Assembly Health Committee Update: April - June
June 9, 2016

The Assembly Committee on Health favorably reported 71 bills at its meetings on April 12, May 4, May 10, May 17, May 23, June 1, and June 15. The Committee reported bills to strengthen health and safety enforcement in adult homes; promote HIV/AIDS research by modernizing medical records access laws; and expand access to medical marijuana by increasing producers and distribution sites and remove requirements that producers be “vertically integrated” – a requirement that severely limits participation in the industry.

The Committee reported the “New York Health Act” single-payer health care bill. New York Health would establish universal, complete health coverage for every New Yorker. It would save tens of billions currently spent on insurance administration and waste and remove the costly barriers to care that lead one in three families with private insurance to put off necessary medical care. The New York Health Act would end the regressive "tax" we pay in insurance premiums, deductibles, co-pays, and out-of-network charges that have no relation to ability to pay, and instead be funded by broad-based progressive premiums based on income.

The Committee also reported aid-in-dying legislation for the first time. The bill would authorize terminally ill adult patients who have mental capacity to make health care decisions to request medication for self-administration for the purpose of ending their own lives. For well over a century, New York law has recognized that an adult patient who has capacity to make health care decisions has the right to refuse medical treatment. So for over a century, a patient who wants to cease life-sustaining treatment and receive pain management and palliative care - or no care - has had that right. We must assure patients that they will have control over their end-of-life decisions, including access to appropriate pain management and palliative care. This critical patient autonomy should extend to the right to choose medically-assisted aid-in-dying.

For more information on a particular bill, please contact the sponsor listed after the description. For the text of a bill, supporting memorandum, and information on its status, go to: http://public.leginfo.state.ny.us/menuf.cgi

April 12

Brooklyn Asthma Study – Directs the Department of Health to conduct a study on the high incidence of asthma in the borough of Brooklyn. (A7835, Simon)

Powdered Pure Caffeine Ban – The Food and Drug Administration has warned consumers to avoid powdered pure caffeine, currently sold as a dietary supplement, due to its strength and overdose risk. This legislation prohibits its sale. (A8144, Ortiz)

Medical Marijuana: Increasing ROs and Dispensaries; Removing Mandatory “Vertical Integration”; and Allowing Sales Among ROs – The Department of Health has authorized just five ROs with four dispensaries each to provide medical marijuana. These ROs are required to be “vertically integrated,” meaning they must perform all aspects of the business from production through dispensing. Finally, ROs are not allowed to sell medical marijuana to other ROs. Since each dispensary is only allowed to sell five individual product lines, patients may have to drive across the state before they find a dispensary with the correct product. This bill removes the limits on the number of ROs and dispensaries; allows ROs to focus on particular parts of the industry (as is the case in almost every other business); and allows ROs to sell and receive products from other ROs. (A9507, Gottfried)

Insurance Exchange Organ Donor Registration – The primary methods for enrollment in New York’s organ donor registry are questions included on driver’s license and voter registration applications. Unfortunately, New York has the second-lowest rate of donor enrollment in the nation. To expand opportunities to enroll, this bill would add an enrollment question to the application for health insurance coverage through the state’s Health Benefits Exchange. (A9667A, Gunther)

Medical Marijuana: Increasing ROs and Dispensaries and Allowing Direct Practitioner Contact - The Department of Health has authorized just five ROs with four dispensaries each to provide medical marijuana. These 20 dispensaries are located in 13 counties, leaving 49 counties without a single one. Statewide, there are 978,000 New Yorkers for every dispensary – compared to an average of just 210,000 people per dispensary in other states with medical marijuana programs. This bill would begin to address patient access problems by requiring the Department of Health to authorize at least give additional ROs by January of 2017 and authorize ROs to operate up to eight rather than four dispensaries. The bill would also allow ROs to directly contact practitioners with information about medical marijuana, such as emerging scientific research, which would help encourage providers to participate in the program. Together, these reforms would enhance patient access to both dispensaries and appropriately-trained providers in numerous underserved areas of the state. (A9747, Gottfried)

May 4

Protection from Radon Exposure – Natural gas distributed to consumers includes radon and potential other radioactive substances. The level varies from one gas production site to another. This bill increases the public’s safety by requiring the commissioner of health to monitor radon levels and provide standards for gas companies; requiring gas companies to establish radon mitigation programs; and establishing a right of civil action for non-compliance. (A778, Rosenthal)

Electronic Cigarette Vendor Registration – Requires vendors of electronic cigarettes to register with the Health Department (to facilitate enforcement of electronic cigarette laws) unless they are already registered as tobacco vendors with the Department of Tax and Finance. (A852, Rosenthal)

Assisted Living Nurse Staffing – Enhanced assisted living and special needs assisted living facilities provide care to higher-needs patients such as those who are chair-fast or suffer from dementia. There is no requirement for ongoing, on-site monitoring and assessment. When the Department of Health adopted policies to implement such policies, a court decision ruled that they needed statutory authority to do so. This bill would provide that authority by requiring that these facilities employ full-time, on-site registered nurses. (A2141, Gottfried)

Improving Indoor Air Quality - Establishes standards, training programs, and compliance investigation methods for indoor air quality in state owned, leased, or operated buildings. (A3098, Lupardo)

Prohibiting Tobacco Coupons – Discount coupons for tobacco products undermine the state’s anti-smoking programs and are particularly attractive to young people. This bill prohibits the offering of such coupons. (A5164A, Mayer)

Dense Breast Tissue Education and Outreach - This bill amends the existing health care and wellness education and outreach program in the Department to include education for patients and providers on potential risks of dense breast tissue. (A5510A, Jaffee)

Adult Home Health and Safety Enforcement – Adult homes, enriched housing programs, and residences for adults serve thousands of New York residents. This bill modernizes and strengthens Department oversight of these facilities by permitting suspension of operating certificates beyond 60 days; requires the Department to levy fines for any violation that endangers a resident and permits the Department to levy “per violation” fines in addition to current law’s “per day” fines; prohibits adult care facilities from claiming rectification as a complete defense for recurring violations; and requires all these facilities to develop and implement quality assurance plans. (A5820A, Gottfried)

Environmental Health Tracking System –While the Department and the Department of Environmental Conservation have various databases for tracking different potential environmental health risks, there is no unified system for analyzing such dangers. This bill creates a joint working group of technical experts to aid the Departments in identifying, tracking, and remediating environmental health risks. (A6824A, Englebright)

Hotel Smoking Ban – Prohibits smoking in hotel or motel rooms. (A8371, Zebrowski)

Brooklyn Health Transformation Transparency – Under current law, capital grants made by the state’s Kings County health care transformation program will be made by the Commissioner and the President of the Dormitory Authority without competitive bidding. As a result, there is no way for the public to know anything about the applicants until after awards are made. This bill would require a more transparent process including public posting of all applications and awards; a public schedule for such applications and awards; and a description of how the grants will be distributed, administered, and monitored. (A9515, Brennan)

Prohibiting Distribution of Free Electronic Cigarettes – This bill adds electronic cigarettes to the prohibition of the distribution of free tobacco products. (A9731, Rosenthal)

Promoting HIV Research – Current law creates barriers to HIV/AIDS research by severely limiting the people permitted to review medical records of HIV-positive patients. Unlike all other diseases, only individuals directly providing health care to HIV/AIDS patients are allowed to review these records. This bill will allow disclosure of HIV/AIDS-related medical information to qualified researchers, with patient protections built in through a human research review committee or a federally-approved institutional review board. (A9834, Gottfried)

Prescription Pharmacy Choice - Currently, all prescriptions (with a few exceptions) must be electronically transmitted from a prescriber to a particular pharmacy to be filled. This prevents patients from shopping around and causes problems if the patient for any reason cannot go to that particular pharmacy. This bill would authorize the prescriber to instead send the electronic prescription to a secure website from which it can be downloaded by the pharmacy of the patient's choice. (A9837, Gottfried)

May 10

Technical Corrections to Do-Not-Resuscitate (DNR) Orders – Repeals sections of Public Health Law related to DNRs that are now covered by the Family Health Care Decisions Act. (A1023, Gunther)

Creating Smoke-Free Cars – Protects children from secondhand smoke by making it illegal to smoke in a car, truck, or van if a child under 14 is a passenger. Offenders would have to pay a $100 fine if caught in violation of the law. (A1982, Weprin)

Surrogate and Hospital Dispute Resolution – The Family Health Care Decisions Act states that if a surrogate directs provision of life-sustaining treatment but the hospital does not wish to provide it, the hospital must either comply with the surrogate, transfer the patient, or seek court review. This bill clarifies that the hospital may prevail if it is carrying out the patient’s own decision. (A2775, Pretlow)

Drinking Water Information Program – Directs the Commissioner to develop a drinking water information program to provide the public with information and reports on the state’s drinking water systems, including results of various existing tests, violations, and enforcement actions taken by the Department. (A4327, Sepulveda)

New York Health Act – Single-Payer Plan - Establishes "New York Health," a universal, single-payer health care program that would cover all New Yorkers without consideration of income. New York Health would replace insurance company premiums, deductibles, and co-pays with a publicly-funded benefit package more comprehensive than commercial health plans. (A5062A, Gottfried)

Bronx Asthma Study – Directs the Department of Health to conduct a study on the high asthma rates in the borough of The Bronx. (A7137, Sepulveda)

Encouraging Organ Donation – “Lauren’s Law” requires an applicant to fill out the organ donation section on a driver’s license or non-driver identification card application. The law is scheduled to expire in 2016. This bill extends it for four years. (A7137, Ortiz)

Expanding Opioid Abuse Prevention Programs – New York State currently registers opioid abuse prevention programs, allowing these providers to dispense and administer Naloxone without a prescription. This bill requires chain pharmacies with over 20 locations to register as opioid abuse prevention programs. (A9078, Mayer)

Updating Patients’ Bill of Rights – The “Patients’ Bill of Rights” spells out the rights and responsibilities of patients that every general hospital must adopt and make public. This bill updates the document to include information on new laws protecting patients against surprise billing and allowing patients to designate caregivers. (A9188A, Gunther)

Expanding Unused Controlled Substance Collection – A 2015 law allows pharmacies and other authorized providers to accept unused controlled substances for proper disposal. This bill would require chain pharmacies with four or more locations to do so. (A9883, Gunther)

Medicaid Managed Care Access to Buprenorphine – Buprenorphine is a life-saving medication to treat opioid addiction. Unfortunately, many Medicaid managed care plans require time-consuming prior authorization processes before it can be prescribed. This bill would prohibit Medicaid managed care plans from requiring prior authorization for it. (A9937A, Rosenthal)

May 17

Home Care Claims Standards – Sets forth standards for “clean claims” for payment of personal care, home health care, and consumer directed personal care. (A379B, Abinanti)

Prohibiting Release of Unclaimed Bodies Without Consent – Prohibits release of unclaimed bodies in the City of New York to universities for embalming, dissection, or autopsy until written consent of the decedent’s spouse or next of kin is acquired. (A6372B, Simanowitz)

Providing Nursing Spaces in Airports – Requires airports that serve greater than 1,000,000 passengers a year to provide nursing spaces for breastfeeding mothers behind security screening areas. (A7989, Solages)

Tick-Borne Disease Awareness and Prevention Program – Includes a tick-borne disease awareness and prevention program in the Department’s existing health care and wellness education program. (A8106A, Barrett)

Confidentiality and Immunity Protections for Group Practice – Current law requires hospitals to maintain malpractice prevention programs and grants certain confidentiality and immunity protections. This bill would allow medical, dental, or podiatric group practices to operate similar programs with similar protections. (A8556, Gottfried)

Preventing Overprescribing – Limits the number of schedule II or III controlled substance pain pills, in order to lessen the risk of diversion and encourage patients to follow up with their doctor. (A8601A, McDonald)

Tracking Opioid Overdose Data – Currently the Department tracks opioid overdose deaths, but not total reported overdoses, making it difficult to determine local resource needs. This bill requires that non-fatal overdoses also be tracked and that data made available on the Department’s website. (A9251A, Rosenthal)

Supplemental Reimbursement for Safety-Net Hospitals – Current definitions used to target financial resources to safety-net hospitals are overly broad and often exclude the neediest public providers. This bill creates a more focused definition to identify true safety-net hospitals as those public hospitals serving at least 50% Medicaid or uninsured patients; at least 3% uninsured; and no greater than 25% commercially insured. (A9476, Gottfried)

Rescheduling Ioflupane - {123I} ioflupane is an FDA-approved visual imaging agent used in tests to differentiate between Parkinson’s symptoms and essential tremors. The federal Drug Enforcement Agency has removed it from the controlled substances list, but since New York does not automatically make matching changes, it still remains a schedule II controlled substance in New York – severely limiting its use – despite being effectively impossible to divert for narcotic or pharmacological effects. This bill removes it from the State schedule. (A9891A, Gottfried)

Expanding Insurance Eligibility to Immigrants – Immigrants considered “permanently residing under color of law,” many of whom are younger adults who arrived as children, are currently eligible for State-only funded Medicaid. However, when their incomes rise above Medicaid level, they are ineligible for the federally-funded Essential Plan or Affordable Care Act plans. This bill would make them eligible for the Essential Plan even though there would not be federal funding support. Access to coverage will help reduce the costs of publicly-funded uncompensated care. (A10054, Gottfried)

Ensuring Access to Maternal Depression Screening - In 2014, New York passed a law to promote maternal depression screening by pediatricians. However, insurers have considered the screening to be a service for the mother rather than the child, resulting in the screening not being covered if the provider is not in the mother’s health plan. This bill clarifies that the “patient” is the child. (A10066, Richardson)

Medical Marijuana Physicians List - There are only about 600 physicians registered to certify patients for medical marijuana – but the Department refuses to make a list of them publicly available. As a result, severely ill patients are forced to cold-call doctors in hopes of finding one, or go through social media or other potentially unreliable sources. This bill would require the names and contact information of registered practitioners to be made available through the Department's website and allows practitioners who do not wish to be listed to opt-out. (A10123, Peoples-Stokes)

May 23

Palliative Care and Pain Management - Requires health care practitioners to complete course work or training in pain management and palliative care, with limited exceptions. (A355A, Rosenthal)

Requiring Epi-Pens in Schools – Requires schools to stock epi-pens and train school personnel to administer them. (A1582, Rosenthal)

School Registration Notification – Requires physicians and hospitals to document the name and address of any school attended by a school-aged patient and include such information in the patient’s file. This will help track and prevent exposure to infectious diseases. (A6427A, Perry)

Medicaid Coverage for Donor Breast Milk – The American Academy of Pediatrics has recommended feeding pre-term infants donated breast milk when maternal breast milk is not available. This bill provides Medicaid coverage for donor breast milk. (A9353A, Solages)

Prohibiting Smoking Near Libraries – Prohibits smoking within 100 feet of the entrance or exit of a library. (A9495B, Gottfried)

Medical Marijuana: Treating Severe Chronic Pain - Severe chronic pain is often treated with opioids that are much more dangerous and addictive than medical marijuana. Research in the Journal of the American Medical Association suggests that authorizing medical marihuana for severe chronic pain treatment may reduce mortality from opioid abuse. This bill expands the list of conditions to include severe chronic pain in cases when other therapeutic interventions, including opiate therapy, are contraindicated, ineffective, or likely to have more serious side effects. (A9514A, Gottfried)

Expanding the Early Intervention Coordinating Council – The Early Intervention program provides services to infants with disabilities aged zero to three and their families. The Early Intervention Coordinating Council (EICC) assists the Department in implementing the program. In order to improve coordination between insurance payors and the Department, this bill adds three insurance plan representatives to the currently 27-member body. (A9889, Jaffee)

Prescription Drug Donation – An estimated 50 million Americans do not fill prescriptions due to cost, even while up to 13% of prescription medications go unused in health care facilities. This bill authorizes health care facilities to donate unused prescription medications, in tamper-evident packaging, for dispensing by prescribers to uninsured and underinsured New Yorkers. (A9905A, Gottfried)

Aid-in-Dying - For well over a century, New York law has recognized that an adult patient who has capacity to make health care decisions has the right to refuse medical treatment. So for over a century, a patient who wants to cease life-sustaining treatment and receive pain management and palliative care - or no care - has had that right. This bill would authorize terminally ill adult patients who have mental capacity to make health care decisions to request medication for self-administration for the purpose of ending their own lives. (A10059, Paulin)

Renaming Department Offices – Renames the Department’s Office of Minority Health as the Office of Health Equity and the Minority Health Council as the Health Equity Council. (A10167, Perry)

Ending the HIV/AIDS Epidemic: Sharing HIV Data with Health Care Providers – This bill enacts recommendations of the Governor’s End the Epidemic Task Force. It allows sharing of HIV data with health care providers and care coordinators in order to improve HIV patient care coordination and care monitoring. (A10182, Gottfried)

Ending the HIV/AIDS Epidemic: HIV Testing Consent - This bill enacts recommendations of the Governor’s End the Epidemic Task Force. It streamlines the process for HIV testing and adheres to Centers for Disease Control recommendations in order to improve the consent process. (A10183, Gottfried)

Ending the HIV/AIDS Epidemic: HIV Treatment Consent for Minors - This bill enacts recommendations of the Governor’s End the Epidemic Task Force. Currently, competent minors are allowed to consent to HIV testing without parental consent. However, they do not have the right to consent to preventive treatment (“pre-exposure prophylaxis,” or PrEP.) This bill allows them to consent to PrEP and ensures that such consent would remain confidential. (A10184, Gottfried)

Inmate Death Certificates – Under current law, the Department and the New York City Bureau of Vital Statistics provide birth certificates at no charge to state and local correctional facilities including the New York City Department of Corrections. This bill adds provision of death certificates for those inmates who die in custody, saving administrative time and cost for such facilities. (A10200, Rozic)

Feminine Hygiene Product Access – This bill creates a pilot program through tampons and other feminine hygiene products shall be made available free of charge to middle school and high school students within selected school districts with the highest child poverty rates. (A10239, Rosenthal)

June 1

Expanding Wellness Programs – Currently, health insurance plans may sponsor “Wellness Programs” with rewards and incentives for participation. This bill expands the kind of programs available to include substance or alcohol abuse cessation programs and programs to manage chronic pain. (A9067, Crespo)

Rural Non-Emergency Medical Transport – Since the adoption of a centralized non-emergency medical transportation (NEMT) system, many rural public transport systems have experienced sharp decreases in ridership and been forced to reduce or eliminate routes. This bill requires that public transportation systems be prioritized for assignment in rural counties if such systems are available and appropriate to a patient’s needs. (A9602, Lifton)

Minority Coordinating Council of Asthmatic Affairs – Establishes a Minority Coordinating Council of Asthmatic Affairs within the Department to assess asthma risk factors and care access for minority populations and conduct a statewide asthma awareness campaign. (A9821, Arroyo)

Food Handling Safety Standards – Requires that sanitary gloves used by food establishments be changed after handling raw foods, handling garbage, or performing tasks that do not involve food preparation. This bill is modeled on existing New York City Health Code regulations. (A10216, Otis)

Medical Marijuana Banking Study – Medical marijuana programs throughout the country have struggled with issues related to banking and tax collection due to both State and Federal rules. This bill requires the Department to conduct a study of implementation of banking and tax collection issues related to New York’s medical marijuana program. (A10303, Gottfried)

Overdose Prevention in Libraries – Existing law authorizes schools to maintain and administer opioid antagonists (such as Nalaxone) in the event of an emergency. This bill expands the law to include public libraries. (A10364, Gottfried)

Technical Corrections to Criminal Background Checks for Nursing Home Employees - Current State law authorizes secondary sharing of Federal Bureau of Investigation (FBI) criminal records from the Department to Department-regulated providers. However, this violates a Federal law which prohibits these records from being shared outside the receiving agency. This bill amends State law to comply with Federal requirements. (A10382, Hyndman)

June 15

Supporting Rural Critical Access Hospitals – Critical access hospitals serve medically underserved, geographically isolated communities. Currently, Medicaid reimbursement rates are capped at lower than operational costs, endangering the financial viability of these facilities. This bill provides that, subject to appropriation, rural critical access hospitals be paid by Medicaid according to the “reasonable costs” standard used by Medicare. (A7111A, Skartados)

Access to Infant Formula – In 2014 the Department changed its rules for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC Program) by announcing that only pharmacies or stores with a pharmacy department could redeem checks for infant formula. This rule change limited the ability of WIC participants to access infant formula from a broader range of vendors, particularly in communities with fewer pharmacies. This bill allows redemption of infant formula checks at any WIC-approved vendor. (A9648A, Crespo)

Reforming the Medical Indemnity Fund – The Medical Indemnity Fund (MIF) was enacted in 2011 to provide funding for health care costs for infants who sustained birth-related neurological injuries. After 4 years of operation and the enrollment of around 400 babies, flaws in the program design have become apparent. Families struggle to find participating providers and unexpectedly pay some costs out-of-pocket. This legislation increases reimbursement rates for MIF health care providers; improves the appeals process for families in the program; and establishes a workgroup of parents and stakeholders to be consulted prior to the creation of Department regulations. (A9835B, Abinanti)

Medicaid Blood Allergy Testing – Historically, allergies were diagnosed using a “skin prick” test that had to be done by an allergist. Medical advances now allow blood testing for allergies that does not require a referral to a specialist. This bill adds Medicaid coverage for such blood tests. (A9867A, Perry)

Simplifying Burial Transit – Current law requires funeral directors to obtain burial transit permits, no matter how late at night or on weekends or holidays, before removing a body from a hospital or nursing home to a “non-adjacent county.” This law is inefficient and outdated and may interfere with the requirement of some religions that a body be buried within 24 hours of death. This bill would allow removal of deceased persons to non-adjacent counties under the same requirements as currently exist for adjacent counties. (A10020A, Santabarbara)

Electronic Transfer of Prescriptions – The majority of prescriptions are required to be done electronically. When a pharmacy receiving a prescription electronically cannot fill it, the patient is forced to go back to the health care provider for the prescription to be sent to a different pharmacy. This bill would allow the pharmacy to instead transfer that prescription to a different pharmacy. (A10448, Schimel)

Expanding HIV Prophylaxis for Sexual Assault Victims - Currently, hospitals are required to provide sexual assault victims with a 7-day treatment for HIV post-exposure prophylaxis and notify them that payment assistance for follow-up care may be available from the Office of Victim Services (OVS). This bill expands the 7-day treatment to the full course of treatment and provides that the any follow-up care be billed by the provider directly to OVS rather than requiring the filing of an application which may dissuade victims from participating. (A10503, Peoples-Stokes)

Ending the HIV/AIDS Epidemic - This bill enacts recommendations of the Governor’s End the Epidemic Task Force. These include reducing administrative hurdles to HIV testing; expanding HIV testing to individuals over 64 years old; allowing registered nurses to screen for sexually transmitted diseases; and allowing pharmacists to dispense 7-day treatments of post-exposure prophylaxis (“PEP”) - currently most patients must go to an emergency room for PEP. (A10724, Gottfried)