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A03007 Summary:

BILL NOA03007A
 
SAME ASSAME AS UNI. S02507-A
 
SPONSORBudget
 
COSPNSR
 
MLTSPNSR
 
Amd Various Laws, generally
 
Enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2021-2022 state fiscal year; extends the medical global cap (Part A); relates to preferred drug program prior authorization (Part B); relates to community health centers (Part C); reduces the hospital capital rate add-on (Part D); adjusts worker recruitment and retention funding (Part E); enacts comprehensive telehealth reforms; directs the creation of an interstate licensure program for physicians in states contiguous with NYS; requires insurers to incorporate adequate telehealth coverage into their network (Part F); establishes a medical respite program to offer a lower-intensity care setting for individuals who would otherwise require a hospital stay or lack safe options for discharge and recovery (Part G); eliminates consumer-paid premium payments in the basic health program (Part H); relates to federal waiver authorization for the New York state of health, the official health plan marketplace (Part I); relates to the licensing of pharmacy benefit managers (Part J); restructures and extends the physicians medical malpractice program (Part K); relates to the general public health work program in the city of New York (Part L); relates to discontinuing the empire clinical research investigator program, the spinal cord injury research board and the empire state stem cell board (Part M); eliminates certain exemptions from electronic prescribing requirements (Part N); repeals the enhanced quality of adult living program; repeals provisions of law requiring the department of health audit hospital working hours; repeals provisions relating to provision of operating subsidies to certain public operated adult care facilities (Part O); relates to the duties of pharmacists (Part P); relates to the state's physician profiles and enhancing the ability of the department of education to investigate, discipline, and monitor licensed physicians, physician assistants, and specialist assistants (Part Q); relates to a change of sex designation or gender designation; updates the publication requirement following a name change on a birth certificate; provides for the sealing of sex designation papers; makes related provisions (Part R); relates to extending certain provisions relating to reimbursements and payments for health care costs (Part S); extends provisions permitting the director of a mental health facility to place funds of a person receiving services, in excess of the appropriate eligibility level for government benefits, into a qualifying Medicaid exception trust (Part T); extends sections relating to the availability of temporary operators to 2026 (Part U); extends the authority of the commissioners in the department of mental hygiene to design and implement time-limited demonstration programs to 2024 (Part V); relates to the membership of subcommittees for mental health of community service boards and the duties of such subcommittees and creating the community mental health and workforce reinvestment account relating to extending such provisions relating thereto (Part W); authorizes the office of mental health to redesign certain facilities and programs and to implement service reductions to ensure the cost effective and efficient operation of such facilities (Part X); relates to the scope of responsibilities of the office of addiction services and supports and defines addiction professional (Part Y); imposes sanctions due to a provider's failure to comply with the terms of their operating certificate or applicable law and charges an application processing fee for the issuance of operation certificates (Part Z); relates to crisis stabilization services (Subpart A); relates to Kendra's law and assisted outpatient treatment (Subpart B); relates to involuntary commitment (Subpart C) (Part AA); establishes the New York state institute for basic research in developmental disabilities (Part BB); creates the office of addiction and mental health services; transfers the functions and powers possessed by and all of the obligations and duties of the office of mental health and the office of addiction services and supports as established pursuant to the mental hygiene law and other laws, to the office of addiction and mental health services; makes related provisions (Part CC); authorizes the commissioners of the department of health, the office of mental health, and the office of addiction services and support to jointly establish a single set of licensing standards and requirements for the construction, operation, reporting and surveillance of comprehensive outpatient services centers; makes related provisions (Part DD); repeals the requirement that the justice center administer an adult home and residence for the adult resident advocacy program (Part EE); amends the public health law, in relation to reimbursement from the Medical Indemnity Fund (Part FF); amends the public health law and the social services law, in relation to improving the safety and quality of nursing homes in New York state; amends part E of chapter 56 of the laws of 2013 amending the public health law relating to the general public health work program, in relation to the effectiveness thereof (Part GG); and amends the executive law, in relation to the composition of the developmental disabilities planning council (Part HH).
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A03007 Actions:

BILL NOA03007A
 
01/20/2021referred to ways and means
02/24/2021amend (t) and recommit to ways and means
02/24/2021print number 3007a
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A03007 Memo:

Memo not available
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A03007 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
            S. 2507--A                                            A. 3007--A
 
                SENATE - ASSEMBLY
 
                                    January 20, 2021
                                       ___________
 
        IN  SENATE -- A BUDGET BILL, submitted by the Governor pursuant to arti-
          cle seven of the Constitution -- read twice and ordered  printed,  and
          when  printed to be committed to the Committee on Finance -- committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee
 
        IN ASSEMBLY -- A BUDGET BILL, submitted  by  the  Governor  pursuant  to
          article  seven  of  the  Constitution -- read once and referred to the
          Committee on Ways and Means --  committee  discharged,  bill  amended,
          ordered reprinted as amended and recommitted to said committee
 
        AN  ACT  to amend part H of chapter 59 of the laws of 2011, amending the
          public health law and other  laws  relating  to  known  and  projected
          department  of health state fund Medicaid expenditures, in relation to
          extending the Medicaid global  cap  (Part  A);  to  amend  the  social
          services law, in relation to copayments for drugs; to amend the public
          health  law, in relation to prescriber prevails; and to repeal certain
          provisions of the social services law relating to coverage for certain
          prescription drugs (Part B);  to  amend  the  public  health  law,  in
          relation  to  community  health  centers (Part C); to amend the public
          health law, in relation to reducing the hospital capital  rate  add-on
          (Part D); to amend the public health law, in relation to adjusting the
          worker recruitment and retention funding (Part E); to amend the public
          health  law,  the  education law and the insurance law, in relation to
          comprehensive telehealth reforms (Part F); to amend the public  health
          law,  in relation to authorizing the implementation of medical respite
          pilot programs (Part G); to amend the social services law, in relation
          to eliminating consumer-paid premium  payments  in  the  basic  health
          program  (Part  H);  to  amend  the  public health law, in relation to
          federal waiver authorization for the NY State of Health, the  official
          Health  Plan  Marketplace  (Part  I);  to  amend the insurance law, in
          relation to the licensing of pharmacy benefit managers  (Part  J);  to
          amend  chapter 266 of the laws of 1986 amending the civil practice law
          and rules and other laws  relating  to  malpractice  and  professional
          medical conduct, in relation to restructuring and extending the physi-
          cians  medical  malpractice  program; to amend part J of chapter 63 of
          the laws of 2001 amending chapter 266 of the laws  of  1986,  amending
          the  civil  practice law and rules and other laws relating to malprac-
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD12571-02-1

        S. 2507--A                          2                         A. 3007--A
 
          tice and professional medical conduct, relating to  the  effectiveness
          of  certain  provisions  of  such  chapter,  in  relation to extending
          certain provisions concerning the hospital excess liability pool;  and
          to  amend  part  H of chapter 57 of the laws of 2017, amending the New
          York Health Care Reform Act of 1996 and other laws relating to extend-
          ing certain provisions relating  thereto,  in  relation  to  extending
          provisions  relating  to excess coverage (Part K); to amend the public
          health law, in relation to the  general  public  health  work  program
          (Part L); to amend the public health law, the state finance law, chap-
          ter 338 of the laws of 1998 amending the public health law, the public
          officers  law  and  the  state  finance law relating to establishing a
          spinal cord injury research board and part H of chapter 58 of the laws
          of 2007 amending the public health law, the public  officers  law  and
          the  state  finance law relating to establishing the empire state stem
          cell board, in relation to the discontinuation of the empire  clinical
          research investigator program (Part M); to amend the public health law
          and  the  education law, in relation to eliminating certain electronic
          prescription exemptions; and  to  repeal  certain  provisions  of  the
          public  health law and the education law relating thereto (Part N); to
          repeal certain provisions of the social services law relating  to  the
          enhanced  quality  of adult living program ("EQUAL") grants; to repeal
          certain provisions of the public health law relating to requiring that
          the department of health audit hospital working hours; and  to  repeal
          certain  provisions  of  the  social  services  law  relating  to  the
          provision providing operating subsidies to certain  publicly  operated
          adult  care  facilities  (Part O); to amend the public health law, the
          education law, the insurance law  and  the  social  services  law,  in
          relation  to  expanding  the role of pharmacists; to amend chapter 563
          of  the  laws  of  2008,  amending   the   education   law   and   the
          public  health  law relating to   immunizing agents to be administered
          to adults  by   pharmacists,   in         relation   to   making  such
          provisions permanent; to amend chapter 116 of the laws of 2012, amend-
          ing  the  education  law relating to authorizing a licensed pharmacist
          and certified nurse  practitioner  to  administer  certain  immunizing
          agents, in relation to the effectiveness thereof; to amend chapter 274
          of  the laws of 2013, amending the education law relating to authoriz-
          ing a licensed pharmacist and certified nurse practitioner to adminis-
          ter meningococcal disease immunizing agents, in relation to the effec-
          tiveness thereof; and to  amend  chapter  21  of  the  laws  of  2011,
          amending  the  education  law  relating  to authorizing pharmacists to
          perform collaborative  drug  therapy  management  with  physicians  in
          certain  settings,  in  relation  to  making such provisions permanent
          (Part P); to amend the education law and the  public  health  law,  in
          relation  to  the state's physician profiles and enhancing the ability
          of the department of education to investigate, discipline, and monitor
          licensed physicians, physician assistants, and  specialist  assistants
          (Part  Q);  to  amend the civil rights law, in relation to a change of
          sex designation (Part R); to amend chapter 884 of the  laws  of  1990,
          amending  the  public  health law relating to authorizing bad debt and
          charity  care  allowances  for  certified  home  health  agencies,  in
          relation  to extending the provisions thereof; to amend chapter 109 of
          the laws of 2010, amending the social services law relating to  trans-
          portation  costs,  in  relation to the effectiveness thereof; to amend
          chapter 81 of the laws of 1995, amending the  public  health  law  and
          other  laws  relating  to medical reimbursement and welfare reform, in
          relation to the effectiveness thereof; to amend chapter 56 of the laws

        S. 2507--A                          3                         A. 3007--A
 
          of 2013 amending chapter 59 of the laws of 2011  amending  the  public
          health  law  and other laws relating to general hospital reimbursement
          for annual rates, in relation to extending government rates for behav-
          ioral  services and adding an alternative payment methodology require-
          ment; to amend chapter 57 of the laws  of  2019  amending  the  public
          health  law  relating to waiver of certain regulations, in relation to
          the effectiveness thereof; to amend chapter 517 of the laws  of  2016,
          amending  the public health law relating to payments from the New York
          state medical indemnity fund, in relation to the effectiveness  there-
          of;  to  amend  the  public  health law, in relation to improved inte-
          gration of health care and financing; and to amend chapter 56  of  the
          laws of 2014, amending the education law relating to the nurse practi-
          tioners  modernization  act,  in  relation to extending the provisions
          thereof (Part S); to amend part A of chapter 111 of the laws  of  2010
          amending the mental hygiene law relating to the receipt of federal and
          state  benefits  received  by individuals receiving care in facilities
          operated by an office of the department of mental hygiene, in relation
          to the effectiveness thereof (Part T); to amend part L of  chapter  59
          of  the  laws of 2016, amending the mental hygiene law relating to the
          appointment of temporary operators  for  the  continued  operation  of
          programs and the provision of services for persons with serious mental
          illness  and/or developmental disabilities and/or chemical dependence,
          in relation to the effectiveness thereof (Part U); to amend part NN of
          chapter 58 of the laws of 2015, amending the mental hygiene law relat-
          ing to clarifying the authority of the commissioners in the department
          of mental hygiene to design and implement  time-limited  demonstration
          programs  in  relation to the effectiveness thereof (Part V); to amend
          chapter 62 of the laws of 2003, amending the mental  hygiene  law  and
          the  state finance law relating to the community mental health support
          and workforce reinvestment program, the  membership  of  subcommittees
          for  mental health of community services boards and the duties of such
          subcommittees and creating the community mental health  and  workforce
          reinvestment  account, in relation to extending such provisions relat-
          ing thereto (Part W); authorizing the office of mental health to rede-
          sign services of certain facilities  and  programs  and  to  implement
          service  reductions;  and  providing for the repeal of such provisions
          upon expiration thereof (Part X); to amend the mental hygiene law,  in
          relation to setting standards for addiction professionals (Part Y); to
          amend the mental hygiene law, in relation to imposing sanctions due to
          a  provider's  failure  to  comply  with  the terms of their operating
          certificate or applicable law and to charge an application  processing
          fee  for the issuance of operating certificates (Part Z); to amend the
          mental hygiene law and the social services law, in relation to  crisis
          stabilization services (Subpart A); to amend the mental hygiene law in
          relation  to  Kendra's  law and assisted outpatient treatment (Subpart
          B); and to amend the mental hygiene law, in  relation  to  involuntary
          commitment  (Subpart C) (Part AA); to amend the mental hygiene law, in
          relation to establishing  the  New  York  state  institute  for  basic
          research  in developmental disabilities (Part BB); to amend the mental
          hygiene law, in relation to  creating  the  office  of  addiction  and
          mental  health  services  (Part CC); to amend the social services law,
          the public health law and the  mental  hygiene  law,  in  relation  to
          setting  comprehensive outpatient services (Part DD); to repeal subdi-
          vision 10 of section  553  of  the  executive  law,  relating  to  the
          requirement that the justice center administer an adult home and resi-
          dence  for  adults  resident  advocacy program (Part EE); to amend the

        S. 2507--A                          4                         A. 3007--A
 
          public health law, in  relation  to  reimbursement  from  the  Medical
          Indemnity  Fund  (Part  FF);  to  amend  the public health law and the
          social services law, in relation to improving the safety  and  quality
          of  nursing  homes in New York state; to amend part E of chapter 56 of
          the laws of 2013 amending the public health law relating to the gener-
          al public health work program, in relation to the effectiveness there-
          of (Part GG); and to amend the  executive  law,  in  relation  to  the
          composition  of  the developmental disabilities planning council (Part
          HH)
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  This  act enacts into law major components of legislation
     2  necessary to implement the state health and mental  hygiene  budget  for
     3  the  2021-2022  state  fiscal  year.  Each component is wholly contained
     4  within a Part identified as Parts A through HH. The effective  date  for
     5  each particular provision contained within such Part is set forth in the
     6  last section of such Part. Any provision in any section contained within
     7  a  Part,  including the effective date of the Part, which makes a refer-
     8  ence to a section "of this act",  when  used  in  connection  with  that
     9  particular  component,  shall  be deemed to mean and refer to the corre-
    10  sponding section of the Part in which it is found. Section three of this
    11  act sets forth the general effective date of this act.
 
    12                                   PART A
 
    13    Section 1. Paragraph (a) of subdivision 1 of section 92 of part  H  of
    14  chapter 59 of the laws of 2011, amending the public health law and other
    15  laws  relating  to  known  and projected department of health state fund
    16  Medicaid expenditures, as amended by section 1 of part CCC of chapter 56
    17  of the laws of 2020, is amended to read as follows:
    18    (a) For state fiscal years  2011-12  through  [2021-22]  2022-23,  the
    19  director  of the budget, in consultation with the commissioner of health
    20  referenced as "commissioner" for purposes of this section, shall  assess
    21  on a monthly basis, as reflected in monthly reports pursuant to subdivi-
    22  sion five of this section known and projected department of health state
    23  funds  medicaid  expenditures  by  category of service and by geographic
    24  regions, as defined by the commissioner.
    25    § 2. This act shall take effect immediately.
 
    26                                   PART B
 
    27    Section 1. Paragraph (a) of subdivision 4  of  section  365-a  of  the
    28  social  services  law, as amended by chapter 493 of the laws of 2010, is
    29  amended to read as follows:
    30    (a) drugs which may be dispensed without a prescription as required by
    31  section sixty-eight hundred ten of the education law; provided, however,
    32  that the state commissioner of health may by regulation specify  certain
    33  of  such  drugs which may be reimbursed as an item of medical assistance
    34  in accordance with the price schedule established by such  commissioner.
    35  Notwithstanding any other provision of law, [additions] modifications to
    36  the  list  of  drugs  reimbursable  under this paragraph may be filed as
    37  regulations by the commissioner  of  health  without  prior  notice  and
    38  comment;

        S. 2507--A                          5                         A. 3007--A
 
     1    §  2.  Paragraph  (b)  of  subdivision  3 of section 273 of the public
     2  health law, as added by section 10 of part C of chapter 58 of  the  laws
     3  of 2005, is amended to read as follows:
     4    (b)  In the event that the patient does not meet the criteria in para-
     5  graph (a) of this subdivision, the  prescriber  may  provide  additional
     6  information  to  the  program  to justify the use of a prescription drug
     7  that is not on the preferred drug list.  The  program  shall  provide  a
     8  reasonable opportunity for a prescriber to reasonably present his or her
     9  justification  of  prior authorization. [If, after consultation with the
    10  program, the prescriber, in his or her reasonable professional judgment,
    11  determines that] The program will consider  the  additional  information
    12  and  the  justification  presented  to  determine  whether  the use of a
    13  prescription drug that is not on the preferred drug list  is  warranted,
    14  and the [prescriber's] program's determination shall be final.
    15    §  3. Subdivisions 25 and 25-a of section 364-j of the social services
    16  law are REPEALED.
    17    § 4. This act shall take effect immediately and  shall  be  deemed  to
    18  have been in full force and effect on and after April 1, 2021.
 
    19                                   PART C
 
    20    Section  1.  The  public health law is amended by adding a new section
    21  2807-pp to read as follows:
    22    § 2807-pp. 340B reimbursement fund. 1. Notwithstanding any  inconsist-
    23  ent  provision  of law and subject to the availability of federal finan-
    24  cial participation, there is hereby created a fund to support activities
    25  that expand health services to the medicaid members, the uninsured,  and
    26  low-income  patients, as supported by the 340B program. All funds avail-
    27  able for distribution pursuant to this section shall be reserved and set
    28  aside and distributed in accordance with this section.
    29    2. Each eligible 340B provider shall receive a proportionate  distrib-
    30  ution to be determined by a methodology established by the commissioner.
    31  Annual  aggregate  distributions pursuant to this section for the fiscal
    32  year from April first, two thousand twenty-one  to  March  thirty-first,
    33  two thousand twenty-two, and each fiscal year thereafter, shall be equal
    34  to  one  hundred two million dollars, but may be increased by additional
    35  amounts authorized by the director of the  division  of  the  budget  in
    36  consultation with the commissioner.
    37    3.  "Eligible  340B provider" means: (a) (1) a voluntary non-profit or
    38  publicly sponsored diagnostic and treatment center licensed pursuant  to
    39  this  article twenty-eight that delivers a comprehensive range of health
    40  care services,  (2)  or  a  voluntary  non-profit  sexually  transmitted
    41  disease  program  receiving  financial  assistance pursuant to 42 U.S.C.
    42  §300ff-ll located in this state, or (3)  an  entity  as  defined  by  42
    43  U.S.C.  §246b(a)(4)(K)  in this state; that (b) was enrolled in the 340B
    44  program pursuant to section 340B(a)(4)  of  the  Federal  Public  Health
    45  Service  act  during  the  calendar  year  two  thousand twenty and that
    46  submits to the department the annual recertification of participation in
    47  the 340B program as provided by the health resources and services admin-
    48  istration.
    49    § 2. This act shall take effect immediately and  shall  be  deemed  to
    50  have been in full force and effect on and after April 1, 2021.
 
    51                                   PART D

        S. 2507--A                          6                         A. 3007--A
 
     1    Section  1.  Paragraph  (c)  of subdivision 8 of section 2807-c of the
     2  public health law, as amended by section 2 of part KK of chapter  56  of
     3  the laws of 2020, is amended to read as follows:
     4    (c)  In order to reconcile capital related inpatient expenses included
     5  in rates of payment based on a budget to actual expenses and  statistics
     6  for  the  rate  period  for  a  general hospital, rates of payment for a
     7  general hospital shall be adjusted to reflect the dollar  value  of  the
     8  difference  between  capital  related inpatient expenses included in the
     9  computation of rates of payment for a prior rate period based on a budg-
    10  et and actual capital related inpatient expenses  for  such  prior  rate
    11  period,  each  as  determined  in  accordance with paragraph (a) of this
    12  subdivision, adjusted to reflect increases or  decreases  in  volume  of
    13  service  in  such  prior  rate  period compared to statistics applied in
    14  determining the capital related inpatient expenses component of rates of
    15  payment based on a budget for such prior rate period. For  rates  effec-
    16  tive [on and after] April first, two thousand twenty through March thir-
    17  ty-first, two thousand twenty-one, the budgeted capital-related expenses
    18  add-on  as  described  in  paragraph (a) of this subdivision, based on a
    19  budget submitted in accordance to paragraph  (a)  of  this  subdivision,
    20  shall  be reduced by five percent relative to the rate in effect on such
    21  date; and the actual capital expenses add-on as described  in  paragraph
    22  (a) of this subdivision, based on actual expenses and statistics through
    23  appropriate  audit  procedures  in accordance with paragraph (a) of this
    24  subdivision shall be reduced by five percent relative  to  the  rate  in
    25  effect  on  such date. For rates effective on and after April first, two
    26  thousand twenty-one, the budgeted  capital-related  expenses  add-on  as
    27  described  in  paragraph  (a)  of  this  subdivision,  based on a budget
    28  submitted in accordance to paragraph (a) of this subdivision,  shall  be
    29  reduced  by ten percent relative to the rate in effect on such date; and
    30  the actual capital expenses add-on as described in paragraph (a) of this
    31  subdivision, based on actual expenses and statistics through appropriate
    32  audit procedures in accordance with paragraph (a)  of  this  subdivision
    33  shall  be  reduced by ten percent relative to the rate in effect on such
    34  date. For any rate year, all reconciliation add-on amounts calculated on
    35  and after April first, two thousand  twenty  shall  be  reduced  by  ten
    36  percent,  and  all  reconciliation  recoupment  amounts calculated on or
    37  after April first, two thousand twenty shall increase  by  ten  percent.
    38  Notwithstanding  any inconsistent provision of subparagraph (i) of para-
    39  graph (e) of subdivision nine of this section, capital related inpatient
    40  expenses of a general hospital included in the computation of  rates  of
    41  payment  based on a budget shall not be included in the computation of a
    42  volume adjustment made in accordance with such subparagraph. Adjustments
    43  to rates of payment for a general hospital made pursuant to  this  para-
    44  graph  shall  be  made  in  accordance with paragraph (c) of subdivision
    45  eleven of this section. Such adjustments shall not  be  carried  forward
    46  except  for  such  volume  adjustment as may be authorized in accordance
    47  with subparagraph (i) of paragraph  (e)  of  subdivision  nine  of  this
    48  section for such general hospital.
    49    §  2.  Clause (A) of subparagraph (ii) of paragraph (b) of subdivision
    50  5-d of section 2807-k of the public health law, as amended by section  3
    51  of  part  KK  of  chapter  56 of the laws of 2020, is amended to read as
    52  follows:
    53    (A) (1) subject to item two of this clause,  one  hundred  thirty-nine
    54  million  four  hundred thousand dollars shall be distributed as Medicaid
    55  Disproportionate Share Hospital ("DSH") payments to major public general
    56  hospitals;

        S. 2507--A                          7                         A. 3007--A
 
     1    (2) for the calendar years two thousand twenty-one through  two  thou-
     2  sand  twenty-two,  and  for  each  calendar  year  thereafter, the total
     3  distributions to major public general hospitals shall be reduced to zero
     4  dollars annually; and
     5    §  3.    This act shall take effect immediately and shall be deemed to
     6  have been in full force and effect on and after April 1, 2021; provided,
     7  however, that amendments to subdivision 5-d of  section  2807-k  of  the
     8  public  health  law made by section two of this act shall not affect the
     9  expiration of such subdivision and shall be deemed to expire therewith.
 
    10                                   PART E
 
    11    Section 1. Clauses (M) and (N) of subparagraph (ii) of paragraph  (bb)
    12  of  subdivision 1 of section 2807-v of the public health law, as amended
    13  by section 14 of part Y of chapter 56 of the laws of 2020,  are  amended
    14  and a new clause (O) is added to read as follows:
    15    (M)  for  each  state  fiscal  year within the period April first, two
    16  thousand seventeen through  March  thirty-first,  two  thousand  twenty,
    17  three hundred forty million dollars; [and]
    18    (N)  for  each  state  fiscal  year within the period April first, two
    19  thousand twenty through March thirty-first, two thousand  [twenty-three]
    20  twenty-one, three hundred forty million dollars[.]; and
    21    (O)  for  each  state  fiscal  year within the period April first, two
    22  thousand twenty-one through March  thirty-first,  two  thousand  twenty-
    23  three,  one  hundred  seventy million dollars and each state fiscal year
    24  thereafter.
    25    § 2. Subparagraphs (xiii) and (xiv) of paragraph (cc) of subdivision 1
    26  of section 2807-v of the public health law, as amended by section 14  of
    27  part Y of chapter 56 of the laws of 2020, are amended and a new subpara-
    28  graph (xv) is added to read as follows:
    29    (xiii)  up  to  eleven million two hundred thousand dollars each state
    30  fiscal year for the period April first, two thousand  seventeen  through
    31  March thirty-first, two thousand twenty; [and]
    32    (xiv)  up  to  eleven  million two hundred thousand dollars each state
    33  fiscal year for the period April  first,  two  thousand  twenty  through
    34  March thirty-first, two thousand [twenty-three.]twenty-one; and
    35    (xv)  up  to  five  million six hundred thousand dollars for the state
    36  fiscal year commencing April first, two  thousand  twenty-one  and  each
    37  state fiscal year thereafter.
    38    § 3. Subparagraphs (ix) and (x) of paragraph (ccc) of subdivision 1 of
    39  section  2807-v  of  the  public health law, as amended by section 14 of
    40  part Y of chapter 56 of the laws of 2020, are amended and a new subpara-
    41  graph (xi) is added to read as follows:
    42    (ix) up to fifty million dollars each state fiscal year for the period
    43  April first, two thousand  seventeen  through  March  thirty-first,  two
    44  thousand twenty; [and]
    45    (x)  up to fifty million dollars each state fiscal year for the period
    46  April first, two thousand twenty through March thirty-first,  two  thou-
    47  sand [twenty-three.] twenty-one; and
    48    (xi)  up  to  twenty-five  million  dollars for each state fiscal year
    49  within the period April first, two  thousand  twenty-one  through  March
    50  thirty-first, two thousand twenty-three and each state fiscal year ther-
    51  eafter.
    52    §  4.  The  opening  paragraph  of  paragraph  (a) of subdivision 8 of
    53  section 3614 of the public health law, as amended by section 55 of  part
    54  A of chapter 56 of the laws of 2013, is amended to read as follows:

        S. 2507--A                          8                         A. 3007--A
 
     1    Notwithstanding  any inconsistent provision of law, rule or regulation
     2  and subject to the provisions of paragraph (b) of this  subdivision  and
     3  to the availability of federal financial participation, the commissioner
     4  shall  adjust  medical assistance rates of payment for services provided
     5  by certified home health agencies for such services provided to children
     6  under eighteen years of age and for services provided to a special needs
     7  population  of  medically  complex and fragile children, adolescents and
     8  young disabled adults by a CHHA operating under a pilot program approved
     9  by the department, long term home health care  programs  and  AIDS  home
    10  care  programs  in  accordance  with this paragraph and paragraph (b) of
    11  this subdivision for purposes of improving recruitment and retention  of
    12  non-supervisory  home  care  services  workers or any worker with direct
    13  patient care  responsibility  in  the  following  amounts  for  services
    14  provided on and after December first, two thousand two, provided, howev-
    15  er,  for  services  provided  in  the state fiscal year commencing April
    16  first, two thousand twenty-one such amounts shall be  reduced  by  fifty
    17  percent.
    18    §  5.  Subdivision  1  of  section  4013  of the public health law, as
    19  amended by section 9 of part MM of chapter 56 of the laws  of  2020,  is
    20  amended to read as follows:
    21    1.  The  commissioner  shall, subject to the provisions of subdivision
    22  two of this section, increase medical assistance rates of payment by  up
    23  to  three  percent  for  hospice services provided on and after December
    24  first, two thousand two,  for  purposes  of  improving  recruitment  and
    25  retention of non-supervisory workers or workers with direct patient care
    26  responsibility,  provided,  however,  for services provided in the state
    27  fiscal  year  commencing  April  first,  two  thousand  twenty-one  such
    28  increase shall be up to one and one-half percent.
    29    §  6.  This  act  shall take effect immediately and shall be deemed to
    30  have been in full force and effect on and after April 1, 2021.
 
    31                                   PART F
 
    32    Section 1. Subdivision 3 of section 2999-cc of the public health  law,
    33  as amended by section 2 of subpart C of part S of chapter 57 of the laws
    34  of 2018, is amended to read as follows:
    35    3.  "Originating  site"  means a site at which a patient is located at
    36  the time health care services are delivered to him or her  by  means  of
    37  telehealth.  [Originating  sites  shall  be  limited  to: (a) facilities
    38  licensed under articles twenty-eight and  forty  of  this  chapter;  (b)
    39  facilities  as  defined in subdivision six of section 1.03 of the mental
    40  hygiene  law;  (c)  certified  and  non-certified  day  and  residential
    41  programs  funded or operated by the office for people with developmental
    42  disabilities; (d) private physician's or dentist's offices located with-
    43  in the state of New York; (e) any type of adult care  facility  licensed
    44  under title two of article seven of the social services law; (f) public,
    45  private  and  charter elementary and secondary schools, school age child
    46  care programs, and child day care centers within the state of New  York;
    47  and (g) the patient's place of residence located within the state of New
    48  York  or other temporary location located within or outside the state of
    49  New York.]
    50    § 2. Paragraph (d) of subdivision 18-a of section 206  of  the  public
    51  health  law, as amended by section 8 of part A of chapter 57 of the laws
    52  of 2015, is amended to read as follows:
    53    (d) The commissioner may make such rules and  regulations  as  may  be
    54  necessary  to  implement federal policies and disburse funds as required

        S. 2507--A                          9                         A. 3007--A
 
     1  by the American Recovery and Reinvestment Act of 2009 and to promote the
     2  development of a self-sufficient SHIN-NY to enable  widespread,  non-du-
     3  plicative  interoperability  among disparate health information systems,
     4  including  electronic  health  records,  personal health records, health
     5  care claims, payment and other administrative data,  and  public  health
     6  information  systems,  while protecting privacy and security. Such rules
     7  and regulations shall include, but not be limited to,  requirements  for
     8  organizations covered by 42 U.S.C. 17938 or any other organizations that
     9  exchange  health  information through the SHIN-NY or any other statewide
    10  health information system recommended by the workgroup.  Such rules  and
    11  regulations  shall  require that qualified entities permit access to all
    12  of a patient's information by all  SHIN-NY  participants  or  any  other
    13  general  designation of who may access such information after consent is
    14  obtained using a single statewide SHIN-NY consent form approved  by  the
    15  department and published on the department's website. If the commission-
    16  er  seeks  to  promulgate rules and regulations prior to issuance of the
    17  report identified in subparagraph (iv) of paragraph (b) of this subdivi-
    18  sion, the commissioner shall submit  the  proposed  regulations  to  the
    19  workgroup  for  its input. If the commissioner seeks to promulgate rules
    20  and regulations after the issuance of  the  report  identified  in  such
    21  subparagraph  (iv)  then  the commissioner shall consider the report and
    22  recommendations of the workgroup. If the commissioner acts in  a  manner
    23  inconsistent  with  the input or recommendations of the workgroup, he or
    24  she shall provide the reasons therefor.
    25    § 3. Paragraphs (w) and (x) of subdivision 2 of section 2999-cc of the
    26  public health law, as amended by section 1 of part HH of chapter  56  of
    27  the laws of 2020, are amended to read as follows:
    28    (w)  a  care  manager  employed  by or under contract to a health home
    29  program, patient centered medical home, office for people with  develop-
    30  mental  disabilities  Care Coordination Organization (CCO), hospice or a
    31  voluntary foster care agency certified by the  office  of  children  and
    32  family services certified and licensed pursuant to article twenty-nine-i
    33  of this chapter; [and]
    34    (x)  practitioners authorized to provide services in New York pursuant
    35  to the interstate licensure program set forth in regulations promulgated
    36  by the commissioner of education in accordance with subdivision three of
    37  section sixty-five hundred one of the education law; and
    38    (y)  any  other provider as determined by the commissioner pursuant to
    39  regulation or, in consultation with the commissioner, by the commission-
    40  er of the office of mental health, the commissioner  of  the  office  of
    41  addiction  services  and supports, or the commissioner of the office for
    42  people with developmental disabilities pursuant to regulation.
    43    § 4. Section 6501 of the education law is  amended  by  adding  a  new
    44  subdivision 3 to read as follows:
    45    3.  Notwithstanding  any  inconsistent provision of law, rule or regu-
    46  lation to the contrary, the commissioner shall, in consultation with the
    47  commissioners of the department of  health,  office  of  mental  health,
    48  office  of  addiction  services and supports, and office for people with
    49  developmental disabilities, issue regulations for  the  creation  of  an
    50  interstate  licensure program which authorizes practitioners licensed by
    51  contiguous states or states in the Northeast  region  to  provide  tele-
    52  health  services,  as  defined  by  article  twenty-nine-g of the public
    53  health law and any implementing regulations promulgated by  the  commis-
    54  sioners  of the department of health, office of mental health, office of
    55  addiction services and supports, and office  for  people  with  develop-
    56  mental  disabilities, to patients located in New York state, taking into

        S. 2507--A                         10                         A. 3007--A
 
     1  consideration the need for  specialty  practice  areas  with  historical
     2  access  issues,  as determined by the commissioners of the department of
     3  health, office of  mental  health,  office  of  addiction  supports  and
     4  services,  or  office  for people with developmental disabilities.  Such
     5  regulations may be promulgated on an emergency basis; provided, however,
     6  they shall be promulgated on a final basis no later than  March  thirty-
     7  first, two thousand twenty-two.
     8    §  5.  Section  3217-h of the insurance law is amended by adding a new
     9  subsection (c) to read as follows:
    10    (c) An insurer that  provides  comprehensive  coverage  for  hospital,
    11  medical,  or surgical care with a network of health care providers shall
    12  ensure that such network is adequate to meet  the  telehealth  needs  of
    13  insured individuals for services covered under the policy when medically
    14  appropriate.
    15    §  6.  Section  4306-g of the insurance law is amended by adding a new
    16  subsection (c) to read as follows:
    17    (c) A corporation that provides comprehensive coverage  for  hospital,
    18  medical,  or surgical care with a network of health care providers shall
    19  ensure that such network is adequate to meet  the  telehealth  needs  of
    20  insured individuals for services covered under the policy when medically
    21  appropriate.
    22    §  7.  Subdivisions 1 and 6 of section 24 of the public health law, as
    23  added by section 17 of part H of chapter 60 of the  laws  of  2014,  are
    24  amended to read as follows:
    25    1.  A  health  care  professional,  or a group practice of health care
    26  professionals, a diagnostic and treatment  center  or  a  health  center
    27  defined  under  42  U.S.C. § 254b on behalf of health care professionals
    28  rendering services at  the  group  practice,  diagnostic  and  treatment
    29  center  or  health  center,  shall  disclose  to patients or prospective
    30  patients in writing or through an internet website the health care plans
    31  in which the health care professional, group  practice,  diagnostic  and
    32  treatment  center  or health center, is a participating provider and the
    33  hospitals with which the health care professional is affiliated prior to
    34  the provision of non-emergency services and  verbally  at  the  time  an
    35  appointment  is  scheduled.  Such  disclosure shall indicate whether the
    36  health care  professional,  group  practice,  diagnostic  and  treatment
    37  center or health center offers telehealth services.
    38    6.  A  hospital  shall  post on the hospital's website: (a) the health
    39  care plans in which the hospital is  a  participating  provider;  (b)  a
    40  statement  that  (i) physician services provided in the hospital are not
    41  included in the hospital's charges; (ii) physicians who provide services
    42  in the hospital may or may not participate with  the  same  health  care
    43  plans  as  the hospital, and; (iii) the prospective patient should check
    44  with the physician arranging for the hospital services to determine  the
    45  health  care  plans in which the physician participates; (c) as applica-
    46  ble, the name, mailing address and telephone  number  of  the  physician
    47  groups that the hospital has contracted with to provide services includ-
    48  ing  anesthesiology,  pathology  or  radiology,  and instructions how to
    49  contact these groups to determine the health care plan participation  of
    50  the physicians in these groups; [and] (d) as applicable, the name, mail-
    51  ing address, and telephone number of physicians employed by the hospital
    52  and  whose services may be provided at the hospital, and the health care
    53  plans in which they participate; and (e) disclosure as  to  whether  the
    54  hospital offers telehealth services.
    55    §  8.  Subdivision 8 of section 24 of the public health law is amended
    56  by adding a new paragraph (d) to read as follows:

        S. 2507--A                         11                         A. 3007--A
 
     1    (d) "Telehealth services" means those services provided in  accordance
     2  with  article  twenty-nine-g  of this chapter, subsection (b) of section
     3  thirty-two hundred seventeen-h of the insurance law, or  subsection  (b)
     4  of  section  forty-three hundred six-g of the insurance law, as applica-
     5  ble.
     6    §  9.  This act shall take effect April 1, 2021; provided, however, if
     7  this act shall have become a law after such date it  shall  take  effect
     8  immediately and shall be deemed to have been in full force and effect on
     9  and  after April 1, 2021; provided further, however, that the amendments
    10  to paragraph (d) of subdivision 18-a of section 206 of the public health
    11  law made by section two of this act shall not affect the repeal of  such
    12  paragraph  and shall be deemed repealed therewith; and provided further,
    13  that sections five and six of this act shall take effect October 1, 2021
    14  and shall apply to policies and  contracts  issued,  renewed,  modified,
    15  altered, or amended on and after such date.
 
    16                                   PART G
 
    17    Section  1.  The  public health law is amended by adding a new article
    18  29-J to read as follows:
    19                                ARTICLE 29-J
    20                           MEDICAL RESPITE PROGRAM
    21  Section 2999-hh. Medical respite program.
    22    § 2999-hh.  Medical  respite  program.  1.  Legislative  findings  and
    23  purpose.  The  legislature  finds that an individual who lacks access to
    24  safe housing faces an increased risk  of  adverse  health  outcomes.  By
    25  offering  medical respite programs as a lower-intensity care setting for
    26  individuals who would otherwise require a hospital stay or lack  a  safe
    27  option  for discharge and recovery, medical respite programs will reduce
    28  hospital inpatient admissions and lengths  of  stay,  hospital  readmis-
    29  sions,  and  emergency room use.   The legislature finds that the estab-
    30  lishment of medical respite programs will protect  the  public  interest
    31  and the interests of patients.
    32    2.  Definitions.  As  used  in this article, the following terms shall
    33  have the  following  meanings,  unless  the  context  clearly  otherwise
    34  requires:
    35    (a)  "Medical  respite  program"  means  a  not-for-profit corporation
    36  licensed or certified pursuant to subdivision three of this  section  to
    37  serve  recipients  whose prognosis or diagnosis necessitates the receipt
    38  of:
    39    (i) Temporary room and board; and
    40    (ii) The provision or arrangement of the provision of health care  and
    41  support  services;  provided,   however, that the operation of a medical
    42  respite program shall be separate and distinct from any housing programs
    43  offered to individuals who do not qualify as recipients.
    44    (b) "Recipient" means an individual who:
    45    (i) Has a qualifying health condition that requires treatment or care;
    46    (ii) Does not require hospital inpatient, observation unit,  or  emer-
    47  gency  room level of care, or a medically indicated emergency department
    48  or observation visit; and
    49    (iii) Is experiencing homelessness or at imminent  risk  of  homeless-
    50  ness.  (A)  Subject  to clause (B) of this subparagraph and any rules or
    51  regulations promulgated pursuant to subdivision four of this section,  a
    52  person  shall be deemed "homeless" if they are unable to secure or main-
    53  tain permanent or stable housing without assistance.

        S. 2507--A                         12                         A. 3007--A
 
     1    (B) An operator of a medical respite program may establish eligibility
     2  standards using a more limited  definition  of  "homelessness"  if  such
     3  limitation  is  necessary to ensure the availability of a funding source
     4  that will support the medical respite program's provision  of  room  and
     5  board,  and  such limitations are otherwise consistent with any rules or
     6  regulations promulgated pursuant to subdivision four  of  this  section.
     7  This applies to conditions that may exist in connection with:
     8    (1)  Public  funding provided by a federal, state, or local government
     9  entity; or
    10    (2) Subject to the approval of the department, private funding from  a
    11  charitable entity or other non-governmental source.
    12    3.  Licensure  or  certification. (a) Notwithstanding any inconsistent
    13  provision of law, the commissioner may license or certify a not-for-pro-
    14  fit corporation as an operator of a medical respite program.
    15    (b) The commissioner may promulgate rules and regulations to establish
    16  procedures to review and approve applications for a license  or  certif-
    17  ication  pursuant  to this article, which may be promulgated on an emer-
    18  gency basis and which shall, at a minimum, specify standards for: recip-
    19  ient eligibility; mandatory medical respite program  services;  physical
    20  environment;  staffing; and policies and procedures governing health and
    21  safety, length of stay, referrals, discharge, and coordination of care.
    22    4. Operating standards;  responsibility  for  standards.  (a)  Medical
    23  respite programs licensed or certified pursuant to this article shall:
    24    (i) Provide recipients with temporary room and board; and
    25    (ii) Provide, or arrange for the provision of, health care and support
    26  services to recipients.
    27    (b)  Nothing  contained  within this article shall affect the applica-
    28  tion, qualification, or requirements that may apply to an operator  with
    29  respect to any other licenses or operating certificates that such opera-
    30  tor  may hold, including, without limitation, under article twenty-eight
    31  of this chapter or article seven of the social services law.
    32    5. Temporary accommodation. A medical respite program shall be consid-
    33  ered a form of emergency shelter or temporary shelter  for  purposes  of
    34  determining  a  recipient's eligibility for housing programs or benefits
    35  administered by the state  or  by  a  local  social  services  district,
    36  including  programs or benefits that support access to accommodations of
    37  a temporary, transitional, or permanent nature.
    38    6. Inspections and compliance. The commissioner shall have  the  power
    39  to  inquire  into  the  operation  of  any licensed or certified medical
    40  respite program and to conduct periodic inspections of  facilities  with
    41  respect  to the fitness and adequacy of the premises, equipment, person-
    42  nel, rules and by-laws, standards of medical care and  services,  system
    43  of accounts, records, and the adequacy of financial resources and sourc-
    44  es of future revenues.
    45    7. Suspension or revocation of license or certification. (a) A license
    46  or certification for a medical respite program under this article may be
    47  revoked,  suspended, limited, annulled or denied by the commissioner, in
    48  consultation with either the  commissioners  of  the  office  of  mental
    49  health, the office of temporary and disability assistance, or the office
    50  of  addiction  services and supports, as appropriate based on a determi-
    51  nation of the department depending on the diagnosis or stated  needs  of
    52  the  individuals  being  served  or proposed to be served in the medical
    53  respite program being considered for revocation, suspension, limitation,
    54  annulment or denial of certification, if an operator  is  determined  to
    55  have  failed  to comply with the provisions of this article or the rules
    56  and regulations promulgated thereunder. No action taken against an oper-

        S. 2507--A                         13                         A. 3007--A
 
     1  ator under this subdivision shall affect an operator's other licenses or
     2  certifications; provided however, that the facts that gave rise  to  the
     3  revocation, suspension, limitation, annulment or denial of certification
     4  may  also  form  the  basis of a limitation, suspension of revocation of
     5  such other licenses or certifications.
     6    (b) No such medical respite program license or certification shall  be
     7  revoked,  suspended,  limited,  annulled  or  denied  without a hearing;
     8  provided that a license or certification may be temporarily suspended or
     9  limited without a hearing for a period not in excess of thirty days upon
    10  written notice that the continuation  of  the  medical  respite  program
    11  places the public health or safety of the recipients in imminent danger.
    12    (c) Nothing in this section shall prevent the commissioner from impos-
    13  ing sanctions or penalties on a medical respite program that are author-
    14  ized under any other law or regulation.
    15    §  2.  This  act  shall take effect immediately and shall be deemed to
    16  have been in full force and effect on and after April 1, 2021.
 
    17                                   PART H
 
    18    Section 1. The title heading of title 11-D of article 5 of the  social
    19  services  law,  as added by chapter 1 of the laws of 1999, is amended to
    20  read as follows:
    21                    [FAMILY] BASIC HEALTH [PLUS] PROGRAM
 
    22    § 2. Paragraph (d) of subdivision 3, subdivision 5 and  subdivision  7
    23  of  section 369-gg of the social services law, as added by section 51 of
    24  part C of chapter 60 of the laws of 2014 and subdivision 7 as renumbered
    25  by section 28 of part B of chapter 57 of the laws of 2015,  are  amended
    26  to read as follows:
    27    (d)  (i)  has  household income at or below two hundred percent of the
    28  federal poverty line defined and annually revised by the  United  States
    29  department  of  health  and  human  services for a household of the same
    30  size; and (ii) has household income that  exceeds  one  hundred  thirty-
    31  three  percent  of the federal poverty line defined and annually revised
    32  by the United States department of  health  and  human  services  for  a
    33  household of the same size; however, MAGI eligible aliens lawfully pres-
    34  ent  in the United States with household incomes at or below one hundred
    35  thirty-three percent of the federal poverty line shall  be  eligible  to
    36  receive  coverage for health care services pursuant to the provisions of
    37  this title if such alien would  be  ineligible  for  medical  assistance
    38  under title eleven of this article due to his or her immigration status.
    39    An  applicant who fails to make an applicable premium payment, if any,
    40  shall lose eligibility to receive coverage for health care  services  in
    41  accordance with time frames and procedures determined by the commission-
    42  er.
    43    5.  Premiums  and  cost  sharing. (a) Subject to federal approval, the
    44  commissioner shall establish premium payments  enrollees  shall  pay  to
    45  approved  organizations for coverage of health care services pursuant to
    46  this title. [Such premium payments shall be established in the following
    47  manner:
    48    (i) up to twenty dollars monthly for an individual  with  a  household
    49  income  above  one hundred and fifty percent of the federal poverty line
    50  but at or below two hundred percent of the federal poverty line  defined
    51  and annually revised by the United States department of health and human
    52  services for a household of the same size; and

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

     1    (ii)  no]  No  payment  is  required  for individuals with a household
     2  income at or below [one hundred and fifty] two hundred  percent  of  the
     3  federal  poverty  line defined and annually revised by the United States
     4  department of health and human services for  a  household  of  the  same
     5  size.
     6    (b)  The  commissioner  shall  establish  cost sharing obligations for
     7  enrollees, subject to federal approval.
     8    7. Any funds transferred by the secretary of health and human services
     9  to the state pursuant to 42 U.S.C. 18051(d) shall be deposited in trust.
    10  Funds from the trust shall be used for providing health benefits through
    11  an approved organization, which, at a minimum, shall  include  essential
    12  health  benefits  as  defined  in  42  U.S.C.  18022(b);  to  reduce the
    13  premiums, if any, and cost sharing of participants in the  basic  health
    14  program;  or  for such other purposes as may be allowed by the secretary
    15  of health and human services.  Health  benefits  available  through  the
    16  basic health program shall be provided by one or more approved organiza-
    17  tions  pursuant  to an agreement with the department of health and shall
    18  meet the requirements of applicable federal and  state  laws  and  regu-
    19  lations.
    20    §  3.  This act shall take effect June 1, 2021 and shall expire and be
    21  deemed repealed should federal approval be withdrawn or 42 U.S.C.  18051
    22  be  repealed;  provided that the commissioner of health shall notify the
    23  legislative bill drafting commission  upon  the  withdrawal  of  federal
    24  approval  or  the repeal of 42 U.S.C. 18051 in order that the commission
    25  may maintain an accurate and timely effective data base of the  official
    26  text of the laws of the state of New York in furtherance of effectuating
    27  the  provisions of section 44 of the legislative law and section 70-b of
    28  the public officers law.
 
    29                                   PART I
 
    30    Section 1. Subdivision 1 of section 268-c of the public health law, as
    31  added by section 2 of part T of chapter 57  of  the  laws  of  2019,  is
    32  amended to read as follows:
    33    1. (a) Perform eligibility determinations for federal and state insur-
    34  ance  affordability  programs including medical assistance in accordance
    35  with section three hundred sixty-six of the social services  law,  child
    36  health  plus  in  accordance  with section twenty-five hundred eleven of
    37  this chapter, the basic health program in accordance with section  three
    38  hundred  sixty-nine-gg  of  the social services law, premium tax credits
    39  and cost-sharing reductions and qualified  health  plans  in  accordance
    40  with applicable law and other health insurance programs as determined by
    41  the commissioner;
    42    (b)  certify  and  make  available to qualified individuals, qualified
    43  health plans, including  dental  plans,  certified  by  the  Marketplace
    44  pursuant  to  applicable  law,  provided  that coverage under such plans
    45  shall not become effective prior to certification  by  the  Marketplace;
    46  [and]
    47    (c)  certify  and/or  make  available  to eligible individuals, health
    48  plans certified by the Marketplace pursuant to  applicable  law,  and/or
    49  participating in an insurance affordability program pursuant to applica-
    50  ble law, provided that coverage under such plans shall not become effec-
    51  tive  prior  to certification by the Marketplace, and/or approval by the
    52  commissioner[.]; and
    53    (d) the commissioner,  in  cooperation  with  the  superintendent,  is
    54  authorized  and directed, subject to the approval of the director of the

        S. 2507--A                         15                         A. 3007--A
 
     1  division of the budget, to apply for federal waivers  when  such  action
     2  would  be  necessary  to  assist  in  promoting  the  objectives of this
     3  section.
     4    §  2.  This  act  shall take effect immediately and shall be deemed to
     5  have been in full force and effect on and after April 1, 2021.
 
     6                                   PART J
 
     7    Section 1. The insurance law is amended by adding a new article 29  to
     8  read as follows:
     9                                 ARTICLE 29
    10                          PHARMACY BENEFIT MANAGERS
    11  Section 2901. Definitions.
    12          2902. Acting without a registration.
    13          2903. Registration requirements for pharmacy benefit managers.
    14          2904. Reporting requirements for pharmacy benefit managers.
    15          2905. Acting without a license.
    16          2906. Licensing of a pharmacy benefit manager.
    17          2907. Revocation or suspension of a registration or license of a
    18                  pharmacy benefit manager.
    19          2908. Penalties for violations.
    20          2909. Stay or suspension of superintendent's determination.
    21          2910. Revoked registrations or licenses.
    22          2911. Change of address.
    23          2912. Duties.
    24          2913. Applicability of other laws.
    25          2914. Assessments.
    26    § 2901. Definitions. For purposes of this article:
    27    (a)  "Health  plan"  means  an insurance company that is an authorized
    28  insurer under this chapter, a  company  organized  pursuant  to  article
    29  forty-three of this chapter, a municipal cooperative health benefit plan
    30  established  pursuant  to article forty-seven of this chapter, an entity
    31  certified pursuant to  article  forty-four  of  the  public  health  law
    32  including  those  providing services pursuant to title eleven of article
    33  five of the social services law and title one-A of  article  twenty-five
    34  of  the  public health law, an institution of higher education certified
    35  pursuant to section one thousand one hundred twenty-four of  this  chap-
    36  ter,  the  state insurance fund, and the New York state health insurance
    37  plan established under article eleven of the civil service law.
    38    (b) "Pharmacy benefit management services"  means  the  management  or
    39  administration of prescription drug benefits pursuant to a contract with
    40  a  health  plan,  directly  or through another entity, and regardless of
    41  whether the pharmacy benefit manager and the health plan are related, or
    42  associated by ownership, common ownership,  organization  or  otherwise;
    43  including  the  procurement  of  prescription  drugs  to be dispensed to
    44  patients, or the administration or management of prescription drug bene-
    45  fits, including but not limited to, any of the following:
    46    (1) mail service pharmacy;
    47    (2) claims processing, retail network management, or payment of claims
    48  to pharmacies for dispensing prescription drugs;
    49    (3) clinical or other formulary or preferred drug list development  or
    50  management;
    51    (4)  negotiation  or  administration  of  rebates,  discounts, payment
    52  differentials, or other incentives,  for  the  inclusion  of  particular
    53  prescription  drugs  in a particular category or to promote the purchase
    54  of particular prescription drugs;

        S. 2507--A                         16                         A. 3007--A
 
     1    (5) patient compliance, therapeutic intervention, or  generic  substi-
     2  tution programs;
     3    (6) disease management;
     4    (7) drug utilization review or prior authorization;
     5    (8) adjudication of appeals or grievances related to prescription drug
     6  coverage;
     7    (9) contracting with network pharmacies; and
     8    (10) controlling the cost of covered prescription drugs.
     9    (c)  "Pharmacy  benefit  manager" means any entity, including a wholly
    10  owned or partially owned or controlled subsidiary of a pharmacy benefits
    11  manager, that contracts to provide pharmacy benefit management  services
    12  on behalf of a health plan.
    13    (d) "Controlling person" means any person or other entity who or which
    14  directly  or  indirectly has the power to direct or cause to be directed
    15  the management, control or activities of a pharmacy benefit manager.
    16    (e)  "Covered  individual"  means  a  member,  participant,  enrollee,
    17  contract holder or policy holder or beneficiary of a health plan.
    18    §  2902.  Acting  without a registration. (a) No person, firm, associ-
    19  ation, corporation or other entity may act as a pharmacy benefit manager
    20  on or after June first, two thousand twenty-one  and  prior  to  January
    21  first, two thousand twenty-three, without having a valid registration as
    22  a  pharmacy  benefit manager filed with the superintendent in accordance
    23  with this article and any regulations promulgated thereunder.
    24    (b) Any person, firm, association, corporation or  other  entity  that
    25  violates  this  section shall, in addition to any other penalty provided
    26  by law, be liable for restitution  to  any  health  plan,  pharmacy,  or
    27  covered  individual harmed by the violation and shall also be subject to
    28  a penalty not exceeding the greater of: (1) one thousand dollars for the
    29  first violation and two thousand five hundred dollars  for  each  subse-
    30  quent  violation; or (2) the aggregate economic gross receipts attribut-
    31  able to all violations.
    32    § 2903. Registration requirements for pharmacy benefit managers.   (a)
    33  Every pharmacy benefit manager that performs pharmacy benefit management
    34  services  on  or  after June first, two thousand twenty-one and prior to
    35  January first, two thousand twenty-three shall register with the  super-
    36  intendent  in  a manner acceptable to the superintendent and shall pay a
    37  fee of one thousand dollars for each year or fraction of a year in which
    38  the registration shall be valid. The superintendent shall  require  that
    39  the pharmacy benefit manager disclose its officer or officers and direc-
    40  tor  or  directors who are responsible for the business entity's compli-
    41  ance with the financial services and insurance  laws,  rules  and  regu-
    42  lations  of this state. The registration shall detail the locations from
    43  which it provides services, and a listing of any entities with which  it
    44  has contracts in New York state.  The superintendent can reject a regis-
    45  tration  application  filed  by a pharmacy benefit manager that fails to
    46  comply with the minimum registration standards.
    47    (b) For each business entity, the officer or officers and director  or
    48  directors  named  in the application shall be designated responsible for
    49  the business entity's compliance with the financial services and  insur-
    50  ance laws, rules and regulations of this state.
    51    (c) Every registration will expire on December thirty-first, two thou-
    52  sand twenty-two regardless of when registration was first made.
    53    (d)  Every  pharmacy  benefit  manager  that performs pharmacy benefit
    54  management services at any time prior to June first, two thousand  twen-
    55  ty-one,  shall  make  the  registration  and  fee  payment  required  by
    56  subsection (a) of this section on or before  June  first,  two  thousand

        S. 2507--A                         17                         A. 3007--A
 
     1  twenty-one.  Any other pharmacy benefit manager shall make the registra-
     2  tion and fee payment required by subsection (a) of this section prior to
     3  performing pharmacy benefit management services.
     4    (e)  Registrants under this section shall be subject to examination by
     5  the superintendent as often as the superintendent may deem it necessary.
     6  The superintendent may promulgate regulations establishing  methods  and
     7  procedures  for  facilitating and verifying compliance with the require-
     8  ments of this article and such other regulations as necessary to enforce
     9  the provisions of this article.
    10    § 2904. Reporting requirements for pharmacy benefit managers.   (a)(1)
    11  On  or before July first of each year, beginning in two thousand twenty-
    12  two, every pharmacy benefit manager shall report to the  superintendent,
    13  in a statement subscribed and affirmed as true under penalties of perju-
    14  ry,  the  information requested by the superintendent including, without
    15  limitation:
    16    (i) any pricing discounts, rebates of any kind, inflationary payments,
    17  credits, clawbacks, fees,  grants,  chargebacks,  reimbursements,  other
    18  financial  or  other reimbursements, incentives, inducements, refunds or
    19  other benefits received by the pharmacy benefit manager; and
    20    (ii) the terms and conditions of any contract or arrangement,  includ-
    21  ing  other  financial or other reimbursements incentives, inducements or
    22  refunds between the pharmacy benefit manager and any other party  relat-
    23  ing  to  pharmacy  benefit management services provided to a health plan
    24  including but not limited to, dispensing fees paid to pharmacies.
    25    (2) The superintendent may require the filing of  quarterly  or  other
    26  statements,  which  shall be in such form and shall contain such matters
    27  as the superintendent shall prescribe.
    28    (3) The superintendent may address to any pharmacy benefit manager  or
    29  its  officers any inquiry in relation to its provision of pharmacy bene-
    30  fit management services or any matter connected therewith. Every pharma-
    31  cy benefit manager or person so addressed shall reply in writing to such
    32  inquiry promptly and truthfully, and such reply shall be, if required by
    33  the superintendent, subscribed by such individual, or by such officer or
    34  officers of the pharmacy benefit manager, as  the  superintendent  shall
    35  designate, and affirmed by them as true under the penalties of perjury.
    36    (b)  In  the  event  any  pharmacy  benefit manager or person does not
    37  submit a report required by paragraphs one or two of subsection  (a)  of
    38  this  section  or  does  not provide a good faith response to an inquiry
    39  from the superintendent pursuant to paragraph three of subsection (a) of
    40  this section within a time period specified by the superintendent of not
    41  less than fifteen business days, the  superintendent  is  authorized  to
    42  levy  a  civil  penalty, after notice and hearing, against such pharmacy
    43  benefit manager or person not to exceed one thousand dollars per day for
    44  each day beyond the date the report is due or the date specified by  the
    45  superintendent for response to the inquiry.
    46    (c)  All  documents,  materials,  or  other information disclosed by a
    47  pharmacy benefit manager under this section which is in the  control  or
    48  possession of the superintendent shall be deemed confidential, shall not
    49  be  disclosed,  either  pursuant  to  freedom of information requests or
    50  subpoena, and further shall not be subject to discovery or admissible in
    51  evidence in any private civil action; provided however that  nothing  in
    52  this  subdivision  shall  prevent the superintendent, in his or her sole
    53  discretion, from providing to any other governmental entity  information
    54  the  superintendent  deems  necessary for the enforcement of the laws of
    55  this state or of the United States.

        S. 2507--A                         18                         A. 3007--A
 
     1    § 2905. Acting without a license. (a) No  person,  firm,  association,
     2  corporation  or other entity may act as a pharmacy benefit manager on or
     3  after January first, two thousand twenty-three without having  authority
     4  to  do  so  by  virtue  of  a  license  issued  in force pursuant to the
     5  provisions of this article.
     6    (b)  Any  person,  firm, association, corporation or other entity that
     7  violates this section shall, in addition to any other  penalty  provided
     8  by  law,  be  subject  to a penalty not exceeding the greater of (1) one
     9  thousand dollars for the first violation and two thousand  five  hundred
    10  dollars  for  each  subsequent  violation  or (2) the aggregate economic
    11  gross receipts attributable to all violations.
    12    § 2906. Licensing of a pharmacy benefit manager. (a)  The  superinten-
    13  dent may issue a pharmacy benefit manager's license to any person, firm,
    14  association  or  corporation  who or that has complied with the require-
    15  ments of this article, including regulations promulgated by  the  super-
    16  intendent.  The superintendent, in consultation with the commissioner of
    17  health, may establish, by regulation, minimum standards for the issuance
    18  of a license to a pharmacy benefit manager.
    19    (b) The minimum standards established under this section may  address,
    20  without limitation:
    21    (1)  prohibitions  on  conflicts  of interest between pharmacy benefit
    22  managers and health plans;
    23    (2)  prohibitions  on  deceptive  practices  in  connection  with  the
    24  performance of pharmacy benefit management services;
    25    (3)  prohibitions on anti-competitive practices in connection with the
    26  performance of pharmacy benefit management services;
    27    (4) prohibitions on pricing models, which may include prohibitions  on
    28  spread pricing;
    29    (5)  prohibitions  on  unfair  claims practices in connection with the
    30  performance of pharmacy benefit management services;
    31    (6) codification of standards and practices in the creation of pharma-
    32  cy networks and contracting with network pharmacies and other providers;
    33    (7) prohibitions on contract provisions which  arbitrarily  require  a
    34  pharmacy  to meet any pharmacy accreditation standard or recertification
    35  requirement inconsistent with or more stringent than, or in addition  to
    36  federal  or  state  requirements and codification of standards and prac-
    37  tices in the creation and use of specialty pharmacy networks; and
    38    (8) best practices for protection of consumers.
    39    (c) The superintendent may require any or all of  the  members,  offi-
    40  cers, directors, or designated employees of the applicant to be named in
    41  the  application  for  a  license  under this article. For each business
    42  entity, the officer or officers and director or directors named  in  the
    43  application  shall  be  designated responsible for the business entity's
    44  compliance with the insurance laws, rules and regulations of this state.
    45    (d)(1) Before a pharmacy benefit manager's license shall be issued  or
    46  renewed,  the  prospective licensee shall properly file in the office of
    47  the superintendent a written application therefor in such form or  forms
    48  and  supplements thereto as the superintendent prescribes, and pay a fee
    49  of two thousand dollars for each year or fraction of a year in  which  a
    50  license shall be valid.
    51    (2)  Every  pharmacy benefit manager's license shall expire thirty-six
    52  months after the date of issue. Every license issued  pursuant  to  this
    53  section  may be renewed for the ensuing period of thirty-six months upon
    54  the filing of an application in conformity with this subsection.
    55    (e) If an application for a renewal license shall have been filed with
    56  the superintendent at least two months before its expiration,  then  the

        S. 2507--A                         19                         A. 3007--A
 
     1  license  sought  to  be  renewed shall continue in full force and effect
     2  either until the issuance by the superintendent of the  renewal  license
     3  applied  for  or  until  five  days  after the superintendent shall have
     4  refused  to  issue such renewal license and given notice of such refusal
     5  to the applicant.
     6    (f) The superintendent may refuse to issue a pharmacy  benefit  manag-
     7  er's  license if, in the superintendent's judgment, the applicant or any
     8  member, principal, officer or director of the applicant, is  not  trust-
     9  worthy  and competent to act as or in connection with a pharmacy benefit
    10  manager, or that any of the foregoing has given cause for revocation  or
    11  suspension  of  such license, or has failed to comply with any prerequi-
    12  site for the issuance of such license. As a part of such  determination,
    13  the  superintendent  is  authorized  to  fingerprint  applicants  or any
    14  member, principal, officer or director of the applicant  for  licensure.
    15  Such fingerprints shall be submitted to the division of criminal justice
    16  services for a state criminal history record check, as defined in subdi-
    17  vision  one  of section three thousand thirty-five of the education law,
    18  and may be submitted to  the  federal  bureau  of  investigation  for  a
    19  national criminal history record check.
    20    (g) Licensees and applicants for a license under this section shall be
    21  subject to examination by the superintendent as often as the superinten-
    22  dent  may  deem  it  expedient.  The superintendent may promulgate regu-
    23  lations establishing methods and procedures for facilitating and verify-
    24  ing compliance with the requirements of  this  section  and  such  other
    25  regulations as necessary.
    26    (h)  The  superintendent  may  issue  a  replacement  for  a currently
    27  in-force license that has been lost or destroyed. Before the replacement
    28  license shall be issued, there shall be on file in  the  office  of  the
    29  superintendent  a  written  application  for  the  replacement  license,
    30  affirming under penalty of perjury that the original  license  has  been
    31  lost or destroyed, together with a fee of two hundred dollars.
    32    (i) No pharmacy benefit manager shall engage in any practice or action
    33  that a health plan is prohibited from engaging in pursuant to this chap-
    34  ter.
    35    §  2907.  Revocation  or  suspension of a registration or license of a
    36  pharmacy benefit manager.  (a) The superintendent may refuse  to  renew,
    37  may  revoke,  or  may suspend for a period the superintendent determines
    38  the registration or license of any  pharmacy  benefit  manager  if,  the
    39  superintendent determines that the registrant or licensee or any member,
    40  principal, officer, director, or controlling person of the registrant or
    41  licensee, has:
    42    (1)  violated  any insurance laws, section two hundred eighty-a or two
    43  hundred eighty-c of the public health law or  violated  any  regulation,
    44  subpoena  or order of the superintendent or of another state's insurance
    45  commissioner, or has violated any law in the course of its  dealings  in
    46  such  capacity after such license has been issued or renewed pursuant to
    47  section two thousand nine hundred six of this article;
    48    (2) provided materially incorrect, materially  misleading,  materially
    49  incomplete  or  materially  untrue  information  in  the registration or
    50  license application;
    51    (3) obtained or attempted to obtain a registration or license  through
    52  misrepresentation or fraud;
    53    (4)(i) used fraudulent, coercive or dishonest practices;
    54    (ii) demonstrated incompetence;
    55    (iii) demonstrated untrustworthiness; or

        S. 2507--A                         20                         A. 3007--A
 
     1    (iv)  demonstrated  financial irresponsibility in the conduct of busi-
     2  ness in this state or elsewhere;
     3    (5)  improperly  withheld,  misappropriated or converted any monies or
     4  properties received in the course of business in  this  state  or  else-
     5  where;
     6    (6)  intentionally  misrepresented  the terms of an actual or proposed
     7  insurance contract;
     8    (7) admitted or been found to  have  committed  any  insurance  unfair
     9  trade practice or fraud;
    10    (8)  had  a  pharmacy  benefit manager registration or license, or its
    11  equivalent, denied, suspended or revoked in any other  state,  province,
    12  district or territory;
    13    (9)  failed  to pay state income tax or comply with any administrative
    14  or court order directing payment of state income tax;
    15    (10) failed to pay any assessment required by this article; or
    16    (11) ceased to meet the requirements  for  registration  or  licensure
    17  under this article.
    18    (b)  Before  revoking or suspending the registration or license of any
    19  pharmacy benefit manager pursuant to the provisions of this article, the
    20  superintendent shall give notice to the registrant or licensee and shall
    21  hold, or cause to be held, a hearing not less than ten  days  after  the
    22  giving of such notice.
    23    (c)  If  a  registration or license pursuant to the provisions of this
    24  article is revoked or suspended by the superintendent, then  the  super-
    25  intendent shall forthwith give notice to the registrant or licensee.
    26    (d) The revocation or suspension of any registration or license pursu-
    27  ant  to  the  provisions  of this article shall terminate forthwith such
    28  registration or license and the authority  conferred  thereby  upon  all
    29  licensees. For good cause shown, the superintendent may delay the effec-
    30  tive  date  of  a  revocation  or suspension to permit the registrant or
    31  licensee to satisfy some  or  all  of  its  contractual  obligations  to
    32  perform pharmacy benefit management services in the state.
    33    (e)(1) No individual, corporation, firm or association whose registra-
    34  tion  or license as a pharmacy benefit manager has been revoked pursuant
    35  to subsection (a) of this section, and no firm or association  of  which
    36  such individual is a member, and no corporation of which such individual
    37  is  an  officer or director, and no controlling person of the registrant
    38  or licensee shall be entitled to  obtain  any  registration  or  license
    39  under  the  provisions  of this article for a minimum period of one year
    40  after such revocation, or, if such revocation  be  judicially  reviewed,
    41  for  a  minimum period of one year after the final determination thereof
    42  affirming the action of the superintendent in revoking such license.
    43    (2) If any such registration or license held by a firm, association or
    44  corporation be revoked, no member of such firm  or  association  and  no
    45  officer or director of such corporation or any controlling person of the
    46  registrant  or  licensee shall be entitled to obtain any registration or
    47  license, under this article for the same  period  of  time,  unless  the
    48  superintendent  determines,  after notice and hearing, that such member,
    49  officer or director was not personally at fault in the matter on account
    50  of which such registration or license was revoked.
    51    (f) If any corporation, firm, association or  person  aggrieved  shall
    52  file  with  the  superintendent a verified complaint setting forth facts
    53  tending to show sufficient ground for the revocation  or  suspension  of
    54  any  pharmacy  benefit  manager's  registration  or license, then if the
    55  superintendent finds the complaint credible, the  superintendent  shall,

        S. 2507--A                         21                         A. 3007--A
 
     1  after  notice  and  a  hearing,  determine  whether such registration or
     2  license shall be suspended or revoked.
     3    (g)  The  superintendent  shall  retain  the  authority to enforce the
     4  provisions of and impose any penalty or remedy authorized by this  chap-
     5  ter  against  any  person  or  entity  who is under investigation for or
     6  charged with a violation of this chapter, even if the person's or  enti-
     7  ty's registration or license has been surrendered, or has expired or has
     8  lapsed by operation of law.
     9    (h)  A  registrant or licensee subject to this article shall report to
    10  the superintendent any administrative action taken  against  the  regis-
    11  trant  or licensee or any of the members, officers, directors, or desig-
    12  nated employees of the applicant named in the registration or  licensing
    13  application in another jurisdiction or by another governmental agency in
    14  this  state  within  thirty days of the final disposition of the matter.
    15  This report shall include a copy of the order, consent to order or other
    16  relevant legal documents.
    17    (i) Within thirty days of the initial pretrial hearing date, a  regis-
    18  trant  or  licensee  subject  to this article shall report to the super-
    19  intendent any criminal prosecution of the registrant or licensee or  any
    20  of  the  members,  officers,  directors,  or designated employees of the
    21  applicant named in the registration or licensing  application  taken  in
    22  any  jurisdiction.  The  report  shall  include  a  copy  of the initial
    23  complaint filed, the order resulting from  the  hearing  and  any  other
    24  relevant legal documents.
    25    §  2908.  Penalties for violations. (a) In addition to any other power
    26  conferred by law, the superintendent may in any one proceeding by order,
    27  require a registrant or licensee who has violated any provision of  this
    28  article  or  whose  license  would otherwise be subject to revocation or
    29  suspension to pay to the people of this state a penalty  in  a  sum  not
    30  exceeding  the greater of: (1) one thousand dollars for each offense and
    31  two thousand five hundred dollars for each subsequent violation; or  (2)
    32  the aggregate gross receipts attributable to all offenses.
    33    (b)  Upon  the  failure  of  such  a registrant or licensee to pay the
    34  penalty ordered pursuant to subsection (a) of this section within twenty
    35  days after the mailing of the order, postage  prepaid,  registered,  and
    36  addressed  to  the  last known place of business of the licensee, unless
    37  the order is stayed by an order of a court  of  competent  jurisdiction,
    38  the  superintendent may revoke the registration or license of the regis-
    39  trant or licensee or may suspend the same for such period as the  super-
    40  intendent determines.
    41    §  2909.  Stay  or  suspension  of superintendent's determination. The
    42  commencement of a proceeding under article seventy-eight  of  the  civil
    43  practice  law  and  rules, to review the action of the superintendent in
    44  suspending or revoking or refusing to renew any certificate  under  this
    45  article,  shall  stay  such action of the superintendent for a period of
    46  thirty days. Such stay shall not be extended for a longer period  unless
    47  the  court  shall  determine,  after  a preliminary hearing of which the
    48  superintendent is notified forty-eight hours in advance, that a stay  of
    49  the  superintendent's  action pending the final determination or further
    50  order of the court will not injure the interests of the  people  of  the
    51  state.
    52    §  2910.  Revoked  registrations  or licenses. (a)(1) No person, firm,
    53  association, corporation or other entity subject to  the  provisions  of
    54  this  article  whose registration or license under this article has been
    55  revoked, or whose registration or license to engage in the  business  of
    56  pharmacy  benefit  management  in  any  capacity has been revoked by any

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

     1  other state or territory of the United States shall become  employed  or
     2  appointed  by a pharmacy benefit manager as an officer, director, manag-
     3  er, controlling person or for other services, without the prior  written
     4  approval of the superintendent, unless such services are for maintenance
     5  or are clerical or ministerial in nature.
     6    (2)  No person, firm, association, corporation or other entity subject
     7  to the provisions of this article shall knowingly employ or appoint  any
     8  person or entity whose registration or license issued under this article
     9  has  been  revoked,  or  whose  registration or license to engage in the
    10  business of pharmacy benefit management in any capacity has been revoked
    11  by any other state or territory of the United  States,  as  an  officer,
    12  director, manager, controlling person or for other services, without the
    13  prior  written  approval of the superintendent, unless such services are
    14  for maintenance or are clerical or ministerial in nature.
    15    (3) No corporation or partnership subject to the  provisions  of  this
    16  article  shall knowingly permit any person whose registration or license
    17  issued under this article has been revoked,  or  whose  registration  or
    18  license  to engage in the business of pharmacy benefit management in any
    19  capacity has been revoked by any other state, or territory of the United
    20  States, to be a shareholder or have an interest in such  corporation  or
    21  partnership,  nor  shall any such person become a shareholder or partner
    22  in such corporation or partnership, without the prior  written  approval
    23  of the superintendent.
    24    (b)  The  superintendent  may  approve  the employment, appointment or
    25  participation of any such person whose registration or license has  been
    26  revoked:
    27    (1)  if the superintendent determines that the duties and responsibil-
    28  ities of such person are subject to  appropriate  supervision  and  that
    29  such  duties  and  responsibilities will not have an adverse effect upon
    30  the public, other registrants or licensees, or the registrant or  licen-
    31  see proposing employment or appointment of such person; or
    32    (2)  if  such  person  has  filed an application for reregistration or
    33  relicensing pursuant to this article and the application for reregistra-
    34  tion or relicensing has not been approved or denied within  one  hundred
    35  twenty  days  following  the  filing  thereof, unless the superintendent
    36  determines within the said time that employment or appointment  of  such
    37  person  by a registrant or licensee in the conduct of a pharmacy benefit
    38  management business would not be in the public interest.
    39    (c) The provisions of this section shall not apply to the ownership of
    40  shares of any corporation registered or licensed pursuant to this  arti-
    41  cle  if  the  shares of such corporation are publicly held and traded in
    42  the over-the-counter market or upon any national or regional  securities
    43  exchange.
    44    § 2911. Change of address. A registrant or licensee under this article
    45  shall inform the superintendent by a means acceptable to the superinten-
    46  dent of a change of address within thirty days of the change.
    47    §  2912.  Duties.  (a) A pharmacy benefit manager shall be required to
    48  adhere to the code of conduct, as the superintendent  may  establish  by
    49  regulation pursuant to section twenty-nine hundred six of this article.
    50    (b)  No contract with a health plan shall limit access to financial or
    51  utilization information of the pharmacy benefit manager in  relation  to
    52  pharmacy benefit management services provided to the health plan.
    53    (c)  A  pharmacy benefit manager shall disclose in writing to a health
    54  plan with whom a contract for pharmacy benefit management  services  has
    55  been executed any activity, policy, practice, contract or arrangement of
    56  the  pharmacy  benefit  manager  that  directly or indirectly presents a

        S. 2507--A                         23                         A. 3007--A
 
     1  conflict of interest with the  pharmacy  benefit  manager's  contractual
     2  relationship with, or duties and obligations to, the health plan.
     3    (d) A pharmacy benefit manager shall assist a health plan in answering
     4  any inquiry made under section three hundred eight of this chapter.
     5    (e)  No  pharmacy  benefit  manager shall violate any provision of the
     6  public health law applicable to pharmacy benefit managers.
     7    (f) (1) Any information required to be disclosed by a pharmacy benefit
     8  manager to a health plan under this section that  is  reasonably  desig-
     9  nated  by  the  pharmacy  benefit manager as proprietary or trade secret
    10  information shall be kept confidential by the  health  plan,  except  as
    11  required or permitted by law or court order, including disclosure neces-
    12  sary  to  prosecute  or  defend  any  legitimate legal claim or cause of
    13  action.
    14    (2) Designation as proprietary or trade secret information under  this
    15  subsection shall have no effect on the obligations of any pharmacy bene-
    16  fit  manager  or  health plan to provide that information to the depart-
    17  ment.
    18    § 2913. Applicability of other laws. Nothing in this article shall  be
    19  construed  to  exempt a pharmacy benefit manager from complying with the
    20  provisions of articles twenty-one and forty-nine  of  this  chapter  and
    21  articles forty-four and forty-nine and sections two hundred eighty-a and
    22  two  hundred  eighty-c  of  the public health law, section three hundred
    23  sixty-four-j of the social services law, or any other provision of  this
    24  chapter or the financial services law.
    25    §  2914.  Assessments.  Notwithstanding section two hundred six of the
    26  financial services law, pharmacy benefit managers that file a  registra-
    27  tion  with  the  department  or  are licensed by the department shall be
    28  assessed by the superintendent for the operating expenses of the depart-
    29  ment that are attributable to regulating such pharmacy benefit  managers
    30  in  such  proportions  as the superintendent shall deem just and reason-
    31  able.
    32    § 2. Subsection (b) of section 2402 of the insurance law,  as  amended
    33  by section 71 of part A of chapter 62 of the laws of 2011, is amended to
    34  read as follows:
    35    (b)  "Defined  violation"  means  the commission by a person of an act
    36  prohibited by: subsection (a) of section one thousand one  hundred  two,
    37  section  one  thousand  two  hundred  fourteen, one thousand two hundred
    38  seventeen, one thousand two hundred twenty, one thousand  three  hundred
    39  thirteen, subparagraph (B) of paragraph two of subsection (i) of section
    40  one thousand three hundred twenty-two, subparagraph (B) of paragraph two
    41  of subsection (i) of section one thousand three hundred twenty-four, two
    42  thousand  one hundred two, two thousand one hundred seventeen, two thou-
    43  sand one hundred twenty-two,  two  thousand  one  hundred  twenty-three,
    44  subsection  (p)  of section two thousand three hundred thirteen, section
    45  two thousand three hundred twenty-four, two thousand five  hundred  two,
    46  two  thousand  five  hundred  three, two thousand five hundred four, two
    47  thousand six hundred one, two thousand six hundred two, two thousand six
    48  hundred three, two thousand six hundred four, two thousand  six  hundred
    49  six,  two  thousand  seven hundred three, two thousand nine hundred two,
    50  two thousand nine hundred five, three thousand one hundred  nine,  three
    51  thousand  two hundred twenty-four-a, three thousand four hundred twenty-
    52  nine, three thousand  four  hundred  thirty-three,  paragraph  seven  of
    53  subsection  (e)  of section three thousand four hundred twenty-six, four
    54  thousand two hundred twenty-four, four thousand two hundred twenty-five,
    55  four thousand two hundred twenty-six, seven thousand eight hundred nine,
    56  seven thousand eight hundred ten, seven thousand eight  hundred  eleven,

        S. 2507--A                         24                         A. 3007--A
 
     1  seven  thousand  eight  hundred  thirteen,  seven thousand eight hundred
     2  fourteen and seven thousand eight hundred fifteen of  this  chapter;  or
     3  section  135.60,  135.65,  175.05,  175.45,  or  190.20,  or article one
     4  hundred five of the penal law.
     5    § 3. Severability. If any provision of this act, or any application of
     6  any provision of this act, is held to be invalid, or ruled by any feder-
     7  al  agency to violate or be inconsistent with any applicable federal law
     8  or regulation, that shall not affect the validity  or  effectiveness  of
     9  any  other  provision  of  this  act, or of any other application of any
    10  provision of this act.
    11    § 4. This act shall take effect immediately.
 
    12                                   PART K
 
    13    Section 1. Section 18 of chapter 266 of the laws of 1986, amending the
    14  civil practice law and rules and other laws relating to malpractice  and
    15  professional medical conduct is amended by adding a new subdivision 9 to
    16  read as follows:
    17    (9)  This subdivision shall apply only to excess insurance coverage or
    18  equivalent excess coverage for physicians or dentists that  is  eligible
    19  to  be  paid  for  from funds available in the hospital excess liability
    20  pool.
    21    (a) Notwithstanding any law to the contrary,  for  any  policy  period
    22  beginning  on  or after July 1, 2021, excess coverage shall be purchased
    23  by a physician or dentist directly from a provider of  excess  insurance
    24  coverage  or equivalent excess coverage.  Such provider of excess insur-
    25  ance coverage or equivalent excess coverage  shall  bill,  in  a  manner
    26  consistent  with  paragraph  (e)  of  this subdivision, the physician or
    27  dentist for an amount equal to fifty percent of  the  premium  for  such
    28  coverage,  as established pursuant to paragraph (c) of this subdivision,
    29  during the policy period.  At the conclusion of the  policy  period  the
    30  superintendent  of  financial services and the commissioner of health or
    31  their designee shall,  from  funds  available  in  the  hospital  excess
    32  liability  pool  created  pursuant to subdivision 5 of this section, pay
    33  half of the remaining fifty percent of the premium to  the  provider  of
    34  excess insurance coverage or equivalent excess coverage, and the remain-
    35  ing twenty-five percent shall be paid one year thereafter.  If the funds
    36  available in the hospital excess liability pool are insufficient to meet
    37  the  percent  of  the  costs  of  the excess coverage, the provisions of
    38  subdivision 8 of this section shall apply.
    39    (b) If at the conclusion of the policy period, a physician or dentist,
    40  eligible for excess coverage paid for from funds available in the hospi-
    41  tal excess liability pool, has failed to pay an amount  equal  to  fifty
    42  percent  of the premium as established pursuant to paragraph (c) of this
    43  subdivision, such excess coverage shall be cancelled and shall  be  null
    44  and  void  as  of the first day on or after the commencement of a policy
    45  period where the liability for payment pursuant to this subdivision  has
    46  not  been met.   The provider of excess coverage shall remit any portion
    47  of premium paid by the eligible physician or dentist for such  a  policy
    48  period.
    49    (c)  The  superintendent  of financial services shall establish a rate
    50  consistent with subdivision 3 of this section that providers  of  excess
    51  insurance  coverage  or  equivalent excess coverage will charge for such
    52  coverage for each policy period.  For the policy period  beginning  July
    53  1,  2021,  the  superintendent of financial services may direct that the

        S. 2507--A                         25                         A. 3007--A
 
     1  premium for that policy period be the same as  it  was  for  the  policy
     2  period that concluded June 30, 2020.
     3    (d)  No  provider  of  excess  insurance coverage or equivalent excess
     4  coverage shall issue excess coverage to which this  subdivision  applies
     5  to  any  physician or dentist unless that physician or dentist meets the
     6  eligibility requirements for such coverage set forth  in  this  section.
     7  The  superintendent of financial services and the commissioner of health
     8  or their designee shall not make any payment under this subdivision to a
     9  provider of excess insurance coverage or equivalent excess coverage  for
    10  excess  coverage  issued to a physician or dentist who does not meet the
    11  eligibility  requirements  for  participation  in  the  hospital  excess
    12  liability pool program set forth in this section.
    13    (e)  A  provider  of  excess insurance coverage or equivalent coverage
    14  that issues excess coverage under this subdivision shall bill the physi-
    15  cian or dentist for the portion of the premium required under  paragraph
    16  (a)  of this subdivision in twelve equal monthly installments or in such
    17  other manner as the physician or dentist may agree.
    18    (f) The superintendent of financial services in consultation with  the
    19  commissioner  of  health may promulgate regulations giving effect to the
    20  provisions of this subdivision.
    21    § 2. Paragraph (a) of subdivision 1 of section 18 of  chapter  266  of
    22  the  laws  of  1986, amending the civil practice law and rules and other
    23  laws relating  to  malpractice  and  professional  medical  conduct,  as
    24  amended  by  section 1 of part AAA of chapter 56 of the laws of 2020, is
    25  amended to read as follows:
    26    (a) The superintendent of financial services and the  commissioner  of
    27  health  or  their  designee  shall, from funds available in the hospital
    28  excess liability pool created pursuant to subdivision 5 of this section,
    29  purchase a policy or policies for excess insurance coverage, as  author-
    30  ized  by  paragraph 1 of subsection (e) of section 5502 of the insurance
    31  law; or from an insurer, other than an insurer described in section 5502
    32  of the insurance law, duly authorized to write such coverage and actual-
    33  ly writing  medical  malpractice  insurance  in  this  state;  or  shall
    34  purchase equivalent excess coverage in a form previously approved by the
    35  superintendent  of  financial  services for purposes of providing equiv-
    36  alent excess coverage in accordance with section 19 of  chapter  294  of
    37  the  laws of 1985, for medical or dental malpractice occurrences between
    38  July 1, 1986 and June 30, 1987, between July 1, 1987 and June 30,  1988,
    39  between  July  1,  1988 and June 30, 1989, between July 1, 1989 and June
    40  30, 1990, between July 1, 1990 and June 30, 1991, between July  1,  1991
    41  and  June 30, 1992, between July 1, 1992 and June 30, 1993, between July
    42  1, 1993 and June 30, 1994, between July  1,  1994  and  June  30,  1995,
    43  between  July  1,  1995 and June 30, 1996, between July 1, 1996 and June
    44  30, 1997, between July 1, 1997 and June 30, 1998, between July  1,  1998
    45  and  June 30, 1999, between July 1, 1999 and June 30, 2000, between July
    46  1, 2000 and June 30, 2001, between July  1,  2001  and  June  30,  2002,
    47  between  July  1,  2002 and June 30, 2003, between July 1, 2003 and June
    48  30, 2004, between July 1, 2004 and June 30, 2005, between July  1,  2005
    49  and  June 30, 2006, between July 1, 2006 and June 30, 2007, between July
    50  1, 2007 and June 30, 2008, between July  1,  2008  and  June  30,  2009,
    51  between  July  1,  2009 and June 30, 2010, between July 1, 2010 and June
    52  30, 2011, between July 1, 2011 and June 30, 2012, between July  1,  2012
    53  and  June 30, 2013, between July 1, 2013 and June 30, 2014, between July
    54  1, 2014 and June 30, 2015, between July  1,  2015  and  June  30,  2016,
    55  between  July  1,  2016 and June 30, 2017, between July 1, 2017 and June
    56  30, 2018, between July 1, 2018 and June 30, 2019, between July  1,  2019

        S. 2507--A                         26                         A. 3007--A
 
     1  and  June  30,  2020,  [and] between July 1, 2020 and June 30, 2021, and
     2  between July 1, 2021 and June 30, 2022 or reimburse the  hospital  where
     3  the hospital purchases equivalent excess coverage as defined in subpara-
     4  graph  (i)  of  paragraph  (a)  of  subdivision  1-a of this section for
     5  medical or dental malpractice occurrences between July 1, 1987 and  June
     6  30,  1988,  between July 1, 1988 and June 30, 1989, between July 1, 1989
     7  and June 30, 1990, between July 1, 1990 and June 30, 1991, between  July
     8  1,  1991  and  June  30,  1992,  between July 1, 1992 and June 30, 1993,
     9  between July 1, 1993 and June 30, 1994, between July 1,  1994  and  June
    10  30,  1995,  between July 1, 1995 and June 30, 1996, between July 1, 1996
    11  and June 30, 1997, between July 1, 1997 and June 30, 1998, between  July
    12  1,  1998  and  June  30,  1999,  between July 1, 1999 and June 30, 2000,
    13  between July 1, 2000 and June 30, 2001, between July 1,  2001  and  June
    14  30,  2002,  between July 1, 2002 and June 30, 2003, between July 1, 2003
    15  and June 30, 2004, between July 1, 2004 and June 30, 2005, between  July
    16  1,  2005  and  June  30,  2006,  between July 1, 2006 and June 30, 2007,
    17  between July 1, 2007 and June 30, 2008, between July 1,  2008  and  June
    18  30,  2009,  between July 1, 2009 and June 30, 2010, between July 1, 2010
    19  and June 30, 2011, between July 1, 2011 and June 30, 2012, between  July
    20  1,  2012  and  June  30,  2013,  between July 1, 2013 and June 30, 2014,
    21  between July 1, 2014 and June 30, 2015, between July 1,  2015  and  June
    22  30,  2016,  between July 1, 2016 and June 30, 2017, between July 1, 2017
    23  and June 30, 2018, between July 1, 2018 and June 30, 2019, between  July
    24  1, 2019 and June 30, 2020, [and] between July 1, 2020 and June 30, 2021,
    25  and  between  July  1, 2021 and June 30, 2022 for physicians or dentists
    26  certified as eligible for each such period or periods pursuant to subdi-
    27  vision 2 of this section by a  general  hospital  licensed  pursuant  to
    28  article  28  of  the  public health law; provided that no single insurer
    29  shall write more than fifty percent of the total excess  premium  for  a
    30  given  policy year; and provided, however, that such eligible physicians
    31  or dentists must have in force an individual  policy,  from  an  insurer
    32  licensed  in  this  state  of  primary malpractice insurance coverage in
    33  amounts of no less than one million three hundred thousand  dollars  for
    34  each  claimant  and  three million nine hundred thousand dollars for all
    35  claimants under that policy during the period of  such  excess  coverage
    36  for  such  occurrences  or  be  endorsed  as additional insureds under a
    37  hospital professional liability policy which is offered through a volun-
    38  tary attending physician ("channeling") program previously permitted  by
    39  the  superintendent  of  financial  services  during  the period of such
    40  excess coverage for such occurrences. During such  period,  such  policy
    41  for  excess  coverage  or  such  equivalent  excess coverage shall, when
    42  combined with the physician's or dentist's primary malpractice insurance
    43  coverage or coverage provided through a  voluntary  attending  physician
    44  ("channeling")  program,  total  an aggregate level of two million three
    45  hundred thousand dollars for each claimant and six million nine  hundred
    46  thousand  dollars  for all claimants from all such policies with respect
    47  to occurrences in each of such years provided, however, if the  cost  of
    48  primary malpractice insurance coverage in excess of one million dollars,
    49  but  below  the  excess  medical malpractice insurance coverage provided
    50  pursuant to this act, exceeds the rate of nine percent per  annum,  then
    51  the  required  level of primary malpractice insurance coverage in excess
    52  of one million dollars for each claimant shall be in an  amount  of  not
    53  less  than  the dollar amount of such coverage available at nine percent
    54  per annum; the required level of such coverage for all  claimants  under
    55  that  policy  shall be in an amount not less than three times the dollar
    56  amount of coverage for each claimant; and excess coverage, when combined

        S. 2507--A                         27                         A. 3007--A
 
     1  with such primary malpractice insurance  coverage,  shall  increase  the
     2  aggregate  level  for  each  claimant  by  one million dollars and three
     3  million dollars for all claimants;  and  provided  further,  that,  with
     4  respect to policies of primary medical malpractice coverage that include
     5  occurrences  between  April  1, 2002 and June 30, 2002, such requirement
     6  that coverage be in amounts no less than one million three hundred thou-
     7  sand dollars for each claimant and three million nine  hundred  thousand
     8  dollars  for all claimants for such occurrences shall be effective April
     9  1, 2002.
    10    § 3. Subdivision 3 of section 18 of chapter 266 of the laws  of  1986,
    11  amending  the  civil  practice  law and rules and other laws relating to
    12  malpractice and professional medical conduct, as amended by section 2 of
    13  part AAA of chapter 56 of the laws  of  2020,  is  amended  to  read  as
    14  follows:
    15    (3)(a)  The  superintendent  of financial services shall determine and
    16  certify to each general hospital and to the commissioner of  health  the
    17  cost  of  excess malpractice insurance for medical or dental malpractice
    18  occurrences between July 1, 1986 and June 30, 1987, between July 1, 1988
    19  and June 30, 1989, between July 1, 1989 and June 30, 1990, between  July
    20  1,  1990  and  June  30,  1991,  between July 1, 1991 and June 30, 1992,
    21  between July 1, 1992 and June 30, 1993, between July 1,  1993  and  June
    22  30,  1994,  between July 1, 1994 and June 30, 1995, between July 1, 1995
    23  and June 30, 1996, between July 1, 1996 and June 30, 1997, between  July
    24  1,  1997  and  June  30,  1998,  between July 1, 1998 and June 30, 1999,
    25  between July 1, 1999 and June 30, 2000, between July 1,  2000  and  June
    26  30,  2001,  between July 1, 2001 and June 30, 2002, between July 1, 2002
    27  and June 30, 2003, between July 1, 2003 and June 30, 2004, between  July
    28  1,  2004  and  June  30,  2005,  between July 1, 2005 and June 30, 2006,
    29  between July 1, 2006 and June 30, 2007, between July 1,  2007  and  June
    30  30,  2008,  between July 1, 2008 and June 30, 2009, between July 1, 2009
    31  and June 30, 2010, between July 1, 2010 and June 30, 2011, between  July
    32  1, 2011 and June 30, 2012, between July 1, 2012 and June 30, 2013, [and]
    33  between  July  1,  2013 and June 30, 2014, between July 1, 2014 and June
    34  30, 2015, between July 1, 2015 and June 30, 2016, [and] between July  1,
    35  2016  and June 30, 2017, between July 1, 2017 and June 30, 2018, between
    36  July 1, 2018 and June 30, 2019, between July 1, 2019 and June 30,  2020,
    37  [and]  between  July 1, 2020 and June 30, 2021, and between July 1, 2021
    38  and June 30, 2022 allocable to each general hospital for  physicians  or
    39  dentists  certified  as  eligible  for  purchase  of a policy for excess
    40  insurance coverage by such general hospital in accordance with  subdivi-
    41  sion  2  of  this  section, and may amend such determination and certif-
    42  ication as necessary.
    43    (b) The superintendent  of  financial  services  shall  determine  and
    44  certify  to  each general hospital and to the commissioner of health the
    45  cost of excess malpractice insurance or equivalent excess  coverage  for
    46  medical  or dental malpractice occurrences between July 1, 1987 and June
    47  30, 1988, between July 1, 1988 and June 30, 1989, between July  1,  1989
    48  and  June 30, 1990, between July 1, 1990 and June 30, 1991, between July
    49  1, 1991 and June 30, 1992, between July  1,  1992  and  June  30,  1993,
    50  between  July  1,  1993 and June 30, 1994, between July 1, 1994 and June
    51  30, 1995, between July 1, 1995 and June 30, 1996, between July  1,  1996
    52  and  June 30, 1997, between July 1, 1997 and June 30, 1998, between July
    53  1, 1998 and June 30, 1999, between July  1,  1999  and  June  30,  2000,
    54  between  July  1,  2000 and June 30, 2001, between July 1, 2001 and June
    55  30, 2002, between July 1, 2002 and June 30, 2003, between July  1,  2003
    56  and  June 30, 2004, between July 1, 2004 and June 30, 2005, between July

        S. 2507--A                         28                         A. 3007--A
 
     1  1, 2005 and June 30, 2006, between July  1,  2006  and  June  30,  2007,
     2  between  July  1,  2007 and June 30, 2008, between July 1, 2008 and June
     3  30, 2009, between July 1, 2009 and June 30, 2010, between July  1,  2010
     4  and  June 30, 2011, between July 1, 2011 and June 30, 2012, between July
     5  1, 2012 and June 30, 2013, between July  1,  2013  and  June  30,  2014,
     6  between  July  1,  2014 and June 30, 2015, between July 1, 2015 and June
     7  30, 2016, between July 1, 2016 and June 30, 2017, between July  1,  2017
     8  and  June 30, 2018, between July 1, 2018 and June 30, 2019, between July
     9  1, 2019 and June 30, 2020, [and] between July 1, 2020 and June 30, 2021,
    10  and between July 1, 2021 and June 30, 2022  allocable  to  each  general
    11  hospital  for  physicians or dentists certified as eligible for purchase
    12  of a policy for excess insurance coverage or equivalent excess  coverage
    13  by  such  general  hospital  in  accordance  with  subdivision 2 of this
    14  section, and may amend such determination and  certification  as  neces-
    15  sary.  The  superintendent  of  financial  services  shall determine and
    16  certify to each general hospital and to the commissioner of  health  the
    17  ratable  share  of  such  cost  allocable  to the period July 1, 1987 to
    18  December 31, 1987, to the period January 1, 1988 to June  30,  1988,  to
    19  the  period  July 1, 1988 to December 31, 1988, to the period January 1,
    20  1989 to June 30, 1989, to the period July 1, 1989 to December 31,  1989,
    21  to  the  period  January 1, 1990 to June 30, 1990, to the period July 1,
    22  1990 to December 31, 1990, to the period January 1,  1991  to  June  30,
    23  1991,  to  the  period  July 1, 1991 to December 31, 1991, to the period
    24  January 1, 1992 to June 30, 1992, to the period July 1, 1992 to December
    25  31, 1992, to the period January 1, 1993 to June 30, 1993, to the  period
    26  July 1, 1993 to December 31, 1993, to the period January 1, 1994 to June
    27  30, 1994, to the period July 1, 1994 to December 31, 1994, to the period
    28  January 1, 1995 to June 30, 1995, to the period July 1, 1995 to December
    29  31,  1995, to the period January 1, 1996 to June 30, 1996, to the period
    30  July 1, 1996 to December 31, 1996, to the period January 1, 1997 to June
    31  30, 1997, to the period July 1, 1997 to December 31, 1997, to the period
    32  January 1, 1998 to June 30, 1998, to the period July 1, 1998 to December
    33  31, 1998, to the period January 1, 1999 to June 30, 1999, to the  period
    34  July 1, 1999 to December 31, 1999, to the period January 1, 2000 to June
    35  30, 2000, to the period July 1, 2000 to December 31, 2000, to the period
    36  January 1, 2001 to June 30, 2001, to the period July 1, 2001 to June 30,
    37  2002, to the period July 1, 2002 to June 30, 2003, to the period July 1,
    38  2003  to  June 30, 2004, to the period July 1, 2004 to June 30, 2005, to
    39  the period July 1, 2005 and June 30, 2006, to the period  July  1,  2006
    40  and  June 30, 2007, to the period July 1, 2007 and June 30, 2008, to the
    41  period July 1, 2008 and June 30, 2009, to the period July  1,  2009  and
    42  June  30,  2010,  to  the  period July 1, 2010 and June 30, 2011, to the
    43  period July 1, 2011 and June 30, 2012, to the period July  1,  2012  and
    44  June  30,  2013,  to  the  period July 1, 2013 and June 30, 2014, to the
    45  period July 1, 2014 and June 30, 2015, to the period July  1,  2015  and
    46  June  30,  2016,  to  the  period July 1, 2016 and June 30, 2017, to the
    47  period July 1, 2017 to June 30, 2018, to the period July 1, 2018 to June
    48  30, 2019, to the period July 1, 2019 to June  30,  2020,  [and]  to  the
    49  period  July 1, 2020 to June 30, 2021, and to the period July 1, 2021 to
    50  June 30, 2022.
    51    § 4. Paragraphs (a), (b), (c), (d) and (e) of subdivision 8 of section
    52  18 of chapter 266 of the laws of 1986, amending the civil  practice  law
    53  and  rules  and  other  laws  relating  to  malpractice and professional
    54  medical conduct, as amended by section 3 of part AAA of  chapter  56  of
    55  the laws of 2020, are amended to read as follows:

        S. 2507--A                         29                         A. 3007--A
 
     1    (a)  To  the  extent  funds available to the hospital excess liability
     2  pool pursuant to subdivision 5 of this section as amended, and  pursuant
     3  to  section  6  of part J of chapter 63 of the laws of 2001, as may from
     4  time to time be amended, which amended this  subdivision,  are  insuffi-
     5  cient  to  meet  the  costs  of  excess insurance coverage or equivalent
     6  excess coverage for coverage periods during the period July 1,  1992  to
     7  June  30,  1993, during the period July 1, 1993 to June 30, 1994, during
     8  the period July 1, 1994 to June 30, 1995, during the period July 1, 1995
     9  to June 30, 1996, during the period July  1,  1996  to  June  30,  1997,
    10  during  the period July 1, 1997 to June 30, 1998, during the period July
    11  1, 1998 to June 30, 1999, during the period July 1,  1999  to  June  30,
    12  2000, during the period July 1, 2000 to June 30, 2001, during the period
    13  July  1,  2001  to  October 29, 2001, during the period April 1, 2002 to
    14  June 30, 2002, during the period July 1, 2002 to June 30,  2003,  during
    15  the period July 1, 2003 to June 30, 2004, during the period July 1, 2004
    16  to  June  30,  2005,  during  the  period July 1, 2005 to June 30, 2006,
    17  during the period July 1, 2006 to June 30, 2007, during the period  July
    18  1,  2007  to  June  30, 2008, during the period July 1, 2008 to June 30,
    19  2009, during the period July 1, 2009 to June 30, 2010, during the period
    20  July 1, 2010 to June 30, 2011, during the period July 1,  2011  to  June
    21  30,  2012,  during  the period July 1, 2012 to June 30, 2013, during the
    22  period July 1, 2013 to June 30, 2014, during the period July 1, 2014  to
    23  June  30,  2015, during the period July 1, 2015 to June 30, 2016, during
    24  the period July 1, 2016 to June 30, 2017, during the period July 1, 2017
    25  to June 30, 2018, during the period July  1,  2018  to  June  30,  2019,
    26  during the period July 1, 2019 to June 30, 2020, [and] during the period
    27  July  1,  2020  to  June 30, 2021, and during the period July 1, 2021 to
    28  June 30, 2022 allocated or reallocated in accordance with paragraph  (a)
    29  of  subdivision  4-a  of  this section to rates of payment applicable to
    30  state governmental agencies, each physician or dentist for whom a policy
    31  for excess insurance coverage or equivalent excess coverage is purchased
    32  for such period shall be responsible for  payment  to  the  provider  of
    33  excess  insurance coverage or equivalent excess coverage of an allocable
    34  share of such insufficiency, based on the ratio of  the  total  cost  of
    35  such  coverage  for  such physician to the sum of the total cost of such
    36  coverage for all physicians applied to such insufficiency.
    37    (b) Each provider of excess insurance coverage  or  equivalent  excess
    38  coverage  covering the period July 1, 1992 to June 30, 1993, or covering
    39  the period July 1, 1993 to June 30, 1994, or covering the period July 1,
    40  1994 to June 30, 1995, or covering the period July 1, 1995 to  June  30,
    41  1996,  or covering the period July 1, 1996 to June 30, 1997, or covering
    42  the period July 1, 1997 to June 30, 1998, or covering the period July 1,
    43  1998 to June 30, 1999, or covering the period July 1, 1999 to  June  30,
    44  2000,  or covering the period July 1, 2000 to June 30, 2001, or covering
    45  the period July 1, 2001 to October 29,  2001,  or  covering  the  period
    46  April  1,  2002 to June 30, 2002, or covering the period July 1, 2002 to
    47  June 30, 2003, or covering the period July 1, 2003 to June 30, 2004,  or
    48  covering the period July 1, 2004 to June 30, 2005, or covering the peri-
    49  od July 1, 2005 to June 30, 2006, or covering the period July 1, 2006 to
    50  June  30, 2007, or covering the period July 1, 2007 to June 30, 2008, or
    51  covering the period July 1, 2008 to June 30, 2009, or covering the peri-
    52  od July 1, 2009 to June 30, 2010, or covering the period July 1, 2010 to
    53  June 30, 2011, or covering the period July 1, 2011 to June 30, 2012,  or
    54  covering the period July 1, 2012 to June 30, 2013, or covering the peri-
    55  od July 1, 2013 to June 30, 2014, or covering the period July 1, 2014 to
    56  June  30, 2015, or covering the period July 1, 2015 to June 30, 2016, or

        S. 2507--A                         30                         A. 3007--A
 
     1  covering the period July 1, 2016 to June 30, 2017, or covering the peri-
     2  od July 1, 2017 to June 30, 2018, or covering the period July 1, 2018 to
     3  June 30, 2019, or covering the period July 1, 2019 to June 30, 2020,  or
     4  covering the period July 1, 2020 to June 30, 2021, or covering the peri-
     5  od  July  1,  2021  to June 30, 2022 shall notify a covered physician or
     6  dentist by mail, mailed to the address shown on the last application for
     7  excess insurance coverage or equivalent excess coverage, of  the  amount
     8  due  to  such  provider from such physician or dentist for such coverage
     9  period determined in accordance with paragraph (a) of this  subdivision.
    10  Such amount shall be due from such physician or dentist to such provider
    11  of excess insurance coverage or equivalent excess coverage in a time and
    12  manner determined by the superintendent of financial services.
    13    (c)  If  a physician or dentist liable for payment of a portion of the
    14  costs of excess insurance coverage or equivalent excess coverage  cover-
    15  ing  the  period  July  1, 1992 to June 30, 1993, or covering the period
    16  July 1, 1993 to June 30, 1994, or covering the period July  1,  1994  to
    17  June  30, 1995, or covering the period July 1, 1995 to June 30, 1996, or
    18  covering the period July 1, 1996 to June 30, 1997, or covering the peri-
    19  od July 1, 1997 to June 30, 1998, or covering the period July 1, 1998 to
    20  June 30, 1999, or covering the period July 1, 1999 to June 30, 2000,  or
    21  covering the period July 1, 2000 to June 30, 2001, or covering the peri-
    22  od  July  1,  2001  to October 29, 2001, or covering the period April 1,
    23  2002 to June 30, 2002, or covering the period July 1, 2002 to  June  30,
    24  2003,  or covering the period July 1, 2003 to June 30, 2004, or covering
    25  the period July 1, 2004 to June 30, 2005, or covering the period July 1,
    26  2005 to June 30, 2006, or covering the period July 1, 2006 to  June  30,
    27  2007,  or covering the period July 1, 2007 to June 30, 2008, or covering
    28  the period July 1, 2008 to June 30, 2009, or covering the period July 1,
    29  2009 to June 30, 2010, or covering the period July 1, 2010 to  June  30,
    30  2011,  or covering the period July 1, 2011 to June 30, 2012, or covering
    31  the period July 1, 2012 to June 30, 2013, or covering the period July 1,
    32  2013 to June 30, 2014, or covering the period July 1, 2014 to  June  30,
    33  2015,  or covering the period July 1, 2015 to June 30, 2016, or covering
    34  the period July 1, 2016 to June 30, 2017, or covering the period July 1,
    35  2017 to June 30, 2018, or covering the period July 1, 2018 to  June  30,
    36  2019,  or covering the period July 1, 2019 to June 30, 2020, or covering
    37  the period July 1, 2020 to June 30, 2021, or covering the period July 1,
    38  2021 to June 30, 2022 determined in accordance  with  paragraph  (a)  of
    39  this  subdivision  fails,  refuses  or  neglects  to make payment to the
    40  provider of excess insurance coverage or equivalent excess  coverage  in
    41  such  time  and  manner as determined by the superintendent of financial
    42  services pursuant to paragraph (b) of this subdivision, excess insurance
    43  coverage or equivalent excess coverage purchased for such  physician  or
    44  dentist  in  accordance with this section for such coverage period shall
    45  be cancelled and shall be null and void as of the first day on or  after
    46  the  commencement  of  a  policy  period where the liability for payment
    47  pursuant to this subdivision has not been met.
    48    (d) Each provider of excess insurance coverage  or  equivalent  excess
    49  coverage  shall  notify the superintendent of financial services and the
    50  commissioner of health or their designee of each physician  and  dentist
    51  eligible  for  purchase  of  a  policy  for excess insurance coverage or
    52  equivalent excess coverage covering the period July 1, 1992 to June  30,
    53  1993,  or covering the period July 1, 1993 to June 30, 1994, or covering
    54  the period July 1, 1994 to June 30, 1995, or covering the period July 1,
    55  1995 to June 30, 1996, or covering the period July 1, 1996 to  June  30,
    56  1997,  or covering the period July 1, 1997 to June 30, 1998, or covering

        S. 2507--A                         31                         A. 3007--A
 
     1  the period July 1, 1998 to June 30, 1999, or covering the period July 1,
     2  1999 to June 30, 2000, or covering the period July 1, 2000 to  June  30,
     3  2001, or covering the period July 1, 2001 to October 29, 2001, or cover-
     4  ing  the  period  April 1, 2002 to June 30, 2002, or covering the period
     5  July 1, 2002 to June 30, 2003, or covering the period July  1,  2003  to
     6  June  30, 2004, or covering the period July 1, 2004 to June 30, 2005, or
     7  covering the period July 1, 2005 to June 30, 2006, or covering the peri-
     8  od July 1, 2006 to June 30, 2007, or covering the period July 1, 2007 to
     9  June 30, 2008, or covering the period July 1, 2008 to June 30, 2009,  or
    10  covering the period July 1, 2009 to June 30, 2010, or covering the peri-
    11  od July 1, 2010 to June 30, 2011, or covering the period July 1, 2011 to
    12  June  30, 2012, or covering the period July 1, 2012 to June 30, 2013, or
    13  covering the period July 1, 2013 to June 30, 2014, or covering the peri-
    14  od July 1, 2014 to June 30, 2015, or covering the period July 1, 2015 to
    15  June 30, 2016, or covering the period July 1, 2016 to June 30, 2017,  or
    16  covering the period July 1, 2017 to June 30, 2018, or covering the peri-
    17  od July 1, 2018 to June 30, 2019, or covering the period July 1, 2019 to
    18  June  30, 2020, or covering the period July 1, 2020 to June 30, 2021, or
    19  covering the period July 1, 2021 to June 30, 2022 that has made  payment
    20  to  such  provider  of  excess  insurance  coverage or equivalent excess
    21  coverage in accordance with paragraph (b) of  this  subdivision  and  of
    22  each  physician and dentist who has failed, refused or neglected to make
    23  such payment.
    24    (e) A provider of  excess  insurance  coverage  or  equivalent  excess
    25  coverage  shall  refund to the hospital excess liability pool any amount
    26  allocable to the period July 1, 1992 to June 30, 1993, and to the period
    27  July 1, 1993 to June 30, 1994, and to the period July 1,  1994  to  June
    28  30,  1995,  and  to the period July 1, 1995 to June 30, 1996, and to the
    29  period July 1, 1996 to June 30, 1997, and to the period July 1, 1997  to
    30  June  30,  1998, and to the period July 1, 1998 to June 30, 1999, and to
    31  the period July 1, 1999 to June 30, 2000, and to the period July 1, 2000
    32  to June 30, 2001, and to the period July 1, 2001 to  October  29,  2001,
    33  and to the period April 1, 2002 to June 30, 2002, and to the period July
    34  1,  2002  to  June  30, 2003, and to the period July 1, 2003 to June 30,
    35  2004, and to the period July 1, 2004 to June 30, 2005, and to the period
    36  July 1, 2005 to June 30, 2006, and to the period July 1,  2006  to  June
    37  30,  2007,  and  to the period July 1, 2007 to June 30, 2008, and to the
    38  period July 1, 2008 to June 30, 2009, and to the period July 1, 2009  to
    39  June  30,  2010, and to the period July 1, 2010 to June 30, 2011, and to
    40  the period July 1, 2011 to June 30, 2012, and to the period July 1, 2012
    41  to June 30, 2013, and to the period July 1, 2013 to June 30,  2014,  and
    42  to  the  period July 1, 2014 to June 30, 2015, and to the period July 1,
    43  2015 to June 30, 2016, to the period July 1, 2016 to June 30, 2017,  and
    44  to  the  period July 1, 2017 to June 30, 2018, and to the period July 1,
    45  2018 to June 30, 2019, and to the period July 1, 2019 to June 30,  2020,
    46  and  to the period July 1, 2020 to June 30, 2021, and to the period July
    47  1, 2021 to June 30, 2022 received from  the  hospital  excess  liability
    48  pool  for  purchase  of  excess  insurance coverage or equivalent excess
    49  coverage covering the period July 1, 1992 to June 30, 1993, and covering
    50  the period July 1, 1993 to June 30, 1994, and covering the  period  July
    51  1,  1994  to June 30, 1995, and covering the period July 1, 1995 to June
    52  30, 1996, and covering the period July 1, 1996 to  June  30,  1997,  and
    53  covering  the  period  July  1,  1997 to June 30, 1998, and covering the
    54  period July 1, 1998 to June 30, 1999, and covering the  period  July  1,
    55  1999  to June 30, 2000, and covering the period July 1, 2000 to June 30,
    56  2001, and covering the period July 1, 2001  to  October  29,  2001,  and

        S. 2507--A                         32                         A. 3007--A
 
     1  covering  the  period  April  1, 2002 to June 30, 2002, and covering the
     2  period July 1, 2002 to June 30, 2003, and covering the  period  July  1,
     3  2003  to June 30, 2004, and covering the period July 1, 2004 to June 30,
     4  2005,  and covering the period July 1, 2005 to June 30, 2006, and cover-
     5  ing the period July 1, 2006 to June 30, 2007, and  covering  the  period
     6  July  1,  2007 to June 30, 2008, and covering the period July 1, 2008 to
     7  June 30, 2009, and covering the period July 1, 2009 to  June  30,  2010,
     8  and  covering the period July 1, 2010 to June 30, 2011, and covering the
     9  period July 1, 2011 to June 30, 2012, and covering the  period  July  1,
    10  2012  to June 30, 2013, and covering the period July 1, 2013 to June 30,
    11  2014, and covering the period July 1, 2014 to June 30, 2015, and  cover-
    12  ing  the  period  July 1, 2015 to June 30, 2016, and covering the period
    13  July 1, 2016 to June 30, 2017, and covering the period July 1,  2017  to
    14  June  30,  2018,  and covering the period July 1, 2018 to June 30, 2019,
    15  and covering the period July 1, 2019 to June 30, 2020, and covering  the
    16  period  July  1,  2020 to June 30, 2021, and covering the period July 1,
    17  2021 to June 30, 2022 for a  physician  or  dentist  where  such  excess
    18  insurance coverage or equivalent excess coverage is cancelled in accord-
    19  ance with paragraph (c) of this subdivision.
    20    § 5. Section 40 of chapter 266 of the laws of 1986, amending the civil
    21  practice  law  and  rules  and  other  laws  relating to malpractice and
    22  professional medical conduct, as amended by section 5  of  part  AAA  of
    23  chapter 56 of the laws of 2020, is amended to read as follows:
    24    §  40.  The superintendent of financial services shall establish rates
    25  for policies providing coverage  for  physicians  and  surgeons  medical
    26  malpractice  for the periods commencing July 1, 1985 and ending June 30,
    27  [2021] 2022; provided, however, that notwithstanding any other provision
    28  of law, the superintendent shall not establish or approve  any  increase
    29  in  rates  for  the  period  commencing July 1, 2009 and ending June 30,
    30  2010. The superintendent shall direct insurers to  establish  segregated
    31  accounts  for premiums, payments, reserves and investment income attrib-
    32  utable to such premium periods and shall require periodic reports by the
    33  insurers regarding claims and expenses attributable to such  periods  to
    34  monitor whether such accounts will be sufficient to meet incurred claims
    35  and  expenses. On or after July 1, 1989, the superintendent shall impose
    36  a surcharge on premiums  to  satisfy  a  projected  deficiency  that  is
    37  attributable  to the premium levels established pursuant to this section
    38  for such periods; provided, however, that such  annual  surcharge  shall
    39  not  exceed  eight  percent of the established rate until July 1, [2021]
    40  2022, at which time and thereafter such surcharge shall not exceed twen-
    41  ty-five percent of the approved adequate  rate,  and  that  such  annual
    42  surcharges shall continue for such period of time as shall be sufficient
    43  to  satisfy  such  deficiency.  The superintendent shall not impose such
    44  surcharge during the period commencing July 1, 2009 and ending June  30,
    45  2010.  On  and  after  July  1,  1989,  the surcharge prescribed by this
    46  section shall be retained by insurers to the extent  that  they  insured
    47  physicians  and surgeons during the July 1, 1985 through June 30, [2021]
    48  2022 policy periods; in the event  and  to  the  extent  physicians  and
    49  surgeons  were  insured by another insurer during such periods, all or a
    50  pro rata share of the surcharge, as the case may be, shall  be  remitted
    51  to  such  other  insurer  in accordance with rules and regulations to be
    52  promulgated by the superintendent.  Surcharges collected from physicians
    53  and surgeons who were not insured during such policy  periods  shall  be
    54  apportioned  among  all insurers in proportion to the premium written by
    55  each insurer during such policy periods; if a physician or  surgeon  was
    56  insured by an insurer subject to rates established by the superintendent

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

     1  during  such  policy  periods,  and  at  any time thereafter a hospital,
     2  health maintenance organization, employer or institution is  responsible
     3  for  responding in damages for liability arising out of such physician's
     4  or  surgeon's  practice  of medicine, such responsible entity shall also
     5  remit to such prior insurer the equivalent amount  that  would  then  be
     6  collected  as  a  surcharge if the physician or surgeon had continued to
     7  remain insured by such prior insurer. In  the  event  any  insurer  that
     8  provided  coverage  during  such  policy  periods is in liquidation, the
     9  property/casualty insurance security fund shall receive the  portion  of
    10  surcharges to which the insurer in liquidation would have been entitled.
    11  The surcharges authorized herein shall be deemed to be income earned for
    12  the  purposes of section 2303 of the insurance law.  The superintendent,
    13  in establishing adequate rates and in determining  any  projected  defi-
    14  ciency  pursuant  to  the requirements of this section and the insurance
    15  law, shall give substantial weight, determined  in  his  discretion  and
    16  judgment,  to  the  prospective  anticipated  effect  of any regulations
    17  promulgated and laws enacted and the  public  benefit  of    stabilizing
    18  malpractice rates and minimizing rate level fluctuation during the peri-
    19  od  of  time  necessary for the development of more reliable statistical
    20  experience as to the efficacy of such  laws  and  regulations  affecting
    21  medical, dental or podiatric malpractice enacted or promulgated in 1985,
    22  1986,  by this act and at any other time.  Notwithstanding any provision
    23  of the insurance law, rates already established and to be established by
    24  the superintendent pursuant to this section are deemed adequate if  such
    25  rates  would be adequate when taken together with the maximum authorized
    26  annual surcharges to be imposed for a reasonable period of time  whether
    27  or  not  any  such  annual surcharge has been actually imposed as of the
    28  establishment of such rates.
    29    § 6. Section 5 and subdivisions (a) and (e) of section 6 of part J  of
    30  chapter  63  of  the  laws  of 2001, amending chapter 266 of the laws of
    31  1986, amending the civil practice law and rules and other laws  relating
    32  to malpractice and professional medical conduct, as amended by section 6
    33  of  part  AAA  of chapter 56 of the laws of 2020, are amended to read as
    34  follows:
    35    § 5. The superintendent of financial services and the commissioner  of
    36  health shall determine, no later than June 15, 2002, June 15, 2003, June
    37  15,  2004,  June  15, 2005, June 15, 2006, June 15, 2007, June 15, 2008,
    38  June 15, 2009, June 15, 2010, June 15, 2011, June  15,  2012,  June  15,
    39  2013,  June  15, 2014, June 15, 2015, June 15, 2016, June 15, 2017, June
    40  15, 2018, June 15, 2019, June 15, 2020, [and] June 15,  2021,  and  June
    41  15,  2022 the amount of funds available in the hospital excess liability
    42  pool, created pursuant to section 18 of chapter 266 of the laws of 1986,
    43  and whether such funds are sufficient for purposes of purchasing  excess
    44  insurance  coverage  for  eligible participating physicians and dentists
    45  during the period July 1, 2001 to June 30, 2002, or July 1, 2002 to June
    46  30, 2003, or July 1, 2003 to June 30, 2004, or July 1, 2004 to June  30,
    47  2005,  or  July  1,  2005  to June 30, 2006, or July 1, 2006 to June 30,
    48  2007, or July 1, 2007 to June 30, 2008, or July  1,  2008  to  June  30,
    49  2009,  or  July  1,  2009  to June 30, 2010, or July 1, 2010 to June 30,
    50  2011, or July 1, 2011 to June 30, 2012, or July  1,  2012  to  June  30,
    51  2013,  or  July  1,  2013  to June 30, 2014, or July 1, 2014 to June 30,
    52  2015, or July 1, 2015 to June 30, 2016, or July  1,  2016  to  June  30,
    53  2017,  or  July  1,  2017  to June 30, 2018, or July 1, 2018 to June 30,
    54  2019, or July 1, 2019 to June 30, 2020, or July  1,  2020  to  June  30,
    55  2021, or July 1, 2021 to June 30, 2022 as applicable.

        S. 2507--A                         34                         A. 3007--A
 
     1    (a)  This section shall be effective only upon a determination, pursu-
     2  ant to section five of this act,  by  the  superintendent  of  financial
     3  services  and  the  commissioner  of health, and a certification of such
     4  determination to the state director of the  budget,  the  chair  of  the
     5  senate  committee  on finance and the chair of the assembly committee on
     6  ways and means, that the amount of funds in the hospital excess  liabil-
     7  ity  pool,  created pursuant to section 18 of chapter 266 of the laws of
     8  1986, is insufficient for purposes of purchasing excess insurance cover-
     9  age for eligible participating physicians and dentists during the period
    10  July 1, 2001 to June 30, 2002, or July 1, 2002 to June 30, 2003, or July
    11  1, 2003 to June 30, 2004, or July 1, 2004 to June 30, 2005, or  July  1,
    12  2005 to June 30, 2006, or July 1, 2006 to June 30, 2007, or July 1, 2007
    13  to  June  30, 2008, or July 1, 2008 to June 30, 2009, or July 1, 2009 to
    14  June 30, 2010, or July 1, 2010 to June 30, 2011, or July 1, 2011 to June
    15  30, 2012, or July 1, 2012 to June 30, 2013, or July 1, 2013 to June  30,
    16  2014,  or  July  1,  2014  to June 30, 2015, or July 1, 2015 to June 30,
    17  2016, or July 1, 2016 to June 30, 2017, or July  1,  2017  to  June  30,
    18  2018,  or  July  1,  2018  to June 30, 2019, or July 1, 2019 to June 30,
    19  2020, or July 1, 2020 to June 30, 2021, or July 1, 2021 to June 30, 2022
    20  as applicable.
    21    (e) The commissioner of health  shall  transfer  for  deposit  to  the
    22  hospital excess liability pool created pursuant to section 18 of chapter
    23  266  of  the laws of 1986 such amounts as directed by the superintendent
    24  of financial services for the purchase  of  excess  liability  insurance
    25  coverage  for  eligible  participating  physicians  and dentists for the
    26  policy year July 1, 2001 to June 30, 2002, or July 1, 2002 to  June  30,
    27  2003,  or  July  1,  2003  to June 30, 2004, or July 1, 2004 to June 30,
    28  2005, or July 1, 2005 to June 30, 2006, or July  1,  2006  to  June  30,
    29  2007,  as  applicable, and the cost of administering the hospital excess
    30  liability pool for such applicable policy year,  pursuant to the program
    31  established in chapter 266 of the laws of 1986,  as  amended,  no  later
    32  than  June  15,  2002, June 15, 2003, June 15, 2004, June 15, 2005, June
    33  15, 2006, June 15, 2007, June 15, 2008, June 15, 2009,  June  15,  2010,
    34  June  15,  2011,  June  15, 2012, June 15, 2013, June 15, 2014, June 15,
    35  2015, June 15, 2016, June 15, 2017, June 15, 2018, June 15,  2019,  June
    36  15, 2020, [and] June 15, 2021, and June 15, 2022 as applicable.
    37    §  7. Section 20 of part H of chapter 57 of the laws of 2017, amending
    38  the New York Health Care Reform Act of 1996 and other laws  relating  to
    39  extending  certain  provisions  thereto, as amended by section 7 of part
    40  AAA of chapter 56 of the laws of 2020, is amended to read as follows:
    41    § 20. Notwithstanding any law, rule or  regulation  to  the  contrary,
    42  only  physicians  or dentists who were eligible, and for whom the super-
    43  intendent of financial services and the commissioner of health, or their
    44  designee, purchased, with funds available in the hospital excess liabil-
    45  ity pool, a full or partial policy for  excess  coverage  or  equivalent
    46  excess  coverage  for  the coverage period ending the thirtieth of June,
    47  two thousand [twenty] twenty-one, shall be eligible to  apply  for  such
    48  coverage  for the coverage period beginning the first of July, two thou-
    49  sand [twenty] twenty-one; provided, however,  if  the  total  number  of
    50  physicians  or  dentists  for  whom  such  excess coverage or equivalent
    51  excess coverage was purchased for the policy year ending  the  thirtieth
    52  of  June,  two  thousand [twenty] twenty-one exceeds the total number of
    53  physicians or dentists certified as eligible  for  the  coverage  period
    54  beginning  the first of July, two thousand [twenty] twenty-one, then the
    55  general hospitals may certify additional eligible physicians or dentists
    56  in a number equal to such general hospital's proportional share  of  the

        S. 2507--A                         35                         A. 3007--A
 
     1  total  number  of  physicians  or  dentists  for whom excess coverage or
     2  equivalent excess coverage was purchased with  funds  available  in  the
     3  hospital excess liability pool as of the thirtieth of June, two thousand
     4  [twenty]  twenty-one, as applied to the difference between the number of
     5  eligible physicians or dentists for whom a policy for excess coverage or
     6  equivalent excess coverage was purchased for the coverage period  ending
     7  the  thirtieth  of June, two thousand [twenty] twenty-one and the number
     8  of such eligible physicians or dentists  who  have  applied  for  excess
     9  coverage or equivalent excess coverage for the coverage period beginning
    10  the first of July, two thousand [twenty] twenty-one.
    11    §  8.  This  act  shall take effect immediately and shall be deemed to
    12  have been in full force and effect on and after April 1, 2021.
 
    13                                   PART L
 
    14    Section 1. Subdivision 2 of section 605 of the public health  law,  as
    15  amended  by  section  1  of part O of chapter 57 of the laws of 2019, is
    16  amended to read as follows:
    17    2. State aid reimbursement for public health services  provided  by  a
    18  municipality  under  this  title,  shall  be made if the municipality is
    19  providing some or all of the core public health services  identified  in
    20  section  six hundred two of this title, pursuant to an approved applica-
    21  tion for state aid, at a rate of no less  than  thirty-six  per  centum,
    22  except  for the city of New York which shall receive no less than [twen-
    23  ty] ten per centum, of the  difference  between  the  amount  of  moneys
    24  expended  by  the  municipality  for  public health services required by
    25  section six hundred two of this title during the  fiscal  year  and  the
    26  base grant provided pursuant to subdivision one of this section. No such
    27  reimbursement  shall  be provided for services that are not eligible for
    28  state aid pursuant to this article.
    29    § 2. Subdivision 1 of section 616 of the public health law, as amended
    30  by section 2 of part O of chapter 57 of the laws of 2019, is amended  to
    31  read as follows:
    32    1.  The  total  amount  of state aid provided pursuant to this article
    33  shall be limited to the amount of the annual appropriation made  by  the
    34  legislature.  In no event, however, shall such state aid be less than an
    35  amount to provide the full base grant  and,  as  otherwise  provided  by
    36  subdivision  two  of  section  six hundred five of this article, no less
    37  than thirty-six per centum, except for the city of New York which  shall
    38  receive  no less than [twenty] ten per centum, of the difference between
    39  the amount of moneys expended by the municipality  for  eligible  public
    40  health services pursuant to an approved application for state aid during
    41  the  fiscal year and the base grant provided pursuant to subdivision one
    42  of section six hundred five of this article.
    43    § 3. This act shall take effect July 1, 2021.
 
    44                                   PART M
 
    45    Section 1. Subdivision 1, paragraph (f) of subdivision  3,  paragraphs
    46  (a)  and  (d)  of  subdivision  5 and subdivisions 5-a and 12 of section
    47  2807-m of the public health law, subdivision 1, paragraph (f) of  subdi-
    48  vision 3, paragraph (a) of subdivision 5, and subdivision 5-a as amended
    49  and  paragraph  (d)  of subdivision 5 as added by section 6 of part Y of
    50  chapter 56 of the laws of 2020, are amended to read as follows:
    51    1.  Definitions. For purposes of this  section,  the  following  defi-
    52  nitions shall apply, unless the context clearly requires otherwise:

        S. 2507--A                         36                         A. 3007--A
 
     1    (a) ["Clinical research" means patient-oriented research, epidemiolog-
     2  ic  and  behavioral  studies,  or  outcomes research and health services
     3  research that is approved by an institutional review board by  the  time
     4  the clinical research position is filled.
     5    (b) "Clinical research plan" means a plan submitted by a consortium or
     6  teaching  general hospital for a clinical research position which demon-
     7  strates, in a form to be provided by the commissioner, the following:
     8    (i) financial support for overhead, supervision, equipment  and  other
     9  resources  equal  to the amount of funding provided pursuant to subpara-
    10  graph (i) of paragraph (b) of subdivision five-a of this section by  the
    11  teaching  general hospital or consortium for the clinical research posi-
    12  tion;
    13    (ii) experience the sponsor-mentor and teaching general  hospital  has
    14  in clinical research and the medical field of the study;
    15    (iii)  methods, data collection and anticipated measurable outcomes of
    16  the clinical research to be performed;
    17    (iv) training goals, objectives and experience the researcher will  be
    18  provided to assess a future career in clinical research;
    19    (v)  scientific  relevance,  merit  and  health  implications  of  the
    20  research to be performed;
    21    (vi) information on potential  scientific  meetings  and  peer  review
    22  journals where research results can be disseminated;
    23    (vii)  clear  and comprehensive details on the clinical research posi-
    24  tion;
    25    (viii) qualifications necessary for the clinical research position and
    26  strategy for recruitment;
    27    (ix) non-duplication with other clinical research positions  from  the
    28  same teaching general hospital or consortium;
    29    (x)  methods  to  track the career of the clinical researcher once the
    30  term of the position is complete; and
    31    (xi) any other information required by the commissioner  to  implement
    32  subparagraph (i) of paragraph (b) of subdivision five-a of this section.
    33    (xii) The clinical review plan submitted in accordance with this para-
    34  graph  may  be reviewed by the commissioner in consultation with experts
    35  outside the department of health.
    36    (c) "Clinical research position" means a post-graduate residency posi-
    37  tion which:
    38    (i) shall not be required in order for the researcher  to  complete  a
    39  graduate medical education program;
    40    (ii)  may  be reimbursed by other sources but only for costs in excess
    41  of the funding distributed in accordance with subparagraph (i) of  para-
    42  graph (b) of subdivision five-a of this section;
    43    (iii)  shall  exceed  the  minimum  standards that are required by the
    44  residency review committee in the specialty the researcher  has  trained
    45  or is currently training;
    46    (iv)  shall  not be previously funded by the teaching general hospital
    47  or supported by another funding source at the teaching general  hospital
    48  in  the  past  three  years  from the date the clinical research plan is
    49  submitted to the commissioner;
    50    (v) may supplement an existing research project;
    51    (vi) shall be equivalent to a full-time position comprising of no less
    52  than thirty-five hours per week for one or two years;
    53    (vii) shall provide, or be filled by a researcher who  has  formalized
    54  instruction  in  clinical  research,  including  biostatistics, clinical
    55  trial design, grant writing and research ethics;

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

     1    (viii) shall be supervised by a sponsor-mentor who shall either (A) be
     2  employed, contracted for employment or paid through an affiliated facul-
     3  ty practice plan by a teaching general hospital which  has  received  at
     4  least  one  research grant from the National Institutes of Health in the
     5  past five years from the date the clinical research plan is submitted to
     6  the  commissioner;  (B)  maintain  a  faculty  appointment at a medical,
     7  dental or podiatric school located in New York state that  has  received
     8  at  least  one  research grant from the National Institutes of Health in
     9  the past five years from the date the clinical research plan is  submit-
    10  ted  to  the  commissioner;  or  (C)  be  collaborating  in the clinical
    11  research plan with  a  researcher  from  another  institution  that  has
    12  received  at  least  one  research grant from the National Institutes of
    13  Health in the past five years from the date the clinical  research  plan
    14  is submitted to the commissioner; and
    15    (ix)  shall  be  filled  by  a  researcher  who is (A) enrolled or has
    16  completed a graduate medical education program, as defined in  paragraph
    17  (i)  of  this  subdivision;  (B)  a  United States citizen, national, or
    18  permanent resident of the  United  States;  and  (C)  a  graduate  of  a
    19  medical,  dental or podiatric school located in New York state, a gradu-
    20  ate or resident in a graduate medical education program, as  defined  in
    21  paragraph  (i) of this subdivision, where the sponsoring institution, as
    22  defined in paragraph (q) of this subdivision, is  located  in  New  York
    23  state,  or  resides  in New York state at the time the clinical research
    24  plan is submitted to the commissioner.
    25    (d)] "Consortium" means an organization or  association,  approved  by
    26  the  commissioner in consultation with the council, of general hospitals
    27  which provide graduate medical education, together with  any  affiliated
    28  site;  provided  that  such organization or association may also include
    29  other providers of health care  services,  medical  schools,  payors  or
    30  consumers,  and which meet other criteria pursuant to subdivision six of
    31  this section.
    32    [(e)] (b) "Council" means the  New  York  state  council  on  graduate
    33  medical education.
    34    [(f)]  (c)  "Direct medical education" means the direct costs of resi-
    35  dents, interns and supervising physicians.
    36    [(g)] (d) "Distribution period" means each calendar year set forth  in
    37  subdivision two of this section.
    38    [(h)]  (e)  "Faculty"  means  persons  who  are  employed  by or under
    39  contract for employment with a teaching general  hospital  or  are  paid
    40  through  a  teaching general hospital's affiliated faculty practice plan
    41  and maintain a faculty appointment at a  medical  school.  Such  persons
    42  shall not be limited to persons with a degree in medicine.
    43    [(i)]  (f)  "Graduate medical education program" means a post-graduate
    44  medical education residency in the  United  States  which  has  received
    45  accreditation  from  a  nationally  recognized accreditation body or has
    46  been approved by  a  nationally  recognized  organization  for  medical,
    47  osteopathic,  podiatric  or dental residency programs including, but not
    48  limited to, specialty boards.
    49    [(j)] (g) "Indirect medical education" means the  estimate  of  costs,
    50  other than direct costs, of educational activities in teaching hospitals
    51  as determined in accordance with the methodology applicable for purposes
    52  of  determining  an  estimate  of  indirect  medical education costs for
    53  reimbursement for inpatient hospital service pursuant to title XVIII  of
    54  the federal social security act (medicare).

        S. 2507--A                         38                         A. 3007--A
 
     1    [(k)]  (h) "Medicare" means the methodology used for purposes of reim-
     2  bursing inpatient hospital services provided to beneficiaries  of  title
     3  XVIII of the federal social security act.
     4    [(l)]  (i)  "Primary  care" residents specialties shall include family
     5  medicine, general pediatrics, primary care internal medicine, and prima-
     6  ry care obstetrics and gynecology. In determining whether a residency is
     7  in primary care, the commissioner shall consult with the council.
     8    [(m)] (j) "Regions", for purposes of  this  section,  shall  mean  the
     9  regions  as  defined  in paragraph (b) of subdivision sixteen of section
    10  twenty-eight hundred seven-c of this article as in effect on June  thir-
    11  tieth, nineteen hundred ninety-six. For purposes of distributions pursu-
    12  ant  to subdivision five-a of this section, except distributions made in
    13  accordance with paragraph (a) of subdivision  five-a  of  this  section,
    14  "regions" shall be defined as New York city and the rest of the state.
    15    [(n)]  (k)  "Regional pool" means a professional education pool estab-
    16  lished on a regional basis by  the  commissioner  from  funds  available
    17  pursuant  to  sections  twenty-eight  hundred  seven-s  and twenty-eight
    18  hundred seven-t of this article.
    19    [(o)] (l) "Resident" means a person in a  graduate  medical  education
    20  program  which  has  received accreditation from a nationally recognized
    21  accreditation body or in a program  approved  by  any  other  nationally
    22  recognized  organization  for  medical,  osteopathic or dental residency
    23  programs including, but not limited to, specialty boards.
    24    [(p) "Shortage specialty" means a specialty determined by the  commis-
    25  sioner,  in  consultation with the council, to be in short supply in the
    26  state of New York.
    27    (q)] (m) "Sponsoring institution" means the entity that has the  over-
    28  all  responsibility  for  a  program of graduate medical education. Such
    29  institutions shall include teaching general hospitals, medical  schools,
    30  consortia and diagnostic and treatment centers.
    31    [(r)]  (n)  "Weighted  resident count" means a teaching general hospi-
    32  tal's total number of residents as of July first, nineteen hundred nine-
    33  ty-five,  including  residents  in  affiliated  non-hospital  ambulatory
    34  settings,  reported  to  the  commissioner.  Such  resident counts shall
    35  reflect the weights established in accordance with rules and regulations
    36  adopted by the state hospital review and planning council  and  approved
    37  by the commissioner for purposes of implementing subdivision twenty-five
    38  of section twenty-eight hundred seven-c of this article and in effect on
    39  July  first,  nineteen  hundred  ninety-five.  Such weights shall not be
    40  applied to specialty hospitals, specified  by  the  commissioner,  whose
    41  primary  care  mission  is  to engage in research, training and clinical
    42  care in specialty  eye  and  ear,  special  surgery,  orthopedic,  joint
    43  disease, cancer, chronic care or rehabilitative services.
    44    [(s)]  (o)  "Adjustment  amount"  means  an amount determined for each
    45  teaching hospital for periods prior to January first, two thousand  nine
    46  by:
    47    (i)  determining the difference between (A) a calculation of what each
    48  teaching general hospital would have been paid if payments made pursuant
    49  to paragraph (a-3) of subdivision one of  section  twenty-eight  hundred
    50  seven-c  of this article between January first, nineteen hundred ninety-
    51  six and December thirty-first, two thousand three were based  solely  on
    52  the  case  mix  of  persons  eligible  for  medical assistance under the
    53  medical assistance program pursuant to title eleven of article  five  of
    54  the social services law who are enrolled in health maintenance organiza-
    55  tions and persons paid for under the family health plus program enrolled
    56  in  approved organizations pursuant to title eleven-D of article five of

        S. 2507--A                         39                         A. 3007--A
 
     1  the social services law during those years, and (B) the actual  payments
     2  to  each such hospital pursuant to paragraph (a-3) of subdivision one of
     3  section twenty-eight hundred seven-c of  this  article  between  January
     4  first,  nineteen hundred ninety-six and December thirty-first, two thou-
     5  sand three.
     6    (ii) reducing proportionally each of the amounts determined in subpar-
     7  agraph (i) of this paragraph so that the sum of all such amounts  totals
     8  no more than one hundred million dollars;
     9    (iii)  further reducing each of the amounts determined in subparagraph
    10  (ii) of this paragraph by the amount received  by  each  hospital  as  a
    11  distribution  from funds designated in paragraph (a) of subdivision five
    12  of this section attributable to the period January first,  two  thousand
    13  three  through December thirty-first, two thousand three, except that if
    14  such amount was  provided  to  a  consortium  then  the  amount  of  the
    15  reduction  for  each  hospital  in the consortium shall be determined by
    16  applying the proportion  of  each  hospital's  amount  determined  under
    17  subparagraph  (i)  of this paragraph to the total of such amounts of all
    18  hospitals in such consortium to the consortium award;
    19    (iv) further reducing each of the amounts determined  in  subparagraph
    20  (iii)  of this paragraph by the amounts specified in paragraph [(t)] (p)
    21  of this subdivision; and
    22    (v) dividing each of the amounts determined in subparagraph  (iii)  of
    23  this paragraph by seven.
    24    [(t)] (p) "Extra reduction amount" shall mean an amount determined for
    25  a  teaching hospital for which an adjustment amount is calculated pursu-
    26  ant to paragraph [(s)] (o) of this subdivision that  is  the  hospital's
    27  proportionate  share  of  the  sum of the amounts specified in paragraph
    28  [(u)] (q) of this subdivision determined based upon a comparison of  the
    29  hospital's  remaining  liability  calculated pursuant to paragraph [(s)]
    30  (o) of this subdivision to the sum  of  all  such  hospital's  remaining
    31  liabilities.
    32    [(u)]  (q)  "Allotment  amount"  shall  mean  an amount determined for
    33  teaching hospitals as follows:
    34    (i) for a hospital for which an adjustment amount  pursuant  to  para-
    35  graph  [(s)] (o) of this subdivision does not apply, the amount received
    36  by the hospital pursuant to paragraph (a) of subdivision  five  of  this
    37  section  attributable  to  the  period January first, two thousand three
    38  through December thirty-first, two thousand three, or
    39    (ii) for a hospital for which an adjustment amount pursuant  to  para-
    40  graph  [(s)]  (o)  of  this  subdivision  applies  and  which received a
    41  distribution pursuant to paragraph  (a)  of  subdivision  five  of  this
    42  section  attributable  to  the  period January first, two thousand three
    43  through December thirty-first, two thousand three that is  greater  than
    44  the  hospital's  adjustment  amount, the difference between the distrib-
    45  ution amount and the adjustment amount.
    46    (f) Effective January first, two thousand five through December  thir-
    47  ty-first,  two  thousand  eight,  each  teaching  general hospital shall
    48  receive a distribution from the applicable regional pool  based  on  its
    49  distribution amount determined under paragraphs (c), (d) and (e) of this
    50  subdivision  and reduced by its adjustment amount calculated pursuant to
    51  paragraph [(s)] (o) of subdivision one of this section and, for distrib-
    52  utions for the period January first, two thousand five through  December
    53  thirty-first,  two thousand five, further reduced by its extra reduction
    54  amount calculated pursuant to paragraph [(t)] (p) of subdivision one  of
    55  this section.

        S. 2507--A                         40                         A. 3007--A
 
     1    (a)  Up to thirty-one million dollars annually for the periods January
     2  first, two thousand through December thirty-first, two  thousand  three,
     3  and up to twenty-five million dollars plus the sum of the amounts speci-
     4  fied  in  paragraph [(n)] (k) of subdivision one of this section for the
     5  period  January  first, two thousand five through December thirty-first,
     6  two thousand five, and up to thirty-one million dollars annually for the
     7  period January first, two thousand six  through  December  thirty-first,
     8  two  thousand seven, shall be set aside and reserved by the commissioner
     9  from the regional pools established pursuant to subdivision two of  this
    10  section for supplemental distributions in each such region to be made by
    11  the  commissioner to consortia and teaching general hospitals in accord-
    12  ance with a distribution methodology developed in consultation with  the
    13  council  and  specified  in rules and regulations adopted by the commis-
    14  sioner.
    15    (d) Notwithstanding any other provision of law or regulation, for  the
    16  period  January  first, two thousand five through December thirty-first,
    17  two thousand five, the commissioner  shall  distribute  as  supplemental
    18  payments  the  allotment specified in paragraph [(n)] (k) of subdivision
    19  one of this section.
    20    5-a. Graduate medical education  innovations  pool.  (a)  Supplemental
    21  distributions.  (i)  Thirty-one  million  dollars for the period January
    22  first, two thousand eight through December  thirty-first,  two  thousand
    23  eight,  shall  be  set  aside  and reserved by the commissioner from the
    24  regional pools established pursuant to subdivision two of  this  section
    25  and shall be available for distributions pursuant to subdivision five of
    26  this  section  and in accordance with section 86-1.89 of title 10 of the
    27  codes, rules and regulations of the state of New York as  in  effect  on
    28  January  first,  two thousand eight[; provided, however, for purposes of
    29  funding the empire clinical research investigation  program  (ECRIP)  in
    30  accordance  with paragraph eight of subdivision (e) and paragraph two of
    31  subdivision (f) of section 86-1.89 of title 10 of the codes,  rules  and
    32  regulations  of the state of New York, distributions shall be made using
    33  two regions defined as New York city and the rest of the state  and  the
    34  dollar amount set forth in subparagraph (i) of paragraph two of subdivi-
    35  sion  (f)  of  section 86-1.89 of title 10 of the codes, rules and regu-
    36  lations of the state of New York shall be increased from sixty  thousand
    37  dollars to seventy-five thousand dollars].
    38    (ii)  For  periods  on  and  after  January  first, two thousand nine,
    39  supplemental distributions pursuant to subdivision five of this  section
    40  and  in  accordance with section 86-1.89 of title 10 of the codes, rules
    41  and regulations of the state of New York shall no longer be made and the
    42  provisions of section 86-1.89 of title 10 of the codes, rules and  regu-
    43  lations of the state of New York shall be null and void.
    44    (b)  [Empire  clinical  research  investigator  program  (ECRIP). Nine
    45  million one hundred twenty thousand  dollars  annually  for  the  period
    46  January  first,  two  thousand  nine  through December thirty-first, two
    47  thousand ten, and two million two hundred eighty  thousand  dollars  for
    48  the  period  January  first,  two thousand eleven, through March thirty-
    49  first, two thousand eleven, nine million  one  hundred  twenty  thousand
    50  dollars  each state fiscal year for the period April first, two thousand
    51  eleven through March thirty-first, two thousand fourteen,  up  to  eight
    52  million  six  hundred twelve thousand dollars each state fiscal year for
    53  the period April first, two  thousand  fourteen  through  March  thirty-
    54  first,  two  thousand  seventeen, up to eight million six hundred twelve
    55  thousand dollars each state fiscal year for the period April first,  two
    56  thousand  seventeen through March thirty-first, two thousand twenty, and

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

     1  up to eight million six  hundred  twelve  thousand  dollars  each  state
     2  fiscal  year  for  the  period  April first, two thousand twenty through
     3  March thirty-first, two thousand twenty-three, shall be  set  aside  and
     4  reserved  by the commissioner from the regional pools established pursu-
     5  ant to subdivision two of this section to be allocated  regionally  with
     6  two-thirds of the available funding going to New York city and one-third
     7  of  the  available  funding  going to the rest of the state and shall be
     8  available for distribution as follows:
     9    Distributions shall first be made to consortia  and  teaching  general
    10  hospitals  for the empire clinical research investigator program (ECRIP)
    11  to help secure federal funding for biomedical research,  train  clinical
    12  researchers,  recruit national leaders as faculty to act as mentors, and
    13  train residents and fellows  in  biomedical  research  skills  based  on
    14  hospital-specific  data  submitted  to the commissioner by consortia and
    15  teaching general hospitals in accordance with clause (G) of this subpar-
    16  agraph. Such distributions shall be made in accordance with the  follow-
    17  ing methodology:
    18    (A)  The  greatest  number  of clinical research positions for which a
    19  consortium or teaching general hospital may be funded pursuant  to  this
    20  subparagraph  shall  be  one  percent  of  the total number of residents
    21  training at the consortium or teaching general hospital on  July  first,
    22  two  thousand  eight  for  the  period  January first, two thousand nine
    23  through December thirty-first, two thousand nine rounded up to the near-
    24  est one position.
    25    (B) Distributions made to a consortium or  teaching  general  hospital
    26  shall  equal  the product of the total number of clinical research posi-
    27  tions submitted  by  a  consortium  or  teaching  general  hospital  and
    28  accepted  by the commissioner as meeting the criteria set forth in para-
    29  graph (b) of subdivision one of this section, subject to  the  reduction
    30  calculation  set  forth  in  clause  (C) of this subparagraph, times one
    31  hundred ten thousand dollars.
    32    (C) If the dollar amount for the total  number  of  clinical  research
    33  positions  in  the  region  calculated  pursuant  to  clause (B) of this
    34  subparagraph exceeds the total amount appropriated for purposes of  this
    35  paragraph,  including clinical research positions that continue from and
    36  were funded in prior distribution periods, the commissioner shall elimi-
    37  nate one-half of the  clinical  research  positions  submitted  by  each
    38  consortium  or teaching general hospital rounded down to the nearest one
    39  position. Such reduction shall be repeated until the dollar  amount  for
    40  the  total  number of clinical research positions in the region does not
    41  exceed the total amount appropriated for purposes of this paragraph.  If
    42  the  repeated  reduction  of the total number of clinical research posi-
    43  tions in the region by one-half does not render a total  funding  amount
    44  that  is equal to or less than the total amount reserved for that region
    45  within the appropriation, the funding for each clinical  research  posi-
    46  tion  in  that  region  shall  be reduced proportionally in one thousand
    47  dollar increments until the total dollar amount for the total number  of
    48  clinical  research  positions  in  that region does not exceed the total
    49  amount reserved for that region within the appropriation. Any  reduction
    50  in  funding will be effective for the duration of the award. No clinical
    51  research positions that continue from and were funded in prior  distrib-
    52  ution periods shall be eliminated or reduced by such methodology.
    53    (D)  Each  consortium  or  teaching general hospital shall receive its
    54  annual distribution amount in accordance with the following:
    55    (I) Each consortium or teaching general hospital with a one-year ECRIP
    56  award  shall  receive  its  annual  distribution  amount  in  full  upon

        S. 2507--A                         42                         A. 3007--A

     1  completion of the requirements set forth in items (I) and (II) of clause
     2  (G)  of  this subparagraph. The requirements set forth in items (IV) and
     3  (V) of clause (G) of this subparagraph must be completed by the  consor-
     4  tium  or teaching general hospital in order for the consortium or teach-
     5  ing general hospital to be eligible to apply for ECRIP  funding  in  any
     6  subsequent funding cycle.
     7    (II)  Each  consortium  or  teaching  general hospital with a two-year
     8  ECRIP award shall receive its first annual distribution amount  in  full
     9  upon  completion  of the requirements set forth in items (I) and (II) of
    10  clause (G) of this subparagraph. Each  consortium  or  teaching  general
    11  hospital will receive its second annual distribution amount in full upon
    12  completion  of the requirements set forth in item (III) of clause (G) of
    13  this subparagraph. The requirements set forth in items (IV) and  (V)  of
    14  clause  (G)  of this subparagraph must be completed by the consortium or
    15  teaching general hospital in order for the consortium or teaching gener-
    16  al hospital to be eligible to apply for ECRIP funding in any  subsequent
    17  funding cycle.
    18    (E)  Each  consortium  or teaching general hospital receiving distrib-
    19  utions pursuant to this subparagraph shall reserve seventy-five thousand
    20  dollars to primarily fund salary and fringe  benefits  of  the  clinical
    21  research  position  with  the remainder going to fund the development of
    22  faculty who are involved in biomedical research, training  and  clinical
    23  care.
    24    (F)  Undistributed  or  returned  funds  available  to  fund  clinical
    25  research positions pursuant to this paragraph for a distribution  period
    26  shall  be  available to fund clinical research positions in a subsequent
    27  distribution period.
    28    (G) In order to be eligible for distributions pursuant to this subpar-
    29  agraph, each consortium and teaching general hospital shall  provide  to
    30  the  commissioner by July first of each distribution period, the follow-
    31  ing data and information on a hospital-specific  basis.  Such  data  and
    32  information  shall  be  certified as to accuracy and completeness by the
    33  chief executive officer, chief financial officer or chair of the consor-
    34  tium governing body of each consortium or teaching general hospital  and
    35  shall be maintained by each consortium and teaching general hospital for
    36  five years from the date of submission:
    37    (I)  For  each  clinical  research  position, information on the type,
    38  scope, training objectives,  institutional  support,  clinical  research
    39  experience of the sponsor-mentor, plans for submitting research outcomes
    40  to  peer reviewed journals and at scientific meetings, including a meet-
    41  ing sponsored by the department, the name of a principal contact  person
    42  responsible for tracking the career development of researchers placed in
    43  clinical  research positions, as defined in paragraph (c) of subdivision
    44  one of this section, and who is authorized to certify to the commission-
    45  er that all the requirements of the clinical  research  training  objec-
    46  tives  set  forth  in this subparagraph shall be met. Such certification
    47  shall be provided by July first of each distribution period;
    48    (II) For each clinical research position,  information  on  the  name,
    49  citizenship  status, medical education and training, and medical license
    50  number of the researcher, if applicable, shall be provided  by  December
    51  thirty-first of the calendar year following the distribution period;
    52    (III)  Information on the status of the clinical research plan, accom-
    53  plishments, changes in research activities, progress, and performance of
    54  the researcher shall be provided upon  completion  of  one-half  of  the
    55  award term;

        S. 2507--A                         43                         A. 3007--A

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

        S. 2507--A                         44                         A. 3007--A
 
     1  going  to  New  York city and two-thirds of available funds going to the
     2  rest of the state and shall be distributed in a manner to be  determined
     3  by  the  commissioner  without a competitive bid or request for proposal
     4  process as follows:
     5    (i) Funding shall first be awarded to repay loans of up to twenty-five
     6  physicians  who  train  in  primary care or specialty tracks in teaching
     7  general hospitals, and who enter and remain in primary care or specialty
     8  practices in underserved communities, as determined by the commissioner.
     9    (ii) After distributions in accordance with subparagraph (i)  of  this
    10  paragraph, all remaining funds shall be awarded to repay loans of physi-
    11  cians  who  enter  and  remain in primary care or specialty practices in
    12  underserved communities, as determined by  the  commissioner,  including
    13  but  not  limited  to  physicians working in general hospitals, or other
    14  health care facilities.
    15    (iii) In no case shall less than fifty percent of the funds  available
    16  pursuant  to  this  paragraph be distributed in accordance with subpara-
    17  graphs (i) and (ii) of this paragraph to physicians identified by gener-
    18  al hospitals.
    19    (iv) In addition to the funds allocated under this paragraph, for  the
    20  period April first, two thousand fifteen through March thirty-first, two
    21  thousand  sixteen,  two  million  dollars  shall  be  available  for the
    22  purposes described in subdivision ten of this section;
    23    (v) In addition to the funds allocated under this paragraph,  for  the
    24  period April first, two thousand sixteen through March thirty-first, two
    25  thousand  seventeen,  two  million  dollars  shall  be available for the
    26  purposes described in subdivision ten of this section;
    27    (vi) Notwithstanding any provision of law to the contrary, and subject
    28  to the extension of the Health Care Reform Act of 1996, sufficient funds
    29  shall be available for the purposes described in subdivision ten of this
    30  section in amounts necessary to fund the remaining year commitments  for
    31  awards made pursuant to subparagraphs (iv) and (v) of this paragraph.
    32    [(d)]  (c) Physician practice support. Four million nine hundred thou-
    33  sand dollars for the period January first, two  thousand  eight  through
    34  December  thirty-first,  two  thousand  eight, four million nine hundred
    35  thousand dollars annually for the period  January  first,  two  thousand
    36  nine  through  December  thirty-first, two thousand ten, one million two
    37  hundred twenty-five thousand dollars for the period January  first,  two
    38  thousand  eleven  through  March thirty-first, two thousand eleven, four
    39  million three hundred thousand dollars each state fiscal  year  for  the
    40  period  April first, two thousand eleven through March thirty-first, two
    41  thousand fourteen, up to  four  million  three  hundred  sixty  thousand
    42  dollars  each state fiscal year for the period April first, two thousand
    43  fourteen through March thirty-first, two thousand seventeen, up to  four
    44  million  three hundred sixty thousand dollars for each state fiscal year
    45  for the period April first, two thousand seventeen through  March  thir-
    46  ty-first,  two  thousand  twenty,  and  up to four million three hundred
    47  sixty thousand dollars for each fiscal year for the period April  first,
    48  two  thousand  twenty  through  March thirty-first, two thousand twenty-
    49  three, shall be set aside and reserved  by  the  commissioner  from  the
    50  regional  pools  established pursuant to subdivision two of this section
    51  and shall be available  for  purposes  of  physician  practice  support.
    52  Notwithstanding  any  contrary  provision  of this section, sections one
    53  hundred twelve and one hundred sixty-three of the state finance law,  or
    54  any  other  contrary  provision  of law, such funding shall be allocated
    55  regionally with one-third of available funds going to New York city  and
    56  two-thirds  of  available funds going to the rest of the state and shall

        S. 2507--A                         45                         A. 3007--A
 
     1  be distributed in a manner to be determined by the commissioner  without
     2  a competitive bid or request for proposal process as follows:
     3    (i)  Preference in funding shall first be accorded to teaching general
     4  hospitals for up to twenty-five awards, to  support  costs  incurred  by
     5  physicians  trained in primary or specialty tracks who thereafter estab-
     6  lish or join practices in underserved communities, as determined by  the
     7  commissioner.
     8    (ii)  After  distributions in accordance with subparagraph (i) of this
     9  paragraph, all remaining funds shall be awarded to physicians to support
    10  the cost of establishing or joining practices  in  underserved  communi-
    11  ties,  as  determined  by  the  commissioner, and to hospitals and other
    12  health care providers to recruit new physicians to provide  services  in
    13  underserved communities, as determined by the commissioner.
    14    (iii)  In no case shall less than fifty percent of the funds available
    15  pursuant to this  paragraph  be  distributed  to  general  hospitals  in
    16  accordance with subparagraphs (i) and (ii) of this paragraph.
    17    [(e)]  (d)  Work  group.  For funding available pursuant to paragraphs
    18  [(c) and (d) (e)] (b) and (c) of this subdivision:
    19    (i) The department shall appoint a  work  group  from  recommendations
    20  made  by  associations  representing  physicians,  general hospitals and
    21  other health care facilities to develop a streamlined application  proc-
    22  ess by June first, two thousand twelve.
    23    (ii) Subject to available funding, applications shall be accepted on a
    24  continuous  basis.  The department shall provide technical assistance to
    25  applicants to facilitate their completion of applications. An  applicant
    26  shall  be  notified  in  writing  by  the  department within ten days of
    27  receipt of an application as to whether the application is complete  and
    28  if  the  application is incomplete, what information is outstanding. The
    29  department shall act on an application within thirty days of receipt  of
    30  a complete application.
    31    [(f)]  (e)  Study on physician workforce. Five hundred ninety thousand
    32  dollars annually for  the  period  January  first,  two  thousand  eight
    33  through December thirty-first, two thousand ten, one hundred forty-eight
    34  thousand  dollars  for  the  period  January  first, two thousand eleven
    35  through March thirty-first, two thousand eleven,  five  hundred  sixteen
    36  thousand  dollars each state fiscal year for the period April first, two
    37  thousand eleven through March thirty-first, two thousand fourteen, up to
    38  four hundred eighty-seven thousand dollars each state  fiscal  year  for
    39  the  period  April  first,  two  thousand fourteen through March thirty-
    40  first, two thousand seventeen, up to four hundred eighty-seven  thousand
    41  dollars for each state fiscal year for the period April first, two thou-
    42  sand  seventeen  through March thirty-first, two thousand twenty, and up
    43  to four hundred eighty-seven thousand dollars each state fiscal year for
    44  the period April first, two thousand twenty through March  thirty-first,
    45  two  thousand  twenty-three,  shall  be  set  aside  and reserved by the
    46  commissioner from the regional pools established pursuant to subdivision
    47  two of this section and shall be available to fund a study of  physician
    48  workforce needs and solutions including, but not limited to, an analysis
    49  of  residency  programs  and projected physician workforce and community
    50  needs. The commissioner shall enter into agreements  with  one  or  more
    51  organizations  to  conduct  such  study  based on a request for proposal
    52  process.
    53    [(g)] (f) Diversity in medicine/post-baccalaureate  program.  Notwith-
    54  standing any inconsistent provision of section one hundred twelve or one
    55  hundred  sixty-three  of  the  state  finance  law or any other law, one
    56  million nine hundred sixty thousand  dollars  annually  for  the  period

        S. 2507--A                         46                         A. 3007--A
 
     1  January  first,  two  thousand  eight through December thirty-first, two
     2  thousand ten, four hundred ninety thousand dollars for the period  Janu-
     3  ary  first, two thousand eleven through March thirty-first, two thousand
     4  eleven,  one  million  seven  hundred thousand dollars each state fiscal
     5  year for the period April first, two thousand eleven through March thir-
     6  ty-first, two thousand fourteen, up to  one  million  six  hundred  five
     7  thousand  dollars each state fiscal year for the period April first, two
     8  thousand fourteen through March thirty-first, two thousand seventeen, up
     9  to one million six hundred five thousand dollars each state fiscal  year
    10  for  the  period April first, two thousand seventeen through March thir-
    11  ty-first, two thousand twenty, and up to one million  six  hundred  five
    12  thousand  dollars each state fiscal year for the period April first, two
    13  thousand twenty through March thirty-first, two  thousand  twenty-three,
    14  shall  be  set  aside and reserved by the commissioner from the regional
    15  pools established pursuant to subdivision two of this section and  shall
    16  be  available for distributions to the Associated Medical Schools of New
    17  York to fund its diversity program including existing and new  post-bac-
    18  calaureate programs for minority and economically disadvantaged students
    19  and  encourage  participation  from all medical schools in New York. The
    20  associated medical schools of New York shall report to the  commissioner
    21  on  an  annual basis regarding the use of funds for such purpose in such
    22  form and manner as specified by the commissioner.
    23    [(h)] (g) In the event there are undistributed  funds  within  amounts
    24  made  available  for  distributions  pursuant  to this subdivision, such
    25  funds may be  reallocated  and  distributed  in  current  or  subsequent
    26  distribution  periods in a manner determined by the commissioner for any
    27  purpose set forth in this subdivision.
    28    12. Notwithstanding any provision of law to the contrary, applications
    29  submitted on or after April first, two thousand sixteen, for the  physi-
    30  cian  loan repayment program pursuant to paragraph [(c)] (b) of subdivi-
    31  sion five-a of this section and subdivision ten of this section  or  the
    32  physician  practice  support  program pursuant to paragraph [(d)] (c) of
    33  subdivision five-a of this section, shall be subject  to  the  following
    34  changes:
    35    (a)  Awards  shall  be  made  from the total funding available for new
    36  awards under the physician loan  repayment  program  and  the  physician
    37  practice  support  program,  with  neither program limited to a specific
    38  funding amount within such total funding available;
    39    (b) An applicant may apply for an  award  for  either  physician  loan
    40  repayment or physician practice support, but not both;
    41    (c)  An applicant shall agree to practice for three years in an under-
    42  served area and each award shall provide up to  forty  thousand  dollars
    43  for each of the three years; and
    44    (d)  To the extent practicable, awards shall be timed to be of use for
    45  job offers made to applicants.
    46    § 2. Subparagraph (xvi) of paragraph (a) of subdivision 7  of  section
    47  2807-s  of  the  public health law, as amended by section 8 of part Y of
    48  chapter 56 of the laws of 2020, is amended to read as follows:
    49    (xvi) provided further, however, for periods prior to July first,  two
    50  thousand  nine,  amounts set forth in this paragraph shall be reduced by
    51  an amount equal to the actual distribution reductions for all facilities
    52  pursuant to paragraph [(s)] (o) of subdivision one  of  section  twenty-
    53  eight hundred seven-m of this article.
    54    §  3.  Subdivision  (c)  of section 92-dd of the state finance law, as
    55  amended by section 9 of part Y of chapter 56 of the  laws  of  2020,  is
    56  amended to read as follows:

        S. 2507--A                         47                         A. 3007--A
 
     1    (c)  The pool administrator shall, from appropriated funds transferred
     2  to the  pool  administrator  from  the  comptroller,  continue  to  make
     3  payments  as required pursuant to sections twenty-eight hundred seven-k,
     4  twenty-eight hundred seven-m (not including payments  made  pursuant  to
     5  subdivision five-b and paragraphs (b), (c)[, (d),, (f)] and [(g)] (f) of
     6  subdivision  five-a  of section twenty-eight hundred seven-m), and twen-
     7  ty-eight hundred seven-w of the public  health  law,  paragraph  (e)  of
     8  subdivision  twenty-five  of section twenty-eight hundred seven-c of the
     9  public health law, paragraphs (b)  and  (c)  of  subdivision  thirty  of
    10  section twenty-eight hundred seven-c of the public health law, paragraph
    11  (b) of subdivision eighteen of section twenty-eight hundred eight of the
    12  public health law, subdivision seven of section twenty-five hundred-d of
    13  the  public  health  law  and section eighty-eight of chapter one of the
    14  laws of nineteen hundred ninety-nine.
    15    § 4.  Subdivision 2 of section 251 of the public health law, as  added
    16  by chapter 338 of the laws of 1998, is amended to read as follows:
    17    2.  Solicit,  receive, and review applications from public and private
    18  agencies and  organizations  and  qualified  research  institutions  for
    19  grants from the spinal cord injury research trust fund, created pursuant
    20  to  section  ninety-nine-f of the state finance law, to conduct research
    21  programs which focus on the treatment and cure of  spinal  cord  injury.
    22  The  board  shall  make  recommendations  to  the  commissioner, and the
    23  commissioner shall, in his or her discretion, grant approval of applica-
    24  tions for grants from  those  applications  recommended  by  the  board;
    25  provided,  however,  that the board shall not recommend, and the commis-
    26  sioner shall not approve, any new grants on or after  April  first,  two
    27  thousand twenty-one.
    28    § 5. Subdivision 1 of section 265-a of the public health law, as added
    29  by  section 1 of part H of chapter 58 of the laws of 2007, is amended to
    30  read as follows:
    31    1. The empire state stem cell board ("board"), comprised of a  funding
    32  committee and an ethics committee, both of which shall be chaired by the
    33  commissioner, is hereby created within the department for the purpose of
    34  administering  the  empire  state stem cell trust fund ("fund"), created
    35  pursuant to section ninety-nine-p of the state finance law. The board is
    36  hereby empowered, subject to annual  appropriations  and  other  funding
    37  authorized or made available, to make grants to basic, applied, transla-
    38  tional  or  other  research and development activities that will advance
    39  scientific discoveries in fields related to stem cell biology; provided,
    40  however, that the board shall not make any  grants  on  or  after  April
    41  first, two thousand twenty-one.
    42    § 6.  Section 6 of chapter 338 of the laws of 1998 amending the public
    43  health  law,  the public officers law and the state finance law relating
    44  to establishing a spinal cord injury research board, is amended to  read
    45  as follows:
    46    §  6.  This act shall take effect January 1, 1999 and shall expire and
    47  be deemed repealed December 31, 2024.
    48    § 7. Section 4 of part H of chapter 58 of the laws  of  2007  amending
    49  the public health law, the public officers law and the state finance law
    50  relating to establishing the empire state stem cell board, is amended to
    51  read as follows:
    52    §  4.  This  act  shall take effect immediately and shall be deemed to
    53  have been in full force and effect on and after April 1, 2007 and  shall
    54  expire and be deemed repealed December 31, 2025.
    55    §  8.  This  act  shall take effect immediately and shall be deemed to
    56  have been in full force and effect on and after April 1, 2021; provided,

        S. 2507--A                         48                         A. 3007--A

     1  however the amendments to subparagraph (xvi) of paragraph (a) of  subdi-
     2  vision  7 of section 2807-s of the public health law made by section two
     3  of this act shall not affect the expiration of such section and shall be
     4  deemed  to  expire therewith; provided further, however, that the amend-
     5  ments to section 251 of the public health law made by  section  four  of
     6  this  act  shall  not affect the expiration of such section and shall be
     7  deemed to expire therewith; and provided further,  however,  the  amend-
     8  ments  to section 265-a of the public health law made by section five of
     9  this act shall not affect the expiration of such section  and  shall  be
    10  deemed to expire therewith.
 
    11                                   PART N
 
    12    Section  1.  Subdivision 3 of section 281 of the public health law, as
    13  amended by chapter 13 of the  laws  of  2015,  is  amended  to  read  as
    14  follows:
    15    3.  On  or  before  December  thirty-first,  two  thousand twelve, the
    16  commissioner shall promulgate  regulations,  in  consultation  with  the
    17  commissioner   of   education,  establishing  standards  for  electronic
    18  prescriptions. Notwithstanding any other provision of  this  section  or
    19  any  other  law to the contrary, effective three years subsequent to the
    20  date on which such regulations are promulgated, no  person  shall  issue
    21  any prescription in this state unless such prescription is made by elec-
    22  tronic  prescription from the person issuing the prescription to a phar-
    23  macy  in  accordance  with  such  regulatory   standards,   except   for
    24  prescriptions:  (a)  [issued  by  veterinarians;  (b)] issued in circum-
    25  stances where electronic prescribing is not available due  to  temporary
    26  technological  or  electrical failure, as set forth in regulation; [(c)]
    27  (b) issued by practitioners [who have received a  waiver  or  a  renewal
    28  thereof  for  a  specified period determined by the commissioner, not to
    29  exceed one year, from the requirement  to  use  electronic  prescribing,
    30  pursuant  to a process established in regulation by the commissioner, in
    31  consultation with the commissioner of education, due to  economic  hard-
    32  ship,  technological  limitations  that  are  not  reasonably within the
    33  control of the practitioner, or other] in such exceptional [circumstance
    34  demonstrated by the practitioner; (d)] circumstances as  may  be  deter-
    35  mined  by  the  commissioner; (c) issued by a practitioner under circum-
    36  stances where, notwithstanding the  practitioner's  present  ability  to
    37  make  an  electronic  prescription as required by this subdivision, such
    38  practitioner reasonably determines that it would be impractical for  the
    39  patient  to obtain substances prescribed by electronic prescription in a
    40  timely manner, and such  delay  would  adversely  impact  the  patient's
    41  medical   condition,  provided  that  if  such  prescription  is  for  a
    42  controlled substance, the quantity of  controlled  substances  does  not
    43  exceed  a  five  day  supply  if  the  controlled substance were used in
    44  accordance with the directions for use; or [(e)] (d) issued by a practi-
    45  tioner to be dispensed by a pharmacy located outside the state,  as  set
    46  forth in regulation.
    47    § 2. Subdivision 5 of section 281 of the public health law, as amended
    48  by chapter 350 of the laws of 2016, is amended to read as follows:
    49    5.  In the case of a prescription for a controlled substance issued by
    50  a practitioner under paragraph [(d)] (c) or  [(e)]  (d)  of  subdivision
    51  three  of  this  section,  the  practitioner  shall,  upon  issuing such
    52  prescription, indicate in the patient's health record  either  that  the
    53  prescription  was  issued  other  than electronically because it (a) was
    54  impractical to issue an electronic prescription in a timely  manner  and

        S. 2507--A                         49                         A. 3007--A
 
     1  such  delay  would  have adversely impacted the patient's medical condi-
     2  tion, or (b) was to be dispensed  by  a  pharmacy  located  outside  the
     3  state.
     4    §  3.  Subdivision 10 of section 6810 of the education law, as amended
     5  by chapter 13 of the laws of 2015, is amended to read as follows:
     6    10. Notwithstanding any other provision of this section or  any  other
     7  law  to  the  contrary,  effective three years subsequent to the date on
     8  which regulations establishing standards  for  electronic  prescriptions
     9  are  promulgated by the commissioner of health, in consultation with the
    10  commissioner pursuant to subdivision three of section two hundred eight-
    11  y-one of  the  public  health  law,  no  practitioner  shall  issue  any
    12  prescription  in  this  state, unless such prescription is made by elec-
    13  tronic prescription from the practitioner  to  a  pharmacy,  except  for
    14  prescriptions: (a) [issued by veterinarians; (b)] issued or dispensed in
    15  circumstances  where  electronic  prescribing  is  not  available due to
    16  temporary technological or electrical failure, as  set  forth  in  regu-
    17  lation; [(c)] (b) issued by practitioners [who have received a waiver or
    18  a  renewal thereof for a specified period determined by the commissioner
    19  of health, not to exceed one year, from the requirement to use electron-
    20  ic prescribing, pursuant to a process established in regulation  by  the
    21  commissioner  of  health,  in  consultation with the commissioner due to
    22  economic hardship, technological limitations  that  are  not  reasonably
    23  within  the  control  of the practitioner, or other] in such exceptional
    24  [circumstance demonstrated by the practitioner] circumstances as may  be
    25  determined by the commissioner of health ; [(d)] (c) issued by a practi-
    26  tioner  under  circumstances  where,  notwithstanding the practitioner's
    27  present ability to make an electronic prescription as required  by  this
    28  subdivision,  such  practitioner  reasonably determines that it would be
    29  impractical for the patient to obtain substances prescribed by electron-
    30  ic prescription in a timely  manner,  and  such  delay  would  adversely
    31  impact   the   patient's   medical  condition,  provided  that  if  such
    32  prescription is for a controlled substance, the quantity that  does  not
    33  exceed a five day supply if the controlled substance was used in accord-
    34  ance  with the directions for use; or [(e)] (d) issued by a practitioner
    35  to be dispensed by a pharmacy located outside the state, as set forth in
    36  regulation.
    37    § 4. Subdivisions 11 and 12 of section 6810 of the education  law,  as
    38  amended  by  chapter  350  of  the  laws of 2016, are amended to read as
    39  follows:
    40    11. In the case of a prescription issued by a practitioner under para-
    41  graph [(b)] (a) of subdivision ten of  this  section,  the  practitioner
    42  shall  be  required  to indicate in the patient's health record that the
    43  prescription was issued other than electronically due to temporary tech-
    44  nological or electrical failure.
    45    12. In the case of a prescription issued by a practitioner under para-
    46  graph [(d)] (c) or [(e)] (d) of subdivision ten  of  this  section,  the
    47  practitioner  shall,  upon  issuing  such  prescription, indicate in the
    48  patient's health record either that the prescription  was  issued  other
    49  than electronically because it (a) was impractical to issue an electron-
    50  ic  prescription  in a timely manner and such delay would have adversely
    51  impacted the patient's medical condition, or (b) was to be dispensed  by
    52  a pharmacy located outside the state.
    53    §  5. Subdivisions 6 and 7 of section 281 of the public health law are
    54  REPEALED.
    55    § 6. Subdivisions 13 and 15 of section 6810 of the education  law  are
    56  REPEALED.

        S. 2507--A                         50                         A. 3007--A
 
     1    § 7. This act shall take effect on November 1, 2021.
 
     2                                   PART O
 
     3    Section 1. Section 461-s of the social services law is REPEALED.
     4    §  2.  Subdivision  9  of  section  2803  of  the public health law is
     5  REPEALED.
     6    § 3. Paragraph (c) of subdivision 1 of section  461-b  of  the  social
     7  services law is REPEALED.
     8    §  4.  This  act  shall take effect immediately and shall be deemed to
     9  have been in full force and effect on and after April 1, 2021.
 
    10                                   PART P
 
    11    Section 1. Subdivision 6 of section 571 of the public health  law,  as
    12  amended  by  chapter  444  of  the  laws  of 2013, is amended to read as
    13  follows:
    14    6. "Qualified health care professional" means  a  physician,  dentist,
    15  podiatrist,  optometrist performing a clinical laboratory test that does
    16  not use an invasive modality as defined in section  seventy-one  hundred
    17  one  of  the  education law, pharmacist, physician assistant, specialist
    18  assistant, nurse practitioner, or midwife, who is  licensed  and  regis-
    19  tered with the state education department.
    20    §  2.  Section  6801 of the education law is amended by adding two new
    21  subdivisions 6 and 7 to read as follows:
    22    6. A licensed pharmacist is a qualified health care professional under
    23  section five hundred seventy-one  of  the  public  health  law  for  the
    24  purposes  of  directing  a  limited  service laboratory and ordering and
    25  administering tests approved by the Food and Drug Administration  (FDA),
    26  subject  to  certificate  of waiver requirements established pursuant to
    27  the federal clinical laboratory  improvement  act  of  nineteen  hundred
    28  eighty-eight.
    29    7.  A  licensed  pharmacist may act as a referring healthcare provider
    30  for diabetes self-management education and asthma self-management train-
    31  ing.
    32    § 3. Subdivision 7 of section 6527 of the education law, as amended by
    33  chapter 110 of the laws of 2020, is amended to read as follows:
    34    7. A licensed physician may prescribe and  order  a  patient  specific
    35  order or non-patient specific regimen to a licensed pharmacist, pursuant
    36  to  regulations promulgated by the commissioner, and consistent with the
    37  public health law, for administering immunizations to prevent influenza,
    38  pneumococcal, acute herpes zoster, meningococcal,  tetanus,  diphtheria,
    39  COVID-19, or pertussis disease or, for patients eighteen years of age or
    40  older,  any other immunizations recommended by the advisory committee on
    41  immunization  practices  of  the  centers  for   disease   control   and
    42  prevention,  and medications required for emergency treatment of anaphy-
    43  laxis. Nothing in this subdivision shall authorize unlicensed persons to
    44  administer immunizations, vaccines or other drugs.
    45    § 4. Subdivision 7 of section 6909 of the education law, as amended by
    46  chapter 110 of the laws of 2020, is amended to read as follows:
    47    7. A certified nurse practitioner may prescribe and  order  a  patient
    48  specific order or non-patient specific regimen to a licensed pharmacist,
    49  pursuant  to regulations promulgated by the commissioner, and consistent
    50  with the public health law, for administering immunizations  to  prevent
    51  influenza,  pneumococcal,  acute  herpes zoster, meningococcal, tetanus,
    52  diphtheria, COVID-19, or pertussis disease  or,  for  patients  eighteen

        S. 2507--A                         51                         A. 3007--A
 
     1  years  of age or older, any other immunizations recommended by the advi-
     2  sory committee on immunization practices  of  the  centers  for  disease
     3  control and prevention, and medications required for emergency treatment
     4  of  anaphylaxis.  Nothing in this subdivision shall authorize unlicensed
     5  persons to administer immunizations, vaccines or other drugs.
     6    § 5.  Paragraph a of subdivision 22 of section 6802 of  the  education
     7  law,  as  amended by chapter 110 of the laws of 2020, is amended to read
     8  as follows:
     9    a. the direct application of an immunizing agent to adults, whether by
    10  injection, ingestion, inhalation or  any  other  means,  pursuant  to  a
    11  patient  specific  order  or  non-patient specific regimen prescribed or
    12  ordered by a physician or certified nurse practitioner, who has a  prac-
    13  tice site in the county or adjoining county in which the immunization is
    14  administered,  for  immunizations  to  prevent  influenza, pneumococcal,
    15  acute herpes zoster, meningococcal, tetanus,  diphtheria,  COVID-19,  or
    16  pertussis  disease, or, for patients eighteen years of age or older, any
    17  other immunizations recommended by the advisory committee  on  immuniza-
    18  tion  practices  of  the centers for disease control and prevention, and
    19  medications required for emergency  treatment  of  anaphylaxis.  If  the
    20  commissioner  of health determines that there is an outbreak of disease,
    21  or that there is the imminent threat of an outbreak of disease, then the
    22  commissioner of health may issue a non-patient specific regimen applica-
    23  ble statewide.
    24    § 6. Section 6801-a of the education law, as amended by chapter 238 of
    25  the laws of 2015, is amended to read as follows:
    26    §  6801-a.  Collaborative  drug  therapy  management   [demonstration]
    27  program.  1. As used in this section, the following terms shall have the
    28  following meanings:
    29    a.  "Board"  shall  mean the state board of pharmacy as established by
    30  section sixty-eight hundred four of this article.
    31    b. "Clinical services" shall mean the collection and interpretation of
    32  patient data for the purpose of [initiating, modifying  and]  monitoring
    33  drug  therapy and prescribing in order to adjust or manage drug therapy,
    34  with associated accountability and  responsibility  for  outcomes  in  a
    35  direct patient care setting.
    36    c.  "Collaborative drug therapy management" shall mean the performance
    37  of clinical services by a pharmacist relating to the review,  evaluation
    38  and  management  of drug therapy to a patient, who is being treated by a
    39  physician, or nurse practitioner for a specific  disease  or  associated
    40  disease  states, in accordance with a written agreement or protocol with
    41  a voluntarily participating physician,  or  nurse  practitioner  and  in
    42  accordance with the policies, procedures, and protocols of the facility.
    43  Such  agreement  or  protocol as entered into by the physician, or nurse
    44  practitioner and a pharmacist, may include[, and shall be limited to]:
    45    (i) [adjusting or managing] prescribing in order to adjust or manage a
    46  drug regimen of a patient, pursuant to a patient specific order or  non-
    47  patient specific protocol made by the patient's physician or nurse prac-
    48  titioner, which may include adjusting drug strength, frequency of admin-
    49  istration  or route of administration[. Adjusting the drug regimen shall
    50  not include substituting] or selecting a [different] drug which  differs
    51  from  that  initially prescribed by the patient's physician [unless such
    52  substitution is expressly] or nurse practitioner as  authorized  in  the
    53  written  [order] agreement or protocol. The pharmacist shall be required
    54  to immediately document in  the  patient  record  changes  made  to  the
    55  patient's  drug  therapy  and  shall  use any reasonable means or method
    56  established by the facility or practice to notify  the  patient's  other

        S. 2507--A                         52                         A. 3007--A
 
     1  treating  physicians [with whom he or she does not have a written agree-
     2  ment or protocol regarding such changes.  The  patient's  physician  may
     3  prohibit,  by  written  instruction,  any  adjustment  or  change in the
     4  patient's drug regimen by the pharmacist], nurse practitioners and other
     5  health  care professionals as required by the facility or the collabora-
     6  tive practice agreement;
     7    (ii) evaluating [and, only  if  specifically]  as  authorized  by  the
     8  protocol  and only to the extent necessary to discharge the responsibil-
     9  ities set forth in this section, ordering disease state laboratory tests
    10  related to the drug therapy  management  for  the  specific  disease  or
    11  disease  [state] states specified within the written agreement or proto-
    12  col; and
    13    (iii) [only if specifically] as authorized by the written agreement or
    14  protocol and only to the extent necessary to discharge the  responsibil-
    15  ities  set forth in this section, ordering or performing routine patient
    16  monitoring functions as may be necessary in the drug therapy management,
    17  including the collecting and reviewing of patient histories, and  order-
    18  ing  or  checking  patient  vital  signs[, including pulse, temperature,
    19  blood pressure and respiration].
    20    d. "Facility" shall mean[:  (i)]  a  [teaching  hospital  or]  general
    21  hospital, [including any] diagnostic center, treatment center, or hospi-
    22  tal-based  outpatient  department  as  defined  in  section twenty-eight
    23  hundred one of the public health law[; or (ii)], a nursing home, or  any
    24  facility  as  defined  in section twenty-eight hundred one of the public
    25  health law or other entity that provides direct patient care  under  the
    26  auspices  of  a  medical director; with an on-site pharmacy staffed by a
    27  licensed pharmacist; provided, however, for the purposes of this section
    28  the term "facility" shall not include dental clinics, dental  dispensar-
    29  ies[, residential health care facilities] and rehabilitation centers. In
    30  addition,  a  "practice" shall mean a place or situation in which physi-
    31  cians and nurse practitioners either alone or in group practices provide
    32  diagnostic and treatment care for patients.
    33    [For the purposes of this section, a "teaching hospital" shall mean  a
    34  hospital  licensed pursuant to article twenty-eight of the public health
    35  law that is eligible to receive  direct  or  indirect  graduate  medical
    36  education payments pursuant to article twenty-eight of the public health
    37  law.]
    38    e.  "Physician  or  nurse  practitioner"  shall mean the physician, or
    39  nurse practitioner selected by or assigned to a patient, who has primary
    40  responsibility for the treatment and care of the patient for the disease
    41  and associated disease states that are the subject of the  collaborative
    42  drug therapy management.
    43    f.  "Written  agreement  or  protocol"  shall mean a written document,
    44  pursuant to and consistent with any applicable state or federal require-
    45  ments, that addresses a specific disease or  associated  disease  states
    46  and  that  describes  the nature and scope of collaborative drug therapy
    47  management to be undertaken by the pharmacists,  in  collaboration  with
    48  the  participating  physician,  or nurse practitioner in accordance with
    49  the provisions of this section.
    50    2. a. A pharmacist who meets the experience requirements of  paragraph
    51  b  of  this  subdivision and who is [employed by or otherwise affiliated
    52  with a facility] certified by the department to engage in  collaborative
    53  drug  therapy  management  and  who  is  either employed by or otherwise
    54  affiliated with a facility or is participating with a practicing  physi-
    55  cian  or  nurse  practitioner shall be permitted to enter into a written
    56  agreement or protocol with a physician or nurse practitioner authorizing

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

     1  collaborative drug therapy management, subject to  the  limitations  set
     2  forth  in this section, within the scope of such employment [or], affil-
     3  iation or participation. Only pharmacists so  certified  may  engage  in
     4  collaborative drug therapy management as defined in this section.
     5    b. A participating pharmacist must:
     6    (i)[(A) have been awarded either a master of science in clinical phar-
     7  macy or a doctor of pharmacy degree;
     8    (B)] maintain a current unrestricted license; and
     9    [(C)  have  a  minimum  of two years experience, of which at least one
    10  year of such experience shall include clinical experience  in  a  health
    11  facility,  which  involves  consultation with physicians with respect to
    12  drug therapy and may include a residency at a  facility  involving  such
    13  consultation; or
    14    (ii)(A) have been awarded a bachelor of science in pharmacy;
    15    (B) maintain a current unrestricted license; and
    16    (C) within the last seven years, have a minimum of three years experi-
    17  ence,  of which at least one year of such experience shall include clin-
    18  ical experience in a health facility, which involves  consultation  with
    19  physicians with respect to drug therapy and may include a residency at a
    20  facility involving such consultation; and
    21    (iii) meet any additional education, experience, or other requirements
    22  set forth by the department in consultation with the board]
    23    (ii) satisfy any two of the following criteria:
    24    (A)  certification  in  a  relevant area of practice including but not
    25  limited to ambulatory care, critical care, geriatric  pharmacy,  nuclear
    26  pharmacy, nutrition support pharmacy, oncology pharmacy, pediatric phar-
    27  macy,  pharmacotherapy, or psychiatric pharmacy, from a national accred-
    28  iting body as approved by the department;
    29    (B) postgraduate residency through an accredited postgraduate  program
    30  requiring  at least fifty percent of the experience be in direct patient
    31  care services with interdisciplinary terms; or
    32    (C) have provided clinical services to patients for at least one  year
    33  either:
    34    (I) under a collaborative practice agreement or protocol with a physi-
    35  cian, nurse practitioner or facility; or
    36    (II)  has  documented  experience in provision of clinical services to
    37  patients for at least one year or one thousand hours, and deemed accept-
    38  able to the department upon recommendation of the board of pharmacy.
    39    c. Notwithstanding any provision of law, nothing in this section shall
    40  prohibit a licensed pharmacist from engaging in clinical services  asso-
    41  ciated  with  collaborative  drug  therapy  management, in order to gain
    42  experience necessary to qualify under [clause (C) of subparagraph (i) or
    43  (ii) of paragraph b of this subdivision] item  (II)  of  clause  (C)  of
    44  subparagraph (ii) of paragraph b of this subdivision, provided that such
    45  practice  is  under the supervision of a pharmacist that currently meets
    46  the referenced requirement, and that such practice is  authorized  under
    47  the  written  agreement  or protocol with the physician or nurse practi-
    48  tioner.
    49    d. Notwithstanding any provision of this section, nothing herein shall
    50  authorize the pharmacist to diagnose disease. In the event that a treat-
    51  ing physician or nurse practitioner may disagree with  the  exercise  of
    52  professional  judgment  by  a  pharmacist,  the judgment of the treating
    53  physician or nurse practitioner shall prevail.
    54    [3. The physician who is a party to a written  agreement  or  protocol
    55  authorizing  collaborative  drug therapy management shall be employed by

        S. 2507--A                         54                         A. 3007--A

     1  or otherwise affiliated with the same facility with which the pharmacist
     2  is also employed or affiliated.]
     3    4.  [The existence of a written agreement or protocol on collaborative
     4  drug therapy management and the patient's right to choose to not partic-
     5  ipate in collaborative drug therapy management shall be disclosed to any
     6  patient who is eligible to receive collaborative  drug  therapy  manage-
     7  ment. Collaborative drug therapy management shall not be utilized unless
     8  the  patient  or  the  patient's  authorized representative consents, in
     9  writing, to such management. If the patient or the patient's  authorized
    10  representative  consents,  it  shall  be  noted on the patient's medical
    11  record. If the patient or the patient's  authorized  representative  who
    12  consented  to collaborative drug therapy management chooses to no longer
    13  participate in such management, at any time, it shall be  noted  on  the
    14  patient's  medical  record.  In  addition,  the existence of the written
    15  agreement or protocol and the patient's consent to such management shall
    16  be disclosed to the patient's primary physician and any  other  treating
    17  physician  or healthcare provider.] A pharmacist who is certified by the
    18  department to engage in collaborative drug therapy management may  enter
    19  into  a  written  collaborative  practice  agreement  or protocol with a
    20  physician, nurse practitioner or practice as an independent health  care
    21  provider or as an employee of a pharmacy or other health care provider.
    22    5. Participation in a written agreement or protocol authorizing colla-
    23  borative  drug  therapy  management  shall be voluntary, and no patient,
    24  physician, nurse practitioner, pharmacist, or facility shall be required
    25  to participate.
    26    [6. Nothing in this section shall be deemed  to  limit  the  scope  of
    27  practice of pharmacy nor be deemed to limit the authority of pharmacists
    28  and physicians to engage in medication management prior to the effective
    29  date of this section and to the extent authorized by law.]
    30    §  7. Subparagraph (A) of paragraph 15-a of subdivision (i) of section
    31  3216 of the insurance law, as amended by chapter  338  of  the  laws  of
    32  2003, is amended to read as follows:
    33    (A)  Every policy which provides medical coverage that includes cover-
    34  age for physician services in a  physician's  office  and  every  policy
    35  which  provides  major  medical  or  similar comprehensive-type coverage
    36  shall include coverage for the following equipment and supplies for  the
    37  treatment  of  diabetes,  if recommended or prescribed by a physician or
    38  other licensed health care  provider  legally  authorized  to  prescribe
    39  under title eight of the education law: blood glucose monitors and blood
    40  glucose  monitors  for  the  visually impaired, data management systems,
    41  test strips for glucose monitors and visual reading  and  urine  testing
    42  strips,  insulin,  injection aids, cartridges for the visually impaired,
    43  syringes, insulin pumps  and  appurtenances  thereto,  insulin  infusion
    44  devices,  and  oral agents for controlling blood sugar. In addition, the
    45  commissioner of the department of health shall provide and  periodically
    46  update by rule or regulation a list of additional diabetes equipment and
    47  related  supplies  such  as are medically necessary for the treatment of
    48  diabetes, for which there shall also be coverage.  Such  policies  shall
    49  also  include  coverage for diabetes self-management education to ensure
    50  that persons with diabetes are educated as to the proper self-management
    51  and treatment of their  diabetic  condition,  including  information  on
    52  proper  diets. Such coverage for self-management education and education
    53  relating to diet shall be limited to visits medically necessary upon the
    54  diagnosis of diabetes, where a physician diagnoses a significant  change
    55  in  the  patient's symptoms or conditions which necessitate changes in a
    56  patient's self-management, or where reeducation or  refresher  education

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

     1  is  necessary.  Such education may be provided by the physician or other
     2  licensed health care provider  legally  authorized  to  prescribe  under
     3  title  eight  of the education law, or their staff, as part of an office
     4  visit  for  diabetes  diagnosis or treatment, or by a certified diabetes
     5  nurse educator, certified nutritionist, certified  dietitian  or  regis-
     6  tered dietitian upon the referral of a physician, a pharmacist, or other
     7  licensed  health  care  provider  legally  authorized to prescribe under
     8  title eight of the education law. Education provided  by  the  certified
     9  diabetes  nurse educator, certified nutritionist, certified dietitian or
    10  registered dietitian may be limited to group settings wherever practica-
    11  ble.  Coverage for self-management education and education  relating  to
    12  diet shall also include home visits when medically necessary.
    13    §  8.  Subparagraph  (A)  of paragraph 7 of subdivision (k) of section
    14  3221 of the insurance law, as amended by chapter  338  of  the  laws  of
    15  2003, is amended to read as follows:
    16    (A) Every group or blanket accident and health insurance policy issued
    17  or  issued  for  delivery  in this state which provides medical coverage
    18  that includes coverage for physician services in  a  physician's  office
    19  and  every policy which provides major medical or similar comprehensive-
    20  type coverage shall include coverage for  the  following  equipment  and
    21  supplies  for the treatment of diabetes, if recommended or prescribed by
    22  a physician or other licensed health care provider legally authorized to
    23  prescribe under title eight of the education law: blood glucose monitors
    24  and blood glucose monitors for the visually  impaired,  data  management
    25  systems,  test  strips for glucose monitors and visual reading and urine
    26  testing strips, insulin, injection aids,  cartridges  for  the  visually
    27  impaired,  syringes,  insulin  pumps  and appurtenances thereto, insulin
    28  infusion devices, and oral agents for controlling blood sugar. In  addi-
    29  tion,  the  commissioner  of  the department of health shall provide and
    30  periodically update by rule or regulation a list of additional  diabetes
    31  equipment  and  related supplies such as are medically necessary for the
    32  treatment of diabetes, for which there  shall  also  be  coverage.  Such
    33  policies shall also include coverage for diabetes self-management educa-
    34  tion  to ensure that persons with diabetes are educated as to the proper
    35  self-management and treatment of  their  diabetic  condition,  including
    36  information on proper diets. Such coverage for self-management education
    37  and  education  relating  to  diet  shall be limited to visits medically
    38  necessary upon the diagnosis of diabetes, where a physician diagnoses  a
    39  significant  change in the patient's symptoms or conditions which neces-
    40  sitate changes in a patient's self-management, or where  reeducation  or
    41  refresher  education is necessary. Such education may be provided by the
    42  physician or other licensed health care provider legally  authorized  to
    43  prescribe  under  title  eight  of the education law, or their staff, as
    44  part of an office visit for diabetes diagnosis or  treatment,  or  by  a
    45  certified  diabetes  nurse  educator,  certified nutritionist, certified
    46  dietitian or registered dietitian upon the referral of  a  physician,  a
    47  pharmacist, or other licensed health care provider legally authorized to
    48  prescribe  under title eight of the education law. Education provided by
    49  the certified diabetes nurse educator, certified nutritionist, certified
    50  dietitian or registered dietitian may be limited to group settings wher-
    51  ever practicable.  Coverage for self-management education and  education
    52  relating  to  diet  shall also include home visits when medically neces-
    53  sary.
    54    § 9. Paragraph 1 of subdivision (u) of section 4303 of  the  insurance
    55  law,  as  amended by chapter 338 of the laws of 2003, is amended to read
    56  as follows:

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

        S. 2507--A                         57                         A. 3007--A
 
     1  federal financial participation in the costs  of  health  care  services
     2  provided  pursuant to this paragraph. Nothing in this paragraph shall be
     3  construed to modify any licensure, certification or  scope  of  practice
     4  provision under title eight of the education law.
     5    (r)  asthma  self-management  training  services for persons diagnosed
     6  with asthma when such services are ordered by  a  physician,  registered
     7  physician's  assistant,  registered  nurse  practitioner, pharmacist, or
     8  licensed midwife and provided by a licensed,  registered,  or  certified
     9  health  care  professional, as determined by the commissioner of health,
    10  who is certified as an asthma educator by the National  Asthma  Educator
    11  Certification  Board,  or  a  successor  national  certification  board;
    12  provided, however, that the provisions of this paragraph shall not  take
    13  effect  unless  all necessary approvals under federal law and regulation
    14  have been obtained to receive federal  financial  participation  in  the
    15  costs  of  health  care  services  provided  pursuant to this paragraph.
    16  Nothing in this paragraph shall be construed to  modify  any  licensure,
    17  certification  or  scope  of practice provision under title eight of the
    18  education law.
    19    § 11. Section 8 of chapter 563 of  the  laws  of  2008,  amending  the
    20  education law and the public health law relating to immunizing agents to
    21  be  administered  to  adults by pharmacists, as amended by section 18 of
    22  part BB of chapter 56 of the  laws  of  2020,  is  amended  to  read  as
    23  follows:
    24    §  8.  This  act shall take effect on the ninetieth day after it shall
    25  have become a law [and shall expire  and  be  deemed  repealed  July  1,
    26  2022].
    27    §  12.  Section  5  of  chapter  116 of the laws of 2012, amending the
    28  education law relating to authorizing a licensed pharmacist  and  certi-
    29  fied  nurse  practitioner  to  administer  certain immunizing agents, as
    30  amended by section 19 of part BB of chapter 56 of the laws of  2020,  is
    31  amended to read as follows:
    32    §  5.  This  act shall take effect on the ninetieth day after it shall
    33  have become a law[, provided, however, that the provisions  of  sections
    34  one,  two  and four of this act shall expire and be deemed repealed July
    35  1, 2022 provided, that:
    36    (a) the amendments to subdivision 7 of section 6527 of  the  education
    37  law  made by section one of this act shall not affect the repeal of such
    38  subdivision and shall be deemed to be repealed therewith;
    39    (b) the amendments to subdivision 7 of section 6909 of  the  education
    40  law, made by section two of this act shall not affect the repeal of such
    41  subdivision and shall be deemed to be repealed therewith;
    42    (c)  the amendments to subdivision 22 of section 6802 of the education
    43  law made by section three of this act shall not  affect  the  repeal  of
    44  such subdivision and shall be deemed to be repealed therewith; and
    45    (d)  the  amendments  to  section  6801  of  the education law made by
    46  section four of this act shall not affect the expiration of such section
    47  and shall be deemed to expire therewith].
    48    § 13. Section 4 of chapter 274 of  the  laws  of  2013,  amending  the
    49  education  law  relating to authorizing a licensed pharmacist and certi-
    50  fied nurse practitioner to administer meningococcal  disease  immunizing
    51  agents, is amended to read as follows:
    52    §  4.  This  act shall take effect on the ninetieth day after it shall
    53  have become a law[; provided, that:
    54    (a) the amendments to subdivision 7 of section 6527 of  the  education
    55  law, made by section one of this act shall not affect the expiration and

        S. 2507--A                         58                         A. 3007--A

     1  reversion  of  such subdivision, as provided in section 6 of chapter 116
     2  of the laws of 2012, and shall be deemed to expire therewith; and
     3    (b)  the  amendments to subdivision 7 of section 6909 of the education
     4  law, made by section two of this act shall not affect the expiration and
     5  reversion of such subdivision, as provided in section 6 of  chapter  116
     6  of the laws of 2012, and shall be deemed to be expire therewith; and
     7    (c)  the amendments to subdivision 22 of section 6802 of the education
     8  law made by section three of this act shall not affect the expiration of
     9  such subdivision and shall be deemed to expire therewith].
    10    § 14. Section 5 of chapter 21 of the laws of 2011, amending the educa-
    11  tion law relating to authorizing pharmacists  to  perform  collaborative
    12  drug  therapy management with physicians in certain settings, as amended
    13  by section 20 of part BB of chapter 56 of the laws of 2020,  is  amended
    14  to read as follows:
    15    § 5. This act shall take effect on the one hundred twentieth day after
    16  it  shall  have become a law[, provided, however, that the provisions of
    17  sections two, three, and four of this act shall  expire  and  be  deemed
    18  repealed  July 1, 2022; provided, however, that the amendments to subdi-
    19  vision 1 of section 6801 of the education law made  by  section  one  of
    20  this act shall be subject to the expiration and reversion of such subdi-
    21  vision  pursuant  to  section 8 of chapter 563 of the laws of 2008, when
    22  upon such date the provisions of section one-a of this  act  shall  take
    23  effect;  provided,  further, that effective]. Effective immediately, the
    24  addition, amendment and/or repeal of any rule  or  regulation  necessary
    25  for  the implementation of this act on its effective date are authorized
    26  and directed to be made and completed on or before such effective date.
    27    § 15. This act shall take effect immediately and shall  be  deemed  to
    28  have been in full force and effect on and after April 1, 2021; provided,
    29  however,  that  sections three and four of this act shall take effect on
    30  the same date and in the same manner as chapter 110 of the laws of  2020
    31  takes  effect; and provided further that the amendments to subdivision 7
    32  of section 6527 of the education law made by section three of  this  act
    33  shall  be  subject  to  the expiration and reversion of such subdivision
    34  pursuant to section 4 of chapter 110 of  the  laws  of  2020  and  shall
    35  expire  and  be deemed repealed therewith; and provided further that the
    36  amendments to subdivision 7 of section 6909 of the education law made by
    37  section four of this act shall be subject to the expiration  and  rever-
    38  sion  of  such  subdivision  pursuant to section 4 of chapter 110 of the
    39  laws of 2020 and shall expire and be deemed repealed therewith.
 
    40                                   PART Q
 
    41    Section 1. Subdivision 1 of section 6502  of  the  education  law,  as
    42  amended  by  chapter  599  of  the  laws of 1996, is amended and two new
    43  subdivisions 1-a and 1-b are added to read as follows:
    44    1. [A] Except pursuant to subdivision one-a of this section, a license
    45  shall be valid during the life of the holder unless revoked, annulled or
    46  suspended by the board of regents [or in the case of physicians,  physi-
    47  cians   practicing  under  a  limited  permit,  physician's  assistants,
    48  specialist's assistants and medical residents, the licensee is  stricken
    49  from  the  roster of such licensees by the board of regents on the order
    50  of the state board for professional medical conduct in the department of
    51  health. A licensee must  register  with  the  department  and  meet  the
    52  requirements  prescribed in section 3-503 of the general obligations law
    53  to practice in this state].

        S. 2507--A                         59                         A. 3007--A
 
     1    1-a. In the case of physicians, physicians practicing under a  limited
     2  permit,  physician  assistants,  specialist assistants and medical resi-
     3  dents, a license shall be valid during the life of the holder unless:
     4    (i)  the licensee is stricken from the roster of such licensees by the
     5  board of regents on the  order  of  the  state  board  for  professional
     6  medical conduct in the department of health; or
     7    (ii)  the  licensee has failed to register with the department for two
     8  consecutive registration periods, in which case the  licensee  shall  be
     9  immediately  stricken  from the roster of such licensees by the board of
    10  regents.
    11    1-b. A licensee  must  register  with  the  department  and  meet  the
    12  requirements  prescribed in section 3-503 of the general obligations law
    13  to practice in this state.
    14    § 2. Section 6524 of the education law is  amended  by  adding  a  new
    15  subdivision 6-a to read as follows:
    16    (6-a)  Fingerprints  and  criminal  history  record  check: consent to
    17  submission of fingerprints for purposes of conducting a criminal history
    18  record check. The commissioner shall submit to the division of  criminal
    19  justice  services  two  sets of fingerprints of applicants for licensure
    20  pursuant to this article, and the division of criminal justice  services
    21  processing  fee imposed pursuant to subdivision eight-a of section eight
    22  hundred thirty-seven of the executive law and any  fee  imposed  by  the
    23  federal  bureau  of  investigation.  The  division  of  criminal justice
    24  services and the federal bureau  of  investigation  shall  forward  such
    25  criminal  history record to the commissioner in a timely manner. For the
    26  purposes of this section, the term "criminal history record" shall  mean
    27  a  record  of all convictions of crimes and any pending criminal charges
    28  maintained on an individual by the division of criminal justice services
    29  and the federal bureau  of  investigation.  All  such  criminal  history
    30  records  sent  to the commissioner pursuant to this subdivision shall be
    31  confidential pursuant to the applicable federal and  state  laws,  rules
    32  and  regulations,  and shall not be published or in any way disclosed to
    33  persons other than the commissioner, unless otherwise authorized by law;
    34    § 3. Paragraph (c) of subdivision 9 and subdivisions 20, 28 and 31  of
    35  section  6530  of the education law, as added by chapter 606 of the laws
    36  of 1991, are amended and a new  subdivision  51  is  added  to  read  as
    37  follows:
    38    (c)  Having been found guilty in an adjudicatory proceeding of violat-
    39  ing a state or federal statute or regulation, pursuant to a final  deci-
    40  sion  or  determination,  and when no appeal is pending, or after resol-
    41  ution of the proceeding or a complaint alleging a violation of  a  state
    42  or  federal  statute or regulation by stipulation or agreement, and when
    43  the violation would constitute professional misconduct pursuant to  this
    44  section;
    45    20. Conduct [in the practice of medicine] which evidences moral unfit-
    46  ness to practice medicine;
    47    28.  Failing  to  respond within [thirty] ten days to written communi-
    48  cations from the department of health and to make available any relevant
    49  records with respect to an inquiry or  complaint  about  the  licensee's
    50  professional  misconduct. The period of [thirty] ten days shall commence
    51  on the date when such communication  was  delivered  personally  to  the
    52  licensee.  If the communication is sent from the department of health by
    53  registered or certified mail, with  return  receipt  requested,  to  the
    54  address  appearing  in the last registration, the period of [thirty] ten
    55  days shall commence on the date of delivery to the  licensee,  as  indi-
    56  cated by the return receipt;

        S. 2507--A                         60                         A. 3007--A
 
     1    31.  Willfully  harassing, abusing, or intimidating a patient [either]
     2  or a patient's caregiver or surrogate physically or verbally;
     3    51.  Except  for good cause shown, failing to notify the department of
     4  health within twenty-four hours of having been charged with a  crime  in
     5  any jurisdiction or of any event meeting the definitions of professional
     6  misconduct set forth in subdivision nine of this section.
     7    § 4. Section 6532 of the education law, as added by chapter 606 of the
     8  laws of 1991, is amended to read as follows:
     9    § 6532. Enforcement,  administration  and interpretation of this arti-
    10  cle.  The board [of] for professional medical conduct and the department
    11  of health shall enforce, administer and interpret this  article.  Before
    12  issuing a declaratory ruling pursuant to section two hundred four of the
    13  state  administrative  procedure  act  with respect to this article, the
    14  department of health shall fully consult with the department  of  educa-
    15  tion.  [Neither  the commissioner of education, the board of regents nor
    16  the] The commissioner of health may promulgate any rules or  regulations
    17  concerning this article.
    18    § 5. Subdivision 4 of section 206 of the public health law, as amended
    19  by chapter 602 of the laws of 2007, is amended to read as follows:
    20    4. The commissioner may:
    21    (a)  issue  subpoenas,  compel  the attendance of witnesses and compel
    22  them to testify in any matter or proceeding before [him] the commission-
    23  er, and may also require a witness to attend and  give  testimony  in  a
    24  county where [he] the witness resides or has a place of business without
    25  the payment of any fees;
    26    (b)  require, in writing, the production of any and all relevant docu-
    27  ments in the possession or control of an individual or entity subject to
    28  an investigation or inquiry under this chapter. Unless a shorter  period
    29  is  specified  in  such  writing,  as  determined  for good cause by the
    30  commissioner, the required documents shall be produced no later than ten
    31  days after the delivery of the writing. Failure by the subject  individ-
    32  ual or entity to produce to the department the required documents within
    33  the  ten day or otherwise specified period shall be a violation or fail-
    34  ure within the meaning of paragraph (d) of this subdivision. Each  addi-
    35  tional day of non-production shall be a separate violation or failure;
    36    (c)  annul  or  modify  an order, regulation, by-law or ordinance of a
    37  local board of health concerning a matter which in his judgment  affects
    38  the  public  health  beyond the territory over which such local board of
    39  health has jurisdiction;
    40    [(c)] (d) assess any penalty prescribed for a violation of or a  fail-
    41  ure  to  comply  with  any  term  or provision of this chapter or of any
    42  lawful notice, order or regulation pursuant thereto, not  exceeding  two
    43  thousand  dollars for every such violation or failure, which penalty may
    44  be assessed after a hearing or an opportunity to be heard;
    45    [(d)] (e) assess civil penalties against a public water  system  which
    46  provides  water  to  the  public  for human consumption through pipes or
    47  other constructed conveyances, as further defined in the state  sanitary
    48  code  or,  in  the  case  of  mass  gatherings,  the person who holds or
    49  promotes the mass gathering as defined in subdivision  five  of  section
    50  two  hundred twenty-five of this article not to exceed twenty-five thou-
    51  sand dollars per day, for each violation of or failure  to  comply  with
    52  any term or provision of the state sanitary code as it relates to public
    53  water  systems  that serve a population of five thousand or more persons
    54  or any mass gatherings, which penalty may be assessed after a hearing or
    55  an opportunity to be heard; and

        S. 2507--A                         61                         A. 3007--A
 
     1    (f) seek to obtain a warrant based on probable cause that  a  licensee
     2  has committed professional misconduct or a crime from a judicial officer
     3  authorized  to issue a warrant. Such warrant shall authorize the commis-
     4  sioner and any person authorized by the commissioner to have the author-
     5  ity to inspect all grounds, erections, vehicles, structures, apartments,
     6  buildings,  places  and  the  contents  therein and to remove any books,
     7  records, papers, documents,  computers,  electronic  devices  and  other
     8  physical objects.
     9    § 6. Subdivision 1 of section 230 of the public health law, as amended
    10  by chapter 537 of the laws of 1998, is amended to read as follows:
    11    1. A state board for professional medical conduct is hereby created in
    12  the  department  in  matters  of  professional  misconduct as defined in
    13  sections sixty-five hundred thirty and sixty-five hundred thirty-one  of
    14  the  education  law.  Its  physician  members  shall be appointed by the
    15  commissioner at least eighty-five percent of whom shall  be  from  among
    16  nominations  submitted  by the medical society of the state of New York,
    17  the New York state osteopathic society, the New York  academy  of  medi-
    18  cine, county medical societies, statewide specialty societies recognized
    19  by  the council of medical specialty societies, and the hospital associ-
    20  ation of New York state. Its lay  members  shall  be  appointed  by  the
    21  commissioner  with  the  approval  of the governor. The board of regents
    22  shall also appoint twenty percent of the members of the board. Not  less
    23  than  sixty-seven  percent  of  the  members  appointed  by the board of
    24  regents shall be physicians. Not less than eighty-five  percent  of  the
    25  physician  members appointed by the board of regents shall be from among
    26  nominations submitted by the medical society of the state of  New  York,
    27  the  New  York  state osteopathic society, the New York academy of medi-
    28  cine, county medical societies, statewide medical  societies  recognized
    29  by  the council of medical specialty societies, and the hospital associ-
    30  ation of New York state. Any failure to meet the  percentage  thresholds
    31  stated  in  this  subdivision  shall not be grounds for invalidating any
    32  action by or on authority of the board for professional medical  conduct
    33  or  a  committee or a member thereof. The board for professional medical
    34  conduct shall consist of not fewer than eighteen physicians licensed  in
    35  the  state  for  at  least  five  years, two of whom shall be doctors of
    36  osteopathy, not fewer than two of whom shall be physicians who  dedicate
    37  a  significant  portion of their practice to the use of non-conventional
    38  medical treatments who may be nominated by New York state medical  asso-
    39  ciations  dedicated  to the advancement of such treatments, at least one
    40  of whom shall have expertise in palliative  care,  and  not  fewer  than
    41  seven  lay  members.  An  executive  secretary shall be appointed by the
    42  chairperson and shall be a licensed physician. Such executive  secretary
    43  shall  not  be  a member of the board, shall hold office at the pleasure
    44  of, and shall have the powers and duties assigned and the annual  salary
    45  fixed  by[,  the  chairperson.  The  chairperson  shall also assign such
    46  secretaries or other persons to the board as are necessary] the  commis-
    47  sioner.
    48    §  7. Clause (C) of subparagraph (iii) of paragraph (a) of subdivision
    49  10 of section 230 of the public health law, as amended by chapter 477 of
    50  the laws of 2008, is amended to read as follows:
    51    (C) If the director determines that the matter shall be  submitted  to
    52  an investigation committee, an investigation committee shall be convened
    53  [within  ninety  days  of  any  interview of the licensee]. The director
    54  shall present the investigation committee  with  relevant  documentation
    55  including, but not limited to: (1) a copy of the original complaint; (2)
    56  the  report  of  the  interviewer and the stenographic record if one was

        S. 2507--A                         62                         A. 3007--A

     1  taken; (3) the report of any medical or scientific expert; (4) copies of
     2  reports  of  any  patient  record  reviews;  and  (5)   the   licensee's
     3  submissions.
     4    §  8.  Subparagraph  (v) of paragraph (a) of subdivision 10 of section
     5  230 of the public health law, as amended by chapter 477 of the  laws  of
     6  2008, is amended to read as follows:
     7    (v)  The  files of the office of professional medical conduct relating
     8  to the investigation of possible instances  of  professional  misconduct
     9  shall  be  confidential  and not subject to disclosure at the request of
    10  any person, except as provided by law in a pending  disciplinary  action
    11  or  proceeding.  The  provisions of this paragraph shall not prevent the
    12  office from sharing information  concerning  investigations  within  the
    13  department  and, pursuant to subpoena, with other duly authorized public
    14  agencies responsible for  professional  regulation  or  criminal  prose-
    15  cution.  Nothing in this subparagraph shall affect the duties of notifi-
    16  cation set forth in subdivision nine-a of this section  or  prevent  the
    17  publication  of charges or of the findings, conclusions, determinations,
    18  or order of a hearing committee pursuant to paragraphs  (d)  or  (g)  of
    19  this  subdivision. In addition, the commissioner may, in his or her sole
    20  discretion, disclose [the] any information [when, in his or her  profes-
    21  sional  judgment, disclosure of such information would avert or minimize
    22  a public health  threat]  relating  to  the  investigation  of  possible
    23  instances  of  professional  misconduct.  Any  such disclosure shall not
    24  affect the confidentiality of other information  in  the  files  of  the
    25  office of professional medical conduct related to the investigation.
    26    §  9. Subparagraphs (i) and (ii) of paragraph (d) of subdivision 10 of
    27  section 230 of the public health law, as amended by chapter 477  of  the
    28  laws of 2008, are amended to read as follows:
    29    (i)  A  copy  of  the  charges  and the notice of the hearing shall be
    30  served on the licensee either: (A) personally [by the  board]  at  least
    31  thirty  days  before  the hearing[.]; (B) [If personal service cannot be
    32  made after due diligence and such fact is certified under oath,  a  copy
    33  of  the charges and the notice of hearing shall be served] by registered
    34  or certified mail to the licensee's [last known] current residential  or
    35  practice  address [by the board] mailed at least fifteen days before the
    36  hearing; (C) by registered or certified  mail  to  the  licensee's  most
    37  recent mailing address pursuant to section sixty-five hundred two of the
    38  education law or the licensee's most recent mailing address on file with
    39  the department of education pursuant to the notification requirement set
    40  forth  in  subdivision  five of such section, mailed at least forty-five
    41  days before the hearing; or (D) by first  class  mail  to  an  attorney,
    42  licensed  to  practice  in  the state, who has appeared on behalf of the
    43  licensee and who has been provided with  written  authorization  of  the
    44  licensee to accept service, mailed at least thirty days before the hear-
    45  ing.
    46    (ii)  The  charges  shall be made public, consistent with subparagraph
    47  (iv) of paragraph (a) of this subdivision, [no earlier than  five  busi-
    48  ness  days]  immediately after they are served, and the charges shall be
    49  accompanied by a statement advising the licensee that  such  publication
    50  will  occur;  [provided, however, that] charges may be made public imme-
    51  diately upon issuance of the commissioner's order in the case of summary
    52  action taken pursuant to subdivision twelve of this section and no prior
    53  notification of such publication need be made to the licensee.
    54    § 10. Subparagraph (ii) of paragraph (m) of subdivision 10 of  section
    55  230  of  the public health law, as amended by chapter 606 of the laws of
    56  1991, is amended to read as follows:

        S. 2507--A                         63                         A. 3007--A
 
     1    (ii) Administrative warning and consultation. If the director  of  the
     2  office  of professional medical conduct, after obtaining the concurrence
     3  of a majority of a committee on professional conduct, and after  consul-
     4  tation  with  the executive secretary, determines that there is substan-
     5  tial  evidence of professional misconduct of a minor or technical nature
     6  or of substandard medical practice which  does  not  constitute  profes-
     7  sional  misconduct,  the  director  may  issue an administrative warning
     8  and/or provide for consultation with a panel of  one  or  more  experts,
     9  chosen  by  the director. Panels of one or more experts may include, but
    10  shall not be limited to, a peer review committee  of  a  county  medical
    11  society  or a specialty board. Administrative warnings and consultations
    12  shall be [confidential and] made public, but  shall  not  constitute  an
    13  adjudication of guilt or be used as evidence that the licensee is guilty
    14  of the alleged misconduct. However, in the event of a further allegation
    15  of  similar  misconduct by the same licensee, the matter may be reopened
    16  and further proceedings instituted as provided in this section.
    17    § 11. Paragraph (p) of subdivision 10 of section  230  of  the  public
    18  health law, as amended by chapter 599 of the laws of 1996, is amended to
    19  read as follows:
    20    (p)  Convictions  of  crimes or administrative violations.  Except for
    21  good cause shown, a licensee shall notify the department within  twenty-
    22  four hours of having been charged with a crime in any jurisdiction or of
    23  any  event  meeting the definitions of professional misconduct set forth
    24  in subdivision nine of section sixty-five hundred thirty of  the  educa-
    25  tion  law.  In  cases  of  professional  misconduct  based solely upon a
    26  violation of subdivision nine of section sixty-five  hundred  thirty  of
    27  the  education law, the director may direct that charges be prepared and
    28  served and may refer the matter to a committee on  professional  conduct
    29  for  its  review  and  report  of findings, conclusions as to guilt, and
    30  determination. In such cases, the notice of hearing shall state that the
    31  licensee shall file a written answer to each of the charges and  allega-
    32  tions  in  the  statement of charges no later than ten days prior to the
    33  hearing, and that any charge or allegation  not  so  answered  shall  be
    34  deemed  admitted, that the licensee may wish to seek the advice of coun-
    35  sel prior to filing such answer that the licensee may file a  brief  and
    36  affidavits with the committee on professional conduct, that the licensee
    37  may  appear personally before the committee on professional conduct, may
    38  be represented by counsel and may present evidence or sworn testimony in
    39  his or her behalf, and the notice may contain such other information  as
    40  may  be  considered appropriate by the director. The department may also
    41  present evidence or sworn testimony and file a brief at the  hearing.  A
    42  stenographic record of the hearing shall be made. Such evidence or sworn
    43  testimony  offered  to  the  committee  on professional conduct shall be
    44  strictly limited to evidence and testimony relating to  the  nature  and
    45  severity  of  the  penalty  to  be  imposed upon the licensee. Where the
    46  charges are based on the conviction of state law crimes in other  juris-
    47  dictions, evidence may be offered to the committee which would show that
    48  the  conviction would not be a crime in New York state. The committee on
    49  professional conduct may reasonably limit the number of witnesses  whose
    50  testimony  will  be  received and the length of time any witness will be
    51  permitted to testify. The determination of the committee shall be served
    52  upon the licensee and the department in accordance with  the  provisions
    53  of  paragraph  (h) of this subdivision. A determination pursuant to this
    54  subdivision may be reviewed  by  the  administrative  review  board  for
    55  professional medical conduct.

        S. 2507--A                         64                         A. 3007--A
 
     1    §  12.  Subdivision  12  of  section  230 of the public health law, as
     2  amended by chapter 627 of the laws of 1996, paragraph (a) as amended  by
     3  chapter  477 of the laws of 2008 and paragraph (b) as amended by section
     4  3 of part CC of chapter 57 of the laws of 2018, is amended  to  read  as
     5  follows:
     6    12.  Summary  action.  (a)  Whenever the commissioner, (i) after being
     7  presented with information indicating that a licensee is causing, engag-
     8  ing in or maintaining a condition or activity which has resulted in  the
     9  transmission  or  suspected  transmission,  or  is likely to lead to the
    10  transmission, of communicable disease as defined in the  state  sanitary
    11  code  or  HIV/AIDS, by the state and/or a local health department and if
    12  in the commissioner's opinion it would be prejudicial to  the  interests
    13  of  the people to delay action until an opportunity for a hearing can be
    14  provided in accordance with the prehearing  and  hearing  provisions  of
    15  this  section;  [or]  (ii) after requiring that a licensee produce docu-
    16  ments in accordance with subdivision four of section two hundred six  of
    17  this chapter, and such licensee has failed to produce the required docu-
    18  ments  within  ten  days, or within such shorter period as may have been
    19  specified in the commissioner's written demand for documents;  or  (iii)
    20  after  an  investigation  and a recommendation by a committee on profes-
    21  sional conduct of the state  board  for  professional  medical  conduct,
    22  based  upon  a  determination that a licensee is causing, engaging in or
    23  maintaining a condition or activity which in the commissioner's  opinion
    24  [constitutes  an  imminent  danger] presents a risk to the health of the
    25  people, and that it therefore appears to be prejudicial to the interests
    26  of the people to delay action until an opportunity for a hearing can  be
    27  provided  in  accordance  with  the prehearing and hearing provisions of
    28  this section; the  commissioner  may  order  the  licensee,  by  written
    29  notice,  to  discontinue  such  dangerous  condition or activity or take
    30  certain action immediately and for a  period  of  [ninety]  one  hundred
    31  twenty  days  from the date of service of the order. Within [ten] thirty
    32  days from the date of service of the said order,  the  state  board  for
    33  professional  medical conduct shall commence and regularly schedule such
    34  hearing proceedings as required by this section, provided, however, that
    35  the hearing shall be completed within [ninety] one hundred  twenty  days
    36  of  the  date  of  service of the order. To the extent that the issue of
    37  [imminent danger] risk of the health of the people can be proven without
    38  the attorney representing the office  of  professional  medical  conduct
    39  putting  in  its  entire  case,  the  committee of the board shall first
    40  determine whether by a preponderance of the  evidence  the  licensee  is
    41  causing,  engaging  in  or  maintaining  a  condition  or activity which
    42  [constitutes an imminent danger] presents a risk to the  health  of  the
    43  people.  The  attorney  representing  the office of professional medical
    44  conduct shall have the burden of going forward and proving by a  prepon-
    45  derance of the evidence that the licensee's condition, activity or prac-
    46  tice  [constitutes  an imminent danger] presents a risk to the health of
    47  the people. The licensee shall have an opportunity to be  heard  and  to
    48  present  proof.  When  both  the  office and the licensee have completed
    49  their cases with respect to the question of [imminent  danger]  risk  to
    50  the  health of the people, the committee shall promptly make a recommen-
    51  dation to the commissioner on the issue of [imminent danger] risk to the
    52  health of the people and determine whether the summary order  should  be
    53  left in effect, modified or vacated, and continue the hearing on all the
    54  remaining  charges, if any, in accordance with paragraph (f) of subdivi-
    55  sion ten of this section. Within ten days of the committee's recommenda-
    56  tion, the commissioner shall determine  whether  or  not  to  adopt  the

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

     1  committee's  recommendations,  in  whole  or in part, and shall leave in
     2  effect, modify or vacate his summary order. The state board for  profes-
     3  sional  medical  conduct shall make every reasonable effort to avoid any
     4  delay in completing and determining such proceedings. If, at the conclu-
     5  sion  of  the  hearing, (i) the hearing committee of the board finds the
     6  licensee guilty of one or more of the charges which are  the  basis  for
     7  the summary order, (ii) the hearing committee determines that the summa-
     8  ry  order  continue,  and (iii) the ninety day term of the order has not
     9  expired, the summary order shall remain in full force and effect until a
    10  final decision has been rendered by  the  committee  or,  if  review  is
    11  sought,  by  the  administrative  review board. A summary order shall be
    12  public upon issuance.
    13    (b) When a licensee has pleaded or been found guilty or  convicted  of
    14  committing  an  act  constituting  a  felony under New York state law or
    15  federal law, or the law of  another  jurisdiction  which,  if  committed
    16  within  this state, would have constituted a felony under New York state
    17  law, or when a licensee has been charged with committing an act  consti-
    18  tuting a felony under New York state or federal law or the law of anoth-
    19  er jurisdiction, where the licensee's alleged conduct, which, if commit-
    20  ted  within  this  state, would have constituted a felony under New York
    21  state law, and [in the commissioner's  opinion  the  licensee's  alleged
    22  conduct  constitutes  an  imminent  danger] where the licensee's alleged
    23  conduct may present a risk to the health of the people, or when the duly
    24  authorized professional disciplinary agency of another jurisdiction  has
    25  made  a  finding substantially equivalent to a finding that the practice
    26  of medicine by the licensee in that jurisdiction [constitutes  an  immi-
    27  nent  danger]  presents  a  risk  to the health of its people, or when a
    28  licensee has been disciplined by a duly authorized  professional  disci-
    29  plinary  agency  of  another jurisdiction for acts which if committed in
    30  this state would have constituted the basis for summary  action  by  the
    31  commissioner  pursuant to paragraph (a) of this subdivision, the commis-
    32  sioner, after a recommendation by a committee of professional conduct of
    33  the state board for professional medical conduct, may order  the  licen-
    34  see,  by written notice, to discontinue or refrain from practicing medi-
    35  cine in whole or in part or to take certain actions authorized  pursuant
    36  to  this  title immediately. The order of the commissioner shall consti-
    37  tute summary action against the licensee and become  public  upon  issu-
    38  ance.  The  summary  suspension  shall  remain in effect until the final
    39  conclusion of a hearing which shall commence within ninety days  of  the
    40  date  of  service  of  the commissioner's order, end within [ninety] one
    41  hundred eighty days thereafter and otherwise be held in accordance  with
    42  paragraph  (a)  of  this  subdivision,  provided, however, that when the
    43  commissioner's order is based upon a finding substantially equivalent to
    44  a finding that the practice of  medicine  by  the  licensee  in  another
    45  jurisdiction  [constitutes  an  imminent  danger] presents a risk to the
    46  health of its people, the hearing  shall  commence  within  thirty  days
    47  after  the  disciplinary  proceedings  in  that jurisdiction are finally
    48  concluded. If, at any time, the felony charge is dismissed, withdrawn or
    49  reduced to a non-felony charge, the commissioner's summary  order  shall
    50  terminate.
    51    §  13.  Paragraph (a) of subdivision 1 of section 2803-e of the public
    52  health law, as amended by chapter 294 of the laws of 1985, is amended to
    53  read as follows:
    54    (a) Hospitals and other facilities approved pursuant to  this  article
    55  shall  make  a report or cause a report to be made within thirty days of
    56  the occurrence of any of the  following:  the  suspension,  restriction,

        S. 2507--A                         66                         A. 3007--A
 
     1  termination  or  curtailment of the training, employment, association or
     2  professional privileges or the denial of the certification of completion
     3  of training of an individual licensed  pursuant  to  the  provisions  of
     4  title  eight  of  the  education  law or of a medical resident with such
     5  facility for reasons related in any way to alleged  mental  or  physical
     6  impairment,  incompetence,  malpractice  or  misconduct or impairment of
     7  patient safety or welfare; the voluntary or involuntary  resignation  or
     8  withdrawal  of  association or of privileges with such facility to avoid
     9  the imposition of disciplinary measures; notification by the hospital or
    10  facility, to any entity  providing  personnel  to  perform  professional
    11  services  to such hospital or facility, that the entity may not assign a
    12  particular individual to provide such services to the hospital or facil-
    13  ity, for reasons related in  any  way  to  alleged  mental  or  physical
    14  impairment,  incompetence,  malpractice  or  misconduct or impairment of
    15  patient safety or welfare; or the receipt of information which indicates
    16  that any professional licensee or medical resident has been convicted of
    17  a crime; the denial of staff privileges to a physician  if  the  reasons
    18  stated for such denial are related to alleged mental or physical impair-
    19  ment,  incompetence,  malpractice,  misconduct  or impairment of patient
    20  safety or welfare.
    21    § 14. Paragraphs (n), (p) and (q) of subdivision 1 of  section  2995-a
    22  of  the  public health law, as added by chapter 542 of the laws of 2000,
    23  are amended and three new paragraphs (r), (s) and (t) are added to  read
    24  as follows:
    25    (n)  (i) the location of the licensee's primary practice setting iden-
    26  tified as such; [and]
    27    (ii) [the names of any licensed  physicians  with  whom  the  licensee
    28  shares  a  group practice, as defined in subdivision five of section two
    29  hundred  thirty-eight  of  this  chapter]  hours  of  operation  of  the
    30  licensee's primary practice setting;
    31    (iii)  availability  of assistive technology at the licensee's primary
    32  practice setting; and
    33    (iv) whether the licensee is accepting new patients;
    34    (p) whether the licensee participates  in  the  medicaid  or  medicare
    35  program  or  any  other  state  or  federally  financed health insurance
    36  program; [and]
    37    (q) health care plans with which the licensee has  contracts,  employ-
    38  ment,  or  other affiliation[.] provided that the reporting and accuracy
    39  of such information shall not be the responsibility  of  the  physician,
    40  but  shall  be included and updated by the department utilizing provider
    41  network participation information, or other reliable sources of informa-
    42  tion submitted by the health care plans;
    43    (r) the physician's website and social media accounts;
    44    (s) the names of any licensed physicians with whom the licensee shares
    45  a group practice, as defined in subdivision five of section two  hundred
    46  thirty-eight of this chapter; and
    47    (t)  workforce  research and planning information as determined by the
    48  commissioner.
    49    § 15. Section 2995-a of the public health law is amended by  adding  a
    50  new subdivision 1-b to read as follows:
    51    1-b.  (a)  For  the purposes of this section, a physician licensed and
    52  registered to practice in this state may authorize a designee to  regis-
    53  ter,  transmit,  enter  or  update  information  on  his  or her behalf,
    54  provided that:
    55    (i) the designee so authorized is employed by  the  physician  or  the
    56  same professional practice or is under contract with such practice;

        S. 2507--A                         67                         A. 3007--A
 
     1    (ii) the physician takes reasonable steps to ensure that such designee
     2  is sufficiently competent in the profile requirements;
     3    (iii)  the  physician remains responsible for ensuring the accuracy of
     4  the information provided and for any failure to provide accurate  infor-
     5  mation; and
     6    (iv)  the  physician  shall notify the department upon terminating the
     7  authorization of any designee, in a manner determined by the department.
     8    (b) The commissioner shall grant access to the profile in a reasonably
     9  prompt manner to designees authorized  by  physicians  and  establish  a
    10  mechanism  to prevent designees terminated pursuant to subparagraph (iv)
    11  of paragraph (a) of this subdivision from accessing  the  profile  in  a
    12  reasonably prompt manner following notification of termination.
    13    §  16.  Subdivision  4  of section 2995-a of the public health law, as
    14  amended by section 3 of part A of chapter 57 of the  laws  of  2015,  is
    15  amended to read as follows:
    16    4. Each physician shall periodically report to the department on forms
    17  and in the time and manner required by the commissioner any other infor-
    18  mation  as is required by the department for the development of profiles
    19  under this section which is  not  otherwise  reasonably  obtainable.  In
    20  addition  to  such  periodic reports and providing the same information,
    21  each physician shall update his or her profile  information  within  the
    22  six  months  prior to [the expiration date of such physician's registra-
    23  tion period] submission of the re-registration application, as a  condi-
    24  tion  of  registration  renewal  [under  article one hundred thirty-one]
    25  pursuant to section sixty-five hundred twenty-four of the education law.
    26  Except for optional information provided and information required  under
    27  subparagraph  (iv) of paragraph (n) and paragraphs (q) and (t) of subdi-
    28  vision one of this section, physicians shall notify  the  department  of
    29  any change in the profile information within thirty days of such change.
    30    §  17.  Subdivision  6  of section 2995-a of the public health law, as
    31  added by chapter 542 of the laws of 2000, is amended to read as follows:
    32    6. A physician may elect to have  his  or  her  profile  omit  certain
    33  information provided pursuant to paragraphs (k), (l), (m), [(n) and (q)]
    34  (r)  and  (s)  of  subdivision one of this section. Information provided
    35  pursuant to paragraph (t) of subdivision one of this  section  shall  be
    36  omitted  from  a physician's profile and shall be exempt from disclosure
    37  under article six of the public officers law. In collecting  information
    38  for  such  profiles  and  disseminating  the  same, the department shall
    39  inform physicians that they may choose not to provide  such  information
    40  required pursuant to paragraphs (k), (l), (m), [(n) and (q)] (r) and (s)
    41  of subdivision one of this section.
    42    §  18.  This  act shall take effect immediately and shall be deemed to
    43  have been in full force and effect on and after April 1, 2021; provided,
    44  however, that the amendments to  paragraph  (a)  of  subdivision  10  of
    45  section 230 of the public health law made by sections seven and eight of
    46  this  act shall not affect the expiration of such paragraph and shall be
    47  deemed to expire therewith; and further provided that sections fourteen,
    48  fifteen, sixteen and seventeen of this act shall take effect on the  one
    49  hundred eightieth day after it shall have become a law.
 
    50                                   PART R
 
    51    Section  1.  Section 63 of the civil rights law, as amended by chapter
    52  253 of the laws of 2014, is amended to read as follows:
    53    § 63. Order. If the court to which the petition is presented is satis-
    54  fied thereby, or by the affidavit and certificate  presented  therewith,

        S. 2507--A                         68                         A. 3007--A
 
     1  that  the petition is true, and that there is no reasonable objection to
     2  the change of name proposed, and if the petition be to change  the  name
     3  of  an  infant,  that  the interests of the infant will be substantially
     4  promoted  by  the  change, the court shall make an order authorizing the
     5  petitioner to assume the name proposed. The order shall  further  recite
     6  the  date  and place of birth of the applicant and, if the applicant was
     7  born in the state of New York, such order shall set forth the number  of
     8  [his]  the applicant's birth certificate or that no birth certificate is
     9  available. The order shall be directed to be entered and the  papers  on
    10  which  it  was granted to be filed [prior to the publication hereinafter
    11  directed] in the clerk's office of the county in  which  the  petitioner
    12  resides  if  he  be  an individual, or in the office of the clerk of the
    13  civil court of the city of New York if the order be made by that  court.
    14  [Such  order  shall  also  direct the publication, at least once, within
    15  sixty days after the making of the order, in a designated  newspaper  in
    16  the county in which the order is directed to be entered and if the peti-
    17  tion is made by a person subject to the provisions of subdivision two of
    18  section  sixty-two  of  this  article,  in a designated newspaper in any
    19  county wherein such person was convicted if different from the county in
    20  which the order is otherwise directed to be  entered,  of  a  notice  in
    21  substantially  the  following form: Notice is hereby given that an order
    22  entered by the ............ court,............ county, on the ...... day
    23  of......., bearing Index Number..........., a copy of which may be exam-
    24  ined at the office of the clerk, located at .................,  in  room
    25  number.......,   grants   me   the   right   to   assume   the  name  of
    26  ...................   The city and  state  of  my  present  address  are
    27  .........................;   the   month   and  year  of  my  birth  are
    28  ................; the place of  my  birth  is  ....................;  my
    29  present name is .................................]
    30    §  2. Section 64 of the civil rights law, as amended by chapter 258 of
    31  the laws of 2006, and the closing paragraph  as  separately  amended  by
    32  chapters  258,  320  and  481 of the laws of 2006, is amended to read as
    33  follows:
    34    § 64. Effect. If the order [shall be fully complied with,  and  within
    35  ninety  days after the making of the order, an affidavit of the publica-
    36  tion thereof shall be filed  in  the  office  in  which  the  order]  is
    37  entered,  the  petitioner  shall  be  known by the name which is thereby
    38  authorized to be assumed. If the surname  of  a  parent  be  changed  as
    39  provided  in this article, any minor child of such parent at the time of
    40  such change may thereafter assume such changed surname.
    41    [Upon compliance with the order and the filing of the affidavit of the
    42  publication, as provided in this section, the  clerk  of  the  court  in
    43  which  the  order has been entered shall certify that the order has been
    44  complied with; and, if] (1) If the petition states that  the  petitioner
    45  stands convicted of a violent felony offense as defined in section 70.02
    46  of  the penal law or a felony defined in article one hundred twenty-five
    47  of such law or any of the following  provisions  of  such  law  sections
    48  130.25,  130.30,  130.40,  130.45,  255.25,  255.26, 255.27, article two
    49  hundred sixty-three, 135.10, 135.25, 230.05, 230.06, subdivision two  of
    50  section  230.30  or 230.32, [such] the clerk [(1)] of the court in which
    51  the order has been entered shall deliver, by first class mail, a copy of
    52  such certified order to the division of criminal justice services at its
    53  office in the county of Albany and (2) [upon  the  clerk  of  the  court
    54  reviewing  the  petitioner's  application for name change and subsequent
    55  in-court inquiry, may, in the  clerk's  discretion,  deliver,  by  first
    56  class  mail,  the petitioner's new name with such certified order to the

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

     1  court of competent jurisdiction which imposed  the  orders  of  support.
     2  Such  certification shall appear on the original order and on any certi-
     3  fied copy thereof and shall be entered in the  clerk's  minutes  of  the
     4  proceeding]  if  the  petition states that the petitioner is responsible
     5  for spousal support or  child  support  obligations  pursuant  to  court
     6  order,  upon  review of the petitioner's application for name change and
     7  subsequent in-court inquiry, the court may, in its discretion, order the
     8  petitioner to deliver by first class mail,  the  petitioner's  new  name
     9  with  such  certified order to the court of competent jurisdiction which
    10  imposed the orders of support. Such certification shall  appear  on  the
    11  original order and on any certified copy thereof and shall be entered in
    12  the court's minutes of the proceeding.
    13    §  3.  Section 64-a of the civil rights law, as amended by chapter 241
    14  of the laws of 2015, is amended to read as follows:
    15    § 64-a. [Exemption from publication requirements] Sealing name  change
    16  papers. 1. If the court shall find that [the publication] open record of
    17  an applicant's change of name would jeopardize such applicant's personal
    18  safety,  based  on  totality  of  the  circumstances  [the provisions of
    19  sections sixty-three and sixty-four of this article  requiring  publica-
    20  tion  shall  be waived and shall be inapplicable. Provided, however, the
    21  court shall not deny such waiver soley on the basis that  the  applicant
    22  lacks  specific instances of or a personal history of threat to personal
    23  safety.  The], the court shall order the records of such change of  name
    24  proceeding  [to]  be sealed, to be opened only by order of the court for
    25  good cause shown or at the request of the applicant.   For the  purposes
    26  of  this section, "totality of the circumstances" shall include, but not
    27  be limited to, a consideration of the risk of violence or discrimination
    28  against the applicant.  The court shall not deny  such  sealing  request
    29  solely  on the basis that the applicant lacks specific instances of or a
    30  personal history of threat to personal safety.
    31    2. Notwithstanding any other provision of law, pending such a  finding
    32  in subdivision one of this section where an applicant seeks relief under
    33  this  section, the court shall immediately order the applicant's current
    34  name, proposed new name, residential and business  addresses,  telephone
    35  numbers,  and any other information contained in any pleadings or papers
    36  submitted to the court to be safeguarded and sealed in order to  prevent
    37  their  inadvertent or unauthorized use or disclosure while the matter is
    38  pending.
    39    § 4. The civil rights law is amended by adding a new  article  6-A  to
    40  read as follows:
    41                                 ARTICLE 6-A
    42               CHANGE OF SEX DESIGNATION OR GENDER DESIGNATION
    43  Section 67. Petition to change sex designation or gender designation.
    44          67-a. Order.
    45          67-b. Sealing  change  of  sex designation or gender designation
    46                papers.
    47          67-c. Effect on government issued identity documents.
    48    § 67. Petition to change sex designation or gender designation.  1.  A
    49  petition  for  leave to change sex designation or gender designation may
    50  be made by a resident of the state to the county court of the county  or
    51  the  supreme  court in the county in which such resident resides, or, if
    52  such resident resides in the city of New York,  either  to  the  supreme
    53  court  or  to  any branch of the civil court of the city of New York, in
    54  any county of the city of New York.  The  petition  to  change  the  sex
    55  designation or gender designation of an infant may be made by the infant

        S. 2507--A                         70                         A. 3007--A
 
     1  through  either  of  such  infant's parents, or by such infant's general
     2  guardian or by the guardian of such infant's person.
     3    2.    When an individual petitions the court to recognize their gender
     4  identity or to amend the sex designation   or gender designation  on  an
     5  identity  document,  the court shall issue such an order upon receipt of
     6  an affidavit from such individual attesting to their gender identity  or
     7  reason for the change.  No additional medical evidence shall be required
     8  to grant such request. No such order shall be required to amend an iden-
     9  tity  document  issued  within  New  York  state. No such order shall be
    10  required to otherwise recognize the gender of an  individual  and  treat
    11  them  consistent  with  their  gender  identity within New York state or
    12  under New York state law.
    13    3.  Such request may be made simultaneously with a petition for change
    14  of name pursuant to section sixty or sixty-five of this  chapter  or  on
    15  its own.
    16    §  67-a.  Order.  If  the  court to which the petition is presented is
    17  satisfied thereby, or by the affidavit and certificate presented  there-
    18  with,  and  that  there  is no reasonable objection to the change of sex
    19  designation or gender designation proposed, and if the  petition  is  to
    20  change  the sex designation or gender designation of an infant, that the
    21  interests of the infant will be substantially promoted  by  the  change,
    22  the  court  shall make an order authorizing the petitioner to assume the
    23  sex designation or gender designation proposed.
    24    § 67-b. Sealing  change  of  sex  designation  or  gender  designation
    25  papers.  1.  Upon  request  of  the applicant, the court shall order the
    26  records of such change of sex designation or gender designation proceed-
    27  ing to be sealed, to be opened only by order of the court for good cause
    28  shown or at the request of the applicant.
    29    2. Notwithstanding any other provision of law, pending such a  finding
    30  in subdivision one of this section where an applicant seeks relief under
    31  this  section, the court shall immediately order the applicant's current
    32  name, sex designation, proposed new sex  designation  or  gender  desig-
    33  nation,  residential  and business addresses, telephone numbers, and any
    34  other information contained in any pleadings or papers submitted to  the
    35  court to be safeguarded and sealed in order to prevent their inadvertent
    36  or unauthorized use or disclosure while the matter is pending.
    37    §  67-c.  Effect  on  government  issued identity documents. Any state
    38  agency that maintains a system or issues an identity document  requiring
    39  a  sex  designation  or  gender  designation that, due to federal law or
    40  systems processing requirements, is unable to  process  or  change  such
    41  record  or  document  consistent  with  an order issued pursuant to this
    42  section shall make reasonable  efforts  to  otherwise  accommodate  such
    43  request.
    44    § 5. This act shall take effect on the one hundred eightieth day after
    45  it  shall have become a law. Effective immediately, the addition, amend-
    46  ment and/or repeal of any rule or regulation necessary for the implemen-
    47  tation of this act on its effective date are authorized to be  made  and
    48  completed on or before such effective date.
 
    49                                   PART S
 
    50    Section 1. Section 11 of chapter 884 of the laws of 1990, amending the
    51  public  health  law  relating  to  authorizing bad debt and charity care
    52  allowances for certified home health agencies, as amended by  section  3
    53  of  part  E  of  chapter  57  of the laws of 2019, is amended to read as
    54  follows:

        S. 2507--A                         71                         A. 3007--A
 
     1    § 11. This act shall take effect immediately and:
     2    (a) sections one and three shall expire on December 31, 1996,
     3    (b)  sections  four  through ten shall expire on June 30, [2021] 2023,
     4  and
     5    (c) provided that the amendment to section 2807-b of the public health
     6  law by section two of this act shall not affect the expiration  of  such
     7  section  2807-b  as  otherwise  provided  by  law and shall be deemed to
     8  expire therewith.
     9    § 2. Subdivision (a) of section 40 of part B of  chapter  109  of  the
    10  laws  of  2010, amending the social services law relating to transporta-
    11  tion costs, as amended by section 5 of part E of chapter 57 of the  laws
    12  of 2019, is amended to read as follows:
    13    (a)  sections  two, three, three-a, three-b, three-c, three-d, three-e
    14  and twenty-one of this act shall take  effect  July  1,  2010;  sections
    15  fifteen,  sixteen,  seventeen,  eighteen  and nineteen of this act shall
    16  take effect January 1, 2011; [and provided further that  section  twenty
    17  of  this  act  shall  be  deemed  repealed  ten years after the date the
    18  contract entered into pursuant to section 365-h of the  social  services
    19  law,  as  amended  by  section twenty of this act, is executed; provided
    20  that the commissioner of health shall notify the legislative bill draft-
    21  ing commission upon the execution of the contract entered into  pursuant
    22  to section 367-h of the social services law in order that the commission
    23  may  maintain an accurate and timely effective data base of the official
    24  text of the laws of the state of New York in furtherance of effectuating
    25  the provisions of section 44 of the legislative law and section 70-b  of
    26  the public officers law;]
    27    § 3. Subdivision 5-a of section 246 of chapter 81 of the laws of 1995,
    28  amending  the  public  health  law  and  other  laws relating to medical
    29  reimbursement and welfare reform, as amended by section 12 of part E  of
    30  chapter 57 of the laws of 2019, is amended to read as follows:
    31    5-a.  Section sixty-four-a of this act shall be deemed to have been in
    32  full force and effect on and after April 1, 1995 through March 31,  1999
    33  and  on  and  after July 1, 1999 through March 31, 2000 and on and after
    34  April 1, 2000 through March 31, 2003 and on  and  after  April  1,  2003
    35  through March 31, 2007, and on and after April 1, 2007 through March 31,
    36  2009,  and on and after April 1, 2009 through March 31, 2011, and on and
    37  after April 1, 2011 through March 31, 2013, and on and  after  April  1,
    38  2013  through  March  31,  2015,  and on and after April 1, 2015 through
    39  March 31, 2017 and on and after April 1, 2017 through  March  31,  2019,
    40  and  on and after April 1, 2019 through March 31, 2021, and on and after
    41  April 1, 2021 through March 31, 2023;
    42    § 4. Section 64-b of chapter 81 of the  laws  of  1995,  amending  the
    43  public  health  law and other laws relating to medical reimbursement and
    44  welfare reform, as amended by section 13 of part E of chapter 57 of  the
    45  laws of 2019, is amended to read as follows:
    46    §  64-b.  Notwithstanding  any  inconsistent  provision  of  law,  the
    47  provisions of subdivision 7 of section 3614 of the public health law, as
    48  amended, shall remain and be in full force and effect on April  1,  1995
    49  through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
    50  and after April 1, 2000 through March 31, 2003 and on and after April 1,
    51  2003  through  March  31,  2007,  and on and after April 1, 2007 through
    52  March 31, 2009, and on and after April 1, 2009 through March  31,  2011,
    53  and  on and after April 1, 2011 through March 31, 2013, and on and after
    54  April 1, 2013 through March 31, 2015, and on and  after  April  1,  2015
    55  through  March 31, 2017 and on and after April 1, 2017 through March 31,

        S. 2507--A                         72                         A. 3007--A
 
     1  2019, and on and after April 1, 2019 through March 31, 2021, and on  and
     2  after April 1, 2021 through March 31, 2023.
     3    § 5. Section 4-a of part A of chapter 56 of the laws of 2013, amending
     4  chapter  59 of the laws of 2011 amending the public health law and other
     5  laws relating to general hospital reimbursement  for  annual  rates,  as
     6  amended  by  section  14 of part E of chapter 57 of the laws of 2019, is
     7  amended to read as follows:
     8    § 4-a. Notwithstanding paragraph (c)  of  subdivision  10  of  section
     9  2807-c  of the public health law, section 21 of chapter 1 of the laws of
    10  1999, or any other contrary provision of law, in  determining  rates  of
    11  payments  by state governmental agencies effective for services provided
    12  on and after January 1, 2017 through March 31, [2021]  2023,  for  inpa-
    13  tient  and  outpatient services provided by general hospitals, for inpa-
    14  tient services and adult day health care outpatient services provided by
    15  residential health care facilities pursuant to article 28 of the  public
    16  health  law,  except  for residential health care facilities or units of
    17  such facilities providing services primarily to children  under  twenty-
    18  one  years  of  age,  for home health care services provided pursuant to
    19  article 36 of the public health law by certified home  health  agencies,
    20  long term home health care programs and AIDS home care programs, and for
    21  personal  care services provided pursuant to section 365-a of the social
    22  services law, the commissioner of health shall  apply  no  greater  than
    23  zero  trend  factors  attributable  to the 2017, 2018, 2019, 2020, [and]
    24  2021, 2022 and 2023 calendar years in accordance with paragraph  (c)  of
    25  subdivision  10  of  section  2807-c of the public health law, provided,
    26  however, that such no greater than zero trend  factors  attributable  to
    27  such  2017,  2018,  2019, 2020, [and] 2021, 2022 and 2023 calendar years
    28  shall also be applied to rates of payment provided on and after  January
    29  1,  2017  through  March  31,  [2021]  2023  for  personal care services
    30  provided in those local social services districts,  including  New  York
    31  city,  whose  rates of payment for such services are established by such
    32  local social services districts pursuant  to  a  rate-setting  exemption
    33  issued  by  the  commissioner  of  health  to such local social services
    34  districts  in  accordance  with  applicable  regulations;  and  provided
    35  further,  however, that for rates of payment for assisted living program
    36  services provided on and after January 1, 2017 through March 31,  [2021]
    37  2023,  such  trend  factors  attributable to the 2017, 2018, 2019, 2020,
    38  [and] 2021, 2022 and 2023 calendar years  shall  be  established  at  no
    39  greater than zero percent.
    40    §  6.  Subdivision 2 of section 246 of chapter 81 of the laws of 1995,
    41  amending the public health  law  and  other  laws  relating  to  medical
    42  reimbursement  and welfare reform, as amended by section 17 of part E of
    43  chapter 57 of the laws of 2019, is amended to read as follows:
    44    2. Sections five, seven through nine,  twelve  through  fourteen,  and
    45  eighteen  of  this  act  shall  be deemed to have been in full force and
    46  effect on and after April 1, 1995 through March  31,  1999  and  on  and
    47  after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
    48  through  March 31, 2003 and on and after April 1, 2003 through March 31,
    49  2006 and on and after April 1, 2006 through March 31, 2007  and  on  and
    50  after  April  1,  2007  through March 31, 2009 and on and after April 1,
    51  2009 through March 31, 2011 and sections twelve, thirteen  and  fourteen
    52  of  this act shall be deemed to be in full force and effect on and after
    53  April 1, 2011 through March 31, 2015 and on  and  after  April  1,  2015
    54  through  March 31, 2017 and on and after April 1, 2017 through March 31,
    55  2019, and on and after April 1, 2019 through March 31, 2021, and on  and
    56  after April 1, 2021 through March 31, 2023;

        S. 2507--A                         73                         A. 3007--A
 
     1    §  7.  Section 7 of part H of chapter 57 of the laws of 2019, amending
     2  the public health law relating to  waiver  of  certain  regulations,  as
     3  amended  by  section 11 of part BB of chapter 56 of the laws of 2020, is
     4  amended to read as follows:
     5    §  7.  This  act  shall take effect immediately and shall be deemed to
     6  have been in full force and effect on and after April 1, 2019, provided,
     7  however, that section two of this act shall expire on  April  1,  [2021]
     8  2024.
     9    § 8. Section 5 of chapter 517 of the laws of 2016, amending the public
    10  health  law  relating to payments from the New York state medical indem-
    11  nity fund, as amended by section 18 of part Y of chapter 56 of the  laws
    12  of 2020, is amended to read as follows:
    13    §  5. This act shall take effect on the forty-fifth day after it shall
    14  have become a law, provided that the  amendments  to  subdivision  4  of
    15  section  2999-j of the public health law made by section two of this act
    16  shall take effect on June 30,  2017  and  shall  expire  and  be  deemed
    17  repealed December 31, [2021] 2022.
    18    §  9.  Subdivision  1  of section 2999-aa of the public health law, as
    19  amended by chapter 80 of the  laws  of  2017,  is  amended  to  read  as
    20  follows:
    21    1.  In order to promote improved quality and efficiency of, and access
    22  to, health care services and to promote improved  clinical  outcomes  to
    23  the  residents  of  New  York,  it  shall  be the policy of the state to
    24  encourage, where appropriate, cooperative, collaborative and integrative
    25  arrangements including but not  limited  to,  mergers  and  acquisitions
    26  among  health  care  providers  or  among  others who might otherwise be
    27  competitors, under the active supervision of the  commissioner.  To  the
    28  extent  such arrangements, or the planning and negotiations that precede
    29  them, might be anti-competitive within the meaning  and  intent  of  the
    30  state and federal antitrust laws, the intent of the state is to supplant
    31  competition  with  such  arrangements  under  the active supervision and
    32  related administrative actions  of  the  commissioner  as  necessary  to
    33  accomplish  the  purposes  of  this article, and to provide state action
    34  immunity under the state and federal  antitrust  laws  with  respect  to
    35  activities  undertaken  by  health care providers and others pursuant to
    36  this article, where the benefits of such  active  supervision,  arrange-
    37  ments  and actions of the commissioner outweigh any disadvantages likely
    38  to result from a reduction of competition. The  commissioner  shall  not
    39  approve  an  arrangement for which state action immunity is sought under
    40  this article without first consulting with, and receiving a  recommenda-
    41  tion from, the public health and health planning council. No arrangement
    42  under  this  article  shall be approved after December thirty-first, two
    43  thousand [twenty] twenty-four.
    44    § 10. Section 3 of part D of chapter 56 of the laws of 2014,  amending
    45  the education law relating to the nurse practitioners modernization act,
    46  is amended to read as follows:
    47    § 3. This act shall take effect on the first of January after it shall
    48  have  become  a law and shall expire June 30 of the [sixth] twelfth year
    49  after it shall have become a law, when upon such date the provisions  of
    50  this  act  shall  be  deemed repealed; provided, however, that effective
    51  immediately, the addition, amendment and/or repeal of any rule or  regu-
    52  lation  necessary  for  the  implementation of this act on its effective
    53  date is authorized and directed to be made and completed  on  or  before
    54  such effective date.

        S. 2507--A                         74                         A. 3007--A
 
     1    §  11.  Subparagraph (vi) of paragraph (b) of subdivision 2 of section
     2  2807-d of the public health law, as amended by section 9 of  part  E  of
     3  chapter 57 of the laws of 2019, is amended to read as follows:
     4    (vi)  Notwithstanding  any contrary provision of this paragraph or any
     5  other provision of law or regulation to the  contrary,  for  residential
     6  health care facilities the assessment shall be six percent of each resi-
     7  dential  health care facility's gross receipts received from all patient
     8  care services and other operating income on a cash basis for the  period
     9  April  first,  two thousand two through March thirty-first, two thousand
    10  three for hospital  or  health-related  services,  including  adult  day
    11  services;  provided,  however,  that residential health care facilities'
    12  gross receipts attributable to payments received pursuant to title XVIII
    13  of the federal social security act (medicare) shall be excluded from the
    14  assessment; provided, however, that for all such gross receipts received
    15  on or after April first, two thousand three through March  thirty-first,
    16  two  thousand  five,  such assessment shall be five percent, and further
    17  provided that for all such gross receipts received  on  or  after  April
    18  first,  two thousand five through March thirty-first, two thousand nine,
    19  and on or after April first, two thousand  nine  through  March  thirty-
    20  first,  two  thousand  eleven  such assessment shall be six percent, and
    21  further provided that for all such gross receipts received on  or  after
    22  April  first,  two thousand eleven through March thirty-first, two thou-
    23  sand thirteen such assessment shall be six percent, and further provided
    24  that for all such gross receipts received on or after April  first,  two
    25  thousand  thirteen through March thirty-first, two thousand fifteen such
    26  assessment shall be six percent, and further provided that for all  such
    27  gross  receipts  received  on or after April first, two thousand fifteen
    28  through March thirty-first, two thousand seventeen such assessment shall
    29  be six percent, and further provided that for all  such  gross  receipts
    30  received  on  or after April first, two thousand seventeen through March
    31  thirty-first,  two  thousand  nineteen  such  assessment  shall  be  six
    32  percent,  and further provided that for all such gross receipts received
    33  on or after April first, two thousand  nineteen  through  March  thirty-
    34  first, two thousand twenty-one such assessment shall be six percent, and
    35  further  provided  that for all such gross receipts received on or after
    36  April first, two thousand twenty-one  through  March  thirty-first,  two
    37  thousand twenty-three such assessment shall be six percent.
    38    §  12.  This  act shall take effect immediately and shall be deemed to
    39  have been in full force and effect on and after April 1, 2021.
 
    40                                   PART T
 
    41    Section 1. Section 3 of part A of chapter 111  of  the  laws  of  2010
    42  amending  the  mental hygiene law relating to the receipt of federal and
    43  state benefits received by  individuals  receiving  care  in  facilities
    44  operated by an office of the department of mental hygiene, as amended by
    45  section  1  of  part  X of chapter 57 of the laws of 2018, is amended to
    46  read as follows:
    47    § 3. This act shall take effect immediately; and shall expire  and  be
    48  deemed repealed June 30, [2021] 2024.
    49    § 2. This act shall take effect immediately.
 
    50                                   PART U

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

        S. 2507--A                         75                         A. 3007--A
 
     1  operators for the continued operation of programs and the  provision  of
     2  services  for  persons  with serious mental illness and/or developmental
     3  disabilities and/or chemical dependence, is amended to read as follows:
     4    §  4.  This  act  shall take effect immediately and shall be deemed to
     5  have been in full force and effect on and after April 1, 2016; provided,
     6  however, that sections one and two of  this  act  shall  expire  and  be
     7  deemed repealed on March 31, [2021] 2026.
     8    § 2. This act shall take effect immediately.
 
     9                                   PART V

    10    Section  1.  Section  2  of part NN of chapter 58 of the laws of 2015,
    11  amending the mental hygiene law relating to clarifying the authority  of
    12  the  commissioners  in  the  department  of mental hygiene to design and
    13  implement time-limited demonstration programs, as amended by  section  1
    14  of  part  U  of  chapter  57  of the laws of 2018, is amended to read as
    15  follows:
    16    § 2. This act shall take effect immediately and shall  expire  and  be
    17  deemed repealed March 31, [2021] 2024.
    18    § 2. This act shall take effect immediately.
 
    19                                   PART W
 
    20    Section  1.  Section  7  of part R2 of chapter 62 of the laws of 2003,
    21  amending the mental hygiene law and the state finance  law  relating  to
    22  the  community mental health support and workforce reinvestment program,
    23  the membership of subcommittees for mental health of community  services
    24  boards  and  the duties of such subcommittees and creating the community
    25  mental health and workforce reinvestment account, as amended by  section
    26  1  of  part  V  of chapter 57 of the laws of 2018, is amended to read as
    27  follows:
    28    § 7. This act shall take effect immediately and shall expire March 31,
    29  [2021] 2024 when upon such date the provisions  of  this  act  shall  be
    30  deemed repealed.
    31    § 2. This act shall take effect immediately.
 
    32                                   PART X
 
    33    Section  1. Notwithstanding the provisions of subdivisions (b) and (e)
    34  of section 7.17 and section 41.55 of the mental hygiene law or any other
    35  law to the contrary, the office of mental health is authorized in  state
    36  fiscal year 2021-22 to close, consolidate, reduce, transfer or otherwise
    37  redesign  services  of hospitals, other facilities and programs operated
    38  by the office of mental health, and  to  implement  significant  service
    39  reductions  and  reconfigurations  according to this section as shall be
    40  determined by the commissioner of mental health to be necessary for  the
    41  cost-effective  and efficient operation of such hospitals, other facili-
    42  ties and programs. Any transfers of capacity or any  resulting  transfer
    43  of  functions  shall  be  authorized  to  be made by the commissioner of
    44  mental health and any transfer of personnel upon such transfer of capac-
    45  ity or transfer of functions shall be accomplished  in  accordance  with
    46  the provisions of subdivision 2 of section 70 of the civil service law.
    47    § 2. This act shall take effect immediately and shall expire March 31,
    48  2022  when  upon  such  date  the provisions of this act shall be deemed
    49  repealed.

        S. 2507--A                         76                         A. 3007--A
 
     1                                   PART Y
 
     2    Section 1.  Section 19.07 of the mental hygiene law, as added by chap-
     3  ter  223  of  the  laws  of 1992, subdivisions (a) and (g) as amended by
     4  chapter 271 of the laws of 2010, subdivisions (b) and (c) as amended  by
     5  chapter 281 of the laws of 2019, subdivision (d) as amended by section 5
     6  of part I of chapter 58 of the laws of 2005,  subdivision (e) as amended
     7  by  chapter 558 of the laws of 1999, subdivision (f) as added by chapter
     8  383 of the laws of 1998, subdivision (h) as amended by section 118-f  of
     9  subpart  B  of part C of chapter 62 of the laws of 2011, subdivision (i)
    10  as amended by section 31-a of part AA of chapter 56 of the laws of 2019,
    11  subdivision (j) as amended by chapter 146 of the laws of 2014,  subdivi-
    12  sion (k) as added by  chapter 40 of the laws of 2014, subdivision (l) as
    13  added by chapter 323 of the laws of 2018 and subdivision (m) as added by
    14  chapter 493 of the laws of 2019, is amended to read as follows:
    15  § 19.07 Office  of  [alcoholism  and substance abuse services] addiction
    16            services and supports; scope of responsibilities.
    17    (a) The office of [alcoholism and substance abuse services]  addiction
    18  services  and  supports  is charged with the responsibility for assuring
    19  the development of comprehensive plans, programs, and  services  in  the
    20  areas  of research, prevention, care, treatment, rehabilitation, includ-
    21  ing relapse prevention and recovery maintenance, education, and training
    22  of persons who [abuse or are dependent  on  alcohol  and/or  substances]
    23  have  or  are  at  risk of an addictive disorder and their families. The
    24  term addictive  disorder  shall  include  gambling  disorder  education,
    25  prevention  and treatment consistent with section 41.57 of this chapter.
    26  Such plans, programs, and services shall be developed with  the  cooper-
    27  ation of the office, the other offices of the department where appropri-
    28  ate,  local governments, consumers and community organizations and enti-
    29  ties.  The  office  shall  provide  appropriate  facilities  and   shall
    30  encourage  the provision of facilities by local government and community
    31  organizations and entities. [The office is also responsible for develop-
    32  ing plans, programs and services related to compulsive  gambling  educa-
    33  tion,  prevention  and  treatment  consistent with section 41.57 of this
    34  chapter.]
    35    (b) The office of [alcoholism and substance abuse services]  addiction
    36  services  and supports shall advise and assist the governor in improving
    37  services and developing policies designed to meet the needs  of  persons
    38  who  suffer from or are at risk of an addictive disorder and their fami-
    39  lies, and to encourage their rehabilitation,  maintenance  of  recovery,
    40  and functioning in society.
    41    (c)  The office of [alcoholism and substance abuse services] addiction
    42  services and supports shall have  the  responsibility  for  seeing  that
    43  persons  who  suffer  from  or  are at risk of an addictive disorder and
    44  their families are provided with addiction services, care and treatment,
    45  and that such services, care, treatment and rehabilitation  is  of  high
    46  quality  and  effectiveness,  and  that the personal and civil rights of
    47  persons seeking and receiving addiction services,  care,  treatment  and
    48  rehabilitation are adequately protected.
    49    (d)  The office of [alcoholism and substance abuse services] addiction
    50  services and supports shall foster programs for the training and  devel-
    51  opment of persons capable of providing the foregoing services, including
    52  but  not  limited  to  a  process of issuing, either directly or through
    53  contract, licenses,  credentials,  certificates  or  authorizations  for
    54  [alcoholism and substance abuse counselors or gambling] addiction [coun-
    55  selors] professionals in accordance with the following:

        S. 2507--A                         77                         A. 3007--A
 
     1    (1) The office shall establish minimum qualifications [for counselors]
     2  and  a  definition  of  the  practice  of the profession of an addiction
     3  professional in all phases of delivery of services to persons and  their
     4  families  who  are suffering from [alcohol and/or substance abuse and/or
     5  chemical  dependence  and/or  compulsive gambling that shall include] or
     6  are at risk of an addictive disorder including, but not be  limited  to,
     7  completion of approved courses of study or equivalent on-the-job experi-
     8  ence  in [alcoholism and substance abuse counseling and/or counseling of
     9  compulsive gambling] addiction disorder services.
    10    (i) The office shall establish procedures  for  issuing,  directly  or
    11  through  contract, licenses, credentials, certificates or authorizations
    12  to [counselors] addiction professionals who meet minimum qualifications,
    13  including the establishment  of  appropriate  fees,  and  shall  further
    14  establish procedures to suspend, revoke, or annul such licenses, creden-
    15  tials,  certificates  or  authorizations for good cause. Such procedures
    16  shall be promulgated by the commissioner by rule or regulation.
    17    (ii) The commissioner shall establish [a credentialing]  an  addiction
    18  professionals board which shall provide advice concerning the licensing,
    19  credentialing, certification or authorization process.
    20    (iii)  The commissioner shall establish fees for the education, train-
    21  ing,  licensing,  credentialing,  certification  or   authorization   of
    22  addiction professionals.
    23    (2)  The  establishment,  with  the  advice of the advisory council on
    24  alcoholism and substance abuse services, of minimum  qualifications  for
    25  [counselors]  addiction  professionals  in  all  phases  of  delivery of
    26  services to those suffering from [alcoholism, substance and/or  chemical
    27  abuse and/or dependence and/or compulsive gambling] or at risk of addic-
    28  tive disorders and their families that shall include, but not be limited
    29  to,  completion  of  approved  courses of study or equivalent on-the-job
    30  experience in [counseling  for  alcoholism,  substance  and/or  chemical
    31  abuse and/or dependence] addiction disorder services and/or [compulsive]
    32  gambling  disorder  services,  and  establish  appropriate  fees,  issue
    33  licenses, credentials, certificates or  authorizations  to  [counselors]
    34  addiction  professionals  who  meet  minimum qualifications and suspend,
    35  revoke, or annul such licenses, credentials,  certificates  or  authori-
    36  zations  for good cause in accordance with procedures promulgated by the
    37  commissioner by rule or regulation.
    38    (3) For the purpose of this title, the term "addiction  professional",
    39  including  "credentialed  alcoholism  and  substance abuse counselor" or
    40  "C.A.S.A.C.", means an official designation identifying an individual as
    41  one who holds a currently  registered  and  valid  license,  credential,
    42  certificate  or authorization issued or approved by the office of [alco-
    43  holism and substance abuse services]  addiction  services  and  supports
    44  pursuant  to this section which documents an individual's qualifications
    45  to provide [alcoholism and substance abuse counseling] addiction  disor-
    46  der  services.  The  term "gambling addiction [counselor"] professional"
    47  means an official designation identifying an individual as one who holds
    48  a currently registered and valid  license,  credential,  certificate  or
    49  authorization  issued  by  the office of [alcoholism and substance abuse
    50  services] addiction services and supports pursuant to this section which
    51  documents an individual's qualifications to provide [compulsive]  gambl-
    52  ing [counseling] disorder services.
    53    (i)  No  person  shall  use  the  title  [credentialed  alcoholism and
    54  substance abuse counselor or "C.A.S.A.C." or gambling addiction  counse-
    55  lor]  "addiction  professional"  or  the  title  given  to any licenses,
    56  credentials, certificates or authorizations issued by the office  unless

        S. 2507--A                         78                         A. 3007--A
 
     1  authorized  [pursuant  to]  by  the commissioner in accordance with this
     2  title.
     3    (ii)  Failure  to  comply  with the requirements of this section shall
     4  constitute a violation as defined in the penal law.
     5    (4) All persons holding previously  issued  and  valid  alcoholism  or
     6  substance  abuse counselor credentials issued by the office or an entity
     7  designated by  the  office,  including  a  credentialed  alcoholism  and
     8  substance abuse counselor, certified prevention specialist, credentialed
     9  prevention professional, credentialed problem gambling counselor, gambl-
    10  ing  specialty  designation,  certified  recovery  peer advocate, on the
    11  effective date of amendments to this section shall be deemed [C.A.S.A.C.
    12  designated] an addiction professional consistent with  their  experience
    13  and education.
    14    (e)  Consistent  with  the  requirements of subdivision (b) of section
    15  5.05 of this chapter, the office shall carry out the provisions of arti-
    16  cle thirty-two of this chapter as such article  pertains  to  regulation
    17  and   quality   control  of  [chemical  dependence]  addiction  disorder
    18  services, including but not limited to the  establishment  of  standards
    19  for  determining  the necessity and appropriateness of care and services
    20  provided  by  [chemical  dependence]  addiction  disorder  providers  of
    21  services. In implementing this subdivision, the commissioner, in consul-
    22  tation  with the commissioner of health, shall adopt standards including
    23  necessary rules and regulations including but not limited to  those  for
    24  determining the necessity or appropriate level of admission, controlling
    25  the  length  of stay and the provision of services, and establishing the
    26  methods and procedures for making such determination.
    27    (f) The office of [alcoholism and substance abuse services]  addiction
    28  services  and  supports  shall develop a list of all agencies throughout
    29  the state which are currently certified by the office and are capable of
    30  and available to provide evaluations in accordance with  section  sixty-
    31  five-b of the alcoholic beverage control law so as to determine need for
    32  treatment  pursuant  to  such  section and to assure the availability of
    33  such evaluation services by  a  certified  agency  within  a  reasonable
    34  distance  of every court of a local jurisdiction in the state. Such list
    35  shall be updated on a regular basis and shall be made available to every
    36  supreme court law library in this state, or, if  no  supreme  court  law
    37  library is available in a certain county, to the county court library of
    38  such  county. The commissioner may establish an annual fee for inclusion
    39  on such list.
    40    (g) The office of [alcoholism and substance abuse services]  addiction
    41  services and supports shall develop and maintain a list of the names and
    42  locations  of  all  licensed  agencies and [alcohol and substance abuse]
    43  addiction professionals, as defined in paragraphs (a) and (b) of  subdi-
    44  vision  one  of section eleven hundred ninety-eight-a of the vehicle and
    45  traffic law, throughout the state which are capable of and available  to
    46  provide  an  assessment  of,  and  treatment for, [alcohol and substance
    47  abuse and dependency] addiction disorders. Such list shall  be  provided
    48  to the chief administrator of the office of court administration and the
    49  commissioner of motor vehicles. Persons who may be aggrieved by an agen-
    50  cy  decision  regarding inclusion on the list may request an administra-
    51  tive appeal in accordance with rules and regulations of the office.  The
    52  commissioner may establish an annual fee for inclusion on such list.
    53    (h)  The office of [alcoholism and substance abuse services] addiction
    54  services and supports shall monitor programs providing care  and  treat-
    55  ment to inmates in correctional facilities operated by the department of
    56  corrections  and community supervision who have a history of [alcohol or

        S. 2507--A                         79                         A. 3007--A

     1  substance abuse or dependence] an addiction disorder. The  office  shall
     2  also  develop  guidelines  for  the  operation of [alcohol and substance
     3  abuse treatment programs] addiction disorder services  in  such  correc-
     4  tional  facilities  in  order  to ensure that such programs sufficiently
     5  meet the needs of inmates with a history of [alcohol or substance  abuse
     6  or  dependence] an addiction disorder and promote the successful transi-
     7  tion to treatment in the community upon release. No later than the first
     8  day of December of each year, the office shall submit a report regarding
     9  the adequacy and effectiveness of alcohol and substance abuse  treatment
    10  programs  operated by the department of corrections and community super-
    11  vision to the governor, the  temporary  president  of  the  senate,  the
    12  speaker  of  the assembly, the chairman of the senate committee on crime
    13  victims, crime and correction, and the chairman of the assembly  commit-
    14  tee on correction.
    15    (i)  The office of [alcoholism and substance abuse services] addiction
    16  services and supports shall periodically, in consultation with the state
    17  director of veterans' services: (1) review the programs operated by  the
    18  office  to  ensure  that the needs of the state's veterans who served in
    19  the U.S. armed forces  and  who  are  recovering  from  [alcohol  and/or
    20  substance  abuse]  an  addiction  disorder  are being met and to develop
    21  improvements to programs to meet such needs; and  (2)  in  collaboration
    22  with  the  state  director of veterans' services and the commissioner of
    23  the office of mental health, review and make recommendations to  improve
    24  programs that provide treatment, rehabilitation, relapse prevention, and
    25  recovery  services  to  veterans  who have served in a combat theatre or
    26  combat zone of operations and have  a  co-occurring  mental  health  and
    27  [alcoholism or substance abuse] addiction disorder.
    28    (j)  The  office, in consultation with the state education department,
    29  shall identify or develop materials on problem gambling among school-age
    30  youth which may be used by school districts and  boards  of  cooperative
    31  educational  services,  at  their  option,  to  educate  students on the
    32  dangers and consequences of problem gambling as they  deem  appropriate.
    33  Such  materials  shall be available on the internet website of the state
    34  education department. The internet website of the office shall provide a
    35  hyperlink to the internet page of the state  education  department  that
    36  displays such materials.
    37    (k)  Heroin  and opioid addiction awareness and education program. The
    38  commissioner, in cooperation with the commissioner of the department  of
    39  health,  shall  develop  and  conduct a public awareness and educational
    40  campaign on heroin and opioid  addiction.  The  campaign  shall  utilize
    41  public  forums,  social media and mass media, including, but not limited
    42  to, internet, radio, and print advertising such as billboards and  post-
    43  ers  and  shall also include posting of materials and information on the
    44  office website.  The  campaign  shall  be  tailored  to  educate  youth,
    45  parents,  healthcare professionals and the general public regarding: (1)
    46  the risks associated with the abuse and misuse of  heroin  and  opioids;
    47  (2)  how  to  recognize  the  signs  of addiction; and (3) the resources
    48  available for those needing assistance with heroin or opioid  addiction.
    49  The  campaign  shall  further  be  designed  to enhance awareness of the
    50  opioid overdose prevention program authorized pursuant to section  thir-
    51  ty-three  hundred  nine of the public health law and the "Good Samaritan
    52  law" established pursuant to sections 220.03 and 220.78 of the penal law
    53  and section 390.40 of the criminal procedure  law,  and  to  reduce  the
    54  stigma associated with addiction.
    55    (l)  The office of [alcoholism and substance abuse services] addiction
    56  services and supports, in consultation with the state education  depart-

        S. 2507--A                         80                         A. 3007--A
 
     1  ment,  shall  develop  or  utilize  existing educational materials to be
     2  provided to school  districts  and  boards  of  cooperative  educational
     3  services  for  use  in  addition  to or in conjunction with any drug and
     4  alcohol  related  curriculum  regarding the misuse and abuse of alcohol,
     5  tobacco, prescription medication and other drugs with an increased focus
     6  on substances that are most prevalent among school aged  youth  as  such
     7  term is defined in section eight hundred four of the education law. Such
     8  materials  shall  be age appropriate for school age children, and to the
     9  extent practicable, shall include information or resources  for  parents
    10  to identify the warning signs and address the risks of substance [abuse]
    11  misuse and addiction.
    12    (m)  (1)  The office shall report on the status and outcomes of initi-
    13  atives created in response to the heroin  and  opioid  epidemic  to  the
    14  temporary  president  of  the  senate,  the speaker of the assembly, the
    15  chairs of the assembly and senate  committees  on  alcoholism  and  drug
    16  abuse,  the chair of the assembly ways and means committee and the chair
    17  of the senate finance committee.
    18    (2) Such reports shall include, to the extent practicable and applica-
    19  ble, information on:
    20    (i) The number of  individuals  enrolled  in  the  initiative  in  the
    21  preceding quarter;
    22    (ii)  The number of individuals who completed the treatment program in
    23  the preceding quarter;
    24    (iii) The number of individuals discharged from the treatment  program
    25  in the preceding quarter;
    26    (iv) The age and sex of the individuals served;
    27    (v) Relevant regional data about the individuals;
    28    (vi) The populations served; and
    29    (vii) The outcomes and effectiveness of each initiative surveyed.
    30    (3)  Such  initiatives shall include opioid treatment programs, crisis
    31  detoxification programs, 24/7 open access centers, adolescent club hous-
    32  es, family navigator programs,  peer  engagement  specialists,  recovery
    33  community  and outreach centers, regional addiction resource centers and
    34  the state implementation of the federal opioid state  targeted  response
    35  initiatives.
    36    (4)  Such  information shall be provided quarterly, beginning no later
    37  than July first, two thousand nineteen.
    38    § 2. This act shall take effect April 1, 2021.
 
    39                                   PART Z
 
    40    Section 1. The opening paragraph of subdivision (g) of  section  31.16
    41  of  the  mental  hygiene  law,  as amended by chapter 351 of the laws of
    42  1994, is amended to read as follows:
    43    The commissioner may impose [a fine] sanctions upon a finding that the
    44  holder of the certificate has failed to comply with  the  terms  of  the
    45  operating  certificate or with the provisions of any applicable statute,
    46  rule or regulation. [The maximum amount of such fine  shall  not  exceed
    47  one thousand dollars per day or fifteen thousand dollars per violation.]
    48  The  commissioner is authorized to develop a schedule for the purpose of
    49  imposing such sanctions.
    50    § 2. Subdivision (a) of section 31.04 of the  mental  hygiene  law  is
    51  amended by adding a new paragraph 8 to read as follows:
    52    8.  establishing  a  schedule  of  fees  for the purpose of processing
    53  applications for the issuance of operating certificates. All fees pursu-

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

     1  ant to this section shall be payable to the office for deposit into  the
     2  general fund.
     3    §  3.    This  act  shall take effect on the one hundred eightieth day
     4  after it shall have become a law.   Effective immediately,  the  commis-
     5  sioner  of  mental  health is authorized to promulgate any and all rules
     6  and regulations and take any other measures necessary to implement  this
     7  act on its effective date or before such date.
 
     8                                   PART AA
 
     9    Section  1.  This  Part enacts into law legislation relating to crisis
    10  stabilization services, Kendra's law and assisted  outpatient  treatment
    11  and  involuntary commitment. Each component is wholly contained within a
    12  Subpart identified as Subparts A through C. The effective date for  each
    13  particular  provision  contained within each Subpart is set forth in the
    14  last section of such Subpart. Any provision  in  any  section  contained
    15  within  a  Subpart,  including  the effective date of the Subpart, which
    16  makes a reference to a section "of this act", when  used  in  connection
    17  with that particular component, shall be deemed to mean and refer to the
    18  corresponding section of the Subpart in which it is found. Section three
    19  of this Part sets forth the general effective date of this Part.
 
    20                                  SUBPART A
 
    21    Section  1.  The mental hygiene law is amended by adding a new section
    22  31.36 to read as follows:
    23  § 31.36 Crisis stabilization services.
    24    The commissioner shall have the power, in conjunction with the commis-
    25  sioner of the office of  addiction  services  and  supports,  to  create
    26  crisis  stabilization  centers  within New York state in accordance with
    27  article thirty-six of this title, including the  promulgation  of  joint
    28  regulations and implementation of a financing mechanism to allow for the
    29  sustainable operation of such programs.
    30    §  2.  The mental hygiene law is amended by adding a new section 32.36
    31  to read as follows:
    32  § 32.36 Crisis stabilization services.
    33    The commissioner shall have the power, in conjunction with the commis-
    34  sioner of the office of mental health, to  create  crisis  stabilization
    35  centers  within  New York state in accordance with article thirty-six of
    36  this title, including the promulgation of joint regulations  and  imple-
    37  mentation  of  a financing mechanism to allow for the sustainable opera-
    38  tion of such programs.
    39    § 3. The mental hygiene law is amended by adding a new article  36  to
    40  read as follows:
    41                                ARTICLE XXXVI
    42              ADDICTION AND MENTAL HEALTH SERVICES AND SUPPORTS
    43  Section 36.01 Crisis stabilization centers.
    44  § 36.01 Crisis stabilization centers.
    45    (a)  (1)  The  commissioners  are authorized to jointly license crisis
    46  stabilization centers subject to the availability of state  and  federal
    47  funding.
    48    (2)  A crisis stabilization center shall serve as an emergency service
    49  provider for persons with psychiatric and/or substance use disorder that
    50  are in need of crisis stabilization services. Each crisis  stabilization
    51  center  shall  provide  or  contract  to  provide  crisis  stabilization

        S. 2507--A                         82                         A. 3007--A
 
     1  services for mental health or substance use twenty-four hours  per  day,
     2  seven days per week, including but not limited to:
     3    (i) Engagement, triage and assessment;
     4    (ii) Continuous observation;
     5    (iii) Mild to moderate detoxification;
     6    (iv) Sobering services;
     7    (v) Therapeutic interventions;
     8    (vi) Discharge and after care planning;
     9    (vii) Telemedicine;
    10    (viii) Peer support services; and
    11    (ix) Medication assisted treatment.
    12    (3)  The  commissioners shall require each crisis stabilization center
    13  to submit a plan. The plan shall be approved by the commissioners  prior
    14  to  the  issuance  of an operating certificate pursuant to this article.
    15  Each plan shall include:
    16    (i) a description of the center's catchment area,
    17    (ii) a description of the center's crisis stabilization services,
    18    (iii) agreements or affiliations with hospitals as defined in  section
    19  1.03 of this chapter,
    20    (iv) agreements or affiliations with general hospitals or law enforce-
    21  ment to receive persons,
    22    (v)  a  description  of  local  resources  available  to the center to
    23  prevent unnecessary hospitalizations of persons,
    24    (vi) a description of the center's linkages with  local  police  agen-
    25  cies, emergency medical services, ambulance services and other transpor-
    26  tation agencies,
    27    (vii)  a  description  of  local  resources available to the center to
    28  provide appropriate community mental health and substance  use  disorder
    29  services upon release,
    30    (viii)  written  criteria and guidelines for the development of appro-
    31  priate planning for persons in  need  of  post  community  treatment  or
    32  services,
    33    (ix)  a  statement  indicating that the center has been included in an
    34  approved local services plan developed pursuant to article forty-one  of
    35  this  chapter  for  each  local  government  located within the center's
    36  catchment area; and
    37    (x) any other information or agreements required by the commissioners.
    38    (4) Crisis stabilization  centers  shall  participate  in  county  and
    39  community  planning  activities annually, and as additionally needed, in
    40  order to participate in local community service  planning  processes  to
    41  ensure, maintain, improve or develop community services that demonstrate
    42  recovery outcomes. These outcomes include, but are not limited to, qual-
    43  ity  of life, socio-economic status, entitlement status, social network-
    44  ing, coping skills and reduction in use of crisis services.
    45    (b) Each crisis stabilization center shall be staffed with a multidis-
    46  ciplinary team capable of meeting the needs of individuals  experiencing
    47  all  levels  of  crisis  in  the  community  but shall have at least one
    48  psychiatrist or psychiatric nurse practitioner, a credentialed  alcohol-
    49  ism  and  substance  abuse  counselor and one peer support specialist on
    50  duty and available at all times, provided,  however,  the  commissioners
    51  may  promulgate  regulations  to permit the issuance of a waiver of this
    52  requirement when the volume of service of a center does not require such
    53  level of staff coverage.
    54    (c) The commissioners shall promulgate regulations  necessary  to  the
    55  operation of such crisis stabilization centers.

        S. 2507--A                         83                         A. 3007--A
 
     1    (d)  For the purpose of addressing unique rural service delivery needs
     2  and conditions, the commissioners shall provide technical assistance for
     3  the establishment of crisis  stabilization  centers  otherwise  approved
     4  under  the provisions of this section, including technical assistance to
     5  promote  and facilitate the establishment of such centers in rural areas
     6  in the state or combinations of rural counties.
     7    (e) The commissioners shall develop guidelines for educational materi-
     8  als to assist crisis stabilization centers in  educating  local  practi-
     9  tioners,  hospitals,  law  enforcement  and  peers. Such materials shall
    10  include appropriate  education  relating  to  de-escalation  techniques,
    11  cultural competency, the recovery process, mental health, substance use,
    12  and avoidance of aggressive confrontation.
    13    § 4. Section 9.41 of the mental hygiene law, as amended by chapter 723
    14  of the laws of 1989, is amended to read as follows:
    15  § 9.41 Emergency  [admissions]  assessment  for  immediate  observation,
    16             care, and treatment; powers of  certain  peace  officers  and
    17             police officers.
    18    Any  peace officer, when acting pursuant to his or her special duties,
    19  or police officer who is a member of the state police or of  an  author-
    20  ized  police  department  or force or of a sheriff's department may take
    21  into custody any person who appears to be mentally ill and is conducting
    22  himself or herself in a manner which is likely to result in serious harm
    23  to the person or others. Such officer may direct  the  removal  of  such
    24  person  or  remove him or her to: (a) any hospital specified in subdivi-
    25  sion (a) of section 9.39 of  this  article,  or  (b)  any  comprehensive
    26  psychiatric  emergency  program  specified in subdivision (a) of section
    27  9.40 of this article, or[,] (c) to any crisis stabilization center spec-
    28  ified in section 36.01 of this chapter,  when  the  officer  deems  such
    29  center  is  appropriate and where such person agrees, or (d) pending his
    30  or her examination or admission to any such hospital [or],  program,  or
    31  center, temporarily detain any such person in another safe and comforta-
    32  ble  place,  in  which  event, such officer shall immediately notify the
    33  director of community services or, if there be none, the health  officer
    34  of the city or county of such action.
    35    § 5. Section 9.43 of the mental hygiene law, as amended by chapter 723
    36  of the laws of 1989, is amended to read as follows:
    37  § 9.43 Emergency  [admissions]  assessment  for  immediate  observation,
    38             care, and treatment; powers of courts.
    39    (a) Whenever any court of inferior or general jurisdiction is informed
    40  by verified statement that a person is apparently mentally  ill  and  is
    41  conducting  himself  or herself in a manner which in a person who is not
    42  mentally ill would be deemed disorderly conduct or which  is  likely  to
    43  result  in  serious harm to himself or herself, such court shall issue a
    44  warrant directing that such person be brought before it. If,  when  said
    45  person  is  brought  before  the  court, it appears to the court, on the
    46  basis of evidence presented to it, that such person has or  may  have  a
    47  mental  illness  which is likely to result in serious harm to himself or
    48  herself or others, the court shall issue a civil order directing his  or
    49  her removal to any hospital specified in subdivision (a) of section 9.39
    50  of this article or any comprehensive psychiatric emergency program spec-
    51  ified  in  subdivision  (a)  of  section 9.40 of this article, or to any
    52  crisis stabilization center specified in section 36.01 of  this  chapter
    53  when  the  court  deems such center is appropriate and where such person
    54  agrees; that is willing to receive such person for  a  determination  by
    55  the  director  of  such  hospital  [or],  program or center whether such
    56  person should be [retained] received therein pursuant to such section.

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

     1    (b) Whenever a person before a court in a criminal action  appears  to
     2  have  a  mental  illness  which  is  likely to result in serious harm to
     3  himself or herself or others and the court determines  either  that  the
     4  crime  has  not  been committed or that there is not sufficient cause to
     5  believe  that such person is guilty thereof, the court may issue a civil
     6  order as above provided, and in such cases  the  criminal  action  shall
     7  terminate.
     8    § 6. Section 9.45 of the mental hygiene law, as amended by chapter 723
     9  of  the laws of 1989 and the opening paragraph as amended by chapter 192
    10  of the laws of 2005, is amended to read as follows:
    11  § 9.45 Emergency  [admissions]  assessment  for  immediate  observation,
    12             care,   and  treatment;  powers  of  directors  of  community
    13             services.
    14    The director of community services or the  director's  designee  shall
    15  have  the  power  to direct the removal of any person, within his or her
    16  jurisdiction, to a hospital approved by  the  commissioner  pursuant  to
    17  subdivision  (a)  of section 9.39 of this article, or to a comprehensive
    18  psychiatric emergency program pursuant to  subdivision  (a)  of  section
    19  9.40 of this article, or to any crisis stabilization center specified in
    20  section  36.01  of  this  chapter when the director deems such center is
    21  appropriate and where such person agrees, if the parent, adult  sibling,
    22  spouse  or  child  of the person, the committee or legal guardian of the
    23  person, a licensed psychologist, registered professional nurse or certi-
    24  fied  social  worker  currently  responsible  for  providing   treatment
    25  services to the person, a supportive or intensive case manager currently
    26  assigned  to  the  person  by a case management program which program is
    27  approved by the office of mental health for  the  purpose  of  reporting
    28  under  this section, a licensed physician, health officer, peace officer
    29  or police officer reports to him or her that such person  has  a  mental
    30  illness for which immediate care and treatment [in a hospital] is appro-
    31  priate  and  which  is  likely  to  result in serious harm to himself or
    32  herself or others. It shall be the duty of peace officers,  when  acting
    33  pursuant to their special duties, or police officers, who are members of
    34  an authorized police department or force or of a sheriff's department to
    35  assist  representatives of such director to take into custody and trans-
    36  port any such person. Upon  the  request  of  a  director  of  community
    37  services  or the director's designee an ambulance service, as defined in
    38  subdivision two of section three thousand one of the public health  law,
    39  is  authorized  to  transport  any  such person. Such person may then be
    40  retained in a hospital pursuant to the provisions  of  section  9.39  of
    41  this  article or in a comprehensive psychiatric emergency program pursu-
    42  ant to the provisions of section 9.40 of this article or to  any  crisis
    43  stabilization center specified in section 36.01 of this chapter when the
    44  director deems such center is appropriate and where such person agrees.
    45    §  7.    Subdivision (a) of section 9.58 of the mental hygiene law, as
    46  added by chapter 678 of the laws of 1994, is amended to read as follows:
    47    (a) A physician or qualified  mental  health  professional  who  is  a
    48  member  of  an approved mobile crisis outreach team shall have the power
    49  to remove, or pursuant to subdivision (b) of this section, to direct the
    50  removal of any person who appears to be mentally ill and  is  conducting
    51  themselves  in  a  manner  which  is likely to result in serious harm to
    52  themselves or others, to a hospital approved by the commissioner  pursu-
    53  ant  to subdivision (a) of section 9.39 or section 31.27 of this chapter
    54  [for the purpose of evaluation for admission if such person  appears  to
    55  be  mentally  ill and is conducting himself or herself in a manner which
    56  is likely to result in serious harm to the person or  others]  or  where

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     1  the  director deems appropriate and where the person agrees, to a crisis
     2  stabilization center specified in section 36.01 of this chapter.
     3    §  8.  Subdivision  2  of  section 365-a of the social services law is
     4  amended by adding a new paragraph (gg) to read as follows:
     5    (gg) addiction and mental health services  and  supports  provided  by
     6  facilities licensed pursuant to article thirty-six of the mental hygiene
     7  law.
     8    §  9.  Paragraph  5  of subdivision (a) of section 22.09 of the mental
     9  hygiene law, as amended by section 1 of part D of chapter 69 of the laws
    10  of 2016, is amended to read as follows:
    11    5. "Treatment facility" means a facility designated by the commission-
    12  er which may only include a general hospital as defined in article twen-
    13  ty-eight of the public health law, or a medically managed  or  medically
    14  supervised withdrawal, inpatient rehabilitation, or residential stabili-
    15  zation  treatment program that has been certified by the commissioner to
    16  have appropriate medical staff available on-site at all times to provide
    17  emergency services and continued evaluation of capacity  of  individuals
    18  retained  under  this  section or a crisis stabilization center licensed
    19  pursuant to article 36.01 of this chapter.
    20    § 10. The commissioner of health, in consultation with the  office  of
    21  mental  health  and the office of addiction services and supports, shall
    22  seek Medicaid federal financial participation from the  federal  centers
    23  for Medicare and Medicaid services for the federal share of payments for
    24  the services authorized pursuant to this Subpart.
    25    §  11.  This act shall take effect October 1, 2021; provided, however,
    26  that the amendments to sections  9.41,  9.43  and  9.45  of  the  mental
    27  hygiene  law  made  by sections four, five and six of this act shall not
    28  affect the expiration of  such  sections  and  shall  expire  therewith.
    29  Effective immediately, the addition, amendment and/or repeal of any rule
    30  or regulation necessary for the implementation of this act on its effec-
    31  tive  date  are  authorized  to  be made and completed on or before such
    32  effective date.
 
    33                                  SUBPART B
 
    34    Section 1. Paragraph 4 of subdivision (c), paragraph 2 of  subdivision
    35  (h),  paragraph 1 of subdivision (k) and subdivision (l) of section 9.60
    36  of the mental hygiene law, as amended by chapter 158 of the laws of 2005
    37  and paragraph 1 of subdivision (k) as added by chapter 1 of the laws  of
    38  2013, are amended to read as follows:
    39    (4)  has  a  history  of  lack of compliance with treatment for mental
    40  illness that has:
    41    (i) except as otherwise provided in subparagraph (ii)  of  this  para-
    42  graph,  prior  to  the filing of the petition, at least twice within the
    43  last thirty-six months been a significant factor in necessitating hospi-
    44  talization in a hospital, or receipt of services in a forensic or  other
    45  mental  health  unit  of a correctional facility or a local correctional
    46  facility, not including any current period, or period ending within  the
    47  last  six  months,  during  which  the  person was or is hospitalized or
    48  incarcerated; or
    49    (ii) except as otherwise provided in subparagraph (iii) of this  para-
    50  graph, prior to the filing of the petition, resulted in one or more acts
    51  of  serious  violent  behavior  toward  self or others or threats of, or
    52  attempts at, serious physical harm to self or  others  within  the  last
    53  forty-eight  months,  not including any current period, or period ending

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     1  within the last six months, in which the person was or  is  hospitalized
     2  or incarcerated; [and] or
     3    (iii)  notwithstanding  subparagraphs  (i) and (ii) of this paragraph,
     4  resulted in the issuance of an order for assisted  outpatient  treatment
     5  which  has  expired within the last six months, and since the expiration
     6  of the order, the person has experienced a substantial increase in symp-
     7  toms of mental illness and a loss of function.
     8    (2) The court shall not order assisted outpatient treatment unless  an
     9  examining  physician,  who  recommends assisted outpatient treatment and
    10  has personally examined the subject of the petition  no  more  than  ten
    11  days  before  the  filing  of the petition, testifies [in person] at the
    12  hearing. Such physician shall state  the  facts  and  clinical  determi-
    13  nations  which  support  the allegation that the subject of the petition
    14  meets each of the criteria for assisted outpatient treatment.
    15    (1) Prior to the expiration of an order pursuant to this section,  the
    16  appropriate  director  shall  review  whether  the  assisted  outpatient
    17  continues to [meet the criteria for] benefit  from  assisted  outpatient
    18  treatment.  If,  as  documented in the petition, (i) the director deter-
    19  mines that [such criteria continue to be met]: (A) as a result of his or
    20  her mental illness, the outpatient is unlikely  to  voluntarily  partic-
    21  ipate in outpatient treatment that would enable him or her to live safe-
    22  ly in the community; and (B) in view of his or her treatment history and
    23  current  behavior,  is in need of assisted outpatient treatment in order
    24  to prevent a relapse or deterioration which would be likely to result in
    25  serious harm to the person or others as defined in section 9.01 of  this
    26  article;  and  (C)  the  outpatient  is likely to benefit from continued
    27  assisted outpatient treatment; or (ii) the director has made appropriate
    28  attempts to, but has not been successful in eliciting,  the  cooperation
    29  of  the subject to submit to an examination, within thirty days prior to
    30  the expiration of an order of assisted outpatient treatment, such direc-
    31  tor may petition the court to order continued assisted outpatient treat-
    32  ment pursuant to paragraph two of  this  subdivision.  Upon  determining
    33  whether such criteria continue to be met, such director shall notify the
    34  program  coordinator  in  writing as to whether a petition for continued
    35  assisted outpatient treatment is warranted and whether such  a  petition
    36  was or will be filed.
    37    (l)  Petition  for an order to stay, vacate [or], modify or extend the
    38  order. (1) In addition to any other right or  remedy  available  by  law
    39  with  respect  to  the  order  for  assisted  outpatient  treatment, the
    40  assisted outpatient, the mental hygiene legal service, or anyone  acting
    41  on  the assisted outpatient's behalf may petition the court on notice to
    42  the director, the original petitioner, and all others entitled to notice
    43  under subdivision (f) of this section to stay, vacate [or],  modify,  or
    44  extend  the  order.   An application for an extension of a current order
    45  can be made when the appropriate director has made attempts but has  not
    46  been  successful in giving the subject of the petition the notice of the
    47  hearing.
    48    (2) The appropriate director shall petition  the  court  for  approval
    49  before instituting a proposed material change in the assisted outpatient
    50  treatment  plan,  unless  such  change is authorized by the order of the
    51  court. Such petition shall be filed on notice to all parties entitled to
    52  notice under subdivision (f) of this section. Not later than  five  days
    53  after  receiving  such  petition, excluding Saturdays, Sundays and holi-
    54  days, the court shall hold a hearing on the petition; provided  that  if
    55  the  assisted  outpatient informs the court that he or she agrees to the
    56  proposed material change, the court may approve such  change  without  a

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     1  hearing.  Non-material changes may be instituted by the director without
     2  court approval. For the purposes of this paragraph, a material change is
     3  an addition or deletion of a category of services to or from  a  current
     4  assisted  outpatient  treatment  plan,  or  any  deviation  without  the
     5  assisted outpatient's consent from the terms of a current order relating
     6  to the administration of psychotropic drugs.
     7    § 2. This act shall take effect immediately; provided,  however,  that
     8  the amendments to section 9.60 of the mental hygiene law made by section
     9  one of this act shall not affect the repeal of such section and shall be
    10  deemed repealed therewith.
 
    11                                  SUBPART C
 
    12    Section  1.  The  third  undesignated paragraph of section 9.01 of the
    13  mental hygiene law, as amended by chapter 723 of the laws  of  1989,  is
    14  amended to read as follows:
    15    "likelihood to result in serious harm" or "likely to result in serious
    16  harm"  means  (a)  a  substantial risk of physical harm to the person as
    17  manifested by threats of or attempts at suicide or serious  bodily  harm
    18  or  other  conduct demonstrating that the person is dangerous to himself
    19  or herself[,]; or (b) a substantial risk of physical harm to the  person
    20  arising  from  such  complete neglect of basic needs for food, clothing,
    21  shelter or personal safety as to render serious  accident,  illness,  or
    22  death  is  highly  probable  if  care  by another is not taken; or (c) a
    23  substantial risk of physical harm to  other  persons  as  manifested  by
    24  homicidal  or  other  violent  behavior  by  which  others are placed in
    25  reasonable fear of serious physical harm.
    26    § 2. Paragraph 2 of subdivision (a) of  section  9.39  of  the  mental
    27  hygiene  law,  as amended by chapter 789 of the laws of 1985, is amended
    28  and a new paragraph 3 is added to read as follows:
    29    2. a substantial risk of physical harm to other persons as  manifested
    30  by  homicidal  or  other  violent behavior by which others are placed in
    31  reasonable fear of serious physical harm[.], or
    32    3. a substantial risk of physical harm to the person arising from such
    33  complete neglect of basic needs for food, clothing, shelter or  personal
    34  safety as to render serious accident, illness, or death is highly proba-
    35  ble if care by another is not taken.
    36    § 3. This act shall take effect October 1, 2021.
    37    § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
    38  sion,  section  or  part  of  this act shall be adjudged by any court of
    39  competent jurisdiction to be invalid, such judgment  shall  not  affect,
    40  impair,  or  invalidate  the remainder thereof, but shall be confined in
    41  its operation to the clause, sentence, paragraph,  subdivision,  section
    42  or part thereof directly involved in the controversy in which such judg-
    43  ment shall have been rendered. It is hereby declared to be the intent of
    44  the  legislature  that  this  act  would  have been enacted even if such
    45  invalid provisions had not been included herein.
    46    § 3. This act shall take effect immediately; provided,  however,  that
    47  the  applicable effective date of Subparts A through C of this act shall
    48  be as specifically set forth in the last section of such Subparts.
 
    49                                   PART BB
 
    50    Section 1. Subdivision (b) of section 7.17 of the mental hygiene  law,
    51  as  amended by section 1 of part H of chapter 56 of the laws of 2013, is
    52  amended to read as follows:

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     1    (b) There shall be in the office the hospitals  named  below  for  the
     2  care,  treatment  and  rehabilitation of persons with mental illness and
     3  for research and teaching in the science and  skills  required  for  the
     4  care, treatment and rehabilitation of such persons with mental illness.
     5    Greater Binghamton Health Center
     6    Bronx Psychiatric Center
     7    Buffalo Psychiatric Center
     8    Capital District Psychiatric Center
     9    Central New York Psychiatric Center
    10    Creedmoor Psychiatric Center
    11    Elmira Psychiatric Center
    12    Kingsboro Psychiatric Center
    13    Kirby Forensic Psychiatric Center
    14    Manhattan Psychiatric Center
    15    Mid-Hudson Forensic Psychiatric Center
    16    Mohawk Valley Psychiatric Center
    17    Nathan S. Kline Institute for Psychiatric Research
    18    New York State Psychiatric Institute
    19    Pilgrim Psychiatric Center
    20    Richard H. Hutchings Psychiatric Center
    21    Rochester Psychiatric Center
    22    Rockland Psychiatric Center
    23    St. Lawrence Psychiatric Center
    24    South Beach Psychiatric Center
    25    New York City Children's Center
    26    Rockland Children's Psychiatric Center
    27    Sagamore Children's Psychiatric Center
    28    Western New York Children's Psychiatric Center
    29    The  New  York  State  Psychiatric  Institute  and The Nathan S. Kline
    30  Institute for Psychiatric Research are designated as institutes for  the
    31  conduct  of medical research and other scientific investigation directed
    32  towards furthering knowledge of the etiology, diagnosis,  treatment  and
    33  prevention  of mental illness.  The New York State Psychiatric Institute
    34  shall operate, as a sub-entity, the New York State Institute  for  Basic
    35  Research in Developmental Disabilities, which is designated as an insti-
    36  tute  for  the conduct of medical research and other scientific investi-
    37  gation directed towards furthering knowledge of the etiology, diagnosis,
    38  treatment and prevention of developmental disabilities.
    39    § 2. All employees of the office for people with  developmental  disa-
    40  bilities'  New  York State Institute for Basic Research in Developmental
    41  Disabilities, who are substantially  engaged  in  the  functions  to  be
    42  transferred,  will  be  transferred to the office of mental health's New
    43  York State Psychiatric Institute pursuant to subdivision 2 of section 70
    44  of the civil service law.
    45    § 3. This act shall take effect immediately
 
    46                                   PART CC
 
    47    Section 1. Subdivisions 2 and  2-a  of  section  1.03  of  the  mental
    48  hygiene  law,  subdivision  2 as amended and subdivision 2-a as added by
    49  chapter 281 of the laws of 2019, are amended to read as follows:
    50    2. ["Commissioner" means the commissioner of mental  health]  "Commis-
    51  sioner"  means the commissioner of addiction and mental health services,
    52  and the commissioner of developmental disabilities [and the commissioner
    53  of addiction services and supports] as used in this chapter.  Any  power
    54  or  duty heretofore assigned to the commissioner of mental hygiene or to

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     1  the department of mental hygiene pursuant to this chapter shall hereaft-
     2  er be assigned to  the  commissioner  of  addiction  and  mental  health
     3  services  in  the case of facilities, programs, or services for individ-
     4  uals with mental illness, to the commissioner of developmental disabili-
     5  ties  in  the  case of facilities, programs, or services for individuals
     6  with developmental disabilities, to the commissioner  of  addiction  and
     7  mental  health  services  [and  supports]  in  the  case  of facilities,
     8  programs,  or  addiction  disorder  services  in  accordance  with   the
     9  provisions of titles D and E of this chapter.
    10    2-a.  Notwithstanding  any  other section of law or regulation, on and
    11  after the effective date of this subdivision, any and all references  to
    12  the  office of alcoholism and substance abuse services and the predeces-
    13  sor agencies to the office of alcoholism and  substance  abuse  services
    14  including  the division of alcoholism and alcohol abuse and the division
    15  of substance abuse services and all references to the office  of  mental
    16  health,  shall  be  known  as the "office of addiction and mental health
    17  services [and supports]." Nothing in this subdivision shall be construed
    18  as requiring or prohibiting the further amendment of statutes  or  regu-
    19  lations to conform to the provisions of this subdivision.
    20    § 2. Section 5.01 of the mental hygiene law, as amended by chapter 281
    21  of  the  laws of 2019, is amended and two new sections 5.01-a and 5.01-b
    22  are added to read as follows:
    23  § 5.01 Department of mental hygiene.
    24    There shall continue to be in the state  government  a  department  of
    25  mental  hygiene.  Within  the  department  there  shall be the following
    26  autonomous offices:
    27    (1) office of addiction and mental health services; and
    28    (2) office for people with developmental disabilities[;
    29    (3) office of addiction services and supports].
    30  § 5.01-a Office of addiction and mental health services.
    31    (a) The office of  addiction and mental health services shall be a new
    32  office within the department formed by the integration of the offices of
    33  mental health and addiction services and supports which shall  focus  on
    34  issues  related  to  both  mental illness and addiction in the state and
    35  carry out the intent of the  legislature  in  establishing  the  offices
    36  pursuant  to  articles seven and nineteen of this chapter. The office of
    37  addiction and mental health services is charged with ensuring the devel-
    38  opment of comprehensive plans for programs and services in the  area  of
    39  research,  prevention, and care and treatment, rehabilitation, education
    40  and training, and shall  be  staffed  to  perform  the  responsibilities
    41  attributed  to  the  office  pursuant to sections 7.07 and 19.07 of this
    42  chapter and provide services and programs to promote recovery for  indi-
    43  viduals  with  mental illness, substance use disorder, or mental illness
    44  and substance use disorder.
    45    (b) The commissioner of the office  of  addiction  and  mental  health
    46  services shall be vested with the powers, duties, and obligations of the
    47  office  of  mental  health  and  the  office  of  addiction services and
    48  supports.
    49    (c)  The office of addiction and mental health  services  may  license
    50  providers  to  provide  integrated  services for individuals with mental
    51  illness, substance use disorder, or mental  illness  and  substance  use
    52  disorder, in accordance with regulations issued by the commissioner.
    53  § 5.01-b Office of addiction and mental health services.
    54    Until  January first, two thousand twenty-two, the office of addiction
    55  and mental health services shall consist of the office of mental  health
    56  and the office of addiction services and supports.

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     1    § 3. Section 5.03 of the mental hygiene law, as amended by chapter 281
     2  of the laws of 2019, is amended to read as follows:
     3  § 5.03 Commissioners.
     4    The  head  of the office of addiction and mental health services shall
     5  be the commissioner of addiction and mental  health  services;  and  the
     6  head  of  the office for people with developmental disabilities shall be
     7  the commissioner of developmental disabilities[; and  the  head  of  the
     8  office  of  addiction services and supports shall be the commissioner of
     9  addiction services and supports]. Each commissioner shall  be  appointed
    10  by  the  governor,  by and with the advice and consent of the senate, to
    11  serve at the pleasure of  the  governor.    Until  the  commissioner  of
    12  addiction  and  mental  health services is appointed by the governor and
    13  confirmed by the senate, the  commissioner  of  mental  health  and  the
    14  commissioner  of addiction services and supports shall continue to over-
    15  see mental health and addiction services respectively, and work collabo-
    16  ratively to integrate care for individuals with both mental  health  and
    17  substance use disorders.
    18    §  4.  Section 5.05 of the mental hygiene law, as added by chapter 978
    19  of the laws of 1977, subdivision (a) as amended by chapter  168  of  the
    20  laws  of  2010, subdivision (b) as amended by chapter 294 of the laws of
    21  2007, paragraph 1 of subdivision (b) as amended by section 14 of part  J
    22  of  chapter  56 of the laws of 2012, subdivision (d) as added by chapter
    23  58 of the laws of 1988 and subdivision (e) as added by  chapter  588  of
    24  the laws of 2011, is amended to read as follows:
    25  § 5.05 Powers and duties of the head of the department.
    26    (a)  The  commissioners  of  the office of addiction and mental health
    27  services and the office for people with developmental  disabilities,  as
    28  the  heads  of the department, shall jointly visit and inspect, or cause
    29  to be visited and inspected, all facilities  either  public  or  private
    30  used  for  the  care,  treatment  and rehabilitation of individuals with
    31  mental illness, substance use disorder and developmental disabilities in
    32  accordance with the requirements of section four of article seventeen of
    33  the New York state constitution.
    34    (b) (1) The commissioners  of  the  office  of  addiction  and  mental
    35  health[,] services and the office for people with developmental disabil-
    36  ities  [and the office of alcoholism and substance abuse services] shall
    37  constitute an inter-office coordinating council which,  consistent  with
    38  the  autonomy  of each office for matters within its jurisdiction, shall
    39  ensure that the state policy for the  prevention,  care,  treatment  and
    40  rehabilitation  of individuals with mental illness, substance use disor-
    41  ders  and  developmental  disabilities[,  alcoholism,   alcohol   abuse,
    42  substance  abuse,  substance  dependence,  and  chemical  dependence] is
    43  planned,  developed  and  implemented  comprehensively;  that  gaps   in
    44  services  to  individuals  with multiple disabilities are eliminated and
    45  that no person is denied treatment and services because he  or  she  has
    46  more than one disability; that procedures for the regulation of programs
    47  which  offer  care and treatment for more than one class of persons with
    48  mental disabilities be coordinated between the offices having  jurisdic-
    49  tion  over  such programs; and that research projects of the institutes,
    50  as identified in section 7.17 [or], 13.17, or 19.17 of this  chapter  or
    51  as  operated  by  the office for people with developmental disabilities,
    52  are coordinated to maximize the success and cost effectiveness  of  such
    53  projects and to eliminate wasteful duplication.
    54    (2)  The  inter-office  coordinating  council  shall  annually issue a
    55  report on its activities to the legislature on or before December  thir-
    56  ty-first.   Such annual report shall include, but not be limited to, the

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

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     1  report a plan to achieve the staffing requirements  and  the  length  of
     2  time necessary to meet these requirements.]
     3    (e)  The commissioners of the office of addiction and mental health[,]
     4  services and the office for people with developmental disabilities[, and
     5  the office of alcoholism and substance abuse services]  shall  cause  to
     6  have  all  new  contracts  with  agencies  and providers licensed by the
     7  offices to have a clause requiring notice be provided to all current and
     8  new employees of such agencies and providers stating that all  instances
     9  of  abuse  shall  be  investigated  pursuant to this chapter, and, if an
    10  employee leaves employment prior to the conclusion of  a  pending  abuse
    11  investigation, the investigation shall continue. Nothing in this section
    12  shall  be  deemed to diminish the rights, privileges, or remedies of any
    13  employee under any other law  or  regulation  or  under  any  collective
    14  bargaining agreement or employment contract.
    15    §  5.  Section 7.01 of the mental hygiene law, as added by chapter 978
    16  of the laws of 1977, is amended to read as follows:
    17  § 7.01 Declaration of policy.
    18    The state of New York and its local governments have a  responsibility
    19  for  the  prevention  and  early detection of mental illness and for the
    20  comprehensively planned care,  treatment  and  rehabilitation  of  their
    21  mentally ill citizens.
    22    Therefore, it shall be the policy of the state to conduct research and
    23  to  develop  programs  which  further  prevention and early detection of
    24  mental illness; to develop a comprehensive, integrated system of  treat-
    25  ment  and  rehabilitative  services  for the mentally ill. Such a system
    26  should include, whenever possible, the provision of necessary  treatment
    27  services  to  people  in  their  home  communities; it should assure the
    28  adequacy and appropriateness of residential arrangements for  people  in
    29  need  of  service; and it should rely upon improved programs of institu-
    30  tional care only when necessary and appropriate. Further, such a  system
    31  should  recognize  the  important  therapeutic  roles of all disciplines
    32  which may contribute to the care or treatment of the mentally ill,  such
    33  as  psychology,  social work, psychiatric nursing, special education and
    34  other disciplines in the field of mental illness, as well as  psychiatry
    35  and  should  establish accountability for implementation of the policies
    36  of the state with regard to the care and rehabilitation of the  mentally
    37  ill.
    38    To  facilitate  the  implementation  of  these policies and to further
    39  advance the interests of the mentally ill  and  their  families,  a  new
    40  autonomous  agency  to  be  known  as the office of addiction and mental
    41  health services has been established by this article. The office and its
    42  commissioner shall plan and work with local governments, voluntary agen-
    43  cies and all providers and consumers of mental health services in  order
    44  to develop an effective, integrated, comprehensive system for the deliv-
    45  ery  of  all services to the mentally ill and to create financing proce-
    46  dures and mechanisms to support such a system of services to ensure that
    47  mentally ill persons in  need  of  services  receive  appropriate  care,
    48  treatment and rehabilitation close to their families and communities. In
    49  carrying  out  these  responsibilities,  the office and its commissioner
    50  shall make full use of existing  services  in  the  community  including
    51  those provided by voluntary organizations.
    52    §  6. Section 19.01 of the mental hygiene law, as added by chapter 223
    53  of the laws of 1992, is amended to read as follows:
    54  § 19.01 Declaration of policy.
    55    The legislature declares the following:

        S. 2507--A                         93                         A. 3007--A

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

        S. 2507--A                         94                         A. 3007--A
 
     1  [alcoholism and substance abuse] addiction and mental health services in
     2  furtherance of a comprehensive service delivery system.
     3    §  7.  Upon  or prior to January 1, 2022, the governor may nominate an
     4  individual to serve as commissioner  of  the  office  of  addiction  and
     5  mental  health  services.  If such individual is confirmed by the senate
     6  prior to January 1, 2022, they shall  become  the  commissioner  of  the
     7  office  of addiction and mental health services. The governor may desig-
     8  nate a person to exercise the powers of the commissioner of  the  office
     9  of  addiction  and  mental  health  services  on  an acting basis, until
    10  confirmation of a nominee by the senate, who  is  hereby  authorized  to
    11  take  such  actions as are necessary and proper to implement the orderly
    12  transition of the  functions,  powers  as  duties  as  herein  provided,
    13  including  the preparation for a budget request for the office as estab-
    14  lished by this act.
    15    § 8. Upon the transfer pursuant to  this  act  of  the  functions  and
    16  powers  possessed by and all of the obligations and duties of the office
    17  of mental health and the office of addiction services  and  supports  as
    18  established  pursuant  to  the mental hygiene law and other laws, to the
    19  office of addiction and mental health services  as  prescribed  by  this
    20  act,  provision shall be made for the transfer of all employees from the
    21  office of mental  health  and  the  office  of  addiction  services  and
    22  supports  into  the  office  of  addiction  and  mental health services.
    23  Employees so transferred shall be transferred without  further  examina-
    24  tion  or qualification to the same or similar titles and shall remain in
    25  the same collective bargaining units and shall retain  their  respective
    26  civil  service  classifications,  status,  and  rights pursuant to their
    27  collective bargaining units and collective bargaining agreements.
    28    § 9. Notwithstanding any contrary provision of law, on or before Octo-
    29  ber 1, 2021 and annually thereafter, the office of addiction and  mental
    30  health    services, in consultation with the department of health, shall
    31  issue a report, and post such report on their public website,  detailing
    32  the  office's  expenditures for mental health and addiction services and
    33  supports, including total Medicaid spending directly  by  the  state  to
    34  licensed  or designated providers and payments to managed care providers
    35  pursuant to section 364-j of the social  services  law.  The  office  of
    36  addiction  and  mental  health  services  shall examine reports produced
    37  pursuant to this section and may make recommendations  to  the  governor
    38  and  the  legislature  regarding  appropriations  for  mental health and
    39  addiction services and supports or other provisions of law which may  be
    40  necessary  to effectively implement the creation and continued operation
    41  of the office.
    42    § 10. Severability. If any clause,  sentence,  paragraph,  section  or
    43  part  of  this act shall be adjudged by any court of competent jurisdic-
    44  tion to be invalid, such judgment shall not affect, impair or invalidate
    45  the remainder thereof, but shall be confined in  its  operation  to  the
    46  clause,  sentence,  paragraph, section or part thereof directly involved
    47  in the controversy in which such judgment shall have been rendered.
    48    § 11. This act shall take effect immediately.  Effective  immediately,
    49  the  office  of  mental  health and the office of addiction services and
    50  supports are authorized to promulgate  the  addition,  amendment  and/or
    51  repeal of any rule or regulation or engage in any work necessary for the
    52  implementation  of  this act on its effective date authorized to be made
    53  and completed on or before such effective date.

    54                                   PART DD

        S. 2507--A                         95                         A. 3007--A
 
     1    Section 1. This act shall be known and may be cited as the "comprehen-
     2  sive outpatient services act of 2021".
     3    §  2.  Section 364-m of the social services law is amended by adding a
     4  new subdivision 6 to read as follows:
     5    6. Comprehensive outpatient services centers. (a)  Definitions.    For
     6  the  purpose of this article, unless the context clearly requires other-
     7  wise:
     8    (i) "Mental health services"  means  services  for  the  treatment  of
     9  mental illness.
    10    (ii)   "Addiction  services"  means  services  for  the  treatment  of
    11  addiction disorders.
    12    (iii) "Comprehensive outpatient services" means the systematic coordi-
    13  nation of evidence-based health care services, to include the  preventa-
    14  tive,  diagnostic,  therapeutic and rehabilitative care and treatment of
    15  mental illness, addiction and the provision of physical health services,
    16  otherwise provided by a  diagnostic  and  treatment  center  or  general
    17  hospital  outpatient  program  pursuant  to  article twenty-eight of the
    18  public health law, a mental health clinic licensed pursuant  to  article
    19  thirty-one of the mental hygiene law, or an addiction provider certified
    20  pursuant  to article thirty-two of the mental hygiene law to an individ-
    21  ual seeking services regardless of their  primary  diagnosis  or  health
    22  complaint;  provided,  however,  that  the scope of such services may be
    23  restricted pursuant to regulation.
    24    (iv) "Comprehensive outpatient  services  centers"  means  a  facility
    25  approved in accordance with this section to provide comprehensive outpa-
    26  tient  services  in  order to promote health and better outcomes for the
    27  recipient, particularly for populations at risk.
    28    (v) "Medical director" is a  physician  who  is  responsible  for  the
    29  services  delivered  by  the comprehensive outpatient services provider,
    30  for the overall direction of the services provided and the direct super-
    31  vision of medical staff in the delivery of services.
    32    (vi) "Physical health services" means services provided  by  a  physi-
    33  cian, physician's assistant, nurse practitioner, or midwife acting with-
    34  in  his  or her lawful scope of practice under title eight of the educa-
    35  tion law and who is practicing in a primary care specialty.
    36    (b) Notwithstanding any law, rule, or regulation to the contrary,  the
    37  commissioners  of the department of health, the office of mental health,
    38  and the office of addiction services  and  supports  are  authorized  to
    39  jointly  establish  a single set of licensing standards and requirements
    40  for the construction, operation, reporting and surveillance  of  compre-
    41  hensive  outpatient  services  centers.  Such standards and requirements
    42  shall include, but not be limited to:
    43    (i) scope of comprehensive outpatient services;
    44    (ii) creation of an efficient application review process  for  compre-
    45  hensive outpatient services centers;
    46    (iii)  facilitation  of  integrated treatment records that comply with
    47  applicable federal and state confidentiality requirements;
    48    (iv) optimal use of clinical resources, including the development of a
    49  workforce capable of  providing  comprehensive  care  to  an  individual
    50  utilizing evidence-based approaches to integrated treatment;
    51    (v)  development of billing and reimbursement structures to enable the
    52  provision of comprehensive services to individuals regardless  of  their
    53  primary diagnosis or healthcare complaint;
    54    (vi)  reasonable  physical  plant  standards to foster proper care and
    55  treatment;

        S. 2507--A                         96                         A. 3007--A
 
     1    (vii) standards for incident reporting  and  remediation  pursuant  to
     2  article eleven of the social services law; and
     3    (viii)  standards  for  adverse event reporting, provided however that
     4  any such adverse event reports shall be kept confidential and shall  not
     5  be subject to disclosure under article six of the public officers law or
     6  article thirty-one of the civil practice law and rules.
     7    (c) A provider shall not be authorized to provide comprehensive outpa-
     8  tient  services  unless  they have sufficiently demonstrated, consistent
     9  with the standards and requirements set forth by the commissioners:
    10    (i) experience  in  the  delivery  of  physical,  mental  health,  and
    11  addiction services;
    12    (ii)  capacity  to  offer  comprehensive  outpatient  services in each
    13  comprehensive outpatient services center approved by each of the commis-
    14  sioners of the department of health, the office of  mental  health,  and
    15  the office of addiction services and supports; and
    16    (iii)  compliance  with standards established pursuant to this section
    17  for  providing  and  receiving  payment  for  comprehensive   outpatient
    18  services.
    19    (d)  Notwithstanding  any  provision  of  law to the contrary, for the
    20  purposes of this subdivision, comprehensive outpatient service providers
    21  shall be considered contracted, approved or otherwise authorized by  the
    22  office  of  addiction  services  and  supports  and the office of mental
    23  health for the purpose of sections 19.20,  19.20-a,  and  31.35  of  the
    24  mental hygiene law, as may be applicable. Providers shall be required to
    25  comply  with  the review of criminal history information, as required in
    26  such sections, for prospective employees or  volunteers  who  will  have
    27  regular  and  substantial  unsupervised or unrestricted physical contact
    28  with the clients of such provider.
    29    (e) The commissioners of the  department  of  health,  the  office  of
    30  mental  health,  and  the  office of addiction services and supports are
    31  authorized to promulgate any regulatory requirements necessary to imple-
    32  ment comprehensive outpatient  services  centers  consistent  with  this
    33  section, including amending existing requirements.
    34    §  3.  Subdivision  4  of  section  488  of the social services law is
    35  amended by adding a new paragraph (a-1) to read as follows:
    36    (a-1) a comprehensive outpatient services center which is licensed, or
    37  certified  by  section  three  hundred  sixty-four-m  of  this  chapter,
    38  provided however that such term shall not include the provision of phys-
    39  ical health services rendered in such facility or program;
    40    §  4.  Subdivision  1  of  section  2801  of the public health law, as
    41  amended by section 1 of part Z of chapter 57 of the  laws  of  2019,  is
    42  amended to read as follows:
    43    1.  "Hospital"  means a facility or institution engaged principally in
    44  providing services by or under the supervision of a physician or, in the
    45  case of a dental clinic or dental dispensary, of a dentist, or,  in  the
    46  case  of  a  midwifery  birth  center, of a midwife, for the prevention,
    47  diagnosis or treatment of human  disease,  pain,  injury,  deformity  or
    48  physical  condition,  including, but not limited to, a general hospital,
    49  public health center, diagnostic center, treatment center, dental  clin-
    50  ic,  dental dispensary, rehabilitation center other than a facility used
    51  solely for vocational rehabilitation, nursing home, tuberculosis  hospi-
    52  tal,  chronic  disease  hospital,  maternity  hospital,  midwifery birth
    53  center,  lying-in-asylum,  out-patient  department,  out-patient  lodge,
    54  dispensary  and  a laboratory or central service facility serving one or
    55  more such institutions, but the  term  hospital  shall  not  include  an
    56  institution, sanitarium or other facility engaged principally in provid-

        S. 2507--A                         97                         A. 3007--A
 
     1  ing  services for the prevention, diagnosis or treatment of mental disa-
     2  bility and which is subject to the powers  of  visitation,  examination,
     3  inspection  and investigation of the department of mental hygiene except
     4  for  those  distinct  parts  of  such  a facility which provide hospital
     5  service. The provisions of this article shall not apply to a facility or
     6  institution engaged principally in providing services by  or  under  the
     7  supervision of the bona fide members and adherents of a recognized reli-
     8  gious  organization  whose teachings include reliance on spiritual means
     9  through prayer alone for healing in the practice of the religion of such
    10  organization and where services are provided in  accordance  with  those
    11  teachings.  No  provision  of this article or any other provision of law
    12  shall be construed to: (a) limit the volume  of  primary  care  services
    13  that  can  be  provided by comprehensive outpatient services centers, as
    14  defined in section three hundred sixty-four-m  of  the  social  services
    15  law;  (b)  limit  the  volume  of  mental health, substance use disorder
    16  services or developmental disability services that can be provided by  a
    17  provider  of  primary  care  services  licensed  under  this article and
    18  authorized to provide integrated services in accordance with regulations
    19  issued by the commissioner in consultation with the commissioner of  the
    20  office  of  mental health, the commissioner of the office of [alcoholism
    21  and substance abuse services] addiction services and  supports  and  the
    22  commissioner  of  the office for people with developmental disabilities,
    23  including regulations issued pursuant to subdivision  seven  of  section
    24  three hundred sixty-five-l of the social services law or part L of chap-
    25  ter  fifty-six  of  the laws of two thousand twelve; [(b)] (c) require a
    26  provider licensed pursuant to article thirty-one of the  mental  hygiene
    27  law  or  certified  pursuant to article sixteen or article thirty-two of
    28  the mental hygiene law to  obtain  an  operating  certificate  from  the
    29  department  if  such  provider has been authorized to provide integrated
    30  services in accordance with regulations issued by  the  commissioner  in
    31  consultation  with  the commissioner of the office of mental health, the
    32  commissioner of the office of [alcoholism and substance abuse  services]
    33  addiction  services  and supports and the commissioner of the office for
    34  people with developmental  disabilities,  including  regulations  issued
    35  pursuant  to  subdivision seven of section three hundred sixty-five-l of
    36  the social services law or part L of chapter fifty-six of  the  laws  of
    37  two thousand twelve.
    38    §  5.  Subdivision  (f) of section 31.02 of the mental hygiene law, as
    39  amended by section 2 of part Z of chapter 57 of the  laws  of  2019,  is
    40  amended to read as follows:
    41    (f)  No  provision of this article or any other provision of law shall
    42  be construed to require a provider licensed pursuant to article  twenty-
    43  eight  of the public health law or certified pursuant to article sixteen
    44  or article thirty-two of this chapter to obtain an operating certificate
    45  from the office of mental health if such provider has been authorized to
    46  provide integrated services in accordance with regulations issued by the
    47  commissioner of the office of mental health  in  consultation  with  the
    48  commissioner of the department of health, the commissioner of the office
    49  of  [alcoholism  and  substance  abuse  services] addiction services and
    50  supports and the commissioner of the office  for  people  with  develop-
    51  mental  disabilities,  including regulations issued pursuant to subdivi-
    52  sion seven of section three hundred sixty-five-l of the social  services
    53  law  or  part L of chapter fifty-six of the laws of two thousand twelve.
    54  Furthermore, except as provided in paragraph (d) of subdivision  six  of
    55  section  three  hundred  sixty-four-m  of  the  social  services law, no
    56  provision of this article  or  any  other  provision  of  law  shall  be

        S. 2507--A                         98                         A. 3007--A
 
     1  construed  to  limit  the  volume  of mental health services that can be
     2  provided by comprehensive outpatient services  centers,  as  defined  in
     3  section three hundred sixty-four-m of the social services law.
     4    §  6.  Subdivision  (b) of section 32.05 of the mental hygiene law, as
     5  amended by section 3 of part Z of chapter 57 of the  laws  of  2019,  is
     6  amended to read as follows:
     7    (b)  (i)  Methadone,  or such other controlled substance designated by
     8  the commissioner of health as appropriate for such use, may be  adminis-
     9  tered  to  an  addict, as defined in section thirty-three hundred two of
    10  the public health law, by individual physicians,  groups  of  physicians
    11  and  public  or private medical facilities certified pursuant to article
    12  twenty-eight or thirty-three of the public health law as part of a chem-
    13  ical dependence program which has been issued an  operating  certificate
    14  by the commissioner pursuant to subdivision (b) of section 32.09 of this
    15  article,  provided,  however,  that  such administration must be done in
    16  accordance with all applicable federal and state laws  and  regulations.
    17  Individual physicians or groups of physicians who have obtained authori-
    18  zation  from  the  federal  government  to  administer  buprenorphine to
    19  addicts may do so without obtaining an operating  certificate  from  the
    20  commissioner.  (ii)  No provision of this article or any other provision
    21  of law shall be construed to require a  provider  licensed  pursuant  to
    22  article  twenty-eight  of  the  public health law, article thirty-one of
    23  this chapter or a provider certified pursuant to article sixteen of this
    24  chapter to obtain an operating certificate from the office of  [alcohol-
    25  ism  and  substance  abuse  services] addiction services and supports if
    26  such provider has been authorized  to  provide  integrated  services  in
    27  accordance  with  regulations  issued by the commissioner of [alcoholism
    28  and substance abuse services] addiction services and supports in consul-
    29  tation with the commissioner of the department of  health,  the  commis-
    30  sioner of the office of mental health and the commissioner of the office
    31  for people with developmental disabilities, including regulations issued
    32  pursuant  to  subdivision seven of section three hundred sixty-five-l of
    33  the social services law or part L of chapter fifty-six of  the  laws  of
    34  two  thousand twelve.   Furthermore, except as provided in paragraph (d)
    35  of subdivision six of section three hundred sixty-four-m of  the  social
    36  services law, no provision of this article or any other provision of law
    37  shall be construed to limit the volume of addiction services that can be
    38  provided  by  comprehensive  outpatient  services centers, as defined in
    39  section three hundred sixty-four-m of the social services law.
    40    § 7. This act shall take effect January 1,  2022;  provided,  however,
    41  that  the amendments to section 364-m of the social services law made by
    42  section two of this act shall not affect the repeal of such section  and
    43  shall  be deemed to repeal therewith. Effective immediately, the commis-
    44  sioner of the department of health, the commissioner of  the  office  of
    45  mental  health  and the commissioner of the office of addiction services
    46  and supports are authorized to issue any rule  or  regulation  necessary
    47  for the implementation of this act on or before its effective date.
 
    48                                   PART EE
 
    49    Section  1.  Subdivision  10  of  section  553 of the executive law is
    50  REPEALED.
    51    § 2. This act shall take effect April 1, 2021.
 
    52                                   PART FF

        S. 2507--A                         99                         A. 3007--A
 
     1    Section 1.  Subdivision 3 of section 2999-h of the public health  law,
     2  as  amended  by  chapter  4  of  the laws of 2017, is amended to read as
     3  follows:
     4    3.  "Qualifying health care costs" means the future medical, hospital,
     5  surgical, nursing, dental, rehabilitation, habilitation, respite, custo-
     6  dial care provided  in  a  residential  health  care  facility,  durable
     7  medical  equipment,  home  modifications,  assistive technology, vehicle
     8  modifications,  transportation  for  purposes  of  health  care  related
     9  appointments,  prescription  and non-prescription medications, and other
    10  health care  costs  actually  incurred  for  services  rendered  to  and
    11  supplies  utilized  by qualified plaintiffs, which are necessary to meet
    12  their health care needs, as determined  by  their  treating  physicians,
    13  physician assistants, or nurse practitioners and as otherwise defined by
    14  the commissioner in regulation.
    15    §  2. Subdivisions 2 and 4 of section 2999-j of the public health law,
    16  subdivision 2 as amended by section 3 of part K of  chapter  57  of  the
    17  laws  of 2019 and subdivision 4 as amended by chapter 517 of the laws of
    18  2016, are amended to read as follows:
    19    2. (a) The provision of qualifying  health  care  costs  to  qualified
    20  plaintiffs  shall  not  be  subject  to  prior  authorization, except as
    21  described by the commissioner in regulation; provided, however:
    22    [(a)] (i) such regulation shall not prevent qualified plaintiffs  from
    23  receiving  care  or  assistance  that would, at a minimum, be authorized
    24  under the medicaid program;
    25    [(b)] (ii) if any prior authorization is required by such  regulation,
    26  the  regulation  shall  require that requests for prior authorization be
    27  processed within a reasonably prompt period of time and shall identify a
    28  process for prompt administrative review of any denial of a request  for
    29  prior authorization; and
    30    [(c)] (iii) such regulations shall not prohibit qualifying health care
    31  costs  on  the  grounds  that  the qualifying health care cost may inci-
    32  dentally benefit other members of the household, provided  that  whether
    33  the  qualifying  health  care cost primarily benefits the patient may be
    34  considered.
    35    (b) Under no circumstances shall a parent, or a guardian residing with
    36  the enrollee, who is legally required to provide care and support  to  a
    37  qualified  plaintiff be approved as a provider of qualifying health care
    38  costs reimbursable by the fund.
    39    4. The amount of qualifying health care costs to be paid from the fund
    40  shall be calculated on the basis of one hundred percent of the usual and
    41  customary cost. For the purposes of this section, "usual  and  customary
    42  costs"  shall  mean  the  eightieth  percentile  of  all charges for the
    43  particular health care service performed by a provider in  the  same  or
    44  similar specialty and provided in the same geographical area as reported
    45  in a benchmarking database maintained by a nonprofit organization speci-
    46  fied  by  the superintendent of financial services. If no such rates are
    47  available qualifying health care costs shall be calculated on the  basis
    48  of  no  less  than one hundred thirty percent of Medicaid or one hundred
    49  percent of Medicare rates of reimbursement, whichever is higher.  If  no
    50  such  rate  exists,  costs shall be reimbursed as defined by the commis-
    51  sioner in regulation.
    52    § 3. This act shall take effect immediately and  shall  be  deemed  to
    53  have been in full force and effect on and after April 1, 2021; provided,
    54  however,  that  the amendments to subdivision 4 of section 2999-j of the
    55  public health law made by section two of this act shall not  affect  the
    56  expiration of such subdivision and shall be deemed to expire therewith.

        S. 2507--A                         100                        A. 3007--A
 
     1                                   PART GG
 
     2    Section  1.  Subdivision  1 of section 12 of the public health law, as
     3  amended by section 16 of part A of chapter 58 of the laws  of  2008,  is
     4  amended and a new paragraph (e) is added to read as follows:
     5    1.  (a)  Except as provided in paragraphs (b) and (c) of this subdivi-
     6  sion, any person who  violates,  disobeys  or  disregards  any  term  or
     7  provision  of  this chapter or of any lawful notice, order or regulation
     8  pursuant thereto for which a civil penalty is  not  otherwise  expressly
     9  prescribed  by  law,  shall  be  liable to the people of the state for a
    10  civil penalty [of] not to exceed [two] ten thousand  dollars  for  every
    11  such violation.
    12    (b)  The penalty provided for in paragraph (a) of this subdivision may
    13  be increased to an amount not to exceed [five] fifteen thousand  dollars
    14  for  a  subsequent violation if the person committed the same violation,
    15  with respect to the same or any other person or persons,  within  twelve
    16  months  of the initial violation for which a penalty was assessed pursu-
    17  ant to paragraph (a) of this subdivision  and  said  violations  were  a
    18  serious threat to the health and safety of an individual or individuals.
    19    (c)  The penalty provided for in paragraph (a) of this subdivision may
    20  be increased to an amount  not  to  exceed  [ten]  twenty-five  thousand
    21  dollars  if  the  violation directly results in serious physical harm to
    22  any patient or patients.
    23    (d) Effective on and after April first, two thousand  [eight]  twenty-
    24  one the comptroller is hereby authorized and directed to deposit amounts
    25  collected  in excess of [two] ten thousand dollars but less than fifteen
    26  thousand dollars per violation to the patient safety center  account  to
    27  be  used  for purposes of the patient safety center created by title two
    28  of article twenty-nine-D of this chapter.
    29    (e) Effective on and  after  April  first,  two  thousand  twenty-one,
    30  amounts collected for violations of article twenty-eight, thirty-six, or
    31  forty  of this chapter equal to or in excess of fifteen thousand dollars
    32  per violation may be used by the commissioner,  notwithstanding  section
    33  one  hundred twelve or one hundred sixty-three of the state finance law,
    34  for initiatives that, in the discretion of the commissioner, are  likely
    35  to  improve  the quality of care or quality of life of patients or resi-
    36  dents served by providers licensed  pursuant  to  article  twenty-eight,
    37  thirty-six, or forty of this chapter. Such purposes may include, but are
    38  not  limited  to,  surveillance  and  inspection  activities; activities
    39  designed to improve the quality, performance and  compliance  of  poorly
    40  performing  providers;  training  and  education  of provider staff; and
    41  improving patient, resident, and consumer involvement in initiatives  to
    42  improve patient and resident quality of care or quality of life.
    43    §  2. Subdivision 1 of section 12 of the public health law, as amended
    44  by chapter 190 of the laws of 1990, is amended and four  new  paragraphs
    45  (b), (c), (d) and (e) are added to read as follows:
    46    1.  [Any]  (a)  Except  as  provided in paragraphs (b) and (c) of this
    47  subdivision, any person who violates, disobeys or disregards any term or
    48  provision of this chapter or of any lawful notice, order  or  regulation
    49  pursuant  thereto  for  which a civil penalty is not otherwise expressly
    50  prescribed by law, shall be liable to the people  of  the  state  for  a
    51  civil  penalty  [of]  not to exceed [two] ten thousand dollars for every
    52  such violation.
    53    (b) The penalty provided for in paragraph (a) of this subdivision  may
    54  be  increased  to an amount not to exceed fifteen thousand dollars for a
    55  subsequent violation if the person committed the  same  violation,  with

        S. 2507--A                         101                        A. 3007--A
 
     1  respect to the same or any other person or persons, within twelve months
     2  of  the  initial  violation for which a penalty was assessed pursuant to
     3  paragraph (a) of this subdivision and said  violations  were  a  serious
     4  threat to the health and safety of an individual or individuals.
     5    (c)  The penalty provided for in paragraph (a) of this subdivision may
     6  be increased to an amount not to exceed twenty-five thousand dollars  if
     7  the  violation  directly results in serious physical harm to any patient
     8  or patients.
     9    (d) Effective on and after April first, two  thousand  twenty-one  the
    10  comptroller  is  hereby  authorized  and  directed  to  deposit  amounts
    11  collected in excess of ten thousand dollars but less than fifteen  thou-
    12  sand  dollars  per  violation to the patient safety center account to be
    13  used for purposes of the patient safety center created by title  two  of
    14  article twenty-nine-D of this chapter.
    15    (e)  Effective  on  and  after  April  first, two thousand twenty-one,
    16  amounts collected for violations of article twenty-eight, thirty-six, or
    17  forty of this chapter equal to or in excess of fifteen thousand  dollars
    18  per  violation  may be used by the commissioner, notwithstanding section
    19  one hundred twelve or one hundred sixty-three of the state finance  law,
    20  for  initiatives that, in the discretion of the commissioner, are likely
    21  to improve the quality of care or quality of life of patients  or  resi-
    22  dents  served  by  providers  licensed pursuant to article twenty-eight,
    23  thirty-six, or forty of this chapter. Such purposes may include, but are
    24  not limited  to,  surveillance  and  inspection  activities;  activities
    25  designed  to  improve  the quality, performance and compliance of poorly
    26  performing providers; training and  education  of  provider  staff;  and
    27  improving  patient, resident, and consumer involvement in initiatives to
    28  improve patient and resident quality of care or quality of life.
    29    § 3. Subdivision 2 of section  12-b  of  the  public  health  law,  as
    30  amended  by  section  17 of part A of chapter 58 of the laws of 2008, is
    31  amended to read as follows:
    32    2. A person who wilfully violates any provision of  this  chapter,  or
    33  any  regulation  lawfully  made  or established by any public officer or
    34  board under authority of this  chapter,  the  punishment  for  violating
    35  which  is  not otherwise prescribed by this chapter or any other law, is
    36  punishable by imprisonment not exceeding one year,  or  by  a  fine  not
    37  exceeding  [ten]  twenty-five  thousand dollars or by both. Effective on
    38  and after April first, two thousand [eight] twenty-one  the  comptroller
    39  is hereby authorized and directed to deposit amounts collected in excess
    40  of [two] ten thousand dollars but less than fifteen thousand dollars per
    41  violation  to  the patient safety center account to be used for purposes
    42  of the patient safety center created by title  two  of  article  twenty-
    43  nine-D of this chapter. Effective on and after April first, two thousand
    44  twenty-one,  amounts  collected  for violations of article twenty-eight,
    45  thirty-six, or forty of this chapter equal to or in  excess  of  fifteen
    46  thousand  dollars per violation may be used by the commissioner pursuant
    47  to paragraph (e) of subdivision one of section twelve of this chapter.
    48    § 4. Subdivision 2 of section  12-b  of  the  public  health  law,  as
    49  amended  by  chapter  463  of  the  laws  of 1969, is amended to read as
    50  follows:
    51    2. A person who wilfully violates any provision of  this  chapter,  or
    52  any  regulation  lawfully  made  or established by any public officer or
    53  board under authority of this  chapter,  the  punishment  for  violating
    54  which  is  not otherwise prescribed by this chapter or any other law, is
    55  punishable by imprisonment not exceeding one year,  or  by  a  fine  not
    56  exceeding  [two]  twenty-five  thousand dollars or by both. Effective on

        S. 2507--A                         102                        A. 3007--A
 
     1  and after April first, two thousand twenty-one the comptroller is hereby
     2  authorized and directed to deposit amounts collected in  excess  of  ten
     3  thousand dollars but less than fifteen thousand dollars per violation to
     4  the patient safety center account to be used for purposes of the patient
     5  safety  center  created  by  title  two of article twenty-nine-D of this
     6  chapter. Effective on and after April first,  two  thousand  twenty-one,
     7  amounts collected for violations of article twenty-eight, thirty-six, or
     8  forty  of this chapter equal to or in excess of fifteen thousand dollars
     9  per violation may be used by the commissioner pursuant to paragraph  (e)
    10  of subdivision one of section twelve of this chapter.
    11    §  5.  Paragraph  (c)  of  subdivision  4 of section 206 of the public
    12  health law, as amended by chapter 602 of the laws of 2007, is amended to
    13  read as follows:
    14    (c) assess any penalty prescribed for a violation of or a  failure  to
    15  comply  with  any  term  or  provision  of this chapter or of any lawful
    16  notice, order or regulation pursuant thereto, not exceeding [two]  twen-
    17  ty-five  thousand  dollars  for  every  such violation or failure, which
    18  penalty may be assessed after a hearing or an opportunity to be heard;
    19    § 6. The opening paragraph of subdivision 11 of section 2801-a of  the
    20  public  health  law, as amended by section 57 of part A of chapter 58 of
    21  the laws of 2010, is amended and a new paragraph (e) is added to read as
    22  follows:
    23    Any person filing a proposed certificate of incorporation, articles of
    24  organization or an application for establishment of a residential health
    25  care facility for approval of the  public  health  and  health  planning
    26  council shall file with the commissioner such information [on the owner-
    27  ship  of  the  property  interests  in such facility as shall] as may be
    28  prescribed by regulation, including, but not limited to, the following:
    29    (e) Information pertaining to staffing, the source  of  staffing,  and
    30  staff skill mix.
    31    §  7. Section 2803-w of the public health law, as added by chapter 677
    32  of the laws of 2019, is amended to read as follows:
    33    § 2803-w. Independent quality monitors and quality improvement  organ-
    34  izations  for  residential health care facilities. 1. The department may
    35  require a residential health  care  facility  or  group  of  residential
    36  health  care  facilities to contract with an independent quality monitor
    37  selected, and on reasonable terms determined, by the department,  pursu-
    38  ant  to a selection process conducted notwithstanding [sections] section
    39  one hundred twelve or one hundred sixty-three of the state finance  law,
    40  for  purposes of monitoring the operator's compliance with a written and
    41  mandatory corrective plan and reporting to the department on the  imple-
    42  mentation  of such corrective action, when the department has determined
    43  in its discretion that operational deficiencies exist at  such  facility
    44  that show:
    45    [1.]  (a)  a  condition  or conditions in substantial violation of the
    46  standards for health, safety, or resident care  established  in  law  or
    47  regulation that constitute a danger to resident health or safety;
    48    [2.]  (b) a pattern or practice of habitual violation of the standards
    49  of health, safety, or resident care established in law or regulation; or
    50    [3.] (c) any other condition dangerous to resident  life,  health,  or
    51  safety.    Such written mandatory corrective plans shall include caps on
    52  administrative and general costs that are unrelated to providing  direct
    53  care (including providing at least minimum staffing levels as determined
    54  by the department) or care coordination.
    55    2.  Where, in two consecutive inspections, regardless of the timeframe
    56  between such inspections, a residential health care  facility  has  been

        S. 2507--A                         103                        A. 3007--A
 
     1  issued  more than one statement of deficiencies citing violations of the
     2  department's regulations concerning infection control, such  residential
     3  health  care facility shall, at its own expense, contract with a quality
     4  improvement  organization,  or  such  other  independent quality monitor
     5  selected by the  department,  to  assess  and  resolve  such  facility's
     6  infection  control  deficiencies,  including  establishing new infection
     7  control policies and procedures in consultation with such  organization.
     8  The  administrator,  director  of  nursing, and medical director of such
     9  residential health care facility shall work with and  provide  necessary
    10  support, facility access, and information to such organization to effec-
    11  tuate resolution of infection control deficiencies.
    12    3. For the purposes of this section:
    13    (a)  "Quality  improvement  organization"  shall  mean an organization
    14  operating with the purpose of improving healthcare quality for  Medicare
    15  beneficiaries, which has been designated by the United States Department
    16  of  Health and Human Services, Centers of Medicare and Medicaid Services
    17  through the Quality Improvement Organization Program; and
    18    (b) "Independent quality monitor" shall mean  an  organization,  other
    19  than  a quality improvement organization, which has been selected by the
    20  department pursuant to subdivision one or two of this section.
    21    § 8. The public health law is amended by adding a new section 2828  to
    22  read as follows:
    23    §  2828.  Residential  health  care  facilities;  excess  revenue.  1.
    24  Notwithstanding any law to the contrary, the department shall promulgate
    25  regulations governing the disposition of revenue in excess  of  expenses
    26  for  residential  health care facilities. Such regulations shall require
    27  that a minimum of seventy percent of revenue be spent on direct resident
    28  care, and that forty percent of revenue shall be spent on  resident-fac-
    29  ing  staffing,  provided  that amounts spent on resident-facing staffing
    30  shall be included as a part of amounts spent on  direct  resident  care.
    31  Beginning  on  and after January first, two thousand twenty-two, fifteen
    32  percent of  costs  associated  with  resident-facing  staffing  that  is
    33  contracted  out  by a facility shall be deducted from the calculation of
    34  the amount spent on resident-facing staffing and direct  resident  care.
    35  Such regulations shall further include at a minimum that any residential
    36  health  care  facility  for  which total operating revenue exceeds total
    37  operating and non-operating expenses by more than five percent of  total
    38  operating and non-operating expenses, or that fails to spend the minimum
    39  amount necessary to comply with the minimum spending standards for resi-
    40  dent-facing  staffing  or  direct resident care, calculated on an annual
    41  basis, shall expend such excess revenue, or the difference  between  the
    42  minimum  spending requirement and the actual amount of spending on resi-
    43  dent-facing staffing or direct care staffing, as the case may be,  in  a
    44  manner  to  be  determined  by such regulations, by October first of the
    45  following year. In the event any residential health care facility  fails
    46  to  spend  any excess revenue in the manner directed by such regulations
    47  by October first of the following year, such  excess  revenue  shall  be
    48  payable  to  the  state  by  November first of such year. The department
    49  shall collect such payments by methods including, but  not  limited  to,
    50  deductions  or  offsets  from  payments  made  pursuant  to the Medicaid
    51  program.
    52    2. For the purposes of this section and section  twenty-eight  hundred
    53  twenty-eight-a  of  this  article,  the  following  terms shall have the
    54  following meanings:

        S. 2507--A                         104                        A. 3007--A
 
     1    (a) "Revenue" shall mean the total operating revenue  from  all  payer
     2  sources as reported in the residential health care facility cost reports
     3  submitted to the department.
     4    (b) "Expenses" shall include all operating and non-operating expenses,
     5  before  extraordinary gains, reported in cost reports submitted pursuant
     6  to this section, except as expressly excluded by regulations and/or this
     7  section. Such exclusions shall include,  but  not  be  limited  to,  any
     8  related  party  transaction  to the extent that the value of such trans-
     9  action is greater than fair market value, and  the  payment  of  compen-
    10  sation  for  employees  who  are  not  actively  engaged in or providing
    11  services at the facility.
    12    (c) "Direct resident care" shall exclude, at  a  minimum  and  without
    13  limitation,  capital depreciation, rent and leases, fiscal services, and
    14  administrative services.
    15    (d) "Resident-facing staffing" shall include all staffing expenses  in
    16  the  ancillary and program services categories on exhibit h of the resi-
    17  dential health care reports as in  effect  on  February  fifteenth,  two
    18  thousand  twenty-one; provided that the department may by regulation, or
    19  by emergency regulation, adjust such staffing expenses to align with any
    20  change to the residential health care reports.
    21    § 8-a. The public health law is amended by adding a new section 2828-a
    22  to read as follows:
    23    § 2828-a. Excess revenues for management salaries. Within the  amounts
    24  prescribed by section twenty-eight hundred twenty-eight of this article,
    25  a salary for any executive or managerial position which does not involve
    26  direct  resident  care  shall be limited by regulation by the department
    27  based upon the number of beds for resident care at such facility. In any
    28  event such salary shall not exceed two hundred  fifty  thousand  dollars
    29  annually. Provided further, notwithstanding any other law to the contra-
    30  ry,  a  residential  care  facility  shall  not expend more than fifteen
    31  percent of expenses on executive or managerial salaries, and the depart-
    32  ment shall be authorized to promulgate regulations  to  effectuate  this
    33  section.
    34    §  9. Section 2860 of the public health law is amended by adding three
    35  new subdivisions 3, 4 and 5 to read as follows:
    36    3. A company shall post maximum rates to be charged for facilities and
    37  services, fixed pursuant to  subdivision  one  of  this  section,  on  a
    38  publicly  accessible website. Such posting shall be updated on an annual
    39  basis no later than April first of each year. Such posting shall  detail
    40  rates for each non-governmental payer source.
    41    4.  A  company  shall: (a) publicly list all owners on a website main-
    42  tained by the facility and shall submit such list to the department  for
    43  posting on its website and update such information within thirty days of
    44  any  change or transaction affecting ownership; (b) publicly disclose on
    45  such facility's website and  regularly  update  the  name  and  business
    46  address  of  any  landlord of such facility's premises; and (c) publicly
    47  provide a summary of all contracts for provision of  goods  or  services
    48  for  which  such  facility pays with any portion of Medicaid or Medicare
    49  funds or other agreements entered into by the company on such facility's
    50  website within thirty days of execution of such agreement or contract.
    51    5. The commissioner may promulgate such regulations as may  be  deemed
    52  necessary  or  appropriate  to  implement subdivisions three and four of
    53  this section.
    54    § 10. Subdivision 7 of section 460-d of the social  services  law,  as
    55  added  by  chapter  669 of the laws of 1977, paragraph (a) as amended by
    56  chapter 719 of the laws of 1989, paragraph (b) as amended by chapter 524

        S. 2507--A                         105                        A. 3007--A

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

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

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     1  ment not less than five days prior to the date of the hearing.    Demon-
     2  stration  by  the  facility  that  it possessed an operating certificate
     3  issued pursuant to this article,  article  twenty-eight  of  the  public
     4  health law or article sixteen, twenty-three, thirty-one or thirty-two of
     5  the  mental  hygiene  law  at  the  time the hearing was commenced shall
     6  constitute a complete defense to  any  charges  made  pursuant  to  this
     7  subdivision.
     8    §  12.  Subdivision  (c) of section 122 of part E of chapter 56 of the
     9  laws of 2013 amending the public health  law  relating  to  the  general
    10  public health work program, as amended by section 7 of part E of chapter
    11  57 of the laws of 2019, is amended to read as follows:
    12    (c) section fifty of this act shall take effect immediately [and shall
    13  expire nine years after it becomes law];
    14    §  13.  Subdivisions  2,  3,  5  and 6 of section 2806-a of the public
    15  health law, as added by section 50 of part E of chapter 56 of  the  laws
    16  of  2013, and paragraph (a) of subdivision 2 as amended by section 8 and
    17  subparagraph (iii) of paragraph (c)  of  subdivision  5  as  amended  by
    18  section  9  of  part K of chapter 57 of the laws of 2015, are amended to
    19  read as follows:
    20    2. (a) In the event that: (i) a facility seeks extraordinary financial
    21  assistance and the commissioner finds that the facility is  experiencing
    22  serious financial instability that is jeopardizing existing or continued
    23  access  to  essential services within the community, or (ii) the commis-
    24  sioner finds that there are conditions within the facility  that  [seri-
    25  ously] endanger the life, health or safety of residents or patients, the
    26  commissioner may appoint a temporary operator to assume sole control and
    27  sole  responsibility  for  the operations of that facility, or (iii) the
    28  commissioner finds that there has been an improper delegation of manage-
    29  ment authority by the governing  authority  or  operator  of  a  general
    30  hospital,  the commissioner shall appoint a temporary operator to assume
    31  sole control and sole responsibility for the operations of that  facili-
    32  ty.  The  appointment  of  the  temporary  operator shall be effectuated
    33  pursuant to this section and shall be in addition to any other  remedies
    34  provided by law.
    35    (b) The established operator of a facility may at any time request the
    36  commissioner  to  appoint  a  temporary  operator. Upon receiving such a
    37  request, the commissioner may, if he or  she  determines  that  such  an
    38  action is necessary to restore or maintain the provision of quality care
    39  to  the  residents  or  patients  or  alleviate the facility's financial
    40  instability, enter into an agreement with the established  operator  for
    41  the  appointment of a temporary operator to assume sole control and sole
    42  responsibility for the operations of that facility.
    43    3. (a) A temporary operator appointed pursuant to this section  shall,
    44  prior  to  his  or  her  appointment  as temporary operator, provide the
    45  commissioner with a  work  plan  satisfactory  to  the  commissioner  to
    46  address  the  facility's  deficiencies and serious financial instability
    47  and a schedule for implementation of such plan. A work plan shall not be
    48  required prior to the appointment of the temporary operator [pursuant to
    49  clause (ii) of paragraph (a) of subdivision two of this section] if  the
    50  commissioner  has  determined that the immediate appointment of a tempo-
    51  rary operator is necessary because public health or safety is  in  immi-
    52  nent  danger  or  there exists any condition or practice or a continuing
    53  pattern of conditions or practices which poses imminent  danger  to  the
    54  health  or safety of any patient or resident of the facility. Where such
    55  immediate appointment has been found  to  be  necessary,  the  temporary

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

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

        S. 2507--A                         110                        A. 3007--A
 
     1  the  appointment  of  the temporary operator [pursuant to clause (ii) of
     2  paragraph (a) of subdivision two of this section]  if  the  commissioner
     3  has determined that the immediate appointment of a temporary operator is
     4  necessary because public health or safety is in imminent danger or there
     5  exists  any  condition or practice or a continuing pattern of conditions
     6  or practices which poses imminent danger to the health or safety of  any
     7  patient  or  resident  of  the  facility.  An  administrative hearing as
     8  provided for under this paragraph shall begin no later than  sixty  days
     9  from the date of the notice to the established operator and shall not be
    10  extended  without the consent of both parties. Any such hearing shall be
    11  strictly limited to the  issue  of  whether  the  determination  of  the
    12  commissioner to appoint a temporary operator is supported by substantial
    13  evidence. A copy of the decision shall be sent to the established opera-
    14  tor.
    15    (d) The commissioner shall, upon making a determination to reappoint a
    16  temporary operator for the first of an additional ninety-day term pursu-
    17  ant  to  paragraph  (a)  of  subdivision five of this section, cause the
    18  established operator of the facility to be notified of the determination
    19  by registered or certified mail addressed to the principal office of the
    20  established operator. If the  commissioner  determines  that  additional
    21  reappointments pursuant to subparagraph (i) of paragraph (b) of subdivi-
    22  sion  five  of  this  section are required, the commissioner shall again
    23  cause the established operator of the facility to be  notified  of  such
    24  determination by registered or certified mail addressed to the principal
    25  office  of  the established operator at the commencement of the first of
    26  every two additional terms. Upon receipt of  such  notification  at  the
    27  principal  office  of the established operator and before the expiration
    28  of ten days thereafter, the established operator may request an adminis-
    29  trative hearing on the determination to begin no later than  sixty  days
    30  from  the date of the reappointment of the temporary operator.  Any such
    31  hearing shall be strictly limited to the issue of whether  the  determi-
    32  nation  of  the  commissioner  to  reappoint  the  temporary operator is
    33  supported by substantial evidence.
    34    § 14. Section 2810 of the public health law is amended by adding a new
    35  subdivision 2-a to read as follows:
    36    2-a. Notwithstanding any other law to the contrary,  the  commissioner
    37  may  appoint an emergency receiver, upon no less than twenty-four hours'
    38  notice to the operator of a facility, upon a determination  that  public
    39  health  or  safety is in imminent danger or that there exists any condi-
    40  tion or practice or a continuing pattern of conditions or practices that
    41  poses imminent danger to the health or safety of any patient or resident
    42  of such facility. Such an emergency receiver shall serve until  a  final
    43  determination has been made upon an order to show cause filed in accord-
    44  ance  with  subdivision  two of this section; provided, however, that an
    45  application for such an order shall be made to the supreme court  within
    46  thirty days of the appointment of such emergency receiver.
    47    §  15.  Severability. If any provision of this act, or any application
    48  of any provision of this act, is held to  be  invalid,  that  shall  not
    49  affect  the validity or effectiveness of any other provision of this act
    50  or any other application of any provision of this act.
    51    § 16. This act shall take effect on  the  one  hundred  eightieth  day
    52  after it shall have become a law; provided that the amendments to subdi-
    53  vision  1  of section 12 of the public health law made by section one of
    54  this act shall be subject to the expiration and reversion of such subdi-
    55  vision pursuant to section 32 of part A of chapter 58  of  the  laws  of
    56  2008,  as  amended, when upon such date the provisions of section two of

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     1  this act shall take effect; and provided further that the amendments  to
     2  subdivision  2  of section 12-b of the public health law made by section
     3  three of this act shall be subject to the expiration  and  reversion  of
     4  such  subdivision  pursuant to section 32 of part A of chapter 58 of the
     5  laws of 2008, as amended, when upon such date the provisions of  section
     6  four of this act shall take effect. Effective immediately, the addition,
     7  amendment and/or repeal of any rule, regulation, or emergency regulation
     8  necessary  for  the implementation of this act on its effective date are
     9  authorized to be made and completed on or before such effective date.
 
    10                                   PART HH
 
    11    Section 1. Subdivision 3 of section 450 of the executive law, as added
    12  by chapter 588 of the laws of 1981, is amended to read as follows:
    13    3. (a) The [membership  of  the  developmental  disabilities  planning
    14  council  shall  at  all  times  include representatives of the principal
    15  state agencies, higher education training facilities,] following  people
    16  shall serve as ex officio members of the council:
    17    (i) the head of any state agency that administers funds provided under
    18  federal  laws related to individuals with disabilities, or such person's
    19  designee;
    20    (ii) the head of any university center for excellence in developmental
    21  disabilities, or such person's designee; and
    22    (iii) the head of the state's protection and advocacy system, or  such
    23  person's designee.
    24    (b)  The membership of the developmental disabilities planning council
    25  shall also include local agencies,  and  non-governmental  agencies  and
    26  groups  concerned  with services to persons with developmental disabili-
    27  ties in New York state[;].
    28    [(b)] (c) At  least  [one-half]  sixty  percent  of  the  [membership]
    29  members appointed by the governor shall consist of[:
    30    (i)] developmentally disabled persons or their parents or guardians or
    31  of immediate relatives or guardians of persons with [mentally impairing]
    32  developmental disabilities[,].
    33    [(ii)  these] (i) These members may not be employees of a state agency
    34  receiving funds or providing services under  the  federal  developmental
    35  disabilities  assistance  act  or  have  a  managerial,  proprietary  or
    36  controlling interest in an  entity  which  receives  funds  or  provides
    37  services under such act,
    38    [(iii)  at] (ii) At least one-third of these members shall be develop-
    39  mentally disabled,
    40    [(iv) at] (iii) At least one-third of these members shall be immediate
    41  relatives or guardians of persons  with  [mentally  impairing]  develop-
    42  mental disabilities, and
    43    [(v)  at]  (iv)  At least one member shall be an immediate relative or
    44  guardian of an institutionalized developmentally disabled person[;
    45    (c) The membership may include some or all of the members of the advi-
    46  sory council on mental retardation and developmental disabilities].
    47    § 2. This act shall take effect immediately.
    48    § 2. Severability clause. If any clause, sentence, paragraph, subdivi-
    49  sion, section or part of this act shall be  adjudged  by  any  court  of
    50  competent  jurisdiction  to  be invalid, such judgment shall not affect,
    51  impair, or invalidate the remainder thereof, but shall  be  confined  in
    52  its  operation  to the clause, sentence, paragraph, subdivision, section
    53  or part thereof directly involved in the controversy in which such judg-
    54  ment shall have been rendered. It is hereby declared to be the intent of

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     1  the legislature that this act would  have  been  enacted  even  if  such
     2  invalid provisions had not been included herein.
     3    §  3.  This  act shall take effect immediately provided, however, that
     4  the applicable effective date of Parts A through HH of this act shall be
     5  as specifically set forth in the last section of such Parts.
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