO PRESCRIBED, WHICH SHALL AT A MINIMUM PROVIDE FOR THE PRESCRIBING OF AN OPIOID ANTAGONIST TO ANY INDIVIDUAL S. 7507--B 34 WITH A TREATMENT PLAN THAT CONSISTS OF OPIOID USE FOR MORE THAN ONE MONTH; (B) IDENTIFYING PATIENTS AT RISK OF ANY OPIOID OVERDOSE AND WHEN PRESCRIBING AN OPIOID ANTAGONIST TO THAT PATIENT OR A PERSON IN A POSI- TION TO ADMINISTER THE OPIOID ANTAGONISTS IS APPROPRIATE; AND (C) INFORMATION ON HOW CONSUMERS CAN ACCESS OPIOID ANTAGONISTS WITH OR WITHOUT A PRESCRIPTION. 2. IN ADOPTING THESE GUIDELINES THE COMMISSIONER SHALL CONSULT WITH THE STATE BOARD OF PHARMACY AS WELL AS MATERIALS PUBLISHED BY THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION OF THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND OTHER APPROPRIATE MATERIALS INCLUDING MEDICAL JOURNALS SUBJECT TO PEER REVIEW AND PUBLICA- TIONS BY MEDICAL ASSOCIATIONS. § 8-g. Subdivision 4 of section 365-a of the social services law is amended by adding a new paragraph (h) to read as follows: (H) OPIOIDS PRESCRIBED TO A PATIENT INITIATING OR BEING MAINTAINED ON OPIOID TREATMENT FOR PAIN WHICH HAS LASTED MORE THAN ONE MONTH OR PAST THE TIME OF NORMAL TISSUE HEALING, UNLESS THE MEDICAL RECORD CONTAINS A WRITTEN TREATMENT PLAN THAT INCLUDES: GOALS FOR PAIN MANAGEMENT AND FUNCTIONAL IMPROVEMENT BASED ON DIAGNOSIS; INFORMATION ON WHETHER NON-O- PIOID THERAPIES HAVE BEEN TRIED AND OPTIMIZED OR ARE CONTRAINDICATED; A STATEMENT THAT THE PRESCRIBER HAS EXPLAINED TO THE PATIENT THE RISKS OF AND ALTERNATIVES TO OPIOID TREATMENT; AN EVALUATION OF THE PATIENT FOR RISK FACTORS OF HARM AND MISUSE OF OPIOIDS; AN ASSESSMENT OF THE PATIENT'S ADHERENCE TO TREATMENT WITH RESPECT TO OTHER CONDITIONS TREAT- ED BY THE SAME PROVIDER; THE SIGNATURE OF THE PATIENT AND/OR AN ATTESTA- TION BY THE PRESCRIBER THAT THE PATIENT VERBALLY AGREED TO THE TREATMENT PLAN; AND ANY OTHER INFORMATION REQUIRED BY THE DEPARTMENT. SUCH TREAT- MENT PLAN SHALL ALSO INCLUDE A PRESCRIPTION FOR AN OPIOID ANTAGONIST AND INFORMATION ON THE ADMINISTRATION AND USE OF SUCH OPIOID ANTAGONISTS. THE TREATMENT PLAN SHALL BE UPDATED TWICE WITHIN THE YEAR IMMEDIATELY FOLLOWING ITS INITIATION AND ANNUALLY THEREAFTER. THE REQUIREMENTS OF THIS PARAGRAPH SHALL NOT APPLY IN THE CASE OF PATIENTS WHO ARE BEING TREATED FOR CANCER THAT IS NOT IN REMISSION, WHO ARE IN HOSPICE OR OTHER END-OF-LIFE CARE, OR WHOSE PAIN IS BEING TREATED AS PART OF PALLIATIVE CARE PRACTICES. § 8-h. Section 4303 of the insurance law is amended by adding a new subsection (rr) to read as follows: (RR) EVERY CONTRACT ISSUED BY A CORPORATION SUBJECT TO THE PROVISIONS OF THIS ARTICLE WHICH PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR COMPRE- HENSIVE-TYPE COVERAGE SHALL NOT BE REQUIRED TO COVER OPIOIDS PRESCRIBED TO A PATIENT INITIATING OR BEING MAINTAINED ON OPIOID TREATMENT FOR PAIN WHICH HAS LASTED MORE THAN ONE MONTH OR PAST THE TIME OF NORMAL TISSUE HEALING, UNLESS THE MEDICAL RECORD CONTAINS A WRITTEN TREATMENT PLAN THAT INCLUDES: GOALS FOR PAIN MANAGEMENT AND FUNCTIONAL IMPROVEMENT BASED ON DIAGNOSIS; INFORMATION ON WHETHER NON-OPIOID THERAPIES HAVE BEEN TRIED AND OPTIMIZED OR ARE CONTRAINDICATED; A STATEMENT THAT THE PRESCRIBER HAS EXPLAINED TO THE PATIENT THE RISKS OF AND ALTERNATIVES TO OPIOID TREATMENT; AN EVALUATION OF THE PATIENT FOR RISK FACTORS OF HARM AND MISUSE OF OPIOIDS; AN ASSESSMENT OF THE PATIENT'S ADHERENCE TO TREATMENT WITH RESPECT TO OTHER CONDITIONS TREATED BY THE SAME PROVIDER; THE SIGNATURE OF THE PATIENT AND/OR ATTESTATION BY THE PRESCRIBER THAT THE PATIENT VERBALLY AGREED TO THE TREATMENT PLAN; AND ANY OTHER INFOR- MATION REQUIRED BY THE DEPARTMENT. SUCH TREATMENT PLAN SHALL ALSO INCLUDE A PRESCRIPTION FOR AN OPIOID ANTAGONIST AND INFORMATION ON THE ADMINISTRATION AND USE OF SUCH OPIOID ANTAGONISTS. THE TREATMENT PLAN S. 7507--B 35 SHALL BE UPDATED TWICE WITHIN THE YEAR IMMEDIATELY FOLLOWING ITS INITI- ATION AND ANNUALLY THEREAFTER. THE REQUIREMENTS OF THIS SUBSECTION SHALL NOT APPLY IN THE CASE OF PATIENTS WHO ARE BEING TREATED FOR CANCER THAT IS NOT IN REMISSION, WHO ARE IN HOSPICE OR OTHER END-OF-LIFE CARE, OR WHOSE PAIN IS BEING TREATED AS PART OF PALLIATIVE CARE PRACTICES. § 8-i. Section 3216 of the insurance law is amended by adding a new subsection (n) to read as follows: (N) NO POLICY OF ACCIDENT AND HEALTH INSURANCE DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE SHALL PROVIDE FOR REIMBURSEMENT OR COVERAGE OF OPIOIDS PRESCRIBED TO A PATIENT INITIATING OR BEING MAINTAINED ON OPIOID TREATMENT FOR PAIN WHICH HAS LASTED MORE THAN ONE MONTH OR PAST THE TIME OF NORMAL TISSUE HEALING, UNLESS THE MEDICAL RECORD CONTAINS A WRITTEN TREATMENT PLAN THAT INCLUDES: GOALS FOR PAIN MANAGEMENT AND FUNCTIONAL IMPROVEMENT BASED ON DIAGNOSIS; INFORMATION ON WHETHER NON-OPIOID THERA- PIES HAVE BEEN TRIED AND OPTIMIZED OR ARE CONTRAINDICATED; A STATEMENT THAT THE PRESCRIBER HAS EXPLAINED TO THE PATIENT THE RISKS OF AND ALTER- NATIVES TO OPIOID TREATMENT; AN EVALUATION OF THE PATIENT FOR RISK FACTORS OF HARM AND MISUSE OF OPIOIDS; AN ASSESSMENT OF THE PATIENT'S ADHERENCE TO TREATMENT WITH RESPECT TO OTHER CONDITIONS TREATED BY THE SAME PROVIDER; THE SIGNATURE OF THE PATIENT AND/OR ATTESTATION BY THE PRESCRIBER THAT THE PATIENT VERBALLY AGREED TO THE TREATMENT PLAN; AND ANY OTHER INFORMATION REQUIRED BY THE DEPARTMENT. SUCH TREATMENT PLAN SHALL ALSO INCLUDE A PRESCRIPTION FOR AN OPIOID ANTAGONIST AND INFORMA- TION ON THE ADMINISTRATION AND USE OF SUCH OPIOID ANTAGONISTS. THE TREATMENT PLAN SHALL BE UPDATED TWICE WITHIN THE YEAR IMMEDIATELY FOLLOWING ITS INITIATION AND ANNUALLY THEREAFTER. THE REQUIREMENTS OF THIS SUBSECTION SHALL NOT APPLY IN THE CASE OF PATIENTS WHO ARE BEING TREATED FOR CANCER THAT IS NOT IN REMISSION, WHO ARE IN HOSPICE OR OTHER END-OF-LIFE CARE, OR WHOSE PAIN IS BEING TREATED AS PART OF PALLIATIVE CARE PRACTICES. § 8-j. Section 3221 of the insurance law is amended by adding a new subsection (j-1) to read as follows: (J-1) NO POLICY OF GROUP OR BLANKET ACCIDENT AND HEALTH INSURANCE DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE SHALL PROVIDE FOR REIMBURSEMENT OR COVERAGE OF OPIOIDS PRESCRIBED TO A PATIENT INITIATING OR BEING MAINTAINED ON OPIOID TREATMENT FOR PAIN WHICH HAS LASTED MORE THAN ONE MONTH OR PAST THE TIME OF NORMAL TISSUE HEALING, UNLESS THE MEDICAL RECORD CONTAINS A WRITTEN TREATMENT PLAN THAT INCLUDES: GOALS FOR PAIN MANAGEMENT AND FUNCTIONAL IMPROVEMENT BASED ON DIAGNOSIS; INFORMATION ON WHETHER NON-OPIOID THERAPIES HAVE BEEN TRIED AND OPTIMIZED OR ARE CONTRAINDICATED; A STATEMENT THAT THE PRESCRIBER HAS EXPLAINED TO THE PATIENT THE RISKS OF AND ALTERNATIVES TO OPIOID TREATMENT; AN EVALUATION OF THE PATIENT FOR RISK FACTORS OF HARM AND MISUSE OF OPIOIDS; AN ASSESSMENT OF THE PATIENT'S ADHERENCE TO TREATMENT WITH RESPECT TO OTHER CONDITIONS TREATED BY THE SAME PROVIDER; THE SIGNATURE OF THE PATIENT AND/OR ATTESTATION BY THE PRESCRIBER THAT THE PATIENT VERBALLY AGREED TO THE TREATMENT PLAN; AND ANY OTHER INFOR- MATION REQUIRED BY THE DEPARTMENT. SUCH TREATMENT PLAN SHALL ALSO INCLUDE A PRESCRIPTION FOR AN OPIOID ANTAGONIST AND INFORMATION ON THE ADMINISTRATION AND USE OF SUCH OPIOID ANTAGONISTS. THE TREATMENT PLAN SHALL BE UPDATED TWICE WITHIN THE YEAR IMMEDIATELY FOLLOWING ITS INITI- ATION AND ANNUALLY THEREAFTER. THE REQUIREMENTS OF THIS SUBSECTION SHALL NOT APPLY IN THE CASE OF PATIENTS WHO ARE BEING TREATED FOR CANCER THAT IS NOT IN REMISSION, WHO ARE IN HOSPICE OR OTHER END-OF-LIFE CARE, OR WHOSE PAIN IS BEING TREATED AS PART OF PALLIATIVE CARE PRACTICES. S. 7507--B 36 § 8-k. Subparagraph (v) of paragraph (a) of subdivision 2 of section 3343-a of the public health law, as added by section 2 of part A of chapter 447 of the laws of 2012, is amended to read as follows: (v) a practitioner prescribing a controlled substance in the emergency department of a general hospital, provided that the quantity of controlled substance prescribed does not exceed a [five] THREE day supply if the controlled substance were used in accordance with the directions for use; § 8-l. The public health law is amended by adding a new section 2827 to read as follows: § 2827. OPIOID ALTERNATIVE PILOT PROJECT. THERE SHALL BE ESTABLISHED AN OPIOID ALTERNATIVE PILOT PROJECT WHEREBY THE COMMISSIONER, IN CONSUL- TATION WITH THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, SHALL IDENTIFY AT LEAST FIVE ACUTE CARE EMERGENCY DEPARTMENTS IN THE STATE TO PARTICIPATE IN THE OPIOID ALTERNATIVE PILOT PROJECT. WHILE TRADITIONALLY OPIOIDS HAVE BEEN THE PRIMARY TREATMENT FOR ACUTE PAIN IN EMERGENCY DEPARTMENTS, THEY ARE NOT ALWAYS NECESSARY OR THE MOST EFFEC- TIVE TREATMENT AND THE SIDE EFFECTS OF MISUSE AND ADDICTION CAN BE DEAD- LY. THE OPIOID ALTERNATIVE PILOT PROJECT SHALL BE DESIGNED TO REDUCE THE USE OF OPIOIDS IN EMERGENCY DEPARTMENTS BY USING A MULTIMODAL TREATMENT APPROACH TO PAIN INCLUDING COORDINATION ACROSS PROVIDERS, PHARMACIES, CLINICAL STAFF AND ADMINISTRATORS, AS WELL AS LOOKING AT NEW PROCEDURES, METHODS OF TREATMENT AND LESS ADDICTIVE ALTERNATIVES. WITHIN ONE YEAR OF THE EFFECTIVE DATE OF THIS SECTION THE PARTICIPANTS IN THE PROJECT SHALL REPORT TO THE COMMISSIONER, THE SPEAKER OF THE ASSEMBLY AND THE TEMPO- RARY PRESIDENT OF THE SENATE ON THE EFFECTIVENESS OF THE OPIOID ALTERNA- TIVE PILOT PROJECT IN REDUCING OPIOID USE AND ANY RECOMMENDATIONS FOR EXPANSIONS OF OR ALTERATIONS TO THE PROJECT. § 8-m. Paragraphs (i) and (j) of subdivision 1 of section 3371 of the public health law, as added by section 4 of part A of chapter 447 of the laws of 2012, are amended to read as follows: (i) to a medical examiner or coroner who is an officer of or employed by a state or local government, pursuant to his or her official duties; [and] (j) to an individual for the purpose of providing such individual with his or her own controlled substance history or, in appropriate circum- stances, in the case of a patient who lacks capacity to make health care decisions, a person who has legal authority to make such decisions for the patient and who would have legal access to the patient's health care records, if requested from the department pursuant to subdivision six of section thirty-three hundred forty-three-a of this article or from a treating practitioner pursuant to subparagraph (iv) of paragraph (a) of subdivision two of this section; AND (K) TO A PRACTITIONER TO INFORM HIM OR HER THAT A PATIENT IS UNDER TREATMENT FOR A CONTROLLED SUBSTANCE OVERDOSE BY HOSPITAL OR EMERGENCY ROOM PRACTITIONER FOR THE PURPOSES OF SUBDIVISION TWO OF THIS SECTION. § 8-n. Paragraph (a) of subdivision 2 of section 3371 of the public health law, as amended by chapter 90 of the laws of 2014, is amended to read as follows: (a) a practitioner, or a designee authorized by such practitioner pursuant to paragraph (b) of subdivision two of section thirty-three hundred forty-three-a or section thirty-three hundred sixty-one of this article, for the purposes of: (i) informing the practitioner that a patient may be under treatment with a controlled substance by another practitioner OR THAT A PATIENT IS UNDER TREATMENT FOR A CONTROLLED SUBSTANCE OVERDOSE; (ii) providing the practitioner with notifications S. 7507--B 37 of controlled substance activity as deemed relevant by the department, including but not limited to a notification made available on a monthly or other periodic basis through the registry of controlled substances activity pertaining to his or her patient; (iii) allowing the practi- tioner, through consultation of the prescription monitoring program registry, to review his or her patient's controlled substances history as required by section thirty-three hundred forty-three-a or section thirty-three hundred sixty-one of this article; and (iv) providing to his or her patient, or person authorized pursuant to paragraph (j) of subdivision one of this section, upon request, a copy of such patient's controlled substance history as is available to the practitioner through the prescription monitoring program registry; or § 8-o. Paragraph (a) of subdivision 2 of section 3371 of the public health law, as added by section 5 of part A of chapter 447 of the laws of 2012, is amended to read as follows: (a) a practitioner, or a designee authorized by such practitioner pursuant to paragraph (b) of subdivision two of section thirty-three hundred forty-three-a of this article, for the purposes of: (i) inform- ing the practitioner that a patient may be under treatment with a controlled substance by another practitioner OR THAT A PATIENT IS UNDER TREATMENT FOR A CONTROLLED SUBSTANCE OVERDOSE; (ii) providing the prac- titioner with notifications of controlled substance activity as deemed relevant by the department, including but not limited to a notification made available on a monthly or other periodic basis through the registry of controlled substances activity pertaining to his or her patient; (iii) allowing the practitioner, through consultation of the prescription monitoring program registry, to review his or her patient's controlled substances history as required by section thirty-three hundred forty-three-a of this article; and (iv) providing to his or her patient, or person authorized pursuant to paragraph (j) of subdivision one of this section, upon request, a copy of such patient's controlled substance history as is available to the practitioner through the prescription monitoring program registry; or § 8-p. The opening paragraph of paragraph (a) of subdivision 2 of section 3343-a of the public health law, as added by section 2 of part A of chapter 447 of the laws of 2012, is amended to read as follows: Every practitioner shall consult the prescription monitoring program registry prior to prescribing or dispensing any controlled substance listed on schedule II, III or IV of section thirty-three hundred six of this article, for the purpose of reviewing a patient's controlled substance history as set forth in such registry AND EVERY EMERGENCY ROOM OR HOSPITAL PRACTITIONER SHALL CONSULT THE PRESCRIPTION MONITORING PROGRAM REGISTRY WHEN TREATING A PATIENT FOR A CONTROLLED SUBSTANCE OVERDOSE AND SHALL NOTIFY THE PATIENT'S PRESCRIBER OF SUCH OVERDOSE; provided, however, that nothing in this section shall preclude an authorized practitioner, other than a veterinarian, from consulting the registry at his or her option prior to prescribing or dispensing any controlled substance. The duty to consult the registry shall not apply to: § 8-q. Subparagraph (iv) of paragraph (a) of subdivision 4 of section 3331 of the public health law, as added by chapter 415 of the laws of 1981, is amended to read as follows: (iv) the legend, prominently marked or printed in either boldface or upper case lettering: "CONTROLLED SUBSTANCE, DANGEROUS UNLESS USED AS DIRECTED"; PROVIDED HOWEVER, SUBSTANCES LISTED IN SUBDIVISIONS (B) AND (C) OF SCHEDULE II, SUBDIVISIONS (D) AND (E) OF SCHEDULE III, SUBDIVI- S. 7507--B 38 SIONS (B) AND (F) OF SCHEDULE IV, AND SUBDIVISION (B) OF SCHEDULE V OF SECTION 3306 OF THIS ARTICLE, SHALL BE AFFIXED WITH A RED LABEL WITH TEXT PRINTED IN A LARGE WHITE FONT TO BE EASILY AND CLEARLY READABLE, "OPIOID CONTROLLED SUBSTANCES TAKEN AS DIRECTED MAY LEAD TO ADDICTION"; § 8-r. Article 25 of the public health law is amended by adding a new title 4-A to read as follows: TITLE 4-A CHILDREN AND RECOVERING MOTHERS SECTION 2576. RECOVERING EXPECTANT MOTHERS PROGRAM. 2577. NEWBORN SCREENING. 2578. PROVIDER EDUCATION. 2579. WORKGROUP. § 2576. RECOVERING EXPECTANT MOTHERS PROGRAM. THERE SHALL BE ESTAB- LISHED A RECOVERING EXPECTANT MOTHERS PROGRAM WITHIN THE DEPARTMENT WHEREBY THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF ALCO- HOLISM AND SUBSTANCE ABUSE SERVICES, SHALL PROVIDE GUIDANCE, EDUCATION AND ASSISTANCE TO PROVIDERS CARING FOR RECOVERING EXPECTANT MOTHERS, WHICH SHALL INCLUDE, BUT NOT BE LIMITED TO: 1. ESTABLISHING, IN CONSULTATION WITH RELEVANT HEALTH CARE PROVIDERS, GUIDANCE ON UNIVERSAL SCREENING TECHNIQUES FOR SUBSTANCE USE DISORDER AT PRENATAL VISITS. SUCH GUIDANCE SHALL RELY ON VALIDATED SCREENING TOOLS AND QUESTIONNAIRES AND UTILIZE LANGUAGE TO HELP REDUCE STIGMA; 2. PROVIDING INFORMATION REGARDING USE OF MEDICATION ASSISTED TREAT- MENT FOR PREGNANT WOMEN, WHICH SHALL INCLUDE INFORMATION REGARDING BUPRENORPHRINE TRAINING, TOOLS FOR PROVIDERS ON EFFECTIVE MANAGEMENT OF WOMEN WITH OPIOID USE DISORDER IN PREGNANCY, AND A REFERRAL LIST OF CERTIFIED PROVIDERS; 3. PROVIDING REFERRAL INFORMATION FOR SUBSTANCE ABUSE COUNSELING, SOCIAL SUPPORT AND BASIC NEEDS REFERRALS, WHICH SHALL ALSO INCLUDE GUID- ANCE ON REFERRING WOMEN TO HOME VISITING SERVICES THAT THEY MAY BE ELIGIBLE FOR AFTER BIRTH; AND 4. DEVELOPING A SYSTEM FOR RAPID CONSULTATION AND REFERRAL LINKAGE SERVICES FOR OBSTETRICIANS AND PRIMARY CARE PROVIDERS STATEWIDE WHO PROVIDE CARE FOR EXPECTANT MOTHERS WITH SUBSTANCE USE DISORDER. § 2577. NEWBORN SCREENING. THE COMMISSIONER, IN CONJUNCTION WITH THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, SHALL DEVELOP GUIDANCE FOR HOSPITALS AND MIDWIFERY BIRTH CENTERS ON NEONATAL ABSTI- NENCE SYNDROME WHICH SHALL INCLUDE, BUT NOT BE LIMITED TO, APPROPRIATE TREATMENT METHODS FOR NEONATAL ABSTINENCE SYNDROME AND INFORMATION ON HOME VISITING SERVICES THAT RECOVERING MOTHERS MAY BE ELIGIBLE FOR, AS WELL AS OTHER SUBSTANCE ABUSE SERVICES, SOCIAL SUPPORTS AND BASIC NEED REFERRALS IN THE COMMUNITY. § 2578. PROVIDER EDUCATION. THE COMMISSIONER SHALL DEVELOP OR APPROVE A CONTINUING MEDICAL EDUCATION COURSE FOR NEONATAL NURSES, OBSTETRI- CIANS, MIDWIVES, PEDIATRICIANS, AND OTHER HEALTH CARE PROVIDERS REGARD- ING TREATMENT OF EXPECTANT MOTHERS AND NEW MOTHERS SUFFERING FROM SUBSTANCE USE DISORDER, AND THE TREATMENT OF NEWBORNS SUFFERING FROM NEONATAL ABSTINENCE SYNDROME, WHICH MAY INCLUDE FEDERALLY APPROVED BUPRENORPHINE TRAINING, IN ORDER TO FACILITATE COMPREHENSIVE PRENATAL AND POSTPARTUM CARE TO THIS POPULATION. § 2579. WORKGROUP. THE COMMISSIONER, IN CONJUNCTION WITH THE COMMIS- SIONER OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, SHALL CONVENE A WORK- GROUP OF STAKEHOLDERS, INCLUDING BUT NOT LIMITED TO, HOSPITALS, LOCAL HEALTH DEPARTMENTS, OBSTETRICIANS, MIDWIVES, PEDIATRICIANS, AND SUBSTANCE ABUSE PROVIDERS TO STUDY AND EVALUATE CURRENT BARRIERS AND CHALLENGES IN IDENTIFYING AND TREATING EXPECTANT MOTHERS, NEWBORNS, AND S. 7507--B 39 NEW PARENTS WITH SUBSTANCE USE DISORDER. THE WORKGROUP SHALL REPORT ON ITS FINDINGS AND RECOMMENDATIONS TO THE COMMISSIONER, THE SPEAKER OF THE ASSEMBLY AND THE TEMPORARY PRESIDENT OF THE SENATE WITHIN ONE YEAR OF THE EFFECTIVE DATE OF THIS SECTION. § 8-s. Title 1 of article 25 of the public health law is amended by adding a new section 2509 to read as follows: § 2509. INFANT RECOVERY CENTERS PILOT PROGRAM. THERE SHALL BE ESTAB- LISHED AN INFANT RECOVERY CENTERS PILOT PROGRAM WHEREBY THE COMMISSION- ER, IN CONSULTATION WITH THE COMMISSIONER OF ALCOHOL AND SUBSTANCE ABUSE SERVICES, SHALL ESTABLISH AT LEAST FOUR INFANT RECOVERY CENTERS IN AREAS OF NEED IN THE STATE. SUCH CENTERS SHALL PROVIDE COST EFFECTIVE, NECES- SARY SERVICES AND ENHANCE THE QUALITY OF CARE FOR TARGETED POPULATIONS IN ORDER TO DEMONSTRATE THE EFFECTIVENESS OF SUCH PROGRAM. ELIGIBLE INFANTS SHALL BE UNDER ONE YEAR OF AGE AND SUFFER FROM WITHDRAWAL RESULTING FROM IN UTERO EXPOSURE TO DRUGS. SUCH INFANT WITHDRAWAL MAY BE THE RESULT OF CONDITIONS INCLUDING, BUT NOT LIMITED TO, NEONATAL ABSTI- NENCE SYNDROME. THE PROGRAM SHALL PROVIDE MORE APPROPRIATE SETTINGS AND COST EFFECTIVE CARE FOR THESE INFANTS THAN HOSPITALS, WHILE ALSO PROVID- ING SUPPORTS AND SERVICES TO PARENTS PREPARING TO BRING THEIR INFANTS HOME. ACCESS TO SUCH SUPPORTS SHALL CONTINUE FOR A PERIOD AFTER THE INFANT HAS LEFT A CENTER. THE DEPARTMENT SHALL BE RESPONSIBLE FOR MONITORING THE QUALITY, APPRO- PRIATENESS AND EFFECTIVENESS OF THE CENTERS AND SHALL REPORT TO THE LEGISLATURE WITHIN ONE YEAR OF THE ESTABLISHMENT OF THE INFANT RECOVERY CENTERS AND AGAIN WITHIN TWO YEARS OF THE EFFECTIVE DATE OF THIS SECTION ON THE PROGRAM'S EFFECTIVENESS. § 8-t. Subdivision (a) of section 2500-a of the public health law, as amended by chapter 184 of the laws of 2013, is amended to read as follows: (a) It shall be the duty of the administrative officer or other person in charge of each institution caring for infants twenty-eight days or less of age and the person required in pursuance of the provisions of section forty-one hundred thirty of this chapter to register the birth of a child, to cause to have administered to every such infant or child in its or his care a test for phenylketonuria, homozygous sickle cell disease, hypothyroidism, branched-chain ketonuria, galactosemia, homo- cystinuria, critical congenital heart defects through pulse oximetry screening, NEONATAL ABSTINENCE SYNDROME, and such other diseases and conditions as may from time to time be designated by the commissioner in accordance with rules or regulations prescribed by the commissioner. Testing, the recording of the results of such tests, tracking, follow-up reviews and educational activities shall be performed at such times and in such manner as may be prescribed by the commissioner. The commission- er shall promulgate regulations setting forth the manner in which infor- mation describing the purposes of the requirements of this section shall be disseminated to parents or a guardian of the infant tested. § 8-u. Subparagraph (A) of paragraph 31 of subsection (i) of section 3216 of the insurance law, as added by chapter 41 of the laws of 2014, is amended to read as follows: (A) Every policy that provides medical, major medical or similar comprehensive-type coverage must provide outpatient coverage for the diagnosis and treatment of substance use disorder, including detoxifica- tion and rehabilitation services. Such coverage shall not BE SUBJECT TO PRIOR AUTHORIZATION AND SHALL NOT apply financial requirements or treat- ment limitations to outpatient substance use disorder benefits that are more restrictive than the predominant financial requirements and treat- S. 7507--B 40 ment limitations applied to substantially all medical and surgical bene- fits covered by the policy. Further, such coverage shall be provided consistent with the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a). § 8-v. Subparagraph (A) of paragraph 7 of subsection (1) of section 3221 of the insurance law, as amended by chapter 41 of the laws of 2014, is amended to read as follows: (A) Every policy that provides medical, major medical or similar comprehensive-type coverage must provide outpatient coverage for the diagnosis and treatment of substance use disorder, including detoxifica- tion and rehabilitation services. Such coverage shall not BE SUBJECT TO PRIOR AUTHORIZATION AND SHALL NOT apply financial requirements or treat- ment limitations to outpatient substance use disorder benefits that are more restrictive than the predominant financial requirements and treat- ment limitations applied to substantially all medical and surgical bene- fits covered by the policy. Further, such coverage shall be provided consistent with the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a). § 8-w. Paragraph 1 of subsection (l) of section 4303 of the insurance law, as amended by chapter 41 of the laws of 2014, is amended to read as follows: (1) Every contract that provides medical, major medical or similar comprehensive-type coverage must provide outpatient coverage for the diagnosis and treatment of substance use disorder, including detoxifica- tion and rehabilitation services. Such coverage shall not BE SUBJECT TO PRIOR AUTHORIZATION AND SHALL NOT apply financial requirements or treat- ment limitations to outpatient substance use disorder benefits that are more restrictive than the predominant financial requirements and treat- ment limitations applied to substantially all medical and surgical bene- fits covered by the contract. Further, such coverage shall be provided consistent with the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a). § 8-x. The mental hygiene law is amended by adding a new section 7.46 to read as follows: § 7.46 OPERATING CERTIFICATES. (A) THE COMMISSIONER OR THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES SHALL NOT DENY AN OPERATING CERTIFICATE PURSUANT TO SECTION 31.02 OR 32.05 OF THIS CHAPTER TO A FACILITY PROVID- ING OUT-PATIENT OR NON-RESIDENTIAL SERVICES FOR THE MENTALLY DISABLED OR INDIVIDUALS SUFFERING FROM CHEMICAL ABUSE OR DEPENDENCE THAT INCLUDES A PHARMACY WITHIN THE FACILITY, PROVIDED THAT THE PHARMACY: (1) CONFORMS WITH PARAGRAPH G OF SUBDIVISION TWO OF SECTION SIXTY- EIGHT HUNDRED EIGHT OF THE EDUCATION LAW; (2) IS NOT OPERATED BY THE FACILITY; (3) DOES NOT SHARE REVENUE OF THE PHARMACY WITH THE FACILITY; AND (4) DOES NOT REQUIRE OR OTHERWISE COERCE PATIENTS TO UTILIZE SUCH PHARMACY. (B) FURTHERMORE, PATIENTS, CLINIC STAFF AND OTHER INDIVIDUALS MAY TRAVERSE THE COMMON WAITING AREA WITHIN THE CLINIC SPACE TO ACCESS SUCH PHARMACY, AND THE PHARMACY NEED NOT HAVE A SEPARATE PUBLIC ENTRANCE LEADING FROM OUTSIDE OF THE BUILDING TO SUCH PHARMACY. NOTHING IN THIS SUBDIVISION SHALL PREVENT THE FACILITY FROM COLLECTING RENT FROM THE OPERATOR OF SUCH PHARMACY IF SUCH PHARMACY IS LEASING SPACE FROM THE FACILITY. S. 7507--B 41 § 8-y. Paragraphs g and h of subdivision 2 of section 6808 of the education law are relettered paragraphs h and i and a new paragraph g is added to read as follows: G. A PHARMACY WITHIN A FACILITY PROVIDING OUT-PATIENT OR NON-RESIDEN- TIAL SERVICES FOR THE MENTALLY DISABLED OR INDIVIDUALS SUFFERING FROM CHEMICAL ABUSE OR DEPENDENCE. WHEN A PHARMACY IS OPERATED WITHIN A FACILITY PROVIDING OUT-PATIENT OR NON-RESIDENTIAL SERVICES FOR THE MENTALLY DISABLED OR INDIVIDUALS SUFFERING FROM CHEMICAL ABUSE OR DEPENDENCE UNDER AN OPERATING CERTIFICATE ISSUED BY THE COMMISSIONERS OF THE OFFICE OF MENTAL HEALTH OR THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES PURSUANT TO SECTION 31.02 OR 32.05 OF THE MENTAL HYGIENE LAW, THE AREA COMPROMISING THE PHARMACY SHALL BE SECURED, PREVENTING UNAUTHORIZED ACCESS TO THE PHARMACY AND DRUGS WHEN A PHARMACIST IS NOT ON DUTY. IDENTIFICATION OF THE AREA WITHIN THE PHARMACY BY USE OF THE WORDS "DRUGS", "MEDICINES", "DRUG STORE", OR "PHARMACY" OR SIMILAR TERMS SHALL BE RESTRICTED TO THE AREA LICENSED BY THE DEPARTMENT AS A PHARMA- CY. PATIENTS, CLINIC STAFF AND OTHER INDIVIDUALS MAY TRAVERSE THE COMMON WAITING AREA WITHIN THE CLINIC SPACE TO ACCESS SUCH PHARMACY, AND SUCH PHARMACY NEED NOT HAVE A SEPARATE PUBLIC ENTRANCE LEADING FROM OUTSIDE OF THE BUILDING TO SUCH PHARMACY. § 8-z. Intentionally omitted. § 8-aa. The public health law is amended by adding a new section 280-c to read as follows: § 280-C. PHARMACY AUDITS BY PHARMACY BENEFIT MANAGERS. 1. DEFI- NITIONS. AS USED IN THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS: (A) "PHARMACY BENEFIT MANAGER" SHALL HAVE THE SAME MEANING AS IN SECTION TWO HUNDRED EIGHTY-A OF THIS ARTICLE. (B) "PHARMACY" SHALL MEAN A PHARMACY THAT HAS CONTRACTED WITH A PHAR- MACY BENEFIT MANAGER FOR THE PROVISION OF PHARMACY SERVICES. 2. WHEN CONDUCTING AN AUDIT OF A PHARMACY'S RECORDS, A PHARMACY BENE- FIT MANAGER SHALL: (A) NOT CONDUCT AN ON-SITE AUDIT OF A PHARMACY AT ANY TIME DURING THE FIRST THREE CALENDAR DAYS OF A MONTH; (B) NOTIFY THE PHARMACY OR ITS CONTRACTING AGENT NO LATER THAN FIFTEEN DAYS BEFORE THE DATE OF INITIAL ON-SITE AUDIT. SUCH NOTIFICATION TO THE PHARMACY OR ITS CONTRACTING AGENT SHALL BE IN WRITING DELIVERED EITHER (I) BY MAIL OR COMMON CARRIER, RETURN RECEIPT REQUESTED, OR (II) ELEC- TRONICALLY WITH ELECTRONIC RECEIPT CONFIRMATION, ADDRESSED TO THE SUPER- VISING PHARMACIST OF RECORD AND PHARMACY CORPORATE OFFICE WHERE APPLICA- BLE, AT LEAST FIFTEEN DAYS BEFORE THE DATE OF AN INITIAL ON-SITE AUDIT; (C) LIMIT THE AUDIT PERIOD TO TWENTY-FOUR MONTHS AFTER THE DATE A CLAIM IS SUBMITTED TO OR ADJUDICATED BY THE PHARMACY BENEFIT MANAGER; (D) INCLUDE IN THE WRITTEN ADVANCE NOTICE OF AN ON-SITE AUDIT THE LIST OF SPECIFIC PRESCRIPTION NUMBERS TO BE INCLUDED IN THE AUDIT THAT MAY OR MAY NOT INCLUDE THE FINAL TWO DIGITS OF THE PRESCRIPTION NUMBERS; (E) USE THE WRITTEN AND VERIFIABLE RECORDS OF A HOSPITAL, PHYSICIAN OR OTHER AUTHORIZED PRACTITIONER, WHICH ARE TRANSMITTED BY ANY MEANS OF COMMUNICATION, TO VALIDATE THE PHARMACY RECORDS IN ACCORDANCE WITH STATE AND FEDERAL LAW; (F) LIMIT THE NUMBER OF PRESCRIPTIONS AUDITED TO NO MORE THAN ONE HUNDRED RANDOMLY SELECTED IN A TWELVE-MONTH PERIOD, EXCEPT IN CASES OF FRAUD; (G) PROVIDE THE PHARMACY OR ITS CONTRACTING AGENT WITH A COPY OF THE PRELIMINARY AUDIT REPORT WITHIN FORTY-FIVE DAYS AFTER THE CONCLUSION OF THE AUDIT; S. 7507--B 42 (H) BE ALLOWED TO CONDUCT A FOLLOW-UP AUDIT ON-SITE IF A REMOTE OR DESK AUDIT REVEALS THE NECESSITY FOR A REVIEW OF ADDITIONAL CLAIMS; (I) IN THE CASE OF INVOICE AUDITS, ACCEPT AS VALIDATION INVOICES FROM ANY WHOLESALER REGISTERED WITH THE DEPARTMENT OF EDUCATION FROM WHICH THE PHARMACY HAS PURCHASED PRESCRIPTION DRUGS OR, IN THE CASE OF DURABLE MEDICAL EQUIPMENT OR SICKROOM SUPPLIES, INVOICES FROM AN AUTHORIZED DISTRIBUTOR OTHER THAN A WHOLESALER; (J) PROVIDE THE PHARMACY OR ITS CONTRACTING AGENT WITH THE ABILITY TO PROVIDE DOCUMENTATION TO ADDRESS A DISCREPANCY OR AUDIT FINDING, PROVIDED THAT SUCH DOCUMENTATION MUST BE RECEIVED BY THE PHARMACY BENE- FIT MANAGER NO LATER THAN THE FORTY-FIFTH DAY AFTER THE PRELIMINARY AUDIT REPORT WAS PROVIDED TO THE PHARMACY OR ITS CONTRACTING AGENT. THE PHARMACY BENEFIT MANAGER SHALL CONSIDER A REASONABLE REQUEST FROM THE PHARMACY FOR AN EXTENSION OF TIME TO SUBMIT DOCUMENTATION TO ADDRESS OR CORRECT ANY FINDINGS IN THE REPORT; AND (K) PROVIDE THE PHARMACY OR ITS CONTRACTING AGENT WITH THE FINAL AUDIT REPORT NO LATER THAN SIXTY DAYS AFTER THE INITIAL AUDIT REPORT WAS PROVIDED TO THE PHARMACY OR ITS CONTRACTING AGENT. 3. ANY CLAIM THAT WAS RETROACTIVELY DENIED FOR A CLERICAL ERROR, TYPO- GRAPHICAL ERROR, SCRIVENER'S ERROR OR COMPUTER ERROR SHALL BE PAID IF THE PRESCRIPTION WAS PROPERLY AND CORRECTLY DISPENSED, UNLESS A PATTERN OF SUCH ERRORS EXISTS, FRAUDULENT BILLING IS ALLEGED OR THE ERROR RESULTS IN ACTUAL FINANCIAL LOSS TO THE ENTITY. A CLERICAL ERROR IS AN ERROR THAT DOES NOT RESULT IN ACTUAL FINANCIAL HARM TO THE COVERED ENTI- TY OR CONSUMER AND DOES NOT INCLUDE THE DISPENSING OF AN INCORRECT DOSE, AMOUNT OR TYPE OF MEDICATION OR DISPENSING A PRESCRIPTION DRUG TO THE WRONG PERSON. 4. THIS SECTION SHALL NOT APPLY TO: (A) AUDITS IN WHICH SUSPECTED FRAUDULENT ACTIVITY OR OTHER INTENTIONAL OR WILLFUL MISREPRESENTATION IS EVIDENCED BY A PHYSICAL REVIEW, REVIEW OF CLAIMS DATA OR STATEMENTS, OR OTHER INVESTIGATIVE METHODS; OR (B) AUDITS OF CLAIMS PAID FOR BY FEDERALLY FUNDED PROGRAMS; OR (C) CONCURRENT REVIEWS OR DESK AUDITS THAT OCCUR WITHIN THREE BUSINESS DAYS OF TRANSMISSION OF A CLAIM AND WHERE NO CHARGEBACK OR RECOUPMENT IS DEMANDED. § 8-bb. Section 280-a of the public health law is amended by adding two new subdivisions 3 and 4 to read as follows: 3. NO PHARMACY BENEFIT MANAGER SHALL, WITH RESPECT TO CONTRACTS BETWEEN SUCH PHARMACY BENEFIT MANAGER AND A PHARMACY OR, ALTERNATIVELY, SUCH PHARMACY BENEFIT MANAGER AND A PHARMACY'S CONTRACTING AGENT, SUCH AS A PHARMACY SERVICES ADMINISTRATIVE ORGANIZATION: (A) PROHIBIT OR PENALIZE A PHARMACIST OR PHARMACY FROM DISCLOSING TO AN INDIVIDUAL PURCHASING A PRESCRIPTION MEDICATION INFORMATION REGARD- ING: (1) THE COST OF THE PRESCRIPTION MEDICATION TO THE INDIVIDUAL, OR (2) THE AVAILABILITY OF ANY THERAPEUTICALLY EQUIVALENT ALTERNATIVE MEDICATIONS OR ALTERNATIVE METHODS OF PURCHASING THE PRESCRIPTION MEDI- CATION, INCLUDING BUT NOT LIMITED TO, PAYING A CASH PRICE; OR (B) CHARGE OR COLLECT FROM AN INDIVIDUAL A COPAYMENT THAT EXCEEDS THE TOTAL SUBMITTED CHARGES BY THE PHARMACY FOR WHICH THE PHARMACY IS PAID. IF AN INDIVIDUAL PAYS A COPAYMENT, THE PHARMACY SHALL RETAIN THE ADJUDI- CATED COSTS AND THE PHARMACY BENEFIT MANAGER SHALL NOT REDACT OR RECOUP THE ADJUDICATED COST. 4. ANY PROVISION OF A CONTRACT THAT VIOLATES THE PROVISIONS OF THIS SECTION SHALL BE DEEMED TO BE VOID AND UNENFORCEABLE. § 8-cc. Intentionally omitted. S. 7507--B 43 § 8-dd. Intentionally omitted. § 8-ee. Intentionally omitted. § 8-ff. Intentionally omitted. § 8-gg. Intentionally omitted. § 8-hh. Intentionally omitted. § 9. This act shall take effect immediately; provided, however, that: (a) the amendments to paragraph (d) of subdivision 9 of section 367-a of the social services law made by section one of this act shall not affect the expiration of such subdivision and shall expire therewith; (b) the amendments to subdivision 1 of section 292 of the public health law, as added by section eight-a of this act, shall take effect on the one hundred eightieth day after it shall have become a law; (c) the provisions of sections eight-d, eight-e, eight-f, eight-g, eight-k, eight-l, eight-r, and eight-bb of this act shall take effect on the ninetieth day after it shall have become a law; (d) sections eight-h, eight-i and eight-j of this act shall take effect on the first of January next succeeding the date on which this act shall have become a law and shall apply to all policies issued, modified or renewed on and after such date; (e) the amendments to paragraph (a) of subdivision 2 of section 3371 of the public health law, as amended by section eight-n of this act shall be subject to the expiration and reversion of such subdivision pursuant to section 12 of chapter 90 of the laws of 2014, as amended, when upon such date the provisions of section eight-o of this act shall take effect; (f) sections eight-q and eight-t of this act shall take effect on the one hundred eightieth day after it shall have become a law; (g) the provisions of section eight-s of this act shall expire and be deemed repealed 4 years after such date; (h) the provisions of section eight-t of this act shall expire and be deemed repealed on March 31, 2023; (i) the provisions of sections eight-u, eight-v, and eight-w of this act shall apply to policies and contracts issued, renewed, modified, altered or amended on or after such date; (j) the provisions of section eight-aa of this act shall take effect on the sixtieth day after it shall have become a law; and (k) effective immediately, the addition, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized to be made and completed on or before such effective date. PART E Section 1. Subdivision 4 of section 365-h of the social services law, as separately amended by section 50 of part B and section 24 of part D of chapter 57 of the laws of 2015, is amended to read as follows: 4. The commissioner of health is authorized to assume responsibility from a local social services official for the provision and reimburse- ment of transportation costs under this section. If the commissioner elects to assume such responsibility, the commissioner shall notify the local social services official in writing as to the election, the date upon which the election shall be effective and such information as to transition of responsibilities as the commissioner deems prudent. The commissioner is authorized to contract with a transportation manager or managers to manage transportation services in any local social services district, other than transportation services provided or arranged for S. 7507--B 44 [enrollees of managed long term care plans issued certificates of authority under section forty-four hundred three-f of the public health law]: ADULT DAY HEALTH CARE PROGRAMS LOCATED AT A LICENSED RESIDENTIAL HEALTH CARE FACILITY AS DEFINED BY SECTION TWENTY-EIGHT HUNDRED ONE OF THE PUBLIC HEALTH LAW OR ANY APPROVED EXTENSION SITE THEREOF; PARTIC- IPANTS OF A PROGRAM DESIGNATED AS A PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) AS AUTHORIZED BY FEDERAL PUBLIC LAW 105-33, SUBTITLE 1 OF TITLE IV OF THE BALANCED BUDGET ACT OF 1997; AND ENROLLEES OF A MANAGED LONG TERM CARE PLAN ISSUED A CERTIFICATE OF AUTHORITY UNDER SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW THAT ELECTS TO PROVIDE OR ARRANGE FOR TRANSPORTATION SERVICES DIRECTLY. THE COMMIS- SIONER SHALL OFFER MANAGED LONG TERM CARE PLANS OTHER THAN PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY, AND ADULT DAY HEALTH CARE PROGRAMS THE OPTION TO ARRANGE TRANSPORTATION DIRECTLY OR UTILIZE A TRANSPORTA- TION MANAGER OR MANAGERS SELECTED BY THE COMMISSIONER. Any transporta- tion manager or managers selected by the commissioner to manage trans- portation 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 transpor- tation 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. § 2. Intentionally omitted. § 3. Intentionally omitted. § 4. This act shall take effect immediately and shall be deemed to have been in full force and effect on and after April 1, 2018; provided, however, that section one of this act shall take effect October 1, 2018; provided, further that the amendments to subdivision 4 of section 365-h of the social services law made by section one of this act shall not affect the repeal of such section and shall expire and be deemed repealed therewith. PART F Intentionally Omitted PART G Section 1. Section 2801-a of the public health law is amended by adding a new subdivision 17 to read as follows: 17. (A) DIAGNOSTIC OR TREATMENT CENTERS ESTABLISHED TO PROVIDE HEALTH CARE SERVICES WITHIN THE SPACE OF A RETAIL BUSINESS OPERATION, SUCH AS A PHARMACY OR A STORE OPEN TO THE GENERAL PUBLIC, OR WITHIN SPACE USED BY AN EMPLOYER FOR PROVIDING HEALTH CARE SERVICES TO ITS EMPLOYEES, MAY BE OPERATED BY LEGAL ENTITIES FORMED UNDER THE LAWS OF THE STATE OF NEW YORK: (I) WHOSE STOCKHOLDERS OR MEMBERS, AS APPLICABLE, ARE NOT NATURAL PERSONS; (II) WHOSE PRINCIPAL STOCKHOLDERS AND MEMBERS, AS APPLICABLE, S. 7507--B 45 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, AND FURTHER DEMONSTRATE A COMMITMENT TO OPERATE LIMITED SERVICES CLINICS IN MEDICALLY UNDER- SERVED AREAS OF THE STATE. SUCH DIAGNOSTIC AND TREATMENT CENTERS SHALL BE REFERRED TO IN THIS SECTION AS "LIMITED SERVICES CLINICS". (B) FOR PURPOSES OF PARAGRAPH (A) OF THIS SUBDIVISION, THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL SHALL ADOPT AND AMEND RULES AND REGU- LATIONS, NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION, TO ADDRESS ANY MATTER IT DEEMS PERTINENT TO THE ESTABLISHMENT OF LIMITED SERVICES CLINICS. SUCH RULES AND REGULATIONS SHALL INCLUDE, BUT NOT BE LIMITED TO, PROVISIONS GOVERNING OR RELATING TO: (I) ANY DIRECT OR 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 SERVICES CLINIC LOSES ITS ACCREDITATION; (II) DESIGNATING OR LIMITING THE TREATMENTS AND SERVICES THAT MAY BE PROVIDED, INCLUDING: (A) LIMITING THE SCOPE OF SERVICES TO THE FOLLOWING, PROVIDED THAT SUCH SERVICES SHALL NOT INCLUDE MONITORING OR TREATMENT AND SERVICES OVER PROLONGED PERIODS: (1) THE PROVISION OF TREATMENT AND SERVICES TO PATIENTS FOR MINOR ACUTE EPISODIC ILLNESSES OR CONDITIONS; (2) EPISODIC PREVENTIVE AND WELLNESS TREATMENTS AND SERVICES SUCH AS IMMUNIZATIONS; AND (3) TREATMENT AND SERVICES FOR MINOR TRAUMAS THAT ARE NOT REASONABLY LIKELY TO BE LIFE THREATENING OR POTENTIALLY DISABLING IF AMBULATORY CARE WITHIN THE CAPACITY OF THE LIMITED SERVICES CLINIC IS PROVIDED; S. 7507--B 46 (B) PROHIBITING THE PROVISION OF SERVICES TO PATIENTS TWENTY-FOUR MONTHS OF AGE OR YOUNGER; (C) THE PROVISION OF SPECIFIC IMMUNIZATIONS TO PATIENTS YOUNGER THAN EIGHTEEN YEARS OF AGE; (III) REQUIRING LIMITED SERVICES CLINICS TO ACCEPT WALK-INS AND OFFER EXTENDED BUSINESS HOURS; (IV) SETTING FORTH GUIDELINES FOR ADVERTISING AND SIGNAGE, WHICH SHALL INCLUDE SIGNAGE INDICATING THAT PRESCRIPTIONS AND OVER-THE-COUNTER SUPPLIES MAY BE PURCHASED BY A PATIENT FROM ANY BUSINESS AND DO NOT NEED TO BE PURCHASED ON-SITE; (V) SETTING FORTH GUIDELINES FOR DISCLOSURE OF OWNERSHIP INTERESTS, INFORMED CONSENT, RECORD KEEPING, REFERRAL FOR TREATMENT AND CONTINUITY OF CARE, CASE REPORTING TO THE PATIENT'S PRIMARY CARE OR OTHER HEALTH CARE PROVIDERS, DESIGN, CONSTRUCTION, FIXTURES, AND EQUIPMENT; AND (VI) REQUIRING THE OPERATOR TO DIRECTLY EMPLOY A MEDICAL DIRECTOR WHO IS LICENSED AND CURRENTLY REGISTERED TO PRACTICE MEDICINE IN THE STATE OF NEW YORK. (F) SUCH REGULATIONS ALSO SHALL PROMOTE AND STRENGTHEN PRIMARY CARE BY REQUIRING LIMITED SERVICES CLINICS TO: (I) INQUIRE OF EACH PATIENT WHETHER HE OR SHE HAS A PRIMARY CARE PROVIDER; (II) MAINTAIN AND REGULARLY UPDATE A LIST OF LOCAL PRIMARY CARE PROVIDERS AND PROVIDE SUCH LIST TO EACH PATIENT WHO INDICATES THAT HE OR SHE DOES NOT HAVE A PRIMARY CARE PROVIDER; (III) REFER PATIENTS TO THEIR PRIMARY CARE PROVIDERS OR OTHER HEALTH CARE PROVIDERS AS APPROPRIATE; (IV) TRANSMIT, BY ELECTRONIC MEANS WHENEVER POSSIBLE, RECORDS OF SERVICES TO PATIENTS' PRIMARY CARE PROVIDERS; (V) EXECUTE PARTICIPATION AGREEMENTS WITH HEALTH INFORMATION ORGANIZA- TIONS, ALSO KNOWN AS QUALIFIED ENTITIES, PURSUANT TO WHICH LIMITED SERVICES CLINICS AGREE TO PARTICIPATE IN THE STATEWIDE HEALTH INFORMA- TION NETWORK FOR NEW YORK (SHIN-NY); AND (VI) DECLINE TO TREAT ANY PATIENT FOR THE SAME CONDITION OR ILLNESS MORE THAN THREE TIMES IN A YEAR. (G) A LIMITED SERVICES CLINIC SHALL PROVIDE TREATMENT WITHOUT DISCRIM- INATION AS TO SOURCE OF PAYMENT. (H) NOTWITHSTANDING THIS SUBDIVISION AND OTHER LAW OR REGULATION TO THE CONTRARY AND SUBJECT TO THE PROVISIONS OF SECTION TWENTY-EIGHT HUNDRED TWO OF THIS ARTICLE, A GENERAL HOSPITAL, A DIAGNOSTIC AND TREAT- MENT CENTER, COMMUNITY HEALTH CENTER OR FEDERALLY QUALIFIED HEALTH CENTER MAY OPERATE A LIMITED SERVICES CLINIC WHICH MEETS THE REGULATION PROMULGATED PURSUANT TO PARAGRAPH (E) OF THIS SUBDIVISION REGARDING OPERATIONAL PHYSICAL PLANT STANDARDS. (I) IN DETERMINING WHETHER TO APPROVE ADDITIONAL LIMITED SERVICES CLINIC LOCATIONS, THE DEPARTMENT SHALL CONSIDER WHETHER THE OPERATOR HAS FULFILLED ITS COMMITMENT TO OPERATE LIMITED SERVICES CLINICS IN MEDICALLY UNDERSERVED AREAS OF THE STATE. § 2. This act shall take effect immediately. PART H Intentionally Omitted PART I S. 7507--B 47 Section 1. Section 364-j of the social services law is amended by adding a new subdivision 34 to read as follows: 34. FOR PURPOSES OF RECOUPING OVERPAYMENTS RELATING TO FRAUD AND ABUSE, MONIES PAID BY THE DEPARTMENT TO MANAGED CARE ORGANIZATIONS FOR COVERED MEDICAL ASSISTANCE SERVICES, EXCLUSIVE OF ANY REIMBURSEMENT FOR ADMINISTRATIVE EXPENSES OR CARE MANAGEMENT SERVICES ARE PUBLIC FUNDS AND RETAIN THEIR STATUS AS PUBLIC FUNDS WHEN PAID BY THE MANAGED CARE ORGAN- IZATION TO SUBCONTRACTORS OR PROVIDERS. § 2. Section 364-j of the social services law is amended by adding a new subdivision 35 to read as follows: 35. RECOVERY AND RETENTION OF OVERPAYMENTS FROM NETWORK PROVIDERS. (A) WHERE THE MEDICAID INSPECTOR GENERAL OR THE MEDICAID FRAUD CONTROL UNIT OF THE OFFICE OF THE ATTORNEY GENERAL, DURING THE COURSE OF AN AUDIT OR INVESTIGATION, IDENTIFIES IMPROPER MEDICAL ASSISTANCE PAYMENTS MADE BY A MANAGED CARE ORGANIZATION TO ITS SUBCONTRACTOR OR SUBCONTRACTORS OR PROVIDER OR PROVIDERS, THE STATE SHALL, SUBJECT TO PARAGRAPHS (B) AND (C) OF THIS SUBDIVISION HAVE THE RIGHT TO RECOVER THE IMPROPER PAYMENT FROM THE SUBCONTRACTOR OR SUBCONTRACTORS, PROVIDER OR PROVIDERS, OR THE MANAGED CARE ORGANIZATION. (B) CONTRACTS BETWEEN THE STATE AND A MANAGED CARE ORGANIZATION SHALL SPECIFY: (I) THE RETENTION POLICIES FOR THE TREATMENT OF RECOVERIES OF ALL OVERPAYMENTS FROM THE MANAGED CARE ORGANIZATION TO A PROVIDER, INCLUDING SPECIFICALLY THE RETENTION POLICIES FOR THE TREATMENT OF RECOVERIES OF OVERPAYMENTS DUE TO FRAUD OR ABUSE; (II) THE PROCESS, TIMEFRAMES, AND DOCUMENTATION REQUIRED FOR REPORTING THE RECOVERY OF ALL OVERPAYMENTS FROM NETWORK PROVIDERS; AND (III) THE PROCESS, TIMEFRAMES, AND DOCUMENTATION REQUIRED FOR PAYMENT OF RECOVERIES OF OVERPAYMENTS TO THE STATE IN SITUATIONS WHERE THE MANAGED CARE ORGANIZATION IS NOT PERMITTED TO RETAIN SOME OR ALL OF THE RECOVERIES OF OVERPAYMENTS. (C) ANY RECOVERY FROM A SUBCONTRACTOR OR PROVIDER PURSUANT TO THIS SECTION SHALL BE SHARED PROPORTIONALLY BETWEEN THE STATE AND THE MANAGED CARE ORGANIZATION BASED ON (I) THE ENTITY THAT INITIATED THE RECOVERY EFFORTS AND (II) THE EFFORTS BY EACH PARTY TO SECURE THE RECOVERY. (D) THIS SUBDIVISION SHALL NOT APPLY TO ANY AMOUNT OF A RECOVERY TO BE RETAINED UNDER FALSE CLAIMS ACT CASES. § 3. Section 364-j of the social services law is amended by adding a new subdivision 36 to read as follows: 36. REPORTING ACTS OF FRAUD. (A) ALL MANAGED CARE ORGANIZATIONS SHALL PROMPTLY REFER TO THE OFFICE OF THE MEDICAID INSPECTOR GENERAL ALL CASES IN WHICH THERE IS A REASONABLE SUSPICION OF FRAUD OR ABUSE. (B) ANY MANAGED CARE ORGANIZATION MAKING A COMPLAINT OR FURNISHING A REPORT, REFERRAL, INFORMATION OR RECORDS IN GOOD FAITH PURSUANT TO THIS SECTION SHALL BE IMMUNE FROM CIVIL LIABILITY FOR MAKING SUCH COMPLAINT, REFERRAL, OR REPORT TO THE OFFICE OF THE MEDICAID INSPECTOR GENERAL. (C) A MANAGED CARE ORGANIZATION THAT WILLFULLY FAILS TO PROMPTLY MAKE A REFERRAL TO THE MEDICAID INSPECTOR GENERAL WHEN THERE IS ACTUAL KNOW- LEDGE THAT AN ACT OF FRAUD IS BEING OR HAS BEEN COMMITTED MAY, IN THE DISCRETION OF THE COMMISSIONER, BE FINED IN AN AMOUNT NOT EXCEEDING TEN THOUSAND DOLLARS FOR EACH DETERMINATION. § 4. The public health law is amended by adding a new section 12-e to read as follows: § 12-E. VIOLATIONS OF MEDICAL ASSISTANCE PROGRAM LAWS, REGULATIONS OR DIRECTIVES; FINES. 1. (A) ANY INDIVIDUAL OR ENTITY PARTICIPATING IN THE MEDICAL ASSISTANCE PROGRAM THAT FAILS TO COMPLY WITH OR VIOLATES ANY S. 7507--B 48 STATUTE, RULE, REGULATION, OR DIRECTIVE OF THE MEDICAL ASSISTANCE PROGRAM, MAY BE FINED IN AN AMOUNT NOT EXCEEDING THE SUM OF TWO THOUSAND DOLLARS FOR EACH VIOLATION. (B) THE PENALTY PROVIDED FOR IN PARAGRAPH (A) OF THIS SUBDIVISION MAY BE INCREASED TO AN AMOUNT NOT TO EXCEED FIVE THOUSAND DOLLARS FOR A SUBSEQUENT VIOLATION IF THE PERSON COMMITTED THE IDENTICAL VIOLATION, WITH RESPECT TO THE SAME OR ANY OTHER PERSON OR PERSONS, WITHIN TWELVE MONTHS OF THE INITIAL VIOLATION FOR WHICH A PENALTY WAS ASSESSED PURSU- ANT TO PARAGRAPH (A) OF THIS SUBDIVISION AND SAID VIOLATIONS WERE A SERIOUS THREAT TO THE HEALTH AND SAFETY OF AN INDIVIDUAL OR INDIVIDUALS. 2. (A) ANY ENTITY AUTHORIZED TO OPERATE UNDER ARTICLE FORTY-FOUR OF THIS CHAPTER OR ARTICLE FORTY-THREE OF THE INSURANCE LAW, INCLUDING ANY SUBCONTRACTOR OR PROVIDER THEREOF, AND PARTICIPATING IN THE MEDICAL ASSISTANCE PROGRAM THAT FAILS TO COMPLY WITH OR VIOLATES ANY STATUTE, RULE, REGULATION, OR DIRECTIVE OF THE MEDICAL ASSISTANCE PROGRAM, OR ANY TERM OF ITS CONTRACT WITH THE DEPARTMENT, INCLUDING, BUT NOT LIMITED TO, THE SUBMISSION OF COST REPORTS OR ENCOUNTER DATA THAT IS INTENTIONALLY OR SYSTEMATICALLY INACCURATE OR IMPROPER, MAY BE FINED IN AN AMOUNT NOT EXCEEDING THE SUM OF TWO THOUSAND DOLLARS FOR EACH VIOLATION. (B) THE PENALTY PROVIDED FOR IN PARAGRAPH (A) OF THIS SUBDIVISION MAY BE INCREASED TO AN AMOUNT NOT TO EXCEED FIVE THOUSAND DOLLARS FOR A SUBSEQUENT VIOLATION IF THE PERSON COMMITTED THE SAME VIOLATION, WITH RESPECT TO THE SAME OR ANY OTHER PERSON OR PERSONS, WITHIN TWELVE MONTHS OF THE INITIAL VIOLATION FOR WHICH A PENALTY WAS ASSESSED PURSUANT TO PARAGRAPH (A) OF THIS SUBDIVISION AND SAID VIOLATIONS WERE A SERIOUS THREAT TO THE HEALTH AND SAFETY OF AN INDIVIDUAL OR INDIVIDUALS. (C) THE COMMISSIONER SHALL CONSIDER THE FOLLOWING PRIOR TO ASSESSING A PENALTY AGAINST A MANAGED CARE ORGANIZATION AND HAVE THE DISCRETION TO REDUCE OR ELIMINATE A PENALTY: (I) THE EFFECT, IF ANY, ON THE QUALITY OF MEDICAL CARE PROVIDED TO OR ARRANGED FOR RECIPIENTS OF MEDICAL ASSISTANCE AS A RESULT OF THE ACTS OF THE MANAGED CARE ORGANIZATION; (II) THE AMOUNT OF DAMAGES TO THE PROGRAM; (III) ANY PRIOR VIOLATIONS COMMITTED BY THE MANAGED CARE ORGANIZATION RELATING TO THE MEDICAL ASSISTANCE PROGRAM, MEDICARE OR ANY OTHER SOCIAL SERVICES PROGRAMS WHICH RESULTED IN EITHER CRIMINAL OR ADMINISTRATIVE SANCTION, PENALTY, OR FINE; (IV) THE DEGREE TO WHICH FACTORS GIVING RISE TO THE PROSCRIBED ACTIONS WERE OUT OF THE CONTROL OF THE MANAGED CARE ORGANIZATION; (V) THE NUMBER AND NATURE OF THE VIOLATIONS OR OTHER RELATED OFFENSES; (VI) THE TIMELINESS OF THE MANAGED CARE ORGANIZATION IN CURING OR CORRECTING VIOLATIONS; (VII) WHETHER THE VIOLATION WAS CAUSED BY THE MANAGED CARE ORGANIZA- TION OR A THIRD PARTY; (VIII) WHETHER THE MANAGED CARE ORGANIZATION HAS TAKEN CORRECTIVE ACTION TO REDUCE THE LIKELIHOOD OF FUTURE VIOLATIONS; (IX) WHETHER THE MANAGED CARE ORGANIZATION WAS OR SHOULD HAVE BEEN AWARE OF SUCH VIOLATION; AND (X) ANY OTHER FACTS RELATING TO THE NATURE AND SERIOUSNESS OF THE VIOLATIONS INCLUDING ANY EXCULPATORY FACTS. 3. THE COMMISSIONER SHALL CONSIDER THE FOLLOWING PRIOR TO ASSESSING A FINE AGAINST AN INDIVIDUAL OR ENTITY UNDER THIS SECTION AND HAVE THE DISCRETION TO REDUCE OR ELIMINATE A FINE UNDER THIS SECTION: (A) THE EFFECT, IF ANY, ON THE QUALITY OF MEDICAL CARE PROVIDED TO OR ARRANGED FOR RECIPIENTS OF MEDICAL ASSISTANCE AS A RESULT OF THE ACTS OF THE INDIVIDUAL OR ENTITY; S. 7507--B 49 (B) THE AMOUNT OF DAMAGES TO THE PROGRAM; (C) THE DEGREE OF CULPABILITY OF THE INDIVIDUAL OR ENTITY IN COMMIT- TING THE PROSCRIBED ACTIONS AND ANY MITIGATING CIRCUMSTANCES; (D) ANY PRIOR VIOLATIONS COMMITTED BY THE INDIVIDUAL OR ENTITY RELAT- ING TO THE MEDICAL ASSISTANCE PROGRAM, MEDICARE OR ANY OTHER SOCIAL SERVICES PROGRAMS WHICH RESULTED IN EITHER CRIMINAL OR ADMINISTRATIVE SANCTION, PENALTY, OR FINE; (E) THE DEGREE TO WHICH FACTORS GIVING RISE TO THE PROSCRIBED ACTIONS WERE OUT OF THE CONTROL OF THE INDIVIDUAL OR ENTITY; (F) THE NUMBER AND NATURE OF THE VIOLATIONS OR OTHER RELATED OFFENSES; (G) ANY OTHER FACTS RELATING TO THE NATURE AND SERIOUSNESS OF THE VIOLATIONS INCLUDING ANY EXCULPATORY FACTS; AND/OR (H) ANY OTHER RELEVANT FACTORS. 4. THE COMMISSIONER MAY PROMULGATE REGULATIONS ENUMERATING THOSE VIOLATIONS WHICH MAY RESULT IN A FINE PURSUANT TO SUBDIVISIONS ONE AND TWO OF THIS SECTION, AND THE APPEAL RIGHTS AFFORDED TO INDIVIDUALS OR ENTITIES SUBJECT TO A FINE. § 5. Paragraph (d) of subdivision 32 of section 364-j of the social services law, as added by section 15 of part B of chapter 59 of the laws of 2016, is amended to read as follows: (d) (I) Penalties under this subdivision may be applied to any and all circumstances described in paragraph (b) of this subdivision until the managed care organization complies with the requirements for submission of encounter data. (II) No penalties for late, incomplete or inaccurate encounter data shall be assessed against managed care organizations in addition to those provided for in this subdivision, PROVIDED, HOWEVER, THAT NOTHING IN THIS PARAGRAPH SHALL PROHIBIT THE IMPOSITION OF PENAL- TIES, IN CASES OF FRAUD OR ABUSE, OTHERWISE AUTHORIZED BY LAW. § 6. This act shall take effect on the ninetieth day after it shall have become a law; provided, however, that the amendments to section 364-j of the social services law made by sections one, two, three and five of this act shall not affect the repeal of such section and shall be deemed repealed therewith. PART J Section 1. Section 190-a of the state finance law, as amended by section 2 of part HH of chapter 55 of the laws of 2014, is amended to read as follows: § 190-a. Monies recovered. 1. Notwithstanding any law to the contrary, all monies recovered or obtained under this article by a state agency or state official or employee acting in their official capacity shall be subject to subdivision eleven of section four of this chapter. 2. EXPENDITURE OF MONIES RECOVERED PURSUANT TO THE FALSE CLAIMS ACT RELATED TO THE MEDICAID PROGRAM. TO THE EXTENT PRACTICABLE, ALL MONIES RECOVERED PURSUANT TO THE FALSE CLAIMS ACT AS IT RELATES TO THE MEDICAID PROGRAM RECEIVED AND/OR EXPENDED DURING A FISCAL YEAR SHALL BE ACCOUNTED FOR BY THE HEAD OF THE AGENCY OR ENTITY RECOVERING AND/OR EXPENDING THE MONIES. THE HEAD OF THE AGENCY OR ENTITY RECOVERING AND/OR EXPENDING THE MONIES, IN CONSULTATION WITH THE DIVISION OF BUDGET, SHALL REPORT ANNU- ALLY ON THE USE OF SUCH MONIES TO THE TEMPORARY PRESIDENT OF THE SENATE, SPEAKER OF THE ASSEMBLY, CHAIR OF THE SENATE FINANCE COMMITTEE, CHAIR OF THE ASSEMBLY WAYS AND MEANS COMMITTEE, CHAIR OF THE HEALTH COMMITTEES IN THE SENATE AND ASSEMBLY BY DECEMBER FIRST OF EACH YEAR. SUCH REPORT SHALL INCLUDE, BUT NOT BE LIMITED TO, ANY AND ALL FILINGS OF AN ACTION UNDER SECTION 190(1) OF THE FALSE CLAIMS ACT BY A LOCAL GOVERNMENT, THE S. 7507--B 50 AMOUNT OF MONIES COLLECTED AND DISBURSED PURSUANT TO THE FALSE CLAIMS ACT AS IT RELATES TO THE MEDICAID PROGRAM, RECIPIENTS OF SUCH DISBURSE- MENTS AND THE AMOUNT RECEIVED BY RECIPIENTS, AND ESTIMATES OF ALL RECEIPTS, ALL DISBURSEMENTS AND ANTICIPATED RECEIPTS FOR THE CURRENT AND SUCCEEDING FISCAL YEARS. § 2. This act shall take effect immediately. PART K Section 1. Notwithstanding any contrary provision of law, the depart- ment of health is authorized to require any Medicaid-enrolled licensed home care services agency, and any fiscal intermediary operating pursu- ant to section 365-f of the social services law, to report on costs incurred in rendering health care services to Medicaid beneficiaries, including those enrolled in managed care. The department of health may specify the frequency and format of such reports, determine the type and amount of information to be submitted, and require the submission of supporting documentation. However, licensed home care services agencies shall submit such cost reports to the department of health and the public health and planning council by July 1, 2018 for purposes of the review required by subdivision 8 of section 3612 of the public health law. § 2. Subdivision 1 of section 92 of part H of chapter 59 of the laws of 2011, amending the public health law and other laws relating to known and projected department of health state fund medicaid expenditures, as amended by section 1 of part G of chapter 57 of the laws of 2017, is amended to read as follows: 1. For state fiscal years 2011-12 through 2018-19, the director of the budget, in consultation with the commissioner of health referenced as "commissioner" for purposes of this section, shall assess on a monthly basis, as reflected in monthly reports pursuant to subdivision five of this section known and projected department of health state funds medi- caid expenditures by category of service and by geographic regions, as defined by the commissioner, and if the director of the budget deter- mines that such expenditures are expected to cause medicaid disburse- ments for such period to exceed the projected department of health medi- caid state funds disbursements in the enacted budget financial plan pursuant to subdivision 3 of section 23 of the state finance law, the commissioner of health, in consultation with the director of the budget, shall develop a medicaid savings allocation plan to limit such spending to the aggregate limit level specified in the enacted budget financial plan, provided, however, such [projections may be adjusted by the direc- tor of the budget to account for any changes in the New York state federal medical assistance percentage amount established pursuant to the federal social security act, changes in provider revenues, reductions to local social services district medical assistance administration, mini- mum wage increases, and beginning April 1, 2012 the operational costs of the New York state medical indemnity fund and state costs or savings from the basic health plan. Such projections may be adjusted by the director of the budget to account for increased or expedited department of health state funds medicaid expenditures as a result of a natural or other type of disaster, including a governmental declaration of emergen- cy] SAVINGS ALLOCATION PLAN MUST BE APPROVED BY LEGISLATION PRIOR TO IMPLEMENTATION. § 3. Subdivision 1 of section 91 of part H of chapter 59 of the laws of 2011, amending the public health law and other laws relating to S. 7507--B 51 general hospital reimbursement for annual rates, as amended by section 2 of part A of chapter 56 of the laws of 2013, is amended to read as follows: 1. Notwithstanding any inconsistent provision of state law, rule or regulation to the contrary, subject to federal approval, the year to year rate of growth of department of health state funds Medicaid spend- ing shall not exceed the ten year [rolling] average of the medical component of the consumer price index as published by the United States department of labor, bureau of labor statistics, for the [preceding ten years] TEN YEAR PERIOD ENDING SIX MONTHS PRIOR TO THE START OF THE COMING FISCAL YEAR; provided, however, that for state fiscal year 2013- 14 and for each fiscal year thereafter, the maximum allowable annual increase in the amount of department of health state funds Medicaid spending shall be calculated by multiplying the department of health state funds Medicaid spending for the previous year, minus the amount of any department of health state operations spending included therein, by such ten year [rolling] average. § 4. The public health law is amended by adding a new section 206-c to read as follows: § 206-C. KIDNEY DISEASE OUTREACH AND EDUCATION PROGRAM. THE NEW YORK CENTER FOR KIDNEY TRANSPLANTATION SHALL, WITHIN AMOUNTS APPROPRIATED, ESTABLISH AND IMPLEMENT AN EDUCATION AND OUTREACH PROGRAM FOR FINANCIAL COORDINATORS AT KIDNEY TRANSPLANT PROGRAMS IN NEW YORK STATE TO ASSIST PATIENTS WITH END STAGE RENAL DISEASE WHO MEET THE MEDICARE ELIGIBILITY REQUIREMENTS, AND WHO ARE WAITING FOR KIDNEY TRANSPLANTS, IN ACCESSING MEDICARE COVERAGE. THE CENTER SHALL ALSO ESTABLISH AND IMPLEMENT AN EDUCATION AND OUTREACH