S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
     S. 2507                                                  A. 3007
 
                       S E N A T E - A S S E M B L Y
 
                             January 20, 2021
                                ___________
 
 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 part H of chapter 59 of the laws of 2011, amending the
   public health law and other  laws  relating  to  known  and  projected
   department  of health state fund Medicaid expenditures, in relation to
   extending the Medicaid global  cap  (Part  A);  to  amend  the  social
   services law, in relation to copayments for drugs; to amend the public
   health  law, in relation to prescriber prevails; and to repeal certain
   provisions of the social services law relating to coverage for certain
   prescription drugs (Part B);  to  amend  the  public  health  law,  in
   relation  to  community  health  centers (Part C); to amend the public
   health law, in relation to reducing the hospital capital  rate  add-on
   (Part D); to amend the public health law, in relation to adjusting the
   worker recruitment and retention funding (Part E); to amend the public
   health  law,  the  education law and the insurance law, in relation to
   comprehensive telehealth reforms (Part F); to amend the public  health
   law,  in relation to authorizing the implementation of medical respite
   pilot programs (Part G); to amend the social services law, in relation
   to eliminating consumer-paid premium  payments  in  the  basic  health
   program  (Part  H);  to  amend  the  public health law, in relation to
   federal waiver authorization for the NY State of Health, the  official
   Health  Plan  Marketplace  (Part  I);  to  amend the insurance law, in
   relation to the licensing of pharmacy benefit managers  (Part  J);  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 restructuring and extending the physi-
   cians  medical  malpractice  program; 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 malprac-
   tice and professional medical conduct, relating to  the  effectiveness
   of  certain  provisions  of  such  chapter,  in  relation to extending
   certain provisions concerning the hospital excess liability pool;  and
 
              

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD12571-01-1

 S. 2507                             2                            A. 3007
 
   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 extend-
   ing certain provisions relating  thereto,  in  relation  to  extending
   provisions  relating  to excess coverage (Part K); to amend the public
   health law, in relation to the  general  public  health  work  program
   (Part L); to amend the public health law, the state finance law, chap-
   ter 338 of the laws of 1998 amending the public health law, the public
   officers  law  and  the  state  finance law relating to establishing a
   spinal cord injury research board and part H of chapter 58 of the laws
   of 2007 amending the public health law, the public  officers  law  and
   the  state  finance law relating to establishing the empire state stem
   cell board, in relation to the discontinuation of the empire  clinical
   research investigator program (Part M); to amend the public health law
   and  the  education law, in relation to eliminating certain electronic
   prescription exemptions; and  to  repeal  certain  provisions  of  the
   public  health law and the education law relating thereto (Part N); to
   repeal certain provisions of the social services law relating  to  the
   enhanced  quality  of adult living program ("EQUAL") grants; to repeal
   certain provisions of the public health law relating to requiring that
   the department of health audit hospital working hours; and  to  repeal
   certain  provisions  of  the  social  services  law  relating  to  the
   provision providing operating subsidies to certain  publicly  operated
   adult  care  facilities  (Part O); to amend the public health law, the
   education law, the insurance law  and  the  social  services  law,  in
   relation  to  expanding  the role of pharmacists; 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  such
   provisions permanent; to amend chapter 116 of the laws of 2012, amend-
   ing  the  education  law relating to authorizing a licensed pharmacist
   and certified nurse  practitioner  to  administer  certain  immunizing
   agents, in relation to the effectiveness thereof; to amend chapter 274
   of  the laws of 2013, amending the education law relating to authoriz-
   ing a licensed pharmacist and certified nurse practitioner to adminis-
   ter meningococcal disease immunizing agents, in relation to the effec-
   tiveness thereof; and to  amend  chapter  21  of  the  laws  of  2011,
   amending  the  education  law  relating  to authorizing pharmacists to
   perform collaborative  drug  therapy  management  with  physicians  in
   certain  settings,  in  relation  to  making such provisions permanent
   (Part P); to amend the education law and the  public  health  law,  in
   relation  to  the state's physician profiles and enhancing the ability
   of the department of education to investigate, discipline, and monitor
   licensed physicians, physician assistants, and  specialist  assistants
   (Part  Q);  to  amend the civil rights law, in relation to a change of
   sex designation (Part R); to amend chapter 884 of the  laws  of  1990,
   amending  the  public  health law relating to authorizing bad debt and
   charity  care  allowances  for  certified  home  health  agencies,  in
   relation  to extending the provisions thereof; to amend chapter 109 of
   the laws of 2010, amending the social services law relating to  trans-
   portation  costs,  in  relation to the effectiveness thereof; to amend
   chapter 81 of the laws of 1995, amending the  public  health  law  and
   other  laws  relating  to medical reimbursement and welfare reform, in
   relation to the 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, in relation to extending government rates for behav-

 S. 2507                             3                            A. 3007
 
   ioral services and adding an alternative payment methodology  require-
   ment;  to  amend  chapter  57  of the laws of 2019 amending the public
   health law relating to waiver of certain regulations, in  relation  to
   the  effectiveness  thereof; to amend chapter 517 of the laws of 2016,
   amending the public health law relating to payments from the New  York
   state  medical indemnity fund, in relation to the effectiveness there-
   of; to amend the public health law,  in  relation  to  improved  inte-
   gration  of  health care and financing; and to amend chapter 56 of the
   laws of 2014, amending the education law relating to the nurse practi-
   tioners modernization act, in relation  to  extending  the  provisions
   thereof  (Part  S); to amend part A of chapter 111 of the laws of 2010
   amending the mental hygiene law relating to the receipt of federal and
   state benefits received by individuals receiving  care  in  facilities
   operated by an office of the department of mental hygiene, in relation
   to  the  effectiveness thereof (Part T); to amend part L of chapter 59
   of the laws of 2016, amending the mental hygiene law relating  to  the
   appointment  of  temporary  operators  for  the continued operation of
   programs and the provision of services for persons with serious mental
   illness and/or developmental disabilities and/or chemical  dependence,
   in relation to the effectiveness thereof (Part U); to amend part NN of
   chapter 58 of the laws of 2015, amending the mental hygiene law relat-
   ing 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 V);  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  relat-
   ing thereto (Part W); authorizing the office of mental health to rede-
   sign  services  of  certain  facilities  and programs and to implement
   service reductions; and providing for the repeal  of  such  provisions
   upon  expiration thereof (Part X); to amend the mental hygiene law, in
   relation to setting standards for addiction professionals (Part Y); to
   amend the mental hygiene law, in relation to imposing sanctions due to
   a provider's failure to comply  with  the  terms  of  their  operating
   certificate  or applicable law and to charge an application processing
   fee for the issuance of operating certificates (Part Z); to amend  the
   mental  hygiene law and the social services law, in relation to crisis
   stabilization services (Subpart A); to amend the mental hygiene law in
   relation to Kendra's law and assisted  outpatient  treatment  (Subpart
   B);  and  to  amend the mental hygiene law, in relation to involuntary
   commitment (Subpart C) (Part AA); to amend the mental hygiene law,  in
   relation  to  establishing  the  New  York  state  institute for basic
   research in developmental disabilities (Part BB); to amend the  mental
   hygiene  law,  in  relation  to  creating  the office of addiction and
   mental health services (Part CC); to amend the  social  services  law,
   the  public  health  law  and  the  mental hygiene law, in relation to
   setting comprehensive outpatient services (Part  DD);  and  to  repeal
   subdivision  10  of  section 553 of the executive law, relating to the
   requirement that the justice center administer an adult home and resi-
   dence for adults resident advocacy program (Part EE)

 S. 2507                             4                            A. 3007
 
   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
 necessary to implement the state health and mental  hygiene  budget  for
 the  2021-2022  state  fiscal  year.  Each component is wholly contained
 within a Part identified as Parts A through EE. 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,  including the effective date of the Part, which makes a refer-
 ence 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 Part in which it is found. Section three of this
 act sets forth the general effective date of this act.
 
                                  PART A
 
   Section 1. Paragraph (a) of 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 CCC of chapter 56
 of the laws of 2020, is amended to read as follows:
   (a) For state fiscal years  2011-12  through  [2021-22]  2022-23,  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.
   § 2. This act shall take effect immediately.
 
                                  PART B
 
   Section 1. 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;
   §  2.  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 PROGRAM WILL CONSIDER  THE  ADDITIONAL  INFORMATION

 S. 2507                             5                            A. 3007
 
 AND  THE  JUSTIFICATION  PRESENTED  TO  DETERMINE  WHETHER  the use of a
 prescription drug that is not on the preferred drug list  is  warranted,
 AND the [prescriber's] PROGRAM'S determination shall be final.
   §  3. Subdivisions 25 and 25-a of section 364-j of the social services
 law are 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, 2021.
 
                                  PART C
 
   Section  1.  The  public health law is amended by adding a new section
 2807-pp to read as follows:
   § 2807-PP. 340B REIMBURSEMENT FUND. 1. NOTWITHSTANDING ANY  INCONSIST-
 ENT  PROVISION  OF LAW AND SUBJECT TO THE AVAILABILITY OF FEDERAL FINAN-
 CIAL PARTICIPATION, THERE IS HEREBY CREATED A FUND TO SUPPORT ACTIVITIES
 THAT EXPAND HEALTH SERVICES TO THE MEDICAID MEMBERS, THE UNINSURED,  AND
 LOW-INCOME  PATIENTS, AS SUPPORTED BY THE 340B PROGRAM. ALL FUNDS AVAIL-
 ABLE FOR DISTRIBUTION PURSUANT TO THIS SECTION SHALL BE RESERVED AND SET
 ASIDE AND DISTRIBUTED IN ACCORDANCE WITH THIS SECTION.
   2. EACH ELIGIBLE 340B PROVIDER SHALL RECEIVE A PROPORTIONATE  DISTRIB-
 UTION TO BE DETERMINED BY A METHODOLOGY ESTABLISHED BY THE COMMISSIONER.
 ANNUAL  AGGREGATE  DISTRIBUTIONS PURSUANT TO THIS SECTION FOR THE FISCAL
 YEAR FROM APRIL FIRST, TWO THOUSAND TWENTY-ONE  TO  MARCH  THIRTY-FIRST,
 TWO THOUSAND TWENTY-TWO, AND EACH FISCAL YEAR THEREAFTER, SHALL BE EQUAL
 TO  ONE  HUNDRED TWO MILLION DOLLARS, BUT MAY BE INCREASED BY ADDITIONAL
 AMOUNTS AUTHORIZED BY THE DIRECTOR OF THE  DIVISION  OF  THE  BUDGET  IN
 CONSULTATION WITH THE COMMISSIONER.
   3.  "ELIGIBLE  340B PROVIDER" MEANS A VOLUNTARY NON-PROFIT OR PUBLICLY
 SPONSORED DIAGNOSTIC AND TREATMENT  CENTER  LICENSED  PURSUANT  TO  THIS
 ARTICLE  TWENTY-EIGHT THAT DELIVERS A COMPREHENSIVE RANGE OF HEALTH CARE
 SERVICES AND THAT WAS ENROLLED IN THE 340B PROGRAM PURSUANT  TO  SECTION
 340B(A)(4)  OF THE FEDERAL PUBLIC HEALTH SERVICE ACT DURING THE CALENDAR
 YEAR TWO THOUSAND TWENTY AND THAT SUBMITS TO THE DEPARTMENT  THE  ANNUAL
 RECERTIFICATION  OF PARTICIPATION IN THE 340B PROGRAM AS PROVIDED BY THE
 HEALTH RESOURCES AND SERVICES ADMINISTRATION.
   § 2. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2021.
 
                                  PART D
 
   Section  1.  Paragraph  (c)  of subdivision 8 of section 2807-c of the
 public health law, as amended by section 2 of part KK of chapter  56  of
 the laws of 2020, is amended to read as follows:
   (c)  In order to reconcile capital related inpatient expenses included
 in rates of payment based on a budget to actual expenses and  statistics
 for  the  rate  period  for  a  general hospital, rates of payment for a
 general hospital shall be adjusted to reflect the dollar  value  of  the
 difference  between  capital  related inpatient expenses included in the
 computation of rates of payment for a prior rate period based on a budg-
 et and actual capital related inpatient expenses  for  such  prior  rate
 period,  each  as  determined  in  accordance with paragraph (a) of this
 subdivision, adjusted to reflect increases or  decreases  in  volume  of
 service  in  such  prior  rate  period compared to statistics applied in
 determining the capital related inpatient expenses component of rates of
 payment based on a budget for such prior rate period. For  rates  effec-
 tive [on and after] April first, two thousand twenty THROUGH MARCH THIR-

 S. 2507                             6                            A. 3007
 
 TY-FIRST, TWO THOUSAND TWENTY-ONE, the budgeted capital-related expenses
 add-on  as  described  in  paragraph (a) of this subdivision, based on a
 budget submitted in accordance to paragraph  (a)  of  this  subdivision,
 shall  be reduced by five percent relative to the rate in effect on such
 date; and the actual capital expenses add-on as described  in  paragraph
 (a) of this subdivision, based on actual expenses and statistics through
 appropriate  audit  procedures  in accordance with paragraph (a) of this
 subdivision shall be reduced by five percent relative  to  the  rate  in
 effect  on  such date. FOR RATES EFFECTIVE ON AND AFTER APRIL FIRST, TWO
 THOUSAND TWENTY-ONE, THE BUDGETED  CAPITAL-RELATED  EXPENSES  ADD-ON  AS
 DESCRIBED  IN  PARAGRAPH  (A)  OF  THIS  SUBDIVISION,  BASED ON A BUDGET
 SUBMITTED IN ACCORDANCE TO PARAGRAPH (A) OF THIS SUBDIVISION,  SHALL  BE
 REDUCED  BY TEN PERCENT RELATIVE TO THE RATE IN EFFECT ON SUCH DATE; AND
 THE ACTUAL CAPITAL EXPENSES ADD-ON AS DESCRIBED IN PARAGRAPH (A) OF THIS
 SUBDIVISION, BASED ON ACTUAL EXPENSES AND STATISTICS THROUGH APPROPRIATE
 AUDIT PROCEDURES IN ACCORDANCE WITH PARAGRAPH (A)  OF  THIS  SUBDIVISION
 SHALL  BE  REDUCED BY TEN PERCENT RELATIVE TO THE RATE IN EFFECT ON SUCH
 DATE. For any rate year, all reconciliation add-on amounts calculated on
 and after April first, two thousand  twenty  shall  be  reduced  by  ten
 percent,  and  all  reconciliation  recoupment  amounts calculated on or
 after April first, two thousand twenty shall increase  by  ten  percent.
 Notwithstanding  any inconsistent provision of subparagraph (i) of para-
 graph (e) of subdivision nine of this section, capital related inpatient
 expenses of a general hospital included in the computation of  rates  of
 payment  based on a budget shall not be included in the computation of a
 volume adjustment made in accordance with such subparagraph. Adjustments
 to rates of payment for a general hospital made pursuant to  this  para-
 graph  shall  be  made  in  accordance with paragraph (c) of subdivision
 eleven of this section. Such adjustments shall not  be  carried  forward
 except  for  such  volume  adjustment as may be authorized in accordance
 with subparagraph (i) of paragraph  (e)  of  subdivision  nine  of  this
 section for such general hospital.
   §  2.  Clause (A) of subparagraph (ii) of paragraph (b) of subdivision
 5-d of section 2807-k of the public health law, as amended by section  3
 of  part  KK  of  chapter  56 of the laws of 2020, is amended to read as
 follows:
   (A) (1) SUBJECT TO ITEM TWO OF THIS CLAUSE,  one  hundred  thirty-nine
 million  four  hundred thousand dollars shall be distributed as Medicaid
 Disproportionate Share Hospital ("DSH") payments to major public general
 hospitals;
   (2) FOR THE CALENDAR YEARS TWO THOUSAND TWENTY-ONE THROUGH  TWO  THOU-
 SAND  TWENTY-TWO,  AND  FOR  EACH  CALENDAR  YEAR  THEREAFTER, THE TOTAL
 DISTRIBUTIONS TO MAJOR PUBLIC GENERAL HOSPITALS SHALL BE REDUCED TO ZERO
 DOLLARS ANNUALLY; and
   § 3.  This act shall take effect immediately and shall  be  deemed  to
 have been in full force and effect on and after April 1, 2021; provided,
 however,  that  amendments  to  subdivision 5-d of section 2807-k of the
 public health law made by section two of this act shall not  affect  the
 expiration of such subdivision and shall be deemed to expire therewith.
 
                                  PART E
 
   Section  1. Clauses (M) and (N) of subparagraph (ii) of paragraph (bb)
 of subdivision 1 of section 2807-v of the public health law, as  amended
 by  section  14 of part Y of chapter 56 of the laws of 2020, are amended
 and a new clause (O) is added to read as follows:

 S. 2507                             7                            A. 3007
 
   (M) for each state fiscal year within  the  period  April  first,  two
 thousand  seventeen  through  March  thirty-first,  two thousand twenty,
 three hundred forty million dollars; [and]
   (N)  for  each  state  fiscal  year within the period April first, two
 thousand twenty through March thirty-first, two thousand  [twenty-three]
 TWENTY-ONE, three hundred forty million dollars[.]; AND
   (O)  FOR  EACH  STATE  FISCAL  YEAR WITHIN THE PERIOD APRIL FIRST, TWO
 THOUSAND TWENTY-ONE THROUGH MARCH  THIRTY-FIRST,  TWO  THOUSAND  TWENTY-
 THREE,  ONE  HUNDRED  SEVENTY MILLION DOLLARS AND EACH STATE FISCAL YEAR
 THEREAFTER.
   § 2. Subparagraphs (xiii) and (xiv) of paragraph (cc) of subdivision 1
 of section 2807-v of the public health law, as amended by section 14  of
 part Y of chapter 56 of the laws of 2020, are amended and a new subpara-
 graph (xv) is added to read as follows:
   (xiii)  up  to  eleven million two hundred thousand dollars each state
 fiscal year for the period April first, two thousand  seventeen  through
 March thirty-first, two thousand twenty; [and]
   (xiv)  up  to  eleven  million two hundred thousand dollars each state
 fiscal year for the period April  first,  two  thousand  twenty  through
 March thirty-first, two thousand [twenty-three.]TWENTY-ONE; AND
   (XV)  UP  TO  FIVE  MILLION SIX HUNDRED THOUSAND DOLLARS FOR THE STATE
 FISCAL YEAR COMMENCING APRIL FIRST, TWO  THOUSAND  TWENTY-ONE  AND  EACH
 STATE FISCAL YEAR THEREAFTER.
   § 3. Subparagraphs (ix) and (x) of paragraph (ccc) of subdivision 1 of
 section  2807-v  of  the  public health law, as amended by section 14 of
 part Y of chapter 56 of the laws of 2020, are amended and a new subpara-
 graph (xi) is added to read as follows:
   (ix) up to fifty million dollars each state fiscal year for the period
 April first, two thousand  seventeen  through  March  thirty-first,  two
 thousand twenty; [and]
   (x)  up to fifty million dollars each state fiscal year for the period
 April first, two thousand twenty through March thirty-first,  two  thou-
 sand [twenty-three.] TWENTY-ONE; AND
   (XI)  UP  TO  TWENTY-FIVE  MILLION  DOLLARS FOR EACH STATE FISCAL YEAR
 WITHIN THE PERIOD APRIL FIRST, TWO  THOUSAND  TWENTY-ONE  THROUGH  MARCH
 THIRTY-FIRST, TWO THOUSAND TWENTY-THREE AND EACH STATE FISCAL YEAR THER-
 EAFTER.
   §  4.  The  opening  paragraph  of  paragraph  (a) of subdivision 8 of
 section 3614 of the public health law, as amended by section 55 of  part
 A of chapter 56 of the laws of 2013, is amended to read as follows:
   Notwithstanding  any inconsistent provision of law, rule or regulation
 and subject to the provisions of paragraph (b) of this  subdivision  and
 to the availability of federal financial participation, the commissioner
 shall  adjust  medical assistance rates of payment for services provided
 by certified home health agencies for such services provided to children
 under eighteen years of age and for services provided to a special needs
 population of medically complex and fragile  children,  adolescents  and
 young disabled adults by a CHHA operating under a pilot program approved
 by  the  department,  long  term home health care programs and AIDS home
 care programs in accordance with this paragraph  and  paragraph  (b)  of
 this  subdivision for purposes of improving recruitment and retention of
 non-supervisory home care services workers or  any  worker  with  direct
 patient  care  responsibility  in  the  following  amounts  for services
 provided on and after December first, two thousand two, PROVIDED, HOWEV-
 ER, FOR SERVICES PROVIDED IN THE  STATE  FISCAL  YEAR  COMMENCING  APRIL

 S. 2507                             8                            A. 3007
 
 FIRST,  TWO  THOUSAND  TWENTY-ONE SUCH AMOUNTS SHALL BE REDUCED BY FIFTY
 PERCENT.
   §  5.  Subdivision  1  of  section  4013  of the public health law, as
 amended by section 9 of part MM of chapter 56 of the laws  of  2020,  is
 amended to read as follows:
   1.  The  commissioner  shall, subject to the provisions of subdivision
 two of this section, increase medical assistance rates of payment by  up
 to  three  percent  for  hospice services provided on and after December
 first, two thousand two,  for  purposes  of  improving  recruitment  and
 retention of non-supervisory workers or workers with direct patient care
 responsibility,  PROVIDED,  HOWEVER,  FOR SERVICES PROVIDED IN THE STATE
 FISCAL  YEAR  COMMENCING  APRIL  FIRST,  TWO  THOUSAND  TWENTY-ONE  SUCH
 INCREASE SHALL BE UP TO ONE AND ONE-HALF PERCENT.
   §  6.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2021.
 
                                  PART F
 
   Section 1. Subdivision 3 of section 2999-cc of the public health  law,
 as amended by section 2 of subpart C of part S of chapter 57 of the laws
 of 2018, 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)  certified  and  non-certified  day  and  residential
 programs  funded or operated by the office for people with developmental
 disabilities; (d) private physician's or dentist's offices located with-
 in the state of New York; (e) any type of adult care  facility  licensed
 under title two of article seven of the social services law; (f) 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 (g) the patient's place of residence located within the state of New
 York  or other temporary location located within or outside the state of
 New York.]
   § 2. Paragraph (d) of subdivision 18-a of section 206  of  the  public
 health  law, as amended by section 8 of part A of chapter 57 of the laws
 of 2015, is amended to read as follows:
   (d) The commissioner may make such rules and  regulations  as  may  be
 necessary  to  implement federal policies and disburse funds as required
 by the American Recovery and Reinvestment Act of 2009 and to promote the
 development of a self-sufficient SHIN-NY to enable  widespread,  non-du-
 plicative  interoperability  among disparate health information systems,
 including electronic health records,  personal  health  records,  health
 care  claims,  payment  and other administrative data, and public health
 information systems, while protecting privacy and security.  Such  rules
 and  regulations  shall include, but not be limited to, requirements for
 organizations covered by 42 U.S.C. 17938 or any other organizations that
 exchange health information through the SHIN-NY or any  other  statewide
 health  information system recommended by the workgroup.  SUCH RULES AND
 REGULATIONS SHALL REQUIRE THAT QUALIFIED ENTITIES PERMIT ACCESS  TO  ALL
 OF  A  PATIENT'S  INFORMATION  BY  ALL SHIN-NY PARTICIPANTS OR ANY OTHER
 GENERAL DESIGNATION OF WHO MAY ACCESS SUCH INFORMATION AFTER CONSENT  IS
 OBTAINED  USING  A SINGLE STATEWIDE SHIN-NY CONSENT FORM APPROVED BY THE
 DEPARTMENT AND PUBLISHED ON THE DEPARTMENT'S WEBSITE. If the commission-

 S. 2507                             9                            A. 3007
 
 er seeks to promulgate rules and regulations prior to  issuance  of  the
 report identified in subparagraph (iv) of paragraph (b) of this subdivi-
 sion,  the  commissioner  shall  submit  the proposed regulations to the
 workgroup  for  its input. If the commissioner seeks to promulgate rules
 and regulations after the issuance of  the  report  identified  in  such
 subparagraph  (iv)  then  the commissioner shall consider the report and
 recommendations of the workgroup. If the commissioner acts in  a  manner
 inconsistent  with  the input or recommendations of the workgroup, he or
 she shall provide the reasons therefor.
   § 3. Paragraphs (w) and (x) of subdivision 2 of section 2999-cc of the
 public health law, as amended by section 1 of part HH of chapter  56  of
 the laws of 2020, are amended to read as follows:
   (w)  a  care  manager  employed  by or under contract to a health home
 program, patient centered medical home, office for people with  develop-
 mental  disabilities  Care Coordination Organization (CCO), hospice or a
 voluntary foster care agency certified by the  office  of  children  and
 family services certified and licensed pursuant to article twenty-nine-i
 of this chapter; [and]
   (x)  PRACTITIONERS AUTHORIZED TO PROVIDE SERVICES IN NEW YORK PURSUANT
 TO THE INTERSTATE LICENSURE PROGRAM SET FORTH IN REGULATIONS PROMULGATED
 BY THE COMMISSIONER OF EDUCATION IN ACCORDANCE WITH SUBDIVISION THREE OF
 SECTION SIXTY-FIVE HUNDRED ONE OF THE EDUCATION LAW; AND
   (Y)  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
 addiction  services  and supports, or the commissioner of the office for
 people with developmental disabilities pursuant to regulation.
   § 4. Section 6501 of the education law is  amended  by  adding  a  new
 subdivision 3 to read as follows:
   3.  NOTWITHSTANDING  ANY  INCONSISTENT PROVISION OF LAW, RULE OR REGU-
 LATION TO THE CONTRARY, THE COMMISSIONER SHALL, IN CONSULTATION WITH THE
 COMMISSIONERS OF THE DEPARTMENT OF  HEALTH,  OFFICE  OF  MENTAL  HEALTH,
 OFFICE  OF  ADDICTION  SERVICES AND SUPPORTS, AND OFFICE FOR PEOPLE WITH
 DEVELOPMENTAL DISABILITIES, ISSUE REGULATIONS FOR  THE  CREATION  OF  AN
 INTERSTATE  LICENSURE PROGRAM WHICH AUTHORIZES PRACTITIONERS LICENSED BY
 CONTIGUOUS STATES OR STATES IN THE NORTHEAST  REGION  TO  PROVIDE  TELE-
 HEALTH  SERVICES,  AS  DEFINED  BY  ARTICLE  TWENTY-NINE-G OF THE PUBLIC
 HEALTH LAW AND ANY IMPLEMENTING REGULATIONS PROMULGATED BY  THE  COMMIS-
 SIONERS  OF THE DEPARTMENT OF HEALTH, OFFICE OF MENTAL HEALTH, OFFICE OF
 ADDICTION SERVICES AND SUPPORTS, AND OFFICE  FOR  PEOPLE  WITH  DEVELOP-
 MENTAL  DISABILITIES, TO PATIENTS LOCATED IN NEW YORK STATE, TAKING INTO
 CONSIDERATION THE NEED FOR  SPECIALTY  PRACTICE  AREAS  WITH  HISTORICAL
 ACCESS  ISSUES,  AS DETERMINED BY THE COMMISSIONERS OF THE DEPARTMENT OF
 HEALTH, OFFICE OF  MENTAL  HEALTH,  OFFICE  OF  ADDICTION  SUPPORTS  AND
 SERVICES,  OR  OFFICE  FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES.  SUCH
 REGULATIONS MAY BE PROMULGATED ON AN EMERGENCY BASIS; PROVIDED, HOWEVER,
 THEY SHALL BE PROMULGATED ON A FINAL BASIS NO LATER THAN  MARCH  THIRTY-
 FIRST, TWO THOUSAND TWENTY-TWO.
   §  5.  Section  3217-h of the insurance law is amended by adding a new
 subsection (c) to read as follows:
   (C) AN INSURER THAT  PROVIDES  COMPREHENSIVE  COVERAGE  FOR  HOSPITAL,
 MEDICAL,  OR SURGICAL CARE WITH A NETWORK OF HEALTH CARE PROVIDERS SHALL
 ENSURE THAT SUCH NETWORK IS ADEQUATE TO MEET  THE  TELEHEALTH  NEEDS  OF
 INSURED INDIVIDUALS FOR SERVICES COVERED UNDER THE POLICY WHEN MEDICALLY
 APPROPRIATE.

 S. 2507                            10                            A. 3007
 
   §  6.  Section  4306-g of the insurance law is amended by adding a new
 subsection (c) to read as follows:
   (C)  A  CORPORATION THAT PROVIDES COMPREHENSIVE COVERAGE FOR HOSPITAL,
 MEDICAL, OR SURGICAL CARE WITH A NETWORK OF HEALTH CARE PROVIDERS  SHALL
 ENSURE  THAT  SUCH  NETWORK  IS ADEQUATE TO MEET THE TELEHEALTH NEEDS OF
 INSURED INDIVIDUALS FOR SERVICES COVERED UNDER THE POLICY WHEN MEDICALLY
 APPROPRIATE.
   § 7. Subdivisions 1 and 6 of section 24 of the public health  law,  as
 added  by  section  17  of part H of chapter 60 of the laws of 2014, are
 amended to read as follows:
   1. A health care professional, or a  group  practice  of  health  care
 professionals,  a  diagnostic  and  treatment  center or a health center
 defined under 42 U.S.C. § 254b on behalf of  health  care  professionals
 rendering  services  at  the  group  practice,  diagnostic and treatment
 center or health center,  shall  disclose  to  patients  or  prospective
 patients in writing or through an internet website the health care plans
 in  which  the  health care professional, group practice, diagnostic and
 treatment center or health center, is a participating provider  and  the
 hospitals with which the health care professional is affiliated prior to
 the  provision  of  non-emergency  services  and verbally at the time an
 appointment is scheduled. SUCH DISCLOSURE  SHALL  INDICATE  WHETHER  THE
 HEALTH  CARE  PROFESSIONAL,  GROUP  PRACTICE,  DIAGNOSTIC  AND TREATMENT
 CENTER OR HEALTH CENTER OFFERS TELEHEALTH SERVICES.
   6. A hospital shall post on the hospital's  website:  (a)  the  health
 care  plans  in  which  the  hospital is a participating provider; (b) a
 statement that (i) physician services provided in the hospital  are  not
 included in the hospital's charges; (ii) physicians who provide services
 in  the  hospital  may  or may not participate with the same health care
 plans as the hospital, and; (iii) the prospective patient  should  check
 with  the physician arranging for the hospital services to determine the
 health care plans in which the physician participates; (c)  as  applica-
 ble,  the  name,  mailing  address and telephone number of the physician
 groups that the hospital has contracted with to provide services includ-
 ing anesthesiology, pathology or  radiology,  and  instructions  how  to
 contact  these groups to determine the health care plan participation of
 the physicians in these groups; [and] (d) as applicable, the name, mail-
 ing address, and telephone number of physicians employed by the hospital
 and whose services may be provided at the hospital, and the health  care
 plans  in  which  they participate; AND (E) DISCLOSURE AS TO WHETHER THE
 HOSPITAL OFFERS TELEHEALTH SERVICES.
   § 8. Subdivision 8 of section 24 of the public health law  is  amended
 by adding a new paragraph (d) to read as follows:
   (D)  "TELEHEALTH SERVICES" MEANS THOSE SERVICES PROVIDED IN ACCORDANCE
 WITH ARTICLE TWENTY-NINE-G OF THIS CHAPTER, SUBSECTION  (B)  OF  SECTION
 THIRTY-TWO  HUNDRED  SEVENTEEN-H OF THE INSURANCE LAW, OR SUBSECTION (B)
 OF SECTION FORTY-THREE HUNDRED SIX-G OF THE INSURANCE LAW,  AS  APPLICA-
 BLE.
   §  9.  This act shall take effect April 1, 2021; provided, however, if
 this act shall have become a law after such date it  shall  take  effect
 immediately and shall be deemed to have been in full force and effect on
 and  after April 1, 2021; provided further, however, that the amendments
 to paragraph (d) of subdivision 18-a of section 206 of the public health
 law made by section two of this act shall not affect the repeal of  such
 paragraph  and shall be deemed repealed therewith; and provided further,
 that sections five and six of this act shall take effect October 1, 2021

 S. 2507                            11                            A. 3007

 and shall apply to policies and  contracts  issued,  renewed,  modified,
 altered, or amended on and after such date.
 
                                  PART G
 
   Section  1.  The  public health law is amended by adding a new article
 29-J to read as follows:
                               ARTICLE 29-J
                          MEDICAL RESPITE PROGRAM
 SECTION 2999-HH. MEDICAL RESPITE PROGRAM.
   § 2999-HH.  MEDICAL  RESPITE  PROGRAM.  1.  LEGISLATIVE  FINDINGS  AND
 PURPOSE.  THE  LEGISLATURE  FINDS THAT AN INDIVIDUAL WHO LACKS ACCESS TO
 SAFE HOUSING FACES AN INCREASED RISK  OF  ADVERSE  HEALTH  OUTCOMES.  BY
 OFFERING  MEDICAL RESPITE PROGRAMS AS A LOWER-INTENSITY CARE SETTING FOR
 INDIVIDUALS WHO WOULD OTHERWISE REQUIRE A HOSPITAL STAY OR LACK  A  SAFE
 OPTION  FOR DISCHARGE AND RECOVERY, MEDICAL RESPITE PROGRAMS WILL REDUCE
 HOSPITAL INPATIENT ADMISSIONS AND LENGTHS  OF  STAY,  HOSPITAL  READMIS-
 SIONS,  AND  EMERGENCY ROOM USE.   THE LEGISLATURE FINDS THAT THE ESTAB-
 LISHMENT OF MEDICAL RESPITE PROGRAMS WILL PROTECT  THE  PUBLIC  INTEREST
 AND THE INTERESTS OF PATIENTS.
   2.  DEFINITIONS.  AS  USED  IN THIS ARTICLE, THE FOLLOWING TERMS SHALL
 HAVE THE  FOLLOWING  MEANINGS,  UNLESS  THE  CONTEXT  CLEARLY  OTHERWISE
 REQUIRES:
   (A)  "MEDICAL  RESPITE  PROGRAM"  MEANS  A  NOT-FOR-PROFIT CORPORATION
 LICENSED OR CERTIFIED PURSUANT TO SUBDIVISION THREE OF THIS  SECTION  TO
 SERVE  RECIPIENTS  WHOSE PROGNOSIS OR DIAGNOSIS NECESSITATES THE RECEIPT
 OF:
   (I) TEMPORARY ROOM AND BOARD; AND
   (II) THE PROVISION OR ARRANGEMENT OF THE PROVISION OF HEALTH CARE  AND
 SUPPORT  SERVICES;  PROVIDED,   HOWEVER, THAT THE OPERATION OF A MEDICAL
 RESPITE PROGRAM SHALL BE SEPARATE AND DISTINCT FROM ANY HOUSING PROGRAMS
 OFFERED TO INDIVIDUALS WHO DO NOT QUALIFY AS RECIPIENTS.
   (B) "RECIPIENT" MEANS AN INDIVIDUAL WHO:
   (I) HAS A QUALIFYING HEALTH CONDITION THAT REQUIRES TREATMENT OR CARE;
   (II) DOES NOT REQUIRE HOSPITAL INPATIENT, OBSERVATION UNIT,  OR  EMER-
 GENCY  ROOM LEVEL OF CARE, OR A MEDICALLY INDICATED EMERGENCY DEPARTMENT
 OR OBSERVATION VISIT; AND
   (III) IS EXPERIENCING HOMELESSNESS OR AT IMMINENT  RISK  OF  HOMELESS-
 NESS.  (A)  SUBJECT  TO CLAUSE (B) OF THIS SUBPARAGRAPH AND ANY RULES OR
 REGULATIONS PROMULGATED PURSUANT TO SUBDIVISION FOUR OF THIS SECTION,  A
 PERSON  SHALL BE DEEMED "HOMELESS" IF THEY ARE UNABLE TO SECURE OR MAIN-
 TAIN PERMANENT OR STABLE HOUSING WITHOUT ASSISTANCE.
   (B) AN OPERATOR OF A MEDICAL RESPITE PROGRAM MAY ESTABLISH ELIGIBILITY
 STANDARDS USING A MORE LIMITED  DEFINITION  OF  "HOMELESSNESS"  IF  SUCH
 LIMITATION  IS  NECESSARY TO ENSURE THE AVAILABILITY OF A FUNDING SOURCE
 THAT WILL SUPPORT THE MEDICAL RESPITE PROGRAM'S PROVISION  OF  ROOM  AND
 BOARD,  AND  SUCH LIMITATIONS ARE OTHERWISE CONSISTENT WITH ANY RULES OR
 REGULATIONS PROMULGATED PURSUANT TO SUBDIVISION FOUR  OF  THIS  SECTION.
 THIS APPLIES TO CONDITIONS THAT MAY EXIST IN CONNECTION WITH:
   (1)  PUBLIC  FUNDING PROVIDED BY A FEDERAL, STATE, OR LOCAL GOVERNMENT
 ENTITY; OR
   (2) SUBJECT TO THE APPROVAL OF THE DEPARTMENT, PRIVATE FUNDING FROM  A
 CHARITABLE ENTITY OR OTHER NON-GOVERNMENTAL SOURCE.
   3.  LICENSURE  OR  CERTIFICATION. (A) NOTWITHSTANDING ANY INCONSISTENT
 PROVISION OF LAW, THE COMMISSIONER MAY LICENSE OR CERTIFY A NOT-FOR-PRO-
 FIT CORPORATION AS AN OPERATOR OF A MEDICAL RESPITE PROGRAM.

 S. 2507                            12                            A. 3007
 
   (B) THE COMMISSIONER MAY PROMULGATE RULES AND REGULATIONS TO ESTABLISH
 PROCEDURES TO REVIEW AND APPROVE APPLICATIONS FOR A LICENSE  OR  CERTIF-
 ICATION  PURSUANT  TO THIS ARTICLE, WHICH MAY BE PROMULGATED ON AN EMER-
 GENCY BASIS AND WHICH SHALL, AT A MINIMUM, SPECIFY STANDARDS FOR: RECIP-
 IENT  ELIGIBILITY;  MANDATORY MEDICAL RESPITE PROGRAM SERVICES; PHYSICAL
 ENVIRONMENT; STAFFING; AND POLICIES AND PROCEDURES GOVERNING HEALTH  AND
 SAFETY, LENGTH OF STAY, REFERRALS, DISCHARGE, AND COORDINATION OF CARE.
   4.  OPERATING  STANDARDS;  RESPONSIBILITY  FOR  STANDARDS. (A) MEDICAL
 RESPITE PROGRAMS LICENSED OR CERTIFIED PURSUANT TO THIS ARTICLE SHALL:
   (I) PROVIDE RECIPIENTS WITH TEMPORARY ROOM AND BOARD; AND
   (II) PROVIDE, OR ARRANGE FOR THE PROVISION OF, HEALTH CARE AND SUPPORT
 SERVICES TO RECIPIENTS.
   (B) NOTHING CONTAINED WITHIN THIS ARTICLE SHALL  AFFECT  THE  APPLICA-
 TION,  QUALIFICATION, OR REQUIREMENTS THAT MAY APPLY TO AN OPERATOR WITH
 RESPECT TO ANY OTHER LICENSES OR OPERATING CERTIFICATES THAT SUCH OPERA-
 TOR MAY HOLD, INCLUDING, WITHOUT LIMITATION, UNDER ARTICLE  TWENTY-EIGHT
 OF THIS CHAPTER OR ARTICLE SEVEN OF THE SOCIAL SERVICES LAW.
   5. TEMPORARY ACCOMMODATION. A MEDICAL RESPITE PROGRAM SHALL BE CONSID-
 ERED  A  FORM  OF EMERGENCY SHELTER OR TEMPORARY SHELTER FOR PURPOSES OF
 DETERMINING A RECIPIENT'S ELIGIBILITY FOR HOUSING PROGRAMS  OR  BENEFITS
 ADMINISTERED  BY  THE  STATE  OR  BY  A  LOCAL SOCIAL SERVICES DISTRICT,
 INCLUDING PROGRAMS OR BENEFITS THAT SUPPORT ACCESS TO ACCOMMODATIONS  OF
 A TEMPORARY, TRANSITIONAL, OR PERMANENT NATURE.
   6.  INSPECTIONS  AND COMPLIANCE. THE COMMISSIONER SHALL HAVE THE POWER
 TO INQUIRE INTO THE OPERATION  OF  ANY  LICENSED  OR  CERTIFIED  MEDICAL
 RESPITE  PROGRAM  AND TO CONDUCT PERIODIC INSPECTIONS OF FACILITIES WITH
 RESPECT TO THE FITNESS AND ADEQUACY OF THE PREMISES, EQUIPMENT,  PERSON-
 NEL,  RULES  AND BY-LAWS, STANDARDS OF MEDICAL CARE AND SERVICES, SYSTEM
 OF ACCOUNTS, RECORDS, AND THE ADEQUACY OF FINANCIAL RESOURCES AND SOURC-
 ES OF FUTURE REVENUES.
   7. SUSPENSION OR REVOCATION OF LICENSE OR CERTIFICATION. (A) A LICENSE
 OR CERTIFICATION FOR A MEDICAL RESPITE PROGRAM UNDER THIS ARTICLE MAY BE
 REVOKED, SUSPENDED, LIMITED, ANNULLED OR DENIED BY THE COMMISSIONER,  IN
 CONSULTATION  WITH  EITHER  THE  COMMISSIONERS  OF  THE OFFICE OF MENTAL
 HEALTH, THE OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE, OR THE OFFICE
 OF ADDICTION SERVICES AND SUPPORTS, AS APPROPRIATE BASED ON  A  DETERMI-
 NATION  OF  THE DEPARTMENT DEPENDING ON THE DIAGNOSIS OR STATED NEEDS OF
 THE INDIVIDUALS BEING SERVED OR PROPOSED TO BE  SERVED  IN  THE  MEDICAL
 RESPITE PROGRAM BEING CONSIDERED FOR REVOCATION, SUSPENSION, LIMITATION,
 ANNULMENT  OR  DENIAL  OF CERTIFICATION, IF AN OPERATOR IS DETERMINED TO
 HAVE FAILED TO COMPLY WITH THE PROVISIONS OF THIS ARTICLE OR  THE  RULES
 AND REGULATIONS PROMULGATED THEREUNDER. NO ACTION TAKEN AGAINST AN OPER-
 ATOR UNDER THIS SUBDIVISION SHALL AFFECT AN OPERATOR'S OTHER LICENSES OR
 CERTIFICATIONS;  PROVIDED  HOWEVER, THAT THE FACTS THAT GAVE RISE TO THE
 REVOCATION, SUSPENSION, LIMITATION, ANNULMENT OR DENIAL OF CERTIFICATION
 MAY ALSO FORM THE BASIS OF A LIMITATION,  SUSPENSION  OF  REVOCATION  OF
 SUCH OTHER LICENSES OR CERTIFICATIONS.
   (B)  NO SUCH MEDICAL RESPITE PROGRAM LICENSE OR CERTIFICATION SHALL BE
 REVOKED, SUSPENDED, LIMITED,  ANNULLED  OR  DENIED  WITHOUT  A  HEARING;
 PROVIDED THAT A LICENSE OR CERTIFICATION MAY BE TEMPORARILY SUSPENDED OR
 LIMITED WITHOUT A HEARING FOR A PERIOD NOT IN EXCESS OF THIRTY DAYS UPON
 WRITTEN  NOTICE  THAT  THE  CONTINUATION  OF THE MEDICAL RESPITE PROGRAM
 PLACES THE PUBLIC HEALTH OR SAFETY OF THE RECIPIENTS IN IMMINENT DANGER.
   (C) NOTHING IN THIS SECTION SHALL PREVENT THE COMMISSIONER FROM IMPOS-
 ING SANCTIONS OR PENALTIES ON A MEDICAL RESPITE PROGRAM THAT ARE AUTHOR-
 IZED UNDER ANY OTHER LAW OR REGULATION.

 S. 2507                            13                            A. 3007
 
   § 2. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2021.
 
                                  PART H
 
   Section  1. The title heading of title 11-D of article 5 of the social
 services law, as added by chapter 1 of the laws of 1999, is  amended  to
 read as follows:
                   [FAMILY] BASIC HEALTH [PLUS] PROGRAM
 
   §  2.  Paragraph (d) of subdivision 3, subdivision 5 and subdivision 7
 of section 369-gg of the social services law, as added by section 51  of
 part C of chapter 60 of the laws of 2014 and subdivision 7 as renumbered
 by  section  28 of part B of chapter 57 of the laws of 2015, are amended
 to read as follows:
   (d) (i) has household income at or below two hundred  percent  of  the
 federal  poverty  line defined and annually revised by the United States
 department of health and human services for  a  household  of  the  same
 size;  and  (ii)  has  household income that exceeds one hundred thirty-
 three percent of the federal poverty line defined and  annually  revised
 by  the  United  States  department  of  health and human services for a
 household of the same size; however, MAGI eligible aliens lawfully pres-
 ent in the United States with household incomes at or below one  hundred
 thirty-three  percent  of  the federal poverty line shall be eligible to
 receive coverage for health care services pursuant to the provisions  of
 this  title  if  such  alien  would be ineligible for medical assistance
 under title eleven of this article due to his or her immigration status.
   An applicant who fails to make an applicable premium payment, IF  ANY,
 shall  lose  eligibility to receive coverage for health care services in
 accordance with time frames and procedures determined by the commission-
 er.
   5. Premiums and cost sharing. (a) Subject  to  federal  approval,  the
 commissioner  shall  establish  premium  payments enrollees shall pay to
 approved organizations for coverage of health care services pursuant  to
 this title. [Such premium payments shall be established in the following
 manner:
   (i)  up  to  twenty dollars monthly for an individual with a household
 income above one hundred and fifty percent of the federal  poverty  line
 but  at or below two hundred percent of the federal poverty line defined
 and annually revised by the United States department of health and human
 services for a household of the same size; and
   (ii) no] NO payment is  required  for  individuals  with  a  household
 income  at  or  below [one hundred and fifty] TWO HUNDRED percent of the
 federal poverty line defined and annually revised by the  United  States
 department  of  health  and  human  services for a household of the same
 size.
   (b) The commissioner shall  establish  cost  sharing  obligations  for
 enrollees, subject to federal approval.
   7. Any funds transferred by the secretary of health and human services
 to the state pursuant to 42 U.S.C. 18051(d) shall be deposited in trust.
 Funds from the trust shall be used for providing health benefits through
 an  approved  organization, which, at a minimum, shall include essential
 health benefits  as  defined  in  42  U.S.C.  18022(b);  to  reduce  the
 premiums,  IF  ANY, and cost sharing of participants in the basic health
 program; or for such other purposes as may be allowed by  the  secretary
 of  health  and  human  services.  Health benefits available through the

 S. 2507                            14                            A. 3007
 
 basic health program shall be provided by one or more approved organiza-
 tions pursuant to an agreement with the department of health  and  shall
 meet  the  requirements  of  applicable federal and state laws and regu-
 lations.
   §  3.  This act shall take effect June 1, 2021 and shall expire and be
 deemed repealed should  federal  approval  be  withdrawn  or  42  U.S.C.
 18022(b)  be  repealed;  provided  that the commissioner of health shall
 notify the legislative bill drafting commission upon the  withdrawal  of
 federal  approval  or the repeal of 42 U.S.C. 18022(b) in order that the
 commission may maintain an accurate and timely effective  data  base  of
 the official text of the laws of the state of New York in furtherance of
 effectuating  the  provisions  of  section 44 of the legislative law and
 section 70-b of the public officers law.
 
                                  PART I
 
   Section 1. Subdivision 1 of section 268-c of the public health law, as
 added by section 2 of part T of chapter 57  of  the  laws  of  2019,  is
 amended to read as follows:
   1. (a) Perform eligibility determinations for federal and state insur-
 ance  affordability  programs including medical assistance in accordance
 with section three hundred sixty-six of the social services  law,  child
 health  plus  in  accordance  with section twenty-five hundred eleven of
 this chapter, the basic health program in accordance with section  three
 hundred  sixty-nine-gg  of  the social services law, premium tax credits
 and cost-sharing reductions and qualified  health  plans  in  accordance
 with applicable law and other health insurance programs as determined by
 the commissioner;
   (b)  certify  and  make  available to qualified individuals, qualified
 health plans, including  dental  plans,  certified  by  the  Marketplace
 pursuant  to  applicable  law,  provided  that coverage under such plans
 shall not become effective prior to certification  by  the  Marketplace;
 [and]
   (c)  certify  and/or  make  available  to eligible individuals, health
 plans certified by the Marketplace pursuant to  applicable  law,  and/or
 participating in an insurance affordability program pursuant to applica-
 ble law, provided that coverage under such plans shall not become effec-
 tive  prior  to certification by the Marketplace, and/or approval by the
 commissioner[.]; AND
   (D) THE COMMISSIONER,  IN  COOPERATION  WITH  THE  SUPERINTENDENT,  IS
 AUTHORIZED  AND DIRECTED, SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE
 DIVISION OF THE BUDGET, TO APPLY FOR FEDERAL WAIVERS  WHEN  SUCH  ACTION
 WOULD  BE  NECESSARY  TO  ASSIST  IN  PROMOTING  THE  OBJECTIVES 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, 2021.
 
                                  PART J
 
   Section  1. The insurance law is amended by adding a new article 29 to
 read as follows:
                                ARTICLE 29
                         PHARMACY BENEFIT MANAGERS
 SECTION 2901. DEFINITIONS.
         2902. ACTING WITHOUT A REGISTRATION.
         2903. REGISTRATION REQUIREMENTS FOR PHARMACY BENEFIT MANAGERS.

 S. 2507                            15                            A. 3007
 
         2904. REPORTING REQUIREMENTS FOR PHARMACY BENEFIT MANAGERS.
         2905. ACTING WITHOUT A LICENSE.
         2906. LICENSING OF A PHARMACY BENEFIT MANAGER.
         2907. REVOCATION OR SUSPENSION OF A REGISTRATION OR LICENSE OF A
                 PHARMACY BENEFIT MANAGER.
         2908. PENALTIES FOR VIOLATIONS.
         2909. STAY OR SUSPENSION OF SUPERINTENDENT'S DETERMINATION.
         2910. REVOKED REGISTRATIONS OR LICENSES.
         2911. CHANGE OF ADDRESS.
         2912. DUTIES.
         2913. APPLICABILITY OF OTHER LAWS.
         2914. ASSESSMENTS.
   § 2901. DEFINITIONS. FOR PURPOSES OF THIS ARTICLE:
   (A)  "HEALTH  PLAN"  MEANS  AN INSURANCE COMPANY THAT IS AN AUTHORIZED
 INSURER UNDER THIS CHAPTER, A  COMPANY  ORGANIZED  PURSUANT  TO  ARTICLE
 FORTY-THREE OF THIS CHAPTER, A MUNICIPAL COOPERATIVE HEALTH BENEFIT PLAN
 ESTABLISHED  PURSUANT  TO ARTICLE FORTY-SEVEN OF THIS CHAPTER, AN ENTITY
 CERTIFIED PURSUANT TO  ARTICLE  FORTY-FOUR  OF  THE  PUBLIC  HEALTH  LAW
 INCLUDING  THOSE  PROVIDING SERVICES PURSUANT TO TITLE ELEVEN OF ARTICLE
 FIVE OF THE SOCIAL SERVICES LAW AND TITLE ONE-A OF  ARTICLE  TWENTY-FIVE
 OF  THE  PUBLIC HEALTH LAW, AN INSTITUTION OF HIGHER EDUCATION CERTIFIED
 PURSUANT TO SECTION ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF  THIS  CHAP-
 TER,  THE  STATE INSURANCE FUND, AND THE NEW YORK STATE HEALTH INSURANCE
 PLAN ESTABLISHED UNDER ARTICLE ELEVEN OF THE CIVIL SERVICE LAW.
   (B) "PHARMACY BENEFIT MANAGEMENT SERVICES"  MEANS  THE  MANAGEMENT  OR
 ADMINISTRATION OF PRESCRIPTION DRUG BENEFITS PURSUANT TO A CONTRACT WITH
 A  HEALTH  PLAN,  DIRECTLY  OR THROUGH ANOTHER ENTITY, AND REGARDLESS OF
 WHETHER THE PHARMACY BENEFIT MANAGER AND THE HEALTH PLAN ARE RELATED, OR
 ASSOCIATED BY OWNERSHIP, COMMON OWNERSHIP,  ORGANIZATION  OR  OTHERWISE;
 INCLUDING  THE  PROCUREMENT  OF  PRESCRIPTION  DRUGS  TO BE DISPENSED TO
 PATIENTS, OR THE ADMINISTRATION OR MANAGEMENT OF PRESCRIPTION DRUG BENE-
 FITS, INCLUDING BUT NOT LIMITED TO, ANY OF THE FOLLOWING:
   (1) MAIL SERVICE PHARMACY;
   (2) CLAIMS PROCESSING, RETAIL NETWORK MANAGEMENT, OR PAYMENT OF CLAIMS
 TO PHARMACIES FOR DISPENSING PRESCRIPTION DRUGS;
   (3) CLINICAL OR OTHER FORMULARY OR PREFERRED DRUG LIST DEVELOPMENT  OR
 MANAGEMENT;
   (4)  NEGOTIATION  OR  ADMINISTRATION  OF  REBATES,  DISCOUNTS, PAYMENT
 DIFFERENTIALS, OR OTHER INCENTIVES,  FOR  THE  INCLUSION  OF  PARTICULAR
 PRESCRIPTION  DRUGS  IN A PARTICULAR CATEGORY OR TO PROMOTE THE PURCHASE
 OF PARTICULAR PRESCRIPTION DRUGS;
   (5) PATIENT COMPLIANCE, THERAPEUTIC INTERVENTION, OR  GENERIC  SUBSTI-
 TUTION PROGRAMS;
   (6) DISEASE MANAGEMENT;
   (7) DRUG UTILIZATION REVIEW OR PRIOR AUTHORIZATION;
   (8) ADJUDICATION OF APPEALS OR GRIEVANCES RELATED TO PRESCRIPTION DRUG
 COVERAGE;
   (9) CONTRACTING WITH NETWORK PHARMACIES; AND
   (10) CONTROLLING THE COST OF COVERED PRESCRIPTION DRUGS.
   (C)  "PHARMACY  BENEFIT  MANAGER" MEANS ANY ENTITY, INCLUDING A WHOLLY
 OWNED OR PARTIALLY OWNED OR CONTROLLED SUBSIDIARY OF A PHARMACY BENEFITS
 MANAGER, THAT CONTRACTS TO PROVIDE PHARMACY BENEFIT MANAGEMENT  SERVICES
 ON BEHALF OF A HEALTH PLAN.
   (D) "CONTROLLING PERSON" MEANS ANY PERSON OR OTHER ENTITY WHO OR WHICH
 DIRECTLY  OR  INDIRECTLY HAS THE POWER TO DIRECT OR CAUSE TO BE DIRECTED
 THE MANAGEMENT, CONTROL OR ACTIVITIES OF A PHARMACY BENEFIT MANAGER.

 S. 2507                            16                            A. 3007
 
   (E)  "COVERED  INDIVIDUAL"  MEANS  A  MEMBER,  PARTICIPANT,  ENROLLEE,
 CONTRACT HOLDER OR POLICY HOLDER OR BENEFICIARY OF A HEALTH PLAN.
   §  2902.  ACTING  WITHOUT A REGISTRATION. (A) NO PERSON, FIRM, ASSOCI-
 ATION, CORPORATION OR OTHER ENTITY MAY ACT AS A PHARMACY BENEFIT MANAGER
 ON OR AFTER JUNE FIRST, TWO THOUSAND TWENTY-ONE  AND  PRIOR  TO  JANUARY
 FIRST, TWO THOUSAND TWENTY-THREE, WITHOUT HAVING A VALID REGISTRATION AS
 A  PHARMACY  BENEFIT MANAGER FILED WITH THE SUPERINTENDENT IN ACCORDANCE
 WITH THIS ARTICLE AND ANY REGULATIONS PROMULGATED THEREUNDER.
   (B) ANY PERSON, FIRM, ASSOCIATION, CORPORATION OR  OTHER  ENTITY  THAT
 VIOLATES  THIS  SECTION SHALL, IN ADDITION TO ANY OTHER PENALTY PROVIDED
 BY LAW, BE LIABLE FOR RESTITUTION  TO  ANY  HEALTH  PLAN,  PHARMACY,  OR
 COVERED  INDIVIDUAL HARMED BY THE VIOLATION AND SHALL ALSO BE SUBJECT TO
 A PENALTY NOT EXCEEDING THE GREATER OF: (1) ONE THOUSAND DOLLARS FOR THE
 FIRST VIOLATION AND TWO THOUSAND FIVE HUNDRED DOLLARS  FOR  EACH  SUBSE-
 QUENT  VIOLATION; OR (2) THE AGGREGATE ECONOMIC GROSS RECEIPTS ATTRIBUT-
 ABLE TO ALL VIOLATIONS.
   § 2903. REGISTRATION REQUIREMENTS FOR PHARMACY BENEFIT MANAGERS.   (A)
 EVERY PHARMACY BENEFIT MANAGER THAT PERFORMS PHARMACY BENEFIT MANAGEMENT
 SERVICES  ON  OR  AFTER JUNE FIRST, TWO THOUSAND TWENTY-ONE AND PRIOR TO
 JANUARY FIRST, TWO THOUSAND TWENTY-THREE SHALL REGISTER WITH THE  SUPER-
 INTENDENT  IN  A MANNER ACCEPTABLE TO THE SUPERINTENDENT AND SHALL PAY A
 FEE OF ONE THOUSAND DOLLARS FOR EACH YEAR OR FRACTION OF A YEAR IN WHICH
 THE REGISTRATION SHALL BE VALID. THE SUPERINTENDENT SHALL  REQUIRE  THAT
 THE PHARMACY BENEFIT MANAGER DISCLOSE ITS OFFICER OR OFFICERS AND DIREC-
 TOR  OR  DIRECTORS WHO ARE RESPONSIBLE FOR THE BUSINESS ENTITY'S COMPLI-
 ANCE WITH THE FINANCIAL SERVICES AND INSURANCE  LAWS,  RULES  AND  REGU-
 LATIONS  OF THIS STATE. THE REGISTRATION SHALL DETAIL THE LOCATIONS FROM
 WHICH IT PROVIDES SERVICES, AND A LISTING OF ANY ENTITIES WITH WHICH  IT
 HAS CONTRACTS IN NEW YORK STATE.  THE SUPERINTENDENT CAN REJECT A REGIS-
 TRATION  APPLICATION  FILED  BY A PHARMACY BENEFIT MANAGER THAT FAILS TO
 COMPLY WITH THE MINIMUM REGISTRATION STANDARDS.
   (B) FOR EACH BUSINESS ENTITY, THE OFFICER OR OFFICERS AND DIRECTOR  OR
 DIRECTORS  NAMED  IN THE APPLICATION SHALL BE DESIGNATED RESPONSIBLE FOR
 THE BUSINESS ENTITY'S COMPLIANCE WITH THE FINANCIAL SERVICES AND  INSUR-
 ANCE LAWS, RULES AND REGULATIONS OF THIS STATE.
   (C) EVERY REGISTRATION WILL EXPIRE ON DECEMBER THIRTY-FIRST, TWO THOU-
 SAND TWENTY-TWO REGARDLESS OF WHEN REGISTRATION WAS FIRST MADE.
   (D)  EVERY  PHARMACY  BENEFIT  MANAGER  THAT PERFORMS PHARMACY BENEFIT
 MANAGEMENT SERVICES AT ANY TIME PRIOR TO JUNE FIRST, TWO THOUSAND  TWEN-
 TY-ONE,  SHALL  MAKE  THE  REGISTRATION  AND  FEE  PAYMENT  REQUIRED  BY
 SUBSECTION (A) OF THIS SECTION ON OR BEFORE  JUNE  FIRST,  TWO  THOUSAND
 TWENTY-ONE.  ANY OTHER PHARMACY BENEFIT MANAGER SHALL MAKE THE REGISTRA-
 TION AND FEE PAYMENT REQUIRED BY SUBSECTION (A) OF THIS SECTION PRIOR TO
 PERFORMING PHARMACY BENEFIT MANAGEMENT SERVICES.
   (E) REGISTRANTS UNDER THIS SECTION SHALL BE SUBJECT TO EXAMINATION  BY
 THE SUPERINTENDENT AS OFTEN AS THE SUPERINTENDENT MAY DEEM IT NECESSARY.
 THE  SUPERINTENDENT  MAY PROMULGATE REGULATIONS ESTABLISHING METHODS AND
 PROCEDURES FOR FACILITATING AND VERIFYING COMPLIANCE WITH  THE  REQUIRE-
 MENTS OF THIS ARTICLE AND SUCH OTHER REGULATIONS AS NECESSARY TO ENFORCE
 THE PROVISIONS OF THIS ARTICLE.
   §  2904. REPORTING REQUIREMENTS FOR PHARMACY BENEFIT MANAGERS.  (A)(1)
 ON OR BEFORE JULY FIRST OF EACH YEAR, BEGINNING IN TWO THOUSAND  TWENTY-
 TWO,  EVERY PHARMACY BENEFIT MANAGER SHALL REPORT TO THE SUPERINTENDENT,
 IN A STATEMENT SUBSCRIBED AND AFFIRMED AS TRUE UNDER PENALTIES OF PERJU-
 RY, THE INFORMATION REQUESTED BY THE SUPERINTENDENT  INCLUDING,  WITHOUT
 LIMITATION:

 S. 2507                            17                            A. 3007

   (I) ANY PRICING DISCOUNTS, REBATES OF ANY KIND, INFLATIONARY PAYMENTS,
 CREDITS,  CLAWBACKS,  FEES,  GRANTS,  CHARGEBACKS, REIMBURSEMENTS, OTHER
 FINANCIAL OR OTHER REIMBURSEMENTS, INCENTIVES, INDUCEMENTS,  REFUNDS  OR
 OTHER BENEFITS RECEIVED BY THE PHARMACY BENEFIT MANAGER; AND
   (II)  THE TERMS AND CONDITIONS OF ANY CONTRACT OR ARRANGEMENT, INCLUD-
 ING OTHER FINANCIAL OR OTHER REIMBURSEMENTS INCENTIVES,  INDUCEMENTS  OR
 REFUNDS  BETWEEN THE PHARMACY BENEFIT MANAGER AND ANY OTHER PARTY RELAT-
 ING TO PHARMACY BENEFIT MANAGEMENT SERVICES PROVIDED TO  A  HEALTH  PLAN
 INCLUDING BUT NOT LIMITED TO, DISPENSING FEES PAID TO PHARMACIES.
   (2)  THE  SUPERINTENDENT  MAY REQUIRE THE FILING OF QUARTERLY OR OTHER
 STATEMENTS, WHICH SHALL BE IN SUCH FORM AND SHALL CONTAIN  SUCH  MATTERS
 AS THE SUPERINTENDENT SHALL PRESCRIBE.
   (3)  THE SUPERINTENDENT MAY ADDRESS TO ANY PHARMACY BENEFIT MANAGER OR
 ITS OFFICERS ANY INQUIRY IN RELATION TO ITS PROVISION OF PHARMACY  BENE-
 FIT MANAGEMENT SERVICES OR ANY MATTER CONNECTED THEREWITH. EVERY PHARMA-
 CY BENEFIT MANAGER OR PERSON SO ADDRESSED SHALL REPLY IN WRITING TO SUCH
 INQUIRY PROMPTLY AND TRUTHFULLY, AND SUCH REPLY SHALL BE, IF REQUIRED BY
 THE SUPERINTENDENT, SUBSCRIBED BY SUCH INDIVIDUAL, OR BY SUCH OFFICER OR
 OFFICERS  OF  THE  PHARMACY BENEFIT MANAGER, AS THE SUPERINTENDENT SHALL
 DESIGNATE, AND AFFIRMED BY THEM AS TRUE UNDER THE PENALTIES OF PERJURY.
   (B) IN THE EVENT ANY PHARMACY  BENEFIT  MANAGER  OR  PERSON  DOES  NOT
 SUBMIT  A  REPORT REQUIRED BY PARAGRAPHS ONE OR TWO OF SUBSECTION (A) OF
 THIS SECTION OR DOES NOT PROVIDE A GOOD FAITH  RESPONSE  TO  AN  INQUIRY
 FROM THE SUPERINTENDENT PURSUANT TO PARAGRAPH THREE OF SUBSECTION (A) OF
 THIS SECTION WITHIN A TIME PERIOD SPECIFIED BY THE SUPERINTENDENT OF NOT
 LESS  THAN  FIFTEEN  BUSINESS  DAYS, THE SUPERINTENDENT IS AUTHORIZED TO
 LEVY A CIVIL PENALTY, AFTER NOTICE AND HEARING,  AGAINST  SUCH  PHARMACY
 BENEFIT MANAGER OR PERSON NOT TO EXCEED ONE THOUSAND DOLLARS PER DAY FOR
 EACH  DAY BEYOND THE DATE THE REPORT IS DUE OR THE DATE SPECIFIED BY THE
 SUPERINTENDENT FOR RESPONSE TO THE INQUIRY.
   (C) ALL DOCUMENTS, MATERIALS, OR  OTHER  INFORMATION  DISCLOSED  BY  A
 PHARMACY  BENEFIT  MANAGER UNDER THIS SECTION WHICH IS IN THE CONTROL OR
 POSSESSION OF THE SUPERINTENDENT SHALL BE DEEMED CONFIDENTIAL, SHALL NOT
 BE DISCLOSED, EITHER PURSUANT TO  FREEDOM  OF  INFORMATION  REQUESTS  OR
 SUBPOENA, AND FURTHER SHALL NOT BE SUBJECT TO DISCOVERY OR ADMISSIBLE IN
 EVIDENCE  IN  ANY PRIVATE CIVIL ACTION; PROVIDED HOWEVER THAT NOTHING IN
 THIS SUBDIVISION SHALL PREVENT THE SUPERINTENDENT, IN HIS  OR  HER  SOLE
 DISCRETION,  FROM PROVIDING TO ANY OTHER GOVERNMENTAL ENTITY INFORMATION
 THE SUPERINTENDENT DEEMS NECESSARY FOR THE ENFORCEMENT OF  THE  LAWS  OF
 THIS STATE OR OF THE UNITED STATES.
   §  2905.  ACTING  WITHOUT A LICENSE. (A) NO PERSON, FIRM, ASSOCIATION,
 CORPORATION OR OTHER ENTITY MAY ACT AS A PHARMACY BENEFIT MANAGER ON  OR
 AFTER  JANUARY FIRST, TWO THOUSAND TWENTY-THREE WITHOUT HAVING AUTHORITY
 TO DO SO BY VIRTUE  OF  A  LICENSE  ISSUED  IN  FORCE  PURSUANT  TO  THE
 PROVISIONS OF THIS ARTICLE.
   (B)  ANY  PERSON,  FIRM, ASSOCIATION, CORPORATION OR OTHER ENTITY THAT
 VIOLATES THIS SECTION SHALL, IN ADDITION TO ANY OTHER  PENALTY  PROVIDED
 BY  LAW,  BE  SUBJECT  TO A PENALTY NOT EXCEEDING THE GREATER OF (1) ONE
 THOUSAND DOLLARS FOR THE FIRST VIOLATION AND TWO THOUSAND  FIVE  HUNDRED
 DOLLARS  FOR  EACH  SUBSEQUENT  VIOLATION  OR (2) THE AGGREGATE ECONOMIC
 GROSS RECEIPTS ATTRIBUTABLE TO ALL VIOLATIONS.
   § 2906. LICENSING OF A PHARMACY BENEFIT MANAGER. (A)  THE  SUPERINTEN-
 DENT MAY ISSUE A PHARMACY BENEFIT MANAGER'S LICENSE TO ANY PERSON, FIRM,
 ASSOCIATION  OR  CORPORATION  WHO OR THAT HAS COMPLIED WITH THE REQUIRE-
 MENTS OF THIS ARTICLE, INCLUDING REGULATIONS PROMULGATED BY  THE  SUPER-
 INTENDENT.  THE SUPERINTENDENT, IN CONSULTATION WITH THE COMMISSIONER OF

 S. 2507                            18                            A. 3007
 
 HEALTH, MAY ESTABLISH, BY REGULATION, MINIMUM STANDARDS FOR THE ISSUANCE
 OF A LICENSE TO A PHARMACY BENEFIT MANAGER.
   (B)  THE MINIMUM STANDARDS ESTABLISHED UNDER THIS SECTION MAY ADDRESS,
 WITHOUT LIMITATION:
   (1) PROHIBITIONS ON CONFLICTS OF  INTEREST  BETWEEN  PHARMACY  BENEFIT
 MANAGERS AND HEALTH PLANS;
   (2)  PROHIBITIONS  ON  DECEPTIVE  PRACTICES  IN  CONNECTION  WITH  THE
 PERFORMANCE OF PHARMACY BENEFIT MANAGEMENT SERVICES;
   (3) PROHIBITIONS ON ANTI-COMPETITIVE PRACTICES IN CONNECTION WITH  THE
 PERFORMANCE OF PHARMACY BENEFIT MANAGEMENT SERVICES;
   (4)  PROHIBITIONS ON PRICING MODELS, WHICH MAY INCLUDE PROHIBITIONS ON
 SPREAD PRICING;
   (5) PROHIBITIONS ON UNFAIR CLAIMS PRACTICES  IN  CONNECTION  WITH  THE
 PERFORMANCE OF PHARMACY BENEFIT MANAGEMENT SERVICES;
   (6) CODIFICATION OF STANDARDS AND PRACTICES IN THE CREATION OF PHARMA-
 CY NETWORKS AND CONTRACTING WITH NETWORK PHARMACIES AND OTHER PROVIDERS;
   (7)  PROHIBITIONS  ON  CONTRACT PROVISIONS WHICH ARBITRARILY REQUIRE A
 PHARMACY TO MEET ANY PHARMACY ACCREDITATION STANDARD OR  RECERTIFICATION
 REQUIREMENT  INCONSISTENT WITH OR MORE STRINGENT THAN, OR IN ADDITION TO
 FEDERAL OR STATE REQUIREMENTS AND CODIFICATION OF  STANDARDS  AND  PRAC-
 TICES IN THE CREATION AND USE OF SPECIALTY PHARMACY NETWORKS; AND
   (8) BEST PRACTICES FOR PROTECTION OF CONSUMERS.
   (C)  THE  SUPERINTENDENT  MAY REQUIRE ANY OR ALL OF THE MEMBERS, OFFI-
 CERS, DIRECTORS, OR DESIGNATED EMPLOYEES OF THE APPLICANT TO BE NAMED IN
 THE APPLICATION FOR A LICENSE UNDER  THIS  ARTICLE.  FOR  EACH  BUSINESS
 ENTITY,  THE  OFFICER OR OFFICERS AND DIRECTOR OR DIRECTORS NAMED IN THE
 APPLICATION SHALL BE DESIGNATED RESPONSIBLE FOR  THE  BUSINESS  ENTITY'S
 COMPLIANCE WITH THE INSURANCE LAWS, RULES AND REGULATIONS OF THIS STATE.
   (D)(1)  BEFORE A PHARMACY BENEFIT MANAGER'S LICENSE SHALL BE ISSUED OR
 RENEWED, THE PROSPECTIVE LICENSEE SHALL PROPERLY FILE IN THE  OFFICE  OF
 THE  SUPERINTENDENT A WRITTEN APPLICATION THEREFOR IN SUCH FORM OR FORMS
 AND SUPPLEMENTS THERETO AS THE SUPERINTENDENT PRESCRIBES, AND PAY A  FEE
 OF  TWO  THOUSAND DOLLARS FOR EACH YEAR OR FRACTION OF A YEAR IN WHICH A
 LICENSE SHALL BE VALID.
   (2) EVERY PHARMACY BENEFIT MANAGER'S LICENSE SHALL  EXPIRE  THIRTY-SIX
 MONTHS  AFTER  THE  DATE OF ISSUE. EVERY LICENSE ISSUED PURSUANT TO THIS
 SECTION MAY BE RENEWED FOR THE ENSUING PERIOD OF THIRTY-SIX MONTHS  UPON
 THE FILING OF AN APPLICATION IN CONFORMITY WITH THIS SUBSECTION.
   (E) IF AN APPLICATION FOR A RENEWAL LICENSE SHALL HAVE BEEN FILED WITH
 THE  SUPERINTENDENT  AT LEAST TWO MONTHS BEFORE ITS EXPIRATION, THEN THE
 LICENSE SOUGHT TO BE RENEWED SHALL CONTINUE IN  FULL  FORCE  AND  EFFECT
 EITHER  UNTIL  THE ISSUANCE BY THE SUPERINTENDENT OF THE RENEWAL LICENSE
 APPLIED FOR OR UNTIL FIVE  DAYS  AFTER  THE  SUPERINTENDENT  SHALL  HAVE
 REFUSED  TO  ISSUE SUCH RENEWAL LICENSE AND GIVEN NOTICE OF SUCH REFUSAL
 TO THE APPLICANT.
   (F) THE SUPERINTENDENT MAY REFUSE TO ISSUE A PHARMACY  BENEFIT  MANAG-
 ER'S  LICENSE IF, IN THE SUPERINTENDENT'S JUDGMENT, THE APPLICANT OR ANY
 MEMBER, PRINCIPAL, OFFICER OR DIRECTOR OF THE APPLICANT, IS  NOT  TRUST-
 WORTHY  AND COMPETENT TO ACT AS OR IN CONNECTION WITH A PHARMACY BENEFIT
 MANAGER, OR THAT ANY OF THE FOREGOING HAS GIVEN CAUSE FOR REVOCATION  OR
 SUSPENSION  OF  SUCH LICENSE, OR HAS FAILED TO COMPLY WITH ANY PREREQUI-
 SITE FOR THE ISSUANCE OF SUCH LICENSE. AS A PART OF SUCH  DETERMINATION,
 THE  SUPERINTENDENT  IS  AUTHORIZED  TO  FINGERPRINT  APPLICANTS  OR ANY
 MEMBER, PRINCIPAL, OFFICER OR DIRECTOR OF THE APPLICANT  FOR  LICENSURE.
 SUCH FINGERPRINTS SHALL BE SUBMITTED TO THE DIVISION OF CRIMINAL JUSTICE
 SERVICES FOR A STATE CRIMINAL HISTORY RECORD CHECK, AS DEFINED IN SUBDI-

 S. 2507                            19                            A. 3007
 
 VISION  ONE  OF SECTION THREE THOUSAND THIRTY-FIVE OF THE EDUCATION LAW,
 AND MAY BE SUBMITTED TO  THE  FEDERAL  BUREAU  OF  INVESTIGATION  FOR  A
 NATIONAL CRIMINAL HISTORY RECORD CHECK.
   (G) LICENSEES AND APPLICANTS FOR A LICENSE UNDER THIS SECTION SHALL BE
 SUBJECT TO EXAMINATION BY THE SUPERINTENDENT AS OFTEN AS THE SUPERINTEN-
 DENT  MAY  DEEM  IT  EXPEDIENT.  THE SUPERINTENDENT MAY PROMULGATE REGU-
 LATIONS ESTABLISHING METHODS AND PROCEDURES FOR FACILITATING AND VERIFY-
 ING COMPLIANCE WITH THE REQUIREMENTS OF  THIS  SECTION  AND  SUCH  OTHER
 REGULATIONS AS NECESSARY.
   (H)  THE  SUPERINTENDENT  MAY  ISSUE  A  REPLACEMENT  FOR  A CURRENTLY
 IN-FORCE LICENSE THAT HAS BEEN LOST OR DESTROYED. BEFORE THE REPLACEMENT
 LICENSE SHALL BE ISSUED, THERE SHALL BE ON FILE IN  THE  OFFICE  OF  THE
 SUPERINTENDENT  A  WRITTEN  APPLICATION  FOR  THE  REPLACEMENT  LICENSE,
 AFFIRMING UNDER PENALTY OF PERJURY THAT THE ORIGINAL  LICENSE  HAS  BEEN
 LOST OR DESTROYED, TOGETHER WITH A FEE OF TWO HUNDRED DOLLARS.
   (I) NO PHARMACY BENEFIT MANAGER SHALL ENGAGE IN ANY PRACTICE OR ACTION
 THAT A HEALTH PLAN IS PROHIBITED FROM ENGAGING IN PURSUANT TO THIS CHAP-
 TER.
   §  2907.  REVOCATION  OR  SUSPENSION OF A REGISTRATION OR LICENSE OF A
 PHARMACY BENEFIT MANAGER.  (A) THE SUPERINTENDENT MAY REFUSE  TO  RENEW,
 MAY  REVOKE,  OR  MAY SUSPEND FOR A PERIOD THE SUPERINTENDENT DETERMINES
 THE REGISTRATION OR LICENSE OF ANY  PHARMACY  BENEFIT  MANAGER  IF,  THE
 SUPERINTENDENT DETERMINES THAT THE REGISTRANT OR LICENSEE OR ANY MEMBER,
 PRINCIPAL, OFFICER, DIRECTOR, OR CONTROLLING PERSON OF THE REGISTRANT OR
 LICENSEE, HAS:
   (1)  VIOLATED  ANY INSURANCE LAWS, SECTION TWO HUNDRED EIGHTY-A OR TWO
 HUNDRED EIGHTY-C OF THE PUBLIC HEALTH LAW OR  VIOLATED  ANY  REGULATION,
 SUBPOENA  OR ORDER OF THE SUPERINTENDENT OR OF ANOTHER STATE'S INSURANCE
 COMMISSIONER, OR HAS VIOLATED ANY LAW IN THE COURSE OF ITS  DEALINGS  IN
 SUCH  CAPACITY AFTER SUCH LICENSE HAS BEEN ISSUED OR RENEWED PURSUANT TO
 SECTION TWO THOUSAND NINE HUNDRED SIX OF THIS ARTICLE;
   (2) PROVIDED MATERIALLY INCORRECT, MATERIALLY  MISLEADING,  MATERIALLY
 INCOMPLETE  OR  MATERIALLY  UNTRUE  INFORMATION  IN  THE REGISTRATION OR
 LICENSE APPLICATION;
   (3) OBTAINED OR ATTEMPTED TO OBTAIN A REGISTRATION OR LICENSE  THROUGH
 MISREPRESENTATION OR FRAUD;
   (4)(I) USED FRAUDULENT, COERCIVE OR DISHONEST PRACTICES;
   (II) DEMONSTRATED INCOMPETENCE;
   (III) DEMONSTRATED UNTRUSTWORTHINESS; OR
   (IV)  DEMONSTRATED  FINANCIAL IRRESPONSIBILITY IN THE CONDUCT OF BUSI-
 NESS IN THIS STATE OR ELSEWHERE;
   (5) IMPROPERLY WITHHELD, MISAPPROPRIATED OR CONVERTED  ANY  MONIES  OR
 PROPERTIES  RECEIVED  IN  THE  COURSE OF BUSINESS IN THIS STATE OR ELSE-
 WHERE;
   (6) INTENTIONALLY MISREPRESENTED THE TERMS OF AN  ACTUAL  OR  PROPOSED
 INSURANCE CONTRACT;
   (7)  ADMITTED  OR  BEEN  FOUND  TO HAVE COMMITTED ANY INSURANCE UNFAIR
 TRADE PRACTICE OR FRAUD;
   (8) HAD A PHARMACY BENEFIT MANAGER REGISTRATION  OR  LICENSE,  OR  ITS
 EQUIVALENT,  DENIED,  SUSPENDED OR REVOKED IN ANY OTHER STATE, PROVINCE,
 DISTRICT OR TERRITORY;
   (9) FAILED TO PAY STATE INCOME TAX OR COMPLY WITH  ANY  ADMINISTRATIVE
 OR COURT ORDER DIRECTING PAYMENT OF STATE INCOME TAX;
   (10) FAILED TO PAY ANY ASSESSMENT REQUIRED BY THIS ARTICLE; OR
   (11)  CEASED  TO  MEET  THE REQUIREMENTS FOR REGISTRATION OR LICENSURE
 UNDER THIS ARTICLE.

 S. 2507                            20                            A. 3007
 
   (B) BEFORE REVOKING OR SUSPENDING THE REGISTRATION OR LICENSE  OF  ANY
 PHARMACY BENEFIT MANAGER PURSUANT TO THE PROVISIONS OF THIS ARTICLE, THE
 SUPERINTENDENT SHALL GIVE NOTICE TO THE REGISTRANT OR LICENSEE AND SHALL
 HOLD,  OR  CAUSE  TO BE HELD, A HEARING NOT LESS THAN TEN DAYS AFTER THE
 GIVING OF SUCH NOTICE.
   (C)  IF  A  REGISTRATION OR LICENSE PURSUANT TO THE PROVISIONS OF THIS
 ARTICLE IS REVOKED OR SUSPENDED BY THE SUPERINTENDENT, THEN  THE  SUPER-
 INTENDENT SHALL FORTHWITH GIVE NOTICE TO THE REGISTRANT OR LICENSEE.
   (D) THE REVOCATION OR SUSPENSION OF ANY REGISTRATION OR LICENSE PURSU-
 ANT  TO  THE  PROVISIONS  OF THIS ARTICLE SHALL TERMINATE FORTHWITH SUCH
 REGISTRATION OR LICENSE AND THE AUTHORITY  CONFERRED  THEREBY  UPON  ALL
 LICENSEES. FOR GOOD CAUSE SHOWN, THE SUPERINTENDENT MAY DELAY THE EFFEC-
 TIVE  DATE  OF  A  REVOCATION  OR SUSPENSION TO PERMIT THE REGISTRANT OR
 LICENSEE TO SATISFY SOME  OR  ALL  OF  ITS  CONTRACTUAL  OBLIGATIONS  TO
 PERFORM PHARMACY BENEFIT MANAGEMENT SERVICES IN THE STATE.
   (E)(1) NO INDIVIDUAL, CORPORATION, FIRM OR ASSOCIATION WHOSE REGISTRA-
 TION  OR LICENSE AS A PHARMACY BENEFIT MANAGER HAS BEEN REVOKED PURSUANT
 TO SUBSECTION (A) OF THIS SECTION, AND NO FIRM OR ASSOCIATION  OF  WHICH
 SUCH INDIVIDUAL IS A MEMBER, AND NO CORPORATION OF WHICH SUCH INDIVIDUAL
 IS  AN  OFFICER OR DIRECTOR, AND NO CONTROLLING PERSON OF THE REGISTRANT
 OR LICENSEE SHALL BE ENTITLED TO  OBTAIN  ANY  REGISTRATION  OR  LICENSE
 UNDER  THE  PROVISIONS  OF THIS ARTICLE FOR A MINIMUM PERIOD OF ONE YEAR
 AFTER SUCH REVOCATION, OR, IF SUCH REVOCATION  BE  JUDICIALLY  REVIEWED,
 FOR  A  MINIMUM PERIOD OF ONE YEAR AFTER THE FINAL DETERMINATION THEREOF
 AFFIRMING THE ACTION OF THE SUPERINTENDENT IN REVOKING SUCH LICENSE.
   (2) IF ANY SUCH REGISTRATION OR LICENSE HELD BY A FIRM, ASSOCIATION OR
 CORPORATION BE REVOKED, NO MEMBER OF SUCH FIRM  OR  ASSOCIATION  AND  NO
 OFFICER OR DIRECTOR OF SUCH CORPORATION OR ANY CONTROLLING PERSON OF THE
 REGISTRANT  OR  LICENSEE SHALL BE ENTITLED TO OBTAIN ANY REGISTRATION OR
 LICENSE, UNDER THIS ARTICLE FOR THE SAME  PERIOD  OF  TIME,  UNLESS  THE
 SUPERINTENDENT  DETERMINES,  AFTER NOTICE AND HEARING, THAT SUCH MEMBER,
 OFFICER OR DIRECTOR WAS NOT PERSONALLY AT FAULT IN THE MATTER ON ACCOUNT
 OF WHICH SUCH REGISTRATION OR LICENSE WAS REVOKED.
   (F) IF ANY CORPORATION, FIRM, ASSOCIATION OR  PERSON  AGGRIEVED  SHALL
 FILE  WITH  THE  SUPERINTENDENT A VERIFIED COMPLAINT SETTING FORTH FACTS
 TENDING TO SHOW SUFFICIENT GROUND FOR THE REVOCATION  OR  SUSPENSION  OF
 ANY  PHARMACY  BENEFIT  MANAGER'S  REGISTRATION  OR LICENSE, THEN IF THE
 SUPERINTENDENT FINDS THE COMPLAINT CREDIBLE, THE  SUPERINTENDENT  SHALL,
 AFTER  NOTICE  AND  A  HEARING,  DETERMINE  WHETHER SUCH REGISTRATION OR
 LICENSE SHALL BE SUSPENDED OR REVOKED.
   (G) THE SUPERINTENDENT SHALL  RETAIN  THE  AUTHORITY  TO  ENFORCE  THE
 PROVISIONS  OF AND IMPOSE ANY PENALTY OR REMEDY AUTHORIZED BY THIS CHAP-
 TER AGAINST ANY PERSON OR ENTITY  WHO  IS  UNDER  INVESTIGATION  FOR  OR
 CHARGED  WITH A VIOLATION OF THIS CHAPTER, EVEN IF THE PERSON'S OR ENTI-
 TY'S REGISTRATION OR LICENSE HAS BEEN SURRENDERED, OR HAS EXPIRED OR HAS
 LAPSED BY OPERATION OF LAW.
   (H) A REGISTRANT OR LICENSEE SUBJECT TO THIS ARTICLE SHALL  REPORT  TO
 THE  SUPERINTENDENT  ANY  ADMINISTRATIVE ACTION TAKEN AGAINST THE REGIS-
 TRANT OR LICENSEE OR ANY OF THE MEMBERS, OFFICERS, DIRECTORS, OR  DESIG-
 NATED  EMPLOYEES OF THE APPLICANT NAMED IN THE REGISTRATION OR LICENSING
 APPLICATION IN ANOTHER JURISDICTION OR BY ANOTHER GOVERNMENTAL AGENCY IN
 THIS STATE WITHIN THIRTY DAYS OF THE FINAL DISPOSITION  OF  THE  MATTER.
 THIS REPORT SHALL INCLUDE A COPY OF THE ORDER, CONSENT TO ORDER OR OTHER
 RELEVANT LEGAL DOCUMENTS.
   (I)  WITHIN THIRTY DAYS OF THE INITIAL PRETRIAL HEARING DATE, A REGIS-
 TRANT OR LICENSEE SUBJECT TO THIS ARTICLE SHALL  REPORT  TO  THE  SUPER-

 S. 2507                            21                            A. 3007
 
 INTENDENT  ANY CRIMINAL PROSECUTION OF THE REGISTRANT OR LICENSEE OR ANY
 OF THE MEMBERS, OFFICERS, DIRECTORS,  OR  DESIGNATED  EMPLOYEES  OF  THE
 APPLICANT  NAMED  IN  THE REGISTRATION OR LICENSING APPLICATION TAKEN IN
 ANY  JURISDICTION.  THE  REPORT  SHALL  INCLUDE  A  COPY  OF THE INITIAL
 COMPLAINT FILED, THE ORDER RESULTING FROM  THE  HEARING  AND  ANY  OTHER
 RELEVANT LEGAL DOCUMENTS.
   §  2908.  PENALTIES FOR VIOLATIONS. (A) IN ADDITION TO ANY OTHER POWER
 CONFERRED BY LAW, THE SUPERINTENDENT MAY IN ANY ONE PROCEEDING BY ORDER,
 REQUIRE A REGISTRANT OR LICENSEE WHO HAS VIOLATED ANY PROVISION OF  THIS
 ARTICLE  OR  WHOSE  LICENSE  WOULD OTHERWISE BE SUBJECT TO REVOCATION OR
 SUSPENSION TO PAY TO THE PEOPLE OF THIS STATE A PENALTY  IN  A  SUM  NOT
 EXCEEDING  THE GREATER OF: (1) ONE THOUSAND DOLLARS FOR EACH OFFENSE AND
 TWO THOUSAND FIVE HUNDRED DOLLARS FOR EACH SUBSEQUENT VIOLATION; OR  (2)
 THE AGGREGATE GROSS RECEIPTS ATTRIBUTABLE TO ALL OFFENSES.
   (B)  UPON  THE  FAILURE  OF  SUCH  A REGISTRANT OR LICENSEE TO PAY THE
 PENALTY ORDERED PURSUANT TO SUBSECTION (A) OF THIS SECTION WITHIN TWENTY
 DAYS AFTER THE MAILING OF THE ORDER, POSTAGE  PREPAID,  REGISTERED,  AND
 ADDRESSED  TO  THE  LAST KNOWN PLACE OF BUSINESS OF THE LICENSEE, UNLESS
 THE ORDER IS STAYED BY AN ORDER OF A COURT  OF  COMPETENT  JURISDICTION,
 THE  SUPERINTENDENT MAY REVOKE THE REGISTRATION OR LICENSE OF THE REGIS-
 TRANT OR LICENSEE OR MAY SUSPEND THE SAME FOR SUCH PERIOD AS THE  SUPER-
 INTENDENT DETERMINES.
   §  2909.  STAY  OR  SUSPENSION  OF SUPERINTENDENT'S DETERMINATION. THE
 COMMENCEMENT OF A PROCEEDING UNDER ARTICLE SEVENTY-EIGHT  OF  THE  CIVIL
 PRACTICE  LAW  AND  RULES, TO REVIEW THE ACTION OF THE SUPERINTENDENT IN
 SUSPENDING OR REVOKING OR REFUSING TO RENEW ANY CERTIFICATE  UNDER  THIS
 ARTICLE,  SHALL  STAY  SUCH ACTION OF THE SUPERINTENDENT FOR A PERIOD OF
 THIRTY DAYS. SUCH STAY SHALL NOT BE EXTENDED FOR A LONGER PERIOD  UNLESS
 THE  COURT  SHALL  DETERMINE,  AFTER  A PRELIMINARY HEARING OF WHICH THE
 SUPERINTENDENT IS NOTIFIED FORTY-EIGHT HOURS IN ADVANCE, THAT A STAY  OF
 THE  SUPERINTENDENT'S  ACTION PENDING THE FINAL DETERMINATION OR FURTHER
 ORDER OF THE COURT WILL NOT INJURE THE INTERESTS OF THE  PEOPLE  OF  THE
 STATE.
   §  2910.  REVOKED  REGISTRATIONS  OR LICENSES. (A)(1) NO PERSON, FIRM,
 ASSOCIATION, CORPORATION OR OTHER ENTITY SUBJECT TO  THE  PROVISIONS  OF
 THIS  ARTICLE  WHOSE REGISTRATION OR LICENSE UNDER THIS ARTICLE HAS BEEN
 REVOKED, OR WHOSE REGISTRATION OR LICENSE TO ENGAGE IN THE  BUSINESS  OF
 PHARMACY  BENEFIT  MANAGEMENT  IN  ANY  CAPACITY HAS BEEN REVOKED BY ANY
 OTHER STATE OR TERRITORY OF THE UNITED STATES SHALL BECOME  EMPLOYED  OR
 APPOINTED  BY A PHARMACY BENEFIT MANAGER AS AN OFFICER, DIRECTOR, MANAG-
 ER, CONTROLLING PERSON OR FOR OTHER SERVICES, WITHOUT THE PRIOR  WRITTEN
 APPROVAL OF THE SUPERINTENDENT, UNLESS SUCH SERVICES ARE FOR MAINTENANCE
 OR ARE CLERICAL OR MINISTERIAL IN NATURE.
   (2)  NO PERSON, FIRM, ASSOCIATION, CORPORATION OR OTHER ENTITY SUBJECT
 TO THE PROVISIONS OF THIS ARTICLE SHALL KNOWINGLY EMPLOY OR APPOINT  ANY
 PERSON OR ENTITY WHOSE REGISTRATION OR LICENSE ISSUED UNDER THIS ARTICLE
 HAS  BEEN  REVOKED,  OR  WHOSE  REGISTRATION OR LICENSE TO ENGAGE IN THE
 BUSINESS OF PHARMACY BENEFIT MANAGEMENT IN ANY CAPACITY HAS BEEN REVOKED
 BY ANY OTHER STATE OR TERRITORY OF THE UNITED  STATES,  AS  AN  OFFICER,
 DIRECTOR, MANAGER, CONTROLLING PERSON OR FOR OTHER SERVICES, WITHOUT THE
 PRIOR  WRITTEN  APPROVAL OF THE SUPERINTENDENT, UNLESS SUCH SERVICES ARE
 FOR MAINTENANCE OR ARE CLERICAL OR MINISTERIAL IN NATURE.
   (3) NO CORPORATION OR PARTNERSHIP SUBJECT TO THE  PROVISIONS  OF  THIS
 ARTICLE  SHALL KNOWINGLY PERMIT ANY PERSON WHOSE REGISTRATION OR LICENSE
 ISSUED UNDER THIS ARTICLE HAS BEEN REVOKED,  OR  WHOSE  REGISTRATION  OR
 LICENSE  TO ENGAGE IN THE BUSINESS OF PHARMACY BENEFIT MANAGEMENT IN ANY

 S. 2507                            22                            A. 3007
 
 CAPACITY HAS BEEN REVOKED BY ANY OTHER STATE, OR TERRITORY OF THE UNITED
 STATES, TO BE A SHAREHOLDER OR HAVE AN INTEREST IN SUCH  CORPORATION  OR
 PARTNERSHIP,  NOR  SHALL ANY SUCH PERSON BECOME A SHAREHOLDER OR PARTNER
 IN  SUCH  CORPORATION OR PARTNERSHIP, WITHOUT THE PRIOR WRITTEN APPROVAL
 OF THE SUPERINTENDENT.
   (B) THE SUPERINTENDENT MAY  APPROVE  THE  EMPLOYMENT,  APPOINTMENT  OR
 PARTICIPATION  OF ANY SUCH PERSON WHOSE REGISTRATION OR LICENSE HAS BEEN
 REVOKED:
   (1) IF THE SUPERINTENDENT DETERMINES THAT THE DUTIES AND  RESPONSIBIL-
 ITIES  OF  SUCH  PERSON  ARE SUBJECT TO APPROPRIATE SUPERVISION AND THAT
 SUCH DUTIES AND RESPONSIBILITIES WILL NOT HAVE AN  ADVERSE  EFFECT  UPON
 THE  PUBLIC, OTHER REGISTRANTS OR LICENSEES, OR THE REGISTRANT OR LICEN-
 SEE PROPOSING EMPLOYMENT OR APPOINTMENT OF SUCH PERSON; OR
   (2) IF SUCH PERSON HAS FILED  AN  APPLICATION  FOR  REREGISTRATION  OR
 RELICENSING PURSUANT TO THIS ARTICLE AND THE APPLICATION FOR REREGISTRA-
 TION  OR  RELICENSING HAS NOT BEEN APPROVED OR DENIED WITHIN ONE HUNDRED
 TWENTY DAYS FOLLOWING THE  FILING  THEREOF,  UNLESS  THE  SUPERINTENDENT
 DETERMINES  WITHIN  THE SAID TIME THAT EMPLOYMENT OR APPOINTMENT OF SUCH
 PERSON BY A REGISTRANT OR LICENSEE IN THE CONDUCT OF A PHARMACY  BENEFIT
 MANAGEMENT BUSINESS WOULD NOT BE IN THE PUBLIC INTEREST.
   (C) THE PROVISIONS OF THIS SECTION SHALL NOT APPLY TO THE OWNERSHIP OF
 SHARES  OF ANY CORPORATION REGISTERED OR LICENSED PURSUANT TO THIS ARTI-
 CLE IF THE SHARES OF SUCH CORPORATION ARE PUBLICLY HELD  AND  TRADED  IN
 THE  OVER-THE-COUNTER MARKET OR UPON ANY NATIONAL OR REGIONAL SECURITIES
 EXCHANGE.
   § 2911. CHANGE OF ADDRESS. A REGISTRANT OR LICENSEE UNDER THIS ARTICLE
 SHALL INFORM THE SUPERINTENDENT BY A MEANS ACCEPTABLE TO THE SUPERINTEN-
 DENT OF A CHANGE OF ADDRESS WITHIN THIRTY DAYS OF THE CHANGE.
   § 2912. DUTIES. (A) A PHARMACY BENEFIT MANAGER SHALL  BE  REQUIRED  TO
 ADHERE  TO  THE  CODE OF CONDUCT, AS THE SUPERINTENDENT MAY ESTABLISH BY
 REGULATION PURSUANT TO SECTION TWENTY-NINE HUNDRED SIX OF THIS ARTICLE.
   (B) NO CONTRACT WITH A HEALTH PLAN SHALL LIMIT ACCESS TO FINANCIAL  OR
 UTILIZATION  INFORMATION  OF THE PHARMACY BENEFIT MANAGER IN RELATION TO
 PHARMACY BENEFIT MANAGEMENT SERVICES PROVIDED TO THE HEALTH PLAN.
   (C) A PHARMACY BENEFIT MANAGER SHALL DISCLOSE IN WRITING TO  A  HEALTH
 PLAN  WITH  WHOM A CONTRACT FOR PHARMACY BENEFIT MANAGEMENT SERVICES HAS
 BEEN EXECUTED ANY ACTIVITY, POLICY, PRACTICE, CONTRACT OR ARRANGEMENT OF
 THE PHARMACY BENEFIT MANAGER THAT  DIRECTLY  OR  INDIRECTLY  PRESENTS  A
 CONFLICT  OF  INTEREST  WITH  THE PHARMACY BENEFIT MANAGER'S CONTRACTUAL
 RELATIONSHIP WITH, OR DUTIES AND OBLIGATIONS TO, THE HEALTH PLAN.
   (D) A PHARMACY BENEFIT MANAGER SHALL ASSIST A HEALTH PLAN IN ANSWERING
 ANY INQUIRY MADE UNDER SECTION THREE HUNDRED EIGHT OF THIS CHAPTER.
   (E) NO PHARMACY BENEFIT MANAGER SHALL VIOLATE  ANY  PROVISION  OF  THE
 PUBLIC HEALTH LAW APPLICABLE TO PHARMACY BENEFIT MANAGERS.
   (F) (1) ANY INFORMATION REQUIRED TO BE DISCLOSED BY A PHARMACY BENEFIT
 MANAGER  TO  A  HEALTH PLAN UNDER THIS SECTION THAT IS REASONABLY DESIG-
 NATED BY THE PHARMACY BENEFIT MANAGER AS  PROPRIETARY  OR  TRADE  SECRET
 INFORMATION  SHALL  BE  KEPT  CONFIDENTIAL BY THE HEALTH PLAN, EXCEPT AS
 REQUIRED OR PERMITTED BY LAW OR COURT ORDER, INCLUDING DISCLOSURE NECES-
 SARY TO PROSECUTE OR DEFEND ANY  LEGITIMATE  LEGAL  CLAIM  OR  CAUSE  OF
 ACTION.
   (2)  DESIGNATION AS PROPRIETARY OR TRADE SECRET INFORMATION UNDER THIS
 SUBSECTION SHALL HAVE NO EFFECT ON THE OBLIGATIONS OF ANY PHARMACY BENE-
 FIT MANAGER OR HEALTH PLAN TO PROVIDE THAT INFORMATION  TO  THE  DEPART-
 MENT.

 S. 2507                            23                            A. 3007

   §  2913. APPLICABILITY OF OTHER LAWS. NOTHING IN THIS ARTICLE SHALL BE
 CONSTRUED TO EXEMPT A PHARMACY BENEFIT MANAGER FROM COMPLYING  WITH  THE
 PROVISIONS  OF  ARTICLES  TWENTY-ONE  AND FORTY-NINE OF THIS CHAPTER AND
 ARTICLES FORTY-FOUR AND FORTY-NINE AND SECTIONS TWO HUNDRED EIGHTY-A AND
 TWO  HUNDRED  EIGHTY-C  OF  THE PUBLIC HEALTH LAW, SECTION THREE HUNDRED
 SIXTY-FOUR-J OF THE SOCIAL SERVICES LAW, OR ANY OTHER PROVISION OF  THIS
 CHAPTER OR THE FINANCIAL SERVICES LAW.
   §  2914.  ASSESSMENTS.  NOTWITHSTANDING SECTION TWO HUNDRED SIX OF THE
 FINANCIAL SERVICES LAW, PHARMACY BENEFIT MANAGERS THAT FILE A  REGISTRA-
 TION  WITH  THE  DEPARTMENT  OR  ARE LICENSED BY THE DEPARTMENT SHALL BE
 ASSESSED BY THE SUPERINTENDENT FOR THE OPERATING EXPENSES OF THE DEPART-
 MENT THAT ARE ATTRIBUTABLE TO REGULATING SUCH PHARMACY BENEFIT  MANAGERS
 IN  SUCH  PROPORTIONS  AS THE SUPERINTENDENT SHALL DEEM JUST AND REASON-
 ABLE.
   § 2. Subsection (b) of section 2402 of the insurance law,  as  amended
 by section 71 of part A of chapter 62 of the laws of 2011, is amended to
 read as follows:
   (b)  "Defined  violation"  means  the commission by a person of an act
 prohibited by: subsection (a) of section one thousand one  hundred  two,
 section  one  thousand  two  hundred  fourteen, one thousand two hundred
 seventeen, one thousand two hundred twenty, one thousand  three  hundred
 thirteen, subparagraph (B) of paragraph two of subsection (i) of section
 one thousand three hundred twenty-two, subparagraph (B) of paragraph two
 of subsection (i) of section one thousand three hundred twenty-four, two
 thousand  one hundred two, two thousand one hundred seventeen, two thou-
 sand one hundred twenty-two,  two  thousand  one  hundred  twenty-three,
 subsection  (p)  of section two thousand three hundred thirteen, section
 two thousand three hundred twenty-four, two thousand five  hundred  two,
 two  thousand  five  hundred  three, two thousand five hundred four, two
 thousand six hundred one, two thousand six hundred two, two thousand six
 hundred three, two thousand six hundred four, two thousand  six  hundred
 six,  two  thousand  seven hundred three, TWO THOUSAND NINE HUNDRED TWO,
 TWO THOUSAND NINE HUNDRED FIVE, three thousand one hundred  nine,  three
 thousand  two hundred twenty-four-a, three thousand four hundred twenty-
 nine, three thousand  four  hundred  thirty-three,  paragraph  seven  of
 subsection  (e)  of section three thousand four hundred twenty-six, four
 thousand two hundred twenty-four, four thousand two hundred twenty-five,
 four thousand two hundred twenty-six, seven thousand eight hundred nine,
 seven thousand eight hundred ten, seven thousand eight  hundred  eleven,
 seven  thousand  eight  hundred  thirteen,  seven thousand eight hundred
 fourteen and seven thousand eight hundred fifteen of  this  chapter;  or
 section  135.60,  135.65,  175.05,  175.45,  or  190.20,  or article one
 hundred five of the penal law.
   § 3. Severability. If any provision of this act, or any application of
 any provision of this act, is held to be invalid, or ruled by any feder-
 al agency to violate or be inconsistent with any applicable federal  law
 or  regulation,  that  shall not affect the validity or effectiveness of
 any other provision of this act, or of  any  other  application  of  any
 provision of this act.
   § 4. This act shall take effect immediately.
 
                                  PART K
 
   Section 1. Section 18 of chapter 266 of the laws of 1986, amending the
 civil  practice law and rules and other laws relating to malpractice and

 S. 2507                            24                            A. 3007
 
 professional medical conduct is amended by adding a new subdivision 9 to
 read as follows:
   (9)  THIS SUBDIVISION SHALL APPLY ONLY TO EXCESS INSURANCE COVERAGE OR
 EQUIVALENT EXCESS COVERAGE FOR PHYSICIANS OR DENTISTS THAT  IS  ELIGIBLE
 TO  BE  PAID  FOR  FROM FUNDS AVAILABLE IN THE HOSPITAL EXCESS LIABILITY
 POOL.
   (A) NOTWITHSTANDING ANY LAW TO THE CONTRARY,  FOR  ANY  POLICY  PERIOD
 BEGINNING  ON  OR AFTER JULY 1, 2021, EXCESS COVERAGE SHALL BE PURCHASED
 BY A PHYSICIAN OR DENTIST DIRECTLY FROM A PROVIDER OF  EXCESS  INSURANCE
 COVERAGE  OR EQUIVALENT EXCESS COVERAGE.  SUCH PROVIDER OF EXCESS INSUR-
 ANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE  SHALL  BILL,  IN  A  MANNER
 CONSISTENT  WITH  PARAGRAPH  (E)  OF  THIS SUBDIVISION, THE PHYSICIAN OR
 DENTIST FOR AN AMOUNT EQUAL TO FIFTY PERCENT OF  THE  PREMIUM  FOR  SUCH
 COVERAGE,  AS ESTABLISHED PURSUANT TO PARAGRAPH (C) OF THIS SUBDIVISION,
 DURING THE POLICY PERIOD.  AT THE CONCLUSION OF THE  POLICY  PERIOD  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, PAY
 HALF OF THE REMAINING FIFTY PERCENT OF THE PREMIUM TO  THE  PROVIDER  OF
 EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE, AND THE REMAIN-
 ING TWENTY-FIVE PERCENT SHALL BE PAID ONE YEAR THEREAFTER.  IF THE FUNDS
 AVAILABLE IN THE HOSPITAL EXCESS LIABILITY POOL ARE INSUFFICIENT TO MEET
 THE  PERCENT  OF  THE  COSTS  OF  THE EXCESS COVERAGE, THE PROVISIONS OF
 SUBDIVISION 8 OF THIS SECTION SHALL APPLY.
   (B) IF AT THE CONCLUSION OF THE POLICY PERIOD, A PHYSICIAN OR DENTIST,
 ELIGIBLE FOR EXCESS COVERAGE PAID FOR FROM FUNDS AVAILABLE IN THE HOSPI-
 TAL EXCESS LIABILITY POOL, HAS FAILED TO PAY AN AMOUNT  EQUAL  TO  FIFTY
 PERCENT  OF THE PREMIUM AS ESTABLISHED PURSUANT TO PARAGRAPH (C) OF THIS
 SUBDIVISION, SUCH EXCESS COVERAGE 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.   THE PROVIDER OF EXCESS COVERAGE SHALL REMIT ANY PORTION
 OF PREMIUM PAID BY THE ELIGIBLE PHYSICIAN OR DENTIST FOR SUCH  A  POLICY
 PERIOD.
   (C)  THE  SUPERINTENDENT  OF FINANCIAL SERVICES SHALL ESTABLISH A RATE
 CONSISTENT WITH SUBDIVISION 3 OF THIS SECTION THAT PROVIDERS  OF  EXCESS
 INSURANCE  COVERAGE  OR  EQUIVALENT EXCESS COVERAGE WILL CHARGE FOR SUCH
 COVERAGE FOR EACH POLICY PERIOD.  FOR THE POLICY PERIOD  BEGINNING  JULY
 1,  2021,  THE  SUPERINTENDENT OF FINANCIAL SERVICES MAY DIRECT THAT THE
 PREMIUM FOR THAT POLICY PERIOD BE THE SAME AS  IT  WAS  FOR  THE  POLICY
 PERIOD THAT CONCLUDED JUNE 30, 2020.
   (D)  NO  PROVIDER  OF  EXCESS  INSURANCE COVERAGE OR EQUIVALENT EXCESS
 COVERAGE SHALL ISSUE EXCESS COVERAGE TO WHICH THIS  SUBDIVISION  APPLIES
 TO  ANY  PHYSICIAN OR DENTIST UNLESS THAT PHYSICIAN OR DENTIST MEETS THE
 ELIGIBILITY REQUIREMENTS FOR SUCH COVERAGE SET FORTH  IN  THIS  SECTION.
 THE  SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER OF HEALTH
 OR THEIR DESIGNEE SHALL NOT MAKE ANY PAYMENT UNDER THIS SUBDIVISION TO A
 PROVIDER OF EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE  FOR
 EXCESS  COVERAGE  ISSUED TO A PHYSICIAN OR DENTIST WHO DOES NOT MEET THE
 ELIGIBILITY  REQUIREMENTS  FOR  PARTICIPATION  IN  THE  HOSPITAL  EXCESS
 LIABILITY POOL PROGRAM SET FORTH IN THIS SECTION.
   (E)  A  PROVIDER  OF  EXCESS INSURANCE COVERAGE OR EQUIVALENT COVERAGE
 THAT ISSUES EXCESS COVERAGE UNDER THIS SUBDIVISION SHALL BILL THE PHYSI-
 CIAN OR DENTIST FOR THE PORTION OF THE PREMIUM REQUIRED UNDER  PARAGRAPH
 (A)  OF THIS SUBDIVISION IN TWELVE EQUAL MONTHLY INSTALLMENTS OR IN SUCH
 OTHER MANNER AS THE PHYSICIAN OR DENTIST MAY AGREE.

 S. 2507                            25                            A. 3007

   (F) THE SUPERINTENDENT OF FINANCIAL SERVICES IN CONSULTATION WITH  THE
 COMMISSIONER  OF  HEALTH MAY PROMULGATE REGULATIONS GIVING EFFECT TO THE
 PROVISIONS OF THIS SUBDIVISION.
   §  2.  Paragraph  (a) of subdivision 1 of section 18 of chapter 266 of
 the laws of 1986, amending the civil practice law and  rules  and  other
 laws  relating  to  malpractice  and  professional  medical  conduct, as
 amended by section 1 of part AAA of chapter 56 of the laws of  2020,  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, between July 1,  2017  and  June
 30,  2018,  between July 1, 2018 and June 30, 2019, between July 1, 2019
 and June 30, 2020, [and] between July 1, 2020 and  June  30,  2021,  AND
 BETWEEN  JULY  1, 2021 AND JUNE 30, 2022 or reimburse the hospital where
 the hospital purchases equivalent excess coverage as defined in subpara-
 graph (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

 S. 2507                            26                            A. 3007
 
 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, between July  1,  2017
 and  June 30, 2018, between July 1, 2018 and June 30, 2019, between July
 1, 2019 and June 30, 2020, [and] between July 1, 2020 and June 30, 2021,
 AND BETWEEN JULY 1, 2021 AND JUNE 30, 2022 for  physicians  or  dentists
 certified as eligible for each such period or periods pursuant to subdi-
 vision  2  of  this  section  by a general hospital licensed pursuant to
 article 28 of the public health law; provided  that  no  single  insurer
 shall  write  more  than fifty percent of the total excess premium for a
 given policy year; and provided, however, that such eligible  physicians
 or  dentists  must  have  in force an individual policy, from an insurer
 licensed in this state of  primary  malpractice  insurance  coverage  in
 amounts  of  no less than one million three hundred thousand dollars for
 each claimant and three million nine hundred thousand  dollars  for  all
 claimants  under  that  policy during the period of such excess coverage
 for such occurrences or be  endorsed  as  additional  insureds  under  a
 hospital professional liability policy which is offered through a volun-
 tary  attending physician ("channeling") program previously permitted by
 the superintendent of financial  services  during  the  period  of  such
 excess  coverage  for  such occurrences. During such period, such policy
 for excess coverage or  such  equivalent  excess  coverage  shall,  when
 combined with the physician's or dentist's primary malpractice insurance
 coverage  or  coverage  provided through a voluntary attending physician
 ("channeling") program, total an aggregate level of  two  million  three
 hundred  thousand dollars for each claimant and six million nine hundred
 thousand dollars for all claimants from all such policies  with  respect
 to  occurrences  in each of such years provided, however, if the cost of
 primary malpractice insurance coverage in excess of one million dollars,
 but below the excess medical  malpractice  insurance  coverage  provided
 pursuant  to  this act, exceeds the rate of nine percent per annum, then
 the required level of primary malpractice insurance coverage  in  excess
 of  one  million  dollars for each claimant shall be in an amount of not
 less than the dollar amount of such coverage available at  nine  percent
 per  annum;  the required level of such coverage for all claimants under
 that policy shall be in an amount not less than three times  the  dollar
 amount of coverage for each claimant; and excess coverage, when combined
 with  such  primary  malpractice  insurance coverage, shall increase the
 aggregate level for each claimant  by  one  million  dollars  and  three
 million  dollars  for  all  claimants;  and provided further, that, with
 respect to policies of primary medical malpractice coverage that include
 occurrences between April 1, 2002 and June 30,  2002,  such  requirement
 that coverage be in amounts no less than one million three hundred thou-
 sand  dollars  for each claimant and three million nine hundred thousand
 dollars for all claimants for such occurrences shall be effective  April
 1, 2002.
   §  3.  Subdivision 3 of section 18 of chapter 266 of the laws of 1986,
 amending the civil practice law and rules and  other  laws  relating  to
 malpractice and professional medical conduct, as amended by section 2 of
 part  AAA  of  chapter  56  of  the  laws of 2020, 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. 2507                            27                            A. 3007
 
 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, between July 1, 2017 and June 30, 2018,  between
 July  1, 2018 and June 30, 2019, between July 1, 2019 and June 30, 2020,
 [and] between July 1, 2020 and June 30, 2021, AND BETWEEN JULY  1,  2021
 AND  JUNE  30, 2022 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 subdivi-
 sion 2 of this section, and may amend  such  determination  and  certif-
 ication 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,  between July 1, 2016 and June 30, 2017, between July 1, 2017
 and June 30, 2018, between July 1, 2018 and June 30, 2019, between  July
 1, 2019 and June 30, 2020, [and] between July 1, 2020 and June 30, 2021,
 AND  BETWEEN  JULY  1,  2021 AND JUNE 30, 2022 allocable to each general
 hospital for physicians or dentists certified as eligible  for  purchase
 of  a policy for excess insurance coverage or equivalent excess coverage
 by such general hospital  in  accordance  with  subdivision  2  of  this
 section,  and  may  amend such determination and certification as neces-
 sary. 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

 S. 2507                            28                            A. 3007
 
 December  31,  1987,  to the period January 1, 1988 to June 30, 1988, to
 the period July 1, 1988 to December 31, 1988, to the period  January  1,
 1989  to June 30, 1989, to the period July 1, 1989 to December 31, 1989,
 to  the  period  January 1, 1990 to June 30, 1990, to the period July 1,
 1990 to December 31, 1990, to the period January 1,  1991  to  June  30,
 1991,  to  the  period  July 1, 1991 to December 31, 1991, to the period
 January 1, 1992 to June 30, 1992, to the period July 1, 1992 to December
 31, 1992, to the period January 1, 1993 to June 30, 1993, to the  period
 July 1, 1993 to December 31, 1993, to the period January 1, 1994 to June
 30, 1994, to the period July 1, 1994 to December 31, 1994, to the period
 January 1, 1995 to June 30, 1995, to the period July 1, 1995 to December
 31,  1995, to the period January 1, 1996 to June 30, 1996, to the period
 July 1, 1996 to December 31, 1996, to the period January 1, 1997 to June
 30, 1997, to the period July 1, 1997 to December 31, 1997, to the period
 January 1, 1998 to June 30, 1998, to the period July 1, 1998 to December
 31, 1998, to the period January 1, 1999 to June 30, 1999, to the  period
 July 1, 1999 to December 31, 1999, to the period January 1, 2000 to June
 30, 2000, to the period July 1, 2000 to December 31, 2000, to the period
 January 1, 2001 to June 30, 2001, to the period July 1, 2001 to June 30,
 2002, to the period July 1, 2002 to June 30, 2003, to the period July 1,
 2003  to  June 30, 2004, to the period July 1, 2004 to June 30, 2005, to
 the period July 1, 2005 and June 30, 2006, to the period  July  1,  2006
 and  June 30, 2007, to the period July 1, 2007 and June 30, 2008, to the
 period July 1, 2008 and June 30, 2009, to the period July  1,  2009  and
 June  30,  2010,  to  the  period July 1, 2010 and June 30, 2011, to the
 period July 1, 2011 and June 30, 2012, to the period July  1,  2012  and
 June  30,  2013,  to  the  period July 1, 2013 and June 30, 2014, to the
 period July 1, 2014 and June 30, 2015, to the period July  1,  2015  and
 June  30,  2016,  to  the  period July 1, 2016 and June 30, 2017, to the
 period July 1, 2017 to June 30, 2018, to the period July 1, 2018 to June
 30, 2019, to the period July 1, 2019 to June  30,  2020,  [and]  to  the
 period  July 1, 2020 to June 30, 2021, AND TO THE PERIOD JULY 1, 2021 TO
 JUNE 30, 2022.
   § 4. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
 18 of chapter 266 of the laws of 1986, amending the civil  practice  law
 and  rules  and  other  laws  relating  to  malpractice and professional
 medical conduct, as amended by section 3 of part AAA of  chapter  56  of
 the laws of 2020, 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,

 S. 2507                            29                            A. 3007
 
 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 to June 30,  2016,  during
 the period July 1, 2016 to June 30, 2017, during the period July 1, 2017
 to  June  30,  2018,  during  the  period July 1, 2018 to June 30, 2019,
 during the period July 1, 2019 to June 30, 2020, [and] during the period
 July 1, 2020 to June 30, 2021, AND DURING THE PERIOD  JULY  1,  2021  TO
 JUNE  30, 2022 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 coverage is purchased
 for  such  period  shall  be  responsible for payment to the provider of
 excess insurance coverage or equivalent excess coverage of an  allocable
 share  of  such  insufficiency,  based on the ratio of the total cost of
 such coverage for such physician to the sum of the total  cost  of  such
 coverage for all physicians applied to such insufficiency.
   (b)  Each  provider  of excess insurance coverage or equivalent excess
 coverage covering the period July 1, 1992 to June 30, 1993, or  covering
 the period July 1, 1993 to June 30, 1994, or covering the period July 1,
 1994  to  June 30, 1995, or covering the period July 1, 1995 to June 30,
 1996, or covering the period July 1, 1996 to June 30, 1997, or  covering
 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, or covering the period July 1, 2019 to June 30, 2020, or
 covering the period July 1, 2020 to June 30, 2021, OR COVERING THE PERI-
 OD JULY 1, 2021 TO JUNE 30, 2022 shall notify  a  covered  physician  or
 dentist by mail, mailed to the address shown on the last application for
 excess  insurance  coverage or equivalent excess coverage, of the amount
 due to such provider from such physician or dentist  for  such  coverage
 period  determined in accordance with paragraph (a) of this subdivision.
 Such amount shall be due from such physician or dentist to such provider
 of excess insurance coverage or equivalent excess coverage in a time and
 manner determined by the superintendent of financial services.
   (c) If a physician or dentist liable for payment of a portion  of  the
 costs  of excess insurance coverage or equivalent excess coverage cover-
 ing the period July 1, 1992 to June 30, 1993,  or  covering  the  period
 July  1,  1993  to June 30, 1994, or covering the period July 1, 1994 to
 June 30, 1995, or covering the period July 1, 1995 to June 30, 1996,  or
 covering the period July 1, 1996 to June 30, 1997, or covering the peri-

 S. 2507                            30                            A. 3007
 
 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,  or covering the period July 1, 2019 to June 30, 2020, or covering
 the period July 1, 2020 to June 30, 2021, OR COVERING THE PERIOD JULY 1,
 2021 TO JUNE 30, 2022 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 equivalent excess coverage purchased for such  physician  or
 dentist  in  accordance with this section for such coverage period shall
 be cancelled and shall be null and void as of the first day on or  after
 the  commencement  of  a  policy  period where the liability for payment
 pursuant to this subdivision has not been met.
   (d) Each provider of excess insurance coverage  or  equivalent  excess
 coverage  shall  notify the superintendent of financial services and the
 commissioner of health or their designee of each physician  and  dentist
 eligible  for  purchase  of  a  policy  for excess insurance coverage or
 equivalent excess coverage covering the period July 1, 1992 to June  30,
 1993,  or covering the period July 1, 1993 to June 30, 1994, or covering
 the period July 1, 1994 to June 30, 1995, or covering the period July 1,
 1995 to June 30, 1996, or covering the period July 1, 1996 to  June  30,
 1997,  or covering the period July 1, 1997 to June 30, 1998, or covering
 the period July 1, 1998 to June 30, 1999, or covering the period July 1,
 1999 to June 30, 2000, or covering the period July 1, 2000 to  June  30,
 2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
 ing  the  period  April 1, 2002 to June 30, 2002, or covering the period
 July 1, 2002 to June 30, 2003, or covering the period July  1,  2003  to
 June  30, 2004, or covering the period July 1, 2004 to June 30, 2005, or
 covering the period July 1, 2005 to June 30, 2006, or covering the peri-
 od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
 June 30, 2008, or covering the period July 1, 2008 to June 30, 2009,  or
 covering the period July 1, 2009 to June 30, 2010, or covering the peri-
 od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
 June  30, 2012, or covering the period July 1, 2012 to June 30, 2013, or
 covering the period July 1, 2013 to June 30, 2014, or covering the peri-
 od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
 June 30, 2016, or covering the period July 1, 2016 to June 30, 2017,  or
 covering the period July 1, 2017 to June 30, 2018, or covering the peri-
 od July 1, 2018 to June 30, 2019, or covering the period July 1, 2019 to
 June  30, 2020, or covering the period July 1, 2020 to June 30, 2021, OR

 S. 2507                            31                            A. 3007
 
 COVERING THE PERIOD JULY 1, 2021 TO JUNE 30, 2022 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, and to the period July 1, 2019 to June 30,  2020,
 and  to the period July 1, 2020 to June 30, 2021, AND TO THE PERIOD JULY
 1, 2021 TO JUNE 30, 2022 received from  the  hospital  excess  liability
 pool  for  purchase  of  excess  insurance coverage or equivalent excess
 coverage covering the period July 1, 1992 to June 30, 1993, and covering
 the period July 1, 1993 to June 30, 1994, and covering the  period  July
 1,  1994  to June 30, 1995, and covering the period July 1, 1995 to June
 30, 1996, and covering the period July 1, 1996 to  June  30,  1997,  and
 covering  the  period  July  1,  1997 to June 30, 1998, and covering the
 period July 1, 1998 to June 30, 1999, and covering the  period  July  1,
 1999  to June 30, 2000, and 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  cover-
 ing  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 covering the period July 1, 2010 to June 30, 2011, and covering  the
 period  July  1,  2011 to June 30, 2012, and covering the period July 1,
 2012 to June 30, 2013, and covering the period July 1, 2013 to June  30,
 2014,  and covering the period July 1, 2014 to June 30, 2015, and cover-
 ing 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,
 and  covering the period July 1, 2019 to June 30, 2020, and covering the
 period July 1, 2020 to June 30, 2021, AND COVERING THE  PERIOD  JULY  1,
 2021  TO  JUNE  30,  2022  for  a physician or dentist where such excess

 S. 2507                            32                            A. 3007
 
 insurance coverage or equivalent excess coverage is cancelled in accord-
 ance with paragraph (c) of this subdivision.
   § 5. Section 40 of chapter 266 of the laws of 1986, amending the civil
 practice  law  and  rules  and  other  laws  relating to malpractice and
 professional medical conduct, as amended by section 5  of  part  AAA  of
 chapter 56 of the laws of 2020, 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,
 [2021] 2022; 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, [2021]
 2022, 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, [2021]
 2022 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

 S. 2507                            33                            A. 3007
 
 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.
   § 6. Section 5 and subdivisions (a) and (e) of section 6 of part J  of
 chapter  63  of  the  laws  of 2001, amending chapter 266 of the laws of
 1986, amending the civil practice law and rules and other laws  relating
 to malpractice and professional medical conduct, as amended by section 6
 of  part  AAA  of chapter 56 of the laws of 2020, 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, June
 15, 2018, June 15, 2019, June 15, 2020, [and] June 15,  2021,  AND  JUNE
 15,  2022 the amount of funds available in the hospital excess liability
 pool, created pursuant to section 18 of chapter 266 of the laws of 1986,
 and whether such funds are sufficient for purposes of purchasing  excess
 insurance  coverage  for  eligible participating physicians and dentists
 during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June
 30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June  30,
 2005,  or  July  1,  2005  to June 30, 2006, or July 1, 2006 to June 30,
 2007, or July 1, 2007 to June 30, 2008, or July  1,  2008  to  June  30,
 2009,  or  July  1,  2009  to June 30, 2010, or July 1, 2010 to June 30,
 2011, or July 1, 2011 to June 30, 2012, or July  1,  2012  to  June  30,
 2013,  or  July  1,  2013  to June 30, 2014, or July 1, 2014 to June 30,
 2015, or July 1, 2015 to June 30, 2016, or July  1,  2016  to  June  30,
 2017,  or  July  1,  2017  to June 30, 2018, or July 1, 2018 to June 30,
 2019, or July 1, 2019 to June 30, 2020, or July  1,  2020  to  June  30,
 2021, OR JULY 1, 2021 TO JUNE 30, 2022 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, or July 1, 2019 to June 30,

 S. 2507                            34                            A. 3007
 
 2020, or July 1, 2020 to June 30, 2021, OR JULY 1, 2021 TO JUNE 30, 2022
 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, June 15, 2018, June 15, 2019, June
 15, 2020, [and] June 15, 2021, AND JUNE 15, 2022 as applicable.
   § 7. 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, as amended by section  7  of  part
 AAA of chapter 56 of the laws of 2020, 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  [twenty]  TWENTY-ONE, shall be eligible to apply for such
 coverage for the coverage period beginning the first of July, two  thou-
 sand  [twenty]  TWENTY-ONE;  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 [twenty] TWENTY-ONE exceeds the  total  number  of
 physicians  or  dentists  certified  as eligible for the coverage period
 beginning the first of July, two thousand [twenty] TWENTY-ONE, 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
 [twenty] TWENTY-ONE, 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 [twenty] TWENTY-ONE 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 [twenty] TWENTY-ONE.
   § 8. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2021.
 
                                  PART L
 
   Section  1.  Subdivision 2 of section 605 of the public health law, as
 amended by section 1 of part O of chapter 57 of the  laws  of  2019,  is
 amended to read as follows:

 S. 2507                            35                            A. 3007
 
   2.  State  aid  reimbursement for public health services provided by a
 municipality under this title, shall be  made  if  the  municipality  is
 providing  some  or all of the core public health services identified in
 section six hundred two of this title, pursuant to an approved  applica-
 tion  for  state  aid,  at a rate of no less than thirty-six per centum,
 except for the city of New York which shall receive no less than  [twen-
 ty]  TEN  per  centum,  of  the  difference between the amount of moneys
 expended by the municipality for  public  health  services  required  by
 section  six  hundred  two  of this title during the fiscal year and the
 base grant provided pursuant to subdivision one of this section. No such
 reimbursement shall be provided for services that are not  eligible  for
 state aid pursuant to this article.
   § 2. Subdivision 1 of section 616 of the public health law, as amended
 by  section 2 of part O of chapter 57 of the laws of 2019, is amended to
 read as follows:
   1. The total amount of state aid provided  pursuant  to  this  article
 shall  be  limited to the amount of the annual appropriation made by the
 legislature. In no event, however, shall such state aid be less than  an
 amount  to  provide  the  full  base grant and, as otherwise provided by
 subdivision two of section six hundred five of  this  article,  no  less
 than  thirty-six per centum, except for the city of New York which shall
 receive no less than [twenty] TEN per centum, of the difference  between
 the  amount  of  moneys expended by the municipality for eligible public
 health services pursuant to an approved application for state aid during
 the fiscal year and the base grant provided pursuant to subdivision  one
 of section six hundred five of this article.
   § 3. This act shall take effect July 1, 2021.
 
                                  PART M
 
   Section  1.  Subdivision 1, paragraph (f) of subdivision 3, paragraphs
 (a) and (d) of subdivision 5 and subdivisions  5-a  and  12  of  section
 2807-m  of the public health law, subdivision 1, paragraph (f) of subdi-
 vision 3, paragraph (a) of subdivision 5, and subdivision 5-a as amended
 and paragraph (d) of subdivision 5 as added by section 6 of  part  Y  of
 chapter 56 of the laws of 2020, are amended to read as follows:
   1.    Definitions.  For  purposes of this section, the following defi-
 nitions shall apply, unless the context clearly requires otherwise:
   (a) ["Clinical research" means patient-oriented research, epidemiolog-
 ic and behavioral studies, or  outcomes  research  and  health  services
 research  that  is approved by an institutional review board by the time
 the clinical research position is filled.
   (b) "Clinical research plan" means a plan submitted by a consortium or
 teaching general hospital for a clinical research position which  demon-
 strates, in a form to be provided by the commissioner, the following:
   (i)  financial  support for overhead, supervision, equipment and other
 resources equal to the amount of funding provided pursuant  to  subpara-
 graph  (i) of paragraph (b) of subdivision five-a of this section by the
 teaching general hospital or consortium for the clinical research  posi-
 tion;
   (ii)  experience  the sponsor-mentor and teaching general hospital has
 in clinical research and the medical field of the study;
   (iii) methods, data collection and anticipated measurable outcomes  of
 the clinical research to be performed;
   (iv)  training goals, objectives and experience the researcher will be
 provided to assess a future career in clinical research;

 S. 2507                            36                            A. 3007

   (v)  scientific  relevance,  merit  and  health  implications  of  the
 research to be performed;
   (vi)  information  on  potential  scientific  meetings and peer review
 journals where research results can be disseminated;
   (vii) clear and comprehensive details on the clinical  research  posi-
 tion;
   (viii) qualifications necessary for the clinical research position and
 strategy for recruitment;
   (ix)  non-duplication  with other clinical research positions from the
 same teaching general hospital or consortium;
   (x) methods to track the career of the clinical  researcher  once  the
 term of the position is complete; and
   (xi)  any  other information required by the commissioner to implement
 subparagraph (i) of paragraph (b) of subdivision five-a of this section.
   (xii) The clinical review plan submitted in accordance with this para-
 graph may be reviewed by the commissioner in consultation  with  experts
 outside the department of health.
   (c) "Clinical research position" means a post-graduate residency posi-
 tion which:
   (i)  shall  not  be required in order for the researcher to complete a
 graduate medical education program;
   (ii) may be reimbursed by other sources but only for costs  in  excess
 of  the funding distributed in accordance with subparagraph (i) of para-
 graph (b) of subdivision five-a of this section;
   (iii) shall exceed the minimum standards  that  are  required  by  the
 residency  review  committee in the specialty the researcher has trained
 or is currently training;
   (iv) shall not be previously funded by the teaching  general  hospital
 or  supported by another funding source at the teaching general hospital
 in the past three years from the date  the  clinical  research  plan  is
 submitted to the commissioner;
   (v) may supplement an existing research project;
   (vi) shall be equivalent to a full-time position comprising of no less
 than thirty-five hours per week for one or two years;
   (vii)  shall  provide, or be filled by a researcher who has formalized
 instruction in  clinical  research,  including  biostatistics,  clinical
 trial design, grant writing and research ethics;
   (viii) shall be supervised by a sponsor-mentor who shall either (A) be
 employed, contracted for employment or paid through an affiliated facul-
 ty  practice  plan  by a teaching general hospital which has received at
 least one research grant from the National Institutes of Health  in  the
 past five years from the date the clinical research plan is submitted to
 the  commissioner;  (B)  maintain  a  faculty  appointment at a medical,
 dental or podiatric school located in New York state that  has  received
 at  least  one  research grant from the National Institutes of Health in
 the past five years from the date the clinical research plan is  submit-
 ted  to  the  commissioner;  or  (C)  be  collaborating  in the clinical
 research plan with  a  researcher  from  another  institution  that  has
 received  at  least  one  research grant from the National Institutes of
 Health in the past five years from the date the clinical  research  plan
 is submitted to the commissioner; and
   (ix)  shall  be  filled  by  a  researcher  who is (A) enrolled or has
 completed a graduate medical education program, as defined in  paragraph
 (i)  of  this  subdivision;  (B)  a  United States citizen, national, or
 permanent resident of the  United  States;  and  (C)  a  graduate  of  a
 medical,  dental or podiatric school located in New York state, a gradu-

 S. 2507                            37                            A. 3007

 ate or resident in a graduate medical education program, as  defined  in
 paragraph  (i) of this subdivision, where the sponsoring institution, as
 defined in paragraph (q) of this subdivision, is  located  in  New  York
 state,  or  resides  in New York state at the time the clinical research
 plan is submitted to the commissioner.
   (d)] "Consortium" means an organization or  association,  approved  by
 the  commissioner in consultation with the council, of general hospitals
 which provide graduate medical education, together with  any  affiliated
 site;  provided  that  such organization or association may also include
 other providers of health care  services,  medical  schools,  payors  or
 consumers,  and which meet other criteria pursuant to subdivision six of
 this section.
   [(e)] (B) "Council" means the  New  York  state  council  on  graduate
 medical education.
   [(f)]  (C)  "Direct medical education" means the direct costs of resi-
 dents, interns and supervising physicians.
   [(g)] (D) "Distribution period" means each calendar year set forth  in
 subdivision two of this section.
   [(h)]  (E)  "Faculty"  means  persons  who  are  employed  by or under
 contract for employment with a teaching general  hospital  or  are  paid
 through  a  teaching general hospital's affiliated faculty practice plan
 and maintain a faculty appointment at a  medical  school.  Such  persons
 shall not be limited to persons with a degree in medicine.
   [(i)]  (F)  "Graduate medical education program" means a post-graduate
 medical education residency in the  United  States  which  has  received
 accreditation  from  a  nationally  recognized accreditation body or has
 been approved by  a  nationally  recognized  organization  for  medical,
 osteopathic,  podiatric  or dental residency programs including, but not
 limited to, specialty boards.
   [(j)] (G) "Indirect medical education" means the  estimate  of  costs,
 other than direct costs, of educational activities in teaching hospitals
 as determined in accordance with the methodology applicable for purposes
 of  determining  an  estimate  of  indirect  medical education costs for
 reimbursement for inpatient hospital service pursuant to title XVIII  of
 the federal social security act (medicare).
   [(k)]  (H) "Medicare" means the methodology used for purposes of reim-
 bursing inpatient hospital services provided to beneficiaries  of  title
 XVIII of the federal social security act.
   [(l)]  (I)  "Primary  care" residents specialties shall include family
 medicine, general pediatrics, primary care internal medicine, and prima-
 ry care obstetrics and gynecology. In determining whether a residency is
 in primary care, the commissioner shall consult with the council.
   [(m)] (J) "Regions", for purposes of  this  section,  shall  mean  the
 regions  as  defined  in paragraph (b) of subdivision sixteen of section
 twenty-eight hundred seven-c of this article as in effect on June  thir-
 tieth, nineteen hundred ninety-six. For purposes of distributions pursu-
 ant  to subdivision five-a of this section, except distributions made in
 accordance with paragraph (a) of subdivision  five-a  of  this  section,
 "regions" shall be defined as New York city and the rest of the state.
   [(n)]  (K)  "Regional pool" means a professional education pool estab-
 lished on a regional basis by  the  commissioner  from  funds  available
 pursuant  to  sections  twenty-eight  hundred  seven-s  and twenty-eight
 hundred seven-t of this article.
   [(o)] (L) "Resident" means a person in a  graduate  medical  education
 program  which  has  received accreditation from a nationally recognized
 accreditation body or in a program  approved  by  any  other  nationally

 S. 2507                            38                            A. 3007
 
 recognized  organization  for  medical,  osteopathic or dental residency
 programs including, but not limited to, specialty boards.
   [(p)  "Shortage specialty" means a specialty determined by the commis-
 sioner, in consultation with the council, to be in short supply  in  the
 state of New York.
   (q)]  (M) "Sponsoring institution" means the entity that has the over-
 all responsibility for a program of  graduate  medical  education.  Such
 institutions  shall include teaching general hospitals, medical schools,
 consortia and diagnostic and treatment centers.
   [(r)] (N) "Weighted resident count" means a  teaching  general  hospi-
 tal's total number of residents as of July first, nineteen hundred nine-
 ty-five,  including  residents  in  affiliated  non-hospital  ambulatory
 settings, reported to  the  commissioner.  Such  resident  counts  shall
 reflect the weights established in accordance with rules and regulations
 adopted  by  the state hospital review and planning council and approved
 by the commissioner for purposes of implementing subdivision twenty-five
 of section twenty-eight hundred seven-c of this article and in effect on
 July first, nineteen hundred ninety-five.  Such  weights  shall  not  be
 applied  to  specialty  hospitals,  specified by the commissioner, whose
 primary care mission is to engage in  research,  training  and  clinical
 care  in  specialty  eye  and  ear,  special  surgery, orthopedic, joint
 disease, cancer, chronic care or rehabilitative services.
   [(s)] (O) "Adjustment amount" means  an  amount  determined  for  each
 teaching  hospital for periods prior to January first, two thousand nine
 by:
   (i) determining the difference between (A) a calculation of what  each
 teaching general hospital would have been paid if payments made pursuant
 to  paragraph  (a-3)  of subdivision one of section twenty-eight hundred
 seven-c of this article between January first, nineteen hundred  ninety-
 six  and  December thirty-first, two thousand three were based solely on
 the case mix of  persons  eligible  for  medical  assistance  under  the
 medical  assistance  program pursuant to title eleven of article five of
 the social services law who are enrolled in health maintenance organiza-
 tions and persons paid for under the family health plus program enrolled
 in approved organizations pursuant to title eleven-D of article five  of
 the  social services law during those years, and (B) the actual payments
 to each such hospital pursuant to paragraph (a-3) of subdivision one  of
 section  twenty-eight  hundred  seven-c  of this article between January
 first, nineteen hundred ninety-six and December thirty-first, two  thou-
 sand three.
   (ii) reducing proportionally each of the amounts determined in subpar-
 agraph  (i) of this paragraph so that the sum of all such amounts totals
 no more than one hundred million dollars;
   (iii) further reducing each of the amounts determined in  subparagraph
 (ii)  of  this  paragraph  by  the amount received by each hospital as a
 distribution from funds designated in paragraph (a) of subdivision  five
 of  this  section attributable to the period January first, two thousand
 three through December thirty-first, two thousand three, except that  if
 such  amount  was  provided  to  a  consortium  then  the  amount of the
 reduction for each hospital in the consortium  shall  be  determined  by
 applying  the  proportion  of  each  hospital's  amount determined under
 subparagraph (i) of this paragraph to the total of such amounts  of  all
 hospitals in such consortium to the consortium award;
   (iv)  further  reducing each of the amounts determined in subparagraph
 (iii) of this paragraph by the amounts specified in paragraph [(t)]  (P)
 of this subdivision; and

 S. 2507                            39                            A. 3007
 
   (v)  dividing  each of the amounts determined in subparagraph (iii) of
 this paragraph by seven.
   [(t)] (P) "Extra reduction amount" shall mean an amount determined for
 a  teaching hospital for which an adjustment amount is calculated pursu-
 ant to paragraph [(s)] (O) of this subdivision that  is  the  hospital's
 proportionate  share  of  the  sum of the amounts specified in paragraph
 [(u)] (Q) of this subdivision determined based upon a comparison of  the
 hospital's  remaining  liability  calculated pursuant to paragraph [(s)]
 (O) of this subdivision to the sum  of  all  such  hospital's  remaining
 liabilities.
   [(u)]  (Q)  "Allotment  amount"  shall  mean  an amount determined for
 teaching hospitals as follows:
   (i) for a hospital for which an adjustment amount  pursuant  to  para-
 graph  [(s)] (O) of this subdivision does not apply, the amount received
 by the hospital pursuant to paragraph (a) of subdivision  five  of  this
 section  attributable  to  the  period January first, two thousand three
 through December thirty-first, two thousand three, or
   (ii) for a hospital for which an adjustment amount pursuant  to  para-
 graph  [(s)]  (O)  of  this  subdivision  applies  and  which received a
 distribution pursuant to paragraph  (a)  of  subdivision  five  of  this
 section  attributable  to  the  period January first, two thousand three
 through December thirty-first, two thousand three that is  greater  than
 the  hospital's  adjustment  amount, the difference between the distrib-
 ution amount and the adjustment amount.
   (f) Effective January first, two thousand five through December  thir-
 ty-first,  two  thousand  eight,  each  teaching  general hospital shall
 receive a distribution from the applicable regional pool  based  on  its
 distribution amount determined under paragraphs (c), (d) and (e) of this
 subdivision  and reduced by its adjustment amount calculated pursuant to
 paragraph [(s)] (O) of subdivision one of this section and, for distrib-
 utions for the period January first, two thousand five through  December
 thirty-first,  two thousand five, further reduced by its extra reduction
 amount calculated pursuant to paragraph [(t)] (P) of subdivision one  of
 this section.
   (a)  Up to thirty-one million dollars annually for the periods January
 first, two thousand through December thirty-first, two  thousand  three,
 and up to twenty-five million dollars plus the sum of the amounts speci-
 fied  in  paragraph [(n)] (K) of subdivision one of this section for the
 period January first, two thousand five through  December  thirty-first,
 two thousand five, and up to thirty-one million dollars annually for the
 period  January  first,  two thousand six through December thirty-first,
 two thousand seven, shall be set aside and reserved by the  commissioner
 from  the regional pools established pursuant to subdivision two of this
 section for supplemental distributions in each such region to be made by
 the commissioner to consortia and teaching general hospitals in  accord-
 ance  with a distribution methodology developed in consultation with the
 council and specified in rules and regulations adopted  by  the  commis-
 sioner.
   (d)  Notwithstanding any other provision of law or regulation, for the
 period January first, two thousand five through  December  thirty-first,
 two  thousand  five,  the  commissioner shall distribute as supplemental
 payments the allotment specified in paragraph [(n)] (K)  of  subdivision
 one of this section.
   5-a.  Graduate  medical  education  innovations pool. (a) Supplemental
 distributions. (i) Thirty-one million dollars  for  the  period  January
 first,  two  thousand  eight through December thirty-first, two thousand

 S. 2507                            40                            A. 3007
 
 eight, shall be set aside and reserved  by  the  commissioner  from  the
 regional  pools  established pursuant to subdivision two of this section
 and shall be available for distributions pursuant to subdivision five of
 this  section  and in accordance with section 86-1.89 of title 10 of the
 codes, rules and regulations of the state of New York as  in  effect  on
 January  first,  two thousand eight[; provided, however, for purposes of
 funding the empire clinical research investigation  program  (ECRIP)  in
 accordance  with paragraph eight of subdivision (e) and paragraph two of
 subdivision (f) of section 86-1.89 of title 10 of the codes,  rules  and
 regulations  of the state of New York, distributions shall be made using
 two regions defined as New York city and the rest of the state  and  the
 dollar amount set forth in subparagraph (i) of paragraph two of subdivi-
 sion  (f)  of  section 86-1.89 of title 10 of the codes, rules and regu-
 lations of the state of New York shall be increased from sixty  thousand
 dollars to seventy-five thousand dollars].
   (ii)  For  periods  on  and  after  January  first, two thousand nine,
 supplemental distributions pursuant to subdivision five of this  section
 and  in  accordance with section 86-1.89 of title 10 of the codes, rules
 and regulations of the state of New York shall no longer be made and the
 provisions of section 86-1.89 of title 10 of the codes, rules and  regu-
 lations of the state of New York shall be null and void.
   (b)  [Empire  clinical  research  investigator  program  (ECRIP). 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 thirty-
 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, 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, and
 up to eight million six  hundred  twelve  thousand  dollars  each  state
 fiscal  year  for  the  period  April first, two thousand twenty through
 March thirty-first, two thousand twenty-three, shall be  set  aside  and
 reserved  by the commissioner from the regional pools established pursu-
 ant 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:
   Distributions shall first be made to consortia  and  teaching  general
 hospitals  for the empire clinical research investigator program (ECRIP)
 to help secure federal funding for biomedical research,  train  clinical
 researchers,  recruit national leaders as faculty to act as mentors, and
 train residents and fellows  in  biomedical  research  skills  based  on
 hospital-specific  data  submitted  to the commissioner by consortia and
 teaching general hospitals in accordance with clause (G) of this subpar-
 agraph. Such distributions shall be made in accordance with the  follow-
 ing methodology:
   (A)  The  greatest  number  of clinical research positions for which a
 consortium or teaching general hospital may be funded pursuant  to  this
 subparagraph  shall  be  one  percent  of  the total number of residents
 training at the consortium or teaching general hospital on  July  first,
 two  thousand  eight  for  the  period  January first, two thousand nine

 S. 2507                            41                            A. 3007

 through December thirty-first, two thousand nine rounded up to the near-
 est one position.
   (B)  Distributions  made  to a consortium or teaching general hospital
 shall equal the product of the total number of clinical  research  posi-
 tions  submitted  by  a  consortium  or  teaching  general  hospital and
 accepted by the commissioner as meeting the criteria set forth in  para-
 graph  (b)  of subdivision one of this section, subject to the reduction
 calculation set forth in clause (C)  of  this  subparagraph,  times  one
 hundred ten thousand dollars.
   (C)  If  the  dollar  amount for the total number of clinical research
 positions in the region  calculated  pursuant  to  clause  (B)  of  this
 subparagraph  exceeds the total amount appropriated for purposes of this
 paragraph, including clinical research positions that continue from  and
 were funded in prior distribution periods, the commissioner shall elimi-
 nate  one-half  of  the  clinical  research  positions submitted by each
 consortium or teaching general hospital rounded down to the nearest  one
 position.  Such  reduction shall be repeated until the dollar amount for
 the total number of clinical research positions in the region  does  not
 exceed  the total amount appropriated for purposes of this paragraph. If
 the repeated reduction of the total number of  clinical  research  posi-
 tions  in  the region by one-half does not render a total funding amount
 that is equal to or less than the total amount reserved for that  region
 within  the  appropriation, the funding for each clinical research posi-
 tion in that region shall be  reduced  proportionally  in  one  thousand
 dollar  increments until the total dollar amount for the total number of
 clinical research positions in that region does  not  exceed  the  total
 amount  reserved for that region within the appropriation. Any reduction
 in funding will be effective for the duration of the award. No  clinical
 research  positions that continue from and were funded in prior distrib-
 ution periods shall be eliminated or reduced by such methodology.
   (D) Each consortium or teaching general  hospital  shall  receive  its
 annual distribution amount in accordance with the following:
   (I) Each consortium or teaching general hospital with a one-year ECRIP
 award  shall  receive  its  annual  distribution  amount  in  full  upon
 completion of the requirements set forth in items (I) and (II) of clause
 (G) of this subparagraph. The requirements set forth in items  (IV)  and
 (V)  of clause (G) of this subparagraph must be completed by the consor-
 tium or teaching general hospital in order for the consortium or  teach-
 ing  general  hospital  to be eligible to apply for ECRIP funding in any
 subsequent funding cycle.
   (II) Each consortium or teaching  general  hospital  with  a  two-year
 ECRIP  award  shall receive its first annual distribution amount in full
 upon completion of the requirements set forth in items (I) and  (II)  of
 clause  (G)  of  this  subparagraph. Each consortium or teaching general
 hospital will receive its second annual distribution amount in full upon
 completion of the requirements set forth in item (III) of clause (G)  of
 this  subparagraph.  The requirements set forth in items (IV) and (V) of
 clause (G) of this subparagraph must be completed by the  consortium  or
 teaching general hospital in order for the consortium or teaching gener-
 al  hospital to be eligible to apply for ECRIP funding in any subsequent
 funding cycle.
   (E) Each consortium or teaching general  hospital  receiving  distrib-
 utions pursuant to this subparagraph shall reserve seventy-five thousand
 dollars  to  primarily  fund  salary and fringe benefits of the clinical
 research position with the remainder going to fund  the  development  of

 S. 2507                            42                            A. 3007

 faculty  who  are involved in biomedical research, training and clinical
 care.
   (F)  Undistributed  or  returned  funds  available  to  fund  clinical
 research positions pursuant to this paragraph for a distribution  period
 shall  be  available to fund clinical research positions in a subsequent
 distribution period.
   (G) In order to be eligible for distributions pursuant to this subpar-
 agraph, each consortium and teaching general hospital shall  provide  to
 the  commissioner by July first of each distribution period, the follow-
 ing data and information on a hospital-specific  basis.  Such  data  and
 information  shall  be  certified as to accuracy and completeness by the
 chief executive officer, chief financial officer or chair of the consor-
 tium governing body of each consortium or teaching general hospital  and
 shall be maintained by each consortium and teaching general hospital for
 five years from the date of submission:
   (I)  For  each  clinical  research  position, information on the type,
 scope, training objectives,  institutional  support,  clinical  research
 experience of the sponsor-mentor, plans for submitting research outcomes
 to  peer reviewed journals and at scientific meetings, including a meet-
 ing sponsored by the department, the name of a principal contact  person
 responsible for tracking the career development of researchers placed in
 clinical  research positions, as defined in paragraph (c) of subdivision
 one of this section, and who is authorized to certify to the commission-
 er that all the requirements of the clinical  research  training  objec-
 tives  set  forth  in this subparagraph shall be met. Such certification
 shall be provided by July first of each distribution period;
   (II) For each clinical research position,  information  on  the  name,
 citizenship  status, medical education and training, and medical license
 number of the researcher, if applicable, shall be provided  by  December
 thirty-first of the calendar year following the distribution period;
   (III)  Information on the status of the clinical research plan, accom-
 plishments, changes in research activities, progress, and performance of
 the researcher shall be provided upon  completion  of  one-half  of  the
 award term;
   (IV)  A  final report detailing training experiences, accomplishments,
 activities and performance of the clinical researcher, and  data,  meth-
 ods,  results  and  analyses  of  the  clinical  research  plan shall be
 provided three months after the clinical research position ends; and
   (V) Tracking information concerning past  researchers,  including  but
 not  limited  to (A) background information, (B) employment history, (C)
 research status, (D) current research activities, (E)  publications  and
 presentations,  (F)  research  support,  and  (G)  any other information
 necessary to track the researcher; and
   (VI) Any other data or information required  by  the  commissioner  to
 implement this subparagraph.
   (H)  Notwithstanding  any  inconsistent provision of this subdivision,
 for periods on and after April first, two thousand thirteen, ECRIP grant
 awards shall be made in accordance with rules and regulations promulgat-
 ed by the commissioner. Such regulations shall, at a minimum:
   (1) provide that ECRIP grant awards shall be made with  the  objective
 of  securing  federal funding for biomedical research, training clinical
 researchers, recruiting national leaders as faculty to act  as  mentors,
 and training residents and fellows in biomedical research skills;
   (2)  provide that ECRIP grant applicants may include interdisciplinary
 research teams comprised of teaching general hospitals acting in collab-

 S. 2507                            43                            A. 3007

 oration with entities including but  not  limited  to  medical  centers,
 hospitals, universities and local health departments;
   (3) provide that applications for ECRIP grant awards shall be based on
 such  information requested by the commissioner, which shall include but
 not be limited to hospital-specific data;
   (4) establish the qualifications for  investigators  and  other  staff
 required for grant projects eligible for ECRIP grant awards; and
   (5)  establish a methodology for the distribution of funds under ECRIP
 grant awards.
   (c)] Physician loan repayment program. One million nine hundred  sixty
 thousand  dollars  for  the  period  January  first,  two thousand eight
 through December thirty-first, two  thousand  eight,  one  million  nine
 hundred  sixty  thousand dollars for the period January first, two thou-
 sand nine through December thirty-first, two thousand nine, one  million
 nine  hundred  sixty  thousand dollars for the period January first, two
 thousand ten through  December  thirty-first,  two  thousand  ten,  four
 hundred  ninety thousand dollars for the period January first, two thou-
 sand eleven through March thirty-first, two thousand eleven, one million
 seven hundred thousand dollars each state fiscal  year  for  the  period
 April  first,  two thousand eleven through March thirty-first, two thou-
 sand fourteen, up to one million seven  hundred  five  thousand  dollars
 each state fiscal year for the period April first, two thousand fourteen
 through  March  thirty-first,  two thousand seventeen, up to one million
 seven hundred five thousand dollars each state fiscal year for the peri-
 od April first, two thousand seventeen through March  thirty-first,  two
 thousand  twenty,  and  up  to  one  million seven hundred five thousand
 dollars each state fiscal year for the period April first, two  thousand
 twenty  through  March thirty-first, two thousand twenty-three, shall be
 set aside and reserved by  the  commissioner  from  the  regional  pools
 established  pursuant  to  subdivision  two of this section and shall be
 available for purposes of physician loan repayment  in  accordance  with
 subdivision  ten of this section. Notwithstanding any contrary provision
 of this section, sections one hundred twelve and one hundred sixty-three
 of the state finance law, or any other contrary provision of  law,  such
 funding  shall be allocated regionally with one-third of available funds
 going to New York city and two-thirds of available funds  going  to  the
 rest  of the state and shall be distributed in a manner to be determined
 by the commissioner without a competitive bid or  request  for  proposal
 process as follows:
   (i) Funding shall first be awarded to repay loans of up to twenty-five
 physicians  who  train  in  primary care or specialty tracks in teaching
 general hospitals, and who enter and remain in primary care or specialty
 practices in underserved communities, as determined by the commissioner.
   (ii) After distributions in accordance with subparagraph (i)  of  this
 paragraph, all remaining funds shall be awarded to repay loans of physi-
 cians  who  enter  and  remain in primary care or specialty practices in
 underserved communities, as determined by  the  commissioner,  including
 but  not  limited  to  physicians working in general hospitals, or other
 health care facilities.
   (iii) In no case shall less than fifty percent of the funds  available
 pursuant  to  this  paragraph be distributed in accordance with subpara-
 graphs (i) and (ii) of this paragraph to physicians identified by gener-
 al hospitals.
   (iv) In addition to the funds allocated under this paragraph, for  the
 period April first, two thousand fifteen through March thirty-first, two

 S. 2507                            44                            A. 3007

 thousand  sixteen,  two  million  dollars  shall  be  available  for the
 purposes described in subdivision ten of this section;
   (v)  In  addition to the funds allocated under this paragraph, for the
 period April first, two thousand sixteen through March thirty-first, two
 thousand seventeen, two million  dollars  shall  be  available  for  the
 purposes described in subdivision ten of this section;
   (vi) Notwithstanding any provision of law to the contrary, and subject
 to the extension of the Health Care Reform Act of 1996, sufficient funds
 shall be available for the purposes described in subdivision ten of this
 section  in amounts necessary to fund the remaining year commitments for
 awards made pursuant to subparagraphs (iv) and (v) of this paragraph.
   [(d)] (C) Physician practice support. Four million nine hundred  thou-
 sand  dollars  for  the period January first, two thousand eight through
 December thirty-first, two thousand eight,  four  million  nine  hundred
 thousand  dollars  annually  for  the period January first, two thousand
 nine through December thirty-first, two thousand ten,  one  million  two
 hundred  twenty-five  thousand dollars for the period January first, two
 thousand eleven through March thirty-first, two  thousand  eleven,  four
 million  three  hundred  thousand dollars each state fiscal year for the
 period April first, two thousand eleven through March thirty-first,  two
 thousand  fourteen,  up  to  four  million  three hundred sixty thousand
 dollars each state fiscal year for the period April first, two  thousand
 fourteen  through March thirty-first, two thousand seventeen, up to four
 million three hundred sixty thousand dollars for each state fiscal  year
 for  the  period April first, two thousand seventeen through March thir-
 ty-first, two thousand twenty, and up  to  four  million  three  hundred
 sixty  thousand dollars for each fiscal year for the period April first,
 two thousand twenty through March  thirty-first,  two  thousand  twenty-
 three,  shall  be  set  aside  and reserved by the commissioner from the
 regional pools established pursuant to subdivision two of  this  section
 and  shall  be  available  for  purposes  of physician practice support.
 Notwithstanding any contrary provision of  this  section,  sections  one
 hundred  twelve and one hundred sixty-three of the state finance law, or
 any other contrary provision of law, such  funding  shall  be  allocated
 regionally  with one-third of available funds going to New York city and
 two-thirds of available funds going to the rest of the state  and  shall
 be  distributed in a manner to be determined by the commissioner without
 a competitive bid or request for proposal process as follows:
   (i) Preference in funding shall first be accorded to teaching  general
 hospitals  for  up  to  twenty-five awards, to support costs incurred by
 physicians trained in primary or specialty tracks who thereafter  estab-
 lish  or join practices in underserved communities, as determined by the
 commissioner.
   (ii) After distributions in accordance with subparagraph (i)  of  this
 paragraph, all remaining funds shall be awarded to physicians to support
 the  cost  of  establishing or joining practices in underserved communi-
 ties, as determined by the commissioner,  and  to  hospitals  and  other
 health  care  providers to recruit new physicians to provide services in
 underserved communities, as determined by the commissioner.
   (iii) In no case shall less than fifty percent of the funds  available
 pursuant  to  this  paragraph  be  distributed  to  general hospitals in
 accordance with subparagraphs (i) and (ii) of this paragraph.
   [(e)] (D) Work group. For funding  available  pursuant  to  paragraphs
 [(c) and (d) (e)] (B) AND (C) of this subdivision:
   (i)  The  department  shall  appoint a work group from recommendations
 made by associations  representing  physicians,  general  hospitals  and

 S. 2507                            45                            A. 3007
 
 other  health care facilities to develop a streamlined application proc-
 ess by June first, two thousand twelve.
   (ii) Subject to available funding, applications shall be accepted on a
 continuous  basis.  The department shall provide technical assistance to
 applicants to facilitate their completion of applications. An  applicant
 shall  be  notified  in  writing  by  the  department within ten days of
 receipt of an application as to whether the application is complete  and
 if  the  application is incomplete, what information is outstanding. The
 department shall act on an application within thirty days of receipt  of
 a complete application.
   [(f)]  (E)  Study on physician workforce. Five hundred ninety thousand
 dollars annually for  the  period  January  first,  two  thousand  eight
 through December thirty-first, two thousand ten, one hundred forty-eight
 thousand  dollars  for  the  period  January  first, two thousand eleven
 through March thirty-first, two thousand eleven,  five  hundred  sixteen
 thousand  dollars each state fiscal year for the period April first, two
 thousand eleven through March thirty-first, two thousand fourteen, up to
 four hundred eighty-seven thousand dollars each state  fiscal  year  for
 the  period  April  first,  two  thousand fourteen through March thirty-
 first, two thousand seventeen, up to four hundred eighty-seven  thousand
 dollars for each state fiscal year for the period April first, two thou-
 sand  seventeen  through March thirty-first, two thousand twenty, and up
 to four hundred eighty-seven thousand dollars each state fiscal year for
 the period April first, two thousand twenty through March  thirty-first,
 two  thousand  twenty-three,  shall  be  set  aside  and reserved by the
 commissioner from the regional pools established pursuant to subdivision
 two of this section and shall be available to fund a study of  physician
 workforce needs and solutions including, but not limited to, an analysis
 of  residency  programs  and projected physician workforce and community
 needs. The commissioner shall enter into agreements  with  one  or  more
 organizations  to  conduct  such  study  based on a request for proposal
 process.
   [(g)] (F) Diversity in medicine/post-baccalaureate  program.  Notwith-
 standing any inconsistent provision of section one hundred twelve or one
 hundred  sixty-three  of  the  state  finance  law or any other law, one
 million nine hundred sixty thousand  dollars  annually  for  the  period
 January  first,  two  thousand  eight through December thirty-first, two
 thousand ten, four hundred ninety thousand dollars for the period  Janu-
 ary  first, two thousand eleven through March thirty-first, two thousand
 eleven, one million seven hundred thousand  dollars  each  state  fiscal
 year for the period April first, two thousand eleven through March thir-
 ty-first,  two  thousand  fourteen,  up  to one million six hundred five
 thousand dollars each state fiscal year for the period April first,  two
 thousand fourteen through March thirty-first, two thousand seventeen, up
 to  one million six hundred five thousand dollars each state fiscal year
 for the period April first, two thousand seventeen through  March  thir-
 ty-first,  two  thousand  twenty, and up to one million six hundred five
 thousand dollars each state fiscal year for the period April first,  two
 thousand  twenty  through March thirty-first, two thousand twenty-three,
 shall be set aside and reserved by the commissioner  from  the  regional
 pools  established pursuant to subdivision two of this section and shall
 be available for distributions to the Associated Medical Schools of  New
 York  to fund its diversity program including existing and new post-bac-
 calaureate programs for minority and economically disadvantaged students
 and encourage participation from all medical schools in  New  York.  The
 associated  medical schools of New York shall report to the commissioner

 S. 2507                            46                            A. 3007
 
 on an annual basis regarding the use of funds for such purpose  in  such
 form and manner as specified by the commissioner.
   [(h)]  (G)  In  the event there are undistributed funds within amounts
 made available for distributions  pursuant  to  this  subdivision,  such
 funds  may  be  reallocated  and  distributed  in  current or subsequent
 distribution periods in a manner determined by the commissioner for  any
 purpose set forth in this subdivision.
   12. Notwithstanding any provision of law to the contrary, applications
 submitted  on or after April first, two thousand sixteen, for the physi-
 cian loan repayment program pursuant to paragraph [(c)] (B) of  subdivi-
 sion  five-a  of this section and subdivision ten of this section or the
 physician practice support program pursuant to paragraph  [(d)]  (C)  of
 subdivision  five-a  of  this section, shall be subject to the following
 changes:
   (a) Awards shall be made from the  total  funding  available  for  new
 awards  under  the  physician  loan  repayment program and the physician
 practice support program, with neither program  limited  to  a  specific
 funding amount within such total funding available;
   (b)  An  applicant  may  apply  for an award for either physician loan
 repayment or physician practice support, but not both;
   (c) An applicant shall agree to practice for three years in an  under-
 served  area  and  each award shall provide up to forty thousand dollars
 for each of the three years; and
   (d) To the extent practicable, awards shall be timed to be of use  for
 job offers made to applicants.
   §  2.  Subparagraph (xvi) of paragraph (a) of subdivision 7 of section
 2807-s of the public health law, as amended by section 8 of  part  Y  of
 chapter 56 of the laws of 2020, is amended to read as follows:
   (xvi)  provided further, however, for periods prior to July first, two
 thousand nine, amounts set forth in this paragraph shall be  reduced  by
 an amount equal to the actual distribution reductions for all facilities
 pursuant  to  paragraph  [(s)] (O) of subdivision one of section twenty-
 eight hundred seven-m of this article.
   § 3. Subdivision (c) of section 92-dd of the  state  finance  law,  as
 amended  by  section  9  of part Y of chapter 56 of the laws of 2020, is
 amended to read as follows:
   (c) The pool administrator shall, from appropriated funds  transferred
 to  the  pool  administrator  from  the  comptroller,  continue  to make
 payments as required pursuant to sections twenty-eight hundred  seven-k,
 twenty-eight  hundred  seven-m  (not including payments made pursuant to
 SUBDIVISION FIVE-B AND paragraphs (B), (c)[, (d),, (f)] and [(g)] (F) of
 subdivision five-a of section twenty-eight hundred seven-m),  and  twen-
 ty-eight  hundred  seven-w  of  the  public health law, paragraph (e) of
 subdivision twenty-five of section twenty-eight hundred seven-c  of  the
 public  health  law,  paragraphs  (b)  and  (c) of subdivision thirty of
 section twenty-eight hundred seven-c of the public health law, paragraph
 (b) of subdivision eighteen of section twenty-eight hundred eight of the
 public health law, subdivision seven of section twenty-five hundred-d of
 the public health law and section eighty-eight of  chapter  one  of  the
 laws of nineteen hundred ninety-nine.
   §  4.  Subdivision 2 of section 251 of the public health law, as added
 by chapter 338 of the laws of 1998, is amended to read as follows:
   2. Solicit, receive, and review applications from public  and  private
 agencies  and  organizations  and  qualified  research  institutions for
 grants from the spinal cord injury research trust fund, created pursuant
 to section ninety-nine-f of the state finance law, to  conduct  research

 S. 2507                            47                            A. 3007
 
 programs  which  focus  on the treatment and cure of spinal cord injury.
 The board shall  make  recommendations  to  the  commissioner,  and  the
 commissioner shall, in his or her discretion, grant approval of applica-
 tions  for  grants  from  those  applications  recommended by the board;
 PROVIDED, HOWEVER, THAT THE BOARD SHALL NOT RECOMMEND, AND  THE  COMMIS-
 SIONER  SHALL  NOT  APPROVE, ANY NEW GRANTS ON OR AFTER APRIL FIRST, TWO
 THOUSAND TWENTY-ONE.
   § 5. Subdivision 1 of section 265-a of the public health law, as added
 by section 1 of part H of chapter 58 of the laws of 2007, is amended  to
 read as follows:
   1.  The empire state stem cell board ("board"), comprised of a funding
 committee and an ethics committee, both of which shall be chaired by the
 commissioner, is hereby created within the department for the purpose of
 administering the empire state stem cell trust  fund  ("fund"),  created
 pursuant to section ninety-nine-p of the state finance law. The board is
 hereby  empowered,  subject  to  annual appropriations and other funding
 authorized or made available, to make grants to basic, applied, transla-
 tional or other research and development activities  that  will  advance
 scientific discoveries in fields related to stem cell biology; PROVIDED,
 HOWEVER,  THAT  THE  BOARD  SHALL  NOT MAKE ANY GRANTS ON OR AFTER APRIL
 FIRST, TWO THOUSAND TWENTY-ONE.
   § 6.  Section 6 of chapter 338 of the laws of 1998 amending the public
 health law, the public officers law and the state finance  law  relating
 to  establishing a spinal cord injury research board, is amended to read
 as follows:
   § 6. This act shall take effect January 1, 1999 AND SHALL  EXPIRE  AND
 BE DEEMED REPEALED DECEMBER 31, 2024.
   §  7.  Section  4 of part H of chapter 58 of the laws of 2007 amending
 the public health law, the public officers law and the state finance law
 relating to establishing the empire state stem cell board, is amended to
 read as follows:
   § 4. This act shall take effect immediately and  shall  be  deemed  to
 have  been in full force and effect on and after April 1, 2007 AND SHALL
 EXPIRE AND BE DEEMED REPEALED DECEMBER 31, 2025.
   § 8. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2021; provided,
 however  the amendments to subparagraph (xvi) of paragraph (a) of subdi-
 vision 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; provided further, however, that the amend-
 ments to section 251 of the public health law made by  section  four  of
 this  act  shall  not affect the expiration of such section and shall be
 deemed to expire therewith; and provided further,  however,  the  amend-
 ments  to section 265-a of the public health law made by section five of
 this act shall not affect the expiration of such section  and  shall  be
 deemed to expire therewith.
 
                                  PART N
 
   Section  1.  Subdivision 3 of section 281 of the public health law, as
 amended by chapter 13 of the  laws  of  2015,  is  amended  to  read  as
 follows:
   3.  On  or  before  December  thirty-first,  two  thousand twelve, the
 commissioner shall promulgate  regulations,  in  consultation  with  the
 commissioner   of   education,  establishing  standards  for  electronic
 prescriptions. Notwithstanding any other provision of  this  section  or

 S. 2507                            48                            A. 3007
 
 any  other  law to the contrary, effective three years subsequent to the
 date on which such regulations are promulgated, no  person  shall  issue
 any prescription in this state unless such prescription is made by elec-
 tronic  prescription from the person issuing the prescription to a phar-
 macy  in  accordance  with  such  regulatory   standards,   except   for
 prescriptions:  (a)  [issued  by  veterinarians;  (b)] issued in circum-
 stances where electronic prescribing is not available due  to  temporary
 technological  or  electrical failure, as set forth in regulation; [(c)]
 (B) issued by practitioners [who have received a  waiver  or  a  renewal
 thereof  for  a  specified period determined by the commissioner, not to
 exceed one year, from the requirement  to  use  electronic  prescribing,
 pursuant  to a process established in regulation by the commissioner, in
 consultation with the commissioner of education, due to  economic  hard-
 ship,  technological  limitations  that  are  not  reasonably within the
 control of the practitioner, or other] IN SUCH exceptional [circumstance
 demonstrated by the practitioner; (d)] CIRCUMSTANCES AS  MAY  BE  DETER-
 MINED  BY  THE  COMMISSIONER; (C) issued by a practitioner under circum-
 stances where, notwithstanding the  practitioner's  present  ability  to
 make  an  electronic  prescription as required by this subdivision, such
 practitioner reasonably determines that it would be impractical for  the
 patient  to obtain substances prescribed by electronic prescription in a
 timely manner, and such  delay  would  adversely  impact  the  patient's
 medical   condition,  provided  that  if  such  prescription  is  for  a
 controlled substance, the quantity of  controlled  substances  does  not
 exceed  a  five  day  supply  if  the  controlled substance were used in
 accordance with the directions for use; or [(e)] (D) issued by a practi-
 tioner to be dispensed by a pharmacy located outside the state,  as  set
 forth in regulation.
   § 2. Subdivision 5 of section 281 of the public health law, as amended
 by chapter 350 of the laws of 2016, is amended to read as follows:
   5.  In the case of a prescription for a controlled substance issued by
 a practitioner under paragraph [(d)] (C) or  [(e)]  (D)  of  subdivision
 three  of  this  section,  the  practitioner  shall,  upon  issuing such
 prescription, indicate in the patient's health record  either  that  the
 prescription  was  issued  other  than electronically because it (a) was
 impractical to issue an electronic prescription in a timely  manner  and
 such  delay  would  have adversely impacted the patient's medical condi-
 tion, or (b) was to be dispensed  by  a  pharmacy  located  outside  the
 state.
   §  3.  Subdivision 10 of section 6810 of the education law, as amended
 by chapter 13 of the laws of 2015, is amended to read as follows:
   10. Notwithstanding any other provision of this section or  any  other
 law  to  the  contrary,  effective three years subsequent to the date on
 which regulations establishing standards  for  electronic  prescriptions
 are  promulgated by the commissioner of health, in consultation with the
 commissioner pursuant to subdivision three of section two hundred eight-
 y-one of  the  public  health  law,  no  practitioner  shall  issue  any
 prescription  in  this  state, unless such prescription is made by elec-
 tronic prescription from the practitioner  to  a  pharmacy,  except  for
 prescriptions: (a) [issued by veterinarians; (b)] issued or dispensed in
 circumstances  where  electronic  prescribing  is  not  available due to
 temporary technological or electrical failure, as  set  forth  in  regu-
 lation; [(c)] (B) issued by practitioners [who have received a waiver or
 a  renewal thereof for a specified period determined by the commissioner
 of health, not to exceed one year, from the requirement to use electron-
 ic prescribing, pursuant to a process established in regulation  by  the

 S. 2507                            49                            A. 3007

 commissioner  of  health,  in  consultation with the commissioner due to
 economic hardship, technological limitations  that  are  not  reasonably
 within  the  control  of the practitioner, or other] IN SUCH exceptional
 [circumstance  demonstrated by the practitioner] CIRCUMSTANCES AS MAY BE
 DETERMINED BY THE COMMISSIONER OF HEALTH ; [(d)] (C) issued by a practi-
 tioner under circumstances  where,  notwithstanding  the  practitioner's
 present  ability  to make an electronic prescription as required by this
 subdivision, such practitioner reasonably determines that  it  would  be
 impractical for the patient to obtain substances prescribed by electron-
 ic  prescription  in  a  timely  manner,  and such delay would adversely
 impact  the  patient's  medical  condition,  provided   that   if   such
 prescription  is  for a controlled substance, the quantity that does not
 exceed a five day supply if the controlled substance was used in accord-
 ance with the directions for use; or [(e)] (D) issued by a  practitioner
 to be dispensed by a pharmacy located outside the state, as set forth in
 regulation.
   §  4.  Subdivisions 11 and 12 of section 6810 of the education law, as
 amended by chapter 350 of the laws of  2016,  are  amended  to  read  as
 follows:
   11. In the case of a prescription issued by a practitioner under para-
 graph  [(b)]  (A)  of  subdivision ten of this section, the practitioner
 shall be required to indicate in the patient's health  record  that  the
 prescription was issued other than electronically due to temporary tech-
 nological or electrical failure.
   12. In the case of a prescription issued by a practitioner under para-
 graph  [(d)]  (C)  or  [(e)] (D) of subdivision ten of this section, the
 practitioner shall, upon issuing  such  prescription,  indicate  in  the
 patient's  health  record  either that the prescription was issued other
 than electronically because it (a) was impractical to issue an electron-
 ic prescription in a timely manner and such delay would  have  adversely
 impacted  the patient's medical condition, or (b) was to be dispensed by
 a pharmacy located outside the state.
   § 5. Subdivisions 6 and 7 of section 281 of the public health law  are
 REPEALED.
   §  6.  Subdivisions 13 and 15 of section 6810 of the education law are
 REPEALED.
   § 7. This act shall take effect on November 1, 2021.
 
                                  PART O
 
   Section 1. Section 461-s of the social services law is REPEALED.
   § 2. Subdivision 9 of  section  2803  of  the  public  health  law  is
 REPEALED.
   §  3.  Paragraph  (c)  of subdivision 1 of section 461-b 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, 2021.
 
                                  PART P
 
   Section  1.  Subdivision 6 of section 571 of the public health law, as
 amended by chapter 444 of the laws  of  2013,  is  amended  to  read  as
 follows:
   6.  "Qualified  health  care professional" means a physician, dentist,
 podiatrist, optometrist performing a clinical laboratory test that  does
 not  use  an invasive modality as defined in section seventy-one hundred

 S. 2507                            50                            A. 3007
 
 one of the education law, PHARMACIST,  physician  assistant,  specialist
 assistant,  nurse  practitioner,  or midwife, who is licensed and regis-
 tered with the state education department.
   §  2.  Section  6801 of the education law is amended by adding two new
 subdivisions 6 and 7 to read as follows:
   6. A LICENSED PHARMACIST IS A QUALIFIED HEALTH CARE PROFESSIONAL UNDER
 SECTION FIVE HUNDRED SEVENTY-ONE  OF  THE  PUBLIC  HEALTH  LAW  FOR  THE
 PURPOSES  OF  DIRECTING  A  LIMITED  SERVICE LABORATORY AND ORDERING AND
 ADMINISTERING TESTS APPROVED BY THE FOOD AND DRUG ADMINISTRATION  (FDA),
 SUBJECT  TO  CERTIFICATE  OF WAIVER REQUIREMENTS ESTABLISHED PURSUANT TO
 THE FEDERAL CLINICAL LABORATORY  IMPROVEMENT  ACT  OF  NINETEEN  HUNDRED
 EIGHTY-EIGHT.
   7.  A  LICENSED  PHARMACIST MAY ACT AS A REFERRING HEALTHCARE PROVIDER
 FOR DIABETES SELF-MANAGEMENT EDUCATION AND ASTHMA SELF-MANAGEMENT TRAIN-
 ING.
   § 3. Subdivision 7 of section 6527 of the education law, as amended by
 chapter 110 of the laws of 2020, is amended to read as follows:
   7. A licensed physician may prescribe and  order  a  patient  specific
 order or non-patient specific regimen to a licensed pharmacist, pursuant
 to  regulations promulgated by the commissioner, and consistent with the
 public health law, for administering immunizations to prevent influenza,
 pneumococcal, acute herpes zoster, meningococcal,  tetanus,  diphtheria,
 COVID-19, or pertussis disease OR, FOR PATIENTS EIGHTEEN YEARS OF AGE OR
 OLDER,  ANY OTHER IMMUNIZATIONS RECOMMENDED BY THE ADVISORY COMMITTEE ON
 IMMUNIZATION  PRACTICES  OF  THE  CENTERS  FOR   DISEASE   CONTROL   AND
 PREVENTION,  and medications required for emergency treatment of anaphy-
 laxis. Nothing in this subdivision shall authorize unlicensed persons to
 administer immunizations, vaccines or other drugs.
   § 4. Subdivision 7 of section 6909 of the education law, as amended by
 chapter 110 of the laws of 2020, is amended to read as follows:
   7. A certified nurse practitioner may prescribe and  order  a  patient
 specific order or non-patient specific regimen to a licensed pharmacist,
 pursuant  to regulations promulgated by the commissioner, and consistent
 with the public health law, for administering immunizations  to  prevent
 influenza,  pneumococcal,  acute  herpes zoster, meningococcal, tetanus,
 diphtheria, COVID-19, or pertussis disease  OR,  FOR  PATIENTS  EIGHTEEN
 YEARS  OF AGE OR OLDER, ANY OTHER IMMUNIZATIONS RECOMMENDED BY THE ADVI-
 SORY COMMITTEE ON IMMUNIZATION PRACTICES  OF  THE  CENTERS  FOR  DISEASE
 CONTROL AND PREVENTION, and medications required for emergency treatment
 of  anaphylaxis.  Nothing in this subdivision shall authorize unlicensed
 persons to administer immunizations, vaccines or other drugs.
   § 5. Section 6801-a of the education law, as amended by chapter 238 of
 the laws of 2015, is amended to read as follows:
   §  6801-a.  Collaborative  drug  therapy  management   [demonstration]
 program.  1. As used in this section, the following terms shall have the
 following meanings:
   a.  "Board"  shall  mean the state board of pharmacy as established by
 section sixty-eight hundred four of this article.
   b. "Clinical services" shall mean the collection and interpretation of
 patient data for the purpose of [initiating, modifying  and]  monitoring
 drug  therapy AND PRESCRIBING IN ORDER TO ADJUST OR MANAGE DRUG THERAPY,
 with associated accountability and  responsibility  for  outcomes  in  a
 direct patient care setting.
   c.  "Collaborative drug therapy management" shall mean the performance
 of clinical services by a pharmacist relating to the review,  evaluation
 and  management  of drug therapy to a patient, who is being treated by a

 S. 2507                            51                            A. 3007
 
 physician, OR NURSE PRACTITIONER for a specific  disease  or  associated
 disease  states, in accordance with a written agreement or protocol with
 a voluntarily participating physician,  OR  NURSE  PRACTITIONER  and  in
 accordance with the policies, procedures, and protocols of the facility.
 Such  agreement  or  protocol as entered into by the physician, OR NURSE
 PRACTITIONER and a pharmacist, may include[, and shall be limited to]:
   (i) [adjusting or managing] PRESCRIBING IN ORDER TO ADJUST OR MANAGE a
 drug regimen of a patient, pursuant to a patient specific order or  NON-
 PATIENT SPECIFIC protocol made by the patient's physician OR NURSE PRAC-
 TITIONER, which may include adjusting drug strength, frequency of admin-
 istration  or route of administration[. Adjusting the drug regimen shall
 not include substituting] or selecting a [different] drug which  differs
 from  that  initially prescribed by the patient's physician [unless such
 substitution is expressly] OR NURSE PRACTITIONER AS  authorized  in  the
 written  [order] AGREEMENT or protocol. The pharmacist shall be required
 to immediately document in  the  patient  record  changes  made  to  the
 patient's  drug  therapy  and  shall  use any reasonable means or method
 established by the facility OR PRACTICE to notify  the  patient's  other
 treating  physicians [with whom he or she does not have a written agree-
 ment or protocol regarding such changes.  The  patient's  physician  may
 prohibit,  by  written  instruction,  any  adjustment  or  change in the
 patient's drug regimen by the pharmacist], NURSE PRACTITIONERS AND OTHER
 HEALTH CARE PROFESSIONALS AS REQUIRED BY THE FACILITY OR THE  COLLABORA-
 TIVE PRACTICE AGREEMENT;
   (ii)  evaluating  [and,  only  if  specifically]  AS authorized by the
 protocol and only to the extent necessary to discharge the  responsibil-
 ities set forth in this section, ordering disease state laboratory tests
 related  to  the  drug  therapy  management  for the specific disease or
 disease [state] STATES specified within the written agreement or  proto-
 col; and
   (iii) [only if specifically] AS authorized by the written agreement or
 protocol  and only to the extent necessary to discharge the responsibil-
 ities set forth in this section, ordering or performing routine  patient
 monitoring functions as may be necessary in the drug therapy management,
 including  the collecting and reviewing of patient histories, and order-
 ing or checking patient  vital  signs[,  including  pulse,  temperature,
 blood pressure and respiration].
   d.  "Facility"  shall  mean[:  (i)]  a  [teaching hospital or] general
 hospital, [including any] diagnostic center, treatment center, or hospi-
 tal-based outpatient  department  as  defined  in  section  twenty-eight
 hundred  one of the public health law[; or (ii)], a nursing home, OR ANY
 FACILITY AS DEFINED IN SECTION TWENTY-EIGHT HUNDRED ONE  OF  THE  PUBLIC
 HEALTH  LAW  OR OTHER ENTITY THAT PROVIDES DIRECT PATIENT CARE UNDER THE
 AUSPICES OF A MEDICAL DIRECTOR; with an on-site pharmacy  staffed  by  a
 licensed pharmacist; provided, however, for the purposes of this section
 the  term "facility" shall not include dental clinics, dental dispensar-
 ies[, residential health care facilities] and rehabilitation centers. IN
 ADDITION, A "PRACTICE" SHALL MEAN A PLACE OR SITUATION IN  WHICH  PHYSI-
 CIANS AND NURSE PRACTITIONERS EITHER ALONE OR IN GROUP PRACTICES PROVIDE
 DIAGNOSTIC AND TREATMENT CARE FOR PATIENTS.
   [For  the purposes of this section, a "teaching hospital" shall mean a
 hospital licensed pursuant to article twenty-eight of the public  health
 law  that  is  eligible  to  receive direct or indirect graduate medical
 education payments pursuant to article twenty-eight of the public health
 law.]

 S. 2507                            52                            A. 3007

   e. "Physician OR NURSE PRACTITIONER"  shall  mean  the  physician,  OR
 NURSE PRACTITIONER selected by or assigned to a patient, who has primary
 responsibility for the treatment and care of the patient for the disease
 and  associated disease states that are the subject of the collaborative
 drug therapy management.
   f.  "Written  agreement  or  protocol"  shall mean a written document,
 pursuant to and consistent with any applicable state or federal require-
 ments, that addresses a specific disease or  associated  disease  states
 and  that  describes  the nature and scope of collaborative drug therapy
 management to be undertaken by the pharmacists,  in  collaboration  with
 the  participating  physician,  OR NURSE PRACTITIONER in accordance with
 the provisions of this section.
   2. a. A pharmacist who meets the experience requirements of  paragraph
 b  of  this  subdivision and who is [employed by or otherwise affiliated
 with a facility] CERTIFIED BY THE DEPARTMENT TO ENGAGE IN  COLLABORATIVE
 DRUG  THERAPY  MANAGEMENT  AND  WHO  IS  EITHER EMPLOYED BY OR OTHERWISE
 AFFILIATED WITH A FACILITY OR IS PARTICIPATING WITH A PRACTICING  PHYSI-
 CIAN  OR  NURSE  PRACTITIONER shall be permitted to enter into a written
 agreement or protocol with a physician OR NURSE PRACTITIONER authorizing
 collaborative drug therapy management, subject to  the  limitations  set
 forth  in this section, within the scope of such employment [or], affil-
 iation OR PARTICIPATION. ONLY PHARMACISTS SO  CERTIFIED  MAY  ENGAGE  IN
 COLLABORATIVE DRUG THERAPY MANAGEMENT AS DEFINED IN THIS SECTION.
   b. A participating pharmacist must:
   (i)[(A) have been awarded either a master of science in clinical phar-
 macy or a doctor of pharmacy degree;
   (B)] maintain a current unrestricted license; and
   [(C)  have  a  minimum  of two years experience, of which at least one
 year of such experience shall include clinical experience  in  a  health
 facility,  which  involves  consultation with physicians with respect to
 drug therapy and may include a residency at a  facility  involving  such
 consultation; or
   (ii)(A) have been awarded a bachelor of science in pharmacy;
   (B) maintain a current unrestricted license; and
   (C) within the last seven years, have a minimum of three years experi-
 ence,  of which at least one year of such experience shall include clin-
 ical experience in a health facility, which involves  consultation  with
 physicians with respect to drug therapy and may include a residency at a
 facility involving such consultation; and
   (iii) meet any additional education, experience, or other requirements
 set forth by the department in consultation with the board]
   (II) SATISFY ANY TWO OF THE FOLLOWING CRITERIA:
   (A)  CERTIFICATION  IN  A  RELEVANT AREA OF PRACTICE INCLUDING BUT NOT
 LIMITED TO AMBULATORY CARE, CRITICAL CARE, GERIATRIC  PHARMACY,  NUCLEAR
 PHARMACY, NUTRITION SUPPORT PHARMACY, ONCOLOGY PHARMACY, PEDIATRIC PHAR-
 MACY,  PHARMACOTHERAPY, OR PSYCHIATRIC PHARMACY, FROM A NATIONAL ACCRED-
 ITING BODY AS APPROVED BY THE DEPARTMENT;
   (B) POSTGRADUATE RESIDENCY THROUGH AN ACCREDITED POSTGRADUATE  PROGRAM
 REQUIRING  AT LEAST FIFTY PERCENT OF THE EXPERIENCE BE IN DIRECT PATIENT
 CARE SERVICES WITH INTERDISCIPLINARY TERMS; OR
   (C) HAVE PROVIDED CLINICAL SERVICES TO PATIENTS FOR AT LEAST ONE  YEAR
 EITHER:
   (I) UNDER A COLLABORATIVE PRACTICE AGREEMENT OR PROTOCOL WITH A PHYSI-
 CIAN, NURSE PRACTITIONER OR FACILITY; OR

 S. 2507                            53                            A. 3007
 
   (II)  HAS  DOCUMENTED  EXPERIENCE IN PROVISION OF CLINICAL SERVICES TO
 PATIENTS FOR AT LEAST ONE YEAR OR ONE THOUSAND HOURS, AND DEEMED ACCEPT-
 ABLE TO THE DEPARTMENT UPON RECOMMENDATION OF THE BOARD OF PHARMACY.
   c. Notwithstanding any provision of law, nothing in this section shall
 prohibit  a licensed pharmacist from engaging in clinical services asso-
 ciated with collaborative drug therapy  management,  in  order  to  gain
 experience necessary to qualify under [clause (C) of subparagraph (i) or
 (ii)  of  paragraph  b  of  this subdivision] ITEM (II) OF CLAUSE (C) OF
 SUBPARAGRAPH (II) OF PARAGRAPH B OF THIS SUBDIVISION, provided that such
 practice is under the supervision of a pharmacist that  currently  meets
 the  referenced  requirement, and that such practice is authorized under
 the written agreement or protocol with the physician  OR  NURSE  PRACTI-
 TIONER.
   d. Notwithstanding any provision of this section, nothing herein shall
 authorize the pharmacist to diagnose disease. In the event that a treat-
 ing  physician  OR  NURSE PRACTITIONER may disagree with the exercise of
 professional judgment by a pharmacist,  the  judgment  of  the  treating
 physician OR NURSE PRACTITIONER shall prevail.
   [3.  The  physician  who is a party to a written agreement or protocol
 authorizing collaborative drug therapy management shall be  employed  by
 or otherwise affiliated with the same facility with which the pharmacist
 is also employed or affiliated.]
   4.  [The existence of a written agreement or protocol on collaborative
 drug therapy management and the patient's right to choose to not partic-
 ipate in collaborative drug therapy management shall be disclosed to any
 patient who is eligible to receive collaborative  drug  therapy  manage-
 ment. Collaborative drug therapy management shall not be utilized unless
 the  patient  or  the  patient's  authorized representative consents, in
 writing, to such management. If the patient or the patient's  authorized
 representative  consents,  it  shall  be  noted on the patient's medical
 record. If the patient or the patient's  authorized  representative  who
 consented  to collaborative drug therapy management chooses to no longer
 participate in such management, at any time, it shall be  noted  on  the
 patient's  medical  record.  In  addition,  the existence of the written
 agreement or protocol and the patient's consent to such management shall
 be disclosed to the patient's primary physician and any  other  treating
 physician  or healthcare provider.] A PHARMACIST WHO IS CERTIFIED BY THE
 DEPARTMENT TO ENGAGE IN COLLABORATIVE DRUG THERAPY MANAGEMENT MAY  ENTER
 INTO  A  WRITTEN  COLLABORATIVE  PRACTICE  AGREEMENT  OR PROTOCOL WITH A
 PHYSICIAN, NURSE PRACTITIONER OR PRACTICE AS AN INDEPENDENT HEALTH  CARE
 PROVIDER OR AS AN EMPLOYEE OF A PHARMACY OR OTHER HEALTH CARE PROVIDER.
   5. Participation in a written agreement or protocol authorizing colla-
 borative  drug  therapy  management  shall be voluntary, and no patient,
 physician, NURSE PRACTITIONER, pharmacist, or facility shall be required
 to participate.
   [6. Nothing in this section shall be deemed  to  limit  the  scope  of
 practice of pharmacy nor be deemed to limit the authority of pharmacists
 and physicians to engage in medication management prior to the effective
 date of this section and to the extent authorized by law.]
   §  6. Subparagraph (A) of paragraph 15-a of subdivision (i) of section
 3216 of the insurance law, as amended by chapter  338  of  the  laws  of
 2003, is amended to read as follows:
   (A)  Every policy which provides medical coverage that includes cover-
 age for physician services in a  physician's  office  and  every  policy
 which  provides  major  medical  or  similar comprehensive-type coverage
 shall include coverage for the following equipment and supplies for  the

 S. 2507                            54                            A. 3007
 
 treatment  of  diabetes,  if recommended or prescribed by a physician or
 other licensed health care  provider  legally  authorized  to  prescribe
 under title eight of the education law: blood glucose monitors and blood
 glucose  monitors  for  the  visually impaired, data management systems,
 test strips for glucose monitors and visual reading  and  urine  testing
 strips,  insulin,  injection aids, cartridges for the visually impaired,
 syringes, insulin pumps  and  appurtenances  thereto,  insulin  infusion
 devices,  and  oral agents for controlling blood sugar. In addition, the
 commissioner of the department of health shall provide and  periodically
 update by rule or regulation a list of additional diabetes equipment and
 related  supplies  such  as are medically necessary for the treatment of
 diabetes, for which there shall also be coverage.  Such  policies  shall
 also  include  coverage for diabetes self-management education to ensure
 that persons with diabetes are educated as to the proper self-management
 and treatment of their  diabetic  condition,  including  information  on
 proper  diets. Such coverage for self-management education and education
 relating to diet shall be limited to visits medically necessary upon the
 diagnosis of diabetes, where a physician diagnoses a significant  change
 in  the  patient's symptoms or conditions which necessitate changes in a
 patient's self-management, or where reeducation or  refresher  education
 is  necessary.  Such education may be provided by the physician or other
 licensed health care provider  legally  authorized  to  prescribe  under
 title  eight  of the education law, or their staff, as part of an office
 visit for diabetes diagnosis or treatment, or by  a  certified  diabetes
 nurse  educator,  certified  nutritionist, certified dietitian or regis-
 tered dietitian upon the referral of a physician, A PHARMACIST, or other
 licensed health care provider  legally  authorized  to  prescribe  under
 title  eight  of  the education law. Education provided by the certified
 diabetes nurse educator, certified nutritionist, certified dietitian  or
 registered dietitian may be limited to group settings wherever practica-
 ble.    Coverage for self-management education and education relating to
 diet shall also include home visits when medically necessary.
   § 7. Subparagraph (A) of paragraph 7 of  subdivision  (k)  of  section
 3221  of  the  insurance  law,  as amended by chapter 338 of the laws of
 2003, is amended to read as follows:
   (A) Every group or blanket accident and health insurance policy issued
 or issued for delivery in this state  which  provides  medical  coverage
 that  includes  coverage  for physician services in a physician's office
 and every policy which provides major medical or similar  comprehensive-
 type  coverage  shall  include  coverage for the following equipment and
 supplies for the treatment of diabetes, if recommended or prescribed  by
 a physician or other licensed health care provider legally authorized to
 prescribe under title eight of the education law: blood glucose monitors
 and  blood  glucose  monitors for the visually impaired, data management
 systems, test strips for glucose monitors and visual reading  and  urine
 testing  strips,  insulin,  injection  aids, cartridges for the visually
 impaired, syringes, insulin pumps  and  appurtenances  thereto,  insulin
 infusion  devices, and oral agents for controlling blood sugar. In addi-
 tion, the commissioner of the department of  health  shall  provide  and
 periodically  update by rule or regulation a list of additional diabetes
 equipment and related supplies such as are medically necessary  for  the
 treatment  of  diabetes,  for  which  there shall also be coverage. Such
 policies shall also include coverage for diabetes self-management educa-
 tion to ensure that persons with diabetes are educated as to the  proper
 self-management  and  treatment  of  their diabetic condition, including
 information on proper diets. Such coverage for self-management education

 S. 2507                            55                            A. 3007
 
 and education relating to diet shall  be  limited  to  visits  medically
 necessary  upon the diagnosis of diabetes, where a physician diagnoses a
 significant change in the patient's symptoms or conditions which  neces-
 sitate  changes  in a patient's self-management, or where reeducation or
 refresher education is necessary. Such education may be provided by  the
 physician  or  other licensed health care provider legally authorized to
 prescribe under title eight of the education law,  or  their  staff,  as
 part  of  an  office  visit for diabetes diagnosis or treatment, or by a
 certified diabetes nurse  educator,  certified  nutritionist,  certified
 dietitian  or  registered  dietitian upon the referral of a physician, A
 PHARMACIST, or other licensed health care provider legally authorized to
 prescribe under title eight of the education law. Education provided  by
 the certified diabetes nurse educator, certified nutritionist, certified
 dietitian or registered dietitian may be limited to group settings wher-
 ever  practicable.  Coverage for self-management education and education
 relating to diet shall also include home visits  when  medically  neces-
 sary.
   §  8.  Paragraph 1 of subdivision (u) of section 4303 of the insurance
 law, as amended by chapter 338 of the laws of 2003, is amended  to  read
 as follows:
   (1) A medical expense indemnity corporation or a health service corpo-
 ration which provides medical coverage that includes coverage for physi-
 cian  services  in  a physician's office and every policy which provides
 major medical  or  similar  comprehensive-type  coverage  shall  include
 coverage  for  the following equipment and supplies for the treatment of
 diabetes, if recommended or prescribed by a physician or other  licensed
 health  care  provider legally authorized to prescribe under title eight
 of the education law: blood glucose monitors and blood glucose  monitors
 for  the  visually  impaired,  data  management systems, test strips for
 glucose monitors and visual reading and urine testing  strips,  insulin,
 injection  aids, cartridges for the visually impaired, syringes, insulin
 pumps and appurtenances thereto,  insulin  infusion  devices,  and  oral
 agents for controlling blood sugar. In addition, the commissioner of the
 department  of  health  shall provide and periodically update by rule or
 regulation a list of additional diabetes equipment and related  supplies
 such as are medically necessary for the treatment of diabetes, for which
 there  shall also be coverage. Such policies shall also include coverage
 for diabetes self-management  education  to  ensure  that  persons  with
 diabetes  are educated as to the proper self-management and treatment of
 their diabetic condition, including information on  proper  diets.  Such
 coverage  for  self-management  education and education relating to diet
 shall be limited to visits medically necessary  upon  the  diagnosis  of
 diabetes,  where  a  physician  diagnoses  a  significant  change in the
 patient's  symptoms  or  conditions  which  necessitate  changes  in   a
 patient's  self-management,  or where reeducation or refresher education
 is necessary. Such education may be provided by the physician  or  other
 licensed  health  care  provider  legally  authorized to prescribe under
 title eight of the education law, or their staff, as part of  an  office
 visit  for  diabetes  diagnosis or treatment, or by a certified diabetes
 nurse educator, certified nutritionist, certified  dietitian  or  regis-
 tered  dietitian  upon the referral of a physician, PHARMACIST, or other
 licensed health care provider  legally  authorized  to  prescribe  under
 title  eight  of  the education law. Education provided by the certified
 diabetes nurse educator, certified nutritionist, certified dietitian  or
 registered dietitian may be limited to group settings wherever practica-

 S. 2507                            56                            A. 3007
 
 ble.    Coverage for self-management education and education relating to
 diet shall also include home visits when medically necessary.
   § 9. Subdivisions (q) and (r) of subdivision 2 of section 365-a of the
 social  services law, subdivision (q) as amended by section 35 of part B
 of chapter 58 of the laws of  2010  and  subdivision  (r)  as  added  by
 section  32  of part C of chapter 58 of the laws of 2008, are amended to
 read as follows:
   (q) diabetes self-management training services for  persons  diagnosed
 with  diabetes when such services are ordered by a physician, registered
 physician  assistant,  registered  nurse  practitioner,  PHARMACIST,  or
 licensed  midwife  and  provided by a licensed, registered, or certified
 health care professional, as determined by the commissioner  of  health,
 who  is  certified  as a diabetes educator by the National Certification
 Board for Diabetes Educators,  or  a  successor  national  certification
 board,  or  provided  by  such  a  professional who is affiliated with a
 program certified by the American  Diabetes  Association,  the  American
 Association  of  Diabetes  Educators, the Indian Health Services, or any
 other  national  accreditation  organization  approved  by  the  federal
 centers  for medicare and medicaid services; provided, however, that the
 provisions of this paragraph shall not take effect unless all  necessary
 approvals under federal law and regulation have been obtained to receive
 federal  financial  participation  in  the costs of health care services
 provided pursuant to this paragraph. Nothing in this paragraph shall  be
 construed  to  modify  any licensure, certification or scope of practice
 provision under title eight of the education law.
   (r) asthma self-management training  services  for  persons  diagnosed
 with  asthma  when  such services are ordered by a physician, registered
 physician's assistant, registered  nurse  practitioner,  PHARMACIST,  or
 licensed  midwife  and  provided by a licensed, registered, or certified
 health care professional, as determined by the commissioner  of  health,
 who  is  certified as an asthma educator by the National Asthma Educator
 Certification  Board,  or  a  successor  national  certification  board;
 provided,  however, that the provisions of this paragraph shall not take
 effect unless all necessary approvals under federal law  and  regulation
 have  been  obtained  to  receive federal financial participation in the
 costs of health care  services  provided  pursuant  to  this  paragraph.
 Nothing  in  this  paragraph shall be construed to modify any licensure,
 certification or scope of practice provision under title  eight  of  the
 education law.
   §  10.  Section  8  of  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, as amended by  section  18  of
 part  BB  of  chapter  56  of  the  laws  of 2020, 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,
 2022].
   § 11. Section 5 of chapter 116 of  the  laws  of  2012,  amending  the
 education  law  relating to authorizing a licensed pharmacist and certi-
 fied nurse practitioner to  administer  certain  immunizing  agents,  as
 amended  by  section 19 of part BB of chapter 56 of the laws of 2020, is
 amended to read as follows:
   § 5. This act shall take effect on the ninetieth day  after  it  shall
 have  become  a law[, provided, however, that the provisions of sections
 one, two and four of this act shall expire and be deemed  repealed  July
 1, 2022 provided, that:

 S. 2507                            57                            A. 3007

   (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].
   §  12.  Section  4  of  chapter  274 of the laws of 2013, amending the
 education law relating to authorizing a licensed pharmacist  and  certi-
 fied  nurse  practitioner to administer meningococcal disease immunizing
 agents, is amended to read as follows:
   § 4. This act shall take effect on the ninetieth day  after  it  shall
 have become a law[; provided, that:
   (a)  the  amendments to subdivision 7 of section 6527 of the education
 law, made by section one of this act shall not affect the expiration and
 reversion of such subdivision, as provided in section 6 of  chapter  116
 of the laws of 2012, and shall be deemed to expire therewith; and
   (b)  the  amendments to subdivision 7 of section 6909 of the education
 law, made by section two of this act shall not affect the expiration and
 reversion of such subdivision, as provided in section 6 of  chapter  116
 of the laws of 2012, and shall be deemed to be expire therewith; and
   (c)  the amendments to subdivision 22 of section 6802 of the education
 law made by section three of this act shall not affect the expiration of
 such subdivision and shall be deemed to expire therewith].
   § 13. 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 section 20 of part BB of chapter 56 of the laws of 2020,  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[, provided, however, that the provisions of
 sections two, three, and four of this act shall  expire  and  be  deemed
 repealed  July 1, 2022; provided, however, that the amendments to subdi-
 vision 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 subdi-
 vision  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]. 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.
   § 14. This act shall take effect immediately and shall  be  deemed  to
 have been in full force and effect on and after April 1, 2021; provided,
 however,  that  sections three and four of this act shall take effect on
 the same date and in the same manner as chapter 110 of the laws of  2020
 takes  effect; and provided further that the amendments to subdivision 7
 of section 6527 of the education law made by section three of  this  act
 shall  be  subject  to  the expiration and reversion of such subdivision
 pursuant to section 4 of chapter 110 of  the  laws  of  2020  and  shall
 expire  and  be deemed repealed therewith; and provided further that the
 amendments to subdivision 7 of section 6909 of the education law made by

 S. 2507                            58                            A. 3007
 
 section four of this act shall be subject to the expiration  and  rever-
 sion  of  such  subdivision  pursuant to section 4 of chapter 110 of the
 laws of 2020 and shall expire and be deemed repealed therewith.
 
                                  PART Q
 
   Section  1.  Subdivision  1  of  section 6502 of the education law, as
 amended by chapter 599 of the laws of  1996,  is  amended  and  two  new
 subdivisions 1-a and 1-b are added to read as follows:
   1. [A] EXCEPT PURSUANT TO SUBDIVISION ONE-A OF THIS SECTION, A license
 shall be valid during the life of the holder unless revoked, annulled or
 suspended  by the board of regents [or in the case of physicians, physi-
 cians  practicing  under  a  limited  permit,  physician's   assistants,
 specialist's  assistants and medical residents, the licensee is stricken
 from the roster of such licensees by the board of regents on  the  order
 of the state board for professional medical conduct in the department of
 health.  A  licensee  must  register  with  the  department and meet the
 requirements prescribed in section 3-503 of the general obligations  law
 to practice in this state].
   1-A.  IN THE CASE OF PHYSICIANS, PHYSICIANS PRACTICING UNDER A LIMITED
 PERMIT, PHYSICIAN ASSISTANTS, SPECIALIST ASSISTANTS  AND  MEDICAL  RESI-
 DENTS, A LICENSE SHALL BE VALID DURING THE LIFE OF THE HOLDER UNLESS:
   (I)  THE LICENSEE IS STRICKEN FROM THE ROSTER OF SUCH LICENSEES BY THE
 BOARD OF REGENTS ON THE  ORDER  OF  THE  STATE  BOARD  FOR  PROFESSIONAL
 MEDICAL CONDUCT IN THE DEPARTMENT OF HEALTH; OR
   (II)  THE  LICENSEE HAS FAILED TO REGISTER WITH THE DEPARTMENT FOR TWO
 CONSECUTIVE REGISTRATION PERIODS, IN WHICH CASE THE  LICENSEE  SHALL  BE
 IMMEDIATELY  STRICKEN  FROM THE ROSTER OF SUCH LICENSEES BY THE BOARD OF
 REGENTS.
   1-B. A LICENSEE  MUST  REGISTER  WITH  THE  DEPARTMENT  AND  MEET  THE
 REQUIREMENTS  PRESCRIBED IN SECTION 3-503 OF THE GENERAL OBLIGATIONS LAW
 TO PRACTICE IN THIS STATE.
   § 2. Section 6524 of the education law is  amended  by  adding  a  new
 subdivision 6-a to read as follows:
   (6-A)  FINGERPRINTS  AND  CRIMINAL  HISTORY  RECORD  CHECK: CONSENT TO
 SUBMISSION OF FINGERPRINTS FOR PURPOSES OF CONDUCTING A CRIMINAL HISTORY
 RECORD CHECK. THE COMMISSIONER SHALL SUBMIT TO THE DIVISION OF  CRIMINAL
 JUSTICE  SERVICES  TWO  SETS OF FINGERPRINTS OF APPLICANTS FOR LICENSURE
 PURSUANT TO THIS ARTICLE, AND THE DIVISION OF CRIMINAL JUSTICE  SERVICES
 PROCESSING  FEE IMPOSED PURSUANT TO SUBDIVISION EIGHT-A OF SECTION EIGHT
 HUNDRED THIRTY-SEVEN OF THE EXECUTIVE LAW AND ANY  FEE  IMPOSED  BY  THE
 FEDERAL  BUREAU  OF  INVESTIGATION.  THE  DIVISION  OF  CRIMINAL JUSTICE
 SERVICES AND THE FEDERAL BUREAU  OF  INVESTIGATION  SHALL  FORWARD  SUCH
 CRIMINAL  HISTORY RECORD TO THE COMMISSIONER IN A TIMELY MANNER. FOR THE
 PURPOSES OF THIS SECTION, THE TERM "CRIMINAL HISTORY RECORD" SHALL  MEAN
 A  RECORD  OF ALL CONVICTIONS OF CRIMES AND ANY PENDING CRIMINAL CHARGES
 MAINTAINED ON AN INDIVIDUAL BY THE DIVISION OF CRIMINAL JUSTICE SERVICES
 AND THE FEDERAL BUREAU  OF  INVESTIGATION.  ALL  SUCH  CRIMINAL  HISTORY
 RECORDS  SENT  TO THE COMMISSIONER PURSUANT TO THIS SUBDIVISION SHALL BE
 CONFIDENTIAL PURSUANT TO THE APPLICABLE FEDERAL AND  STATE  LAWS,  RULES
 AND  REGULATIONS,  AND SHALL NOT BE PUBLISHED OR IN ANY WAY DISCLOSED TO
 PERSONS OTHER THAN THE COMMISSIONER, UNLESS OTHERWISE AUTHORIZED BY LAW;
   § 3. Paragraph (c) of subdivision 9 and subdivisions 20, 28 and 31  of
 section  6530  of the education law, as added by chapter 606 of the laws
 of 1991, are amended and a new  subdivision  51  is  added  to  read  as
 follows:

 S. 2507                            59                            A. 3007
 
   (c)  Having been found guilty in an adjudicatory proceeding of violat-
 ing a state or federal statute or regulation, pursuant to a final  deci-
 sion  or  determination,  and when no appeal is pending, or after resol-
 ution of the proceeding OR A COMPLAINT ALLEGING A VIOLATION OF  A  STATE
 OR  FEDERAL  STATUTE OR REGULATION by stipulation or agreement, and when
 the violation would constitute professional misconduct pursuant to  this
 section;
   20. Conduct [in the practice of medicine] which evidences moral unfit-
 ness to practice medicine;
   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;
   31.  Willfully  harassing, abusing, or intimidating a patient [either]
 OR A PATIENT'S CAREGIVER OR SURROGATE physically or verbally;
   51. EXCEPT FOR GOOD CAUSE SHOWN, FAILING TO NOTIFY THE  DEPARTMENT  OF
 HEALTH  WITHIN  TWENTY-FOUR HOURS OF HAVING BEEN CHARGED WITH A CRIME IN
 ANY JURISDICTION OR OF ANY EVENT MEETING THE DEFINITIONS OF PROFESSIONAL
 MISCONDUCT SET FORTH IN SUBDIVISION NINE OF THIS SECTION.
   § 4. Section 6532 of the education law, as added by chapter 606 of the
 laws of 1991, is amended to read as follows:
   § 6532. Enforcement, administration and interpretation of  this  arti-
 cle.  The board [of] FOR professional medical conduct and the department
 of  health  shall enforce, administer and interpret this article. Before
 issuing a declaratory ruling pursuant to section two hundred four of the
 state administrative procedure act with respect  to  this  article,  the
 department  of  health shall fully consult with the department of educa-
 tion. [Neither the commissioner of education, the board of  regents  nor
 the]  THE commissioner of health may promulgate any rules or regulations
 concerning this article.
   § 5. 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] THE COMMISSION-
 ER,  and  may  also  require a witness to attend and give testimony in a
 county where [he] THE WITNESS 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

 S. 2507                            60                            A. 3007
 
 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 THAT A LICENSEE
 HAS COMMITTED PROFESSIONAL MISCONDUCT OR A CRIME FROM A JUDICIAL OFFICER
 AUTHORIZED TO ISSUE A WARRANT. SUCH WARRANT SHALL AUTHORIZE THE  COMMIS-
 SIONER AND ANY PERSON AUTHORIZED BY THE COMMISSIONER TO HAVE THE AUTHOR-
 ITY TO INSPECT ALL GROUNDS, ERECTIONS, VEHICLES, STRUCTURES, APARTMENTS,
 BUILDINGS,  PLACES  AND  THE  CONTENTS  THEREIN AND TO REMOVE ANY BOOKS,
 RECORDS, PAPERS, DOCUMENTS,  COMPUTERS,  ELECTRONIC  DEVICES  AND  OTHER
 PHYSICAL OBJECTS.
   § 6. Subdivision 1 of section 230 of the public health law, as amended
 by chapter 537 of the laws of 1998, is amended to read as follows:
   1. A state board for professional medical conduct is hereby created in
 the  department  in  matters  of  professional  misconduct as defined in
 sections sixty-five hundred thirty and sixty-five hundred thirty-one  of
 the  education  law.  Its  physician  members  shall be appointed by the
 commissioner at least eighty-five percent of whom shall  be  from  among
 nominations  submitted  by the medical society of the state of New York,
 the New York state osteopathic society, the New York  academy  of  medi-
 cine, county medical societies, statewide specialty societies recognized
 by  the council of medical specialty societies, and the hospital associ-
 ation of New York state. Its lay  members  shall  be  appointed  by  the
 commissioner  with  the  approval  of the governor. The board of regents
 shall also appoint twenty percent of the members of the board. Not  less
 than  sixty-seven  percent  of  the  members  appointed  by the board of
 regents shall be physicians. Not less than eighty-five  percent  of  the
 physician  members appointed by the board of regents shall be from among
 nominations submitted by the medical society of the state of  New  York,
 the  New  York  state osteopathic society, the New York academy of medi-
 cine, county medical societies, statewide medical  societies  recognized
 by  the council of medical specialty societies, and the hospital associ-
 ation of New York state. Any failure to meet the  percentage  thresholds
 stated  in  this  subdivision  shall not be grounds for invalidating any
 action by or on authority of the board for professional medical  conduct
 or  a  committee or a member thereof. The board for professional medical
 conduct shall consist of not fewer than eighteen physicians licensed  in
 the  state  for  at  least  five  years, two of whom shall be doctors of
 osteopathy, not fewer than two of whom shall be physicians who  dedicate
 a  significant  portion of their practice to the use of non-conventional
 medical treatments who may be nominated by New York state medical  asso-

 S. 2507                            61                            A. 3007
 
 ciations  dedicated  to the advancement of such treatments, at least one
 of whom shall have expertise in palliative  care,  and  not  fewer  than
 seven  lay  members.  An  executive  secretary shall be appointed by the
 chairperson  and shall be a licensed physician. Such executive secretary
 shall not be a member of the board, shall hold office  at  the  pleasure
 of,  and shall have the powers and duties assigned and the annual salary
 fixed by[, the chairperson.  The  chairperson  shall  also  assign  such
 secretaries  or other persons to the board as are necessary] THE COMMIS-
 SIONER.
   § 7. Clause (C) of subparagraph (iii) of paragraph (a) of  subdivision
 10 of section 230 of the public health law, as amended by chapter 477 of
 the laws of 2008, is amended to read as follows:
   (C)  If  the director determines that the matter shall be submitted to
 an investigation committee, an investigation committee shall be convened
 [within ninety days of any interview  of  the  licensee].  The  director
 shall  present  the  investigation committee with relevant documentation
 including, but not limited to: (1) a copy of the original complaint; (2)
 the report of the interviewer and the stenographic  record  if  one  was
 taken; (3) the report of any medical or scientific expert; (4) copies of
 reports   of   any  patient  record  reviews;  and  (5)  the  licensee's
 submissions.
   § 8. Subparagraph (v) of paragraph (a) of subdivision  10  of  section
 230  of  the public health law, as amended by chapter 477 of the laws of
 2008, is amended to read as follows:
   (v) The files of the office of professional medical  conduct  relating
 to  the  investigation  of possible instances of professional misconduct
 shall be confidential and not subject to disclosure at  the  request  of
 any  person,  except as provided by law in a pending disciplinary action
 or proceeding. The provisions of this paragraph shall  not  prevent  the
 office  from  sharing  information  concerning investigations within the
 department and, pursuant to subpoena, with other duly authorized  public
 agencies  responsible  for  professional  regulation  or criminal prose-
 cution. Nothing in this subparagraph shall affect the duties of  notifi-
 cation  set  forth  in subdivision nine-a of this section or prevent the
 publication of charges or of the findings, conclusions,  determinations,
 or  order  of  a  hearing committee pursuant to paragraphs (d) or (g) of
 this subdivision. In addition, the commissioner may, IN HIS OR HER  SOLE
 DISCRETION,  disclose [the] ANY information [when, in his or her profes-
 sional judgment, disclosure of such information would avert or  minimize
 a  public  health  threat]  RELATING  TO  THE  INVESTIGATION OF POSSIBLE
 INSTANCES OF PROFESSIONAL MISCONDUCT.  Any  such  disclosure  shall  not
 affect  the  confidentiality  of  other  information in the files of the
 office of professional medical conduct related to the investigation.
   § 9. Subparagraphs (i) and (ii) of paragraph (d) of subdivision 10  of
 section  230  of the public health law, as amended by chapter 477 of the
 laws of 2008, are amended to read as follows:
   (i) A copy of the charges and the  notice  of  the  hearing  shall  be
 served  on  the  licensee EITHER: (A) personally [by the board] at least
 thirty days before the hearing[.]; (B) [If personal  service  cannot  be
 made  after  due diligence and such fact is certified under oath, a copy
 of the charges and the notice of hearing shall be served] by  registered
 or  certified mail to the licensee's [last known] CURRENT RESIDENTIAL OR
 PRACTICE address [by the board] MAILED at least fifteen days before  the
 hearing;  (C)  BY  REGISTERED  OR  CERTIFIED MAIL TO THE LICENSEE'S MOST
 RECENT MAILING ADDRESS PURSUANT TO SECTION SIXTY-FIVE HUNDRED TWO OF THE
 EDUCATION LAW OR THE LICENSEE'S MOST RECENT MAILING ADDRESS ON FILE WITH

 S. 2507                            62                            A. 3007
 
 THE DEPARTMENT OF EDUCATION PURSUANT TO THE NOTIFICATION REQUIREMENT SET
 FORTH IN SUBDIVISION FIVE OF SUCH SECTION, MAILED  AT  LEAST  FORTY-FIVE
 DAYS  BEFORE  THE  HEARING;  OR  (D) BY FIRST CLASS MAIL TO AN ATTORNEY,
 LICENSED  TO  PRACTICE  IN  THE STATE, WHO HAS APPEARED ON BEHALF OF THE
 LICENSEE AND WHO HAS BEEN PROVIDED WITH  WRITTEN  AUTHORIZATION  OF  THE
 LICENSEE TO ACCEPT SERVICE, MAILED AT LEAST THIRTY DAYS BEFORE THE HEAR-
 ING.
   (ii)  The  charges  shall be made public, consistent with subparagraph
 (iv) of paragraph (a) of this subdivision, [no earlier than  five  busi-
 ness  days]  IMMEDIATELY after they are served, and the charges shall be
 accompanied by a statement advising the licensee that  such  publication
 will  occur;  [provided, however, that] charges may be made public imme-
 diately upon issuance of the commissioner's order in the case of summary
 action taken pursuant to subdivision twelve of this section and no prior
 notification of such publication need be made to the licensee.
   § 10. Subparagraph (ii) of paragraph (m) of subdivision 10 of  section
 230  of  the public health law, as amended by chapter 606 of the laws of
 1991, is amended to read as follows:
   (ii) Administrative warning and consultation. If the director  of  the
 office  of professional medical conduct, after obtaining the concurrence
 of a majority of a committee on professional conduct, and after  consul-
 tation  with  the executive secretary, determines that there is substan-
 tial evidence of professional misconduct of a minor or technical  nature
 or  of  substandard  medical  practice which does not constitute profes-
 sional misconduct, the director  may  issue  an  administrative  warning
 and/or  provide  for  consultation  with a panel of one or more experts,
 chosen by the director. Panels of one or more experts may  include,  but
 shall  not  be  limited  to, a peer review committee of a county medical
 society or a specialty board. Administrative warnings and  consultations
 shall  be  [confidential  and]  MADE PUBLIC, BUT shall not constitute an
 adjudication of guilt or be used as evidence that the licensee is guilty
 of the alleged misconduct. However, in the event of a further allegation
 of similar misconduct by the same licensee, the matter may  be  reopened
 and further proceedings instituted as provided in this section.
   §  11.  Paragraph  (p)  of subdivision 10 of section 230 of the public
 health law, as amended by chapter 599 of the laws of 1996, is amended to
 read as follows:
   (p) Convictions of crimes or administrative violations.    EXCEPT  FOR
 GOOD  CAUSE SHOWN, A LICENSEE SHALL NOTIFY THE DEPARTMENT WITHIN TWENTY-
 FOUR HOURS OF HAVING BEEN CHARGED WITH A CRIME IN ANY JURISDICTION OR OF
 ANY EVENT MEETING THE DEFINITIONS OF PROFESSIONAL MISCONDUCT  SET  FORTH
 IN  SUBDIVISION  NINE OF SECTION SIXTY-FIVE HUNDRED THIRTY OF THE EDUCA-
 TION LAW. In cases  of  professional  misconduct  based  solely  upon  a
 violation  of  subdivision  nine of section sixty-five hundred thirty of
 the education law, the director may direct that charges be prepared  and
 served  and  may refer the matter to a committee on professional conduct
 for its review and report of findings,  conclusions  as  to  guilt,  and
 determination. In such cases, the notice of hearing shall state that the
 licensee  shall file a written answer to each of the charges and allega-
 tions in the statement of charges no later than ten days  prior  to  the
 hearing,  and  that  any  charge  or allegation not so answered shall be
 deemed admitted, that the licensee may wish to seek the advice of  coun-
 sel  prior  to filing such answer that the licensee may file a brief and
 affidavits with the committee on professional conduct, that the licensee
 may appear personally before the committee on professional conduct,  may
 be represented by counsel and may present evidence or sworn testimony in

 S. 2507                            63                            A. 3007
 
 his  or her behalf, and the notice may contain such other information as
 may be considered appropriate by the director. The department  may  also
 present  evidence  or sworn testimony and file a brief at the hearing. A
 stenographic record of the hearing shall be made. Such evidence or sworn
 testimony  offered  to  the  committee  on professional conduct shall be
 strictly limited to evidence and testimony relating to  the  nature  and
 severity  of  the  penalty  to  be  imposed upon the licensee. Where the
 charges are based on the conviction of state law crimes in other  juris-
 dictions, evidence may be offered to the committee which would show that
 the  conviction would not be a crime in New York state. The committee on
 professional conduct may reasonably limit the number of witnesses  whose
 testimony  will  be  received and the length of time any witness will be
 permitted to testify. The determination of the committee shall be served
 upon the licensee and the department in accordance with  the  provisions
 of  paragraph  (h) of this subdivision. A determination pursuant to this
 subdivision may be reviewed  by  the  administrative  review  board  for
 professional medical conduct.
   §  12.  Subdivision  12  of  section  230 of the public health law, as
 amended by chapter 627 of the laws of 1996, paragraph (a) as amended  by
 chapter  477 of the laws of 2008 and paragraph (b) as amended by section
 3 of part CC of chapter 57 of the laws of 2018, is amended  to  read  as
 follows:
   12.  Summary  action.  (a)  Whenever the commissioner, (i) after being
 presented with information indicating that a licensee is causing, engag-
 ing in or maintaining a condition or activity which has resulted in  the
 transmission  or  suspected  transmission,  or  is likely to lead to the
 transmission, of communicable disease as defined in the  state  sanitary
 code  or  HIV/AIDS, by the state and/or a local health department and if
 in the commissioner's opinion it would be prejudicial to  the  interests
 of  the people to delay action until an opportunity for a hearing can be
 provided in accordance with the prehearing  and  hearing  provisions  of
 this  section;  [or]  (ii) AFTER REQUIRING THAT A LICENSEE PRODUCE DOCU-
 MENTS IN ACCORDANCE WITH SUBDIVISION FOUR OF SECTION TWO HUNDRED SIX  OF
 THIS CHAPTER, AND SUCH LICENSEE HAS FAILED TO PRODUCE THE REQUIRED DOCU-
 MENTS  WITHIN  TEN  DAYS, OR WITHIN SUCH SHORTER PERIOD AS MAY HAVE BEEN
 SPECIFIED IN THE COMMISSIONER'S WRITTEN DEMAND FOR DOCUMENTS;  OR  (III)
 after  an  investigation  and a recommendation by a committee on profes-
 sional conduct of the state  board  for  professional  medical  conduct,
 based  upon  a  determination that a licensee is causing, engaging in or
 maintaining a condition or activity which in the commissioner's  opinion
 [constitutes  an  imminent  danger] PRESENTS A RISK to the health of the
 people, and that it therefore appears to be prejudicial to the interests
 of the people to delay action until an opportunity for a hearing can  be
 provided  in  accordance  with  the prehearing and hearing provisions of
 this section; the  commissioner  may  order  the  licensee,  by  written
 notice,  to  discontinue  such  dangerous  condition or activity or take
 certain action immediately and for a  period  of  [ninety]  ONE  HUNDRED
 TWENTY  days  from the date of service of the order. Within [ten] THIRTY
 days from the date of service of the said order,  the  state  board  for
 professional  medical conduct shall commence and regularly schedule such
 hearing proceedings as required by this section, provided, however, that
 the hearing shall be completed within [ninety] ONE HUNDRED  TWENTY  days
 of  the  date  of  service of the order. To the extent that the issue of
 [imminent danger] RISK OF THE HEALTH OF THE PEOPLE can be proven without
 the attorney representing the office  of  professional  medical  conduct
 putting  in  its  entire  case,  the  committee of the board shall first

 S. 2507                            64                            A. 3007
 
 determine whether by a preponderance of the  evidence  the  licensee  is
 causing,  engaging  in  or  maintaining  a  condition  or activity which
 [constitutes an imminent danger] PRESENTS A RISK to the  health  of  the
 people.  The  attorney  representing  the office of professional medical
 conduct shall have the burden of going forward and proving by a  prepon-
 derance of the evidence that the licensee's condition, activity or prac-
 tice  [constitutes  an imminent danger] PRESENTS A RISK to the health of
 the people. The licensee shall have an opportunity to be  heard  and  to
 present  proof.  When  both  the  office and the licensee have completed
 their cases with respect to the question of [imminent  danger]  RISK  TO
 THE  HEALTH OF THE PEOPLE, the committee shall promptly make a recommen-
 dation to the commissioner on the issue of [imminent danger] RISK TO THE
 HEALTH OF THE PEOPLE and determine whether the summary order  should  be
 left in effect, modified or vacated, and continue the hearing on all the
 remaining  charges, if any, in accordance with paragraph (f) of subdivi-
 sion ten of this section. Within ten days of the committee's recommenda-
 tion, the commissioner shall determine  whether  or  not  to  adopt  the
 committee's  recommendations,  in  whole  or in part, and shall leave in
 effect, modify or vacate his summary order. The state board for  profes-
 sional  medical  conduct shall make every reasonable effort to avoid any
 delay in completing and determining such proceedings. If, at the conclu-
 sion of the hearing, (i) the hearing committee of the  board  finds  the
 licensee  guilty  of  one or more of the charges which are the basis for
 the summary order, (ii) the hearing committee determines that the summa-
 ry order continue, and (iii) the ninety day term of the  order  has  not
 expired, the summary order shall remain in full force and effect until a
 final  decision  has  been  rendered  by  the committee or, if review is
 sought, by the administrative review board. A  summary  order  shall  be
 public upon issuance.
   (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, which, if commit-
 ted within this state, would have constituted a felony  under  New  York
 state  law,  and  [in  the commissioner's opinion the licensee's alleged
 conduct constitutes an imminent danger]  WHERE  THE  LICENSEE'S  ALLEGED
 CONDUCT MAY PRESENT A RISK to the health of the people, or when the duly
 authorized  professional disciplinary agency of another jurisdiction has
 made a finding substantially equivalent to a finding that  the  practice
 of  medicine  by the licensee in that jurisdiction [constitutes an immi-
 nent danger] PRESENTS A RISK to the health of  its  people,  or  when  a
 licensee  has  been disciplined by a duly authorized professional disci-
 plinary agency of another jurisdiction for acts which  if  committed  in
 this  state  would  have constituted the basis for summary action by the
 commissioner pursuant to paragraph (a) of this subdivision, the  commis-
 sioner, after a recommendation by a committee of professional conduct of
 the  state  board for professional medical conduct, may order the licen-
 see, by written notice, to discontinue or refrain from practicing  medi-
 cine  in whole or in part or to take certain actions authorized pursuant
 to this title immediately. The order of the commissioner  shall  consti-
 tute  summary  action  against the licensee and become public upon issu-
 ance. The summary suspension shall remain  in  effect  until  the  final
 conclusion  of  a hearing which shall commence within ninety days of the

 S. 2507                            65                            A. 3007
 
 date of service of the commissioner's order,  end  within  [ninety]  ONE
 HUNDRED  EIGHTY days thereafter and otherwise 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  medicine by the licensee in another
 jurisdiction [constitutes an imminent danger] PRESENTS  A  RISK  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.
   § 13. Paragraph (a) of subdivision 1 of section 2803-e of  the  public
 health law, as amended by chapter 294 of the laws of 1985, is amended to
 read as follows:
   (a)  Hospitals  and other facilities approved pursuant to this article
 shall make a report or cause a report to be made within thirty  days  of
 the  occurrence  of  any  of the following: the suspension, restriction,
 termination or curtailment of the training, employment,  association  or
 professional privileges or the denial of the certification of completion
 of  training  of  an  individual  licensed pursuant to the provisions of
 title eight of the education law or of  a  medical  resident  with  such
 facility  for  reasons  related in any way to alleged mental or physical
 impairment, incompetence, malpractice or  misconduct  or  impairment  of
 patient  safety  or welfare; the voluntary or involuntary resignation or
 withdrawal of association or of privileges with such facility  to  avoid
 the imposition of disciplinary measures; NOTIFICATION BY THE HOSPITAL OR
 FACILITY,  TO  ANY  ENTITY  PROVIDING  PERSONNEL TO PERFORM PROFESSIONAL
 SERVICES TO SUCH HOSPITAL OR FACILITY, THAT THE ENTITY MAY NOT ASSIGN  A
 PARTICULAR INDIVIDUAL TO PROVIDE SUCH SERVICES TO THE HOSPITAL OR FACIL-
 ITY,  FOR  REASONS  RELATED  IN  ANY  WAY  TO ALLEGED MENTAL OR PHYSICAL
 IMPAIRMENT, INCOMPETENCE, MALPRACTICE OR  MISCONDUCT  OR  IMPAIRMENT  OF
 PATIENT SAFETY OR WELFARE; or the receipt of information which indicates
 that any professional licensee or medical resident has been convicted of
 a  crime;  the  denial of staff privileges to a physician if the reasons
 stated for such denial are related to alleged mental or physical impair-
 ment, incompetence, malpractice, misconduct  or  impairment  of  patient
 safety or welfare.
   §  14.  Paragraphs (n), (p) and (q) of subdivision 1 of section 2995-a
 of the public health law, as added by chapter 542 of the laws  of  2000,
 are  amended and three new paragraphs (r), (s) and (t) are added to read
 as follows:
   (n) (i) the location of the licensee's primary practice setting  iden-
 tified as such; [and]
   (ii)  [the  names  of  any  licensed physicians with whom the licensee
 shares a group practice, as defined in subdivision five of  section  two
 hundred  thirty-eight  of  this  chapter]  HOURS  OF  OPERATION  OF  THE
 LICENSEE'S PRIMARY PRACTICE SETTING;
   (III) AVAILABILITY OF ASSISTIVE TECHNOLOGY AT THE  LICENSEE'S  PRIMARY
 PRACTICE SETTING; AND
   (IV) WHETHER THE LICENSEE IS ACCEPTING NEW PATIENTS;
   (p)  whether  the  licensee  participates  in the medicaid or medicare
 program or any  other  state  or  federally  financed  health  insurance
 program; [and]
   (q)  health  care plans with which the licensee has contracts, employ-
 ment, or other affiliation[.] PROVIDED THAT THE REPORTING  AND  ACCURACY
 OF  SUCH  INFORMATION  SHALL NOT BE THE RESPONSIBILITY OF THE PHYSICIAN,

 S. 2507                            66                            A. 3007
 
 BUT SHALL BE INCLUDED AND UPDATED BY THE DEPARTMENT  UTILIZING  PROVIDER
 NETWORK PARTICIPATION INFORMATION, OR OTHER RELIABLE SOURCES OF INFORMA-
 TION SUBMITTED BY THE HEALTH CARE PLANS;
   (R) THE PHYSICIAN'S WEBSITE AND SOCIAL MEDIA ACCOUNTS;
   (S) THE NAMES OF ANY LICENSED PHYSICIANS WITH WHOM THE LICENSEE SHARES
 A  GROUP PRACTICE, AS DEFINED IN SUBDIVISION FIVE OF SECTION TWO HUNDRED
 THIRTY-EIGHT OF THIS CHAPTER; AND
   (T) WORKFORCE RESEARCH AND PLANNING INFORMATION AS DETERMINED  BY  THE
 COMMISSIONER.
   §  15.  Section 2995-a of the public health law is amended by adding a
 new subdivision 1-b to read as follows:
   1-B. (A) FOR THE PURPOSES OF THIS SECTION, A  PHYSICIAN  LICENSED  AND
 REGISTERED  TO PRACTICE IN THIS STATE MAY AUTHORIZE A DESIGNEE TO REGIS-
 TER, TRANSMIT, ENTER  OR  UPDATE  INFORMATION  ON  HIS  OR  HER  BEHALF,
 PROVIDED THAT:
   (I)  THE  DESIGNEE  SO  AUTHORIZED IS EMPLOYED BY THE PHYSICIAN OR THE
 SAME PROFESSIONAL PRACTICE OR IS UNDER CONTRACT WITH SUCH PRACTICE;
   (II) THE PHYSICIAN TAKES REASONABLE STEPS TO ENSURE THAT SUCH DESIGNEE
 IS SUFFICIENTLY COMPETENT IN THE PROFILE REQUIREMENTS;
   (III) THE PHYSICIAN REMAINS RESPONSIBLE FOR ENSURING THE  ACCURACY  OF
 THE  INFORMATION PROVIDED AND FOR ANY FAILURE TO PROVIDE ACCURATE INFOR-
 MATION; AND
   (IV) THE PHYSICIAN SHALL NOTIFY THE DEPARTMENT  UPON  TERMINATING  THE
 AUTHORIZATION OF ANY DESIGNEE, IN A MANNER DETERMINED BY THE DEPARTMENT.
   (B) THE COMMISSIONER SHALL GRANT ACCESS TO THE PROFILE IN A REASONABLY
 PROMPT  MANNER  TO  DESIGNEES  AUTHORIZED  BY PHYSICIANS AND ESTABLISH A
 MECHANISM TO PREVENT DESIGNEES TERMINATED PURSUANT TO SUBPARAGRAPH  (IV)
 OF  PARAGRAPH  (A)  OF  THIS SUBDIVISION FROM ACCESSING THE PROFILE IN A
 REASONABLY PROMPT MANNER FOLLOWING NOTIFICATION OF TERMINATION.
   § 16. Subdivision 4 of section 2995-a of the  public  health  law,  as
 amended  by  section  3  of part A of chapter 57 of the laws of 2015, is
 amended to read as follows:
   4. Each physician shall periodically report to the department on forms
 and in the time and manner required by the commissioner any other infor-
 mation as is required by the department for the development of  profiles
 under  this  section  which  is  not otherwise reasonably obtainable. In
 addition to such periodic reports and providing  the  same  information,
 each  physician  shall  update his or her profile information within the
 six months prior to [the expiration date of such  physician's  registra-
 tion  period] SUBMISSION OF THE RE-REGISTRATION APPLICATION, as a condi-
 tion of registration renewal  [under  article  one  hundred  thirty-one]
 PURSUANT TO SECTION SIXTY-FIVE HUNDRED TWENTY-FOUR of the education law.
 Except  for optional information provided AND INFORMATION REQUIRED UNDER
 SUBPARAGRAPH (IV) OF PARAGRAPH (N) AND PARAGRAPHS (Q) AND (T) OF  SUBDI-
 VISION  ONE  OF  THIS SECTION, physicians shall notify the department of
 any change in the profile information within thirty days of such change.
   § 17. Subdivision 6 of section 2995-a of the  public  health  law,  as
 added by chapter 542 of the laws of 2000, is amended to read as follows:
   6.  A  physician  may  elect  to  have his or her profile omit certain
 information provided pursuant to paragraphs (K), (l), (m), [(n) and (q)]
 (R) AND (S) of subdivision one of  this  section.  INFORMATION  PROVIDED
 PURSUANT  TO  PARAGRAPH  (T) OF SUBDIVISION ONE OF THIS SECTION SHALL BE
 OMITTED FROM A PHYSICIAN'S PROFILE AND SHALL BE EXEMPT  FROM  DISCLOSURE
 UNDER  ARTICLE SIX OF THE PUBLIC OFFICERS LAW. In collecting information
 for such profiles and  disseminating  the  same,  the  department  shall
 inform  physicians  that they may choose not to provide such information

 S. 2507                            67                            A. 3007

 required pursuant to paragraphs (K), (l), (m), [(n) and (q)] (R) AND (S)
 of subdivision one of this section.
   §  18.  This  act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2021; provided,
 however, that the amendments to  paragraph  (a)  of  subdivision  10  of
 section 230 of the public health law made by sections seven and eight of
 this  act shall not affect the expiration of such paragraph and shall be
 deemed to expire therewith; and further provided that sections fourteen,
 fifteen, sixteen and seventeen of this act shall take effect on the  one
 hundred eightieth day after it shall have become a law.
 
                                  PART R
 
   Section  1.  Section 63 of the civil rights law, as amended by chapter
 253 of the laws of 2014, is amended to read as follows:
   § 63. Order. If the court to which the petition is presented is satis-
 fied thereby, or by the affidavit and certificate  presented  therewith,
 that  the petition is true, and that there is no reasonable objection to
 the change of name proposed, and if the petition be to change  the  name
 of  an  infant,  that  the interests of the infant will be substantially
 promoted by the change, the court shall make an  order  authorizing  the
 petitioner  to  assume the name proposed. The order shall further recite
 the date and place of birth of the applicant and, if the  applicant  was
 born  in the state of New York, such order shall set forth the number of
 [his] THE APPLICANT'S birth certificate or that no birth certificate  is
 available.  The  order shall be directed to be entered and the papers on
 which it was granted to be filed [prior to the  publication  hereinafter
 directed]  in  the  clerk's office of the county in which the petitioner
 resides if he be an individual, or in the office of  the  clerk  of  the
 civil  court of the city of New York if the order be made by that court.
 [Such order shall also direct the publication,  at  least  once,  within
 sixty  days  after the making of the order, in a designated newspaper in
 the county in which the order is directed to be entered and if the peti-
 tion is made by a person subject to the provisions of subdivision two of
 section sixty-two of this article, in  a  designated  newspaper  in  any
 county wherein such person was convicted if different from the county in
 which  the  order  is  otherwise  directed to be entered, of a notice in
 substantially the following form: Notice is hereby given that  an  order
 entered by the ............ court,............ county, on the ...... day
 of......., bearing Index Number..........., a copy of which may be exam-
 ined  at  the office of the clerk, located at ................., in room
 number.......,  grants  me   the   right   to   assume   the   name   of
 ...................    The  city  and  state  of  my present address are
 .........................;  the  month  and  year  of   my   birth   are
 ................;  the  place  of  my  birth is ....................; my
 present name is .................................]
   § 2. Section 64 of the civil rights law, as amended by chapter 258  of
 the  laws  of  2006,  and the closing paragraph as separately amended by
 chapters 258, 320 and 481 of the laws of 2006, is  amended  to  read  as
 follows:
   §  64.  Effect. If the order [shall be fully complied with, and within
 ninety days after the making of the order, an affidavit of the  publica-
 tion  thereof  shall  be  filed  in  the  office  in which the order] is
 entered, the petitioner shall be known by  the  name  which  is  thereby
 authorized  to  be  assumed.  If  the  surname of a parent be changed as

 S. 2507                            68                            A. 3007
 
 provided in this article, any minor child of such parent at the time  of
 such change may thereafter assume such changed surname.
   [Upon compliance with the order and the filing of the affidavit of the
 publication,  as  provided  in  this  section, the clerk of the court in
 which the order has been entered shall certify that the order  has  been
 complied  with;  and, if] (1) IF the petition states that the petitioner
 stands convicted of a violent felony offense as defined in section 70.02
 of the penal law or a felony defined in article one hundred  twenty-five
 of  such  law  or  any  of the following provisions of such law sections
 130.25, 130.30, 130.40, 130.45,  255.25,  255.26,  255.27,  article  two
 hundred  sixty-three, 135.10, 135.25, 230.05, 230.06, subdivision two of
 section 230.30 or 230.32, [such] THE clerk [(1)] OF THE COURT  IN  WHICH
 THE ORDER HAS BEEN ENTERED shall deliver, by first class mail, a copy of
 such certified order to the division of criminal justice services at its
 office  in  the  county  of  Albany and (2) [upon the clerk of the court
 reviewing the petitioner's application for name  change  and  subsequent
 in-court  inquiry,  may,  in  the  clerk's discretion, deliver, by first
 class mail, the petitioner's new name with such certified order  to  the
 court  of  competent  jurisdiction  which imposed the orders of support.
 Such certification shall appear on the original order and on any  certi-
 fied  copy  thereof  and  shall be entered in the clerk's minutes of the
 proceeding] IF THE PETITION STATES THAT THE  PETITIONER  IS  RESPONSIBLE
 FOR  SPOUSAL  SUPPORT  OR  CHILD  SUPPORT  OBLIGATIONS PURSUANT TO COURT
 ORDER, UPON REVIEW OF THE PETITIONER'S APPLICATION FOR NAME  CHANGE  AND
 SUBSEQUENT IN-COURT INQUIRY, THE COURT MAY, IN ITS DISCRETION, ORDER THE
 PETITIONER  TO  DELIVER  BY  FIRST CLASS MAIL, THE PETITIONER'S NEW NAME
 WITH SUCH CERTIFIED ORDER TO THE COURT OF COMPETENT  JURISDICTION  WHICH
 IMPOSED  THE  ORDERS  OF SUPPORT. SUCH CERTIFICATION SHALL APPEAR ON THE
 ORIGINAL ORDER AND ON ANY CERTIFIED COPY THEREOF AND SHALL BE ENTERED IN
 THE COURT'S MINUTES OF THE PROCEEDING.
   § 3. Section 64-a of the civil rights law, as amended by  chapter  241
 of the laws of 2015, is amended to read as follows:
   §  64-a. [Exemption from publication requirements] SEALING NAME CHANGE
 PAPERS. 1. If the court shall find that [the publication] OPEN RECORD of
 an applicant's change of name would jeopardize such applicant's personal
 safety, based on  totality  of  the  circumstances  [the  provisions  of
 sections  sixty-three  and sixty-four of this article requiring publica-
 tion shall be waived and shall be inapplicable. Provided,  however,  the
 court  shall  not deny such waiver soley on the basis that the applicant
 lacks specific instances of or a personal history of threat to  personal
 safety.   The], THE court shall order the records of such change of name
 proceeding [to] be sealed, to be opened only by order of the  court  for
 good  cause  shown or at the request of the applicant.  FOR THE PURPOSES
 OF THIS SECTION, "TOTALITY OF THE CIRCUMSTANCES" SHALL INCLUDE, BUT  NOT
 BE LIMITED TO, A CONSIDERATION OF THE RISK OF VIOLENCE OR DISCRIMINATION
 AGAINST  THE  APPLICANT.   THE COURT SHALL NOT DENY SUCH SEALING REQUEST
 SOLELY ON THE BASIS THAT THE APPLICANT LACKS SPECIFIC INSTANCES OF OR  A
 PERSONAL HISTORY OF THREAT TO PERSONAL SAFETY.
   2.  Notwithstanding any other provision of law, pending such a finding
 in subdivision one of this section where an applicant seeks relief under
 this section, the court shall immediately order the applicant's  current
 name,  proposed  new name, residential and business addresses, telephone
 numbers, and any other information contained in any pleadings or  papers
 submitted  to the court to be safeguarded and sealed in order to prevent
 their inadvertent or unauthorized use or disclosure while the matter  is
 pending.

 S. 2507                            69                            A. 3007
 
   §  4.  The  civil rights law is amended by adding a new article 6-A to
 read as follows:
                                ARTICLE 6-A
              CHANGE OF SEX DESIGNATION OR GENDER DESIGNATION
 SECTION 67. PETITION TO CHANGE SEX DESIGNATION OR GENDER DESIGNATION.
         67-A. ORDER.
         67-B. SEALING  CHANGE  OF  SEX DESIGNATION OR GENDER DESIGNATION
               PAPERS.
         67-C. EFFECT ON GOVERNMENT ISSUED IDENTITY DOCUMENTS.
   § 67. PETITION TO CHANGE SEX DESIGNATION OR GENDER DESIGNATION.  1.  A
 PETITION  FOR  LEAVE TO CHANGE SEX DESIGNATION OR GENDER DESIGNATION MAY
 BE MADE BY A RESIDENT OF THE STATE TO THE COUNTY COURT OF THE COUNTY  OR
 THE  SUPREME  COURT IN THE COUNTY IN WHICH SUCH RESIDENT RESIDES, OR, IF
 SUCH RESIDENT RESIDES IN THE CITY OF NEW YORK,  EITHER  TO  THE  SUPREME
 COURT  OR  TO  ANY BRANCH OF THE CIVIL COURT OF THE CITY OF NEW YORK, IN
 ANY COUNTY OF THE CITY OF NEW YORK.  THE  PETITION  TO  CHANGE  THE  SEX
 DESIGNATION OR GENDER DESIGNATION OF AN INFANT MAY BE MADE BY THE INFANT
 THROUGH  EITHER  OF  SUCH  INFANT'S PARENTS, OR BY SUCH INFANT'S GENERAL
 GUARDIAN OR BY THE GUARDIAN OF SUCH INFANT'S PERSON.
   2.  WHEN AN INDIVIDUAL PETITIONS THE COURT TO RECOGNIZE  THEIR  GENDER
 IDENTITY  OR  TO  AMEND THE SEX DESIGNATION  OR GENDER DESIGNATION ON AN
 IDENTITY DOCUMENT, THE COURT SHALL ISSUE SUCH AN ORDER UPON  RECEIPT  OF
 AN  AFFIDAVIT FROM SUCH INDIVIDUAL ATTESTING TO THEIR GENDER IDENTITY OR
 REASON FOR THE CHANGE.  NO ADDITIONAL MEDICAL EVIDENCE SHALL BE REQUIRED
 TO GRANT SUCH REQUEST. NO SUCH ORDER SHALL BE REQUIRED TO AMEND AN IDEN-
 TITY DOCUMENT ISSUED WITHIN NEW YORK  STATE.  NO  SUCH  ORDER  SHALL  BE
 REQUIRED  TO  OTHERWISE  RECOGNIZE THE GENDER OF AN INDIVIDUAL AND TREAT
 THEM CONSISTENT WITH THEIR GENDER IDENTITY  WITHIN  NEW  YORK  STATE  OR
 UNDER NEW YORK STATE LAW.
   3.  SUCH REQUEST MAY BE MADE SIMULTANEOUSLY WITH A PETITION FOR CHANGE
 OF  NAME  PURSUANT  TO SECTION SIXTY OR SIXTY-FIVE OF THIS CHAPTER OR ON
 ITS OWN.
   § 67-A. ORDER. IF THE COURT TO WHICH  THE  PETITION  IS  PRESENTED  IS
 SATISFIED  THEREBY, OR BY THE AFFIDAVIT AND CERTIFICATE PRESENTED THERE-
 WITH, AND THAT THERE IS NO REASONABLE OBJECTION TO  THE  CHANGE  OF  SEX
 DESIGNATION  OR  GENDER  DESIGNATION PROPOSED, AND IF THE PETITION IS TO
 CHANGE THE SEX DESIGNATION OR GENDER DESIGNATION OF AN INFANT, THAT  THE
 INTERESTS  OF  THE  INFANT WILL BE SUBSTANTIALLY PROMOTED BY THE CHANGE,
 THE COURT SHALL MAKE AN ORDER AUTHORIZING THE PETITIONER TO  ASSUME  THE
 SEX DESIGNATION OR GENDER DESIGNATION PROPOSED.
   §  67-B.  SEALING  CHANGE  OF  SEX  DESIGNATION  OR GENDER DESIGNATION
 PAPERS. 1. UPON REQUEST OF THE APPLICANT,  THE  COURT  SHALL  ORDER  THE
 RECORDS OF SUCH CHANGE OF SEX DESIGNATION OR GENDER DESIGNATION PROCEED-
 ING TO BE SEALED, TO BE OPENED ONLY BY ORDER OF THE COURT FOR GOOD CAUSE
 SHOWN OR AT THE REQUEST OF THE APPLICANT.
   2.  NOTWITHSTANDING ANY OTHER PROVISION OF LAW, PENDING SUCH A FINDING
 IN SUBDIVISION ONE OF THIS SECTION WHERE AN APPLICANT SEEKS RELIEF UNDER
 THIS SECTION, THE COURT SHALL IMMEDIATELY ORDER THE APPLICANT'S  CURRENT
 NAME,  SEX  DESIGNATION,  PROPOSED  NEW SEX DESIGNATION OR GENDER DESIG-
 NATION, RESIDENTIAL AND BUSINESS ADDRESSES, TELEPHONE NUMBERS,  AND  ANY
 OTHER  INFORMATION CONTAINED IN ANY PLEADINGS OR PAPERS SUBMITTED TO THE
 COURT TO BE SAFEGUARDED AND SEALED IN ORDER TO PREVENT THEIR INADVERTENT
 OR UNAUTHORIZED USE OR DISCLOSURE WHILE THE MATTER IS PENDING.
   § 67-C. EFFECT ON GOVERNMENT  ISSUED  IDENTITY  DOCUMENTS.  ANY  STATE
 AGENCY  THAT MAINTAINS A SYSTEM OR ISSUES AN IDENTITY DOCUMENT REQUIRING
 A SEX DESIGNATION OR GENDER DESIGNATION THAT,  DUE  TO  FEDERAL  LAW  OR

 S. 2507                            70                            A. 3007
 
 SYSTEMS  PROCESSING  REQUIREMENTS,  IS  UNABLE TO PROCESS OR CHANGE SUCH
 RECORD OR DOCUMENT CONSISTENT WITH AN  ORDER  ISSUED  PURSUANT  TO  THIS
 SECTION  SHALL  MAKE  REASONABLE  EFFORTS  TO OTHERWISE ACCOMMODATE SUCH
 REQUEST.
   § 5. This act shall take effect on the one hundred eightieth day after
 it  shall have become a law. Effective immediately, the addition, amend-
 ment and/or repeal of any rule or regulation necessary for the implemen-
 tation of this act on its effective date are authorized to be  made  and
 completed on or before such effective date.
 
                                  PART S
 
   Section 1. Section 11 of chapter 884 of the laws of 1990, amending the
 public  health  law  relating  to  authorizing bad debt and charity care
 allowances for certified home health agencies, as amended by  section  3
 of  part  E  of  chapter  57  of the laws of 2019, is amended to read as
 follows:
   § 11. This act shall take effect immediately and:
   (a) sections one and three shall expire on December 31, 1996,
   (b) sections four through ten shall expire on June  30,  [2021]  2023,
 and
   (c) provided that the amendment to section 2807-b of the public health
 law  by  section two of this act shall not affect the expiration of such
 section 2807-b as otherwise provided by  law  and  shall  be  deemed  to
 expire therewith.
   §  2.  Subdivision  (a)  of section 40 of part B of chapter 109 of the
 laws of 2010, amending the social services law relating  to  transporta-
 tion  costs, as amended by section 5 of part E of chapter 57 of the laws
 of 2019, is amended to read as follows:
   (a) sections two, three, three-a, three-b, three-c,  three-d,  three-e
 and  twenty-one  of  this  act  shall take effect July 1, 2010; sections
 fifteen, sixteen, seventeen, eighteen and nineteen  of  this  act  shall
 take  effect  January 1, 2011; [and provided further that section twenty
 of this act shall be deemed  repealed  ten  years  after  the  date  the
 contract  entered  into pursuant to section 365-h of the social services
 law, as amended by section twenty of this  act,  is  executed;  provided
 that the commissioner of health shall notify the legislative bill draft-
 ing  commission upon the execution of the contract entered into pursuant
 to section 367-h of the social services law in order that the commission
 may maintain an accurate and timely effective data base of the  official
 text of the laws of the state of New York in furtherance of effectuating
 the  provisions of section 44 of the legislative law and section 70-b of
 the public officers law;]
   § 3. Subdivision 5-a of section 246 of chapter 81 of the laws of 1995,
 amending the public health  law  and  other  laws  relating  to  medical
 reimbursement  and welfare reform, as amended by section 12 of part E of
 chapter 57 of the laws of 2019, is amended to read as follows:
   5-a. Section sixty-four-a of this act shall be deemed to have been  in
 full  force and effect on and after April 1, 1995 through March 31, 1999
 and on and after July 1, 1999 through March 31, 2000 and  on  and  after
 April  1,  2000  through  March  31, 2003 and on and after April 1, 2003
 through March 31, 2007, and on and after April 1, 2007 through March 31,
 2009, and on and after April 1, 2009 through March 31, 2011, and on  and
 after  April  1,  2011 through March 31, 2013, and on and after April 1,
 2013 through March 31, 2015, and on and  after  April  1,  2015  through
 March  31,  2017  and on and after April 1, 2017 through March 31, 2019,

 S. 2507                            71                            A. 3007
 
 and on and after April 1, 2019 through March 31, 2021, AND ON AND  AFTER
 APRIL 1, 2021 THROUGH MARCH 31, 2023;
   §  4.  Section  64-b  of  chapter 81 of the laws of 1995, amending the
 public health law and other laws relating to medical  reimbursement  and
 welfare  reform, as amended by section 13 of part E of chapter 57 of the
 laws of 2019, is amended to read as follows:
   §  64-b.  Notwithstanding  any  inconsistent  provision  of  law,  the
 provisions of subdivision 7 of section 3614 of the public health law, as
 amended,  shall  remain and be in full force and effect on April 1, 1995
 through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
 and after April 1, 2000 through March 31, 2003 and on and after April 1,
 2003 through March 31, 2007, and on and  after  April  1,  2007  through
 March  31,  2009, and on and after April 1, 2009 through March 31, 2011,
 and on and after April 1, 2011 through March 31, 2013, and on and  after
 April  1,  2013  through  March 31, 2015, and on and after April 1, 2015
 through March 31, 2017 and on and after April 1, 2017 through March  31,
 2019,  and on and after April 1, 2019 through March 31, 2021, AND ON AND
 AFTER APRIL 1, 2021 THROUGH MARCH 31, 2023.
   § 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, as
 amended by section 14 of part E of chapter 57 of the laws  of  2019,  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, 2017 through March 31, [2021] 2023, 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,  2019,  2020,  [and]
 2021,  2022  AND 2023 calendar 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, 2019, 2020, [and] 2021, 2022 AND  2023  calendar  years
 shall  also be applied to rates of payment provided on and after January
 1, 2017 through  March  31,  [2021]  2023  for  personal  care  services
 provided  in  those  local social services districts, including New York
 city, whose rates of payment for such services are established  by  such
 local  social  services  districts  pursuant to a rate-setting exemption
 issued by the commissioner of  health  to  such  local  social  services
 districts  in  accordance  with  applicable  regulations;  and  provided
 further, however, that for rates of payment for assisted living  program
 services  provided on and after January 1, 2017 through March 31, [2021]
 2023, such trend factors attributable to the  2017,  2018,  2019,  2020,
 [and]  2021,  2022  AND  2023  calendar years shall be established at no
 greater than zero percent.

 S. 2507                            72                            A. 3007
 
   § 6. Subdivision 2 of section 246 of chapter 81 of the laws  of  1995,
 amending  the  public  health  law  and  other  laws relating to medical
 reimbursement and welfare reform, as amended by section 17 of part E  of
 chapter 57 of the laws of 2019, is amended to read as follows:
   2.  Sections  five,  seven  through nine, twelve through fourteen, and
 eighteen of this act shall be deemed to have  been  in  full  force  and
 effect  on  and  after  April  1, 1995 through March 31, 1999 and on and
 after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
 through March 31, 2003 and on and after April 1, 2003 through March  31,
 2006  and  on  and after April 1, 2006 through March 31, 2007 and on and
 after April 1, 2007 through March 31, 2009 and on  and  after  April  1,
 2009  through  March 31, 2011 and sections twelve, thirteen and fourteen
 of this act shall be deemed to be in full force and effect on and  after
 April  1,  2011  through  March  31, 2015 and on and after April 1, 2015
 through March 31, 2017 and on and after April 1, 2017 through March  31,
 2019,  and on and after April 1, 2019 through March 31, 2021, AND ON AND
 AFTER APRIL 1, 2021 THROUGH MARCH 31, 2023;
   § 7. Section 7 of part H of chapter 57 of the laws of  2019,  amending
 the  public  health  law  relating  to waiver of certain regulations, as
 amended by section 11 of part BB of chapter 56 of the laws of  2020,  is
 amended to read as follows:
   §  7.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2019, provided,
 however, that section two of this act shall expire on  April  1,  [2021]
 2024.
   § 8. Section 5 of chapter 517 of the laws of 2016, amending the public
 health  law  relating to payments from the New York state medical indem-
 nity fund, as amended by section 18 of part Y of chapter 56 of the  laws
 of 2020, is amended to read as follows:
   §  5. This act shall take effect on the forty-fifth day after it shall
 have become a law, provided that the  amendments  to  subdivision  4  of
 section  2999-j of the public health law made by section two of this act
 shall take effect on June 30,  2017  and  shall  expire  and  be  deemed
 repealed December 31, [2021] 2022.
   §  9.  Subdivision  1  of section 2999-aa of the public health law, as
 amended by chapter 80 of the  laws  of  2017,  is  amended  to  read  as
 follows:
   1.  In order to promote improved quality and efficiency of, and access
 to, health care services and to promote improved  clinical  outcomes  to
 the  residents  of  New  York,  it  shall  be the policy of the state to
 encourage, where appropriate, cooperative, collaborative and integrative
 arrangements including but not  limited  to,  mergers  and  acquisitions
 among  health  care  providers  or  among  others who might otherwise be
 competitors, under the active supervision of the  commissioner.  To  the
 extent  such arrangements, or the planning and negotiations that precede
 them, might be anti-competitive within the meaning  and  intent  of  the
 state and federal antitrust laws, the intent of the state is to supplant
 competition  with  such  arrangements  under  the active supervision and
 related administrative actions  of  the  commissioner  as  necessary  to
 accomplish  the  purposes  of  this article, and to provide state action
 immunity under the state and federal  antitrust  laws  with  respect  to
 activities  undertaken  by  health care providers and others pursuant to
 this article, where the benefits of such  active  supervision,  arrange-
 ments  and actions of the commissioner outweigh any disadvantages likely
 to result from a reduction of competition. The  commissioner  shall  not
 approve  an  arrangement for which state action immunity is sought under

 S. 2507                            73                            A. 3007
 
 this article without first consulting with, and receiving a  recommenda-
 tion from, the public health and health planning council. No arrangement
 under  this  article  shall be approved after December thirty-first, two
 thousand [twenty] TWENTY-FOUR.
   §  10. Section 3 of part D of chapter 56 of the laws of 2014, amending
 the education law relating to the nurse practitioners modernization act,
 is amended to read as follows:
   § 3. This act shall take effect on the first of January after it shall
 have become a law and shall expire June 30 of the [sixth]  TWELFTH  year
 after  it shall have become a law, when upon such date the provisions of
 this act shall be deemed repealed;  provided,  however,  that  effective
 immediately,  the addition, amendment and/or repeal of any rule or regu-
 lation necessary for the implementation of this  act  on  its  effective
 date  is  authorized  and directed to be made and completed on or before
 such effective date.
   § 11. Subparagraph (vi) of paragraph (b) of subdivision 2  of  section
 2807-d  of  the  public health law, as amended by section 9 of part E of
 chapter 57 of the laws of 2019, is amended to read as follows:
   (vi) Notwithstanding any contrary provision of this paragraph  or  any
 other  provision  of  law or regulation to the contrary, for residential
 health care facilities the assessment shall be six percent of each resi-
 dential health care facility's gross receipts received from all  patient
 care  services and other operating income on a cash basis for the period
 April first, two thousand two through March thirty-first,  two  thousand
 three  for  hospital  or  health-related  services,  including adult day
 services; provided, however, that residential  health  care  facilities'
 gross receipts attributable to payments received pursuant to title XVIII
 of the federal social security act (medicare) shall be excluded from the
 assessment; provided, however, that for all such gross receipts received
 on  or after April first, two thousand three through March thirty-first,
 two thousand five, such assessment shall be five  percent,  and  further
 provided  that  for  all  such gross receipts received on or after April
 first, two thousand five through March thirty-first, two thousand  nine,
 and  on  or  after  April first, two thousand nine through March thirty-
 first, two thousand eleven such assessment shall  be  six  percent,  and
 further  provided  that for all such gross receipts received on or after
 April first, two thousand eleven through March thirty-first,  two  thou-
 sand thirteen such assessment shall be six percent, and further provided
 that  for  all such gross receipts received on or after April first, two
 thousand thirteen through March thirty-first, two thousand fifteen  such
 assessment  shall be six percent, and further provided that for all such
 gross receipts received on or after April first,  two  thousand  fifteen
 through March thirty-first, two thousand seventeen such assessment shall
 be  six  percent,  and further provided that for all such gross receipts
 received on or after April first, two thousand seventeen  through  March
 thirty-first,  two  thousand  nineteen  such  assessment  shall  be  six
 percent, and further provided that for all such gross receipts  received
 on  or  after  April  first, two thousand nineteen through March thirty-
 first, two thousand twenty-one such assessment shall be six percent, AND
 FURTHER PROVIDED THAT FOR ALL SUCH GROSS RECEIPTS RECEIVED ON  OR  AFTER
 APRIL  FIRST,  TWO  THOUSAND  TWENTY-ONE THROUGH MARCH THIRTY-FIRST, TWO
 THOUSAND TWENTY-THREE SUCH ASSESSMENT SHALL BE SIX PERCENT.
   § 12. This act shall take effect immediately and shall  be  deemed  to
 have been in full force and effect on and after April 1, 2021.
 
                                  PART T

 S. 2507                            74                            A. 3007
 
   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  X of chapter 57 of the laws of 2018, is amended to
 read as follows:
   § 3. This act shall take effect immediately; and shall expire  and  be
 deemed repealed June 30, [2021] 2024.
   § 2. This act shall take effect immediately.
 
                                  PART U
 
   Section  1.  Section  4  of  part L of chapter 59 of the laws of 2016,
 amending the mental hygiene law relating to the appointment of temporary
 operators for the continued operation of programs and the  provision  of
 services  for  persons  with serious mental illness and/or developmental
 disabilities and/or chemical dependence, is amended to read as follows:
   § 4. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2016; provided,
 however,  that  sections  one  and  two  of this act shall expire and be
 deemed repealed on March 31, [2021] 2026.
   § 2. This act shall take effect immediately.
 
                                  PART V
 
   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, as amended by section 1
 of part U of chapter 57 of the laws of  2018,  is  amended  to  read  as
 follows:
   §  2.  This  act shall take effect immediately and shall expire and be
 deemed repealed March 31, [2021] 2024.
   § 2. This act shall take effect immediately.
 
                                  PART W
 
   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
 1 of part V of chapter 57 of the laws of 2018, is  amended  to  read  as
 follows:
   § 7. This act shall take effect immediately and shall expire March 31,
 [2021]  2024  when  upon  such  date the provisions of this act shall be
 deemed repealed.
   § 2. This act shall take effect immediately.
 
                                  PART X
 
   Section 1. Notwithstanding the provisions of subdivisions (b) and  (e)
 of section 7.17 and section 41.55 of the mental hygiene law or any other
 law  to the contrary, the office of mental health is authorized in state
 fiscal year 2021-22 to close, consolidate, reduce, transfer or otherwise

 S. 2507                            75                            A. 3007
 
 redesign services of hospitals, other facilities and  programs  operated
 by  the  office  of  mental health, and to implement significant service
 reductions and reconfigurations according to this section  as  shall  be
 determined  by the commissioner of mental health to be necessary for the
 cost-effective and efficient operation of such hospitals, other  facili-
 ties  and  programs. Any transfers of capacity or any resulting transfer
 of functions shall be authorized to  be  made  by  the  commissioner  of
 mental health and any transfer of personnel upon such transfer of capac-
 ity  or  transfer  of functions shall be accomplished in accordance with
 the provisions of subdivision 2 of section 70 of the civil service law.
   § 2. This act shall take effect immediately and shall expire March 31,
 2022 when upon such date the provisions of  this  act  shall  be  deemed
 repealed.
 
                                  PART Y

   Section 1.  Section 19.07 of the mental hygiene law, as added by chap-
 ter  223  of  the  laws  of 1992, subdivisions (a) and (g) as amended by
 chapter 271 of the laws of 2010, subdivisions (b) and (c) as amended  by
 chapter 281 of the laws of 2019, subdivision (d) as amended by section 5
 of part I of chapter 58 of the laws of 2005,  subdivision (e) as amended
 by  chapter 558 of the laws of 1999, subdivision (f) as added by chapter
 383 of the laws of 1998, subdivision (h) as amended by section 118-f  of
 subpart  B  of part C of chapter 62 of the laws of 2011, subdivision (i)
 as amended by section 31-a of part AA of chapter 56 of the laws of 2019,
 subdivision (j) as amended by chapter 146 of the laws of 2014,  subdivi-
 sion (k) as added by  chapter 40 of the laws of 2014, subdivision (l) as
 added by chapter 323 of the laws of 2018 and subdivision (m) as added by
 chapter 493 of the laws of 2019, is amended to read as follows:
 § 19.07 Office  of  [alcoholism  and substance abuse services] ADDICTION
           SERVICES AND SUPPORTS; scope of responsibilities.
   (a) The office of [alcoholism and substance abuse services]  ADDICTION
 SERVICES  AND  SUPPORTS  is charged with the responsibility for assuring
 the development of comprehensive plans, programs, and  services  in  the
 areas  of research, prevention, care, treatment, rehabilitation, includ-
 ing relapse prevention and recovery maintenance, education, and training
 of persons who [abuse or are dependent  on  alcohol  and/or  substances]
 HAVE  OR  ARE  AT  RISK OF AN ADDICTIVE DISORDER and their families. THE
 TERM ADDICTIVE  DISORDER  SHALL  INCLUDE  GAMBLING  DISORDER  EDUCATION,
 PREVENTION  AND TREATMENT CONSISTENT WITH SECTION 41.57 OF THIS CHAPTER.
 Such plans, programs, and services shall be developed with  the  cooper-
 ation of the office, the other offices of the department where appropri-
 ate,  local governments, consumers and community organizations and enti-
 ties.  The  office  shall  provide  appropriate  facilities  and   shall
 encourage  the provision of facilities by local government and community
 organizations and entities. [The office is also responsible for develop-
 ing plans, programs and services related to compulsive  gambling  educa-
 tion,  prevention  and  treatment  consistent with section 41.57 of this
 chapter.]
   (b) The office of [alcoholism and substance abuse services]  ADDICTION
 SERVICES  AND SUPPORTS shall advise and assist the governor in improving
 services and developing policies designed to meet the needs  of  persons
 who  suffer from OR ARE AT RISK OF an addictive disorder and their fami-
 lies, and to encourage their rehabilitation,  maintenance  of  recovery,
 and functioning in society.

 S. 2507                            76                            A. 3007
 
   (c)  The office of [alcoholism and substance abuse services] ADDICTION
 SERVICES AND SUPPORTS shall have  the  responsibility  for  seeing  that
 persons  who  suffer  from  OR  ARE AT RISK OF an addictive disorder and
 their families are provided with addiction services, care and treatment,
 and  that  such  services, care, treatment and rehabilitation is of high
 quality and effectiveness, and that the personal  and  civil  rights  of
 persons  seeking  and  receiving addiction services, care, treatment and
 rehabilitation are adequately protected.
   (d) The office of [alcoholism and substance abuse services]  ADDICTION
 SERVICES  AND SUPPORTS shall foster programs for the training and devel-
 opment of persons capable of providing the foregoing services, including
 but not limited to a process of  issuing,  either  directly  or  through
 contract,  LICENSES,  credentials,  CERTIFICATES  OR  AUTHORIZATIONS for
 [alcoholism and substance abuse counselors or gambling] addiction [coun-
 selors] PROFESSIONALS in accordance with the following:
   (1) The office shall establish minimum qualifications [for counselors]
 AND A DEFINITION OF THE PRACTICE  OF  THE  PROFESSION  OF  AN  ADDICTION
 PROFESSIONAL  in all phases of delivery of services to persons and their
 families who are suffering from [alcohol and/or substance  abuse  and/or
 chemical  dependence  and/or  compulsive gambling that shall include] OR
 ARE AT RISK OF AN ADDICTIVE DISORDER INCLUDING, but not be  limited  to,
 completion of approved courses of study or equivalent on-the-job experi-
 ence  in [alcoholism and substance abuse counseling and/or counseling of
 compulsive gambling] OR AT RISK OF ADDICTION DISORDER SERVICES.
   (i) The office shall establish procedures  for  issuing,  directly  or
 through  contract, LICENSES, credentials, CERTIFICATES OR AUTHORIZATIONS
 to [counselors] ADDICTION PROFESSIONALS who meet minimum qualifications,
 including the establishment  of  appropriate  fees,  and  shall  further
 establish procedures to suspend, revoke, or annul such LICENSES, creden-
 tials,  CERTIFICATES  OR  AUTHORIZATIONS for good cause. Such procedures
 shall be promulgated by the commissioner by rule or regulation.
   (ii) The commissioner shall establish [a credentialing]  AN  ADDICTION
 PROFESSIONALS board which shall provide advice concerning the LICENSING,
 credentialing, CERTIFICATION OR AUTHORIZATION process.
   (III)  THE COMMISSIONER SHALL ESTABLISH FEES FOR THE EDUCATION, TRAIN-
 ING,  LICENSING,  CREDENTIALING,  CERTIFICATION  OR   AUTHORIZATION   OF
 ADDICTION PROFESSIONALS.
   (2)  The  establishment,  with  the  advice of the advisory council on
 alcoholism and substance abuse services, of minimum  qualifications  for
 [counselors]  ADDICTION  PROFESSIONALS  in  all  phases  of  delivery of
 services to those suffering from [alcoholism, substance and/or  chemical
 abuse and/or dependence and/or compulsive gambling] OR AT RISK OF ADDIC-
 TIVE DISORDERS and their families that shall include, but not be limited
 to,  completion  of  approved  courses of study or equivalent on-the-job
 experience in [counseling  for  alcoholism,  substance  and/or  chemical
 abuse and/or dependence] ADDICTION DISORDER SERVICES and/or [compulsive]
 gambling  DISORDER  SERVICES,  and  ESTABLISH  APPROPRIATE  FEES,  issue
 LICENSES, credentials, CERTIFICATES OR  AUTHORIZATIONS  to  [counselors]
 ADDICTION  PROFESSIONALS  who  meet  minimum qualifications and suspend,
 revoke, or annul such LICENSES, credentials,  CERTIFICATES  OR  AUTHORI-
 ZATIONS  for good cause in accordance with procedures promulgated by the
 commissioner by rule or regulation.
   (3) For the purpose of this title, the term "ADDICTION  PROFESSIONAL",
 INCLUDING  "credentialed  alcoholism  and  substance abuse counselor" or
 "C.A.S.A.C.", means an official designation identifying an individual as
 one who holds a currently  registered  and  valid  LICENSE,  credential,

 S. 2507                            77                            A. 3007
 
 CERTIFICATE  OR AUTHORIZATION issued OR APPROVED by the office of [alco-
 holism and substance abuse services]  ADDICTION  SERVICES  AND  SUPPORTS
 pursuant  to this section which documents an individual's qualifications
 to  provide [alcoholism and substance abuse counseling] ADDICTION DISOR-
 DER SERVICES. The term "gambling  addiction  [counselor"]  PROFESSIONAL"
 means an official designation identifying an individual as one who holds
 a  currently  registered  and  valid LICENSE, credential, CERTIFICATE OR
 AUTHORIZATION issued by the office of [alcoholism  and  substance  abuse
 services] ADDICTION SERVICES AND SUPPORTS pursuant to this section which
 documents  an individual's qualifications to provide [compulsive] gambl-
 ing [counseling] DISORDER SERVICES.
   (i) No  person  shall  use  the  title  [credentialed  alcoholism  and
 substance  abuse counselor or "C.A.S.A.C." or gambling addiction counse-
 lor] "ADDICTION PROFESSIONAL"  OR  THE  TITLE  GIVEN  TO  ANY  LICENSES,
 CREDENTIALS,  CERTIFICATES OR AUTHORIZATIONS ISSUED BY THE OFFICE unless
 authorized [pursuant to] BY THE COMMISSIONER  IN  ACCORDANCE  WITH  this
 title.
   (ii)  Failure  to  comply  with the requirements of this section shall
 constitute a violation as defined in the penal law.
   (4) All persons holding previously  issued  and  valid  alcoholism  or
 substance  abuse counselor credentials ISSUED BY THE OFFICE OR AN ENTITY
 DESIGNATED BY  THE  OFFICE,  INCLUDING  A  CREDENTIALED  ALCOHOLISM  AND
 SUBSTANCE ABUSE COUNSELOR, CERTIFIED PREVENTION SPECIALIST, CREDENTIALED
 PREVENTION PROFESSIONAL, CREDENTIALED PROBLEM GAMBLING COUNSELOR, GAMBL-
 ING  SPECIALTY  DESIGNATION,  CERTIFIED  RECOVERY  PEER ADVOCATE, on the
 effective date of amendments to this section shall be deemed [C.A.S.A.C.
 designated] AN ADDICTION PROFESSIONAL CONSISTENT WITH  THEIR  EXPERIENCE
 AND EDUCATION.
   (e)  Consistent  with  the  requirements of subdivision (b) of section
 5.05 of this chapter, the office shall carry out the provisions of arti-
 cle thirty-two of this chapter as such article  pertains  to  regulation
 and   quality   control  of  [chemical  dependence]  ADDICTION  DISORDER
 services, including but not limited to the  establishment  of  standards
 for  determining  the necessity and appropriateness of care and services
 provided  by  [chemical  dependence]  ADDICTION  DISORDER  providers  of
 services. In implementing this subdivision, the commissioner, in consul-
 tation  with the commissioner of health, shall adopt standards including
 necessary rules and regulations including but not limited to  those  for
 determining the necessity or appropriate level of admission, controlling
 the  length  of stay and the provision of services, and establishing the
 methods and procedures for making such determination.
   (f) The office of [alcoholism and substance abuse services]  ADDICTION
 SERVICES  AND  SUPPORTS  shall develop a list of all agencies throughout
 the state which are currently certified by the office and are capable of
 and available to provide evaluations in accordance with  section  sixty-
 five-b of the alcoholic beverage control law so as to determine need for
 treatment  pursuant  to  such  section and to assure the availability of
 such evaluation services by  a  certified  agency  within  a  reasonable
 distance  of every court of a local jurisdiction in the state. Such list
 shall be updated on a regular basis and shall be made available to every
 supreme court law library in this state, or, if  no  supreme  court  law
 library is available in a certain county, to the county court library of
 such  county. THE COMMISSIONER MAY ESTABLISH AN ANNUAL FEE FOR INCLUSION
 ON SUCH LIST.
   (g) The office of [alcoholism and substance abuse services]  ADDICTION
 SERVICES AND SUPPORTS shall develop and maintain a list of the names and

 S. 2507                            78                            A. 3007
 
 locations  of  all  licensed  agencies and [alcohol and substance abuse]
 ADDICTION professionals, as defined in paragraphs (a) and (b) of  subdi-
 vision  one  of section eleven hundred ninety-eight-a of the vehicle and
 traffic  law, throughout the state which are capable of and available to
 provide an assessment of, and  treatment  for,  [alcohol  and  substance
 abuse  and  dependency] ADDICTION DISORDERS. Such list shall be provided
 to the chief administrator of the office of court administration and the
 commissioner of motor vehicles. Persons who may be aggrieved by an agen-
 cy decision regarding inclusion on the list may request  an  administra-
 tive  appeal in accordance with rules and regulations of the office. THE
 COMMISSIONER MAY ESTABLISH AN ANNUAL FEE FOR INCLUSION ON SUCH LIST.
   (h) The office of [alcoholism and substance abuse services]  ADDICTION
 SERVICES  AND  SUPPORTS shall monitor programs providing care and treat-
 ment to inmates in correctional facilities operated by the department of
 corrections and community supervision who have a history of [alcohol  or
 substance  abuse  or dependence] AN ADDICTION DISORDER. The office shall
 also develop guidelines for the  operation  of  [alcohol  and  substance
 abuse  treatment  programs]  ADDICTION DISORDER SERVICES in such correc-
 tional facilities in order to ensure  that  such  programs  sufficiently
 meet  the needs of inmates with a history of [alcohol or substance abuse
 or dependence] AN ADDICTION DISORDER and promote the successful  transi-
 tion to treatment in the community upon release. No later than the first
 day of December of each year, the office shall submit a report regarding
 the  adequacy and effectiveness of alcohol and substance abuse treatment
 programs operated by the department of corrections and community  super-
 vision  to  the  governor,  the  temporary  president of the senate, the
 speaker of the assembly, the chairman of the senate committee  on  crime
 victims,  crime and correction, and the chairman of the assembly commit-
 tee on correction.
   (i) The office of [alcoholism and substance abuse services]  ADDICTION
 SERVICES AND SUPPORTS shall periodically, in consultation with the state
 director  of veterans' services: (1) review the programs operated by the
 office to ensure that the needs of the state's veterans  who  served  in
 the  U.S.  armed  forces  and  who  are  recovering from [alcohol and/or
 substance abuse] AN ADDICTION DISORDER are  being  met  and  to  develop
 improvements  to  programs  to meet such needs; and (2) in collaboration
 with the state director of veterans' services and  the  commissioner  of
 the  office of mental health, review and make recommendations to improve
 programs that provide treatment, rehabilitation, relapse prevention, and
 recovery services to veterans who have served in  a  combat  theatre  or
 combat  zone  of  operations  and  have a co-occurring mental health and
 [alcoholism or substance abuse] ADDICTION disorder.
   (j) The office, in consultation with the state  education  department,
 shall identify or develop materials on problem gambling among school-age
 youth  which  may  be used by school districts and boards of cooperative
 educational services, at  their  option,  to  educate  students  on  the
 dangers  and  consequences of problem gambling as they deem appropriate.
 Such materials shall be available on the internet website of  the  state
 education department. The internet website of the office shall provide a
 hyperlink  to  the  internet page of the state education department that
 displays such materials.
   (k) Heroin and opioid addiction awareness and education  program.  The
 commissioner,  in cooperation with the commissioner of the department of
 health, shall develop and conduct a  public  awareness  and  educational
 campaign  on  heroin  and  opioid  addiction. The campaign shall utilize
 public forums, social media and mass media, including, but  not  limited

 S. 2507                            79                            A. 3007
 
 to,  internet, radio, and print advertising such as billboards and post-
 ers and shall also include posting of materials and information  on  the
 office  website.  The  campaign  shall  be  tailored  to  educate youth,
 parents,  healthcare professionals and the general public regarding: (1)
 the risks associated with the abuse and misuse of  heroin  and  opioids;
 (2)  how  to  recognize  the  signs  of addiction; and (3) the resources
 available for those needing assistance with heroin or opioid  addiction.
 The  campaign  shall  further  be  designed  to enhance awareness of the
 opioid overdose prevention program authorized pursuant to section  thir-
 ty-three  hundred  nine of the public health law and the "Good Samaritan
 law" established pursuant to sections 220.03 and 220.78 of the penal law
 and section 390.40 of the criminal procedure  law,  and  to  reduce  the
 stigma associated with addiction.
   (l)  The office of [alcoholism and substance abuse services] ADDICTION
 SERVICES AND SUPPORTS, in consultation with the state education  depart-
 ment,  shall  develop  or  utilize  existing educational materials to be
 provided to school  districts  and  boards  of  cooperative  educational
 services  for  use  in  addition  to or in conjunction with any drug and
 alcohol related curriculum regarding the misuse and  abuse  of  alcohol,
 tobacco, prescription medication and other drugs with an increased focus
 on  substances  that  are most prevalent among school aged youth as such
 term is defined in section eight hundred four of the education law. Such
 materials shall be age appropriate for school age children, and  to  the
 extent  practicable,  shall include information or resources for parents
 to identify the warning signs and address the risks of substance [abuse]
 MISUSE AND ADDICTION.
   (m) (1) The office shall report on the status and outcomes  of  initi-
 atives  created  in  response  to  the heroin and opioid epidemic to the
 temporary president of the senate, the  speaker  of  the  assembly,  the
 chairs  of  the  assembly  and  senate committees on alcoholism and drug
 abuse, the chair of the assembly ways and means committee and the  chair
 of the senate finance committee.
   (2) Such reports shall include, to the extent practicable and applica-
 ble, information on:
   (i)  The  number  of  individuals  enrolled  in  the initiative in the
 preceding quarter;
   (ii) The number of individuals who completed the treatment program  in
 the preceding quarter;
   (iii)  The number of individuals discharged from the treatment program
 in the preceding quarter;
   (iv) The age and sex of the individuals served;
   (v) Relevant regional data about the individuals;
   (vi) The populations served; and
   (vii) The outcomes and effectiveness of each initiative surveyed.
   (3) Such initiatives shall include opioid treatment  programs,  crisis
 detoxification programs, 24/7 open access centers, adolescent club hous-
 es,  family  navigator  programs,  peer engagement specialists, recovery
 community and outreach centers, regional addiction resource centers  and
 the  state  implementation of the federal opioid state targeted response
 initiatives.
   (4) Such information shall be provided quarterly, beginning  no  later
 than July first, two thousand nineteen.
   § 2. This act shall take effect April 1, 2021.
 
                                  PART Z

 S. 2507                            80                            A. 3007
 
   Section  1.  The opening paragraph of subdivision (g) of section 31.16
 of the mental hygiene law, as amended by chapter  351  of  the  laws  of
 1994, is amended to read as follows:
   The commissioner may impose [a fine] SANCTIONS upon a finding that the
 holder  of  the  certificate  has failed to comply with the terms of the
 operating certificate or with the provisions of any applicable  statute,
 rule  or  regulation.  [The maximum amount of such fine shall not exceed
 one thousand dollars per day or fifteen thousand dollars per violation.]
 THE COMMISSIONER IS AUTHORIZED TO DEVELOP A SCHEDULE FOR THE PURPOSE  OF
 IMPOSING SUCH SANCTIONS.
   §  2.  Subdivision  (a)  of section 31.04 of the mental hygiene law is
 amended by adding a new paragraph 8 to read as follows:
   8. ESTABLISHING A SCHEDULE OF  FEES  FOR  THE  PURPOSE  OF  PROCESSING
 APPLICATIONS FOR THE ISSUANCE OF OPERATING CERTIFICATES. ALL FEES PURSU-
 ANT  TO THIS SECTION SHALL BE PAYABLE TO THE OFFICE FOR DEPOSIT INTO THE
 GENERAL FUND.
   § 3.  This act shall take effect on  the  one  hundred  eightieth  day
 after  it  shall  have become a law.  Effective immediately, the commis-
 sioner of mental health is authorized to promulgate any  and  all  rules
 and  regulations and take any other measures necessary to implement this
 act on its effective date or before such date.
 
                                  PART AA
 
   Section 1. This Part enacts into law legislation  relating  to  crisis
 stabilization  services,  Kendra's law and assisted outpatient treatment
 and involuntary commitment. Each component is wholly contained within  a
 Subpart  identified as Subparts A through C. The effective date for each
 particular provision contained within each Subpart is set forth  in  the
 last  section  of  such  Subpart. Any provision in any section contained
 within a Subpart, including the effective date  of  the  Subpart,  which
 makes  a  reference  to a section "of this act", when used in connection
 with that particular component, shall be deemed to mean and refer to the
 corresponding section of the Subpart in which it is found. Section three
 of this Part sets forth the general effective date of this Part.
 
                                 SUBPART A
 
   Section 1. The mental hygiene law is amended by adding a  new  section
 31.36 to read as follows:
 § 31.36 CRISIS STABILIZATION SERVICES.
   THE COMMISSIONER SHALL HAVE THE POWER, IN CONJUNCTION WITH THE COMMIS-
 SIONER  OF  THE  OFFICE  OF  ADDICTION  SERVICES AND SUPPORTS, TO CREATE
 CRISIS STABILIZATION CENTERS WITHIN NEW YORK STATE  IN  ACCORDANCE  WITH
 ARTICLE  THIRTY-SIX  OF  THIS TITLE, INCLUDING THE PROMULGATION OF JOINT
 REGULATIONS AND IMPLEMENTATION OF A FINANCING MECHANISM TO ALLOW FOR THE
 SUSTAINABLE OPERATION OF SUCH PROGRAMS.
   § 2. The mental hygiene law is amended by adding a new  section  32.36
 to read as follows:
 § 32.36 CRISIS STABILIZATION SERVICES.
   THE COMMISSIONER SHALL HAVE THE POWER, IN CONJUNCTION WITH THE COMMIS-
 SIONER  OF  THE  OFFICE OF MENTAL HEALTH, TO CREATE CRISIS STABILIZATION
 CENTERS WITHIN NEW YORK STATE IN ACCORDANCE WITH ARTICLE  THIRTY-SIX  OF
 THIS  TITLE,  INCLUDING THE PROMULGATION OF JOINT REGULATIONS AND IMPLE-
 MENTATION OF A FINANCING MECHANISM TO ALLOW FOR THE  SUSTAINABLE  OPERA-
 TION OF SUCH PROGRAMS.

 S. 2507                            81                            A. 3007
 
   §  3.  The mental hygiene law is amended by adding a new article 36 to
 read as follows:
                               ARTICLE XXXVI
             ADDICTION AND MENTAL HEALTH SERVICES AND SUPPORTS
 SECTION 36.01 CRISIS STABILIZATION CENTERS.
 § 36.01 CRISIS STABILIZATION CENTERS.
   (A)  (1)  THE  COMMISSIONERS  ARE AUTHORIZED TO JOINTLY LICENSE CRISIS
 STABILIZATION CENTERS SUBJECT TO THE AVAILABILITY OF STATE  AND  FEDERAL
 FUNDING.
   (2)  A CRISIS STABILIZATION CENTER SHALL SERVE AS AN EMERGENCY SERVICE
 PROVIDER FOR PERSONS WITH PSYCHIATRIC AND/OR SUBSTANCE USE DISORDER THAT
 ARE IN NEED OF CRISIS STABILIZATION SERVICES. EACH CRISIS  STABILIZATION
 CENTER  SHALL  PROVIDE  OR  CONTRACT  TO  PROVIDE  CRISIS  STABILIZATION
 SERVICES FOR MENTAL HEALTH OR SUBSTANCE USE TWENTY-FOUR HOURS  PER  DAY,
 SEVEN DAYS PER WEEK, INCLUDING BUT NOT LIMITED TO:
   (I) ENGAGEMENT, TRIAGE AND ASSESSMENT;
   (II) CONTINUOUS OBSERVATION;
   (III) MILD TO MODERATE DETOXIFICATION;
   (IV) SOBERING SERVICES;
   (V) THERAPEUTIC INTERVENTIONS;
   (VI) DISCHARGE AND AFTER CARE PLANNING;
   (VII) TELEMEDICINE;
   (VIII) PEER SUPPORT SERVICES; AND
   (IX) MEDICATION ASSISTED TREATMENT.
   (3)  THE  COMMISSIONERS SHALL REQUIRE EACH CRISIS STABILIZATION CENTER
 TO SUBMIT A PLAN. THE PLAN SHALL BE APPROVED BY THE COMMISSIONERS  PRIOR
 TO  THE  ISSUANCE  OF AN OPERATING CERTIFICATE PURSUANT TO THIS ARTICLE.
 EACH PLAN SHALL INCLUDE:
   (I) A DESCRIPTION OF THE CENTER'S CATCHMENT AREA,
   (II) A DESCRIPTION OF THE CENTER'S CRISIS STABILIZATION SERVICES,
   (III) AGREEMENTS OR AFFILIATIONS WITH HOSPITALS AS DEFINED IN  SECTION
 1.03 OF THIS CHAPTER,
   (IV) AGREEMENTS OR AFFILIATIONS WITH GENERAL HOSPITALS OR LAW ENFORCE-
 MENT TO RECEIVE PERSONS,
   (V)  A  DESCRIPTION  OF  LOCAL  RESOURCES  AVAILABLE  TO THE CENTER TO
 PREVENT UNNECESSARY HOSPITALIZATIONS OF PERSONS,
   (VI) A DESCRIPTION OF THE CENTER'S LINKAGES WITH  LOCAL  POLICE  AGEN-
 CIES, EMERGENCY MEDICAL SERVICES, AMBULANCE SERVICES AND OTHER TRANSPOR-
 TATION AGENCIES,
   (VII)  A  DESCRIPTION  OF  LOCAL  RESOURCES AVAILABLE TO THE CENTER TO
 PROVIDE APPROPRIATE COMMUNITY MENTAL HEALTH AND SUBSTANCE  USE  DISORDER
 SERVICES UPON RELEASE,
   (VIII)  WRITTEN  CRITERIA AND GUIDELINES FOR THE DEVELOPMENT OF APPRO-
 PRIATE PLANNING FOR PERSONS IN  NEED  OF  POST  COMMUNITY  TREATMENT  OR
 SERVICES,
   (IX)  A  STATEMENT  INDICATING THAT THE CENTER HAS BEEN INCLUDED IN AN
 APPROVED LOCAL SERVICES PLAN DEVELOPED PURSUANT TO ARTICLE FORTY-ONE  OF
 THIS  CHAPTER  FOR  EACH  LOCAL  GOVERNMENT  LOCATED WITHIN THE CENTER'S
 CATCHMENT AREA; AND
   (X) ANY OTHER INFORMATION OR AGREEMENTS REQUIRED BY THE COMMISSIONERS.
   (4) CRISIS STABILIZATION  CENTERS  SHALL  PARTICIPATE  IN  COUNTY  AND
 COMMUNITY  PLANNING  ACTIVITIES ANNUALLY, AND AS ADDITIONALLY NEEDED, IN
 ORDER TO PARTICIPATE IN LOCAL COMMUNITY SERVICE  PLANNING  PROCESSES  TO
 ENSURE, MAINTAIN, IMPROVE OR DEVELOP COMMUNITY SERVICES THAT DEMONSTRATE
 RECOVERY OUTCOMES. THESE OUTCOMES INCLUDE, BUT ARE NOT LIMITED TO, QUAL-

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 ITY  OF LIFE, SOCIO-ECONOMIC STATUS, ENTITLEMENT STATUS, SOCIAL NETWORK-
 ING, COPING SKILLS AND REDUCTION IN USE OF CRISIS SERVICES.
   (B) EACH CRISIS STABILIZATION CENTER SHALL BE STAFFED WITH A MULTIDIS-
 CIPLINARY  TEAM CAPABLE OF MEETING THE NEEDS OF INDIVIDUALS EXPERIENCING
 ALL LEVELS OF CRISIS IN THE  COMMUNITY  BUT  SHALL  HAVE  AT  LEAST  ONE
 PSYCHIATRIST  OR PSYCHIATRIC NURSE PRACTITIONER, A CREDENTIALED ALCOHOL-
 ISM AND SUBSTANCE ABUSE COUNSELOR AND ONE  PEER  SUPPORT  SPECIALIST  ON
 DUTY  AND  AVAILABLE  AT ALL TIMES, PROVIDED, HOWEVER, THE COMMISSIONERS
 MAY PROMULGATE REGULATIONS TO PERMIT THE ISSUANCE OF A  WAIVER  OF  THIS
 REQUIREMENT WHEN THE VOLUME OF SERVICE OF A CENTER DOES NOT REQUIRE SUCH
 LEVEL OF STAFF COVERAGE.
   (C)  THE  COMMISSIONERS  SHALL PROMULGATE REGULATIONS NECESSARY TO THE
 OPERATION OF SUCH CRISIS STABILIZATION CENTERS.
   (D) FOR THE PURPOSE OF ADDRESSING UNIQUE RURAL SERVICE DELIVERY  NEEDS
 AND CONDITIONS, THE COMMISSIONERS SHALL PROVIDE TECHNICAL ASSISTANCE FOR
 THE  ESTABLISHMENT  OF  CRISIS  STABILIZATION CENTERS OTHERWISE APPROVED
 UNDER THE PROVISIONS OF THIS SECTION, INCLUDING TECHNICAL ASSISTANCE  TO
 PROMOTE  AND FACILITATE THE ESTABLISHMENT OF SUCH CENTERS IN RURAL AREAS
 IN THE STATE OR COMBINATIONS OF RURAL COUNTIES.
   (E) THE COMMISSIONERS SHALL DEVELOP GUIDELINES FOR EDUCATIONAL MATERI-
 ALS TO ASSIST CRISIS STABILIZATION CENTERS IN  EDUCATING  LOCAL  PRACTI-
 TIONERS,  HOSPITALS,  LAW  ENFORCEMENT  AND  PEERS. SUCH MATERIALS SHALL
 INCLUDE APPROPRIATE  EDUCATION  RELATING  TO  DE-ESCALATION  TECHNIQUES,
 CULTURAL COMPETENCY, THE RECOVERY PROCESS, MENTAL HEALTH, SUBSTANCE USE,
 AND AVOIDANCE OF AGGRESSIVE CONFRONTATION.
   § 4. Section 9.41 of the mental hygiene law, as amended by chapter 723
 of the laws of 1989, is amended to read as follows:
 § 9.41 Emergency  [admissions]  ASSESSMENT  for  immediate  observation,
            care, and treatment; powers of  certain  peace  officers  and
            police officers.
   Any  peace officer, when acting pursuant to his or her special duties,
 or police officer who is a member of the state police or of  an  author-
 ized  police  department  or force or of a sheriff's department may take
 into custody any person who appears to be mentally ill and is conducting
 himself or herself in a manner which is likely to result in serious harm
 to the person or others. Such officer may direct  the  removal  of  such
 person  or  remove him or her to: (A) any hospital specified in subdivi-
 sion (a) of section 9.39 OF  THIS  ARTICLE,  or  (B)  any  comprehensive
 psychiatric  emergency  program  specified in subdivision (a) of section
 9.40 OF THIS ARTICLE, or[,] (C) TO ANY CRISIS STABILIZATION CENTER SPEC-
 IFIED IN SECTION 36.01 OF THIS CHAPTER,  WHEN  THE  OFFICER  DEEMS  SUCH
 CENTER  IS  APPROPRIATE AND WHERE SUCH PERSON AGREES, OR (D) pending his
 or her examination or admission to any such hospital [or],  program,  OR
 CENTER, temporarily detain any such person in another safe and comforta-
 ble  place,  in  which  event, such officer shall immediately notify the
 director of community services or, if there be none, the health  officer
 of the city or county of such action.
   § 5. Section 9.43 of the mental hygiene law, as amended by chapter 723
 of the laws of 1989, is amended to read as follows:
 § 9.43 Emergency  [admissions]  ASSESSMENT  for  immediate  observation,
            care, and treatment; powers of courts.
   (a) Whenever any court of inferior or general jurisdiction is informed
 by verified statement that a person is apparently mentally  ill  and  is
 conducting  himself  or herself in a manner which in a person who is not
 mentally ill would be deemed disorderly conduct or which  is  likely  to
 result  in  serious harm to himself or herself, such court shall issue a

 S. 2507                            83                            A. 3007

 warrant directing that such person be brought before it. If,  when  said
 person  is  brought  before  the  court, it appears to the court, on the
 basis of evidence presented to it, that such person has or  may  have  a
 mental  illness  which is likely to result in serious harm to himself or
 herself or others, the court shall issue a civil order directing his  or
 her removal to any hospital specified in subdivision (a) of section 9.39
 OF THIS ARTICLE or any comprehensive psychiatric emergency program spec-
 ified  in  subdivision  (a)  of  section 9.40 OF THIS ARTICLE, OR TO ANY
 CRISIS STABILIZATION CENTER SPECIFIED IN SECTION 36.01 OF  THIS  CHAPTER
 WHEN  THE  COURT  DEEMS SUCH CENTER IS APPROPRIATE AND WHERE SUCH PERSON
 AGREES; THAT IS willing to receive such person for  a  determination  by
 the  director  of  such  hospital  [or],  program OR CENTER whether such
 person should be [retained] RECEIVED therein pursuant to such section.
   (b) Whenever a person before a court in a criminal action  appears  to
 have  a  mental  illness  which  is  likely to result in serious harm to
 himself or herself or others and the court determines  either  that  the
 crime  has  not  been committed or that there is not sufficient cause to
 believe that such person is guilty thereof, the court may issue a  civil
 order  as  above  provided,  and in such cases the criminal action shall
 terminate.
   § 6. Section 9.45 of the mental hygiene law, as amended by chapter 723
 of the laws of 1989 and the opening paragraph as amended by chapter  192
 of the laws of 2005, is amended to read as follows:
 § 9.45 Emergency  [admissions]  ASSESSMENT  for  immediate  observation,
            care,  and  treatment;  powers  of  directors  of   community
            services.
   The  director  of  community services or the director's designee shall
 have the power to direct the removal of any person, within  his  or  her
 jurisdiction,  to  a  hospital  approved by the commissioner pursuant to
 subdivision (a) of section 9.39 of this article, or to  a  comprehensive
 psychiatric  emergency  program  pursuant  to subdivision (a) of section
 9.40 of this article, OR TO ANY CRISIS STABILIZATION CENTER SPECIFIED IN
 SECTION 36.01 OF THIS CHAPTER WHEN THE DIRECTOR  DEEMS  SUCH  CENTER  IS
 APPROPRIATE  AND WHERE SUCH PERSON AGREES, if the parent, adult sibling,
 spouse or child of the person, the committee or legal  guardian  of  the
 person, a licensed psychologist, registered professional nurse or certi-
 fied   social  worker  currently  responsible  for  providing  treatment
 services to the person, a supportive or intensive case manager currently
 assigned to the person by a case management  program  which  program  is
 approved  by  the  office  of mental health for the purpose of reporting
 under this section, a licensed physician, health officer, peace  officer
 or  police  officer  reports to him or her that such person has a mental
 illness for which immediate care and treatment [in a hospital] is appro-
 priate and which is likely to result  in  serious  harm  to  himself  or
 herself  or  others. It shall be the duty of peace officers, when acting
 pursuant to their special duties, or police officers, who are members of
 an authorized police department or force or of a sheriff's department to
 assist representatives of such director to take into custody and  trans-
 port  any  such  person.  Upon  the  request  of a director of community
 services or the director's designee an ambulance service, as defined  in
 subdivision  two of section three thousand one of the public health law,
 is authorized to transport any such person.  Such  person  may  then  be
 retained  in  a  hospital  pursuant to the provisions of section 9.39 of
 this article or in a comprehensive psychiatric emergency program  pursu-
 ant  to  the provisions of section 9.40 of this article OR TO ANY CRISIS

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 STABILIZATION CENTER SPECIFIED IN SECTION 36.01 OF THIS CHAPTER WHEN THE
 DIRECTOR DEEMS SUCH CENTER IS APPROPRIATE AND WHERE SUCH PERSON AGREES.
   §  7.    Subdivision (a) of section 9.58 of the mental hygiene law, as
 added by chapter 678 of the laws of 1994, is amended to read as follows:
   (a) A physician or qualified  mental  health  professional  who  is  a
 member  of  an approved mobile crisis outreach team shall have the power
 to remove, or pursuant to subdivision (b) of this section, to direct the
 removal of any person WHO APPEARS TO BE MENTALLY ILL AND  IS  CONDUCTING
 THEMSELVES  IN  A  MANNER  WHICH  IS LIKELY TO RESULT IN SERIOUS HARM TO
 THEMSELVES OR OTHERS, to a hospital approved by the commissioner  pursu-
 ant  to subdivision (a) of section 9.39 or section 31.27 of this chapter
 [for the purpose of evaluation for admission if such person  appears  to
 be  mentally  ill and is conducting himself or herself in a manner which
 is likely to result in serious harm to the person or  others]  OR  WHERE
 THE  DIRECTOR DEEMS APPROPRIATE AND WHERE THE PERSON AGREES, TO A CRISIS
 STABILIZATION CENTER SPECIFIED IN SECTION 36.01 OF THIS CHAPTER.
   § 8. Subdivision 2 of section 365-a of  the  social  services  law  is
 amended by adding a new paragraph (gg) to read as follows:
   (GG)  ADDICTION  AND  MENTAL  HEALTH SERVICES AND SUPPORTS PROVIDED BY
 FACILITIES LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF THE MENTAL HYGIENE
 LAW.
   § 9. Paragraph 5 of subdivision (a) of section  22.09  of  the  mental
 hygiene law, as amended by section 1 of part D of chapter 69 of the laws
 of 2016, is amended to read as follows:
   5. "Treatment facility" means a facility designated by the commission-
 er which may only include a general hospital as defined in article twen-
 ty-eight  of  the public health law, or a medically managed or medically
 supervised withdrawal, inpatient rehabilitation, or residential stabili-
 zation treatment program that has been certified by the commissioner  to
 have appropriate medical staff available on-site at all times to provide
 emergency  services  and continued evaluation of capacity of individuals
 retained under this section OR A CRISIS  STABILIZATION  CENTER  LICENSED
 PURSUANT TO ARTICLE 36.01 OF THIS CHAPTER.
   §  10.  The commissioner of health, in consultation with the office of
 mental health and the office of addiction services and  supports,  shall
 seek  Medicaid  federal financial participation from the federal centers
 for Medicare and Medicaid services for the federal share of payments for
 the services authorized pursuant to this Subpart.
   § 11. This act shall take effect October 1, 2021;  provided,  however,
 that  the  amendments  to  sections  9.41,  9.43  and 9.45 of the mental
 hygiene law made by sections four, five and six of this  act  shall  not
 affect  the  expiration  of  such  sections  and shall expire therewith.
 Effective immediately, the addition, amendment and/or repeal of any rule
 or regulation necessary for the implementation of this act on its effec-
 tive date are authorized to be made and  completed  on  or  before  such
 effective date.
 
                                 SUBPART B
 
   Section  1. Paragraph 4 of subdivision (c), paragraph 2 of subdivision
 (h), paragraph 1 of subdivision (k) and subdivision (l) of section  9.60
 of the mental hygiene law, as amended by chapter 158 of the laws of 2005
 and  paragraph 1 of subdivision (k) as added by chapter 1 of the laws of
 2013, are amended to read as follows:
   (4) has a history of lack of  compliance  with  treatment  for  mental
 illness that has:

 S. 2507                            85                            A. 3007
 
   (i)  EXCEPT  AS  OTHERWISE PROVIDED IN SUBPARAGRAPH (II) OF THIS PARA-
 GRAPH, prior to the filing of the petition, at least  twice  within  the
 last thirty-six months been a significant factor in necessitating hospi-
 talization  in a hospital, or receipt of services in a forensic or other
 mental  health  unit  of a correctional facility or a local correctional
 facility, not including any current period, or period ending within  the
 last  six  months,  during  which  the  person was or is hospitalized or
 incarcerated; or
   (ii) EXCEPT AS OTHERWISE PROVIDED IN SUBPARAGRAPH (III) OF THIS  PARA-
 GRAPH, prior to the filing of the petition, resulted in one or more acts
 of  serious  violent  behavior  toward  self or others or threats of, or
 attempts at, serious physical harm to self or  others  within  the  last
 forty-eight  months,  not including any current period, or period ending
 within the last six months, in which the person was or  is  hospitalized
 or incarcerated; [and] OR
   (III)  NOTWITHSTANDING  SUBPARAGRAPHS  (I) AND (II) OF THIS PARAGRAPH,
 RESULTED IN THE ISSUANCE OF AN ORDER FOR ASSISTED  OUTPATIENT  TREATMENT
 WHICH  HAS  EXPIRED WITHIN THE LAST SIX MONTHS, AND SINCE THE EXPIRATION
 OF THE ORDER, THE PERSON HAS EXPERIENCED A SUBSTANTIAL INCREASE IN SYMP-
 TOMS OF MENTAL ILLNESS AND A LOSS OF FUNCTION.
   (2) The court shall not order assisted outpatient treatment unless  an
 examining  physician,  who  recommends assisted outpatient treatment and
 has personally examined the subject of the petition  no  more  than  ten
 days  before  the  filing  of the petition, testifies [in person] at the
 hearing. Such physician shall state  the  facts  and  clinical  determi-
 nations  which  support  the allegation that the subject of the petition
 meets each of the criteria for assisted outpatient treatment.
   (1) Prior to the expiration of an order pursuant to this section,  the
 appropriate  director  shall  review  whether  the  assisted  outpatient
 continues to [meet the criteria for] BENEFIT  FROM  assisted  outpatient
 treatment.  If,  as  documented in the petition, (I) the director deter-
 mines that [such criteria continue to be met]: (A) AS A RESULT OF HIS OR
 HER MENTAL ILLNESS, THE OUTPATIENT IS UNLIKELY  TO  VOLUNTARILY  PARTIC-
 IPATE IN OUTPATIENT TREATMENT THAT WOULD ENABLE HIM OR HER TO LIVE SAFE-
 LY IN THE COMMUNITY; AND (B) IN VIEW OF HIS OR HER TREATMENT HISTORY AND
 CURRENT  BEHAVIOR,  IS IN NEED OF ASSISTED OUTPATIENT TREATMENT IN ORDER
 TO PREVENT A RELAPSE OR DETERIORATION WHICH WOULD BE LIKELY TO RESULT IN
 SERIOUS HARM TO THE PERSON OR OTHERS AS DEFINED IN SECTION 9.01 OF  THIS
 ARTICLE;  AND  (C)  THE  OUTPATIENT  IS LIKELY TO BENEFIT FROM CONTINUED
 ASSISTED OUTPATIENT TREATMENT; or (II) THE DIRECTOR has made appropriate
 attempts to, but has not been successful in eliciting,  the  cooperation
 of  the subject to submit to an examination, within thirty days prior to
 the expiration of an order of assisted outpatient treatment, such direc-
 tor may petition the court to order continued assisted outpatient treat-
 ment pursuant to paragraph two of  this  subdivision.  Upon  determining
 whether such criteria continue to be met, such director shall notify the
 program  coordinator  in  writing as to whether a petition for continued
 assisted outpatient treatment is warranted and whether such  a  petition
 was or will be filed.
   (l)  Petition  for an order to stay, vacate [or], modify OR EXTEND THE
 ORDER. (1) In addition to any other right or  remedy  available  by  law
 with  respect  to  the  order  for  assisted  outpatient  treatment, the
 assisted outpatient, the mental hygiene legal service, or anyone  acting
 on  the assisted outpatient's behalf may petition the court on notice to
 the director, the original petitioner, and all others entitled to notice
 under subdivision (f) of this section to stay, vacate [or],  modify,  OR

 S. 2507                            86                            A. 3007
 
 EXTEND  the  order.   AN APPLICATION FOR AN EXTENSION OF A CURRENT ORDER
 CAN BE MADE WHEN THE APPROPRIATE DIRECTOR HAS MADE ATTEMPTS BUT HAS  NOT
 BEEN  SUCCESSFUL IN GIVING THE SUBJECT OF THE PETITION THE NOTICE OF THE
 HEARING.
   (2)  The  appropriate  director  shall petition the court for approval
 before instituting a proposed material change in the assisted outpatient
 treatment plan, unless such change is authorized by  the  order  of  the
 court. Such petition shall be filed on notice to all parties entitled to
 notice  under  subdivision (f) of this section. Not later than five days
 after receiving such petition, excluding Saturdays,  Sundays  and  holi-
 days,  the  court shall hold a hearing on the petition; provided that if
 the assisted outpatient informs the court that he or she agrees  to  the
 proposed  material  change,  the court may approve such change without a
 hearing. Non-material changes may be instituted by the director  without
 court approval. For the purposes of this paragraph, a material change is
 an  addition  or deletion of a category of services to or from a current
 assisted  outpatient  treatment  plan,  or  any  deviation  without  the
 assisted outpatient's consent from the terms of a current order relating
 to the administration of psychotropic drugs.
   §  2.  This act shall take effect immediately; provided, however, that
 the amendments to section 9.60 of the mental hygiene law made by section
 one of this act shall not affect the repeal of such section and shall be
 deemed repealed therewith.
 
                                 SUBPART C
 
   Section 1. The third undesignated paragraph of  section  9.01  of  the
 mental  hygiene  law,  as amended by chapter 723 of the laws of 1989, is
 amended to read as follows:
   "likelihood to result in serious harm" or "likely to result in serious
 harm" means (a) a substantial risk of physical harm  to  the  person  as
 manifested  by  threats of or attempts at suicide or serious bodily harm
 or other conduct demonstrating that the person is dangerous  to  himself
 or  herself[,]; or (b) A SUBSTANTIAL RISK OF PHYSICAL HARM TO THE PERSON
 ARISING FROM SUCH COMPLETE NEGLECT OF BASIC NEEDS  FOR  FOOD,  CLOTHING,
 SHELTER  OR  PERSONAL  SAFETY AS TO RENDER SERIOUS ACCIDENT, ILLNESS, OR
 DEATH IS HIGHLY PROBABLE IF CARE BY ANOTHER  IS  NOT  TAKEN;  OR  (C)  a
 substantial  risk  of  physical  harm  to other persons as manifested by
 homicidal or other violent  behavior  by  which  others  are  placed  in
 reasonable fear of serious physical harm.
   §  2.  Paragraph  2  of  subdivision (a) of section 9.39 of the mental
 hygiene law, as amended by chapter 789 of the laws of 1985,  is  amended
 and a new paragraph 3 is added to read as follows:
   2.  a substantial risk of physical harm to other persons as manifested
 by homicidal or other violent behavior by which  others  are  placed  in
 reasonable fear of serious physical harm[.], OR
   3. A SUBSTANTIAL RISK OF PHYSICAL HARM TO THE PERSON ARISING FROM SUCH
 COMPLETE  NEGLECT OF BASIC NEEDS FOR FOOD, CLOTHING, SHELTER OR PERSONAL
 SAFETY AS TO RENDER SERIOUS ACCIDENT, ILLNESS, OR DEATH IS HIGHLY PROBA-
 BLE IF CARE BY ANOTHER IS NOT TAKEN.
   § 3. This act shall take effect October 1, 2021.
   § 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

 S. 2507                            87                            A. 3007
 
 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 Subparts A through C of this act  shall
 be as specifically set forth in the last section of such Subparts.
 
                                  PART BB
 
   Section  1. Subdivision (b) of section 7.17 of the mental hygiene law,
 as amended by section 1 of part H of chapter 56 of the laws of 2013,  is
 amended to read as follows:
   (b)  There  shall  be  in the office the hospitals named below for the
 care, treatment and rehabilitation of persons with  mental  illness  and
 for  research  and  teaching  in the science and skills required for the
 care, treatment and rehabilitation of such persons with mental illness.
   Greater Binghamton Health Center
   Bronx Psychiatric Center
   Buffalo Psychiatric Center
   Capital District Psychiatric Center
   Central New York Psychiatric Center
   Creedmoor Psychiatric Center
   Elmira Psychiatric Center
   Kingsboro Psychiatric Center
   Kirby Forensic Psychiatric Center
   Manhattan Psychiatric Center
   Mid-Hudson Forensic Psychiatric Center
   Mohawk Valley Psychiatric Center
   Nathan S. Kline Institute for Psychiatric Research
   New York State Psychiatric Institute
   Pilgrim Psychiatric Center
   Richard H. Hutchings Psychiatric Center
   Rochester Psychiatric Center
   Rockland Psychiatric Center
   St. Lawrence Psychiatric Center
   South Beach Psychiatric Center
   New York City Children's Center
   Rockland Children's Psychiatric Center
   Sagamore Children's Psychiatric Center
   Western New York Children's Psychiatric Center
   The New York State Psychiatric  Institute  and  The  Nathan  S.  Kline
 Institute  for Psychiatric Research are designated as institutes for the
 conduct of medical research and other scientific investigation  directed
 towards  furthering  knowledge of the etiology, diagnosis, treatment and
 prevention of mental illness.  THE NEW YORK STATE PSYCHIATRIC  INSTITUTE
 SHALL  OPERATE,  AS A SUB-ENTITY, THE NEW YORK STATE INSTITUTE FOR BASIC
 RESEARCH IN DEVELOPMENTAL DISABILITIES, WHICH IS DESIGNATED AS AN INSTI-
 TUTE FOR THE CONDUCT OF MEDICAL RESEARCH AND OTHER  SCIENTIFIC  INVESTI-
 GATION DIRECTED TOWARDS FURTHERING KNOWLEDGE OF THE ETIOLOGY, DIAGNOSIS,
 TREATMENT AND PREVENTION OF DEVELOPMENTAL DISABILITIES.
   §  2.  All employees of the office for people with developmental disa-
 bilities' New York State Institute for Basic Research  in  Developmental
 Disabilities,  who  are  substantially  engaged  in  the functions to be
 transferred, will be transferred to the office of  mental  health's  New

 S. 2507                            88                            A. 3007
 
 York State Psychiatric Institute pursuant to subdivision 2 of section 70
 of the civil service law.
   § 3. This act shall take effect immediately
 
                                  PART CC

   Section  1.  Subdivisions  2  and  2-a  of  section 1.03 of the mental
 hygiene law, subdivision 2 as amended and subdivision 2-a  as  added  by
 chapter 281 of the laws of 2019, are amended to read as follows:
   2.  ["Commissioner"  means the commissioner of mental health] "COMMIS-
 SIONER" MEANS THE COMMISSIONER OF ADDICTION AND MENTAL HEALTH  SERVICES,
 AND the commissioner of developmental disabilities [and the commissioner
 of  addiction  services and supports] as used in this chapter. Any power
 or duty heretofore assigned to the commissioner of mental hygiene or  to
 the department of mental hygiene pursuant to this chapter shall hereaft-
 er  be  assigned  to  the  commissioner  of  ADDICTION AND mental health
 SERVICES in the case of facilities, programs, or services  for  individ-
 uals with mental illness, to the commissioner of developmental disabili-
 ties  in  the  case of facilities, programs, or services for individuals
 with developmental disabilities, to the commissioner  of  addiction  AND
 MENTAL  HEALTH  services  [and  supports]  in  the  case  of facilities,
 programs,  or  addiction  disorder  services  in  accordance  with   the
 provisions of titles D and E of this chapter.
   2-a.  Notwithstanding  any  other section of law or regulation, on and
 after the effective date of this subdivision, any and all references  to
 the  office of alcoholism and substance abuse services and the predeces-
 sor agencies to the office of alcoholism and  substance  abuse  services
 including  the division of alcoholism and alcohol abuse and the division
 of substance abuse services AND ALL REFERENCES TO THE OFFICE  OF  MENTAL
 HEALTH,  shall  be  known  as the "office of addiction AND MENTAL HEALTH
 services [and supports]." Nothing in this subdivision shall be construed
 as requiring or prohibiting the further amendment of statutes  or  regu-
 lations to conform to the provisions of this subdivision.
   § 2. Section 5.01 of the mental hygiene law, as amended by chapter 281
 of  the  laws of 2019, is amended and two new sections 5.01-a and 5.01-b
 are added to read as follows:
 § 5.01 Department of mental hygiene.
   There shall continue to be in the state  government  a  department  of
 mental  hygiene.  Within  the  department  there  shall be the following
 autonomous offices:
   (1) office of ADDICTION AND mental health SERVICES; AND
   (2) office for people with developmental disabilities[;
   (3) office of addiction services and supports].
 § 5.01-A OFFICE OF ADDICTION AND MENTAL HEALTH SERVICES.
   (A) THE OFFICE OF  ADDICTION AND MENTAL HEALTH SERVICES SHALL BE A NEW
 OFFICE WITHIN THE DEPARTMENT FORMED BY THE INTEGRATION OF THE OFFICES OF
 MENTAL HEALTH AND ADDICTION SERVICES AND SUPPORTS WHICH SHALL  FOCUS  ON
 ISSUES  RELATED  TO  BOTH  MENTAL ILLNESS AND ADDICTION IN THE STATE AND
 CARRY OUT THE INTENT OF THE  LEGISLATURE  IN  ESTABLISHING  THE  OFFICES
 PURSUANT  TO  ARTICLES SEVEN AND NINETEEN OF THIS CHAPTER. THE OFFICE OF
 ADDICTION AND MENTAL HEALTH SERVICES IS CHARGED WITH ENSURING THE DEVEL-
 OPMENT OF COMPREHENSIVE PLANS FOR PROGRAMS AND SERVICES IN THE  AREA  OF
 RESEARCH,  PREVENTION, AND CARE AND TREATMENT, REHABILITATION, EDUCATION
 AND TRAINING, AND SHALL  BE  STAFFED  TO  PERFORM  THE  RESPONSIBILITIES
 ATTRIBUTED  TO  THE  OFFICE  PURSUANT TO SECTIONS 7.07 AND 19.07 OF THIS
 CHAPTER AND PROVIDE SERVICES AND PROGRAMS TO PROMOTE RECOVERY FOR  INDI-

 S. 2507                            89                            A. 3007
 
 VIDUALS  WITH  MENTAL ILLNESS, SUBSTANCE USE DISORDER, OR MENTAL ILLNESS
 AND SUBSTANCE USE DISORDER.
   (B)  THE  COMMISSIONER  OF  THE  OFFICE OF ADDICTION AND MENTAL HEALTH
 SERVICES SHALL BE VESTED WITH THE POWERS, DUTIES, AND OBLIGATIONS OF THE
 OFFICE OF MENTAL  HEALTH  AND  THE  OFFICE  OF  ADDICTION  SERVICES  AND
 SUPPORTS.
   (C)    THE  OFFICE OF ADDICTION AND MENTAL HEALTH SERVICES MAY LICENSE
 PROVIDERS TO PROVIDE INTEGRATED SERVICES  FOR  INDIVIDUALS  WITH  MENTAL
 ILLNESS,  SUBSTANCE  USE  DISORDER,  OR MENTAL ILLNESS AND SUBSTANCE USE
 DISORDER, IN ACCORDANCE WITH REGULATIONS ISSUED BY THE COMMISSIONER.
 § 5.01-B OFFICE OF ADDICTION AND MENTAL HEALTH SERVICES.
   UNTIL JANUARY FIRST, TWO THOUSAND TWENTY-TWO, THE OFFICE OF  ADDICTION
 AND  MENTAL HEALTH SERVICES SHALL CONSIST OF THE OFFICE OF MENTAL HEALTH
 AND THE OFFICE OF ADDICTION SERVICES AND SUPPORTS.
   § 3. Section 5.03 of the mental hygiene law, as amended by chapter 281
 of the laws of 2019, is amended to read as follows:
 § 5.03 Commissioners.
   The head of the office of ADDICTION AND mental health  SERVICES  shall
 be  the  commissioner  of  ADDICTION AND mental health SERVICES; AND the
 head of the office for people with developmental disabilities  shall  be
 the  commissioner  of  developmental  disabilities[; and the head of the
 office of addiction services and supports shall be the  commissioner  of
 addiction  services  and supports]. Each commissioner shall be appointed
 by the governor, by and with the advice and consent of  the  senate,  to
 serve  at  the  pleasure  of  the  governor.   UNTIL THE COMMISSIONER OF
 ADDICTION AND MENTAL HEALTH SERVICES IS APPOINTED BY  THE  GOVERNOR  AND
 CONFIRMED  BY  THE  SENATE,  THE  COMMISSIONER  OF MENTAL HEALTH AND THE
 COMMISSIONER OF ADDICTION SERVICES AND SUPPORTS SHALL CONTINUE TO  OVER-
 SEE MENTAL HEALTH AND ADDICTION SERVICES RESPECTIVELY, AND WORK COLLABO-
 RATIVELY  TO  INTEGRATE CARE FOR INDIVIDUALS WITH BOTH MENTAL HEALTH AND
 SUBSTANCE USE DISORDERS.
   § 4. Section 5.05 of the mental hygiene law, as added by  chapter  978
 of  the  laws  of 1977, subdivision (a) as amended by chapter 168 of the
 laws of 2010, subdivision (b) as amended by chapter 294 of the  laws  of
 2007,  paragraph 1 of subdivision (b) as amended by section 14 of part J
 of chapter 56 of the laws of 2012, subdivision (d) as added  by  chapter
 58  of  the  laws of 1988 and subdivision (e) as added by chapter 588 of
 the laws of 2011, is amended to read as follows:
 § 5.05 Powers and duties of the head of the department.
   (a) The commissioners of the office of  ADDICTION  AND  mental  health
 SERVICES  and  the office for people with developmental disabilities, as
 the heads of the department, shall jointly visit and inspect,  or  cause
 to  be  visited  and  inspected, all facilities either public or private
 used for the care, treatment  and  rehabilitation  of  individuals  with
 mental illness, SUBSTANCE USE DISORDER and developmental disabilities in
 accordance with the requirements of section four of article seventeen of
 the New York state constitution.
   (b)  (1)  The  commissioners  of  the  office  of ADDICTION AND mental
 health[,] SERVICES AND the office for people with developmental disabil-
 ities [and the office of alcoholism and substance abuse services]  shall
 constitute  an  inter-office coordinating council which, consistent with
 the autonomy of each office for matters within its  jurisdiction,  shall
 ensure  that  the  state  policy for the prevention, care, treatment and
 rehabilitation of individuals with mental illness, SUBSTANCE USE  DISOR-
 DERS   and   developmental  disabilities[,  alcoholism,  alcohol  abuse,
 substance abuse,  substance  dependence,  and  chemical  dependence]  is

 S. 2507                            90                            A. 3007
 
 planned,   developed  and  implemented  comprehensively;  that  gaps  in
 services to individuals with multiple disabilities  are  eliminated  and
 that  no  person  is denied treatment and services because he or she has
 more than one disability; that procedures for the regulation of programs
 which  offer  care and treatment for more than one class of persons with
 mental disabilities be coordinated between the offices having  jurisdic-
 tion  over  such programs; and that research projects of the institutes,
 as identified in section 7.17 [or], 13.17, OR 19.17 of this  chapter  or
 as  operated  by  the office for people with developmental disabilities,
 are coordinated to maximize the success and cost effectiveness  of  such
 projects and to eliminate wasteful duplication.
   (2)  The  inter-office  coordinating  council  shall  annually issue a
 report on its activities to the legislature on or before December  thir-
 ty-first.   Such annual report shall include, but not be limited to, the
 following information: proper treatment models and programs for  persons
 with multiple disabilities and suggested improvements to such models and
 programs;  research  projects  of  the institutes and their coordination
 with each other; collaborations and joint initiatives undertaken by  the
 offices  of  the department; consolidation of regulations of each of the
 offices of the department to reduce regulatory  inconsistencies  between
 the  offices;  inter-office  or  office  activities related to workforce
 training and  development;  data  on  the  prevalence,  availability  of
 resources and service utilization by persons with multiple disabilities;
 eligibility standards of each office of the department affecting clients
 suffering  from  multiple  disabilities, and eligibility standards under
 which a client is determined to be an office's  primary  responsibility;
 agreements  or  arrangements on statewide, regional and local government
 levels addressing how determinations over client responsibility are made
 and client responsibility disputes  are  resolved;  information  on  any
 specific cohort of clients with multiple disabilities for which substan-
 tial  barriers  in  accessing  or  receiving  appropriate  care has been
 reported or is known to the inter-office  coordinating  council  or  the
 offices  of  the  department; and coordination of planning, standards or
 services for persons with multiple disabilities between the inter-office
 coordinating council, the offices of the department  and  local  govern-
 ments  in  accordance  with the local planning requirements set forth in
 article forty-one of this chapter.
   (c) The commissioners shall meet from time to time with the  New  York
 state  conference of local mental hygiene directors to assure consistent
 procedures in fulfilling the responsibilities required by  this  section
 and by article forty-one of this chapter.
   (d)  1. The commissioner of ADDICTION AND mental health SERVICES shall
 evaluate the type and level of care required by patients  in  the  adult
 psychiatric  centers  authorized  by  section  7.17  of this chapter and
 develop appropriate comprehensive requirements for the staffing of inpa-
 tient wards. These  requirements  should  reflect  measurable  need  for
 administrative  and  direct  care staff including physicians, nurses and
 other clinical staff, direct  and  related  support  and  other  support
 staff, established on the basis of sound clinical judgment. The staffing
 requirements  shall include but not be limited to the following: (i) the
 level of care based on patient needs, including on ward activities, (ii)
 the number of admissions, (iii) the geographic location of each  facili-
 ty,  (iv) the physical layout of the campus, and (v) the physical design
 of patient care wards.
   2. Such commissioner, in developing the  requirements,  shall  provide
 for  adequate ward coverage on all shifts taking into account the number

 S. 2507                            91                            A. 3007
 
 of individuals expected to be off the ward due to sick  leave,  workers'
 compensation, mandated training and all other off ward leaves.
   3.  The staffing requirements shall be designed to reflect the legiti-
 mate needs of facilities so as to ensure full accreditation and  certif-
 ication by appropriate regulatory bodies. The requirements shall reflect
 appropriate industry standards. The staffing requirements shall be fully
 measurable.
   [4.  The  commissioner of mental health shall submit an interim report
 to the governor and the legislature on the development of  the  staffing
 requirements  on  October first, nineteen hundred eighty-eight and again
 on April first, nineteen hundred  eighty-nine.  The  commissioner  shall
 submit  a final report to the governor and the legislature no later than
 October first, nineteen hundred eighty-nine and  shall  include  in  his
 report  a  plan  to  achieve the staffing requirements and the length of
 time necessary to meet these requirements.]
   (e) The commissioners of the office of ADDICTION AND mental  health[,]
 SERVICES AND THE office for people with developmental disabilities[, and
 the  office  of  alcoholism and substance abuse services] shall cause to
 have all new contracts with  agencies  and  providers  licensed  by  the
 offices to have a clause requiring notice be provided to all current and
 new  employees of such agencies and providers stating that all instances
 of abuse shall be investigated pursuant to  this  chapter,  and,  if  an
 employee  leaves  employment  prior to the conclusion of a pending abuse
 investigation, the investigation shall continue. Nothing in this section
 shall be deemed to diminish the rights, privileges, or remedies  of  any
 employee  under  any  other  law  or  regulation or under any collective
 bargaining agreement or employment contract.
   § 5. Section 7.01 of the mental hygiene law, as added by  chapter  978
 of the laws of 1977, is amended to read as follows:
 § 7.01 Declaration of policy.
   The  state of New York and its local governments have a responsibility
 for the prevention and early detection of mental  illness  and  for  the
 comprehensively  planned  care,  treatment  and  rehabilitation of their
 mentally ill citizens.
   Therefore, it shall be the policy of the state to conduct research and
 to develop programs which further  prevention  and  early  detection  of
 mental  illness; to develop a comprehensive, integrated system of treat-
 ment and rehabilitative services for the mentally  ill.  Such  a  system
 should  include, whenever possible, the provision of necessary treatment
 services to people in their  home  communities;  it  should  assure  the
 adequacy  and  appropriateness of residential arrangements for people in
 need of service; and it should rely upon improved programs  of  institu-
 tional  care only when necessary and appropriate. Further, such a system
 should recognize the important  therapeutic  roles  of  all  disciplines
 which  may contribute to the care or treatment of the mentally ill, such
 as psychology, social work, psychiatric nursing, special  education  and
 other  disciplines in the field of mental illness, as well as psychiatry
 and should establish accountability for implementation of  the  policies
 of  the state with regard to the care and rehabilitation of the mentally
 ill.
   To facilitate the implementation of  these  policies  and  to  further
 advance  the  interests  of  the  mentally ill and their families, a new
 autonomous agency to be known as the  office  of  ADDICTION  AND  mental
 health SERVICES has been established by this article. The office and its
 commissioner shall plan and work with local governments, voluntary agen-
 cies  and all providers and consumers of mental health services in order

 S. 2507                            92                            A. 3007
 
 to develop an effective, integrated, comprehensive system for the deliv-
 ery of all services to the mentally ill and to create  financing  proce-
 dures and mechanisms to support such a system of services to ensure that
 mentally  ill  persons  in  need  of  services receive appropriate care,
 treatment and rehabilitation close to their families and communities. In
 carrying out these responsibilities, the  office  and  its  commissioner
 shall  make  full  use  of  existing services in the community including
 those provided by voluntary organizations.
   § 6. Section 19.01 of the mental hygiene law, as added by chapter  223
 of the laws of 1992, is amended to read as follows:
 § 19.01 Declaration of policy.
   The legislature declares the following:
   Alcoholism,  substance abuse and chemical dependence pose major health
 and social  problems  for  individuals  and  their  families  when  left
 untreated, including family devastation, homelessness, and unemployment.
 It  has been proven that successful prevention and treatment can dramat-
 ically reduce costs to the health  care,  criminal  justice  and  social
 welfare systems.
   The  tragic, cumulative and often fatal consequences of alcoholism and
 substance abuse are, however,  preventable  and  treatable  disabilities
 that require a coordinated and multi-faceted network of services.
   The  legislature recognizes locally planned and implemented prevention
 as a primary means to avert the onset of alcoholism and substance abuse.
 It is the policy of the state to promote comprehensive, age  appropriate
 education  for  children and youth and stimulate public awareness of the
 risks associated with  alcoholism  and  substance  abuse.  Further,  the
 legislature acknowledges the need for a coordinated state policy for the
 establishment  of  prevention and treatment programs designed to address
 the problems of chemical dependency among  youth,  including  prevention
 and intervention efforts in school and community-based programs designed
 to  identify  and  refer  high risk youth in need of chemical dependency
 services.
   Substantial benefits can be gained through  alcoholism  and  substance
 abuse  treatment for both addicted individuals and their families. Posi-
 tive treatment outcomes that may be generated through a complete contin-
 uum of care offer a cost effective and comprehensive approach  to  reha-
 bilitating such individuals. The primary goals of the rehabilitation and
 recovery  process  are  to restore social, family, lifestyle, vocational
 and economic  supports  by  stabilizing  an  individual's  physical  and
 psychological functioning.  The legislature recognizes the importance of
 varying  treatment  approaches  and levels of care designed to meet each
 client's needs.  Relapse prevention and aftercare are two primary compo-
 nents of treatment that serve to promote and maintain recovery.
   The legislature  recognizes  that  the  distinct  treatment  needs  of
 special  populations,  including  women and women with children, persons
 with HIV infection, persons diagnosed with mental illness,  persons  who
 abuse  chemicals,  the  homeless  and veterans with posttraumatic stress
 disorder, merit particular attention. It is the intent of  the  legisla-
 ture  to promote effective interventions for such populations in need of
 particular attention. The legislature also recognizes the importance  of
 family  support  for individuals in alcohol or substance abuse treatment
 and recovery. Such family participation can provide lasting  support  to
 the  recovering individual to prevent relapse and maintain recovery. The
 intergenerational cycle of chemical dependency within  families  can  be
 intercepted through appropriate interventions.

 S. 2507                            93                            A. 3007
 
   The  state of New York and its local governments have a responsibility
 in coordinating the delivery of alcoholism and substance abuse services,
 through the entire network of service  providers.  To  accomplish  these
 objectives, the legislature declares that the establishment of a single,
 unified  office of [alcoholism and substance abuse] ADDICTION AND MENTAL
 HEALTH services will provide an integrated framework  to  plan,  oversee
 and  regulate  the state's prevention and treatment network. In recogni-
 tion of the growing trends and incidence of  chemical  dependency,  this
 consolidation  allows  the  state  to respond to the changing profile of
 chemical dependency.  The legislature recognizes that some  distinctions
 exist  between  the  alcoholism and substance abuse field and THE MENTAL
 HEALTH FIELD AND where appropriate, those distinctions may be preserved.
 Accordingly, it is the intent of the state to establish  one  office  of
 [alcoholism and substance abuse] ADDICTION AND MENTAL HEALTH services in
 furtherance of a comprehensive service delivery system.
   §  7.  Upon  or prior to January 1, 2022, the governor may nominate an
 individual to serve as commissioner  of  the  office  of  addiction  and
 mental  health  services.  If such individual is confirmed by the senate
 prior to January 1, 2022, they shall  become  the  commissioner  of  the
 office  of addiction and mental health services. The governor may desig-
 nate a person to exercise the powers of the commissioner of  the  office
 of  addiction  and  mental  health  services  on  an acting basis, until
 confirmation of a nominee by the senate, who  is  hereby  authorized  to
 take  such  actions as are necessary and proper to implement the orderly
 transition of the  functions,  powers  as  duties  as  herein  provided,
 including  the preparation for a budget request for the office as estab-
 lished by this act.
   § 8. Upon the transfer pursuant to  this  act  of  the  functions  and
 powers  possessed by and all of the obligations and duties of the office
 of mental health and the office of addiction services  and  supports  as
 established  pursuant  to  the mental hygiene law and other laws, to the
 office of addiction and mental health services  as  prescribed  by  this
 act,  provision shall be made for the transfer of all employees from the
 office of mental  health  and  the  office  of  addiction  services  and
 supports  into  the  office  of  addiction  and  mental health services.
 Employees so transferred shall be transferred without  further  examina-
 tion  or qualification to the same or similar titles and shall remain in
 the same collective bargaining units and shall retain  their  respective
 civil  service  classifications,  status,  and  rights pursuant to their
 collective bargaining units and collective bargaining agreements.
   § 9. Notwithstanding any contrary provision of law, on or before Octo-
 ber 1, 2021 and annually thereafter, the office of addiction and  mental
 health    services, in consultation with the department of health, shall
 issue a report, and post such report on their public website,  detailing
 the  office's  expenditures for mental health and addiction services and
 supports, including total Medicaid spending directly  by  the  state  to
 licensed  or designated providers and payments to managed care providers
 pursuant to section 364-j of the social  services  law.  The  office  of
 addiction  and  mental  health  services  shall examine reports produced
 pursuant to this section and may make recommendations  to  the  governor
 and  the  legislature  regarding  appropriations  for  mental health and
 addiction services and supports or other provisions of law which may  be
 necessary  to effectively implement the creation and continued operation
 of the office.
   § 10. Severability. If any clause,  sentence,  paragraph,  section  or
 part  of  this act shall be adjudged by any court of competent jurisdic-

 S. 2507                            94                            A. 3007
 
 tion 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, section or part thereof directly involved
 in the controversy in which such judgment shall have been rendered.
   §  11.  This act shall take effect immediately. Effective immediately,
 the office of mental health and the office  of  addiction  services  and
 supports  are  authorized  to  promulgate the addition, amendment and/or
 repeal of any rule or regulation or engage in any work necessary for the
 implementation of this act on its effective date authorized to  be  made
 and completed on or before such effective date.
 
                                  PART DD
 
   Section 1. This act shall be known and may be cited as the "comprehen-
 sive outpatient services act of 2021".
   §  2.  Section 364-m of the social services law is amended by adding a
 new subdivision 6 to read as follows:
   6. COMPREHENSIVE OUTPATIENT SERVICES CENTERS. (A)  DEFINITIONS.    FOR
 THE  PURPOSE OF THIS ARTICLE, UNLESS THE CONTEXT CLEARLY REQUIRES OTHER-
 WISE:
   (I) "MENTAL HEALTH SERVICES"  MEANS  SERVICES  FOR  THE  TREATMENT  OF
 MENTAL ILLNESS.
   (II)   "ADDICTION  SERVICES"  MEANS  SERVICES  FOR  THE  TREATMENT  OF
 ADDICTION DISORDERS.
   (III) "COMPREHENSIVE OUTPATIENT SERVICES" MEANS THE SYSTEMATIC COORDI-
 NATION OF EVIDENCE-BASED HEALTH CARE SERVICES, TO INCLUDE THE  PREVENTA-
 TIVE,  DIAGNOSTIC,  THERAPEUTIC AND REHABILITATIVE CARE AND TREATMENT OF
 MENTAL ILLNESS, ADDICTION AND THE PROVISION OF PHYSICAL HEALTH SERVICES,
 OTHERWISE PROVIDED BY A  DIAGNOSTIC  AND  TREATMENT  CENTER  OR  GENERAL
 HOSPITAL  OUTPATIENT  PROGRAM  PURSUANT  TO  ARTICLE TWENTY-EIGHT OF THE
 PUBLIC HEALTH LAW, A MENTAL HEALTH CLINIC LICENSED PURSUANT  TO  ARTICLE
 THIRTY-ONE OF THE MENTAL HYGIENE LAW, OR AN ADDICTION PROVIDER CERTIFIED
 PURSUANT  TO ARTICLE THIRTY-TWO OF THE MENTAL HYGIENE LAW TO AN INDIVID-
 UAL SEEKING SERVICES REGARDLESS OF THEIR  PRIMARY  DIAGNOSIS  OR  HEALTH
 COMPLAINT;  PROVIDED,  HOWEVER,  THAT  THE SCOPE OF SUCH SERVICES MAY BE
 RESTRICTED PURSUANT TO REGULATION.
   (IV) "COMPREHENSIVE OUTPATIENT  SERVICES  CENTERS"  MEANS  A  FACILITY
 APPROVED IN ACCORDANCE WITH THIS SECTION TO PROVIDE COMPREHENSIVE OUTPA-
 TIENT  SERVICES  IN  ORDER TO PROMOTE HEALTH AND BETTER OUTCOMES FOR THE
 RECIPIENT, PARTICULARLY FOR POPULATIONS AT RISK.
   (V) "MEDICAL DIRECTOR" IS A  PHYSICIAN  WHO  IS  RESPONSIBLE  FOR  THE
 SERVICES  DELIVERED  BY  THE COMPREHENSIVE OUTPATIENT SERVICES PROVIDER,
 FOR THE OVERALL DIRECTION OF THE SERVICES PROVIDED AND THE DIRECT SUPER-
 VISION OF MEDICAL STAFF IN THE DELIVERY OF SERVICES.
   (VI) "PHYSICAL HEALTH SERVICES" MEANS SERVICES PROVIDED  BY  A  PHYSI-
 CIAN, PHYSICIAN'S ASSISTANT, NURSE PRACTITIONER, OR MIDWIFE ACTING WITH-
 IN  HIS  OR HER LAWFUL SCOPE OF PRACTICE UNDER TITLE EIGHT OF THE EDUCA-
 TION LAW AND WHO IS PRACTICING IN A PRIMARY CARE SPECIALTY.
   (B) NOTWITHSTANDING ANY LAW, RULE, OR REGULATION TO THE CONTRARY,  THE
 COMMISSIONERS  OF THE DEPARTMENT OF HEALTH, THE OFFICE OF MENTAL HEALTH,
 AND THE OFFICE OF ADDICTION SERVICES  AND  SUPPORTS  ARE  AUTHORIZED  TO
 JOINTLY  ESTABLISH  A SINGLE SET OF LICENSING STANDARDS AND REQUIREMENTS
 FOR THE CONSTRUCTION, OPERATION, REPORTING AND SURVEILLANCE  OF  COMPRE-
 HENSIVE  OUTPATIENT  SERVICES  CENTERS.  SUCH STANDARDS AND REQUIREMENTS
 SHALL INCLUDE, BUT NOT BE LIMITED TO:
   (I) SCOPE OF COMPREHENSIVE OUTPATIENT SERVICES;

 S. 2507                            95                            A. 3007
 
   (II) CREATION OF AN EFFICIENT APPLICATION REVIEW PROCESS  FOR  COMPRE-
 HENSIVE OUTPATIENT SERVICES CENTERS;
   (III)  FACILITATION  OF  INTEGRATED TREATMENT RECORDS THAT COMPLY WITH
 APPLICABLE FEDERAL AND STATE CONFIDENTIALITY REQUIREMENTS;
   (IV) OPTIMAL USE OF CLINICAL RESOURCES, INCLUDING THE DEVELOPMENT OF A
 WORKFORCE CAPABLE OF  PROVIDING  COMPREHENSIVE  CARE  TO  AN  INDIVIDUAL
 UTILIZING EVIDENCE-BASED APPROACHES TO INTEGRATED TREATMENT;
   (V)  DEVELOPMENT OF BILLING AND REIMBURSEMENT STRUCTURES TO ENABLE THE
 PROVISION OF COMPREHENSIVE SERVICES TO INDIVIDUALS REGARDLESS  OF  THEIR
 PRIMARY DIAGNOSIS OR HEALTHCARE COMPLAINT;
   (VI)  REASONABLE  PHYSICAL  PLANT  STANDARDS TO FOSTER PROPER CARE AND
 TREATMENT;
   (VII) STANDARDS FOR INCIDENT REPORTING  AND  REMEDIATION  PURSUANT  TO
 ARTICLE ELEVEN OF THE SOCIAL SERVICES LAW; AND
   (VIII)  STANDARDS  FOR  ADVERSE EVENT REPORTING, PROVIDED HOWEVER THAT
 ANY SUCH ADVERSE EVENT REPORTS SHALL BE KEPT CONFIDENTIAL AND SHALL  NOT
 BE SUBJECT TO DISCLOSURE UNDER ARTICLE SIX OF THE PUBLIC OFFICERS LAW OR
 ARTICLE THIRTY-ONE OF THE CIVIL PRACTICE LAW AND RULES.
   (C) A PROVIDER SHALL NOT BE AUTHORIZED TO PROVIDE COMPREHENSIVE OUTPA-
 TIENT  SERVICES  UNLESS  THEY HAVE SUFFICIENTLY DEMONSTRATED, CONSISTENT
 WITH THE STANDARDS AND REQUIREMENTS SET FORTH BY THE COMMISSIONERS:
   (I) EXPERIENCE  IN  THE  DELIVERY  OF  PHYSICAL,  MENTAL  HEALTH,  AND
 ADDICTION SERVICES;
   (II)  CAPACITY  TO  OFFER  COMPREHENSIVE  OUTPATIENT  SERVICES IN EACH
 COMPREHENSIVE OUTPATIENT SERVICES CENTER APPROVED BY EACH OF THE COMMIS-
 SIONERS OF THE DEPARTMENT OF HEALTH, THE OFFICE OF  MENTAL  HEALTH,  AND
 THE OFFICE OF ADDICTION SERVICES AND SUPPORTS; AND
   (III)  COMPLIANCE  WITH STANDARDS ESTABLISHED PURSUANT TO THIS SECTION
 FOR  PROVIDING  AND  RECEIVING  PAYMENT  FOR  COMPREHENSIVE   OUTPATIENT
 SERVICES.
   (D)  NOTWITHSTANDING  ANY  PROVISION  OF  LAW TO THE CONTRARY, FOR THE
 PURPOSES OF THIS SUBDIVISION, COMPREHENSIVE OUTPATIENT SERVICE PROVIDERS
 SHALL BE CONSIDERED CONTRACTED, APPROVED OR OTHERWISE AUTHORIZED BY  THE
 OFFICE  OF  ADDICTION  SERVICES  AND  SUPPORTS  AND THE OFFICE OF MENTAL
 HEALTH FOR THE PURPOSE OF SECTIONS 19.20,  19.20-A,  AND  31.35  OF  THE
 MENTAL HYGIENE LAW, AS MAY BE APPLICABLE. PROVIDERS SHALL BE REQUIRED TO
 COMPLY  WITH  THE REVIEW OF CRIMINAL HISTORY INFORMATION, AS REQUIRED IN
 SUCH SECTIONS, FOR PROSPECTIVE EMPLOYEES OR  VOLUNTEERS  WHO  WILL  HAVE
 REGULAR  AND  SUBSTANTIAL  UNSUPERVISED OR UNRESTRICTED PHYSICAL CONTACT
 WITH THE CLIENTS OF SUCH PROVIDER.
   (E) THE COMMISSIONERS OF THE  DEPARTMENT  OF  HEALTH,  THE  OFFICE  OF
 MENTAL  HEALTH,  AND  THE  OFFICE OF ADDICTION SERVICES AND SUPPORTS ARE
 AUTHORIZED TO PROMULGATE ANY REGULATORY REQUIREMENTS NECESSARY TO IMPLE-
 MENT COMPREHENSIVE OUTPATIENT  SERVICES  CENTERS  CONSISTENT  WITH  THIS
 SECTION, INCLUDING AMENDING EXISTING REQUIREMENTS.
   §  3.  Subdivision  4  of  section  488  of the social services law is
 amended by adding a new paragraph (a-1) to read as follows:
   (A-1) A COMPREHENSIVE OUTPATIENT SERVICES CENTER WHICH IS LICENSED, OR
 CERTIFIED  BY  SECTION  THREE  HUNDRED  SIXTY-FOUR-M  OF  THIS  CHAPTER,
 PROVIDED HOWEVER THAT SUCH TERM SHALL NOT INCLUDE THE PROVISION OF PHYS-
 ICAL HEALTH SERVICES RENDERED IN SUCH FACILITY OR PROGRAM;
   §  4.  Subdivision  1  of  section  2801  of the public health law, as
 amended by section 1 of part Z of chapter 57 of the  laws  of  2019,  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

 S. 2507                            96                            A. 3007
 
 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) APPLY TO COMPREHENSIVE OUTPATIENT SERVICES
 CENTERS, AS DEFINED IN SECTION THREE HUNDRED SIXTY-FOUR-M OF THE  SOCIAL
 SERVICES  LAW;  (B)  limit  the  volume  of mental health, substance use
 disorder services or  developmental  disability  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  commis-
 sioner of the office of mental health, the commissioner of the office of
 [alcoholism   and  substance  abuse  services]  ADDICTION  SERVICES  AND
 SUPPORTS and the commissioner of the office  for  people  with  develop-
 mental  disabilities,  including regulations issued pursuant to subdivi-
 sion 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)] (C) require a provider licensed pursuant to article thirty-one  of
 the mental hygiene law or certified pursuant to article sixteen or arti-
 cle  thirty-two of the mental hygiene law to obtain an operating certif-
 icate 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,  the  commissioner  of  the  office  of  [alcoholism  and
 substance  abuse  services]  ADDICTION  SERVICES  AND  SUPPORTS  and the
 commissioner of the office for people with  developmental  disabilities,
 including  regulations  issued  pursuant to subdivision seven of section
 three hundred sixty-five-l of the social services law or part L of chap-
 ter fifty-six of the laws of two thousand twelve.
   § 5. Subdivision (f) of section 31.02 of the mental  hygiene  law,  as
 amended  by  section  2  of part Z of chapter 57 of the laws of 2019, is
 amended 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  sixteen
 or article thirty-two of this chapter to obtain an operating certificate
 from the office of mental health if such provider has been authorized to

 S. 2507                            97                            A. 3007
 
 provide integrated services in accordance with regulations issued by the
 commissioner  of  the  office  of mental health in consultation with the
 commissioner of the department of health, the commissioner of the office
 of  [alcoholism  and  substance  abuse  services] ADDICTION SERVICES AND
 SUPPORTS and the commissioner of the office  for  people  with  develop-
 mental  disabilities,  including regulations issued pursuant to subdivi-
 sion 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.
 FURTHERMORE, EXCEPT AS PROVIDED IN PARAGRAPH (D) OF SUBDIVISION  SIX  OF
 SECTION  THREE  HUNDRED  SIXTY-FOUR-M  OF  THE  SOCIAL  SERVICES LAW, NO
 PROVISION OF THIS ARTICLE  OR  ANY  OTHER  PROVISION  OF  LAW  SHALL  BE
 CONSTRUED  TO  APPLY  TO  COMPREHENSIVE  OUTPATIENT SERVICES CENTERS, AS
 DEFINED IN SECTION THREE HUNDRED SIXTY-FOUR-M  OF  THE  SOCIAL  SERVICES
 LAW.
   §  6.  Subdivision  (b) of section 32.05 of the mental hygiene law, as
 amended by section 3 of part Z of chapter 57 of the  laws  of  2019,  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, article thirty-one of
 this chapter or a provider certified pursuant to article sixteen of this
 chapter to obtain an operating certificate from the office of  [alcohol-
 ism  and  substance  abuse  services] ADDICTION SERVICES AND SUPPORTS if
 such provider has been authorized  to  provide  integrated  services  in
 accordance  with  regulations  issued by the commissioner of [alcoholism
 and substance abuse services] ADDICTION SERVICES AND SUPPORTS in consul-
 tation with the commissioner of the department of  health,  the  commis-
 sioner of the office of mental health and the commissioner of the office
 for people with developmental disabilities, 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.   FURTHERMORE, EXCEPT AS PROVIDED IN PARAGRAPH (D)
 OF SUBDIVISION SIX OF SECTION THREE HUNDRED SIXTY-FOUR-M OF  THE  SOCIAL
 SERVICES LAW, NO PROVISION OF THIS ARTICLE OR ANY OTHER PROVISION OF LAW
 SHALL  BE  CONSTRUED  TO  APPLY  TO  COMPREHENSIVE  OUTPATIENT  SERVICES
 CENTERS, AS DEFINED IN SECTION THREE HUNDRED SIXTY-FOUR-M OF THE  SOCIAL
 SERVICES LAW.
   §  7.  This  act shall take effect January 1, 2022; provided, however,
 that the amendments to section 364-m of the social services law made  by
 section  two of this act shall not affect the repeal of such section and
 shall be deemed to repeal therewith. Effective immediately, the  commis-
 sioner  of  the  department of health, the commissioner of the office of
 mental health and the commissioner of the office of  addiction  services

 S. 2507                            98                            A. 3007
 
 and  supports  are  authorized to issue any rule or regulation necessary
 for the implementation of this act on or before its effective date.
 
                                  PART EE
 
   Section  1.  Subdivision  10  of  section  553 of the executive law is
 REPEALED.
   § 2. This act shall take effect April 1, 2021.
   § 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 EE 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. 2507--A                                            A. 3007--A
 
                       S E N A T E - A S S E M B L Y
 
                             January 20, 2021
                                ___________
 
 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 part H of chapter 59 of the laws of 2011, amending the
   public health law and other  laws  relating  to  known  and  projected
   department  of health state fund Medicaid expenditures, in relation to
   extending the Medicaid global  cap  (Part  A);  to  amend  the  social
   services law, in relation to copayments for drugs; to amend the public
   health  law, in relation to prescriber prevails; and to repeal certain
   provisions of the social services law relating to coverage for certain
   prescription drugs (Part B);  to  amend  the  public  health  law,  in
   relation  to  community  health  centers (Part C); to amend the public
   health law, in relation to reducing the hospital capital  rate  add-on
   (Part D); to amend the public health law, in relation to adjusting the
   worker recruitment and retention funding (Part E); to amend the public
   health  law,  the  education law and the insurance law, in relation to
   comprehensive telehealth reforms (Part F); to amend the public  health
   law,  in relation to authorizing the implementation of medical respite
   pilot programs (Part G); to amend the social services law, in relation
   to eliminating consumer-paid premium  payments  in  the  basic  health
   program  (Part  H);  to  amend  the  public health law, in relation to
   federal waiver authorization for the NY State of Health, the  official
   Health  Plan  Marketplace  (Part  I);  to  amend the insurance law, in
   relation to the licensing of pharmacy benefit managers  (Part  J);  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 restructuring and extending the physi-
   cians  medical  malpractice  program; 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 malprac-
 
              

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD12571-02-1

 S. 2507--A                          2                         A. 3007--A
 
   tice and professional medical conduct, relating 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 extend-
   ing certain provisions relating  thereto,  in  relation  to  extending
   provisions  relating  to excess coverage (Part K); to amend the public
   health law, in relation to the  general  public  health  work  program
   (Part L); to amend the public health law, the state finance law, chap-
   ter 338 of the laws of 1998 amending the public health law, the public
   officers  law  and  the  state  finance law relating to establishing a
   spinal cord injury research board and part H of chapter 58 of the laws
   of 2007 amending the public health law, the public  officers  law  and
   the  state  finance law relating to establishing the empire state stem
   cell board, in relation to the discontinuation of the empire  clinical
   research investigator program (Part M); to amend the public health law
   and  the  education law, in relation to eliminating certain electronic
   prescription exemptions; and  to  repeal  certain  provisions  of  the
   public  health law and the education law relating thereto (Part N); to
   repeal certain provisions of the social services law relating  to  the
   enhanced  quality  of adult living program ("EQUAL") grants; to repeal
   certain provisions of the public health law relating to requiring that
   the department of health audit hospital working hours; and  to  repeal
   certain  provisions  of  the  social  services  law  relating  to  the
   provision providing operating subsidies to certain  publicly  operated
   adult  care  facilities  (Part O); to amend the public health law, the
   education law, the insurance law  and  the  social  services  law,  in
   relation  to  expanding  the role of pharmacists; 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  such
   provisions permanent; to amend chapter 116 of the laws of 2012, amend-
   ing  the  education  law relating to authorizing a licensed pharmacist
   and certified nurse  practitioner  to  administer  certain  immunizing
   agents, in relation to the effectiveness thereof; to amend chapter 274
   of  the laws of 2013, amending the education law relating to authoriz-
   ing a licensed pharmacist and certified nurse practitioner to adminis-
   ter meningococcal disease immunizing agents, in relation to the effec-
   tiveness thereof; and to  amend  chapter  21  of  the  laws  of  2011,
   amending  the  education  law  relating  to authorizing pharmacists to
   perform collaborative  drug  therapy  management  with  physicians  in
   certain  settings,  in  relation  to  making such provisions permanent
   (Part P); to amend the education law and the  public  health  law,  in
   relation  to  the state's physician profiles and enhancing the ability
   of the department of education to investigate, discipline, and monitor
   licensed physicians, physician assistants, and  specialist  assistants
   (Part  Q);  to  amend the civil rights law, in relation to a change of
   sex designation (Part R); to amend chapter 884 of the  laws  of  1990,
   amending  the  public  health law relating to authorizing bad debt and
   charity  care  allowances  for  certified  home  health  agencies,  in
   relation  to extending the provisions thereof; to amend chapter 109 of
   the laws of 2010, amending the social services law relating to  trans-
   portation  costs,  in  relation to the effectiveness thereof; to amend
   chapter 81 of the laws of 1995, amending the  public  health  law  and
   other  laws  relating  to medical reimbursement and welfare reform, in
   relation to the effectiveness thereof; to amend chapter 56 of the laws

 S. 2507--A                          3                         A. 3007--A
 
   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, in relation to extending government rates for behav-
   ioral  services and adding an alternative payment methodology require-
   ment; to amend chapter 57 of the laws  of  2019  amending  the  public
   health  law  relating to waiver of certain regulations, in relation to
   the effectiveness thereof; to amend chapter 517 of the laws  of  2016,
   amending  the public health law relating to payments from the New York
   state medical indemnity fund, in relation to the effectiveness  there-
   of;  to  amend  the  public  health law, in relation to improved inte-
   gration of health care and financing; and to amend chapter 56  of  the
   laws of 2014, amending the education law relating to the nurse practi-
   tioners  modernization  act,  in  relation to extending the provisions
   thereof (Part S); to amend part A of chapter 111 of the laws  of  2010
   amending the mental hygiene law relating to the receipt of federal and
   state  benefits  received  by individuals receiving care in facilities
   operated by an office of the department of mental hygiene, in relation
   to the effectiveness thereof (Part T); to amend part L of  chapter  59
   of  the  laws of 2016, amending the mental hygiene law relating to the
   appointment of temporary operators  for  the  continued  operation  of
   programs and the provision of services for persons with serious mental
   illness  and/or developmental disabilities and/or chemical dependence,
   in relation to the effectiveness thereof (Part U); to amend part NN of
   chapter 58 of the laws of 2015, amending the mental hygiene law relat-
   ing 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 V); 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 relat-
   ing thereto (Part W); authorizing the office of mental health to rede-
   sign services of certain facilities  and  programs  and  to  implement
   service  reductions;  and  providing for the repeal of such provisions
   upon expiration thereof (Part X); to amend the mental hygiene law,  in
   relation to setting standards for addiction professionals (Part Y); to
   amend the mental hygiene law, in relation to imposing sanctions due to
   a  provider's  failure  to  comply  with  the terms of their operating
   certificate or applicable law and to charge an application  processing
   fee  for the issuance of operating certificates (Part Z); to amend the
   mental hygiene law and the social services law, in relation to  crisis
   stabilization services (Subpart A); to amend the mental hygiene law in
   relation  to  Kendra's  law and assisted outpatient treatment (Subpart
   B); and to amend the mental hygiene law, in  relation  to  involuntary
   commitment  (Subpart C) (Part AA); to amend the mental hygiene law, in
   relation to establishing  the  New  York  state  institute  for  basic
   research  in developmental disabilities (Part BB); to amend the mental
   hygiene law, in relation to  creating  the  office  of  addiction  and
   mental  health  services  (Part CC); to amend the social services law,
   the public health law and the  mental  hygiene  law,  in  relation  to
   setting  comprehensive outpatient services (Part DD); to repeal subdi-
   vision 10 of section  553  of  the  executive  law,  relating  to  the
   requirement that the justice center administer an adult home and resi-
   dence  for  adults  resident  advocacy program (Part EE); to amend the

 S. 2507--A                          4                         A. 3007--A
 
   public health law, in  relation  to  reimbursement  from  the  Medical
   Indemnity  Fund  (Part  FF);  to  amend  the public health law and the
   social services law, in relation to improving the safety  and  quality
   of  nursing  homes in New York state; to amend part E of chapter 56 of
   the laws of 2013 amending the public health law relating to the gener-
   al public health work program, in relation to the effectiveness there-
   of (Part GG); and to amend the  executive  law,  in  relation  to  the
   composition  of  the developmental disabilities planning council (Part
   HH)
 
   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
 necessary to implement the state health and mental  hygiene  budget  for
 the  2021-2022  state  fiscal  year.  Each component is wholly contained
 within a Part identified as Parts A through HH. 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,  including the effective date of the Part, which makes a refer-
 ence 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 Part in which it is found. Section three of this
 act sets forth the general effective date of this act.
 
                                  PART A
 
   Section 1. Paragraph (a) of 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 CCC of chapter 56
 of the laws of 2020, is amended to read as follows:
   (a) For state fiscal years  2011-12  through  [2021-22]  2022-23,  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.
   § 2. This act shall take effect immediately.
 
                                  PART B
 
   Section 1. 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. 2507--A                          5                         A. 3007--A
 
   §  2.  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 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,
 AND the [prescriber's] PROGRAM'S determination shall be final.
   §  3. Subdivisions 25 and 25-a of section 364-j of the social services
 law are 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, 2021.
 
                                  PART C
 
   Section  1.  The  public health law is amended by adding a new section
 2807-pp to read as follows:
   § 2807-PP. 340B REIMBURSEMENT FUND. 1. NOTWITHSTANDING ANY  INCONSIST-
 ENT  PROVISION  OF LAW AND SUBJECT TO THE AVAILABILITY OF FEDERAL FINAN-
 CIAL PARTICIPATION, THERE IS HEREBY CREATED A FUND TO SUPPORT ACTIVITIES
 THAT EXPAND HEALTH SERVICES TO THE MEDICAID MEMBERS, THE UNINSURED,  AND
 LOW-INCOME  PATIENTS, AS SUPPORTED BY THE 340B PROGRAM. ALL FUNDS AVAIL-
 ABLE FOR DISTRIBUTION PURSUANT TO THIS SECTION SHALL BE RESERVED AND SET
 ASIDE AND DISTRIBUTED IN ACCORDANCE WITH THIS SECTION.
   2. EACH ELIGIBLE 340B PROVIDER SHALL RECEIVE A PROPORTIONATE  DISTRIB-
 UTION TO BE DETERMINED BY A METHODOLOGY ESTABLISHED BY THE COMMISSIONER.
 ANNUAL  AGGREGATE  DISTRIBUTIONS PURSUANT TO THIS SECTION FOR THE FISCAL
 YEAR FROM APRIL FIRST, TWO THOUSAND TWENTY-ONE  TO  MARCH  THIRTY-FIRST,
 TWO THOUSAND TWENTY-TWO, AND EACH FISCAL YEAR THEREAFTER, SHALL BE EQUAL
 TO  ONE  HUNDRED TWO MILLION DOLLARS, BUT MAY BE INCREASED BY ADDITIONAL
 AMOUNTS AUTHORIZED BY THE DIRECTOR OF THE  DIVISION  OF  THE  BUDGET  IN
 CONSULTATION WITH THE COMMISSIONER.
   3.  "ELIGIBLE  340B PROVIDER" MEANS: (A) (1) A VOLUNTARY NON-PROFIT OR
 PUBLICLY SPONSORED DIAGNOSTIC AND TREATMENT CENTER LICENSED PURSUANT  TO
 THIS  ARTICLE TWENTY-EIGHT THAT DELIVERS A COMPREHENSIVE RANGE OF HEALTH
 CARE SERVICES,  (2)  OR  A  VOLUNTARY  NON-PROFIT  SEXUALLY  TRANSMITTED
 DISEASE  PROGRAM  RECEIVING  FINANCIAL  ASSISTANCE PURSUANT TO 42 U.S.C.
 §300FF-LL LOCATED IN THIS STATE, OR (3)  AN  ENTITY  AS  DEFINED  BY  42
 U.S.C.  §246B(A)(4)(K)  IN THIS STATE; THAT (B) WAS ENROLLED IN THE 340B
 PROGRAM PURSUANT TO SECTION 340B(A)(4)  OF  THE  FEDERAL  PUBLIC  HEALTH
 SERVICE  ACT  DURING  THE  CALENDAR  YEAR  TWO  THOUSAND TWENTY AND THAT
 SUBMITS TO THE DEPARTMENT THE ANNUAL RECERTIFICATION OF PARTICIPATION IN
 THE 340B PROGRAM AS PROVIDED BY THE HEALTH RESOURCES AND SERVICES ADMIN-
 ISTRATION.
   § 2. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2021.
 
                                  PART D

 S. 2507--A                          6                         A. 3007--A
 
   Section  1.  Paragraph  (c)  of subdivision 8 of section 2807-c of the
 public health law, as amended by section 2 of part KK of chapter  56  of
 the laws of 2020, is amended to read as follows:
   (c)  In order to reconcile capital related inpatient expenses included
 in rates of payment based on a budget to actual expenses and  statistics
 for  the  rate  period  for  a  general hospital, rates of payment for a
 general hospital shall be adjusted to reflect the dollar  value  of  the
 difference  between  capital  related inpatient expenses included in the
 computation of rates of payment for a prior rate period based on a budg-
 et and actual capital related inpatient expenses  for  such  prior  rate
 period,  each  as  determined  in  accordance with paragraph (a) of this
 subdivision, adjusted to reflect increases or  decreases  in  volume  of
 service  in  such  prior  rate  period compared to statistics applied in
 determining the capital related inpatient expenses component of rates of
 payment based on a budget for such prior rate period. For  rates  effec-
 tive [on and after] April first, two thousand twenty THROUGH MARCH THIR-
 TY-FIRST, TWO THOUSAND TWENTY-ONE, the budgeted capital-related expenses
 add-on  as  described  in  paragraph (a) of this subdivision, based on a
 budget submitted in accordance to paragraph  (a)  of  this  subdivision,
 shall  be reduced by five percent relative to the rate in effect on such
 date; and the actual capital expenses add-on as described  in  paragraph
 (a) of this subdivision, based on actual expenses and statistics through
 appropriate  audit  procedures  in accordance with paragraph (a) of this
 subdivision shall be reduced by five percent relative  to  the  rate  in
 effect  on  such date. FOR RATES EFFECTIVE ON AND AFTER APRIL FIRST, TWO
 THOUSAND TWENTY-ONE, THE BUDGETED  CAPITAL-RELATED  EXPENSES  ADD-ON  AS
 DESCRIBED  IN  PARAGRAPH  (A)  OF  THIS  SUBDIVISION,  BASED ON A BUDGET
 SUBMITTED IN ACCORDANCE TO PARAGRAPH (A) OF THIS SUBDIVISION,  SHALL  BE
 REDUCED  BY TEN PERCENT RELATIVE TO THE RATE IN EFFECT ON SUCH DATE; AND
 THE ACTUAL CAPITAL EXPENSES ADD-ON AS DESCRIBED IN PARAGRAPH (A) OF THIS
 SUBDIVISION, BASED ON ACTUAL EXPENSES AND STATISTICS THROUGH APPROPRIATE
 AUDIT PROCEDURES IN ACCORDANCE WITH PARAGRAPH (A)  OF  THIS  SUBDIVISION
 SHALL  BE  REDUCED BY TEN PERCENT RELATIVE TO THE RATE IN EFFECT ON SUCH
 DATE. For any rate year, all reconciliation add-on amounts calculated on
 and after April first, two thousand  twenty  shall  be  reduced  by  ten
 percent,  and  all  reconciliation  recoupment  amounts calculated on or
 after April first, two thousand twenty shall increase  by  ten  percent.
 Notwithstanding  any inconsistent provision of subparagraph (i) of para-
 graph (e) of subdivision nine of this section, capital related inpatient
 expenses of a general hospital included in the computation of  rates  of
 payment  based on a budget shall not be included in the computation of a
 volume adjustment made in accordance with such subparagraph. Adjustments
 to rates of payment for a general hospital made pursuant to  this  para-
 graph  shall  be  made  in  accordance with paragraph (c) of subdivision
 eleven of this section. Such adjustments shall not  be  carried  forward
 except  for  such  volume  adjustment as may be authorized in accordance
 with subparagraph (i) of paragraph  (e)  of  subdivision  nine  of  this
 section for such general hospital.
   §  2.  Clause (A) of subparagraph (ii) of paragraph (b) of subdivision
 5-d of section 2807-k of the public health law, as amended by section  3
 of  part  KK  of  chapter  56 of the laws of 2020, is amended to read as
 follows:
   (A) (1) SUBJECT TO ITEM TWO OF THIS CLAUSE,  one  hundred  thirty-nine
 million  four  hundred thousand dollars shall be distributed as Medicaid
 Disproportionate Share Hospital ("DSH") payments to major public general
 hospitals;

 S. 2507--A                          7                         A. 3007--A
 
   (2) FOR THE CALENDAR YEARS TWO THOUSAND TWENTY-ONE THROUGH  TWO  THOU-
 SAND  TWENTY-TWO,  AND  FOR  EACH  CALENDAR  YEAR  THEREAFTER, THE TOTAL
 DISTRIBUTIONS TO MAJOR PUBLIC GENERAL HOSPITALS SHALL BE REDUCED TO ZERO
 DOLLARS ANNUALLY; and
   §  3.    This act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2021; provided,
 however, that amendments to subdivision 5-d of  section  2807-k  of  the
 public  health  law made by section two of this act shall not affect the
 expiration of such subdivision and shall be deemed to expire therewith.
 
                                  PART E
 
   Section 1. Clauses (M) and (N) of subparagraph (ii) of paragraph  (bb)
 of  subdivision 1 of section 2807-v of the public health law, as amended
 by section 14 of part Y of chapter 56 of the laws of 2020,  are  amended
 and a new clause (O) is added to read as follows:
   (M)  for  each  state  fiscal  year within the period April first, two
 thousand seventeen through  March  thirty-first,  two  thousand  twenty,
 three hundred forty million dollars; [and]
   (N)  for  each  state  fiscal  year within the period April first, two
 thousand twenty through March thirty-first, two thousand  [twenty-three]
 TWENTY-ONE, three hundred forty million dollars[.]; AND
   (O)  FOR  EACH  STATE  FISCAL  YEAR WITHIN THE PERIOD APRIL FIRST, TWO
 THOUSAND TWENTY-ONE THROUGH MARCH  THIRTY-FIRST,  TWO  THOUSAND  TWENTY-
 THREE,  ONE  HUNDRED  SEVENTY MILLION DOLLARS AND EACH STATE FISCAL YEAR
 THEREAFTER.
   § 2. Subparagraphs (xiii) and (xiv) of paragraph (cc) of subdivision 1
 of section 2807-v of the public health law, as amended by section 14  of
 part Y of chapter 56 of the laws of 2020, are amended and a new subpara-
 graph (xv) is added to read as follows:
   (xiii)  up  to  eleven million two hundred thousand dollars each state
 fiscal year for the period April first, two thousand  seventeen  through
 March thirty-first, two thousand twenty; [and]
   (xiv)  up  to  eleven  million two hundred thousand dollars each state
 fiscal year for the period April  first,  two  thousand  twenty  through
 March thirty-first, two thousand [twenty-three.]TWENTY-ONE; AND
   (XV)  UP  TO  FIVE  MILLION SIX HUNDRED THOUSAND DOLLARS FOR THE STATE
 FISCAL YEAR COMMENCING APRIL FIRST, TWO  THOUSAND  TWENTY-ONE  AND  EACH
 STATE FISCAL YEAR THEREAFTER.
   § 3. Subparagraphs (ix) and (x) of paragraph (ccc) of subdivision 1 of
 section  2807-v  of  the  public health law, as amended by section 14 of
 part Y of chapter 56 of the laws of 2020, are amended and a new subpara-
 graph (xi) is added to read as follows:
   (ix) up to fifty million dollars each state fiscal year for the period
 April first, two thousand  seventeen  through  March  thirty-first,  two
 thousand twenty; [and]
   (x)  up to fifty million dollars each state fiscal year for the period
 April first, two thousand twenty through March thirty-first,  two  thou-
 sand [twenty-three.] TWENTY-ONE; AND
   (XI)  UP  TO  TWENTY-FIVE  MILLION  DOLLARS FOR EACH STATE FISCAL YEAR
 WITHIN THE PERIOD APRIL FIRST, TWO  THOUSAND  TWENTY-ONE  THROUGH  MARCH
 THIRTY-FIRST, TWO THOUSAND TWENTY-THREE AND EACH STATE FISCAL YEAR THER-
 EAFTER.
   §  4.  The  opening  paragraph  of  paragraph  (a) of subdivision 8 of
 section 3614 of the public health law, as amended by section 55 of  part
 A of chapter 56 of the laws of 2013, is amended to read as follows:

 S. 2507--A                          8                         A. 3007--A
 
   Notwithstanding  any inconsistent provision of law, rule or regulation
 and subject to the provisions of paragraph (b) of this  subdivision  and
 to the availability of federal financial participation, the commissioner
 shall  adjust  medical assistance rates of payment for services provided
 by certified home health agencies for such services provided to children
 under eighteen years of age and for services provided to a special needs
 population  of  medically  complex and fragile children, adolescents and
 young disabled adults by a CHHA operating under a pilot program approved
 by the department, long term home health care  programs  and  AIDS  home
 care  programs  in  accordance  with this paragraph and paragraph (b) of
 this subdivision for purposes of improving recruitment and retention  of
 non-supervisory  home  care  services  workers or any worker with direct
 patient care  responsibility  in  the  following  amounts  for  services
 provided on and after December first, two thousand two, PROVIDED, HOWEV-
 ER,  FOR  SERVICES  PROVIDED  IN  THE STATE FISCAL YEAR COMMENCING APRIL
 FIRST, TWO THOUSAND TWENTY-ONE SUCH AMOUNTS SHALL BE  REDUCED  BY  FIFTY
 PERCENT.
   §  5.  Subdivision  1  of  section  4013  of the public health law, as
 amended by section 9 of part MM of chapter 56 of the laws  of  2020,  is
 amended to read as follows:
   1.  The  commissioner  shall, subject to the provisions of subdivision
 two of this section, increase medical assistance rates of payment by  up
 to  three  percent  for  hospice services provided on and after December
 first, two thousand two,  for  purposes  of  improving  recruitment  and
 retention of non-supervisory workers or workers with direct patient care
 responsibility,  PROVIDED,  HOWEVER,  FOR SERVICES PROVIDED IN THE STATE
 FISCAL  YEAR  COMMENCING  APRIL  FIRST,  TWO  THOUSAND  TWENTY-ONE  SUCH
 INCREASE SHALL BE UP TO ONE AND ONE-HALF PERCENT.
   §  6.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2021.
 
                                  PART F
 
   Section 1. Subdivision 3 of section 2999-cc of the public health  law,
 as amended by section 2 of subpart C of part S of chapter 57 of the laws
 of 2018, 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)  certified  and  non-certified  day  and  residential
 programs  funded or operated by the office for people with developmental
 disabilities; (d) private physician's or dentist's offices located with-
 in the state of New York; (e) any type of adult care  facility  licensed
 under title two of article seven of the social services law; (f) 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 (g) the patient's place of residence located within the state of New
 York  or other temporary location located within or outside the state of
 New York.]
   § 2. Paragraph (d) of subdivision 18-a of section 206  of  the  public
 health  law, as amended by section 8 of part A of chapter 57 of the laws
 of 2015, is amended to read as follows:
   (d) The commissioner may make such rules and  regulations  as  may  be
 necessary  to  implement federal policies and disburse funds as required

 S. 2507--A                          9                         A. 3007--A
 
 by the American Recovery and Reinvestment Act of 2009 and to promote the
 development of a self-sufficient SHIN-NY to enable  widespread,  non-du-
 plicative  interoperability  among disparate health information systems,
 including  electronic  health  records,  personal health records, health
 care claims, payment and other administrative data,  and  public  health
 information  systems,  while protecting privacy and security. Such rules
 and regulations shall include, but not be limited to,  requirements  for
 organizations covered by 42 U.S.C. 17938 or any other organizations that
 exchange  health  information through the SHIN-NY or any other statewide
 health information system recommended by the workgroup.  SUCH RULES  AND
 REGULATIONS  SHALL  REQUIRE THAT QUALIFIED ENTITIES PERMIT ACCESS TO ALL
 OF A PATIENT'S INFORMATION BY ALL  SHIN-NY  PARTICIPANTS  OR  ANY  OTHER
 GENERAL  DESIGNATION OF WHO MAY ACCESS SUCH INFORMATION AFTER CONSENT IS
 OBTAINED USING A SINGLE STATEWIDE SHIN-NY CONSENT FORM APPROVED  BY  THE
 DEPARTMENT AND PUBLISHED ON THE DEPARTMENT'S WEBSITE. If the commission-
 er  seeks  to  promulgate rules and regulations prior to issuance of the
 report identified in subparagraph (iv) of paragraph (b) of this subdivi-
 sion, the commissioner shall submit  the  proposed  regulations  to  the
 workgroup  for  its input. If the commissioner seeks to promulgate rules
 and regulations after the issuance of  the  report  identified  in  such
 subparagraph  (iv)  then  the commissioner shall consider the report and
 recommendations of the workgroup. If the commissioner acts in  a  manner
 inconsistent  with  the input or recommendations of the workgroup, he or
 she shall provide the reasons therefor.
   § 3. Paragraphs (w) and (x) of subdivision 2 of section 2999-cc of the
 public health law, as amended by section 1 of part HH of chapter  56  of
 the laws of 2020, are amended to read as follows:
   (w)  a  care  manager  employed  by or under contract to a health home
 program, patient centered medical home, office for people with  develop-
 mental  disabilities  Care Coordination Organization (CCO), hospice or a
 voluntary foster care agency certified by the  office  of  children  and
 family services certified and licensed pursuant to article twenty-nine-i
 of this chapter; [and]
   (x)  PRACTITIONERS AUTHORIZED TO PROVIDE SERVICES IN NEW YORK PURSUANT
 TO THE INTERSTATE LICENSURE PROGRAM SET FORTH IN REGULATIONS PROMULGATED
 BY THE COMMISSIONER OF EDUCATION IN ACCORDANCE WITH SUBDIVISION THREE OF
 SECTION SIXTY-FIVE HUNDRED ONE OF THE EDUCATION LAW; AND
   (Y)  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
 addiction  services  and supports, or the commissioner of the office for
 people with developmental disabilities pursuant to regulation.
   § 4. Section 6501 of the education law is  amended  by  adding  a  new
 subdivision 3 to read as follows:
   3.  NOTWITHSTANDING  ANY  INCONSISTENT PROVISION OF LAW, RULE OR REGU-
 LATION TO THE CONTRARY, THE COMMISSIONER SHALL, IN CONSULTATION WITH THE
 COMMISSIONERS OF THE DEPARTMENT OF  HEALTH,  OFFICE  OF  MENTAL  HEALTH,
 OFFICE  OF  ADDICTION  SERVICES AND SUPPORTS, AND OFFICE FOR PEOPLE WITH
 DEVELOPMENTAL DISABILITIES, ISSUE REGULATIONS FOR  THE  CREATION  OF  AN
 INTERSTATE  LICENSURE PROGRAM WHICH AUTHORIZES PRACTITIONERS LICENSED BY
 CONTIGUOUS STATES OR STATES IN THE NORTHEAST  REGION  TO  PROVIDE  TELE-
 HEALTH  SERVICES,  AS  DEFINED  BY  ARTICLE  TWENTY-NINE-G OF THE PUBLIC
 HEALTH LAW AND ANY IMPLEMENTING REGULATIONS PROMULGATED BY  THE  COMMIS-
 SIONERS  OF THE DEPARTMENT OF HEALTH, OFFICE OF MENTAL HEALTH, OFFICE OF
 ADDICTION SERVICES AND SUPPORTS, AND OFFICE  FOR  PEOPLE  WITH  DEVELOP-
 MENTAL  DISABILITIES, TO PATIENTS LOCATED IN NEW YORK STATE, TAKING INTO

 S. 2507--A                         10                         A. 3007--A
 
 CONSIDERATION THE NEED FOR  SPECIALTY  PRACTICE  AREAS  WITH  HISTORICAL
 ACCESS  ISSUES,  AS DETERMINED BY THE COMMISSIONERS OF THE DEPARTMENT OF
 HEALTH, OFFICE OF  MENTAL  HEALTH,  OFFICE  OF  ADDICTION  SUPPORTS  AND
 SERVICES,  OR  OFFICE  FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES.  SUCH
 REGULATIONS MAY BE PROMULGATED ON AN EMERGENCY BASIS; PROVIDED, HOWEVER,
 THEY SHALL BE PROMULGATED ON A FINAL BASIS NO LATER THAN  MARCH  THIRTY-
 FIRST, TWO THOUSAND TWENTY-TWO.
   §  5.  Section  3217-h of the insurance law is amended by adding a new
 subsection (c) to read as follows:
   (C) AN INSURER THAT  PROVIDES  COMPREHENSIVE  COVERAGE  FOR  HOSPITAL,
 MEDICAL,  OR SURGICAL CARE WITH A NETWORK OF HEALTH CARE PROVIDERS SHALL
 ENSURE THAT SUCH NETWORK IS ADEQUATE TO MEET  THE  TELEHEALTH  NEEDS  OF
 INSURED INDIVIDUALS FOR SERVICES COVERED UNDER THE POLICY WHEN MEDICALLY
 APPROPRIATE.
   §  6.  Section  4306-g of the insurance law is amended by adding a new
 subsection (c) to read as follows:
   (C) A CORPORATION THAT PROVIDES COMPREHENSIVE COVERAGE  FOR  HOSPITAL,
 MEDICAL,  OR SURGICAL CARE WITH A NETWORK OF HEALTH CARE PROVIDERS SHALL
 ENSURE THAT SUCH NETWORK IS ADEQUATE TO MEET  THE  TELEHEALTH  NEEDS  OF
 INSURED INDIVIDUALS FOR SERVICES COVERED UNDER THE POLICY WHEN MEDICALLY
 APPROPRIATE.
   §  7.  Subdivisions 1 and 6 of section 24 of the public health law, as
 added by section 17 of part H of chapter 60 of the  laws  of  2014,  are
 amended to read as follows:
   1.  A  health  care  professional,  or a group practice of health care
 professionals, a diagnostic and treatment  center  or  a  health  center
 defined  under  42  U.S.C. § 254b on behalf of health care professionals
 rendering services at  the  group  practice,  diagnostic  and  treatment
 center  or  health  center,  shall  disclose  to patients or prospective
 patients in writing or through an internet website the health care plans
 in which the health care professional, group  practice,  diagnostic  and
 treatment  center  or health center, is a participating provider and the
 hospitals with which the health care professional is affiliated prior to
 the provision of non-emergency services and  verbally  at  the  time  an
 appointment  is  scheduled.  SUCH  DISCLOSURE SHALL INDICATE WHETHER THE
 HEALTH CARE  PROFESSIONAL,  GROUP  PRACTICE,  DIAGNOSTIC  AND  TREATMENT
 CENTER OR HEALTH CENTER OFFERS TELEHEALTH SERVICES.
   6.  A  hospital  shall  post on the hospital's website: (a) the health
 care plans in which the hospital is  a  participating  provider;  (b)  a
 statement  that  (i) physician services provided in the hospital are not
 included in the hospital's charges; (ii) physicians who provide services
 in the hospital may or may not participate with  the  same  health  care
 plans  as  the hospital, and; (iii) the prospective patient should check
 with the physician arranging for the hospital services to determine  the
 health  care  plans in which the physician participates; (c) as applica-
 ble, the name, mailing address and telephone  number  of  the  physician
 groups that the hospital has contracted with to provide services includ-
 ing  anesthesiology,  pathology  or  radiology,  and instructions how to
 contact these groups to determine the health care plan participation  of
 the physicians in these groups; [and] (d) as applicable, the name, mail-
 ing address, and telephone number of physicians employed by the hospital
 and  whose services may be provided at the hospital, and the health care
 plans in which they participate; AND (E) DISCLOSURE AS  TO  WHETHER  THE
 HOSPITAL OFFERS TELEHEALTH SERVICES.
   §  8.  Subdivision 8 of section 24 of the public health law is amended
 by adding a new paragraph (d) to read as follows:

 S. 2507--A                         11                         A. 3007--A
 
   (D) "TELEHEALTH SERVICES" MEANS THOSE SERVICES PROVIDED IN  ACCORDANCE
 WITH  ARTICLE  TWENTY-NINE-G  OF THIS CHAPTER, SUBSECTION (B) OF SECTION
 THIRTY-TWO HUNDRED SEVENTEEN-H OF THE INSURANCE LAW, OR  SUBSECTION  (B)
 OF  SECTION  FORTY-THREE HUNDRED SIX-G OF THE INSURANCE LAW, AS APPLICA-
 BLE.
   §  9.  This act shall take effect April 1, 2021; provided, however, if
 this act shall have become a law after such date it  shall  take  effect
 immediately and shall be deemed to have been in full force and effect on
 and  after April 1, 2021; provided further, however, that the amendments
 to paragraph (d) of subdivision 18-a of section 206 of the public health
 law made by section two of this act shall not affect the repeal of  such
 paragraph  and shall be deemed repealed therewith; and provided further,
 that sections five and six of this act shall take effect October 1, 2021
 and shall apply to policies and  contracts  issued,  renewed,  modified,
 altered, or amended on and after such date.
 
                                  PART G
 
   Section  1.  The  public health law is amended by adding a new article
 29-J to read as follows:
                               ARTICLE 29-J
                          MEDICAL RESPITE PROGRAM
 SECTION 2999-HH. MEDICAL RESPITE PROGRAM.
   § 2999-HH.  MEDICAL  RESPITE  PROGRAM.  1.  LEGISLATIVE  FINDINGS  AND
 PURPOSE.  THE  LEGISLATURE  FINDS THAT AN INDIVIDUAL WHO LACKS ACCESS TO
 SAFE HOUSING FACES AN INCREASED RISK  OF  ADVERSE  HEALTH  OUTCOMES.  BY
 OFFERING  MEDICAL RESPITE PROGRAMS AS A LOWER-INTENSITY CARE SETTING FOR
 INDIVIDUALS WHO WOULD OTHERWISE REQUIRE A HOSPITAL STAY OR LACK  A  SAFE
 OPTION  FOR DISCHARGE AND RECOVERY, MEDICAL RESPITE PROGRAMS WILL REDUCE
 HOSPITAL INPATIENT ADMISSIONS AND LENGTHS  OF  STAY,  HOSPITAL  READMIS-
 SIONS,  AND  EMERGENCY ROOM USE.   THE LEGISLATURE FINDS THAT THE ESTAB-
 LISHMENT OF MEDICAL RESPITE PROGRAMS WILL PROTECT  THE  PUBLIC  INTEREST
 AND THE INTERESTS OF PATIENTS.
   2.  DEFINITIONS.  AS  USED  IN THIS ARTICLE, THE FOLLOWING TERMS SHALL
 HAVE THE  FOLLOWING  MEANINGS,  UNLESS  THE  CONTEXT  CLEARLY  OTHERWISE
 REQUIRES:
   (A)  "MEDICAL  RESPITE  PROGRAM"  MEANS  A  NOT-FOR-PROFIT CORPORATION
 LICENSED OR CERTIFIED PURSUANT TO SUBDIVISION THREE OF THIS  SECTION  TO
 SERVE  RECIPIENTS  WHOSE PROGNOSIS OR DIAGNOSIS NECESSITATES THE RECEIPT
 OF:
   (I) TEMPORARY ROOM AND BOARD; AND
   (II) THE PROVISION OR ARRANGEMENT OF THE PROVISION OF HEALTH CARE  AND
 SUPPORT  SERVICES;  PROVIDED,   HOWEVER, THAT THE OPERATION OF A MEDICAL
 RESPITE PROGRAM SHALL BE SEPARATE AND DISTINCT FROM ANY HOUSING PROGRAMS
 OFFERED TO INDIVIDUALS WHO DO NOT QUALIFY AS RECIPIENTS.
   (B) "RECIPIENT" MEANS AN INDIVIDUAL WHO:
   (I) HAS A QUALIFYING HEALTH CONDITION THAT REQUIRES TREATMENT OR CARE;
   (II) DOES NOT REQUIRE HOSPITAL INPATIENT, OBSERVATION UNIT,  OR  EMER-
 GENCY  ROOM LEVEL OF CARE, OR A MEDICALLY INDICATED EMERGENCY DEPARTMENT
 OR OBSERVATION VISIT; AND
   (III) IS EXPERIENCING HOMELESSNESS OR AT IMMINENT  RISK  OF  HOMELESS-
 NESS.  (A)  SUBJECT  TO CLAUSE (B) OF THIS SUBPARAGRAPH AND ANY RULES OR
 REGULATIONS PROMULGATED PURSUANT TO SUBDIVISION FOUR OF THIS SECTION,  A
 PERSON  SHALL BE DEEMED "HOMELESS" IF THEY ARE UNABLE TO SECURE OR MAIN-
 TAIN PERMANENT OR STABLE HOUSING WITHOUT ASSISTANCE.

 S. 2507--A                         12                         A. 3007--A
 
   (B) AN OPERATOR OF A MEDICAL RESPITE PROGRAM MAY ESTABLISH ELIGIBILITY
 STANDARDS USING A MORE LIMITED  DEFINITION  OF  "HOMELESSNESS"  IF  SUCH
 LIMITATION  IS  NECESSARY TO ENSURE THE AVAILABILITY OF A FUNDING SOURCE
 THAT WILL SUPPORT THE MEDICAL RESPITE PROGRAM'S PROVISION  OF  ROOM  AND
 BOARD,  AND  SUCH LIMITATIONS ARE OTHERWISE CONSISTENT WITH ANY RULES OR
 REGULATIONS PROMULGATED PURSUANT TO SUBDIVISION FOUR  OF  THIS  SECTION.
 THIS APPLIES TO CONDITIONS THAT MAY EXIST IN CONNECTION WITH:
   (1)  PUBLIC  FUNDING PROVIDED BY A FEDERAL, STATE, OR LOCAL GOVERNMENT
 ENTITY; OR
   (2) SUBJECT TO THE APPROVAL OF THE DEPARTMENT, PRIVATE FUNDING FROM  A
 CHARITABLE ENTITY OR OTHER NON-GOVERNMENTAL SOURCE.
   3.  LICENSURE  OR  CERTIFICATION. (A) NOTWITHSTANDING ANY INCONSISTENT
 PROVISION OF LAW, THE COMMISSIONER MAY LICENSE OR CERTIFY A NOT-FOR-PRO-
 FIT CORPORATION AS AN OPERATOR OF A MEDICAL RESPITE PROGRAM.
   (B) THE COMMISSIONER MAY PROMULGATE RULES AND REGULATIONS TO ESTABLISH
 PROCEDURES TO REVIEW AND APPROVE APPLICATIONS FOR A LICENSE  OR  CERTIF-
 ICATION  PURSUANT  TO THIS ARTICLE, WHICH MAY BE PROMULGATED ON AN EMER-
 GENCY BASIS AND WHICH SHALL, AT A MINIMUM, SPECIFY STANDARDS FOR: RECIP-
 IENT ELIGIBILITY; MANDATORY MEDICAL RESPITE PROGRAM  SERVICES;  PHYSICAL
 ENVIRONMENT;  STAFFING; AND POLICIES AND PROCEDURES GOVERNING HEALTH AND
 SAFETY, LENGTH OF STAY, REFERRALS, DISCHARGE, AND COORDINATION OF CARE.
   4. OPERATING STANDARDS;  RESPONSIBILITY  FOR  STANDARDS.  (A)  MEDICAL
 RESPITE PROGRAMS LICENSED OR CERTIFIED PURSUANT TO THIS ARTICLE SHALL:
   (I) PROVIDE RECIPIENTS WITH TEMPORARY ROOM AND BOARD; AND
   (II) PROVIDE, OR ARRANGE FOR THE PROVISION OF, HEALTH CARE AND SUPPORT
 SERVICES TO RECIPIENTS.
   (B)  NOTHING  CONTAINED  WITHIN THIS ARTICLE SHALL AFFECT THE APPLICA-
 TION, QUALIFICATION, OR REQUIREMENTS THAT MAY APPLY TO AN OPERATOR  WITH
 RESPECT TO ANY OTHER LICENSES OR OPERATING CERTIFICATES THAT SUCH OPERA-
 TOR  MAY HOLD, INCLUDING, WITHOUT LIMITATION, UNDER ARTICLE TWENTY-EIGHT
 OF THIS CHAPTER OR ARTICLE SEVEN OF THE SOCIAL SERVICES LAW.
   5. TEMPORARY ACCOMMODATION. A MEDICAL RESPITE PROGRAM SHALL BE CONSID-
 ERED A FORM OF EMERGENCY SHELTER OR TEMPORARY SHELTER  FOR  PURPOSES  OF
 DETERMINING  A  RECIPIENT'S ELIGIBILITY FOR HOUSING PROGRAMS OR BENEFITS
 ADMINISTERED BY THE STATE  OR  BY  A  LOCAL  SOCIAL  SERVICES  DISTRICT,
 INCLUDING  PROGRAMS OR BENEFITS THAT SUPPORT ACCESS TO ACCOMMODATIONS OF
 A TEMPORARY, TRANSITIONAL, OR PERMANENT NATURE.
   6. INSPECTIONS AND COMPLIANCE. THE COMMISSIONER SHALL HAVE  THE  POWER
 TO  INQUIRE  INTO  THE  OPERATION  OF  ANY LICENSED OR CERTIFIED MEDICAL
 RESPITE PROGRAM AND TO CONDUCT PERIODIC INSPECTIONS OF  FACILITIES  WITH
 RESPECT  TO THE FITNESS AND ADEQUACY OF THE PREMISES, EQUIPMENT, PERSON-
 NEL, RULES AND BY-LAWS, STANDARDS OF MEDICAL CARE AND  SERVICES,  SYSTEM
 OF ACCOUNTS, RECORDS, AND THE ADEQUACY OF FINANCIAL RESOURCES AND SOURC-
 ES OF FUTURE REVENUES.
   7. SUSPENSION OR REVOCATION OF LICENSE OR CERTIFICATION. (A) A LICENSE
 OR CERTIFICATION FOR A MEDICAL RESPITE PROGRAM UNDER THIS ARTICLE MAY BE
 REVOKED,  SUSPENDED, LIMITED, ANNULLED OR DENIED BY THE COMMISSIONER, IN
 CONSULTATION WITH EITHER THE  COMMISSIONERS  OF  THE  OFFICE  OF  MENTAL
 HEALTH, THE OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE, OR THE OFFICE
 OF  ADDICTION  SERVICES AND SUPPORTS, AS APPROPRIATE BASED ON A DETERMI-
 NATION OF THE DEPARTMENT DEPENDING ON THE DIAGNOSIS OR STATED  NEEDS  OF
 THE  INDIVIDUALS  BEING  SERVED  OR PROPOSED TO BE SERVED IN THE MEDICAL
 RESPITE PROGRAM BEING CONSIDERED FOR REVOCATION, SUSPENSION, LIMITATION,
 ANNULMENT OR DENIAL OF CERTIFICATION, IF AN OPERATOR  IS  DETERMINED  TO
 HAVE  FAILED  TO COMPLY WITH THE PROVISIONS OF THIS ARTICLE OR THE RULES
 AND REGULATIONS PROMULGATED THEREUNDER. NO ACTION TAKEN AGAINST AN OPER-

 S. 2507--A                         13                         A. 3007--A
 
 ATOR UNDER THIS SUBDIVISION SHALL AFFECT AN OPERATOR'S OTHER LICENSES OR
 CERTIFICATIONS; PROVIDED HOWEVER, THAT THE FACTS THAT GAVE RISE  TO  THE
 REVOCATION, SUSPENSION, LIMITATION, ANNULMENT OR DENIAL OF CERTIFICATION
 MAY  ALSO  FORM  THE  BASIS OF A LIMITATION, SUSPENSION OF REVOCATION OF
 SUCH OTHER LICENSES OR CERTIFICATIONS.
   (B) NO SUCH MEDICAL RESPITE PROGRAM LICENSE OR CERTIFICATION SHALL  BE
 REVOKED,  SUSPENDED,  LIMITED,  ANNULLED  OR  DENIED  WITHOUT A HEARING;
 PROVIDED THAT A LICENSE OR CERTIFICATION MAY BE TEMPORARILY SUSPENDED OR
 LIMITED WITHOUT A HEARING FOR A PERIOD NOT IN EXCESS OF THIRTY DAYS UPON
 WRITTEN NOTICE THAT THE CONTINUATION  OF  THE  MEDICAL  RESPITE  PROGRAM
 PLACES THE PUBLIC HEALTH OR SAFETY OF THE RECIPIENTS IN IMMINENT DANGER.
   (C) NOTHING IN THIS SECTION SHALL PREVENT THE COMMISSIONER FROM IMPOS-
 ING SANCTIONS OR PENALTIES ON A MEDICAL RESPITE PROGRAM THAT ARE AUTHOR-
 IZED UNDER ANY OTHER LAW OR REGULATION.
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2021.
 
                                  PART H
 
   Section 1. The title heading of title 11-D of article 5 of the  social
 services  law,  as added by chapter 1 of the laws of 1999, is amended to
 read as follows:
                   [FAMILY] BASIC HEALTH [PLUS] PROGRAM
 
   § 2. Paragraph (d) of subdivision 3, subdivision 5 and  subdivision  7
 of  section 369-gg of the social services law, as added by section 51 of
 part C of chapter 60 of the laws of 2014 and subdivision 7 as renumbered
 by section 28 of part B of chapter 57 of the laws of 2015,  are  amended
 to read as follows:
   (d)  (i)  has  household income at or below two hundred percent of the
 federal poverty line defined and annually revised by the  United  States
 department  of  health  and  human  services for a household of the same
 size; and (ii) has household income that  exceeds  one  hundred  thirty-
 three  percent  of the federal poverty line defined and annually revised
 by the United States department of  health  and  human  services  for  a
 household of the same size; however, MAGI eligible aliens lawfully pres-
 ent  in the United States with household incomes at or below one hundred
 thirty-three percent of the federal poverty line shall  be  eligible  to
 receive  coverage for health care services pursuant to the provisions of
 this title if such alien would  be  ineligible  for  medical  assistance
 under title eleven of this article due to his or her immigration status.
   An  applicant who fails to make an applicable premium payment, IF ANY,
 shall lose eligibility to receive coverage for health care  services  in
 accordance with time frames and procedures determined by the commission-
 er.
   5.  Premiums  and  cost  sharing. (a) Subject to federal approval, the
 commissioner shall establish premium payments  enrollees  shall  pay  to
 approved  organizations for coverage of health care services pursuant to
 this title. [Such premium payments shall be established in the following
 manner:
   (i) up to twenty dollars monthly for an individual  with  a  household
 income  above  one hundred and fifty percent of the federal poverty line
 but at or below two hundred percent of the federal poverty line  defined
 and annually revised by the United States department of health and human
 services for a household of the same size; and

 S. 2507--A                         14                         A. 3007--A

   (ii)  no]  NO  payment  is  required  for individuals with a household
 income at or below [one hundred and fifty] TWO HUNDRED  percent  of  the
 federal  poverty  line defined and annually revised by the United States
 department of health and human services for  a  household  of  the  same
 size.
   (b)  The  commissioner  shall  establish  cost sharing obligations for
 enrollees, subject to federal approval.
   7. Any funds transferred by the secretary of health and human services
 to the state pursuant to 42 U.S.C. 18051(d) shall be deposited in trust.
 Funds from the trust shall be used for providing health benefits through
 an approved organization, which, at a minimum, shall  include  essential
 health  benefits  as  defined  in  42  U.S.C.  18022(b);  to  reduce the
 premiums, IF ANY, and cost sharing of participants in the  basic  health
 program;  or  for such other purposes as may be allowed by the secretary
 of health and human services.  Health  benefits  available  through  the
 basic health program shall be provided by one or more approved organiza-
 tions  pursuant  to an agreement with the department of health and shall
 meet the requirements of applicable federal and  state  laws  and  regu-
 lations.
   §  3.  This act shall take effect June 1, 2021 and shall expire and be
 deemed repealed should federal approval be withdrawn or 42 U.S.C.  18051
 be  repealed;  provided that the commissioner of health shall notify the
 legislative bill drafting commission  upon  the  withdrawal  of  federal
 approval  or  the repeal of 42 U.S.C. 18051 in order that the commission
 may maintain an accurate and timely effective data base of the  official
 text of the laws of the state of New York in furtherance of effectuating
 the  provisions of section 44 of the legislative law and section 70-b of
 the public officers law.
 
                                  PART I
 
   Section 1. Subdivision 1 of section 268-c of the public health law, as
 added by section 2 of part T of chapter 57  of  the  laws  of  2019,  is
 amended to read as follows:
   1. (a) Perform eligibility determinations for federal and state insur-
 ance  affordability  programs including medical assistance in accordance
 with section three hundred sixty-six of the social services  law,  child
 health  plus  in  accordance  with section twenty-five hundred eleven of
 this chapter, the basic health program in accordance with section  three
 hundred  sixty-nine-gg  of  the social services law, premium tax credits
 and cost-sharing reductions and qualified  health  plans  in  accordance
 with applicable law and other health insurance programs as determined by
 the commissioner;
   (b)  certify  and  make  available to qualified individuals, qualified
 health plans, including  dental  plans,  certified  by  the  Marketplace
 pursuant  to  applicable  law,  provided  that coverage under such plans
 shall not become effective prior to certification  by  the  Marketplace;
 [and]
   (c)  certify  and/or  make  available  to eligible individuals, health
 plans certified by the Marketplace pursuant to  applicable  law,  and/or
 participating in an insurance affordability program pursuant to applica-
 ble law, provided that coverage under such plans shall not become effec-
 tive  prior  to certification by the Marketplace, and/or approval by the
 commissioner[.]; AND
   (D) THE COMMISSIONER,  IN  COOPERATION  WITH  THE  SUPERINTENDENT,  IS
 AUTHORIZED  AND DIRECTED, SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE

 S. 2507--A                         15                         A. 3007--A
 
 DIVISION OF THE BUDGET, TO APPLY FOR FEDERAL WAIVERS  WHEN  SUCH  ACTION
 WOULD  BE  NECESSARY  TO  ASSIST  IN  PROMOTING  THE  OBJECTIVES 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, 2021.
 
                                  PART J
 
   Section 1. The insurance law is amended by adding a new article 29  to
 read as follows:
                                ARTICLE 29
                         PHARMACY BENEFIT MANAGERS
 SECTION 2901. DEFINITIONS.
         2902. ACTING WITHOUT A REGISTRATION.
         2903. REGISTRATION REQUIREMENTS FOR PHARMACY BENEFIT MANAGERS.
         2904. REPORTING REQUIREMENTS FOR PHARMACY BENEFIT MANAGERS.
         2905. ACTING WITHOUT A LICENSE.
         2906. LICENSING OF A PHARMACY BENEFIT MANAGER.
         2907. REVOCATION OR SUSPENSION OF A REGISTRATION OR LICENSE OF A
                 PHARMACY BENEFIT MANAGER.
         2908. PENALTIES FOR VIOLATIONS.
         2909. STAY OR SUSPENSION OF SUPERINTENDENT'S DETERMINATION.
         2910. REVOKED REGISTRATIONS OR LICENSES.
         2911. CHANGE OF ADDRESS.
         2912. DUTIES.
         2913. APPLICABILITY OF OTHER LAWS.
         2914. ASSESSMENTS.
   § 2901. DEFINITIONS. FOR PURPOSES OF THIS ARTICLE:
   (A)  "HEALTH  PLAN"  MEANS  AN INSURANCE COMPANY THAT IS AN AUTHORIZED
 INSURER UNDER THIS CHAPTER, A  COMPANY  ORGANIZED  PURSUANT  TO  ARTICLE
 FORTY-THREE OF THIS CHAPTER, A MUNICIPAL COOPERATIVE HEALTH BENEFIT PLAN
 ESTABLISHED  PURSUANT  TO ARTICLE FORTY-SEVEN OF THIS CHAPTER, AN ENTITY
 CERTIFIED PURSUANT TO  ARTICLE  FORTY-FOUR  OF  THE  PUBLIC  HEALTH  LAW
 INCLUDING  THOSE  PROVIDING SERVICES PURSUANT TO TITLE ELEVEN OF ARTICLE
 FIVE OF THE SOCIAL SERVICES LAW AND TITLE ONE-A OF  ARTICLE  TWENTY-FIVE
 OF  THE  PUBLIC HEALTH LAW, AN INSTITUTION OF HIGHER EDUCATION CERTIFIED
 PURSUANT TO SECTION ONE THOUSAND ONE HUNDRED TWENTY-FOUR OF  THIS  CHAP-
 TER,  THE  STATE INSURANCE FUND, AND THE NEW YORK STATE HEALTH INSURANCE
 PLAN ESTABLISHED UNDER ARTICLE ELEVEN OF THE CIVIL SERVICE LAW.
   (B) "PHARMACY BENEFIT MANAGEMENT SERVICES"  MEANS  THE  MANAGEMENT  OR
 ADMINISTRATION OF PRESCRIPTION DRUG BENEFITS PURSUANT TO A CONTRACT WITH
 A  HEALTH  PLAN,  DIRECTLY  OR THROUGH ANOTHER ENTITY, AND REGARDLESS OF
 WHETHER THE PHARMACY BENEFIT MANAGER AND THE HEALTH PLAN ARE RELATED, OR
 ASSOCIATED BY OWNERSHIP, COMMON OWNERSHIP,  ORGANIZATION  OR  OTHERWISE;
 INCLUDING  THE  PROCUREMENT  OF  PRESCRIPTION  DRUGS  TO BE DISPENSED TO
 PATIENTS, OR THE ADMINISTRATION OR MANAGEMENT OF PRESCRIPTION DRUG BENE-
 FITS, INCLUDING BUT NOT LIMITED TO, ANY OF THE FOLLOWING:
   (1) MAIL SERVICE PHARMACY;
   (2) CLAIMS PROCESSING, RETAIL NETWORK MANAGEMENT, OR PAYMENT OF CLAIMS
 TO PHARMACIES FOR DISPENSING PRESCRIPTION DRUGS;
   (3) CLINICAL OR OTHER FORMULARY OR PREFERRED DRUG LIST DEVELOPMENT  OR
 MANAGEMENT;
   (4)  NEGOTIATION  OR  ADMINISTRATION  OF  REBATES,  DISCOUNTS, PAYMENT
 DIFFERENTIALS, OR OTHER INCENTIVES,  FOR  THE  INCLUSION  OF  PARTICULAR
 PRESCRIPTION  DRUGS  IN A PARTICULAR CATEGORY OR TO PROMOTE THE PURCHASE
 OF PARTICULAR PRESCRIPTION DRUGS;

 S. 2507--A                         16                         A. 3007--A
 
   (5) PATIENT COMPLIANCE, THERAPEUTIC INTERVENTION, OR  GENERIC  SUBSTI-
 TUTION PROGRAMS;
   (6) DISEASE MANAGEMENT;
   (7) DRUG UTILIZATION REVIEW OR PRIOR AUTHORIZATION;
   (8) ADJUDICATION OF APPEALS OR GRIEVANCES RELATED TO PRESCRIPTION DRUG
 COVERAGE;
   (9) CONTRACTING WITH NETWORK PHARMACIES; AND
   (10) CONTROLLING THE COST OF COVERED PRESCRIPTION DRUGS.
   (C)  "PHARMACY  BENEFIT  MANAGER" MEANS ANY ENTITY, INCLUDING A WHOLLY
 OWNED OR PARTIALLY OWNED OR CONTROLLED SUBSIDIARY OF A PHARMACY BENEFITS
 MANAGER, THAT CONTRACTS TO PROVIDE PHARMACY BENEFIT MANAGEMENT  SERVICES
 ON BEHALF OF A HEALTH PLAN.
   (D) "CONTROLLING PERSON" MEANS ANY PERSON OR OTHER ENTITY WHO OR WHICH
 DIRECTLY  OR  INDIRECTLY HAS THE POWER TO DIRECT OR CAUSE TO BE DIRECTED
 THE MANAGEMENT, CONTROL OR ACTIVITIES OF A PHARMACY BENEFIT MANAGER.
   (E)  "COVERED  INDIVIDUAL"  MEANS  A  MEMBER,  PARTICIPANT,  ENROLLEE,
 CONTRACT HOLDER OR POLICY HOLDER OR BENEFICIARY OF A HEALTH PLAN.
   §  2902.  ACTING  WITHOUT A REGISTRATION. (A) NO PERSON, FIRM, ASSOCI-
 ATION, CORPORATION OR OTHER ENTITY MAY ACT AS A PHARMACY BENEFIT MANAGER
 ON OR AFTER JUNE FIRST, TWO THOUSAND TWENTY-ONE  AND  PRIOR  TO  JANUARY
 FIRST, TWO THOUSAND TWENTY-THREE, WITHOUT HAVING A VALID REGISTRATION AS
 A  PHARMACY  BENEFIT MANAGER FILED WITH THE SUPERINTENDENT IN ACCORDANCE
 WITH THIS ARTICLE AND ANY REGULATIONS PROMULGATED THEREUNDER.
   (B) ANY PERSON, FIRM, ASSOCIATION, CORPORATION OR  OTHER  ENTITY  THAT
 VIOLATES  THIS  SECTION SHALL, IN ADDITION TO ANY OTHER PENALTY PROVIDED
 BY LAW, BE LIABLE FOR RESTITUTION  TO  ANY  HEALTH  PLAN,  PHARMACY,  OR
 COVERED  INDIVIDUAL HARMED BY THE VIOLATION AND SHALL ALSO BE SUBJECT TO
 A PENALTY NOT EXCEEDING THE GREATER OF: (1) ONE THOUSAND DOLLARS FOR THE
 FIRST VIOLATION AND TWO THOUSAND FIVE HUNDRED DOLLARS  FOR  EACH  SUBSE-
 QUENT  VIOLATION; OR (2) THE AGGREGATE ECONOMIC GROSS RECEIPTS ATTRIBUT-
 ABLE TO ALL VIOLATIONS.
   § 2903. REGISTRATION REQUIREMENTS FOR PHARMACY BENEFIT MANAGERS.   (A)
 EVERY PHARMACY BENEFIT MANAGER THAT PERFORMS PHARMACY BENEFIT MANAGEMENT
 SERVICES  ON  OR  AFTER JUNE FIRST, TWO THOUSAND TWENTY-ONE AND PRIOR TO
 JANUARY FIRST, TWO THOUSAND TWENTY-THREE SHALL REGISTER WITH THE  SUPER-
 INTENDENT  IN  A MANNER ACCEPTABLE TO THE SUPERINTENDENT AND SHALL PAY A
 FEE OF ONE THOUSAND DOLLARS FOR EACH YEAR OR FRACTION OF A YEAR IN WHICH
 THE REGISTRATION SHALL BE VALID. THE SUPERINTENDENT SHALL  REQUIRE  THAT
 THE PHARMACY BENEFIT MANAGER DISCLOSE ITS OFFICER OR OFFICERS AND DIREC-
 TOR  OR  DIRECTORS WHO ARE RESPONSIBLE FOR THE BUSINESS ENTITY'S COMPLI-
 ANCE WITH THE FINANCIAL SERVICES AND INSURANCE  LAWS,  RULES  AND  REGU-
 LATIONS  OF THIS STATE. THE REGISTRATION SHALL DETAIL THE LOCATIONS FROM
 WHICH IT PROVIDES SERVICES, AND A LISTING OF ANY ENTITIES WITH WHICH  IT
 HAS CONTRACTS IN NEW YORK STATE.  THE SUPERINTENDENT CAN REJECT A REGIS-
 TRATION  APPLICATION  FILED  BY A PHARMACY BENEFIT MANAGER THAT FAILS TO
 COMPLY WITH THE MINIMUM REGISTRATION STANDARDS.
   (B) FOR EACH BUSINESS ENTITY, THE OFFICER OR OFFICERS AND DIRECTOR  OR
 DIRECTORS  NAMED  IN THE APPLICATION SHALL BE DESIGNATED RESPONSIBLE FOR
 THE BUSINESS ENTITY'S COMPLIANCE WITH THE FINANCIAL SERVICES AND  INSUR-
 ANCE LAWS, RULES AND REGULATIONS OF THIS STATE.
   (C) EVERY REGISTRATION WILL EXPIRE ON DECEMBER THIRTY-FIRST, TWO THOU-
 SAND TWENTY-TWO REGARDLESS OF WHEN REGISTRATION WAS FIRST MADE.
   (D)  EVERY  PHARMACY  BENEFIT  MANAGER  THAT PERFORMS PHARMACY BENEFIT
 MANAGEMENT SERVICES AT ANY TIME PRIOR TO JUNE FIRST, TWO THOUSAND  TWEN-
 TY-ONE,  SHALL  MAKE  THE  REGISTRATION  AND  FEE  PAYMENT  REQUIRED  BY
 SUBSECTION (A) OF THIS SECTION ON OR BEFORE  JUNE  FIRST,  TWO  THOUSAND

 S. 2507--A                         17                         A. 3007--A
 
 TWENTY-ONE.  ANY OTHER PHARMACY BENEFIT MANAGER SHALL MAKE THE REGISTRA-
 TION AND FEE PAYMENT REQUIRED BY SUBSECTION (A) OF THIS SECTION PRIOR TO
 PERFORMING PHARMACY BENEFIT MANAGEMENT SERVICES.
   (E)  REGISTRANTS UNDER THIS SECTION SHALL BE SUBJECT TO EXAMINATION BY
 THE SUPERINTENDENT AS OFTEN AS THE SUPERINTENDENT MAY DEEM IT NECESSARY.
 THE SUPERINTENDENT MAY PROMULGATE REGULATIONS ESTABLISHING  METHODS  AND
 PROCEDURES  FOR  FACILITATING AND VERIFYING COMPLIANCE WITH THE REQUIRE-
 MENTS OF THIS ARTICLE AND SUCH OTHER REGULATIONS AS NECESSARY TO ENFORCE
 THE PROVISIONS OF THIS ARTICLE.
   § 2904. REPORTING REQUIREMENTS FOR PHARMACY BENEFIT MANAGERS.   (A)(1)
 ON  OR BEFORE JULY FIRST OF EACH YEAR, BEGINNING IN TWO THOUSAND TWENTY-
 TWO, EVERY PHARMACY BENEFIT MANAGER SHALL REPORT TO THE  SUPERINTENDENT,
 IN A STATEMENT SUBSCRIBED AND AFFIRMED AS TRUE UNDER PENALTIES OF PERJU-
 RY,  THE  INFORMATION REQUESTED BY THE SUPERINTENDENT INCLUDING, WITHOUT
 LIMITATION:
   (I) ANY PRICING DISCOUNTS, REBATES OF ANY KIND, INFLATIONARY PAYMENTS,
 CREDITS, CLAWBACKS, FEES,  GRANTS,  CHARGEBACKS,  REIMBURSEMENTS,  OTHER
 FINANCIAL  OR  OTHER REIMBURSEMENTS, INCENTIVES, INDUCEMENTS, REFUNDS OR
 OTHER BENEFITS RECEIVED BY THE PHARMACY BENEFIT MANAGER; AND
   (II) THE TERMS AND CONDITIONS OF ANY CONTRACT OR ARRANGEMENT,  INCLUD-
 ING  OTHER  FINANCIAL OR OTHER REIMBURSEMENTS INCENTIVES, INDUCEMENTS OR
 REFUNDS BETWEEN THE PHARMACY BENEFIT MANAGER AND ANY OTHER PARTY  RELAT-
 ING  TO  PHARMACY  BENEFIT MANAGEMENT SERVICES PROVIDED TO A HEALTH PLAN
 INCLUDING BUT NOT LIMITED TO, DISPENSING FEES PAID TO PHARMACIES.
   (2) THE SUPERINTENDENT MAY REQUIRE THE FILING OF  QUARTERLY  OR  OTHER
 STATEMENTS,  WHICH  SHALL BE IN SUCH FORM AND SHALL CONTAIN SUCH MATTERS
 AS THE SUPERINTENDENT SHALL PRESCRIBE.
   (3) THE SUPERINTENDENT MAY ADDRESS TO ANY PHARMACY BENEFIT MANAGER  OR
 ITS  OFFICERS ANY INQUIRY IN RELATION TO ITS PROVISION OF PHARMACY BENE-
 FIT MANAGEMENT SERVICES OR ANY MATTER CONNECTED THEREWITH. EVERY PHARMA-
 CY BENEFIT MANAGER OR PERSON SO ADDRESSED SHALL REPLY IN WRITING TO SUCH
 INQUIRY PROMPTLY AND TRUTHFULLY, AND SUCH REPLY SHALL BE, IF REQUIRED BY
 THE SUPERINTENDENT, SUBSCRIBED BY SUCH INDIVIDUAL, OR BY SUCH OFFICER OR
 OFFICERS OF THE PHARMACY BENEFIT MANAGER, AS  THE  SUPERINTENDENT  SHALL
 DESIGNATE, AND AFFIRMED BY THEM AS TRUE UNDER THE PENALTIES OF PERJURY.
   (B)  IN  THE  EVENT  ANY  PHARMACY  BENEFIT MANAGER OR PERSON DOES NOT
 SUBMIT A REPORT REQUIRED BY PARAGRAPHS ONE OR TWO OF SUBSECTION  (A)  OF
 THIS  SECTION  OR  DOES  NOT PROVIDE A GOOD FAITH RESPONSE TO AN INQUIRY
 FROM THE SUPERINTENDENT PURSUANT TO PARAGRAPH THREE OF SUBSECTION (A) OF
 THIS SECTION WITHIN A TIME PERIOD SPECIFIED BY THE SUPERINTENDENT OF NOT
 LESS THAN FIFTEEN BUSINESS DAYS, THE  SUPERINTENDENT  IS  AUTHORIZED  TO
 LEVY  A  CIVIL  PENALTY, AFTER NOTICE AND HEARING, AGAINST SUCH PHARMACY
 BENEFIT MANAGER OR PERSON NOT TO EXCEED ONE THOUSAND DOLLARS PER DAY FOR
 EACH DAY BEYOND THE DATE THE REPORT IS DUE OR THE DATE SPECIFIED BY  THE
 SUPERINTENDENT FOR RESPONSE TO THE INQUIRY.
   (C)  ALL  DOCUMENTS,  MATERIALS,  OR  OTHER INFORMATION DISCLOSED BY A
 PHARMACY BENEFIT MANAGER UNDER THIS SECTION WHICH IS IN THE  CONTROL  OR
 POSSESSION OF THE SUPERINTENDENT SHALL BE DEEMED CONFIDENTIAL, SHALL NOT
 BE  DISCLOSED,  EITHER  PURSUANT  TO  FREEDOM OF INFORMATION REQUESTS OR
 SUBPOENA, AND FURTHER SHALL NOT BE SUBJECT TO DISCOVERY OR ADMISSIBLE IN
 EVIDENCE IN ANY PRIVATE CIVIL ACTION; PROVIDED HOWEVER THAT  NOTHING  IN
 THIS  SUBDIVISION  SHALL  PREVENT THE SUPERINTENDENT, IN HIS OR HER SOLE
 DISCRETION, FROM PROVIDING TO ANY OTHER GOVERNMENTAL ENTITY  INFORMATION
 THE  SUPERINTENDENT  DEEMS  NECESSARY FOR THE ENFORCEMENT OF THE LAWS OF
 THIS STATE OR OF THE UNITED STATES.

 S. 2507--A                         18                         A. 3007--A
 
   § 2905. ACTING WITHOUT A LICENSE. (A) NO  PERSON,  FIRM,  ASSOCIATION,
 CORPORATION  OR OTHER ENTITY MAY ACT AS A PHARMACY BENEFIT MANAGER ON OR
 AFTER JANUARY FIRST, TWO THOUSAND TWENTY-THREE WITHOUT HAVING  AUTHORITY
 TO  DO  SO  BY  VIRTUE  OF  A  LICENSE  ISSUED  IN FORCE PURSUANT TO THE
 PROVISIONS OF THIS ARTICLE.
   (B)  ANY  PERSON,  FIRM, ASSOCIATION, CORPORATION OR OTHER ENTITY THAT
 VIOLATES THIS SECTION SHALL, IN ADDITION TO ANY OTHER  PENALTY  PROVIDED
 BY  LAW,  BE  SUBJECT  TO A PENALTY NOT EXCEEDING THE GREATER OF (1) ONE
 THOUSAND DOLLARS FOR THE FIRST VIOLATION AND TWO THOUSAND  FIVE  HUNDRED
 DOLLARS  FOR  EACH  SUBSEQUENT  VIOLATION  OR (2) THE AGGREGATE ECONOMIC
 GROSS RECEIPTS ATTRIBUTABLE TO ALL VIOLATIONS.
   § 2906. LICENSING OF A PHARMACY BENEFIT MANAGER. (A)  THE  SUPERINTEN-
 DENT MAY ISSUE A PHARMACY BENEFIT MANAGER'S LICENSE TO ANY PERSON, FIRM,
 ASSOCIATION  OR  CORPORATION  WHO OR THAT HAS COMPLIED WITH THE REQUIRE-
 MENTS OF THIS ARTICLE, INCLUDING REGULATIONS PROMULGATED BY  THE  SUPER-
 INTENDENT.  THE SUPERINTENDENT, IN CONSULTATION WITH THE COMMISSIONER OF
 HEALTH, MAY ESTABLISH, BY REGULATION, MINIMUM STANDARDS FOR THE ISSUANCE
 OF A LICENSE TO A PHARMACY BENEFIT MANAGER.
   (B) THE MINIMUM STANDARDS ESTABLISHED UNDER THIS SECTION MAY  ADDRESS,
 WITHOUT LIMITATION:
   (1)  PROHIBITIONS  ON  CONFLICTS  OF INTEREST BETWEEN PHARMACY BENEFIT
 MANAGERS AND HEALTH PLANS;
   (2)  PROHIBITIONS  ON  DECEPTIVE  PRACTICES  IN  CONNECTION  WITH  THE
 PERFORMANCE OF PHARMACY BENEFIT MANAGEMENT SERVICES;
   (3)  PROHIBITIONS ON ANTI-COMPETITIVE PRACTICES IN CONNECTION WITH THE
 PERFORMANCE OF PHARMACY BENEFIT MANAGEMENT SERVICES;
   (4) PROHIBITIONS ON PRICING MODELS, WHICH MAY INCLUDE PROHIBITIONS  ON
 SPREAD PRICING;
   (5)  PROHIBITIONS  ON  UNFAIR  CLAIMS PRACTICES IN CONNECTION WITH THE
 PERFORMANCE OF PHARMACY BENEFIT MANAGEMENT SERVICES;
   (6) CODIFICATION OF STANDARDS AND PRACTICES IN THE CREATION OF PHARMA-
 CY NETWORKS AND CONTRACTING WITH NETWORK PHARMACIES AND OTHER PROVIDERS;
   (7) PROHIBITIONS ON CONTRACT PROVISIONS WHICH  ARBITRARILY  REQUIRE  A
 PHARMACY  TO MEET ANY PHARMACY ACCREDITATION STANDARD OR RECERTIFICATION
 REQUIREMENT INCONSISTENT WITH OR MORE STRINGENT THAN, OR IN ADDITION  TO
 FEDERAL  OR  STATE  REQUIREMENTS AND CODIFICATION OF STANDARDS AND PRAC-
 TICES IN THE CREATION AND USE OF SPECIALTY PHARMACY NETWORKS; AND
   (8) BEST PRACTICES FOR PROTECTION OF CONSUMERS.
   (C) THE SUPERINTENDENT MAY REQUIRE ANY OR ALL OF  THE  MEMBERS,  OFFI-
 CERS, DIRECTORS, OR DESIGNATED EMPLOYEES OF THE APPLICANT TO BE NAMED IN
 THE  APPLICATION  FOR  A  LICENSE  UNDER THIS ARTICLE. FOR EACH BUSINESS
 ENTITY, THE OFFICER OR OFFICERS AND DIRECTOR OR DIRECTORS NAMED  IN  THE
 APPLICATION  SHALL  BE  DESIGNATED RESPONSIBLE FOR THE BUSINESS ENTITY'S
 COMPLIANCE WITH THE INSURANCE LAWS, RULES AND REGULATIONS OF THIS STATE.
   (D)(1) BEFORE A PHARMACY BENEFIT MANAGER'S LICENSE SHALL BE ISSUED  OR
 RENEWED,  THE  PROSPECTIVE LICENSEE SHALL PROPERLY FILE IN THE OFFICE OF
 THE SUPERINTENDENT A WRITTEN APPLICATION THEREFOR IN SUCH FORM OR  FORMS
 AND  SUPPLEMENTS THERETO AS THE SUPERINTENDENT PRESCRIBES, AND PAY A FEE
 OF TWO THOUSAND DOLLARS FOR EACH YEAR OR FRACTION OF A YEAR IN  WHICH  A
 LICENSE SHALL BE VALID.
   (2)  EVERY  PHARMACY BENEFIT MANAGER'S LICENSE SHALL EXPIRE THIRTY-SIX
 MONTHS AFTER THE DATE OF ISSUE. EVERY LICENSE ISSUED  PURSUANT  TO  THIS
 SECTION  MAY BE RENEWED FOR THE ENSUING PERIOD OF THIRTY-SIX MONTHS UPON
 THE FILING OF AN APPLICATION IN CONFORMITY WITH THIS SUBSECTION.
   (E) IF AN APPLICATION FOR A RENEWAL LICENSE SHALL HAVE BEEN FILED WITH
 THE SUPERINTENDENT AT LEAST TWO MONTHS BEFORE ITS EXPIRATION,  THEN  THE

 S. 2507--A                         19                         A. 3007--A
 
 LICENSE  SOUGHT  TO  BE  RENEWED SHALL CONTINUE IN FULL FORCE AND EFFECT
 EITHER UNTIL THE ISSUANCE BY THE SUPERINTENDENT OF THE  RENEWAL  LICENSE
 APPLIED  FOR  OR  UNTIL  FIVE  DAYS  AFTER THE SUPERINTENDENT SHALL HAVE
 REFUSED  TO  ISSUE SUCH RENEWAL LICENSE AND GIVEN NOTICE OF SUCH REFUSAL
 TO THE APPLICANT.
   (F) THE SUPERINTENDENT MAY REFUSE TO ISSUE A PHARMACY  BENEFIT  MANAG-
 ER'S  LICENSE IF, IN THE SUPERINTENDENT'S JUDGMENT, THE APPLICANT OR ANY
 MEMBER, PRINCIPAL, OFFICER OR DIRECTOR OF THE APPLICANT, IS  NOT  TRUST-
 WORTHY  AND COMPETENT TO ACT AS OR IN CONNECTION WITH A PHARMACY BENEFIT
 MANAGER, OR THAT ANY OF THE FOREGOING HAS GIVEN CAUSE FOR REVOCATION  OR
 SUSPENSION  OF  SUCH LICENSE, OR HAS FAILED TO COMPLY WITH ANY PREREQUI-
 SITE FOR THE ISSUANCE OF SUCH LICENSE. AS A PART OF SUCH  DETERMINATION,
 THE  SUPERINTENDENT  IS  AUTHORIZED  TO  FINGERPRINT  APPLICANTS  OR ANY
 MEMBER, PRINCIPAL, OFFICER OR DIRECTOR OF THE APPLICANT  FOR  LICENSURE.
 SUCH FINGERPRINTS SHALL BE SUBMITTED TO THE DIVISION OF CRIMINAL JUSTICE
 SERVICES FOR A STATE CRIMINAL HISTORY RECORD CHECK, AS DEFINED IN SUBDI-
 VISION  ONE  OF SECTION THREE THOUSAND THIRTY-FIVE OF THE EDUCATION LAW,
 AND MAY BE SUBMITTED TO  THE  FEDERAL  BUREAU  OF  INVESTIGATION  FOR  A
 NATIONAL CRIMINAL HISTORY RECORD CHECK.
   (G) LICENSEES AND APPLICANTS FOR A LICENSE UNDER THIS SECTION SHALL BE
 SUBJECT TO EXAMINATION BY THE SUPERINTENDENT AS OFTEN AS THE SUPERINTEN-
 DENT  MAY  DEEM  IT  EXPEDIENT.  THE SUPERINTENDENT MAY PROMULGATE REGU-
 LATIONS ESTABLISHING METHODS AND PROCEDURES FOR FACILITATING AND VERIFY-
 ING COMPLIANCE WITH THE REQUIREMENTS OF  THIS  SECTION  AND  SUCH  OTHER
 REGULATIONS AS NECESSARY.
   (H)  THE  SUPERINTENDENT  MAY  ISSUE  A  REPLACEMENT  FOR  A CURRENTLY
 IN-FORCE LICENSE THAT HAS BEEN LOST OR DESTROYED. BEFORE THE REPLACEMENT
 LICENSE SHALL BE ISSUED, THERE SHALL BE ON FILE IN  THE  OFFICE  OF  THE
 SUPERINTENDENT  A  WRITTEN  APPLICATION  FOR  THE  REPLACEMENT  LICENSE,
 AFFIRMING UNDER PENALTY OF PERJURY THAT THE ORIGINAL  LICENSE  HAS  BEEN
 LOST OR DESTROYED, TOGETHER WITH A FEE OF TWO HUNDRED DOLLARS.
   (I) NO PHARMACY BENEFIT MANAGER SHALL ENGAGE IN ANY PRACTICE OR ACTION
 THAT A HEALTH PLAN IS PROHIBITED FROM ENGAGING IN PURSUANT TO THIS CHAP-
 TER.
   §  2907.  REVOCATION  OR  SUSPENSION OF A REGISTRATION OR LICENSE OF A
 PHARMACY BENEFIT MANAGER.  (A) THE SUPERINTENDENT MAY REFUSE  TO  RENEW,
 MAY  REVOKE,  OR  MAY SUSPEND FOR A PERIOD THE SUPERINTENDENT DETERMINES
 THE REGISTRATION OR LICENSE OF ANY  PHARMACY  BENEFIT  MANAGER  IF,  THE
 SUPERINTENDENT DETERMINES THAT THE REGISTRANT OR LICENSEE OR ANY MEMBER,
 PRINCIPAL, OFFICER, DIRECTOR, OR CONTROLLING PERSON OF THE REGISTRANT OR
 LICENSEE, HAS:
   (1)  VIOLATED  ANY INSURANCE LAWS, SECTION TWO HUNDRED EIGHTY-A OR TWO
 HUNDRED EIGHTY-C OF THE PUBLIC HEALTH LAW OR  VIOLATED  ANY  REGULATION,
 SUBPOENA  OR ORDER OF THE SUPERINTENDENT OR OF ANOTHER STATE'S INSURANCE
 COMMISSIONER, OR HAS VIOLATED ANY LAW IN THE COURSE OF ITS  DEALINGS  IN
 SUCH  CAPACITY AFTER SUCH LICENSE HAS BEEN ISSUED OR RENEWED PURSUANT TO
 SECTION TWO THOUSAND NINE HUNDRED SIX OF THIS ARTICLE;
   (2) PROVIDED MATERIALLY INCORRECT, MATERIALLY  MISLEADING,  MATERIALLY
 INCOMPLETE  OR  MATERIALLY  UNTRUE  INFORMATION  IN  THE REGISTRATION OR
 LICENSE APPLICATION;
   (3) OBTAINED OR ATTEMPTED TO OBTAIN A REGISTRATION OR LICENSE  THROUGH
 MISREPRESENTATION OR FRAUD;
   (4)(I) USED FRAUDULENT, COERCIVE OR DISHONEST PRACTICES;
   (II) DEMONSTRATED INCOMPETENCE;
   (III) DEMONSTRATED UNTRUSTWORTHINESS; OR

 S. 2507--A                         20                         A. 3007--A
 
   (IV)  DEMONSTRATED  FINANCIAL IRRESPONSIBILITY IN THE CONDUCT OF BUSI-
 NESS IN THIS STATE OR ELSEWHERE;
   (5)  IMPROPERLY  WITHHELD,  MISAPPROPRIATED OR CONVERTED ANY MONIES OR
 PROPERTIES RECEIVED IN THE COURSE OF BUSINESS IN  THIS  STATE  OR  ELSE-
 WHERE;
   (6)  INTENTIONALLY  MISREPRESENTED  THE TERMS OF AN ACTUAL OR PROPOSED
 INSURANCE CONTRACT;
   (7) ADMITTED OR BEEN FOUND TO  HAVE  COMMITTED  ANY  INSURANCE  UNFAIR
 TRADE PRACTICE OR FRAUD;
   (8)  HAD  A  PHARMACY  BENEFIT MANAGER REGISTRATION OR LICENSE, OR ITS
 EQUIVALENT, DENIED, SUSPENDED OR REVOKED IN ANY OTHER  STATE,  PROVINCE,
 DISTRICT OR TERRITORY;
   (9)  FAILED  TO PAY STATE INCOME TAX OR COMPLY WITH ANY ADMINISTRATIVE
 OR COURT ORDER DIRECTING PAYMENT OF STATE INCOME TAX;
   (10) FAILED TO PAY ANY ASSESSMENT REQUIRED BY THIS ARTICLE; OR
   (11) CEASED TO MEET THE REQUIREMENTS  FOR  REGISTRATION  OR  LICENSURE
 UNDER THIS ARTICLE.
   (B)  BEFORE  REVOKING OR SUSPENDING THE REGISTRATION OR LICENSE OF ANY
 PHARMACY BENEFIT MANAGER PURSUANT TO THE PROVISIONS OF THIS ARTICLE, THE
 SUPERINTENDENT SHALL GIVE NOTICE TO THE REGISTRANT OR LICENSEE AND SHALL
 HOLD, OR CAUSE TO BE HELD, A HEARING NOT LESS THAN TEN  DAYS  AFTER  THE
 GIVING OF SUCH NOTICE.
   (C)  IF  A  REGISTRATION OR LICENSE PURSUANT TO THE PROVISIONS OF THIS
 ARTICLE IS REVOKED OR SUSPENDED BY THE SUPERINTENDENT, THEN  THE  SUPER-
 INTENDENT SHALL FORTHWITH GIVE NOTICE TO THE REGISTRANT OR LICENSEE.
   (D) THE REVOCATION OR SUSPENSION OF ANY REGISTRATION OR LICENSE PURSU-
 ANT  TO  THE  PROVISIONS  OF THIS ARTICLE SHALL TERMINATE FORTHWITH SUCH
 REGISTRATION OR LICENSE AND THE AUTHORITY  CONFERRED  THEREBY  UPON  ALL
 LICENSEES. FOR GOOD CAUSE SHOWN, THE SUPERINTENDENT MAY DELAY THE EFFEC-
 TIVE  DATE  OF  A  REVOCATION  OR SUSPENSION TO PERMIT THE REGISTRANT OR
 LICENSEE TO SATISFY SOME  OR  ALL  OF  ITS  CONTRACTUAL  OBLIGATIONS  TO
 PERFORM PHARMACY BENEFIT MANAGEMENT SERVICES IN THE STATE.
   (E)(1) NO INDIVIDUAL, CORPORATION, FIRM OR ASSOCIATION WHOSE REGISTRA-
 TION  OR LICENSE AS A PHARMACY BENEFIT MANAGER HAS BEEN REVOKED PURSUANT
 TO SUBSECTION (A) OF THIS SECTION, AND NO FIRM OR ASSOCIATION  OF  WHICH
 SUCH INDIVIDUAL IS A MEMBER, AND NO CORPORATION OF WHICH SUCH INDIVIDUAL
 IS  AN  OFFICER OR DIRECTOR, AND NO CONTROLLING PERSON OF THE REGISTRANT
 OR LICENSEE SHALL BE ENTITLED TO  OBTAIN  ANY  REGISTRATION  OR  LICENSE
 UNDER  THE  PROVISIONS  OF THIS ARTICLE FOR A MINIMUM PERIOD OF ONE YEAR
 AFTER SUCH REVOCATION, OR, IF SUCH REVOCATION  BE  JUDICIALLY  REVIEWED,
 FOR  A  MINIMUM PERIOD OF ONE YEAR AFTER THE FINAL DETERMINATION THEREOF
 AFFIRMING THE ACTION OF THE SUPERINTENDENT IN REVOKING SUCH LICENSE.
   (2) IF ANY SUCH REGISTRATION OR LICENSE HELD BY A FIRM, ASSOCIATION OR
 CORPORATION BE REVOKED, NO MEMBER OF SUCH FIRM  OR  ASSOCIATION  AND  NO
 OFFICER OR DIRECTOR OF SUCH CORPORATION OR ANY CONTROLLING PERSON OF THE
 REGISTRANT  OR  LICENSEE SHALL BE ENTITLED TO OBTAIN ANY REGISTRATION OR
 LICENSE, UNDER THIS ARTICLE FOR THE SAME  PERIOD  OF  TIME,  UNLESS  THE
 SUPERINTENDENT  DETERMINES,  AFTER NOTICE AND HEARING, THAT SUCH MEMBER,
 OFFICER OR DIRECTOR WAS NOT PERSONALLY AT FAULT IN THE MATTER ON ACCOUNT
 OF WHICH SUCH REGISTRATION OR LICENSE WAS REVOKED.
   (F) IF ANY CORPORATION, FIRM, ASSOCIATION OR  PERSON  AGGRIEVED  SHALL
 FILE  WITH  THE  SUPERINTENDENT A VERIFIED COMPLAINT SETTING FORTH FACTS
 TENDING TO SHOW SUFFICIENT GROUND FOR THE REVOCATION  OR  SUSPENSION  OF
 ANY  PHARMACY  BENEFIT  MANAGER'S  REGISTRATION  OR LICENSE, THEN IF THE
 SUPERINTENDENT FINDS THE COMPLAINT CREDIBLE, THE  SUPERINTENDENT  SHALL,

 S. 2507--A                         21                         A. 3007--A
 
 AFTER  NOTICE  AND  A  HEARING,  DETERMINE  WHETHER SUCH REGISTRATION OR
 LICENSE SHALL BE SUSPENDED OR REVOKED.
   (G)  THE  SUPERINTENDENT  SHALL  RETAIN  THE  AUTHORITY TO ENFORCE THE
 PROVISIONS OF AND IMPOSE ANY PENALTY OR REMEDY AUTHORIZED BY THIS  CHAP-
 TER  AGAINST  ANY  PERSON  OR  ENTITY  WHO IS UNDER INVESTIGATION FOR OR
 CHARGED WITH A VIOLATION OF THIS CHAPTER, EVEN IF THE PERSON'S OR  ENTI-
 TY'S REGISTRATION OR LICENSE HAS BEEN SURRENDERED, OR HAS EXPIRED OR HAS
 LAPSED BY OPERATION OF LAW.
   (H)  A  REGISTRANT OR LICENSEE SUBJECT TO THIS ARTICLE SHALL REPORT TO
 THE SUPERINTENDENT ANY ADMINISTRATIVE ACTION TAKEN  AGAINST  THE  REGIS-
 TRANT  OR LICENSEE OR ANY OF THE MEMBERS, OFFICERS, DIRECTORS, OR DESIG-
 NATED EMPLOYEES OF THE APPLICANT NAMED IN THE REGISTRATION OR  LICENSING
 APPLICATION IN ANOTHER JURISDICTION OR BY ANOTHER GOVERNMENTAL AGENCY IN
 THIS  STATE  WITHIN  THIRTY DAYS OF THE FINAL DISPOSITION OF THE MATTER.
 THIS REPORT SHALL INCLUDE A COPY OF THE ORDER, CONSENT TO ORDER OR OTHER
 RELEVANT LEGAL DOCUMENTS.
   (I) WITHIN THIRTY DAYS OF THE INITIAL PRETRIAL HEARING DATE, A  REGIS-
 TRANT  OR  LICENSEE  SUBJECT  TO THIS ARTICLE SHALL REPORT TO THE SUPER-
 INTENDENT ANY CRIMINAL PROSECUTION OF THE REGISTRANT OR LICENSEE OR  ANY
 OF  THE  MEMBERS,  OFFICERS,  DIRECTORS,  OR DESIGNATED EMPLOYEES OF THE
 APPLICANT NAMED IN THE REGISTRATION OR LICENSING  APPLICATION  TAKEN  IN
 ANY  JURISDICTION.  THE  REPORT  SHALL  INCLUDE  A  COPY  OF THE INITIAL
 COMPLAINT FILED, THE ORDER RESULTING FROM  THE  HEARING  AND  ANY  OTHER
 RELEVANT LEGAL DOCUMENTS.
   §  2908.  PENALTIES FOR VIOLATIONS. (A) IN ADDITION TO ANY OTHER POWER
 CONFERRED BY LAW, THE SUPERINTENDENT MAY IN ANY ONE PROCEEDING BY ORDER,
 REQUIRE A REGISTRANT OR LICENSEE WHO HAS VIOLATED ANY PROVISION OF  THIS
 ARTICLE  OR  WHOSE  LICENSE  WOULD OTHERWISE BE SUBJECT TO REVOCATION OR
 SUSPENSION TO PAY TO THE PEOPLE OF THIS STATE A PENALTY  IN  A  SUM  NOT
 EXCEEDING  THE GREATER OF: (1) ONE THOUSAND DOLLARS FOR EACH OFFENSE AND
 TWO THOUSAND FIVE HUNDRED DOLLARS FOR EACH SUBSEQUENT VIOLATION; OR  (2)
 THE AGGREGATE GROSS RECEIPTS ATTRIBUTABLE TO ALL OFFENSES.
   (B)  UPON  THE  FAILURE  OF  SUCH  A REGISTRANT OR LICENSEE TO PAY THE
 PENALTY ORDERED PURSUANT TO SUBSECTION (A) OF THIS SECTION WITHIN TWENTY
 DAYS AFTER THE MAILING OF THE ORDER, POSTAGE  PREPAID,  REGISTERED,  AND
 ADDRESSED  TO  THE  LAST KNOWN PLACE OF BUSINESS OF THE LICENSEE, UNLESS
 THE ORDER IS STAYED BY AN ORDER OF A COURT  OF  COMPETENT  JURISDICTION,
 THE  SUPERINTENDENT MAY REVOKE THE REGISTRATION OR LICENSE OF THE REGIS-
 TRANT OR LICENSEE OR MAY SUSPEND THE SAME FOR SUCH PERIOD AS THE  SUPER-
 INTENDENT DETERMINES.
   §  2909.  STAY  OR  SUSPENSION  OF SUPERINTENDENT'S DETERMINATION. THE
 COMMENCEMENT OF A PROCEEDING UNDER ARTICLE SEVENTY-EIGHT  OF  THE  CIVIL
 PRACTICE  LAW  AND  RULES, TO REVIEW THE ACTION OF THE SUPERINTENDENT IN
 SUSPENDING OR REVOKING OR REFUSING TO RENEW ANY CERTIFICATE  UNDER  THIS
 ARTICLE,  SHALL  STAY  SUCH ACTION OF THE SUPERINTENDENT FOR A PERIOD OF
 THIRTY DAYS. SUCH STAY SHALL NOT BE EXTENDED FOR A LONGER PERIOD  UNLESS
 THE  COURT  SHALL  DETERMINE,  AFTER  A PRELIMINARY HEARING OF WHICH THE
 SUPERINTENDENT IS NOTIFIED FORTY-EIGHT HOURS IN ADVANCE, THAT A STAY  OF
 THE  SUPERINTENDENT'S  ACTION PENDING THE FINAL DETERMINATION OR FURTHER
 ORDER OF THE COURT WILL NOT INJURE THE INTERESTS OF THE  PEOPLE  OF  THE
 STATE.
   §  2910.  REVOKED  REGISTRATIONS  OR LICENSES. (A)(1) NO PERSON, FIRM,
 ASSOCIATION, CORPORATION OR OTHER ENTITY SUBJECT TO  THE  PROVISIONS  OF
 THIS  ARTICLE  WHOSE REGISTRATION OR LICENSE UNDER THIS ARTICLE HAS BEEN
 REVOKED, OR WHOSE REGISTRATION OR LICENSE TO ENGAGE IN THE  BUSINESS  OF
 PHARMACY  BENEFIT  MANAGEMENT  IN  ANY  CAPACITY HAS BEEN REVOKED BY ANY

 S. 2507--A                         22                         A. 3007--A

 OTHER STATE OR TERRITORY OF THE UNITED STATES SHALL BECOME  EMPLOYED  OR
 APPOINTED  BY A PHARMACY BENEFIT MANAGER AS AN OFFICER, DIRECTOR, MANAG-
 ER, CONTROLLING PERSON OR FOR OTHER SERVICES, WITHOUT THE PRIOR  WRITTEN
 APPROVAL OF THE SUPERINTENDENT, UNLESS SUCH SERVICES ARE FOR MAINTENANCE
 OR ARE CLERICAL OR MINISTERIAL IN NATURE.
   (2)  NO PERSON, FIRM, ASSOCIATION, CORPORATION OR OTHER ENTITY SUBJECT
 TO THE PROVISIONS OF THIS ARTICLE SHALL KNOWINGLY EMPLOY OR APPOINT  ANY
 PERSON OR ENTITY WHOSE REGISTRATION OR LICENSE ISSUED UNDER THIS ARTICLE
 HAS  BEEN  REVOKED,  OR  WHOSE  REGISTRATION OR LICENSE TO ENGAGE IN THE
 BUSINESS OF PHARMACY BENEFIT MANAGEMENT IN ANY CAPACITY HAS BEEN REVOKED
 BY ANY OTHER STATE OR TERRITORY OF THE UNITED  STATES,  AS  AN  OFFICER,
 DIRECTOR, MANAGER, CONTROLLING PERSON OR FOR OTHER SERVICES, WITHOUT THE
 PRIOR  WRITTEN  APPROVAL OF THE SUPERINTENDENT, UNLESS SUCH SERVICES ARE
 FOR MAINTENANCE OR ARE CLERICAL OR MINISTERIAL IN NATURE.
   (3) NO CORPORATION OR PARTNERSHIP SUBJECT TO THE  PROVISIONS  OF  THIS
 ARTICLE  SHALL KNOWINGLY PERMIT ANY PERSON WHOSE REGISTRATION OR LICENSE
 ISSUED UNDER THIS ARTICLE HAS BEEN REVOKED,  OR  WHOSE  REGISTRATION  OR
 LICENSE  TO ENGAGE IN THE BUSINESS OF PHARMACY BENEFIT MANAGEMENT IN ANY
 CAPACITY HAS BEEN REVOKED BY ANY OTHER STATE, OR TERRITORY OF THE UNITED
 STATES, TO BE A SHAREHOLDER OR HAVE AN INTEREST IN SUCH  CORPORATION  OR
 PARTNERSHIP,  NOR  SHALL ANY SUCH PERSON BECOME A SHAREHOLDER OR PARTNER
 IN SUCH CORPORATION OR PARTNERSHIP, WITHOUT THE PRIOR  WRITTEN  APPROVAL
 OF THE SUPERINTENDENT.
   (B)  THE  SUPERINTENDENT  MAY  APPROVE  THE EMPLOYMENT, APPOINTMENT OR
 PARTICIPATION OF ANY SUCH PERSON WHOSE REGISTRATION OR LICENSE HAS  BEEN
 REVOKED:
   (1)  IF THE SUPERINTENDENT DETERMINES THAT THE DUTIES AND RESPONSIBIL-
 ITIES OF SUCH PERSON ARE SUBJECT TO  APPROPRIATE  SUPERVISION  AND  THAT
 SUCH  DUTIES  AND  RESPONSIBILITIES WILL NOT HAVE AN ADVERSE EFFECT UPON
 THE PUBLIC, OTHER REGISTRANTS OR LICENSEES, OR THE REGISTRANT OR  LICEN-
 SEE PROPOSING EMPLOYMENT OR APPOINTMENT OF SUCH PERSON; OR
   (2)  IF  SUCH  PERSON  HAS  FILED AN APPLICATION FOR REREGISTRATION OR
 RELICENSING PURSUANT TO THIS ARTICLE AND THE APPLICATION FOR REREGISTRA-
 TION OR RELICENSING HAS NOT BEEN APPROVED OR DENIED WITHIN  ONE  HUNDRED
 TWENTY  DAYS  FOLLOWING  THE  FILING  THEREOF, UNLESS THE SUPERINTENDENT
 DETERMINES WITHIN THE SAID TIME THAT EMPLOYMENT OR APPOINTMENT  OF  SUCH
 PERSON  BY A REGISTRANT OR LICENSEE IN THE CONDUCT OF A PHARMACY BENEFIT
 MANAGEMENT BUSINESS WOULD NOT BE IN THE PUBLIC INTEREST.
   (C) THE PROVISIONS OF THIS SECTION SHALL NOT APPLY TO THE OWNERSHIP OF
 SHARES OF ANY CORPORATION REGISTERED OR LICENSED PURSUANT TO THIS  ARTI-
 CLE  IF  THE  SHARES OF SUCH CORPORATION ARE PUBLICLY HELD AND TRADED IN
 THE OVER-THE-COUNTER MARKET OR UPON ANY NATIONAL OR REGIONAL  SECURITIES
 EXCHANGE.
   § 2911. CHANGE OF ADDRESS. A REGISTRANT OR LICENSEE UNDER THIS ARTICLE
 SHALL INFORM THE SUPERINTENDENT BY A MEANS ACCEPTABLE TO THE SUPERINTEN-
 DENT OF A CHANGE OF ADDRESS WITHIN THIRTY DAYS OF THE CHANGE.
   §  2912.  DUTIES.  (A) A PHARMACY BENEFIT MANAGER SHALL BE REQUIRED TO
 ADHERE TO THE CODE OF CONDUCT, AS THE SUPERINTENDENT  MAY  ESTABLISH  BY
 REGULATION PURSUANT TO SECTION TWENTY-NINE HUNDRED SIX OF THIS ARTICLE.
   (B)  NO CONTRACT WITH A HEALTH PLAN SHALL LIMIT ACCESS TO FINANCIAL OR
 UTILIZATION INFORMATION OF THE PHARMACY BENEFIT MANAGER IN  RELATION  TO
 PHARMACY BENEFIT MANAGEMENT SERVICES PROVIDED TO THE HEALTH PLAN.
   (C)  A  PHARMACY BENEFIT MANAGER SHALL DISCLOSE IN WRITING TO A HEALTH
 PLAN WITH WHOM A CONTRACT FOR PHARMACY BENEFIT MANAGEMENT  SERVICES  HAS
 BEEN EXECUTED ANY ACTIVITY, POLICY, PRACTICE, CONTRACT OR ARRANGEMENT OF
 THE  PHARMACY  BENEFIT  MANAGER  THAT  DIRECTLY OR INDIRECTLY PRESENTS A

 S. 2507--A                         23                         A. 3007--A
 
 CONFLICT OF INTEREST WITH THE  PHARMACY  BENEFIT  MANAGER'S  CONTRACTUAL
 RELATIONSHIP WITH, OR DUTIES AND OBLIGATIONS TO, THE HEALTH PLAN.
   (D) A PHARMACY BENEFIT MANAGER SHALL ASSIST A HEALTH PLAN IN ANSWERING
 ANY INQUIRY MADE UNDER SECTION THREE HUNDRED EIGHT OF THIS CHAPTER.
   (E)  NO  PHARMACY  BENEFIT  MANAGER SHALL VIOLATE ANY PROVISION OF THE
 PUBLIC HEALTH LAW APPLICABLE TO PHARMACY BENEFIT MANAGERS.
   (F) (1) ANY INFORMATION REQUIRED TO BE DISCLOSED BY A PHARMACY BENEFIT
 MANAGER TO A HEALTH PLAN UNDER THIS SECTION THAT  IS  REASONABLY  DESIG-
 NATED  BY  THE  PHARMACY  BENEFIT MANAGER AS PROPRIETARY OR TRADE SECRET
 INFORMATION SHALL BE KEPT CONFIDENTIAL BY THE  HEALTH  PLAN,  EXCEPT  AS
 REQUIRED OR PERMITTED BY LAW OR COURT ORDER, INCLUDING DISCLOSURE NECES-
 SARY  TO  PROSECUTE  OR  DEFEND  ANY  LEGITIMATE LEGAL CLAIM OR CAUSE OF
 ACTION.
   (2) DESIGNATION AS PROPRIETARY OR TRADE SECRET INFORMATION UNDER  THIS
 SUBSECTION SHALL HAVE NO EFFECT ON THE OBLIGATIONS OF ANY PHARMACY BENE-
 FIT  MANAGER  OR  HEALTH PLAN TO PROVIDE THAT INFORMATION TO THE DEPART-
 MENT.
   § 2913. APPLICABILITY OF OTHER LAWS. NOTHING IN THIS ARTICLE SHALL  BE
 CONSTRUED  TO  EXEMPT A PHARMACY BENEFIT MANAGER FROM COMPLYING WITH THE
 PROVISIONS OF ARTICLES TWENTY-ONE AND FORTY-NINE  OF  THIS  CHAPTER  AND
 ARTICLES FORTY-FOUR AND FORTY-NINE AND SECTIONS TWO HUNDRED EIGHTY-A AND
 TWO  HUNDRED  EIGHTY-C  OF  THE PUBLIC HEALTH LAW, SECTION THREE HUNDRED
 SIXTY-FOUR-J OF THE SOCIAL SERVICES LAW, OR ANY OTHER PROVISION OF  THIS
 CHAPTER OR THE FINANCIAL SERVICES LAW.
   §  2914.  ASSESSMENTS.  NOTWITHSTANDING SECTION TWO HUNDRED SIX OF THE
 FINANCIAL SERVICES LAW, PHARMACY BENEFIT MANAGERS THAT FILE A  REGISTRA-
 TION  WITH  THE  DEPARTMENT  OR  ARE LICENSED BY THE DEPARTMENT SHALL BE
 ASSESSED BY THE SUPERINTENDENT FOR THE OPERATING EXPENSES OF THE DEPART-
 MENT THAT ARE ATTRIBUTABLE TO REGULATING SUCH PHARMACY BENEFIT  MANAGERS
 IN  SUCH  PROPORTIONS  AS THE SUPERINTENDENT SHALL DEEM JUST AND REASON-
 ABLE.
   § 2. Subsection (b) of section 2402 of the insurance law,  as  amended
 by section 71 of part A of chapter 62 of the laws of 2011, is amended to
 read as follows:
   (b)  "Defined  violation"  means  the commission by a person of an act
 prohibited by: subsection (a) of section one thousand one  hundred  two,
 section  one  thousand  two  hundred  fourteen, one thousand two hundred
 seventeen, one thousand two hundred twenty, one thousand  three  hundred
 thirteen, subparagraph (B) of paragraph two of subsection (i) of section
 one thousand three hundred twenty-two, subparagraph (B) of paragraph two
 of subsection (i) of section one thousand three hundred twenty-four, two
 thousand  one hundred two, two thousand one hundred seventeen, two thou-
 sand one hundred twenty-two,  two  thousand  one  hundred  twenty-three,
 subsection  (p)  of section two thousand three hundred thirteen, section
 two thousand three hundred twenty-four, two thousand five  hundred  two,
 two  thousand  five  hundred  three, two thousand five hundred four, two
 thousand six hundred one, two thousand six hundred two, two thousand six
 hundred three, two thousand six hundred four, two thousand  six  hundred
 six,  two  thousand  seven hundred three, TWO THOUSAND NINE HUNDRED TWO,
 TWO THOUSAND NINE HUNDRED FIVE, three thousand one hundred  nine,  three
 thousand  two hundred twenty-four-a, three thousand four hundred twenty-
 nine, three thousand  four  hundred  thirty-three,  paragraph  seven  of
 subsection  (e)  of section three thousand four hundred twenty-six, four
 thousand two hundred twenty-four, four thousand two hundred twenty-five,
 four thousand two hundred twenty-six, seven thousand eight hundred nine,
 seven thousand eight hundred ten, seven thousand eight  hundred  eleven,

 S. 2507--A                         24                         A. 3007--A
 
 seven  thousand  eight  hundred  thirteen,  seven thousand eight hundred
 fourteen and seven thousand eight hundred fifteen of  this  chapter;  or
 section  135.60,  135.65,  175.05,  175.45,  or  190.20,  or article one
 hundred five of the penal law.
   § 3. Severability. If any provision of this act, or any application of
 any provision of this act, is held to be invalid, or ruled by any feder-
 al  agency to violate or be inconsistent with any applicable federal law
 or regulation, that shall not affect the validity  or  effectiveness  of
 any  other  provision  of  this  act, or of any other application of any
 provision of this act.
   § 4. This act shall take effect immediately.
 
                                  PART K
 
   Section 1. Section 18 of chapter 266 of the laws of 1986, amending the
 civil practice law and rules and other laws relating to malpractice  and
 professional medical conduct is amended by adding a new subdivision 9 to
 read as follows:
   (9)  THIS SUBDIVISION SHALL APPLY ONLY TO EXCESS INSURANCE COVERAGE OR
 EQUIVALENT EXCESS COVERAGE FOR PHYSICIANS OR DENTISTS THAT  IS  ELIGIBLE
 TO  BE  PAID  FOR  FROM FUNDS AVAILABLE IN THE HOSPITAL EXCESS LIABILITY
 POOL.
   (A) NOTWITHSTANDING ANY LAW TO THE CONTRARY,  FOR  ANY  POLICY  PERIOD
 BEGINNING  ON  OR AFTER JULY 1, 2021, EXCESS COVERAGE SHALL BE PURCHASED
 BY A PHYSICIAN OR DENTIST DIRECTLY FROM A PROVIDER OF  EXCESS  INSURANCE
 COVERAGE  OR EQUIVALENT EXCESS COVERAGE.  SUCH PROVIDER OF EXCESS INSUR-
 ANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE  SHALL  BILL,  IN  A  MANNER
 CONSISTENT  WITH  PARAGRAPH  (E)  OF  THIS SUBDIVISION, THE PHYSICIAN OR
 DENTIST FOR AN AMOUNT EQUAL TO FIFTY PERCENT OF  THE  PREMIUM  FOR  SUCH
 COVERAGE,  AS ESTABLISHED PURSUANT TO PARAGRAPH (C) OF THIS SUBDIVISION,
 DURING THE POLICY PERIOD.  AT THE CONCLUSION OF THE  POLICY  PERIOD  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, PAY
 HALF OF THE REMAINING FIFTY PERCENT OF THE PREMIUM TO  THE  PROVIDER  OF
 EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE, AND THE REMAIN-
 ING TWENTY-FIVE PERCENT SHALL BE PAID ONE YEAR THEREAFTER.  IF THE FUNDS
 AVAILABLE IN THE HOSPITAL EXCESS LIABILITY POOL ARE INSUFFICIENT TO MEET
 THE  PERCENT  OF  THE  COSTS  OF  THE EXCESS COVERAGE, THE PROVISIONS OF
 SUBDIVISION 8 OF THIS SECTION SHALL APPLY.
   (B) IF AT THE CONCLUSION OF THE POLICY PERIOD, A PHYSICIAN OR DENTIST,
 ELIGIBLE FOR EXCESS COVERAGE PAID FOR FROM FUNDS AVAILABLE IN THE HOSPI-
 TAL EXCESS LIABILITY POOL, HAS FAILED TO PAY AN AMOUNT  EQUAL  TO  FIFTY
 PERCENT  OF THE PREMIUM AS ESTABLISHED PURSUANT TO PARAGRAPH (C) OF THIS
 SUBDIVISION, SUCH EXCESS COVERAGE 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.   THE PROVIDER OF EXCESS COVERAGE SHALL REMIT ANY PORTION
 OF PREMIUM PAID BY THE ELIGIBLE PHYSICIAN OR DENTIST FOR SUCH  A  POLICY
 PERIOD.
   (C)  THE  SUPERINTENDENT  OF FINANCIAL SERVICES SHALL ESTABLISH A RATE
 CONSISTENT WITH SUBDIVISION 3 OF THIS SECTION THAT PROVIDERS  OF  EXCESS
 INSURANCE  COVERAGE  OR  EQUIVALENT EXCESS COVERAGE WILL CHARGE FOR SUCH
 COVERAGE FOR EACH POLICY PERIOD.  FOR THE POLICY PERIOD  BEGINNING  JULY
 1,  2021,  THE  SUPERINTENDENT OF FINANCIAL SERVICES MAY DIRECT THAT THE

 S. 2507--A                         25                         A. 3007--A
 
 PREMIUM FOR THAT POLICY PERIOD BE THE SAME AS  IT  WAS  FOR  THE  POLICY
 PERIOD THAT CONCLUDED JUNE 30, 2020.
   (D)  NO  PROVIDER  OF  EXCESS  INSURANCE COVERAGE OR EQUIVALENT EXCESS
 COVERAGE SHALL ISSUE EXCESS COVERAGE TO WHICH THIS  SUBDIVISION  APPLIES
 TO  ANY  PHYSICIAN OR DENTIST UNLESS THAT PHYSICIAN OR DENTIST MEETS THE
 ELIGIBILITY REQUIREMENTS FOR SUCH COVERAGE SET FORTH  IN  THIS  SECTION.
 THE  SUPERINTENDENT OF FINANCIAL SERVICES AND THE COMMISSIONER OF HEALTH
 OR THEIR DESIGNEE SHALL NOT MAKE ANY PAYMENT UNDER THIS SUBDIVISION TO A
 PROVIDER OF EXCESS INSURANCE COVERAGE OR EQUIVALENT EXCESS COVERAGE  FOR
 EXCESS  COVERAGE  ISSUED TO A PHYSICIAN OR DENTIST WHO DOES NOT MEET THE
 ELIGIBILITY  REQUIREMENTS  FOR  PARTICIPATION  IN  THE  HOSPITAL  EXCESS
 LIABILITY POOL PROGRAM SET FORTH IN THIS SECTION.
   (E)  A  PROVIDER  OF  EXCESS INSURANCE COVERAGE OR EQUIVALENT COVERAGE
 THAT ISSUES EXCESS COVERAGE UNDER THIS SUBDIVISION SHALL BILL THE PHYSI-
 CIAN OR DENTIST FOR THE PORTION OF THE PREMIUM REQUIRED UNDER  PARAGRAPH
 (A)  OF THIS SUBDIVISION IN TWELVE EQUAL MONTHLY INSTALLMENTS OR IN SUCH
 OTHER MANNER AS THE PHYSICIAN OR DENTIST MAY AGREE.
   (F) THE SUPERINTENDENT OF FINANCIAL SERVICES IN CONSULTATION WITH  THE
 COMMISSIONER  OF  HEALTH MAY PROMULGATE REGULATIONS GIVING EFFECT TO THE
 PROVISIONS OF THIS SUBDIVISION.
   § 2. Paragraph (a) of subdivision 1 of section 18 of  chapter  266  of
 the  laws  of  1986, amending the civil practice law and rules and other
 laws relating  to  malpractice  and  professional  medical  conduct,  as
 amended  by  section 1 of part AAA of chapter 56 of the laws of 2020, 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, between July 1, 2017 and June
 30, 2018, between July 1, 2018 and June 30, 2019, between July  1,  2019

 S. 2507--A                         26                         A. 3007--A
 
 and  June  30,  2020,  [and] between July 1, 2020 and June 30, 2021, AND
 BETWEEN JULY 1, 2021 AND JUNE 30, 2022 or reimburse the  hospital  where
 the hospital purchases equivalent excess coverage as defined in subpara-
 graph  (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, between July 1, 2017
 and June 30, 2018, between July 1, 2018 and June 30, 2019, between  July
 1, 2019 and June 30, 2020, [and] between July 1, 2020 and June 30, 2021,
 AND  BETWEEN  JULY  1, 2021 AND JUNE 30, 2022 for physicians or dentists
 certified as eligible for each such period or periods pursuant to subdi-
 vision 2 of this section by a  general  hospital  licensed  pursuant  to
 article  28  of  the  public health law; provided that no single insurer
 shall write more than fifty percent of the total excess  premium  for  a
 given  policy year; and provided, however, that such eligible physicians
 or dentists must have in force an individual  policy,  from  an  insurer
 licensed  in  this  state  of  primary malpractice insurance coverage in
 amounts of no less than one million three hundred thousand  dollars  for
 each  claimant  and  three million nine hundred thousand dollars for all
 claimants under that policy during the period of  such  excess  coverage
 for  such  occurrences  or  be  endorsed  as additional insureds under a
 hospital professional liability policy which is offered through a volun-
 tary attending physician ("channeling") program previously permitted  by
 the  superintendent  of  financial  services  during  the period of such
 excess coverage for such occurrences. During such  period,  such  policy
 for  excess  coverage  or  such  equivalent  excess coverage shall, when
 combined with the physician's or dentist's primary malpractice insurance
 coverage or coverage provided through a  voluntary  attending  physician
 ("channeling")  program,  total  an aggregate level of two million three
 hundred thousand dollars for each claimant and six million nine  hundred
 thousand  dollars  for all claimants from all such policies with respect
 to occurrences in each of such years provided, however, if the  cost  of
 primary malpractice insurance coverage in excess of one million dollars,
 but  below  the  excess  medical malpractice insurance coverage provided
 pursuant to this act, exceeds the rate of nine percent per  annum,  then
 the  required  level of primary malpractice insurance coverage in excess
 of one million dollars for each claimant shall be in an  amount  of  not
 less  than  the dollar amount of such coverage available at nine percent
 per annum; the required level of such coverage for all  claimants  under
 that  policy  shall be in an amount not less than three times the dollar
 amount of coverage for each claimant; and excess coverage, when combined

 S. 2507--A                         27                         A. 3007--A
 
 with such primary malpractice insurance  coverage,  shall  increase  the
 aggregate  level  for  each  claimant  by  one million dollars and three
 million dollars for all claimants;  and  provided  further,  that,  with
 respect to policies of primary medical malpractice coverage that include
 occurrences  between  April  1, 2002 and June 30, 2002, such requirement
 that coverage be in amounts no less than one million three hundred thou-
 sand dollars for each claimant and three million nine  hundred  thousand
 dollars  for all claimants for such occurrences shall be effective April
 1, 2002.
   § 3. Subdivision 3 of section 18 of chapter 266 of the laws  of  1986,
 amending  the  civil  practice  law and rules and other laws relating to
 malpractice and professional medical conduct, as amended by section 2 of
 part AAA of chapter 56 of the laws  of  2020,  is  amended  to  read  as
 follows:
   (3)(a)  The  superintendent  of financial services shall determine and
 certify to each general hospital and to the commissioner of  health  the
 cost  of  excess malpractice insurance for medical or dental malpractice
 occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
 and June 30, 1989, between July 1, 1989 and June 30, 1990, between  July
 1,  1990  and  June  30,  1991,  between July 1, 1991 and June 30, 1992,
 between July 1, 1992 and June 30, 1993, between July 1,  1993  and  June
 30,  1994,  between July 1, 1994 and June 30, 1995, between July 1, 1995
 and June 30, 1996, between July 1, 1996 and June 30, 1997, between  July
 1,  1997  and  June  30,  1998,  between July 1, 1998 and June 30, 1999,
 between July 1, 1999 and June 30, 2000, between July 1,  2000  and  June
 30,  2001,  between July 1, 2001 and June 30, 2002, between July 1, 2002
 and June 30, 2003, between July 1, 2003 and June 30, 2004, between  July
 1,  2004  and  June  30,  2005,  between July 1, 2005 and June 30, 2006,
 between July 1, 2006 and June 30, 2007, between July 1,  2007  and  June
 30,  2008,  between July 1, 2008 and June 30, 2009, between July 1, 2009
 and June 30, 2010, between July 1, 2010 and June 30, 2011, between  July
 1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, [and]
 between  July  1,  2013 and June 30, 2014, between July 1, 2014 and June
 30, 2015, between July 1, 2015 and June 30, 2016, [and] between July  1,
 2016  and June 30, 2017, between July 1, 2017 and June 30, 2018, between
 July 1, 2018 and June 30, 2019, between July 1, 2019 and June 30,  2020,
 [and]  between  July 1, 2020 and June 30, 2021, AND BETWEEN JULY 1, 2021
 AND JUNE 30, 2022 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  subdivi-
 sion  2  of  this  section, and may amend such determination and certif-
 ication 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

 S. 2507--A                         28                         A. 3007--A
 
 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, between July  1,  2017
 and  June 30, 2018, between July 1, 2018 and June 30, 2019, between July
 1, 2019 and June 30, 2020, [and] between July 1, 2020 and June 30, 2021,
 AND BETWEEN JULY 1, 2021 AND JUNE 30, 2022  allocable  to  each  general
 hospital  for  physicians or dentists certified as eligible for purchase
 of a policy for excess insurance coverage or equivalent excess  coverage
 by  such  general  hospital  in  accordance  with  subdivision 2 of this
 section, and may amend such determination and  certification  as  neces-
 sary.  The  superintendent  of  financial  services  shall determine and
 certify to each general hospital and to the commissioner of  health  the
 ratable  share  of  such  cost  allocable  to the period July 1, 1987 to
 December 31, 1987, to the period January 1, 1988 to June  30,  1988,  to
 the  period  July 1, 1988 to December 31, 1988, to the period January 1,
 1989 to June 30, 1989, to the period July 1, 1989 to December 31,  1989,
 to  the  period  January 1, 1990 to June 30, 1990, to the period July 1,
 1990 to December 31, 1990, to the period January 1,  1991  to  June  30,
 1991,  to  the  period  July 1, 1991 to December 31, 1991, to the period
 January 1, 1992 to June 30, 1992, to the period July 1, 1992 to December
 31, 1992, to the period January 1, 1993 to June 30, 1993, to the  period
 July 1, 1993 to December 31, 1993, to the period January 1, 1994 to June
 30, 1994, to the period July 1, 1994 to December 31, 1994, to the period
 January 1, 1995 to June 30, 1995, to the period July 1, 1995 to December
 31,  1995, to the period January 1, 1996 to June 30, 1996, to the period
 July 1, 1996 to December 31, 1996, to the period January 1, 1997 to June
 30, 1997, to the period July 1, 1997 to December 31, 1997, to the period
 January 1, 1998 to June 30, 1998, to the period July 1, 1998 to December
 31, 1998, to the period January 1, 1999 to June 30, 1999, to the  period
 July 1, 1999 to December 31, 1999, to the period January 1, 2000 to June
 30, 2000, to the period July 1, 2000 to December 31, 2000, to the period
 January 1, 2001 to June 30, 2001, to the period July 1, 2001 to June 30,
 2002, to the period July 1, 2002 to June 30, 2003, to the period July 1,
 2003  to  June 30, 2004, to the period July 1, 2004 to June 30, 2005, to
 the period July 1, 2005 and June 30, 2006, to the period  July  1,  2006
 and  June 30, 2007, to the period July 1, 2007 and June 30, 2008, to the
 period July 1, 2008 and June 30, 2009, to the period July  1,  2009  and
 June  30,  2010,  to  the  period July 1, 2010 and June 30, 2011, to the
 period July 1, 2011 and June 30, 2012, to the period July  1,  2012  and
 June  30,  2013,  to  the  period July 1, 2013 and June 30, 2014, to the
 period July 1, 2014 and June 30, 2015, to the period July  1,  2015  and
 June  30,  2016,  to  the  period July 1, 2016 and June 30, 2017, to the
 period July 1, 2017 to June 30, 2018, to the period July 1, 2018 to June
 30, 2019, to the period July 1, 2019 to June  30,  2020,  [and]  to  the
 period  July 1, 2020 to June 30, 2021, AND TO THE PERIOD JULY 1, 2021 TO
 JUNE 30, 2022.
   § 4. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
 18 of chapter 266 of the laws of 1986, amending the civil  practice  law
 and  rules  and  other  laws  relating  to  malpractice and professional
 medical conduct, as amended by section 3 of part AAA of  chapter  56  of
 the laws of 2020, are amended to read as follows:

 S. 2507--A                         29                         A. 3007--A
 
   (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 to June 30, 2016, during
 the period July 1, 2016 to June 30, 2017, during the period July 1, 2017
 to June 30, 2018, during the period July  1,  2018  to  June  30,  2019,
 during the period July 1, 2019 to June 30, 2020, [and] during the period
 July  1,  2020  to  June 30, 2021, AND DURING THE PERIOD JULY 1, 2021 TO
 JUNE 30, 2022 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 coverage is purchased
 for such period shall be responsible for  payment  to  the  provider  of
 excess  insurance coverage or equivalent excess coverage of an allocable
 share of such insufficiency, based on the ratio of  the  total  cost  of
 such  coverage  for  such physician to the sum of the total cost of such
 coverage for all physicians applied to such insufficiency.
   (b) Each provider of excess insurance coverage  or  equivalent  excess
 coverage  covering the period July 1, 1992 to June 30, 1993, or covering
 the period July 1, 1993 to June 30, 1994, or covering the period July 1,
 1994 to June 30, 1995, or covering the period July 1, 1995 to  June  30,
 1996,  or covering the period July 1, 1996 to June 30, 1997, or covering
 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

 S. 2507--A                         30                         A. 3007--A
 
 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, or covering the period July 1, 2019 to June 30, 2020,  or
 covering the period July 1, 2020 to June 30, 2021, OR COVERING THE PERI-
 OD  JULY  1,  2021  TO JUNE 30, 2022 shall notify a covered physician or
 dentist by mail, mailed to the address shown on the last application for
 excess insurance coverage or equivalent excess coverage, of  the  amount
 due  to  such  provider from such physician or dentist for such coverage
 period determined in accordance with paragraph (a) of this  subdivision.
 Such amount shall be due from such physician or dentist to such provider
 of excess insurance coverage or equivalent excess coverage in a time and
 manner determined by the superintendent of financial services.
   (c)  If  a physician or dentist liable for payment of a portion of the
 costs of excess insurance coverage or equivalent excess coverage  cover-
 ing  the  period  July  1, 1992 to June 30, 1993, or covering the period
 July 1, 1993 to June 30, 1994, or covering the period July  1,  1994  to
 June  30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
 covering the period July 1, 1996 to June 30, 1997, or covering the peri-
 od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
 June 30, 1999, or covering the period July 1, 1999 to June 30, 2000,  or
 covering the period July 1, 2000 to June 30, 2001, or covering the peri-
 od  July  1,  2001  to October 29, 2001, or covering the period April 1,
 2002 to June 30, 2002, or covering the period July 1, 2002 to  June  30,
 2003,  or covering the period July 1, 2003 to June 30, 2004, or covering
 the period July 1, 2004 to June 30, 2005, or covering the period July 1,
 2005 to June 30, 2006, or covering the period July 1, 2006 to  June  30,
 2007,  or covering the period July 1, 2007 to June 30, 2008, or covering
 the period July 1, 2008 to June 30, 2009, or covering the period July 1,
 2009 to June 30, 2010, or covering the period July 1, 2010 to  June  30,
 2011,  or covering the period July 1, 2011 to June 30, 2012, or covering
 the period July 1, 2012 to June 30, 2013, or covering the period July 1,
 2013 to June 30, 2014, or covering the period July 1, 2014 to  June  30,
 2015,  or covering the period July 1, 2015 to June 30, 2016, or covering
 the period July 1, 2016 to June 30, 2017, or covering the period July 1,
 2017 to June 30, 2018, or covering the period July 1, 2018 to  June  30,
 2019,  or covering the period July 1, 2019 to June 30, 2020, or covering
 the period July 1, 2020 to June 30, 2021, OR COVERING THE PERIOD JULY 1,
 2021 TO JUNE 30, 2022 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 equivalent excess coverage purchased for such  physician  or
 dentist  in  accordance with this section for such coverage period shall
 be cancelled and shall be null and void as of the first day on or  after
 the  commencement  of  a  policy  period where the liability for payment
 pursuant to this subdivision has not been met.
   (d) Each provider of excess insurance coverage  or  equivalent  excess
 coverage  shall  notify the superintendent of financial services and the
 commissioner of health or their designee of each physician  and  dentist
 eligible  for  purchase  of  a  policy  for excess insurance coverage or
 equivalent excess coverage covering the period July 1, 1992 to June  30,
 1993,  or covering the period July 1, 1993 to June 30, 1994, or covering
 the period July 1, 1994 to June 30, 1995, or covering the period July 1,
 1995 to June 30, 1996, or covering the period July 1, 1996 to  June  30,
 1997,  or covering the period July 1, 1997 to June 30, 1998, or covering

 S. 2507--A                         31                         A. 3007--A
 
 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, or covering the period July 1, 2019 to
 June  30, 2020, or covering the period July 1, 2020 to June 30, 2021, OR
 COVERING THE PERIOD JULY 1, 2021 TO JUNE 30, 2022 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, and to the period July 1, 2019 to June 30,  2020,
 and  to the period July 1, 2020 to June 30, 2021, AND TO THE PERIOD JULY
 1, 2021 TO JUNE 30, 2022 received from  the  hospital  excess  liability
 pool  for  purchase  of  excess  insurance coverage or equivalent excess
 coverage covering the period July 1, 1992 to June 30, 1993, and covering
 the period July 1, 1993 to June 30, 1994, and covering the  period  July
 1,  1994  to June 30, 1995, and covering the period July 1, 1995 to June
 30, 1996, and covering the period July 1, 1996 to  June  30,  1997,  and
 covering  the  period  July  1,  1997 to June 30, 1998, and covering the
 period July 1, 1998 to June 30, 1999, and covering the  period  July  1,
 1999  to June 30, 2000, and covering the period July 1, 2000 to June 30,
 2001, and covering the period July 1, 2001  to  October  29,  2001,  and

 S. 2507--A                         32                         A. 3007--A
 
 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 cover-
 ing 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  covering the period July 1, 2010 to June 30, 2011, and covering the
 period July 1, 2011 to June 30, 2012, and covering the  period  July  1,
 2012  to June 30, 2013, and covering the period July 1, 2013 to June 30,
 2014, and covering the period July 1, 2014 to June 30, 2015, and  cover-
 ing  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,
 and covering the period July 1, 2019 to June 30, 2020, and covering  the
 period  July  1,  2020 to June 30, 2021, AND COVERING THE PERIOD JULY 1,
 2021 TO JUNE 30, 2022 for a  physician  or  dentist  where  such  excess
 insurance coverage or equivalent excess coverage is cancelled in accord-
 ance with paragraph (c) of this subdivision.
   § 5. Section 40 of chapter 266 of the laws of 1986, amending the civil
 practice  law  and  rules  and  other  laws  relating to malpractice and
 professional medical conduct, as amended by section 5  of  part  AAA  of
 chapter 56 of the laws of 2020, 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,
 [2021] 2022; 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, [2021]
 2022, 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, [2021]
 2022 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

 S. 2507--A                         33                         A. 3007--A

 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.
   § 6. Section 5 and subdivisions (a) and (e) of section 6 of part J  of
 chapter  63  of  the  laws  of 2001, amending chapter 266 of the laws of
 1986, amending the civil practice law and rules and other laws  relating
 to malpractice and professional medical conduct, as amended by section 6
 of  part  AAA  of chapter 56 of the laws of 2020, 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, June
 15, 2018, June 15, 2019, June 15, 2020, [and] June 15,  2021,  AND  JUNE
 15,  2022 the amount of funds available in the hospital excess liability
 pool, created pursuant to section 18 of chapter 266 of the laws of 1986,
 and whether such funds are sufficient for purposes of purchasing  excess
 insurance  coverage  for  eligible participating physicians and dentists
 during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June
 30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June  30,
 2005,  or  July  1,  2005  to June 30, 2006, or July 1, 2006 to June 30,
 2007, or July 1, 2007 to June 30, 2008, or July  1,  2008  to  June  30,
 2009,  or  July  1,  2009  to June 30, 2010, or July 1, 2010 to June 30,
 2011, or July 1, 2011 to June 30, 2012, or July  1,  2012  to  June  30,
 2013,  or  July  1,  2013  to June 30, 2014, or July 1, 2014 to June 30,
 2015, or July 1, 2015 to June 30, 2016, or July  1,  2016  to  June  30,
 2017,  or  July  1,  2017  to June 30, 2018, or July 1, 2018 to June 30,
 2019, or July 1, 2019 to June 30, 2020, or July  1,  2020  to  June  30,
 2021, OR JULY 1, 2021 TO JUNE 30, 2022 as applicable.

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   (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, or July 1, 2019 to June 30,
 2020, or July 1, 2020 to June 30, 2021, OR JULY 1, 2021 TO JUNE 30, 2022
 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, June 15, 2018, June 15,  2019,  June
 15, 2020, [and] June 15, 2021, AND JUNE 15, 2022 as applicable.
   §  7. 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, as amended by section 7 of part
 AAA of chapter 56 of the laws of 2020, 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 [twenty] TWENTY-ONE, shall be eligible to  apply  for  such
 coverage  for the coverage period beginning the first of July, two thou-
 sand [twenty] TWENTY-ONE; 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 [twenty] TWENTY-ONE exceeds the total number of
 physicians or dentists certified as eligible  for  the  coverage  period
 beginning  the first of July, two thousand [twenty] TWENTY-ONE, then the
 general hospitals may certify additional eligible physicians or dentists
 in a number equal to such general hospital's proportional share  of  the

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 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
 [twenty]  TWENTY-ONE, 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 [twenty] TWENTY-ONE 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 [twenty] TWENTY-ONE.
   §  8.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2021.
 
                                  PART L
 
   Section 1. Subdivision 2 of section 605 of the public health  law,  as
 amended  by  section  1  of part O of chapter 57 of the laws of 2019, is
 amended to read as follows:
   2. State aid reimbursement for public health services  provided  by  a
 municipality  under  this  title,  shall  be made if the municipality is
 providing some or all of the core public health services  identified  in
 section  six hundred two of this title, pursuant to an approved applica-
 tion for state aid, at a rate of no less  than  thirty-six  per  centum,
 except  for the city of New York which shall receive no less than [twen-
 ty] TEN per centum, of the  difference  between  the  amount  of  moneys
 expended  by  the  municipality  for  public health services required by
 section six hundred two of this title during the  fiscal  year  and  the
 base grant provided pursuant to subdivision one of this section. No such
 reimbursement  shall  be provided for services that are not eligible for
 state aid pursuant to this article.
   § 2. Subdivision 1 of section 616 of the public health law, as amended
 by section 2 of part O of chapter 57 of the laws of 2019, is amended  to
 read as follows:
   1.  The  total  amount  of state aid provided pursuant to this article
 shall be limited to the amount of the annual appropriation made  by  the
 legislature.  In no event, however, shall such state aid be less than an
 amount to provide the full base grant  and,  as  otherwise  provided  by
 subdivision  two  of  section  six hundred five of this article, no less
 than thirty-six per centum, except for the city of New York which  shall
 receive  no less than [twenty] TEN per centum, of the difference between
 the amount of moneys expended by the municipality  for  eligible  public
 health services pursuant to an approved application for state aid during
 the  fiscal year and the base grant provided pursuant to subdivision one
 of section six hundred five of this article.
   § 3. This act shall take effect July 1, 2021.
 
                                  PART M
 
   Section 1. Subdivision 1, paragraph (f) of subdivision  3,  paragraphs
 (a)  and  (d)  of  subdivision  5 and subdivisions 5-a and 12 of section
 2807-m of the public health law, subdivision 1, paragraph (f) of  subdi-
 vision 3, paragraph (a) of subdivision 5, and subdivision 5-a as amended
 and  paragraph  (d)  of subdivision 5 as added by section 6 of part Y of
 chapter 56 of the laws of 2020, are amended to read as follows:
   1.  Definitions. For purposes of this  section,  the  following  defi-
 nitions shall apply, unless the context clearly requires otherwise:

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   (a) ["Clinical research" means patient-oriented research, epidemiolog-
 ic  and  behavioral  studies,  or  outcomes research and health services
 research that is approved by an institutional review board by  the  time
 the clinical research position is filled.
   (b) "Clinical research plan" means a plan submitted by a consortium or
 teaching  general hospital for a clinical research position which demon-
 strates, in a form to be provided by the commissioner, the following:
   (i) financial support for overhead, supervision, equipment  and  other
 resources  equal  to the amount of funding provided pursuant to subpara-
 graph (i) of paragraph (b) of subdivision five-a of this section by  the
 teaching  general hospital or consortium for the clinical research posi-
 tion;
   (ii) experience the sponsor-mentor and teaching general  hospital  has
 in clinical research and the medical field of the study;
   (iii)  methods, data collection and anticipated measurable outcomes of
 the clinical research to be performed;
   (iv) training goals, objectives and experience the researcher will  be
 provided to assess a future career in clinical research;
   (v)  scientific  relevance,  merit  and  health  implications  of  the
 research to be performed;
   (vi) information on potential  scientific  meetings  and  peer  review
 journals where research results can be disseminated;
   (vii)  clear  and comprehensive details on the clinical research posi-
 tion;
   (viii) qualifications necessary for the clinical research position and
 strategy for recruitment;
   (ix) non-duplication with other clinical research positions  from  the
 same teaching general hospital or consortium;
   (x)  methods  to  track the career of the clinical researcher once the
 term of the position is complete; and
   (xi) any other information required by the commissioner  to  implement
 subparagraph (i) of paragraph (b) of subdivision five-a of this section.
   (xii) The clinical review plan submitted in accordance with this para-
 graph  may  be reviewed by the commissioner in consultation with experts
 outside the department of health.
   (c) "Clinical research position" means a post-graduate residency posi-
 tion which:
   (i) shall not be required in order for the researcher  to  complete  a
 graduate medical education program;
   (ii)  may  be reimbursed by other sources but only for costs in excess
 of the funding distributed in accordance with subparagraph (i) of  para-
 graph (b) of subdivision five-a of this section;
   (iii)  shall  exceed  the  minimum  standards that are required by the
 residency review committee in the specialty the researcher  has  trained
 or is currently training;
   (iv)  shall  not be previously funded by the teaching general hospital
 or supported by another funding source at the teaching general  hospital
 in  the  past  three  years  from the date the clinical research plan is
 submitted to the commissioner;
   (v) may supplement an existing research project;
   (vi) shall be equivalent to a full-time position comprising of no less
 than thirty-five hours per week for one or two years;
   (vii) shall provide, or be filled by a researcher who  has  formalized
 instruction  in  clinical  research,  including  biostatistics, clinical
 trial design, grant writing and research ethics;

 S. 2507--A                         37                         A. 3007--A

   (viii) shall be supervised by a sponsor-mentor who shall either (A) be
 employed, contracted for employment or paid through an affiliated facul-
 ty practice plan by a teaching general hospital which  has  received  at
 least  one  research grant from the National Institutes of Health in the
 past five years from the date the clinical research plan is submitted to
 the  commissioner;  (B)  maintain  a  faculty  appointment at a medical,
 dental or podiatric school located in New York state that  has  received
 at  least  one  research grant from the National Institutes of Health in
 the past five years from the date the clinical research plan is  submit-
 ted  to  the  commissioner;  or  (C)  be  collaborating  in the clinical
 research plan with  a  researcher  from  another  institution  that  has
 received  at  least  one  research grant from the National Institutes of
 Health in the past five years from the date the clinical  research  plan
 is submitted to the commissioner; and
   (ix)  shall  be  filled  by  a  researcher  who is (A) enrolled or has
 completed a graduate medical education program, as defined in  paragraph
 (i)  of  this  subdivision;  (B)  a  United States citizen, national, or
 permanent resident of the  United  States;  and  (C)  a  graduate  of  a
 medical,  dental or podiatric school located in New York state, a gradu-
 ate or resident in a graduate medical education program, as  defined  in
 paragraph  (i) of this subdivision, where the sponsoring institution, as
 defined in paragraph (q) of this subdivision, is  located  in  New  York
 state,  or  resides  in New York state at the time the clinical research
 plan is submitted to the commissioner.
   (d)] "Consortium" means an organization or  association,  approved  by
 the  commissioner in consultation with the council, of general hospitals
 which provide graduate medical education, together with  any  affiliated
 site;  provided  that  such organization or association may also include
 other providers of health care  services,  medical  schools,  payors  or
 consumers,  and which meet other criteria pursuant to subdivision six of
 this section.
   [(e)] (B) "Council" means the  New  York  state  council  on  graduate
 medical education.
   [(f)]  (C)  "Direct medical education" means the direct costs of resi-
 dents, interns and supervising physicians.
   [(g)] (D) "Distribution period" means each calendar year set forth  in
 subdivision two of this section.
   [(h)]  (E)  "Faculty"  means  persons  who  are  employed  by or under
 contract for employment with a teaching general  hospital  or  are  paid
 through  a  teaching general hospital's affiliated faculty practice plan
 and maintain a faculty appointment at a  medical  school.  Such  persons
 shall not be limited to persons with a degree in medicine.
   [(i)]  (F)  "Graduate medical education program" means a post-graduate
 medical education residency in the  United  States  which  has  received
 accreditation  from  a  nationally  recognized accreditation body or has
 been approved by  a  nationally  recognized  organization  for  medical,
 osteopathic,  podiatric  or dental residency programs including, but not
 limited to, specialty boards.
   [(j)] (G) "Indirect medical education" means the  estimate  of  costs,
 other than direct costs, of educational activities in teaching hospitals
 as determined in accordance with the methodology applicable for purposes
 of  determining  an  estimate  of  indirect  medical education costs for
 reimbursement for inpatient hospital service pursuant to title XVIII  of
 the federal social security act (medicare).

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   [(k)]  (H) "Medicare" means the methodology used for purposes of reim-
 bursing inpatient hospital services provided to beneficiaries  of  title
 XVIII of the federal social security act.
   [(l)]  (I)  "Primary  care" residents specialties shall include family
 medicine, general pediatrics, primary care internal medicine, and prima-
 ry care obstetrics and gynecology. In determining whether a residency is
 in primary care, the commissioner shall consult with the council.
   [(m)] (J) "Regions", for purposes of  this  section,  shall  mean  the
 regions  as  defined  in paragraph (b) of subdivision sixteen of section
 twenty-eight hundred seven-c of this article as in effect on June  thir-
 tieth, nineteen hundred ninety-six. For purposes of distributions pursu-
 ant  to subdivision five-a of this section, except distributions made in
 accordance with paragraph (a) of subdivision  five-a  of  this  section,
 "regions" shall be defined as New York city and the rest of the state.
   [(n)]  (K)  "Regional pool" means a professional education pool estab-
 lished on a regional basis by  the  commissioner  from  funds  available
 pursuant  to  sections  twenty-eight  hundred  seven-s  and twenty-eight
 hundred seven-t of this article.
   [(o)] (L) "Resident" means a person in a  graduate  medical  education
 program  which  has  received accreditation from a nationally recognized
 accreditation body or in a program  approved  by  any  other  nationally
 recognized  organization  for  medical,  osteopathic or dental residency
 programs including, but not limited to, specialty boards.
   [(p) "Shortage specialty" means a specialty determined by the  commis-
 sioner,  in  consultation with the council, to be in short supply in the
 state of New York.
   (q)] (M) "Sponsoring institution" means the entity that has the  over-
 all  responsibility  for  a  program of graduate medical education. Such
 institutions shall include teaching general hospitals, medical  schools,
 consortia and diagnostic and treatment centers.
   [(r)]  (N)  "Weighted  resident count" means a teaching general hospi-
 tal's total number of residents as of July first, nineteen hundred nine-
 ty-five,  including  residents  in  affiliated  non-hospital  ambulatory
 settings,  reported  to  the  commissioner.  Such  resident counts shall
 reflect the weights established in accordance with rules and regulations
 adopted by the state hospital review and planning council  and  approved
 by the commissioner for purposes of implementing subdivision twenty-five
 of section twenty-eight hundred seven-c of this article and in effect on
 July  first,  nineteen  hundred  ninety-five.  Such weights shall not be
 applied to specialty hospitals, specified  by  the  commissioner,  whose
 primary  care  mission  is  to engage in research, training and clinical
 care in specialty  eye  and  ear,  special  surgery,  orthopedic,  joint
 disease, cancer, chronic care or rehabilitative services.
   [(s)]  (O)  "Adjustment  amount"  means  an amount determined for each
 teaching hospital for periods prior to January first, two thousand  nine
 by:
   (i)  determining the difference between (A) a calculation of what each
 teaching general hospital would have been paid if payments made pursuant
 to paragraph (a-3) of subdivision one of  section  twenty-eight  hundred
 seven-c  of this article between January first, nineteen hundred ninety-
 six and December thirty-first, two thousand three were based  solely  on
 the  case  mix  of  persons  eligible  for  medical assistance under the
 medical assistance program pursuant to title eleven of article  five  of
 the social services law who are enrolled in health maintenance organiza-
 tions and persons paid for under the family health plus program enrolled
 in  approved organizations pursuant to title eleven-D of article five of

 S. 2507--A                         39                         A. 3007--A
 
 the social services law during those years, and (B) the actual  payments
 to  each such hospital pursuant to paragraph (a-3) of subdivision one of
 section twenty-eight hundred seven-c of  this  article  between  January
 first,  nineteen hundred ninety-six and December thirty-first, two thou-
 sand three.
   (ii) reducing proportionally each of the amounts determined in subpar-
 agraph (i) of this paragraph so that the sum of all such amounts  totals
 no more than one hundred million dollars;
   (iii)  further reducing each of the amounts determined in subparagraph
 (ii) of this paragraph by the amount received  by  each  hospital  as  a
 distribution  from funds designated in paragraph (a) of subdivision five
 of this section attributable to the period January first,  two  thousand
 three  through December thirty-first, two thousand three, except that if
 such amount was  provided  to  a  consortium  then  the  amount  of  the
 reduction  for  each  hospital  in the consortium shall be determined by
 applying the proportion  of  each  hospital's  amount  determined  under
 subparagraph  (i)  of this paragraph to the total of such amounts of all
 hospitals in such consortium to the consortium award;
   (iv) further reducing each of the amounts determined  in  subparagraph
 (iii)  of this paragraph by the amounts specified in paragraph [(t)] (P)
 of this subdivision; and
   (v) dividing each of the amounts determined in subparagraph  (iii)  of
 this paragraph by seven.
   [(t)] (P) "Extra reduction amount" shall mean an amount determined for
 a  teaching hospital for which an adjustment amount is calculated pursu-
 ant to paragraph [(s)] (O) of this subdivision that  is  the  hospital's
 proportionate  share  of  the  sum of the amounts specified in paragraph
 [(u)] (Q) of this subdivision determined based upon a comparison of  the
 hospital's  remaining  liability  calculated pursuant to paragraph [(s)]
 (O) of this subdivision to the sum  of  all  such  hospital's  remaining
 liabilities.
   [(u)]  (Q)  "Allotment  amount"  shall  mean  an amount determined for
 teaching hospitals as follows:
   (i) for a hospital for which an adjustment amount  pursuant  to  para-
 graph  [(s)] (O) of this subdivision does not apply, the amount received
 by the hospital pursuant to paragraph (a) of subdivision  five  of  this
 section  attributable  to  the  period January first, two thousand three
 through December thirty-first, two thousand three, or
   (ii) for a hospital for which an adjustment amount pursuant  to  para-
 graph  [(s)]  (O)  of  this  subdivision  applies  and  which received a
 distribution pursuant to paragraph  (a)  of  subdivision  five  of  this
 section  attributable  to  the  period January first, two thousand three
 through December thirty-first, two thousand three that is  greater  than
 the  hospital's  adjustment  amount, the difference between the distrib-
 ution amount and the adjustment amount.
   (f) Effective January first, two thousand five through December  thir-
 ty-first,  two  thousand  eight,  each  teaching  general hospital shall
 receive a distribution from the applicable regional pool  based  on  its
 distribution amount determined under paragraphs (c), (d) and (e) of this
 subdivision  and reduced by its adjustment amount calculated pursuant to
 paragraph [(s)] (O) of subdivision one of this section and, for distrib-
 utions for the period January first, two thousand five through  December
 thirty-first,  two thousand five, further reduced by its extra reduction
 amount calculated pursuant to paragraph [(t)] (P) of subdivision one  of
 this section.

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   (a)  Up to thirty-one million dollars annually for the periods January
 first, two thousand through December thirty-first, two  thousand  three,
 and up to twenty-five million dollars plus the sum of the amounts speci-
 fied  in  paragraph [(n)] (K) of subdivision one of this section for the
 period  January  first, two thousand five through December thirty-first,
 two thousand five, and up to thirty-one million dollars annually for the
 period January first, two thousand six  through  December  thirty-first,
 two  thousand seven, shall be set aside and reserved by the commissioner
 from the regional pools established pursuant to subdivision two of  this
 section for supplemental distributions in each such region to be made by
 the  commissioner to consortia and teaching general hospitals in accord-
 ance with a distribution methodology developed in consultation with  the
 council  and  specified  in rules and regulations adopted by the commis-
 sioner.
   (d) Notwithstanding any other provision of law or regulation, for  the
 period  January  first, two thousand five through December thirty-first,
 two thousand five, the commissioner  shall  distribute  as  supplemental
 payments  the  allotment specified in paragraph [(n)] (K) of subdivision
 one of this section.
   5-a. Graduate medical education  innovations  pool.  (a)  Supplemental
 distributions.  (i)  Thirty-one  million  dollars for the period January
 first, two thousand eight through December  thirty-first,  two  thousand
 eight,  shall  be  set  aside  and reserved by the commissioner from the
 regional pools established pursuant to subdivision two of  this  section
 and shall be available for distributions pursuant to subdivision five of
 this  section  and in accordance with section 86-1.89 of title 10 of the
 codes, rules and regulations of the state of New York as  in  effect  on
 January  first,  two thousand eight[; provided, however, for purposes of
 funding the empire clinical research investigation  program  (ECRIP)  in
 accordance  with paragraph eight of subdivision (e) and paragraph two of
 subdivision (f) of section 86-1.89 of title 10 of the codes,  rules  and
 regulations  of the state of New York, distributions shall be made using
 two regions defined as New York city and the rest of the state  and  the
 dollar amount set forth in subparagraph (i) of paragraph two of subdivi-
 sion  (f)  of  section 86-1.89 of title 10 of the codes, rules and regu-
 lations of the state of New York shall be increased from sixty  thousand
 dollars to seventy-five thousand dollars].
   (ii)  For  periods  on  and  after  January  first, two thousand nine,
 supplemental distributions pursuant to subdivision five of this  section
 and  in  accordance with section 86-1.89 of title 10 of the codes, rules
 and regulations of the state of New York shall no longer be made and the
 provisions of section 86-1.89 of title 10 of the codes, rules and  regu-
 lations of the state of New York shall be null and void.
   (b)  [Empire  clinical  research  investigator  program  (ECRIP). 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 thirty-
 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, 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, and

 S. 2507--A                         41                         A. 3007--A

 up to eight million six  hundred  twelve  thousand  dollars  each  state
 fiscal  year  for  the  period  April first, two thousand twenty through
 March thirty-first, two thousand twenty-three, shall be  set  aside  and
 reserved  by the commissioner from the regional pools established pursu-
 ant 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:
   Distributions shall first be made to consortia  and  teaching  general
 hospitals  for the empire clinical research investigator program (ECRIP)
 to help secure federal funding for biomedical research,  train  clinical
 researchers,  recruit national leaders as faculty to act as mentors, and
 train residents and fellows  in  biomedical  research  skills  based  on
 hospital-specific  data  submitted  to the commissioner by consortia and
 teaching general hospitals in accordance with clause (G) of this subpar-
 agraph. Such distributions shall be made in accordance with the  follow-
 ing methodology:
   (A)  The  greatest  number  of clinical research positions for which a
 consortium or teaching general hospital may be funded pursuant  to  this
 subparagraph  shall  be  one  percent  of  the total number of residents
 training at the consortium or teaching general hospital on  July  first,
 two  thousand  eight  for  the  period  January first, two thousand nine
 through December thirty-first, two thousand nine rounded up to the near-
 est one position.
   (B) Distributions made to a consortium or  teaching  general  hospital
 shall  equal  the product of the total number of clinical research posi-
 tions submitted  by  a  consortium  or  teaching  general  hospital  and
 accepted  by the commissioner as meeting the criteria set forth in para-
 graph (b) of subdivision one of this section, subject to  the  reduction
 calculation  set  forth  in  clause  (C) of this subparagraph, times one
 hundred ten thousand dollars.
   (C) If the dollar amount for the total  number  of  clinical  research
 positions  in  the  region  calculated  pursuant  to  clause (B) of this
 subparagraph exceeds the total amount appropriated for purposes of  this
 paragraph,  including clinical research positions that continue from and
 were funded in prior distribution periods, the commissioner shall elimi-
 nate one-half of the  clinical  research  positions  submitted  by  each
 consortium  or teaching general hospital rounded down to the nearest one
 position. Such reduction shall be repeated until the dollar  amount  for
 the  total  number of clinical research positions in the region does not
 exceed the total amount appropriated for purposes of this paragraph.  If
 the  repeated  reduction  of the total number of clinical research posi-
 tions in the region by one-half does not render a total  funding  amount
 that  is equal to or less than the total amount reserved for that region
 within the appropriation, the funding for each clinical  research  posi-
 tion  in  that  region  shall  be reduced proportionally in one thousand
 dollar increments until the total dollar amount for the total number  of
 clinical  research  positions  in  that region does not exceed the total
 amount reserved for that region within the appropriation. Any  reduction
 in  funding will be effective for the duration of the award. No clinical
 research positions that continue from and were funded in prior  distrib-
 ution periods shall be eliminated or reduced by such methodology.
   (D)  Each  consortium  or  teaching general hospital shall receive its
 annual distribution amount in accordance with the following:
   (I) Each consortium or teaching general hospital with a one-year ECRIP
 award  shall  receive  its  annual  distribution  amount  in  full  upon

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 completion of the requirements set forth in items (I) and (II) of clause
 (G)  of  this subparagraph. The requirements set forth in items (IV) and
 (V) of clause (G) of this subparagraph must be completed by the  consor-
 tium  or teaching general hospital in order for the consortium or teach-
 ing general hospital to be eligible to apply for ECRIP  funding  in  any
 subsequent funding cycle.
   (II)  Each  consortium  or  teaching  general hospital with a two-year
 ECRIP award shall receive its first annual distribution amount  in  full
 upon  completion  of the requirements set forth in items (I) and (II) of
 clause (G) of this subparagraph. Each  consortium  or  teaching  general
 hospital will receive its second annual distribution amount in full upon
 completion  of the requirements set forth in item (III) of clause (G) of
 this subparagraph. The requirements set forth in items (IV) and  (V)  of
 clause  (G)  of this subparagraph must be completed by the consortium or
 teaching general hospital in order for the consortium or teaching gener-
 al hospital to be eligible to apply for ECRIP funding in any  subsequent
 funding cycle.
   (E)  Each  consortium  or teaching general hospital receiving distrib-
 utions pursuant to this subparagraph shall reserve seventy-five thousand
 dollars to primarily fund salary and fringe  benefits  of  the  clinical
 research  position  with  the remainder going to fund the development of
 faculty who are involved in biomedical research, training  and  clinical
 care.
   (F)  Undistributed  or  returned  funds  available  to  fund  clinical
 research positions pursuant to this paragraph for a distribution  period
 shall  be  available to fund clinical research positions in a subsequent
 distribution period.
   (G) In order to be eligible for distributions pursuant to this subpar-
 agraph, each consortium and teaching general hospital shall  provide  to
 the  commissioner by July first of each distribution period, the follow-
 ing data and information on a hospital-specific  basis.  Such  data  and
 information  shall  be  certified as to accuracy and completeness by the
 chief executive officer, chief financial officer or chair of the consor-
 tium governing body of each consortium or teaching general hospital  and
 shall be maintained by each consortium and teaching general hospital for
 five years from the date of submission:
   (I)  For  each  clinical  research  position, information on the type,
 scope, training objectives,  institutional  support,  clinical  research
 experience of the sponsor-mentor, plans for submitting research outcomes
 to  peer reviewed journals and at scientific meetings, including a meet-
 ing sponsored by the department, the name of a principal contact  person
 responsible for tracking the career development of researchers placed in
 clinical  research positions, as defined in paragraph (c) of subdivision
 one of this section, and who is authorized to certify to the commission-
 er that all the requirements of the clinical  research  training  objec-
 tives  set  forth  in this subparagraph shall be met. Such certification
 shall be provided by July first of each distribution period;
   (II) For each clinical research position,  information  on  the  name,
 citizenship  status, medical education and training, and medical license
 number of the researcher, if applicable, shall be provided  by  December
 thirty-first of the calendar year following the distribution period;
   (III)  Information on the status of the clinical research plan, accom-
 plishments, changes in research activities, progress, and performance of
 the researcher shall be provided upon  completion  of  one-half  of  the
 award term;

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   (IV)  A  final report detailing training experiences, accomplishments,
 activities and performance of the clinical researcher, and  data,  meth-
 ods,  results  and  analyses  of  the  clinical  research  plan shall be
 provided three months after the clinical research position ends; and
   (V)  Tracking  information  concerning past researchers, including but
 not limited to (A) background information, (B) employment  history,  (C)
 research  status,  (D) current research activities, (E) publications and
 presentations, (F) research  support,  and  (G)  any  other  information
 necessary to track the researcher; and
   (VI)  Any  other  data  or information required by the commissioner to
 implement this subparagraph.
   (H) Notwithstanding any inconsistent provision  of  this  subdivision,
 for periods on and after April first, two thousand thirteen, ECRIP grant
 awards shall be made in accordance with rules and regulations promulgat-
 ed by the commissioner. Such regulations shall, at a minimum:
   (1)  provide  that ECRIP grant awards shall be made with the objective
 of securing federal funding for biomedical research,  training  clinical
 researchers,  recruiting  national leaders as faculty to act as mentors,
 and training residents and fellows in biomedical research skills;
   (2) provide that ECRIP grant applicants may include  interdisciplinary
 research teams comprised of teaching general hospitals acting in collab-
 oration  with  entities  including  but  not limited to medical centers,
 hospitals, universities and local health departments;
   (3) provide that applications for ECRIP grant awards shall be based on
 such information requested by the commissioner, which shall include  but
 not be limited to hospital-specific data;
   (4)  establish  the  qualifications  for investigators and other staff
 required for grant projects eligible for ECRIP grant awards; and
   (5) establish a methodology for the distribution of funds under  ECRIP
 grant awards.
   (c)]  Physician loan repayment program. One million nine hundred sixty
 thousand dollars for  the  period  January  first,  two  thousand  eight
 through  December  thirty-first,  two  thousand  eight, one million nine
 hundred sixty thousand dollars for the period January first,  two  thou-
 sand  nine through December thirty-first, two thousand nine, one million
 nine hundred sixty thousand dollars for the period  January  first,  two
 thousand  ten  through  December  thirty-first,  two  thousand ten, four
 hundred ninety thousand dollars for the period January first, two  thou-
 sand eleven through March thirty-first, two thousand eleven, one million
 seven  hundred  thousand  dollars  each state fiscal year for the period
 April first, two thousand eleven through March thirty-first,  two  thou-
 sand  fourteen,  up  to  one million seven hundred five thousand dollars
 each state fiscal year for the period April first, two thousand fourteen
 through March thirty-first, two thousand seventeen, up  to  one  million
 seven hundred five thousand dollars each state fiscal year for the peri-
 od  April  first, two thousand seventeen through March thirty-first, two
 thousand twenty, and up to  one  million  seven  hundred  five  thousand
 dollars  each state fiscal year for the period April first, two thousand
 twenty through March thirty-first, two thousand twenty-three,  shall  be
 set  aside  and  reserved  by  the  commissioner from the regional pools
 established pursuant to subdivision two of this  section  and  shall  be
 available  for  purposes  of physician loan repayment in accordance with
 subdivision ten of this section. Notwithstanding any contrary  provision
 of this section, sections one hundred twelve and one hundred sixty-three
 of  the  state finance law, or any other contrary provision of law, such
 funding shall be allocated regionally with one-third of available  funds

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 going  to  New  York city and two-thirds of available funds going to the
 rest of the state and shall be distributed in a manner to be  determined
 by  the  commissioner  without a competitive bid or request for proposal
 process as follows:
   (i) Funding shall first be awarded to repay loans of up to twenty-five
 physicians  who  train  in  primary care or specialty tracks in teaching
 general hospitals, and who enter and remain in primary care or specialty
 practices in underserved communities, as determined by the commissioner.
   (ii) After distributions in accordance with subparagraph (i)  of  this
 paragraph, all remaining funds shall be awarded to repay loans of physi-
 cians  who  enter  and  remain in primary care or specialty practices in
 underserved communities, as determined by  the  commissioner,  including
 but  not  limited  to  physicians working in general hospitals, or other
 health care facilities.
   (iii) In no case shall less than fifty percent of the funds  available
 pursuant  to  this  paragraph be distributed in accordance with subpara-
 graphs (i) and (ii) of this paragraph to physicians identified by gener-
 al hospitals.
   (iv) In addition to the funds allocated under this paragraph, for  the
 period April first, two thousand fifteen through March thirty-first, two
 thousand  sixteen,  two  million  dollars  shall  be  available  for the
 purposes described in subdivision ten of this section;
   (v) In addition to the funds allocated under this paragraph,  for  the
 period April first, two thousand sixteen through March thirty-first, two
 thousand  seventeen,  two  million  dollars  shall  be available for the
 purposes described in subdivision ten of this section;
   (vi) Notwithstanding any provision of law to the contrary, and subject
 to the extension of the Health Care Reform Act of 1996, sufficient funds
 shall be available for the purposes described in subdivision ten of this
 section in amounts necessary to fund the remaining year commitments  for
 awards made pursuant to subparagraphs (iv) and (v) of this paragraph.
   [(d)]  (C) Physician practice support. Four million nine hundred thou-
 sand dollars for the period January first, two  thousand  eight  through
 December  thirty-first,  two  thousand  eight, four million nine hundred
 thousand dollars annually for the period  January  first,  two  thousand
 nine  through  December  thirty-first, two thousand ten, one million two
 hundred twenty-five thousand dollars for the period January  first,  two
 thousand  eleven  through  March thirty-first, two thousand eleven, four
 million three hundred thousand dollars each state fiscal  year  for  the
 period  April first, two thousand eleven through March thirty-first, two
 thousand fourteen, up to  four  million  three  hundred  sixty  thousand
 dollars  each state fiscal year for the period April first, two thousand
 fourteen through March thirty-first, two thousand seventeen, up to  four
 million  three hundred sixty thousand dollars for each state fiscal year
 for the period April first, two thousand seventeen through  March  thir-
 ty-first,  two  thousand  twenty,  and  up to four million three hundred
 sixty thousand dollars for each fiscal year for the period April  first,
 two  thousand  twenty  through  March thirty-first, two thousand twenty-
 three, shall be set aside and reserved  by  the  commissioner  from  the
 regional  pools  established pursuant to subdivision two of this section
 and shall be available  for  purposes  of  physician  practice  support.
 Notwithstanding  any  contrary  provision  of this section, sections one
 hundred twelve and one hundred sixty-three of the state finance law,  or
 any  other  contrary  provision  of law, such funding shall be allocated
 regionally with one-third of available funds going to New York city  and
 two-thirds  of  available funds going to the rest of the state and shall

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 be distributed in a manner to be determined by the commissioner  without
 a competitive bid or request for proposal process as follows:
   (i)  Preference in funding shall first be accorded to teaching general
 hospitals for up to twenty-five awards, to  support  costs  incurred  by
 physicians  trained in primary or specialty tracks who thereafter estab-
 lish or join practices in underserved communities, as determined by  the
 commissioner.
   (ii)  After  distributions in accordance with subparagraph (i) of this
 paragraph, all remaining funds shall be awarded to physicians to support
 the cost of establishing or joining practices  in  underserved  communi-
 ties,  as  determined  by  the  commissioner, and to hospitals and other
 health care providers to recruit new physicians to provide  services  in
 underserved communities, as determined by the commissioner.
   (iii)  In no case shall less than fifty percent of the funds available
 pursuant to this  paragraph  be  distributed  to  general  hospitals  in
 accordance with subparagraphs (i) and (ii) of this paragraph.
   [(e)]  (D)  Work  group.  For funding available pursuant to paragraphs
 [(c) and (d) (e)] (B) AND (C) of this subdivision:
   (i) The department shall appoint a  work  group  from  recommendations
 made  by  associations  representing  physicians,  general hospitals and
 other health care facilities to develop a streamlined application  proc-
 ess by June first, two thousand twelve.
   (ii) Subject to available funding, applications shall be accepted on a
 continuous  basis.  The department shall provide technical assistance to
 applicants to facilitate their completion of applications. An  applicant
 shall  be  notified  in  writing  by  the  department within ten days of
 receipt of an application as to whether the application is complete  and
 if  the  application is incomplete, what information is outstanding. The
 department shall act on an application within thirty days of receipt  of
 a complete application.
   [(f)]  (E)  Study on physician workforce. Five hundred ninety thousand
 dollars annually for  the  period  January  first,  two  thousand  eight
 through December thirty-first, two thousand ten, one hundred forty-eight
 thousand  dollars  for  the  period  January  first, two thousand eleven
 through March thirty-first, two thousand eleven,  five  hundred  sixteen
 thousand  dollars each state fiscal year for the period April first, two
 thousand eleven through March thirty-first, two thousand fourteen, up to
 four hundred eighty-seven thousand dollars each state  fiscal  year  for
 the  period  April  first,  two  thousand fourteen through March thirty-
 first, two thousand seventeen, up to four hundred eighty-seven  thousand
 dollars for each state fiscal year for the period April first, two thou-
 sand  seventeen  through March thirty-first, two thousand twenty, and up
 to four hundred eighty-seven thousand dollars each state fiscal year for
 the period April first, two thousand twenty through March  thirty-first,
 two  thousand  twenty-three,  shall  be  set  aside  and reserved by the
 commissioner from the regional pools established pursuant to subdivision
 two of this section and shall be available to fund a study of  physician
 workforce needs and solutions including, but not limited to, an analysis
 of  residency  programs  and projected physician workforce and community
 needs. The commissioner shall enter into agreements  with  one  or  more
 organizations  to  conduct  such  study  based on a request for proposal
 process.
   [(g)] (F) Diversity in medicine/post-baccalaureate  program.  Notwith-
 standing any inconsistent provision of section one hundred twelve or one
 hundred  sixty-three  of  the  state  finance  law or any other law, one
 million nine hundred sixty thousand  dollars  annually  for  the  period

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 January  first,  two  thousand  eight through December thirty-first, two
 thousand ten, four hundred ninety thousand dollars for the period  Janu-
 ary  first, two thousand eleven through March thirty-first, two thousand
 eleven,  one  million  seven  hundred thousand dollars each state fiscal
 year for the period April first, two thousand eleven through March thir-
 ty-first, two thousand fourteen, up to  one  million  six  hundred  five
 thousand  dollars each state fiscal year for the period April first, two
 thousand fourteen through March thirty-first, two thousand seventeen, up
 to one million six hundred five thousand dollars each state fiscal  year
 for  the  period April first, two thousand seventeen through March thir-
 ty-first, two thousand twenty, and up to one million  six  hundred  five
 thousand  dollars each state fiscal year for the period April first, two
 thousand twenty through March thirty-first, two  thousand  twenty-three,
 shall  be  set  aside and reserved by the commissioner from the regional
 pools established pursuant to subdivision two of this section and  shall
 be  available for distributions to the Associated Medical Schools of New
 York to fund its diversity program including existing and new  post-bac-
 calaureate programs for minority and economically disadvantaged students
 and  encourage  participation  from all medical schools in New York. The
 associated medical schools of New York shall report to the  commissioner
 on  an  annual basis regarding the use of funds for such purpose in such
 form and manner as specified by the commissioner.
   [(h)] (G) In the event there are undistributed  funds  within  amounts
 made  available  for  distributions  pursuant  to this subdivision, such
 funds may be  reallocated  and  distributed  in  current  or  subsequent
 distribution  periods in a manner determined by the commissioner for any
 purpose set forth in this subdivision.
   12. Notwithstanding any provision of law to the contrary, applications
 submitted on or after April first, two thousand sixteen, for the  physi-
 cian  loan repayment program pursuant to paragraph [(c)] (B) of subdivi-
 sion five-a of this section and subdivision ten of this section  or  the
 physician  practice  support  program pursuant to paragraph [(d)] (C) of
 subdivision five-a of this section, shall be subject  to  the  following
 changes:
   (a)  Awards  shall  be  made  from the total funding available for new
 awards under the physician loan  repayment  program  and  the  physician
 practice  support  program,  with  neither program limited to a specific
 funding amount within such total funding available;
   (b) An applicant may apply for an  award  for  either  physician  loan
 repayment or physician practice support, but not both;
   (c)  An applicant shall agree to practice for three years in an under-
 served area and each award shall provide up to  forty  thousand  dollars
 for each of the three years; and
   (d)  To the extent practicable, awards shall be timed to be of use for
 job offers made to applicants.
   § 2. Subparagraph (xvi) of paragraph (a) of subdivision 7  of  section
 2807-s  of  the  public health law, as amended by section 8 of part Y of
 chapter 56 of the laws of 2020, is amended to read as follows:
   (xvi) provided further, however, for periods prior to July first,  two
 thousand  nine,  amounts set forth in this paragraph shall be reduced by
 an amount equal to the actual distribution reductions for all facilities
 pursuant to paragraph [(s)] (O) of subdivision one  of  section  twenty-
 eight hundred seven-m of this article.
   §  3.  Subdivision  (c)  of section 92-dd of the state finance law, as
 amended by section 9 of part Y of chapter 56 of the  laws  of  2020,  is
 amended to read as follows:

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   (c)  The pool administrator shall, from appropriated funds transferred
 to the  pool  administrator  from  the  comptroller,  continue  to  make
 payments  as required pursuant to sections twenty-eight hundred seven-k,
 twenty-eight hundred seven-m (not including payments  made  pursuant  to
 SUBDIVISION FIVE-B AND paragraphs (B), (c)[, (d),, (f)] and [(g)] (F) of
 subdivision  five-a  of section twenty-eight hundred seven-m), and twen-
 ty-eight hundred seven-w of the public  health  law,  paragraph  (e)  of
 subdivision  twenty-five  of section twenty-eight hundred seven-c of the
 public health law, paragraphs (b)  and  (c)  of  subdivision  thirty  of
 section twenty-eight hundred seven-c of the public health law, paragraph
 (b) of subdivision eighteen of section twenty-eight hundred eight of the
 public health law, subdivision seven of section twenty-five hundred-d of
 the  public  health  law  and section eighty-eight of chapter one of the
 laws of nineteen hundred ninety-nine.
   § 4.  Subdivision 2 of section 251 of the public health law, as  added
 by chapter 338 of the laws of 1998, is amended to read as follows:
   2.  Solicit,  receive, and review applications from public and private
 agencies and  organizations  and  qualified  research  institutions  for
 grants from the spinal cord injury research trust fund, created pursuant
 to  section  ninety-nine-f of the state finance law, to conduct research
 programs which focus on the treatment and cure of  spinal  cord  injury.
 The  board  shall  make  recommendations  to  the  commissioner, and the
 commissioner shall, in his or her discretion, grant approval of applica-
 tions for grants from  those  applications  recommended  by  the  board;
 PROVIDED,  HOWEVER,  THAT THE BOARD SHALL NOT RECOMMEND, AND THE COMMIS-
 SIONER SHALL NOT APPROVE, ANY NEW GRANTS ON OR AFTER  APRIL  FIRST,  TWO
 THOUSAND TWENTY-ONE.
   § 5. Subdivision 1 of section 265-a of the public health law, as added
 by  section 1 of part H of chapter 58 of the laws of 2007, is amended to
 read as follows:
   1. The empire state stem cell board ("board"), comprised of a  funding
 committee and an ethics committee, both of which shall be chaired by the
 commissioner, is hereby created within the department for the purpose of
 administering  the  empire  state stem cell trust fund ("fund"), created
 pursuant to section ninety-nine-p of the state finance law. The board is
 hereby empowered, subject to annual  appropriations  and  other  funding
 authorized or made available, to make grants to basic, applied, transla-
 tional  or  other  research and development activities that will advance
 scientific discoveries in fields related to stem cell biology; PROVIDED,
 HOWEVER, THAT THE BOARD SHALL NOT MAKE ANY  GRANTS  ON  OR  AFTER  APRIL
 FIRST, TWO THOUSAND TWENTY-ONE.
   § 6.  Section 6 of chapter 338 of the laws of 1998 amending the public
 health  law,  the public officers law and the state finance law relating
 to establishing a spinal cord injury research board, is amended to  read
 as follows:
   §  6.  This act shall take effect January 1, 1999 AND SHALL EXPIRE AND
 BE DEEMED REPEALED DECEMBER 31, 2024.
   § 7. Section 4 of part H of chapter 58 of the laws  of  2007  amending
 the public health law, the public officers law and the state finance law
 relating to establishing the empire state stem cell board, is amended to
 read as follows:
   §  4.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2007 AND  SHALL
 EXPIRE AND BE DEEMED REPEALED DECEMBER 31, 2025.
   §  8.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2021; provided,

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 however the amendments to subparagraph (xvi) of paragraph (a) of  subdi-
 vision  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; provided further, however, that the amend-
 ments to section 251 of the public health law made by  section  four  of
 this  act  shall  not affect the expiration of such section and shall be
 deemed to expire therewith; and provided further,  however,  the  amend-
 ments  to section 265-a of the public health law made by section five of
 this act shall not affect the expiration of such section  and  shall  be
 deemed to expire therewith.
 
                                  PART N
 
   Section  1.  Subdivision 3 of section 281 of the public health law, as
 amended by chapter 13 of the  laws  of  2015,  is  amended  to  read  as
 follows:
   3.  On  or  before  December  thirty-first,  two  thousand twelve, the
 commissioner shall promulgate  regulations,  in  consultation  with  the
 commissioner   of   education,  establishing  standards  for  electronic
 prescriptions. Notwithstanding any other provision of  this  section  or
 any  other  law to the contrary, effective three years subsequent to the
 date on which such regulations are promulgated, no  person  shall  issue
 any prescription in this state unless such prescription is made by elec-
 tronic  prescription from the person issuing the prescription to a phar-
 macy  in  accordance  with  such  regulatory   standards,   except   for
 prescriptions:  (a)  [issued  by  veterinarians;  (b)] issued in circum-
 stances where electronic prescribing is not available due  to  temporary
 technological  or  electrical failure, as set forth in regulation; [(c)]
 (B) issued by practitioners [who have received a  waiver  or  a  renewal
 thereof  for  a  specified period determined by the commissioner, not to
 exceed one year, from the requirement  to  use  electronic  prescribing,
 pursuant  to a process established in regulation by the commissioner, in
 consultation with the commissioner of education, due to  economic  hard-
 ship,  technological  limitations  that  are  not  reasonably within the
 control of the practitioner, or other] IN SUCH exceptional [circumstance
 demonstrated by the practitioner; (d)] CIRCUMSTANCES AS  MAY  BE  DETER-
 MINED  BY  THE  COMMISSIONER; (C) issued by a practitioner under circum-
 stances where, notwithstanding the  practitioner's  present  ability  to
 make  an  electronic  prescription as required by this subdivision, such
 practitioner reasonably determines that it would be impractical for  the
 patient  to obtain substances prescribed by electronic prescription in a
 timely manner, and such  delay  would  adversely  impact  the  patient's
 medical   condition,  provided  that  if  such  prescription  is  for  a
 controlled substance, the quantity of  controlled  substances  does  not
 exceed  a  five  day  supply  if  the  controlled substance were used in
 accordance with the directions for use; or [(e)] (D) issued by a practi-
 tioner to be dispensed by a pharmacy located outside the state,  as  set
 forth in regulation.
   § 2. Subdivision 5 of section 281 of the public health law, as amended
 by chapter 350 of the laws of 2016, is amended to read as follows:
   5.  In the case of a prescription for a controlled substance issued by
 a practitioner under paragraph [(d)] (C) or  [(e)]  (D)  of  subdivision
 three  of  this  section,  the  practitioner  shall,  upon  issuing such
 prescription, indicate in the patient's health record  either  that  the
 prescription  was  issued  other  than electronically because it (a) was
 impractical to issue an electronic prescription in a timely  manner  and

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 such  delay  would  have adversely impacted the patient's medical condi-
 tion, or (b) was to be dispensed  by  a  pharmacy  located  outside  the
 state.
   §  3.  Subdivision 10 of section 6810 of the education law, as amended
 by chapter 13 of the laws of 2015, is amended to read as follows:
   10. Notwithstanding any other provision of this section or  any  other
 law  to  the  contrary,  effective three years subsequent to the date on
 which regulations establishing standards  for  electronic  prescriptions
 are  promulgated by the commissioner of health, in consultation with the
 commissioner pursuant to subdivision three of section two hundred eight-
 y-one of  the  public  health  law,  no  practitioner  shall  issue  any
 prescription  in  this  state, unless such prescription is made by elec-
 tronic prescription from the practitioner  to  a  pharmacy,  except  for
 prescriptions: (a) [issued by veterinarians; (b)] issued or dispensed in
 circumstances  where  electronic  prescribing  is  not  available due to
 temporary technological or electrical failure, as  set  forth  in  regu-
 lation; [(c)] (B) issued by practitioners [who have received a waiver or
 a  renewal thereof for a specified period determined by the commissioner
 of health, not to exceed one year, from the requirement to use electron-
 ic prescribing, pursuant to a process established in regulation  by  the
 commissioner  of  health,  in  consultation with the commissioner due to
 economic hardship, technological limitations  that  are  not  reasonably
 within  the  control  of the practitioner, or other] IN SUCH exceptional
 [circumstance demonstrated by the practitioner] CIRCUMSTANCES AS MAY  BE
 DETERMINED BY THE COMMISSIONER OF HEALTH ; [(d)] (C) issued by a practi-
 tioner  under  circumstances  where,  notwithstanding the practitioner's
 present ability to make an electronic prescription as required  by  this
 subdivision,  such  practitioner  reasonably determines that it would be
 impractical for the patient to obtain substances prescribed by electron-
 ic prescription in a timely  manner,  and  such  delay  would  adversely
 impact   the   patient's   medical  condition,  provided  that  if  such
 prescription is for a controlled substance, the quantity that  does  not
 exceed a five day supply if the controlled substance was used in accord-
 ance  with the directions for use; or [(e)] (D) issued by a practitioner
 to be dispensed by a pharmacy located outside the state, as set forth in
 regulation.
   § 4. Subdivisions 11 and 12 of section 6810 of the education  law,  as
 amended  by  chapter  350  of  the  laws of 2016, are amended to read as
 follows:
   11. In the case of a prescription issued by a practitioner under para-
 graph [(b)] (A) of subdivision ten of  this  section,  the  practitioner
 shall  be  required  to indicate in the patient's health record that the
 prescription was issued other than electronically due to temporary tech-
 nological or electrical failure.
   12. In the case of a prescription issued by a practitioner under para-
 graph [(d)] (C) or [(e)] (D) of subdivision ten  of  this  section,  the
 practitioner  shall,  upon  issuing  such  prescription, indicate in the
 patient's health record either that the prescription  was  issued  other
 than electronically because it (a) was impractical to issue an electron-
 ic  prescription  in a timely manner and such delay would have adversely
 impacted the patient's medical condition, or (b) was to be dispensed  by
 a pharmacy located outside the state.
   §  5. Subdivisions 6 and 7 of section 281 of the public health law are
 REPEALED.
   § 6. Subdivisions 13 and 15 of section 6810 of the education  law  are
 REPEALED.

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   § 7. This act shall take effect on November 1, 2021.
 
                                  PART O
 
   Section 1. Section 461-s of the social services law is REPEALED.
   §  2.  Subdivision  9  of  section  2803  of  the public health law is
 REPEALED.
   § 3. Paragraph (c) of subdivision 1 of section  461-b  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, 2021.
 
                                  PART P
 
   Section 1. Subdivision 6 of section 571 of the public health  law,  as
 amended  by  chapter  444  of  the  laws  of 2013, is amended to read as
 follows:
   6. "Qualified health care professional" means  a  physician,  dentist,
 podiatrist,  optometrist performing a clinical laboratory test that does
 not use an invasive modality as defined in section  seventy-one  hundred
 one  of  the  education law, PHARMACIST, physician assistant, specialist
 assistant, nurse practitioner, or midwife, who is  licensed  and  regis-
 tered with the state education department.
   §  2.  Section  6801 of the education law is amended by adding two new
 subdivisions 6 and 7 to read as follows:
   6. A LICENSED PHARMACIST IS A QUALIFIED HEALTH CARE PROFESSIONAL UNDER
 SECTION FIVE HUNDRED SEVENTY-ONE  OF  THE  PUBLIC  HEALTH  LAW  FOR  THE
 PURPOSES  OF  DIRECTING  A  LIMITED  SERVICE LABORATORY AND ORDERING AND
 ADMINISTERING TESTS APPROVED BY THE FOOD AND DRUG ADMINISTRATION  (FDA),
 SUBJECT  TO  CERTIFICATE  OF WAIVER REQUIREMENTS ESTABLISHED PURSUANT TO
 THE FEDERAL CLINICAL LABORATORY  IMPROVEMENT  ACT  OF  NINETEEN  HUNDRED
 EIGHTY-EIGHT.
   7.  A  LICENSED  PHARMACIST MAY ACT AS A REFERRING HEALTHCARE PROVIDER
 FOR DIABETES SELF-MANAGEMENT EDUCATION AND ASTHMA SELF-MANAGEMENT TRAIN-
 ING.
   § 3. Subdivision 7 of section 6527 of the education law, as amended by
 chapter 110 of the laws of 2020, is amended to read as follows:
   7. A licensed physician may prescribe and  order  a  patient  specific
 order or non-patient specific regimen to a licensed pharmacist, pursuant
 to  regulations promulgated by the commissioner, and consistent with the
 public health law, for administering immunizations to prevent influenza,
 pneumococcal, acute herpes zoster, meningococcal,  tetanus,  diphtheria,
 COVID-19, or pertussis disease OR, FOR PATIENTS EIGHTEEN YEARS OF AGE OR
 OLDER,  ANY OTHER IMMUNIZATIONS RECOMMENDED BY THE ADVISORY COMMITTEE ON
 IMMUNIZATION  PRACTICES  OF  THE  CENTERS  FOR   DISEASE   CONTROL   AND
 PREVENTION,  and medications required for emergency treatment of anaphy-
 laxis. Nothing in this subdivision shall authorize unlicensed persons to
 administer immunizations, vaccines or other drugs.
   § 4. Subdivision 7 of section 6909 of the education law, as amended by
 chapter 110 of the laws of 2020, is amended to read as follows:
   7. A certified nurse practitioner may prescribe and  order  a  patient
 specific order or non-patient specific regimen to a licensed pharmacist,
 pursuant  to regulations promulgated by the commissioner, and consistent
 with the public health law, for administering immunizations  to  prevent
 influenza,  pneumococcal,  acute  herpes zoster, meningococcal, tetanus,
 diphtheria, COVID-19, or pertussis disease  OR,  FOR  PATIENTS  EIGHTEEN

 S. 2507--A                         51                         A. 3007--A
 
 YEARS  OF AGE OR OLDER, ANY OTHER IMMUNIZATIONS RECOMMENDED BY THE ADVI-
 SORY COMMITTEE ON IMMUNIZATION PRACTICES  OF  THE  CENTERS  FOR  DISEASE
 CONTROL AND PREVENTION, and medications required for emergency treatment
 of  anaphylaxis.  Nothing in this subdivision shall authorize unlicensed
 persons to administer immunizations, vaccines or other drugs.
   § 5.  Paragraph a of subdivision 22 of section 6802 of  the  education
 law,  as  amended by chapter 110 of the laws of 2020, is amended to read
 as follows:
   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,  COVID-19,  or
 pertussis  disease, OR, FOR PATIENTS EIGHTEEN YEARS OF AGE OR OLDER, ANY
 OTHER IMMUNIZATIONS RECOMMENDED BY THE ADVISORY COMMITTEE  ON  IMMUNIZA-
 TION  PRACTICES  OF  THE CENTERS FOR DISEASE CONTROL AND PREVENTION, 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 applica-
 ble statewide.
   § 6. Section 6801-a of the education law, as amended by chapter 238 of
 the laws of 2015, is amended to read as follows:
   §  6801-a.  Collaborative  drug  therapy  management   [demonstration]
 program.  1. As used in this section, the following terms shall have the
 following meanings:
   a.  "Board"  shall  mean the state board of pharmacy as established by
 section sixty-eight hundred four of this article.
   b. "Clinical services" shall mean the collection and interpretation of
 patient data for the purpose of [initiating, modifying  and]  monitoring
 drug  therapy AND PRESCRIBING IN ORDER TO ADJUST OR MANAGE DRUG THERAPY,
 with associated accountability and  responsibility  for  outcomes  in  a
 direct patient care setting.
   c.  "Collaborative drug therapy management" shall mean the performance
 of clinical services by a pharmacist relating to the review,  evaluation
 and  management  of drug therapy to a patient, who is being treated by a
 physician, OR NURSE PRACTITIONER for a specific  disease  or  associated
 disease  states, in accordance with a written agreement or protocol with
 a voluntarily participating physician,  OR  NURSE  PRACTITIONER  and  in
 accordance with the policies, procedures, and protocols of the facility.
 Such  agreement  or  protocol as entered into by the physician, OR NURSE
 PRACTITIONER and a pharmacist, may include[, and shall be limited to]:
   (i) [adjusting or managing] PRESCRIBING IN ORDER TO ADJUST OR MANAGE a
 drug regimen of a patient, pursuant to a patient specific order or  NON-
 PATIENT SPECIFIC protocol made by the patient's physician OR NURSE PRAC-
 TITIONER, which may include adjusting drug strength, frequency of admin-
 istration  or route of administration[. Adjusting the drug regimen shall
 not include substituting] or selecting a [different] drug which  differs
 from  that  initially prescribed by the patient's physician [unless such
 substitution is expressly] OR NURSE PRACTITIONER AS  authorized  in  the
 written  [order] AGREEMENT or protocol. The pharmacist shall be required
 to immediately document in  the  patient  record  changes  made  to  the
 patient's  drug  therapy  and  shall  use any reasonable means or method
 established by the facility OR PRACTICE to notify  the  patient's  other

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 treating  physicians [with whom he or she does not have a written agree-
 ment or protocol regarding such changes.  The  patient's  physician  may
 prohibit,  by  written  instruction,  any  adjustment  or  change in the
 patient's drug regimen by the pharmacist], NURSE PRACTITIONERS AND OTHER
 HEALTH  CARE PROFESSIONALS AS REQUIRED BY THE FACILITY OR THE COLLABORA-
 TIVE PRACTICE AGREEMENT;
   (ii) evaluating [and, only  if  specifically]  AS  authorized  by  the
 protocol  and only to the extent necessary to discharge the responsibil-
 ities set forth in this section, ordering disease state laboratory tests
 related to the drug therapy  management  for  the  specific  disease  or
 disease  [state] STATES specified within the written agreement or proto-
 col; and
   (iii) [only if specifically] AS authorized by the written agreement or
 protocol and only to the extent necessary to discharge the  responsibil-
 ities  set forth in this section, ordering or performing routine patient
 monitoring functions as may be necessary in the drug therapy management,
 including the collecting and reviewing of patient histories, and  order-
 ing  or  checking  patient  vital  signs[, including pulse, temperature,
 blood pressure and respiration].
   d. "Facility" shall mean[:  (i)]  a  [teaching  hospital  or]  general
 hospital, [including any] diagnostic center, treatment center, or hospi-
 tal-based  outpatient  department  as  defined  in  section twenty-eight
 hundred one of the public health law[; or (ii)], a nursing home, OR  ANY
 FACILITY  AS  DEFINED  IN SECTION TWENTY-EIGHT HUNDRED ONE OF THE PUBLIC
 HEALTH LAW OR OTHER ENTITY THAT PROVIDES DIRECT PATIENT CARE  UNDER  THE
 AUSPICES  OF  A  MEDICAL DIRECTOR; with an on-site pharmacy staffed by a
 licensed pharmacist; provided, however, for the purposes of this section
 the term "facility" shall not include dental clinics, dental  dispensar-
 ies[, residential health care facilities] and rehabilitation centers. IN
 ADDITION,  A  "PRACTICE" SHALL MEAN A PLACE OR SITUATION IN WHICH PHYSI-
 CIANS AND NURSE PRACTITIONERS EITHER ALONE OR IN GROUP PRACTICES PROVIDE
 DIAGNOSTIC AND TREATMENT CARE FOR PATIENTS.
   [For the purposes of this section, a "teaching hospital" shall mean  a
 hospital  licensed pursuant to article twenty-eight of the public health
 law that is eligible to receive  direct  or  indirect  graduate  medical
 education payments pursuant to article twenty-eight of the public health
 law.]
   e.  "Physician  OR  NURSE  PRACTITIONER"  shall mean the physician, OR
 NURSE PRACTITIONER selected by or assigned to a patient, who has primary
 responsibility for the treatment and care of the patient for the disease
 and associated disease states that are the subject of the  collaborative
 drug therapy management.
   f.  "Written  agreement  or  protocol"  shall mean a written document,
 pursuant to and consistent with any applicable state or federal require-
 ments, that addresses a specific disease or  associated  disease  states
 and  that  describes  the nature and scope of collaborative drug therapy
 management to be undertaken by the pharmacists,  in  collaboration  with
 the  participating  physician,  OR NURSE PRACTITIONER in accordance with
 the provisions of this section.
   2. a. A pharmacist who meets the experience requirements of  paragraph
 b  of  this  subdivision and who is [employed by or otherwise affiliated
 with a facility] CERTIFIED BY THE DEPARTMENT TO ENGAGE IN  COLLABORATIVE
 DRUG  THERAPY  MANAGEMENT  AND  WHO  IS  EITHER EMPLOYED BY OR OTHERWISE
 AFFILIATED WITH A FACILITY OR IS PARTICIPATING WITH A PRACTICING  PHYSI-
 CIAN  OR  NURSE  PRACTITIONER shall be permitted to enter into a written
 agreement or protocol with a physician OR NURSE PRACTITIONER authorizing

 S. 2507--A                         53                         A. 3007--A

 collaborative drug therapy management, subject to  the  limitations  set
 forth  in this section, within the scope of such employment [or], affil-
 iation OR PARTICIPATION. ONLY PHARMACISTS SO  CERTIFIED  MAY  ENGAGE  IN
 COLLABORATIVE DRUG THERAPY MANAGEMENT AS DEFINED IN THIS SECTION.
   b. A participating pharmacist must:
   (i)[(A) have been awarded either a master of science in clinical phar-
 macy or a doctor of pharmacy degree;
   (B)] maintain a current unrestricted license; and
   [(C)  have  a  minimum  of two years experience, of which at least one
 year of such experience shall include clinical experience  in  a  health
 facility,  which  involves  consultation with physicians with respect to
 drug therapy and may include a residency at a  facility  involving  such
 consultation; or
   (ii)(A) have been awarded a bachelor of science in pharmacy;
   (B) maintain a current unrestricted license; and
   (C) within the last seven years, have a minimum of three years experi-
 ence,  of which at least one year of such experience shall include clin-
 ical experience in a health facility, which involves  consultation  with
 physicians with respect to drug therapy and may include a residency at a
 facility involving such consultation; and
   (iii) meet any additional education, experience, or other requirements
 set forth by the department in consultation with the board]
   (II) SATISFY ANY TWO OF THE FOLLOWING CRITERIA:
   (A)  CERTIFICATION  IN  A  RELEVANT AREA OF PRACTICE INCLUDING BUT NOT
 LIMITED TO AMBULATORY CARE, CRITICAL CARE, GERIATRIC  PHARMACY,  NUCLEAR
 PHARMACY, NUTRITION SUPPORT PHARMACY, ONCOLOGY PHARMACY, PEDIATRIC PHAR-
 MACY,  PHARMACOTHERAPY, OR PSYCHIATRIC PHARMACY, FROM A NATIONAL ACCRED-
 ITING BODY AS APPROVED BY THE DEPARTMENT;
   (B) POSTGRADUATE RESIDENCY THROUGH AN ACCREDITED POSTGRADUATE  PROGRAM
 REQUIRING  AT LEAST FIFTY PERCENT OF THE EXPERIENCE BE IN DIRECT PATIENT
 CARE SERVICES WITH INTERDISCIPLINARY TERMS; OR
   (C) HAVE PROVIDED CLINICAL SERVICES TO PATIENTS FOR AT LEAST ONE  YEAR
 EITHER:
   (I) UNDER A COLLABORATIVE PRACTICE AGREEMENT OR PROTOCOL WITH A PHYSI-
 CIAN, NURSE PRACTITIONER OR FACILITY; OR
   (II)  HAS  DOCUMENTED  EXPERIENCE IN PROVISION OF CLINICAL SERVICES TO
 PATIENTS FOR AT LEAST ONE YEAR OR ONE THOUSAND HOURS, AND DEEMED ACCEPT-
 ABLE TO THE DEPARTMENT UPON RECOMMENDATION OF THE BOARD OF PHARMACY.
   c. Notwithstanding any provision of law, nothing in this section shall
 prohibit a licensed pharmacist from engaging in clinical services  asso-
 ciated  with  collaborative  drug  therapy  management, in order to gain
 experience necessary to qualify under [clause (C) of subparagraph (i) or
 (ii) of paragraph b of this subdivision] ITEM  (II)  OF  CLAUSE  (C)  OF
 SUBPARAGRAPH (II) OF PARAGRAPH B OF THIS SUBDIVISION, provided that such
 practice  is  under the supervision of a pharmacist that currently meets
 the referenced requirement, and that such practice is  authorized  under
 the  written  agreement  or protocol with the physician OR NURSE PRACTI-
 TIONER.
   d. Notwithstanding any provision of this section, nothing herein shall
 authorize the pharmacist to diagnose disease. In the event that a treat-
 ing physician OR NURSE PRACTITIONER may disagree with  the  exercise  of
 professional  judgment  by  a  pharmacist,  the judgment of the treating
 physician OR NURSE PRACTITIONER shall prevail.
   [3. The physician who is a party to a written  agreement  or  protocol
 authorizing  collaborative  drug therapy management shall be employed by

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 or otherwise affiliated with the same facility with which the pharmacist
 is also employed or affiliated.]
   4.  [The existence of a written agreement or protocol on collaborative
 drug therapy management and the patient's right to choose to not partic-
 ipate in collaborative drug therapy management shall be disclosed to any
 patient who is eligible to receive collaborative  drug  therapy  manage-
 ment. Collaborative drug therapy management shall not be utilized unless
 the  patient  or  the  patient's  authorized representative consents, in
 writing, to such management. If the patient or the patient's  authorized
 representative  consents,  it  shall  be  noted on the patient's medical
 record. If the patient or the patient's  authorized  representative  who
 consented  to collaborative drug therapy management chooses to no longer
 participate in such management, at any time, it shall be  noted  on  the
 patient's  medical  record.  In  addition,  the existence of the written
 agreement or protocol and the patient's consent to such management shall
 be disclosed to the patient's primary physician and any  other  treating
 physician  or healthcare provider.] A PHARMACIST WHO IS CERTIFIED BY THE
 DEPARTMENT TO ENGAGE IN COLLABORATIVE DRUG THERAPY MANAGEMENT MAY  ENTER
 INTO  A  WRITTEN  COLLABORATIVE  PRACTICE  AGREEMENT  OR PROTOCOL WITH A
 PHYSICIAN, NURSE PRACTITIONER OR PRACTICE AS AN INDEPENDENT HEALTH  CARE
 PROVIDER OR AS AN EMPLOYEE OF A PHARMACY OR OTHER HEALTH CARE PROVIDER.
   5. Participation in a written agreement or protocol authorizing colla-
 borative  drug  therapy  management  shall be voluntary, and no patient,
 physician, NURSE PRACTITIONER, pharmacist, or facility shall be required
 to participate.
   [6. Nothing in this section shall be deemed  to  limit  the  scope  of
 practice of pharmacy nor be deemed to limit the authority of pharmacists
 and physicians to engage in medication management prior to the effective
 date of this section and to the extent authorized by law.]
   §  7. Subparagraph (A) of paragraph 15-a of subdivision (i) of section
 3216 of the insurance law, as amended by chapter  338  of  the  laws  of
 2003, is amended to read as follows:
   (A)  Every policy which provides medical coverage that includes cover-
 age for physician services in a  physician's  office  and  every  policy
 which  provides  major  medical  or  similar comprehensive-type coverage
 shall include coverage for the following equipment and supplies for  the
 treatment  of  diabetes,  if recommended or prescribed by a physician or
 other licensed health care  provider  legally  authorized  to  prescribe
 under title eight of the education law: blood glucose monitors and blood
 glucose  monitors  for  the  visually impaired, data management systems,
 test strips for glucose monitors and visual reading  and  urine  testing
 strips,  insulin,  injection aids, cartridges for the visually impaired,
 syringes, insulin pumps  and  appurtenances  thereto,  insulin  infusion
 devices,  and  oral agents for controlling blood sugar. In addition, the
 commissioner of the department of health shall provide and  periodically
 update by rule or regulation a list of additional diabetes equipment and
 related  supplies  such  as are medically necessary for the treatment of
 diabetes, for which there shall also be coverage.  Such  policies  shall
 also  include  coverage for diabetes self-management education to ensure
 that persons with diabetes are educated as to the proper self-management
 and treatment of their  diabetic  condition,  including  information  on
 proper  diets. Such coverage for self-management education and education
 relating to diet shall be limited to visits medically necessary upon the
 diagnosis of diabetes, where a physician diagnoses a significant  change
 in  the  patient's symptoms or conditions which necessitate changes in a
 patient's self-management, or where reeducation or  refresher  education

 S. 2507--A                         55                         A. 3007--A

 is  necessary.  Such education may be provided by the physician or other
 licensed health care provider  legally  authorized  to  prescribe  under
 title  eight  of the education law, or their staff, as part of an office
 visit  for  diabetes  diagnosis or treatment, or by a certified diabetes
 nurse educator, certified nutritionist, certified  dietitian  or  regis-
 tered dietitian upon the referral of a physician, A PHARMACIST, or other
 licensed  health  care  provider  legally  authorized to prescribe under
 title eight of the education law. Education provided  by  the  certified
 diabetes  nurse educator, certified nutritionist, certified dietitian or
 registered dietitian may be limited to group settings wherever practica-
 ble.  Coverage for self-management education and education  relating  to
 diet shall also include home visits when medically necessary.
   §  8.  Subparagraph  (A)  of paragraph 7 of subdivision (k) of section
 3221 of the insurance law, as amended by chapter  338  of  the  laws  of
 2003, is amended to read as follows:
   (A) Every group or blanket accident and health insurance policy issued
 or  issued  for  delivery  in this state which provides medical coverage
 that includes coverage for physician services in  a  physician's  office
 and  every policy which provides major medical or similar comprehensive-
 type coverage shall include coverage for  the  following  equipment  and
 supplies  for the treatment of diabetes, if recommended or prescribed by
 a physician or other licensed health care provider legally authorized to
 prescribe under title eight of the education law: blood glucose monitors
 and blood glucose monitors for the visually  impaired,  data  management
 systems,  test  strips for glucose monitors and visual reading and urine
 testing strips, insulin, injection aids,  cartridges  for  the  visually
 impaired,  syringes,  insulin  pumps  and appurtenances thereto, insulin
 infusion devices, and oral agents for controlling blood sugar. In  addi-
 tion,  the  commissioner  of  the department of health shall provide and
 periodically update by rule or regulation a list of additional  diabetes
 equipment  and  related supplies such as are medically necessary for the
 treatment of diabetes, for which there  shall  also  be  coverage.  Such
 policies shall also include coverage for diabetes self-management educa-
 tion  to ensure that persons with diabetes are educated as to the proper
 self-management and treatment of  their  diabetic  condition,  including
 information on proper diets. Such coverage for self-management education
 and  education  relating  to  diet  shall be limited to visits medically
 necessary upon the diagnosis of diabetes, where a physician diagnoses  a
 significant  change in the patient's symptoms or conditions which neces-
 sitate changes in a patient's self-management, or where  reeducation  or
 refresher  education is necessary. Such education may be provided by the
 physician or other licensed health care provider legally  authorized  to
 prescribe  under  title  eight  of the education law, or their staff, as
 part of an office visit for diabetes diagnosis or  treatment,  or  by  a
 certified  diabetes  nurse  educator,  certified nutritionist, certified
 dietitian or registered dietitian upon the referral of  a  physician,  A
 PHARMACIST, or other licensed health care provider legally authorized to
 prescribe  under title eight of the education law. Education provided by
 the certified diabetes nurse educator, certified nutritionist, certified
 dietitian or registered dietitian may be limited to group settings wher-
 ever practicable.  Coverage for self-management education and  education
 relating  to  diet  shall also include home visits when medically neces-
 sary.
   § 9. Paragraph 1 of subdivision (u) of section 4303 of  the  insurance
 law,  as  amended by chapter 338 of the laws of 2003, is amended to read
 as follows:

 S. 2507--A                         56                         A. 3007--A
 
   (1) A medical expense indemnity corporation or a health service corpo-
 ration which provides medical coverage that includes coverage for physi-
 cian services in a physician's office and every  policy  which  provides
 major  medical  or  similar  comprehensive-type  coverage  shall include
 coverage  for  the following equipment and supplies for the treatment of
 diabetes, if recommended or prescribed by a physician or other  licensed
 health  care  provider legally authorized to prescribe under title eight
 of the education law: blood glucose monitors and blood glucose  monitors
 for  the  visually  impaired,  data  management systems, test strips for
 glucose monitors and visual reading and urine testing  strips,  insulin,
 injection  aids, cartridges for the visually impaired, syringes, insulin
 pumps and appurtenances thereto,  insulin  infusion  devices,  and  oral
 agents for controlling blood sugar. In addition, the commissioner of the
 department  of  health  shall provide and periodically update by rule or
 regulation a list of additional diabetes equipment and related  supplies
 such as are medically necessary for the treatment of diabetes, for which
 there  shall also be coverage. Such policies shall also include coverage
 for diabetes self-management  education  to  ensure  that  persons  with
 diabetes  are educated as to the proper self-management and treatment of
 their diabetic condition, including information on  proper  diets.  Such
 coverage  for  self-management  education and education relating to diet
 shall be limited to visits medically necessary  upon  the  diagnosis  of
 diabetes,  where  a  physician  diagnoses  a  significant  change in the
 patient's  symptoms  or  conditions  which  necessitate  changes  in   a
 patient's  self-management,  or where reeducation or refresher education
 is necessary. Such education may be provided by the physician  or  other
 licensed  health  care  provider  legally  authorized to prescribe under
 title eight of the education law, or their staff, as part of  an  office
 visit  for  diabetes  diagnosis or treatment, or by a certified diabetes
 nurse educator, certified nutritionist, certified  dietitian  or  regis-
 tered  dietitian  upon the referral of a physician, PHARMACIST, or other
 licensed health care provider  legally  authorized  to  prescribe  under
 title  eight  of  the education law. Education provided by the certified
 diabetes nurse educator, certified nutritionist, certified dietitian  or
 registered dietitian may be limited to group settings wherever practica-
 ble.    Coverage for self-management education and education relating to
 diet shall also include home visits when medically necessary.
   § 10. Subdivisions (q) and (r) of subdivision 2 of  section  365-a  of
 the  social  services  law,  subdivision (q) as amended by section 35 of
 part B of chapter 58 of the laws of 2010 and subdivision (r) as added by
 section 32 of part C of chapter 58 of the laws of 2008, are  amended  to
 read as follows:
   (q)  diabetes  self-management training services for persons diagnosed
 with diabetes when such services are ordered by a physician,  registered
 physician  assistant,  registered  nurse  practitioner,  PHARMACIST,  or
 licensed midwife and provided by a licensed,  registered,  or  certified
 health  care  professional, as determined by the commissioner of health,
 who is certified as a diabetes educator by  the  National  Certification
 Board  for  Diabetes  Educators,  or  a successor national certification
 board, or provided by such a  professional  who  is  affiliated  with  a
 program  certified  by  the  American Diabetes Association, the American
 Association of Diabetes Educators, the Indian Health  Services,  or  any
 other  national  accreditation  organization  approved  by  the  federal
 centers for medicare and medicaid services; provided, however, that  the
 provisions  of this paragraph shall not take effect unless all necessary
 approvals under federal law and regulation have been obtained to receive

 S. 2507--A                         57                         A. 3007--A
 
 federal financial participation in the costs  of  health  care  services
 provided  pursuant to this paragraph. Nothing in this paragraph shall be
 construed to modify any licensure, certification or  scope  of  practice
 provision under title eight of the education law.
   (r)  asthma  self-management  training  services for persons diagnosed
 with asthma when such services are ordered by  a  physician,  registered
 physician's  assistant,  registered  nurse  practitioner, PHARMACIST, or
 licensed midwife and provided by a licensed,  registered,  or  certified
 health  care  professional, as determined by the commissioner of health,
 who is certified as an asthma educator by the National  Asthma  Educator
 Certification  Board,  or  a  successor  national  certification  board;
 provided, however, that the provisions of this paragraph shall not  take
 effect  unless  all necessary approvals under federal law and regulation
 have been obtained to receive federal  financial  participation  in  the
 costs  of  health  care  services  provided  pursuant to this paragraph.
 Nothing in this paragraph shall be construed to  modify  any  licensure,
 certification  or  scope  of practice provision under title eight of the
 education law.
   § 11. Section 8 of 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, as amended by section 18 of
 part BB of chapter 56 of the  laws  of  2020,  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,
 2022].
   §  12.  Section  5  of  chapter  116 of the laws of 2012, amending the
 education law relating to authorizing a licensed pharmacist  and  certi-
 fied  nurse  practitioner  to  administer  certain immunizing agents, as
 amended by section 19 of part BB of chapter 56 of the laws of  2020,  is
 amended to read as follows:
   §  5.  This  act shall take effect on the ninetieth day after it shall
 have become a law[, provided, however, that the provisions  of  sections
 one,  two  and four of this act shall expire and be deemed repealed July
 1, 2022 provided, that:
   (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].
   § 13. Section 4 of chapter 274 of  the  laws  of  2013,  amending  the
 education  law  relating to authorizing a licensed pharmacist and certi-
 fied nurse practitioner to administer meningococcal  disease  immunizing
 agents, is amended to read as follows:
   §  4.  This  act shall take effect on the ninetieth day after it shall
 have become a law[; provided, that:
   (a) the amendments to subdivision 7 of section 6527 of  the  education
 law, made by section one of this act shall not affect the expiration and

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 reversion  of  such subdivision, as provided in section 6 of chapter 116
 of the laws of 2012, and shall be deemed to expire therewith; and
   (b)  the  amendments to subdivision 7 of section 6909 of the education
 law, made by section two of this act shall not affect the expiration and
 reversion of such subdivision, as provided in section 6 of  chapter  116
 of the laws of 2012, and shall be deemed to be expire therewith; and
   (c)  the amendments to subdivision 22 of section 6802 of the education
 law made by section three of this act shall not affect the expiration of
 such subdivision and shall be deemed to expire therewith].
   § 14. 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 section 20 of part BB of chapter 56 of the laws of 2020,  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[, provided, however, that the provisions of
 sections two, three, and four of this act shall  expire  and  be  deemed
 repealed  July 1, 2022; provided, however, that the amendments to subdi-
 vision 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 subdi-
 vision  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]. 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.
   § 15. This act shall take effect immediately and shall  be  deemed  to
 have been in full force and effect on and after April 1, 2021; provided,
 however,  that  sections three and four of this act shall take effect on
 the same date and in the same manner as chapter 110 of the laws of  2020
 takes  effect; and provided further that the amendments to subdivision 7
 of section 6527 of the education law made by section three of  this  act
 shall  be  subject  to  the expiration and reversion of such subdivision
 pursuant to section 4 of chapter 110 of  the  laws  of  2020  and  shall
 expire  and  be deemed repealed therewith; and provided further that the
 amendments to subdivision 7 of section 6909 of the education law made by
 section four of this act shall be subject to the expiration  and  rever-
 sion  of  such  subdivision  pursuant to section 4 of chapter 110 of the
 laws of 2020 and shall expire and be deemed repealed therewith.
 
                                  PART Q
 
   Section 1. Subdivision 1 of section 6502  of  the  education  law,  as
 amended  by  chapter  599  of  the  laws of 1996, is amended and two new
 subdivisions 1-a and 1-b are added to read as follows:
   1. [A] EXCEPT PURSUANT TO SUBDIVISION ONE-A OF THIS SECTION, A license
 shall be valid during the life of the holder unless revoked, annulled or
 suspended by the board of regents [or in the case of physicians,  physi-
 cians   practicing  under  a  limited  permit,  physician's  assistants,
 specialist's assistants and medical residents, the licensee is  stricken
 from  the  roster of such licensees by the board of regents on the order
 of the state board for professional medical conduct in the department of
 health. A licensee must  register  with  the  department  and  meet  the
 requirements  prescribed in section 3-503 of the general obligations law
 to practice in this state].

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   1-A. IN THE CASE OF PHYSICIANS, PHYSICIANS PRACTICING UNDER A  LIMITED
 PERMIT,  PHYSICIAN  ASSISTANTS,  SPECIALIST ASSISTANTS AND MEDICAL RESI-
 DENTS, A LICENSE SHALL BE VALID DURING THE LIFE OF THE HOLDER UNLESS:
   (I)  THE LICENSEE IS STRICKEN FROM THE ROSTER OF SUCH LICENSEES BY THE
 BOARD OF REGENTS ON THE  ORDER  OF  THE  STATE  BOARD  FOR  PROFESSIONAL
 MEDICAL CONDUCT IN THE DEPARTMENT OF HEALTH; OR
   (II)  THE  LICENSEE HAS FAILED TO REGISTER WITH THE DEPARTMENT FOR TWO
 CONSECUTIVE REGISTRATION PERIODS, IN WHICH CASE THE  LICENSEE  SHALL  BE
 IMMEDIATELY  STRICKEN  FROM THE ROSTER OF SUCH LICENSEES BY THE BOARD OF
 REGENTS.
   1-B. A LICENSEE  MUST  REGISTER  WITH  THE  DEPARTMENT  AND  MEET  THE
 REQUIREMENTS  PRESCRIBED IN SECTION 3-503 OF THE GENERAL OBLIGATIONS LAW
 TO PRACTICE IN THIS STATE.
   § 2. Section 6524 of the education law is  amended  by  adding  a  new
 subdivision 6-a to read as follows:
   (6-A)  FINGERPRINTS  AND  CRIMINAL  HISTORY  RECORD  CHECK: CONSENT TO
 SUBMISSION OF FINGERPRINTS FOR PURPOSES OF CONDUCTING A CRIMINAL HISTORY
 RECORD CHECK. THE COMMISSIONER SHALL SUBMIT TO THE DIVISION OF  CRIMINAL
 JUSTICE  SERVICES  TWO  SETS OF FINGERPRINTS OF APPLICANTS FOR LICENSURE
 PURSUANT TO THIS ARTICLE, AND THE DIVISION OF CRIMINAL JUSTICE  SERVICES
 PROCESSING  FEE IMPOSED PURSUANT TO SUBDIVISION EIGHT-A OF SECTION EIGHT
 HUNDRED THIRTY-SEVEN OF THE EXECUTIVE LAW AND ANY  FEE  IMPOSED  BY  THE
 FEDERAL  BUREAU  OF  INVESTIGATION.  THE  DIVISION  OF  CRIMINAL JUSTICE
 SERVICES AND THE FEDERAL BUREAU  OF  INVESTIGATION  SHALL  FORWARD  SUCH
 CRIMINAL  HISTORY RECORD TO THE COMMISSIONER IN A TIMELY MANNER. FOR THE
 PURPOSES OF THIS SECTION, THE TERM "CRIMINAL HISTORY RECORD" SHALL  MEAN
 A  RECORD  OF ALL CONVICTIONS OF CRIMES AND ANY PENDING CRIMINAL CHARGES
 MAINTAINED ON AN INDIVIDUAL BY THE DIVISION OF CRIMINAL JUSTICE SERVICES
 AND THE FEDERAL BUREAU  OF  INVESTIGATION.  ALL  SUCH  CRIMINAL  HISTORY
 RECORDS  SENT  TO THE COMMISSIONER PURSUANT TO THIS SUBDIVISION SHALL BE
 CONFIDENTIAL PURSUANT TO THE APPLICABLE FEDERAL AND  STATE  LAWS,  RULES
 AND  REGULATIONS,  AND SHALL NOT BE PUBLISHED OR IN ANY WAY DISCLOSED TO
 PERSONS OTHER THAN THE COMMISSIONER, UNLESS OTHERWISE AUTHORIZED BY LAW;
   § 3. Paragraph (c) of subdivision 9 and subdivisions 20, 28 and 31  of
 section  6530  of the education law, as added by chapter 606 of the laws
 of 1991, are amended and a new  subdivision  51  is  added  to  read  as
 follows:
   (c)  Having been found guilty in an adjudicatory proceeding of violat-
 ing a state or federal statute or regulation, pursuant to a final  deci-
 sion  or  determination,  and when no appeal is pending, or after resol-
 ution of the proceeding OR A COMPLAINT ALLEGING A VIOLATION OF  A  STATE
 OR  FEDERAL  STATUTE OR REGULATION by stipulation or agreement, and when
 the violation would constitute professional misconduct pursuant to  this
 section;
   20. Conduct [in the practice of medicine] which evidences moral unfit-
 ness to practice medicine;
   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;

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   31.  Willfully  harassing, abusing, or intimidating a patient [either]
 OR A PATIENT'S CAREGIVER OR SURROGATE physically or verbally;
   51.  EXCEPT  FOR GOOD CAUSE SHOWN, FAILING TO NOTIFY THE DEPARTMENT OF
 HEALTH WITHIN TWENTY-FOUR HOURS OF HAVING BEEN CHARGED WITH A  CRIME  IN
 ANY JURISDICTION OR OF ANY EVENT MEETING THE DEFINITIONS OF PROFESSIONAL
 MISCONDUCT SET FORTH IN SUBDIVISION NINE OF THIS SECTION.
   § 4. Section 6532 of the education law, as added by chapter 606 of the
 laws of 1991, is amended to read as follows:
   § 6532. Enforcement,  administration  and interpretation of this arti-
 cle.  The board [of] FOR professional medical conduct and the department
 of health shall enforce, administer and interpret this  article.  Before
 issuing a declaratory ruling pursuant to section two hundred four of the
 state  administrative  procedure  act  with respect to this article, the
 department of health shall fully consult with the department  of  educa-
 tion.  [Neither  the commissioner of education, the board of regents nor
 the] THE commissioner of health may promulgate any rules or  regulations
 concerning this article.
   § 5. 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] THE COMMISSION-
 ER, and may also require a witness to attend and  give  testimony  in  a
 county where [he] THE WITNESS 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

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   (F) SEEK TO OBTAIN A WARRANT BASED ON PROBABLE CAUSE THAT  A  LICENSEE
 HAS COMMITTED PROFESSIONAL MISCONDUCT OR A CRIME FROM A JUDICIAL OFFICER
 AUTHORIZED  TO ISSUE A WARRANT. SUCH WARRANT SHALL AUTHORIZE THE COMMIS-
 SIONER AND ANY PERSON AUTHORIZED BY THE COMMISSIONER TO HAVE THE AUTHOR-
 ITY TO INSPECT ALL GROUNDS, ERECTIONS, VEHICLES, STRUCTURES, APARTMENTS,
 BUILDINGS,  PLACES  AND  THE  CONTENTS  THEREIN AND TO REMOVE ANY BOOKS,
 RECORDS, PAPERS, DOCUMENTS,  COMPUTERS,  ELECTRONIC  DEVICES  AND  OTHER
 PHYSICAL OBJECTS.
   § 6. Subdivision 1 of section 230 of the public health law, as amended
 by chapter 537 of the laws of 1998, is amended to read as follows:
   1. A state board for professional medical conduct is hereby created in
 the  department  in  matters  of  professional  misconduct as defined in
 sections sixty-five hundred thirty and sixty-five hundred thirty-one  of
 the  education  law.  Its  physician  members  shall be appointed by the
 commissioner at least eighty-five percent of whom shall  be  from  among
 nominations  submitted  by the medical society of the state of New York,
 the New York state osteopathic society, the New York  academy  of  medi-
 cine, county medical societies, statewide specialty societies recognized
 by  the council of medical specialty societies, and the hospital associ-
 ation of New York state. Its lay  members  shall  be  appointed  by  the
 commissioner  with  the  approval  of the governor. The board of regents
 shall also appoint twenty percent of the members of the board. Not  less
 than  sixty-seven  percent  of  the  members  appointed  by the board of
 regents shall be physicians. Not less than eighty-five  percent  of  the
 physician  members appointed by the board of regents shall be from among
 nominations submitted by the medical society of the state of  New  York,
 the  New  York  state osteopathic society, the New York academy of medi-
 cine, county medical societies, statewide medical  societies  recognized
 by  the council of medical specialty societies, and the hospital associ-
 ation of New York state. Any failure to meet the  percentage  thresholds
 stated  in  this  subdivision  shall not be grounds for invalidating any
 action by or on authority of the board for professional medical  conduct
 or  a  committee or a member thereof. The board for professional medical
 conduct shall consist of not fewer than eighteen physicians licensed  in
 the  state  for  at  least  five  years, two of whom shall be doctors of
 osteopathy, not fewer than two of whom shall be physicians who  dedicate
 a  significant  portion of their practice to the use of non-conventional
 medical treatments who may be nominated by New York state medical  asso-
 ciations  dedicated  to the advancement of such treatments, at least one
 of whom shall have expertise in palliative  care,  and  not  fewer  than
 seven  lay  members.  An  executive  secretary shall be appointed by the
 chairperson and shall be a licensed physician. Such executive  secretary
 shall  not  be  a member of the board, shall hold office at the pleasure
 of, and shall have the powers and duties assigned and the annual  salary
 fixed  by[,  the  chairperson.  The  chairperson  shall also assign such
 secretaries or other persons to the board as are necessary] THE  COMMIS-
 SIONER.
   §  7. Clause (C) of subparagraph (iii) of paragraph (a) of subdivision
 10 of section 230 of the public health law, as amended by chapter 477 of
 the laws of 2008, is amended to read as follows:
   (C) If the director determines that the matter shall be  submitted  to
 an investigation committee, an investigation committee shall be convened
 [within  ninety  days  of  any  interview of the licensee]. The director
 shall present the investigation committee  with  relevant  documentation
 including, but not limited to: (1) a copy of the original complaint; (2)
 the  report  of  the  interviewer and the stenographic record if one was

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 taken; (3) the report of any medical or scientific expert; (4) copies of
 reports  of  any  patient  record  reviews;  and  (5)   the   licensee's
 submissions.
   §  8.  Subparagraph  (v) of paragraph (a) of subdivision 10 of section
 230 of the public health law, as amended by chapter 477 of the  laws  of
 2008, is amended to read as follows:
   (v)  The  files of the office of professional medical conduct relating
 to the investigation of possible instances  of  professional  misconduct
 shall  be  confidential  and not subject to disclosure at the request of
 any person, except as provided by law in a pending  disciplinary  action
 or  proceeding.  The  provisions of this paragraph shall not prevent the
 office from sharing information  concerning  investigations  within  the
 department  and, pursuant to subpoena, with other duly authorized public
 agencies responsible for  professional  regulation  or  criminal  prose-
 cution.  Nothing in this subparagraph shall affect the duties of notifi-
 cation set forth in subdivision nine-a of this section  or  prevent  the
 publication  of charges or of the findings, conclusions, determinations,
 or order of a hearing committee pursuant to paragraphs  (d)  or  (g)  of
 this  subdivision. In addition, the commissioner may, IN HIS OR HER SOLE
 DISCRETION, disclose [the] ANY information [when, in his or her  profes-
 sional  judgment, disclosure of such information would avert or minimize
 a public health  threat]  RELATING  TO  THE  INVESTIGATION  OF  POSSIBLE
 INSTANCES  OF  PROFESSIONAL  MISCONDUCT.  Any  such disclosure shall not
 affect the confidentiality of other information  in  the  files  of  the
 office of professional medical conduct related to the investigation.
   §  9. Subparagraphs (i) and (ii) of paragraph (d) of subdivision 10 of
 section 230 of the public health law, as amended by chapter 477  of  the
 laws of 2008, are amended to read as follows:
   (i)  A  copy  of  the  charges  and the notice of the hearing shall be
 served on the licensee EITHER: (A) personally [by the  board]  at  least
 thirty  days  before  the hearing[.]; (B) [If personal service cannot be
 made after due diligence and such fact is certified under oath,  a  copy
 of  the charges and the notice of hearing shall be served] by registered
 or certified mail to the licensee's [last known] CURRENT RESIDENTIAL  OR
 PRACTICE  address [by the board] MAILED at least fifteen days before the
 hearing; (C) BY REGISTERED OR CERTIFIED  MAIL  TO  THE  LICENSEE'S  MOST
 RECENT MAILING ADDRESS PURSUANT TO SECTION SIXTY-FIVE HUNDRED TWO OF THE
 EDUCATION LAW OR THE LICENSEE'S MOST RECENT MAILING ADDRESS ON FILE WITH
 THE DEPARTMENT OF EDUCATION PURSUANT TO THE NOTIFICATION REQUIREMENT SET
 FORTH  IN  SUBDIVISION  FIVE OF SUCH SECTION, MAILED AT LEAST FORTY-FIVE
 DAYS BEFORE THE HEARING; OR (D) BY FIRST  CLASS  MAIL  TO  AN  ATTORNEY,
 LICENSED  TO  PRACTICE  IN  THE STATE, WHO HAS APPEARED ON BEHALF OF THE
 LICENSEE AND WHO HAS BEEN PROVIDED WITH  WRITTEN  AUTHORIZATION  OF  THE
 LICENSEE TO ACCEPT SERVICE, MAILED AT LEAST THIRTY DAYS BEFORE THE HEAR-
 ING.
   (ii)  The  charges  shall be made public, consistent with subparagraph
 (iv) of paragraph (a) of this subdivision, [no earlier than  five  busi-
 ness  days]  IMMEDIATELY after they are served, and the charges shall be
 accompanied by a statement advising the licensee that  such  publication
 will  occur;  [provided, however, that] charges may be made public imme-
 diately upon issuance of the commissioner's order in the case of summary
 action taken pursuant to subdivision twelve of this section and no prior
 notification of such publication need be made to the licensee.
   § 10. Subparagraph (ii) of paragraph (m) of subdivision 10 of  section
 230  of  the public health law, as amended by chapter 606 of the laws of
 1991, is amended to read as follows:

 S. 2507--A                         63                         A. 3007--A
 
   (ii) Administrative warning and consultation. If the director  of  the
 office  of professional medical conduct, after obtaining the concurrence
 of a majority of a committee on professional conduct, and after  consul-
 tation  with  the executive secretary, determines that there is substan-
 tial  evidence of professional misconduct of a minor or technical nature
 or of substandard medical practice which  does  not  constitute  profes-
 sional  misconduct,  the  director  may  issue an administrative warning
 and/or provide for consultation with a panel of  one  or  more  experts,
 chosen  by  the director. Panels of one or more experts may include, but
 shall not be limited to, a peer review committee  of  a  county  medical
 society  or a specialty board. Administrative warnings and consultations
 shall be [confidential and] MADE PUBLIC, BUT  shall  not  constitute  an
 adjudication of guilt or be used as evidence that the licensee is guilty
 of the alleged misconduct. However, in the event of a further allegation
 of  similar  misconduct by the same licensee, the matter may be reopened
 and further proceedings instituted as provided in this section.
   § 11. Paragraph (p) of subdivision 10 of section  230  of  the  public
 health law, as amended by chapter 599 of the laws of 1996, is amended to
 read as follows:
   (p)  Convictions  of  crimes or administrative violations.  EXCEPT FOR
 GOOD CAUSE SHOWN, A LICENSEE SHALL NOTIFY THE DEPARTMENT WITHIN  TWENTY-
 FOUR HOURS OF HAVING BEEN CHARGED WITH A CRIME IN ANY JURISDICTION OR OF
 ANY  EVENT  MEETING THE DEFINITIONS OF PROFESSIONAL MISCONDUCT SET FORTH
 IN SUBDIVISION NINE OF SECTION SIXTY-FIVE HUNDRED THIRTY OF  THE  EDUCA-
 TION  LAW.  In  cases  of  professional  misconduct  based solely upon a
 violation of subdivision nine of section sixty-five  hundred  thirty  of
 the  education law, the director may direct that charges be prepared and
 served and may refer the matter to a committee on  professional  conduct
 for  its  review  and  report  of findings, conclusions as to guilt, and
 determination. In such cases, the notice of hearing shall state that the
 licensee shall file a written answer to each of the charges and  allega-
 tions  in  the  statement of charges no later than ten days prior to the
 hearing, and that any charge or allegation  not  so  answered  shall  be
 deemed  admitted, that the licensee may wish to seek the advice of coun-
 sel prior to filing such answer that the licensee may file a  brief  and
 affidavits with the committee on professional conduct, that the licensee
 may  appear personally before the committee on professional conduct, may
 be represented by counsel and may present evidence or sworn testimony in
 his or her behalf, and the notice may contain such other information  as
 may  be  considered appropriate by the director. The department may also
 present evidence or sworn testimony and file a brief at the  hearing.  A
 stenographic record of the hearing shall be made. Such evidence or sworn
 testimony  offered  to  the  committee  on professional conduct shall be
 strictly limited to evidence and testimony relating to  the  nature  and
 severity  of  the  penalty  to  be  imposed upon the licensee. Where the
 charges are based on the conviction of state law crimes in other  juris-
 dictions, evidence may be offered to the committee which would show that
 the  conviction would not be a crime in New York state. The committee on
 professional conduct may reasonably limit the number of witnesses  whose
 testimony  will  be  received and the length of time any witness will be
 permitted to testify. The determination of the committee shall be served
 upon the licensee and the department in accordance with  the  provisions
 of  paragraph  (h) of this subdivision. A determination pursuant to this
 subdivision may be reviewed  by  the  administrative  review  board  for
 professional medical conduct.

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   §  12.  Subdivision  12  of  section  230 of the public health law, as
 amended by chapter 627 of the laws of 1996, paragraph (a) as amended  by
 chapter  477 of the laws of 2008 and paragraph (b) as amended by section
 3 of part CC of chapter 57 of the laws of 2018, is amended  to  read  as
 follows:
   12.  Summary  action.  (a)  Whenever the commissioner, (i) after being
 presented with information indicating that a licensee is causing, engag-
 ing in or maintaining a condition or activity which has resulted in  the
 transmission  or  suspected  transmission,  or  is likely to lead to the
 transmission, of communicable disease as defined in the  state  sanitary
 code  or  HIV/AIDS, by the state and/or a local health department and if
 in the commissioner's opinion it would be prejudicial to  the  interests
 of  the people to delay action until an opportunity for a hearing can be
 provided in accordance with the prehearing  and  hearing  provisions  of
 this  section;  [or]  (ii) AFTER REQUIRING THAT A LICENSEE PRODUCE DOCU-
 MENTS IN ACCORDANCE WITH SUBDIVISION FOUR OF SECTION TWO HUNDRED SIX  OF
 THIS CHAPTER, AND SUCH LICENSEE HAS FAILED TO PRODUCE THE REQUIRED DOCU-
 MENTS  WITHIN  TEN  DAYS, OR WITHIN SUCH SHORTER PERIOD AS MAY HAVE BEEN
 SPECIFIED IN THE COMMISSIONER'S WRITTEN DEMAND FOR DOCUMENTS;  OR  (III)
 after  an  investigation  and a recommendation by a committee on profes-
 sional conduct of the state  board  for  professional  medical  conduct,
 based  upon  a  determination that a licensee is causing, engaging in or
 maintaining a condition or activity which in the commissioner's  opinion
 [constitutes  an  imminent  danger] PRESENTS A RISK to the health of the
 people, and that it therefore appears to be prejudicial to the interests
 of the people to delay action until an opportunity for a hearing can  be
 provided  in  accordance  with  the prehearing and hearing provisions of
 this section; the  commissioner  may  order  the  licensee,  by  written
 notice,  to  discontinue  such  dangerous  condition or activity or take
 certain action immediately and for a  period  of  [ninety]  ONE  HUNDRED
 TWENTY  days  from the date of service of the order. Within [ten] THIRTY
 days from the date of service of the said order,  the  state  board  for
 professional  medical conduct shall commence and regularly schedule such
 hearing proceedings as required by this section, provided, however, that
 the hearing shall be completed within [ninety] ONE HUNDRED  TWENTY  days
 of  the  date  of  service of the order. To the extent that the issue of
 [imminent danger] RISK OF THE HEALTH OF THE PEOPLE can be proven without
 the attorney representing the office  of  professional  medical  conduct
 putting  in  its  entire  case,  the  committee of the board shall first
 determine whether by a preponderance of the  evidence  the  licensee  is
 causing,  engaging  in  or  maintaining  a  condition  or activity which
 [constitutes an imminent danger] PRESENTS A RISK to the  health  of  the
 people.  The  attorney  representing  the office of professional medical
 conduct shall have the burden of going forward and proving by a  prepon-
 derance of the evidence that the licensee's condition, activity or prac-
 tice  [constitutes  an imminent danger] PRESENTS A RISK to the health of
 the people. The licensee shall have an opportunity to be  heard  and  to
 present  proof.  When  both  the  office and the licensee have completed
 their cases with respect to the question of [imminent  danger]  RISK  TO
 THE  HEALTH OF THE PEOPLE, the committee shall promptly make a recommen-
 dation to the commissioner on the issue of [imminent danger] RISK TO THE
 HEALTH OF THE PEOPLE and determine whether the summary order  should  be
 left in effect, modified or vacated, and continue the hearing on all the
 remaining  charges, if any, in accordance with paragraph (f) of subdivi-
 sion ten of this section. Within ten days of the committee's recommenda-
 tion, the commissioner shall determine  whether  or  not  to  adopt  the

 S. 2507--A                         65                         A. 3007--A

 committee's  recommendations,  in  whole  or in part, and shall leave in
 effect, modify or vacate his summary order. The state board for  profes-
 sional  medical  conduct shall make every reasonable effort to avoid any
 delay in completing and determining such proceedings. If, at the conclu-
 sion  of  the  hearing, (i) the hearing committee of the board finds the
 licensee guilty of one or more of the charges which are  the  basis  for
 the summary order, (ii) the hearing committee determines that the summa-
 ry  order  continue,  and (iii) the ninety day term of the order has not
 expired, the summary order shall remain in full force and effect until a
 final decision has been rendered by  the  committee  or,  if  review  is
 sought,  by  the  administrative  review board. A summary order shall be
 public upon issuance.
   (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, which, if commit-
 ted  within  this  state, would have constituted a felony under New York
 state law, and [in the commissioner's  opinion  the  licensee's  alleged
 conduct  constitutes  an  imminent  danger] WHERE THE LICENSEE'S ALLEGED
 CONDUCT MAY PRESENT A RISK to the health of the people, or when the duly
 authorized professional disciplinary agency of another jurisdiction  has
 made  a  finding substantially equivalent to a finding that the practice
 of medicine by the licensee in that jurisdiction [constitutes  an  immi-
 nent  danger]  PRESENTS  A  RISK  to the health of its people, or when a
 licensee has been disciplined by a duly authorized  professional  disci-
 plinary  agency  of  another jurisdiction for acts which if committed in
 this state would have constituted the basis for summary  action  by  the
 commissioner  pursuant to paragraph (a) of this subdivision, the commis-
 sioner, after a recommendation by a committee of professional conduct of
 the state board for professional medical conduct, may order  the  licen-
 see,  by written notice, to discontinue or refrain from practicing medi-
 cine in whole or in part or to take certain actions authorized  pursuant
 to  this  title immediately. The order of the commissioner shall consti-
 tute summary action against the licensee and become  public  upon  issu-
 ance.  The  summary  suspension  shall  remain in effect until the final
 conclusion of a hearing which shall commence within ninety days  of  the
 date  of  service  of  the commissioner's order, end within [ninety] ONE
 HUNDRED EIGHTY days thereafter and otherwise 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  medicine  by  the  licensee  in  another
 jurisdiction  [constitutes  an  imminent  danger] PRESENTS A RISK 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.
   §  13.  Paragraph (a) of subdivision 1 of section 2803-e of the public
 health law, as amended by chapter 294 of the laws of 1985, is amended to
 read as follows:
   (a) Hospitals and other facilities approved pursuant to  this  article
 shall  make  a report or cause a report to be made within thirty days of
 the occurrence of any of the  following:  the  suspension,  restriction,

 S. 2507--A                         66                         A. 3007--A
 
 termination  or  curtailment of the training, employment, association or
 professional privileges or the denial of the certification of completion
 of training of an individual licensed  pursuant  to  the  provisions  of
 title  eight  of  the  education  law or of a medical resident with such
 facility for reasons related in any way to alleged  mental  or  physical
 impairment,  incompetence,  malpractice  or  misconduct or impairment of
 patient safety or welfare; the voluntary or involuntary  resignation  or
 withdrawal  of  association or of privileges with such facility to avoid
 the imposition of disciplinary measures; NOTIFICATION BY THE HOSPITAL OR
 FACILITY, TO ANY ENTITY  PROVIDING  PERSONNEL  TO  PERFORM  PROFESSIONAL
 SERVICES  TO SUCH HOSPITAL OR FACILITY, THAT THE ENTITY MAY NOT ASSIGN A
 PARTICULAR INDIVIDUAL TO PROVIDE SUCH SERVICES TO THE HOSPITAL OR FACIL-
 ITY, FOR REASONS RELATED IN  ANY  WAY  TO  ALLEGED  MENTAL  OR  PHYSICAL
 IMPAIRMENT,  INCOMPETENCE,  MALPRACTICE  OR  MISCONDUCT OR IMPAIRMENT OF
 PATIENT SAFETY OR WELFARE; or the receipt of information which indicates
 that any professional licensee or medical resident has been convicted of
 a crime; the denial of staff privileges to a physician  if  the  reasons
 stated for such denial are related to alleged mental or physical impair-
 ment,  incompetence,  malpractice,  misconduct  or impairment of patient
 safety or welfare.
   § 14. Paragraphs (n), (p) and (q) of subdivision 1 of  section  2995-a
 of  the  public health law, as added by chapter 542 of the laws of 2000,
 are amended and three new paragraphs (r), (s) and (t) are added to  read
 as follows:
   (n)  (i) the location of the licensee's primary practice setting iden-
 tified as such; [and]
   (ii) [the names of any licensed  physicians  with  whom  the  licensee
 shares  a  group practice, as defined in subdivision five of section two
 hundred  thirty-eight  of  this  chapter]  HOURS  OF  OPERATION  OF  THE
 LICENSEE'S PRIMARY PRACTICE SETTING;
   (III)  AVAILABILITY  OF ASSISTIVE TECHNOLOGY AT THE LICENSEE'S PRIMARY
 PRACTICE SETTING; AND
   (IV) WHETHER THE LICENSEE IS ACCEPTING NEW PATIENTS;
   (p) whether the licensee participates  in  the  medicaid  or  medicare
 program  or  any  other  state  or  federally  financed health insurance
 program; [and]
   (q) health care plans with which the licensee has  contracts,  employ-
 ment,  or  other affiliation[.] PROVIDED THAT THE REPORTING AND ACCURACY
 OF SUCH INFORMATION SHALL NOT BE THE RESPONSIBILITY  OF  THE  PHYSICIAN,
 BUT  SHALL  BE INCLUDED AND UPDATED BY THE DEPARTMENT UTILIZING PROVIDER
 NETWORK PARTICIPATION INFORMATION, OR OTHER RELIABLE SOURCES OF INFORMA-
 TION SUBMITTED BY THE HEALTH CARE PLANS;
   (R) THE PHYSICIAN'S WEBSITE AND SOCIAL MEDIA ACCOUNTS;
   (S) THE NAMES OF ANY LICENSED PHYSICIANS WITH WHOM THE LICENSEE SHARES
 A GROUP PRACTICE, AS DEFINED IN SUBDIVISION FIVE OF SECTION TWO  HUNDRED
 THIRTY-EIGHT OF THIS CHAPTER; AND
   (T)  WORKFORCE  RESEARCH AND PLANNING INFORMATION AS DETERMINED BY THE
 COMMISSIONER.
   § 15. Section 2995-a of the public health law is amended by  adding  a
 new subdivision 1-b to read as follows:
   1-B.  (A)  FOR  THE PURPOSES OF THIS SECTION, A PHYSICIAN LICENSED AND
 REGISTERED TO PRACTICE IN THIS STATE MAY AUTHORIZE A DESIGNEE TO  REGIS-
 TER,  TRANSMIT,  ENTER  OR  UPDATE  INFORMATION  ON  HIS  OR HER BEHALF,
 PROVIDED THAT:
   (I) THE DESIGNEE SO AUTHORIZED IS EMPLOYED BY  THE  PHYSICIAN  OR  THE
 SAME PROFESSIONAL PRACTICE OR IS UNDER CONTRACT WITH SUCH PRACTICE;

 S. 2507--A                         67                         A. 3007--A
 
   (II) THE PHYSICIAN TAKES REASONABLE STEPS TO ENSURE THAT SUCH DESIGNEE
 IS SUFFICIENTLY COMPETENT IN THE PROFILE REQUIREMENTS;
   (III)  THE  PHYSICIAN REMAINS RESPONSIBLE FOR ENSURING THE ACCURACY OF
 THE INFORMATION PROVIDED AND FOR ANY FAILURE TO PROVIDE ACCURATE  INFOR-
 MATION; AND
   (IV)  THE  PHYSICIAN  SHALL NOTIFY THE DEPARTMENT UPON TERMINATING THE
 AUTHORIZATION OF ANY DESIGNEE, IN A MANNER DETERMINED BY THE DEPARTMENT.
   (B) THE COMMISSIONER SHALL GRANT ACCESS TO THE PROFILE IN A REASONABLY
 PROMPT MANNER TO DESIGNEES AUTHORIZED  BY  PHYSICIANS  AND  ESTABLISH  A
 MECHANISM  TO PREVENT DESIGNEES TERMINATED PURSUANT TO SUBPARAGRAPH (IV)
 OF PARAGRAPH (A) OF THIS SUBDIVISION FROM ACCESSING  THE  PROFILE  IN  A
 REASONABLY PROMPT MANNER FOLLOWING NOTIFICATION OF TERMINATION.
   §  16.  Subdivision  4  of section 2995-a of the public health law, as
 amended by section 3 of part A of chapter 57 of the  laws  of  2015,  is
 amended to read as follows:
   4. Each physician shall periodically report to the department on forms
 and in the time and manner required by the commissioner any other infor-
 mation  as is required by the department for the development of profiles
 under this section which is  not  otherwise  reasonably  obtainable.  In
 addition  to  such  periodic reports and providing the same information,
 each physician shall update his or her profile  information  within  the
 six  months  prior to [the expiration date of such physician's registra-
 tion period] SUBMISSION OF THE RE-REGISTRATION APPLICATION, as a  condi-
 tion  of  registration  renewal  [under  article one hundred thirty-one]
 PURSUANT TO SECTION SIXTY-FIVE HUNDRED TWENTY-FOUR of the education law.
 Except for optional information provided AND INFORMATION REQUIRED  UNDER
 SUBPARAGRAPH  (IV) OF PARAGRAPH (N) AND PARAGRAPHS (Q) AND (T) OF SUBDI-
 VISION ONE OF THIS SECTION, physicians shall notify  the  department  of
 any change in the profile information within thirty days of such change.
   §  17.  Subdivision  6  of section 2995-a of the public health law, as
 added by chapter 542 of the laws of 2000, is amended to read as follows:
   6. A physician may elect to have  his  or  her  profile  omit  certain
 information provided pursuant to paragraphs (K), (l), (m), [(n) and (q)]
 (R)  AND  (S)  of  subdivision one of this section. INFORMATION PROVIDED
 PURSUANT TO PARAGRAPH (T) OF SUBDIVISION ONE OF THIS  SECTION  SHALL  BE
 OMITTED  FROM  A PHYSICIAN'S PROFILE AND SHALL BE EXEMPT FROM DISCLOSURE
 UNDER ARTICLE SIX OF THE PUBLIC OFFICERS LAW. In collecting  information
 for  such  profiles  and  disseminating  the  same, the department shall
 inform physicians that they may choose not to provide  such  information
 required pursuant to paragraphs (K), (l), (m), [(n) and (q)] (R) AND (S)
 of subdivision one of this section.
   §  18.  This  act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2021; provided,
 however, that the amendments to  paragraph  (a)  of  subdivision  10  of
 section 230 of the public health law made by sections seven and eight of
 this  act shall not affect the expiration of such paragraph and shall be
 deemed to expire therewith; and further provided that sections fourteen,
 fifteen, sixteen and seventeen of this act shall take effect on the  one
 hundred eightieth day after it shall have become a law.
 
                                  PART R
 
   Section  1.  Section 63 of the civil rights law, as amended by chapter
 253 of the laws of 2014, is amended to read as follows:
   § 63. Order. If the court to which the petition is presented is satis-
 fied thereby, or by the affidavit and certificate  presented  therewith,

 S. 2507--A                         68                         A. 3007--A
 
 that  the petition is true, and that there is no reasonable objection to
 the change of name proposed, and if the petition be to change  the  name
 of  an  infant,  that  the interests of the infant will be substantially
 promoted  by  the  change, the court shall make an order authorizing the
 petitioner to assume the name proposed. The order shall  further  recite
 the  date  and place of birth of the applicant and, if the applicant was
 born in the state of New York, such order shall set forth the number  of
 [his]  THE APPLICANT'S birth certificate or that no birth certificate is
 available. The order shall be directed to be entered and the  papers  on
 which  it  was granted to be filed [prior to the publication hereinafter
 directed] in the clerk's office of the county in  which  the  petitioner
 resides  if  he  be  an individual, or in the office of the clerk of the
 civil court of the city of New York if the order be made by that  court.
 [Such  order  shall  also  direct the publication, at least once, within
 sixty days after the making of the order, in a designated  newspaper  in
 the county in which the order is directed to be entered and if the peti-
 tion is made by a person subject to the provisions of subdivision two of
 section  sixty-two  of  this  article,  in a designated newspaper in any
 county wherein such person was convicted if different from the county in
 which the order is otherwise directed to be  entered,  of  a  notice  in
 substantially  the  following form: Notice is hereby given that an order
 entered by the ............ court,............ county, on the ...... day
 of......., bearing Index Number..........., a copy of which may be exam-
 ined at the office of the clerk, located at .................,  in  room
 number.......,   grants   me   the   right   to   assume   the  name  of
 ...................   The city and  state  of  my  present  address  are
 .........................;   the   month   and  year  of  my  birth  are
 ................; the place of  my  birth  is  ....................;  my
 present name is .................................]
   §  2. Section 64 of the civil rights law, as amended by chapter 258 of
 the laws of 2006, and the closing paragraph  as  separately  amended  by
 chapters  258,  320  and  481 of the laws of 2006, is amended to read as
 follows:
   § 64. Effect. If the order [shall be fully complied with,  and  within
 ninety  days after the making of the order, an affidavit of the publica-
 tion thereof shall be filed  in  the  office  in  which  the  order]  is
 entered,  the  petitioner  shall  be  known by the name which is thereby
 authorized to be assumed. If the surname  of  a  parent  be  changed  as
 provided  in this article, any minor child of such parent at the time of
 such change may thereafter assume such changed surname.
   [Upon compliance with the order and the filing of the affidavit of the
 publication, as provided in this section, the  clerk  of  the  court  in
 which  the  order has been entered shall certify that the order has been
 complied with; and, if] (1) IF the petition states that  the  petitioner
 stands convicted of a violent felony offense as defined in section 70.02
 of  the penal law or a felony defined in article one hundred twenty-five
 of such law or any of the following  provisions  of  such  law  sections
 130.25,  130.30,  130.40,  130.45,  255.25,  255.26, 255.27, article two
 hundred sixty-three, 135.10, 135.25, 230.05, 230.06, subdivision two  of
 section  230.30  or 230.32, [such] THE clerk [(1)] OF THE COURT IN WHICH
 THE ORDER HAS BEEN ENTERED shall deliver, by first class mail, a copy of
 such certified order to the division of criminal justice services at its
 office in the county of Albany and (2) [upon  the  clerk  of  the  court
 reviewing  the  petitioner's  application for name change and subsequent
 in-court inquiry, may, in the  clerk's  discretion,  deliver,  by  first
 class  mail,  the petitioner's new name with such certified order to the

 S. 2507--A                         69                         A. 3007--A

 court of competent jurisdiction which imposed  the  orders  of  support.
 Such  certification shall appear on the original order and on any certi-
 fied copy thereof and shall be entered in the  clerk's  minutes  of  the
 proceeding]  IF  THE  PETITION STATES THAT THE PETITIONER IS RESPONSIBLE
 FOR SPOUSAL SUPPORT OR  CHILD  SUPPORT  OBLIGATIONS  PURSUANT  TO  COURT
 ORDER,  UPON  REVIEW OF THE PETITIONER'S APPLICATION FOR NAME CHANGE AND
 SUBSEQUENT IN-COURT INQUIRY, THE COURT MAY, IN ITS DISCRETION, ORDER THE
 PETITIONER TO DELIVER BY FIRST CLASS MAIL,  THE  PETITIONER'S  NEW  NAME
 WITH  SUCH  CERTIFIED ORDER TO THE COURT OF COMPETENT JURISDICTION WHICH
 IMPOSED THE ORDERS OF SUPPORT. SUCH CERTIFICATION SHALL  APPEAR  ON  THE
 ORIGINAL ORDER AND ON ANY CERTIFIED COPY THEREOF AND SHALL BE ENTERED IN
 THE COURT'S MINUTES OF THE PROCEEDING.
   §  3.  Section 64-a of the civil rights law, as amended by chapter 241
 of the laws of 2015, is amended to read as follows:
   § 64-a. [Exemption from publication requirements] SEALING NAME  CHANGE
 PAPERS. 1. If the court shall find that [the publication] OPEN RECORD of
 an applicant's change of name would jeopardize such applicant's personal
 safety,  based  on  totality  of  the  circumstances  [the provisions of
 sections sixty-three and sixty-four of this article  requiring  publica-
 tion  shall  be waived and shall be inapplicable. Provided, however, the
 court shall not deny such waiver soley on the basis that  the  applicant
 lacks  specific instances of or a personal history of threat to personal
 safety.  The], THE court shall order the records of such change of  name
 proceeding  [to]  be sealed, to be opened only by order of the court for
 good cause shown or at the request of the applicant.   FOR THE  PURPOSES
 OF  THIS SECTION, "TOTALITY OF THE CIRCUMSTANCES" SHALL INCLUDE, BUT NOT
 BE LIMITED TO, A CONSIDERATION OF THE RISK OF VIOLENCE OR DISCRIMINATION
 AGAINST THE APPLICANT.  THE COURT SHALL NOT DENY  SUCH  SEALING  REQUEST
 SOLELY  ON THE BASIS THAT THE APPLICANT LACKS SPECIFIC INSTANCES OF OR A
 PERSONAL HISTORY OF THREAT TO PERSONAL SAFETY.
   2. Notwithstanding any other provision of law, pending such a  finding
 in subdivision one of this section where an applicant seeks relief under
 this  section, the court shall immediately order the applicant's current
 name, proposed new name, residential and business  addresses,  telephone
 numbers,  and any other information contained in any pleadings or papers
 submitted to the court to be safeguarded and sealed in order to  prevent
 their  inadvertent or unauthorized use or disclosure while the matter is
 pending.
   § 4. The civil rights law is amended by adding a new  article  6-A  to
 read as follows:
                                ARTICLE 6-A
              CHANGE OF SEX DESIGNATION OR GENDER DESIGNATION
 SECTION 67. PETITION TO CHANGE SEX DESIGNATION OR GENDER DESIGNATION.
         67-A. ORDER.
         67-B. SEALING  CHANGE  OF  SEX DESIGNATION OR GENDER DESIGNATION
               PAPERS.
         67-C. EFFECT ON GOVERNMENT ISSUED IDENTITY DOCUMENTS.
   § 67. PETITION TO CHANGE SEX DESIGNATION OR GENDER DESIGNATION.  1.  A
 PETITION  FOR  LEAVE TO CHANGE SEX DESIGNATION OR GENDER DESIGNATION MAY
 BE MADE BY A RESIDENT OF THE STATE TO THE COUNTY COURT OF THE COUNTY  OR
 THE  SUPREME  COURT IN THE COUNTY IN WHICH SUCH RESIDENT RESIDES, OR, IF
 SUCH RESIDENT RESIDES IN THE CITY OF NEW YORK,  EITHER  TO  THE  SUPREME
 COURT  OR  TO  ANY BRANCH OF THE CIVIL COURT OF THE CITY OF NEW YORK, IN
 ANY COUNTY OF THE CITY OF NEW YORK.  THE  PETITION  TO  CHANGE  THE  SEX
 DESIGNATION OR GENDER DESIGNATION OF AN INFANT MAY BE MADE BY THE INFANT

 S. 2507--A                         70                         A. 3007--A
 
 THROUGH  EITHER  OF  SUCH  INFANT'S PARENTS, OR BY SUCH INFANT'S GENERAL
 GUARDIAN OR BY THE GUARDIAN OF SUCH INFANT'S PERSON.
   2.    WHEN AN INDIVIDUAL PETITIONS THE COURT TO RECOGNIZE THEIR GENDER
 IDENTITY OR TO AMEND THE SEX DESIGNATION   OR GENDER DESIGNATION  ON  AN
 IDENTITY  DOCUMENT,  THE COURT SHALL ISSUE SUCH AN ORDER UPON RECEIPT OF
 AN AFFIDAVIT FROM SUCH INDIVIDUAL ATTESTING TO THEIR GENDER IDENTITY  OR
 REASON FOR THE CHANGE.  NO ADDITIONAL MEDICAL EVIDENCE SHALL BE REQUIRED
 TO GRANT SUCH REQUEST. NO SUCH ORDER SHALL BE REQUIRED TO AMEND AN IDEN-
 TITY  DOCUMENT  ISSUED  WITHIN  NEW  YORK  STATE. NO SUCH ORDER SHALL BE
 REQUIRED TO OTHERWISE RECOGNIZE THE GENDER OF AN  INDIVIDUAL  AND  TREAT
 THEM  CONSISTENT  WITH  THEIR  GENDER  IDENTITY WITHIN NEW YORK STATE OR
 UNDER NEW YORK STATE LAW.
   3.  SUCH REQUEST MAY BE MADE SIMULTANEOUSLY WITH A PETITION FOR CHANGE
 OF NAME PURSUANT TO SECTION SIXTY OR SIXTY-FIVE OF THIS  CHAPTER  OR  ON
 ITS OWN.
   §  67-A.  ORDER.  IF  THE  COURT TO WHICH THE PETITION IS PRESENTED IS
 SATISFIED THEREBY, OR BY THE AFFIDAVIT AND CERTIFICATE PRESENTED  THERE-
 WITH,  AND  THAT  THERE  IS NO REASONABLE OBJECTION TO THE CHANGE OF SEX
 DESIGNATION OR GENDER DESIGNATION PROPOSED, AND IF THE  PETITION  IS  TO
 CHANGE  THE SEX DESIGNATION OR GENDER DESIGNATION OF AN INFANT, THAT THE
 INTERESTS OF THE INFANT WILL BE SUBSTANTIALLY PROMOTED  BY  THE  CHANGE,
 THE  COURT  SHALL MAKE AN ORDER AUTHORIZING THE PETITIONER TO ASSUME THE
 SEX DESIGNATION OR GENDER DESIGNATION PROPOSED.
   § 67-B. SEALING  CHANGE  OF  SEX  DESIGNATION  OR  GENDER  DESIGNATION
 PAPERS.  1.  UPON  REQUEST  OF  THE APPLICANT, THE COURT SHALL ORDER THE
 RECORDS OF SUCH CHANGE OF SEX DESIGNATION OR GENDER DESIGNATION PROCEED-
 ING TO BE SEALED, TO BE OPENED ONLY BY ORDER OF THE COURT FOR GOOD CAUSE
 SHOWN OR AT THE REQUEST OF THE APPLICANT.
   2. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, PENDING SUCH A  FINDING
 IN SUBDIVISION ONE OF THIS SECTION WHERE AN APPLICANT SEEKS RELIEF UNDER
 THIS  SECTION, THE COURT SHALL IMMEDIATELY ORDER THE APPLICANT'S CURRENT
 NAME, SEX DESIGNATION, PROPOSED NEW SEX  DESIGNATION  OR  GENDER  DESIG-
 NATION,  RESIDENTIAL  AND BUSINESS ADDRESSES, TELEPHONE NUMBERS, AND ANY
 OTHER INFORMATION CONTAINED IN ANY PLEADINGS OR PAPERS SUBMITTED TO  THE
 COURT TO BE SAFEGUARDED AND SEALED IN ORDER TO PREVENT THEIR INADVERTENT
 OR UNAUTHORIZED USE OR DISCLOSURE WHILE THE MATTER IS PENDING.
   §  67-C.  EFFECT  ON  GOVERNMENT  ISSUED IDENTITY DOCUMENTS. ANY STATE
 AGENCY THAT MAINTAINS A SYSTEM OR ISSUES AN IDENTITY DOCUMENT  REQUIRING
 A  SEX  DESIGNATION  OR  GENDER  DESIGNATION THAT, DUE TO FEDERAL LAW OR
 SYSTEMS PROCESSING REQUIREMENTS, IS UNABLE TO  PROCESS  OR  CHANGE  SUCH
 RECORD  OR  DOCUMENT  CONSISTENT  WITH  AN ORDER ISSUED PURSUANT TO THIS
 SECTION SHALL MAKE REASONABLE  EFFORTS  TO  OTHERWISE  ACCOMMODATE  SUCH
 REQUEST.
   § 5. This act shall take effect on the one hundred eightieth day after
 it  shall have become a law. Effective immediately, the addition, amend-
 ment and/or repeal of any rule or regulation necessary for the implemen-
 tation of this act on its effective date are authorized to be  made  and
 completed on or before such effective date.
 
                                  PART S
 
   Section 1. Section 11 of chapter 884 of the laws of 1990, amending the
 public  health  law  relating  to  authorizing bad debt and charity care
 allowances for certified home health agencies, as amended by  section  3
 of  part  E  of  chapter  57  of the laws of 2019, is amended to read as
 follows:

 S. 2507--A                         71                         A. 3007--A
 
   § 11. This act shall take effect immediately and:
   (a) sections one and three shall expire on December 31, 1996,
   (b)  sections  four  through ten shall expire on June 30, [2021] 2023,
 and
   (c) provided that the amendment to section 2807-b of the public health
 law by section two of this act shall not affect the expiration  of  such
 section  2807-b  as  otherwise  provided  by  law and shall be deemed to
 expire therewith.
   § 2. Subdivision (a) of section 40 of part B of  chapter  109  of  the
 laws  of  2010, amending the social services law relating to transporta-
 tion costs, as amended by section 5 of part E of chapter 57 of the  laws
 of 2019, is amended to read as follows:
   (a)  sections  two, three, three-a, three-b, three-c, three-d, three-e
 and twenty-one of this act shall take  effect  July  1,  2010;  sections
 fifteen,  sixteen,  seventeen,  eighteen  and nineteen of this act shall
 take effect January 1, 2011; [and provided further that  section  twenty
 of  this  act  shall  be  deemed  repealed  ten years after the date the
 contract entered into pursuant to section 365-h of the  social  services
 law,  as  amended  by  section twenty of this act, is executed; provided
 that the commissioner of health shall notify the legislative bill draft-
 ing commission upon the execution of the contract entered into  pursuant
 to section 367-h of the social services law in order that the commission
 may  maintain an accurate and timely effective data base of the official
 text of the laws of the state of New York in furtherance of effectuating
 the provisions of section 44 of the legislative law and section 70-b  of
 the public officers law;]
   § 3. Subdivision 5-a of section 246 of chapter 81 of the laws of 1995,
 amending  the  public  health  law  and  other  laws relating to medical
 reimbursement and welfare reform, as amended by section 12 of part E  of
 chapter 57 of the laws of 2019, is amended to read as follows:
   5-a.  Section sixty-four-a of this act shall be deemed to have been in
 full force and effect on and after April 1, 1995 through March 31,  1999
 and  on  and  after July 1, 1999 through March 31, 2000 and on and after
 April 1, 2000 through March 31, 2003 and on  and  after  April  1,  2003
 through March 31, 2007, and on and after April 1, 2007 through March 31,
 2009,  and on and after April 1, 2009 through March 31, 2011, and on and
 after April 1, 2011 through March 31, 2013, and on and  after  April  1,
 2013  through  March  31,  2015,  and on and after April 1, 2015 through
 March 31, 2017 and on and after April 1, 2017 through  March  31,  2019,
 and  on and after April 1, 2019 through March 31, 2021, AND ON AND AFTER
 APRIL 1, 2021 THROUGH MARCH 31, 2023;
   § 4. Section 64-b of chapter 81 of the  laws  of  1995,  amending  the
 public  health  law and other laws relating to medical reimbursement and
 welfare reform, as amended by section 13 of part E of chapter 57 of  the
 laws of 2019, is amended to read as follows:
   §  64-b.  Notwithstanding  any  inconsistent  provision  of  law,  the
 provisions of subdivision 7 of section 3614 of the public health law, as
 amended, shall remain and be in full force and effect on April  1,  1995
 through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
 and after April 1, 2000 through March 31, 2003 and on and after April 1,
 2003  through  March  31,  2007,  and on and after April 1, 2007 through
 March 31, 2009, and on and after April 1, 2009 through March  31,  2011,
 and  on and after April 1, 2011 through March 31, 2013, and on and after
 April 1, 2013 through March 31, 2015, and on and  after  April  1,  2015
 through  March 31, 2017 and on and after April 1, 2017 through March 31,

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 2019, and on and after April 1, 2019 through March 31, 2021, AND ON  AND
 AFTER APRIL 1, 2021 THROUGH MARCH 31, 2023.
   § 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,  as
 amended  by  section  14 of part E of chapter 57 of the laws of 2019, 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, 2017 through March 31, [2021]  2023,  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, 2019, 2020, [and]
 2021, 2022 AND 2023 calendar 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,  2019, 2020, [and] 2021, 2022 AND 2023 calendar years
 shall also be applied to rates of payment provided on and after  January
 1,  2017  through  March  31,  [2021]  2023  for  personal care services
 provided in those local social services districts,  including  New  York
 city,  whose  rates of payment for such services are established by such
 local social services districts pursuant  to  a  rate-setting  exemption
 issued  by  the  commissioner  of  health  to such local social services
 districts  in  accordance  with  applicable  regulations;  and  provided
 further,  however, that for rates of payment for assisted living program
 services provided on and after January 1, 2017 through March 31,  [2021]
 2023,  such  trend  factors  attributable to the 2017, 2018, 2019, 2020,
 [and] 2021, 2022 AND 2023 calendar years  shall  be  established  at  no
 greater than zero percent.
   §  6.  Subdivision 2 of section 246 of chapter 81 of the laws of 1995,
 amending the public health  law  and  other  laws  relating  to  medical
 reimbursement  and welfare reform, as amended by section 17 of part E of
 chapter 57 of the laws of 2019, is amended to read as follows:
   2. Sections five, seven through nine,  twelve  through  fourteen,  and
 eighteen  of  this  act  shall  be deemed to have been in full force and
 effect on and after April 1, 1995 through March  31,  1999  and  on  and
 after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
 through  March 31, 2003 and on and after April 1, 2003 through March 31,
 2006 and on and after April 1, 2006 through March 31, 2007  and  on  and
 after  April  1,  2007  through March 31, 2009 and on and after April 1,
 2009 through March 31, 2011 and sections twelve, thirteen  and  fourteen
 of  this act shall be deemed to be in full force and effect on and after
 April 1, 2011 through March 31, 2015 and on  and  after  April  1,  2015
 through  March 31, 2017 and on and after April 1, 2017 through March 31,
 2019, and on and after April 1, 2019 through March 31, 2021, AND ON  AND
 AFTER APRIL 1, 2021 THROUGH MARCH 31, 2023;

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   §  7.  Section 7 of part H of chapter 57 of the laws of 2019, amending
 the public health law relating to  waiver  of  certain  regulations,  as
 amended  by  section 11 of part BB of chapter 56 of the laws of 2020, is
 amended to read as follows:
   §  7.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2019, provided,
 however, that section two of this act shall expire on  April  1,  [2021]
 2024.
   § 8. Section 5 of chapter 517 of the laws of 2016, amending the public
 health  law  relating to payments from the New York state medical indem-
 nity fund, as amended by section 18 of part Y of chapter 56 of the  laws
 of 2020, is amended to read as follows:
   §  5. This act shall take effect on the forty-fifth day after it shall
 have become a law, provided that the  amendments  to  subdivision  4  of
 section  2999-j of the public health law made by section two of this act
 shall take effect on June 30,  2017  and  shall  expire  and  be  deemed
 repealed December 31, [2021] 2022.
   §  9.  Subdivision  1  of section 2999-aa of the public health law, as
 amended by chapter 80 of the  laws  of  2017,  is  amended  to  read  as
 follows:
   1.  In order to promote improved quality and efficiency of, and access
 to, health care services and to promote improved  clinical  outcomes  to
 the  residents  of  New  York,  it  shall  be the policy of the state to
 encourage, where appropriate, cooperative, collaborative and integrative
 arrangements including but not  limited  to,  mergers  and  acquisitions
 among  health  care  providers  or  among  others who might otherwise be
 competitors, under the active supervision of the  commissioner.  To  the
 extent  such arrangements, or the planning and negotiations that precede
 them, might be anti-competitive within the meaning  and  intent  of  the
 state and federal antitrust laws, the intent of the state is to supplant
 competition  with  such  arrangements  under  the active supervision and
 related administrative actions  of  the  commissioner  as  necessary  to
 accomplish  the  purposes  of  this article, and to provide state action
 immunity under the state and federal  antitrust  laws  with  respect  to
 activities  undertaken  by  health care providers and others pursuant to
 this article, where the benefits of such  active  supervision,  arrange-
 ments  and actions of the commissioner outweigh any disadvantages likely
 to result from a reduction of competition. The  commissioner  shall  not
 approve  an  arrangement for which state action immunity is sought under
 this article without first consulting with, and receiving a  recommenda-
 tion from, the public health and health planning council. No arrangement
 under  this  article  shall be approved after December thirty-first, two
 thousand [twenty] TWENTY-FOUR.
   § 10. Section 3 of part D of chapter 56 of the laws of 2014,  amending
 the education law relating to the nurse practitioners modernization act,
 is amended to read as follows:
   § 3. This act shall take effect on the first of January after it shall
 have  become  a law and shall expire June 30 of the [sixth] TWELFTH year
 after it shall have become a law, when upon such date the provisions  of
 this  act  shall  be  deemed repealed; provided, however, that effective
 immediately, the addition, amendment and/or repeal of any rule or  regu-
 lation  necessary  for  the  implementation of this act on its effective
 date is authorized and directed to be made and completed  on  or  before
 such effective date.

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   §  11.  Subparagraph (vi) of paragraph (b) of subdivision 2 of section
 2807-d of the public health law, as amended by section 9 of  part  E  of
 chapter 57 of the laws of 2019, is amended to read as follows:
   (vi)  Notwithstanding  any contrary provision of this paragraph or any
 other provision of law or regulation to the  contrary,  for  residential
 health care facilities the assessment shall be six percent of each resi-
 dential  health care facility's gross receipts received from all patient
 care services and other operating income on a cash basis for the  period
 April  first,  two thousand two through March thirty-first, two thousand
 three for hospital  or  health-related  services,  including  adult  day
 services;  provided,  however,  that residential health care facilities'
 gross receipts attributable to payments received pursuant to title XVIII
 of the federal social security act (medicare) shall be excluded from the
 assessment; provided, however, that for all such gross receipts received
 on or after April first, two thousand three through March  thirty-first,
 two  thousand  five,  such assessment shall be five percent, and further
 provided that for all such gross receipts received  on  or  after  April
 first,  two thousand five through March thirty-first, two thousand nine,
 and on or after April first, two thousand  nine  through  March  thirty-
 first,  two  thousand  eleven  such assessment shall be six percent, and
 further provided that for all such gross receipts received on  or  after
 April  first,  two thousand eleven through March thirty-first, two thou-
 sand thirteen such assessment shall be six percent, and further provided
 that for all such gross receipts received on or after April  first,  two
 thousand  thirteen through March thirty-first, two thousand fifteen such
 assessment shall be six percent, and further provided that for all  such
 gross  receipts  received  on or after April first, two thousand fifteen
 through March thirty-first, two thousand seventeen such assessment shall
 be six percent, and further provided that for all  such  gross  receipts
 received  on  or after April first, two thousand seventeen through March
 thirty-first,  two  thousand  nineteen  such  assessment  shall  be  six
 percent,  and further provided that for all such gross receipts received
 on or after April first, two thousand  nineteen  through  March  thirty-
 first, two thousand twenty-one such assessment shall be six percent, AND
 FURTHER  PROVIDED  THAT FOR ALL SUCH GROSS RECEIPTS RECEIVED ON OR AFTER
 APRIL FIRST, TWO THOUSAND TWENTY-ONE  THROUGH  MARCH  THIRTY-FIRST,  TWO
 THOUSAND TWENTY-THREE SUCH ASSESSMENT SHALL BE SIX PERCENT.
   §  12.  This  act shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2021.
 
                                  PART T
 
   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  X of chapter 57 of the laws of 2018, is amended to
 read as follows:
   § 3. This act shall take effect immediately; and shall expire  and  be
 deemed repealed June 30, [2021] 2024.
   § 2. This act shall take effect immediately.
 
                                  PART U

   Section  1.  Section  4  of  part L of chapter 59 of the laws of 2016,
 amending the mental hygiene law relating to the appointment of temporary

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 operators for the continued operation of programs and the  provision  of
 services  for  persons  with serious mental illness and/or developmental
 disabilities and/or chemical dependence, is amended to read as follows:
   §  4.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2016; provided,
 however, that sections one and two of  this  act  shall  expire  and  be
 deemed repealed on March 31, [2021] 2026.
   § 2. This act shall take effect immediately.
 
                                  PART V

   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, as amended by  section  1
 of  part  U  of  chapter  57  of the laws of 2018, is amended to read as
 follows:
   § 2. This act shall take effect immediately and shall  expire  and  be
 deemed repealed March 31, [2021] 2024.
   § 2. This act shall take effect immediately.
 
                                  PART W
 
   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
 1  of  part  V  of chapter 57 of the laws of 2018, is amended to read as
 follows:
   § 7. This act shall take effect immediately and shall expire March 31,
 [2021] 2024 when upon such date the provisions  of  this  act  shall  be
 deemed repealed.
   § 2. This act shall take effect immediately.
 
                                  PART X
 
   Section  1. Notwithstanding the provisions of subdivisions (b) and (e)
 of section 7.17 and section 41.55 of the mental hygiene law or any other
 law to the contrary, the office of mental health is authorized in  state
 fiscal year 2021-22 to close, consolidate, reduce, transfer or otherwise
 redesign  services  of hospitals, other facilities and programs operated
 by the office of mental health, and  to  implement  significant  service
 reductions  and  reconfigurations  according to this section as shall be
 determined by the commissioner of mental health to be necessary for  the
 cost-effective  and efficient operation of such hospitals, other facili-
 ties and programs. Any transfers of capacity or any  resulting  transfer
 of  functions  shall  be  authorized  to  be made by the commissioner of
 mental health and any transfer of personnel upon such transfer of capac-
 ity or transfer of functions shall be accomplished  in  accordance  with
 the provisions of subdivision 2 of section 70 of the civil service law.
   § 2. This act shall take effect immediately and shall expire March 31,
 2022  when  upon  such  date  the provisions of this act shall be deemed
 repealed.

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                                  PART Y
 
   Section 1.  Section 19.07 of the mental hygiene law, as added by chap-
 ter  223  of  the  laws  of 1992, subdivisions (a) and (g) as amended by
 chapter 271 of the laws of 2010, subdivisions (b) and (c) as amended  by
 chapter 281 of the laws of 2019, subdivision (d) as amended by section 5
 of part I of chapter 58 of the laws of 2005,  subdivision (e) as amended
 by  chapter 558 of the laws of 1999, subdivision (f) as added by chapter
 383 of the laws of 1998, subdivision (h) as amended by section 118-f  of
 subpart  B  of part C of chapter 62 of the laws of 2011, subdivision (i)
 as amended by section 31-a of part AA of chapter 56 of the laws of 2019,
 subdivision (j) as amended by chapter 146 of the laws of 2014,  subdivi-
 sion (k) as added by  chapter 40 of the laws of 2014, subdivision (l) as
 added by chapter 323 of the laws of 2018 and subdivision (m) as added by
 chapter 493 of the laws of 2019, is amended to read as follows:
 § 19.07 Office  of  [alcoholism  and substance abuse services] ADDICTION
           SERVICES AND SUPPORTS; scope of responsibilities.
   (a) The office of [alcoholism and substance abuse services]  ADDICTION
 SERVICES  AND  SUPPORTS  is charged with the responsibility for assuring
 the development of comprehensive plans, programs, and  services  in  the
 areas  of research, prevention, care, treatment, rehabilitation, includ-
 ing relapse prevention and recovery maintenance, education, and training
 of persons who [abuse or are dependent  on  alcohol  and/or  substances]
 HAVE  OR  ARE  AT  RISK OF AN ADDICTIVE DISORDER and their families. THE
 TERM ADDICTIVE  DISORDER  SHALL  INCLUDE  GAMBLING  DISORDER  EDUCATION,
 PREVENTION  AND TREATMENT CONSISTENT WITH SECTION 41.57 OF THIS CHAPTER.
 Such plans, programs, and services shall be developed with  the  cooper-
 ation of the office, the other offices of the department where appropri-
 ate,  local governments, consumers and community organizations and enti-
 ties.  The  office  shall  provide  appropriate  facilities  and   shall
 encourage  the provision of facilities by local government and community
 organizations and entities. [The office is also responsible for develop-
 ing plans, programs and services related to compulsive  gambling  educa-
 tion,  prevention  and  treatment  consistent with section 41.57 of this
 chapter.]
   (b) The office of [alcoholism and substance abuse services]  ADDICTION
 SERVICES  AND SUPPORTS shall advise and assist the governor in improving
 services and developing policies designed to meet the needs  of  persons
 who  suffer from OR ARE AT RISK OF an addictive disorder and their fami-
 lies, and to encourage their rehabilitation,  maintenance  of  recovery,
 and functioning in society.
   (c)  The office of [alcoholism and substance abuse services] ADDICTION
 SERVICES AND SUPPORTS shall have  the  responsibility  for  seeing  that
 persons  who  suffer  from  OR  ARE AT RISK OF an addictive disorder and
 their families are provided with addiction services, care and treatment,
 and that such services, care, treatment and rehabilitation  is  of  high
 quality  and  effectiveness,  and  that the personal and civil rights of
 persons seeking and receiving addiction services,  care,  treatment  and
 rehabilitation are adequately protected.
   (d)  The office of [alcoholism and substance abuse services] ADDICTION
 SERVICES AND SUPPORTS shall foster programs for the training and  devel-
 opment of persons capable of providing the foregoing services, including
 but  not  limited  to  a  process of issuing, either directly or through
 contract, LICENSES,  credentials,  CERTIFICATES  OR  AUTHORIZATIONS  for
 [alcoholism and substance abuse counselors or gambling] addiction [coun-
 selors] PROFESSIONALS in accordance with the following:

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   (1) The office shall establish minimum qualifications [for counselors]
 AND  A  DEFINITION  OF  THE  PRACTICE  OF THE PROFESSION OF AN ADDICTION
 PROFESSIONAL in all phases of delivery of services to persons and  their
 families  who  are suffering from [alcohol and/or substance abuse and/or
 chemical  dependence  and/or  compulsive gambling that shall include] OR
 ARE AT RISK OF AN ADDICTIVE DISORDER INCLUDING, but not be  limited  to,
 completion of approved courses of study or equivalent on-the-job experi-
 ence  in [alcoholism and substance abuse counseling and/or counseling of
 compulsive gambling] ADDICTION DISORDER SERVICES.
   (i) The office shall establish procedures  for  issuing,  directly  or
 through  contract, LICENSES, credentials, CERTIFICATES OR AUTHORIZATIONS
 to [counselors] ADDICTION PROFESSIONALS who meet minimum qualifications,
 including the establishment  of  appropriate  fees,  and  shall  further
 establish procedures to suspend, revoke, or annul such LICENSES, creden-
 tials,  CERTIFICATES  OR  AUTHORIZATIONS for good cause. Such procedures
 shall be promulgated by the commissioner by rule or regulation.
   (ii) The commissioner shall establish [a credentialing]  AN  ADDICTION
 PROFESSIONALS board which shall provide advice concerning the LICENSING,
 credentialing, CERTIFICATION OR AUTHORIZATION process.
   (III)  THE COMMISSIONER SHALL ESTABLISH FEES FOR THE EDUCATION, TRAIN-
 ING,  LICENSING,  CREDENTIALING,  CERTIFICATION  OR   AUTHORIZATION   OF
 ADDICTION PROFESSIONALS.
   (2)  The  establishment,  with  the  advice of the advisory council on
 alcoholism and substance abuse services, of minimum  qualifications  for
 [counselors]  ADDICTION  PROFESSIONALS  in  all  phases  of  delivery of
 services to those suffering from [alcoholism, substance and/or  chemical
 abuse and/or dependence and/or compulsive gambling] OR AT RISK OF ADDIC-
 TIVE DISORDERS and their families that shall include, but not be limited
 to,  completion  of  approved  courses of study or equivalent on-the-job
 experience in [counseling  for  alcoholism,  substance  and/or  chemical
 abuse and/or dependence] ADDICTION DISORDER SERVICES and/or [compulsive]
 gambling  DISORDER  SERVICES,  and  ESTABLISH  APPROPRIATE  FEES,  issue
 LICENSES, credentials, CERTIFICATES OR  AUTHORIZATIONS  to  [counselors]
 ADDICTION  PROFESSIONALS  who  meet  minimum qualifications and suspend,
 revoke, or annul such LICENSES, credentials,  CERTIFICATES  OR  AUTHORI-
 ZATIONS  for good cause in accordance with procedures promulgated by the
 commissioner by rule or regulation.
   (3) For the purpose of this title, the term "ADDICTION  PROFESSIONAL",
 INCLUDING  "credentialed  alcoholism  and  substance abuse counselor" or
 "C.A.S.A.C.", means an official designation identifying an individual as
 one who holds a currently  registered  and  valid  LICENSE,  credential,
 CERTIFICATE  OR AUTHORIZATION issued OR APPROVED by the office of [alco-
 holism and substance abuse services]  ADDICTION  SERVICES  AND  SUPPORTS
 pursuant  to this section which documents an individual's qualifications
 to provide [alcoholism and substance abuse counseling] ADDICTION  DISOR-
 DER  SERVICES.  The  term "gambling addiction [counselor"] PROFESSIONAL"
 means an official designation identifying an individual as one who holds
 a currently registered and valid  LICENSE,  credential,  CERTIFICATE  OR
 AUTHORIZATION  issued  by  the office of [alcoholism and substance abuse
 services] ADDICTION SERVICES AND SUPPORTS pursuant to this section which
 documents an individual's qualifications to provide [compulsive]  gambl-
 ing [counseling] DISORDER SERVICES.
   (i)  No  person  shall  use  the  title  [credentialed  alcoholism and
 substance abuse counselor or "C.A.S.A.C." or gambling addiction  counse-
 lor]  "ADDICTION  PROFESSIONAL"  OR  THE  TITLE  GIVEN  TO ANY LICENSES,
 CREDENTIALS, CERTIFICATES OR AUTHORIZATIONS ISSUED BY THE OFFICE  unless

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 authorized  [pursuant  to]  BY  THE COMMISSIONER IN ACCORDANCE WITH this
 title.
   (ii)  Failure  to  comply  with the requirements of this section shall
 constitute a violation as defined in the penal law.
   (4) All persons holding previously  issued  and  valid  alcoholism  or
 substance  abuse counselor credentials ISSUED BY THE OFFICE OR AN ENTITY
 DESIGNATED BY  THE  OFFICE,  INCLUDING  A  CREDENTIALED  ALCOHOLISM  AND
 SUBSTANCE ABUSE COUNSELOR, CERTIFIED PREVENTION SPECIALIST, CREDENTIALED
 PREVENTION PROFESSIONAL, CREDENTIALED PROBLEM GAMBLING COUNSELOR, GAMBL-
 ING  SPECIALTY  DESIGNATION,  CERTIFIED  RECOVERY  PEER ADVOCATE, on the
 effective date of amendments to this section shall be deemed [C.A.S.A.C.
 designated] AN ADDICTION PROFESSIONAL CONSISTENT WITH  THEIR  EXPERIENCE
 AND EDUCATION.
   (e)  Consistent  with  the  requirements of subdivision (b) of section
 5.05 of this chapter, the office shall carry out the provisions of arti-
 cle thirty-two of this chapter as such article  pertains  to  regulation
 and   quality   control  of  [chemical  dependence]  ADDICTION  DISORDER
 services, including but not limited to the  establishment  of  standards
 for  determining  the necessity and appropriateness of care and services
 provided  by  [chemical  dependence]  ADDICTION  DISORDER  providers  of
 services. In implementing this subdivision, the commissioner, in consul-
 tation  with the commissioner of health, shall adopt standards including
 necessary rules and regulations including but not limited to  those  for
 determining the necessity or appropriate level of admission, controlling
 the  length  of stay and the provision of services, and establishing the
 methods and procedures for making such determination.
   (f) The office of [alcoholism and substance abuse services]  ADDICTION
 SERVICES  AND  SUPPORTS  shall develop a list of all agencies throughout
 the state which are currently certified by the office and are capable of
 and available to provide evaluations in accordance with  section  sixty-
 five-b of the alcoholic beverage control law so as to determine need for
 treatment  pursuant  to  such  section and to assure the availability of
 such evaluation services by  a  certified  agency  within  a  reasonable
 distance  of every court of a local jurisdiction in the state. Such list
 shall be updated on a regular basis and shall be made available to every
 supreme court law library in this state, or, if  no  supreme  court  law
 library is available in a certain county, to the county court library of
 such  county. THE COMMISSIONER MAY ESTABLISH AN ANNUAL FEE FOR INCLUSION
 ON SUCH LIST.
   (g) The office of [alcoholism and substance abuse services]  ADDICTION
 SERVICES AND SUPPORTS shall develop and maintain a list of the names and
 locations  of  all  licensed  agencies and [alcohol and substance abuse]
 ADDICTION professionals, as defined in paragraphs (a) and (b) of  subdi-
 vision  one  of section eleven hundred ninety-eight-a of the vehicle and
 traffic law, throughout the state which are capable of and available  to
 provide  an  assessment  of,  and  treatment for, [alcohol and substance
 abuse and dependency] ADDICTION DISORDERS. Such list shall  be  provided
 to the chief administrator of the office of court administration and the
 commissioner of motor vehicles. Persons who may be aggrieved by an agen-
 cy  decision  regarding inclusion on the list may request an administra-
 tive appeal in accordance with rules and regulations of the office.  THE
 COMMISSIONER MAY ESTABLISH AN ANNUAL FEE FOR INCLUSION ON SUCH LIST.
   (h)  The office of [alcoholism and substance abuse services] ADDICTION
 SERVICES AND SUPPORTS shall monitor programs providing care  and  treat-
 ment to inmates in correctional facilities operated by the department of
 corrections  and community supervision who have a history of [alcohol or

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 substance abuse or dependence] AN ADDICTION DISORDER. The  office  shall
 also  develop  guidelines  for  the  operation of [alcohol and substance
 abuse treatment programs] ADDICTION DISORDER SERVICES  in  such  correc-
 tional  facilities  in  order  to ensure that such programs sufficiently
 meet the needs of inmates with a history of [alcohol or substance  abuse
 or  dependence] AN ADDICTION DISORDER and promote the successful transi-
 tion to treatment in the community upon release. No later than the first
 day of December of each year, the office shall submit a report regarding
 the adequacy and effectiveness of alcohol and substance abuse  treatment
 programs  operated by the department of corrections and community super-
 vision to the governor, the  temporary  president  of  the  senate,  the
 speaker  of  the assembly, the chairman of the senate committee on crime
 victims, crime and correction, and the chairman of the assembly  commit-
 tee on correction.
   (i)  The office of [alcoholism and substance abuse services] ADDICTION
 SERVICES AND SUPPORTS shall periodically, in consultation with the state
 director of veterans' services: (1) review the programs operated by  the
 office  to  ensure  that the needs of the state's veterans who served in
 the U.S. armed forces  and  who  are  recovering  from  [alcohol  and/or
 substance  abuse]  AN  ADDICTION  DISORDER  are being met and to develop
 improvements to programs to meet such needs; and  (2)  in  collaboration
 with  the  state  director of veterans' services and the commissioner of
 the office of mental health, review and make recommendations to  improve
 programs that provide treatment, rehabilitation, relapse prevention, and
 recovery  services  to  veterans  who have served in a combat theatre or
 combat zone of operations and have  a  co-occurring  mental  health  and
 [alcoholism or substance abuse] ADDICTION disorder.
   (j)  The  office, in consultation with the state education department,
 shall identify or develop materials on problem gambling among school-age
 youth which may be used by school districts and  boards  of  cooperative
 educational  services,  at  their  option,  to  educate  students on the
 dangers and consequences of problem gambling as they  deem  appropriate.
 Such  materials  shall be available on the internet website of the state
 education department. The internet website of the office shall provide a
 hyperlink to the internet page of the state  education  department  that
 displays such materials.
   (k)  Heroin  and opioid addiction awareness and education program. The
 commissioner, in cooperation with the commissioner of the department  of
 health,  shall  develop  and  conduct a public awareness and educational
 campaign on heroin and opioid  addiction.  The  campaign  shall  utilize
 public  forums,  social media and mass media, including, but not limited
 to, internet, radio, and print advertising such as billboards and  post-
 ers  and  shall also include posting of materials and information on the
 office website.  The  campaign  shall  be  tailored  to  educate  youth,
 parents,  healthcare professionals and the general public regarding: (1)
 the risks associated with the abuse and misuse of  heroin  and  opioids;
 (2)  how  to  recognize  the  signs  of addiction; and (3) the resources
 available for those needing assistance with heroin or opioid  addiction.
 The  campaign  shall  further  be  designed  to enhance awareness of the
 opioid overdose prevention program authorized pursuant to section  thir-
 ty-three  hundred  nine of the public health law and the "Good Samaritan
 law" established pursuant to sections 220.03 and 220.78 of the penal law
 and section 390.40 of the criminal procedure  law,  and  to  reduce  the
 stigma associated with addiction.
   (l)  The office of [alcoholism and substance abuse services] ADDICTION
 SERVICES AND SUPPORTS, in consultation with the state education  depart-

 S. 2507--A                         80                         A. 3007--A
 
 ment,  shall  develop  or  utilize  existing educational materials to be
 provided to school  districts  and  boards  of  cooperative  educational
 services  for  use  in  addition  to or in conjunction with any drug and
 alcohol  related  curriculum  regarding the misuse and abuse of alcohol,
 tobacco, prescription medication and other drugs with an increased focus
 on substances that are most prevalent among school aged  youth  as  such
 term is defined in section eight hundred four of the education law. Such
 materials  shall  be age appropriate for school age children, and to the
 extent practicable, shall include information or resources  for  parents
 to identify the warning signs and address the risks of substance [abuse]
 MISUSE AND ADDICTION.
   (m)  (1)  The office shall report on the status and outcomes of initi-
 atives created in response to the heroin  and  opioid  epidemic  to  the
 temporary  president  of  the  senate,  the speaker of the assembly, the
 chairs of the assembly and senate  committees  on  alcoholism  and  drug
 abuse,  the chair of the assembly ways and means committee and the chair
 of the senate finance committee.
   (2) Such reports shall include, to the extent practicable and applica-
 ble, information on:
   (i) The number of  individuals  enrolled  in  the  initiative  in  the
 preceding quarter;
   (ii)  The number of individuals who completed the treatment program in
 the preceding quarter;
   (iii) The number of individuals discharged from the treatment  program
 in the preceding quarter;
   (iv) The age and sex of the individuals served;
   (v) Relevant regional data about the individuals;
   (vi) The populations served; and
   (vii) The outcomes and effectiveness of each initiative surveyed.
   (3)  Such  initiatives shall include opioid treatment programs, crisis
 detoxification programs, 24/7 open access centers, adolescent club hous-
 es, family navigator programs,  peer  engagement  specialists,  recovery
 community  and outreach centers, regional addiction resource centers and
 the state implementation of the federal opioid state  targeted  response
 initiatives.
   (4)  Such  information shall be provided quarterly, beginning no later
 than July first, two thousand nineteen.
   § 2. This act shall take effect April 1, 2021.
 
                                  PART Z
 
   Section 1. The opening paragraph of subdivision (g) of  section  31.16
 of  the  mental  hygiene  law,  as amended by chapter 351 of the laws of
 1994, is amended to read as follows:
   The commissioner may impose [a fine] SANCTIONS upon a finding that the
 holder of the certificate has failed to comply with  the  terms  of  the
 operating  certificate or with the provisions of any applicable statute,
 rule or regulation. [The maximum amount of such fine  shall  not  exceed
 one thousand dollars per day or fifteen thousand dollars per violation.]
 THE  COMMISSIONER IS AUTHORIZED TO DEVELOP A SCHEDULE FOR THE PURPOSE OF
 IMPOSING SUCH SANCTIONS.
   § 2. Subdivision (a) of section 31.04 of the  mental  hygiene  law  is
 amended by adding a new paragraph 8 to read as follows:
   8.  ESTABLISHING  A  SCHEDULE  OF  FEES  FOR THE PURPOSE OF PROCESSING
 APPLICATIONS FOR THE ISSUANCE OF OPERATING CERTIFICATES. ALL FEES PURSU-

 S. 2507--A                         81                         A. 3007--A

 ANT TO THIS SECTION SHALL BE PAYABLE TO THE OFFICE FOR DEPOSIT INTO  THE
 GENERAL FUND.
   §  3.    This  act  shall take effect on the one hundred eightieth day
 after it shall have become a law.   Effective immediately,  the  commis-
 sioner  of  mental  health is authorized to promulgate any and all rules
 and regulations and take any other measures necessary to implement  this
 act on its effective date or before such date.
 
                                  PART AA
 
   Section  1.  This  Part enacts into law legislation relating to crisis
 stabilization services, Kendra's law and assisted  outpatient  treatment
 and  involuntary commitment. Each component is wholly contained within a
 Subpart identified as Subparts A through C. The effective date for  each
 particular  provision  contained within each Subpart is set forth in the
 last section of such Subpart. Any provision  in  any  section  contained
 within  a  Subpart,  including  the effective date of the Subpart, which
 makes a reference to a section "of this act", when  used  in  connection
 with that particular component, shall be deemed to mean and refer to the
 corresponding section of the Subpart in which it is found. Section three
 of this Part sets forth the general effective date of this Part.
 
                                 SUBPART A
 
   Section  1.  The mental hygiene law is amended by adding a new section
 31.36 to read as follows:
 § 31.36 CRISIS STABILIZATION SERVICES.
   THE COMMISSIONER SHALL HAVE THE POWER, IN CONJUNCTION WITH THE COMMIS-
 SIONER OF THE OFFICE OF  ADDICTION  SERVICES  AND  SUPPORTS,  TO  CREATE
 CRISIS  STABILIZATION  CENTERS  WITHIN NEW YORK STATE IN ACCORDANCE WITH
 ARTICLE THIRTY-SIX OF THIS TITLE, INCLUDING THE  PROMULGATION  OF  JOINT
 REGULATIONS AND IMPLEMENTATION OF A FINANCING MECHANISM TO ALLOW FOR THE
 SUSTAINABLE OPERATION OF SUCH PROGRAMS.
   §  2.  The mental hygiene law is amended by adding a new section 32.36
 to read as follows:
 § 32.36 CRISIS STABILIZATION SERVICES.
   THE COMMISSIONER SHALL HAVE THE POWER, IN CONJUNCTION WITH THE COMMIS-
 SIONER OF THE OFFICE OF MENTAL HEALTH, TO  CREATE  CRISIS  STABILIZATION
 CENTERS  WITHIN  NEW YORK STATE IN ACCORDANCE WITH ARTICLE THIRTY-SIX OF
 THIS TITLE, INCLUDING THE PROMULGATION OF JOINT REGULATIONS  AND  IMPLE-
 MENTATION  OF  A FINANCING MECHANISM TO ALLOW FOR THE SUSTAINABLE OPERA-
 TION OF SUCH PROGRAMS.
   § 3. The mental hygiene law is amended by adding a new article  36  to
 read as follows:
                               ARTICLE XXXVI
             ADDICTION AND MENTAL HEALTH SERVICES AND SUPPORTS
 SECTION 36.01 CRISIS STABILIZATION CENTERS.
 § 36.01 CRISIS STABILIZATION CENTERS.
   (A)  (1)  THE  COMMISSIONERS  ARE AUTHORIZED TO JOINTLY LICENSE CRISIS
 STABILIZATION CENTERS SUBJECT TO THE AVAILABILITY OF STATE  AND  FEDERAL
 FUNDING.
   (2)  A CRISIS STABILIZATION CENTER SHALL SERVE AS AN EMERGENCY SERVICE
 PROVIDER FOR PERSONS WITH PSYCHIATRIC AND/OR SUBSTANCE USE DISORDER THAT
 ARE IN NEED OF CRISIS STABILIZATION SERVICES. EACH CRISIS  STABILIZATION
 CENTER  SHALL  PROVIDE  OR  CONTRACT  TO  PROVIDE  CRISIS  STABILIZATION

 S. 2507--A                         82                         A. 3007--A
 
 SERVICES FOR MENTAL HEALTH OR SUBSTANCE USE TWENTY-FOUR HOURS  PER  DAY,
 SEVEN DAYS PER WEEK, INCLUDING BUT NOT LIMITED TO:
   (I) ENGAGEMENT, TRIAGE AND ASSESSMENT;
   (II) CONTINUOUS OBSERVATION;
   (III) MILD TO MODERATE DETOXIFICATION;
   (IV) SOBERING SERVICES;
   (V) THERAPEUTIC INTERVENTIONS;
   (VI) DISCHARGE AND AFTER CARE PLANNING;
   (VII) TELEMEDICINE;
   (VIII) PEER SUPPORT SERVICES; AND
   (IX) MEDICATION ASSISTED TREATMENT.
   (3)  THE  COMMISSIONERS SHALL REQUIRE EACH CRISIS STABILIZATION CENTER
 TO SUBMIT A PLAN. THE PLAN SHALL BE APPROVED BY THE COMMISSIONERS  PRIOR
 TO  THE  ISSUANCE  OF AN OPERATING CERTIFICATE PURSUANT TO THIS ARTICLE.
 EACH PLAN SHALL INCLUDE:
   (I) A DESCRIPTION OF THE CENTER'S CATCHMENT AREA,
   (II) A DESCRIPTION OF THE CENTER'S CRISIS STABILIZATION SERVICES,
   (III) AGREEMENTS OR AFFILIATIONS WITH HOSPITALS AS DEFINED IN  SECTION
 1.03 OF THIS CHAPTER,
   (IV) AGREEMENTS OR AFFILIATIONS WITH GENERAL HOSPITALS OR LAW ENFORCE-
 MENT TO RECEIVE PERSONS,
   (V)  A  DESCRIPTION  OF  LOCAL  RESOURCES  AVAILABLE  TO THE CENTER TO
 PREVENT UNNECESSARY HOSPITALIZATIONS OF PERSONS,
   (VI) A DESCRIPTION OF THE CENTER'S LINKAGES WITH  LOCAL  POLICE  AGEN-
 CIES, EMERGENCY MEDICAL SERVICES, AMBULANCE SERVICES AND OTHER TRANSPOR-
 TATION AGENCIES,
   (VII)  A  DESCRIPTION  OF  LOCAL  RESOURCES AVAILABLE TO THE CENTER TO
 PROVIDE APPROPRIATE COMMUNITY MENTAL HEALTH AND SUBSTANCE  USE  DISORDER
 SERVICES UPON RELEASE,
   (VIII)  WRITTEN  CRITERIA AND GUIDELINES FOR THE DEVELOPMENT OF APPRO-
 PRIATE PLANNING FOR PERSONS IN  NEED  OF  POST  COMMUNITY  TREATMENT  OR
 SERVICES,
   (IX)  A  STATEMENT  INDICATING THAT THE CENTER HAS BEEN INCLUDED IN AN
 APPROVED LOCAL SERVICES PLAN DEVELOPED PURSUANT TO ARTICLE FORTY-ONE  OF
 THIS  CHAPTER  FOR  EACH  LOCAL  GOVERNMENT  LOCATED WITHIN THE CENTER'S
 CATCHMENT AREA; AND
   (X) ANY OTHER INFORMATION OR AGREEMENTS REQUIRED BY THE COMMISSIONERS.
   (4) CRISIS STABILIZATION  CENTERS  SHALL  PARTICIPATE  IN  COUNTY  AND
 COMMUNITY  PLANNING  ACTIVITIES ANNUALLY, AND AS ADDITIONALLY NEEDED, IN
 ORDER TO PARTICIPATE IN LOCAL COMMUNITY SERVICE  PLANNING  PROCESSES  TO
 ENSURE, MAINTAIN, IMPROVE OR DEVELOP COMMUNITY SERVICES THAT DEMONSTRATE
 RECOVERY OUTCOMES. THESE OUTCOMES INCLUDE, BUT ARE NOT LIMITED TO, QUAL-
 ITY  OF LIFE, SOCIO-ECONOMIC STATUS, ENTITLEMENT STATUS, SOCIAL NETWORK-
 ING, COPING SKILLS AND REDUCTION IN USE OF CRISIS SERVICES.
   (B) EACH CRISIS STABILIZATION CENTER SHALL BE STAFFED WITH A MULTIDIS-
 CIPLINARY TEAM CAPABLE OF MEETING THE NEEDS OF INDIVIDUALS  EXPERIENCING
 ALL  LEVELS  OF  CRISIS  IN  THE  COMMUNITY  BUT SHALL HAVE AT LEAST ONE
 PSYCHIATRIST OR PSYCHIATRIC NURSE PRACTITIONER, A CREDENTIALED  ALCOHOL-
 ISM  AND  SUBSTANCE  ABUSE  COUNSELOR AND ONE PEER SUPPORT SPECIALIST ON
 DUTY AND AVAILABLE AT ALL TIMES, PROVIDED,  HOWEVER,  THE  COMMISSIONERS
 MAY  PROMULGATE  REGULATIONS  TO PERMIT THE ISSUANCE OF A WAIVER OF THIS
 REQUIREMENT WHEN THE VOLUME OF SERVICE OF A CENTER DOES NOT REQUIRE SUCH
 LEVEL OF STAFF COVERAGE.
   (C) THE COMMISSIONERS SHALL PROMULGATE REGULATIONS  NECESSARY  TO  THE
 OPERATION OF SUCH CRISIS STABILIZATION CENTERS.

 S. 2507--A                         83                         A. 3007--A
 
   (D)  FOR THE PURPOSE OF ADDRESSING UNIQUE RURAL SERVICE DELIVERY NEEDS
 AND CONDITIONS, THE COMMISSIONERS SHALL PROVIDE TECHNICAL ASSISTANCE FOR
 THE ESTABLISHMENT OF CRISIS  STABILIZATION  CENTERS  OTHERWISE  APPROVED
 UNDER  THE PROVISIONS OF THIS SECTION, INCLUDING TECHNICAL ASSISTANCE TO
 PROMOTE  AND FACILITATE THE ESTABLISHMENT OF SUCH CENTERS IN RURAL AREAS
 IN THE STATE OR COMBINATIONS OF RURAL COUNTIES.
   (E) THE COMMISSIONERS SHALL DEVELOP GUIDELINES FOR EDUCATIONAL MATERI-
 ALS TO ASSIST CRISIS STABILIZATION CENTERS IN  EDUCATING  LOCAL  PRACTI-
 TIONERS,  HOSPITALS,  LAW  ENFORCEMENT  AND  PEERS. SUCH MATERIALS SHALL
 INCLUDE APPROPRIATE  EDUCATION  RELATING  TO  DE-ESCALATION  TECHNIQUES,
 CULTURAL COMPETENCY, THE RECOVERY PROCESS, MENTAL HEALTH, SUBSTANCE USE,
 AND AVOIDANCE OF AGGRESSIVE CONFRONTATION.
   § 4. Section 9.41 of the mental hygiene law, as amended by chapter 723
 of the laws of 1989, is amended to read as follows:
 § 9.41 Emergency  [admissions]  ASSESSMENT  for  immediate  observation,
            care, and treatment; powers of  certain  peace  officers  and
            police officers.
   Any  peace officer, when acting pursuant to his or her special duties,
 or police officer who is a member of the state police or of  an  author-
 ized  police  department  or force or of a sheriff's department may take
 into custody any person who appears to be mentally ill and is conducting
 himself or herself in a manner which is likely to result in serious harm
 to the person or others. Such officer may direct  the  removal  of  such
 person  or  remove him or her to: (A) any hospital specified in subdivi-
 sion (a) of section 9.39 OF  THIS  ARTICLE,  or  (B)  any  comprehensive
 psychiatric  emergency  program  specified in subdivision (a) of section
 9.40 OF THIS ARTICLE, or[,] (C) TO ANY CRISIS STABILIZATION CENTER SPEC-
 IFIED IN SECTION 36.01 OF THIS CHAPTER,  WHEN  THE  OFFICER  DEEMS  SUCH
 CENTER  IS  APPROPRIATE AND WHERE SUCH PERSON AGREES, OR (D) pending his
 or her examination or admission to any such hospital [or],  program,  OR
 CENTER, temporarily detain any such person in another safe and comforta-
 ble  place,  in  which  event, such officer shall immediately notify the
 director of community services or, if there be none, the health  officer
 of the city or county of such action.
   § 5. Section 9.43 of the mental hygiene law, as amended by chapter 723
 of the laws of 1989, is amended to read as follows:
 § 9.43 Emergency  [admissions]  ASSESSMENT  for  immediate  observation,
            care, and treatment; powers of courts.
   (a) Whenever any court of inferior or general jurisdiction is informed
 by verified statement that a person is apparently mentally  ill  and  is
 conducting  himself  or herself in a manner which in a person who is not
 mentally ill would be deemed disorderly conduct or which  is  likely  to
 result  in  serious harm to himself or herself, such court shall issue a
 warrant directing that such person be brought before it. If,  when  said
 person  is  brought  before  the  court, it appears to the court, on the
 basis of evidence presented to it, that such person has or  may  have  a
 mental  illness  which is likely to result in serious harm to himself or
 herself or others, the court shall issue a civil order directing his  or
 her removal to any hospital specified in subdivision (a) of section 9.39
 OF THIS ARTICLE or any comprehensive psychiatric emergency program spec-
 ified  in  subdivision  (a)  of  section 9.40 OF THIS ARTICLE, OR TO ANY
 CRISIS STABILIZATION CENTER SPECIFIED IN SECTION 36.01 OF  THIS  CHAPTER
 WHEN  THE  COURT  DEEMS SUCH CENTER IS APPROPRIATE AND WHERE SUCH PERSON
 AGREES; THAT IS willing to receive such person for  a  determination  by
 the  director  of  such  hospital  [or],  program OR CENTER whether such
 person should be [retained] RECEIVED therein pursuant to such section.

 S. 2507--A                         84                         A. 3007--A

   (b) Whenever a person before a court in a criminal action  appears  to
 have  a  mental  illness  which  is  likely to result in serious harm to
 himself or herself or others and the court determines  either  that  the
 crime  has  not  been committed or that there is not sufficient cause to
 believe  that such person is guilty thereof, the court may issue a civil
 order as above provided, and in such cases  the  criminal  action  shall
 terminate.
   § 6. Section 9.45 of the mental hygiene law, as amended by chapter 723
 of  the laws of 1989 and the opening paragraph as amended by chapter 192
 of the laws of 2005, is amended to read as follows:
 § 9.45 Emergency  [admissions]  ASSESSMENT  for  immediate  observation,
            care,   and  treatment;  powers  of  directors  of  community
            services.
   The director of community services or the  director's  designee  shall
 have  the  power  to direct the removal of any person, within his or her
 jurisdiction, to a hospital approved by  the  commissioner  pursuant  to
 subdivision  (a)  of section 9.39 of this article, or to a comprehensive
 psychiatric emergency program pursuant to  subdivision  (a)  of  section
 9.40 of this article, OR TO ANY CRISIS STABILIZATION CENTER SPECIFIED IN
 SECTION  36.01  OF  THIS  CHAPTER WHEN THE DIRECTOR DEEMS SUCH CENTER IS
 APPROPRIATE AND WHERE SUCH PERSON AGREES, if the parent, adult  sibling,
 spouse  or  child  of the person, the committee or legal guardian of the
 person, a licensed psychologist, registered professional nurse or certi-
 fied  social  worker  currently  responsible  for  providing   treatment
 services to the person, a supportive or intensive case manager currently
 assigned  to  the  person  by a case management program which program is
 approved by the office of mental health for  the  purpose  of  reporting
 under  this section, a licensed physician, health officer, peace officer
 or police officer reports to him or her that such person  has  a  mental
 illness for which immediate care and treatment [in a hospital] is appro-
 priate  and  which  is  likely  to  result in serious harm to himself or
 herself or others. It shall be the duty of peace officers,  when  acting
 pursuant to their special duties, or police officers, who are members of
 an authorized police department or force or of a sheriff's department to
 assist  representatives of such director to take into custody and trans-
 port any such person. Upon  the  request  of  a  director  of  community
 services  or the director's designee an ambulance service, as defined in
 subdivision two of section three thousand one of the public health  law,
 is  authorized  to  transport  any  such person. Such person may then be
 retained in a hospital pursuant to the provisions  of  section  9.39  of
 this  article or in a comprehensive psychiatric emergency program pursu-
 ant to the provisions of section 9.40 of this article OR TO  ANY  CRISIS
 STABILIZATION CENTER SPECIFIED IN SECTION 36.01 OF THIS CHAPTER WHEN THE
 DIRECTOR DEEMS SUCH CENTER IS APPROPRIATE AND WHERE SUCH PERSON AGREES.
   §  7.    Subdivision (a) of section 9.58 of the mental hygiene law, as
 added by chapter 678 of the laws of 1994, is amended to read as follows:
   (a) A physician or qualified  mental  health  professional  who  is  a
 member  of  an approved mobile crisis outreach team shall have the power
 to remove, or pursuant to subdivision (b) of this section, to direct the
 removal of any person WHO APPEARS TO BE MENTALLY ILL AND  IS  CONDUCTING
 THEMSELVES  IN  A  MANNER  WHICH  IS LIKELY TO RESULT IN SERIOUS HARM TO
 THEMSELVES OR OTHERS, to a hospital approved by the commissioner  pursu-
 ant  to subdivision (a) of section 9.39 or section 31.27 of this chapter
 [for the purpose of evaluation for admission if such person  appears  to
 be  mentally  ill and is conducting himself or herself in a manner which
 is likely to result in serious harm to the person or  others]  OR  WHERE

 S. 2507--A                         85                         A. 3007--A

 THE  DIRECTOR DEEMS APPROPRIATE AND WHERE THE PERSON AGREES, TO A CRISIS
 STABILIZATION CENTER SPECIFIED IN SECTION 36.01 OF THIS CHAPTER.
   §  8.  Subdivision  2  of  section 365-a of the social services law is
 amended by adding a new paragraph (gg) to read as follows:
   (GG) ADDICTION AND MENTAL HEALTH SERVICES  AND  SUPPORTS  PROVIDED  BY
 FACILITIES LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF THE MENTAL HYGIENE
 LAW.
   §  9.  Paragraph  5  of subdivision (a) of section 22.09 of the mental
 hygiene law, as amended by section 1 of part D of chapter 69 of the laws
 of 2016, is amended to read as follows:
   5. "Treatment facility" means a facility designated by the commission-
 er which may only include a general hospital as defined in article twen-
 ty-eight of the public health law, or a medically managed  or  medically
 supervised withdrawal, inpatient rehabilitation, or residential stabili-
 zation  treatment program that has been certified by the commissioner to
 have appropriate medical staff available on-site at all times to provide
 emergency services and continued evaluation of capacity  of  individuals
 retained  under  this  section OR A CRISIS STABILIZATION CENTER LICENSED
 PURSUANT TO ARTICLE 36.01 OF THIS CHAPTER.
   § 10. The commissioner of health, in consultation with the  office  of
 mental  health  and the office of addiction services and supports, shall
 seek Medicaid federal financial participation from the  federal  centers
 for Medicare and Medicaid services for the federal share of payments for
 the services authorized pursuant to this Subpart.
   §  11.  This act shall take effect October 1, 2021; provided, however,
 that the amendments to sections  9.41,  9.43  and  9.45  of  the  mental
 hygiene  law  made  by sections four, five and six of this act shall not
 affect the expiration of  such  sections  and  shall  expire  therewith.
 Effective immediately, the addition, amendment and/or repeal of any rule
 or regulation necessary for the implementation of this act on its effec-
 tive  date  are  authorized  to  be made and completed on or before such
 effective date.
 
                                 SUBPART B
 
   Section 1. Paragraph 4 of subdivision (c), paragraph 2 of  subdivision
 (h),  paragraph 1 of subdivision (k) and subdivision (l) of section 9.60
 of the mental hygiene law, as amended by chapter 158 of the laws of 2005
 and paragraph 1 of subdivision (k) as added by chapter 1 of the laws  of
 2013, are amended to read as follows:
   (4)  has  a  history  of  lack of compliance with treatment for mental
 illness that has:
   (i) EXCEPT AS OTHERWISE PROVIDED IN SUBPARAGRAPH (II)  OF  THIS  PARA-
 GRAPH,  prior  to  the filing of the petition, at least twice within the
 last thirty-six months been a significant factor in necessitating hospi-
 talization in a hospital, or receipt of services in a forensic or  other
 mental  health  unit  of a correctional facility or a local correctional
 facility, not including any current period, or period ending within  the
 last  six  months,  during  which  the  person was or is hospitalized or
 incarcerated; or
   (ii) EXCEPT AS OTHERWISE PROVIDED IN SUBPARAGRAPH (III) OF THIS  PARA-
 GRAPH, prior to the filing of the petition, resulted in one or more acts
 of  serious  violent  behavior  toward  self or others or threats of, or
 attempts at, serious physical harm to self or  others  within  the  last
 forty-eight  months,  not including any current period, or period ending

 S. 2507--A                         86                         A. 3007--A
 
 within the last six months, in which the person was or  is  hospitalized
 or incarcerated; [and] OR
   (III)  NOTWITHSTANDING  SUBPARAGRAPHS  (I) AND (II) OF THIS PARAGRAPH,
 RESULTED IN THE ISSUANCE OF AN ORDER FOR ASSISTED  OUTPATIENT  TREATMENT
 WHICH  HAS  EXPIRED WITHIN THE LAST SIX MONTHS, AND SINCE THE EXPIRATION
 OF THE ORDER, THE PERSON HAS EXPERIENCED A SUBSTANTIAL INCREASE IN SYMP-
 TOMS OF MENTAL ILLNESS AND A LOSS OF FUNCTION.
   (2) The court shall not order assisted outpatient treatment unless  an
 examining  physician,  who  recommends assisted outpatient treatment and
 has personally examined the subject of the petition  no  more  than  ten
 days  before  the  filing  of the petition, testifies [in person] at the
 hearing. Such physician shall state  the  facts  and  clinical  determi-
 nations  which  support  the allegation that the subject of the petition
 meets each of the criteria for assisted outpatient treatment.
   (1) Prior to the expiration of an order pursuant to this section,  the
 appropriate  director  shall  review  whether  the  assisted  outpatient
 continues to [meet the criteria for] BENEFIT  FROM  assisted  outpatient
 treatment.  If,  as  documented in the petition, (I) the director deter-
 mines that [such criteria continue to be met]: (A) AS A RESULT OF HIS OR
 HER MENTAL ILLNESS, THE OUTPATIENT IS UNLIKELY  TO  VOLUNTARILY  PARTIC-
 IPATE IN OUTPATIENT TREATMENT THAT WOULD ENABLE HIM OR HER TO LIVE SAFE-
 LY IN THE COMMUNITY; AND (B) IN VIEW OF HIS OR HER TREATMENT HISTORY AND
 CURRENT  BEHAVIOR,  IS IN NEED OF ASSISTED OUTPATIENT TREATMENT IN ORDER
 TO PREVENT A RELAPSE OR DETERIORATION WHICH WOULD BE LIKELY TO RESULT IN
 SERIOUS HARM TO THE PERSON OR OTHERS AS DEFINED IN SECTION 9.01 OF  THIS
 ARTICLE;  AND  (C)  THE  OUTPATIENT  IS LIKELY TO BENEFIT FROM CONTINUED
 ASSISTED OUTPATIENT TREATMENT; or (II) THE DIRECTOR has made appropriate
 attempts to, but has not been successful in eliciting,  the  cooperation
 of  the subject to submit to an examination, within thirty days prior to
 the expiration of an order of assisted outpatient treatment, such direc-
 tor may petition the court to order continued assisted outpatient treat-
 ment pursuant to paragraph two of  this  subdivision.  Upon  determining
 whether such criteria continue to be met, such director shall notify the
 program  coordinator  in  writing as to whether a petition for continued
 assisted outpatient treatment is warranted and whether such  a  petition
 was or will be filed.
   (l)  Petition  for an order to stay, vacate [or], modify OR EXTEND THE
 ORDER. (1) In addition to any other right or  remedy  available  by  law
 with  respect  to  the  order  for  assisted  outpatient  treatment, the
 assisted outpatient, the mental hygiene legal service, or anyone  acting
 on  the assisted outpatient's behalf may petition the court on notice to
 the director, the original petitioner, and all others entitled to notice
 under subdivision (f) of this section to stay, vacate [or],  modify,  OR
 EXTEND  the  order.   AN APPLICATION FOR AN EXTENSION OF A CURRENT ORDER
 CAN BE MADE WHEN THE APPROPRIATE DIRECTOR HAS MADE ATTEMPTS BUT HAS  NOT
 BEEN  SUCCESSFUL IN GIVING THE SUBJECT OF THE PETITION THE NOTICE OF THE
 HEARING.
   (2) The appropriate director shall petition  the  court  for  approval
 before instituting a proposed material change in the assisted outpatient
 treatment  plan,  unless  such  change is authorized by the order of the
 court. Such petition shall be filed on notice to all parties entitled to
 notice under subdivision (f) of this section. Not later than  five  days
 after  receiving  such  petition, excluding Saturdays, Sundays and holi-
 days, the court shall hold a hearing on the petition; provided  that  if
 the  assisted  outpatient informs the court that he or she agrees to the
 proposed material change, the court may approve such  change  without  a

 S. 2507--A                         87                         A. 3007--A
 
 hearing.  Non-material changes may be instituted by the director without
 court approval. For the purposes of this paragraph, a material change is
 an addition or deletion of a category of services to or from  a  current
 assisted  outpatient  treatment  plan,  or  any  deviation  without  the
 assisted outpatient's consent from the terms of a current order relating
 to the administration of psychotropic drugs.
   § 2. This act shall take effect immediately; provided,  however,  that
 the amendments to section 9.60 of the mental hygiene law made by section
 one of this act shall not affect the repeal of such section and shall be
 deemed repealed therewith.
 
                                 SUBPART C
 
   Section  1.  The  third  undesignated paragraph of section 9.01 of the
 mental hygiene law, as amended by chapter 723 of the laws  of  1989,  is
 amended to read as follows:
   "likelihood to result in serious harm" or "likely to result in serious
 harm"  means  (a)  a  substantial risk of physical harm to the person as
 manifested by threats of or attempts at suicide or serious  bodily  harm
 or  other  conduct demonstrating that the person is dangerous to himself
 or herself[,]; or (b) A SUBSTANTIAL RISK OF PHYSICAL HARM TO THE  PERSON
 ARISING  FROM  SUCH  COMPLETE NEGLECT OF BASIC NEEDS FOR FOOD, CLOTHING,
 SHELTER OR PERSONAL SAFETY AS TO RENDER SERIOUS  ACCIDENT,  ILLNESS,  OR
 DEATH  IS  HIGHLY  PROBABLE  IF  CARE  BY ANOTHER IS NOT TAKEN; OR (C) a
 substantial risk of physical harm to  other  persons  as  manifested  by
 homicidal  or  other  violent  behavior  by  which  others are placed in
 reasonable fear of serious physical harm.
   § 2. Paragraph 2 of subdivision (a) of  section  9.39  of  the  mental
 hygiene  law,  as amended by chapter 789 of the laws of 1985, is amended
 and a new paragraph 3 is added to read as follows:
   2. a substantial risk of physical harm to other persons as  manifested
 by  homicidal  or  other  violent behavior by which others are placed in
 reasonable fear of serious physical harm[.], OR
   3. A SUBSTANTIAL RISK OF PHYSICAL HARM TO THE PERSON ARISING FROM SUCH
 COMPLETE NEGLECT OF BASIC NEEDS FOR FOOD, CLOTHING, SHELTER OR  PERSONAL
 SAFETY AS TO RENDER SERIOUS ACCIDENT, ILLNESS, OR DEATH IS HIGHLY PROBA-
 BLE IF CARE BY ANOTHER IS NOT TAKEN.
   § 3. This act shall take effect October 1, 2021.
   § 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 Subparts A through C of this act shall
 be as specifically set forth in the last section of such Subparts.
 
                                  PART BB
 
   Section 1. Subdivision (b) of section 7.17 of the mental hygiene  law,
 as  amended by section 1 of part H of chapter 56 of the laws of 2013, is
 amended to read as follows:

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   (b) There shall be in the office the hospitals  named  below  for  the
 care,  treatment  and  rehabilitation of persons with mental illness and
 for research and teaching in the science and  skills  required  for  the
 care, treatment and rehabilitation of such persons with mental illness.
   Greater Binghamton Health Center
   Bronx Psychiatric Center
   Buffalo Psychiatric Center
   Capital District Psychiatric Center
   Central New York Psychiatric Center
   Creedmoor Psychiatric Center
   Elmira Psychiatric Center
   Kingsboro Psychiatric Center
   Kirby Forensic Psychiatric Center
   Manhattan Psychiatric Center
   Mid-Hudson Forensic Psychiatric Center
   Mohawk Valley Psychiatric Center
   Nathan S. Kline Institute for Psychiatric Research
   New York State Psychiatric Institute
   Pilgrim Psychiatric Center
   Richard H. Hutchings Psychiatric Center
   Rochester Psychiatric Center
   Rockland Psychiatric Center
   St. Lawrence Psychiatric Center
   South Beach Psychiatric Center
   New York City Children's Center
   Rockland Children's Psychiatric Center
   Sagamore Children's Psychiatric Center
   Western New York Children's Psychiatric Center
   The  New  York  State  Psychiatric  Institute  and The Nathan S. Kline
 Institute for Psychiatric Research are designated as institutes for  the
 conduct  of medical research and other scientific investigation directed
 towards furthering knowledge of the etiology, diagnosis,  treatment  and
 prevention  of mental illness.  THE NEW YORK STATE PSYCHIATRIC INSTITUTE
 SHALL OPERATE, AS A SUB-ENTITY, THE NEW YORK STATE INSTITUTE  FOR  BASIC
 RESEARCH IN DEVELOPMENTAL DISABILITIES, WHICH IS DESIGNATED AS AN INSTI-
 TUTE  FOR  THE CONDUCT OF MEDICAL RESEARCH AND OTHER SCIENTIFIC INVESTI-
 GATION DIRECTED TOWARDS FURTHERING KNOWLEDGE OF THE ETIOLOGY, DIAGNOSIS,
 TREATMENT AND PREVENTION OF DEVELOPMENTAL DISABILITIES.
   § 2. All employees of the office for people with  developmental  disa-
 bilities'  New  York State Institute for Basic Research in Developmental
 Disabilities, who are substantially  engaged  in  the  functions  to  be
 transferred,  will  be  transferred to the office of mental health's New
 York State Psychiatric Institute pursuant to subdivision 2 of section 70
 of the civil service law.
   § 3. This act shall take effect immediately
 
                                  PART CC
 
   Section 1. Subdivisions 2 and  2-a  of  section  1.03  of  the  mental
 hygiene  law,  subdivision  2 as amended and subdivision 2-a as added by
 chapter 281 of the laws of 2019, are amended to read as follows:
   2. ["Commissioner" means the commissioner of mental  health]  "COMMIS-
 SIONER"  MEANS THE COMMISSIONER OF ADDICTION AND MENTAL HEALTH SERVICES,
 AND the commissioner of developmental disabilities [and the commissioner
 of addiction services and supports] as used in this chapter.  Any  power
 or  duty heretofore assigned to the commissioner of mental hygiene or to

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 the department of mental hygiene pursuant to this chapter shall hereaft-
 er be assigned to  the  commissioner  of  ADDICTION  AND  mental  health
 SERVICES  in  the case of facilities, programs, or services for individ-
 uals with mental illness, to the commissioner of developmental disabili-
 ties  in  the  case of facilities, programs, or services for individuals
 with developmental disabilities, to the commissioner  of  addiction  AND
 MENTAL  HEALTH  services  [and  supports]  in  the  case  of facilities,
 programs,  or  addiction  disorder  services  in  accordance  with   the
 provisions of titles D and E of this chapter.
   2-a.  Notwithstanding  any  other section of law or regulation, on and
 after the effective date of this subdivision, any and all references  to
 the  office of alcoholism and substance abuse services and the predeces-
 sor agencies to the office of alcoholism and  substance  abuse  services
 including  the division of alcoholism and alcohol abuse and the division
 of substance abuse services AND ALL REFERENCES TO THE OFFICE  OF  MENTAL
 HEALTH,  shall  be  known  as the "office of addiction AND MENTAL HEALTH
 services [and supports]." Nothing in this subdivision shall be construed
 as requiring or prohibiting the further amendment of statutes  or  regu-
 lations to conform to the provisions of this subdivision.
   § 2. Section 5.01 of the mental hygiene law, as amended by chapter 281
 of  the  laws of 2019, is amended and two new sections 5.01-a and 5.01-b
 are added to read as follows:
 § 5.01 Department of mental hygiene.
   There shall continue to be in the state  government  a  department  of
 mental  hygiene.  Within  the  department  there  shall be the following
 autonomous offices:
   (1) office of ADDICTION AND mental health SERVICES; AND
   (2) office for people with developmental disabilities[;
   (3) office of addiction services and supports].
 § 5.01-A OFFICE OF ADDICTION AND MENTAL HEALTH SERVICES.
   (A) THE OFFICE OF  ADDICTION AND MENTAL HEALTH SERVICES SHALL BE A NEW
 OFFICE WITHIN THE DEPARTMENT FORMED BY THE INTEGRATION OF THE OFFICES OF
 MENTAL HEALTH AND ADDICTION SERVICES AND SUPPORTS WHICH SHALL  FOCUS  ON
 ISSUES  RELATED  TO  BOTH  MENTAL ILLNESS AND ADDICTION IN THE STATE AND
 CARRY OUT THE INTENT OF THE  LEGISLATURE  IN  ESTABLISHING  THE  OFFICES
 PURSUANT  TO  ARTICLES SEVEN AND NINETEEN OF THIS CHAPTER. THE OFFICE OF
 ADDICTION AND MENTAL HEALTH SERVICES IS CHARGED WITH ENSURING THE DEVEL-
 OPMENT OF COMPREHENSIVE PLANS FOR PROGRAMS AND SERVICES IN THE  AREA  OF
 RESEARCH,  PREVENTION, AND CARE AND TREATMENT, REHABILITATION, EDUCATION
 AND TRAINING, AND SHALL  BE  STAFFED  TO  PERFORM  THE  RESPONSIBILITIES
 ATTRIBUTED  TO  THE  OFFICE  PURSUANT TO SECTIONS 7.07 AND 19.07 OF THIS
 CHAPTER AND PROVIDE SERVICES AND PROGRAMS TO PROMOTE RECOVERY FOR  INDI-
 VIDUALS  WITH  MENTAL ILLNESS, SUBSTANCE USE DISORDER, OR MENTAL ILLNESS
 AND SUBSTANCE USE DISORDER.
   (B) THE COMMISSIONER OF THE OFFICE  OF  ADDICTION  AND  MENTAL  HEALTH
 SERVICES SHALL BE VESTED WITH THE POWERS, DUTIES, AND OBLIGATIONS OF THE
 OFFICE  OF  MENTAL  HEALTH  AND  THE  OFFICE  OF  ADDICTION SERVICES AND
 SUPPORTS.
   (C)  THE OFFICE OF ADDICTION AND MENTAL HEALTH  SERVICES  MAY  LICENSE
 PROVIDERS  TO  PROVIDE  INTEGRATED  SERVICES FOR INDIVIDUALS WITH MENTAL
 ILLNESS, SUBSTANCE USE DISORDER, OR MENTAL  ILLNESS  AND  SUBSTANCE  USE
 DISORDER, IN ACCORDANCE WITH REGULATIONS ISSUED BY THE COMMISSIONER.
 § 5.01-B OFFICE OF ADDICTION AND MENTAL HEALTH SERVICES.
   UNTIL  JANUARY FIRST, TWO THOUSAND TWENTY-TWO, THE OFFICE OF ADDICTION
 AND MENTAL HEALTH SERVICES SHALL CONSIST OF THE OFFICE OF MENTAL  HEALTH
 AND THE OFFICE OF ADDICTION SERVICES AND SUPPORTS.

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   § 3. Section 5.03 of the mental hygiene law, as amended by chapter 281
 of the laws of 2019, is amended to read as follows:
 § 5.03 Commissioners.
   The  head  of the office of ADDICTION AND mental health SERVICES shall
 be the commissioner of ADDICTION AND mental  health  SERVICES;  AND  the
 head  of  the office for people with developmental disabilities shall be
 the commissioner of developmental disabilities[; and  the  head  of  the
 office  of  addiction services and supports shall be the commissioner of
 addiction services and supports]. Each commissioner shall  be  appointed
 by  the  governor,  by and with the advice and consent of the senate, to
 serve at the pleasure of  the  governor.    UNTIL  THE  COMMISSIONER  OF
 ADDICTION  AND  MENTAL  HEALTH SERVICES IS APPOINTED BY THE GOVERNOR AND
 CONFIRMED BY THE SENATE, THE  COMMISSIONER  OF  MENTAL  HEALTH  AND  THE
 COMMISSIONER  OF ADDICTION SERVICES AND SUPPORTS SHALL CONTINUE TO OVER-
 SEE MENTAL HEALTH AND ADDICTION SERVICES RESPECTIVELY, AND WORK COLLABO-
 RATIVELY TO INTEGRATE CARE FOR INDIVIDUALS WITH BOTH MENTAL  HEALTH  AND
 SUBSTANCE USE DISORDERS.
   §  4.  Section 5.05 of the mental hygiene law, as added by chapter 978
 of the laws of 1977, subdivision (a) as amended by chapter  168  of  the
 laws  of  2010, subdivision (b) as amended by chapter 294 of the laws of
 2007, paragraph 1 of subdivision (b) as amended by section 14 of part  J
 of  chapter  56 of the laws of 2012, subdivision (d) as added by chapter
 58 of the laws of 1988 and subdivision (e) as added by  chapter  588  of
 the laws of 2011, is amended to read as follows:
 § 5.05 Powers and duties of the head of the department.
   (a)  The  commissioners  of  the office of ADDICTION AND mental health
 SERVICES and the office for people with developmental  disabilities,  as
 the  heads  of the department, shall jointly visit and inspect, or cause
 to be visited and inspected, all facilities  either  public  or  private
 used  for  the  care,  treatment  and rehabilitation of individuals with
 mental illness, SUBSTANCE USE DISORDER and developmental disabilities in
 accordance with the requirements of section four of article seventeen of
 the New York state constitution.
   (b) (1) The commissioners  of  the  office  of  ADDICTION  AND  mental
 health[,] SERVICES AND the office for people with developmental disabil-
 ities  [and the office of alcoholism and substance abuse services] shall
 constitute an inter-office coordinating council which,  consistent  with
 the  autonomy  of each office for matters within its jurisdiction, shall
 ensure that the state policy for the  prevention,  care,  treatment  and
 rehabilitation  of individuals with mental illness, SUBSTANCE USE DISOR-
 DERS  and  developmental  disabilities[,  alcoholism,   alcohol   abuse,
 substance  abuse,  substance  dependence,  and  chemical  dependence] is
 planned,  developed  and  implemented  comprehensively;  that  gaps   in
 services  to  individuals  with multiple disabilities are eliminated and
 that no person is denied treatment and services because he  or  she  has
 more than one disability; that procedures for the regulation of programs
 which  offer  care and treatment for more than one class of persons with
 mental disabilities be coordinated between the offices having  jurisdic-
 tion  over  such programs; and that research projects of the institutes,
 as identified in section 7.17 [or], 13.17, OR 19.17 of this  chapter  or
 as  operated  by  the office for people with developmental disabilities,
 are coordinated to maximize the success and cost effectiveness  of  such
 projects and to eliminate wasteful duplication.
   (2)  The  inter-office  coordinating  council  shall  annually issue a
 report on its activities to the legislature on or before December  thir-
 ty-first.   Such annual report shall include, but not be limited to, the

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 following information: proper treatment models and programs for  persons
 with multiple disabilities and suggested improvements to such models and
 programs;  research  projects  of  the institutes and their coordination
 with  each other; collaborations and joint initiatives undertaken by the
 offices of the department; consolidation of regulations of each  of  the
 offices  of  the department to reduce regulatory inconsistencies between
 the offices; inter-office or  office  activities  related  to  workforce
 training  and  development;  data  on  the  prevalence,  availability of
 resources and service utilization by persons with multiple disabilities;
 eligibility standards of each office of the department affecting clients
 suffering from multiple disabilities, and  eligibility  standards  under
 which  a  client is determined to be an office's primary responsibility;
 agreements or arrangements on statewide, regional and  local  government
 levels addressing how determinations over client responsibility are made
 and  client  responsibility  disputes  are  resolved; information on any
 specific cohort of clients with multiple disabilities for which substan-
 tial barriers in  accessing  or  receiving  appropriate  care  has  been
 reported  or  is  known  to the inter-office coordinating council or the
 offices of the department; and coordination of  planning,  standards  or
 services for persons with multiple disabilities between the inter-office
 coordinating  council,  the  offices of the department and local govern-
 ments in accordance with the local planning requirements  set  forth  in
 article forty-one of this chapter.
   (c)  The  commissioners shall meet from time to time with the New York
 state conference of local mental hygiene directors to assure  consistent
 procedures  in  fulfilling the responsibilities required by this section
 and by article forty-one of this chapter.
   (d) 1. The commissioner of ADDICTION AND mental health SERVICES  shall
 evaluate  the  type  and level of care required by patients in the adult
 psychiatric centers authorized by  section  7.17  of  this  chapter  and
 develop appropriate comprehensive requirements for the staffing of inpa-
 tient  wards.  These  requirements  should  reflect  measurable need for
 administrative and direct care staff including  physicians,  nurses  and
 other  clinical  staff,  direct  and  related  support and other support
 staff, established on the basis of sound clinical judgment. The staffing
 requirements shall include but not be limited to the following: (i)  the
 level of care based on patient needs, including on ward activities, (ii)
 the  number of admissions, (iii) the geographic location of each facili-
 ty, (iv) the physical layout of the campus, and (v) the physical  design
 of patient care wards.
   2.  Such  commissioner,  in developing the requirements, shall provide
 for adequate ward coverage on all shifts taking into account the  number
 of  individuals  expected to be off the ward due to sick leave, workers'
 compensation, mandated training and all other off ward leaves.
   3. The staffing requirements shall be designed to reflect the  legiti-
 mate  needs of facilities so as to ensure full accreditation and certif-
 ication by appropriate regulatory bodies. The requirements shall reflect
 appropriate industry standards. The staffing requirements shall be fully
 measurable.
   [4. The commissioner of mental health shall submit an  interim  report
 to  the  governor and the legislature on the development of the staffing
 requirements on October first, nineteen hundred eighty-eight  and  again
 on  April  first,  nineteen  hundred eighty-nine. The commissioner shall
 submit a final report to the governor and the legislature no later  than
 October  first,  nineteen  hundred  eighty-nine and shall include in his

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 report a plan to achieve the staffing requirements  and  the  length  of
 time necessary to meet these requirements.]
   (e)  The commissioners of the office of ADDICTION AND mental health[,]
 SERVICES AND THE office for people with developmental disabilities[, and
 the office of alcoholism and substance abuse services]  shall  cause  to
 have  all  new  contracts  with  agencies  and providers licensed by the
 offices to have a clause requiring notice be provided to all current and
 new employees of such agencies and providers stating that all  instances
 of  abuse  shall  be  investigated  pursuant to this chapter, and, if an
 employee leaves employment prior to the conclusion of  a  pending  abuse
 investigation, the investigation shall continue. Nothing in this section
 shall  be  deemed to diminish the rights, privileges, or remedies of any
 employee under any other law  or  regulation  or  under  any  collective
 bargaining agreement or employment contract.
   §  5.  Section 7.01 of the mental hygiene law, as added by chapter 978
 of the laws of 1977, is amended to read as follows:
 § 7.01 Declaration of policy.
   The state of New York and its local governments have a  responsibility
 for  the  prevention  and  early detection of mental illness and for the
 comprehensively planned care,  treatment  and  rehabilitation  of  their
 mentally ill citizens.
   Therefore, it shall be the policy of the state to conduct research and
 to  develop  programs  which  further  prevention and early detection of
 mental illness; to develop a comprehensive, integrated system of  treat-
 ment  and  rehabilitative  services  for the mentally ill. Such a system
 should include, whenever possible, the provision of necessary  treatment
 services  to  people  in  their  home  communities; it should assure the
 adequacy and appropriateness of residential arrangements for  people  in
 need  of  service; and it should rely upon improved programs of institu-
 tional care only when necessary and appropriate. Further, such a  system
 should  recognize  the  important  therapeutic  roles of all disciplines
 which may contribute to the care or treatment of the mentally ill,  such
 as  psychology,  social work, psychiatric nursing, special education and
 other disciplines in the field of mental illness, as well as  psychiatry
 and  should  establish accountability for implementation of the policies
 of the state with regard to the care and rehabilitation of the  mentally
 ill.
   To  facilitate  the  implementation  of  these policies and to further
 advance the interests of the mentally ill  and  their  families,  a  new
 autonomous  agency  to  be  known  as the office of ADDICTION AND mental
 health SERVICES has been established by this article. The office and its
 commissioner shall plan and work with local governments, voluntary agen-
 cies and all providers and consumers of mental health services in  order
 to develop an effective, integrated, comprehensive system for the deliv-
 ery  of  all services to the mentally ill and to create financing proce-
 dures and mechanisms to support such a system of services to ensure that
 mentally ill persons in  need  of  services  receive  appropriate  care,
 treatment and rehabilitation close to their families and communities. In
 carrying  out  these  responsibilities,  the office and its commissioner
 shall make full use of existing  services  in  the  community  including
 those provided by voluntary organizations.
   §  6. Section 19.01 of the mental hygiene law, as added by chapter 223
 of the laws of 1992, is amended to read as follows:
 § 19.01 Declaration of policy.
   The legislature declares the following:

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   Alcoholism, substance abuse and chemical dependence pose major  health
 and  social  problems  for  individuals  and  their  families  when left
 untreated, including family devastation, homelessness, and unemployment.
 It has been proven that successful prevention and treatment can  dramat-
 ically  reduce  costs  to  the  health care, criminal justice and social
 welfare systems.
   The tragic, cumulative and often fatal consequences of alcoholism  and
 substance  abuse  are,  however,  preventable and treatable disabilities
 that require a coordinated and multi-faceted network of services.
   The legislature recognizes locally planned and implemented  prevention
 as a primary means to avert the onset of alcoholism and substance abuse.
 It  is the policy of the state to promote comprehensive, age appropriate
 education for children and youth and stimulate public awareness  of  the
 risks  associated  with  alcoholism  and  substance  abuse. Further, the
 legislature acknowledges the need for a coordinated state policy for the
 establishment of prevention and treatment programs designed  to  address
 the  problems  of  chemical dependency among youth, including prevention
 and intervention efforts in school and community-based programs designed
 to identify and refer high risk youth in  need  of  chemical  dependency
 services.
   Substantial  benefits  can  be gained through alcoholism and substance
 abuse treatment for both addicted individuals and their families.  Posi-
 tive treatment outcomes that may be generated through a complete contin-
 uum  of  care offer a cost effective and comprehensive approach to reha-
 bilitating such individuals. The primary goals of the rehabilitation and
 recovery process are to restore social,  family,  lifestyle,  vocational
 and  economic  supports  by  stabilizing  an  individual's  physical and
 psychological functioning.  The legislature recognizes the importance of
 varying treatment approaches and levels of care designed  to  meet  each
 client's needs.  Relapse prevention and aftercare are two primary compo-
 nents of treatment that serve to promote and maintain recovery.
   The  legislature  recognizes  that  the  distinct  treatment  needs of
 special populations, including women and women  with  children,  persons
 with  HIV  infection, persons diagnosed with mental illness, persons who
 abuse chemicals, the homeless and  veterans  with  posttraumatic  stress
 disorder,  merit  particular attention. It is the intent of the legisla-
 ture to promote effective interventions for such populations in need  of
 particular  attention. The legislature also recognizes the importance of
 family support for individuals in alcohol or substance  abuse  treatment
 and  recovery.  Such family participation can provide lasting support to
 the recovering individual to prevent relapse and maintain recovery.  The
 intergenerational  cycle  of  chemical dependency within families can be
 intercepted through appropriate interventions.
   The state of New York and its local governments have a  responsibility
 in coordinating the delivery of alcoholism and substance abuse services,
 through  the  entire  network  of service providers. To accomplish these
 objectives, the legislature declares that the establishment of a single,
 unified office of [alcoholism and substance abuse] ADDICTION AND  MENTAL
 HEALTH  services  will  provide an integrated framework to plan, oversee
 and regulate the state's prevention and treatment network.  In  recogni-
 tion  of  the  growing trends and incidence of chemical dependency, this
 consolidation allows the state to respond to  the  changing  profile  of
 chemical  dependency.  The legislature recognizes that some distinctions
 exist between the alcoholism and substance abuse field  and  THE  MENTAL
 HEALTH FIELD AND where appropriate, those distinctions may be preserved.
 Accordingly,  it  is  the intent of the state to establish one office of

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 [alcoholism and substance abuse] ADDICTION AND MENTAL HEALTH services in
 furtherance of a comprehensive service delivery system.
   §  7.  Upon  or prior to January 1, 2022, the governor may nominate an
 individual to serve as commissioner  of  the  office  of  addiction  and
 mental  health  services.  If such individual is confirmed by the senate
 prior to January 1, 2022, they shall  become  the  commissioner  of  the
 office  of addiction and mental health services. The governor may desig-
 nate a person to exercise the powers of the commissioner of  the  office
 of  addiction  and  mental  health  services  on  an acting basis, until
 confirmation of a nominee by the senate, who  is  hereby  authorized  to
 take  such  actions as are necessary and proper to implement the orderly
 transition of the  functions,  powers  as  duties  as  herein  provided,
 including  the preparation for a budget request for the office as estab-
 lished by this act.
   § 8. Upon the transfer pursuant to  this  act  of  the  functions  and
 powers  possessed by and all of the obligations and duties of the office
 of mental health and the office of addiction services  and  supports  as
 established  pursuant  to  the mental hygiene law and other laws, to the
 office of addiction and mental health services  as  prescribed  by  this
 act,  provision shall be made for the transfer of all employees from the
 office of mental  health  and  the  office  of  addiction  services  and
 supports  into  the  office  of  addiction  and  mental health services.
 Employees so transferred shall be transferred without  further  examina-
 tion  or qualification to the same or similar titles and shall remain in
 the same collective bargaining units and shall retain  their  respective
 civil  service  classifications,  status,  and  rights pursuant to their
 collective bargaining units and collective bargaining agreements.
   § 9. Notwithstanding any contrary provision of law, on or before Octo-
 ber 1, 2021 and annually thereafter, the office of addiction and  mental
 health    services, in consultation with the department of health, shall
 issue a report, and post such report on their public website,  detailing
 the  office's  expenditures for mental health and addiction services and
 supports, including total Medicaid spending directly  by  the  state  to
 licensed  or designated providers and payments to managed care providers
 pursuant to section 364-j of the social  services  law.  The  office  of
 addiction  and  mental  health  services  shall examine reports produced
 pursuant to this section and may make recommendations  to  the  governor
 and  the  legislature  regarding  appropriations  for  mental health and
 addiction services and supports or other provisions of law which may  be
 necessary  to effectively implement the creation and continued operation
 of the office.
   § 10. Severability. If any clause,  sentence,  paragraph,  section  or
 part  of  this act shall be adjudged by any court of competent jurisdic-
 tion 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, section or part thereof directly involved
 in the controversy in which such judgment shall have been rendered.
   § 11. This act shall take effect immediately.  Effective  immediately,
 the  office  of  mental  health and the office of addiction services and
 supports are authorized to promulgate  the  addition,  amendment  and/or
 repeal of any rule or regulation or engage in any work necessary for the
 implementation  of  this act on its effective date authorized to be made
 and completed on or before such effective date.

                                  PART DD

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   Section 1. This act shall be known and may be cited as the "comprehen-
 sive outpatient services act of 2021".
   §  2.  Section 364-m of the social services law is amended by adding a
 new subdivision 6 to read as follows:
   6. COMPREHENSIVE OUTPATIENT SERVICES CENTERS. (A)  DEFINITIONS.    FOR
 THE  PURPOSE OF THIS ARTICLE, UNLESS THE CONTEXT CLEARLY REQUIRES OTHER-
 WISE:
   (I) "MENTAL HEALTH SERVICES"  MEANS  SERVICES  FOR  THE  TREATMENT  OF
 MENTAL ILLNESS.
   (II)   "ADDICTION  SERVICES"  MEANS  SERVICES  FOR  THE  TREATMENT  OF
 ADDICTION DISORDERS.
   (III) "COMPREHENSIVE OUTPATIENT SERVICES" MEANS THE SYSTEMATIC COORDI-
 NATION OF EVIDENCE-BASED HEALTH CARE SERVICES, TO INCLUDE THE  PREVENTA-
 TIVE,  DIAGNOSTIC,  THERAPEUTIC AND REHABILITATIVE CARE AND TREATMENT OF
 MENTAL ILLNESS, ADDICTION AND THE PROVISION OF PHYSICAL HEALTH SERVICES,
 OTHERWISE PROVIDED BY A  DIAGNOSTIC  AND  TREATMENT  CENTER  OR  GENERAL
 HOSPITAL  OUTPATIENT  PROGRAM  PURSUANT  TO  ARTICLE TWENTY-EIGHT OF THE
 PUBLIC HEALTH LAW, A MENTAL HEALTH CLINIC LICENSED PURSUANT  TO  ARTICLE
 THIRTY-ONE OF THE MENTAL HYGIENE LAW, OR AN ADDICTION PROVIDER CERTIFIED
 PURSUANT  TO ARTICLE THIRTY-TWO OF THE MENTAL HYGIENE LAW TO AN INDIVID-
 UAL SEEKING SERVICES REGARDLESS OF THEIR  PRIMARY  DIAGNOSIS  OR  HEALTH
 COMPLAINT;  PROVIDED,  HOWEVER,  THAT  THE SCOPE OF SUCH SERVICES MAY BE
 RESTRICTED PURSUANT TO REGULATION.
   (IV) "COMPREHENSIVE OUTPATIENT  SERVICES  CENTERS"  MEANS  A  FACILITY
 APPROVED IN ACCORDANCE WITH THIS SECTION TO PROVIDE COMPREHENSIVE OUTPA-
 TIENT  SERVICES  IN  ORDER TO PROMOTE HEALTH AND BETTER OUTCOMES FOR THE
 RECIPIENT, PARTICULARLY FOR POPULATIONS AT RISK.
   (V) "MEDICAL DIRECTOR" IS A  PHYSICIAN  WHO  IS  RESPONSIBLE  FOR  THE
 SERVICES  DELIVERED  BY  THE COMPREHENSIVE OUTPATIENT SERVICES PROVIDER,
 FOR THE OVERALL DIRECTION OF THE SERVICES PROVIDED AND THE DIRECT SUPER-
 VISION OF MEDICAL STAFF IN THE DELIVERY OF SERVICES.
   (VI) "PHYSICAL HEALTH SERVICES" MEANS SERVICES PROVIDED  BY  A  PHYSI-
 CIAN, PHYSICIAN'S ASSISTANT, NURSE PRACTITIONER, OR MIDWIFE ACTING WITH-
 IN  HIS  OR HER LAWFUL SCOPE OF PRACTICE UNDER TITLE EIGHT OF THE EDUCA-
 TION LAW AND WHO IS PRACTICING IN A PRIMARY CARE SPECIALTY.
   (B) NOTWITHSTANDING ANY LAW, RULE, OR REGULATION TO THE CONTRARY,  THE
 COMMISSIONERS  OF THE DEPARTMENT OF HEALTH, THE OFFICE OF MENTAL HEALTH,
 AND THE OFFICE OF ADDICTION SERVICES  AND  SUPPORTS  ARE  AUTHORIZED  TO
 JOINTLY  ESTABLISH  A SINGLE SET OF LICENSING STANDARDS AND REQUIREMENTS
 FOR THE CONSTRUCTION, OPERATION, REPORTING AND SURVEILLANCE  OF  COMPRE-
 HENSIVE  OUTPATIENT  SERVICES  CENTERS.  SUCH STANDARDS AND REQUIREMENTS
 SHALL INCLUDE, BUT NOT BE LIMITED TO:
   (I) SCOPE OF COMPREHENSIVE OUTPATIENT SERVICES;
   (II) CREATION OF AN EFFICIENT APPLICATION REVIEW PROCESS  FOR  COMPRE-
 HENSIVE OUTPATIENT SERVICES CENTERS;
   (III)  FACILITATION  OF  INTEGRATED TREATMENT RECORDS THAT COMPLY WITH
 APPLICABLE FEDERAL AND STATE CONFIDENTIALITY REQUIREMENTS;
   (IV) OPTIMAL USE OF CLINICAL RESOURCES, INCLUDING THE DEVELOPMENT OF A
 WORKFORCE CAPABLE OF  PROVIDING  COMPREHENSIVE  CARE  TO  AN  INDIVIDUAL
 UTILIZING EVIDENCE-BASED APPROACHES TO INTEGRATED TREATMENT;
   (V)  DEVELOPMENT OF BILLING AND REIMBURSEMENT STRUCTURES TO ENABLE THE
 PROVISION OF COMPREHENSIVE SERVICES TO INDIVIDUALS REGARDLESS  OF  THEIR
 PRIMARY DIAGNOSIS OR HEALTHCARE COMPLAINT;
   (VI)  REASONABLE  PHYSICAL  PLANT  STANDARDS TO FOSTER PROPER CARE AND
 TREATMENT;

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   (VII) STANDARDS FOR INCIDENT REPORTING  AND  REMEDIATION  PURSUANT  TO
 ARTICLE ELEVEN OF THE SOCIAL SERVICES LAW; AND
   (VIII)  STANDARDS  FOR  ADVERSE EVENT REPORTING, PROVIDED HOWEVER THAT
 ANY SUCH ADVERSE EVENT REPORTS SHALL BE KEPT CONFIDENTIAL AND SHALL  NOT
 BE SUBJECT TO DISCLOSURE UNDER ARTICLE SIX OF THE PUBLIC OFFICERS LAW OR
 ARTICLE THIRTY-ONE OF THE CIVIL PRACTICE LAW AND RULES.
   (C) A PROVIDER SHALL NOT BE AUTHORIZED TO PROVIDE COMPREHENSIVE OUTPA-
 TIENT  SERVICES  UNLESS  THEY HAVE SUFFICIENTLY DEMONSTRATED, CONSISTENT
 WITH THE STANDARDS AND REQUIREMENTS SET FORTH BY THE COMMISSIONERS:
   (I) EXPERIENCE  IN  THE  DELIVERY  OF  PHYSICAL,  MENTAL  HEALTH,  AND
 ADDICTION SERVICES;
   (II)  CAPACITY  TO  OFFER  COMPREHENSIVE  OUTPATIENT  SERVICES IN EACH
 COMPREHENSIVE OUTPATIENT SERVICES CENTER APPROVED BY EACH OF THE COMMIS-
 SIONERS OF THE DEPARTMENT OF HEALTH, THE OFFICE OF  MENTAL  HEALTH,  AND
 THE OFFICE OF ADDICTION SERVICES AND SUPPORTS; AND
   (III)  COMPLIANCE  WITH STANDARDS ESTABLISHED PURSUANT TO THIS SECTION
 FOR  PROVIDING  AND  RECEIVING  PAYMENT  FOR  COMPREHENSIVE   OUTPATIENT
 SERVICES.
   (D)  NOTWITHSTANDING  ANY  PROVISION  OF  LAW TO THE CONTRARY, FOR THE
 PURPOSES OF THIS SUBDIVISION, COMPREHENSIVE OUTPATIENT SERVICE PROVIDERS
 SHALL BE CONSIDERED CONTRACTED, APPROVED OR OTHERWISE AUTHORIZED BY  THE
 OFFICE  OF  ADDICTION  SERVICES  AND  SUPPORTS  AND THE OFFICE OF MENTAL
 HEALTH FOR THE PURPOSE OF SECTIONS 19.20,  19.20-A,  AND  31.35  OF  THE
 MENTAL HYGIENE LAW, AS MAY BE APPLICABLE. PROVIDERS SHALL BE REQUIRED TO
 COMPLY  WITH  THE REVIEW OF CRIMINAL HISTORY INFORMATION, AS REQUIRED IN
 SUCH SECTIONS, FOR PROSPECTIVE EMPLOYEES OR  VOLUNTEERS  WHO  WILL  HAVE
 REGULAR  AND  SUBSTANTIAL  UNSUPERVISED OR UNRESTRICTED PHYSICAL CONTACT
 WITH THE CLIENTS OF SUCH PROVIDER.
   (E) THE COMMISSIONERS OF THE  DEPARTMENT  OF  HEALTH,  THE  OFFICE  OF
 MENTAL  HEALTH,  AND  THE  OFFICE OF ADDICTION SERVICES AND SUPPORTS ARE
 AUTHORIZED TO PROMULGATE ANY REGULATORY REQUIREMENTS NECESSARY TO IMPLE-
 MENT COMPREHENSIVE OUTPATIENT  SERVICES  CENTERS  CONSISTENT  WITH  THIS
 SECTION, INCLUDING AMENDING EXISTING REQUIREMENTS.
   §  3.  Subdivision  4  of  section  488  of the social services law is
 amended by adding a new paragraph (a-1) to read as follows:
   (A-1) A COMPREHENSIVE OUTPATIENT SERVICES CENTER WHICH IS LICENSED, OR
 CERTIFIED  BY  SECTION  THREE  HUNDRED  SIXTY-FOUR-M  OF  THIS  CHAPTER,
 PROVIDED HOWEVER THAT SUCH TERM SHALL NOT INCLUDE THE PROVISION OF PHYS-
 ICAL HEALTH SERVICES RENDERED IN SUCH FACILITY OR PROGRAM;
   §  4.  Subdivision  1  of  section  2801  of the public health law, as
 amended by section 1 of part Z of chapter 57 of the  laws  of  2019,  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-

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 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  PRIMARY  CARE  SERVICES
 THAT  CAN  BE  PROVIDED BY COMPREHENSIVE OUTPATIENT SERVICES CENTERS, AS
 DEFINED IN SECTION THREE HUNDRED SIXTY-FOUR-M  OF  THE  SOCIAL  SERVICES
 LAW;  (B)  limit  the  volume  of  mental health, substance use disorder
 services or developmental disability 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, the commissioner of the office of [alcoholism
 and substance abuse services] ADDICTION SERVICES AND  SUPPORTS  and  the
 commissioner  of  the office for people with developmental disabilities,
 including regulations issued pursuant to subdivision  seven  of  section
 three hundred sixty-five-l of the social services law or part L of chap-
 ter  fifty-six  of  the laws of two thousand twelve; [(b)] (C) require a
 provider licensed pursuant to article thirty-one of the  mental  hygiene
 law  or  certified  pursuant to article sixteen or 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, the
 commissioner of the office of [alcoholism and substance abuse  services]
 ADDICTION  SERVICES  AND SUPPORTS and the commissioner of the office for
 people with developmental  disabilities,  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.
   §  5.  Subdivision  (f) of section 31.02 of the mental hygiene law, as
 amended by section 2 of part Z of chapter 57 of the  laws  of  2019,  is
 amended 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 sixteen
 or 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 integrated services in accordance with regulations issued by the
 commissioner of the office of mental health  in  consultation  with  the
 commissioner of the department of health, the commissioner of the office
 of  [alcoholism  and  substance  abuse  services] ADDICTION SERVICES AND
 SUPPORTS and the commissioner of the office  for  people  with  develop-
 mental  disabilities,  including regulations issued pursuant to subdivi-
 sion 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.
 FURTHERMORE, EXCEPT AS PROVIDED IN PARAGRAPH (D) OF SUBDIVISION  SIX  OF
 SECTION  THREE  HUNDRED  SIXTY-FOUR-M  OF  THE  SOCIAL  SERVICES LAW, NO
 PROVISION OF THIS ARTICLE  OR  ANY  OTHER  PROVISION  OF  LAW  SHALL  BE

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 CONSTRUED  TO  LIMIT  THE  VOLUME  OF MENTAL HEALTH SERVICES THAT CAN BE
 PROVIDED BY COMPREHENSIVE OUTPATIENT SERVICES  CENTERS,  AS  DEFINED  IN
 SECTION THREE HUNDRED SIXTY-FOUR-M OF THE SOCIAL SERVICES LAW.
   §  6.  Subdivision  (b) of section 32.05 of the mental hygiene law, as
 amended by section 3 of part Z of chapter 57 of the  laws  of  2019,  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, article thirty-one of
 this chapter or a provider certified pursuant to article sixteen of this
 chapter to obtain an operating certificate from the office of  [alcohol-
 ism  and  substance  abuse  services] ADDICTION SERVICES AND SUPPORTS if
 such provider has been authorized  to  provide  integrated  services  in
 accordance  with  regulations  issued by the commissioner of [alcoholism
 and substance abuse services] ADDICTION SERVICES AND SUPPORTS in consul-
 tation with the commissioner of the department of  health,  the  commis-
 sioner of the office of mental health and the commissioner of the office
 for people with developmental disabilities, 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.   FURTHERMORE, EXCEPT AS PROVIDED IN PARAGRAPH (D)
 OF SUBDIVISION SIX OF SECTION THREE HUNDRED SIXTY-FOUR-M OF  THE  SOCIAL
 SERVICES LAW, NO PROVISION OF THIS ARTICLE OR ANY OTHER PROVISION OF LAW
 SHALL BE CONSTRUED TO LIMIT THE VOLUME OF ADDICTION SERVICES THAT CAN BE
 PROVIDED  BY  COMPREHENSIVE  OUTPATIENT  SERVICES CENTERS, AS DEFINED IN
 SECTION THREE HUNDRED SIXTY-FOUR-M OF THE SOCIAL SERVICES LAW.
   § 7. This act shall take effect January 1,  2022;  provided,  however,
 that  the amendments to section 364-m of the social services law made by
 section two of this act shall not affect the repeal of such section  and
 shall  be deemed to repeal therewith. Effective immediately, the commis-
 sioner of the department of health, the commissioner of  the  office  of
 mental  health  and the commissioner of the office of addiction services
 and supports are authorized to issue any rule  or  regulation  necessary
 for the implementation of this act on or before its effective date.
 
                                  PART EE
 
   Section  1.  Subdivision  10  of  section  553 of the executive law is
 REPEALED.
   § 2. This act shall take effect April 1, 2021.
 
                                  PART FF

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   Section 1.  Subdivision 3 of section 2999-h of the public health  law,
 as  amended  by  chapter  4  of  the laws of 2017, is amended to read as
 follows:
   3.  "Qualifying health care costs" means the future medical, hospital,
 surgical, nursing, dental, rehabilitation, habilitation, respite, custo-
 dial CARE PROVIDED  IN  A  RESIDENTIAL  HEALTH  CARE  FACILITY,  durable
 medical  equipment,  home  modifications,  assistive technology, vehicle
 modifications,  transportation  for  purposes  of  health  care  related
 appointments,  prescription  and non-prescription medications, and other
 health care  costs  actually  incurred  for  services  rendered  to  and
 supplies  utilized  by qualified plaintiffs, which are necessary to meet
 their health care needs, as determined  by  their  treating  physicians,
 physician assistants, or nurse practitioners and as otherwise defined by
 the commissioner in regulation.
   §  2. Subdivisions 2 and 4 of section 2999-j of the public health law,
 subdivision 2 as amended by section 3 of part K of  chapter  57  of  the
 laws  of 2019 and subdivision 4 as amended by chapter 517 of the laws of
 2016, are amended to read as follows:
   2. (A) The provision of qualifying  health  care  costs  to  qualified
 plaintiffs  shall  not  be  subject  to  prior  authorization, except as
 described by the commissioner in regulation; provided, however:
   [(a)] (I) such regulation shall not prevent qualified plaintiffs  from
 receiving  care  or  assistance  that would, at a minimum, be authorized
 under the medicaid program;
   [(b)] (II) if any prior authorization is required by such  regulation,
 the  regulation  shall  require that requests for prior authorization be
 processed within a reasonably prompt period of time and shall identify a
 process for prompt administrative review of any denial of a request  for
 prior authorization; and
   [(c)] (III) such regulations shall not prohibit qualifying health care
 costs  on  the  grounds  that  the qualifying health care cost may inci-
 dentally benefit other members of the household, provided  that  whether
 the  qualifying  health  care cost primarily benefits the patient may be
 considered.
   (B) UNDER NO CIRCUMSTANCES SHALL A PARENT, OR A GUARDIAN RESIDING WITH
 THE ENROLLEE, WHO IS LEGALLY REQUIRED TO PROVIDE CARE AND SUPPORT  TO  A
 QUALIFIED  PLAINTIFF BE APPROVED AS A PROVIDER OF QUALIFYING HEALTH CARE
 COSTS REIMBURSABLE BY THE FUND.
   4. The amount of qualifying health care costs to be paid from the fund
 shall be calculated on the basis of one hundred percent of the usual and
 customary cost. For the purposes of this section, "usual  and  customary
 costs"  shall  mean  the  eightieth  percentile  of  all charges for the
 particular health care service performed by a provider in  the  same  or
 similar specialty and provided in the same geographical area as reported
 in a benchmarking database maintained by a nonprofit organization speci-
 fied  by  the superintendent of financial services. If no such rates are
 available qualifying health care costs shall be calculated on the  basis
 of  no  less  than one hundred thirty percent of Medicaid or ONE HUNDRED
 PERCENT OF Medicare rates of reimbursement, whichever is higher.  If  no
 such  rate  exists,  costs shall be reimbursed as defined by the commis-
 sioner in regulation.
   § 3. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2021; provided,
 however,  that  the amendments to subdivision 4 of section 2999-j of the
 public health law made by section two of this act shall not  affect  the
 expiration of such subdivision and shall be deemed to expire therewith.

 S. 2507--A                         100                        A. 3007--A
 
                                  PART GG
 
   Section  1.  Subdivision  1 of section 12 of the public health law, as
 amended by section 16 of part A of chapter 58 of the laws  of  2008,  is
 amended and a new paragraph (e) is added to read as follows:
   1.  (a)  Except as provided in paragraphs (b) and (c) of this subdivi-
 sion, any person who  violates,  disobeys  or  disregards  any  term  or
 provision  of  this chapter or of any lawful notice, order or regulation
 pursuant thereto for which a civil penalty is  not  otherwise  expressly
 prescribed  by  law,  shall  be  liable to the people of the state for a
 civil penalty [of] not to exceed [two] TEN thousand  dollars  for  every
 such violation.
   (b)  The penalty provided for in paragraph (a) of this subdivision may
 be increased to an amount not to exceed [five] FIFTEEN 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 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.
   (c)  The penalty provided for in paragraph (a) of this subdivision may
 be increased to an amount  not  to  exceed  [ten]  TWENTY-FIVE  thousand
 dollars  if  the  violation directly results in serious physical harm to
 any patient or patients.
   (D) Effective on and after April first, two thousand  [eight]  TWENTY-
 ONE the comptroller is hereby authorized and directed to deposit amounts
 collected  in excess of [two] TEN thousand dollars BUT LESS THAN FIFTEEN
 THOUSAND DOLLARS per violation to the patient safety center  account  to
 be  used  for purposes of the patient safety center created by title two
 of article twenty-nine-D of this chapter.
   (E) EFFECTIVE ON AND  AFTER  APRIL  FIRST,  TWO  THOUSAND  TWENTY-ONE,
 AMOUNTS COLLECTED FOR VIOLATIONS OF ARTICLE TWENTY-EIGHT, THIRTY-SIX, OR
 FORTY  OF THIS CHAPTER EQUAL TO OR IN EXCESS OF FIFTEEN THOUSAND DOLLARS
 PER VIOLATION MAY BE USED BY THE COMMISSIONER,  NOTWITHSTANDING  SECTION
 ONE  HUNDRED TWELVE OR ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW,
 FOR INITIATIVES THAT, IN THE DISCRETION OF THE COMMISSIONER, ARE  LIKELY
 TO  IMPROVE  THE QUALITY OF CARE OR QUALITY OF LIFE OF PATIENTS OR RESI-
 DENTS SERVED BY PROVIDERS LICENSED  PURSUANT  TO  ARTICLE  TWENTY-EIGHT,
 THIRTY-SIX, OR FORTY OF THIS CHAPTER. SUCH PURPOSES MAY INCLUDE, BUT ARE
 NOT  LIMITED  TO,  SURVEILLANCE  AND  INSPECTION  ACTIVITIES; ACTIVITIES
 DESIGNED TO IMPROVE THE QUALITY, PERFORMANCE AND  COMPLIANCE  OF  POORLY
 PERFORMING  PROVIDERS;  TRAINING  AND  EDUCATION  OF PROVIDER STAFF; AND
 IMPROVING PATIENT, RESIDENT, AND CONSUMER INVOLVEMENT IN INITIATIVES  TO
 IMPROVE PATIENT AND RESIDENT QUALITY OF CARE OR QUALITY OF LIFE.
   §  2. Subdivision 1 of section 12 of the public health law, as amended
 by chapter 190 of the laws of 1990, is amended and four  new  paragraphs
 (b), (c), (d) and (e) are added to read as follows:
   1.  [Any]  (A)  EXCEPT  AS  PROVIDED IN PARAGRAPHS (B) AND (C) OF THIS
 SUBDIVISION, ANY person who violates, disobeys or disregards any term or
 provision of this chapter or of any lawful notice, order  or  regulation
 pursuant  thereto  for  which a civil penalty is not otherwise expressly
 prescribed by law, shall be liable to the people  of  the  state  for  a
 civil  penalty  [of]  not to exceed [two] TEN thousand dollars for every
 such violation.
   (B) THE PENALTY PROVIDED FOR IN PARAGRAPH (A) OF THIS SUBDIVISION  MAY
 BE  INCREASED  TO AN AMOUNT NOT TO EXCEED FIFTEEN THOUSAND DOLLARS FOR A
 SUBSEQUENT VIOLATION IF THE PERSON COMMITTED THE  SAME  VIOLATION,  WITH

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 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 PENALTY PROVIDED FOR IN PARAGRAPH (A) OF THIS SUBDIVISION MAY
 BE INCREASED TO AN AMOUNT NOT TO EXCEED TWENTY-FIVE THOUSAND DOLLARS  IF
 THE  VIOLATION  DIRECTLY RESULTS IN SERIOUS PHYSICAL HARM TO ANY PATIENT
 OR PATIENTS.
   (D) EFFECTIVE ON AND AFTER APRIL FIRST, TWO  THOUSAND  TWENTY-ONE  THE
 COMPTROLLER  IS  HEREBY  AUTHORIZED  AND  DIRECTED  TO  DEPOSIT  AMOUNTS
 COLLECTED IN EXCESS OF TEN THOUSAND DOLLARS BUT LESS THAN FIFTEEN  THOU-
 SAND  DOLLARS  PER  VIOLATION TO THE PATIENT SAFETY CENTER ACCOUNT TO BE
 USED FOR PURPOSES OF THE PATIENT SAFETY CENTER CREATED BY TITLE  TWO  OF
 ARTICLE TWENTY-NINE-D OF THIS CHAPTER.
   (E)  EFFECTIVE  ON  AND  AFTER  APRIL  FIRST, TWO THOUSAND TWENTY-ONE,
 AMOUNTS COLLECTED FOR VIOLATIONS OF ARTICLE TWENTY-EIGHT, THIRTY-SIX, OR
 FORTY OF THIS CHAPTER EQUAL TO OR IN EXCESS OF FIFTEEN THOUSAND  DOLLARS
 PER  VIOLATION  MAY BE USED BY THE COMMISSIONER, NOTWITHSTANDING SECTION
 ONE HUNDRED TWELVE OR ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE  LAW,
 FOR  INITIATIVES THAT, IN THE DISCRETION OF THE COMMISSIONER, ARE LIKELY
 TO IMPROVE THE QUALITY OF CARE OR QUALITY OF LIFE OF PATIENTS  OR  RESI-
 DENTS  SERVED  BY  PROVIDERS  LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT,
 THIRTY-SIX, OR FORTY OF THIS CHAPTER. SUCH PURPOSES MAY INCLUDE, BUT ARE
 NOT LIMITED  TO,  SURVEILLANCE  AND  INSPECTION  ACTIVITIES;  ACTIVITIES
 DESIGNED  TO  IMPROVE  THE QUALITY, PERFORMANCE AND COMPLIANCE OF POORLY
 PERFORMING PROVIDERS; TRAINING AND  EDUCATION  OF  PROVIDER  STAFF;  AND
 IMPROVING  PATIENT, RESIDENT, AND CONSUMER INVOLVEMENT IN INITIATIVES TO
 IMPROVE PATIENT AND RESIDENT QUALITY OF CARE OR QUALITY OF LIFE.
   § 3. Subdivision 2 of section  12-b  of  the  public  health  law,  as
 amended  by  section  17 of part A of chapter 58 of the laws of 2008, is
 amended to read as follows:
   2. A person who wilfully violates any provision of  this  chapter,  or
 any  regulation  lawfully  made  or established by any public officer or
 board under authority of this  chapter,  the  punishment  for  violating
 which  is  not otherwise prescribed by this chapter or any other law, is
 punishable by imprisonment not exceeding one year,  or  by  a  fine  not
 exceeding  [ten]  TWENTY-FIVE  thousand dollars or by both. Effective on
 and after April first, two thousand [eight] TWENTY-ONE  the  comptroller
 is hereby authorized and directed to deposit amounts collected in excess
 of [two] TEN thousand dollars BUT LESS THAN FIFTEEN THOUSAND DOLLARS per
 violation  to  the patient safety center account to be used for purposes
 of the patient safety center created by title  two  of  article  twenty-
 nine-D of this chapter. EFFECTIVE ON AND AFTER APRIL FIRST, TWO THOUSAND
 TWENTY-ONE,  AMOUNTS  COLLECTED  FOR VIOLATIONS OF ARTICLE TWENTY-EIGHT,
 THIRTY-SIX, OR FORTY OF THIS CHAPTER EQUAL TO OR IN  EXCESS  OF  FIFTEEN
 THOUSAND  DOLLARS PER VIOLATION MAY BE USED BY THE COMMISSIONER PURSUANT
 TO PARAGRAPH (E) OF SUBDIVISION ONE OF SECTION TWELVE OF THIS CHAPTER.
   § 4. Subdivision 2 of section  12-b  of  the  public  health  law,  as
 amended  by  chapter  463  of  the  laws  of 1969, is amended to read as
 follows:
   2. A person who wilfully violates any provision of  this  chapter,  or
 any  regulation  lawfully  made  or established by any public officer or
 board under authority of this  chapter,  the  punishment  for  violating
 which  is  not otherwise prescribed by this chapter or any other law, is
 punishable by imprisonment not exceeding one year,  or  by  a  fine  not
 exceeding  [two]  TWENTY-FIVE  thousand dollars or by both. EFFECTIVE ON

 S. 2507--A                         102                        A. 3007--A
 
 AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-ONE THE COMPTROLLER IS HEREBY
 AUTHORIZED AND DIRECTED TO DEPOSIT AMOUNTS COLLECTED IN  EXCESS  OF  TEN
 THOUSAND DOLLARS BUT LESS THAN FIFTEEN THOUSAND DOLLARS PER VIOLATION TO
 THE PATIENT SAFETY CENTER ACCOUNT TO BE USED FOR PURPOSES OF THE PATIENT
 SAFETY  CENTER  CREATED  BY  TITLE  TWO OF ARTICLE TWENTY-NINE-D OF THIS
 CHAPTER. EFFECTIVE ON AND AFTER APRIL FIRST,  TWO  THOUSAND  TWENTY-ONE,
 AMOUNTS COLLECTED FOR VIOLATIONS OF ARTICLE TWENTY-EIGHT, THIRTY-SIX, OR
 FORTY  OF THIS CHAPTER EQUAL TO OR IN EXCESS OF FIFTEEN THOUSAND DOLLARS
 PER VIOLATION MAY BE USED BY THE COMMISSIONER PURSUANT TO PARAGRAPH  (E)
 OF SUBDIVISION ONE OF SECTION TWELVE OF THIS CHAPTER.
   §  5.  Paragraph  (c)  of  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:
   (c) assess any penalty prescribed for a violation of or a  failure  to
 comply  with  any  term  or  provision  of this chapter or of any lawful
 notice, order or regulation pursuant thereto, not exceeding [two]  TWEN-
 TY-FIVE  thousand  dollars  for  every  such violation or failure, which
 penalty may be assessed after a hearing or an opportunity to be heard;
   § 6. The opening paragraph of subdivision 11 of section 2801-a of  the
 public  health  law, as amended by section 57 of part A of chapter 58 of
 the laws of 2010, is amended and a new paragraph (e) is added to read as
 follows:
   Any person filing a proposed certificate of incorporation, articles of
 organization or an application for establishment of a residential health
 care facility for approval of the  public  health  and  health  planning
 council shall file with the commissioner such information [on the owner-
 ship  of  the  property  interests  in such facility as shall] AS MAY be
 prescribed by regulation, including, BUT NOT LIMITED TO, the following:
   (E) INFORMATION PERTAINING TO STAFFING, THE SOURCE  OF  STAFFING,  AND
 STAFF SKILL MIX.
   §  7. Section 2803-w of the public health law, as added by chapter 677
 of the laws of 2019, is amended to read as follows:
   § 2803-w. Independent quality monitors AND QUALITY IMPROVEMENT  ORGAN-
 IZATIONS  for  residential health care facilities. 1. The department may
 require a residential health  care  facility  OR  GROUP  OF  RESIDENTIAL
 HEALTH  CARE  FACILITIES to contract with an independent quality monitor
 selected, and on reasonable terms determined, by the department,  pursu-
 ant  to a selection process conducted notwithstanding [sections] SECTION
 one hundred twelve or one hundred sixty-three of the state finance  law,
 for  purposes of monitoring the operator's compliance with a written and
 mandatory corrective plan and reporting to the department on the  imple-
 mentation  of such corrective action, when the department has determined
 in its discretion that operational deficiencies exist at  such  facility
 that show:
   [1.]  (A)  a  condition  or conditions in substantial violation of the
 standards for health, safety, or resident care  established  in  law  or
 regulation that constitute a danger to resident health or safety;
   [2.]  (B) a pattern or practice of habitual violation of the standards
 of health, safety, or resident care established in law or regulation; or
   [3.] (C) any other condition dangerous to resident  life,  health,  or
 safety.    Such written mandatory corrective plans shall include caps on
 administrative and general costs that are unrelated to providing  direct
 care (including providing at least minimum staffing levels as determined
 by the department) or care coordination.
   2.  WHERE, IN TWO CONSECUTIVE INSPECTIONS, REGARDLESS OF THE TIMEFRAME
 BETWEEN SUCH INSPECTIONS, A RESIDENTIAL HEALTH CARE  FACILITY  HAS  BEEN

 S. 2507--A                         103                        A. 3007--A
 
 ISSUED  MORE THAN ONE STATEMENT OF DEFICIENCIES CITING VIOLATIONS OF THE
 DEPARTMENT'S REGULATIONS CONCERNING INFECTION CONTROL, SUCH  RESIDENTIAL
 HEALTH  CARE FACILITY SHALL, AT ITS OWN EXPENSE, CONTRACT WITH A QUALITY
 IMPROVEMENT  ORGANIZATION,  OR  SUCH  OTHER  INDEPENDENT QUALITY MONITOR
 SELECTED BY THE  DEPARTMENT,  TO  ASSESS  AND  RESOLVE  SUCH  FACILITY'S
 INFECTION  CONTROL  DEFICIENCIES,  INCLUDING  ESTABLISHING NEW INFECTION
 CONTROL POLICIES AND PROCEDURES IN CONSULTATION WITH SUCH  ORGANIZATION.
 THE  ADMINISTRATOR,  DIRECTOR  OF  NURSING, AND MEDICAL DIRECTOR OF SUCH
 RESIDENTIAL HEALTH CARE FACILITY SHALL WORK WITH AND  PROVIDE  NECESSARY
 SUPPORT, FACILITY ACCESS, AND INFORMATION TO SUCH ORGANIZATION TO EFFEC-
 TUATE RESOLUTION OF INFECTION CONTROL DEFICIENCIES.
   3. FOR THE PURPOSES OF THIS SECTION:
   (A)  "QUALITY  IMPROVEMENT  ORGANIZATION"  SHALL  MEAN AN ORGANIZATION
 OPERATING WITH THE PURPOSE OF IMPROVING HEALTHCARE QUALITY FOR  MEDICARE
 BENEFICIARIES, WHICH HAS BEEN DESIGNATED BY THE UNITED STATES DEPARTMENT
 OF  HEALTH AND HUMAN SERVICES, CENTERS OF MEDICARE AND MEDICAID SERVICES
 THROUGH THE QUALITY IMPROVEMENT ORGANIZATION PROGRAM; AND
   (B) "INDEPENDENT QUALITY MONITOR" SHALL MEAN  AN  ORGANIZATION,  OTHER
 THAN  A QUALITY IMPROVEMENT ORGANIZATION, WHICH HAS BEEN SELECTED BY THE
 DEPARTMENT PURSUANT TO SUBDIVISION ONE OR TWO OF THIS SECTION.
   § 8. The public health law is amended by adding a new section 2828  to
 read as follows:
   §  2828.  RESIDENTIAL  HEALTH  CARE  FACILITIES;  EXCESS  REVENUE.  1.
 NOTWITHSTANDING ANY LAW TO THE CONTRARY, THE DEPARTMENT SHALL PROMULGATE
 REGULATIONS GOVERNING THE DISPOSITION OF REVENUE IN EXCESS  OF  EXPENSES
 FOR  RESIDENTIAL  HEALTH CARE FACILITIES. SUCH REGULATIONS SHALL REQUIRE
 THAT A MINIMUM OF SEVENTY PERCENT OF REVENUE BE SPENT ON DIRECT RESIDENT
 CARE, AND THAT FORTY PERCENT OF REVENUE SHALL BE SPENT ON  RESIDENT-FAC-
 ING  STAFFING,  PROVIDED  THAT AMOUNTS SPENT ON RESIDENT-FACING STAFFING
 SHALL BE INCLUDED AS A PART OF AMOUNTS SPENT ON  DIRECT  RESIDENT  CARE.
 BEGINNING  ON  AND AFTER JANUARY FIRST, TWO THOUSAND TWENTY-TWO, FIFTEEN
 PERCENT OF  COSTS  ASSOCIATED  WITH  RESIDENT-FACING  STAFFING  THAT  IS
 CONTRACTED  OUT  BY A FACILITY SHALL BE DEDUCTED FROM THE CALCULATION OF
 THE AMOUNT SPENT ON RESIDENT-FACING STAFFING AND DIRECT  RESIDENT  CARE.
 SUCH REGULATIONS SHALL FURTHER INCLUDE AT A MINIMUM THAT ANY RESIDENTIAL
 HEALTH  CARE  FACILITY  FOR  WHICH TOTAL OPERATING REVENUE EXCEEDS TOTAL
 OPERATING AND NON-OPERATING EXPENSES BY MORE THAN FIVE PERCENT OF  TOTAL
 OPERATING AND NON-OPERATING EXPENSES, OR THAT FAILS TO SPEND THE MINIMUM
 AMOUNT NECESSARY TO COMPLY WITH THE MINIMUM SPENDING STANDARDS FOR RESI-
 DENT-FACING  STAFFING  OR  DIRECT RESIDENT CARE, CALCULATED ON AN ANNUAL
 BASIS, SHALL EXPEND SUCH EXCESS REVENUE, OR THE DIFFERENCE  BETWEEN  THE
 MINIMUM  SPENDING REQUIREMENT AND THE ACTUAL AMOUNT OF SPENDING ON RESI-
 DENT-FACING STAFFING OR DIRECT CARE STAFFING, AS THE CASE MAY BE,  IN  A
 MANNER  TO  BE  DETERMINED  BY SUCH REGULATIONS, BY OCTOBER FIRST OF THE
 FOLLOWING YEAR. IN THE EVENT ANY RESIDENTIAL HEALTH CARE FACILITY  FAILS
 TO  SPEND  ANY EXCESS REVENUE IN THE MANNER DIRECTED BY SUCH REGULATIONS
 BY OCTOBER FIRST OF THE FOLLOWING YEAR, SUCH  EXCESS  REVENUE  SHALL  BE
 PAYABLE  TO  THE  STATE  BY  NOVEMBER FIRST OF SUCH YEAR. THE DEPARTMENT
 SHALL COLLECT SUCH PAYMENTS BY METHODS INCLUDING, BUT  NOT  LIMITED  TO,
 DEDUCTIONS  OR  OFFSETS  FROM  PAYMENTS  MADE  PURSUANT  TO THE MEDICAID
 PROGRAM.
   2. FOR THE PURPOSES OF THIS SECTION AND SECTION  TWENTY-EIGHT  HUNDRED
 TWENTY-EIGHT-A  OF  THIS  ARTICLE,  THE  FOLLOWING  TERMS SHALL HAVE THE
 FOLLOWING MEANINGS:

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   (A) "REVENUE" SHALL MEAN THE TOTAL OPERATING REVENUE  FROM  ALL  PAYER
 SOURCES AS REPORTED IN THE RESIDENTIAL HEALTH CARE FACILITY COST REPORTS
 SUBMITTED TO THE DEPARTMENT.
   (B) "EXPENSES" SHALL INCLUDE ALL OPERATING AND NON-OPERATING EXPENSES,
 BEFORE  EXTRAORDINARY GAINS, REPORTED IN COST REPORTS SUBMITTED PURSUANT
 TO THIS SECTION, EXCEPT AS EXPRESSLY EXCLUDED BY REGULATIONS AND/OR THIS
 SECTION. SUCH EXCLUSIONS SHALL INCLUDE,  BUT  NOT  BE  LIMITED  TO,  ANY
 RELATED  PARTY  TRANSACTION  TO THE EXTENT THAT THE VALUE OF SUCH TRANS-
 ACTION IS GREATER THAN FAIR MARKET VALUE, AND  THE  PAYMENT  OF  COMPEN-
 SATION  FOR  EMPLOYEES  WHO  ARE  NOT  ACTIVELY  ENGAGED IN OR PROVIDING
 SERVICES AT THE FACILITY.
   (C) "DIRECT RESIDENT CARE" SHALL EXCLUDE, AT  A  MINIMUM  AND  WITHOUT
 LIMITATION,  CAPITAL DEPRECIATION, RENT AND LEASES, FISCAL SERVICES, AND
 ADMINISTRATIVE SERVICES.
   (D) "RESIDENT-FACING STAFFING" SHALL INCLUDE ALL STAFFING EXPENSES  IN
 THE  ANCILLARY AND PROGRAM SERVICES CATEGORIES ON EXHIBIT H OF THE RESI-
 DENTIAL HEALTH CARE REPORTS AS IN  EFFECT  ON  FEBRUARY  FIFTEENTH,  TWO
 THOUSAND  TWENTY-ONE; PROVIDED THAT THE DEPARTMENT MAY BY REGULATION, OR
 BY EMERGENCY REGULATION, ADJUST SUCH STAFFING EXPENSES TO ALIGN WITH ANY
 CHANGE TO THE RESIDENTIAL HEALTH CARE REPORTS.
   § 8-a. The public health law is amended by adding a new section 2828-a
 to read as follows:
   § 2828-A. EXCESS REVENUES FOR MANAGEMENT SALARIES. WITHIN THE  AMOUNTS
 PRESCRIBED BY SECTION TWENTY-EIGHT HUNDRED TWENTY-EIGHT OF THIS ARTICLE,
 A SALARY FOR ANY EXECUTIVE OR MANAGERIAL POSITION WHICH DOES NOT INVOLVE
 DIRECT  RESIDENT  CARE  SHALL BE LIMITED BY REGULATION BY THE DEPARTMENT
 BASED UPON THE NUMBER OF BEDS FOR RESIDENT CARE AT SUCH FACILITY. IN ANY
 EVENT SUCH SALARY SHALL NOT EXCEED TWO HUNDRED  FIFTY  THOUSAND  DOLLARS
 ANNUALLY. PROVIDED FURTHER, NOTWITHSTANDING ANY OTHER LAW TO THE CONTRA-
 RY,  A  RESIDENTIAL  CARE  FACILITY  SHALL  NOT EXPEND MORE THAN FIFTEEN
 PERCENT OF EXPENSES ON EXECUTIVE OR MANAGERIAL SALARIES, AND THE DEPART-
 MENT SHALL BE AUTHORIZED TO PROMULGATE REGULATIONS  TO  EFFECTUATE  THIS
 SECTION.
   §  9. Section 2860 of the public health law is amended by adding three
 new subdivisions 3, 4 and 5 to read as follows:
   3. A COMPANY SHALL POST MAXIMUM RATES TO BE CHARGED FOR FACILITIES AND
 SERVICES, FIXED PURSUANT TO  SUBDIVISION  ONE  OF  THIS  SECTION,  ON  A
 PUBLICLY  ACCESSIBLE WEBSITE. SUCH POSTING SHALL BE UPDATED ON AN ANNUAL
 BASIS NO LATER THAN APRIL FIRST OF EACH YEAR. SUCH POSTING SHALL  DETAIL
 RATES FOR EACH NON-GOVERNMENTAL PAYER SOURCE.
   4.  A  COMPANY  SHALL: (A) PUBLICLY LIST ALL OWNERS ON A WEBSITE MAIN-
 TAINED BY THE FACILITY AND SHALL SUBMIT SUCH LIST TO THE DEPARTMENT  FOR
 POSTING ON ITS WEBSITE AND UPDATE SUCH INFORMATION WITHIN THIRTY DAYS OF
 ANY  CHANGE OR TRANSACTION AFFECTING OWNERSHIP; (B) PUBLICLY DISCLOSE ON
 SUCH FACILITY'S WEBSITE AND  REGULARLY  UPDATE  THE  NAME  AND  BUSINESS
 ADDRESS  OF  ANY  LANDLORD OF SUCH FACILITY'S PREMISES; AND (C) PUBLICLY
 PROVIDE A SUMMARY OF ALL CONTRACTS FOR PROVISION OF  GOODS  OR  SERVICES
 FOR  WHICH  SUCH  FACILITY PAYS WITH ANY PORTION OF MEDICAID OR MEDICARE
 FUNDS OR OTHER AGREEMENTS ENTERED INTO BY THE COMPANY ON SUCH FACILITY'S
 WEBSITE WITHIN THIRTY DAYS OF EXECUTION OF SUCH AGREEMENT OR CONTRACT.
   5. THE COMMISSIONER MAY PROMULGATE SUCH REGULATIONS AS MAY  BE  DEEMED
 NECESSARY  OR  APPROPRIATE  TO  IMPLEMENT SUBDIVISIONS THREE AND FOUR OF
 THIS SECTION.
   § 10. Subdivision 7 of section 460-d of the social  services  law,  as
 added  by  chapter  669 of the laws of 1977, paragraph (a) as amended by
 chapter 719 of the laws of 1989, paragraph (b) as amended by chapter 524

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 of the laws of 1984, and paragraph 2 of  paragraph  (b)  as  amended  by
 chapter 733 of the laws of 1994, is amended to read as follows:
   7.  (a)  The  department  shall  adopt  regulations establishing civil
 penalties of up to [one] TEN thousand dollars per  day  to  be  assessed
 against all adult care facilities except facilities operated by a social
 services  district  for  violations of (i) regulations of the department
 pertaining to the care of residents in such facilities,  (ii)  paragraph
 (a)  of  subdivision  three  of section four hundred sixty-one-a of this
 chapter, or (iii) an order issued pursuant to subdivision eight of  this
 section. The regulations shall specify the violations subject to penalty
 and  the  amount  of  the penalty to be assessed in connection with each
 such violation and shall specify that only  civil  penalties  of  up  to
 [one]  TEN  thousand  dollars  per  day  per violation shall be assessed
 pursuant to this paragraph against an adult care facility found  respon-
 sible  for  an  act  of  retaliation  or  reprisal against any resident,
 employee, or other person for having filed a complaint  with  or  having
 provided information to any long term care patient ombudsman functioning
 in  accordance  with  section  five  hundred  forty-four or five hundred
 forty-five of the executive law.
   (b) [(1)] In addition to any other civil or criminal penalty  provided
 by law, the department shall have the power to assess civil penalties in
 accordance  with  its  regulations  adopted pursuant to paragraph (a) of
 this subdivision, after a  hearing  conducted  in  accordance  with  the
 procedures established by regulations of the department. Such procedures
 shall require that notice of the time and place of the hearing, together
 with  a statement of charges of violations, shall be served in person or
 by certified mail addressed to the facility at least thirty  days  prior
 to the date of the hearing. The statement of charges of violations shall
 set  forth  the  existence  of the violations, the amount of penalty for
 which it may become liable and the steps which must be taken to  rectify
 the  violation  and,  where  applicable, a statement that the department
 contends that a penalty may be imposed under this  paragraph  regardless
 of  rectification.  An  answer to the charges of violations, in writing,
 shall be filed with the department, not less than ten days prior to  the
 date  of  hearing. The answer shall notify the department of the facili-
 ty's position with respect to each of the charges and shall include  all
 matters which if not disclosed in the answer would be likely to take the
 department  by  surprise. The commissioner, or a member of his staff who
 is designated and authorized by him to hold such  hearing,  may  in  his
 discretion  allow  the  facility to prove any matter not included in the
 answer. [Where the facility satisfactorily demonstrates that  it  either
 had  rectified  the  violations  within thirty days of receiving written
 notification of the results of the inspection pursuant to  section  four
 hundred sixty-one-a of this chapter, or had submitted within thirty days
 an  acceptable  plan for rectification and was rectifying the violations
 in accordance with the steps and within the additional periods  of  time
 as accepted by the department in such plan, no penalty shall be imposed,
 except as provided in subparagraph two of this paragraph.
   (2)  Rectification  shall  not preclude the assessment of a penalty if
 the department establishes at a hearing  that  a  particular  violation,
 although  corrected,  endangered  or resulted in harm to any resident as
 the result of:
   (i) the total or substantial failure of the facility's fire  detection
 or  prevention systems, or emergency evacuation procedures prescribed by
 department safety standard regulations;

 S. 2507--A                         106                        A. 3007--A

   (ii) the retention of any resident who has been evaluated by the resi-
 dent's physician as being medically or mentally unsuited for care in the
 facility or as requiring placement in a hospital or  residential  health
 care facility and for whom the operator is not making persistent efforts
 to secure appropriate placement;
   (iii) the failure in systemic practices and procedures;
   (iv)  the  failure  of  the  operator  to  take actions as required by
 department regulations in the event of a resident's illness or accident;
   (v) the failure of the operator to provide at all times supervision of
 residents by numbers of staff at least equivalent to the night  staffing
 requirement set forth in department regulations; or
   (vi)  unreasonable threats of retaliation or taking reprisals, includ-
 ing but not limited to unreasonable threats of eviction or  hospitaliza-
 tion  against  any  resident,  employee  or  other  person  who  makes a
 complaint concerning the operation of an adult  care  facility,  partic-
 ipates  in  the  investigation  of  a  complaint or is the subject of an
 action identified in a complaint.
   The department shall specify in its regulations those  regulations  to
 which this subparagraph two shall apply.
   (3)  In assessing penalties pursuant to this paragraph, the department
 shall consider promptness of  rectification,  delay  occasioned  by  the
 department, and the specific circumstances of the violations as mitigat-
 ing factors.]
   (c)  Upon  the  request  of  the  department, the attorney general may
 commence an action in any court of competent  jurisdiction  against  any
 facility  subject  to  the  provisions  of this section, and against any
 person or corporation operating such facility, for the recovery  of  any
 penalty  assessed by the department in accordance with the provisions of
 this subdivision.
   (d) Any such penalty assessed by the department  may  be  released  or
 compromised by the department before the matter has been referred to the
 attorney  general, and where such matter has been referred to the attor-
 ney general, any such penalty may be released  or  compromised  and  any
 action  commenced to recover the same may be settled and discontinued by
 the attorney general with the consent of the department.
   § 11. Paragraph (a) of subdivision 9 of section 460-d  of  the  social
 services  law, as amended by chapter 558 of the laws of 1999, is amended
 to read as follows:
   (a) The department shall have authority to impose a civil penalty  not
 exceeding  [one]  TEN  thousand dollars per day against, and to issue an
 order requiring the closing of,  after  notice  and  opportunity  to  be
 heard, any facility which does not possess a valid operating certificate
 issued  by  the  department and is an adult care facility subject to the
 provisions of this article and the  regulations  of  the  department.  A
 hearing  shall be conducted in accordance with procedures established by
 department regulations which procedures shall require that notice of the
 determination that the facility  is  an  adult  care  facility  and  the
 reasons  for  such determination and notice of the time and place of the
 hearing be served in person on the operator, owner or prime  lessor,  if
 any,  or  by certified mail, return receipt requested, addressed to such
 person and received at least twenty days prior to the date of the  hear-
 ing.  If  such  operator, owner or prime lessor, if any, is not known to
 the department, then service may be made by posting a copy thereof in  a
 conspicuous  place  within  the facility or by sending a copy thereof by
 certified mail, return receipt requested, addressed to the  facility.  A
 written  answer to the notice of violation may be filed with the depart-

 S. 2507--A                         107                        A. 3007--A
 
 ment not less than five days prior to the date of the hearing.    Demon-
 stration  by  the  facility  that  it possessed an operating certificate
 issued pursuant to this article,  article  twenty-eight  of  the  public
 health law or article sixteen, twenty-three, thirty-one or thirty-two of
 the  mental  hygiene  law  at  the  time the hearing was commenced shall
 constitute a complete defense to  any  charges  made  pursuant  to  this
 subdivision.
   §  12.  Subdivision  (c) of section 122 of part E of chapter 56 of the
 laws of 2013 amending the public health  law  relating  to  the  general
 public health work program, as amended by section 7 of part E of chapter
 57 of the laws of 2019, is amended to read as follows:
   (c) section fifty of this act shall take effect immediately [and shall
 expire nine years after it becomes law];
   §  13.  Subdivisions  2,  3,  5  and 6 of section 2806-a of the public
 health law, as added by section 50 of part E of chapter 56 of  the  laws
 of  2013, and paragraph (a) of subdivision 2 as amended by section 8 and
 subparagraph (iii) of paragraph (c)  of  subdivision  5  as  amended  by
 section  9  of  part K of chapter 57 of the laws of 2015, are amended to
 read as follows:
   2. (a) In the event that: (i) a facility seeks extraordinary financial
 assistance and the commissioner finds that the facility is  experiencing
 serious financial instability that is jeopardizing existing or continued
 access  to  essential services within the community, or (ii) the commis-
 sioner finds that there are conditions within the facility  that  [seri-
 ously] endanger the life, health or safety of residents or patients, the
 commissioner may appoint a temporary operator to assume sole control and
 sole  responsibility  for  the operations of that facility, or (iii) the
 commissioner finds that there has been an improper delegation of manage-
 ment authority by the governing  authority  or  operator  of  a  general
 hospital,  the commissioner shall appoint a temporary operator to assume
 sole control and sole responsibility for the operations of that  facili-
 ty.  The  appointment  of  the  temporary  operator shall be effectuated
 pursuant to this section and shall be in addition to any other  remedies
 provided by law.
   (b) The established operator of a facility may at any time request the
 commissioner  to  appoint  a  temporary  operator. Upon receiving such a
 request, the commissioner may, if he or  she  determines  that  such  an
 action is necessary to restore or maintain the provision of quality care
 to  the  residents  or  patients  or  alleviate the facility's financial
 instability, enter into an agreement with the established  operator  for
 the  appointment of a temporary operator to assume sole control and sole
 responsibility for the operations of that facility.
   3. (a) A temporary operator appointed pursuant to this section  shall,
 prior  to  his  or  her  appointment  as temporary operator, provide the
 commissioner with a  work  plan  satisfactory  to  the  commissioner  to
 address  the  facility's  deficiencies and serious financial instability
 and a schedule for implementation of such plan. A work plan shall not be
 required prior to the appointment of the temporary operator [pursuant to
 clause (ii) of paragraph (a) of subdivision two of this section] if  the
 commissioner  has  determined that the immediate appointment of a tempo-
 rary operator is necessary because public health or safety is  in  immi-
 nent  danger  or  there exists any condition or practice or a continuing
 pattern of conditions or practices which poses imminent  danger  to  the
 health  or safety of any patient or resident of the facility. Where such
 immediate appointment has been found  to  be  necessary,  the  temporary

 S. 2507--A                         108                        A. 3007--A
 
 operator shall provide the commissioner with a work plan satisfactory to
 the commissioner as soon as practicable.
   (b) The temporary operator shall use his or her best efforts to imple-
 ment  the  work plan provided to the commissioner, if applicable, and to
 correct or eliminate any deficiencies or financial  instability  in  the
 facility  and  to  promote  the quality and accessibility of health care
 services in the community served by the  facility.  Such  correction  or
 elimination  of  deficiencies or serious financial instability shall not
 include major alterations of the physical  structure  of  the  facility.
 During  the term of his or her appointment, the temporary operator shall
 have the sole authority to direct the management of the facility in  all
 aspects  of  operation and shall be afforded full access to the accounts
 and records of the facility. The temporary operator shall,  during  this
 period,  operate  the facility in such a manner as to promote safety and
 the quality and accessibility of health  care  services  or  residential
 care  in  the  community  served by the facility. The temporary operator
 shall have the power to let contracts  therefor  or  incur  expenses  on
 behalf of the facility, provided that where individual items of repairs,
 improvements  or  supplies  exceed  ten  thousand dollars, the temporary
 operator shall obtain price quotations from  at  least  three  reputable
 sources.  The temporary operator shall not be required to file any bond.
 No security interest in any real or  personal  property  comprising  the
 facility  or  contained  within  the  facility, or in any fixture of the
 facility, shall be impaired or diminished in priority by  the  temporary
 operator. Neither the temporary operator nor the department shall engage
 in  any activity that constitutes a confiscation of property without the
 payment of fair compensation.
   5. (a) The initial term of the appointment of the  temporary  operator
 shall not exceed one hundred eighty days. After one hundred eighty days,
 if  the commissioner determines that termination of the temporary opera-
 tor would cause significant deterioration of the quality of,  or  access
 to,  health care or residential care in the community or that reappoint-
 ment is necessary to correct the conditions  within  the  facility  that
 [seriously]  endanger  the  life,  health  or  safety  of  residents  or
 patients, or the financial instability that required the appointment  of
 the  temporary  operator, the commissioner may authorize up to two addi-
 tional ninety-day terms.
   (b) Upon the completion of the  two  ninety-day  terms  referenced  in
 paragraph (a) of this subdivision,
   (i) if the established operator is the debtor in a bankruptcy proceed-
 ing,  and  the  commissioner  determines  that  the  temporary  operator
 requires additional terms to operate the facility during the pendency of
 the bankruptcy proceeding and to carry out any plan resulting  from  the
 proceeding,  the  commissioner  may reappoint the temporary operator for
 additional ninety-day terms until  the  termination  of  the  bankruptcy
 proceeding,  provided that the commissioner shall provide for notice and
 a hearing as set forth in subdivision six of this section; or
   (ii) if the established operator requests  the  reappointment  of  the
 temporary  operator, the commissioner may reappoint the temporary opera-
 tor for one additional ninety-day term, pursuant to an agreement between
 the established operator, the temporary operator and the department.
   (c) Within fourteen days prior to the termination of each term of  the
 appointment  of  the  temporary  operator,  the temporary operator shall
 submit to the commissioner and to  the  established  operator  a  report
 describing:

 S. 2507--A                         109                        A. 3007--A
 
   (i) the actions taken during the appointment to address such deficien-
 cies and financial instability,
   (ii)  objectives for the continuation of the temporary operatorship if
 necessary and a schedule for satisfaction of such objectives,
   (iii) recommended actions for the ongoing operation  of  the  facility
 subsequent  to  the term of the temporary operator including recommenda-
 tions regarding the proper management of the facility and ongoing agree-
 ments with individuals or entities with proper delegation of  management
 authority; and
   (iv) with respect to the first ninety-day term referenced in paragraph
 (a)  of  this  subdivision,  a  plan  for sustainable operation to avoid
 closure, or transformation of the facility which may include any  option
 permissible under this chapter or the social services law and implement-
 ing  regulations  thereof.  The  report  shall  reflect  best efforts to
 produce a full and complete accounting.
   (d) The term of the initial appointment and of  any  subsequent  reap-
 pointment  may  be  terminated prior to the expiration of the designated
 term, if the established operator and the commissioner agree on  a  plan
 of correction and the implementation of such plan.
   6.  (a)  The  commissioner,  upon  making a determination to appoint a
 temporary operator pursuant to paragraph (a) of subdivision two of  this
 section  shall,  prior to the commencement of the appointment, cause the
 established operator of the facility to be notified of the determination
 by registered or certified mail addressed to the principal office of the
 established  operator.  Such  notification  shall  include  a   detailed
 description  of  the  findings underlying the determination to appoint a
 temporary operator, and the date and time of a required meeting with the
 commissioner and/or his or her designee within ten business days of  the
 date  of  such  notice.  At such meeting, the established operator shall
 have the opportunity to review and discuss  all  relevant  findings.  At
 such  meeting  or  within ten additional business days, the commissioner
 and the established operator shall attempt to develop a mutually  satis-
 factory plan of correction and schedule for implementation. In the event
 such  plan  of  correction is agreed upon, the commissioner shall notify
 the established operator that the  commissioner  no  longer  intends  to
 appoint  a  temporary operator. A meeting shall not be required prior to
 the appointment of the temporary operator [pursuant to  clause  (ii)  of
 paragraph  (a)  of  subdivision two of this section] if the commissioner
 has determined that the immediate appointment of a temporary operator is
 necessary because public health or safety is in imminent danger or there
 exists any condition or practice or a continuing pattern  of  conditions
 or  practices which poses imminent danger to the health or safety of any
 patient or resident of the facility. Where  such  immediate  appointment
 has  been  found  to  be  necessary,  the commissioner shall provide the
 established operator with a notice as required under this  paragraph  on
 the date of the appointment of the temporary operator.
   (b)  Should the commissioner and the established operator be unable to
 establish a plan of correction pursuant to paragraph (a) of this  subdi-
 vision,  or  should  the  established  operator  fail  to respond to the
 commissioner's initial  notification,  a  temporary  operator  shall  be
 appointed  as  soon  as is practicable and shall operate pursuant to the
 provisions of this section.
   (c) The established operator shall be afforded an opportunity  for  an
 administrative  hearing on the commissioner's determination to appoint a
 temporary operator. Such administrative hearing  shall  occur  prior  to
 such appointment, except that the hearing shall not be required prior to

 S. 2507--A                         110                        A. 3007--A
 
 the  appointment  of  the temporary operator [pursuant to clause (ii) of
 paragraph (a) of subdivision two of this section]  if  the  commissioner
 has determined that the immediate appointment of a temporary operator is
 necessary because public health or safety is in imminent danger or there
 exists  any  condition or practice or a continuing pattern of conditions
 or practices which poses imminent danger to the health or safety of  any
 patient  or  resident  of  the  facility.  An  administrative hearing as
 provided for under this paragraph shall begin no later than  sixty  days
 from the date of the notice to the established operator and shall not be
 extended  without the consent of both parties. Any such hearing shall be
 strictly limited to the  issue  of  whether  the  determination  of  the
 commissioner to appoint a temporary operator is supported by substantial
 evidence. A copy of the decision shall be sent to the established opera-
 tor.
   (d) The commissioner shall, upon making a determination to reappoint a
 temporary operator for the first of an additional ninety-day term pursu-
 ant  to  paragraph  (a)  of  subdivision five of this section, cause the
 established operator of the facility to be notified of the determination
 by registered or certified mail addressed to the principal office of the
 established operator. If the  commissioner  determines  that  additional
 reappointments pursuant to subparagraph (i) of paragraph (b) of subdivi-
 sion  five  of  this  section are required, the commissioner shall again
 cause the established operator of the facility to be  notified  of  such
 determination by registered or certified mail addressed to the principal
 office  of  the established operator at the commencement of the first of
 every two additional terms. Upon receipt of  such  notification  at  the
 principal  office  of the established operator and before the expiration
 of ten days thereafter, the established operator may request an adminis-
 trative hearing on the determination to begin no later than  sixty  days
 from  the date of the reappointment of the temporary operator.  Any such
 hearing shall be strictly limited to the issue of whether  the  determi-
 nation  of  the  commissioner  to  reappoint  the  temporary operator is
 supported by substantial evidence.
   § 14. Section 2810 of the public health law is amended by adding a new
 subdivision 2-a to read as follows:
   2-A. NOTWITHSTANDING ANY OTHER LAW TO THE CONTRARY,  THE  COMMISSIONER
 MAY  APPOINT AN EMERGENCY RECEIVER, UPON NO LESS THAN TWENTY-FOUR HOURS'
 NOTICE TO THE OPERATOR OF A FACILITY, UPON A DETERMINATION  THAT  PUBLIC
 HEALTH  OR  SAFETY IS IN IMMINENT DANGER OR THAT THERE EXISTS ANY CONDI-
 TION OR PRACTICE OR A CONTINUING PATTERN OF CONDITIONS OR PRACTICES THAT
 POSES IMMINENT DANGER TO THE HEALTH OR SAFETY OF ANY PATIENT OR RESIDENT
 OF SUCH FACILITY. SUCH AN EMERGENCY RECEIVER SHALL SERVE UNTIL  A  FINAL
 DETERMINATION HAS BEEN MADE UPON AN ORDER TO SHOW CAUSE FILED IN ACCORD-
 ANCE  WITH  SUBDIVISION  TWO OF THIS SECTION; PROVIDED, HOWEVER, THAT AN
 APPLICATION FOR SUCH AN ORDER SHALL BE MADE TO THE SUPREME COURT  WITHIN
 THIRTY DAYS OF THE APPOINTMENT OF SUCH EMERGENCY RECEIVER.
   §  15.  Severability. If any provision of this act, or any application
 of any provision of this act, is held to  be  invalid,  that  shall  not
 affect  the validity or effectiveness of any other provision of this act
 or any other application of any provision of this act.
   § 16. This act shall take effect on  the  one  hundred  eightieth  day
 after it shall have become a law; provided that the amendments to subdi-
 vision  1  of section 12 of the public health law made by section one of
 this act shall be subject to the expiration and reversion of such subdi-
 vision pursuant to section 32 of part A of chapter 58  of  the  laws  of
 2008,  as  amended, when upon such date the provisions of section two of

 S. 2507--A                         111                        A. 3007--A
 
 this act shall take effect; and provided further that the amendments  to
 subdivision  2  of section 12-b of the public health law made by section
 three of this act shall be subject to the expiration  and  reversion  of
 such  subdivision  pursuant to section 32 of part A of chapter 58 of the
 laws of 2008, as amended, when upon such date the provisions of  section
 four of this act shall take effect. Effective immediately, the addition,
 amendment and/or repeal of any rule, regulation, or emergency 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 HH
 
   Section 1. Subdivision 3 of section 450 of the executive law, as added
 by chapter 588 of the laws of 1981, is amended to read as follows:
   3. (a) The [membership  of  the  developmental  disabilities  planning
 council  shall  at  all  times  include representatives of the principal
 state agencies, higher education training facilities,] FOLLOWING  PEOPLE
 SHALL SERVE AS EX OFFICIO MEMBERS OF THE COUNCIL:
   (I) THE HEAD OF ANY STATE AGENCY THAT ADMINISTERS FUNDS PROVIDED UNDER
 FEDERAL  LAWS RELATED TO INDIVIDUALS WITH DISABILITIES, OR SUCH PERSON'S
 DESIGNEE;
   (II) THE HEAD OF ANY UNIVERSITY CENTER FOR EXCELLENCE IN DEVELOPMENTAL
 DISABILITIES, OR SUCH PERSON'S DESIGNEE; AND
   (III) THE HEAD OF THE STATE'S PROTECTION AND ADVOCACY SYSTEM, OR  SUCH
 PERSON'S DESIGNEE.
   (B)  THE MEMBERSHIP OF THE DEVELOPMENTAL DISABILITIES PLANNING COUNCIL
 SHALL ALSO INCLUDE local agencies,  and  non-governmental  agencies  and
 groups  concerned  with services to persons with developmental disabili-
 ties in New York state[;].
   [(b)] (C) At  least  [one-half]  SIXTY  PERCENT  of  the  [membership]
 MEMBERS APPOINTED BY THE GOVERNOR shall consist of[:
   (i)] developmentally disabled persons or their parents or guardians or
 of immediate relatives or guardians of persons with [mentally impairing]
 developmental disabilities[,].
   [(ii)  these] (I) THESE MEMBERS may not be employees of a state agency
 receiving funds or providing services under  the  federal  developmental
 disabilities  assistance  act  or  have  a  managerial,  proprietary  or
 controlling interest in an  entity  which  receives  funds  or  provides
 services under such act,
   [(iii)  at] (II) AT least one-third of these members shall be develop-
 mentally disabled,
   [(iv) at] (III) AT least one-third OF THESE MEMBERS shall be immediate
 relatives or guardians of persons  with  [mentally  impairing]  develop-
 mental disabilities, AND
   [(v)  at]  (IV)  AT least one member shall be an immediate relative or
 guardian of an institutionalized developmentally disabled person[;
   (c) The membership may include some or all of the members of the advi-
 sory council on mental retardation and developmental disabilities].
   § 2. 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

 S. 2507--A                         112                        A. 3007--A
 
 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 HH 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
 ________________________________________________________________________
 
                                  3007--B
 
                           I N  A S S E M B L Y
 
                             January 20, 2021
                                ___________
 
 A  BUDGET  BILL,  submitted by the Governor pursuant to article seven of
   the Constitution -- read once and referred to the  Committee  on  Ways
   and  Means -- committee discharged, bill amended, ordered reprinted as
   amended and recommitted to said committee -- again reported from  said
   committee  with amendments, ordered reprinted as amended and recommit-
   ted to said committee

 AN ACT to repeal sections 91 and 92 of part H of chapter 59 of the  laws
   of  2011  relating to the year to year rate of growth of Department of
   Health state funds and Medicaid funding, relating to the  state  Medi-
   caid  spending cap and related processes (Part A); intentionally omit-
   ted (Part B); to amend part FFF of chapter 56 of  the  laws  of  2020,
   amending the public health law relating to extending and enhancing the
   Medicaid  drug  cap and to reduce unnecessary pharmacy benefit manager
   costs to the Medicaid program, in relation  to  temporarily  exempting
   covered  entities under the federal 340B program and comprehensive HIV
   special needs plans (Part C); intentionally omitted (Part  D);  inten-
   tionally  omitted (Part E); to amend the public health law in relation
   to the definition  of  originating  sites  in  regards  to  telehealth
   services  (Part  F);  to  amend  the public health law, in relation to
   authorizing the implementation of medical respite pilot programs (Part
   G); to amend the social  services  law,  in  relation  to  eliminating
   consumer-paid  premium  payments  in  the  basic  health  program; and
   providing for the repeal of certain provisions of such law upon  expi-
   ration thereof (Part H); intentionally omitted (Part I); intentionally
   omitted  (Part  J);  to amend chapter 266 of the laws of 1986 amending
   the civil practice law and rules and other laws relating  to  malprac-
   tice  and  professional  medical conduct, in relation to extending the
   physicians medical malpractice program; 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 malprac-
   tice and professional medical conduct, relating 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 extend-
   ing certain provisions relating  thereto,  in  relation  to  extending
   provisions relating to excess coverage (Part K); intentionally omitted
 
              

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD12571-03-1

 A. 3007--B                          2
 
   (Part  L); intentionally omitted (Part M); intentionally omitted (Part
   N); intentionally omitted (Part O); intentionally  omitted  (Part  P);
   intentionally  omitted  (Part  Q);  intentionally omitted (Part R); to
   amend  chapter 884 of the laws of 1990, amending the public health law
   relating to authorizing bad  debt  and  charity  care  allowances  for
   certified   home   health  agencies,  in  relation  to  extending  the
   provisions thereof; to amend chapter 109 of the laws of 2010, amending
   the social services law relating to transportation costs, in  relation
   to the effectiveness thereof; to amend chapter 81 of the laws of 1995,
   amending  the  public  health  law  and other laws relating to medical
   reimbursement and welfare reform, in  relation  to  the  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, in
   relation to extending government rates  for  behavioral  services  and
   adding  an alternative payment methodology requirement; to amend chap-
   ter 517 of the laws of 2016, amending the public health  law  relating
   to  payments  from  the  New  York  state  medical  indemnity fund, in
   relation to the effectiveness thereof; to amend the public health law,
   in relation to improved integration of health care and  financing;  to
   amend  chapter  56  of  the  laws  of 2014, amending the education law
   relating to the nurse practitioners modernization act, in relation  to
   extending  the provisions thereof; and to amend chapter 66 of the laws
   of 2016, amending the public  health  law  relating  to  reporting  of
   opioid  overdose  data, in relation to the effectiveness thereof (Part
   S); to amend part A of chapter 111 of the laws of  2010  amending  the
   mental  hygiene law relating to the receipt of federal and state bene-
   fits received by individuals receiving care in facilities operated  by
   an  office  of  the  department  of mental hygiene, in relation to the
   effectiveness thereof (Part T); intentionally  omitted  (Part  U);  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-lim-
   ited demonstration programs in relation to the effectiveness  thereof;
   and  to amend the mental hygiene law, in relation to requiring certain
   evaluations, assessments and recommendations to  be  included  in  the
   commissioners  statewide comprehensive plan (Part V); 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 work-
   force reinvestment program, the membership of subcommittees for mental
   health of community services boards and the duties of such  subcommit-
   tees  and creating the community mental health and workforce reinvest-
   ment account, in relation to extending such provisions relating there-
   to;  and  to  amend  the  mental  hygiene  law,  in  relation  to  the
   appropriation  of  funds  for  the community mental health support and
   workforce reinvestment program (Part W); intentionally  omitted  (Part
   X);  intentionally  omitted (Part Y); to amend the mental hygiene law,
   in relation to imposing sanctions  due  to  a  provider's  failure  to
   comply with the terms of their operating certificate or applicable law
   and  to charge an application processing fee for the issuance of oper-
   ating certificates (Part Z); to amend the mental hygiene law  and  the
   social  services  law,  in  relation  to crisis stabilization services
   (Subpart A); intentionally omitted (Subpart B); intentionally  omitted
   (Subpart  C) (Part AA); intentionally omitted (Part BB); intentionally
   omitted (Part CC);  intentionally  omitted  (Part  DD);  intentionally
   omitted  (Part  EE);  intentionally  omitted  (Part FF); intentionally

 A. 3007--B                          3
 
   omitted (Part GG); intentionally  omitted  (Part  HH);  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 II); to amend
   the  social  services  law, in relation to school-based health centers
   for purposes of managed care programs under  medicaid  (Part  JJ);  to
   amend  the  social services law, in relation to extending the Medicaid
   coverage period for pregnancy (Part KK); to amend  the  public  health
   law, in relation to the adult cystic fibrosis assistance program (Part
   LL);  in  relation  to  requiring the commissioner of health to review
   rates of reimbursement made through the Medicaid program for ambulette
   transportation for rate adequacy (Part MM); to amend the public health
   law, in relation to requiring the commissioner of health to review the
   rates of reimbursement and adequacy of the early intervention  program
   (Part  NN);  to  amend  chapter  495 of the laws of 2004, amending the
   insurance law and the public health law relating to the New York state
   health insurance continuation  assistance  demonstration  project,  in
   relation  to  the effectiveness thereof (Part OO); to amend the public
   health law, in relation to prohibiting  program-wide  service  limita-
   tions  (Part  PP);  to  amend  the social services law, in relation to
   eligibility for medical assistance (Part  QQ);  to  amend  the  mental
   hygiene  law,  in  relation to suicide prevention for high risk groups
   (Part RR); to amend the mental hygiene law,  in  relation  to  suicide
   prevention  for  law  enforcement,  veterans,  first  responders,  and
   correction officers (Part SS); to amend  the  public  health  law,  in
   relation  to funds for the New York state area health education center
   program for certain programs (Part TT); to amend part C of chapter  57
   of  the laws of 2006 relating to establishing a cost of living adjust-
   ment for designated human services programs, in relation to  extending
   COLA  provisions for the purpose of establishing rates of payments and
   in relation to the effectiveness  thereof  (Part  UU);  to  amend  the
   public health law, in relation to funding early intervention services;
   and  to  repeal  certain  provisions  of the public health law and the
   insurance law relating thereto (Part VV); to amend part KKK of chapter
   56 of the laws of 2020 amending the social services law and other laws
   relating  to  managed  care  encounter  data,  authorizing  electronic
   notifications,  and  establishing  regional demonstration projects, in
   relation to the regional demonstration program (Part WW); and to amend
   the public health law and the insurance law, in relation to  enhancing
   coverage and care for medically fragile children (Part XX)

   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
 necessary  to  implement  the state health and mental hygiene budget for
 the 2021-2022 state fiscal year.  Each  component  is  wholly  contained
 within  a  Part identified as Parts A through XX. 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, including the effective date of the Part, which makes  a  refer-
 ence  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 Part in which it is found. Section three of this
 act sets forth the general effective date of this act.

 A. 3007--B                          4
 
                                  PART A
 
   Section  1.  Sections 91 and 92 of part H of chapter 59 of the laws of
 2011 relating to the year to year rate of growth of Department of Health
 state funds and Medicaid funding are REPEALED.
   § 2. This act shall take effect immediately.
 
                                  PART B
 
                           Intentionally Omitted
 
                                  PART C
 
   Section 1. Part FFF of chapter 56 of the laws of  2020,  amending  the
 public  health law relating to extending and enhancing the Medicaid drug
 cap and to reduce unnecessary pharmacy  benefit  manager  costs  to  the
 Medicaid  program,  is  amended  by  adding a new section 1-b to read as
 follows:
   § 1-B. NOTWITHSTANDING ANY PROVISION OF THIS PART  OR  OTHER  LAW,  NO
 ACTION SHALL BE TAKEN BY THE COMMISSIONER OF HEALTH OR THE DEPARTMENT OF
 HEALTH  TO  REMOVE  THE  PHARMACY  BENEFIT FROM THE MANAGED CARE BENEFIT
 PACKAGE UNDER MEDICAL ASSISTANCE (MEDICAID) BEFORE APRIL 1, 2024 FOR THE
 FOLLOWING ENTITIES: (A) AN ELIGIBLE PROVIDER UNDER SECTION 340B  OF  THE
 FEDERAL  PUBLIC  HEALTH  SERVICE ACT AND (B) A COMPREHENSIVE HIV SPECIAL
 NEEDS PLAN UNDER SECTION 4403-C OF THE PUBLIC HEALTH LAW.
   § 2. This act shall take effect immediately.
 
                                  PART D
 
                           Intentionally Omitted
 
                                  PART E
 
                           Intentionally Omitted
 
                                  PART F

   Section 1. Subdivision 3 of section 2999-cc of the public health  law,
 as amended by section 2 of subpart C of part S of chapter 57 of the laws
 of 2018, 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)  certified  and  non-certified  day  and  residential
 programs  funded or operated by the office for people with developmental
 disabilities; (d) private physician's or dentist's offices located with-
 in the state of New York; (e) any type of adult care  facility  licensed
 under title two of article seven of the social services law; (f) 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 (g) the patient's place of residence located within the state of New
 York  or other temporary location located within or outside the state of
 New York.]
   § 2. Intentionally omitted.

 A. 3007--B                          5
 
   § 3. Intentionally omitted.
   § 4. Intentionally omitted.
   § 5. Intentionally omitted.
   § 6. Intentionally omitted.
   § 7. Intentionally omitted.
   § 8. Intentionally omitted.
   §  9.  This act shall take effect April 1, 2021; provided, however, if
 this act shall have become a law after such date it  shall  take  effect
 immediately and shall be deemed to have been in full force and effect on
 and after April 1, 2021.
 
                                  PART G
 
   Section  1.  The  public health law is amended by adding a new article
 29-J to read as follows:
                               ARTICLE 29-J
                          MEDICAL RESPITE PROGRAM
 SECTION 2999-HH. MEDICAL RESPITE PROGRAM.
   § 2999-HH. MEDICAL RESPITE PROGRAM. 1.  DEFINITIONS. AS USED  IN  THIS
 ARTICLE,  THE  FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS, UNLESS
 THE CONTEXT CLEARLY OTHERWISE REQUIRES:
   (A) "MEDICAL  RESPITE  PROGRAM"  MEANS  A  NOT-FOR-PROFIT  CORPORATION
 CERTIFIED  PURSUANT  TO SUBDIVISION TWO OF THIS SECTION TO SERVE RECIPI-
 ENTS WHOSE PROGNOSIS OR DIAGNOSIS NECESSITATES THE RECEIPT OF:
   (I) TEMPORARY ROOM AND BOARD WITH  APPROPRIATE  KITCHEN  AND  BATHROOM
 FACILITIES  FOR  THE  RECIPIENT,  AND  WHERE  APPLICABLE, FAMILY MEMBERS
 AND/OR DEPENDENTS; AND
   (II) THE PROVISION OR ARRANGEMENT OF THE PROVISION OF HEALTH CARE  AND
 SUPPORT  SERVICES;  PROVIDED,   HOWEVER, THAT THE OPERATION OF A MEDICAL
 RESPITE PROGRAM SHALL BE SEPARATE AND DISTINCT FROM ANY HOUSING PROGRAMS
 OFFERED TO INDIVIDUALS WHO DO NOT QUALIFY  AS  RECIPIENTS,  UNLESS  SUCH
 INDIVIDUALS ARE THE RECIPIENT'S FAMILY MEMBER AND/OR DEPENDENT.
   (B) "RECIPIENT" MEANS AN INDIVIDUAL WHO:
   (I) HAS A QUALIFYING HEALTH CONDITION THAT REQUIRES TREATMENT OR CARE;
   (II)  DOES  NOT REQUIRE HOSPITAL INPATIENT, OBSERVATION UNIT, OR EMER-
 GENCY ROOM LEVEL OF CARE, OR A MEDICALLY INDICATED EMERGENCY  DEPARTMENT
 OR OBSERVATION VISIT; AND
   (III)  IS  EXPERIENCING  HOMELESSNESS OR AT IMMINENT RISK OF HOMELESS-
 NESS.  A PERSON SHALL BE DEEMED "HOMELESS" IF THEY LACK A FIXED, REGULAR
 AND ADEQUATE NIGHTTIME RESIDENCE IN A  LOCATION  ORDINARILY  USED  AS  A
 REGULAR SLEEPING ACCOMMODATION FOR PEOPLE.
   2.  CERTIFICATION.  (A)  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF
 LAW, THE COMMISSIONER MAY CERTIFY A  NOT-FOR-PROFIT  CORPORATION  AS  AN
 OPERATOR OF A MEDICAL RESPITE PROGRAM.
   (B)  THE  COMMISSIONER MAY MAKE REGULATIONS TO ESTABLISH PROCEDURES TO
 REVIEW AND APPROVE APPLICATIONS FOR A  CERTIFICATION  PURSUANT  TO  THIS
 ARTICLE,  WHICH  SHALL,  AT  A MINIMUM, SPECIFY STANDARDS FOR: RECIPIENT
 ELIGIBILITY; MEDICAL RESPITE PROGRAM SERVICES THAT  SHALL  BE  PROVIDED;
 PHYSICAL  ENVIRONMENT;  STAFFING;  AND POLICIES AND PROCEDURES GOVERNING
 HEALTH AND SAFETY, LENGTH OF STAY,  REFERRALS,  DISCHARGE,  AND  COORDI-
 NATION OF CARE.
   3.  OPERATING  STANDARDS;  RESPONSIBILITY  FOR  STANDARDS. (A) MEDICAL
 RESPITE PROGRAMS CERTIFIED PURSUANT TO THIS ARTICLE SHALL:
   (I) PROVIDE RECIPIENTS AND WHERE APPLICABLE, THEIR FAMILY MEMBERS WITH
 TEMPORARY ROOM AND BOARD WITH APPROPRIATE KITCHEN AND  BATHROOM  FACILI-
 TIES; AND

 A. 3007--B                          6
 
   (II) PROVIDE, OR ARRANGE FOR THE PROVISION OF, HEALTH CARE AND SUPPORT
 SERVICES TO RECIPIENTS.
   (B)  NOTHING  IN THIS ARTICLE SHALL AFFECT THE APPLICATION, QUALIFICA-
 TION, OR REQUIREMENTS THAT MAY APPLY TO AN OPERATOR WITH RESPECT TO  ANY
 OTHER  LICENSES  OR  OPERATING CERTIFICATES THAT SUCH OPERATOR MAY HOLD,
 INCLUDING, WITHOUT LIMITATION, UNDER ARTICLE TWENTY-EIGHT OF THIS  CHAP-
 TER OR ARTICLE SEVEN OF THE SOCIAL SERVICES LAW.
   4. TEMPORARY ACCOMMODATION. A MEDICAL RESPITE PROGRAM SHALL BE CONSID-
 ERED  A  FORM  OF EMERGENCY SHELTER OR TEMPORARY SHELTER FOR PURPOSES OF
 DETERMINING A RECIPIENT'S ELIGIBILITY FOR HOUSING PROGRAMS  OR  BENEFITS
 ADMINISTERED  BY  THE  STATE  OR  BY  A  LOCAL SOCIAL SERVICES DISTRICT,
 INCLUDING PROGRAMS OR BENEFITS THAT SUPPORT ACCESS TO ACCOMMODATIONS  OF
 A  TEMPORARY,  TRANSITIONAL,  OR PERMANENT NATURE.  NO CLAIM OF RECOVERY
 SHALL ACCRUE AGAINST A  RECIPIENT  TO  RECOVER  THE  COST  OF  CARE  AND
 SERVICES  PROVIDED UNDER THIS ARTICLE.  CARE AND SERVICES PROVIDED UNDER
 THIS ARTICLE SHALL NOT BE DEEMED PUBLIC BENEFITS  THAT  WOULD  AFFECT  A
 RECIPIENT'S IMMIGRATION STATUS UNDER FEDERAL LAW.
   5. INSPECTIONS AND COMPLIANCE. THE COMMISSIONER SHALL HAVE THE AUTHOR-
 ITY  TO INQUIRE INTO THE OPERATION OF ANY MEDICAL RESPITE PROGRAM AND TO
 CONDUCT PERIODIC INSPECTIONS OF FACILITIES WITH RESPECT TO  THE  FITNESS
 AND  ADEQUACY  OF THE PREMISES, EQUIPMENT, PERSONNEL, RULES AND BY-LAWS,
 STANDARDS OF MEDICAL CARE AND SERVICES, SYSTEM OF ACCOUNTS, RECORDS, AND
 THE ADEQUACY OF FINANCIAL RESOURCES AND SOURCES OF FUTURE REVENUES.
   6. SUSPENSION OR REVOCATION OF CERTIFICATION. (A) A CERTIFICATION  FOR
 A  MEDICAL  RESPITE PROGRAM MAY BE REVOKED, SUSPENDED, LIMITED, ANNULLED
 OR DENIED BY THE COMMISSIONER, IN CONSULTATION WITH EITHER  THE  COMMIS-
 SIONERS  OF  THE  OFFICE  OF  MENTAL HEALTH, THE OFFICE OF TEMPORARY AND
 DISABILITY ASSISTANCE, OR THE OFFICE OF ADDICTION SERVICES AND SUPPORTS,
 AS APPROPRIATE BASED ON A DETERMINATION OF THE DEPARTMENT  DEPENDING  ON
 THE  DIAGNOSIS  OR  STATED  NEEDS  OF  THE  INDIVIDUALS  BEING SERVED OR
 PROPOSED TO BE SERVED IN THE MEDICAL RESPITE PROGRAM, IF AN OPERATOR  IS
 DETERMINED  TO  HAVE FAILED TO COMPLY WITH THIS ARTICLE. NO ACTION TAKEN
 AGAINST AN OPERATOR UNDER THIS SUBDIVISION SHALL  AFFECT  AN  OPERATOR'S
 OTHER  LICENSES OR CERTIFICATIONS; PROVIDED HOWEVER, THAT THE FACTS THAT
 GAVE RISE TO THE REVOCATION, SUSPENSION, LIMITATION, ANNULMENT OR DENIAL
 OF CERTIFICATION MAY ALSO FORM THE BASIS OF A LIMITATION, SUSPENSION  OF
 REVOCATION OF SUCH OTHER LICENSES OR CERTIFICATIONS.
   (B)  NO  MEDICAL  RESPITE  PROGRAM  CERTIFICATION  SHALL  BE  REVOKED,
 SUSPENDED, LIMITED, ANNULLED OR DENIED WITHOUT A HEARING; PROVIDED  THAT
 A  CERTIFICATION MAY BE TEMPORARILY SUSPENDED OR LIMITED WITHOUT A HEAR-
 ING FOR A PERIOD NOT IN EXCESS OF THIRTY DAYS UPON WRITTEN  NOTICE  THAT
 THE  CONTINUATION  OF  THE  MEDICAL RESPITE PROGRAM PLACES THE HEALTH OR
 SAFETY OF THE RECIPIENTS IN IMMINENT DANGER, AND THAT THE ACTION  IS  IN
 THE  INTEREST OF THE RECIPIENTS.  HOWEVER, THE DEPARTMENT SHALL NOT MAKE
 A DETERMINATION UNTIL THE PROGRAM  HAS  HAD  A  REASONABLE  OPPORTUNITY,
 FOLLOWING  THE  INITIAL DETERMINATION THAT THE PROGRAM PLACES THE HEALTH
 OR SAFETY OF THE RECIPIENTS IN IMMINENT DANGER, TO CORRECT ITS DEFICIEN-
 CIES AND FOLLOWING THIS PERIOD, HAS BEEN GIVEN WRITTEN NOTICE AND OPPOR-
 TUNITY FOR HEARING.
   (C) NOTHING IN THIS SECTION SHALL PREVENT THE COMMISSIONER FROM IMPOS-
 ING SANCTIONS OR PENALTIES ON A MEDICAL RESPITE PROGRAM THAT ARE AUTHOR-
 IZED UNDER ANY OTHER LAW OR REGULATION.
   7. THE COMMISSIONER SHALL PROMULGATE  REGULATIONS  TO  IMPLEMENT  THIS
 ARTICLE.
   §  2.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2021.

 A. 3007--B                          7
 
                                  PART H
 
   Section  1. The title heading of title 11-D of article 5 of the social
 services law, as added by chapter 1 of the laws of 1999, is  amended  to
 read as follows:
                   [FAMILY] BASIC HEALTH [PLUS] PROGRAM
 
   §  2.  Paragraph (d) of subdivision 3, subdivision 5 and subdivision 7
 of section 369-gg of the social services law, as added by section 51  of
 part C of chapter 60 of the laws of 2014 and subdivision 7 as renumbered
 by  section  28 of part B of chapter 57 of the laws of 2015, are amended
 to read as follows:
   (d) (i) has household income at or below two hundred  percent  of  the
 federal  poverty  line defined and annually revised by the United States
 department of health and human services for  a  household  of  the  same
 size;  and  (ii)  has  household income that exceeds one hundred thirty-
 three percent of the federal poverty line defined and  annually  revised
 by  the  United  States  department  of  health and human services for a
 household of the same size; however, MAGI eligible aliens lawfully pres-
 ent in the United States with household incomes at or below one  hundred
 thirty-three  percent  of  the federal poverty line shall be eligible to
 receive coverage for health care services pursuant to the provisions  of
 this  title  if  such  alien  would be ineligible for medical assistance
 under title eleven of this article due to his or her immigration status.
   An applicant who fails to make an applicable premium payment, IF  ANY,
 shall  lose  eligibility to receive coverage for health care services in
 accordance with time frames and procedures determined by the commission-
 er.
   5. Premiums and cost sharing. (a) Subject  to  federal  approval,  the
 commissioner  shall  establish  premium  payments enrollees shall pay to
 approved organizations for coverage of health care services pursuant  to
 this title. [Such premium payments shall be established in the following
 manner:
   (i)  up  to  twenty dollars monthly for an individual with a household
 income above one hundred and fifty percent of the federal  poverty  line
 but  at or below two hundred percent of the federal poverty line defined
 and annually revised by the United States department of health and human
 services for a household of the same size; and
   (ii) no] NO payment is  required  for  individuals  with  a  household
 income  at  or  below [one hundred and fifty] TWO HUNDRED percent of the
 federal poverty line defined and annually revised by the  United  States
 department  of  health  and  human  services for a household of the same
 size.
   (b) [The commissioner shall establish  cost  sharing  obligations  for
 enrollees,  subject  to federal approval] THERE SHALL BE NO COST SHARING
 OBLIGATIONS FOR ENROLLEES, INCLUDING FOR DENTAL AND VISION SERVICES.
   7. Any funds transferred by the secretary of health and human services
 to the state pursuant to 42 U.S.C. 18051(d) shall be deposited in trust.
 Funds from the trust shall be used for providing health benefits through
 an approved organization, which, at a minimum, shall  include  essential
 health  benefits  as  defined  in  42  U.S.C.  18022(b);  to  reduce the
 premiums, IF ANY, and cost sharing of participants in the  basic  health
 program;  or  for such other purposes as may be allowed by the secretary
 of health and human services.  Health  benefits  available  through  the
 basic health program shall be provided by one or more approved organiza-
 tions  pursuant  to an agreement with the department of health and shall

 A. 3007--B                          8
 
 meet the requirements of applicable federal and  state  laws  and  regu-
 lations.
   §  2-a. Section 369-gg of the social services law is amended by adding
 a new subdivision 3-a to read as follows:
   3-A. NOVEL CORONAVIRUS, COVID-19 ELIGIBILITY. A PERSON SHALL  ALSO  BE
 ELIGIBLE  TO RECEIVE COVERAGE FOR HEALTH CARE SERVICES UNDER THIS TITLE,
 WITHOUT REGARD TO FEDERAL FINANCIAL PARTICIPATION, IF HE  OR  SHE  IS  A
 RESIDENT  OF  THE STATE, HAS OR HAS HAD A CONFIRMED OR SUSPECTED CASE OF
 NOVEL CORONAVIRUS, COVID-19, HOUSEHOLD INCOME BELOW TWO HUNDRED  PERCENT
 OF  THE  FEDERAL  POVERTY  LINE  AS  DEFINED AND ANNUALLY REVISED BY THE
 UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR A HOUSEHOLD OF
 THE SAME SIZE, AND IS INELIGIBLE FOR FEDERAL FINANCIAL PARTICIPATION  IN
 THE  BASIC  HEALTH PROGRAM UNDER 42 U.S.C. SECTION 18051 ON THE BASIS OF
 IMMIGRATION STATUS, BUT OTHERWISE MEETS THE ELIGIBILITY REQUIREMENTS  IN
 PARAGRAPHS  (B)  AND (C) OF SUBDIVISION THREE OF THIS SECTION. AN APPLI-
 CANT WHO FAILS TO MAKE AN APPLICABLE PREMIUM PAYMENT SHALL  LOSE  ELIGI-
 BILITY  TO  RECEIVE COVERAGE FOR HEALTH CARE SERVICES IN ACCORDANCE WITH
 THE TIME FRAMES AND PROCEDURES DETERMINED BY THE COMMISSIONER.
   § 3. This act shall take effect immediately; provided,  however,  that
 sections  one  and  two  of  this  act  shall  take effect June 1, 2021;
 provided further, however, that section two-a of this act  shall  expire
 and  be deemed repealed sixty days following the conclusion of the state
 disaster emergency declared pursuant to executive  order  202,  provided
 that the commissioner of health shall notify the legislative bill draft-
 ing  commission  upon the occurrence of the conclusion of such executive
 order in order that the commission may maintain an accurate  and  timely
 effective data base of the official text of the laws of the state of New
 York  in furtherance of effectuating the provisions of section 44 of the
 legislative law and section 70-b of the public officers law.
 
                                  PART I
 
                           Intentionally Omitted
 
                                  PART J
 
                           Intentionally Omitted
 
                                  PART K
 
   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 1 of part AAA of chapter 56 of the laws of 2020, 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

 A. 3007--B                          9
 
 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, between July 1,  2017  and  June
 30,  2018,  between July 1, 2018 and June 30, 2019, between July 1, 2019
 and June 30, 2020, [and] between July 1, 2020 and  June  30,  2021,  AND
 BETWEEN  JULY  1, 2021 AND JUNE 30, 2022 or reimburse the hospital where
 the hospital purchases equivalent excess coverage as defined in subpara-
 graph (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, between July  1,  2017
 and  June 30, 2018, between July 1, 2018 and June 30, 2019, between July
 1, 2019 and June 30, 2020, [and] between July 1, 2020 and June 30, 2021,
 AND BETWEEN JULY 1, 2021 AND JUNE 30, 2022 for  physicians  or  dentists
 certified as eligible for each such period or periods pursuant to subdi-
 vision  2  of  this  section  by a general hospital licensed pursuant to
 article 28 of the public health law; provided  that  no  single  insurer
 shall  write  more  than fifty percent of the total excess premium for a
 given policy year; and provided, however, that such eligible  physicians
 or  dentists  must  have  in force an individual policy, from an insurer
 licensed in this state of  primary  malpractice  insurance  coverage  in
 amounts  of  no less than one million three hundred thousand dollars for
 each claimant and three million nine hundred thousand  dollars  for  all
 claimants  under  that  policy during the period of such excess coverage
 for such occurrences or be  endorsed  as  additional  insureds  under  a

 A. 3007--B                         10
 
 hospital professional liability policy which is offered through a volun-
 tary  attending physician ("channeling") program previously permitted by
 the superintendent of financial  services  during  the  period  of  such
 excess  coverage  for  such occurrences. During such period, such policy
 for excess coverage or  such  equivalent  excess  coverage  shall,  when
 combined with the physician's or dentist's primary malpractice insurance
 coverage  or  coverage  provided through a voluntary attending physician
 ("channeling") program, total an aggregate level of  two  million  three
 hundred  thousand dollars for each claimant and six million nine hundred
 thousand dollars for all claimants from all such policies  with  respect
 to  occurrences  in each of such years provided, however, if the cost of
 primary malpractice insurance coverage in excess of one million dollars,
 but below the excess medical  malpractice  insurance  coverage  provided
 pursuant  to  this act, exceeds the rate of nine percent per annum, then
 the required level of primary malpractice insurance coverage  in  excess
 of  one  million  dollars for each claimant shall be in an amount of not
 less than the dollar amount of such coverage available at  nine  percent
 per  annum;  the required level of such coverage for all claimants under
 that policy shall be in an amount not less than three times  the  dollar
 amount of coverage for each claimant; and excess coverage, when combined
 with  such  primary  malpractice  insurance coverage, shall increase the
 aggregate level for each claimant  by  one  million  dollars  and  three
 million  dollars  for  all  claimants;  and provided further, that, with
 respect to policies of primary medical malpractice coverage that include
 occurrences between April 1, 2002 and June 30,  2002,  such  requirement
 that coverage be in amounts no less than one million three hundred thou-
 sand  dollars  for each claimant and three million nine hundred thousand
 dollars for all claimants for such occurrences shall be effective  April
 1, 2002.
   §  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 2 of
 part  AAA  of  chapter  56  of  the  laws of 2020, is amended to read as
 follows:
   (3)(a) The superintendent of financial services  shall  determine  and
 certify  to  each general hospital and to the commissioner of health the
 cost of excess malpractice insurance for medical or  dental  malpractice
 occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
 and  June 30, 1989, between July 1, 1989 and June 30, 1990, between July
 1, 1990 and June 30, 1991, between July  1,  1991  and  June  30,  1992,
 between  July  1,  1992 and June 30, 1993, between July 1, 1993 and June
 30, 1994, between July 1, 1994 and June 30, 1995, between July  1,  1995
 and  June 30, 1996, between July 1, 1996 and June 30, 1997, between July
 1, 1997 and June 30, 1998, between July  1,  1998  and  June  30,  1999,
 between  July  1,  1999 and June 30, 2000, between July 1, 2000 and June
 30, 2001, between July 1, 2001 and June 30, 2002, between July  1,  2002
 and  June 30, 2003, between July 1, 2003 and June 30, 2004, between July
 1, 2004 and June 30, 2005, between July  1,  2005  and  June  30,  2006,
 between  July  1,  2006 and June 30, 2007, between July 1, 2007 and June
 30, 2008, between July 1, 2008 and June 30, 2009, between July  1,  2009
 and  June 30, 2010, between July 1, 2010 and June 30, 2011, between July
 1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, [and]
 between July 1, 2013 and June 30, 2014, between July 1,  2014  and  June
 30,  2015, between July 1, 2015 and June 30, 2016, [and] between July 1,
 2016 and June 30, 2017, between July 1, 2017 and June 30, 2018,  between
 July  1, 2018 and June 30, 2019, between July 1, 2019 and June 30, 2020,

 A. 3007--B                         11
 
 [and] between July 1, 2020 and June 30, 2021, AND BETWEEN JULY  1,  2021
 AND  JUNE  30, 2022 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 subdivi-
 sion 2 of this section, and may amend  such  determination  and  certif-
 ication 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,  between July 1, 2016 and June 30, 2017, between July 1, 2017
 and June 30, 2018, between July 1, 2018 and June 30, 2019, between  July
 1, 2019 and June 30, 2020, [and] between July 1, 2020 and June 30, 2021,
 AND  BETWEEN  JULY  1,  2021 AND JUNE 30, 2022 allocable to each general
 hospital for physicians or dentists certified as eligible  for  purchase
 of  a policy for excess insurance coverage or equivalent excess coverage
 by such general hospital  in  accordance  with  subdivision  2  of  this
 section,  and  may  amend such determination and certification as neces-
 sary. The superintendent  of  financial  services  shall  determine  and
 certify  to  each general hospital and to the commissioner of health the
 ratable share of such cost allocable to  the  period  July  1,  1987  to
 December  31,  1987,  to the period January 1, 1988 to June 30, 1988, to
 the period July 1, 1988 to December 31, 1988, to the period  January  1,
 1989  to June 30, 1989, to the period July 1, 1989 to December 31, 1989,
 to the period January 1, 1990 to June 30, 1990, to the  period  July  1,
 1990  to  December  31,  1990, to the period January 1, 1991 to June 30,
 1991, to the period July 1, 1991 to December 31,  1991,  to  the  period
 January 1, 1992 to June 30, 1992, to the period July 1, 1992 to December
 31,  1992, to the period January 1, 1993 to June 30, 1993, to the period
 July 1, 1993 to December 31, 1993, to the period January 1, 1994 to June
 30, 1994, to the period July 1, 1994 to December 31, 1994, to the period
 January 1, 1995 to June 30, 1995, to the period July 1, 1995 to December
 31, 1995, to the period January 1, 1996 to June 30, 1996, to the  period
 July 1, 1996 to December 31, 1996, to the period January 1, 1997 to June
 30, 1997, to the period July 1, 1997 to December 31, 1997, to the period
 January 1, 1998 to June 30, 1998, to the period July 1, 1998 to December
 31,  1998, to the period January 1, 1999 to June 30, 1999, to the period
 July 1, 1999 to December 31, 1999, to the period January 1, 2000 to June
 30, 2000, to the period July 1, 2000 to December 31, 2000, to the period
 January 1, 2001 to June 30, 2001, to the period July 1, 2001 to June 30,

 A. 3007--B                         12
 
 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,  to  the  period July 1, 2016 and June 30, 2017, to the
 period July 1, 2017 to June 30, 2018, to the period July 1, 2018 to June
 30, 2019, to the period July 1, 2019 to June  30,  2020,  [and]  to  the
 period  July 1, 2020 to June 30, 2021, AND TO THE PERIOD JULY 1, 2021 TO
 JUNE 30, 2022.
   § 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 3 of part AAA of  chapter  56  of
 the laws of 2020, 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 to June 30, 2016, during
 the period July 1, 2016 to June 30, 2017, during the period July 1, 2017
 to June 30, 2018, during the period July  1,  2018  to  June  30,  2019,
 during the period July 1, 2019 to June 30, 2020, [and] during the period
 July  1,  2020  to  June 30, 2021, AND DURING THE PERIOD JULY 1, 2021 TO
 JUNE 30, 2022 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 coverage is purchased
 for such period shall be responsible for  payment  to  the  provider  of
 excess  insurance coverage or equivalent excess coverage of an allocable
 share of such insufficiency, based on the ratio of  the  total  cost  of
 such  coverage  for  such physician to the sum of the total cost of such
 coverage for all physicians applied to such insufficiency.

 A. 3007--B                         13
 
   (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, or covering the period July 1, 2019 to June 30, 2020,  or
 covering the period July 1, 2020 to June 30, 2021, OR COVERING THE PERI-
 OD  JULY  1,  2021  TO JUNE 30, 2022 shall notify a covered physician or
 dentist by mail, mailed to the address shown on the last application for
 excess insurance coverage or equivalent excess coverage, of  the  amount
 due  to  such  provider from such physician or dentist for such coverage
 period determined in accordance with paragraph (a) of this  subdivision.
 Such amount shall be due from such physician or dentist to such provider
 of excess insurance coverage or equivalent excess coverage in a time and
 manner determined by the superintendent of financial services.
   (c)  If  a physician or dentist liable for payment of a portion of the
 costs of excess insurance coverage or equivalent excess coverage  cover-
 ing  the  period  July  1, 1992 to June 30, 1993, or covering the period
 July 1, 1993 to June 30, 1994, or covering the period July  1,  1994  to
 June  30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
 covering the period July 1, 1996 to June 30, 1997, or covering the peri-
 od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
 June 30, 1999, or covering the period July 1, 1999 to June 30, 2000,  or
 covering the period July 1, 2000 to June 30, 2001, or covering the peri-
 od  July  1,  2001  to October 29, 2001, or covering the period April 1,
 2002 to June 30, 2002, or covering the period July 1, 2002 to  June  30,
 2003,  or covering the period July 1, 2003 to June 30, 2004, or covering
 the period July 1, 2004 to June 30, 2005, or covering the period July 1,
 2005 to June 30, 2006, or covering the period July 1, 2006 to  June  30,
 2007,  or covering the period July 1, 2007 to June 30, 2008, or covering
 the period July 1, 2008 to June 30, 2009, or covering the period July 1,
 2009 to June 30, 2010, or covering the period July 1, 2010 to  June  30,
 2011,  or covering the period July 1, 2011 to June 30, 2012, or covering
 the period July 1, 2012 to June 30, 2013, or covering the period July 1,
 2013 to June 30, 2014, or covering the period July 1, 2014 to  June  30,
 2015,  or covering the period July 1, 2015 to June 30, 2016, or covering
 the period July 1, 2016 to June 30, 2017, or covering the period July 1,
 2017 to June 30, 2018, or covering the period July 1, 2018 to  June  30,
 2019,  or covering the period July 1, 2019 to June 30, 2020, or covering

 A. 3007--B                         14
 
 the period July 1, 2020 to June 30, 2021, OR COVERING THE PERIOD JULY 1,
 2021 TO JUNE 30, 2022 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  equivalent excess coverage purchased for such physician or
 dentist in accordance with this section for such coverage  period  shall
 be  cancelled and shall be null and void as of the first day on or after
 the commencement of a policy period  where  the  liability  for  payment
 pursuant to this subdivision has not been met.
   (d)  Each  provider  of excess insurance coverage or equivalent excess
 coverage shall notify the superintendent of financial services  and  the
 commissioner  of  health or their designee of each physician and dentist
 eligible for purchase of a  policy  for  excess  insurance  coverage  or
 equivalent  excess coverage covering the period July 1, 1992 to June 30,
 1993, or covering the period July 1, 1993 to June 30, 1994, or  covering
 the period July 1, 1994 to June 30, 1995, or covering the period July 1,
 1995  to  June 30, 1996, or covering the period July 1, 1996 to June 30,
 1997, or covering the period July 1, 1997 to June 30, 1998, or  covering
 the period July 1, 1998 to June 30, 1999, or covering the period July 1,
 1999  to  June 30, 2000, or covering the period July 1, 2000 to June 30,
 2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
 ing the period April 1, 2002 to June 30, 2002, or  covering  the  period
 July  1,  2002  to June 30, 2003, or covering the period July 1, 2003 to
 June 30, 2004, or covering the period July 1, 2004 to June 30, 2005,  or
 covering the period July 1, 2005 to June 30, 2006, or covering the peri-
 od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
 June  30, 2008, or covering the period July 1, 2008 to June 30, 2009, or
 covering the period July 1, 2009 to June 30, 2010, or covering the peri-
 od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
 June 30, 2012, or covering the period July 1, 2012 to June 30, 2013,  or
 covering the period July 1, 2013 to June 30, 2014, or covering the peri-
 od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
 June  30, 2016, or covering the period July 1, 2016 to June 30, 2017, or
 covering the period July 1, 2017 to June 30, 2018, or covering the peri-
 od July 1, 2018 to June 30, 2019, or covering the period July 1, 2019 to
 June 30, 2020, or covering the period July 1, 2020 to June 30, 2021,  OR
 COVERING  THE PERIOD JULY 1, 2021 TO JUNE 30, 2022 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

 A. 3007--B                         15

 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, and to the period July 1, 2019 to June 30, 2020,
 and to the period July 1, 2020 to June 30, 2021, AND TO THE PERIOD  JULY
 1,  2021  TO  JUNE  30, 2022 received from the hospital excess liability
 pool for purchase of excess  insurance  coverage  or  equivalent  excess
 coverage covering the period July 1, 1992 to June 30, 1993, and covering
 the  period  July 1, 1993 to June 30, 1994, and covering the period July
 1, 1994 to June 30, 1995, and covering the period July 1, 1995  to  June
 30,  1996,  and  covering  the period July 1, 1996 to June 30, 1997, and
 covering the period July 1, 1997 to June  30,  1998,  and  covering  the
 period  July  1,  1998 to June 30, 1999, and covering the period July 1,
 1999 to June 30, 2000, and 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 cover-
 ing 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  covering the period July 1, 2010 to June 30, 2011, and covering the
 period July 1, 2011 to June 30, 2012, and covering the  period  July  1,
 2012  to June 30, 2013, and covering the period July 1, 2013 to June 30,
 2014, and covering the period July 1, 2014 to June 30, 2015, and  cover-
 ing  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,
 and covering the period July 1, 2019 to June 30, 2020, and covering  the
 period  July  1,  2020 to June 30, 2021, AND COVERING THE PERIOD JULY 1,
 2021 TO JUNE 30, 2022 for a  physician  or  dentist  where  such  excess
 insurance coverage or equivalent excess coverage is cancelled in accord-
 ance 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 5  of  part  AAA  of
 chapter 56 of the laws of 2020, 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,
 [2021] 2022; 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

 A. 3007--B                         16
 
 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, [2021]
 2022, 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,  [2021]
 2022  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, as amended by section 6
 of  part  AAA  of chapter 56 of the laws of 2020, 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

 A. 3007--B                         17
 
 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, June
 15,  2018,  June  15, 2019, June 15, 2020, [and] June 15, 2021, AND JUNE
 15, 2022 the amount of funds available in the hospital excess  liability
 pool, created pursuant to section 18 of chapter 266 of the laws of 1986,
 and  whether such funds are sufficient for purposes of purchasing excess
 insurance coverage for eligible participating  physicians  and  dentists
 during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June
 30,  2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June 30,
 2005, or July 1, 2005 to June 30, 2006, or July  1,  2006  to  June  30,
 2007,  or  July  1,  2007  to June 30, 2008, or July 1, 2008 to June 30,
 2009, or July 1, 2009 to June 30, 2010, or July  1,  2010  to  June  30,
 2011,  or  July  1,  2011  to June 30, 2012, or July 1, 2012 to June 30,
 2013, or July 1, 2013 to June 30, 2014, or July  1,  2014  to  June  30,
 2015,  or  July  1,  2015  to June 30, 2016, or July 1, 2016 to June 30,
 2017, or July 1, 2017 to June 30, 2018, or July  1,  2018  to  June  30,
 2019,  or  July  1,  2019  to June 30, 2020, or July 1, 2020 to June 30,
 2021, OR JULY 1, 2021 TO JUNE 30, 2022 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, or July  1,  2019  to  June  30,
 2020, or July 1, 2020 to June 30, 2021, OR JULY 1, 2021 TO JUNE 30, 2022
 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, June 15, 2018, June 15, 2019, June
 15, 2020, [and] June 15, 2021, AND JUNE 15, 2022 as applicable.

 A. 3007--B                         18
 
   § 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, as amended by section  7  of  part
 AAA of chapter 56 of the laws of 2020, 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  [twenty]  TWENTY-ONE, shall be eligible to apply for such
 coverage for the coverage period beginning the first of July, two  thou-
 sand  [twenty]  TWENTY-ONE;  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 [twenty] TWENTY-ONE exceeds the  total  number  of
 physicians  or  dentists  certified  as eligible for the coverage period
 beginning the first of July, two thousand [twenty] TWENTY-ONE, 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
 [twenty] TWENTY-ONE, 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 [twenty] TWENTY-ONE 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 [twenty] TWENTY-ONE.
   § 7. This act shall take effect immediately and  shall  be  deemed  to
 have been in full force and effect on and after April 1, 2021.
 
                                  PART L
 
                           Intentionally Omitted
 
                                  PART M
 
                           Intentionally Omitted
 
                                  PART N
 
                           Intentionally Omitted
 
                                  PART O
 
                           Intentionally Omitted
 
                                  PART P
 
                           Intentionally Omitted
 
                                  PART Q
 
                           Intentionally Omitted

 A. 3007--B                         19

                                  PART R
 
                           Intentionally Omitted
 
                                  PART S
 
   Section 1. Section 11 of chapter 884 of the laws of 1990, amending the
 public  health  law  relating  to  authorizing bad debt and charity care
 allowances for certified home health agencies, as amended by  section  3
 of  part  E  of  chapter  57  of the laws of 2019, is amended to read as
 follows:
   § 11. This act shall take effect immediately and:
   (a) sections one and three shall expire on December 31, 1996,
   (b) sections four through ten shall expire on June  30,  [2021]  2023,
 and
   (c) provided that the amendment to section 2807-b of the public health
 law  by  section two of this act shall not affect the expiration of such
 section 2807-b as otherwise provided by  law  and  shall  be  deemed  to
 expire therewith.
   §  2.  Subdivision  (a)  of section 40 of part B of chapter 109 of the
 laws of 2010, amending the social services law relating  to  transporta-
 tion  costs, as amended by section 5 of part E of chapter 57 of the laws
 of 2019, is amended to read as follows:
   (a) sections two, three, three-a, three-b, three-c,  three-d,  three-e
 and  twenty-one  of  this  act  shall take effect July 1, 2010; sections
 fifteen, sixteen, seventeen, eighteen and nineteen  of  this  act  shall
 take effect January 1, 2011; and provided further that section twenty of
 this  act shall be deemed repealed [ten] TWELVE years after the date the
 contract entered into pursuant to section 365-h of the  social  services
 law,  as  amended  by  section twenty of this act, is executed; provided
 that the commissioner of health shall notify the legislative bill draft-
 ing commission upon the execution of the contract entered into  pursuant
 to section 367-h of the social services law in order that the commission
 may  maintain an accurate and timely effective data base of the official
 text of the laws of the state of New York in furtherance of effectuating
 the provisions of section 44 of the legislative law and section 70-b  of
 the public officers law;
   § 3. Subdivision 5-a of section 246 of chapter 81 of the laws of 1995,
 amending  the  public  health  law  and  other  laws relating to medical
 reimbursement and welfare reform, as amended by section 12 of part E  of
 chapter 57 of the laws of 2019, is amended to read as follows:
   5-a.  Section sixty-four-a of this act shall be deemed to have been in
 full force and effect on and after April 1, 1995 through March 31,  1999
 and  on  and  after July 1, 1999 through March 31, 2000 and on and after
 April 1, 2000 through March 31, 2003 and on  and  after  April  1,  2003
 through March 31, 2007, and on and after April 1, 2007 through March 31,
 2009,  and on and after April 1, 2009 through March 31, 2011, and on and
 after April 1, 2011 through March 31, 2013, and on and  after  April  1,
 2013  through  March  31,  2015,  and on and after April 1, 2015 through
 March 31, 2017 and on and after April 1, 2017 through  March  31,  2019,
 and  on and after April 1, 2019 through March 31, 2021, AND ON AND AFTER
 APRIL 1, 2021 THROUGH MARCH 31, 2022;
   § 4. Section 64-b of chapter 81 of the  laws  of  1995,  amending  the
 public  health  law and other laws relating to medical reimbursement and
 welfare reform, as amended by section 13 of part E of chapter 57 of  the
 laws of 2019, is amended to read as follows:

 A. 3007--B                         20
 
   §  64-b.  Notwithstanding  any  inconsistent  provision  of  law,  the
 provisions of subdivision 7 of section 3614 of the public health law, as
 amended, shall remain and be in full force and effect on April  1,  1995
 through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
 and after April 1, 2000 through March 31, 2003 and on and after April 1,
 2003  through  March  31,  2007,  and on and after April 1, 2007 through
 March 31, 2009, and on and after April 1, 2009 through March  31,  2011,
 and  on and after April 1, 2011 through March 31, 2013, and on and after
 April 1, 2013 through March 31, 2015, and on and  after  April  1,  2015
 through  March 31, 2017 and on and after April 1, 2017 through March 31,
 2019, and on and after April 1, 2019 through March 31, 2021, AND ON  AND
 AFTER APRIL 1, 2021 THROUGH MARCH 31, 2022.
   § 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,  as
 amended  by  section  14 of part E of chapter 57 of the laws of 2019, 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, 2017 through March 31, [2021]  2022,  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, 2019, 2020, [and]
 2021 AND 2022 calendar years in accordance with paragraph (c) of  subdi-
 vision 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, 2019, 2020, [and] 2021 AND  2022  calendar  years  shall  also  be
 applied  to  rates  of  payment  provided  on  and after January 1, 2017
 through March 31, [2021] 2022 for personal  care  services  provided  in
 those  local  social  services districts, including New York city, whose
 rates of payment for such services are established by such local  social
 services  districts  pursuant  to a rate-setting exemption issued by the
 commissioner of health  to  such  local  social  services  districts  in
 accordance  with  applicable regulations; and provided further, however,
 that for rates of payment for assisted living program services  provided
 on  and  after January 1, 2017 through March 31, [2021] 2022, such trend
 factors attributable to the 2017, 2018, 2019, 2020, [and] 2021 AND  2022
 calendar years shall be established at no greater than zero percent.
   §  6.  Subdivision 2 of section 246 of chapter 81 of the laws of 1995,
 amending the public health  law  and  other  laws  relating  to  medical
 reimbursement  and welfare reform, as amended by section 17 of part E of
 chapter 57 of the laws of 2019, is amended to read as follows:
   2. Sections five, seven through nine,  twelve  through  fourteen,  and
 eighteen  of  this  act  shall  be deemed to have been in full force and
 effect on and after April 1, 1995 through March  31,  1999  and  on  and
 after July 1, 1999 through March 31, 2000 and on and after April 1, 2000

 A. 3007--B                         21
 
 through  March 31, 2003 and on and after April 1, 2003 through March 31,
 2006 and on and after April 1, 2006 through March 31, 2007  and  on  and
 after  April  1,  2007  through March 31, 2009 and on and after April 1,
 2009  through  March 31, 2011 and sections twelve, thirteen and fourteen
 of this act shall be deemed to be in full force and effect on and  after
 April  1,  2011  through  March  31, 2015 and on and after April 1, 2015
 through March 31, 2017 and on and after April 1, 2017 through March  31,
 2019,  and on and after April 1, 2019 through March 31, 2021, AND ON AND
 AFTER APRIL 1, 2021 THROUGH MARCH 31, 2022;
   § 7. Intentionally omitted.
   § 8. Section 5 of chapter 517 of the laws of 2016, amending the public
 health law relating to payments from the New York state  medical  indem-
 nity  fund, as amended by section 18 of part Y of chapter 56 of the laws
 of 2020, is amended to read as follows:
   § 5. This act shall take effect on the forty-fifth day after it  shall
 have  become  a  law,  provided  that the amendments to subdivision 4 of
 section 2999-j of the public health law made by section two of this  act
 shall  take  effect  on  June  30,  2017  and shall expire and be deemed
 repealed December 31, [2021] 2022.
   § 9. Subdivision 1 of section 2999-aa of the  public  health  law,  as
 amended  by  chapter  80  of  the  laws  of  2017, is amended to read as
 follows:
   1. In order to promote improved quality and efficiency of, and  access
 to,  health  care  services and to promote improved clinical outcomes to
 the residents of New York, it shall  be  the  policy  of  the  state  to
 encourage, where appropriate, cooperative, collaborative and integrative
 arrangements  including  but  not  limited  to, mergers and acquisitions
 among health care providers or  among  others  who  might  otherwise  be
 competitors,  under  the  active supervision of the commissioner. To the
 extent such arrangements, or the planning and negotiations that  precede
 them,  might  be  anti-competitive  within the meaning and intent of the
 state and federal antitrust laws, the intent of the state is to supplant
 competition with such arrangements  under  the  active  supervision  and
 related  administrative  actions  of  the  commissioner  as necessary to
 accomplish the purposes of this article, and  to  provide  state  action
 immunity  under  the  state  and  federal antitrust laws with respect to
 activities undertaken by health care providers and  others  pursuant  to
 this  article,  where  the benefits of such active supervision, arrange-
 ments and actions of the commissioner outweigh any disadvantages  likely
 to  result  from  a reduction of competition. The commissioner shall not
 approve an arrangement for which state action immunity is  sought  under
 this  article without first consulting with, and receiving a recommenda-
 tion from, the public health and health planning council. No arrangement
 under this article shall be approved after  December  thirty-first,  two
 thousand [twenty] TWENTY-FOUR.
   §  10. Section 3 of part D of chapter 56 of the laws of 2014, amending
 the education law relating to the nurse practitioners modernization act,
 is amended to read as follows:
   § 3. This act shall take effect on the first of January after it shall
 have become a law and shall expire June 30 of the [sixth]  TWELFTH  year
 after  it shall have become a law, when upon such date the provisions of
 this act shall be deemed repealed;  provided,  however,  that  effective
 immediately,  the addition, amendment and/or repeal of any rule or regu-
 lation necessary for the implementation of this  act  on  its  effective
 date  is  authorized  and directed to be made and completed on or before
 such effective date.

 A. 3007--B                         22
 
   § 11. Subparagraph (vi) of paragraph (b) of subdivision 2  of  section
 2807-d  of  the  public health law, as amended by section 9 of part E of
 chapter 57 of the laws of 2019, is amended to read as follows:
   (vi)  Notwithstanding  any contrary provision of this paragraph or any
 other provision of law or regulation to the  contrary,  for  residential
 health care facilities the assessment shall be six percent of each resi-
 dential  health care facility's gross receipts received from all patient
 care services and other operating income on a cash basis for the  period
 April  first,  two thousand two through March thirty-first, two thousand
 three for hospital  or  health-related  services,  including  adult  day
 services;  provided,  however,  that residential health care facilities'
 gross receipts attributable to payments received pursuant to title XVIII
 of the federal social security act (medicare) shall be excluded from the
 assessment; provided, however, that for all such gross receipts received
 on or after April first, two thousand three through March  thirty-first,
 two  thousand  five,  such assessment shall be five percent, and further
 provided that for all such gross receipts received  on  or  after  April
 first,  two thousand five through March thirty-first, two thousand nine,
 and on or after April first, two thousand  nine  through  March  thirty-
 first,  two  thousand  eleven  such assessment shall be six percent, and
 further provided that for all such gross receipts received on  or  after
 April  first,  two thousand eleven through March thirty-first, two thou-
 sand thirteen such assessment shall be six percent, and further provided
 that for all such gross receipts received on or after April  first,  two
 thousand  thirteen through March thirty-first, two thousand fifteen such
 assessment shall be six percent, and further provided that for all  such
 gross  receipts  received  on or after April first, two thousand fifteen
 through March thirty-first, two thousand seventeen such assessment shall
 be six percent, and further provided that for all  such  gross  receipts
 received  on  or after April first, two thousand seventeen through March
 thirty-first,  two  thousand  nineteen  such  assessment  shall  be  six
 percent,  and further provided that for all such gross receipts received
 on or after April first, two thousand  nineteen  through  March  thirty-
 first, two thousand twenty-one such assessment shall be six percent, AND
 FURTHER  PROVIDED  THAT FOR ALL SUCH GROSS RECEIPTS RECEIVED ON OR AFTER
 APRIL FIRST, TWO THOUSAND TWENTY-ONE  THROUGH  MARCH  THIRTY-FIRST,  TWO
 THOUSAND TWENTY-TWO SUCH ASSESSMENT SHALL BE SIX PERCENT.
   §  11-a.  Section  2  of  chapter 66 of the laws of 2016, amending the
 public health law, relating to reporting of  opioid  overdose  data,  is
 amended to read as follows:
   § 2. This act shall take effect immediately, provided that subdivision
 6  of  section 3309 of the public health law, as added by section one of
 this act, shall expire and be deemed repealed March 31, [2021] 2026.
   § 12. This act shall take effect immediately and shall  be  deemed  to
 have been in full force and effect on and after April 1, 2021.
 
                                  PART T
 
   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 X of chapter 57 of the laws of  2018,  is  amended  to
 read as follows:
   §  3.  This act shall take effect immediately; and shall expire and be
 deemed repealed June 30, [2021] 2024.

 A. 3007--B                         23

   § 2. This act shall take effect immediately.
 
                                  PART U
 
                           Intentionally Omitted
 
                                  PART V
 
   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, as amended by  section  1
 of  part  U  of  chapter  57  of the laws of 2018, is amended to read as
 follows:
   § 2. This act shall take effect immediately and shall  expire  and  be
 deemed repealed March 31, [2021] 2024.
   §  1-a. Subdivision (d) of section 41.35 of the mental hygiene law, as
 amended by chapter 658 of the laws  of  1977,  is  amended  to  read  as
 follows:
   (d)  Quarterly  reviews and evaluations of the program shall be under-
 taken and a final report shall be developed by  representatives  of  the
 commissioner  or commissioners having jurisdiction over the services and
 the local governmental unit assessing the program, indicating its poten-
 tial for continuation or use elsewhere, and making any further recommen-
 dations related to the program. Copies of such quarterly evaluations and
 final reports shall be sent NO LATER  THAN  NOVEMBER  FIFTEENTH  to  the
 director  of  the division of the budget, and the chairmen of the senate
 finance committee and the assembly committee on ways and means AND SHALL
 BE INCLUDED IN THE  RELEVANT  COMMISSIONER  OR  COMMISSIONERS  STATEWIDE
 COMPREHENSIVE PLAN PURSUANT TO SECTION 5.07 OF THIS CHAPTER.
   §  1-b.  Subparagraphs  f  and  g of paragraph 1 of subdivision (b) of
 section 5.07 of the mental hygiene law, as amended by section 3 of  part
 N  of chapter 56 of the laws of 2012, are amended and a new subparagraph
 h is added to read as follows:
   f. encourage and  promote  person-centered,  culturally  and  linguis-
 tically  competent community-based programs, services, and supports that
 reflect the partnership between  state  and  local  governmental  units;
 [and]
   g.  include  progress reports on the implementation of both short-term
 and long-term recommendations of the children's plan  required  pursuant
 to  section  four  hundred eighty-three-f of the social services law[.];
 AND
   H. INCLUDE QUARTERLY EVALUATIONS, ASSESSMENTS, AND RECOMMENDATIONS FOR
 TIME LIMITED DEMONSTRATION  PROGRAMS  PURSUANT  TO  SUBDIVISION  (D)  OF
 SECTION 41.53 OF THIS CHAPTER.
   § 2. This act shall take effect immediately.
 
                                  PART W
 
   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

 A. 3007--B                         24
 
 1  of  part  V  of chapter 57 of the laws of 2018, is amended to read as
 follows:
   § 7. This act shall take effect immediately and shall expire March 31,
 [2021]  2024  when  upon  such  date the provisions of this act shall be
 deemed repealed.
   § 1-a. Subdivision (h) of section 41.55 of the mental hygiene law,  as
 added  by  section 2 of part R2 of chapter 62 of the laws of 2003 and as
 relettered by section 4 of part C of chapter 111 of the laws of 2010, is
 amended to read as follows:
   (h) Amounts made available to the community mental health support  and
 workforce  reinvestment  program of the office of mental health shall be
 subject to annual appropriations therefor[. Up]:
   (1) UP to fifteen percent of the amounts so appropriated shall be made
 available for staffing at state mental health facilities;
   (2) NO LESS THAN TWENTY PERCENT OF THE AMOUNTS SO  APPROPRIATED  SHALL
 BE  MADE  AVAILABLE  FOR  WORKFORCE  RECRUITMENT AND RETENTION AT MENTAL
 HEALTH PROGRAMS CERTIFIED UNDER ARTICLE THIRTY-ONE OF THIS CHAPTER; and
   (3) at least seven percent of the remaining funds may be allocated for
 state operated community services pursuant to this section.
   § 2. This act shall take effect immediately, provided,  however,  that
 the amendments to subdivision (h) of section 41.55 of the mental hygiene
 law  made  by  section  one-a of this act shall not affect the repeal of
 such section and shall be deemed to be repealed therewith.
 
                                  PART X
 
                           Intentionally Omitted
 
                                  PART Y
 
                           Intentionally Omitted

                                  PART Z
 
   Section 1. Intentionally omitted.
   § 2. Subdivision (a) of section 31.04 of the  mental  hygiene  law  is
 amended by adding a new paragraph 8 to read as follows:
   8.  ESTABLISHING  A  SCHEDULE  OF  FEES  FOR THE PURPOSE OF PROCESSING
 APPLICATIONS FOR THE ISSUANCE OF OPERATING CERTIFICATES. ALL FEES PURSU-
 ANT TO THIS SECTION SHALL BE PAYABLE TO THE MENTAL  ILLNESS  ANTI-STIGMA
 FUND UNDER SECTION 95-H OF THE STATE FINANCE LAW.
   §  3.    This  act  shall take effect on the one hundred eightieth day
 after it shall have become a law.   Effective immediately,  the  commis-
 sioner  of  mental  health is authorized to promulgate any and all rules
 and regulations and take any other measures necessary to implement  this
 act on its effective date or before such date.

                                  PART AA
 
   Section  1.  This  Part enacts into law legislation relating to crisis
 stabilization services, Kendra's law and assisted  outpatient  treatment
 and  involuntary commitment. Each component is wholly contained within a
 Subpart identified as Subparts A through C. The effective date for  each
 particular  provision  contained within each 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

 A. 3007--B                         25
 
 makes a reference to a section "of this act", when  used  in  connection
 with that particular component, shall be deemed to mean and refer to the
 corresponding section of the Subpart in which it is found. Section three
 of this Part sets forth the general effective date of this Part.
 
                                 SUBPART A
 
   Section  1.  The mental hygiene law is amended by adding a new section
 31.36 to read as follows:
 § 31.36 CRISIS STABILIZATION SERVICES.
   THE COMMISSIONER IS AUTHORIZED, IN CONJUNCTION WITH  THE  COMMISSIONER
 OF  THE  OFFICE  OF  ADDICTION  SERVICES  AND SUPPORTS, TO CREATE CRISIS
 STABILIZATION CENTERS WITHIN NEW YORK STATE IN ACCORDANCE  WITH  ARTICLE
 THIRTY-SIX  OF  THIS  TITLE,  INCLUDING  THE PROMULGATION OF JOINT REGU-
 LATIONS AND IMPLEMENTATION OF A FINANCING MECHANISM  TO  ALLOW  FOR  THE
 SUSTAINABLE OPERATION OF SUCH PROGRAMS.
   §  2.  The mental hygiene law is amended by adding a new section 32.36
 to read as follows:
 § 32.36 CRISIS STABILIZATION SERVICES.
   THE COMMISSIONER IS AUTHORIZED, IN CONJUNCTION WITH  THE  COMMISSIONER
 OF  THE  OFFICE OF MENTAL HEALTH, TO CREATE CRISIS STABILIZATION CENTERS
 WITHIN NEW YORK STATE IN ACCORDANCE  WITH  ARTICLE  THIRTY-SIX  OF  THIS
 TITLE,  INCLUDING  THE PROMULGATION OF JOINT REGULATIONS AND IMPLEMENTA-
 TION OF A FINANCING MECHANISM TO ALLOW FOR THE SUSTAINABLE OPERATION  OF
 SUCH PROGRAMS.
   §  3.  The mental hygiene law is amended by adding a new article 36 to
 read as follows:
                               ARTICLE XXXVI
             ADDICTION AND MENTAL HEALTH SERVICES AND SUPPORTS
 SECTION 36.01 CRISIS STABILIZATION CENTERS.
         36.02 REFERRAL TO CRISIS STABILIZATION CENTERS.
 § 36.01 CRISIS STABILIZATION CENTERS.
   (A) (1) THE COMMISSIONERS ARE AUTHORIZED  TO  JOINTLY  LICENSE  CRISIS
 STABILIZATION  CENTERS  SUBJECT TO THE AVAILABILITY OF STATE AND FEDERAL
 FUNDING.
   (2) A CRISIS STABILIZATION CENTER  SHALL  SERVE  AS  A  VOLUNTARY  AND
 URGENT  CARE  SERVICE PROVIDER FOR PERSONS AT RISK OF A MENTAL HEALTH OR
 SUBSTANCE USE CRISIS OR ARE EXPERIENCING A CRISIS RELATED TO A PSYCHIAT-
 RIC AND/OR SUBSTANCE USE DISORDER THAT ARE IN NEED OF CRISIS  STABILIZA-
 TION  SERVICES.  EACH  CRISIS  STABILIZATION  CENTER  SHALL  PROVIDE  OR
 CONTRACT TO PROVIDE PERSON CENTERED AND PATIENT DRIVEN CRISIS STABILIZA-
 TION SERVICES FOR MENTAL HEALTH OR SUBSTANCE USE TWENTY-FOUR  HOURS  PER
 DAY, SEVEN DAYS PER WEEK, INCLUDING BUT NOT LIMITED TO:
   (I) ENGAGEMENT, TRIAGE AND ASSESSMENT;
   (II) CONTINUOUS OBSERVATION;
   (III) MILD TO MODERATE DETOXIFICATION;
   (IV) SOBERING SERVICES;
   (V) THERAPEUTIC INTERVENTIONS;
   (VI) DISCHARGE AND AFTER CARE PLANNING;
   (VII) TELEMEDICINE;
   (VIII) PEER SUPPORT SERVICES; AND
   (IX) MEDICATION ASSISTED TREATMENT.
   (3)  THE  COMMISSIONERS SHALL REQUIRE EACH CRISIS STABILIZATION CENTER
 TO SUBMIT A PLAN. THE PLAN SHALL BE APPROVED BY THE COMMISSIONERS  PRIOR
 TO  THE  ISSUANCE  OF AN OPERATING CERTIFICATE PURSUANT TO THIS ARTICLE.
 EACH PLAN SHALL INCLUDE:

 A. 3007--B                         26
 
   (I) A DESCRIPTION OF THE CENTER'S CATCHMENT AREA,
   (II) A DESCRIPTION OF THE CENTER'S CRISIS STABILIZATION SERVICES,
   (III)  AGREEMENTS OR AFFILIATIONS WITH HOSPITALS AS DEFINED IN SECTION
 1.03 OF THIS CHAPTER,
   (IV) AGREEMENTS OR AFFILIATIONS WITH GENERAL HOSPITALS OR LAW ENFORCE-
 MENT TO RECEIVE PERSONS,
   (V) A DESCRIPTION OF  LOCAL  RESOURCES  AVAILABLE  TO  THE  CENTER  TO
 PREVENT UNNECESSARY HOSPITALIZATIONS OF PERSONS,
   (VI)  A  DESCRIPTION  OF THE CENTER'S LINKAGES WITH LOCAL POLICE AGEN-
 CIES, EMERGENCY MEDICAL SERVICES, AMBULANCE SERVICES AND OTHER TRANSPOR-
 TATION AGENCIES,
   (VII) A DESCRIPTION OF LOCAL RESOURCES  AVAILABLE  TO  THE  CENTER  TO
 PROVIDE  APPROPRIATE  COMMUNITY MENTAL HEALTH AND SUBSTANCE USE DISORDER
 SERVICES UPON RELEASE,
   (VIII) WRITTEN CRITERIA AND GUIDELINES FOR THE DEVELOPMENT  OF  APPRO-
 PRIATE  PLANNING  FOR  PERSONS  IN  NEED  OF POST COMMUNITY TREATMENT OR
 SERVICES,
   (IX) A STATEMENT INDICATING THAT THE CENTER HAS BEEN  INCLUDED  IN  AN
 APPROVED  LOCAL SERVICES PLAN DEVELOPED PURSUANT TO ARTICLE FORTY-ONE OF
 THIS CHAPTER FOR EACH  LOCAL  GOVERNMENT  LOCATED  WITHIN  THE  CENTER'S
 CATCHMENT AREA; AND
   (X) ANY OTHER INFORMATION OR AGREEMENTS REQUIRED BY THE COMMISSIONERS.
   (4)  CRISIS  STABILIZATION  CENTERS  SHALL  PARTICIPATE  IN COUNTY AND
 COMMUNITY PLANNING ACTIVITIES ANNUALLY, AND AS ADDITIONALLY  NEEDED,  IN
 ORDER  TO  PARTICIPATE  IN LOCAL COMMUNITY SERVICE PLANNING PROCESSES TO
 ENSURE, MAINTAIN, IMPROVE OR DEVELOP COMMUNITY SERVICES THAT DEMONSTRATE
 RECOVERY OUTCOMES. THESE OUTCOMES INCLUDE, BUT ARE NOT LIMITED TO, QUAL-
 ITY OF LIFE, SOCIO-ECONOMIC STATUS, ENTITLEMENT STATUS, SOCIAL  NETWORK-
 ING, COPING SKILLS AND REDUCTION IN USE OF CRISIS SERVICES.
   (B) EACH CRISIS STABILIZATION CENTER SHALL BE STAFFED WITH A MULTIDIS-
 CIPLINARY  TEAM CAPABLE OF MEETING THE NEEDS OF INDIVIDUALS EXPERIENCING
 ALL LEVELS OF CRISIS IN THE COMMUNITY WHICH SHALL INCLUDE,  BUT  NOT  BE
 LIMITED TO, AT LEAST ONE PSYCHIATRIST OR PSYCHIATRIC NURSE PRACTITIONER,
 A  CREDENTIALED  ALCOHOLISM  AND  SUBSTANCE ABUSE COUNSELOR AND ONE PEER
 SUPPORT SPECIALIST ON DUTY AND AVAILABLE AT ALL TIMES, PROVIDED,  HOWEV-
 ER,  THE COMMISSIONERS MAY PROMULGATE REGULATIONS TO PERMIT THE ISSUANCE
 OF A WAIVER OF THIS REQUIREMENT WHEN THE VOLUME OF SERVICE OF  A  CENTER
 DOES  NOT  REQUIRE SUCH LEVEL OF STAFF COVERAGE.  A WAIVER MAY BE ISSUED
 TO A CRISIS STABILIZATION CENTER, WHICH HAS BEEN  ESTABLISHED  PRIOR  TO
 THE EFFECTIVE DATE OF THIS ARTICLE, THAT HAS DEMONSTRATED THE ABILITY TO
 EFFECTIVELY  OPERATE  CRISIS  STABILIZATION  CENTERS  UNDER AN EFFECTIVE
 MODEL OF CARE WHICH MAY BE REPLICATED THROUGHOUT THE STATE.
   (C) THE COMMISSIONERS SHALL PROMULGATE REGULATIONS  NECESSARY  TO  THE
 OPERATION OF SUCH CRISIS STABILIZATION CENTERS.
   (D)  FOR THE PURPOSE OF ADDRESSING UNIQUE RURAL SERVICE DELIVERY NEEDS
 AND CONDITIONS, THE COMMISSIONERS SHALL PROVIDE TECHNICAL ASSISTANCE FOR
 THE ESTABLISHMENT OF CRISIS  STABILIZATION  CENTERS  OTHERWISE  APPROVED
 UNDER  THE PROVISIONS OF THIS SECTION, INCLUDING TECHNICAL ASSISTANCE TO
 PROMOTE AND FACILITATE THE ESTABLISHMENT OF SUCH CENTERS IN RURAL  AREAS
 IN THE STATE OR COMBINATIONS OF RURAL COUNTIES.
   (E)  THE COMMISSIONERS SHALL DEVELOP OR USE EXISTING EDUCATIONAL MATE-
 RIALS AND PROVIDE THE MATERIALS  TO  CRISIS  STABILIZATION  CENTERS  WHO
 SHALL  DISSEMINATE  THEM TO LOCAL PRACTITIONERS, COMMUNITY MENTAL HEALTH
 AND SUBSTANCE USE PROGRAMS, HOSPITALS, LAW ENFORCEMENT, THE LOCAL  JUDI-
 CIAL  SYSTEM,  AND PEERS. THE MATERIALS SHALL INCLUDE APPROPRIATE EDUCA-
 TION RELATING TO  DE-ESCALATION  TECHNIQUES,  CULTURAL  COMPETENCY,  THE

 A. 3007--B                         27
 
 RECOVERY PROCESS, MENTAL HEALTH, SUBSTANCE USE, AND AVOIDANCE OF AGGRES-
 SIVE CONFRONTATION.
   (F)  WITHIN  THE  AMOUNTS APPROPRIATED, THE COMMISSIONERS SHALL ENSURE
 THAT THE APPROPRIATE TRAINING IS PROVIDED TO EACH LAW ENFORCEMENT  ENTI-
 TY,  FIRST  RESPONDERS, AND ANY OTHER ENTITIES DEEMED APPROPRIATE BY THE
 COMMISSIONERS, LOCATED WITHIN THE CATCHMENT AREA OF A CRISIS  STABILIZA-
 TION  CENTER.  THE  TRAINING  SHALL  INCLUDE BUT NOT BE LIMITED TO:  (1)
 CRISIS INTERVENTION TEAM TRAINING; (2) MENTAL HEALTH FIRST AID; AND  (3)
 IMPLICIT  BIAS TRAINING.  SUCH TRAINING MAY BE PROVIDED IN AN ELECTRONIC
 FORMAT OR OTHER FORMAT AS DEEMED APPROPRIATE BY THE  COMMISSIONERS.  THE
 COMMISSIONERS SHALL CONTRACT WITH AN ORGANIZATION WITH THE KNOWLEDGE AND
 EXPERTISE IN PROVIDING THE TRAINING REQUIRED UNDER THIS SUBDIVISION.
 § 36.02 REFERRAL TO CRISIS STABILIZATION CENTERS.
   (A)  AN AUTHORIZED REFERRAL TO CRISIS STABILIZATION CENTER MAY INCLUDE
 BUT NOT BE LIMITED  TO:  (1)  WALK-INS  OR  SELF-REFERRALS;  (2)  FAMILY
 MEMBERS;  (3) SCHOOLS; (4) HOSPITALS; (5) COMMUNITY-BASED PROVIDERS; (6)
 MOBILE MENTAL HEALTH CRISIS TEAMS; (7) CRISIS CALL CENTERS; (8)  PRIMARY
 CARE DOCTORS; (9) LAW ENFORCEMENT; AND (10) PRIVATE PRACTITIONERS.
   (B)  ALL  SERVICES  PROVIDED  IN CRISIS STABILIZATION CENTERS SHALL BE
 VOLUNTARY.   NO CRISIS STABILIZATION  CENTER  SHALL  ACCEPT  INVOLUNTARY
 REFERRALS,  AND  NO  PERSON SHALL BE FORCED OR COERCED TO PARTICIPATE IN
 SERVICES OR TREATMENT.  A CRISIS STABILIZATION CENTER MAY  AT  ANY  TIME
 REFER  A  PERSON  IN THEIR CARE TO A HIGHER LEVEL OF TREATMENT IF DEEMED
 APPROPRIATE.
   (C) FOR A PERSON WHO IS NEED OF EMERGENCY  OBSERVATION  UNDER  SECTION
 9.41,  9.43, 9.45, OR 9.58 OF THIS CHAPTER, THE APPROPRIATE POLICE OFFI-
 CER, PEACE OFFICER, COURT, COMMUNITY SERVICES DIRECTOR OR MOBILE  CRISIS
 TEAM  MUST INFORM THE PERSON OF THE AVAILABILITY OF CRISIS STABILIZATION
 CENTER SERVICES.  A CRISIS STABILIZATION CENTER MAY CONDUCT  AN  ASSESS-
 MENT  PRIOR TO ACCEPTING A REFERRAL.   A CRISIS STABILIZATION CENTER MAY
 DIRECT OR MAKE A REFERRAL TO A  HOSPITAL  OR  COMPREHENSIVE  PSYCHIATRIC
 EMERGENCY  PROGRAM  IF  AN ASSESSMENT DETERMINES THAT THEY ARE UNABLE TO
 MEET THE SERVICE NEEDS OF A PERSON AND SUCH PERSON VOLUNTARILY  CONSENTS
 TO GO.
   § 4. Section 9.41 of the mental hygiene law, as amended by chapter 723
 of the laws of 1989, is amended to read as follows:
 § 9.41 Emergency  [admissions]  ASSESSMENT  for  immediate  observation,
            care, and treatment; powers of  certain  peace  officers  and
            police officers.
   (A)  Any  peace  officer,  when  acting pursuant to his or her special
 duties, or police officer who is a member of the state police or  of  an
 authorized  police  department or force or of a sheriff's department may
 take into custody any person who appears  to  be  mentally  ill  and  is
 conducting  himself  or herself in a manner which is likely to result in
 serious harm to the person  or  others.  Such  officer  may  direct  the
 removal  of such person or remove him or her to: (A) any hospital speci-
 fied in subdivision (a) of section 9.39 OF  THIS  ARTICLE,  or  (B)  any
 comprehensive psychiatric emergency program specified in subdivision (a)
 of  section 9.40 OF THIS ARTICLE, or, (C) pending his or her examination
 or admission to any such hospital or, program,  temporarily  detain  any
 such  person in another safe and comfortable place, in which event, such
 officer shall immediately notify the director of community services  or,
 if  there  be  none,  the  health  officer of the city or county of such
 action.
   (B) AS AN ALTERNATIVE TO AN EMERGENCY ADMISSION,  A  PERSON  OTHERWISE
 DETERMINED  TO  MEET THE CRITERIA FOR AN EMERGENCY ADMISSION PURSUANT TO

 A. 3007--B                         28
 
 THIS SECTION, MAY VOLUNTARILY  AGREE  TO  BE  TRANSPORTED  TO  A  CRISIS
 STABILIZATION  CENTER  UNDER  SECTION 36.01 OF THIS CHAPTER FOR CARE AND
 TREATMENT, AND IN ACCORDANCE WITH THIS ARTICLE,  AN  ASSESSMENT  BY  THE
 CRISIS  STABILIZATION  CENTER  DETERMINES THAT THEY ARE ABLE TO MEET THE
 SERVICE NEEDS OF THE PERSON IN NEED OF TREATMENT.
   § 5. Section 9.43 of the mental hygiene law, as amended by chapter 723
 of the laws of 1989, is amended to read as follows:
 § 9.43 Emergency  [admissions]  ASSESSMENT  for  immediate  observation,
            care, and treatment; powers of courts.
   (a) Whenever any court of inferior or general jurisdiction is informed
 by  verified  statement  that a person is apparently mentally ill and is
 conducting himself or herself in a manner which in a person who  is  not
 mentally  ill  would  be deemed disorderly conduct or which is likely to
 result in serious harm to himself or herself, such court shall  issue  a
 warrant  directing  that such person be brought before it. If, when said
 person is brought before the court, it appears  to  the  court,  on  the
 basis  of  evidence  presented to it, that such person has or may have a
 mental illness which is likely to result in serious harm to  himself  or
 herself  or others, the court shall issue a civil order directing his or
 her removal to any hospital specified in subdivision (a) of section 9.39
 OF THIS ARTICLE or any comprehensive psychiatric emergency program spec-
 ified in subdivision (a) of section 9.40 OF THIS ARTICLE, THAT IS  will-
 ing  to  receive such person for a determination by the director of such
 hospital or program whether such person should  be  [retained]  RECEIVED
 therein pursuant to such section.
   (b)  Whenever  a person before a court in a criminal action appears to
 have a mental illness which is likely  to  result  in  serious  harm  to
 himself  or  herself  or others and the court determines either that the
 crime has not been committed or that there is not  sufficient  cause  to
 believe  that such person is guilty thereof, the court may issue a civil
 order as above provided, and in such cases  the  criminal  action  shall
 terminate.
   (C)  AS  AN  ALTERNATIVE TO AN EMERGENCY ADMISSION, A PERSON OTHERWISE
 DETERMINED TO MEET THE CRITERIA FOR AN EMERGENCY ADMISSION  PURSUANT  TO
 THIS  SECTION,  MAY  VOLUNTARILY  AGREE  TO  BE  TRANSPORTED TO A CRISIS
 STABILIZATION CENTER UNDER SECTION 36.01 OF THIS CHAPTER  FOR  CARE  AND
 TREATMENT,  AND  IN  ACCORDANCE  WITH THIS ARTICLE, AN ASSESSMENT BY THE
 CRISIS STABILIZATION CENTER DETERMINES THAT THEY ARE ABLE  TO  MEET  THE
 SERVICE NEEDS OF THE PERSON IN NEED OF TREATMENT.
   § 6. Section 9.45 of the mental hygiene law, as amended by chapter 723
 of  the laws of 1989 and the opening paragraph as amended by chapter 192
 of the laws of 2005, is amended to read as follows:
 § 9.45 Emergency  [admissions]  ASSESSMENT  for  immediate  observation,
            care,   and  treatment;  powers  of  directors  of  community
            services.
   (A) The director of community  services  or  the  director's  designee
 shall  have the power to direct the removal of any person, within his or
 her jurisdiction, to a hospital approved by the commissioner pursuant to
 subdivision (a) of section 9.39 of this article, or to  a  comprehensive
 psychiatric  emergency  program  pursuant  to subdivision (a) of section
 9.40 of this article, if the parent, adult sibling, spouse or  child  of
 the  person,  the  committee or legal guardian of the person, a licensed
 psychologist, registered professional nurse or certified  social  worker
 currently  responsible for providing treatment services to the person, a
 supportive or intensive case manager currently assigned to the person by
 a case management program which program is approved  by  the  office  of

 A. 3007--B                         29
 
 mental  health  for  the  purpose  of  reporting  under  this section, a
 licensed physician, health officer,  peace  officer  or  police  officer
 reports  to  him  or her that such person has a mental illness for which
 immediate care and treatment [in a hospital] is appropriate and which is
 likely  to  result  in  serious harm to himself or herself or others. It
 shall be the duty of peace  officers,  when  acting  pursuant  to  their
 special  duties,  or  police  officers, who are members of an authorized
 police department or force or of a sheriff's department to assist repre-
 sentatives of such director to take into custody and transport any  such
 person.  Upon  the  request  of  a director of community services or the
 director's designee an ambulance service, as defined in subdivision  two
 of section three thousand one of the public health law, is authorized to
 transport  any such person. Such person may then be retained in a hospi-
 tal pursuant to the provisions of section 9.39 of this article or  in  a
 comprehensive  psychiatric  emergency program pursuant to the provisions
 of section 9.40 of this article.
   (B) AS AN ALTERNATIVE TO AN EMERGENCY ADMISSION,  A  PERSON  OTHERWISE
 DETERMINED  TO  MEET THE CRITERIA FOR AN EMERGENCY ADMISSION PURSUANT TO
 THIS SECTION, MAY VOLUNTARILY  AGREE  TO  BE  TRANSPORTED  TO  A  CRISIS
 STABILIZATION  CENTER  UNDER  SECTION 36.01 OF THIS CHAPTER FOR CARE AND
 TREATMENT, AND IN ACCORDANCE WITH THIS ARTICLE,  AN  ASSESSMENT  BY  THE
 CRISIS  STABILIZATION  CENTER  DETERMINES THAT THEY ARE ABLE TO MEET THE
 SERVICE NEEDS OF THE PERSON IN NEED OF TREATMENT.
   § 7.  Subdivision (a) of section 9.58 of the mental  hygiene  law,  as
 added by chapter 678 of the laws of 1994, is amended to read as follows:
   (a)  A  physician  or  qualified  mental  health professional who is a
 member of an approved mobile crisis outreach team shall have  the  power
 to remove, or pursuant to subdivision (b) of this section, to direct the
 removal  of  any person WHO APPEARS TO BE MENTALLY ILL AND IS CONDUCTING
 THEMSELVES IN A MANNER WHICH IS LIKELY TO  RESULT  IN  SERIOUS  HARM  TO
 THEMSELVES  OR OTHERS, to a hospital approved by the commissioner pursu-
 ant to subdivision (a) of section 9.39 or section 31.27 of this  chapter
 [for  the  purpose of evaluation for admission if such person appears to
 be mentally ill and is conducting himself or herself in a  manner  which
 is likely to result in serious harm to the person or others].
   (B)  AS  AN  ALTERNATIVE TO AN EMERGENCY ADMISSION, A PERSON OTHERWISE
 DETERMINED TO MEET THE CRITERIA FOR AN EMERGENCY ASSESSMENT PURSUANT  TO
 THIS  SECTION,  MAY  VOLUNTARILY  AGREE  TO  BE  TRANSPORTED TO A CRISIS
 STABILIZATION CENTER UNDER SECTION 36.01 OF THIS CHAPTER  FOR  CARE  AND
 TREATMENT,  AND  IN  ACCORDANCE  WITH THIS ARTICLE, AN ASSESSMENT BY THE
 CRISIS STABILIZATION CENTER DETERMINES THAT THEY ARE ABLE  TO  MEET  THE
 SERVICE NEEDS OF THE PERSON IN NEED OF TREATMENT.
   §  8.  Subdivision  2  of  section 365-a of the social services law is
 amended by adding a new paragraph (gg) to read as follows:
   (GG) ADDICTION AND MENTAL HEALTH SERVICES  AND  SUPPORTS  PROVIDED  BY
 FACILITIES LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF THE MENTAL HYGIENE
 LAW.
   §  9.  Paragraph  5  of subdivision (a) of section 22.09 of the mental
 hygiene law, as amended by section 1 of part D of chapter 69 of the laws
 of 2016, is amended to read as follows:
   5. "Treatment facility" means a facility designated by the commission-
 er which may only include a general hospital as defined in article twen-
 ty-eight of the public health law, or a medically managed  or  medically
 supervised withdrawal, inpatient rehabilitation, or residential stabili-
 zation  treatment program that has been certified by the commissioner to
 have appropriate medical staff available on-site at all times to provide

 A. 3007--B                         30
 
 emergency services and continued evaluation of capacity  of  individuals
 retained  under  this  section OR A CRISIS STABILIZATION CENTER LICENSED
 PURSUANT TO ARTICLE 36.01 OF THIS CHAPTER.
   §  10.  The commissioner of health, in consultation with the office of
 mental health and the office of addiction services and  supports,  shall
 seek  Medicaid  federal financial participation from the federal centers
 for Medicare and Medicaid services for the federal share of payments for
 the services authorized pursuant to this Subpart.
   § 11. This act shall take effect October 1, 2021;  provided,  however,
 that  the  amendments  to  sections  9.41,  9.43  and 9.45 of the mental
 hygiene law made by sections four, five and six of this  act  shall  not
 affect  the  expiration  of  such  sections  and shall expire therewith.
 Effective immediately, the addition, amendment and/or repeal of any rule
 or regulation necessary for the implementation of this act on its effec-
 tive date are authorized to be made and  completed  on  or  before  such
 effective date.
 
                                 SUBPART B
 
                           Intentionally Omitted
 
                                 SUBPART C
 
                           Intentionally Omitted
   § 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 Subparts A through C of this act shall
 be as specifically set forth in the last section of such Subparts.
 
                                  PART BB
 
                           Intentionally Omitted
 
                                  PART CC
 
                           Intentionally Omitted
 
                                  PART DD
 
                           Intentionally Omitted
 
                                  PART EE
 
                           Intentionally Omitted
 
                                  PART FF
 
                           Intentionally Omitted

 A. 3007--B                         31
 
                                  PART GG
 
                           Intentionally Omitted
 
                                  PART HH
 
                           Intentionally Omitted
 
                                  PART II
 
   Section  1.   Paragraph (d-2) of subdivision 3 of section 364-j of the
 social services law, as amended by section 10 of part B of chapter 57 of
 the laws of 2018, 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 twenty-two] ESTABLISHED PURSUANT TO
 THIS SECTION; PROVIDED, FURTHER THAT THE COMMISSIONER OF HEALTH IS HERE-
 BY DIRECTED TO TAKE ANY ACTION REQUIRED, INCLUDING BUT  NOT  LIMITED  TO
 FILING  WAIVERS  AND  WAIVER  EXTENSIONS  AS  NECESSARY WITH THE FEDERAL
 GOVERNMENT, TO CONTINUE THE PROVISION OF SUCH SERVICES.
   § 2. This act shall take effect immediately, provided that the  amend-
 ments  to  section 364-j of the social services law, made by section one
 of this act, shall not affect the expiration and repeal of such section,
 and shall expire and be deemed repealed therewith.

                                  PART JJ
 
   Section 1. Subdivision 1 of section 364-j of the social  services  law
 is  amended  by  adding  two  new  paragraphs  (w)  and (w-1) to read as
 follows:
   (W) "SCHOOL-BASED HEALTH CENTER".  A  CLINIC  LICENSED  UNDER  ARTICLE
 TWENTY-EIGHT  OF  THE  PUBLIC  HEALTH  LAW  OR SPONSORED EITHER FULLY OR
 PARTIALLY BY A FACILITY  LICENSED  UNDER  ARTICLE  TWENTY-EIGHT  OF  THE
 PUBLIC  HEALTH  LAW  OR  WHERE  SUCH SPONSORSHIP IS DUALLY SHARED WITH A
 FACILITY LICENSED UNDER ARTICLE THIRTY-ONE OF  THE  MENTAL  HYGIENE  LAW
 WHICH  PROVIDES PRIMARY AND PREVENTIVE CARE WHICH MAY INCLUDE BUT IS NOT
 LIMITED TO HEALTH MAINTENANCE, WELL-CHILD CARE, DIAGNOSIS AND  TREATMENT
 OF  INJURY  AND  ACUTE  ILLNESS,  DIAGNOSIS  AND  MANAGEMENT  OF CHRONIC
 DISEASE, BEHAVIORAL SERVICES, VISION CARE, DENTAL CARE, AND  NUTRITIONAL
 OR OTHER ENHANCED SERVICES TO CHILDREN AND ADOLESCENTS, ANY OF WHICH MAY
 BE  PROVIDED  BY REFERRAL, WITHIN AN ELEMENTARY, SECONDARY OR PREKINDER-
 GARTEN PUBLIC SCHOOL SETTING.
   (W-1) "SPONSORING ORGANIZATION". A  FACILITY  LICENSED  UNDER  ARTICLE
 TWENTY-EIGHT  OF  THE  PUBLIC HEALTH LAW WHICH ACTS AS THE SPONSOR FOR A
 SCHOOL-BASED HEALTH CENTER, WHICH SUCH SPONSORSHIP MAY BE DUALLY  SHARED
 WITH  A FACILITY LICENSED UNDER ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE
 LAW.
   § 2. Section 364-j of the social services law is amended by  adding  a
 new subdivision 4-a to read as follows:
   4-A.  (A)  MEDICAL  ASSISTANCE  SERVICES  AND  SUPPLIES  PROVIDED BY A
 SCHOOL-BASED HEALTH CENTER MAY BE PROVIDED AND PAID FOR OTHER THAN BY  A
 MANAGED  CARE PROVIDER. IN SUCH CASE, THE SERVICES AND SUPPLIES SHALL BE

 A. 3007--B                         32
 
 PAID IN ACCORDANCE WITH APPLICABLE  REIMBURSEMENT  METHODOLOGIES,  WHICH
 SHALL MEAN:
   (I)  FOR A SCHOOL-BASED HEALTH CENTER THAT IS SPONSORED BY A FEDERALLY
 QUALIFIED HEALTH CENTER, RATES  OF  REIMBURSEMENT  AND  REQUIREMENTS  IN
 ACCORDANCE   WITH   THOSE  MANDATED  BY  42  U.S.C.  SECS.    1396A(BB),
 1396B(M)(2)(A)(IX) AND 1396A(A)(13)(C); AND
   (II) FOR A SCHOOL-BASED HEALTH CENTER THAT IS SPONSORED BY  AN  ENTITY
 LICENSED  PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW THAT
 IS NOT A FEDERALLY QUALIFIED HEALTH CENTER OR IS A  FEDERALLY  QUALIFIED
 HEALTH  CENTER  THAT  CHOOSES  NOT  TO RECEIVE REIMBURSEMENT PURSUANT TO
 SUBPARAGRAPH (I) OF THIS PARAGRAPH, RATES OF REIMBURSEMENT  AT  THE  FEE
 FOR  SERVICE RATE FOR SUCH SERVICES AND SUPPLIES IN EFFECT ON THE EFFEC-
 TIVE DATE OF THIS SUBPARAGRAPH FOR THE AMBULATORY PATIENT GROUP RATE FOR
 THE APPLICABLE SERVICE AND SUPPLY AND  IN  ACCORDANCE  WITH  ANY  FUTURE
 ADJUSTMENTS MADE TO SUCH RATES BY THE DEPARTMENT OF HEALTH.
   (B)  THIS  SUBDIVISION SHALL NOT PRECLUDE A SCHOOL-BASED HEALTH CENTER
 OR SPONSORING ORGANIZATION FROM CHOOSING TO PROVIDE  MEDICAL  ASSISTANCE
 SERVICES AND SUPPLIES THROUGH MANAGED CARE PROVIDERS.
   (C)  THIS  PARAGRAPH APPLIES WHERE A MANAGED CARE PROVIDER INCLUDES AS
 AN ENROLLEE A STUDENT WHO IS ELIGIBLE TO BE  SERVED  BY  A  SCHOOL-BASED
 HEALTH  CENTER,  REGARDLESS OF WHETHER THE SCHOOL-BASED HEALTH CENTER OR
 SPONSORING ORGANIZATION CHOOSES TO PROVIDE MEDICAL  ASSISTANCE  SERVICES
 AND  SUPPLIES THROUGH THE MANAGED CARE PROVIDER. THE SCHOOL-BASED HEALTH
 CENTER OR SPONSORING ORGANIZATION AND THE MANAGED  CARE  PROVIDER  SHALL
 ENTER INTO A STANDARD MEMORANDUM OF UNDERSTANDING, WHICH SHALL BE DEVEL-
 OPED  BY  THE  COMMISSIONER FOR THE PURPOSE OF PROMOTING THE DELIVERY OF
 COORDINATED HEALTH CARE AND PARTICIPATION IN QUALITY IMPROVEMENT  INITI-
 ATIVES. THE COMMISSIONER SHALL PERIODICALLY SHARE ENROLLMENT, ENCOUNTER,
 AND  ANY  OTHER  DATA  THE  COMMISSIONER  DETERMINES NECESSARY WITH EACH
 ENROLLED PARTICIPANT'S MEDICAID  MANAGED  CARE  PROVIDER  TO  ALLOW  THE
 EXCHANGE  OF  SUCH  DATA  BETWEEN  MEDICAID  MANAGED  CARE PROVIDERS AND
 SCHOOL-BASED HEALTH CENTERS FOR THE PURPOSE OF THIS PARAGRAPH AND FACIL-
 ITATING ENROLLEE ACCESS TO SERVICES AND IMPROVING COORDINATION AND QUAL-
 ITY OF CARE.
   § 3. This act shall take effect on the one hundred eightieth day after
 it shall have become a law; provided  that  the  amendments  to  section
 364-j  of  the  social services law made by sections one and two of this
 act shall not affect the repeal of such section and shall expire and  be
 deemed  repealed therewith.   Effective immediately, the commissioner of
 health shall make regulations and take other actions  reasonably  neces-
 sary to implement this act on its effective date.
 
                                  PART KK
 
   Section 1. Subparagraph 3 of paragraph (d) of subdivision 1 of section
 366 of the social services law, as added by section 1 of part D of chap-
 ter 56 of the laws of 2013, is amended to read as follows:
   (3)  cooperates  with  the appropriate social services official or the
 department in establishing paternity or in establishing,  modifying,  or
 enforcing  a  support  order with respect to his or her child; provided,
 however, that nothing herein contained shall be construed to  require  a
 payment  under this title for care or services, the cost of which may be
 met in whole or in part by a third party; notwithstanding the foregoing,
 a social services official shall not require  such  cooperation  if  the
 social  services official or the department determines that such actions
 would be detrimental to the best interest of the  child,  applicant,  or

 A. 3007--B                         33
 
 recipient, or with respect to pregnant women during pregnancy and during
 the  [sixty-day] ONE YEAR period beginning on the last day of pregnancy,
 in accordance with procedures and criteria established by regulations of
 the department consistent with federal law; and
   §  2.  Subparagraph 1 of paragraph (b) of subdivision 4 of section 366
 of the social services law, as added by section 2 of part D  of  chapter
 56 of the laws of 2013, is amended to read as follows:
   (1)  A  pregnant  woman eligible for medical assistance under subpara-
 graph two or four of paragraph (b) of subdivision one of this section on
 any day of her pregnancy will continue to be eligible for such care  and
 services [through the end of the month in which the sixtieth day follow-
 ing  the end of the pregnancy occurs] FOR A PERIOD OF ONE YEAR FOLLOWING
 THE END OF THE PREGNANCY, without regard to any change in the income  of
 the  family that includes the pregnant woman, even if such change other-
 wise would have rendered her ineligible for medical assistance.
   § 3. This act shall take effect on the one hundred eightieth day after
 it shall have become a law. The commissioner of health shall immediately
 take all steps necessary and shall use best efforts  to  secure  federal
 financial  participation  for  eligible beneficiaries under title XIX of
 the social security act, for the purposes of  this  act,  including  the
 prompt submission of appropriate amendments to the title XIX state plan.
 
                                  PART LL

   Section  1.  The  public health law is amended by adding a new article
 27-g to read as follows:
                               ARTICLE 27-G
                 ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
 SECTION 2795. ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM.
   § 2795. ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM. 1. THE  COMMISSIONER
 SHALL ESTABLISH A PROGRAM TO REIMBURSE THE COST OF PROVIDING HEALTH CARE
 OR HEALTH INSURANCE TO ELIGIBLE INDIVIDUALS WHO HAVE CYSTIC FIBROSIS.
   2.  TO  BE  A  FULLY  ELIGIBLE INDIVIDUAL FOR WHOM HEALTH CARE WILL BE
 PROVIDED UNDER THIS SECTION, SUCH INDIVIDUAL:
   (A) SHALL BE AT LEAST TWENTY-ONE YEARS OLD;
   (B) SHALL HAVE BEEN DIAGNOSED AS HAVING CYSTIC FIBROSIS;
   (C) SHALL HAVE RESIDED IN THE STATE FOR A MINIMUM OF TWELVE CONTINUOUS
 MONTHS IMMEDIATELY PRIOR TO APPLICATION FOR SERVICES UNDER THIS SECTION;
   (D) SHALL NOT BE ELIGIBLE FOR MEDICAL  BENEFITS  UNDER  ANY  GROUP  OR
 INDIVIDUAL HEALTH INSURANCE POLICY; AND
   (E)  SHALL  NOT  BE  ELIGIBLE FOR MEDICAL ASSISTANCE PURSUANT TO TITLE
 ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW SOLELY DUE  TO  EARNED
 INCOME.
   3.  TO BE A PARTIALLY ELIGIBLE INDIVIDUAL FOR WHOM HEALTH CARE WILL BE
 PROVIDED UNDER THIS SECTION, SUCH INDIVIDUAL SHALL MEET ALL THE CRITERIA
 OF A FULLY ELIGIBLE INDIVIDUAL EXCEPT THAT A PARTIALLY ELIGIBLE INDIVID-
 UAL SHALL BE AN INDIVIDUAL WHO IS ELIGIBLE FOR  MEDICAL  BENEFITS  UNDER
 ANY GROUP OR INDIVIDUAL HEALTH INSURANCE POLICY BUT WHICH DOES NOT COVER
 ALL SERVICES NECESSARY FOR THE CARE AND TREATMENT OF CYSTIC FIBROSIS.
   4. THE COMMISSIONER SHALL REQUIRE EACH FULLY ELIGIBLE INDIVIDUAL, UPON
 DETERMINATION  OF  ELIGIBILITY,  TO MAKE APPLICATION TO A PRIVATE HEALTH
 INSURANCE PROVIDER AS PRESCRIBED BY THE COMMISSIONER FOR  AN  INDIVIDUAL
 HEALTH INSURANCE POLICY. IF AND WHEN SUCH POLICY IS GRANTED, THE COMMIS-
 SIONER SHALL APPROVE PAYMENT FOR THE ASSOCIATED PREMIUM.
   5.  THE  COMMISSIONER  SHALL AUTHORIZE PAYMENT FOR SERVICES RELATED TO
 THE CARE AND TREATMENT OF CYSTIC FIBROSIS NOT  OTHERWISE  COVERED  BY  A

 A. 3007--B                         34

 HEALTH INSURANCE POLICY.  PROVIDERS OF SUCH SERVICES SHALL BE REIMBURSED
 AT  THE  SAME RATE AND CLAIMS FOR PAYMENT SHALL BE MADE AS IF SUCH INDI-
 VIDUAL WAS ELIGIBLE FOR BENEFITS PURSUANT TO  TITLE  ELEVEN  OF  ARTICLE
 FIVE OF THE SOCIAL SERVICES LAW.
   6.  ALL  ELIGIBLE  INDIVIDUALS  SHALL  BE REQUIRED TO CONTRIBUTE SEVEN
 PERCENT OF THEIR NET ANNUAL INCOME TOWARD THE COST OF  CARE  AND/OR  THE
 COST OF THE ANNUAL HEALTH INSURANCE PREMIUM.
   7.  THE  COMMISSIONER  SHALL, IN CONSULTATION WITH THE COMMISSIONER OF
 SOCIAL SERVICES, PROMULGATE RULES AND REGULATIONS NECESSARY TO IMPLEMENT
 THE PROVISIONS OF THIS ARTICLE.
   § 2. This act shall take effect immediately.
 
                                  PART MM

   Section 1. Ambulette transportation rate adequacy review. The  commis-
 sioner  of  health  shall review the rates of reimbursement made through
 the Medicaid program for ambulette transportation for rate adequacy.  By
 December 31, 2021, the commissioner of health shall report such findings
 of the rate adequacy review to the temporary president of the senate and
 the speaker of the assembly.
   § 2. This act shall take effect immediately.
 
                                  PART NN
 
   Section  1.  The  public health law is amended by adding a new section
 2559-c to read as follows:
   § 2559-C. EARLY INTERVENTION RATE ADEQUACY REVIEW. 1. THE COMMISSIONER
 SHALL REVIEW THE RATES OF REIMBURSEMENT MADE THROUGH  THE  EARLY  INTER-
 VENTION PROGRAM FOR RATE ADEQUACY. THE REVIEW SHALL INCLUDE:
   (A)    COMPREHENSIVE  ASSESSMENT  OF  THE EXISTING METHODOLOGY USED TO
 DETERMINE  PAYMENT  FOR  EARLY  INTERVENTION  SCREENINGS,   EVALUATIONS,
 SERVICES AND SERVICE COORDINATION, INCLUDING BUT NOT LIMITED TO:
   (I)  ANALYSIS  OF EARLY INTERVENTION RULES, REGULATIONS, AND POLICIES,
 INCLUDING POLICIES, PROCESSES, AND REVENUE SOURCES;
   (II) ANALYSIS OF COSTS TO PROVIDERS  OF  PARTICIPATING  IN  THE  EARLY
 INTERVENTION  PROGRAM,  INCLUDING  TIME  AND  COST  OF  TRAVEL,  SERVICE
 PROVISION, AND ADMINISTRATIVE ACTIVITIES;
   (III) ANALYSIS BY DISCIPLINE AND LABOR REGION  OF  SALARY  LEVELS  FOR
 INDIVIDUALS PROVIDING EARLY INTERVENTION SERVICES COMPARED TO THE SALARY
 LEVELS FOR INDIVIDUALS IN THE SAME DISCIPLINES AND LABOR REGIONS PROVID-
 ING SERVICES OTHER THAN IN THE EARLY INTERVENTION PROGRAM.
   (B)  RECOMMENDATIONS FOR MAINTAINING OR CHANGING REIMBURSEMENT METHOD-
 OLOGIES.  RECOMMENDATIONS UNDER THIS PARAGRAPH SHALL BE CONSISTENT  WITH
 FEDERAL LAW AND SHALL INCLUDE RECOMMENDATIONS FOR APPROPRIATE CHANGES IN
 STATE  LAW AND REGULATIONS. THE RECOMMENDATIONS SHALL CONSIDER APPROPRI-
 ATE PAYMENT METHODOLOGIES AND RATES FOR IN-PERSON AND  TELEHEALTH  EARLY
 INTERVENTION  EVALUATIONS  AND  SERVICES  TO  ADDRESS BARRIERS IN TIMELY
 SERVICE PROVISION, AS WELL AS RACIAL AND  SOCIOECONOMIC  DISPARITIES  IN
 ACCESS,  WITH  CONSIDERATION  OF  FACTORS INCLUDING, BUT NOT LIMITED TO,
 PAYMENT FOR BILINGUAL SERVICES,  TRAVEL  TIME,  GEOGRAPHIC  VARIABILITY,
 ACCESS  TO AND COST OF TECHNOLOGY, COST OF LIVING, AND OTHER BARRIERS TO
 TIMELY SERVICE PROVISION.
   (C) THE PROJECTED NUMBER OF CHILDREN WHO WILL NEED EARLY  INTERVENTION
 SERVICES IN THE NEXT FIVE YEARS DISAGGREGATED BY COUNTY.

 A. 3007--B                         35
 
   (D) THE WORKFORCE NEEDED TO PROVIDE SERVICES IN THE NEXT FIVE YEARS TO
 ALL  CHILDREN ELIGIBLE FOR EARLY INTERVENTION SERVICES, DISAGGREGATED BY
 COUNTY.
   (E) OPPORTUNITIES FOR STAKEHOLDER INPUT ON CURRENT RATE METHODOLOGIES.
    2.    WITHIN  ONE  YEAR AFTER THE EFFECTIVE DATE OF THIS SECTION, THE
 COMMISSIONER SHALL SUBMIT A REPORT OF THE FINDINGS  AND  RECOMMENDATIONS
 UNDER  THIS  SECTION  TO  THE  GOVERNOR,  THE TEMPORARY PRESIDENT OF THE
 SENATE, THE SPEAKER OF THE ASSEMBLY, AND THE CHAIRS OF  THE  SENATE  AND
 ASSEMBLY  COMMITTEES ON HEALTH, AND SHALL POST THE REPORT ON THE DEPART-
 MENT'S WEBSITE.
   § 2.  This act shall take effect immediately.
 
                                  PART OO
 
   Section 1. Section 4 of chapter 495 of the laws of 2004, amending  the
 insurance  law  and the public health law relating to the New York state
 health  insurance  continuation  assistance  demonstration  project,  as
 amended  by  section 17 of part BB of chapter 56 of the laws of 2020, is
 amended to read as follows:
   § 4. This act shall take effect on the sixtieth  day  after  it  shall
 have  become  a  law;  provided,  however, that this act shall remain in
 effect until July 1, [2021] 2022 when upon such date the  provisions  of
 this  act shall expire and be deemed repealed; provided, further, that a
 displaced worker shall be eligible for continuation assistance  retroac-
 tive to July 1, 2004.
   §  2.  This act shall take effect immediately; provided, however, that
 the amendments to part BB of chapter 56 of the  laws  of  2020  made  by
 section  one  of  this act shall not affect the expiration and repeal of
 such part and shall be deemed to expire and repeal therewith.
 
                                  PART PP
 
   Section 1. The public health law is amended by adding  a  new  section
 2559-c to read as follows:
   §  2559-C.  BLANKET  SERVICE LIMITS PROHIBITED. THE COMMISSIONER SHALL
 NOT IMPOSE  PREDETERMINED  LIMITATIONS,  INCLUDING  LIMITATIONS  ON  THE
 LENGTH,  DURATION, FREQUENCY, INTENSITY, METHOD OF DELIVERY, GROUP SIZE,
 OR STAFF RATIOS, ON AUTHORIZED SERVICES UNDER THIS  TITLE.  THE  COMMIS-
 SIONER  SHALL  NOT IMPOSE PROGRAM-WIDE SERVICE LIMITATIONS THAT RESTRICT
 THE ABILITY OF AN IFSP TEAM TO CREATE AN INDIVIDUALIZED  PLAN  OF  EARLY
 INTERVENTION  SERVICES MOST APPROPRIATE TO ACCOMMODATE THE NEEDS OF EACH
 CHILD AND FAMILY.
   § 2. This act shall take effect immediately.
 
                                  PART QQ
 
   Section 1. Subdivision 14 of section 366 of the social  services  law,
 as amended by section 71 of part A of chapter 56 of the laws of 2013, is
 amended to read as follows:
   14.  The  commissioner  of health may make any available amendments to
 the state plan for medical  assistance  submitted  pursuant  to  section
 three  hundred  sixty-three-a  of this title, or, if an amendment is not
 possible, develop and submit an application for any waiver  or  approval
 under the federal social security act that may be necessary to disregard
 or exempt an amount of income, for the purpose of assisting with housing
 costs,  for  individuals receiving coverage of nursing facility services

 A. 3007--B                         36
 
 under this title, other than short-term rehabilitation services, and for
 individuals in receipt of medical assistance while in an adult home,  as
 defined  in  subdivision  twenty-five  of  section  two of this chapter,
 who[:]  are  EITHER  (i)  discharged  to  the community[;] and [(ii)] if
 eligible, enrolled in a plan certified pursuant  to  section  forty-four
 hundred  three-f  of  the  public  health  law OR (II) DISCHARGED TO THE
 COMMUNITY AND UPON DISCHARGE WILL RECEIVE PERSONAL CARE OR  CONSUMER-DI-
 RECTED  PERSONAL  ASSISTANCE SERVICES BASED ON A DETERMINATION THAT THEY
 ARE IN IMMEDIATE NEED OF  SUCH  SERVICES  UNDER  SUBDIVISION  TWELVE  OF
 SECTION  THREE  HUNDRED SIXTY-SIX-A OF THIS TITLE; and (iii) do not meet
 the criteria to be considered an "institutionalized spouse" for purposes
 of section three hundred sixty-six-c of this title.
   § 2. This act shall take effect immediately.
 
                                  PART RR
 
   Section 1. Subdivision (g) of section 7.07 of the mental hygiene  law,
 as  amended  by  chapter  626 of the laws of 2019, is amended to read as
 follows:
   (g) 1. The office of mental health shall have the  responsibility  for
 assuring  the  development of plans, programs, and services in the areas
 of research and prevention of suicide, to reduce suicidal  behavior  and
 suicide through consultation, training, implementation of evidence-based
 practices,  and  use of suicide surveillance data. Such plans, programs,
 and services shall consider the unique needs  of  differing  demographic
 groups  and  the  impact of gender, race and ethnicity, and cultural and
 language needs. Such plans, programs, and services shall be developed in
 cooperation with other agencies and  departments  of  the  state,  local
 governments,  community  organizations  and entities, or other organiza-
 tions and individuals. The office shall prepare  and  submit  a  written
 report to the governor, the speaker of the assembly, and temporary pres-
 ident  of  the  senate that sets forth the progress of the office in the
 development of such plans, programs, and services by December first, two
 thousand nineteen, and biennially thereafter. In addition to delineating
 the progress the office has made, such report shall also include  infor-
 mation  on  specific suicide prevention services and program initiatives
 developed and implemented to address the needs  of  high  risk  minority
 groups  or  special populations, including but not limited to latina and
 latino adolescents, black youth, individuals residing in rural  communi-
 ties,  veterans,  members  of the lesbian, gay, bisexual and transgender
 community, and any other group deemed high risk or  underserved  by  the
 office.
   2.  (A)  WITHIN  AMOUNTS  APPROPRIATED,  THE  OFFICE SHALL ESTABLISH A
 SUICIDE PREVENTION PROGRAM WHICH SHALL PROVIDE GRANTS  TO  ORGANIZATIONS
 ENGAGED   IN  ACTIVITIES  WHICH  PROVIDE  CULTURALLY  COMPETENT  SUICIDE
 PREVENTION SERVICES TO  HIGH-RISK  POPULATIONS.  THE  PROGRAM  SHALL  BE
 ADMINISTERED  BY  THE  OFFICE  IN  COOPERATION WITH OTHER STATE AGENCIES
 NECESSARY FOR THE OPERATION OF THE PROGRAM AS DETERMINED BY THE  COMMIS-
 SIONER.
   (B)  FOR THE PURPOSES OF THIS SUBDIVISION "HIGH-RISK POPULATION" SHALL
 INCLUDE LATINA ADOLESCENTS, BLACK YOUTH, MEMBERS OF  THE  LESBIAN,  GAY,
 BI-SEXUAL, TRANSGENDER, AND QUEER COMMUNITY, AND RURAL COMMUNITIES.
   3. (A) THE COMMISSIONER SHALL ISSUE A REQUEST FOR PROPOSALS AND ESTAB-
 LISH  CRITERIA TO DETERMINE THE ELIGIBILITY OF APPLICANTS FOR THE GRANTS
 AUTHORIZED HEREIN. THE COMMISSIONER SHALL RECEIVE ON APPROPRIATE  FORMS,
 INFORMATION  NECESSARY  AND  RELEVANT  IN  ESTABLISHING  ELIGIBILITY, AS

 A. 3007--B                         37
 
 DETERMINED BY THE COMMISSIONER. THE  APPLICATION,  SHALL  AT  A  MINIMUM
 INCLUDE:  (I)  PROJECTED  GOALS  AND OUTCOMES OF THE PROGRAM; (II) RANGE
 AND TYPE OF SERVICES OFFERED; (III) COMMUNITY  PARTNERSHIPS  WITH  LOCAL
 ORGANIZATIONS  OR  PUBLIC  INSTITUTIONS, FOR THE PURPOSE OF FACILITATING
 PREVENTION AND TREATMENT REFERRAL SERVICES IN COMMUNITY BASED  SETTINGS;
 (IV)  METHODS  AND  STRATEGIES  TO DEVELOP CULTURALLY AND LINGUISTICALLY
 COMPETENT PROGRAMS, REDUCE BARRIERS AND PROMOTE ACCESS TO PREVENTION AND
 TREATMENT SERVICES FOR  HIGH-RISK POPULATIONS; AND (V) THE OVERALL OPER-
 ATING COSTS OF THE PROGRAM.
   (B) GRANTS SHALL BE AWARDED NO LATER THAN SEPTEMBER FIRST,  TWO  THOU-
 SAND  TWENTY-ONE.    UPON APPROVAL OF EACH GRANT, THE COMMISSIONER SHALL
 CONTRACT WITH EACH GRANTEE FOR A PERIOD OF TIME NOT TO EXCEED ONE  YEAR,
 BUT  MAY EXTEND THE CONTRACT FOR ADDITIONAL ONE YEAR PERIODS WHEN APPRO-
 PRIATE.
   4. THE COMMISSIONER MAY  CONSIDER  APPLICANTS  THAT  HAVE  ESTABLISHED
 EFFECTIVE SUICIDE PREVENTION PROGRAMS FOR HIGH-RISK POPULATIONS AND THAT
 MAY BE EXPANDED IN OTHER GEOGRAPHIC AREAS OF THE STATE WHICH ARE IN NEED
 OF  SUICIDE  PREVENTION  SERVICES  FOR  HIGH-RISK  POPULATIONS, PROVIDED
 HOWEVER, PREFERENCE MAY BE GIVEN TO REQUESTS FOR PROPOSALS WHICH IDENTI-
 FY LOCAL COMMUNITIES WITH A HIGH  PREVALENCE  OF  DEATH  BY  SUICIDE  OR
 SUICIDE ATTEMPTS FOR ONE OR MORE HIGH-RISK POPULATIONS AND HAVE A DEMON-
 STRATED NEED FOR SUICIDE PREVENTION SERVICES.
   5.  THE COMMISSIONER SHALL PROVIDE A SUMMARY OF EACH GRANTEE'S SUICIDE
 PREVENTION PROGRAM AND ITS FULFILLMENT OF THE  CRITERIA  UNDER  SUBPARA-
 GRAPH (A) OF PARAGRAPH THREE OF THIS SUBDIVISION AND INCLUDE THIS SUMMA-
 RY IN THE REPORT REQUIRED UNDER THIS PARAGRAPH.
   § 2. This act shall take effect take effect on April 1, 2021.
 
                                  PART SS
 
   Section  1. Subdivision (g) of section 7.07 of the mental hygiene law,
 as amended by chapter 626 of the laws of 2019, is  amended  to  read  as
 follows:
   (g)  (1)  (A)  (I)  WITHIN  AMOUNTS APPROPRIATED, THE OFFICE OF MENTAL
 HEALTH SHALL ESTABLISH A SUICIDE PREVENTION PROGRAM WHICH SHALL  PROVIDE
 GRANTS  TO  ORGANIZATIONS ENGAGED IN ACTIVITIES WHICH PROVIDE CULTURALLY
 COMPETENT SUICIDE PREVENTION SERVICES TO HIGH-RISK  POPULATIONS.    SUCH
 PROGRAM  SHALL  BE  ADMINISTERED BY THE OFFICE IN COOPERATION WITH OTHER
 STATE AGENCIES NECESSARY FOR THE OPERATION OF THE PROGRAM AS  DETERMINED
 BY THE COMMISSIONER.
   (II)  FOR  THE PURPOSES OF THIS PARAGRAPH "HIGH-RISK POPULATION" SHALL
 INCLUDE LAW ENFORCEMENT,  VETERANS,  FIRST  RESPONDERS,  AND  CORRECTION
 OFFICERS.
   (B)  (I)  THE  COMMISSIONER  SHALL  ISSUE  A REQUEST FOR PROPOSALS AND
 ESTABLISH CRITERIA TO DETERMINE THE ELIGIBILITY OF  APPLICANTS  FOR  THE
 GRANTS AUTHORIZED HEREIN.  THE COMMISSIONER SHALL RECEIVE ON APPROPRIATE
 FORMS,  INFORMATION  NECESSARY AND RELEVANT IN ESTABLISHING ELIGIBILITY,
 AS DETERMINED BY THE COMMISSIONER.  THE APPLICATION SHALL  INCLUDE,  BUT
 NOT  BE LIMITED TO: (A) PROJECTED GOALS AND OUTCOMES OF THE PROGRAM; (B)
 RANGE AND  TYPE OF SERVICES OFFERED;  (C)  COMMUNITY  PARTNERSHIPS  WITH
 LOCAL  ORGANIZATIONS  OR PUBLIC INSTITUTIONS, FOR THE PURPOSE OF FACILI-
 TATING PREVENTION AND TREATMENT REFERRAL  SERVICES  IN  COMMUNITY  BASED
 SETTINGS;  (D) METHODS AND STRATEGIES TO DEVELOP CULTURALLY AND LINGUIS-
 TICALLY COMPETENT  PROGRAMS,  REDUCE  BARRIERS  AND  PROMOTE  ACCESS  TO
 PREVENTION  AND  TREATMENT SERVICES FOR   HIGH-RISK POPULATIONS; AND (E)
 THE OVERALL OPERATING COSTS OF THE PROGRAM.

 A. 3007--B                         38
 
   (II) GRANTS SHALL BE AWARDED NO LATER THAN SEPTEMBER FIRST, TWO  THOU-
 SAND  TWENTY-ONE.    UPON APPROVAL OF EACH GRANT, THE COMMISSIONER SHALL
 CONTRACT WITH EACH GRANTEE FOR A PERIOD OF TIME NOT TO EXCEED ONE  YEAR,
 BUT MAY EXTEND THE CONTRACT FOR ONE YEAR PERIODS WHEN APPROPRIATE.
   (C)  THE  COMMISSIONER  MAY  CONSIDER APPLICANTS THAT HAVE ESTABLISHED
 EFFECTIVE SUICIDE PREVENTION PROGRAMS FOR HIGH-RISK POPULATIONS AND THAT
 MAY BE EXPANDED IN OTHER GEOGRAPHIC AREAS OF THE STATE WHICH ARE IN NEED
 OF SUICIDE  PREVENTION  SERVICES  FOR  HIGH-RISK  POPULATIONS,  PROVIDED
 HOWEVER, PREFERENCE MAY BE GIVEN TO REQUESTS FOR PROPOSALS WHICH IDENTI-
 FY  LOCAL  COMMUNITIES  WITH  A  HIGH  PREVALENCE OF DEATH BY SUICIDE OR
 SUICIDE ATTEMPTS FOR ONE OR MORE HIGH-RISK POPULATIONS AND HAVE A DEMON-
 STRATED NEED FOR SUICIDE PREVENTION SERVICES.
   (D) THE COMMISSIONER SHALL PROVIDE A SUMMARY OF EACH GRANTEE'S SUICIDE
 PREVENTION PROGRAM AND ITS FULFILLMENT OF THE CRITERIA UNDER CLAUSE  (I)
 OF  SUBPARAGRAPH  (B)  OF THIS PARAGRAPH AND INCLUDE THIS SUMMARY IN THE
 REPORT REQUIRED UNDER PARAGRAPH TWO OF THIS SUBDIVISION.
   (2) The office of mental health  shall  have  the  responsibility  for
 assuring  the  development of plans, programs, and services in the areas
 of research and prevention of suicide, to reduce suicidal  behavior  and
 suicide through consultation, training, implementation of evidence-based
 practices,  and  use of suicide surveillance data. Such plans, programs,
 and services shall consider the unique needs  of  differing  demographic
 groups  and  the  impact of gender, race and ethnicity, and cultural and
 language needs. Such plans, programs, and services shall be developed in
 cooperation with other agencies and  departments  of  the  state,  local
 governments,  community  organizations  and entities, or other organiza-
 tions and individuals. The office shall prepare  and  submit  a  written
 report to the governor, the speaker of the assembly, and temporary pres-
 ident  of  the  senate that sets forth the progress of the office in the
 development of such plans, programs, and services by December first, two
 thousand nineteen, and biennially thereafter. In addition to delineating
 the progress the office has made, such report shall also include  infor-
 mation  on  specific suicide prevention services and program initiatives
 developed and implemented to address the needs  of  high  risk  minority
 groups  or  special populations, including but not limited to latina and
 latino adolescents, black youth, individuals residing in rural  communi-
 ties,  veterans,  members  of the lesbian, gay, bisexual and transgender
 community, and any other group deemed high risk or  underserved  by  the
 office.
   § 2. This act shall take effect April 1, 2021.
 
                                  PART TT
 
   Section  1.  Section  2807-m  of  the  public health law is amended by
 adding a new subdivision 7 to read as follows:
   7. NOTWITHSTANDING ANY INCONSISTENT PROVISIONS OF SECTION ONE  HUNDRED
 TWELVE  OR ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW OR ANY OTHER
 LAW TO THE CONTRARY, FOR THE PERIOD BEGINNING ON APRIL FIRST, TWO  THOU-
 SAND  TWENTY-ONE  AND  ANNUALLY  THEREAFTER AN AMOUNT OF ONE MILLION ONE
 HUNDRED THOUSAND DOLLARS SHALL BE SET ASIDE AND RESERVED BY THE  COMMIS-
 SIONER FROM THE REGIONAL POOLS ESTABLISHED UNDER SUBDIVISION TWO OF THIS
 SECTION  AND  SHALL BE AVAILABLE FOR DISTRIBUTIONS TO THE NEW YORK STATE
 AREA HEALTH EDUCATION CENTER PROGRAM FOR THE PURPOSE OF EXPANDING COMMU-
 NITY-BASED TRAINING OF MEDICAL STUDENTS. IN  ADDITION,  FOR  THE  PERIOD
 BEGINNING ON APRIL FIRST, TWO THOUSAND TWENTY-ONE AND ANNUALLY THEREAFT-
 ER,  AN  AMOUNT OF ONE MILLION ONE HUNDRED THOUSAND DOLLARS SHALL BE SET

 A. 3007--B                         39
 
 ASIDE AND RESERVED BY THE COMMISSIONER FROM THE  REGIONAL  POOLS  ESTAB-
 LISHED  UNDER SUBDIVISION TWO OF THIS SECTION AND SHALL BE AVAILABLE FOR
 DISTRIBUTIONS TO THE NEW YORK STATE AREA HEALTH EDUCATION CENTER PROGRAM
 FOR  THE PURPOSE OF POST-SECONDARY TRAINING OF HEALTH CARE PROFESSIONALS
 WHO WILL ACHIEVE SPECIFIC PROGRAM OUTCOMES WITHIN  THE  NEW  YORK  STATE
 AREA  HEALTH  EDUCATION  CENTER  PROGRAM. THE NEW YORK STATE AREA HEALTH
 EDUCATION CENTER PROGRAM SHALL REPORT TO THE COMMISSIONER ON  AN  ANNUAL
 BASIS REGARDING THE USE OF FUNDS FOR EACH PURPOSE IN ANY FORM AND MANNER
 AS SPECIFIED BY THE COMMISSIONER.
   § 2. This act shall take effect April 1, 2021.
 
                                  PART UU
 
   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 Y of chapter 57 of the laws of 2019, 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, [2020] 2021, 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]
 ADDICTION SERVICES AND SUPPORTS shall not include a COLA beginning April
 1, 2017 and ending March 31, 2021.
   3-c.  Notwithstanding  any  inconsistent  provision  of law, beginning
 April 1, [2020] 2021 and [ending March 31, 2023] EVERY YEAR  THEREAFTER,
 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. 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, is amended by adding a new subdivision 3-g to read as
 follows:
   3-G.  NOTWITHSTANDING  ANY OTHER PROVISION OF LAW TO THE CONTRARY, AND
 SUBJECT TO AVAILABLE APPROPRIATIONS THEREFORE, FOR ALL ELIGIBLE PROGRAMS
 AS DETERMINED PURSUANT TO SUBDIVISION FOUR OF THIS SECTION, THE  COMMIS-
 SIONERS  SHALL  PROVIDE  FUNDING TO SUPPORT A ONE PERCENT (1.0%) COST OF
 LIVING ADJUSTMENT, AS DETERMINED PURSUANT TO SUBDIVISION THREE-C OF THIS
 SECTION, BEGINNING APRIL 1, 2021. SUCH COST OF LIVING  ADJUSTMENT  SHALL
 CONTINUE  TO  BE  PROVIDED EVERY YEAR THEREAFTER IN AN AMOUNT DETERMINED
 PURSUANT TO SUBDIVISION THREE-C OF THIS SECTION.
   § 3. Section 4 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 I of  chapter  60  of
 the laws of 2014, is amended to read as follows:
   §  4.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2006;  provided
 section  one  of  this  act shall expire and be deemed repealed April 1,
 [2019] 2024; provided, further, that sections two and three of this  act
 shall expire and be deemed repealed December 31, 2009.

 A. 3007--B                         40
 
   §  4.  This  act  shall take effect immediately and shall be deemed to
 have been in full force and effect on and after April 1, 2019; provided,
 however, that the amendments to 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 made by sections one and two of this
 act shall not affect the repeal of such  section  and  shall  be  deemed
 repealed therewith.
 
                                  PART VV
 
   Section  1.  The  public health law is amended by adding a new section
 2807-o to read as follows:
   § 2807-O.  EARLY  INTERVENTION  SERVICES  POOL.  1.  DEFINITIONS.  THE
 FOLLOWING  WORDS  OR  PHRASES  AS  USED  IN  THIS SECTION SHALL HAVE THE
 FOLLOWING MEANINGS:
   (A) "EARLY INTERVENTION SERVICES" SHALL MEAN SERVICES DELIVERED TO  AN
 ELIGIBLE  CHILD, PURSUANT TO AN INDIVIDUALIZED FAMILY SERVICE PLAN UNDER
 THE EARLY INTERVENTION PROGRAM.
   (B) "EARLY INTERVENTION PROGRAM" SHALL  MEAN  THE  EARLY  INTERVENTION
 PROGRAM  FOR TODDLERS WITH DISABILITIES AND THEIR FAMILIES AS CREATED BY
 TITLE TWO-A OF ARTICLE TWENTY-FIVE OF THIS CHAPTER.
   (C) "MUNICIPALITY" SHALL MEAN ANY COUNTY OUTSIDE OF THE  CITY  OF  NEW
 YORK OR THE CITY OF NEW YORK.
   2.  PAYMENTS  FOR  EARLY  INTERVENTION  SERVICES. (A) THE COMMISSIONER
 SHALL, FROM FUNDS ALLOCATED FOR SUCH  PURPOSE  UNDER  PARAGRAPH  (G)  OF
 SUBDIVISION SIX OF SECTION TWENTY-EIGHT HUNDRED SEVEN-S OF THIS ARTICLE,
 MAKE  PAYMENTS TO MUNICIPALITIES AND THE STATE FOR THE DELIVERY OF EARLY
 INTERVENTION SERVICES.
   (B) PAYMENTS UNDER THIS SUBDIVISION SHALL BE  MADE  TO  MUNICIPALITIES
 AND  THE  STATE  BY THE COMMISSIONER. EACH MUNICIPALITY AND THE STATE OF
 NEW YORK SHALL RECEIVE A SHARE OF SUCH PAYMENTS  EQUAL  TO  ITS  PROPOR-
 TIONATE  SHARE  OF THE TOTAL APPROVED STATEWIDE DOLLARS NOT REIMBURSABLE
 BY THE MEDICAL ASSISTANCE PROGRAM PAID  TO  PROVIDERS  OF  EARLY  INTER-
 VENTION  SERVICES  BY  THE  STATE AND MUNICIPALITIES ON ACCOUNT OF EARLY
 INTERVENTION SERVICES IN THE LAST COMPLETE STATE FISCAL YEAR  FOR  WHICH
 SUCH DATA IS AVAILABLE.
   §  2.  Subdivision  6  of  section  2807-s of the public health law is
 amended by adding two new paragraphs (g) and (h) to read as follows:
   (G) A FURTHER GROSS STATEWIDE AMOUNT FOR THE  STATE  FISCAL  YEAR  TWO
 THOUSAND TWENTY-TWO AND EACH STATE FISCAL YEAR THEREAFTER SHALL BE FORTY
 MILLION DOLLARS.
   (H) THE AMOUNT SPECIFIED IN PARAGRAPH (G) OF THIS SUBDIVISION SHALL BE
 ALLOCATED  UNDER  SECTION  TWENTY-EIGHT  HUNDRED SEVEN-O OF THIS ARTICLE
 AMONG THE MUNICIPALITIES AND THE STATE OF NEW YORK BASED ON EACH MUNICI-
 PALITY'S SHARE AND THE  STATE'S  SHARE  OF  EARLY  INTERVENTION  PROGRAM
 EXPENDITURES  NOT REIMBURSABLE BY THE MEDICAL ASSISTANCE PROGRAM FOR THE
 LATEST TWELVE MONTH PERIOD FOR WHICH SUCH DATA IS AVAILABLE.
   § 3. Subdivision 7 of section 2807-s  of  the  public  health  law  is
 amended by adding a new paragraph (d) to read as follows:
   (D)  FUNDS  SHALL  BE ADDED TO THE FUNDS COLLECTED BY THE COMMISSIONER
 FOR DISTRIBUTION IN ACCORDANCE WITH SECTION TWENTY-EIGHT HUNDRED SEVEN-O
 OF THIS ARTICLE, IN THE FOLLOWING AMOUNT: FORTY MILLION DOLLARS FOR  THE
 PERIOD  BEGINNING  APRIL  FIRST, TWO THOUSAND TWENTY-TWO, AND CONTINUING
 EACH STATE FISCAL YEAR THEREAFTER.

 A. 3007--B                         41
 
   § 4. Subdivision 1 of section  2557  of  the  public  health  law,  as
 amended  by  section  4  of  part C of chapter 1 of the laws of 2002, is
 amended to read as follows:
   1. The approved costs for an eligible child who receives an evaluation
 and early intervention services pursuant to this title shall be a charge
 upon  the  municipality wherein the eligible child resides or, where the
 services are covered by the medical assistance program, upon the  social
 services  district of fiscal responsibility with respect to those eligi-
 ble children who are also eligible for medical assistance. All  approved
 costs  shall be paid in the first instance and at least quarterly by the
 appropriate governing body or officer of the municipality upon  vouchers
 presented  and  audited  in  the same manner as the case of other claims
 against the municipality. Notwithstanding the  insurance  law  or  regu-
 lations thereunder relating to the permissible exclusion of payments for
 services under governmental programs, no such exclusion shall apply with
 respect  to  payments  made  pursuant to this title. Notwithstanding the
 insurance law or any other law or agreement to  the  contrary,  benefits
 under this title shall be considered secondary to [any plan of insurance
 or  state government benefit] THE MEDICAL ASSISTANCE program under which
 an eligible child may have coverage.  [Nothing  in  this  section  shall
 increase  or enhance coverages provided for within an insurance contract
 subject to the provisions of this title.]
   § 5. Subdivision 2 of section  2557  of  the  public  health  law,  as
 amended  by  section 9-a of part A of chapter 56 of the laws of 2012, is
 amended to read as follows:
   2. The department shall reimburse the approved costs paid by a munici-
 pality for the purposes of this title, other than those reimbursable  by
 the  medical assistance program [or by third party payors], in an amount
 of fifty percent of the amount expended in accordance with the rules and
 regulations  of  the  commissioner;  provided,  however,  that  in   the
 discretion  of  the  department and with the approval of the director of
 the division of the budget, the department may reimburse  municipalities
 in  an  amount  greater  than fifty percent of the amount expended. Such
 state reimbursement to the municipality shall not be paid prior to April
 first of the year in which the approved costs are paid  by  the  munici-
 pality,  provided, however that, subject to the approval of the director
 of the budget, the department may pay such state  aid  reimbursement  to
 the municipality prior to such date.
   §  6. The section heading of section 2559 of the public health law, as
 added by chapter 428 of the laws of 1992, is amended to read as follows:
   [Third  party  insurance  and  medical]  MEDICAL  assistance   program
 payments.
   §  7. Subdivision 3 of section 2559 of the public health law, as added
 by chapter 428 of the laws of 1992,  paragraphs  (a),  (c)  and  (d)  as
 amended  by  section  11 of part A of chapter 56 of the laws of 2012 and
 paragraph (b) as further amended by section 104 of part A of chapter  62
 of the laws of 2011, is amended to read as follows:
   3.  (a)  [Providers  of  evaluations  and early intervention services,
 hereinafter 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

 A. 3007--B                         42

 such payment, and will apply such payment,  to  an  annual  or  lifetime
 limit specified in the insured's policy.
   (i)  Parents  shall  provide  the municipality and service coordinator
 information on any insurance policy, plan or  contract  under  which  an
 eligible child has coverage.
   (ii)] Parents shall provide the municipality and the service coordina-
 tor  with  a written referral from a primary care provider as documenta-
 tion, for eligible children, of the medical necessity  of  early  inter-
 vention services.
   [(iii)  providers] (B) PROVIDERS shall utilize the department's fiscal
 agent and data system for claiming payment for evaluations and  services
 rendered under the early intervention program.
   [(b) The commissioner, in consultation with the director of budget and
 the  superintendent  of financial services, shall promulgate regulations
 providing public reimbursement for deductibles and copayments which  are
 imposed  under  an insurance policy or health benefit plan to the extent
 that such deductibles and copayments  are  applicable  to  early  inter-
 vention services.
   (c)  Payments  made for early intervention services under an insurance
 policy or health benefit plan, including payments made  by  the  medical
 assistance  program  or  other governmental third party payor, which are
 provided as part of an IFSP  pursuant  to  section  twenty-five  hundred
 forty-five  of  this  title  shall not be applied by the insurer or plan
 administrator against any maximum lifetime or annual limits specified in
 the policy or health benefits plan, pursuant to section  eleven  of  the
 chapter  of  the  laws  of  nineteen hundred ninety-two which added this
 title.
   (d)] (C) A municipality, or its designee,  and  a  provider  shall  be
 subrogated,  to  the  extent of the expenditures by such municipality or
 for early intervention services furnished to persons eligible for  bene-
 fits under this title, to any rights such person may have or be entitled
 to  from [third party reimbursement] THE MEDICAL ASSISTANCE PROGRAM. The
 provider 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]. NOTWITHSTANDING ANY INCON-
 SISTENT PROVISION OF THIS TITLE, EXCEPT AS PROVIDED FOR HEREIN, NO THIRD
 PARTY PAYOR OTHER THAN THE MEDICAL ASSISTANCE PROGRAM SHALL BE  REQUIRED
 TO REIMBURSE FOR EARLY INTERVENTION SERVICES PROVIDED UNDER THIS TITLE.
   §  8.  Subdivision  3  of  section  2543  of  the public health law is
 REPEALED.
   § 9. Section 3235-a of the insurance law is REPEALED.
   § 10. Subparagraph (F) of paragraph 25 of subsection  (i)  of  section
 3216 of the insurance law is REPEALED.
   §  11.  Subparagraph  (F) of paragraph 17 of subsection (1) of section
 3221 of the insurance law is REPEALED.
   § 12. Paragraph 6 of subsection (ee) of section 4303 of the  insurance
 law is REPEALED.
   §  13.  This act shall take effect January 1, 2022; provided, however,
 that the amendments to section 2807-s of the public health law  made  by
 sections  two  and  three of this act shall not affect the expiration of
 such section and shall be deemed to expire  therewith.  Effective  imme-
 diately, the addition, amendment and/or repeal of any rule or regulation

 A. 3007--B                         43

 necessary  for  the implementation of this act on its effective date are
 authorized to be made and completed by the commissioner of health, on or
 before such effective date.
 
                                  PART WW
 
   Section  1.  Section  10 of part KKK of chapter 56 of the laws of 2020
 amending the social services law and other laws relating to managed care
 encounter data, authorizing electronic notifications,  and  establishing
 regional demonstration projects, is amended to read as follows:
   §  10.  Contingent  upon the availability of federal financial partic-
 ipation or other federal authorization from the centers of medicare  and
 medicaid  services, the commissioner of health, in consultation with the
 superintendent of the department of financial services, is authorized to
 implement one or more five-year  regional  demonstration  programs  that
 would  be  designed to improve health outcomes and reduce costs, using a
 value based model that pays providers an actuarially sound global,  pre-
 paid and fully capitated amount for individuals in the designated region
 who  are enrolled in the state's plan for medical assistance established
 pursuant to title XIX, or any successor title,  of  the  federal  social
 security  act; the Medicare program established pursuant to title XVIII,
 or any successor title, of the federal social security act;  and  insur-
 ers,  corporations,  and  health  care  plans authorized pursuant to the
 insurance law or public health law. The demonstration program may  offer
 funding  and  incentives  designed to improve health outcomes for attri-
 buted individual beneficiaries  designed  to  improve  health  outcomes,
 develop necessary infrastructure and systems; and connect individuals to
 community  based  organizations  that address the social determinants of
 health.  AT LEAST ONE REGIONAL DEMONSTRATION PROGRAM  SHALL  BE  IN  THE
 WESTERN,  CENTRAL,  SOUTHERN  TIER,  OR  CAPITAL  REGIONS  OF THE STATE.
 Notwithstanding any provision of law to the contrary,  the  commissioner
 or  the superintendent of the department of financial services may waive
 any regulatory requirements as are necessary  to  implement  the  demon-
 stration  program;  provided  however,  that  regulations  pertaining to
 patient safety, patient autonomy, patient privacy, patient  rights,  due
 process,   scope  of  practice,  professional  licensure,  environmental
 protections, provider reimbursement methodologies, or occupational stan-
 dards and employee rights may not be waived, nor shall  any  regulations
 be  waived  if  such waiver would risk patient safety.  Participation in
 such program shall be voluntary. One year after this section shall  take
 effect  and annually thereafter the commissioner of health shall provide
 a report detailing the activities and outcomes of such program,  includ-
 ing  any  regulatory requirements that are waived, to the speaker of the
 assembly and the temporary president of the senate.
   § 2. This act shall take effect immediately.
 
                                  PART XX
 
   Section 1. Subparagraph (iv) of paragraph  (a)  of  subdivision  2  of
 section 4900 of the public health law, as added by section 42 of subpart
 A  of  part  BB  of chapter 57 of the laws of 2019, is amended and a new
 subparagraph (v) is added to read as follows:
   (iv) for purposes of a determination involving treatment for a  mental
 health condition:
   (A)  a  physician  who  possesses  a  current and valid non-restricted
 license to practice medicine and who specializes  in  behavioral  health

 A. 3007--B                         44
 
 and  has  experience  in the delivery of mental health courses of treat-
 ment; or
   (B)  a  health  care  professional other than a licensed physician who
 specializes in behavioral health and has experience in the delivery of a
 mental health courses of treatment and, where  applicable,  possesses  a
 current  and  valid non-restricted license, certificate, or registration
 or, where no  provision  for  a  license,  certificate  or  registration
 exists,  is credentialed by the national accrediting body appropriate to
 the profession; [and] OR
   (V) FOR PURPOSES OF A DETERMINATION INVOLVING TREATMENT OF A MEDICALLY
 FRAGILE CHILD:
   (A) A PHYSICIAN WHO  POSSESSES  A  CURRENT  AND  VALID  NON-RESTRICTED
 LICENSE  TO PRACTICE MEDICINE AND WHO IS BOARD CERTIFIED OR BOARD ELIGI-
 BLE IN PEDIATRIC REHABILITATION, PEDIATRIC CRITICAL CARE, OR  NEONATOLO-
 GY; OR
   (B)  A  PHYSICIAN  WHO  POSSESSES  A  CURRENT AND VALID NON-RESTRICTED
 LICENSE TO PRACTICE MEDICINE AND  IS  BOARD  CERTIFIED  IN  A  PEDIATRIC
 SUBSPECIALTY DIRECTLY RELEVANT TO THE PATIENT'S MEDICAL CONDITION; AND
   §  2.  Paragraph  (b)  of  subdivision 2 of section 4900 of the public
 health law, as amended by chapter 586 of the laws of 1998, is amended to
 read as follows:
   (b) for purposes of title two of this article:
   (i) a physician who:
   (A) possesses a current and valid non-restricted license  to  practice
 medicine;
   (B) where applicable, is board certified or board eligible in the same
 or  similar  specialty as the health care provider who typically manages
 the medical condition or disease or provides the health care service  or
 treatment under appeal;
   (C)  has  been practicing in such area of specialty for a period of at
 least five years; and
   (D) is knowledgeable about the health care service or treatment  under
 appeal; or
   (ii) a health care professional other than a licensed physician who:
   (A)  where  applicable,  possesses  a current and valid non-restricted
 license, certificate or registration;
   (B) where applicable, is credentialed by the national accrediting body
 appropriate to the profession in the same profession and same or similar
 specialty as the health care provider who typically manages the  medical
 condition  or  disease  or provides the health care service or treatment
 under appeal;
   (C) has been practicing in such area of specialty for a period  of  at
 least five years;
   (D)  is knowledgeable about the health care service or treatment under
 appeal; and
   (E) where applicable to such health care professional's scope of prac-
 tice, is clinically supported by a physician who possesses a current and
 valid non-restricted license to practice medicine; OR
   (III) FOR  PURPOSES  OF  A  DETERMINATION  INVOLVING  TREATMENT  OF  A
 MEDICALLY FRAGILE CHILD:
   (A)  A  PHYSICIAN  WHO  POSSESSES  A  CURRENT AND VALID NON-RESTRICTED
 LICENSE TO PRACTICE MEDICINE AND WHO IS BOARD CERTIFIED OR BOARD  ELIGI-
 BLE  IN PEDIATRIC REHABILITATION, PEDIATRIC CRITICAL CARE, OR NEONATOLO-
 GY, OR

 A. 3007--B                         45
 
   (B) A PHYSICIAN WHO  POSSESSES  A  CURRENT  AND  VALID  NON-RESTRICTED
 LICENSE  TO  PRACTICE  MEDICINE  AND  IS  BOARD CERTIFIED IN A PEDIATRIC
 SUBSPECIALTY DIRECTLY RELEVANT TO THE PATIENT'S MEDICAL CONDITION.
   §  3.  Subdivision  2-a  of  section 4900 of the public health law, as
 added by chapter 586 of the laws of 1998, is amended to read as follows:
   2-a. "Clinical standards" means those  guidelines  and  standards  set
 forth  in  the  utilization  review plan by the utilization review agent
 whose adverse determination is under appeal OR, IN THE CASE OF MEDICALLY
 FRAGILE CHILDREN, THOSE GUIDELINES AND STANDARDS AS REQUIRED BY  SECTION
 FORTY-NINE HUNDRED THREE-A OF THIS ARTICLE.
   §  4.  Paragraph  (c)  of subdivision 10 of section 4900 of the public
 health law, as added by chapter 705 of the laws of 1996, is  amended  to
 read as follows:
   (c)  a  description  of  practice  guidelines  and standards used by a
 utilization review agent in carrying  out  a  determination  of  medical
 necessity,  WHICH IN THE CASE OF MEDICALLY FRAGILE CHILDREN SHALL INCOR-
 PORATE THE STANDARDS REQUIRED BY SECTION FORTY-NINE HUNDRED  THREE-A  OF
 THIS ARTICLE;
   §  5. Section 4900 of the public health law is amended by adding a new
 subdivision 11 to read as follows:
   11. "MEDICALLY FRAGILE CHILD" MEANS AN INDIVIDUAL WHO IS  UNDER  TWEN-
 TY-ONE  YEARS  OF AGE AND HAS A CHRONIC DEBILITATING CONDITION OR CONDI-
 TIONS, WHO MAY OR MAY NOT  BE  HOSPITALIZED  OR  INSTITUTIONALIZED,  AND
 MEETS  ONE  OR  MORE  OF  THE  FOLLOWING CRITERIA (A) IS TECHNOLOGICALLY
 DEPENDENT FOR LIFE  OR  HEALTH  SUSTAINING  FUNCTIONS,  (B)  REQUIRES  A
 COMPLEX  MEDICATION  REGIMEN  OR MEDICAL INTERVENTIONS TO MAINTAIN OR TO
 IMPROVE THEIR HEALTH STATUS, OR (C) IS IN NEED OF ONGOING ASSESSMENT  OR
 INTERVENTION  TO PREVENT SERIOUS DETERIORATION OF THEIR HEALTH STATUS OR
 MEDICAL COMPLICATIONS THAT PLACE THEIR LIFE, HEALTH  OR  DEVELOPMENT  AT
 RISK.  CHRONIC  DEBILITATING CONDITIONS INCLUDE, BUT ARE NOT LIMITED TO,
 BRONCHOPULMONARY DYSPLASIA, CEREBRAL PALSY,  CONGENITAL  HEART  DISEASE,
 MICROCEPHALY,  PULMONARY  HYPERTENSION, AND MUSCULAR DYSTROPHY. THE TERM
 "MEDICALLY FRAGILE CHILD" SHALL ALSO INCLUDE SEVERE CONDITIONS,  INCLUD-
 ING  BUT  NOT LIMITED TO TRAUMATIC BRAIN INJURY, WHICH TYPICALLY REQUIRE
 CARE IN A SPECIALTY CARE CENTER FOR  MEDICALLY  FRAGILE  CHILDREN,  EVEN
 THOUGH  THE CHILD DOES NOT HAVE A CHRONIC DEBILITATING CONDITION OR ALSO
 MEET ONE OF THE THREE CONDITIONS OF THIS SUBDIVISION. IN ORDER TO FACIL-
 ITATE THE PROMPT AND CONVENIENT  IDENTIFICATION  OF  PARTICULAR  PATIENT
 CARE SITUATIONS MEETING THE DEFINITIONS OF THIS SUBDIVISION, THE COMMIS-
 SIONER  MAY ISSUE WRITTEN GUIDANCE LISTING (BY DIAGNOSIS CODES, UTILIZA-
 TION THRESHOLDS, OR OTHER AVAILABLE  CODING  OR  COMMONLY  USED  MEDICAL
 CLASSIFICATIONS)  THE  TYPES  OF  PATIENT CARE NEEDS WHICH ARE DEEMED TO
 MEET THIS DEFINITION. NOTWITHSTANDING THE DEFINITIONS SET FORTH IN  THIS
 SUBDIVISION, ANY PATIENT WHICH HAS RECEIVED PRIOR APPROVAL FROM A UTILI-
 ZATION  REVIEW  AGENT  FOR  ADMISSION  TO  A SPECIALTY CARE FACILITY FOR
 MEDICALLY FRAGILE CHILDREN SHALL BE CONSIDERED A MEDICALLY FRAGILE CHILD
 AT LEAST UNTIL DISCHARGE FROM THAT FACILITY OCCURS.
   § 6. The public health law is amended by adding a new  section  4903-a
 to read as follows:
   §  4903-A.  UTILIZATION  REVIEW  DETERMINATIONS  FOR MEDICALLY FRAGILE
 CHILDREN. 1.  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THE UTILIZA-
 TION REVIEW AGENT'S CLINICAL STANDARDS,  THE  UTILIZATION  REVIEW  AGENT
 SHALL  ADMINISTER  AND  APPLY  THE CLINICAL STANDARDS (AND MAKE DETERMI-
 NATIONS OF MEDICAL NECESSITY) REGARDING MEDICALLY  FRAGILE  CHILDREN  IN
 ACCORDANCE  WITH  THE  REQUIREMENTS  OF THIS SECTION. IF THE UTILIZATION
 REVIEW AGENT IS A SEPARATE ENTITY FROM THE HEALTH MAINTENANCE  ORGANIZA-

 A. 3007--B                         46
 
 TION  CERTIFIED  UNDER  ARTICLE  FORTY-FOUR  OF THIS CHAPTER, THE HEALTH
 MAINTENANCE ORGANIZATION SHALL MAKE CONTRACTUAL OR OTHER ARRANGEMENTS IN
 ORDER TO FACILITATE THE UTILIZATION REVIEW AGENT'S COMPLIANCE WITH  THIS
 SECTION.
   2.  IN  THE  CASE  OF  A  MEDICALLY FRAGILE CHILD, THE TERM "MEDICALLY
 NECESSARY" SHALL MEAN HEALTH CARE AND SERVICES  THAT  ARE  NECESSARY  TO
 PROMOTE  NORMAL  GROWTH  AND  DEVELOPMENT  AND PREVENT, DIAGNOSE, TREAT,
 AMELIORATE OR PALLIATE THE EFFECTS OF A  PHYSICAL,  MENTAL,  BEHAVIORAL,
 GENETIC, OR CONGENITAL CONDITION, INJURY OR DISABILITY.  WHEN APPLIED TO
 THE  CIRCUMSTANCES  OF  ANY PARTICULAR MEDICALLY FRAGILE CHILD, THE TERM
 "MEDICALLY NECESSARY" SHALL INCLUDE (A) THE CARE OR  SERVICES  THAT  ARE
 ESSENTIAL  TO  PREVENT, DIAGNOSE, PREVENT THE WORSENING OF, ALLEVIATE OR
 AMELIORATE THE EFFECTS OF AN ILLNESS, INJURY,  DISABILITY,  DISORDER  OR
 CONDITION,  (B)  THE  CARE OR SERVICES THAT ARE ESSENTIAL TO THE OVERALL
 PHYSICAL, COGNITIVE AND MENTAL GROWTH AND  DEVELOPMENTAL  NEEDS  OF  THE
 CHILD,  AND  (C)  THE  CARE  OR  SERVICES  THAT WILL ASSIST THE CHILD TO
 ACHIEVE OR MAINTAIN MAXIMUM  FUNCTIONAL  CAPACITY  IN  PERFORMING  DAILY
 ACTIVITIES,  TAKING  INTO  ACCOUNT  BOTH  THE FUNCTIONAL CAPACITY OF THE
 CHILD AND THOSE FUNCTIONAL CAPACITIES THAT ARE APPROPRIATE FOR  INDIVID-
 UALS  OF  THE  SAME AGE AS THE CHILD. THE UTILIZATION REVIEW AGENT SHALL
 BASE  ITS  DETERMINATION  ON  MEDICAL  AND  OTHER  RELEVANT  INFORMATION
 PROVIDED BY THE CHILD'S PRIMARY CARE PROVIDER, OTHER HEALTH CARE PROVID-
 ERS, SCHOOL, LOCAL SOCIAL SERVICES, AND/OR LOCAL PUBLIC HEALTH OFFICIALS
 THAT  HAVE  EVALUATED  THE  CHILD, AND THE UTILIZATION REVIEW AGENT WILL
 ENSURE THE CARE AND SERVICES ARE PROVIDED IN SUFFICIENT AMOUNT, DURATION
 AND SCOPE TO REASONABLY BE EXPECTED TO PRODUCE THE INTENDED RESULTS  AND
 TO  HAVE  THE  EXPECTED  BENEFITS  THAT  OUTWEIGH  THE POTENTIAL HARMFUL
 EFFECTS.
   3. UTILIZATION  REVIEW  AGENTS  SHALL  UNDERTAKE  THE  FOLLOWING  WITH
 RESPECT TO MEDICALLY FRAGILE CHILDREN:
   (A)  CONSIDER  AS MEDICALLY NECESSARY ALL COVERED SERVICES THAT ASSIST
 MEDICALLY FRAGILE CHILDREN IN REACHING THEIR MAXIMUM FUNCTIONAL  CAPACI-
 TY,  TAKING  INTO ACCOUNT THE APPROPRIATE FUNCTIONAL CAPACITIES OF CHIL-
 DREN OF THE SAME AGE. HEALTH MAINTENANCE ORGANIZATIONS MUST CONTINUE  TO
 COVER  SERVICES  UNTIL  THAT  CHILD  ACHIEVES AGE-APPROPRIATE FUNCTIONAL
 CAPACITY. A MANAGED CARE PROVIDER, AUTHORIZED BY SECTION  THREE  HUNDRED
 SIXTY-FOUR-J  OF THE SOCIAL SERVICES LAW, SHALL ALSO BE REQUIRED TO MAKE
 PAYMENT FOR COVERED SERVICES REQUIRED TO COMPLY WITH FEDERAL EARLY PERI-
 ODIC SCREENING, DIAGNOSIS, AND TREATMENT ("EPSDT") STANDARDS, AS  SPECI-
 FIED BY THE COMMISSIONER OF HEALTH.
   (B)  SHALL NOT BASE DETERMINATIONS SOLELY UPON REVIEW STANDARDS APPLI-
 CABLE TO (OR DESIGNED FOR) ADULTS TO MEDICALLY FRAGILE  CHILDREN.  ADULT
 STANDARDS INCLUDE, BUT ARE NOT LIMITED TO, MEDICARE REHABILITATION STAN-
 DARDS  AND  THE "MEDICARE 3 HOUR RULE." DETERMINATIONS HAVE TO TAKE INTO
 CONSIDERATION THE SPECIFIC NEEDS OF  THE  CHILD  AND  THE  CIRCUMSTANCES
 PERTAINING TO THEIR GROWTH AND DEVELOPMENT.
   (C)  ACCOMMODATE  UNUSUAL  STABILIZATION AND PROLONGED DISCHARGE PLANS
 FOR MEDICALLY  FRAGILE  CHILDREN,  AS  APPROPRIATE.  ISSUES  UTILIZATION
 REVIEW  AGENTS  MUST  CONSIDER  WHEN  DEVELOPING AND APPROVING DISCHARGE
 PLANS INCLUDE, BUT ARE NOT LIMITED TO:  SUDDEN REVERSALS OF CONDITION OR
 PROGRESS, WHICH MAY MAKE DISCHARGE DECISIONS UNCERTAIN OR MORE PROLONGED
 THAN FOR OTHER CHILDREN OR ADULTS;  NECESSARY  TRAINING  OF  PARENTS  OR
 OTHER  ADULTS  TO  CARE  FOR MEDICALLY FRAGILE CHILDREN AT HOME; UNUSUAL
 DISCHARGE DELAYS ENCOUNTERED IF  PARENTS  OR  OTHER  RESPONSIBLE  ADULTS
 DECLINE  OR  ARE  SLOW  TO  ASSUME  FULL  RESPONSIBILITY  FOR CARING FOR
 MEDICALLY FRAGILE CHILDREN; THE NEED TO AWAIT  AN  APPROPRIATE  HOME  OR

 A. 3007--B                         47
 
 HOME-LIKE  ENVIRONMENT  RATHER  THAN  DISCHARGE  TO A HOUSING SHELTER OR
 OTHER INAPPROPRIATE SETTING FOR MEDICALLY FRAGILE CHILDREN, THE NEED  TO
 AWAIT  CONSTRUCTION ADAPTATIONS TO THE HOME (SUCH AS THE INSTALLATION OF
 GENERATORS  OR OTHER EQUIPMENT); AND LACK OF AVAILABLE SUITABLE SPECIAL-
 IZED CARE (SUCH AS UNAVAILABILITY OF PEDIATRIC NURSING HOME BEDS, PEDIA-
 TRIC VENTILATOR UNITS, PEDIATRIC PRIVATE DUTY NURSING IN  THE  HOME,  OR
 SPECIALIZED  PEDIATRIC  HOME CARE SERVICES).   UTILIZATION REVIEW AGENTS
 MUST DEVELOP A PERSON CENTERED DISCHARGE PLAN FOR THE CHILD  TAKING  THE
 ABOVE SITUATIONS INTO CONSIDERATION.
   (D)  IT IS THE UTILIZATION REVIEW AGENT'S NETWORK MANAGEMENT RESPONSI-
 BILITY TO IDENTIFY AN AVAILABLE PROVIDER OF NEEDED COVERED SERVICES,  AS
 DETERMINED THROUGH A PERSON CENTERED CARE PLAN, TO EFFECT SAFE DISCHARGE
 FROM  A  HOSPITAL  OR  OTHER FACILITY; PAYMENTS SHALL NOT BE DENIED TO A
 DISCHARGING HOSPITAL OR OTHER FACILITY DUE TO LACK OF AN AVAILABLE POST-
 DISCHARGE PROVIDER AS LONG AS THEY  HAVE  WORKED  WITH  THE  UTILIZATION
 REVIEW  AGENT  TO  IDENTIFY AN APPROPRIATE PROVIDER.  UTILIZATION REVIEW
 AGENTS ARE REQUIRED TO APPROVE THE USE OF  OUT-OF-NETWORK  PROVIDERS  IF
 THE  HEALTH  MAINTENANCE  ORGANIZATION  DOES  NOT  HAVE  A PARTICIPATING
 PROVIDER TO ADDRESS THE NEEDS OF THE CHILD.
   (E) THIS SECTION DOES NOT LIMIT ANY OTHER RIGHTS THE MEDICALLY FRAGILE
 CHILD MAY HAVE, INCLUDING THE RIGHT TO  APPEAL  THE  DENIAL  OF  OUT  OF
 NETWORK  COVERAGE AT IN-NETWORK COST SHARING LEVELS WHERE AN APPROPRIATE
 IN-NETWORK PROVIDER IS NOT AVAILABLE PURSUANT TO  SUBDIVISION  ONE-B  OF
 SECTION FORTY-NINE HUNDRED FOUR OF THIS TITLE.
   (F) UTILIZATION REVIEW AGENTS MUST ENSURE THAT MEDICALLY FRAGILE CHIL-
 DREN RECEIVE SERVICES FROM APPROPRIATE PROVIDERS THAT HAVE THE EXPERTISE
 TO  EFFECTIVELY  TREAT  THE  CHILD AND MUST CONTRACT WITH PROVIDERS WITH
 DEMONSTRATED EXPERTISE IN CARING FOR  THE  MEDICALLY  FRAGILE  CHILDREN.
 NETWORK  PROVIDERS  SHALL  REFER  TO  APPROPRIATE  NETWORK COMMUNITY AND
 FACILITY PROVIDERS TO MEET THE NEEDS OF THE CHILD OR SEEK  AUTHORIZATION
 FROM  THE  UTILIZATION  REVIEW  AGENT  FOR OUT-OF-NETWORK PROVIDERS WHEN
 PARTICIPATING PROVIDERS CANNOT MEET THE CHILD'S NEEDS.  THE  UTILIZATION
 REVIEW AGENT MUST AUTHORIZE SERVICES AS FAST AS THE ENROLLEE'S CONDITION
 REQUIRES  AND IN ACCORDANCE WITH ESTABLISHED TIMEFRAMES IN THE CONTRACTS
 OR POLICY FORMS.
   4. A HEALTH MAINTENANCE ORGANIZATION SHALL HAVE A PROCEDURE  BY  WHICH
 AN  ENROLLEE  WHO  IS A MEDICALLY FRAGILE CHILD WHO REQUIRES SPECIALIZED
 MEDICAL CARE OVER A PROLONGED PERIOD OF TIME, MAY RECEIVE A REFERRAL  TO
 A  SPECIALTY  CARE  CENTER FOR MEDICALLY FRAGILE CHILDREN. IF THE HEALTH
 MAINTENANCE ORGANIZATION, OR THE PRIMARY CARE PROVIDER OR THE SPECIALIST
 TREATING THE PATIENT, IN CONSULTATION WITH A  MEDICAL  DIRECTOR  OF  THE
 UTILIZATION REVIEW AGENT, DETERMINES THAT THE ENROLLEE'S CARE WOULD MOST
 APPROPRIATELY BE PROVIDED BY SUCH A SPECIALTY CARE CENTER, THE ORGANIZA-
 TION SHALL REFER THE ENROLLEE TO SUCH CENTER. IN NO EVENT SHALL A HEALTH
 MAINTENANCE  ORGANIZATION  BE REQUIRED TO PERMIT AN ENROLLEE TO ELECT TO
 HAVE A NON-PARTICIPATING SPECIALTY CARE CENTER, UNLESS THE  ORGANIZATION
 DOES  NOT  HAVE  AN  APPROPRIATE  SPECIALTY  CARE  CENTER  TO  TREAT THE
 ENROLLEE'S DISEASE OR CONDITION WITHIN ITS NETWORK. SUCH REFERRAL  SHALL
 BE  PURSUANT  TO A TREATMENT PLAN DEVELOPED BY THE SPECIALTY CARE CENTER
 AND APPROVED BY THE HEALTH  MAINTENANCE  ORGANIZATION,  IN  CONSULTATION
 WITH  THE  PRIMARY  CARE  PROVIDER, IF ANY, OR A SPECIALIST TREATING THE
 PATIENT, AND THE ENROLLEE OR THE ENROLLEE'S DESIGNEE. IF AN ORGANIZATION
 REFERS AN ENROLLEE TO A SPECIALTY CARE CENTER THAT DOES NOT  PARTICIPATE
 IN  THE  ORGANIZATION'S  NETWORK,  SERVICES  PROVIDED  PURSUANT  TO  THE
 APPROVED TREATMENT PLAN SHALL BE PROVIDED AT NO ADDITIONAL COST  TO  THE
 ENROLLEE  BEYOND  WHAT  THE  ENROLLEE  WOULD  OTHERWISE PAY FOR SERVICES

 A. 3007--B                         48
 
 RECEIVED WITHIN THE NETWORK.  FOR PURPOSES OF THIS SECTION, A  SPECIALTY
 CARE  CENTER  FOR  MEDICALLY  FRAGILE  CHILDREN  SHALL MEAN A CHILDREN'S
 HOSPITAL AS DEFINED PURSUANT TO SUBPARAGRAPH (IV) OF PARAGRAPH (E-2)  OF
 SUBDIVISION  FOUR  OF SECTION TWENTY-EIGHT HUNDRED SEVEN-C OF THIS CHAP-
 TER, A RESIDENTIAL HEALTH CARE FACILITY AFFILIATED  WITH  SUCH  A  CHIL-
 DREN'S  HOSPITAL,  ANY RESIDENTIAL HEALTH CARE FACILITY WITH A SPECIALTY
 PEDIATRIC BED AVERAGE DAILY CENSUS  DURING  TWO  THOUSAND  SEVENTEEN  OF
 FIFTY  OR MORE PATIENTS, OR A FACILITY WHICH SATISFIES SUCH OTHER CRITE-
 RIA AS THE COMMISSIONER MAY DESIGNATE.
   5. WHEN RENDERING OR ARRANGING FOR CARE OR PAYMENT, BOTH THE  PROVIDER
 AND  THE  HEALTH  MAINTENANCE  ORGANIZATION  SHALL INQUIRE OF, AND SHALL
 CONSIDER THE DESIRES OF THE FAMILY OF A MEDICALLY FRAGILE CHILD  INCLUD-
 ING,  BUT  NOT  LIMITED TO, THE AVAILABILITY AND CAPACITY OF THE FAMILY,
 THE NEED FOR THE FAMILY TO SIMULTANEOUSLY CARE FOR  THE  FAMILY'S  OTHER
 CHILDREN, AND THE NEED FOR PARENTS TO CONTINUE EMPLOYMENT.
   6.  THE  HEALTH MAINTENANCE ORGANIZATION MUST PAY AT LEAST EIGHTY-FIVE
 PERCENT (UNLESS A DIFFERENT  PERCENTAGE  OR  METHOD  HAS  BEEN  MUTUALLY
 AGREED  TO) OF THE FACILITY'S NEGOTIATED ACUTE CARE RATE FOR ALL DAYS OF
 INPATIENT HOSPITAL CARE AT A SPECIALTY CARE CENTER FOR MEDICALLY FRAGILE
 CHILDREN WHEN THE HEALTH MAINTENANCE ORGANIZATION AND THE SPECIALTY CARE
 FACILITY MUTUALLY AGREE THE PATIENT IS  READY  FOR  DISCHARGE  FROM  THE
 SPECIALTY  CARE  CENTER  TO  THE PATIENT'S HOME BUT REQUIRES SPECIALIZED
 HOME SERVICES THAT ARE NOT AVAILABLE OR IN  PLACE,  OR  THE  PATIENT  IS
 AWAITING  DISCHARGE  TO A RESIDENTIAL HEALTH CARE FACILITY WHEN NO RESI-
 DENTIAL HEALTH CARE FACILITY BED  IS  AVAILABLE  GIVEN  THE  SPECIALIZED
 NEEDS  OF  THE MEDICALLY FRAGILE CHILD. THE HEALTH MAINTENANCE ORGANIZA-
 TION MUST PAY AT LEAST THE FACILITY'S MEDICAID SKILLED NURSING  FACILITY
 RATE, UNLESS A DIFFERENT RATE HAS BEEN MUTUALLY NEGOTIATED, FOR ALL DAYS
 OF  RESIDENTIAL HEALTH CARE FACILITY CARE AT A SPECIALTY CARE CENTER FOR
 MEDICALLY FRAGILE CHILDREN WHEN THE HEALTH MAINTENANCE ORGANIZATION  AND
 THE  SPECIALTY  CARE  FACILITY  MUTUALLY  AGREE THE PATIENT IS READY FOR
 DISCHARGE FROM THE SPECIALTY CARE  CENTER  TO  THE  PATIENT'S  HOME  BUT
 REQUIRES  SPECIALIZED  HOME SERVICES THAT ARE NOT AVAILABLE OR IN PLACE.
 SUCH REQUIREMENTS SHALL APPLY UNTIL THE HEALTH  PLAN  CAN  IDENTIFY  AND
 SECURE  ADMISSION TO AN ALTERNATE PROVIDER RENDERING THE NECESSARY LEVEL
 OF SERVICES. THE SPECIALTY CARE CENTER MUST COOPERATE  WITH  THE  HEALTH
 MAINTENANCE ORGANIZATION'S PLACEMENT EFFORTS.
   7.  IN  THE  EVENT  A  HEALTH  MAINTENANCE  ORGANIZATION ENTERS INTO A
 PARTICIPATION AGREEMENT WITH A SPECIALTY CARE CENTER FOR MEDICALLY FRAG-
 ILE CHILDREN IN THIS STATE, THE REQUIREMENTS OF THIS SECTION SHALL APPLY
 TO SUCH PARTICIPATION AGREEMENT AND  TO  ALL  CLAIMS  SUBMITTED  TO,  OR
 PAYMENTS  MADE  BY, ANY OTHER HEALTH MAINTENANCE ORGANIZATIONS, INSURERS
 OR PAYORS MAKING PAYMENT TO THE SPECIALTY CARE CENTER  PURSUANT  TO  THE
 PROVISIONS OF THAT PARTICIPATION AGREEMENT.
   8. (A) THE COMMISSIONER SHALL DESIGNATE A SINGLE SET OF CLINICAL STAN-
 DARDS  APPLICABLE  TO  ALL UTILIZATION REVIEW AGENTS REGARDING PEDIATRIC
 EXTENDED ACUTE CARE STAYS (DEFINED FOR THE PURPOSES OF THIS  SECTION  AS
 DISCHARGE  FROM  ONE ACUTE CARE HOSPITAL FOLLOWED BY IMMEDIATE ADMISSION
 TO A SECOND ACUTE CARE HOSPITAL; NOT INCLUDING TRANSFERS OF CASE PAYMENT
 CASES AS DEFINED IN SECTION TWENTY-EIGHT HUNDRED SEVEN-C OF  THIS  CHAP-
 TER).  THE STANDARDS SHALL BE ADAPTED FROM NATIONAL LONG TERM ACUTE CARE
 HOSPITAL STANDARDS FOR ADULTS AND SHALL BE APPROVED BY THE COMMISSIONER,
 AFTER CONSULTATION WITH ONE OR MORE SPECIALTY CARE CENTERS FOR MEDICALLY
 FRAGILE CHILDREN.  THE STANDARDS SHALL INCLUDE, BUT NOT BE  LIMITED  TO,
 SPECIFICATIONS OF THE LEVEL OF CARE SUPPORTS IN THE PATIENT'S HOME, AT A
 SKILLED  NURSING  FACILITY  OR  OTHER  SETTING, THAT MUST BE IN PLACE IN

 A. 3007--B                         49
 
 ORDER TO SAFELY AND ADEQUATELY CARE FOR A MEDICALLY FRAGILE CHILD BEFORE
 MEDICALLY COMPLEX ACUTE CARE CAN BE DEEMED NO  LONGER  MEDICALLY  NECES-
 SARY.    THE STANDARDS DESIGNATED BY THE COMMISSIONER SHALL PRE-EMPT THE
 CLINICAL  STANDARDS, IF ANY, FOR PEDIATRIC EXTENDED ACUTE CARE SET FORTH
 IN THE UTILIZATION REVIEW PLAN BY THE UTILIZATION REVIEW AGENT.
   (B) THE COMMISSIONER SHALL DESIGNATE  A  SINGLE  SET  OF  SUPPLEMENTAL
 CLINICAL  STANDARDS  (IN  ADDITION TO THE CLINICAL STANDARDS SELECTED BY
 THE UTILIZATION REVIEW  AGENT)  APPLICABLE  TO  ALL  UTILIZATION  REVIEW
 AGENTS  REGARDING  ACUTE  AND  SUB-ACUTE  INPATIENT  REHABILITATION  FOR
 MEDICALLY FRAGILE CHILDREN. THE SUPPLEMENTAL STANDARDS SHALL SPECIFY THE
 LEVEL OF CARE SUPPORTS IN THE  PATIENT'S  HOME,  AT  A  SKILLED  NURSING
 FACILITY  OR OTHER SETTING, THAT MUST BE IN PLACE IN ORDER TO SAFELY AND
 ADEQUATELY CARE FOR A MEDICALLY FRAGILE CHILD BEFORE ACUTE OR  SUB-ACUTE
 INPATIENT  REHABILITATION  CAN  BE DEEMED NO LONGER MEDICALLY NECESSARY.
 THE SUPPLEMENTAL STANDARDS DESIGNATED BY THE COMMISSIONER SHALL PRE-EMPT
 THE CLINICAL STANDARDS, IF ANY, REGARDING  READINESS  FOR  DISCHARGE  OF
 MEDICALLY  FRAGILE  CHILDREN FROM ACUTE OR SUB-ACUTE INPATIENT REHABILI-
 TATION, AS SET FORTH IN THE UTILIZATION REVIEW PLAN BY  THE  UTILIZATION
 REVIEW AGENT.
   9.  IN  ALL  INSTANCES THE UTILIZATION REVIEW AGENT SHALL DEFER TO THE
 RECOMMENDATIONS OF THE REFERRING PHYSICIAN TO REFER A MEDICALLY  FRAGILE
 CHILD  FOR  CARE AT A PARTICULAR SPECIALTY PROVIDER OF CARE TO MEDICALLY
 FRAGILE CHILDREN, OR THE RECOMMENDED  TREATMENT  PLAN  BY  THE  TREATING
 PHYSICIAN  AT  A  SPECIALTY  CARE CENTER FOR MEDICALLY FRAGILE CHILDREN,
 EXCEPT WHERE THE UTILIZATION REVIEW AGENT HAS DETERMINED, BY  CLEAR  AND
 CONVINCING  EVIDENCE,  THAT:  (A)  THE  RECOMMENDED PROVIDER OR PROPOSED
 TREATMENT PLAN IS NOT IN THE BEST  INTEREST  OF  THE  MEDICALLY  FRAGILE
 CHILD,  OR  (B)  AN ALTERNATIVE PROVIDER OFFERING SUBSTANTIALLY THE SAME
 LEVEL OF CARE IN ACCORDANCE WITH SUBSTANTIALLY THE SAME  TREATMENT  PLAN
 IS AVAILABLE FROM A LOWER COST PROVIDER.
   § 7. Subparagraph (D) of paragraph 1 of subsection (b) of section 4900
 of  the insurance law, as added by section 36 of subpart A of part BB of
 chapter 57 of the laws of 2019, is amended and a new subparagraph (E) is
 added to read as follows:
   (D) for purposes of a determination involving treatment for  a  mental
 health condition:
   (i)  a  physician  who  possesses  a  current and valid non-restricted
 license to practice medicine and who specializes  in  behavioral  health
 and  has  experience  in the delivery of mental health courses of treat-
 ment; or
   (ii) a health care professional other than a  licensed  physician  who
 specializes  in  behavioral health and has experience in the delivery of
 mental health courses of treatment and, where  applicable,  possesses  a
 current  and  valid non-restricted license, certificate, or registration
 or, where no  provision  for  a  license,  certificate  or  registration
 exists,  is credentialed by the national accrediting body appropriate to
 the profession; [and] OR
   (E) FOR PURPOSES OF A DETERMINATION INVOLVING TREATMENT OF A MEDICALLY
 FRAGILE CHILD:
   (I) A PHYSICIAN WHO  POSSESSES  A  CURRENT  AND  VALID  NON-RESTRICTED
 LICENSE  TO PRACTICE MEDICINE AND WHO IS BOARD CERTIFIED OR BOARD ELIGI-
 BLE IN PEDIATRIC REHABILITATION, PEDIATRIC CRITICAL CARE, OR  NEONATOLO-
 GY; OR
   (II)  A  PHYSICIAN  WHO  POSSESSES  A CURRENT AND VALID NON-RESTRICTED
 LICENSE TO PRACTICE MEDICINE AND  IS  BOARD  CERTIFIED  IN  A  PEDIATRIC
 SUBSPECIALTY DIRECTLY RELEVANT TO THE PATIENT'S MEDICAL CONDITION; AND

 A. 3007--B                         50
 
   §  8.  Paragraph  2 of subsection (b) of section 4900 of the insurance
 law, as amended by chapter 586 of the laws of 1998, is amended  to  read
 as follows:
   (2) for purposes of title two of this article:
   (A) a physician who:
   (i)  possesses  a current and valid non-restricted license to practice
 medicine;
   (ii) where applicable, is board certified or  board  eligible  in  the
 same  or  similar  specialty  as  the health care provider who typically
 manages the medical condition or disease or  provides  the  health  care
 service or treatment under appeal;
   (iii) has been practicing in such area of specialty for a period of at
 least five years; and
   (iv) is knowledgeable about the health care service or treatment under
 appeal; or
   (B) a health care professional other than a licensed physician who:
   (i)  where  applicable,  possesses  a current and valid non-restricted
 license, certificate or registration;
   (ii) where applicable, is credentialed  by  the  national  accrediting
 body  appropriate  to  the profession in the same profession and same or
 similar specialty as the health care provider who typically manages  the
 medical  condition  or  disease  or  provides the health care service or
 treatment under appeal;
   (iii) has been practicing in such area of specialty for a period of at
 least five years;
   (iv) is knowledgeable about the health care service or treatment under
 appeal; and
   (v) where applicable to such health care professional's scope of prac-
 tice, is clinically supported by a physician who possesses a current and
 valid non-restricted license to practice medicine; OR
   (C) FOR PURPOSES OF A DETERMINATION INVOLVING TREATMENT OF A MEDICALLY
 FRAGILE CHILD:
   (I) A PHYSICIAN WHO  POSSESSES  A  CURRENT  AND  VALID  NON-RESTRICTED
 LICENSE  TO PRACTICE MEDICINE AND WHO IS BOARD CERTIFIED OR BOARD ELIGI-
 BLE IN PEDIATRIC REHABILITATION, PEDIATRIC CRITICAL CARE, OR  NEONATOLO-
 GY; OR
   (II)  A  PHYSICIAN  WHO  POSSESSES  A CURRENT AND VALID NON-RESTRICTED
 LICENSE TO PRACTICE MEDICINE AND  IS  BOARD  CERTIFIED  IN  A  PEDIATRIC
 SUBSPECIALTY DIRECTLY RELEVANT TO THE PATIENT'S MEDICAL CONDITION.
   §  9.  Subsection (b-1) of section 4900 of the insurance law, as added
 by chapter 586 of the laws of 1998, is amended to read as follows:
   (b-1) "Clinical standards" means those guidelines  and  standards  set
 forth  in  the  utilization  review plan by the utilization review agent
 whose adverse determination is under appeal OR, IN THE CASE OF MEDICALLY
 FRAGILE CHILDREN THOSE GUIDELINES AND STANDARDS AS REQUIRED  BY  SECTION
 FORTY-NINE HUNDRED THREE-A OF THIS ARTICLE.
   § 10. Subsection (j) of section 4900 of the insurance law, as added by
 chapter 705 of the laws of 1996, is amended to read as follows:
   (j)  "Utilization review plan" means: (1) a description of the process
 for developing the written clinical review criteria; (2)  a  description
 of  the  types  of  written  clinical  information  which the plan might
 consider in its clinical review, including but not limited to, a set  of
 specific written clinical review criteria; (3) a description of practice
 guidelines  and standards used by a utilization review agent in carrying
 out a  determination  of  medical  necessity,  WHICH,  IN  THE  CASE  OF
 MEDICALLY  FRAGILE CHILDREN, SHALL INCORPORATE THE STANDARDS REQUIRED BY

 A. 3007--B                         51

 SECTION FORTY-NINE HUNDRED THREE-A OF THIS ARTICLE; (4)  the  procedures
 for  scheduled  review  and  evaluation  of  the written clinical review
 criteria; and (5) a description of the qualifications and experience  of
 the  health  care  professionals  who  developed  the  criteria, who are
 responsible for periodic evaluation of the criteria and  of  the  health
 care  professionals or others who use the written clinical review crite-
 ria in the process of utilization review.
   § 11. Section 4900 of the insurance law is amended  by  adding  a  new
 subsection (k) to read as follows:
   (K)  "MEDICALLY  FRAGILE CHILD" MEANS AN INDIVIDUAL WHO IS UNDER TWEN-
 TY-ONE YEARS OF AGE AND HAS A CHRONIC DEBILITATING CONDITION  OR  CONDI-
 TIONS,  WHO  MAY  OR  MAY  NOT BE HOSPITALIZED OR INSTITUTIONALIZED, AND
 MEETS ONE OR MORE OF THE  FOLLOWING  CRITERIA:  (1)  IS  TECHNOLOGICALLY
 DEPENDENT  FOR  LIFE  OR  HEALTH  SUSTAINING  FUNCTIONS;  (2) REQUIRES A
 COMPLEX MEDICATION REGIMEN OR MEDICAL INTERVENTIONS TO  MAINTAIN  OR  TO
 IMPROVE  THEIR HEALTH STATUS; OR (3) IS IN NEED OF ONGOING ASSESSMENT OR
 INTERVENTION TO PREVENT SERIOUS DETERIORATION OF THEIR HEALTH STATUS  OR
 MEDICAL  COMPLICATIONS  THAT  PLACE THEIR LIFE, HEALTH OR DEVELOPMENT AT
 RISK. CHRONIC DEBILITATING CONDITIONS INCLUDE, BUT ARE NOT  LIMITED  TO,
 BRONCHOPULMONARY  DYSPLASIA,  CEREBRAL  PALSY, CONGENITAL HEART DISEASE,
 MICROCEPHALY, PULMONARY HYPERTENSION, AND MUSCULAR DYSTROPHY.  THE  TERM
 "MEDICALLY  FRAGILE CHILD" SHALL ALSO INCLUDE SEVERE CONDITIONS, INCLUD-
 ING BUT NOT LIMITED TO TRAUMATIC BRAIN INJURY, WHICH  TYPICALLY  REQUIRE
 CARE  IN  A  SPECIALTY  CARE CENTER FOR MEDICALLY FRAGILE CHILDREN, EVEN
 THOUGH THE CHILD DOES NOT HAVE A CHRONIC DEBILITATING CONDITION OR  ALSO
 MEET ONE OF THE THREE CONDITIONS OF THIS SUBSECTION. IN ORDER TO FACILI-
 TATE THE PROMPT AND CONVENIENT IDENTIFICATION OF PARTICULAR PATIENT CARE
 SITUATIONS  MEETING  THE DEFINITIONS OF THIS SUBSECTION, THE SUPERINTEN-
 DENT, AFTER CONSULTING WITH THE COMMISSIONER OF HEALTH, MAY ISSUE  WRIT-
 TEN  GUIDANCE  LISTING  (BY  DIAGNOSIS CODES, UTILIZATION THRESHOLDS, OR
 OTHER AVAILABLE CODING OR COMMONLY  USED  MEDICAL  CLASSIFICATIONS)  THE
 TYPES  OF  PATIENT  CARE NEEDS WHICH ARE DEEMED TO MEET THIS DEFINITION.
 NOTWITHSTANDING THE  DEFINITIONS  SET  FORTH  IN  THIS  SUBSECTION,  ANY
 PATIENT  WHICH  HAS  RECEIVED  PRIOR  APPROVAL FROM A UTILIZATION REVIEW
 AGENT FOR ADMISSION TO A SPECIALTY CARE FACILITY FOR  MEDICALLY  FRAGILE
 CHILDREN  SHALL  BE  CONSIDERED A MEDICALLY FRAGILE CHILD AT LEAST UNTIL
 DISCHARGE FROM THAT FACILITY OCCURS.
   § 12. The insurance law is amended by adding a new section  4903-a  to
 read as follows:
   §  4903-A.  UTILIZATION  REVIEW  DETERMINATIONS  FOR MEDICALLY FRAGILE
 CHILDREN. (A) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THE UTILIZA-
 TION REVIEW AGENT'S CLINICAL STANDARDS,  THE  UTILIZATION  REVIEW  AGENT
 SHALL  ADMINISTER  AND  APPLY  THE CLINICAL STANDARDS (AND MAKE DETERMI-
 NATIONS OF MEDICAL NECESSITY) REGARDING MEDICALLY  FRAGILE  CHILDREN  IN
 ACCORDANCE  WITH  THE  REQUIREMENTS  OF THIS SECTION. IF THE UTILIZATION
 REVIEW AGENT IS A SEPARATE ENTITY FROM THE HEALTH CARE PLAN, THE  HEALTH
 CARE  PLAN  SHALL  MAKE  CONTRACTUAL  OR  OTHER ARRANGEMENTS IN ORDER TO
 FACILITATE THE UTILIZATION REVIEW AGENT'S COMPLIANCE WITH THIS SECTION.
   (B) IN THE CASE OF A MEDICALLY  FRAGILE  CHILD,  THE  TERM  "MEDICALLY
 NECESSARY"  SHALL  MEAN  HEALTH  CARE AND SERVICES THAT ARE NECESSARY TO
 PROMOTE NORMAL GROWTH AND  DEVELOPMENT  AND  PREVENT,  DIAGNOSE,  TREAT,
 AMELIORATE  OR  PALLIATE  THE EFFECTS OF A PHYSICAL, MENTAL, BEHAVIORAL,
 GENETIC, OR CONGENITAL CONDITION, INJURY OR DISABILITY.  WHEN APPLIED TO
 THE CIRCUMSTANCES OF ANY PARTICULAR MEDICALLY FRAGILE  CHILD,  THE  TERM
 "MEDICALLY  NECESSARY"  SHALL INCLUDE: (1) THE CARE OR SERVICES THAT ARE
 ESSENTIAL TO PREVENT, DIAGNOSE, PREVENT THE WORSENING OF,  ALLEVIATE  OR

 A. 3007--B                         52
 
 AMELIORATE  THE  EFFECTS  OF AN ILLNESS, INJURY, DISABILITY, DISORDER OR
 CONDITION; (2) THE CARE OR SERVICES THAT ARE ESSENTIAL  TO  THE  OVERALL
 PHYSICAL,  COGNITIVE  AND  MENTAL  GROWTH AND DEVELOPMENTAL NEEDS OF THE
 CHILD;  AND  (3)  THE  CARE  OR  SERVICES  THAT WILL ASSIST THE CHILD TO
 ACHIEVE OR MAINTAIN MAXIMUM  FUNCTIONAL  CAPACITY  IN  PERFORMING  DAILY
 ACTIVITIES,  TAKING  INTO  ACCOUNT  BOTH  THE FUNCTIONAL CAPACITY OF THE
 CHILD AND THOSE FUNCTIONAL CAPACITIES THAT ARE APPROPRIATE FOR  INDIVID-
 UALS  OF  THE  SAME AGE AS THE CHILD. THE UTILIZATION REVIEW AGENT SHALL
 BASE  ITS  DETERMINATION  ON  MEDICAL  AND  OTHER  RELEVANT  INFORMATION
 PROVIDED BY THE CHILD'S PRIMARY CARE PROVIDER, OTHER HEALTH CARE PROVID-
 ERS, SCHOOL, LOCAL SOCIAL SERVICES, AND/OR LOCAL PUBLIC HEALTH OFFICIALS
 THAT  HAVE  EVALUATED  THE  CHILD, AND THE UTILIZATION REVIEW AGENT WILL
 ENSURE THE CARE AND SERVICES ARE PROVIDED IN SUFFICIENT AMOUNT, DURATION
 AND SCOPE TO REASONABLY BE EXPECTED TO PRODUCE THE INTENDED RESULTS  AND
 TO  HAVE  THE  EXPECTED  BENEFITS  THAT  OUTWEIGH  THE POTENTIAL HARMFUL
 EFFECTS.
   (C) UTILIZATION REVIEW  AGENTS  SHALL  UNDERTAKE  THE  FOLLOWING  WITH
 RESPECT TO MEDICALLY FRAGILE CHILDREN:
   (1)  CONSIDER  AS MEDICALLY NECESSARY ALL COVERED SERVICES THAT ASSIST
 MEDICALLY FRAGILE CHILDREN IN REACHING THEIR MAXIMUM FUNCTIONAL  CAPACI-
 TY,  TAKING  INTO ACCOUNT THE APPROPRIATE FUNCTIONAL CAPACITIES OF CHIL-
 DREN OF THE SAME AGE.  UTILIZATION REVIEW AGENTS MUST CONTINUE TO  COVER
 SERVICES UNTIL THAT CHILD ACHIEVES AGE-APPROPRIATE FUNCTIONAL CAPACITY.
   (2)  SHALL NOT BASE DETERMINATIONS SOLELY UPON REVIEW STANDARDS APPLI-
 CABLE TO (OR DESIGNED FOR) ADULTS TO MEDICALLY FRAGILE  CHILDREN.  ADULT
 STANDARDS INCLUDE, BUT ARE NOT LIMITED TO, MEDICARE REHABILITATION STAN-
 DARDS  AND THE "MEDICARE 3 HOUR RULE."  DETERMINATIONS HAVE TO TAKE INTO
 CONSIDERATION THE SPECIFIC NEEDS OF  THE  CHILD  AND  THE  CIRCUMSTANCES
 PERTAINING TO THEIR GROWTH AND DEVELOPMENT.
   (3)  ACCOMMODATE  UNUSUAL  STABILIZATION AND PROLONGED DISCHARGE PLANS
 FOR MEDICALLY  FRAGILE  CHILDREN,  AS  APPROPRIATE.  ISSUES  UTILIZATION
 REVIEW  AGENTS  MUST  CONSIDER  WHEN  DEVELOPING AND APPROVING DISCHARGE
 PLANS INCLUDE, BUT ARE NOT LIMITED TO: SUDDEN REVERSALS OF CONDITION  OR
 PROGRESS, WHICH MAY MAKE DISCHARGE DECISIONS UNCERTAIN OR MORE PROLONGED
 THAN  FOR  OTHER  CHILDREN  OR  ADULTS; NECESSARY TRAINING OF PARENTS OR
 OTHER ADULTS TO CARE FOR MEDICALLY FRAGILE  CHILDREN  AT  HOME;  UNUSUAL
 DISCHARGE  DELAYS  ENCOUNTERED  IF  PARENTS  OR OTHER RESPONSIBLE ADULTS
 DECLINE OR ARE  SLOW  TO  ASSUME  FULL  RESPONSIBILITY  FOR  CARING  FOR
 MEDICALLY  FRAGILE  CHILDREN;  THE  NEED TO AWAIT AN APPROPRIATE HOME OR
 HOME-LIKE ENVIRONMENT RATHER THAN DISCHARGE  TO  A  HOUSING  SHELTER  OR
 OTHER  INAPPROPRIATE SETTING FOR MEDICALLY FRAGILE CHILDREN, THE NEED TO
 AWAIT CONSTRUCTION ADAPTATIONS TO THE HOME (SUCH AS THE INSTALLATION  OF
 GENERATORS  OR OTHER EQUIPMENT); AND LACK OF AVAILABLE SUITABLE SPECIAL-
 IZED CARE (SUCH AS UNAVAILABILITY OF PEDIATRIC NURSING HOME BEDS, PEDIA-
 TRIC VENTILATOR UNITS, PEDIATRIC PRIVATE DUTY NURSING IN  THE  HOME,  OR
 SPECIALIZED  PEDIATRIC  HOME CARE SERVICES).   UTILIZATION REVIEW AGENTS
 MUST DEVELOP A PERSON CENTERED DISCHARGE PLAN FOR THE CHILD  TAKING  THE
 ABOVE SITUATIONS INTO CONSIDERATION.
   (4)  IT  IS THE UTILIZATION REVIEW AGENTS NETWORK MANAGEMENT RESPONSI-
 BILITY TO IDENTIFY AN AVAILABLE PROVIDER OF NEEDED COVERED SERVICES,  AS
 DETERMINED THROUGH A PERSON CENTERED CARE PLAN, TO EFFECT SAFE DISCHARGE
 FROM  A  HOSPITAL  OR  OTHER FACILITY; PAYMENTS SHALL NOT BE DENIED TO A
 DISCHARGING HOSPITAL OR OTHER FACILITY DUE TO LACK OF AN AVAILABLE POST-
 DISCHARGE PROVIDER AS LONG AS THEY  HAVE  WORKED  WITH  THE  UTILIZATION
 REVIEW  AGENT  TO  IDENTIFY AN APPROPRIATE PROVIDER.  UTILIZATION REVIEW
 AGENTS ARE REQUIRED TO APPROVE THE USE OF  OUT-OF-NETWORK  PROVIDERS  IF

 A. 3007--B                         53
 
 THEY  DO  NOT  HAVE A PARTICIPATING PROVIDER TO ADDRESS THE NEEDS OF THE
 CHILD.
   (5)  THIS  SECTION DOES NOT LIMIT ANY OTHER RIGHTS A MEDICALLY FRAGILE
 CHILD MAY HAVE, INCLUDING THE RIGHT TO  APPEAL  THE  DENIAL  OF  OUT  OF
 NETWORK  COVERAGE AT IN-NETWORK COST SHARING LEVELS WHERE AN APPROPRIATE
 IN-NETWORK PROVIDER IS NOT AVAILABLE PURSUANT  TO  SUBSECTION  A-TWO  OF
 SECTION FOUR THOUSAND NINE HUNDRED FOUR OF THIS TITLE.
   (6) UTILIZATION REVIEW AGENTS MUST ENSURE THAT MEDICALLY FRAGILE CHIL-
 DREN RECEIVE SERVICES FROM APPROPRIATE PROVIDERS THAT HAVE THE EXPERTISE
 TO  EFFECTIVELY  TREAT  THE  CHILD AND MUST CONTRACT WITH PROVIDERS WITH
 DEMONSTRATED EXPERTISE IN CARING FOR  THE  MEDICALLY  FRAGILE  CHILDREN.
 NETWORK  PROVIDERS  SHALL  REFER  TO  APPROPRIATE  NETWORK COMMUNITY AND
 FACILITY PROVIDERS TO MEET THE NEEDS OF THE CHILD OR SEEK  AUTHORIZATION
 FROM  THE  UTILIZATION  REVIEW  AGENT  FOR OUT-OF-NETWORK PROVIDERS WHEN
 PARTICIPATING PROVIDERS CANNOT MEET THE CHILD'S NEEDS.  THE  UTILIZATION
 REVIEW  AGENT MUST AUTHORIZE SERVICES AS FAST AS THE INSURED'S CONDITION
 REQUIRES AND IN ACCORDANCE WITH ESTABLISHED TIMEFRAMES IN THE  CONTRACTS
 OR POLICY FORMS.
   (D)  A  UTILIZATION  REVIEW  AGENT  SHALL HAVE A PROCEDURE BY WHICH AN
 INSURED WHO IS  A  MEDICALLY  FRAGILE  CHILD  WHO  REQUIRES  SPECIALIZED
 MEDICAL  CARE OVER A PROLONGED PERIOD OF TIME, MAY RECEIVE A REFERRAL TO
 A SPECIALTY CARE CENTER FOR MEDICALLY FRAGILE CHILDREN. IF THE  UTILIZA-
 TION REVIEW AGENT, OR THE PRIMARY CARE PROVIDER OR THE SPECIALIST TREAT-
 ING THE PATIENT, IN CONSULTATION WITH A MEDICAL DIRECTOR OF THE UTILIZA-
 TION  REVIEW  AGENT,  DETERMINES  THAT  THE  INSURED'S  CARE  WOULD MOST
 APPROPRIATELY BE PROVIDED BY SUCH A SPECIALTY CARE CENTER, THE  UTILIZA-
 TION  REVIEW  AGENT  SHALL REFER THE INSURED TO SUCH CENTER. IN NO EVENT
 SHALL A UTILIZATION REVIEW AGENT BE REQUIRED TO  PERMIT  AN  INSURED  TO
 ELECT  TO  HAVE  A  NON-PARTICIPATING  SPECIALTY CARE CENTER, UNLESS THE
 HEALTH CARE PLAN DOES NOT HAVE AN APPROPRIATE SPECIALTY CARE  CENTER  TO
 TREAT THE INSURED'S DISEASE OR CONDITION WITHIN ITS NETWORK. SUCH REFER-
 RAL  SHALL  BE  PURSUANT  TO A TREATMENT PLAN DEVELOPED BY THE SPECIALTY
 CARE CENTER AND APPROVED BY THE UTILIZATION REVIEW AGENT,  IN  CONSULTA-
 TION  WITH  THE  PRIMARY CARE PROVIDER, IF ANY, OR A SPECIALIST TREATING
 THE PATIENT, AND THE INSURED OR THE INSURED'S DESIGNEE. IF A UTILIZATION
 REVIEW AGENT REFERS AN INSURED TO A SPECIALTY CARE CENTER THAT DOES  NOT
 PARTICIPATE  IN THE HEALTH CARE PLAN'S NETWORK, SERVICES PROVIDED PURSU-
 ANT TO THE APPROVED TREATMENT PLAN SHALL BE PROVIDED  AT  NO  ADDITIONAL
 COST  TO  THE  INSURED  BEYOND  WHAT THE INSURED WOULD OTHERWISE PAY FOR
 SERVICES RECEIVED WITHIN THE NETWORK. FOR PURPOSES OF  THIS  SECTION,  A
 SPECIALTY  CARE CENTER FOR MEDICALLY FRAGILE CHILDREN SHALL MEAN A CHIL-
 DREN'S HOSPITAL AS DEFINED PURSUANT TO SUBPARAGRAPH  (IV)  OF  PARAGRAPH
 (E-2)  OF SUBDIVISION FOUR OF SECTION TWO THOUSAND EIGHT HUNDRED SEVEN-C
 OF THE PUBLIC HEALTH LAW, A RESIDENTIAL HEALTH CARE FACILITY  AFFILIATED
 WITH  SUCH  A  CHILDREN'S HOSPITAL, ANY RESIDENTIAL HEALTH CARE FACILITY
 WITH A SPECIALTY PEDIATRIC BED AVERAGE DAILY CENSUS DURING TWO  THOUSAND
 SEVENTEEN  OF FIFTY OR MORE PATIENTS, OR A FACILITY WHICH SATISFIES SUCH
 OTHER CRITERIA AS THE COMMISSIONER OF HEALTH MAY DESIGNATE.
   (E) WHEN RENDERING OR ARRANGING FOR CARE OR PAYMENT, BOTH THE PROVIDER
 AND THE HEALTH CARE PLAN  SHALL  INQUIRE  OF,  AND  SHALL  CONSIDER  THE
 DESIRES  OF,  THE FAMILY OF A MEDICALLY FRAGILE CHILD INCLUDING, BUT NOT
 LIMITED TO, THE AVAILABILITY AND CAPACITY OF THE FAMILY,  THE  NEED  FOR
 THE  FAMILY  TO SIMULTANEOUSLY CARE FOR THE FAMILY'S OTHER CHILDREN, AND
 THE NEED FOR PARENTS TO CONTINUE EMPLOYMENT.
   (F) THE HEALTH CARE PLAN MUST PAY AT LEAST EIGHTY-FIVE PERCENT (UNLESS
 A DIFFERENT PERCENTAGE OR METHOD HAS BEEN MUTUALLY  AGREED  TO)  OF  THE

 A. 3007--B                         54
 
 FACILITY'S NEGOTIATED ACUTE CARE RATE FOR ALL DAYS OF INPATIENT HOSPITAL
 CARE  AT A SPECIALTY CARE CENTER FOR MEDICALLY FRAGILE CHILDREN WHEN THE
 INSURER AND THE SPECIALTY CARE FACILITY MUTUALLY AGREE  THE  PATIENT  IS
 READY FOR DISCHARGE FROM THE SPECIALTY CARE CENTER TO THE PATIENT'S HOME
 BUT  REQUIRES  SPECIALIZED  HOME  SERVICES  THAT ARE NOT AVAILABLE OR IN
 PLACE, OR THE PATIENT IS AWAITING DISCHARGE TO A RESIDENTIAL HEALTH CARE
 FACILITY WHEN NO RESIDENTIAL HEALTH CARE FACILITY BED IS AVAILABLE GIVEN
 THE SPECIALIZED NEEDS OF THE MEDICALLY FRAGILE CHILD.  THE  HEALTH  CARE
 PLAN  MUST PAY AT LEAST THE FACILITY'S SKILLED NURSING MEDICAID FACILITY
 RATE, UNLESS A DIFFERENT RATE HAS BEEN MUTUALLY NEGOTIATED, FOR ALL DAYS
 OF RESIDENTIAL HEALTH CARE FACILITY CARE AT A SPECIALTY CARE CENTER  FOR
 MEDICALLY  FRAGILE  CHILDREN  WHEN  THE  INSURER  AND THE SPECIALTY CARE
 FACILITY MUTUALLY AGREE THE PATIENT IS  READY  FOR  DISCHARGE  FROM  THE
 SPECIALTY  CARE  CENTER  TO  THE PATIENT'S HOME BUT REQUIRES SPECIALIZED
 HOME SERVICES THAT ARE NOT AVAILABLE  OR  IN  PLACE.  SUCH  REQUIREMENTS
 SHALL APPLY UNTIL THE HEALTH CARE PLAN CAN IDENTIFY AND SECURE ADMISSION
 TO  AN ALTERNATE PROVIDER RENDERING THE NECESSARY LEVEL OF SERVICES. THE
 SPECIALTY CARE CENTER MUST COOPERATE WITH THE HEALTH CARE PLAN'S  PLACE-
 MENT EFFORTS.
   (G) IN THE EVENT A HEALTH CARE PLAN ENTERS INTO A PARTICIPATION AGREE-
 MENT WITH A SPECIALTY CARE CENTER FOR MEDICALLY FRAGILE CHILDREN IN THIS
 STATE,  THE  REQUIREMENTS  OF  THIS  SECTION SHALL APPLY TO THAT PARTIC-
 IPATION AGREEMENT AND TO ALL CLAIMS SUBMITTED TO, OR PAYMENTS  MADE  BY,
 ANY  OTHER  INSURERS,  HEALTH MAINTENANCE ORGANIZATIONS OR PAYORS MAKING
 PAYMENT TO THE SPECIALTY CARE CENTER PURSUANT TO THE PROVISIONS OF  THAT
 PARTICIPATION AGREEMENT.
   (H)  (1) THE SUPERINTENDENT, AFTER CONSULTING WITH THE COMMISSIONER OF
 HEALTH, SHALL DESIGNATE A SINGLE SET OF CLINICAL STANDARDS APPLICABLE TO
 ALL UTILIZATION REVIEW AGENTS REGARDING PEDIATRIC  EXTENDED  ACUTE  CARE
 STAYS  (DEFINED  FOR  THE PURPOSES OF THIS SECTION AS DISCHARGE FROM ONE
 ACUTE CARE HOSPITAL FOLLOWED BY IMMEDIATE ADMISSION TO  A  SECOND  ACUTE
 CARE  HOSPITAL; NOT INCLUDING TRANSFERS OF CASE PAYMENT CASES AS DEFINED
 IN SECTION TWO THOUSAND EIGHT HUNDRED SEVEN-C OF THE PUBLIC HEALTH LAW).
 THE STANDARDS SHALL BE ADAPTED FROM NATIONAL LONG TERM ACUTE CARE HOSPI-
 TAL STANDARDS FOR ADULTS AND SHALL BE APPROVED  BY  THE  SUPERINTENDENT,
 AFTER CONSULTATION WITH ONE OR MORE SPECIALTY CARE CENTERS FOR MEDICALLY
 FRAGILE  CHILDREN.  THE  STANDARDS SHALL INCLUDE, BUT NOT BE LIMITED TO,
 SPECIFICATIONS OF THE LEVEL OF CARE SUPPORTS IN THE PATIENT'S HOME, AT A
 SKILLED NURSING FACILITY OR OTHER SETTING, THAT  MUST  BE  IN  PLACE  IN
 ORDER TO SAFELY AND ADEQUATELY CARE FOR A MEDICALLY FRAGILE CHILD BEFORE
 MEDICALLY  COMPLEX  ACUTE  CARE CAN BE DEEMED NO LONGER MEDICALLY NECES-
 SARY. THE STANDARDS DESIGNATED BY THE COMMISSIONER  SHALL  PRE-EMPT  THE
 CLINICAL  STANDARDS, IF ANY, FOR PEDIATRIC EXTENDED ACUTE CARE SET FORTH
 IN THE UTILIZATION REVIEW PLAN BY THE UTILIZATION REVIEW AGENT.
   (2) THE SUPERINTENDENT, AFTER  CONSULTING  WITH  THE  COMMISSIONER  OF
 HEALTH,  SHALL DESIGNATE A SINGLE SET OF SUPPLEMENTAL CLINICAL STANDARDS
 (IN ADDITION TO THE  CLINICAL  STANDARDS  SELECTED  BY  THE  UTILIZATION
 REVIEW  AGENT)  APPLICABLE  TO  ALL  UTILIZATION REVIEW AGENTS REGARDING
 ACUTE AND SUB-ACUTE INPATIENT REHABILITATION FOR MEDICALLY FRAGILE CHIL-
 DREN. THE STANDARDS SHALL SPECIFY THE LEVEL  OF  CARE  SUPPORTS  IN  THE
 PATIENT'S  HOME,  AT  A  SKILLED NURSING FACILITY OR OTHER SETTING, THAT
 MUST BE IN PLACE IN ORDER TO SAFELY AND ADEQUATELY CARE FOR A  MEDICALLY
 FRAGILE  CHILD BEFORE ACUTE OR SUB-ACUTE INPATIENT REHABILITATION CAN BE
 DEEMED NO LONGER MEDICALLY NECESSARY. THE SUPPLEMENTAL STANDARDS  DESIG-
 NATED  BY  THE  SUPERINTENDENT SHALL PRE-EMPT THE CLINICAL STANDARDS, IF
 ANY, REGARDING READINESS FOR DISCHARGE  OF  MEDICALLY  FRAGILE  CHILDREN

 A. 3007--B                         55

 FROM  ACUTE  OR  SUB-ACUTE INPATIENT REHABILITATION, AS SET FORTH IN THE
 UTILIZATION REVIEW PLAN BY THE UTILIZATION REVIEW AGENT.
   (I)  IN  ALL INSTANCES THE UTILIZATION REVIEW AGENT SHALL DEFER TO THE
 RECOMMENDATIONS OF THE REFERRING PHYSICIAN TO REFER A MEDICALLY  FRAGILE
 CHILD  FOR  CARE AT A PARTICULAR SPECIALTY PROVIDER OF CARE TO MEDICALLY
 FRAGILE CHILDREN, OR THE RECOMMENDED  TREATMENT  PLAN  BY  THE  TREATING
 PHYSICIAN  AT  A  SPECIALTY  CARE CENTER FOR MEDICALLY FRAGILE CHILDREN,
 EXCEPT WHERE THE UTILIZATION REVIEW AGENT HAS DETERMINED, BY  CLEAR  AND
 CONVINCING  EVIDENCE,  THAT:  (1)  THE  RECOMMENDED PROVIDER OR PROPOSED
 TREATMENT PLAN IS NOT IN THE BEST  INTEREST  OF  THE  MEDICALLY  FRAGILE
 CHILD;  OR  (2)  AN ALTERNATIVE PROVIDER OFFERING SUBSTANTIALLY THE SAME
 LEVEL OF CARE IN ACCORDANCE WITH SUBSTANTIALLY THE SAME  TREATMENT  PLAN
 IS AVAILABLE FROM A LOWER COST PROVIDER.
   § 13. This act shall take effect January 1, 2022.
   § 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 XX of this act shall be
 as specifically set forth in the last section of such Parts.