The New York State Senate

                    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

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  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

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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.

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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

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  (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

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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.

                    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

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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,

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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

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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

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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

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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-

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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:

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  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

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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

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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-

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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

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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.

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  § 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.

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  § 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;

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  § 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.

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  §  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

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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

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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

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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

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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:

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  (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.

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  (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

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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.

                    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 PROGRAM FOR DIALYSIS PATIENTS TO ENSURE  PATIENTS
ARE  AWARE  OF  AND  HAVE  ACCESS  TO  OPPORTUNITIES  FOR  LIVING KIDNEY
DONATION.
  § 5. 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-
tutions, is REPEALED.
  § 6. This act shall take effect immediately; provided,  however,  that
nothing  in  this  act  shall invalidate or otherwise impact any sale of
accounts receivable effected pursuant to section five of this act  prior
to the repeal of such section.

                                 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, PURSUANT TO A REQUEST FOR PROPOSAL PROCESS, TO CONDUCT

S. 7507--B                         52

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 respon-
sibility  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 subdivision.
  § 2. Intentionally omitted.
  § 3. Paragraph 1 of subsection (a) of section 3231  of  the  insurance
law,  as  amended  by  section 69 of part D of chapter 56 of the laws of
2013, is amended to read as follows:
  (1) No individual health insurance policy and no group  health  insur-
ance  policy  covering between one and fifty employees or members of the
group [or between one and one hundred employees or members of the  group
for  policies  issued or renewed on or after January first, two thousand
sixteen] exclusive of spouses and dependents, hereinafter referred to as
a small group, providing hospital  and/or  medical  benefits,  including
medicare  supplemental  insurance,  shall be issued in this state unless
such policy is community rated and, notwithstanding any other provisions
of law, the underwriting of such policy involves no more than the  impo-
sition  of a pre-existing condition limitation if otherwise permitted by
this article.
  § 4. Paragraph 3 of subsection (a) of section 3231  of  the  insurance
law,  as  amended  by  section 69 of part D of chapter 56 of the laws of
2013, is amended to read as follows:
  (3) Once accepted for coverage, an individual or small group cannot be
terminated by the insurer due to claims experience.   Termination of  an
individual  or  small  group  shall  be based only on one or more of the
reasons set forth in  subsection  (g)  of  section  three  thousand  two
hundred  sixteen or subsection (p) of section three thousand two hundred
twenty-one of this article.  Group  hospital  and/or  medical  coverage,
including  medicare  supplemental insurance, obtained through an out-of-
state trust covering a group of fifty or fewer  employees,  [or  between
one and one hundred employees for policies issued or renewed on or after
January  first,  two thousand sixteen,] or participating persons who are
residents of this state must be community rated regardless of the  situs
of  delivery of the policy. Notwithstanding any other provisions of law,
the underwriting of such policy may involve no more than the  imposition
of a pre-existing condition limitation if permitted by this article, and
once  accepted  for  coverage,  an  individual  or small group cannot be
terminated due to claims experience. Termination  of  an  individual  or
small  group shall be based only on one or more of the reasons set forth
in subsection (p) of section three thousand two  hundred  twenty-one  of
this article.
  §  5.  Paragraph  1 of subsection (h) of section 3231 of the insurance
law, as amended by chapter 12 of the laws of 2016, is amended to read as
follows:
  (1) Notwithstanding any other provision of this chapter,  no  insurer,
subsidiary  of  an  insurer,  or  controlled person of a holding company
system may act as an administrator or claims paying agent, as opposed to
an insurer, on behalf of small groups which, if  they  purchased  insur-
ance,  would  be  subject  to  this section. No insurer may provide stop
loss, catastrophic or reinsurance coverage to  small  groups  which,  if
they  purchased  insurance, would be subject to this section. [Provided,
however, the provisions of this paragraph shall not apply  to:  (A)  the
renewal of stop loss, catastrophic or reinsurance coverage issued and in

S. 7507--B                         53

effect  on  January first, two thousand fifteen to small groups covering
between fifty-one and one hundred employees or members of the group; and
(B) the issuance between January first, two thousand sixteen and  Decem-
ber  thirty-first,  two  thousand sixteen, of stop loss, catastrophic or
reinsurance coverage, and any renewal thereof, to a small group covering
between fifty-one and one hundred employees or  members  of  the  group,
provided  that  such  group  had  stop loss, catastrophic or reinsurance
coverage issued and in effect on January first, two thousand fifteen.]
  § 6. Paragraph 1 of subsection (a) of section 4317  of  the  insurance
law,  as  amended  by  section 72 of part D of chapter 56 of the laws of
2013, is amended to read as follows:
  (1) No individual health insurance contract and no group health insur-
ance contract covering between one and fifty employees or members of the
group, [or between one and one hundred employees or members of the group
for policies issued or renewed on or after January first,  two  thousand
sixteen]  exclusive  of  spouses and dependents, including contracts for
which the premiums are paid by a remitting agent for a group, hereinaft-
er referred to as a small group, providing hospital and/or medical bene-
fits, including Medicare supplemental insurance, shall be issued in this
state unless such contract is community rated and,  notwithstanding  any
other  provisions  of law, the underwriting of such contract involves no
more than the imposition  of  a  pre-existing  condition  limitation  if
otherwise permitted by this article.
  §  7.  Paragraph  1 of subsection (e) of section 4317 of the insurance
law, as amended by chapter 12 of the laws of 2016, is amended to read as
follows:
  (1) Notwithstanding any other provision of this chapter,  no  insurer,
subsidiary  of  an  insurer,  or  controlled person of a holding company
system may act as an administrator or claims paying agent, as opposed to
an insurer, on behalf of small groups which, if  they  purchased  insur-
ance,  would  be  subject  to  this section. No insurer may provide stop
loss, catastrophic or reinsurance coverage to  small  groups  which,  if
they  purchased  insurance, would be subject to this section. [Provided,
however, the provisions of this paragraph shall not apply  to:  (A)  the
renewal of stop loss, catastrophic or reinsurance coverage issued and in
effect  on  January first, two thousand fifteen to small groups covering
between fifty-one and one hundred employees or members of the group; and
(B) the issuance between January first, two thousand sixteen, and Decem-
ber thirty-first, two thousand sixteen, of stop  loss,  catastrophic  or
reinsurance coverage, and any renewal thereof, to a small group covering
between  fifty-one  and  one  hundred employees or members of the group,
provided that such group had  stop  loss,  catastrophic  or  reinsurance
coverage issued and in effect on January first, two thousand fifteen.]
  §  8.  Paragraph  1 of subsection (g) of section 3231 of the insurance
law, as amended by chapter 12 of the laws of 2016, is amended to read as
follows:
  (1) [(A)] This section shall also apply to policies issued to a  group
defined  in  subsection (c) of section four thousand two hundred thirty-
five of this chapter, including but not limited  to  an  association  or
trust  of  employers, if the group includes one or more member employers
or other member groups having [one hundred] FIFTY or fewer employees  or
members  exclusive  of  spouses  and  dependents. For a policy issued or
renewed on or after January first, two thousand fourteen, if  the  group
includes  one or more member small group employers eligible for coverage
subject to this section, then such member employers shall be  classified
as  small  groups for rating purposes and the remaining members shall be

S. 7507--B                         54

rated consistent with the rating  rules  applicable  to  such  remaining
members  pursuant to paragraph two of this subsection. [(B) Subparagraph
A of this paragraph shall not apply to either the renewal  of  a  policy
issued  to  a group or the issuance, between January first, two thousand
sixteen and December thirty-first, two thousand sixteen,  of  a  policy,
and  any  renewal thereof, to a group, provided that the following three
requirements are met: (I) the group had been issued a policy that was in
effect on July first, two thousand fifteen; (II) the  group  had  member
employers,  who,  on  or  after  July  first, two thousand fifteen, have
between fifty-one and one hundred employees, exclusive  of  spouses  and
dependents; and (III) the group is either: (i) comprised entirely of one
or  more  municipal corporations or districts (as such terms are defined
in section one hundred nineteen-n of the general municipal law); or (ii)
comprised entirely of nonpublic schools providing education in any grade
from pre-kindergarten through twelfth grade.]
  § 9. Paragraph 1 of subsection (d) of section 4317  of  the  insurance
law, as amended by chapter 12 of the laws of 2016, is amended to read as
follows:
  (1)  [(A)]  This  section  shall  also apply to a contract issued to a
group defined in subsection (c) of section  four  thousand  two  hundred
thirty-five of this chapter, including but not limited to an association
or  trust of employers, if the group includes one or more member employ-
ers or other member groups having [one hundred] FIFTY or fewer employees
or members exclusive of spouses and dependents. For a contract issued or
renewed on or after January first, two thousand fourteen, if  the  group
includes  one or more member small group employers eligible for coverage
subject to this section, then such member employers shall be  classified
as  small  groups for rating purposes and the remaining members shall be
rated consistent with the rating  rules  applicable  to  such  remaining
members  pursuant to paragraph two of this subsection. [(B) Subparagraph
A of this paragraph shall not apply to either the renewal of a  contract
issued  to  a group or the issuance, between January first, two thousand
sixteen and December thirty-first, two thousand sixteen, of a  contract,
and  any  renewal thereof, to a group, provided that the following three
requirements are met: (I) the group had been issued a contract that  was
in effect on July first, two thousand fifteen; (II) the group had member
employers,  who,  on  or  after  July  first, two thousand fifteen, have
between fifty-one and one hundred employees, exclusive  of  spouses  and
dependents; and (III) the group is either: (i) comprised entirely of one
or  more  municipal corporations or districts (as such terms are defined
in section one hundred nineteen-n of the general municipal law); or (ii)
comprised entirely of nonpublic schools providing education in any grade
from pre-kindergarten through twelfth grade.]
  § 10. 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, is REPEALED.
  § 10-a. Section 213 of the insurance law, as added  by  section  1  of
part L of chapter 57 of the laws of 2007, is amended to read as follows:
  § 213. New York state health care quality and cost containment commis-
sion.  (a)  There  is hereby established within the department a commis-
sion, to be known as the "New York state health care  quality  and  cost
containment  commission".  The  commission  shall  consist  of  thirteen
members appointed by the governor, one of whom shall be the  superinten-
dent,  one  of whom shall be the commissioner of health, and six of whom

S. 7507--B                         55

shall be appointed on the recommendation of the legislative leaders, two
on the recommendation of the temporary president of the senate,  two  on
the  recommendation of the speaker of the assembly, one on the recommen-
dation  of the minority leader of the senate, and one on the recommenda-
tion of the minority leader of the assembly. All members shall serve  at
the  pleasure  of  the governor, and vacancies shall be appointed in the
same manner as original appointments. Members of  the  commission  shall
serve without compensation, but shall be reimbursed for reasonable trav-
el  expenses.  In  making  appointments  to the commission, the governor
shall ensure that the interests of health care  consumers,  small  busi-
nesses,  the  medical  community and health plans are represented on the
commission.   THE COMMISSION SHALL BE REQUIRED  TO  MEET  ON  THE  FIRST
MONDAY  AFTER  THE  FIRST  OF  JANUARY OF EACH CALENDAR YEAR TO CONSIDER
OUTSTANDING REQUESTS OR DUTIES.  ANY VACANCIES SHALL BE DEEMED WAIVED BY
THE APPOINTING AUTHORITY FOR THE PURPOSES OF THE FIRST MEETING.  NOTHING
IN  THIS SECTION SHALL FORFEIT THE RIGHT FOR AN APPOINTMENT AUTHORITY TO
FILL VACANCIES WITHIN THEIR STATUTORILY ALLOWED MEMBERS.
  (b)(1) The purpose of the commission shall be to analyze the impact on
health insurance costs and quality of proposed legislation  which  would
mandate  that health benefits be offered or made available in individual
and group health insurance policies, contracts and comprehensive  health
service plans, including legislation that affects the delivery of health
benefits or services or the reimbursement of health care providers.
  (2)  [The]  NOTWITHSTANDING  ANY OTHER PROVISION OF LAW, THE governor,
the chair of the senate insurance committee and the chair of the  assem-
bly insurance committee may request in writing that the commission eval-
uate  a  proposed  mandated  benefit. Upon receiving such a request, the
commission may, by a majority vote of its members, undertake  an  evalu-
ation of such proposed mandated benefit.
  (3) In evaluating a proposed mandated benefit, the commission shall:
  (A)  investigate  the current practices of health plans with regard to
the proposed mandated benefit, and, to the extent possible,  self-funded
health benefit plans;
  (B)  investigate the potential premium impact of the proposed mandated
benefits on all segments of the insurance market, as well as the  poten-
tial  for  avoided costs through early detection and treatment of condi-
tions, or more cost-effective delivery of medical services; and
  (C) analyze the most current medical literature regarding the proposed
mandated benefit to determine its impact on health care quality.
  (4) In evaluating a proposed mandated benefit, the commission may hold
one or more public hearings, and shall strive to obtain independent  and
verifiable information from diverse sources within the healthcare indus-
try,  medical  community  and among health care consumers with regard to
the proposed mandated benefit.
  (c) To assist the commission in its duties, and upon the direction  of
the  commission,  the  superintendent is authorized to enter into one or
more contracts with independent entities and organizations  with  demon-
strable expertise in health care quality, finance, utilization and actu-
arial  services.  For  the  purposes of this section, the superintendent
shall not enter into contracts with health plans, entities or  organiza-
tions  owned or controlled by health plans, or with significant business
relationships with health plans.
  (d) Upon completion of its evaluation of a proposed  mandated  benefit
pursuant  to this section, the commission shall deliver a written report
of its findings to the chair of the assembly insurance committee and the
chair of the senate insurance committee.

S. 7507--B                         56

  (E) THE COMMISSION SHALL ISSUE A REPORT TO THE GOVERNOR, THE  MAJORITY
LEADER  OF  THE  SENATE,  THE SPEAKER OF THE ASSEMBLY, THE CHAIRS OF THE
SENATE AND ASSEMBLY INSURANCE COMMITTEES, AND THE CHAIR  OF  THE  SENATE
TASK  FORCE  ON  LYME AND TICK-BORNE DISEASES, CONSIDERING THE IMPACT ON
HEALTH  INSURANCE COSTS AND QUALITY OF LEGISLATION REQUIRING COVERAGE OF
LONG-TERM AND CHRONIC LYME DISEASE AND OTHER  TICK-BORNE  DISEASES.  THE
COMMISSION  SHALL  BE  REQUIRED  TO  CONSIDER  ISSUES INCLUDING, BUT NOT
LIMITED TO, THE SPECIFIC MEDICAL IMPACTS TO PARTICULAR GEOGRAPHIC  AREAS
IN THE STATE INCLUDING THE HUDSON VALLEY AND LONG ISLAND, BEST PRACTICES
DEVELOPED  FOR  COVERAGE FOR LONG-TERM AND CHRONIC LYME DISEASE IN OTHER
STATES, AND THE ASSOCIATED COSTS OF MANDATED  COVERAGE  IN  ADDITION  TO
PROJECTED  COSTS  OF UNTREATED SYMPTOMS.  THE COMMISSION SHALL DELIVER A
WRITTEN REPORT OF ITS FINDINGS BY MAY FIRST, TWO THOUSAND NINETEEN.
  § 10-b. Section 1119 of the insurance law is amended by adding  a  new
subsection (d) to read as follows:
  (D)  EXCEPT  AS  EXPRESSLY  REQUIRED  BY THIS SECTION, AN ORGANIZATION
AUTHORIZED TO OPERATE UNDER ARTICLE FORTY-SIX OF THE PUBLIC  HEALTH  LAW
SHALL  NOT  BE  SUBJECT  TO  THE  JURISDICTION OF THE SUPERINTENDENT AND
REQUIRED TO COMPLY WITH RULES AND REGULATIONS OF THE  SUPERINTENDENT  ON
MATTERS  UNRELATED TO THE PROVISIONS OF THIS SECTION, INCLUDING, BUT NOT
LIMITED TO,  REGULATIONS  RELATING  TO  CYBERSECURITY  REQUIREMENTS  FOR
FINANCIAL  SERVICES  COMPANIES.  SUCH  ORGANIZATIONS  SHALL  INSTEAD  BE
SUBJECT TO THE JURISDICTION OF THE DEPARTMENT OF HEALTH ON SUCH  MATTERS
UNRELATED  TO  THE  PROVISIONS  OF THIS SECTION, INCLUDING ANY PERTINENT
REGULATIONS OR OVERSIGHT REGARDING CYBERSECURITY REQUIREMENTS.
  § 11. This act shall take effect immediately; provided,  however  that
the  amendments  to  paragraph  1  of  subsection (g) and paragraph 1 of
subsection (h) of section 3231, and paragraph 1 of  subsection  (d)  and
paragraph  1 of subsection (e) of section 4317 of the insurance law made
by sections eight, five, nine and seven of this act  respectively  shall
not  affect  the  expiration  and reversion of such paragraphs and shall
expire and be deemed repealed therewith.

                                 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

S. 7507--B                         57

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-
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

S. 7507--B                         58

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 a