BILL NUMBER:A1663A
TITLE OF BILL: An act to amend the mental hygiene law and the
insurance law, in relation to the definition of autism and autism
spectrum disorder
PURPOSE OR GENERAL IDEA OF BILL: To insert into the mental hygiene law
a definition of autism and other autism spectrum disorders. The
definition is the currently generally accepted definition as set forth
in the American Psychiatric Association's Diagnostic and Statistical
Manual of Mental Disorders (DSM).
SUMMARY OF SPECIFIC PROVISIONS: Section 1 amends Section 1.03 of the
mental hygiene law by adding a new subdivision 59 to define autism to
mean a pervasive developmental disorder that meets the criteria set
forth in the subdivision, including Autistic Disorder, Asperger's
Disorder, Pervasive Developmental Disorder Not Otherwise Specified,
Rhett's Disorder and Childhood Disintegrative Disorder.
Sections 2 through 4 make conforming changes to the insurance law.
Section 5 is the effective date.
JUSTIFICATION: Presently, New York's Mental. Hygiene law fails to
include a definition of autism and other autism spectrum disorders
even though it refers to the terms. The Mental Hygiene law should
include a definition for disorders that are referenced in the statute
and which are now occurring in a significant number of our children.
Currently at least 1 in 88 children are diagnosed with autism or
another autism spectrum disorder.
LEGISLATIVE HISTORY: A.9983, 2012 referred to Mental Health, reported
referred to ways and means. Same as S.7072 (McDonald), 2012 referred
to,Mental Health and Developmental Disabilities.
FISCAL IMPLICATIONS: : None to the State.
EFFECTIVE DATE: Immediately.
S T A T E O F N E W Y O R K
________________________________________________________________________
1663--A
2013-2014 Regular Sessions
I N A S S E M B L Y
(PREFILED)
January 9, 2013
___________
Introduced by M. of A. ABINANTI, ORTIZ, CURRAN, STIRPE, WEISENBERG,
COLTON, MILLMAN, GUNTHER, ABBATE, TITUS, PRETLOW, MOYA, CRESPO,
MAISEL, ZEBROWSKI, TITONE, JAFFEE, CAHILL, WEPRIN, ENGLEBRIGHT,
LAVINE, CUSICK, STEVENSON, MARKEY, ROBERTS, KEARNS, SIMANOWITZ,
BARRETT, GABRYSZAK, QUART, RODRIGUEZ, SCHIMEL, SANTABARBARA, CAMARA,
BENEDETTO, BRINDISI, SKOUFIS, V. LOPEZ, MILLER, COOK -- Multi-Spon-
sored by -- M. of A. ARROYO, BARCLAY, BORELLI, BOYLAND, BRENNAN,
CORWIN, CROUCH, CYMBROWITZ, DUPREY, GIBSON, HOOPER, JACOBS, JOHNS,
KATZ, McDONALD, McDONOUGH, McKEVITT, McLAUGHLIN, MONTESANO, O'DONNELL,
PERRY, RABBITT, RAIA, SCHIMMINGER, SKARTADOS, STEC, SWEENEY, THIELE,
WALTER -- read once and referred to the Committee on Mental Health --
committee discharged, bill amended, ordered reprinted as amended and
recommitted to said committee
AN ACT to amend the mental hygiene law and the insurance law, in
relation to the definition of autism and autism spectrum disorder
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Section 1.03 of the mental hygiene law is amended by adding
2 a new subdivision 59 to read as follows:
3 59. "AUTISM" MEANS A PERVASIVE DEVELOPMENTAL DISORDER THAT MEETS ANY
4 OF THE FOLLOWING CRITERIA:
5 (A) AUTISTIC DISORDER, WHICH IS:
6 (I) THE DIAGNOSES OF AT LEAST SIX OF THE FOLLOWING SYMPTOMS, WITH AT
7 LEAST TWO SYMPTOMS COMING FROM CLAUSE ONE OF THIS SUBPARAGRAPH, ONE
8 SYMPTOM COMING FROM CLAUSE TWO OF THIS SUBPARAGRAPH, AND ONE SYMPTOM
9 COMING FROM CLAUSE THREE OF THIS SUBPARAGRAPH.
10 (1) QUALITATIVE IMPAIRMENT IN SOCIAL INTERACTION, AS MANIFESTED BY AT
11 LEAST TWO OF THE FOLLOWING:
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02950-04-3
A. 1663--A 2
1 (A) MARKED IMPAIRMENT IN THE USE OF MULTIPLE, NONVERBAL BEHAVIORS SUCH
2 AS EYE-TO-EYE GAZE, FACIAL EXPRESSION, BODY POSTURES, AND GESTURES, TO
3 REGULATE SOCIAL INTERACTION.
4 (B) FAILURE TO DEVELOP PEER RELATIONSHIPS APPROPRIATE TO DEVELOPMENTAL
5 LEVEL.
6 (C) A LACK OF SPONTANEOUS SEEKING TO SHARE ENJOYMENT, INTERESTS, OR
7 ACHIEVEMENTS WITH OTHER PEOPLE (E.G., BY A LACK OF SHOWING, BRINGING, OR
8 POINTING OUT OBJECTS OF INTEREST).
9 (D) LACK OF SOCIAL OR EMOTIONAL RECIPROCITY.
10 (2) QUALITATIVE IMPAIRMENTS IN COMMUNICATION AS MANIFESTED BY AT LEAST
11 ONE OF THE FOLLOWING:
12 (A) DELAY IN, OR TOTAL LACK OF, THE DEVELOPMENT OF SPOKEN LANGUAGE
13 (NOT ACCOMPANIED BY AN ATTEMPT TO COMPENSATE THROUGH ALTERNATIVE MODES
14 OF COMMUNICATION SUCH AS GESTURE OR MIME).
15 (B) IN INDIVIDUALS WITH ADEQUATE SPEECH, MARKED IMPAIRMENT IN THE
16 ABILITY TO INITIATE OR SUSTAIN A CONVERSATION WITH OTHERS.
17 (C) STEREOTYPED AND REPETITIVE USE OF LANGUAGE OR IDIOSYNCRATIC
18 LANGUAGE.
19 (D) LACK OF VARIED, SPONTANEOUS MAKE-BELIEVE PLAY OR SOCIAL IMITATIVE
20 PLAY APPROPRIATE TO DEVELOPMENTAL LEVEL.
21 (3) RESTRICTED REPETITIVE AND STEREOTYPED PATTERNS OF BEHAVIOR, INTER-
22 ESTS, AND ACTIVITIES, AS MANIFESTED BY AT LEAST ONE OF THE FOLLOWING:
23 (A) ENCOMPASSING PREOCCUPATION WITH ONE OR MORE STEREOTYPED AND
24 RESTRICTED PATTERNS OF INTEREST THAT IS ABNORMAL EITHER IN INTENSITY OR
25 FOCUS.
26 (B) APPARENTLY INFLEXIBLE ADHERENCE TO SPECIFIC, NONFUNCTIONAL
27 ROUTINES OR RITUALS.
28 (C) STEREOTYPED AND REPETITIVE MOTOR MANNERS (E.G., HAND OR FINGER
29 FLAPPING OR TWISTING, OR COMPLEX WHOLE-BODY MOVEMENTS).
30 (D) PERSISTENT PREOCCUPATION WITH PARTS OF OBJECTS.
31 (II) DELAYS OR ABNORMAL FUNCTIONING IN AT LEAST ONE OF THE FOLLOWING
32 AREAS, WITH ONSET PRIOR TO THREE YEARS OF AGE:
33 (1) SOCIAL INTERACTION,
34 (2) LANGUAGE AS USED IN SOCIAL COMMUNICATION, OR
35 (3) SYMBOLIC OR IMAGINATIVE PLAY.
36 (III) THE DISTURBANCE IS NOT BETTER ACCOUNTED FOR BY RETT'S DISORDER
37 OR CHILDHOOD DISINTEGRATIVE DISORDER.
38 (B) ASPERGER'S DISORDER, WHICH IS:
39 (I) QUALITATIVE IMPAIRMENT IN SOCIAL INTERACTION, AS MANIFESTED BY AT
40 LEAST TWO OF THE FOLLOWING:
41 (1) MARKED IMPAIRMENT IN THE USE OF MULTIPLE NONVERBAL BEHAVIORS SUCH
42 AS EYE-TO-EYE GAZE, FACIAL EXPRESSION, BODY POSTURES, AND GESTURES TO
43 REGULATE SOCIAL INTERACTION.
44 (2) FAILURE TO DEVELOP PEER RELATIONSHIPS APPROPRIATE TO DEVELOPMENTAL
45 LEVEL.
46 (3) A LACK OF SPONTANEOUS SEEKING TO SHARE ENJOYMENT, INTERESTS, OR
47 ACHIEVEMENTS WITH OTHER PEOPLE (E.G., BY A LACK OF SHOWING, BRINGING, OR
48 POINTING OUT OBJECTS OF INTEREST TO OTHER PEOPLE).
49 (4) LACK OF SOCIAL OR EMOTIONAL RECIPROCITY.
50 (II) RESTRICTED REPETITIVE AND STEREOTYPED PATTERNS OF BEHAVIOR,
51 INTERESTS AND ACTIVITIES, AS MANIFESTED BY AT LEAST ONE OF THE FOLLOW-
52 ING:
53 (1) ENCOMPASSING PREOCCUPATION WITH ONE OR MORE STEREOTYPED AND
54 RESTRICTED PATTERNS OF INTEREST THAT IS ABNORMAL EITHER IN INTENSITY OR
55 FOCUS.
A. 1663--A 3
1 (2) APPARENTLY INFLEXIBLE ADHERENCE TO SPECIFIC, NONFUNCTIONAL
2 ROUTINES OR RITUALS.
3 (3) STEREOTYPED AND REPETITIVE MOTOR MANNERISMS (E.G., HAND OR FINGER
4 FLAPPING OR TWISTING, OR COMPLEX WHOLE-BODY MOVEMENTS).
5 (4) PERSISTENT PREOCCUPATION WITH PARTS OF OBJECTS.
6 (III) THE DISTURBANCE CAUSES CLINICALLY SIGNIFICANT IMPAIRMENT IN
7 SOCIAL, OCCUPATIONAL, OR OTHER IMPORTANT AREAS OF FUNCTIONING.
8 (IV) THERE IS NO CLINICALLY SIGNIFICANT GENERAL DELAY IN LANGUAGE
9 (E.G., SINGLE WORDS USED BY AGE TWO, COMMUNICATIVE PHRASES USED BY AGE
10 THREE).
11 (V) THERE IS NO CLINICALLY SIGNIFICANT DELAY IN COGNITIVE DEVELOPMENT
12 OR IN THE DEVELOPMENT OF AGE-APPROPRIATE SELF-HELP SKILLS, ADAPTIVE
13 BEHAVIOR (OTHER THAN IN SOCIAL INTERACTION), AND CURIOSITY ABOUT THE
14 ENVIRONMENT IN CHILDHOOD.
15 (VI) CRITERIA ARE NOT MET FOR ANOTHER SPECIFIC PERVASIVE DEVELOPMENTAL
16 DISORDER OR SCHIZOPHRENIA.
17 (C) PERVASIVE DEVELOPMENTAL DISORDER NOT OTHERWISE SPECIFIED (INCLUD-
18 ING ATYPICAL AUTISM), WHICH IS WHEN THERE IS A SEVERE AND PERVASIVE
19 IMPAIRMENT IN THE DEVELOPMENT OF RECIPROCAL SOCIAL INTERACTION ASSOCI-
20 ATED WITH IMPAIRMENT IN EITHER VERBAL OR NONVERBAL COMMUNICATION SKILLS
21 OR WITH THE PRESENCE OF STEREOTYPED BEHAVIOR, INTERESTS, AND ACTIVITIES,
22 BUT THE CRITERIA ARE NOT MET FOR A SPECIFIC PERVASIVE DEVELOPMENTAL
23 DISORDER, SCHIZOPHRENIA, SCHIZOTYPAL PERSONALITY DISORDER, OR AVOIDANT
24 PERSONALITY DISORDER. FOR EXAMPLE, THIS CATEGORY INCLUDES "ATYPICAL
25 AUTISM" - PRESENTATIONS THAT DO NOT MEET THE CRITERIA FOR AUTISTIC
26 DISORDER BECAUSE OF LATE AGE AT ONSET, ATYPICAL SYMPTOMATOLOGY, OR
27 SUBTHRESHOLD SYMPTOMATOLOGY, OR ALL OF THESE.
28 (D) RETT'S DISORDER, WHICH IS:
29 (I) THE DIAGNOSIS OF ALL OF THE FOLLOWING:
30 (1) APPARENTLY NORMAL PRENATAL AND PERINATAL DEVELOPMENT.
31 (2) APPARENTLY NORMAL PSYCHOMOTOR DEVELOPMENT THROUGH THE FIRST FIVE
32 MONTHS AFTER BIRTH.
33 (3) NORMAL HEAD CIRCUMFERENCE AT BIRTH.
34 (II) ONSET OF ALL OF THE FOLLOWING AFTER THE PERIOD OF NORMAL DEVELOP-
35 MENT:
36 (1) DECELERATION OF HEAD GROWTH BETWEEN AGES FIVE MONTHS AND
37 FORTY-EIGHT MONTHS.
38 (2) LOSS OF PREVIOUSLY ACQUIRED PURPOSEFUL HAND SKILLS BETWEEN AGES
39 FIVE MONTHS AND THIRTY MONTHS WITH THE SUBSEQUENT DEVELOPMENT OF STERE-
40 OTYPED HAND MOVEMENTS (E.G., HAND-WRINGING OR HAND WASHING).
41 (3) LOSS OF SOCIAL ENGAGEMENT EARLY IN THE COURSE (ALTHOUGH OFTEN
42 SOCIAL INTERACTION DEVELOPS LATER).
43 (4) APPEARANCE OF POORLY COORDINATED GAIT OR TRUNK MOVEMENTS.
44 (5) SEVERELY IMPAIRED EXPRESSIVE AND RECEPTIVE LANGUAGE DEVELOPMENT
45 WITH SEVERE PSYCHOMOTOR RETARDATION.
46 (E) CHILDHOOD DISINTEGRATIVE DISORDER, WHICH IS:
47 (I) APPARENTLY NORMAL DEVELOPMENT FOR AT LEAST THE FIRST TWO YEARS
48 AFTER BIRTH AS MANIFESTED BY THE PRESENCE OF AGE-APPROPRIATE VERBAL AND
49 NONVERBAL COMMUNICATION, SOCIAL RELATIONSHIPS, PLAY, AND ADAPTIVE BEHAV-
50 IOR.
51 (II) CLINICALLY SIGNIFICANT LOSS OF PREVIOUSLY ACQUIRED SKILLS (BEFORE
52 AGE TEN YEARS) IN AT LEAST TWO OF THE FOLLOWING AREAS:
53 (1) EXPRESSIVE OR RECEPTIVE LANGUAGE.
54 (2) SOCIAL SKILLS OR ADAPTIVE BEHAVIOR.
55 (3) BOWEL OR BLADDER CONTROL.
56 (4) PLAY.
A. 1663--A 4
1 (5) MOTOR SKILLS.
2 (III) ABNORMALITIES OF FUNCTIONING IN AT LEAST TWO OF THE FOLLOWING
3 AREAS:
4 (1) QUALITATIVE IMPAIRMENT IN SOCIAL INTERACTION (E.G., IMPAIRMENT IN
5 NONVERBAL BEHAVIORS, FAILURE TO DEVELOP PEER RELATIONSHIPS, LACK OF
6 SOCIAL OR EMOTIONAL RECIPROCITY).
7 (2) QUALITATIVE IMPAIRMENTS IN COMMUNICATION (E.G., DELAY OR LACK OF
8 SPOKEN LANGUAGE, INABILITY TO INITIATE OR SUSTAIN A CONVERSATION, STERE-
9 OTYPED AND REPETITIVE USE OF LANGUAGE, LACK OF VARIED MAKE-BELIEVE
10 PLAY).
11 (3) RESTRICTED, REPETITIVE, AND STEREOTYPED PATTERNS OF BEHAVIOR,
12 INTEREST, AND ACTIVITIES, INCLUDING MOTOR STEREOTYPES AND MANNERISMS.
13 (IV) THE DISTURBANCE IS NOT BETTER ACCOUNTED FOR BY ANOTHER SPECIFIC
14 PERVASIVE DEVELOPMENTAL DISORDER OR BY SCHIZOPHRENIA.
15 S 2. Clause (i) of subparagraph (C) of paragraph 25 of subdivision (i)
16 of section 3216 of the insurance law, as amended by chapter 596 of the
17 laws of 2011, is amended to read as follows:
18 (i) "autism spectrum disorder" means any pervasive developmental
19 disorder as defined in [the most recent edition of the diagnostic and
20 statistical manual of mental disorders, including autistic disorder,
21 Asperger's disorder, Rett's disorder, childhood disintegrative disorder,
22 or pervasive developmental disorder not otherwise specified (PDD-NOS)]
23 SUBDIVISION FIFTY-NINE OF SECTION 1.03 OF THE MENTAL HYGIENE LAW.
24 S 3. Clause (i) of subparagraph (C) of paragraph 17 of subdivision (1)
25 of section 3221 of the insurance law, as amended by chapter 596 of the
26 laws of 2011, is amended to read as follows:
27 (i) "autism spectrum disorder" means any pervasive developmental
28 disorder as defined in [the most recent edition of the diagnostic and
29 statistical manual of mental disorders, including autistic disorder,
30 Asperger's disorder, Rett's disorder, childhood disintegrative disorder,
31 or pervasive developmental disorder not otherwise specified (PDD-NOS)]
32 SUBDIVISION FIFTY-NINE OF SECTION 1.03 OF THE MENTAL HYGIENE LAW.
33 S 4. Subparagraph (A) of paragraph 3 of subdivision (ee) of section
34 4303 of the insurance law, as amended by chapter 596 of the laws of
35 2011, is amended to read as follows:
36 (A) "autism spectrum disorder" means any pervasive developmental
37 disorder as defined in [the most recent edition of the diagnostic and
38 statistical manual of mental disorders, including autistic disorder,
39 Asperger's disorder, Rett's disorder, childhood disintegrative disorder,
40 or pervasive developmental disorder not otherwise specified (PDD-NOS)]
41 SUBDIVISION FIFTY-NINE OF SECTION 1.03 OF THE MENTAL HYGIENE LAW.
42 S 5. This act shall take effect immediately.
