S06256 Summary:

BILL NOS06256D
 
SAME ASSAME AS UNI. A09056-D
 
SPONSORBUDGET
 
COSPNSR
 
MLTSPNSR
 
Amd Various Laws, generally
 
Relates to evaluations or services under the early intervention program for infants and toddlers with disabilities and their families, state aid reimbursement to municipalities for respite services, and service coordination; repeals subdivision 7 of section 2551 and subdivision 4 of section 2557 of the public health law, relating to administering early intervention services; requires that each municipality be responsible for providing early intervention services; requires health maintenance organizations to include coverage for otherwise covered services that are part of an early intervention program; relates to payment for early intervention services; repeals subsection (e) of section 3235-a of the insurance law relating to claims for early intervention program services; relates to special education services and programs for preschool children with handicapping conditions; and repeals subdivision 18 of section 4403 of the education law, relating to the power of the education department to approve the provision of early intervention services (Part A); relates to funding and operations of the Roswell Park Cancer Institute (Part B); establishes the supportive housing development reinvestment program; relates to applicability of the assisted living program; includes podiatry services and lactation services under the term medical assistance; relates to comprehensive HIV special needs plan, in relation to HEAL-NY, and in relation to the EQUAL program; relates to education, outreach services and facilitated enrollment activities for certain aged, blind and disabled persons; expands prenatal care programs, establishes the primary care service corps practitioner loan repayment program, authorizes moneys in the medical indemnity fund to be invested in obligations of the United States or the state or obligations where the principal and interest are guaranteed by the United States or the state and moneys distributed as non-Medicaid grants to non-major public academic medical centers; relates to the powers of the dormitory authority; directs a workgroup on medically fragile children; relates to notice requirement for preferred drug program, payment to the commissioner of health by third-party payors, audit of payments to the commissioner of health, electronic submission of reports by hospitals, and changing the definition of eligible applicant; relates to medical assistance where relative is absent or refuses or fails to provide necessary care; relates to third-party payor's election to make payments; relates to reserved bed days; relates to the personal care services worker recruitment and retention program; relates to the tobacco control and insurance initiatives pool distributions; relates to certain public school districts and state operated/state supported schools; relates to the licensure of home care services agencies; relates to managed care programs; relates to the distribution of the professional education pools; relates to the powers and duties of the dormitory authority of the state of New York relative to the establishment of subsidiaries for certain purposes, in relation to the effectiveness thereof; relates to costs incurred in excess of revenues by general hospitals in providing services in eligible programs to uninsured patients and patients eligible for Medicaid assistance; relates to the effectiveness of known and projected department of health state funds Medicaid expenditures; relates to certain payments with regard to local governments; relates to Medicaid reimbursement; and repeals certain provisions of the public health law relating thereto (Part D); relates to an administrative cap on reimbursements for expenditures made by or on behalf of social services districts for medical assistance for needy persons and the administration thereof; relates to general hospital reimbursement for annual rates, in relation to the cap on local Medicaid expenditures; relates to the department assumption of program administration for medical assistance; and provides for the repeal of certain provisions of the social services law upon expiration thereof (Part F); relates to the regulations for computing hospital inpatient rates and to the effectiveness of the preferred drug program (Part G); establishes a cost of living adjustment for designated human services programs, in relation to foregoing such adjustment during the 2012-2013 state fiscal year (Part H); relates to the office for people with developmental disabilities and the creation of developmental disabilities regional offices and state operations offices; and provides for the repeal of certain provisions upon expiration thereof (Part J); extends certain provisions relating to comprehensive psychiatric emergency programs (Part K); permits the commissioners of the department of health, the office of mental health, the office of alcoholism and substance abuse services and the office for people with developmental disabilities the regulatory flexibility to more efficiently and effectively integrate health and behavioral health services (Part L); authorizes contracts for the provision of special education and related services for certain patients hospitalized in hospitals operated by the office of mental health and provides for the repeal of such provisions upon expiration thereof (Part M); relates to the statewide comprehensive services plan for people with mental disabilities and in relation to the local planning process; and repeals certain provisions of the mental hygiene law relating thereto (Part N); relates to the closure and the reduction in size of certain facilities serving persons with mental illness; and provides for the repeal of such provisions upon expiration thereof (Part O); amends procedures under the sex offender management and treatment act (Part P); provides for outpatient capacity restoration of felony defendants at article 28 hospitals (Part Q); relates to the effectiveness of provisions related to the recovery of exempt income by the office of mental health for community residences and family-based treatment programs (Part R); relates to the excess medical malpractice liability coverage pool (Part S); and relates to the program for elderly pharmaceutical insurance coverage; and repeals certain provisions of such law relating thereto (Part T).
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S06256 Actions:

BILL NOS06256D
 
01/17/2012REFERRED TO FINANCE
02/10/2012AMEND AND RECOMMIT TO FINANCE
02/10/2012PRINT NUMBER 6256A
02/17/2012AMEND (T) AND RECOMMIT TO FINANCE
02/17/2012PRINT NUMBER 6256B
03/11/2012AMEND (T) AND RECOMMIT TO FINANCE
03/11/2012PRINT NUMBER 6256C
03/27/2012AMEND (T) AND RECOMMIT TO FINANCE
03/27/2012PRINT NUMBER 6256D
03/29/2012ORDERED TO THIRD READING CAL.484
03/30/2012MOTION TO AMEND LOST - ROLL CALL VOTE
03/30/2012SUBSTITUTED BY A9056D
 A09056 AMEND=D Budget
 01/17/2012referred to ways and means
 02/10/2012amend and recommit to ways and means
 02/10/2012print number 9056a
 02/17/2012amend (t) and recommit to ways and means
 02/17/2012print number 9056b
 03/09/2012amend (t) and recommit to ways and means
 03/09/2012print number 9056c
 03/27/2012amend (t) and recommit to ways and means
 03/27/2012print number 9056d
 03/29/2012reported referred to rules
 03/29/2012reported
 03/29/2012rules report cal.31
 03/29/2012ordered to third reading rules cal.31
 03/30/2012motion to amend lost
 03/30/2012motion to amend lost
 03/30/2012passed assembly
 03/30/2012delivered to senate
 03/30/2012REFERRED TO FINANCE
 03/30/2012SUBSTITUTED FOR S6256D
 03/30/20123RD READING CAL.484
 03/30/2012PASSED SENATE
 03/30/2012RETURNED TO ASSEMBLY
 03/30/2012delivered to governor
 03/30/2012signed chap.56
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S06256 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
            S. 6256--D                                            A. 9056--D
 
                SENATE - ASSEMBLY
 
                                    January 17, 2012
                                       ___________
 
        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  --  committee  discharged,  bill  amended,  ordered

          reprinted  as  amended  and recommitted to said committee -- committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee  --  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  --
          again  reported from said committee with amendments, ordered reprinted
          as amended and recommitted to said committee --  again  reported  from
          said  committee  with  amendments,  ordered  reprinted  as amended and
          recommitted to said committee -- again reported  from  said  committee

          with  amendments, ordered reprinted as amended and recommitted to said
          committee
 
        AN ACT to amend the public health law, in  relation  to  evaluations  or
          services under the early intervention program for infants and toddlers
          with disabilities and their families, state aid reimbursement to muni-
          cipalities  for  respite services, and service coordination; to repeal
          subdivision 7 of section 2551 and subdivision 4 of section 2557 of the
          public  health  law,  relating  to  administering  early  intervention
          services;  to  amend  the  public health law, in relation to requiring
          that each municipality be responsible for providing early intervention
          services; to amend the public health law,  in  relation  to  requiring
          health  maintenance  organizations  to  include coverage for otherwise
          covered services that are part of an early  intervention  program;  to

          amend the insurance law, in relation to payment for early intervention
          services;  to repeal subsection (e) of section 3235-a of the insurance
          law relating to claims for early  intervention  program  services;  to
          amend the education law, in relation to special education services and
          programs  for  preschool children with handicapping conditions; and to
          repeal subdivision 18 of section 4403 of the education  law,  relating
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD12671-06-2

        S. 6256--D                          2                         A. 9056--D
 
          to  the  power of the education department to approve the provision of

          early intervention services (Part A); to amend the public  authorities
          law,  in relation to funding and operations of the Roswell Park Cancer
          Institute  (Part  B);  intentionally  omitted  (Part  C); to amend the
          public health law, in relation to establishing the supportive  housing
          development reinvestment program; to amend the social services law, in
          relation to applicability of the assisted living program; to amend the
          social  services  law,  in relation to including podiatry services and
          lactation services under the term medical  assistance;  to  amend  the
          public  health  law,  in  relation  to comprehensive HIV special needs
          plan, in relation to HEAL-NY, and in relation to the EQUAL program; to
          amend the social services law,  in  relation  to  education,  outreach
          services and facilitated enrollment activities for certain aged, blind

          and  disabled  persons; to amend the public health law, in relation to
          expanding  prenatal  care  programs,  establishing  the  primary  care
          service  corps practitioner loan repayment program, authorizing moneys
          in the medical indemnity fund to be invested  in  obligations  of  the
          United  States  or  the  state  or obligations where the principal and
          interest are guaranteed by the United States or the state  and  moneys
          distributed  as  non-Medicaid  grants  to  non-major  public  academic
          medical centers; to amend the public authorities law, in  relation  to
          the  powers  of  the  dormitory  authority;  directs  a  workgroup  on
          medically fragile  children;  to  amend  the  public  health  law,  in
          relation  to notice requirement for preferred drug program, payment to
          the commissioner of health by third-party payors, audit of payments to

          the commissioner of health, electronic submission of reports by hospi-
          tals, and changing the definition of eligible applicant; to amend  the
          social  services law, in relation to medical assistance where relative
          is absent or refuses or fails to provide necessary care; to amend  the
          public health law, in relation to third-party payor's election to make
          payments;  to amend the public health law, in relation to reserved bed
          days; to amend the social services law, in relation  to  the  personal
          care  services  worker recruitment and retention program; to amend the
          public health law, in relation to the tobacco  control  and  insurance
          initiatives  pool  distributions; to amend the social services law, in
          relation to certain public school districts and  state  operated/state
          supported  schools; to amend the public health law, in relation to the

          licensure of home care services agencies; to amend the social services
          law, in relation to managed care programs; to amend the public  health
          law,  in  relation  to  the distribution of the professional education
          pools; to amend chapter 584 of the laws of 2011, amending  the  public
          authorities  law,  relating  to the powers and duties of the dormitory
          authority of the state of New York relative to  the  establishment  of
          subsidiaries  for  certain  purposes, in relation to the effectiveness
          thereof; to amend chapter 119 of the laws of 1997 relating to  author-
          izing the department of health to establish certain payments to gener-
          al  hospitals,  in relation to costs incurred in excess of revenues by
          general hospitals in providing services in eligible programs to  unin-
          sured patients and patients eligible for Medicaid assistance; to amend

          subdivision  1  of  section  92 of part H of chapter 59 of the laws of
          2011, relating to known and projected department of health state funds
          Medicaid expenditures, in relation to the  effectiveness  thereof;  to
          amend section 90 of part H of chapter 59 of the laws of 2011, relating
          to types of appropriations exempt from certain reductions, in relation
          to certain payments with regard to local governments; to amend section
          1 of part C of chapter 58 of the laws of 2005, relating to authorizing

        S. 6256--D                          3                         A. 9056--D
 
          reimbursements  for  expenditures  made  by  or  on  behalf  of social
          services districts for medical assistance for needy  persons  and  the
          administration  thereof, in relation to Medicaid reimbursement; and to

          repeal  certain  provisions  of the public health law relating thereto
          (Part D); intentionally omitted (Part E); to amend chapter 58  of  the
          laws of 2005 authorizing reimbursements for expenditures made by or on
          behalf  of  social services districts for medical assistance for needy
          persons and the administration thereof, in relation to an  administra-
          tive  cap  on  such  program; to amend 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 the cap on
          local Medicaid expenditures; to amend  the  social  services  law,  in
          relation  to  the  department assumption of program administration for
          medical assistance; and providing for the repeal of certain provisions
          of the social services law upon expiration thereof (Part F); to  amend

          the public health law, in relation to regulations for computing hospi-
          tal inpatient rates and to amend chapter 58 of the laws of 2005 relat-
          ing  to  the  preferred drug program, in relation to the effectiveness
          thereof (Part G); to amend chapter 57 of the laws of 2006, relating to
          establishing a cost of living adjustment for designated human services
          programs,  in  relation  to  foregoing  such  adjustment  during   the
          2012-2013  state fiscal year (Part H); intentionally omitted (Part I);
          to amend the mental hygiene law, the public health  law,  the  general
          municipal  law,  the  education  law,  the social services law and the
          surrogate's court procedure act, in relation to the office for  people
          with  developmental  disabilities  and  the  creation of developmental
          disabilities  regional  offices  and  state  operations  offices;  and

          providing for the repeal of certain provisions upon expiration thereof
          (Part J); to amend chapter 723 of the laws of 1989 amending the mental
          hygiene law and other laws relating to comprehensive psychiatric emer-
          gency  programs,  in  relation  to  extending  the  repeal  of certain
          provisions thereof (Part  K);  to  permit  the  commissioners  of  the
          department of health, the office of mental health, the office of alco-
          holism  and  substance  abuse  services and the office for people with
          developmental disabilities the regulatory flexibility  to  more  effi-
          ciently   and  effectively  integrate  health  and  behavioral  health
          services (Part L); to amend the education law, in relation to  author-
          izing  contracts  for  the  provision of special education and related
          services for certain patients hospitalized in  hospitals  operated  by

          the  office  of  mental  health  and  providing for the repeal of such
          provisions upon expiration thereof  (Part  M);  to  amend  the  mental
          hygiene  law  and  the public health law, in relation to the statewide
          comprehensive services plan for people with mental disabilities and in
          relation  to  the  local  planning  process;  and  to  repeal  certain
          provisions  of  the  mental  hygiene law relating thereto (Part N); to
          amend the mental hygiene law, in  relation  to  the  closure  and  the
          reduction  in  size  of certain facilities serving persons with mental
          illness; and providing for the repeal of such provisions upon  expira-
          tion thereof (Part O); to amend the mental hygiene law, in relation to
          amending  procedures  under  the sex offender management and treatment
          act (Part P); to amend the criminal  procedure  law,  in  relation  to

          providing  for outpatient capacity restoration of felony defendants at
          article 28 hospitals (Part Q); to amend chapter 111  of  the  laws  of
          2010 relating to the recovery of exempt income by the office of mental
          health  for  community residences and family-based treatment programs,
          in relation to the effectiveness thereof (Part R); in relation to  the

        S. 6256--D                          4                         A. 9056--D
 
          excess  medical  malpractice  liability coverage pool (Part S); and to
          amend the elder law, in relation to the program for elderly pharmaceu-
          tical insurance coverage; and to repeal certain provisions of such law
          relating thereto (Part T)
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 

     1    Section 1. This act enacts into law major  components  of  legislation
     2  which are necessary to implement the state fiscal plan for the 2012-2013
     3  state  fiscal  year.  Each  component  is wholly contained within a Part
     4  identified as Parts A through T. The effective date for each  particular
     5  provision contained within such Part is set forth in the last section of
     6  such Part. Any provision in any section contained within a Part, includ-
     7  ing the effective date of the Part, which makes a reference to a section
     8  "of  this  act", when used in connection with that particular component,
     9  shall be deemed to mean and refer to the corresponding  section  of  the
    10  Part  in  which  it  is  found. Section three of this act sets forth the
    11  general effective date of this act.
 
    12                                   PART A
 
    13    Section 1.  Subdivision 2 of section 2544 of the public health law  is

    14  amended by adding a new paragraph (c) to read as follows:
    15    (c)  If,  in  consultation with the evaluator, the service coordinator
    16  identifies a child that is potentially eligible for programs or services
    17  offered by or under the auspices of the office for people with  develop-
    18  mental disabilities, the service coordinator shall, with parent consent,
    19  notify  the  office for people with developmental disabilities' regional
    20  developmental disabilities services office of the potential  eligibility
    21  of such child for said programs or services.
    22    § 2. Intentionally omitted.
    23    §  2-a.  Section  2545 of the public health law is amended by adding a
    24  new subdivision 10 to read as follows:
    25    10. The service coordinator shall ensure that the IFSP, including  any

    26  amendments thereto, is implemented in a timely manner but not later than
    27  thirty  days after the projected dates for initiation of the services as
    28  set forth in the plan.
    29    § 3. Intentionally omitted.
    30    § 4. Subdivision 2 of section  2547  of  the  public  health  law,  as
    31  amended  by  chapter  231  of  the  laws  of 1993, is amended to read as
    32  follows:
    33    2. In addition to respite services provided  pursuant  to  subdivision
    34  one  of  this  section and subject to the amounts appropriated therefor,
    35  the state shall  reimburse  the  municipality  in  accordance  with  the
    36  percentage of state aid reimbursement for approved costs as set forth in
    37  subdivision  two  of  section  twenty-five  hundred  fifty-seven of this

    38  title, for [fifty percent of] the costs of respite services provided  to
    39  eligible  children  and  their  families  with the approval of the early
    40  intervention official.
    41    § 5. Section 2548 of the public health law, as amended by  section  20
    42  of  part  H  of  chapter  686 of the laws of 2003, is amended to read as
    43  follows:
    44    § 2548. Transition plan. To the extent that a toddler with a disabili-
    45  ty is thought to be eligible for services pursuant to section forty-four

        S. 6256--D                          5                         A. 9056--D
 
     1  hundred ten of the education  law,  the  [early  intervention  official]
     2  service  coordinator  shall notify in writing the committee on preschool
     3  special education of the local school  district  in  which  an  eligible

     4  child  resides  of  the  potential  transition  of  such child and, with
     5  parental consent, arrange for a conference among the  service  coordina-
     6  tor,  the  parent  and  the  chairperson  of  the preschool committee on
     7  special education or his or her designee at  least  ninety  days  before
     8  such  child  would  be  eligible  for  services under section forty-four
     9  hundred ten of the education law to review the child's  program  options
    10  and to establish a transition plan, if appropriate. If a parent does not
    11  consent to a conference with the service coordinator and the chairperson
    12  of  the  preschool committee on special education or his or her designee
    13  to determine whether the child should be  referred  for  services  under
    14  section  forty-four  hundred  ten of the education law, and the child is
    15  not determined to be eligible by  the  committee  on  preschool  special

    16  education  for  such  services  prior to the child's third birthday, the
    17  child's eligibility for early intervention program services shall end at
    18  the child's third birthday.
    19    § 6. Subdivision 2 of section  2550  of  the  public  health  law,  as
    20  amended  by  section  5 of part B3 of chapter 62 of the laws of 2003, is
    21  amended to read as follows:
    22    2. In meeting the requirements of subdivision one of this section, the
    23  lead agency shall adopt and use  proper  methods  of  administering  the
    24  early intervention program, including:
    25    (a)  establishing  standards  for evaluators, service coordinators and
    26  providers of early intervention services;
    27    (b) approving, and periodically re-approving evaluators, service coor-
    28  dinators and providers of early intervention services who  meet  depart-
    29  ment  standards;  provided  however that the department may require that

    30  approved evaluators, service coordinators and providers of early  inter-
    31  vention  services  enter into agreements with the department in order to
    32  conduct evaluations or render service coordination or early intervention
    33  services in the early intervention program. Such  agreements  shall  set
    34  forth  the  terms and conditions of participation in the program. If the
    35  department requires that such providers enter into agreements  with  the
    36  department for participation in the program, "approval" or "approved" as
    37  used  in this title shall mean a provider who is approved by the depart-
    38  ment in accordance with department regulations and has entered  into  an
    39  agreement  with the department for the provision of evaluations, service

    40  coordination or early intervention services.  The department  shall  use
    41  best  efforts  to  ensure  provider  capacity  in the early intervention
    42  program.
    43    (c) [compiling  and  disseminating  to  the  municipalities  lists  of
    44  approved  evaluators, service coordinators and providers of early inter-
    45  vention services;
    46    (d)] monitoring of agencies, institutions and organizations under this
    47  title and  agencies,  institutions  and  organizations  providing  early
    48  intervention  services which are under the jurisdiction of a state early
    49  intervention service agency;
    50    [(e)] (d) enforcing any obligations imposed on  those  agencies  under
    51  this title or Part H of the federal individuals with disabilities educa-
    52  tion act and its regulations;

    53    [(f)]  (e)  providing training and technical assistance to those agen-
    54  cies, institutions and  organizations,  including  initial  and  ongoing
    55  training  and technical assistance to municipalities to help enable them
    56  to identify, locate  and  evaluate  eligible  children,  develop  IFSPs,

        S. 6256--D                          6                         A. 9056--D
 
     1  ensure the provision of appropriate early intervention services, promote
     2  the  development of new services, where there is a demonstrated need for
     3  such services and afford procedural safeguards to infants  and  toddlers
     4  and their families;
     5    [(g)] (f) correcting deficiencies that are identified through monitor-
     6  ing; and
     7    [(h)]  (g) in monitoring early intervention services, the commissioner

     8  shall provide municipalities with the results of  any  review  of  early
     9  intervention  services  undertaken  and shall provide the municipalities
    10  with the opportunity to comment thereon.
    11    § 7. Subdivision 7 of  section  2551  of  the  public  health  law  is
    12  REPEALED,  and subdivisions 8, 9 and 10 are renumbered subdivisions 7, 8
    13  and 9.
    14    § 8.  Section 2552 of the public health law, as added by  chapter  428
    15  of  the  laws of 1992, subdivisions 2 and 3 as amended by chapter 231 of
    16  the laws of 1993, and subdivision 4 as added by section 6 of part B3  of
    17  chapter 62 of the laws of 2003, is amended to read as follows:
    18    § 2552. Responsibility of municipality.  1. Each municipality shall be
    19  responsible  for ensuring that the early intervention services contained
    20  in an IFSP are provided to eligible  children  and  their  families  who

    21  reside in such municipality [and may contract with approved providers of
    22  early intervention services for such purpose].  A municipality may moni-
    23  tor, which may include site visitation, evaluators and providers of such
    24  services within the municipality in accordance with this title and regu-
    25  lations promulgated hereunder, including making the determinations spec-
    26  ified  in  this  section.    The  service coordinator shall report, in a
    27  manner and format as determined by the municipality, on the delivery  of
    28  services  to  an  eligible child in accordance with the eligible child's
    29  IFSP. A municipality may request that the parent select  a  new  service
    30  coordinator or require that the service coordinator select a new provid-

    31  er  of  services  if the municipality finds that the service coordinator
    32  has not been performing his or her responsibilities as required by  this
    33  title  or  that  services  have not been provided in accordance with the
    34  eligible child's IFSP.  If the early  intervention  official  determines
    35  that  the  evaluator  has not followed the requirements in this title or
    36  regulations promulgated hereunder, the early intervention  official  may
    37  require  that  the evaluator immediately submit additional documentation
    38  to support the eligibility determination.  If  the  evaluator  does  not
    39  provide  the  requested  documentation,  or  the  documentation provided
    40  continues to be inconsistent with the  requirements  of  this  title  or

    41  regulations, the early intervention official can require that the parent
    42  select  another  evaluator  to conduct a multidisciplinary evaluation to
    43  determine whether the child meets eligibility for program services.
    44    2. [After consultation with early intervention officials, the  commis-
    45  sioner  shall develop procedures to permit a municipality to contract or
    46  otherwise make arrangements with other municipalities  for  an  eligible
    47  child and the child's family to receive services from such other munici-
    48  palities.
    49    3.  The  municipality  shall  monitor claims for service reimbursement
    50  authorized by this title and shall verify such claims prior to  payment.
    51  The municipality shall inform the commissioner of discrepancies in bill-

    52  ing and when payment is to be denied or withheld by the municipality.
    53    4.]  The early intervention official shall require an eligible child's
    54  parent to furnish the parents'  and  eligible  child's  social  security
    55  numbers  for the purpose of the department's and municipality's adminis-
    56  tration of the program.

        S. 6256--D                          7                         A. 9056--D
 
     1    § 9. Intentionally omitted.
     2    §  9-a.  Subdivision  4  of  section  2557 of the public health law is
     3  REPEALED and subdivisions 2 and 5, subdivision 2 as added by chapter 428
     4  of the laws of 1992 and subdivision 5 as added by section 7 of  part  B3
     5  of chapter 62 of the laws of 2003, are amended to read as follows:
     6    2. The department shall reimburse the approved costs paid by a munici-

     7  pality  for the purposes of this title, other than those reimbursable by
     8  the medical assistance program or by third party payors, in an amount of
     9  fifty percent of the amount expended in accordance with  the  rules  and
    10  regulations   of  the  commissioner;  provided,  however,  that  in  the
    11  discretion of the department and with the approval of  the  director  of
    12  the  division of the budget, the department may reimburse municipalities
    13  in an amount greater than fifty percent of the amount  expended.    Such
    14  state reimbursement to the municipality shall not be paid prior to April
    15  first  of  the  year in which the approved costs are paid by the munici-
    16  pality, provided, however that, subject to the approval of the  director
    17  of  the  budget,  the department may pay such state aid reimbursement to

    18  the municipality prior to such date.
    19    5. [The  department  shall]  (a)  The  commissioner,  in  his  or  her
    20  discretion, is authorized to contract with [an independent organization]
    21  one  or  more entities to act as the fiscal agent for the department and
    22  municipalities with respect to fiscal management and  payment  of  early
    23  intervention  claims. Municipalities shall grant sufficient authority to
    24  the fiscal agent to act on their behalf. Municipalities, and  individual
    25  and  agency providers as defined by the commissioner in regulation shall
    26  utilize such fiscal agent for payment of early  intervention  claims  as
    27  determined  by  the  department  and  shall provide such information and

    28  documentation as required by the department and necessary for the fiscal
    29  agent to carry out its duties.
    30    (b) Notwithstanding any inconsistent provision of section one  hundred
    31  twelve or one hundred sixty-three of the state finance law, sections one
    32  hundred  forty-two  and one hundred forty-three of the economic develop-
    33  ment law, or any other contrary provision of law,  the  commissioner  is
    34  authorized  to enter into a contract or contracts under paragraph (a) of
    35  this subdivision without a competitive bid or request for proposal proc-
    36  ess, provided, however, that:
    37    (i) The department shall post on its website, for a period of no  less
    38  than thirty days:
    39    (1)  A description of the proposed services to be provided pursuant to

    40  the contract or contracts;
    41    (2) The criteria for selection of a contractor or contractors;
    42    (3) The period of time during which a prospective contractor may  seek
    43  selection,  which  shall be no less than thirty days after such informa-
    44  tion is first posted on the website; and
    45    (4) The manner  by  which  a  prospective  contractor  may  seek  such
    46  selection, which may include submission by electronic means;
    47    (ii)  All reasonable and responsive submissions that are received from
    48  prospective contractors in a timely fashion shall  be  reviewed  by  the
    49  commissioner; and
    50    (iii)  The  commissioner  shall  select such contractor or contractors
    51  that, in his or her discretion, are best suited to serve the purposes of

    52  this section.
    53    (c) Paragraph (b) of this subdivision shall apply only to the  initial
    54  contract or contracts necessary to obtain the services of a fiscal agent
    55  for  early  intervention  program fiscal management and payment of early
    56  intervention claims and shall not apply to subsequent  contracts  needed

        S. 6256--D                          8                         A. 9056--D
 
     1  to  maintain  such services, as determined by the commissioner in his or
     2  her discretion.  [A municipality may elect to utilize  the  services  of
     3  such  organization  for early intervention program fiscal management and
     4  claiming  as determined by the commissioner or may select an independent

     5  agent to act as the fiscal agent for such municipality or may act as its
     6  own fiscal agent.]
     7    § 10. Subdivision 4 of section 2558 of the public health law, as added
     8  by chapter 428 of the laws of 1992, is amended to read as follows:
     9    4. Local contribution. The municipality of residence shall  be  finan-
    10  cially  responsible  for  the  local contribution in the amount of fifty
    11  percent of the [approved costs] amount expended provided, however,  that
    12  in  the discretion of the department and with the approval of the direc-
    13  tor of the division of the budget, in accordance with subdivision two of
    14  section twenty-five hundred fifty-seven of this  title,  the  department
    15  may  require  that municipalities be financially responsible for a local

    16  contribution in  an  amount  less  than  fifty  percent  of  the  amount
    17  expended.   The commissioner shall certify to the comptroller the amount
    18  of the local contribution owed by each municipality to  the  state.  The
    19  comptroller  shall  deduct  the  amount of such local contribution first
    20  from any moneys due the municipality  pursuant  to  section  twenty-five
    21  hundred fifty-six of this title and then from any other moneys due or to
    22  become due to the municipality.
    23    §  11. Paragraphs (a), (c) and (d) of subdivision 3 of section 2559 of
    24  the public health law, paragraph (a) as amended  and  paragraph  (d)  as
    25  added  by chapter 231 of the laws of 1993, subparagraphs (i) and (ii) of
    26  paragraph (a) as added by chapter 406 of the laws of 2011, and paragraph
    27  (c) as added by chapter 428 of the laws of 1992, are amended to read  as
    28  follows:

    29    (a)  Providers  of  evaluations  and  early intervention services [and
    30  transportation services], hereinafter collectively referred to  in  this
    31  subdivision  as  "provider"  or "providers", shall in the first instance
    32  and where applicable, seek payment from all third party payors including
    33  governmental agencies prior to claiming payment  from  a  given  munici-
    34  pality  for  evaluations  conducted  under  the program and for services
    35  rendered to eligible children, provided that, [for the purpose of  seek-
    36  ing  payment  from  the  medical  assistance program or from other third
    37  party payors, the municipality shall be  deemed  the  provider  of  such
    38  early intervention services to the extent that the provider has promptly

    39  furnished  to  the municipality adequate and complete information neces-
    40  sary to support the municipality billing, and provided further that] the
    41  obligation to seek payment shall not apply to a  payment  from  a  third
    42  party  payor  who is not prohibited from applying such payment, and will
    43  apply such payment, to an annual or  lifetime  limit  specified  in  the
    44  insured's policy.
    45    (i)  Parents  shall  provide [and] the municipality [shall obtain] and
    46  service coordinator information on any  [plan  of  insurance]  insurance
    47  policy, plan or contract under which an eligible child has coverage.
    48    (ii)  Parents shall provide the municipality and the service coordina-
    49  tor with a written referral from a primary care provider  as  documenta-

    50  tion,  for  eligible  children, of the medical necessity of early inter-
    51  vention services.
    52    (iii) providers shall utilize the department's fiscal agent  and  data
    53  system  for claiming payment for evaluations and services rendered under
    54  the early intervention program.
    55    (c) Payments made for early intervention services under  an  insurance
    56  policy  or  health  benefit plan, including payments made by the medical

        S. 6256--D                          9                         A. 9056--D
 
     1  assistance program or other governmental third party  payor,  which  are
     2  provided  as  part  of  an  IFSP pursuant to section twenty-five hundred
     3  forty-five of this title shall not be applied by  the  insurer  or  plan
     4  administrator against any maximum lifetime or annual limits specified in

     5  the  policy  or  health benefits plan, pursuant to section eleven of the
     6  chapter of the laws of nineteen  hundred  ninety-two  which  added  this
     7  title.
     8    (d) A municipality, or its designee, and a provider shall be subrogat-
     9  ed,  to the extent of the expenditures by such municipality or for early
    10  intervention services furnished to persons eligible for  benefits  under
    11  this  title,  to  any rights such person may have or be entitled to from
    12  third party reimbursement. The  provider  shall  submit  notice  to  the
    13  insurer  or  plan  administrator of his or her exercise of such right of
    14  subrogation upon the provider's assignment  as  the  early  intervention
    15  service provider for the child. The right of subrogation does not attach
    16  to benefits paid or provided under any health insurance policy or health

    17  benefits  plan  prior  to  receipt  of written notice of the exercise of
    18  subrogation rights by the insurer or plan administrator  providing  such
    19  benefits.
    20    § 12. Intentionally omitted.
    21    § 13. Intentionally omitted.
    22    § 14. Intentionally omitted.
    23    § 15. Intentionally omitted.
    24    §  16.  Subsection  (e)  of  section  3235-a  of  the insurance law is
    25  REPEALED.
    26    § 17. Subsection (c) of  section  3235-a  of  the  insurance  law,  as
    27  amended  by  chapter  406  of  the  laws  of 2011, is amended to read as
    28  follows:
    29    (c) Any right of subrogation  to  benefits  which  a  municipality  or
    30  provider  is  entitled  in  accordance with paragraph (d) of subdivision
    31  three of section twenty-five hundred fifty-nine of the public health law
    32  shall be valid and enforceable to  the  extent  benefits  are  available

    33  under any accident and health insurance policy. The right of subrogation
    34  does  not  attach to insurance benefits paid or provided under any acci-
    35  dent and health insurance policy prior to  receipt  by  the  insurer  of
    36  written  notice  from the municipality or provider, as applicable. [Upon
    37  the insurer's receipt of written request and  notice  from  the  munici-
    38  pality  that  such right of subrogation has been granted to such munici-
    39  pality and that the insured has authorized the release of information to
    40  the municipality, the] The insurer shall provide  the  municipality  and
    41  service coordinator with information on the extent of benefits available
    42  to  the  covered  person  under  such  policy within fifteen days of the

    43  insurer's  receipt  of  written  request  and  notice  authorizing  such
    44  release.   The service coordinator shall provide such information to the
    45  rendering provider assigned to provide services to the child.
    46    § 18. Subdivision 18 of section 4403 of the education law is REPEALED.
    47    § 19. Paragraph f of subdivision 3 and the opening paragraph of  para-
    48  graph  a  of  subdivision  9  of  section  4410 of the education law, as
    49  amended by chapter 82 of the laws  of  1995,  are  amended  to  read  as
    50  follows:
    51    f.  After  notification  by [an early intervention official] a service
    52  coordinator, as defined in section twenty-five hundred forty-one of  the
    53  public  health  law,  that  a child receiving services pursuant to title
    54  II-A of article twenty-five of the public health  law  potentially  will

    55  transition  to  receiving services under this section and that a confer-
    56  ence is to be convened to review the child's program options and  estab-

        S. 6256--D                         10                         A. 9056--D
 
     1  lish a transition plan, which conference must occur at least ninety days
     2  before such child would be eligible for services under this section, the
     3  chairperson of the committee on preschool special education of the local
     4  school district or his or her designee in which such child resides shall
     5  participate in the conference.
     6    Providers  of  special services or programs shall apply to the commis-
     7  sioner for program approval on a form prescribed  by  the  commissioner;
     8  such  application shall include, but not be limited to, a listing of the
     9  services to be provided, the population to be served, a plan for provid-

    10  ing services in the least restrictive environment and a  description  of
    11  its  evaluation  component,  if  any.  [Providers  of early intervention
    12  services seeking approval pursuant to subdivision seven of section twen-
    13  ty-five hundred fifty-one of the public health law shall  apply  to  the
    14  commissioner  for  such approval on a form prescribed by the commission-
    15  er.] The commissioner shall approve programs in  accordance  with  regu-
    16  lations  adopted  for  such  purpose  and shall periodically review such
    17  programs at which time the commissioner shall provide  the  municipality
    18  in  which  the  program  is  located or for which the municipality bears
    19  fiscal responsibility an opportunity for comment within thirty  days  of
    20  the  review. In collaboration with municipalities and representatives of

    21  approved  programs,  the  commissioner  shall  develop  procedures   for
    22  conducting  such reviews. Municipalities shall be allowed to participate
    23  in such departmental review process. Such review shall be  conducted  by
    24  individuals with appropriate experience as determined by the commission-
    25  er and shall be conducted not more than once every three years.
    26    § 20. Intentionally omitted.
    27    § 21. Intentionally omitted.
    28    § 22. Intentionally omitted.
    29    §  23.  This act shall take effect January 1, 2013; provided, however,
    30  that sections two-a, four, five, seven, eight, nine-a, ten, eighteen and
    31  nineteen of this act shall take effect April 1, 2013.
 
    32                                   PART B
 
    33    Section 1. Subdivisions 9, 10 and 11 of section  3555  of  the  public
    34  authorities  law, as added by chapter 5 of the laws of 1997, are amended
    35  to read as follows:

    36    9. to determine the conditions under which a physician may be extended
    37  the privilege of practicing within a health facility under the jurisdic-
    38  tion of the corporation, to promulgate internal policies for the conduct
    39  of all persons, physicians and allied health practitioners  within  such
    40  facility, and to appoint and grant privileges to qualified and competent
    41  clinical practitioners; [and]
    42    10.  except as provided in this subdivision or as expressly limited by
    43  any applicable state law or regulation, and in  support  of  the  powers
    44  granted  by  subdivisions  five  and six of this section, to form and to
    45  participate in the formation of one or more corporations, and  to  exer-
    46  cise  and perform such purposes, powers, duties, functions or activities
    47  through one or more subsidiary corporations or other entities  owned  or

    48  controlled  wholly  or in part by the corporation, which shall be formed
    49  pursuant to the business corporation law, the limited liability  company
    50  law,  the  not-for-profit  corporation  law, or the partnership law; any
    51  such subsidiary may be authorized to act as a general or limited partner
    52  in a partnership or as a member of  a  limited  liability  company,  and
    53  enter  into an arrangement calling for an initial and subsequent payment
    54  or payments or contributions to capital by such subsidiary in  consider-

        S. 6256--D                         11                         A. 9056--D
 
     1  ation of an interest in revenues or other contractual rights.  An entity
     2  shall  be  deemed  a  subsidiary corporation whenever and so long as (a)
     3  more than half of any voting shares or other membership interest of such

     4  subsidiary are owned or held by the corporation or (b) a majority of the
     5  directors,  trustees  or members of such subsidiary are designees of the
     6  corporation[.];
     7    11.  to take all necessary and appropriate steps and  arrangements  to
     8  develop  a  plan and, on or before January first, two thousand fourteen,
     9  seek the necessary approvals to execute such plan which may include  but
    10  are  not  limited to entering into arrangements, mergers or other affil-
    11  iations with one or more health care, academic or other entities for the
    12  purposes of protecting and promoting the health of the  patients  served
    13  by  its  health  facilities,  advancing  the  corporation's  mission  of
    14  conducting innovative research into the causes and treatment of  cancer,

    15  securing  its  financial  viability and achieving operational and fiscal
    16  independence from the state, and to the extent possible, contributing to
    17  the economic revitalization of the region; provided that the commission-
    18  er of health shall monitor such steps and arrangements  and  participate
    19  with  the  corporation  in establishment of goals and benchmarks for the
    20  achievement  of  such  independence,  and  the  corporation  shall  make
    21  requests  for  assistance and approvals needed to execute such steps and
    22  arrangements.
    23    12. No subsidiary of the corporation shall  own,  operate,  manage  or
    24  control  the existing research, education, acute inpatient or outpatient
    25  facilities and services now operated by the Roswell Park  Cancer  Insti-
    26  tute.

    27    § 2. This act shall take effect April 1, 2012.
 
    28                                   PART C
 
    29                            Intentionally omitted
 
    30                                   PART D
 
    31    Section  1.  The  public health law is amended by adding a new section
    32  2823 to read as follows:
    33    § 2823. Supportive housing development program.  1. For  the  purposes
    34  of  this  section  "eligible  applicant"  shall mean (a) a unit of local
    35  government, or (b) a not-for-profit corporation that has been in  exist-
    36  ence for a period of at least one year prior to application and has been
    37  engaged in supportive housing programs for vulnerable populations.
    38    2. Grants provided pursuant to this section shall be used only to fund
    39  housing development activities and other general programmatic activities

    40  to  help  ensure  a  stable  system of supportive housing for vulnerable
    41  persons in the community. Reinvestment funds for supportive housing  for
    42  vulnerable  populations, which are general fund savings directly related
    43  to inpatient hospital and nursing home bed decertification and/or facil-
    44  ity closure, shall be allocated annually by the commissioner based  upon
    45  the following criteria:
    46    (a)  the  efficiency  and  effectiveness of the use of funding for the
    47  development of adequate and accessible  housing  to  support  vulnerable
    48  persons  in  the community and to ensure access to supports necessary to
    49  maximize expected outcomes; and
    50    (b) other relevant factors relating to  the  maintenance  of  existing

    51  supportive  housing  and  the  development of new supportive housing and
    52  associated services.

        S. 6256--D                         12                         A. 9056--D
 
     1    3. The commissioner shall establish an application  process  by  which
     2  eligible applicants may apply for a grant under this section. The appli-
     3  cation shall include:
     4    (a)  the  geographic  area  in  which  the  housing/services  shall be
     5  provided;
     6    (b) a detailed description of the housing/services to be provided;
     7    (c) a plan for the efficient and effective  use  of  funding  for  the
     8  development  of  adequate  and  accessible housing to support vulnerable
     9  persons in the community;

    10    (d) other relevant factors relating to the  need  for  maintenance  of
    11  existing  supportive housing and the development of new supportive hous-
    12  ing and associated services; and
    13    (e) any other information that the  commissioner  deems  relevant  and
    14  appropriate.
    15    4.  Grantees  under  this section shall file an annual report with the
    16  commissioner, in such form and with such information  and  data  as  the
    17  commissioner  prescribes  detailing  the  expenditure of grant funds. In
    18  addition,  the  commissioner  is  authorized  and  empowered   to   make
    19  inspections  and examine records of any entity funded pursuant to subdi-
    20  vision two of this section. Such examination shall include all  medical,

    21  service and financial records, receipts, disbursements, contracts, loans
    22  and other moneys relating to the financial operation of the provider.
    23    5. The amount of supportive housing development reinvestment funds for
    24  the  department  shall be subject to annual appropriation. The methodol-
    25  ogies used to calculate the savings shall be developed  by  the  commis-
    26  sioner and the director of the budget. In no event shall the full annual
    27  value  of supportive housing development reinvestment programs attribut-
    28  able to inpatient hospital and nursing home bed  decertification  and/or
    29  facility  closure  exceed  the  twelve  month value of the department of
    30  health general  fund  reductions  resulting  from  such  decertification
    31  and/or facility closure.

    32    6.  The  annual  supportive housing development reinvestment appropri-
    33  ation shall reflect a proportion of the amount of general  fund  savings
    34  resulting  from subdivision five of this section. Within any fiscal year
    35  where appropriation increases are recommended for the supportive housing
    36  development reinvestment program, insofar  as  projected  bed  decertif-
    37  ication  and/or facility closures do not occur as estimated, and general
    38  fund savings do not result, then the reinvestment appropriations may  be
    39  reduced in the next year's annual budget itemization.
    40    7.  No  provision  in this section shall create or be deemed to create
    41  any right, interest or entitlement to services or funds that are subject

    42  to this section, or to any other services or funds, whether to  individ-
    43  uals, localities, providers or others, individually or collectively.
    44    8.  The  commissioner shall promulgate regulations, and may promulgate
    45  emergency regulations, to effectuate the provisions of this section.
    46    § 2. Paragraph (e) of subdivision 1 of section  461-l  of  the  social
    47  services law, as added by chapter 165 of the laws of 1991, is amended to
    48  read as follows:
    49    (e)  "Services"  shall  mean all services for which full payment to an
    50  assisted living program is included in the capitated  rate  of  payment,
    51  which  shall include personal care services, home care services and such
    52  other services as the commissioner in conjunction with the  commissioner
    53  of health determine by regulation must be included in the capitated rate

    54  of  payment,  and  which  the  assisted living program shall provide, or
    55  arrange for the provision of, through contracts with a  social  services

        S. 6256--D                         13                         A. 9056--D
 
     1  district, [a] long term home health care [program or a] programs, certi-
     2  fied home health [agency, and] agencies, and other qualified providers.
     3    §  3.  Paragraphs (b) and (d) of subdivision 2 of section 461-l of the
     4  social services law, as added by chapter 165 of the  laws  of  1991  and
     5  subparagraph  (iii)  of  paragraph  (d) as amended by chapter 569 of the
     6  laws of 2000, are amended to read as follows:
     7    (b) If an assisted living program  itself  is  not  a  certified  home
     8  health agency or long term home health care program, the assisted living

     9  program shall contract with [a] one or more certified home health [agen-
    10  cy or] agencies and/or long term home health care [program] programs for
    11  the  provision  of services pursuant to article thirty-six of the public
    12  health law. [An assisted living program shall contract with no more than
    13  one certified home health agency or long term home health care  program,
    14  provided,  however, that the commissioner and the commissioner of health
    15  may approve additional contracts for good cause.]
    16    (d) Patient services and care. (i) An assisted living program[, or  if
    17  the  assisted  living  program  itself does not include a long term home
    18  health care program or certified home health agency an  assisted  living

    19  program  and  a  long  term  home  health care program or certified home
    20  health agency,] shall, either directly or through contract with  a  long
    21  term  home  health care program or certified home health agency, conduct
    22  an initial assessment to determine  whether  a  person  would  otherwise
    23  require  placement  in a residential health care facility if not for the
    24  availability of the assisted  living  program  and  is  appropriate  for
    25  admission  to  an assisted living program.  [The assisted living program
    26  shall forward such assessment  of  a  medical  assistance  applicant  or
    27  recipient to the appropriate social services district.]
    28    (ii)  No  person  shall  be determined eligible for and admitted to an
    29  assisted living program unless the assisted living program [and the long

    30  term home health care program or the certified home health  care  agency
    31  agree, based on the initial assessment,] finds that the person meets the
    32  criteria  provided  in  paragraph (d) of subdivision one of this section
    33  [and unless the appropriate social services  district  prior  authorizes
    34  payment for services].
    35    (iii)  Appropriate  services  shall  be provided to an eligible person
    36  only in accordance with a plan of care which is based  upon  an  initial
    37  assessment  and  periodic  reassessments conducted by an assisted living
    38  program[, or if the assisted living program itself does  not  include  a
    39  long  term  home  health care program or certified home health agency an
    40  assisted living program and a long term  home  health  care  program  or

    41  certified  home health agency], either directly or through contract with
    42  a long term home health care program or certified home health agency.  A
    43  reassessment  shall be conducted as frequently as is required to respond
    44  to changes in the resident's condition and ensure  immediate  access  to
    45  necessary and appropriate services by the resident, but in no event less
    46  frequently than once every six months. No person shall be admitted to or
    47  retained  in  an  assisted  living  program  unless [the assisted living
    48  program, and long term home health care program or certified home health
    49  agency are in agreement that] the person can be  safely  and  adequately
    50  cared  for  with the provision of services determined by such assessment
    51  or reassessment.

    52    § 4. Paragraph (i) of subdivision 3 of section  461-l  of  the  social
    53  services  law,  as  amended by section 16 of part D of chapter 58 of the
    54  laws of 2009, is amended to read as follows:
    55    (i) The commissioner of health is authorized to add up to six thousand
    56  assisted living program beds to the  gross  number  of  assisted  living

        S. 6256--D                         14                         A. 9056--D
 
     1  program  beds  having been determined to be available as of April first,
     2  two thousand nine[, provided that, for each assisted living program  bed
     3  so  added,  a nursing home bed has been decertified upon the application
     4  of  the  nursing  home  operator  or that the commissioner of health has
     5  found pursuant to subdivision six of section twenty-eight hundred six of

     6  the public health law that any assisted  living  program  bed  so  added
     7  would  serve  as  a  more appropriate alternative to a certified nursing
     8  home bed and has accordingly limited or revoked  the  operating  certif-
     9  icate  of  the  nursing  home providing that certified nursing home bed,
    10  provided further that nothing]. Nothing herein shall be  interpreted  as
    11  prohibiting  any  eligible  applicant from submitting an application for
    12  any assisted living program bed so added.  The  commissioner  of  health
    13  shall  not  be  required  to  review on a comparative basis applications
    14  submitted for assisted living program beds  made  available  under  this
    15  paragraph.  The commissioner of health shall only authorize the addition
    16  of six thousand beds pursuant to a five year plan.

    17    § 4-a. Paragraph (a) of subdivision 6 of section 3614  of  the  public
    18  health law, as amended by section 17 of part D of chapter 58 of the laws
    19  of 2009, is amended to read as follows:
    20    (a)  The  commissioner  shall,  subject  to  the approval of the state
    21  director of  the  budget,  establish  capitated  rates  of  payment  for
    22  services  provided  by  assisted living programs as defined by paragraph
    23  (a) of subdivision one of section four hundred sixty-one-l of the social
    24  services law.  Such rates of payment shall be related to costs  incurred
    25  by  residential health care facilities. The rates shall reflect the wage
    26  equalization factor established  by  the  commissioner  for  residential
    27  health  care  facilities  in  the  region  in  which the assisted living
    28  program is provided and real property capital construction costs associ-

    29  ated with the construction of a free-standing  assisted  living  program
    30  such rate shall include a payment equal to the cost of interest owed and
    31  depreciation  costs  of  such construction. The rates shall also reflect
    32  the efficient provision  of  a  quality  and  quantity  of  services  to
    33  patients in such residential health care facilities, with needs compara-
    34  ble  to  the needs of residents served in such assisted living programs.
    35  Such rates of payment shall be equal to fifty  percent  of  the  amounts
    36  which otherwise would have been expended, based upon the mean prices for
    37  the  first  of  July,  nineteen  hundred  ninety-two (utilizing nineteen
    38  hundred eighty-three costs) for freestanding, low intensity  residential
    39  health  care facilities with less than three hundred beds, and for years
    40  subsequent to nineteen hundred ninety-two,  adjusted  for  inflation  in

    41  accordance  with  the  provisions  of subdivision ten of section twenty-
    42  eight hundred seven-c of this chapter, to provide the appropriate  level
    43  of  care for such residents in residential health care facilities in the
    44  applicable wage equalization factor regions  plus  an  amount  equal  to
    45  capital  construction  costs  associated  with  the  construction  of an
    46  assisted living program facility as provided for  in  this  subdivision.
    47  The  commissioner  shall also promulgate regulations, and may promulgate
    48  emergency regulations, to provide  for  reimbursement  of  the  cost  of
    49  preadmission assessments conducted directly by assisted living programs.
    50    §  5.  Notwithstanding any contrary provision of law, inpatient hospi-
    51  tals licensed pursuant to the mental hygiene law by the office of mental

    52  health shall be subject to audit fees as set forth in regulations issued
    53  by the department of health pursuant to subparagraph (xiii) of paragraph
    54  (D) of subdivision 35 of section 2807-c of the public health  law,  with
    55  regard  to  cost  reports  submitted  to the department of health on and
    56  after April 1, 2012.

        S. 6256--D                         15                         A. 9056--D
 
     1    § 6. Subdivision 2 of section 365-a of  the  social  services  law  is
     2  amended  by  adding four new paragraphs (w), (x), (y) and (z) to read as
     3  follows:
     4    (w)  podiatry  services  for  individuals with a diagnosis of diabetes
     5  mellitus; provided, however, that the provisions of this paragraph shall
     6  not take effect unless all necessary approvals  under  federal  law  and

     7  regulation have been obtained to receive federal financial participation
     8  in  the  costs  of  health care services provided pursuant to this para-
     9  graph.
    10    (x) lactation counseling services for pregnant  and  postpartum  women
    11  when  such  services  are  ordered  by a physician, registered physician
    12  assistant,  registered  nurse  practitioner,  or  licensed  midwife  and
    13  provided  by  a  certified  lactation  consultant,  as determined by the
    14  commissioner of health; provided, however, that the provisions  of  this
    15  paragraph  shall  not  take  effect unless all necessary approvals under
    16  federal law and regulation have been obtained to receive federal  finan-
    17  cial  participation in the costs of health care services provided pursu-

    18  ant to this paragraph. Nothing in this paragraph shall be  construed  to
    19  modify any licensure, certification or scope of practice provision under
    20  title eight of the education law.
    21    (y)  harm  reduction counseling and services to reduce or minimize the
    22  adverse health consequences associated with  drug  use,  provided  by  a
    23  qualified  drug  treatment  program  or community-based organization, as
    24  determined by the commissioner of health; provided,  however,  that  the
    25  provisions  of this paragraph shall not take effect unless all necessary
    26  approvals under federal law and regulation have been obtained to receive
    27  federal financial participation in the costs  of  health  care  services

    28  provided  pursuant to this paragraph. Nothing in this paragraph shall be
    29  construed to modify any licensure, certification or  scope  of  practice
    30  provision under title eight of the education law.
    31    (z)  hepatitis C wrap-around services to promote care coordination and
    32  integration when ordered by a physician, registered physician assistant,
    33  registered nurse practitioner, or licensed midwife, and  provided  by  a
    34  qualified  professional,  as  determined  by the commissioner of health.
    35  Such services may include client outreach, identification  and  recruit-
    36  ment,  hepatitis  C  education  and counseling, coordination of care and
    37  adherence to treatment, assistance in obtaining appropriate  entitlement

    38  services, peer support and other supportive services; provided, however,
    39  that  the  provisions of this paragraph shall not take effect unless all
    40  necessary approvals under federal law and regulation have been  obtained
    41  to  receive  federal financial participation in the costs of health care
    42  services provided pursuant to this paragraph.  Nothing in this paragraph
    43  shall be construed to modify any licensure, certification  or  scope  of
    44  practice provision under title eight of the education law.
    45    §  7.  Paragraph  (g)  of subdivision 2 of section 365-a of the social
    46  services law, as amended by section 23 of part H of chapter  59  of  the
    47  laws of 2011, is amended to read as follows:
    48    (g)  sickroom  supplies,  eyeglasses, prosthetic appliances and dental

    49  prosthetic appliances furnished in accordance with  the  regulations  of
    50  the department; provided further that: (i) the commissioner of health is
    51  authorized  to implement a preferred diabetic supply program wherein the
    52  department of  health  will  receive  enhanced  rebates  from  preferred
    53  manufacturers  of  glucometers and test strips, and may subject non-pre-
    54  ferred manufacturers' glucometers and test strips to prior authorization
    55  under section two hundred seventy-three of the public health  law;  (ii)
    56  enteral  formula  therapy  and  nutritional  supplements  are limited to

        S. 6256--D                         16                         A. 9056--D
 
     1  coverage only for nasogastric, jejunostomy, or gastrostomy tube  feeding
     2  [or],  for  treatment  of  an  inborn  metabolic disorder, or to address

     3  growth and development problems in children, or,  subject  to  standards
     4  established  by  the  commissioner,  for persons with a diagnosis of HIV
     5  infection, AIDS or HIV-related illness or other diseases and conditions;
     6  (iii) prescription footwear and inserts are  limited  to  coverage  only
     7  when  used  as  an  integral part of a lower limb orthotic appliance, as
     8  part of a diabetic treatment plan, or to address growth and  development
     9  problems  in  children;  and  (iv) compression and support stockings are
    10  limited to coverage only for pregnancy or  treatment  of  venous  stasis
    11  ulcers;
    12    §  8.  Subdivision  9  of  section 4403-c of the public health law, as
    13  added by chapter 649 of the laws of 1996, is amended to read as follows:
    14    9. Notwithstanding any other provision of  law,  a  comprehensive  HIV

    15  special  needs  plan  certified  pursuant  to  this  section shall limit
    16  enrollment to HIV positive persons [but may enroll related  children  up
    17  to  the  age  of  nineteen], except for the following persons who may be
    18  enrolled regardless of their HIV status[.]:
    19    (a) related children up to the age of twenty-one; and
    20    (b) individuals who are homeless or who are members of other high need
    21  populations which, in the discretion of the commissioner, would  benefit
    22  from  receiving  services  through  a  plan  certified  pursuant to this
    23  section; provided however, that rates paid to special  needs  plans  for
    24  such  populations  shall  be comparable to rates paid for the same popu-
    25  lations in other managed care plans.

    26    § 9.  Paragraph (f) of subdivision 1 of section 367-a  of  the  social
    27  services  law, as added by section 1 of part E of chapter 58 of the laws
    28  of 2008, is amended to read as follows:
    29    (f) Amounts payable under this title for  medical  assistance  in  the
    30  form  of  outpatient  mental health services under article thirty-one or
    31  outpatient  chemical  dependence  services  including  opioid  treatment
    32  services  under article thirty-two of the mental hygiene law provided to
    33  eligible persons who are also beneficiaries under part B of title  XVIII
    34  of  the  federal social security act shall not be less than the approved
    35  medical assistance payment level less the amount payable under part B.
    36    § 10. Intentionally omitted.
    37    § 11. Intentionally omitted.
    38    § 12. Intentionally omitted.
    39    § 13. Intentionally omitted.

    40    § 14. Intentionally omitted.
    41    § 15. Intentionally omitted.
    42    § 16. Intentionally omitted.
    43    § 17. Intentionally omitted.
    44    § 18. Intentionally omitted.
    45    § 19.  Subdivisions (f) and (g) of section 2522 of the  public  health
    46  law,  as  amended  by chapter 484 of the laws of 2009, are amended and a
    47  new subdivision (h) is added to read as follows:
    48    (f) follow-up of patient  participation  in  prenatal  care  services;
    49  [and]
    50    (g)  identification  of regional perinatal health care system barriers
    51  and limitations that lead to poor perinatal outcomes and development  of
    52  strategies to address such barriers and limitations[.]; and
    53    (h)  coordination of service delivery by community-based organizations

    54  among health care providers and health plans  using  health  information
    55  technology and uniform screening criteria for perinatal risk.

        S. 6256--D                         17                         A. 9056--D
 
     1    §  20.    Subdivision  6  of section 2818 of the public health law, as
     2  added by section 25-a of part A of chapter 59 of the laws  of  2011,  is
     3  amended to read as follows:
     4    6.  Notwithstanding  any  contrary provision of this section, sections
     5  one hundred twelve and one hundred sixty-three of the state finance law,
     6  or any other contrary provision of law, subject to  available  appropri-
     7  ations,  funds available for expenditure pursuant to this section may be
     8  distributed by the commissioner without a competitive bid or request for
     9  proposal process for grants to general hospitals and residential  health

    10  care  facilities  for  the purpose of facilitating closures, mergers and
    11  restructuring of such facilities in  order  to  strengthen  and  protect
    12  continued  access  to essential health care resources. Provided however,
    13  that to the extent practicable, the commissioner shall award such grants
    14  equitably among health planning  regions  of  the  state.  Prior  to  an
    15  [awarded] award being granted to an eligible applicant without a compet-
    16  itive bid or request for proposal process, the commissioner shall notify
    17  the  chair  of  the  senate finance committee, the chair of the assembly
    18  ways and means committee and the director of the division of  budget  of
    19  the intent to grant such an award. Such notice shall include information
    20  regarding how the eligible applicant meets criteria established pursuant
    21  to this section.

    22    §  21.    The  social  services law is amended by adding a new section
    23  461-s to read as follows:
    24    § 461-s. Enhancing the quality of adult living program for adult  care
    25  facilities.  1.  The commissioner of health shall establish the enhanced
    26  quality of adult living program (referred to  in  this  section  as  the
    27  "EQUAL program" or the "program") for adult care facilities. The program
    28  shall be targeted at improving the quality of life for adult care facil-
    29  ity  residents  by means of grants to facilities for specified purposes.
    30  The department of health, subject to the approval of the director of the
    31  budget, shall develop an allocation methodology taking into account  the
    32  financial status and size of the facility as well as resident needs.

    33    2.  No  payment shall be made under the program to a facility that has
    34  received official written notice from the department of a proposed revo-
    35  cation, suspension, limitation or denial  of  the  operator's  operating
    36  certificate.
    37    3. Prior to applying for EQUAL program funds, a facility shall receive
    38  approval  of  its  expenditure  plan from the residents' council for the
    39  facility.
    40    § 22. Section 366 of the social services law is amended  by  adding  a
    41  new subdivision 15 to read as follows:
    42    15.  The commissioner may contract with one or more entities to engage
    43  in  education,  outreach services, and facilitated enrollment activities
    44  for aged, blind, and disabled persons who may be eligible  for  coverage
    45  under this title.

    46    §  23. The public health law is amended by adding a new article 9-B to
    47  read as follows:
    48                                  ARTICLE 9-B
    49           PRIMARY CARE SERVICE CORPS PRACTITIONER LOAN REPAYMENT
    50                                   PROGRAM
    51  Section 923. Definitions.
    52          924. Primary care  service  corps  practitioner  loan  repayment
    53          program.
    54    §  923.  Definitions.   The following words or phrases as used in this
    55  section shall have the following meanings:

        S. 6256--D                         18                         A. 9056--D
 
     1    1. "Underserved area" means an area  or  medically  underserved  popu-
     2  lation  designated  by  the commissioner as having a shortage of primary

     3  care physicians, other primary care practitioners, dental  practitioners
     4  or mental health practitioners.
     5    2. "Primary care service corps practitioner" means a physician assist-
     6  ant,  nurse practitioner, midwife, general or pedodontic dentist, dental
     7  hygienist,  clinical  psychologist,  licensed  clinical  social  worker,
     8  psychiatric  nurse practitioner, licensed marriage and family therapist,
     9  or a licensed mental health counselor, who is licensed,  registered,  or
    10  certified  to  practice  in  New York state and who provides coordinated
    11  primary care services, including, but not limited to,  oral  health  and
    12  mental health services and meets the national health service corps state
    13  loan repayment program eligibility criteria.

    14    3.  "Physician  assistant"  means  a person who has been registered as
    15  such pursuant to article one hundred thirty-one-B of the  education  law
    16  and meets the national health service corps state loan repayment program
    17  eligibility criteria.
    18    4.  "Nurse practitioner" means a person who has been certified as such
    19  pursuant to section sixty-nine hundred ten  of  the  education  law  and
    20  meets  the  national  health  service corps state loan repayment program
    21  eligibility criteria.
    22    5. "Midwife" means a person who has been licensed as such pursuant  to
    23  section sixty-nine hundred fifty-five of the education law and meets the
    24  national  health  service corps state loan repayment program eligibility
    25  criteria.

    26    6. "Psychologist" means a person who has been licensed as such  pursu-
    27  ant  to section seventy-six hundred three of the education law and meets
    28  the national health service corps state loan repayment program eligibil-
    29  ity criteria.
    30    7. "Licensed clinical social worker"  means  a  person  who  has  been
    31  licensed  as  such  pursuant to section seventy-seven hundred two of the
    32  education law and meets the national health  service  corps  state  loan
    33  repayment program eligibility criteria.
    34    8. "Psychiatric nurse practitioner" means a nurse practitioner who, by
    35  reason of training and experience, provides a full spectrum of psychiat-
    36  ric  care, assessing, diagnosing, and managing the prevention and treat-

    37  ment of psychiatric disorders and mental health problems and  meets  the
    38  national  health  service corps state loan repayment program eligibility
    39  criteria.
    40    9. "Licensed marriage and family therapist" means  a  person  who  has
    41  been  licensed  as such pursuant to section eighty-four hundred three of
    42  the education law and meets the national health service corps state loan
    43  repayment program eligibility criteria.
    44    10. "Licensed mental health counselor" means a  person  who  has  been
    45  licensed  as  such  pursuant  to  section eighty-four hundred two of the
    46  education law and meets the national health  service  corps  state  loan
    47  repayment program eligibility criteria.

    48    11.  "General  or  pedodontic  dentist"  means  a  person who has been
    49  licensed or otherwise authorized to practice dentistry pursuant to arti-
    50  cle one hundred thirty-three of the education  law  excluding  orthodon-
    51  tists,  endodontists  and  periodontists  and  meets the national health
    52  service corps state loan repayment program eligibility criteria.
    53    12. "Dental hygienist" means a person  who  is  licensed  to  practice
    54  dental  hygiene pursuant to section sixty-six hundred nine of the educa-
    55  tion law and meets the national health service corps state  loan  repay-
    56  ment program eligibility criteria.

        S. 6256--D                         19                         A. 9056--D
 

     1    § 924. Primary care service corps practitioner loan repayment program.
     2  1. The commissioner is authorized, within amounts available therefor, to
     3  make  loan repayment awards to eligible primary care service corps prac-
     4  titioners who agree to practice full-time in an underserved area in  New
     5  York  state, in amounts to be determined by the commissioner, but not to
     6  exceed thirty-two thousand dollars per year for any year in  which  such
     7  practitioners provide full-time eligible obligated service.
     8    2.  Loan repayment awards made to a primary care service corps practi-
     9  tioner pursuant to subdivision one of this section shall not exceed  the
    10  total qualifying outstanding debt of the practitioner from student loans

    11  to  cover  tuition  and  other  related educational expenses, made by or
    12  guaranteed by the federal or state government, or made by a  lending  or
    13  educational  institution  approved  under title IV of the federal higher
    14  education act. Loan repayment awards shall be used solely to repay  such
    15  outstanding debt.
    16    3.  In  the event that any commitment pursuant to the agreement refer-
    17  enced in subdivision one of this section is not fulfilled, the recipient
    18  shall be responsible for repayment in amounts which shall be  calculated
    19  in  accordance  with the formula set forth in subdivision (b) of section
    20  two hundred fifty-four-o of title forty-two of the United  States  Code,
    21  as amended.

    22    4.  The  commissioner  is  authorized to apply any funds available for
    23  purposes of subdivision one of this section for use  as  matching  funds
    24  for  any available federal grants for the purpose of assisting states in
    25  operating loan repayment programs.
    26    5. The commissioner may postpone, change or waive  the  service  obli-
    27  gation and repayments amounts set forth in subdivisions one and three of
    28  this  section,  respectively, in individual circumstances where there is
    29  compelling need or hardship.
    30    6. In order to be eligible to receive a  loan  repayment  award  under
    31  this  section,  a primary care service corps practitioner must meet site
    32  and service eligibility criteria as determined by the commissioner.

    33    7. The commissioner shall promulgate regulations necessary to effectu-
    34  ate the provisions and purposes of this article.
    35    § 24. Intentionally omitted.
    36    § 25. Intentionally omitted.
    37    § 26. Section 2803 of the public health law is amended by adding a new
    38  subdivision 8-a to read as follows:
    39    8-a. Notwithstanding any inconsistent provision of law to the  contra-
    40  ry,  the commissioner shall develop a program to facilitate the use of a
    41  triage system of care in emergency rooms of hospitals that  are  subject
    42  to  the  provisions  of  this  article.  In  developing such program the
    43  commissioner shall consider the manner in which such a system  would  be
    44  coordinated, how such a system would provide greater efficiency, provide

    45  cost  savings  to  public  health programs and a higher quality of care.
    46  Within one year from the enactment of  such  program,  the  commissioner
    47  shall  submit  a report to the temporary president of the senate and the
    48  speaker of the assembly regarding: the impact of such a  system  on  the
    49  cost  of  Medicaid  covered services in the hospital setting; quality of
    50  care in facilities; along with any other data as may be appropriate.
    51    § 27. Intentionally omitted.
    52    § 28. Section 2 of chapter 584 of  the  laws  of  2011,  amending  the
    53  public  authorities law, relating to the powers and duties of the dormi-
    54  tory authority of the state of New York relative to the establishment of
    55  subsidiaries for certain purposes, is amended to read as follows:


        S. 6256--D                         20                         A. 9056--D
 
     1    § 2. This act shall take effect immediately and shall  expire  and  be
     2  deemed repealed on July 1, [2012] 2014; provided however, that the expi-
     3  ration  of  this  act  shall  not  impair or otherwise affect any of the
     4  powers, duties, responsibilities, functions, rights  or  liabilities  of
     5  any  subsidiary  duly  created  pursuant  to  subdivision twenty-five of
     6  section 1678 of the public authorities law prior to such expiration.
     7    § 28-a. Paragraph (a) of subdivision 25 of section 1678 of the  public
     8  authorities  law,  as  amended  by  chapter  584 of the laws of 2011, is
     9  amended to read as follows:
    10    (a) To form one or more subsidiaries for the purpose of  limiting  the
    11  potential  liability  of  the  authority  when exercising the powers and

    12  duties conferred upon the authority by this article [eight of this chap-
    13  ter] in connection with  the  exercise  of  remedies  by  the  authority
    14  against  any borrower regulated under article twenty-eight of the public
    15  health law that has defaulted in its obligations under its  loan  agree-
    16  ment  or  mortgage  with the authority and for which an event of default
    17  has been declared by the authority. Each such subsidiary created  pursu-
    18  ant  to  this  subdivision  may  exercise and perform one or more of the
    19  purposes, powers, duties, functions, rights and responsibilities of  the
    20  authority  (other  than the issuance of indebtedness) in connection with
    21  real and personal property with respect to which the authority holds  or
    22  held  a mortgage, security interest or other collateral interest includ-

    23  ing: (i) bidding for, taking, holding, selling, conveying, assigning  or
    24  transferring   title  to  such  property;  (ii)  entering  into  leases,
    25  subleases, operating agreements, security agreements, loan agreements or
    26  other encumbrances or arrangements with  regard  to  such  property  and
    27  acting  in a manner consistent with the rights, obligations or responsi-
    28  bilities of the owner of such property pursuant to  such  agreements  or
    29  encumbrances;  (iii)  assuming  any  indebtedness  or  other liabilities
    30  secured by such property. Notwithstanding any other provision of law  to
    31  the  contrary,  but  in  all  instances subject to the provisions of any
    32  contract with bondholders, the transfer of title to any such  subsidiary
    33  or  any  other  actions  taken  by  the  authority or such subsidiary to
    34  enforce the authority's rights under the mortgage, security interest  or

    35  other  collateral  interest or to protect, acquire, manage or dispose of
    36  the property shall be deemed to be a corporate purpose of the  authority
    37  and  shall  not  impair  the validity of any bonds, notes or other obli-
    38  gations of the authority to which the  mortgage,  security  interest  or
    39  other collateral interest relates.
    40    §  29.    Subdivision 1 of section 2999-i of the public health law, as
    41  added by section 52 of part H of chapter 59 of  the  laws  of  2011,  is
    42  amended to read as follows:
    43    1. (a) The commissioner of taxation and finance shall be the custodian
    44  of  the  fund  and  the  special account established pursuant to section
    45  ninety-nine-t of the state finance law. All payments from the fund shall
    46  be made by the commissioner of taxation and  finance  upon  certificates
    47  signed by the superintendent of financial services, or his or her desig-

    48  nee,  as hereinafter provided. The fund shall be separate and apart from
    49  any other fund and from all other state monies; provided, however,  that
    50  monies of the fund may be invested as set forth in paragraph (b) of this
    51  subdivision.   No monies from the fund shall be transferred to any other
    52  fund, nor shall any such monies be applied to the making of any  payment
    53  for any purpose other than the purpose set forth in this title.
    54    (b)  Any monies of the fund not required for immediate use may, at the
    55  discretion of the commissioner of  financial  services  in  consultation
    56  with  the  commissioner  of  health  and  the director of the budget, be

        S. 6256--D                         21                         A. 9056--D
 

     1  invested by the commissioner of taxation and finance in  obligations  of
     2  the United States or the state or obligations the principal and interest
     3  of  which are guaranteed by the United States or the state. The proceeds
     4  of  any  such  investment  shall be retained by the fund as assets to be
     5  used for the purposes of the fund.
     6    § 30. Intentionally omitted.
     7    § 31. Paragraph (b) of subdivision 1-a of section 2802 of  the  public
     8  health law, as amended by chapter 174 of the laws of 2011, is amended to
     9  read as follows:
    10    (b)  repair  or  maintenance,  regardless  of  cost, including routine
    11  purchases and the acquisition  of  minor  equipment  undertaken  in  the
    12  course  of  a  hospital's inventory control functions; provided that for

    13  projects under this paragraph with a total cost of  up  to  six  million
    14  dollars, no written notice shall be required;
    15    §  32.   Subdivision 1 of section 1 of chapter 119 of the laws of 1997
    16  relating to authorizing the department of health  to  establish  certain
    17  payments  to  general  hospitals,  as amended by section 1 of part S2 of
    18  chapter 62 of the laws of 2003, is amended to read as follows:
    19    1. Notwithstanding any inconsistent provision of  law  or  regulation,
    20  effective for the period [April 1, 1997 through March 31, 1998] April 1,
    21  2012  through December 31, 2012 and for annual periods beginning [April]
    22  January 1 thereafter, the [department] Department of [health] Health  is

    23  authorized  to  pay voluntary non-profit general hospitals as defined in
    24  subdivision 10 of section 2801  of  the  public  health  law  additional
    25  payments  for inpatient hospital services as medical assistance payments
    26  pursuant to title 11 of article 5 of the social services law and federal
    27  law and regulations governing disproportionate share payments, based  on
    28  the  [amount  of state aid for which such general hospitals are eligible
    29  pursuant to articles 25, 26 and 41 of the  mental  hygiene  law  and  as
    30  identified in subdivision 2 of this section] costs incurred in excess of
    31  revenues by general hospitals in providing services in eligible programs
    32  to  uninsured  patients  and  patients  eligible for medical assistance.
    33  Payment made pursuant to this section shall not exceed each such general

    34  hospital's cost of providing services to uninsured patients and patients
    35  eligible for medical assistance pursuant to title 11 of article 5 of the
    36  social services law after taking into consideration  all  other  medical
    37  assistance  received,  including disproportionate share payments made to
    38  such general hospital, and payments from or on behalf of such  uninsured
    39  patients, and shall also not exceed the total amount of state aid, iden-
    40  tified  by  subdivision  2  of  this  section, available to such general
    41  hospital by law. Payments made to such  general  hospitals  pursuant  to
    42  this  section  shall be made in lieu of any state aid payments available
    43  to such general hospital by law.
    44    § 33. Intentionally omitted.
    45    § 33-a. Intentionally omitted.
    46    § 33-b. Intentionally omitted.
    47    § 33-c. Intentionally omitted.
    48    § 33-d. Intentionally omitted.

    49    § 33-e. Intentionally omitted.
    50    § 33-f. Intentionally omitted.
    51    § 33-g. Intentionally omitted.
    52    § 34.  Subdivision 25 of section 2808 of the  public  health  law,  as
    53  added  by  section  31  of  part  B  of chapter 109 of the laws of 2010,
    54  subparagraph (iii) of paragraph (b) as amended and subparagraph (iv)  of
    55  paragraph (b) as added by section 69 of part H of chapter 59 of the laws
    56  of 2011, is amended to read as follows:

        S. 6256--D                         22                         A. 9056--D
 
     1    25.  Reserved  bed  days.  (a)  For  purposes  of  this subdivision, a
     2  "reserved bed day" is a day for which a governmental agency pays a resi-
     3  dential health care facility to reserve a bed for a person eligible  for
     4  medical  assistance  pursuant  to  title  eleven  of article five of the

     5  social  services  law  while he or she is temporarily hospitalized or on
     6  leave of absence from the facility.
     7    (b) Notwithstanding any other provisions of this section or any  other
     8  law  or  regulation  to  the contrary, for reserved bed days provided on
     9  behalf of persons twenty-one years of age or older:
    10    (i) payments for reserved  bed  days  shall  be  made  at  ninety-five
    11  percent  of  the  Medicaid  rate  otherwise  payable to the facility for
    12  services provided on behalf of such person;
    13    (ii) payment to a facility for reserved bed days provided on behalf of
    14  such person for temporary hospitalizations may not exceed fourteen  days
    15  in any twelve month period;
    16    (iii)  payment  to a facility for reserved bed days provided on behalf
    17  of such person for non-hospitalization leaves of absence may not  exceed
    18  ten days in any twelve month period[; and

    19    (iv)  payments  for  reserved  bed days for temporary hospitalizations
    20  shall only be made to a residential health care  facility  if  at  least
    21  fifty  percent  of the facility's residents eligible to participate in a
    22  Medicare managed care plan are enrolled in such a plan].
    23    (c)(i) Notwithstanding any contrary provision of this  subdivision  or
    24  any  other  law  and  subject  to  the availability of federal financial
    25  participation, with regard to services provided  to  residential  health
    26  care  facility  residents twenty-one years of age and older, the commis-
    27  sioner shall promulgate regulations, and may promulgate emergency  regu-
    28  lations,  effective  for  periods  on and after July first, two thousand

    29  twelve, establishing reimbursement rates for reserved bed days.
    30    (ii) Such regulations shall, for each Medicaid patient for any  twelve
    31  month  period,  provide for reimbursement for reserved bed days for: (A)
    32  up to an aggregate of fourteen days for hospitalizations and  for  other
    33  therapeutic  leave of absences consistent with a plan of care ordered by
    34  such patient's treating health care  professional;  and  (B)  up  to  an
    35  aggregate of ten days of other leaves of absence.
    36    (iii)  No  later  than  thirty  days  after promulgation of such regu-
    37  lations, the commissioner shall advise the  chairs  of  the  senate  and
    38  assembly  finance  and  health  committees  of  the projected reductions

    39  expected to be achieved under the methodology set forth  in  such  regu-
    40  lations.
    41    (iv)  In  the  event the commissioner determines, in consultation with
    42  the director of the budget, that the regulations promulgated pursuant to
    43  subparagraph (i) of this paragraph  shall  achieve  projected  aggregate
    44  Medicaid  savings, as determined by the commissioner, of less than forty
    45  million dollars for the state fiscal year  beginning  April  first,  two
    46  thousand twelve, and each state fiscal year thereafter, the commissioner
    47  shall  establish  a prospective per diem rate adjustment for all nursing
    48  homes, other than nursing homes providing services primarily to children
    49  under the age of twenty-one, sufficient to achieve  such  forty  million

    50  dollars in savings for each such state fiscal year.
    51    §  34-a. Notwithstanding any contrary provision of law, the department
    52  of health shall consult with stakeholders  about  effectively  extending
    53  managed  long  term care to the nursing home population in a manner that
    54  reasonably addresses concerns regarding capital financing and its impact
    55  on payment rates.

        S. 6256--D                         23                         A. 9056--D
 
     1    § 34-b. Workgroup on medicaid payment for services for medically frag-
     2  ile children. 1. The commissioner of health and the commissioner of  the
     3  office  for  people  with  developmental  disabilities shall convene and
     4  co-chair, directly or through a designee or designees,  a  workgroup  on
     5  Medicaid  payment  for services for medically fragile children (referred

     6  to in this section as the "workgroup") to make  recommendations  on  the
     7  adequacy  and  viability  of Medicaid payment rates to certain pediatric
     8  providers who provide critical services for medically  fragile  children
     9  including  recommendations  on  appropriate models for care coordination
    10  and the transition of the pediatric nursing home population and  benefit
    11  into Medicaid managed care, including home care agencies affiliated with
    12  pediatric  nursing  homes  and  diagnostic  and  treatment centers which
    13  primarily serve medically fragile children.
    14    2. The workgroup shall be comprised of stakeholders of medically frag-
    15  ile children, including providers or representatives of pediatric  nurs-
    16  ing  homes,  home  care  agencies affiliated with such pediatric nursing
    17  homes  and  diagnostic  and  treatment  centers  which  primarily  serve

    18  medically  fragile children (including pediatric rehabilitation diagnos-
    19  tic and treatment centers), representatives  of  families  of  medically
    20  fragile children, and other experts on Medicaid payment for services for
    21  medically fragile children. Members (other than representatives of fami-
    22  lies  of  medically  fragile children) shall have demonstrated knowledge
    23  and experience in providing care to medically fragile children in pedia-
    24  tric nursing homes  and  diagnostic  and  treatment  centers,  including
    25  providers  who  provide  care  primarily  to the Medicaid population, or
    26  expertise in Medicaid  payment  for  such  services.  Members  shall  be
    27  permitted to participate in workgroup meetings by telephone or videocon-
    28  ference,  and  reasonable efforts shall be made to enhance opportunities
    29  for in-person participation in meetings by  members  who  are  represen-

    30  tatives of families of medically fragile children.
    31    3. The commissioners shall present the findings and recommendations of
    32  the department of health, the office for people with developmental disa-
    33  bilities  and  the  workgroup  to  the governor, the chair of the senate
    34  finance committee, the chair of the assembly ways and  means  committee,
    35  the  chair  of the senate health committee and the chair of the assembly
    36  health committee by October 1, 2012 at which time  the  workgroup  shall
    37  terminate  its  work  and be relieved of all responsibilities and duties
    38  hereunder. During the timeframe in which the workgroup is  deliberating,
    39  the commissioner of health shall take steps to assist pediatric rehabil-
    40  itation clinics.
    41    §  35. Paragraphs (l) and (m) of subdivision 1 of section 367-q of the
    42  social services law, as added by section 22 of part C of chapter  59  of

    43  the laws of 2011, are amended to read as follows:
    44    (l)  for  the  period  April  first, two thousand twelve through March
    45  thirty-first, two thousand thirteen, up  to  twenty-eight  million  five
    46  hundred thousand dollars; and
    47    (m)  for  the  period April first, two thousand thirteen through March
    48  thirty-first, two thousand fourteen, up  to  twenty-eight  million  five
    49  hundred thousand dollars.
    50    §  35-a.  Clause (K) of subparagraph (i) of paragraph (bb) of subdivi-
    51  sion 1 of section 2807-v of the public health law, as amended by section
    52  8 of part C of chapter 59 of the laws of 2011, is  amended  to  read  as
    53  follows:
    54    (K)  up  to  one  hundred thirty-six million dollars each state fiscal
    55  year for the period April first, two thousand eleven through March thir-
    56  ty-first, two thousand fourteen.

        S. 6256--D                         24                         A. 9056--D
 
     1    § 35-b. Subparagraph (xi)  of  paragraph  (cc)  of  subdivision  1  of
     2  section 2807-v of the public health law, as amended by section 8 of part
     3  C of chapter 59 of the laws of 2011, is amended to read as follows:
     4    (xi)  up  to  eleven  million  two hundred thousand dollars each state
     5  fiscal year for the period April  first,  two  thousand  eleven  through
     6  March thirty-first, two thousand fourteen.
     7    §  35-c.  Subparagraph  (vii)  of  paragraph (ccc) of subdivision 1 of
     8  section 2807-v of the public health law, as amended by section 8 of part
     9  C of chapter 59 of the laws of 2011, is amended to read as follows:
    10    (vii) up to fifty million dollars each state fiscal year for the peri-

    11  od April first, two thousand  eleven  through  March  thirty-first,  two
    12  thousand fourteen.
    13    §  36. The public health law is amended by adding a new section 2807-z
    14  to read as follows:
    15    § 2807-z.  Limited or administrative review.  1.  Notwithstanding  any
    16  provision of this chapter or regulations or any other state law or regu-
    17  lation,  for  any eligible capital project as defined in subdivision six
    18  of this section, the department shall have thirty days of receipt of the
    19  certificate of need application for a limited or  administrative  review
    20  to  deem  such  application  complete.  If the department determines the
    21  application is incomplete or that  more  information  is  required,  the
    22  department  shall  notify the applicant in writing within thirty days of

    23  the date of the application's submission, and the applicant  shall  have
    24  twenty  business  days  to  provide  additional information or otherwise
    25  correct the deficiency in the application.
    26    2. For an eligible capital project requiring a limited or  administra-
    27  tive  review,  within ninety days of the department deeming the applica-
    28  tion complete, the department shall make a decision to approve  (and  in
    29  the  case  of  limited  reviews)  or  disapprove the certificate of need
    30  application for such project. If the department determines to disapprove
    31  the project, the basis for such disapproval shall be provided  in  writ-
    32  ing;  however,  disapproval  shall not be based on the incompleteness of

    33  the application. If the department fails to take action  to  approve  or
    34  disapprove the application within ninety days of the certificate of need
    35  application  being  deemed  complete,  the  application  will  be deemed
    36  approved.
    37    3. For an eligible capital project requiring full review by the Public
    38  Health and Health Planning Council, the certificate of need  application
    39  shall  be placed on the next PHHPC agenda following the department deem-
    40  ing the application complete.
    41    4. Where the commissioner or  department  requires  the  applicant  to
    42  submit  a  contingency  submission  for an eligible capital project, the
    43  commissioner or department shall have thirty days to review and  approve

    44  or disapprove the contingency submission. If the commissioner or depart-
    45  ment  determines that the contingency submission is incomplete, it shall
    46  so notify the applicant in writing and provide the  applicant  with  ten
    47  business  days  to correct the deficiency or provide additional informa-
    48  tion. If the commissioner or department  determines  to  disapprove  the
    49  contingency  of  the submission, the basis for such disapproval shall be
    50  provided in writing; however, disapproval shall  not  be  based  on  the
    51  incompleteness  of  the  application.  Within  fifteen  days of complete
    52  contingency satisfaction, the commissioner or department shall  transmit
    53  the final approval letter to the applicant.

    54    5. The department shall develop expedited pre-opening survey processes
    55  for  eligible  capital  projects  approved under subdivision one of this

        S. 6256--D                         25                         A. 9056--D
 
     1  section, but under no circumstances shall pre-opening survey reviews  be
     2  scheduled later than thirty days after final approval.
     3    6. "Eligible capital project" shall mean:
     4    (a)  A  project  whose  total  budget is three million dollars or more
     5  funded with federal monies pursuant to section 330 of the Public  Health
     6  Service (PHS), 42 USC 254b, as amended; or
     7    (b)  A  project  whose  total  budget is three million dollars or more
     8  funded with federal monies pursuant to the federal Capital  Development-

     9  Building  Capacity (CD-BC) Grant Program and Immediate Facility Improve-
    10  ments (CD-IFI) Grant Program, as authorized by  the  Patient  Protection
    11  and  Affordable  Care  Act (Affordable Care Act)((P.L. 111-148), Section
    12  10503(c)).
    13    Capital protects funded in whole or in part through section 330 of the
    14  Public Health Service (PHS), 42 USC 254b, as  amended,  or  whose  total
    15  budget  is  less  than three million dollars shall not be subject to the
    16  provisions of this section or the federal  Capital  Development-Building
    17  Capacity  (CD-BC)  Grant  Program  and  Immediate  Facility Improvements
    18  (CD-IFI) Grant Program, as authorized  by  the  Patient  Protection  and
    19  Affordable  Care  Act  (Affordable  Care  Act)((P.L.   111-148), Section

    20  10503(c)), shall not be subject to the requirements set  forth  in  this
    21  section  or  any  other  law or regulation regarding certificate of need
    22  process or requirements.
    23    § 37. Subdivision 6 of section 368-d of the social  services  law,  as
    24  added  by  section  6  of  part  H of chapter 59 of the laws of 2011, is
    25  amended to read as follows:
    26    6. The commissioner shall evaluate the results of the study  conducted
    27  pursuant  to  subdivision four of this section to determine, after iden-
    28  tification of actual direct and indirect costs incurred by public school
    29  districts and state operated[/] and state supported  schools  for  blind
    30  and  deaf  students, whether it is advisable to claim federal reimburse-
    31  ment for expenditures under this section as  certified  public  expendi-

    32  tures.  In the event such claims are submitted, if federal reimbursement
    33  received for certified public expenditures on behalf of medical  assist-
    34  ance  recipients  whose  assistance and care are the responsibility of a
    35  social services district [in a  city  with  a  population  of  over  two
    36  million,]  results  in  a decrease in the state share of annual expendi-
    37  tures pursuant to this section for such recipients, then to  the  extent
    38  that  the amount of any such decrease when combined with any decrease in
    39  the state share of annual expenditures described in subdivision five  of
    40  section  three  hundred  sixty-eight-e of this title exceeds one hundred
    41  fifty million dollars for the period April 1,  2011  through  March  31,
    42  2013,  or exceeds one hundred million dollars in state fiscal year 2012-

    43  13 or any fiscal year thereafter, the excess amount shall be transferred
    44  to such [city] public school districts  and  state  operated  and  state
    45  supported schools for blind and deaf students in amounts proportional to
    46  their percentage contribution to the statewide savings.  Any such excess
    47  amount  transferred  shall  not be considered a revenue received by such
    48  social services district in determining the  district's  actual  medical
    49  assistance  expenditures for purposes of paragraph (b) of section one of
    50  part C of chapter fifty-eight of the laws of two thousand five.
    51    § 38. Subdivision 5 of section 368-e of the social  services  law,  as
    52  added  by  section  7  of  part  H of chapter 59 of the laws of 2011, is
    53  amended to read as follows:
    54    5. The commissioner shall evaluate the results of the study  conducted

    55  pursuant  to subdivision three of this section to determine, after iden-
    56  tification of actual direct and indirect costs incurred by counties  for

        S. 6256--D                         26                         A. 9056--D
 
     1  medical  care,  services,  and supplies furnished to pre-school children
     2  with handicapping conditions, whether it is advisable to  claim  federal
     3  reimbursement  for  expenditures  under this section as certified public
     4  expenditures.  In  the  event  such  claims  are  submitted,  if federal
     5  reimbursement received for certified public expenditures  on  behalf  of
     6  medical  assistance recipients whose assistance and care are the respon-
     7  sibility of a social services district [in a city with a  population  of
     8  over  two  million],  results in a decrease in the state share of annual

     9  expenditures pursuant to this section for such recipients, then  to  the
    10  extent  that  the  amount  of  any  such decrease when combined with any
    11  decrease in the state share of annual expenditures described in subdivi-
    12  sion six of section three hundred sixty-eight-d of  this  title  exceeds
    13  one  hundred  fifty million dollars for the period April 1, 2011 through
    14  March 31, 2013, or exceeds one hundred million dollars in  state  fiscal
    15  year  2012-13  or any fiscal year thereafter, the excess amount shall be
    16  transferred to such [city] counties in  amounts  proportional  to  their
    17  percentage  contribution  to  the  statewide  savings.   Any such excess
    18  amount transferred shall not be considered a revenue  received  by  such
    19  social  services  district  in determining the district's actual medical

    20  assistance expenditures for purposes of paragraph (b) of section one  of
    21  part C of chapter fifty-eight of the laws of two thousand five.
    22    §  39. Subparagraph (i) of paragraph (a-1) of subdivision 4 of section
    23  365-a of the social services law, as amended by section 46 of part C  of
    24  chapter 58 of the laws of 2009, is amended to read as follows:
    25    (i)  a  brand  name  drug for which a multi-source therapeutically and
    26  generically equivalent drug, as determined by the federal food and  drug
    27  administration,  is  available,  unless  previously  authorized  by  the
    28  department of health.  The  commissioner  of  health  is  authorized  to
    29  exempt,  for good cause shown, any brand name drug from the restrictions
    30  imposed by this subparagraph[. This subparagraph shall not apply to  any
    31  drug  that is in a therapeutic class included on the preferred drug list

    32  under section two hundred seventy-two of the public health law or is  in
    33  the  clinical drug review program under section two hundred seventy-four
    34  of the public health law];
    35    § 40. Paragraph (u) of subdivision 4 of section 364-j  of  the  social
    36  services law, as added by section 19 of part H of chapter 59 of the laws
    37  of 2011, is amended to read as follows:
    38    (u)  A  managed  care provider that provides coverage for prescription
    39  drugs shall permit each participant  to  fill  any  mail  order  covered
    40  prescription,  at  his or her option, at any mail order pharmacy or non-
    41  mail-order retail pharmacy in the managed care provider network, if  the
    42  non-mail-order retail pharmacy offers to accept a price that is compara-
    43  ble  to  that  of  the  mail order pharmacy. Every non-mail-order retail

    44  pharmacy in the managed care provider's  network  with  respect  to  any
    45  prescription  drug  shall be deemed to be in the managed care provider's
    46  network for every covered prescription drug; provided, however, that the
    47  managed care provider may limit its network of pharmacies for  specified
    48  drugs,  approved by the commissioner, based on clinical, professional or
    49  cost criteria. Such limitation shall not be based solely on cost.
    50    § 40-a. Subparagraph (vii)  of  paragraph  (b)  of  subdivision  7  of
    51  section  4403-f  of  the  public health law, as added by section 41-b of
    52  part H of chapter 59 of the laws of 2011, is amended to read as follows:
    53    (vii) Managed long term care provided and  plans  certified  or  other
    54  care  coordination  model  established  pursuant to this paragraph shall

    55  comply with the provisions of paragraphs (d), (i), [and]  (t),  and  (u)
    56  and  subparagraph  (iii) of paragraph (a) and subparagraph (iv) of para-

        S. 6256--D                         27                         A. 9056--D
 
     1  graph (e) of subdivision four of section three hundred  sixty-four-j  of
     2  the social services law.
     3    § 41. Paragraphs (e), (f) and (g) of subdivision 1 of section 367-a of
     4  the  social  services  law, paragraph (e) as added by chapter 433 of the
     5  laws of 1997, paragraph (f) as added by section 1 of part E  of  chapter
     6  58 of the laws of 2008, paragraph (g) as added by section 65-a of part H
     7  of chapter 59 of the laws of 2011, are amended to read as follows:
     8    (e)  Amounts  payable  under  this title for medical assistance in the
     9  form of clinic services pursuant to article twenty-eight of  the  public

    10  health  law  and  article  sixteen of the mental hygiene law provided to
    11  eligible persons diagnosed with a developmental disability who are  also
    12  beneficiaries  under  part  [b]  B of title [xviii] XVIII of the federal
    13  social security act [and who are also], or provided to persons diagnosed
    14  with a developmental disability who are qualified medicare beneficiaries
    15  under part B of title XVIII of such act  shall  not  be  less  than  the
    16  approved  medical assistance payment level less the amount payable under
    17  part [b] B.
    18    (f) Amounts payable under this title for  medical  assistance  in  the
    19  form  of  outpatient  mental health services under article thirty-one of
    20  the mental hygiene law provided to eligible persons who are also benefi-

    21  ciaries under part B of title XVIII of the federal social  security  act
    22  or  provided  to  qualified medicare beneficiaries under part B of title
    23  XVIII of such act shall not be less than the approved medical assistance
    24  payment level less the amount payable under part B.
    25    (g) Notwithstanding any provision of this  section  to  the  contrary,
    26  amounts  payable  under this title for medical assistance in the form of
    27  hospital outpatient services or diagnostic and treatment center services
    28  pursuant to article twenty-eight of the public health  law  provided  to
    29  eligible  persons who are also beneficiaries under part B of title XVIII
    30  of the federal social security act or  provided  to  qualified  medicare
    31  beneficiaries  under  part B of title XVIII of such act shall not exceed

    32  the approved medical assistance payment level less  the  amount  payable
    33  under part B.
    34    § 42. Intentionally omitted.
    35    § 43. Paragraph (a) of subdivision 8-a of section 2807-j of the public
    36  health law, as amended by section 16 of part D of chapter 57 of the laws
    37  of 2006, is amended to read as follows:
    38    (a)  Payments and reports submitted or required to be submitted to the
    39  commissioner or to the commissioner's designee pursuant to this  section
    40  and  section  twenty-eight hundred seven-s of this article by designated
    41  providers of services and by third-party payors which  have  elected  to
    42  make  payments  directly  to  the  commissioner or to the commissioner's
    43  designee in accordance with subdivision five-a of this section, shall be
    44  subject to audit by the commissioner for a period of six years following

    45  the close of the calendar year in which such payments  and  reports  are
    46  due,  after which such payments shall be deemed final and not subject to
    47  further adjustment or reconciliation, including through  offset  adjust-
    48  ments  or reconciliations made by designated providers of services or by
    49  third-party payors with regard to subsequent payments, provided,  howev-
    50  er, that nothing herein shall be construed as precluding the commission-
    51  er from pursuing collection of any such payments which are identified as
    52  delinquent  within  such  six  year  period,  or which are identified as
    53  delinquent as a result of an audit commenced within such six year  peri-
    54  od, or from conducting an audit of any adjustment or reconciliation made
    55  by a designated provider of services or by a third party payor which has

    56  elected  to  make  such  payments  directly  to  the commissioner or the

        S. 6256--D                         28                         A. 9056--D
 
     1  commissioner's designee, or from conducting an audit  of  payments  made
     2  prior  to  such  six  year  period which are found to be commingled with
     3  payments which are otherwise subject to timely audit  pursuant  to  this
     4  section.
     5    § 44.  Paragraph (a) of subdivision 10 of section 2807-t of the public
     6  health law, as amended by section 17 of part D of chapter 57 of the laws
     7  of 2006, is amended to read as follows:
     8    (a)  Payments and reports submitted or required to be submitted to the
     9  commissioner or to the commissioner's designee pursuant to this  section
    10  by specified third-party payors shall be subject to audit by the commis-

    11  sioner  for  a  period  of six years following the close of the calendar
    12  year in which such payments  and  reports  are  due,  after  which  such
    13  payments  shall be deemed final and not subject to further adjustment or
    14  reconciliation, including through offset adjustments or  reconciliations
    15  made  by  such  specified  third-party  payors with regard to subsequent
    16  payments, provided, however, that nothing herein shall be  construed  as
    17  precluding  the  commissioner  from  pursuing  collection  of  any  such
    18  payments which are identified as delinquent within such six year period,
    19  or which are identified as delinquent as a result of an audit  commenced
    20  within  such six year period, or from conducting an audit of any adjust-
    21  ments and reconciliation made by a specified third  party  payor  within

    22  such six year period, or from conducting an audit of payments made prior
    23  to  such  six year period which are found to be commingled with payments
    24  which are otherwise subject to timely audit pursuant to this section.
    25    § 45. Subdivision 7 of section 2807-d of  the  public  health  law  is
    26  amended by adding a new paragraph (f) to read as follows:
    27    (f)  Payments and reports submitted or required to be submitted to the
    28  commissioner or to the commissioner's designee pursuant to this  section
    29  shall  be subject to audit by the commissioner for a period of six years
    30  following the close of the calendar year  in  which  such  payments  and
    31  reports are due, after which such payments shall be deemed final and not

    32  subject  to  further  adjustment  or  reconciliation,  including through
    33  offset adjustments or reconciliations made to subsequent  payments  made
    34  pursuant  to  this section, provided, however, that nothing herein shall
    35  be construed as precluding the commissioner from pursuing collection  of
    36  any  such  payments  which  are identified as delinquent within such six
    37  year period, or which are identified as delinquent as  a  result  of  an
    38  audit commenced within such six year period, or from conducting an audit
    39  of any adjustment or reconciliation made by a hospital.
    40    § 46.  Paragraph (f) of subdivision 18 of section 2807-c of the public
    41  health law, as amended by section 15 of part D of chapter 57 of the laws
    42  of 2006, is amended to read as follows:

    43    (f) Payments of assessments and allowances required to be submitted by
    44  general hospitals pursuant to this subdivision and subdivisions fourteen
    45  and  fourteen-b  of this section and paragraph (a) of subdivision two of
    46  section twenty-eight hundred seven-d of this article shall be subject to
    47  audit by the commissioner for a period of six years following the  close
    48  of  the  calendar  year in which such payments are due, after which such
    49  payments shall be deemed final and not subject to further adjustment  or
    50  reconciliation,  including through offset adjustments or reconciliations
    51  made by general hospitals with regard to subsequent payments,  provided,
    52  however,  that  nothing  herein  shall  be  construed  as precluding the
    53  commissioner from pursuing collection of any such assessments and allow-
    54  ances which are identified as delinquent within such six year period, or

    55  which are identified as delinquent as a result  of  an  audit  commenced
    56  within  such  six  year audit period, or from conducting an audit of any

        S. 6256--D                         29                         A. 9056--D
 
     1  adjustment or reconciliation made by a general hospital within such  six
     2  year  period, or from conducting an audit of payments made prior to such
     3  six year period which are found to be commingled with payments which are
     4  otherwise  subject  to  timely  audit  pursuant to this section. General
     5  hospitals which, in the course of such an audit, fail to produce data or
     6  documentation requested in furtherance of such an audit,  within  thirty
     7  days  of such request may be assessed a civil penalty of up to ten thou-
     8  sand dollars for each such failure, provided, however, that  such  civil

     9  penalty shall not be imposed if the hospital demonstrates good cause for
    10  such  failure.   The imposition of such civil penalties shall be subject
    11  to the provisions of section twelve-a of this chapter.
    12    § 47.  Paragraph (e) of subdivision 2-a of section 2807 of the  public
    13  health  law  is  amended  by  adding a new subparagraph (iii) to read as
    14  follows:
    15    (iii) Regulations issued pursuant to this  paragraph  may  incorporate
    16  quality  related measures limiting or excluding reimbursement related to
    17  potentially preventable conditions and complications; provided  however,
    18  such  quality  related measures shall not include any preventable condi-
    19  tions and complications not identified for Medicare nonpayment or limit-
    20  ed payment.

    21    § 48.  Paragraph (c) of subdivision 7 of section 2807-d of the  public
    22  health  law,  as added by chapter 938 of the laws of 1990, is amended to
    23  read as follows:
    24    (c) The reports shall be in such form as  may  be  prescribed  by  the
    25  commissioner  to  accurately  disclose information required to implement
    26  this section, provided, however, that for  periods  on  and  after  July
    27  first,  two  thousand  twelve,  such  reports and any associated certif-
    28  ications shall be submitted electronically in a form as may be  required
    29  by the commissioner.
    30    §  48-a. Subparagraph (i) of paragraph (a) of subdivision 7 of section
    31  2807-j of the public health law, as amended by section 36 of part  B  of
    32  chapter 58 of the laws of 2008, is amended to read as follows;

    33    (i)  Every designated provider of services shall submit reports of net
    34  patient service revenues received for or on account of patient  services
    35  for  each  month which shall be in such form as may be prescribed by the
    36  commissioner to accurately disclose information  required  to  implement
    37  this section. For periods on and after January first, two thousand five,
    38  reports by designated providers of services shall be submitted electron-
    39  ically  in  a  form  as  may  be required by the commissioner; provided,
    40  however, any designated provider of  services  is  not  prohibited  from
    41  submitting  reports  electronically  on  a voluntary basis prior to such
    42  date,  and  provided  further,  however,  that   all   such   electronic
    43  submissions submitted on and after July first, two thousand twelve shall

    44  be  verified  with  an electronic signature as prescribed by the commis-
    45  sioner.
    46    § 48-b. Subparagraph (ii) of paragraph (b) of subdivision 7 of section
    47  2807-j of the public health law, as amended by section 25 of part A3  of
    48  chapter 62 of the laws of 2003, is amended to read as follows:
    49    (ii)  For  periods on and after July first, two thousand four, reports
    50  submitted on a monthly basis by third-party payors  in  accordance  with
    51  subparagraph (i) of this paragraph and reports submitted on a monthly or
    52  annual  basis by payors acting in an administrative services capacity on
    53  behalf of electing third-party payors in  accordance  with  subparagraph
    54  (i)  of  this paragraph shall be made electronically in a form as may be
    55  required by the commissioner; provided, however, any third-party  payor,

    56  except payors acting in an administrative services capacity on behalf of

        S. 6256--D                         30                         A. 9056--D
 
     1  electing third-party payors, which, on or after January first, two thou-
     2  sand  four,  elects to make payments directly to the commissioner or the
     3  commissioner's designee pursuant to subdivision five  of  this  section,
     4  shall  be  subject to this subparagraph only after one full year of pool
     5  payment experience which results in reports being submitted on a monthly
     6  basis,  and  provided  further,  however,  that  all   such   electronic
     7  submissions submitted on and after July first, two thousand twelve shall
     8  be  verified  with  an electronic signature as prescribed by the commis-
     9  sioner.   This subparagraph shall not be  interpreted  to  prohibit  any

    10  third-party  payor from submitting reports electronically on a voluntary
    11  basis.
    12    § 48-c. Subparagraph (ii)  of  paragraph  (b)  of  subdivision  20  of
    13  section  2807-c of the public health law, as added by section 26 of part
    14  A3 of chapter 62 of the laws of 2003, is amended to read as follows:
    15    (ii) For periods on  and  after  January  first,  two  thousand  five,
    16  reports  submitted  by general hospitals to implement the assessment set
    17  forth in subdivision eighteen of this section shall be  submitted  elec-
    18  tronically  in  a form as may be required by the commissioner; provided,
    19  however, general hospitals are not prohibited  from  submitting  reports
    20  electronically  on  a  voluntary  basis prior to such date, and provided
    21  further, however, that all such electronic submissions submitted on  and

    22  after  July  first,  two thousand twelve shall be verified with an elec-
    23  tronic signature as prescribed by the commissioner.
    24    § 49.  Subdivision 8 of section 3605 of  the  public  health  law,  as
    25  added by chapter 959 of the laws of 1984, is amended to read as follows:
    26    8. Agencies licensed pursuant to this section but not certified pursu-
    27  ant  to  section three thousand six hundred eight of this article, shall
    28  not be qualified to participate  as  a  home  health  agency  under  the
    29  provisions  of  title  XVIII  or  XIX of the federal Social Security Act
    30  provided, however, an agency which has a contract with a state agency or
    31  its locally designated office or, as specified by the commissioner, with
    32  a managed care organization participating in the  managed  care  program

    33  established pursuant to section three hundred sixty-four-j of the social
    34  services  law or with a managed long term care plan established pursuant
    35  to section forty-four hundred  three-f  of  this  chapter,  may  receive
    36  reimbursement under title XIX of the federal Social Security Act.
    37    §  50.  Subdivision  6  of section 365-f of the social services law is
    38  renumbered subdivision 7 and a new subdivision 6 is  added  to  read  as
    39  follows:
    40    6.  Notwithstanding  any inconsistent provision of this section or any
    41  other contrary provision  of  law,  managed  care  programs  established
    42  pursuant to section three hundred sixty-four-j of this title and managed
    43  long  term  care  plans  and  other care coordination models established

    44  pursuant to section four thousand four hundred  three-f  of  the  public
    45  health law shall offer consumer directed personal assistance programs to
    46  enrollees.
    47    §  51.  Subdivision  3-c  of  section 3614 of the public health law is
    48  amended by adding a new paragraph (e) to read as follows:
    49    (e) The  commissioner  shall,  within  monies  appropriated  therefor,
    50  establish  a  rural home telehealth delivery demonstration study program
    51  in counties having a population of not  less  than  one  hundred  thirty
    52  thousand  and not more than one hundred forty thousand, according to the
    53  two thousand ten decennial federal census. The commissioner shall direct
    54  a home health organization serving in  such  county  to  study  patients

    55  receiving  telehealth  services,  pursuant to this subdivision, who have
    56  been diagnosed with congestive heart failure,  diabetes  and/or  chronic

        S. 6256--D                         31                         A. 9056--D
 
     1  pulmonary  obstructive  disease,  and  whose  medical, functional and/or
     2  environmental needs are appropriately met at home through  the  applica-
     3  tion  of telehealth services interventions. Such a study shall determine
     4  the  cost of providing telehealth services, the quality of care provided
     5  through telehealth services and the outcomes of patients receiving  such
     6  telehealth  services.  The  commissioner shall reimburse the home health
     7  organization for conducting the study with  amounts  appropriated  under

     8  this  subdivision. The home health organization shall evaluate the find-
     9  ings of the study and report to the governor, the temporary president of
    10  the senate, the speaker of the assembly, the commissioner, and the chair
    11  of the legislative commission on rural  resources  on  its  findings  of
    12  providing  telehealth  services for each condition, so as to provide the
    13  cost benchmarks with and without telehealth care, as well  as  providing
    14  cost  benefit  measurements in terms of the quality benefit outcomes for
    15  each of the conditions addressed via telehealth.
    16    § 52.  The public health law is amended by adding a new section 3309-a
    17  to read as follows:
    18    § 3309-a. Prescription pain medication awareness program.  1. There is

    19  hereby established within the department a prescription pain  medication
    20  awareness  program  to  educate the public and health care practitioners
    21  about the  risks  associated  with  prescribing  and  taking  controlled
    22  substance pain medications.
    23    2.  Within the amounts appropriated, the commissioner, in consultation
    24  with the commissioner of the office of alcoholism  and  substance  abuse
    25  services, shall:
    26    (a)  Develop  and  conduct  a  public  health education media campaign
    27  designed to alert youth, parents and the general  population  about  the
    28  risks  associated  with  prescription  pain  medications and the need to
    29  properly dispose of any unused medication. In developing this  campaign,

    30  the  commissioner shall consult with and use information provided by the
    31  work group established pursuant to subdivision (b) of this  section  and
    32  other relevant professional organizations. The campaign shall include an
    33  internet  website providing information for parents, children and health
    34  care professionals on the  risks  associated  with  taking  opioids  and
    35  resources  available  to those needing assistance with prescription pain
    36  medication  addiction.  Such  website  shall  also  provide  information
    37  regarding   where   individuals   may  properly  dispose  of  controlled
    38  substances in their community and include active links to further infor-
    39  mation and resources. The campaign shall begin no later  than  September
    40  first, two thousand twelve.

    41    (b)  Establish  a  work  group, no later than June first, two thousand
    42  twelve, which shall be composed of experts in the fields  of  palliative
    43  and  chronic care pain management and addiction medicine. Members of the
    44  work group shall receive no compensation for their services,  but  shall
    45  be  allowed  actual  and  necessary expenses in the performance of their
    46  duties pursuant to this section. The work group shall:
    47    (i) Report to the commissioner regarding the development of  recommen-
    48  dations  and  model  courses for continuing medical education, refresher
    49  courses and other training materials for licensed  health  care  profes-
    50  sionals  on appropriate use of prescription pain medication. Such recom-

    51  mendations, model courses and other training materials shall be  submit-
    52  ted  to  the commissioner, who shall make such information available for
    53  the use in medical education, residency programs,  fellowship  programs,
    54  and  for  use  in continuing medication education programs no later than
    55  January first, two thousand thirteen;

        S. 6256--D                         32                         A. 9056--D
 
     1    (ii) No later than  January  first,  two  thousand  thirteen,  provide
     2  outreach  and  assistance  to  health care professional organizations to
     3  encourage and facilitate continuing medical education training  programs
     4  for  their  members  regarding appropriate prescribing practices and the

     5  risks associated with prescription pain medication; and
     6    (iii)  Provide information to the commissioner for use in the develop-
     7  ment and continued update of the public  awareness  campaign,  including
     8  information,  resources, and active web links that should be included on
     9  the website.
    10    3. The commissioner shall report to the governor, the temporary presi-
    11  dent of the senate and the speaker of the assembly no later  than  March
    12  first,  two  thousand  thirteen,  and  annually  thereafter, on the work
    13  group's findings. The report shall include information on  opioid  over-
    14  dose  deaths,  emergency  room  utilization  for the treatment of opioid
    15  overdose, the utilization of pre-hospital addiction services and  recom-

    16  mendations to reduce opioid addiction and the consequences thereof.
    17    §  53.  Paragraphs (d) and (e) of subdivision 5-a of section 2807-m of
    18  the public health law, as amended by section 26 of part C of chapter  59
    19  of the laws of 2011, are amended to read as follows:
    20    (d)  Physician  loan repayment program. One million nine hundred sixty
    21  thousand dollars for  the  period  January  first,  two  thousand  eight
    22  through  December  thirty-first,  two  thousand  eight, one million nine
    23  hundred sixty thousand dollars for the period January first,  two  thou-
    24  sand  nine through December thirty-first, two thousand nine, one million
    25  nine hundred sixty thousand dollars for the period  January  first,  two
    26  thousand  ten  through  December  thirty-first,  two  thousand ten, four
    27  hundred ninety thousand dollars for the period January first, two  thou-

    28  sand  eleven  through  March  thirty-first, two thousand eleven, and one
    29  million seven hundred thousand dollars each state fiscal  year  for  the
    30  period  April first, two thousand eleven through March thirty-first, two
    31  thousand fourteen, shall be set aside and reserved by  the  commissioner
    32  from  the regional pools established pursuant to subdivision two of this
    33  section and shall be available for purposes of physician loan  repayment
    34  in accordance with subdivision ten of this section. [Such] Notwithstand-
    35  ing  any contrary provision of this section, sections one hundred twelve
    36  and one hundred sixty-three of the  state  finance  law,  or  any  other
    37  contrary  provision  of  law, such funding shall be allocated regionally
    38  with one-third of available funds going to New York city and  two-thirds

    39  of  available funds going to the rest of the state and shall be distrib-
    40  uted in a manner to be determined by the commissioner without a  compet-
    41  itive bid or request for proposal process as follows:
    42    (i) Funding shall first be awarded to repay loans of up to twenty-five
    43  physicians  who  train  in  primary care or specialty tracks in teaching
    44  general hospitals, and who enter and remain in primary care or specialty
    45  practices in underserved communities, as determined by the commissioner.
    46    (ii) After distributions in accordance with subparagraph (i)  of  this
    47  paragraph, all remaining funds shall be awarded to repay loans of physi-
    48  cians  who  enter  and  remain in primary care or specialty practices in
    49  underserved communities, as determined by  the  commissioner,  including
    50  but  not  limited  to  physicians working in general hospitals, or other

    51  health care facilities.
    52    (iii) In no case shall less than fifty percent of the funds  available
    53  pursuant  to  this  paragraph be distributed in accordance with subpara-
    54  graphs (i) and (ii) of this paragraph to physicians identified by gener-
    55  al hospitals.

        S. 6256--D                         33                         A. 9056--D
 
     1    (e) Physician practice support. Four  million  nine  hundred  thousand
     2  dollars  for the period January first, two thousand eight through Decem-
     3  ber thirty-first, two thousand eight, four million nine hundred thousand
     4  dollars annually for the period January first, two thousand nine through
     5  December  thirty-first,  two thousand ten, one million two hundred twen-
     6  ty-five thousand dollars for the  period  January  first,  two  thousand
     7  eleven through March thirty-first, two thousand eleven, and four million

     8  three  hundred  thousand  dollars  each state fiscal year for the period
     9  April first, two thousand eleven through March thirty-first,  two  thou-
    10  sand  fourteen, shall be set aside and reserved by the commissioner from
    11  the regional pools established  pursuant  to  subdivision  two  of  this
    12  section  and  shall  be  available  for  purposes  of physician practice
    13  support. [Such] Notwithstanding any contrary provision of this  section,
    14  sections  one  hundred  twelve  and one hundred sixty-three of the state
    15  finance law, or any other contrary provision of law, such funding  shall
    16  be  allocated  regionally with one-third of available funds going to New
    17  York city and two-thirds of available funds going to  the  rest  of  the
    18  state  and  shall  be  distributed  in  a manner to be determined by the

    19  commissioner without a competitive bid or request for  proposal  process
    20  as follows:
    21    (i)  Preference in funding shall first be accorded to teaching general
    22  hospitals for up to twenty-five awards, to  support  costs  incurred  by
    23  physicians  trained in primary or specialty tracks who thereafter estab-
    24  lish or join practices in underserved communities, as determined by  the
    25  commissioner.
    26    (ii)  After  distributions in accordance with subparagraph (i) of this
    27  paragraph, all remaining funds shall be awarded to physicians to support
    28  the cost of establishing or joining practices  in  underserved  communi-
    29  ties,  as  determined  by  the  commissioner, and to hospitals and other
    30  health care providers to recruit new physicians to provide  services  in
    31  underserved communities, as determined by the commissioner.

    32    (iii)  In no case shall less than fifty percent of the funds available
    33  pursuant to this  paragraph  be  distributed  to  general  hospitals  in
    34  accordance with subparagraphs (i) and (ii) of this paragraph.
    35    §  54.  Subdivision  5-a of section 2807-m of the public health law is
    36  amended by adding a new paragraph (e-1) to read as follows:
    37    (e-1) Work group.  For funding available pursuant  to  paragraphs  (d)
    38  and (e) of this subdivision:
    39    (i)  The  department  shall  appoint a work group from recommendations
    40  made by associations  representing  physicians,  general  hospitals  and
    41  other  health care facilities to develop a streamlined application proc-
    42  ess by June first, two thousand twelve.
    43    (ii) Subject to available funding, applications shall be accepted on a

    44  continuous basis. The department shall provide technical  assistance  to
    45  applicants  to facilitate their completion of applications. An applicant
    46  shall be notified in writing  by  the  department  within  ten  days  of
    47  receipt  of an application as to whether the application is complete and
    48  if the application is incomplete, what information is  outstanding.  The
    49  department  shall act on an application within thirty days of receipt of
    50  a complete application.
    51    § 55. Section 364-j of the social services law is amended by adding  a
    52  new subdivision 25 to read as follows:
    53    25.  Effective  January  first, two thousand thirteen, notwithstanding
    54  any provision of law to the contrary, managed care providers shall cover

    55  medically necessary prescription drugs  in  the  atypical  antipsychotic
    56  therapeutic  class, including non-formulary drugs, upon demonstration by

        S. 6256--D                         34                         A. 9056--D
 
     1  the prescriber, after consulting with the managed  care  provider,  that
     2  such  drugs,  in  the prescriber's reasonable professional judgment, are
     3  medically necessary and warranted.
     4    §  56.  Subdivision  6  of  section 369 of the social services law, as
     5  amended by section 53 of part H of chapter 59 of the laws  of  2011,  is
     6  amended to read as follows:
     7    6.  For  purposes of this section, [an individual's] the term "estate"
     8  [includes] means all [of the individual's] real  and  personal  property

     9  and  other  assets  included  within the individual's estate and passing
    10  under the terms of a valid will or  by  intestacy.  [Pursuant  to  regu-
    11  lations  adopted  by  the  commissioner,  which may be promulgated on an
    12  emergency basis, an individual's estate also includes any other property
    13  in which the individual has any legal title or interest at the  time  of
    14  death,  including  jointly  held  property,  retained  life estates, and
    15  interests in trusts, to the extent of such interests; provided, however,
    16  that a claim against a recipient of such  property  by  distribution  or
    17  survival  shall  be limited to the value of the property received or the
    18  amount of medical assistance benefits otherwise recoverable pursuant  to

    19  this  section,  whichever  is less. Nothing in this subdivision shall be
    20  construed as authorizing the department or a social services district to
    21  impose liens or make recoveries that  are  prohibited  by  federal  laws
    22  governing the medical assistance program.]
    23    § 56-a. Paragraph (b) of subdivision 7 of section 4403-f of the public
    24  health  law  is  amended  by adding a new subparagraph (viii) to read as
    25  follows:
    26    (viii) (1) The commissioner shall report biannually on the implementa-
    27  tion of this subdivision. The reports shall include, but not be  limited
    28  to:
    29    (A)  satisfaction of enrollees with care coordination/case management;
    30  timeliness of care;
    31    (B) service utilization data including changes in  the  level,  hours,

    32  frequency, and types of services and providers;
    33    (C) enrollment data, including auto-assignment rates by plan;
    34    (D) quality data; and
    35    (E)  continuity  of care for participants as they move to managed long
    36  term care, with respect to community based and nursing home populations,
    37  including pediatric nursing  home  populations,  and  medically  fragile
    38  children  being  served  by home care agencies affiliated with pediatric
    39  nursing homes and diagnostic and  treatment  centers  primarily  serving
    40  medically fragile children.
    41    (2)  The  commissioner  shall  publish  the report on the department's
    42  website and provide notice to the temporary president of the senate, the

    43  speaker of the assembly, the chair of the senate standing  committee  on
    44  health,  the  chair  of  the  assembly health committee and the Medicaid
    45  Managed Care Advisory Review Panel upon availability of the report.  The
    46  initial  report  shall  be  provided  by  September  first, two thousand
    47  twelve. The reports shall be made available by each February first,  and
    48  September  first  thereafter.  Such  reports shall be formatted to allow
    49  comparisons between plans.
    50    § 56-b. Section 4403-f of the public health law is amended by adding a
    51  new subdivision 11 to read as follows:
    52    11. The department shall develop transition  and  continuity  of  care
    53  policies  for  participants  in home and community based long term care,

    54  including the long term home  health  care  program,  as  they  move  to
    55  managed long term care plans addressing:

        S. 6256--D                         35                         A. 9056--D
 
     1    (a)  a timetable and plan for implementation and transition by partic-
     2  ipants, plans and providers;
     3    (b)  informative  disclosure  of participants' options as to impending
     4  actions affecting or relating to the home care services they receive;
     5    (c) reasonable  opportunity  for  plans'  and  providers'  good  faith
     6  pursuit  of  contracts,  program  changes or state approvals relevant to
     7  plan implementation;
     8    (d) notice that a participant with a previously  established  plan  of

     9  care provided by a certified home health agency or long term home health
    10  care  program,  or  provided  pursuant  to the personal care or consumer
    11  directed personal assistance service programs, may elect  to  have  such
    12  care  plan  continued  subject  to  the participant's next comprehensive
    13  assessment; and
    14    (e) delineation of responsibilities  for  service  delivery  and  care
    15  coordination,  so  as  to  avoid  conflict,  duplication and unnecessary
    16  disruption of direct care staffing for the patient, and maintain compli-
    17  ance with state  and  federal  statute  and  regulation,  including  the
    18  provisions  of  this  section,  article  thirty-six  of this chapter and
    19  section three hundred sixty-five-f of the social services law.

    20    In addition, the department shall provide technical assistance to long
    21  term home health care providers  with  contracting  options  under  this
    22  section.  The  department  shall  work with affected stakeholders in the
    23  development of these policies.
    24    § 56-c. Notwithstanding any inconsistent law or regulation, an  exist-
    25  ing long term home health care program making application to the commis-
    26  sioner  of  health  for  the  issuance of a certificate of approval as a
    27  general purpose certified home health care agency shall  be  granted  an
    28  expedited  review  and  the  commissioner  of  health  may waive certain
    29  elements of such review in his or her sole discretion.
    30    § 57. Subdivision 1 of section 92 of part H of chapter 59 of the  laws
    31  of 2011, amending the public health law and other laws relating to known

    32  and projected department of health state funds Medicaid expenditures, is
    33  amended to read as follows:
    34    1.  For  state fiscal years 2011-12 [and 2012-13] through 2013-14, the
    35  director of the budget, in consultation with the commissioner of  health
    36  referenced  as "commissioner" for purposes of this section, shall assess
    37  on a monthly basis, as reflected in monthly reports pursuant to subdivi-
    38  sion five of this section known and projected department of health state
    39  funds medicaid expenditures by category of  service  and  by  geographic
    40  regions,  as  defined  by  the  commissioner, and if the director of the
    41  budget determines that such expenditures are expected to cause  medicaid
    42  disbursements  for  such  period  to  exceed the projected department of
    43  health medicaid state funds disbursements in the enacted  budget  finan-

    44  cial  plan  pursuant to subdivision 3 of section 23 of the state finance
    45  law, the commissioner of health, in consultation with  the  director  of
    46  the  budget,  shall  develop a medicaid savings allocation plan to limit
    47  such spending to the aggregate limit  level  specified  in  the  enacted
    48  budget  financial  plan,  provided,  however,  such  projections  may be
    49  adjusted by the director of the budget to account for any changes in the
    50  New York state federal medical assistance percentage amount  established
    51  pursuant  to the federal social security act, changes in provider reven-
    52  ues, reductions to local social  services  district  medical  assistance
    53  administration, and beginning April 1, 2012 the operational costs of the
    54  New York state medical indemnity fund.
    55    § 58.  Paragraph (b) of section 90 of part H of chapter 59 of the laws

    56  of 2011, amending the public health law and other laws relating to types

        S. 6256--D                         36                         A. 9056--D
 
     1  of  appropriations exempt from certain reductions, is amended to read as
     2  follows:
     3    (b)  The  following  types  of  appropriations  shall  be  exempt from
     4  reductions pursuant to this section:
     5    (i) any reductions that would violate federal law including,  but  not
     6  limited to, payments required pursuant to the federal Medicare program;
     7    (ii)  any reductions related to payments pursuant to article 32, arti-
     8  cle 31 and article 16 of the mental hygiene law;
     9    (iii) payments the state is obligated to make pursuant to court orders
    10  or judgments;
    11    (iv) payments for which the non-federal share  does  not  reflect  any
    12  state funding; [and]

    13    (v)  at  the discretion of the commissioner of health and the director
    14  of the budget, payments with regard to which it  is  determined  by  the
    15  commissioner  of  health and the director of the budget that application
    16  of reductions pursuant to this section would  result,  by  operation  of
    17  federal law, in a lower federal medical assistance percentage applicable
    18  to such payments; and
    19    (vi)  payments  made  with  regard  to  the early intervention program
    20  pursuant to section 2540 of the public health law.
    21    § 59. Subparagraph (ii) of paragraph (a) of subdivision 5  of  section
    22  2807-j of the public health law, as amended by section 23 of part A-3 of
    23  chapter 62 of the laws of 2003, is amended to read as follows:
    24    (ii) An election shall remain in effect unless revoked in writing by a

    25  specified  third-party payor, which revocation shall be effective on the
    26  first day of the next [calendar year quarter] month, provided that  such
    27  payor  has provided notice of its intention to so revoke at least [thir-
    28  ty] twenty days prior to the beginning of such [calendar quarter] month.
    29    § 60. Paragraph (b) of subdivision 5-a of section 2807-m of the public
    30  health law is amended by adding  a  new  subparagraph  (H)  to  read  as
    31  follows:
    32    (H)  Notwithstanding  any  inconsistent provision of this subdivision,
    33  for periods on and after April first, two thousand thirteen, ECRIP grant
    34  awards shall be made in accordance with rules and regulations promulgat-
    35  ed by the commissioner.  Such regulations shall, at a minimum:

    36    (1) provide that ECRIP grant awards shall be made with  the  objective
    37  of  securing  federal funding for biomedical research, training clinical
    38  researchers, recruiting national leaders as faculty to act  as  mentors,
    39  and training residents and fellows in biomedical research skills;
    40    (2)  provide that ECRIP grant applicants may include interdisciplinary
    41  research teams comprised of teaching general hospitals acting in collab-
    42  oration with entities including but  not  limited  to  medical  centers,
    43  hospitals, universities and local health departments;
    44    (3) provide that applications for ECRIP grant awards shall be based on
    45  such  information requested by the commissioner, which shall include but
    46  not be limited to hospital-specific data;

    47    (4) establish the qualifications for  investigators  and  other  staff
    48  required for grant projects eligible for ECRIP grant awards; and
    49    (5)  establish a methodology for the distribution of funds under ECRIP
    50  grant awards.
    51    § 61. Section 1 of part C of chapter 58 of the laws of 2005,  relating
    52  to  authorizing  reimbursements for expenditures made by or on behalf of
    53  social services districts for medical assistance for needy  persons  and
    54  the  administration  thereof, is amended by adding a new subdivision (h)
    55  to read as follows:

        S. 6256--D                         37                         A. 9056--D
 
     1    (h) Notwithstanding the provisions of  section  368-a  of  the  social
     2  services  law  or  any other contrary provision of law, no reimbursement

     3  shall be made for social services districts'  claims  submitted  on  and
     4  after  the  effective  date of this paragraph, for district expenditures
     5  incurred  prior  to  January  1,  2006,  including,  but not limited to,
     6  expenditures for services provided to individuals who were eligible  for
     7  medical  assistance  pursuant  to section three hundred sixty-six of the
     8  social services law  as  a  result  of  a  mental  disability,  formerly
     9  referred to as human services overburden aid to counties.
    10    §  61-a.    Section 32 of the public health law is amended by adding a
    11  new subdivision 6-a to read as follows:
    12    6-a. to post on the department's internet website,  within  reasonably
    13  prompt fashion, all final administrative determinations issued by admin-

    14  istrative  law judges in connection with any actions taken by the office
    15  pursuant to this title;
    16    § 62.   Notwithstanding any inconsistent provision  of  law,  rule  or
    17  regulation,  for  purposes  of implementing the provisions of the public
    18  health law and the social services law, references to titles XIX and XXI
    19  of the federal social security act in the  public  health  law  and  the
    20  social  services  law  shall  be  deemed to include and also to mean any
    21  successor titles thereto under the federal social security act.
    22    § 63. Notwithstanding any inconsistent provision of law, rule or regu-
    23  lation, the effectiveness of the provisions of sections 2807 and 3614 of
    24  the public health law, section 18 of chapter 2 of the laws of 1988,  and
    25  18  NYCRR  505.14(h), as they relate to time frames for notice, approval

    26  or certification of rates of payment, are hereby suspended  and  without
    27  force or effect for purposes of implementing the provisions of this act.
    28    § 64.  Severability clause. If any clause, sentence, paragraph, subdi-
    29  vision,  section  or  part of this act shall be adjudged by any court of
    30  competent jurisdiction to be invalid, such judgment  shall  not  affect,
    31  impair or invalidate the remainder thereof, but shall be confined in its
    32  operation  to  the  clause, sentence, paragraph, subdivision, section or
    33  part thereof directly involved in the controversy in which such judgment
    34  shall have been rendered. It is hereby declared to be the intent of  the
    35  legislature  that  this act would have been enacted even if such invalid
    36  provisions had not been included herein.
    37    § 65. This act shall take effect immediately, and shall be  deemed  to

    38  have been in full force and effect on and after April 1, 2012, provided,
    39  however, that:
    40    (a)  the  commissioner  of health may promulgate emergency regulations
    41  necessary to effectuate the provisions of sections two, three  and  four
    42  of this act;
    43    (b)  the  amendments  to  section  4403-c  of the public health law by
    44  section eight of this act shall not affect the repeal  of  such  section
    45  and shall be deemed to be repealed therewith;
    46    (b-1)  the  amendments  made  to subdivision 25 of section 1678 of the
    47  public authorities law by section twenty-eight-a of this act  shall  not
    48  affect the expiration of such subdivision and shall expire therewith;
    49    (c) provided, further, that the amendments to section 1 of chapter 119
    50  of  the laws of 1997 made by section thirty-two of this act, relating to
    51  authorizing the department of health to establish  certain  payments  to

    52  general  hospitals,  shall  be subject to the expiration of such chapter
    53  and shall be deemed expired therewith;
    54    (d) the amendments to paragraph (a-1)  of  subdivision  4  of  section
    55  365-a of the social services law made by section thirty-nine of this act

        S. 6256--D                         38                         A. 9056--D
 
     1  shall  not  affect  the  expiration  and reversion of such paragraph and
     2  shall be deemed to expire therewith;
     3    (e)  provided,  further,  that the amendments to section 2807-j of the
     4  public health law made by sections  forty-three,  forty-eight-a,  forty-
     5  eight-b  and  fifty-nine  of this act shall not affect the expiration of
     6  such section and shall be deemed to expire therewith;
     7    (f) provided, further, that the amendments to section  2807-t  of  the

     8  public  health  law  made  by  section  forty-four of this act shall not
     9  affect the expiration of such section and  shall  be  deemed  to  expire
    10  therewith;
    11    (g)  provided,  further,  that the amendments to section 4403-f of the
    12  public health law, made by sections forty-a, fifty-six-a and fifty-six-b
    13  of this act shall not affect the repeal of such  section  and  shall  be
    14  deemed to repeal therewith;
    15    (h)  provided,  further,  that  the amendments to section 364-j of the
    16  social services law made by sections forty and fifty-five  of  this  act
    17  shall not affect the repeal of such section and shall be deemed repealed
    18  therewith;
    19    (i)  provided, further, that section fifty-five of this act shall take
    20  effect January 1, 2013;
    21    (j) provided, further, that any  rules  or  regulations  necessary  to
    22  implement  the  provisions of this act may be promulgated and any proce-

    23  dures, forms, or instructions necessary for such implementation  may  be
    24  adopted  and  issued  on  or after the date this act shall have become a
    25  law;
    26    (k) provided, further, that this act shall not be construed to  alter,
    27  change,  affect,  impair  or  defeat  any rights, obligations, duties or
    28  interests accrued, incurred or conferred prior to the effective date  of
    29  this act;
    30    (l)  provided, further, that the commissioner of health and the super-
    31  intendent of financial services and any appropriate council may take any
    32  steps necessary to implement this act prior to its effective date;
    33    (m) provided, further, that notwithstanding any inconsistent provision
    34  of the state administrative procedure act or any other provision of law,
    35  rule or regulation, the commissioner of health and the superintendent of
    36  financial services and any appropriate council is authorized to adopt or

    37  amend or promulgate on an emergency basis any regulation he  or  she  or
    38  such council determines necessary to implement any provision of this act
    39  on its effective date; and
    40    (n)  provided,  further,  that the provisions of this act shall become
    41  effective notwithstanding the failure of the commissioner of  health  or
    42  the  superintendent  of  financial  services  or any council to adopt or
    43  amend or promulgate regulations implementing this act.
 
    44                                   PART E
    45                            Intentionally Omitted
 
    46                                   PART F
 
    47    Section 1. Section 1 of part C of chapter 58  of  the  laws  of  2005,
    48  authorizing  reimbursements  for  expenditures  made  by or on behalf of
    49  social services districts for medical assistance for needy  persons  and
    50  the administration thereof, is amended by adding a new subdivision (c-1)

    51  to read as follows:

        S. 6256--D                         39                         A. 9056--D
 
     1    (c-1)  Notwithstanding  any  provisions  of  subdivision  (c)  of this
     2  section to the contrary, effective April 1, 2013, for the period January
     3  1, 2013 through December 31, 2013 and for each calendar year thereafter,
     4  the medical  assistance  expenditure  amount  for  the  social  services
     5  district  for such period shall be equal to the previous calendar year's
     6  medical assistance expenditure amount, except that:
     7    (1) for the period January 1, 2013  through  December  31,  2013,  the
     8  previous  calendar  year  medical  assistance expenditure amount will be
     9  increased by 2%;

    10    (2) for the period January 1, 2014  through  December  31,  2014,  the
    11  previous  calendar  year  medical  assistance expenditure amount will be
    12  increased by 1%.
    13    § 2. Paragraph (iii) of subdivision (g) of section  1  of  part  C  of
    14  chapter  58 of the laws of 2005, authorizing reimbursements for expendi-
    15  tures made by or on behalf of  social  services  districts  for  medical
    16  assistance  for needy persons and the administration thereof, as amended
    17  by section 59 of part A of chapter 57 of the laws of 2006, is amended to
    18  read as follows:
    19    (iii) During each state fiscal year subject to the provisions of  this
    20  section  and  prior to state fiscal year 2015-16, the commissioner shall
    21  maintain an accounting, for each social services district,  of  the  net

    22  amounts that would have been expended by, or on behalf of, such district
    23  had the social services district medical assistance shares provisions in
    24  effect  on  January 1, 2005 been applied to such district.  For purposes
    25  of this paragraph, fifty percent of the payments made by New York  State
    26  to  the secretary of the federal department of health and human services
    27  pursuant to section 1935(c) of the social security act shall  be  deemed
    28  to  be  payments made on behalf of social services districts; such fifty
    29  percent share shall be apportioned to each district in the same ratio as
    30  the number of "full-benefit dual eligible individuals," as that term  is
    31  defined  in  section  1935(c)(6) of such act, for whom such district has
    32  fiscal responsibility pursuant to section 365  of  the  social  services
    33  law,  relates  to  the total of such individuals for whom districts have

    34  fiscal responsibility.  As soon as practicable after the  conclusion  of
    35  each  such  fiscal year, but in no event later than six months after the
    36  conclusion of each such fiscal year, the  commissioner  shall  reconcile
    37  such  net  amounts  with  such  fiscal  year's  social services district
    38  expenditure cap amount. Such reconciliation shall  be  based  on  actual
    39  expenditures  made  by  or  on  behalf of social services districts, and
    40  revenues received by social services districts, during such fiscal  year
    41  and  shall  be  made  without  regard to expenditures made, and revenues
    42  received, outside such fiscal year that are related to services provided
    43  during, or prior to, such fiscal year. The  commissioner  shall  pay  to
    44  each  social  services  district  the  amount,  if  any,  by  which such
    45  district's expenditure cap amount exceeds such net amount.

    46    § 3. Paragraph (i) of subdivision (b) of section 2 of part C of  chap-
    47  ter  58 of the laws of 2005, authorizing reimbursements for expenditures
    48  made by or on behalf of social services districts for medical assistance
    49  for needy persons and the administration thereof, is amended and  a  new
    50  paragraph (iii) is added to read as follows:
    51    (i)  A social services district shall exercise the option described in
    52  this section through the adoption of a resolution by its local  legisla-
    53  tive body, in the form set forth in subparagraph (ii) of this paragraph,
    54  to  elect  the medical assistance reimbursement methodology set forth in
    55  paragraph (a) of this section and to elect the tax intercept methodology
    56  set forth in subdivision (f) of section 1261 of the tax law or  subdivi-

        S. 6256--D                         40                         A. 9056--D
 

     1  sion  (g) of section 1261 and subdivision (h) of section 1313 of the tax
     2  law, as applicable. A social services district, acting through its local
     3  legislative body, is hereby authorized to adopt such a resolution.  Such
     4  a  resolution  shall  be  effective only if it is adopted exactly as set
     5  forth in subparagraph (ii) of this paragraph no later than September 30,
     6  2007, and a certified copy of such resolution is mailed to  the  commis-
     7  sioner  of  health  by  certified mail by such date. The commissioner of
     8  health shall, no later than October 31, 2007, certify to the commission-
     9  er of taxation and finance a list of  those  social  services  districts
    10  which  have  elected  the  option  described  in  this section. A social
    11  services district [shall have no authority to rescind the  exercise  of]

    12  that  elected  the  option described in this section, acting through its
    13  local legislative body, may repeal that election by  adopting  a  resol-
    14  ution  exactly  as  set forth in paragraph (iii) of this subdivision and
    15  mailing a certified copy of such repeal resolution to  the  commissioner
    16  of  health  no  later  than January 1, 2013.  The commissioner of health
    17  shall, within two weeks of receiving any such copy of a certified repeal
    18  resolution by certified mail from a social services district, certify in
    19  writing to the commissioner of taxation and finance the name of any such
    20  social services district that adopted such a resolution  to  repeal  its
    21  election. Upon receiving such written certification, the commissioner of

    22  taxation  and  finance  shall no longer calculate the Medicaid amount of
    23  such county under subdivision (f) of section 1261 of the  tax  law,  and
    24  the  amount  due  such county under subdivision (c) of such section 1261
    25  shall no longer be reduced by such Medicaid amount, effective the  first
    26  day of the month next commencing at least 10 days after the commissioner
    27  of  taxation  and  finance  has  received such written certification. If
    28  every social service district  that  elected  such  option  repeals  its
    29  election  and  the  commissioner  of  health certifies in writing to the
    30  commissioner of taxation and finance that  every  such  social  services
    31  district  has  repealed  its  election, then subdivisions (f) and (g) of

    32  section 1261 and subdivision (h) of section 1313  of  the  tax  law  tax
    33  shall  be  repealed  and  the  phrase "or a tax revenue intercept amount
    34  calculated pursuant to subdivision (f) or (g) of section 1261 of the tax
    35  law" in section four of this act shall be deleted, effective  the  first
    36  day  of  the  month  next  commencing at least 10 days after the date on
    37  which the commissioner of taxation and  finance  receives  such  written
    38  certification from the commissioner of health. At the same time that the
    39  commissioner  of  health makes such certification to the commissioner of
    40  taxation and finance that every county has repealed  its  election,  the
    41  commissioner  of  health shall also notify the legislative bill drafting

    42  commission that every social service district that elected  such  option
    43  has  repealed  its  election in order that the legislative bill drafting
    44  commission may maintain an accurate and timely data base of the official
    45  text of the laws of the state of New York in  furtherance  of  effecting
    46  the  provisions of section 44 of the legislative law and section 70-b of
    47  the public officers law.
    48    (iii) Form of resolution.
    49    Be it enacted by the (county) of (insert county's name) as follows:
    50    Section one. The (county) of (insert county's name) hereby repeals its
    51  election in 2007 of the  medical  assistance  reimbursement  option  and
    52  revenue  intercept for Medicaid purposes described in section 2 of chap-
    53  ter 58 of the laws of 2005.

    54    Section 2. This resolution shall take effect immediately.
    55    § 4. Part C of chapter 58 of the laws of 2005, authorizing  reimburse-
    56  ments for expenditures made by or on behalf of social services districts

        S. 6256--D                         41                         A. 9056--D
 
     1  for medical assistance for needy persons and the administration thereof,
     2  is amended by adding a new section 4-a to read as follows:
     3    §  4-a.  (a)  For state fiscal year 2012-13, and for each state fiscal
     4  year thereafter, a social services district will be  reimbursed  by  the
     5  state for the full non-federal share of expenditures by the district for
     6  the  administration of the medical assistance program, not to exceed the
     7  administrative cap amount determined in accordance with subdivision  (b)

     8  of  this  section. Any portion of the non-federal share of such expendi-
     9  tures in excess of the administrative cap amount shall be the  responsi-
    10  bility  of  the social services district and shall be in addition to the
    11  medical assistance expenditure  amount  calculated  in  accordance  with
    12  subdivisions (b), (c), (c-1), and (d) of section one of this act. Begin-
    13  ning  in  state  fiscal  year 2013-14, no reimbursement will be made for
    14  administrative expenditures in excess of such cap.
    15    (b) The administrative cap amount for a social services district shall
    16  be equal to a percentage of the amount included in the state fiscal year
    17  2011-12 enacted budget for the non-federal share of  medical  assistance

    18  administrative  costs  pursuant  to  this  section. Each social services
    19  district's percentage shall  be  equal  to  the  percentage  of  medical
    20  assistance  administrative  costs  claimed  by such district in the 2011
    21  calendar year in relation to all other social services districts.
    22    (c) Notwithstanding the provisions of subdivision (b) of this section,
    23  the commissioner of health may, at his or her sole discretion, reduce  a
    24  social  services  district's  administrative cap amount to account for a
    25  reduction in the  scope  or  volume  of  the  district's  administrative
    26  responsibilities,  including but not limited to such a reduction result-
    27  ing from the process of converting the medical assistance program  to  a

    28  department-administered  program pursuant to section 365-n of the social
    29  services law.
    30    (d) If, for state fiscal year 2012-13 and for any  state  fiscal  year
    31  thereafter,  the  aggregate  amount  of  administrative costs claimed or
    32  projected to be claimed by all social services districts  is  less  than
    33  the  non-federal  financial plan appropriation for the administration of
    34  the medical assistance program for  that  fiscal  year,  the  difference
    35  between  such  aggregate  amount  of claims or projected claims and such
    36  appropriation shall be used for reimbursement to those districts  deter-
    37  mined  by  the  commissioner,  with  the approval of the director of the
    38  budget, to have claims or projected claims for reasonable administrative

    39  costs which exceed or are projected to  exceed  the  administrative  cap
    40  amount  as established pursuant to subdivision (b) of this section. Such
    41  reimbursement shall be accomplished by allocating  proportionally  among
    42  such districts the aggregate amount of such excess.
    43    §  5.  Section 91 of part H of chapter 59 of the laws of 2011 amending
    44  the public health law  and  other  laws  relating  to  general  hospital
    45  reimbursement for annual rates is amended to read as follows:
    46    § 91. 1. Notwithstanding any inconsistent provision of state law, rule
    47  or  regulation to the contrary, subject to federal approval, the year to
    48  year rate of growth of department of health state funds Medicaid  spend-
    49  ing  shall not exceed the ten year rolling average of the medical compo-

    50  nent of the consumer price index  as  published  by  the  United  States
    51  department  of  labor, bureau of labor statistics, for the preceding ten
    52  years.
    53    2. Except as provided in subdivision three of this section, for  state
    54  fiscal  year  2013-14  and for each fiscal year thereafter, the spending
    55  limit calculated pursuant to subdivision one of this  section  shall  be
    56  increased  by an amount equal to the difference between the total social

        S. 6256--D                         42                         A. 9056--D
 
     1  services district medical assistance expenditure amounts calculated  for
     2  such period in conformance with subdivisions (b), (c), (c-1), and (d) of
     3  section  1  of  part  C  of chapter 58 of the laws of 2005 and the total

     4  social  services  district  medical  expenditure amounts that would have
     5  resulted if the provisions of subdivision (c-1) of such section had  not
     6  been applied.
     7    3.  With respect to a social services district that rescinds the exer-
     8  cise of the option provided in  paragraph  (i)  of  subdivision  (b)  of
     9  section  2 of part C of chapter 58 of the laws of 2005, for state fiscal
    10  year 2013-14 and for each fiscal year  thereafter,  the  spending  limit
    11  calculated  pursuant to subdivision one of this section shall be reduced
    12  by the amount of the medical assistance  expenditure  amount  calculated
    13  for such district for such period.
    14    §  6. The social services law is amended by adding a new section 365-n
    15  to read as follows:

    16    § 365-n. Department of health assumption  of  program  administration.
    17  1.  Notwithstanding the provisions of title two of article three of this
    18  chapter or of section three hundred sixty-five of this title or  of  any
    19  other  law to the contrary, the commissioner of health (commissioner) is
    20  authorized to take actions explicitly authorized by  this  section  that
    21  are  necessary  to transfer responsibility for the administration of the
    22  medical assistance program from local social services districts  to  the
    23  department  of  health  (department) by March thirty-first, two thousand
    24  eighteen.
    25    2. For purposes of this section, the  administration  of  the  medical
    26  assistance  program  includes:  processing applications for benefits and

    27  services available under this title and title eleven-D of this  article;
    28  making  determinations of initial and ongoing eligibility for such bene-
    29  fits and services; making coverage determinations with respect to  bene-
    30  fits  and  services  requiring prior authorization; notifying applicants
    31  and recipients of these determinations and of their rights and responsi-
    32  bilities, authorizing benefits and services for persons found  eligible;
    33  exercising  subrogation  rights  with  respect  to amounts received from
    34  insurance carriers or other liable third  parties;  imposing  liens  and
    35  pursuing  recoveries;  and any other such tasks and functions identified
    36  by the commissioner.
    37    3. Notwithstanding sections sixty-one, sixty-three, seventy,  seventy-

    38  eight, seventy-nine, eighty-one and eight-one-a of the civil service law
    39  or  any provisions to the contrary contained in any general, special, or
    40  local laws, all lawful appointees of a county performing  the  functions
    41  established  in subdivision two of this section as of the effective date
    42  of this section will be eligible for voluntary transfer  to  appropriate
    43  positions,  in the department, that are classified to perform such func-
    44  tions without further examination, qualification, or probationary  peri-
    45  od;  and, upon such transfer, will have all the rights and privileges of
    46  the jurisdictional classification to which such positions are  allocated
    47  in the classified service of the state.

    48    4.  Within  one  hundred  twenty  days  of  the effective date of this
    49  section, the department shall develop and implement a  local  department
    50  of social services statement of interest. The statement of interest will
    51  elicit  from  local departments of social services their interest in and
    52  capacity to contract with the department to perform the functions estab-
    53  lished in subdivision two of this section. To the extent practicable and
    54  in the best interest of the medical assistance program,  the  department
    55  shall  contract with local social services districts to perform all or a
    56  portion of the functions described in subdivision two of  this  section.

        S. 6256--D                         43                         A. 9056--D
 

     1  In no event, however, shall the department, by means of such a contract,
     2  delegate  its  authority  to  exercise  administrative discretion in the
     3  administration or supervision of the state plan for  medical  assistance
     4  submitted pursuant to section three hundred sixty-three-a of this title,
     5  or  to issue policies, rules, and regulations on program matters nor may
     6  any contracted entity be given the authority to change or disapprove any
     7  administrative decision of the department, or otherwise substitute  such
     8  entity's  judgment for that of the department with respect to the appli-
     9  cation of policies, rules, and regulations  issued  by  the  department.
    10  Notwithstanding  any  inconsistent  provision  of  sections  one hundred

    11  twelve and one hundred sixty-three of the state finance law, or sections
    12  one hundred forty-two and one hundred forty-three of the economic devel-
    13  opment law, or any other contrary provision of law, the commissioner  is
    14  authorized  to  enter  into  a contract with local departments of social
    15  services without a competitive bid or request for proposal process.
    16    5. Notwithstanding any inconsistent provision of sections one  hundred
    17  twelve and one hundred sixty-three of the state finance law, or sections
    18  one hundred forty-two and one hundred forty-three of the economic devel-
    19  opment  law, or any other contrary provision of law, the commissioner is
    20  authorized to amend the terms of contracts awarded prior to  the  effec-

    21  tive date of this section, including a contract entered into pursuant to
    22  subdivision  twenty-four of section two hundred six of the public health
    23  law, as added by section thirty-nine of part C of chapter fifty-eight of
    24  the laws of two thousand eight, without a competitive bid or request for
    25  proposal process, upon a determination that the existing  contractor  is
    26  qualified  to  provide assistance with one or more functions established
    27  in subdivision two of this section. Such amendments shall be limited  to
    28  implementation of: (i) automation enhancements, including but not limit-
    29  ed  to,  the  Medicare  savings  program and the family planning benefit
    30  program; (ii) processes for verification of third  party  insurance  and

    31  processing  enrollment  in  medical  assistance  with third party health
    32  insurance; (iii) procedures that will increase efficiencies  at  enroll-
    33  ment  centers;  (iv)  an asset verification system; and (v) processes to
    34  comply with federal law, including, but not limited to, the use of modi-
    35  fied adjusted gross income in eligibility determinations.
    36    6. The commissioner shall submit an annual  report  to  the  governor,
    37  temporary president of the senate, speaker of the assembly, the chair of
    38  the senate health committee and the chair of the assembly health commit-
    39  tee  by  December thirty-first, beginning in two thousand twelve and for
    40  each year thereafter until the year following full implementation.   The

    41  initial  report  shall  consist  of  modifications to the plan developed
    42  pursuant to section forty-seven-b of part B of  chapter  fifty-eight  of
    43  the  laws of two thousand ten, and shall include anticipated implementa-
    44  tion of the revised plan, its elements, a timeline for such  implementa-
    45  tion,  recommendations for legislative action, and such other matters as
    46  may be pertinent.
    47    The report shall include a plan and timeline for the state to:
    48    (i) assume specific functions related to  the  administration  of  the
    49  medical  assistance  program;  (ii)  coordinate  the  implementation  of
    50  provisions of federal law with the assumption of the  administration  of
    51  the  medical  assistance program; and (iii) address the financing of the

    52  medical assistance program administration and any associated administra-
    53  tive cost relief to local social services districts.  The  report  shall
    54  also  indicate  any  function  that  the  state  intends to enter into a
    55  contract with a public and/or private entity to perform, and the date in
    56  which the state anticipates entering into any such  contract.  In  addi-

        S. 6256--D                         44                         A. 9056--D
 
     1  tion,  reports  shall,  at  a  minimum,  indicate:  (i) any progress the
     2  department has made regarding its proposed timeline, including a summary
     3  of all functions assumed by the state during the previous year; (ii) any
     4  anticipated  and/or  actual  delay from the proposed timeline; (iii) the

     5  reason for any such delay; and (iv) actions the department has undertak-
     6  en to mitigate any such delay.
     7    7. The commissioner shall promulgate such regulations that are  neces-
     8  sary  to  carry  out  the  provisions  of this section. In addition, the
     9  commissioner shall make any amendments to the  state  plan  for  medical
    10  assistance,  or  develop  and  submit  an  application for any waiver or
    11  approval under the federal social security act, that are  necessary  and
    12  required to carry out the provisions of this section.
    13    § 7. Subdivision 7 of section 369 of the social services law, as added
    14  by  section 71-a of part C of chapter 58 of the laws of 2008, is amended
    15  to read as follows:
    16    7. Notwithstanding any provision of law to the contrary,  the  depart-

    17  ment [may commence] shall, when it determines necessary program features
    18  are  in  place,  assume  sole  responsibility  for commencing actions or
    19  proceedings in accordance with the provisions of this section,  sections
    20  one  hundred one, one hundred four, one hundred four-b, paragraph (a) of
    21  subdivision three of section three hundred sixty-six,  subparagraph  one
    22  of paragraph (h) of subdivision four of section three hundred sixty-six,
    23  and paragraph (b) of subdivision two of section three hundred sixty-sev-
    24  en-a  of  this  chapter,  to  recover  the  cost  of  medical assistance
    25  furnished pursuant to this title and title eleven-D of this article. The
    26  department is authorized to contract with an entity that  shall  conduct
    27  activities  on  behalf  of  the department pursuant to this subdivision.

    28  Prior to assuming such responsibility from a social  services  district,
    29  the  department  of  health  shall,  in  consultation with the district,
    30  define the scope of the  services  the  district  will  be  required  to
    31  perform  on behalf of the department of health pursuant to this subdivi-
    32  sion.
    33    § 8. Notwithstanding any inconsistent provision of law, rule or  regu-
    34  lation, for purposes of implementing the provisions of the public health
    35  law and the social services law, references to titles XIX and XXI of the
    36  federal  social  security  act  in  the public health law and the social
    37  services law shall be deemed to include and also to mean  any  successor
    38  titles thereto under the federal social security act.
    39    §  9. Notwithstanding any inconsistent provision of law, rule or regu-

    40  lation, the effectiveness of the provisions of sections 2807 and 3614 of
    41  the public health law, section 18 of chapter 2 of the laws of 1988,  and
    42  18  NYCRR  505.14(h), as they relate to time frames for notice, approval
    43  or certification of rates of payment, are hereby suspended  and  without
    44  force or effect for purposes of implementing the provisions of this act.
    45    §  10. Severability clause. If any clause, sentence, paragraph, subdi-
    46  vision, section or part of this act shall be adjudged by  any  court  of
    47  competent  jurisdiction  to  be invalid, such judgment shall not affect,
    48  impair or invalidate the remainder thereof, but shall be confined in its
    49  operation to the clause, sentence, paragraph,  subdivision,  section  or
    50  part thereof directly involved in the controversy in which such judgment
    51  shall  have been rendered. It is hereby declared to be the intent of the

    52  legislature that this act would have been enacted even if  such  invalid
    53  provisions had not been included herein.
    54    §  11.  This  act shall take effect immediately and shall be deemed to
    55  have been in full force and effect on and after April 1, 2012,  provided
    56  that:

        S. 6256--D                         45                         A. 9056--D
 
     1    1. section one of this act shall take effect April 1, 2013;
     2    2.  any  rules or regulations necessary to implement the provisions of
     3  this act may be promulgated and any procedures, forms,  or  instructions
     4  necessary  for such implementation may be adopted and issued on or after
     5  the date this act shall have become a law;
     6    3. this act shall not be construed to alter, change, affect, impair or
     7  defeat any rights, obligations, duties or interests accrued, incurred or

     8  conferred prior to the effective date of this act;
     9    4. the commissioner of health  and  the  superintendent  of  financial
    10  services  and  any  appropriate  council may take any steps necessary to
    11  implement this act prior to its effective date;
    12    5. notwithstanding any inconsistent provision of the state administra-
    13  tive procedure act or any other provision of law,  rule  or  regulation,
    14  the  commissioner of health and the superintendent of financial services
    15  and any appropriate council is authorized to adopt or amend  or  promul-
    16  gate  on  an  emergency  basis  any regulation he or she or such council
    17  determines necessary to implement any  provision  of  this  act  on  its
    18  effective date;
    19    6.  the amendment to section 91 of part H of chapter 59 of the laws of
    20  2011, amending the public health law and other laws relating to  general

    21  hospital  reimbursement  for  annual rates, made by section five of this
    22  act shall take effect on the same date and in the same  manner  as  such
    23  section takes effect;
    24    7.  the  provisions of this act shall become effective notwithstanding
    25  the failure of the commissioner  of  health  or  the  superintendent  of
    26  financial  services or any council to adopt or amend or promulgate regu-
    27  lations implementing this act;
    28    8. subdivision 5 of section 365-n of the social services law, as added
    29  by section six of this act shall expire and be deemed repealed March 31,
    30  2015.
 
    31                                   PART G
 
    32    Section 1. Subdivision 1 of section 79 of part C of chapter 58 of  the
    33  laws  of  2005 relating to the preferred drug program is amended to read
    34  as follows:
    35    1. [sections ten through fifteen] section fourteen of this  act  shall

    36  expire and be deemed repealed on and after June 15, 2012;
    37    §  2.  Subparagraph  (v) of paragraph (b) of subdivision 35 of section
    38  2807-c of the public health law, as amended by section 35-a of part H of
    39  chapter 59 of the laws of 2011, is amended to read as follows:
    40    (v) such  regulations  shall  incorporate  quality  related  measures,
    41  including,  but  not  limited  to, potentially preventable re-admissions
    42  (PPRs) and provide for rate adjustments or payment disallowances related
    43  to PPRs and other potentially  preventable  negative  outcomes  (PPNOs),
    44  which shall be calculated in accordance with methodologies as determined
    45  by the commissioner, provided, however, that such methodologies shall be
    46  based on a comparison of the actual and risk adjusted expected number of
    47  PPRs and other PPNOs in a given hospital and with benchmarks established

    48  by  the  commissioner and provided further that such rate adjustments or
    49  payment disallowances shall result in an aggregate reduction in Medicaid
    50  payments of no less than thirty-five million dollars for the period July
    51  first, two thousand ten through March thirty-first, two thousand  eleven
    52  and no less than fifty-one million dollars for [the period] annual peri-
    53  ods  beginning  April  first,  two thousand eleven through March thirty-
    54  first, two thousand [twelve] thirteen, provided further that such aggre-

        S. 6256--D                         46                         A. 9056--D
 
     1  gate reductions shall be offset by Medicaid payment reductions occurring
     2  as a result of decreased PPRs during the period July first, two thousand

     3  ten through March thirty-first, two thousand eleven and the period April
     4  first,  two  thousand  eleven  through  March thirty-first, two thousand
     5  [twelve] thirteen and as a result of decreased PPNOs during  the  period
     6  April  first,  two thousand eleven through March thirty-first, two thou-
     7  sand [twelve] thirteen; and provided further that for  the  period  July
     8  first,  two  thousand  ten  through  March  thirty-first,  two  thousand
     9  [twelve] thirteen, such rate adjustments or payment disallowances  shall
    10  not apply to behavioral health PPRs; or to readmissions that occur on or
    11  after fifteen days following an initial admission. By no later than July
    12  first,  two  thousand eleven the commissioner shall enter into consulta-
    13  tions with representatives of the health care facilities subject to this

    14  section regarding potential prospective revisions to applicable  method-
    15  ologies  and benchmarks set forth in regulations issued pursuant to this
    16  subparagraph;
    17    § 3. This act shall take effect immediately and  shall  be  deemed  to
    18  have been in full force and effect on and after April 1, 2012.
 
    19                                   PART H
 
    20    Section  1.    Subdivisions  3-b and 3-c of section 1 and section 4 of
    21  part C of chapter 57 of the laws of 2006,  relating  to  establishing  a
    22  cost of living adjustment for designated human services programs, subdi-
    23  visions  3-b  and 3-c of section 1 as amended by section 1 and section 4
    24  as amended by section 2 of part F of chapter 59 of the laws of 2011,  is
    25  amended to read as follows:
    26    3-b.  Notwithstanding  any  inconsistent  provision  of law, beginning

    27  April 1, 2009 and ending March 31, [2012] 2013, the commissioners  shall
    28  not  include  a  COLA for the purpose of establishing rates of payments,
    29  contracts or any other form of reimbursement.
    30    3-c. Notwithstanding any  inconsistent  provision  of  law,  beginning
    31  April 1, [2012] 2013 and ending March 31, [2015] 2016, the commissioners
    32  shall develop the COLA under this section using the actual U.S. consumer
    33  price  index  for  all  urban  consumers (CPI-U) published by the United
    34  States department of labor, bureau of labor statistics  for  the  twelve
    35  month  period  ending  in  July  of  the budget year prior to such state
    36  fiscal  year,  for  the  purpose  of  establishing  rates  of  payments,
    37  contracts or any other form of reimbursement.

    38    §  4.  This  act  shall take effect immediately and shall be deemed to
    39  have been in full force and effect on and after April 1, 2006;  provided
    40  section  one  of  this  act shall expire and be deemed repealed April 1,
    41  [2015] 2016; provided, further, that sections two and three of this  act
    42  shall expire and be deemed repealed December 31, 2009.
    43    §  2.  This  act  shall take effect immediately and shall be deemed to
    44  have been in full force and effect on and after April 1, 2012; provided,
    45  however, that the amendments to section 1 of part C of chapter 57 of the
    46  laws of 2006 made by section one of this act shall not affect the repeal
    47  of such section and shall be deemed repealed therewith.
 
    48                                   PART I
    49                            Intentionally Omitted
 
    50                                   PART J

        S. 6256--D                         47                         A. 9056--D
 
     1    Section 1. Section 13.17 of the mental hygiene law, as added by  chap-
     2  ter  978  of the laws of 1977, the section heading as amended by chapter
     3  168 of the laws of 2010, subdivisions (b) and (d) as amended by  chapter
     4  37  of the laws of 2011 and subdivision (c) as amended by chapter 538 of
     5  the laws of 1987, is amended to read as follows:
     6  § 13.17 Programs, services, and operations [of facilities] in the office
     7            for people with developmental disabilities.
     8    (a)  The  commissioner  shall  establish policy and procedures for the
     9  organization, administration, and [operation of the facilities]  service
    10  delivery  system  under  his  or  her  jurisdiction[. He] and shall make

    11  provision for the  effective  rendition  of  supports  and  services  to
    12  [patients  by  such  facilities  or  office  personnel] individuals with
    13  developmental disabilities.
    14    (b) There shall be [in], within the state operations  offices  of  the
    15  office,  the  developmental  disabilities  services  offices named below
    16  serving the areas either currently or previously served by a school, for
    17  the care and treatment of persons with  developmental  disabilities  and
    18  for  research  and  teaching  in the science and skills required for the
    19  care and treatment of such persons with developmental disabilities:
    20    Bernard M. Fineson Developmental Disabilities Services Office
    21    Brooklyn Developmental Disabilities Services Office
    22    Broome Developmental Disabilities Services Office

    23    Capital District Developmental Disabilities Services Office
    24    Central New York Developmental Disabilities Services Office
    25    Finger Lakes Developmental Disabilities Services Office
    26    Institute for Basic Research in Developmental Disabilities
    27    Hudson Valley Developmental Disabilities Services Office
    28    Metro New York Developmental Disabilities Services Office
    29    Long Island Developmental Disabilities Services Office
    30    Sunmount Developmental Disabilities Services Office
    31    Taconic Developmental Disabilities Services Office
    32    Western New York Developmental Disabilities Services Office
    33    Staten Island Developmental Disabilities Services Office
    34    The New York State Institute for Basic Research in Developmental Disa-
    35  bilities is designated as  an  institute  for  the  conduct  of  medical
    36  research  and other scientific investigation directed towards furthering

    37  knowledge of the etiology, diagnosis, treatment and prevention of devel-
    38  opmental disabilities.
    39    (c) The commissioner shall establish [the areas  which  each  facility
    40  or],  at  his  or  her  discretion, developmental disabilities [services
    41  office under his jurisdiction shall serve and the categories of  clients
    42  which  shall  be  served  thereby]  regional offices and shall establish
    43  state operations  offices  that  provide  for  the  direct  delivery  of
    44  supports  and services by the office for people with developmental disa-
    45  bilities.
    46    [(d)] (c) The commissioner may [permit] authorize other offices of the
    47  department and any public or private non-profit  organization  or  poli-

    48  tical subdivision of the state to [operate programs for persons] deliver
    49  supports  and  services  to individuals with developmental disabilities,
    50  not inconsistent with the programs and objectives of the office  in  any
    51  facility under his jurisdiction. The commissioner may permit any facili-
    52  ty  under  his  jurisdiction to operate programs for persons with mental
    53  disabilities, not inconsistent  with  programs  and  objectives  of  the
    54  department,  under contracts or agreements with other offices within the
    55  department.

        S. 6256--D                         48                         A. 9056--D
 
     1    § 2. Section 13.19 of the mental hygiene law, as added by chapter  978
     2  of  the laws of 1977, subdivisions (a) and (d) as amended by chapter 168
     3  of the laws of 2010 and subdivision (e) as added by chapter 307  of  the

     4  laws of 1979, is amended to read as follows:
     5  § 13.19 Personnel of the office; regulations.
     6    (a)  The  commissioner  may, within the amounts appropriated therefor,
     7  appoint and remove in accordance with law and applicable  rules  of  the
     8  state  civil  service  commission,  such  officers  and employees of the
     9  office for people with developmental disabilities [and school and facil-
    10  ity officers and employees who are designated managerial or confidential
    11  pursuant to article fourteen of the civil service law] as are  necessary
    12  for efficient administration.  The commissioner shall, in exercising his
    13  or   her   appointing   authority,   take,   consistent   with   article
    14  twenty-three-A of the correction law, all reasonable and necessary steps

    15  to ensure that any such person so appointed has not  previously  engaged
    16  in  any  act in violation of any law which indicates a propensity to act
    17  in a manner that would compromise the health and safety  of  individuals
    18  with developmental disabilities.
    19    (b)  The  director of a hospital or institute in the office shall have
    20  professional qualifications and  experience  to  be  prescribed  by  the
    21  commissioner.
    22    (c)  Notwithstanding  the provisions of any other law, the [positions]
    23  position of [psychiatrist III and] deputy director in  [any]  an  office
    24  facility may be filled by new hire or by promotion open to employees [of
    25  all  such  facilities]  who  possess  the minimum qualifications for the

    26  [respective positions. Promotion lists which are established  for  those
    27  positions shall be general eligible promotion lists from which names are
    28  certified  in  the  order of final earned ratings and from which certif-
    29  ication shall not be subdivided by the facility or department  in  which
    30  such persons are employed. Nothing in this subdivision shall prevent the
    31  use of open competitive examinations] position.
    32    [(d)]  (c)  The  use  of  volunteers [at facilities] in the office for
    33  people with developmental disabilities shall be encouraged. The  commis-
    34  sioner may establish regulations governing such volunteer services.
    35    [(e)]  (d)  Where,  and  to  the extent that, an agreement between the

    36  state and an employee organization  entered  into  pursuant  to  article
    37  fourteen  of  the  civil  service  law  so provides, the commissioner is
    38  authorized to implement the provisions of  such  agreement  relating  to
    39  discipline consistent with the terms thereof.
    40    §  3. Section 13.21 of the mental hygiene law, as added by chapter 978
    41  of the laws of 1977, the section heading and subdivisions (a) and (c) as
    42  amended by chapter 168 of the laws of 2010, subdivision (b)  as  amended
    43  by  chapter 558 of the laws of 2011, subdivision (d) as added by chapter
    44  355 of the laws of 1987 and subdivision (e) as added by chapter  492  of
    45  the  laws  of 1978 and as relettered by chapter 355 of the laws of 1987,
    46  is amended to read as follows:
    47  § 13.21 Directors of [schools] state  operations  offices  and  develop-

    48            mental  disabilities regional offices in the office for people
    49            with developmental disabilities.
    50    (a) The [director] directors of [a school] both the  state  operations
    51  offices  and  developmental  disabilities regional offices in the office
    52  for people with developmental disabilities shall  be  appointed  by  the
    53  commissioner  [and shall be its chief executive officer. The director of
    54  a school  shall  be  the  director  of  the  developmental  disabilities
    55  services  office  serving  the  areas  designated by the commissioner in
    56  regulation, and in such context, the term facility shall also  refer  to

        S. 6256--D                         49                         A. 9056--D


     1  such  developmental  disabilities  services  office]. Each such director
     2  shall be in the non-competitive class and designated as confidential  as
     3  defined  by  subdivision two-a of section forty-two of the civil service
     4  law  and  shall  serve  at the pleasure of the commissioner. [Except for
     5  school and facility officers and employees for which subdivision (a)  of
     6  section  13.19 of this article makes the commissioner the appointing and
     7  removing authority, the director of a school shall have the power, with-
     8  in amounts appropriated therefor, to appoint and  remove  in  accordance
     9  with law and applicable rules of the state civil service commission such
    10  officers and employees of the facility of which he or she is director as

    11  are  necessary  for  its  efficient  administration.] He or she shall in
    12  exercising his or her appointing authority take, consistent with article
    13  twenty-three-A of the correction law, all reasonable and necessary steps
    14  to insure that any such person so appointed has not  previously  engaged
    15  in  any act in violation of any law which [could] indicates a propensity
    16  to act in a manner that  would  compromise  the  health  and  safety  of
    17  patients in the facility of which he or she is director. He or she shall
    18  manage  the [facility, and administer its personnel system,] state oper-
    19  ations office or developmental disabilities regional office and adminis-
    20  ter its personnel system subject to applicable law, the  regulations  of

    21  the  commissioner,  and the rules of the state civil service commission.
    22  [Before the commissioner shall issue any such regulation or  any  amend-
    23  ment  or revision thereof, he or she shall consult with the directors of
    24  schools in the office regarding its suitability.] The [director]  direc-
    25  tors  of the developmental disabilities regional offices and state oper-
    26  ations offices shall maintain effective supervision of all parts of [the
    27  facility and over all persons employed therein or  coming  thereon  and]
    28  their  respective  offices.  The  directors  of state operations offices
    29  shall  generally  [direct]  provide  for  the  [care  and  treatment  of

    30  patients.  Directors presently serving at facilities of the office shall
    31  continue to serve under the terms of their original appointment]  admin-
    32  istration  of  supports  and  services to individuals with developmental
    33  disabilities in state operated programs. Directors of  regional  offices
    34  shall  generally  oversee the administration of supports and services to
    35  individuals with developmental  disabilities  in  settings  outside  the
    36  state operated programs.
    37    (b)  Such [director] directors shall have the responsibility of seeing
    38  that there is humane treatment of [the  patients  at  his  facility  and
    39  shall  investigate  every case of alleged patient abuse or mistreatment]

    40  individuals  with  developmental  disabilities  receiving  services   in
    41  settings  operated,  licensed,  certified,  funded  or  approved by this
    42  office.  [The] A director of a  state  operations  office  shall  notify
    43  immediately,  and  in  any event within three working days, the board of
    44  visitors of the facility and the mental hygiene legal service located in
    45  the same judicial department as [the hospital,  school  or  institution]
    46  the  state  operations  office  of  every  complaint of patient abuse or
    47  mistreatment and shall inform the board and  the  mental  hygiene  legal
    48  service of the results of his or her investigation. If it appears that a
    49  crime  may  have  been  committed,  [the] such state operations director

    50  shall give notice thereof to the district attorney or other  appropriate
    51  law  enforcement  official  as soon as possible, and in any event within
    52  three working days unless it appears that the crime includes an  employ-
    53  ee,  intern,  volunteer,  consultant,  contractor,  or  visitor  and the
    54  alleged conduct caused physical injury or the  patient  was  subject  to
    55  unauthorized  sexual  contact, or if it appears the crime is endangering
    56  the welfare of an incompetent or physically disabled person pursuant  to

        S. 6256--D                         50                         A. 9056--D
 
     1  section  260.25  of  the penal law, or if the crime was any felony under
     2  state or federal law, then the district attorney  or  other  appropriate
     3  law enforcement official must be contacted immediately, and in any event
     4  no later than twenty-four hours.

     5    (c)  In  any  investigation  into the treatment and care of [patients]
     6  individuals with developmental disabilities or the conduct, performance,
     7  or neglect of duty of officers or employees, the [director of  a  school
     8  in  the  office for people with developmental disabilities] commissioner
     9  or his or her designee shall be authorized to subpoena witnesses, compel
    10  their attendance, administer oaths to witnesses, examine witnesses under
    11  oath, and require the production of any books or papers deemed  relevant
    12  to  the  inquiry  or investigation. A subpoena issued under this section
    13  shall be regulated by the civil practice law and rules.
    14    (d) [Such] The director of a [school] state operations office shall be

    15  responsible for the provision of state operated community  developmental
    16  disabilities  services[,]  in  those  areas  that  the  commissioner may
    17  assign. Such responsibility shall, consistent with article forty-one  of
    18  this  chapter, include the operation of state operated facilities[,] and
    19  the development of needed facilities[, and the provision  of  assistance
    20  to  service  providers  in such areas and any necessarily related activ-
    21  ities.  All powers and duties as set forth in this section  shall  apply
    22  to  such responsibilities]. The director of a developmental disabilities
    23  regional office shall be responsible  for  the  provision  of  community
    24  developmental  disabilities  services  to  individuals in settings other

    25  than state operated programs. Such  regional  director's  responsibility
    26  shall,  consistent  with  article forty-one of this chapter, include the
    27  oversight of facilities and programs other than those  operated  by  the
    28  state.
    29    (e)  Each  [facility]  state  operations director of the office shall,
    30  upon notice from the commissioner or upon  knowledge  that  programs  of
    31  such  facility  may be contracted or terminated, implement procedures to
    32  ensure timely notification to affected employees. Such procedures  shall
    33  include, but not be limited to:
    34    (1)  dissemination  and  posting of all decisions, policies and proce-
    35  dures with respect to all aspects of such actions and  their  impact  on
    36  facility staff; and
    37    (2) compliance with all requirements and protection of employee rights

    38  pursuant  to  collective bargaining agreements with the designated legal
    39  representative of the employees and the civil service law.
    40    § 4. Section 13.33 of the mental hygiene law, as added by chapter  978
    41  of  the  laws  of  1977, subdivision (a) as amended by chapter 37 of the
    42  laws of 2011, subdivision (d) as amended by chapter 686 of the  laws  of
    43  1995,  subdivisions (f) and (h) as amended by chapter 175 of the laws of
    44  1986, subdivision (i) as amended by chapter 14  of  the  laws  of  1990,
    45  paragraph  1  of subdivision (i) as amended by chapter 75 of the laws of
    46  1992, paragraph 2 of subdivision (i) and subdivision (m) as  amended  by
    47  chapter  168  of the laws of 2010, subdivision (j) as amended by chapter
    48  264 of the laws of 1980 and subdivisions (j) and (k)  as  relettered  by
    49  chapter  84  of  the laws of 1980, subdivision (l) as amended by chapter

    50  406 of the laws of 1994 and subdivision (n) as amended by chapter 662 of
    51  the laws of 1995, is amended to read as follows:
    52  § 13.33 Boards of visitors.
    53    (a) Each [developmental disabilities services] state operations office
    54  under the jurisdiction of the commissioner shall have a minimum  of  one
    55  board  of  visitors consisting of at least seven but not more than four-
    56  teen members[; provided, however, that the  Central  New  York  develop-

        S. 6256--D                         51                         A. 9056--D

     1  mental  disabilities  services  office  shall  have  a board of visitors
     2  consisting of at least ten, but not more  than  seventeen  members;  and
     3  that  the  Finger Lakes developmental disabilities services office shall

     4  have  a  board of visitors consisting of at least fourteen, but not more
     5  than twenty-one members. When a school is replaced  by  a  developmental
     6  disabilities  services  office,  the  members  of that school's board of
     7  visitors shall continue to serve their terms as the  board  of  visitors
     8  for   the  new  developmental  disabilities  services  office].  Members
     9  appointed or reappointed after the effective date of this chapter  shall
    10  be  appointed by the governor, by and with the advice and consent of the
    11  senate.  Members shall be appointed for four year terms to expire on the
    12  thirty-first day of December of the fourth year of the  term  of  office
    13  provided  however,  when  more  than three terms expire in any one year,
    14  members may be appointed for terms of fewer years as designated  by  the

    15  governor  so  that  no  more than three members' terms expire in any one
    16  year. All terms of office shall expire on the thirty-first day of Decem-
    17  ber of the designated year. A  member  whose  term  has  expired  shall,
    18  however,  remain  in  office  until  such  member's  successor  has been
    19  appointed and has taken office, or until such member shall have resigned
    20  or have been removed from office in  the  manner  hereinafter  provided.
    21  Should  any  member resign or be removed from office, the governor shall
    22  promptly submit, for senate consent, a successor candidate to  fill  the
    23  remaining  term  of  the vacated office. A visitor may be removed by the
    24  governor for cause after notice and an opportunity for a hearing on  the
    25  charges.  In  making  appointments  to  boards of visitors, the governor
    26  shall endeavor to ensure that the membership of each  such  board  shall

    27  adequately  reflect  the  composition  of  the  community or communities
    28  served by the [facility] state operations office, that the membership of
    29  each such board includes at least three individuals who are  parents  or
    30  relatives  of  patients  or  of  former  patients and that the remainder
    31  includes only those persons, including former patients, who  shall  have
    32  expressed  an  active  interest  in, or shall have obtained professional
    33  knowledge in the care of persons with developmental disabilities  or  in
    34  developmental disability endeavors generally.
    35    (b) No elected state officer or member of the legislature may serve as
    36  a visitor.
    37    (c) [If the facility serves an area] Each visitor shall reside, at the
    38  time of appointment or reappointment, in the area, as established by the

    39  regulations  of the commissioner, [the visitors shall reside at the time
    40  of appointment or reappointment in such area] served by the state  oper-
    41  ated  office  that it oversees.  [If no specific area is designated, the
    42  visitors shall reside at the time of appointment or reappointment in the
    43  developmental disabilities area, established  by  the  commissioner,  in
    44  which the facility is located.]
    45    (d) Each board shall, at the first meeting of each calendar year elect
    46  one member to serve as president of the board and one member to serve as
    47  secretary;  provided however, that no member may serve for more than two
    48  consecutive years as president.
    49    (e) Visitors shall not receive compensation but  shall  be  reimbursed

    50  for their actual expenses in connection with their service as visitors.
    51    (f) (1) Each board of visitors shall hold six bi-monthly regular meet-
    52  ings annually, but a greater number of regular meetings may be scheduled
    53  by the board. Each board of visitors shall establish in their by-laws or
    54  otherwise,  in  writing, whether these six meetings shall be held during
    55  months represented by odd numbers or months represented by even numbers.
    56  The president of the board shall notify the chairman of  the  commission

        S. 6256--D                         52                         A. 9056--D
 
     1  on  quality of care [for the mentally disabled] and advocacy for persons
     2  with disabilities and the [facility] state operations  director  of  the

     3  determination   made  concerning  the  designated  months  for  the  six
     4  bi-monthly regular meetings. The president of the board, the commission-
     5  er, the director, or the members as determined by the rules of the board
     6  may  call special meetings. The board may require the director to submit
     7  a report at each  meeting.  Each  board  shall  keep  a  record  of  its
     8  proceedings  and  activities.  A  member  of a board of visitors who has
     9  failed to attend three consecutive bi-monthly regular meetings shall  be
    10  considered  to  have  vacated his office unless otherwise ordered by the
    11  governor. The board shall cause notice of any of its public meetings  to
    12  be sent to the mental hygiene legal service located in the same judicial
    13  department  as the [school] state operations office.  The mental hygiene
    14  legal service may send a representative to any such public meeting,  and

    15  may  request  the  board  to  review  patient  complaints or investigate
    16  alleged incidents of abuse or mistreatment. The board shall  notify  the
    17  appropriate  representative  of  the mental hygiene legal service of the
    18  board's actions and findings in relation to any such request.
    19    (2) The president of the board of visitors shall notify  a  member  by
    20  certified  or  registered mail return receipt requested when such member
    21  of the board has failed to attend any two consecutive bi-monthly regular
    22  meetings. This notice shall be sent within ten days following the second
    23  meeting and shall include the dates  of  the  two  meetings  which  were
    24  missed, the date of the next bi-monthly regular meeting, and a statement
    25  concerning the consequences of failure to attend the next meeting.
    26    (3)  Within  three  days  after  the  third  consecutive  absence at a

    27  bi-monthly regular meeting by a member, the president of  the  board  of
    28  visitors  shall  notify, in writing, the governor, the commissioner, the
    29  chairman of the commission on quality of care [for  the  mentally  disa-
    30  bled]  and  advocacy  for  persons  with disabilities and the [facility]
    31  state operations director of such absences. The president of  the  board
    32  of  visitors shall send a copy of this notice by registered or certified
    33  mail return receipt requested to the member to  whom  it  pertains.  The
    34  member may petition the governor to excuse his absences. If the governor
    35  does  not  excuse the absences within forty-five days of the date of the
    36  third consecutive meeting absence, the office of  the  member  shall  be
    37  deemed vacated.
    38    (g)  Upon the request of the commissioner or the director, or upon the

    39  board's initiative, the board shall consult, advise, and work  with  the
    40  director  with  respect  to  community  relations, conditions at [the] a
    41  state operated facility, preliminary plans for construction  and  alter-
    42  ations, and programs and activities of [the] a state operated facility.
    43    (h)  Each board or any member of the board may visit and inspect [the]
    44  a state operated facility that is in the catchment  area  of  the  state
    45  operations  region  in  which  such  member or members serve at any time
    46  without prior notice and may report on conditions to  the  governor,  to
    47  the  commissioner and to the chairman of the state commission on quality
    48  of care [for the mentally disabled] and advocacy for persons with  disa-

    49  bilities  and,  subject  to  confidential  information being redacted to
    50  protect the confidentiality of individuals  in  such  facility,  to  the
    51  temporary  president  of  the senate and to the speaker of the assembly.
    52  In addition, each board shall ensure  that  a  member  or  committee  of
    53  members  shall inspect [the] such facility once every three months with-
    54  out prior notice. A report on conditions may be submitted to the  gover-
    55  nor,  to  the commissioner or to the chairman of the state commission on
    56  quality of care [for the mentally disabled]  and  advocacy  for  persons

        S. 6256--D                         53                         A. 9056--D
 
     1  with disabilities and, subject to confidential information being redact-

     2  ed  to  protect  the confidentiality of individuals in such facility, to
     3  the temporary president  of  the  senate  and  to  the  speaker  of  the
     4  assembly.    Each  board  member  shall visit and inspect [the] any such
     5  facility at least twice during each calendar year.  Within  thirty  days
     6  after  the  conclusion of each calendar year, the president of the board
     7  of visitors shall notify the governor, the commissioner, the chairman of
     8  the commission on quality of care [for the mentally disabled] and  advo-
     9  cacy  for persons with disabilities, and the [facility] state operations
    10  director, if any member of the board has failed  to  visit  and  inspect
    11  [the]  any  such facility at least twice during that year. The president

    12  of the board of visitors shall send a copy of this notice  by  certified
    13  or  registered  mail  return  receipt requested to the member to whom it
    14  pertains. A member of a board of visitors who has failed  to  visit  and
    15  inspect  [the]  a  facility at least twice a year shall be considered to
    16  have vacated his or her office unless otherwise ordered by the  governor
    17  within  forty-five  days  after  the end of the calendar year. The board
    18  shall have the power to investigate all charges against the state  oper-
    19  ations  director, and all cases of alleged patient abuse or mistreatment
    20  made against any  employee,  and  shall  have  the  power  to  interview
    21  patients  and  employees of the [facility] facilities in pursuit of such

    22  investigations. In conducting such an  investigation,  the  board  shall
    23  have  the power, in accordance with the civil practice law and rules, to
    24  subpoena  witnesses,  compel  their  testimony,  administer   oaths   to
    25  witnesses,  examine  witnesses under oath, and require the production of
    26  any books or papers deemed relevant to the investigation. A board  or  a
    27  member  may  include  in the report or separately at any time any matter
    28  pertaining to the management and affairs of [the facility] such  facili-
    29  ties  and  may make recommendations to the governor, to the commissioner
    30  and to the chairman of the state commission on quality of care [for  the
    31  mentally  disabled]  and  advocacy  for  persons with disabilities. Each
    32  board member shall enter in a book, kept at each such facility for  that

    33  purpose, the date of each visit.
    34    (i)  (1)  Any  member  or members of the board may visit and inspect a
    35  family care home[, which] that is  within  the  catchment  area  of  the
    36  [school on the board of] state operations region in which such member or
    37  members  serve.  Such  member or members shall be granted access to such
    38  facility and to all books, records and data pertaining to such  facility
    39  deemed  necessary  for carrying out the purposes of such visit. Informa-
    40  tion, books, records or data [which] that are confidential  as  provided
    41  by  law  shall  be  kept confidential and any limitations on the release
    42  thereof imposed by law upon the party furnishing the information, books,
    43  records or data shall apply to such member  or  members  of  the  board.

    44  After  any  such visits or inspections, a report containing findings and
    45  recommendations may be submitted to the governor, to the commissioner or
    46  to the state commission on quality of care [for the  mentally  disabled]
    47  and  advocacy  for persons with disabilities and subject to confidential
    48  information being redacted to protect the confidentiality of individuals
    49  in such facility to the temporary president of the  senate  and  to  the
    50  speaker of the assembly.
    51    (2)  Any member or members of the board may visit and inspect a commu-
    52  nity residence operated by the  office  for  people  with  developmental
    53  disabilities[,  which]  that is within the catchment area of the [school
    54  on the board of] state operations region in which such member or members

    55  serve. Such member or members shall be granted access to  such  facility
    56  and  to  all  books, records and data pertaining to such facility deemed

        S. 6256--D                         54                         A. 9056--D
 
     1  necessary for carrying out the purposes of such  visit  and  inspection.
     2  Information,  books,  records  or  data [which] that are confidential as
     3  provided by law shall be kept confidential and any  limitations  on  the
     4  release  thereof  imposed  by law upon the party furnishing the informa-
     5  tion, books, records or data shall apply to such member  or  members  of
     6  the  board.  After  any  such  visits or inspection, a report containing
     7  findings and recommendations shall be submitted promptly to the  commis-
     8  sioner  and  to  the chairman of the state commission on quality of care

     9  and advocacy for persons with disabilities.
    10    (j) Once each year, each board shall make an independent assessment of
    11  conditions at [the facility] such facilities and shall submit  a  report
    12  on  the  assessment  and recommendations to the governor, to the commis-
    13  sioner, to the temporary president of the senate, to the speaker of  the
    14  assembly  and to the chairman of the state commission on quality of care
    15  [for the mentally disabled] and advocacy for persons with disabilities.
    16    (k) The commissioner shall notify the board of visitors of a  [school]
    17  facility  under his or her jurisdiction of the proposed appointment of a
    18  state operations director [to such facility] or the proposed transfer of

    19  a state operations director [from such facility], with  a  request  that
    20  the  board  report  an  expression  of its opinion of the appointment or
    21  transfer and, if it objects thereto, the reasons for such objection.
    22    (l) The commissioner  shall  appoint  representatives  of  the  office
    23  [department]  to  serve  as liaison between the office and the boards of
    24  visitors. At least once each year the commissioner shall meet  with  the
    25  boards  collectively.  The  commissioner,  or his or her designee, shall
    26  meet quarterly with representatives of boards of visitors.
    27    (m) Members of the boards of visitors shall be considered officers  of
    28  the  office  for people with developmental disabilities for the purposes
    29  of sections seventy-three, to the extent provided therein, and  seventy-

    30  four  of  the  public  officers law relating to business or professional
    31  activities by state officers and employees and the code of ethics.
    32    (n) Each member shall attend, within one year of the initial  appoint-
    33  ment  or  any  subsequent reappointment, an orientation training program
    34  provided by the commission on quality of care [for  the  mentally  disa-
    35  bled]  and  advocacy for persons with disabilities for members of boards
    36  of visitors. The chairman of the commission on quality of care [for  the
    37  mentally  disabled]  and  advocacy  for  persons with disabilities shall
    38  notify the governor and the appointed member of any such member's  fail-
    39  ure to attend such a training program. A member who has failed to attend
    40  such a training program scheduled for such member shall be considered to

    41  have  vacated his office unless otherwise ordered by the governor within
    42  forty-five days after the notice.
    43    § 5. Paragraph (c) of subdivision 3 of  section  2963  of  the  public
    44  health  law,  as added by chapter 818 of the laws of 1987, is amended to
    45  read as follows:
    46    (c) If the attending physician determines that a patient lacks capaci-
    47  ty because of a developmental disability, the  concurring  determination
    48  required  by  paragraph  (a)  of this subdivision shall be provided by a
    49  physician or psychologist employed by a [school] developmental disabili-
    50  ties services office named in section 13.17 of the mental  hygiene  law,
    51  or  who  has been employed for a minimum of two years to render care and
    52  service in a facility operated or licensed  by  the  office  [of  mental

    53  retardation  and] for people with developmental disabilities, or who has
    54  been approved by the commissioner of [mental retardation  and]  develop-
    55  mental  disabilities  in accordance with regulations promulgated by such
    56  commissioner.  Such  regulations  shall  require  that  a  physician  or

        S. 6256--D                         55                         A. 9056--D
 
     1  psychologist  possess  specialized training or three years experience in
     2  treating developmental disabilities.
     3    §  6.  Paragraph  (c)  of  subdivision 2 of section 2981 of the public
     4  health law, as added by chapter 752 of the laws of 1990, is  amended  to
     5  read as follows:
     6    (c)  For  persons  who reside in a mental hygiene facility operated or
     7  licensed by the office [of  mental  retardation  and]  for  people  with

     8  developmental  disabilities, at least one witness shall be an individual
     9  who is not affiliated with the facility and at least one  witness  shall
    10  be  a  physician  or  clinical  psychologist who either is employed by a
    11  [school] developmental disabilities services  office  named  in  section
    12  13.17  of  the mental hygiene law or who has been employed for a minimum
    13  of two years to render care  and  service  in  a  facility  operated  or
    14  licensed  by  the  office  [of  mental  retardation and] for people with
    15  developmental disabilities, or [who] has been approved  by  the  commis-
    16  sioner of [mental retardation and] developmental disabilities in accord-
    17  ance  with  regulations  approved  by the commissioner. Such regulations
    18  shall require that a physician or clinical psychologist possess special-

    19  ized training or three years experience in treating developmental  disa-
    20  bilities.
    21    §  7.  Paragraph  (c)  of  subdivision 1 of section 2983 of the public
    22  health law, as added by chapter 752 of the laws of 1990, is  amended  to
    23  read as follows:
    24    (c) If the attending physician determines that a patient lacks capaci-
    25  ty  because  of  a developmental disability, the attending physician who
    26  makes the determination must be, or must consult,  for  the  purpose  of
    27  confirming  the determination, with a physician or clinical psychologist
    28  who either is employed by a [school] developmental disabilities services
    29  office named in section 13.17 of the mental hygiene law, or who has been
    30  employed for a minimum of two years to render  care  and  service  in  a
    31  facility  operated or licensed by the office [of mental retardation and]

    32  for people with developmental disabilities, or [who] has  been  approved
    33  by  the commissioner of [mental retardation and] developmental disabili-
    34  ties in accordance with regulations promulgated  by  such  commissioner.
    35  Such regulations shall require that a physician or clinical psychologist
    36  possess  specialized  training  or  three  years  experience in treating
    37  developmental disabilities. A  record  of  such  consultation  shall  be
    38  included in the patient's medical record.
    39    §  8.  Subparagraph  ii  of  paragraph (c) of subdivision 3 of section
    40  2994-c of the public health law, as added by chapter 8 of  the  laws  of
    41  2010, is amended to read as follows:
    42    (ii)  If the attending physician makes an initial determination that a
    43  patient lacks decision-making capacity because  of  [mental  retardation

    44  or]  a  developmental  disability,  either  such physician must have the
    45  following qualifications, or another  professional  with  the  following
    46  qualifications  must  independently  determine whether the patient lacks
    47  decision-making capacity:  a  physician  or  clinical  psychologist  who
    48  either  is  employed  by  a [school] developmental disabilities services
    49  office named in section 13.17 of the mental hygiene law, or who has been
    50  employed for a minimum of two years to render  care  and  service  in  a
    51  facility  operated or licensed by the office [of mental retardation and]
    52  for people with developmental disabilities, or [who] has  been  approved
    53  by  the commissioner of [mental retardation and] developmental disabili-

    54  ties in accordance with regulations promulgated  by  such  commissioner.
    55  Such regulations shall require that a physician or clinical psychologist
    56  possess  specialized  training  or  three  years  experience in treating

        S. 6256--D                         56                         A. 9056--D
 
     1  developmental disabilities. A  record  of  such  consultation  shall  be
     2  included in the patient's medical record.
     3    §  9.  Subdivision  10 of section 2994-aa of the public health law, as
     4  added by chapter 8 of the laws of 2010, is amended to read as follows:
     5    10. "Hospital" means a general hospital as defined in subdivision  ten
     6  of  section  twenty-eight  hundred one of this chapter and a residential
     7  health care facility as defined in subdivision three of section  twenty-
     8  eight  hundred  one of this chapter or a hospital as defined in subdivi-

     9  sion ten of section 1.03 of the mental hygiene law or a [school]  devel-
    10  opmental  disabilities  services  office  named  in section 13.17 of the
    11  mental hygiene law.
    12    § 10. Subdivision 6 of section 2994-dd of the public  health  law,  as
    13  added by chapter 8 of the laws of 2010, is amended to read as follows:
    14    6.  The  commissioner may authorize the use of one or more alternative
    15  forms for issuing a nonhospital order not to resuscitate  (in  place  of
    16  the  standard  form prescribed by the commissioner under subdivision two
    17  of this section). Such alternative form or forms may  also  be  used  to
    18  issue  a  non-hospital do not intubate order. Any such alternative forms
    19  intended for use for persons with [mental retardation or]  developmental
    20  disabilities  or persons with mental illness who are incapable of making

    21  their own health care decisions or who have a  guardian  of  the  person
    22  appointed  pursuant  to  article eighty-one of the mental hygiene law or
    23  article seventeen-A of the surrogate's court procedure act must also  be
    24  approved  by  the commissioner of [mental retardation and] developmental
    25  disabilities or the commissioner of mental health,  as  appropriate.  An
    26  alternative  form  under  this  subdivision shall otherwise conform with
    27  applicable federal and state  law.  This  subdivision  does  not  limit,
    28  restrict  or  impair the use of an alternative form for issuing an order
    29  not to resuscitate in a general  hospital  or  residential  health  care
    30  facility  under article twenty-eight of this chapter or a hospital under
    31  subdivision ten of section 1.03 of the mental hygiene law [or  a  school
    32  under section 13.17 of the mental hygiene law].

    33    § 11. Subparagraph (B) of paragraph (vi) of subdivision (c) of section
    34  958  of the general municipal law, as amended by chapter 708 of the laws
    35  of 1993, is amended to read as follows:
    36    (B) a state-operated hospital or facility listed in [sections] section
    37  7.17 or 13.17 of the mental hygiene law [which], or a facility  operated
    38  by  the office for people with developmental disabilities, that has been
    39  designated by either the commissioner of mental health  or  the  commis-
    40  sioner  of  [mental  retardation  and]  developmental  disabilities  for
    41  contraction or discontinuance.   Provided however, that  not  more  than
    42  one-third of the zones designated pursuant to paragraph (iii) or (iv) of
    43  subdivision  (b) of section nine hundred sixty of this article, shall be

    44  based on applications filed pursuant to this  paragraph  [(vi)  of  this
    45  subdivision].
    46    §  12. Paragraph (b) of subdivision 4 of section 6810 of the education
    47  law, as added by chapter 519 of the laws of 2002, is amended to read  as
    48  follows:
    49    (b)  Oral  prescriptions  for  patients  in general hospitals, nursing
    50  homes, residential health care facilities as defined in section  twenty-
    51  eight  hundred  one  of  the  public health law, hospitals as defined in
    52  subdivision ten of section 1.03 of the mental hygiene law, or  [develop-
    53  mental  centers or developmental disabilities services offices listed in
    54  subdivision (b) of section 13.17 of the mental hygiene  law]  facilities
    55  operated  by  the office for people with developmental disabilities, may

    56  be communicated to a pharmacist serving as a  vendor  of  pharmaceutical

        S. 6256--D                         57                         A. 9056--D
 
     1  services  based upon a contractual arrangement by an agent designated by
     2  and under the direction of the prescriber or the institution. Such agent
     3  shall be a health care practitioner currently  licensed  and  registered
     4  under this title.
     5    §  13. Paragraph (b) of subdivision 7 of section 6810 of the education
     6  law, as amended by chapter 519 of the laws of 2002, is amended  to  read
     7  as follows:
     8    (b)  With  respect  to  drugs  other  than  controlled substances, the
     9  provisions of this subdivision shall not apply to  pharmacists  employed
    10  by  or  providing  services under contract to general hospitals, nursing
    11  homes, residential health care facilities as defined in section  twenty-

    12  eight  hundred  one  of  the  public health law, hospitals as defined in
    13  subdivision ten of section 1.03 of the mental hygiene law, or  [develop-
    14  mental  centers or developmental disabilities services offices listed in
    15  subdivision (b) of section 13.17 of the mental hygiene  law]  facilities
    16  operated  by  the office for people with developmental disabilities, who
    17  dispense drugs in the course of said employment  or  in  the  course  of
    18  providing  such  services  under  contract. With respect to such pharma-
    19  cists, each prescription shall be  transcribed  on  a  patient  specific
    20  prescription form.
    21    §  14.  Paragraph  1  of subdivision (b) of section 5.05 of the mental
    22  hygiene law, as amended by chapter 168 of the laws of 2010,  is  amended
    23  to read as follows:

    24    (1)  The  commissioners of the office of mental health, the office for
    25  people with developmental disabilities and the office of alcoholism  and
    26  substance  abuse  services shall constitute an inter-office coordinating
    27  council which, consistent with the autonomy of each office  for  matters
    28  within  its  jurisdiction,  shall  ensure  that the state policy for the
    29  prevention, care,  treatment  and  rehabilitation  of  individuals  with
    30  mental  illness  and  developmental  disabilities,  alcoholism,  alcohol
    31  abuse, substance abuse, substance dependence, and chemical dependence is
    32  planned,  developed  and  implemented  comprehensively;  that  gaps   in
    33  services  to  individuals  with multiple disabilities are eliminated and
    34  that no person is denied treatment and services because he  or  she  has
    35  more than one disability; that procedures for the regulation of programs

    36  which  offer  care and treatment for more than one class of persons with
    37  mental disabilities be coordinated between the offices having  jurisdic-
    38  tion  over  such programs; and that research projects of the institutes,
    39  as identified in section 7.17 or 13.17 of this chapter or as operated by
    40  the office for people with developmental disabilities,  are  coordinated
    41  to  maximize  the success and cost effectiveness of such projects and to
    42  eliminate wasteful duplication.
    43    § 15. Subdivision (b) of section 13.11 of the mental hygiene  law,  as
    44  added by chapter 978 of the laws of 1977, is amended to read as follows:
    45    (b)  The commissioner shall control the organization of the office and
    46  may continue, establish, discontinue, expand,  and  contract  facilities
    47  under his or her jurisdiction. The facilities set forth in section 13.17

    48  in state operations offices may not be discontinued by the commissioner.
    49  Units and facilities shall have such functions, duties, and responsibil-
    50  ities as may be assigned to them by the commissioner.
    51    § 16. Subdivisions 1 and 2 of section 13.34 of the mental hygiene law,
    52  as  amended  by  chapter 542 of the laws of 2011, are amended to read as
    53  follows:
    54    1. There shall be at each  developmental  center  facility  listed  in
    55  section  13.17 of this article, an ombudsman who shall be an employee of
    56  the commission on quality of care and advocacy for persons with disabil-

        S. 6256--D                         58                         A. 9056--D
 
     1  ities under article forty-five of this chapter and who shall be  respon-
     2  sible  for receiving and responding to any complaints regarding individ-

     3  ual clients residing in such facility.  The  ombudsman  shall  have  the
     4  following powers and duties:
     5    i.  to  advise and consult with parents, guardians, correspondents and
     6  other interested persons with  respect  to  any  complaints,  or  issues
     7  related to the conditions of clients' residents;
     8    ii. to review and attempt to remedy specific complaints with responsi-
     9  ble and appropriate staff;
    10    iii.  where  it appears that care has not been rendered as required by
    11  applicable standards to refer the complaint to the appropriate agency or
    12  body for its attention;
    13    iv. to receive and keep confidential  any  complaint,  information  or
    14  inquiry from any source. The records of the ombudsman shall be confiden-
    15  tial, and shall not be available to the public;
    16    v.  to  advise and consult with the board of visitors [of the develop-

    17  mental center] served by the ombudsman with respect to any complaints or
    18  issues relating to conditions of client's residence, treatment and  care
    19  and to regularly attend the meetings of such board; and
    20    vi.  to meet with the commissioner, or a representative of the commis-
    21  sioner, on a quarterly basis regarding systemic issues  in  the  ombuds-
    22  man's jurisdiction.
    23    2.  The  president  of  the  board  of visitors of each [developmental
    24  center facility listed in section 13.17 of this article] catchment  area
    25  of  the  state  operations region in which such member serves, shall, in
    26  consultation with the members of such board, recommend three persons  to
    27  serve  as  ombudsman at the facility. In making such recommendation, the
    28  president shall also consider the expressed opinion of parents,  guardi-

    29  ans and correspondents of clients residing at such facility. The persons
    30  so  recommended  as ombudsman shall have expressed an active interest or
    31  shall have had professional knowledge in advocating for persons who  are
    32  mentally  disabled.  The  commission on quality of care and advocacy for
    33  persons with disabilities shall select one of the recommended persons as
    34  ombudsman. The ombudsman may only be removed from office for just cause.
    35  An individual appointed as ombudsman shall be an exempt  class  employee
    36  as  defined  by  section  forty-one  of the civil service law and may be
    37  removed by the commissioner upon the recommendation of the president  of
    38  the  board  of  visitors,  for  cause after notice and opportunity for a
    39  hearing on the charges.
    40    § 17. Subdivision 1 of section 157 of  the  social  services  law,  as

    41  amended  by  section 43 of part B of chapter 436 of the laws of 1997, is
    42  amended to read as follows:
    43    1. Safety net assistance means  allowances  pursuant  to  section  one
    44  hundred  thirty-one-a  of  this article for all support, maintenance and
    45  need, and costs of suitable training in a trade to enable  a  person  to
    46  become  self-supporting,  furnished eligible needy persons in accordance
    47  with applicable provisions of law, by a municipal corporation, or a town
    48  where safety net assistance is a town charge, to persons or their depen-
    49  dents in their abode or habitation whenever possible and  includes  such
    50  relief  granted  to  veterans  under  existing laws but does not include
    51  hospital or institutional care, except as  otherwise  provided  in  this
    52  subdivision,  or  family  assistance    or  medical assistance for needy

    53  persons granted under titles ten and eleven of this article, respective-
    54  ly, or aid to persons receiving  federal  supplemental  security  income
    55  payments  and/or  additional state payments.   Safety net assistance may
    56  also be provided in a family home or boarding home, operated in  compli-

        S. 6256--D                         59                         A. 9056--D
 
     1  ance  with  the  regulations of the department, and on and after January
     2  first, nineteen hundred seventy-four, in facilities in which a person is
     3  receiving family care or residential care, as those terms  are  used  in
     4  title  six  of  [article five of] this [chapter] article, and to persons
     5  receiving care in a facility supervised by the office of alcoholism  and

     6  substance  abuse  services or in a residential facility for the mentally
     7  disabled approved, licensed or operated by the office of  mental  health
     8  or  the office [of mental retardation and] for people with developmental
     9  disabilities, other than those facilities defined in sections  7.17  and
    10  13.17  of  the  mental  hygiene  law, in a developmental center facility
    11  operated by the office for people  with  developmental  disabilities  or
    12  residential  care  centers  for  adults operated by the office of mental
    13  health, when such type of care is deemed  necessary.  Payments  to  such
    14  homes  and facilities for care and maintenance provided by them shall be
    15  at rates established pursuant to law and regulations of the  department.
    16  The  department,  however,  shall not establish rates of payment to such

    17  homes or facilities without approval of the director of the budget.
    18    § 18. Subparagraph (i) of paragraph (a) and clause A  of  subparagraph
    19  (i)  of  paragraph  (e) of subdivision 4 of section 1750-b of the surro-
    20  gate's court procedure act, as added by chapter 500 of the laws of 2002,
    21  are amended to read as follows:
    22    (i) be employed by a developmental disabilities services office  named
    23  in section 13.17 of the mental hygiene law or employed by the office for
    24  people  with developmental disabilities to provide treatment and care to
    25  people with developmental disabilities, or
    26    A. be employed by a developmental disabilities services  office  named
    27  in section 13.17 of the mental hygiene law or employed by the office for
    28  people  with developmental disabilities to provide treatment and care to

    29  people with developmental disabilities, or
    30    § 19. (a) Wherever the  terms  "directors  of  office  facilities"  or
    31  "directors  of schools" or "director of facilities" appear in the mental
    32  hygiene law in reference to a facility operated by the office for people
    33  with developmental  disabilities,  such  terms  are  hereby  changed  to
    34  "directors of state operations offices".
    35    (b)  The  legislative  bill  drafting commission is hereby directed to
    36  effectuate this provision, and  shall  be  guided  by  a  memorandum  of
    37  instruction  setting forth the specific provisions of law to be amended.
    38  Such memorandum shall be transmitted to the  legislative  bill  drafting
    39  commission within sixty days of enactment of this provision.  Such memo-
    40  randum  shall be issued jointly by the governor, the temporary president

    41  of the senate and the speaker of the assembly, or  by  the  delegate  of
    42  each.
    43    §  20.  The  commissioner  of the office for people with developmental
    44  disabilities shall provide notification to the  temporary  president  of
    45  the  senate  and  the  speaker  of  the  assembly  sixty days prior to a
    46  reduction in capacity of twenty persons or more or closure of a develop-
    47  mental center or other institutional setting which is  subject  to  such
    48  reduction  or closure pursuant to such commissioner's planned downsizing
    49  and closing of institutional capacity.
    50    § 21. This act shall take effect immediately, provided  however,  that
    51  on or before May 31, 2012 the office for people with developmental disa-
    52  bilities  shall submit a report to the temporary president of the senate
    53  and the speaker  of  the  assembly  on  implementation  related  to  the

    54  restructuring of developmental disabilities services offices. The office
    55  shall  also publish the report on the office's website. The report shall
    56  include but not be limited to: the plan timeline for transition of  each

        S. 6256--D                         60                         A. 9056--D
 
     1  of  the  developmental  disabilities  service offices into a state oper-
     2  ations offices of the office for people with developmental disabilities;
     3  the location of each state operations office, its catchment area, and  a
     4  list  of  services that will be administered under its jurisdiction; and
     5  the location of each developmental  disabilities  regional  office,  its
     6  catchment  area,  and  a  list  of  programs under its jurisdiction; and
     7  provided further that section twenty of this act  shall  expire  and  be
     8  deemed repealed on March 31, 2013.
 

     9                                   PART K
 
    10    Section  1.  Sections  19  and  21  of chapter 723 of the laws of 1989
    11  amending the mental hygiene law and other laws relating to comprehensive
    12  psychiatric emergency programs, as amended by section 1  of  part  F  of
    13  chapter 58 of the laws of 2008, are amended to read as follows:
    14    §  19. Notwithstanding any other provision of law, the commissioner of
    15  mental health shall, until July 1, [2012] 2016, be solely authorized, in
    16  his or her discretion,  to  designate  those  general  hospitals,  local
    17  governmental units and voluntary agencies which may apply and be consid-
    18  ered  for the approval and issuance of an operating certificate pursuant
    19  to article 31 of the mental hygiene law for the operation of  a  compre-
    20  hensive psychiatric emergency program.

    21    §  21.  This  act shall take effect immediately, and sections one, two
    22  and four through twenty of this act  shall  remain  in  full  force  and
    23  effect,  until  July  1,  [2012]  2016, at which time the amendments and
    24  additions made by such sections of  this  act  shall  be  deemed  to  be
    25  repealed,  and  any  provision of law amended by any of such sections of
    26  this act shall revert to its text as it existed prior to  the  effective
    27  date of this act.
    28    §  2.  This  act  shall take effect immediately and shall be deemed to
    29  have been in full force and effect on and after April 1, 2012.
 
    30                                   PART L
 
    31    Section 1.  (a) Notwithstanding any law, rule  or  regulation  to  the
    32  contrary,  two or more of the commissioners of the department of health,
    33  the office of mental health, the  office  of  alcoholism  and  substance

    34  abuse  services or the office for people with developmental disabilities
    35  are  jointly  authorized   to   establish   operating,   reporting   and
    36  construction  requirements,  as  well  as  joint survey requirements and
    37  procedures for entities operating under the auspices of one or more such
    38  agencies, that:
    39    (1) can demonstrate experience  and  competence  in  the  delivery  of
    40  health,  mental  health,  alcohol  and  substance  abuse services and/or
    41  services to persons with developmental disabilities and the capacity  to
    42  offer  the  integrated  delivery of such services at locations as may be
    43  approved by two or more of the respective commissioners; and
    44    (2) meet the standards that  may  be  established  by  the  respective
    45  commissioners  for  the  provision  of such services; provided, however,
    46  that an entity  meeting  the  standards  established  pursuant  to  this

    47  section  shall  not  be  required  to  be an integrated service provider
    48  pursuant to subdivision seven of section three hundred  sixty-five-l  of
    49  the social services law.
    50    (b)  In  establishing one or more sets of joint requirements or proce-
    51  dures for entities described in this section, each participating commis-
    52  sioner is authorized to waive any regulatory requirements, or to  deter-

        S. 6256--D                         61                         A. 9056--D
 
     1  mine   that   compliance   with   another  participating  commissioner's
     2  regulatory requirements shall be deemed to meet the regulatory  require-
     3  ments  of  his  or her agency, as may be necessary or desirable to avoid
     4  duplication  of requirements and/or to permit the integrated delivery of
     5  health and behavioral health services  in  an  efficient  and  effective
     6  manner.

     7    (c)  The  authority  granted  the  commissioners  in  this  section is
     8  intended to complement and supplement  the  authority  granted  to  such
     9  commissioners  pursuant  to  subdivision  seven of section three hundred
    10  sixty-five-l of the social services law.
    11    (d) All operating, reporting and construction requirements, as well as
    12  joint survey requirements and procedures, promulgated pursuant  to  this
    13  section  shall be so done as to increase efficiencies, and reduce admin-
    14  istrative burdens. The affected agency will post a notice on its website
    15  when regulations are waived or regulatory  requirements  are  deemed  to
    16  have  been  met.  No  regulation promulgated under this section, nor any
    17  action taken pursuant to subdivision (b) of this section, shall conflict
    18  with statutory requirements pertaining to entities operating  under  the

    19  auspices  of  the department of health, the office of mental health, the
    20  office of alcoholism and substance abuse services,  or  the  office  for
    21  people  with  developmental  disabilities. The promulgation of any regu-
    22  lation or rule, and the adoption of any emergency rule, pursuant to this
    23  section, shall be done in accordance with section two hundred two of the
    24  state administrative procedure act.
    25    § 2. This act shall take effect immediately and  shall  be  deemed  to
    26  have been in full force and effect on and after April 1, 2012.
 
    27                                   PART M
 
    28    Section  1. Paragraph h of subdivision 4 of section 1950 of the educa-
    29  tion law is amended by adding a new subparagraph 9 to read as follows:
    30    (9) To enter into contracts with the commissioner  of  the  office  of

    31  mental  health,  to  provide  special education and related services, in
    32  accordance with subdivision six-b of section thirty-two hundred  two  of
    33  this  chapter  to  patients  hospitalized  in  hospitals operated by the
    34  office of mental health who are between the ages of five and  twenty-one
    35  who  have not received a high school diploma. Any such proposed contract
    36  shall be subject to the review by  the  commissioner  and  his  and  her
    37  determination  that  it  is an approved cooperative educational service.
    38  Services provided pursuant to such contracts shall be provided  at  cost
    39  and  approved by the commissioner of the office of mental health and the
    40  director of the division of the budget, and  the  board  of  cooperative

    41  educational  services  shall  not  be  authorized  to charge any   costs
    42  incurred in providing such services to its component school districts.
    43    § 2. Section 3202 of the education law is  amended  by  adding  a  new
    44  subdivision 6-b to read as follows:
    45    6-b. The commissioner of mental health may meet his or her obligations
    46  under section 33.11 of the mental hygiene law by contracting pursuant to
    47  this  subdivision for educational services for children between the ages
    48  of five and twenty-one who do not hold a high school diploma and who are
    49  hospitalized in hospitals operated by the office of mental  health  with
    50  the  trustees  or  board  of education of any school district for educa-
    51  tional services or with a board of cooperative educational services  for

    52  the provision of special education and related services to such children
    53  in accordance with their individualized education programs. The costs of

        S. 6256--D                         62                         A. 9056--D
 
     1  such  education shall not be a charge upon a school district pursuant to
     2  section 33.11 of the mental hygiene law.
     3    (1)  The  education  department shall reimburse the school district or
     4  board of cooperative educational services providing educational services
     5  pursuant to this subdivision for the full cost of all services  pursuant
     6  to the terms of such contract.
     7    (2) The commissioner of mental health, with the approval of the direc-
     8  tor of the division of the budget, shall be authorized to transfer fund-

     9  ing  to  the  commissioner of education to the extent necessary to reim-
    10  burse school districts and boards of  cooperative  educational  services
    11  for services and educational programming provided under such contracts.
    12    (3)  Notwithstanding  any provision of law to the contrary, nothing in
    13  this subdivision or subparagraph nine of paragraph h of subdivision four
    14  of section nineteen hundred fifty of this chapter shall be construed  as
    15  requiring participation by any local school district or board of cooper-
    16  ative educational services.
    17    §  3.  The  commissioner  of  mental  health, in consultation with the
    18  commissioner of education, shall submit to  the  governor,  and  to  the
    19  temporary  president  of  the  senate and the speaker of the assembly, a

    20  report and recommendations by December 15, 2014, on the number of  chil-
    21  dren  hospitalized  in hospitals operated by the office of mental health
    22  who received educational services from school districts  and  boards  of
    23  cooperative  educational services pursuant to the provisions of this act
    24  in the 2012-2013 and 2013-2014 school years and the projected number  to
    25  be  served  in the 2014-2015 school year, the services provided to these
    26  children, and the actual or projected  cost  of  such  services.    Such
    27  report  shall  also  provide  detailed proposals regarding whether addi-
    28  tional actions should be taken to ensure that children  hospitalized  in
    29  hospitals  operated  by  the office of mental health continue to receive
    30  education programming and services as required by state and federal law.
    31    § 4. This act shall take effect July 1, 2012 and shall expire June 30,

    32  2015, when upon such date the provisions of this  act  shall  be  deemed
    33  repealed.
 
    34                                   PART N
 
    35    Section 1. Section 1.03 of the mental hygiene law is amended by adding
    36  three new subdivisions 56, 57 and 58 to read as follows:
    37    56.  "Substance  use  disorder" means the misuse of, dependence on, or
    38  addiction to alcohol and/or legal or illegal drugs  leading  to  effects
    39  that  are detrimental to the individual's physical and mental health, or
    40  the welfare of others  and  shall  include  alcoholism,  alcohol  abuse,
    41  substance  abuse,  substance dependence, chemical abuse, and/or chemical
    42  dependence.
    43    57. "Substance use disorder services" shall mean and include  examina-
    44  tion,  evaluation, diagnosis, care, treatment, rehabilitation, or train-

    45  ing of persons with  substance  use  disorders  and  their  families  or
    46  significant others.
    47    58.  "Behavioral  health services" means examination, diagnosis, care,
    48  treatment, rehabilitation, or training for persons with mental  illness,
    49  substance use disorder, or compulsive gambling disorder.
    50    § 2. The mental hygiene law is amended by adding a new section 5.06 to
    51  read as follows:
    52  § 5.06 Behavioral health services advisory council.
    53    (a)  There is hereby created within the department a behavioral health
    54  services advisory council, the purpose of which shall be to  advise  the

        S. 6256--D                         63                         A. 9056--D
 

     1  offices  of mental health and alcoholism and substance abuse services on
     2  matters relating to the provision of behavioral health services;  issues
     3  of  joint  concern  to the offices, including the integration of various
     4  behavioral  health  services  and  the  integration of behavioral health
     5  services with health services; and issues related  to  the  delivery  of
     6  behavioral  health  services  that  are  responsive  to local, state and
     7  federal concerns. The council shall  consist  of  the  commissioners  of
     8  mental  health and of alcoholism and substance abuse services, who shall
     9  not have the right to vote, the chair of the conference of local  mental
    10  hygiene  directors  or  his  or  her  designee, and twenty-eight members

    11  appointed by the governor, upon the advice and consent  of  the  senate.
    12  Members  shall  be appointed only if they have professional knowledge in
    13  the care of persons receiving behavioral health services, or  an  active
    14  interest in the behavioral health services system.
    15    (b)  The governor shall designate one of the members of the council as
    16  chair. At least one-half of the members of  the  council  shall  not  be
    17  providers  of  behavioral  health services.   Membership shall reflect a
    18  balanced representation of persons with interests in mental  health  and
    19  substance use disorder services and shall include:
    20    (1)  at  least  five  current or former consumers of behavioral health
    21  services;

    22    (2) at least three individuals who are parents or relatives of current
    23  or former consumers of behavioral health services;
    24    (3) at least three members who are not providers of behavioral  health
    25  services  and who represent non-governmental organizations, such as not-
    26  for-profit  entities  representing  health  or  behavioral  health  care
    27  employees, private payors of behavioral health services, or other organ-
    28  izations concerned with the provision of behavioral health services;
    29    (4)  at least five representatives of providers of services to persons
    30  with mental illness and at least five representatives  of  providers  of
    31  services  to  persons with substance use disorders, at least two of whom

    32  shall be physicians and  at  least  one  of  whom  shall  have  provided
    33  services  to  veterans  who served in a combat theater or combat zone of
    34  operations;
    35    (5) one member appointed on the recommendation of the  state  director
    36  of  the  division  of  veterans' affairs and one member appointed on the
    37  recommendation of the adjutant general of the division of  military  and
    38  naval affairs, at least one of whom shall be a current or former consum-
    39  er of mental health services or substance use disorder services who is a
    40  veteran  who has served in a combat theater or combat zone of operations
    41  and is a member of a veterans organization;
    42    (6) at least three representatives of local governments or other state

    43  and local agencies concerned with the  provision  of  behavioral  health
    44  services; and
    45    (7) at least two members who are also members of the public health and
    46  health  planning  council  pursuant to section two hundred twenty of the
    47  public health law.
    48    (c) Members shall be appointed for  terms  of  three  years  provided,
    49  however,  that  of  the  members  first  appointed,  one-third  shall be
    50  appointed for one year terms and one-third shall be  appointed  for  two
    51  year  terms.  Vacancies  shall  be filled in the same manner as original
    52  appointments for the remainder of any unexpired term. No person shall be
    53  an appointed member of the council for more than six years in any period
    54  of twelve consecutive years.

        S. 6256--D                         64                         A. 9056--D
 
     1    (d) The council shall meet at least four times in each  full  calendar
     2  year.  The  council  shall  meet  at  the request of its chair or either
     3  commissioner.
     4    (e)  The council shall establish such committees as it deems necessary
     5  to address the service needs  of  special  populations  and  to  address
     6  particular  subjects  of importance in the development and management of
     7  behavioral health services.
     8    (f) The council may consider any matter relating to the improvement of
     9  behavioral health services in the state and shall advise the commission-
    10  ers on any such matter, including, but not limited to:

    11    (1) care and services to persons  with  behavioral  health  disorders,
    12  including  special  and  underserved  populations  as  determined by the
    13  commissioner;
    14    (2) financing behavioral health services;
    15    (3) integration of behavioral health services with health services;
    16    (4) care and services  for  persons  with  co-occurring  disorders  or
    17  multiple disabilities;
    18    (5) prevention of behavioral health disorders; and
    19    (6) improvement of care in state operated or community based programs,
    20  recruitment,  education and training of qualified direct care personnel,
    21  and protection of the interests of employees affected by adjustments  in
    22  the behavioral health service system.

    23    (g)  The  council shall, in cooperation with the commissioners, estab-
    24  lish statewide goals and objectives for services to persons with  behav-
    25  ioral health disorders, pursuant to section 5.07 of this article.
    26    (h)  (1) The council shall review the portion of the statewide plan to
    27  be developed and updated  annually  by  the  commissioners  pursuant  to
    28  section  5.07 of this article, and report its recommendations thereon to
    29  the commissioners.
    30    (2) The council shall review any mental health or substance use compo-
    31  nent of statewide health plans developed in accordance with any applica-
    32  ble federal law, and shall report its  recommendations  thereon  to  the
    33  commissioners.

    34    (i) The council shall review applications filed in accordance with:
    35    (1)  section  31.22  of  this chapter for approval of incorporation or
    36  establishment of a facility, and  section  31.23  of  this  chapter  for
    37  approval  of  the construction of a facility for which approval from the
    38  commissioner of mental health is required; and
    39    (2) section 32.29 or 32.31 of this chapter for  approval  of  incorpo-
    40  ration or establishment or construction of a facility for which approval
    41  to operate is required from the commissioner of alcoholism and substance
    42  abuse  services  pursuant  to article thirty-two of this chapter, and as
    43  otherwise requested by such commissioner;
    44    (j)  The  council  shall  be  notified  of,  and  may  review  at  its

    45  discretion,  any  closure  of a hospital or ward thereof operated by the
    46  office of mental health or office  of  alcoholism  and  substance  abuse
    47  services,  and  may issue recommendations pertaining to issues including
    48  community reinvestment and continuity of care. All such  recommendations
    49  shall  be  provided  to  the relevant commissioner or commissioners, the
    50  temporary president of the senate and the speaker of the assembly.
    51    (k) At least sixty days prior to the commissioners' final approval  of
    52  rules  and  regulations  under their respective jurisdiction, other than
    53  emergency rules and regulations and regulations promulgated pursuant  to
    54  section  43.01  of  this  chapter,  the  commissioners shall submit such

    55  proposed rules and regulations to the council for its review. The  coun-
    56  cil  shall  review  all  proposed  rules  and regulations and report its

        S. 6256--D                         65                         A. 9056--D
 
     1  recommendations thereon to the  commissioners  within  sixty  days.  The
     2  commissioner  having  statutory  jurisdiction  over the proposed rule or
     3  regulation shall not act in a manner inconsistent with  the  recommenda-
     4  tions  of  the  council  without  first  appearing before the council to
     5  report the reasons therefor. The council, upon a majority  vote  of  its
     6  members,  may require that an alternative approach to the proposed rules
     7  and regulations be published with the notice of the proposed  rules  and

     8  regulations pursuant to section two hundred two of the state administra-
     9  tive  procedure  act. When an alternative approach is published pursuant
    10  to this section, the commissioner having statutory jurisdiction  of  the
    11  subject  proposed  rule  or  regulation  shall state the reasons for not
    12  selecting such alternative approach.
    13    (l) The council, by a majority vote of its members, may propose  rules
    14  and  regulations on any matter within the regulatory jurisdiction of the
    15  offices of mental health or alcoholism  and  substance  abuse  services,
    16  other  than  establishment of fee schedules pursuant to section 43.01 of
    17  this chapter, and forward such proposed rules and  regulations  to  both

    18  commissioners for review and consideration; provided, however, that only
    19  the  approval  of  the  commissioner  with statutory jurisdiction of the
    20  proposed rule or regulation shall be required. Prior to such commission-
    21  er's final approval and promulgation of such proposed  rules  and  regu-
    22  lations, if such rules and regulations are modified in any respect, they
    23  shall  be  submitted  to the council pursuant to subdivision (k) of this
    24  section. If such commissioner determines not to promulgate such proposed
    25  rules and regulations, the commissioner shall appear before the  council
    26  to report the reasons therefor.
    27    (m) The members of the council shall receive no compensation for their

    28  services  but  shall be reimbursed for expenses actually and necessarily
    29  incurred in the performance of their duties.
    30    (n) The commissioners, upon request of the  council,  shall  designate
    31  one or more officers or employees from either or both offices to provide
    32  administrative support services to the council, and may assign from time
    33  to time such other employees as the council may request.
    34    (o)  No  civil action shall be brought in any court against any member
    35  of the behavioral health services advisory council  for  any  act  done,
    36  failure  to  act, or statement or opinion made, while discharging his or
    37  her duties as a member of the council, without leave from a  justice  of

    38  the  supreme  court,  first  had and obtained. In any event, such member
    39  shall not be liable for damages in any such action if he or she acted in
    40  good faith, with reasonable care and upon probable cause.    Members  of
    41  the  council  shall  be  considered  public officers for the purposes of
    42  section seventeen of the public officers law.
    43    (p) The council may establish written bylaws.
    44    § 3. The section heading, subdivision (a), the opening  paragraph  and
    45  paragraphs  1  and  3  of subdivision (b) and subdivision (c) of section
    46  5.07 of the mental hygiene law, the section heading as amended by  chap-
    47  ter  55  of the laws of 1992, subdivision (a), the opening paragraph and
    48  paragraphs 1 and 3 of subdivision (b) and subdivision (c) as amended  by

    49  chapter  223  of  the  laws  of  1992, paragraph 1 of subdivision (a) as
    50  amended by chapter 37 of the laws of  2011,  the  opening  paragraph  of
    51  paragraph  1 of subdivision (b) as amended by chapter 168 of the laws of
    52  2010, subparagraphs h and i as amended and subparagraph j of paragraph 1
    53  of subdivision (b) as added by chapter 413 of the laws of 2009 and para-
    54  graph 3 of subdivision (b) as renumbered by chapter 322 of the  laws  of
    55  1992, are amended to read as follows:

        S. 6256--D                         66                         A. 9056--D
 
     1  Establishment  of [statewide goals and objectives;] statewide comprehen-
     2           sive plans of services for [the mentally disabled] persons with
     3           mental disabilities.

     4    (a)  (1) The [mental health] behavioral health services advisory coun-
     5  cil and the advisory [councils] council  on  developmental  disabilities
     6  [and  alcoholism  and  substance  abuse services] shall [each establish]
     7  provide recommendations for statewide priorities and goals  [and  objec-
     8  tives]  to  guide comprehensive planning, resource allocation and evalu-
     9  ation processes for state and local services  for  persons  with  mental
    10  illness,  developmental disabilities [and], and/or those [suffering from
    11  chemical abuse  or  dependence,  respectively]  with  substance  use  or
    12  compulsive gambling disorders. Such goals and objectives shall:

    13    a.  be  measurable  in terms of attainment and focused on outcomes for
    14  those being served;
    15    b. be developed in collaboration with, and communicated to,  providers
    16  of  services,  department  facilities,  consumers and consumer represen-
    17  tatives, and other appropriate state and local governmental agencies;
    18    c. [require that all state and local public and private  services  for
    19  persons  with  mental disabilities be organized, staffed and financed to
    20  best meet the needs of all  persons  with  mental  disabilities  whether
    21  receiving in-patient or non in-patient services;
    22    d.]  reflect  the  partnership  between  state  and local governmental
    23  units; and
    24    [e.] d. emphasize [that gaps in services be filled and  that  services

    25  are  provided to persons with mental disabilities] the need to integrate
    26  behavioral health and health services.
    27    (2) Such advisory councils shall [establish, review, augment or delete
    28  from such goals and objectives, as appropriate,] accomplish their duties
    29  by means of a [continuing annual goal-setting] process which is:
    30    a. open, visible and accessible to the public; and
    31    b. consistent with the  statewide  and  federally  mandated  planning,
    32  appropriation  and  evaluation  processes and activities for services to
    33  [the mentally disabled] persons with mental disabilities.
    34    (3) The advisory councils are hereby empowered to hold public hearings
    35  and meetings to enable them to accomplish their duties.

    36    Statewide comprehensive plan for services to [the  mentally  disabled]
    37  persons with mental disabilities.
    38    (1)  The  office of mental health, the office for people with develop-
    39  mental disabilities and the office of  alcoholism  and  substance  abuse
    40  services shall [each] formulate a statewide comprehensive five-year plan
    41  for  the  provision  of  all  state  and local services for persons with
    42  mental illness [and], developmental  disabilities,  [and]  and/or  those
    43  [suffering from alcoholism and] with substance [abuse, respectively] use
    44  or  compulsive  gambling disorders.   [Each] The statewide comprehensive

    45  plan shall be [formulated from] based upon an analysis of local [compre-
    46  hensive] services plans developed by each local governmental unit, [with
    47  participation of]  in  consultation  with  consumers,  consumer  groups,
    48  providers  of  services  and  departmental  facilities [furnishing] that
    49  furnish behavioral health services [to individuals with mental disabili-
    50  ties of the area] in conformance with  statewide  priorities  and  goals
    51  [and objectives] established [by] with recommendations of the behavioral
    52  health services advisory council [of each office] and the advisory coun-

    53  cil on developmental disabilities. [Each] The plan shall:
    54    a.  identify  [needs  and  problems which must be addressed during the
    55  next ensuing five years which such plan encompasses]  statewide  priori-
    56  ties;

        S. 6256--D                         67                         A. 9056--D
 
     1    b.  specify  [time-limited] statewide goals [to meet those needs] that
     2  reflect the statewide priorities and are focused on  obtaining  positive
     3  measurable outcomes;
     4    c. [identify resources to achieve the goals, including but not limited
     5  to resource reallocations;
     6    d. establish] propose strategies and initiatives to address the prior-

     7  ities  [for resource allocation] and facilitate achievement of statewide
     8  goals;
     9    [e. define the  authority  and  responsibility  for  state  and  local
    10  participation  in  the  delivery of services] d.   identify services and
    11  supports, which may include programs run  or  led  by  peers,  that  are
    12  designed  to  promote  the  health  and  wellness of persons with mental
    13  illness, developmental disabilities, and/or substance use or  compulsive
    14  gambling disorders;
    15    [f.  propose programs to achieve the goals, which programs may include
    16  direct services, development of multi-purpose facilities, contracts  for
    17  services, and innovative financial and organizational relationships with

    18  public and private providers;
    19    g.  identify  services and programs that assist the informal caregiver
    20  to care for the mentally disabled; make recommendations to  enhance  the
    21  ability of the informal caregiver to continue providing care; and devel-
    22  op strategies for creating informal caregivers for clients in the commu-
    23  nity who do not have a system in place;
    24    h. analyze] e. provide analysis of current and anticipated utilization
    25  of  state  and local, and public and private facilities [and], programs,
    26  services, and/or supports;
    27    [i.] f. encourage and promote person-centered, culturally and linguis-

    28  tically competent  community-based  programs  [which]  ,  services,  and
    29  supports  that  reflect  the partnership between state and local govern-
    30  mental units; and
    31    [j.] g. include progress reports on the implementation of both  short-
    32  term  and  long-term  recommendations  of  the  children's plan required
    33  pursuant to section four hundred eighty-three-f of the  social  services
    34  law.
    35    (3)  The commissioners of each of the offices shall be responsible for
    36  the development of such statewide five-year plan for services within the
    37  jurisdiction of their respective offices and  after  giving  due  notice
    38  shall  conduct  one or more public hearings on such plan. The behavioral
    39  health services advisory council [of each office] and the advisory coun-

    40  cil on developmental disabilities shall review the statewide  five  year
    41  comprehensive  plan  developed  by such office or offices and report its
    42  recommendations thereon to  such  commissioner  or  commissioners.  Each
    43  commissioner  shall  submit the plan, with appropriate modifications, to
    44  the governor no later than the first day of [October] November  of  each
    45  year in order that such plan may be considered with the estimates of the
    46  offices  for the preparation of the executive budget of the state of New
    47  York for the next succeeding state  fiscal  year.    [Each  commissioner
    48  shall also submit such plan to the legislature. The statewide plan] Such
    49  comprehensive  plan  shall  be  submitted to the legislature and also be

    50  posted to the website of each office. Statewide plans  shall  [be  reas-
    51  sessed  and updated at least annually to encompass the next ensuing five
    52  years to] ensure responsiveness to changing needs  and  goals  and  [to]
    53  shall  reflect  the development of new information and the completion of
    54  program evaluations. An  interim  report  detailing  the  commissioner's
    55  actions in fulfilling the requirements of this section in preparation of
    56  the  plan  and modifications in the plan of services being considered by

        S. 6256--D                         68                         A. 9056--D
 
     1  the commissioner shall be submitted to the governor and the  legislature
     2  on  or  before  the fifteenth day of [February] March of each year. Such

     3  interim report shall include, but need not be limited to:
     4    (a)  actions  to  include participation of consumers, consumer groups,
     5  providers of services and departmental facilities, as required  by  this
     6  subdivision; and
     7    (b)  any modifications in the plan of services being considered by the
     8  commissioner, to include:  (i)  compelling  budgetary,  programmatic  or
     9  clinical  justifications  or  other  major  appropriate  reason  for any
    10  significant new statewide  programs  or  policy  changes  from  a  prior
    11  (approved)  five year comprehensive plan; and (ii) procedures to involve
    12  or inform local governmental units of such actions or plans.
    13    (c) Three year capital plan. (1) On or before July first of each year,
    14  the commissioners of the offices of the  department  of  mental  hygiene
    15  shall  each submit to the advisory council of their respective offices a

    16  statewide three year capital plan for facilities within the jurisdiction
    17  of their respective offices.  The  capital  plan  shall  set  forth  the
    18  projects  proposed to be designed, constructed, acquired, reconstructed,
    19  rehabilitated or otherwise substantially altered pursuant  to  appropri-
    20  ation  to  meet the capital development needs of the respective agencies
    21  for the next ensuing three years; the years of such  plan  shall  corre-
    22  spond to the years of the statewide five year plan as required by subdi-
    23  vision (b) of this section.
    24    (2)  Such  plan  for each office shall include but not be limited to a
    25  detailed project schedule indicating the location by county  or  borough
    26  and  estimated  cost of each project, the anticipated dates on which the
    27  design and construction of the project  is  to  commence,  the  proposed

    28  method  of financing for the project, the estimated economic life of the
    29  project  and  whether  the  proposed  project  constitutes  design,  new
    30  construction or rehabilitation.
    31    (3)  Such  plan  shall  further  specify  for each project whether the
    32  project is to be a residential or nonresidential facility,  a  state  or
    33  voluntary  operated  facility,  and, the number of clients, by source of
    34  clients, proposed to utilize the facility. The information on the source
    35  of the client shall include but not  be  limited  to  identification  of
    36  clients  currently  living  independently,  or at home with families, or
    37  with caretakers, clients defined by their respective agencies as special
    38  populations, or clients currently residing in an  institutional  setting
    39  under the jurisdiction of the offices of the department.
    40    (4)  The  advisory council of the appropriate office shall review such

    41  plan and report its recommendation to the  commissioner  for  inclusion,
    42  provided, however, that the [mental] behavioral health services advisory
    43  council  shall forward its comments on the capital plan of the office of
    44  mental health to the mental health planning council which shall  forward
    45  such  recommendations after review to the commissioner of mental health.
    46  The commissioner shall submit his or her plan with the formal  recommen-
    47  dations  of the advisory council of his or her office and any subsequent
    48  appropriate modifications to the governor no later than the first day of
    49  [October] November of each year or concurrent with the annual submission
    50  of estimates and information required by section one of article seven of
    51  the constitution in order that such plans shall be considered  with  the

    52  estimates  of the offices for the preparation of the executive budget of
    53  the state of New York for the next succeeding  state  fiscal  year.  The
    54  commissioners shall also submit such plans to the chairmen of the senate
    55  finance committee and the assembly ways and means committee.

        S. 6256--D                         69                         A. 9056--D
 
     1    (5)  Each  statewide  three  year capital plan for facilities shall be
     2  evaluated and revised annually to encompass  the  fiscal  year  then  in
     3  progress  and the next ensuing two fiscal years to ensure responsiveness
     4  to the changing needs and goals of the department, and  to  reflect  the
     5  development of new information and project completion.
     6    § 4. Section 7.05 of the mental hygiene law is REPEALED.
     7    §  5.  Subdivision  (c) of section 13.05 of the mental hygiene law, as

     8  amended by chapter 37 of the  laws  of  2011,  is  amended  to  read  as
     9  follows:
    10    (c)  The  developmental  disabilities  advisory  council shall have no
    11  executive, administrative or appointive duties. The council  shall  have
    12  the  duty to foster public understanding and acceptance of developmental
    13  disabilities. It shall, in cooperation with the commissioner of develop-
    14  mental disabilities, [establish] provide recommendations  for  statewide
    15  priorities  and goals [and objectives] for services for individuals with
    16  developmental disabilities and shall advise the commissioner on  matters
    17  related  to  development  and  implementation  of the [OPWDD's triennial
    18  state  developmental  disabilities]  statewide  comprehensive  plan   as

    19  required  under  [paragraph  two  of subdivision (b) of] section 5.07 of
    20  this chapter. The advisory council shall have the power to consider  any
    21  matter  relating to the improvement of the state developmental disabili-
    22  ties program and shall advise the commissioner of developmental disabil-
    23  ities thereon and on any matter relating to  the  performance  of  their
    24  duties  with relation to individuals with developmental disabilities and
    25  on policies, goals, budget and operation of  developmental  disabilities
    26  services.
    27    § 6. Section 19.05 of the mental hygiene law is REPEALED.
    28    §  7.   Section 220 of the public health law, as amended by section 45
    29  of part A of chapter 58 of the laws of  2010,  is  amended  to  read  as
    30  follows:
    31    §  220.  Public  health  and  health  planning council; appointment of

    32  members. There shall continue to be in the department  a  public  health
    33  and  health planning council to consist of the commissioner and fourteen
    34  members to be appointed by the governor with the advice and  consent  of
    35  the  senate;  provided  that effective December first, two thousand ten,
    36  the membership of the council shall  consist  of  the  commissioner  and
    37  twenty-four  members to be appointed by the governor with the advice and
    38  consent of the senate. Membership on the council shall be reflective  of
    39  the  diversity  of the state's population including, but not limited to,
    40  the various geographic areas and  population  densities  throughout  the
    41  state.  The  members  shall include representatives of the public health
    42  system, health care providers that  comprise  the  state's  health  care
    43  delivery system, individuals with expertise in the clinical and adminis-

    44  trative  aspects  of  health care delivery, issues affecting health care
    45  consumers, health planning, health  care  financing  and  reimbursement,
    46  health care regulation and compliance, and public health practice and at
    47  least  two  members  shall  also  be  members of the [mental] behavioral
    48  health services advisory council; at least four members shall be  repre-
    49  sentatives  of  general  hospitals  or  nursing  homes; and at least one
    50  member shall be a representative of each of the following  groups:  home
    51  care  agencies,  diagnostic  and  treatment centers, health care payors,
    52  labor organizations for health care employees, and health care  consumer
    53  advocacy organizations.
    54    §  8.  This  act  shall take effect immediately and shall be deemed to
    55  have been in full force and effect on and after April 1, 2012; provided,

    56  however, that sections one, two and five of this act shall  take  effect

        S. 6256--D                         70                         A. 9056--D
 
     1  on  the  one hundred eightieth day after it shall have become a law, and
     2  sections three, four and six of this act shall take effect upon  certif-
     3  ication  by  the  commissioner  of mental health and the commissioner of
     4  alcoholism  and  substance  abuse  services  that  the behavioral health
     5  services advisory council has sufficient confirmed membership to perform
     6  its functions, powers and duties pursuant to section two  of  this  act;
     7  provided  that the commissioner of mental health shall notify the legis-
     8  lative bill drafting commission upon the date that such commissioner and
     9  the commissioner of alcoholism and substance abuse services have  certi-

    10  fied that the behavioral health services advisory council has sufficient
    11  confirmed  membership  to  perform  its  functions, powers and duties in
    12  order that the commission may maintain an accurate and timely  effective
    13  data  base  of the official text of the laws of the state of New York in
    14  furtherance of effectuating the provisions of section 44 of the legisla-
    15  tive law and section 70-b of the public officers law.
 
    16                                   PART O
 
    17    Section 1. Subdivision (b) of section 7.17 of the mental hygiene  law,
    18  as  amended by section 1 of part G of chapter 59 of the laws of 2011, is
    19  amended to read as follows:
    20    (b) There shall be in the office the hospitals  named  below  for  the
    21  care,  treatment  and  rehabilitation of persons with mental illness and
    22  for research and teaching in the science and  skills  required  for  the

    23  care, treatment and rehabilitation of such persons with mental illness.
    24    Greater Binghamton Health Center
    25    Bronx Psychiatric Center
    26    Buffalo Psychiatric Center
    27    Capital District Psychiatric Center
    28    Central New York Psychiatric Center
    29    Creedmoor Psychiatric Center
    30    Elmira Psychiatric Center
    31    [Hudson River Psychiatric Center]
    32    Kingsboro Psychiatric Center
    33    Kirby Forensic Psychiatric Center
    34    Manhattan Psychiatric Center
    35    Mid-Hudson Forensic Psychiatric Center
    36    Mohawk Valley Psychiatric Center
    37    Nathan S. Kline Institute for Psychiatric Research
    38    New York State Psychiatric Institute
    39    Pilgrim Psychiatric Center
    40    Richard H. Hutchings Psychiatric Center
    41    Rochester Psychiatric Center
    42    Rockland Psychiatric Center
    43    St. Lawrence Psychiatric Center
    44    South Beach Psychiatric Center

    45    [Bronx Children's Psychiatric Center
    46    Brooklyn Children's Center
    47    Queens Children's Psychiatric Center]
    48    New York City Children's Center
    49    Rockland Children's Psychiatric Center
    50    Sagamore Children's Psychiatric Center
    51    Western New York Children's Psychiatric Center
    52    The  New  York  State  Psychiatric  Institute  and The Nathan S. Kline
    53  Institute for Psychiatric Research are designated as institutes for  the
    54  conduct  of medical research and other scientific investigation directed

        S. 6256--D                         71                         A. 9056--D
 
     1  towards furthering knowledge of the etiology, diagnosis,  treatment  and
     2  prevention  of  mental  illness.  [The  Brooklyn  Children's Center is a

     3  facility operated by the office to provide community-based mental health
     4  services for children with serious emotional disturbances.] Whenever the
     5  term  Bronx Children's Psychiatric Center, Brooklyn Children's Psychiat-
     6  ric Center and Queens Children's Psychiatric Center is  referred  to  or
     7  designated  in  any  regulation,  contract or document pertaining to the
     8  functions,  powers,  obligations  and  duties  hereby  transferred   and
     9  assigned,  such reference or designation shall be deemed to refer to the
    10  New York City Children's Center.
    11    § 2. Notwithstanding the provisions of subdivisions  (b)  and  (e)  of
    12  section  7.17  of  the  mental  hygiene law, section 41.55 of the mental
    13  hygiene law, or any other law to the  contrary,  the  office  of  mental

    14  health  is  authorized to close, consolidate, reduce, transfer or other-
    15  wise redesign services of hospitals, other facilities and programs oper-
    16  ated by the office  of  mental  health,  and  to  implement  significant
    17  service  reductions  and  reconfigurations  according to this section as
    18  shall be determined by the commissioner of mental health to be necessary
    19  for the cost-effective and efficient operation of such hospitals,  other
    20  facilities and programs. One of the intents of actions taken that result
    21  in  closure,  consolidation,  reduction,  transfer  or other redesign of
    22  services of hospitals is to reinvest savings such that,  to  the  extent
    23  practicable,  comparable  or  greater  levels  of community based mental
    24  health services will be provided to persons with mental illness in  need
    25  of  services within the catchment areas of such hospitals, as determined

    26  by the commissioner of mental health with approval from the director  of
    27  the division of the budget.
    28    (a) In addition to the closure, consolidation or merger of one or more
    29  facilities,  the  commissioner of mental health is authorized to perform
    30  any significant service  reductions  that  would  reduce  inpatient  bed
    31  capacity  by  up to 400 beds, which shall include but not be limited to,
    32  closures of wards at a state-operated psychiatric center or the  conver-
    33  sion  of  beds  to  transitional  placement  programs, provided that the
    34  commissioner provide at least 45 days notice of such reductions  to  the
    35  temporary  president  of  the senate and the speaker of the assembly and
    36  simultaneously post such notice upon its public  website.  In  assessing
    37  which  significant  service  reductions  to  undertake, the commissioner

    38  shall consider data related to inpatient census, indicating  nonutiliza-
    39  tion or under utilization of beds, and the efficient operation of facil-
    40  ities.
    41    (b)  At  least 75 days prior to the anticipated closure, consolidation
    42  or merger of any hospitals named in subdivision (b) of section  7.17  of
    43  the  mental hygiene law, the commissioner of mental health shall provide
    44  notice of such closure, consolidation or merger to the temporary  presi-
    45  dent  of  the  senate,  and speaker of the assembly, the chief executive
    46  officer of the county in which the facility is located, and  shall  post
    47  such  notice  upon its public website. The commissioner shall be author-
    48  ized to conduct any and all preparatory actions which may be required to
    49  effectuate such closures during such 75 day period.  In assessing  which
    50  of  such hospitals to close, the commissioner shall consider the follow-

    51  ing factors: (1) the size, scope and type of services  provided  by  the
    52  hospital; (2) the relative quality of the care and treatment provided by
    53  the  hospital,  as  may  be  informed by internal or external quality or
    54  accreditation reviews; (3) the current and  anticipated  long-term  need
    55  for  the types of services provided by the facility within its catchment
    56  area, which may include, but not be limited to, services for  adults  or

        S. 6256--D                         72                         A. 9056--D
 
     1  children,  or other specialized services, such as forensic services; (4)
     2  the availability of staff sufficient to address the current  and  antic-
     3  ipated  long  term  service  needs; (5) the long term capital investment
     4  required  to  ensure  that the facility meets relevant state and federal

     5  regulatory and capital construction requirements, and national  accredi-
     6  tation  standards; (6) the proximity of the facility to other facilities
     7  with space that could accommodate anticipated need, the relative cost of
     8  any necessary renovations of such space, the relative potential  operat-
     9  ing  efficiency  of  such  facilities,  and the size, scope and types of
    10  services provided by the other facilities; (7) anticipated savings based
    11  upon economies of scale or other factors; (8)  community  mental  health
    12  services  available  in  the  facility catchment area and the ability of
    13  such community mental health services  to  meet  the  behavioral  health
    14  needs  of  the  impacted  consumers; (9) the obligations of the state to
    15  place persons with mental disabilities in community settings rather than
    16  in institutions, when appropriate; and (10) the  anticipated  impact  of

    17  the closure on access to mental health services.
    18    (c)  Any  transfers of inpatient capacity or any resulting transfer of
    19  functions shall be authorized to be made by the commissioner  of  mental
    20  health  and  any transfer of personnel upon such transfer of capacity or
    21  transfer of functions shall  be  accomplished  in  accordance  with  the
    22  provisions of section 70 of the civil service law.
    23    § 3. Severability clause. If any clause, sentence, paragraph, subdivi-
    24  sion,  section  or  part  of  this act shall be adjudged by any court of
    25  competent jurisdiction to be invalid, such judgment  shall  not  affect,
    26  impair,  or  invalidate  the remainder thereof, but shall be confined in
    27  its operation to the clause, sentence, paragraph,  subdivision,  section
    28  or part thereof directly involved in the controversy in which such judg-

    29  ment shall have been rendered. It is hereby declared to be the intent of
    30  the  legislature  that  this  act  would  have been enacted even if such
    31  invalid provisions had not been included herein.
    32    § 4. This act shall take effect immediately and  shall  be  deemed  to
    33  have  been in full force and effect on and after April 1, 2012; provided
    34  that the date for any closure or  consolidation  pursuant  to  this  act
    35  shall  be  on a date certified by the commissioner of mental health; and
    36  provided further, however, that this act  shall  expire  and  be  deemed
    37  repealed March 31, 2013.
 
    38                                   PART P
 
    39    Section  1.  Section  10.06  of  the  mental hygiene law is amended by
    40  adding a new subdivision (l) to read as follows:
    41    (l) (1) If a respondent who  is  transferred  to  a  secure  treatment

    42  facility  pursuant  to  subdivision  (k)  of  this  section, has not yet
    43  reached his or her maximum expiration date on the underlying determinate
    44  or indeterminate sentence of imprisonment, is  significantly  disruptive
    45  of  the  treatment program at such secure treatment facility, the person
    46  in charge of treatment programs at such facility may initiate a proceed-
    47  ing to obtain an order that the respondent shall be transferred  to  the
    48  custody  of  the department of corrections and community supervision for
    49  such conduct.
    50    (2) Such a proceeding shall be initiated by a  written  notice  served
    51  upon  the  respondent, and provided by mail to his or her counsel (or by
    52  electronic mail or facsimile to a destination identified by such counsel

    53  for such purpose). Such notice shall identify in detail the dates, times
    54  and nature of the alleged misconduct pursuant to paragraph one  of  this

        S. 6256--D                         73                         A. 9056--D
 
     1  subdivision,  the possible sanctions, and the date, time and location of
     2  the hearing.
     3    (3)  A  hearing on the allegations shall be held no less than ten days
     4  nor more than sixty days after such notice is served on  the  respondent
     5  and  provided  to  his or her counsel. The hearing shall be conducted by
     6  the director of the secure treatment facility, or his or  her  designee.
     7  The  respondent  may be represented by counsel. Evidence shall be intro-

     8  duced through witnesses and documents, if any, and both  the  person  in
     9  charge  of  the treatment program presenting the case and the respondent
    10  may call and cross-examine witnesses and  present  documentary  evidence
    11  relevant to the question of whether the respondent has been significant-
    12  ly disruptive of the treatment program. The presiding officer may accept
    13  such  evidence  without  applying  formal  state  or  federal  rules  of
    14  evidence. The hearing shall be recorded or a stenographic record of  the
    15  proceeding  shall  be  kept. When hearing the matter and, if the allega-
    16  tions are sustained, the presiding officer shall consider  the  respond-
    17  ent's  mental  health  condition  and  its effect, if any, on his or her
    18  conduct.

    19    (4) At the conclusion of the hearing,  if  the  presiding  officer  is
    20  satisfied  that there is a preponderance of evidence that the respondent
    21  has been significantly disruptive of the treatment program at the secure
    22  treatment facility, the presiding officer shall so find.  In such event,
    23  the presiding officer may order the respondent's transfer  back  to  the
    24  custody of the department of corrections and community supervision for a
    25  period  of up to six months, provided however, that when such respondent
    26  reaches the maximum expiration date of his or her underlying sentence he
    27  or she shall be returned to a secure treatment facility unless he or she
    28  consents in writing as provided in subdivision (k) of  this  section  to

    29  remaining  in the custody of the department of corrections and community
    30  supervision and provided further that he or she shall be returned  to  a
    31  secure treatment facility if the final order issued pursuant to subdivi-
    32  sion (f) of section 10.07 of this article requires placement in a secure
    33  treatment facility.
    34    (5)  At  the  conclusion  of  the hearing, the presiding officer shall
    35  prepare a written statement, to be made available to the respondent  and
    36  his  or  her counsel, indicating the evidence relied on, the reasons for
    37  the determination and specifying  the  procedures  and  time  frame  for
    38  administrative  appeal  to  the  commissioner.  The determination may be
    39  appealed to the commissioner in accordance with  procedures  established

    40  in writing by the department. The respondent shall be given at least ten
    41  days  after  notice  of  the determination has been served and the tran-
    42  script or recording of the proceeding (with  appropriate  access  equip-
    43  ment)  has  been  provided  to perfect the appeal. The respondent may be
    44  represented by counsel on the administrative appeal.
    45    § 2. Section 10.08 of the mental hygiene law is amended  by  adding  a
    46  new subdivision (i) to read as follows:
    47    (i)  (1)  At a proceeding conducted pursuant to subdivision (g) or (h)
    48  of section 10.06 of this  article,  a  psychiatric  examiner  called  to
    49  testify may be permitted, upon good cause shown, to testify by electron-
    50  ic  appearance  in  the  court  by  means of an independent audio-visual

    51  system, as that phrase is defined in subdivision one of  section  182.10
    52  of  the criminal procedure law. It shall constitute good cause to permit
    53  such an electronic appearance that such proposed  witness  is  currently
    54  employed  by  the  state  at a secure treatment facility or another work
    55  location  unless  there  are  compelling  circumstances  requiring   the
    56  witness' personal presence at the court proceeding.

        S. 6256--D                         74                         A. 9056--D
 
     1    (2)  A  copy  of  any clinical record or other document that the party
     2  calling such psychiatric examiner intends to present to the  witness  or
     3  introduce  during  the  direct testimony of such psychiatric examiner by

     4  electronic appearance shall be provided to opposing counsel  and,  in  a
     5  manner  consistent  with  section 33.16 of this chapter, the respondent:
     6  (i) five days or more before the date such person is called  to  testify
     7  by  electronic appearance at a proceeding conducted pursuant to subdivi-
     8  sion (g) of section 10.06 of this article, and (ii) twenty-four hours or
     9  more before the date such person is  called  to  testify  by  electronic
    10  appearance at a proceeding conducted pursuant to subdivision (h) of such
    11  section 10.06.
    12    (3)  Except  as provided in paragraph four of this subdivision, copies
    13  of clinical records and documents not made available to opposing counsel
    14  and, where applicable, the respondent as required by  paragraph  two  of

    15  this  subdivision  shall not be permitted to be presented to the witness
    16  on direct examination or introduced in evidence without the  consent  of
    17  opposing  counsel  provided, however, that where good cause is shown why
    18  such clinical record or other document was not provided sufficiently  in
    19  advance  as  required  by  this  subdivision, the court shall allow such
    20  clinical record or other document to be provided by  appropriate  means,
    21  including  but  not  limited  to facsimile or electronic means, and then
    22  used or considered in the same manner as if  timely  advance  disclosure
    23  had been made.
    24    (4)  The  court  shall order that copies of clinical records and other
    25  documents  relevant  for  cross-examination,  re-direct  examination  or

    26  re-cross examination of such witness testifying by electronic means, not
    27  otherwise provided pursuant to this subdivision, be provided to opposing
    28  counsel  and, in a manner consistent with section 33.16 of this chapter,
    29  the respondent, by appropriate  means,  including  but  not  limited  to
    30  facsimile or other electronic means.
    31    (5) For purposes of this subdivision, an "electronic appearance" means
    32  an appearance at which a participant is not present in the court, but in
    33  which  all of the participants are able to see and hear the simultaneous
    34  reproductions of the voices and images of the judge, counsel, respondent
    35  and any other appropriate participant. When a witness makes an electron-

    36  ic appearance pursuant to this subdivision, the court stenographer shall
    37  record any statements in the same manner as if the witness  had  made  a
    38  personal appearance.
    39    §  3.  Subdivision  (b) of section 10.09 of the mental hygiene law, as
    40  added by chapter 7 of the laws of 2007, is amended to read as follows:
    41    (b) The commissioner shall also assure that each respondent  committed
    42  under  this  article  shall have an examination for evaluation of his or
    43  her mental condition made at least once every year (calculated from  the
    44  date  on  which  the  supreme  or  county  court  judge  last ordered or
    45  confirmed the need for continued confinement pursuant to this article or
    46  the date on which the  respondent  waived  the  right  to  petition  for

    47  discharge  pursuant  to this section, whichever is later, as applicable)
    48  conducted by a psychiatric examiner who shall report to the commissioner
    49  his or her written findings as to whether the respondent is currently  a
    50  dangerous sex offender requiring confinement. At such time, the respond-
    51  ent  also shall have the right to be evaluated by an independent psychi-
    52  atric examiner.  If the respondent is financially unable  to  obtain  an
    53  examiner, the court shall appoint an examiner of the respondent's choice
    54  to  be  paid  within the limits prescribed by law. Following such evalu-
    55  ation, each psychiatric examiner shall report his  or  her  findings  in
    56  writing  to  the commissioner and to counsel for respondent. The commis-

        S. 6256--D                         75                         A. 9056--D
 

     1  sioner shall review relevant records and reports, along with  the  find-
     2  ings  of  the  psychiatric  examiners, and shall make a determination in
     3  writing as to whether the respondent is currently a dangerous sex offen-
     4  der requiring confinement.
     5    § 4. This act shall take effect immediately.
 
     6                                   PART Q
 
     7    Section  1. Section 730.10 of the criminal procedure law is amended by
     8  adding a new subdivision 9 to read as follows:
     9    9. "Appropriate institution" means: (a) a  hospital  operated  by  the
    10  office of mental health or a developmental center operated by the office
    11  for  people  with developmental disabilities; or (b) a hospital licensed
    12  by the department of health which operates a psychiatric  unit  licensed

    13  by  the  office  of  mental  health,  as  determined by the commissioner
    14  provided, however, that any such hospital that is not  operated  by  the
    15  state shall qualify as an "appropriate institution" only pursuant to the
    16  terms of an agreement between the commissioner and the hospital. Nothing
    17  in this article shall be construed as requiring a hospital to consent to
    18  providing  care  and treatment to an incapacitated person at such hospi-
    19  tal.
    20    § 2. Subdivision 1 of section 730.40 of the criminal procedure law, as
    21  amended by chapter 231 of the laws  of  2008,  is  amended  to  read  as
    22  follows:
    23    1. When a local criminal court, following a hearing conducted pursuant
    24  to  subdivision  three  or four of section 730.30, is satisfied that the

    25  defendant is not an incapacitated person, the  criminal  action  against
    26  him  or  her  must  proceed. If it is satisfied that the defendant is an
    27  incapacitated person, or if no motion for such a hearing is  made,  such
    28  court  must  issue  a final or temporary order of observation committing
    29  him or her to the custody of the commissioner for care and treatment  in
    30  an  appropriate  institution for a period not to exceed ninety days from
    31  the date of the order, provided,  however,  that  the  commissioner  may
    32  designate  an appropriate hospital for placement of a defendant for whom
    33  a final order of observation has been issued,  where  such  hospital  is
    34  licensed  by  the office of mental health and has agreed to accept, upon
    35  referral by the commissioner, defendants  subject  to  final  orders  of
    36  observation  issued  under this subdivision. When a local criminal court

    37  accusatory instrument other than  a  felony  complaint  has  been  filed
    38  against  the  defendant, such court must issue a final order of observa-
    39  tion[; when]. When a felony complaint has been filed against the defend-
    40  ant, such court must issue a temporary order of  observation  committing
    41  him  or her to the custody of the commissioner for care and treatment in
    42  an appropriate institution or, upon the consent of the  district  attor-
    43  ney,  committing  him or her to the custody of the commissioner for care
    44  and treatment on an out-patient basis, for a period not to exceed ninety
    45  days from the date of such order, except that, with the consent  of  the
    46  district attorney, it may issue a final order of observation.
    47    § 3. Subdivision 1 of section 730.50 of the criminal procedure law, as

    48  amended  by  chapter  231  of  the  laws  of 2008, is amended to read as
    49  follows:
    50    1. When a superior court, following a hearing  conducted  pursuant  to
    51  subdivision  three  or  four  of  section  730.30, is satisfied that the
    52  defendant is not an incapacitated person, the  criminal  action  against
    53  him  or  her  must  proceed. If it is satisfied that the defendant is an
    54  incapacitated person, or if no motion for such a  hearing  is  made,  it

        S. 6256--D                         76                         A. 9056--D
 
     1  must  adjudicate  him  or  her an incapacitated person, and must issue a
     2  final order of observation or an order of commitment. When  the  indict-
     3  ment  does  not charge a felony or when the defendant has been convicted
     4  of  an  offense  other  than a felony, such court (a) must issue a final

     5  order of observation committing the defendant  to  the  custody  of  the
     6  commissioner  for care and treatment in an appropriate institution for a
     7  period not to exceed ninety days from the date of such order,  provided,
     8  however, that the commissioner may designate an appropriate hospital for
     9  placement  of a defendant for whom a final order of observation has been
    10  issued, where such hospital is licensed by the office of  mental  health
    11  and  has agreed to accept, upon referral by the commissioner, defendants
    12  subject to final orders of observation issued  under  this  subdivision,
    13  and  (b)  must  dismiss  the  indictment filed in such court against the
    14  defendant, and such dismissal constitutes a bar to  any  further  prose-
    15  cution  of  the charge or charges contained in such indictment. When the
    16  indictment charges a felony or when the defendant has been convicted  of

    17  a  felony, it must issue an order of commitment committing the defendant
    18  to the custody of the commissioner for care and treatment in  an  appro-
    19  priate  institution  or,  upon  the  consent  of  the district attorney,
    20  committing him or her to the custody of the commissioner  for  care  and
    21  treatment  on  an out-patient basis, for a period not to exceed one year
    22  from the date of such order. Upon the issuance of an  order  of  commit-
    23  ment,  the  court  must  exonerate the defendant's bail if he or she was
    24  previously at liberty on bail; provided, however,  that  exoneration  of
    25  bail is not required when a defendant is committed to the custody of the
    26  commissioner for care and treatment on an out-patient basis.
    27    § 4. This act shall take effect immediately.
 

    28                                   PART R
 
    29    Section  1.    Section  1 of part D of chapter 111 of the laws of 2010
    30  relating to the recovery of exempt income by the office of mental health
    31  for community residences and family-based treatment programs is  amended
    32  to read as follows:
    33    Section  1. The office of mental health is authorized to recover fund-
    34  ing from  community  residences  and  family-based  treatment  providers
    35  licensed  by  the  office  of mental health, consistent with contractual
    36  obligations of such providers, and notwithstanding any other  inconsist-
    37  ent  provision  of law to the contrary, in an amount equal to 50 percent
    38  of the income received by such providers which exceeds the fixed  amount
    39  of  annual  Medicaid  revenue limitations, as established by the commis-
    40  sioner of mental health. Recovery of such excess income shall be for the

    41  following fiscal periods: for programs in counties  located  outside  of
    42  the  city of New York, the applicable fiscal periods shall be January 1,
    43  2003 through December 31, 2009 and January 1, 2011 through December  31,
    44  2013; and for programs located within the city of New York, the applica-
    45  ble  fiscal periods shall be July 1, 2003 through June 30, 2010 and July
    46  1, 2011 through June 30, 2013.
    47    § 2. This act shall take effect immediately.
 
    48                                   PART S
 
    49    Section 1.  Notwithstanding any law, rule or regulation to the contra-
    50  ry, only physicians or dentists who were  eligible,  and  for  whom  the
    51  superintendent  of financial services and the commissioner of health, or
    52  their designee, purchased, with funds available in the  hospital  excess


        S. 6256--D                         77                         A. 9056--D
 
     1  liability  pool,  a full or partial policy for excess coverage or equiv-
     2  alent excess coverage for the coverage periods ending the  thirtieth  of
     3  June,  two thousand ten, the thirtieth of June, two thousand eleven, and
     4  the  thirtieth  of  June, two thousand twelve shall be eligible to apply
     5  for such coverage for the coverage period beginning the first  of  July,
     6  two  thousand  twelve. If the total number of physicians or dentists for
     7  whom such excess coverage or equivalent excess  coverage  was  purchased
     8  with  funds  available  in  the hospital excess liability pool as of the
     9  thirtieth of June, two thousand ten is more than  the  total  number  of
    10  physicians  and  dentists  certified as eligible for the coverage period
    11  beginning the first of July,  two  thousand  twelve,  then  the  general

    12  hospitals  may  certify additional eligible physicians or dentists up to
    13  the greater of the total number  of  physicians  or  dentists  for  whom
    14  excess  coverage  or equivalent excess coverage was purchased with funds
    15  available in the hospital excess liability pool as of the  thirtieth  of
    16  June,  two  thousand  ten,  or  one  thousand  physicians  or  dentists;
    17  provided, however, that  no  general  hospital  may  certify  additional
    18  eligible  physicians or dentists in a greater number than the proportion
    19  of its physicians and dentists for whom excess  coverage  or  equivalent
    20  excess  coverage  was  purchased  with  funds  available in the hospital
    21  excess liability pool as of the thirtieth of June, two thousand  ten  as
    22  applied  to  the  difference  between  the total eligible physicians and
    23  dentists for the coverage period beginning the first of July, two  thou-

    24  sand  twelve  and  the  total  eligible physicians and dentists for whom
    25  excess coverage or equivalent excess coverage was purchased  with  funds
    26  available  in  the hospital excess liability pool as of the thirtieth of
    27  June, two thousand ten.
    28    § 2. The superintendent of financial services and the commissioner  of
    29  health  shall  prepare  a report that includes, but is not limited to: a
    30  review of the nature and  extent  of  affiliations  between  physicians,
    31  dentists,  general hospitals, private practices and universities; and an
    32  actuarial analysis of the adequacy of  premiums  paid  by  the  hospital
    33  excess liability pool for excess coverage and equivalent excess coverage
    34  with  regard  to  liabilities and claims history, and relative to budget
    35  appropriations to the hospital excess liability pool. The  report  shall

    36  also include recommendations to support the sustainability of the excess
    37  medical  malpractice liability coverage pool, maintaining the assumption
    38  that the future annual appropriations for the pool will not  exceed  the
    39  amount  appropriated  for  the  pool  in  state fiscal year two thousand
    40  twelve-thirteen.  The  superintendent  of  financial  services  and  the
    41  commissioner  of  health shall submit the report to the governor, tempo-
    42  rary president of the senate and speaker of the assembly by the first of
    43  November, two thousand twelve.
    44    § 3. This act shall take effect immediately.
 
    45                                   PART T
 
    46    Section 1. Paragraph (f) of subdivision 3 of section 242 of the  elder
    47  law,  as  amended  by section 3-d of part A of chapter 59 of the laws of
    48  2011, is amended to read as follows:

    49    (f) As a condition of eligibility for benefits  under  this  title,  a
    50  program participant is required to be enrolled in Medicare part D and to
    51  maintain  such  enrollment.   For unmarried participants with individual
    52  annual income less than or equal to twenty-three  thousand  dollars  and
    53  married  participants  with  joint  annual  income less than or equal to
    54  twenty-nine  thousand  dollars,  the  elderly  pharmaceutical  insurance

        S. 6256--D                         78                         A. 9056--D
 
     1  coverage program shall pay for the portion of the part D monthly premium
     2  that  is  the  responsibility  of the participant. Such payment shall be
     3  limited to the low-income benchmark premium amount  established  by  the

     4  federal  centers for medicare and medicaid services and any other amount
     5  which such agency establishes under its de minimus premium policy.
     6    § 1-a. Subdivision 1 of section 241 of the elder law,  as  amended  by
     7  section  29  of  part A of chapter 58 of the laws of 2008, is amended to
     8  read as follows:
     9    1. "Covered drug" shall mean a drug dispensed  subject  to  a  legally
    10  authorized  prescription  pursuant to section sixty-eight hundred ten of
    11  the education law, and  insulin,  an  insulin  syringe,  or  an  insulin
    12  needle.  Such  term  shall  not  include: (a) any drug determined by the
    13  commissioner of the federal food and drug administration to be  ineffec-
    14  tive  or  unsafe; (b) any drug dispensed in a package, or form of dosage
    15  or administration, as to which the commissioner of health finally deter-

    16  mines in accordance with the provisions of section two hundred fifty-two
    17  of this title that a less expensive package, or form of dosage or admin-
    18  istration, is available that is pharmaceutically equivalent  and  equiv-
    19  alent  in  its therapeutic effect for the general health characteristics
    20  of the eligible program participant population; (c) any device  for  the
    21  aid  or correction of vision; (d) any drug, including vitamins, which is
    22  generally available without a physician's prescription;  and  (e)  drugs
    23  for  the  treatment of sexual or erectile dysfunction, unless such drugs
    24  are used to treat a condition, other than sexual  or  erectile  dysfunc-
    25  tion,  for  which  the  drugs have been approved by the federal food and
    26  drug administration; and (f) a brand name drug for which a  multi-source
    27  therapeutically  and  generically  equivalent drug, as determined by the

    28  federal food and drug administration, is  available,  unless  previously
    29  authorized  by  the  elderly  pharmaceutical insurance coverage program,
    30  provided, however, that the [elderly pharmaceutical  insurance  coverage
    31  panel]  commissioner  is authorized to exempt, for good cause shown, any
    32  brand name drug from such restriction, and provided  further  that  such
    33  restriction  shall  not  apply  to  any  drug  that  is  included on the
    34  preferred drug list under section two hundred seventy-two of the  public
    35  health  law  or is in the clinical drug review program under section two
    36  hundred seventy-four of the public health law to  the  extent  that  the
    37  preferred  drug program and the clinical drug review program are applied
    38  to the elderly pharmaceutical insurance  coverage  program  pursuant  to

    39  section  two  hundred  seventy-five  of the public health law, or to any
    40  drug covered under a program participant's  Medicare  part  D  or  other
    41  primary  insurance  plan.  Any  of the drugs enumerated in the preceding
    42  sentence shall be considered a covered drug or a prescription  drug  for
    43  purposes of this article if it is added to the preferred drug list under
    44  article  two-A of the public health law.  For the purpose of this title,
    45  except as otherwise provided in this section, a covered  drug  shall  be
    46  dispensed  in  quantities  no  greater  than  a thirty day supply or one
    47  hundred units, whichever is greater. In the case of a drug dispensed  in
    48  a  form  of  administration  other than a tablet or capsule, the maximum
    49  allowed quantity shall be a thirty day supply; the [panel]  commissioner
    50  is  authorized  to  approve  exceptions  to  these  limits  for specific

    51  products following consideration of recommendations from  pharmaceutical
    52  or medical experts regarding commonly packaged quantities, unusual forms
    53  of  administration,  length  of  treatment or cost effectiveness. In the
    54  case of a drug prescribed pursuant to section thirty-three hundred thir-
    55  ty-two of the public health law to treat one of the conditions that have
    56  been enumerated by the commissioner of health pursuant to regulation  as

        S. 6256--D                         79                         A. 9056--D
 
     1  warranting  the  prescribing  of  greater than a thirty day supply, such
     2  drug shall be dispensed in  quantities  not  to  exceed  a  three  month
     3  supply.
     4    §  1-b.  Subdivision  1 of section 241 of the elder law, as amended by
     5  section 12 of part B of chapter 57 of the laws of 2006,  is  amended  to
     6  read as follows:

     7    1.  "Covered  drug"  shall  mean a drug dispensed subject to a legally
     8  authorized prescription pursuant to section sixty-eight hundred  ten  of
     9  the  education  law,  and  insulin,  an  insulin  syringe, or an insulin
    10  needle. Such term shall not include: (a)  any  drug  determined  by  the
    11  commissioner  of the federal food and drug administration to be ineffec-
    12  tive or unsafe; (b) any drug dispensed in a package, or form  of  dosage
    13  or administration, as to which the commissioner of health finally deter-
    14  mines in accordance with the provisions of section two hundred fifty-two
    15  of this title that a less expensive package, or form of dosage or admin-
    16  istration,  is  available that is pharmaceutically equivalent and equiv-
    17  alent in its therapeutic effect for the general  health  characteristics
    18  of  the  eligible program participant population; (c) any device for the

    19  aid or correction of vision, or any drug, including vitamins,  which  is
    20  generally  available  without  a physician's prescription; and (d) drugs
    21  for the treatment of sexual or erectile dysfunction, unless  such  drugs
    22  are  used  to  treat a condition, other than sexual or erectile dysfunc-
    23  tion, for which the drugs have been approved by  the  federal  food  and
    24  drug  administration. For the purpose of this title, except as otherwise
    25  provided in this section, a covered drug shall be dispensed  in  quanti-
    26  ties no greater than a thirty day supply or one hundred units, whichever
    27  is  greater. In the case of a drug dispensed in a form of administration
    28  other than a tablet or capsule, the maximum allowed quantity shall be  a
    29  thirty  day  supply;  the  [panel] commissioner is authorized to approve
    30  exceptions to these limits for specific products following consideration

    31  of recommendations from  pharmaceutical  or  medical  experts  regarding
    32  commonly packaged quantities, unusual forms of administration, length of
    33  treatment or cost effectiveness. In the case of a drug prescribed pursu-
    34  ant  to section thirty-three hundred thirty-two of the public health law
    35  to treat one of the conditions that have been enumerated by the  commis-
    36  sioner of health pursuant to regulation as warranting the prescribing of
    37  greater  than a thirty day supply, such drug shall be dispensed in quan-
    38  tities not to exceed a three month supply.
    39    § 2. Subdivision 6 of section 241 of the  elder  law,  as  amended  by
    40  section  2  of  part  A of chapter 59 of the laws of 2011, is amended to
    41  read as follows:
    42    6. "Annual coverage period" shall mean the period  of  twelve  consec-
    43  utive  calendar months for which an eligible program participant has met

    44  the [requirements of section two hundred forty-two] application  fee  or
    45  deductible  requirements,  as  the  case may be, of sections two hundred
    46  forty-seven and two hundred forty-eight of this title.
    47    § 3. Subdivision 8 of section 241 of the elder  law  is  REPEALED  and
    48  subdivision 9 is renumbered subdivision 8.
    49    §  4.  Subdivision  1  of  section 242 of the elder law, as amended by
    50  section 3 of part A of chapter 59 of the laws of  2011,  is  amended  to
    51  read as follows:
    52    1.  Persons  eligible  for  comprehensive  coverage  under section two
    53  hundred forty-seven of this title shall include:
    54    (a) any unmarried resident who is at least sixty-five years  of  age[,
    55  who  is  enrolled in Medicare part D,] and whose income for the calendar

    56  year immediately preceding the effective date  of  the  annual  coverage

        S. 6256--D                         80                         A. 9056--D
 
     1  period  beginning  on or after January first, two thousand five, is less
     2  than or equal  to  [thirty-five]  twenty  thousand  dollars.  After  the
     3  initial  determination  of eligibility, each eligible individual must be
     4  redetermined eligible at least every twenty-four months; and
     5    (b) any married resident who is at least sixty-five years of age[, who
     6  is  enrolled in Medicare part D,] and whose income for the calendar year
     7  immediately preceding the effective date of the annual  coverage  period
     8  when  combined with the income in the same calendar year of such married
     9  person's spouse beginning on or after January first, two  thousand  one,

    10  is  less than or equal to [fifty] twenty-six thousand dollars. After the
    11  initial determination of eligibility, each eligible individual  must  be
    12  redetermined eligible at least every twenty-four months.
    13    §  5. Section 242 of the elder law is amended by adding a new subdivi-
    14  sion 2 to read as follows:
    15    2. Persons  eligible  for  catastrophic  coverage  under  section  two
    16  hundred forty-eight of this title shall include:
    17    (a) any unmarried resident who is at least sixty-five years of age and
    18  whose  income  for the calendar year immediately preceding the effective
    19  date of the annual coverage period beginning on or after January  first,
    20  two thousand one, is more than twenty thousand and less than or equal to

    21  thirty-five  thousand dollars. After the initial determination of eligi-
    22  bility, each eligible individual must be redetermined eligible at  least
    23  every twenty-four months; and
    24    (b)  any  married resident who is at least sixty-five years of age and
    25  whose income for the calendar year immediately preceding  the  effective
    26  date  of the annual coverage period when combined with the income in the
    27  same calendar year of such married person's spouse beginning on or after
    28  January first, two  thousand  one,  is  more  than  twenty-six  thousand
    29  dollars  and  less  than  or  equal to fifty thousand dollars. After the
    30  initial determination of eligibility, each eligible individual  must  be
    31  redetermined eligible at least every twenty-four months.

    32    § 6. Paragraph (c) of subdivision 3 of section 242 of the elder law is
    33  REPEALED and a new paragraph (c) is added to read as follows:
    34    (c)  The  participant  registration  fee  charged  to eligible program
    35  participants for comprehensive coverage pursuant to section two  hundred
    36  forty-seven  of this title shall be waived for the portion of the annual
    37  coverage period that the participant is also enrolled as a full  subsidy
    38  individual  in  a  prescription drug or MA-PD plan under part D of title
    39  XVIII of the federal social security act.
    40    § 7. Intentionally omitted.
    41    § 8. Intentionally omitted.
    42    § 9. Intentionally omitted.
    43    § 10. Intentionally omitted.
    44    § 11. Intentionally omitted.
    45    § 12. Intentionally omitted.

    46    § 12-a. Section 242 of the elder law is amended by adding a new subdi-
    47  vision 4 to read as follows:
    48    4. As a condition  of  eligibility  for  benefits  under  this  title,
    49  participants  must  be  enrolled  in  medicare  part D and maintain such
    50  enrollment. For persons who meet the eligibility requirements to partic-
    51  ipate in the elderly  pharmaceutical  insurance  coverage  program,  the
    52  program will pay for a drug covered by the person's medicare part D plan
    53  or a drug in a medicare part D excluded drug class, as defined in subdi-
    54  vision  eight  of  section two hundred forty-one of this title, provided
    55  that such drug is a covered drug,  as  defined  in  subdivision  one  of
    56  section  two  hundred  forty-one of this title, and that the participant

        S. 6256--D                         81                         A. 9056--D
 
     1  complies with the point of sale co-payment  requirements  set  forth  in
     2  sections  two  hundred  forty-seven  and two hundred forty-eight of this
     3  title. No payment shall be made for medicare part D plan deductibles.
     4    § 12-b. Section 245 of the elder law is REPEALED.
     5    §  12-c.  Subdivision 1 of section 249 of the elder law, as amended by
     6  section 111 of part C of chapter 58 of the laws of 2009, is  amended  to
     7  read as follows:
     8    1. The state shall offer an opportunity to participate in this program
     9  to  all  provider pharmacies as defined in section two hundred forty-one
    10  of this title, provided, however, that the participation  of  pharmacies
    11  registered  in the state pursuant to section sixty-eight hundred eight-b

    12  of the education law shall be limited to state assistance provided under
    13  this title for prescription drugs covered  by  a  program  participant's
    14  medicare [or other] drug plan.
    15    §  12-d.  Subdivisions  1  and  2  of section 253 of the elder law are
    16  amended to read as follows:
    17    1. In counties having a population of seventy-five  thousand  or  less
    18  that  are in proximity to the state boundary and which are determined by
    19  the [executive director] commissioner of health  to  be  not  adequately
    20  served  by  provider  pharmacies  registered in New York, and in Fishers
    21  Island in the town of Southold, Suffolk county, the [executive director]
    22  commissioner may approve as provider pharmacies, pharmacies  located  in
    23  New  Jersey,  Connecticut,  Vermont, Pennsylvania or Massachusetts. Such

    24  approvals shall be made after (a) consideration of the  convenience  and
    25  necessity  of New York residents in the rural areas served by such phar-
    26  macies, (b) consideration of the quality of service of  such  pharmacies
    27  and the standing of such pharmacies with the governmental board or agen-
    28  cy  of  the  state in which such pharmacy is located, (c) the [executive
    29  director] commissioner shall give all  licensed  pharmacies  within  the
    30  county  notice  of  his  or  her  intention to approve such out-of-state
    31  provider pharmacies, and (d) the [executive director]  commissioner  has
    32  held  a  public hearing at which he or she has determined factually that
    33  the licensed pharmacies within such county are not adequately serving as
    34  provider pharmacies.

    35    2. The [executive director] commissioner of health  shall  investigate
    36  and  determine whether certification shall be granted within ninety days
    37  of the filing of an application for certification by the governing  body
    38  of  any city, town or village, within a county determined by the [execu-
    39  tive director] commissioner to be  not  adequately  served  by  provider
    40  pharmacies  registered  in  New York pursuant to subdivision one of this
    41  section, claiming to be lacking adequate pharmaceutical service.
    42    § 13. The section heading of section 247 of the elder law, as  amended
    43  by  section  3-i of part A of chapter 59 of the laws of 2011, is amended
    44  to read as follows:
    45    Cost-sharing responsibilities of  eligible  program  participants  for
    46  comprehensive coverage.

    47    §  14. Subdivision 1 of section 247 of the elder law is REPEALED and a
    48  new subdivision 1 is added to read as follows:
    49    1. Registration fee. Eligible individuals meeting the registration fee
    50  requirements of this section may purchase prescribed covered  drugs  for
    51  an amount specified by subdivision three of this section, subject to the
    52  limits  on  point  of  sale co-payments specified by subdivision four of
    53  this section.
    54    § 15. Subdivision 2 of section 247 of the elder law, as renumbered  by
    55  section  3-k  of part A of chapter 59 of the laws of 2011, is renumbered

        S. 6256--D                         82                         A. 9056--D
 
     1  subdivision 3 and two new subdivisions 2 and 4  are  added  to  read  as
     2  follows:

     3    2.  Registration  fee  schedule. Eligible individuals electing to meet
     4  the requirements of this subdivision shall pay a quarterly  registration
     5  fee  in  a  manner and form determined by the executive director; at the
     6  option of the participant, the registration fee may be paid annually  in
     7  a lump sum upon the beginning of the annual coverage period. No eligible
     8  individual  electing  to meet the requirements of this subdivision shall
     9  have his participation in the program lapse by virtue of non-payment  of
    10  the  applicable  registration  fee  unless  the  contractor has provided
    11  notification of the amount and due date thereof, and  more  than  thirty
    12  days  have  elapsed  since the due date of the individual's registration

    13  fee. The registration fee to be charged to eligible program participants
    14  for comprehensive coverage under this option shall be in accordance with
    15  the following schedule:
    16    (a) Quarterly  registration  fees  for  unmarried  individual  program
    17  participants:
    18  individual income of $5,000 or less                    $2.00
    19  individual income of $5,001 to $6,000                  $2.00
    20  individual income of $6,001 to $7,000                  $4.00
    21  individual income of $7,001 to $8,000                  $5.50
    22  individual income of $8,001 to $9,000                  $7.00
    23  individual income of $9,001 to $10,000                 $9.00

    24  individual income of $10,001 to $11,000                $10.00
    25  individual income of $11,001 to $12,000                $11.50
    26  individual income of $12,001 to $13,000                $13.50
    27  individual income of $13,001 to $14,000                $15.00
    28  individual income of $14,001 to $15,000                $20.00
    29  individual income of $15,001 to $16,000                $27.50
    30  individual income of $16,001 to $17,000                $35.00
    31  individual income of $17,001 to $18,000                $42.50
    32  individual income of $18,001 to $19,000                $50.00
    33  individual income of $19,001 to $20,000                $57.50

    34    (b)  Quarterly  registration  fees for each married individual program
    35  participant:
    36  joint income of $5,000 or less                         $2.00
    37  joint income of $5,001 to $6,000                       $2.00
    38  joint income of $6,001 to $7,000                       $3.00
    39  joint income of $7,001 to $8,000                       $4.00
    40  joint income of $8,001 to $9,000                       $5.00
    41  joint income of $9,001 to $10,000                      $6.00
    42  joint income of $10,001 to $11,000                     $7.00
    43  joint income of $11,001 to $12,000                     $8.00

    44  joint income of $12,001 to $13,000                     $9.00
    45  joint income of $13,001 to $14,000                     $10.00
    46  joint income of $14,001 to $15,000                     $10.00
    47  joint income of $15,001 to $16,000                     $21.00
    48  joint income of $16,001 to $17,000                     $26.50
    49  joint income of $17,001 to $18,000                     $31.50
    50  joint income of $18,001 to $19,000                     $37.50
    51  joint income of $19,001 to $20,000                     $43.00
    52  joint income of $20,001 to $21,000                     $48.50
    53  joint income of $21,001 to $22,000                     $54.00

    54  joint income of $22,001 to $23,000                     $59.50
    55  joint income of $23,001 to $24,000                     $65.00

        S. 6256--D                         83                         A. 9056--D
 
     1  joint income of $24,001 to $25,000                     $68.75
     2  joint income of $25,001 to $26,000                     $75.00
     3    (c)  In  the event that the state expenditures per participant meeting
     4  the registration fee requirements  of  this  subdivision,  exclusive  of
     5  expenditures  for program administration, in the program year commencing
     6  October first, nineteen hundred eighty-eight, and in each  program  year
     7  thereafter,  exceed  such expenditures in the previous program year by a

     8  minimum of ten percent, the annual registration fees set forth  in  this
     9  subdivision  may,  unless  otherwise provided by law, be increased, pro-
    10  rata, for the subsequent program year, provided that such increase shall
    11  not exceed seven and one-half percent of  the  prior  year  registration
    12  fees as may have been adjusted in accordance with this paragraph.
    13    (d)  In  the  event  that the state expenditures per such participant,
    14  incurred pursuant to this subdivision,  exclusive  of  expenditures  for
    15  program  administration,  in  the program year commencing October first,
    16  nineteen hundred eighty-eight, and in each program year thereafter,  are
    17  less than such expenditures in the previous program year by a minimum of

    18  ten  percent, the annual registration fees set forth in this subdivision
    19  may, unless otherwise provided by law, be decreased, pro-rata,  for  the
    20  subsequent  program  year,  provided that such decrease shall not exceed
    21  seven and one-half percent of the prior year registration  fees  as  may
    22  have been adjusted in accordance with this paragraph.
    23    (e)  The determination to adjust annual registration fees set forth in
    24  this subdivision shall follow a review of such factors as  the  relative
    25  financial  capacity  of the state and such eligible program participants
    26  to support such adjustments and changes in the consumer price index. The
    27  frequency of such adjustments shall not exceed once in any program  year

    28  and  such  adjustments shall not become effective for individual program
    29  participants prior to the first day of the next annual  coverage  period
    30  for each participant.
    31    4.  Limits  on  point of sale co-payments. During each annual coverage
    32  period no point of sale co-payment as set forth in subdivision three  of
    33  this  section  shall  be  required  to be made for the remainder of such
    34  period by any eligible program  participant  who  has  already  incurred
    35  co-payments in excess of the limits set forth in the following schedule:
    36    (a)  Limits  on  co-payments  by unmarried individual eligible program
    37  participants:
    38  individual income of $5,000 or less                 no more than $340

    39  individual income of $5,001 to $6,000               no more than $408
    40  individual income of $6,001 to $7,000               no more than $476
    41  individual income of $7,001 to $8,000               no more than $544
    42  individual income of $8,001 to $9,000               no more than $612
    43  individual income of $9,001 to $10,000              no more than $700
    44  individual income of $10,001 to $11,000             no more than $720
    45  individual income of $11,001 to $12,000             no more than $827
    46  individual income of $12,001 to $13,000             no more than $896
    47  individual income of $13,001 to $14,000             no more than $964

    48  individual income of $14,001 to $15,000             no more than $1,016
    49  individual income of $15,001 to $16,000             no more than $1,034
    50  individual income of $16,001 to $17,000             no more than $1,052
    51  individual income of $17,001 to $18,000             no more than $1,070
    52  individual income of $18,001 to $19,000             no more than $1,088
    53  individual income of $19,001 to $20,000             no more than $1,160
    54    (b) Limits on co-payments by each married individual eligible program
    55  participant:

        S. 6256--D                         84                         A. 9056--D
 

     1  joint income of $5,000 or less                      no more than $291
     2  joint income of $5,001 to $6,000                    no more than $342
     3  joint income of $6,001 to $7,000                    no more than $399
     4  joint income of $7,001 to $8,000                    no more than $456
     5  joint income of $8,001 to $9,000                    no more than $513
     6  joint income of $9,001 to $10,000                   no more than $570
     7  joint income of $10,001 to $11,000                  no more than $622
     8  joint income of $11,001 to $12,000                  no more than $641
     9  joint income of $12,001 to $13,000                  no more than $660

    10  joint income of $13,001 to $14,000                  no more than $684
    11  joint income of $14,001 to $15,000                  no more than $710
    12  joint income of $15,001 to $16,000                  no more than $826
    13  joint income of $16,001 to $17,000                  no more than $877
    14  joint income of $17,001 to $18,000                  no more than $928
    15  joint income of $18,001 to $19,000                  no more than $980
    16  joint income of $19,001 to $20,000                  no more than $990
    17  joint income of $20,001 to $21,000                  no more than $1,008
    18  joint income of $21,001 to $22,000                  no more than $1,026

    19  joint income of $22,001 to $23,000                  no more than $1,044
    20  joint income of $23,001 to $24,000                  no more than $1,062
    21  joint income of $24,001 to $25,000                  no more than $1,080
    22  joint income of $25,001 to $26,000                  no more than $1,150
    23    (c) Effective October first, nineteen hundred eighty-eight, the limits
    24  on  point  of  sale  co-payments as set forth in this subdivision may be
    25  adjusted by the panel on the anniversary date of  each  program  partic-
    26  ipant's  annual  coverage period, and such adjustment shall be in effect
    27  for the duration of that annual coverage period. Any such annual adjust-

    28  ment shall be made using a percentage adjustment factor which shall  not
    29  exceed  one-half  of  the difference between the year-to-year percentage
    30  increase in the  consumer  price  index  for  all  urban  consumers,  as
    31  published  by the United States Department of Labor, and, if larger, the
    32  year-to-year percentage  increase  in  the  aggregate  average  cost  of
    33  covered  drugs purchased under this title, which year-to-year percentage
    34  increase in such cost shall be determined by comparison of such cost  in
    35  the  same  month  of each of the appropriate successive years; provided,
    36  however, that for any such adjustment based wholly on experience in  the
    37  program  year  commencing  October first, nineteen hundred eighty-seven,

    38  the year-to-year percentage increase in such cost shall be determined by
    39  comparison of such cost in each of two months no less than  five  months
    40  apart  and  within  such program year, which comparison shall be annual-
    41  ized. Such percentage adjustment factor shall be the same as  that  used
    42  to  determine any similar annual adjustment for the same annual coverage
    43  periods pursuant to the provisions of subdivision four  of  section  two
    44  hundred forty-eight of this title.
    45    (d)  Such  annual  adjustments  shall be calculated by multiplying the
    46  percentage adjustment factor by (1) ten percent and applying the result-
    47  ing percentage to the upper income limitation of each income  level  for

    48  unmarried  individuals  contained  in this subdivision, and by (2) seven
    49  and one-half percent and applying the resulting percentage to the  upper
    50  income limitation of each income level for married individuals contained
    51  in  this subdivision; each result of such calculations, minus any appli-
    52  cable registration fee increases made pursuant  to  subdivision  two  of
    53  this  section  and plus the result of applying the percentage adjustment
    54  factor to the sum of any such annual adjustments applicable thereto  for
    55  any prior annual coverage period, shall be the amount by which the limit
    56  on  co-payments  for  each  such  income level may be adjusted, and such

        S. 6256--D                         85                         A. 9056--D
 

     1  amount shall be in addition to any such amount or amounts applicable  to
     2  prior annual coverage periods.
     3    (e)  The  determination  to adjust the limits on point of sale co-pay-
     4  ments set forth in this  subdivision  shall  follow  a  review  of  such
     5  factors  as the relative financial capacity of the state and such eligi-
     6  ble program participants to support such adjustments.
     7    § 16. Paragraph (a) of subdivision 3 of section 247 of the elder  law,
     8  as  amended  by section 3-k of part A of chapter 59 of the laws of 2011,
     9  such subdivision as renumbered  by  section  fifteen  of  this  act,  is
    10  amended to read as follows:
    11    (a)  [A]  Upon  satisfaction  of the registration fee pursuant to this
    12  section an eligible program participant must pay a point of sale co-pay-

    13  ment as set forth in paragraph (b) of this subdivision at  the  time  of
    14  each  purchase of a covered drug prescribed for such individual [that is
    15  described in paragraph (c) of subdivision three of section  two  hundred
    16  forty-two of this title]. Such co-payment shall not be waived or reduced
    17  in  whole  or in part subject to the limits provided by subdivision four
    18  of this section.
    19    § 17. The elder law is amended by adding a new section 248 to read  as
    20  follows:
    21    §  248. Cost-sharing responsibilities of eligible program participants
    22  for catastrophic coverage. 1. Deductible. Eligible  individuals  meeting
    23  the  deductible  requirements  of  this  section may purchase prescribed

    24  covered drugs for an amount  specified  by  subdivision  three  of  this
    25  section, subject to the limits on point of sale co-payments specified by
    26  subdivision four of this section.
    27    2.  Deductible  schedule.  Eligible  individuals  electing to meet the
    28  requirements of this subdivision  shall  incur  an  amount  of  personal
    29  covered  drug  expenditures  during any annual coverage period which are
    30  not reimbursed by any other public or private third party payment source
    31  or insurance plan, and shall be deemed  to  have  met  their  deductible
    32  requirements  for  the  remainder  of  such  annual coverage period. The
    33  amount of personal covered drug expenditures to be incurred by  eligible

    34  program  participants  for catastrophic coverage under this option shall
    35  be in accordance with the following schedule:
    36    (a) Annual personal covered drug expenditures for unmarried individual
    37  eligible program participants:
    38  individual income of $20,001 to $21,000                $530
    39  individual income of $21,001 to $22,000                $550
    40  individual income of $22,001 to $23,000                $580
    41  individual income of $23,001 to $24,000                $720
    42  individual income of $24,001 to $25,000                $750
    43  individual income of $25,001 to $26,000                $780
    44  individual income of $26,001 to $27,000                $810

    45  individual income of $27,001 to $28,000                $840
    46  individual income of $28,001 to $29,000                $870
    47  individual income of $29,001 to $30,000                $900
    48  individual income of $30,001 to $31,000                $930
    49  individual income of $31,001 to $32,000                $960
    50  individual income of $32,001 to $33,000                $1,160
    51  individual income of $33,001 to $34,000                $1,190
    52  individual income of $34,001 to $35,000                $1,230
    53    (b) Annual personal covered drug expenditures for each married
    54  individual eligible program participant:

    55  joint income of $26,001 to $27,000                     $650
    56  joint income of $27,001 to $28,000                     $675

        S. 6256--D                         86                         A. 9056--D
 
     1  joint income of $28,001 to $29,000                     $700
     2  joint income of $29,001 to $30,000                     $725
     3  joint income of $30,001 to $31,000                     $900
     4  joint income of $31,001 to $32,000                     $930
     5  joint income of $32,001 to $33,000                     $960
     6  joint income of $33,001 to $34,000                     $990
     7  joint income of $34,001 to $35,000                     $1,020

     8  joint income of $35,001 to $36,000                     $1,050
     9  joint income of $36,001 to $37,000                     $1,080
    10  joint income of $37,001 to $38,000                     $1,110
    11  joint income of $38,001 to $39,000                     $1,140
    12  joint income of $39,001 to $40,000                     $1,170
    13  joint income of $40,001 to $41,000                     $1,200
    14  joint income of $41,001 to $42,000                     $1,230
    15  joint income of $42,001 to $43,000                     $1,260
    16  joint income of $43,001 to $44,000                     $1,290
    17  joint income of $44,001 to $45,000                     $1,320

    18  joint income of $45,001 to $46,000                     $1,575
    19  joint income of $46,001 to $47,000                     $1,610
    20  joint income of $47,001 to $48,000                     $1,645
    21  joint income of $48,001 to $49,000                     $1,680
    22  joint income of $49,001 to $50,000                     $1,715
    23    (c)  In the event that the state expenditures per participant electing
    24  to meet the deductible requirements of this  subdivision,  exclusive  of
    25  expenditures  for program administration, in the program year commencing
    26  October first, nineteen hundred eighty-eight, and in each  program  year
    27  thereafter,  exceed  such expenditures in the previous program year by a

    28  minimum of ten percent, the annual personal  covered  drug  expenditures
    29  set  forth in this subdivision may, unless otherwise provided by law, be
    30  increased, pro-rata, for the subsequent program year, provided that such
    31  increase shall not exceed eight  percent  of  the  prior  year  personal
    32  covered  drug  expenditures as may have been adjusted in accordance with
    33  this paragraph.
    34    (d) In the event that the state  expenditures  per  such  participant,
    35  incurred  pursuant  to  this  subdivision, exclusive of expenditures for
    36  program administration, in the program year  commencing  October  first,
    37  nineteen  hundred eighty-eight, and in each program year thereafter, are
    38  less than such expenditures in the previous program year by a minimum of

    39  ten percent, the annual personal covered drug expenditures set forth  in
    40  this  subdivision  may,  unless otherwise provided by law, be decreased,
    41  pro-rata, for the subsequent program year, provided that  such  decrease
    42  shall  not  exceed eight percent of the prior year personal covered drug
    43  expenditures as may have been adjusted in  accordance  with  this  para-
    44  graph.
    45    (e)  The determination to adjust annual personal covered drug expendi-
    46  tures set forth in this subdivision,  shall  follow  a  review  of  such
    47  factors  as the relative financial capacity of the state and such eligi-
    48  ble program participants to support such adjustments and changes in  the
    49  consumer price index. The frequency of such adjustments shall not exceed

    50  once  in  any  twelve month period and such adjustments shall not become
    51  effective for individual program participants prior to the first day  of
    52  the next annual coverage period for each participant.
    53    3.  Point  of sale co-payment. (a) Upon satisfaction of the deductible
    54  requirements pursuant to subdivision two of this  section,  an  eligible
    55  program participant shall pay a point of sale co-payment as set forth in
    56  paragraph  (b)  of  this  subdivision  at the time of each purchase of a

        S. 6256--D                         87                         A. 9056--D
 
     1  covered drug prescribed for such individual. Such co-payment  shall  not
     2  be waived or reduced in whole or in part, subject to the limits provided

     3  by subdivision four of this section.
     4    (b)  The  point  of  sale  co-payment  amounts which are to be charged
     5  eligible program participants shall be in accordance with the  following
     6  schedule:
     7  For each prescription of covered
     8  drugs costing $15.00 or less                           $3.00
     9  For each prescription of covered
    10  drugs costing $15.01 to $35.00                         $7.00
    11  For each prescription of covered
    12  drugs costing $35.01 to $55.00                         $15.00
    13  For each prescription of covered
    14  drugs costing $55.01 or more                           $20.00
    15    (c)  For  the  purposes  of  the  foregoing  schedule of point of sale

    16  co-payments, "costing" shall mean  the  amount  of  reimbursement  which
    17  shall  be  paid  by  the  state  to a participating provider pharmacy in
    18  accordance with section two hundred fifty of this title plus  the  point
    19  of sale co-payment, calculated as of the date of sale.
    20    4.  Annual  limits  on  point  of sale co-payments. During each annual
    21  coverage period, no point of sale co-payments as set forth  in  subdivi-
    22  sion  three of this section shall be required to be made for the remain-
    23  der of such period by  any  eligible  program  participant  meeting  the
    24  personal  covered  drug  expenditure  requirements of subdivision two of
    25  this section in excess of the limits set forth in the  following  sched-
    26  ule:

    27    (a)  Limits  on  co-payments  by unmarried individual eligible program
    28  participants:
    29  individual income of $20,001 to $21,000           no more than $1,050
    30  individual income of $21,001 to $22,000           no more than $1,100
    31  individual income of $22,001 to $23,000           no more than $1,150
    32  individual income of $23,001 to $24,000           no more than $1,200
    33  individual income of $24,001 to $25,000           no more than $1,250
    34  individual income of $25,001 to $26,000           no more than $1,300
    35  individual income of $26,001 to $27,000           no more than $1,350
    36  individual income of $27,001 to $28,000           no more than $1,400

    37  individual income of $28,001 to $29,000           no more than $1,450
    38  individual income of $29,001 to $30,000           no more than $1,500
    39  individual income of $30,001 to $31,000           no more than $1,550
    40  individual income of $31,001 to $32,000           no more than $1,600
    41  individual income of $32,001 to $33,000           no more than $1,650
    42  individual income of $33,001 to $34,000           no more than $1,700
    43  individual income of $34,001 to $35,000           no more than $1,750
    44    (b) Limits on co-payments by each married individual eligible  program
    45  participant:
    46  joint income of $26,001 to $27,000                no more than $1,080

    47  joint income of $27,001 to $28,000                no more than $1,120
    48  joint income of $28,001 to $29,000                no more than $1,160
    49  joint income of $29,001 to $30,000                no more than $1,200
    50  joint income of $30,001 to $31,000                no more than $1,240
    51  joint income of $31,001 to $32,000                no more than $1,280
    52  joint income of $32,001 to $33,000                no more than $1,320
    53  joint income of $33,001 to $34,000                no more than $1,360
    54  joint income of $34,001 to $35,000                no more than $1,400
    55  joint income of $35,001 to $36,000                no more than $1,440

    56  joint income of $36,001 to $37,000                no more than $1,480

        S. 6256--D                         88                         A. 9056--D
 
     1  joint income of $37,001 to $38,000                no more than $1,520
     2  joint income of $38,001 to $39,000                no more than $1,560
     3  joint income of $39,001 to $40,000                no more than $1,600
     4  joint income of $40,001 to $41,000                no more than $1,640
     5  joint income of $41,001 to $42,000                no more than $1,680
     6  joint income of $42,001 to $43,000                no more than $1,720
     7  joint income of $43,001 to $44,000                no more than $1,760

     8  joint income of $44,001 to $45,000                no more than $1,800
     9  joint income of $45,001 to $46,000                no more than $1,840
    10  joint income of $46,001 to $47,000                no more than $1,880
    11  joint income of $47,001 to $48,000                no more than $1,920
    12  joint income of $48,001 to $49,000                no more than $1,960
    13  joint income of $49,001 to $50,000                no more than $2,000
    14    (c) Effective October first, nineteen hundred eighty-eight, the limits
    15  on  point  of  sale  co-payments as set forth in this subdivision may be
    16  adjusted by the commissioner on the anniversary  date  of  each  program

    17  participant's  annual  coverage  period, and such adjustment shall be in
    18  effect for the duration of that annual coverage period. Any such  annual
    19  adjustment  shall  be  made  using  a percentage adjustment factor which
    20  shall not exceed one-half of the  difference  between  the  year-to-year
    21  percentage increase in the consumer price index for all urban consumers,
    22  as  published  by the United States department of labor, and, if larger,
    23  the year-to-year percentage increase in the aggregate  average  cost  of
    24  covered  drugs purchased under this title, which year-to-year percentage
    25  increase in such cost shall be determined by comparison of such cost  in
    26  the  same  month  of each of the appropriate successive years; provided,

    27  however, that for any such adjustment based wholly on experience in  the
    28  program  year  commencing  October first, nineteen hundred eighty-seven,
    29  the year-to-year percentage increase in such cost shall be determined by
    30  comparison of such cost in each of two months no less than  five  months
    31  apart  and  within  such program year, which comparison shall be annual-
    32  ized. Such percentage adjustment factor shall be the same as  that  used
    33  to  determine any similar annual adjustment for the same annual coverage
    34  periods pursuant to the provisions of subdivision four  of  section  two
    35  hundred  forty-seven  of  this  title.  Such annual adjustments shall be
    36  calculated by multiplying the percentage adjustment factor  by  (1)  ten

    37  percent  and applying the resulting percentage to the upper income limi-
    38  tation of each income level for unmarried individuals contained in  this
    39  subdivision,  and  by  (2)  seven  and one-half percent and applying the
    40  resulting percentage to the upper income limitation of each income level
    41  for married individuals contained in this subdivision;  each  result  of
    42  such calculations, minus any applicable deductible increases made pursu-
    43  ant  to  subdivision two of this section and plus the result of applying
    44  the percentage adjustment factor to the sum of any such  annual  adjust-
    45  ments  applicable thereto for any prior annual coverage period, shall be
    46  the amount by which the limit on co-payments for each such income  level

    47  may be adjusted, and such amount shall be in addition to any such amount
    48  or amounts applicable to prior annual coverage periods.
    49    (d)  The  determination  to adjust the limits on point of sale co-pay-
    50  ments set forth in this  subdivision  shall  follow  a  review  of  such
    51  factors  as the relative financial capacity of the state and such eligi-
    52  ble program participant to support such adjustments.
    53    § 18. Section 250 of the elder law, as amended by section 3-m of  part
    54  A of chapter 59 of the laws of 2011, is amended to read as follows:
    55    §  250.  Reimbursement  to  participating  provider pharmacies. 1. The
    56  amount of reimbursement which shall be paid by the state  to  a  partic-

        S. 6256--D                         89                         A. 9056--D
 

     1  ipating  provider  pharmacy  [filling  or refilling a prescription for a
     2  drug that is described in paragraph (c) of subdivision three of  section
     3  two  hundred  forty-two  of  this  title] for any covered drug filled or
     4  refilled  for  any  eligible  program  participant shall be equal to the
     5  allowed amount defined as follows, minus the point of sale co-payment as
     6  required by [section] sections two hundred forty-seven and  two  hundred
     7  forty-eight of this title:
     8    (a)  Multiple  source  covered drugs. Except for brand name drugs that
     9  are required by the prescriber to be dispensed as written,  the  allowed
    10  amount for a multiple source covered drug shall equal the lower of:
    11    (1)  The  pharmacy's usual and customary charge to the general public,

    12  taking into consideration any quantity and promotional discounts to  the
    13  general public at the time of purchase, or
    14    (2) The upper limit, if any, set by the centers for medicare and medi-
    15  caid services for such multiple source drug, or
    16    (3) Average wholesale price discounted by twenty-five percent, or
    17    (4) The maximum allowable cost, if any, established by the commission-
    18  er  of  health  pursuant to paragraph (e) of subdivision nine of section
    19  three hundred sixty-seven-a of the social services law.
    20    Plus a dispensing fee for drugs reimbursed pursuant  to  subparagraphs
    21  two,  three,  and four of this paragraph, as defined in paragraph (c) of
    22  this subdivision.
    23    (b) Other covered drugs. The  allowed  amount  for  brand  name  drugs
    24  required  by  the  prescriber to be dispensed as written and for covered

    25  drugs other than multiple source drugs shall be determined  by  applying
    26  the lower of:
    27    (1)  Average wholesale price discounted by sixteen and twenty-five one
    28  hundredths percent, plus a dispensing fee as defined in paragraph (c) of
    29  this subdivision, or
    30    (2) The pharmacy's usual and customary charge to the  general  public,
    31  taking  into consideration any quantity and promotional discounts to the
    32  general public at the time of purchase.
    33    (c) As required by paragraphs (a)  and  (b)  of  this  subdivision,  a
    34  dispensing  fee  of four dollars fifty cents will apply to generic drugs
    35  and a dispensing fee of three dollars fifty cents will  apply  to  brand
    36  name drugs.
    37    2. For purposes of determining the amount of reimbursement which shall
    38  be paid to a participating provider pharmacy, the commissioner of health

    39  shall determine or cause to be determined, through a statistically valid
    40  survey,  the quantities of each covered drug that participating provider
    41  pharmacies buy most frequently. Using the result  of  this  survey,  the
    42  contractor  shall update every thirty days the list of average wholesale
    43  prices upon which such  reimbursement  is  determined  using  nationally
    44  recognized and most recently revised sources. Such price revisions shall
    45  be  made available to all participating provider pharmacies. The pharma-
    46  cist shall be reimbursed based on the price in effect at  the  time  the
    47  covered drug is dispensed.
    48    3.  (a) Notwithstanding any inconsistent provision of law, the program
    49  for  elderly  pharmaceutical  insurance  coverage  shall  reimburse  for
    50  covered  drugs which are dispensed under the program by a provider phar-

    51  macy only pursuant to the  terms  of  a  rebate  agreement  between  the
    52  program  and  the  manufacturer  (as  defined  under section 1927 of the
    53  federal social security act) of such covered drugs;  provided,  however,
    54  that:
    55    (1)  any agreement between the program and a manufacturer entered into
    56  before August first, nineteen hundred ninety-one,  shall  be  deemed  to

        S. 6256--D                         90                         A. 9056--D
 
     1  have  been entered into on April first, nineteen hundred ninety-one; and
     2  provided further, that if a manufacturer has not entered into an  agree-
     3  ment  with  the department before August first, nineteen hundred ninety-

     4  one,  such  agreement shall not be effective until April first, nineteen
     5  hundred ninety-two, unless such agreement provides that rebates will  be
     6  retroactively calculated as if the agreement had been in effect on April
     7  first, nineteen hundred ninety-one; and
     8    (2) the program may reimburse for any covered drugs pursuant to subdi-
     9  visions  one  and two of this section, for which a rebate agreement does
    10  not exist and which are determined by the commissioner to  be  essential
    11  to  the  health  of  persons participating in the program; and likely to
    12  provide effective therapy or diagnosis  for  a  disease  not  adequately
    13  treated or diagnosed by any other covered drug.
    14    (b) The rebate agreement between such manufacturer and the program for

    15  elderly  pharmaceutical  insurance  coverage  shall  utilize for covered
    16  drugs the identical formula used to determine  the  rebate  for  federal
    17  financial  participation  for  drugs, pursuant to section 1927(c) of the
    18  federal social security act, to  determine  the  amount  of  the  rebate
    19  pursuant to this subdivision.
    20    (c) The amount of rebate pursuant to paragraph (b) of this subdivision
    21  shall  be  calculated by multiplying the required rebate formulas by the
    22  total number of units of each dosage form and  strength  dispensed.  The
    23  rebate  agreement shall also provide for periodic payment of the rebate,
    24  provision of information to the program, audits, verification  of  data,

    25  damages to the program for any delay or non-production of necessary data
    26  by the manufacturer and for the confidentiality of information.
    27    (d)  The  program  in providing utilization data to a manufacturer (as
    28  provided for under section 1927 (b) of the federal social security  act)
    29  shall  provide  such  data  by zip code, if requested, for the top three
    30  hundred most commonly used drugs by volume covered under a rebate agree-
    31  ment.
    32    (e) Any funds collected pursuant to any rebate agreements entered into
    33  with a manufacturer pursuant to this  subdivision,  shall  be  deposited
    34  into  the  elderly  pharmaceutical  insurance  coverage  program premium
    35  account.
    36    4. Notwithstanding any other provision of law,  entities  which  offer

    37  insurance  coverage for provision of and/or reimbursement for pharmaceu-
    38  tical   expenses,   including   but    not    limited    to,    entities
    39  licensed/certified  pursuant  to  article  thirty-two, forty-two, forty-
    40  three or forty-four of the insurance law (employees  welfare  funds)  or
    41  article  forty-four  of  the  public  health law, shall participate in a
    42  benefit recovery  program  with  the  elderly  pharmaceutical  insurance
    43  coverage  (EPIC)  program which includes, but is not limited to, a semi-
    44  annual match of EPIC's file of enrollees against the  entity's  file  of
    45  insured  to identify individuals enrolled in both plans with claims paid
    46  within the twenty-four months preceding the date the entity receives the
    47  match request information from EPIC. Such entity shall indicate if phar-
    48  maceutical coverage  is  available  from  the  entity  for  the  insured

    49  persons,  list the copayment or other payment obligations of the insured
    50  persons applicable to the pharmaceutical coverage, and (after  receiving
    51  necessary claim information from EPIC) list the amounts which the entity
    52  would have paid for the pharmaceutical claims for those identified indi-
    53  viduals  and the entity shall reimburse EPIC for pharmaceutical expenses
    54  paid by EPIC that are covered under the contract between the entity  and
    55  its  insured  in  only  those instances where the entity has not already
    56  made payment of the claim.  Reimbursement  of  the  net  amount  payable

        S. 6256--D                         91                         A. 9056--D
 
     1  (after rebates and discounts) that would have been paid under the cover-
     2  age issued by the entity will be made by the entity to EPIC within sixty

     3  days  of  receipt  from  EPIC  of the standard data in electronic format
     4  necessary  for  the  entity  to adjudicate the claim and if the standard
     5  data is provided to the entity by EPIC in paper format  payment  by  the
     6  entity  shall  be made within one hundred eighty days.  After completing
     7  at least one match process with EPIC in  electronic  format,  an  entity
     8  shall  be entitled to elect a monthly or bi-monthly match process rather
     9  than a semi-annual match process.
    10    [4.] 5. Notwithstanding any other provision of law,  the  commissioner
    11  of  health  shall  maximize  the  coordination  of  benefits for persons
    12  enrolled under Title XVIII of the federal social security act (medicare)
    13  and enrolled under this title in order to facilitate medicare payment of
    14  claims. The commissioner of health may select an independent contractor,

    15  through a request-for-proposal process, to implement a centralized coor-
    16  dination of benefits system under this subdivision for individuals qual-
    17  ified in both  the  elderly  pharmaceutical  insurance  coverage  (EPIC)
    18  program  and  medicare programs who receive medications or other covered
    19  products from a pharmacy provider  currently  enrolled  in  the  elderly
    20  pharmaceutical insurance coverage (EPIC) program.
    21    [5.]  6.  The EPIC program shall be the payor of last resort for indi-
    22  viduals qualified in both the EPIC program and title XVIII of the feder-
    23  al social security act (Medicare).
    24    § 19. Section 254 of the elder law, as amended by section 3-n of  part
    25  A of chapter 59 of the laws of 2011, is amended to read as follows:
    26    §  254. Cost of living adjustment. 1. Within amounts appropriated, the

    27  commissioner of health shall adjust the  program  eligibility  standards
    28  set  forth  in subdivision [one] two of section two hundred forty-two of
    29  this title to account for increases in the cost of living.
    30    2. The commissioner shall further adjust individual and  joint  income
    31  categories set forth in subdivisions two and four of section two hundred
    32  forty-eight of this title to conform to the adjustments made pursuant to
    33  subdivision one of this section.
    34    §  19-a.  Subdivision  5  of section 244 of the elder law, as added by
    35  section 3-h of part A of chapter 59 of the laws of 2011, is amended  and
    36  a new subdivision 6 is added to read as follows:
    37    5.  establishing  or  contracting  for  a  therapeutic drug monitoring
    38  program, for the purpose of monitoring therapeutic drug use by  eligible

    39  program  participants  in an effort to prevent the incorrect or unneces-
    40  sary consumption of such therapeutic drugs[.]; and
    41    6. monitor the provision of services pursuant to contractual  arrange-
    42  ments  entered  into pursuant to section two hundred forty-three of this
    43  title and examine and review all  documents  and  other  information  to
    44  assure compliance with all provisions of this article whether such docu-
    45  ments  or  other  information are under the control of a contractor or a
    46  participating provider pharmacy.
    47    § 20. This act shall take effect January 1, 2013,  provided  that  the
    48  amendments  to  subdivision  1  of  section 241 of the elder law made by
    49  section one-a of this act shall be subject to the expiration and  rever-

    50  sion  of such subdivision pursuant to section 79 of part C of chapter 58
    51  of the laws of 2005, as amended, when upon such date the  provisions  of
    52  section one-b of this act shall take effect.
    53    § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
    54  sion,  section  or  part  of  this act shall be adjudged by any court of
    55  competent jurisdiction to be invalid, such judgment  shall  not  affect,
    56  impair,  or  invalidate  the remainder thereof, but shall be confined in

        S. 6256--D                         92                         A. 9056--D
 
     1  its operation to the clause, sentence, paragraph,  subdivision,  section
     2  or part thereof directly involved in the controversy in which such judg-
     3  ment shall have been rendered. It is hereby declared to be the intent of
     4  the  legislature  that  this  act  would  have been enacted even if such

     5  invalid provisions had not been included herein.
     6    § 3. This act shall take effect immediately  provided,  however,  that
     7  the  applicable effective date of Parts A through T of this act shall be
     8  as specifically set forth in the last section of such Parts.
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