The New York State Senate

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9963
 
                           I N  A S S E M B L Y
 
                              April 21, 2022
                                ___________
 
 Introduced  by  M.  of  A.  GOTTFRIED  --  read once and referred to the
   Committee on Health
 
 AN ACT to amend the public health  law,  the  mental  hygiene  law,  the
   social  services  law and the insurance law, in relation to permitting
   certain minors to consent to health care treatment
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1. Section 2504 of the public health law, as added by chapter
 769 of the laws of 1972, subdivision 2 as amended by chapter 119 of  the
 laws of 2005, subdivision 3 as added by chapter 976 of the laws of 1984,
 subdivision 4 as amended by chapter 623 of the laws of 2019, subdivision
 5 as added and subdivision 6 as renumbered by chapter 521 of the laws of
 1994,  and subdivision 7 as added by chapter 360 of the laws of 2019, is
 amended to read as follows:
   § 2504. Enabling certain  persons  to  consent  for  certain  medical,
 dental,  health  and  hospital  services.  1. Any person who is eighteen
 years of age or older, or is the parent of a child or has  married,  may
 give effective consent for medical, dental, health and hospital services
 for  [himself  or  herself] THEMSELF, and the consent of no other person
 shall be necessary.
   (A) ANY PERSON, INCLUDING A MINOR, WHO COMPREHENDS THE NEED  FOR,  THE
 NATURE OF, AND THE REASONABLY FORESEEABLE RISKS AND BENEFITS INVOLVED IN
 ANY  CONTEMPLATED  MEDICAL, DENTAL, HEALTH, OR HOSPITAL SERVICE, AS WELL
 AS ANY ALTERNATIVES THERETO, MAY  GIVE  EFFECTIVE  CONSENT  THERETO  FOR
 THEMSELF, AND THE CONSENT OF NO OTHER PERSON SHALL BE NECESSARY.
   (B)  ANY  RUNAWAY  YOUTH OR HOMELESS YOUTH, AS DEFINED IN SECTION FIVE
 HUNDRED THIRTY-TWO-A OF THE EXECUTIVE LAW, MAY  GIVE  EFFECTIVE  CONSENT
 FOR MEDICAL, DENTAL, HEALTH AND HOSPITAL SERVICES FOR THEMSELF.
   (C)  THE  COMMISSIONER MAY PROMULGATE REGULATIONS AS REASONABLY NECES-
 SARY TO IMPLEMENT PARAGRAPHS (A) AND (B) OF THIS SUBDIVISION.
   2. Any person who has been married or who has borne a child  may  give
 effective  consent for medical, dental, health and hospital services for
 his [or], her, OR THEIR child. Any person who has been designated pursu-
 ant to title fifteen-A of article five of the general obligations law as
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD15173-03-2
 A. 9963                             2
 
 a person in parental relation to a child may  consent  to  any  medical,
 dental, health and hospital services for such child for which consent is
 otherwise  required  [which  are  not:  (a)  major  medical treatment as
 defined  in  subdivision (a) of section 80.03 of the mental hygiene law;
 (b) electroconvulsive therapy; or (c) the withdrawal  or  discontinuance
 of medical treatment which is sustaining life functions].
   3.  Any person who is pregnant may give effective consent for medical,
 dental, health and hospital services relating to prenatal care.
   4. Medical, dental, health and hospital services may  be  rendered  to
 persons  of  any  age without the consent of a parent, legal guardian or
 person possessing a lawful order of custody when, in  the  [physician's]
 PRACTITIONER'S judgment an emergency exists and the person is in immedi-
 ate  need  of  medical  attention and an attempt to secure consent would
 result in delay of treatment  which  would  increase  the  risk  to  the
 person's life or health.
   5.  Where not otherwise already authorized by law to do so, any person
 in a parental relation to a  child  as  defined  in  section  twenty-one
 hundred  sixty-four  of  this  chapter  and, [(i)] (A) a grandparent, an
 adult brother or sister, an adult aunt or uncle, any of whom has assumed
 care of the child and, [(ii)] (B) an adult who has care of the child and
 has written authorization  to  consent  from  a  person  in  a  parental
 relation  to a child as defined in section twenty-one hundred sixty-four
 of this chapter, may give effective consent for the  immunization  of  a
 child.  However,  a  person other than one in a parental relation to the
 child shall not give consent under this subdivision if [he or  she  has]
 THEY  HAVE  reason  to believe that a person in parental relation to the
 child as defined in section twenty-one hundred sixty-four of this  chap-
 ter objects to the immunization. HOWEVER, A CHILD WHO MAY GIVE EFFECTIVE
 CONSENT  UNDER  THIS  SECTION  MAY  GIVE  EFFECTIVE CONSENT TO THEIR OWN
 IMMUNIZATION, AND THE CONSENT OF NO OTHER PERSON SHALL BE NECESSARY.
   6. Anyone who acts in good faith based  on  the  representation  by  a
 person  that  [he is] THEY ARE eligible to consent pursuant to the terms
 of this section shall be deemed to have received effective consent.
   7. No person shall perform  a  pelvic  examination  or  supervise  the
 performance  of  a  pelvic examination on an anesthetized or unconscious
 patient unless the person performing the pelvic examination  is  legally
 authorized  to  do  so and the person supervising the performance of the
 pelvic examination is legally authorized to do so and:
   (a) the patient or the patient's authorized representative gives prior
 oral or written informed consent specific to the pelvic examination;
   (b) the performance of a pelvic examination is  within  the  scope  of
 care  for  the surgical procedure or diagnostic examination scheduled to
 be performed on the patient and to which the patient has  already  given
 oral or written consent; or
   (c) the patient is unconscious and the pelvic examination is medically
 necessary  for  diagnostic  or treatment purposes, and the patient is in
 immediate need of medical attention and an  attempt  to  secure  consent
 would  result  in  a delay of treatment which would increase the risk to
 the patient's life or health.
   Nothing in this subdivision diminishes any other requirement to obtain
 informed consent for a pelvic examination or any other procedure.
   § 2. Subdivision (a) of section 9.13 of the  mental  hygiene  law,  as
 amended  by  chapter  465  of  the  laws  of 1992, is amended to read as
 follows:
   (a) The director of any hospital may receive as  a  voluntary  patient
 any suitable person in need of care and treatment, who voluntarily makes
 A. 9963                             3
 
 written  application  therefor.  If the person is under sixteen years of
 age, the person may be received as a voluntary  patient  [only]  on  the
 application  of  the  parent,  legal  guardian,  or  next-of-kin of such
 person[, or,]; subject to the terms of any court order or any instrument
 executed  pursuant  to section three hundred eighty-four-a of the social
 services law, a social services official or authorized agency with  care
 and  custody  of  such  person  pursuant to the social services law, the
 director of the division for youth, acting in  accordance  with  section
 five  hundred  nine  of  the executive law, or a person or entity having
 custody of the person pursuant to an order issued  pursuant  to  section
 seven  hundred  fifty-six or one thousand fifty-five of the family court
 act; OR ON THEIR OWN APPLICATION, IF THEY  MAY  GIVE  EFFECTIVE  CONSENT
 UNDER  SECTION  TWO THOUSAND FIVE HUNDRED FOUR OF THE PUBLIC HEALTH LAW.
 If the person is over sixteen and  under  eighteen  years  of  age,  the
 director  may,  in [his] THEIR discretion, admit such person either as a
 voluntary patient on [his] THEIR own application or on  the  application
 of  the person's parent, legal guardian, next-of-kin, or, subject to the
 terms of any court order or any instrument executed pursuant to  section
 three  hundred  eighty-four-a  of  the  social  services  law,  a social
 services official or authorized agency with care  and  custody  of  such
 person pursuant to the social services law, the director of the division
 for  youth,  acting  in accordance with section five hundred nine of the
 executive law, provided  that  such  person  knowingly  and  voluntarily
 consented  to  such  application  in  accordance with such section, or a
 person or entity having custody of  the  person  pursuant  to  an  order
 issued  pursuant  to  section  seven  hundred  fifty-six or one thousand
 fifty-five of the family court act.
   § 3. Subdivisions (b) and (c) of section 22.11 of the  mental  hygiene
 law, as added by chapter 558 of the laws of 1999, are amended to read as
 follows:
   (b) In treating a minor for chemical dependence on an inpatient, resi-
 dential, or outpatient basis, the important role of the parents or guar-
 dians  shall  be recognized. Steps shall be taken to involve the parents
 or guardians in the course of treatment, and consent from such a  person
 for  inpatient, residential, or outpatient treatment for minors shall be
 required, except as  otherwise  provided  by  subdivision  (c)  of  this
 section  OR  SECTION TWO THOUSAND FIVE HUNDRED FOUR OF THE PUBLIC HEALTH
 LAW.
   (c) Minors admitted for inpatient, residential or outpatient treatment
 without parental or guardian involvement.
   1. If, in the judgment of a [physician] QUALIFIED HEALTH PROFESSIONAL,
 parental or guardian involvement and consent would  have  a  detrimental
 effect  on the course of treatment of a minor who is voluntarily seeking
 treatment for chemical dependence or if a parent or guardian refuses  to
 consent  to  such treatment and the [physician] QUALIFIED HEALTH PROFES-
 SIONAL believes that such treatment is necessary for the best  interests
 of the child, such treatment may be provided to the minor by a [licensed
 physician] QUALIFIED HEALTH PROFESSIONAL on an inpatient, residential or
 outpatient basis, a staff [physician] HEALTH PROFESSIONAL in a hospital,
 or  persons  operating  under  their supervision, without the consent or
 involvement of the parent or guardian. Such [physician] QUALIFIED HEALTH
 PROFESSIONAL shall fully document the reasons why  the  requirements  of
 subdivision  (b)  of  this  section  were  dispensed  within the minor's
 medical record[, provided, however, that for providers of services which
 are not required to include physicians on staff, pursuant to regulations
 promulgated by the commissioner, a  qualified  health  professional,  as
 A. 9963                             4

 defined  in  such regulations, shall fulfill the role of a physician for
 purposes of this paragraph].
   2.  If the provider of services cannot locate the parents or guardians
 of a minor seeking treatment for  chemical  dependence  after  employing
 reasonable  measures to do so, or if such parents or guardians refuse or
 fail to communicate with the provider of services  within  a  reasonable
 time regarding the minor's treatment, the program director may authorize
 that  such  minor  be treated on an inpatient, residential or outpatient
 basis by the provider of services without the consent or involvement  of
 the  parent  or guardian. Such program director shall fully document the
 reasons why the requirements of subdivision (b)  of  this  section  were
 dispensed within the minor's medical record, including an explanation of
 all efforts employed to attempt to contact such parents or guardians.
   3.  IF THE MINOR MAY GIVE EFFECTIVE CONSENT UNDER SECTION TWO THOUSAND
 FIVE HUNDRED FOUR OF THE  PUBLIC  HEALTH  LAW,  SUCH  TREATMENT  MAY  BE
 PROVIDED  TO  THE  MINOR  BY A QUALIFIED HEALTH PROFESSIONAL ON AN INPA-
 TIENT, RESIDENTIAL OR OUTPATIENT BASIS, A STAFF HEALTH PROFESSIONAL IN A
 HOSPITAL, OR PERSONS OPERATING  UNDER  THEIR  SUPERVISION,  WITHOUT  THE
 CONSENT OR INVOLVEMENT OF THE PARENT OR GUARDIAN.
   4.  Admission  and  discharge  for  inpatient or residential treatment
 shall be made in accordance with subdivision (d) of this section.
   § 4. Section 33.21 of the mental hygiene law, as added by chapter  790
 of the laws of 1983, subdivisions (a), (b) and (c) as amended and subdi-
 vision  (e)  as  added by chapter 461 of the laws of 1994, is amended to
 read as follows:
 § 33.21 Consent for mental health treatment of minors.
   (a) For the purposes of this section:
   (1) "minor" shall mean a person under eighteen years of age, but shall
 not include a person who is the parent  of  a  child,  emancipated,  has
 married  or is on voluntary status on [his or her] THEIR own application
 pursuant to section 9.13 of this chapter;
   (2) "mental health practitioner" shall mean a  physician,  a  licensed
 psychologist,  or  persons  providing  MENTAL  HEALTH services under the
 supervision of a physician in a facility operated  or  licensed  by  the
 office of mental health OR PROVIDING OUTPATIENT MENTAL HEALTH SERVICES;
   (3) "outpatient  mental  health  services"  shall mean [those services
 provided in an outpatient program licensed or operated pursuant  to  the
 regulations of the commissioner of] mental health SERVICES PROVIDED TO A
 PERSON  THAT  OCCUR IN A COMMUNITY LOCATION AND/OR IN AN AMBULATORY CARE
 SETTING SUCH AS A MENTAL HEALTH CENTER OR SUBSTANCE USE DISORDER CLINIC,
 HOSPITAL OUTPATIENT DEPARTMENT, COMMUNITY HEALTH CENTER, OR  PRACTITION-
 ER'S  OFFICE, OR VIA TELEHEALTH.  THE SERVICES MAY ALSO BE PROVIDED AT A
 PERSON'S HOME OR SCHOOL. TREATMENT AT THIS LEVEL CAN INCLUDE PSYCHOTHER-
 APY AND/OR MEDICATION MANAGEMENT. THESE SERVICES CAN BE DELIVERED IN  AN
 INDIVIDUAL, FAMILY, OR GROUP SETTING;
   (4) "reasonably  available"  shall  mean  a  parent or guardian can be
 contacted with diligent efforts by a mental health practitioner; and
   (5) "capacity" shall mean the minor's ability to understand and appre-
 ciate the nature and consequences of the proposed  treatment,  including
 the benefits and risks of, and alternatives to, such proposed treatment,
 and to reach an informed decision.
   (b)  In  providing  outpatient  mental health services to a minor, [or
 psychotropic medications to a minor residing in a hospital,] the  impor-
 tant role of the parents or guardians shall be recognized. As clinically
 appropriate,  steps  shall  be  taken to actively involve the parents or
 guardians, and the consent of such persons shall be  required  for  such
 A. 9963                             5
 
 treatment  in  non-emergency  situations, except as provided in subdivi-
 sions (c), (d) and (e) of this section  or  section  two  thousand  five
 hundred four of the public health law.
   (c)  A mental health practitioner may provide outpatient mental health
 services[, other than those treatments and procedures for which  consent
 is  specifically  required by section 33.03 of this article,] to a minor
 voluntarily seeking such services without parental or  guardian  consent
 if the mental health practitioner determines that:
   (1)  THE  MINOR  MAY GIVE EFFECTIVE CONSENT UNDER SECTION TWO THOUSAND
 FIVE HUNDRED FOUR OF THE PUBLIC HEALTH LAW; OR
   (2) the minor is knowingly and voluntarily seeking such services; and
   [(2)] (3) provision of  such  services  is  clinically  indicated  and
 necessary to the minor's well-being; and
   [(3)] (4) (i) a parent or guardian is not reasonably available; or
   (ii)  requiring parental or guardian consent or involvement would have
 a detrimental effect on the course of outpatient treatment; or
   (iii) a parent or guardian has refused to  give  such  consent  and  a
 [physician]  PRACTITIONER  determines that treatment is necessary and in
 the best interests of the minor.
   The mental health practitioner shall fully document  the  reasons  for
 [his  or her] THEIR determinations. Such documentation shall be included
 in the minor's clinical record, along with a written statement signed by
 the minor indicating that [he or she is] THEY  ARE  voluntarily  seeking
 services.  As  clinically  appropriate,  notice  of a determination made
 pursuant to subparagraph (iii) of paragraph [three] FOUR of this  subdi-
 vision shall be provided to the parent or guardian.
   (d) A mental health practitioner may provide a minor voluntarily seek-
 ing outpatient services an initial interview without parental or guardi-
 an  consent or involvement to determine whether the criteria of subdivi-
 sion (c) of this section are present.
   (e) (1) Subject to the  regulations  of  the  commissioner  of  mental
 health governing the patient's right to object to treatment, subdivision
 (b)  of  this section and paragraph two of this subdivision, the consent
 of a parent or guardian  or  the  authorization  of  a  court  shall  be
 required  for  the  non-emergency administration of psychotropic medica-
 tions to a minor residing in a hospital UNLESS THE MINOR MAY GIVE EFFEC-
 TIVE CONSENT UNDER SECTION TWO THOUSAND FIVE HUNDRED FOUR OF THE  PUBLIC
 HEALTH LAW.
   (2) A minor [sixteen years of age or older] who consents may be admin-
 istered  psychotropic  medications  without  the  consent of a parent or
 guardian or the authorization of a court where[:
   (i) a parent or guardian is not  reasonably  available,  provided  the
 treating  physician  determines that (A) the minor has capacity; and (B)
 such medications are in the minor's best interests; or
   (ii) requiring consent of a parent or guardian  would  have  a  detri-
 mental effect on the minor, provided the treating physician and a second
 physician  who  specializes  in psychiatry and is not an employee of the
 hospital determine that (A) such detrimental effect would occur; (B) the
 minor has capacity; and (C) such medications are  in  the  minor's  best
 interests; or
   (iii)  the  parent  or  guardian  has  refused  to  give such consent,
 provided the treating physician and a second physician  who  specializes
 in  psychiatry and is not an employee of the hospital determine that (A)
 the minor has capacity; and (B) such medications are in the minor's best
 interests. Notice of the decision to administer psychotropic medications
 pursuant to this subparagraph shall be provided to the parent or guardi-
 A. 9963                             6

 an] THE MINOR MAY GIVE EFFECTIVE CONSENT UNDER SECTION TWO THOUSAND FIVE
 HUNDRED FOUR OF THE PUBLIC HEALTH LAW.
   (3)  The reasons for an exception authorized pursuant to paragraph two
 of this subdivision shall be fully  documented  and  such  documentation
 shall be included in the minor's clinical record.
   §  5.  Subdivision  8  of  section  372 of the social services law, as
 amended by chapter 684 of the laws  of  1996,  is  amended  to  read  as
 follows:
   8.  In  any case where a child is to be placed with or discharged to a
 relative or other person legally responsible  pursuant  to  section  ten
 hundred  seventeen  or  ten  hundred fifty-five of the family court act,
 such relative or other person shall be provided with such information by
 an authorized agency as is provided to foster parents pursuant  to  this
 section and applicable regulations of the department; PROVIDED, HOWEVER,
 THAT  NO  INFORMATION  ABOUT  ANY  MEDICAL,  DENTAL, HEALTH, OR HOSPITAL
 SERVICE A CHILD HAS CONSENTED TO THEMSELF SHALL BE INCLUDED WITHOUT  THE
 CHILD'S  AUTHORIZATION.  A  CHILD MAY CONSENT TO DISCLOSURE GENERALLY OR
 ONLY IN AN EMERGENCY OR MAY WITHHOLD CONSENT ALL TOGETHER.
   § 6. Section 373-a of the social services law, as amended  by  chapter
 305 of the laws of 2008, is amended to read as follows:
   § 373-a. Medical histories. Notwithstanding any other provision of law
 to the contrary, to the extent they are available, the medical histories
 of  a  child  legally  freed  for adoption or of a child to be placed in
 foster care and of [his or her] THEIR birth  parents,  with  information
 identifying  such  birth  parents  eliminated,  shall  be provided by an
 authorized agency to such child's prospective adoptive parent or  foster
 parent  and  upon  request  to the adoptive parent or foster parent when
 such child has been adopted or placed in foster care; PROVIDED, HOWEVER,
 THAT NO INFORMATION ABOUT  ANY  MEDICAL,  DENTAL,  HEALTH,  OR  HOSPITAL
 SERVICE  A CHILD HAS CONSENTED TO THEMSELF SHALL BE INCLUDED WITHOUT THE
 CHILD'S AUTHORIZATION. A CHILD MAY CONSENT TO  DISCLOSURE  GENERALLY  OR
 ONLY IN AN EMERGENCY OR MAY WITHHOLD CONSENT ALL TOGETHER. To the extent
 they  are available, the medical histories of a child in foster care and
 of [his or her] THEIR birth parents shall be provided by  an  authorized
 agency  to such child when discharged to [his or her] THEIR own care and
 upon request to any adopted  former  foster  child;  provided,  however,
 medical  histories of birth parents shall be provided to an adoptee with
 information identifying such  birth  parents  eliminated.  Such  medical
 histories  shall  include all available information setting forth condi-
 tions or diseases believed to be hereditary,  any  drugs  or  medication
 taken  during pregnancy by the child's birth mother and any other infor-
 mation, including any psychological information in the case of  a  child
 legally  freed  for  adoption or when such child has been adopted, or in
 the case of a child to be placed in foster care or placed in foster care
 which may be a factor influencing the child's present or future  health.
 The  department  shall  promulgate  and  may  alter or amend regulations
 governing the release of medical histories pursuant to this section.
   § 7. The social services law is amended by adding a new section  373-b
 to read as follows:
   § 373-B. REPRODUCTIVE AND SEXUAL HEALTH CARE SERVICES AND INFORMATION.
 1. EACH FOSTER PARENT MUST BE ADVISED, IN WRITING, INITIALLY AND ANNUAL-
 LY  THEREAFTER,  OF  THE AVAILABILITY OF SOCIAL, EDUCATIONAL AND MEDICAL
 REPRODUCTIVE AND SEXUAL HEALTH CARE SERVICES AND INFORMATION BY MEANS OF
 A LETTER OR BROCHURE DESIGNED FOR THIS PURPOSE.
   2. AN AUTHORIZED AGENCY AS DEFINED IN THIS TITLE SHALL OFFER  AGE  AND
 DEVELOPMENTALLY APPROPRIATE REPRODUCTIVE AND SEXUAL HEALTH CARE SERVICES
 A. 9963                             7
 
 AND INFORMATION TO ALL FOSTER CHILDREN WHO ARE OR MAY BE SEXUALLY ACTIVE
 OR  WHO  REQUEST SUCH SERVICES OR INFORMATION THROUGH THE AGENCY'S CASE-
 WORKER CONTACT AND AS PART OF THE COMPREHENSIVE SERVICE  PLAN  FOR  EACH
 CHILD.  SUCH  AN  OFFER MAY BE MADE ORALLY TO THE CHILD AS LONG AS IT IS
 ALSO MADE IN WRITING, BY MEANS OF A LETTER OR BROCHURE DESIGNED FOR THIS
 PURPOSE. IF SUCH A PLAN IS DEVELOPED BY A SOCIAL SERVICES DISTRICT,  THE
 DISTRICT MUST CONTINUE TO MONITOR THE PARTICULAR AGENCY'S PROGRAM IMPLE-
 MENTATION,  TO  ENSURE  THAT THE OFFER IS BEING MADE IN WRITING AND THAT
 REQUESTED SERVICES ARE PROVIDED WITHIN THIRTY DAYS, AND TO  REQUIRE  AND
 COLLECT REPORTS AND DATA FROM THE AGENCY.
   3.  SERVICES  AND  INFORMATION  OFFERED  UNDER  THIS  SECTION  MUST BE
 RESPECTFUL AND INCLUSIVE OF ALL FOSTER CHILDREN REGARDLESS OF ACTUAL  OR
 PERCEIVED  RACE, COLOR, WEIGHT, NATIONAL ORIGIN, ETHNIC GROUP, RELIGION,
 RELIGIOUS PRACTICE, DISABILITY, SEXUAL ORIENTATION, OR GENDER AS DEFINED
 IN SECTION ELEVEN OF THE EDUCATION LAW.
   § 8. Paragraph (c) of subdivision 1  of  section  366  of  the  social
 services  law  is  amended  by  adding  a new subparagraph 11 to read as
 follows:
   (11) A MINOR WHO IS NOT  OTHERWISE  ELIGIBLE  FOR  MEDICAL  ASSISTANCE
 UNDER THIS SECTION WHO CONSENTS TO THEIR OWN MEDICAL, DENTAL, HEALTH AND
 HOSPITAL SERVICES UNDER SUBDIVISION TWO OR THREE OF SECTION TWO THOUSAND
 FIVE  HUNDRED  FOUR  OF  THE  PUBLIC HEALTH LAW IS ELIGIBLE FOR STANDARD
 COVERAGE ONLY FOR THE SPECIFIC SERVICES CONSENTED TO; PROVIDED THAT THIS
 SUBPARAGRAPH ONLY APPLIES IF THE MINOR IS UNABLE TO USE  ANOTHER  SOURCE
 OF  HEALTH  INSURANCE  TO PAY FOR THE SERVICES CONSENTED TO. THE COMMIS-
 SIONER OF HEALTH SHALL PROMULGATE SUCH REGULATIONS AS MAY  BE  NECESSARY
 TO CARRY OUT THE PROVISIONS OF THIS SUBPARAGRAPH.
   § 9. Section 17 of the public health law, as amended by section 165 of
 the laws of 1991, the first undesignated paragraph as amended by chapter
 322 of the laws of 2017, is amended to read as follows:
   §  17.  Release  of medical records.   Upon the written request of any
 competent patient, parent or guardian of an infant, a guardian appointed
 pursuant to article eighty-one of the mental hygiene law, or conservator
 of a conservatee, an examining,  consulting  or  treating  physician  or
 hospital  must  release  and deliver, exclusive of personal notes of the
 said physician or hospital, copies of all x-rays,  medical  records  and
 test  records  including  all laboratory tests regarding that patient to
 any other designated physician or hospital provided, however, that  such
 records  concerning  the  treatment  of  an  infant patient for venereal
 disease [or], the performance of an abortion operation upon such  infant
 patient,  OR  ANY MEDICAL, DENTAL, HEALTH AND HOSPITAL SERVICES THAT THE
 INFANT PATIENT HAS CONSENTED TO THEMSELF UNDER SECTION TWO THOUSAND FIVE
 HUNDRED FOUR OF THIS CHAPTER shall not be released or in any  manner  be
 made  available  to  the  parent or guardian of such infant[,]; PROVIDED
 FURTHER THAT ANY INFANT PATIENT WHO MAY  GIVE  EFFECTIVE  CONSENT  UNDER
 SECTION  TWO  THOUSAND  FIVE  HUNDRED  FOUR  OF THIS CHAPTER MAY REQUEST
 RELEASE OF THEIR OWN RECORDS AND THE REQUEST OF NO OTHER PERSON SHALL BE
 NECESSARY; and provided, further, that original mammograms, rather  than
 copies thereof, shall be released and delivered. Either the physician or
 hospital  incurring  the  expense of providing copies of x-rays, medical
 records and test records including all laboratory tests pursuant to  the
 provisions  of this section may impose a reasonable charge to be paid by
 the person requesting the release and deliverance  of  such  records  as
 reimbursement  for  such expenses, provided, however, that the physician
 or hospital may not impose a charge for copying  an  original  mammogram
 when  the  original  has  been  released  or  delivered to any competent
 A. 9963                             8

 patient, parent or guardian of an infant, a guardian appointed  pursuant
 to  article  eighty-one of the mental hygiene law, or a conservator of a
 conservatee and provided, further, that any  charge  for  delivering  an
 original  mammogram  pursuant to this section shall not exceed the docu-
 mented costs associated therewith. However, the  reasonable  charge  for
 paper  copies shall not exceed seventy-five cents per page. A release of
 records under this section shall not be denied solely because of inabil-
 ity to pay. No charge may be imposed under this section  for  providing,
 releasing,  or  delivering  medical records or copies of medical records
 where requested for the purpose of supporting an application,  claim  or
 appeal  for  any  government  benefit or program, provided that, where a
 provider maintains medical records in electronic form, it shall  provide
 the  copy in either electronic or paper form, as required by the govern-
 ment benefit or program, or at the patient's request.
   § 10. Paragraph (c) of subdivision 3  of  section  18  of  the  public
 health  law,  as added by chapter 497 of the laws of 1986, is amended to
 read as follows:
   (c) A subject [over the age of twelve years may] SHALL be notified  of
 any  request  by  a  qualified  person to review [his/her] THEIR patient
 information, and, if the subject objects to disclosure, the provider may
 deny the request. In the case of a facility, the  treating  practitioner
 shall  be  consulted.    IN NO EVENT MAY A PROVIDER DISCLOSE INFORMATION
 ABOUT ANY MEDICAL, DENTAL, HEALTH, OR HOSPITAL  SERVICE  AN  INFANT  HAS
 CONSENTED  TO  THEMSELF  TO  THE INFANT'S PARENT OR GUARDIAN WITHOUT THE
 INFANT'S AUTHORIZATION. AN INFANT MAY CONSENT  TO  DISCLOSURE  TO  THEIR
 PARENT  OR  GUARDIAN  GENERALLY  OR ONLY IN AN EMERGENCY OR MAY WITHHOLD
 CONSENT ALL TOGETHER. AN  INFANT  WHO  MAY  GIVE  EFFECTIVE  CONSENT  TO
 MEDICAL, DENTAL, HEALTH, OR HOSPITAL SERVICES UNDER SECTION TWO THOUSAND
 FIVE  HUNDRED  FOUR  OF  THIS CHAPTER MAY ALSO GIVE EFFECTIVE CONSENT TO
 RELEASE THEIR PATIENT INFORMATION TO ANY PERSON.
   § 11. Paragraph 2 of subdivision (c) of section 33.16  of  the  mental
 hygiene  law, as added by chapter 498 of the laws of 1986, is amended to
 read as follows:
   2. A patient or client [over the age of twelve may] SHALL be  notified
 of  any  request  by a qualified person to review [his/her] THEIR record
 and if the patient or client objects to  disclosure,  the  facility,  in
 consultation  with the treating practitioner may deny the request. IN NO
 EVENT MAY A FACILITY, PRACTITIONER, OR  TREATING  PRACTITIONER  DISCLOSE
 CLINICAL  RECORDS  PERTAINING  TO  TREATMENT AN INFANT PATIENT OR CLIENT
 CONSENTED TO THEMSELF TO THE INFANT'S PARENT  OR  GUARDIAN  WITHOUT  THE
 MINOR'S  AUTHORIZATION.  AN  INFANT  PATIENT  OR  CLIENT  MAY CONSENT TO
 DISCLOSURE TO THEIR PARENT OR GUARDIAN GENERALLY OR ONLY IN AN EMERGENCY
 OR MAY WITHHOLD CONSENT ALL TOGETHER. AN INFANT WHO MAY  GIVE  EFFECTIVE
 CONSENT  TO A MEDICAL, DENTAL, HEALTH, OR HOSPITAL SERVICE UNDER SECTION
 TWO THOUSAND FIVE HUNDRED FOUR OF THE PUBLIC HEALTH LAW  MAY  ALSO  GIVE
 EFFECTIVE CONSENT TO RELEASE THEIR CLINICAL RECORD TO ANY PERSON.
   §  12.  Section  3244  of the insurance law is amended by adding a new
 subsection (f) to read as follows:
   (F) (1) AN INSURER, INCLUDING HEALTH MAINTENANCE ORGANIZATIONS OPERAT-
 ING UNDER ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW OR ARTICLE  FORTY-
 THREE  OF THIS CHAPTER AND ANY OTHER CORPORATION OPERATING UNDER ARTICLE
 FORTY-THREE OF THIS CHAPTER SHALL TAKE THE FOLLOWING  STEPS  TO  PROTECT
 THE  CONFIDENTIALITY  OF  AN  INSURED'S,  INCLUDING  A  SUBSCRIBER'S  OR
 ENROLLEE'S, MEDICAL INFORMATION:
   (I) INSURERS SHALL  PERMIT  AN  INSURED  WHO  CONSENTS  TO  THEIR  OWN
 MEDICAL,  DENTAL,  HEALTH AND HOSPITAL SERVICES UNDER SUBDIVISION TWO OR
 A. 9963                             9
 
 THREE OF SECTION TWO THOUSAND FIVE HUNDRED FOUR OF THE PUBLIC HEALTH LAW
 TO CHOOSE A METHOD OF  RECEIVING  EXPLANATION  OF  BENEFITS  FORMS  THAT
 CONTAIN  INFORMATION  RELATING  TO  THE RECEIPT OF THE SPECIFIC SERVICES
 CONSENTED TO, WHICH SHALL INCLUDE, BUT NOT BE LIMITED TO, THE FOLLOWING:
 SENDING  THE  FORM TO THE ADDRESS OF THE SUBSCRIBER; SENDING THE FORM TO
 THE ADDRESS OF THE INSURED; SENDING THE FORM  TO  AN  ALTERNATE  ADDRESS
 DESIGNATED  BY THE INSURED; OR SENDING THE FORM THROUGH ELECTRONIC MEANS
 WHEN AVAILABLE. WHEN AN INSURED HAS SUBMITTED A  REQUEST  FOR  RECEIVING
 EXPLANATION  OF  BENEFITS FORMS UNDER THIS SECTION AN INSURER IS THEREBY
 PROHIBITED FROM SENDING DUPLICATIVE EXPLANATION OF BENEFITS FORMS  TO  A
 NON-SPECIFIED  RECIPIENT OR IN A MANNER INCONSISTENT WITH THE REQUEST OF
 THE INSURED; AND
   (II) INSURERS SHALL NOT IN ANY WAY IDENTIFY THE DIAGNOSIS OR  SERVICES
 RECEIVED  AS  RELATES  TO  MEDICAL, DENTAL, HEALTH AND HOSPITAL SERVICES
 UNDER SUBDIVISION TWO OR THREE OF SECTION TWO THOUSAND FIVE HUNDRED FOUR
 OF THE PUBLIC HEALTH IN AN EXPLANATION  OF  BENEFITS  FORMS  OR  IN  ANY
 ONLINE PORTAL THAT ALLOWS SUBSCRIBERS TO ACCESS CLAIM INFORMATION.
   (2)  THE  DEPARTMENT  SHALL  DEVELOP AND MAKE AVAILABLE A STANDARDIZED
 FORM FOR AN INSURED TO USE TO REQUEST CONFIDENTIAL  COMMUNICATIONS  THAT
 SHALL BE ACCEPTED BY ALL INSURERS.
   (3)  FOR  THE  PURPOSES OF THIS SECTION, AN ALTERNATIVE COMMUNICATIONS
 REQUEST AS DESCRIBED IN  SUBPARAGRAPH  (I)  OF  PARAGRAPH  ONE  OF  THIS
 SUBSECTION SHALL BE IMPLEMENTED BY AN INSURER WITHIN SEVEN CALENDAR DAYS
 OF RECEIPT OF AN ELECTRONIC TRANSMISSION OR TELEPHONIC REQUEST OR WITHIN
 FOURTEEN  CALENDAR DAYS OF RECEIPT BY FIRST-CLASS MAIL. AN INSURER SHALL
 ACKNOWLEDGE RECEIPT OF THE ALTERNATIVE COMMUNICATIONS REQUEST AND ADVISE
 THE INSURED OF THE STATUS  OF  IMPLEMENTATION  OF  THE  REQUEST  IF  THE
 INSURED CONTACTS THE INSURER.
   (4) AN INSURER SHALL NOT CONDITION ENROLLMENT OR COVERAGE ON THE WAIV-
 ER OF RIGHTS PROVIDED IN THIS SUBSECTION.
   (5)  THIS  SUBSECTION  MAY  NOT BE CONSTRUED TO LIMIT ACCEPTANCE BY AN
 INSURER OF ANY OTHER FORM OF WRITTEN REQUEST FROM AN INSURED FOR  CONFI-
 DENTIAL COMMUNICATIONS FROM A CARRIER UNDER 45 C.F.R. § 164.522(B).
   § 13. Paragraph (c) and subparagraph (vi) of paragraph (d) of subdivi-
 sion  8  and  subdivision  10  of section 2168 of the public health law,
 paragraph (c) of subdivision 8 as amended by chapter 420 of the laws  of
 2014,  subparagraph (vi) of paragraph (d) of subdivision 8 as amended by
 chapter 154 of the laws of  2013,  and  subdivision  10  as  amended  by
 section  7  of  part A of chapter 58 of the laws of 2009, are amended to
 read as follows:
   (c) health care providers and their designees, registered professional
 nurses, and pharmacists authorized to administer immunizations  pursuant
 to  subdivision  two of section sixty-eight hundred one of the education
 law shall have access to the statewide immunization  information  system
 and  the  blood  lead  information  in  such system only for purposes of
 submission of information about  vaccinations  received  by  a  specific
 registrant,  determination  of  the  immunization  status  of a specific
 registrant, determination of the blood lead testing status of a specific
 registrant, submission of the results from a blood lead  analysis  of  a
 sample  obtained from a specific registrant in accordance with paragraph
 (h) of subdivision two of this section,  review  of  practice  coverage,
 generation  of  reminder notices, quality improvement and accountability
 and printing a copy of the immunization or lead testing record  for  the
 registrant's medical record, for the registrant's parent or guardian, or
 other  person  in  parental  or  custodial relation to a child, or for a
 registrant [upon reaching eighteen years  of  age];  PROVIDED,  HOWEVER,
 A. 9963                            10
 
 THAT  ANY IMMUNIZATION RECORD PRINTED FOR A REGISTRANT'S PARENT, GUARDI-
 AN, OR OTHER PERSON IN A CUSTODIAL RELATION TO  A  CHILD  SHALL  EXCLUDE
 INFORMATION  ABOUT  ANY IMMUNIZATION A REGISTRANT HAS CONSENTED TO THEM-
 SELF.
   (vi) commissioners of local social services districts with regard to a
 child in [his/her] THEIR legal custody;
   10.  The  person  to  whom any immunization record relates, or [his or
 her] THEIR parent, or guardian, or other person in parental or custodial
 relation to such person may request a copy of an  immunization  or  lead
 testing  record from the registrant's healthcare provider, the statewide
 immunization information system or the  citywide  immunization  registry
 according  to procedures established by the commissioner or, in the case
 of the citywide immunization registry, by the city of New  York  commis-
 sioner  of the department of health and mental hygiene; PROVIDED HOWEVER
 THAT ANY IMMUNIZATION RECORD PROVIDED TO THE PERSON'S PARENT OR GUARDIAN
 OR OTHER PERSON IN A PARENTAL OR CUSTODIAL RELATION TO SUCH PERSON SHALL
 EXCLUDE INFORMATION ABOUT ANY IMMUNIZATION THE PERSON HAS  CONSENTED  TO
 THEMSELF.
   §  14.  This  act  shall  take effect on the one hundred eightieth day
 after it shall have become a law. 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.